Serving People, Building Strength and Upgrading Lives | Anthony’s Secrets to Success

Enrich - Published on March 27, 2017

Anthony MorandoAnthony Morando is all about serving others and upgrading lives. In his role as manager of Altru’s Sports Advantage, Anthony continually inspires positive change and everyday strength for his clients and staff. Let’s take a behind-the-scenes look into Anthony Morando’s secrets to success.

Give us a run-down of a day in your life. What does your typical Tuesday look like?

  • 4:30-5 a.m. – Wake up, have my coffee and breakfast.

  • 6 a.m. – Train a group or kick off my day with a chapter out of a book.

  • 7-8 a.m. – Get my workout in. (My workouts Monday through Friday have to stay consistent because if I don’t get my physical fitness in, I don’t feel well. I don’t feel energized for the day.)

  • 8 a.m. – 5 or 6 p.m. – I’m either training a group, or fulfilling my role as the manager of Sports Advantage, and in addition to that I am constantly learning how to make our facility better. It’s always pretty busy.

  • Evening – Enjoy downtime at home with my wife, maybe watch a funny movie before bed.

  • 9:30-10 p.m. – Bedtime. Sleep is probably the most important part of my day. I boil some hot water with apple cider vinegar and a little bit of honey. It just kind of relaxes my stomach at the end of the day. I’ll go through a little bit of foam rolling before I go to bed to relax my muscles.

How do you spend your downtime?
I’m a big football fan. I played it in college; it’s my favorite sport in the whole wide world.

On weekends, I really, really try to get some time with my wife. We are two busy people. We try to do things together, whether going for a walk or getting away for the weekend. We value our downtime. We spend our week taking care of everybody else, as our goal is to upgrade lives. We also have to keep in mind that if we’re taking care of everyone else, we also have to take care of ourselves.

What do you keep in your car in case you have extra time?
I have two books: a Bible and a pocket book (about Kaizen). It’s a good reminder that you don’t have to go from 0 to 60. If you can live your life like that, you can see how you improve with little steps. I also have a bottle of water handy and an air freshener, because I don’t want it to stink.

What personal development goals are you working toward right now?
I am fortunate to have a great base of information and knowledge. My personal goals are always refining those patterns. What can I do better? How can I constantly improve within my craft? That is going to entail reading more, learning more, going to different seminars, etc. Just being a better person and learning new things.

Fill in the blank:
I’m going to (  worry  ) less.
I’m going to (  explore the Midwest  ) more.
To get motivated, I (  try to create a different perspective for myself  ).

What’s the best choice you made last year?
Marrying my wife (Monique). 

What’s your mantra?
Always excel. It’s nothing fancy. It just means always try to do what you can do to get better. It can mean anything in your life. I have it written down in English and in Greek in my office and in a notebook. It’s a quick reminder and keeps me going. 

What’s your worst habit?
Biting my nails. 

Best habit for a healthy life?
Nutrition. You can work out as hard as you want, and you can read all the motivational books in the world. But if your nutrition isn’t on point, your tank is not fueled correctly. You have control of what you’re eating. That doesn’t mean don’t reward yourself. It means eating right 80-90 percent of the time. 

Favorite thing about our community?
Everybody is nice. I’ve never experienced this small-town feel before in my life. I had three kids come up to my door the other day, and they had baked us cookies. Also, there’s no traffic—that might be my other favorite thing. 

What foods do you buy most often at the grocery store?
Chicken, ground turkey, string beans, lettuce, tomato, avocado, broccoli, eggs, yogurt, apples, bananas and recently cranberries. We drink a lot of water, tea and almond milk. 

Favorite go-to recipe?
My wife bakes banana bread that’s really good and really healthy. (Get the recipe for Crazy Bread.) 

How do you find balance in your daily life?
Reading provides balance because it provides perspective. My next project is to re-read “Where the Red Fern Grows” because it’s going to relate to my life a lot differently now than when I first read it at eight years old. 

What message do you have for those who are struggling with their health and body image?
Try to create a new habit. Try to do something. Don’t be negative, because if you are, it’s going to make things 10 times worse.

We’re all about helping people. You can’t help anyone else unless you help yourself. It’s not being selfish; it’s being smart. Start somewhere. We upgrade lives; we don’t just train athletes. If you want your life to upgrade, we’re a great resource for you. There is zero intimidation here. We’re here to help this community. 

What is your favorite indulgence?
Pizza. I can’t say enough about pizza. Cheese, well done, no toppings. 

