TAKE CONTROL Lower your cancer risk with these tips VITALITY BE FAST: KNOWTHE SIGNS OF A STROKE SPRING 2022
2 VITALITY Spring 2022 facebook.com/citizensmemorial We’d love to hear from you ON FACEBOOK WE’RE ALSO ON twitter.com/cmhbolivar Citizens Memorial Hospital • Citizens Memorial Health Care Foundation 1500 N. Oakland Ave. Bolivar, MO 65613 417-326-6000 CEO/Executive Director Michael Calhoun Marketing Director Tamera Heitz-Peek Marketing Department Tessa Arnold Wren Hall Amy Gimpel Aaron Tallant Mission Caring for every generation through exceptional services by leading physicians and a compassionate health care team. Vision Be the first choice for customer-focused health care to every generation. CoreValues I am…positive, respectful, innovative, dedicated, empowered. Together, we are CMH PRIDE. For permission to reprint any portion of this magazine, call 417-328-7245. If you wish to be removed from the mailing list, please email theitz@citizensmemorial.com or call 417-328-7245. VITALITY is published as a community service for the friends and patrons of CITIZENS MEMORIAL HOSPITAL. Information inVITALITY comes from a wide range of medical experts. If you have any concerns or questions about specific content that may affect your health, please contact your health care provider. Models may be used in photos and illustrations. 2022 © Coffey Communications, Inc. All rights reserved. WELCOME 7 Got long COVID-19? See why you should consider pulmonary rehab. 8 Scam alert! Don’t be fooled by bogus weight-loss claims—know what really works. 10 Women: Get the facts You’ve been told you have dense breasts, but do you know what it means? 14 Check your knowledge Do you know these four facts about cholesterol? Exceptional, compassionate care On Jan. 1, I hit the ground running as the third CEO and executive director of Citizens Memorial Hospital and Citizens Memorial Health Care Foundation. My predecessors, Donald J. Babb and Gary Fulbright, created a wonderful legacy and positioned CMH well for future expansion and growth. It is an honor to follow in their footsteps. In this issue of Vitality, I’ll be sharing highlights, patient access and quality initiatives, employee features, and ways CMH is navigating the pandemic. Also, don’t miss the many health and wellness articles to help your family stay healthy. CMH will be celebrating its ruby anniversary. We opened our doors on Sept. 28, 1982, and since then we have grown significantly. Like our CMH mission states, we care for every generation through exceptional services by leading physicians and a compassionate health care team. Another highlight is the Aim for Excellence Award mentioned on page 5. CMH was one of two organizations to receive the award. On page 3, see highlights of former CEO Gary Fulbright’s retirement reception and meet Tregg Geren, CMH’s new chief operating officer, who started Jan. 3. Patients in the Willard area now have more access to care with the opening of our new clinic. A ribbon cutting ceremony and open house were held for Willard Medical Center and Walk-in Clinic on Jan. 21. Read more on page 4. On page 6, learn how CMH received national certification as an Acute Stroke Ready Center and is now designated as a Level III stroke center by the Missouri Department of Health and Senior Services. And on page 7, read how therapy with Pulmonary Rehabilitation is helping patients heal from long-term effects of COVID-19. Finally, on page 16 we profile our newest providers. Thank you for allowing our CMH family to care for your family. Sincerely, Michael Calhoun CEO/Executive Director Citizens Memorial Hospital/Citizens Memorial Health Care Foundation Michael Calhoun, CEO/Executive Director
citizensmemorial.com 3 Tregg Geren, R.N., BSN, was named chief operating officer (COO) for Citizens Memorial Hospital District beginning Jan. 3, 2022. Geren assumed the role vacated by Michael Calhoun, who was promoted to CEO/executive director of CMH and Citizens Memorial Health Care Foundation beginning Jan. 1, 2022. Former CEO/Executive Director Gary Fulbright retired Dec. 31, 2021, after working nearly 40 years as the chief financial officer and most recently as CEO/executive director. Beverly Derrickson is continuing as chief operating officer for CMH Foundation and special projects coordinator for the hospital. Geren previously served as chief nursing officer for CMH for four years from 2013 to 2017 and has more than 30 years of progressive health care experience. He also is an entrepreneur and is the owner/ operator of Polka Dot Pig Barbecue and Catering. “Tregg has extensive health care experience over his career. He has worked for us before as the chief nursing officer and did an outstanding job,” says Calhoun. “His knowledge and experience of both the clinical and operational areas of health care, combined with his character; strong work ethic; and previous leadership roles, including at CMH, will make him very successful as our next COO for the hospital.” Geren received his nursing degree from St. John’s School of Nursing, a Bachelor of Science in nursing from Missouri State University and a Master of Business Administration from Webster University. As the hospital COO, Geren oversees the daily hospital operations and has organizational responsibility for