Training can help surgeons tell patients best and worse scenarios

Stock image.Surgeons who get extra training to sharpen their communication skills may have an easier time explaining best and worst case scenarios to frail elderly patients as part of shared decision making, a small study suggests. They were candidates for surgery to address problems like hernia, valve or vascular conditions, or bowel issues. For the study, researchers paid 25 surgeons to complete a two-hour training session on how to discuss a range of possible outcomes with patients and families. Surgeons' communication scores improved after training because they got higher marks for presenting treatment options, describing what different intervention choices would involve and then encouraging patients to thoughtfully deliberate and arrive at the best choice for their particular circumstances and goals. Before and after training, researchers analyzed transcripts of surgeons’ interactions with patients and families, awarding up to 100 points for optimal communication.Half of the surgeons scored at least 74 points after training, up from 41 points before, researchers report in JAMA Surgery.”Surgeons commonly disclose treatment risks using the language of informed consent, for example, quoting a 35 percent chance of stroke or a 20 percent chance of death,” senior study author Dr. Peter Angelos of the University of Chicago writes in an accompanying editorial.”At the point when a patient needs surgery, he or she is in a particularly vulnerable state and may not be thinking in the most analytic manner possible,” Angelos told Reuters Health by email.”In addition, surgeons have tended to focus on the risks, benefits, and alternatives to a specific operation in the informed consent process,” Angelos added. “Although that information is necessary, it is not sufficient for a patient to understand how a particular operation might impact their overall status in terms of independent living or other important aspects for their quality of life.” Margaret Schwarze of the University of Wisconsin in Madison said by email.”This information satisfies legal requirements; however, it does little to help patients imagine what life might look like should they suffer an adverse events or help them to think about treatment options in relation to their values and goals,” Schwarze added.All of the patients were at least 65 years old and frail, at increased risk for death or complications, or had multiple medical problems that surgeons thought would impact their long-term health outcomes.Patients needed acute care, but not emergency operations. Surgeons participating in the study specialized in cardiothoracic, vascular or acute care procedures.Among other things, surgeons’ training included exercises designed to help them focus beyond the risks and benefits of specific operations to consider alternative treatments or no intervention as options that might fit better with patients’ quality of life goals.”When surgeons talk to patients they typically focus on the patient’s isolated problem and the surgery required to fix it,” Schwarze said.”This model makes it difficult for patients to consider a non-operative alternative and gives patients a false sense that surgery will fix their problem and return them to normal,” Schwarze added. “Yet for the patients in our study, their surgical problem was bad news and many were unlikely to survive even with surgery.”By focusing on what researchers called “scenario planning,” surgeons learned to use stories to describe what life might look like after surgery or alternatives like medical management or palliative care.Surgeons’ communication scores improved after training because they got higher marks for presenting treatment options, describing what different intervention choices would involve and then encouraging patients to thoughtfully deliberate and arrive at the best choice for their particular circumstances and goals.Beyond its small size, other limitations of the study include a lack of data on whether this type of training for surgeons improves clinical outcomes for patients, the authors note.Still, the findings suggest it might be possible for surgeons to change how they describe treatment options so patients think about surgery in terms of how it would impact their life, not just in terms of what might happen during the operation itself, Dr.

Crosslake Area Garden Club to meet Feb. 15

JoAnn Weaver will present “Garden Voices: Writers in the Garden” at the Crosslake Area Garden Club’s monthly meeting Wednesday, Feb. New members are always welcome.For more information, contact Jayne at 218-763-1222 or visit 15. the third Wednesday of each month at the Crosslake Community Center. The club meets at 1 p.m.

Blood drives planned in Nisswa, Pequot Lakes

The American Red Cross will have blood drives next week in Nisswa and Pequot Lakes.Drives are scheduled from noon to 6 p.m. 14, at the Gull Lake Center at Grand View Lodge in Nisswa, and from noon to 6 p.m. 15, at the Pequot Lakes American Legion. Wednesday, Feb. Donors are encouraged to make appointments and complete the RapidPass online health history questionnaire at to save time when donating.All blood types are needed to ensure a reliable supply for patients. Tuesday, Feb. A blood donor card or driver’s license or two other forms of identification are required at check-in. Individuals who are 17 years of age in most states (16 with parental consent where allowed by state law), weigh at least 110 pounds and are in generally good health may be eligible to donate blood. High school students and other donors 18 years of age and younger also have to meet certain height and weight requirements. To make an appointment to give blood, download the Red Cross Blood Donor App, visit or call 1-800-RED CROSS (1-800-733-2767).

