Thrive Spring 2024

Shelly Boyle, PA-C Hamilton Clinic

Brittany Nichols, LCSW Counseling Hamilton Clinic

Randy Lee, MD Chief of Staff Hamilton Clinic

Robbye Lengefeld, MD Hamilton Clinic

Tim Rudolph, MD Hamilton General Hospital Hospital ER

Luke Killian, MD Hamilton General Hospital Hospital ER

Brad Bartels, MD Hamilton General Hospital Hospital ER

Gerald Snyder, MD Hamilton Clinic

Charles Johnson, MD

Hamilton Clinic Hico Clinic

Shalor Craig, MD Hamilton Clinic Hico Clinic

Shelly Lengefeld, PA-C Hamilton Clinic

Ryan Adams, MD General Surgery Specialty Services

William Moore, MD Interventional Pain Management Specialty Services

Keith Ellison, MD Orthopedics Specialty Services

Kristen Stegemoller, MD FPC Mills County

Jim Davis, OD, FAAO Central Texas Eye Care

Jacque Wellborn, FNP-BC Hico Clinic Wound Care

Jennifer Plumlee, FNP-BC Wound Care

John Seth, APRN, FNP-C FPC Mills County

Trevor Watson, APRN, FNP-C FPC Mills County

Basic Hygiene for kids

• Brush teeth in the morning

• Wear clean underwear, socks, clothing, and shoes

• Use deodorant/antiperspirant if needed

• Wash body with warm soap and water

• Make sure hair is clean and brushed/combed

• Wipe well after using the bathroom

• Wash hands after using the bathroom, coughing and sneezing

• Wash hands before eating

• Keep nails trimmed

• Brush teeth and floss before bed at night

• Cover mouth when coughing or sneezing

ow often should children bathe?

If they look clean, smell clean, do not have bug spray or sunscreen on and have not been in a pool or other body of water, it is not necessary to bathe. For many kids, bathing 3 to 4 times a week is appropriate. Wash their hair?

ask the doc

importance of hygiene and grooming – bathing themselves, brushing their teeth, washing hands, using the bathroom independently, etc. when they are toddlers. By ages 3-5, let your child try to do these tasks by themselves with you observing. As they become more proficient, you can leave them to do these tasks on their own when safe

What can parents do when children push back on hygiene?

It is important to explain to children that you are trying to keep them safe and healthy by having them practice good hygiene behaviors. Staying consistent and closely monitoring their habits will help along the way.

How should hygiene habits change as children develop into teenagers?

As kids develop into teenagers, their bodies begin to change and often sweat more. It is therefore important that they are aware of this as they will often need to increase their bathing/showering practices and will need to be even more diligent in wearing deodorants, antiperspirants, clean socks, clean underwear, etc.

The underarm area, between the toes, and in the genital and groin areas are common places where odors can build up. This is because bacteria can get trapped in the oil and dirt on the surface of the skin. These germs can lead to body odor. You can avoid bad odors by routine bathing and using a deodorant or antiperspirant every day. Additionally, wearing clean socks, underwear and clothes can also help. Girls should wipe from front to back after going to the toilet.

What tips do you give parents to teach period hygiene and why is this important?

Washing hands and all body parts consistently is always very important, but even more so during their period. When you are active during the day, your menstrual flow is normally heavier, so the pad absorbs more blood and sweat. This creates a breeding ground for bacteria, and therefore you should not wear one pad for more than four hours. When you are asleep, your bodily function slows down, and the bleeding intensity decreases. Therefore, you can typically wear a pad overnight. However, do not use tampons for more than eight hours. They are associated with toxic shock syndrome, which is a severe infection requiring medical evaluation and treatment.

When should teens begin shaving?

To determine how often your child needs to shampoo, you need to consider their hair type, age and activity level. In general, 3-4 times weekly is appropriate, but one should consider shampooing more often if your child’s hair or scalp is oily. You should shampoo less if their hair is dull and shedding or feels dry.

Why is it important to instill good hygiene in children?

Hygiene is directly related to health and well-being. Following good hygiene practices helps prevent illnesses.

How can parents encourage good hygiene in children?

Start them young. You don’t have to wait. Start by teaching them about the

When should children begin using deodorant? There is no set age for when kids should start using deodorants or antiperspirants. Some start using deodorant as soon as puberty starts to cause body odor, which can be as early as 8 or 9 years old. As kids get older, then switching to an antiperspirant combination is appropriate if needed. Deodorant covers up odor, while an antiperspirant actually decreases the amount you sweat. Both products work wherever they are applied to your body, most commonly in the underarms. Many times, deodorant and antiperspirant are combined in a single product.

What causes sweaty feet, excessive underarm wetness, etc. and how can these issues be treated or managed?

Sweating is the body’s mechanism to cool itself. The nervous system automatically triggers sweat glands when your body temperature rises. Sweating also occurs, especially on your palms, when you’re nervous.

Though there isn’t a set age to talk to your children about shaving, you can look for noticeable cues it’s time to have the conversation. For instance, they may approach you about wanting to start shaving, or you may start noticing body hair and want to start that conversation. Either way, make sure they know you are there to talk with them about shaving when they are ready. Especially as puberty hits, your child might bring up shaving on their own. It could be out of simple curiosity or because their friends are starting to shave. Or they could be feeling self-conscious about their new body hair.

When is it time to consult a practitioner about body odor, bad breath, excessive sweating or other body change issues?

If a child has been diligent with appropriate bathing/hair washing, wearing clean clothes, brushing and flossing teeth routinely, and using deodorant/antiperspirants, it would be reasonable to consult a practitioner to ensure there are no further issues contributing to these issues. The providers at the Hamilton Healthcare System are happy to further evaluate and treat children and educate and offer guidance for parents regarding hygiene and other health related issues.

Shelly Lengefeld is a certified physicians assistant serving patients at the Family Practice Rural Health Clinic in Hamilton. Shelly is a Hamilton native. She and her husband Grant have three daughters, Campbell, Harper and Berkley.

Shelly Lengefeld, PA

Hamilton Family Practice Clinic

CHRONIC CARE SERVICES

Our clinic can help coordinate and monitor your conditions with personalized care plans:

Diabetic Care & Education

Alzheimer’s & Dementia

High Cholesterol

Anxiety & Depression

Hypertension Cancer

Arthritis

Atrial Fibrillation

Asthma COPD

For questions or more information please call one of our Family Practice Clinics!

(254) 386-1700

Family Practice

(325) 648-2850

Family Practice

(254) 796-4224

Healthy Habits eating

hat are some tips to help instill healthy eating habits in children?

The best way to instill healthy eating in children is to eat well yourself. Modeling healthy habits encourages children to try new foods, but it may take time. Another way parents can support healthy eating habits is to make these choices easy and accessible by keeping nutritious foods and snacks in the home. Have a fruit bowl, healthy snack bags, veggies already washed and prepped for grab ‘n go. And at the same time, keep sugary drinks and processed snacks out of the home. Create a healthy home environment.

How can parents help kids/teens develop healthy relationships with food?

Avoid fighting over food and make mealtime a positive experience. Involve kids in preparing meals and try to eat as a family whenever possible.

When children are small, they often don’t eat for days and then eat everything in sight. How can I make sure my child is getting adequate nutrition?

Pay attention to their food choices and offer each food group at meals to support a balanced diet rich in a variety of nutrients. At annual wellness visits, your pediatrician will monitor growth and development to ensure adequate nutrition.

What are warning signs that children may be developing unhealthy eating habits?

Warning signs could include abnormal weight changes, ongoing constipation or digestion problems, tooth decay, lethargy or delayed growth.

Do you provide nutrition and weight loss counseling for children and teens?

We offer nutrition counseling for both children and teens. These sessions focus on building healthy habits, mindful eating and improving the quality of food choices.

When should parents consult a physician or dietitian about concerns with their children’s eating behaviors or weight?

If parents have concerns about a child’s eating behaviors or weight changes, a meeting with their primary care provider or dietitian can help identify possible reasons for these changes and support healthy long-term growth.

Krista Lindley has worked as a registered dietitian and certified diabetes educator since 2012 at Hamilton Healthcare System. In addition to diabetes education, Krista also conducts nutrition and weight loss counseling. For those with a BMI greater than 30, insurance may cover the cost of the program. For more information, call Krista at 254-386-1531.

Krista Lindley, MS, RD, LD, CDCES Diabetes Coordinator

Banana Pops

Fun to make. Fun to eat! These banana pops are a great nutritious snack that everyone will enjoy making and eating!

INGREDIENTS:

3 medium bananas, peeled and cut in half

3 cups Greek yogurt, plain non-fat 1oz vanilla or chocolate instant pudding mix, sugar-free 2 tsp sprinkles, chopped nuts or coconut

6 Popsicle sticks

Per serving: 170 calories, 3g total fat, 2g saturated fat, 0g trans fat, 10 mg cholesterol, 230 mg sodium, 23 g total carbohydrate, 2 g dietary fiber, 13 g sugars, 13 g protein, 144 mg calcium, 384 mg potassium. Serves

Health Benefits of Bananas

Bananas are a healthy source of fiber, potassium, vitamin B6, vitamin C and various antioxidants and phytonutrients.

Easy to digest

Bananas are rich in fiber, which makes for a filling snack that is easy to digest even for young tummies. Fiber can help prevent constipation and promotes gut health. The starch found in bananas forms butyrate, a short chain fatty acid that benefits gut health.

INSTRUCTIONS:

1. Peel bananas and cut in half. Insert popsicle stick into the flat end of the banana.

2. Mix together yogurt and pudding mix until combined.

3. Dip bananas into yogurt mixture, use a spoon to coat each banana evenly if necessary.

4. Add sprinkles to the pops, evenly distributing among all six.

5. Place bananas on a flat tray and freeze until yogurt has hardened, approximately two hours.

Heart healthy

Bananas are high in potassiium and magnesium and low in sodium, which makes them a heart healthy food.

Natural energy boost

Bananas contain natural sucrose, fructose and glucose, making them a fat-free, cholesterol-free energy source. With a low glycemic index of 42-58, banana sugars enter the blood stream slowly without a sudden spike.

Did you know?

Bunches of bananas are called “hands” and each hand has about 20 “fingers.”

Christie

Tasty

veggie tots

How do I get more creative with my vegetable game? How do I get my kids to eat broccoli? The answer is veggie tots!

Serves 8 (4 tots per serving)

2 cups Russet potatoes, ready to serve

2 cups Frozen broccoli florets, thawed

1.5 cups Shredded parmesan cheese

1/8 cup Grated parmesan cheese

½ cup Dry bread crumbs

1large Egg white

1Tbsp Italian seasoning

Health Benefits of Broccoli

Loaded with nutrients, broccoli can be eaten raw or cooked. However, recent research shows steaming offers the most health benefits.

