Thrive Fall-Winter 2021

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Thr ve Fall/Winter 2021

Health and Wellness Magazine for Rural Central Texans

Mmm Good! Ask the Doc:

Preventing Pneumonia

Pain management Relax & Unwind Yoga for stress relief


HAMILTON HEALTHCARE SYSTEM

Committed to Quality S I LV E

R

Randy Lee, MD Chief of Staff

Robbye Lengefeld, MD Hamilton Clinic

Luke Killian, MD Hamilton General Hospital ER

Tim Rudolph, MD Hamilton General Hospital ER

Brad Bartels, MD Hamilton General Hospital ER

Charles Johnson, MD Hamilton Clinic Hico Clinic

Thomas Aycock, MD Wound Care

Ryan Adams, MD General Surgery Specialty Services

Keith Ellison, MD Orthopedics Specialty Services

Kristen Stegemoller, MD FPC Mills County

Mistee Jefferies, APRN, PMHNP-BC Behavioral Health

Jennifer Armstrong, FNP-BC Wound Care

Shelly Lengefeld, PA-C Hamilton Clinic

Arlene Brown, APRN, FNP-C Hamilton Clinic

John Seth, APRN, FNP-C FPC Mills County

Hamilton Clinic

Shelly Boyle, PA-C Hamilton Clinic

Grant Ward, PA-C Hamilton Clinic Hico Clinic

400 North Brown • Hamilton, TX 76531

(254) 386-1600

www.hamiltonhospital.org

Stephanie Shepherd, APRN, FNP-C Hico Clinic

Gerald Snyder, MD Hamilton Clinic

W. Shalor Craig, MD Hamilton Clinic Hico Clinic

Melanie Bartek, Jim Davis, OD, FCOVD OD, FAAO Central Texas Eye Care Central Texas Eye Care

Kayla Routh, APRN, FNP-C FPC Mills County

Trevor Watson, APRN, FNP-C FPC Mills County

Yvonne Joseph, APRN, PMHNP-BC Behavioral Health

Committed to You


HAMILTON HEALTHCARE SYSTEM

Swing Bed at Hamilton General Hospital Have you ever pictured a Swing Bed? What is Swing Bed? Swing Bed is skilled nursing and rehabilitation services provided within the hospital. Why Swing Bed? When you are in need of nursing care or rehab to recover from a surgery or hospitalization, you may benefit from staying at Hamilton General Hospital. Our Swing Bed program offers skilled nursing care and therapy services to treat a wide range of conditions.

Benefits Include:

• Low nurse to patient ratio

• Private rooms

• RN staffing

• Daily physical therapy

• Respiratory therapist available 24/7

• Occupational and speech therapy

• Emergency Department on site

• Room service and dietary menu

• Physician visits three times weekly

• Quiet hours

For more information call: 400 North Brown

(254) 386-1600 •

Hamilton, Texas 76531

www.hamiltonhospital.org



contents

Greetings Thr ve readers! he past 18 months in healthcare have presented some of the most trying times we have seen. We have seen the challenges of treating Covid-19, the challenge of acquiring vaccines in our rural area and then providing mass vaccination, the challenge of maintaining our supply chain and the challenges of getting patients to the right level of care when hospital beds and staffing are at a premium. The model for care Grady delivery has significantly changed and the landscape of Hooper, CEO healthcare will be different here going forward. Hamilton Looking back as 2021 is coming to a close, we have learned so much. This has been one of the shortest Healthcare System timeframes with the most growth and change in how we care for our patients. From additional isolation rooms, protective equipment for staff, telemedicine and curbside appointments, our physicians and staff of Hamilton Healthcare System have gone above and beyond. We are seeing our services rebound and patients returning for needed preventative care that has been pushed off for too long. There is an excitement among staff to see departments being able to return to a more normal pace. While things may never be back to the “normal” we knew in the pre-pandemic world, we have great hope in seeing this delivery of care and how we can successfully and safely treat patients for all their needs from chronic disease to acute illnesses and preventative medicine. With the holiday season upon us, I encourage you to consider your health needs. Take the time to make the appointment you have been waiting on or schedule the mammogram or lab work that is past due. Hamilton Healthcare System is here to serve you and we have a bright future ahead in providing you the very best care. We continue to look toward growth opportunities to provide more specialties and services to our community. Enjoy this holiday season and we hope this edition of Thrive provides you with a few tips on how to make it the best and healthiest year yet! Thank you to all of the Thrive readers out there that have been so supportive of the services and staff of our health system! Happy Holidays!

Fall/Winter 2021

6 NUTRITION

24 HEALTHY MIND

8 ASK THE DOC

26 FITNESS

Cranberry & Butternut Squash

Discovering Holiday Magic Relax & Unwind Yoga

Preventing Pneumonia Vaccinations

28 SAFETY

10 OUR TEAM

Head Injury

Let’s go to Vegas

32 SPOTLIGHT

12 PREVENTION

Our Holiday Traditions

Pulmonary Rehabilitation Quit Smoking

14 INNOVATION

34 LIFESTYLE

Making Resolutions Stick

37 ASK THE EXPERT

Mm Mm Good! Measuring Excellence

38 PETS

Winter Paws

18 HEALING

Health through Healing

20 PAIN MANAGEMENT

ABOUT THE COVER Becky Wells and granddaughter Sasha Pittsford whip up a little holiday magic in Becky’s SWING BED beautiful kitchen. Continuous Care Close to Home Photo by Kim Hinton

Dr. Moore is Back!

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H

H

amilton erald-News Published by 101 N. Rice Street | Hamilton, TX 76531 254-386-3145 | hhnpaper.com

Need a healthy way to bank?

Check out MCBank: stress-free and easy, with friendly, personal service.

It’s banking for the way you 1-800-285-2216 | www.mcbanktx.com An HHN publication

live.

Member FDIC

Hamilton Healthcare System | Thrive

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Health Benefits of Cranberries

One cup of raw cranberries

Vitamin C 25% Manganese 16% Vitamin A 9% Vitamin E 8% Vitamin B Complex 8% Vitamin K 6% Vitamin K 6%

Rich in antioxidants

Cranberry Orange

Pound Cake

This cake is supremely tender, thanks to the Greek yogurt, and it is full of sweet sunshiny taste and festive cranberries. Such a classic flavor combination!

INGREDIENTS:

2 ¾ cups 1 ½ tsp ¾ tsp ½ tsp 3 tbsp

white whole wheat flour baking powder baking soda salt freshly grated orange zest

1 tbsp

unsalted butter, melted and cooled slightly egg whites, room temperature vanilla extract liquid stevia plain non-fat Greek yogurt freshly-squeezed orange juice

3 large 1 tbsp 1 tbsp ¾ cup ½ cup

(about 2 extra-large oranges)

(about 1 extra-large orange)

½ cup non-fat milk 1 ½ cups fresh whole cranberries, diced

INSTRUCTIONS:

1. Preheat the oven to 350 degrees. Line a 9x5” loaf pan with foil. Lightly coat the foil with nonstick cooking spray. 2. To prepare the cake, whisk together the flour, baking powder, baking soda, salt and orange zest in a medium bowl. 3. In a separate bowl, whisk together the butter, egg whites, vanilla extract, and stevia. Stir in the Greek yogurt, mixing until there are no large lumps. Stir in the orange juice and 2 tablespoons of milk. 4. Alternate between adding the flour mixture and remaining milk, beginning and ending with the flour mixture. Stir just until incorporated. (For best results add flour mixture in 3 equal parts.) 5. Gently fold in cranberries. 6. Spread batter into the prepared pan. Bake at 350 for 50-60 minutes or until the top feels firm to the touch and a toothpick inserted into the center comes out clean. 7. Cool in the pan for 10 minutes before lifting out the cake by the foil and transferring to a wire rack to completely cool.

Cranberries are rich in antioxidants that reduce oxidative damage to cells that can lead to cancer, heart disease and other degenerative diseases.

High in anthocyanins

The compound that gives cranberries their dark red color, may also protect against liver disease, lower blood pressure, improve eyesight and improve cardiovascular health. Studies have shown they may have anti-cancer and anti-inflammatory effects.

Keep urinary tract on the right track

Studies have shown that cranberries can help lessen the risk of urinary tract infection in certain people. This includes women and children that get them often.

Good for gut health

Studies have shown that they can improve gut bacteria in people who eat an animal-based diet. They also reduce bile acids in the gut that have a link to colon and gastrointestinal cancers.

Keep your mouth healthy

Just like in your digestive system, cranberries help control harmful acids in your mouth. They lessen the amount of acid you make and keep it from sticking to your teeth. This helps stop cavities, gum disease and tooth decay.

Submitted by Bruce Boyd

County Extension Agent

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An HHN publication


nutrition Cinnamon-Roasted

Health Benefits of

Butternut Squash 1 cup

Vitamin A Vitamin C Magnesium Potassium Calcium

100% 48% 12% 14% 6%

Percent of USDA daily requirement.

Great hydrator

One serving of butternut squash is roughly 87% water, which can help keep you hydrated.

Good for immunity

Butternut Squash This Cinnamon Roasted Butternut Squash is the perfect holiday side dish, great for wowing those Thanksgiving guests or impressing your co-workers at the company potluck.

