Kelly Nieuwenhuis is no stranger to hard work. "I'm a family farmer. I farm with two brothers. This would be my 40th year in 2023." He's been part of the biofuels industry for years and has watched it grow and evolve with a changing market. "I've been involved in the biofuels industry for 20 years," he told me on a visit to his farm. "And the last 10 years I've been involved in the industry and definitely focused on carbon in tax reductions or carbon intensity reductions." Farming in O'Brien County, Iowa, he's one of several landowners who have proposed carbon capture pipelines mapped for their property and he's already on board. Summit Carbon Solutions and Heartland Greenway's Navigator CO2 Ventures are two liquid carbon-capture pipelines in production through the central United States. They would carry liquid CO2 from ethanol plants to a central location for underground sequestration. The success of these pipelines relies largely on voluntary easements signed by the landowners like Nieuwenhuis on the route. "I was on board right away. Absolutely," he said of the pipelines. He's signed easements with both companies to install their pipelines through his farmland. "Nut the absolute best thing you could do is you could capture and sequester underground permanently." Carbon has become a commodity in the ag industry and it's in many everyday items we use. "A lot of this stuff is used in carbonation, it's used in refrigeration, it's used in dry ice," Nieuwenhuis explained. "Markets are somewhat saturated, so we need to find another place for the CO2 to reduce the CO2 emissions." "Prior to the ethanol industry or biofuels, we had livestock and we had exports and if those didn't work or the export numbers were down, we overproduced and we're subsidized," Nieuwenhuis said as he explained what he calls the 'agricultural stool. "And then we built the third leg of the stool, the biofuels industry, and that's been the absolute best wealth-building industry." THE EASEMENT LOCATION The area of Nieuwenhuis' farmland where the Summit and Navigator pipelines will be laid is a few miles from his home. We drove to the area so I could see it for myself. "The Summit pipeline is going to go straight east and west right here," he pointed as we looked over his farmland on a windy February day. "Just over the hill there I have a natural gas pipeline that goes diagonally that's been there for 40-50 years and then behind that, probably 200-300 yards to the west of that is where the Navigator line is going to go, diagonally across." "And how much of this area is the easement for the construction?" I asked. "They are going to have a 50-foot-wide permanent easement and then a 50-foot temporary during the construction phase," Nieuwenhuis explained. Nieuwenhuis has already received payment for the estimated crop damage to his land. "You know they pay you, compensate you for crop damages over three to five years or longer," he said. He's already received part of those payments. "After three years, we stopped seeing issues with crop damages." The Dakota Access oil pipeline runs through his farmland already. Several years removed from when it was installed, he says he doesn't see any change in yield. "We've got yield maps that show over the last two years, we can't see the pipeline," he explained. "We're pretty confident that over time, I'm not saying it's an instant repair, things take a few years and that's why they pay in three to five years in crop damages or more if there's an issue. But I've learned to not say the word 'never' or 'forever' because it doesn't harm the property forever or anything like that." Overall, Nieuwenhuis sees carbon capture as the next major step forward for the ag industry. "It just came home from the U.S. Grains Council meetings, and every country was talking about the need to lower your carbon intensities, and in their markets, they're paying you a premium to do it. And so I think if the biofuels industry wants to compete with the rest of the energy industry." And as the world rallies for net-zero emissions by the year 2030, "that's a huge step to the race to net zero," said Nieuwehnuis. "And I think we can get to net zero in the next decade in biofuels and with the energy of the world focusing on low carbon we need to meet or continue to improve our process to stay in the game." FOLLOW FOR MORE "Along the Route: A Pipeline Discussion" is a multi-part series of reports looking at everything from the companies that want to build them to those "for" and those "against" and a deeper dive into to carbon and ethanol industries at the center of the project. SEE THE VIDEO
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For many residents in the Midwest, farming isn't their job. It's their life. Land passed from generation to generation, decades of history throughout the grounds. We have a century farm," said Woodbury County landowner Deb Main, "My dad entrusted me to care for his land.Now, two multi-million dollar companies want to use that land to install carbon capture pipelines across the central United States. "We have spent hundreds of millions of dollars on easements to date to the U.S. landowner and we're not stopping," said Summit CEO Lee Blank. "We're going to continue to do that until we get ourselves in a position where we got 100%." THE PIPELINES Summit Carbon Solutions plans to build a pipeline that will take liquid CO2 from ethanol plants in five states into an underground storage facility in Bismarck, North Dakota. Heartland Greenway's Navigator CO2 Ventures pipeline runs on the same concept. Capture liquid CO2 and store it underground in south-central Illinois. To do this, both companies need voluntary easements from landowners along the route of their pipelines, giving them permission to pass through hundreds of miles of private land. "We have great success in all areas throughout the project footprint to date, but that is necessarily a long-term process," said Elizabeth Burns-Thompson, Vice President of Government and Public Affairs for Navigator. "So again, landowner negotiations necessarily are weeks and months type of progress, not something that you do in a matter of days." Those negotiations are for easements that give each company access to private land to work and install the pipeline. "Negotiation is far more broad than that," said Burns-Thompson. "Negotiation is how that pipeline is put in. Is there different and additional restoration steps that you as a landowner want to include or delineate as part of that? Is there a different placement of that pipe that you would like to see as part of that? So again, placement of the pipe, how we do the work, and then ultimately also how that compensation looks. That is what is encompassed in that negotiation." EASEMENT AGREEMENTS Kelly Nieuwenhuis lives and farms near Primghar, Iowa. Farming is a family business. So we're pretty proud of that, that we have a family farm and been doing it for 40 years. He's already reached easement agreements with both Summit and Navigator for access to his farmland. "We negotiated with both of them," he told me on his farm in northwest Iowa. "We had very respectable land agents come to our farms and visit with us and we probably met with them three or four times at least and we asked for a few other things that we wanted done. And they were happy to do that." Part of the easement agreement details potential property damage, and for farmland, potential crop losses. That isn't just for the time of construction, but for several years after. "We feel like we're partnering with the U.S. agricultural landowner, as well as others that have easements and with those partnerships, we're working through this economic discussion," said Blank. "Also talking through the nuts and bolts of compensation," said Burns-Thompson. "And so making sure that what we're putting forward is something that's fair and that's what's in the eyes of the beholder. So we necessarily want to make sure that we're taking the time to talk to folks and figuring out something that's fair and equitable." Summit Carbon Solutions has more than 65% of the easements needed for their project footprint, according to the latest numbers sent to Siouxland News on April 3, 2023.
Navigator CO2 Ventures says they have spent upwards of $15.5 million on easement payments to landowners in the project path as of April 5, 2023.
LANDOWNERS HOLDING OUT But not everyone in the path of the pipeline is on board. "Without the limitation of contact with landowners, then land agents are still harassing landowners incessantly to sign easements and offering more and more and more money, which is the bribery situation. It's not a business plan. It's a bribery situation." Deb Main is one of more than a dozen landowners in the tri-state area who oppose these pipelines. She has yet to sign an easement to give the companies access to her land. "And that's a proposed pipeline route also," she explained about the proposed pipeline path through her property. "It doesn't mean they're going to stick with that because some people have signed an easement because it just went across the corner of my property. Well, now it goes like (Roger's property), down the middle because they can put it anywhere on your property they want." I sat down with nearly a dozen landowners and residents who oppose the pipelines to discuss why they are fighting back against these multi-million dollar companies. One of their biggest points was easements. "It goes from a six-inch pipeline to a 24-inch pipeline," said Stee Maxwell, another landowner from northwest Iowa. "It seems to be a lot of variances as far as how large the pipeline is, and like to say we got that much pressure coming through that pipeline, that's going to be..." "And the depths," echoed Jim Colyer. "I've heard from three foot to eight foot. So, what is it going to be? During these informative meetings, you hear lots of different stories." Landowners were sent certified letters in 2021, informing them of the pipelines and informational meetings held in each county the pipelines were passing through. "At the informative meetings that are required in Iowa by the Iowa Utilities Board," said Main, "you not only got the information from the pipeline company, but outside the meeting, they had survey companies there and land agents and they invited you to go talk with them and schedule your survey and sign an easement before you knew anything about this." DISCUSSIONS CONTINUE Both companies are still working with landowners on negotiations to find an agreement that suits the needs of all parties involved. We want to make sure that this truly is a dialogue to negotiation that's two-sided and we're coming to the table with ears wide open," said Burns-Thompson."We haven't had the opportunity to really explain the economic model," said Blank. "Some of the economics that we're delivering, a lot of the economics we're delivering, they're different because every farmer landowner has got a different situation. There may be things that are unique, that could change the economics, the agricultural economics around the easements that we actually are paying for." That payment the companies are offering, Nieuwenhuis says, is satisfactory. "I figured on my property where the permanent easement was, if I was guaranteed a $300 an acre profit forever, it would take me over 100 years equal this one-time payment," Nieuwenhuis explained, "so pretty satisfied with the compensation." But for some, that land they hold is priceless. "The easements are permanent easements," said Jodie Wilson, who is fighting for her mother's rights as a property owner. "They are just not for the project. They get done with it after they’ve collected all of their tax credits, they could sell it to another company and we have no say about it and we just have to live with it." Jim Colyer: It’s forever. Roger Schmid: It hangs on your land forever. FOLLOW FOR MORE "Along the Route: A Pipeline Discussion" is a multi-part series of reports looking at everything from the companies that want to build them to those "for" and those "against" and a deeper dive into to carbon and ethanol industries at the center of the project. SEE THE VIDEO Lincolnway Energy is an ethanol plant in Nevada, Iowa. It's one of dozens of ethanol plants scattered across the Midwest. Its largest byproduct is carbon dioxide. Upwards of 5 billion tons are emitted in the U.S. every year. Now, three companies want to sequester that gas, liquify it, and store it underground. That process is known as carbon sequestration and it has become a hot-button topic across the corn belt. "I think it's really great to partner up with Summit Carbon Solutions because it's going to secure the future of ethanol plants," said Chris Cleveland, "not only Lincolnway here, but other ethanol producers along with the farmers and the corn growers and their future and their next generations, too." SUMMIT CARBON SOLUTIONS Summit Carbon Solutions has partnered with Lincolnway Energy to capture and sequester its carbon dioxide. Summit is one of the corporations with plans to build a $3.7 billion liquid carbon-capture pipeline through the Midwest. "It's compressing that carbon, putting it into a transportation infrastructure system or a pipeline and then moving it to a sequestration site, which ultimately will then store that carbon molecule under Caprock in North Dakota." Lee Blank is the CEO of Summit Carbon Solutions. "Really what I liken it to maybe the transcontinental railroad. You know, in 1862 I believe, we decided as a country to open markets up and the railroad helped us do that. That's really what this does." If you think about the infrastructure project almost as logistics, it opens markets for plants like this one here in Nevada to give it other places that they can ship their products at a premium.Summit's pipeline will connect more than 30 ethanol plants