Extinguish the burn of acid reflux

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By David Kloss, M.D., FACS


You know that painful little burn you get in your chest after you eat? That’s acid reflux. It’s a pretty common occurrence in this country, and sometimes, it can interfere with everyday life.

Tri-County Health Care has advanced by leaps and bounds in our available technology for treating and managing reflux. Our newest gadget, software for esophageal manometry testing, examines how well your esophagus, or food pipe, muscles work.

manometry testing

Dr. Kloss volunteered to let operating room nurses practice the new manometry testing on him.

When we installed this new technology on May 23, I enthusiastically volunteered to let the operating room nurses practice on me to get them prepped and educated for our first patient.

To conduct this test, we gently insert a thin electronic catheter covered in tiny sensors down your throat to measure the pressure in your esophagus. Nurses give you liquid to swallow while the machine records the pressure, represented by colors on our chart.

Purple shows low pressure the moment you swallow. After that, the chart should display red for high pressure as your esophagus contracts to push the liquid into your stomach.

Why is this important? It shows us if the sphincters in your esophagus are working properly. Sphincters are handy muscles at the top and bottom of your esophagus that keep out fluid and saliva. We pay the most attention to the lower sphincter because when that isn’t working properly, it allows stomach acid to splash into your esophagus and causes reflux.

Once we determine you have bad reflux, you could be a candidate for our LINX procedure. LINX involves putting a little ring of magnetic beads around your esophagus by the lower sphincter to tighten it just enough so that stomach acid can’t get in. The magnets are weak enough so that when you swallow, your esophageal muscles can still push food through.

test results

Manometry testing records esophagus pressure using a color chart. Purple is low, and red is high. Operating room nurses check the results of Dr. Kloss’ test.

Manometry testing plays a crucial role in determining if you are even eligible for LINX because esophagus function is the deciding factor. If your esophageal muscles are weak or don’t work properly and you have the LINX procedure, then your muscles won’t be strong enough to open up those magnets and push food through. Then you’ll be really unhappy.

This technology benefits thousands of people in the area because you don’t have to go to the Mayo, Brainerd, Fargo or elsewhere. In fact, TCHC is one of only nine hospitals in the entire state that offers this surgery. We can do it all here and quickly get you on the road to recovery and relief.

To schedule an appointment for a consultation about the LINX procedure, call 218-631-7581. For more information, click here.


About the Author: Dr. Kloss is a board-certified general surgeon at Tri-County Health Care. In his free time, Dr. Kloss is an avid marathon runner. His race résumé includes the Marine Corps Marathon in Washington, D.C., as well as marathons in Dublin, Ireland; Paris, France; and Pittsburgh. He also ran the Twin Cities Marathon for the Leukemia and Lymphoma Society and the New York City marathon for the American Cancer Society. Dr. Kloss also earned Ironman status, having completed the Madison, Wisconsin, Ironman race in 2014. All this running helps Dr. Kloss control his weight so he can eat cookies WHENEVER he wants.

Telestroke reduces stroke statistics

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By Dennis Faith, M.D. – Emergency Medicine Physician

May is National Stroke Awareness Month, and did you know that strokes are the fifth leading cause of death in the United States? That being said, did you also know that Tri-County Health Care’s new Telestroke program is reducing that statistic?

stroke-Telestroke care-Tri-County Health Care-emergency medecine

Dr. Dennis Faith, Emergency Medicine Physician (right), works with staff from TCHC and St. Cloud Hospital’s Stroke Center to implement and continue Telestroke care at Tri-County Health Care in Wadena.

Strokes occur when a blood vessel is either blocked by a clot or ruptures. This deprives the brain of blood and oxygen, destroying millions of nerve cells within minutes. The resulting damage can lead to paralysis, speech difficulties and emotional problems.

Tri-County has made amazing strides in treating stroke patients with its Telestroke program, which it introduced in the fall of 2016. It works like this:

If you or your loved one comes to the emergency room with stroke symptoms, we have immediate access to a 24/7 stroke intervention specialist at the St. Cloud Hospital Stroke Center through a live video conference. That specialist can conduct a brief interview and interactive examination and see lab tests and images in real time as if they were standing in the room.

In mere minutes, we can complete a comprehensive stroke evaluation, administer clot-busting medications, dispatch a medical helicopter and transfer you for life-saving care. In many cases, you can receive stroke-reversing treatments within 30 minutes and actually be landing in St. Cloud within 60 minutes.

But here’s the important piece: We can’t help you if you don’t get here. And you need to get here within the treatment window. That time frame is up to four and a half hours from symptom onset. Though, even if you wake up with stroke symptoms, we could still treat you. We can do this with multiple interventions, such as administering medication that dissolves clots or utilizing methods that “fish” the clot right out of the blood vessel.