Immune booster

Rich in antioxidant vitamins A, K and C, broccoli boosts the immune system, reduces inflammation and the risk of chronic disesase and protects against oxidative stress.

Bone strengthener

INSTRUCTIONS:

1. Pre-heat oven to 425, place oven rack in the middle of the oven and line baking sheet with silicone mat or parchment paper.

2. Steam or microwave the potatoes to the point where a fork is easily inserted but is too tough to eat (20 seconds for ready-to-eat potatoes in the microwave).

3. Once they are cooked, drain them and set aside to let them cool.

4. Then place 2 cups thawed broccoli florets into your food processor and pulse it until the broccoli resembles coarse rice. (should yield 1 ½ cups chopped) Measure out the 1 ½ cups of finely chopped broccoli and transfer into a large bowl.

5. Next, pulse the semi-cooked potatoes and 1 ½ cups of the parmesan cheese pulse just enough to break up the potatoes and combine with the cheese.

6. Place cheese and potato mixture into the bowl with the broccoli. Add seasoning to the large bowl and fold all ingredients with a large spatula to combine ingredients evenly.

7. Then place grated parmesan cheese and bread crumbs into a small bowl. Form small balls with a tablespoon-sized cookie scoop or your hands and a spoon with the folded ingredients. Once the ball is formed, roll each veggie tot in the grated parmesan cheese and bread crumbs to coat them.

8. Place each veggie tot on the baking sheet ½ inch apart. Bake 12 minutes or until golden brown. Remove from the oven and let cool 2-3 minutes. Air Fryer Instructions:

1. Complete steps 2 through 8 from the oven instructions.

2. Pre-heat the air fryer to 400 and set the timer for 7 minutes.

Broccoli is an excellent source of calcium which is essential for bone growth and osteoporosis prevention.

Eye health

Two of the main carotenoids in broccoli, lutein and zeaxanthin, are associated with a decreased risk of age related macular degeneration an eye disease that impairs vision.

3. Once preheated, place food on the tray/ basket making sure not to crowd the tots. Spray the top of the tots with non-stick cooking spray.

4. Close the air fryer and start cooking. Halfway through, turn the tots over and spray the tops with non-stick cooking spray, then finish cooking.

Per serving: 45 calories, 1.5g total fat, .5g saturated fat, 5 mg cholesterol, 95 mg sodium, 6 g total carbohydrate, 1 g dietary fiber, 2 g protein, 45 mg calcium, 116 mg potassium.

lay that engages the senses, sight, touch, taste, smell and sound are fun memory makers but it can be vital for childhood development. Sensory play, like finger painting and play dough, can help with cognitive growth or problem solving, language development and fine motor skills. Tactile play can stimulate creativity in children or have a calming effect on children who might have hyperactivity. Here are some fun sensory play recipes. Turn on a little music during play to add another sense.

Moon Sand

INGREDIENTS:

8 cups all-purpose flour

1 cup baby oil or make it taste-safe with cooking oil

INSTRUCTIONS:

Add flour and oil in a large bowl, stir until combined. The mixture will be crumbly but moldable. Sand can be died with food coloring. Store in an airtight container.

Making Messes,

Edible Marshmallow Slime

INGREDIENTS:

1Tbsp cooking oil

1Tbsp cornstarch

1½ cups mini marshmallows or 6 jumbo marshmallows

INSTRUCTIONS:

1. Place marshmallows in a microwave safe bowl and pour oil over marshmallows.

2. Heat in the microwave for 10 seconds at a time until marshmallows are melted. Carefully remove and stir until fluff forms.

3. Before the mixture cools, stir in half the cornstarch. If the mixture is too runny or sticky, add more cornstarch.

4. Knead mixture until slime is formed. Store in an airtight container.

Making Memories

Play Dough

INGREDIENTS:

½ cup salt

1 cup water

2Tbsp cream of tartar

1 cup flour

1Tbsp oil

Food coloring

INSTRUCTIONS:

1. Mix the flour, salt, cream of tartar and oil in a pan.

2. Mix the water with the food coloring.

3. Add the water/color-mix to the other ingredients, stir well.

4. Cook on medium heat for 4-5 minutes, while constantly stiring.

5. When the mixture becomes “doughy,” remove from heat and start kneading. (the dough will be hot, so mind your hands)

6. When desired texture is achieved, the playdough is finished, enjoy!

Salt Painting

INGREDIENTS:

Elmer’s liquid glue

Cardstock or construction paper

Table salt

Watercolor paint or food coloring

Paintbrush

Water

INSTRUCTIONS:

1. Layout the paper, cup of water and paints on a flat surface.

2. Use glue to create a design. Feel free to trace or freehand. Get creative!

3. Sprinkle a heavy amount of salt onto the glue design then carefully pour off the excess salt from the paper.

4. Dip your paintbrush into the watercolor and carefully begin to dab onto the design. Watch the color spread each direction.

6. When you finish your masterpiece, let the painting dry. This could take a day or two.

Edible Sugar Finger Paint

INGREDIENTS:

4 Tbsp Imperial extra fine granulated sugar

⅓ cup corn starch

2 cups water red, green, blue and yellow food coloring

INSTRUCTIONS:

1. Mix together sugar, corn starch and water in a saucepan.

2. Heat mixture over medium heat while stirring with a whisk. As soon as it begins to thicken, remove from heat. If mixture is too thick, add water.

3. Divide mixture equally between four bowls and add four drops of food coloring to each bowl.

4. Store in an airtight container. Can be stored in the refrigerator for up to a week.

ImperialSugar.com

Recommended Immunizations for Children

Birth through 16 Years Old

Did you know?

Today, vaccines use 305 antigens to protect against 14 diseases by age two.

protects against hepatitis B. Spread by contact with blood or body fluids. Disease symptoms may include fever, headache, weakness, vomiting, jaundice and joint pain. Hepatitis B could cause chronic liver infection, liver failure, liver cancer and death.

protects against rotavirus. Spread through the mouth. Disease symptoms may include diarrhea, fever and vomiting. Rotavirus could cause severe diarrhea, dehydration and death.

protects against diphtheria, pertussis (whooping cough) and tetanus. Diptheria and pertussis are spread by air or direct contact, while tetanus is through cuts in skin. Symptoms of diphtheria are sore throat, mild fever, weakness and swollen glands in neck, and diphtheria could cause swelling of the heart muscle, heart failure, coma, paralysis or death Symptoms of pertusis are severe cough, runny nose and apnea, a pause in breathing in infants, and pertusis could cause pneumonia or death Symptoms of tetanus are stiffness in neck and abdominal muscles, difficulty swallowing, muscle spasms and fever, and tetanus could cause broken bones, breathing difficulty and death

protects against pneumococcal disease. Spread by air or direct contact. May be no symptoms or pneumonia. Pneumococcal infection could cause bacteremia (blood infection), meningitis and death.

protects against polio. Spread by air, direct contact or through the mouth. May be no symptoms, sore throat, fever, nausea or headache. Polio could cause paralysis and death.

meningitis, encephalitis, inflammation of testicles or ovaries, deafness and death. Symptoms of rubella may include rash, fever or swollen lymph nodes. Rubella is very serious in pregnant women and can lead to miscarriage, stillbirth, premature delivery and birth defects.

protects against chickenpox. Spread by air or direct contact. Disease symptoms may include rash, tiredness, headache or fever. Chickenpox could cause infected blisters, bleeding disorders, encephalitis, pneumonia and death.

protects against Haemophilus influenzae type B. Spread by air or direct contact. May be no symptoms unless bacteria enter the blood. Hib infection could cause meningitis (infection of the covering around the brain and spinal cord), intellectual disability, epiglottitis (life-threatening infection that can block the windpipe and lead to serious breathing problems), pneumonia (infection in the lungs) and death.

protects against severe complications from coronavirus disease 2019. Spread by air or direct contact. May be no symptoms, fever, muscle aches, sore throat, cough, runny nose, diarrhea, vomiting or new loss of taste or smell. COVID could cause pneumonia, respiratory failure, blood clots, bleeding disorder, injury to liver, heart or kidney, multi-system inflammatory syndrome, post-COVID syndrome and death.

protects against influenza. Spread by air or direct contact. Disease symptoms may include fever, muscle pain, sore throat, cough or extreme fatigue. The flu could cause pneumonia, bronchitis, sinus infections, ear infections and death.

protects against measles, mumps and rubella. All of which are spread by air or direct contact. Symptoms of measles may include rash, fever, cough, runny nose, pink eye. Measles could cause encephalitis (brain swelling), pneumonia (infection in the lungs) and death. Symptoms of mumps may include swollen salivary glands under the jaw, fever, headache, tiredness or muscle pain. Mumps could cause

protects against hepatitis A. Spread by direct contact or through contaminated food or water. May be no symptoms, fever, stomach pain, loss of appetite, fatigue, vomiting, jaundice or dark urine. Hepatitis A could cause liver failure, arthralgia (joint pain), kidney, pancreatic and blood disorders and death.

protects against human papillomavirus. Spread by direct skin contact. Disease may not have symptoms or genital warts. HPV could cause cervical, vaginal, vulvar, penile, anal and oropharyngeal cancers.

protects against meningococcal disease. Spread by air or direct contact. Disease symptoms may include sudden onset of fever, headache, and stiff neck or dark purple rash. Meningitis could cause loss of limb, deafness, nervous system disorders, developmental disabilities, seizure disorder, stroke and death.

Talk with your child’s doctor if you have questions about your child's vaccinations.

HepB

RV DTaP

Hib

PCV

IPV

COVID-19

Flu MMR

Varicella

HepA

HPV MenACWY

prevention Vaccinate

Protect children for a lifetime

to

accination is a simple, safe and effective way of protecting children against harmful diseases before they come into contact with them. Vaccines teach the immune system how to create antibodies that protect the body from diseases. It’s safer for the immune system to learn this through vaccination than by catching the diseases and treating them. Once the immune system knows how to fight a disease, it can give your child lifelong protection.

Disease Control. Combination Vaccines

Combination vaccines combine two or more vaccines into one shot.

During a doctor’s visit, your child may only get two or three shots to protect them from five diseases, instead of five individual shots.

Combining vaccines into fewer shots may means more children will get recommended vaccinations on time. That means fewer delays in disease protection. Benefits for children are fewer shots, less pain and discomfort and one-time protection. Common combination vaccines include:

Why it’s important to vaccinate

While some vaccine-preventable infectious diseases, such as measles, mumps, and polio, are rarely seen in the United States, they still circulate in other parts of the world.

If a group of people fall behind on their vaccines, these diseases may have an opportunity to reemerge, causing outbreaks and potential deaths in our communities once again.

It is critically important that your child receives their vaccines on schedule to protect them against serious diseases.

