Editors Note: Emily Schouten is the Laboratory Director at Woodlawn Hospital.

Did you ever wonder what happens to your blood sample after you leave the lab? I recently asked my teenagers what they thought happened to samples in a lab and my daughter asked, “Do you have vampires in the lab?” Fortunately, we do not have any vampires in the lab. We do have staff who want to give the best possible care to our patients.

What happens to a blood sample in the lab after a phlebotomist draws your blood?

At Woodlawn Hospital, a blood sample’s first stop is in the Chemistry department. A lab technologist, who has extensive training, reviews the doctor’s order to make sure the correct samples are collected by the phlebotomist. Next, the sample is processed so that it is ready to be tested on one of the many machines in the lab, called an analyzer. There are many analyzers with cutting edge technology in the lab and each analyzer tests for very specific items in your blood. Some analyzers measure material in your blood such as glucose or cholesterol. Other analyzers count the red blood cells that carry oxygen and the white blood cells that fight infections.

Not every blood sample is tested on an analyzer. Many samples are handled by the lab technologists, stained with special dyes, and looked at under a microscope to help identify unusual cells in the blood or bacteria growing inside the body. A lab technologist is trained to identify common problems such as bacteria from a person with a urinary tract infection to unusual parasites like malaria.

Woodlawn Hospital has a microbiology department on site inside the lab. Microbiology is a specialized department where samples from the human body are placed in petri dishes to grow the bacteria that are causing infections. Once the bacteria grow, the lab technologist places the bacteria in an analyzer that can determine which antibiotic is best to treat the infection.

Most lab tests are completed on the same day they are collected. All results are reviewed by the lab technologists before the report is sent to your doctor. Sometimes there are tests that are not finished at Woodlawn Hospital. These tests are sent to a reference lab for more testing.

The next time you are in the lab at Woodlawn Hospital ask the phlebotomist about what happens to your blood sample, but please do not expect to find any vampires.

Today, I want to talk about hearing aids. Have you ever heard of someone wearing a little device in their ear to help them hear better? That's a hearing aid! But did you know there are two different types of hearing aids? Yes, that's right! There are Over The Counter (OTC) hearing aids and Prescription hearing aids.

But what’s the differences???

Let's start with OTC hearing aids. OTC hearing aids are the type of hearing aids you can buy without a prescription from a doctor or a hearing specialist. They are usually a little less expensive and easier to get because you don't need to go to the doctor first. Just like you can buy glasses without a prescription, you can buy OTC hearing aids without one too.

Now, let's talk about Prescription hearing aids. These are the type of hearing aids that you need a prescription from a doctor or a hearing specialist to buy. This is because prescription hearing aids are more powerful and can help with more serious hearing problems. They are also custom-fit and programmed to your ear and your specific prescription of hearing loss, so they are more comfortable and work better for you.

So, what are the differences between OTC and Prescription hearing aids? Well, for starters, OTC hearing aids are designed for someone with a ‘perceived’ mild to moderate hearing loss and are less powerful than prescription hearing aids. They are also a little less expensive and don't need a prescription, which is why some people choose them. But, if you have a more serious hearing problem, struggle to understand in group settings and in background noise, than an OTC hearing aid might not be strong enough to help you hear properly. That's why prescription hearing aids are a better choice in that case.

Another difference is the level of customization. OTC hearing aids are not customized to your ear or your specific type and degree of hearing loss. They come in different sizes, but they might not fit your ear perfectly. This can make them uncomfortable to wear, and they might not work as well as they should. There is also no state mandated return period and you have no one to help you when you have trouble. On the other hand, prescription hearing aids are custom-fit to your ear and custom programmed to your individual needs. This means they are made to fit your ear perfectly and are much more comfortable to wear.

Prescription hearing aids also have more features and settings than OTC hearing aids. This allows you to adjust the hearing aid to your specific needs. For example, if you have trouble hearing in noisy places, a prescription hearing aid can be set to help you hear better in those situations. OTC hearing aids don't have these extra features and settings.

