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St. Cloud Surgical Center

The Outpatient Outlook

A St. Cloud Surgical Center Blog

The Inside Scoop: A Conversation with Dr. Yara Tinawi

If you have had the opportunity to walk through the doors at the St. Cloud Surgical Center, you know it’s a special place. We aim to make patients and their families comfortable every step of the way. While you’ll see many smiling faces on your journey, perhaps the most important one belongs to your doctor. We are proud to have created positive partnerships with surgeons from the Greater St. Cloud area, and we know it only benefits you, the patient.

One of our strongest partnerships comes from Central Minnesota Foot & Ankle. Dr. Greg and Karen Rouw have been staples in our community since 2008. They have built a reputable business, and it continues to grow! At the beginning of 2024, they brought on Dr. Yara Tinawi as their newest foot and ankle specialist.

We recently sat down with Dr. Tinawi to learn more about her journey and what being a podiatrist means to her. Take a look! 

SCSC: Hi, Yara; thank you so much for sitting down with us today. Can you tell us briefly about yourself and what you do at the St. Cloud Surgical Center?

Dr. Tinawi: Thank you for having me. My name is Dr. Yara Tinawi. I am a podiatrist at Central Minnesota Foot and Ankle. We focus on all general podiatric work here, from diet and diabetic care to nail and fungal care, ankle fractures, foot reconstructions, and trauma. If there is anything to do below the knee, we can treat it. 

SCSC: A well-rounded practice, no doubt! You have a unique background. Would you share that with our readers? 

Dr. Tinawi: Of course. I was born and raised in Mount Damascus, Syria. My family and I moved to the States in 2010, more specifically, to Michigan. Not soon after, I started my schooling when we were in Michigan and moved to Ohio for podiatric school. I feel like I’ve been all over the place. My family resides in Michigan, but I moved to Minnesota for better work opportunities. 

SCSC: How exciting to have lived and experienced so many places! What made you decide to come to Minnesota, of all places? You know it’s cold here, right? 

Dr. Tinawi: I chose Minnesota because it felt the most like Michigan, and I actually have family here. My uncle and cousins live close by. Meeting Greg and Karen helped, too. When I interviewed with the Rouw’s at St. Cloud Foot and Ankle, I knew they would be awesome to work with, and the clinic was amazing. For a young physician like me, it was important to have a good working environment and support behind it, and I definitely found that there. 

SCSC: What a wonderful experience. The Rouw’s are a staple in our facility. We’re happy you found a perfect fit! Since starting at the St. Cloud Surgical Center, what is your favorite part about being a podiatrist?

Dr. Tinawi: My favorite part about being a podiatrist is being able to pursue my passion: helping people. I am also surrounded by a team with that same passion; we’re all here for the same purpose, making us a strong unit. The St. Cloud Surgical Center is one of the most positive and friendly environments I have been in, and it makes my job easy. I can show up and do what I love successfully. 

SCSC: We love your passion. Have you always had a passion for podiatry, or did something happen in your life that led you here?

Dr. Tinawi: My heart has always been in medicine. Most of my family works in medicine, so I’ve been around it my whole life. When I started to shadow different areas, I found that podiatrists were some of the happiest doctors. It was clear they have a great work/life balance, which is important to me. Even though I don’t have a family of my own yet, I plan to one day, and felt this profession would be perfect for when that time comes. 

SCSC: We understand how important that blend is, especially for our doctors. Do you think podiatry is a well-understood field? 

Dr. Tinawi: No, and personally, that’s disappointing. Our profession is still kind of unknown. Patients come to us all the time confused because they think there’s a difference between podiatrists and foot and ankle surgeons when we’re really the same thing. Podiatrists aren’t only caring for nail beds and wounds; our scope is so broad. We fix bunions, general aches, foot and ankle breaks, and fractures. The list truly could go on and on. I think it’s important for patients and the general population to understand this. 

SCSC: Education is important for patients, so we’re here today. Do you have an area of focus as a podiatrist? What do you like to do the most? 

Dr. Tinawi: The thing about podiatry is that it’s a huge umbrella. I enjoy pediatric care, specifically sports medicine, but my passion lies in limb salvage and foot reconstruction. This can range from a toe amputation to trying any means necessary to save the foot, even collaborating with plastic surgery. Oh, and I also like helping anyone with foot deformities, not only life-threatening but lifestyle adjustment conditions.

SCSC: Since you started at the St. Cloud Surgical Center, what would you say is the most common podiatric surgery you perform?

