Trisomy 21 Diagnosis: When Plan B is Better

Altru Moment NatalieThis guest blog post was submitted by Maranda Everson of Duluth, Minnesota. She and her husband, Brent, gave birth to their second child, Natalie, at Altru Health System just over a year ago.

As we celebrated our daughter, Natalie’s, first birthday, I stole a few moments to sit and reflect upon the past year and her birth. Natalie was diagnosed with Trisomy 21 (Down syndrome) at 20 weeks gestation. We were scared. Scared of the unknown. Scared of the medical complications associated with Trisomy 21. Scared of the diagnosis itself.

We grieved for the loss of the life we had envisioned for our little girl. We grieved for this perfect life we had imagined. We grieved for the loss of our Plan A. You know, the one where everything works out to be happily ever after.

Instead we found ourselves dealing with the upside-down, inside-out version where nothing goes as you had planned or envisioned.

While reflecting on Natalie’s birth and diagnosis I find myself asking: What were we worried about? I realize now that it was the unknown that we feared, not the Trisomy 21.

Altru Acknowledgements
Throughout our journey, we were blessed by many members of Altru’s staff. They helped us navigate through a time when we briefly lost our bearings.

Words could never express our overwhelming gratitude. Words will never repay the kindness and professionalism that was bestowed upon us throughout my pregnancy and the birth of our beautiful Natalie.

A special thank you to… 

  • Dr. Andrea Lays for referring us to a perinatologist, guiding us through the initial diagnosis, providing resources and giving us peace of mind. She took amazing care of me. During the first few months of Natalie’s life, filled with a hectic schedule of doctor appointments, she checked in regularly. Yes, she wanted to hear about Natalie, but she also wanted to hear about my health and well-being. That meant a lot.
  • Chunky CheeksDr. Panda, Dr. Dwarakanath and Dr. Mallipaddi for their wonderful care of our little Natalie and for making our stay in the Neonatal Intensive Care Unit as pleasant as possible. They did an amazing job navigating all the medical complications that Natalie faced at birth and for that we are forever grateful!
  • The NICU nurses for their delicate care of Natalie. They made us laugh, let us cry and assisted us in experiencing and preserving Natalie’s “firsts.”
  • Jodie Storhaug, occupational therapist, for all your support, for finding what worked best for Natalie and teaching us new methods to help us care for our daughter. I still remember the mini celebration we had when she drank her first 60 milliliters and when Dr. Panda removed her feeding tube.
  • Mandy Anderson, RN, for her comforting words and allowing us to see that this world we were about to enter wasn’t as scary as we’d imagined. It was actually magical, amazing and a privilege to experience.
  • Tiffany Galletta at the pediatric lab, for being so gentle while poking Natalie’s tiny heals what seemed like every other day.
  • Dr. Jennifer Peterson, who was so thorough. She took a tremendous amount of time caring for Natalie and guiding us through the first months of a different type of parenthood. Knowing Natalie was in great hands was such a relief. Dr. Peterson is not only an amazing doctor; she is an amazing, caring person. After experiencing her care, she will be my standard of measurement for medical care with my children.

Natalie Eight MonthsPlan B, or life with Trisomy 21, was scary at the time of diagnosis. Today, we are so grateful our Plan A was thrown out the window. We wouldn’t change anything and wouldn’t have been fearful of Plan B had we known all along how amazing it would be.

Valerie’s World-Class Experience at Altru

Val Altru Moment

Photo captured by Savannah Hayes, Valerie’s daughter, owner of In His Image Photography.

Twelve major surgeries. Twenty hospitalizations. Ten medical centers. Four states. Over the last 35 years, Valerie McGinty hasn’t been a stranger to medical care.

“I think I’m qualified to speak from a patient’s point of view,” she explained in a recent letter to Altru Health System. “I feel compelled to tell someone what happened to me while I was an Altru patient.”

In September 2014, Val was scheduled for her first surgery at Altru: a hernia repair.