across five states, spanning 2,000 miles, capturing more than 12 million tons of CO2 each year. The pressurized liquid carbon dioxide will be stored deep underground near Bismarck, North Dakota. If everything goes according to plan, "we would hope to be fully operational first quarter of 2025," Lee said. NAVIGATOR CO2 VENTURES "Navigator CO2 is a midstream company, midstream meaning pipeline. So the folks that work for our team are individuals that have a great level of experience and expertise designing, constructing, and operating midstream or pipeline infrastructure all around the United States." A second pipeline, Heartland Greenway's Navigator CO2 Ventures, will also capture and liquefy CO2 from ethanol producers to be stored in South-Central Illinois. "The Heartland Greenway, the project itself, at its initial kind of stages, looks to be about 1,300 miles of new pipeline infrastructure, connecting 21 facilities across five states here in the corn belt," said Elizabeth Burns-Thompson, Vice President of Government and Public Affairs for Navigator. "All of that infrastructure is really looking to do carbon management at its core, right." We've taken that skill set, curated it into the CO2 space and brought forward the project the Heartland Greenway that's being talked about largely today.Navigator's pipeline, once installed and in operation, will capture and store approximately 15 million metric tons of CO2 a year. They too, plan to be up and running in 2025. WOLF CARBON SOLUTIONS A third carbon capture pipeline, Wolf Carbon Solutions, is a smaller 280-mile pipeline crossing Cedar Rapids and Davenport in eastern Iowa on its way to storage sites in Illinois. These three pipelines have been met with heavy resistance from some landowners along their path. THE LANDOWNERS It was just out of the blue. We got a registered mail, and it just notified us what they were thinking about doing and the meeting, the upcoming meeting.Roger Schmid is one of those landowners. Living in northwest Iowa, he and hundreds of others received registered letters in the mail informing them of a meeting with Summit and Navigator. Those meetings announced the project and informed these landowners they were in the path of these pipelines. Landowners are asked to sign easements allowing the pipeline to pass through their property. Some are not on board, like Jim Colyer. "Whatever meetings that we have attended on the informational meeting, the information is different," Colyer told me. "So they have honed their skill on what they're telling us over different meetings, in different places and other people, that we've all heard from meetings in different counties, in different towns. And we know that they've told us different things. And I don't know if they're all false, but they seem to be leaning towards benefit rather than safety. And that is one of our main concerns is safety." "Our legislature should be standing up. Our county governments need to stand up," said Doyle Turner, another Iowan fighting against the installation of these pipelines. "But the big thing that we need is for more people to realize this affects a lot more people than just these landowners and that we all need to be stepping up and talking to our county board of supervisors. We need to be talking to our state legislators. We need to talk to our federal legislators." THE PIPELINE DISCUSSION REACHES STATE CAPITOLS AND THE COURTS Many legislators are on board with carbon sequestration. "It's value-added agriculture and it's adding value for the farmers," said Nebraska Governor Jim Pillen at a Siouxland Ethanol event in March 2023. "We raise an incredibly low carbon footprint corn but also the sequestration to be able to sell our ethanol to the markets we're able to capture more value. "Sequestration is really critical whether we're piping it or whether it's a formation that is close to a plant," Pillen said. "Both have to happen, they are both safe. They are critical to energy independence." But questions arise about using eminent domain to make these projects happen, which is where much of the debate has happened in legislatures across the Midwest. "The use of eminent domain is a last resort scenario, especially on a project like this," said Nebraska Representative Adrian Smith. "Ultimately, it's an infrastructure project and there's been some misinformation out there in terms of what the pipelines do. It's actually the safest way to transport products. All things considered, it's my hope that the right of way can be achieved and accomplished without the use of eminent domain." Both Summit and Navigator are taking the fight over property rights to court. In Woodbury County, Vicki Hulse is fighting to keep Navigator land surveyors off of her property. Her 151 acres of land are something she holds with pride. "We have worked hard to pay for our land," Hulse told me during an interview at the Siouxland News studios in September 2022. "We bought the farm from his dad's estate, and he worked two jobs. I work two jobs to pay for this farm. And we have two children that we want to hand the farm down to. And I'm fighting against eminent domain for private gain." In March 2023, Hulse and Navigator presented their cases in Woodbury County Court where they now await a judge's ruling on separate injunctions for access to Hulse's land. In spite of the resistance, Summit, Navigator, and Wolf are pushing forward with the goal of changing the CO2 landscape in the Midwest. "I believe it's a big part of the future of the family farms and the next generation," said Cleveland with Lincolnway Energy. FOLLOW FOR MORE "Along the Route: A Pipeline Discussion" is a multi-part series of reports looking at everything from the companies that want to build them to those "for" and those "against" and a deeper dive into to carbon and ethanol industries at the center of the project. SEE THE VIDEO Rehabbing your heart with MercyOne Siouxland Cardiac Rehab Center Cardiac rehabilitation is an important step in recovery after almost any cardiac event. It doesn't change your past, but it can help prolong your future. "If I didn't do any cardiac rehab, I would seriously doubt I'd have the life expectancy I have now." Mike Pesky has been through cardiac rehab four separate times. "There's always a possibility you know, when you have heart problems," Pesky said after class. "I got nine stents in me and there's always a possibility of more down the line." "You only get one heart and we have to take care of it from youth on up." ~ Ruth Ann McKeever, RN Inside the Cardiac Rehab Center at MercyOne Siouxland, a team of medical specialists helps Siouxlanders through a cardiac rehabilitation program designed just for them. "We look at lots of things, what their history is, what their ejection fraction is, how well their heart muscles able to pump blood out to their body, what their symptoms were if they had arrhythmias and if that caused their event what was going on?" Ruth Ann McKeever, a registered nurse in the cardiac rehab center said. "So each person is individualized and we look at them individually." "They care about you as an individual. And it's not like oh, okay, do your workout and we'll see you next time. It's, Do you have questions? Is there anything bothering you? Kind of thing and if you have like depressed, you can feel free to talk to them. And sometimes that's all it takes," said Pesky. Cardiac Rehabilitation is important for anyone who is recovering from heart surgery, had a heart attack, or is suffering from other heart conditions like coronary artery disease, angina or heart failure. Because your heart is a muscle and needs to be taken care of. "And once you lose your heart muscle, if you drop your ejection fraction, there's no going back," McKeever said. "The older we get, the more likely we're going to have to have an event or to have something happen." Exercise uses your entire cardiovascular system, but while the room may look like a gym, cardiac rehab involves more than a workout. "That heart muscle is weakened," McKeever said. "And so you need to start slow and gradually build that heart muscle back up again." This is also a chance for participants to learn more about their heart and how heart health impacts every aspect of their life. "Once a week they have education and so we go over a different topic of education with them once a week, so that they continue to learn about their heart and heart-healthy habits," said McKeever. But while this room may look like a gym, cardiac rehab involves more than a workout. It's also a chance to learn. "Heart is one thing but the heart and the mind go together. ~Mike Pesky" Changing the way a person thinks about their life, their stress, and other triggers is an important part of the process. "It's not just getting the heart. That's only a part of it," said Pesky. "You got to get the mind is well and that's one thing I have liked all the way through." Because you only have one beating heart. "So we have to really take care of that heart muscle," McKeever said, "because you don't always get a second chance." Pesky can't say enough about the team at MercyOne. "These gals care and it shines like the sun outside, it shines through," he said. "And you know I am been very, very blessed to have the nurses here and through my years of coming, to have them here and I can't say enough good things about them." SEE THE VIDEO Surviving a widow maker heart attack - Aurelio's storyI was 50 and this was October 13th I believe. Aurelio Hernandez is counting his blessings. Just 5 months ago, at age 50, he had a heart attack. One with a scary name, the Widow Maker. "So, heart attacks are all bad," said Dr. Mir Subla with MercyOne Siouxland Medical Center. "Usually, we talk about Widow Maker, we are talking about the artery that supplies the left ventricle. That's the chamber of the heart that pumps the blood." There are three main arteries in the heart, one on the right and two on the left. The Widow Maker occurs in the left anterior descending artery which supplies blood to a large portion of the heart. "In the Widow Maker, what happens is this artery gets blocked, there is a plaque in the wall and that ruptures and a clot forms in the artery and an artery gets blocked and there's no blood flow," said Dr. Subla. A Widow Maker feels like any other heart attack, with symptoms like shortness of breath, chest pain and heaviness. "It was actually during work, felt a little tired so I figured I'd go home while the texture was drying," Hernandez recalled about the day he had his heart attack. "I was gonna try to take a nap but then I felt pain across the chest. I actually started on one area and kind of gradually started moving. I didn't think anything of it until it started all the way across, and then my breathing kind of got a little difficult." Hernandez went to a nearby ER and they sent him to MercyOne Siouxland. Because when it comes to matters of the heart, time is critical. "Nowadays, it has improved a lot," said Dr. Subla. "Fatality rates have dropped if they receive care in what we call "door to balloon time", or "contact to balloon time". Dr. Subla says the standard time from first medical contact to balloon time or the point where doctors open the artery, is 120 minutes, or 2 hours. "It's usually fatal if not treated. People can develop heart failure because that portion of the heart doesn't get any blood and the part of the muscle dies. - Dr. Subla" Hernandez got treatment in time, but he also knew what to look for. "Just watching what happened to my brother, passing away at the same age of 50 and leaving four kids," Hernandez said. "I guess it wasn't actually surprising because of my family history of it. But at that time, you know, I was always active. I know my lifestyle of working all the time and not eating right and all had something to do with it but it was a to where I can't believe this is happening to me." By the time Hernandez arrived at MercyOne last October 13th, the cardiology team was ready. Dr. Subla recalls that day, "we took him immediately to the catheterization laboratory, his Widow Maker was 100% blocked and we opened up with a balloon and a stent and it had good flow at the end. He was symptom-free and his heart muscle did not suffer any damage." READ MORE - HEART MONTH: Rehabbing your heart with MercyOne Siouxland Cardiac Rehab Center He is one of the lucky ones, especially in a time when many are not seeking treatment because of COVID-19. "It's what we call timeless muscle," said Dr. Subla. "So the more you delay, the more muscle will die. And even if you survive, if you don't come to the hospital, you will have heart failure and we see a lot with those patients especially in COVID times, people didn't want to come to the hospital for obvious reasons. And we see a lot of heart failure patients." When I met Hernandez, he was graduating MercyOne's cardiac rehab program. Leaving with a new lease on life and a vow to teach his kids and others around him that heart attacks aren't for the faint of heart. "So you change your outlook on a lot of things. So there's not like what I don't care if it happens to me, now you got to what does it matter if it just happens to you, but everybody else behind you to it, you know, it affects them as well," Hernandez said after graduation. His one tip for Siouxlanders? "Just be careful. You know, know your signs, figure it out, you know, if you don't feel something right, you know, there are issues there and it's not fun. It's not fun at all." Hernandez says he plans to keep up his workout routine and healthy eating habits, with a focus on overall heart health. SEE THE VIDEO Local cardiologists explain stents and how they are used It's smaller than the tip of your finger but powerful enough to open the arteries of your heart. Millions of Americans receive stents each year, but what are these tiny, life-saving devices? If