Beat the Summer Heat by Adding Some Wow to Your Water

Enrich - Published on May 31, 2017

Water is essential for our well-being. In fact, our bodies are made up of 50 to 60 percent water. It is continually used as our body functions, which makes it important to ensure it’s replenished. The correct balance of water and electrolytes determines how well our body runs; this includes our nerves and muscles. Staying hydrated removes waste through urine, controls body temperature, heart rate, and blood pressure, and helps maintain a healthy metabolism.



For years, we’ve been told to drink eight, eight ounce glasses of water each day. Turns out there isn’t much science behind that recommendation. But, before you put down your water bottle, there’s plenty to back up why it’s needed. In fact, we all need about one milliliter of fluid per calorie we eat. For example, if you follow a 1,600 calorie diet, you need almost seven cups of fluid per day. And, if you follow a 2,000 calorie diet, you need a little over eight cups of fluid per day. That age-old rule of eight glasses a day isn’t too far off the mark. Even more, our fluids can come from a variety of beverages, including those that contain caffeine. The diuretic effect of the caffeine is mild compared to the fluid provided. Want more good news? Your fluid intake doesn’t stop at what fills your cup. We can also get our fluids from foods such as soups, yogurt, fruits and vegetables.

Even though fluids can be found in a wide variety of sources, the liquid source is your best option. You should drink enough so that you go to the bathroom every two to four hours and your urine should be light in color. Dark urine is an indicator that you most likely need to drink more. Everyone is unique and certainly your size, calorie intake, activity level and type of environment you live and work in will determine how much fluid you need.

Add Wow to your Water
When it comes to beverages, water is a great calorie-free thirst quencher. Check out these ideas to add some “WOW” to your water without adding a lot of sugar and calories.


  • Add the traditional lemon or lime for a little fresh zing.



  • Drink fruit infused water. Add fruit to your glass of water or use special water bottles and pitchers that hold fruit and water. These can be purchased at a variety of stores.



  • Freeze fruit juice in ice cube trays. Add the frozen fruit cubes to water in place of ice cubes.



  • Add a packet of True Lemon and a spoonful of instant unsweetened tea to 16 ounces of water.



  • Add a small amount of cherry juice and an optional lime.



  • Make green iced tea: Boil four cups of water in a kettle and leave for a few minutes so the temperature naturally drops to no less than 195°F. Add three to five green teabags to a heat-proof pitcher and pour in the water. Leave to brew for one to five minutes. Remove teabags and add a little sugar if desired. Stir in six cups of ice cubes until melted, or use four cups of cold water. Add freshly sliced lemon to taste. Keep refrigerated and drink within 24 hours.


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.

The Scoop on Poop: What’s Normal, What’s Not

Enrich - Published on May 30, 2017

Poop. There, I said it. It’s not a fun thing to talk about, but if we are healthy, our poop should be, too. Let’s move beyond the awkwardness and into the important stuff. Here’s what you need to know to make sure your digestive health is in tip-top shape.



What is poop?
Bowel movements consist of dead cells, fiber and bacteria. Nutrients from the food we consume are absorbed into the blood stream. The rest is discarded.

So, how often should you poop?
Most people should have bowel movements between once a week and up to three times per day. The frequency and consistency of bowel movements combined with other symptoms such as abdominal pain, urgency or even bloating can be a sign of illness.

What does a healthy bowel movement look like?
The texture should be similar to toothpaste consistency—not too hard, not too soft. Stool which is too watery may mean you are not absorbing water or nutrients, which should be discussed with your doctor.



Seeing the Rainbow?
It’s important to pay attention to the color of your bowel movements. Like the famous emoji, healthy poop should be a medium shade of brown. Here are some colors to watch for:


  • White or gray: you could be having a problem with your pancreas or gallbladder.

  • Bright green: leafy greens (or artificial food coloring) can make your stool appear green.

  • Black: could indicate dried blood higher up in the digestive tract. Consult your doctor.

  • Red: blood in the stool is abnormal and should be brought your doctor’s attention.

  • Food in your stool: it is normal to see undigested food, such as corn, in the stool from time to time.


