Is it time for joint surgery?

Here’s how to know.

If you’re wondering when (and if) to get hip or knee replacement surgery, you’re not alone. That’s the number one question our doctors at Welia Health hear when a joint starts to influence what someone can do comfortably.

The question’s a good one. There are lot of things you can do before surgery—maybe even to avoid surgery all together. At the same time, wait too long and you might not get the full benefit of a new joint. Gradual inactivity and bone wear can actually make surgery less effective.

The great thing is, the first step is easy: it’s just a conversation.

A chat is a great place to start.

The key to finding the perfect timing for surgery is to talk with an expert. A conversation isn’t a commitment, it’s just an easy way to get peace of mind and have a view of what’s coming.

At Welia Health, you can lean on our doctors to help you find—and plan for—a well-timed joint replacement so you can continue to live life well. (That’s important: it’s about maintaining and extending your quality of life.) Believe it or not, chronic pain, stiffness and lack of mobility isn’t a natural part of aging, so don’t think you just need to tough it out, especially when “toughing it out” can make you miss out on the great things in life.

With knees and hips, there are many great options to get you feeling your best—and we’ll help you discover the plan that’s right for you.

Let’s start with the big picture.

There are a few things Welia Health doctors consider when advising on when to do surgery.

First: “How are you doing?” We really want to know, because well-functioning joints can be at the very center of your quality of life and all the things that make you happy. So tell us.

The challenges with a joint could be something as simple as not being able to get on the floor with grandkids and easily get up again. Do you have pain or stiffness, even while relaxing? Does it take you longer to dress? Or maybe it’s uncomfortable to get in and out of a car. Are you seeing swelling or deformity? Are you feeling a lack of confidence about the joint in question? Sometimes, the pain simply becomes unbearable.

(Yes, there are a million things that could be happening that make you wonder if you might need surgery.)

Then let’s fill in the blanks.

Second, give us a history. How long has your joint been affecting you? A good timeline with specific memories allows us to consider progression. (Pro-tip: keep a notebook handy, and write down when daily activities have been hard, or when your flexibility or pain changes.) Have you tried other things like exercise, massage or medication?

Third, we might take a look at what’s happening within the joint with x-ray or an MRI. We’ll be able to see where there’s degradation and how much. We’ll add in factors like your age and your health, as both give us insight into whether to act sooner or later.

Adding up all the elements, we come to a thoughtful and shared decision on when to act.

Is surgery always the answer?

Surgery isn’t the goal—it’s just one good solution to keep you active. As we consider whether and when surgery is needed, we also explore the non-surgical options that can make a world of difference.

Unless you’ve had previous injury to a joint, exercise, physical therapy and modifying activities are tried and true ways of staying at the top of your game. The simple act of being active can actually reduce pain; in the long winter months, consider Welia Center or Hinckley Fitness Center where we have a walking track, fitness rooms, and wellness education programs.

Strengthening your muscles alone can sometimes relieve the pain you’re feeling, and Welia Health has physical therapists that can put you on a good course. Weight loss can also be helpful if it’s causing joint stress; losing single pound of weight takes 4-5 pounds of pressure off a joint. Joint injections may also provide relief, as well as smart use of anti-inflammatory medications.

Bottom line, Welia Health will help you consider the many good options to keep you up and about.

Finding the moment that’s right for you.

As you might have already guessed, everyone has a different timeline for when surgery is right. If you’re wondering about your own timeline, the key is to ask.

At Welia Health, we are experienced in helping patients find the ideal time for your situation, not to mention having some of the most experienced doctors and leading technology in Minnesota when surgery is the best course forward.

As common as knee and hip replacements are, with over a million surgeries each year according to the National Institutes of Health, finding the ideal window for you can make a big difference. The right timing will let you keep doing those things that bring you joy.

Learn more

Questions about hip or knee replacement? Talk with your primary care provider about joint replacement surgery. Your provider will be able to refer you to Welia Health. Call 320.679.1313 to schedule.

Regenerative medicine procedures

PRP (platelet-rich plasma) treatments

The body has an incredible ability to heal itself. Platelet-rich plasma (PRP) therapy takes advantage of that phenomenon by using the body’s own blood to help accelerate the healing process.

What is PRP?

PRP is a blood product containing an increased concentration of platelets. Blood is made of different cells, including:

• Red blood cells: cells carry oxygen to the body
• White blood cells: cells that fight infection
• Platelets: cells that help blood clot and help the body heal from injury

When an injury occurs, the body responds by starting a healing process to repair the damaged tissue. Blood flows to the injured area and the healing process begins. Platelets that migrate to the site of the injury contain growth factors and proteins that are released that help promote healing.