Another important difference is the level of support you receive. When you buy an OTC hearing aid, you are basically on your own. If you have trouble using it or if it's not working properly, you may not be able to get the help you need. On the other hand, if you buy a prescription hearing aid, you will have the support of a hearing specialist. They can help you adjust the hearing aid and make sure it's working properly. They can also help you if you have any questions or concerns. Many people are unaware that hearing aids need to be maintained since they are exposed to the elements and to heat, perspiration, dirt, dust and cold. Having your hearing aids cleaned and professionally serviced on a regular basis ensures not only that they are working properly but also helps to extend the longevity and life of the hearing aids. The average life of a hearing aid ranges between 5-7 years, when properly cared for and maintained.

So, which one is better? It really depends on your specific needs. If you have a mild hearing problem and just need a little extra help, an OTC hearing aid might be a good choice. But, if you have a more serious hearing problem, a prescription hearing aid is probably a better choice. It's more powerful, custom-fit to your ear, and comes with the support of a hearing specialist.

In conclusion, there are two types of hearing aids: OTC hearing aids and Prescription hearing aids. OTC hearing aids may be a little less expensive and easier to get, but they are less powerful and not custom-fit to your ear. Prescription hearing aids are more powerful, custom-fit to your ear, and come with the support of a hearing specialist. Which one is better for you depends on your specific needs, so it's important to talk to a doctor or hearing specialist to determine what type of hearing aid would be best for you.

Remember, taking care of your hearing is important. If you have trouble hearing, don't ignore it! Talk to a doctor or hearing specialist to find out if a hearing aid could help you. With the right hearing aid, you can enjoy all the sounds of the world again!

In summary, the differences between OTC and Prescription hearing aids are:

1.    Power: Prescription hearing aids are more powerful than OTC hearing aids.

2.    Customization: Prescription hearing aids are custom-fit to your ear, while OTC hearing aids are not.

3.    Features: Prescription hearing aids have more features and settings than OTC hearing aids.

4.    Support: When you buy a prescription hearing aid, you have the support of a hearing specialist.

If you or someone you know has trouble hearing, don't hesitate to talk to a doctor or hearing specialist. With the right hearing aid, you can enjoy all the sounds of the world again!

Editor’s Note: Ginger Richard is a Nurse Practitioner for Woodlawn Hospital at the Shafer Medical Clinic. She is accepting new patients and you can schedule an appointment with her at 574-223-9525.

Depression is a common emotion that, at one time or another, we have all felt. Sometimes the stigma of admitting one's concerns or feelings keeps us from speaking up. Rest assured that depression is the most common mood disorder causing disability in the United States and throughout the world. When depression is left untreated, an individual is at risk of developing other conditions such as cardiovascular disease, obesity, thyroid disease, and diabetes. Depression is characterized by persistent feelings of despair and sadness, and it can lead to a loss of interest in previously pleasurable activities as well as a loss of interest in relationships.

The following are some signs and symptoms of depression:

• Feeling sad or anxious frequently or all of the time

• Not wanting to do activities that used to be fun

• feeling irritable, easily frustrated, or restless

• Having difficulty falling or staying asleep?

• Waking up too early or sleeping too much

• Eating more or less than usual, or having no appetite

• Experiencing aches, pains, headaches, or stomach problems that do not improve with treatment

• Having trouble concentrating, remembering details, or making decisions • feeling tired, even after sleeping well.

• Feeling guilty, worthless, or helpless • Thinking about suicide or hurting yourself

When any of these symptoms last over a period of time, one needs to seek help from a medical provider as they can interfere with one’s quality of life. Depression can be caused by a variety of factors, including a life stressor, trauma, the death of a loved one, suffering relatives, or financial stress. While no one person handles depression alike, there are different therapies to help cope with it. The first step is to seek help in dealing with the issue at hand. Therapy or counseling can often help sort through the thoughts and feelings one is experiencing in their life. Counseling helps with behavioral change and finding solutions to the issues at hand.

To help improve coping skills and mood, antidepressants and other medications can be started. There are many different drug classes available for your provider to try in treatment. While taking these medications, it’s important for the patient to know they may not feel the benefit in a few days and that it takes up to four weeks for the full effects.

