Dr. Den Hartog in Haiti
 1/16/2010
 

Article Courtesy of the Rapid City Journal: Posted Jan 16, 2010

“I wish I could do more for them”

What haunts Dr. Bryan Den Hartog's dreams are the sounds made by the people trapped in the collapsed buildings in Port-au-Prince, Haiti. The first two children that his group pulled from the rubble were dead; three more died in his arms.

Dr Bryan Den Hartog of BHOSC treats a child in Haiti. 

"The most heart-wrenching thing for me that I hear just before I go to sleep at night is the cries of the women and children," he said.

After last week's devastating earthquake flattened Haiti's capital, Den Hartog and the other members of a South Dakota mission group tried to help in any way they could. The group wanted to stay, but the possibility of a typhoid outbreak, rioting and dwindling fuel and supplies forced the group's evacuation on Friday.

Luckily unhurt by Tuesday's 7.0 earthquake, the South Dakota group helped treat people who were initially injured by the earthquake.

Yet as the hours drifted by, the dead that were pulled from the rubble of collapsed houses, schools and businesses were left lying on the sidewalks, covered with cloth or pieces of cardboard in the tropical heat.

The Rapid City physician, one of the Mission to Haiti members, said the suffering was immense. "My heart just goes out to them," Den Hartog said.

"You can't see, hear or smell these things without being changed," Den Hartog said.

He had arrived Monday in Port-au-Prince with his two sons, Jordan 23, and Addison, 22, and his father, Gene Den Hartog. He was going to work in an outreach medical program while his family was on a carpentry team putting up a new building in the mission compound.

They had just completed their first day's work when the earthquake struck, shaking several construction workers off their scaffolding and bouncing the medical team around in a bus as they arrived from a field visit.

He said they quickly made sure no one in the group was seriously hurt, beyond some scrapes and bruises. Then they heard the screams and cries coming from women and children in a nearby school, alerting them to its collapse.

"I had three kids die in my arms Tuesday. It's hard to take. I wish we could do more for them -- to have saved them. We were doing what we could with what we had," Den Hartog said.

Dr. Terry Graber, another Rapid City physician who was part of the mission group, worked through Tuesday night after the quake.

"After the earthquake, people from the neighborhood streamed in with various injuries, from scrapes and lacerations, broken bones, open fractures and head injuries," Graber said. "We tried to bring them into the inner part of the compound and do as much first aid as we could."

Carpenters rolled out plastic roofing material to give people a clean place to rest. Several tables were set up for treatment areas and one for a pharmacy. Hundreds came to the mission compound, seeking not only medical aid but security, he said. "There were lights. It was safe," he said.

As the night went on, the more seriously injured arrived. "Nobody had supplies for that kind of patient load," he said.

By the next day, they had 15 seriously injured people, whom they moved to a small Catholic hospital. The mission group had exhausted its medical supplies.

With carnage all around them, group members knew they had to leave the country as a matter of safety.

After contacting the U.S. Embassy, the group eventually made its way Thursday to the city's airport. Its terminal and single landing strip were badly damaged, and the traffic control tower was reduced to rubble. They waited for 12 hours trying to get a commercial flight out before returning to the mission compound.

In the meantime, Mission to Haiti organizers in Florida had contacted the Mississippi National Guard to coordinate supplies and to help their stranded team.

"Our angel in camouflage was Lt. Col. Scott Patterson, who arrived at about 12:30 a.m. Friday and told us to get our bags packed," Den Hartog said.

A C-17 cargo plane had landed with a load of generators, and the guard offered the group a ride home. Patterson escorted the South Dakota group out of Port-au-Prince. They drove directly onto the airport tarmac, where they boarded a plane at 2 a.m. and were airborne in 30 minutes…  

The plane landed at McGuire Air Force Base in Allentown, Pa. From there the group split up, taking commercial flights out of Newark, N.J., and Philadelphia. Den Hartog said many arrived in Rapid City at about 10 p.m. Friday.

"We couldn't save all the lives and care for all the people who needed help, but I feel privileged to have tried," Graber said.

….. for more photos and videos visit   
Rapid City Journal

If people are interested in giving to the relief efforts in Haiti, the two agencies BHOSC is familiar with, and can verify are legitimate, are www.missiontohaiti.org and www.samaritanspurse.org .


 Dr. Den Hartog in Haiti
 1/13/2010
 

Hills area physicians in Haiti scramble to help wounded RCJournal Post January 13, 2010 Dr Bryan den Hartog, along with his father, two sons, and another area physician, Dr. Terry Graber, were part of a medical missions team that arrived in Port-au-Prince 24 hours before it was hit by the 7.0-magnitude quake. (Courtesy photo)

Two Black Hills physicians who arrived in Haiti Monday on an annual mission trip were suddenly thrust into helping victims of a devastating earthquake which has potentially killed tens of thousands.

