DEAR MAYO CLINIC: I've taken up running again and decided to enter a half-marathon. I know I have to push myself to get ready for the race, but I don't want to overdo it. What should I watch out for as I train?

ANSWER: We're surrounded by warning signs — on the roads, at work, and on packaging and equipment. Your body sends warning signs, too. As your race date nears, it's tempting to pull out all the stops. But that makes this a prime time to watch for warning signs of overtraining.

Overtraining or overuse injuries are any muscle, joint or bony injuries, such as tendinitis or a stress fracture, that result from repetitive trauma. Overuse injuries typically occur because of training or technique errors.

Runners are tenacious athletes. Pulling back and slowing down may be tough, but while some overtraining issues can be resolved with simple rest, others may evolve into more significant problems.

How overtraining and overuse injuries occur

Going too fast, exercising for too long or simply doing too much of one type of activity can strain your muscles and lead to an overuse injury. Improper technique also takes a toll on your body. For example, if you use poor form while running or doing strength-training exercises, you may overload certain areas of the body, which can cause an overuse injury.

Thankfully, most overuse injuries are avoidable. Try these suggestions to prevent them:

• Use proper form and gear.
  Whether you're starting a new activity or have been playing a sport for a long time, taking lessons can help ensure you're using the correct technique. Talk with an expert about proper form, equipment and gear fit to help ensure success.
• Pace yourself.
  Rely on your training program, which should spread your aerobic activity throughout the week. Take time to warm up before physical activity and cool down afterward.
• Gradually increase your activity level.
  When changing the intensity or duration of physical activity, do so gradually. Try not to increase anything by more than about 10% per week. Your body needs time to adapt to the new stress.
• Mix up your routine.
  Instead of focusing on one type of exercise, build variety into your training program. Doing a variety of low-impact activities prevents overuse injuries and allows your body to use different muscle groups.

Overtraining signs and what to do 

It can be hard to know when you’re pushing through your training for continuous improvement and when you’re moving into overtraining. Your feet and legs take a pounding as you run mile after mile, so watch for these issues: 

• Callous blistering and broken toenails are common overtraining problems. 
• Early morning pain on the sole of your foot can be a sign of plantar fasciitis. 
• Tendinitis can leave you with pain in the back of your ankle or in the front of your shins, also called shin splints.

Typically, these can be treated with rest and medication to relieve pain and inflammation. Slow down your training. Return to the level you were at before the problem or consider cross-training with low- or no-impact exercise, such as a stationary bike, elliptical or swimming. Take an extra day off. These symptoms can be short-term if you treat them early and appropriately.

If pain continues despite rest or gets worse, it could indicate a bone issue, which is potentially serious. Stress reactions or stress fractures are common in the mid-foot, mid-shin or, most concerning, high up in your leg by your hip. Pain that doesn't go away is a symptom, so consult your healthcare team.

What to do if you suspect an overuse injury

Tell your healthcare practitioner if you've recently changed your workout technique, intensity, duration, frequency or types of exercises. Identifying the cause of your overuse injury will help you correct the problem and avoid repeating it. You can seek further guidance by talking with specialists such as sports medicine physicians, athletic trainers and physical therapists.

Once your injury has healed, ask a specialist to check that you've completely regained strength, motion, flexibility and balance before beginning the activity again. Pay special attention to proper technique to avoid future injuries.

Staying strong

Don't allow an overuse injury to prevent you from being physically active. By working with a specialist, listening to your body and pacing yourself, you can avoid this common setback and safely increase your activity level.

Knowing you worked hard to prepare will add to your feeling of accomplishment on race day, but don’t overdo it. You’re almost there. Take care of yourself so you can keep going strong all the way to the finish line.

Corey Wencl, Sports Medicine, Mayo Clinic Health System, La Crosse, Wisconsin

The post Mayo Clinic Q and A: Signs of overtraining appeared first on Mayo Clinic News Network.

DEAR MAYO CLINIC: I know there's a knee replacement in my not too distant future. I'm wondering if there are new techniques or technologies that will give me a good outcome?

ANSWER: Not so long ago, undergoing a total hip or knee replacement and recovery was a grueling and often painful ordeal. While these are still major surgeries, new techniques and technologies are redefining them — and improving people's outcomes. 

Robotic-assisted joint replacement technology has revolutionized hip and knee surgeries. This technology allows the surgeon to:

• Perform enhanced, three-dimensional preoperative planning and modeling to ensure there's no impingement or pinching of tissues, and to refine implant sizing and positioning for a high degree of accuracy.
• Prepare the bone and insert the implants with an unprecedented level of precision.
• Produce personalized, patient-specific joint replacements.  

In addition, major advances have been made in anesthesia used for total joint replacement surgery in the past decade. With these advances, patients recover more quickly and get up and move sooner after surgery with less pain, nausea and vomiting.