Dr. Tinawi: At the SCSC, I haven’t seen a specific niche of surgeries yet. But my surgeries range from limb salvage to bunion corrections, and as I build up more of a patient population, it’s expanding into that reconstructive aspect as well. I’ve done a few of these and am looking forward to doing more in the future. 

SCSC: Let’s dive deeper into that. What is limb salvage?

Dr. Tinawi: Limb Salvage is an umbrella term in the medical world. For me, it comes down to saving the foot. The focus is not only to save the foot as a limb but to make sure it’s functional for the patient in the future. A large part of my training focused on ulcer care, especially in people with diabetes or neuropathic patients who see higher rates of amputation. Prevention is the best medicine, but if a patient comes to us when surgery is necessary, we’ll do that. At the end of the day, my goal is to save the foot and take amputation off the table. In our profession, we know that when you get an amputation at any level of your foot, your mortality rate decreases by five percent, so the more that we can help preserve, the better lifestyle we can offer for patients. 

SCSC: Five percent? Wow. We see why limb salvage is so important to you. Are you ready for our last question? 

Dr. Tinawi: Yes, let’s do it!

SCSC: As a surgeon, what does success look like to you? 

Dr. Tinawi: As a surgeon, success is, as cheesy as it sounds, instead of saying ‘happy wife, happy life,’ I say, ‘happy patient, happy life.’ It’s about having a career where I can use my skills to the best of my ability and help my patients return to optimal health. That’s not to say it’s always an easy task. There are many highs and lows along the way that surgeons have to accept. But if I can sleep at night knowing I have done my absolute best to help people, then I feel successful. 

SCSC: We love how you say ‘happy patient, happy life.’ That sums up our motto at St. Cloud Surgical Center. Thank you so much for your time, Dr. Tinawi. We have enjoyed chatting with you today and learning more about your passions as a podiatrist. We are excited to have you on our team and hope you have a prosperous career at Central Minnesota Foot and Ankle!

If you are experiencing foot or ankle pain, don’t wait to contact one of our experienced podiatrists. The solution you have been looking for could be right around the corner. Contact us today for more information.

The Importance of Prioritizing Mental Health Before and After Surgery

Point Of View: You’ve just been told you need surgery, and your mind is racing. An uneasy feeling has washed over you like a giant ocean wave. While surgery is the best option to heal your ailment, you are still understandably anxious.

Undergoing even the most minor of surgeries is a significant event that not only affects the body, but also the mind. While surgical procedures aim to improve physical health, the impact on mental well-being should not be overlooked. Prioritizing mental health before and after surgery is essential for a smoother recovery and overall well-being.

In honor of Mental Health Awareness Month, the staff at the St. Cloud Surgical Center put together a list of things to do before, during, and after your surgery to help with any mental health concerns. 


Before you head into the operating room, it’s important to take the following steps to support your mental health: 

  1. Maintain Open Communication with your healthcare team. They are there to discuss any concerns or anxiety you may have about your upcoming procedure. Our team will help understand what to expect and can help alleviate any fears or uncertainties. 
  2. Practice Relaxation Techniques such as deep breathing or meditation to promote a sense of calmness. 
  3. Engage in Activities that bring you joy, like spending time with loved ones, listening to music, or going for a walk. Life doesn’t have to stop while you are waiting for your surgery date. 
  4. Setup Your Support System before surgery and lean on them for emotional support. Surround yourself with family members or friends who can offer encouragement during unsettling times. 


Although it may seem silly since most surgeries require general anesthesia, mental health considerations still play a role during surgery. The biggest thing we want to address is trust. Trusting in your healthcare team and the surgery process is essential. If you don’t feel safe in the operating room, please address this with the staff immediately. At St. Cloud Surgical Center, we want you to feel comfortable and remember we are trained professionals dedicated to your well-being. 

What About Children? 

A child undergoing surgery is not only scary for them, but also for the parent. First and foremost, it’s your job as their caretaker to remain calm and assure them everything is going to be okay. 

For most children, the fear of the unknown is what causes them to be anxious. If it’s their first surgery, they may struggle to understand the complexities of medical procedures. Your care team can help provide resources for age-appropriate information about the surgery to help alleviate their concerns. Simple things like reading their favorite books, listening to soothing music, or practicing breathing exercises together can help keep the butterflies at bay. 

Lastly, be the kind, loving parent that you are. Sometimes all they need is emotional support, their hand held, and a big hug! Like all of us, they want to feel safe and supported as they navigate an unfamiliar experience. 


