Years of Service

Trinity Health honored its long-term employees at a service awards banquet at the Grand Hotel on February 20. President and CEO John M. Kutch presented certificates to 122 Trinity Health associates, all of whom celebrated milestone anniversaries with Trinity Health last year.

Celebrating 45 YEARS of service were: service were: Valorie Aftem, Radiology Technologist, Radiology, and Marilyn Scott, RN, Emergency/Trauma. Fourteen associates celebrated

40 YEARS of service, including: Gae Avers, LPN, Pre-Admission Testing; Susan Brown, Housekeeper, Environmental Services; Loretta Duchsherer, LPN, OB/GYN; Dianne Goebel, Housekeeper, Environmental Services; Linda Hanneman, Ward Secretary, Behavioral Health Unit- Trinity Hospital – St. Joseph’s; Gail Merck, Radiology Technologist, Radiology; Vicki Miller, RNFA, Surgery; David Pope, Housekeeping Director, Trinity Homes; Barbara Power, Data Entry Clerk, Business Services; Mark Priess, Plant Operations Director, Trinity Homes; Dee Purseglove, Administrative Assistant, Community Relations; Omana Slorby, Perfusionist, Surgery; Charlene Strand, Nursing Supervisor CLN, Trinity Community Clinic-Western Dakota; and Harvey Wittmayer, IT Applications Manager, Information Technology.

Other employees who received honors include: 35 YEARS: Sabrina Beaulac, LPN, OB/GYN Nursing; LaDawn Berg, LPN, Nephrology; Mary Blada, RN, Protime; Robert Franca, LPN, Podiatry; Patricia Gerszewski, Physical Therapist, Physical Therapy; Laurie Hickman, RN, NICU/Transitional; Bonnie Langley, LPN, Pulmonology; Bonnie Ler, Nurse Practitioner, Gastoenterology; Bharati Mehta, Occupational Therapist, Home Health; Julie Nunziato, RN, Surgery; Carla Robillard, Clinical Nurse Educator, Nursing Services; and Pala Waswick, Technical Supervisor, Lab.

30 YEARS: Cheryl Bjella, Surgical Tech Supervisor, Trinity Regional Eyecare-Western Dakota; Laurel Burner, RN, Kidney Dialysis; Connie Busch, Mammography Tech Supervisor, Breast Imaging; Robin Forbes, RN, Pediatric Nursing; Deborah Goodman, Distribution Assistant, Trinity Homes Business Office; Paula Grossman, Transcriptionist, Radiology; Jerry Hansen, Pharmacist, Pharmacy; Kristie Harris, Lab Technician, Kenmare Community Hospital; Lynn Helmers, Social Services/Discharge Planning Coordinator, Kenmare Community Hospital; Bonnie Holmen, Nuclear Medicine Tech Supervisor, Nuclear Medicine; Sandra Holzer, Administrative Assistant, Materials Management; Melody Johnson, HIM Coordinator, Trinity Homes, Clinical Excellence & Resident Safety; Rhonda Johnson, Business Service Director, Business Services, Trinity Medical Group; Kathryn Larson, Account Representative, Business Services-Trinity Hospital; Wanda Maixner, Activities/Occupational Therapy Director, Trinity Homes; Jill Martinson-Redekopp, OD, Optometry, Trinity Regional Eyecare – Minot; Priscilla May, CT/MR Technologist, CT Scanner; Pamela Olson, CNA, Trinity Homes; Carol Phillips, Medical Technologist, Lab; Vicki Reile, RN, Family Medicine; Agnes Rey, Library Assistant, Library; Shawn Smothers, Special Projects Director, Trinity Homes; Holly Stein, Account Representative, Business Offices, Trinity Hospital; Mary Storbeck, RN, Trinity Homes; Kelly Voeller, RN, Urology; and Gina Weaver, LPN, Medical Nursing.

