Boone Health SPRING 2021
My Weight Was
WEIGHING ME DOWN How Boone Health's Bariatric Services helped Meagan Fansler change her weight and her life. PG . 1 8
Vaccinating and Saving Lives
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Table of Contents CEO Troy Greer
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 Sadie Thibodeaux Contributing Writers Wes Glenn, Kate Lohman, Emily Nusbaum, Jennifer Tveitnes, Hannah Kueck
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A Note from Troy
His Safe Haven
There’s An App For That
A New Boone
Get to Know a BHC Doctor
A Cape For A Supermom
Get to Know a BHC Nurse
Spring Clean Your Pantry
Vaccinating and Saving Lives
My Weight Was
Weighing Me Down
#1 RANKED in Mid-Missouri
in the state
6 YEARS in a row
For the sixth year in a row, Boone Hospital Center was ranked the #1 hospital in Mid-Missouri by U.S. News & World Report. We were also ranked #4 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.
A NOTE FROM TROY
Strengthening Our Community Support
am proud to introduce the first issue of My Boone Health published by the new Boone Health, an independent health care system that includes Boone Hospital Center, Boone Medical Group, Boone Home Care and Hospice, and a network of private practice clinics and affiliated hospitals throughout mid-Missouri. In our 100-year history, I cannot imagine a more challenging period than this last year. Our team has actively prepared for our transition to Boone Health in addition to their incredibly heroic efforts to confront a global pandemic. We kept our patients safe while simultaneously migrating to a new electronic medical record system and over 140 other different technology platforms, training staff on these new systems, moving over employee benefits, negotiating contracts with insurance providers, and establishing new departments. Our progress despite these obstacles reflects the incredible culture at Boone. Well before April 1, 2021, the positive impacts of our transition on our community have been apparent. Over 70 new team members have been added, resulting in over $6 million in wages being added to our local economy. Multiple contracts have been signed with local vendors, returning dollars to our region and further supporting local growth. The decision to become an independent health care organization was done with our mission – to improve the health of the people and communities we serve – in mind, giving us more flexibility to better support mid-Missouri and our community health needs. During our lease with BJC HealthCare, Boone Hospital Center and our Board of Trustees made supporting our community a priority. For example, most county hospitals receive funding from their counties but, for decades, Boone Hospital Center has given back to Boone County, contributing millions of dollars. Even with the financial
challenges presented by the pandemic, we contributed over $2.5 million to Boone County in 2020. Additionally, $500,000 of each year’s contributions has gone to the Boone County Community Services Fund, which in turn has funded a myriad of local family support, mental health, behavioral health, dental care and social safety net programs. This support has helped Boone County address identified community health needs, including the social indicators of health. These contributions are just one part of our community benefit. Every year, we support mid-Missouri by offering free health screenings, educating and training the next generation of healthcare professionals, contributing to local organizations, and helping patients access a continuum of affordable health care covering wellness, prevention, detection and treatment. Supporting mid-Missouri is also a priority for Boone employees. For 22 years, Boone Hospital has committed to setting a high fundraising goal as a United Way Pacesetter. In 2020 our employees contributed over $49,900 to our local Heart of Missouri United Way chapter. Our Boone teammates also donated over $18,000 to the Boone Hospital Foundation, which funds our community benefit programs and enhanced patient care services. Many of these programs were first proposed by employees. Their eagerness to support an organization designed to support them reflects an extraordinary commitment to a higher standard of care. Boone Health also supports our community by offering high quality care at an excellent value. I encourage you to see for yourself at Missouri Hospital Association’s Focus on Hospitals website, FocusOnHospitals.com, which lets you compare quality and pricing among over 150 Missouri hospitals. When it comes to
reducing harm, preventing infection and managing readmissions, Boone Hospital consistently performs better than the average of participating hospitals. And our charges are consistently below average for a wide array of health care services, including childbirth, joint replacement surgery, treatment for heart disease and more. We’re a community healthcare organization whose reputation travels beyond mid-Missouri. In 2020, Newsweek ranked Boone Hospital Center #104 of its Best Hospitals in the United States. This ranking – based on quality, safety, patient satisfaction and other data for over 5,000 community hospitals – puts us in the top 2% of community hospitals nationwide. But our employees don’t hold themselves to high standards just for the accolades. They do so because they believe in our mission. Our independence will further strengthen our community relationships, starting with the establishment of our new governance board which includes five community stakeholders who are introduced in this issue of My Boone Health. As spring brings brighter days, and as we see more people receive COVID vaccinations while cases continue to decline, I can’t think of a better time for Boone Health to start this exciting new era. I am enthusiastic about what we – our employees, our physicians, and our communities – will accomplish by working together. I believe in Boone!
Troy Greer CEO, Boone Hospital Center
Boone Health Awarded ACC Transcatheter Valve Certification The American College of Cardiology, or ACC, has recognized Boone Health for its demonstrated expertise and commitment in treating patients for transcatheter valve repair and replacement procedures. Boone Hospital Center was awarded transcatheter valve certification in January, making it the only hospital in Missouri to achieve this recognition. Transcatheter aortic valve replacement, also called TAVR, is a minimally invasive procedure to treat aortic valve stenosis. TAVR may be an option for patients who would be at risk for complications from open-heart surgery. Boone Hospital Center first began offering TAVR in 2017. The ACC’s Transcatheter Valve Certification uses an external review and certification process, using established national clinical databases to monitor patient safety and outcomes during and after TAVR procedures. The review includes evaluation of the hospital’s ability to meet standards for multidisciplinary teams, formalized training, shared decision-making and registry performance. “Boone Health has demonstrated its commitment to providing mid-Missouri with excellent heart care,” says Phillip D. Levy, MD, MPH, chair of the ACC Accreditation Management Board. “ACC Accreditation Services is proud to award Boone Health with transcatheter valve certification.” Hospitals that achieve transcatheter valve certification learn best practices in evidence-based medicine to support patient-centered decision making and can track key performance metrics to better identify opportunities for improvement. “We are proud of our Cardiology and Cardiothoracic Surgery Service Line and our ability to achieve the high standards set forth by the ACC for this certification. The fact that we are the only hospital in Missouri that has been granted this certification speaks volumes to the dedication of our staff and physicians in providing our patients with the best outcomes,” says Amy Begemann, Boone Hospital Cardiology and Cardiothoracic Surgery Service Line Director. The ACC offers U.S. and international hospitals access to a comprehensive suite of cardiac accreditation services designed to improve patient outcomes and hospital financial performance for all aspects of cardiac care.
