VITALITY FALL 2023 PREDIABETES AND DIABETES TIPS TO PREVENT AND MANAGE THE DISEASE BACK-TOSCHOOL PREP Everything you need to know
2 VITALITY Fall 2023 Transitioning back to school Summer is a busy time for most families. Vacations, sports, camps and other fun activities fill the long summer days. With school starting back up, many of us are settling back into a routine centered around school days. To help you transition back to school, read the back-to-school prep list on page 7. You can also read on pages 8 and 9 about how we address children’s mental health needs in local schools and our clinics. On the other end of the health care spectrum, employees of our long-term care facilities provide safe, quality care for older generations. The American Health Care Association recognizes this commitment to quality. Butterfield Residential Care Center and Citizens Memorial Healthcare Facility received Silver Quality awards this year. Our other five long-term care facilities are Bronze Quality award recipients. Read more about the quality recognition program on page 4. You also will enjoy reading about Bolivar resident Judy Hougham’s newfound independence after a total knee replacement surgery performed by one of our board certified orthopedic surgeons, Jonathan Gray, D.O., in practice at CMH Orthopedic & Spine Center. Other topics in this issue include diabetes, on pages 12 and 13, and nutrition, on page 15. Fall brings cooler weather and the anticipation of new projects. For the CMH family, 2023 has been a busy year of planning for the new hospital expansion project. Progress will be more evident by the end of the year. Watch our social media, website, emails and local media for project updates. Sincerely, Michael Calhoun, CEO/Executive Director Citizens Memorial Hospital/Citizens Memorial Health Care Foundation We’d love to hear from you on social media 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 Amy Gimpel 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. 2023 © Coffey Communications, Inc. All rights reserved. 4 Raking in national quality awards If you need senior care, see why you can trust our facilities. 6 Virtual learning We’re bringing virtual reality to the classroom! See how it’ll help our nursing students. 10 Feeling better with knee replacement Learn how Judy Hougham got her life and mobility back after surgery. 15 Whole-grain heroes Do you know what whole grains are? How about why you need them? Find out! Michael Calhoun, CEO/Executive Director WELCOME facebook.com/citizensmemorial twitter.com/cmhbolivar instagram.com/cmhbolivar linkedin.com/company/ citizens-memorial-healthcare
citizensmemorial.com 3 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. CMH NEWS SBJ honors CMH with Dynamic Dozen award Citizens Memorial Hospital was named to Springfield Business Journal’s 2023 Dynamic Dozen, honoring the 12 fastest-growing companies in southwest Missouri. CMH was ranked 12th in this year’s awards program and has appeared on the Dynamic Dozen honoree list 11 times since SBJ established the awards program in 2004. SBJ announced rankings for the Dynamic Dozen companies at a May 18 reception and awards ceremony at the Oasis Hotel and Convention Center in Springfield. SHIP VOLUNTEERS HELP MEDICARE RECIPIENTS Medicare’s open enrollment period is Oct. 15 to Dec. 7, 2023. During this time, Medicare beneficiaries can change health and drug plans. Information for next year’s plans will be available beginning in October. Whether you are new to Medicare or considering changing your Medicare plan, Missouri SHIP volunteers can help you know your options. Volunteers provide free, unbiased and confidential services for Missouri Medicare recipients. Volunteer counselors will: » Check your coverage. » Compare plans. » Lower your costs. Missouri SHIP, formerly known as Missouri CLAIM, is Missouri’s official State Health Insurance Assistance entity. Visit missouriship.org or call 800-390-3330 for more information. CMH welcomes new board member, announces appointment Citizens Memorial Hospital and Citizens Memorial Health Care Foundation announced changes to their boards of directors earlier this year. The hospital board appointed Janieca Hancock to a position vacated by Joan Woods, effective March 28. Her appointment is effective through the next general election in April 2024, when she will be elected to serve the remainder of Woods’ term through April 2028. Hancock is president of the CMH Foundation board of directors and has served on the CMH Foundation board for five years. She is the Bolivar community president at Mid-Missouri Bank. Other hospital board members are Patrick Douglas, Chairman; Dave Berry, Vice Chairman; Robin Sechler, Secretary; Corey Rich, Treasurer; and John Kallenbach. CMH Foundation added K. Ron Smith, M.D., to its board of directors, effective Feb. 23. He replaced William Donnell, M.D. Dr. Smith has been on the CMH medical staff for 32 years and is a board certified orthopedic surgeon with CMH Orthopedic & Spine Center in Bolivar. Other CMH Foundation board members are Hancock, President; Kallenbach, Vice President; James Ashworth; Donald J. Babb; Trina Banner; Gary Fulbright; D. Michaele Meents, M.D.; and Michael Calhoun, ex-officio member. Janieca Hancock K. Ron Smith, M.D.