Easing Anxiety
Because of past experiences with hospitals, Val feels anxious before any surgery. “I approached my upcoming visit to Altru with dread.”

After meeting with Dr. Billie Jo Grieve, general surgeon, Val’s fears diminished.

“Dr. Grieve stands out as the best of the best,” Val raves. “She assured me she could do the surgery, but that Mayo Clinic had a special hernia department. If I felt more comfortable, I could go there. My insurance didn’t allow it. For that, I’m so grateful.”

“She allowed time for every question and concern. She made me feel like I could make intelligent decisions regarding my care, and that my knowledge of my own body was valid and respected.” Val explains, “Dr. Grieve exhibits a comforting ability to make you feel safe in her care. I cannot tell you how relieved I felt when I left her office.”

A Hard Stick
While in the prep room, Val informed the nurses that she was often a “hard stick” when setting up an IV.

“In the past, I’ve had technicians try 17 times—no exaggeration. It took them three attempts to put in my initial line, taking extra care to be as gentle and pain-free as possible.”

Other Standouts
Vicky Haines, surgical resident, also stood out to Val. “She was the pinnacle of professional and personal care. Her genuine compassion was visible in every encounter. She seems to take real joy in caring for her patients.”

Val had to return to the emergency room twice after discharge. “There, I was treated with the same respect and dignity.”

Nurses and Aides
Val shares, ”Aides are the ones who do the nitty gritty, often embarrassing, care. They can make you feel uncomfortable or comforted. My aides were wonderful in their gentleness and respect for my dignity.”

“Nurses are the frontline caregivers. They bear the daily responsibility for their patients’ care, while being professional, compassionate, patient and tolerant of a hundred different complaints,” explains Val. “The nurses I had at Altru are without a doubt the finest I have ever had. I have never had an experience like this where every single one of my nurses was exactly who I needed, at exactly the right time, for every moment I was under their care.”

World-Class Experience
Val ends by saying, “In my opinion, Altru Health System is a world-class facility—in every sense. Every person genuinely seemed to care about what effect their position had on me. They treated me like an intelligent, whole person. I would absolutely recommend Altru’s care to everyone I know.”

Have you experienced that moment in care when you knew your life had changed for the better? We’d love to hear your story. Let us know.

Cartilage Restoration Saves Sydney’s Basketball Career

Sydney Boike“Basketball teaches you to be driven, goal-oriented and disciplined,” explains Sydney Boike, a senior at Crookston High School.

Sydney has been playing basketball since she was five years old. Inspired by her dad, a former college basketball coach at Clarke University, Sydney’s love for the game has only grown through the years. At 5’11”, Sydney’s position is versatile—playing as a shooting guard or small forward.

The Injury
In February of 2014, during the final game of her junior season, Sydney went for a loose ball. She planted her foot and twisted her knee on the way down. Even though she was walking afterwards, Sydney’s knee would never be the same again.

With her mom by her side, Sydney saw Dr. Darin Leetun of Altru’s Orthopedics. “They did an MRI, went in with a scope and took out broken cartilage,” explains Sydney. Cartilage repair was the next step, and an OATS (osteochondral allograft transfer system) procedure was scheduled for May.

“Going in, I was freaked out, and my mom was emotional,” explains Sydney. “Dr. Leetun was great about answering all our questions and easing our nerves.”

The Procedure
“Cartilage restoration treats injuries that are more like a pothole,” explains Dr. Leetun. “Think of a pothole in the road. To fix it, you fill in that one spot instead of replacing the whole road. Cartilage replacement is similar—we fill in the hole instead of replacing the entire joint.”

Cartilage restoration is best for those ages 15 to 50 with near full-thickness cartilage loss.

“Without adding cartilage, Sydney would have struggled to continue playing,” explains Dr. Leetun. “Eventually, she would have had to replace the joint or quit. Cartilage restoration was the best option.”

After taking the summer off to heal, Sydney was fully recovered and cleared to play again in October.

