Citizens Memorial Hospital | Vitality | Winter 2024

WINTER 2024 Treat yourself to the best gift Find ways to give New med slows Alzheimer’s Research offers hope Out with the old, in with the new How to heal well with a hip replacement

2 VITALITY Winter 2024 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 Jennifer Stegner Katie Duncan Aaron Tallant Charlotte Marsch Mission Providing compassionate care for all generations by leading physicians and an exceptional health care team. Vision Be the first choice for health care by delivering the safest, highest quality and best experience for the communities we serve. Values I am Safe, Engaged, Respectful, Valued and Empowered. Together, we make a difference by serving others. 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 in VITALITY 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. 2024 © Coffey Communications, Inc. All rights reserved. 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) 417-326-6000. We’d love to hear from you on social media facebook.com/citizensmemorial x.com/cmhbolivar instagram.com/cmhbolivar linkedin.com/company/citizens-memorial-healthcare Michael Calhoun, CEO/Executive Director Citizens Memorial Hospital and the Citizens Memorial Health Care Foundation Overflowing with gratitude It’s a joy to slow down and spend time with family over Thanksgiving, especially during such a busy year. I have so much to be thankful for this holiday season, especially here at CMH. On page 3, you’ll read about our recent 4-star hospital, home health and hospice ratings from the Centers for Medicare & Medicaid Services. These ratings affirm our high-quality, patient-centered care. Great work is happening in our Research Department too. On pages 6 and 7, read about how CMH is at the forefront of Alzheimer’s disease research and treatment—and how you might be able to participate in a new Alzheimer’s study. I am grateful to all the amazing people who take part in our research studies! They are incredible individuals, selflessly giving their time and energy to help others. We continue to add services at CMH to improve the patient experience. One example is our new Orthopedic Navigator program described on page 11. Olivia Cumley, DNP, FNP-C, is an excellent guide and advocate for patients throughout the orthopedic surgery process. On pages 12 and 13, you can read about longtime CMH supporters Craig and Lisa Lehman and why they give to CMH. The Citizens Memorial Health Care Foundation Impact Report, included with this issue, recognizes our donors. Finally, we are excited to start construction soon on a dialysis clinic, opening in late 2025. We also continue to see incredible progress on our hospital expansion project. With concrete poured for the first two floors, we are really starting to see the building’s footprint. I wish you a wonderful Christmas and a joyful and blessed New Year.

citizensmemorial.com 3 Sporting clay fundraiser In September, 42 teams gathered for the second annual Citizens Memorial Health Care Foundation Sporting Clay Fundraiser, presented by SGC Foodservice. Teams of four competed to raise money for the Foundation, which helps to provide lifesaving care and services to Citizens Memorial patients and residents. Tournament sponsors donated more than $40,000. CMH introduces new payment plans through ClearBalance Healthcare Citizens Memorial Hospital patients now have a more flexible payment plan option with 0% interest through a partnership with ClearBalance Healthcare. ClearBalance’s solutions offer best-inclass patient financing models that simplify the account management process. Patients benefit from these programs without needing credit checks or approvals, and they do not incur finance charges or additional fees. ClearBalance has an online portal where patients can manage their accounts. For more information, visit cmhbolivar.info/ PaymentPlans or clearbalance.org. CMS 4-star ratings for the hospital, hospice and home health Citizens Memorial Hospital, CMH Hospice and CMH Home Health Services achieved 4-star ratings from the Centers for Medicare & Medicaid Services this year. Only 40% of the 2,847 rated hospitals have a rating of four stars or higher. “Safety and quality are a high priority at CMH and a team effort that involves everyone,” says Michael Calhoun, CEO/ Executive Director of CMH/CMH Foundation. “We are continually reviewing processes and taking innovative approaches to providing the best patient experience.” The ratings appear on the CMS Care Compare site at medicare.gov/care-compare. Pictured is the White River Marine Group (Kyle Gaddy, Caleb Skopec, Steve Skopec and Dennis Gaddy) that took first place in the afternoon A flight. Adam Naegler, with Fast N’ Friendly, and Ron Anderson, with Anderson Cattle Co., were the top shooters.