you have a blockage or narrowing of an artery around your heart, you may be told you need a balloon angioplasty and a stent placed. "This is called balloon and stenting and this is a very common procedure that has been done in the entire world millions of times already," said Dr. Gary Chan with MercyOne Siouxland's cardiology team. "So actually the rest is pretty safe." "Most of the times stents do a wonderful job and the patient doesn't have to go through a huge surgery," explained fellow cardiologist, Dr. Mir Subla. Stents are common and a lot smaller than you may think, fitting on the tip of your finger. It's typically a minimally invasive procedure where a tubing is inserted into the blocked artery. "And this tubing has some special features to it. It has a little saucer-shaped balloon attached to it so that when it's inflated, it will push the cholesterol blockage up against the wall, opening it up temporarily," explained Dr. Chan. "But then this is only a short-term solution. To really prevent it from coming back in we have to deflate that balloon, withdraw the entire tubing, put another tubing across the lesion. The next piece is the stent itself which looks a bit like chicken wire. READ MORE: Surviving a widow maker heart attack - Aurelio's story "But then in addition to the balloon, it has a metal scaffold attached to it so that when it's inflated, and then the balloon is deflated," said Dr. Chan. "The macro scaffolds stay behind keeping it up, keeping the arteries open for a long time." Patients can have multiple stents and they are permanent. "Patients can have multiple stents and they can be overlapping they can be the side branches," said Dr. Subla. "If a patient has stents and they decide to have bypass surgery as the disease progresses, they can still have bypass surgery down the road." If you have a stent placed, it's typically managed with medication and a few lifestyle modifications and can help prevent a bigger heart surgery down the road. "The stents remain open with the medications and little follow-ups with the cardiologist and it reduces the huge burden of surgery for the patient," said Dr. Subla. "And the stent just takes is one hour at least and they can go home the next day." Once a stent is placed, tissue will begin to grow around the area, completely covering the device like a layer of skin. SEE THE VIDEO What is atrial fibrillation and how is it treated?I just knew something was not right. Stephen Lordemann had his wife take him to the hospital in 2008. He'd been helping his daughter move when he started to not feel well. His heart was racing. His wife, an EMT, couldn't count his heartbeats when feeling his pulse. Lordemann was in AFIB or atrial fibrillation, which is an irregular and often rapid heart rhythm. "So in atrial fibrillation, the top chambers of the heart are beating erratically, said Dr. Gary Chan with MercyOne Siouxland Medical Center. "And because of that, blood is not being moved efficiently from the top chamber to the bottom chamber." AFIB is fairly common and some who experience it don't have any symptoms at all. So how can you tell if you could be in AFIB? "For the patient, for the general population, the easiest way to tell will be to feel their pulse. And if they feel that from one pulse to the next one, and if the duration is different then they are in AFIB," said Dr. Chan. While AFIB isn't usually life-threatening on its own, ignoring it could lead to more life-threatening issues like blood clots and increase the risk of heart failure or stroke. "In atrial fibrillation, the top chamber is, instead of pumping effectively, is actually quivering," said Dr. Chan. "So blood stays there not moving well, and as a result, blood clots can form. And the end result is that if the blood clot flows down to the bottom chamber, and pump up to the brain, it can cause a stroke." So how do doctors treat AFIB? There are a few ways. Medication might be enough to get the heart pumping in rhythm again and in some cases, shocking the heart might be needed. "And we can either give them an electrical shock, that brings it back to that sort of reset the heart and then get it back to normal or give them medicine to bring them back to a regular rhythm," said Chan. Many patients who experience AFIB end up on blood thinners, at least for some time. Age is a big factor in those who experience AFIB, other risk factors include obesity, high blood pressure, smoking and heavy drinking. "If there are structural abnormalities such as the top chambers are dilated, they are at increased risk. If they have an issue with the valve, that could also increase the chance of having AFib in the first place," said Chan. "I've experienced twice," Lordemann said, regarding AFIB. "Then had two heart attacks. Both of them had stents." Lordemann credits his MercyOne cardiology team for getting him where he is today with a few lifestyle changes and a little cardiac rehab, he and his heart are doing great. For Dr. Chan, his one piece of advice is if you feel something could be wrong don't wait to seek medical care. "But then sometimes times does matter," Chan said, "especially when it comes to matters of the heart." SEE THE VIDEO Mitral valve issues in women"I had had a heart attack on July 6th and had been having some problems with passing out. And finally, Dr. Ciuffo said he was going to fix it." Gloria Lordemann had experienced issues with her heart before. "I'd had a bypass a couple of years before that. And then this was something new and different," she said. She had a problem with her mitral valve, something fairly common for women. "If you take a sample of the population between the age of 25 and 40, one woman out of six has what we call mitral valve prolapse," said Dr. Giovanni Ciuffo with MercyOne Siouxland Medical Center. "It's like sort of a redundant amount of tissue." But what is a mitral valve and how does it work in your heart? "The heart has four valves and they work as one-way valves. You have two on the right side which is the side of your heart that pumps into the lungs, oxygenates the blood and then it goes back to the left side of the heart," explained Dr. Ciuffo. "Mitral valve is in a pumping chamber, when the heart squeezes the mitral valve closes to make sure there's not backflow into the lungs and it flows into the main pipeline in the body that carries oxygenated blood all over the body." There are two main problems a person can develop with their mitral valve; it can leak causing blood to flow backward into the lungs, or it can struggle to open properly leading to a buildup of blood and pressure in the lungs. "In severe degrees, mitral regurgitation will really make your life miserable, swollen legs, very short of breath," said Dr. Ciuffo. "You can't even go to a supermarket and push a cart, it gets that bad." The surgical procedure to fix a mitral valve used to mean open heart surgery. Now, it is a minimally invasive procedure. "But for the last 20 years, I was able to implement a minimally invasive technique, such as the one I use in this patient, where you can actually make a small incision on under the skin fold of the right breast and you go between the fourth and the fifth rib. That's what we call minimally invasive," he explained. "You don't break any bones. It's minimal amounts of bleeding." This also means a quicker recovery. But why do doctors see more mitral valve issues in women than men? "They actually would tell you that probably one of the most common things is, that's sort of a far-fetched theory, there are moments in a woman's life where soft tissue becomes loose," explained Dr. Ciuffo. "One classic thing is when during pregnancy is a natural adaptation because you have to deliver a baby and having the extra loose stations it makes it easier. But other than that, I would say there are certain features that belong to one sex or the other the general." For Gloria and her husband who also receives cardiac care here, making the drive to MercyOne for their heart health was a no-brainer. "I've had the best of luck here with mercy. they've handled all my problems and taken great care of me," Gloria said. SEE THE VIDEO MercyOne cardiologists find lifesaving treatment for early COVID-19 patientsIn the early days of the COVID-19 pandemic, doctors didn't know how to treat the sickest patients. Everything about the virus and how it interacted with the body was unknown. But when ICU specialists and the cardiology team at MercyOne Siouxland Medical Center came together in the fall of 2020, they discovered that a piece of equipment in their arsenal was just what they needed. "We learned a lot about managing COVID patients. You know, our first wave was truly disheartening because it was sort of a new disease that we had to deal with. And our therapeutic options were pretty limited." Dr. Giovanni Ciuffo wasn't used to working with Intensive Care Unit staff. "Intensive Care Unit specialists don't interface much with a heart surgeon but that became a necessity," he recalled. That necessity began when the first wave of COVID-19 hit Siouxland and doctors had to use everything at their disposal to save lives. Doctors turned to an external oxygenation device, something cardiologists typically used for patients who suffered cardiac issues. it's a modular cooler, heater-cooler, that circulates water through these pipes and it controls the temperature in the patient," Dr. Ciuffo explained. "You can hook it up to the machine and dial the machine and say bring the patient back to a normal body temperature 98-99." This machine can essentially oxygenate your blood for you. Something many otherwise healthy people were struggling to do after testing positive for COVID-19 and ending up in the ICU fighting for their lives. When the MercyOne team first began using this machine to treat COVID-19 positive patients, they were among the first in the nation to do so. "You know, when we started doing this, we were among the first guys doing it in the country. Here was a brand new concept where, well let's try to bail these patients out," Ciuffo said. But they worked in cooperation with hospitals nationwide in finding a new way to care for patients with an unknown virus. "You can see there's an oxygen tank here. And in addition to that, there's an oxygen rate regulator, see the air oxygen mixer," Dr. Ciuffo said as he walked me through the large machine. "And we can basically modulate how much oxygen is put through the oxygenator while the machine flows so that I can control the patient's temperature, how much I'm flowing." This machine takes your blood, oxygenates it, and gives it back, taking work away from your body and giving it a chance to heal. "And what you do with his machines, you actually connect them to veins and arteries in the body and circulate the blood into an oxygenator something that basically is replacing your lungs," Dr. Ciuffo said. "You oxygenate the blood, give it back to them and that will give them the break they need to get through the COVID infection until the lungs recover their ability to oxygenate." The oxygenator is used to help those who have suffered a massive heart attack, pulmonary embolism, or blood clots, and those whose heart has stopped because they got too cold. This machine can help bring their temperature back up and help bring them back to life. "So this one is basically what will keep your patient alive and well. While they go into the next level of treatment if it's available to them." While the outcomes were initially unknown when treating COVID-positive patients, they saw positive results. "In medicine, you always had to strike a balance between what's reasonable to help someone and what's just far fetched," Ciuffo explained. "In those patients that we use this machine on really he was not far fetched. They survived. So it was well worth all the effort we put on it." For Dr. Ciuffo, and others in the fight to save lives, it's all about giving people a 2nd chance at life. "Human Physiology, this complex beautiful machine we call the human body with lungs and kidneys and heart and brain and electrical system and all that is incredibly complex." SEE THE VIDEO A peek inside the Cath Lab at MercyOne SiouxlandA catheterization laboratory may look like a scary place with a big name, but it's a common stop for patients entering the hospital with possible cardiovascular problems. "In the Cath Lab, what happens is patients will be brought into the cath lab such as this, and their heads will be up here near the imager and their feet down here," said Dr. Gary Chan, a cardiologist with MercyOne Siouxland Medical Center. In the Cath Lab, cardiologists use diagnostic imaging equipment to visualize the arteries and chambers of the heart. "Now there are two ways to do the cath. One is to the wrist and another one is through the groin." During the procedure, the patient will be moderately sedated to help calm the nerves and ensure they can lay still for 45 to 90 minutes. "They will put a fine tube in a way very similar to an IV but then the tubing is way longer because it has to be long enough to go all the way up to your arms to your heart or from the groin so that they can inject some contrast to it," said Chan. "And then with that, they can visualize the three coronary arteries in the heart and see if there's any blockage." Dr. Chan says there are generally four outcomes from a cath procedure. The first, nothing is wrong and the issues the patient is feeling are not related to a blockage in the heart. "Outcome number two is the patient does indeed has some blockage and that can be fixed by a stent," said Chan. The third outcome is when a stent doesn't work and the patient will be referred to a cardiothoracic surgeon to see if they qualify for bypass surgery. "In a bypass surgery, what happens is they either use your own blood vessel in your chest wall area, or harvest a piece of veins in