Pharmacy Week: Mark Carlson Q&A

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Pharmacists provide a much-needed service in the healthcare industry. They are responsible for the storage, distribution and mixing of medications. They also play an important role in patient education. To celebrate National Pharmacy Week, we caught up with our pharmacist, Mark Carlson. In this interview, we discussed his career at Tri-County Health Care.

Mark Carlson

Q: Why did you become a pharmacist?

A: I wanted to become a pharmacist after working in a pharmacy as a technician.  I saw the diverse career paths in the profession with many options ranging from retail to research.

I liked where the pharmacy profession was heading from a patient experience perspective.  It is very rewarding to educate patients on medications and the nuances of how the medication works for their condition. I find drug-to-drug interactions, adherence and medication safety to be fascinating.

Q: What was your education like?

A: I went to Augsburg College for my Bachelors of Arts in Biology and then obtained my Doctorate of Pharmacy at the University of Minnesota. I was in the second class coming out of the Duluth campus. This program focused on pharmacy in rural Minnesota.

Q: What is your favorite part of the job?

A: I enjoy the variety. My day involves the clinical side of pharmacy, like knowing medication information and helping develop treatment options. Additionally, there is a lot of administrative work as well. I am very blessed to have a tremendous pharmacy team. They are very skilled and often go above and beyond.

Q: How has COVID-19 affected your work?

A: I have been able to integrate with other departments more during the pandemic. It has been a great experience to work with so many talented individuals. The vaccine and monoclonal team have done an excellent job. The pandemic has added to the daily challenge. but our collective effort is really making a difference.

Q: What is it like being a pharmacist at Tri-County Health Care?

A: Being a pharmacist at TCHC has been an excellent opportunity to expand my knowledge and skills. Everyone over the past five years has been great to work with. I was allowed to learn and develop on the job. Before coming here, I didn’t have as much hospital pharmacy experience. Tri-County Health Care places a high value on professional growth.

Q: What career achievement are you most proud of?

A: Being a part of the COVID-19 pandemic response team. Our mission is to help improve the health of the communities we serve and I firmly believe we are doing that, even during these challenging circumstances.

Please call 218-631-3510 to schedule an appointment. To learn more, visit and follow Tri-County Health Care on social media for regular updates.

Treating the tongue-tied

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Imagine being a new mother, you just gave birth to a beautiful baby, but after closer inspection, you notice something is amiss. The doctor confirms that your baby suffers from ankyloglossia, more commonly known as tongue-tie. This medical condition occurs at birth when a baby is born with a tight piece of connective tissue under the tongue. This tissue restricts the tongue’s movement. Luckily, this condition is well known and treatable. Being tongue-tied may result in difficulty breastfeeding or swallowing.

Dawn Dahlgren-Roemmich, CNM, has alot of experience with tongue-tied babies.

Dawn Dahlgren-Roemmich, CNM

Midwife perspectives

Dawn Dahlgren-Roemmich, a certified nurse midwife, has worked with many tongue-tied babies. According to Dawn, only about 10 percent of babies are born with this problem. In the last 20 years, she’s cared for over 100 babies with ankyloglossia. Her second daughter was actually born with ankyloglossia.

“Typically, this condition is very treatable and doesn’t cause any long-term issues if dealt with right away. If the frenulum is not snipped it can cause speech ipediments later in life. This is the reason we chose to have our daughter’s snipped.” – Dawn Dahlgren-Roemmich

When Dawn works with a baby having trouble feeding, she looks at the frenulum. If she finds the frenulum is interfering with feeding, she recommends the baby have the frenulum clipped by a provider or ENT specialist. After the frenulum is snipped, she works with the parents to reteach the baby how to feed.

Chiropractic intervention

Dr. Mitchell does occasionally work with tongue-tied babies.

Carissa Mitchell, DC

Tri-County Health Care has a diverse staff of medical professionals trained to detect this issue. From birthing services to chiropractic care, everyone is on the lookout for symptoms of tongue-tie. Carissa Mitchell, DC, has extensive knowledge of the muscle and bone structures of the human body. As a chiropractor, she is trained to observe and feel for problems affecting bodily alignment. She does see newborns and has had success detecting ankyloglossia. “I see many infants that have trouble latching or feeding and I focus on that. As a chiropractor, I’m not the person to diagnose a tongue-tie but rather check the musculoskeletal components and make sure they’re functioning properly,” explained Dr. Mitchell.

In some cases, extra tissue may not be causing restriction to the tongue. It could be an issue with the nerves and muscles associated with the tongue. A chiropractor can make adjustments to ease the tightness of the tongue, allowing for easier breastfeeding and swallowing.

Read more about this process in this article published by Andrew Dorough DC, CACCP.

Schedule today!

To learn more about obstetrics and birthing services, please visit Call 218-631-3510 to schedule an appointment and follow Tri-County Health Care on Facebook for regular updates.

