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Boone Health FALL 2019

What’s Cooking at Boone PG . 18

PG. 14

An OB/GYN’s take on home births


When you don’t need an ambulance, but can’t wait for an appointment. Boone Medical Group can see you same-day to give you the urgent care you need at one of our convenient care clinics, and get you scheduled with a long-term provider for your ongoing care. And it never hurts to have the area’s only five-star hospital on your team. Schedule an appointment at one of our primary care clinics or walk-in to one of our convenient cares whenever you need us.

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Table of Contents 18

President Jim Sinek Director of Marketing & Public Relations Ben Cornelius Communications Consultant II Jessica Park Digital Communications & Marketing Consultant II Madison Loethen Marketing Consultant I Erin Wegner Photography Tiffany Schmidt, Sadie Thibodeaux Contributing Writers Brandon Grammer

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Please submit comments or feedback to bcc1170@bjc.org or call 573.815.3392 1600 East Broadway Columbia, MO 65201 573.815.8000

For a FREE subscription, call 573.815.3392 or visit myBooneHealth.com and click on the subscription link on the right side of the page.

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A Note from Jim

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Bringing Up Boone Babies

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Hospital Headlines

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Introducing Chef Sam

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An Update from the

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Meat Substitutes

Board of Trustees

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Wound Healing Clinic

Pritikin Intensive Cardiac Rehab

Get to Know a BHC Doctor

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Enhanced Detection

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Get to Know a BHC Nurse

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Balance Exercises

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Foundation News

of Breast Cancer

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An OB/GYN’s Take on Home Births


I believe in Boone. Richard King | Founder of Roots N Blues Festival


A NOTE FROM JIM

Priority Access Health Plan Have you ever wished that you could buy the highest quality product at a lower cost? Well, now you can! The Priority Access Health Plan is a health insurance product currently being offered to employers so that they can offer the plan to their employees. The Priority Access Health Plan will be available through participating employers’ employee benefits packages, which are typically available during the employer’s benefit open enrollment period. Fall is when numerous employers hold open enrollment periods for benefits effective on January 1, 2020. The Priority Access Health Plan may appeal to you and your family because it provides access to the Boone Hospital Center and both our independent and employed medical staff. Boone Hospital Center is mid-Missouri’s #1 ranked hospital by U.S. News & World Report, and the only hospital in the area rated five stars by the Centers for Medicare & Medicaid Services. Our #1 ranking and CMS five-star ranking validate the superior clinical quality that Boone Hospital Center and our medical staff bring to the Priority Access Health Plan. In addition, the Missouri Hospital Association (MHA) has verified through a survey of all hospitals in Missouri that not only are Boone’s clinical outcomes better than our local competitor, but our costs are significantly less. This data is published on the MHA website focusonhospitals.com. I have provided a list of the more prevalent clinical quality indicators and procedures included in the MHA survey so that you can compare for yourself. When it comes to high quality health care at an affordable price, your wish has come true! By selecting the Priority Access Health Plan through your employer, you’ll be purchasing the highest quality health care at a lower cost to both you and your employer. That’s our value proposition to you and to all citizens of mid-Missouri. When it comes to your health, don’t take risks. Choose Boone and our highly acclaimed hospital and medical providers through the Priority Access Health Plan. Ask your employer if Priority Access Health Plan is available to you. You can also contact Jim Tune, Regional Vice President for Priority Access Health Plan, at 573.449.6540.

HOSPITAL QUALITY INDICATORS Boone Hospital Center

MU Health Care

Missouri State Average

Major Bedsores Obtained

0.3 per 1,000 discharges

1.5 per 1,000 discharges

0.5 per 1,000 discharges

Unexpected Patient Deaths

0.0 per 1,000 discharges

0.0 per 1,000 discharges

0.3 per 1,000 discharges

Falls with Injury

0.3 per 1,000 discharges

0.6 per 1,000 discharges

0.3 per 1,000 discharges

Blood Clots Following Surgery

1.3 per 1,000 discharges

3.9 per 1,000 discharges

3.6 per 1,000 discharges

Serious Complications from Infection Following Surgery

3.5 per 1,000 discharges

4.9 per 1,000 discharges

8.9 per 1,000 discharges

Urinary Tract Infections for Patients with Urinary Tube

0.610 Standardized Infection Ratio

0.664 Standardized Infection Ratio

0.861 Standardized Infection Ratio

Clostridium Difficile (C. Diff) Infections

0.629 Standardized Infection Ratio

0.673 Standardized Infection Ratio

0.798 Standardized Infection Ratio

HOSPITAL PROCEDURE COSTS Boone Hospital Center

MU Health Care

Missouri State Average

Bleeding of Skull or Stroke with Major Complications

$20,993

$29,437

$29,607

Skull Surgery and Procedures

$70,319

$98,536

$109,504

Lung Infections and Irritations with Multiple Complications

$29,596

$44,131

$38,311

Lung Surgical Procedures with Major Complications

$52,557

$59,261

$82,073

Heart Catheterization with Stent without Complications

$51,894

$69,417

$64,803

Heart Attack with Major Complications

$33,984

$49,903

$39,627

Major Bowel Procedure with Major Complications

$73,221

$92,371

$96,410

Major Joint Replacement of Upper Arms

$48,987

$80,450

$52,233

Major Joint Replacement of Lower Leg

$33,003

$64,791

$43,178

Normal Newborn Delivery without Complications

$7,429

$12,447

$12,775

Cesarean Section with Major Complications

$13,869

$26,873

$23,359

All data sourced from FocusOnHospitals.com

Jim Sinek President, Boone Hospital Center

Focus on Hospitals is designed to help consumers explore pricing for participating hospital services, the quality of care delivered and how hospitals create value for the communities they serve. It’s a continuation of our conversation about improving hospital and health care and a commitment to the next step in helping consumers understand their health care services. Focus on Hospitals is owned and maintained by the Missouri Hospital Association, an organization representing more than 150 Missouri hospitals.