Advances in medical technology now allow physicians to concentrate the platelets and inject them to the injured or painful area. Rather than injecting medication, or taking a pill, PRP uses the body’s own cells to help promote healing.

How does PRP therapy work?

To prepare PRP, blood is drawn from the patient and then placed in a centrifuge. The centrifuge separates the blood into its individual components. Once the blood is separated, the platelets are removed and injected into the injured or painful structure. An ultrasound machine is often used to ensure the platelets are administered precisely to the appropriate structure. The process takes about 30 minutes and is performed in the office.

Is PRP therapy right for me?

PRP is rarely a first-line treatment for an injury or painful condition and is typically used when other treatments have failed. Most acute and overuse injuries do have the capacity to heal with time, physical therapy, activity modification, etc. PRP has the potential accelerate healing, which is why a lot of professional athletes are incorporating PRP treatments in their recovery plans. The more common use of PRP treatments is for chronic painful conditions that have not improved with other interventions. PRP injections are commonly performed for painful tendons and ligaments but there is increasing evidence that they may reduce pain in arthritic joints as well.

PRP helps promote healing but improvement in symptoms typically takes 6–12 weeks and pain may actually increase for the first 1–2 weeks after the injection. This is a normal response and is part of the inflammatory reaction that helps trigger the healing process. Between 1 to 3 injections may be required and are typically spaced weeks to months apart. PRP is less invasive than surgery and is often used in an effort to avoid surgery, or cases when surgery is not a good option.

Learn more

If you have a painful condition that has not improved with other treatments and time, PRP therapy may be an option. To learn more, or to schedule a consultation, call Welia Health at 1.800.245.5671 or schedule an appointment using MyChart to see our Sports Medicine specialist.

PRP treatments are typically not covered by most private insurance plans. However, health savings accounts (HSA) may be used to pay for the procedure. In addition, workers’ compensation insurance may pay for the procedure. Please check with your health insurance company regarding coverage.

Resources for quitting tobacco

Ready to quit or want more information?

Tobacco cessation services are offered in Mora, Hinckley and Pine City. Call 320.225.3356 with questions or to get started!

In addition to Welia Health’s personalized Quit Tobacco program, tips and online help can be found with these trusted resources.

Quit Partner

Quit Partner helps Minnesota residents quit commercial tobacco, including smoking, vaping and chewing.

Quitlines for tobacco cessation

• Phone > 800.QUIT-NOW (800.784.8669)
• Free 24/7 tools to help you quit your way

• Just for teens, My Life, My Quit
  • Programs focused on teens between the ages of 13–17

• American Indian Quitline
  • A dedicated team of American Indian coaches who understand Indian culture and respect traditions
  • Phone > 1.833.9AI.QUIT (1.833.924.7848)

• Spanish Quitline
  • Phone > 1.855.DEJELO.YA (1.855.335.3569)

Online support for tobacco cessation

• Minnesota Department of Health
• Smokefree.gov
• Options for veterans, women, teens, and 60+

American Lung Association

• Tobacco Quitline
• Phone > 651.227.8014 or 1.800.586.4872

Mayo Clinic Nicotine Dependence Center

• A four-day residential treatment program
• Personalized treatment plan within a safe, tobacco-free environment and group support
• Phone > 507.266.9392

Chantix GetQuit® Support Plan

• Quitting smoking can be a journey – find the support you need
• Phone > 1.877.CHANTIX (1.877.242.6849)

Tips and advice for quitting tobacco

Common questions and quit smoking aids

Welia Health’s Certified Tobacco Cessation Specialist answered the most common questions he gets when helping people quit their tobacco habit- whether it is smoking, vaping, or chewing.

Why is quitting so hard?

Nicotine is the main addictive drug in tobacco that makes quitting so hard, and cigarettes or e-cigarettes are designed to rapidly deliver nicotine to your brain. Once inside your brain, nicotine triggers the release of chemicals that make you feel good. So as the nicotine stimulates parts of your brain over and over, your brain gets used to having the nicotine around. Over time, nicotine changes how your brain works and makes it seem like you need nicotine just to feel okay. When you quit smoking, your brain gets irritable, and as a result, you might feel anxious or upset or have a hard time concentrating or sleeping, have strong urges to smoke or chew, or just generally feel uncomfortable. These feelings are called withdrawal. After a few weeks, while your brain gets used to not having the nicotine around, these feelings will be lessened, and you will tend to feel better.

There are ads everywhere about quitting tobacco using hypnosis. Does it really work?