Another rapidly advancing technology in orthopedic surgery is 3D printing, which allows the designing and creation of custom implants to address challenging problems, including deformities, bone loss, and unusual hip or knee anatomy. 

This promising technology needs more long-term data before it becomes widely used. Mayo Clinic is at the forefront of 3D printing and has been integral in advancing its clinical applications.

If a total hip or knee replacement is in your future, here's what you can expect.

Hip replacements 

Any patient who is a candidate for a "conventional" total hip replacement is a candidate for a robotic-assisted total hip replacement.

Hip replacements are no longer a one-technique-fits-all approach. With a "360 degree" approach, your surgeon can tailor the surgery to you, choosing from direct anterior, posterior or anterolateral approaches. The surgeon will discuss these options with you during your pre-op consultation.

The surgeon also will review with you the entire surgical experience in detail. You'll also have a standardized patient education session with a specialty nurse and pre-op evaluation by a physical therapist. These sessions will set you up for success beginning immediately after surgery.

When it comes to recovery and rehabilitation:

• For most patients, total hip replacement surgery is either a same-day surgery or a one-night hospital stay.
• Patients can walk and navigate stairs right after surgery.
• The majority of patients will follow a self-directed physical therapy plan at home — no need to go to an outpatient physical therapy facility.
  

Knee replacements

As with hip replacements, any patient who is a candidate for a conventional total knee replacement is a candidate for robotic-assisted total knee replacement. You'll also take part in a comprehensive education experience and physical therapy assessment to review the technique your surgeon will use during surgery.

Like hip replacements, total knee replacements typically are same-day surgeries or may involve a one-night hospital stay.

Once you've awakened from the anesthesia, you can walk and navigate stairs. Within one week after surgery, you'll begin meeting with a physical therapist who specializes in working with knee-replacement patients. For best results with strength and range of motion, you'll also be assigned daily exercises to do at home to supplement your physical therapy sessions at an outpatient facility.

The excellent news for total hip and knee replacement patients is that the techniques and technologies for these surgeries continue to evolve. They have the primary goals of reducing pain, enhancing function, and getting patients back to their day-to-day activities and those they love to do.

Brandon Bukowski, M.D., Orthopedic Surgery, Mayo Clinic Health System, Mankato, Minnesota

The post Mayo Clinic Q&A: It’s a new era for knee replacements and other joint surgeries appeared first on Mayo Clinic News Network.

Craig Scherer takes a deep breath and a bold step into his second chance at life

Lung disease is a condition that affects millions of people worldwide. Some of those diseases, like chronic obstructive pulmonary disease, or COPD, are among the top leading causes of death globally.

COPD alone affects over 16 million people, like Arizona resident Craig Schuerer. Craig got treatments to manage his condition, but there's no cure. The disease is progressive, meaning it gets worse over time, making it harder and harder for a person to breathe.

Craig's disease progressed until treatments no longer worked, leaving him gasping for air and facing death. Doctors said his only hope for survival was a lung transplant. 

Craig turned to Mayo Clinic in Phoenix, where doctors just launched a new multidisciplinary, specialized lung transplant program. Craig became the new program's first patient, and today he is breathing easy.

Watch: Breathing easy thanks to the gift of life and Mayo Clinic's new lung transplant program in Arizona

Journalists: Broadcast-quality video (2:43) is in the downloads at the end of this post. Please courtesy: "Mayo Clinic News Network." Read the script.

It was love at first sight for Craig and Nanci Scherer.

They met at a little league game in the spring of 1992. Eight months later, they were married. This year, Craig and Nanci celebrated their 32nd anniversary. 

Their smiles today are just as radiant as on their wedding day.

Happiness turns to heartache

The couple raised four children. Their family grew to include 14 grandchildren and six great-grandchildren. They planned for retirement and looked forward to the day when they could travel and enjoy their future together.

But when Craig turned 60, life took a sharp turn. He was diagnosed with chronic obstructive pulmonary disease. COPD is a progressive disease that causes damage to the lungs, making it hard to breathe. Treatments can help manage the disease, but there's no cure. As the disease continues its silent assault, quality of life often slowly slips away. 

"I couldn't do things, and even if I could do things, I didn't have the strength to do it or the stamina because my lungs would wear out," says Craig.

Craig's COPD continued to get worse. Eventually he couldn't breathe, walk or even talk. "It was silent at our house. We didn't talk because he couldn't talk. He didn't have the oxygen," says Nanci. "We lived in silence and isolation."

Last hope for survival

Eventually, Craig reached end-stage lung disease. Treatments no longer worked and his health continued to decline. Craig was left with only one last hope for survival, a lung transplant. Craig and Nanci turned to Mayo Clinic in Arizona.