For many patients, the period following surgery can be challenging both physically and emotionally. What we want you to know is, it’s normal to experience a range of emotions including relief, gratitude, frustration, and even sadness. Prioritizing your mental health during the recovery process is optimal for healing. 

Managing Pain and Discomfort

While some pain and discomfort are expected for patients, they are oftentimes confused when mental well-being becomes an added pain point. If the pain is becoming too overwhelming that it causes thoughts of self-harm, affects your sleep, or causes bouts of depression and anxiety, contact your healthcare team immediately. Do not let these feelings go unaddressed.

When you are a patient of St. Cloud Surgical Center, our team of nurses will follow-up with you at various times post-surgery to discuss how your recovery is going. At this time, they will get a pulse on your mental health. Keeping that line of communication open and honest is paramount. 

Setting Realistic Expectations

Rome wasn’t built in a day and your recovery won’t happen overnight either. Recovery from surgery takes time, especially if you’re looking at something as major as a joint replacement. It’s important to set realistic expectations for yourself. Your care team will also help with this and remind you to take things slow. Progress may be gradual, and for some there may be setbacks along the way. Be patient with yourself and celebrate the small victories! 

If you find yourself struggling with the progress, or lack thereof, you have made in your recovery, you are not alone. Emotions may fluctuate during this time. Allow yourself to feel and express your emotions without judgment. 

It’s also important to recognize that emotions may fluctuate during the recovery process. Allow yourself to feel and express your emotions without judgment. Talking to a trusted friend, family member, or mental health professional can provide support and perspective during this time.

Maintaining a Healthy Lifestyle

Lastly, maintaining a healthy lifestyle post-surgery is key. No matter what the situation, taking care of your body is essential for both physical and mental well-being, but even more so post-surgery. Diet and exercise play a vital role in healing. 

Diet: Eat a well-balanced diet rich in nutrients, stay hydrated, and avoid excessive alcohol or caffeine intake as both can interfere with sleep and mood. 

Exercise: Gentle exercise at the recommendation of your surgeon can promote physical and emotional recovery. Simple things such as short walks around the block and gentle stretching can improve mood and reduce stress. If you are required to attend physical therapy, don’t skip your sessions!

Prioritizing mental health before and after surgery is essential for overall well-being and optimal recovery. By taking proactive steps to manage pre-surgery anxiety, addressing pain and discomfort, setting realistic expectations, maintaining a healthy lifestyle, and seeking support when needed, you can navigate the surgical process with greater ease and resilience. Remember, your mental health matters, and investing in self-care during this time is a vital aspect of your healing journey.

If you’re struggling with your mental health during the recovery process, don’t hesitate to seek support. Your healthcare team can provide resources and referrals to mental health professionals who specialize in supporting individuals through medical procedures.

Remember, you’re not alone, and reaching out for help is a sign of strength, not weakness.

Total Shoulder Surgery Now Offered At St. Cloud Surgical Center Under Medicare

A win for us is a win for you! 

2024 marks a big year for total shoulder surgery. It is now covered by Medicare at outpatient facilities like St. Cloud Surgical Center. 

Our center is no stranger to joint replacement surgeries and the role Medicare plays for qualified individuals. We have been performing total joint replacements for decades.  While some patients may be better suited for, or even prefer, an inpatient setting, time and time again, we have seen the good that outpatient facilities can bring. 

To get the scoop on this new change to total shoulder surgery and what it means for our patients, we sat down with resident shoulder expert, Dr. Matthew Hwang. We discussed candidacy for total shoulder surgery, the perks of it being offered in an outpatient setting, and what one might expect when opting into this type of surgery. 

For over 20 years, Dr. Hwang has provided orthopedic services to patients in the St. Cloud Area. While he services all areas including knee, hip, and elbow, he has a special interest in total shoulder and reverse shoulder replacement surgeries. Thanks to a change in Medicare coverage, his practice is about to get a whole lot busier. 

Dr. Hwang approaches total shoulder replacement conservatively. Surgery is not always his go to answer. In fact, he believes most conditions can be treated through activity modification, physical therapy, medications (oral, topical, or injectable), and even non-traditional methods. However, for roughly 50,000 people in the United States each year, conservative methods are not enough and total shoulder surgery is the appropriate path forward.

Candidacy for Surgery

For Dr. Hwang specifically, there are a few elements he looks at when determining someone a good candidate for total shoulder surgery: 

  • Patient is in their mid-60s or older
  • Radiographic evidence of arthritis
  • Pain that is no longer responding to conservative treatments

In most cases, total shoulder surgery is an elective procedure and it is the patient’s decision to move forward with the operation. If a patient feels they have tried reasonably conservative treatment, yet, their shoulder is not getting to where it needs to be, surgery would be the next step. When a patient comes to this decision, Dr. Hwang recommends they prepare themselves by talking with their surgeon, and anyone in their network who has had similar surgery. Preparation is the key to success! 