Masks matter in schools!

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“I choose to wear a mask for a couple of different reasons. I currently have a high-risk teacher, and I want to protect the residents I work with at Mills Manor. I also don’t want to miss out on things like homecoming, prom, sports, and graduation,” said Lauryn Gravelle when asked about masks in school.

Senior year of high school is a major milestone in a person’s K-12 education. It is the grand finale that makes all the homework, cramming, and pop quizzes fade away. However, students have been missing out on this well-earned victory lap in the last couple of years. In 2020, graduations and proms were canceled in mass or held in an orthodox fashion. This year is gearing up to be no different as schools around the nation report high numbers of positive COVID-19 cases.

Lauryn is very busy with school, sports, and masks!

Lauryn Gravelle

Out of fashion

For a good chunk of 2020, masks were in style. Students across the country were sewing and bedazzling mask fabric in an act of pandemic unity. Unfortunately, things have shifted over the last several months, with mask no longer being seen as a helpful resource, only a hindrance. Right now, masks and the vaccine are two of the most powerful tools in the fight against COVID-19, but fatigue has set in. Months ago, classrooms were filled with masked students doing their best to continue studying during a pandemic. That fatigue is seen in school systems across the country.

Doing the right thing isn’t always comfortable

Lauryn’s mother, Wendy Gravelle, is a certified registered nurse anesthetist at Tri-County Health Care. She is also passionate about masking and the vaccine. “I was surprised as I didn’t know she was doing it. At a volleyball game, I saw her wearing it. I asked why she had it on, thinking maybe she wasn’t feeling well,” explained Wendy. Lauryn told her mother she wanted to protect those around her and do more to help during the pandemic.

“I honestly was just so proud at that moment to realize this is something she chose on her own, and it wasn’t me forcing her to do it.  Her sisters have also started wearing their masks, and I believe it was because of the impact she had on them.” – Wendy Gravelle

Wendy has four children, and all of them willfully chose to be vaccinated. Her family is very connected to the caregiving environment, and they would never want to accidentally transmit the virus to others, especially the elderly and immunocompromised. Lauryn works in an assisted living home and is frequently around people highly susceptible to COVID-19.

Masks have fallen out of fashion at many schools.

Masked and united

Masking is still crucial in the fight against COVID-19. It’s so important that even the vaccinated should wear one. Breakthrough infections can still occur in the vaccinated, making masks necessary for everyone when out and about. “I decided that Lauryn is empowering me to also follow her lead, and I wore my mask to her volleyball game. Everyone assumes you’re sick if you wear it. I informed them that if Lauryn can wear her mask at school, so can I,” said Wendy. Lauryn and some of her friends have been wearing masks to school, sporting events and while out shopping. They hope wearing their masks will inspire others to do the same. Lauryn is especially concerned for younger people that claim COVID-19 is a hoax.

The vaccine is currently available to children 12 and up. The vaccine is expected to be open to children ages 5 to 11 soon. Wendy spoke with Tri-County providers before getting her kids vaccinated. She recommends that parents talk to a trusted medical professional in addition to gathering information from trusted sources.

Wendy Gravelle is supporter of masks and vaccinations.

Wendy Gravelle

Getting the COVID-19 vaccine

Tri-County Health Care aims to vaccinate as many people as possible. To schedule an appointment, call 218-631-3510. Patients can also request the vaccine during regular provider appointments. Please follow Tri-County Health Care on social media or visit for regular updates.

Fight the flu!

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Necessary prevention

“I never get the flu shot.” How many times have you heard that? Avoiding this crucial vaccination seems to be a point of pride for some people. It shouldn’t be a proud choice to leave yourself vulnerable to illness during a pandemic. This year, help yourself, your family, and the ailing healthcare systems across the nation. Join us and fight the flu!

Every year the flu does immense damage to the population, resulting in many hospitalizations. Over the years, the flu has become another obstacle we deal with, but we can’t take the risk this year. With beds filling rapidly, hospitals and clinics may not have the resources to stave off the flu effectively. Help them fight back and get the jab.

Do it for you too!

There are many reasons to get the flu shot aside from lending a hand to nurses, doctors and other medical staff. Here are our top three:

  1. Healthy holidays

Getting sick on Christmas or Thanksgiving is pretty crumby. We’ve all experienced that woeful Thanksgiving where the rest of the family enjoys a delicious dinner while you struggle to keep down warm soup. Do yourself a favor and don’t let the flu stifle your plans to enjoy the holidays.

  1. Preserve time off

Wouldn’t you like to enjoy a day off doing something you love? Having to use up all of your vacation days battling the flu is no fun. Don’t let the flu dictate your days off, miss work for something fun and fight the flu.

