Prairie Doc Perspective Week of May 12th, 2024
Telegraph, Telephone, Telemedicine By Jill Kruse, DO Technology has come a long way in the past 200 years. The telegraph was invented in 1837 and made rapid long range communication possible. Messages could be sent around the world through a series of connected wires. The telegraph had medical applications in the Civil War. It was used to order medical supplies and report information about injuries and casualties to medical teams. This was cutting edge technology at the time, but it now is considered an obsolete method of communication. Alexander Graham Bell patented the telephone in 1876. By 1900 there were nearly 600,000 telephones in use. At the end of 1910 there were over 5.8 million active telephones. The telephone was seen as a tool to connect doctors and patients together over a distance. A report in The Lancet Journal from 1879 described how a doctor could use the telephone to listen to a baby’s cough and diagnose croup. In 1924 The Radio News Magazine predicted a two way video encounter with a “radio doctor” using a television-like device. In 1959 the University of Nebraska became the first place to use two-way video communications for telemedicine applications. This was done using closed circuit television to connect medical students at the main campus in Omaha with patients at the Norfolk State Hospital 112 miles away. However, Telemedicine as we know it today did not get its start until the 1970’s. Telemedicine can also be used to send radiology images remotely to radiologists who can be in a different state or even a different country. With the improvement of cellular technology, EKGs can be sent from the back of an ambulance to the hospital. So before a patient even sets foot inside the door of the hospital, the Emergency Room doctors and Cardiologists can be prepared. This can not only save time, but can save lives when someone is having a heart attack. With the COVID 19 pandemic, there was an increased push to use telemedicine for virtual visits in the clinic setting. Telemedicine has also been used when patient transfer from smaller hospitals to larger tertiary care centers is not possible or when dangerous winter driving conditions make transfers unsafe. This technology helps bridge the gap in medical care between rural areas without specialists and urban medical centers. The jump from telegraphs to telemedicine with virtual visits is a big one. I can only imagine what the next 200 years of technological advancements will bring to how we deliver health care. No matter how we interact, there will always be a doctor ready to connect and help you, stay 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 and Instagram featuring On Call with the Prairie Doc®, a medical Q&A show providing 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 May 5th, 2024
“Learning to Adapt after a stroke” By Carter Holm, RN Working as an RN in inpatient rehab, I am often called upon to care for patients who have had a cerebrovascular accident, or more commonly called a stroke. I have observed that every stroke patient experiences a unique combination of symptoms but the one of the most important tasks they accomplish in rehab is learning how to be adaptable. According to the American Stroke Association, left sided strokes (which affect the right side of the body) cause patients to experience more difficulty with language, both in speech and understanding. Right sided strokes, can cause more behavioral changes that may lead to uncharacteristic impulsivity, and may affect the patient’s vision. Based upon the type of stroke, each patient's experience is different and they will have their own set of challenges to overcome as they work towards recovery. Identifying the challenges is a crucial aspect of stroke rehabilitation. A main focus of the rehab team, for example, is balance and gait. Physical therapy is crucial in recovering strength and coordination in the affected side. If a patient is experiencing weakness to the left or right side of their body, they may require the use of a walker to allow for safe ambulation. Some patients may instead require the use of a cane, quad cane, or hemi-walker. Finding the correct assistive devices is one way stroke patients work to return to some normalcy. Stroke patients may regain their freedom of movement with the help of an adaptive foot brace, or the use of a specialized cane. They may adapt to using their non-dominant hand for eating or writing. They may learn tools to adapt their speech patterns, or use electrical stimulation of the facial muscles to increase strength, and improve oral function. What all of these things have in common is learning how to change, how to adapt. And while each stroke is different, and symptoms vary from patient to patient, one common thread is that all stroke patients, their families, and friends must learn to adapt. And it isn’t just the physical recovery, people must adapt to the emotional and psychological changes as well. Depression, anxiety, altered moods or sudden mood changes are all common symptoms following a stroke. Often, I have had patients who are so frustrated that they feel like giving up on therapy, even giving up on life. Patients and family members may experience grief: mourning the loss of the person that they were, or that they once knew. Author Delanie Stephenson wrote of her stroke, “While my body and mind were healing, I was learning to be a new person”. Just as the body needs time and practice to adapt to the physical changes, the brain also needs time and practice. Neuroplasticity does not return overnight, and may take months to return to normal. Regaining function requires setting goals, hard work, patience, and most important an acceptance of the need to adapt! Carter Holm, RN is a Registered Nurse at Avera McKennan in Sioux Falls Specializing in inpatient rehabilitation. Holm is a Certified Rehabilitation Registered Nurse and works with patients through their rehabilitation from strokes, brain injuries, spinal cord injuries, and trauma. 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, broadcast on SDPB and streaming live on Facebook most Thursdays at 7 p.m. central. Prairie Doc Perspective Week of April 28th, 2024
