Don't Put Your Health on Hold

This feature was written by Studio MSP writers. While some of our advertisers were sourced, no advertiser paid to be included.

These times have many of us feeling confused about how to prioritize our health care needs, so our editors went to local specialists to help us navigate the ever-changing landscape of options and recommendations. From the latest in telehealth to the appointments that can (or can’t!) wait, leading experts in dermatology, orthopedics, OB-GYN, mental health, back and spinal care, and dental answer all our burning questions.

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Vision

Now Is a Great Time to Get LASIK

Between distance learning, professional and personal Zoom calls, and an ever expanding library of new TV shows and movies (Mighty Ducks, anyone?), many of us haven’t given our poor eyes a break in almost a year—and there are definitely some dry eyes in the house.

In addition to that extra dose of screen time, masks can contribute to eye strain, which may come as a surprise to those of us who don’t wear glasses. If a mask is ill-fitting, the air that we breathe has nowhere to go but up, drying us out even more.

“There are a lot of patients seeking laser vision correction because they want to get rid of their contacts and glasses because of [eye strain],” says Dr. Ralph Chu of Chu Vision Institute. “Those symptoms of dryness of the eyes, overuse on the computer screen—those are really common reasons we get called.”

“Every 20 minutes, take a look at something 20 feet away for about 20 seconds just to rest your eyes.” —Dr. Ralph Chu, Chu Vision Institute

And there’s no reason to put off that call. If you’ve considered getting your vision corrected, the time of constant mask-wearing is the perfect time to do it.

“We have [patients] who work in construction and wear glasses, and they’re working outside—and their glasses are always fogging up—but they’re really trying to support their communities during COVID,” Chu says. “Helping them get out of their glasses with laser surgery like LASIK is the most amazing feeling when you see the gratitude on their faces.”

If LASIK isn’t for you, there are other things you can do to eliminate eye strain. Whether you’re bespectacled or not, Chu recommends wearing a mask that fits tightly across your nose or putting a piece of tape over the upper portion to hold it down.

He also recommends the 20/20/20 rule, especially when you’re being exposed to a lot of blue light from your computer and phone: “Every 20 minutes, take a look at something 20 feet away for about 20 seconds just to rest your eyes,” he says. “That will let you be able to focus, stay in tune longer when you’re using a screen all day.”

But whether it’s dry eyes, or something more serious, like a sudden change in your ability to see, it’s important to get a consultation set up sooner rather than later. The sooner you get in, the lesser the chance of permanent damage to your eyes, Chu says.

“There’s a lot of anxiety about going out and being in public spaces—especially health care environments,” he says. “Even in an eye practice like ours, we’re seeing patients wait a longer time before seeking care, so the diseases they come in with are more severe.

“I would encourage all patients to not be afraid, use their best judgment, and make sure they’re masked up when they see their health care provider.”

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Dermatology

Virtual versus In-Person: What’s Best for Me?

In times when COVID-19 is on everyone’s minds, that little mole on the back of your leg may not seem like a priority. But the fact that dermatologists can take a peek at it—as well as eczema, acne, or psoriasis—via telehealth leaves no room for excuses.

“The quality is really good, so it’s like you’re sitting there talking to the patient, looking right at them,” says Dr. Charles E. Crutchfield III of Crutchfield Dermatology, who has treated over 5,000 patients via telehealth since March. “They can point the camera right at the spot and you can evaluate it, and if you’re a seasoned, board-certified dermatologist, you can oftentimes make the diagnosis by looking at it that way.”

Since Crutchfield Dermatology started using telehealth more often, about half of its appointments have been virtual. While checking specific spots and moles can be done over video, it’s downright impossible to do things like a full-body checkup, let alone a biopsy or culture without meeting face mask–to–face mask.

Crutchfield recommends that patients who are nervous about setting up an in-person appointment do an initial consultation over telehealth, and if they need to come in, they can find out from that virtual appointment.

If you do have a concern, it’s best to get that initial appointment scheduled sooner rather than later.

“The earlier we detect it, the better results we can get,” says Dr. Brian Zelickson of Zel Skin & Laser Specialists. “And same thing with other types of skin conditions that we see—eczema, psoriasis, acne—that, you know, may not be life threatening, but they’re sometimes much harder to deal with.”