  1. Do it for the immunocompromised

Fight the flu! Don't let the flu stifle our COVID-19 treatments.Some people can’t get the vaccine due to medical complications and allergies. We can help them by reducing the amount of illness in the population. Remember them when offered the flu shot at your next appointment.

The Centers for Disease Control and Prevention have released updated information regarding this year’s flu season. Visit their website for more details.

Upcoming flu shot clinics

Tri-County Health Care will be hosting several flu shot clinics during September and October. Clinics will be available in Wadena, Bertha, Henning, Ottertail and Sebeka.

Wadena              218-631-3510

Saturday              Oct. 2                   7-12 p.m.            all ages

Saturday              Oct. 16                 7-12 p.m.            all ages

Bertha                  218-924-2250

Wednesday         Sept. 29               7-4:15 p.m.        65+ day

Wednesday         Oct. 13                 7-4:15 p.m.         all ages

Henning              218-583-2953

Wednesday         Oct. 20                 8-4:15 p.m.         all ages

Ottertail               218-367-6262

Tuesday               Oct. 26                 8-4:15 p.m.         all ages

Sebeka                 218-837-5333

Wednesday         Oct. 6                   8-4:15 p.m.         all ages

Tri-County Health Care offers a significant discount for individuals paying at the time of the flu shot clinic. Medicare Advantage Plans, Humana, Medicare, Medicaid and many other commercial insurances are accepted. Please confirm with your insurance company before the clinic. Pre-registration is strongly encouraged, but walk-in appointments are available.

When is the pain too much?

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Lorinda wants to help you with pain management.

Pain is a part of life. No one should suffer in silence and solitude. Getting help is the first step toward a life with less pain. Recently, I sat down and thought about my personal and professional feeling on the topic of pain regarding orthopedic health. After some deliberation, I put my thoughts down on paper.

  1. Chronic pain

Ongoing pain can be stifling. If you find yourself suffering from the same old pain every single day, it might be time to make the call. Check-in with yourself. Is your knee pulsing? Do you find it hard to move in certain ways? Don’t suffer in silence. Meet with a professional and figure out what’s going on.

  1. Activity loss

As we get older, we often experience a loss in mobility, but it doesn’t have to be that way. If you’re experiencing trouble gardening or keeping up with the grandkids like you once did, consider seeking orthopedic consultation.

  1. Limited range of motion

Our joints take a lot of abuse. It’s important to keep an eye on our joints as they move. If things don’t feel the same, it’s probably a red flag. This change may be slow and gradual. Aches, pains, and problems doing household chores could be an indicator of joint issues.

  1. Difficulty standing and walking

We definitely take some movements for granted. Every day, most of us get out of bed knowing we will be unhindered. Unfortunately, for some, the simple act of standing can be painful. Struggles with standing and walking shouldn’t be taken lightly. This struggle could be an indicator of more problems to come and should be immediately addressed.

  1. Sprains and soft tissue injuries

Working hard and playing hard sometimes comes with consequences. Sprains are a problem, but in many cases, they don’t require immediate orthopedic intervention. However, if you experience a sprain that doesn’t improve in 48 hours and you’ve tried applying ice and elevation, please schedule an appointment. This kind of pain should be addressed by a professional.

Pain can sometimes be alleviated with simple stretching.

My injuries

I’ve had orthopedic injuries just like anyone else. I ran track in high school and strained my hamstring tendon. My parents got me into physical therapy right away to work on stretching my hamstrings which prevented further injury. I’ve also recovered from other injuries affecting my back. For me, consultation, stretching, yoga, and strength training put me on the road to recovery. During an initial appointment with me, we will work together to find what works best for you.

What to expect during your first visit

A first appointment can be anxiety-inducing, but it doesn’t have to be. In many ways, meeting with Ben Robertson, M.D., or myself isn’t all that different from a regular check-up. During a visit with Dr. Robertson or myself, you should expect us to listen to your story. Getting your perspective on what brought you to us is of great importance. Additionally, we need to know what treatments you have received. We will perform an exam and show you related radiologic images. We will discuss treatment options and outcomes so you can make an informed decision about your care.

About the guest author: Lorinda Zigan, PA-CLorinda Zigan, PA-C, is an expert in pain management and helping people live fuller lives.

Lorinda is passionate about pain management and orthopedic care. Throughout her career, she has helped many people live fuller lives with less pain. In her free time, she enjoys spending time with family. She also enjoys tending to her garden and horses.

If you’re experiencing chronic pain, please consider scheduling an appointment with the Orthopedics team at Tri-County Health Care. Call 218-631-3510 to schedule today!

The COVID-19 variants and Mu

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The nature of a virus is to mutate so it can more easily spread. COVID-19 is no exception, and right now, there are four dominant variants. According to the Centers for Disease Control, scientists actively monitor populations for new mutations. This is necessary for tracking the virus and devising treatments.