This means you need to learn to recognize stroke warning signs and act quickly. Symptoms aren’t always left-side numbness and slurred speech. It could be a little hand weakness, slight vision change or dizziness. Other symptoms include confusion, severe headaches and difficulty walking.

A helpful way to remember the signs and symptoms of a stroke is “FAST”:

Face Drooping: Ask the person to smile. Is one side of the face numb or does it droop?

Arm Weakness: Ask the person to raise both arms. Is one arm weak or numb?

Speech Difficulty: Ask the person to say a simple sentence. Is speech slurred, are they unable to speak or are they hard to understand?

Time to call 911: As soon as you have even the slightest thought that your symptoms could be a stroke, call 911. Don’t call the hospital. Don’t call the clinic. Call 911. Our paramedics are trained to start the evaluation and treatment process wherever you are: home, work, the lake or a local store.

Tri-County has invested a lot of resources and a lot of faith in this program, and it’s working. This technology clearly improves our ability to provide stroke care here at Tri-County, and in fact, has already proven invaluable with several of our patients. The early data shows us that we’re treating more patients with appropriate treatment, we’re treating them faster and their outcomes seem to be better. So the moment you suspect a stroke, call 911 and get here. Once you arrive, you’re only two minutes away from a stroke specialist and the best care modern medicine has to offer. Any time of the day, every day of the year, we are prepared, we are here, we are trained and we are ready!

For more information about Telestroke and other services offered by the TCHC Emergency Department, click here.


Dennis Faith-M.D.-Emergency Medicine

Dennis Faith, M.D. – Emergency Medicine Physician

About the Author: Dennis Faith, M.D., specializes in emergency medicine, with special interest in preventive medicine and clinical research. A science nerd at heart, Faith loves that medicine allows him the opportunity to combine his interests of working with kids, teaching and researching. Though he has a lifelong fascination with astronomy and recently got back into cycling and triathlons, most of his time, by far, is spent with his family.

Car seats: Do you have the right one for your child?

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By: Denise Peltier, RN, OB/Prenatal Educator

Do you travel much? Do you have kids? If the answer is yes, then let’s talk car seats.

From 1930 to the ’50s, car seats, which originated as a sack hung on the back seat, were designed to keep kids still and maybe give them a view. In the ’60s, a few were made with safety in mind. Federal safety standards were adopted in 1971.

Tennessee enacted the first restraint law in 1979. By 1985, all states had a minimal car seat law, but only 80 percent of those children were restrained. Today, you wouldn’t think of holding your baby during a car ride. We have come a long way. Are you shopping for a seat? Start with research. The website healthychildren.org, managed by the American Academy of Pediatrics (AAP), has a product listing of car seats, which is updated every year. You will see a section that includes rear-facing only, convertible, rear-facing and forward-facing, three in one, combination and booster seats, as well as height and weight limits and approximate cost. Choose a few seats that will fit your child’s size. Then go to safercar.gov and check the Ease-of-Use Ratings. By cross referencing, you now have a better idea of what to look for in the store.

At TCHC, we want to help you. Our nurses have been trained and can answer your questions and even help you in your car. We have hosted car seat clinics for the past 13 years, where you can drive in and get one-to-one help in your car with your child and car seat. Watch for those now through September around Todd and Wadena counties.

Let’s review the law, MN State Statute 169.685, Subd. 5, which is listed at carseatsmadesimple.org:

Denise Peltier (arm on car seat) with one of the ECFE classes she educated in March about car seats.

Infants less than 20 pounds and 1 year of age must be in a rear-facing safety seat. A child who is both younger than age 8 and shorter than 4 foot 9 (57 inches) is required to be fastened in a child safety seat that meets federal safety standards. Under this law, a child cannot use a seat belt alone until they are age 8 or at least 4 foot 9. It is recommended to keep a child in a booster based on their height rather than their age.

This is an abbreviated version of the complete law. There are also exceptions to the law listed on the website. The best practice is to keep your child boosted until they reach 4 foot 9.

Compared to laws in neighboring states, Minnesota, along with 25 other states, has the safest law. A new law in California that went into effect on Jan. 1 states that children 2 years or younger or less than 40 pounds must be in the back seat in a rear-facing seat. We likely will see more of this.

AAP recommends that once your child exceeds the height and weight limit of his or her infant car seat, you should purchase a convertible or three-in-one car seat with a higher height and weight limit and continue to use it rear-facing until age 2 or until your child reaches the height or weight limit for rear-facing use.

If you’re really into car seats, here are a few more facts:

  • Each manufacturer has a website listing products and videos of use and installation.
  • If you’re into blogs, thecarseatlady.com can really keep you up to date on topics and changes in child passenger safety.
  • And if you want to help others, the National Child Passenger Safety Training is available in our area for anyone. Join the team of more than 39,000 child passenger safety technicians and be a community advocate or resource. Go to safekids.org for more.

