Prairie Doc Perspective Week of July 2, 2023
“Do Not Miss the Signs of a Blood Clot”
By Andrew Ellsworth, MD
The patient was young, healthy, and short of breath. She had not been sick recently, other than a minor cough. Her oxygen level was normal and her lungs sounded clear. Her heart rate was a little fast and she was breathing rather quickly, too. She was anxious about it, but she knew there was more to this than anxiety. Meanwhile, she was taking an antibiotic for bronchitis which did not seem to be helping. We did some additional tests, some blood work, to look for other possible causes. One test result gave us a big clue: her “d-dimer” was elevated. While not tied to a specific diagnosis, this gave us more reason to keep looking.
We proceeded to get a CT pulmonary angiogram, a special scan of the chest, specifically looking at the vessels that run from the heart to the lungs, looking for a blood clot. Sure enough, that is what it was: a pulmonary embolism. The treatment was medication to help thin the blood, which helps the clot to gradually dissolve. She was relieved to know the cause of her symptoms and within days she was feeling better.
Without treatment a pulmonary embolism, or blood clot in the lungs, can be fatal. Thus, early detection and treatment is key. Unfortunately, detecting it may be difficult, especially since the symptoms are often vague and common with numerous other illnesses.
In addition to shortness of breath, coughing, wheezing, coughing up blood, or pain with breathing can be symptoms of a blood clot. Another hallmark symptom of a blood clot may be calf pain or swelling. Unexplained swelling and pain of a limb may indicate a deep vein thrombosis (DVT), a blood clot in the leg or arm. Left untreated, a DVT can become larger and may break off and go through the heart to the lung vessels and cause a pulmonary embolism (PE).
A person may be at increased risk of a clot due to a genetic condition, an illness, pregnancy, after surgery, after an injury, because of cancer, or because of medications such as birth control pills. Covid has been a more recent cause. Sometimes a clot happens for no apparent reason. Prolonged travel is also a reason, so on a long drive or flight, take time to stop and stretch your legs. Wearing high compression socks while traveling may also be helpful.
Shortness of breath can be a symptom of numerous ailments, major or minor. No matter the reason, however, please consult your doctor if you are short of breath or have unexplained swelling of an arm or leg. It could be a blood clot.
Prairie Doc Perspective for the week of June 25th, 2023
“Make the Change for Yourself. Prevent High Cholesterol”
By Marissia Schaefer, CNP
Many of us have likely been educated on how to be healthier, which includes the foods we should consume, and the exercise we should complete on a daily basis, so we can achieve being ‘healthy.’ This information is important to know, but have you ever been educated about the risks that your current diet and habits of daily living impose on your health?
An ‘unhealthy’ diet that is filled with excessive amounts of sugars, fast foods, fatty and processed foods, as well as alcohol can increase your risk of acquiring high cholesterol. Tobacco use or exposure to tobacco can also have a negative impact on your cholesterol, as well as a lack of physical exercise.
When your cholesterol is elevated to a certain level it can be known as hyperlipidemia, dyslipidemia, or hypercholesterolemia. Cholesterol is a fat found within your body. Though it is good to have this, too much of it can cause negative health effects.
Most people likely do not realize they have this until they are screened within a clinic setting with their primary care provider. Others may find out that they have this disease once a significant event occurs, such as a heart attack or stroke. These events in specific, can occur as a result of high cholesterol.
When your cholesterol is too high it can build up in your blood system and cause blockages making it hard for your blood to pass through, or even cause blood clots.
We commonly start screening for high cholesterol as young as the age of 9, and continue forward based on each individual's risk.
For many people high cholesterol can be preventable, yet for some it is familial. To prevent high cholesterol, we recommend maintaining a healthy weight, daily physical exercise, avoiding tobacco, as well as a healthy diet.
For those that have been screened and are proven to have high cholesterol levels, we recommend the same lifestyle modifications mentioned above for initial treatment. Making these changes can be beneficial to many other disease states as well.
If these lifestyle modifications do not demonstrate benefit to your cholesterol level, there are medications that can be taken to help lower your risk of worsening condition and prevent poor health outcomes.
Get screened. Know your risk. Making these changes to your lifestyle now, can help prevent significant medical concerns later.
Marissia Schaefer, CNP Family Nurse Practitioner practicing in Arlington, SD at the Arlington Medical Center. Follow The Prairie Doc® at www.prairiedoc.org and on Facebook featuring On Call with the Prairie Doc® a medical Q&A show based on science, built on trust for 21 seasons, streaming live on Facebook and SDPB most Thursdays at 7 p.m. central.