Happy Bowels
For happy bowels, remember the four Fs: fiber, fluids, flora and fitness. Eat plenty of fiber, stay hydrated by drinking water, consume foods such as white potatoes, vegetables and dry beans that support the growth of good bacteria, and move your body daily.

New areas of research are showing how what we eat and how we exercise can determine if we have healthy bacteria in our colons. Unhealthy bacteria can lead to obesity, diabetes, depression, and even Crohn’s and Ulcerative Colitis.

If unusual colors, patterns or pains persist beyond a day or two, call your doctor. The experts at Altru’s Gastroenterology Clinic specialize in prevention, diagnosis and treatment of disorders of the liver and digestive tract, including the esophagus, stomach, pancreas, gallbladder, small intestine and colon. We work with you to develop the best care plan to maintain good health.

Dr. Howard Hack, gastroenterologist, found the pursuit of medicine to be a perfect match for his lifelong passion for learning and helping others. He has worked in a variety of settings, including urban, suburban and rural areas. He has taught medical students, internal medicine residents and GI fellows at Stanford University, and has his work published in The Lancet (London, UK). In his spare time, Dr. Hack enjoys swimming, bike riding and ice skating with his family. 

 

See also:

Back to Baking & Time With Grandkids | Rita's Altru Advanced Orthopedics Story

Altru Moments - Published on May 1, 2017

Rita Brodina spent over 25 years working as a nurse at the Good Samaritan Society in Park River. She retired in June of 2016, looking forward to spending time with her grandkids and working in her garden. Unfortunately, hip and back pain were getting in the way of her plans.



“I wasn’t able to live my normal life,” explained Rita. “Simply walking to the garden was difficult. Bending over to get cookies out of the oven became a challenge. The pain was keeping me from my normal activities.”

Rita sought care for her pain for several months without finding the right solution. She saw a chiropractor, tried physical therapy and nothing seemed to help.

Finally, after an X-ray indicated her hip might be the culprit of most of her pain, she was referred to Dr. Jeremy Gardner at Altru Advanced Orthopedics. Wanting to avoid surgery if possible, Dr. Gardner first treated Rita with a cortisone injection to see if that would ease her pain. For a while it was successful, but after a few weeks her pain was back.

“At that point, my pain was so distracting and had been for so long that I knew a more long-term solution was necessary.”

When Rita and Dr. Gardner made the decision that a hip replacement was the right treatment, he recommended total replacement with the Mako Robotic Arm. A new addition to the treatment options at Altru Advanced Orthopedics, the Mako allowed for a more precise replacement, which in turn meant less pain and a more natural-feeling joint for Rita.

“Dr. Gardner was confident I was a good candidate for a replacement with the robotic arm,” remembers Rita. “They took a CT scan of my hip to ensure everything would match up precisely, and my new joint would be a perfect fit for me.”

Prior to her procedure, she and her husband attended an informational class held by Altru’s Joint Replacement Center so they’d know what to expect.

“The class was so important for my husband,” shared Rita. “It really showed him that he would have to be my coach and partner through this, and that he’d have a big role right after surgery. The information made him more comfortable with that and prepared us both.”

Rita had her replacement on November 21, 2016, at 7:30 a.m., and by 2:30 p.m. that same day, she was walking to the bathroom with the help of a therapist.

“It was really kind of amazing. I was up and moving so soon, already starting exercises with physical therapists in the hospital and preparing to leave the day after my surgery.”

Now, about four months later, Rita is looking forward to getting her garden ready for summer without assistance.

“Before my surgery, I was in too much pain to tend to my garden, so my kids had to help me,” shared Rita. “I’m so looking forward to doing my own flower beds.”



She’s also grateful to be more active with her grandkids since recovery.

“Before, I didn’t pick up my granddaughter,” reflected Rita. “I was unsteady, and it made me nervous. Now, she’s ten months old and I can carry her around. That feels great.”

With the advanced technology of the Mako Robotic Arm, a strong support system in her family and a dedication to her exercises to strengthen her leg and hip, Rita was able get back to an active and enjoyable retirement.