Todd Wadena Healthy Connections, a community health collaborative organization, will sponsor a car seat clinic on Thursday, June 8, in Wadena. To register or for more information, contact Sarah Riedel at (218) 631-7538 or sarah.riedel@tchc.org or click here.

National Hospital Week: It’s all about the people

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By: Joel Beiswenger, President/CEO

A hospital is far more than just a place where people go to heal. It’s a vital element of the community that encourages health and embodies hope. From providing treatment and comfort to the sick, to welcoming new life into the world, hospitals are central to healthy, vibrant and optimistic communities.

That’s the message Tri-County Health Care and other hospitals will emphasize during National Hospital Week, May 7-13, the nation’s largest health care event.

This annual event originated in 1921 when a magazine editor proposed the idea with the hope that a community-wide celebration might alleviate public fears about hospitals. The celebration was launched in Chicago and succeeded in establishing trust among members of the public, eventually spreading that trust to facilities across the country.

Above all, National Hospital Week is a celebration of people. Each member of our staff works diligently every day to meet the needs and improve the health of the communities we serve. We are extremely proud of the work ethic that is displayed each and every day.

That’s not all. This week also celebrates the history, technology and committed professionals that make our hospitals a shining example of compassion and care. The effects of the week are far reaching, offering many advantages throughout the year, such as enhanced departmental interaction, satisfied patients, staff retention, improved recruitment and increased community awareness.

This year, take the opportunity during  National Hospital Week to say thank you to all of the dedicated individuals who continuously promote health in our communities and beyond, whether physicians, providers, nurses, therapists, technicians, volunteers, food service workers, engineers, administrators and many more.

A Peek into the Past

Tri-County Health Care has a rich history of providing health care in this community, reaching all the way back to the 1920s. To celebrate this history, and in keeping with the National Hospital Week mission, here’s a brief snapshot of some key moments of health care’s long-past history in this area.

Wesley Hospital

1912: Dr. and Mrs. Charles Coulter open a hospital in a converted home at 321 Bryant Ave. SW in Wadena

1914-15: Drs. Kenyon and McKinnon run a hospital out of a home at 124 Second St. SE, Wadena.

1915: The Coulter hospital is passed to Dr. Luther Davis and renamed Davis Hospital.

1922: After discussions about building a Wadena hospital begin, the first contribution to this new hospital comes in 1922 in the form of $1 from a widow in Hewitt. In June, Wadena becomes first Minnesota city to start a White Cross chapter, a national organization geared to raising money for hospitals.

1923: The first dirt is moved for the Wesley Hospital’s construction.

1924: Wesley Hospital is officially dedicated on Nov. 30.

1925: Wesley Hospital opens for business at 4 p.m. on Jan. 30.

1928: The first class graduates from Wesley Hospital School of Nursing. It included Violette Colby, Viola Hirschey, Ruth Jacobson, Gertrude Palmer, Marie Trana, Helen Warmboe and Marion Willis.

1957: Dr. C.W. Parker approaches the Wadena Civic and Commerce members about the need for improvements in the Wesley Hospital.

1958: Work begins in mid-May on the 40×50-foot basement and two-story addition on the hospital’s east end. The hospital also adds a new basement kitchen, Hy-Lo beds, updated rooms, enclosed fire escapes, and the third floor was remodeled for obstetrics with a new delivery room and nursery.

1962: Wesley Hospital surpasses the 50,000 patient mark, averaging 1,090 patients per year.

1968: Local businessmen pro

pose a new hospital, as Wesley Hospital was no longer modern or up to date.

1971: Wesley Hospital is approved for a $1.9 million loan and the communities are challenged to raise the rest of the expected $2.1 million cost of a new 43,000-square-foot, 56-bed hospital.

1972: Builders break ground on Aug. 2 across the street from Wesley Hospital for the new Tri-County Hospital.

1974: Tri-County Hospital holds open house on Jan. 6.

Tri-County Health Care today








By the Numbers – Wesley Hospital


  • 3 carloads of cement (1,200 sacks)
  • 900 yards of gravel/sand
  • 2 carloads steel beams
  • 1 carload structural steel
  • 1 carload metal lathe
  • 196,000 tiles
  • 2 carloads Pyrobar
  • 5-ply asphalt roofing


  • 3 carloads rug face brick (76,000)
  • 1 carload cut stone
  • 550 sacks bricklayers’ cement
  • 5-ply asphalt roofing


  • 60 tons of plaster
  • 130 yards of sands


  • 116 windows
  • 120 doors
  • 18,000 square feet of floors
  • 4,700 lineal feet of base

When is the right time for your daughter’s first gynecology visit?

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By: Shaneen Schmidt, MD

So when is the right time for your daughter’s first gynecology visit? Generally, the sooner the better. Certainly all young women are different and as a mother you will have a good sense of whether you believe your daughter is ready or not. The American Congress of Obstetricians and Gynecologists (ACOG) recommends that young women have their first gynecological visit between the ages of 13 and 15. This may seem like a young age to bring your daughter in for a visit, but know that most girls do not need a pelvic exam during their first visit unless there are abnormal symptoms present. Rather, this visit offers a phenomenal opportunity for your daughter to learn important information about her body.