“While the image quality [through telehealth] is pretty good, there’s really nothing like seeing somebody in person.” —Dr. Brian Zelickson, Zel Skin & Laser Specialists

And with masks, constant handwashing, hand sanitizer, stress, and Minnesota’s trademark cold weather, Crutchfield and Zelickson have seen an uptick in skin conditions like eczema and the now infamous maskne—most of which can be diagnosed over telehealth, but Zelickson encourages in-person visits if you’re especially worried or have a history of skin cancer.

“We always think that dermatology is so well suited for it because it’s a visual specialty,” Zelickson says. “But in reality, while the image quality is pretty good, there’s really nothing like seeing somebody in person.”

Zelickson says that a majority of his patients have preferred to come into the clinic since it reopened in June.

To help keep patients safe, clinics like Crutchfield’s and Zelickson’s have implemented new COVID-19 measures: limiting staff numbers, requiring masks, having patients wait for their appointments in their cars, and doing COVID-19 screenings in an effort to slow and prevent COVID-19 cases. Whether it’s in person or over telehealth, it’s important to set up an appointment for any changes in your skin that worry you.

“We saw a lot of people [who] obviously were very nervous about going to do anything and ended up putting off their routine visits or even follow-ups for conditions they had in the past,” says Zelickson. “We know when that happens, things tend not to get better with time—certainly skin cancers don’t.”

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Back & Spine

Pinpointing the Pain: Early Detection = Better Results

Last spring, a patient at Midwest Spine & Brain Institute started having lower back pain. Over a few weeks, the pain radiated down her legs as she walked, exercised, and drove. Troubling, yes, but was it enough to seek help? This was early in the pandemic, and Dr. Todd E. Jackman, an orthopedic spine surgeon at Midwest Spine, says, “She thought about seeing a physician but was nervous to go to the clinic and thought it would work itself out.” But the pain didn’t resolve itself; instead, her body started adjusting, and she developed a limp. After several months, she went in for evaluation, and Jackman discovered a herniated disc in her low back pressing on her nerves. Thankfully, the herniated disc could be fixed with surgery, and her leg is regaining strength and mobility.

This isn’t an isolated case. In the pandemic, health care specialists often see patients who’ve pushed their conditions too far.

“[People] have put their own physical health on the back burner while they manage the stresses of home life, family, business, and so on,” Jackman says. And during the recent spike, “I think some hear the hospitals are ‘nearing capacity’ and feel their situation doesn’t warrant taking a spot at this time.”

Catching nerve, neck, and back issues early is crucial, Jackman says. “Whereas a patient may have come in earlier from a pinched nerve, now they are coming in later, when the nerve function is further damaged and weakness is a concern,” he says. Other benefits of early interception include limited reliance on medications and a potentially shorter timeline to resume regular activity. “Unfortunately,” he continues, “the longer a nerve is pinched and damaged, the lower the chance it completely recovers to normal function after a surgery.”

But not everyone’s back pain necessitates going under the knife. “Surgery is the last resort,” Jackman says. Having your pain diagnosed “allows us to create a plan to start the myriad of nonoperative modalities that can provide significant relief.”

As members of the low back pain club can attest, winter + working from home is no friend to our spines. “Between colder weather, working from home, and shorter hours of sunlight, our energy level decreases, we become more inactive, and our muscles can tighten and atrophy,” Jackman warns.

All that pressure adds up: “It’s usually just the straw that breaks the camel’s back,” says Michele Vincent, faculty clinician and associate professor at Northwestern Health Sciences University. “What is most relevant is that people do the same things over and over, day after day, for eight to 10 hours a day. The lower back gets weakened, and down the road they end up having lower back pain.”

But, spine sufferers, there are at-home options to provide relief and prevent further pain. Vincent recommends stretching your lower back, glutes, and hamstrings for natural relief. Add in a few lifestyle changes like reducing sugar intake—a big culprit for increased inflammation, which can lead to aggravated pain, she says. And to back up your spine, talk to your doctor about taking magnesium, a supplement that supports muscle and nerve function.