your legs, and then just sew it across the blockage, that's why it's called bypass," said Chan. "The earlier we open a blockage, blood vessels supply the heart the more recovery the heart can retain the functions we can prevent loss of functions of the heart." The 4th outcome, if a stent or bypass is not an option, is medical management. "The last outcome is then also not a candidate for this and that will be managed medical management," said Chan. "Only meaning that we keep them we give them the medicine that will help prevent further progression of the disease." Dr. Chan says health risks in the cath lab are minimal, with possibly some minor bleeding at the insertion site or a drop in blood pressure. "If this is an elective procedure is generally safer than someone coming in with a cardiac arrest or having an acute heart failure flown in from a rural area," said Chan. "So this is totally different. The risks are totally different." SEE THE VIDEO Cold weather and heart attacksWinter weather typically means snow and ice which also means shoveling snow and bitterly cold temperatures, but did you know that combination could lead to a heart attack? "It is comparable to if we got on one of these treadmills and we're running full speed." Bridget Hayes Beck is a Registered Nurse at Mercyone Siouxland's Cardiac Rehab Center, "it just shocks people that when they go out and shovel their walks in their driveways that how much stress that puts on their heart." She's helped Siouxlanders recover after suffering a heart attack in the winter and has a word of warning for Siouxlanders. "If we could get the word out to the public, that is very dangerous to just go out and start shoveling the walk and the driveway." But why are heart attacks common in the winter months? Simple... the cold. "It does really wear on the heart, that cold air coming into the lungs, into the heart can constrict down the coronary arteries and that's where people have problems," she said. "It will cause those coronary arteries that are smaller than drinking straw to constrict down. And at that point, some people do have a heart attack meaning that the heart cells do not get oxygen and do not get the blood that they need." There are a few things you can do to stay a little safer while shoveling snow or working in the cold, like taking frequent breaks. "It's very important to warm up. It's very important not to have a big meal beforehand," she said. "And then when you do go out there take small breaks." And this is especially true for Siouxland farmers, who spend hours outside working at a time. "Now if you try to tell that to a farmer who's going to be out there for three hours, no take your breaks," she said. "Especially let a family member know that you're out there." When in doubt, take a break, and if something doesn't feel right, seek medical assistance right away. "But the most important thing is to make that phone call or have your family member make the phone call for you." SEE THE VIDEO Preventing heart attacks with simple life changesHeart attacks and heart disease can present differently in everybody. "In women, in particular, especially older women, the symptoms are typically unusual," said Dr. Glynne Edwards. "It can be breathlessness and just shortness of breath, unusual sweating episodes, sometimes a toothache, even belching, unusual belching symptoms." Signs and symptoms of heart attacks, heart disease or coronary artery disease can manifest with pain or pressure in the chest, which typically moves toward the left side of the body. But what can cause these life-threatening events? "A very common thing is high blood pressure and high blood pressure has a lot of effects on the heart that, if unchecked, you know, heart failure relationship," said Dr. Edwards. Another common denominator? Genetics. "Knowing your family history of heart disease is also important," said Dr. Edwards. So how can you stay heart healthy?Regular exercise is a good place to start. "The American College of Cardiology has a recommendation for 120 minutes of aerobic exercise in the seven-day period," said Dr. Edwards. Watching what you eat is important, too, as well as staying away from tobacco use. "Smoking is the number one modifiable risk factor for the use of hierarchy disease animalism formation, vascular disease in the legs and the stroke." At the end of the day, staying active, eating a balanced diet and knowing your family medical history can be a good start in keeping your heart healthy each and every day. SEE THE VIDEO Smoking isn't just bad for your lungs, but your heart, too"Smoking is probably the number one most important preventable risk factor when it comes to heart disease." We've all heard the warnings about smoking and your lungs, but did you know it's just as bad for your heart? Not only heart disease but coronary artery disease and many other life-threatening health issues. "There is increased risk of strokes, increased risk of blockages in the leg arteries and damage to the major arteries of the heart and the body, in particular, the aorta which can become involved forming an aortic aneurysm," said Dr. Glynne Edwards. "And in these cases, these always require emergency surgery. So, an ounce of prevention is better in this in this instance." Smoking and tobacco use can cause your arteries to shrink, "and what we call vasoconstriction, where the arteries actually shrink from this size to 1/3 of the size in response to these toxic chemicals," said Dr. Edwards. Not only that smoking and tobacco can also cause plaque build-up in the arteries feeding your heart. "In some instances, the narrowing may not be acute but so severe that it weakens the heart muscle to the extent that you develop what is called heart failure," said Dr. Edwards. "Overall, it triples or quadruples your risk of getting a heart attack. If you're under 50. That risk is increased sevenfold. more than doubled your risk of having a stroke." And if keeping yourself healthy isn't motivation enough, think of the health damage it can cause to those around you. "The only thing I want to mention is that secondhand smoke also tripled your risk of having heart disease and we've actually looked at data for folks who have been exposed to secondhand smoke over a lifetime 20-30 years, their risk of developing coronary disease even though they didn't smoke themselves, is three times higher than folks who are not exposed to secondhand smoke." While this is probably something we've all heard before, the best thing you can do is put that cigarette down. "So generally the advice in anyone who smokes and who has heart disease would be to find a way to try to quit." SEE THE VIDEO Breast Cancer Awareness: The importance of monthly self-checks The month of October is Breast Cancer Awareness Month and while it's a great time to shine a light on the women who are fighting, have fought, and who have lost the battle to breast cancer, it's also a time to highlight the importance of prevention. Katie Couric is a familiar face to many. She woke Americans up every morning on NBC's TODAY Show from 1991 to 2996, became the first woman to anchor the CBS Evening News in 2006, and has been a longtime advocate for cancer research after losing her first husband to colon cancer. On September 28th, 2022, Couric announced her own health battle, with breast cancer. "It was June 20th and because of the pandemic, I was 6 months overdue for a mammogram." Couric was just like many other women across the U.S. and put off her yearly mammogram. When she went in for her appointment in June, she took the camera with her to document the journey, much like she did in 2000 when she got a colonoscopy on the TODAY Show. But that appointment quickly took a turn when doctors found a concerning spot on her mammogram and ultrasound. "I had a wire put in my boob, which is basically providing guidance for the surgeon because I have a little lump situation," Couric said in the video she posted on her Instagram page sharing she had been diagnosed with HR-positive, Her2neu-negative breast cancer on June 21st. Women over the age of 40 are encouraged to get a yearly mammogram and because of COVID, many have put off this lifesaving screening, and for some, they haven't had a mammogram since the start of the pandemic. This is why medical providers are highlighting the importance of monthly self-checks at home. "You're going to know before anybody else." Jeanne Rasmussen is an ARNP with UnityPoint Clinics and says these monthly self-checks can be quick and easy, and the first sign that something could be wrong. "Boobs are like bags of rice and you're looking for a pee in there," she said of the checks It's also important to remember that breast tissue can be located up into the armpit. It isn't just adults who should be doing self-checks, but teens as well, because getting familiar with your body and its ebbs and flows are an important part of your health. "As soon as you start getting your period you're going to have breast changes or hormones. Even when you're pregnant. All of those things stress can cause changes," Rasmussen said. "And just to be aware of those and if you find something, that's concerning them to let us know." Dr. Adnon Qualbani is a radiologist at MercyOne's Breast Care Clinic and says spending a few minutes on each side is all it takes. "I think it's important to conduct the self-exams kind of the right way. Check up into your axilla as well. Some women have accessory breast tissue that hides up there," he said. "You want to move a motion from the outside and in toward the nipple, kind of like spokes on a wheel." "We always check for any dimpling of the skin, like if it looks like an orange peel. That's something that you want to let your doctor know about," Rasmussen said. "If you have any redness, any soreness, any pain." The best time to do these self-checks is 7-10 days into your menstrual cycle. "If you check your breasts before you have your cycle, you're going to feel a lot more lumps and pain and so forth," said Dr. Qualbani. "If you do it a day seven to day 10, meaning the day your period starts you call that day 1, seven to 10 days out there's a window where your breasts are the most sort of calm and less lumpy, less painful. That's the right time to check." Dr. Qualbani says if you find something unusual during these monthly checks, it is perfectly okay to wait a month to see if anything changes before you call your doctor. If you do feel something it's perfectly okay to wait one menstrual cycle and then check again and see if it changes," he said. "If you check it every day or every week you'll go nuts wondering if that thing is real or is it changing?" As for when a woman should start getting yearly mammograms, the recommended age is once you turn 40, but there are some stipulations. If there is a history of breast cancer in your immediate family, like a mother or sister, yearly mammograms should begin 10 prior to their diagnosis age. So if your mother was diagnosed at age 42, you'd begin yearly screenings at age 32. At the end of the day, these medical providers say, you know your body best. If you feel something is wrong or concerning, call your primary care provider and get it checked out. SEE THE VIDEO Breast Cancer Awareness: A Siouxland woman's journey from mammography tech to patient "I came in happy-go-lucky to see my own colleagues and have plans to have lunch with them and left thinking what's going to happen next?" Andrea Roost turned 40 in January. in May.. she returned to MercyOne's Breast Care Center where she worked as a mammography tech for 12 years to get her first mammogram. It would also happen to be the last routine mammogram that she'd need. Roost was diagnosed with breast cancer on May 5th. She did everything she was supposed to: self-examinations, conversations with her primary care doctor, and a mammogram at 40. Nothing led her to believe breast cancer was in her future until it was. "I am the reason this is why we start screening at 40," she said, "because the cancer that I have would have killed me if I would have waited until 45. Or even 50." Roost is grateful to have the team at MercyOne's Breast Care Center next to her through this journey, something these women do for all who walk through their doors, and a team she was part of for more than a decade. "The heart behind every staff member in this office is 100% pure," she said. "They understand what these patients are going through. And they kind of change and flow with that patient with their needs." For women needing a mammogram, the fear and anxiety of what the scans may show is real and something those in the breast cancer community calls scanxiety. "It's in reference to the anxiety that you have before, during and after your scans, whether it's you know, engaging in chemo response or your follow-up," Roost said. "I think that's really relevant in the screening and diagnostic world as well. I counseled people on this when I was an active technologist." Once holding the hand of those coming to the clinic, she is now leaning on her former colleagues to guide her through her own journey with breast cancer. "It's okay to be scared. That's why we're here is to get you through that to talk you through that," Roost said. "The unknown is scary, but ignorance is worse. That's the best way I can put it." Roost's cancer journey is just beginning but she hopes that sharing her story can shine a light on the importance of breast care. "I still have a rough road ahead of me. I've finished chemo. I've had one surgery to remove the tumor and my lymph nodes. I still have a bilateral full mastectomy to do. So it's the worst is yet to come," she explained. "But I'll be looking back on this in a year and be smiling in here to continue to tell my journey." SEE THE VIDEO Breast Cancer Awareness: Breast Care Coordinators bring unique care to Midlands clinic Receiving