4 VITALITY Fall 2023 RESIDENTIAL AND LONG-TERM CARE FACILITIES RECEIVE NATIONAL QUALITY AWARDS Four Citizens Memorial Health Care Foundation residential and long-term care facilities received national quality awards. The American Health Care Association and National Center for Assisted Living (AHCA/ NCAL) gives the awards to facilities that meet standards for quality and service. Butterfield Residential Care Center and Citizens Memorial Healthcare Facility earned the Silver Quality award in 2023. Only six other facilities in the state have the Silver rating. Community Springs Healthcare Facility, in El Dorado Springs, and Lake Stockton Healthcare Facility, in Stockton, received the Bronze award. All long-term care and residential care facilities owned and operated by the Citizens Memorial Health Care Foundation have achieved the Bronze Quality award. They are among just 44 facilities in Missouri to receive the Bronze award. The award program has three progressive levels: Bronze, Silver and Gold. At the Silver level, recipients first met the criteria for the Bronze award. The next level is to evaluate and improve their processes. Facilities create a systematic approach that leads to positive outcomes and success. Trained examiners review each application to determine if the center has met the criteria. The program’s goal is to further improve the lives of residents and staff in long-term care. AHCA/NCAL recognizes entities that meet progressively rigorous performance standards. The facilities will receive the awards on Oct. 3 at the AHCA/NCAL national convention in Denver. WE CARE. Visit citizensmemorial.com or call 417-328-6731 for more information about senior living options at CMH. CMH NEWS STAY UP-TO-DATE WITH THE CMH BLOG The Citizens Memorial blog features a monthly CEO update with a video. CEO/Executive Director Michael Calhoun and other CMH leaders share the latest news about CMH. Recent CEO update posts include: » A best-in-class experience in the Emergency Department. » Growing behavioral health services. » Selecting a construction manager for the expansion project. » Serving others is the heartbeat of our mission. CHECK IT OUT! V isit citizensmemorial.com/blog. Help us welcome Colonial Springs’ new leadership team Colonial Springs Healthcare Center, a Citizens Memorial Health Care Foundation long-term care facility in Buffalo, has a new leadership team. Cindy Cain is the administrator, Justin Slack is the director of nursing and Zachary Spaulding is the assistant director of nursing. Cain has worked at CMH for 11 years. She previously worked in social services at the hospital, Citizens Memorial Healthcare Facility, Colonial Springs and Parkview Health Care Center. Before entering social work in 2005, she worked as a dietary aide and certified medication aide in long-term care facilities in the Carthage area. She has a Bachelor of Science in sociology from Missouri Southern State University in Joplin. Slack has an associate degree in nursing from Bolivar Technical College (BTC). His work experience includes eight years in direct patient care and nursing administration roles in hospice and long-term care settings. Spaulding has an associate degree in nursing from BTC. He has 10 years of nursing experience in long-term care and operating room settings. For more information about Colonial Springs, call 417-345-2228. Cindy Cain Justin Slack Zachary Spaulding
citizensmemorial.com 5 CMH NEWS ALZHEIMER’S DRUG CLINICAL TRIAL UPDATE Patients at the Missouri Memory Center at Citizens Memorial Hospital participated in an international clinical trial with positive results in Alzheimer’s disease (AD) treatment. Pharmaceutical company Eli Lilly and Company (Lilly) is proceeding with global regulatory submissions and has submitted for approval to the U.S. Food and Drug Administration based on the results of this study. In the phase 3 study, donanemab significantly slowed cognitive and functional decline by 35% in patients with early symptomatic AD dementia or mild cognitive impairment due to AD. Results reported by Lilly include: » 47% of participants on donanemab showed no decline based on a key measure of disease severity at one year, compared to 29% of participants on placebo. » Participants on donanemab had 40% less decline in their ability to perform activities of daily living at 18 months. » Participants on donanemab experienced a 39% lower risk of disease progression than participants taking the placebo. Curtis P. Schreiber, M.D., Medical Director of the Missouri Memory Center and CMH Research Department, was the principal investigator on the study in Bolivar, which started in 2021. READ MORE ABOUT THE TRIAL RESULTS at https://bit.ly/44I92qY. CMH is expanding clinical research studies Citizens Memorial Hospital recently created the CMH Research Department to expand clinical research studies