4 VITALITY Winter 2024 Soirée success Sponsors and supporters raised more than $126,000 for the inaugural CMH Soirée in September. The evening under the stars at the farm of Tim and Nancy Erickson included fine dining, entertainment and a live auction. Proceeds benefit the CMH Birth Place and area newborns and their families. CMH earns awards for excellence Citizens Memorial Hospital recently received awards recognizing excellence in quality improvement, patient safety and employee wellness. Hospital Quality Improvement Contractors (HQIC) gave CMH its Platinum medal—the highest level—for commitment to quality improvement and patient safety efforts. The award recognizes CMH’s performance in more than 30 focus areas. The HQIC program focuses on a commitment to improving quality and patient safety, providing person-centered and equitable care, and producing better health outcomes. CMH received the Missouri Silver Level Workplace Wellness Award from the Department of Health and Senior Services, Missouri Council for Activity and Nutrition, and the University of Missouri Extension. The program recognizes employers with policies supportive of employee health and wellness. CMH boosts employee wages with $4 million investment More than 70% of CMH’s workforce received wage increases this summer as part of $4 million in salary adjustments. “Our employees are the foundation of everything we do at CMH,” says Michael Calhoun, CEO/Executive Director of CMH and Citizens Memorial Health Care Foundation. “Many of them are on the front lines, providing compassionate, quality medical care, while others work in critical support roles to ensure the best overall experience for our patients and residents. We want our employees to know they are a valued part of CMH.” CMH’s administration used minimum wage increases and recent updates to the U.S. Department of Labor’s Fair Labor Standards to determine how to distribute the wage adjustments. For more information about open positions and to apply online, visit careers.citizensmemorial.com. From the CEO Learn more about how CMH is supporting employees through the wage increases from CEO/Executive Director Michael Calhoun at cmhbolivar.info/4eB9Sdc. Photo by Brynna Wehner

citizensmemorial.com 5 A national leader in quality and patient safety CMH was honored to present at Huron Consulting Group’s annual What’s Right in Health Care® national conference. CEO/Executive Director Michael Calhoun and Chief Nursing Officer Sarah Hanak shared CMH’s journey to high reliability, resulting in increased quality and patient safety throughout the organization. Photo credit: Huron Consulting Group Professional leadership updates Home Health Valerie Noblitt, Director of Home Care Services, received the Pioneer Leadership Award from the Missouri Alliance for Home Care (MAHC). She is the president of MAHC and has served on the board since 2014. She is a dedicated advocate for home care services. Long-Term Care CMH long-term care administrators were voted into these leadership roles in the Missouri Health Care Association (MHCA): Chris McBratney—MHCA President. He will serve a one-year term with the option to run for a second term next year. He has been on the MHCA board of directors since 2000. McBratney is the administrator at Lake Stockton Healthcare Facility, Stockton. Roy Pace—Convention Chair for 2025. This is his second year to serve as convention chair. He has served on the board of directors since 2014. Pace is the administrator at Colonial Springs Healthcare Center, Buffalo. Tim Francka—Council of States Representative for Missouri on the American Health Care Association Board of Directors. He has served in this role since 2017 after serving as the MHCA president and past president from 2012 to 2016. Francka is the administrative director of long-term care at CMH. Pharmacy Mariah Hollabaugh, PharmD, MBA, BCPS, CPEL, earned the Certified Pharmacy Executive Leader credential from the American Society of Health-System Pharmacists. She is the system director of pharmacy at CMH. Hollabaugh is one of 16 pharmacy leaders to participate in the program’s most recent cohort. Receive CMH Health News through email Stay current on the latest happenings at CMH between issues of Vitality magazine. Sign up for the twice-monthly CMH Health News email newsletter for the latest information about CMH events, news and services. Scan the QR code to sign up now, or visit cmhbolivar.info/CMHNews.