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HOSPITAL HEADLINES

Emergency Management Team Participates in Disaster Drill

Boone Medical Group Welcomes New Surgeon Hussein Waliye, MD, has joined Boone Medical Group Surgery. Dr. Waliye received his medical degree from the University of Iowa, Carver College of Medicine. He then completed his general surgery residency at Spectrum Health/Michigan State University. At Boone Medical Group Surgery, Dr. Waliye performs open and laparoscopic hernia repair, laparoscopic cholecystectomy, laparoscopic nissen, laparoscopic appendectomy, hernia repair patients, gallbladder surgery, skin cancer surgery and abdominal surgery. “Commitment to patient care and treating each patient individually” is very important to Dr. Waliye. He says he loves his specialty because “of the ability to fix the problem immediately.” Dr. Waliye is orginally from Minnesota. His wife and two children enjoy spending time outside. He is excited to move to Columbia and stay in the Midwest.

On the afternoon of Wednesday August 14, Boone Hospital Center’s ambulance services team participated in a disaster drill held at Columbia Regional Airport. Eleven emergency response agencies from across Boone County participated in the drill, which included live firefighting training with a mock aircraft. Keeping mid-Missouri safe is a joint effort. Boone Hospital Center’s emergency management team works year-round with local, regional, state and federal agencies to ensure that we’re prepared to respond immediately when the unexpected occurs.

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Back-to-Back-to-Back-to-Back-to-Back For the fifth year in a row, Boone Hospital Center was ranked the #1 hospital in mid-Missouri by U.S. News & World Report. It also ranked #5 in the state of Missouri. U.S. News ranks hospitals based on 12 specialties utilizing a mathematical model combining reputation, mortality rate, patient safety and care-related factors such as nursing and patient services. Boone Hospital Center was rated High Performing in six of the nine categories – chronic obstructive pulmonary disease (COPD), colon cancer surgery, heart bypass surgery, heart failure treatment, hip replacement surgery and knee replacement surgery. The rankings have been published on the U.S. News website, health. usnews.com/best-hospitals/area/mo, and will appear in print in the “Best Hospitals 2019” guidebook.

Kids on Track’s Eighth Season Crosses the Finish Line The Eighth Kids on Track season has come to a close. This year, 1,030 kids 14 and under pledged to be physically active over their summer months by running, walking or biking 26.2 miles - a marathon! This program is designed to keep kids active year-round and to instill healthy habits early.

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TRUSTEE ANNOUNCEMENTS

An Update from the Board of Trustees

From left to right, in the front row; Jan Beckett and Dr. Jerry Kennett, back row; Randy Morrow, Greg Steinhoff and former chair, Brian Neuner.

Boone Hospital Center Trustees want to provide an update to employees, medical staff and the public about the status of our work to secure the hospital’s future. Boone Hospital Center’s Future Earlier this year, we outlined two possibilities for the future management of the hospital – either partnering with a national health care provider, or moving forward as a locally-controlled, independent community hospital. We are now focused on the independent hospital option and are working to ensure this option will give us the ability to meet patients’ needs for generations to come. Operating as a locally-controlled, independent community hospital could benefit patients, employees and the medical staff by creating: • Flexibility to partner with local physicians and other health care providers to better address patients’ needs. • Local decision-making authority about the future of Boone Hospital Center and health care in mid-Missouri. • Ability to reinvest every dollar we make into local patient care.

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Boone Hospital Center is nearing 100 years of service. As we think about the future, we want to ensure the hospital can continue to be the region’s high quality health care leader for the next 100 years. In considering the independent option, we want to ensure: • The long-term financial sustainability of Boone Hospital Center, so we can fulfill our vision of service to patients. • Valued employees and physicians have information about our work and confidence in the future of Boone Hospital Center. • Our ability to continue providing high quality patient care and to retain and recruit talented physicians, nurses and other caregivers. We are actively working with professional advisors to finalize our future direction and we are making progress. To date, we have had informal conversations with many local physicians and regional health care providers who are excited about the possibility of future partnerships, and we will continue to engage with them. Their willingness to be part of our future will be a key factor in our ability to operate independently.


Brian Neuner Steps Down from Board With the focus of Boone Hospital Center’s future determined, the Board of Trustees will have a transition in leadership. Board Chair and 12-year Board Member Brian Neuner will be ending his service to Boone Hospital Center. Neuner recently accepted an executive position with Special Olympics Missouri, a statewide organization that activates individuals with intellectual disabilities. “Serving the citizens of Boone County and the dedicated employees of Boone Hospital Center for the past 12 years has been an honor,” says Neuner. “With the hospital’s future now in focus, it’s the right time for me to step away to devote more time and energy to my new career at Special Olympics Missouri. During my time as a trustee, I worked to advocate for the nurses, physicians and other caregivers who are the lifeblood of Boone Hospital Center. Boone would not be a five-star hospital without them. And as a leader of a true community hospital, I pushed to hire local companies to work with the hospital to keep our dollars here at home and to keep our local economy strong. While I will no longer be serving as a trustee, I am excited about the hospital’s future. I ask that all citizens of Boone County join me in supporting the Board as it moves forward in the best interest of us all.” In his 12 years on the Board, Boone Hospital Center experienced tremendous growth, including: • Construction of the $124 million patient tower that came in under budget and ahead of schedule. The tower is the only LEED-certified health care facility in central Missouri. • Building of the Nifong Medical Plaza to provide greater access to high quality care. • Establishment of the Stewart Cancer Center at Boone Hospital, which provides cancer care to more than 2,000 patients annually. • Purchase of the first da Vinci robot used for surgical purposes at Boone Hospital Center. • Purchase of Boone Hospital Center’s Mobile Health Unit, which provides on-site health screenings across mid-Missouri. Neuner will be replaced on the Board by a familiar face, Dr. Robert McDavid. The County Commission has appointed McDavid to serve until April 2020, when an election will be held to fill

the remaining four years of Neuner’s term. McDavid served as Columbia’s mayor from 2010-2015 and served on the Boone Hospital Center Board of Trustees from 1998-2010. McDavid’s prior service on the Board of Trustees and 28-year career as a practicing physician at Boone Hospital Center make him prepared to serve on the Board. “Having practiced medicine at Boone Hospital Center for 28 years and having previously served as a Boone Hospital Center trustee for 12 years, I am humbled by the opportunity to serve my community again as a trustee,” says McDavid. “I appreciate Brian Neuner’s leadership and know he will be missed on the Board. In the coming months, the Board will be working to secure the hospital’s future, and I look forward to working with the other trustees to ensure Boone Hospital Center is successful for future generations.” Dr. Jerry Kennett will serve as Interim Chairman of the Boone Hospital Center Board of Trustees. The trustees will elect a new slate of officers once McDavid is sworn in.

