catholic health non-profit org. initiatives u.s...
TRANSCRIPT
Weight?Non-Profit Org.U.S. Postage
PAIDPark Rapids, MN
Permit No. 52
T H E C E N T E R F O R W E I G H T M A N A G E M E N TCatholicHealth Initiatives
A service of St. Joseph’s Area Health Services
CATHOLIC HEALTHINITIATIVES
600 Pleasant Avenue Park Rapids, MN 56470Phone: (218) 732-3311 Fax: (218) 732-1368
The Cent er for Wei ght Management
Thiaminefor the restof your life
Surgerypatients livelonger...
Triathlonwinners!
The New You!is coming...
Plus, what you needto know about yourvitamins...
Surgical weight losspatients dig deep,
inspire... Take Note
The New You!On Dec. 13, the Y Weight? Support Group will be
focusing on ʻThe New You!ʼParticipantsʼ successes will be celebrated by giving
them an opportunity to briefly share their “before sur-gery” story and picture with other attendees. It is achance to inspire others and mark the incredibleprogress you and others have made in changing yourlives.
Anyone interested in participating should pleasesend a “before surgery” picture to Arlys Hess at St.Josephʼs Area Health Services, 600 Pleasant Ave.,Park Rapids, MN 56470, or [email protected].
By sending a picture, participants are consenting toread their story to the group while the “before” pictureis being shown on a video screen.
If participants do not have a “before” picture toshare, they are welcome to hold or wear “before”clothing as they tell their short story.
Please have your pictures to Arlys by Dec. 6. Wewill be looking forward to seeing you at the Dec. 13
meeting from 4:30 – 5:30 p.m. (Support group meet-ings are held at St. Josephʼs Area Health Servicesbasement meeting room.)
In support of supportResearch is showing that participation in a support
group after weight loss surgery promotes on-goingweight loss/maintenance success. The Center forWeight Management also conducts training sessionsfor support group leaders located in your neck of thewoods. Anyone interested in starting a new supportgroup in your town outside of The Center for WeightManagementʼs service area or to find a support groupnear you, call Arlys at 218-237-5588 or 1-800-566-3311.
Retreat/Walk combined eventWatch for information on the Fall 2008 Weight Loss
Retreat/Walk From Obesity combined event in futureY Weight? newsletters.
yB a r i a t r i c s
November, 2007
Weight?6
The Center for Weight Management is a service of St. Josephʼs Area Health Services
y
For more information about our bariatric services call 1-800-566-3311 or 218-237-5757.
Pages 2, 3
Page 5
Page 6
Page 4
Address Service Requested
By Diane J. RhodyDietetic Intern
Remember that first educa-tional session at The Center forWeight Management when thedietitian kept repeating theadvice to take your B-100 vita-mins?
We tell people to take theirBs, but we often forget to reallyexplain why it’s so important totake them; and why taking thi-amine is so important everydayfor the rest of your life.
What is thiamine?It’s one of the B-complex of
vitamins and is also known asB1. It is important in nervefunction, energy production, andhelps keep your heart beating.
Thiamine’s importance wasfirst discovered in 1910 in Japanas a cure for the disease,beriberi (translated, “I can’t, Ican’t”). Beriberi caused peopleto waste away, have pain, nervedamage, heart failure, paralysis,
edema, and eventually death. Later, thiamine was found to
be an important nutrient that isdeficient in alcoholics who haveWernicke’s encephalopathy.Soon after that, the same defi-ciency was found in those whohad undergone gastric bypasssurgery.
To avoid the grim future pos-sibility of Wernicke’sencephalopathy and the quicklyfollowing beriberi, a simple rou-tine of taking your B vitaminscan be adopted so one never hasto experience the unpleasant andill effects of a thiamine defi-ciency. In any normal person,daily needs for thiamine rangefrom 1-1.4 mg, but needs for thebariatric patient are greater, andthe B-100 vitamins adequatelycover those needs.
Foods that block the absorp-tion of thiamine should beavoided. These foods include anexcess of raw shellfish as wellas tea and coffee. Tea and coffeeshould be avoided in any casedue to their caffeine content.
Happiness is a healthy nerv-ous system, energy to digestyour food, and a heart thatbeats; all made possible by theimportant intake of thiamine.
