Prairie Doc Perspective Week of November 24th, 2024
“Giving Thanks”
By Joanie Holm, CNP


Would you like to sleep better, have a healthier heart and less aches and pains? How about a lower blood pressure, a higher self -esteem and enhanced relationships? Would you believe that the Mayo Clinic and Harvard University, as well as other scientist all say these benefits can be yours with very little effort. And it doesn’t require a change in your diet or excessive exercise!
So, what is this magical therapy? GRATITUDE!! 


Gratitude comes from the Latin word gratia, which means grace, graciousness or gratefulness. Psychologist’s Robert Emmons of University of California, Davis and Michael McCullough, University of Miami, were early researchers in this field. They found that 10 weeks of practicing gratitude can result in the outcomes listed above as well as: an increased happiness score, increased optimism,  increased  exercise,  decreased physician visits,  increased focus, increased patience and strengthened social connections. Wow, who doesn’t want these health and relationship benefits?


Gratitude is like a muscle that you can build with exercise and practice. There are many ways to increase your gratitude muscle such as writing thank you notes, saying thank you to others in person or just mentally, writing a gratitude journal, praying and meditating. Other experts mention benefits from a brief, positive chat with a friend, a kind gesture toward a stranger and a peaceful stroll in nature. A change in mindset can help you feel better, for example feeling grateful for a helpful friend rather than feeling frustrated that you can do the task alone.


Lets get started on this journey of gratitude. Thank you for reading this essay and for watching On Call with the Prairie Doc. Thanks to all of my friends and family for the love and support you give me daily. Thanks to my church family for your spiritual support. 


Now it is your turn…. 


Joanie Holm, CNP is the Prairie Doc Board President and co-founder of Prairie Doc Programming. 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, providing health information based on science, built on trust. 

Prairie Doc® Perspectives for week of November 24th, 2024
Caring for Expectant Moms
By Debra Johnston, M.D.
Lately my teenager has been fascinated by medical dramas. Although my “doctor self” is usually rolling my eyes throughout the program, it’s often a good conversation starter.

One recent show featured a pregnant woman who experienced one medical crisis after another. Her kidneys, liver, and lungs failed in succession as the team raced to identify the underlying obstetrical problem and find a treatment. At the climax of the episode, her heart stopped. Of course, being television, the correct diagnosis was made, the experimental treatment worked, and the episode ended with a perfectly healthy mother at home, holding her perfectly healthy baby. 
For all the erroneous and outrageous details that transform bad fictional medicine into good TV, they did get something right. Pregnancy is a dangerous condition. In fact, in America, pregnancy complications account for approximately two percent of all deaths among women between the ages of 20 and 44. 
To put the two percent into perspective, consider that pregnancy complications can only happen in the months during and immediately following pregnancy. On average a woman in the United States will birth between one and two children. This means that between the ages of 20 and 44, the risk of pregnancy-related death isn’t spread across those 25 years as are the risks of cancer or car accidents. It is concentrated into the relatively few months during which she is pregnant. And for women younger than 20 and older than 44 the risk of pregnancy complications is even greater but, statistically speaking, women in those age groups simply don’t have enough babies to categorize pregnancy complications as a major cause of death. 
Consider also that death by violence is not counted as a pregnancy complication, even though pregnancy is a significant trigger for violence. 
What’s more, consider that these risks are not distributed equally between women. Socioeconomic status, education, physical location, and race all impact the likelihood of pregnancy complications, and death from those complications. 

Issues that affect pregnant people affect their whole family. In medical school, I was taught “nothing is worse for a fetus than a dead mother.” It’s hard to disagree. 


So, what can we do to make pregnancy safer? The answer to that question is multi-faceted. Access to quality obstetric care is one factor. However, we must also ensure women are as healthy as possible before they conceive. They need good nutrition and safe places to live and work. They need education to know what is normal, and what is not. They and their families need access to psychiatric care to address mental illness and addiction. 

It may not make for good TV, but in the real world, the starting place is as basic, and as difficult, as that. 