INGREDIENTS:

1 lb.

butternut squash, peeled and cubed 2 tbsp avocado oil 2 tbsp honey ⅓ cup cranberries, halved ½ tsp cinnamon 1/8 tsp cayenne pepper 1 tsp salt ¼ tsp black pepper

INSTRUCTIONS:

1. Heat the oven to 425 degrees. 2. First, cut your butternut squash in 1-2” cubes if you don’t buy the pre-cut. 3. Place the squash on a parchment paper-lined baking sheet and drizzle with the avocado oil, salt and pepper; toss to coat. 4. Roast for 25 – 30 minutes, or until squash can be easily pierced with a fork and the edges are starting to brown and caramelize. 5. Remove from oven and add the honey, cinnamon, cranberries and cayenne pepper. It’s easiest to mix these in a bowl. 6. Pour back on the baking sheet and place back in the oven for 10 minutes; be careful not to let it burn.

Like other orange-colored fruits and vegetables, butternut squash is full of beta carotene and alpha carotene. Your body converts them to vitamin A, which is important for your immune system.

Excellent for your eyes

Butternut squash has lutein and zeaxanthin, often found in yellow fruits and vegetable and eggs. These protect your eyes from ultraviolet rays.

Fabulous source of fiber

Food high in dietary fiber helps keep your weight in balance and lowers your cancer risk.

Help blood pressure

Butternut squash is high in potassium, which can help keep your blood pressure in check. Managing your blood pressure can reduce your risk for stroke and heart disease.

Regulate blood sugar

Butternut squash has a low glycemic index which means that its carbohydrates are digested more slowly. This helps keep your blood sugar from spiking. An HHN publication

Hamilton Healthcare System | Thrive

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ask the doc Family Practice Rural Health Clinic 400 N. Brown, Bldg II Hamilton, TX

254-386-1700

Monday -Thursday 7 a.m. - 7 p.m. Friday 7 a.m. - 5 p.m.

Hico Clinic

104 Walnut Hico, TX

254-796-4224

Preventing Pneu Q. Is there a season for pneumonia or can it be contracted at any time of the year?

Q: What is pneumonia?

A. An infection of the lungs.

A. You can get it any time. We may see more of it during the winter because common colds and viruses are more prevalent. Sometimes the common cold can knock you down enough for bacteria to get in.

Q. What causes it?

A. Numerous things can cause pneumonia. There are bacterial and viral pneumonia and now we have COVID pneumonia, which is also a virus.

Q. Is it contagious?

Kristen Stegemoller, M.D.

Q. How do you know when to see a doctor about possible pneumonia?

Family Practice Clinic of Mills County

A. Any time you have fever, cough and congestion and you are not improving. If you are starting to feel worse, then it is time to let us evaluate.

A. Sometimes. If it is a viral, it is; if bacteria, not so much. If it is COVID pneumonia, definitely!

Monday 8 a.m. - 7 p.m. Tuesday, Thursday, Friday 8 a.m. - 5 p.m. Wednesday 9 a.m. - 5 p.m.

Q. How do I know if I am deficient/need to take a vitamin?

Family Practice Clinic of Mills County

Q. Who is most susceptible?

1501 W. Front Street Goldthwaite, TX

325-648-2850

Monday and Thursday 8 a.m. - 7 p.m. Tuesday, Wednesday and Friday 8 a.m. - 5 p.m.

A. If you have symptoms of fatigue or joint pain, see your doctor so labs can be ordered to check levels.

A. The immunosuppressed: those taking cancer drugs, with autoimmune issues, diabetes and the elderly.

Q. What are the symptoms?

A. Fever, shortness of breath and a worsening cough.

Q. How is it treated? Will it go away on its own? A. Bacterial prenumonia needs antibiotics. If it is viral, depending on the cause, it may eventually resolve itself, but sometimes we need to treat those as well such as with COVID. Sometimes the vital signs need further treatment.

Q. What happens if pneumonia is left untreated? A. Sepsis, worsening infection and difficulty breathing.

COMPOUNDING EXCELLENCE

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CHRONIC CARE MANAGEMENT

Individually tailored

SERVICES healthier, happier YOU. for a

1503 W. Front St, Goldthwaite, Texas

325.648.2484

Mon-Fri: 8:30-5:30pm • Sat: 8:30am-12pm

mcmahanpharmacy.com 8

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Hamilton Healthcare System

Chronic Care Management is care coordination for patients with two or more chronic medical conditions. Chronic Care Management helps the patient reach better health outcomes and quality of life. By focusing on your chronic care conditions more often, you decrease the risk of trips to the emergency room, hospital, and declining health status.

• Chronic disease education and support to reach health goals. • Preventive care (ie. Immunizations, lab work) • Medication Reconciliation • Regular communication • Personal attention for your health care needs • Provide 24/7 access to care For more information contact

Sammie Montgomery, Pharm.D.

at 325-648-2484 or sammie@mcmahanpharmacy.com

An HHN publication


eumonia Q. What is the best way to prevent pneumonia? A. You can't 100 percent prevent it. Get your flu shot every year. The COVID vaccine can help prevent, and get the pneumonia shot, if you qualify.

Q. Once you get pneumonia, are you more susceptible? A. Not necessarily.

Kristen Stegemoller, M.D. joined Hamilton Healthcare System in 2012. A graduate of the University of Texas Medical School at Houston, she completed her residency at John Peter Smith Hospital in Fort Worth in June 2012. Dr. Stegemoller specializes in family medicine at the Family Practice Clinic of Mills County.

Don't hesitate - vaccinate! Flu Vaccine. Everyone 6 months of age and older should get an influenza (flu) vaccine every season with rare exception. Ideally, everyone should be vaccinated between September and October. It takes about two weeks after vaccination for antibodies to develop in the body and provide protection against influenza virus infection.

Pneumococcal Vaccine.

• PCV13 - CDC recommends routine administration PCV13 for all children younger than 2 as a series of 4 doses: one each at 2 months, 4 months, 6 months, and 12 through 15 months. • PPSV23 - CDC recommends for all adults 65 years or older, people 2 through 64 with certain medical conditions, and adults 19 through 64 who smoke cigarettes. Most people need only one dose of PPSV23.

COVID-19 Vaccine. CDC recommends everyone 5 years* and

older should get a COVID-19 vaccination. The number of vaccine doses needed depends on which vaccine you receive. To get the most protection: • Pfizer-BioNTech - Two doses three weeks (21 days) apart. • Moderna - Two doses four weeks (28 days) apart. • Johnson & Johnson/Janssen - One dose of vaccine Pfizer/Moderna Booster - • J&J/Janssen • Six months from the primary series Booster • ages 65+ years 18+ years at • 18+ years least 2 months - in long-term care, after first vaccine - with underlying medical conditions - working in high-risk settings *Children ages 5-11 are eligible to receive the Pfizer pediatric COVID-19 vaccine only CDC CDC

Every Day Excellence 

A Five Star skilled nursing facility, the highest quality rating from the Centers for Medicare and Medicaid Services (CMS), Focused Care at Hamilton believes every day begins with the expectation of excellence. Every team member strives to deliver patient-centered care for your loved one.

Short Term Rehabilitation • 24-hr Skilled Nursing Care • Assisted Living 1315 E Hwy 22 • Hamilton, TX 76531 • 254-386-3171 • www.fpacp.com An HHN publication

Hamilton Healthcare System | Thrive

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our team

Solutions Behavioral Health Counselor Kayelen Helton, M.Ed, LPC, NCC competes nationally in breakaway and team roping events.

Youth counselor to rope in World Series Finals By Kymbirlee Jeschke or rodeo fans, December is synonymous with Vegas. Kayelen Helton, Licensed Professional Counselor at Solutions Behavioral Health, is heading to the World Series of Team Roping Finals in Las Vegas on Dec. 6. This is the culminating event for the popular series that roping fans enjoy at Circle T Arena in Hamilton. A Keller native who lives in Stephenville, Helton received her bachelor’s and master’s degrees from Tarleton State University on a full rodeo scholarship. During the week, she works with children and adolescents at Solutions Behavioral Health, but on the weekend Helton continues to compete at the national level in breakaway and team roping events. After so many cancellations in rodeo competitions last year, she says this year has been a successful rodeo year. Helton competed in eight rodeos in nine days during the July 4th week and earned a spot in the semifinals at Cheyenne Frontier Rodeo Days.

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Helton and Jessy Remsburg bested 202 teams to win the third annual Abilene Special All Girl Team Roping in September. She was seeded in the semifinals of the Woman’s Rodeo World Championships in Vegas at the end of October and scheduled to compete in the Women’s Professional Rodeo Associations Finals in Waco in November. “My roping lends itself well to relating to clients,” she said. “For example, when I get a bad run, I have to let it go. I give myself a 15-minute window, then let it go. I don’t take it home with me, and I stay positive. “My clients deal with so much more than that,” she said. “I set goals in the arena and strive to achieve them, and I motivate my clients to set goals as well, to move forward, always. “I guess my saying is, ‘get up, get moving, stay busy.’” It has been a busy year for Helton both in the arena and helping kids. “The last two years have been hard on kids,” said Helton. She said many kids dealing with anxiety and worry. They are having trouble

adjusting to the lack of socialization. “We are the only department that increased through the pandemic,” she said. “We never stopped seeing people faceto-face.” It may be hard for parents to discern when to seek professional help for their kids. According to Helton indicators may be changes in their personality, a loss of interest in activities that they love or negative changes in the way they talk about themselves. “The big thing for parents is to listen to your child,” said Helton. “It’s usually a random time when they ask for help.” Help is easy to get. Most insurances cover counseling and no referral is needed. Sometimes a child may benefit from just three to five sessions while others may need longer depending on their experiences. Helton sees patients in Goldthwaite on Mondays and in Hamilton on Tuesdays through Thursday. Call 254-386-1800 to book a visit.