Dental care important for children

Keeping children’s teeth healthy and preventing oral disease is an important part of their overall health. The earlier these problems are caught, usually the less painful and expensive they are to treat,” Patnode said. Oral diseases, including cavities, are nearly 100 percent preventable, yet they are extremely common, affecting children all across Minnesota every day.”Fortunately there are many ways to help prevent oral diseases and many of them start with things you can do in your own home,” said Stacy Patnode, public health nurse with Crow Wing County Community Services and the Child and Teen Check-up Outreach program.• Children should brush their teeth or if too young to brush effectively themselves, have their teeth brushed for them, at least twice a day.• Ensure your child is using toothpaste that contains fluoride, if they are old enough to rinse and spit. February is National Children’s Dental Health Month. This is an important habit for children to start at an early age, especially once their teeth start to touch together.• Provide your child with plenty of fresh fruits and vegetables and offer less sugar sweetened beverages and foods to help prevent tooth decay, gum disease and cancer.”In addition to keeping teeth healthy while at home, bringing your child in to see a dentist at least once a year starting at 12 months of age is extremely important in preventing tooth decay and identifying dental diseases. Fortunately we have dental providers that host special events each year in our community that allows these families to have access to dental care services,” Patnode said.Visit for a list of dentists in Crow Wing County who accept Medical Assistance. “Dentists are also able to place dental sealants on children’s permanent molar teeth to prevent future cavities.”Finding dental care can sometimes be a challenge for some families, especially those who have financial concerns or who are on medical assistance. Also consider fluoride rinses, especially if your water is not treated with fluoride (most homes within city limits have treated water).• Have children floss at least once a day.

Facebook is topic of Pequot Lakes class

Bring your own device if you have it. Tuesday, Feb. Cost is $10.Learn how to create and update your account, send and receive messages, notifications, video messaging and searching and adding friends. Contact Pequot Lakes Community Education at 218-568-9200. Carver Wahlstrom, Pequot Lakes High School information technology specialist, will lead a Community Education session about Facebook from 6-7:30 p.m. Students will have one-on-one instruction.Pre-registration is required. 14, at the high school.

Pine River Dental Arts ‘Gives Kids a Smile’