laboratory services, radiology, pharmacy, rehabilitation services, environmental and nutritional services, health information management, materials management, plant facilities, auxiliary, pre-hospital services, and emergency management. Additionally, he provides administrative support for hospitalbased physicians. Citizens Memorial Hospital and Citizens Memorial Health Care Foundation Boards of Directors hosted a retirement reception Dec. 20, 2021, honoring Gary Fulbright, CEO/ Executive Director of CMH/CMH Foundation. Fulbright retired Dec. 31, 2021, after nearly 40 years of faithful service to CMH. View highlights from the reception at cmhbolivar.info/ Fulbright. Citizens Memorial Hospital complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability or sex. CMH has arranged for language assistance services free of charge. Call 417-326-6000. (Spanish) ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 417-326-6000. (Chinese) 注意：如果您使用繁體中文，您可以免費獲得 語言援助服務。請致電 417-326-6000. The CEOs of CMH (left to right): Michael Calhoun, incoming CEO, with Gary Fulbright, retiring CEO, and Donald J. Babb, founding CEO. Dr. Troy Morrison and Gary Fulbright. Gary Fulbright (center) and his family during his retirement reception, held Dec. 20, 2021. CMH namesTregg Geren next hospital COO A fond farewell CMH NEWS Tregg Geren, R.N., BSN
4 VITALITY Spring 2022 Willard area residents attended the ribbon-cutting and open house for the Willard Medical Center and Walk-In Clinic Jan. 21. Guests toured the clinic, met the medical staff, and enjoyed grab-and-go lunches. CMH is excited to be part of the Willard community, providing exceptional, patient-centered care in our local communities. The clinic offers primary care, daily walk-in care and an array of outpatient specialty services, helping our patients to have more access to the services and health care they need close to home. CMH operates 14 family medicine, pediatric and walk-in clinics in Ash Grove, Bolivar, Buffalo, El Dorado Springs, Greenfield, Humansville, Osceola, Pleasant Hope, Stockton and Willard, Missouri. The clinic is located at 502 S. Miller Road in Willard. CMH accepts most local and major insurance plans, including Medicare and Medicaid. Call 417-761-6655 to schedule your appointment. WillardMedical Center Meet our team Mylhan Myers, D.O., Family Medicine/OB Kaylee Ankrom, NP-C, Nurse Practitioner Magen Blades, PA-C, Physician Assistant Erin Payne, PA-C, Physician Assistant HOURS Primary Care Clinic: 8 a.m. to 5 p.m., Monday through Friday Walk-In Clinic: 9 a.m. to 8 p.m., daily SERVICES » Family Medicine. » Walk-In Care. » Obstetrics. » Pediatrics. » Digital X-Ray. » Laboratory Services. OUTPATIENT SPECIALISTS » Cardiology. » Gastroenterology. » Orthopedics. » Podiatry. » Pulmonology. WELCOMING CMH NEWS
citizensmemorial.com 5 CMH/CMH Foundation make wage adjustments Citizens Memorial Hospital/Citizens Memorial Health Care Foundation established a new minimum wage of $12.65 starting November 2021. The multimilliondollar investment in wages for CMH/CMH Foundation employees was on top of the merit increases employees received in October. The new rates are designed to be market competitive after applying experience factors. These changes also increased the pay ceilings for many positions across the organization and allow for greater opportunities of future wage improvements. All individuals’ pay rates were reviewed and rate increases were applied for positions that were below market competitiveness. Almost 70% of CMH employees received a portion of this market adjustment. In addition to the new base rate increases, CMH implemented revised salary schedules for applicants/ new hires that included credit for prior work experience up to 3% per year of experience (10 years max credit). The change allows CMH to be more competitive with wages by giving credit for relevant work experience. CMH continues to provide free health and dental insurance options to full-time employees, an employerpaid term life insurance policy, matched savings plan and profit-sharing plan, employee health and wellness program, and paid time off. Additionally, employees receive at no cost group long-term disability coverage after one year of employment. Aim for Excellence Award Citizens Memorial Hospital was one of two Missouri health care organizations recognized with the 2021 Aim for Excellence Award by the Missouri Hospital Association (MHA). The award recognizes progress toward the Triple Aim—better health, improved care and lower cost. The awards were announced at MHA’s 99th annual convention. CMH was recognized for its monoclonal antibody infusion program, which was central to its COVID-19 response and strategy to reduce the need for hospitalization and improve outcomes for patients with COVID-19. To date, CMH has provided monoclonal antibodies to 1,207 patients. To learn more about this honor, visit bit.ly/3BTxl5E. CMH NEWS TIME TO TEE UP! The 32nd annual Citizens Memorial Health Care Foundation Medical Excellence Golf Classic, presented by SGC Foodservice, is scheduled for Thursday, June 2. The classic is an 18-hole, four-person scramble at Silo Ridge Golf and Country Club in Bolivar. All monies raised go to the Medical Excellence Scholarship, which provides financial assistance to individuals