Automated Chemistry Line — Laboratory In 2019, the laboratory started a $2.2 million project to upgrade their main chemistry analyzers and automation line. In January, the laboratory officially completed this project! The combination of new analyzers and a fully automated robotics line has improved Boone’s ability to respond to the significant increases in laboratory testing. In just the past two years, Boone has grown overall lab volumes by 26% and outpatient lab volumes by over 45%. Boone Hospital Laboratory has partnered with Roche Diagnostics for over 25 years to provide the latest technology and innovation when it comes to the clinical laboratory.
Boone County Medical Society Honors Dr. Robin Blount The Boone County Medical Society has selected Robin Blount, MD, Boone Health Chief Medical Officer, as their 2020 Distinguished Physician of the Year for her dedicated service to medicine and to her community, particularly during the COVID-19 pandemic. Boone County Medical Society, or BCMS, supports physicians in Boone, Howard and Cooper counties and their efforts to provide high quality, patient-centered care. According to BCMS, “Dr. Blount's current position at Boone Hospital Center has given her a community leadership role which has enhanced medicine in central Missouri. She has been a strong participant in the Boone County Medical Society webinars, giving valuable information to our medical community. During the COVID-19 pandemic, she has sat on numerous planning committees for not only her hospital, but also for the city of Columbia and for Boone County.” Dr. Blount has practiced as a physician in Boone County for over 30 years. She attended medical school and completed her internal medicine residency and an infectious disease fellowship at MU. As a private practitioner, Dr. Blount has worked at both Boone Hospital Center and Columbia Regional Hospital and held multiple leadership positions on each hospital’s medical staff. She left private practice to become Boone Hospital’s Chief Medical Officer in summer 2015. Dr. Blount’s complete 2020 Distinguished Physician of the Year profile is available on the BCMS website at boonecountymedicalsociety.org
A New Boone Meet the new community members
that make up the new Boone Health.
he process for Boone Hospital Center to become independent was a project that was in the works for five years, but the end result was well worth the wait. After a 32-year long lease with BJC HealthCare, the hospital had several options to explore to see what was right for the community. They could extend the lease with BJC, or explore an opportunity to work with MU Health that could create a relationship to help both parties, which they explored for about eight months. But in the end, it was all about what the community wanted and needed. And the community wanted the community hospital to remain just that — a community hospital. So, after some more exploring, the journey to become independent began. “Because of our low costs and high-quality ratings in the region, our consulting firm told us that they thought we could make it as an independent institution,” Jerry Kennett, MD, board of trustees chair, says. In the process of transitioning to be independent, the board of trustees, made up of Dr. Kennett, Randy Morrow, Jan Beckett, Greg Steinhoff, and Bob McDavid, felt it was important to add other members of the community with different areas of expertise to the governing board. Dr. Kennett explains, “The process [the board] is going through is that the trustees are leasing the hospital with the approval of the county commissioners to a new 501(c)3 entity.” This new entity is Boone Health, and it incorporates more than just the hospital. It incorporates the hospital’s physician platform, home health and hospice, and overtime, and the trustees hope to add entities to this list. Meet the New Boone Health “We’ve added expertise in the areas of education, health care, finance, business, insurance, and human resources,” Dr. Kennett says. “We’re thrilled with the individuals who have been willing to give their time and expertise to be on the governing board of the hospital.” Going forward, Boone Health will be the governing body, but will allow CEO Troy Greer and his team to be the managing and operational directors of the hospital. After pulling together a list of community members the board felt would be great additions, the governing board of five grew to a board of 11 with the latest additions of Barry Orscheln, Gary W. Thompson, Stacye Smith, Dianne M. Lynch, PhD, Charles P. Bondurant, MD, FABNS, FACS and Judy Starr.
“We’ve added expertise in the areas of education, health care, finance, business, insurance, and human resources. We’re thrilled with the individuals who have been willing to give their time and expertise to be on the governing board of the hospital.”
— DR. JERRY KENNE TT
William “Barry” Orscheln Barry Orscheln is the chairman and CEO of Orscheln Industries, a privately owned, third generation business. In 1972, Barry graduated from Central Methodist University with degrees in business administration and economics. After he obtained his degrees, he worked for Liberty Mutual Insurance Company for five years before returning to the family business. In 1977, Barry returned to Moberly to manage his family’s insurance business. Around this time, he started Third Century, a small ticket leasing company that became one of the largest small ticket leasing companies in the country. In 1985, Barry sold his company to Chase Manhattan Bank and returned to Orscheln as Chief Financial Officer. In 1990, he was named Chairman and Chief Executive Officer of Orscheln Industries, a position he still holds today.
Gary W. Thompson, MBA Gary Thompson has always made it a priority to be active in the community. Currently serving as the President and Chief Executive Officer of Columbia Insurance Group, Gary has a passion for learning. He earned his Bachelor of Science degree from MU and his MBA with an emphasis in risk management and insurance from Walden University, and he has earned several designations for his professional career, such as certified insurance counselor and associate in information technology. On top of his passion for learning, Gary has a passion for volunteering around the community, including service as campaign chair, director, and board president of the Heart of Missouri United Way and director and board chair of Job Point. When Gary isn’t working or volunteering, he and his wife Julie enjoy spending time with their children and eight grandchildren, who enrich and challenge them every day.
Stacye Smith A Columbia native, Stayce Smith graduated from Rock Bridge High School and moved on to obtain her Bachelor of Arts degree in business administration from Stephens College. In 1987, Stayce joined the team at Shelter Insurance Companies, holding positions in the areas of underwriting, training, and human resources. Currently, Stayce holds the position of director of inclusion and engagement. In this role, Stayce is responsible for diversity and inclusion, employee and community engagement, and employee communications. Stayce has a passion for the community and has served on the board of the Boys and Girls Clubs of Columbia, Columbia African American Association, Heart of Missouri CASA, and much, much more.