Travis Grimler/Echo Journal
Ready for approximately 50 patients during the Give Kids a Smile event Friday, Feb. Feliciano Salgado, Dr. Mike Steinmetz, Dr. Jaime Preble, (row four) Shaun Jacobsen, Avery Cunningham, Amy Wiese, Renee Stranne.1 / 2Travis Grimler/Echo Journal 3, at Pine River Dental Arts were (From the back, left to right) Jennifer Volk, Kristine Frank, Amy Reis, Katie Bertrand, Jane Steinmetz, (row two) Melissa Hagberg, Trista Hawkinson, Gail Britton, Tara Jarvi, Jennifer Kelley, Sandy Kelley, (row three) Dr.
This year, Pine River Dental Arts joined in that tradition. Age 1 is the target age.””It seems to be common that 3 is a good age for the first dental visit among some pediatricians and some community recommendations,” Preble said. “I agree. In the Pine River office, owner Jaime Preble estimated 50 children were scheduled ahead of the event, making for a busy day in the office Friday, Feb. “They would probably have to go to sleep to get that done.”Ahead of the event, the dental arts office sent a notice through Pine River-Backus School to reach the target audience, especially the underserved. “Then we have some kids scheduled with doctors for operative. 3.”We have four hygienists running full columns to see children,” Preble said that morning, before patients arrived. Dentists handled almost anything that didn’t require unconsciousness, unless it included extraction of permanent teeth.”From a general dentist standpoint, as a pediatric dentist it will be more about if we can manage behaviors in the office,” said general dentist Feliciano Salgado. The American Academy of Pediatric Dentistry, because of that, recommends that kids come in by the age of 1 for a dental examination. 3, at Pine River Dental Arts. Braydon Lane was the first child seen during the Give Kids a Smile event Friday, Feb. In dentistry they can find other problems too sometimes. It’s more about education and prevention. That’s the focus of that first appointment. Not that we are doing much, but it is about talking to the parents about nutrition, bottles, sippy cups, habits and also getting a child used to just coming in for what we call ‘happy visits’ so when it comes to the real stuff, they aren’t so afraid.”Randy Olson, of Pine River, brought his grandchildren to the office for dental work during the event. I’ll be doing exams all day and we’ll kind of book kids in for work as needed.”Care during the event ranged from cleanings and fillings to crowns and nerve treatments. There is a significant portion of children who have had no dental care at all.”About half of kids in this country have not seen a dentist,” Steinmetz said. I would love to see kids at age 1. Here general dentist Feliciano Salgado prepares him for dental work.2 / 2For 15 years the American Dental Association has given free oral health services through its Give Kids a Smile event. It’s good. “About 30 percent of 2 to 5-year-olds have cavities. We’ve seen kids go to the operating room at 15 months. setting, then that is where we would refer them – to the pediatric office to handle more complex cases.””If they are 3 and have a mouth full of cavities, we probably won’t be able to handle that awake,” said pediatric dentist Michael Steinmetz. His grandson, Braydon Lane, was the first customer of the day, though six others were immediately brought to other rooms for simultaneous care.”I like it. It’s a good deal,” Olson said. “It’s important just to make sure their teeth are taken care of. The possibility is there, so we recommend kids come in. It’s a good thing.”Preble said the results and experiences this year will serve as a learning opportunity for next year, when Pine River Dental Arts participates again in the Give Kids a Smile event.”I think it’s going to go great, but I think we will also learn a few things and make changes necessary for next year,” Preble said. “If children have so much work they need an O.R.

Senior Menus: Feb. 12, 2017

To make a reservation or for Meals on Wheels information, call 218-587-2921.In Crosslake, meals are served at the Crosslake Community Center, 14126 Daggett Pine Road. 13-17MondayTeriyaki glazed chicken, rice pilaf, broccoli, tropical fruit, ice cream.TuesdayHamburger tomato casserole, green beans, pineapple, lemon chiffon dessert.WednesdayVegetable beef soup, meat salad sandwich, pea and cheese salad, crackers, bar.ThursdaySalmon, baked potato with sour cream, mixed vegetables, slice of pie.FridaySloppy joe, potato salad, corn, fresh orange. The Senior Nutrition Program offers a nutritionally balanced meal for all people to enjoy.Meals are served Monday-Friday at 11:30 a.m. Menus are subject to change.Meals are served with bread, margarine and low-fat milk.Feb. To make a reservation by noon a day in advance or for Meals on Wheels information, call 218-692-4271. Meals on Wheels are available for homebound seniors in area communities.In Pine River, meals are served at the Heartland Apartments, 445 Snell Ave. in Pine River and Crosslake. The suggested voluntary donation is $4 per meal for those over 60 and $7.15 for those under 60.

Pequot Lakes students to participate in Sno Daze events

Lori Westlund/Echo Journal Correspondent
13, including coronation of Sno Daze candidates at 12:30 p.m. Pequot Lakes High School Sno Daze candidates are Jacob Tschida (front row, left), Gage Westlund, Hunter Clement and Justin Gerber; Lyndsey Johnson (back row, left), Corina Ruud, Chloe Bermel and Jasmine Danielowski.Pequot Lakes High School students will celebrate winter with Sno Daze activities the week of Feb. 16. Sno Daze candidates are seniors Jacob Tschida, Gage Westlund, Hunter Clement, Justin Gerber, Lyndsey Johnson, Corina Ruud, Chloe Bermel and Jasmine Danielowski. Thursday, Feb.

Faith column: What if tomorrow never comes?