If you have a child or know a child ages 10through 15 who would be interested in partici-pating in a weight management program gearedfor youth, let them know about The Center forWeight Management’s “Healthy ’n Fit Kids”program.
St. Joseph’s Area Health Services received a$10,000 grant from Dakota Medical Foundationto support this multidisciplinary adolescent
weight management program. It’s not too late to join. To learn more, or to
sign up, please call St. Joseph’s and DakotaClinic’s Center for Weight Management at (218)237-5757, option 2.
Dakota Medical Foundation of Fargo focusesits efforts on improving health and access tomedical and dental care in the region, with anemphasis on kids.
Others finished before them, many others,but the six women (two teams) who enteredthe Northwoods Triathlon in Nevis in Augustwere winners in every regard.
These six challenged themselves to com-pete in a race all but one would never haveconsidered a possibility a year ago.
The story of these particular six competi-tors is one of personal gain. Well, that andloss.
The logo on their warm-up suits reads:“The Center for Weight Management,” a serv-ice of St. Joseph’s Area Health Services andDakota Clinic. All have undergone gastricbypass surgery and collectively lost morethan 500 pounds.
Short of two hours after the start, LeahWalters, The Center for Weight ManagementCoordinator, wipes away tears as a grinningHannah Gurno of Cloquet charges throughthe finish line. Each woman has finished theirleg of the race. While many went into the racewith a personal goal of simply surviving, as itturns out none had finished last.
“I am so proud of them,” Walters beams. Days before the race, Linda Hanson was
mentally getting herself pumped. For yearsshe has been associated with the triathlon,but in the role of volunteer at the finish line.She has lost 110 pounds since her surgery 19months ago and started running in December.
“The first year I volunteered for thetriathlon, I thought to myself: I want to dothat some day,” Hanson says. Watching fromthe sidelines, she was always inspired by thecompetitors. “My heart was there, it was justthat my body wasn’t. Now I think they’reboth there. I’m ready. ”She is amazed by whatshe has been able to accomplish.
“I am so thankful because I have my lifeback. This has been such an amazing jour-ney,” Hanson adds. “Mentally, I’m healthier.Physically, I’m definitely healthier, and Iknow I’m going to live a whole lot longer.This is the best decision I’ve ever made in mywhole entire life. I have absolutely no regrets,and would do it again (have the surgery) in aheartbeat.” Her eyes are on next year’striathlon; next time as a solo competitor. Theminute she crossed the finish line she became
an inspiration for others.It took effort for Connie Nygaard of
Fergus Falls to go up and down stairs prior toher surgery. “I was not a happy camper,” shesays, having shed 120-pounds in excess bodyweight. “I was not feeling good and was frus-trated with how my life was turning out.Today is about me for once in my life, and Iwant that to be my own motivation. I want tobe an inspiration to myself.”
Following a quarter of a mile swimaround the big, orange buoys, Nygaard’ssmile was priceless as she waded out of thewater. Nygaard holds every intention of stick-ing to an exercise routine. Let’s just say she’sbecome addicted. She, too, vows to enter thetriathlon as a soloist next year.
Abby Rolffs of Lake Lillian was anotherteam member to emerge from the swim witha new sense of pride. She’s lost 80 poundssince December. Her team, “Becuz We can!,”was a scene from All in the Family. Rolffs,Gurno (a cousin) and Lisa Schneider ofWillmar (a sister) are all related. In addition,they also had two aunts and a cousin compet-ing. Weight loss and better health is their newfamily tradition.
Having met their goals with a triathlonteam effort under their shrinking belts, theyare encouraged by similar challenges. As withall of these women-turned-triathletes, theirstories of transformation are still unfolding. Note: For a full version of this story and morephotos, see St. Joseph’s Area Health Services’website at: www.sjahs.org. Click underServices/Bariatric.
Connie Nygaard, (l to r) LindaHanson and Cathy Hensel make upthe team, “New Beginnings.”
We want to hear from you...Y Weight invites you to submit articles, questions, stories,
your personal profile or any information you feel wouldbenefit other gastric patients, to Arlys Hess, social worker,at 218-237-5588. Address correspondence to her at St.Joseph’s Area Health Services, 600 Pleasant Ave., ParkRapids, MN 56470 or e-mail: [email protected]
If you choose to no longer receive this newsletter,please call 218-237-5711 or 1-800-566-3311 ext. 588 andask to have your name removed from the mailing list. Also,drop us a line if you have a change of address you wouldlike us to know about. Thank you.