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An HHN publication



prevention What is

Pulmonary Rehabilitation? Hamilton Healthcare System offers pulmonary rehab, a medically supervised program for individuals with lung problems including those with:

COPD • Bronchitis • Emphysema • COPD/Asthma The program consists of 36 30-minute sessions of education and lung conditioning, 3 days per week. Participants are closely monitored by nurses and respiratory therapists during exercise activities. Pulmonary rehab program is a covered service by Medicare and most insurance companies.

Pulmonary Rehabilitation helps participants: • • • • • • •

Experience less difficulty with breathing Increase muscle strength and endurance Improve their ability to cope with daily activities Understand how to use medications and oxygen appropriately Improve quality of life Reduce hospitalizations Improve depression

Qu t Sm moking is the single largest preventable cause of death and illness in the world. Not only does it increase cancer risk, cause COPD and acerbate other diseases, but smoking lowers immunity, bone density, the ability to taste and smell and reduces fertility. The benefits of quitting smoking begin immediately. Heart rate and blood pressure improve just 20 minutes after quitting, and lung function shows improvement just weeks after you last cigarette.

Pulmonary rehabilitation helps you to improve your quality of life and enjoy doing the things that bring you happiness. Talk to your physician about how to enroll in pulmonary rehab at Hamilton Healthcare System.

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Do You Have a Sleep Disorder? Our Sleep Center is Here For You

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HAMILTON HEALTHCARE SYSTEM

The Sleep Center at Hamilton General Hospital specializes in the diagnosis and treatment of sleep disorders in adults and children ages 14 and above for the treatment of:

Obstructive Sleep Apnea • Snoring • Insomnia Restless Leg Syndrome • Daytime Sleepiness The sleep study is done in a comfortable, private room. Our objective is to provide a natural sleeping environment with hotel-like accommodations.

Schedule a Sleep Study by Calling

(254) 386-1887

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An HHN publication


moking On the third Thursday in November, many Americans start their journey toward a healthier smoke-free life with the Great American Smokeout. Quitting isn’t easy. It takes time and looks different for different people. A plan and support increases chances of success. Medications are available to help too. Visit CDC.gov/quit or smokefree.gov to learn about tools to start the journey to a smoke-free life, or call your doctor for more information.

Blood pressure and heart rate drop to normal levels.

Nicotine levels decrease. Carbon Monoxide levels decrease. Oxygen levels increase.

Risk of coronary heart disease decreases to close to that of a non-smoker.

Taste and smell heighten. Heart attack risk decreases. Lung capacity increases.

Risk of lung cancer decreases up to 50%.

*

7 in 10 adult cigarette smokers want to stop smoking

Risk of mouth, throat, bladder and cervical cancer decreases. Stroke risk decreases.

Blood circulation improves and lung function increases.

Risk of heart attack drops dramatically.

CDC

The quitSTART app is a free smartphone app that helps you quit smoking with tailored tips, inspiration and challenges.

Your Hometown Drug Store

Hamilton City Drug

Friendly Faces • Quality Care

Danny and Suzanne Ray, owners, Cindy Kinsey RPh/PIC, David Cleveland RPh, John Opryshek RPh

Come see us for Christmas gifts and more!

Relieve pain. Repair injury. Retain activity. Rejuvenate skin. Revitalize life.

Microcurrent therapy with Acuscope Myopulse is an advanced solution for chronic pain and injury recovery. Sessions are noninvasive, painless and specific to your body and your condition. Enjoy high quality of life and get back to doing the things you love. Call for a free phone consult to see if this is an option for you.

105 E Henry St in Hamilton • (254) 386-3121 Monday - Friday 8 am - 5:30 pm • Saturday 8 am - Noon

803-389-7480 108 W 1st Street in Hico

www.OmniTherapyByTyler.com An HHN publication

Tyler Vandermeer BSN, RN

Hamilton Healthcare System | Thrive

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Measuring Excellence  amilton Healthcare System is embracing the theme, “We are always here to serve you.” For Director of Quality Tracey Karasek, patient satisfaction is a top focus. One way the hospital system focuses on making sure patients have the top experience is encouraging and listening to feedback, especially in the form of patient satisfaction surveys. Recently, the hospital system began sending follow-up cards with a message thanking patients for choosing the Hamilton Healthcare System several days after leaving the hospital. The card also encourages patients to respond to a satisfaction survey done by a vendor, PressGaney. “We are already seeing an impact,” Karasek said, about sending the thank you cards. “Scores went up a little bit.” In general, patient satisfaction scores are high, she said, and Hamilton General Hospital is a five-star hospital. Though patient satisfaction scores are not the only factor that goes into the fivestar rating, they do make a difference. “They have a choice, and we want to keep them here and keep them happy,” Karasek said. “We want them coming back.” It is important that patients complete the surveys, both with negative experiences and with positive ones. “It gives us a more accurate depiction of what patients truly feel,” she said. Many times when patients have a positive experience, they will not fill out a patient survey. The surveys can be done anonymously, or patients have the option to leave a name and even a follow-up number. A committee meets every other week to talk about the surveys in real time. Continuing problems that are mentioned through the patient satisfaction surveys are addressed with management and staff members. “We listen to what they say,” she said. “We are here to serve, and we encourage people to give us an idea of how we are doing.”

Mm Mm G

Erma's Grill serves up quality room ser By Wyndi Veigel hoices, a commitment to eliminating waste and the quality of food is what Erma’s Grill in the Hamilton General Hospital is all about. In February 2020, right before the COVID-19 pandemic hit full stride, the hospital decided to change the way it provided food to both patients and employees. They decided to alter service from a cook/serve non-select menu to room service-style meals. “Meals with very few choices have seen their way out,” Director of Transition Initiatives at Hamilton Healthcare System Olinda Harbaugh said. “It costs so much more.” The non-select service makes diet restrictions, such as those for diabetics, more difficult to implement, she said. When transitioning to the new service, the hospital looked at how hotels and medical facilities were changing their food options. With the room service implementation, patients can decline a hot meal in favor of salads, soups or sandwiches. They can place an order from 7 a.m. to 7 p.m. any time they are hungry. For example, if a new patient checks in at 3 p.m. they do not have to wait until dinnertime to order food. “This reduces floor stock that was

required before, such as extra soup,” Harbaugh said. Another benefit to the new program is physicians can trust that their diet restrictions are being followed to the letter. Diet restrictions are entered for each patient, if required, so food service staff can see if they are following guidelines. Patients place their own meals through calling and ordering off a menu. If someone is on a low-sodium diet, for example, and orders a cheeseburger and fries, food service personnel may call and offer an alternative like removing the cheese or pickles to lower the sodium. “It makes their care easier. It’s a tool to make things more efficient,” Harbaugh said. Unsurprisingly, the hospital has found that patients nearly always eat 100% of what they ordered, reducing the amount of food waste. This has dramatically decreased the hospital’s food costs. “Patients are really happy,” Harbaugh said. The elderly have expressed pleasure that food is not being wasted. “Patients who have choices are always happier.” As part of the food service expansion, a new sous chef, Jack Matthews has been hired by the hospital and began Oct. 18. One of Matthews’ goals will be to expand the retail portion for those outside the hospital who wish to order food. Within the next six months, citizens will be

Erma's Grill Roast Beef with mashed potatoes and gravy

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An HHN publication


Good!

service-style meals

able to pick up grab n’ go items such as a family-sized lasagna. These options will be available after 5 p.m. so residents can take them home after work for dinner. To implement the new food service, several changes were put into place including new equipment. Eight employees work in the food service area and they serve food to the patients. “They like that they get to interact. They feel like they are a part of the patients’ care,” Harbaugh said. A part of that care has included new uniforms for food service personnel, adding to their pride and professionalism with their jobs. On the cooking side, the hospital has invested in a blast chiller that also can cook. This piece of equipment allows staff, for example, to cook a roast overnight and then have it lowered to the correct temperature for food safety protocols. An Irinox was purchased that allows consistent cooking on a variety of items at the same time. The equipment can cook

innovation Top 10 Patient Choices at Erma's Grill

1. Roast beef, mashed potatoes, gravy 2. Bacon and eggs 3. Quesadillas 4. Hamburgers/ Cheeseburgers 5. Breakfast burritos 6. Soups (Tomato Basil, Veggie and Broccoli Cheese) 7. Pancakes, Bacon and Sausage 8. Italian Lemon Ice 9. Catfish and grilled veggies 10.Mac and Cheese

HAMILTON HEALTHCARE SYSTEM

400 North Brown • Hamilton, TX 76531

(254) 386-1600 www.hamiltonhospital.org

24-Hour Emergency Care • Ambulance Service • General Surgery Orthopedics • Radiology • Laboratory Services • Diabetes Education • Physical Therapy CHF • Sleep Lab • Wound Care • Cardiac & Pulmonary Rehabilitation • Endoscopy Infusion Therapy • Swing Bed • Solutions Behavioral Health • Wellness Center Rural Health Clinics in Hamilton, Hico and Goldthwaite

An HHN publication

Hamilton Healthcare System | Thrive

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“Patients who have choices are always happier.” Olinda Harbaugh, Director of Transition Initiatives

Long-time food service employee, Lea Ann Rae prepares and serves room service-style meals to Hamilton General Hospital patients.

bacon, eggs, and pancakes all together and alert staff when each item is ready. “The equipment has reduced processed food by half,” she said. With no more deep frying, food such as chicken strips become healthier for patients through a rapid cook oven. A commercial grade microwave was another purchase, along with a plate warmer. “We’ve also been focusing on presentation,” she said. For presentation, food service workers learn how to make food on trays more appetizing, how to place beverages and desserts. A smaller cart was implemented to allow food service personnel to carry only one or two trays at a time. “Patients who eat get better faster,” Harbaugh said.