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CARE Christine Helms shares her experience with Boone Hospital Center’s new Pritikin Intensive Cardiac Rehab.

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n 2014, Christine Helms underwent a quintuple bypass after five of her major arteries to the heart were severely blocked. It was a very scary, emotional and confusing experience. After recovering from surgery and waking up in the hospital, thoughts and questions flooded Christine’s brain. What would she do now? Where would she go from here? Could she have a normal life again? Thankfully, she was at Boone Hospital Center, where she immediately entered the hospital’s Cardiac Rehabilitation program. The program helps patients who have experienced a heart event or problem, including heart disease, cardiac interventions, surgery and peripheral vascular disease. When Christine first participated in Cardiac Rehab, her care focused primarily on medically supervised exercise. She was thankful for the program, which helped improve her blood pressure, decrease her body fat, improve her good cholesterol while decreasing the bad cholesterol, and improve the blood flow to her heart muscle. She also received education about leading a healthy lifestyle. She was especially grateful for the Cardiac Rehab team, who monitored and encouraged her progress. In 2019, Christine returned to Boone Hospital Center to have a stent replaced. She was excited to learn that this time around, she had an opportunity to participate in the hospital’s new Pritikin Intensive Cardiac Rehab program, also known as ICR. The Pritikin ICR program came to Boone earlier this year and is approved by Medicare and many private insurance carriers. The program is based on three pillars that help participants embrace the keys to leading a healthy lifestyle: healthy eating, regular exercise and a healthy mindset. Christine was excited to resume exercising with the Cardiac Rehab team, this time with added hands-on experience in nutrition and lifestyle education, including cooking classes, videos and presentations.


Kate Mirly, MS, RDN, LD, teaches healthy eating habits in the Pritikin ICR program

Nutrition, Pritikin’s first pillar, can play a large role in your recovery after a heart event. More time spent on nutrition education is important for a successful outcome. Christine and her husband Dale met one-on-one with a registered dietitian and attended cooking classes where they sampled healthy Pritikinfriendly recipes. Christine and Dale found the presentations and extra time learning new tricks in the kitchen to be very beneficial for her recovery. When she was last in Cardiac Rehab, Christine received ideas and recipes to

take home. Pritikin ICR expanded her nutritional knowledge with cooking demonstrations. She learned about plantbased protein and how to add flavor to her meals without adding sodium or fat. Exercise, Pritikin’s second pillar, has always been a staple of Boone Hospital’s Cardiac Rehab program. For many patients, exercise may not have been part of daily life before their heart event. Getting regular exercise, understanding the importance of exercise, and committing to continued exercise after the program ends are keys to a successful journey.

Christine liked that her exercise routine was designed just for her, based on her abilities. She has a regular routine she follows on the exercise machines, and she is working hard to increase her strength and endurance. When Christine first did Cardiac Rehab in 2014, Dale would sit and wait for her exercise sessions to finish. With Pritikin ICR, Dale comes with her three times a week and gets to exercise in the Fitness Center at no additional charge. The couple enjoyed working together in learning to make healthy lifestyle changes. A healthy mindset is Pritikin’s third pillar and is critical to the program. ICR includes sessions about coping with stress, relaxation techniques like yoga, turning negative thoughts into positive ones and learning how to handle all of the emotions that follow after a heart event. Christine has found this part of the program to be very beneficial, increasing her awareness of what causes her stress and anxiety and learning new coping techniques. The mindset part of her ICR sessions have helped her think about her behaviors, evaluate her thoughts and realize she’s doing the right thing. Christine enjoyed participating in Pritikin ICR and found the added education and focus on nutrition and mindset to be helpful in her recovery. But one thing remains the same between her two experiences – her favorite part was working with the staff. As she did in 2014, Christine found the ICR team to be friendly and nice every time she came, and says they made her experience that much more enjoyable. Christine and Dale Helms have been married for 60 years. With 5 kids, they have many grandchildren and greatgrandchildren that keep them very busy. In their free time, they love to bowl, garden, work in the yard and socialize at the Senior Center. Christine and Dale are both grateful that the Pritikin ICR program at Boone Hospital is helping them continue to lead an active life together. By Erin Wegner

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Keeping Abreast of Cancer Boone Medical Group’s High Risk Breast Clinic enhances breast cancer detection and prevention for women at higher risk.

A variety of health or family history factors can cause you to be at higher risk for developing breast cancer. While this can be a scary thought, Boone Hospital Center’s Harris Breast Center and Boone Medical Group’s High Risk Breast Clinic have teamed up to provide a plan for early detection, treatment and prevention of breast cancer. Harris Breast Center provides breast tomosynthesis, also known as a 3D mammogram, to everyone who receives a mammogram. When you come in for your screening mammogram, your technologist will first complete a risk assessment, asking you about your personal and family medical history. Your answers are put into the Tyrer Cuzick Risk Model, a tool that calculates your lifetime risk of developing breast cancer. After your mammogram, a radiologist will review your images and prepare a report of your results that includes your breast density type and lifetime risk score. “We have been evaluating breast density for many years and know that there is an increased risk of developing breast cancer in women with dense breasts. The newest version of the TyrerCuzick Model allows us to integrate breast density into the risk equation and helps us determine which women with increased density should undergo further screening. It allows us to create an individualized assessment that is unique to each patient,” says Terry Elwing, MD, director of the Harris Breast Center. Based on your results, you may be referred for additional screening to be completed at an appointment with Boone Medical Group’s High Risk Breast Clinic. At this appointment, you will be asked about additional factors that may contribute to your risk of developing breast cancer, including your lifestyle and further details of your family history.

