Living & Laughing Beyond Breast Cancer | Renee’s Altru Moment

Altru Moments - Published on October 18, 2017

Renee Amundson has spent the last 15 years working tirelessly in Altru’s Environmental Services department, keeping hospital facilities spick and span for patients and staff.

In 2013, Renee noticed a suspicious lump in her breast. At 56 years old, she had never had a mammogram.

“I worried about it for a month before taking action,” admits Renee. “I didn’t tell anyone—not even my husband or daughter.”

After Renee mentioned it to her primary care provider, she quickly got in for her first and only mammogram.

At her follow-up appointment to discuss the results of her biopsy, Renee saw a small black bag with a pink ribbon. Her heart sank. “I knew it couldn’t be good.” Renee was diagnosed with stage two breast cancer on March 4.

Starting the Fight
Within a two-week timeframe, Renee found a general surgeon, an oncologist and a reconstructive surgeon.

“Things moved really fast,” she shares. “There were a lot of appointments.”

Renee’s general surgeon, Dr. Grieve, recommended a double mastectomy. Dr. Meland, a hometown friend of Renee’s originally from Northwood, North Dakota, explained reconstructive surgery.

Renee elected to go with both the double mastectomy and complete reconstruction. “Sometimes, you’ve just got to put on your big girl panties and face it,” she smiles.

Dr. Meland walked her through the process of how the implants expand over time. On Good Friday, March 29, Renee underwent her first surgery. After surgery, Renee saw Dr. Meland every two weeks to expand the implants via injection.

After three weeks of recovery, Renee had a port placed and started six months of chemotherapy at Altru Cancer Center with Dr. Kevin Panico and Amanda Dudgeon, NP, oncology.

“None of this was easy,” shares Renee. “I was just so tired of hurting all the time.”

Staying Positive
Despite the hard moments, Renee kept her bright smile and positive attitude.

Throughout her cancer journey, Renee’s husband, Keith, was her constant caretaker. When she was uncomfortable sleeping and had to sit up in a recliner, he slept in a recliner by her side. He kept the house running smoothly, did all the chores and prepared all the food. “He was such a good wife,” Renee smirks.

“I asked my oncologist when I would lose my hair, and he said on my second round of chemo. Sure enough, he was right. On my second round, I was brushing my hair and saw a lot of hair in my brush. I had a meltdown and called my husband at work. I asked him to shave the rest off when he came home that day.”

She continues, “My brothers and sisters-in-law, Laramie and Doni-Erin Olson and Rodney and Linda Olson, would come and visit me during my chemo treatments. They were there to help with anything. When my hair started to fall out, my brother Rodney and others shaved their heads. Also, some co-workers came by and sat with me. My adult children pitched in and took my youngest daughter prom dress shopping when I couldn’t. With all the visits and phone calls, I never went through this alone.”

Caring for the Providers
Even while she was the patient, Renee was giving back to others.

She knew Dr. Panico had a sweet tooth, and when she often saw him around 3 p.m. for appointments, she would thoughtfully bring homemade treats, such as chocolate bars or caramel popcorn, for him to enjoy with afternoon coffee. For Amanda, Renee would make her favorite—cream cheese pumpkin rolls—as well as a pink “Hope” wreath, which is still on display in Amanda’s office.

“Renee has been such a delight,” shares Amanda. “We enjoy seeing her smile and visiting with her. We also enjoy her beautiful crafts and yummy treats.”

Dr. Panico adds, “Renee had a positive attitude during and after treatment. She is always a pleasure to see in clinic!”

Renee finished her last round of treatment on August 20. By the second week of September, she was completely done with implant injections and had the port removed. Renee was cancer-free.

“All the nurses that cared for me are the best. A big thank you to everyone at Altru for all the awesome care and kindness.”

Today, Renee continues to have check-ups every six months, and she will switch to annual visits after five years, or August 2018.

Renee is back to enjoying all her favorite things. She continues to create a welcoming experience for patients, working full-time in Environmental Services at Altru Professional Center. She loves spending time with her kids and grandkids, escaping to Golden Lake with family in the summer, and cooking and baking delicious foods for loved ones whenever she can.

Numerous studies have shown that getting a mammogram and a breast exam reduces the risk of dying from breast cancer. Breast cancers found during a mammogram are more likely to be smaller and still confined to the breast. To learn more or schedule your mammogram, please visit

Take Action Against Breast Cancer With These 5 Tips

Enrich - Published on October 4, 2017

Are you seeing pink? It's a popular pick during the month of October, and for good reason: about one in eight U.S. women will develop breast cancer in her lifetime (American Cancer Society). Here are five tips for taking action against breast cancer, year-round.

