Boone Health SUMMER 2017
Helping a Hero PG. 14
U S A rm y Ve t eran Josep h Toe pke s hares h i s s tory.
PA GE 1 2 B O O N E B A B Y PA R E N T S PAY I T F O R W A R D
I’m a Boone Baby! When it comes to having a baby, the Boone Touch is your touch. We don’t tell you how to have your baby. We listen to how you want to have your baby. From low intervention to high risk and everything in between, your trusted family of Boone Hospital professionals is with you. That’s the Boone Touch. And whether it’s breast feeding or formula, rooming in or nursery, that’s your touch.
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Jim Sinek Director of Marketing and Public Relations
Multimedia Marketing Specialist
Madison Loethen Photography
Madison Loethen Keith Borgmeyer Contributing Writer
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A Note from Jim
Drinking Your Calories
Keeping Kids Healthy
Manicured with Love
Get to Know a BHC Doctor
Get to Know a BHC Nurse
Helping a Hero
Life Saving Testing
Lessons of the Heart
Coping with Postpartum
The Pros and Cons of Coffee
BOONE MEDICAL GROUP - SURGERY Ly Phan, MD; Anne Petersen, MBA, MD, FACS; Reggie Vaden, MD, FACS, FACRS
From your first doctor’s visit to your post-op care, our Boone Medical Group surgery team is there for you 24 hours a day. Every general surgery procedure, inpatient or outpatient, is done in the care, privacy and safety of Boone hospital.
That’s the Boone Touch.
A NOTE FROM JIM
Get Outside for Health
“Our goal is to get kids outside – and get their family members to join them – to exercise their minds and muscles, and have fun while improving their health.”
mproving health is the mission of Boone Hospital Center. Here are a few ways we are working towards that mission. One aspect of improving health is providing convenient primary care services to the residents of midMissouri. This convenient access facilitates annual physicals, wellness checks, on-going assessment and monitoring of chronic illnesses and efficient treatments of minor injuries and illnesses. Boone continues to build upon our already substantial network of primary care clinics and convenient care locations. Soon we will add a new primary care clinic in Osage Beach, MO. The clinic will be located in Hy-Vee at 929 Highway D and is scheduled to open in fall 2017. Paul E. Bernabe, MD, and Maria Bernabe, MD, have been practicing medicine for over 20 years, the last 12 years in Eldon, MO. The Bernabes will join the Boone Medical Group and will be our primary care providers at the Osage Beach Clinic. It’s another way we’re bringing Boone Hospital and BJC HealthCare primary care closer to you! With summer here, we continue to build upon an annual tradition of improving the health of our children. Our Kids on Track program will be in full swing throughout the summer in nine communities across mid-Missouri. The Kids on Track program encourages children of all ages to collectively run, walk, bike or skate 26.2 miles — the length of a full marathon — during the summer, earning prizes from sponsors along the way. The program concludes in
August with a celebration including activities for the entire family, medals for the participants, food and fun! Our goal is to get the kids outside – and get their family members to join them – to exercise their minds and muscles, and have fun while improving their health. Finally, Boone Hospital and BJC HealthCare will transition to the Epic electronic medical record system over the next 18 months. Boone will be the pilot hospital with a go-live date of August 5, 2017. Our Boone Medical Group providers went live with Epic on June 3, 2017. This initiative is designed to improve the health and safety of our patients. The Epic system provides new and better tools to improve access to medical data, enhance communication between caregivers, facilitate the use of evidence-based best practices and elevate patient safety. The Epic implementation is one more way Boone Hospital and BJC HealthCare are improving the health of the people and communities we serve.