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ABOUT HARRIS BREAST CENTER Boone Hospital’s Harris Breast Center is located inside the hospital’s Outpatient Services wing. With convenient parking and registration, the Harris Breast Center combines the ease of a freestanding center with the technology, expertise and resources of a hospital-based provider. The center is ACR accredited with licensed, certified, professional and welltrained radiology providers and technologists.

Anne Petersen, MD

Boone Medical Group Surgery

Terry Elwing, MD

Radiology Consultants, Inc.

Liana Makarian, MD Missouri Cancer Associates


To schedule your screening mammogram with Boone Hospital Harris Breast Center, call 573.815.8150

According to Boone Medical Group board-certified surgeon and breast health expert Anne Petersen, MD, thorough screening for breast cancer risk is incredibly important. “This is an area of medicine that is newer in its development, and it is exciting that we have been able to start this program for everyone getting a mammogram. Not everyone is aware of the extra screening that should be done so that we can catch cancer sooner, hopefully, before it has a chance to spread. There are some cases where we may be able to prescribe medicine to even prevent cancer from ever happening,” says Dr. Petersen. The clinic may recommend lifestyle changes, an MRI or ultrasound study, genetic testing, risk-reducing medication or risk-reducing surgery, based on a combination of your mammogram and risk assessment results. Liana Makarian, MD from Missouri Cancer Associates, provides genetic counseling for patients who are at high risk for developing breast cancer. “A subset of all cancers are hereditary. Genetic testing can allow us to find out if a patient has a gene to develop cancer. Once we know that, we can prevent cancer from occurring. An ounce of prevention is worth a pound of cure,” says Dr. Makarian. By Madison Loethen

Hidden Scar Surgery Dr. Petersen is a certified Hidden Scar Breast Cancer Surgeon. With a Hidden Scar approach, your surgeon will place your incision in a location that is hard to see, so that the scar is not visible when your incision heals. As a result, you have little to no visible reminder of the surgery or your cancer.


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Making Plans

FOR BABY Should you have your baby at home or in a hospital? An OB/GYN shares options for a happy and healthy childbirth.

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ll mothers have their own labor and delivery stories. We love to tell them, and we love to hear them. This is a very personal time in a woman’s life. Each woman has a plan – a birth plan, if you will – or idea about how the process will unfold. At Boone Family Birthplace, we strive to achieve what each expectant mother has envisioned to bring their baby into the world. There are wide ranges for what each mother desires on the labor and delivery unit. Some women are open to all interventions for induction, delivery and pain relief. Other women want to limit any interventions. There is no right or wrong way to have a baby – this is an individual and very personal choice. Of course, as physicians, our ultimate goal is a healthy mother and baby. We believe that this is best achieved within a hospital setting. Whatever a woman desires for her labor and delivery, whether at home or in a hospital, it’s important that she makes an informed decision based on reliable information. In this day and age, there is so much information and misinformation available that it can be daunting. We are happy to take the time to answer any questions and help make a personal plan to meet a new mother’s expectations. From a medical standpoint, it is difficult to study the risks and benefits of home births versus births in a hospital setting or birth center. While it does appear there are fewer risks of fetal death and seizures when babies are delivered in a hospital, there are more maternal interventions available, such as induction, pain relief and monitoring, when mothers deliver

in a hospital. We believe that there can certainly be a balance of the risk and benefits by having a lowintervention delivery in the hospital. Why not have the best of both worlds, with the assurance of emergency care for mom and baby, but with minimal interventions? For the average low-risk OB patient, Boone Family Birthplace offers low intervention deliveries. An IV access is all that is required. We have capabilities for intermittent monitoring or wireless monitoring of your baby. Delivery can be achieved in a variety of positions. Many different laboring tools and techniques are available, and you are welcome to bring a doula or labor coach if you choose. Most importantly, perhaps, we have staff who are trained to help you through the process. At Women’s Health Associates and Boone Family Birthplace, we strive to meet each expectant mother’s wishes and desires for their labor and delivery. At the same time, we have a duty to ensure the best health of both mother and baby. Expectant mothers should be aware that almost any birth plan can be achieved at Boone Hospital Center. If you are considering a home birth, I challenge you to consider having a low intervention delivery in a hospital setting. The nurses and staff on labor and delivery pride themselves on making each experience a personal and happy one at Boone, no matter how you want your Boone Baby to arrive.

By Leah Smith, MD, Women’s Health Associates

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BRIN GIN G UP BO O N E BABIES

WHAT TO EXPECT DURING A NICU STAY No one plans on a neonatal intensive care unit, or NICU, stay for their newborn. If you find yourself in this position, it can feel overwhelming and a bit scary. As a Registered Nurse with Boone Hospital Center’s Level III NICU and an international board certified lactation consultant, I help parents understand what they can expect from the experience. Knowledge is power – and it’s my hope that this information helps lower their stress level and brings new parents peace of mind during a challenging time.

BY TARA PHILLIPS, RN, IBCLC, BOONE FAMILY BIRTHPLACE

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NEED MORE SUPPORT?

The NICU Team At Boone Family Birthplace, we are proud of the dedicated, highly skilled team members who are involved in the care of a baby during their NICU stay. Our team includes neonatologists – doctors who specialize in the care of newborns – neonatal nurse practitioners, and registered nurses. Respiratory, physical, occupational and speech therapists are also involved in your baby’s care in the NICU, as well as lactation consultants and registered dietitians. Social workers and chaplains from our Spiritual Care department round out the team, providing support to parents. Each team member takes their role seriously and is committed to providing the very best care for our littlest patients. Machines and Alarms There are many unfamiliar machines and noises in the NICU. These machines include feeding pumps, IV pumps, breast pumps and respiratory equipment to help your baby breathe. Some of the equipment will make sounds. Often the beeps are warnings to the nurses and don’t signal an emergency. Preparing yourself for these noises will hopefully minimize the fear and worry you may experience. Beds In the NICU, babies stay in different types of beds, depending on their size

Bonding Time At Boone Family Birthplace, we encourage skin-to-skin contact with your baby as soon and as often as possible, including babies in our NICU. Skin-to-skin contact offers many benefits, including enhanced bonding, and helps your baby regulate his or her breathing, body temperature and blood sugar. We encourage breastfeeding for NICU babies as soon as it is possible. Skin-toskin contact can help with successful breastfeeding for Mom and baby.

