The reasons why I run

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By Pam Doebbeling, Registered Nurse


As I sit here writing this, I’m trying to brainstorm the reasons why I exercise and keep active, so let me first fill you in a little bit about myself. I have worked at TCHC for 25 years. I started when my kids, Alison and Brett, were 5 and 10 years old. My husband worked out of town, so I was essentially a single mom most of the time. I worked full time.

I used to consistently exercise, walk and run in the early days, but with two kids, it became a little harder. Walking was OK with the kids but kind of slow. So I went back to running. I could get done quicker. Ha!

Pam and her friend Rachel pose for a photo after finishing a run together. I took classes like Jazzercise and loved the group classes. They kept me accountable. When we moved and there were no classes, I got certified and started teaching. No, I did not have leg warmers, but we did all wear leotards!

I taught for 20 years. So many things have changed and yet remained the same. When I go to classes now, I think, “We use to do that.”

Over the past 15 years, I have gone back to running as my main source of exercise. I know a lot of people think that they can’t run. I felt that way myself, having been a walker for many years.

I started out slowly, which is the key if you want to condition your body for running. I would walk a while, then would find a street sign and run to it. Eventually, I worked my way up to just running.

Running for me has been more than exercise. For instance, if I have a really bad day at work, I will go for a short run, and it is amazing how much just three miles lowers my stress. My kids always teased me that I would leave ready to kick the dog, but when I got home, I was in a much better mood.

I have also joined a running group. I love the people and the different levels of running represented. Our love of running keeps us a tight-knit group, and that makes the time go by so fast.

However, I also prefer to run alone. No music. Just me and the pavement.

Last summer, I experienced a setback with a torn meniscus. Not being able to exercise was devastating to me. I did do more biking after surgery, but it just wasn’t the same.

After my injury, I learned a lot. I now stretch before and after each run and have changed my running form. I choose specially fitted shoes and take it slower. I use a foam roller after long runs.

Now, I am totally back to running and am doing Grandmas Half Marathon this year.Pam Doebbeling poses by the Sunnybrook Stomp sign with co-workers.

Another reason why I prioritize exercising is that my dad died at age 61 of cardiac arrest. Three of his sisters had strokes. I didn’t want to have health issues later in life.

But the main reason I exercise is so that I can be there and be active with my grandkids. I took my granddaughter hiking the other day, and she called her mom and said, “Grandma has me hiking another mountain!” I want to be that kind of grandma, to enjoy life and share my love of fitness.


You can run (or walk) too!

Next Saturday, June 23, you have an opportunity to try some walking or running with the Sunnybrook Stomp hosted by Tri-County Health Care. It’s a 5K walk/run that starts out at Sunnybrook Park in Wadena. Registration opens at 7:30 a.m., and the race starts at 8:30 a.m. I ran my first Sunnybrook Stomp in 1988!

It’s a great opportunity to get outside, spend time with friends (and meet some new ones), and see the sights of Wadena.

For more information or to register, click here.


About the Author: Pam Doebbeling is a registered nurse at Tri-County Health Care. She has six grandchildren: Mya, Jack, Abby, Emily, Laynee and James. Besides running, she loves kayaking, paddle boarding, snowshoeing and cross-country skiing with her grandchildren. She also enjoys reading and took up knitting last winter.

Things you don’t know about provider recruitment

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By Susan Marco, Provider Recruiter


Most people might look at my résumé and wonder how the heck I became a provider recruiter. I was a high school English teacher for 20 years, helped to run an assisted living memory care facility and taught in the marketing department at the Herberger Business School at SCSU.

My family and I moved to this area two short years ago. I was still working remotely, and then, in my research, I noticed that Tri-County Health Care was hiring. I was always interested in the health care world and thought I would take a chance and apply. Foremost being a people person, I wanted to use my skills in a way that would challenge me. God must have been listening.


The heart of recruiting

The VP of HR told me that TCHC was looking for a recruiter and someone that “lived and breathed TCHC.” Recruitment isn’t a 9 to 5 job. It takes place late at night, in the early morning, on the weekends and doesn’t take a break for a holiday. Recruitment has to be a living, continuous process because health care is a living, continuous process.A provider recruitment booth set up with TCHC materials.

This is especially true for health care in rural areas. Let’s face it. When we aren’t feeling well or are experiencing a traumatic health moment, we want help and we want help NOW! We want to know we can depend on the hospital being open and fully staffed. We want our clinics and providers to be accessible. Besides all of these needs, we want to have quality providers too. That is why health care organizations need recruiters due to the staggering low numbers of those going into the health care field – specifically, the advanced practice and medical training programs.

Here’s a brief overview of the numbers:

  • Currently, in the U.S., there are just over 841,000 active physicians. Of those, only 246,000 are family practice physicians.
  • Those in residency or in a fellowship program number around 125,000.
  • With less than 300,000 family practice physicians serving a U.S. population of 327 million, competition for providers is intense, and recruitment needs to be focused and deliberate.

Those numbers indicate only family practice physicians and don’t take into account the need for surgeons, OB/GYNs, nurse practitioners and physician assistants. The list of needs could go on forever.

I grew up in a small town in southwestern Minnesota and know the importance of having a strong medical community. When I was 5 years old, my 3-year-old brother was diagnosed with cancer. Without the local medical personnel, our church, our friends and our neighbors, I don’t know that my family would have been able to cope with such a heartbreaking situation.

Just recently, my own mother was put in hospice. My family is overwhelmed with decisions and sadness, but we have an awesome medical support system that is strong and constant. Provider recruitment, for me, is making sure we are all taken care of.


Benefiting the community

Besides the care component of recruitment, there is a strong economic factor, which plays an important role for all communities, especially for small rural towns.