from CMH’s eight-county service area who are working toward careers in health care. Upon completion of their education, Medical Excellence recipients return to work at CMH. To date, the fund has provided more than $2.5 million in assistance to more than 400 students. The tournament will feature two shotgun starts at 7:30 a.m. and 1 p.m. Each player will receive a gift bag, grab-and-go breakfast, lunch, snacks, range balls, and complimentary Coca-Cola products. Green fees and cart rentals are included in the entry fee. Each player also will be entered into course contests, and mulligans are available at $40 per team. Prizes for first, second, third and fourth place finishes will be awarded in four flights. There is a maximum of 55 teams, and spots will be filled on a first-come, first-served basis. To make a donation or register a team for the tournament, contact Wren Hall, Director of Community Relations, at 417-328-6318 or register online at cmhbolivar.info/Golf2022. Jon D. Doolittle, president and CEO of the Missouri Hospital Association, presented CMH with the Aim for Excellence Award in November 2021. »
6 VITALITY Spring 2022 Citizens Memorial Hospital received national certification from DNV, an industry leader in hospital excellence and quality, as an Acute Stroke Ready Center, affirming the hospital’s readiness to handle strokes and stroke-related medical problems. CMH is also a designated Level III stroke center by the Missouri Department of Health and Senior Services. CMH partners with CoxHealth to offer 24/7 telestroke coverage, which remotely connects CMH stroke patients to neurologists at Cox South, the region’s only DNV-certified Comprehensive Stroke Center. The program allows treatment to begin within minutes of a patient’s arrival at the hospital. “We know that ‘time is brain.’ The faster a patient can get to a certified stroke center, the faster the patient will be diagnosed and treated,” says Jenna Hicks, R.N., director of population health at CMH. “Saving this valuable time is known to decrease complications of a stroke. This certification lets our community know that we have the resources and commitment to provide the best possible stroke care.” QUICK CARE When patients present to CMH with stroke-like symptoms, recognized as BE FAST—balance, eyes, face, arm, speech, time—emergency room staff quickly perform advanced brain imaging and contact CoxHealth, where they are connected with a neurologist. A televideo visit takes place so the neurologist can evaluate the patient in real time. The neurological evaluation helps support timely treatment for optimal patient outcomes. For eligible stroke patients, alteplase (tPA), the clotbusting medication, must be given within a certain treatment window after symptoms begin, so calling 911 immediately upon stroke symptom onset is critical. Through CT angiography and CT perfusion, patients who are eligible for thrombectomy can be rapidly identified and transferred to the most appropriate stroke-certified facility for higher levels of care. “It’s a combination of the right equipment, personnel and training to assess, identify and treat strokes quickly. Achieving certification validates the tremendous effort we have put into this program, ensuring the health and safety of our patients,” Hicks says. According to the American Stroke Association, stroke is a leading cause of death, killing nearly 130,000 people each year, and is a leading cause of serious, long-term adult disability. BE FAST TO SPOT A STROKE BALANCE: Having trouble with balance or coordination? EYES: Sudden blurred or double vision or loss of vision in one or both eyes? FACE: Does one side of the face droop when smiling? ARMS: Does one arm drift downward when both arms are raised? SPEECH: Is speech slurred or strange when repeating a simple phrase? TIME: If you see any of these signs, call 911 right away. From left: Chelsea Turner, R.N.; Andrew Nicholes, D.O.; Denise Silva, R.N.; Brian Schnitzer, R.N.; Josie Davis, PCT; Michelle Neal, R.N.; Lisa Higgins, CNA; and Jenna Hicks, R.N. STROKE CARE CMH named area leader in stroke readiness
citizensmemorial.com 7 Moving forward with heart disease In the wake of a serious heart issue, your doctor might suggest something called cardiac rehabilitation, or cardiac rehab—a program of supervised exercise and education for people with heart disease. And it has big benefits. For instance, cardiac rehab may improve the quality and even the length of your life by: » Helping you safely get moving again so you can enjoy more of your daily activities. » Lessening your risk for further problems, like heart attacks and hospital stays. » Reducing your need for medicines to treat angina. » Reducing your risk of heart disease-related death. A typical cardiac rehab program lasts for 36 sessions. To help improve the health of your heart and build your endurance, you will exercise about three times a week. A specially trained nurse will monitor your vital signs to ensure your safety. In cardiac rehab, you also may receive: » Information to help you live a heart-healthy lifestyle, such as eating healthier foods and quitting smoking, if you smoke. » Stress-reduction tips. » Emotional support from the cardiac rehab team and your fellow participants. There’s more good news