at CMH. CMH Neurology and Headache Center and Missouri Memory Center have conducted clinical research studies on Alzheimer’s disease and migraine headaches since 2016 under the direction of Curtis P. Schreiber, M.D. He is a board certified neurologist and headache medicine specialist with more than 20 years of experience in 221 research studies. “We are participating in national clinical trials that are advancing science and leading to new therapies for patients,” says Dr. Schreiber. “By creating the CMH Research Department, we are building on our successes of the past seven years, allowing us to elevate our research efforts even further by soon expanding into additional therapeutic areas.” Clinical research trials provide patients with opportunities to participate in the process of advancing options for medical treatments. Currently, the CMH Research Department is conducting seven Alzheimer’s studies and one migraine study. The department will be starting three additional studies, including two for Alzheimer’s and one for migraine. Plans are to begin offering clinical trials beyond Alzheimer’s and migraine research. Curtis P. Schreiber, M.D., was a featured expert on an international webinar about phase 3 trial results of donanemab. 350 people in 40 countries around the world participated in the webinar. INTERESTED? For more information about the CMH Research Department or current studies, contact Kasie Atchison, Clinical Research Manager, at 417-328-7781 or cmhresearch@citizensmemorial.com. Patients who choose to participate in a clinical trial: » Can be part of the process to advance options for treatment. » Have access to investigational study drugs. » May receive a new treatment for a disease before it is available to the public. » Receive in-depth clinical monitoring throughout the study. » Have access to cuttingedge diagnostic tools.
6 VITALITY Fall 2023 CMH NEWS CMH and BTC take new approach to clinical rotations A new program by Citizens Memorial Hospital and Bolivar Technical College gives nursing students a different approach to clinical rotations. Nine CMH nurses completed a six-week training program this summer to be academic clinical preceptors for BTC nursing students. The preceptor model pairs a CMH nurse with one or two nursing students for academic training. “The preceptor model allows more personalized instruction than large clinical groups,” says Erin Mock, Director of Nursing Education at BTC. “Preceptors adapt instruction based on the student’s academic level of training in a fully immersed environment.” “This is a new and innovative approach to addressing the nursing shortages colleges are seeing as it relates to having enough clinical instructors,” says Sarah Hanak, Chief Nursing Officer at CMH. “At the same time, it gives bedside nurses a new opportunity to earn extra pay by teaching nursing students.” Grant funding from the Missouri State Board of Nursing funded the preceptor training program. “The CMH nurses that participated in the training were phenomenal,” Mock says. “They really brought CMH values into the class, making it a super successful pilot program thus far.” VR ENTERS THE NURSING CLASSROOM With a virtual reality (VR) headset strapped to their heads, nursing students at Bolivar Technical College (BTC) practice real-life medical scenarios. A student’s actions may appear strange without context. But watching the scenario through the connected computer screen reveals how each movement is a step in practicing real-world nursing skills. A student may stand at a patient’s bedside and use a stethoscope to listen to the patient’s chest. Then they might retrieve insulin from the medicine cabinet, measure it and administer it. They can place oxygen on the patient and talk to them and a family member. That is just one of many possible scenarios. The immersive experience allows students to practice critical thinking and decision-making skills. The VR training system covers many scenarios, including patient assessments, wound care, medication administration and infection control. “VR brings new experiences and opportunities to our students at the touch of a button,” says Lucinda Schmidt, BTC Simulation and Skills Center Coordinator. “I can select a scenario for students to immerse themselves in that will help to bring their classroom lectures to life. I also can provide a simulation for those having trouble with a skill or topic to make those connections and feel empowered when caring for real patients.” FOR MORE INFORMATION about nursing degrees at BTC, call 417-777-5062, send an email to info@ bolivarcollege.edu or send a text message to 417-771-3543. An Elsevier representative trains Courtney Sulltrop on how to use the virtual reality equipment in a simulation. Sulltrop is an instructor and practical nursing program coordinator at Bolivar Technical College.