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 November 10th, 2024
“Protecting Children from Online Harms”
By Christina Young, Director for the Center for the Prevention of Child Maltreatment
With the rapid rise in internet use among children, the dangers of online exploitation have grown alarmingly. Children’s access to the internet has become nearly ubiquitous, especially following the COVID-19 pandemic. Remote learning, online gaming, and social media are now integral to daily life, meaning more children, even preschool-age children, are regularly online, often unsupervised and unprotected. This new reality demands that we consider not only physical safety for our children, but also the dangers they are facing online.
The Scope of the Issue
In 2022, the National Center for Missing & Exploited Children received almost 32 million reports of suspected child sexual abuse materials (CSAM), representing 88.3 million files. In 2023, more than 100 million such files were reported. There has also been an increase in “self-generated” content (children taking pictures of themselves and sharing it with others online), involving children as young as seven, shows how manipulation and grooming by online predators are impacting younger children.
Another concern is how easily children can access harmful content—often unintentionally. One study found that 15% of children encounter pornographic material before age 10, often due to algorithms or suggested content. This early exposure to harmful content can initiate a cycle of curiosity and risky behavior online. Over time, children can become desensitized and seek more extreme material, a phenomenon known as "content escalation." This can distort their understanding of healthy relationships and boundaries which could lead to long-term psychological and social risks that complicate their ability to form safe, meaningful connections.
Understanding Risk Factors
Every time a child accesses the internet, they face potential risks. Children with low self-esteem, developmental challenges, or mental health struggles are particularly vulnerable to manipulation. Sensation-seeking behaviors and inadequate supervision heighten this risk, as children venture into digital spaces that leave them exposed to harm. 
How Technology Compounds the Problem
Artificial intelligence (AI) and social media are significant drivers of online exploitation. AI enables the creation of “deep fakes,” complicating victim identification and creating new avenues for child exploitation. Meanwhile, social media algorithms frequently push harmful content to young users, and data privacy concerns remain largely unaddressed. Platforms designed for engagement can lead to addictive behaviors, making children even more vulnerable.
The Path Forward: What We Can Do
We have a shared responsibility to protect children. Here are essential steps we can take:

1. Legislative Advocacy: State and federal laws should require parental consent and enforce stricter age restrictions on content. Contacting legislators and advocating for child-centered online safety laws is vital.
2. Community Education: Parents, professionals, and policymakers must recognize the gravity of online risks. Education on privacy settings, content controls, and open dialogue with children can empower families to create safer online spaces.
3. Utilize Available Resources: Many organizations provide resources and reporting mechanisms. Platforms like the South Dakota Center for the Prevention of Child Maltreatment offer information on preventing online child abuse. 

Protecting our children requires proactive steps from every part of our community. By remaining vigilant and informed, we can build a safer online environment and help our children navigate the digital world with resilience and security.
For more information on protecting children from online harms, visit the South Dakota Center for the Prevention of Child Maltreatment’s website. Together, we can make a difference.
Christina Young has been an influential figure in the child welfare field for over a decade, dedicating her career to the well-being of children and families. She directed an in-home family services program covering 30 western counties in Iowa, demonstrating her commitment to community-based support. Christina has also served with a Single-Family Office and as COO of a mid-sized, midwestern law firm. Christina has a bachelor’s degree in psychology and a master’s in human services administration. 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 on 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 November 3rd, 2024
“Listen up and keep your hearing”
By Andrew Ellsworth, MD


Hearing loss affects millions of Americans. In fact, by age 75 over half of adults will have some form of hearing loss. 


Signs of hearing loss include having trouble hearing speech in noisy places, finding it hard to follow speech in groups, trouble hearing on the phone, listening makes you tired, or if you need to turn the volume up on the TV or radio while others complain it is too loud. 


To some, hearing loss may just be a minor inconvenience. If it is more severe, however, it can have a big impact on day to day activities, impairing communication, safe driving, safe walking, and has even been shown to increase rates of depression and dementia. When people disengage from others because they cannot hear well enough, people may become more withdrawn, and might not enjoy many of the things they used to. 


The simplest solution is to try hearing aids. While hearing aids are available over the counter, they are recommended only for adults with mild to moderate hearing loss. Meanwhile, it may be a good idea to see an audiologist or an Ear, Nose, and Throat (ENT) physician for a thorough assessment first. 


Warning signs you should seek medical care include seeing blood, pus, or fluid coming out of your ear, ear pain, an ear deformity, feeling something is in your ear, dizziness or vertigo, sudden changes or variations in hearing, worse hearing in one ear, or ringing or buzzing (tinnitus) especially if it is in only one ear.  


At least one quarter of hearing loss is due to prolonged exposure to loud noises, and even brief exposure to very loud noises like gunfire can cause hearing loss. Loud concerts, sporting events, car stereos, machinery, occupational exposures, and more all play a role. In addition, because of ear buds with the volume turned up, even going on a walk on a peaceful bike path can contribute to hearing loss.


Besides loud noises, other causes of hearing loss include ear infections, genetic factors, infections during fetal development, trauma, medications, smoking, chronic diseases, and more. Ear wax can cause temporary hearing loss. However, be careful how you remove it to avoid causing damage to the tympanic membrane. In other words, it’s best to avoid sticking anything in your ear.


In addition to hearing aids and other hearing assisted devices, cochlear implants have been revolutionary in treating hearing loss. Instead of amplifying sound, cochlear implants help by bypassing damaged portions of the ear and directly stimulating the auditory nerve. This has been a life-changing method at helping people of all ages to hear, even infants as young as 9 months of age.  If you ever need a pick-me-up, search online for videos of infants and kids hearing for the first time with a cochlear implant.  


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), 2 podcasts, and a Radio program (on SDPB), providing health information based on science, built on trust.