about cardiac rehab: It is covered by most insurance plans. Talk with your doctor to learn more about the benefits of cardiac rehab and what to expect. Sources: American Heart Association; National Heart, Lung, and Blood Institute Help for COVID-19 long-haulers Citizens Memorial Hospital offers pulmonary rehabilitation for individuals healing from longterm effects of COVID-19, also called long COVID-19 or long-haul COVID-19. Due to the nature of the virus, many patients experience difficulty breathing even after the virus has left the body. Patients that require ventilators are at an even higher risk of experiencing long-term effects. Post COVID-19 symptoms are conditions that persist for more than four weeks after diagnosis. Individuals may experience symptoms for weeks and even months following a COVID-19 diagnosis. Some of the pulmonary symptoms may include: » Pain persisting beyond the normal healing process (usually three months). » Shortness of breath and poor endurance. » Weakness or trouble walking. » Problems with balance or dizziness. » Trouble performing activities of daily life. » Pain or achiness. CMH Pulmonary Rehabilitation offers individualized and supportive therapy that will help those who have had a confirmed or suspected COVID-19 diagnosis decrease symptoms and get back to daily life. The program is covered by most insurance plans. Talk to your doctor about COVID-19 rehabilitation at CMH. For more information, call CMH Cardio-Pulmonary Rehabilitation at 417-328-6574. CMH Cardio-Pulmonary Rehabilitation is nationally certified by the American Association of Cardiovascular and Pulmonary Rehabilitation. Our participants enjoy individualized treatment plans, exercise prescriptions, education classes and counseling sessions in an environment that makes healthy living fun! Due to our nurses’ advanced skills and the personal attention given, patients can feel safe as they embark on a healthier lifestyle. To get started on your rehab journey, call 417-328-6574. WELLNESS CARDIAC REHAB
8 VITALITY Spring 2022 While it may not have the glamour of other fitness trends, a move you mastered in toddlerhood is still hard to beat. We’re talking about walking. What makes walking such a great fitness move? For starters, it’s easy and inexpensive. There’s no need to visit a gym, buy special equipment or learn a new sport. For the most part, all you need are shoes that fit well and cushion your feet. Then just follow your own two feet. Also, walking is generally safe. It’s less likely to hurt your joints than running, for instance. For reasons like these, walking has a low dropout rate. So you’re likely to keep doing it. Best of all, walking is great for your body and your well-being. Walking is a type of aerobic exercise (the kind that elevates your heart rate and breathing.) Among other things, aerobic exercise can: » Help you burn more calories for better weight control. » Improve the health of your heart and blood vessels, which may help lower your risk of heart disease. » Help you maintain healthy blood pressure and cholesterol levels. » Help you prevent or manage type 2 diabetes. » Improve your fitness level, giving you the stamina to do everyday activities with greater ease. » Help you maintain strong bones. » Lower stress and elevate your mood. » Help you live longer. Losing weight is rarely fast and easy. So it may be tempting to try a product or diet that promises to make the process go quickly or claims you won’t have to change how you eat or exercise. Unfortunately, there are no magical solutions to safe and permanent weight loss. Real success means healthy, long-term lifestyle changes to diet and exercise habits. But with so many advertisers and scammers claiming these extraordinary weight-loss results, how can you sort out fact from fake? SCAMALERT According to the Federal Trade Commission, if you see any of the following in an ad or on a website, the promise is definitely a fake: » Lose weight without dieting, exercising or watching what you eat. » Use this product to drop weight permanently. » This pill makes you lose weight automatically. » Eat anything you want and still lose weight. » It works for everyone. » This cream or patch can help you lose weight. Step up to the benefits WALKING FOR EXERCISE WELLNESS Be wary of bogus weight-loss claims
citizensmemorial.com 9 GETTINGSTARTED IS EASY Most people don’t need to see a doctor to begin a walking program. But you may want to do that if you have a chronic health condition, you’re over 40 years old or you haven’t been active in a while. Once you get the green light to start a walking program, follow these tips for a successful and safe time: Set small, doable goals to start. Experts say an adult exercise routine should include about 150 minutes per week of moderately intense aerobic exercise such as brisk walking. (When you walk at a brisk pace, you can carry on a conversation and breathe without much effort.) But you may want to start with a more doable goal. Even a 10-minute walk, a few times a week, is a good start. Gradually work your way up to longer walks at a brisk pace. That’s when many of the health benefits of walking start to kick in. Meeting your goals will put more wind at your back. 1} Be aware of your surroundings. If you wear earphones, keep the volume low enough so you can hear traffic and other sounds. Wear bright colors when walking in low light. 