Sometimes, yes and sometimes, no. While hypnosis can be effective in helping people deal with pain, stress, and anxiety, cognitive behavioral counseling is thought to be the first and best way to quit tobacco. Hypnosis should be used in conjunction with a comprehensive program instead of a stand-alone option. Hypnosis isn’t right for everyone, though, as not everyone may not be able to enter a full state of hypnosis to make it effective. Some therapists believe that the more likely you are to be hypnotized, the more likely it is that you’ll benefit from hypnosis.

What’s the big deal with nicotine gum?

The most common branded nicotine gum, Nicorette® Gum, works by providing nicotine to your body to decrease the withdrawal symptoms experienced when smoking is stopped. It is classified as a smoking cessation medication aid that substitutes the oral activity associated with smoking/vaping to help reduce the urge to smoke. It is one of several methods to deliver nicotine to your brain that is much safer than cigarettes or chewing tobacco. Most people are unaware that the cancer-causing chemical in cigarettes or chewing tobacco is actually not nicotine but rather chemicals included in cigarettes or chewing tobacco.

Are there other quit-smoking aids or over-the-counter (OTC) methods to help quit?

Many nicotine replacement tools, commonly called NRTs, are available OTC. NRTs can effectively reduce the severity of withdrawal symptoms and cravings, so choose what’s right for you! Nicotine withdrawal symptoms begin within a few hours of quitting, peak within a few days, and generally last about four weeks. If you can get past the first week without smoking, you have a greater chance of success! Below are the benefits of using NRTs:

• Gum
  • Relief of oral cravings
  • Flexible dosing to manage withdrawal symptoms
• Lozenges
  • More discreet than gum
  • Flexible dosing to help manage withdrawal symptoms
  • Gives relief of oral cravings
• Patches
  • Use once per day
  • Convenient and discreet

As with any medication, there may be side effects. Speak with your primary care provider or the certified tobacco cessation therapist.

Can my doctor prescribe medication to help me quit?

Several prescriptions are available, the most common include Chantix (varenicline), Zyban and Wellbutrin (bupropion). Prescription costs should be explored with your insurance company. Your primary care provider or pharmacist should discuss potential side effects and precautions.

Hands down, what are your best tips?

1. Try nicotine replacement – nicotine patches, gum, or lozenges.
2. Avoid triggers – coffee, after eating, socially drinking, etc.
3. You might want to avoid social scenes, parties and bars for a while.
4. Have your car cleaned and detailed.
5. Delay –tell yourself to wait just 10 minutes more before lighting that cigarette.
6. Chew on it — give your mouth something to do – try sugarless gum or hard candy or munch on raw carrots, nuts, or sunflower seeds.
7. Get physical – go for a walk or bike ride. Even a short walk can distract you from tobacco cravings.
8. Try relaxation techniques. Tobacco may have been your way to deal with stress. Try learning a new technique like deep breathing, muscle relaxation, yoga, massage, visualization, or listening to calming music.
9. Call for reinforcements–connect with a friend or family member, or seek counseling. Check the resources page for support, which is available 24/7.
10. Go online for support– online stop-smoking group, subscribe to a quitter’s blog and post encouraging thoughts for someone else who might be dealing with tobacco cravings.
11. Remind yourself of the benefits of quitting – getting healthier, feeling better, saving money, and sparing your loved ones from secondhand smoke.

Ready to quit or want more information?

Tobacco cessation services are offered in Mora, Hinckley and Pine City. Call 320.225.3356 with questions or to get started!

Benefits of quitting tobacco

A timeline about what happens when you quit smoking

Your overall health will begin to improve about 20 minutes after you decide to quit, whether you smoke, chew or vape.

Pregnancy and quitting tobacco

If you are pregnant or planning to become pregnant, quitting smoking or vaping will help your baby:

• Grow, your baby may be smaller due to the decreased oxygen
• Reduce the chances of premature delivery
• Have a smaller chance of dying because of SIDS (Sudden infant death syndrome)
• Have a lower chance of being miscarried or stillborn
• Lessen the chances that smoking will cause lifelong learning problems

Cigarettes increase carbon monoxide in the fetus, which then causes decreased oxygen to the growing baby. Explore more online resources about quitting smoking during pregnancy.

Overall health benefits of quitting tobacco

Making the decision to quit tobacco, you can experience the following:

• Lowered chances of getting heart disease, cancer and lung problems
• Have improved blood flow
• Normalized temperature of your hands and feet
• Have a normal level of oxygen in your blood
• Be able to smell and taste food better
• Reduced coughing
• Fewer wrinkles
• Save a lot of money
  • According to World Population Review, the average cost of a pack of cigarettes in the United States is $8.00 in 2022. The American Lung Association has calculated that the average daily smoker smokes 15 cigarettes a day, adding to about $6 a day, or $2,190 per year.

Ready to quit or want more information?

Tobacco cessation services are offered in Mora, Hinckley and Pine City. Call 320.225.3356 with questions or to get started!

