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.

 

 


How Mommy Got Her Groove Back

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By Guest Blogger: Rebecca Undem, 2016 Women’s Day Out Keynote Speaker

When I graduated from high school, I had a plan.rebecca-undem-promo-picture-8-grand-sign

My plan was simple.

It was as follows: go to college, graduate from college, get a great job, marry an amazing man, promote within said job, have a family, retire in Mexico.

Boom.

My life would be fulfilling, I would feel complete and by all accounts and standards, I would be successful.

Being successful was the key—without success, what would be the point?

Here’s the thing about plans: rarely does life serve up the circumstances to perfectly accommodate them.

I’m sorry. I don’t mean to let the air out of your tires.

Then there’s the concept of success. Here’s the thing about success: it looks different on everyone. And the idea of what it means to you will change over time as you change, grow and develop.

I know. It almost doesn’t seem like you can count on anything, does it?

book-image-for-digital-productIn my memoir How Mommy Got Her Groove BackTM I share my personal journey of returning to my hometown in rural North Dakota, starting a family and how, in combination, these two choices made me question nearly every single thing I thought I knew about myself.

Here’s an excerpt from the book below:

“At times during our first few months in Oakes, I’d travel to Fargo to meet with Tonya and Tamara or help out with a training. Inevitably, I’d run into someone I knew. When we had decided to leave Fargo, I only shared the news with my Nesties, my employer, and the Dale Carnegie women.

Naturally, when I visited, people would say, “Rebecca! Wow! I haven’t seen you in so long! How’s the bank?”

I would return their greetings and say, “Oh, I, uh, left the bank in August.”

“What? I hadn’t heard that! Where are you now? Do you have a business card on you?” Most assumed I’d accepted a job with a competitor.

Each time this happened, I was overcome by embarrassment, too uncomfortable to explain the choice we’d made. I felt ashamed. Hoping they’d move on from the topic, I’d quietly mumble, “Oh, uh, we moved back to Oakes.”

Once I’d said that loud enough to be heard, I always anticipated the look. The look that suggested they were thinking, Really? Why would you do that? And here I thought you were a real go-getter. Did your dreams die? What happened to you?

Rebecca & her family

Rebecca & her family

When faced with someone from my professional past, I felt like I had squandered my potential by moving home. Like I was some sad, unfulfilled version of the woman I was supposed to become. It was hard not to question whether I’d ever feel professionally fulfilled in Oakes.

Each trip to Fargo was a painful reminder of all I’d left behind. I loved the hustle of the city. I loved meeting people for coffee dates and happy hour cocktails. I loved shopping for shoes and clothes and trying new restaurants. It was thrilling. It was exhilarating.

Now life was simple. Quiet. Boring, even.”

Throughout the book, I share how I came to get my own groove back and my hope is that through my story, you’ll find some truths you can apply to your own life.

wdo-external-sign-fb-graphicI couldn’t possibly be more thrilled about joining you on Sunday, November 20 in Wadena for the 2016 Women’s Day Out event. I’m bringing books so you can get a signed copy (or buy them for the women on your Christmas list—it will be nearly time for those pesky lists!) and sharing my signature keynote message of living BIG, which stands for being bold, getting inspired and choosing to grow.

Living BIG isn’t about what you do, where you live or what your specific roles are.

It’s about learning to follow your heart, surround yourself with good people and enjoy the journey—detours included.

Join me.

We’ll laugh, we may cry and above all else, we’ll remember that as women, there is more connecting us than dividing us. So let’s celebrate all it means to be a woman!

And in the meantime, if you want to connect or chat, don’t hesitate to reach out:

Website: www.rebeccaundem.com

Facebook: https://www.facebook.com/Rebecca-Undem-483632858479007/

Twitter: https://twitter.com/RebeccaUndem

Email: rebecca@rebeccaundem.com

To your groove…


Two New Tools in the Fight Against Breast Cancer

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By: Shannon Brauch, RN, TCHC Breast Navigator

3D Mammography

ret9992-4x6When it comes to breast health, every woman deserves the very best care possible. With the addition of 3D Mammography and Minimally Invasive Breast Biopsies at Tri-County Health Care, that is exactly what they will get.

A revolutionary tool in the early detection of breast cancer, 3D Mammography is the new standard in breast cancer screening today, with Tri-County’s new Genius 3D technology providing a 41% increase in the detection of invasive breast cancers compared to 2D alone, as well as up to a 40% reduction in anxiety producing false-positive recalls. The result is greater accuracy in diagnosis and ideally, reduced stress on the patient.