2} Enlist a walking buddy. Active fun with a walking partner can increase your motivation. 3} Have a bad-weather plan. Consider walking in an indoor mall in rain or cold weather. Or plot a walking path in your home. 4} Change up your walking route from time to time. Variety keeps exercise interesting. Walk a different route, for instance. Or go for a shorter walk one day and a longer one the next. 5} Track your progress. Monitor how far you can walk with a step counter, a phone app or a journal. You’ll feel great when you see how far you’ve come. Sources: American Heart Association; Arthritis Foundation; National Institutes of Health FIVEWEIGHT-LOSS TIPS THAT REALLYWORK According to the National Weight Control Registry, 98% of people in the registry who have dropped pounds and kept them off did so by changing their eating habits, and 94% increased their physical activity. Here is how you can do those things too. Start easy. Set realistic, short-term weight-loss goals, and work your way up to your long-term goals. For example, aim to lose (and keep off) just 3% to 5% of your body weight to start. Track your eating habits. Use a food diary or tracking app to understand what you eat, how much and when. Knowing when you are more likely to overindulge enables you to break that habit faster. Size matters. Cut back on your portions to reach a reasonable serving size. That’ll help you meet your daily caloric goal. Choose smarter. Eat more fruits, vegetables and whole grains. These can keep you feeling fuller longer. Sit less, move more. Walk, dance or do any other form of exercise you like to get your heart pumping. Try to get at least 150 minutes of moderate activity each week. » Eat this combination of food (or avoid these particular foods) to burn fat fast. » Lose 30 pounds in 30 days. What dishonest advertisers really want is for you to spend your money on a product or plan. That could include signing up for a recurring monthly subscription that can be difficult to stop or getting hit with additional fees instead of the advertised rate. In short, if a weight-loss promise seems too good to be true, it probably is. Additional sources: Academy of Nutrition and Dietetics; American Heart Association
10 VITALITY Spring 2022 You just got the results of your latest mammogram, and you don’t have cancer. That’s great news! However, the report says you have dense breasts. What does that mean? Here are some answers to questions about dense breasts. Q: What are dense breasts? A: Your breasts are made of lobules, ducts, and fatty and fibrous connective tissue. The lobules (or glandular tissue) produce milk, and ducts are the tiny tubes that carry milk from the lobules to the nipples. The fatty and fibrous tissue gives breasts their size and shape. If you have dense breasts, you have a lot of glandular or fibrous tissue and not much fatty tissue. About half of women over 40 years old have dense breasts. Generally, your breasts become less dense as you get older. However, that’s not always the case. The only way to know if you have dense breasts is to get a mammogram. Dense breasts don’t feel different from breasts with more fatty tissue. There are four categories for dense breasts, from slightly dense to very dense. The radiologist who reads your mammogram decides which of those four categories best describes the density of your breasts. Some states require health care providers to tell people whether they have dense breasts. Q: What are possible risks with dense breasts? A: Dense breasts do increase the risk of breast cancer. The reason for this is still not known. But the denser your breasts, the greater your risk for breast cancer. Dense breasts can make it more difficult for radiologists to see cancer on a mammogram. That’s because both dense tissue and breast masses and tumors appear as white areas on a mammogram. “Ladies need to get a screening mammogram every year starting at age 40 no matter your tissue density and to get a clinical breast exam every year,” says Jana Horner, M.D., with CMH Breast Care Center in Bolivar. “Those two things go further to finding new breast cancers than any other tests studied and is what will lead to early detection of cancer.” Q: How do dense breasts affect screening recommendations? A: “If you have dense breasts, that doesn’t necessarily mean you will need other screening tests for breast cancer in addition to mammograms,” says Dr. Horner. “At CMH Breast Care Center, we have state-of-the-art mammogram hardware, top-notch technologists and an excellent success rate in detecting cancers at an early stage.” As always, if you notice a change in your breasts, talk to your provider as soon as possible. And remember to get regular mammograms, which are the best way to find breast cancer early and save lives. Sources: American Cancer Society; American College of Radiology; Office on Women’s Health MAMMOGRAMS CAN HELP FIND BREAST CANCER EARLY. Is it time to schedule your next screening? Give us a call today at 417-328-6261. EXPERT IN BREAST CARE Radiologist Jana Horner, M.D., is the Medical Director of the CMH Breast Care Center, located in the Kerry and Synda Douglas Medical Center. She is board certified and completed a residency at the Cleveland Clinic. She is also fellowship-trained at the renowned MD Anderson Cancer Center in Houston, Texas. CMH Breast Care Center services » Digital mammograms (screening and diagnostic). » Breast ultrasound. » Breast aspiration. » Ultrasound-guided biopsies. » Breast localizations. » MRI breast imaging. BREAST HEALTH Learn the facts about dense breasts
