BACK ON HIS FEETKnee replacements help Bismarck man live with

no limitations Page 6

SHM A G A Z I N EWinter 2014

M A G A Z I N E

SANFORD IMAGENETICS

Your comments,concerns and questionsare always welcome.

P L E A S E C O N T A C TTim Flagstad, editorSanford HealthPO Box 5525Bismarck, ND 58506-5525tim.flagstad@sanfordhealth.org(701) 323-6512

SH Magazine is published as a community service of Sanford Health.

P H O T O G R A P H YThe Creative Treatmentd’Joyce Image International

C O V E R P H O T OBefore two knee replacements at Sanford Medical Center, Dean Eichele had trouble walking up and down the stairs into his home.

SANFORDspotlight

Because of one man’s continued generosity, Sanford Health is launching a revolutionary program to improve health and prevent some diseases with personalized plans of care. Denny Sanford is the preeminent health care philanthropist in the United States (see more on Page 8) and is helping change the face of medicine. Sanford Imagenetics will be the first program in the nation to embed the latest in genomic medicine with primary care for adults. Genetic counselors and medical geneticists will evaluate a patient’s family history and, when applicable, recommend advanced genetic analysis. This program will provide Sanford’s expert internal medicine physicians with unprecedented patient-specific information, so they can design treatments and preventive care based on patients’ specific needs. Beginning later this year, Sanford will be able to translate patients’ genetic makeup to customize prescriptions and other treatments for adult patients. This will allow our internists to individualize care for their patients with cancer, diabetes, hypertension, coronary artery disease and other conditions. Sanford Internal Medicine practice will become the “hub” for genetics at Sanford, though will not be the only area to apply genetics in patient care. Existing patients will benefit from Sanford Imagenetics without having to change physicians. For more information, visit www.sanfordhealth.org/imagenetics.

Winter 2014

FACTS BEHIND ANTIBIOTICSAntibiotics must be used wisely to prevent the growth and spread of resistant bacteria. Repeated and improper use of antibiotics is the primary cause for drug-resistant bacteria, a health care issue that has become a global health concern. Most illnesses, such as the common cold, are usually viral and will get better on their own.

Methicillin-resistant Staphylococcus aureus (MRSA) is a good example of a drug-resistant illness. At one time, MRSA infections were primarily found only in people who were hospitalized. A newer form of MRSA causes infections in healthy people. Antibiotic-resistant infections such as MRSA are difficult to treat and can contribute to longer lasting illnesses, more doctor visits, extended hospital stays, the need for more expensive and toxic medications and can even cause death.

Appropriate antibiotic useBacterial infections, some fungal infections and kinds of parasites are effectively treated with antibiotics. Bladder infections, severe ear and sinus infections, strep throat and skin infections are examples of health issues effectively treated with antibiotics. Antibiotics are not effective for viral infections, such as colds, flu and bronchitis.

Not taking antibiotics exactly as prescribed can lead to problems, and it is important to take the full course of antibiotics. If you take a portion of the recommended prescription, the antibiotic may wipe out some bacteria, resulting in your feeling better, but remaining bacteria become more resistant. When you need an antibiotic again, your doctor has to resort to more costly, stronger prescription drugs that can also be accompanied by more serious side effects.

Avoid taking antibiotics whenever possible. If you take antibiotics too often for things they don’t effectively treat, they become less effective in battling the bacteria in your body. If antibiotics are prescribed, take them according to your doctor’s instructions. Get recommended vaccinations, which prevent illnesses. Wash hands frequently with soap and water, especially after using the bathroom or during food preparation.

Sara Reinke, MD, is a pediatrician at Sanford Children’s North Clinic in Bismarck. A graduate of the University of North Dakota School of Medicine and Health Sciences at Grand Forks, she completed a residency in pediatrics at the University of Nebraska Medical Center, Creighton University Medical Center, and Children’s Hospital and Medical Center in Omaha.

Sara Reinke, MDPediatricianSanford Children’s North ClinicBismarck

HEALTH IN FOCUS

SANFORD HEALTH MAGAZINE 3

Maureen Randles has an interesting job for a 52-year-old woman. She is part of an environmental hazard clean-up crew in the oil fields of North Dakota. She spends her days climbing and cleaning gas plant compressors. It is a physically demanding job, and Randles loves it.

“I really enjoy my work,” said Randles, who lives in Watford City, N.D. “I get to do something where I am active and kept busy. I climb up on those machines, and I can pretty much do anything.”

