Heart Health and Hypertension

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February is American Heart Month, and Tri-County Health Care wants you to take extra special care of your body’s hardest-working muscle. Use the month to focus on heart health and hypertension. Lower that sodium intake, get some exercise and educate yourself on just how important the heart is.

Feeling the pressure

The CDC has partnered with healthcare leaders across the country to spread awareness about hypertension. Hypertension or high blood pressure is caused by the increased pressure of blood against arterial walls. High blood pressure is classified at 130/80 mm Hg or higher. Stage 2 hypertension is 140/90 mm Hg.

This call for hypertension awareness was prompted by a call to action made by the Surgeon General. In his address, the Surgeon General explains that high blood pressure is a preventable risk factor in most people. By controlling high blood pressure, individuals can lower their risk of heart disease and stroke.

The call to action lays out a simple but direct plan of action:

  • Goal 1: Make hypertension control a national priority.
  • Goal 2: Ensure that the places where people live, learn, work, and play support hypertension control.
  • High blood pressure can lead to heart disease and stroke if left uncontrolled. Heart health and hypertension should be monitored.Goal 3: Optimize patient care for hypertension.

Do it for your heart!

Obesity, smoking, diabetes, poor diet are all factors in heart health and hypertension. February should be a jumpstart for healthier living. The first step should be meeting with a cardiologist to ensure your heart is in good working order. From there, change your eating habits. A simple change in diet can be the easiest way to curb high blood pressure. Reducing sodium and replacing junk food with fresh fruits and vegetables can vastly improve heart health. Also, making time for physical activity is important. The CDC recommends 150 minutes of physical activity each week. Get creative and find an activity you love. Heart health doesn’t need to involve going to the gym several times a week.

Cardiology expansion

Recently, Tri-County Health Care expanded its partnership with CentraCare Heart and Vascular Center. This expansion introduced increased coverage for cardiac services in Wadena. The cardiology department offers diagnostic testing like EKGs, Holter monitoring and vascular ultrasounds. Additionally, providers can also answer questions about complex heart-related procedures and provide consultation.

“The partnership between Tri-County Health Care and the CentraCare Heart and Vascular Center will elevate the level of cardiac care provided to the people of Northwest Minnesota. This collaboration will bring access to advanced cardiac care with seamless follow up close to home,” said Executive Director Phil Martin of CentraCare Heart and Vascular Center.

You should consult a cardiologist if you’re experiencing chest pain, high blood pressure, shortness of breath, palpitations, dizziness or have diabetes. Seeing a cardiologist can also be beneficial if you have a history of smoking, high cholesterol, or plan to start an exercise routine.

To schedule an appointment with the cardiologists in Wadena, call 218-631-7579.


TCHC has expanded its cardiology partnership

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Cardiology expansion

The heart is the engine of the human body. Just like any engine, it needs to be maintained. Tri-County Health Care has expanded its cardiology partnership with CentraCare to bring heart health closer to home. This expansion streamlines the services CentraCare provides weekly.

Dr. Wade Schmidt, a cardiologist at CentraCare expanded its cardiology partnership

“Working with Tri-County Health Care has been an excellent opportunity to bring our services to people that really need them. I look forward to the continued growth of this partnership as we add new procedures to our already robust cardiac services in the region,” said Wade Schmidt, M.D.

CentraCare is one of the leading providers of heart and vascular care in the nation. In an annual ranking, which evaluates nearly 5,000 hospitals, U.S. News & World Report ranked the hospital in the country’s Top-50 for cardiology and heart surgery. The rankings are based on outcomes, experience, nurse staffing, patient services and more.

“We are excited to team up with the top-ranked staff at CentraCare’s Heart & Vascular Center,” said Jose Alba, Chief Ambulatory Officer at Tri-County. “This expands access to service and provides heart health close to home for all of the communities Tri-County Health Care serves.”

Helping hearts

expanded its cardiology partnership This expansion will allow for a wider array of cardiology services CentraCare cardiology heart health cardiac care tri-county health care wadena wadena county hospital todd county otter tail county

This expansion introduces new cardiac services in Wadena. The cardiology department will offer diagnostic testing like EKGs, Holter monitoring and vascular ultrasounds. Providers can also answer questions about complex heart-related procedures and provide consultation.