citizensmemorial.com 11 Cancer is a leading cause of death in the U.S., which is why hearing the words “you have cancer” can be terrifying. There are numerous risk factors for cancer, and some of them we can’t control, such as our age or our family history of the disease. But at the same time, we have the power to help lower our risk of developing many types of cancer. What follows are six steps we can take to help prevent cancer. There’s no guarantee, of course, that even if we adopt all of these recommendations, we won’t get cancer. But they can help keep the disease at bay. And that makes trying them worthwhile. 1} Maintain a healthy weight. Controlling your weight may decrease the risk of certain cancers, including breast cancer in postmenopausal women; endometrial (uterine) cancer; and kidney, pancreatic and colorectal cancers. One of the main ways being overweight increases cancer risk is that excess weight causes the body to make and circulate estrogen and insulin, hormones that can stimulate cancer cells. 2} Keep moving. Exercise is key to achieving a healthy weight, and it can help lower the risk of colorectal cancer, postmenopausal breast cancer and endometrial cancer. Adults should get 150 to 300 minutes of moderate or 75 to 150 minutes of vigorous exercise each week. 3} Steer clear of tobacco— whether you smoke or not. Lung cancer is the leading cause of cancer death, and cigarettes cause most cases. Smoking also causes a long list of other cancers, including cancers of the mouth and throat, stomach, colon, liver, bladder, and pancreas. In addition, adults exposed to secondhand smoke are 20% to 30% more likely to develop lung cancer. 4} Know the risks of alcohol. Drinking alcohol, even in small amounts, can increase the risk of certain cancers, including breast cancer. PREVENTION of your cancer risk 5} Protect your skin. Skin cancer is the most common cancer in the United States. Ultraviolet rays from the sun and tanning beds can damage the skin and trigger cancer. You can lower your risk by seeking shade from the sun; avoiding tanning beds; applying sunscreen; and wearing sun-protective clothing, a hat and sunglasses. 6} Get any needed vaccines. Some cancers—such as those of the cervix, penis, vagina, anus and oropharynx—are caused by the human papillomavirus (HPV), a very common sexually transmitted infection. The HPV vaccine protects against the types of HPV that most often cause these cancers. There is also a vaccine to prevent hepatitis B, which can lead to liver disease or cancer. Talk to your primary care provider to see if you need one or both of these vaccines. Sources: American Cancer Society; Centers for Disease Control and Prevention; National Cancer Institute These 6 tips may help prevent the disease
12 VITALITY Spring 2022 Young athletes need nutritious fuel If you’re like many families, you might have one or more sporty kids at home. And you may already know that nutrition plays a key role in kids’ overall health. But how can you help your young athlete fuel up right for sports? It’s a win to remember that eating right for everyone starts with a healthy, balanced diet. In addition, these nutrition pointers specifically for sports-minded kids can help. » Don’t let your young athlete skip breakfast. Breakfast really is that important, especially before a practice or game. Offer wholegrain cereal with low-fat milk and fruit for a quick and easy choice. » Provide power with carbs. Carbohydrates, or carbs, are the body’s main fuel source. Your young athlete should eat plenty of carbs on game day. » Make protein a part of every meal. Protein helps muscles recover after a workout. Serve lean meats, like skinless poultry; fish; low-fat dairy; beans; or tofu. » Avoid giving your kids supplements. Most kids can get all the vitamins and minerals they need from a well-balanced diet. And supplements don’t really make kids better athletes. » Encourage proper hydration. Athletes should drink fluids before, during and after exercise. During practices or games that last longer than one hour, or in hot weather, your child may need a sports drink to replace lost carbs and electrolytes. Your child should drink water or a sports drink every 15 minutes during a practice or competition. » Discourage energy drinks. Energy drinks should not be used as a form of hydration or to enhance performance. They contain caffeine and other stimulants that may not be safe for kids. Some kids have even ended up in the emergency department after using energy drinks. Talk to your child’s primary care provider or a registered dietitian for more advice about nutrition for athletes. Sources: Academy of Nutrition and Dietetics; American Academy of Pediatrics FAMILY Serve up nutritious snacks. Good options include fresh fruit and veggies, dried fruit, unsalted nuts, hardboiled eggs, microwaveable popcorn, and protein bars.