6 VITALITY Winter 2024 in clinical use of new Alzheimer med Citizens Memorial Hospital’s Infusion Center administered the new Alzheimer’s disease medication Kisunla (donanemab) to the first patients in southwestern Missouri in September. Neurologist Curtis P. Schreiber, M.D., and his team at Missouri Memory Center at CMH and the CMH Research Department participated in the clinical research trial that led to the approval of Kisunla by the U.S. Food and Drug Administration (FDA) on July 2. The CMH system was also the first health system in Missouri to add Kisunla to its formulary. “Now, for the first time ever, there are options for patients with memory concerns related to Alzheimer’s disease, who are diagnosed when the symptoms are in the early stages, to slow the progression of Alzheimer’s,” Dr. Schreiber says. “Kisunla is the second medication fully approved by FDA in less than a year that can slow down the progression of cognitive changes and loss of ability to function at a normal level in daily life.” Studies show Kisunla significantly slows cognitive and functional decline in people with early, symptomatic Alzheimer’s disease. State-of-the-art diagnostic tests, called biomarkers, can detect the disease in its earliest stages. “We have been using biomarkers in our Alzheimer research program for several years,” Dr. Schreiber says. “These same tests are now being used in New Alzheimer research at CMH Through the Missouri Memory Center and the CMH Research Department, 15 patients participated in national clinical research studies for Kisunla (donanemab), the newest medication approved by the U.S. Food and Drug Administration that can help slow the progression of Alzheimer’s disease. “We are grateful to our patients who volunteered for the research study that helped provide the necessary evidence that the drug is effective in significantly slowing cognitive and functional decline in patients with early symptomatic Alzheimer’s disease,” says Curtis P. Schreiber, M.D., board certified neurologist at CMH. Amyloid plaque buildup in the brain is prominent as Alzheimer’s disease progresses. Research studies show that amyloid buildup in the brain can be measured with amyloid biomarkers for 10 to 20 years before symptoms occur. Now, scientists are testing whether drugs, such as Kisunla, that remove amyloid plaque can slow the progression of Alzheimer symptoms earlier in the course of the disease—even before memory loss symptoms begin. The CMH Research Department is now enrolling individuals in a new clinical trial for an amyloid plaque-removing drug. CMH LEADS THE WAY

citizensmemorial.com 7 Request our free Alzheimer’s Guide In the Introduction to What’s New in Alzheimer’s Disease Treatment by Curtis P. Schreiber, M.D., you will learn more about disease-modifying therapies. The guide provides a solid, basic understanding of the issues to consider about the new medications that can slow the progression of Alzheimer’s disease. Visit cmhbolivar.info/ 3ylensC. Missouri Memory Center, CMH Neurology and Headache Center, and CMH Research Department staff our clinic to accurately diagnose Alzheimer’s disease earlier than before. In order to be a candidate for the new medications that can slow the progression of Alzheimer’s, the diagnosis must be proven with biomarker testing.” Kisunla is administered by intravenous infusion every four weeks. It works by reducing amyloid plaques in the brain, which are associated with Alzheimer’s disease. “The new treatments for Alzheimer’s disease open up more options than ever before for people with the earliest stages of Alzheimer’s,” Dr. Schreiber says. “Not everyone is a candidate, but for the right patient at the right stage of the disease, there are more options to consider.” To learn more about Alzheimer care at CMH, call the Missouri Memory Center at 417-328-7781 or visit citizensmemorial.com. The trial is testing whether this form of treatment will delay the progression into symptomatic stages of Alzheimer’s in people who have a positive biomarker showing that amyloid plaques are building up in the brain but have no current Alzheimer symptoms. “There would have been no advancements in Alzheimer treatment without the help of people who are willing to be part of research,” Dr. Schreiber says. “They are not just looking out for themselves but for other people in the future.” If you are interested in participating in this study, please call the CMH Research Department at 417-328-7781 or email CMHResearch@citizensmemorial .com. A research specialist will ask some questions to determine if you might qualify for the study. Free cognitive screenings The Missouri Memory Center hosts free cognitive screenings from 9 to 11:30 a.m. on the third Friday of each month. Trained staff complete the screenings in about 30 minutes. You will have your results immediately and can share them with your primary care provider. Call 417-327‑3530 to make an appointment. John Duff received his first infusion of Kisunla at the CMH Infusion Center in September.