1. Physical Activity. Staying active may help lower the risk of breast cancer. Regular exercise lowers estrogen levels, fights obesity, lowers insulin levels and boosts the immune system.

2. Healthy Nutrition. Maintaining a healthy diet can help lower the risk of breast and other types of cancer. Eat more whole grains and fewer sweets and high fat foods. (Try these tips for menu planning and prepping for less stress.)

3. Drink Less Alcohol. High levels of alcohol intake increase the risk of breast cancer.

4. Don't Smoke. Smoking is linked to higher risk of several types of cancer. It can also negatively affect healing during treatment of breast cancer. Need help quitting? Start here >>

5. Breast Care. The best protection is early detection! Despite the recent controversies over screening mammography, no one disputes the fact that annual mammograms starting at age 40 saves the most lives. Breast cancers found during a mammogram are more likely to be smaller and still confined to the breast. Finding breast cancer early can improve the chances that breast cancer can be treated successfully and with more treatment options, less extensive surgery, and ultimately, better treatment outcomes.

To schedule your mammogram, call 701.780.6157 or visit 

Lashonda Soma, MD, always knew she’d be in medicine. “As a child, I was happiest when I was caring for others. The choice (to be in medicine) was made for me,” she says. "I love my job. While it can be emotionally taxing at times, I wouldn't trade it for the world."

Why Colonoscopy Matters | Vaughn’s Altru Moment

Altru Moments - Published on September 25, 2017

Years ago, Vaughn Jevning of Crookston, Minnesota, enjoyed many hunting and fishing adventures. Yet, hunting for polyps was never on the agenda.

“You should get a colonoscopy,” recommended Kamrin Macki, gastroenterology nurse practitioner, during a routine liver check-up in October of 2016.

At 65 years young, Vaughn took Kamrin’s advice and was in for his first-ever colonoscopy with Dr. Bradley Belluk the following month. 

No History, No Symptoms… Cancer?
While Vaughn wasn’t excited, he wasn’t too nervous.

“I had no family history, no symptoms,” he explains. “It was just a matter of getting in the door and getting it done.”

However, Dr. Belluk found something.

“It was a polyp, and it was cancer,” shares Vaughn.

Dr. Belluk referred Vaughn to the Virginia Piper Cancer Institute® in Minneapolis for surgery to remove the cancer. Surgery was successful, and Vaughn is back in Grand Forks cancer-free. He continues follow-up care every several months, and will for the next few years.

Vaughn quickly informed his siblings of his cancer. All were checked, and one brother also found colon cancer and underwent surgery to remove it—all thanks to Kamrin’s recommendation to Vaughn.

“My sisters had no problem,” shares Vaughn. “I think women are more used to going to the doctor. Before Kamrin mentioned it, no one had ever told me to get a colonoscopy. I’m so thankful she did.”

Vaughn continues, “Don’t be fearful. Don’t be embarrassed. Just get in the door, and they’ll take care of you. If you don’t find anything, it’s no big deal. Cancer is much scarier than a simple colonoscopy.” 

Why Screen?
Kamrin Macki encourages all of her patients at age 50 (or sooner, with family history or other factors), to get a screening colonoscopy.

“Most colon cancers are preventable,” she shares. “If a colon cancer is detected on colonoscopy, if we catch it in the early stages before it spreads, then it can be surgically resected.”

Roughly, one in 20 adults has colon cancer. It is the third-leading cause of death in women and the second-leading cause of death in men. 

Encouraging Others
Perhaps you have a family member or friend in need of getting a colonoscopy? Kamrin shares this advice: “Knowledge is essential. When people are well-informed of the risk of colon cancer and what can be done to prevent it, they usually will pursue screening.”

Vaughn is glad Kamrin educated him. “I’m just happy to be alive to tell others.”

To learn more about colonoscopy, visit 

If the cost of a colonoscopy is standing in your way, Altru Health System may have funding available through its No-Cost Colonoscopy program.

Enjoying Life as an Active Mom and Wife | Yvonne’s Altru Advanced Orthopedics Story

Altru Moments - Published on September 25, 2017

Thirty-one-year-old Yvonne Fossen of Maddock, North Dakota, spent the summer of 2017 playing with her two kids for the first time in four years. In the past, she couldn’t possibly get down on her hands and knees to play. That was until she met Dr. Darin Leetun of Altru Advanced Orthopedics.