Now, it’s absolutely normal for most young girls to feel embarrassed, nervous, or afraid, just thinking about a this prospect, however, most feel much more at east if they are able to meet the provider and establish a relationship before the need to undress or have a pelvic exam is even necessary.

Your provider is a wonderful resource, friend and ally in helping to articulate the changes young ladies can expect as they progress through adolescence. More importantly, your daughter will receive accurate information from a trusted professional, rather than at school, on the bus, or from friends.  There is so much misinformation out there, but getting your daughter off on the right foot can have a lasting effect on her future health.

At Tri-County Health Care, we offer a safe and warm atmosphere with caring providers and the latest in healthcare information. In planning for your visit, talk ahead of time with your daughter and discuss whether she would like you in the room with her.  Some will want you to join them in the exam room while others may choose to go solo. Either way, our providers will take the time to listen, ask questions, and if needed, inform them on a wide range of health topics from appropriate hygiene, menstrual cycles and pelvic pain, to sexually transmitted infections, birth control and pregnancy.  Of course, everything discussed during this time is private and only between your daughter and her doctor.

Shaneen Schmidt, MD

Shaneen Schmidt, MD

If your daughter is between 13 and 15 years old or older, and hasn’t yet had her first gynecological visit, now is the time to bring her in. Certainly, all young women are different and you will have a good sense of whether your daughter is ready or not. But regardless of age, it’s good practice to make a preventative appointment now rather than waiting until something is wrong. Use this opportunity to help your daughter understand the importance of preventative care, all within a safe, comfortable environment.

About the Author: Shaneen Schmidt, MD, enjoys spending time with family and friends, volunteering, attending her children’s activities, planning and enjoying family vacations, reading science fiction, fishing and cheering on the Minnesota Twins. She and her husband Kent, reside in Wadena with their four children – twin daughters, Zoe and Kate, son, Michael, and daughter, Ryann.



Tip for Parents on Internet Safety for Youth

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Mobile devicesBy: Wadena Police Chief Naomi J. Plautz

Wow, everywhere you look there is technology! At work, at school, at home, there is no getting away from it; frightening to some, and a natural part of everyday life for others.  I remember in elementary we were privileged to play “Oregon Trail” only in the library, and only if it was your turn; we only had two dos computers. J

Don’t stress about your kids/teens using the internet. I have some easy tips to get you started and the more you do these things the easier it will be and you can then graduate into knowing more about it. Trust me, I’ve had to “learn” too!

First of all, you are the parent, even if your child bought, or was gifted their own phone, iPad, tablet etc. You are responsible for them and therefore expected to view anything your child/teen is doing on them.  Have them show you early on how to use certain apps, or watch them as they use them – or they don’t get to. Set up parental restrictions on the unit. Ask someone you know to show you if you don’t feel comfortable trying to do it on your own or with your child/teen.  Search the browser history, OFTEN.  Tell your child/teen that you are going to search the history, maybe do it with them.  The younger they are when you start “lets surf the web together” idea, the less resistance you will receive!

Click here for a full list of Website Help Centers that Netsmartz, a program created by National Center for Missing & Exploited Children. They put together a lot of common apps and websites for you to use.

It’s so easy and quick for a child/teen to get to something “inappropriate” on the web, even by accident.

Happy surfing!

Police Chief Naomi J. Plautz

Police Chief Naomi J. Plautz

About the Guest Author: Chief Naomi J. Plautz is the Police Chief for the City of Wadena and has been lucky enough to work for the citizens of Wadena for 19 years. She lives in Deer Creek with her husband four children, ranging in ages from 7-21. At the police department they strive to serve the citizens in the best way possible and she feels privileged to serve such a great community!

Reducing Your Risk for Cervical Cancer

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cervcancIn the month of January we raise awareness nationally about cervical cancer, in hopes of continuing to reduce the number of Americans affected by this disease. According to the U.S. Department of Health and Human Services there are 12,000 new people diagnosed each year, and primarily in women over the age of 30. Roughly 79 million Americans are currently living with the human papillomavirus (HPV), which is the main cause of cervical cancer.

I always tell my patients that you can be proactive and work to prevent the incidence for you or a family member by: toolkit_badge_jan

  • Having the HPV vaccine (shots) that can prevent HPV.
  • Regular screening tests (called Pap tests) can often prevent Cervical Cancer by finding the abnormal cells early, so you prevent them turning into cancer.

Most deaths from cervical cancer could be prevented by having regular Pap tests and annual appointments with your provider. The Center for Disease Control found that around 50% of the patients diagnosed with cervical cancer never had cervical cytology testing, and another 10% had not been screened within the 5 years before diagnosis.