See also:

Colonoscopy: Real Questions, Real Answers from Altru’s Gastroenterology Providers

It's Altru - Published on March 21, 2017

Colonscopy QuestionsFriend: What’d you get for your 50th birthday?

You: I got a colonoscopy!

Probably not the answer your friend was looking for.

While a colonoscopy isn’t as exciting as a new gadget or as fancy as a new piece of jewelry, it’s one of the best presents you can give yourself (and those who love you).

Altru’s Gastroenterology Providers tackle some of the frequently asked questions about colonoscopy.

Do I really need to have a colonoscopy? What are the chances you’ll find something?

» Yes. While screenings for other cancers detect the presence of cancer, colonoscopy screenings can prevent colon cancer. During a colonoscopy, the physician is looking for polyps, small growths that over time can become cancer.

» If a polyp is found, the physician will remove it. In those over 50, polyps are found in approximately 25 percent of males and 15 percent of females, but are usually not cancerous. One in 20 adults will develop colon cancer in their lifetime. If caught early, colon cancer has a 90 percent cure rate.

» Colonoscopy is recommended beginning at age 50 and continuing until 75 years of age. People with an increased risk of developing colorectal cancer should begin screening at a younger age, and may need to be tested more frequently.

Real answers by Anthony Chu, MD.

Will my insurance cover the procedure?

» Most insurance plans and Medicare cover colorectal cancer screening for people who are age 50 or older. Colorectal cancer screening tests may be covered by your health insurance policy without a deductible or co-pay. Consult your insurance provider for your specific coverage.

» Altru’s No-Cost Colonoscopy program offers financial assistance for eligible patients who are uninsured or underinsured. Funding is available from Altru Health Foundation, thanks to Altru’s Gala and grants from the North Dakota Department of Health. For more information, call 701.780.6533.

Real answers by James R. Wood, MD, FACP.

What does the colon prep liquid taste like? Why is it necessary to drink it prior to my colonoscopy?

» Patients have a choice when it comes to colon prep. GoLYTELY® is typically recommended as it has the best coverage from insurance. GoLYTELY® is mildly salty, but patients can mix lemonade or limeade flavor packets in to the liquid to make the flavor more enjoyable. The other two options – Prepopik and Miralax – aren’t covered as well by insurance, resulting in additional out-of-pocket cost to the patient. Prepopik tastes similar to sour orange cream candy. With Miralax, the taste is determined by the Gatorade flavor with which you mix the powder.

» It’s important to drink all of the colon prep to properly clean your colon. This helps to provide your physician with a clear view of your colon.

Real answers by Kamrin Macki, NP.

Who will perform my colonoscopy?

» Our doctors are experienced, board-certified and University-trained gastroenterologists. We follow the national guidelines for performance of the procedures, which assures the highest quality exams. We utilize a state-of-the-art facility with experienced nursing staff. Colonoscopies are performed differently for different issues in different patients, and thus need to be individualized.

» Endoscopic procedures performed by physicians with different training may not be able to provide the same ability to provide the quality of care. For example, identifying and removing large or "flat" polyps requires special training and experience which is available at Altru. Flat polyps were first identified at Stanford University in 2007. These flat polyps are more difficult to identify and appear to pose a higher risk for developing into colon cancers.

Real answers by Howard Hack, MD.

Why is good colonoscopy preparation so important?

» Bowel preparation for colonoscopy refers to the laxatives taken before the procedure to clean the colon of fecal debris. A colonoscope is a long, flexible tube with a television camera on the tip. The camera cannot see through fecal debris. So any fecal debris left in the colon could obscure identification of a polyp or even a small cancer.

» Several studies have shown that fewer small and large polyps are detected in patients with less-than-optimal bowel preparation. And, poor preparation has several potential consequences during the procedure itself. First, your colonoscopy may last longer because the doctor will need to take time to clear out debris. Second, your doctor may lack confidence that the colon lining was seen adequately and may ask you to return for a subsequent screening earlier than would be otherwise recommended (say one year, rather than five or 10 years). This will subject you to increased costs and risk. Finally, if the preparation is very poor, the doctor may have to stop the procedure entirely, and you will need to reschedule.

Real answers by Israr Sheikh, MD

Altru's Gastroenterology Team

To schedule a screening colonoscopy, call 701.780.6533. Learn more at

From Admission to Discharge, Your Safety Is Our Priority

It's Altru - Published on March 16, 2017

As we celebrate Patient Safety Awareness Week (March 12-18, 2017), here are some of the many ways we ensure safe care for our patients at Altru Health System.

Patient Safety Week

Addressing concerns. We diligently address every concern brought forth by patients, families and staff. We encourage patients to provide feedback and/or report any and all safety concerns by privately calling a patient representative.

