BROOKINGS – Dr. Jonathan Mellema has in a fashion lived his whole life around medicine.
He was born and spent his early years in Oklahoma, where his father was a family practice physician with the Indian Health Service. His grandfather was a general surgeon. Mellema later moved with his family to Wilmar, Minnesota, where he lived before doing his undergraduate studies at Bethel University in St. Paul.
There he earned his bachelor’s degree in biology in 1996, after which he attended University of Minnesota Medical School (Minneapolis/Duluth). After he received his MD in 2000, he completed a 5-year residency program at the University of Cincinnati Department of Otolaryngology-Head & Neck Surgery.
He then returned to Wilmar and practiced there for 14 years. During that time he also did outreach to Marshall, Minnesota, via the ACMC system, for 10 to 12 years. Now the ear, nose and throat specialist and board-certified head and neck surgeon has joined the staff at Avera Medical Group Specialty Care Clinic in Brookings.
“I decided I wanted to change my job,” the doctor said, when asked what brought him to Brookings. “Right now, I have a 2-year non-compete clause, so I can’t just be anywhere close to the eight to 10 clinics I was at before, a 20-mile radius around those clinics.”
Expert and compassionate care
Mellema brings to Brookings his vast range of experience in treating ENT conditions and is familiar with working in rural settings. His expertise is coupled with compassion in his treating patients of all backgrounds and ages.
The age range of the doctor’s patients is “probably from 2 weeks of age until 100 (years old). Sometimes we get little babies that are tongue-tied and have to clip their tongues.”
“We do things from minor surgery, tubes and tonsils, to more extensive sinus cases, image-guidance sinus cases, neck masses, thyroid cancer, parathyroid abnormalities, other congenital growths and masses of the neck that we remove,” he said, listing some but not all of the conditions ENT specialists deal with. “We work some with voice, some with head and neck cancer – more about diagnosing; a lot of times that’s going to be eventually treated elsewhere if it’s more advanced, but we’re getting the diagnosis and getting them plugged in where they need to go.”
Add to that list: surgery to straighten the nasal septum between nasal cavities; pressure equalization (PE) tube inserts for children; ear surgery for chronic ear disease, sometimes for hearing restoration; and skin cancer repairs on the face.
While most ENT needs in the Brookings area had been referred to Sioux Falls in the recent past, Mellama said “the population center here is large enough to have ENT support full-time; and it’s more convenient for the patient not to have to travel.”
The Brookings area did have ENT services, but following the retirement of Dr. Robert Reitz about 2014, there was no full-time ENT specialist in the area. There was a “circuit rider” who provided services here. However, a full-time ENT doc was warranted.
”That’s part of the reason why we worked to recruit Dr. Mellema,” added Julia Yoder, director of marketing and public relations for Brookings Health System.
Tonsils, adenoids … in, out?
One ENT procedure that used to be common and widespread was the insertion of ear tubes in children, almost a rite of passage for many kids. Now, not so much but …
“It’s not as common as it was,” Mellema explained, “primarily because the immunizations for some of the more common bacteria that cause ear infections has helped reduce it some. But it’s still the most common procedure done in the U.S.
“Risk-factor wise, if there’s a family history of it, if there’s tobacco exposure, if there’s daycare. Daycare, of course, there’s a higher number of it than 30 years ago. So the risks are still there in significance.
“So you still see a fair amount. And there’s also tubes in adults, when people in their 70s and 80s have trouble getting their ears to drain.”
A couple of other procedures that used to be performed almost routinely two or three generations ago was the removal of tonsils and adenoids. Again, like ear tubes, not so much now.
“The pendulum kind of swung from being ‘everybody takes them out because they’re there’ to being ‘let’s keep them at all costs,’” Mellema said. “Now I’d like to think that there is a coming closer to a more reasonable indication. Now the most common reason they take them out is because kids can’t sleep while they snore. They don’t get good rest.
“Strep tonsillitis is the one that’s the second most common. It used to be people said if it happens a lot then you just go ahead and take out the tonsils.
“It’s not uncommon to have maybe a bad year with tonsillitis. The American Academy of Otolaryngology recommendation is that if you have seven or more tonsillitis episodes in one year, five or more two years in a row or three or more three years in a row from an infection standpoint that you should take them out.”
New technology brings more precision
As like so many other medical and surgical specialties, ENT continues to move forward new procedures: such as “image guidance technology” and “balloon technology.”
Image guidance technology, which has been around for about 20 years, matches a CAT scan of the patient’s sinuses with the doctor’s instruments, so the computer system can tell where the doctor’s instruments are in relation to the computer.
It’s a safety factor by showing how close the instruments are to the patient’s brain, eyes, carotid artery and optic nerve. “Those things are all right around the sinuses,” Mellema explained. “It also helps you to see a better pathway into the sinuses. It’s a very good tool for doing better and more complete surgery as well as safer surgery in the sinuses.”
Balloon technology in sinus surgery has also evolved. It is used more for the maxillary sinuses, the forehead or frontal sinuses, and the sphenoid sinuses.
In any and all aspects of seeking medical care, Mellema has some basic advice for his patients: “Be your own health advocate. Seek a second opinion and address issues right away before they become larger problems.”
To schedule an ENT appointment with Dr. Mellema, call Avera Medical Group Specialty Care Clinic at 696-2700.
COURTESY OF: The Brookings Register