Did you know:

  • According to the American Medical Association’s latest economic impact study, doctors in the U.S. each support, directly or indirectly, an average of 17 jobs. From hospital employees to medical personnel to local contractors to bankers to grocers, restaurateurs, medical providers impact the bottom line.
  • According to a 2016 study by Jackson and Coker, a family practice physician, on average, brings in more than $1 million in revenue per year. A specialist can easily double or triple that number.

In rural areas, providers especially contribute to the overall economic impact through purchased goods and services, taxes, property, and so on.


Looking to the future of health care

I am not going to lie; physician and provider recruitment is hard. If one looks at the numbers, it seems like they are stacked against you. Location is always a key factor in any job or career, and part of the recruiter’s job is to sell the area as well as the healthcare organization.

The future of provider recruitment is one of cultivating the healthcare system’s backyard. Awarding scholarships to local high school students and following those students in their educational journey is one key component. Having a strong presence at career fairs and university events helps to generate awareness of an organization. Encouraging existing providers to mentor medical students through their clinical rotations creates connections and passes on valuable knowledge.

As far as being a recruiter, I can honestly say that I love it. It is fast paced, always changing, and always challenging, but at the end of the day, I believe there is a noble purpose in all of it: striving for the guarantee of continuous health care.


About the Author: Susan Marco lives with her husband, Troy, and has two children, Kenzie (20) and Jack (16). Susan enjoys spending time with her family and enjoys reading and writing. Susan also has her own personal blog where she writes about her various experiences as well as tackles the topic of Alzheimer’s, which she knows first-hand in caring for her mother.

Conquering cancer

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By Jessica Sly, Communications Specialist


In October of last year, at the age of 44, Stephanie Sellin saw and felt a lump in her breast. She went to Tri-County Health Care straight away for a mammogram. The findings prompted further testing.

In November, David Kloss, M.D., FACS, performed a minimally invasive breast biopsy. A couple days later, the hospital called and told Stephanie the news. It was positive for cancer.

“I kind of had a feeling,” Stephanie said. “There’s no history in my family, so it was kind of a shock. There were no symptoms. I didn’t feel sick.”Cancer patient, Stephanie, with her husband.

Stephanie’s husband, DJ, stepped confidently into the role of her support system, keeping her spirits up, providing refreshing laughter and giving her a familiar hand to hold. Stephanie noted that their three children, Madisyn, Rachel and Alex, were scared at first but that they handled the situation well.

As Stephanie faced her diagnosis, she tried to cope with the reality that she may have passed the breast cancer gene on to her girls.

“Right away, it was like, ‘Oh my gosh, I’ve cursed them,’” Stephanie said. “That was probably one of the hardest parts. I didn’t really think about me. It was more, what about my girls?”

Stephanie went in for genetic testing with her oncologist at TCHC, Wade Swenson, M.D., and much to her relief, she found that it wasn’t hereditary.

Cancer patient, Stephanie Sellin,, receiving chemo treatment.With that question cleared, Stephanie underwent a lumpectomy to remove the cancer and then had one more test to determine if she needed chemotherapy. The results indicated her recurrence rate might be higher, so under Dr. Swenson’s care, Stephanie began chemotherapy. She needed four treatments, each spaced three weeks apart.

Displaying an unwavering positive attitude, Stephanie faced the treatment head-on, reveling in the family-like atmosphere at TCHC and the compassionate nurses who gave her heartfelt care.

“Everybody’s awesome, fun, and makes jokes, and it’s not serious,” she said. “We’re laughing and joking and having fun. It feels like everybody’s family. I love it.”

During chemo, however, one of Stephanie’s struggles was saying goodbye to her long hair.

“That was one of the hard parts,” she said. “My hair was down to my butt, and it was really curly. I cried once and then said, ‘Let’s just cut it.’”

Stephanie eased into the transition with a few haircuts. To start, she styled her hair into three braids and let each of her kids cut one off to keep. Then she went to a hairdresser to get it cut further. Once she started chemo, she decided to buzz it all off at home. Her husband also shaved his head.Cancer patient, Stephanie, holds hands with husband, DJ.

“We couldn’t talk any of the kids into it,” she said with a laugh.

Patients of TCHC cancer care receive free wig fittings and wigs in Fergus Falls. Stephanie selected a wig and purchased an assortment of cute hats, but she soon grew accustomed to going without.

Stephanie completed chemotherapy on March 20, the day before her wedding anniversary, so she and DJ celebrated with a special day out.

Following chemo, she began radiation treatment with Dr. Swenson in Fergus Falls every day for four weeks. She completed radiation on May 22.

The experience opened Stephanie’s eyes to the importance of family, finding laughter in the face of adversity, and being proactive with health screenings.

“(Women should) make sure they get their mammograms and find cancer early,” Stephanie urged. “It is very important. It is treatable.”


For more information about TCHC’s cancer care program, call 218-631-7461 or visit

Trails4Transplants: Saddling up for organ donation

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By Jessica Sly, Communications Specialist


As splashes of an orange and pink sunrise paint the sky over Wadena, high energy buzzes at the fairgrounds. Horses paw the ground in excitement, tails swishing and heads bobbing. Nearly 50 riders pack up camp and saddle up their mounts. Laughter and singing float into the air as the troupe trots off on its next adventure.

Trails4Transplants riders and volunteers, Tri-County Health Care staff, and Lions Gift of Sight representative pose at Tri-County’s Garden of Hope.

Trails4Transplants riders and volunteers, Tri-County Health Care staff, and Lions Gift of Sight representative pose at Tri-County’s Garden of Hope.