Dr. Bryan Den Hartog, a Rapid City orthopedic surgeon at Black Hills Orthopedic & Spine Center, and Dr. Terry Graber, a family physician at Custer Regional Hospital, treated trauma patients Wednesday at a hospital in Port-au-Prince, 10 miles from the epicenter of a 7.0-magnitude earthquake that struck this small impoverished island country Tuesday. The quake occurred 6 miles underground and included 10 aftershocks, two of which registered magnitudes of 5.0, according to the U.S. Geological Survey. It is the largest earthquake to strike Haiti in two centuries.

All team members for Mission to Haiti, a Christian ministry headquartered in Sheldon, Iowa, were safe, according to Taylor Den Hartog, who has been in communication with his father and other members of his extended family on the trip. Taylor's brothers, Addison, 22, and Jordan, 23, as well as a cousin and their grandfather, Gene Den Hartog, of Sheldon, are also in Haiti.

"Everybody's safe," Taylor said Wednesday morning.

Addison is using a laptop computer to stay in touch with family in Rapid City through e-mail and Skype, an Internet video chat site. Cell phone communication is impossible because of cell tower damage. Taylor, a senior at Stevens High School, said his brother had difficulty explaining his first earthquake experience.

"My brother said he just about fell over. It took him a while to realize what was going on. He said the whole earth was rocking back and forth and that he could barely stand up straight," he said.

The mission team is staying at a compound about 10 minutes from the Port-au-Prince airport. It was damaged in the earthquake, but no one inside was killed, Taylor said. At least five earthquake victims brought into the compound for medical attention died there.

Originally, the group intended to spend a week in Haiti doing medical work in numerous outlying clinics and building a medical facility inside the compound.

In the aftermath of the earthquake, doctors Den Hartog and Graber transferred earthquake victims to a hospital about 30 minutes away from their compound and spent Wednesday performing emergency surgical procedures there, Taylor said.

Marcia Graber admits she has had conflicting feelings. She wanted her husband to return home to safety but also knew he needed to stay to assist with the extraordinary medical needs the country now faces.

"I'm sure those guys are working as hard as they possibly can to help," she said.

Terry Graber, a veteran of numerous medical mission trips, is on his first trip to Haiti. Den Hartog was making his fifth mission trip to there. The group from his hometown in Iowa travels to Haiti annually.

The government is working to get volunteer missionaries out of the country and replace them with military personnel and professional relief workers. The Rapid City group might have been able to get out of Haiti as early as Wednesday night, if they were able to get transport to the Dominican Republic, where they'll fly to the U.S., Taylor said. Their status was unknown as of news deadline.

Eight people from Hot Springs have been on the island of La Gonave off the coast of Haiti since Jan. 7, as part of another medical missions team. The Dakotas Conference of the United Methodist Church team includes Jan Speirs, Cecile Tays, Dr. Garry Strauser, Jeanne Wyatt, Debbie Okerson, Cathy Nelson, Anne Zwetzig and Paula Hofer, all of Hot Springs. The team felt the earthquake on the island about 50 miles from Port-au-Prince but didn't suffer any injuries, according to a conference spokesman. A spokesman at United Churches in Hot Springs said that as of Wednesday, the team expects to complete its trip as planned and return to South Dakota on Jan. 19, if commercial air travel is restored to Port-au-Prince

If people are interested in giving to the relief efforts in Haiti, the two agencies BHOSC is familiar with, and can verify are legitimate, are www.missiontohaiti.org and www.samaritanspurse.org .




 Letter to patients who have received a total joint replacement (either knee or hip)
 12/3/2009
 

Dear Patient:

Our records indicate that some time in the past, you have received a total joint replacement (either knee or hip) by one of the orthopedic surgeons of Black Hills Orthopedic & Spine Center (BHOSC).  We are sending this letter to update you on recent changes and recommendations from the American Association of Orthopedic Surgery (AAOS) Board of Directors regarding, "Antibiotic Prophylaxis for Dental Procedures for Patients with Total Joint Replacements".  The new recommendations state, "there is now reasonable data to support the belief that bacteriemia from oral procedures may result in total joint infections even several years after surgery".

Because of this new information, our organization recently sent a letter to all of the Western South Dakota dentists as well as the South Dakota Dental Association making them aware of the change in recommendations and the change in BHOSC protocol.

BHOSC orthopedic surgeons now recommend all of their total joint replacement patients need to have antibiotics prophylatically for patients undergoing dental procedures indefinitely".

BHOSC physicians have provided state of the art bone & joint care for both surgical and non-surgical patients for 30 plus years.  Our commitment to our patients and our community necessitates that we provide this follow-up information to assure that you as a patient can benefit from the information that we are currently providing all of our knee and/or hip joint patients.  As you contemplate dental procedures, please contact your personal dentist for his antibiotic recommendations prior to scheduling your dental appointment.

