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Park Nicollet Health Services
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Park Nicollet Health Services is a nonprofit, integrated healthcare system located in St. Louis Park, MN
Park Nicollet Health Services is a nonprofit, integrated healthcare system located in St. Louis Park, MN

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The Mediterranean Diet is based on the traditional lifestyle of the people in the regions that border the Mediterranean Sea. Following a Mediterranean style of eating can help promote health and prevent disease. Research has shown that the traditional Mediterranean diet reduces the risk of heart disease, Alzheimer’s and Parkinson’s disease, certain types of cancers and may aid in weight loss.

The Mediterranean style of eating emphasizes a plant based diet of fruits and vegetables, legumes, beans, whole grains, and nuts with olive oil as the primary fat.

Guidelines to get you started on a Mediterranean style of eating:

•Focus on minimally processed, seasonally fresh and local foods. Emphasis of plant based foods daily – vegetables, fruit, nuts, beans and grains. 
•Fats are plant based such as olive oil, nuts and avocados. Low intake of saturated fat such butter, lard and fatty meats.  
•Fish and seafood is served at least twice a week.
•Dairy products such as cheese and yogurt are served daily usually 1-2 servings.
•Poultry and eggs are served twice weekly.
•Red meat and sugary-sweets are less common in the Mediterranean diet. Typically no more than 1-2 servings per week.  
•Fruit is the more commonly eaten dessert.
•Red wine is typically served with meals. 1 serving is 5 oz. Men should have no more than 2 servings per day and women, 1 serving per day.
•Include plenty of water. Aim for 64 fluid ounces per day.

The Mediterranean diet is not just about the foods you eat but the lifestyle you live. The Mediterranean lifestyle includes regular exercise such as walking and biking as well as taking time with your meals to sit and enjoy the company of loved ones.

Sample meal plan:
Breakfast: Oatmeal with berries and walnuts, milk, coffee or tea
Lunch: Veggie pita with whole grain pita, lettuce, cucumbers, tomatoes, sliced bell pepper, radishes, onion, feta cheese with hummus and parsley along with a sliced apple.
Dinner: Salmon steaks with couscous, asparagus and side salad with olive oil, vinegar, lemon and garlic along with a pear for dessert.
 
Join Park Nicollet registered dietitians on November 5 in St. Louis Park as they demonstrate how to prepare a Mediterranean meal and discuss what eating Mediterranean style is. Dietitians also will give practical ideas for making healthy lifestyle changes. Expect lively conversation and fun!

Registration is required, and the cost of the class is $30. Call 952-993-3454 or register by visiting: http://bit.ly/MedDietPN
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Katherine Ferrand's father was a smalltown doctor. Thanks to his inspiration, she’s always had an interest in helping people. So three years ago, when a friend encouraged her to volunteer with the Park Nicollet hospice program, based in St. Louis Park, Ferrand jumped in, and has been with the program ever since. For fellow volunteer Lynn Regan, who was also recruited by a friend, it’s been six years of service. “In retrospect,” Regan says, “I had no idea how rewarding it would be for me.”

Simply defined, hospice is a supplemental service available to people at the end of life, says Park Nicollet hospice volunteer coordinator Libby Swanson. Hospice patients might be in residential care settings (hospitals or nursing homes), or in the care of family at home, says Swanson. Hospice provides services like nursing visits, social workers, spiritual guidance, bath aides, medication for comfort, and equipment like hospital beds or oxygen. Medicare covers some hospice services, but “day-to-day care for at-home hospice patients is provided by the family,” and not Medicare, says Swanson. That’s where volunteers come in.

The Park Nicollet hospice program was founded in 1979 and volunteers have always played a big role, says Swanson. In fact, Medicare requires hospice programs to have volunteers specifically to provide much-needed respite for weary, and sometimes overwhelmed, caregivers.

Most volunteers commit to a maximum of four hours each week and are usually assigned to one hospice family at a time. “Clients and their families are so grateful for what we do,” says Ferrand. A volunteer doesn’t provide direct medical care—instead, duties include everything from light housekeeping and putting away groceries to simply sitting with patients, reading to them or looking at photographs. “Basically, we visit with them,” says Regan. Family members might use the break for a rest or for activities outside the house, but sometimes, says Regan, “our job is simply to listen to caregivers, to support them in this challenging time of their lives.” Volunteers with the program, now numbering
about 90, work in a variety of venues, including homes and assisted living facilities.

Volunteers might work with a family for a few weeks or a few months, Ferrand says. Often, at the very end of a client’s life, more family members gather for support, and the volunteer isn’t needed quite so much. There are, however, volunteers specially trained for supporting a patient in his or her final hours. “They’re called 11th hour volunteers,” says Regan.

