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Sun Safety Should Include Sunscreen

With spring here and summer around the corner, nicer weather and warmer temperatures invite people to spend more time outdoors.

This is a good time to remember to always wear your sunscreen.

Protecting your skin with sunscreen isn’t just to prevent sunburn. It can also help prevent skin cancer – the most common cancer worldwide – from developing.

The three most common types of skin cancer are basal cell carcinoma, squamous cell carcinoma, and malignant melanoma, explained Jennifer Hunter, MD, a dermatologist with Trinity Health. According to the Skin Cancer Foundation, sunscreen can reduce your risk of developing squamous cell carcinoma by about 40 percent and lower your melanoma risk by 50 percent.

As there are many functions of the skin, including protecting the inner organs from environmental stressors, it is important to protect the skin – and sunscreen can help.

“Men, women, and children over six months of age should use sunscreen every day,” the Skin Cancer Foundation advised. “This includes people who tan easily and those who don’t.” They also note that skin can be damaged by sun exposure even if you do not burn.

Sunscreen is an important tool that shouldn’t be limited to just the summer months, Dr. Hunter explained. “We’re exposed to UV rays year-round, even on rainy days, snowy days, and cloudy days.”

Dr. Hunter recommends the following tips to keep your skin safe year-round:

Check the SPF on your sunscreen. The SPF is the sun protection factor of sunscreen. “The number tells you how long the sun’s UVB rays would take to redden your skin if you apply the sunscreen exactly as directed compared with the amount of time without sunscreen,” the Skin Cancer Foundation noted.
For example, a sunscreen with SPF 30, when used properly, would protect you 30 times longer than if you used no sunscreen. A sunscreen with an SPF of 30 or higher is necessary for casual exposure and extended outdoor activities, such as distance running, hiking, swimming, and outdoor sports. Dr. Hunter noted: “The higher the number, the better since there is a tendency to underapply sunscreen in general.”

It is also important to note that the sunscreen should be “broad spectrum,” which means that it blocks both UVA and UVB rays.

Check the expiration date on the sunscreen. Yes, sunscreen has an expiration date – and when it reaches that date, it begins to lose its effectiveness, Dr. Hunter said. It won’t become completely ineffective immediately, but over time, the efficacy of the sunscreen will diminish, she added. “Make sure you can find that date and honor it.”

Use a lip balm with SPF 30 or higher. Don’t forget about your lips which, according to the Skin Cancer Foundation, receive a lot of sun exposure, which makes the lips – especially the lower lip – a common spot for skin cancers.

Wear your sunglasses. According to the Centers for Disease Control and Prevention, sunglasses protect your eyes from UV rays and reduce the risk of cataracts. “They also protect the tender skin around your eyes from sun exposure,” they add.

The CDC advised that sunglasses that block both UVA and UVB rays offer the best protection.

Be sure to cover up. This can include ultraviolet protection factor (UPF) clothing, long sleeves and long pants, wide-brimmed hats, and protective gloves.

“If wearing this type of clothing isn’t practical, at least try to wear a T-shirt or a beach cover-up,” the CDC advised. “Keep in mind that a typical T-shirt has an SPF rating lower than 15, so use other types of protection as well.”

Wear your sunscreen – and reapply. The Skin Cancer Foundation recommends reapplying sunscreen every two hours of exposure, as well as immediately after swimming or excessive sweating.

Apply sunscreen 30 minutes before you need it. This allows the sunscreen to bind to your skin, the Skin Cancer Foundation noted. Dr. Hunter suggested putting it on the first thing in the morning if you know you will be outside for any period of time during the day, in a vehicle, or inside by windows; she notes that UVA rays can go through window glass.

Apply an ample amount of sunscreen. For the face and neck, Dr. Hunter noted the standard is to apply a teaspoon-and-a-half for each application; for the body, about one to two fluid ounces (or “a shot glass” worth) of sunscreen should be used.

Avoid tanning and sunburns. Dr. Hunter warns against tanning or getting sunburns. “When you tan or burn, you’re damaging your skin,” she said, noting that you never want to tan or burn through sunscreen. When it comes to protecting your skin, “there is no such thing as a good base tan.”