Assessing fall risk daily. We perform a thorough standardized assessment immediately upon hospital admission, followed by daily assessments to determine individual fall risk. Each patient gets a score—low, moderate or high—and actions are taken to ensure patient safety depending on risk level. Actions may include: bed alarm, chair alarm, patient sitter and/or rounder.

Altru’s inpatient fall rate is 3.45 per 1,000 patient days. This is on the low end of the national, publicly reported inpatient range of 3.3-11.5 falls per 1,000 patient days, according to the NDNQI (National Database of Nursing Quality Indicators) database.

Encouraging honest feedback. Altru has a robust reporting culture for any patient safety or quality care issues. Our reporting structure is non-punitive, encouraging open and honest communication about concerns relating to patient care and safety. In addition to reporting falls, we also document any and all near-falls. This is all tracked in real time to accurately reflect reality and consistently hold staff accountable.


Analyzing errors. If a fall does occur, action is taken immediately. This includes notifying the charge nurse and hospital supervisor, provider and other caregivers, including the patient’s family. We include the patient in a group huddle to assess and revise interventions. Then, a root cause analysis (RCA) is completed to analyze what went wrong and make sure the issue never happens again.

Using the best technology. Healthcare technology can assist staff by providing simple reminders and prompts to keep our patients safe. Electronic medical records can improve the ability to diagnose diseases and reduce—even prevent—medical errors, thus improving patient outcomes.

Washing hands—often and well. Hand hygiene is a great way to prevent infections. Providers might need to clean their hands as many as 100 times per 12-hour shift, depending on the number of patients and intensity of care. Healthcare providers can explain how and why they clean their hands before, after and sometimes during patient care, and let patients know it's okay to ask about hand hygiene.

Keeping it clean. Our Environmental Services team uses a number of quality checks to ensure patient rooms are as clean as possible. For example, an “encompass room check” marks 18 touchpoints before and after a room is cleaned to check and score overall cleanliness. This attention to detail doesn’t go unnoticed—we ranked at the 84th percentile (goal was 70th) overall for 2016 in HCAHPS scores for cleanliness. Beyond the basics, we take extra measures keep our environment squeaky clean, from using bleach for C-diff cases to adding new UV light machines to kill 99.9% of bacteria.

Although we are using this week to celebrate our patient safety achievements and increase awareness, safe care is Altru’s focus 24 hours a day, 7 days a week, 365 days a year.

See also:

Lynn Huot has been a nurse for 30 plus years with the past 12 years as a Registered Nurse. She obtained her BSN from Mayville State University in 2016 and is currently the Director of Quality and Patient Safety at Altru Health System. Lynn enjoys spending her free time with her family as well as spending time at the family cabin.

Central Sterile: Where Healthcare Really Starts

It's Altru - Published on March 13, 2017

Central Sterile is actually the first step in ensuring you recover from whatever ails you, because those technicians are responsible for properly tracking, cleaning and sterilizing all the instruments and medical supplies that may cross your path.

Because the work of Central Sterile is done behind-the-scenes, patients may never realize the crucial role they play in keeping you healthy and helping you recover. These individuals exist solely to protect the welfare and safety of every patient that comes through the hospital doors.

Central Sterile technicians are the people who organize and assemble the instruments needed for surgical cases, meticulously track every scissor, screw and drape in the facility and maintain adequate amounts of each, as well as disassemble and reassemble contaminated medical supplies and equipment.

It’s not a role to be taken lightly.

Central Sterile technicians are an integral part of the healthcare process, and it’s a great fit for someone interested in medicine who doesn’t want to shell out hundreds of thousands of dollars for medical school. In fact, many sterile processing technician programs can be completed in six months to a year, and for much less investment than other medical career paths.

That’s good news, especially considering the job market for Central Sterile processing technicians is expected to grow by 20 percent by 2020. Even though improved technology is making it easier for these technicians to track and order equipment, individuals still maintain a critical function for any hospital or healthcare facility. Thanks to high demand in the market, job security and professional development, opportunities abound as entry-level technicians move up toward supervisor and management levels.

Perhaps the most important aspect of the central sterile role is the ability to develop a rewarding career in the healthcare industry. Though patients are not doling out hugs or handshakes on a regular basis, central sterile technicians can find fulfillment knowing those patients have left healthier. That’s thanks to the vital job technicians have provided by supplying the tools necessary to set them on a path toward recovery.