Who should have a Mammogram?

It’s recommended that all women 40 years of age and older receive an annual mammogram.

With 3D mammography, do I still need an annual screening?

Yes. All women are at risk for breast cancer, regardless of symptoms or family history. Mammograms often can detect potential problems before they can be felt. Early detection greatly increases treatment options and the likelihood of successful recovery.

Is 3D Mammography safe?

3D mammography is quite safe. Radiation exposure to the breast is very low. In fact, the radiation dose for a combined 2D/3D mammography exam is well below the acceptable limits defined by the FDA, and is only a fraction of the level of radiation you receive from natural sources.

Minimally Invasive Breast Biopsiesret9856-4x6

One of the only systems in the immediate region to offer minimally invasive breast biopsies, Tri-County Health Care is committed to providing female patients with care and technology required for the early detection and treatment of breast cancer.

A minimally invasive breast biopsy (or Stereotactic Breast Biopsy) is a procedure that uses mammography to precisely identify and biopsy an abnormality within the breast. It is normally done when the radiologist sees a suspicious abnormality on a mammogram that can’t be felt in a physical exam. This procedure will help determine whether or not you have breast cancer or any other concerning abnormalities in your breast.

Utilizing 3D Mammography as a guide, stereotactic breast biopsies use mammographic images to locate and target the area of concern and to help guide the biopsy needle to a precise location. This technique helps ensure the area that is biopsied is the exact area where the abnormality was seen on the mammogram.

Benefits of Minimally Invasive Breast Biopsies

A stereotactic breast biopsy is less invasive than a surgical biopsy, requires less recovery time and causes minimal scaring. Women who undergo the procedure can be in and out of the hospital the same day and able to sleep in their own bed that night.

Why is a Minimally Invasive Breast Biopsy Performed?

A breast biopsy is typically done if your doctor becomes concerned following a mammogram or breast ultrasound. It is used to investigate irregularities (such as a lump) in the breast.

Shannon Brauch, RN

Shannon Brauch, RN

About the Author: Shannon Brauch, RN, is the TCHC Breast Navigator. In her role she paves the path for women with breast health concerns and helps patients and their families navigate through the health care system. To learn more click here: http://www.tchc.org/what-we-offer/womens-health.

 

 

*Article was originally printed in Healthy Times Summer 2016.


Finding the Right Obstetrics Provider to Deliver Our Baby

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By: Lonna Dille, Licensed Social Worker – Medical Social Services

Finding a medical provider was never really a difficult task, but I found that choosing an OB provider was daunting! I had previously been receiving care at another facility, but when I started working at Tri-County Health Care in September, 2014, I knew I wanted to receive my OB care at Tri-County. The nurses and doctors here made that decision very easy for me! Yet, after working with all the wonderful doctors, how on earth do I decide on just one?! I knew all of the providers had great qualities, but I had to decide who was the best match for me, my personality, my family and whose style I thought would best motivate and encourage me. I knew I needed someone down-to-earth, kind, but who was also going to be straightforward. I chose Laura DuChene, MD.

My husband and I were very excited to start a family, but it was a roller coaster of emotions because we miscarried our first child. Even though we were very excited to try again I was nervous about the possibility of miscarrying again. However, when we found out we were expecting we were ecstatic!! We told our families at Christmas (a memory I very much cherish) and asked them to support us in our new adventure, but also asked that they not share the news until we were “safe to tell”. We did this knowing that if we were to miscarry again, we would have the support of our families rather than feel isolated and alone. We didn’t tell our friends, extended relatives, etc. until I was about 17 weeks along in my pregnancy.

I will admit that my anxieties about miscarriage got the best of me. Poor Dr. DuChene! I am certain my questions and concerns were incessant, but she didn’t mind once. When I was working one day, I actually fainted on the inpatient floor and the nurses brought me to her and she made room in her schedule immediately for me. I could’ve seen another medical provider in the emergency department but she made it a priority to see me! Another thing I loved about Dr. Duchene was her advice. It wasn’t just clinical advice, it was things like letting me know that Target had great maternity clothes and the comfiest maternity jeans! She is a mother of three, so she shared some great tips with me! She was also amazing through labor. I had no idea what I was doing (like any first time mom). Of course I got advice from friends and family who tried to explain what labor was going to be like, but its pretty hard to remember in the craziness! Her instruction was always helpful and well-articulated. She was so encouraging, and I remember she called me a “champ” during labor and I just remember thinking yes, I CAN DO THIS!