From Altru Clinic in Crookston, Carter Kunz, physical therapist, and Daniel Struthers, physical therapy assistant, really stood out to Sydney. “They pushed me throughout the process and were a great support system.”

Sydney’s Future
Even though she missed playing with her summer team, the Minnesota Stars, Sydney was focused on the bigger picture of getting well for senior year and college basketball. After being recruited during her junior year, she committed to the University of North Dakota in July.

“It was an easy decision,” she shares. “I have great memories from basketball camp. I like that it’s close to home. Basketball has always been a big part of my family’s life.”

Sydney's Family

At UND, Sydney will major in biology, with future plans to attend medical school. “I’ve always wanted to help others in my career. My studies have been just as important as sports.” Sydney is interested in specializing in neurology or hematology someday.

Fully recovered and in the middle of a busy basketball season, Sydney is taking extra care of herself these days. She’s icing her knee, listening to her body and taking breaks as needed, after practice and games. Follow-up care is only necessary if problems arise.

“Most of all, basketball has taught me what it means to be a team and work well with others toward a goal.” And that’s exactly what Sydney did with her team at Altru’s Orthopedics

New Knee, New Energy for Teaching

Sandy EspeSandy Espe has taught business classes at Grand Forks Central High School for the past 30 years. She’s passionate about teaching and helping her students succeed.

Last year, Sandy could no longer give it her all.

“I felt like I was jipping my students of having a teacher who was able to put her whole self into teaching,” confesses Sandy. “It was awful feeling so miserable and trying to be myself in front of the class.”

By spring, Sandy had had enough. She underwent full knee replacement surgery of her left knee in May 2014 with Dr. Robert Johnson, whom she knew through church.

The Time is Now
With arthritis in both knees, Sandy’s pain started several years ago. At age 51, she knew it was time to seriously consider surgery. Living in Grand Forks, having surgery close to home was also important to Sandy.

“Looking back, I am very thankful I had the surgery. I put it off thinking I wanted to wait as long as possible,” she explains. “However, my quality of life was horrible.”


“Trevor Lennon is a first-year teacher at Central High School in Grand Forks. I feel blessed to be able to be healthy again so that I can mentor him through his first year of teaching. We are also co-advisors for Future Business Leaders of America (FBLA).”

Sandy’s honest advice to anyone contemplating knee surgery: “Do it! It’s painful, and the exercises hurt a lot at first. However, it is well worth it in the long run, when you’re able to walk again without pain.”

Recovery and Returning to School
Sandy cannot say enough about her care team. “Dr. Johnson is wonderful, as are his nurses and therapists. They made me feel at ease. Recovery was especially great. It was quiet, and I felt like I got a lot of attention.”

Sandy was able to recover and concentrate on physical therapy over summer break. She returned to teaching in the fall.

“I can now last the whole day without crying in pain by the time I get home,” she smiles. “If I am going to do a good job teaching, I need to be up and on my feet walking around, helping kids in my classroom. I want to be the best teacher I can be, and I am so happy I can concentrate on my students again.”

Is joint pain getting in your way? Our goal is to get patients back to an active, pain-free lifestyle as quickly as possible. Learn more about Altru’s Joint Replacement Center.

Deep Sea Fishing with New Shoulders

Ralph's AMRalph Osterhout is looking forward to a trip to Mexico in January. Deep sea fishing is on his list of things to do, and with two brand new shoulders, he’s ready to enjoy his upcoming adventure.

Through Altru’s Orthopedics, Ralph underwent total joint replacement of his right shoulder in May, followed by his left shoulder in September.

An American veteran, Ralph’s shoulder damage started in the service, with three operations in 1969. “Later, when I was experiencing a great deal of discomfort, I was diagnosed with degenerative arthritis,” Ralph explains. “My joints were completely destroyed.”

Quality of Care
Ralph raves about the quality care he received at Altru.

