Prairie Doc Perspective Week of September 9th, 2024
“Backpacks and Back to School”
By Jill Kruse, DO


    School is back in session so it is time for a little pop quiz.   What is an item that almost every student carries? If you said backpack you are off to a great start. Do you know what it takes to be at the head of the class?  Let’s find out if you are a star student or need to brush up a little on your backpack knowledge.      
Most students carry a backpack filled with their books at some point during their school day.  Did you know a heavy back pack can cause neck, shoulder, or back pain.  Those narrow straps can also compress on nerves in the shoulder leading to arm numbness, tingling, or weakness.  Overweight backpacks can also change the center of balance making it easier to trip.
Here is the first quiz question.  A student’s backpack should not weigh more than what percentage of the student’s weight? A) 50%, B) 25%, or C) 15%?  Answer: (C) The American Academy of Pediatrics recommends that a backpack weigh no more than 15% of a child’s weight.  For example, a 60 pound child’s backpack should weigh no more than 9 pounds.  
Next question:  What is the best way to wear a back pack? A) with one strap slung over one shoulder, B) with both straps used and using any additional chest or waist straps to help distribute the weight, C) dragging on the ground behind?  The answer is, of course (B).  Injuries are reduced when the backpack’s load is distributed across the body.  Padded wide shoulder straps help distribute the weight evenly across the shoulders. Chest or waist clips can help take some of that load off the shoulders.  There are some backpacks now that have wheels like suitcases.  In that case, (C) rolling, not dragging, your backpack behind you may be a better option, but dragging a regular backpack is not a great idea if you want your backpack to last. 
Here is the last quiz question.  Where should you put the heaviest items in your backpack? A) at the very top of the backpack, B) on one side of the backpack, or C) at the bottom and center of the backpack?  The answer is (C) at the bottom and center of the backpack.  The load should be closer to the wearer’s center of gravity at the small of the back. This helps decrease risk for tripping or falling from the wearer being off balance.
How did you do?  Before your student heads off to school, or you head off for a weekend hike, it is important for everyone to consider these wear and safety tips.  Hopefully you do not find a forgotten sandwich from last year still stuck in the bottom.  With this knowledge your students can be standing tall and proud at the head of the class.  Have a great school year by staying safe and healthy 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, 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.   

​Prairie Doc Perspective Week of August 18th, 2024
Our Brain’s Happy Hormones
 By: Curstie Konold MPH, LCSW, QMHP

Our brain releases chemicals into our body that impact functions in our body, such as our mood. There are four chemicals that commonly support “feeling good,” and they are also known as “happiness chemicals.” These four chemicals are dopamine, oxytocin, serotonin, and endorphins. 
Dopamine provides us with pleasure, motivation, and learning. Known as the reward chemical, dopamine may help us feel determined to accomplish our goals or meet our needs. Oxytocin is often known as the love hormone, and it creates a feeling of trust and security in maintaining relationships and bonding with others. Serotonin is often known as the mood stabilizer, and is the chemical that helps in regulating our moods. It often helps us with accepting ourselves, the people around us, and feeling significant within our relationships. Finally, endorphins are the natural “pain killer” in our body that releases a response to pain or stress to help in alleviating physical pain, anxiety, or depression. When we have a deficiency in each of these hormones, it can affect us in negative ways. 
Dopamine deficiencies can lead us to procrastinate, have low self-esteem, lack motivation, have low energy, feel fatigued, struggle to focus, and feel anxious or hopeless. Natural ways to increase dopamine levels in our body may include mediation, self-care, creating long term goals, creating a daily to-do list to maintain organization, celebrate small wins, regular exercise, and being creative through writing, music or art. 
Oxytocin deficiencies can leave us feeling lonely, stressed, lack motivation, have low energy or fatigue, feel disconnected, feel anxious, and experience insomnia. Some natural ways to increase oxytocin may include physical touch from a loved one, socializing, massage, acupuncture, listening to music, regular exercise, meditation, or giving others compliments. 
Serotonin deficiencies can lead to low self-esteem, feeling overly sensitive, feeling anxiety, having panic attacks, mood swings, feeling hopeless, feeling nervous about social events, experiencing obsessions, and experiencing insomnia. Natural ways to increase serotonin may be spending time outdoors, meditating, regular exercise, cold showers, sunlight and massage. 
Endorphin deficiencies can lead to anxiety, depression, mood swings, aches and pains, insomnia and impulsive behavior. Natural ways to increase endorphins may be laughing, creating music, art or writing, eating spicy foods, regular exercise, stretching, massage, and helping others. 
By working to become aware of deficiencies we may be experiencing within our body, we can implement natural skills to increase release of the happiness chemicals. This is one positive way we can take care of our mental health and increase our mood in a positive way.
Curstie provides outpatient therapy for across the lifespan for adults, adolescents, and children starting at age 4. She utilizes a trauma-informed approach for people struggling with anxiety, depression, abuse, trauma, interpersonal issues, grief and social and emotional wellness. Her practice includes play therapy, solution-focused therapy, strengths-based therapy, and cognitive behavioral therapy and mindfulness strategies. Follow The Prairie Doc® at www.prairiedoc.org and on Facebook featuring On Call with the Prairie Doc® a medical Q&A show providing health information based on science, built on trust for 22 Seasons, on SDPB and streaming live on Facebook most Thursdays at 7 p.m. central. 