A service of St . Joseph’s Area Health Services
CATHOLIC HEALTHINITIATIVES
600 Pleasant Avenue Park Rapids, MN 56470Phone: (218) 732-3311 Fax: (218) 732-1368
The Center for Weight Management
For more information about our bariatric services call services call 1-800-566-3311 or 218-237-5757.
The best way to ‘B’ healthy is to takeyour vitamins, thiamine every day for life
Weight?2 Weight?5y y
Thiamineʼs vital benefits�Nerve function�Energy production�Heart function
Did you know?Some studies suggestthat taking thiamine
may reduce mosquito bites.Thiamine produces a skinodor that is not detectable byhumans, but is disagreeableto female mosquitoes. NewThiamine-based repellents areon the market, although thereis no clinical evidence yet toback their effectiveness.
Swim, ride, runSix amazing bariatric surgery patients ‘win’ triathlon
Abby Rolffs, (l to r) HannahGurno and Lisa Schneider, allrelated, made exercise a familytradition.
Youth sought to participate in ‘Healthy ’n Fit Kids’ program
Starting Nov. 2, Dr. Dan Smith addedLAP-BAND® System procedures to thelist of offerings at The Center forWeight Management. It is available topatients who meet the criteria for thissurgery.
While the Roux en-Y procedure forgastric bypass surgery is considered thegold standard in the bariatric industryand is one in which Dr. Smith standsout with success rates above the nation-al average, the LAP-BAND® gives mor-bidly obese patients a choice when considering their optionsto dramatically improve their health. A non-surgical option isalso available to patients through the LEARN Program.
The LAP-BAND® System is an adjustable gastric banddesigned to help you lose excess body weight. It reduces thestomach capacity and restricts the amount of food that can
be consumed at one time.The LAP-BAND® procedure doesn’t require stomach cut-
ting and stapling or gastrointestinal re-routing to bypass nor-mal digestion. During the procedure, a silicone ring is placedaround the upper part of the stomach and filled with saline inits inner surface. This creates a new, smaller stomach pouchthat can hold only a small amount of food, so the food stor-age area in the stomach is reduced. The band also controlsthe stoma between the new upper pouch and the lower partof the stomach.
Once in place, an access port fixed beneath the skin ofyour abdomen allows LAP-BAND®-certified physicians suchas Dr. Smith to change the stoma size by adding or subtract-ing saline. The diameter of the band can be modified to meetindividual needs.
Dr. Robert Wroblewski will also perform LAP-BAND®surgeries upon his arrival to The Center for WeightManagement in 2008.
Be sure to look for the following items when selecting vitamins and supplements. Some ingredients are hiddenmore than others, and itʼs vital to your health that you select appropriate vitamins and supplements.
REMEMBER: You need to take these for the rest of your life!
Sorting through the Multivitamin Mayhem:Chewable - Adult or Children’s is acceptable
Complete - Look for this KEY word on the labelVitamin D - 400 IU to help with calcium absorption
Take 2 a day - 1 in the morning, and 1 laterSome options: Flintstones Complete, Centrum Kids
Complete, One a Day Kids Complete, Wal-Mart’s One SourceActive Kids, or another generic equivalent.
Remember: Your multivitamin does not come close to mak-ing up for an unhealthy diet. It is merely a nutritional safety net.
“B” Healthy with yourB-Complex:
Thiamine! The complex MUSThave this invaluable vitamin -
100mg is desirableTake 1 a day - you may need to
split or divide the dose.Available from several brands in
various forms; liquids often haveno thiamine. Bariatric Advantagehas smaller capsules you can takewhole, but you need 2-4 per day.
B12and
beyond:Sublingual form(most readily
absorbed) or naso-gel.
Take 1000 mcgdaily. Blood levelsdrawn should betwice the “normallevel” due to malab-sorption.
“Ironing” out the Iron:Chewable is most tolerableVitamin C helps absorption
Women: Ferrous fumarate or ferronyl in doseas needed and discussed with physician. DO takedaily during menstrual cycle and 2 days after oras directed.
Men: An iron supplement may be necessarywithout proper nutrition; take as directed.
Some Options: Bariatric Advantage, Vitron C.