Store your sunscreen properly. Like food, sunscreen can spoil if it is not stored properly. “The compounds in sunscreens are compromised in extreme temperatures,” Dr. Hunter said. “You never want sunscreens to melt or freeze.” Sunscreen should be stored in a cool, dark place. The Food and Drug Administration recommends that, when outdoors, sunscreen containers should be wrapped in towels or kept in the shade, as well as in coolers while outside in the heat for long periods of time.

Be mindful of reflection. UV rays can reflect off concrete, sand, and water. (And in the winter, it can also reflect off snow and ice, Dr. Hunter notes.)

Avoiding peak sun times between 10:00 a.m. to 4:00 p.m., if possible. The time when UV exposure is likely to be greatest is between 10:00 a.m. and 4:00 p.m., the American Skin Association noted. “Nonetheless, protection from UV rays during all daylight hours and weather conditions is important,” they added.

Lastly, Dr. Hunter advised not to be swayed by products, such as makeup or moisturizers, that have sunscreen in them. While these don’t need to be avoided, it is important that “dedicated sunscreens” – or regular sunscreens – are also used. “Dedicated sunscreens do not have an issue with dilution, and thus they will give you the SPF coverage as stated on the label if used as recommended,” she said.

She added that when applying multiple products, the order of application is important. When applying sunscreen, medication (such as medication for acne) should be applied first, and then sunscreen. After that, moisturizer, makeup, and the like can then be added.

Trinity Health Dermatology includes Jennifer Hunter, MD, and Ann Welch, FNP-C. For appointments or consultations, please contact Dr. Hunter at 701-857-5760 or Ann at 701-857-7382.

Western Dakota Gains CT Scanner
Services at Williston Clinic Expand

The addition of a Philips Incisive 128-slice CT scanner will afford patients at Trinity Community Clinic – Western Dakota more opportunities for quality healthcare.

The computed tomography (CT) scanner uses digital detectors and an X-ray tube, along with computers, to create cross-sectional images of the body, thus creating images with more detail than normal X-ray images. CT images can show soft tissues, blood vessels, and bones in various parts of the body. Anatomy can be seen in three different planes.

This technology, which was installed at the Williston clinic in early April, will make it easier for patients, who will no longer need to travel elsewhere for CT imaging services, explained Tessah Richardson, clinic director at

Western Dakota. Scheduling will be better, which will get patients appointments more quickly, she added. “It will also give us the opportunity to do pretty much everything Trinity Health in Minot does with CT.”

“We’ll be able to offer patients in the Williston region lung screening, calcium scoring, coronary artery evaluation, and more, just like we do here in Minot,” added Jim Coffin, RT(R), CT, ARRT, director of imaging services at Trinity Health, noting that the CT scanner has the capability of scanning “any anatomical structure” on the body.

With the CT scanner, providers at Western Dakota will be able to offer a continuity of care for patients who can come to the clinic, have the procedure performed by clinic staff, and then have the results read and interpreted by Trinity Health radiologists, Coffin explained. “In body imaging, CT scanners have become the backbone of radiology departments because of the speed, accuracy, and ability to utilize an ongoing technology that continues to improve.”

With the recent purchase of this CT scanner, the clinic can now offer the same list of MyChoice Health Checks that Trinity Health offers in Minot. MyChoice Health Checks are self-referred. (Cardiac imaging studies need to be approved by the radiology nurse practitioner.)

The MyChoice Health Checks include: • Abdominal Aneurysm: Abdominal Aortic Aneurysm (AAA) is when the

aorta, the largest artery in the body stretches and balloons in the abdomen, possibly rupturing. Symptoms can include abdominal pain or back pain that is severe, sudden, or constant; clammy skin; dizziness; nausea and vomiting; or rapid heart rate.

  • Stroke: For those at risk of stroke or heart disease, or who have a family history of stroke or heart disease, the Carotid Artery Disease screening looks for build-up of plaque in the carotid arteries. Symptoms can include sudden severe headache, dizziness, blurred vision, sudden weakness, or numbness in the face or limbs.
  • Heart Attack: Coronary Artery Calcium Scoring can detect developing plaque/calcium in the coronary arteries, which can lead to a heart attack.
  • Heart Disease: An electrocardiogram can screen for signs of heart disease. An EKG can check your heart for rhythm, see if you have poor blood flow to the heart muscle, diagnose a heart attack, and check for abnormalities such as a thickened heart muscle.
  • Painful Legs and Feet: Hardening of the arteries in the legs, due to plaque, can diminish blood supply and cause pain in the legs and feet. The Peripheral Artery Disease (PAD) screening is available to check for PAD.