Four years ago, Yvonne had torn her ACL and meniscus and had them repaired at another healthcare facility. “I was 27 years old at the time and had never been hard on my knees,” explains Yvonne. “I had two small children at home, and the pain after surgery just never seemed to go away.”

“The last straw was when I could no longer take a short walk without it throbbing,” she explains. “That’s no way to live at 31 years old!”

She saw her primary care provider, Dr. Heidi Bittner, who recommended Dr. Leetun.

Yvonne recalls, “The first time I met him, I knew he was going to make my knee better… and my life.”

Just Phenomenal
Yvonne not only appreciated Dr. Leetun, but also the care environment and other staff members she encountered. She shares, “The technology installed in Altru Professional Center is just phenomenal. I couldn’t get over how awesome it was, and how caring everyone was. They genuinely wanted to make my life better. The initial nurse was amazing at informing me of the process, and Dr. Leetun re-explained everything in an easy-to-understand way. He let me know that I had options, and we were going to fix my knee.”

Dr. Leetun scheduled Yvonne for x-rays and an MRI that day. After reviewing the results, he explained she would need a minimum of two procedures to improve her knee pain. “We scheduled an arthroscopy and cleaned up the cartilage,” she explains, “and he repaired another tear in the meniscus.”

Yvonne was on crutches for two weeks, followed by physical therapy for six weeks. At her eight-week check-up, she was still experiencing some pain and stiffness, so Dr. Leetun gave her a shot of cortisone to make her more comfortable.

Living Pain-Free
“It feels better now than it has in four years!” exclaims Yvonne. “We will schedule the next procedure for the winter. Dr. Leetun really listened to my concerns and understand that I am way too young to not be able to get down and play with my daughters and dogs.”

Yvonne, along with her husband and two girls, enjoys being outside and biking, skiing, walking, swimming and hunting. Now that Yvonne is living pain-free again, the Fossens are back to sharing their favorite activities—together.

Knee pain can affect people of all ages, often resulting in discomfort, aching and soreness. Altru Advanced Orthopedics' providers offer a wide range of personalized treatment options for knee pain and injury. Learn more >>

Prostate Cancer: Do You Know Your Risk?

Enrich - Published on September 11, 2017

Prostate cancer is the second leading cause of cancer death in men and second most commonly diagnosed cancer in American men. Prostate cancer screening with a risk assessment, prostate specific antigen (PSA) blood test, and a digital rectal exam (DRE) detects cancer at an earlier stage than in men who have no screening. A positive screening does not mean that you have prostate cancer; a biopsy is required to determine if cancer is present.

There are certain risk factors associated with the development of prostate cancer, including:

  • Age: Risk increases with age.

  • Race: African American men are more than twice as likely to be diagnosed with and to die from prostate cancer.

  • Family History: Men with a close relative who has prostate cancer are at an increased risk.

  • Diet: Studies show there may be a link between a diet higher in fat and prostate cancer.

  • Chemical Exposure: Men with a history of exposure to certain chemicals, such as pesticides and herbicides, and veterans who were exposed to Agent Orange are at a higher risk. Also, newer studies show that firefighters are at an increased risk.

The American Urological Association recommends screening at the following ages:

  • Average risk men benefit the most between the ages of 55 and 69.

  • High risk men between the ages of 40 and 54 should discuss screening with their healthcare provider.

  • Men age 70 and older should only be screened if in excellent health.

This annual screening takes into account a health history that assesses for risk, the PSA trend and the DRE to assess for the need for follow up.

Altru Health System will be offering a Free Prostate Cancer Screening on Wednesday, September 13. To register, please call 701.780.5396. 

LeAnneLeAnne Kilzer is the oncology resource nurse with Altru Cancer Center. In her role she coordinates screening and awareness events in the community, manages patient educational materials, educates staff on new chemotherapies and follows up with screenings. During her free time, LeAnne enjoys crafting and spending time with her two daughters.

Pre-race Tips From Performance Experts You’ll Want to Follow

Enrich - Published on September 8, 2017

Whether you are running your first 5k or you are an avid marathoner, it’s important to prepare properly before a race. Here are five tips you should be sure to check off of your list the day before and day-of a race.