"We see this with patients, when there are no other options, no medical interventions you can do at that point," says Dr. Jonathan D'Cunha, surgical director of the Mayo Clinic Lung Transplant Program in Arizona transplant center

For six years, Dr. D'Cunha had been working on building a multidisciplinary team of medical and surgical experts to create a new lung transplant program at Mayo Clinic in Arizona. 

The transplant center is the largest in the country, performing more adult solid organ transplants than any other center in the U.S. The addition of the lung transplant program establishes Mayo Clinic in Arizona as a comprehensive transplant destination medical center.

The program will provide transplantation for the full range of patients with end-stage lung disease. "This is the beginning of a remarkable new era for lung transplantation in Arizona," says Dr. D'Cunha. "We are excited and honored to offer patients and families renewed hope and a second chance at life through Mayo's unrivaled expertise in comprehensive adult organ transplant care."

Craig became the new program's first patient to receive a lung transplant.

Giving the gift of life

On May 30, 2025, Dr. D'Cunha led a team of surgeons in performing Craig's lung transplant. The surgery was a success, and soon after, Craig was slowly starting to breathe with his new lungs. 

"It is surreal to be able to breathe and not gasp for air when I talk," says Craig, who was up and walking within days of surgery. "I told the doctors when I got here that I will do whatever it takes. I'm 100% committed. If you want me to walk six times a day, I'll walk seven," says Craig.

"He did phenomenal," says Dr. D'Cunha. "His optimism and energy he brought with him is absolutely critical because the stronger you are going into these big operations, the better you are on the other side.

"I'm very proud of Craig. He always amazing me throughout the journey of transplant," says Ashraf Omar, M.B., B.Ch., medical director of the transplant program. "He is a special person. Motivation is the cornerstone of his success."

A fighter's farewell

Two and a half weeks after his transplant, Craig was heading home. The transplant team bid him farewell with a victory celebration with pom-poms waving and confetti raining down.

Watch: Craig crosses the finish line of his journey with a breathtaking victory celebration from Mayo's transplant team.

A few days later, on June 23, Craig returned to Mayo to join his transplant team for a news conference announcing the official launch of the lung transplant program.

It was also Craig's 67th birthday.

In honor of his organ donor and the donor family, Craig used his new lungs to blow out the candles on his birthday cake.

Watch: Craig's heartfelt moment in honor of the gift of life

Craig and Nanci are back at home and looking forward to beginning the next chapter of their story. 

"I have a lot of life left to live in me. Everything is a motivator — my wife, my kids, my grandkids, my health," says Craig. "Before, I had no quality of life and couldn't do anything. Now, there's nothing I can't accomplish." 

Related stories:

• Mayo Clinic in Arizona announces launch of new lung transplant program offering hope and restored function to patients facing advanced lung disease
• Lung Transplant Program
• Breathing easier with COPD

The post (VIDEO) Breathing easy thanks to the gift of life and new Mayo Clinic Lung Transplant Program in Arizona appeared first on Mayo Clinic News Network.

ROCHESTER, Minn. — You likely are accustomed to encountering a range of menus in daily life, but there is one that may be new to you: a dopamine menu. Dr. Robert Wilfahrt, a family medicine physician at Mayo Clinic and an expert in attention-deficit/hyperactivity disorder, or ADHD, explains.

“A dopamine menu is a rebranding of what psychologists or healthcare professionals previously called behavioral activation — ways to get yourself to do what’s best for you, instead of what you feel like doing in the moment,” Dr. Wilfahrt says.

In this case, the best route to getting that tough task done is to step away from it for a minute, do something else that feeds you energy and then dive back into the task.

The purpose? To stimulate dopamine — a hormone and neurotransmitter in the brain involved in mood, attention, reward and motivation. It’s also known as the “feel-good hormone.” Dopamine comes in many forms — reaching for your phone to doomscroll social media is an easy and convenient way to get a bit of a lift, but that’s not the only option. What other accessible activities can bring you joy and a happy brain break?

Examples of healthy “dopamenu” activities include:

• Going for a brief walk.
• Jamming out to your favorite song.
• Making a cup of tea.
• Petting your dog or cat.
• Lighting a candle.
• Reaching out to a friend or family member.

“The idea is to break up what you’re doing,” says Dr. Wilfahrt. And if the selected menu item is purposeful, you can feel a sense of reward for small progresses.

When are dopamine menus most useful? If we’re not necessarily enthusiastic about the task we’ve been assigned, we struggle to maintain attention or interest. We then risk not meeting the expectation or obligation. We feel bad about it, get flooded with remorse and have an even tougher time completing the task due to that sense of anxiety.

“It can become a vicious cycle,” says Dr. Wilfahrt. “It can be easy to become avoidant when we’re in these sort of doom loops.”