Less Time Traveling, More Time Enjoying the Outdoors | Matthew’s Altru Moment

Altru Moments - Published on April 24, 2017

Growing up in northwestern Minnesota was like a giant playground for Matthew Sisler, an avid fisherman, hunter and overall outdoorsman.

On a Saturday in June of 2010, Matthew was at work, and his mother expected him home shortly after his shift ended. They had plans to go clothing shopping for an upcoming school trip. When Matthew did not return home as expected, worry overcame his mother, Beth.

Like many rural communities, word traveled quickly that Matthew was missing, and a small search was soon underway. Matthew was found within hours, a few miles from his home, his vehicle lodged in the ditch. He was disoriented in a country setting that should have been more than familiar to him.

Because he was alone and unable to recall what had actually happened, this frightening event was left unsolved and somewhat unexplainable. Matthew was 17 at the time, received routine care and went on with his youthful adventures.



Puzzling Seizures
In January 2011 while ice fishing, Matthew experienced a seizure that raised more concern and initiated more medical care, with no clear diagnosis of a problem. Within a few short weeks, Matthew experienced yet another seizure while at school and was quickly transported to the emergency room in Thief River Falls. It was after the third incident that appointments were arranged with Dr. Matthew Roller, a neurologist at Altru Health System. Soon, EEG and MRI’s became common acronyms in the Sislers’ vocabulary.

Dr. Roller was determined to treat and diagnose whatever was causing the seizures. Matthew’s mother, Beth, smiles, “We have always had a lot of confidence in Dr. Roller.”

Rhonda, Dr. Roller’s nurse, worked closely with Matthew and his family to find the best fit with seizure medication. This type of medication can alter personality, and the Sislers appreciated Rhonda’s extreme patience, understanding and informative style during a scary and trying time.

Consulting with Mayo Experts
Dr. Roller recognized the benefit the Mayo Clinic Care Network could provide in properly treating Matthew. He reached out to his colleagues at Mayo with an eConsult, discussing the conditions Matthew was experiencing. Tests led to the diagnosis and finding of Arteriovenous Malformation (AVM), or a tangle of blood vessels in the brain that occurs in less than one percent of the population. Matthew was sent to Mayo Clinic in Rochester to further discuss options, which included invasive surgery or the Gamma Knife Radiosurgery. The therapy took place at Mayo in June of 2011.

“Everything at Mayo is like clockwork and very organized,” Matthew said. “There are no guessing games.”

All of Matthew’s follow-up care, from his initial Gamma Knife radiosurgery to his second surgery in June of 2015, has been at Altru’s Neurology department with the utilization of the Mayo Clinic Care Network through Dr. Roller. The exchange of information and quick responses to questions or concerns have been comforting for Matthew and his family. The availability of eConsults at Altru has saved the Sislers many miles and hours of travel, time away from work and responsibilities at home, and has reduced the financial burden.



Matthew’s condition, while difficult to detect, could have resulted in a stroke if left unidentified. Dr. Roller’s knowledge, coupled with the Mayo Clinic Care Network, has allowed Matthew to continue doing all the things he loves. He is a true outdoor enthusiast, hunting and fishing as often as possible, a wonderful brother, a fiancé ready to start a life with his bride-to-be, a first responder, a board member and a volunteer with the Red Lake Falls Ambulance service. Matthew says, “Life goes on.  I haven’t stopped living.”

As the first member of the Mayo Clinic Care Network, Altru Health System is helping to bring Mayo Clinic’s knowledge and expertise to the Red River Valley. Learn more about how we’re helping patients save travel time, money and miles through this collaboration.

Nursing Careers: Limitless Possibilities, Growing Demand

It's Altru - Published on April 18, 2017

Anyone who has visited a doctor’s office or spent a day in the hospital might feel like they know what it means to be a nurse. But the truth is, nursing is more than meets the eye and much more in demand than Americans probably realize.

Nursing has become the fastest-growing occupation in the United States. According to the Bureau of Labor Statistics, in 2008, there were approximately 2.6 million nursing jobs in the country. By 2018, estimates show that figure will grow to 3.2 million – a 22 percent increase of a half-million jobs.

Why the Demand?
Many factors contribute to the increasing need for nurses in the workforce. One of the biggest reasons is simple demographics. As the baby boom generation ages, more people need healthcare services. Studies show as many as 1/3 of people over the age of 65 have more than one chronic health condition.