1. Hydrate
Stay hydrated throughout the day of the race, and the day before the race to optimize concentration and reduce the risk of injury during performance. Water helps cushion joints and muscles, flush out toxins, deliver nutrients, regulate core temperature and improve brain activity. Try for 5-12 ounces of water every 15-20 minutes during the race, and 16 ounces before the race.

2Sleep Well
Sleep better, perform better. Adjust your sleeping environment to what personally fits your needs. For example, turn off your phone or the television if they tend to distract you during or before sleep. Adjust your bedroom temperature to what makes you the most comfortable (ignore the heating/cooling bill the week before a race – good sleep is worth it!). Also try a hot bath or shower before you go to bed along with relaxation breathing techniques to slow down your sympathetic nervous system, preparing you for an optimal sleep.

3. Foam Roll
Before a race, use a foam roller prior to an active warm-up. Foam rollers work on your soft tissue which enhances circulation of blood flow through your muscles, increases joint range of motion, removes metabolic waste products (tightness), and assists in fixing muscle imbalances allowing for proper movement patterns. A foam roller can be used on most areas of the body; focus on legs and back before running.

Watch Paul Ewbank, performance manager with Altru's Sports Advantage, demonstrate foam rolling:

4Have a Nutrition Plan
It’s important to think about your nutrition before a race to ensure that you are fueling your body properly. Planning out meals for the night before and day-of a race can help your body perform its best.

The night before the race:
Eat similar to what you have been eating during training. This is not the time to incorporate new foods into your fueling plan. Nutrition rules to follow during training include:

  • Fuel with carbohydrates (about 300 grams of carbs at meals and as snacks). Carbohydrate sources might include: rice, potatoes, corn, squash, fruits and vegetables.

  • Moderate fiber intake.

  • Go easy on fats.

  • Don’t forget to hydrate.

The day of the race:
Eat familiar and easy-to-digest foods. Follow this nutrition timeline to keep yourself fueled:

  • 3-4 hours prior to the race:

    • Fuel with carbohydrates.

    • Incorporate low-fat protein options.

    • Go easy on fat and fiber.

    • Drink plenty of Fluids.

  • 1 hour prior to the race:

    • Emphasize liquids and easy-to-digest carbs.

    • Avoid protein, fat and fiber.

5Include an Active, Dynamic Warm-up
An active or dynamic warm-up coordinates all of your moving parts (muscles, ligaments and tendons). An active warm-up ensures immediate range of motion improvement through your joints by actively stretching your muscles, increasing your heart rate, reinforcing great posture and leaving you ready to hit the ground running. Try these five moves to refresh your warm up.

Most of all, try not to stress out about your PR, performance or other race anxieties. Stay calm and excited about what you are about to accomplish. Have a great run.

Katelyn Klapprodt is a performance specialist with Altru's Sports Advantage powered by EXOS. She is also a member/ professional intern for the University of North Dakota Strength and Conditioning team for Women’s Basketball and Men’s Football programs. If she is not studying, working, or lifting, Katelyn enjoys spending time outside enjoying activities that promote a healthy lifestyle and spending time with her friends and family.

Healthy Heart & Sweet Tooth: Can They Be Friends?

Enrich - Published on September 6, 2017

Most humans are born with a natural sweet tooth, craving sugar at the most unusual times. It usually occurs when you are done eating a nutritious meal that was full of fruits, vegetables and proteins. Your body starts to crave sugar, and you just can’t help yourself. Sugar is a carbohydrate that is made from the separation of the sugar itself from a sugar beet or cane, which results in 99.95 percent pure sucrose, or sugar.

Sugar’s Effect on Cardiovascular Disease Development
Many people tend to overlook sugar as a detriment to cardiovascular health, although it is a very important contributor. Sugar causes an inflammatory response, which in turn damages the lining of your arteries. Low-density lipoprotein builds up within the damaged lining and causes Atherosclerosis, which is the leading cause of heart disease and stroke, and most likely will lead to a heart attack.

In a recent study published in JAMA Internal Medicine, researchers found that participants who consumed greater than or equal to 10 percent but less than 25 percent of calories from added sugar had a 30 percent higher risk of cardiovascular disease mortality. Further, those who consumed more the 25 percent of calories from added sugar had a tripled risk of cardiovascular disease mortality.

Recommended Sugar Intake
Without knowing, you are more than likely consuming more sugar than recommended. The American Heart Association recommends that women consume no more than six teaspoons, or 100 calories, a day of sugar and that men consume no more than nine teaspoons, or 150 calories, a day of sugar.

