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.

Prairie Doc® Perspective week of September 4th, 2022
“Keeping on the sunny side of life”
By Andrew Ellsworth, M.D.
After a visit about aches, pains and various medical issues, a patient was commenting on getting older. Similar to other patients, I expected him to say something like, “It’s no fun getting older.” To my surprise, the patient said, “I’m 85. That means I have a lot to be thankful for.”


Some people are almost always positive, and some are usually negative.Those that are positive have been found to have better outcomes and seem to enjoy themselves more while unfortunately, those that tend to be more negative do not do as well. Granted, factors such as poor health and misfortune can diminish anyone’s attitude. Thankfully, with a little effort, anyone can change their mindset. It really is amazing how much gratitude and a positive demeanor can improve your health. 

There are many small ways to brighten your outlook. To start with, begin and end your day listing what you are grateful for.
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Stop comparing yourself to others. This is one of the reasons social media has been shown to make people unhappy. If one is constantly looking at how others are doing, dressing, and where they are traveling, one cannot resist comparing themselves and thinking they are missing out. 
Exercise helps you feel better. Getting fresh air, some sun, and getting that heart pumping creates endorphins in your brain that can help improve your mental health in addition to the benefits to your physical health. 
Look to build lasting relationships. Studies have shown that people who have satisfying relationships with friends and family are happier, have fewer health problems, and live longer. Start building those relationships now. It takes time to gain trust, to listen, and show you care. 
As we get older, our world tends to get smaller. The places we go may decrease, the people we see may become fewer, and our daily activities may become more limited. However, that does not need to lead to less happiness. In fact, quite the contrary.
There is a poem that starts with “When I am an old woman I shall wear purple," It draws on the wisdom of being yourself.  When the pressure to perform and impress has passed, it can be liberating to know more about yourself, what you like, and what you do not like. Then you will be free to just enjoy your day, and maybe wear purple with a red hat, if you feel so inclined. 
Andrew Ellsworth, M.D. is part of The Prairie Doc® team of physicians and currently practices family medicine in Brookings, South Dakota. 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, broadcast on SDPB and streaming live on Facebook most Thursdays at 7 p.m. central.