The results from these tests are interpreted by board-certified cardiologists, radiologists, and technologists. “Our MyChoice Health Checks are the best deal in healthcare,” Coffin said. “It’s a great deal and can be a lifesaver.”

He added, “Trinity Health is very proud and committed to continue investing in our Western Dakota clinic. We have been a part of the community for decades and will continue to be so.”

To schedule MyChoice Health Checks in Williston, please call 701-774-0810.

Head and Neck Cancer

Head and neck cancer is an umbrella term that includes cancers of the tongue, tonsil, throat, and voice box. While cigarette smoking and/or excessive drinking are often attributed to causing these, there is another factor that has been become a leading cause: the human papillomavirus, otherwise known as HPV.

Rob Thomas, MD, an ear, nose, and throat doctor with Trinity Health, said that he – as well as other ENT providers globally – have seen a significant increase in HPV-related head and neck cancer. “In the 1990s, 50 percent of oropharyngeal head and neck cancers were attributed to HPV,” he said. “Now, it accounts for 70 to 80 percent.”

Additionally, he noted, patients are being diagnosed at a younger age.

“As a lot of people are aware, the HPV vaccine will prevent this kind of head and neck cancer in anyone that gets it,” Dr. Thomas said. “We’re very optimistic that because of the vaccination efforts against HPV, we will eventually see a decline in these new, HPV-related head and neck cancers.”

However, Dr. Thomas attributes the rise in HPV-related head and neck cancers to the fact that “a majority of patients have not had the vaccine.” He explained that the HPV vaccination is recommended at age 11-12, but it is also approved for adolescents and adults ages 13 to 26.

“Anyone older than that should speak with their primary care provider to see if this is something to consider,” he said, noting that vaccines are available through primary care providers.

In 2021, an estimated 54,010 people will get oral cavity or oropharyngeal cancer, and about 10,850 people will die from it, the American Cancer Society said. Men are twice as likely to develop these types of cancers over women. The death rate for these cancers have decreased over the last 30 years.

In addition to HPV, people who smoke daily or are heavy drinkers – those who have four to five drinks a day – also are at risk for developing head and neck cancers. Dr. Thomas noted that smokers are five to 25 times more likely to develop head and neck cancer as opposed to non-smokers and people who abuse alcohol are five to six times more likely than non-drinkers or those who drink less to develop head and neck cancer. Additionally, he said, those who smoke and drink have “multiplicative effects.”

Things to watch for:

  • Mouth sores or bleeding in the mouth
  • Persistent sore throat
  • Trouble swallowing
  • Hoarse voice
  • Long lasting cough
  • Lump in the neck
  • Ear pain (Dr. Thomas noted that one of the frequent symptoms of tonsil cancer is ear pain. “In my opinion, a heavy smoker/drinker that has ear pain needs to come in for a cancer evaluation immediately,” he said.)

If you experience any of these, speak to primary care provider, who can then make a referral to ENT. At the ENT’s office, a scope exam – using a thin tube with a camera and light – is performed to look for possible cancer. If there any concerning findings, a biopsy and further imaging, either through CT, MRI, or PET, is done. “If we do find cancer, the next step is to discuss the various treatment options offered here at Trinity Health including surgery, chemotherapy, and radiation.”

A tumor conference, a meeting of doctors that treat cancer and “everyone who is involved in the care,” is held to decide the best methods of treatment “to get them treated as quickly as possible,” Dr. Thomas said.

To better avoid head and neck cancer, Dr. Thomas advised that quitting smoking, minimizing alcohol intake, and making healthy lifestyle decisions are the best ways. “Unfortunately, with HPV-related head and neck cancer, the vast majority of adults have already been exposed to HPV (though not necessarily the cancer-causing kind) and there isn’t anything to do but monitor for symptoms.”