citizensmemorial.com 7 WELLNESS Get your kids ready for the first day Are your kids prepared for the new school year? Are you? Here’s a handy checklist of preparations to tackle before school starts. HEALTH PREP Get vaccinations up-to-date. Immunizations can protect your child against serious childhood diseases. Check with the school to find out what vaccinations it requires. Arrange for a sports physical if your child plays sports. Most sports require it, and it’ll give you peace of mind knowing that they’re physically able to play. TO-AND-FROMSCHOOL PREP Review your child’s route to school in advance. Drive the route so your child knows what to expect. Or bicycle or walk the route with them. Set up carpooling shifts. If you prefer to drive your child, find other parents who are safety minded. Talk to your child about bus stop, bicycling and walking safety. Make sure they know about crosswalk, biking and walking protocols. AT-HOME PREP Transition to and earlier sleep/wake schedule. A good night’s sleep will help your child concentrate, retain information and prevent mood swings. You can start with short changes, like 15 minutes earlier, until their schedule is back on track. Create a study area. Prepare a well-lit place where your child can do their homework. Make sure it’s a quiet space without electronic distractions. Choose a suitable backpack. For safety’s sake, a filled backpack should weigh no more than 10% to 20% of your child’s body weight. Adjust the backpack so the bottom meets your child’s waist. You can also consider a rolling backpack. Talk to your kids about bullying. Bullying is linked to a range of educational and emotional problems. Make sure your child knows: » To seek a trusted adult for help if they are bullied. » How to respond nonviolently to bullying. » That you’re monitoring their texts and social media accounts for bullying behavior. » That it’s never OK to bully someone, even if encouraged by others. Sources: American Academy of Pediatrics; Centers for Disease Control and Prevention; Sleep Foundation BEFORE-ANDAFTER-SCHOOL CARE PREP Arrange for caretaking. If you need help before or after school, look into responsible school programs, off-site institutions, or caretakers at your home or theirs. Your back-to-school prep list
8 VITALITY Fall 2023 One in five children and adolescents experiences a mental health problem during their school years, according to the U.S. Department of Health and Human Services. Poor mental health can cause students to struggle with school, grades, decision-making and health. This is why Citizens Memorial works with local school districts to increase student access to behavioral health care. Licensed clinical social workers and licensed professional counselors provide services at partner schools. “Students receive counseling during regular school hours,” says Rachael Swopes, PhD, a licensed psychologist and clinical director of Behavioral Health Services at Citizens Memorial Hospital. “This makes it easier for students to receive help, because parents don’t have to provide transportation or leave work for appointments.” HOW WE HELP CMH providers can help students with depression, anxiety, recent loss and grief, and these behavioral issues: » Aggression. » Defiance. » Hyperactivity. » Suicidal ideations/cutting. » Anger outbursts. » Substance use. » Bullying. Teachers, school counselors, primary care physicians and parents may refer students to a CMH counselor. Their first visit will be at a CMH clinic. MAKING AN IMPACT CMH behavioral health providers conduct 760 schoolbased counseling sessions per month. “These numbers show how common it is for students to need help,” Dr. Swopes says. “Students and parents should know it is OK to ask for help.” Services are strictly confidential and adhere to state licensing and HIPAA regulations. CMH accepts most major insurance plans, and financial assistance is available. CMH currently provides school-based counseling in the Bolivar, Dallas County, El Dorado, Osceola and Stockton school districts. FOR MORE INFORMATION » Parents: If you want to find out more about enrolling your child in school-based counseling, contact your local CMH primary care clinic. » Schools or agencies wanting to find out more about offering school-based counseling in their district should contact Angela Long, Director of Behavioral Health Operations, at 417-328-6708. CHILDREN’S HEALTH CMH provides in-school counseling at partner locations MENTAL HEALTH