25 YEARS: Jerilyn Alexander, Stroke Supervisor, Stroke Program; Clifford Black, Flight Paramedic, NorthStar Criticair; Margo Dailey-Filipkowski, Clinical Nurse Educator, Nursing Services; Colleen Durward, CNA, Kenmare Community Hospital; Carey Erickson, Pre-Certification Specialist, Patient Financial Services; Kristel Ficek, Oasis-HIS Review Nurse, Home Health; Charlene Gustavson, Cook, Kenmare Community Hospital; Carlen Hardy, CT/MR Technologist, MRI; Sandra Haugen, LPN, Trinity Regional Eyecare-Minot Center; Rochelle Hudson, Unit Manager, Same Day Surgery; Alita Iverson, Distribution Assistant, Materials Management; Richelle Koistinen, LPN, Kidney Dialysis Unit, Belcourt; Lisa Kuntz, CNA, Pulmonology; Pam Melby, LPN, Trinity Community Clinic – Kenmare; Clarice Michels, Cashier, Nutrition Services, Trinity Hospital – St. Joseph’s; Jennifer Mitchell, Clinical Excellence & Resident Safety, Trinity Homes; Paul Olson, MD, Physician, Emergency/Trauma Center; Jodie Overton, RN, Same Day Surgery; Tami Petersen, Training Officer, Community Ambulance Services; Cheryl Ree, MD, Family Medicine; Christine Rossland, Transcriptionist, Business Office, Trinity Regional Eyecare –Western Dakota; Martin Rothberg, MD, Cardiothoracic Surgery; Jeffrey Sather, MD, Emergency/Trauma Center; Correne Spelhaug, Pharmacist, Pharmacy; Terry Stock, CRNA, Anesthesiology; Sarah Summers, LPN, Podiatry; Rhonda Walter, Vice President Trinity Homes; Lynwood Wedar, Physical Therapist, Physical Therapy; Karin Will, RN, Pre-Admission Testing; Roxanne Wittmeier, Coder/Abstractor, Coding/Reimbursement; and Julie Yanish, Coder/Abstractor, Coding/Reimbursement.

20 YEARS: Sherilyn Abrahamson, Coding Supervisor, Coding/Reimbursement; Terri Anderson, CNA, Home Health; Evelyne Bouchard Kindy, MD, Ophthalmology; Shannon Brown, Coder/Abstractor, Coding/Reimbursement; Cynthia Brunner, Volunteer Coordinator/Activities Assistant, Trinity Homes; Julie Dietrich, Housekeeper, Environmental Services; Kristi Fredricksen, Accounting Supervisor, Corporate Finance; Patricia Getzlaff, Reimbursement Specialist, Business Services, Trinity Medical Group; Jennifer Henjum, CRNA, Anesthesiology; Gregory Johnson, Manager, Neurodiagnostics; Tracy Johnson, Special Procedures Technologist, Cath Lab; Candace Juma-Brown, RN, Pediatrics; Alexandre Kindy, MD, Orthopedics; Kathy Marchand, Financial Counselor, Patient Financial Services; Lisa Mohl, RN, Cardiology; Laurel Myers, Dietary Aide, Trinity Homes; Jennifer Napora, RN, ETC/UR Case Management, Case Management; Mary Olson, Medical Aide, Trinity Homes; Meredyth Pritchett, LPN, Trinity Homes; Tawny Quist, Ward Secretary, Trinity Homes; Tina Rodgers, CT/MR Technologist, MRI; Jutta Schmidt, Sleep Center Manager, Sleep Center; Amber Soine, Master Patient Index Specialist, Health Information Management; Della Turcotte, LPN, Trinity Community Clinic-Western Dakota; Darrell Williams, MD, Ophthalmology; Tyson Williams, DPM, Podiatry; and Cynthia Ystaas, LPN, Cardiology.

Trinity Health Welcomes New Providers

Trinity Health is pleased to welcome four new providers, including two orthopedic surgeons.

Tessa Hartmann (13) January-01-201802 PrintA certified registered nurse anesthetist, Tessa Hartmann, CRNA, provides anesthesia care to patients across a wide spectrum of surgical cases. Originally from Pierre, SD, she received her Bachelor of Science in Nursing from South Dakota State University, Brookings, and completed her Master of Science in Nurse Anesthesia at the University of Alabama at Birmingham. Her nursing experience includes critical care settings at hospitals in Oklahoma and Alabama. Tessa is certified in adult, basic, and pediatric life support, and is certified by the National Board of  Certification and Recertification of Nurse Anesthetists. She’s a member of the American Association of Nurse Anesthetists.

HashemiMohammad Hashemi, MD, is board certified and fellowship trained in total joint reconstruction. He specializes in total joint replacement of the hip and knee, including minimally invasive approaches. Dr. Hashemi received residency training in orthopedic surgery at the University of Texas Southwestern Medical Center and completed his post-residency fellowship in total joint reconstruction at Desert Orthopaedic Center, Las Vegas. He’s dedicated to helping people of all ages maintain an active, healthy lifestyle.