Variants of concern

The CDC uses the classifications of interest, concern and high-consequence. Fortunately, no current variants are high-consequence. However, four of them have been identified as variants of concern.


Delta is the dominant strain. It was first discovered in India and is significantly more transmissible. It may cause more severe symptoms.


Alpha was found in the United Kingdom and is a quick-spreading variant. Vaccines and treatments are effective against the Alpha variant.


The very transmissible Gamma variant was detected in Brazil and Japan. The Gamma variant draws concern due to its ability to spread quickly and render some treatments less effective.


Similar to Gamma, the Beta variant spreads quickly from one host to another. Vaccines are effective but it does seem to be more virulent, making monoclonal anti-body treatment less effective. This variant was discovered in South Africa.

Variants are a constant concern for the medical community.

Variants of interest and Mu

A global pandemic gives a virus many opportunities to mutate. It’s important to keep tabs on every new mutation so medical professionals can be ready. Several variants of interest have been identified.

There is one particular variant of interest that has many on edge. The Mu variant has been making headlines for some time now, adding to the slew of identified variants. The Mu variant was discovered in Columbia back in January 2021. It has slowly made its way to the United States in small numbers. The problem with the Mu variant centers on its elusiveness. Vaccine experts predict this could be the virus that evades the current roster of COVID-19 vaccines. If the Mu variant were to pick up speed and become the new dominant strain, it would mean starting from square one again.

Tackling the fourth wave

During a recent interview with Lakeland PBS News, Tammy Suchy, Tri-County Health Care Quality and Risk Management Director, spoke frankly about the current difficulties with COVID-19.

“We have unfortunately had to keep people here longer than normal for things like strokes, heart attacks and sepsis, because there are no beds available in our region. We’ve even transferred a patient as far away as South Dakota.”

Tammy and the staff of Tri-County Health Care know that with every new variant comes the possibility of worsening circumstances. During her interview, Suchy made it very clear that the vaccine is the only way out of the pandemic and defeating the slew of variants on our doorstep.

Getting the COVID-19 vaccine

Tri-County Health Care aims to vaccinate as many people as possible. To schedule an appointment, call 218-631-3510. Patients can also request the vaccine during normal provider appointments. Please follow Tri-County Health Care on social media or visit for regular updates.

Prostate cancer and early detection

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Prostate cancer is no joke. Every year, it claims the lives of thousands, reminding us of the importance of early detection. Around age 50, it is recommended that men get tested for prostate cancer. Testing and the early detection of the cancer allow for a wide array of treatment options.

The American Cancer Society lists prostate cancer as the most common cancer in men aside for skin cancer. They estimate around 248,530 new cases occurred in 2021 with 34,130 deaths.

Times have changed

Testing has evolved over the years. As a result, the days of rectal examinations are on the way out, with physicians favoring the prostate-specific antigen test. According to the National Cancer Institute, a PSA refers to a specific protein produced by malignant and normal cells found in the prostate. This test measures the level of the antigen present in a blood sample. An elevated PSA level may indicate prostate cancer.

A medical perspective

Dr. Hess has seen a sizable decline in traditional prostate examinations in recent years.

Ben Hess, M.D.

With blood testing gaining popularity, there is almost no reason to ignore the importance of screening. Chief Medical Officer Ben Hess, M.D., is a supporter of PSA testing.

“I very rarely have to do prostate exams. It is no longer recommended for asymptomatic patients. Instead I focus on how and why we use the PSA test instead.” -Dr. Hess

He commented on the hesitancy felt by men when the touchy subject is brought up. Dr. Hess reassures them that old-school rectal examinations are no longer universally recommended. The PSA blood test may be better in most cases.


Screening should begin around age 50 unless a family history of the cancer prompts earlier screening. Symptoms of the cancer are:PSA testing has replaced traditional prostate exams in many instances.

  • Frequent urination
  • Weak urination
  • Erectile dysfunction
  • Painful ejaculation
  • Pain in the rectum
  • Pain in the lower back


This form of cancer can be treated in many ways, including surgery, radiation and cryotherapy. According to the Prostate Cancer Foundation, the chances of dying from prostate cancer are fairly low with a 5-year survival rate of 99%. Most trusted sources point to early detection as the key to beating this cancer.

If you are nearing 50 or have symptoms of prostate cancer, Tri-County Health Care can help. To schedule an appointment, please call 218-631-3510.

Yoga and the quest for pregnancy calm

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The benefits of regular yoga are well known and well documented. This fun exercise method has grown in popularity over the years by offering a simple way to condition the body and mind without expensive exercise equipment or gym memberships.

Calm the mind and body

Pam Doebbeling, RN, has made yoga a regular part of her fitness routine for over 30 years. Pam discovered yoga while in college, long before its explosion in popularity. She immediately loved it and now teaches regular pre/postnatal yoga classes at Tri-County Health Care. She is a certified yoga instructor and is accustomed to working with a wide range of skill levels.

