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Varicose Veins Overview

Varicose Veins Overview

by | Dec 15, 2023 | General Surgery

Varicose Veins are common in both women and men as they age. Varicose veins are not just a cosmetic problem…they can lead to complications such as skin changes and skin ulcers. Because of medical issues like these, insurance will sometimes cover treatment of the varicose veins if the treating provider can document that the patient is having leg pain or heaviness. Insurance companies will also take into account if the veins are causing symptoms severe enough to cause issues standing or walking, or if the veins are causing skin changes or ulcers.

Why do varicose veins happen?

Varicose veins most often occur due to backflow or reflux into the superficial (saphenous) veins. Veins have valves to push blood up the legs to the heart against gravity. If those valves stretch apart, they can allow blood to flow down the leg to the foot rather than up the heart. These leaky valves can occur from prolonged standing, pregnancy, and many other reasons.

How do I know if I have a vein valve issue?

A special type of ultrasound can be done with the patient standing and lying to measure the amount of backflow or reflux in the veins. Both the superficial system (saphenous) and deep (femoral) systems are evaluated.

What can be done if I have leaky valves?

Usually, using compression stockings is recommended first. If this does not help and symptoms are worsening despite wearing the stockings, different procedures could be recommended. One of these procedures is called a vein ablation. Ablation is where a catheter is placed into the vein. Usually, superficial veins are the culprit when leaky valves are involved. The vein is then closed with the ablation. Blood then flows back to the heart through the femoral system.

Will ablation fix the bulging varicose veins?

In most cases, the ablation will decrease the size of the varicose veins and help with symptoms such as leg heaviness and fatigue. Sometimes a separate small incision is made to pull out the bulging veins. This is called an avulsion or phlebectomy procedure.

Lakeview Clinic has three surgical vein specialists that your primary doctor can refer to for varicose veins evaluations: General Surgeons, Dr. Todd Elftmann, Dr. Dawn Stapleton and Dr. Steven Turner. Consultation appointments are available at the Chaska, Waconia, and Norwood offices.

Dawn M. Stapleton

Dawn M. Stapleton

MD

Dr. Stapleton’s practice includes surgical and endoscopic services. She has special interests in breast surgery, laparoscopic surgery and robotic assisted surgery for cancers and benign conditions including hernia repairs. She also performs upper endoscopy and colonoscopy.

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Recognizing and Dealing with Holiday Stress

Recognizing and Dealing with Holiday Stress

by | Dec 11, 2023 | General

Are you feeling joyful or anxious this holiday season? For most people the answer may be a blend of the two. The holiday season places additional demands on what may be an already busy life…social gatherings, shopping, decorating, travel. It can be a wonderful time of the year but may also be stressful.

Physical effects of stress on your body

Stress and anxiety can change how your body feels and can influence both your mood and behavior. It may cause fatigue, increasing the desire to sleep more. It can also cause physical symptoms of headache, heart racing, abdominal pain, and nausea.  Some people note a change in appetite – overeating or not eating at all. Stress can also increase your chance of getting sick.

Stress influences your mood.

While stress may be a motivator for some people to get things done, for others stress causes them to feel paralyzed and overwhelmed. Further, stress can cause anger and agitation in some, depression, or tearfulness in others. Stress may cause you to isolate yourself, not wanting to be around others, which can be particularly hard during the holidays when “being social” is encouraged.

Stress can change your behavior.

Alcohol or caffeine use may increase during times of stress, which can worsen the physical feelings of anxiety. Because stress can make you feel tired, routines get disrupted – sleep may suffer, exercise may decline and eating times or amounts change. You may find yourself withdrawing from others at a time when social gatherings are increasing.

How can you cope with stress this holiday season?

  1. Exercise. Move your body. Every step counts.  Ideally, set aside time for physical activity most days of the week. Be selfish with this. In addition, incorporate activity into your day…park farther away, walk when you can, do jumping jacks on your break. Exercise helps with sleep, achiness, and tension.
  2. Focus on healthy foods first. Then, allow yourself a treat but limit the amount. This can be hard when you may be surrounded by cookies and fudge. Consider eating something healthy prior to a gathering so you resist overeating.
  3. Express your gratitude toward others. Look for the positive in people. Reflect on the good that is happening around you.
  4. Know your limits – It is ok to say no.
  5. Take time to reflect, meditate, pray. Quiet time, even if it is just for a few minutes a day, can help you relax and reset.
  6. Remember to get enough sleep.
  7. Recognize that there are some people that are not feeling joyous this season. They may be having difficulties emotionally or financially. Express your support and meet them where they are at.