the news that you have breast cancer is shocking leaving most wondering, what do I do next? At Midlands Clinic in Dakota Dunes, they have a pair of dedicated women whose job is to help women through their breast cancer journey. "I would say the unique part about our offices, the coordinators, and the role they play in navigating care for those women from start to finish," said Dr. Craig Nemechek, a general surgeon at Midlands Clinic. "We just help patients navigate through their journey," Nicole Trudeau is one of the Breast Care Coordinators at Midlands Clinic. She and Sophia Summervold play a key role in helping women navigate their new reality. "We basically start the process of getting them post-diagnosis, getting everything lined up so that they can go through the next process or next part of the process," said Summervold. "They have so many different doctors that they're seeing. They don't know who to call, what do I do next? Who do I call? What's the next step? So we kind of take that and we do all of that in the background so that they don't have to worry about that." They help women through the emotional journey the diagnosis brings, too. "It's a big diagnosis, people are overwhelmed," Trudeau said. "It's a lot of terminologies that they don't know. It's a lot of tests that they've never had done before." Trudeau and Summervold carry a cell phone, one that their breast cancer patients have a direct line to. "They can call a direct number instead of kind of going through the rigmarole of going through the office. So they can call us directly or text so we can talk to them directly and answer their specific questions," said Trudeau. "Women are very different in how they react to that news," said Nemechek about the diagnosis, "and I think the nice part is that with our coordinators, they've seen all types of different reactions and they know very well how to handle those emotions." "Everybody's breast cancer is completely different. So it's hard because some people know so and so who had it but they can't always rely on what that person had because it's very different for everybody," said Summervold. "I just think it's important for people in Siouxland to know that there is a strong support system at many of our medical facilities dealing with breast cancer, not only as their physician but there's also other support staff who can help everyone through their journey," said Trudeau. And for the month of October, their biggest message is this. "Do your monthly screenings no matter what age you are," said Summervold, "and then also working with your primary care doctor to make sure you're getting your screenings is super important. Because the sooner that you can get that diagnosis, the sooner you can kind of get through it." SEE THE VIDEO Breast Cancer Awareness: June E. Nylen Cancer Center at forefront of treatment advancement The treatment for breast cancer has changed a lot over the years, and a Sioux City medical center has played a key role in that development. "We have actually been involved in trials that have actually changed how we treat breast cancer patients," Dr. Donald Wender, a physician at the June E. Nylen Cancer Center in Downtown Sioux City, has been one of the doctors on the leading edge of those advancements. "There's a study looking at a test that who we should give chemotherapy or who doesn't need chemotherapy," said Dr. Wender. There's been a shift in treating certain types of breast cancer which have also led to a common misconception. "We're using less chemotherapy after surgery, so a lot of people think they are going to get chemotherapy and they don't." Instead, thanks to clinical trials and medical advancements over the last several years, many types of breast cancers are being treated with more immunotherapies and fewer chemotherapies." "And in the most recent advance in there as with immunotherapy," said Dr. Wender, "we know that there's with chemotherapy and immunotherapy we can get another a lot of them to get a complete response with chemotherapy before surgery." Dr. Wender has been working with breast cancer patients throughout his career and involved in some major advancements in breast care. In fact, the way we standardly treat breast cancer patients we were involved in most of those trials. According to the State Health Registry of Iowa, over 14% of all new cancer diagnoses in Iowa this year are projected to be breast cancer, the largest percentage for any type of cancer statewide. Sioux City is the lowest metropolitan area in Iowa with women age 40 and up who have skipped getting a yearly mammogram. And looking at data from a 12-year study from 2004 to 2015, the risk of developing late-stage breast cancer is higher in the Sioux City area compared to the 12-year state average. Which is why these new therapies and clinical trials are important. The June E Nylen Cancer Center has played a big part in the advancement of breast cancer treatment and while there aren't as many clinical trials as in the past, Dr. Wender says the ones that are available, are working to answer the even harder questions. "There are not as many trials but there are a bunch of trials looking at new approaches. And then, of course, we try to add immunotherapy," Dr. Wender said. "The clinical trials have slowed down. Before we had a lot of big questions that needed answered, you know, do you give chemotherapy, what chemotherapy do you give? Now we're trying to refine them down to new agents looking at things in metastatic disease." The treatment for breast cancer has come a long way and the standard of care is constantly evolving. Thanks to the dedicated work of physicians like Dr. Wender and the team at the June E. Nylen Cancer Center. SEE THE VIDEO Breast Cancer Awareness: Breast cancer doesn't end when the pink ribbons come down As the month of October of comes to an end and the pink ribbons come down, it's a good moment to remember what they stand for: our mothers, daughters, sisters and friends fighting breast cancer. "I also think it's a good month to remember the women that have done that had been through a battle with breast cancer or other breast ailment or disease and kind of remember those women as well and what they've gone through," said general surgeon, Dr. Craig Nemechek with Midlands Clinic. Siouxland has a vast array of resources for women from breast cancer prevention to treatment to post-cancer care. "I just think it's important for people in Siouxland to know that there is a strong support system at many of our medical facilities dealing with breast cancer," said Nicole Trudeau, a breast care coordinator at Midlands Clinic, "not only as their physicians, but there's also other support staff who can help everyone through their journey." "We try to provide support, we try to answer questions as best we can. We try to give women a path, some knowledge that tries to ease their concerns," said Dr. Nemechek. "We can't obviously answer every question, but I think and I hope that women after that first visit have a better bit better understanding of what they're going to go through and what they can expect, and hopefully that can ease their mind." One of the biggest pushes during the month of October is the importance of yearly mammograms for women beginning at age 40, or for some, sooner. "Typically we start at age 40 unless there's a first-degree relative, that would be like your mother or sister," said Jeanne Rasmussen, an ARNP with UnityPoint Clinics. "And they begin having their (yearly mammogram) done 10 years prior to when they had breast cancer. So if Mom was 42 when she got diagnosed, at age 32 you would start getting screening mammograms." Many women skip their yearly mammograms, and that is especially true after the COVID-19 pandemic. "Some people, I think just kind of put it off because they're scared, but I think it's important to kind of face that fear because not everybody ends up having breast cancer," said Sophie Summervold, another breast care coordinator at Midlands Clinic, "but if you have a lump or a bump, it's important to address that with your primary care doctor or ask for that referral. Kind of be your own advocate to move on to the next step to see if you do need to be concerned." There is also one piece of preventative care women of all ages can do right at home each month: self-checks. "Get to know what your breast feels like, what your normal lumpiness feels like, what your cyclical changes feel like, and then you'll know if there's a change therein," said Dr. Adnan Qualbani, a radiologist at MercyOne's Breast Care Center. "There are all these things available for dealing with lumps that are even benign and sometimes just even getting a benign lump assessed to see what it is and then you know it's benign. It doesn't have to always be a suspicious lump you want to be checked, anything that bothers you is worth getting checked." And if you feel something concerning it never hurts to get it checked out. SEE THE VIDEO Serving Siouxland: Center For Siouxland empowers financial freedom for Siouxlanders The Center For Siouxland is a home for many Siouxlanders, providing financial help and literacy to people from all walks of life. "So our mission is to help people empowering lives and building futures through providing self-sufficiency," said Executive Director, Jonette Spurlock. "Helping people provide financial stability, and that doesn't always mean giving them cash to help them that means giving them the tools to do it themselves, being a resource being here if they have questions." Spurlock says they help people from all across Siouxland, and often, see them come back to utilize various services, or just to say hello. "We'd like to develop relationships with our clients, we don't want to be a one and done." One of the biggest programs the Center For Siouxland is known for is the VITA program, or the Volunteer Income Tax Assistance program, which has been around in some form for about 40 years. "The tax program really saves those households, anywhere between $250 and $400, per year," said Susan McGuire. "So that's money that they get to keep in their pockets." VITA is completely volunteer-run and the need for the service has grown exponentially. McGuire, who helps oversee the program, said they helped more than 2,000 Siouxlanders last tax season. "And there is so much more need," McGuire said, "I mean if we could get more volunteers and have, you know, more offices more times available. There are so many more families who could benefit from the service." Alongside tax services, the Center For Siouxland also helps rebuild or rework finances for those who need a hand, from credit to mortgages and everything in between. "Finances are a private thing, typically," said Lori Scott, who manages the financial arm of Center For Siouxland. "People aren't typically just going out and telling all their friends, 'I'm struggling with making my payments'."Everything we do here is confidential," Scott said, "but our goal is just to let people know that we're here to help them and that they don't have to be alone." She says the first and most important step for anyone in a financial struggle is asking for help. "Typically, the most difficult part of this process is making the phone call originally, and then once the phone call is made, we get the ball rolling and help get them in as soon as possible," Scott said, "so that we can try to work with them and find a solution to their, their particular situation." The Center for Siouxland also provides transitional housing with Bridges West, which celebrated 20 years in operation this year. "We have 22 units of transitional housing for homeless families and individuals, and they can stay in our program for up to two years," McGuire said about Bridges West. "Our goal is to have them move through our program and exit to their own permanent housing within a year." McGuire says while some at Bridges West are homeless, they come from different backgrounds and struggles. Some fleeing domestic violence or abuse, others have been evicted from their homes, or have just fallen on hard times. Each of them has a goal and a plan to get back on their feet. "While they're in our program, folks work with our case managers to develop goals to help them with income, employment, education," she explained. At Center For Siouxland, their mission is to help people navigate the crazy and ever-changing world we live in. Because helping one person, can change the entire course of their life. To learn more about Center For Siouxland and its programs, visit their website here. SEE THE VIDEO Serving Siouxland: Boys and Girls Clubs teach kids to be the best they can be The Boys and Girls Clubs of Siouxland have been a staple in the community for decades, helping Siouxland youth from all walks of life be the best humans they can be. "You've actually been here for 53 years now in Siouxland and we have tremendous support within our community," said Kalynn Sortino. "We're an after-school program," Jen Williams, "and so our mission is to have productive caring, responsible citizens." Jen Williams is the Director of Operations at the Clubs and has spent many years within the national organization. "We're not just you know, babysitting," Williams said. "We're an after-school program. We teach the kids different things that they might not get at school, and different life skills and social skills here at the club." She's seen firsthand the positive impact a non-profit like the Boys and Girls Clubs of Siouxland can have on local kids. "Some of the kids, when I first started, are graduating high school, going to college. Some of them are currently working for the club, so I get to see how they've gone through school, starting college their first jobs, maybe their first jobs here and they want to give back to the community," Williams said. "So that's just the thing that sticks out the