citizensmemorial.com 13 DIGESTIVE HEALTH It’s not unusual to have indigestion once in a while, especially after a big meal. But heartburn that happens frequently—or comes on with other symptoms—could be a sign of something more serious called gastroesophageal reflux disease (GERD). “GERD is a common digestive complaint,” says Ryan Denney, D.O., with CMH Gastroenterology Clinic in Bolivar. GERD is a digestive disorder that occurs when food and acid from the stomach flow back into the esophagus. It’s uncomfortable and, when left untreated, can increase the risk of esophageal inflammation and cancer. IS HEARTBURN GERD? GERD is often marked by frequent heartburn—a painful, burning feeling in your upper belly and below your chest bone. But GERD can cause other symptoms, too, including regurgitation—spitting up of food from the stomach without nausea—and can atypically contribute to breathing problems like throat clearing, wheezing, coughing or loss of voice. Anyone can have GERD. Being overweight or smoking can significantly raise a person’s risk though. GET HELP FOR GERD GERD has the potential to cause health problems over time. Getting the condition under control is the best way to start feeling better and lower your risk for possible complications. Start by talking with your primary care provider. Together you can come up with a GERD management plan, including lifestyle changes like: » Identifying and avoiding heartburn-triggering foods, such as spicy or acidic foods. » Eating a lower-fat diet. » Trading large meals for smaller, more frequent meals. » Losing weight if needed. » Quitting smoking if you smoke. » Elevating your head while you sleep. “Management of reflux begins with lifestyle modifications, which includes avoiding common triggers of reflux,” says Dr. Denney. “Additionally, some people have more reflux at night, generally when they lie down to sleep.” Solution: Don’t eat before bed, or consider elevating the head of your bed to alleviate reflux symptoms. Over-the-counter and prescription drugs—like antacids, H2 blockers and proton pump inhibitors—can help too. Surgery can be another option when lifestyle changes and medicines aren’t enough. “Talk to your primary care physician or specialist to see what options are best for you,” says Dr. Denney. Sources: Academy of Nutrition and Dietetics; American Academy of Family Physicians; National Institutes of Health IF SYMPTOMS OF GERDARE GETTINGYOU DOWN, talk to your PCP and ask for a referral to CMH Gastroenterology Clinic. Board certified gastroenterologist Ryan Denney, M.D., and nurse practitioner Candi Erven, NP-C, specialize in preventing, diagnosing and treating gastroenterology and liver disorders. Call 417-326-8700 for more information. Ryan Denney, D.O. Candi Erven, NP-C GERD? Is your heartburn actually Hear more about GERD from Dr. Denney at cmhbolivar .info/GERD.
14 VITALITY Spring 2022 Have you given some thought to your cholesterol levels lately? The more you know about cholesterol, the better you might be able to reduce your chances of having a heart attack or stroke. To start, check out the following facts about cholesterol: WELLNESS Your body needs some cholesterol to function properly. Cholesterol is a fat-like substance present in your bloodstream and your cells. It can be unhealthy to have too much or too little of certain kinds of cholesterol in your blood. A high level of LDL (lowdensity lipoprotein) cholesterol can build up in arteries and reduce blood flow to your heart or brain. This can lead to a heart attack, stroke or other serious diseases. So you’ll want a low LDL level. HDL (high-density lipoprotein) cholesterol helps remove cholesterol from the body. So a high HDL level may actually lower your risk of heart disease. You usually can’t tell if you have a cholesterol problem. An abnormal cholesterol level usually doesn’t cause any symptoms. So you can have one and feel just fine. You’ll need a cholesterol blood test to find out if your cholesterol levels are healthy. How often you need your cholesterol checked depends on your age and other risk factors. Ask your primary care provider what’s right for you. Lifestyle changes can often treat cholesterol problems. A heart-healthy lifestyle may be all you need to get your cholesterol levels within a healthy range. For example, for a more cholesterol-friendly diet, try eating leaner meats and more beans instead of fatty meats. Switch to low-fat or nonfat dairy products. These moves will help you avoid artery-clogging saturated and trans fats, which can cause your body to make more cholesterol than you need. Be sure to also get regular exercise and maintain a healthy weight. They’re good for your cholesterol levels too. Some people may need medicines. Sometimes lifestyle changes alone aren’t enough to control cholesterol levels. Drugs called statins are most often used to manage high LDL cholesterol. They have been shown to lower the risk of heart attacks and strokes. Your primary care provider may prescribe other medicines if you can’t take a statin because of side effects or if you need more than one type of medicine to lower your cholesterol. Sources: American Heart Association; National Heart, Lung, and Blood Institute 4 facts to know about cholesterol