8 VITALITY Winter 2024 If you have been diagnosed with non-Hodgkin lymphoma (NHL), you probably have questions about your condition and how it’s treated. Here are the basics. Non-Hodgkin lymphoma explained NHL is a type of cancer that develops in white blood cells called lymphocytes, which belong to your immune system. Lymph tissue is found in many places in your body, including: ● Adenoids and tonsils. ● Bone marrow. ● Digestive system. ● Lymph nodes. ● Spleen. ● Thymus (an organ behind your breastbone). NHL can appear in any of these sites, and it can affect two types of lymphocytes: ● B lymphocytes, or B cells, protect you from illness by making antibodies, which flag germ cells so the immune system can destroy them. ● T lymphocytes, or T cells, help direct how your immune system’s cells behave. They also can kill germs and other potentially dangerous cells. If you’ve been diagnosed with NHL, your doctor will talk to you about the cancer’s progress. Stage I means the cancer is very localized and hasn’t spread. Stage IV means the cancer has spread to other organs outside of the lymph system. To determine the stage of your NHL, your doctor will examine you and perform tests and procedures. These might include blood and imaging tests and a lymph node or bone marrow biopsy. Questions to ask Talk with your doctor and other members of your health care team about your NHL diagnosis. Write down a list of questions, and take notes during your doctor visits. Information about cancer treatment can be confusing, so be sure to ask follow-up questions until you understand. Here are several questions to ask your doctor: ● What stage is my lymphoma? ● How soon should I start treatment? ● Do I need a second opinion? If so, can you recommend another provider or a cancer center? ● What are my treatment options? ● How will I prepare for treatment? ● How successful do you think the treatment will be? ● What should I do if the lymphoma returns after treatment? ● What are the risks and possible side effects of the treatment? ● How long will it take for me to recover? ● What precautions should I take during and after treatment? Sources: American Cancer Society; CancerCare; Leukemia & Lymphoma Society What is non-Hodgkin lymphoma? Questions for your health care provider Get the care you need Are you concerned about your health? Make an appointment with one of our expert providers. Call 417-328-6010 or visit citizensmemorial.com.

citizensmemorial.com 9 For many of us, having a bad case of the flu can be a miserable experience. But sometimes the flu can be more than just an annoying sickness. It can be downright dangerous. How the flu can be severe Although it takes a few days to a week or two, most people recover from the flu, which is a viral respiratory infection. But some people develop severe and potentially life-threatening complications, like pneumonia. The flu can also lead to dehydration. And it can make other health problems a person may already have, like asthma or heart disease, worse. Although anyone can develop flu complications, people at higher risk include adults over age 65, younger children and pregnant women. People with underlying health conditions—such as diabetes or heart, kidney or lung disease—are also at higher risk. Warning signs of a flu emergency If you have flu-like symptoms (including fever, chills, body aches and a sore throat) and you’re in a high-risk group, ask your doctor about antiviral medicines. When Flu vaccine available at Stephens Pharmacy Reduce your likelihood of the flu becoming an emergency by getting the annual flu vaccine. Stephens Pharmacy, in Bolivar, makes it easy to get a flu vaccine, with walkin hours from 8:30 a.m. to 4 p.m., Monday through Friday. Call Stephens Pharmacy at 417-326-2416 for more information about the flu vaccine or other immunizations. Is it an emergency? If you’re not sure whether your flu illness rises to the level of an emergency, call your primary care provider or visit the nearest emergency room. What to do when the flu becomes an emergency started early, they may help you recover sooner. You should also pay attention to your symptoms and seek medical care right away if you have signs or symptoms of a flu emergency, which can include: ● Trouble breathing or fast breathing in children. ● Chest pain. ● Dizziness or confusion. ● Severe muscle pain, which can be bad enough to affect walking. ● Seizures. ● A fever or cough that improves but then returns or worsens. ● In children, a fever above 104 degrees or, in infants younger than 12 weeks, any fever. ● Dehydration. Signs include not urinating, having a dry mouth and having no tears when crying. ● A worsening of chronic health conditions. Sources: American Academy of Family Physicians; American College of Emergency Physicians; Centers for Disease Control and Prevention