But it isn’t just the aging baby boomers causing the need for more nurses. Jennifer Nuelle-Dimoulas, director of regional clinic operations for Altru Health System, says part of the issue is the high number of veteran nurses nearing retirement. She says of the estimated three million nurses in the United States, about 1/3 of them are over the age of 50.

“By 2025 we expect this will be the largest shortage of nurses since Medicare and Medicaid started in the 1960s,” she says.

Nuelle-Dimoulas says there is also more competition from other occupational fields. Women today aspire to many different kinds of careers, whereas—prior to 1970—they might have felt limited to teaching or nursing.

Healthy Salaries
But healthcare professionals are working hard to encourage people to give nursing another look, and it starts with salaries. Recent nursing school graduates can receive some of the highest starting salaries in the nation and have potential for raises as they gain career experiences.

According to the Bureau of Labor Statistics, the annual median salary for a nurse in 2015 was approximately $67,000. Nurses in personal care services, which include work in doctors’ offices, hospital and outpatient facilities, are the leading earners.

Nurses who opt to continue their training and education can expect even higher salaries. Advanced practice nurse practitioners (APRN’s) which include nurse anesthetists, nurse midwives and nurse practitioners have a median salary of about $105,000 a year.



Room for Growth and Change
Many people who choose nursing for a career will tell you they enjoy the flexibility it affords. With more than 100 nursing specialties—as well as advanced nursing degrees—nurses don’t need to stay in the same career track for years unless they choose. Movement can be lateral—from one specialized area to the next—or progressive, where nurses climb the ranks to supervisory or administrative positions.

With the great number of nursing jobs available at healthcare facilities, many nurses looking for employment can write their own ticket, choosing what kind of nursing work they’d like to do and the hours and days they want to work.

But Nuelle-Dimoulas says nursing goes beyond direct patient care. She says nurses with advanced degrees are policy makers, researchers and decision makers.

“Nursing is as creative as one sets their mind to be,” Nuelle-Dimoulas says. “The opportunities in nursing are expansive. Whatever piques your interest, there is a field of nursing for it. I’ve lived that creativity myself.”

Before accepting her position at Altru in 2016, Nuelle-Dimoulas—who is a native of Langdon, North Dakota—used her nurse and nurse practitioner degrees in a variety of ways from editing a medical journal to developing healthcare applications in IT and working in international medicine in Dubai, United Arab Emirates.

“I would challenge everyone to expand their view of nursing with a dose of creativity and imagination. The possibilities are limitless,” she says. “I have the benefit of looking at my career in a rear view mirror and I can see just how incredible it is.”

Do what you love. Make a difference. Join our team of over 4,000 health professionals and support staff committed to caring for the region for more than 100 years. Learn about nursing career opportunities at Altru Health System.

Heart Disease: What Is and Isn’t in Your Control

It's Altru - Published on April 17, 2017

heart-disease-in-control-tipsBeating an average of 115,200 beats per day, hearts provide the lifeblood of oxygen and nutrients to keep our bodies alive and well. A lot goes on in those four little chambers.

Dr. Rabeea Aboufakher, section chief of cardiology at Altru Health System, explains some of the most common heart diseases, as well as risk factors and lifestyle prevention tips to keep your ticker in top shape.

Coronary artery disease (CAD)


  • What it is: Coronary artery disease (CAD) is a chronic disease characterized by plaque buildup in the walls of the coronary arteries. These are the small arteries that run on the surface of the heart muscle and provide the heart with blood. Blockage can develop slowly to cause angina (chest discomfort on exertion) or suddenly to cause a heart attack.



  • What you can control: High blood pressure, diabetes and high cholesterol through lifestyle modifications or medication. Smoking cessation is particularly important. Patients with CAD will also benefit from a diet low in saturated fat and cholesterol, as well as regular exercise. Weight is important, but diet and exercise matter even more. Certain medications such as aspirin and a statin reduce the risk of future cardiac events.



  • What you can’t control: Family history plays a role. While you can manage high blood pressure and diabetes with lifestyle and/or medication, the onset of these conditions is not always in your control.