Speaking of success, the success rate for total shoulder surgery is incredibly high. Dr. Hwang reports that up to 95% of patients will see significant pain improvement after a shoulder replacement, along with improvements in both range of motion and strength. After 2 weeks patients report less pain and by week twelve, there is a clear difference. For many patients, this surgery really does mean the chance at living a better, more healthy life.

Medicare Now Covering Total Shoulder Surgery 

Total shoulder replacements have always been covered by Medicare, however, until recently, they could only be done in a hospital setting. However, with total shoulder replacements becoming more prevalent, there was a need for change. It was no longer sufficient to only offer this procedure for qualified candidates at an inpatient setting. 

Outpatient total shoulder surgery has a number of benefits and is a preferred method for restoring mobility and alleviating pain for qualified candidates with arthritis in their shoulder by many providers. It’s easy to see why outpatient should be considered a standard practice of care for orthopedic surgeries. 

Benefits of Out-Patient Surgery Settings

  • Cost Effective 
  • Case-By-Case Approach
  • One-On-One Care Team
  • Access to Physical Therapy Sooner
  • Faster Recovery Time While At Home

Perhaps, the largest benefit of having your surgery at the St. Cloud Surgical Center is the people, just ask Dr. Hwang. 

“What I enjoy most about working here is the people, they are special. Really unique. No matter the role, everyone helps to make this place run. From the admitting nurses who see the patients to the anesthesiologist who work hard to get the blocks right, they all play a part. All members of our staff are imperative for making a positive patient experience.”

To find out if you qualify for Medicare coverage, contact your provider directly. If you are curious about potential surgery costs under your Medicare plan, you can visit their Procedure Price Lookup site. 


Physician Focus: Dr. Matthew Hwang MD

CMS ASC Covered Procedures

BeckersAsc.com: Shoulder Replacements Added to ASC Payable List

Our Best Slept Secret

Happy Sleep Week St. Cloud Surgical Center fans! Each year, the National Sleep Foundation focuses on the importance of sleep and how it affects your physical and mental health. During Sleep Week, observed nationally the second week of March, many organizations who focus on sleep health will become involved in the cause. 

Here at St. Cloud Surgical Center, we are no different. Known for our innovative technology, our center is home to one of the largest Inspire® therapy practices in the country, all thanks to Dr. Hanson and Dr. Dearking. The pair have helped hundreds of sleep apnea patients, and their significant others reclaim their sleep through this mask-free solution. To learn more about Inspire®, check out the blog we published.

If you’re reading this and thinking sleep apnea isn’t a condition you struggle with, but sleep is still hard, we’re here to help with that too! As physicians and wellness experts, we know how important deep, restorative sleep is for our patients, especially once they are in recovery. It’s the key to a happy, healthy, wonderful life. In short, it’s our best slept secret!

5 Quick Facts About Sleep

  1. Healthy sleep starts before you hit the sheets. 

What you do BEFORE you enter your bed matters. Creating a simple bedtime routine can send signals to your brain that it is time to wind down for the night. The more you commit to this routine, the easier it will be to fall asleep once you enter your bed. 

A simple routine can look like brushing your teeth, washing your face, and reading for 30 minutes. This might be the trick to send you to sleepy land!

  1. Sleep is linked to your mental health.

There is a large connection between sleep and your well-being. Sleep quality and quantity are deeply intertwined with your mental health.

When we sleep, our body goes into a restorative state where it repairs and rejuvenates our cells, processes emotions from the day, and cleanses our brains of toxins. Without good sleep, this restoration of the body doesn’t happen and can cause a downward spiral. 

  1. Exposure to light can affect how well we sleep.

We are all familiar with the school of thought that blue light from screens affects our sleep, and we’re here to tell you it is true. But regular light exposure can have a negative effect too. Light plays a crucial role in our circadian rhythm. Our brains are hardwired to stay awake during the day and sleep when it’s dark. We should all be using light as a tool to get better sleep.

A general rule of thumb is to expose yourself to bright light in the morning and afternoon, dimming the lights as you get closer to bedtime. As for screens, put them away at least one hour before bed. 

  1. Exercise can help kick start a healthy sleep schedule. 

You can add better sleep to the widespread list of health benefits that come from daily exercise. Not only does exercise keep you focused and energized throughout the day, but it also helps to promote deeper, more restorative sleep at night. 

