Sunday, February 15, 2026
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“Joint replacement surgery: an individualized decision”

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As a general internist who does primary care for adult and elderly patients, I talk to patients a lot about arthritis and joint replacement surgery. This type of surgery, also known as arthroplasty, is one of the most common types of elective surgery done in the United States. Knees, hips, and shoulders are the most frequently done arthroplasties, and most of those surgeries are done for severe osteoarthritis.

Osteoarthritis, the most common type of arthritis, is due to wear-and-tear of the joint, and becomes very common as we age. It often can cause debilitating pain and difficulty with function which, for some patients, warrants the intervention of surgery.

My patients often want to know when it is the right time for a joint replacement. Well, no x-ray or diagnostic test can tell us that. The decision to go ahead with arthroplasty is very much individualized to the patient. How severe are their symptoms? How risky is surgery for this particular patient? How much quality of life do they stand to gain from a successful arthroplasty?

While the orthopedic surgeon is the expert who patients should trust in talking about the risks and benefits of surgery itself, sometimes as a primary care provider who knows intricately my patient’s medical history, general day-to-day life, and feelings about medical and surgical interventions, I can be helpful in guiding my patients facing this decision. Often I help nudge the reluctant patient who is suffering from severe arthritis toward choosing a surgery very likely to improve their quality of life. Rarely, I might help a patient with less to gain from a surgery reconsider its risk to benefit profile.

A couple years ago I surprised myself by encouraging my patient, then 95, to consider hip replacement surgery. I never thought I would urge a patient in their 90’s to undergo elective surgery, but this particular patient was in excellent health and rendered unable to continue his beloved daily exercise because of his hip arthritis. The inability to exercise, for him, was a major problem for quality of life. He got his hip arthroplasty and enjoyed a couple more active years before his recent death.

So, if you are wondering whether you should go ahead with replacing that bothersome arthritic joint, there is no perfect formula that applies to everyone. But a primary care provider who knows you well can sure assist you in making the best decision for yourself.

Kelly Evans-Hullinger, M.D. is part of The Prairie Doc® team of physicians and currently practices internal medicine in Brookings, South Dakota. Follow The Prairie Doc® at www.prairiedoc.org and on Facebook featuring On Call with the Prairie Doc® a medical Q&A show providing health information based on science, built on trust, streaming live on Facebook most Thursdays at 7 p.m. central

Learn and grow something new in the plant world!

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Learn and grow something new in the plant world! Here is your chance! We are conducting a Mushroom Cultivation Workshop where you will discover easy, low-cost methods for growing delicious gourmet mushrooms such as shiitake, wine cap and oyster. Learn how to inoculate logs and woodchip beds so that you can harvest and sell your own mushrooms year after year!

The topics covered in this workshop include: Growing mushrooms on substrate, Inoculating mushroom logs (hands-on), Growing mushrooms in woodchips or straw mulch and log selection and harvest.

 

Each participant will receive a gray dove oyster mushroom production kit and an inoculated log with their choice of Lion’s Mane or Golden Oyster.

Join us for this hands-on educational program. Registration is required and space is limited for this workshop. The cost is $35 for materials. Contact the Harvey County Extension office for a registration form and call us for more details (316) 248-6930. You can also email us for an application at [email protected] or [email protected].

“Feeling winded?”

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“Well, doc,” the patient was telling me, “I get winded so easily now. I can hardly go to the mailbox without stopping to catch my breath. It did not used to be that way. Do you think something is wrong?”

Many of us have experienced shortness of breath. After a period of inactivity, such as winter or a busy month, when we decide to exercise again, it may be easier to feel winded. That experience can be due to deconditioning, feeling out of shape. A good remedy for that is a gradual increase in exercise, helping us to regain our strength and endurance.

Sometimes we get short of breath for other reasons. A recent infection can be a common cause, giving us a bad cough and leaving us winded for a while. There are several other lung causes like asthma or chronic obstructive pulmonary disease, including emphysema and chronic bronchitis, which can leave us short of breath.

However, the feeling of shortness of breath does not necessarily mean there is a problem with the lungs. Shortness of breath can be a symptom of heart disease. A partial or total blockage of an artery in the heart may give someone chest pain, but sometimes shortness of breath could be one of the only symptoms.

One can feel winded from heart failure, when the heart is not pumping as well. As the heart has trouble keeping up, a person can get short of breath from the buildup of fluid, which may cause swelling of the legs and sometimes buildup of fluid in the lungs.