Based on Science, Built on Trust By Jill Kruse, DO As we approach the end of our 22nd season, I would like to thank our audience for trusting us to bring them health information that is current and accurate. There are many doctors out there who cannot make the same claims as the Prairie Doc’s and I would like to take this opportunity to help sort out those charlatans and quacks from trusted sources of health information. While tasty and refreshing, I would not trust Dr. Pepper for medical advice. Nor would I trust Dr. Evil from Austin Powers, despite his claims that he went to “four years of Evil Medical School”. I like to read Dr. Seuss’ books, but I would not let him take a look. While I think he is a dear, I would not let him peek in my ear. He is not the doctor that I want to see if I needed an appendectomy. While you can trust Doc Martin and his shoes to help you look cool, I am certain he has no medical training. Doc Brown from Back to the Future is another doctor I’m not sure I would listen to. Beside the fact that he likely has a PhD rather than an MD/DO degree, can you really trust someone who would make a time machine out of a Delorian? “The Doctor” from Doctor Who, is someone whom his companions trust with their life. Unfortunately a sonic screwdriver will not replace a stethoscope for making a medical diagnosis. The Doctor has also been known to put those companions in grave danger from Darleks and Cybermen. Although Dr. Steven Strange from the Marvel Universe is a legitimate doctor by training, I suspect he allowed his license and board certification to lapse when he became an Avenger. Thus he would not be my first choice for current medical advice or treatment. Similarly, I would not let Doc Octo, a known villain from the Spider-Man series, use any of his mechanical arms examine me. Dr. Benjamin Franklin Pierce, aka “Hawkeye”, from M.A.S.H. was an excellent surgeon, but his treatments and techniques are decades out of date. We have come a long way in surgery and anesthesia since the Korean War. I would also trust Dr. Quinn, Medicine Woman, but only if I was living back in the 1800’s on the prairie. The current Prairie Docs have much more training and knowledge than she had access to at the time. As you can see, there are many doctors out there. However, when looking for medical advice, you need not only someone you can trust, but also someone who has the training to give you the most current and up to date advice. The Prairie Docs strive to answer your medical questions each week with such information. So tune in and ask anything. We are here to help you stay healthy out there, with health information that is based on science and built on over twenty years of trust. 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 and Instagram featuring On Call with the Prairie Doc®, a medical Q&A show providing 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 April 21st, 2024
“Dry skin? Join the club” By Kelly Evans-Hullinger, MD An exceedingly common question I get in clinic, especially in the heart of a South Dakota winter, is how to remedy dry skin. And the questions aren’t just in clinic; my own kids, family, friends, everyone seems to have an occasional problem with dry and irritated skin. Dry skin is something we are all familiar with; if your dry spots come with a rash or anything else unusual, it may be worth showing it to your primary care provider, as it could be something else entirely. Eczema, a common inflammatory skin condition, often goes along with and is made worse by dryness. Soothing your dry skin doesn’t have to be fancy or expensive. There are a handful of tricks we can all use to help ourselves when it comes to dryness. The first advice is to avoid things that cause your skin to become drier. For many, that means to bathe less. That’s right; I said it: bathe less. Every time you bathe or shower, it washes away natural oils on the skin. Often our instinct when our skin becomes irritated is to wash it more, but in this case more is not better. Of course, I’m not asking you to forego hygiene entirely. But most people can probably bathe every other or every third day. This is especially true of babies and kids who struggle with eczema – cut down the daily baths. When we do bathe or shower, we can modify factors that will worsen dry skin. The hotter the water, the drier the skin afterward, so try lowering the temperature a bit. Less time spent in the bath or shower can help. And be mindful of the soap or cleanser you use – to reduce dryness, use less soap and a gentler soap. For kids who love the tub, skip the bubble bath and just put some gentle soap on a washcloth at the end of the bath when it is time to wash up. After that bath or shower, how do you choose from the hundreds of creams or lotions out there claiming to soothe dry skin? The dermatologists I know love products with petroleum jelly (i.e. Vaseline®) for dry skin; remember, I said this didn’t need to be fancy! Stick with fragrance-free products and keep it simple. Whatever you choose, slather it on as soon as the skin is dry. Dry skin affects many of us, but I hope these tips will help the next time you find yourself irritated with this common condition. Kelly Evans-Hullinger, M.D. is part of The Prairie Doc® team of physicians and currently practices internal 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 providing health information based on science, built on trust, streaming live on Facebook most Thursdays at 7 p.m. central. |
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