I hope that you have a joy-filled holiday season. Remember, if your stress is turning into anxiety that is affecting your day-to-day functioning, seek help from others, including your Lakeview Clinic provider.

Sandra Beulke, M.D.

Sandra Beulke, M.D.

Dr. Beulke joined Lakeview Clinic in April 2003. She provides the full spectrum of family medicine, including obstetrics and gynecology, pediatrics and geriatrics. She has special interest in women’s health and diabetes care. Dr. Beulke serves as Lakeview Clinic’s Medical Director and is also active on several committees which aim to promote quality and reliability in health care.

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Internal Medicine vs Family Medicine: Which provider should you choose?

Internal Medicine vs Family Medicine: Which provider should you choose?

by | Nov 20, 2023 | Family Medicine, General, Internal Medicine

Internal Medicine vs Family Medicine: Which provider should you choose?  

A question often asked in clinic is which type of provider will fit my personal and physical needs to ensure optimal health outcomes. So, what exactly is the difference between an internal medicine provider (also referred to as an internist) and a family medicine provider when choosing a provider.  Below are listed similarities and differences but ultimately the choice is a personal one depending on the situation.  

Similarities 

Both family medicine and internal medicine providers can be a choice for a primary care provider (PCP) for adult patients (typically 18 and above). They can provide general health maintenance services such as an annual physical/wellness exam as well as chronic disease management and most same day visits. As part of training, both specialties undergo a 3-year residency before practicing independently in a clinical setting.  

Differences 

One of the main differences between internal medicine and family medicine is the age range of patients they are trained to provide medical care for. Family medicine typically sees any age of patient including pregnant patients in some practices vs internal medicine who sees patients aged 18 and older in general. Of course, there are always exceptions such as Lakeview physician, Dr. Peter Rogers who is both a pediatrician and internal medicine doctor.  

In general, internal medicine training has a larger focus on chronic diseases and specialty care such as cardiology and gastroenterology. They spend more time in the hospital and intensive care settings as opposed to family medicine training which is more typically spent in the outpatient setting. Family Medicine residencies focus more on procedures such as toenail removals, IUD placements, skin biopsies, casting, and joint injections.  

Bottom line:  

Internal medicine 

    • Sees adults only (~18 years and older). 

    • Typically have more training and exposure to chronic disease management, specialty care, and geriatrics. 

    • Training is based more in the hospital setting as well as critical care areas such as an ICU.  

    • Typically sees more “complex” patients in the outpatient setting such as patients who have needed recurrent hospitalizations or multiple specialty needs.  

    • Performs annual physicals and wellness visits. 

Family medicine 

    • Sees a full spectrum of patients including obstetrics and pediatrics. Providers can see the whole family. 

    • Typically have more training in orthopedics, urgent care, and emergency medicine such as laceration repairs and procedures described above.  

    • Performs annual physicals and wellness exams.  

Disclaimer: The above description of each specialty are generalizations. Each provider has unique skills and interests that may differ from the above information. For more information on each provider, please visit the provider section of the Lakeview clinic website. 

Jordyn Walter

Jordyn Walter

Internal Medicine M.D.

Jordyn Walter, M.D. began practicing Internal Medicine at Lakeview Clinic in 2022. Dr. Walter has special interests in chronic disease management such as diabetes, heart failure and hypertension. She also utilizes point-of-care ultrasound.

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This is your life; how do you want to live it?

This is your life; how do you want to live it?

by | Nov 13, 2023 | General, Geriatrics

The following blog is a discussion and differentiation of palliative care and hospice care.

     November is National Hospice and Palliative Care Month. With the holidays on the horizon, it is a great time of year to focus on our family and friends. When considering palliative care and hospice care, naturally many of us immediately think of death and dying. Discussing death and dying feels burdensome at any time of year, but especially during the holiday season. However, I would like to shine an entirely different light on what palliative care and hospice embody.