Dianne M. Lynch, PhD Dr. Dianne Lynch has been serving as the 24th president of Stephens College since 2009, and under her leadership, the college has seen impressive growth, national honors, and recognition. In 2020, the college launched a new Bachelor of Science in nursing program, a joint venture with Boone Hospital Center, and graduated its third class of physician assistant students in December 2020. Lynch holds a bachelor's and master’s degree in mass communication and feminist history and a PhD in art history and communications from McGill University in Montreal. Lynch looks forward to her position on the new Boone Health Board. She says, “It’s my privilege and honor to serve as a community member of the new Boone Health Board . . . I applaud the Boone Trustees for recognizing that Boone Health will benefit from an open door and communication pipeline between the hospital and the communities it serves, and that’s the role of the community board members. We’re at the table to share our insights across business and nonprofit sectors — including education! — and to represent the perspectives of our friends and colleagues in the larger community. It’s a strong and inclusive governance foundation upon which to build Boone Health’s future.”
Dr. Charles P. Bondurant MD, FABNS, FACS For 26 years, Dr. Charles Bondurant has been a member of the Boone medical staff and serves as a courtesy provider at University Hospital and Rusk Rehabilitation. Dr. Bondurant works to offer advanced neurological procedures in a comfortable, small clinic setting at Mid-Missouri Neurosurgery. Dr. Bondurant got his medical degree from the University of Oklahoma and completed his residency in neurological surgery at the University of Missouri. He is also a member of several professional organizations, including the American Medical Association, Congress of Neurological Surgeons, and the Boone County Medical Society.
Judy Starr For over 30 years, Judy Starr has held the position of executive vice president and chief financial officer for the Central Bank of Boone County. In 1983, Judy obtained her Bachelor of Science degree in accounting from Lincoln University, and in 2007, Judy returned to school to receive her professional master of banking from Sheshunoff School of Executive Management. For the past eight years, Judy has held the position of treasurer for the Food Bank for Central and Northeast Missouri, and she has also served as the budget and finance committee co-chair for the Columbia Chamber of Commerce. By Hannah Kueck
“I applaud the Boone Trustees for recognizing that Boone Health will benefit from an open door and communication pipeline between the hospital and the communities it serves — and that’s the role of the community board members.” — DIANNE LY NC H
A CAPE FOR A
SUPERMOM A Boone Family Birthplace nurse helps a mother of two feel like a superhero. CEO Troy Greer gave Dawn Milford his red cape.
hen Dawn and Rodney Milford began preparing for marriage, one of their major discussions was children — a conversation which came as a surprise to some family members, since they were both in their late 40s. When they married, Dawn was 46 and Rodney was 49. “I already had two grown children, Kirstie and Parker, but Rodney did not have any kids, and he really wanted to have children of his own. We talked about what we wanted to do with this next chapter of our lives, and we decided that was having children,” says Dawn. Dawn and Rodney saw Gilbert Wilshire, MD, a reproductive endocrinologist at Missouri Fertility, to discuss getting pregnant. They decided in vitro fertilization was the best option for them, and Dawn became pregnant on their first IVF try. “We were so excited and happy,” says Rodney. During her pregnancy, Dawn was under the care of Sarah Bernard, MD, FACOG, of Women’s Health Associates, and high-risk physician Mark Grant, MD, of Women’s Wellness Center. She says, “I couldn’t have asked for better care.” At 48 years old, Dawn gave birth their daughter Emily in 2019. Dawn and Rodney cherished their time with Emily and were both very grateful to have jobs that allowed them to spend time at home. “We both just love the baby phase,” says Dawn. Not even a year later, the Milfords discovered they were expecting again. Little Lillie was born in October 2020. Lillie was born four weeks early and, after her birth, had drops in her blood sugar
"I told Dawn that the new CEO of Boone Hospital was dressed as Superman for Halloween and wanted her to have his cape because she was the real superwoman." Emily and Lillie Milford.
levels and temperature regulation issues that were of concern to the Boone Family Birthplace staff. Caregivers from the NICU, Boone's neonatal intensive care unit, made regular visits to Dawn’s room to check on Lillie, including nurse Julie Brown. “I became close to Lillie’s NICU nurse Julie,” Dawn says. “I joked with her I deserved a red cape for having two babies in two years at my age. And then a little bit later, Julie walked in with a cape!” Dawn was unaware that, earlier that day, Julie had met Troy Greer, Boone Health’s new CEO. During this encounter, Troy was dressed as Superman while delivering treats to the super heroic hospital staff for Halloween. When Julie told Troy about Dawn’s remark, Troy removed his red cape and handed it to Julie so she could give it to Dawn. “The Milfords’ story is very heartwarming. I thought it would be a nice touch to let her have the cape she deserved,” says Troy. “I told Dawn that the new CEO of Boone Hospital was dressed as Superman for Halloween and wanted her to have his cape because she was the real superwoman. She was thrilled. This experience was very fun and exciting,” says Julie. Dawn and Rodney say they will always remember the sweet gesture and will tell their girls about it when they’re older. They say life is busy with two under 2, but they wouldn’t have it any other way. By Madison Loethen
Left to right: Parker, Emily, Kirstie, Dawn, Lillie and Rodney.
Rodney and Dawn say they love every second of being parents. The Milford's pregnancy announcement when they were expecting Lillie.
Keep your child engaged after school with healthy snacks and activities.
ids’ brains are worn out by the end of the school day. Seven hours of switching from subject to subject, solving problems, reading, absorbing new information and navigating social interactions is enough to exhaust anyone’s mind. What’s the best way to energize your child and help everyone power through the rest of the day? Two basic needs: nutrition and activity. When it comes to after-school snacks, your kids’ brains need glucose or carbohydrates for fuel, and their bellies need fiber and protein to stay full and satisfied. Liven up your daily snack
routine by offering snacks with color — brightly colored fruits and vegetables provide an assortment of vitamins and minerals needed by the brain. They’re a great addition to your child’s diet and can encourage them to continue to eat healthy as adults. Regular physical activity has been shown to boost brain function. Kids sit during most of the school day. Taking time after school to move their bodies can help kids do better while completing homework, and it improves their memory retention. Physical activity is also a great mood booster and can help make everyone’s evening a little more pleasant.