In comparison, a can of Pepsi, which is 12 fluid ounces, contains 150 total calories and 41 grams from sugar alone. Cutting out such beverages would decrease your sugar intake immensely, and allow for your sugar intake to come from natural sources, such as fruits and vegetables. A heart-healthy diet would include limiting sodium, saturated and trans fats, added sugars and alcohol.

What Foods Do Sugars Come From?
Some of the most popular foods and beverages that added sugars come from include:

  • Soda, sports & energy drinks

  • Candy bars

  • Desserts, such as cake, cookies and ice cream

  • Sweetened yogurt

Some foods that have naturally occurring sugars. Examples include:

  • Citrus fruits like grapefruits, oranges and limes

  • Blueberries and blackberries

  • Tomatoes and avocados

  • Celery and cucumber

  • Squash and carrots

  • Bell peppers and onions

  • Asparagus and broccoli 

Recommendations to Reduce Sugar
Some ways to reduce added sugars from your diet include:

  • Reduce the amount of sugary drinks; replace them with low-calorie or sugar-free options.

  • Have fruit for dessert instead of a piece of cake or cookie.

  • Read food labels and pay attention to the amount of sugar in the items you are purchasing.

  • Before going to a restaurant, look up their menu online and see if the nutrition facts are available.

  • Be aware of the amount of condiments and sauces you are using, which can typically be high in sugar. 

In order to avoid serious health complications, especially cardiovascular disease, reducing sugar is the way to go. To learn more about heart healthy habits, visit

Allie Harvey is a senior attending the University of North Dakota. Her major is Community Nutrition, and she is spending her semester working with Jennifer Haugen, a dietitian at Altru. Allie is from Lakeville, Minnesota, and is one of four children. In her spare time, Allie loves to play sports such as hockey and soccer, listen to music, and hang out with her sorority sisters. Allie has always had a passion for nutrition and is growing more and more each day through her work with Jennifer.

Learn to Meal Plan + Prep for Less Stress

Enrich - Published on September 6, 2017

Fall is fast approaching, a time filled with school activities, sporting events and a kickoff to the holiday season. Just as it’s time to put away the shorts and bring out the sweatshirts, it’s time to put away the grill and bring out the slow cookers.

A few simple meal planning steps can help you save time, money and stress while feeding yourself and your family nutritious, well-balanced meals. Give these practical tips a whirl as you rush off to football games and pumpkin patches.

  • With the input of your family create a list of favorite meals and post it in the cupboard. As you try new recipes that most everyone likes, add them to the list.

  • Look at your family’s schedule for the week to see which meals will be prepared at home. Do you need a crockpot meal, or something quick and easy coupled with a fruit and vegetable? Post the meal plan along with your family’s schedule that may interfere with meal prep on the refrigerator.

  • Keep a grocery list in the kitchen where everyone can see it. As you run out of staple foods, add them to the list and instruct your family members to do the same. 

  • Create a weekly meal plan. Keep it simple and start with your family’s main meal. Use themes to help you with ideas such as: Pizza Party Sunday, Meatless Monday, Crock Pot Tuesday, Soup and Sandwich Wednesday, Pasta Thursday, From the Freezer Friday, and leftovers on Saturday. Involve your family as much as possible in the planning process. 

  • Include at least three to four food groups in your meals. Keep in mind that half of the plate should be fruits and vegetables, one fourth protein, one fourth grains and a serving of dairy or dairy substitute on the side. For dessert, consider baking apples with cinnamon in the slow cooker; add cool vanilla Greek yogurt for a sweet treat. 

  • Eat seasonally. Fall is a great time for several flavor-packed, versatile fruits and vegetables. Roast a butternut squash with herbs, garlic and olive oil until golden brown. For a simple side dish, toss fresh cauliflower florets with a few tablespoons of olive oil, pepper and chopped garlic. Roast in oven at 425 degrees until caramelized and crispy. Sprinkle with Parmesan cheese if desired.

  • Don’t forgot to plan your breakfasts, even in the middle of a hectic schedule. Try oatmeal with a dab of pumpkin puree, all-spice and cinnamon to fit the season and give you a change of pace. Or, try a creamy fall smoothie such as:

    • Apple Crisp Smoothie: apples, yogurt, oats and cinnamon

    • Fall Green Smoothie: almond milk, kale, pear, green grapes and ½ banana 

Other meal planning ideas include:

  • Plan a meal swap with your friends. Each take a night of the week to prepare a meal for everyone’s family. You may have to cook four of the same meals on one night but the other nights, one of your friends will be delivering a meal to you!