But she didn’t always have such an adventurous lifestyle. After she had her first child, Randles had trouble losing the baby weight. As the years went on, her weight increased, and she continued to feel not quite right.

“I just felt off-balance,” Randles said. “It was like I was too tall or too big for my body.”

The added weight not only affected Randles’ balance, but her health suffered drastically.

“I had diabetes and was on insulin,” she said. “I had a lot of problems and never felt good.”

After having weight-loss surgery in Washington, Maureen Randles moved to North Dakota where her weight-loss surgeon also happened to move.

4 bismarck.sanfordhealth.org

A CHANCE REUNION

Patient, surgeon reconnect 1,100 miles from where they first formed bond

Decision timeAfter trying several different ways to drop the weight, Randles made the choice to pursue weight-loss surgery. Living in Washington State at the time, she made an appointment with one of the top bariatric surgeons in the country, Steven Bock, MD, now a surgeon at Sanford Health in Bismarck.

“I just wanted to feel better,” Randles said. “I wanted to be able to play with my grandkids and not huff and puff.”

The process to have the surgery was a long one for Randles. Between meeting insurance requirements, the need for additional testing to evaluate her overall health and improving the control of her obesity-related diabetes, it took nearly three years before she was able to meet the requirements for gastric bypass surgery.

“I almost thought I would give up,” she said.

After the first meeting with Dr. Bock, her surgery was delayed for a short time to improve diabetes control, but, at her next check-up, Randles was cleared for surgery.

“There is a certain degree of patient responsibility when it comes to surgery, and she did what she needed to do,” Dr. Bock said. “I helped Maureen get her diabetes under control, and, by doing so, the risks of surgery were decreased.”

After a problem-free surgery, Randles’ life started to change in a big way.

1,100 miles and a crazy coincidence“They tell you not to make any big life choices right after surgery,” Randles said with a laugh.

“But I didn’t listen.”

She packed her bags and moved the 1,100 miles to Watford City to join her husband and son who had already moved to work in the oil fields. In a new city and state and only a year out of surgery, Randles knew she needed to find a physician to help her post-surgery.

“It is so essential to have both short- and long-term follow-up,” Dr. Bock said. “Patients need to get that support during the initial weight-loss period and also when they are most at risk for weight gain.”

“I knew I needed to make an appointment for a check-up,” Randles said. “I was flipping through the paper, and there was an ad for Dr. Bock! I just couldn’t believe it.”

Unbeknownst to Randles, Dr. Bock had also left the Pacific Northwest for the Midwest to take a position at Sanford Health in Bismarck.

“I had probably been there less than a month,” Dr. Bock said. “And I saw her name on my clinic schedule. It was very nice to see her again.”

Continued on Page 10

“I still saw myself as a fat girl, and I was always on guard for people to look at me differently. But not once did I ever experience that at Sanford. The whole crew was absolutely wonderful.” – Maureen Randles

When grocery shopping with his wife, Maureen, Dean Eichele used to stay in the pickup if he knew it would be a lengthy excursion.

Knee troubles made the pain nearly unbearable for the 60-year-old Bismarck man if he remained standing for too long, and, after a prolonged trip inside, his knees would stiffen up, making it hard to get back into the pickup.

Those troubles have since passed after Eichele had total knee replacement surgery in both knees at Sanford Health in Bismarck. He also was one of the first patients to benefit from the Sanford Joint Replacement Center, an evidence-based, best-practice program focused on patients and their families.

Matthew Carpenter, MD, orthopedic surgeon, replaced Eichele’s left knee June 24 and followed up by doing the same to his right knee Aug. 26.

NEW KNEES,NEWLIFE

6 bismarck.sanfordhealth.org

“The left knee felt so much better I knew if the other one felt half that good, I’d be thrilled,” Eichele said of his decision to have both procedures only two months apart.

For the second operation, Eichele participated in the Joint Replacement Center program, which opened Aug. 26 at Sanford in Bismarck, making it the first of its kind in the region.

The Joint Replacement Center provides care for patients who have hip or knee replacements, with the goal of having quicker recovery and decreased length of stay for the patients. While staying at the Joint Replacement Center, patients have private rooms tailored to meet the needs of joint replacement patients, and the center follows a wellness model, meaning the patients wear normal clothes instead of hospital gowns and are as active as possible during their stay. As part of that, the floor features a dedicated area for group therapy. Patients also receive a daily newsletter and goal sheets that help guide them through each step of recovery. All of the nursing staff on the floor have specialized training in total hip and knee replacements. As part of the program, patients designate a coach, who attends therapy sessions and ensures the patients have the help they need once they go home.