​Prairie Doc Perspective week of August 11th, 2024
“Food Anaphylaxis”
By Mark E. Bubak, MD


 True food allergic reactions cause anaphylaxis.  Eating even a tiny bit of the allergenic food causes the patient to quickly develop symptoms that can include shortness of breath, hives, vomiting, diarrhea, throat swelling, passing out, and at times it can be fatal.  The patient makes IgE allergy antibody to the food.  The cause of the reactions can be determined by the history and confirmed by allergy skin or blood testing.  


 Once we know the allergenic food, a treatment plan can be put into place.  The three parts are avoidance, epinephrine, and becoming less allergic.


 Avoiding the allergenic food prevents reactions.  Reading labels, thinking about ways of cross contamination, and ways people interact are all essential.  An excellent resource on avoidance is the Food Allergy Research and Education national support group (foodallergy.org).  Remember-the food has to be eaten to cause full anaphylaxis.  Contact is only going to cause some hives. 
 Unfortunately, three percent of patients experience an accidental ingestion and have a reaction every year.  Epinephrine injections can be life-saving.  All patients need access to epinephrine.  The epinephrine needs to be given right away and the patient taken promptly to the emergency room for ongoing care.  No other medication changes the outcome of an anaphylactic reaction.  We used to think antihistamines could help—they do not.


 A new method of becoming less allergic was approved in March 2024.  This product is Xolair (omalizumab).  Xolair decreases the allergy antibody IgE so that when the patient has a small exposure to their allergen they are far less likely to have a bad anaphylaxis.  It is not a cure.  The treatment is a program of ongoing injections.  They can help any kind of food allergy and works even if the patient has multiple food allergies.  


 Becoming less allergic has been done longer for peanut allergy using the product called Palforzia.  It is a peanut powder that one takes daily to become less allergic.  This means that you are far less likely to react to a small amount of peanut.  It is not a cure.  The Palforzia has a higher allergic reaction side effect profile than the Xolair does.  Both therapies can make a huge impact for the right patients.  Other treatments such as allergy drops don’t help enough to be approved by the FDA and are not recommended.  


Don’t miss out--by working with your allergist, primary care physician, dietician, school, daycare center, and family, the food allergic patient can make the most of their life!


Mark E. Bubak, M.D. practicing in Sioux Falls, South Dakota is a contributing Prairie Doc® columnist and owner of Dakota Allergy and Asthma. He is certified by the American Board of Allergy and Immunology to care for adults and children with asthma and allergies. Follow The Prairie Doc® at www.prairiedoc.org and on Facebook and instagram featuring On Call with the Prairie Doc® a medical Q&A show celebrating its 22nd season of health information based on science, built on trust, on SDPB and streaming live on Facebook most Thursdays at 7 p.m. central. 

Prairie Doc Perspective Week of August 4th, 2024
“Lived Experiences”
By Curstie Konold MPH, LCSW, QMHP
Everyone we know, meet, or pass in the grocery store has their own set of personal life experiences that are unique from our own. We all come from different places, have our own set of genetics, and have different parents or families, which is part of what makes us unique from each other. We can even have different experiences than our siblings who grow up in the same home as us. 
Our experiences are part of what help us learn, create adaptations to the world around us, and how we continue to grow into who we want to be.  The number one goal of our body and brain is to maintain safety and security within our environment. From the moment we are born, our brain seeks for our basic needs to be met, whether it is connection, sleep, or food. As we grow, these needs becomes more complex as our abilities and understanding of the world grow with us. 
During our most informative early years, our brain and body are developing rapidly to learn how to maintain safety and connection in the world around us. The experiences that we have during these impactful times set the stage for how we begin to create adaptations, responses, and our view of ourselves. 
Our lived experiences can be either positive or negative, and sometimes they can even be traumatic. Everyone creates their own set of responses to experiences and threats in their environment through these lived experiences, and the most common responses are fight, flight, freeze and fawn. The prefrontal cortex of our brain is where we maintain our ability to reason, make good decisions, and take in information around us. When our body experiences a threat to our safety within our environment, our prefrontal cortex may go “offline” and our amygdala takes over, which is the portion of our brain that controls our emotions. Our amygdala signals for our response to keep ourselves safe from the threat to take control.
If our response is fight, we might have anger outbursts, become aggressive, be impulsive, or have explosive behaviors. If our response is flight, we might become, anxious, experience panic attacks, throw ourselves into our work, and tend to be perfectionists, or become over analytical. If our response is freeze, we may have depressive tendencies, disassociate, feel indecisive, feel numb, space out or isolate from others. If we have a fawn response, we may people please, be co-dependent, have a lack of identity and boundaries with others, avoid conflict, or have an inability to say no. You can experience on or all of these responses during any given event.
These responses are natural adaptations that may be our brain’s way of keeping us safe in situations or environments that feel threatening. While these responses may be a natural way for our brain to maintain safety, we can also work to re-wire our responses through coping skills and awareness of how our experiences have affected us. 
It starts with an awareness that we, and others around us, have had lived experiences that have created these responses. When we are aware of this, we have the ability to process, understand, and create positive mechanisms to heal from our traumatic experiences. 
Curstie provides outpatient therapy for across the lifespan for adults, adolescents, and children starting at age 4. She utilizes a trauma-informed approach for people struggling with anxiety, depression, abuse, trauma, interpersonal issues, grief and social and emotional wellness. Her practice includes play therapy, solution-focused therapy, strengths-based therapy, and cognitive behavioral therapy and mindfulness strategies. Follow The Prairie Doc® at www.prairiedoc.org and on Facebook featuring On Call with the Prairie Doc® a medical Q&A show providing health information based on science, built on trust for 22 Seasons, streaming live on Facebook most Thursdays at 7 p.m. central. ​