Prairie Doc Perspective Week of January 12th
“The Seven Warning Signs of Cancer”
By Andrew Ellsworth, MD


Recently I was working with my son’s scout troop to help them achieve the personal fitness merit badge. This merit badge has many requirements including discussions about healthy habits, diet, and exercise. The scouts keep track of their exercise over a 12 week period and log everything they eat over a few days as well. One of the discussions covers the seven warning signs of cancer.  


This is a simple list of concerning symptoms to watch out for and reasons to go see a doctor. Indeed, with each of these I am reminded of patients that caught their cancer diagnoses early enough to get the treatments they needed. While having any of these symptoms certainly does not mean someone has cancer, it would be wise to seek medical attention.  


One warning sign is a change in bowel or bladder habits.  These could be signs of colon or bladder cancer.  


A second sign is abnormal bleeding. Blood in the stool and blood in the urine are symptoms to get checked out soon.  Abnormal uterine bleeding, which may include heavy or irregular periods, and bleeding after menopause, deserve more attention as well. 


If you experience a sore that does not heal on the skin or in the mouth, or see changes to moles or other skin lesions, then these may be a third sign of cancer that warrant an examination and possibly a biopsy to evaluate for skin cancer.  


Abnormal lumps or bumps is a fourth sign. If you experience a breast lump or thickening or change in breast tissue, please get this checked out as it could be a sign of breast cancer. A lump in the testicle could be a sign of testicular cancer. Persistent swollen lymph nodes warrant further attention. 


Unintentional weight loss is a fifth reason to see your doctor. While efforts at a healthy diet and exercise are good reasons to lose weight, bad reasons can include thyroid problems, depression, diabetes, and cancer. 


Trouble swallowing or ongoing indigestion or heartburn is a sixth sign that could be a sign of cancer of the mouth, throat, esophagus, or stomach.  


Finally, a seventh set of symptoms to watch for include a chronic cough or hoarseness that persists for a month or more. These could be a sign of throat or lung cancer, and warrant further evaluation. 


This list could be longer and more detailed, and having any of these symptoms can often be caused by benign, common reasons that are nothing to worry about. However, it is important to see your trusted physician or other medical provider if you experience any of the above symptoms. Please, do not delay and wait for a symptom to pass on its own. Your body is giving you a chance to get evaluated and help yourself. Pay attention!


Andrew Ellsworth, MD. is part of The Prairie Doc® team of physicians and currently practices Family Medicine at Avera Medical Group in Brookings, South Dakota. Follow The Prairie Doc® at www.prairiedoc.org, Facebook, Instagram, Youtube and Threads. Prairie Doc Programming includes On Call with the Prairie Doc®, a medical Q&A show (most Thursdays at 7pm streaming on Facebook and SDPB), 2 podcasts, and a Radio program (on SDPB), providing health information based on science, built on trust. 

Prairie Doc Perspective for the Week of January 5th, 2025
“Let’s Get Moving!”
By Jill Kruse, DO    
As we start the New Year, many people are making resolutions and setting goals for the next 12 months.  One of the most common resolutions is to be more active.  At Prairie Doc, we want all of our viewers to be both healthy and happy.  This week, On Call with the Prairie Doc will be showcasing different ways people can incorporate movement into their lives.  There is truly something for everyone.  
Personally, I’ve explored a variety of activities with varying levels of success and competence.   Regardless of the activity, what has made many of these experiences memorable and enjoyable are the people I have met along the way.  Some of my most cherished friendships have formed through shared activities, proving to be just as beneficial to my mental health as any physical benefits of the activity itself.   
Let me share some of the more unusual ways that I’ve stayed active throughout my life.  In fourth grade, I joined the wrestling team.  I became the first girl in my school to do so.  I was not particularly good, ending the season with a 1-11 record.  However, I was proud of myself for trying.  By sixth grade, two other girls joined the team with me.  
In junior high I tried volleyball, and while I loved, but was not very skilled.  The place I did excel in was taekwondo.  I started when I was ten and earned my 3rd degree black belt while in college.  When I was in medical school, I still found time for activities and needed to try things that were the complete opposite of my school work.  I tried rock climbing, belly dancing, and fencing.  All activities that were outside my comfort zone, but quickly became welcome breaks from studying.  
In Brookings, we are blessed with a multitude of activities in the area to try.  I have participated in an adult kickball league.  I have also started curling with the Brookings Curling Club.  This game involves not only skill and strategy but a little bit of luck.  On Prairie Doc, viewers will get to see me doing my favorite exercise activity, aerial silks.  My medical residency training was in Baraboo, Wisconsin, the home town of the Ringling Brothers.  I always loved the circus and aerial silks allows me to feel like I have joined the circus, if only for a few moments.  
Finding the right activity may take some trial and error, but once you find something you love it will be worth it.  So, as you set your goals for the coming year, consider trying something completely different.  You may just discover an activity that brings you joy and a new community of friends along the way.  Until next time, Stay healthy and active out there!
Jill Kruse, D.O. is part of The Prairie Doc® team of physicians and currently practices as a hospitalist in Brookings, South Dakota. Follow The Prairie Doc® at www.prairiedoc.org and on Facebook, Instagram, and Threads featuring On Call with the Prairie Doc®, a medical Q&A show on SDPB, 2 podcasts, and a Radio program, providing health information based on science, built on trust, streaming live on Facebook most Thursdays at 7 p.m. central and wherever podcast can be found.