Vaccines are tested to ensure that they are safe and effective for children to receive at recommended ages and approved for use by the Centers for

• MMR = measles, mumps, rubella

• DTaP = diptheria, tetanus and pertussis

• Pediarix = diptheria, tetanus, pertussis, hepatitis B and polio

• Pentacel = Diptheria, tetanus, pertussis, polio and Hib (Haemophilus influenzae type B)

• Kinrix or Quadrace = Diptheria, tetanus, pertussis and polio

• Vaxelis = Diptheria, tetanus, pertussis, polio, hepatitis B and Hib

• ProQuad = measles, mumps, rubella and varicella/chickenpox

varicella/chickenpox

A Hamilton native, Shawna McKandless has cared for her community for more than 25 years as a nurse at Hamilton Healthcare System. She works in Quakity as the Vaccine Coordinator. Shawna and her husband, Kyle, have two children Cameron and Cade.

At

Shawna McKandless, LVN

Vaccine Coordinator

ask the doc

Tonsils and

hat are tonsils and adenoids?

Tonsils are tissues in the throat that are a part of the immune system. They can get really irritated and cause swelling, a sore throat and even snoring.

What is tonsillitis?

Tonsillitis is inflammation of the tonsils caused by a sore throat or strep throat.

What is the difference between tonsillitis and strep throat?

While tonsillitis can be caused by many things, strep throat is a definitive diagnosis. It is identified as a sore throat caused by streptococcus pyogenes bacteria.

What are the symptoms of strep throat?

A really bad sore throat. Fever is common and sometimes a rash. Occasionally, we’ll see some nasal drainage and a cough, but usually not. White spots are not always present.

How important is it to be treated for strep throat?

It is very important. If you suspect a sore throat might be strep, it is important to see

your provider. A bacterial infection like strep needs to be treated with antibiotics. When left untreated, strep can cause rheumatic fever. This usually develops one to two weeks after a strep infection and can be acute. It may cause heart issues down the road like endocarditis, an inflammation of the heart lining and valves. It can also be associated with joint pain. It’s very important that a patient be treated appropriately.

Can tonsillitis be prevented?

weeks

Not in all cases, no. Good hand washing and keeping your distance from people who are sick will help prevent it but we are going to have it.

How do you know when it’s best to remove a child’s tonsils?

Ultimately an Ear, Nose and Throat specialist makes that determination. It’s usually time to refer a patient when we see tonsillitis reoccurrences multiple times a year; once a quarter or three to four times a year.

Another indicator that can sometimes be overlooked is really enlarged tonsils. Parents may notice snoring or that kids aren’t sleeping well. Enlarged tonsils can fall back in the airway, interfering with good quality sleep. When kids are tired, it can lead to problems at school. They can even fall behind.

Should the adenoids automatically come out too?

Ask the ENT, but usually they take them together.

Are there any adverse long-term effects of not having tonsils?

Not usually. We usually see a much better outcome when tonsils are removed. If surgery is what it has come down to, that’s the last measure we want to take.

Is there an age when tonsil issues crop up?

Usually our younger patients, early elementary age. It’s not as common in teens and young adults, because the issue is usually caught when patients are younger.

Can kids without tonsils get strep throat?

Rarely, but yes, then can. It doesn’t happen very often.

How can Hamilton Healthcare System providers help children and parents treat and manage tonsil issues?

We can evaluate and confirm cases, treat strep throat with antibiotics and hold patients over until they can be seen by an ENT. Typically they perk up pretty quick. We are happy to help with referrals when the time is right.

Grant Ward is a Physicians Assistant serving the Family Practice Clinic of Hamilton and Hico Clinic for more than seven years. He completed his medical training at UT Galveston. Ward enjoys spending time with his wife, Kim and their daugthers, Lexie and Hannah.

Grant Ward, PA

Hamilton Family Practice Clinic Hico Clinic

and Tubes

hat causes earaches in children?

Ear infections, also called acute otitis media, are a common problem in children. They are caused by bacteria that children have in their nose and throat. Most of the time ear infections develop after a viral upper respiratory infection. This usually causes nasal passage and throat swelling, making it difficult for the child to clear secretions. Viral URI can also cause Eustachian tube dysfunction, which in turn changes the pressure in the middle ear which may cause fluid to form. Viruses and bacteria then follow, causing inflammation causing the eardrum to bulge, which is what causes the pain. Young children may be more fussy or pull at the affected ear. Sometimes the eardrum can rupture, causing drainage of fluid from the ear canal.

APRN, FNP

How many earaches are too many?

If a child has too many ear infections they might need ear tubes called tympanostomy tubes. Three or more ear infections in six months or four or more in one year would qualify a child for ear tubes. Another reason for ear tubes would be if there is fluid in the middle ear that will not go away. Ear tubes would let the fluid drain. This is important because fluid in the middle ear can cause hearing loss. Long-term hearing loss can cause language and speech problems.

Is there an age when parents may start to notice ear/hearing issues?

About ¼ of infants will have an ear infection before their first birthday. Five out of six children will have an ear infection before their

third birthday. Ear infections occur most often in children six months to two years of age; however, children who are between four and eight years of age may also get infections.

Do tubes impact hearing?

A child may actually hear better after tube placement because the fluid that was in the middle ear can now drain and allows air in the middle ear.

Are some children predispositioned genetically to need tubes?

There are many studies that show there is a familial link. If a parent or sibling has had ear tubes, there is an increased chance the child will need tubes.

What are the benefits of tubes?

As mentioned earlier, because tubes allow fluid out of the middle ear and air into the middle ear there is a decrease in future ear infections and improvement in language and speech development. It is still possible to get ear infections with tubes in place, but those infections are much easier to treat. Usually treated with prescription antibiotic ear drops rather than systemic antibiotics.

Are there any drawbacks, complications or long-term effects to consider?

Any surgery that your child may have is a big deal to parents. As with any surgery, there is the chance of complications or side effects that should always be discussed with your child’s ear doctor beforehand. Your child will have to undergo anesthesia, which scares a lot of parents. Anesthesia today is very safe, much safer than 20 years ago; probably even more safe than flying or the car ride to the ear doctor. General risks of ear tube insertion with anesthesia include ear drainage, a hole in the ear drum that may not heal when the tube falls out, hearing loss, breathing problems, medication reactions, bleeding, infection.

How long do tubes last?

Ear tubes usually last about one year on average but that can vary anywhere from six months to close to two years. If they stay in over two years the ear doctor will assess the tubes and may choose to remove them surgically.

Are there any activities that need to be avoided when children have tubes?

Most parents worry about their child bathing/showering or swimming with ear tubes. Most children can shower or bathe like they normally would. Children can swim without earplugs as long as the body of water has been treated (such as a pool) and they are surface swimming. If they plan on diving more than 2-3 feet deep, earplugs are recommended. It is not recommended that children with ear tubes put their head under water that has NOT been treated such as lakes, rivers or oceans. Specific information and instruction provided by the ear doctor should always be followed.

How can Hamilton Healthcare System providers help children and parents through diagnosis, treatment and/or prevention of hearing-related illnesses or issues?

If there are any questions or concerns about ear infections or ear tubes, please call and make an appointment. The process includes a clinic history, physical exam, diagnosis, treatment and a referral if needed. At any of our three rural health care clinics, we are committed to helping and serving our community with the highest quality healthcare available.

Kaleb Davis is a nurse practicioner serving the Family Practice Clinic of Hamilton and Hico Clinic since 2021. He has worked in medsurg, ER, trauma and even as a traveling nurse before settling in Hamilton with his wife Brittany and children Alice and Harvey.

Kaleb Davis,

Hamilton Family Practice Clinic Hico Clinic

about Speech!

by CHRISSY HOPPER, MS CCC-SLP

What is speech therapy?

Speech-language therapy is the assessment and treatment for children with communication delays and/or speech and/or language disorders. It is performed by speech-language pathologists (SLPs), which are often referred to as speech therapists.

What is a speech delay?

A speech and language delay is when a child isn’t developing speech and language skills at an expected rate. Your child may not need treatment. Some children just take more time to start talking. But if your child needs treatment, a referral may be made to a speech-language pathologist for an evaluation.

It is important to understand that children develop at different rates and there is a developmental

Why do some children need speech-language therapy?

Kids might need speech-language therapy for many reasons, including:

• hearing impairments (may be related to chronic ear infections)

• cognitive (intellectual, thinking) or other developmental delays

• traumatic brain injury or stroke

• chronic hoarseness

• cleft lip or cleft palate or short frenulum

• autism or sensory integration disorders

• motor planning problems or weak oral muscles

• articulation problems

• fluency disorders

• respiratory problems (breathing disorders)

• feeding and swallowing disorders

Early intervention is important. Children who start therapy early (before they’re 5 years old) tend to have better results than those who begin later. This doesn’t mean that older kids won’t do well in therapy, but their progress might be slower, because they have learned patterns that need to be changed. With early intervention, speech therapy can improve communication, improve social-emotional skills and boost self-confidence.

progression to speech and language development. A sound substitution at 2 years old may be developmentally appropriate but the same error at 4-5 years old would need remediation. A great resource for communication milestones is found on the American Speech Language and Hearing Association’s website www.asha.org Your child’s pediatrician will also be able to provide you with resources for understanding developmental milestones.

What is a speech disorder?

A speech disorder refers to when a child is unable to articulate or produce speech sounds correctly or fluently or has problems with his/her voice.

What is a language disorder?

A language disorder refers to when a child has difficulty understanding others (receptive language disorder) or sharing thoughts, ideas and feelings completely or in socially acceptable ways (expressive language disorder.) Cognitivecommunication disorders are difficulties with communication skills that involve memory, attention, perception, organization, regulation and problem solving.

What are feeding disorders?

Dysphagia/oral feeding disorders are disorders in the way someone eats or drinks. They include problems with chewing, swallowing, coughing, choking, gagging and refusing foods.

What should I do if I suspect that my child has a speech or language disorder?

If you have concerns about your child’s speech, ask your child’s doctor or teacher for a referral for a speech-language evaluation or consultation. It is also important to have your child’s hearing screened at the doctor’s office or by a school nurse. If your child’s hearing is not within normal limits, he/she may need to see the physician and/ or have a referral to an audiologist, before the speech and language assessment can begin.

Where do I find speech therapy services for my child?

Speech therapy services can be provided through Early Childhood Intervention (ECI), which is a statewide program within the Texas Health and Human Services Commission for families with children birth up to age 3, with developmental delays, disabilities or certain medical diagnoses that may impact development. Speech therapy services can be provided through the public school districts

specialists

Home activities for enhancing communication skills:

• reading books and/or talking about pictures in books – don’t’ just read, but also stop and ask questions about the what’s been read, about the character’s feelings, about “what might happen next?”