Should you have any questions, please contact your personal dentist.

Thank you for your cooperation.  As always, the physicians and staff at Black Hills Orthopedic & Spine Center are available to provide care for you and your family.  On behalf of our organization, we wish each of  you a very safe and blessed holiday season.

Sincerely,

Black Hills Orthopedic & Spine Center Physicians

 


 Rapid City man still recovering from Falling Rock fall
 11/15/2009
 

Everything Jake Wegner knows about the first two weeks of August he’s learned secondhand.

It was hot on Sunday, Aug. 2, when Wegner and three friends -- Taylor Rave, Justin Butler and Cam Duivbig -- decided to go tubing down Rapid Creek. They drove to the Falling Rock area of Dark Canyon just west of town, parked and started climbing down the steep slopes to the water far below.

That was when Wegner lost his footing. That was when he struck his head on a rock, knocking himself out. That was when he went tumbling down the side of the hill, finally plunging off a 25-foot cliff to the bottom of the canyon, more than 100 feet below where he first slipped.

He doesn’t recall a thing.

“I don’t even remember what I did that weekend,” he said recently.

His friends won’t ever forget it. Rave scrambled down to Wegner’s side while Butler and Duivbig went for help. With no cell phone reception, they had to drive back to town to call 911. (Wegner had wanted to take his car keys, but Butler persuaded him to leave the keys under a rock.)

“He just kind of went head over heels,” Rave said, telling how he was initially afraid he might find Wegner dead at the bottom of the slope. Instead, “When I finally looked over the cliff, I heard him snoring.”

Wegner did talk to him but slipped in and out of consciousness as they waited about 45 minutes for help to arrive, Rave said.

Rescue crews used inner tubes to float Wegner down the creek to a spot where he could be loaded into an ambulance, then taken to Johnson Siding. From there, he was flown by helicopter to Rapid City Regional Hospital.

Read more at the Rapid City Journal ...





 BHOSC Aggressively Pursues New Physicians
 7/31/2009
 

BHOSC is currently seeking to hire three fellowship trained orthopedic surgeons. Specialists in the areas of hand, spine and total joint reconstruction are being recruited with the help of Merritt Hawkins & Associates, a leading national physician recruitment firm based in Dallas, TX.

Business Director, Jim Scherrer reports a growing patient load. “In 2008 we treated in excess of 52,000 patients. Our mission is to provide the highest level of bone and joint care to all surgical and non-surgical patients in this area. We are recruiting highly trained, specialized physicians to meet the needs of our service region.”

Ryan Hopkins, Senior Search Consultant for Merrit Hawkins, anticipates a positive response to BHOSC’s search. “It’s an amazingly skilled and dedicated group, with a state-of-the-art facility, in a beautiful area of the country. BHOSC has an incredibly high standard for patient care, as well as being invested in the community. That’s the kind of practice that attracts quality physicians.”




 Black Hills Orthopedics & Spine Center Selects Sage Intergy EHR to Improve Clinical, Operational and Financial Efficiencies
 5/5/2009
 

TAMPA, Fla., April 6 /PRNewswire/ --Today, Sage announced that Black Hills Orthopedics & Spine Center(BHOSC), a Rapid City, S.D., 15-doctor orthopedics and rheumatology practice, has selected Sage Intergy EHR electronic health records and Sage Intergy practice management solution to improve clinical, financial and operational efficiencies. The practice operates six offices serving residents of Montana, Nebraska, North Dakota, South Dakota and Wyoming.

"The physicians selected Intergy EHR because of its ease of use, robustness and flexibility that will support future expansion," said Jim Scherrer, Pharm.D, business director at BHOSC. "Most importantly, Sage Intergy EHR positions BHOSC to extend its leadership as a center of excellence for surgical and non-surgical bone and joint care in our service area. Physicians and other caregivers will be able to easily access patient records at the point of care and employees will be more productive because they won't have to waste time chasing down paper records."

According to Sharon Howard, senior vice president, sales and marketing for Sage. "We are pleased to partner with one of the leading orthopedic practices in the country. We look forward to helping them realize their clinical, financial and strategic objectives."

To see a demonstration of Sage Intergy EHR, stop by booth 4404 at HIMSS in Chicago.

About Black Hills Orthopedics & Spine Center

Based in Rapid City, S.D., Black Hills Orthopedics & Spine Center (BHOSC) provides a full spectrum of surgical and non-surgical bone and joint care. BHOSC's medical team of 12 orthopedic surgeons, two rheumatologists, a podiatrist, six physician assistants and 10 physical therapists serves residents of Montana, Nebraska, North Dakota, South Dakota and Wyoming. The group practice has six offices and 125 employees.