The most important thing is to realize you are not alone, and resources are available to help. Contact your primary care provider, as they can perform a depression screening to determine if you fit the diagnosis of depression.

With my 44-year association with South Dakota, I have gotten to observe the many differences in species from that part of the country to ours. The Dakotas are part of the Great Plains, an area once covered by prairie grasses and not trees. That is by far the most noticeable difference, but when you start to dig a little deeper the less conspicuous non-Indiana plants such as crested wheatgrass, lead plant, buck brush, and sage fill the prairie.

The wildlife variations are even more unique. Yes, they do have cotton-tail rabbits but they also have jackrabbits. In fact, the South Dakota State University mascot is a jackrabbit. Their main rival South Dakota University has a coyote as their mascot. An animal that I can hear announcing their presence, nightly, around my Indiana house.

That area of the country is well known for its rattlesnakes. Back when I was in college in South Dakota, I had just finished watching a parade when I was invited into a downstairs apartment by some guys I knew. They were talking about their rattlesnake adventures and said they had some snakes. Fully expecting something fake to jump out at me, they dumped a burlap sack with five rattlesnakes into a big garbage can. They were not fake. Consequently, I didn’t stay long.

One animal I guess I can't say I have run into is the porcupine. I never recall seeing one but the tire sidewalls of a relative's car were filled with quills. I always wondered if that was a near miss or the animal's last desperate act. 

Desperate would describe my wife’s sister's dog that had 5 quills stuck in its nose. It had gotten too close to a porcupine and suffered the consequences. This dog was very people shy so it took a while to catch it. After suffering for the better part of a day, it was finally caught and I had to use a pair of plyers for plucking the quills from its nose. The dog did not like the process but was greatly relieved in the end.

Wild turkeys are now a part of our agriculture landscape in Indiana after being missing since around the year 1900. According to the Indiana Department of Natural Resources, between 1956 and 2004, wild trapped birds were released around the state. Wild turkeys are now found in all 92 counties. Spring density over most of Indiana ranges from 1 to 14 birds per square mile, with an average of 4 birds per square mile in recent years.

Walking one cold frosty winter morning near the Dakota cattle feed yard, I spied several turkeys roosting in a tree. I took their picture and years later in a conversation with a wildlife specialist, I mentioned seeing these turkeys. After looking at the picture, I was told they were not the eastern wild turkey historically found in Indiana but another closely related species, the Merriam turkey.

Probably the most despised species by ranchers is the prairie dog. Prairie dogs are stocky burrowing rodents that live in colonies called “towns.” French explorers called them “little dogs” because of the barking noise they make.

Prairie dogs are social animals that live in towns of up to 1,000 acres with 30 to 50 burrow entrances per acre. They primarily eat grass and can lay the ground bare within their towns.

Because of their unwantedness, most ranchers are receptive to out-of-state prairie dog hunters that frequent the area. One of the reasons for their disdain comes from the potential of a horse stepping in a hole and breaking a leg.

Prairie dogs have flea problems. Last summer I lay down on the grass in an area of prairie dogs. Several days later I came up with multiple flea bites on my torso.

Prairie dogs are susceptible to a disease caused by the bacterium Yersinia pestis. You may know it better by the name, Black Plague. I can say that I am lucky that the town did not have disease issues, but their fleas knew how to bite. Luckily, my grave marker will not say “Done in by the bubonic plaque.”

Mark Kepler

Purdue Extension Educator, ANR

Fulton County

The Merriam turkeys roosting in trees overlooking a feedlot in South Dakota.

Photo provided by Mark Kepler

Where’s the Beef Cows

The big news in the cattle production world is that cow numbers are at the lowest in this country since 1962. At first glance, that sure is amazing since the United States human population was 184 million in that year and today it is 334 million.

One would expect that with those huge increases in the human population and a cut in the number of cows that beef consumption would also be drastically cut. In 1962 the average consumption of beef per person/year was 62 pounds. In 2022, the average beef consumption was 55 pounds. A definite drop but nothing like the number of cows.