  • Treatment: When patients suffer from a heart attack caused by a blocked coronary artery, opening the artery with a stent is life-saving. At Altru, we have a team on call 24 hours a day to make sure this therapy is offered quickly and effectively. In certain situations, bypass surgery is needed and this too is offered at Altru.


Peripheral arterial disease (PAD)

  • What it is: Peripheral arterial disease (PAD) is a chronic disease characterized by plaque buildup in the large peripheral arteries, such as the arteries that supply the lower extremities. In severe cases, it can lead to non-healing wounds and possible amputation. A common symptom is pain and fatigue in the leg muscles with walking.



  • What you can control: Similar to that for CAD, high blood pressure, diabetes and high cholesterol through lifestyle modifications or medication. Smoking cessation is particularly important.



  • Treatment: When the arteries are blocked, procedures such as balloons, stents or bypass surgery are needed. Altru offers all these treatments.


Congestive heart failure (CHF)

  • What it is: Congestive heart failure (CHF) is a syndrome caused by inability of the heart muscle to pump blood adequately, failing to meet the demand of organs and tissues. Symptoms are related to fluid overload, such as shortness of breath and leg swelling. Any heart disease can result in CHF when advanced. Close follow-up is necessary to avoid fluid accumulation and hospital admissions.



  • What you can control: Follow a low sodium diet and occasional fluid restriction. Keep regular check-ups.



  • Treatment: Certain patients should have a defibrillator to protect them from dangerous arrhythmia. For others, a permanent monitor placed in the pulmonary artery can track fluid status and direct therapy. Altru offers all these services and will soon launch a special congestive heart failure clinic. 


Atrial fibrillation 

  • What it is: Atrial fibrillation is a very common arrhythmia. The atria, or the upper chambers of the heart, fibrillate (instead of squeeze), causing fast heart rates. Symptoms include palpitations, dizziness, shortness of breath and chest pain, among others.



  • What you can control: Unfortunately, the only thing you can do is be aware. Keep regular check-ups.



  • What you can’t control: Family history.



  • Treatment: Medications are often needed to slow the heart rate. Blood thinners protect from blood clot formation inside the heart. Different treatments are available, including ablation procedure now offered at Altru.




Patients who already have heart disease benefit from regular visits with their cardiologist to assess symptoms and evaluate risk. For all, checking blood pressure and cholesterol levels regularly is important to reduce risk. Stress testing can also be helpful if symptoms occur or are difficult to evaluate.

Aboufakher, RabeeaDr. Rabeea Aboufakher is the section chief of cardiology at Altru Health system. He is board certified in cardiovascular disease, interventional cardiology, internal medicine and geriatric medicine. He is a fellow of the American College of Cardiology and the Society of Cardiovascular Angiography and Intervention. In his free time, Dr. Aboufakher enjoys reading, swimming and playing table tennis.

 

 

See also:

Music Therapy + Child Life | Calming Patients, Healing Patients

Altru Moments - Published on April 7, 2017

Everly is a sweet and smiley toddler who happens to have MMIHS (megacycstis microcolon intestinal hypoperistalsis syndrome), a rare genetic syndrome. She receives music therapy and child life services during her weekly visits to Altru for dressing changes and lab draws. These appointments had always caused a sense of fear.


Yet, music therapy and child life services at Altru have helped melt away Everly’s anxiety.


“We are able to sing favorite songs with Everly, her parents and the staff doing the procedure,” explains Leslie Saulsbury, Altru’s Board-Certified, Licensed Music Therapist. “This allows her to feel more comfortable, which results in the procedures going much smoother."


“Through the use of age appropriate distraction, toys, and comfort positioning, Everly is able to complete her weekly appointments with a smile on her face,” adds Melissa Swenson, Altru’s Certified Child Life Specialist.


Though music therapy and child life make a “dream team,” as Everly’s family calls it, music therapy and child life can co-treat, but frequently work with separate patients throughout Altru Health System.


Rocking & Rolling & Healing
Leslie provides music therapy for patients of all ages in the medical/surgical unit, orthopedics, cardiac care, pediatrics, inpatient psychiatry, NICU, intensive care, surgical critical care, palliative care and oncology.