10 VITALITY Winter 2024 A new hip can mean returning to your old activities. However, the healing process will take time. Here’s what to expect when you’re recovering from a hip replacement. Before discharge Many people stay in the hospital for just a day or two, and some people even go home the same day. No matter how long you’re there, there are several things you’ll need to show you can do before being sent home, including: ● Getting in and out of bed on your own. ● Eating, drinking and going to the bathroom. ● Walking with your walker. ● Doing the exercises you’ve been prescribed. With those boxes ticked, you’ll be on your way home. Sources: American Academy of Orthopaedic Surgeons; National Institute of Arthritis and Musculoskeletal and Skin Diseases If you have questions about recovering from a hip replacement, make an appointment with one of our surgeons at the CMH Orthopedic & Spine Center by visiting citizensmemorial.com or calling 417-777-2663. Don’t: ● Go it alone. Arrange to have a friend or family member around to help you in the weeks after your surgery. ● Shower or take a bath before your health care provider says it is OK. ● Take any medication, even over-the-counter medicines, without talking to your provider. ● Drink alcohol. ● Cross your legs at the knees for at least six weeks. ● Bend at your waist more than 90 degrees. Do: ● Have someone move your furniture so you can get around easily with a walker. ● Remove loose wires or rugs to prevent falls. ● Keep items you use often (like your phone, glasses or laptop) in easy reach. ● Get help from gear like a shower chair, a long-handled shoehorn and a grabbing device. ● Keep your wound clean and dry. ● Use ice to relieve pain and swelling. ● Keep your affected leg facing forward. Recovery do’s and don’ts When you leave the hospital, your health care provider will go over everything you should and shouldn’t do during your recovery. Here are some of the do’s and don’ts you’re likely to hear. Recovering from a hip replacement

citizensmemorial.com 11 5 ways to prepare for a joint replacement surgery Olivia Cumley, DNP, FNP-C, starts each workday at the hospital by checking on patients after orthopedic surgeries, coordinating their care and planning for discharge. In the afternoons, she meets with patients planning for an upcoming surgery, helping them understand what will happen during surgery and recovery. As the orthopedic patient navigator at the CMH Orthopedic & Spine Center, Cumley is a liaison between the patients and surgeons. Her goal is for patients to be well-informed and have the best possible outcomes through a personalized experience. “I don’t want anyone going into the hospital saying, ‘I didn’t know about that,’” she says. Cumley gives five tips for patients to have the best outcome after surgery. Do you have joint pain that isn’t going away? Our orthopedic experts at the CMH Orthopedic & Spine Center can help with a variety of treatment options. Call 417-777‑2663 for more information. Cumley is the main point of contact for patients from when they decide on surgery through their recovery. “I like patients to be on a first-name basis with me,” she says. “If I can’t answer their question directly, I will find out the answer and get back to them.” Have a support system in place. One of the most important things after surgery is a good support system. We want a safe discharge plan for all patients. 1 2 3 4 5 Olivia Cumley, DNP, FNP-C Have realistic pain expectations. We talk a lot about pain and what to expect during recovery. Be ready for physical therapy. The surgeons do a great job replacing the joint. Then, the patient’s hard work begins. We need them to give 100% in therapy. The first few weeks are the most important. The more you put into it, the more you get out of it. Be active. We often ask patients to start their post-operative exercises before their surgery. It helps them understand what they’re lacking and what they need. It gives them a baseline. Prepare your home. Do you need adaptive equipment? Can you use the entry to your house during recovery? Do you need changes to your bathroom or bedroom setup? We can look at all of these ahead of time to make changes or order adaptive equipment in advance.

12 VITALITY Winter 2024 For Craig and Lisa Lehman, of Bolivar, giving back to their community is a lifelong pursuit that started by following the example set by their parents. “Craig’s parents are very active in their church, and my parents were active in the community and especially the hospital,” Lisa says. “They were involved in school, and my dad was in Rotary. Philanthropy has always been a big thing, even in college. We were active in philanthropy organizations there too. It seems like the natural thing to do.” Passing on a passion for service The family’s roots run deep at CMH. Lisa’s dad, Wayne Wilson, was a charter member of the Citizens Memorial Hospital District Board of Directors from 1978 to 2017. Her mother, Rowena Wilson, was a charter member of the CMH Auxiliary. They were both actively involved with the opening of the hospital. “My dad really believed that Bolivar needed a hospital,” Lisa says. “Not just Bolivar, but all the counties north of us and east and west. He was on the hospital board until his death and just loved everything about it. He was so proud of everything.” Lisa recalls how much time her dad invested in the board, especially during the early years. “I remember they were shopping Philanthr A LIFELONG PURSUIT for hospital beds,” Lisa says. “As a kid, I’m thinking, just buy beds, for crying out loud. I’m tired of hearing about them. Now, looking back, it’s pretty unique that they had that much hands-on involvement.” Lisa also recalls her mom’s service through the CMH Auxiliary. “For the grand opening, the Auxiliary women were taking their own irons and ironing curtains and bedsheets to help get the hospital up and going,” Lisa says. “That is one of my fondest memories.” The Auxiliary members then decided to start raising money for the hospital. They started a “potpourri” fundraiser that was the precursor to today’s annual Auxiliary Bake Sale. “They made snacks, candy and crafts to sell because there wasn’t a gift shop at that time,” Lisa says. Rowena was the chairperson for the potpourri sales, and Lisa is an active Auxiliary member who now serves as the chairperson for the Bake Sale. Lisa has donated 1,025 volunteer hours and counting. While the CMH Auxiliary began with women only, men are now among the 310 current volunteers. Why give to CMH? “When you give to the hospital, it reaches so many people,” Lisa Lisa and Craig Lehman, of Bolivar, are dedicated to supporting CMH.

