35 episodes

The mission of this podcast is to educate and inform about health matters affecting adults, from latest research updates to tips on navigating the health system and everything in between.

Everything Your Doc Wants You To Know Lindsey Dahl & Kirsten Juhl

    • Medicine

The mission of this podcast is to educate and inform about health matters affecting adults, from latest research updates to tips on navigating the health system and everything in between.

    Common Aches and Pains

    Common Aches and Pains

    Common Aches and Pains



    Tendonitis:  Inflammation of the tendons (attachment of muscle to bone).  Elbow, ankles, wrist, overuse.

    Treatment: rest, ice, NSAIDS.  Physical Therapy can be necessary and helpful



    Bursitis:  fluid filled sacs in areas of friction that can become inflamed.  

    Common:  Trochanteric Bursitis (hip), Anserine bursitis (medial knee), Olecranon Bursitis (elbow)

    Treatment:  Physical therapy, Steroid injections, Ice, NSAIDS, stretching

    Arthritis:  Pain in the joints

    Osteoarthritis:  wear and tear or degenerative joint disease.  Knees, hips, Spine, hands, shoulders

    Risks: age, obesity, family history, prior injury, occupation

    Pain worsens with use

    Treatment: scheduled Tylenol, NSAIDS if able, injections ultimate joint replacement

    Topicals always worth a try

    Inflammatory Arthritis:  most common Rheumatoid Arthritis (autoimmune- immune system fighting itself at the joints)

    AM stiffness lasts hours, red, warm swollen joints, symmetric- hands wrists, feet, knees

    Treatment: prescription medication to avoid destruction/deformity in the future



    Future: Gut microbiome and diets role in joint inflammation and pain? 

    Health Pearl: Anti-inflammatory diet limit processed food, sugar, simple carbohydrates

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    • 32 min
    4M's To Discuss With Your Physician

    4M's To Discuss With Your Physician

    Episode 34: the 4M’s 

    4M’s to discuss with your physician: Medications, Mobility, Mentation, Matters Most (what Matters Most)



    Help shape patient-centered care

    Reduce hospitalizations, decrease the need for care



    Mobility - evaluate yearly

    Measures:

    Gait speed is one measure (slower than 1 m/s increased risk of falling, increased risk of hospitalization)

    Timed get up and go

    Balance evaluation by physical therapy

    Getting up from chair without using arms

    Next step: 

    Home exercise program (NIH healthy aging)

    Physical therapy

    Multi-disciplinary falls and stability clinic

    Driving

    - Multiple falls indicate increased risk for driving safety issues

    Everyday movement is important to maintain mobility

    Home exercises, Youtube exercises 



    Medications

    Beer’s list - potentially inappropriate medications for older adults due to risk of side effects

    Examples include benadryl, benzodiazepines, narcotic pain medications, some seizure medications

    Need to look at benefits versus side effects

    Evaluate for “prescribing cascades” - one medication is used to treat a side effect of another medication, and then another medication is used to treat side effects of that medication. 

    Polypharmacy - more than 6 medications is polypharmacy. More medications = more side effects and medication interactions. Deprescribing can help with this. 

    Goals of care can help determine which medications are adding value



    Matters Most

    It’s important to discuss what’s important and what makes life worth living, then delve deeper. 

    “What could you live without and still feel you have good quality of life?” Focuses on quality of life rather than just quantity

    Patients can bring this topic up by bringing in an Advance Care Directive or Polst form, or mentioning this as a goal of the visit

    Evolves depending on stage of life



    Mentation 

    Assessment of memory and cognition, as well as mood

    Generally we evaluate cognition when family brings up a concern or clinician notices a change

    Can be done as part of Medicare Wellness Exam

    Depression and anxiety can look like physical symptoms and cognitive changes in older population

    Next steps if a concern is present: 

    Evaluate medications, which can impact cognition and mood

    Obtain more information from screening tests, family members

    Consider referral for further testing; this isn’t required to make a diagnosis

    Neuropsych testing can distinguish between depression, anxiety, dementia

    References

    NIH National Institute on Aging: https://www.nia.nih.gov/health/exercise-physical-activity

    Deprescribing: http://www.deprescribing.org

    https://www.cdc.gov/aging/pdf/acp-resources-public.pdf

    https://polst.org/



    Health pearl: Get your influenza vaccines! They’re very important this year.

    • 35 min
    Genetic Counseling

    Genetic Counseling

    Everything Doc Show Notes: Genetic Counseling



    Special guest:  Allison Hutchinson a certified genetic counselor.  Has worked at Sanford Imaginetics for the last 2 years.  Her focus is working with teams to offer genomic and pharmacogenomics education to providers, patients, and the public.  She is part of a research collaborative investigating whether these education interventions have been successful and how to continuously improve.  Prior to this Allison was a high school science teacher for over a decade. She enjoys listening to podcasts in her spare time!