About Sage Software Healthcare, Inc.

Sage Software Healthcare, Inc., provides integrated electronic health records, EDI applications and practice management systems to thousands of ambulatory care practices throughout North America. These systems enable physicians and practice managers to better manage their practices and improve profitability. Sage Software Healthcare, Inc. is based in Tampa, Fla., and is a division of Sage North America. For more information, please visit www.sagehealth.com or call (877) 932-6301.

About Sage North America

Sage North America is part of The Sage Group plc, a leading global supplier of business management software and services. At Sage, we live and breathe business every day. We are passionate about helping our customers achieve their ambitions. Our range of business software and services is continually evolving as we innovate to answer our customers' needs. Our solutions support accounting, operations, customer relationship management, human resources, time tracking, merchant services and the specialized needs of the construction, distribution, healthcare, manufacturing, nonprofit and real estate industries. Sage North America employs approximately 5,000 people and supports nearly 2.9 million small and medium-size business customers. The Sage Group plc, formed in 1981, was floated on the London Stock Exchange in 1989 and now employs 14,800 people and supports 5.7 million customers worldwide. For more information, please visit the web site at www.sagesoftware.com or call 866-308-2378.

(C) 2009 Sage Software, Inc. All rights reserved. Sage, Sage Software, Sage logos and the Sage product and service names mentioned herein are registered trademarks or trademarks of Sage Software, Inc. or its affiliated entities. All other trademarks are the property of their respective owners.

Website: http://www.bhosc.com/
Website: http://www.sagesoftware.com/
Website: http://www.sagehealth.com/

 


 Fracture Assessment & Prevention Program
 3/1/2009
 

For patients at risk of additional fractures, Black Hills Orthopedic & Spine Center has added a new program called the Fracture Assessment & Prevention Program (FRAPP). Continue reading for more information.

Why did my Doctor refer me to the FRAPP?

Your Doctor has recommended that you consider the Fracture Risk Assessment and Prevention Program (FRAPP). Because of your recent fracture or other bone problems, your Doctor feels you are at an increased risk of having more fractures. By completing this FRAPP referral, you will have a complete assessment of your bone status to determine what can be done to improve your bone health and most importantly REDUCE THE RISK of having new fractures. 

Why does my Doctor think I might have increased fracture risk? 

 A fracture that occurs with only minimal trauma, such as falling from standing height or less, is called a fragility fracture. The occurrence of a fragility fracture is sometimes the first sign of an underlying bone problem such as osteoporosis, or other bone condition. Having one fragility fracture greatly increases the likelihood of more fractures, many of which could be prevented with proper intervention.

Why is it so important to reduce my risk of fractures?

Three words: Cost, Quality, and Life

Treating fractures cost a lot of health care dollars. Just the dollars and cents saved make prevention important. All fractures impact the quality of life. From the simple aggravation of casts and crutches, to the permanent loss of function, quality of life is reduced. Most importantly is the very risk to survival associated with fractures. Medical studies have shown an 18-33 percent risk of death in the first two years following fractures in patients over 70 years old. (1,2,3)

Prevention saves: Dollars, Quality, and Lives. 

What is the FRAPP?

The Fracture Risk Assessment and Prevention Program at BHOSC is conducted by our specialists in bone and joint disease, Rheumatologists Dr. James Engelbrecht, and Dr. Jennifer May, with the assistance of our Rheumatology Nurse Practitioner, Shari Fechner. Your case is reviewed in terms of the circumstances of your fracture, contributing medical conditions, previous bone assessments and treatments, and current bone studies that could include laboratory tests, x-rays, and bone density measurements. The findings will be reviewed with you along with recommendations on how best to reduce the risk of future fractures. A full report of this will also be shared with your primary care or other physician of choice. 

Our Goals for You: 

-Provide a complete and accurate assessment of your bone health and fracture risk.

 

-Prevent further bone loss or the development of osteoporosis.

-If bone conditions such as osteoporosis are identified, provide appropriate treatment recommendations.

-Allow you to maintain mobility, independence, and quality of life with proper bone health.

 

1) Population-Based Study of Survival after Osteoporotic Fractures. C Cooper et al (Mayo Clinic) A Journal of Epidemiology 137: 9, 1001-05 (1993)

2) Excess Mortality Attributable to Hip Fracture in White Women Aged 70 and Older. Magaziner, J et al. Am J Public Health 87: 1630-36 (1997)

3) Mortality Risk Associated with Low-Trauma Osteoporotic Fractures and subsequent Fracture in Men and Women. Bluic et al. JAMA 301: 5, 513-21 (Feb 4, 2009)

 





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Black Hills Orthopedic & Spine Center, P.C.
7220 S. Highway 16
Rapid City, SD 57702
605-341-1414
1-800-446-9556
Fax: 605-341-7062


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