HomeArchives August 2019

Aspire Center for Healthy Living — Community Presentation

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If you couldn’t make it to one of our Community Meetings — or you just want to watch our CEO Marty Guthmiller’s presentation again — click on PowerPoint presentation link.

Keep in mind that this PPT has been greatly edited to reduce the file for viewing here.


For a “fly-through” of the facility, click on the architect’s image below.

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Click here for (an edited) PowerPoint presentation. For the entire presentation, please attend one of our Community Meetings.
[embeddoc url=”http://kpth130275site.wpengine.com/wp-content/uploads/2019/08/Aspire-Presentation-revised-august-30-reduced-6.pptx” download=”all” viewer=”google”]

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-by Brad Zwart, DPT, Orange City Area Physical & Occupational Therapy

Stress usually has a negative meaning to it, but stress of the right dose, the right type and an appropriate response helps us grow in many ways.

S Science is clear – our bodies need a good dose of physical stress to be their healthiest. Without stress our cartilage, muscles, bones and movement system get weaker and less resilient. Some components of physical stress include frequency, duration, rest periods, and size of the load.

T Training is a system of consistently giving our bodies stress, monitoring the results, and adjusting the dose of stress accordingly. Physical and Occupational therapists have the training to help determine the right dose and type when you’re struggling to move normally due to injury or disease.

R Recreation is a great way to incorporate physical stress in settings that you enjoy like walking on a trail, being in a facility with people encouraging you, in water that’s relaxing, participating in sports where you compete with others or challenge yourself to be your best, or playing games that are fun.

E Environmental factors play a role in how our bodies tolerate and experience stress. This can include the physical environment affecting you such as the surface you sit or walk on, the temperature, and the lighting. A work environment that includes adequate activity might be enough physical stress for a health benefit. Our social environments play a major role too. Through being around encouraging people, and through developing structure, goals and accountability around what matters most to us; our dose of stress can stay in a healthy range.

S Systemic effects from physical stress are many, from improving our heart’s function, to increasing mental capacity. Physical stress through activity has the ability to start the cascade of a whole host of hormones and enzymes that help us be our healthiest so we can do the things we need and want to do.

S Side Effects are real when there’s an overdose – but also an underdose. Overdose of stress can be in the form of stress fracture, worsening stiff and sore joints while an underdose of stress can result in stress fractures and worsening stiff and sore joints; interestingly very similar side effects. An underdose of physical stress makes your physical capacity reserve less, making an overdose happen easier. If you’re struggling to find the right dose of physical stress, work with your doctor, physical therapist, occupational therapist, or personal trainer to find the right dose of physical stress. Remember, if we only do what’s easy, soon, what’s easy will become difficult.

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-by Sharon Vermeer, Dietary Manager at our Senior Care Campus

RAGBRAI ended last Saturday, July 27. If you’ve been hiding under a rock and don’t know what RAGBRAI is, it stands for Register’s Annual Great Bicycle Ride Across Iowa, a bike race organized by the Des Moines Register in 1973. In 2017 RAGBRAI XLV started in Orange City. The usual ride averages more than 67 miles a day, and can range from 35 to 85 miles a day (and you can make it longer by riding the extra loop if you’re really insane). This year they started in Council Bluffs and ended in Keokuk, dipping their bike tires in the Mississippi, as is tradition. My brother-in-law rode the race for years with his National Guard group. I have never ridden. I’m sure it is fun, but all I ever think about when bike riding is how sore my derriere is getting…so, no, I’ll take a pass. But I know there are a LOT of riders from our area, and this year a new group joined the masses. Well, kind of.

Landsmeer Ridge Retirement Community activity coordinator Christa Smith had an amazing idea: have a week-long mini- RAGBRAI at Landsmeer Ridge. She shortened the route to one lap equaling ½ mile. She provided bikes, helmets and a clipboard so they could keep track of who rode, how long, and how far. She had a map of Iowa out all week that showed where the riders were each day. She also vowed that whoever logged the most miles could dump a pail of water on her! But she was a little concerned. Would anyone ride the bikes she put out? Or were the tenants, well, over the hill? (Lots of hills on RAGBRAI…yeah…).

Smith didn’t have to worry. The tenants took to it like, uh, riding a bike. Don Schreur, Phyllis Vander Werff, Art Hielkema, and Dean Hofmeyer were particularly dedicated to it. Bikes were rode, miles were logged, and finally, on Friday afternoon, it was time for the grand finale. I made sure to show up on time so I could hear who had ridden the most miles.

A kiddie pool (complete with rubber duckies) stood in for the mighty Mississippi. Under a large tent, tenants could get floats: root beer, orange and strawberry. And at the entrance stood assorted bikes: children’s bikes, three-wheeled adult trikes, and even a 53 year old Huffy bike with a banana seat.