SNACKS • Crunchy Chickpeas
Drain a 15-ounce can of chickpeas. Cook in an ovenproof skillet with 2 tablespoons olive oil and 1 teaspoon each of cumin and smoked paprika for 2 minutes. Season with salt, then transfer the chickpeas to a baking sheet and bake for 20 minutes at 425°F.
Spread peanut butter on a whole wheat cracker. Top with a few thin strawberry slices, then lightly drizzle with honey and top with another cracker.
• Pretzel Melts
Place small slices of cheddar on a mini pretzel. Top with ﬁnely diced bell peppers, then another pretzel. Put on a parchment-lined baking sheet and bake for 7 to 10 minutes at 425°F. Serve with mustard.
• Tuxedo Olives
Cut cheese sticks into thin strips. Stuff the strips inside large pitted olives. Serve plain, or toss with olive oil, red wine vinegar, and parsley.
• Jicama Sticks
• Themed family walks:
• Flavored Milk
• Family bike rides
Peel a jicama and cut into sticks. Toss with lime juice and sprinkle with chopped cilantro, salt, sugar, and chili powder.
In a blender, puree 2 cups thawed frozen strawberries, peaches, or mixed berries with 3 tablespoons no-sugaradded white grape juice concentrate. Stir about 1/3 cup of the fruit puree into 1 cup low-fat milk. Cover and refrigerate the remaining puree for up to 5 days.
• Apple Moons
Slice an apple into crescents. Spread with peanut or almond butter and press a small amount of granola on top.
• Yogurt Parfaits
Top your favorite ﬂavor of fatfree Greek yogurt with berries and a tablespoon of chopped walnuts
• Pickle Roll-Ups
Spread a thin layer of reducedfat cream cheese on a slice of deli meat, then wrap the meat around a pickle spear.
Look for different shapes, use all of your senses, ﬁnd things for every color, or have your kids choose a theme!
• Play a family game of soccer, basketball, or another favorite sport.
• Plant ﬂowers together.
Let your kids pick which ﬂowers they want to plant.
• Play in the rain (as long as there’s no lightning).
• Fly a kite. • Have a home dance party to your favorite music or follow along with your favorite dance videos on social media.
• Exercise at home together. Follow along
with instructional videos, like Cosmic Kids, which offers free yoga videos that are fun for all ages. Visit cosmickids. com to learn more.
By Jennifer Tveitnes, RD, LDN
Vaccinating And Saving Lives From the second COVID-19 vaccines became available, Boone Health has been working around the clock to get as many individuals as possible vaccinated.
hen the first shipment arrived, Boone set up a clinic for its staff, but it didn’t stop there. Boone began working with the health department to reach out to and vaccinate local 1A health care providers who otherwise would not have access to the vaccine. This included private practice physicians and their staff, along with anyone else in our area who fell in the 1A tier group. “Even if they don’t work directly at a hospital, they are still frontline workers and seeing patients every day. We wanted to do what we could to protect them,” says Boone Health Chief Medical Officer Robin Blount, MD.
1. Boone Health staff and physicians receive the first vaccines on Dec. 17, 2020. 2. Dr. Robin Blount gives Boone Health Trustee Dr. Jerry Kennett the hospital's first COVID vaccine dose.
3. Staff from all areas are encouraged to get vaccinated.
“It is imperative that we get vaccinated. That vaccine is the first weapon we have that actually takes the fight to the virus. We need herd immunity to beat this virus. If we get that, that virus won’t be able to spread as easily to those who are Boone Health Chief Medical Officer Dr. Robin Blount vulnerable.”
Boone’s partner hospitals — Samaritan Hospital, in Macon, and Pershing Health System, in Brookfield — did not receive an allocation of vaccine, and so Boone sent staff and vaccine to them. “As the public is aware, I'm sure, many rural community hospitals did not have access to the COVID-19 vaccine. Doses that we were told would be available for rural facilities had not been provided by the state and no date has been given as to when it will be available,” says Pershing Health System CEO Phil Hamilton, RN, MA. “Boone provided their own staff and vaccine to nearly 100 of our employees at a clinic on January 6. This effort by Boone expedited the protection that our health care workers need to continue to provide care to the communities we serve. Essentially, this clinic saved lives among our staff and within the general population of our service area. We are most grateful to Boone Hospital Center for being more than a friend in this pandemic situation."
4 4. Boone nurses prepare their stations at the Pershing Memorial Hospital vaccine clinic. 5. A Pershing Hospital employee shares why he got the vaccine. 6 & 7. Boone Health nurse Brenda Wilson vaccinates Samaritan Hospital employees. 8. Pershing CEO Phil Hamilton expresses gratitude to Boone Health.
As more vaccine doses became available, Boone held public vaccination clinics at the Columbia Mall, working with the county health department to schedule eligible individuals. By Madison Loethen
9. Community members register to receive vaccines at the Boone vaccine clinic at Columbia Mall.
10. Boone Health nurses and pharmacists administer vaccine doses. 11. Screenings and social distancing are followed at all vaccine clinics.
‘MY WEIGHT WAS WEIGHING ME DOWN’ Boone Health Bariatric Services helped Meagan Fansler change her weight and her life.
eagan started struggling with her weight in college. After getting married and having three kids, she couldn’t keep her weight in a healthy range. She tried weight loss and exercise programs, but was never able to keep the weight off because the programs didn’t set her up for long-term weight loss success. Meagan had thought about bariatric surgery before but didn’t know if she qualified and never looked into it further. Meagan later realized she was in denial about her weight. At 5-foot-2, Meagan’s ideal body weight, according to Body Mass Index, or BMI, should be between 104 and 131 pounds. At her heaviest, Meagan was 265 pounds, putting her BMI at 47. “The higher one’s BMI, the more at risk they are for cardiovascular disease, diabetes, high blood pressure, high cholesterol, and a list of other conditions,” says Jennifer Tveitnes, a registered dietitian with Boone Health Bariatric Services. In 2016, Meagan and her husband divorced. Now a single mom, she was motivated by the need to keep up with the kids. She also realized she needed to be the healthiest parent she could be for them. Now was the time. At Boone Health, the bariatric surgery journey starts with an informational seminar that covers the different surgical procedures available, nutritional needs, activity requirements, and what to expect after surgery. Meagan attended a seminar in September 2017 and signed up for nutrition appointments. At Boone Health, surgery candidates meet with a registered dietitian for seven months before surgery, depending on their insurance company’s requirements. “It was a long process,” Meagan recalls. “But I think that’s one thing that helped make it successful for me. Because my insurance had those requirements, it set me up for success.” Going through this process helped Meagan realize she was an emotional eater. She adds, “I also realized how much our society circles everything around food — if there’s a celebration, you eat. If someone’s sad, you eat. You can never just get together with friends and there’s not food involved. It was really eye-opening.” The dietitian visits helped Meagan set attainable goals and work on meal plans. “It was really good to meet with the dietitian and make those goals ahead of time, just to get in the right mindset of what needed to change in my life prior to surgery. I just tried to make small changes leading up to surgery so that everything wasn’t cold turkey.”