So how can you stop this cycle? Brainstorm. Make a mental or physical list of things you can do to get recentered.

Dr. Wilfahrt says the more recently rebranded concept tends to be targeted to people with ADHD, but anyone would benefit:

“It’s not a bad idea for anybody to know how to best manage energy. Sitting still to labor over one idea isn’t healthy for anyone.”

And while activities on your dopamine menu are meant to be enjoyable, don’t forget to go back to the hard task. A journey to the dopamine menu is meant to provide a burst of enthusiasm, not to be something that sucks you in. Consider setting a timer — perhaps for an unusual interval like 13 minutes and 17 seconds. Enjoy the boost and get back to the (real) to-do list.

For more healthy living tips, visit Mayo Clinic Press and MayoClinic.org.

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About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news.

Media contact:

• Sharon Theimer, Mayo Clinic Communications, newsbureau@mayo.edu

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Callie Jones, a social worker for Mayo Clinic Health System (MCHS) in Mankato, Minnesota, spends her days helping patients and their families navigate their healthcare journeys. She takes pride in living by Mayo Clinic's primary value — the needs of the patient come first. 

In early February, however, Callie's role quickly flipped from social worker to patient when she began experiencing life-threatening symptoms and complications related to her baclofen pump — the device that helps her to move through life without the spasms or stiffness that often come with having cerebral palsy.

Where it all began

As a child, Callie was diagnosed with spastic cerebral palsy — a neurological condition that can affect movement and posture.

"My muscles were so stiff that it made everyday tasks like diaper changes and eating meals very difficult," Callie says.

At just four years old, Callie was the youngest patient at the time to receive a baclofen pump surgically placed under the skin in front of her abdomen. This pump delivers medicine slowly and continuously through a port that connects to a long catheter. The catheter travels around her abdomen and introduces the medicine directly into her spinal canal to help relax her muscles.

Dr. Cole Cheney, pain medicine physician at MCHS in Mankato, says that baclofen pumps are normally replaced every six to seven years. In addition, it is often routine to adjust medicine delivery dosages over time as the body's needs change. However, he noted that sometimes, pumps can require troubleshooting.

"If the medication is disrupted, the patient can start feeling sick," Dr. Cheney says. "Receiving too much medicine or too little can be life threatening."

That's why when Callie started to feel strong "itchy and twitchy" symptoms earlier this year, she knew it was serious and quickly sought medical attention in Mankato.

From social worker to patient

Following rounds of tests and scans, the Pain Medicine team found that Callie was experiencing severe baclofen withdrawal, thought to be due to a kink in her catheter. The complication can be fatal without quick intervention.

The team quickly performed surgery on Feb. 10 to fix the kink, but Callie's relief was short-lived. Her symptoms continued on and off for the next six weeks. All the while, her care team meticulously tested, explored and exhausted all causes and options to help find the root cause of Callie's symptoms. Her care required extensive involvement from patient access staff, nursing staff, radiation technologists and other healthcare professionals from the Emergency Department, Pain Medicine, Radiology, the Intensive Care Unit, Anesthesiology and Hospitalist teams.

"Callie's pump consistently showed normal medication values, which initially suggested that the pump was functioning correctly," Dr. Cheney says. "For that reason, we avoided intervening at the pump site for as long as we could. It was only after we had ruled out every other potential cause of her symptoms that we determined a pump replacement was the necessary next step."

This would be Callie's most invasive surgery yet, and was particularly high stakes, as Callie has spinal rods that increased the risk of her team failing to re-gain spinal canal access for the device if they lost that during surgery. 

However, it was a risk that proved worth taking. Six clinic visits, four hospital admissions and three surgeries later, Callie was back to feeling like her old self — and grateful she turned to her workplace back in February when she first sensed something was wrong.

"If it wasn't for the quick actions taken by the Pain Medicine team and the ability for me to access care locally, my situation truly could have had a very different outcome," Callie says. 

A story of teamwork, persistence and partnership

Dr. Jason Dauffenbach, MCHS Minnesota Pain Medicine chair, says Callie's successful outcome was the result of a true team effort.

"We utilized the close relationships between our practice in Mankato and the expertise and experience of colleagues across the health system and in Rochester," said Dr. Dauffenbach. 

While the malfunctioning of her device led to a traumatic and emotional time, Callie says she leaned on the positives in her situation — being close to home, near family and colleagues that treated her like family. 

"My coworkers would visit me before or after work — they decorated my hospital room for my birthday and they even brought my favorite drink to brighten my day," Callie says. 

Now, after more than 10 years of caring for others, Callie has an even deeper appreciation for and understanding of what it means to live by Mayo's RICH TIES values of respect, integrity, compassion, healing, teamwork, innovation, excellence and stewardship. 

"With the team's expertise and efforts, I was able to remain in my home community and receive the care and intervention needed from a team that knew me and my medical complexities best," she says. "I had an amazing team."