Bringing Up Boone Babies is a monthly support group provided by Boone Family Birthplace. We meet on the third Thursday of each month at 10 a.m. at Boone Hospital Center. Each hourlong session is led by a Boone Family Birthplace nurse and includes a short presentation on a different topic, followed by open group discussion. This support group is free and open to all parents of newborns, infants, and toddlers – and you’re welcome to bring your baby with you! No registration is required.

Your Voice Matters Boone Family Birthplace considers parents our most valued partners in a baby’s care. We encourage frequent visits, and your involvement in your baby’s care during their NICU stay is important. We want you to be connected to your baby’s plan of care. Please ask as many questions as you want, and don’t be afraid to speak up and share any concerns with your baby’s care team.

For a list of upcoming dates and information on how to join our Bringing Up Boone Babies Facebook group, visit boone.org/ BringingUpBooneBabies

and health. Premature babies have trouble maintaining body heat, so radiant warmers and isolettes – also known as incubators – are used to keep your baby warm. These special beds have sensors and equipment that let us monitor your baby’s health. The NICU also has open cribs. It’s our goal to help your baby progress to sleeping in an open crib before they go home.

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Hospital Chef with Restaurant Skills Chef Sam Sawyer developed his skills in a variety of restaurants before joining Boone.

S

am Sawyer has been a Sous Chef at Boone Hospital Center for almost a year. His introduction to cooking started at a young age, but his love for cooking grew, as he did. He is now passionate about cooking because it’s a form of art and a way to express himself in the dishes he creates. As a 14-year-old, Sam knew he was ready to work. On his 15th birthday, as a present to himself, he got a work permit and a bus pass, then got his first job. While he was washing dishes at a little greasy spoon, he got his first invitation into the kitchen where he learned how to cook a hamburger. He also learned he enjoyed being in the kitchen and was already thinking about going to culinary school. At 17, Sam had moved on to a steakhouse where he learned how to make things from scratch in a high-volume corporate setting. But as he got older, and life happened, instead of pursuing his culinary school dream, Sam continued traveling and cooking in different establishments to learn everything he possibly could. As his knowledge grew, so did his love of cooking. Sam’s on-the-job training has given him a chance to grow inside the kitchen. Before he was 20, he worked alongside a chef at an Italian restaurant who taught him invaluable lessons. This is where he learned knife work and knife techniques, as well as fundamental culinary skills. These opportunities have led to his rise from line cook to executive chef. He learned the corporate management side of things as a kitchen manager at a seafood restaurant and enjoyed complete freedom and unlimited resources as a sous chef in a casino kitchen. Sam has found his new home here at Boone, where he oversees all of the production in the cafeteria, from what is

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served to the patients, to what is offered on the salad bar. This includes the 951,000 meals served every year by Boone Hospital’s Nutrition and Food Services team. This new role in the health care world has taught Sam the importance of dietary restrictions and the risks of giving the wrong patient a straw (some patients can aspirate if they try drinking through a straw). On any given day, the department has to accommodate for over 22 different diet restrictions, such as low sodium, gluten free or low cholesterol. Food allergies are another challenge, impacting as many as 20 patients per day. Allergy alerts and cross-contamination

practices help Nutrition and Food Services staff keep sensitive patients safe. Attention to detail is key. Sam has developed a family-like professional relationship with his peers and loves working with them every day. He also loves spending time with his wife, Tiffany, and their three kids. Being able to be home with his family in the evenings was very important to Sam, so his work-life balance is another reason why he loves working at Boone. The Sawyer family can be found doing scavenger hunts, going to the park and taking trips to the zoo and the beach. By Erin Wegner


Chef Sam Approved - Vegetarian

4 Cheese Macaroni

INGREDIENTS 1 lb Macaroni Noodles

2 qts Water

3 Tbsp Kosher Salt

1 tsp Canola Oil

1 Tbsp Chopped Garlic

1 ½ cups Half

INSTRUCTIONS 1. Preheat oven to 375°. 2. In a medium sauce pot over medium heat, add canola oil and chopped garlic. Cook garlic until golden brown, stirring frequently to ensure the garlic doesn’t burn. 3. Add vegetable broth and half and half to the pot. 4. Add all of the American, parmesan, and monterey jack cheese, and add half of the cheddar cheese, setting the other half aside for later. 5. Reduce heat to low and let sauce simmer for 20 minutes, stirring occasionally.

6. In a large pot, bring water and kosher salt to a boil.

and Half Cream

7. Add in uncooked macaroni noodles and cook for 8 minutes.

1 ½ cups

8. Drain noodles. (Chef’s Tip: Do NOT rinse the noodles with water. This washes all of the starch off the noodles, preventing the cheese sauce from sticking to the pasta.) 9. Pour drained noodles into the cheese sauce mixture and stir well. 10. P our the macaroni and cheese into a 9”x13” baking dish and sprinkle the remaining cheddar cheese on top. 11. B ake in oven for 15 minutes.

Vegetable Broth

½ cup American Cheese

¼ cup Shredded Parmesan Cheese

½ cup Shredded Monterey Jack cheese

1 cup Shredded Cheddar Cheese

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Chef Sam Approved – Vegan

Three Bean Chili

INGREDIENTS 2 lbs Canned Kidney Beans, Drained 1 lb Canned Great Northern Beans, Drained 1 lb Canned Pinto Beans, drained 1 cup Chopped Yellow Onion 1 cup Chopped Celery 1 Tbsp Chopped Garlic 1 qt Water 3 qts Canned Crushed Tomatoes, Including Liquid 6 Tbsp Chili Powder 2 tsp Dried Oregano 1 ½ cup Canned Tomato Paste

INSTRUCTIONS 1. In a large pot, sauté the chopped onions and celery until translucent over medium-high heat (about 4 to 5 minutes).