• playing social games (i.e. peek-aboo, patty-cake, etc)

• playing I-Spy at home or in the car

• coloring together and comparing similarities/differences in the pictures

• working puzzles and building with blocks

• playing outside and talking about what you see, hear, smell and feel

• playing hide-and-seek (together or with objects) and use location words (i.e. you were “behind” the couch; I found the ball “under” the blanket, etc)

• cooking together

• playing board games or card games

• playing dress-up and pretend-play with your child

• make silly faces in a mirror

• eating at the dinner table together and talking about the day

for children ages 3 and up, as stated in the federal law called the Individuals with Disabilities Education Act (IDEA). Speech therapy services are also available through private organizations, pediatric hospitals and therapy clinics.

What can I do to help with my child’s communication skills?

Communication development begins in the first year of life! The best way to build communication skills with your child is through your daily interactions and modeling good speech! Look at your baby/ child when talking to him/her and respond when he/she makes a sound or says something. Speak clearly and ensure that you have your child’s attention when interacting. Make communication fun and meaningful.

specialists DY Decoding

Did you know?

The word dyslexia comes from the Greek language and means  poor language.

Signs to watch for as your child begins learning to read:

• Difficulty learning the letter names and their corresponding sounds

• Difficulty reading single words in isolation

• Difficulty spelling accurately and phonetically

• Slow, choppy and labored reading

• Avoids reading aloud

• Avoids reading for pleasure

• Difficulty understanding text because of slow and inaccurate word reading

Did you know?

Dyslexia is not due to either lack of intelligence or a desire to learn; with appropriate teaching methods people with dyslexia can learn successfully.

by sheila ondrusek, Misty Johnson and Kim Raibourn,HISD reading specialists

What is dyslexia?

The word dyslexia comes from the Greek language and means poor language, but the International Dyslexia Association's definition of dyslexia, published in the Dyslexia Handbook by the Texas Education Agency, is that dyslexia is a specific learning disability that is neurological in origin. It is characterized by difficulties with accurate and/or fluent word recognition and by poor spelling and decoding abilities. These difficulties typically result from a deficit in the phonological component of language that is often unexpected in relation to other cognitive abilities and the provision of effective classroom instruction. Secondary consequences may include problems in reading comprehension and reduced reading experience that can impede growth of vocabulary and background knowledge.

What does all of that mean? Let’s break down the definition of dyslexia:

“Dyslexia is a specific learning disability”

Dyslexia is one specific type of learning disability. It may exist along with other conditions such as attention deficit hyperactivity disorder (ADHD) or an oral language disorder.

“neurological in origin”

When a person has dyslexia, their brain works differently. These differences have been shown in studies of the brain.

“characterized by difficulties with accurate and/or fluent word recognition and by poor spelling”

The student misreads common words The student stumbles over words when reading. The student may read a word correctly once and then misread it another time. The student misspells common words and has problems using spelling rules.

“difficulties typically result from a deficit in the phonological component of language”

The “phonological component” is the sound system of our language. Phonological processing abilities include phonemic awareness-rhyming, blending sounds, and segmenting sounds. Phonological memory is the ability to remember the correct order of sounds in words. Rapid naming is another component, which is quickly naming things such as colors, numbers, letters and common words.

Problems with these skills lead to problems in learning to read.

Surprisingly, intelligence does not always lead to strong reading skills. This explains why a child who does well in other areas can struggle with reading.

“unexpected in relation to other cognitive abilities and the provision of effective classroom instruction”

The reading problem of the student with dyslexia is not predicted by the child’s age, intelligence or other abilities in school.

Failure to respond to good classroom instruction can help identify children who need more intensive instruction for dyslexia.

“secondary consequences may include problems in reading comprehension and reduced reading experience that can impede growth of vocabulary and background knowledge”

Recognize that if a child struggles to read, that child will read less. A child who reads less does not “practice” and does not progress as quickly as classmates. A child who reads less learns fewer vocabulary words and factual information.

What causes dyslexia?

The exact causes of dyslexia are still not completely clear, but anatomical and brain imagery studies show differences in the way the brain of a person with dyslexia develops and functions. Moreover, most people with dyslexia have been found to have difficulty with identifying the separate speech sounds within a word and/or learning how letters represent those sounds, a key factor in their reading difficulties. Dyslexia is not due to either lack of intelligence or desire to learn; with appropriate teaching methods, individuals with dyslexia can learn successfully.

What are the effects of dyslexia?

Dyslexia is a life-long status, however, its impact can change at different stages in a person’s life.

The impact that dyslexia has is different for each person and depends on the severity of the condition and the effectiveness of instruction or remediation. The core difficulty is with reading words, and this is related to difficulty with processing and manipulating sounds. Some individuals with dyslexia manage to learn early reading and spelling tasks, especially with excellent instruction, but later experience their most challenging problems when more complex language skills are required, such as grammar, understanding textbook material and writing essays.

People with dyslexia can also have problems with spoken language, even after they have been exposed to good language models in their homes and good language instruction in school. They may find it difficult to express themselves clearly, or to fully comprehend what others mean when they speak. Such language problems are often difficult to recognize, but they can lead to major problems in school, in the workplace, and in relating to other people. The effects of dyslexia can reach well beyond the classroom.

Dyslexia can also affect a person’s selfimage. Students with dyslexia often end

Y l xia e s

up feeling less intelligent and less capable than they actually are. After experiencing a great deal of stress due to academic problems, a student may become discouraged about continuing in school.

How common are language-based learning disabilities?

15-20% of the population have language-based learning disabilities. Of the students with specific learning disabilities receiving special education services, 70-80% have deficits in reading. Dyslexia is the most common cause of reading, writing and spelling difficulties. Dyslexia affects males and females and people from different ethnic and socio-economic backgrounds nearly equally.

Can individuals who have dyslexia learn to read?

Yes. Early identification and treatment is the key to helping dyslexics achieve in school and in life. If children who have dyslexia receive effective phonological awareness and phonics training in kindergarten and first grade, they will have significantly fewer problems in

learning to read at grade level than do children who are not identified or helped until third grade. 74% of the children who are poor readers in third grade remain poor readers in the ninth grade, many because they do not receive appropriate structured literacy instruction with the needed intensity or duration. Often they can’t read well as adults either. It is never too late for individuals with dyslexia to learn to read, process and express information more efficiently. Research shows that programs utilizing Structured Literacy instructional techniques can help children and adults learn to read.

How do people “get” dyslexia?

The causes for dyslexia are neurobiological and genetic. Individuals inherit the genetic links for dyslexia. Chances are that one of the child’s parents, grandparents, aunts or uncles has dyslexia.  Dyslexia is not a disease. With proper diagnosis, appropriate instruction, hard work, and support from family, teachers, friends and others, individuals who have dyslexia can succeed in school and later as working adults.

Other learning disabilities besides dyslexia:

Dyscalculia – a mathematical disability in which a person has unusual difficulty solving arithmetic problems and grasping math concepts.

Dysgraphia – a condition of impaired letter writing by hand—disabled handwriting. Impaired handwriting can interfere with learning to spell words in writing and speed of writing text. Children with dysgraphia may have only impaired handwriting, only impaired spelling (without reading problems), or both impaired handwriting and impaired spelling.

Attention Deficit Disorder (ADD) and Attention Deficit Hyperactive Disorder (ADHD) can and do impact learning but they are not learning disabilities.  An individual can have more than one learning or behavioral disability. In various studies, as many as 50% of those diagnosed with a learning or reading disability have also been diagnosed with ADHD.

Although disabilities may co-occur, one is not the cause of the other.

International Dyslexia Association

Region 1O Education Service Center

Luke Waites Center for Dyslexia and Learning Disorders

illiam Bradford Cannon, an American physiologist who died in 1945, first described the fight or flight response in his 1915 research on the emotional response to threats in animals. This theory has evolved over the years and is sometimes referred to as the fight, flight, freeze or fawn response. It is how we, as individuals, respond to a perceived threat to our safety or well-being. This includes threats to our emotional well-being as well.

Fight, Flight or Freeze

Recognizing and Managing the Stress Response in Kids

They may procrastinate, become avoidant or ignore the situation. They may physically move away from what they feel is the threat. They may appear anxious, panicked, scared, worried, or overwhelmed. These may ALL be stress responses if their go-to is flight.

Cathy Kolodziej, M.Ed, LPC, CSC, LCDC, NCC Hamilton ISD

Have you ever lashed out at someone or something when you knew good and well that they were not the source of your emotional discomfort? Your boss yelled at you, so you went home and yelled at your spouse, who then yelled at the kid, who then threw a toy across the room. Each of these actions was a response to a perceived threat. This response in children can take on many characteristics, and often, as adults, we see these responses in kids as being disrespectful or undisciplined and they are met with punishment. I would like to offer an alternative perspective.

Our brain switches on the fight, flight, or freeze response whenever it percieves danger. We are hard wired to stay alive and stave off danger. Our brain prepares us to run or to fight for our lives when we feel worried or anxious.

A child may yell, scream or use mean words. They may hit, kick, bite or throw punches. You may see them blame, deflect responsibility or become defensive. They may make demands or appear controlling. They may appear oppositional, defiant or non-compliant. You may think they are angry, unreasonable or aggressive. These may ALL be stress responses if their go-to is fight.

A child may attempt to hide or run away. They may suddenly find it hard to focus or pay attention. They may become fidgety, restless or hyperactive. They may become preoccupied with something other than the issue at hand.

A child may appear to shut down or have their mind go blank. They may isolate themselves. They may become verbally unresponsive, or say, “I don’t know” a lot. They may zone out or daydream and find it difficult to complete tasks. They may physically freeze or find it difficult to move. They may appear depressed, numb, bored or apathetic. They may feel helpless. These may ALL be stress responses if their go-to is freeze.

Many times, adults then perceive the child’s actions as a threat to their authority and have similar stress reactions of their own. It is important to be aware of what we are feeling as well as what the child may be feeling and to re-center ourselves. So how do we do this?

How do we turn off the stress response?

1) Exercise is key in managing many emotional distresses including stress, panic and anger. The fight or flight response gears the body up to do just that; fight or run for your life. If you are running from a percieved threat your brain knows you have survived when you stop to breathe. If you don’t run or fight, then the stress builds in your body, and the stress response remains.

Exercise can calm the nervous system by not only using energy in the body, but by lowering stress hormones and calming the mind. Any activity that gets the heart rate up can be surprisingly helpful. For a kid, this may mean a quick run or calisthenics such as jumping jacks. You may find it beneficial to take a walk with your child. Exercise increases endorphins, and endorphins make us feel good!

2) Feeling Safe. Knowing that we are safe is important. It can be frightening to feel unsafe, and this can induce physical symptoms such as headaches, stomach aches, tightness in the chest or the feeling that we can’t breathe.