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HAMILTON HEALTHCARE SYSTEM

Ryan Adams, MD General Surgeon

Keith Ellison, MD Orthopedic Surgeon

Back to a Healthy Lifestyle Compassionate Care

Don’t let illness or injury hold you back from a healthy lifestyle. From colonoscopies to gallbladder removal and knee replacement, you and your family are in capable hands with Hamilton General Hospital’s surgical specialists. General surgeon, Ryan Adams has extensive knowledge and training and treats a broad range of conditions that require surgery at Hamilton General Hospital. Orthopedic Surgeon, Keith Ellison performs knee replacement surgeries, shoulder and knee scopes and rotator cuff repairs at Hamilton General Hospital. He is skilled in hand surgeries including carpal tunnel release, trigger finger release, fracture care and surgeries. Reach out to your primary care physician for a referral. HAMILTON HEALTHCARE SYSTEM

Family Practice Rural Health Clinic (254) 386-1700

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(254) 386-1524

400 North Brown • Hamilton, TX 76531 www.hamiltonhospital.org

Hico Clinic (254) 796-4224

Hamilton Healthcare System

Family Practice Clinic of Mills County (325) 648-2850

Diabetes Education

Certified Diabetes Care and Education Specialists (CDCES) American Diabetes Association (ADA) accredited program

Comprehensive diabetic education focusing on disease management and education. Learn daily self-management through individual sessions or televisits: Making Healthy Food Choices • Staying Physically Active Monitoring Your Blood Sugar • Taking Medications

For more information or to schedule an appointment call:

(254) 386-1891

400 North Brown • Hamilton, TX 76531 www.hamiltonhospital.org An HHN publication


WE’RE ALL FIGHTING CANCER A FREE Test Could Save Your Life. Call 888.223.8620 TO QUALIFY FOR A FREE AT-HOME COLORECTAL CANCER SCREENING TEST YOU MUST: Be between the ages of 45 and 74 Have no personal history of colorectal cancer or colon surgery Have not completed a stool-based test in the last year or colonoscopy in the last 10 years Colorectal cancer screenings for those who qualify provided by Cancer Prevention and Research Institute of Texas (CPRIT).

MONCRIEF.COM Other cancer screening and survivor services available. Call 888.233.8620 for details.


healing Wound Care Clinic

400 N. Brown, Hamilton, TX

254-386-1895

Monday- Friday 8 a.m. - 5 p.m.

Wellborn earns Nurse Practitioner By Wyndi Veigel

Therapies include: • Negative pressure wound care • Advanced dressings • Cellular tissue products • Multi-layer compression

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or Jacque Wellborn, becoming a nurse practitioner has been a dream for quite a while simply so she could more greatly aid patients at the Wound Care Center at Hamilton Healthcare System. Growing up, Wellborn knew she wanted to be a nurse and that it was her calling. However, she was moved to go into teaching. “I really wanted to teach patients, not teach in a classroom,” she said. In 2010, when there was a reduction in the teaching force, Wellborn decided to follow her original calling and went back to school at Tarleton State University. After becoming a nurse, Wellborn found watching procedures on the medical/ surgical floor interesting. When Dr. Randy Lee mentioned to Wellborn that the hospital was interested in starting a Wound Care Clinic and asked if she would be interested in helping, Wellborn jumped at the chance. On Oct. 15, 2017, she began serving one day a week at the Wound Care Clinic while keeping her rotation on the med/ surg floor. The Wound Care Clinic is an outpatient service of the hospital system to aid in the management of problematic wounds. These wounds are typically slow or difficult to heal such as those caused by surgery, trauma, diabetes or vascular disease. Wellborn said the clinic grew rapidly. “We were in the middle of an area that didn’t have what patients needed,” she said. “We want to meet the needs of patients close to home.”

Along with Dr. Thomas Aycock and Nurse Practitioner Jennifer Armstrong, Wellborn knew if she became a nurse practitioner, she could do procedures, which would help the clinic. Currently, the Wound Care Clinic has Dr. Aycock for a day and a half and Armstrong two days a week, leaving a gap in days. “This helps us fill in holes and see more patients,” she said. After getting her master’s degree from the University of Texas at Arlington, Wellborn passed her state boards, which will allow her to be licensed by the state as a nurse practitioner. “It’s rewarding,” Wellborn said. “I enjoy coordinating care and helping identify underlying causes that may exist.” For Wellborn, getting to develop relationships with her patients is truly her favorite part of the job. As far as the Wound Care Clinic is concerned, part of that care includes a variety of checks and procedures for those who may have multiple comorbidities such as diabetes or vascular issues. When vascular problems arise, flow issues may be addressed with stent placements in veins to help wounds heal. They may also collaborate with infectious disease. “We care for inpatients as well,” Wellborn explained. “ER docs will refer them, or we go over to the hospital.” On a personal level, Wellborn enjoys her family including her husband Troy who manages a ranch, Micah, her son who graduates from Tarleton in December, and her daughter, Emily, who graduated in May and works at a vet clinic. Though Wellborn misses watching An HHN publication


Health through Healing

ner at Wound Clinic her children play sports, she has recently enjoyed watching her niece play soccer. She enjoys being part of the praise team at Grace Bible Fellowship in Hico. Patients at the Wound Care Clinic are referred by a doctor. The clinic is open Monday through Friday from 8 a.m. to 5 p.m. “It’s a great system, and we enjoy working together,” she said. “We are here for the community.”

Frequently treated wounds: • Minor burns • Diabetic wounds • Arterial wounds secondary to PAD • Pressure ulcers • Venous stasis ulcers • Trauma wounds • Complex soft tissue wounds • Skin tears • Radiation tissue damage • Chronic, non-healing wounds • Non-healing or slow to heal wounds • Non-healing surgical wounds • Lymphedema related wounds • Neuropathic wounds

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Proudly serving Central Texans since 1991

(254) 386-8971 leehealthcare.com An HHN publication

Hamilton Healthcare System | Thrive

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what's new Pain Management

Specialty Services Building 400 N. Brown, Hamilton, TX

254-386-1524 2ND & 4TH Thursdays

Treating: •

Diseases of the Spine causing Pain

Paresthesias or Weakness including Disc Bulges

Herniations

Nerve Impingement

Stenosis

Radiculopathies

Facet Arthritis

Spondylosis

Spondylolisthesis and Compression Fractures

Chronic Neuropathic Pain following Surgery to the Spine or Joints

Offering:

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Epidurals

Nerve Blocks

Radiofrequency Ablations

Joint Injections

Kyphoplasty or Vertebral Augmentation

Surgical Solutions Thrive |

Hamilton Healthcare System

Dr. M

Pain Management physician returns to Hamilton Clinic By Wyndi Veigel amiltonians may recognize a familiar face as Dr. William Moore returns to the Hamilton Healthcare William System. Moore, M.D. Moore, who is working in the Specialty Services Pain Management Building, previously worked for the healthcare group for about four years. He then moved to practice medicine in Fort Worth for three years, he said. When he had an opportunity to return to Hamilton, he excitedly accepted. “Frankly I missed being here,” he said. “I missed the ease of practicing medicine, and I enjoyed the patients. I missed them.” Dr. Moore got his start in medicine by attending medical school at UT Health Science Center in San Antonio. He completed his anesthesiologist residency at Ochsner Clinic Foundation Hospital in New Orleans, Louisiana. His pain medicine and interventional pain management fellowship was completed at Texas Tech University Health Sciences Center in Lubbock. Though Dr. Moore originally thought he wanted to go into the field of anesthesiology, he discovered he wanted a more lasting relationship with his patients. The specialty of pain management covers a variety of conditions including neuropathic pain, sciatica, post operative pain and more. Typically, a patient is referred to a pain management specialist by another doctor such as a general practitioner. According to Dr. Moore, after a patient is referred to him, imaging is secured, either from previous appointments or new testing. A thorough conversation about the pain and injury itself is conducted including what may have caused the pain and other treatments a patient has tried. Typically, after imaging is reviewed, a

patient will need to try the least invasive medical treatment first, which in most cases is physical therapy, Dr. Moore said. Injections may also help, and then surgery may be required. “Over the past few years, the field of interventional pain management has expanded a great deal,” he said. “We have begun to offer more, less invasive care.” For example, spinal surgery is being done more endoscopically. Posterior spinal implants are another part of pain management that have advanced since it very safe and done outside the spinal canal, Dr. Moore said. Sacroiliac fusion is another process that has advanced to aid with pain. In the surgery, a small hole is drilled, and a bone graft is utilized to encourage bone growth over the sacroiliac joint to create one immobile unit. No metal is left in the patient, helping to reduce pain. Joint fusion can effectively reduce pain and instability caused by sacroiliac joint dysfunction. Currently, Dr. Moore treats diseases of the spine that cause pain, herniations, nerve impingement, stenosis, radiculopathies, facet arthritis, spondylosis, spondylolisthesis and compression fractures and chronic neuropathic pain following surgery. Procedures include epidurals, nerve blocks, radiofrequency ablations, joint injections and kyphoplasty or vertebral augmentation. For those needing surgery, the options include: lumbar endoscopic decompression, discectomy, posterior spinal fixation implants, sacroiliac fusion, spinal cord stimulator, implants and intrathecal pumps. Dr. Moore is excited to see patients in Hamilton again and extends his services to anyone in need of a pain management specialist. He is seeing patients on the second and fourth Thursdays of each month. To schedule an appointment, contact the hospital at 254-386-1524. A PCP referral is required.

