Touching Lives Touching Lives - North Dakota Medicine

symptoms. He found that patients who
live closer to the pollen counter in
Fargo had more severe symptoms.
A pollen counter looks like a
weathervane, with a slide that collects
pollens in the air, Fenstad says. Dalan
reads them and reports the data to the
National Allergy Bureau which disperses
the information through allergy
websites and news outlets. Based on
this data, doctors can assess the pollen
threat and make recommendations to
their patients about how to treat their
allergy symptoms in advance of a rise
in the pollen count.
However doctors who practice outside
Fargo don’t have local pollen count
records to help them advise and treat
patients; they must rely on past records
and generalized information. Fenstad is
hoping his study helps to “raise
awareness that there aren’t enough
pollen counters,” he says. But “right
now, it’s the best tool we have.”
Dalan advised him on how to analyze
and present data at the national
meeting of the AAAAI which updates
allergy specialists from around the
world on new research advances.
Fenstad attended the meeting, all
expenses paid, under the Chrysalis
program, which introduces students to
the life of an allergist.
“It was an awesome experience,” he says.
“It gives you more insight into allergy
medicine prior to committing to the field.”
Dalan, who conducts numerous studies
related to the practice of allergy
medicine in an agricultural area and
other issues, praises Fenstad for taking
the initiative and seeking him out to do
research, he says. “It was a natural
progression for him to do research
that’s relevant to our area.”
Therapeutic hypothermia
For another study, this one in
cardiology, Fenstad re-connected with
Tim Henry, MD (BS Med ’80), director
of research at the Minneapolis Heart
Institute and world-renowned
cardiologist with whom he had worked
before enrolling in medical school.
(Henry is originally from Mohall, ND.)
During a cardiology rotation, Fenstad
was introduced by Henry to
cardiologists who use therapeutic
hypothermia to treat patients who’ve
experienced sudden cardiac arrest.
With this relatively new process, the
body is cooled to between 32 and 34
degrees Celsius as soon as possible
after the arrest.
For patients who suffer a sudden
cardiac arrest, “the majority… do not
survive,” Fenstad explains, “and those
who do often have severe neurological
deficits and cognitive impairment.”
“ ”
Research strengthened my ability
to critically appraise the medical literature
Studies have proven that “the quicker
they can cool the patient down after the
heart attack, the better the outcome, the
metabolism slows down, the heart and
brain don’t require as much oxygen –
it’s protective to cool them,” Fenstad
says. “These patients, with therapy,
experience 40 to 50 percent
improvement recovery in symptoms,
and can become semi-independent.”
Results of the first big trials of
therapeutic hypothermia, released in
2002, showed that the treatment
effectively decreased mortality and
improved neurologic outcomes, Fenstad
says. His study sought to build on that
knowledge by “looking at predictors of
better outcomes such as patient
characteristics,” like age, and other
factors including the length of time
between the cool-down and heart
pumping action.
Therapeutic hypothermia is starting to
become standard treatment for patients
with sudden cardiac arrest, he says. “It’s
something I hope to implement when I
come back to North Dakota eventually.”
- Pamela D. Knudson
NORTH DAKOTA MEDICINE Holiday 2008 23