Trails4Transplants. It’s a group – or rather, a family – that has spent the last six years riding hundreds of miles on horseback raising awareness for organ, eye and tissue donation. And now they’re in the home stretch.


Humble beginnings

Back in 2012, friends and avid horsemen Roger Hille and Ashley Peterson were contemplating organizing a long-distance horse ride, but it wasn’t until Roger suggested riding 300-plus miles from Warren, Minnesota, to his ranch near St. Anthony, North Dakota, that they got the ball rolling. But in order to ride that far, they determined they needed a cause.

A recent LifeSource volunteer, Ashley suggested riding for organ, eye and tissue donation awareness. Not only that but both of their lives had been touched by this. Roger’s son-in-law received a liver transplant, and Ashley’s brother was an organ donor who saved four lives.

“I always tell people that it really was a glimpse of hope for us in a traumatic time,” Ashley said. “Because of donation, we had the opportunity to continue his legacy.”

That November, Trails4Transplants was officially formed.

As they planned their 14-day ride, Roger and Ashley attracted the support of countless other horsemen, businesses, communities and individuals who committed to either riding along, donating funds or volunteering.

The ride took place in June of 2013. Once it was in the books, they faced a choice. To continue or not to continue.


Riders from Trails4Transplants set out bright and early Sunday morning from the Wadena County Fairgrounds. This is the final leg of their six-year 2,000-mile journey raising awareness and money for organ, eye and tissue donation.

Riders from Trails4Transplants set out bright and early Sunday morning from the Wadena County Fairgrounds. This is the final leg of their six-year 2,000-mile journey raising awareness and money for organ, eye and tissue donation.

Creating a legacy

“It was supposed to be a one-year deal,” Ashley explained, “but we had such a fun first year, we thought, ‘We have to do it again.’”

Not to mention interest was catching on. Media had begun to cover their endeavors, and supporters, riders and volunteers continued to commit to the project.

So Roger and Ashley decided to make it long-term, with awareness and education as the main focus, followed closely by fundraising.

T4T takes a weeks-long trip once a year. During each ride, an average of 40 horsemen participate every day, followed by ground support of 15-20 people, who help move vehicles, set up camp and scout the route.

As the riders pass through town after town, they take the time to explain their passion and goals by scheduling speaking engagements and visiting with local residents.

“Horses really are the perfect catalyst for conversation,” Ashley said. “It’s the perfect opportunity to share our very simple message: Check the box for organ donation.”

Money raised comes from all over. Riders collect money and sponsors, some individuals mail in donations and others stop the riders on the road to hand them donations. T4T also sells merchandise and raffle tickets and holds silent auctions.

The bulk of T4T’s funds goes toward the Gift of Life House in Rochester, but it also helps other smaller projects and supports the families of donors and recipients.

“We are 100-percent volunteer run. This is all people doing it out of the goodness of their hearts,” Ashley said. “We don’t have an office. We are just strictly volunteer-based, and we chose to do it that way so that you know exactly where your dollar is going. One hundred percent goes toward the cause.”


The final stretch

On behalf of Trails4Transplants, Rita Hawkins (left) and Roger Hille present Lois Miller with a check for $1,500 to go toward Tri-County Health Care’s Garden of Hope.

On behalf of Trails4Transplants, Rita Hawkins (left) and Roger Hille present Lois Miller with a check for $1,500 to go toward Tri-County Health Care’s Garden of Hope.

Now six years into the venture, T4T is a little over 300 miles away from reaching 2,000.

“Back then, we thought, ‘That’s a long way. We’re crazy. Is this humanly possible?’” Ashley recalled. “It is totally possible!”

As they began planning the 2018 ride, they knew they only had 317 miles to go and that their final destination was Rochester. They studied a map and found that Wadena sat in the sweet spot. So it was only natural to kick off their ride at Tri-County Health Care’s Garden of Hope, which honors organ and tissue donors and recipients.

T4T had actually learned of the Garden of Hope the year prior through Barb Nelson-Agnew, hospital liaison with LifeSource. She explained TCHC’s idea for the garden, and T4T jumped at the chance to help. They donated $1,500 to the cause.

On Saturday, May 19, the T4T group rode into Wadena and set up camp at the Wadena County Fairgrounds. TCHC then hosted a dinner for the riders and volunteers, a chance for those touched by organ donation to share their stories. Following the dinner, they visited the Garden of Hope. Then they set out bright and early Sunday morning, launching their two-week-long trip to Rochester.

The 2018 ride will mark the end of T4T’s annual long treks. However, T4T is far from finished. Ashley noted that they may start planning some smaller rides. And most importantly, they hope to maintain the awareness and education part of it.

“Check the box,” she said. “It really is such a positive thing, seeing someone live on and give the gift of life.”

You can sign up to be an organ donor here, at your local DMV, or when you purchase a fishing or hunting license from the DNR in Minnesota.

For more information about T4T, visit

Treat your feet

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Feet take us everywhere we want to go. But if your feet are in rough shape or are causing you pain, navigating the world can be difficult.

That’s why Tri-County Health Care introduced foot care clinics in May at each of its rural locations. These clinics give you a designated time devoted to foot care, creating ample time for you to spend with your provider at your regular checkup addressing other health care questions or concerns.

Photo of a nurse working on a patient's feet to keep them clean and healthy.Specially trained licensed professionals will groom and clean your feet while monitoring their health. If they find an issue, they will refer you to your provider.

Kayla Januszewski, LPN, one of the nurses trained to provide foot care at TCHC, stressed the importance of foot care due to the fact that people were made to be on their feet.