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An HHN publication


Moore is Back!

20.4

%

of U.S. adults suffer from chronic pain CDC

One-third of people living with chronic pain don't receive any kind of treatment.

ORDAN PHARMACY

Back pain

represents % of all types of pain.

27 % headache 15 or migraine % neck 15 pain % facial 4 pain Women are twice as likely to suffer from facial pain, migraines and headaches than men.

Looking outside the box? We offer Specialty Compounding ► Friendly Attentive Team ► Vaccinations - Shingles, Flu, Pneumonia, COVID

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Hamilton Healthcare System | Thrive

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Continued Care Close to Your Home

Hamilton General Hospital offers option for post-hospital care

By Kymbirlee Jeschke

amilton General Hospital offers a unique program for post-hospital care. Swing Bed is for patients ready for discharge but in need of further rehabilitation, wound care or IV medication. “Previously these patients would be referred to a skilled nursing facility,” said Case Management Director Sharon Humphreys, MSN, BSN, RN, ACM. “It is a different level of care for those who need more than they can get anywhere else.” With the Swing Bed program, patients can stay in the same hospital bed with the same nurses, therapists and physicians. “A lot of times they don’t even have to change rooms,” said Humphreys. “It really helps with people who can’t adjust to moves well, especially those with dementia.”

Hamilton Healthcare System’s rehabilitative therapies are available to swing bed patients including physical, occupational and speech therapies. “Patients see all of the same therapists but we are able to do it longer and more often through Swing Bed,” said Humphreys. Hamilton General Hospital’s laboratory, radiology, emergency and pharmacy departments ensure patients receive the services they need without waiting or transportation. “You don’t have to wait on labs. Xrays and scans are available right down the hall. You don’t have to wait for the pharmacy to deliver meds. It is all right here,” said Humphreys. “If there is an emergency, you are already here.” With 24-hour care provided by hometown healthcare professionals, Swing Bed gives both the patient and family peace of mind. Visitors are welcome. “Patients can bring things from home to make them more comfortable,” said Humphreys. “You have the same nurses who took care of you in the hospital,” she said. Swing Bed offers

Live, local team dedicated to serving YOU!

INTERNET - PHONE

254-785-3278 www.usapathway.com

a low patient-to-nurse ratio. “And the food is good here,” said Humphreys. “Where else would you go?” Swing Bed does not take the place of skilled nursing facilities or home health but adds another option to healthcare services. “Each of these serves a very needed purpose,” said Humphreys, who explains that physicians help determine each patient’s unique needs. A skilled nursing facility might be a better option to get a patient adjusted to a more permanent living situation. Home Health has eyes in a patient’s living environment and can help find essential services to improve the patient’s quality of life at home. Swing Bed stays generally range from a week to three weeks depending on the patient’s needs. “It really depends on the patient’s motivation and participation; how much the patient wants to go home,” said Humphreys. Patients looking ahead to a surgery, even at another hospital, can visit with their doctor about the possibility of post-hospital care through Swing Bed at HGH. Before being discharged, they can visit with a discharge planner, social worker or nurse case worker. “Swing Bed is quality care that you can’t get anywhere else,” said Humphreys. “We are a 5-star hospital. Where else could you go for such excellent and compassionate care?”

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Chronic Care Management Services We proudly offer Chronic Care Management Services led by an experienced CCM Registered Nurse to coordinate your healthcare needs and help you manage your chronic conditions. If you have any of the following conditions you may be eligible with little to no cost! Call today to learn more!

Alzheimer’s and Dementia Arthritis • Asthma • Atrial fibrillation

Cancer Cardiovascular Disease • COPD

Depression Diabetes • Hypertension

Eligible to Rural Health Clinic patients with two or more chronic conditions. Contact your doctor for information: Hamilton Family Rural Health Clinic • (254) 386-1700 Hico Clinic • (254) 796-4224 Family Practice Clinic of Mills County • (325) 648-2850

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An HHN publication


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healthy mind

discovering

Holiday Ma your

e are in the midst of the holiday season. Thanksgiving then Christmas and the start of a New Year immerse us in the sights, sounds, smells and activities of Linda C. festivity! Who doesn’t Kolodziej , love the holidays? M.Ed., LPC, CSC, Actually, many LCDC, NCC Solutions people struggle through Behavioral Health the season. Intense emotions, both negative and positive, may be triggered. For some, the stimulus overload may cue love-based emotions and stir happy memories and dreams of a bright and magical future. Fond memories of childhood may be evoked. For others, fear-based emotions such as dread and feelings of inadequacy may be summoned. Feelings of not having enough money or family drama may rise to the surface. It is important to self-reflect and take note of what emotions are being triggered within you. When you are aware of your feelings, you are better prepared to reframe those negative emotions and channel them into something more positive. Whether you find yourself gravitating toward fear-based emotions such as anger, resentment and bitterness or love-based emotions such as gratitude, appreciation and happiness, selfawareness is important. Practicing selfcare and participating in simple acts of love can be beneficial for both ends of the holiday emotion spectrum. Experiencing your emotions and expressing them in a healthy way may make a big difference in the way you feel. Demonstrating positive emotions can set you apart from negative, unhappy

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people. Positive emotions can lend way to a more positive disposition, however, positive emotions may have to be practiced before they become a habit. Repressing or avoiding emotions can result in unhealthy expression. One of the keys to understanding your emotions is awareness of yourself, others and your environment. When we hear the phrase “holiday magic,” what does it mean? We don’t have to believe in real magic to feel possibility. Possibility of brighter days. Possibility of happier times. Just... possibility. Possibility can also open us up to vulnerability. When we love we are vulnerable. When we hope we are vulnerable because things might not go like we hope. A person who leans toward negative emotion may feel that the vulnerability is not worth the possible negative implications. They may subconsciously believe that if they don’t allow themselves

to hope for good things, they will never be disappointed when the good things don’t happen. A person who leans toward positive emotion is often more likely to immerse themselves in the “holiday magic” of possibility, allowing themselves to experience joy. I encourage you to self-reflect and be aware of what emotions you are feeling during this holiday season. Replace fearbased or negative emotions with positive ones to create your own “holiday magic.” Choose happiness, and don’t be afraid to reach out to a healthcare or mental health professional. According to the National Alliance on Mental Illness, one in every five adults in America suffers from a mental disorder. The National Institute of Mental Health states that depression is the leading cause of disability worldwide and is a major contributor to the global burden of disease. The holiday season can intensify feelings of anxiety and depression in

An HHN publication


5 tips to create holiday magic

Magic

Making new associations with the holiday season can help reframe negative or fear-based emotions with positive feelings. Try these tips to evoke your own “holiday magic.”

Bake the cookies. Participating in activities that bring

you joy, like baking, can help bring peace and create positive feelings. Sharing them with others can spread the joy.

many people. This article is in no way intended to make light of or diminish the importance of mental health and self-care. My intention is to focus more on “holiday magic” and possibility. My wish is that you find peace and are able to view the world through a lens of love.

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Cathy Kolodziej received her Masters degree in counseling from Tarleton State University in 2011. She is a Licensed Professional Counselor and Licensed Chemical Dependency Counselor at Solutions Behavioral Health. Cathy serves teens as a counselor at Evant ISD. She is passionate about helping others discover their inner strength in order to achieve a better quality of life.

Hamilton Family Practice Rural Health Clinic HAMILTON HEALTHCARE SYSTEM

303 North Brown • Hamilton, TX 76531

(254) 386-1700

Tune in to holiday entertainment. Choose songs or movies that spark positive memories. Enjoy uplifting and peaceful vibes. For an added lift, sing or dance along.

Smile at friends and strangers.

Smiling releases dopamine, endorphins and serotonin, which work like a mild pain reliever and antidepressant. Even forcing a smile can be a mood booster. Smiling and the happiness it evokes is contagious.

Surround yourself with love.

Take inspiration from those around you. Poet William Blake once wrote, "We become what we behold." When you surround yourself with loving, positive people, you are more likely to adopt empowering beliefs and confidence.

Solutions Behavioral Health Medication Management • Individual & Group Therapy

HAMILTON HEALTHCARE SYSTEM

400 North Brown • Hamilton, TX 76531

(254) 386-1800 www.hamiltonhospital.org

www.hamiltonhospital.org

James Lee, MD • Robbye Lengefeld, MD Gerald Snyder, MD • Shalor Craig, MD Charles Johnson, MD • Grant Ward, PA-C Shelly Boyle, PA-C • Shelly Lengefeld, PA-C Arlene Brown, APRN,FNP Accepting patients of all ages, and most insurances accepted. For an appointment, call (254) 386-1700 today!

Clinic Hours

Monday - Thursday 7:00am - 7:00pm • Friday 7:00am - 5:00pm

An HHN publication

Ring the bell.

Volunteer your time with local organizations. Helping others will make you feel better, and by giving them this positive reinforcement, you are essentially giving it to yourself.

Depression • Anxiety Disorders • Stress Management Teen Issues & Peer Pressure • Mood Disorders Grief and Loss • Chronic Mental Illness Post Traumatic Stress Disorders Substance Use Disorders Accepting patients of all ages, and most insurances accepted. For an appointment, call (254) 386-1800 today!