If you’re interested in filling the important role of a Central Sterile processing technician at Altru Health System, apply at

Activity Tracker vs. Heart Rate Monitor | What’s the Best Pick for You

Enrich - Published on March 6, 2017

It is not uncommon to spot a simple band around a wrist these days. In the last few years, many Americans bought into the fitness tracking trend, utilizing wearable technology to help them monitor different aspects of their health and activity. However, it’s important to note that it’s not one size fits all. What might be a perfect fit for one person won’t tell another the information they need. To help you find your fit, we’ve provided information and insight on heart rate monitors and activity trackers, two of the most popular tools keeping people on top of their health and activity.

Heart Rate Monitors
Heart rate monitors are used to determine exercise intensity of a training session or any type of race. They are easy to use, relatively cheap and can be used in most training scenarios. Heart rate monitors come in chest strap and wrist wearable versions.

It is extremely useful to increase your exercise level in a graded and careful manner in order to avoid injuries, overexertion and excessive stress on the trainable human system. Using a heart rate monitor is a supreme method of assessing one's general base of fitness, and determining the level of intensity of the exercise session. For individuals with cardiac conditions, or who are at a poor conditioning level, a physician or our staff may recommend that you do not exercise at a heart rate above a certain level. This technology is useful for these individuals because their heart rate can be monitored continuously.

  • Main purpose: Heart rate monitors track your real-time heart rate. You’ll see the zone you are in and be able to adjust your intensity one way or the other depending on your goal.

  • When to wear: In general, you’ll only want to wear your heart rate monitor during a workout, when you can get real-time data about your heart rate during exercise.

  • Other capabilities: A heart rate monitor is more specific than most activity trackers. Most will be able to sync up to your smartphone and provide a few additional pieces of information – such as calories burned, duration of exercise and further assessment of your heart rate and effort.

  • Great for: Heart rate monitors are ideal for high-intensity based workouts so you can ensure that you are exerting the effort required to reach the desired goal. They are also beneficial when you need to vary your heart rate for an exercise so you don’t over-exert yourself.

  • Additional Benefit: Often times, physicians recommend that patients with some heart conditions wear a heart rate monitor if they exercise to ensure they stay in safe heart rate zones. If you are anxious about working out with a heart condition, talk to your doctor about how a heart rate monitor could benefit you.

  • Accuracy: The chest strap variety of heart rate monitors tend to be the most reliable, followed by a wrist-worn version. Some activity trackers also boast heart rate monitoring as a benefit; these are typically the least reliable.

Right for you?
Heart rate monitors are generally more beneficial for athletes or those who train more intensely. A more casual exerciser would not likely see the benefit out of the level of in-the-moment detail they provide. They can also be a good fit for those who must monitor heart rate for a health condition.

Activity Trackers
There are a wide range of activity trackers, sometimes referred to as fitness trackers, on the market. Their capabilities range from a simple pedometer that counts your steps, to those that sync with a smartphone app and can track and provide feedback on sleep, heart rate, your personal goals, distance and more. Activity trackers are most commonly found as wrist wearables; some are clip on versions or even hidden in a piece of jewelry.

  • Main purpose: The main attribute of an activity tracker is to count your steps. They include accelerometers to track each step you take. Many can also provide “warning buzzes” if you haven’t hit your step goal by a certain time, as well as provide other minimal on-device feedback. Most will connect with an app on your smartphone where you can track your progress.

  • When to wear: It is important to wear or carry your activity tracker at all times (sans the shower, unless yours is waterproof) to ensure it is capturing all of your activity. Many people are most surprised by the amount of steps they get in doing regular tasks, and how many they might miss if they don’t make an effort to get up and move.

  • Other capabilities: With the popularity of activity trackers, many companies have added additional benefits to attract wearers. Some can track your sleep patterns, and even wake you with a buzz at the right time. Most will show you calories burned and distance walked, and some can also track your heart rate. Many of the apps can also be used to enter and track nutrition and other health information so you have everything in one spot.

  • Accuracy: In general, you can expect to see accurate step count on your activity tracker. Granted, there is some variation among products, and some non-stepping activity can at times get counted, but in general they are a good barometer of your movement. Some of the additional tracking—heart rate, calories burned, etc.—are likely not as accurate.

Right for you?
Activity trackers can be beneficial for most people, as they gauge our simplest activities right along with more stringent exercise. They are especially great for those starting out with a workout program to keep them motivated to move. Someone who is more intensely invested in their workout regimen—say a marathon runner—may find that the lack of detail about their core activity (think speed, splits, distance and pace) on these devices may keep them shopping for something more specific to their sport, such as a running watch.