There has been much discussion over the years about when is the best age to start getting tested and the frequency. I follow the American Congress of Obstetricians and Gynecologists recommendation of:

  • Younger than 21 – You do not need a screening.
  • 21 – 29 years old – Have a Pap test every 3 years.
  • 30 – 65 years old – Have a Pap test + an HPV test (co-testing) every 5 years or a Pap test alone every 3 years.
  • 65 years or older – You do not need a screening if you have no history, and either have had three negative Pap test results in a row, or two negative co-test results in a row within the last 10 years.
Dr. Arnhold

Dr. Arnhold

A majority of insurance plans cover well-woman visits and cervical cancer screenings. The incidence of cervical cancer in the United States has decreased by more than 50% in the past 30 years and that’s directly correlated to raising awareness about the importance of these tests.

If you have questions about these screenings or would like to schedule an appointment at Tri-County Health Care, call 218-631-1100, or Embrace Women’s Health Clinic in Baxter at 218-454-1754.

About the Author: Jennifer Arnhold, MD, lives with her husband, three-year old son and poodle in the Brainerd Lakes Area. She graduated from medical school in 2000 and performs gynecology and gynecological surgery at Tri-County Health Care in Wadena, MN. You can also see her for outpatient appointments at Embrace Women’s Health Clinic in Baxter.

Tri-County Auxiliary Raises Record High at Annual Holiday Auction

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2016 Holiday Auction

2016 Holiday Auction

The Tri-County Auxiliary dates back to 1925, when the organization was called Wesley Guild. At the monthly meetings, members did mending for the hospital, as well as sewing new items. A 10¢ lunch was served. Almost 100 years later and the Auxiliary is still giving back to the community that they love and care about with having recently hosted their annual Holiday Auction themed, “All that Glitters”.  The event took place on November 28 at the Whitetail Golf Course in Wadena. There were 60 beautiful baskets that were donated by various TCHC


Highlights from the evening included:

2016 Holiday Auction Baskets

2016 Holiday Auction Baskets

  • 55 Live Auction Items
  • 22 Silent Auction Items
  • 62 People Attended
  • A record $11,150 was raised!

All funds raised from the auction are used to fulfill the Auxiliary Wish List grants. TCHC departments are able to fill out an application that would benefit patients in the areas of patient comfort, patient education and technology. In the past dollars have been used to purchase education technology, videos, blanket warmers, toys and/or books for waiting areas.

Joyce Jampsa - TCHC Auxiliary President

Joyce Jampsa – TCHC Auxiliary President

Tri-County Health Care Auxiliary consists of women and men who are interested in supporting our community’s health care system through service and fundraising. Meetings are every third Monday at noon from September-April at Tri-County Health Care in Wadena. Joyce Jampsa is currently the Auxiliary President. If you’re interested in joining, or learning more, contact Auxiliary@tchc.org.

2015 Auxiliary donations

2015 Auxiliary donations

Why Step Out for Diabetes in Wadena

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By: Pam Doebbeling, RN

pamdiabetesblog2As part of the Tri-County Health Care Diabetes Education team since 2007, I have seen many changes in diabetes from treatment to the sheer number of people diabetes. Today, 29 million Americans have diabetes, and those numbers are only increasing.

I feel diabetes is a disease that has or will touch almost everyone at some time in their life, thru family members or friends.

It is a disease that involves participation and lifestyle changes to help control.  These seem to be the biggest benefits and the biggest drawbacks. Change is hard.

Thru the American Diabetes Association (ADA), we are able to “Step Out” and make more people aware of diabetes.  This past May we hosted our first ever diabetes walk. We had a group of people participate on a cold Saturday morning in May at Sunnybrook Park. Many local Wadena businesses participated along with Novo Nordisk, Lilly, and Bayer. Not only did we have fun and support each other while out getting some exercise, but we raised $1,000 for the American Diabetes Association!

At Tri County we are proud to have “stepped out” for diabetes as an awareness event.

Look for an announcement coming soon about our date for 2017! We will be having vendor displays, a beautiful walk around the park, and the opportunity to raise money, plus awareness for diabetes.

Get on your walking shoes and join us in supporting this important cause!

2016 Diabetes Walk

2016 Diabetes Walk

About the Author: Pam Doebbeling, RN, has been at TCHC for 23 years. She’s been a part of the diabetes education team for nine years. She lives in Verndale and has two grown children and five grandchildren, and one cranky cat! She’s also part of the Wellness Committee and is in charge of the monthly Diabetes Support Group. To learn more about that group and the various monthly topics, click here: http://www.tchc.org/education-and-resources/event-listing/diabetes-support-group.


Gestational Diabetes: My personal perspective of getting diagnosed

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By: Jennifer Arnhold, OB/GYN

The prevalence of gestational diabetes is as high as 9.2%, according to a 2014 analysis by the Centers for Disease Control and Prevention. The American Diabetes Association describes gestational diabetes as, “A pregnant women who have never had diabetes before but who have high blood glucose (sugar) levels during pregnancy.”