How could that be true?

For me, 1962 is only a few memories away. It would have been in 1965 that I would have shown at my first county fair. I remember those beef steers of that era. Even though I was small and they were big, they were nothing like the steers of today. Steer carcass weights increased from 656 pounds in 1960 to 907 pounds in 2020, an average increase of 4.2 pounds per year. Today’s cow produces much more beef.

Our cows have also gotten better reproductive efficacy. I read in a journal article that comparing numbers from 1977 to 2007, the same amount of beef is produced with 69.9% of the animals, 81.4% of the feed, 87.9% of water, and 67.0% of land in the US. These numbers tout that today’s beef producers are utilizing our environmental resources better.

Even though we have become more efficient, one of the big reasons for the reduced number of cows is the western drought. The persistence of this dry weather will carry even more cows to the market next year and will also result in a few heifers retained for reproduction.

All this has led to some of the highest beef prices in the past few years. It is ironic that these western cattle producers have an opportunity to make more money but the weather is just not cooperating. Welcome to agriculture.

Mark Kepler

Purdue Extension Educator, ANR

Fulton County

When Heather Bartrum was a student at Ivy Tech Kokomo, the professor leading the Surgical Technology program knew she had a lot of potential.

“Heather was a great student,” says program chair Jia Hardimon-Eddington. “She jumped right in. She worked hard. She helped other students and she contributed to everyone’s success. I knew she would be a great ‘surg tech’ and I’m so proud of all she is doing.”

Today, nearly 11 years after graduation and certification, Bartrum does work full-time as a surgical technologist, serving as “private scrub” for Dr. Thomas Reilly, an orthopedic surgeon in Kokomo who specializes in the care of patients with spinal and nerve disorders of the neck and back, and working at the Indiana Spine Group in Carmel. It’s a job she loves … but not one she ever thought about before a life-changing mid-life accident and a spiritual “battle” that led her to Ivy Tech Community College.

Bartrum was born and raised in Howard County. After graduating from Western High School in 1992, she attended Indiana University Kokomo for a year before going to work, first as an “eye tech” at New Vision Optical and then as a teller at First National Bank. Marriage came in 1996; a daughter arrived in 1997 and a son followed in 2000. She was a full-time mom, later working part-time at Northwestern Schools when the youngest went to kindergarten.

Then, in 2008, came that life-changing accident. While washing her dad’s pick-up truck, she fell from the back and shattered her leg. “Surgery … and three months, no weight bearing. It was a humbling experience,” Heather remembers. “That’s when God first spoke to me. He told me to go into surgery. I was called to help other people going into surgery.”

Bartrum says she fought the idea for months, but, she adds with a smile, God eventually won and her faith took her forward. She had been out of high school for more than 15 years; she says she didn’t think she was smart enough. She knew nothing about surgical technology or what it entailed, but she came to Ivy Tech to see what was available and was soon enrolled in the pre-requisite courses for the program.

“The professors were all phenomenal,” she said, remembering among others a great math teacher and her English professor, Ethan Heicher, who is now Ivy Tech Kokomo’s chancellor. “I wasn’t just a number in the class. The professors helped me. I got into some great study groups.”

With her pre-reqs achieved, Bartrum was admitted into the surg tech program, then located in one room in the Inventrek building on East Firmin Street. She recently visited Ivy Tech’s new Surgical Technology laboratory in the Health Professions Center on the transformed campus at 1815 E. Morgan St. and talked about her very different experience.

“Oh, my gosh, it would be awesome to go through the program as a student in this new facility,” Bartrum said. “They get so much more hands-on experience. We had a big classroom but the lab was very small, just one bed to practice on …” The new Surg Tech lab includes four surgical suites fully outfitted in current technology that offer training opportunities to the same number of students that were in Heather’s class.

“Jia helped me a lot,” Bartrum said. “When I started, I didn’t do very well testing. Jia would go over the tests with me afterwards. I could answer the questions when talking to her and she helped me figure out what I needed to do to capture the correct answers on the tests.” She also credits the partnerships Ivy Tech has with local medical facilities to offer clinical rotations and internships, particularly citing Joyce Hughes, now retired, who, as Heather’s preceptor at Dukes Memorial Hospital, provided great experience.