In the end, both heart rate monitors and activity trackers offer benefit to those looking to understand their health & activity. With either device, you’ll find helpful information to keep you on track with your goals.

If you don’t feel that heart rate monitors or activity trackers are a fit for you, keep shopping. The market for wearable technology is vast and there are options for every runner, walker, lifter and biker that can give you the information you seek and help keep you on track with your goals. Happy tracking!

The experts at Altru's Sports Advantage can help you navigate your fitness goals with performance training and nutrition fit for those of all activity levels.

Help Prevent Colon Cancer with Fiber-Rich Brussels

Enrich - Published on March 3, 2017

Brussels sprouts are full of fiber, hearty and perfect in the cold winter months. Even better, a diet rich in fiber-filled veggies like Brussels can help prevent colon cancer.

In the heart of winter, comfort foods are a heartland favorite. These may include such things as hot dishes and casseroles made with meat and pastas, or scalloped potatoes made with a creamy sauce. I often hear how it is harder to eat vegetables and fruits in the winter, as they are not as fresh or readily available. Living in the far north we do indeed have to rely on foods grown far away—to a point. Instead of focusing on what we do not have in the winter in the tundra of North Dakota, look at what we do have and look for winter produce and try new things.

From Standard Produce to Adventurous Veggies
I was a farm kid that grew up on the standard vegetables: green beans, corn, potatoes, with the occasional California blend vegetable mix if my mom was feeling adventurous. When I got married, my mother-in-law introduced me to new produce. I actually enjoyed them, but maybe not at first. Brussels sprouts are one of these foods.

Brussels sprouts are an often forgotten food and some find them despicable and indicate that they are strong and bitter. I, too, may have felt the same when I saw the green little globes on my plate the first time at my in-laws’ house. At first, they required a good amount of butter to be palatable. Now, I have found ways to make them truly delicious. I purchase fresh when I can. They can be found in nice little bags at our local grocery stores near the salad mixes.

Preppin’ the Green Globes
I wash the Brussels thoroughly and cut off any leaves that look undesirable. I then toss them in my steam pot until they are just beginning to be fork tender. Next, I place them into a bowl and toss with some flavored balsamic vinegar, peanut oil, rosemary, garlic, ground mustard, salt and cracked pepper. I allow them to marinate for 20 minutes to soak in the flavor, and then I place them in a pre-heated oven at 400 degrees for 10 minutes. The results: pure deliciousness.

Brussels sprouts pair nicely with a lean pork chop, chicken breast or fish. Through marinating and steaming, the bitterness nearly disappears and the result is phenomenal. Best of all—Brussels sprouts are an excellent source of dietary fiber, vitamin A, vitamin C, vitamin K, vitamin b6, folate and manganese.

Final lesson: Listen to your mom (or mother-in-law), and eat your vegetables.

Ready to kick off your vegetable adventure? Start here: Roasted Sweet Potatoes and Brussels Sprouts.

Nearly 100,000 people are diagnosed with colon cancer every year, according to the American Cancer Society (ACS). While we have no control over risk factors such as age and family history, we do have control over healthy eating. Adding fiber-rich fruits, vegetables and whole grains aids colon health by keeping you regular. Colonoscopy is the best line of defense in reducing risk.

See also:

Jennifer Haugen has over 14 years of experience as a registered dietitian in the Grand Forks area with eight years in the health and wellness field. She obtained the Certified Specialist in Sports Dietetics (CSSD) credential in July 2011 and also has completed training in adult weight management. Jennifer enjoys many outdoor activities such as ice skating, biking, running, fishing and hunting and spending time with her family.

Finding Balance in the Midst of Difficult Times

It's Altru - Published on March 3, 2017

Whenever I hear that someone has aching knees or back trouble, I suggest physical therapy. Because of the wonderful work of therapists for my foot, joints and spine, I actually think I’m athletically ahead of where I was ten or fifteen years ago!

One tool my physical therapist (PT) introduced to me was a Bosu, which is kind of like one half of a big therapy ball. You try to stand on it, then walk in place on it and finally march on it, none of which is easy. All of this is intended to improve balance by improving the “core” of your body.

The Bosu did two things for me. First, it showed me the limits of my balance (my then-pregnant PT could balance better than I could). Second, the Bosu worked on my weaknesses, and I improved on them quickly. I was so impressed that I bought one.

Have we ever needed balance at Altru more than we need it now? And I don’t mean physical balance. Hundreds of people are working in different ways and in different places since the structural failure at the clinic. Just that would knock a person off balance. But add the trauma of the sudden evacuation and the prospect of a two-year road to a new place and the whole system is being challenged. We’ve been knocked off balance.