“All the nurses were wonderful. They controlled my pain so well. Not only did they provide excellent care for me, but they also cared for my girlfriend, Linda, during my surgery.”

Linda shared, “As a former nurse, I was truly impressed by everyone I encountered. Before Ralph went into the operating room, one of the nurses gave me a big hug to ease my nerves. She even returned the following day before her shift, just to see how we were doing. The nurses at Altru know how to have fun, while still remaining highly professional. In fact, we’re creating a memory book of our experience.”

Ralph smiled, “We actually brought flowers and chocolates to the pre-op nurses the day I was released—that’s how much we appreciated them.”

Coin momento

Ralph keeps this thoughtful note and Canadian coin from a nurse in his wallet. It serves as a reminder of the wonderful experience he had at Altru.

Quality of Life
Today, Ralph’s pain is completely gone, and his range of motion has greatly improved.

“Before surgery, my range of motion was just a tiny box in front of me. Now, I can put my hand behind my back and raise my arm above my head. These movements sound simple, but they make a world of difference in daily life. It’s amazing to be able to move again.”

From the little things, like scratching his own back and getting dressed, to the big things, like deep sea fishing off the coast of Mexico this winter, Ralph is truly enjoying life with his new shoulders.

Is joint pain getting in your way? Our goal is to get patients back to an active, pain-free lifestyle as quickly as possible. Learn more about Altru’s Joint Replacement Center.

Living and Hunting with a New Knee

SamsonA carpenter most of his life and currently working in Maintenance at the University of North Dakota, Dan Samson relies on his hands and knees to get his job done every day. When he’s not pounding nails, you can often find Dan enjoying a fall day deer hunting with the guys.

The last few years haven’t been as enjoyable, however. Living with a bum knee has its drawbacks. Even walking was becoming a challenge for Dan. When the pain became unbearable, he scheduled an appointment with Dr. Jeremy Gardner of Altru’s Orthopedics.

“My knee was knuckle-on-knuckle,” explains Dan. “The constant aching would wake me up in the middle of the night.” Dan underwent total knee replacement surgery with Dr. Gardner on July 18, 2014. Three days later, Dan was back home and starting therapy through the Sanny and Jerry Ryan Center for Prevention and Genetics.

“Altru staff helped him remain as comfortable as possible,” shares Dan’s wife, Sandy. “I was involved throughout the process – at the pre-op education class, where all our questions were answered, and during therapy sessions.”

After eight weeks of intense therapy, Dan returned to work September 15. “When the therapists tell you to do the exercises, make darn sure you do them,” stresses Dan. “It’ll make all the difference.”

Dan’s Advice
For someone considering joint replacement surgery, Dan’s advice is straightforward: “Don’t wait. I waited three years too long. My cartilage was completely gone, so it was bone-on-bone by the time I went in.”

Today, the pain is gone. Dan continues to get better every day. He’s able to walk straighter and faster, do the work he was meant to do and, most importantly, enjoy a pain-free life, including his favorite hobby.

“I’m a hunter,” Dan grins proudly. “I’m excited about deer hunting this fall with my son, brother and nephew. I won’t be dragging behind the rest of the crew.”

Is joint pain getting in your way? Our goal is to get patients back to an active, pain-free lifestyle as quickly as possible. Learn more about Altru’s Joint Replacement Center.

ASTYM Therapy Keeps Matt Running

Astym AMMatt Mutzenberger, 48, began running three years ago. Not long after starting, he began experiencing a variety of injuries ranging from soreness to shin splints. After an initial recommendation from Dr. William Haug Jr., sports medicine, he began therapy sessions with Stephanie Barstad, an Altru physical therapist.

Stephanie, also a runner, began to change Matt’s form to reduce the risk of repeat injuries. In the spring, Matt experienced pain in the front of his ankle, which worsened with running. At that time, he was training for Grandma’s Marathon in Duluth.

She selected ASTYM therapy as the key treatment.