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2. Add the remainder of ingredients and turn heat down to low. 3. Cover pot and let simmer for at least one hour, stirring occasionally.

1/3 cup Green Onion, Sliced ½ cup Ground Cumin 2 Tbsp Sriracha Chili Sauce


Chef Sam Approved

The Best Fried Chicken

INGREDIENTS 2 lbs Chicken Quarters (Bone In)

WET I N GR EDI EN TS

2 cups Corn Starch 1 ½ cups Water 2 Tbsp Kosher Salt 1 tsp Black Pepper

INSTRUCTIONS 1. Preheat oven to 375°. 2. In a deep-sided skillet, pour about an inch of canola oil and heat over medium heat. 3. In a large mixing bowl, add all of the wet ingredients and mix with a whisk until thoroughly blended. Set bowl aside. 4. In a separate large mixing bowl, add all of the dry ingredients and mix with a whisk until thoroughly blended. Set bowl aside. 5. With gloved hands, place chicken quarters in the wet ingredient mixture, making sure the chicken quarters are completely coated. 6. Remove chicken quarters from the wet mixture and place in the dry mixture.

Coat chicken quarters and make sure no liquid is showing. 7. Pick up chicken quarters, one piece at a time, and shake off the excess coating. Gently place chicken in hot oil. (Chef’s Tip: Make sure not to crowd the pan with chicken. This will lower the temperature of your cooking oil, causing the chicken to become greasy and soggy.) 8. Fry chicken quarters on each side for about 3 to 4 minutes. 9. Remove chicken quarters from oil and place on cookie sheet. Finish cooking in the oven until the chicken has reached an internal temperature of 165° and holds there for a minimum of 15 seconds. (This should take about 12 to 15 minutes.)

1 tsp Paprika ½ tsp Cayenne Pepper 2 Tbsp Hot Sauce 1 Lemon, Juiced

DRY I N GR EDI EN TS

2 cups All-Purpose Flour 3 Tbsp Kosher Salt 1 tsp Black Pepper 1 Tbsp Paprika

MyBooneHealth.org

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Meat alternatives are becoming more popular, but

W

ith innovation comes new alternatives to eating meat. Companies like Beyond Meat and Impossible Foods have been creating and improving plant-based hamburger patties, hot dogs and chicken strips for almost a decade now. But are they a healthier option than real meat? “A meatless burger may be exciting if you’re following a vegetarian or vegan diet and are missing the meat texture and meat experience,” says Kate Mirly, a registered dietitian with Boone Hospital Center’s Pritikin Intensive Cardiac Rehab program. Meat alternatives can be a good choice every once in a while. Even though a meatless burger patty is lower in saturated fats, it’s higher in sodium, which can be a concern if you have high blood pressure or heart disease. A 4-ounce meatless patty has a filling amount of plant protein, but

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are they healthier?

the leading brands don’t have any more protein than a real meat patty. Meat alternatives are also considered a processed food because of the amount of additives used to make them look, feel and taste like meat. “It can be confusing. A meatless burger looks like it would be healthy because it is vegetablebased, but you still have to watch your intake,” Kate recommends. As dietitians have advised us for decades, we need a balanced diet, whether we’re eating real meat burgers or plant-based ones. If you’re not ready to try a Beyond Burger at the next family barbeque, you can include natural plant-based proteins in your daily diet by eating tofu, edamame, lentils, chickpeas, peanuts, almonds, quinoa, beans with rice, potatoes and protein-rich vegetables. By Erin Wegner

COLOR KEY

Beyond Burger

Impossible Burger

All Natural Ground Beef Round (85% lean/15% fat) *4 oz burger patties


8g

250 7g

240

240

6g

SATURATED FAT

390mg

CALORIES

20g

370mg

21g

19g

70mg SODIUM

PROTEIN

9g

3g

75mg

0g CARBOHYDRATES

0g

0g CHOLESTEROL

MyBooneHealth.org

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Donald Burkhalter at the Boone Hospital Wound Healing Center.

Saving Legs and Lives Wound Healing Center helps get patients back on their feet. Over a decade ago, Columbia native Donald Burkhalter was tending to routine yard work. What happened next would change the course of his everyday life. “I was mowing grass and I stepped on a shingle nail,” Donald says. “I’m diabetic, so I didn’t have any feeling in my feet. I didn’t know I had any injury at all. After I got through mowing, when I took my shoe off, the tip of the nail had gone into the foot. It had done quite a bit of damage.” Donald went to his physician, who treated the wound. While it initially healed over, complications soon arose. The wound reopened several times and infection struck. A major obstacle to Donald’s healing was peripheral artery disease, or PAD, which is

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a common circulatory issue caused by the accumulation of plaque in the leg arteries. Despite years of treatment, Donald’s wound refused to completely heal. Eventually, Donald couldn’t put his full weight on his foot, and he was experiencing enough pain that it caused a significant limp. Enter the Boone Hospital Wound Healing Center, or WHC. Amy Bierk, WHC Program Director, says Donald’s scenario is typical of the patients they frequently treat. “I would say 75 percent of our patients are diabetic, and I would say 50 percent of those patients have peripheral artery disease,” says Amy. “We want to make sure that those patients out there know that we’re here.”