“Our feet are very complex with bones, ligaments, tendons and muscles. Feet provide balance and help us maintain correct posture. When they aren’t healthy, we can become stiff or weak, and we’re more vulnerable to falling, which can cause more harm,” she said. “Our feet are also good indicators of our health and what’s happening inside of our body. For example, if you have swelling in your feet, it could indicate that you may have heart disease or kidney problems. This is why daily inspection of our feet is vital.”

Kayla explained that the foot care clinics allow her and other TCHC staff to be the patient’s eyes when it comes to their feet, especially for those who are no longer able to care for their own feet.

Dean and Diane Mickelson were the first patients to experience Tri-County Health Care’s new foot care clinics. Their daughter saw an ad and encouraged them to sign up, not just for the health aspect but for some relaxation.

“Foot care is very important. The reason I’m here is I’m having some swelling and to get some advice,” Dean said. “I’m enjoying it. At this point, I recommend it.”

“He loves this kind of thing,” Diane said of her husband. “It’s important for looking for health concerns. It’s a great service, feels good, and seniors need it.” She noted that she would absolutely use the service again.


The services

At each clinic, you receive:

  • Toenail trimming and filing
  • Foot inspection
  • Foot soak, cleaning and moisturizing massage
  • Callus treatmentPhoto of a patient having his feet treated by a nurse at a TCHC foot care clinic.


The tools

At your first clinic, you will receive a free foot care kit with all of the tools you need, to be used by you and only you.

Your kit contains:


  • Basin
  • Pumice stone
  • Emery board (nail file)
  • Lotion

*Please bring this kit with you to each TCHC foot care clinic you attend. A fee will be charged for additional kits you may require.


Cost: $25


Call your clinic directly or stop in person to schedule an appointment.

Wadena – 218-631-3510

Henning – 218-583-2953

Verndale – 218-445-5990

Ottertail – 218-367-6262

Bertha – 218-924-2250

Sebeka – 218-837-5333

Physical therapy goes straight to the source of pain

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By Jessica Sly, Communications Specialist


When physical therapists approach a problem, they go straight to the source. By doing this, they don’t just treat the current symptom. They balance the entire body and, sometimes, can completely restore function. Two Henning residents discovered the life-changing effects of this after visiting Erin Boesl, PT, DPT, at Henning Physical Therapy Clinic.


Jessica StregePhysical therapy patient receiving treatment.

It was a seemingly ordinary Monday morning when Jessica Strege woke up with a pinched nerve in her neck and left shoulder. She endured the pain for a couple weeks, thinking it would go away on its own, but it soon progressed to numbness and pain in her hand. She called her provider, Amy Severson at the Henning clinic, who referred her to physical therapy.

“Dad and Mom had both seen Erin, and she just did wonders for them,” Jessica said. “So when my arm wouldn’t heal on its own, my dad especially said, ‘You need to go see her.’ My dad is like Erin’s biggest fan.”

After listening to Jessica’s history, Erin started her on postural restoration exercises, which revealed that most of her issues were indeed from poor posture.

When someone has poor posture, their muscles have to compensate in unnatural ways and thus cause problems. Erin helped retrain Jessica’s muscles to have good posture. “She made us blow into balloons,” Jessica recalled. “You’re lying down and you have to concentrate on your breathing and what muscles you’re holding and how your legs are positioned.”

As they worked on Jessica’s posture, they stumbled upon other unresolved pain, and they found that by using physical therapy to treat the problems at the core, many were improved.

“It went from her working on my neck and shoulder to addressing issues that I had been dealing with for probably the last 15 years with my hips and pelvis and my low back,” Jessica said. “It all just kind of fell into place. As soon as one thing was corrected, it helped another thing and another.”

When she finished treatment, Jessica took home the knowledge and exercises to nip poor posture in the bud.

“I don’t have pain every day anymore and I did before. Even before the pinched nerve, my back was just painful every day,” she said. “Whenever I start to feel like something’s out of whack, I go back to some of the things I learned.”


Physical therapy patient, Mary Trana, works with Erin Boesel on exercises to relieve her pain.Mary Trana

During a time in her life when she was under significant stress, Mary Trana’s neck stiffened and filled with pain. She sought the advice of a doctor, who told her that physical therapy was her best option. A Henning resident, Mary was pleased to see there were treatment options nearby.

Erin identified the problem and helped Mary ease into exercises and learn how her body functions and moves. It took an entire year for Mary’s neck to regain mobility. “I was just so impressed with how Erin does physical therapy,” she said. “She’s very caring, and she looked at the whole body. The assessment when I came in was head to toe.”

However, about a year later, Mary’s back, which had been plagued by chronic pain since the 1990s, began to get worse. So she asked her doctor to refer her back to Erin. This time, they found that her gluteus muscles weren’t functioning correctly, so they worked together to get them back to their optimal condition. Soon, Mary found the physical balance that she had been missing for so long.

Erin also passed along skills so that Mary could do self-care at home. She tries to complete exercises a couple times a week and can tell if it needs a little extra care.

“For the first time in years, I feel balanced. She just seemed to find the key that helped it,” Mary said. “It still bothers me, but now I feel like I can keep it under control and not live on Ibuprofen all the time. I can’t emphasize enough how much it’s changed my life.”

A matter of life or death

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By Jessica Sly, Communications Specialist


The start of a new year is typically a time of eager anticipation and the promise of new beginnings. For Thomas and Tammy Williams, it was a time of terror and the very real possibility of loss.

Near the end of December, Thomas had a tonsillectomy to remove his tonsils and a septoplasty to straighten his nose for better airflow. The procedures went off without a hitch, and he was discharged on the 30th.

On the evening of Jan. 1, while recovering from surgery at his home near Henning, Thomas started to cough. Tammy believes that the force dislodged the healing scabs in his throat. He began bleeding severely and heaving up blood.

