Prairie Doc Perspective Week of January 26th, 2025
“What can we learn from the dying?”
By Kelly Evans- Hullinger, MD
For the last five years, I have had the great privilege of serving my local health system as Medical Director for Home Hospice. Every week I sit in a meeting with the multidisciplinary caretakers on this team – the nurses who provide the great majority of the hands-on care, social worker, pharmacist, dietician, and pastor. We discuss all the patients currently under our care and discuss how we can improve each patient’s suffering and maximize their quality of life.
The patients we care for on home hospice are those we believe to be at the end of life. Some are actively in the dying process; others are stable, still going about their lives, but have a terminal disease with a high likelihood of death in the next six months. On home hospice, most patients either stay in their own home with help from a caretaker, often a family member; or they might choose to reside in a care facility where they can get more extensive needs met.
Our nurses and other staff get to know these patients and their families extremely well, and I truly enjoy hearing our patients’ stories relayed. I don’t always get to meet the patients cared for by our team, as most continue to stay under the care of their primary care providers while on hospice. But even when I am hearing their stories second hand, a theme stands out as a common sentiment of our patients - the desire to reflect on their lives.
Patients facing their own deaths want to talk about their lives. Our staff frequently tries to facilitate what they call a “life review” in which a patient can openly talk about their childhood, family, career, service, and sometimes their regrets. This is therapeutic for the dying patient and their loved ones. Even some patients with dementia, with no memory of recent years, can delight in recalling a story from their childhood, looking through old photographs, or listening to music they once loved.
I have recently thought about this particular human need – to reflect and remember one’s life. I take this as a reminder to both seek those stories from my own loved ones (gosh, I wish I had asked my grandmother more questions about her life) and, perhaps, to tell and write about the things in my own life I would want to be remembered after I am gone. For if there is another thing I’ve learned serving patients on hospice, it is that my death is also inevitable; but, I think, life’s finality is what gives it beauty and meaning.
Kelly Evans-Hullinger, MD. is part of The Prairie Doc® team of physicians and currently practices Internal Medicine at Avera Medical Group in Brookings, South Dakota. Follow The Prairie Doc® at www.prairiedoc.org, and on social media. Watch On Call with the Prairie Doc, most Thursday’s at 7PM on streaming on Facebook and listen to Prairie Doc Radio Sunday’s at 6am and 1pm.
​

Prairie Doc Perspective Week of January 19th, 2025
“Its Here”
Debra Johnston, MD


Lately I’ve been reminded of a blockbuster movie from my youth. It contains a scene that even those who never saw the film are likely to recognize. A sleeping family is jolted awake, and from the foot of the bed the young daughter sings “they’re here!” 


One might wonder why I’m thinking so much about Poltergeist. That quote started ringing in my brain during our last monthly clinic meeting, when our lab director reported on the previous day’s influenza statistics. Nearly 90% of the tests were positive. Respiratory viruses may not seem like a natural comparison to malevolent ghosts, but they’re here, and things are likely to get worse before they get better. 


Last season, there were over 20,000 confirmed cases of influenza in South Dakota. Over 800 people were hospitalized. Nearly 50 died. 


When I diagnose someone with influenza, I warn them to expect misery. They will likely have fevers, body aches, exhaustion, and of course cough. Some people are out of commission for only a few days, others for two weeks. Some people can barely get out of bed, and some people just feel a bit run down. 


The flu shot helps, but it is far from perfect. People who get the shot can still get influenza. Generally it is between 40 and 60% effective at preventing infection. Still, those who had the shot and get sick anyway are significantly less likely to be hospitalized. So long as influenza is circulating you should still get your shot. It isn’t too late even if you already had influenza, as the shot contains 3 different strains. 


Of course, things like washing your hands, not touching your face, and avoiding sick people are also useful. It can be hard to distinguish one respiratory virus from another. 


Influenza tends to strike more suddenly than many others, but symptoms have significant overlap. Testing is the best way to distinguish whether or not your illness is influenza. Influenza is also one of the few viruses for which we have specific treatments, so getting that answer can be useful. Treatment is generally used for those at higher risk, such as young children, people over 65, those who have chronic health conditions or are pregnant. Importantly, medicine should be started within the first 48 hours of illness. 


So what can you do if you get sick? First, stay home! Get lots of rest. Drink lots of fluids. Fever reducers and over the counter pain medications can help you be more comfortable. Pseudoephedrine can help the congestion. Guaifenesin can help thin the mucous. Dextromethorphan or honey can help soothe the cough. 


Finally, watch out for signs that you are getting sicker instead of better. Influenza can lead to ear infections, sinus infections, pneumonia, and things that are even more serious, like bloodstream infections, inflammation of the heart or brain, and kidney failure. If something doesn’t seem right, get it checked out.


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.  

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.