School age children may frequent the school nurse as a stress reaction. They may actually be experiencing the symptoms they are complaining of and not be “faking it” just to go home, but there may not be any medical reason, but rather an emotional reason. It is important to listen to your child and seek medical guidance if this becomes a regular occurrence, but it is possible that your child may be exhibiting a stress reaction. It may be helpful to remind your children often that they are safe and loved.

3) Breathing

techniques can also be helpful in switching off the fight or flight response and inducing muscle relaxation. When we are upset, our breathing changes. We take short shallow breaths, which makes us feel even more anxious or stressed. There are many breathing techniques for managing stress, but they all involve deep breathing. Slowly breathe in, hold, slowly breathe out, hold, and repeat. It often helps to count as you complete each step. Slowly breathe in as you count to four. Hold your breath and count to four. Slowly breathe out as you count to four. It takes practice, but regulating our breathing can really help calm anxiety.

In philosophy, Occam’s razor is a problemsolving principle that states we should search for explanations “constructed with the smallest possible set of elements.” We often overthink and over complicate a situation when the answers may be more basic. Kids will be kids, and growing up obviously has learning curves. They may sometimes act in undesirable manners, and this is not an essay on the values of gentle parenting or the spare the rod spoil the child school of thought. This is just to encourage you all to take a deep dive into why your child may be exhibiting some of their behaviors. There are no bad kids. There ARE kids who don’t know how to move past their stress reactions.

Cathy Kolodziej received her Master's degree in counseling from Tarleton State University in 2011. She is a Licensed Professional Counselor at Hamilton ISD. Cathy is passionate about helping others discover their inner strength in order to achieve a better quality of life.

Coping with ADD/ADHD:

When it's hard to What parents should know about ADD/ADHD

Shelly Boyle, PA Hamilton Family Practice Clinic

but no signs of hyperactivity or impulsivity.

400 North Brown | Hamilton, TX 76531 (254)

www.hamiltonhospital.org

have ADD and ADHD is avaiable through

• Intervene. If you notice that your child is getting frustrated, over stimulated or about to lose self-control intervene early to prevent a bad situation. Try to distract your child, because, this may calm them down.

• Establish a bedtime routine. Bedtime may be very difficult for a child with ADHD, because it is very hard for them to fall asleep. Stick to a very strict routine. Make sure your child goes to bed at the same time each night and gets up at the same time every day. Avoid over-stimulating activities in the time before bedtime, such as watching TV.

• Stay involved. Finally, children with ADHD often have problems with their behavior at school, and this condition can negatively affect a child’s academic progress. Make sure to stay in touch with teachers, counselors and any extra support staff that may be available.

ADD and ADHD are usually recognizable before the age of six and are usually genetic in origin. However, the exact cause of ADHD is unknown. Other factors that may be associated with ADHD include premature birth, low birth weight and smoking, alcohol or drug use during pregnancy.

There are many treatment options available including things like therapy, educational support, supportive parents, counseling and medications.

The thought of having a child with ADD or ADHD can be very frightening for a parent. The fearlessness and impulsivity of the child along with chaotic behaviors typical of ADHD can make everyday activities very stressful for the parent. It is important to remember that a child with ADHD cannot always help their behaviors because it makes it difficult to suppress impulses, which means they cannot consider situations or the consequences before they act.

Diagnosis of ADHD or ADD can be made by the general practitioner or by a specialist. This privileges.

Shelly Boyle is a certified Physician Assistant who joined the Rural Health Clinic in the spring of 2015. She completed her undergraduate at Baylor University and Masters in Physician Assistant Studies from University of St. Francis in Albuquerque, NM. Shelly spent six years working with pediatricians followed by three years working with internists. She and her husband Jimmy have two sons.

Kayla Routh, APRN, FNP-C FPC Mills County

Kaleb Davis, APRN, FNP-C Hamilton Clinc Hico Clinic

Shelly Boyle, PA-C Hamilton Clinic

Kristen Stegemoller, MD FPC Mills County

Jim Davis, OD, FAAO Central Texas Eye Care

Jacque Wellborn, FNP-BC Hico Clinic Wound Care

by KYM JESCHKE

n any given Monday night, Olivia Leamon’s gym in Hico is full and her heart is, too.

Full Heart Gym opened in the old rock gym in 2019 for tumblers of all levels.

Owner and coach Olivia began when she was 12 years old.

S“I didn’t want to do it, but my mom made it part of my school curriculum,” she said. “She was right. I never stopped. It’s what I loved the most and stuck with the longest. I love what I do.”

Olivia began with Valerie Haymaker at Valerie’s gym in Dublin. She taught tumbling at the Studio in Hamilton when it was upstairs in the now-McGregor Real Estate building before moving to Jayson Harris Pavilion in the spring of 2010.

When Valerie closed her gym in 2017, she approached Olivia about purchasing her equipment.

“I purchased the equipment but with no place to put it, so it sat in storage for two years,” said Olivia.

“I love old historical buildings. When this came up as an option, it was confirmation. It put the things together that I love. It was the Lord’s doing. It’s been a huge blessing.”

The school board approved her use of the gym, and it has continued to grow each year.

Olivia’s competition team is in its third year and will compete in San Antonio for the first time this spring. The team consisted of three students the first year, six students the second year and this year, there are 12 competitors on the team.

community

Tumblers can begin at Full Heart Gym when they are three years old and potty trained. The oldest tumblers are 15 years old.

Olivia teaches three tumbling classes per night four nights per week. She normally has between 25 and 30 kids in the gym each night.

While she teaches several Hico students, kids come from Hamilton, Stephenville, Dublin, Lingleville, Iredell and Meridian.

Most students take tumbling one night per week while her competition kids take twice per week.

“I also teach an Octos class for kids under three and their parents,” said Olivia. “We started it to help them transition into the gym. It can be overwhelming for younger kids. Octos helps them to get used to being in the gym. That’s what I want, for them to be at home in the gym.”

Olivia also has a coach who comes in and teaches cheer prep for school tryouts.

“I don’t cheer,” she said. “That’s not my forte.”

Olivia is grateful for her mom, sister and brother, who all pitch in at the gym.

“It wouldn’t be possible without the parents,” she said. “They bring the kids and help with fundraisers. The community has been very supportive.”

During the summer, Olivia teaches swimming lessons at the Dublin pool. Last year, she taught 140 kids with the assistance of helpers from Hamilton and Eastland.

tumble into a good book by these local authors

Lizzie and Axel Forever Friends

Written by Chyanne Brake HCHD EMS Division Chief

For more information about Full Heart Gym, contact Olivia through the gym’s Facebook group.

Gym, contact Olivia through the gym’s

Losing a pet can be extremely traumatic and is often a topic that people do not know how to talk about with their children. Brake wrote this book after the loss of her beloved Lizzie to prepare chldren and maybe easy the pain of losing a pet.

When Daddy Comes Home

Written by Misti Polster

Illustrated by Emma Reich

This story is a creative look on the special bond fathers create with their children. Ann Whitney Elementary teacher Polster wrote the book for her children when her husband was a commercial airplane pilot. Reich later illustrated the story to share with her children and you. photos by kim hinton

It ain't easy being wheezyManaging Asthma in Children

such as recurrent wheezing, coughing, shortness of breath or chest tightness. Asthma symptoms can often be worse at night or be triggered by physical activity.

How do these symptoms differ from other respiratory illnesses /viruses?

hat is asthma?

Asthma is a chronic respiratory condition characterized by inflammation and narrowing of the airways.

What causes asthma in children?

Unfortunately, other respiratory illnesses such as viral or bacterial can sometimes overlap, making it challenging to differentiate. However, there are some significant distinctions including asthma symptoms are often chronic or recurrent, unlike other infections which have an acute onset and usually include fever, body aches and nasal congestion.

How are children diagnosed with asthma?

Children with asthma can participate in various activities. However, some activities may trigger symptoms such as running or strenuous cardiovascular activities, cold weather activities or exposure to allergens.

Can asthma be prevented?

Asthma cannot be completely prevented but there are strategies that can help reduce the risk of it developing. Parents can avoid smoking around children or during pregnancy, minimizing exposure to common allergens like dust, pet dander and mold and reducing air pollution exposure.

How serious is asthma in children?

Diagnosing asthma is a comprehensive process involving a thorough medical history, physical examination and diagnostic testing. It is crucial to consult a healthcare provider for accurate diagnosis and appropriate management.

Childhood asthma is a combination of genetic and environmental factors, but the exact cause of asthma in children is not fully understood. A family history of asthma or allergies may place an individual at a higher risk. Additionally, exposure to certain environmental factors, such as tobacco smoke, air pollution, respiratory infections during early childhood and allergens like dust mites or pet dander can contribute to the development of this condition in susceptible individuals.

At what age does asthma normally present in children?

Symptoms of asthma usually become noticeable before the age of five. However, asthma can develop at any age, beginning later in childhood or even adolescence.

What are the symptoms of asthma in children?

It is essential to be aware of potential signs

Is it a lifelong illness or can it go away with time and treatment/management?

Asthma is considered a chronic lifelong condition with no cure, but with appropriate treatment and management asthma can be controlled by reducing permanent lung damage and improving quality/activities of daily life.

Can children with asthma lead “normal” lives?

Yes, many children with asthma can lead active and healthy lives.

How is asthma treated or managed?

Asthma treatment includes various medications like albuterol inhalers and inhaled corticosteroids, avoiding triggers and having an asthma action plan. It is important for individuals with asthma and parents to work closely with their healthcare professionals to monitor and manage their condition over time. This includes regular checkups and adjustments of treatment.

Are there any activities or environments that should be avoided?

Uncontrolled asthma can cause sleep disturbances, limitations in activity and school absences due to flares.

What complications can present in children with asthma?

Complications due to a severe asthma attack can lead to life-threatening situation including hospitalizations due to respiratory failure and worse, death.

When should a child see a doctor if asthma is suspected?

If a parent suspects asthma in their child, we recommend contacting your child’s provider for an appointment to discuss testing and treatment.

How do providers at Hamilton Healthcare System clinics partner with parents to help treat and manage asthma in children?

Providers with Hamilton Healthcare System clinics are always available to work closely with parents of asthmatic children to develop a tailored management plan.

Trevor Watson is a family nurse practictioner at the Family Practice Clinic of Mills County. A 2001 graduate of Goldthwaite High School, Watson earned his Bachelor of Science from UT Arlington before entering the medical field. He is happy to be caring for the community that has given him so much.

Trevor Watson APRN, FNP-C FPC of Mills County

safety

ave you ever thought about how the internet is a world of its own? You wouldn’t let your kids roam freely in our world so don’t let them wander freely in the World Wide Web.

Being knowledgeable about the internet so you can better inform your child about safe practices on the internet is important to help your child navigate through the internet world. Teach your kids to be mindful while using social media platforms. Keeping posts private and being cautious of what you share are a few ways to practice internet safety.