Prairie Doc Perspective Week of December 29th, 2024
“Save and Preserve through movement”
By Carter Holm, RN
“Lack of activity destroys the good condition of every human being while movement and methodical physical exercise saves and preserves it”. Plato said that some 2300 years ago. It is not news to anyone that moving the body is the best way to stay healthy. But sometimes life gets in the way, whether in the form of a motor vehicle accident, a nerve condition like Guillain-Barre syndrome, or a health condition like a stroke, there are times in life when knowing that exercise is good for you is not enough. And it is during those times that physical therapy becomes crucial. 
My work in inpatient rehab places me directly in connection to a wonderful team of physical therapists, and I see first-hand the role they play in helping our patients overcome adversity. Strengthening the muscles is just one aspect of their jobs, they must also help the patients learn to adapt. For example, if an elderly patient has a stroke, in addition to helping the patient work on strengthening the affected side, therapists are tasked with optimizing the patient’s abilities, while helping them overcome their disabilities. They do this is tons of different ways, including introducing adaptive equipment, like walkers, canes, crutches, hemi-walkers, slide boards, etc.. They also help train patients in alternative lifestyle changes, sometimes the best way to overcome a problem is to find a workaround, and physical therapists are experts at problem solving with their patients, and coming up with safe and effective ways to help them improve.
Luckily, exercise is its own reward, and my patients almost always feel better, although a little worn out, after a good session. And this is because our body rewards itself with neurotransmitters following physical activity. Endorphins are released giving people that ‘runner’s high’ sensation, endorphins can relieve pain, reduce stress, improve mood and overall feelings of wellbeing. Working with physical therapists can cause a patient to release dopamine, the ‘feel good’ hormone, which causes improved mood, increased attentiveness, and can even improve memory and learning. Exercise also releases serotonin, which combats depression, improves sleep-wake cycles, and plays a role in digestive health. In my line of work we often talk about pre-medicating the patient, giving a pain medication before the patient needs to do something physically taxing. But it is striking how rarely we need to give pain medications after a patient finishes working with PT. Nature has taken care or that, by providing a built in system of pain relievers, mood improvers, and anti-depressants that accompany exercise.
Every patient is different, and so is the plan of care developed by the therapy team. If you or a loved one is dealing with a health condition that may require physical therapy, I want to be a calming voice or assurance, the therapist or team of therapists will customize a plan of care focused on the patient’s specific needs, that will help them adapt to changes, regain what they can, and improve the patient’s wellbeing. 
Carter Holm, RN is a Registered Nurse at Avera McKennan in Sioux Falls Specializing in inpatient rehabilitation. Holm is a Certified Rehabilitation Registered Nurse and works with patients through their rehabilitation from strokes, brain injuries, spinal cord injuries, and trauma. Follow The Prairie Doc® at www.prairiedoc.org and on Facebook and instagram featuring On Call with the Prairie Doc® a medical Q&A show celebrating its 23rd season of health information based on science, built on trust, streaming live on Facebook most Thursdays at 7 p.m. central. 

Prairie Doc Perspective Week of December 22nd, 2024
“FDA Approval”
By Debra Johnston, MD


Most of my family dreads the thought of going to a museum with me. It really doesn’t matter what the museum is, or how interested they might be in the subject, they’d prefer to do something, perhaps anything, else. 


I recognize that I am the problem. I love museums. One of my early memories is of exploring the King Tut exhibition at the Chicago Field Museum, and being drug out by my exasperated parents long before I was ready to leave. I wasn’t done reading all that fascinating information. 


Perhaps this explains why my Apple News Feed often presents me with historical trivia. Recently, I encountered a description of a patent medication marketed well into the 20th century that almost stopped my doctor heart. This particular product was targeted to parents, promising a myriad of benefits from soothing their fussy infant to freshening his breath. I have no doubt those fussy babies stopped crying. The combination of alcohol and opioids is generally pretty sedating. It is also pretty dangerous, and some of those babies never woke up. 


It wasn’t until the Pure Food and Drug Act of 1906 that companies were required to specifically identify the presence and amount of certain ingredients, at least in products sold across state lines. Importantly, this law did not prohibit the sale of ingredients like cocaine, chloroform, or formaldehyde in over the counter medications. It simply said that if those ingredients were present, and the product wasn’t being sold in the same state where it was manufactured, the label had to say so. At least now those parents knew they were giving morphine to their children! 


This same act prohibited “filthy, decomposed, or putrid animal or vegetable” material in food products. Admittedly, this applied only to items transported from out of state. If your groceries came from your own state, you were on your own. 


Over time, amendments to that original law, court decisions, and new laws brought us to the expectations we as consumers have today: 
-That manufacturer claims about food and medication are true 
-That medications and medical devices are safe and effective
 -That we can find information about the potential risks and side effects of a treatment
 -That product labels are accurate 
-That common allergens are identified 
-That imported foods and medicines are held to the same standards as domestically produced products 
-That ongoing monitoring of products occurs 


Still, the system is imperfect. There aren’t enough inspectors, and there isn’t enough post-market testing. Changes in drug manufacturing processes have introduced risky chemicals that go undetected for years. Contaminated foods sicken and kill before they are identified and pulled out of the food chain. 


Concerningly, people are often unaware that many products aren’t regulated even to these imperfect standards. Herbal and nutritional supplements aren’t reviewed even for safety prior to sale. Most skin and hair care products are classified as cosmetics and can also be marketed without any FDA approval (sunscreen is an exception). 


History has important lessons to teach us. Maybe I should be dragging my family along to those museums after all.


Debra Johnston, MD. is part of The Prairie Doc® team of physicians and currently practices as a Family Medicine Doctor at Avera Medical Group in Brookings, South Dakota. Follow The Prairie Doc® at www.prairiedoc.org, Facebook, Instagram, Youtube and Threads. Prairie Doc Programming includes On Call with the Prairie Doc®, a medical Q&A show (most Thursdays at 7pm streaming on Facebook), 2 podcasts, and a Radio program (on SDPB), providing health information based on science, built on trust.