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.

The Coconut Oil Controversy

Enrich - Published on April 28, 2017

“72 percent of Americans think that coconut oil is a healthy oil to be used for cooking , yet only 37 percent of nutrition experts agree.” -The New York Times 

Coconut Oil

There are three kinds of people in this world. People that use coconut oil religiously, people that believe coconut oil is “bad for you” and people that just have no idea what to think of it so they stick to butter and/or olive oil.

Nonetheless, the demand for coconut oil has skyrocketed in the past decade, likely due to the higher fat, lower carb diet trend, as well as coconut oil’s fatty acid profile. Claims have been made that coconut oil is a healthy substitute for a variety of other cooking oils; however, many still believe that it poses a health concern since 92 percent of its composition is saturated fat.

What most people don’t know is that not all saturated fat is created equal. There are a variety of fatty acids that make up saturated fats, with some being more beneficial or harmful than others.

Fat Basics
In order to better understand why coconut oil is all the rave, one must understand the fundamentals of fat. There are essentially three types of fat:  saturated, unsaturated, and trans fats. All fats are made of fatty acids (carbon-hydrogen chains), which are categorized by how long they are (based on the number of carbons) and whether or not these chains contain double bonds. Saturated fats have no double bonds, while unsaturated fats have one (mono-unsaturated) or more (poly-unsaturated) double bonds.

Coconut oil has become increasingly popular because its purported health benefits appear to be related to its high content of medium-chain fatty acids (MCFAs). Simply put, medium chain fatty acids are basically medium-sized fat molecules or structures. MCFAs are always saturated and contain 6-12 carbons, while long chain fatty acids (LCFAs) contain 13 carbons or more. Whether a fatty acid chain has more or less than 12 carbons matters significantly, because the body finds it easier to absorb short- and medium-chain fatty acids. Their smaller chain lengths allow them to bypass the fat storage pathway and, as a result, are sent directly to the liver to rapidly become energy for the brain and muscles. As a result, coconut oil is in high demand (especially with athletes) because it is the largest food source of MCFAs, a quick source of energy. 

MCT Oil
If you’ve never heard of the previously discussed MCFAs, chances are you may have heard of MCT (medium-chain triglyceride) oil. The fatty acids found in MCT oil are almost exclusively MCFAs. Almost 100% of the fatty acids found in MCT oil are MCFAs, which are quickly converted into fuel for the body to use. Besides MCT oil, other good sources of MCFAs include coconut oil, palm oil as well as grass-fed butter, cheese, whole milk and full fat yogurt. 

Coconut Oil Composition
Coconut oil is composed of both medium-chain fatty acids and long-chain fatty acids. Approximately 62 percent of coconut oil’s fatty acids are MCFAs (medium chains), with the remaining being LCFAs (long chains). For some reason, many confuse the composition of coconut oil with MCT oil, yet they are not identical. You could say they are like cousins—some of their “DNA” matches, but not all of it. Though coconut oil has MCFAs in it, MCT oil is more concentrated and is nearly 100 percent MCFAs.

The big debate on whether or not coconut oil is beneficial to our health arises from the ratio of medium-chain fatty acids to long-chain fatty acids. This is because MCFAs raise both HDL (“good”) and LDL (“bad”) cholesterol. Therefore, it is important to note that coconut oil is not a “win-win” situation when it comes to improving cholesterol levels.



Extra Virgin vs. Refined
Whether it is olive or coconut oil, extra virgin (unrefined) is the better choice. Virgin oils are extracted from one pure source, therefore are less processed.

Refined oils, like canola, are purified via acid and contain fewer nutrients due to chemical processing. These oils are extracted from many sources. For instance, canola oil is an industrial product extracted from several cultivars of rapeseed. Some of these oils are chemically transformed into trans fats during this combination process. In fact, researchers at Health Canada found that canola oil contained the most trans-fat at 2.4 percent when compared to other refined oils. The processed food industry considers refining these oils essential to preserve its sensory value, so they sacrifice health for things like texture, scent and visual appeal. 

Smoke Point: Choosing the Right Fat
When it comes to cooking, the type of fat you choose matters. Assessing the smoke point of fats is a critical part of healthy cooking. Smoke point is the temperature at which a fat starts to burn and smoke. When you cook foods with a fat that’s been heated beyond its smoke point, not only do you end up with a burnt flavor, but you destroy beneficial nutrients.



For very high temperatures (frying in a wok or searing meats), choose avocado oil; it won’t burn or smoke until it reaches 520F! For mid-temperature cooking, use virgin coconut oil, grass-fed butter or virgin olive oil. Choose extra virgin olive oil for salad dressings or already cooked foods, but do not use for high heat cooking.