For more information, please call 573.815.6447 or visit booneweightloss.org
One of her fears was the stigma that bariatric surgery is the "easy way out" for losing weight. “Don’t get me wrong, the weight comes off easily, but it’s all the work leading up to the surgery and the self-work that you need to do to make it successful,” she says. “It’s not an easy fix. I still have to have the control to make the right decisions every day. I essentially had to break up with food. I learned that food was an emotional thing for me and truly an addiction. I’m fully aware that I was addicted to food prior to surgery.” Before her surgery, Meagan attended Boone Health’s weight loss surgery support group, Through Thick & Thin, which is open to people who’ve had weight loss surgery or are considering it. Meagan found it helpful to be in a room full of people who’ve experienced the surgery. Members shared different tips and tricks they’d learned for success after surgery. Meagan had the vertical sleeve gastrectomy, a procedure that reduces the size of the stomach to restrict how much food it can hold. “Boone Health’s entire process set me up for success,” Meagan says. “I think Boone has a really great system. They prep you and follow up with you afterwards to make sure you do well.” As a nurse, Meagan is on her feet a lot. Before her surgery, she had knee and leg pain. After she lost her first 25 pounds, all of her knee and leg pain went away. “I didn’t realize until then how much the weight was weighing me down. I thought that the aches and pains were from being on my feet all the time. I didn’t realize it was because I was carrying extra weight around.” Meagan has inspired others, including co-workers, to have the surgery and feels confident when talking to people who have questions about the process. “If I can help anyone else achieve their goals by sharing my story, then I’m more than happy to tell people how I did it.” Meagan was only two months into her weight loss journey when she met Kaleb Fansler. After getting to know him more, she shared her ultimate goal with him, and he was super supportive. They married in 2019. Meagan loves that her husband got to experience the journey with her. It’s been over two years since her surgery, and her weight has stayed off. Today, Meagan feels like a whole new person. She tries to stay active and encourages her family to join her. She and her husband enjoy kayaking and other outdoor activities with the kids. Instead of sitting outside watching her kids play, she now enjoys playing with them. Meagan says the best compliment she ever got after surgery was from her son, who said, “You just seem so much healthier, Mom!” By Erin Wegner
Meagan used to wear a size 22/24 in pants and a XXL shirt. She now wears a 6/8 in pants and a Medium shirt.
Turkey Trax 2018
Turkey Trax 2019
His Safe Haven Boone Pulmonary Rehab helps a singer before and after his double lung transplant.
owie Ambrus loves to sing. His big, belting voice often took center stage as he sang the National Anthem at Mizzou sporting events. But Howie’s passion for singing was threatened when he was diagnosed with sarcoidosis. Sarcoidosis is a disease that causes inflammation and organ failure. It can occur in any part of the body. In Howie’s case, his lungs were affected. He found himself short of breath and his health quickly deteriorating. “Both my lungs were failing . . . so I needed a double lung transplant,” he says. To qualify for a transplant, Howie had to get into the best shape he could. Weight loss was a critical part of this plan, but Howie found it to be a scary thought, since exercise was difficult because of his failing lungs. “That’s when I first started going to Boone Pulmonary Rehab. I was able to work out while they watched me and made sure I was okay. I probably wouldn’t have had the confidence to work out otherwise,” says Howie. Howie’s team of nurses and exercise physiologists monitored him carefully and helped him get physically stronger. “In order to get on the transplant list, Howie had to be able to meet certain criteria and demonstrate that he had the required degree of physical capability and
Howie Ambrus, double lung transplant patient.
Hear from Howie on youtube.com/BooneHealth Howie with his wife Brandy while hospitalized for the transplant.
Howie recovering shortly after receiving the transplant.
Howie exercising at Boone Pulmonary Rehab.
support,” explains Brenda Wilson, a nurse with Boone Pulmonary Rehab. “Howie worked very hard to meet the goals he needed to accomplish.” Howie successfully lost weight. After three and a half years on the transplant list, he underwent a double lung transplant at Barnes-Jewish Hospital in St. Louis. The recovery was difficult, which he had expected, but when Howie left St. Louis, he had comfort knowing he would be back in the care of Boone Pulmonary Rehab. “Starting to exercise again with the Boone Pulmonary Rehab team gave me so much peace of mind,” says Howie.