A staff race started the celebration: twice around the circle. Maintenance Man Tim clearly won on his banana seat bike, while poor Smith came in half a lap behind everyone else (in her defense, she was “riding” a bike that came up to her knees…). Then the announcement: the most miles were logged by Don Schreur! He had logged 209 laps, sometimes riding twice a day. Together everyone rode 388 laps. Besides the dunking, they had decided if the group rode 132 laps (equal to the second longest stretch of RAGBRAI), Smith would ride the banana seat Bicycle inside the building for a full day wherever she had to go at work. She’ll be riding that any day now…

It was time for the big dunking. Smith filled a five gallon pail from the baby pool. “Boy, Don, this is pretty heavy,” she worried. “ Do you want me to dump some water out?” Fortunately, Henry “Hank” Jonker jumped up from his chair and he and Don carried the bucket to the sidewalk to dump on Smith. Jonker lifted it half way up, and Schreur let go of the bucket . As Smith squeezed her eyes shut and got ready for the water, Hank commented “You know, Don, you really should never dump water on a woman.” “That’s ok, that was the deal!” laughed Smith. Schreur chimed in, “Yeah, I earned this! That was the deal! She’s gonna get it Hank!” So Hank lifted the bucket over Smith’s head…and dumped it over Don Schreur. Schreur stood with his eyes wide and mouth open in shock, completely drenched.

I almost fell off my chair I laughed so hard. And while we all roared with laughter, Hank just shrugged, smiled and sat back down in his chair. Smith swore to Schreur that she knew nothing about it, and he still got to dump a bucket of water on her.

Wow. Do they have that much fun at RAGBRAI? Maybe I should get padded shorts,,,and one of those new electric bikes that you don’t have to pedal much with…

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Fitness, health facility employs medical model for comprehensive wellness

Orange City Area Health System, in partnership with community agencies and organizations, launched a campaign for the creation of a new health and wellness facility to serve Northwest Iowa and the region. The proposed Aspire Center for Healthy Living – a multi-generational, multi-use 115,000-square-foot facility to be constructed on the Highway 10 corridor – will kick off its information campaign with social media and community meetings in August.

“The Aspire Center will feature many of the traditional fitness and wellness activities, but so much more,” reports Marty Guthmiller, CEO of Orange City Area Health System and chair of the planning committee for the Aspire Center. “We are excited to introduce it soon to Orange City residents – and the entire region – and expect it to be yet another reason why someone would choose to live and work and play in our community.”

The impetus for the Aspire Center for Healthy Living was information shared by the American Hospital Association regarding “Social Determinants of Health.” The AHA report determined that the majority (80 percent) of a person’s and population’s health and well-being is outside of the scope of traditional “healthcare.”

“Population health and well-being extends outside the scope of access to, and quality of, traditional healthcare,” explained Guthmiller. “Some of the other determinants of health include the walkability and livability of a community, as well as fitness, nutrition, transportation, housing, economic stability, and various social programs. The Aspire Center will be a significant step in bringing many of these elements to bear in this region.”

The Aspire Center will serve as a destination for a variety of fitness, wellness, and health services and recreational activities. In addition to an Urgent Care Clinic and Physical Therapy Center – managed and staffed by Orange City Area Health System – the facility will house a 6,000 square-foot fitness center featuring cardio, weights, and exercise spaces; nearly 50,000 square-foot indoor turf for soccer, football, and other sports; large separate court area for basketball/volleyball/pickleball; an indoor children’s “playground”; a secure “child watch” area; demonstration kitchen; massage therapy; smoothie/coffee shop; and a Sanford Profile/Perform franchise.

“Without question, this facility will complement our current provision of health care to our region,” commented Guthmiller. “Perhaps as importantly, it adds new depth and breadth to the amenities offered in our community, providing economic stability to our region, supporting community growth and vitality, and increasing all of our focus on well-being.”

A Facebook page serves as the source for updates on this project, and a series of community meetings will be taking place prior to the G.O. Bond vote in September.

Polls open at 7:00am on September 10 for registered Orange City voters.

“We humbly ask for the community’s support of this bond issue,” stated Guthmiller on behalf of the planning committee and associated project partnerships, “and ask that people from the area take advantage of our informational sessions coming soon to learn more.”

Watch for details via media and social media.

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3D Mammography: what’s all the hype?

-by Jameson Guthmiller, MD, Radiologist at Orange City Area Health System

In February 2018 we deployed our 3D mammography system. So what exactly is it? In short, it’s an FDA approved advanced technology that takes 3-dimensional images of the breast, instead of a single photograph.

The best way I’ve heard it explained is to imagine you have a loaf of cinnamon-raisin bread. When you do the 2-dimensional mammogram, you’re probably going to see a bunch of raisins and stripes of cinnamon, but the raisins can be overlapping and hide something underneath.

However, when you do the 3D mammogram, you are analyzing the loaf of bread “slice by slice”. And maybe that time, you find a stray walnut. Finding that walnut is like finding a breast cancer.

3D mammography is quickly becoming the standard of care in breast cancer screening. It’s been shown to find more breast cancers then conventional 2D mammography, and has also been shown to find earlier cancers. The benefits are particularly noticeable in women with dense breasts.

From a patient perspective, women notice very little difference during the exam. The 3D mammogram takes a few more seconds to acquire the image, but is otherwise the same, with “top” and “side” views of each breast.

