Doc Talk with Monument Health

Recorded live in front of an audience at the famous Black Hills Stock Show and Rodeo in Rapid City. Joseph Tuma, M.D., FACC, FSCAI, Interventional Cardiologist at Heart and Vascular Institute, joins Mark Houston for a fascinating conversation regarding peripheral vascular disease, which is when cholesterol builds up in arteries other than those that are in the heart. Knowing the symptoms and early detection is crucial. Among those particularly at risk are people who smoke, who have high blood pressure or who have diabetes. Dr. Tuma lists common symptoms, like wounds that won’t heal, and claudication, which is cramping pain from walking that gets better when you rest. Dr. Tuma also covers a subtype of peripheral vascular disease, such as when there are weak spots in the arteries that begin to dilate, called aneurysmal disease, and some recent advancements in cardiovascular treatments that the HVI team has implemented. If you’re showing symptoms, Dr. Tuma also gives suggestions of how to work with your primary care provider to get screened and the kinds of tests and equipment used to detect peripheral vascular disease and other associated conditions.

Within their subspecialty of electrophysiology, Kelly Brandsted, CNP, and Rebecca Bierle, CNP, both of the Heart and Vascular Institute in Rapid City, see many heart disease patients. It is an under-reported fact that heart disease is the number one killer of women in the U.S. Symptoms can present differently in women than in men, which can lead to heart events being misdiagnosed. Kelly and Rebecca cover surprising factors such as how mental illness and even complications during pregnancy can have a dramatic influence on risk and how such biological signs are sometimes easily dismissed. Increased awareness about misperceptions empowers you with the knowledge needed to understand steps you can take to prevent heart disease. Listen with a loved one in celebration of National Wear Red Day on February 6.

If you suffer from the mental, physical and emotionally challenging problem of restless leg syndrome (RLS), you are not alone. Catherine Fernandez Aristy, M.D., fellowship-trained Family Sleep Medicine Physician and Jessica Hutchinson, CNP, both of Monument Health Neurology and Rehabilitation in Rapid City speak with interim host Leslie Hopton about the most common sensory motor-related sleep disorder. A frustrating and uncontrollable need to move your legs, RLS is often a symptom of another sleep disorder or even iron deficiency. Dr. Fernandez and Jessica list possible symptoms that could lead to a diagnosis, discuss evaluation considerations, such as sleep studies and give treatment options as they pertain to sleep disorders. There are also cardiovascular consequences to untreated RLS, including high blood pressure and heart arrhythmia to consider. Lifestyle modifications can help, though prescription and over the counter medicines often have unhelpful side effects.Listen or watch and find out how getting better sleep can help you to cope with restless leg syndrome.

You may be ligament lax; that doesn’t mean you’re abnormal.” Eric Krohn, D.O., Pediatric Orthopedic Surgeon and Codi Grable, PT, CLT, Physical Therapist, both of Orthopedic & Specialty Hospital in Rapid City join interim host Leslie Hopton to inform you about ligament laxity.Also known as hypermobility (and not to be confused with flexibility) ligament laxity can be genetic. Dr. Krohn and Codi outline techniques for testing ligament laxity, such as Beighton score, and signs that you may be suffering from it, including pain and recurrent injuries. Hypermobility can be related to bony deformity and so it’s important to know when to seek intervention and what possible treatments exist. Both members of the Hip Preservation Institute, Dr. Krohn and Codi detail how they collaborate to treat hypermobility and how “pehab” — or physical therapy before surgical procedures — helps optimize the results and ease fears a patient may have about recovery.

Luis Hernandez, M.D., FACC, fellowship-trained Cardiologist and Medical Director of the Advanced Heart Failure Program at Monument Health Heart and Vascular Institute, gives insight on how devices like defibrillators, pacemakers and pulmonary pressure sensors manage heart failure and help prevent hospital readmissions. He also outlines the importance of medication and patient monitoring in improving heart failure outcomes. Dr. Hernandez brings plenty of visual aides in this episode so be sure to check out the video version on YouTube!

In this Best Of from 2025, Mark sits down with Kenneth Milligan, M.D., Orthopedic Surgeon, and Eric Krohn, D.O., Pediatric Orthopedic Surgeon at Monument Health Orthopedic & Specialty Hospital in Rapid City while they share their vision in starting the Hip Preservation Institute. Typically only available in larger metropolitan areas, the Hip Preservation Institutes team brings much needed and highly specialized hip care to the Black Hills and the surrounding region with the goal of preventing long-term hip deterioration to patients through early intervention, monitoring and minimally-invasive surgery, when required.