Related story:

• Dad walks daughter down the aisle despite ALS

The post Care team’s persistence saves social worker’s life appeared first on Mayo Clinic News Network.

DEAR MAYO CLINIC: My back's been bothering me, and everyone seems to have ideas what's causing the pain. Can you help?

ANSWER: Back pain is more common than homeownership in the U.S. While about 65% of adults own a home, nearly 80% of adults will have back pain at some point. Despite how common this type of pain is, myths about it persist. Here are some facts:  

Myth: Lifting heavy objects is the main cause of back pain. 

Fact: Lifting heavy objects with poor form can contribute to back pain, but the major culprits are a sedentary lifestyle, poor posture, obesity and genetic factors. 

Myth: Bed rest will make my back pain better. 

Fact: Probably not, but it depends on the cause of your pain. If it's muscle strain, taking it easy for a few days may help. However, bed rest can also make back pain last longer or even worsen. If your pain is from nerve compression, a disc issue or joint degeneration, inactivity can cause muscles to tighten, pain to worsen, loss of physical condition and more debility. In these cases, you should modify your activities, switch to low-impact exercises like walking and swimming, and avoid movements like bending, twisting or lifting. Maintaining some degree of physical activity can help you heal faster.

Myth: Back pain is caused by sitting on a fat wallet. 

Fact: Sitting with a large wallet in your back pocket can cause leg or hip pain and numbness, but typically not back pain. A large wallet can tilt your pelvis and compress your sciatic nerve. This nerve is the largest in your body, branching from the lower back through your hips, buttocks and down each leg. Compressing it causes pain or numbness while sitting or driving. After sitting for a long time, you may find walking difficult or feel pins and needles in your legs. 

First, try removing the wallet and taking over-the-counter anti-inflammatory medications. If the leg pain persists, check with a healthcare professional.

Myth: Back pain is always due to a serious underlying condition. 

Fact: Back pain is usually caused by muscle strains or sprains, not by a serious condition like a disc or vertebrae issue. Most back pain resolves on its own,

Myth: Avoid exercise when experiencing back pain. 

Fact: Exercise and physical activity are usually recommended for managing and preventing back pain. Strengthening the core muscles, including your back muscles, improving flexibility, and maintaining a healthy weight can contribute to a healthier back. Depending on your pain, you may need to modify your activity. You know your body best, so listen to it. If something isn't getting better or grows progressively worse, contact a healthcare professional for an evaluation. 

Myth: Surgery is the only solution for chronic back pain. 

Fact: Back pain is often caused by issues that aren't relieved with surgery. Non-surgical treatments like physical therapy, medications, injections and lifestyle modifications are often effective in managing and reducing chronic back pain. Surgery may be necessary if your pain:

• Intensifies, especially at night or when you lie down. 
• Spreads down one or both legs. 
• Causes weakness, numbness or tingling in one or both legs. 
• Occurs with new bowel or bladder control problems.

Seek an immediate medical evaluation if you experience any of these symptoms.

Myth: A firm mattress is the best for alleviating back pain. 

Fact: The ideal mattress firmness varies from person to person. Some people may find relief with a firm mattress, while others may prefer a medium or soft one. When shopping for a new mattress, look for one that provides support and comfort based on your preferences and needs. Also, many companies offer generous return policies so you can try a mattress for a few weeks, or even a few months, before deciding if it's right for you. 

Myth: Poor posture doesn't contribute to back pain. 

Fact: Many people spend hours slouching while staring at a computer rather than sitting at attention, or focusing on cellphones that draw the eyes down and curve the neck. These habits can strain muscles and joints, causing body pain over time. Practice good posture habits and take advantage of ergonomic office equipment to help prevent and alleviate back pain. 

Preventing back pain 

Some back issues can't be avoided, like those caused by injuries, arthritis or genetics. Three things you can do to preserve the health of your back are:  

• Maintain an ideal body weight.
  Excess weight causes increased stress on all joints, including the spine. 
• Strengthen your core.
  Stronger core muscles, including abdominal and intrinsic back muscles, can help take the stress off your spine. 
• Stay active.
  Regular movement is essential for keeping your body active. 

Meghan E. Murphy, M.D., Neurosurgery, Mayo Clinic Health System, Mankato, Minnesota

The post Mayo Clinic Q&A: 8 common myths about back pain appeared first on Mayo Clinic News Network.

DEAR MAYO CLINIC: Recently, I was diagnosed with BPH. This is all new to me, and I hope you can help me better understand the condition and how it's treated. 

ANSWER: Now that you've been diagnosed with benign prostatic hyperplasia (BPH) — noncancerous tissue growth within the prostate — it's time for you and your healthcare team to talk about treatment options. 