With HPV-related head and neck cancer, Dr. Thomas noted that the risk of HPV infection is lower, based on the number of long-term sexual partners.

The Centers for Disease Control and Prevention advise the following to help reduce the chances of developing head and neck cancer:

  • Don’t smoke. If you smoke, quit. Quitting smoking lowers the risk of cancer.
  • Don’t use smokeless tobacco products.
  • Limit the amount of alcohol you drink.
  • Talk to your doctor about HPV vaccination. The HPV vaccine can prevent new infections with the types of HPV that most often cause oropharyngeal and other cancers. Vaccination is recommended only for people at certain ages.
  • Use condoms and dental dams consistently and correctly, which may help lower the chances of giving or getting HPV.
  • Use lip balm that contains sunscreen, wear a wide-brimmed hat when outdoors, and avoid indoor tanning.
  • Visit the dentist regularly. Checkups often can find head and neck cancers early when they are easier to treat.

Trinity Health Ear, Nose, and Throat includes Alycia Coutts, FNP-C, and Rob Thomas, MD. Their offices are based at Health Center – West, 101 3rd Ave SW, Ste 203, Minot. For more information, call 701-857-5986.

Poison Prevention

Let’s face it. Sometimes, kids get into things that they probably shouldn’t.

Everyday household items, such as cleaning products, personal care products, and unsecured medications, can be harmful to kids. “Poisoning is the third
leading cause of unintentional injury death among children ages one to 19 years,” said Amber Emerson, RN, Trinity Health Trauma Services and coordinator of Safe Kids Minot.

According to the Centers for Disease Control and Prevention, over 300 children – those age 19 years and under – in the United States are treated in an emergency department and two children die because of being poisoned. “It’s not just chemicals in your home marked with clear warning labels that can be dangerous to children,” the CDC warned on their website.

One such danger is liquid nicotine, Emerson noted. Disposable and prefilled cartridge e-cigarettes are the least dangerous because the liquid nicotine ordinarily can’t leak out unless the cartridge is somehow broken, Emerson explained. However, the refillable devices need to be refilled from larger containers, which are not fitted with child-resistant caps. The liquid nicotine easily flows out and can be swallowed or spilled onto the child’s skin or clothing.

“The nicotine is so concentrated that even a small amount can be toxic,” Emerson said. Symptoms occur within minutes and include a stinging bitter taste, drooling, gagging, vomiting, and dizziness. “In severe cases, seizures and a fatal drop in blood pressure can occur,” Emerson said, noting that the child should be brought to their medical provider and the poison control hotline notified immediately.

The CDC recommends the following poison prevention tips:

  • Lock them up and away. Medicines and toxic products, such as cleaning solutions and detergent pods, should be kept in their original packaging and in a spot where children can’t see or get them. “Remember that bright labels are attractive to children and that child-resistant does not mean childproof,” Emerson added.
  • Know the number. Put the nationwide poison control center phone number (1-800-222-1222) on or near every telephone in your home and program it into your cell phone. “You never know when you may need it,” Emerson said. “When in doubt, call poison control.”
  • Read the label. Follow the label directions carefully and read all warnings when giving medicines to children.
  • Don’t keep it if you don’t need it. This includes unused, unneeded, or expired prescription drugs and over-the-counter drugs, vitamins, and supplements. Medicines can be mixed with coffee grounds or kitty litter and thrown away or they can be turned in at a local take-back program.

Organ Donation Can Help Many

In North Dakota, there are 148 people on the waiting list for an organ transplant. On a larger scale, there are 3,318 people in the tri-state area (North Dakota, South Dakota, and Minnesota) and overall, 107,938 people nationally in need of a lifesaving organ.

While 2019 was a record-breaking year, last year ended up being the second highest year for this area, explained Mark Ellingson, MDiv, BCC, a Clinical Hospital Coordinator with LifeSource, an organ procurement organization that serves more than seven million people in the Upper Midwest.

While 2020 started off slow, especially with concerns about non-essential staff being within the hospital walls, “the rebound into the summer and on, the year got to be the second highest,” Ellingson said.

In addition to a heightened awareness of going into hospitals, Ellingson noted that a number of potential organ donors who died in the past year died from COVID-19 or COVID-related illnesses, which made them exempt from organ donation.