Dr. Daniel Lee 2 (06) February-02-2018-Edit

Daniel Lee, DO, MMS, is a board certified orthopedic surgeon, fellowship trained in sports medicine. He specializes in arthroscopic procedures of the hip and knee, including ACL reconstruction. His expertise also includes rotator cuff and labral repairs of the shoulder, as well as arthroscopic surgery of the elbow and ankle. He received residency training in orthopedic surgery at New York Medical College and the University of South Florida and completed his post-residency fellowship in sports medicine at Aspen Sports Medicine Foundation in Colorado. Throughout his medical career, Dr. Lee has applied his expertise to serve college and high school athletes both on and off the field. He is dedicated to treating individuals of all ages, getting them back to the activities they most enjoy.

Shawn Thompson (03) February-02-2018-EditShawn Thompson, DSc, PA-C, a doctor of science and board certified physician assistant specializing in Emergency Medicine, has joined our team of providers at the Emergency/Trauma Center. A retired military medical officer, Shawn brings extensive experience to his position, having cared for soldiers in both Iraq and Afghanistan. He enlisted in the U.S.  Army in 1993 and worked as a chemical, biological, radiological and nuclear (CBRN) specialist for 11 years before attending the Interservice Physician Assistant Program (IPAP) earning both his bachelor’s and master’s degrees in PA studies from the University of Nebraska. After graduating he was assigned to the 3rd Brigade, 3rd Infantry Division at Ft. Benning, GA. In addition to primary care medicine, Shawn spent 15 months in Iraq responsible for coordinating medical assets at three separate combat outposts and point of injury care during numerous combat operations. Subsequently he was assigned to the U.S. Army Ranger School. He was sole medical officer for the school’s Ft. Benning phase and later, as the senior medical officer, was responsible for coordinating medical care for the thousands of students attending  annually at three geographically separate locations. In 2013, Shawn completed his Doctor of Science in Emergency Medicine PA Studies at Baylor University, Ft. Sam Houston. He moved to Ft. Bliss, TX, joining the emergency department at William Beaumont Army Medical Center. While at William Beaumont he spent a period of several months as the Officer in Charge of the 31st Combat Support Hospital’s Level 11 trauma center in Kabul, Afghanistan. Returning from the war zone he was named assistant professor and program director for the U.S. Army-Baylor University Emergency Medicine Physician Assistant Residency program, a post he held prior to joining Trinity Health. He’s board certified by the National Commission on Certification of Physician Assistants and certified in advanced trauma, pediatric, and cardiac life support.

Hospice Volunteers Needed

Trinity Hospice is inviting compassionate people who would like to make a difference to consider becoming a hospice volunteer.

“Hospice volunteers fill the gap between loved ones and professional caregivers,” explained La Donna Schreiber, MSW, LCSW, a social worker with Trinity Home Health & Hospice. “Volunteers will be there even when family and friends find it hard to do so.”

Volunteers are trained to meet the needs of patients and families. They visit on a schedule, but are open to change as dictated by the patient’s health and interests. “Volunteers may read to patients, reminisce about their lives, play cards, give the caregiver a short respite break, help with letter writing, or simply call a family member whose loved one has died to provide emotional support,” Schreiber said. “The experience is as rewarding to volunteers as it is to patients.”

Schreiber noted that personal care is not involved in the volunteer’s duties and that volunteers are matched with patients according to their comfort levels. Training is also provided.

For more information, or to sign up as a volunteer, please call La Donna Schreiber at 857-5082.

Healthy Hearts Club Donates $25,000 for Building Funmd

The Trinity Health Auxiliary Healthy Hearts Club has raised $25,000 for the Trinity Health Heart Center, part of Trinity Hospital’s plans for a cardiac care center at the new medical park in southeast Minot. At the club’s Hearts Gala on February 9, the check was presented.

“Since performing North Dakota’s first open heart surgery in 1968, Trinity’s heart program has been a pioneer in cardiac care, characterized by a level of progress and innovation unusual in a rural area like ours,” said Sherry Maragos, event coordinator for the Healthy Hearts Club and director of Volunteer Services at Trinity Hospital. “It is truly an honor to recognize this outstanding program and raise money for its benefit and the benefit of its patients.”

The Trinity Health Auxiliary conducts fundraisings throughout the year to advance the mission of Trinity Health; the Healthy Hearts Club is a program of the Auxiliary to benefit the region’s heart patients and the heart programs at Trinity Health.