citizensmemorial.com 13 Ways to give to CMH Generous donors and volunteers help the Citizens Memorial Health Care Foundation advance the health and wellness needs of local communities. Financial support Donations support programs, services, scholarships and capital equipment needs at CMH. Ways you can give include: ● Donating online at cmhbolivar.info/donate. ● Participating in fundraising events. ● Creating memorials and honorariums. ● Donating to areas you are passionate about, such as medical scholarships, the capital building fund, hospice, the Carrie J. Babb Cancer Center, etc. ● Leaving a legacy through planned giving. For more information, go to cmhbolivar.info/ giving, call 417-328-6318 or send an email to development@citizensmemorial.com. Volunteer support You also can give to CMH by becoming an Auxiliary volunteer. Learn more at cmhbolivar.info/auxiliary or by calling 417-328-6432. ropy says. “I think that’s why we like our dollars to go there. We don’t have to worry about where it’s going. We know that it’s going to be used in a way that it’s going to benefit a lot of people.” From tending to their children’s sports injuries to caring for their parents in long-term care, Craig and Lisa have always depended on CMH and appreciated the convenience of quality health care close to home. “We’re very fortunate to have such an outstanding hospital,” Craig says. Their business—Craig LehmanShelter Insurance in Bolivar—has been the presenting sponsor for the annual Heroes for Hospice 5K/10K Run since 2021. They’ve also supported the Carrie J. Babb Cancer Center at CMH, Medical Excellence Scholarships, the Sporting Clay Shoot and the inaugural Soirée. Giving for future generations “Technology changes so rapidly, particularly in the medical field, that it’s important that we have the current technology, but even more so for our kids and their kids and so that the hospital is prepared,” Craig says. Whether you want to make a financial donation or volunteer with the CMH Auxiliary, you can contribute to your community’s future through CMH. To learn more about the Lehmans and their heart for giving, watch the video at cmhbolivar.info/ Lehmans.

14 VITALITY Winter 2024 If you’ve had chickenpox, even as a kid, you’re at risk for shingles. Shingles is caused by the varicella-zoster virus, which also causes chickenpox. You can recover from chickenpox and forget all about it for decades—until the virus reactivates in your body and gives you a case of shingles. See a doctor If you experience any of the symptoms of shingles, see your health care provider right away. They’ll ask you about your symptoms and if you’ve ever had chickenpox. A physical exam is usually all that’s needed to diagnose shingles. Treatment can help Antiviral medicines can shorten the illness and make it less severe. These medicines work best if shingles is caught early and you start taking medication within three days of developing the rash. “Early treatment with antivirals (ideally within three days), pain management and adjunctive therapy with glucocorticoid can help reduce your risk of longterm symptoms,” says Kendika Abrams, M.D., a gerontologist with Bolivar Family Care Center. “Better yet, you can avoid the pain and long-term issues caused by shingles with the vaccination. It’s 90% effective at preventing shingles in people 50 and older with a healthy immune system.” A vaccine can protect you The Centers for Disease Control and Prevention recommends the shingles vaccine for all adults 50 and older. It’s also recommended for people over the age of 19 with weakened immune systems. If you have questions about shingles or the shingles vaccine, make an appointment with one of our providers by visiting citizensmemorial.com or calling 417-328-6010. Sources: American Academy of Family Physicians; Centers for Disease Control and Prevention; National Institute on Aging Should you get a shingles vaccination? SYMPTOMS OF SHINGLES Shingles’ trademark symptom is a painful rash or blisters that are on one side of the body only. It usually shows up around your midsection or on your face. The blisters typically scab over in about a week to 10 days. Sometimes people experience pain, itching or tingling before the rash even appears. In addition to the rash, other symptoms to watch for include: ● Chills. ● Fever. ● Headache. ● Upset stomach. ● Eye infection. Shingles can lead to long-term nerve pain in 10% to 18% of people who get it. Other complications are rare but include lung infections, hearing problems, brain inflammation, vision loss and even death.