“We certainly lost people that were designated donors,” Ellingson said, noting that if the deceased donor had COVID within the last 28 days of their life or were currently COVID-19-positive at the time of their death, they could not be an organ and/or tissue donor. (Ellingson stressed the importance of getting vaccinated for COVID-19.)

In 2020, the most likely to be recovered organ – and the most needed organ to be donated – was the kidneys, Ellingson said. “A donor can offer two of them. Also, living donors can offer one of their two. That’s not uncommon anymore, where someone donates to someone they know, or if the need is there.”

Additionally, other organs frequently donated are the liver, heart, lungs, pancreas, and even the intestines, although “that’s fairly rare,” Ellingson said.

Organ donation, in general, is very rare. Only
one percent of people who pass away have that opportunity to donate their organs. A variety of factors must align, including dying at a hospital on a ventilator, passing a variety of medical tests, and being free of active cancer.

At Trinity Health, guidelines are followed to try and recover as many life-saving organs as possible. When a patient meets the criteria to be an organ or tissue donor, Trinity Health calls LifeSource, whose personnel determines if the patient may or may not be a potential donor. If the patient does meet criteria for donation, LifeSource will reach out to the family to discuss the donation process.

This process has remained the same during the pandemic, Ellingson said, although he noted that there has been “more monitoring from a distance” during the pandemic.

“When COVID was very active, we were very careful about sending people on site, for our sake and the hospital staff’s,” he added. “We moved to do much more virtual work,” which included speaking to hospitals “from a distance and coming on site when needed.” That has since changed, and LifeSource staff are able to enter hospitals again.

If the patient has requested to be a donor or the family wishes to offer donation, LifeSource will then come into the hospital and start the donation process.

Making your intentions known is as easy as a notation on your driver’s license – the commonly accepted legal expression of your wish to donate. However, it is wise to share your decision with family members to ensure that they will support and honor your choice.

It is important that if a person wishes to be an organ donor that they register officially as one.

Having “Organ Donor” on your driver’s license is the most recognized form, nationally, of being on the organ donor registry. This makes it easier for family to make the decision when it comes to it. “That’s the first thing that gets checked,” Ellingson said. (North Dakota residents can also register online at www.life-source.org/register.)

If you are considering organ donation, perhaps you’ve wondered about ethical or religious viewpoints. Most major religions support organ donation as a noble and compassionate act. Other religions view donations as a matter of personal choice. (The viewpoints of many religious organizations are available at www.organdonation.org.)

Every person waiting for an organ transplant is registered with the United Network for Organ Sharing (UNOS). When a family gives its permission for organ donation, UNOS runs a computerized list of potential recipients in order to find a match. Organs are distributed based on factors such as medical urgency, compatible blood and tissue type, body size, and the length of time on the waiting list. All of the expenses related to organ donation are covered by LifeSource and passed on to the recipient and their insurer. Organ donation is a gift that saves and enhances the lives of many. Make a commitment to be a donor and share those wishes with your family.

If you are interested in learning more about organ donation, call the LifeSource central office at 1-888-5DONATE, or go online: www.life-source.org.

The Importance of a Mammogram

A mammogram is a very important part of a woman’s yearly health routine. The earlier breast cancer is found and diagnosed, the better chance for successful treatment. Consistency with yearly screening mammography exams, in conjunction with monthly self-breast exams, can save your life. All it takes is 15 to 30 minutes one day a year. You’re worth it!

Who should have a mammogram?

  • Women should have a baseline mammogram between 35 to 40 years of age.
  • Women should be having yearly mammograms at 40 years and older, according to the American College of Radiology (ACR).

Women with a first degree relative—mother, sister, father, or brother. They should begin their mammogram 10 years younger than when their relative was diagnosed.

According to the American College of Radiology, one in eight women will develop breast cancer over their lifespan. Breast cancer can be found at any age and any stage of life. Typically, in younger, pre-menopausal women, breast cancers are more aggressive due to the presence of hormones (estrogen). Many cancers are hormone receptive, meaning they will grow faster in the presence of those hormones.