Smoking, vaping and tobacco

You can quit!

You know already that using tobacco is bad for your health. Whether you smoke, vape, or chew tobacco and have been thinking about quitting, Welia Health is here to help. The benefits of quitting are incredible and can be experienced almost immediately.

Welia Health has a personalized plan that uses a Certified Tobacco Treatment Therapist to provide tips and advice, ongoing support, and some incentives to people who follow through with our recommendations. In addition to Welia Health’s program, additional tobacco cessation resources, including quit-smoking apps and online programs, can help.

Tobacco cessation services are offered in Mora, Hinckley and Pine City. Call 320.225.3356 with questions or to get started!

Helping you quit—for good!

Medicare wellness visits

Scheduling an annual Medicare wellness visit is part of your Medicare Part B insurance benefit. This no-cost* annual visit is an important step to help you focus on managing your overall health and prevent disease while providing a valuable opportunity to talk to your provider about your overall wellness.

Your annual wellness visit

Your annual Medicare wellness visit includes the following:

• Complete review of medical history
• Medication review, please bring all prescribed medications and supplements with you to your appointment
• Health risk assessment (a questionnaire used to measure your healthy habits and risk of potential diseases)
• Measurement of your current height, weight, blood pressure, and BMI (body mass index)
• Depression and/or other mood disorder screening
• Review of cognitive and functional abilities, including any fall risks, hearing impairment and overall home safety
• Checklist for the next 5-10 years
• Appropriate referrals for health education, counseling or other services
• Advanced care planning
• Immunizations

Medicare Part B visits

Your Medicare Part B (medical insurance) covers these visits:

• Welcome to Medicare preventive visit This is a one-time visit, completed within your initial 12 months of Medicare Part B coverage.

• First annual wellness visit A one-time visit, at least 12 months after your “Welcome to Medicare preventive visit” is complete.

• Medicare Wellness visit Ongoing annual visits, at least 12 months apart from a prior wellness visit. Exclusively for women, breast and pelvic exams are covered every other year.

* If you find that you are in need of additional medical tests and services, you can schedule additional time with your provider to discuss any new or existing health concerns. There will be additional costs associated (including co-insurance and or deductibles) charged to your insurance.

Additional details can be found at Medicare.gov or call 1.800.MEDICARE (1.800.633.4227). View a copy of CMS’s 2020 annual wellness visit guide.

Appointments are available in Mora, Hinckley and Pine City. Call Welia Health at 1.800.245.5671 or schedule an appointment using MyChart.

Paced bottle feeding

Paced bottle feeding is a way to feed a baby by slowing the flow of milk, giving the baby more control over how fast they eat and preventing unnecessary discomfort and overfeeding.

Helpful hints for paced bottle feeding

• After preparing the baby’s bottle, hold the baby either upright or in the side-lying position.
• Before placing the nipple from the bottle into the baby’s mouth, tilt the bottle downward / toward the floor, so there is no milk in the nipple.
• Allow the baby to suck on the empty nipple.
• Sucking on an empty nipple mimics breastfeeding, as the baby needs to suck before the milk flows.
• Tilt the bottle horizontally so the milk fills the nipple approximately halfway and encourage the baby to suck instead of gulp.
• Gulping can occur when the nipple is too full of milk.

• Generally, babies take breaks while feeding. When this happens, tilt the bottle downward while keeping the empty nipple in the baby’s mouth.
• When the baby begins to suck again, tilt the bottle horizontally, remembering only to fill the nipple halfway. Repeat this until the baby is no longer interested in eating and does not suck on the empty nipple.
• Remember to burp your baby periodically during feeding.

Watch a helpful video demonstrating paced bottle feeding for both bottle and breastfed babies.

Questions?

Call Welia Health’s Lactation Helpline at 320.225.3525.

References

Paced Bottle Feeding: Infant Feeding Series, Minnesota Department of Health

Lactation support

Expertise in successful breastfeeding

Welia Health offers new and experienced mothers breastfeeding advice and education

Our team of certified lactation counselors (CLC) is available to support women with breastfeeding advice and education. Lactation support may include:

• Correct positioning and latch
• Management of sore nipples
• Milk supply concerns
• Plugged duct and mastitis
• Pumping and storing breast milk
• Returning to work while breastfeeding
• Taking medications while breastfeeding
• Addressing individual questions and concerns

When to see your lactation counselor

• Prenatal lactation education
• Postpartum lactation education
• Weight checks

Appointments are available Monday–Friday at our Mora Clinic. Call Welia Health at 320.679.1313 to schedule an appointment.

Questions?

Please call Welia Health’s Lactation Helpline at 320.225.3525.