citizensmemorial.com 9 KNOW THE SIGNS To learn more about mental health in children and what to look out for in your kids’ behavior, visit cdc.gov/ childrensmentalhealth. These seven strategies may help manage attentiondeficit/hyperactivity disorder (ADHD) symptoms. 1 ) Serve up healthy foods. Meals and snacks with plenty of fruits, vegetables, whole grains and lean protein, such as fish and chicken, can help reduce ADHD symptoms. 2 ) Stick to a schedule. Try to follow the same daily routine, including times for waking up, going to bed, doing homework and playing. Post the schedule on the refrigerator or a bulletin board so your child can see it and know what to expect. 3 ) Make sure your child gets plenty of sleep. School-age kids need 9 to 12 hours each night. 4 ) Encourage your child to burn off steam. Physical activity can make it easier for your child to deal with ADHD symptoms. 5 ) Get organized. To minimize frustration, have a place to put household items, such as bins. Remind your child to write down assignments and bring home books and other necessary items. 6 ) Help your child manage complex tasks. Teach your child how to break down complicated assignments into simpler steps. 7 ) Set clear and consistent rules. Children with ADHD especially benefit from consistent rules they can understand, such as “dirty clothes go in the hamper.” Praise or reward your child for following simple household rules and doing a good job. Positive feedback helps children, in general, feel successful. Sources: Centers for Disease Control and Prevention; National Institute of Mental Health 7 ways to help your child with ADHD Need help managing your child’s ADHD behavior? Management of ADHD behaviors in children can be overwhelming for caregivers. Behavioral treatment, such as evidence-based parent behavior-training programs, can help. In parent-training programs, you can learn effective strategies to help your children become more successful at home and school. This treatment helps you develop consistent strategies to help your children in areas such as following instructions, completing tasks and maintaining focus during daily home activities. Rachael Swopes, PhD, offers appointments for parent training at the CMH Pediatric Clinic. Different formats are available for children of a variety of ages, from 2 to 18. For more information or to schedule an appointment, call 417-777-2121. CHILDREN’S HEALTH
ORTHOPEDICS 10 VITALITY Fall 2023 New knee brings increased independence and mobility Knee pain can be a minor annoyance or a constant, painful presence. For Judy Hougham, of Bolivar, what started as a slight pain in her knee became more unpleasant during the past five years. “It would pop and grind and swell to where it was hard to walk,” she says. “I couldn’t squat down on my knees unless there was somebody to help me up. I had to be careful going up the stairs one at a time.” Her knee pain interfered with her ability to tend her garden, mow her yard, take a walk and be independent. Hougham finally decided it was time to see Jonathan Gray, D.O., an orthopedic surgeon at the CMH Orthopedic & Spine Center. “Dr. Gray is great. I thought maybe a simple surgery, but he said total knee replacement. I asked him if I would be able to leap tall buildings in a single bound,” says the 81-year-old. “He just grinned.” NO AND A LOT OF GAIN Jonathan Gray, D.O.
ORTHOPEDICS Get moving For more information about treatment options for knee pain, call the CMH Orthopedic & Spine Center at 417-777-2663. The center’s walk-in clinic is open from 8 a.m. to 4:30 p.m., Monday through Friday. citizensmemorial.com 11 Dr. Gray says it is important to try conservative treatment options first. “But when it gets to the point where their pain is significant and affecting their daily activities, it usually is time to discuss a total knee replacement surgery,” he says. MAKO ROBOTIC SURGERY Knee replacement surgery requires a precise implant that matches the patient’s anatomy. Mako SmartRobotics™ uses a 3D CT scan of the knee to create a 3D model the surgeon uses while planning and performing the operation. During the surgery, Dr. Gray guides Mako’s robotic arm to position the implant perfectly in the knee joint. “We can tension the ligaments and fine-tune the implant to get it in the perfect position,” Dr. Gray says. With a recovery time of four to six weeks, including physical therapy, Dr. Gray says the PAIN surgery eliminates knee pain and restores the full range of motion. RECOVERY Hougham was up and walking the day of her surgery and was released from the hospital the next day. She worked hard during physical therapy sessions and faithfully completed home exercises to help with a full recovery. “I’ve had soreness but no pain,” she says. “Even when they got me up the first time and put weight on it, I had no pain. I’ve had great care and look forward to physical therapy. They’re so pleasant and so much fun.” Hougham’s exercises are just what the doctor ordered. “I know it hurts, and I understand that it hurts, but the more you can stay active and keep those joints moving, the better you will feel,” Dr. Gray reassures her.