  • Batch cooking either with a group of friends or by yourself. You can prepare meals, freeze and take out as needed. If you’re cooking ground beef, cook several pounds at once and re-freeze in one-pound packages. Or cook up several pounds of chicken in the crock pot, shred, repackage and use in hot dish, salads, tacos and soups. (Try this Spicy Taco Soup.)

  • Use “planned-overs.” Leftover chicken can be shredded and used for chicken salad, chicken tacos or BBQ chicken sandwiches. Cook a double batch of spaghetti sauce and use it to make a lasagna or freeze to use later.

Think of it this way: Time spent creating a meal plan takes about the same time as driving to a fast food restaurant. Instead of one meal, you will have a week’s worth of healthy meals to feed you and your family. Fuel up on the right stuff, and focus on what matters most: making wonderful memories together this fall.

For more healthy recipes approved by Altru’s dietitians, visit

See also: A Dietitian's Tips for Long-Lasting Fullness

Becky WesterengWestereng, Becky 4C is a registered dietitian at Altru Health System. She is a diabetes educator and certified in sports nutrition. Becky is especially interested in helping people improve their eating and exercise habits by encouraging small steps and a positive attitude. She enjoys spending time with her husband and watching her three children perform music and play sports, while finding time to stay active herself.

Living With Heart Disease? Know What Medicine is Safe to Take

Enrich - Published on September 5, 2017

For someone recently diagnosed with a heart disease, it might be difficult to know what is safe and what is not. Balancing exercise with healthy eating can be overwhelming, but there’s also another issue that can cause stress and confusion. That issue is how to know which medications you can or can’t take with a congestive heart failure diagnosis.

It is important to remember if you have any questions, concerns or doubts to contact your primary care provider or cardiologist before taking any medication.

What to Avoid
One rule to remember if you’ve been diagnosed with heart failure is to never take medicines that speed up your heart rate, increase your blood pressure or contain sodium, unless you have been instructed to specifically by your provider.

For over the counter medications, here are some to avoid:

  • Over the counter medication with sodium, such as antacids or laxatives.

  • Over the counter medication that contain pseudoephedrine or phenylephrine, such as Sudafed, Contrex, Nyquil.

  • Protein shakes or supplements containing ephedrine, such as ma huang or Herbalife.

  • Over the counter medication or herbs containing oxymetazoline, which includes nasal sprays like Afrin and Dristan.

  • Nonsteroidal Anti-inflammatory Drugs (NSAIDs), such as ibuprofen (Advil, Motrin) and Naproxen (Aleve).

Make sure you read the label of the OTC medication to ensure none of these medications are not in it.

Proceed with Caution (& Provider Direction)
When being prescribed any of these medications, make sure you discuss the benefits and side effects with your primary care provider or cardiologist first:

  • Calcium channel blockers: Commonly prescribed for many different heart related-diseases, these interrupt the movement of calcium to the heart which relaxes blood vessels and increases blood and oxygen supply to the heart, reducing the heart’s workload.

  • Antiarrhythmic medications: Known to treat abnormal heart rhythms, there can be some side effects, so if you’re on these medications make sure to discuss with your cardiologist.

  • Many pain relievers are safe, but may contain a combination including NSAIDs, so consult with your provider when prescribed.

  • There are some over the counter medications, such as cold remedy medications, antacids or laxatives that are safe, consult your pharmacist before purchasing.

The fact that some medications can cause problems for people with heart failure might seem overwhelming, but there are some that are typically safe to take. It’s important to work with your specialist and your pharmacist to make sure you understand what’s right for you and that your dosage is accurate and easy to follow.

Options to Consider
Acetaminophen, like Tylenol, is a great pain reliever and fever reducer that is safe to take with heart failure, unless otherwise directed by your provider.

Since this can be a lot to take in, here are some ways that you can help ensure you are staying safe with medication when living with heart failure:

  • Be sure that you keep up with your routine care and provider visits. Staying in touch with your doctor or physician team on the medications you take and how they’re affecting you is paramount to your health and safety.

  • You’ll also want to setup a stringent routine for taking any prescribed medications. Set alarms on your phone, or use a medication container so you can sort out medications and avoid mistakes.