We are looking for a steadying influence, a way to stay on the path. The idea of balance is really rather practical: we need balance between work and personal, between fun and seriousness, within relationships and with our work. Physical balance comes from strengthening our core, our center, those abdominal and gluteus muscles.  Our mental, spiritual and emotional balance comes as we strengthen the core of our being.

There comes the challenge. We can name the areas of the brain or the ligaments around a knee, but where is our spiritual and emotional center? And, how do we strengthen our spiritual core to deal with stress?

Let’s find our personal center. This is unique for each of us but there are some common places to look.

Beliefs. What we believe in our core drives our behavior and creates our attitudes. An infant or small child “believes” they are the center of the universe. Everyone else is here to serve their needs. That “belief” changes over time.

We might think a belief has to be religious, yet that’s not always the case. I knew a very non-religious man whose central belief was that he was to leave the world better than when he started. He exercised that belief by actively seeking ways to put it into practice and did amazing things. He taught me there’s a difference between saying we believe something and actually believing enough that our actions change.

At Altru, of course, we have a set of core beliefs in the Altru Way and our Behavior Standards. These can help us stay balanced if we actually believe them.

Relationships. Humans are social creatures and relationships are our core. But, we’d have to admit that it is easy to take for granted relationships with family, friends or even God if we have a religious belief.

The Search Institute identified 40 developmental assets for adolescents. Many of them have to do with relationships, such as Asset #4, “Young person experiences caring neighbors” or Asset #8 “Young people are given useful roles in the community.” For children and teens, adults should seek to provide these things. But as adults we should be able to take initiative on our own to find (and be) caring neighbors. We should seek useful roles on our own. Relationships with family and positive work relationships bring us satisfaction, which leads our third general category.

Awareness and Value of Self and Others. Have you even seen yourself on video? I know I’m often surprised how I look (older, you know) or how I sound. We might not always be aware of how we talk or be aware of the people around us.

Self-awareness is part of being human, but it is also a skill we develop. Can we come to actually hear our own words and see how they might be taken positively or negatively?  Can we recognize what we think of ourselves and our relative worth? Can we also be aware of others in similar ways? We cannot know what someone else is thinking, but we can learn to be aware of the words being said and expressions shown.

A strong core brings balance, even during difficult times. At Altru we need balance more than ever. This will require a continual strengthening of our core as individuals and as a system.

Mark-EllingsonMark Ellingson, Altru’s Pastoral Care Manager, has lived in the area for 35 years as a local pastor and chaplain. He is married to Betty, a speech pathologist supervising in schools such as Hillsboro and Central Valley. They have five children and a couple of grandsons. Mark and Betty enjoy living in Grand Forks. Mark plays tennis, fills in at local churches for vacationing pastors and enjoys writing on his personal blog, Thoughts of a Hospice Chaplain.

Joint Replacement Surgery: What to Expect and Why to Be Prepared

Enrich - Published on March 3, 2017

joint-replacement-surgery-assistanceThis year, more than one million Americans will get their knees or hips replaced. Joint replacement surgery is becoming an increasingly popular way for those people affected by joint pain and limited mobility to get their lives back. But as soon as the doctor tells you you’re a candidate for replacement surgery the wheels in your head start spinning.

“Understandably, people have a lot of questions,” says Heidi Solem, Coordinator of Altru’s Joint Replacement Center. “They’ll ask, ‘What’s it going to feel like after surgery?’ ‘What should I expect?’ or ‘How long will I need someone to stay at home with me?’”

Luckily, all of those questions are answered at Altru’s Joint Replacement Center. Joint replacement patients are set up with a comprehensive education and exercise program prior to surgery; they also receive outpatient therapy afterwards.

If you or a loved one are pondering joint replacement surgery, here is a timeline of what you can expect.

2 Weeks Before Surgery

About 14 days before surgery, patients getting a total knee or total hip replacement are invited to attend a class about the procedure. Spouses or family are encouraged to attend the class with the patient.

“The surgery not only affects the patient, but also the spouse and family,” Solem says. “So this is a good way to learn what they might need to know to help their loved one after surgery.”

Solem says they’ll fill out paperwork that will help them figure out what they might need post-operatively. This will help them better prepare their home after surgery – things like moving rugs, getting special chairs, planning meals or purchasing necessary equipment.

A therapist will demonstrate exercises that patients will be instructed to start completing that day through surgery that will work on strengthening their upper and lower bodies.
“After surgery, you’ll be using muscles that you might not use all the time. If your upper body isn’t strengthened, you’ll get sore. Some patients aren’t prepared for that,” Solem says.