“The partnership between Tri-County Health Care and the CentraCare Heart and Vascular Center will elevate the level of cardiac care provided to the people of Northwest Minnesota. This collaboration will bring access to advanced cardiac care with seamless follow up close to home,” said Executive Director Phil Martin of CentraCare Heart and Vascular Center.

You should consult a cardiologist if you’re experiencing chest pain, high blood pressure, shortness of breath, palpitations, dizziness or have diabetes. Seeing a cardiologist can also be beneficial if you have a history of smoking, high cholesterol, or plan to start an exercise routine.

Tri-County Health Care expanded its cardiology partnership to help you! To schedule an appointment with the cardiologists in Wadena, call 218-631-7579.

Don’t be salty

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By Lois Miller, RN, BSN, Cardiac Rehabilitation


When you sit down to a meal and reach for the salt, you might think all you’re doing is adding a touch of flavor. In reality, you might be hurting your body by eating something you already get too much of: sodium.

Do not throw salt in your heart!The common thought is that salt and sodium are the same thing, but they are actually different. Sodium is a mineral that occurs naturally in food, and more is often added to food when it is processed and prepared. Salt is a combination of sodium and chloride. One tsp of salt contains 2,300 mg of sodium.

The American Heart Association recommends that we take in no more than 2,300 mg of sodium a day, and the ideal limit is 1,500 mg a day for most adults. If you have known heart disease, that number may be even lower.

We need sodium to survive. It is necessary for muscle contraction, nerve transmissions and to control systems for balancing bodily fluids, but there is a great divide in the amount we need and the amount we take in daily.

We only need 500 mg of sodium (less that 1 tsp.) a day, but the average American consumes more than 3,400 mg daily. In fact, the American Heart Association says that 9 out of 10 Americans take in too much sodium.

More than 70 percent of our sodium intake comes from packaged, prepared or restaurant food, and when that food arrives at our table, we add more salt.

Sodium pulls water into blood vessels, increasing the volume of blood in them. With more blood volume, the blood pressure rises. High blood pressure may injure the blood vessel walls, and it will speed the buildup of plaque that can block blood flow. Added pressure tires the heart, forcing it to work harder. Over time, the extra work and pressure can stiffen blood vessels, leading to high blood pressure, heart attack, heart failure and stroke, along with dementia and kidney disease.

The Centers for Disease Control and Prevention reports that about 1 in 3 American adults have high blood pressure, and more youth are also falling victim to this condition. High blood pressure puts you at an increased risk for heart disease and stroke, which are two of the top causes of death for Americans.Sodium nutrition facts and a pen on paper.

Too much sodium can also lead to fluid retention, which causes bloating and weight gain but could also lead to more serious problems such as swelling of the legs and feet and other health problems.

The only way to lower your sodium intake is by being mindful of what you eat. Sodium is a master of sneaking into your diet in less obvious ways.

Here’s a breakdown of some popular foods and how much sodium they have on average per serving, according to Healthline.

  • Bagel – 400 mg
  • Baked beans, 1/2 cup – 524 mg
  • Beef broth, 8 oz. – 782 mg
  • Canned soup – 700 mg
  • Cold cut meats, 2 oz. – 497 mg
  • Cottage cheese – 350 mg
  • Flour tortilla, 8-inch – 391 mg
  • Frozen pizza, one slice – 765 mg
  • Hot dog – 578 mg
  • Salad dressing, 2 Tbsp. – 304 mg
  • Soy sauce, 1 Tbsp. – 1,024 mg

Woman salting pizza.

Finally, check out these tips on how to keep track of the sodium in your diet:

  • Many people season their food before tasting it. Try to avoid picking up that salt shaker when you sit down to eat. Be creative with other seasonings such as garlic, ginger, spices, herbs and pepper.
  • Read ingredient labels when grocery shopping. Food is considered low-sodium if it has 150 mg or less per serving. It is considered high-sodium if it has 400 mg or more per serving.
  • Salt and sodium are often used interchangeably, but they are not quite the same thing. Therefore, food can be labeled as having no added salt, but it could still have sodium, so be sure to check the label.
  • Cook from scratch more often, and you can greatly reduce your sodium intake. For instance, one 8 oz. can of tomato juice can have 405 mg of sodium whereas one small tomato only has about 11 mg.
  • When you can, buy fresh fruits, vegetables and meat. If you do buy canned foods such as tuna or vegetables, rinsing them with water can get rid of a lot of the added sodium.