How do we adjust when our dreams vanish in the night? Some others seem focused on simply enduring this life as they long for eternity.I would like to suggest that we should live in the light of eternity, yet truly embrace the journey of this life. Though outwardly we are wasting away, yet inwardly we are being renewed day by day. How do we maintain hope for another tomorrow? a few hours later. Tomorrow never came; it simply got skipped.What if tomorrow never comes? For God said, ‘If they face war, they might change their minds and return to Egypt.’ So God led the people around by the desert road toward the Red Sea.”His provision for the season includes times of pruning and times of plenty. Some are driven to get the most out of this life. What is the probability of our bodies wearing out? Jeremiah reminds us that God’s compassions are new every morning. It’s found in Exodus 13:17-18.Listen to these words, “When Pharaoh let the people go, God did not lead them on the road through the Philistine country, though that was shorter. For our light and momentary troubles are achieving for us an eternal glory that far outweighs them all. The end game is obvious – death is inevitable.But where is our focus? Thursday night and ended on Saturday morning at 8:30 a.m.Considering the change in time zones and time of flight, they basically lost Friday. Face it, sometimes we get tipped over by things we won’t remember in six months.Second, accept the challenges of each season as a part of the refining process. You are not your own; you were bought at a price. In Deuteronomy 8:4, we are reminded that their clothes didn’t wear out and their feet didn’t swell during the 40 years in the desert. This I would frame as His provision for the season. God established a wonderful pattern in Exodus chapter 16 when He provided manna each morning and quail in the evening along with water from the rock. We tend to focus on the purging of the unfaithful spies as the cause for delay. Above all else we must embrace His provision for the journey.2 Corinthians 5:1 Paul writes, “Now we know that if the earthly tent we live in is destroyed, we have a building from God, an eternal house in heaven, not built with human hands.”The word that catches my attention is “if.” “If” the earthly tent we live in is destroyed. Our earthly tent is only temporary. Yet we are commanded to care for our bodies as stewards.In 1 Corinthians 6:19-20, we are asked, “Do you not know that your bodies are temples of the Holy Spirit, who is in you, whom you have received from God? Tomorrow may be spent on this earth, and it may be spent in glory.”Therefore we do not lose heart. We can and must rely on His provision for the season.But there is an overarching provision. Their first flight departed around 6 p.m. Jesus reinforced this principle in Matthew chapter 6 when He reminded his disciples not to worry but to trust God for each day’s needs.We can and must rely on His provision for the day.Yet Scripture also instructs us to plant and harvest, activities that require forethought, focus and fortitude. Yet our lives are marked by seasons; seasons of plenty and season of want.Sometimes we are compelled to live with less. It represents the ones who are in close enough proximity to either extend care to you or receive care from you. He states it this way in Philippians 1:23: “I am torn between the two: I desire to depart and be with Christ, which is better by far.”I believe we find our peace and assurance in the provision of His grace. How often do we wear ourselves out attempting to impress people who have no intention of attending our funeral?And finally, look for God’s fingerprints in the events and experiences of each day. What is your circle of care? But God always provides. and landed in L.A. Our journey through life’s hills and valleys gives us voice in our circle of care.Allow me to expand on that though a moment. Their trip over the Pacific Ocean began at 10:30 p.m. So we fix our eyes not on what is seen, but on what is unseen, since what is seen is temporary, but what is unseen is eternal.” IllustrationRecently I bid farewell to my wife as she and four friends departed on a mission trip to Myanmar.They flew from Minneapolis with stops in Los Angeles and Guangzhou, China, before arriving in Yangon, Myanmar. How do we adjust when our dreams vanish in the night? How do we maintain hope for another tomorrow?In 2 Corinthians 5:1-10, the Apostle Paul is describing a tension that exists within every believer. Our earthly life is but a vapor in comparison to eternity. But Scripture also provides another insight we often overlook. After returning home that evening I took a few moments to review her itinerary and flight schedule I had received only that morning. We do groan; there are burdens; it is a life filled with challenges.But what if tomorrow never comes?Allow me to close with some suggestions for this journey.First, view the daily challenges through the lens of eternity. He has left us a deposit, the person of the Holy Spirit residing in every believer. Therefore honor God with your bodies.”There is provision for the day, but the righteous steward is instructed to invest God’s provision for its optimal use. This might be due to personal hardship or because God has personally challenged us to direct a larger portion of provision to the needs of others.Consider the season the people of Israel endured as they wandered in the wilderness for 40 years. What if tomorrow never comes? This provision is expressed in several ways.First, there is His provision for the day. The events of the day had been a little stressful and somewhat rushed.