Over the past two years, the Healthy Hearts Club has raised funds for cardiac-related purposes. In 2016, they presented a check for $10,000 for new exercise equipment for Trinity’s Cardiopulmonary Rehabilitation department. In 2017, they presented a similar check for $15,000 to purchase specialized chairs for heart surgery patients in the cardiology and cardiothoracic departments.

The Healthy Hearts Club would like to thank TEG Architects, Holiday Inn, KMOT, Blue Cross Blue Shield of North Dakota, and Western Partners LLP, for their sponsorship for the event.

Colorectal Cancer: Know the Signs

A 2017 study from the American Cancer Society published in the Journal of the American Medical Association, shows that colorectal cancer rates among adults age 20 to 54 have increased since the mid-2000s.

According to the study, the five-year survival rate for colorectal cancer – cancer of the colon or the rectum – when it is diagnosed at an early stage is 90 percent. However, diagnosis is often delayed in younger people, who often don’t think they are at risk for colorectal cancer – that is, until symptoms show up, such as rectal bleeding, unexplained weight loss, or persistent abdominal cramping.

Colorectal cancer is the third most common cancer diagnosed in men and women in the United States. The American Cancer Society estimates that in 2018, there will be 97,220 new cases of colon cancer and 43,030 new cases of rectal cancer. The lifetime risk of developing colorectal cancer is about 1 in 22 (4.49 percent) for men and 1 in 24 (4.15 percent) for women.

Risk factors for colorectal cancer include:

  • Being overweight or obese, which increases risk of developing and dying from colorectal cancer
  • Physical inactivity
  • A diet high in red and/or processed meats
  • Smoking
  • Heavy alcohol use

There are risk factors, however, that a person cannot control. Those include:

  • age
  • personal history of colorectal polyps or colorectal cancer
  • history of inflammatory bowel disease
  • family history of colorectal cancer or adenomatous polyps

Screening is recommended at the age of 50 for those who are not at increased risk, explained Edmundo Justino, MD, a gastroenterologist with Trinity Health. Justino added that people with a strong family history of colorectal cancer, or those who have had rectal cancer or precancerous polyps, could benefit from screening at an earlier age.

Abnormal cells grow into polyps; it takes 10 to 15 years for those polyps to develop into colorectal cancer. Regular screenings can catch those polyps, which can then be removed before they have the chance to develop into cancer.

A recent report from the American Institute for Cancer Research and the World Cancer Research Fund shows that eating right and exercise can help lower the risk of colorectal cancer. The report has strong evidence that eating more whole grains reduces the risk of colon cancer, citing that the chemical compounds found in foods high in fiber have “plausible anti-carcinogenic properties.” Three servings of whole grains can lower colorectal cancer risk by 17 percent.

Likewise, eating a lot of red and processed meat could increase the risk; studies show that 1.8 ounces a day of processed meat could increase the risk by as much as 16 percent. These meats have high levels of heme iron, which can promote the growth of colorectal tumors.

Trinity Health’s gastroenterology team includes Rukshana Cader, MD; Kelly Dickinson, FNP-C; Edmundo Justino, MD; and Bonnie Ler, FNP-C. Their offices are located at Health Center – Medical Arts, 400 Burdick Expressway East, Minot. A referral is necessary to see a gastroenterologist.

Caring for area athletes for more than 30 years

Six years ago, Trinity Health’s Sports Medicine department had four full-time certified athletic trainers: Kevin Melby, Barb Nesheim, Robyn Gust, and Jodi Swedlund.

The department was spread pretty thin over four people, allowing them to only cover varsity sporting events and junior varsity boy’s hockey. However, since that time, the program has grown to include 13 athletic trainers and two physicians, Dawn Mattern, MD, Sports Medicine Medical Director, and Daniel Lee, DO, MMS.

“We have some amazing veterans and we have some amazing new people who bring in new ideas and techniques,” Gust said. “We’re able to get the experience and the newest of the new and try to put it all together to offer the best care for our patients, and that’s really important.”

Now, with this number of athletic trainers, “we cover everything in Minot,” said Gust, who also serves as Manager of the Sports Medicine department. “We are able to provide better and more comprehensive services.” In addition to Minot, Trinity Sports Medicine provide services to most of the area high schools within 25 miles and has athletic trainers in Williston and Bottineau.