“ASTYM works well with active people. Patients are usually more motivated,” Stephanie said. “ASTYM allows patients to keep doing what they enjoy.”

How ASTYM Works
ASTYM therapy addresses problems such as scarring, fibrosis and degeneration that often occur in soft tissues. The therapy eliminates or reduces unwanted scar tissue that may be causing pain or movement restrictions.

Most patients experience a significant change in their symptoms after just three to four visits. ASTYM combines therapy sessions with exercise to heal patients.

“After the first treatment, I felt great. I’m 100 percent convinced ASTYM is what helped,” Matt said. “I felt like a new person.”

“Patients experience less pain, and I can see the results,” Stephanie explained.

TC Marathon

Running Grandma’s
After his treatments, Matt was able to run Grandma’s. “Steph didn’t just do her job, she cared about me. That’s a big deal,” he said.

Matt hopes to continue to run the rest of his life. “The trick to running is staying healthy.” ASTYM helped him do just that. 

Providing these services since March of 2014, Altru has several therapists trained in the use of ASTYM techniques. To make an appointment with an ASTYM-certified therapist at Altru, call 701.780.2538. Learn more about ASTYM therapy at Altru.

My Weight Loss Journey by Joe Myers, RN

Joe Myers, RN, Altru’s Administrative Director of Surgical Services, shares about his personal weight loss experience through Altru’s Weight Management Program. 

Myer AM

My weight has been a challenge since I got out of the Army 40 years ago. After college, I put on a few pounds each year due to a much too sedentary lifestyle.

I have been in nursing since 1979 and employed at Altru for most of that time. As health care providers, I think we often overlook our own well-being. As our workday runs longer, we often lack time to cook properly or exercise regularly.

I made a conscious effort to reverse the trend about five years ago, when I began an exercise program through Altru’s Medical Fitness Center. Over a year, I lost about 35 pounds by exercising three to four times per week. I still had more to lose.

Creeping Up
When I took a new position with longer hours, exercise went by the wayside and my weight started to creep up again. My A1C (I’m a type 2 diabetic) was increasing, and my degenerative knee disease was acting up again.

In December 2013, with my retirement date slightly over a year away, I spoke with my primary care physician, Dr. Shane Nygard, about Altru’s Weight Management Program. Within a few days, I was contacted about the specifics of the program.

Structure, Goals, Motivation
I had my baseline visit in mid-January. My realistic goal was to lose 45 pounds by the end of the sixth month. The program gave us a structure that helps to maintain focus on your goal. The diet is fairly rigid based on your caloric need.

Each week we had a weigh-in and classes that focused on either nutrition or exercise. Nearly 10 weeks into the program, I was close to my goal. Before 12 weeks, I had lost the 45 pounds and was determined to continue.

Stretching Beyond the Comfort Zone
Prior to the program, my exercise was limited to treadmill walking and weightlifting. Rachel Aure, Altru’s health and wellness specialist, exposed us to new exercises. I tried core strengthening, stretching, yoga, exercise ball workouts and more. In May, I discovered the rowing machine and began with 30 vigorous minutes, followed by brisk walking.

In June I transitioned from walking to running, which I honestly hadn’t done since leaving the Army. I tried my first mile and did it in a blazing 11:30. By July 14, I ran three miles straight. (I’m going to run the Wild Hog 5K in September, and in the spring I plan to do another 5K in Alabama with my grandkids.)

Health Benefits
I have more energy, my knees feel better and I needed new clothes. At my recent six-month checkup, I also discovered:

  • I had officially lost 53.8 pounds and a total of more than 22 inches.
  • My blood pressure has dropped to normal range, so my medication has been cut in half.
  • My A1C has returned to a normal reading, and all of my other lab work is great.

I have revised my goal to lose another 10 to 15 pounds. The program allows for modification and continuation, so I will continue weighing in and return to the weekly meetings as needed. The skills taught at the meetings will help me manage the day-to-day challenges of continuing and maintaining my weight loss.