A miracle heart

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With the celebration of February as Heart Health Month, this week (Feb. 10-16) highlights an important aspect of keeping your heart healthy after it has experienced a traumatic event: cardiac rehabilitation.

Cardiac rehab is designed to improve the health and function of your heart if you are recovering from heart trauma such as a heart attack or heart surgery.

Red heart in child kid mother and father hands in vintage color tone.Carolyn Flicek knows first-hand the importance of this step of recovery. On April 20, 2018, while she was attending a conference in the Cities, she suffered a major heart attack.

It was early morning when Carolyn felt a deep pain in the center of her chest. She had experienced pain like that before and chalked it up to reflux or a pulled muscle, but she said this time was different. She woke up her roommate and told her to call an ambulance.

“And I prayed right there, I said, ‘God, whatever you are going to do with me, I’m willing to accept whatever it is. I have no control. It’s all you.’”

Carolyn remembers telling first responders what was happening. She remembers the elevator ride and getting in the ambulance. She remembers entering the doors of the emergency room.

“I remember getting zapped twice. After the first zap, whoever was standing there, I just looked at them and said, ‘Don’t you ever, ever do that to me again.’ And I could hear the joules (charging up). And I got zapped again!” She laughed. “The doctor had told my roommate, ‘I hope she doesn’t remember those shocks,’ but I did. You feel every nerve in your head, shoulders, feet, fingers. You feel all the nerves. And I thought, all my nerves are working because I felt every one of them!”

Carolyn remembers small details after that but nothing definitive until she reached the ICU. They put one stent into her blocked artery to open it up and allow blood to start flowing normally. Carolyn was quickly surrounded with love and support by her husband, daughters, parents, sister and church members.

Doctors later revealed that she had suffered from a serious heart attack called the widow maker. It occurs when one of the main arteries providing blood to your heart is blocked, a condition that is fatal without emergency intervention. In Carolyn’s case, her artery was 98 percent blocked.

Amazingly, it was only five days after her heart attack that she was well enough to leave the hospital and went through one final test to see how her heart was functioning. The results surpassed expectations.

“The doctors called me a miracle heart because I was completely healed before I left the hospital,” Carolyn said. “We serve a mighty God.”Carolyn Flicek rides a recumbent bike to gain heart strength after her heart attack.


Strengthening her heart

Despite her miraculous recovery, the heart attack left Carolyn weak and in need of cardiac rehabilitation in order to strengthen her heart. She lives about six miles from Wadena and was pleased to learn that Tri-County Health Care provides cardiac rehabilitation and services from visiting cardiologists, saving her long trips to St. Cloud or Brainerd.

Lois Miller and Gloria Cichy in the cardiac rehab department helped develop a plan for Carolyn and then coached her through it.

“They were so nice. So nice,” Carolyn said. “They were positive about helping you. It wasn’t ‘you gotta do this or else.’ They were really good. They were positive and encouraged you.”

Carolyn’s typical rehab sessions began with a weigh-in, and then Lois or Gloria hooked Carolyn up to a heart monitor to track her heart’s activity. Then they helped her through a series of mild cardio workouts including walking on a treadmill and riding an Airdyne or recumbent bike. Over time, these exercises strengthened Carolyn’s heart and helped her get back to living her life fully.

“Working in cardiac rehab is very rewarding as we watch our patients improve physically and gain confidence,” Lois said.

Cardiac rehab also offers other benefits in addition to conditioning your heart, including weight management, developing healthier habits and lifestyles, increasing self-confidence, lowering the chance of future heart trauma and the ability to return to your daily life.

“It’s encouraging,” Carolyn said of cardiac rehab. “You need to do it to keep your heart strong, keep your muscles strong. It also helps with your lungs. It’s important to do cardiac rehab after you’ve had something like this because it makes you a better person inside as well as outside.”


Still beating strong

Now almost a year later, Carolyn exclaimed that she’s “doing great!” She sticks to a regular exercise routine of about five time a week and tries to hit a goal of 30 minutes a day. She has many tools Carolyn Flicek walks on a treadmill to increase her heart strength after her heart attack. at her disposal to build upon the lessons she learned at cardiac rehab, including a treadmill, bike and pull machine.

One of her favorite things to do is dance, and she loves to swap one of her exercise days for an energetic time on the dance floor. “I’m one of those dancers that can dance from the time the music starts to the end of the night,” she said. “I don’t need to stop. I just keep dancing!”