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OB-GYN

Pregnant in a Pandemic: What You Need to Know

It’s no surprise that, at the beginning of the pandemic, those who were expecting might’ve had a touch more anxiety than most of us. Dr. Jennifer Smolinski, an OB-GYN at OBGYN West, found out she was pregnant about two weeks before the pandemic began. This put her in a prime position to know what hopes, fears, and questions her patients would have during COVID-19.

“It helps a lot of my patients, seeing me pregnant,” Smolinski says. “They’re coming in like, ‘Oh my God, I found out I’m pregnant.’ They see my 20-week belly, and they’re like, ‘OK, it’s not the end of the world—clearly it’s OK.’”

In the past year, a lot of questions were raised over the potential effects of COVID-19 on pregnant women and their future children.

“I think that the biggest thing is that patients are nervous and they don’t know what to expect,” says Dr. Patricia Harper, an OB-GYN with Allina Health who delivers at The Mother Baby Center at Mercy Hospital. “The more you can provide them with the information of how things have changed and what they can expect, the better.”

One of the most common questions is whether pregnant patients are at higher risk for birth complications. According to recent data the answer is no, Smolinski says.

“There’s a little bit more of a concern because pregnant women are a little bit more of a high-risk population, but overall, most women of reproductive age are pretty healthy, and we’re not seeing bad outcomes.”

A typical pregnancy usually requires a dozen or so appointments. But do all of them need to be in person? According to Smolinski, telehealth can replace some of the visits. With the help of a blood pressure cuff or a scale, you can help provide your doctor with information during virtual checkups. The most important thing is that you check in.

But, of course, new symptoms that can pop up during pregnancy don’t always adhere to your OB-GYN appointment schedule.

“In pregnancy there are things that are very normal, like swelling ... and head- aches—but those also can be signs of high blood pressure, which can be a really serious situation for mom,” Harper says.

“The more you can provide [expectant mothers] with the information of how things have changed and what they can expect, the better." —Dr. Patricia Harper, Allina Health

For a lot of clinics during the pandemic, patients need to attend their appointments solo—or with their partner via FaceTime.

At OBGYN West, spouses are allowed to come in for important appointments like the anatomy scan, the initial scan, and discussing the delivery plan. Patients can have one support person with them during labor and delivery, which many couples have seen a silver lining in.

“I had a lot of patients say, ‘Well this is actually kind of nice, not having my mother- in-law here while I’m pushing,’” Smolinski says. “‘It’s kind of nice just having it be my husband and myself—it’s a more intimate, kind of a quieter, more peaceful delivery.'”

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Dental

Tooth Troubles: Do I Need to Go in for This?

CAVITY: Eventually

Everyone’s cavities are special and unique in their own ways. One person may have a tiny cavity that can wait, but others who wait might need to get a root canal. Only your dentist will know which it is. “Deep cavities can be and often are painless,” says Dr. Amy Hughes, owner of Hughes Dental.

LOSING A CROWN: Yes

Contact your dentist to make an appointment to recement that baby back in place. In the meantime, use dental adhesive (or toothpaste, if you forgot the dental adhesive on your last Target run) to keep it in place.

CAVITY FILLING FELL OUT: Yes

The sooner the better for this type of dental demand. Contact your dentist for an emergency appointment to prevent further damage and any root canals.

TOOTH PAIN: Eventually

Like many of these cases, it depends. Take an over-the-counter pain medication. If that doesn’t alleviate the pain, it’s time to make an appointment.

BROKEN TOOTH: Eventually

First, take a deep breath—it’s fixable. Second, snap a pic for your dentist. Depending on how much damage there is, you might be OK waiting it out. As a temporary measure, grab some orthodontic wax from your local convenience store if the break is sharp. “If there’s no pain–broken teeth are more of a nuisance–we recommend you try putting a temporary material in the broken space that you can get at any Target, CVS, or Walgreens,” Hughes says.

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Orthopedics

Don’t Slip Up This Winter: See a Specialist for Injuries Immediately

There’s nothing like stepping out the door in the morning to find your driveway has been transformed into an ice rink overnight. In addition to the conditions underfoot, your shoulders are hunched and neck tight under heavy winter gear, making it even more likely that, if you take a tumble, something will snap.