Pulmonary rehab staff members monitor Howie’s vitals while he performs cardiovascular and muscle strengthening exercises designed to help him meet his personal goals. Howie’s determination and commitment also contribute to his recovery. “Howie has done the exercise. He’s done the rehab. And he’s going for it! He has definitely gotten a lot stronger, and his muscle increases help his body use oxygen better,” notes Hunter Blume, exercise physiologist. “Since Howie got the transplant, he’s like a new man. He’s 10 years younger, and he is able to enjoy things at home
with his wife and his daughter that had really slowed down before the transplant,” says Brenda. Howie continues his treatment plan with Boone Pulmonary Rehab, which he calls his “safe haven” because he knows he’s able to safely push himself towards his goals while being monitored. Howie is starting to sing again. At Pulmonary Rehab, he can often be heard singing while walking around the track and exercising. Howie says he is looking forward to being able to sing at games again, and he knows with the help of Boone Pulmonary Rehab, he’ll get there. By Madison Loethen
B R IN G IN G UP B O O N E B A B IES
Pregnancy Trackers WHAT TO EXPECT
THERE'S AN APP FOR THAT Tools to help you during pregnancy and life with a new baby. When it comes to pregnancy and caring for a newborn, the amount of information you find on the internet can be almost as overwhelming, confusing, and contradicting as raising a new human — welcome to parenthood! New parents can learn most of what they need to know by being present with their baby and learning what works best for their new family. But sometimes, you need a little help staying on track with feedings, keeping all the information organized, or answering questions. That’s where the internet and apps can help. We would like to share a few resources that we or someone we know have used that we think make life with a newborn a little easier. As always, parents know best. If you think something isn’t right with your baby, trust your gut and talk to your baby’s doctor. If you or your baby (or both) are struggling with breastfeeding, talk to one of our lactation consultants, who are available six days a week via phone, email, or in-person visit. While using an app can help you answer questions or manage your time and energy, remember that the best way to learn about your baby is to spend time together. Pay more attention to your baby than to the data. Human babies are all unique. Enjoy getting to know yours! By Emily Nusbaum, RN, IBCLC, Boone Family Birthplace
Mobile Platform: Cost: Free • Resources for trying to conceive • Personalized daily pregnancy tracker and due date countdown • Information broken down by pregnancy week, including videos hosted by What to Expect founder Heidi Murkoff. • Expert advice for baby's ﬁrst year • Share photos, stories, and advice with other moms
FULL TERM CONTRACTION TIMER Mobile Platform: Cost: Free ($0.99 to remove ads) • Tap one button to track the beginning and end of each contraction, and the app will monitor times, durations, and frequency during your entire labor • Kick counter • Weight tracker
TEXT4BABY Mobile Platform: Cost: Free • Week-by-week information about your pregnancy, your baby’s development, and baby’s ﬁrst year • Personalized calendar for prenatal and well-baby visits • Appointment reminders • Vaccination tracker • Pregnancy and parenting resources • Set up personalized text messages
SPROUT PREGNANCY Mobile Platform: Cost: Free ($4.99 for Sprout Premium) • Pregnancy journal • 3D realistic representation of your baby’s development • Daily and weekly information • Personalized pregnancy timeline • Kick counter, contraction timer, and weight tracker
Child Care & Development
Breastfeeding Trackers BABY TRACKER
Mobile Platform: Cost: Free ($4.99 for the full version)
Mobile Platform: Cost: Free ($7.99 a month for
Mobile Platform: Cost: $3.99
• Comprehensive feeding tracker and nursing timer • Track sleep and diaper changes • Record growth and milestones • Export information to share with your baby’s doctor
• Health tracker records your child's symptoms, temperature, medications, illnesses and health events • Track doctor visits and immunizations • Development and growth trackers • Track feedings, sleep, diaper changes
GLOW BABY Mobile Platform: Cost: Free
• Capture and share memories • Share data across multiple devices, including your Apple Watch
• Track your baby’s developmental milestones • Track feedings, diaper changes, sleep, and more
• Weekly notiﬁcations • Interactive growth charts with data summaries • Connect with other parents • Document and share your baby’s milestones • iOS version works with Apple CareKit and Health App
EAT SLEEP Mobile Platform: Cost: Free ($0.99 to remove ads)
Mobile Platform: Cost: Free ($3.99 for full version) • Ensure safe breastfeeding while using prescription and over-thecounter medications • Scan barcodes for information on drug safety and ingredients • Based on research by the Texas Tech University Health Science Center’s InfantRisk Center
MILK MAID Mobile Platform: Cost: $2.99
• Easily track your baby’s feedings, sleep and diaper changes
• Record pumping sessions
• View daily, weekly and monthly activity totals • Track data for multiple children
• Track your fresh and frozen milk inventory at home, work, and other locations
• Track your baby’s development and milestones • Information and videos about your baby’s development schedule and new skills • Tips to help your baby, including games and exercises
WEBMD BABY Mobile Platform: Cost: Free • Health news and a library of medically approved content on pregnancy, infant health, and child care • Track nursing and feeding sessions, sleep, diaper changes, and growth • Capture and share your baby’s milestones with family and friends.
MY NICU BABY BY MARCH OF DIMES Mobile Platform: Cost: Free • Easy to understand information about what to expect while your baby is in the NICU • Tips and helpful videos to care for your baby in the NICU and at home • Track breastfeeding sessions, pumping, kangaroo care, and baby's weight • Connect with other NICU families • Checklists help you prepare to bring baby home
NEED MORE SUPPORT? If you have questions about caring for your baby, Boone Family Birthplace’s Family Life Education classes can help you know more about pregnancy, infant care and safety, and breastfeeding. We also offer one-on-one breastfeeding support with certiﬁed lactation consultants. To learn more about our services, visit boone.health/birthplace MyBooneHealth.org
GETTING TO KNOW A BHC DOCTOR
Kate Grossman, MD Critical Care and Pulmonology
’m originally from New York and have been with Boone Health for ﬁve years. I’m married with two daughters, one who is 14 years old and another who is almost 4.
Why did you get into the health care field? I always wanted to be a doctor. When I was little, my brothers would walk to our neighborhood corner stores to get candy, and I would go next door to the pharmacy to buy gauze and Ace wraps for my injured dolls. What interested you in your particular specialty? It took me a while to decide on my specialty. I am currently quadruple-boarded in adult pulmonary and critical care medicine, internal medicine, and pediatrics (though I no longer practice). I care for pulmonary patients in my outpatient practice at Boone Pulmonary Medicine and see hospitalized patients as a pulmonary consult. I work in the intensive care unit as an intensivist. I love the mix of patients I see. I love caring for inpatients in life-and-death situations and helping both the patients and their loved ones during a critical time. I love helping to diagnose infections and cancers in the least invasive ways possible. I also love the relationships with my clinic patients with chronic medical problems. What is the most rewarding aspect of your job? Providing care for patients with an incredible team of health care providers. After training at academic centers in big cities, I've been amazed at the quality of care we provide at Boone and the teamwork I see daily. What is the most challenging aspect of your job? The COVID pandemic has been a unique time to practice medicine. We are caring for incredibly sick patients and have learned and adjusted our care as the pandemic has continued. The care provided for patients and families — who, for much of the year, have been unable to be present in the hospital — has been incredible to witness. It’s also been frustrating to feel like health care providers travel between two different worlds: the hospital, where we see incredibly sick patients, and the community, where we still see community members not following basic public health guidelines that could truly save lives. What advice would you give someone looking to become a doctor? I do think you have to truly love medicine to become a doctor. It is a long path, but I find it incredibly satisfying.