These options depend on the severity of your symptoms, which can range from having a weak urine stream to not being able to urinate at all. Most treatments are done in the outpatient setting, including your clinician's office, while others may require a hospital stay. Wherever you are on the range of symptoms, there are treatment options that can relieve them, including:   

Behavior modifications

If you're experiencing bothersome, but not severe, symptoms, such as having a weak urine stream or frequently getting up at night to urinate, your treatment may start with:

• Changes to your diet
  Some foods, such as chocolate, citrus, carbonated beverages and caffeine, can irritate your bladder, which can increase your urge to urinate. Cutting back on these foods may ease your symptoms.
• Fluid intake
  Reducing the amount of fluid you drink before bedtime can decrease your need to urinate during the night.
• Timed urination (voiding)
  Holding your urine can also irritate your bladder, so making a point to urinate every hour and a half to two hours can reduce the urge to go "now."

Medications for BPH

If these behavior modifications are no longer effective, your clinician may prescribe a medication, which you'll need to take every day. These include:

• Alpha blockers
  These drugs relax muscles in the bladder and prostate, and they open up the urinary channel to reduce blockage. Side effects include a decrease in blood pressure, dizziness and lightheadedness. They also can cause semen to go back into the bladder instead of the penis, which may be startling, but is harmless.
• 5-alpha reductase inhibitors
  These medications work to shrink the prostate by lowering the production of a specific hormone. There are more side effects, and it may take six to nine months to see any results. Men may have a lower sex drive, and some will experience erectile dysfunction.

Surgical procedures

You and your healthcare team may decide that in-office therapies or surgery to shrink or remove overgrown prostate tissue would be the best treatment option for you. Some treatments work better than others, depending on your symptoms, treatment goals and the size of your prostate. Most preserve sexual function and have little or no effect on erectile or ejaculatory function. 

These treatments include:

• Temporarily implanted nitinol device
  This procedure reshapes the tissue of the prostatic urethra and the bladder neck to create a wider channel through which urine can flow. A narrow, folded nickel titanium device is inserted into the prostatic urethra. As the device expands, gentle pressure reshapes the urethra and bladder opening. After five to seven days, the device is removed.
• Prostatic urethral lift (PUL)
  This procedure reshapes the prostate using a small, permanent implant to compress and lift the side of the enlarged prostate to increase the urethra opening.
• Steam therapy
  During the treatment, a tiny needle is inserted into the urethra and positioned in the prostate gland. In nine seconds, the needle produces a 2-centimeter-wide steam ball that shrinks the surrounding prostate tissue.
• Transurethral resection of the prostate (TURP) and photo-selective vaporization (PVP)
  During a TURP, a lighted scope is inserted into the urethra and the surgeon uses an electric loop to remove all but the outer part of the prostate. TURP generally relieves symptoms quickly, and most men have a stronger urine flow soon after the procedure. 

PVP is laser therapy performed in an operating room under anesthesia. A surgeon inserts a thin, tube-like instrument into the urethra. This instrument has a lens, light and tool that sends out an electrical current to destroy prostate tissue. Heat from the current seals small blood vessels, reducing the risk of bleeding. This procedure destroys or removes overgrown prostate tissue and is a good choice if you need to stay on blood thinners.

• Prostate enucleation (BipoLEP or HoLEP)
  This procedure removes nearly the entire prostate without an incision. It is often a good option for patients with especially large prostates, the inability to stop blood thinners or in significant urinary retention. A thin instrument is inserted into the urethra. Then, a laser cuts the prostate tissue into small, removable pieces. 
• Simple prostatectomy
  This minimally invasive surgery removes tissue blocking the flow of urine. It usually requires a one-night stay in the hospital and is done laparoscopically through a small incision in your side, most often using a surgical robot.

Ross Avant, M.D., Urology, Mayo Clinic Health System, Austin and Red Wing, Minnesota; Mayo Clinic, Rochester, Minnesota

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Superheroes took a short break from fighting crime (and grime) to bring joy and smiles to young patients at Mayo Clinic Children's. The team of window washers from the Squeegee Squad in Rochester, Minnesota, dressed up as Batman, Superman and Spider-Man while demonstrating their superpower rappelling skills for children and their families. Afterward, kids had a chance to meet the team of superhero window washers and take photos with their favorite superhero.  

Watch: Superhero window washers brighten day at Mayo Clinic Children's

Journalists: Broadcast-quality video is in the downloads at the end of this post. Please courtesy: "Mayo Clinic News Network."

Check out these images:

For Cory and his family, it is a gift to be able to give back in a meaningful way and bring joy to young patients currently fighting their own health battles. 

This is a full circle moment for Cory Simonson, who now owns and manages the Squeegee Squad in Rochester, and his son, Carter Simonson.