“Most people think yoga is just stretching, but it really brings mind and body together.” – Pam Doebbeling

Yoga and its benefits

A yoga session with Pam is a fantastic workout. It doesn’t take long to work up a sweat, but more importantly, it calms the mind. Yoga is an opportunity to separate yourself from the hustle and bustle of the world and center yourself in tranquility. People often leave a session with Pam feeling the calming effects of yoga.

Classes with Pam are fun and beginner-friendly. Participants won’t find themselves on the floor struggling to contort their bodies. According to Pam, sessions center on what you can do. Moves can be modified to fit your skill level.

Getting ready for birth

Yoga is an excellent tool for preparing the body for birth. Yoga helps with the physical aspect of stretching the ligaments associated with childbirth. Overall, it keeps the body nimble while introducing important breathing techniques that aid with relaxation. It’s also an opportunity to meet other moms eagerly awaiting their due date.

Pam’s favorite pose

The tree is Pam's favorite yoga pose.

Maintaining balance is tough but it is one of the most exhilarating poses.

After 30 years of attempting nearly every pose in the book, Pam’s favorite move is the tree pose. She explained that it is challenging to balance, but you feel a rush of power over your surroundings when the pose is achieved. She also enjoys the pigeon because it stretches the hips.

Signing up

Pre/postnatal classes are completely free. They take place in the Browne Family Board Room at Tri-County Health Care in Wadena. Class sizes are typically small and may have COVID occupancy limits. Dates are listed below.

  • Sep 15, 2021, 5:30 – 6:30 p.m.
  • Oct 6, 2021, 5:30 – 6:30 p.m.
  • Oct 20, 2021, 5:30 – 6:30 p.m.
  • Nov 3, 2021, 5:30 – 6:30 p.m.
  • Nov 17, 2021, 5:30 – 6:30 p.m.
  • Dec 1, 2021, 5:30 – 6:30 p.m.
  • Dec 15, 2021, 5:30 – 6:30 p.m.

September is National Yoga Month, so if you’re pregnant and looking for a way to maintain your health, please register with Pam by calling 218-639-3689.

Astera Health and defining a brand

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Tri-County Health Care is rebranding to Astera Health.

Astera Health is your trusted partner for life. Our commitment to community is unparalleled and that commitment will remain as our brand evolves. Our premiere goal is to foster an atmosphere of better living in the communities we serve. We do this by constantly innovating, and always putting health first.

Choosing starlight

Astera is a derivative of the Greek word for star. The creative minds behind the name change wanted something fresh and new, but also a name evocative of our location. Minnesota is the North Star State so images of constellations and outer space quickly dominated brainstorming sessions. After some debate, Astera Health emerged as the final choice. It exudes a certain permanence just as Tri-County Health Care does. It’s always been there, always guiding the way.

What defines us

Mission: Astera Health is committed to improving the health of the communities we serve.

Vision: Astera Health will be your trusted partner for life.

Every good organization needs some basic tenents of operation. Astera Health is structured from the ground up to be a foundational resource for the community. Its also a place of personal growth for its many employees. The pillars of Astera Health are:

  • Providing exceptional customer service
  • Building a culture of ownership
  • Adaptable financial stewardship
  • Active community involvement

A change in phases

A rebrand is a major undertaking. It isn’t as simple as just changing the name and printing some new business cards. To ensure a smooth transition, Tri-County Health Care will go through a brand evolution which will occur in phases.

Phase One: Tri-County Health Care is becoming Astera Health

We are in phase one right now. This initial phase of reorganization will form the groundwork for our new brand. In this phase, staff are identifying key areas of change and formulating plans for transition.

August 2021-July 2022

Phase two: Astera Health, formerly Tri-County Health Care

In this step, Astera Health will emerge. Most big changes will have already occurred. At this time, staff will be pushing toward the completion of our brand change. Many small tasks will still need to be addressed, so the Tri-County moniker will stick around for a little longer.

July 2022-March 2023

Phase three: Astera Health

The brand change is complete. Tri-County Health Care is officially Astera Health. The completion of the brand change coincides with the opening of the new facility which has a tentative opening date of Spring 2023.

Learning more

A virtual town hall for the general public will be on Aug. 31 at 2 p.m. the purpose of this meeting is to address questions and concerns regarding the rebrand. The town hall will be hosted on Microsoft Teams and can be accessed here: TCHC Rebrand Q & A

Feel free to submit questions to prior to the meeting.

New chiropractor! Brock Spandl joins the team

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Brock Spandl, DC

Chiropractic care is growing fast! Hundreds of patients have found pain relief working with the talented Carissa Mitchell, DC. Her hands have helped over 300 people since joining the Tri-County family in June 2021. The high demand for chiropractic care led to the expansion of the service, which included Brock Spandl, DC joining the team.

