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Archive for Smart Tips by Dr. Sneden

Welcome Pam Fieber!

We would like to welcome Pam Fieber, Certified Nurse Practitioner, to the primary care team at the Watertown VA Outpatient Clinic.  Pam graduated from Watertown Senior High, Lake Area Technical Institute and USD Nursing Program with a  Registered Nursing Degree.  She worked for 14 years at the Deuel County Hospital while going back to SDSU for her Bachelor’s and Master’s degree.  After passing the Board Exam, she started work at Sanford Clinic in Watertown with a specialty in Diabetes Care for 5 years.  She has worked at Community Health Center in Storm Lake, Iowa for 5 months in Primary Care prior to her current employment.  Pam was hired for the Home Based Primary Care Program.  She now works half time in the Home Based Primary Care Program and half time in Primary Care.  Our Clinic hours are from 8:00 AM to 2:30 PM Monday through Friday with the exception of Federal Holidays.  Please make an appointment and come and see us.  We would like to thank each and every veteran for their sacrifice to our great nation.

John Sneden, MD
Watertown CBOC

Summer Tips

See Your Primary Care Provider Regularly.

Old faces…new faces

A Prescription For Exercise In The New Year

With the new year come many resolutions.  This year, choose a healthier lifestyle by enrolling in the South Dakota Exercise for Health Program from the South Dakota State Medical Association.  Plenty of valuable information as well as your prescription for exercise is available at their website.  I have listed it below for you to explore.  This year, consider your new profession:  exercise.  The pay is lousy but it comes with a great benefits package.  The hours are flexible and you can work from home.  You can’t get fired but you can get promoted (to better health).  You can quit, but it could cost you your life.  Change your life for a better life-start today!


New things with old drugs

There has been some news lately regarding some medications that have been around for some time.  Simvastatin, which was marketed under the brand name Zocor for high cholesterol, has been identified as being associated with increased problems with muscle pain in high dose and in combination with certain other medications.  You may be asked to reduce your dose of this medication as a consequence of this labeling change.  Also, simvastatin is no longer recommended in combination with certain other medications including several popular blood pressure medications.  Consequently, your doctor may recommend a change in either your blood pressure or your cholesterol medications.  Another recent finding involves a change in the depression medication citalopram which was marketed under the brand name Celexa.  It has been associated with heart rhythm problems at doses above 40mg daily.  Consequently, your doctor may recommend a decreased dose or a change in medications.  Please, do not make any changes on your own.  Discuss your concerns with your healthcare provider.




Fall is rapidly approaching which means ragweed season is near. Allergies, especially environmental allergies, can appear at any point in our lives. With all of the standing water from the rains, weeds will be in abundance this year. Ragweed is a particularly nasty player for some allergy sufferers. The mainstay of treatment is antihistamines, however they are not without their own issues. Older antihistamines such as Benadryl (Diphenhydramine) can cause sedation, impairment with operating a motor vehicle and increased risk of falls; especially in the elderly. Newer antihistamines are not as sedating such as Claritin, Zyrtec and the newest Allegra. All antihistamines have the additional side effect of worsening urine retention especially in men who suffer from an enlarged prostate. Caution should be used especially if you take medications from prostate. Nasal steroid sprays are often prescribed, if you suffer from allergies, consider discussing this with your provider to see if you are a candidate for medical therapy.

Audiology expanding in Watertown

I wish to express my deep appreciation and gratitude for bestowing upon me the honorary membership. I hope to be in service to our veterans for years to come. As part of those duties, I have been asked to provide updates regarding services available to veterans in Northeast South Dakota through the Department of Veterans Affairs. At the meeting in June, I shared some information regarding hearing testing. The Watertown VA Outpatient Clinic has added an audiology booth for hearing evaluations. Veterans will no longer be required to travel to Sioux Falls as part of the process of getting hearing aids. At this time, the audiologist is coming to Watertown three days a month but this will soon be increased to four. The VA has changed the criterion for receiving hearing aids. Consequently, even if you were denied hearing aids in the past, you may be eligible now. If you are presently receiving your care through the VA in Watertown and are interested in a hearing evaluation, simply call us and we will submit a request for you. If you are receiving your primary care through Sioux Falls, Fargo, Aberdeen, Montevideo or St. Cloud, contact your primary provider there.