  • Ask your spouse or a loved one to keep you in check so you don’t forget to take something you’re supposed to.

  • Mark medications that aren’t safe for you to take, like Advil or Aleve, so you don’t take them by mistake. Other family members may continue to take these, but you’ll want to be sure you don’t.

If you have any questions or concerns about safely taking medication while living with heart failure, connect with your primary care provider or cardiologist. You can use MyHealth to send them messages and get quick answers to ease your mind.

Altru’s Heart & Vascular team is always here to help you keep your heart in check. To learn more about our team and services, visit

A graduate of the University of North Dakota with a bachelor’s of science in nursing and master’s of science in the family nurse practitioner program, Paula Ricke provides care in cardiology as part of Altru’s Heart and Vascular team. She has been with Altru for two years. Paula's primary focus is treating patients with congestive heart failure. In her free time, she enjoys golfing and watching football and hockey.  

5 Overrated Foods that Get More Credit Than Deserved

Enrich - Published on August 4, 2017

With social media and food blogging being more prevalent than ever, many foods are becoming just as trendy as Taylor Swift! These superstars are deemed “superfoods” for a variety of reasons, perhaps due to their notable antioxidant content or perceived fat-burning abilities. The thing is, not all of these health claims are factual, evidence-based or made by experts.

I recently asked our athletes and clients at Sports Advantage to list foods they believe to be “overrated”. Overrated foods are those that get way more credit than they deserve; when it comes down to overall nutrition, they aren’t that “super” thus do not deserve celebrity status.

Five Overrated Foods

1. Cereal
Cold cereal is probably the easiest, most convenient breakfast option, making it a “good choice” for busy people. Unfortunately, it’s one of the least nutritious options, even if it “contains whole grains.” Did you know many breakfast cereals are higher in sugar than pastries, like cookies and cakes? Cereal is extremely processed, providing an inadequate amount of nutrients and little fiber to keep you full. Adding whole grains, artificial vitamins and minerals does NOT make cereal a healthy choice. Sugar is usually one of the first three ingredients listed, which causes a spike in blood sugar and insulin. This often results in craving another high carb/sugar meal or snack a few hours later. Here are more nutritious, balanced breakfast options that take five minutes or less to prepare and keep you full longer:

  • Whole wheat toast + natural peanut butter + banana

  • Whole wheat English muffin + eggs + avocado

  • Greek yogurt + berries + small handful of raw nuts

  • Quick oats + raisins + walnuts + cinnamon

  • Smoothie: plain Greek yogurt + fruit + spinach

  • Overnight oats; they’re ready when you wake up!

2. Salad
Salads are tricky, because they could be one of the best OR one of the worst items on a menu. For example, an apple pecan chicken salad may sound healthy, but it can have over 80g of fat and 1,300 calories! A garden salad should contain things that would come from a garden, like cucumbers, tomatoes and carrots, NOT croutons and cheese. If you’re trying to make the healthy choice by choosing a salad for your meal, make sure to read the ingredients and follow these guidelines:

  • Select darker greens when possible (spinach, kale, arugula or mixed greens)

  • Aim for three colors from fruits and/or veggies (greens, cucumber, tomato, carrot, strawberries, etc.)

  • Pick a lean protein (grilled chicken, salmon, beans, etc.); say no to “crispy” or breaded items

  • Top it off with a healthy fat; 2-3 tablespoons is an appropriate serving (avocado, seeds, raw nuts)

  • Look for red flags: croutons, tortilla chips, wontons, large amounts of cheese, candied nuts, dried fruit, multiple protein sources (chicken and hard-boiled eggs and bacon) and creamy dressings.

  • Easy on the dressing! Salad dressings alone often pack more fat and calories than the entire salad, so it can truly make or break the nutritional value of this meal. One serving of traditional ranch dressing is two tablespoons and about 150 calories. Most restaurants use four tablespoons, so you’re already at 300 calories... from just the dressing! 

Dressing do’s and don’ts:

  • Do order it on the side: you’ll likely get the same quantity, however you’re now in control of how much you use.

  • Do avoid creamy dressings: vinaigrettes are often the better choice such a balsamic or oil & vinegar. If creamy dressings are the only way you enjoy salad, look for Greek yogurt based dressings or consider making your own.

  • Don’t be fooled by fat-free dressings: though lower in calories, most fat-free products contain more added sugars than its regular counterpart.