I am part of that statistic. During my pregnancy I was diagnosed with gestational diabetes. As a physician I understand the medical side of diabetes, but translating that into real-life is much different.  When you get pregnant, it’s not just about you anymore, you’re also managing the health of your little one. I soon realized the diligence and time it took to manage blood sugars. I didn’t truly realize what it took for day to day management, until it was me. I exercised regularly before I got pregnant and all throughout my pregnancy. I was really surprised when I got the diagnosis. As a physician, and a woman who’s experienced this, I’m passionate about raising the awareness about the risk factors, but also letting others know that you can still have a healthy pregnancy.

Dr. Arnhold playing in the snow with her son.

Dr. Arnhold playing in the snow with her son.

There are some factors that predispose woman to gestational diabetes, including:

  • Prediabetes (blood sugar that’s elevated, but not high enough to be called diabetes)
  • High Blood Pressure
  • A history of gestational diabetes
  • A family history of type 2 diabetes
  • Hormone disorders, such as polycystic ovary syndrome (PCOS)
  • Being overweight, or gaining too much weight during pregnancy
  • Being older than 25
  • Being of African, American Indian, Asian, Hispanic, or Pacific Islander descent
  • Previously giving birth to a baby that weighed at least 9 pounds or had a birth defect
  • Previously having an unexplained stillbirth or miscarriage

gestationaldiabetesfbAfter a woman becomes pregnant, they start to experience insulin resistance, which is when the pancreas can’t secrete enough insulin for the mother and baby’s needs. Without the right amount of insulin, blood sugars rise too high, causing hyperglycemia.  Pregnant woman will generally get the diagnosis late in the pregnancy, around the 24th week. In the case that a woman has been known to have had gestational diabetes in a prior pregnancy, we will monitor earlier.

If a woman is unable to control her blood sugar levels the baby is at risk for several complications:

  • Macrosomia, or an overweight baby. This can cause nerve damage during delivery.
  • Low blood glucose levels at birth.
  • Higher risk for immature lung development.
  • Babies with excess insulin become children who are at risk for obesity and adults who are at risk for type 2 diabetes.

    Dr. Jennifer Arnhold

    Dr. Jennifer Arnhold

This is a diagnosis which must be taken seriously for the health of the mother and baby.

I know the surprise of getting this type of diagnosis while pregnant, but I also am keenly aware by being proactive you can still end up with a healthy Mom and healthy baby.

About the Author: Jennifer Arnhold, MD, lives with her husband, three-year old son and poodle in the Brainerd Lakes Area. She graduated from medical school in 2000 and performs gynecology and gynecological surgery at Tri-County Health Care in Wadena, MN. You can also see her for outpatient appointments at Embrace Women’s Health Clinic in Baxter.



  1. H. Gilmartin, S. H. Ural, and J. T. Repke (2008). “Gestational Diabetes Mellitus.” Reviews in Obstetrics & Gynecology.
  2. L. DeSisto, S. Y. Kim, and A. J. Sharma (2014). “Prevalence Estimates of Gestational Diabetes Mellitus in the United States.
  3. What is Gestational Diabetes? American Diabetes Association.

The information and opinions expressed in this article are the opinions of the author and are not designed to constitute advice or recommendations as to any disease, ailment or physical condition. You should not act or rely solely upon any information contained in this article without seeking the advice of your personal physician.

Tri Aquatics: New Mom Course

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Jeremy & his family.

Jeremy & his family.

Hello all, my name is Jeremy Meyer. I have been a Physical Therapist at TCHC for nearly eight years. I have two beautiful children with my gorgeous wife Alison who also works for TCHC as a Nurse Practitioner, primarily at the Bertha Clinic. When my wife was pregnant with our almost 2-year-old daughter, she was starting to get a lot of low back pain and sacroiliac joint pain (SI pain). She had a significant amount of swelling in her legs starting at 17 weeks. At that time the Maslowski Wellness and Research Center was not up and running yet but was close to opening. Luckily, we were able to transform our home spa from a hot tub to a lukewarm pregnant momma sanctuary. The Physical Therapist in me knew the water would benefit her and this was the best we had at the time. It really seemed to benefit her swelling, reduce her low-back pain and give her 30-40 minutes of reduced discomfort in her entire body. Not only was I excited that my wife could find some comfort, but I was also excited for our patients and community knowing that TCHC would have access to the warm water therapy pool once the wellness center was open in Wadena. This was amazing when my wife was pregnant with our son who is 3-months-old now. The therapy pool is much bigger and nicer than our lukewarm pregnant momma sanctuary at home!

What is Tri Aquatic Therapy?