  • High temperature cooking - Broiling - Avocado Oil

  • Medium temperature cooking - Sauté - Coconut Oil, Butter, Virgin Olive Oil

  • Low temperature cooking - Salad Dressings - Virgin Olive Oil


Coconut Oil vs. Butter
Both coconut oil and butter are significantly high in (saturated) fat, therefore very high in calories. The bottom line is that each has its place in cooking and neither one is superior to the other. When it comes to cooking, they both have the same smoke point so choosing one or the other depends on the flavor profile you’re looking for. If you’re making a curry or stir fry, coconut oil might be your best bet, while you might want to stick with butter to make a delicious chicken piccata.

Pros (+) and Cons (-)
Coconut Oil

  • Antibacterial properties

  • Anti-inflammatory properties

  • Hair and skin care

  • Source of antioxidants

  • Minimally processed (extra virgin)

  • Greater source of MCFA’s

  • Slightly more calories


Grass-Fed Butter

  • Less saturated fat

  • More unsaturated fat

  • Packed with vitamins A, E and K

  • Anti-inflammatory properties

  • Provides more long-lasting energy

  • Composed of palmitic acid, which is associated with plaque build up

  • Can be salted; look for unsalted, grass-fed butter


Dietitian Takeaway
Coconut oil can be used in a variety of ways. While many use coconut oil for cooking or baking, coconut oil can be found in a variety of lotion and soap products due to its antibacterial, antioxidant and anti-inflammatory properties. These properties are just a few reasons why coconut oil has become increasingly popular over the last few years. Another reason includes its fatty acid composition. Coconut oil is a good source of medium-chain fatty acids, which can be converted into quick energy to fuel the brain and muscles.



Nonetheless, coconut oil should not be considered a “superfood” as it has its downfalls. Like other fats, coconut oil is very high in fat and calories, therefore it should be used sparingly to cook and flavor foods. Some may confuse coconut oil and MCT oil, though they certainly have their differences. MCT oil is almost entirely composed of medium chain fatty acids, providing quicker, more efficient energy. On the other hand, MCT oil is typically unflavored and more expensive. It may also cause digestive issues if consumed in large quantities, so one should start with small doses if considering this product. Consuming 1 tbsp (20g) of pure MCT oil, or 5 tsp of virgin coconut oil, 1-3 times/day with food is the current research-supported supplementation protocol.



At the end of the day, our diets should be comprised of primarily unsaturated fats from natural sources like nuts, seeds, olives and avocados, while leaving a spot at the table for saturated fats like coconut oil, as they truly do come with some health benefits... and tons of flavor, of course.

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

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.

The Location of Your Headache Can Help Treat It

Enrich - Published on April 17, 2017

HeadacheAny headache is a bad headache, but a slight adjustment may fix it. With Over 150 different kinds of headaches known, these annoyances have numerous ways to interrupt your day and make it difficult or nearly impossible to concentrate.

“Tension headaches are the most common we see, as people sit for longer periods and carry stress in their upper shoulders and neck,” says Jordan McIntyre, DC, chiropractor with Altru Health System. “We also see headaches from the jaw, because people will clench their teeth from stress or sitting, and those muscles connect to the top of the head and make you feel like your head is throbbing.”

Sit Up Straight
Posture, too, is important, Dr. McIntyre notes. It’s far easier to get stiff and tight in the upper neck if core muscles are inactivated and the head and spine are unsupported.

“With tension and cervicogenic headaches, we typically look to see if anything needs to be adjusted. A lot of times, an adjustment or muscle release will get rid of the headache,” says Christopher Howson, DC, chiropractor with Altru. “Decreasing irritants in the spinal and musculoskeletal system helps a surprising amount when treating headaches.”



A Different Beast
“A lot of people think, ‘Oh, it’s a migraine,’ when they have a particularly bad headache, but migraines aren’t your typical headache,” Dr. Howson says. “Migraines will have a throbbing or pulsing quality, and tend to interfere with everything you do. They get worse with exercise or exertion, and many people will be nauseated or have trouble with light and sound.”

Some people who experience migraines will know beforehand due to a neurological sensation called an aura. A kind of warning, auras can be anything from seeing flashing lights to briefly losing the ability to speak correctly to smelling something that isn’t there, such as campfire smoke.

headache graphic

Where’s Your Pain?
The location of your headache pain gives a better idea of how to treat it.


  • Base of skull—Cervicogenic headaches feel a lot like tension headaches but are often caused by muscle spasms in the area and can be treated with an adjustment of vertebrae.

  • Side of the head—Often, when pain is localized to the side of the head, a chiropractor will work on jaw muscles, even from inside the mouth.

  • Neck—For headaches caused by stiff muscles in the neck, chiropractors use dry needling to release tension at specific trigger points.


Altru’s chiropractors can treat your pain from head to toe. Schedule an appointment with Dr. Howson or Dr. McIntyre by calling 701.732.7620.

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.

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