Clearing up the Calcium Confusion:There are 2 types: citrate and carbonate
Citrate with Vitamin D is recommended. Citratecan be taken with or without food. Without food, itmay decrease iron absorption, so take separately.
Take 2 - 3 a day at different times (your body canonly absorb 500-600mg at a time) for a total of1200-1500mg daily.
ChewableSome Options: Citrical, Chewables, Bariatric
Advantage lozenges or a generic equivalent.
1-800-566-3311 or 218-237-5757.
Weight?3y
Dr. Dan Smith begins LAP-BAND® procedures on patients
What you need to know about your vitamins…
Dr. Dan Smith
The news is good for gastric bypass patients.According to the Boston Globe (Aug. 23,
2007), patients who lost weight as a result ofbypass surgery will live longer.
For the first time, the article states, “researchershave conclusively shown that losing weightthrough stomach surgery can extend the lives ofseverely obese patients, dramatically reducingdeaths from heart disease, cancer, and diabetes.”
Physicians who conducted the research say theresults are “so dramatic that they could spawn amajor shift in who is eligible for weight-loss sur-gery.” Their findings appeared in The NewEngland Journal of Medicine.
At The Center for Weight Management in ParkRapids, Dr. Daniel Smith performs the Roux en-Y, considered to be the gold standard of all gastricbypass surgeries. It is considered a last resortoption for morbidly obese patients with a BMI of40 or higher or who have health-related problemsas a result of excess weight and are desperate tolose weight.
The operation has been found to improve andreverse co-morbidities and other problems associ-ated with obesity such as heart disease, diabetes,high blood pressure, high cholesterol, sleepapnea, and arthritis.
Until these studies were conducted, the officialmedical word was inconclusive as to whether the
surgery prolonged life.The findings from these studies may cause a
shift in eligibility for weight-loss surgeries, thearticle states.
Apparently two studies conducted independent-ly of one another, both in Sweden and Utah, fol-lowed the progress of 20,000 obese patients.Those who lost weight through surgical methodswere close to 40 percent more likely to be alivelater than those who tried conventional methodsto lose weight.
The Globe reported Dr. Lars Sjostrom sayingthe answer as to why there was health improve-ments for the bypass patients remains unclear. Hesays it could be the loss of weight or somethinghaving to do with the manipulation of the diges-tive tract during surgery. Finding out that answerwill be “pivotal,” Sjostrom says.
For more information about our bariatric
Weight?4y
With Leah Walters,Bariatric Coordinator & Dietitian
From The New EnglandJournal of Medicine
Aug. 23, 2007
Report conclusive: obese adults livelonger after gastric bypass surgery
Leah Walters,RD, LD, CDE
Question: Why is exercise soimportant? I am losing weight withoutit.
Answer: It is almost impossible notto lose weight in the early phases afterbariatric surgery.
We find that patients who choose notto exercise lose more muscle mass.
When that muscle (lean body mass) isgone, it is difficult to build back. Andplease remember that the lean bodymass determines your total caloric needeach day. The more muscle, the morecalories you need and the more subse-quent weight loss you will experiencewith your low calorie diet.
Q&A
Conclusion statement:... “Thus, the question as to whether
intentional weight loss (bariatric surgery)improves life span has been answered andthe answer appears to be a resounding yes.”
By Diane J. RhodyDietetic Intern
Remember that first educa-tional session at The Center forWeight Management when thedietitian kept repeating theadvice to take your B-100 vita-mins?
We tell people to take theirBs, but we often forget to reallyexplain why it’s so important totake them; and why taking thi-amine is so important everydayfor the rest of your life.
What is thiamine?It’s one of the B-complex of
vitamins and is also known asB1. It is important in nervefunction, energy production, andhelps keep your heart beating.
Thiamine’s importance wasfirst discovered in 1910 in Japanas a cure for the disease,beriberi (translated, “I can’t, Ican’t”). Beriberi caused peopleto waste away, have pain, nervedamage, heart failure, paralysis,
edema, and eventually death. Later, thiamine was found to
be an important nutrient that isdeficient in alcoholics who haveWernicke’s encephalopathy.Soon after that, the same defi-ciency was found in those whohad undergone gastric bypasssurgery.