What do you see changing in health care in the next five to 10 years? COVID-19 has made clear what many of us have known for years: there are huge disparities in how health care is delivered and in outcomes in different racial and ethnic groups. Racism needs to be fought at every level in our society, especially in health care. I think there will be necessary and increased focus on creating greater equity in healthcare, on recognizing and fighting implicit bias, and on making sure all patients get the care they deserve. What do you enjoy doing outside of work? I love spending time with my family. Before COVID, we enjoyed traveling for pleasure and visiting family in New York and New Orleans. We can’t wait to see our families again after this incredibly hard year. What advice would you give to someone who is going to be a patient in a hospital for a period of time? Because I spent much of my time in the ICU, I think the most important advice for anyone is to have a conversation with trusted family or friends about your wishes if you were to become unable to speak for yourself. Everyone should identify one person you would trust to make health care decisions for you. And if that person isn’t your legal next of kin, fill out a healthcare proxy form to legally allow them to be your decisionmaker if needed. It’s a hard conversation to have, but it’s incredibly helpful to have others know what your wishes would be in a life-or-death scenario. While we hope we never have to use this information, having these conversations ahead of time allows us to care for patients according to their wishes, and it unburdens friends and family who might have to make difficult decisions.
GETTING TO KNOW A BHC NURSE
Brandy Templeton, RNC-OB Labor & Delivery
come from a large extended family in Monroe City, Mo. My husband and I frequently spend time there and in his hometown for family gatherings, camping, boating, and ﬁshing. I attended nursing school at Moberly Area Community College where I was a cheerleader for the Greyhounds basketball team. Columbia has been my home for the last 14 years. I was introduced to my husband by a Boone coworker. We live just outside of Columbia with our three daughters, Addison, Lyla, and Genevieve.
Why did you get into the health care field? I have always loved science, anatomy and caring for others. Working in health care has been my plan for as long as I can remember. I feel so blessed to have a job that I truly love to go to each day. What interested you in your particular specialty? I initially considered pediatrics, but during nursing school I fell in love with obstetrics. I feel so passionately about helping each family have their best birth experience and to be there to provide support when things don’t go as planned. As luck would have it, I became an OB float nurse 3 years ago and got to expand my area of expertise to include pediatrics, our neonatal ICU – or NICU – and general adult medicine. This position feels like it was made for me – I love the change of pace, learning new things, and stepping out of my comfort zone to continue to grow as a nurse. What is the most rewarding part of your job? One of the coolest things about my job as a birth instructor and a float nurse is the many families that I am able to follow from prepregnancy through labor and birth to post-partum and sometimes the NICU. It is really comforting to some patients to have that continuity of care, and I love getting to see them through their journey of parenthood. What is the most challenging aspect of your job? Supporting families through the loss of a baby is so incredibly challenging. It is an honor to be able to help them on their journey of loss and provide them with memories of their baby that are as positive as possible, but it is one of the most emotionally draining aspects of my job. What has changed in your field since you started practicing? I have seen an increased focus on patient- and family-centered care. We are striving to make changes that are not
only better medically for the patient but that better allow the birthing patient and support members to bond and learn to care for their new family. I have been a part of initiatives to bring newborn care to the parents' bedside, including skin-to-skin care in the operating room for Cesarean deliveries and decreasing separation of newborns from their parents for routine care. I believe it’s important to help parents have the experience that they desire while teaching and supporting them when their birth plans must change for the safety of mother and baby. What do you see changing in the next 5 to 10 years? For one, I hope that I won’t be wearing a mask at work every day in 5 years! I don’t know what is on our horizon, but I know we will continue to change and evolve to provide excellent care. I am so proud to be part of Boone Health as we move forward. What do you enjoy doing outside of work? I love to sew and use my Cricut to design shirts and do projects around the house. I enjoy making matching outfits for my daughters. Luckily, they’re young enough to still tolerate this. We enjoy biking and going to concerts as a family. During the pandemic lockdown, we bought a pool for our house where the girls and I spent every spare moment swimming and floating around over the summer. What advice would you give someone looking to become a nurse? It is hard work, but if you love it, becoming a nurse is so worth it. There are so many different paths that you can take as a nurse. Be ready to embrace change and technology and make sure to take care of yourself.
BOONE BOONEHOSPITAL HEALTH CENTER Spring 2021 Winter 2021
ust like the rest of your house, the pantry is a great place to do some spring cleaning. Food items can slowly accumulate and be forgotten over time. Are you always buying more of an item because you can’t remember if you have any left at home? Are you always tossing out food because it goes bad before you get a chance to use it? Organizing your food storage areas can help you cut down on food waste and have everything you need for a healthy meal on hand.
STEP ONE: Take everything out of your pantry.
As you remove items, check the expiration dates and throw out anything expired. Place unexpired and unopened food that you don’t plan to eat in a separate pile to donate to a local food pantry or community food drive. This step is a great opportunity to practice reading labels, especially if you’re trying to revamp your diet. Reading labels in the comfort of your own kitchen is easier than in the aisle of a grocery store. Look for excess sodium and added sugars – two ingredients Americans consume in excess that have a potentially negative effect on health. But you don’t need to throw out foods that are high in sodium or added sugar; eat what you have and look for products with lower sodium and sugar when you restock. Some sodium can be removed through rinsing — just remember to buy a lower sodium product next time.
STEP TWO: Wipe down all surfaces.
After you’ve gone through the hard work of removing everything, you’ll want a clean space to store your food. Dust and spills accumulate over time, and bare shelves are easier to clean. It’s also a great time to lay down shelf liners to make future cleaning even easier.
STEP THREE: Organize your remaining food as you put it back.
Like should go with like. Keep every can of beans together. All of your dry grains should go on the same shelf. Baking ingredients should be in the same spot. Use decorative baskets or containers to keep similar foods together and to prevent different food items from getting mixed up or lost on the shelf. Storing flour or sugar in clear containers instead of the original bags will cut down on mess and let you see how much you have left. Make sure to label your containers so you don’t mix up flour with powdered sugar or salt with granulated sugar!
