Prairie Doc® Perspectives for week of October 2nd, 2022
​Sniff, sniff, sniff.  That darned runny nose. 
by Andrew Ellsworth, M.D.

When your nose runs, although it may not slow you down, it can be annoying. This time of year it’s difficult to know if your runny nose is from a cold, allergies, or another reason. 

Rhinitis can be broadly defined as inflammation of the nasal membrane.

Sometimes a runny nose is from allergies, caused by allergens in the air, such as trees, grass, weeds, molds, dust mites, or pet dander.  Allergy symptoms often include sneezing, an itchy or runny nose, and itchy, watery or red eyes.  

A runny nose can also be caused by a virus, like a cold. As the weather changes and with school back in session, people tend to spend more time indoors which allows airborne viruses to spread more easily. Cold symptoms may include a runny nose, as well as sneezing, sore throat, cough, and congestion. 

Be careful with nasal decongestants. While sprays may temporarily treat rhinitis, regular use of them can cause a rebound effect called rhinitis medicamentosa. Subsequently, a person may use the sprays more, causing a vicious circle. To avoid the rebound effect, try to limit the use of decongestant sprays to less than five days.

Sometimes a runny nose will not ever seem to go away. If allergy pills, steroid nasal sprays, or a change in environment do not help your chronic runny nose, it may be time to consider other causes.  

For many of these causes, your primary care provider can help you sort them out and come up with a treatment plan. There are other treatments beyond avoidance and steroid nasal sprays, such as certain inhalers. As always, talk with your doctor to determine if other factors such as polyps, tumors, or a systemic disease could be causing your condition. 
Accounting for more than half of all non-allergic rhinitis is vasomotor rhinitis. Vasomotor rhinitis is an exaggerated reaction to irritants such as air pollution, perfumes, or temperature changes, especially cold, dry air. 

Cigarette smoke, alcohol, cocaine, and occupational exposures may cause a runny nose along with different medications, such as aspirin or some blood pressure pills. Certain conditions such as pregnancy, acid reflux, as well as the use of your CPAP machine for sleep apnea have been known to affect the nasal membranes.  
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Personally, I know that if I eat something spicy or hot in temperature, I am going to need a Kleenex, for my gustatory rhinitis.  While there might not be a cure for your runny nose, sometimes it is just nice knowing the cause, because I am not going without my favorite pad Thai meal.

Prairie Doc® Perspectives for week of September 25th, 2002
​Transferrable Skills: teaching resilience, humility and self confidence through youth sports
By Kelly Evans-Hullinger, M.D.

I love sports. I have enjoyed playing and watching sports for as long as I can remember. And as someone who participated in a sport year-round in high school and continued in athletics (golf) in college, I am constantly grateful for the large impact being able to play competitive sports has had in my life. 

Now I am a parent, a proud coach of a young girls soccer team, and a more casual observer of youth athletics. I see youth sports through the lens of how they can impact our kids. Statistically, most children who try a sport or activity while young will not compete in that activity in high school; still fewer will go on to college athletics, and of course hardly any will play a sport professionally. But I still think, if done with the right goals in mind, prioritizing fun and learning, sports can do amazing things for children as they develop.

All sports can teach resilience and humility. Learning a new skill - walking on a balance beam or hitting a fast ball - is difficult but can be done with effort and persistence. Children can learn to manage their emotions and actions when things are not easy, because running a mile or making a putt takes persistence. They can learn to accept coaching and constructive criticism, skills we can all use as adults. They can quite literally fall down on the field or the court and learn to get back up and try again.

Another influential facet of sports is social. Being on a team teaches kids valuable social skills. Each child in a team sport will take a turn on the bench or sideline and learn to cheer on their teammates. They can encourage their teammate having a difficult time at practice. They can learn to offer a hand to an opponent who has fallen down. And they can learn how to respectfully shake their rival’s hand after losing, winning, or playing for fun.
Finally, sports can help shape our children’s views of themselves and their bodies. Youth sports make exercise and activity fun, potentially affecting their view of exercise as an adult. Playing a sport helps young people focus on what their body can do and how it can feel, rather than how it looks or how someone judges it. Numerous studies have associated participation in sports with self-confidence. I think about that a lot with my own daughters.
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I did not become a Sue Bird or a Serena Williams, and my kids probably won’t either. But I hope all the kids in my life can experience fun and learn some lessons by being included in sports. It sure made a difference for me. 

Prairie Doc® Perspectives for week of September 18th, 2022
Ask, then act
By Debra Johnston, M.D.