citizensmemorial.com 15 Here are two basic things you need to know about gallstones: They are painfully common—and commonly painful. Nearly 1 million people in the U.S. every year learn they have gallstones. And about a quarter of them will need to have some sort of treatment, usually surgery, to remove their gallbladder. So what are gallstones, and why can they sometimes be so painful? THE TROUBLE WITH STONES Gallstones are hard, abnormal masses that form in the gallbladder—a small, saclike structure located just under your liver. The main function of your gallbladder is to store bile, a liquid made by your liver that aids in digesting fats. Bile is made up of several substances, including cholesterol, bile salts and bilirubin (a waste product). Gallstones may form when bile contains too much cholesterol or bilirubin or not enough bile salts, causing digestive fluid to harden into a stone. Gallstones can be quite tiny—like the size of a grain of sand—or as large as a golf ball. You can have one or more stones, and they can be a mix of large and small sizes. PAINFUL ATTACKS Many times gallstones cause no symptoms and don’t need treatment. However, sometimes a gallstone blocks a bile duct, triggering a painful gallbladder attack. Many people have an attack after a large meal, and most attacks happen in the evening or at night. You’ll feel the pain in your right upper abdomen, and the attack can last for several hours. An attack usually stops when a gallstone moves and no longer blocks the bile duct. But if that stone doesn’t move and the attack doesn’t stop, then you’re at risk for serious complications, which include inflammation of the gallbladder, liver or pancreas. If your attack doesn’t stop or if you experience any of the following symptoms during or after a gallbladder attack, you need to get medical help right away: » Nausea or vomiting. » Fever or chills. » Jaundice—your skin and the whites of your eyes look yellowish. » Dark urine or light-colored stools. TREATMENT OPTIONS Many people can simply live with gallstones if the stones don’t bother them or don’t trigger frequent attacks. But treatment is often needed. Gallstones can be treated with medications and therapies that dissolve them, but the stones can return. Which is why surgery to remove the gallbladder—called a cholecystectomy—is the usual treatment for bothersome stones. And, fortunately, the body functions just fine without a gallbladder. Source: National Institute of Diabetes and Digestive and Kidney Diseases WELLNESS Does that gallbladder need to go? Your guide to gallstones DON’TWAIT! If you’re experiencing pain from a gallbladder attack, talk to your primary care provider or schedule an appointment with one of our general surgeons at CMH Surgical Services Clinic in Bolivar. Brent A. Bartgis, D.O.; Martin S.Tyson, D.O., FACS; andW.WayneWolf III, D.O., are board certified and have decades of combined experience and education.The surgeons and the medical staff provide compassionate, personalized care for their patients. Call 417-326-8700 to schedule an appointment or for more information. Brent A. Bartgis, D.O. Martin S. Tyson, D.O., FACS W. Wayne Wolf III, D.O. Many people can simply live with gallstones if the stones don’t bother them or don’t trigger frequent attacks. But treatment is often needed.
WELCOME Kaylee Ankrom, FNP-C, is a family nurse practitioner at Willard Medical Center and Walk-In Clinic, and she also sees patients at Dallas County Family Medical Center, Buffalo. Ankrom is certified by the American Academy of Nurse Practitioners. For information, call 417-761-6655. Magen Blades, PA-C, is a physician assistant at Willard Medical Center and Walk-In Clinic. She is certified by the National Commission on Certification of Physician Assistants. For information, call 417-761-6655. Shawn F. Brigance, AGNP-C, is an adult gerontology nurse practitioner at Butterfield Park Medical Center. He provides care to long-term care residents at four CMH Foundation facilities. Brigance is certified by the American Association of Nurse Practitioners. For information, call 417-326-7676. Jennifer Gamber, NP-C, is a nurse practitioner at CMHWalk-In Clinic in Bolivar. She is certified by the American Academy of Nurse Practitioners. For information, call 417-777-4800. Jennifer Joy, FNP-C, is a family nurse practitioner for the hospitalist program at Citizens Memorial Hospital. She is certified by the American Nursing Credentialing Center– Family Nurse Practitioner. For information, call 417-326-6000. Pam Kepus, APRN, is an advanced practice nurse at Stockton Family Medical Center. She is certified by the American Academy of Nurse Practitioners. For information, call 417-276-5131. Erin Payne, PA-C, is a physician assistant at Willard Medical Center and Walk-In Clinic. She is certified by the National Commission on Certification of Physician Assistants. For information, call 417-761-6655. Tia Phillips, DNP, FNP-C, is a family nurse practitioner at Ash Grove Family Medical Center. She is certified by the American Academy of Nurse Practitioners. To schedule an appointment, call 417-751-2100. newmedical staff
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