STEP FOUR: Make a list of what you have and what you need to buy.
Keep a list of what you’ve returned to your pantry and use that list to make a second list of items to buy at the store. Remember to update your inventory. When shopping, don’t feel tempted to buy foods because they’re considered pantry staples. If you won’t eat it, don’t buy it. Focus on your personal eating habits. This will help you avoid filling your pantry with food you don’t want or plan to eat. You can follow these steps for other food storage areas. The refrigerator is another place where forgotten and expired foods can accumulate. When cleaning and organizing cold storage, place your food in a cooler to keep it from thawing or getting too warm while you give your fridge a thorough scrubbing. When returning food to your clean fridge, keep food safety in mind. Typically, readyto-eat foods — items that do not need to be cooked before being eaten — should go on your top shelves to decrease the risk of crosscontamination with raw, uncooked foods. After you fill your top shelf with readyto-eat foods, arrange the rest of your food
from top to bottom based on recommended cooking time: Foods with lower cooking times go towards the top, higher cooking times go towards the bottom.
Cooking Temperatures for Meat (From Low to High) • • • • •
Seafood, eggs, ﬁsh: 145° F Raw steak: 145° F Raw pork: 145° F Raw ground beef: 155° F Raw poultry: 165° F
You can store your meat in the designated meat drawer instead of a shelf. If you thaw frozen meat in the fridge, put the meat in a container with raised edges to keep liquid from the meat from contaminating other foods. This is especially important if the meat is thawing on the bottom shelf above your crisper drawer. The crisper drawer is ideal for fruits and vegetables prone to wilting or turning soft. However, not all fruits and vegetables need to be refrigerated. In fact, some produce such as bananas, tomatoes, potatoes, and onions taste better when kept at room temperature. The inside of the door is usually the warmest part of the refrigerator. Use these shelves for butter, dressings, condiments, juices, and other drinks. Don’t store eggs or milk inside the door — your fridge could get too warm for these items to stay safe. Having a system for spring-cleaning your pantry and refrigerator can not only help you keep a clean, well-stocked kitchen with less waste and hassle, but you might also learn about your food buying habits along the way. Happy cleaning! By Kate Lohman, MS, RDN, LD
Staying Flexible A Boone physical therapist
shares simple stretches to ease tight muscles and stiff joints. During the winter, when we typically become less active, we may feel tightness in our arms, legs or back. Tight muscles and stiff joints are common, but they can make daily tasks difficult and cause severe pain or limit our movements. Stretching exercises can help us maintain or improve our muscles’ extensibility — their ability to be stretched — and our joints’ range of motion. If you sit for a long spell, you may notice your muscles are tight when you get up and move around. This is because our muscles are made of contractile fibers that automatically pull close to one another and shorten when we're not moving. Over time, muscles can get used to being in this shortened position. Even if you're active, it's easy to overlook the benefits of regular stretching as part of a well-rounded exercise regimen. In the short term, stretching improves blood flow to muscle tissue and can decrease general aches and pains. Long-term benefits include improved muscle extensibility, range of motion, posture, and control of your limbs while walking, which can reduce your fall risk. These exercises can be performed three to five times a week or every day if you can do them without discomfort. Warm up your muscles first with a few minutes of walking. Do these exercises so that you can feel the stretch, but don’t stretch so far that it hurts. If you need to, reduce how far you stretch, how long you hold the stretch, or how often you stretch until it becomes more comfortable. If you feel pain while doing these stretches, please stop and talk to your primary care provider. By Wes Glenn, DPT, PT, Boone Therapy
Hamstring Stretch Stretches tight hamstring muscles that can cause back pain and reduced hip movement. Sit on the edge of a chair and extend one foot in front of you with heel on the floor. Straighten your knee and then, while sitting up straight, lean forward at the hips until you feel a stretch in the back of your leg. Stretch for 30 to 60 seconds and repeat with the opposite leg. Do this stretch two times in each leg.
Variation Put a short step stool under your heel to make it easier to lean forward.
Knee to Chest Stretch Stretches the lower back and soft tissue in the hips. Lie on a couch or bed and grasp the front of one knee and gently pull your knee towards your chest. You will feel a stretch in your buttocks and lower back. Hold for 30 to 60 seconds and then repeat with the opposite leg. Do this stretch two times for each knee.
Variation Bend the knee on the side being stretched if you feel discomfort in your back.
For more information, visit boone.health/therapy or call 573.815.3868
Upper Trapezius Stretch Stretches the trapezius muscle, which controls the neck and shoulders. Sit in a chair with good posture. Bend your neck to one side as if trying to place your ear against your shoulder, but don’t stretch farther than is comfortable. You will feel a stretch on the opposite side of your neck. Don’t turn your head during this stretch and don’t let your shoulders rise. Repeat in the other direction. Hold for 30 to 60 seconds. Do this stretch 2 times on each side.
Pectoral Stretch Stretches the muscles running from your chest to your shoulders. Standing in an open doorway, raise one arm and place it against the frame as shown. Turn your head and torso away from your arm to feel a stretch in your chest and the front of your shoulder. Hold for 30 seconds. Repeat with the opposite arm. Do this stretch two times on each side.
Variation Raise or lower where you place your arm to find a more comfortable position.
Trunk Rotation Stretch Stretches muscles that can cause stiffness in the middle and lower spine. Sit in a chair with good posture and turn your torso to face one direction as far as you comfortably can. You will feel a stretch in your back and trunk on the opposite side of your body. Hold for 20 to 60 seconds and repeat facing the opposite direction. Do this stretch two or three times on each side.
Trunk Side-Bending Stretch Stretches muscles on the side of the spine. Sit in a chair with good posture. Raise one arm above your head and lean towards your lowered arm until you feel a stretch along the side of your spine. Hold for 30 seconds and repeat with the opposite arm. Do this stretch two or three times on each side.
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CALENDAR OF EVENTS MAY 3 -5
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Your gift advances a legacy of caring. Campaign brochures will follow. For more information, visit boone.health/ Foundation/CommunityCampaign or call 573.815.2801 Thank you for sharing the Gift of Health! C ELEBRATING OUR PAST ... EMBRACING OUR FUTURE !
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