1 Week Before Surgery

Seven days from surgery, patients might be advised to stop the use of prescription or over the counter medications that “thin” the blood.

1 Day Before Surgery

Patients are called by Altru pre-procedure staff and told when to arrive for their scheduled procedure. They’ll also be given any last minute specific instructions about eating, drinking, medications to take and anything else that may pertain to their procedure.

Day of Surgery

When patients get to the hospital they get registered and meet care providers including nurses and anesthesiologists. The patient will be prepped for surgery. Surgery last approximately 1-3 hours and, following it, the patient is sent to the recovery room. During this time, family can track the progress of the patient from screens in the waiting room, and are updated by a provider or nurse on the patient’s status after surgery is complete.

After getting out of surgery, patients won’t stay inactive for long.
“Physical therapists will work with patients within a couple of hours,” Solem says, “We’ve found the sooner we get them up and moving the better they do.”

1-2 Days After Surgery

At this point, patients can change into their own clothing so they can be more comfortable. They’ll be encouraged to be up out of bed the day after surgery. They will work with occupational therapists who will show them how to bathe, dress and shower while recovering.

They’ll also participate in one-on-one physical therapy as well as group therapy.

“We put together small group of people who’ve had the same surgery for group therapy,” she says. “It helps them to see they’re not alone. I’ve had patients build real bonds and friendships during this time.”
“In most cases patients are walking as part of their recovery plan the day of surgery,” shares Dr. Jeremy Gardner, orthopedic surgeon at Altru Advanced Orthopedics. “Because of the level of dedicated therapy and support through Altru’s Joint Replacement Center, they’re able to go home within one to two days after their replacement.”

joint-replacement-guideOne Week After Surgery

Patients will continue with an at-home exercise program for therapy and may participate in an outpatient physical therapy program. Altru usually advises joint replacement patients to have someone stay with them for three to five days after leaving the hospital. Solem says most of the time, doctors will not clear patients to drive for four to six weeks after surgery. This can be very challenging for both the patient and their spouse or loved ones. That’s another thing that can be worked out and looked at ahead of time through the joint replacement education.

Preparing Ahead Has an Impact

While joint replacement surgery is becoming increasingly more common, that doesn’t mean patients aren’t nervous about it. It’s still major surgery. But when patients do a little homework ahead of time, it seems to contribute to a more positive outcome all the way around, including reduced anxiety and even shorter hospital stays - joint replacement patients have gone from four days to two with the implementation of the comprehensive programming at Altru’s Joint Replacement Center.

“It used to be we did all the teaching while they were in the hospital,” shared Solem. “Right before surgery patients are given so much information that it can be very overwhelming,” she says.

So, if you or a loved one are considering joint replacement, make sure you do your pre-planning, then once you’re in the hospital you can concentrate on healing and recovery.

“Some patients will say to me, ‘I didn’t want to come to class. But I’m so glad I did,’” she says. “They always find it very beneficial. Doing some of the work ahead of time can make all the difference in the world.”

Find more helpful information about Altru’s Joint Replacement Center at

Living with Diabetes: Feet to Last a Lifetime

Enrich - Published on February 28, 2017

Healthy-Feet-with-DiabetesOur feet really take the brunt of all our activities in life, whether at the gym or having to carry those few extra pounds we gained over the winter. But with a few practical guidelines, our feet can be healthy for a lifetime.

1. Keep your blood sugars in a manageable range (not always so easy). Having elevated blood sugars puts our feet at increased risk for infection and skin breakdown. If a person has a blister or ingrown toenail or foot injury, elevated blood sugars will increase the risk of infection.

2. Check your feet daily. Right after you hop out of the shower or bath, dry them thoroughly with a clean towel, making sure to get between the toes. Make sure there are no ingrown toenails or blisters. Also check for swelling or callouses.

3. Lotion, lotion, lotion. The only place not to use lotion is between your toes.

4. Always wear well-fitting shoes. Do not wear footgear that has worn out and is no longer supporting your feet. Always wear clean, dry socks. Do not go barefoot, even in your own home. Accidents involving the feet are most likely going to happen right at home.

5. In the cold weather, be careful to wear proper footgear. To prevent frostbite, make sure you are not staying too long in the cold.

6. Keep your toenails trimmed, but not too short, cutting the nails straight across to prevent ingrown toenails. Do not scrape callouses. If using a loofah or pumice stone, do not get too aggressive. (Gently work it in one direction, not back and forth.)

7. Have your provider check your feet thoroughly at least yearly during your physical. If you have a blister or sore on your foot that is not healing, make an appointment to have your provider see it right away.

