Mayo Clinic Health System

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Mayo Clinic Health System patient photo - McDonoughHeading for home

For some people, visits to the clinic are inconveniences that require only minor adjustments to daily routines. For people who have physical impairments, however, getting to the clinic can be difficult and time consuming, if not impossible. Albert Lea Medical Center’s Home Health Department provides healthcare to patients who are homebound or for whom mobility is difficult.

Jason McDonough receives home healthcare to assist with treatment for a severe burn on his ankle. It is his second experience with Home Health. The first was after an accident left him paralyzed from the waist down.

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“I was in a helicopter crash four years ago while spraying crops out by Pipestone, Minn. I had Home Health care for about a month after my release from the hospital,” says McDonough, who is from New Richland.

The paralysis from the accident causes pain in the nerves of McDonough’s legs. He can alleviate the pain with a heating pad.

“Jason has neuropathy, a disorder of the nervous system that disrupts communication between the brain and the muscles, skin or internal organs. He feels pain in his legs, but he is unable to feel pain on his skin,” says Jan King, a registered nurse with Home Health.

This reduced sensitivity left McDonough without a warning system for pain. “I had a heating pad on my leg. I can feel warmth, but I can’t feel how hot the pad is on my leg,” he says. “That’s what led to this burn.”

Home Health visits McDonough three times a week for treatment of the burn, according to Kellie Thompson, a registered nurse. “We apply a device to the wound to drain fluid from it and draw blood to the surface of the leg to help it heal,” she says.

McDonough is grateful for the convenience Home Health provides. “I wouldn’t know what to do without them. I would probably have to go to the hospital or clinic several times a week,” he says.

Because of the assistance from Home Health, McDonough is able to spend time pursuing more enjoyable activities. “The city and county recently put in a bicycle trail on the north side of town. I have a hand cycle that I take out at least three times a week,” he says. “I usually bring my dog. We go about three miles each time.”

Mayo Clinic Health System patient photo - KortzPutting her best foot forward

Judy Kortz makes her living on her feet. As a driver for a package delivery company, she makes dozens of deliveries each day. So when the pain from a bunion began hindering her ability to walk or even drive, she knew the time had come to seek treatment.

“I’ve always had bunions. It got to the point where I couldn’t even hold my foot on the accelerator of my delivery truck,” she says. “After I took my shoes off, the pain would decrease, but I knew it probably was not going to get better.”

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Short term relief vs. long-term solution

A bunion is excess or misaligned bone in the joint of the toe. Treating bunions typically involves modifying the person’s shoes to moderate the pain or correcting the problem with surgery, according to R. Wayne Buckmaster, D.P.M., a podiatrist at Mayo Clinic Health System— Albert Lea.

“Conservative approaches to treatment include stretching the shoe or cutting a hole in it in the area of the bunion. This is usually done for people who are not candidates for surgery,” says Dr. Buckmaster. “We consider a surgical approach if the bunion starts to cause problems for the person and conservative treatment has failed.”

Do you have to get a bunion fixed if you are not having pain? “No,” says Dr. Buckmaster, “but early treatment may prevent some potential arthritic conditions. Since a bunion is a misaligned joint, continued avoidance of treatment will wear out the joint.”

Heal to toe

Surgery to correct bunions is on an outpatient basis. Healing times vary, depending on lifestyle and work demands.

“A typical patient takes four to six weeks off work, returning sooner if she can sit at work or elevate the foot 15 minutes each hour.”

Since Kortz’s job requires sustained time on her feet, rehabilitation included six weeks off work after surgery. Staying home for that length of time was a challenge, but Kortz considers it time well spent to ensure the results she had hoped for.

“Prior to surgery and even before the bunion started causing pain, my foot had a tendency to ache. But it hasn’t ached at all since surgery,” says Kortz. “I am really pleased that I had it done.”

Mayo Clinic Health System patient photo - OsmundsonMore than a measure of heartburn

Occasional heartburn is something many of us experience. Combine that with the feeling of not being able to completely swallow your food and you may get an idea of the discomfort Jim Osmundson had been experiencing prior to seeking treatment at Mayo Clinic Health System— Albert Lea.

“I’ve been fighting this problem for six or seven years, but it really got bad in the last couple years. Sometimes it wouldn’t bother me at all for weeks at a time, but then it would act up again,” says Osmundson. “When eating certain things, they would get stuck way down in my throat.”

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Medications didn’t offer much relief. “I tried everything you can get over-the-counter and I finally went to Dr. Waldron to find out what was wrong.”

Osmundson went to Albert Lea Medical Center for a checkup from Martin Waldron, M.D., a family practice physician, and received a diagnosis of persistent heartburn or gastro-esophageal reflux disease (GERD), from David Appel, M.D., a general surgeon. He had also developed a stricture or narrowing of the end of the esophagus, the channel between your mouth and your stomach. The stricture is a complication of long-term GERD.

“As part of their evaluation, patients undergo two tests. Esophageal manometry measures pressure as the patient swallows,” says Dr. Appel. “It involves gently guiding a soft tube through the patient’s nose into the esophagus. It tells the physician how well the esophagus squeezes food along and into the stomach.

“The other test, pH monitoring, measures pH levels to determine the amount of stomach acid flowing back into the esophagus. A miniature capsule about the size of a gelcap is attached to the patient’s esophagus and transmits information to a small receiver worn on the patient’s belt. Within a week, the capsule falls off the wall of the esophagus and passes through the digestive tract. Previously, patients had to have a thin wire probe inserted through the nose and kept in place for 24 hours.

“The tests used to require two trips to Rochester, which wasn’t convenient for patients. Since acquiring the equipment, we’ve been able to do both in Albert Lea. Jim was among the first patients tested with the new system.”

Dr. Appel discussed treatment options with Osmundson once the diagnosis indicated GERD. “He said surgery was a good option for someone my age,” says Osmundson. “They have pills that take care of acid, but I’d have to take them forever.”

“Jim’s treatment involved a balloon dilation of the stricture and then a minimally-invasive procedure where we wrap a small part of the stomach around the end of the esophagus. This adds support to the natural sphincter mechanism to help prevent acid reflux. He spent only one night in the hospital and made a quick recovery.”

Osmundson is pleased with the results of his operation. “It’s taken care of the obstruction and the acid reflux. I haven’t had any problems since then.”