Bartrum graduated from the program in 2012, 20 years after graduating from high school, earning an Associate of Applied Science degree in Surgical Technology and passing her certification exam on the first try. She was hired as a certified surgical technologist at St. Joseph Hospital and within six weeks was working with Dr. Reilly.

Bartrum offers two pieces of advice to those who follow her. First, always verify the sizes and dates of equipment and material used in the operating room; don’t rely on others. Second, “if you ever mess up, don’t beat yourself up. Write it up, think about how you can do it better and then don’t ever do that again.”

She encourages others to follow their dreams. “By the grace of God, a lot of studying and determination, and pushing yourself, you can do it,” she says. In addition to her “day job,” Bartrum works with her father raising cattle and has been involved with 4-H in Howard and Carroll counties.

“I just love my job. I feel like I’m doing something not just for the person going into surgery but also for my community,” Bartrum adds.  “As I’ve told my kids, a job is something you get and have to go to. A career is something you don’t mind getting up and going to every day, something you enjoy and that is fulfilling to you. I love my job and I don’t regret anything. There are days that are hard, that you’re tired and worn out and your body hurts. But I am blessed.”

About Ivy Tech Community College

Ivy Tech Community College is Indiana’s largest public postsecondary institution and the nation’s largest singly accredited statewide community college system, accredited by the Higher Learning Commission. Ivy Tech has campuses throughout Indiana and also serves thousands of students annually online. It serves as the state’s engine of workforce development, offering associate degrees, short-term certificate programs, industry certifications, and training that aligns to the needs of the community. The College provides seamless transfer to other colleges and universities in Indiana, as well as out of state, for a more affordable route to a bachelor’s degree. Follow Ivy Tech on Facebook, Twitter, Instagram, and LinkedIn for the most up-to-date information.

Ivy Tech Community College Kokomo Service Area serves Cass, Fulton, Howard, Miami, Pulaski and Tipton counties, including the communities of Kokomo, Logansport, Peru, Rochester, Tipton and Winamac.

Heather Bartrum couldn’t help being a little jealous of current students during recent visit to Ivy Tech Kokomo’s new Surg Tech classroom and lab

Surg Tech program chair Jia Hardimon-Eddington shows off new surgical suite to alumna Heather Bartrum

Jia Hardimon-Eddington and Heather Bartrum shared memories and perspectives during Heather’s recent visit to the new home of Ivy Tech Kokomo’s Surgical Technology Program

Winter with Cattle

On Saturday, February 4^th,2023, the record for the lowest recorded wind chill in the United States was set at Mt. Washington in New Hampshire at minus 108° F. I do not know what my personal record is for the lowest wind chill I have experienced but I do remember December 23, 1983, in Little Eagle South Dakota.

That day it was 20 below and winds up to 40 MPH and I found myself helping unroll large round hay bales for cattle on the prairies of South Dakota. We were in and out of warm trucks while those cows did not have that luxury.

A healthy beef animal in winter with a full coat of hair and no wind, rain, or mud on them is comfortable down to around 18 degrees. If they are being fed an adequate diet with hay and other fiber sources, their big old stomach, called a rumen, will be producing a lot of body-warming fermented heat.

When brutal cold conditions happen, cattle will escape the wind by standing in the draw between hills. When arriving with a large round bale of feed on a sunny day, it was difficult to lure those sunning black-haired animals out to the feed.

The Dakotas are no strangers to the cold. Back in the harsh winter of 1886-87, the great cattle barons including Teddy Roosevelt suffered pronounced losses that ended their investment in the Dakotas. Teddy did not know of the loss until he showed up the following spring to find half of his herd dead.

The turn them out and let them roam way of ranching is long gone. When winter comes the ranchers pick specific pastures for their cattle, with adequate areas to escape the wind. Teddy’s method is replaced by winter feeding and moving cattle to areas where they can be better sheltered from the elements. In those temperatures, more hay bales need to be fed to meet the energy needs of the animals.