All hospice volunteers undergo extensive and ongoing training—provided by medical professionals, social workers, spiritual advisors and others—to help them meet all clients’ needs. Training occurs a few times a year, says Swanson. Even before that, prospective volunteers attend an informational interview. After the interview and initial training, the program and the prospective volunteer decide together whether to move forward with an assignment to a family. “We all know that [Swanson] is only a phone call away,” says Regan. “And volunteers learn from and support each other.” She says that volunteers attend social events together as well, often exchanging tips.

“Caring and sharing,” adds Ferrand.

And volunteers learn from and befriend the clients and families they serve. “You can’t help but be impressed with their courage,” says Ferrand. “They’re an inspiration.” Ferrand notes that not all clients are awake and alert, and that sometimes volunteers are called to simply keep another human being company. And yet, she adds, recently she took a bouquet of fresh-cut lilacs to a client who hadn’t been opening her eyes.

“When she smelled the lilacs,” says Ferrand, “she opened her eyes and smiled.”

To learn more or to apply for a volunteer spot with Park Nicollet’s hospice program, contact Libby Swanson at 952-993-5381 or elizabeth.swanson@parknicollet.com. For general information about hospice volunteering, visit mnhpc.org.

Pictured: Hospice volunteers Lynn Regan, left, and Katherine Ferrand often bring bouquets of fresh flowers when they visit with hospice clients and families.
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Last weekend, the last graduating class of the Methodist Hospital Nursing School was welcomed back to the hospital for lunch, a tour and time for sharing memories.

"We were a class never to be forgotten," said Laurie R., a graduate of '75. "We had so much fun."

Forty years ago when this historic class graduated, the school was ready to close as the nursing education programs shifted back to universities. Many in the class of about 50 students went on to further their nursing education or earn certification in a wide range of specialties. Two in the class spent their entire careers at Methodist Hospital.

Methodist has undergone a lot of changes since the Class of 1975 passed through its halls. The dorms that used to house students and staff have since been remodeled, departments have shifted and the hospital has grown.

Thanks to all of the graduates for being an important part of our history!
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Pap testing should start at age 21. Kelin Schultz (http://bit.ly/KelinSchultz), MD at Maple Grove Women’s Services (http://bit.ly/MGWomensServices), offers guidance for getting screened to help prevent cervical cancer.

Q: It seems like the recommendations for when and how often to get a Pap test is constantly changing. Is that true? 

A: Yes, guidelines for when and how often to screen for cervical cancer do continually change. More studies in recent years have helped to shape those guidelines and will continue to do so. Our clinicians stay on top of these changes so talk to your care provider about what is recommended.

Q: When do I need to start having a Pap screen? How often do I need one?

A: Pap testing is currently recommended to begin at age 21 even if you have been sexually active before that age. If test results are normal, we currently recommend screening every 3 years after your initial test. If test results are abnormal, your clinician will help you know what kind of follow-up testing and treatment are needed.

Q: If I don’t need a Pap screen, do I still need to see my clinician every year?

A: Yes. Regardless of whether or not a Pap test is recommended, we still recommend that everyone is seen by their clinician at least once a year for an annual preventive health exam. This is the best way for you and your clinician to partner up to keep you healthy and to catch any problems before they start.

To make an appointment at Park Nicollet Maple Grove Women's Services, call 952-993-3282 or visit: http://bit.ly/MGWomensServices
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From pre-conception care through pregnancy and beyond, our care team is dedicated to partnering with you. Merida Miller (http://bit.ly/MeridaMiller), MD at Park Nicollet Plymouth Women’s Services (http://bit.ly/PlymouthClinic), gives some tips to help promote a healthy pregnancy.

Q: What tips do you have to promote a healthy pregnancy before conception?

A: Taking good care of yourself is the most important thing you can do to prepare for pregnancy. This includes eating healthy foods, exercising and making sure vaccinations are up to date. Taking a multivitamin with 400 micrograms of folic acid every day before and during pregnancy is also recommended to help protect your baby from serious birth defects of the brain and spine. Scheduling a preconception appointment is one of the best ways to make sure your body is ready for pregnancy. Your care provider will review your current health, medical history and life style and answer any questions you have about pregnancy.

Q: What are Braxton Hicks contractions? How soon do they start? 

A: Braxton Hicks, sometimes referred to as “practice contractions,” may be felt during the second trimester of pregnancy and are more common in the third trimester. They come and go, often right up until labor begins. This tightening of the uterus is usually mild and may last from 30 to 60 seconds. If contractions continue and become stronger, longer and closer together, you may be in preterm labor. Call your clinic for guidance about whether to come in if you experience more than four contractions in an hour for two or more hours.