citizensmemorial.com 15 Makes 4 servings. Ingredients For waffles: 1 cup whole-wheat flour ½ cup quick-cooking oats 2 teaspoons baking powder 1 teaspoon sugar ¼ cup unsalted pecans, chopped 2 large eggs, separated* 1½ cups fat-free (skim) milk 1 tablespoon vegetable oil For fruit topping: 2 cups fresh strawberries, rinsed, stems removed and cut in half (or substitute frozen strawberries, thawed) 1 cup fresh blackberries, rinsed (or substitute frozen blackberries, thawed) 1 cup fresh blueberries, rinsed (or substitute frozen blueberries, thawed) 1 teaspoon powdered sugar Directions ● Preheat waffle iron. ● Combine flour, oats, baking powder, sugar and pecans in a large bowl. ● Combine egg yolks, milk and vegetable oil in a separate bowl, and mix well. Oatmeal pecan waffles (or pancakes) ● Add liquid mixture to the dry ingredients, and stir together. Do not overmix; mixture should be a bit lumpy. ● Whip egg whites to medium peaks. Gently fold egg whites into batter.* ● Pour batter into preheated waffle iron, and cook until the waffle iron light signals it’s done or steam stops coming out of the iron. (A waffle is perfect when it is crisp and well-browned on the outside with a moist, light, airy and fluffy inside.) ● Divide fresh fruit into equal portions. Add the fruit and a light dusting of powdered sugar to each waffle and serve. *For pancakes, do not separate eggs. Mix whole eggs with milk and oil, and make pancakes as usual. Nutrition information Serving size: 3 small (2‑inch) or 1 large (6-inch) waffle. Amount per serving: 340 calories, 11g total fat (2g saturated fat), 50g carbohydrates, 14g protein, 9g total fiber, 331mg sodium. Source: National Heart, Lung, and Blood Institute

TERESA HAGEDORN, DNP, FNP-BC, is a family nurse practitioner at the CMH Walk-In Clinic. She holds a Doctor of Nursing Practice from Pittsburg State University, Pittsburg, Kansas. She is certified by the American Nurses Credentialing Center. For more information, call 417-777-4800. HIBA IBAD, M.D., is an orthopedic hand surgeon at CMH Orthopedic & Spine Center. She attended medical school at the Baylor College of Medicine, Houston. She completed an orthopedic surgery residency at the University of Missouri–Kansas City and a hand surgery fellowship at the University of Connecticut. Dr. Ibad is board eligible in orthopedic surgery and hand surgery by the American Board of Orthopaedic Surgery. To schedule an appointment, call 417-777-2663. AJDIN KOBIC, M.D., FAAD, FACMS, is a dermatologist at CMH Dermatology Clinic. Dr. Kobic attended medical school at the Mayo Clinic Alix School of Medicine in Rochester, Minnesota. He completed his dermatology residency at the Mayo Clinic School of Graduate Medical Education in Rochester and his fellowship in Mohs micrographic surgery and dermatologic oncology at Emory University School of Medicine in Atlanta. He specializes in Mohs surgery for treating skin cancers and performs dermatologic procedures. Dr. Kobic is certified by the American Board of Dermatology and has subspecialty certification in micrographic dermatologic surgery. To schedule an appointment, call 417-328-4500. new providers MARK STEWART, D.O., is a psychiatrist and the medical director of Parkview Geriatric Wellness. He attended medical school at the Kansas City University of Medicine and Biosciences College of Osteopathic Medicine and completed a psychiatry residency at the University of Kansas School of Medicine in Wichita, Kansas. He is certified in psychiatry by the American Board of Psychiatry and Neurology. For more information, call 417-328-6305. Trade regular soda for water flavored with citrus, cucumber or melon slices. Sweeten cereal or oatmeal with fruit, such as strawberries or blueberries. Swap sugar for unsweetened applesauce when you bake. Flavor coffee or tea with cinnamon, mint, nutmeg or other spices. 1 2 3 4 Sweet ways to eat less sugar Source: American Heart Association

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