Carissa Mitchell and Brock Spandl are chiropractors at Tri-County Health Care.


Dr. Spandl is a former athlete, having played soccer, hockey, and track while in high school. Running is a passion and that passion took him all the way to the University of Minnesota, where he competed in track and field. He was the freshman record holder in the heptathlon, 7-time top-3 finisher in the Big Ten conference, 2-time NCAA Division-I national qualifier and 1-time NCAA first-team All-American.

As an athlete, Dr. Spandl understands the physical conditioning the human body goes through to compete at a high level. He can speak the language of the sports and connect with athletes on a visceral level. He knows when they are at peak performance, and he knows when they need help. Dr. Spandl gained a great deal of his knowledge through firsthand experience.

“When I was younger, I suffered a significant lower back injury while competing in a Pole vault competition. Seeking treatment for that injury really inspired me to learn the innerworkings of the human body which led me to the world of chiropractic medicine”

The Staples community

Before joining Tri-County Health Care, Dr. Spandl did operate his own chiropractic office in Staples. Throughout the course of running his own practice, Dr. Spandl formed great relationships with the families and individuals of the Staples community. He hopes those people will come with him to receive care at Tri-County Health Care. A unique chiropractor like Dr. Spandl is hard to come by but he’s not really going anywhere, just moving to a bigger building.

A typical appointment

An initial appointment is a bit longer because Dr. Spandl needs to complete a basic examination. There is no set formula for how to treat a patient; each person is different and requires tailored treatment. According to Dr. Spandl, his most common appointment usually involves lower back or neck pain. He also helps with many headaches and radiculopathies. Dr. Spandl likes to keep his appointments concise so his patients can get back to doing what they love.

About Dr. Spandl

Brock Spandl, DC

After growing up in Moorhead, Dr. Spandl now resides in Staples with his wife, Missy. They have two children, Blair and Paxton. In his off time, he enjoys golfing, fishing and maintaining a healthy body. To schedule an appointment with a chiropractor, please call 218-631-3510 and follow Tri-County Health Care on social media for regular updates.

Learn about Chiropractic Care at Tri-County Health Care

Breastfeed better with Sarah Riedel

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August is Breastfeeding Awareness Month! A great time to brush up on the age-old practice that has many first-time mothers a little nervous. I’m here to help! So, take a deep breath and let’s go over a few things so you can breastfeed with ease.

Breastfeeding can be difficult, especially in your first week and if it’s your first baby. With the first baby, neither one of you knows what to do! If you can make it through the first seven to ten days, breastfeeding becomes a lot easier. The process becomes even more natural once you have a little practice. Educate yourself before the baby comes. Watch videos, read from credible sources and meet with our prenatal educators. This process has been shown to reduce anxiety in expecting mothers.

August is Breastfeeding Awareness Month. Breastfeed mothers Tri-County Health Care

The challenges of breastfeeding

First off, I have mothers who put baby to breast and when they don’t immediately latch on, they say, “Oh, I guess he’s not hungry.” Babies need a little stimulation to get them to latch on. Sometimes we need to let the baby wake up a bit first. Even then, they may not latch right away, and if they do, they might not stay latched for long. Most first-time mothers think they are doing something wrong when the baby latches and unlatches multiple times. This is totally normal!

Second, new mothers think that they aren’t making enough milk or that the baby is starving. With colostrum, the amount is very small, sometimes only a few drops per feeding. When the baby is at the breast, you cannot see how much milk the baby is getting. If the mother is pumping, they often become discouraged with only a few drops after a lot of work. Again, this is normal.  I try to make sure moms’ expectations are realistic to start. When they begin pumping, I explain they will likely only get a few drops or a teaspoonful.  If we get more than that, it is a gift. TCHC now offers donor breastmilk if the mother truly doesn’t think she has enough milk and chooses to supplement her baby.

You can do it!

So many mothers think that they can’t make milk at all. If I had a nickel for every time I heard that, I’d be a rich woman. The female body is made to produce milk. That is the sole biological purpose of your breasts! You CAN do it!  A good sign that your body is getting ready to make milk is if your breasts change during pregnancy. You might see them get fuller, bigger, heavier, and more sensitive and translucent (you can see the veins better).

What are the benefits of breastfeeding?

Breastmilk has antibodies that help protect your baby from bacteria and viruses. They are healthier babies if you breastfeed. Mothers who breastfeed have lower rates of breast, cervical, ovarian, and uterine cancers, diabetes and high blood pressure later in life. Breastfeeding burns calories, so it becomes a nice workout for the mother to get back to their goal weight faster.

What are some of your tips for better breastfeeding?