If you’re struggling to find ways to stay active, here are some ideas to get you started on a new healthy habit! 

  1. Nutrition plays a crucial role in your sleep quality. 

Last, but certainly not least, nutrition! Healthy eating habits support your whole well-being, sleep included. If you’re struggling to get to sleep, or even just stay asleep, food could be the culprit. 

A well-balanced diet that includes high amounts of fiber, fresh fruits and vegetables, whole grains, and protein can be all the change you need to make to ensure you’re meeting your sleep quota. 

The 10-3-2-1-0 Rule

The 10-3-2-1-0 rule is a concept loved by many sleep experts and wellness professionals. Not only is it a foolproof method to follow, it’s designed for everyone. No matter your age, gender, race, etc. you can follow this rule to get the best night’s sleep of your life. There’s no magic spray, no specific pillow or mattress involved, just some good old-fashioned commitment to a better, more well-rested you. 

Here’s the breakdown: 

  • 10 hours before bedtime – no more caffeine
  • 3 hours before bedtime – no more alcohol or food
  • 2 hours before bedtime – no more work
  • 1 hour before bedtime – no more screen time
  • 0 times you hit the snooze button in the morning

TEN (10): No caffeine ten hours before bedtime. 

While nothing beats a warm cup of joe in the morning, coffee and other caffeine intake can be our biggest downfall when it comes to sleeping. Caffeine is a silent killer, taking up to an hour to kick in. This means you may not realize the negative impact caffeine is having on you until it’s too late. If you feel wired or anxious before bed, think about your caffeine consumption for the day, it could be the culprit. 

Per the rule, caffeine in all forms, whether it be from tea, coffee, or chocolate shouldn’t be consumed within ten hours of your bedtime. 

Loophole: Caffeine affects everyone differently and you know your body best! If you only need to stop caffeine conception seven hours before bed, change the name of the rule to fit your lifestyle. 

THREE (3): No alcohol or food three hours before bedtime. 

Breaking up with your midnight snack, say it ain’t so!? We hate to break it to you but drinking liquids and eating from the snack drawer too close to bedtime can have a negative effect on your sleep. 

  • High levels of alcohol in the bloodstream at bedtime cause disruptive REM sleep, leading to a rough morning. 
  • Due to the horizontal nature of sleeping, eating too close to bedtime can cause acid reflux, indigestion, or heartburn. 

If you need to have a snack before bed, try something that contains high amounts of protein and less processed sugar, like a handful of nuts.

TWO (2): No more work two hours before bedtime.

For some of us, working at home has made it difficult to shut down for the day, but it is so important for your sleep (and mental health) to unplug. Screen time keeps your brain in overdrive making it hard to shut down, while working long hours can lead to prolonged stress. Both of which are detrimental to your sleep quality. Not to mention, you’re losing your beloved work-life balance. 

ONE (1): No screens one hour before bedtime. 

Put the phone down. I repeat, put the phone down! While, in theory, one of the simplest things on the list, this seems to be the hardest for people to do. Research shows that screens are incredibly detrimental to strong sleep hygiene. 

  • Screens stimulate the brain and keep it alert instead of winding down. 
  • The blue light from screens is said to decrease melatonin (sleep hormone) levels needed for sleep.
  • Information you see online, in the news, or in the shows you watch can mess with your emotions causing stress, anxiety, or sadness that makes it hard to fall asleep. 

If you can do one thing to achieve better quality sleep, this is it! 

ZERO (0): No hitting snooze in the morning! 

We all do it. Even if we promise ourselves at night that we won’t, morning comes around and we’re hitting snooze. The truth is, hitting snooze can lead to more grogginess in the morning because you’re interrupting your REM sleep. If you feel the need to hit the snooze button repeatedly, you probably aren’t getting enough sleep. Time for an earlier bedtime!

Tip: Move your alarm clock away from your bed, so you have to get up to shut it off. No more snoozing on your clock! 

Will you be giving 10-3-2-1-0 a try? 

Looking to do some shopping during Sleep Week? Here are the best deals. 

Sleep Week is one of the best times to upgrade your bedroom. If you’re in the market for a new mattress, sheets, or even pillows, here’s your sign to make a purchase. If  you haven’t been sleeping great lately, now is the time to invest in some new sleepy time necessities. 





With Sleep week underway, it’s a great time to reinvest in your sleep. Create a routine, stop the icky habits like scrolling in bed, maybe try out a new mattress, and you’ll be well on your way to a restful and restorative night!




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