Tri Aquatic Therapy is a specialized form of physical and occupational therapy. It not only improves motion and flexibility, but also the warmth of 92°F water provides therapeutic effects to allow a patient’s muscles to relax while helping to reduce pain. Through an arrangement with the Maslowski Wellness & Research Center, Tri-County Health Care offers access to one of the area’s premiere therapy pools. Paired with our highly skilled and trained staff, patients can expect one of the most comprehensive therapy programs in central Minnesota.

Tri Aquatic Therapy

Tri Aquatic Therapy

We have now been in the warm water therapy pool at the Maslowski Wellness and Research Center for nearly two years. We’ve utilized the pool for patients of all ages and impairments. Including:

  • Pediatric patients for strengthening, coordination, and sensory impairments.
  • Patients with low back pain, arthritic pain, and return to function after healing from a surgery.
  • Reduction of pain in our new expecting mothers.
  • New mothers who are still having issues after bringing a new life to this world.

I feel that we at TCHC can do more for all of the new mothers or expecting mothers in our community. Utilization of the warm water pool is an amazing place to start. The Maslowski Wellness and Research Center is an awesome facility with an out of this world staff.

We’re excited to be hosting our first-ever Tri Aquatics Moms Course on November 10th from 6:30 pm to 7:30 pm! Stacey Callahan, PT, DPT (mom of one), and Katherine Dittmann, COTA (mom of two), who are also aquatictriaquaticsmomscoursefb therapists, will guide mothers through this relaxing one-hour-class.  They each personally know the benefits of getting into the warm water pool for reducing pain and maintaining strength during the pregnancy. They know how safe it is to be in the water and will share their personal stories with you at the class.

You don’t have to be a member at the Maslowski Wellness and Research Center to attend to the class. As well, you don’t have to be a patient at TCHC. The class is free, but is limited to 15 people. Please contact TCHC Rehab front desk at 218-631-7475 to reserve your spot for the class.

To learn more click here:  http://www.tchc.org/education-and-resources/event-listing/triaquatics-moms-course.

Flu Season is Near: Why You Should Get a Flu Shot Today

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By: Amy Severson, FNP, APRN

Have you gotten your flu shot for this upcoming winter season? Influenza, otherwise commonly known as the flu, is a potentially serious disease that can lead to hospitalization and even death.

flushot1The Center of Disease Control (CDC) states:

  • Between 1976 and 2007, flu-associated deaths ranged from 3,000 – 49,000 people.
  • In recent years, 80 – 90% of flu-related deaths occurred in people 65 years and older.
  • Flu vaccine is recommended for nearly everyone starting at 6 months of age.
  • If an expectant mom gets a flu shot during pregnancy, the vaccine also helps protect her baby during its first six months of life.

Flu activity typically begins in the fall months and peaks in January and February, though depending on the season, it can last until May. The CDC recommends getting an annual seasonal flu vaccine to best prevent getting the flu, and not spread it to others. The more people get covered, the less flu we will see in our communities.

A lot of patients ask me, “When is the best time to get a flu shot?”

Since it can take one to two weeks for the flu vaccine to become effective, it’s best to get vaccinated in the month of October if possible. Though Federal Health Officials say it’s better to get a shot anytime, then skip the vaccine altogether.  For the 2016-2017 season, CDC recommends getting a flu shot, and not the nasal spray flu vaccine. Unfortunately, CDC studies found in the past few years, FluMist hasn’t protected against certain influenza strains as well as the flu shot. For this reason, FluMist will not be available this season until more studies are conducted to figure out the reason why this is.

Get your flu shot disease ill illness healthy health doctor

Why bother with getting a flu shot?

The Center for Disease Control states that a flu vaccine can reduce the risk of getting the flu by 50 – 60% when given at the optimal time. So do yourself and your neighbor a favor, and get a flu shot this fall!

Upcoming Area 2016 Flu Shot Clinics:

Tri-County Health Care will be hosting a Flu Shot Clinic at each one of our clinics in the month of October. Pre-registration is encouraged, but not required. Refreshments will be served.

Ottertail: October 14 – 9 a.m. – 4:30 p.m. 218-367-6262

Wadena: October 18 – 7 – 8:30 a.m. 218-631-1100

Henning: October 19 – 7 a.m. – 6 p.m. 218-583-2953

Verndale: October 24 – 9 a.m. – 4:30 p.m. 218-445-5990

Sebeka: October 26 – 9 a.m. – 4:30 p.m. 218-837-5333

Wadena: October 27 – 5:30 – 7 p.m. 218-631-1100

Bertha: October 28 – 9 a.m. – 4:30 p.m. 218-924-2250

To get more information about these upcoming clinics click here.


Amy Severson, APRN, CNP

Amy Severson, APRN, CNP


About the Author: Amy has worked for TCHC for the past 14 years, the last nine years at the Henning Medical Clinic.  She feels privileged to work in the town she was raised in, and take care of families she’s known her whole life. She lives with her husband Eric on East Battle Lake with their three children; Ethan, age 14, Emma, age 12, and Elliot, age 8.  In her time away from the clinic, you’ll find her at Ottertail Central football games and supporting the Henning Hornets in volleyball and basketball.  She also is the head of the youth group at her church.