Clinic Hours Monday, Wednesday, Friday 8:00am - 4:30pm Tuesday 8:00am - 6pm • Thursday 7:00am - 6:00pm

Hamilton Healthcare System | Thrive

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Relax & Unwind End a long day at the office or a hectic day of holiday preparations with these stress-relieving yoga poses. Gently release tension and boost your mood while improving flexibility, lowering blood pressure, easing pain and aiding sleep.

Seated Twist

Twists detoxify the body, aid in digestion and neutralize the spine. Try this gentle twist by creating 90-degree angles with the knees and initiating the twist from the belly muscles toward the front knee, then reverse knees and twist to the other side. Not feeling the knee position? Substitute your favorite seated position - you can even do it in a chair!

Warm Up

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DEMONSTRATED BY YOGA INSTRUCTOR KYM JESCHKE. PHOTOS AND INTERIOR DESIGN BY KIM HINTON. OUTFIT FROM PECANCREEKOUTFITTER.COM

Heart Melting

Sitting at a desk, bent over a phone or standing over a stove, many daily activities cause our shoulders to cave inward. Stretch the spine, calm the mind and open the heart in this tension-relieving posture-improving pose. Feel free to add extra padding under the knees. BONUS: Send the hips to the heels for child's pose.

Follow this flow to warm up for a new day or slow it down to wind-down from a long day. A few rounds will have you loosened up and ready for some deeper stretching.

Hamilton Healthcare System

An HHN publication


Pigeon

fitness Bridge

Release the low back and hips with this feel-good stretch. Feel free to send the chest and head to the mat to relax into the pose. If the seated position stresses the knees, prop the hip with a throw pillow or rolled-up towel or roll over and try the version shown above.

Lifting the hips into a bridge can be a great strengthening pose for the legs as well as heart opener. Turn bridge into a restorative stress buster by propping the hips with a throw pillow or two.

Legs-up-the-Wall

On your feet all day? Treat yourself to this gentle inversion to soothe swollen, cramped legs, increase circulation and stretch hamstrings. For tight hamstrings, scoot the hips farther away from the wall or prop them on a throw pillow. Let the arms relax, release the jaw and breathe.

Find a comfortable position, close or lower the eyes and take breaths deeply into the belly. Inhale through the nose for three-four counts, pause and exhale out of the nose for six-eight counts. Repeat up to five times, then allow the breath to flow freely through the body.

Breathe

Join Kym for yoga at Hamilton Wellness Center every Monday, Wednesday and Friday at noon.

An HHN publication

Hamilton Healthcare System | Thrive

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safety

Head Injury When a bump is more than a bump

concussion or traumatic brain injury (TBI) is an injury to the brain caused by a bump, blow or jolt that causes the head and brain to move rapidly back and forth. Becky This sudden movement Thompson, RN Trauma can cause the brain to Coordinator bounce around in the skull, creating bruising, swelling or bleeding of the brain. A brain injury can also be caused by a penetrating injury to the skull.

Magnitude of the Problem

The Centers for Disease Control estimates that in the U.S. around 1.7 million people sustain a head injury every year. TBI is a contributing factor in almost one- third of all injury deaths and a major cause of disability in the United States. Those who survive TBI can face effects lasting from a few days to disabilities that last the rest of their lives. Head injuries are most commonly sustained by children between the ages of 0 and 4, adolescents between the ages of 15 and 19 and adults age 65 and over. TBI rates are higher for boys than girls. From 2008 to 2017, fall-related TBI deaths increased significantly, as the entire country saw a 17 percent increase. Older adults are most at risk, specifically those 75 and older. These numbers show that we must work to prevent fall-related TBI among older adults as the U.S. population ages.

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Preventing falls in older adults Here are some steps that older adults can take to prevent falls: X Talk to your doctor about fall risk and prevention. X Do strength and balance exercises X Have your eyes checked. X Make your home safer by: • Getting rid of items you can trip over. • Adding grab bars inside and outside your tub or shower and next to the toilet. • Putting railings on both sides of stairs. • Making sure your home has lots of light by adding more or brighter light bulbs.

Signs and symptoms of head injuries; The terms “mild,” “moderate” and “severe” are used to describe the effect of the injury on brain function. A mild injury to the brain is still a serious injury that requires prompt attention and an accurate diagnosis.

Mild traumatic brain injury: The signs and symptoms of mild traumatic brain injury may include: Physical symptoms • • • • •

Headache Nausea or vomiting Fatigue or drowsiness Problems with speech Dizziness or loss of balance Strength and balance exercises, like Tai Chi at Hamilton Wellness Center, can help seniors prevent falls.

An HHN publication


Sensory symptoms

• Sensory problems, such as blurred vision, ringing in the ears, a bad taste in the mouth or changes in the ability to smell • Sensitivity to light or sound

Cognitive, behavioral or mental symptoms • Loss of consciousness for a few seconds to a few minutes • No loss of consciousness, but a state of being dazed, confused or disoriented. Can’t remember events prior to or after a hit or fall • Memory or concentration problems • Mood changes or mood swings • Feeling depressed or anxious • Difficulty sleeping • Sleeping more than usual • Just not feeling “right”

Moderate to severe traumatic brain injuries: Moderate to severe traumatic

brain injuries can include any of the signs and symptoms of mild injury, as well as these symptoms that may appear within the first minutes, hours to days after a head injury:

Physical symptoms

• Loss of consciousness from several minutes to hours • Persistent headache or headache that worsens • Repeated vomiting or nausea • Convulsions or seizures

• Dilation of one or both pupils of the eyes • Clear fluids draining from the nose or ears • Inability to awaken from sleep • Weakness or numbness in fingers and toes • Loss of coordination

Head injuries in sports/ recreational activites The following sports and recreational activities represent the categories contributing to the highest number of estimated head injuries of all ages treated in U.S. hospital emergency rooms in 2018.

Cognitive or mental symptoms • Profound confusion • Agitation, combativeness or other unusual behaviors for that person • Slurred speech • Coma and other disorders of consciousness

Infant’s and Children’s symptoms Infants and young children with brain injuries might not be able to communicate headaches, sensory problems, confusion and similar symptoms. In a child with traumatic brain injury, you may observe: • Changes in eating or nursing habits • Unusual or easy irritability • Persistent crying and inability to be consoled • Change in ability to pay attention • Loss of coordination; clumsiness • Changes in sleep habits • Seizures • Sad or depressed mood • Drowsiness • Loss of interest in favorite toys or activities

1. 2. 3. 4.

Football: 51,892 Baseball and Softball: 24,516 Basketball: 38,898 Powered Recreational Vehicles (ATVs, Dune Buggies,

5. 6. 7. 8. 9.

Skateboards: 10,573 Exercise & Equipment: 37,045 Trampolines: 8,956 Playground Equipment: 38,915 Cheerleading: 5,697

Go-Carts, Mini Bikes): 30,222

Among children 14 and younger, the top 10 head injury categories are : 1. Playground Equipment: 35,058 2. Football: 31,277 3. Basketball: 20,242 4. Cycling: 19,921 5. Baseball and Softball: 12,065 6. Soccer: 12,709 7. Swimming: 9,265 8. Trampolines: 7,921

9. Powered Recreational Vehicles: 6,036 10. Skateboards: 3,101

HAMILTON HEALTHCARE SYSTEM

Sports Injuries

Back or Neck Pain

Hamilton Healthcare System now offering Physical Therapy services in two locations to better serve our patients. With locations in both Hamilton and Goldthwaite, we look forward to serving our rural Central Texas communities.

Don’t Wait! Call now to schedule an appointment! Hamilton Physical Therapy

(254) 386-1894

400 N Brown • Hamilton Mills County Physical Therapy

Balance & Strengthening / Range of Motion An HHN publication

Post-Operative Surgical Recovery

(325) 648-2333

1503 1/2, W Front St • Goldthwaite Hamilton Healthcare System | Thrive

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FREE Course on Concussion in Sports The National Federation of State High School Associations (NFHS) and Centers for Disease Control and Prevention (CDC) have teamed up to provide information and resources to help educate coaches, officials, parents and students on the importance of proper concussion recognition and management in high school sports. In this FREE course you will understand • the impact sports-related concussion can have on your players, • how to recognize a suspected concussion, • the proper protocols to manage a suspected concussion, and • steps to help your player return to play safely after experiencing a concussion.

Check it out at nfhslearn.com HAMILTON HEALTHCARE SYSTEM

When to see a doctor Always see your doctor if you or your child has received a blow to the head or body that concerns you or causes behavioral changes. Seek emergency medical care if there are any signs or symptoms of traumatic brain injury following a recent blow or other traumatic injury to the head.

Head injury Safety All sports and recreational activities: Parents, coaches, sponsors, friends and teammates promote a safe culture, you set

the tone for safety.

Help prevent head injuries by enforcing and following the rules of the activity or sport for fair play, safety and sportsmanship. Ensure athlete participants avoid unsafe actions such as: • Participating without wearing appropriate safety equipment: helmets, pads, protective clothing • Using equipment inappropriate for the size or the age of the participant. Including adult sized motorized vehicles (ATV’s, motor bikes, go carts, golf carts) used by children younger than 16. • Using broken/ malfunctioning equipment • Practicing or playing in an area not intended for that activity • Practicing or playing without appropriate supervision.