ENDOCRINOLOGY We’ve all heard of type 2 diabetes. It’s when blood sugar levels rise because our body can’t properly process sugars in the food we eat. Before type 2 diabetes, there’s usually prediabetes. Your body’s cells become less sensitive to insulin, the blood-sugar processing hormone made by your pancreas. Did you know: 1 ) About 1 in 3 U.S. adults has prediabetes. That’s more than 84 million people ages 18 and older. 2 ) Prediabetes usually has no symptoms. You’ll need a blood test to know for sure. 3 ) Being diagnosed with prediabetes doesn’t mean that you’ll definitely develop type 2 diabetes, particularly if you change your lifestyle. A diabetes diagnosis o ften leads to lifestyle changes, including paying closer attention to what you eat. Tracking the carbohydrates (carbs) in foods can help you manage blood sugar levels to help you stay healthy. Carb counting 101 You can count the grams of carbohydrates in your foods and drinks to improve blood sugar control when taking oral medications. Paying special attention to foods containing carbs is an important tool. Carb-containing foods include: » Grains, such as bread, pasta and cereals. » Fruits. » Starchy vegetables, such as potatoes, corn, beans and peas. » Dairy products, such as milk and yogurt. » Sweets, such as cookies and cake. » Beans. The total amount of carbs you can consume to stay within your target blood sugar range depends on your age, weight and exercise level. How to count carbs One way to count carbs is the Diabetes Plate Method. Using a dinner plate, put non-starchy vegetables, such as broccoli, greens, tomatoes and carrots, on half the plate; meat or another protein on one-fourth of the plate; and a grain or starch, such as corn and peas, on the last fourth. Team up with experts Don’t be afraid to ask your doctor for help, which may Carb counting for diabetes 7about prediabetes FACTS 12 VITALITY Fall 2023 7 ) Exercise makes your cells more sensitive to insulin. That lowers blood sugar levels and helps to reverse prediabetes. Aim for 150 minutes of moderate exercise each week. 4 ) Prediabetes can be reversed by eating healthy foods, getting moderate exercise regularly and taking your medication properly. 5 ) A healthy meal plan for people with prediabetes and diabetes includes plenty of non-starchy vegetables, limited added sugars, whole-grain foods instead of refined grains and whole foods instead of highly processed foods. 6 ) Sugary drinks have been linked to type 2 diabetes. A 12-ounce can of regular soda has the equivalent of 10 teaspoons of sugar. Cut back on these beverages to lower your blood sugar levels.
citizensmemorial.com 13 ENDOCRINOLOGY include a referral to a certified diabetes education and care specialist. CMH Diabetes Education provides oneon-one diabetes-related consultations with a physician referral, as well as group sessions. “You can read a lot of information about different ways to manage your diet with prediabetes or diabetes, but every person is different,” says Rhonda Orrell, certified diabetes education and care specialist with CMH Diabetes Education. “With our professional services in diabetes education, we can help you figure out what works best for you.” Meet the team: CMH Endocrinology Center Our medical team at the CMH Endocrinology Center is growing, with the recent additions of Brian Robinson, D.O., and Julia Magdici, FNP-C, to the medical staff. Dr. Robinson is certified in endocrinology, diabetes and metabolism by the American Board of Internal Medicine and is fellowship-trained in endocrinology. He has more than 20 years of physician experience in the U.S. and Africa. Magdici is a family nurse practitioner with four years of experience in endocrinology. She is board certified by the American Association of Nurse Practitioners. They join endocrinologist Heather Corn, M.D., and physician assistant Hannah Ashlock, PA-C, to provide professional, compassionate treatment for endocrine disorders, including: » Advanced diabetes care. » Reproductive hormone imbalances. » Adrenal disorders. » Obesity. » Pituitary disorders. » Thyroid disorders. » Parathyroid disorders. » Osteoporosis. » Disorders of the endocrine system. Call 417-328-7000 today for more information and to schedule an appointment. Heather Corn, M.D. Hannah Ashlock, PA-C Brian Robinson, D.O. Julia Magdici, FNP-C Sources: American Diabetes Association; Centers for Disease Control and Prevention; National Institute of Diabetes and Digestive and Kidney Diseases WANT TO KNOW MORE? The CMH Diabetes Education Center’s treatment curriculum is recognized by the Association of Diabetes Care & Education Specialists. Jessica Jennings, a registration-eligible dietitian, recently joined CMH Diabetes Education and is providing consultations. Call 417-328-7957 for more information. Concerned about prediabetes or diabetes? Contact your health care provider. That way, you can make changes today to prevent or reverse this disease. “A prediabetes diagnosis can be difficult to hear, but you can keep it from progressing to type 2 diabetes. The diagnosis puts you in control of making lifestyle and dietary changes that could reverse your path toward diabetes. Medication can also help control prediabetes.” —Heather Corn, M.D.