To make an appointment at Park Nicollet Clinic-Plymouth, call 952-993-8900 or visit: http://bit.ly/PlymouthClinic
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We know that when it comes to your period, you want answers. Jeanne Gengerke (http://bit.ly/JeanneGengerke), MD at Maple Grove Women’s Services (http://bit.ly/MGWomensServices) provides insight into what to expect from your period.

Q: How do I know if my period is normal?

A: While everyone’s menstrual cycle, commonly referred to as a period, can be slightly different, there are some normal ranges we use to help you decide if everything is on track or if it’s time for you to schedule an appointment with your clinician. A healthy woman should expect to have a period every 21-35 days. This time period is counted from the first day of bleeding, regardless of how heavy the bleeding is. Normal periods will last on average 3-7 days and most women can expect to change their pad or tampon every 3-4 hours. If you are concerned about your period or any of the symptoms you experience before, during or after, you should schedule an appointment to discuss these with your clinician.

Q: My periods seem to be getting heavier as I get older. Is that normal?

A: As women get closer to menopause, periods often tend to get heavier because of the changes in hormones. Uterine fibroids, polyps, certain medications and other medical conditions can also cause heavier bleeding. Treatment options are available, such as medication or an in-office procedure called ablation. If your periods are concerning you or affecting your lifestyle, make an appointment with your doctor or nurse practitioner. Similarly, if you notice any recent or significant changes it’s also a good idea to schedule an appointment. Figuring out the cause will help determine the best course of treatment.

Q: Is it true that my mother’s age at menopause might help predict when I’ll reach menopause?

A: The average age of menopause is 51. However, some women have their last period in their forties, while some reach menopause later in their fifties. Everyone has their own unique biological clock. There are a number of factors that affect a woman’s age at menopause, but menopause does seem to be genetically linked. Often women fall within a few years either way of the age their mother was at menopause unless they have other factors that can affect their periods.

To make an appointment at Park Nicollet Maple Grove Women's Services, call 952-993-3282 or visit: http://bit.ly/MGWomensServices
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Whether you’re getting ready for a life change or just starting to look around, there are many different birth control options available. Jana Haxton (http://bit.ly/JanaHaxtonRN), Nurse Practitioner at Park Nicollet Plymouth Women’s Services (http://bit.ly/PlymouthClinic) answers a few commonly asked questions when it comes to deciding which birth control option is right for you.

Q: I need to find a reliable birth control. I know there’s a wide range of choices, but how do I choose?

A: Contraception is continually evolving and today’s options are better than ever. We offer everything from oral contraceptives to permanent sterilization with many choices in between. Having a conversation with your doctor or nurse practitioner can help you evaluate which options make the most sense for you based on your age, your contraception goals and many other factors.

Q: How effective are IUDs? I’ve been using the pill for contraception but a few of my friends really like their IUD.

A: From an effectiveness standpoint, IUDs are actually more effective than the pill with a protection rate over 99 percent. Birth control pills taken faithfully still offer a very effective rate of protection around 97 percent. IUDs are a long-lasting method of birth control that require little effort and are easily reversible. The most common, Mirena and Skyla, are hormonal IUDs that release a form of the hormone progestin called Levonorgestrel. An IUD and the pill each have their own advantages and disadvantages, so talk to your care provider about which one is right for you.  

Q: I’m looking for a permanent solution to birth control. What’s available?

A: When you’re ready for permanent birth control there are a few primary options available. Essure is a procedure that can be performed in the clinic setting. Inserts are placed into your fallopian tubes and work with your body to form a natural barrier that keeps sperm from reaching the eggs. A tubal ligation is performed using laparoscopic surgery and also closes the fallopian tubes to prevent pregnancy. Another surgical option, a salpingectomy, involves removing the fallopian tubes. These options all provide effective and reliable results.

To make an appointment at Park Nicollet Clinic-Plymouth, call 952-993-8900 or visit: http://bit.ly/PlymouthClinic
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It seems like just yesterday the new Family Birth Center at Methodist Hospital (http://bit.ly/ParkNicolletFBC) opened, but 2,051 (and counting) babies later, we’re approaching our first birthday.

Meet some of the moms and babies who met for the first time in our new space, and learn what made their experiences unforgettable.

Darcie & Tilly Louise -- MARCH 3, 2014

MY DELIVERY WAS: Fast

WE CHOSE METHODIST BECAUSE: I had heard good things from several friends.