Here are some guidelines for safer internet experiences:

• Monitor your kids closely while they are using the internet.

• Establish guidelines for your kids when they are using the internet so there are no grey areas in them knowing what they can and can’t do online.

• Don’t overshare. Make sure your children know not to share any personal information such as their name and locations where they can be found -- whether it be school, home or any other locations they frequent. They should also never share contact information, including their phone number or email.

for kids Pathway’s

Internet Safety

• Communicate. Talk with your kids about what they are using the internet for. Keeping open lines of communication about social media is important so they know they can come to you if they run into a problem.

• Monitor interactions with others while on the internet. Social interactions on social media can be a good or bad thing. It’s an amazing thing that our kids can now quickly and easily communicate with family and friends through social media. They also have access to interact with other people who may be outside of their normal social range.

• Nix cyberbullying.

With the increased amount of time, we spend socializing on the internet it opens up the door for online bullying. Cyberbullying is a real thing and has become more prominent with the amount of time we spend on the internet. Cyberbullying is bullying with the use of a digital device. Examples of cyberbullying are spreading lies or posting embarrassing photos or videos on social media, sending hurtful or threatening messages, impersonating someone else and sending mean messages.

•Honor age restrictions.

Although age restrictions are in place for social media sites, kids have found ways around them. The age restrictions vary depending which social network you are using. Age restrictions are in place to protect your children from being taken advantage of unknowingly; however, it is ultimately our responsibility to be sure our kids are age

appropriate on the internet. This is another reason why it’s important to keep a close eye while your kids are on the internet.

•Be mindful of mental health.

It is important to monitor our kids’ internet usage and be mindful of how it can affect their mental health. Examples of issues that have been linked to internet usage are attention and mood disorders, impulsivity, trouble sleeping and low self-esteem. These issues along with others are reasons that we need to closely monitor our kids’ internet interactions and be sure they are maintaining healthy social media habits.

Don’t let your kids wander alone in the World Wide Web! Let’s all do our part in protecting our kids from the dangers of the internet just as we do in our world. Remember the internet is limitless, so let’s be sure we have guidelines in place to set boundaries for our kids to help them navigate their way through it.

Jessica Howard Pathway Customer Service and Sales Representative

Meet the Counselor

Stress and Anxietyin Teens healthy mind

by kym jeschke

rittany Nichols, LCSW is a licensed clinical social worker providing counseling services for teens and adults through the Family Practice Rural Health Clinic in Hamilton.

With more than ten years of experience, she has worked with individuals impacted by trauma, as well as depression, anxiety, substance use disorders, grief and stress.

“I enjoy helping people,” said Brittany. “I help people understand their emotions and what they are experiencing.”

Brittany believes in a holistic approach to treatment.

She uses cognitive behavioral therapy, which explores the relationship between thoughts, emotions and behaviors, to treat a variety of issues.

Brittany also likes to use dialectical behavior therapy, which incorporates mindfulness to help regulate emotions and reduce stress.

“I love helping people reach those light bulb moments where they realize ‘this is normal’ or ‘I’m allowed to feel this way’,” she said.

Stress is a normal part of regular life transitions, but sometimes we need someone to talk to; someone to, help work through things, explains Brittany.

Ongoing difficulties with sleep, increased headaches, trouble concentrating, interruptions in the ability to function day-to-day and physical manifestations are all indicators of stress buildup. Counseling could be beneficial.

“I believe in therapy,” said Brittany. “If you need it, I am here.”

Place a call to your primary care physician for a referral to counseling services with Brittany.

o matter our age, we all deal with day-to-day stressors and can experience periods of increased stress related to life circumstances. Adolescence can often present specific stressors, including school issues, social or peer challenges, instability within the home environment, and life transitions, such as going to college and entering the workforce. Although the terms may be used interchangeably, distinct differences exist between what we would regard as “typical stress” versus anxiety.

their teens, as these may indicate a need for increased support.

Just as learning signs and symptoms of stress and anxiety are important, it is equally crucial to understand what may trigger or make a teen more vulnerable to experiencing stress or anxiety. Although there are a plethora of factors that may contribute to stress and anxiety in teens, we will focus on a few common external factors here.

Academic stress is relatively common among teens, including anxiety surrounding testing, making good grades, meeting expectations set by parents and teachers, and pressures related to transitioning to higher education.

Stress is the natural physical or emotional response to an external cause. Stress is not an inherently negative phenomenon. If we had no stress at all, we would lack motivation to work, achieve good grades, meet deadlines, and reach our goals. However, it is important to recognize when stress has become chronic or overwhelming, as this could be an indication of a more serious anxiety disorder.

Anxiety disorders are among the most common mental health disorders in America. According to Johns Hopkins All Children’s Hospital, about one in 10 adolescents will experience anxiety symptoms that reach a clinical level. Both stress and anxiety have the ability to impact mental, emotional, and physical health. Symptoms related to typical stress and anxiety are not long-lasting and may subside in hours to days.

Symptoms of anxiety disorders, however, are often chronic and interfere with the ability to engage in regular life. Symptoms of anxiety disorders often include excessive and repeated worries or fears that are difficult to control, persistent feelings of apprehension or dread, patterns of avoidance, difficulties with sleep, issues with concentration, and frequent somatic complaints, such as headaches or stomachaches.

Important growth and development occurs in the brain during adolescence, and research suggests that this ongoing development may leave teens more vulnerable to stress and impact things like decision-making and the ability to regulate emotions effectively. As neuroscientists continue to study the adolescent brain, findings suggest that parents play an influential role in helping teens learn to process and regulate emotions, including stress and anxiety. It is, therefore, important for parents to be mindful of changes they may notice within

Another contributing factor to stress and anxiety is lack of sleep. Adequate sleep is essential for optimal growth and development in adolescents, and not getting enough quality sleep contributes to heightened stress and further decreases teens' ability to manage emotions effectively.

Because adolescence is naturally a time of increased emphasis on peer relationships, social pressures can certainly contribute to feelings of stress and anxiety in teens. Of course, in this technological age, this undeniably includes social media and digital interactions.

Additionally, stress or discord within the home environment can be a significant stressor for teens. Home-related issues may include rigid expectations or pressure from parents, marital issues in the home, chronic illness within the family, financial issues, or strained sibling or parental relationships.

Managing stress is vital, as chronic stress paired with poor coping impacts overall health and can place teens at risk for an anxiety disorder. As parents, we have the power to support, teach, and influence our teens in a positive direction toward managing emotions and making healthy decisions.

While stress is an inevitable part of life, adolescence can be a unique and challenging time for emotional development. Being mindful of signs your teen may be exhibiting is essential for helping them to navigate this critical time. If you believe your teen is struggling with ongoing anxiety and needs additional support, reaching out to their primary care doctor for guidance can be a positive step. Their symptoms may meet a clinical level that could require additional therapeutic or medical intervention. Rest assured that clinical anxiety is treatable and often responds well to therapeutic intervention. Otherwise, simply being proactive with listening and offering guidance can go a long way toward helping teens manage their stress.

Brittany Nichols, LCSW Hamilton Family Practice Clinic

Tips for supporting your teen:

• Encourage your teen to ask for help or support from teachers, school counselors, etc. for managing academic stress.

• Help them reevaluate their weekly schedule, including extracurriculars, as they may be taking on too much.

• Work with your teen on time management strategies, i.e. prioritizing and breaking down tasks, making to-do lists, taking breaks, etc.

• Encourage a regular sleep pattern. This may include setting boundaries related to technology use in the evenings or encouraging a relaxation routine.

• Encourage boundaries with social media/digital use. Part of this includes setting an example of healthy boundaries with your own technology habits.

• Offer acknowledgement and praise for even the smallest of accomplishments.

• Lead by example. This includes managing your own stress in a healthy manner, modeling proper emotional regulation, and normalizing seeking help and support.

• Pay attention to your teen’s feelings, and try to talk with them in a supportive and nonjudgmental manner, communicating that you want to be there to support them.

• Do not hesitate to seek additional help or guidance, if needed.

Brittany Nichols is a Licensed Clinical Social Worker with over 12 years’ experience in this field. She received her Bachelor of Social Work from the University of North Texas and her Master of Social Work from Texas A&M University-Commerce. She joined Hamilton Healthcare System in November 2021 and currently provides counseling through the Family Practice Rural Health Clinic in Hamilton. She is passionate about helping others know their worth and learn to lead happy and fulfilling lives.

by MARIA WEAVER

hat zit? The huge one taking up your whole face?

Everyone sees it. Pop it, they say. So tempting. So satisfying. But don’t.

“Nope, don’t pop it,” said Dr. Rusty Rowe of Real Skin Dermatology.

“If it comes out, great, but if it goes to side, it causes scarring. If you pick it or mash it, there’s the potential to cause scarring inside the skin.

“Just let it express out on its own. It’s easier to fix acne than scars.”

Acne can’t be prevented. It’s caused by increased oil production and bacteria that live on the skin. The bacteria dive into the oil glands and cause an inflammatory reaction. Inflammation causes acne.

It’s most prevalent in teens and women from their 20s to their 40s.

Dr. Rowe said this is because hormones cause an increase in oil production.

Acne is typically multiplied by open or closed comedones, which are small, flesh-colored, white or dark bumps that give skin a rough texture. The bumps are one type of acne. They are found at the opening of skin pores. A solid core can often be seen in the middle of the small bump.

arise when cells lining

Rusty Rowe, M.D. RealSkin Dermatology Hamilton Clinic

The bumps arise when cells lining the sebaceous duct proliferate and there is increased sebum production. A comedone is formed by the debris blocking the sebaceous duct and hair follicle.

When the sebaceous gland gets clogged, bacteria live inside and cause increased thickening that form pustules, which are whiteheads. Blackheads are open comedones; and whiteheads are closed.

“Whiteheads have pus inside,” Dr. Rowe said. “Washing with soap one or two times a day is important at any age,” he said. “In the preteen timeframe, a gentle cleanser is recommended.”

skin health pop it!

Then, if acne develops, an over-the-counter benzoyl peroxide wash such as one made by Neutrogena is great.

The next step is to kill the bacteria and dry up the oil glands, said Dr. Rowe. For this, dermatologists use Retin A.

“Right now, all Retin A is prescription except Differin, which is over the counter as of a year ago,” he said. “It’s a mild OTC Retin A.

“If you don’t want to see a doctor, buy benzoyl peroxide, and use differin adapalene.

“Once those don’t work, see a physician because you may need to be put on topical antibiotics and prescription-strength retinoids.

“The final step is oral antibiotics or Accutane,” he said.

The myths abound for treatment of acne – ice, crushed aspirin, honey, tea, tea tree oil, Vaseline and toothpaste - are ineffective.

“Lots of people use apple cider vinegar,” he said. “I’m not going to tell them not to, but that’s not what the science says. My advice is based on science and literature.