Winter is prime time for orthopedic injuries, says Dr. Brian Bjerke, a sports medicine–focused orthopedic surgeon at Twin Cities Orthopedics (bonus points: he’s a team physician for the Vikings).

The most important factor in these injuries is time. Be sure to see a specialist right away, rather than using the wait-and-see method. “Because a lot of injuries are time-sensitive,” Bjerke says, “the prognosis and outcome are going to be better if they’re treated early rather than later.”

Plus, exercise is waning in the pandemic. “Patients that typically have been able to manage arthritis symptoms with regular exercise have not been able to stay as active as they typically are ... leading to increased joint pain,” says Dr. Dane Hansen, arthritis specialist and surgeon leader of arthritis service line at Summit Orthopedics.

This year, injuries aren’t just happening on ice. At-home overload equals more DIY-ing. But when you’re not used to it, home improvement projects can lead to repetitive use injuries in the shoulders, elbows, and wrists, Bjerke says.

“The prognosis and outcome are going to be better if [injuries] are treated early rather than later.” —Dr. Brian Bjerke, Twin Cities Orthopedics

Of course, the ideal is not getting injured in the first place. While avoidance isn’t always possible, here are some tips for build- ing up your bones to help prevent injury.

Get moving. “Bone density and bone health are best maintained by weight-bearing exercises,” Hansen says. “Not necessarily heavy weightlifting, but walking, light strengthening exercises.”

Work up to your workout. For those who’ve been out of the gym or their sport and taking advantage of some rest, jumping right back in could create problems. “A lot of injuries can happen that way if [people] are not going in in shape,” Bjerke says.

Nourish those bones. Calcium and vitamin D are key, since the goal is to maintain the bone structure we developed early on, Hansen says. “Most of us do not build new bone as we age, but it is our job to try to maintain what we have through diet and exercise.” Vitamin D deficiency abounds in northern states (surprise, surprise), and because vit D helps with calcium absorption, it’s a double win for skeletal strength.

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Mental Health 

Coping through COVID: Local Therapists Do the Sharing

What’s the biggest need you’re seeing among patients at this time?

We are seeing fairly high demand for services across several areas, but our adult OCD and our adult depression programs have been particularly busy. Our patients are often struggling with the isolation, fear of contracting COVID, losses, and financial impact of the pandemic. —Rachel Leonard, clinical director, Rogers Behavioral Health

Children and adolescents have lost such a large part of their day-to-day normal interactions. They’re looking to parents, who are similarly in a situation without structure and without precedence. As guidelines and safety measures change week to week, many are losing awareness of their future orientation. A major effort in our clinic is to sustain hope and rebuild lost structures. —Dr. Joshua Stein, clinical director, child and adolescent psychiatrist, PrairieCare

What are the most common things you’re treating right now?

We’re seeing more people with a diagnosis called adjustment disorder. This is a set of mood or behavioral symptoms that are triggered by a life stressor, such as the impact of COVID. Therapy can help people who are struggling with how tough this year has been before their symptoms become more acute and could potentially move into a depressive or anxiety disorder. —Andrea Hutchinson, CARE Counseling

As a whole, we are seeing an influx of severe panic attacks, significant overwhelming anxiety, heightened moodiness, irritability, and emotional extremes that feel difficult to manage. We are noting increased suicidal thoughts and hopelessness, especially in teenagers and young adults who are tired of feeling overwhelmingly anxious or devastatingly depressed. —Anastasia Sullwold Ristau, director of psychotherapeutics, PrairieCare

Have you seen any unexpected positives from patients switching to telehealth?

Therapy is more accessible than ever. We’re finding that with telehealth, it’s easier for people to make it to a therapy appointment since there’s no commute and appointments can often occur at work, home, in your car, or at school. —Andrea Hutchinson, CARE Counseling

We are seeing some people interrupt the substance use process sooner because they have access to telehealth. We have eliminated distance and access barriers for many people, which means we are serving people in an outpatient setting who would not otherwise be engaged in our care. —Cecelia Jayme and Lydia Burr, directors of clinical services, Hazelden Betty Ford Foundation

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This article originally appeared in the February 2021 issue of Mpls.St.Paul Magazine.