OUR STORY: I was tired and not feeling well all day. I didn’t have contractions, so I spent the day sleeping and went to get my nails done (I had my priorities!). Then sure enough I laid down around 10 p.m. and my water broke immediately. We left for the hospital shortly after and by the time we got there I was already dilated to an eight and Tilly was born about two hours later.

What was most impressive about our experience at the Family Birth Center was the care. I can't believe how great everyone was. Every nurse was helpful and willing to aid with anything we needed. I also liked how accessible lactation consultants were, because I needed their help.

Amaal & Khataab Muhammed -- JUNE 11, 2014

MY DELIVERY WAS: Incredible

WE CHOSE METHODIST BECAUSE: I had a wonderful time there with my first delivery.

OUR STORY: I was drinking raspberry leaf herbal tea for about two weeks before delivery, hoping it would help with a shorter labor and fewer interventions. I was praying that I wouldn’t need to get induced or take any pain relievers. I really wanted to have a natural delivery. When I knew I was in labor, I called my midwife then I called my husband and some of my family that I wanted to be there. I arrived at the hospital in the late evening, and had totally forgotten about my planned water birth. Thankfully, the nurses were prepared and gently reminded me of my plans.

My labor was really intense, and at times I left like giving up, but my family and my midwife kept me going. I finally delivered my baby boy, and I'm thankful for a wonderful and safe delivery.

Danielle & Daisy -- JUNE 5, 2014

MY DELIVERY WAS: Powerful

WE CHOSE METHODIST BECAUSE: It just felt like the right place.

OUR STORY: My birth experience took many directions, but through it all, I felt courageous, empowered and calm. I have been a doula for four years, and being on the "other side" was magical.

I loved feeling my body working to bring my daughter into the world; it was a deeply intimate and sacred moment. I had witnessed so many other mothers have this moment and I finally got to experience it myself.

Because Daisy was five weeks early, she spent eight days in the Special Care Nursery. Bringing her home was the best feeling because we felt prepared by all the wonderful doctors and nurses who helped our sweet girl stay healthy and well.
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Park Nicollet Health Services announced a major expansion and renovation project at Struthers Parkinson’s Center (http://bit.ly/PNStruthersPC) that will launch a new era in its 20-year history.

The project will add 2,750 square feet and renovate 3,900 square feet of existing space.  It will enhance Struther’s ability to provide comprehensive services, training, education and research in one location. Funding for the $2 million project was provided through gifts from Evelyn Struthers’ estate and from three generations of Struthers family members.  

“As the number of older people increases in our community and nationwide it is important to improve the understanding and treatment of Parkinson’s and this project will help advance the Struthers model,” said Rose Wichmann, manager of Struthers Parkinson’s Center.
 
Only Parkinson Center of Excellence in upper Midwest

The Struthers Center is the only medical facility in our five-state region and one of only 29 in the nation designated as a National Parkinson Foundation Center of Excellence.  Criteria to be designated a Center of Excellence includes seeing a sufficient volume of patients , employing neurologists with training in movement disorders , providing support services for patients and families,  providing a wide- range of therapeutic options, conducting  research and participating in clinical trials. 

As a Center of Excellence, Struthers is part of the Parkinson’s Outcomes Project which is the largest registry of Parkinson’s patients in the world. The Project is collecting clinical information and data about factors that impact the disease. 

Movement therapy garden

A highlight of the expansion project will be to create an innovative outdoor-indoor movement therapy garden.  Evie’s Garden, named after Evelyn Struthers, will feature therapeutic landscapes with natural light, plantings and artwork along a foot path. Struthers has a long standing collaboration with the University of Minnesota Therapeutic Horticultural program and makes therapeutic gardening available for patients.
 
“Having a therapeutic garden at the Center was my mother’s dream and will be a beautiful way to honor her memory.   Our family is honored to be able to make the therapeutic garden concept and education expansion a reality,” said Rich Struthers, son of Evelyn Struthers. 

Renovations will feature space for Struthers Center training and education programs  including The Struthers Parkinson’s Care Network which trains caregivers in 21 nursing homes, assisted living facilities and home care agencies  on best practices in caring for patients with Parkinson’s. 

Parkinson’s disease is the second most common neurodegenerative disease after Alzheimer’s.   As many as 1 million Americans live with Parkinson’s disease and it’s estimated that the number of people with Parkinson’s may double by 2030. Struthers cares for more than 1,500 patients a year and provides 90 support groups in Minnesota, North and South Dakota, Iowa and Wisconsin. 

The expanded and renovated facility, located at 6701 Country Club Dr. in Golden Valley, is scheduled to open with a ribbon cutting ceremony in September, the 20th anniversary of the Struthers Center.
 