Mammography has changed over the course of several years, while the main building blocks of what make it so effective have remained the same. 3D mammogram technology, which Trinity Health implemented in 2016, is proven more effective in detecting breast cancer. Breast cancer has been found at very early stages, and cancers also have been found that were previously not visible on the standard 2D imaging.

If you have been waiting for the “right time” or find yourself saying “I’m too busy right now,” please make the time. Take the moment for yourself and make it an annual priority. Getting a mammogram can set an example for your family, friends, and community. Also, patients who put their mammograms on hold due to COVID-19 should take the time to make that appointment. Staff at Trinity Health are ready to see you, safely and quickly.

Make the time to prioritize YOU now so you can have more tomorrows. Call today to schedule a mammogram. Remember: You’re worth it!

How can you get scheduled?

  • Call Trinity Health’s Mammography Scheduling line in Minot at 701-857-2640.
  • Call Williston’s Trinity Community Clinic – Western Dakota at 701-774-0810.
  • Trinity Health also offers a mobile route, in contract with DMS Health Technologies, for many outlying areas that can be scheduled through your local clinic.

Nutrition Spotlight on Seeds

By Kayla Benson, RDN, LRD, Clinical Dietitian, Trinity Health

CHIA

Chia seeds have gained popularity over recent years. They come from the plant Salvia hispanica which is native to Mexico and Guatemala. The seeds are very small, and can be white, grey, or black in color.

Chia seeds are rich in omega-3 fatty acids, fiber, protein, and calcium. Two tablespoons of dry seeds contain 140 calories, 5 grams of protein, 10 grams of fiber, and 180 milligrams of calcium. Research has shown that omega-3 fatty acids can have a positive effect on cardiovascular, bone, skin, and mental health. The 10 grams of soluble fiber in chia seeds help slow digestion which aids in lowering cholesterol, stabilizing blood sugars, and promotes satiety. Chia seeds contain all nine essential amino acids making them a complete protein.

These tiny seeds are versatile as they can be added to various recipes and have long shelf life of four to five years. Unlike flax seeds, chia seeds are digested well in their whole form or ground.

FLAX

Flax has been around since 3000 B.C. and originated in southern Europe and Asia. The seeds of the flax plant are flat, with a golden to reddish brown hue. Flax is also known as linseed and can be found whole or ground, roasted, or processed into flaxseed oil. Flaxseed is best absorbed when ground.

Two tablespoons of whole flaxseed contain 110 calories, 4 grams of protein, and 5.5 grams of fiber. They are considered a good source of thiamine, copper, magnesium and phosphorus. Lignans are found in almost every plant; however, flaxseeds are especially rich in them. Lignans are classified as phytoestrogens and research indicates that the high amount found in flaxseed may reduce the risk of certain cancers.

Shelf life of flax depends on the quality of the seed and whether it’s stored whole or ground. If stored properly, flax can last up to two years. It is best to store according to brand-specific recommendations.

Treatment Options are Available for Alcohol Abuse

The incidence of alcoholism during the pandemic has risen as many have used alcohol to cope with the stress, anxiety, and isolation that COVID-19 has placed on the world.

A study supported by the National Institute of Alcohol Abuse and Alcoholism (NIAAA), which compared adult drinking habits from 2019 to the present, showed an increase in alcohol consumption between spring 2019 and spring 2020. More specifically, men and women reported increasing the frequency of their binge drinking – five or more drinks for men and four or more drinks for women within a couple of hours. The Blue Cross Blue Shield COVID-19 National Pulse Survey also noted that overall alcohol consumption has risen 23 percent since the pandemic began.

Jason Andersen, LAC, a licensed addiction counselor with Trinity Health’s Addiction Services, believes that the isolation caused by the pandemic may have magnified the issue of alcoholism. “We started to see more people come in and we noticed a trend: they were not aware their drinking was an issue until they were at home and doing nothing but drinking,” he said.

Additionally, an addicted person who was forced into isolation couldn’t maintain their existing support structure, such as face-to-face meetings, and they may have relapsed, Andersen said. “A number of people with some long periods of sobriety and recovery” may have also relapsed due to pandemic concerns, such as healthcares, being stuck at home, or unemployment.

While the addiction cases seen were “primarily alcohol issues,” they also saw a number of patients seeking help with methamphetamine, opioids, and sedative-related issues during this time.