To avoid the grim future pos-sibility of Wernicke’sencephalopathy and the quicklyfollowing beriberi, a simple rou-tine of taking your B vitaminscan be adopted so one never hasto experience the unpleasant andill effects of a thiamine defi-ciency. In any normal person,daily needs for thiamine rangefrom 1-1.4 mg, but needs for thebariatric patient are greater, andthe B-100 vitamins adequatelycover those needs.
Foods that block the absorp-tion of thiamine should beavoided. These foods include anexcess of raw shellfish as wellas tea and coffee. Tea and coffeeshould be avoided in any casedue to their caffeine content.
Happiness is a healthy nerv-ous system, energy to digestyour food, and a heart thatbeats; all made possible by theimportant intake of thiamine.
If you have a child or know a child ages 10through 15 who would be interested in partici-pating in a weight management program gearedfor youth, let them know about The Center forWeight Management’s “Healthy ’n Fit Kids”program.
St. Joseph’s Area Health Services received a$10,000 grant from Dakota Medical Foundationto support this multidisciplinary adolescent
weight management program. It’s not too late to join. To learn more, or to
sign up, please call St. Joseph’s and DakotaClinic’s Center for Weight Management at (218)237-5757, option 2.
Dakota Medical Foundation of Fargo focusesits efforts on improving health and access tomedical and dental care in the region, with anemphasis on kids.
Others finished before them, many others,but the six women (two teams) who enteredthe Northwoods Triathlon in Nevis in Augustwere winners in every regard.
These six challenged themselves to com-pete in a race all but one would never haveconsidered a possibility a year ago.
The story of these particular six competi-tors is one of personal gain. Well, that andloss.
The logo on their warm-up suits reads:“The Center for Weight Management,” a serv-ice of St. Joseph’s Area Health Services andDakota Clinic. All have undergone gastricbypass surgery and collectively lost morethan 500 pounds.
Short of two hours after the start, LeahWalters, The Center for Weight ManagementCoordinator, wipes away tears as a grinningHannah Gurno of Cloquet charges throughthe finish line. Each woman has finished theirleg of the race. While many went into the racewith a personal goal of simply surviving, as itturns out none had finished last.
“I am so proud of them,” Walters beams. Days before the race, Linda Hanson was
mentally getting herself pumped. For yearsshe has been associated with the triathlon,but in the role of volunteer at the finish line.She has lost 110 pounds since her surgery 19months ago and started running in December.
“The first year I volunteered for thetriathlon, I thought to myself: I want to dothat some day,” Hanson says. Watching fromthe sidelines, she was always inspired by thecompetitors. “My heart was there, it was justthat my body wasn’t. Now I think they’reboth there. I’m ready. ”She is amazed by whatshe has been able to accomplish.
“I am so thankful because I have my lifeback. This has been such an amazing jour-ney,” Hanson adds. “Mentally, I’m healthier.Physically, I’m definitely healthier, and Iknow I’m going to live a whole lot longer.This is the best decision I’ve ever made in mywhole entire life. I have absolutely no regrets,and would do it again (have the surgery) in aheartbeat.” Her eyes are on next year’striathlon; next time as a solo competitor. Theminute she crossed the finish line she became
an inspiration for others.It took effort for Connie Nygaard of
Fergus Falls to go up and down stairs prior toher surgery. “I was not a happy camper,” shesays, having shed 120-pounds in excess bodyweight. “I was not feeling good and was frus-trated with how my life was turning out.Today is about me for once in my life, and Iwant that to be my own motivation. I want tobe an inspiration to myself.”
Following a quarter of a mile swimaround the big, orange buoys, Nygaard’ssmile was priceless as she waded out of thewater. Nygaard holds every intention of stick-ing to an exercise routine. Let’s just say she’sbecome addicted. She, too, vows to enter thetriathlon as a soloist next year.
Abby Rolffs of Lake Lillian was anotherteam member to emerge from the swim witha new sense of pride. She’s lost 80 poundssince December. Her team, “Becuz We can!,”was a scene from All in the Family. Rolffs,Gurno (a cousin) and Lisa Schneider ofWillmar (a sister) are all related. In addition,they also had two aunts and a cousin compet-ing. Weight loss and better health is their newfamily tradition.
Having met their goals with a triathlonteam effort under their shrinking belts, theyare encouraged by similar challenges. As withall of these women-turned-triathletes, theirstories of transformation are still unfolding. Note: For a full version of this story and morephotos, see St. Joseph’s Area Health Services’website at: www.sjahs.org. Click underServices/Bariatric.