Trinity’s athletic trainers are responsible for instilling all of the the aspects of sports medicine to student athletes and the physically active population in high school and college throughout the northwest region of North Dakota, covering mostly contact and collision sports, the “higher risk sports,” such as football, basketball, hockey, wrestling, gymnastics, volleyball, and soccer.

For more than 30 years, Trinity Health Sports Medicine has been providing athletic training services for the Minot region. The growth allowed the department “to provide more comprehensive services to the people we are serving,” Gust explained. “We were having to cut things short sometimes or not be places we wanted to be as often because we didn’t have the people.”

“I think we have made great strides with athletic training,” added Melby, an athletic trainer with Trinity since 1994. “We went from two high schools to 14 high schools and one college to two colleges. We’ve added an athletic trainer in Dr. Mattern’s office. We cover the Minotauros and have a full-time athletic trainer at the Maysa Arena. Soon, this summer, we will be covering the Sabre Dogs, a rookie baseball team that will be based at Corbett Field.”

In short, this expansion added services “to the greater portion of northwest North Dakota,” he said.

There are a lot of misconceptions about athletic trainers. They assist these athletes in several ways, all of which keep their health and well-being as a priority. The misconception “comes from what people see us do in the public,” Gust said. “The majority of what people think we do is tape ankles, but that’s probably the smallest thing we do. We do a lot more than that. The healthcare aspect is bigger than the taping.”

Melby added, “With athletic training, we’re not only there for injuries, but we are there for ‘pre-hab’, rehabilitation, and functional training.”

Injury prevention
Athletic trainers aid with injury prevention, looking at different aspects overall to help them avoid potential injury. “We look at the way they move their bodies, especially if they are doing it incorrectly,” Gust said.

The FASTER athletics program – this stands for Flexibility, Agility, and Strength Together Equal Ready – helps student athletes from area schools to not only prevent injury, but to enhance their performance. “We work on different areas that we feel are weak with them to help prevent injury,” Melby said.

Athletic trainers also ensure the environment is safe; for example, making a “lightning call” to delay an outdoor event until it is safe for everyone. Additionally, they plan for emergencies by having a plan for every location at every sporting event, including a mass casualty plan.

“We’ve worked closely with Ward County emergency services on that,” Gust said, adding that she updates them on upcoming sporting events that include a large number of people. “Now that we work alongside them, there is a lot of transparency on what is going on.”

At that point, a decision is made on whether or not the athlete needs immediate care, depending on if an injury is emergency or a “walk-in” injury that can be referred the next day or managed by the Sports Medicine staff.

“We are there when they go down,” Gust said. “That is key to make sure they get immediate care.”

Making those assessment decisions can be the difference between how fast they recover or if they are injured further if they aren’t taken care of properly.

Some of the student athletes that need more extensive rehabilitation are referred to physical therapy, if one-on-one time is needed or if they are at the sites where athletic trainers are not able to follow up with them on a daily basis.

“We work with Dr. Mattern and follow what she would like us to follow for rehabilitation, per her preview,” Gust said. “She tells us the direction she wants us to go, and we go, and we implement that plan.”

Melby credits Gust and Dr. Mattern with promoting sports medicine and bringing it to the level it is today. “Dr. Mattern backs us really well and supports us. She encourages people to see us,” he said. “Between her and Robyn, they got us out in the public. We’ve really opened up our avenues of going out to do these different things.”

Diabetes Coordinator Named

Sarah-PressSarah Rimatzki, RN, BSN

Sarah Rimatzki, RN, BSN, a member of Trinity’s Emergency/Trauma Center team for the past three years, has been named coordinator of the Center for Diabetes Education. Rimatzki oversees the various activities and programs provided at the center, which offers education and nutritional counseling to patients and families dealing with diabetes.

Rimatzki is uniquely qualified for her new position, having been diagnosed with Type 1 diabetes in 2005. “My diabetes journey definitely inspired me to become a diabetes educator,” she said. “I was always motivated by the healthcare providers who took care of me. I feel that I am able to help my patients because I know exactly what it’s like to have this disease. Diabetes isn’t my weakness; it’s my strength when it comes to being a diabetic educator.”

A Minot native, Rimatzki earned her Bachelor of Science in Nursing from Minot State University in 2015. She’s a member of Sigma Theta Tau International Honor Society of Nursing.