 

      It is imperative to first discuss the difference between palliative care and hospice as these concepts are often intertwined. Palliative care ultimately focuses on symptom management in those with serious, but not necessarily terminal, illnesses. Palliative care uses an interdisciplinary and holistic approach to symptom management. Interdisciplinary means using multiple teams to help reach the goal of managing symptoms. This may include doctors, nurses, psychologists, social workers, chaplains, therapists and other resources. A holistic approach means the focus is on the entire person as a whole and not just the disease. This can include not only medical support, but also psychological, spiritual, and social support. Palliative care can be incorporated into the care of those receiving curative treatments or into the care of those who are solely focusing on comfort and are no longer wanting aggressive treatments. For example, a young adult going through cancer treatment who may live another 40+ years may receive palliative care. An elderly patient who is preparing for end of life may also receive palliative care. Hospice care includes palliative care measures, but you do not need to be enrolled in hospice to receive palliative care. The focus of palliative care is improving the quality of life.

       Now that we have a better understanding of palliative care, we can differentiate it with hospice care. Our health care system often is saturated with interventionism that tends to inadvertently teach resistance to mortality. Hospice care is a bridge that can allow people to forgo aggressive treatments and ultimately focus on comfort. Like palliative care, hospice care continues to focus on symptom management and quality of life, but hospice care is for those that have a life expectancy of approximately six months. This six-month life expectancy is not set in stone. It is not rare that a patient will receive hospice services for longer than six months or that a patient’s condition improves to the extent that they no longer qualify for hospice. The focus in hospice is no longer on curing disease with aggressive measures, but rather solely providing the maximum comfort for each person. I like to think of hospice care as a focus on quality of life rather than a focus on quantity of life. Hospice can be provided in multiple settings including patients’ homes, assisted livings, or nursing homes. Hospice care allows people to maximize their quality of life for the rest of their life, however long that may be. This service provides care to those preparing for end-of-life to ensure the rest of their days are filled with the comfort and dignity that all humanity deserves.

         With the holiday season approaching, rather than avoiding these discussions, let’s try to change our way of thinking. Instead of focusing on dying, let’s focus on living. Whether it is you or a loved one experiencing a serious health challenge, it may be helpful to consider these questions: How do you want to live? How does your loved one want to live the rest of their life? What do you value most in your life? What makes you or your loved one feel the happiest, the most comfortable, the safest? What treatments would you want or not want to pursue to help you achieve your goals of care? Exploring these topics can help you and your loved ones pave a path to live the rest of your lives the way you choose. If these topics lead to good discussion, it may be important to talk with your primary care provider about documenting an advanced care plan so you or your loved one’s wishes are in writing. Honoring Choices MN offers many resources that can help prepare you for discussions with both your loved ones and medical provider.

Life is full of uncertainties. If you or someone you know is experiencing a strenuous health journey, opening up this discussion may prove to be more beneficial than burdensome. If you could help yourself or someone you love live with the utmost dignity, comfort, and peacefulness, would you do it? This is your life; how do you want to live it?

Erin K. Dahn

Erin K. Dahn

APRN, NP-C

Erin Dahn, NP-C, is a Lakeview Clinic nurse practitioner specializing in the geriatric population. She works at various long-term care facilities with a home base of Lakeview Clinic – Waconia. Her special interests include palliative care and management of chronic diseases including hypertension, heart failure, diabetes, and dementia.

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Lakeview Staff Aid Girls in Kenya

Lakeview Staff Aid Girls in Kenya

by | Oct 20, 2023 | General

For several years, Dr. Lorene Rutherford has been traveling to Light of Hope Home & School in Kenya to provide medical care for abandoned, abused, orphaned and impoverished girls. Several current and former Lakeview employees have accompanied her on these trips since 2011. Unfortunately, they have been unable to make the trip the last few years due to Covid.  

This year Dr. Rutherford and her team once again made the trip to Kenya the last week of August. Lakeview Clinic would like to recognize Dr. Laura Mohling, Dr. Abby Elliot, Alicia Pysick, Lorie Dyrdahl, Jen Williams, and Cathy Kohnen for contributing their time and skills to such an important effort. Volunteers not only provided medical care but also provided educational support. The group also provided Light of Hope girls with the opportunity to learn about flying, aeronautics and finances as well as providing general encouragement and positivity.  

Lakeview staff members found the trip to be fulfilling in a multifaceted way. Learning about another culture and helping improve the lives of the girls in Kenya was meaningful, but the additional benefit of working as a team in Kenya created bonds between the members of the group as well. “I’m super proud of the team of people who came this year, and I was really happy about the enthusiasm and resilience they showed during the trip,” says Rutherford. “At the end of the day, everyone’s goal is to honor the kids and serve them in the best way we can. I think the team did that with enormous generosity, kindness, and team spirit.” 

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