Prairie Doc Perspective Week of June 18th, 2023
Coping with the “out of our control” reality of Agriculture
By Curstie Konold, MPH, CSW, QMHP
Marrying a farm kid has shown me the immense amount of pride in being part of the Ag community. It is prevalent that the agricultural profession, while rewarding, is challenging. Running big dollar operations that are both physically and mentally demanding creates some serious strain on our mental health. Whether it’s a co-op employee spraying chemicals or spreading fertilizer for 70+ hours a week or a farmer during planting or harvest, the demand never truly stops.
In my practice I talk a lot about focusing on what is within our control. I can control the way I cope in a situation, but I cannot control how someone else chooses to cope. Likewise, I can control my choices on what products I utilize in my operation, but some things are simply out of my control, like grain and livestock prices, or the unpredictable weather of the Midwest. The livelihood of Ag operations and families balances on influences out of our control. We are forced to leave many factors up to chance, and that creates a lot of pressure.
When we focus on things out of our control, we can start to experience negative mental health impacts. During times of stress, our body releases hormones to help regulate our stress responses. We experience toxic stress when our body is constantly releasing stress hormones into our body, which can create negative effects on our health. Starting in childhood and throughout our life, we learn mechanisms to help ourselves cope during stressful experiences.
In Agriculture there are many things outside of our control. So, what can we control? We can control how we choose to take care of ourselves and whether we use healthy coping mechanisms to manage stress. Healthy mechanisms might include exercise, healthy diets, spending time outside, mindfulness, relaxation, quality time with loved ones, or taking time to do things we enjoy. Likewise, when we are experiencing high stress moments, it is okay to step away from machinery, our phone, or other people for short periods of time. This is an example of one healthy coping skill to take care of ourselves in those moments.
There is no shame in seeking support. If you or someone you know is struggling, please reach out:
Curstie Konold, MPH, CSW, QMHP is the Outpatient Clinical Mental Health Therapist Avera Medical Group Behavioral Health Brookings Clinic
Prairie Doc Perspective Week of June 11th, 2023
“Primary, deciduous, baby teeth: Do they even matter?”
By Brock Tidstrom, DDS
In a single word, yes. Our first teeth are important in so many ways. They require just as much attention and love as our permanent teeth. Not to mention that beginning with good habits is the best way for anyone to maintain those healthy habits.
As parents, we know kids don’t come with an owner’s manual and that includes their teeth. One of the best ways to get the answers to all of your pediatric dental questions is to bring your little one to the dentist by age one, or 6 months after they get their first tooth. A first dental visit is often more about answering caregiver questions than examining any teeth. Some common questions may be: when do children get teeth, when do they loose them, do I need to brush them, what kind of brush or toothpaste is best?
A child's first tooth generally erupts into the mouth between 4 and 18 months, and should be brushed from the day they come in. It can also help with teething if you brush the gums before the tooth erupts. The type of toothbrush and toothpaste can be best determined by your dentist but, in general, a small soft bristle toothbrush with a rice size spot of fluoride toothpaste is a great start. Starting the twice-a-day brushing habit is always good too.
Our first set of teeth are meant to be in our mouths for between 4-10 years. Doesn’t seem like too long to maintain, but they are designed with less protection during some of the hardest years to keep clean (childhood!). They have less enamel thickness and larger nerve spaces than our permanent teeth. For this reason cavities can form quickly and become problems much faster. From the moment that a tooth erupts into the mouth it is exposed to acid, sugar and bacteria. As a baby this is either in the form of breastmilk or formula and then baby food. As our children get older it’s common to add juice, fruits, soda and candy to the list. We cannot completely remove food from our diet, but reducing the amount of time our children’s teeth are exposed can reduce the likelihood for dental treatment, especially during their primary dentition.
If a cavity does form in a primary tooth, it is important to detect and treat, if necessary, to try and maintain the tooth. Small cavities can often be treated prophylactically, but once the cavity breaks through the enamel more involved treatment will need to occur in order to avoid nerve involvement and pain. Our primary teeth are required for the most predictable long-term maintenance of our permanent teeth - meaning, without our primary teeth it becomes difficult to maintain proper spacing and a guide path for the permanent tooth to follow.
Teeth matter at all ages, it is never too late to help your children build a healthy relationship with their teeth.
Dr. Brock Tidstrom is a dentist in Brookings, SD and owns and practices at Prairie Sky Dentistry. For more information about Dr. Tidstrom head to www.prairieskydentistry.com.