Sleep Education is Available for CPAP Patients

Are you struggling with your continuous positive airway pressure (CPAP) therapy? Are you unable to tolerate it? Rest assured, there is help for you.

Trinity Health’s Sleep Center, located at Trinity Hospital – St. Joseph’s, includes the services of three board certified sleep educators. They serve as liaisons between the patient, referring physician, the sleep center, and the Durable Medical Equipment (DME) provider. “We help them schedule and coordinate care and follow-up,” explained Jutta Schmidt, RRT, RPSGT, manager of the Sleep Center and a sleep educator. Mary Sather and Susan Irwin are also sleep educators.

As Schmidt noted, patients who are diagnosed with sleep apnea can have issues with the technology prescribed, specifically the CPAP machine. The patient may have tolerance issues and require some visits with the sleep educator to work on desensitization. These patients may come in for “PAP naps” to be guided by the sleep educator and slowly get used to the positive pressure. Other patients may have a mask that does not fit properly and require mask fitting. “Mask fit is one of the easier issues to address, as there are many types of interfaces including nasal masks, full face masks, and very small nasal pillows that just sit at the bottom of the nose,” she said. “If somebody was not able to find a comfortable mask a few years ago and gave up on CPAP therapy, we encourage them to seek treatment again, as there are many new types of masks and headgear available now. We work closely with the DME providers to maximize customer service.”

“A lot of people are diagnosed with sleep apnea but aren’t compliant with CPAP use, whether they are having issues tolerating the machine or don’t think it’s important.” Schmidt added, “Whatever obstacles may stand in their way, we are here to help them. A lot of what we do is education – educating the patient about health benefits of CPAP and helping them understand why it is important to use it.” Untreated sleep apnea brings significant health consequences, including hypertension, heart disease, and stroke.

Sleep apnea is treated through various means, including: CPAP, a machine that is worn during the night to assure the airway remains open; lifestyle changes, such as stopping smoking, cutting back on alcohol use, and weight loss; or in some cases, surgery. CPAP is facilitated through a DME supplier, such as KeyCare Medical. CPAP machines are now equipped with a modem that transmits the patient’s information to a web-based platform accessible by the DME provider and the Sleep Center.

Once the DME sets them up, we call them,” Schmidt said. “We take a look at the download and see how they are doing. If they are doing great and don’t need any help, we may give them a call and keep contact to let them know that if they have any issues, they can all us. If they have any problems or are not using it properly, we contact them and try to troubleshoot those issues over the phone. If that doesn’t work, we have them come to see the sleep educator for a consultation.” There is no charge for this consultation.

Sleep studies are performed by the Sleep Center to help diagnose sleep apnea. A referral is needed, but if a patient has been previously diagnosed, no referral is necessary to consult with the sleep educator. To schedule an appointment with a Trinity sleep educator, call the Sleep Center at 857-2348.

Kidney Disease

With more than 40 million Americans living with kidney disease, it is the ninth leading cause of death in the country.

Nephropathy, or kidney disease, is damage to or disease of the kidney; this usually causes kidney failure to some degree, depending on the type of disease.

Diabetes mellitus — specifically Type 2, or adult onset diabetes — and hypertension (high blood pressure) are the two most common diseases which can lead to kidney failure if not treated adequately, explained Nasser Saffarian, MD, a nephrologist with Trinity Health. Diabetes can injure small blood vessels, which in turn causes the kidneys to not clean blood properly.

The National Kidney Foundation says that African Americans have a higher rate — three to four times more than white Americans — of kidney failure. “It is not fully understood why African Americans are at a higher risk,” the National Kidney Foundation said on their website. “However, diabetes, high blood pressure, family background, and access to healthcare play major roles.”

Lowering risk factors can help, Saffarian said. That can include glucose control, managing blood pressure, lipid control, smoking cessation, lifestyle modification, and certain medications.

People with kidney disease may experience nausea, vomiting, weakness, fatigue, confusion, difficulty concentrating, and loss of appetite, the National Kidney Foundation said. If you show these signs, consult your primary care provider, who can give a blood and urine test to check for kidney disease. Saffarian noted that if you are diabetic, you should look for protein in the urine by having a urine test performed by your primary care provider. Your kidneys filter waste products from your blood while retaining what your body needs, including proteins. However, some diseases and conditions allow proteins to pass through the filters of your kidneys, causing protein in urine. “If you are spilling protein in urine, not only are you increasing your risk for kidney disease progression, you will also increase risk of cardiovascular disease,” Saffarian pointed out.