The information and opinions expressed in this article are the opinions of the author, and are not designed to constitute advice or recommendations as to any disease, ailment or physical condition. You should not act or rely solely upon any information contained in these articles without seeking the advice of your personal physician.

You too can bring home the GOLD!

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By: David Kloss

A triathlon is a fun way to stay active and meet people. It can be a great excuse to travel places you might never go to otherwise, and it gives you an excuse to eat a little bit healthier, to get more sleep at night (a definite health bonus!) and to stay active!

Do I have you hooked in yet? No? Well I was (and still am) a skinny011_09A, nonathletic computer science nerd, who began running tiny little races in medical school in order to socialize with my classmates. Years later a friend “suckered” me in to doing a short “mini” triathlon in a tiny muddy local lake in Connecticut. IT WAS FUN! Sound crazy? No it isn’t! The people at the little local triathlons are fun people, they are full of life, they are happy people to hang around with and the more races you do, the more you learn and the better you get! You feel more alive just like the other people at these races! You can’t help yourself, but feel better about life and about yourself, even if you come in dead last at every race you enter!

“How can it be fun if I come in last?” you ask? I can promise you the crowds will cheer WAY LOUDER for you, the last racer to cross the finish line, than they do for the first person who wins! Everyone at these small races respects you for being there and “just doin’ it”!!!

My first race was 20 years ago now. I still remember running (a 3-mile run at the end of ¼ mile swim and 12-mile bike ride) as hard as I could towards the last mile. I could hear the 10,000 people in the Olympic stadium chanting my name and shouting “USA!” at the top of their voices. The runner from Russia was only 10 yards in front of me…… I could pass him…. The Gold medal within my grasp! He and I fought neck and neck sprinting as hard as we could the last half mile into the finish chute. In the end, he beat me by about 10 feet. The ordinary guy (the “Russian” who I was competing against) who had beat me, turned around and shook my hand. “Thanks for pushing me” he said. Our little mental imaginary Olympics were over for this week. But we had such great fun competing against each other that last mile!

So why is a triathlon (and today I am speaking mostly about the mini-triathlons) so much fun?
This is a sport that doesn’t require super hard training. It doesn’t require super expensive equipment. This is a sport that doesn’t “beat you up” so badly you can’t work the next day! It is fun because you are outside being active and hanging around like-minded people!

What is the training like?

bike pic 2007 musselmanTriathlon combines swimming, biking and running in a variety of different distances. The distances depend upon the race type. A mini-tri is usually a quarter mile swim, 10-15 mile bike ride and 2-5 mile run. Each town will have their own special “flavor” of this race.

An Olympic distance race is 0.9 mile swim (about 68 lengths of the standard pool), a 25-mile bike ride and a six-mile run. Longer distance races include the Half Iron Man race and the “Full Iron”. The Iron Man race is 2.4 mile swim, 112 mile bike ride and 26.2 mile marathon. You can tell an Iron Man vehicle by the “140.6” bumper sticker on their cars! Look for it, honk at them and give a “thumbs up” as you pass!

Of course, the training for a full Iron Man is more intense. But for a mini triathlon, you can spend a little bit of time in your local pool or lake practice gentle swimming. You can practice perhaps once or twice a week (depending upon how good of a natural swimmer you are). A quarter mile swim is 16 lengths of the standard pool. Can’t swim even two lengths? Well, with gentle, slow, persistent practice YOU WILL GET THERE! I did! The 10-mile bike ride can be done in an hour or so. For the first timer, be sure you know your bike is in good working order! Check the tires! Check the brakes!! Make sure your seat is comfortable. Remember, the idea is NOT TO WIN, but to FINIIMG_0541SH!

The hardest part of triathlon is called “T2” (the transition from the bike to the run). It takes a few tries on a Saturday morning, or  a Thursday night, to practice getting off the bike (your legs are a little bit tired) and then to take off jogging! It is OK to walk! But you will find as you practice this once or twice, your body will respond! That is known as conditioning! YOU ARE NOW AN ATHLETE! Keep practicing! Don’t give up! You will slowly get better and stronger (like the bionic man from the 70’s TV show!)
Tri-Wadena Reg Form Art 0216

Here in Wadena, on June 18, starting at the Maslowski Wellness and Research Center (aka The Mas) you will have your chance to take home the GOLD medal! “TRIWADENA, No Spandex Necessary” is our extra small, mini-triathlon geared especially for beginners! Check out our website, triwadena.org and then call the MAS to register! Your kids and family will be impressed! And most importantly you will have fun!

Keep Calm


I’ll see you at the starting line on June 18, at 8:30 a.m. at the Maslowski Wellness & Research Center in Wadena!

David Kloss