So when should you get your mammogram? Unfortunately, there’s been a lot of conflicting reports in the news lately, which can make it confusing for patients.

In a typical patient, we still recommend beginning screening at age 40, and continuing annually thereafter. This has been shown to have the greatest mortality reduction, the most lives saved, and the most life-years-gained. In fact, 1 in 6 breast cancers occurs in patients in their 40s.

The bottom line is to have the discussion with your primary care provider, and determine what’s right for you.

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One out of every 10 women is called back after a screening mammogram. Why?

  • Dense breast tissue. Difficult to see due to multiple densities. Clarification with specialized views are needed. 
  • There is a breast cyst or calcification. These are often benign but need to be clarified with ultrasound and/or specialized mammogram views.
  • The images are not clear and the radiologist has requested a different angle or view.
  • There is no previous mammogram to compare to. With no way of knowing what is new and what is not, extra caution is exercised.
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The diagnostic mammmogram:

  • Can include a mammogram, an ultrasound, or both
  • Results are given immediately by the radiologist
  • Plan on a 90-minute visit

Results of the diagnostic mammogram:

  • It is “nothing” – come back for a screening in one year
  • It is “probably nothing” – come back for follow-up images in six months
  • It is suspicious – referred to a surgeon for a biopsy to test a sample of tissue and determine the make-up of the area of concern
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“I had always made a point to get a yearly mammo done, and had heard great things about 3D mammography. I was excited to try the latest technology. I showed up and was brought to the Women’s Imaging Center waiting room, which I appreciated. The tech was very welcoming and professional when I came for my appointment. After the radiologist read my screening exam, I was called back for additional images for a specific area of concern. I was able to return within a couple of days for my follow-up. I appreciated that when I was finished, Dr. Guthmiller came in to talk with me about the results. He suggested a biopsy, and I was able to get it done the same day! I couldn’t have been happier with the patient care I received at Orange City Area Health System, and how they made me feel comfortable and at ease throughout the whole process.” – Jackie W.

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-by Dr. DeeJay Donlin, PhD, LP
Orange City Area Health System Behavioral Health Clinic

A mental health awareness month has been around since 1949. Each year, all kinds of statistics are provided regarding the prevalence and consequences of behavioral health difficulties.

For example, current information from the National Institute of Mental Health estimates that 1 in 5 adults will experience a mental health difficulty at some point during their life. 70% of youth in juvenile justice systems had at least one mental health condition and at least 20% live with a serious mental illness.

Only 41% of adults and just over half of children aged 8–15 in the US with a mental health condition received mental health services in the previous year.

Untreated behavioral health issues are reported to cost over $190 billion annually (from National Alliance on Mental Illness) because of lost wages. Despite obvious concerns and consequences, we continue to struggle with adequate recognition, acceptance and treatment of behavioral health issues.

Survey data published in 2018 suggested that the strongest barriers for people seeking behavioral health treatment continued to be cost and stigma. In 2008, the Mental Health Parity and Addiction Act (MHPAEA) was passed, which was designed to require group health plans and health insurance issuers to provide mental health coverage that not be more restrictive or expensive than medical–surgical coverage (with some exceptions).

Although the law was very helpful, the fear remains that seeking treatment (medication and/or other therapies) will be prohibitively expensive. Interestingly, the concern for cost of care for medical treatment is a similar barrier and we continue to struggle how to adequately address this concern ethically, socially and politically. Although the short-term costs seem inordinately expensive, we sometimes lack the foresight regarding the long term costs of neglected medical/mental health care.

Perhaps a more daunting barrier is the concern regarding stigma.

In some metropolitan areas, the acknowledgment of taking psychotropic medication or going to therapy may be acceptable and even somewhat of a status symbol. However, in most parts of our country, the acknowledgment of behavioral health issues and the seeking of treatment often results in fear of being labeled/blamed/judged, experiencing social or economic discrimination or a sense of being weak or inadequate.

Although lifestyle choices can sometimes impact both medical and behavioral health issues, the increasing awareness of bio–genetic causes of illness has had a limited impact on public perception. If there were simple or quick solutions to this issue, they would have been implemented years ago.

Nonetheless, we could do a few things today to reduce stigma. One area is education.

Informing ourselves that experiencing a mental health issue does not mean someone is labeled as “schizophrenic” or “depressed” but rather is experiencing symptoms of schizophrenia or depression. Tom is still Tom, but he has certain symptoms.

It also means being aware that someone with behavioral health issues is no more likely to be violent than anyone else. In fact, people struggling with mental health issues are more likely to be victims of violent behavior by others.

Another area is communication.

Being transparent ourselves, as well as being willing to reach out to others about issues, reduces the tendency toward secrecy. Celebrities and athletes who have acknowledged behavioral health issues have been credited with opening the door for others to seek treatment.

A third area to mention is “action.”

We all have a tendency to hear something or read something and say “that’s a good idea” and then go back to our routines of daily living.

Starting today, consider challenging labels, acknowledging the normalcy of a behavioral health disease and reaching out and encouraging treatment to those who are experiencing issues.

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For appointments in our Behavioral Health Clinic, call 712-737-2000.

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