Tammy immediately called 911.

The Henning ambulance picked them up and rushed toward Tri-County Health Care. The TCHC ambulance met them along the way. By the time they got to Wadena, Thomas was unresponsive with a dangerously low blood pressure. He entered hypovolemic shock as they pulled into the ambulance garage, having lost so much blood that his heart couldn’t circulate enough to sustain him.

“Dr. Faith was working that night,” Tammy recalled, “and he said it was a matter of life or death.”A photo of Thomas Williams, who was saved by the TCHC emergency department, with his family posing for a photo on the frozen lake.

With experience as a registered nurse, Tammy knew the gravity of Thomas’ condition. Her mind ran wild as she watched the staff pump Thomas with fluids and blood, hoping to stabilize him.

“I must have looked white because someone pushed up a chair behind me,” she said. “They knew exactly what I needed. That’s just a tiny example of all that they did for us.”

As the team brought Thomas’ blood pressure up, they called for a helicopter to bring him to St. Cloud for emergency surgery.

“It was surreal, but it wasn’t as stressful as it could have been,” Tammy said. “I was impressed with their calmness, quickness and professionalism.”

Tammy couldn’t ride with her husband in the helicopter, so it was imperative for her to see him off and say goodbye in case he didn’t make it to his destination. Their two children, ages 18 and 24, and daughter-in-law were on their way to the hospital when they were held up by a train. By then, the helicopter had arrived and was ready to take Thomas away.

“Dr. Faith said they would wait for them,” Tammy said. “He and the ED staff were so considerate of the whole situation. They waited for the kids to come and tell Thomas goodbye.”

Thomas arrived in St. Cloud and was rushed to surgery to cauterize his wounds and stop the bleeding. The procedure was successful. He was discharged the next day and returned home with his wife and children. The remainder of his recovery went smoothly.

“When a situation like that happens, if someone wasn’t quick enough or if the team didn’t work, it could have been a different story,” Tammy said. “(Without the EMS and ED staff,) Thomas would have been gone. It was the whole team working as a well-oiled machine. They are the whole package. We’re so thankful.”

What your gynecologist wants you to know

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By Jennifer Arnhold, M.D., GYN, Embrace Women’s Health Clinic, Baxter


So you’ve scheduled an exam with your gynecologist. As the day approaches, your mind might be going wild with questions. What will they find? Will they judge my appearance? What if I’m too embarrassed?

A gynecologist’s purpose is to make sure you’re healthy, ease your fears and answer any questions you might have about your body. If you’re still nervous for the big day, take a look at these common questions to help put your mind at rest.Having a checkup with a gynecologist


What if I’m nervous?

That’s OK! It’s normal to be nervous. Usually, the anxiety over the visit is worse than the visit itself. Don’t hesitate to discuss any concerns you might have with your gynecologist before the exam begins.


Can I bring someone with me?

You are always welcome to bring a companion. Just know that you’ll likely undress in front of this person, and depending on the issue, certain questions will be asked and honesty is important. We may also ask that person to step out during the exam.


Do I need to wax or shave?

There’s no need for you to wax or shave. Other than looking for visible lesions on the outside, we are not focused on your outward appearance. During the exam, we’re thinking clinically and medically, not cosmetically. We’re not judging your personal grooming habits.


What if I smell?

It’s actually better that you don’t try to disguise an odor because it could be important for a diagnosis. We also never recommend using products that are marketed to clean that area. They can be unhealthy because they kill off good bacteria that regulate the acidic pH. An acidic pH helps to self-clean and prevent overgrowth of harmful bacteria.


What if I have my period?Experienced female gynecologist is explaining to a woman the concepts of her disease. She is holding and showing a picture of uterus. Young lady is looking at it seriously.

As far as Pap smears and the exams go, it’s typically OK if you have your period. Historically, when we did the Pap smear on a slide with a fixative, red blood cells would obscure the cervical cells, but now we have liquid preps that wash those red blood cells away. However, if you have heavy bleeding or cramping and think an exam is going to be uncomfortable, then it’s OK to reschedule.


What if I leak urine or have discharge?

It’s actually important for us to know if there’s leakage or discharge because it could indicate an issue that we need to address. So don’t be embarrassed. In fact, depending on the situation, we might even ask you to cough or bear down to see if we can get you to leak.


Why do you have to use a speculum?

As much as a speculum might look like a medieval torture device, it’s extremely important for allowing us to look at your cervix. Due to pressure and musculature, your vagina is always closed, so using the speculum is the only way that we can check the health of your cervix and vaginal walls.


I’m afraid to talk about sensitive things.

Generally, women’s hesitancies are based on fears of the worst possible scenario, such as cancer. But that’s why we’re here. We’re here to provide a safe, non-judgmental environment for exactly those things you’re embarrassed to talk about. You can’t possibly shock us. We’ve heard it all. And as with everything in medicine, we have a strict privacy policy, so it stops here.


photo of doctor Jennifer ArnholdAbout the Author: Jennifer Arnhold, M.D., enjoys spoiling her son, Ty, and poodle, Andy. Her hobbies include cooking, yoga and reading. She graduated from medical school in 2000 and performs gynecology and gynecological surgery at Tri-County Health Care in Wadena. You can also see her for outpatient appointments at Embrace Women’s Health Clinic in Baxter.

Close to her heart

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By Jessica Sly, Communications Specialist


Minnesota, October 2011

While enjoying an evening out with friends, Stephanie suffered cardiac arrest in October of 2011, after which a mechanical pump was implanted to keep her heart beating. Photo of heart donor, Ben SchulenburgShe was put on the heart transplant list, and by May, she had moved the top. If she didn’t receive a heart, she’d be resigned to live with the pump for the rest of her days.