14 VITALITY Fall 2023 UROLOGY Do you have pain or burning when you urinate? If so, you may have a urinary tract infection (UTI). Bladder infections are the most common type of UTI. They happen when bacteria from the skin or rectum gets into the urinary tract. Along with discomfort, cramps and frequent urination, you may have pink urine, caused by blood from the infection. Anyone can get a UTI, but they are more common in women. Prompt treatment is important. If the infection spreads, it can cause a kidney infection, which is much more serious. Fever, back pain, nausea or vomiting are common symptoms of a kidney infection. WHAT YOU CAN DO Here are ways to reduce your chances of getting a UTI: » Urinate after sexual activity. » Drink plenty of fluids daily. » Take showers more frequently than baths. » Avoid or minimize the use of powders or other products on the genital area. “I cannot stress enough the importance of drinking plenty of water and other non-sugary fluids throughout the day to maintain a healthy urinary tract,” says Mark Walterskirchen, M.D., with the CMH Urology Surgical Clinic. “When you become dehydrated, your body produces less urine, and you use the bathroom less frequently. This gives more time for bacteria to grow in your urinary tract and cause a painful situation that could lead to further complications. There also may be some benefit to cranberry tablets and prebiotic D-mannose in preventing urinary tract infections.” How to prevent and treat UTIs Mark Walterskirchen, M.D. Expert urology care Mark Walterskirchen, M.D., a urologist with the CMH Urology Surgical Clinic, is one of the few surgical urologists in the region who offers specialized urology procedures, such as: » InterStim™ and Botox® bladder therapy for female incontinence and voiding issues. » Xiaflex® injections for Peyronie’s disease and prostate cryoablation for prostate cancer. » UroLift® for benign prostatic hyperplasia (BPH). » Complex robotic procedures for kidney, prostate and bladder diseases. For more information about urology care at CMH or to schedule an appointment, call 417-326-2550. TREATMENT Talk to your health care provider as soon as you suspect you have a UTI. You may receive a prescription for antibiotics. Be sure to take all the prescribed doses, even if you feel better. Also drink plenty of water and other fluids. Your doctor can recommend medicine for reducing pain and discomfort. If you think you have a UTI, contact your primary care provider. If you don’t have a provider, you can find one by calling 417-328-6010 or visiting citizensmemorial.com. Sources: American College of Obstetricians and Gynecologists; Centers for Disease Control and Prevention; National Institute of Diabetes and Digestive and Kidney Diseases
citizensmemorial.com 15 You may have heard that you should eat more whole grains. But knowing exactly what a whole grain is can be confusing. Here’s a look at what they are and how to find them. WHAT IS A WHOLE GRAIN? Whole grains are made up of the entire grain kernel—bran, germ and endosperm. Refined grains, like enriched breads and white rice, contain only the endosperm. You know a food is a whole grain when you see the words whole grain in the ingredient list. Note that terms like multigrain, stone-ground, 100% wheat and cracked wheat do not necessarily mean that the food is whole grain. Also, just because a food is brown doesn’t mean it is whole grain. The color may come from molasses or another added ingredient. WHY IS A WHOLE GRAIN GOOD FOR YOU? Eating the bran and germ helps keep your body healthy. Whole grains can help cut your chances of getting heart disease, diabetes and some types of cancers. Whole grains also can help with digestion and weight management. Because they are good sources of fiber, they help you feel fuller with fewer calories. HOW TO GET MORE WHOLE GRAINS IN YOUR DIET Most Americans eat enough grains, but not many get enough whole grains. The amount you need depends on many factors. Check out the recommendations for you at myplate.gov/myplate-plan. Aim to make at least half of the grains you eat whole grains. Below