most is just making the relationships with the kids." The Boys and Girls Clubs of Siouxland offers something for everyone. From homework help to sports, reading and theater, there are activities that every kid can enjoy while building relationships that can last a lifetime. "I think the biggest thing though is just for them to have a safe place to go after school, where they can truly be a kid." And it isn't just that, the team at the Boys and Girls Clubs of Siouxland are there for whatever the kids need, even if that's just lending an ear. "If they're having something that they're dealing with at home or personally, and that they want to try to overcome, all of our staff is willing to listen and that is, I think, the best thing that we can provide for any child," said Sortino, the Resource Development Director at the Clubs. Sortino says that while there is a fee to join, the Club makes sure their services, including after-school transportation, are available to anyone. "We always have openings for families," Sortino said. "It is $10 to attend our club for the school year. So it's financially possible for any family to participate." The staff and volunteers at the Club have created a nurturing environment where kids can be kids, each and every day. To learn more about the Boys and Girls Clubs of Siouxland, visit their website here. SEE THE VIDEO Serving Siouxland: Mary J. Treglia Community House helps immigrants create a new home"I came out of my office just for a break, and I walked out and there were five different conversations happening in this room, in five different languages. And that to me is incredible." Becky Carlson is the Executive Director of the Mary J. Treglia Community House and her office sits right off of the lobby of the Jennings Street building. "It's a community house," she said, describing the place the community house has called home for decades. "It's like the place you go when you need something, but also to socialize and to get integrated into your community." The Mary J. Treglia Community House celebrated 100 years this year, a century of service helping generations of new Americans create a home in Siouxland. "Sioux City is kind of a small town when you think about it," Carlson said, "like Chicago and different places like that, but we are a big community because we have so many different cultures here." Sioux City is one of the most diverse communities in Iowa and a big reason why is because of the community house. One of their biggest services is English classes, teaching non-native speakers the basics of the language. "Some of them are non-speaking English at all, zero," said Halima Osman, the ESL instructor at the Community House. "Some can't even say hi." She teaches basic English, two levels of courses, to Siouxlanders to help them navigate this new city and for many, this new country. "I focus more on level one where "Hi my name is so and so", "I am from", just the very basics of what your name is, how old are you, what is your birthday." Osman is also learning right along with her students, too. She says they teach her something new in each class. The Community House continues to spread the message of the woman who shares their name, Mary J. Treglia dedicated her life to serving Siouxland's immigrant population. "I mean, I can't imagine going to a foreign place and not really having somebody to go to for any needs that you have," said Mercedes Dimas, "and for them to come back and say hey, like, I know that you'll help me, that's just a great feeling. The community house helps many in the Spanish-speaking community and that's where Dimas comes in as the Family Services Coordinator. She also helps refugees who now call Siouxland home. " Our primary goal and like what we focus on is really just empowering people that are coming in and hopefully," Dimas said, "with that empowerment, we're encouraging even more people to come into our communities." Andrea Paret has two main roles within the Community House. She's their accredited representative for the Department of Justice and works with those seeking American citizenship. "The immigration system right now is very, very complicated and chaotic, and we have to explain to a lot of our clients now the wait times are very, very long, especially with COVID," Paret said. "But it is expensive and you have to bring a lot of documents and make sure you have everything correct and from now your whole immigration history. So they really look very, very strict into everything, if you're really eligible." "They want to make sure you are entitled to citizenship, with all the responsibilities and advantages that come with it." She helps Siouxlanders through the process of becoming American citizens. "There are a lot of requirements, and one of them is that you need to speak and write and understand English," Paret said, "So we also do offer English classes. But we're excited to help and encourage people who are eligible to apply for naturalization." Along with citizenship services, Paret also teaches preschool at the Community House, which offers a DHS-licensed school to Siouxland kids. "Currently we have children in our preschool from several different countries including Eritrea, Ethiopia, Somalia, Marshall Islands, Mexico, El Salvador and the United States," Paret said, speaking of her class. "70% of communication is by body language and virtual and that was that preschool if you use a lot of visuals no pictures about everything you have like the daily routine and you have pictures, everybody's going on the circle or a book that's being read or, so that helps a lot." In a preschool class with so much diversity, the students are immersed in a world different from their own, learning every day that their friends come from all over the world. "And I think it helps children just from a young age to just to learn that it's okay if we come from different places if we wear different clothing. If we have different customs and it's just a given and fun to learn about each other," Paret said. The Mary J. Treglia Community House offers so much to so many, with programming as diverse as the community they serve. "Like this community, this entire country is really just made up of so many immigrants and it's so fascinating that we have all these cultures, right, like available for us to learn from," Dimas said. "It's easy to forget that if you stay in your little bubbles," Carlson reflected back on all of the people she's met during her time at the Community House. "But if you open up and are able to like, get to know other people or the community you'll see there are some really amazing things that are happening from all different cultures." If you'd like to learn about the services offered at the Mary J. Treglia Community House, visit their website marytreglia.org. SEE THE VIDEO Serving Siouxland: Girls Inc. shows girls that perfection is just being who you truly are For young girls, the pressure to be perfect can be overwhelming, but there is one place in Siouxland girls can go where they can be themselves without those impossible standards. "We know for example that girls are really impacted by perfectionism that they put on themselves or that maybe is from the outside, the influence of peers, and that is a big pressure in their lives. And then people-pleasing so all of those add up to really impossible standards to meet and can impact self-esteem." Mandy Engel-Cartie is the Executive Director at Girls Inc., a local organization that has taught girls that being perfect is just being true to who you are. "We want them to know it's okay to put a little bit of pressure on yourself to succeed to try harder to achieve, but that doesn't have to be the end of the story," Engel-Cartie said. Girls Inc. has been a part of Siouxland for 35 years, helping hundreds of young girls find their true potential throughout the last three decades. "That's kind of my role around here is to make sure that the girls' environment is positive, is always responding to whatever their needs may be, both within the organization, and outside in the world that they face, and also to make sure that we give them any kind of hand up that they might need," Engle-Cartie said as we sat in their science lab. Girls Inc. is more than just an after-school or summer program. They give young girls the space and freedom to discover who they are in the presence of their friends, and mentors who help them along the way. "I love Girls Inc. because they're able to assist kids not only with school and personal matters but pretty much in every aspect and however they need help, we're able to service them," said Program Director Olivia Ray. Inside Girls Inc., girls are able to learn about things they otherwise wouldn't in school, like how taxes work and what to expect from their first job. "This financial literacy course teaches kids about taxes, why we have to pay taxes and what that tax money is used for," said Ray. "They also learn how to fill out a W-4 form, and how to read their pay stub." They also have a computer lab and a science lab, where the girls have a chance to create, make mistakes and learn along the way. Engel-Cartie says science is a perfect example of how being perfect, isn't always the way to go. "We know science is not about perfection." "Science is about experimenting and getting things wrong and then thinking how can I do that again and get it right, so you're focused more on what's going to happen and what you want to happen, and less on your failures." The staff at Girls Inc. lead by example, stepping out of their own comfort zones to show the girls that making mistakes and looking silly is not a bad thing. "A big part of our mission here is saying to girls, we don't care if we look silly doing this for the first time or the 50th time," Engel-Cartie said. "The point is we're all in this together. We're all supporting each other and we don't want you to give up. And many staff, like Ray, continue this work outside the walls of Girls Inc. Ray also works in the juvenile detention center, teaching critical skills needed in the outside world and an opportunity to learn from past mistakes. "It gives them a chance to reflect on the decisions they made and also gives them time to move forward and make better decisions in the future." Ray teaches fitness at the detention center, and also a financial literacy class. Back at Girls Inc., it's all about creating an environment where these young women can feel safe and empowered away from the pressures of social media. "Body Dysmorphia is a huge problem with girls," Engel-Cartie said. "They're self-conscious very often about how they look because of the messages that they've received in their lives and we really want you to know that being a girl means that you have wonderful strengths, and you have an amazing future, and we want to be here to help you go the direction that you want to go." More than three decades after the first girls walked through their doors, Girls Inc. continues to be a place where they can thrive. "We want to learn to know that after 35 years, we believe in girls. We're the expert in girls, and we want your girls to come here, learn about themselves and be part of the supportive environment," Engel-Cartie said. If you want to learn more about Girls Inc. or enroll your child visit their website at girlsincofsiouxcity.org. SEE THE VIDEO Serving Siouxland: Bigs & Littles come together at Big Brothers Big Sisters of Siouxland Having a big brother or big sister is something many kids dream of. One Siouxland organization is helping them have that experience thanks to some generous volunteers. "I hope to get close to him, you know, see him grown up and see what he becomes and just be there for him and know that he can count on me for anything they can needs." Jesus Jimenez is a big brother to Tristan, but not in the way you may think. They are part of Big Brothers Big Sisters of Siouxland, an organization paring adults, or bigs, with local kids, or littles. It's a mentoring program that's created everlasting bonds. "So it's been great just hearing all the success that our matches have had." Kristen Langel is the Program Director at Big Brothers Big Sisters and was a Big Sister herself. She knows firsthand how this program can change the lives of those involved. "It's just having that extra person that a child can reach out to, can talk to," Langel said. "You know kind of share things that they don't have that quote-unquote big brother or big sister at home who they can share problems that they're dealing with friendships or school or their siblings bugging them, just kind of thing and get that one-on-one quality time with somebody else." Matches are made based on interests, preferences, and commonalities. "We make sure we find a big, who you know is interested in the same activities as a child, maybe has those same experiences, and we match them that way," Langel said. Bigs are required to set up at least two outings a month with their littles, but many go above and beyond that. And those meetings can be anything from a movie day to a trip to the ballpark. Jesus has a fun way to create memories with Tristan. "I met with Tristan and his grandma and we kind of thought of ideas to do, and I jotted them down on popsicle sticks and every week that I go visit him, he draws one out and see what we're doing." Jesus and Tristan are a great pair and were heading to a picnic after our interview. Kristen says they are always looking for bigs and little with many on both sides waiting for that perfect match. "I think it's just those connections, and especially in the last 18 months between children being out of school and virtual learning at home and through the pandemic, just the importance of having that person," Langel said. If you'd like to volunteer to be a Big, or if you have a child who could benefit from being a little to someone in