With the current drought situation in much of the west, large amounts of money were spent purchasing hay this year in anticipation of the cows' winter energy needs.

What I find amazing is the insulating ability of the cow. Many times, cattle will have snow on their backs. The thicker the hair coat and variations in, age, size, wind speed, and numerous other factors will affect their ability to insulate. Cattle with a wet hair coat, regardless of how heavy it is, will have a lower critical temperature of around 59 degrees because the hair coats lose their insulation ability when wet.

Chopping ice is a daily ritual. Cattle in that area are watered out of dams. Cutting through a foot of ice with an axe in multiple locations allows the cattle a chance to have a good long drink before the ice freezes over again. From one day to the next, 10-12 inches of ice can refreeze in the previous day's ice hole. Wheeling an axe in those temperatures can help to warm a person up but at the same time, breathing in that cold air will frost the nose hairs.

I was better equipped to perform that task 39 years ago than I am today. But there are cattle still there and I am sure that this morning my brother-in-law could still be found chopping away. A memory for me, daily winter life for him.

Mark Kepler

Purdue Extension Educator, ANR

Fulton County

****photo provided by Mark Kepler****

Caption for photo:

Hay bales purchased to maintain cow health through the potentially cold South Dakota Winter.

Wild Ideas

 Did you ever have a wild idea? Now some people have wild ideas, others have them and actually act on them. There is really no definition for the term, but I suspect the thought of a light bulb was considered a wild idea at one time. Even the ancient thought of the world being flat was gradually disproven starting in the 4th century BC with the wild ideas of Plato. By the time Christopher Columbus sailed the ocean blue in 1492, most scholars maintained that the Earth was a big ball.

In agriculture, there have been a few wild ideas, I will go back to my youth when I was subjected to one, not of my own doing. Mowing hay is normally done by one of two methods. One most prevalent today is a series of rotating horizontal knives slicing the crop off a few inches above the ground in a system called a disc mower.

 Traditionally, the other was the one-long-piece cycle bar mower where jagged cutters remove the plant from just above the ground in one single stem piece. That is what we had on the back of the International H tractor. It laid the cutoff plant on the ground to dry. We then raked it several days later and baled it the same day. Our baler was one that produced what is today referred to as small square bales. An Allis Chalmers WD-45 tractor pulling an International baler followed by a flat rack wagon with generally two people stacking was our setup. I was always one of those stackers doing the manual labor behind the baler.

We had a neighbor that used a third type of mower called a flail chopper. It is a vertical mower that has chains that hang down with knives on the end. When it cuts off a plant it throws it into the air and can cut it multiple times before it hits the ground. Rather than a single stem it slightly pulverized the crop.

Red clover is an excellent Northern Indiana forage crop we have been planting on our farm for many generations. It can be a little fine and what we refer to as dusty. I still have an item called a clover seed buncher that farmers of the past would use to collect clover hay, mowed down by one of the cycle bar mowers, gathered, and threshed for the clover seed that farmer would then plant for another hay crop or sell to a neighbor. 

Clover hay is great feed for cattle, sheep, and goats. It is easy to grow, but it only lasts for two years (some seeds now three) before it has to be replanted. It adds nitrogen to the soil, and this makes it perfect to rotate with corn. A very win-win situation. 

Flail chopping clover, as my neighbor did, was a win-lose battle that I can still vividly recall 55 years later when I was on that wagon baling on a windy day. It was easy for the neighbor to cut, but I was the looser as my eyes were just full of dusty, aggravating, itchy clover. 

For me, one of the most physically taxing jobs on the farm was picking rock. I could have easily left that wagon and gladly hitched up the stone boat. Whoever it was that had the wild idea of flail-chopping clover needed to have found himself on that wagon. We could have put a stop to that notion. That is one idea that never needs repeating

That is unless I wish to not suffer alone, and facetiously, start the Clover Flailing Society that promotes clover mutilation. I can be like the Flat Earth Society, which really does exist today. I just hope I don't go over the edge.

Mark Kepler

Purdue Extension Educator, ANR

Fulton County