• Participating in an activity while under the influence of drugs and/or alcohol Talk about concussion and head injury reporting. This includes parents, coaches, sponsors, friends and teammates: Some athletes, both children and adults, may not report an injury because they think • It’s not serious • They might get in trouble • They might lose their spot on the team or won’t get to play • They might look weak to their friends or teammates • They are letting the team down We can’t prevent every head injury. Things like car wrecks, falls and branches falling from trees are going to happen, but we can decrease the chances of an injury and protect the health of our community members by thinking ahead and following a culture of safety. Becky Thompson has cared for the Hamilton community as a nurse since 2001, first in the Emergency Department and now as Trauma Coordinator. She enjoys educating her community in safety and prevention techniques. Becky enjoys spending time with her grandkids. She’s also an avid baker.

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Care Runs Deep & Close to Home HICO CLINIC

HAMILTON FAMILY PRACTICE RURAL HEALTH CLINIC FAMILY PRACTICE CLINIC OF MILLS COUNTY

SAN SABA

Three Primary Care Clinics Proudly Serving Hamilton County and Our Surrounding Communities. Extended Hours Offered for Your Convenience. Hamilton Healthcare System, Always Here to Serve You.

Hamilton Family Practice Rural Health Clinic (254) 386-1700 Hico Clinic (254) 796-4224 LLANO

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Family Practice Clinic of Mills County (325) 648-2850

An HHN publication


William Moore, MD Pain Management Anesthesiologist Born in Laredo, TX, Dr. Moore earned his medical degree at the University of Texas Health Science Center at San Antonio, followed by a residency in Anesthesiology at Ochsner Clinic Foundation Hospital in New Orleans. Dr. Moore completed his fellowship training in Pain Medicine and Interventional Pain Management at Texas Tech University Health Sciences Center in Lubbock.

We proudly welcome William Moore, MD to our Medical Staff! Dr. Moore treats the following and is taking new patients: CONDITIONS TREATED

PROCEDURES

• Diseases of the Spine causing Pain • Paresthesias or Weakness including Disc Bulges • Herniations • Nerve Impingement • Stenosis • Radiculopathies • Facet Arthritis • Spondylosis • Spondylolisthesis and Compression Fractures • Chronic Neuropathic Pain following Surgery to the Spine or Joints

• • • • •

Epidurals Nerve Blocks Radiofrequency Ablations Joint Injections Kyphoplasty or Vertebral Augmentation

SURGERIES • • • • • • •

Lumbar Endoscopic Decompression Discectomy Posterior Spinal Fixation Implants Sacroiliac Fusion Spinal Cord Stimulator Implants Intrathecal Pumps

Dr. Moore will be here the 2nd & 4th Thursdays of each month! To schedule an appointment, please call

HAMILTON HEALTHCARE SYSTEM

Specialty Services Building

(254) 386-1524 PCP referral required

400 North Brown • Hamilton, Texas 76531


Our holiday

Tradition ith pancakes w g in rn o m s a m start Christ y my Our family loves to a long tradition that was started b kids r s and stockings. It' , and we carry it on today with ou use ho ts sweet grandparen is nothing better than filling the ere and grandkids. Th e, laughter and remembering with lov of Christmas! g in n a e m e u tr e th Luckie JeaneDtirteector in Rural Health Clinic lth Clinic

Rural Hea

Every year, we wear matching Christmas outfits. We stay home on Christmas Day, unwrap presents, watch Christmas movies and enjoy hot chocolate all day. kayLa SchRaub Administrative Assistant-Medical Staff Coordinator in Administration

Our Christmas Eve tradition is to go to the Christmas Eve service at church, bake cookies for Santa, put out food for the reindeer, watch Christmas movies, drink hot chocolate, open one gift from under the Christmas tree and wear matching pajamas! LaShea RatLiff Human Resource Generalist in Human Resources

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I always make my handm ade chocolate pie for Chri stmas! JoRdyn PoweR Executive Assis

S

tant in Admin

istration

An HHN publication


spotlight

ns Our Thanksgiving tradition is cooking and eating a big Thanksgiving dinner with family, getting a Star-Telegram newspaper to plan our shopping strategy and then going Black Friday Shopping! Bridget Bruce Admissions Clerk in Patient Access

er food and toys liv de e w d an a nt Sa as I dress up families. to several less fortunate LonnieicViaon tinaEwVS Floor Techn

My family and I hav e find a hotel that go created a new tradition where we there on Christmas es big with Christmas, and we stay Eve. Last year night at the Gaylord , we enjoyed a wonderful in Grapevine. K yLe Mo Human Re rgan so urces Direct

or, Human

Resources From our family to yours ~ Have a Happy Thanksgiving, Merry Christmas and healthy, safe New Year! An HHN publication

Hamilton Healthcare System | Thrive

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lifestyle The most common resolutions for U.S. adults last year were: • exercising more • losing weight • saving more money • improving diet • pursuing a career ambition

Making Resolu

hile the end of a year and the beginning of a new can be full of nostalgia and hope, setting traditional New Year’s Resolutions can be daunting. According to the American Psychological Association, a more successful approach is setting small, attainable goals throughout the year instead of an overwhelming list on Jan. 1. Realistic resolutions incorporated into everyday life have a greater chance of being kept. The APA offers these tips when thinking about New Year’s resolutions:

Start small –

Want to add exercise to your day? Aim for three to four days a week at the gym instead of seven. Is eating healthier a goal? Instead of viewing your diet changes as punishment, aim to make small, healthier substitutions to your existing diet, like fruit instead of dessert or raw vegetables instead of chips.

One change at a time –

Remember that unhealthy behaviors develop over time so adjusting to healthier behaviors takes time, too. Work toward changing one thing at a time instead of feeling overwhelmed by multiple changes.

Talk about it –

Share your struggles and successes with supportive family or friends. Consider joining a group to reach your goals.

Reslove to recover –

Perfection is unattainable. Minor missteps are completely normal. Don’t give up because you ate the cheesecake or slept in on workout day. It’s OK. Resolve to recover and get back on track.

*

Give a gift that makes a difference. Now more than ever, Central Texans are reminded of how grateful we are to have outstanding healthcare professionals and facilities in Hamilton, thanks to the foresight, tenacity and stewardship of many of our citizens over the years. The Hamilton General Hospital Healthcare Foundation, 501(c)3 organization, maintains the legacy of ensuring vital healthcare services now and for the future for Hamilton County and surrounding areas. Thanks to the generosity of our donors, the Foundation has been instrumental in providing grants for needed equipment and services like the new 3D digital mammography machine and annual community health fair.

As you plan your end-of-the-year gifts, please consider the Hamilton General Hospital Healthcare Foundation.

Join us in supporting the healthcare team that cares for you. 34

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Hamilton Healthcare System

HAMILTON GENERAL HOSPITAL HEALTHCARE FOUNDATION Providing excellence in rural healthcare

P.O. Box 788 • Hamilton, Texas 76531 Donate online at hamiltonhospital.org/hghh-foundation An HHN publication


utions stick! 20 22 Try one of these healthy lifestyle changes this year: • Quit smoking. • Eliminate one soda a week. • Add steps to your day by parking farther away from the store. • Pack your lunch once per week. • Face-time or call a family member or friend. • Volunteer with a local organization. • Try adding 16 oz. of water 30 minutes before a meal. • Book a trip. • Eat a vegetable with every meal. • Give a compliment each day. • Read a book a month.

• Say “No” more often. • Fit in 10 minutes of exercise 3-4 days per week. • Subscribe to your local newspaper and read it instead of scrolling social media one evening each week. • Wash your face before bed. • Switch from plastic water bottles to BPA-free reusable container. • Go to bed 30 minutes earlier. • Start a gratitude journal. • Back up your computer. • Donate a box of items to charity.

Stronger Together with Hope

Central Texas Eye Care

Updating Your Look For Winter?

Detect. Treat. Defeat.

A mammogram is a non-invasive exam used to check breasts for breast cancer and other abnormalities. It is the only test shown to reduce breast cancer deaths. 3D Mammography can detect cancer early – when most treatable – long before it can be felt. This improves odds of survival and can help avoid more extensive treatment. For more information or to schedule an appointment call:

(254) 386-1600

400 North Brown

An HHN publication

Hamilton, Texas 76531

www.hamiltonhospital.org

Come try on the latest styles in eyewear at Central Texas Eye Care. Now carrying sunglasses! Central Texas Eye Care is your go to shop for men’s, women’s, and children’s eyewear.

Shop Local at Central Texas Eye Care! For more information call (325) 648-2040 1020 Fourth Street • Goldthwaite, TX 76844

We look forward to seeing you soon!