She uses clinical and evidence-based music interventions to help patients accomplish individualized goals. Through music, she helps patients like Everly reach non-musical goals, such as managing pain, anxiety or stress, enhancing wellness, expressing feelings or improving communication.



“To do this, we can play music, listen to music, write songs, improvise or engage in music-assisted guided imagery and relaxation,” explains Leslie. “Anyone can participate, regardless of musical ability. I’m using music to help patients cope during their hospital stay.”


And if patients are coping well, their whole hospital experience can have a more positive outcome.


In 2015, Altru made history by being the first hospital in the state of North Dakota to fund a music therapy position, and thousands of patients and families have been able to benefit from these services.


Instruments, equipment, and recorded music used in the program are funded by grants and donations. All music therapy services are complimentary for our patients.


Playing & Exploring & Healing
The child life program, which has been in place at Altru for 23 years, is a complimentary service to pediatric patients and families.


“I help families cope with the challenges of hospitalization, illness and end of life by providing age-appropriate information, emotional support, developing coping strategies and guidance to parents, siblings and extended family members,” explains Melissa. “I help explain a child’s diagnosis in ways they can understand, reducing fear, anxiety and pain.”



Melissa provides support using coping strategies and distraction with patients for procedures such as catheters, lab draws, IV starts, scans and dressing changes. When kids are prepared for what they will experience and are distracted with age appropriate activities, they will cope better with their procedure and it will be more positive for the medical team and their family.


Child Life is run by donations and is a complimentary service to approximately 2,500 pediatric patients and families a year.


Everly’s mom, Erin, shares, “Music therapy and child life has helped us make a scary experience for our daughter each week an enjoyable one. We are beyond grateful for this. She truly loves seeing these wonderful therapists each week and taking part in the singing and dancing.”


For more information about the music therapy program, or questions about donations, contact Leslie Saulsbury, MT-BC/L at lsaulsbury@altru.org.


For more information about the child life program, or questions about donations, contact Melissa Swenson, CCLS at mswenson@altru.org.


See also: Providing Comfort to Children through Song

Staying On Course: Tips for Golfing with Joint Pain

It's Altru - Published on April 4, 2017

Professional golfer Phil Mickelson was preparing to compete in the 2010 U.S. Open when, unexpectedly, his joints started to ache.

When the tests came back, Mickelson learned he had psoriatic arthritis. Genetics, the environment, viruses and the body’s immune system are all factors that might cause psoriatic arthritis. Mickelson has been back on his professional golf game for several years, thanks to early diagnosis and treatment.

Altru Advanced Orthopedics providers, Christopher Howson, DC, Jordan McIntyre, DC, Jeremy Gardner, MD, and Wade Olson, NP, participating in the Special Olympics North Dakota Golf Classic.



Many golfers are playing with pain, such as tendinitis, sore muscles and arthritis. Swinging a golf club requires moving at a very high speed in a short amount of time, increasing the risk of injury. We called on Dr. Jeremy Gardner of Altru Advanced Orthopedics to teach us where golfers are feeling the pain and how you can prevent it.

Golfing affects the entire body. Improper form can affect multiple joints, with special consideration for the lead wrist, elbow, shoulder, lower back, hips and knees. Swing alterations, such as a shorter backswing or proper weight shift, may decrease wear and tear on the body.

Keep in mind: it's important to properly stretch and warm up before and after a round to reduce pain and injury. Stretching and strengthening can help keep you healthy and improve your game.

Here are some other injury prevention tips for different body parts.


(Click to view larger.)


Next Steps
If you've tried these techniques and are still experiencing pain, it might be time to visit Altru Advanced Orthopedics. Altru's experienced orthopedic providers can work with you to understand what's causing your pain, and how to fix it. This might include physical therapy, or it could be time to consider joint replacement.

Altru offers anterior approach hip replacement, which allows for a smaller incision and less damage to muscles, resulting in less pain and faster recovery. With proper recovery time and physical therapy, you can get back to the links sooner.