At the age of 5, Carter was diagnosed with T-cell leukemia and was treated Mayo Clinic Children's. Carter is now 17 years old and remembers the 2014 visit from superheroes when he was hospitalized. 

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Erin Barreto, a pharmacist, reflects on years of infertility, resilience, healing and the joy of welcoming two children through IVF.

"It was a long, uncertain road filled with setbacks around every corner. When you had those moments of hope, you had to hang on to them."

Erin Barreto, Pharm.D., Ph.D., a Mayo Clinic pharmacist and now mom of two, spent nearly seven years navigating the complex path of infertility with the Reproductive Endocrinology and Infertility team at Mayo Clinic in Rochester. The team, comprised of approximately 80 staff members, was recently ranked in the top 10 in Newsweek's "America's Best Fertility Clinics" for the third year in a row. In the last five years, the division has helped welcome more than 1,000 babies into the world.

Erin chose Mayo Clinic because she trusted the data, believed in the success rates and knew that having access to top professionals delivering state-of-the-art care with compassion and empathy could offer hope when it was in short supply.

Though the journey included moments of loss, waiting and resilience, she and her husband, Jason (Jay) Barreto, Pharm.D., held onto the possibility of growing their family. 

Along the way, they had a chance to connect with Ali Ainsworth, M.D., the clinical director of in vitro fertilization in Reproductive Endocrinology and Infertility. 

"Dr. A saw us through it all — miracles and miscarriages," Erin said. "She knew how to advise us because she took the time to get to know us."

"I’m humbled to hear that," says Dr. Ainsworth. "Being part of Erin and Jay's story is a privilege I don't take lightly. Our work is so meaningful — hard and heartbreaking and meaningful." 

A journey marked by care and connections

Erin's journey through infertility opened her eyes not only to the medical demands of in vitro fertilization (IVF) but also to the emotional toll it takes. She found grounding in small rituals like wearing a special pair of wool socks to every egg retrieval, a procedure in the IVF process where mature eggs are collected from the ovaries using a thin needle guided by ultrasound.

Funded by a past Joy Project, the socks carried hopeful messages: IVF got hope. Lucky transfer socks.

Erin remembers putting the socks on before each egg retrieval, channeling all the good energy she could muster.

Support came from people, too — Mayo staff who cared for her not just as a patient, but as a person. 

Maria Lujero, a nurse in Reproductive Endocrinology and Infertility, held Erin's hand during her very first retrieval when she was scared and overwhelmed. 

"She was a relieving force. I will never forget it," Erin says. 

Chelsea Marquardt was a new nurse when Erin started her journey and helped her with medication counseling. This is an important part of the IVF process because the treatment involves complex, time-sensitive medications that patients often administer themselves.

"Chelsea has been a constant support the whole time. While I am a pharmacist, I wanted in that moment to be a patient, to trust that someone would help walk me through things." says Erin. 

Their connection, rooted in that early guidance and nurtured over time, reflects the kind of enduring support that shaped Erin's experience.

Mayo's shift toward a more holistic approach to care also made a difference for Erin, reinforcing her confidence in Mayo Clinic and her care team. 

Erin joined the Mind Body Fertility program led by Nicole Callahan, a nurse practitioner, where participants gathered to talk about the emotional side of fertility treatment. 

"I was further along in my journey when I joined the program, so it felt healing to give back and support others who were just beginning theirs," Erin says." It was rewarding to be a source of hope."

"We know that fertility treatment is more than just a medical process — it touches every part of a person's life," says Dr. Ainsworth. "Programs like Mind Body Fertility reflect our commitment to whole-person care. It's validating to know that patients like Erin have found benefit and support."

Lessons in resilience

There were hard lessons, too. Learning how to self-advocate came later to Erin than she wished. One especially painful experience involved hearing sensitive news in a clinical way, before she was ready and before Jay could be with her. 

In many care settings, results are often shared routinely — sometimes through the patient portal or in straightforward conversations. But over time, Erin realized she needed something more personal. 

"Seeing the Mayo number on my phone on days we were expecting test results was especially triggering. I would think to myself, 'They only call when it's something bad that they don't want to send through the portal.'"

"We talked to the care team and made a new plan. Jay would receive the call and gently share whatever news with me at a time that was right. That way, it wasn't one more thing for me to carry. I wasn't forever having to receive and transmit the news that was so often disappointing. I wish I had realized I needed that sooner."

This small change made a meaningful difference for both Erin and Jay. "Being met with compassion in those vulnerable moments changed how we carried the experience," she said.

Her advice to others considering IVF is heartfelt. 

"Be hopeful," she says. "Be excited. Find people who understand what you're going through. Build a support system, even if it's small."