    Quote:  “Teaching should always start the discussion and never end it.”



    Genetic Counselor:  Advanced healthcare providers with training in genetics and counseling. 

    Education includes semester in classroom, year in clinic, research throughout

    Certified 

    Who should see a genetic counselor?

    Those with rare genetic diseases in family

    Family history of related cancers in 2 or more people on same side, often earlier onset

    Help interpreting consumer driven testing

    Cardiovascular diseases: arrhythmias with sudden cardiac death, familial hypercholesterolemia



    Pretest counseling is important!  Think about all possible outcomes of genetic testing and what you might do with range of results.



    How to prepare?

    Come with information about family members:  cause of death, age of death,  chronic diseases, so pedigree can be developed.  

    Help write letters to family 



    Most insurances cover but varies check with your insurance



    For more information about Genetic Counseling visit:

    https://imagenetics.sanfordhealth.org/

    https://www.aboutgeneticcounselors.org/

    https://www.augie.edu/academics/graduatepeducation/master-science-genetic-counseling 

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    • 45 min
    The Dark Side of Isolation

    The Dark Side of Isolation

    The Dark Side of Isolation During COVID-19

    In this episode, we discuss the unintended isolation that results from social distancing and quarantine measures, especially in the elderly. We review complications of isolation, including frailty, sarcopenia, depression, cognitive changes, and increased suicidality. We also review measures to help mitigate these adverse consequences, and discuss how everyone can help. 

    We explain which outings are safe and whether gathering during the summer can be safe. We review precautions that should be taken when out. 

    Health pearl: Find someone who could benefit from a safe, social distancing outing and do something fun together!

    Resources: 
    Search “Adopt a Grandparent” to find a program near you. 
    Nacional Suicide Prevention Lifeline: (800) 273-8255, https://suicidepreventionlifeline.org

    • 22 min
    Mental Health During the Pandemic

    Mental Health During the Pandemic

    Mental Health During the Pandemic

    Child and Adolescent Psychiatrist Dr. Stefanie Hanisch joins us to discuss mental health, especially that of youth, during the current pandemic.

    Dr. Hanisch was born and raised in South Africa. She attended medical school at the University of Pretoria, South Africa, before obtaining her fellowship in Child and Adolescent Psychiatry at Baylor College of Medicine in Houston, TX. She served as Chief Resident before moving to Fargo, ND. She has been in her current practice since 2007 and currently serves as her Department Chair in addition to having faculty appointment at the UND School of Medicine. Dr. Hanisch is married and has two sons. She enjoys traveling with her family and is an accomplished runner.

    In this episode, we talk about mental health (with a focus on youth) during the pandemic. We discuss the following points:
    How kids might respond differently based on their age and developmental level
    How to talk with kids about their feelings and fears.
    Validation of feelings
    Spend time with the fear, and then transition to constructive thinking (what you can do about the situation)
    The value of parental role modeling
    How to maintain health for all during the pandemic
    When to seek help: WHEN NEEDS OUTWEIGH RESOURCES

    Available resources include:
    Your primary care provider
    First Link (211)
    Emergency department


    Health Pearl: take time to relax and destress. There are many great resources for this, including the following:
    Headspace app
    Ahway Island Podcast (for youth)
    Calm app
    Youtube Meditation
    Peloton app - meditation, yoga, family work outs
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    • 35 min
    COVID-19: A Marathon, Not a Sprint

    COVID-19: A Marathon, Not a Sprint

    Episode 30 COVID-19: A Marathon, Not a Sprint

    Recorded Sunday April 5, 2020

    Today we are joined by Infectious Disease expert Dr. Dubert Guerrero to discuss COVID-19. Dr. Guerrero is a practicing Infectious Disease Physician at Sanford Health. He graduated from the University of the Philippines and completed his training in Internal Medicine at Akron General Medical Center. He went on to complete an Infectious Disease fellowship at Case Western Reserve University in Cleveland, Ohio. Dr. Guerrero is married and has three children.

    In this episode, we discuss common questions related to the current coronavirus pandemic, including
    - What is social distancing?
    - Is social distancing effective?
    - Is it important to sanitize groceries and other items coming into one’s home?
    - What can we expect to see over the next several months regarding COVID-19 cases?
    - When can we expect to see vaccines and/or treatments for the virus?


    Health pearl: take care of your mental health. You can do this by taking time for yourself every day, including exercise and mindfulness/meditation in your daily life.


    Resources:
    Center for Disease Control and Prevention: https://www.cdc.gov/coronavirus/2019-nCoV/index.html
    World Health Organization: https://www.who.int/emergencies/diseases/novel-coronavirus-2019
    Your state health department

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    • 33 min

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