If you know someone who has breastfed in the past, please utilize them when you feel low about your success. Tri-County Health Care has a Certified Lactation Counselor and an Internationally Board-Certified Lactation Consultant here to assist you as well. Enlist your partner for additional support! Write down your reasons for wanting to breastfeed your baby, and if the going gets rough, reread your reasons.

The sooner you put the baby to breast, the better, ideally, within the first hour of life. We put the baby to breast any time they are showing hunger cues. If they are crying to be fed, we missed a lot of cues along the way. Usually, babies start mouthing or smacking their lips. After that, they bring their hands to their mouth. Crying is a very late cue.

When your nipples have stimulation, it causes a surge of a hormone in your body called prolactin. If you have more prolactin surges in the early days of breastfeeding, you will have a better milk supply weeks out. More breastfeeding equals more milk!

Small breasts do not mean you will have difficulty feeding your baby; that is a myth! Smaller breasts do not have as much capacity as large breasts, so you might need to feed your baby a little more often.

Keeping your baby close can really help on your breastfeeding journey. When a baby is skin-to-skin with a mom, it stimulates them and wakes them up more. I call this “putting baby in the BREAST-aurant.” This will help them wake up and put an order in. Being on mom’s chest is the closest they can get to where they came from. This is soothing to them.

We’re here to help!

Sarah Riedel wants to help you breastfeed better.

To learn more about obstetrics and birthing services, please visit Call 218-631-3510 to schedule an appointment and follow Tri-County Health Care on Facebook for regular updates.

About the author: Sarah Riedel

Sarah has been working with Tri-County Health Care for almost three decades. She has personally facilitated hundreds of births and is passionate about helping parents through the birthing process. Helping mothers breastfeed is a special point of interest for her. She also works with Minnesota Milk Bank for Babies and assists with milk donations.

National Immunization Awareness Month: Getting the jab!

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The COVID-19 pandemic has dominated every aspect of life. For the initial months of the pandemic, we were at the mercy of the virus while it targeted people in every phase of life. The pandemic and its economic and social factors forced a race for a vaccine. After months of testing, the vaccines emerged giving everyone hope for a return to a normal life. However, vaccine hesitancy continues to be an ongoing issue. Fortunately, In the face of the delta variant, vaccinations are increasing. August is National Immunization Awareness Month and now is a perfect opportunity for a fresh start.

We as a society have seen the constant news coverage and public addresses. All of this information can lead to mental exhaustion but we cannot lose sight of our goal. For a time, we removed the masks and ventured out, only to put the masks right back on. Understandably, this is depressing but we do have hope. We still have the best weapon against COVID-19 and its current variants. August is the time to take a fresh look at the COVID-19 pandemic as a problem that we can solve with medical science and solidarity.

Use this blog as a point of reflection. As we gear up for the new school year, sports and August gatherings, just know those things would be safer after getting the vaccine.

Voices of TCHC staff

Its important to hear a variety of perspective on such a pressing issue. Several members of Tri-County staff shared their personal thoughts on the vaccine and why they chose to be vaccinated.

Teenagers are able to receive the COVID-19 vaccine with a parental permission

The COVID-19 vaccine is available for people 12 and older.

“While I have limited knowledge of vaccinations, I knew right away that getting the vaccine was at the top of my priority list. Many people are hesitant to get the vaccine due to the political pressure surrounding it, however I never felt that it was a political decision. I made the decision to get the vaccine because I didn’t want COVID to control my life anymore.” – Jessica Frank

“It was simple for me. I do not want to get COVID. Spreading COVID to the people I care about is always a concern. I believe the vaccine is safe.” – Debbie Sly

“I chose to receive the vaccine because I believe in the advances that have been made in medical science. My husband has COPD and is oxygen dependent during the night and has many other diagnosis’ that puts him at high risk. We both received our vaccines as soon as they were available even knowing that they are not guaranteed to be 100 percent effective.” – Brenda Niemela

Abbey Truh and vaccine clinics

In the initial months of vaccine distribution, production issues stifled rollout. There was a great deal of demand but so few vaccines to go around. Attempting to get the vaccine to the people who needed it was an immense challenge. Abbey Truh, a registered nurse at Tri-County Health Care, was chosen to spearhead vaccine clinics. To get a vaccine at Tri-County Health Care, you have to go through Abbey at some point.

For several months Abbey and her team have organized COVID-19 vaccine clinics

Abbey Truh, RN

“Education is a huge part of putting patients at ease,” said Abbey when asked about her experience organizing the clinics. A constant factor of her job is educating people when they walk through the door. Many are on the fence; some are just scared and some simply lack the understanding of how the vaccine can protect them. Abbey has been following the creation of these vaccines from the start. She knows them inside and out. Most of all, she understands the end goal, getting to herd immunity.