Typically, the summer is a slow time in the Chemical Dependency Unit at Trinity Hospital – St. Joseph’s. However, this past year, it maintained a consistent flow of patients into the summer and fall months, Andersen said. He noted that while there are usually waiting lists in the wintertime, there was a similar list in the summer and that overall, the unit has “maintained above average numbers, particularly last spring through summer.”

Treatment for alcoholism is available through Trinity Health Addiction Services, which offers a full range of assessment and treatment programs to help people achieve their personal and professional goals related to recovery from chemical dependence or substance abuse. This includes community education, consultations, evaluations and screening, assessments, medically monitored inpatient programming, aftercare programming, and residential programming.

The goal of Trinity Health Addiction Services is to facilitate this change process to provide individuals the tools they need to develop and maintain a lifestyle of recovery. Addiction Services follows a traditional 12-step model, an effective, long-term approach to recovery. Treatment is holistic, integrating practices from a variety of disciplines to treat the whole person – mind, body, and spirit.

The first step in the healing process is an evaluation. A licensed addiction counselor will screen potential patients to determine appropriate program placement. Those in treatment will be assisted in developing a comprehensive treatment plan that meets their individual needs.

Due to COVID-19, Addiction Services did need to make a few changes, including the restriction of outside engagement with patients. Through the screening process, only one patient had tested positive. “We adjusted the program and followed the State Health Department’s guidelines on how to manage a positive patient,” Andersen said. “Within two weeks, we were back to normal again.”

Trinity Health Addiction Services is staffed by qualified and experienced professionals from the fields of Psychiatry, Psychology, Addiction Counseling, and Social Work. They work closely with the medical director to provide multi-disciplinary, individualized care.

Patients (who must be 18 years of age or older) may be referred for treatment by family members, employers, friends, physicians, mental health professionals, and the judicial system. Many patients also refer themselves. Trinity Health Addiction Services is located at Trinity Hospital – St. Joseph’s, 407 3rd St SE, Minot. For more information, or to self-refer, call 701-857-2480 or 1-800-862-0005.

3T Breast MRI: Trinity Health Adds Another Weapon to Detect and Fight Against Breast Cancer

Trinity Health has upgraded its breast MRI program to provide better service to our patients and community by using 3T technology. Now, with the new 3T breast MRI coil, breast cancer that is difficult to see on dense breast tissue can be much better evaluated by our radiologists.

Magnetic resonance imaging, or MRI, uses a magnet and radio waves to produce images of the breasts, to look for tumors and determine whether they’re noncancerous or cancerous, as well as to determine the size and location of a lesion. Trinity Health’s updated technology uses a 3-tesla magnetic field, tesla being a

unit of measurement that measures the strength of a magnetic field. (Trinity Health was the first hospital in the state of North Dakota to invest in a 3T MRI.)

MRI is used in addition to mammography, a screening
process used to check for
breast cancer or other
abnormalities in breast tissue. When a patient gets a mammogram, there may be a suspicious lesion that isn’t examined well enough, despite 2D or 3D mammograms and ultrasound guidance, explained Jim Coffin, RT(R), CT, ARRT, Director of Imaging Services at Trinity Health.

“Occasionally, our radiologists are not able to completely rule out a lesion on 2D or even 3D tomosynthesis mammography,” he said. “As great as 3D mammography is, there are still times when a radiologist needs better information to be confident in their diagnosis and interpretation.”

Most often, a good screening mammogram with 3D is all that is required, however, if the radiologist still has concern, they may order an ultrasound study of a suspicious looking anomaly. Again, most often that will allow the radiologist to be most confident. But for that percentage of patients that have very dense breast

tissue, the radiologist can now suggest breast MRI with 3T strength.

A breast MRI is very much like a standard MRI: a patient lies on the MRI couch and enters the gantry. In this case, the patient would be on their stomach and depending on if they are able, their arms would be over the head. The patient is positioned so the breasts are surrounded by the breast coil. The study lasts about 15 to 20 minutes, during which time contrast and non-contrast images are taken. These images allow the radiologist to search for any “architectural distortion” or a “mass.” Breast MRI is

the most sensitive way of detecting cancers in patients with very dense breast tissue; this is why Trinity Health continues to invest in newer technology.