Michigan, September 2012

It was a beautiful fall day when 24-year-old Ben Schulenburg decided to take a motorcycle ride with a couple buddies after work. Just as they started heading home, a vehicle turned in front of him. He slid the bike to avoid a collision, but he hit the pavement and his head impacted the back tire. At the hospital, his parents, Art and Christine, learned that he would never wake up again.


Choosing the gift of life

With Ben’s body being sustained by life support, the doctors told the Schulenburgs about the option of donating Ben’s organs.

“He hadn’t even thought about (being an organ donor),” Christine said. “There was just no doubt in our minds that we would do this because it gave life.”

“It was kind of a no-brainer when we knew what the result was going to be,” Art added. “Ben was in excellent health, very physically fit. As far as we knew, there were no health problems at all, so why waste perfectly good organs when they could benefit other people?”Heart Donor - Ben's Grave

Art and Christine agreed to the organ donation and gave their son a final goodbye.

On Sept. 16, Ben’s heart beat for the last time in his chest before it was carefully removed and sent to Minnesota. Surgeons then placed it into Stephanie, where it began pumping new life.


Part of the healing process

After her transplant, Stephanie knew she wanted to reach out to her donor’s family, but she wasn’t quite ready. However, on Jan. 1, 2013, she got a call from LifeSource saying she had a letter from the family.

“What! I couldn’t believe it just because of all the holidays,” Stephanie said. The representative assured her she didn’t have to accept it right away, but Stephanie replied, “Nope, send it. I’m ready.”

Even though this was Art and Christine’s first time experiencing the holidays without their son, they decided it was the perfect time to reach out to the people who had received Ben’s organs.

“Yes, it was maybe very soon, but it just was the right timing,” Christine said. “We were still in that grieving process, but it was an opportunity to just be part of that healing process for us. The gift of life encouraged us.”


Heart donor family meets the recipient of their son's heart, Stephanie.Hearts collide

A couple weeks ago, Stephanie and the Schulenburgs had an opportunity to meet at the dedication of TCHC’s Garden of Hope on April 3. They chose to meet the day before so that they could soak in the moment.

“They called me and they said they were on their way. Of course the weather was horrible, so they were behind,” Stephanie said. “I was kind of anxious about getting their call.”

They decided to meet at the AmericInn where the Schulenburgs were staying. Art and Christine were sitting in the lobby when Stephanie and her husband, Jesse, arrived.

“I was emotional, but it was happy emotions,” Stephanie said. “Some people when they meet for the first time, it brings up all the emotions, and I think that it’s important that they had done their grieving and I had done my grieving in our ways so that we were at a good point in both of our lives in terms of acceptance.”

Christine echoed Stephanie’s sentiments. “When we first met Stephanie, I was expecting that it would be more emotional than it was,” she said. “Her hug said much more than words could say. It was a very special moment.”

Time was lost to the two couples as they chatted, shared pictures, and reminisced.Heart Donor, Ben Schulenburg

During the Garden of Hope dedication ceremony the next day, Ben was one of fifteen donors named and honored. Art and Christine said they were moved by the personal touch. They purchased a paver to be engraved with Ben’s name and added to the outside of the garden.

“Ben loved life,” Christine recalled. “He was always off doing something he loved. He was involved in sports, indoor soccer, CrossFit, and he loved the Lord.”

Six of Ben’s other life-saving or life-changing organs went to individuals in need. Including Stephanie, the Schulenburgs have made contact with four recipients.

“We found it very comforting and important that Stephanie was also a person of faith,” Christine said. “With the other donors, sharing our faith and the faith that Ben had was just the top priority. We just saw that God was using our tragedy to bring good into other people’s lives and that’s certainly part of our healing process and grieving process.”

Of willpower and wonders: overcoming the odds with occupational therapy

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By Jessica Sly, Communications Specialist


Holding a fish for a photo. Playing in the snow. Assembling a Lego creation. These are all typical activities of a young kid, and yet, up until September of 2017, they were things that 10-year-old Jacob Cronk couldn’t do.

Jacob has severe sensory issues, meaning he doesn’t like to touch certain textures or be touched. He also has a plethora of diagnoses, including autism spectrum disorder, attention-deficit hyperactivity disorder, mood dysregulation disorder and oppositional defiant disorder.

Jacob’s parents, Tina and Phil, have been managing his sensory issues for as long as they can remember. “Anytime he would get anything on his hands, he would go into a major meltdown,” Tina said. “His meltdowns went as far as throwing himself on the ground or head-butting the wall.”

The problems became more evident when Jacob started preschool. Even the simplest tasks such as using scissors or eating lunch were nearly impossible.

There are very few foods he will eat, so most of his meals consist of a salad or sandwich. His parents have since had to supplement his diet with nutritional drinks but are struggling to gain insurance coverage.


Coping as a parent

Tina and Phil recently enrolled Jacob at White Pine Academy/Leaf River Academy in Deer Creek, a school for autistic and special needs children. On top of regular schoolwork, the educators help the kids develop social, behavior and coping skills.

“I’ve been in denial over having to put him there,” Tina admitted. “As a parent with a kid of special needs, putting him there makes you always think, ‘I’m going to be looked at different. I’ll be looked at as if I can’t handle my child.’ I feel like that all the time.”

Those fears occasionally come true when Tina brings Jacob along on shopping errands. When he acts out, Tina becomes the target of stares and whispered words such as, “He just needs to be spanked,” or “He just needs to be disciplined.”Photo of Jacob during his occupational therapy session with therapist, Lora Foust.

“Obviously, just because kids melt down doesn’t mean they’re not being disciplined,” Tina said. “Kids with special needs have meltdowns. But they don’t see the big picture. And I want to open my mouth so bad some days.”