Like with other nurses and providers, Abbey is tired and wants to return to normal operations but that can’t happen until we reach herd immunity. Abbey cites rampant misinformation and untrustworthy news sources as a major issue for vaccine hesitancy. People are simply not getting the right information from a trusted source and are instead retreating to social media only to find harmful takes and conspiracies.

Crunching the numbers

To date, Tri-County Health Care has administered 4,498 COVID-19 vaccines with the Pfizer vaccine being the predominant vaccine available. According to the Minnesota Department of Health, 5,123 people have received at least one dose in Wadena County. Currently 13, 654 people reside in Wadena County which puts us at roughly 38 percent vaccinated. To achieve herd immunity, we must reach 70-80 percent. National Immunization Awareness Month is a great chance to push for 50 percent. Half of our county population vaccinated would be a big milestone in the fight against COVID-19. The COVID-19 vaccine has exploded in availability over the last few months and is readily available in most places. Please consult your provider or utilize an online resource to find a COVID-19 vaccination site nearby.

More voices of TCHC staff

“I was more scared of getting COVID than the vaccine. The mask and the vaccine work because I assist people confirmed with COVID and I haven’t gotten it yet.” – Vonnie Perius

“I had COVID-19 before Thanksgiving and I was really sick. Two weeks later my husband got really sick with COVID as well. We didn’t want to get it again and so we decided to get the vaccine. We didn’t have any side effects from getting the vaccine. As far as we are concerned, it was worth getting the shot.” – Diane Crabb

“For myself and my children, there was no question if we would be vaccinated or not. I work with such a high-risk population (newborns) that I choose to vaccinate for myself, my family, and my patients’ health. I see a lot of patients who choose not to vaccinate their children, a few who choose to wait on the vaccines until the baby is a little older, and a few who want to space them out.  It is a very personal decision that I hope no one makes lightly.” – Sarah Riedel

The only tool we have

During an interview, Bobbi Adams, M.D., revealed her personal feelings about the pandemic and the vaccine. She discussed difficulties the providers and medical staff encountered after COVID-19 became prevalent in the area. Dr. Adams misses life before the pandemic and yearns to communicate with her patients unhindered by masks and layers of PPE. From her perspective, the only way to get back to normal life is to get the vaccine.

Getting the COVID-19 vaccine

During National Immunization Awareness Month, Tri-County Health Care wants to vaccinate as many people as possible. Pfizer vaccine clinics will be held every Thursday in August. The one-shot Johnson & Johnson vaccine is also available. Patients can also get the vaccine during a normal provider appointment. To schedule an appointment, call 218-631-3510. Please follow Tri-County Health Care on social media or visit for regular updates.

Helping you age well: Rose Lorentz

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Rose Lorentz, APRN, A-GNP, has been working at Tri-County Health Care for over 40 years. Her career has spanned decades, introducing her to thousands of patients. Each patient is a unique individual that handles aging in their own way. We all age, and Rose believes that the older generation is a foundational pillar of our community, holding years of precious wisdom. Helping them age well is a primary goal of Rose and the rest of the Tri-County team.

“I loved listening to my grandparents and their stories. They have a lot of knowledge to impart to us. I want to make sure they get the care they deserve,” said Rose. Every morning, she does her rounds at Fair Oaks Lodge, addressing various medical problems and facilitating communication between patients and physicians. Rose specializes in wound and ostomy care; a big part of her job is tending to the wounds of elderly patients.

“I was a candy striper at our local nursing home and fell in love with the older residents. That’s when I knew I wanted to make a career out of helping to make their lives better.”

Rose is a primary care provider at Tri-County Health Care helping elderly patients.Dementia

Rose has considerable experience working with patients who have dementia. Patients dealing with memory loss and the slew of medical problems associated with dementia need a heightened level of care.

According to Rose, patients in memory care need to have human contact, not just in the clinical sense. They need to be treated like people. Instead of being left in a room, they need and deserve human touch. She often observes people arguing or treating dementia patients like children. This is incredibly detrimental. People with dementia are still humans. They deserve respect and Rose habitually goes out of her way to respectfully communicate with every patient during a visit.

The end of life

Facing death is an obstacle we will all face. When older adults reach the end of their lives, it stirs emotions not just in them but also in their families. Many times, it’s more difficult for the family to process the incoming loss of a loved one than it is for the patient to pass.

Rose has observed this many times. Rose and medical staff have to do everything they can to provide a comfortable atmosphere for their passing. “Many have no family to sit with them. At that point, you become their family,” explained Rose. She and the nursing home staff are like family to these patients and grieve when they die.

“I feel it is a privilege to be with someone at the end of their life. It is the closest you will get to God here on earth.”

Rose Lorentz, APRN, A-GNP

About Rose Lorentz

Rose Lorentz has been working in the medical field since 1977.  She specializes in wound, diabetic and geriatric care. In her off time, she enjoys quilting and gardening. Helping the elderly is a special passion that she holds very dear.