Additionally, through the 3T technology, needle biopsies can be performed with MRI guidance, Coffin said. The biopsy material is reviewed by a pathologist, who would report the results back to the referring radiologist and ordering provider.

Technically speaking:
• Higher magnetic field strength (3T) improves quality of breast MRI imaging

• Higher resolution imaging assists in characterizing breast lesions

• Breast MRI detects small cancers earlier with greater detail

• MRI imaging provides the ability to use contrast enhancement to highlight tumor activity

• MRI allows excellent discrimination between malignant vs non-malignant masses (cancer or non-cancer)

Practically speaking:

• 3T breast imaging allows the radiologist to better examine dense breast tissue

This new 3T program was a request by Brian Johnson, DO, Trinity Health’s breast fellow trained radiologist. Dr. Johnson earned a Master of Science in Physician Assistant Studies from Philadelphia College of Osteopathic Medicine. He received his Doctor of Osteopathic Medicine from Lake Erie College of Osteopathic Medicine in Pennsylvania. Following a transitional internship at Sanford Health – University of North Dakota School of Medicine, Fargo, he completed a four-year residency in Diagnostic Radiology at Strong Memorial Hospital – University of Rochester School of Medicine, Rochester, NY. He went on to complete his breast imaging fellowship at New York University Langone Health Center in New York, NY. Dr. Johnson is a member of the Radiological Society of North America, American College of Radiology, American Roentgen Ray Society, and Society of Breast Imaging.

Personalize Your Plate

By Bailee Kolden, Student Dietitian

Every March, The Academy of Nutrition and Dietetics highlights nutrition within the country by constructing a creative theme along with tips and tricks to encourage healthy eating. This year, the academy came up with the theme “Personalize Your Plate.” Each of us has individualized bodies, tastes, and backgrounds, and “Personalize Your Plate” makes sure that our nutrition goals are also individualized. No matter where you begin your health journey, The Academy of Nutrition and Dietetics has tips to get you started or take you to the next level with your nutrition goals.

Eating Nutritious Foods
Make a small change to start and eat as many nutritious foods as possible each day! Make it a mission to include at least one food from each food group with every meal. Just a reminder that the five food groups are dairy, protein, grains, vegetables, and fruits. This is a good goal to start with when trying to make a step in the right direction with your nutrition. Hydrating healthfully is another way to up your nutrition. There may be a few unhealthful ingredients hiding in your beverages that you drink every day. Next time you grab a drink, make sure to look closely at the food label to know exactly what you are drinking. Taking the time to look at any food label can also be healthful. You may be surprised at the nutrient content – whether it’s good or bad – and you may even realize that you have never heard of some of the ingredients added to your food or beverage options. Another key reminder is to be mindful when eating. That is, avoid distractions and try to focus on what is right in front of you. Try to remember to take the time you need to fully enjoy your food.

Take the Time to Plan Ahead
Take the time out of your busy schedule to sit down and create a grocery list. Base this grocery list off some new recipes that you’ve always wanted to try. If you are feeling adventurous, try including more healthful options that you wouldn’t have included the week before. By sticking to this list, you will tend to not buy as much of the less nutritious temptations that call your name. Try to stick to healthful recipes and bring the leftovers to work or school. Just because you are away from your home doesn’t mean you have to stop being healthy. Keep it up so it becomes a routine and not a chore!
Learn the Skills to Cook Tastefully
It can be a challenge to cook tasty meals that are also nutritious. Always keep healthful ingredients on hand so you have that option. By having a stockpile of nutritious ingredients in the house, you will tend to want to use them up and find recipes to incorporate those ingredients. If you are stuck on not having good recipes to try, offer to exchange a few recipes with your friends or co-workers. Odds are you aren’t the only one looking for new recipes you and your family will enjoy!
Consult a Registered Dietitian
Dietitians cover a very wide range of topics. By meeting with one face-to-face, you can set personalized nutrition goals and receive advice to help you get on the right track. There is a wide variety of dietitians in the area so no matter what you want to accomplish, someone will be able to help you. Dietitians will assist you at getting started or continuing your journey by providing recommendations that will help you thrive through the changes being made with your nutrition and food choices.