  • Do use alternatives. Consider using salsa, guacamole, cottage cheese (as a protein and dressing) or hummus instead of traditional salad dressings.

Example 1: spinach + cucumber slices + red onion + strawberries + grilled chicken + pecans + balsamic vinaigrette

Example 2: mixed greens + cherry tomato + carrot + black beans + guacamole + salsa

3. Smoothies
Like salad, “smoothie” is one of those words that screams healthy. Once again, smoothies can be one of the best or worst options, depending on the contents. A healthy snack should typically be less than 250 calories; however, store-bought and even homemade smoothies might pack more than 800 calories! For many, that’s half a day’s caloric intake in just a few gulps. For people seeking to lose or maintain their weight, keep in mind that approximately 150-250 calories is an appropriate snack serving, while 400-500 calories is a meal. Here are some tips for making a healthy, balanced smoothie:

  • Pick your protein: plain Greek yogurt, protein powder, silken tofu, milk

  • Choose a liquid: water, dairy-free milk (almond, cashew, soy, etc.) or milk, if it’s not your protein source

  • Sweeten with fruit: fresh or frozen berries, banana, pineapple, mango, etc.

  • Sneak in a veggie: smoothies are a great way to get more veggies in, especially if you don’t like them (spinach, cucumber, kale, etc.)

  • Finish off with healthy fat: add a sprinkle (1-2 Tbsp) of seeds (flax, hemp, etc.) to add some omega 3’s and/or add some natural nut butter to turn a snack into a meal (almond butter, natural peanut butter, etc.)

Snack example (≤ 250kcal): ½ cup non-fat plain Greek yogurt + 1 cup water or unsweetened almond milk + 1 cup frozen berries + 1 cup raw spinach + 1 Tbsp flaxseed

Meal example (400-500kcal): 1 scoop protein powder + 1 cup almond milk + 1 frozen banana + 1 Tbsp flaxseed + 2 Tbsp natural peanut butter 

4. Nutrition/Granola Bars
Granola is another misleading term. Did you know that one cup of granola can pack up to 600 calories, with 250 calories coming from fat? Though extremely convenient, most store-bought nutrition/granola bars aren’t that much better. Sugar is often one of the first 3-5 ingredients, and many bars contain several unnecessary ingredients, some of which I cannot even pronounce. When it comes to granola bars, your best bet is to look for the following:

  • 10 ingredients or less, with sugar being one of the very last ingredients

  • Ingredients you can recognize and pronounce

  • 3g of fiber or more

  • Naturally sweetened with fruit (dates, apples, etc.)

  • Contains healthy fats (nuts and/or seeds)

Popular products that meet these guidelines include Larabars and RX Bars. Another easy, healthy snack option consists of pairing a serving of unsalted nuts (1 oz) with a fruit. For example, almonds and an apple. 

5. Sports Beverages
My favorite topic. Why? Because most people think sports beverages like Gatorade are healthy because a) athletes drink them all the time and b) famous (fit) athletes like Sydney Crosby promote it on TV. Sports beverages have a time and place; they have a purpose. Just because you’re an athlete or exercise daily, you shouldn’t be drinking them throughout the day, or at all. Sports beverages have two main components: sugar and electrolytes. One does not need sugar and electrolytes when at the movie theatre, the mall or even watching a sports game out in the heat. You might as well be drinking a soda (since they’re both extremely high in added sugar). The only time you might benefit from or need a sports beverage is:

  • When exercise is > 90 minutes

  • During high-intensity exercise

  • While exercising in humid environments

What do these situations have in common? Chances are, you are sweating. If you’re not in these situations, hydrate by drinking water. Aim for at least ½ your body weight in ounces per day. For example, someone that is 150 lbs should consume a minimum of 75 oz of pure water per day.

Dietitian Takeaway
A healthy diet is all about balance. This means you can still have your favorite breakfast cereal or smoothie, just have it less often and in appropriate amounts. For example, if you eat a bowl of cereal every single day, try having one bowl per week instead. If you’re a ranch dressing lover, order it on the side, look for a healthier brand (such as OPA by Litehouse) or try making it yourself. There are thousands of recipes available online to make healthier versions of popular meals, snacks and sweets so you can enjoy your favorite foods, and reap the nutrition benefits, too!

Danielle Rancourt700x700_Rancourt is a performance dietitian with Sports Advantage. She enjoys cooking, baking, working out and spending time outdoors to keep busy.

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