Siouxland, you can contact Big Brothers Big Sisters of Siouxland. SEE THE VIDEO Misinformation: What it is and how to identify it "A report just came out recently that showed that 65% of vaccine misinformation comes from 12 people on social media." It's not just false information on vaccines that make the rounds online, nothing is truly spared from being the victim of misinformation. From politics to pizza shops, and sometimes a combination of both, misinformation, or the spread of false information perceived as truth, has been around for decades. "Misinformation is anything that's designed to try to put doubt in people's minds about the truth." David Elder is a professor at Morningside University and specialized in misinformation and propaganda. “I teach a class about propaganda,” he said, “and propaganda is just purposeful manipulation of a large group of people. And usually what you see in misinformation, is it will include some hint of truth and then skew it to fit a certain agenda.” Teaching about misinformation isn’t just looking at how it spreads, but how to identify it. One surefire way to know the information is factual is by verifying that it is from a credible source. "And so, to have a credible source you need to make sure that there's an author,” Elder said. “You need to make sure that they have the right background in order to have some sort of opinion on this thing." A credible source doesn’t necessarily mean someone with a familiar name. It’s important that they have the right background to be speaking on the topic. “There are epidemiologists who are on Facebook, trying to tell us what is true and what is not true. But oftentimes, those aren't the people that we recognize,” Elder said. “Just because you recognize someone via your family member your friend or even some pundit on TV that you watch every night. Just because you recognize them doesn't mean they always have the correct information. So, going to a source that has a scientific background can be a great way to stop that spread.” Misinformation has taken on a new meaning in the age of COVID-19. From the virus itself to mitigation measures and vaccines, the spread of false information now can have deadly consequences. "The spread of misinformation may be used to be something about, ‘oh this celebrity is dating that celebrity’ and there's not that much of a consequence,” Elder said, “but now it's misinformation about things that can save your life, and can save your neighbor's life and your friends, your family." Now, you may be thinking what exactly is considered misinformation? "Anything that tries to undermine the sort of the veracity or the trust that people have in that kind of information would be considered misinformation.” Elder says misinformation has been around for a long time, “I think the biggest thing is to be aware of, sort of the erosion of trust in expertise, over the last 30 years, maybe longer." But as social media grows in popularity, the spread of false information ignites faster than a wildfire, with posts about COVID-19 garnishing thousands of shares in a matter of minutes. "Sadly, I'm not sure it's grown during the pandemic because the spread of misinformation on social media, happens all the time,” Elder said. “I think what we're seeing now is that there are more dire consequences." "This is literally life and death for people." But what can you do to combat misinformation? There are a few things:
SEE THE VIDEO Misinformation: What is immunology and how vaccines work with your immune system The immune system has been making headlines the last 18 months as the COVID-19 pandemic has swept the globe, but what exactly is the immune system and how does it work? "The human being is a very complicated system and immunology essentially looks at how different parts of the immune system fight bacteria, viruses, protozoa and fungi, how they keep you healthy overall." Dr. Anni Moore is a microbiologist and teaches immunology at Morningside University. Part of that involves vaccines, their development and how they work. "The short answer here is vaccines essentially stimulate your immune system," Dr. Moore says, "that gives your immune system the tools to target that specific organism, such as the Coronavirus or the flu virus, and essentially stimulate your immune system to fight it." Just like there are many different types of organisms that can attack an immune system, there are also many different types of vaccines in development even before they are needed. "Vaccine development itself is pretty complicated," Dr. Moore said. "However, because we have been doing that for about 200 years now, we do have the tools. We know what goes into it, and it's a much more seamless process, even when we don't have these pandemics going on." "There is a lot of research going into vaccine developments all throughout the world." With scientists around the globe working on vaccine development every day, creating vaccines to fight a global pandemic in a year isn't a surprise because much of the science behind it was already there. The development of vaccines to fight coronaviruses have been in the works for decades, as described in this report from the Journal of Biomedical Science. Dr. Moore says there are many different types of vaccines being created, but the baseline is the same. "It all starts with identifying, of course, the target, the virus, in this case, the Coronavirus and looking at target proteins, for example, that your body would recognize as a foreign." When creating a vaccine to target a specific virus, like COVID-19, scientists need to identify the spike protein in the virus that your immune system fights off. Dr. Moore says a vaccine can use the identified spike protein itself or the gene from that protein, such as mRNA vaccines, and give your immune system the tools it needs for battle before you become infected. "Essentially, it tries to get those into your body to activate your immune system that would then recognize that protein as foreign and start building up the immune arsenal, such as your T cells, such as your antibodies, against that particular protein," Dr. Moore says about the vaccine's job inside a person's body. "So they would identify that virus, or the bacteria, in some cases, by that antigen, we call that, the identifying protein." One of the biggest debates surrounding the COVID-19 vaccines is their lack of full FDA approval, but the medicine behind the vaccines has been approved with the emergency use authorization. The full FDA approval, Dr. Moore says, involves everything else. "We are out of phase three trial, we have been vaccinating with these emergency approved vaccines for months now, and all the data says medically everything is solid," Dr. Moore says. The medicine behind the vaccine has been given the green light. "Now, what else goes into the FDA approval process, complete approval process, is not just the medical stuff, it's everything aside from that. So things that deal with production and storage, and, and, and. So it's all the non-medical stuff that also goes into the FDA approval." "So to say that these vaccines are sort of iffy because they don't have full approval is somewhat short-sighted because the data is there that medically, these vaccines are definitely solid." What about vaccine immunity versus natural immunity? For those who have had COVID-19, your natural immunity may not be as strong as you think. "So, when you get the vaccine, you have a controlled dose. You have an X number of molecules or viral particles that are given to you." When you get sick naturally with the Coronavirus, Dr. Moore says, "then you don't know how much you've got and you don't know how much your body can handle how much your body could. What kind of proportional response, your body is going to get to that Coronavirus dose that you got naturally." The new Delta variant has brought the topic of 'breakthrough cases' into the spotlight with skeptics saying that the vaccines aren't working when someone who has been inoculated tests positive for COVID-19. But no vaccine is 100% effective and has never been touted as such. The flu vaccine each year is typically between 40%-60% effective against the flu strain. The COVID-19 vaccines are between 60%-95% effective, depending on which one you look at. "Whether the virus has mutated a little bit so it sort of slipped past your immune system," Dr. Moore says. "There are always these cases. But what seems to be the overall data right now is that the vaccines, even if they don't 100% prevent you from getting COVID, it will prevent you from getting very, very sick and they prevent hospitalizations." Want to learn more about the effectiveness of the COVID-19 vaccines against the Delta variant? Read this article from the New England Journal of Medicine. Dr. Moore says that, in spite of the impact this pandemic has had on the world, one positive thing to come out of this is global discussion and interest in science. "A year and a half ago, I don't think people were aware of things like contact tracing and a lot of people did not know how vaccines work and or what viruses are and I think as tragic as this has been, I think it has also been a good public education on epidemiology and public safety, and overall biology." SEE THE VIDEO Misinformation: Debunking Facebook comments with local experts Misinformation about COVID-19 and vaccines has been widespread since the start of the pandemic, but how do you know if the information you are reading is true or false? Simple, you need to find a credible source. "To have a credible source, you need to make sure that there's an author," said Morningside University Professor David Elder, who specializes in propaganda and misinformation. "You need to make sure that they have the right background in order to have some sort of opinion on this thing." Whenever we share a COVID-19 or vaccine-related story on our Siouxland News Facebook page, there are many comments with claims that aren't necessarily true. We decided to take some of those comments and debunk them with local experts. One of the most common comments is that the vaccine does more harm and isn't safe because it isn't fully FDA-approved. "Vaccines are safe. They do have some side effects like any of them do, but generally, they're very well-tolerated for most people." Dr. Jeffrey O'Tool is a physician at UnityPoint Health - St. Luke's. We didn't want to just take his word for it, so we asked MercyOne Family Medicine Doctor David Ensz the same question. "The thing with COVID-19 vaccines, even though it came out really quick, you know, within a year which it had to do because we're going through a pandemic," Dr. Ensz said. "These vaccines have been tested through hundreds of 1,000s of people, millions of people, and they are safe, they do prevent illness." Another claim that often comes across our page and many others are that if you are vaccinated and get COVID-19, it proves the vaccine doesn't work. Both doctors say that's not the case. "You can absolutely still get COVID-19 after having the vaccine," Dr. Ensz said in response to this claim, "but all that means is that the virus is in you." "I think generally the vaccine's working pretty well," said Dr. O'Tool. "People who have been vaccinated tend not to get as sick as those that have been vaccinated or may not have any symptoms at all with COVID-19." Immunologists say the vaccine's goal is to reduce your risk of severe illness, which it largely has done. Dr. O'Tool says that UnityPoint Health has seen some positive cases in people who have been vaccinated, "but a lot of our positive cases here recently have been in those that have not been vaccinated." How about another claim that's been around since the beginning of the pandemic. That masks make you sicker. With mask mandates being reinstated with the rise of the Delta variant, we asked Dr. Ensz, who wore masks as part of his job as a doctor before COVID-19, if this was actually the case. "There's that sensation that you're breathing through a mask, but it doesn't worsen any chronic breathing conditions or breathing in somebody who's healthy," Dr. Ensz said on this claim. "The theory is. "okay I'm so close to my breath, and I'm going to be breathing that in". But all the data show that there's no increase in respiratory illnesses, allergies any of that." Dubbed "anti-vaxers", the voices of those with distrust or hesitation in vaccines have gotten louder in recent months, but vaccines have been around for decades and have eradicated deadly diseases and viruses. Dr. Ensz listed several vaccines that kids need to have and several diseases eradicated thanks to vaccine science saying, "one of the reasons we don't hear about polio anymore is because everybody got vaccinated for polio, and we don't see it, We don't see, you know, kids who aren't walking because polio affected their legs. These vaccines work." "Vaccines are distrusted in this country, anyway," Elder said. "Again from a bunch of false information, but it's a belief that has taken over so adding one more step to the mistrusted vaccines isn't seen as that too far of a bridge." Vaccines aren't 100% effective at preventing any illness, and that's never been said by medical professionals. "Overall, the COVID-19 vaccines seem to be much more efficient than many other vaccines that people are getting all the time." Dr. Anni Moore is a microbiologist and teaches immunology at Morningside University. "Up to 95% effective. There's always that 5%, either the vaccine didn't work properly. Whether the virus has mutated a little bit so it didn't, it sort of slipped past your immune system. There are always these cases." "Generally speaking, vaccines will help," said Dr. O'Tool. "Nothing is perfect. Influenza successful years or 60% protective effect from an influenza vaccine. The COVID-19 vaccine can be much more effective, probably in the high 