Trying something new

Last year, during one of Jacob’s appointments at Tri-County Health Care’s behavioral health, Tina and Aaron Larson, M.D., developed a new plan to help Jacob’s sensory issues: occupational therapy (OT).

Jacob attends OT twice a week with Lora Foust, certified occupational therapist, one day on land and one day in the pool for aquatic therapy. Lora works with Jacob in a sensory-rich environment to help him adapt to various textures or movements. They also focus on hand-eye coordination and dabble with light weights in the gym.

“Lora has done wonders for him,” Tina said. “He’s had a couple bad meltdown incidents, and I thought she wouldn’t want him to come back or she’s not gonna want to work with him anymore. She doesn’t let that bother her. Lora always has him come back. She says, ‘You know what? It was a bad day. Everybody’s allowed to have bad days.’”

Jacob participates in Taekwondo with brother as a supplement to his occupational therapy.Lora’s treatment reaches far beyond their appointments at the rehab clinic. Each week, she creates goals that incorporate OT for Jacob to work toward at home. For instance, she challenged Jacob to clean his room twice a week for two weeks straight. As a reward, she treated him to a pizza party.

“That was something he looked forward to,” Tina said. “He made his goal. He worked so hard for that.”


A life changed for the better

Now more than seven months later, consistent OT has made all the difference in Jacob’s life and then some.

“From the time he was little, he would never ever even go near a fish, touch a fish, whatsoever.” Tears welled in Tina’s eyes. “Since he has started working with Lora, he will now touch them. He will go fishing. And that’s all he wants to do.”

Jacob has also begun playing outside in the snow, building with Legos, and washing his own hair in the shower, activities that used to be far out of reach for him.Jacob coloring Easter eggs.

“He’s hit a lot of milestones since he started OT,” Tina said. “He has had more willpower to learn now than he ever has.”

To further build his behavioral skills, Lora recommended taekwondo at Mid-Minnesota Taekwondo in Wadena. The experience has done wonders for both him and his younger brother, Maverick, who joined with him. Jacob has learned self-respect, as well as how to treat adults and other children with respect.

The road going forward for Jacob will likely contain more setbacks and successes, but Tina is proud of how far her son has come.

“I would never change him for the world because he is made how he is,” Tina said. “He’s the sweetest kid ever. We all have our good days and we all have our bad. He’s just made how he is.”

Dedication solidifies Garden of Hope as memorial for organ donors and recipients

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By Jessica Sly, Communications Specialist


Lois Miller recognizes the organizations and individuals who contributed to the creation of the Garden of Hope. They include the Deer Creek Lions, Wadena Lions, Wadena Rotary, the Browne Foundation and Wadena State Bank, Larry and Judy Spenst, Nellie Wegscheid, Trails 4 Transplants, James and Barbara Swenson, Lamson Trust of First Congregational United Church of Christ, Tri-County Health Care Foundation, Tri-County Health Care Auxiliary and Tri-County Health Care staff.

On Tuesday, April 3, Tri-County Health Care and more than 60 donor families, transplant recipients, TCHC employees and members of the public gathered for a Donate Life flag raising and Garden of Hope dedication. Even though a thick layer of snow covered the ground, Lois Miller, organ/tissue donation project lead, was confident that it didn’t dampen spirits as donor families, recipients and those touched by organ donation shared their stories.


Garden of Hope

TCHC first unveiled the Garden of Hope, built by Youngbauer Landscaping on the Wesley Hospital lawn, last year during the annual TCHC Block Party on July 18. One by one, engraved pavers in honor of organ donors and recipients will be added to the outside of the garden.

Surrounded by protective trees and a peaceful lawn, the garden encourages people to stop and reflect by providing a large bench and a variety of beautiful plants. Lois hopes that it can give visitors a place to rest and a change of scenery from the clinic waiting rooms.

TCHC’s Donate Life flag also found a home in the new garden. The Kelderman family raised the flag at the ceremony on April 3, and it will fly over the garden throughout the month of April to celebrate the thousands of donors and recipients.


Heart transplant recipient Stephanie Larson (middle) met her donor’s family, Art and Christine Schulenberg, for the first time.

Heart transplant recipient Stephanie Larson (middle) met her donor’s family, Art and Christine Schulenberg, for the first time.

Donors save lives

More than 117,000 people nationwide are currently waiting for organ/tissue transplants, and that number rises every day. In fact, the numbers on the waiting list are much higher than the number of donors and transplants available. One person can donate up to eight lifesaving organs – heart, two kidneys, liver, pancreas, two lungs and intestines – as well as other valuable tissue.

Eva Geiser of Bluffton encourages everyone, whether they’ve been touched by organ donation or not, to register as a donor. She and her husband purchased two Garden of Hope pavers, one for her father, a living donor, and one for her brother-in-law’s family in his memory.

“I thought the garden was a good idea and nice way to honor people who have donated their organs. I think it will bring more awareness [to organ donation],” Eva said. “People should sign up to be organ donors. Why not? I can’t think of a reason not to.”

The Kelderman family raises the Donate Life flag, which will fly over the Garden of Hope to honor organ donors and recipients.

The Kelderman family raises the Donate Life flag, which will fly over the Garden of Hope to honor organ donors and recipients.


Steps to becoming a donor

Signing up to be an organ/tissue donor is relatively simple, and yet it has the potential to save lives. Here’s how it works:

  1. Make the commitment to be a donor.
  2. Visit or register in person at your local DMV. If you are a Minnesota resident, you can also register online when purchasing a hunting or fishing license through the DNR.
  3. Tell your family of your decision so they can support your wishes.