Show a little love toward your feet, and you will have feet to last a lifetime. If you or a family member have diabetes, it is easy to arrange a visit to Altru’s Diabetes Center. Talk with your provider and ask for a referral, or call 701.780.1838 for more information.

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5 Tips for Preventing Winter Falls

Enrich - Published on February 27, 2017

winter-walking-preventing-falls-tipsIt might be funny when you see someone slip and fall on the ice in slapstick comedy, but in real life it’s no joking matter.

“In the winter, ice-related falls are a common reason people come to see us,” says Dr. Billy Haug, a Medical Orthopedist at Altru Advanced Orthopedics. “It is usually around age 65 that the risks increase."

According the Centers for Disease Control, every 11 seconds an older adult is seen in emergency rooms after falling. One out of three adults over the age of 65 fall every year and – by the age of 80 – half experience a fall at least once per year.

A 2008 study by the Minnesota Brain Injury Alliance shows the monthly rate of falls doubles from December to March as people try to get around in icy conditions.

“It’s not easy sometimes,” Dr. Haug says. “Navigating an icy sidewalk is a complex mechanical and physiological puzzle. It requires your neuromuscular system to be firing on all cylinders.”

Haug says that balancing on ice gets more challenging as your age increases and your strength and balance decrease. The resulting fall might cause simple bumps and bruises or serious fractures of wrists, shoulders and hips.

“As we age, our bone density decreases and the bones aren’t as strong, these falls can be very serious,” Dr. Haug says. “That’s why it’s so important we first try to prevent falls from happening versus treating them after they happen.”

Here are 5 tips for preventing winter falls.

Adopt a Fitness Plan

“Initially, it is important to determine the cause of the fall," Dr. Haug says. “It might just be a slip on the ice, but if it’s a problem with strength or balance, we’ll look at ways to improve that.”

Pat Carter, a Physical Therapist at Altru, says having a strong core helps individuals catch themselves from falling.

“The better a person’s strength, range of motion and balance, the better chance they have of reducing the effects of the fall and improving the recovery time from their injuries,” she says.

Carter says Altru recently introduced “Stepping On” – a seven-week course which helps people learn how not to fall by working on balance and strength.

“We’ve had very positive reviews from people who have participated in the past,” she says.

To learn more about Altru’s “Stepping On” course, call: 701.780.2516.

preventing-falls-in-winterWalk This Way

There is actually a right and wrong way to walk on ice to prevent falls. Just watch how the penguin does it.

“It is helpful to use a shuffling gait,” Dr. Haug says. “Maintain contact between your feet and the ground at all times. Bend forward a little bit to keep your head out in front of your knees so your center of gravity is moving forward.”

“As you walk, you want your knees to be slightly bent,” Carter recommends. “Take smaller steps and keep your feet in the flat position. You’ll also want to have a wider base of support.”

Proper Footwear

There’s a reason you don’t see a lot of stilettos in the winter time.

“Proper footwear is so important,” says Carter. “You want a good tread, with wide soles and, of course, avoid heels.”

Carter says some people also find detachable cleats and carbon tips an effective way to avoid slips on the ice.

“I know some older adults even carry sand or cat litter with them to sprinkle on icy spots,” she says.

Ask for Help

Whether it’s asking for a hand to hold or just grabbing a railing, experts advise people susceptible to falls not to be too proud to ask for help. Dr. Haug says people are sometimes reluctant to use a cane or a walker, but sometimes it’s better in the long run.

“I advise my patients not to be afraid to use it when they’re outside,” he says. “They may not need to use it in all instances.”

Carter even points out that ice pick attachments can be added to canes to help navigate icy conditions, but can be retracted indoors.

Pay Attention

Go to any public space these days and you’ll see how popular it is to text and walk. It’s fine at the mall, but not a great idea on an icy sidewalk.

“You just can’t be distracted. Put your phone away and try not to carry too much. Pay attention to what you’re doing,” Carter says.

Dr. Haug agrees.
“It’s important to survey your surroundings – to know if you’re going to be on an icy surface. Make sure you know where you will be stepping,” he says.

Carter says in the winter it’s also important to give yourself extra time to get places and do your best to clear sidewalks and driveways to make things easier on yourself and anyone else who is out walking.

Preventing falls isn’t always possible, but learning a few simple tricks might keep you a little safer when the snow starts to fall.

If you do fall, it’s important to seek proper care. Depending on the severity, you might need to visit the emergency room, or you can see a specialist at Altru Advanced Orthopedics. To schedule an appointment, call 701.732.7700 or visit

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