90s, which has been reported all the way along." For those worried about the safety of the COVID-19 vaccines, our local experts say while these were developed quickly in a sense, "vaccine development itself is pretty complicated. However, because we have been doing that for about 200 years now, we do have the tools. We know what goes into it, and it's a much more seamless process, even when we don't have these pandemics going on. There is a lot of research going into vaccine developments all throughout the world." "There's been millions and millions of doses of the COVID-19 vaccine given around the world," said O'Tool. "We all hear reports of side effects and things like that. But those are a very, very small number compared to the total number of doses have been given." "You know, honestly, that's something we don't know at this point," said Dr. Ensz. "You know the one thing we do know is that we're going through a pandemic right now and this virus is still killing people. It's killing healthy people, it's killing ill people. And the best defense we have against it right now is this vaccine." Doctors say that even if you have had COVID-19, getting the vaccine is still recommended. As medical professionals work tirelessly to treat COVID-19 patients and make improvements to the vaccines available, Ensz and O'Tool have one final message for Siouxlanders. "Bottom line is if you're on the fence about getting the vaccine. My recommendation is to absolutely do," said Dr. Ensz. "So that's the only way we're going to get rid of this pandemic. We're already seeing the mask mandate come back in certain states. If you have questions about it, ask your healthcare provider, ask family members who have received the vaccine." "It's been a long year and a half here. And the sooner we get more people vaccinated," said Dr. O'Tool. "Hopefully, we're less likely to get more variants that could eventually have a variant that the vaccine doesn't work for. And then we have to start over again." SEE THE VIDEO Handling a firearm is more than just pointing at something and pulling the trigger. It's a personal responsibility to yourself and everyone around you. With changing laws and growing debate over 2nd Amendment rights and firearm safety, many are turning to concealed and open carry practices. For some states, permits to carry a firearm on your person aren't required, but in other states, like Nebraska, not only is a permit required, but residents have to attend a firearm training class before being able to apply. READ MORE: Concealed Carry Laws: When and where can I legally carry in the tri-state Located about a mile outside of Jackson, Nebraska off of a dirt road on Highway 20, the team at Rev-Tac Firearms Instruction is well-known in the tri-state for their dedication to teaching people of all ages the safety and responsibility that comes with handling firearms of all sizes. One of their most popular classes is a concealed carry class, also known as a firearms training course, which teaches teaching firearm safety, rules, regulations and personal responsibility to anyone wanting to carry a handgun on their person or just get more comfortable handling a pistol. "When you talk to people who have carried for a while, you'll hear that they say that they'll actually go out of their way to avoid the fight, not get into the fight, and that's because they're carrying a gun," Tim Grover, owner and instructor at Rev-Tac said. "They understand the magnitude of carrying a firearm for personal defense." Through a Rev-Tac concealed carry class, participants are first taken through class instruction to learn the ins and outs of concealed carry laws in the tri-state, the basic mechanics of a handgun and how to properly hold, load and handle a pistol. "Rev-Tac firearm instruction is passionate about quality training through instructors who are certified and experienced in personal defense," said Tim Grover. "All our instructors have a real-world background in personal defense." Following class instruction, participants get their first opportunity at handing their weapon, but everything through this point is down to the very basics. "You know the basics are the basics, no matter what firearm you're shooting. ~ Firearms Instructor Howard Hulshof" You know, no matter the person, the basics are the same." Firearms instructor Howard Hulshof teaches a few classes a year at Rev-Tac, showing attendees how to properly load and unload their weapon, the proper stance and grip, where to safely point the gun barrel and a few things unique to Rev-Tac instruction, like drawing from a holster. "We allow some of the things that some other gun ranges don't do," Hulshof said, "drawing from a holster and we work on more real-world scenarios that we help people with." These classes are very hands-on, with Hulshof and Grover spending time with each participant throughout the day, answering any questions, adjusting stance and grip and making sure people are being as safe as possible. "What we usually do with it is when you know when people are shooting and they're struggling," Hulshof said. "That's where we kind of try to drill down into what they're doing and what they're doing wrong and we can help tweak the basics." "I would say this class is great for beginners," said Jenna Kittler, a class participant. "I mean especially with me, I've only shot a gun a handful of times, but they're very patient with me, very thorough with teaching me. It was like a lot of one on one, so that was great too. You didn't just get pushed to the side, they were, they were great that way as well." For Nebraska residents in the course, you also have to take a 30 question multiple-choice test before receiving paperwork to apply for a concealed carry permit as required by Nebraska law. Not everyone who takes a firearms training course like this one does so to get their permit to carry. Some use this class as an opportunity to learn about firearm safety and laws surrounding concealed carry from trained professionals. "We still have a lot of people show up, point their guns at other people, whether they realize it or not, we have people still keeping their fingers on the trigger when they shouldn't be, you know," Grover said. "These are things that unless somebody coaches you on this, you're gonna continue to do this and then your kids watch you do this and they do the same thing and, and this is how firearm accidents are happening is this carelessness." A firearms training course is the first step in obtaining a concealed carry permit for many people, and while some states don't require this class, it is available for anyone who can legally handle a firearm. The next step, should you want a permit to carry, is to apply with your respective states. Rev-Tac offers a large variety of courses, allowing Siouxlanders to expand on their knowledge and training with different firearms. They also offer classes on survival training and field medical response. For more on Rev-Tac and what they offer, visit their website and follow them on Facebook. SEE THE VIDEO Can I legally carry a firearm on my person without a permit? Am I breaking the law if I carry a concealed handgun into a public place for my own protection? There are just a few of the questions commonly asked by those researching concealed carry laws. WHAT IS CONCEALED CARRY? Concealed carry, or carrying a concealed weapon (CCW) on your person, is a hot-button topic throughout the U.S. This is the practice of carrying a weapon, like a handgun, in public in a concealed manner for self-defense where others around you don't know you have it. The opposite of this is called "open carry". Concealed carry laws are set by individual states and vary greatly nationwide. Many states are relaxing their concealed carry laws with new legislation, including Iowa. "I think that a lot of Iowans are hoping that on July 1st when constitutional carry kicks off that they won't need a permit anymore. And that's kind of a misunderstanding of the law,” said Concealed carry instructor, Tim Grover. IOWA Come July 1st, Iowa will move to a Constitutional or Permitess Carry state, meaning individuals who are legally able to possess a firearm will not need a permit to carry a concealed handgun on their person. Until then, you need a permit. This change in Iowa's law comes as Gov. Kim Reynolds and other Republican legislators push for change, saying that allowing Iowans to carry without a permit "protects the 2nd Amendment rights of Iowa's law-abiding citizens." Come July 1st, permits in Iowa will still be available, they just won't be required to have to carry within state lines. For those who do want a permit, there are two options: non-professional and professional. Iowans must be 21 years or older to get a nonprofessional permit to carry. Iowans 18 and older can get a professional permit if they need one for their job. But what about Iowa residents who want to carry in another state, like neighboring Nebraska or South Dakota? Well, you will need to follow that state's concealed carry laws, meaning you'll most likely need an official permit or license to carry. For a full breakdown of Iowa's CCW laws, click here. NEBRASKA The State of Nebraska is a "Shall-Issue" state, meaning CCW permits are issued at the state level by the State Patrol. To carry a concealed weapon, you must have a permit in Nebraska. To get that permit, you first must take a firearms training course and pass a 30 question, multiple-choice test. Nebraska residents must be at least 21 years old to get a permit to carry. Nebraska has the strongest laws for concealed carry in the tri-state, but its permit is recognized by several other states in the U.S. For a full breakdown of Nebraska's CCW laws, click here. SOUTH DAKOTA The concealed carry laws for the State of South Dakota fall between Iowa and Nebraska. South Dakota is a Shall-Issue, Constitutional Carry state with permits being issued by the county sheriff's office. South Dakota gives anyone over the age of 18 who can legally have a firearm the option to conceal carry without a permit, but permits are encouraged and give holders the ability to carry in other recognized states, like Nebraska. South Dakota issues three different types of carry permits: Regular, Gold Card and Enhanced. The regular permit is given to most civilians and is recognized by several other states. Gold Card and Enhanced permits offer more benefits, like training courses and pre-approved background checks. For a full breakdown of South Dakota's CCW laws, click here. DO I REALLY NEED A PERMIT? Now you might be asking yourself if my state is a 'constitutional carry' state where a permit is not required, what's the point of taking a concealed carry class? For many, it's a personal responsibility. “I would say even though Iowa is changing the regulation, where you don't need a class to get a permit and doesn't relieve you from, from responsibility to get training, and to just to know the law is to know when you can use a gun and when you shouldn't,” said concealed carry permit instructor, Howard Hulshof. “And you know what you need to do and just get that basic training, just because you have the gun doesn't mean it's going to save your life, you still have to have the mental ability and the desire to learn." Currently, 20 states have some form of 'constitutional carry' laws, this has grown in the last 12 months with states like Iowa, Montana, Texas, and Tennessee passing new legislation for self-defense rights. "What people are failing to understand with constitutional carry is you still have an obligation to the rest of the community to be capable with that firearm,” said Grover. He owns Rev-Tac Firearm Instruction in Jackson, Nebraska and offers concealed carry classes for people in the tri-state. Unfortunately, a lot of people don't recognize how little training they actually have. And so, it's important that you actually come to a class and learn." Along with concealed carry laws varying by state, so does when and where you can carry. In Iowa, you can legally carry a firearm when you are drinking if your blood alcohol level is below .08%, but in Nebraska, you can’t carry at all if you consume alcohol. For Grover and the team at Rev-Tac, they aren’t just teaching people how to properly shoot a handgun, but everything else that comes with wanting to conceal carry. The best way that we do this is we teach the laws and then we can kind of teach the nuances of the different states,” Grover said. “You have to understand those laws as you travel and what you can and can't do.Along with the laws and regulation, the Rev-Tac team also talk about the emotional and mental ramifications that come should you fire your weapon at another person. "We really focus on the awareness side of things,” Grover said. “We say that you'll win 100% of the fights that you don't get into. And so even though you have the tool on you which would be your, your firearm. Most people who carry after they come to this class, they learn other skills and so they don't even need that. They recognize when there's a threat way before it becomes something that would be deadly, and they also learn how to mitigate that threat and how to deescalate." As Grover says, when you choose to carry a handgun for personal defense, you aren't just representing yourself, but everyone you encounter. "You really need to make it a priority if you're going to carry for personal defense, you have an obligation to the rest of the gun community to be responsible with that,” Grover said, “so make sure you're doing it right, make sure your gears right, make sure your training is correct. and keep continually auditing those skills." Never be the master always the student.If you would like to learn more about concealed carry laws and the laws in your state, visit usconcealedcarry.com. SEE THE VIDEO |
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