Baby Dille with hat from DuChene

Easton shows off his fire department hat knit specially for him by Dr. DuChene.

My husband and I are both firefighters and EMT’s for our local fire department, in Motley. He tried to come to as many appointments as he was able. The couple of times that he came with she made sure to include him in the appointment. In our conversations we spoke of our work with the fire department. We didn’t know the gender of the baby, but we had a firefighter onesie to take our baby home from the hospital. The day after I delivered Easton, Dr. DuChene came to do her rounding and she hand delivered us a FD (fire department) hat that she had personally knit for him. My husband and I were so touched! Not only did she take the time to knit our precious baby a hat, but she remembered that we were fire fighters and that we had decorated his nursery in a fire department theme!

Once we were home, the home visit from the TCHC nurse was a godsend! She was so helpful and supportive! Seriously, the nursing staff at TCHC is so caring and compassionate. They went above and beyond to care for Easton, my husband and I!

At the end of the day you need to be happy with the provider you choose. We have great providers to choose from at Tri-County Health Care, as I and many other will vouch for! My husband and I did not care what gender our baby would be, we just prayed that we had a healthy, full term baby. When Dr. DuChene delivered us a healthy, baby boy, it was the biggest blessing to us! We are so in love with our precious baby boy, and we are so thankful for the amazing we care we received from Dr. Duchene and the nursing staff at Tri-County.

About the Author:IMG_0400_zpsy9lgpmx2
Lonna Dille has been a Medical Social Worker at TCHC since September 2014, providing services to inpatient, clinic, and the emergency department at
Tri-County Health Care. Lonna and her husband Nick have been married four years and now have their son Easton, who is over three months old. Lonna enjoys hunting and fishing with her husband and family, good coffee and shopping. Her new favorite down time is cuddling with her son and husband while watching a good movie. 

 


Breast Health Navigator Eases Patient’s Concerns

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By: Shannon Brauch, RN, Women’s Health Coordinator

It wasn’t that long ago that patients with questions or concerns related to their breast health would rely heavily on their family and their own research to compliment what their doctor was telling them about an abnormal mammogram or other breast concerns.

When faced with a possible breast cancer diagnosis, women’s heads fill immediately with questions and concerns or frightful statistics they find when surfing the web. I have witnessed women whose minds were going 100 miles per hour. It’s these women who have found it nice to have someone else “be in charge” and guide them through this overwhelming process.

onein8info

My role as a breast navigator is to try to pave the path for a woman who have breast health concerns. I help with referrals and scheduling appointments. I also work with our medical team to try to help women understand what their diagnosis really means. And, despite the fact that one in eight women will be diagnosed with breast cancer during her lifetime, there is some good news—98% of women will survive if their breast cancer is found early. More woman are getting regular mammograms, cancer is being detected earlier and breast navigation is gaining in popularity because it fills so many gaps in the current American health care system.

The original concept of patient navigation was pioneered in 1990 by Harold P. Freeman, MD, a surgical oncologist at Harlem Hospital, for the purpose of eliminating barriers to timely cancer screening, diagnosis, treatment and supportive care. Since Dr. Freeman’s groundbreaking work in Harlem, the concept of navigation or advocacy has grown far beyond cancer and now covers almost anything being done to help patients and families find their way through the maze of our health care system.

The role of the Breast Health Navigator has evolved to meet the changing demands of breast health care. The complexity of breast health treatment and the growing demand for out-patient services requires a trained nurse case manager with the ability to increase patient outcomes and patient satisfaction while containing costs. The Breast Health Navigator serves as a consistent coordinator throughout the continuum of care assessing the physical, educational, psychological and social needs of the patient. And, if the patient is diagnosed with breast cancer, I work seamlessly with our surgical team and I am always available as a resource to the oncology team when needed.

As a Breast Navigator at Tri-County Health Care, I feel privileged to be able to support and guide our patients, and their loved ones, through their journey. The support and guidance starts with our initial conversation and continues we me as the point of contact each step of the journey. I like to think of myself as a proactive patient representative who provides support, education and guidance through complex health care issues and treatment as they relate to breast health, and sometimes the diagnosis of breast cancer. I like to think of myself as a communication link between the patient and other care providers.