“There is very little data that anything oral makes it worse or improves it,” he said. “That’s a bummer, but eating chocolate will not make

it worse.

“There are some commonsense things you can do, like if you play sports, wash that chin strap on your helmet. The dirt from that can really clog your pores.”

With prom time right around the corner, lots of young ladies are worried about the bumps on their arms and backs. Sleeveless or strapless lose their effect when blemishes interfere.

“That’s keratosis pilaris,” Dr. Rowe said. “That’s totally different. Those don’t make open and close comedones, which is the hallmark of acne.

“This can be treated with a topical steroid to decrease inflammation. You’ll outgrow it. Please, please do not wax it. Please. It becomes a huge mess.

“These are sebaceous glands influenced by hormones. Your skin gets upregulated before your period, and stress can influence it through the immune system.

“Dysregulation or changes in hormonal status will affect acne. Puberty, menstrual cycles,

things like that.”

If none of the OTC products work, Dr. Rowe suggests seeing your primary care physician, and if nothing there works, see a dermatologist, who has different tools and skills to treat acne.

Dr. Rowe and Physician’s Assistant Nicholas Hagood serve patients in Hamilton, Comanche, Waco, Gatesville, Clifton, Marlin, Temple, Fairfield and Hillsboro.

For more information, visit realskinderm.com.

Dr. Rusty Rowe is Board Certified in Dermatology and Micrographic Dermatologic Surgery.  He retired from Army Medicine after 22 years of service.  Dr. Rowe is the founder of RealSkin Dermatology with 10 clinic locations in Central Texas, including Family Practice Rural Health Clinic in Hamilton, “serving you, closer to home.”

finance 529s: College savings tool and more!

hese versatile savings accounts are a powerful estate planning vehicle.

Most of us associate 529 accounts with college savings. They’re flexible, allowing you to transfer assets to anyone, including yourself, for the express purpose of furthering the education of your beneficiary. But did you know that a 529 can be a powerful estate planning tool?

Modern estate planning

These specialized savings accounts have advantages for the beneficiaries – but there are benefits for the donors, too, given the tax advantages and the option to change heirs.

The tax rules that govern these accounts allow you to pare down your taxable estate, potentially minimizing future federal gift and estate taxes.

With 529s, you can make a lump-sum contribution of up to five times the annual limit of $18,000. That means you can gift $90,000 per recipient ($180,000 for

married couples), as long as you denote your five-year gift on your federal tax return and do not make any more gifts to the same recipient during that five-year period. However, you can elect to give another lump sum after those five years are up. In the meantime, your investments have the luxury of time to compound and potentially grow.

Other benefits

Many people worry that gifting large chunks of money to a 529 means they’ll irrevocably give up control of those assets. However, 529s allow you quite a bit of control, especially if you title the account in your name. You can change the beneficiary to another member of the family as many times as you like, since most 529s have no time limits.

If your chosen beneficiary receives a scholarship or financial aid, they may not need the money you’ve stashed away in a 529. You can earmark the money for other types of education, like graduate school. Or you can take the money and pay the taxes on any gains. Of course, that means it becomes part of your taxable estate again subject to your nominal federal tax rate, and you’ll have to pay an additional 10% penalty on

Melanie J. Housden, AAMS® is both founder of Melanie J Financial, LLC, an independently owned and operated financial planning and investment advisory practice located in Hamilton, and a Wealth Management Advisor with Raymond James Financial Services. She and the team at Melanie J Financial bring more than two decades of financial planning experience to Central Texas.

the earnings portion of the withdrawal. You can always use the funds to pay for other qualified education expenses, like room and board, books and supplies.

Many plans offer you several investment choices, including diversified portfolios allocated among stocks, bonds, mutual funds, CDs and money market instruments, as well as age-based portfolios that are more growth-oriented for younger beneficiaries and less aggressive for those nearing college age.

Saving for college takes discipline, as does estate planning. Talk to your professional advisor about the nuances of different investment strategies and vehicles before making a years-long commitment.

Raymond James and its advisors do not offer tax or legal advice. You should discuss any tax or legal matters with the appropriate professional.This material is being provided for information purposes only and is not a complete description, nor is it a recommendation. Prior to making an investment decision, please consult with your financial advisor about your individual situation. Investors should consider, before investing, whether the investor’s or the designated beneficiary’s home state offers any tax or other benefits that are only available for investment in such state’s 529 savings plan. Such benefits include financial aid, scholarship funds, and protection from creditors. As with other investments, there are generally fees and expenses associated with participation in a 529 plan. There is also a risk that these plans may lose money or not perform well enough to cover education costs as anticipated. Most states offer their own 529 programs, which may provide advantages and benefits exclusively for their residents. The tax implications can vary significantly from state to state. Favorable state tax treatment for investing in Section 529 college savings plans may be limited to investments made in plans offered by your home state. Investors should consult a tax advisor about any state tax consequences of an investment in a 529 plan.

Melanie J. Housden, AAMS

Melanie J. Financial

At that time the disciples came to Jesus, saying, “Who is the greatest in the kingdom of heaven?”

And calling to him a child, he put him in the midst of them and said,

“Truly, I say to you, unless you turn and become like children, you will never enter the kingdom of heaven. Whoever humbles himself like this child is the greatest in the kingdom of heaven.

Matthew 18:1-5 ESV

children

he early years are the most formative years of one’s life.

When we are young, there is so much learning that just becomes ingrained into us and sticks with us. Much of that learning comes from watching those around us, even if we don’t realize it. But they see our actions and learn. That’s an essential part of that stage of life. And we know that it is crucial for us to never stop learning. Yet, we never really stop and think about how while we have much that we can teach children, they too, have much that they can teach us.

anything and everything. And they always have energy. Way too much energy. But those things don’t last.

Some of these traits don’t last for good reasons. Father Time is undefeated, and we can’t just combat that. But the other traits usually go away for not-so-great reasons. We stop asking questions, not because we know everything but because we are too prideful to admit when we don’t know something. Our optimism diminishes as we go through life and experience the world. And our trust has been given out to so many people and broken so many times that we usually don’t trust anything unless we see proof. That’s just the sad reality.

In Matthew 18, Jesus calls on his disciples to be like little children to enter the Kingdom of Heaven. Even the Son of God knows that there are lessons that we need to hear from them. But what are these lessons? After all, he tells us to become like little children, but I don’t think he means for us to shrink down to their size.

One of the first things that he wants us to understand is that children’s minds are innocent. In verse 6, he says that anyone who causes them to stumble will be punished. Because children are trusting, they believe what you tell them. They’re curious-never afraid to ask questions. They are optimistic, always seeing the best in

But Jesus, as one who lived in this reality with us and experienced all of this, tells us that the key to entering God’s Kingdom is to be like a child. Because our Father has never broken our trust, he wants to hear all of our questions, as childish as we might think they are, and we should be optimistic because Heaven will be far better than our wildest dreams. And maybe we can even run forever when we’re there!

We have a lot to teach children about life, like what it means to be good, what it means to love others, and, hopefully, what it means to follow Christ. But they have just as much to teach us, too. How we approach God should be the same way a child approaches the world: with complete faith and trust, abounding curiosity, joyful optimism and all the energy and excitement we can muster.

Andrew McClintock Youth Minister FBC Hamilton

FREE HEALTH SCREENINGS CLOSE TO YOU

BROUGHT TO YOU BY MONCRIEF CANCER INSTITUTE

Free mammograms for women

40+ without insurance and those who qualify

Mammograms are scheduled at Hamilton General Hospital

400 N. Brown St. Hamilton, TX 76531

YOU MUST CALL 800-405-7739 TO SCHEDULE AN APPOINTMENT.

Funding for breast screening is provided by the Cancer Prevention and Research Institute of Texas (CPRIT) and Texas Health and Human Services Commission (HHSC).

5% of 10-year olds may still wet the bed

Bedwetting

pring is a time marked by new life and new growth. Much like the wildflowers growing taller in the fields, our children are growing and changing as well. One of the parts of childhood that can be a difficult challenge for young families (and their more seasoned grandparent caretakers!) is the age-old problem of bedwetting.

What is bedwetting?

Bedwetting, or “nocturnal enuresis," is the involuntary release of urine during sleep. Importantly, a true diagnosis of bedwetting can’t be made until age 5. Although many parents potty-train at much younger ages, it is considered very normal to struggle with nighttime accidents up until that age.

Who is affected by bedwetting?

Tyler Stewart, M.D. Urologist Hamilton Family Practice Clinic

surgery is it just a tummy ache or APPENDICITIS?

hat is the appendix, where is it and what does it do?

The appendix is a small, tail-like projection located in the abdomen and is connected to the large intestine. It is normally located in the lower abdomen, on the right. For many years it was thought that the appendix had no real function or purpose. We now understand that it is a part of the gut-associated lymphoid tissue system (GALT). The GALT is a component of the body’s immune system.

What is appendicitis?

What causes appendicitis?

Ryan Adams M.D. General Surgery Specialty Services

walk or move without making the pain worse. Even bumps in the car while driving can cause pain in advanced appendicitis.

Appendicitis is an inflammation of the appendix that is usually caused by a bacterial infection.

Appendicitis is usually caused by an occlusion of the inside of the appendix. This is most commonly from hard stool, but can also be caused by other conditions that cause the appendix to swell, eventually leading to a bacterial infection.

Can it be prevented?

There is no definitive way to prevent appendicitis, but a healthy diet that is high in fiber can reduce the risk.

Who is most likely to get appendicitis?

Men get appendicitis at a slightly higher rate than women. Appendicitis occurs most frequently in the second and third decades of life, but it can occur at any age.

What are the signs and symptoms of appendicitis?

The classic signs and symptoms of appendicitis are pain in the lower right abdomen, loss of appetite, nausea and vomiting, and fever. Initially appendicitis symptoms may be vague, but will usually worsen with time. It usually gets to the point that normal activities cannot be performed, prompting people to seek medical care. Appendicitis commonly starts with pain near the umbilicus that then migrates to the right lower abdomen. It can become difficult to

How can you tell the difference between a stomachache, gas, kidney pain and appendicitis? It can sometimes be difficult to tell the difference between appendicitis and other gastrointestinal issues- especially early in their onset. That is why it is important to seek medical evaluation in a timely manner to help establish the correct diagnosis and treatment. What complications can arise from appendicitis?

Perforation of the appendix is a common complication. Formation of an abscess in the abdomen, near the appendix can also occur. If not diagnosed in a timely fashion, the infection causing the appendicitis can also spread to the rest of the body causing sepsis or even death.

How fast can appendicitis progress?

Progression can vary from person to person, but the symptoms usually worsen in the first 24 to 48 hours.

When should you seek medical attention, and how important is it?