Share in the legacy

If your family has been touched by organ donation, or if you know someone who has, the Garden of Hope gives you an opportunity to create a memorial by purchasing a paver or by making a donation toward the garden’s preservation. Pavers will be added on an ongoing basis and can be ordered at any time.

Brochures and paver order forms are available at Tri-County Health Care entrances or can be obtained from Lois Miller at 218-631-7485 or A plaque in the garden will recognize those who have made a financial donation.

Skip the colonoscopy with a non-invasive alternative

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By Dylan Folkestad, M.D.


It’s well known that cancer screening has the potential to save lives. By catching cancer early, we can start treating right away when there’s a greater chance that it could be cured. Because March is National Colorectal Cancer Awareness Month, it’s a good time to remind you that routine screening is recommended starting at age 50.

Screening is incredibly important, especially for colorectal cancer. It’s a common disease, with the risk of the general population developing it being 1 in 25. And if you Photo of an elderly couple, who still enjoy each other, on a hiking trip togetherscreen it appropriately, it’s a curable disease.

Now, when you hear colorectal cancer screening, your mind probably goes right to colonoscopies. While it’s true that colonoscopies are one of our key colorectal cancer screenings, there is actually a less invasive option.

This comes in the form of Cologuard, a stool-based DNA test that you can complete in the privacy of your own home. It works by detecting blood or protein in your stool that may indicate cancer. The kit is mailed directly to your home, which you can complete and mail back without having to come in for an appointment. You also don’t have to follow strict preparation instructions such as following a special diet, enduring a bowel prep, or having a pre-op physical. Your provider would then discuss the results with you.

So how do you know if Cologuard is an option for you?

If your provider recommends a colorectal screening and you’ve had a colonoscopy in the past, then you may be a candidate. You may also be eligible for Cologuard if you are at low risk for colorectal cancer, don’t have a family history of cancer or aren’t exhibiting symptoms related to colorectal cancer.

However, if you opt for the Cologuard test and it comes back positive, then your provider may order a colonoscopy. Colonoscopies offer visualization of the entire colon, Digital medical illustration: Perspective x-ray view of human colon with tumor. Anatomically correct. Isolated on black. allowing us to potentially identify early cancer polyps or other pathologies that can’t be detected with Cologuard.


About Cologuard

Cologuard was created by Exact Sciences in collaboration with the Mayo Foundation for Medical Education and Research. It was approved by the Food and Drug Administration in 2014 after undergoing a rigorous review process. The test was available at TCHC starting in 2017.

According to the official website for Cologuard, the test detected 92 percent of cancer in 10,000 participants who had an average risk for colon cancer. The American Cancer Society recommends that Cologuard be performed once every three years.


For more information, speak with your provider about your options for colorectal screening tests.


Cologuard - Dylan Folkestad

About the Author: Dylan Folkestad, M.D., specializes in family medicine at the Henning clinic. He attended medical school at the University of Minnesota, completed his residency at the University of Minnesota Family Medicine – St. John’s Hospital, and is board certified by the American Board of Family Medicine.

Nine ways to appeal to a picky eater

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By Shelby Hunke, Registered Dietitian


As National Nutrition Month, March is a great time to examine the food choices you’re making and how you can develop good eating habits.

But you might be wondering, “How do I form good eating habits in my kids?” While they might put up a fuss if you introduce new and healthy meals, there are ways to Picky eater little girl covering her eyes with her hands not eating her vegetablesfinesse the situation to make the dishes you prepare more appealing.


Prepare one meal

If you put your foot down about cooking a separate meal to appeal to your children’s taste buds, then you condition them to know your expectations. It might be a good idea to try incorporating meals that can be assembled, such as wraps or tacos so that they can customize it and have a little more freedom.


Set an example

You might think that kids will only eat kid-friendly food like hot dogs or macaroni and cheese, but if you set the example, then they’re very likely to mimic you. Children look up to their parents. They desire to be like you, and if you show them you’re excited about your dinner, they might be too.


Use condiments

If your child isn’t too keen on that new fruit or vegetable, then serve it with something to dip it in, such as marshmallow cream, Cool Whip, hummus, salsa or a creamy dressing.


Cook together

Let your child help you prepare the meal, everything from cutting up the ingredients to cooking it. If they’re invested in the creation of their food, they may be more likely to eat it.


Get descriptive

It’s one thing to tell your child to simply “take a bite.” It’s another thing to pique their interest by saying, “What kind of texture is that? What do you smell? What does it look like?”


Incorporate education

If you’re introducing a new food, research fun facts or the history of it to share with your child. You could even try cooking dishes from Mother and daughter having fun with the vegetables in the kitchen to help get picky eater to eat vegetables.other countries and learn about them in the process.


Be artistic

Food is fun and colorful, and you can help your child see it that way. Cut the food into fun shapes, or have your child sort their fruits and veggies by color.


Name it

Fun names put a whole new perspective on food. A child might wrinkle their nose at broccoli and carrots, but if you dub them “bodybuilding broccoli” and “X-ray vision carrots,” then suddenly they become exciting and more appealing to your child’s imagination.


Make believe

Encourage your child to pretend they are a famous chef or food critic. Let them taste each new dish and ask them to comment on what they observe about the food, such as the texture, the smell or the look.


For more resources related to National Nutrition Month, click here.


The author of picky eater article with her familyAbout the Author: Shelby Hunke is a registered dietitian working at Tri-County Health Care in the hospital and clinic. She has a degree in exercise science and a passion for helping patients live a healthy lifestyle. She lives in Wadena with her husband, Paul, and three kids, Madison, Jackson and Conor. In her spare time, she enjoys family time, running and the outdoors!