WHC offers its patients hyperbaric oxygen therapy and a plethora of additional advanced modalities. The clinic treated Donald’s PAD through surgery that opened the vessels in his leg and increased his blood flow. From there, a steady regiment of good wound care, managing his diabetes, offloading and 60 total hyperbaric oxygen treatments set Donald on the track to complete recovery. Had he not been referred to WHC, there was a very real possibility that Donald would have required serious amputation. WHC has teamed up with national nonprofit Save a Leg Save a Life Foundation, or SALSAL, to increase public awareness and avoid more unnecessary amputations. SALSAL employee Carol Barry says the aftereffects of amputation are quite severe. “Say you get a partial amputation,” says Carol. “Within two years you probably get another one. Within five years, the statistics are that you die. You don’t want to lose any portion of a foot or a foot or a limb.” Tackling public awareness has been WHC’s primary hurdle. The clinic encourages its patients to take the time to educate themselves, providing them with a means to do so by holding community screenings, posting radio and television ads, and reserving booths at community events such as the Mature Living Festival occurring in Columbia on Friday, October 4. What makes the clinic’s goal of community education especially challenging is the fact that the knowledge gap extends beyond the general public. Oftentimes, patients in need are trapped in various stages of their healing process because of a lack of awareness within the medical community. “I would love to have a megaphone and ride through the streets going ‘Are you aware? Are you aware?’,” says Carol. For signs that community awareness is trending in the right direction, look no further than Donald. The wound clinic is the reason he’s walking today virtually pain-free. “The end of the rainbow is nowhere in sight because I’m still walking on the rainbow,” says Donald. “I just very much appreciate it, myself and my entire family. If that infection had continued...people mention ‘My aunt lost her entire leg.’ You know the different stories. This is one of the success stories.” By Brandon Grammar Exam room at the new Wound Healing Center location. MyBooneHealth.org

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GETTING TO KNOW A BHC DOCTOR

Timothy Soncasie, MD

Internal Medicine

I

was born in St. Louis and raised in the Metro East region, across the Mississippi River, in Illinois. My father was a pipe fitter with Mallinckrodt Chemical in St. Louis and my mother worked retail. I graduated from Southern Illinois University in Edwardsville with a degree in Biology, then attended Medical School at St. Louis University. I did a four year combined Internal Medicine/Pediatrics residency program in Peoria, Ill. and had extensive urgent care experience prior to coming to Columbia four years ago to open an internal medicine practice. I have three adult children: a daughter in medical school, a son studying occupational therapy and a daughter who is a social worker for the state of Missouri in St. Charles County.

Why did you get into the health care field? I was born with a congenital heart defect and underwent open heart surgery as a child, which initially got me interested in medicine. As an undergraduate student, I worked at a local pharmacy and was encouraged by a professor who mentored me during the process of applying to medical school. What interested you in your particular specialty? I love the intersection of science and art in the practice of Internal Medicine. I approach and manage complex medical conditions, which requires problem-solving as a tool to work with my patients to find solutions that align with their lives and goals. What is the most rewarding aspect of your job? The most rewarding part of my career in medicine is my patients. We are a team, working to optimize health and well-being. I also enjoy collaborating with colleagues, receptionists and nurses to deliver high quality care as efficiently as possible. What is the most challenging aspect of your job? Paperwork! What do you see changing in health care in the next five to 10 years? Advancement in technology, using the knowledge of our DNA to help diagnose and treat many medical problems. The use of nanotechnology to help repair and making surgical procedures less invasive and allowing patients quicker recovery times. I would like to see us going to a one payor system to decrease paperwork, and finally develop one electronic medical record allowing everyone access to their medical records no matter their location, so if they move from Missouri to Colorado, their records move with them.

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What advice would you give someone looking to become a doctor? Stay humble, continue learning every day and remain open to the possibility of the unexpected. What do you enjoy doing outside of work? I enjoy spending time with my wife and family. We play board games, trivia and cards frequently. I walk daily with my wife, and we do crossword puzzles together. In my free time, I like to garden, visit Missouri State Parks, and attend movies, theater and the symphony. I also root for the St. Louis Cardinals, St. Louis Blues, Mizzou Tigers and Kansas City Chiefs. What advice would you give to someone who is going to be a patient in a hospital for a period of time? Always carry a typed list of your current medications with doses. Write down any questions you have and be ready to ask them. Bring a tube of lip balm. Be prepared to tell your story multiple times and understand that your health care providers are working together to get you on the road to recovery.


GETTING TO KNOW A BHC NURSE

Phyliss Golden, RN Admissions

I

have always had a passion for health care. As a small child, I used to play nurse by untwisting an empty tissue paper roll, putting it on my head as a nurse’s cap, and putting on a white robe to serve as my uniform while bandaging my very patient cocker spaniel, Sheila. I was always the first to help the kid with the skinned knee or the older person who just needed someone to sit and talk with. It all just came naturally.

Why did you get into the health care field? I love seeing and being a part of the patient’s journey from illness to health. What interested you in your particular specialty? The admitting nurse role became available when I was seeking a change from emergency nursing – for a variety of reasons. However, it was not long until I realized I still loved and missed the “fluffing the pillow and bending the straw” part of nursing. What is the most rewarding aspect of your job? A simple and sincere “thank you” from my patients and families, and a feeling of necessity and inclusion from my peers, makes my day! What is the most challenging aspect of your job? The tools. I know computers are meant to make our life easier, but there are times when I regret sacrificing time interacting with my patients at the bedside for time spent charting. What has changed in your field since you started practicing? I miss the days when all of the nurses and doctors knew each other by name and knew each other’s skill levels. What do you see changing in the next five to 10 years? I hope there is a renewed interest in actual handson, bedside nursing, but I’m concerned that the demands of documentation are pulling caregivers away from the bedside.

What do you enjoy doing outside of work? I LOVE DOGS! My favorite pastime is spending time with my golden retriever fur baby, Einstein. I am also heavily involved in my church, Second Missionary Baptist Church of Columbia. I’m also a special events coordinator, specializing in coordinating and decorating for weddings, anniversary celebrations, birthday parties, and more. What advice would you give to someone looking to become a nurse? Before enrolling in a nursing program, try to shadow a seasoned nurse. It will make all the difference in the world. Nursing is work! Media, especially television, glamorizes nursing way too much. When new grads realize the actual demands of nursing, I think they get discouraged, and we subsequently see a nursing shortage.