Program Praise
I can’t say enough good things about Altru’s Weight Management Program and the Sanny and Jerry Ryan Center for Prevention and Genetics. Janet Schreier does a great job coordinating the program. Ann Mason is not only an excellent nurse practitioner, but also empathetic and supportive. Jennifer Haugen has a lot of knowledge and enthusiasm as the program dietitian, and Rachel Aure is exactly the right person to run the exercise program, as she is both encouraging and challenging.

Finally, I can’t say enough about my wife, Margaret. She has been incredibly supportive from the decision to begin the program, to all the changes in meal planning and the exercise regimen. We joined Choice Health & Fitness, where we have been regulars since January.

Rewarding Retirement
As the journey continues, we’re even closer to retirement. I’m looking forward to an active lifestyle with my extra free time. My wife and I are moving to North Carolina to winter near our girls and grandchildren, and we plan to spend summers near Detroit Lakes, MN. We will keep a gym membership, and we both enjoy golfing. Our children and their families are all active, and we are looking forward to keeping up with them.

If you or someone you know could benefit from healthy lifestyle changes like Joe, contact Altru’s Weight Management Program or the Sanny & Jerry Ryan Center for Prevention & Genetics.

See also:

Whether Selling Cars or Healing Humans, Great Service is Great Service

CraigRead the raving online reviews or talk to anyone who’s purchased a car from sales consultant Craig Croaker at Rydell Cars. It’s clear that great service is his priority.

Craig talks about Altru Health System in a similar fashion: “I was so impressed by the care that I didn’t even want to go home.”

Strange Warmth
After a relaxing trip to Jamaica, Craig noticed a strange warm spot on his chest while at the gym. He immediately called the clinic, and the nurse recommended he come in for a stress test.

Over the next few days, Craig saw his family practitioner Dr. Joshua Deere, cardiologist Dr. Jason Go, and arranged for an angioplasty with cardiothoracic surgeon Dr. Barry Bjorgaard.

“It was like clockwork,” explains Craig. “Every appointment was exactly on time or within a few minutes.”

Unfortunately, they found seven blocked arteries. Craig went home Friday afternoon, with open heart surgery scheduled bright and early Monday morning.

Seamlessly Positive
From admission on Monday to discharge the following Friday, everything went smoothly. In fact, it was better than he expected.


“I was so impressed by the care. It was very heartfelt,” Craig reflects. “I started writing down the names of people who impressed me, but there were just too many to list. From doctors to nurses to off-site therapists, from the positive attitudes of the cleaning staff to friendly smiles from the front desk staff, everyone was so good. They were true examples of ladies and gentlemen in their work.”

Have you experienced great service from Altru? We would love to hear about it.

Moving Marie, and Helping Marie Move

Marie KozelMarie Kozel is no stranger to hospital rooms. Car accidents, cancer, broken bones, hip replacements, blood transfusions. She’s seen more than her fair share of hospital walls in her 79 years.

On March 25, Marie was one of 13 rehabilitation patients who moved from Altru Rehabilitation Center to Altru Specialty Center. This time, with a broken leg.

Thirty-eight years prior, in 1976, Marie was also a patient at United Hospital, moving from United to Medical Center Rehabilitation Hospital. She got to experience history in the making not once but twice.

“Everything is different today,” Marie explains. “The staff does so many more things for a person nowadays. We felt like celebrities riding in the van and wearing special corsages. I was even on the news!”

Everything Changes, Nothing Changes
From new technologies to facilities, medicine has clearly advanced since 1976. However, one thing that remains the same is the genuine care for the patient.

“The therapists are so smart and helpful,” Marie marveled. “The new space is beautiful. And the people here—they’re just wonderful.” 

After three weeks of recovery, Marie will soon return home to East Grand Forks, where she’ll continue with at-home therapy to continue building strength. She smirked, “And, I’ll keep my medical alert system nearby.”

Learn more about how we’re making history for Marie and other patients at Altru Specialty Center.