During our first conversation, I like to share with my patients that I value open communication and reassure them that I will be with them through every step of the journey. It’s important that my patients know that I will visit with them, occasionally on the phone and sometimes in person, before, during or after appointments, testing and surgery.

breast cancer awareness

Breast health concerns are a priority for women and at Tri-County Health Care we value the experience of our patients and believes it’s important to develop individualized treatment plans for our patients. This individualized approach assures that patients receive timely, quality care and I work diligently to remove barriers that stand between the patient and effective, comprehensive care. Part advocate, part teacher, part problem solver, part advisor, part friend, the nurse navigator provides one-on-one emotional support and services to help ease the burden for breast health patients and their loved ones.

As their trusted breast navigator, I believe it is important to be intricately involved with all areas of care related to my patient’s health. I work closely with our Tri-County Health Care surgeons, Dr. VanBruggen and Dr. Kloss and their nurses to schedule consultations, biopsies and follow-up appointments. When it’s the wish of the patients, I will go with the patient to their breast biopsy and offer support as needed.

The benefit of working with a nurse navigator is that there is never any pressure or rush put on the patients during their visits and if they forget to ask a question during the appointment, they can always call the breast navigator later when they think of it.

As a registered nurse, I am qualified and honored to provide not only information that helps patients navigate through their journey, from diagnosis to recovery and beyond, I also provide emotional support. By helping women through this process, I believe we provide hope.

If you or someone you know would like more information about the breast navigation program at Tri-County Health Car or about breast cancer screenings, diagnosis, treatment or follow-up care, please call me at 218-632-8182 or 218-639-4517.

Shannon, Brian and their beautiful three children.

Shannon, Brian and their beautiful three children.

About the Author:

Shannon is a lifetime resident of Wadena. Her husband Brian and her have three beautiful children Mason 9, McKenna 6 and Aubrey 3. They’ll be welcoming their fourth child in December. Shannon is currently the Women’s Health Coordinator and Breast Navigator at Tri-County Health Care. In her free time, she enjoys spending time with her family and friends and doing anything outdoors.


Why does my bladder have a mind of its own? Incontinence is more common than you think.

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By: Dr. Jennifer Arnhold

Urinary incontinence, or accidental leaking of urine, affects many people, but is often a topic that people don’t want to discuss publicly because they’re embarrassed about it. When a patient does speak with their physician about it, there are several proven ways to provide relief.

Image source: The National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC)

Image source: The National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC)

I always stress this is a medical condition and there is no need to be embarrassed or ashamed by it. There are several different reasons why these issues may arise in some people…

  • Weakened pelvic floor muscles
  • Genetics
  • Structural issues
  • Neurological issues

Two common types of incontinence…

  1. Stress incontinence is involuntarily losing urine, or in other words wetting your pants. This can happen when you laugh, cough, sneeze or even jump on a trampoline.
  2. Urge incontinence is when you get this pressing sensation to go to the bathroom and you feel like you are unable to hold it, for no apparent reason.

It’s important to note that these types of conditions can affect women of any age and that females are twice as more likely to experience urinary incontinence then men.

There are different treatments for each type of incontinence:

  1. Physical therapy to help strengthen the pelvic floor muscles. (stress & urge incontinence)
  2. Prescription medication (stress & urge incontinence)
  3. Outpatient surgery (stress incontinence)

In the case where a patient is a candidate for surgery, it’s a same-day, minimally invasive outpatient surgery with very little downtime. It’s nice for working women who can very quickly return to work or other activities. Prior to this, there was a considerable incision in the abdomen, followed by three days in the hospital.

Today, we have a treatment known as “the sling procedure”. When a patient shows classic symptoms of urinary incontinence and we know that physical therapy or medications have proven unsuccessful, this procedure is a great option and is covered by health insurance.

In my years as a surgeon, I rarely hear women bring up the issue of incontinence in their appointments unless I directly ask them about it. Either they will tell me they were told that “it’s normal to occasionally wet yourself”, or that they’ve been told it’s normal after giving birth.

Mandy Pfeiffer, of Brainerd, came in to see me at my outpatient clinic in Baxter and explained her incontinence struggles. She was an excellent candidate for the outpatient surgery and so she came to Wadena to have it done. When I asked Mandy about her experience, here is what she told me:

Mandy Pfeiffer is the proud mother of three beautiful children and a wife to her best friend. Mandy is a certified, practicing Massage Therapist at MOXY Salon in Nisswa, MN.