Mayo Clinic adds that dehydration, emotional stress, and exposure to extreme cold, fever, or strenuous exercise can also cause a temporary rise in the levels of protein in urine. Saffarian suggests that if you show these signs, you should consult with your primary care provider, who can administer a test to track the glomerural filtration rate, or GFR. This is the best test to measure the level of kidney function and determine, if necessary, the stage of kidney disease. This is calculated from the results of a patient’s blood creatitine test, age, body size, and gender. The higher a person’s GFR, the more function their kidney has and the less chance they are in a stage of chronic kidney disease.

  • Stage 1 Chronic Kidney Disease – has a GFR of 90 or higher; 90 to 100 percent kidney function, but with some kidney disease.
  • Stage 2 Chronic Kidney Disease — has a GFR of 89 to 60; kidney damage with a mild loss of kidney function; the kidneys are usually functioning between 60 to 89 percent.
  • Stage 3a Chronic Kidney Disease — has a GFR of 59 to 45; there is mild to moderate loss of kidney function, and kidneys are operating at 45 to 59 percent.
  • Stage 3b Chronic Kidney Disease — has a GFR of 44 to 30; there is moderate to severe loss of kidney function, with kidneys operating at 30 to 44 percent.
  • Stage 4 Chronic Kidney Disease — has a GFR of 29 to 15; severe loss of kidney function, operating at 15 to 29 percent.
  • Stage 5 Chronic Kidney Disease – has a GRF of less than 15; kidney failure, operating at less than 15 percent.

Once the stage of kidney disease is determined, the primary care provider will refer the patient to a nephrologist, especially if their GFR is in the 59-45 range. Trinity Health’s nephrology department includes nephrologists Warren Ho, MD, and Nasser Saffarian, MD, who are trained to diagnose and manage kidney diseases by regulating blood pressure, regulating electrolytes, balancing out fluids in the body, and administering dialysis if needed.

In addition to referrals, patients can make an appointment with Trinity Health Nephrology by calling 857-5979. Their office is located in Health Center-East, Suite 503, 20 Burdick Expressway West.

New Ultrasound Used on Surgery, Cardiothoracic Patients

Trinity Health’s surgical and cardiothoracic departments have recently benefited from a grant from the Trinity Health Foundation.

In mid-November 2017, an ultrasound machine was purchased to be used by the departments for in-office procedures.

Gary Wease, MD, with Trinity Health’s Surgical Associates, described the ultrasound as “an extension of our physical examination.”

“We use it to identify things like breast cysts, subcutaneous abscesses, and foreign bodies,” Wease said. “If somebody comes in and is hit with a piece of glass or a nail, we can see that with an ultrasound.”

Surgical Associates were limited to “our own senses of a physical exam,” Wease said, noting that before, if there was a concern, a formal exam with radiology was scheduled. “That could delay their care. We have a lot of patients who come from outside of Minot to see us. If they had to come two hours to be seen, and they needed an ultrasound, they would need to make a repeat trip. Some of these things, if we can diagnose it right here in the office, we can achieve their treatment the same day they are here, and that is important when we have patients who come a long way – and there is a fair share.”

In fact, the ultrasound is used several times a week by Wease and his colleagues.

The cardiothoracic department also uses the ultrasound to help patients with pleural effusions.

A pleural effusion is excess fluid that accumulates in the pleural cavity, the space between the lungs and the chest wall, explained C. Etta Tabe, MD, a cardiothoracic surgeon with Trinity Health. While fluid generally gathers in the pleural cavity, an excess of it – when the fluid doesn’t drain out in the normal fashion – can cause breathing difficulties. Draining it can “give them immediate relief,” he added.

“The ultrasound helps us to localize exactly where the fluid collection is,” Tabe said. “In the past, you would basically follow landmarks and pass a needle into the pleural space based on clinical judgment.”

With this procedure came the risk that the needle would not enter the pleural fluid, he said. “The ultrasound helps to localize exactly where the fluid is so the needle would go directly into the pleural effusion.”

The Trinity Health Foundation’s cardiopulmonary fund is used to support programs and services for patients with heart and lung conditions, explained Al Evon, director of the Trinity Health Foundation.

“That fund helps with any cardio or pulmonary needs, to help the doctors serve the patients,” Evon said, noting that it is used specifically on equipment, training, education, or “anything that would support the programs and services.”

For more information on the Trinity Health Foundation, visit: