Injured at Work? Door County Medical Center Can Help

Injuries on the JobThe Worker’s Compensation Act provides for payment of medical expenses and compensation for lost wages resulting from work-related injuries or disabilities.

As a provider of medical services in Door County, Door County Medical Center (DCMC) has a critical role within the worker’s compensation system. We act as the primary connection with the injured worker and we coordinate between insurers and the Worker’s Compensation Division.

The partnership between Door County Medical Center and Prevea Health experts makes it possible to have access to the same level of care that is available in any larger market including, but not limited to, diagnostics like x-rays, MRIs, CT scans, therapy and more.

Getting Back to Work, Safely

The best outcome for the employee – and the employer – is to minimize the amount of work missed and get employees back to their job. Door County Medical Center in partnership with Prevea Health, makes it a priority to get you back to work, safely and efficiently.

The role of the Prevea WorkMed Occupational Health team is to best understand the nature of the injuries, the nature of the work, the effect of the environment, and how your work affects you as you recover.

Select a Doctor of Your Choice

Caring Elderly ConceptAccording to the State of Wisconsin Department of Workforce Development, “When a worker reports an injury, the employer shall offer the worker the right to select a doctor of the worker’s choice for treatment.”

This means that the employee may select any provider, including nurse practitioner, physician, psychologist, chiropractor, podiatrist, etc., licensed to practice in Wisconsin. If the injury creates an emergency situation, the employer may make whatever arrangements are necessary for immediate treatment.

Additionally, if the employee is not satisfied with the first doctor s/he chooses, a second choice is allowed.

I’ve Been Injured at Work. Now What?

  1. Obtain any necessary medical attention immediately. This may include first aid, seeing a provider or going to the emergency room.
  2. Notify your employer without delay even if you think your injury is minor and will heal without medical attention. A delay may negatively affect your health and may even jeopardize your potential workers compensation benefits.
  3. Maintain all relevant medical and payment records for possible future use.

An employee who is injured at work or suffers from an occupational disease, is entitled to payment of all reasonable and necessary medical, surgical and hospital treatment relating to the injury including: doctor bills, hospital bills, medicines, medical and surgical supplies, crutches and artificial limbs. In addition, an injured employee is entitled to compensation for lost time and traveling expenses incurred for treatment or examination. Of course, all claims are subject to evaluation.

For more information on Worker’s Compensation guidelines in the state of Wisconsin, visit State of Wisconsin Department of Workforce Development online at dwd.wisconsin.gov.

To schedule an appointment regarding a Worker’s Compensation case, please make an appointment with your primary care physician at Door County Medical Center, or with Prevea WorkMed Occupational Health directly. Start by calling (920) 746-0726.

More than the Winter Blues

The idea that one’s mental health could be tied to the seasons and to sunlight is actually quite old. Written around 300 B.C.E., one of the most important classics of Taoism, the Neijing Suwen (also referred to as The Yellow Emperor’s Classic of Medicine), describes the affects of the seasons on all living things and recommends that during the winter, “desires and mental activity should be kept quiet and subdued.” In 1806, the French physician Philippe Pinel, in his Treatise on Insanity, remarked upon the noticeable decline in the mental health of some of his patients “when the cold weather of December and January set in.” And in 1984, the South African psychiatrist Nicholas Rosenthal, who, after moving to New York, observed a pattern of depression that occurred during the winter months, coined the term Seasonal Affective Disorder.

What is Seasonal Affective Disorder?

SAD Depression DisorderSeasonal Affective Disorder, appropriately referred to as SAD, is a type of major depressive disorder that is cyclic—that is, the primary characteristic of this disorder is that the onset and remission occur at specific times of the year. There are two types of the disorder: Spring-onset SAD and Fall-onset SAD. The less common Spring-onset SAD begins in the spring and lasts through the summer and goes away during the fall and winter. Fall-onset SAD usually begins in September and lasts through April, peaking in months of December, January and February. Fall-onset SAD is by far the most common form of the disorder and is estimated to affect around 500,000 people in the United States each winter.

What causes SAD?

While the reasons for the development of Fall-onset SAD in some individuals still remains unclear, research has led to a number of theories with regard to an underlying cause, as well as to why certain populations are more vulnerable to the disorder than others.

  • Low light during the winter months. “One of the primary theories as to what causes Fall-onset SAD is that it is related to a drop in the amount of sunlight that people get during the winter months,” says Barb Johnson-Giese, Behavioral Health Coordinator at Door County Medical Center. According to Johnson-Giese, when light hits the retina (the back of the eye), messages are passed to the part of the brain that controls sleep, appetite, sex drive, temperature, mood and activity. If a person is not exposed to enough sunlight during the day, these functions are likely to slow down.
  • Low serotonin and high melatonin. There are several brain chemicals involved in SAD, but the two primary culprits are thought to be serotonin and melatonin. Serotonin is a neurotransmitter—a chemical that transmits signals from one nerve cell to another. People with depression generally have lower levels of serotonin, and particularly during the winter months. Melatonin is the hormone that makes us sleep. People with SAD tend to have higher than normal levels of melatonin in the winter. Moreover, when exposed to bright light, high melatonin levels tend to drop to normal.
  • Disrupted body clock. Your body clock, also known as your circadian rhythm, is set by your brain according to when the sun rises and sets. One hypothesis is that if you’re prone to SAD, the part of the brain that regulates circadian rhythms doesn’t work correctly. When daylight decreases with the winter months, your body clock slows down as well, leading to fatigue and depression.

Who is affected?

SAD primarily affects people in the higher latitudes—or rather, it affects those living in the northernmost and southernmost reaches of the globe—where daylight hours become, during the winter months, the minority. In fact, SAD is rarely reported in areas of the world near the equator.  The onset age for SAD is usually between the ages of 18 and 30, and three out of four people who suffer from SAD are women.

How do I know if I have SAD?

The symptoms of SAD are also the symptoms of major depression. The most commonly reported SAD symptoms include:

  • Fatigue
  • Persistently sad mood
  • Loss of interest in activities
  • Sleeping more than usual
  • Craving and eating more starches and sweets
  • Gaining at least 5 percent of body weight
  • Difficulty concentrating

A diagnosis of SAD can be made if the symptoms recur for three consecutive winters and are followed by a complete remission of symptoms in the spring and summer months.

How do I treat SAD?

The most common medical treatments for SAD include:

  • Antidepressant medications, which can increase the amount of serotonin in the brain.
  • Cognitive behavioral therapy provides the psychological tools that are needed to appropriately cope with the symptoms of SAD. Additionally, cognitive behavioral therapy has been shown to “achieve better long-term outcomes by preventing recurrences in subsequent winters.”
  • Phototherapy: Also known as bright light therapy, involves sitting in front of special lamps that provide, like the sun, a full spectrum of light. According to Ms. Johnson-Giese, “Bright light therapy, has been found to be effective in up to 85% of Seasonal Affective Disorder cases.”
  • Vitamin D: Vitamin D is produced when your skin comes in contact with sunlight, and a vitamin D deficiency has long been associated with low light conditions that accompany SAD. To combat this deficiency, take 4,000 units of vitamin D3 per day.

Additional treatments for SAD

  • Get outside: Johnson-Giese suggests getting fresh air during the day. “Increased exposure to sunlight and fresh air—even if it’s cloudy out—is really important. It really helps to get outside. So, don’t isolate in your house thinking ‘There’s no sun out, and it’s too cold, so it’s not going to be helpful to go outside.’”
  • Diabetes Prevention Program ExerciseExercise: Exercise is always an important when trying to combat any type of depressive disorder, and SAD is no different. High-intensity aerobic exercise, like running or biking, releases endorphins—the brain’s “feel-good chemicals.” Additionally, continual low-intensity exercise “spurs the release of proteins called neurotrophic or growth factors, which cause nerves to grow and make new connections,” and improved brain function corresponds to improved overall mood.
  • Yoga and Active Meditation “Active meditation is really useful, especially for individuals that have difficulty being still” says Ms. Johnson-Giese. “Active meditation is meditation that occurs while you do something rhythmic like: walking, dancing or coloring in a coloring book—coloring books for adults have become more popular and are effective.”
  • Eating a balanced diet: Your brain needs a constant supply of fuel to keep working, and the quality of that fuel can affect how well it functions. Avoid processed foods, and instead load up on fruits, veggies and whole grains. For increased Omega-3 fatty acids and vitamin B12, which are both good for brain function, eat more fish—especially salmon, tuna and mackerel. Avoid caffeine and alcohol.
  • Practice good sleep hygiene: “Good sleep hygiene is important,” says Ms. Johnson-Giese, “People need to make sure that their bedroom is only used for sleep and sex. If they don’t go to bed at a regular time and get up at a regular time, or watch TV in bed, the bedroom can become associated with being awake.”

During the winter months, people who suffer from Seasonal Affective Disorder “tend to isolate,” remarks Ms. Johnson-Giese,  “and the more they isolate, the more they get caught up in their own negative thinking— a symptom of depression that self reinforces and becomes a feedback loop that continues to become more negative.” She adds that “behavioral activation, which is having people push themselves—that is, having people fight the desire to stay inside and not do anything, becomes very important. The more that you do, the less depressed you start to feel. And it just positively builds.”

A number of options exist if you or a loved one feels as though they are suffering from Seasonal Affective Disorder or depression. To schedule an appointment with Door County Medical Center’s Behavioral Health department please call (920) 746-0510. Additional sources of information include your own Employee Assistance Program, accessed through your employer, or the Community Resources tab on the Door County Library website.  If there is a mental health emergency, Ms. Johnson-Giese suggests calling the Suicide/Mental Health Crisis Line at 920-746-2588, texting “HOPELINE” to 741741, which connects you to trained crisis counselors, calling 9-1-1, or going directly to the hospital emergency room.

Local executive earns top healthcare management credential

Jodi Hibbard, MS, BSN, RN, FACHE recently became a Fellow of the American College of Healthcare Executives (ACHE), the nation’s leading professional society for healthcare leaders.

“Achieving FACHE certification has always been a personal goal since finding my passion for leadership in healthcare. It demonstrates my dedication to the field and is truly a very proud achievement,” says Hibbard, Director of Clinic Operations at Door County Medical Center (DCMC), Sturgeon Bay, WI.

Fellow status represents achievement of the highest standard of professional development. In fact, only 9,100 healthcare executives hold this distinction. “Jodi is an outstanding leader, and this achievement is a great capstone to all of her hard work and accomplishments,” according to James Heise, MD, DCMC Chief Medical Director.

To obtain Fellow status, candidates must fulfill multiple requirements, including passing a comprehensive examination, meeting academic and experiential criteria, earning continuing education credits and demonstrating professional/community involvement.

“The healthcare management field plays a vital role in providing high-quality care to the people in our communities, which makes having a standard of excellence promoted by a professional organization critically important,” says Deborah J. Bowen, FACHE, CAE, president and chief executive officer of ACHE. “By becoming an ACHE Fellow and earning the distinction of board certification from ACHE, healthcare leaders demonstrate a commitment to excellence in serving their patients and the community.”

“Jodi’s leadership here at Door County Medical Center has brought our organization to another level over the past seven years,” says Gregory S. Holub, FACHE, DCMC Vice President of Clinic Operations.

Fellows are also committed to ongoing professional development and undergo recertification every three years and signifies board certification in healthcare management.

For more information regarding the FACHE credential, please contact the ACHE Division of Member Services at (312) 424-9400, by emailing contact@ache.org, or visit ache.org/FACHE.

About the American College of Healthcare Executives

The American College of Healthcare Executives is an international professional society of more than 40,000 healthcare executives who lead hospitals, healthcare systems and other healthcare organizations. ACHE offers its prestigious FACHE® credential, signifying board certification in healthcare management. ACHE’s established network of more than 78 chapters provides access to networking, education and career development at the local level. In addition, ACHE is known for its magazine, Healthcare Executive, and its career development and public policy programs. Through such efforts, ACHE works toward its goal of being the premier professional society for healthcare executives dedicated to improving healthcare delivery. The Foundation of the American College of Healthcare Executives was established to further advance healthcare management excellence through education and research. The Foundation of ACHE is known for its educational programs—including the annual Congress on Healthcare Leadership, which draws more than 4,000 participants—and groundbreaking research. Its publishing division, Health Administration Press, is one of the largest publishers of books and journals on health services management including textbooks for college and university courses.

Staying Healthy Through the Holidays

Turkey, gravy and stuffing! Ham, cranberry sauce and mashed potatoes! Gingerbread cookies, apple pie and ice cream! These are just some of the dishes that we look forward to enjoying with family and friends during the holidays. We reconnect with friends over drinks and relive memories of holidays past with family over meals. In many ways, the holiday feast provides friends and families with a place to come together, it helps us maintain close relationships…and it can also help us add on the pounds.

Holiday Cheer that Keeps on Growing

According to studies by the New England Journal of Medicine, while many believe that they gain up to five pounds during the holiday season, on average most people only gain a single pound. This may seem like great news, “just a pound!” you may say, “bring on Grandma’s stuffing!” But those same studies show that once the holidays are over, you are unlikely to shed that pound, and over the years those pounds add up. The typical adult gains one to two pounds per year, which means that your typical middle-age waistline can be, in large part, attributed to overeating at the holidays. Additionally, if you are already overweight, you are likely to gain even more weight during that same period—up to five pounds.

Nicole Welter, APNP

Nicole Welter, APNP

“I think people go to festivities, parties, family gatherings and they indulge way too much at one sitting. And that results in a lot of added calories.” Says Nicole Welter, APNP at Door County Medical Center’s Southern Door Clinic. “To put it in perspective,” she adds, “if you gain five pounds over the holidays, that comes to roughly 40,000 calories that you end up having to burn by working out over time. That type of weight gain can be problematic when you look at the big picture.”

In order to maintain a healthy waistline throughout the holiday season, Ms. Welter suggests the following tips:

  • Watch portion size. An easy way to fill up your plate sans calories is to load up on veggies! This means the majority of the items on your plate should be things like green beans, carrots, or salad—at least double the meat portion. Meat portions should be no larger than the palm of your hand.
  • Maximize your workout. If you have a spare 30 minutes, make it worthwhile by amping up your workout with an interval-training app. Also, keep your gym bag with you so it’s easier to burn calories on the go.
  • Try not to “over-do-it” on cocktails. Cocktails contain a lot of sugar, in both the alcohol and the mixer, and sugar means unnecessary and empty calories. Replace sugary drink mixers with soda water. Be sure to drink plenty of water, I recommend half of your body weight in ounces per day. Water fills you up and provides the hydration your body needs.
  • Get plenty of rest! At least 7-8 hours of sleep of night does wonders for the body. Not enough sleep can result in an increase in the production of the stress hormone cortisol, which can affect metabolism and increase body fat. Additionally, reduced amounts of sleep will make you more prone to crave sweets
  • Plan ahead to make time for self-care. Make sure to include time for yourself, and then stick to the schedule. This is not the time to make excuses to skip the workout!
  • Before big holiday parties. Eat a small amount of lean protein such as yogurt, cottage cheese, turkey or chicken before you go out. This will help take the edge off hunger.

Finally, remember that the holiday season is about reconnecting with family and friends and that reconnecting doesn’t necessarily need to take place over pecan pie! “This is a time of the year when people start coming home,” Ms. Welter says, “If you’re going to be meeting with friends you haven’t seen for a while, instead of centering that meeting around a big meal, why not meet up and go for a hike, or meet up and have a cup of coffee—focus instead on communicating, because when we’re talking, we’re not eating.”

Stopping Diabetes Before it Starts

Diabetes TestThe Centers for Disease Control and Prevention (CDC) estimate that 9.4% of the US population, or 30.3 million people, have type 2 diabetes. Diabetes—a disease that affects your body’s ability to regulate blood glucose levels—is not a death sentence. In fact, according to a recent article published in the journal BMJ, with proper management and weight loss, the symptoms of the disease can be reversed. However, poorly managed diabetes can lead to a number of complications—heart disease, kidney disease and nerve damage (neuropathy) to name a few—and to a reduced life expectancy.

There is a financial cost to poorly managed diabetes as well. According to the CDC, on average the annual out-of-pocket cost of medical care for someone without diabetes is $3,673 as compared to an annual cost of $9,202 for someone with diabetes. Add in treatment for the additional health conditions associated with type 2 diabetes, and that number jumps to $17,762, annually.

Prevention is Possible

Luckily type 2 diabetes is not only treatable, but also preventable. In the United States, it is estimated that 33.9% of the population—or 84.1 million adults—is prediabetic. Being prediabetic does not mean that you will end up with type 2 diabetes. Medications can reduce the number of new cases of diabetes by up to 31%. However, medications alone are not the answer. In fact, changes in lifestyle, like increased exercise and a healthier diet, are far more effective and can reduce the number of new cases of type 2 diabetes by 58%, and 71% in individuals over the age of 60. For example, did you know that reducing your weight by just 2.2 pounds reduces your risk of developing type 2 diabetes by 13%!

The Diabetes Prevention Program

Diabetes Prevention Program ExerciseIn order to promote the type of long-term and healthy lifestyle changes that are needed to reduce the risk of developing type 2 diabetes, the Door County YMCA, in partnership with Y-USA and the CDC, now offers the Diabetes Prevention Program. “The Diabetes Prevention Program is a yearlong program, which focuses on a 7% reduction in weight and increasing physical activity to 150 minutes per week or more,” says Tonya Felhofer, Program Manager for the Diabetes Prevention Program.

The program is comprised of 25, classroom based, small group sessions: 1 through 16 are weekly, 17 through 21 are bi-weekly, and the remaining 4 are monthly, and each session is facilitated by a YMCA trained and certified lifestyle coach. Over the course of the program, participants learn about healthier eating habits and how to increase physical activity. Ms. Felhofer adds, “It’s really about the power of the group—this is very much a support group. We’re not imparting any new-fangled wisdom, we’re not promoting a specific diet, we’re promoting healthy lifestyle—balance and behavior change is really what the program boils down to—finding that healthy lifestyle balance, living it, and maintaining it for life. In any session,” she continues, “we talk about how to change the habits that we’ve developed. So, perhaps what you’re doing—the foods you’re eating, the amount of activity you get—it isn’t working. So, now it’s time to try something different. Each week, each session opens with, ‘How did the week go? What were the challenges?’ And then we, as a group, discuss how to address those challenges.”

Each session starts with a weigh-in. Initially, participants are accountable to the lifestyle coach. Eventually accountability transitions to the group, and then finally, there is a transition of accountability to self.

Program Requirements

In order to take advantage of the Diabetes Prevention Program you must:

      • Be 18 or older.
      • Have a body mass index (BMI) of no less than 25.[1]
      • Be at risk for, or have been diagnosed, via a blood test, with prediabetes. Approved results include:
        • Fasting Plasma Glucose between 100 – 125 mg/dL
        • 2-hour Plasma Glucose between 140 – 199 mg/dL
        • A1c between 5.7% and 6.4%
      • Have previously been diagnosed with gestational diabetes.
      • Or, if a blood test is unavailable, a qualifying risk score based on a combination of risk factors, like family history and age.

A Program that Works

As of December 2016, the YMCA’s Diabetes Prevention Program had helped more than 51,000 participants at more than 1,600 sites and in 47 states across the country. Participants are asked to give feedback on the program, and to date, participants report that by Week 16, 93% of participants had significantly reduce portion size, 88% had increased their amount of weekly exercise, and 91% saw an improvement in overall health.

Additional Programs and Services at DCMC

At Door County Medical Center, we have a number of programs that can help prevent type 2 diabetes or help those who have been diagnosed with type 1, type 2 or gestational diabetes manage the disease and its symptoms. DCMC’s Carmen Schroeder, a Registered Dietician Nutritionist and Certified Diabetes Educator, and Ruth Norton, a Registered Nurse and Certified Diabetes Educator, are on staff to help guide you through each program, either one-on-one or in a classroom setting. Additionally, Ms. Schroeder is currently serving as an advisor on the YMCA Diabetes Prevention Program Community Advisory Committee, working to promote the YMCA’s role as a leader in chronic disease prevention and to improve the Door County area’s health and well-being.

DCMC programs include:

          • Lifestyle Nutrition Coaching. This is a great option for those who have been diagnosed with prediabetes and would like one-on-one sessions. Lifestyle Nutrition Coaching is designed to support people interested in improving their health and well-being through diet. As Ms. Schroeder puts it; “Think of it as having a personal trainer to support healthy eating.”
          • Medical Nutrition Therapy (MNT). Medical nutrition therapy is a therapeutic approach to treating medical conditions, specifically diabetes and kidney diseases, via the use of an individually tailored nutrition plan devised and monitored by registered dietitian nutritionist.   Individuals meet to review their current eating habits and health history and work with the dietitian in setting nutrition goals to improve your health.
          • Diabetes Self-Management Training. This option is for those with diagnosed diabetes that covers all aspects of disease management: from glucose monitoring; to medication management; to nutrition, exercise and stress management; to setting individual goals. As Ms. Schroeder says, “We give patients the information they need to stay healthy and safe. We give them the survival skills they need to manage their specific healthcare needs.”

If you, or a loved one has been diagnosed as prediabetic, and is interested in the YMCA’s Diabetes Prevention Program, please contact Tonya Felhofer by phone: 920.743.4949, or by email: tfelhofer@doorcountyymca.org.

For more information on DCMC’s programs for managing the nutrition and lifestyle changes that a prediabetes or diabetes diagnosis entails, please visit our website: http://dcmedical.org/Medical-Services/Diabetes-Care, or connect with either of our Certified Diabetes Educators by calling 920.746.0510.

[1] For individuals of Asian descent BMI must be 22 or higher.

Alzheimer’s Disease and Memory Loss: The DCMC Memory Clinic is There for You!

Couple Riding BikeMore than 5 million Americans live with Alzheimer’s disease and more than 15 million Americans provide unpaid care for those people living with the disease and other forms of dementia. According to the Alzheimer’s Association, “Alzheimer’s disease is a type of dementia that causes problems with memory, thinking and behavior.” The primary cause is believed to be the development of abnormal structures in the brain called plaques and tangles, which damage and kill nerve cells in the brain. Plaques are “deposits of a protein fragment called beta-amyloid that build up in the spaces between nerve cells” and tangles are “twisted fibers of another protein called tau that build up inside cells.” While the role that plaques and tangles play in the development of Alzheimer’s isn’t fully understood, scientists believe that these structures “play a critical role in blocking communication among nerve cells and disrupting processes that cells need to survive.”

Symptoms

“Many of the referrals we get are from people concerned about increased forgetfulness of names or appointments,” says Christine Wisniewski, Outreach Specialist at Door County Medical Center’s Memory Clinic. “Of course this type of ‘forgetfulness’ is often a normal part of maintaining a busy life. But if it is impacting someone’s ability to do what they want to do on a daily basis, then it’s definitely time to figure out why.  Part of my work with the memory clinic is to identify the many potential causes for forgetfulness, and to decipher what can be done about it.”

However, it is also important to understand that Alzheimer’s is not the only reason someone may be experiencing memory loss. “I just encourage people not to jump to the conclusion that they have Alzheimer’s,” adds Ms. Wisniewski. “There are plenty of other causes: very often memory issues are related to vascular changes or medication side effects; sleep impairment is also a cause, as is mental illness and social isolation.”

Prevention

A common misconception, with regard to prevention, is that Alzheimer’s is a disease that just happens to the elderly—that nothing can be done about it. Ms. Wisniewski comments, “Nothing could be further from the truth. Unfortunately, Alzheimer’s is usually detected well into the disease process. It’s pretty well known that there isn’t a cure as of yet, but there are a number of opportunities, which when started early, can slow the trajectory of the disease and improve functional ability. So, it is really important to evaluate symptoms as early as possible.”

Additionally, some of the symptoms mentioned above can lead to the development of Alzheimer’s. High blood pressure, depression and stress are all considered risk factors in the development of the disease. In fact, long-term stress, at any age, can damage the portions of the brain that are responsible for long term memory storage. According to Ms. Wisniewski, “Exercise, heart-healthy diet, socialization, and good sleep have all been shown to reduce the effects chronic stress poses to our brain health.”

Support for Caregivers

Providing care for a loved one with Alzheimer’s disease can be one of the most difficult tasks that one can undertake, and it is important to understand that support for caregivers exists, and that it is okay to reach out when you need that support. Because there are different types of caregivers, DCMC offers different types of support, including educational workshops, support groups, and individual support. Additionally, because Ms. Wisniewski interacts with many different caregivers, she can “connect caregivers face-to-face and have them just call each other for support.” She adds that “we have a coalition of caregiver service providers here in Door County, so we can easily connect the different resources in the coalition with a specific caregiver.”

Door County Medical Center’s Memory Care Program

In its ongoing support for those concerned about memory loss, or experiencing memory loss, DCMC provides an array of services, which include:

  • Free evaluation: DCMC provides a free memory screening, which is often provided in the comfort of a person’s home. “My role is to meet with anyone concerned about memory and help identify different causes,” says Ms. Wisniewski, “We spend about an hour talking about different causes. I do some simple memory tests, and then we determine what to do with that outcome. Sometimes it’s coming into our memory clinic; sometimes it’s just changing their lifestyle; sometimes it’s going back to their primary care physician.”
  • Free support: In addition to caregiver support networks, DCMC offers a number of classes, workshops and events related to memory loss and memory loss support, including: Powerful Tools for Caregivers, Memory Café, Living Well with Chronic Conditions and Dementia Capable Community, among others.
  • A team approach to diagnosis: Our memory clinic team, comprised of a Physician, Geriatric Nurse Practitioner, Occupational Therapist, Nurse, and Certified Care Manager, partners with the Wisconsin Alzheimer’s Institute of UW Madison to diagnose dementia-related disorders, provide evidence-based therapies, and connect you to current research opportunities. “The goal of our Memory Care Program is to be as accessible as possible and to be as efficient as possible. In one memory clinic visit we gather a team to work with the patient, with the caregiver, and with the primary care provider to get to an accurate diagnosis. We want to empower patient and caregiver with awareness and action steps, so they can continue to make meaningful memories.”

For a more comprehensive look at Alzheimer’s disease please visit the Alzheimer’s Association website: https://www.alz.org/. For more information or DCMC’s Memory Care Program please visit our website at: http://dcmedical.org/Medical-Services/Memory-Care, or call our Memory Clinic at (920) 746-3504 to schedule an appointment. For more information on classes, workshops and events at DCMC, please click here: http://dcmedical.org/Classes,-Groups-Events.

Dr. Ronald Kodras, MD joining the DCMC Internal Medicine team

Dr KodrasDoor County Medical Center is pleased to announce that Dr. Ronald Kodras, MD will be joining our internal medicine team starting December 19, 2017. Dr. Kodras received his medical degree from the Univertisty of Kansas, School of Medicine, completed his internship and residency at Medical College of Wisconsin in Milwaukee, and served as Preceptor for Medical Students at the University of Wisconsin, School of Medicine-Madison. Now, Dr. Kodras is coming to us from Beloit Memorial Hospital, where he has practiced for 27 years.

“My wife and I had come to a point where we decided we needed to look for the place we wanted to retire—our final home, so to speak,” says Dr. Kodras. “We have a condo in Egg Harbor, and have been coming to, and enjoying Door County for years. We are both very active—we love to hike and bike and we’re bringing our cross-country skis and snowshoes—Door County seemed like a natural fit. However,” he adds, “I’m not ready to retire. My specialty is in Geriatric Medicine, and I was the Medical Director of the Stateline Area Memory Clinic in Beloit, so I’m looking forward to both bringing my expertise in memory care to Door County Medical Center and to working with older adults.”

Geriatric Medicine focuses on medical issues and diseases of aging—for those who are healthy or have a number of medical issues. Health care may become more complex as you age and encounter additional medical conditions. Dr. Kodras focuses on patients over the age of 50 and is an expert in the way medical conditions impact one another and how medical conditions and medications uniquely affect you as you age. As your overall health manager, Dr. Kodras will speak directly with your specialists, and together, identify the best course of action for you based on your current health. Using a team approach, he will also manage your care and work directly with those specialists making your care seamless.

Additionally, Dr. Kodras is planning a series of community talks for residents over 50. Talks will focus outdoor activities and will include topics like Traveling Abroad Over 50 and Hiking Over 50.

Our goal is to keep you active, healthy and independent. If your health becomes more complex as you age, Door County Medical Center and Dr. Kodras will be there to maintain your highest quality of life.

Put Down Your Razors! It’s Movember!

Movember MustachesGents, it’s time to grow the mustache of your choice! Handlebar? Push Broom? The Fu Manchu? The choices are endless! But the reason is serious: Movember is upon us. Also know as No-shave November or Moustache November, Movember (a fusion of moustache and November) is designed to help bring awareness to men’s health with moustaches instead of colored ribbon.

What’s Movember?

Movember got its start in 2004 when a group of 30 men in Australia decided to grow moustaches for 30 days in order to promote awareness about prostate cancer and depression in men. To date, the Movember Foundation, which developed out of that initial idea, has raised 174 million dollars worldwide, and has spread from Australia to South Africa to Europe and North America.

Why Movember?

According to the U.S. Department of Health and Human Services (DHHS), lifespan is on average five to six years shorter for men than for women. Additionally, men have higher mortality rates from cancer and heart disease. In order to combat statistics like these, The Movember Foundation is emphasizing early cancer detection and diagnosis, as well as promoting effective treatments for diseases like prostate cancer, testicular cancer, mental health and suicide prevention, with a goal of reducing the number of premature deaths in men by 25 percent by the year 2030.

Men, what can you do to improve your health?

  • Stay connected: Social isolation is known to adversely affect both the physical and mental health of anyone who experiences it. But did you know that social isolation disproportionately affects men. According to the Movember Foundation, “70 percent of men say their friends can rely on them for support, but only 48 percent say they rely on their friends.” In other words, men expect their friends to reach out in times of trouble, but don’t expect to do the same when they, in turn, are in need of support.
  • Mental health: Three of every four suicides are men. Men have a more difficultly discussing their feelings than women do. If a man you know is going through a rough time, help him recognize the symptoms of depression. Encourage them to increase the amount of physical exercise that they get. Make sure they take breaks and fit some enjoyable downtime into every day. If they are still struggling mentally, make sure they seek the help of a professional. For more information on ways you can help yourself or a loved one with mental illness please click here: https://us.movember.com/mens-health/mental-health. To speak with someone immediately, contact the National Suicide Prevention Lifeline at 1-800-273-8255 or dial 911.
  • Be aware of the numbers: Prostate cancer is the second most common cancer in men in the U.S. If detected early, the five-year survival rate is 98 percent, if detected late, that survival rate drops to 26 percent. By the age of 50, you should be talking to your doctor about prostate cancer and whether it’s the right time to have a PSA test. While the survival rate is 95 percent, testicular cancer is the most common cancer for men in the U.S. ages 15-34. “Get to know” your testicles—learn what feels normal, check them regularly, and go to the doctor if something doesn’t feel right. For more information on prostate cancer, please click here: https://us.movember.com/mens-health/prostate-cancer, to learn more about testicular cancer, please click here: https://us.movember.com/mens-health/testicular-cancer.
  • Go to the doctor! It’s important to schedule annual physical exams. Door County Medical Center’s Dr. Brian Matysiak points out that “Men are less likely to see a doctor until there is an issue,” adding that “many common diseases—diabetes, obesity, hypertension, sleep apnea, etc.—do not occur overnight but rather over years. An annual examination is one of the easiest things we can do to bring issues to light before they become problematic. You wouldn’t let your car go without an oil change for 20 years, so why treat your body differently?”
  • Keep moving! Exercise is essential to maintaining good physical and mental health! Dr. Matysiak suggests making small changes to your lifestyle that will provide benefits over time. “You don’t have to go out and join a gym,” he says, “instead, there are many little things that you can do: park far away, take the stairs, use a push mower or take a daily walk.”

Door County Medical Center Sports Medicine Team: Keeping Their Heads in the Game

Door County Sports Medicine Football PlayerWe all know that high school sports offer teenagers an array of benefits: they teach and promote a healthy lifestyle by incorporating exercise into a daily routine; studies show they help improve mental clarity and improve academic performance; and students who participate in team sports often develop close friendships with others on the team. But, of course, there are injuries. Like “love and marriage,” sports and injuries seem to “go together like a horse and carriage.” In fact, on average, high school athletes alone account for an estimated 2 million injuries, 500,000 doctor visits, and 30,000 hospitalizations each year.

Supporting Door County’s High School Athletes

Because the benefits of high school sports programs far outweigh the costs, the Sports Medicine Team at Door County Medical Center has been working with the Door County School District to prevent, reduce and minimize the effect of sports related injuries by providing, at no cost, athletic trainers to all four of the county’s high schools.  This means that, in addition to working with students, coaches and parents to focus on injury prevention and conditioning, a certified athletic trainer is present for every practice and Door County sporting event that is currently in season. “Right now, we are in the middle of our football season,” says Alyssa Lee, Licensed Athletic Trainer with DCMC’s Sports Medicine Team, “but, at this time of year, we also cover men’s soccer, women’s volleyball, men’s and women’s cross country, as well as women’s swimming.” Additionally, the Sports Medicine Team strives to provide trainers not just to home games, but if needed, to away games as well. “Some school districts are not as lucky as ours,” states Ms. Lee, “they do not have full-time athletic trainers. And while they do their best to have coverage at their home events, that’s not always possible. If we know we are sending our sports team to a school or a location that will not have an athletic trainer, we do our best to send an athletic trainer to travel with that sports team.”

It’s About the Athletic Trainers

While a large group of physicians, physician assistants, nurse practitioners, and physical therapists make up the complete team that supports Door County’s high school athletes, Dr. Philip Arnold, certified sports medicine physician and Chair of the Sports Medicine Department, points out that when it comes to high school sporting events, “It’s about the trainers. The trainers are with the athletes day in and day out. They’re with them in practice, they’re with them during games, they’re on the sidelines, and so everything starts with the trainers in terms of high school sports and injuries.” He adds, “The doctors are not in charge; they’re on the sidelines. We are there to back the trainers up, in case there is a major problem. And we have EMS there so if they need to be packaged and transported, there is usually an ambulance squad at the game. But, again, the trainers know the athletes the best, and they know the athletes parents, who expect them to be involved, instead of some random doctor, who shows up twice a year to a game. My approach is: if the trainer signals that they need me then—boom—I’m right there.”

Prevention and Education

Soccer PlayerIn the end, it comes down to not just preventing student athlete injuries, but also preventing injuries from getting worse. Ms. Lee points out that “Without the presence of an athletic trainer, or with no doctor on the sidelines, even an insignificant injury could get serious. Kids may not understand the seriousness of an injury; they could continue playing and actually make that injury worse. But, we do our best to educate, and if you explain an injury and the potential side-effects of continuing to play with an injury to a parent and an athlete, they generally make the correct decision in not playing.”


Door County Medical Center’s Sports Medicine Team is comprised of a wonderful group of experienced doctors, physical therapists and athletic trainers who provide a whole host of services that include training, prevention and rehabilitation, with an emphasis on the importance of early injury recognition and treatment in order to prevent recurring injuries. For more information, please visit http://dcmedical.org/Medical-Services/Sports-Medicine.

Door County Medical Center Now Offers 3D Mammography

3D-Mammography-machineEven though it has been estimated that a woman born in the United States today has a 1 in 8 chance of developing some form of breast cancer during their lifetime, the five-year survival rate is nearly 100% when breast cancer is detected early. In order to improve our own detection rate, Door County Medical Center recently upgraded to 3D mammography. “I am incredibly excited that we have this technology,” says DCMC’s Diagnostic Imaging Director, Amanda Feldbruegge, “Because of the greater detail that 3D mammography provides, the early detection rate is far higher. So, we are going to be able to detect cancers much sooner, and at a much smaller size. As a result, doctors will be able to start treatment sooner, which will result in better outcomes for patients.”

How Does 3D Mammography Work?

Three-dimensional (3D) mammography, also known as tomosynthesis, is a type of digital mammography that, instead of taking a flat 2D image of breast tissue, obtains multiple images and then creates a 2D composite, formed from the images; essentially taking “pictures of thin ‘slices’ of the breast from different angles and [using] computer software…to reconstruct an image.” One common way to describe the process is to compare the 3D images to the pages of a book, which allows doctors to examine breast tissue page by page.

genius-3d-vs-2d-mammography

Genius™ 3D Mammography™

Fewer Cancers Missed

It has been reported that “as many as 20% of breast cancers will be missed by 2D mammography.” 2D mammography compresses the complex layers of breast tissue into a single visual plane. As a result, overlapping layers of tissue occasionally obscure important details. This can lead to ambiguous results, false positives, or even a missed diagnosis. Because 3D mammography allows doctors to evaluate the breast one layer at a time, the tissue above or below no longer obscures the hidden details that lead to the detection of an abnormality. In fact, 3D mammography has been shown to detect on average 41% more invasive breast cancers than 2D mammography.

Less invasive treatments

Catching cancer early means less invasive treatments. It means that the likelihood of a mastectomy is greatly reduced. It also means the number of unnecessary biopsies and the area involved in a lumpectomy is reduced as well. Additionally, the radiation dose is the same as a 2D machine.

Reduced Callback Rate

3D mammography results in fewer false positives and fewer callbacks. In 2016, DCMC performed 3,200 mammograms. “With 2D mammography,” says Ms. Feldbruegge, “our call back rate was around 5%—a call back doesn’t necessarily mean there is an area of concern, but that there is an area of change from the previous mammogram—so about 5% percent of our patients were asked to return for additional imaging; that’s roughly 160 patients a year.” In fact, according to numerous studies, 3D mammography can reduce callbacks by as much as 40%. “We expect our callback rate to decrease.”

DCMC already offers 3D mammography! For more information on 3D mammography and The GeniusTM 3D MammographyTM Exam, please visit: http://www.hologic.com/products/imaging/mammography. For more information on DCMC’s Women’s Center, please visit: http://dcmedical.org/Medical-Services/Womens-Care.

If you ever do need cancer care, the Door County Cancer Center (DCCC) provides leading edge, personalized oncology treatment in a warm and caring setting. Services include radiation oncology and medical oncology physician visits and treatments, clinical trials, patient navigation, and survivorship services. By reducing the burden of travel for cancer care, the DCCC enables patients to focus on their treatment and recovery. Located at Door County Medical Center in Sturgeon Bay, services are provided through HSHS St. Vincent Hospital Cancer Centers.