is a list of common whole grains. Have you tried them all? » Barley. » Brown and wild rice. » Bulgur (cracked wheat). » Corn and popcorn. » Crackers. » Oats. » Quinoa. » Whole-grain pasta, bread or cereal. Sources: Academy of Nutrition and Dietetics; American Heart Association; U.S. Department of Agriculture NUTRITION One-on-one nutrition consults available CMH Nutritional Services offers outpatient consultations with a registered dietitian. Sam Lazar, RD, LDN, can help with various dietary needs through one-on-one consultations. During the 30-minute session, she will assess your nutritional needs, discuss your long-term goals and create an individualized plan. Nutrition focuses for the appointments can include: » Medical nutrition therapy, such as managing cardiovascular disease, high cholesterol, GI conditions and renal disease. » Weight management, including weight loss or gain and maintenance. » Nutrition for wellness and performance. » Pregnancy and postpartum nutrition. » Improvement of lab values. Appointments require a physician referral. Ask your physician about a referral, or call Lazar at 417-328-6752 for more information. Whole grains How and why to add more to your diet Sam Lazar, RD, LDN
KATHERINE DAVIS, M.D., is a physician specializing in internal medicine and pediatrics at CMH Pediatric Clinic in Bolivar and Willard Medical Center and Walk-In Clinic. She attended medical school at the University of Alabama Birmingham School of Medicine and completed an internal medicine and pediatrics residency at Ochsner LSU Health in Shreveport, Louisiana. She is board-eligible in internal medicine and pediatrics with the American Board of Internal Medicine and the American Board of Pediatrics. To schedule an appointment, call 417-777-2121 (Bolivar) or 417-761-6655 (Willard). COURTNEY DESOUZA, M.D., is a family medicine physician at Butterfield Park Medical Center. She attended medical school at St. George’s, University of London, and completed a residency at Swedish Hospital, a part of NorthShore University HealthSystem, in Chicago. She is certified in family medicine by the American Board of Family Medicine. To schedule an appointment, call 417-326-7676. JULIE HENSON, D.O., is a family medicine physician at Bolivar Family Care Center. She attended medical school at A.T. Still University in Kirksville and completed her residency at Madigan Army Medical Center in Tacoma, Washington. She is certified in family medicine by the American Academy of Family Medicine. To schedule an appointment, call 417-326-6021. BRIAN ROBINSON, D.O., is an endocrinologist at the CMH Endocrinology Center. He attended medical school at the Oklahoma State University College of Osteopathic Medicine in Tulsa, Oklahoma, and completed a residency in internal medicine at Penn State University College of Medicine in Hershey, Pennsylvania. He completed an endocrinology fellowship at the University of Oklahoma College of Medicine in Oklahoma City, Oklahoma. He is certified in endocrinology, diabetes and metabolism by the American Board of Internal Medicine. To schedule an appointment, call 417-328-7000. Nonprofit Org. U.S. Postage PAID Walla Walla, WA Permit No. 44 Citizens Memorial Hospital District 1500 N. Oakland Ave. Bolivar, MO 65613 Welcome, new providers! ASHLEY CARPENTER, NP-C, now sees patients at CMH Pediatric Clinic in addition to the CMH Institute of Pain Management. She is certified by the American Academy of Nurse Practitioners. To schedule an appointment, call the Pediatric Clinic at 417-777-2121 or the Institute of Pain Management at 417-326-7246. ROBERT MCGOWIN, PA-C, now sees patients at Stockton Family Medical Center. He previously worked at the El Dorado Springs Medical Center and Walk-In Clinic. He is certified by the American Academy of Physician Assistants. To schedule an appointment, call 417-276-5131. CORRECTION Amber Herring, PA-C, is certified by the National Commission on Certification of Physician Assistants. We apologize for the incorrect information in the Summer 2023 issue of Vitality. PROVIDER ON THE MOVE
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