The joy that waited

After three transfers — the final step in the IVF process, where one or more fertilized embryos are carefully placed into the uterus in hopes of achieving a pregnancy — Erin and Jay finally welcomed their first child, a daughter born during the pandemic. Later, after more heartbreak, their second child arrived. They named them Charlotte and Thomas.

Charlotte, now four, embraces her new role as big sister with delight.

"She calls him her 'baby guy,'" Erin smiles. "She'll say to him, 'Hi, it's Big Sis!' and it's the most magical thing." 

Thomas, just four months old, is beginning to smile, and hints of his personality are already starting to shine through. Erin is soaking in every moment.

"Having my children is the greatest blessing," she says. "In this phase of life, it's about sitting on the floor, doing puzzles and hearing my kids laugh. That's the best part. That's what we were waiting for."

The post ‘What we were waiting for’: Couple shares journey from infertility to joy appeared first on Mayo Clinic News Network.

DEAR MAYO CLINIC: We live in a rural area about 40 minutes from our health system's nearest clinic. However, they do offer the option to meet virtually with our healthcare team members. We'd like to try virtual care. Could you tell us more about it? 

ANSWER: Whether you live in a rural or urban community, virtual care can be a great choice for connecting with healthcare. You can save drive time, avoid bad weather and stay home when it's best not to be in a clinic where you could infect others. 

But even better, if your primary care clinic offers video visits (most do), you maintain continuity of care with your healthcare team, whether you're at home or traveling. Any information and care recommendations are entered into your electronic health record.   

Choose your virtual option

There are typically three main types of virtual care (also called telemedicine or telehealth): messaging, video visits to your home, and video visits at a clinic. 

Messaging. You and your healthcare professional exchange information via a secure messaging platform. This can include questions about a condition, medications or follow-up from a previous appointment. Your clinician usually responds within 24 hours or less. Messaging may lead to a video visit or an in-person appointment.

Video visit to your home. Through your health system's patient portal, you can set up a video appointment with a member of your healthcare team, just as you would an in-person appointment. Just as with an office visit, hearing your story about how something happened, symptoms you're experiencing, medication side effects and more, can help your clinician make an informed diagnosis. 

During a video visit, you can discuss your issue with your clinician, upload photos to give your healthcare team a close-up look at something, like a rash or lump. For example, if your child has an ear infection, there's an inexpensive device you can purchase online that takes a video of the ear canal. With this information, your clinician can recommend care.

Your clinician also may order other services or arrange to have a specialist connect with your visit. You can even invite a family member or friend to join the visit to provide an extra set of ears.

In addition, if you need translation services, they can be arranged when you make your appointment. During the video visit, your clinician, interpreter and you will all be online.

Video visit at the clinic. Another variation of video visit is making an in-office appointment but then connecting with a specialist online. This is particularly helpful for patients who may not have stable internet connections.

On-demand care. Your health system may offer other forms of virtual care, such as on-demand care via a mobile app. This service is typically available 24/7 every day, including weekends and holidays. On-demand care can focus on an urgent problem, but you can also schedule an appointment and arrange to receive helpful reminders about prescriptions, lab work, follow-up appointments and more. 

Your in-person and virtual providers collaborate on your care through a shared medical record. However, the level of integration varies widely across healthcare organizations.

When to consider virtual care

The list of conditions that can be addressed virtually is a long one, including:

• Upper respiratory Infections, including colds, influenza and COVID-19 (especially now with home diagnostic kits)
• Sinusitis
• Rashes
• Insect bites
• Constipation
• Mental health conditions
• Urinary tract infections (often coupled with a lab test)
• Monitoring and adjusting medications for chronic conditions
• Follow-up for many chronic conditions, including:
  • Diabetes
  • Weight-loss medications
  • High blood pressure (if you have a home blood pressure cuff)
  • Cholesterol
  • Low thyroid

However, if you're having difficulty breathing or chest pains, you should go to the emergency department. If you suspect something is broken or infected, you should also seek in-person care because these conditions tend to require a "hands-on" exam and assessment or direct treatment.

Before, during and after your video visit

Here are a few tips for a successful video visit:

• When you make your appointment, upload any photos or videos that could give your clinician a close-up view of the problem.
• Be sure you have a reliable internet connection.
• Arrange for a quiet space for the visit, especially since you'll be sharing protected health information. Having a video visit at a coffee shop or on a public computer may not be a good choice.
• Dress comfortably but appropriately. 
• Make a few notes about what you want to cover with your clinician.
• Be sure to ask questions. If someone is joining the visit, let them know they can ask questions, too.
• Following your visit, you'll receive an after-visit summary just as you do with an in-person visit. It's typically delivered to your patient portal.

David Blair, M.D., Family Medicine, Medical Director, Primary Care on Demand, Mayo Clinic Health System, Bloomer, Wisconsin  

The post Mayo Clinic Q&A: When to consider virtual care appeared first on Mayo Clinic News Network.