Golf is a great way to stay active. It’s beneficial for strength, balance, coordination and range of motion. If walking is a possibility, aerobic exercise improves the heart, lungs and muscles and helps with weight control, mood and sleep.


See also:




Dr. Jeremy GardnerDr. Jeremy Gardner is an orthopedic surgeon at Altru Health System. Board certified in orthopedic surgery, he specializes in joint replacement, including direct anterior approach to hip replacement, osteoarthritis, rotator cuff surgery and sports medicine. Outside the office, Dr. Gardner is an active golfer, runner and scuba diver. He also enjoys hunting, fishing and archery. 

No Polyp Left Behind | Randy’s Altru Moment

Altru Moments - Published on March 31, 2017

For the past six years, Randy Schroder of Minto, North Dakota, has been visiting Altru’s Urology Department for regular six-month check-ups. In 2011 he was diagnosed with bladder cancer and had tumors removed, and has been keeping a close eye on it ever since.

During a routine urology appointment in April of 2016, Randy had a different nurse than usual. Susan Bostad, RN, who is usually in procedural services, was filling in that day.

“She was so sincere,” explains Randy. “She asked me, ‘Randy, have you thought about having a colonoscopy done? I really care about the patients I work with.’ I had one years ago because of abdominal pain, but hadn’t considered it recently.”

Because of his history of bladder cancer, Randy’s risk was higher. He was over 50. Perhaps it was time for a routine screening?

Do I Really Need a Colonoscopy?
Randy casually mentioned it to his wife on the drive home, and she set up an appointment. Two weeks later, he was getting a colonoscopy.

“The whole process felt like 10 minutes,” shares Randy. “Mid-way through the procedure, though, I remember my doctor gave the nurse a head nod, and I don’t remember a thing after that.”

Randy’s “10 minutes” was really two hours.

Dr. Howard Hack, a gastroenterologist at Altru Health System, had spotted ribbon-like tissue that was a different kind of polyp—a flat colon polyp.

“Flat colon polyps went unnoticed until 10 years ago,” explains Dr. Hack. “My former colleague at Stanford, Dr. Roy Soteikno, published a landmark article in March of 2008 about them. Flat polyps account for about 10 percent of all colon polyps. They are thought to have at least the same potential for developing into colon cancer as regular polyps, and in fact, some of them probably are more pre-cancerous.”

Dr. Hack continued, “Flat polyps are only visible by observing subtle changes in the lining of the colon. Sometimes, they are covered with a thin mucous-like layer which betrays their location. If you miss it, then you are at risk for colon cancer.”

Peace Out, Polyp
Thanks to Dr. Hack’s trained eye, Randy’s flat polyp was quickly and painlessly removed before it turned into cancer.

“I use the technique called Endoscopic Mucosal Resection,” explains Dr. Hack. “This involves injecting a bubble of saline mixed with a blue dye, which lifts the polyp tissue away from the lining of the colon, allowing me to identify the border. I remove the polyp and secure the site with temporary clips which fall off after a few weeks. This allows the site to heal with low risk of bleeding.”

Colon cancer awareness

Randy is relieved Dr. Hack was skilled in recognizing this type of polyp and promptly removed it. “He said it was about the size of a quarter,” shares Randy. “He sent it off to be tested, and the results were benign. But, I looked it up online and found that if left untreated, it almost always turns to cancer.”

Randy’s future care plan involves an annual colonoscopy, and he regularly visits urology for check-ups.

“I saw nurse Sue again at my bladder check six months after having the flat polyp removed,” says Randy. “She was so happy to hear I had my colonoscopy done. Her encouragement might have saved my life.”

The 6’4” diesel mechanic thanked her and gave her a heartfelt hug.

“I can’t believe the difference she made. If I hit the lottery tomorrow, I’d give Sue a million dollars,” beams Randy. “She definitely prolonged my life.”

Due to advancements in detection and treatment, colorectal cancer death rate has been dropping for more than 20 years. When detected early, it’s treatable. Colonoscopy is the best line of defense in reducing risk. Schedule yours today >>

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 altru.org/colon.

View More Posts from It’s Altru

Other Altru Blogs

Enrich  |  Altru Moments  |  Faces of Altru  |  It’s Altru  |  Modern Mom