HAMILTON Care Runs Deep in Goldthwaite HEALTHCARE www.centexeyecare.org SYSTEM

Hamilton Healthcare System | Thrive

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directory ADVERTISERS

4 WACO CARDIOLOGY ASSOCIATES

254-399-5400 wacocardiology.com

5 MC BANK

800-285-2216 mcbanktx.com

8 MCMAHAN PHARMACY 1503 W. Front, Goldthwaite 325-648-2484

9 FOCUSED CARE 254-386-3171 fpacp.com

11 SOLARIS

888-3SOLARIS solarisfamily.com

SERVICES

2 PROVIDERS

3 SWING BED 8 RURAL HEALTH CLINICS 12 SLEEP CENTER 15 HAMILTON GENERAL HOSPITAL

16 DIABETES EDUCATION 16 SURGERY 22 CHRONIC CARE MANAGEMENT

13 OMNI THERAPY BY TYLER 803-389-7480 OmniTherapyByTyler.com

13 HAMILTON CITY DRUG 105 E. Henry, Hamilton 254-386-3121

17 MONCRIEF CANCER INSTITUTE

888-233-8620 moncrief.com

19 LEE HEALTHCARE & MEDICAL SUPPLY 254-386-8971 leehealthcare.com

21 JORDAN PHARMACY 107 N. Rice, Hamilton 254-386-3111

22 PATHWAY

254-785-3278 usapathway.com

25 RURAL HEALTH CLINIC 25 SOLUTIONS

BEHAVIORAL HEALTH

29 PHYSICAL THERAPY 30 CARE RUNS DEEP 31 DR. WILLIAM MOORE 35 DETECT. TREAT. DEFEAT. 35 CENTRAL TEXAS EYE CARE

38 COME EXPLORE

23 TEXAS ONCOLOGY 888-864-4226 TexasOncology.com

34 HGHH FOUNDATION

PO Box 788, Hamilton, TX 76531 hamiltonhospital.org/hghh-foundation

39 CAREFLITE

877-DFW CARE (membership) careflite.org

40 HAMILTON EDC hamiltontexas.com

Be a part of the Spring issue of

Thr ve

Health and Wellness Magazine for Rural Central Texans

COMMUNITY RESOURCES General Assistance

211 Texas

Crisis Text Line

Help finding services/resources www.211texas.org 211 or 1-877-541-7905

www.crisistextline.org Text HOME to 741741 to connect with a Crisis Counselor

Texas Health & Human Services Office

Adult Substance Abuse

Medicaid, Food Stamps, Medicare Savings Programs (254) 386-8965

Free 24/7 support at your fingertips

•••

Texas Health & Human Svcs Bluebonnet Trails

Hamilton Co. United Care

1-800-841-1255 (Crisis) 1-844-309-6385 (Main)

Hill Country Community Action

Mental Health & Developmental Disabilities Central Counties Services

Help w/ food & clothing 254-206-7371 1-866-372-5167

Hamilton TX Helping Hands find them on Facebook •••

Aged & Disabled, Veterans

Texas Health & Human Services Long Term Care Services 1-855-937-2372

Area Agency on Aging | Aging & Disability Resource Center Services, Info & Referral for Aged, Disabled & Veterans 254.770.2330 or 1-800-4477169

Hamilton Community Center 254-784-3358

Hico Senior Center 254-796-4488

Mills County Senior Center 325-648-3122

•••

Transportation

Texas Medicaid Transportation

1-877-MED-TRIP (1-800-633-4227)

The Hop Rural Transit

254-933-3700 ext. 5005 or 1-800-791-9601 ext. 5005 •••

Mental Health

Texas Health & Human Services

COVID 19 Mental Health Support Line 1-833-986-1919

254-386-8179 Crisis Hotline 1-800-888-4036

Women & Children Texas Health Steps

Services for Pregnant Women, Children on Medicaid Birth-20 yrs 1-877-THSTEPS (1-877-847-8377)

Texas WIC

Women, Infants, Children 1-866-907-0080 TexasWIC.org 254-216-9211 Hamilton Early Childhood Intervention 254-773-6787

Hamilton Early Head Start 254-386-8936

Choices Hamilton County

www.choicesclinic.net 254-386-3709 or 833-773-3001 •••

Domestic Violence

HOPE – Tri-Rivers Domestic Violence Emergency Shelter

Emergency Shelter & Assistance for DV Survivors 254-865-2151 Social Security Administration 1-800-771-1213 MEDICARE HOTLINE 1-800-MEDICARE (1-800-633-4227) MEDICAID HOTLINE 1-800-335-8957 Texas Department of Insurance 1-800-252-3439 Texas Dept. of Protective & Regulatory Svcs. ABUSE & NEGLECT HOTLINE 1-800-252-5400 Blood donated with Carter Bloodcare goes to local Central Texas hospitals including Hamilton General Hospital.

Call Kym at Hamilton Herald-News 254-386-3145 or kym@hhnpaper.com

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Thrive |

Hamilton Healthcare System

Sign up at carterbloodcare.org An HHN publication


ask the expert nutrition and weight loss What is the best way to stay on track during the holidays? The trouble we often run into with gaining weight over the holidays is that one day, one celebratory meal can turn into grazing on high-calorie leftovers for days after. Enjoy your meal but avoid taking home leftovers. Have healthier options on the table and balance out your plate with healthier vegetable side dishes. Start your meal with a tall glass of water, eat slowly and try to limit the desserts. If you have Medicare Part B and/or a BMI of greater than 30, you may qualify for nutrition counseling and weight loss.

Krista Lindley, MS, RD, LD, CDCES • Hamilton Healthcare System

oncology How are Texas researchers working to improve early lung cancer detection and increase survivorship among men and women? Lung cancer can be treated and is often preventable. New ways to detect and treat it earlier are providing positive outcomes for those diagnosed. Medical breakthroughs like tumor testing and targeted therapies are advancing personalized treatment for patients. Through participation in local clinical trials, both researchers and lung cancer patients can continue to improve survivorship right here in Texas.

Thomas J. Harris, M.D. • Texas Oncology–Waco

400 N. Brown in Hamilton • 254-386-1894 •hamiltonhospital.com

1700 W. State Highway 6• 254-399-0741 • TexasOncology.com

communications

back pain

Why fiber optic is better?

How can I prevent low back pain?

When the internet first became popular, most everything was ran over a copper connection commonly known as DSL. This was an upgrade from the old “dialup” days, but as time went by and more data was being demanded by consumers, DSL was not able to keep up with the demand. With Fiber-to-theHome, it allows consumers the ability to have multiple devices in the homes and still not experience any lag in their service. Fiber is without a doubt the future to staying connected!

When you improve your overall physical fitness and general health, it will benefit your low back. The following measures can help prevent the development, chronicity and flaring of low back pain: • Stay active • Drink lots of water • Minimize alcohol • Get enough sleep • Follow an anti-inflammatory diet • Avoid smoking • Manage stress

Erica Gonzales, CSR and Sales Manager• Pathway

Tye Moseley, PT• Physical Therapy at Hamilton Healthcare System

sleep quality

arthritis

427 N Broadway St in Joshua • 817-484-2222• usapathway.com

400 N. Brown in Hamilton • 254-386-1670 • hamiltonhospital.com

How do I know if I need a sleep study?

What is the best way to beat arthritis pain in the winter?

The best thing to do is get evaluated. Tell your doctor if you are not able to sleep well, wake up in the middle of the night gasping or have a problem with snoring. It is estimated that one or two of every 10 people have some form of sleep disorder. An at-home sleep study is convenient and easy to use in the comfort of your home. It is cost-effective, insurance covers it and you can sleep better in your own bed. The test can easily detect obstructive sleep disorder, and once it is determined positive, doctors can treat with CPAP or continuous positive airway pressure.

The biggest thing is to keep moving. When you stop moving, you freeze up. Anytime we stretch our ligaments and tendons it takes pressure off the joints. Joints degenerate and when we have tendons and ligaments glide over them, it causes more pain and damages cartilage and ligaments. If we stretch and keep them loose, we’ll have less pain. Yoga, massage therapy and swimming is good. Anything to keep the muscles active and stretched out. Consult with your physician for more information.

David Rodriguez, BA, RRT• Sleep Lab Center at Hamilton Healthcare System 400 N. Brown in Hamilton • 254-386-1600 • hamiltonhospital.com

An HHN publication

Stephanie Shepherd, FNP • Hico Clinic

104 Walnut in Hico • 254-796-4224 • hamiltonhospital.com

Email your questions to kym@hhnpaper.com. Hamilton Healthcare System | Thrive

37


pets Dr. Josh Lackey, veterinarian at L & L Veterinary Clinic in Hamilton, gives these tips for caring for pets in winter: By Helena Knutson

Winter

WEATHER: Some pets are more

SHELTER:

Ideally it is good to bring your pet inside in cold and hot temperatures. If your pet lives outside, make sure they have a draft-free shelter with warm bedding and a covered door to help conserve body heat.

FUR MAINTENANCE: Try to keep your pet’s fur longer in the winter. Your animal naturally grows a thicker coat to prepare for the cold. Shaving them or cutting it short can make it difficult for them in colder weather. Try to bathe them less and make sure they are completely dry before going outside.

susceptible to the cold weather than others. It’s important to know what your pet can handle when temperatures start to drop and when it is too cold for them.

Paws

LOST PETS:

Winter is a more common time for pets to become lost. Snow and ice can cover up scents that they use to get back home if they get lost. Make sure your pet has a collar and tags, or ask your vet about microchips to make sure they can get home safely.

*

FOOD: Animals who live outdoors require more food in the winter to help their body replace the energy they are using to stay warm. On the bag of dog food, it’s important to read the ingredients and choose a food that has a high energy or fat percentage. This season you can help support local pets without homes by donating to Hamilton Animal Shelter through Facebook at Hamilton Animal Shelter or by contacting (254) 386-3810.

HAMILTON HEALTHCARE SYSTEM

Come Explore Hamilton, TX At Hamilton Healthcare System our care runs deep for you and your family. While visiting our hospital, outpatient services and our caring providers, take time to experience Hamilton. Great places to eat and stay, while hunting and fishing, and enjoying the ranch and wildlife. Sip and shop as you explore historic architecture and more. It’s small town charm in the big Texas Hill Country. We look forward to seeing you soon!

Hamilton Healthcare System 400 North Brown • Hamilton • (254) 386-1600 Hamilton Family Practice Rural Health Clinic 303 North Brown • Hamilton • (254) 386-1700 Hico Clinic 104 Walnut St • Hico • (254) 796-4224 Family Practice Clinic of Mills County 1501 W Front St • Goldthwaite • (325) 648-2850

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Hamilton Healthcare System

An HHN publication


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