One summer during my college years, I had a roommate who suffered from suicidal thoughts. She’d attempted suicide before we met, and been hospitalized, but continued to struggle. Back in the late 80s, there was very little public understanding of mental health issues, and the stigma was even stronger than it is today. Our other roommate and I didn’t know what to do, or where to turn.
Not surprisingly, we didn’t handle it well.
However, we did one thing right: we restricted access to lethal means. We secured the knives, and took control of her medications. Back before Prozac, the best treatments were lethal if used to overdose.
It’s tempting to view people with mental illness as somehow different from the rest of us. On some level, I think we expect that to mean we can’t be affected. We want to believe it won’t touch us.
However, suicide crosses all boundaries. Anyone can develop suicidal thoughts, so everyone needs to be able to recognize the danger signs, and know what to do.
Risk factors for suicide include a previous suicide attempt, a family history of suicide, and a personal or family history of mental illness or substance use. Living with chronic pain or having experienced violence or abuse in the family are also significant risks. Other stressful life events, such as incarceration, a job loss, a break up, or bullying, make a difference as well.
There are often, although not always, warning signs. Watch for talk about being a burden, about feeling hopeless or worthless, about unbearable pain, and about death. There may be mood swings, anger or anxiety, withdrawal from loved ones or activities, or unusual risk taking. Sometimes the signs are more dramatic. There may be overt talk of suicide and actions that suggest preparation for death: saying goodbye, giving away treasured possessions, drafting a will. A person might research methods of suicide and take steps to implement a plan, such as buying a gun. Don’t consider talk of suicide to be a bid for attention. It is a cry for help.
Of course, recognizing risk isn’t enough. We need to know what to do. The first step is to ask the question: Are you thinking about suicide? Asking won’t “plant the seed.” It’s ok, in fact it is crucial, to ask. Try to keep the person safe by reducing access to means of suicide. Listen, and try to understand what they are thinking and feeling. Connect them to help, via the crisis line or another source of support and assistance. Stay in touch.
Emily, if you ever read this, your life matters. I wish we’d understood how to show you that.

Prairie Doc® Perspectives for week of September 11th, 2022
Listen to your Gut
By Jill Kruse, D.O.

People often talk about having a “gut feeling” when they know something is wrong. What feelings come when there is something wrong with the digestive system itself and how do you differentiate between "butterflies" acting up and a serious gastrointestinal problem?

There are many different organs that can cause GI problems and may include the esophagus, stomach, the small intestine, and the large intestine.

The esophagus is the tube that connects the mouth to the stomach. The most common issue people have with the esophagus is acid reflux or "heartburn." Reflux is a burning sensation in the chest and frequently includes a taste of acid in the back of the throat. Occasional heartburn can be a nuisance, but chronic heartburn can lead to damage to the cells in the esophagus and cause them to change in appearance. This change makes them more likely to develop into cancer over time.

A common stomach issue is ulcers, or an erosion of the lining of the stomach. Ulcers are painful and the pain worsens after eating due to stomach acid being released during digestion. Ulcers are often caused by the bacteria H. Pylori that your doctor, ulcers can test for.

The small intestine connects the stomach and the large intestine and is the longest part of the digestive system. This organ is also where most of the nutrients from your food are absorbed. Issues with the small intestine can lead to diarrhea, malnutrition, and bleeding which could result in anemia. Problems with the small intestine cannot only result in discomfort, but also contribute to nutritional problems which can affect the rest of the body.
Celiac disease, Crohn’s disease and small intestine bacterial overgrowth all affect the small intestine. These disorders can cause abdominal pain, severe diarrhea, fatigue, weight loss, and malnutrition.

The colon or large intestine can suffer from irritable bowel syndrome. Irritable Bowel Syndrome (IBS) is not fully understood but is thought to be at least partially caused by an abnormality in the brain-gut interaction. It can lead to diarrhea, constipation, or a mixture of both. It also causes cramps, bloating, excessive gas, and abdominal pain. Another large intestinal issue is Diverticulitis which results when "pockets" in the colon called diverticula become inflamed and infected. Often individuals with Diverticulitis have left lower abdominal pain, fever, nausea and vomiting.
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As you can see there can be many different complex conditions that can cause your gut to give you "feelings" and many of these conditions have overlapping signs and symptoms. If you have any concerns regarding your gastrointestinal tract, you should talk to your primary care doctor. They can help direct you for further testing which may include a referral to a gastroenterologist or surgeon. Most importantly, remember to listen to what your gut is telling you so you can start feeling better soon.