“As a surgeon, my goal is to have my patients get back to their normal routine as quickly as possible, while also making a complete recovery with no complications,” Dr. Carpenter said. “The Joint Replacement Center helps us achieve these goals, and it’s a great addition for our patients.”

Before opening the Joint Replacement Center, Sanford Medical Center already was a Blue Distinction Center for knee and hip replacements with quality and value designations. The Joint Replacement Center further helps

Innovative Joint Replacement Center helps man return to what he loves

the medical center serve its patients and help them in their recovery. Before opening the center, patients who had knee replacements stayed in the hospital an average of 3.48 days before returning home. Now, that number has been reduced to 2.2 days.

For Eichele, participating in therapy with a group of patients who just had similar procedures pushed him along in his recovery.

“The group therapy was really nice,” he said. “It’s neat when you do it together and see everyone else. You see everyone else do it, and you want to do a little better – put every effort into doing well more than when you do it alone.”

As part of the program, a registered nurse serves as a dedicated orthopedic nurse navigator. The nurse navigator provides preoperative education for patients and their coaches, guides patients through their joint replacement journeys and follows up with patients after discharge to make sure they are on their road to recovery.

“Our goal is to have patients spend a few days with us, so they can spend the rest of their lives doing what they love,” said Debbie Bachmeier, registered nurse

and the program’s orthopedic nurse navigator.

That was exactly the experience Eichele had. For his first procedure – before the Joint Replacement Center – he spent four days in the hospital. For the second, that stay was cut down to two.

Now, Eichele walks around with no limitations, and he rides a recumbent bicycle for 20 to 30 minutes a day.

“It was nice not having a gown on all the time,” he said of the Joint Replacement Center. “It seemed like it sped things up a little bit. You do feel like you’re more at home. I enjoyed it.”

For more on the Sanford Joint Replacement Center, visit bismarck.sanfordhealth.org/orthopedics/jointreplacement.asp.

Dean Eichele, left, can move around easier and without pain following two knee replacements.

Debbie Bachmeier, right, orthopedic nurse navigator, assists Charlie Ledger, a patient at Sanford Medical Center’s innovative new Joint Replacement Center in Bismarck.

Matthew Carpenter, MDOrthopedic SurgeonSanford Orthopedics & Sports Medicine

Bismarck

On Feb. 3, 2007, Denny Sanford changed the health care landscape in the Dakotas and around the world. On that day, he made a $400 million gift to Sioux Valley Hospitals & Health System in Sioux Falls, S.D., to create the Sanford Initiatives, enhance research and development and improve the lives of children. The donation remains the largest single gift ever made to a U.S. health care organization. The transformational nature of the gift was so great that the health system asked to use his name as a way of honoring his gift and legacy. With additional gifts to Sanford Children’s Hospital, Sanford School of Medicine, the fit Program, Edith Sanford Breast Cancer and, most recently, a gift of $125 million to launch Sanford Imagenetics, Mr. Sanford has entrusted Sanford Health with nearly $1 billion to achieve the organization’s vision of improving

the human condition through exceptional care, delivery and innovation. “I am very honored to have Sanford Health as a vehicle I can depend on to achieve significant advances in health care services and medical research that improve lives and the lives of descendants for generations to come,” Mr. Sanford said on the day the health system announced his initial gift. “I can think of no better investment than to financially empower those who have ably demonstrated their ability to set high goals and achieve them.” Mr. Sanford takes no part in the day-to-day operations of Sanford Health, doesn’t sit on any of the health system’s boards and receives no financial gain from the health system. The gift from 2007 established four distinct focus areas called the Sanford Initiatives. These unique and defining elements help Sanford Health build a world-class reputation and strategic partnerships to fulfill its commitment to health and healing.

PHILANTHROPIST’S GIFTS TRANSFORM HEALTH CARE

8 bismarck.sanfordhealth.org

They include:

1. Commitment to children and families: to provide necessary permanent health services for children and young families in areas of need around

the world.

2. Commitment to cure type 1 diabetes: to identify and resolve one of the most pressing health issues of our day, through the Sanford Project, which is dedicated to finding a cure for type 1 diabetes in Mr. Sanford’s lifetime.