Mandy Pfeiffer is the proud mother of three beautiful children and a wife to her best friend. Mandy is a certified, practicing Massage Therapist.

“I so appreciated that you took the time to answer my husband’s questions. He had more questions then I did! I thought it was really important that he and I both felt comfortable with the procedure. After explaining the procedure to both of us, we made the decision to move forward with the surgery. I never knew how bad my quality of life was until after the surgery. In the past, I would sneeze or jump and pee accidently. Some woman shy away from surgery because they think it will be scary. Trust me…this was quick and easy and I would do it again in a heartbeat knowing what I know now! My quality of life increased tremendously and that made everything worth it. I couldn’t imagine how good life could be…and this surgery made the difference for me.”

The good news is that with modern medicine this is a minimally invasive surgery that will get you back to life quickly while also increasing your quality of life. The issue of incontinence no longer needs to prevent you from doing anything. This is not something you need to live with. You also don’t have to wait until you get to a certain age to find relief from it. There is relief now!

About the Author:

Dr. Arnhold's son putting make-up on her and him!

Dr. Arnhold’s son putting make-up on her and him!

 

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.

 

 

 

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.


Mammogram Parties – A party with the potential to save a life

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By: Shannon Brauch, RN, Tri-County Health Care Women’s Health Coordinator

Every year, cancer claims the lives of more than a quarter of a million women in America. Breast cancer is the most common cause of cancer and the second most common cause of cancer deaths in American women.

As the leaves turn color and we approach fall, I like to take this opportunity to remind women that October is Breast Cancer Awareness Month and to highlight the warning signs of breast cancer. The warning signs that should alert a woman to visit with their primary care provider include:

  • Lump, hard knot or thickening inside the breast or underarm area;
  • Swelling, warmth, redness or darkening of the breast;
  • Change in size or shape of breast;
  • Dimpling or puckering of skin;
  • Itchy, scaly sore or rash on the nipple;
  • Pulling in of your nipple or other parts of breast;
  • Nipple discharge that starts suddenly;
  • New pain in one spot that does not go away;

About one in eight women will develop invasive breast cancer over the course of her lifetime, with 85 percent of breast cancer occurring in women with no family history of breast cancer. Because family history is not a reliable indicator, the American Cancer Society recommends that annual mammograms should begin at the age of 40 and continue for as long as a woman is in good health. Mammograms are the best way to find cancer early, even before it can be felt and when it is easier to treat. Some women, because of their family history, genetic tendency or other factors, should talk to their provider about the need for additional tests at an earlier age.

breast-cancer-ad-1-in-8

Cancer is a scary word and sadly the fear surrounding cancer can keep people from scheduling a life-saving appointment. Research shows that by visiting your medical provider and scheduling a cancer screening test you could greatly improve your odds of survival. Screening tests can detect certain cancers early, when they are the most likely to be curable. Knowing the benefits, it’s alarming that less than 51% of women ages 40 and older reported having a mammogram in the last year. And, recent studies suggest that women are getting their first mammogram later than recommended, not having them at recommended intervals or not receiving appropriate and timely follow-up of positive screening results.

At Tri-County Health Care, we value mammograms and want to make them a little less intimidating for women. In October, we are hosting six Mammogram Parties, each designed to help minimize fear and anxiety for women.

Mammo Party 2015 FB Ad

Women age 40 and older are invited to a Mammogram Party and are welcome to bring their friends, co-workers, family and of course “the girls” for a festive and party-life environment. While at the party women will enjoy massages, margaritas, munchies, and of course, receive their mammogram. There will also be neck and shoulder massages; bra fittings; hand massages/reflexology and representatives from Mary Kay and Healthy Living Oils. Each party can accommodate up to 12 people and the Tri-County Caring Heart Boutique Gift Shop will stay open later to allow the women some time to shop if they choose.

The parties will be held Thursday evenings in October (1, 8, 22) from 5-8 p.m. and Saturday morning, October 10, from 9 a.m. – noon.

Registering for a Mammogram Party is as simple as calling 218-631-7466. Call soon as space is limited to 12 women per party.

Cancer screenings can be very scary. We hope these mammogram parties minimize anxiety and encourage women to get their screening in a safe and fun environment.