MyBooneHealth.org

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LIVING WELL

Achieve Balance

Calf Stretch Having flexibility in our calf muscles is important, especially in walking, in order to prevent us from dragging our toes on the ground. Stand facing a wall or sturdy chair. Place your right foot in front as if taking a large step. Keep the left knee straight and the heel on the ground. Lean toward the wall or chair and support yourself with your arms. Let the right knee bend until you feel a stretch in your left calf muscle. Hold for 30-60 seconds. Repeat on the other leg. Try to do this 2-3 times a day.

Many people don’t think about balance when planning an exercise program. Even though we may not be aware of it, good balance is critical for most daily activities. Good balance allows us to walk, change our clothes, and perform basically any other activity that requires us to move our bodies. It is important to train your body with specific balance exercises to improve stability, decrease your risk for falls, increase strength, and improve posture and coordination. These simple exercises are a great starting point to improve your balance. They all can be done at home, using items that you have around the house. If you want further assistance with improving your balance, the Balance Program at Boone Therapy is a great fit. Our therapists are trained to look at the three bodily components that maintain balance including the visual system, the vestibular system in the inner ear, and the somatic sensory system, which gives us the ability to sense motion. We use various tools, including the NeuroCom Balance Master to pinpoint exactly where you may have deficits and then design a treatment program around those areas. Boone Therapy can also provide assistance with vertigo symptoms, dizziness and targeted vestibular exercises. By Laura Grise, PT, CHT and Ingrid Minge, PT, DPT, MBA 28

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Alternating Step Taps This exercise works on shifting your weight side to side as we do in walking. It requires balance and coordination. Stand in front of a six to eight inch step. Start with using some arm support, like a counter top or stair rail. Stand up tall with good posture and squeeze your stomach muscles. Lift one leg and tap your toes on the top of the step. Be sure to lift your foot high enough to avoid hitting the front of the step. Set your foot back down and tap with your other foot. Continue alternating right and left. Start out doing it slow and controlled. You can glance down at the step if needed, but try to stay up tall and straight. Start with 10 taps with each foot. You can then progress to 20 taps or do this without using your hand for support.

Side Leg Lifts The strength in our hips affects our balance, especially the muscles that lift the leg out to the side. If they are weak, we will sway side to side as we walk. Start by standing in front of a steady chair or counter top for arm support. Then lift one leg out to the side (make sure to keep the leg in line with your body and your foot straight ahead). As you lift your leg, stand up tall to prevent leaning your body to the side. Start with five to eight repetitions on each leg. For an extra challenge, you can work up to two sets of 10 repetitions. If that seems easy, you can do this exercise lying on your side (be sure to keep your leg in line with your body as you lift). You could then progress to using some resistance from bands or ankle weights. Fall 2019


For more information, visit boone.org/therapy or call 573.815.3868

Stationary Balance To improve balance, you need to safely challenge your balance. Do this exercise in a corner or next to a sturdy counter or chair so that you can hold on if needed. Start with your feet hip width apart and balance without touching the wall or counter. Hold this position for 30 seconds. If this is easy, place your feet close together for 30 seconds. You can gradually progress to placing your feet heel-to-toe, standing on a firm cushion, or closing your eyes. The exercise should be a slight challenge but still safe. When you try to progress the exercise, start with a light touch on the wall or chair and then progress to not touching.

Sit to Stand This is a good functional exercise because it strengthens your muscles used for sitting down and standing up. Pick a surface that you can stand up from without pushing with your arms or the back of your legs. The higher the surface, the easier it will be. Scoot to the edge of the chair or bed. Keep your feet and knees hip width apart. Keep your back straight and lean forward at your hips. Push through your heels and stand up tall. Try to do this with your hands across your chest or out in front of you. Sit back down again slowly on the edge of the chair. If you are unable to control sitting back down or if you have to jerk forward to stand up, try a higher surface or place your hands on your thighs. Start with 8-10 repetitions and gradually work up to doing two sets of 8-10 repetitions.

Side Stepping Side stepping will challenge your balance and coordination, as well as work your hip muscles in a different way than just walking. Start by standing in front of a counter top. Keep your hips, knees and feet straight ahead. Take steps to the side holding on lightly to the counter. Then step the other direction heading back toward the point where you started. Continue to go back and forth like this for about 30 seconds. Try to progress to doing this without touching the counter top. For an increased challenge, you can then progress to walking forwards and backwards and then heel to toe. Be sure to continue using the counter for support as needed. MyBooneHealth.org

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FOUNDATION NEWS

2019 - 2020

CALENDAR OF EVENTS

Sharing the Gift of Health

NOVEMBER 9

Boone Soiree NOVEMBER 18-19

Jewelry Sale DECEMBER

COMO Gives Campaign MAY 11, 2020

Annual Golf Tournament

Boone Hospital Foundation

Fall Soirèe November 9, 2019 Holiday Inn Executive Center To learn more about reserving your ticket or sponsorship opportunities call the Boone Hospital Foundation office: (573)815-2800 or visit boone.org/foundation

I Believe in Boone Boone. 30

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Thank you, Anna Marie Knipp, for believing in Boone and bringing our community together for Horsepower with Heart.

To all of those who supported Horsepower with Heart with your time and resources, we thank you. Your generosity allows the Foundation to continue to support Boone Hospital Center in its mission to improve the health of the people and communities we serve. Sharing the Gift of Health MyBooneHealth.org

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Boone Hospital Center 1600 East Broadway Columbia, MO 65201 573-815-8000

NONPROFIT U.S. POSTAGE

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COLUMBIA, MO PERMIT 286

Number one five times. Only one with five stars. Boone Hospital Center has been ranked as the top hospital in mid-Missouri for five years in a row by U.S. News and World Report. Boone is also the only hospital in mid-Missouri to achieve a five star rating from the U.S. Centers for Medicare and Medicaid Services. That’s five - plus five - more reasons to believe in Boone.

Profile for My Boone Health

My Boone Health Fall 2019  

My Boone Health Fall 2019