Connie Nygaard, (l to r) LindaHanson and Cathy Hensel make upthe team, “New Beginnings.”
We want to hear from you...Y Weight invites you to submit articles, questions, stories,
your personal profile or any information you feel wouldbenefit other gastric patients, to Arlys Hess, social worker,at 218-237-5588. Address correspondence to her at St.Joseph’s Area Health Services, 600 Pleasant Ave., ParkRapids, MN 56470 or e-mail: [email protected]
If you choose to no longer receive this newsletter,please call 218-237-5711 or 1-800-566-3311 ext. 588 andask to have your name removed from the mailing list. Also,drop us a line if you have a change of address you wouldlike us to know about. Thank you.
A service of St . Joseph’s Area Health Services
CATHOLIC HEALTHINITIATIVES
600 Pleasant Avenue Park Rapids, MN 56470Phone: (218) 732-3311 Fax: (218) 732-1368
The Center for Weight Management
For more information about our bariatric services call services call 1-800-566-3311 or 218-237-5757.
The best way to ‘B’ healthy is to takeyour vitamins, thiamine every day for life
Weight?2 Weight?5y y
Thiamineʼs vital benefits�Nerve function�Energy production�Heart function
Did you know?Some studies suggestthat taking thiamine
may reduce mosquito bites.Thiamine produces a skinodor that is not detectable byhumans, but is disagreeableto female mosquitoes. NewThiamine-based repellents areon the market, although thereis no clinical evidence yet toback their effectiveness.
Swim, ride, runSix amazing bariatric surgery patients ‘win’ triathlon
Abby Rolffs, (l to r) HannahGurno and Lisa Schneider, allrelated, made exercise a familytradition.
Youth sought to participate in ‘Healthy ’n Fit Kids’ program
Weight?Non-Profit Org.U.S. Postage
PAIDPark Rapids, MN
Permit No. 52
T H E C E N T E R F O R W E I G H T M A N A G E M E N TCatholicHealth Initiatives
A service of St. Joseph’s Area Health Services
CATHOLIC HEALTHINITIATIVES
600 Pleasant Avenue Park Rapids, MN 56470Phone: (218) 732-3311 Fax: (218) 732-1368
The Cent er for Wei ght Management
Thiaminefor the restof your life
Surgerypatients livelonger...
Triathlonwinners!
The New You!is coming...
Plus, what you needto know about yourvitamins...
Surgical weight losspatients dig deep,
inspire... Take Note
The New You!On Dec. 13, the Y Weight? Support Group will be
focusing on ʻThe New You!ʼParticipantsʼ successes will be celebrated by giving
them an opportunity to briefly share their “before sur-gery” story and picture with other attendees. It is achance to inspire others and mark the incredibleprogress you and others have made in changing yourlives.
Anyone interested in participating should pleasesend a “before surgery” picture to Arlys Hess at St.Josephʼs Area Health Services, 600 Pleasant Ave.,Park Rapids, MN 56470, or [email protected].
By sending a picture, participants are consenting toread their story to the group while the “before” pictureis being shown on a video screen.
If participants do not have a “before” picture toshare, they are welcome to hold or wear “before”clothing as they tell their short story.
Please have your pictures to Arlys by Dec. 6. Wewill be looking forward to seeing you at the Dec. 13
meeting from 4:30 – 5:30 p.m. (Support group meet-ings are held at St. Josephʼs Area Health Servicesbasement meeting room.)
In support of supportResearch is showing that participation in a support
group after weight loss surgery promotes on-goingweight loss/maintenance success. The Center forWeight Management also conducts training sessionsfor support group leaders located in your neck of thewoods. Anyone interested in starting a new supportgroup in your town outside of The Center for WeightManagementʼs service area or to find a support groupnear you, call Arlys at 218-237-5588 or 1-800-566-3311.
Retreat/Walk combined eventWatch for information on the Fall 2008 Weight Loss
Retreat/Walk From Obesity combined event in futureY Weight? newsletters.
yB a r i a t r i c s
November, 2007
Weight?6
The Center for Weight Management is a service of St. Josephʼs Area Health Services
y
For more information about our bariatric services call 1-800-566-3311 or 218-237-5757.
Pages 2, 3
Page 5
Page 6
Page 4
Address Service Requested