HealthPartners also recently announced plans to begin construction of a neuroscience center in St. Paul (http://bit.ly/HPNeuro). The 130,000 square-foot building will care for stroke, spine care, dementia, Parkinson’s disease, brain and spine tumors and other neurological disorders.  In addition, it will provide space for neuroscience research and clinical trials. Construction is scheduled to begin this summer and be completed by spring of 2017.
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The winter illness season is here, and at our hospitals and clinics, we’ve been seeing patients suffering from sinus infections, sore throats, headaches, fevers, chills and more.

Anytime you’re sick, your first inclination is likely to see a doctor to get a prescription. However, in some cases your ailment might not be treatable by #antibiotics

One of the biggest challenges I have is helping patients understand what conditions can be treated with antibiotics, and which ones can’t. For example, most upper respiratory infections, like colds, coughs, sore throats and sinus infections, are typically viral, which means they can’t be treated with antibiotics. 

Here are some tips to help you get a better understanding of antibiotics and how they may or may not be able to help you this winter.

Q: When do we know, for sure, that an antibiotic can help treat a condition?

A: The easiest to diagnose (and most common) condition are those that involve the ears and throat. Ears that are infected with bacteria have a very distinct appearance, making it easy for your doctor to identify this and treat appropriately. Because it is bacterial, there is a good chance that antibiotics will help.

If you have a sore throat, a rapid strep test will help me decide if antibiotics should be prescribed. If tonsils are enlarged and inflamed, antibiotics are usually the way to go.

Q: If I am coughing up a lot of green phlegm, does that mean I need an antibiotic?

A: No. Studies have shown that the color or thickness of the sputum does not indicate a bacterial infection. 

Q: If I have a fever, an antibiotic is probably needed, right?

A: Viruses can cause a high fever, which is why this is a common symptom of the flu or mono. Unfortunately, these can’t be treated by antibiotics.

Speaking of viruses, most illnesses with cough, congestion and runny nose are caused by viruses, meaning that antibiotics simply won’t help in those cases either. There are some occasions where these conditions can be caused by bacteria, however, which makes diagnoses a little more tricky.

Q: How do you know if a cough is caused by bacteria?

A: One of the most serious conditions associated with coughing is Pneumonia. This can be diagnosed by listening to chest sound carefully and by getting a chest x-ray.  Helping your doctor understand the duration of the cough as well as the severity of your illness can be helpful as well.

For symptoms that have persisted for weeks, we often resort to trying antibiotics. But if they are caused by a virus, antibiotics won’t help. 

Q: But most sinus infections improve with antibiotics, right?

A: No. Most sinus infections are viral and therefore shouldn’t be treated with antibiotics. I try to convince my patients to treat their condition with rest, warm liquids, over the counter pain relievers or decongestants instead. Unfortunately there isn’t a “quick fix” that comes in pill form.

Q: I'm sick, there’s no harm in taking an antibiotic, right?

A: This isn’t true at all. Overuse of antibiotics causes them to be less effective, even if you only take them rarely. As a result, we may have to treat infections with intravenous antibiotics which can be extremely expensive and sometimes have dangerous side effects. In fact, thousands of people die each year from drug-resistant bacteria that used to be treatable. 

In addition to weakening their effectiveness, many antibiotics cause severe diarrhea which can lead to C. diff. This is a serious intestinal infection we can get from taking antibiotics, which requires long treatments of additional medications to cure.

Q: It’s pretty standard to need an antibiotic a couple of times each year, right?

A: No. If you’re generally in good health, most upper respiratory infections will respond to time and rest. Of course, you should see your doctor if you’re concerned.

Q: What if I have asthma or I’m wheezing? An antibiotic is definitely necessary, right?

A: Again, it’s often a virus. Having adequate inhalers and an aggressive asthma management plan is usually more protective against respiratory symptoms. You should make sure you have a good asthma management plan. 

Q: Dr. Richmond, do you and your family use antibiotics for respiratory infections?

A: I have not in the past 10 years, maybe longer. My school-age kids get strep throat occasionally, and this treatment is pretty straight forward.

I welcome all questions from patients about when antibiotics are indicated. I know how debilitating it is to be in sick, unable to work or do your usual activities.  However, we are often pressured by patients to prescribe antibiotics when we would not recommend them otherwise. 

Fortunately, most of us are armed with immune systems which will provide the necessary defense against these infections. Regular exercise, avoiding smoking, getting adequate sleep, hand washing and staying home when you are sick are very practical ways to improve your odds against a respiratory infection.

Lawrence Richmond, MD, practices family medicine out of our Park Nicollet Plymouth location (http://bit.ly/DrRichmond).
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