Or, perhaps the shortness of breath is from anemia. If someone is anemic, the hemoglobin level in their blood is low, which reduces the body’s ability to carry oxygen throughout the body. Anemia can have a variety of causes, such as blood loss, low iron or other nutritional deficiencies, or problems with the production of blood cells. Blood loss can be caused from anything from heavy periods to a stomach ulcer. Everything that can result in anemia, can result in shortness of breath.

My patient with shortness of breath from walking to the mailbox came in to see me and we did several tests including a chest x-ray, blood tests, and an EKG. Ultimately, we did a stress test and after an angiogram and stent in the heart, he feels much better and is walking a mile or two nearly every day.

It is important to tell your healthcare provider if you are feeling shortness of breath. While it could be due to anything from your heart, your lungs, being out of shape, or even anxiety, please do not ignore your body if you are feeling winded.

Andrew Ellsworth, M.D. is part of The Prairie Doc® team of physicians and currently practices family medicine in Brookings, South Dakota. Follow The Prairie Doc® at www.prairiedoc.org and on Facebook and instagram featuring On Call with the Prairie Doc® a medical Q&A show celebrating its 22nd season of health information based on science, built on trust, streaming live on Facebook most Thursdays at 7 p.m. central.

Wheat Scoop: Wheat Rx seminars share K-State research results with Kansas producers

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Kansas Wheat

Contact: Marsha Boswell, [email protected]

For audio version, visit kswheat.com.

As wheat fields green up across Kansas, a pair of Wheat Rx seminars in early March delivered expert advice to growers on how to unlock the genetic potential of wheat varieties for their specific geographies and operations and use research-informed methods to produce high-yielding and high-quality wheat.

 

“Wheat Rx is the Kansas farmer’s prescription for combining best management practices and variety selection for the economical and sustainable production of high-quality winter wheat,” said Aaron Harries, vice president of research and operations for Kansas Wheat. “Informed by the research investments made by Kansas wheat producers through the Kansas Wheat Commission, these seminars are just what the doctor ordered for learning how to maximize profitability through variety selection and practices on the ground.”

 

The March seminars took place in Dodge City and Wichita. Presenters included a rundown of leading experts from Kansas State University that discussed cover crops and soil health, soil fertility, fungicides and the economics of wheat production.

 

Gregg Ibendhal and Daniel O’Brien, professors in K-State’s Department of Agricultural Economics, shared the trends and predictions for wheat profitability in Kansas. They noted that machinery costs are still the largest expense category for growers, although that category is getting smaller. It’s no surprise that fertilizer expenses have increased greatly along with interest rates but explained the futures markets have not fully captured the risk of the continued Russian/Ukraine war. They also discussed the current and future supply and demand situation for the world’s major wheat importers and exporters.

 

Outside of the kernels in the bin, Dr. Romulo Lollato, K-State associate professor of wheat and forage production, discussed the agronomic, ecological and economic benefits of diversifying crop rotations with wheat. He walked through the impacts of simplified crop rotations due to a steep reduction in wheat acreage to food security and biodiversity. Conversely, after a comprehensive review of more than 300 peer-reviewed studies, his team outlined the benefits of adding wheat back into crop rotations, including forage production, dual-purpose use for grazing, weed control, interruption of pest population cycles and other benefits.

 

Speaking of disease and pest management, Kelsey Andersen Onofre, K-State assistant professor of plant pathology, presented on the management of the major wheat diseases in Kansas. Statewide, diseases like stripe rust, Wheat Streak Mosaic Virus (WSMV), and scab are responsible for the most yield lost from 2013-2023. She walked through her research into disease management, including optimal timing of applications, the impact of dual applications, the influence of plant population and how well fungicides work in combination with variety resistance.

 

Moving from above to below ground level, Carlos Pires, a K-State agronomy post-doctoral student, discussed methods to improve soil health. He emphasized the benefits of regenerative ag practices like minimizing disturbance through no-till or minimum-till, maximizing soil cover through practices like cover crops, maximizing biodiversity through a mix of cash and cover crop or an integrated crop-livestock system and maximizing continuous living roots by reducing fallow and increasing cover cropping. He concluded that integrating cover crops into crop rotation will increase soil carbon, the amount of microbes, biological activity and aggregation to retain water, recognizing that these practices take financial investments and time.

 

The seminar ended with a discussion of fertility management specific to wheat by Dorivar Ruiz Diaz, K-State professor and soil fertility specialist. He discussed the most important nutrients to manage for wheat, including nitrogen, phosphorus, sulfur, chloride and lime (for low pH soils). He also walked through how growers can manage both yield and quality, including nitrogen volatilization and placement and the interaction of protein with nitrogen management.