Carolyn carries nitroglycerin with her just in case, which can ease heart-related pain, but so far hasn’t had to use it. Though she has wondered if she could possibly have another heart attack, she doesn’t dwell on the thought.

“I am not afraid it might happen again. I’ve often thought about that,” she said. “Well, if it happens, it happens. There’s not a thing I can do about it. You just take your nitro and call 911 and go from there. I am at peace with it.

“For me, it was just trusting in what God had for me because there’s nothing I can do about it. You just go with it,” Carolyn said and smiled. “I’m here for some reason. He’s not finished with me yet!”


Heart attacks can happen without warning, and the symptoms can be different for men and women. Learn more about the signs and symptoms of a heart attack here.

Is your heart healthy?

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By John Haglund, Sonographer


The heart is one of your most important organs, which is why diseases of the heart cause the highest number of deaths in the U.S. each year. Yet, they can be prevented.

In honor of February as Heart Health Month, I’m going to share a little bit about how we at TCHC make sure your heart is as healthy as it can be with a reliable, non-invasive test called an echocardiogram.


What is an echocardiogram?Mother and daughter showing love by making heart shape with hands.

Essentially, it’s an ultrasound of your heart that lets us see a real-time video. It often serves as screening tests and is a great non-invasive way to look at the heart.

Echoes take about 45 minutes to an hour, and my job as a sonographer is to capture many views and measurements of the heart, such as size, thickness and function, for a cardiologist to read and interpret.

We perform echoes on patients age 12 and up. For younger kids, we typically refer them to the Cities where they have dedicated pediatric echo techs.


Why might someone get an echo?

Your provider might order an echo for a number of different reasons. We can use it to see if your heart is the source of certain symptoms, or to assess the health of your heart before and after a surgery.

Here are some specific conditions we might check for with an echo:

  • Heart attack damage
  • Heart murmur
  • Enlarged heart
  • Fluid around the heart
  • Hole in the heart

A common question I get is, “Can you see the arteries in my heart?” No, we can’t, but while we can’t see the arteries themselves, we can measure the movement of the walls of your heart, which can indicate healthy or abnormal arteries.


Patients come first

TCHC is unique in that we offer our patients an echo tech five days a week. So if you come in for a check-up and need an echo, we can typically get you in right away.

Ultrasonography machine used for echocardiogram. Ultrasound imaging used in medicine. Human heart. Four chambers.I also strive to help patients relax during the procedure by taking time to visit with them, as well as to get the best possible images because I know that things I find could affect their care.

One of my patients, Joan Bakken of Wadena, needed an echo to determine if her heart was healthy enough for an upcoming surgery. She needed results quickly, so we were able to expedite them. Joan was appreciative that she could get right in, otherwise, she would have had to drive to the Cities. Though we found she’s not a candidate for surgery at this time, the echo prompted follow-up care that she’s receiving now.

Another patient of mine, Ted Kuperus of Wadena, had an echo to determine the cause of persistent symptoms and received great news that his heart was working normally. His doctors were extremely happy about his results, so now he can move on to evaluate other areas that may be causing those symptoms.

“They made me feel really comfortable and explained what they were doing and what they were looking for,” Ted said. “They got me in right away. We had no problem with any of it. They made it really easy for me, really comfortable.”


Keep heart health top of mind

Your heart is arguably the most important structure in your body. Without your heart, you’re not going to function.

By offering echocardiograms to patients as screening tests, we’re giving them a way to be proactive with their heart.

I see this every day. Patients will say, “Boy, I wish I would have gone in 10 years ago and done an echo test.” We possibly could have detected damage much earlier. And then I have others who came in right away, allowing us to detect abnormalities sooner and have a better chance of saving their heart function.

Proactivity is key when it comes to heart health, as there are many things you can do to prevent heart disease and other conditions.

The American Heart Association and The Heart Foundation offer these resources for keeping your heart healthy:

Answers by Heart Fact Sheets: Lifestyle and Risk Reduction





Photo of John Haglund sitting next to the echo cardiogram machineAbout the Author: John Haglund has 29 years of experience in diagnostic imaging. He started his career as an X-ray technician and then attended an ultrasound program at the University of Wisconsin, where he was trained in both general ultrasound and echocardiograms.