3. Commitment to research: to allow significant

growth in all areas of Sanford Research, make significant commitments toward unique initiatives in health research and create the Sanford Children’s Health Research Center.

4. Commitment to innovation: to implement a new approach to health care campus and facility design supporting the activities of the system. To ensure patients have access to world-class care, Sanford Health continues to design some of the most innovative facilities found across the globe. Some of these include the Sanford Heart Hospital in Sioux Falls, Sanford Medical Center in Aberdeen, Sanford Children’s Hospital, the future new medical campus in Fargo and The Sanford Sports Complex.

“Mr. Sanford’s generosity to this organization is humbling,” said Kelby Krabbenhoft, president and CEO of Sanford Health while announcing Sanford Imagenetics in January. “It’s an incredible honor as well as a tremendous responsibility.”

Denny Sanford, left, at podium, the namesake of Sanford Health, launched Edith Sanford Breast Cancer in 2011 with a $100 million gift in honor of his mother, who died of breast cancer when he was 4. Kelby Krabbenhoft, president/CEO of Sanford Health, looks on at the announcement.

TIMELINE OF GIVINGSince 2004, Denny Sanford has donated nearly $1 billion to Sanford Health. Here are some highlights:

2004: $16 million to help build Sanford Children’s Hospital – a Castle of Care in Sioux Falls, S.D.

2005: $20 million to University of South Dakota School of Medicine via Sanford Health

2007: $400 million transformational gift resulting in the health system asking to use Mr. Sanford’s name

2007: $20 million to establish Sanford Children’s Health Research Center/Burnham Institute for Medical Research

2011: $35 million to develop Sanford fit, an initiative through which Sanford Health is actively promoting healthy lifestyles in homes, schools, daycares and clinical settings

2011: $100 million toward Edith Sanford Breast Cancer, which is pursuing cutting-edge translational genomic research to identify specific treatments that will work best for each person, prevent the disease on an individual basis and, ultimately, eradicate breast cancer

2014: $125 million for Sanford Imagenetics (see Sanford Spotlight on Page 2 for more information)

The strange coincidence allowed Randles to continue her weight-loss journey with the doctor who helped her start it.

“I just can’t say enough good things about Dr. Bock,” she said. “You aren’t just another patient to him; you’re a person.”

The team of nurses and support staff at Sanford Health also contributed to Randles’comfort level.

“I still saw myself as a fat girl, and I was always on guard for people to look at me differently,” Randles said. “But not once did I ever experience

that at Sanford. The whole crew was absolutely wonderful.”

Going from 368 at her heaviest down to just over 200 pounds, Randles is a new woman living a life she couldn’t have imagined before surgery.

“I have so much energy!” she said. “I feel like this is a whole new world for me.”

To learn more about weight-loss surgery at Sanford, call (701) 323-5300 or visit bismarck.sanfordhealth.org/weightlosssurgery. Potential patients can also attend a monthly weight-loss surgery information session. Visit the above website for more dates, locations and additional details.

A CHANCE REUNION continued from Page 4

10 bismarck.sanfordhealth.org

At her heaviest before weight-loss surgery, Maureen Randles weighed as much as 368 pounds.

Steven Bock, MDWeight-loss surgeon

Bree Dewing, MDWeight-loss surgeon

Sanford Weight-Loss Surgery

Type 2 diabetes, high blood pressure, high cholesterol, sleep apnea. These and other dangerous health conditions often go hand-in-hand with being overweight or obese.

At Sanford Health, our experienced weight-loss surgery team not only helps you lose weight, but also provides the personalized care and support you deserve to keep the weight off for life.

If you find it’s time to start over, we’ll help you begin living a healthier, better life today.

Call (701) 323-5300 to learn more.

Call today. Be seen today.

Call your local clinic or (855) SAME-DAY for a same-day appointment in any of these four areas:

FAMILY MEDICINE • PEDIATRICS • OB/GYN • INTERNAL MEDICINE

Non-Profit OrganizationU.S. Postage

P A I DPermit No. 187Bismarck, ND

ADDRESS LABEL GOES HERE

BIS-0734 2/14

Sanford300 N. Seventh St.Bismarck, ND 58501

Expert walk-in care for sprains, strains and breaks.

Sanford Orthopedic Fast Track (701) 323-3785