 

The seminars are part of Wheat Rx, a partnership between Kansas Wheat and K-State Research and Extension to disseminate the latest research recommendations for high-yielding and high-quality wheat to Kansas wheat farmers. This effort includes a series of extension publications and educational outreach like the March seminars.

 

“We’ve learned a lot from the research funded by Kansas wheat farmers on the impact of variety selection and management practices on yield and quality come harvest,” Harries said. “Wheat Rx is our outreach effort to share those results with growers. We can’t control the weather, but these practices and tools are ones farmers can use to make an appreciable difference in their wheat crop.”

 

Miss the Wheat Rx seminars? Plan to attend the Soil Health and Cropping System Sustainability Field Day in Solomon/Gypsum on April 5 or the Wheat Rx Seminar and Field Day in Phillipsburg on May 23. Learn more at https://kswheat.com/events.

 

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Written by Julia Debes for Kansas Wheat

Whole wheat bread

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What started out as a simple day of making one loaf of bread turned into 3 loaves of bread. The recipe I am featuring today is a very, and I mean very simple whole wheat bread dough. It’s so easy peezy, that you can start playing with switch outs quite easily.

One ingredient will call for some clarification, that is ‘wheat gluten’. What I usually do is add around 3 tablespoons for every loaf of whole wheat bread that I make. If it’s not my recipe I remove 3 tablespoons of whole wheat flour and replace it with the gluten. This helps to render a very light whole wheat bread.

You can purchase the gluten many places. If you live near an Amish store or Mennonite store, this is a good route to choose. My last big bag was around $9.

My son’s gal, Paige and I also re-started sour dough starters this weekend. Hopefully by mid-April we will be making this healthy bread once again. There’s nothing like a sour dough that is fed with potato flakes versus flour. The flavor is just magnified to a whole new level.

In the event you are a regular reader, and you are wondering what I finally served for Easter dinner, well; here goes: Turkey, ham, potato casserole, scalloped pineapple, roasted vegetables, in the oven, Cole slaw, deviled eggs, homemade bread, a fluffy salad, and lemon cake with toppings for dessert. Our dear friends came over following church and we enjoyed a good time of fellowship together.

The week looks like a good one in the weather department. No big rain events and some decent ‘spring’ temps. I have sewing and organization on my home list. The week starts out with ‘donkey basketball’, which is something I haven’t enjoyed for years, it should be fun. I haven’t begun to think about outside flowers yet, it will come in time. Right now, I just want to re-find our bedroom, and pack away some of the heaviest sweaters for the season. Right now, the week looks fairly calm on my Day-Timer, hopefully it will stay that way. Simply yours, The Covered

Dish.

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Sorghum Whole Wheat Bread

5 teaspoons active dry yeast. (This was about 2 1/2 packets.)

2 cups warm water, (105-115)

1/2 cup sorghum

2 large eggs, beaten

3 cups whole wheat flour

3 cups all purpose flour or bread flour

6 tablespoons of gluten

2 tablespoons brown sugar

2 1/2 teaspoons salt

Activate yeast in warm water. If it bothers you not use a teaspoon of sugar to make the activation happen faster, go ahead and add it. Let this set for 5-10 minutes, while you prepare the whisked eggs and the sorghum

Put all the dry ingredients together. *Tip, if you are using the kitchen aid for blending and kneading why not put all the dry ingredients in the mixer bowl and using the whisk head bring all the dry together? Then remove from the bowl.

Combine the yeast mix and the eggs and sorghum together. Using the regular mixer head add half of the dry mix to the bowl. Blend; switch to the dough hook and add the remaining dry ingredients. If the dough would happen to be too dry or too wet add your additions 1 tablespoon at a time. Dough will begin to work up the dough hook when it is ready to remove from the bowl.

Rub a glass or metal bowl with oil or butter, make the dough into a ball place in the bowl and put a bit of oil on top. Cover with a tea towel and allow to rise. You can make a proofing oven by turning an oven to 180 or 200, and then turning it off. Some folks even like a pan of boiling water in the oven while the bread rises.

When the bread has doubled in size knock it down, and work it into 3 oval loaves. Place in greased baking pans. Slide back in a proofing oven or allow to double on the counter. Bake bread at 350 degrees until it’s about 190 degrees, it will continue to increase in temp. once it comes from the oven. Start checking bread at about 20 minutes. Grease tops with butter after removing from the oven.

At home I increase the salt amount to 3 teaspoons. Remember it’s the first rise that flavor develops, not the second.

*IF I remember correctly, when I wrote this recipe I was shooting for low sugar content. Also; you could use milk instead of water in this recipe, milk is a good tenderizer.