If the symptoms of appendicitis are present and increasing in severity, you should seek medical attention. Complications from appendicitis usually increase if the diagnosis is not made in the first 24-48 hours. It is extremely important to seek medical attention if you suspect appendicitis because if undiagnosed, there can be serious, even fatal complications. Additionally, if diagnosed early, treatment and recovery can usually be simplified and shortened.

How is appendicitis treated?

Surgery and antibiotics are the two main treatments for appendicitis

Do you perform appendectomies? even on kids?

Yes. Appendix surgery is one of the most common abdominal surgeries performed worldwide, and as a general surgeon, it is one of the most common surgeries I perform. Advances in minimally invasive surgery and the treatment of appendicitis have dramatically changed the experience for many patients with appendicitis. I routinely perform outpatient appendectomies and utilize modern approaches for pain control that lead

to shorter recovery times and reduce patient suffering. Though discomfort is an expected part of recovery after surgery, most people note an almost immediate improvement in how they feel after their appendectomy.

Describe the appendectomy procedure.

A laparoscopic appendectomy is done in the operating room with the patient under general anesthesia. The surgery is done by making small incisions in the abdomen and using a camera and small surgical instruments to perform the surgery. The appendix is detached from the colon using surgical instruments and is then removed from the abdomen. The operation usually lasts 45 minutes to an hour.

What are parents’ common fears, and how do you reassure them?

It is a normal human response to feel some apprehension or anxiety when you are sick and need surgery. I reassure my patients that the relief they will feel after surgery will be almost immediate. We have a large surgical team made up of surgical, anesthesia and nursing providers that all work together to provide excellent care before, during, and after surgery.

What is recovery like from an appendectomy?

After appendectomy, patients can walk and care for themselves in the usual way. They should limit any physical or strenuous activity for 2-3 weeks while they heal and recover. They will usually start with a soft diet and return to their normal diet in a few days. I see them back in surgery clinic two weeks after surgery where I can examine them, and if they are healing well, they can usually return to normal activity shortly thereafter.

Are there any side effects or long-term effects of not having an appendix?

Scar tissue forms as a normal part of recovery from surgery. This normally is not an issue, but occasionally it can cause problems in the future. Talk to your doctor or surgeon if you experience any issues.

Board Certified General Surgeon Dr. Ryan Adams joined Hamilton Healthcare System in 2019. He treats a broad range of conditions with an emphasis on trauma and acute care surgery. Dr. Adams has specialized training in advanced laproscopic surgery to treat biliary disease.

home

Sanitize Toys with:

• Clorox or Lysol wipes.

Looking for a more natural wipe? Try CleanWell or Seventh Generation. The cleaning surface must be wet for at least 10 seconds to sanitize.

• Peroxide. A cloth wet with a a 3% hydrogen peroxide solution.

• Diluted bleach. 1/2 cup chlorine bleach and one gallon of water. Surfaces must stay wet for five minutes. Bleach can be irritating on the respiratory system, so be careful.

If you use disinfectant sprays, read the instructions and use as directed in a well ventilated area. Never mix cleaning chemicals.

Cleaning Toys

ids share everything, especially germs. As with all infection prevention, the most important thing is to teach kids is frequent and proper hand washing. Other important areas include good respiratory hygiene like covering their cough, avoiding touching their eyes, nose and mouth and staying away from others when they are sick. That means not going to school until they are fever free for at least 24 hours. Frequent disinfection of high touch areas, including toys, is also important to prevent the spread of infection.

Kim Edwards, RN CIC Infection Control Employee Health

rack of the dishwasher. Beware bath toys with holes as they are susceptible to mold. If you ever see mold inside a toy or mold comes out when you shake or squeeze it, immediately toss the toy out.

• Plush toys should be machinewashed weekly or every other week, if possible, depending on how often they are loved. Toys can be placed in a pillow case and run through the gentle cycle. Plush toys that are slept with should be cleaned more often. Check the labels for cleaning instructions. For plush toys that cannot be laundered, use a cloth and sudsy water, then allow to air dry. Also, try a garment steamer and your vacuum’s upholstery attachment.

• Electronics should be wiped with sanitizing wipes weekly and any time a child is sick.

In addition to routine cleaning, toys should be cleaned and disinfected any time a child has been sick, the toy has been dropped on the ground or been in another child’s mouth or when the toy has food, vomit or mucus on it.

• Plastic toys. Sanitize hard plastic and bath toys weekly if they, are played with daily. Try running them in the top

• Baby toys, especially those that are frequently chewed on, should be cleaned the most frequently -- every day or every other day.

Kim Edwards, RN, CIC, is the infection control nurse for Hamilton Healthcare System. With 27 years of nursing experience, she is dedicated to educating others and promoting illness prevention.

Did you know?

The top ten germiest places in the home include the kitchen sponge, kitchen sink, toothbrush holder, pet bowl, coffee reservoir, faucet handles, countertops, stove knobs and cutting boards.

National Sanitation Federation

Carl G. Chakmakjian, D.O., FACP • Tyler W. Snedden, M.D. • Thomas J. Harris, M.D. • Rachel Ramsey, NP, AOCNP

Carlos A. Encarnación, M.D., FACP • Ofobuike N. Okani, M.D., FACP • Katie Bone, MSN, APRN, FNP-BC

Dawn Turner, RN, FNP-C, AOCNP • Justin W. Wray, M.D., Ph.D.

When you’re treated at Texas Oncology, you’re getting leading edge cancer care right here in Waco. Our skilled physicians fight cancer with breakthrough clinical trials and the latest treatment innovations — so Texans everywhere can receive recognized cancer care in their own community.

Waco, TX 76712 • 254-399-0741

Texas Oncology–Horizon Circle

6520 Horizon Circle

Waco, TX 76712 • 254-755-4460

3 MC BANK 800-285-2216 mcbanktx.com

4 WACO CARDIOLOGY ASSOCIATES 254-399-5400 wacocardiology.com

6 SOLARIS 1-888-3SOLARIS solarisfamily.com

9 COMPANION SENIOR CARE 254-784-0300 companioninhomeseniorcare.com

10

254-386-3216 HamiltonTexasChamberofCommerce.com

11

13 JORDAN

254-386-3111 jordanpharmacy.com

21 RAY’S

21

29

254-785-3278

COMMUNITY RESOURCES

General Assistance

211 Texas

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

Texas Health & Human Services Office

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

Lone Star Legal Aid 1-800-234-6606

Hamilton Co. United Care Food & clothing 254-206-7371

Hamilton Community Center Daily free lunches 254-784-3358

Hill Country Community Action 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 1-800-447-7169

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

Suicide Crisis Talk or Text 988

Texas Health & Human Services COVID 19 Mental Health Support Line 1-833-986-1919

Crisis Text Line

www.crisistextline.org

Text HOME to 741741 to connect with a Crisis Counselor Free 24/7 support at your fingertips

Mental Health & Developmental Disabilities

Central Counties Services 254-386-8179

Crisis Hotline 1-800-888-4036 •

Adult Substance Abuse

Texas Health & Human SvcsBluebonnet Trails

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

•

Women & Children

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

Domestic Violence

HOPE – Tri-Rivers Domestic Violence Emergency Shelter Emergency Shelter & Assistance for DV Survivors 254-865-2151

W.A.V. Project Shelter & support 325-648-3326

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

memorial The Children’s

estled in the Serenity Garden on the north side of Hamilton General Hospital, the Children’s Memorial adds an element of beauty and peace that includes a water feature and beautiful rock wall remembering and honoring lost children who will be forever loved and cherished. Any child who passed before their 18th birthday can be recognized with a 4x8 inch red brick paver with their name and date of birth or date of passing for $100.

Loved ones can also be remembered or honored in tiles in the Tribute Walk that winds through the garden. Three brick paver sizes are available: 4x8 for $100, 8x8 for $250 and 12 x12 for $1,000.

Honorary and memorial tiles for both the Tribute Walk and Children’s Memorial are available for purchase for placement in the Serenity Garden. Forms can be obtained at the Hamilton General Hospital Administration office or by calling 254-386-1950.

A Hamilton Healthcare System Auxiliary Team project, the Serenity Garden is maintained by the volunteer group committed to making a difference in the lives of visitors and the healthcare team. The Serenity Garden provides healing and comfort to patients, their families and hospital staff.

Funds raised from the sale of each honorary and memorial tile assist the Auxiliary’s Serenity Garden project and support other projects to further improve patient care and support the growth of the Hamilton Healthcare System.

Support the future of healthcare.

One of the trademarks of a progressive community is strong commitment and support of high quality healthcare services. Central Texans are fortunate to have outstanding healthcare professionals and facilities in Hamilton, Hico and Goldthwaite, 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.

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

HAMILTON GENERAL HOSPITAL HEALTHCARE FOUNDATION

Providing excellence in rural healthcare

P.O. Box 788 • Hamilton, Texas 76531

Donate online at hamiltonhospital.org/hghh-foundation.

Specialized Wound Care

Car Seat Safety

oad injuries are the leading cause of preventable deaths and injuries to children in the United States. Correctly used child safety seats can reduce risk of death by as much as 71 percent. However, more than half of car seats are not used or installed correctly.

The best way to keep your child safe in the car is to use the right car seat in the right way.

Hamilton EMS employs two certified car seat technicians who often incorporate car seat checks with community events. Watch for upcoming events at Hamilton EMS on Facebook.

Here are some care seat safety tips to protect your most precious cargo.

1. Buy the right car seat. Your baby needs to ride in a rear-facing car seat as long as possible until two or more

years. When your child has outgrown the seat, you are ready for a forward-facing car seat.

2. Install your car seat. You will need to decide on using either the seat belt or lower anchors to secure your car seat. Both are safe, but don't use them both at the same time. Once your child is forward facing, it is important to use the tether with the seat belt or lower anchors.

3. Get the right fit. A properly fitted harness gives the best possible protection for your child.

Hamilton Healthcare System Wound Care is here to provide individualized care to all patients. With advanced treatment plans and specialized wound products, our experienced staff is committed to your healing process.

Our clinic is excited to announce the addition of Dr. Ryan Adams to our team as our clinic Medical Director. With a background in general surgery, Dr. Adams' experience will provide a continuum of care for wound patients.

Contact the clinic today for more information about keeping your wound care needs close to home!

4. Know when to change your car seat. Look on the car seat label to ensure your child is still within the weight, height and age limits for that seat.

Fun things to see & do with kids explore

April

May

June 15 R. Crouch Memorial Bull Riding

June 21-23 World Series Team Roping

Circle T Arena

5 miles west of Hamilton on Hwy 36

June 4-7 Summer

summer

June

June

June

June

July

Hamilton Public Library 201 N Pecan St. in Hamilton • hamilton-public-library.org

Jennie Trent Drews Library 1113 Fisher St. in Goldthwaite • jtdlibrary.net Open Mon. - Thurs. 10 a.m. to 6 p.m.