Jim Sinek President, Boone Hospital Center
Boone Hospital Center to open Boone Medical Group Clinic in Osage Beach
oone Hospital Center and the Boone Medical Group are opening a new clinic in Osage Beach. The clinic will be inside the Osage Beach Hy-Vee store located at 929 Highway D. The clinic is scheduled to open in fall 2017, and they will be accepting patients of all ages. “Boone Medical Group and Hy-Vee share similar interests in the health and well-being of the people we serve,” says Erin Bailey, Hy-Vee’s assistant vice president of health and wellness project development. “Healthy eating goes hand in hand with good health care, treatment and preventive care services. This new retail health clinic is a perfect fit for us as it allows our customers the convenience of easily seeking health care services in our very own stores.” Paul E. Bernabe, MD, and Maria Bernabe, MD, have been practicing for more than 20 years, and have practiced the last 12 in Eldon, MO. Both physicians are passionate about caring for their patients and look forward to continuing that work in Osage Beach. Dr. Paul Bernabe graduated from University of Santo Tomas in 1990. He completed a residency at Cook County Hospital in Chicago and is board-certified in family medicine. Dr. Maria Bernabe graduated from University of Santo Tomas in 1989 and completed a residency at Cook County Hospital in Chicago as well. She is board-certified in pediatrics.
Maria Bernabe, MD and Paul E. Bernabe, MD
“We love serving families because healthy families build healthy communities,” says Dr. Maria Bernabe. “We find our joy in service. We are excited to continue serving our patients and their families in our new Boone Medical Group location at Hy-Vee in Osage Beach and becoming part of BJC HealthCare.”
Current plans for the clinic include 14 exam rooms in a 6,400-square-foot space. The Osage Beach location will become the fifteenth Boone Medical Group clinic, joining locations throughout midMissouri in Ashland, Boonville, Centralia, Columbia, Glasgow, Hallsville, Mexico and Moberly.
WELLAWARE Fitness Center now accepting SilverSneakers If your Medicare health plan, Medicare Supplement carrier or group retiree plan includes SilverSneakers as part of your benefit package, you can now exercise at the WELLAWARE Fitness Center for free! The fitness center is located at 1601 E. Broadway, Broadway Medical Plaza 1, lower level, in Columbia, MO. To find out more about SilverSneakers, visit www.silversneakers.com.
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Book Brigade For the second year in a row, the BJC Book Brigade delivered a new readinglevel-appropriate book to every child entering into the third grade in the communities it serves. In all, more than 22,000 books were distributed. Monica Smith, MSN, RN, NE-BC, vice president of patient care services and chief nursing officer at Boone Hospital Center, hand-delivered books to Ms. Armontrout’s class at Paxton Keeley elementary in Columbia. Monica read to the students and answered questions about being a nurse. The books are given to help the children reach a milestone. Studies have shown that if reading at grade level by the third grade, students will be more likely to graduate from high school and live longer, healthier lives.
Each year, Boone Hospital Center honors members of the nursing staff with Professional Excellence in Nursing Awards. Nurses and partners in caring are nominated by their peers in each category. The awards were announced at a circus-themed ceremony on May 9, 2017, as part of the hospital’s celebration of Nurses Week.
2017 WINNERS Year One Wonder
• Cecilia Boessen, Medical Specialties • Stacia Reed, Women’s and Children’s Health
Excellence in Nursing Education
• Lori Humphrey, GI Lab • Pamela Martin, Training and Development
• Mary Manley, Medical Specialties • Nick Weston, Emergency Department
Partner in Caring Bob Wagner and Randy Morrow were elected to serve one-year and five-year terms on the Boone Hospital Board of Trustees, respectively, on April 6, 2017. Bob Wagner has served as a trustee for the past five years. Randy Morrow worked at Boone Hospital Center for 38 years, primarily as the chief financial officer.
• Korey Elkin, Customer Relations • Michelle Vazquez, Women’s and Children’s Health • Sonya McQuitty, Medical Specialties
• Sherri Barnes, Women’s and Children’s Health
Excellence in Professional Nursing
• Rachel Clark, Medical Specialties • Ann Bene, Surgical Specialties • Stephanie Whitbey, Pulmonary Medicine
Nurse Residency Program
The first class has graduated from Boone Hospital’s nurse residency program. Boone’s nurse residency program is based on the Vizient Nurse Residency Program, which is evidence-based, used throughout the nation and has a proven track record of success. The Vizient program includes an evidence-based curriculum developed by experts from academic medical centers and nursing schools across the country. The program focuses on leadership, patient outcomes and developing in a professional role. Boone Hospital Center’s nurse residency program is interactive and fun as well as educational. The nurse residency program is designed to offer support to new graduate nurses. This is done through classroom learning and on-thejob experiences, helping the new nurses build upon their clinical skills and feel more engaged as a heath care team member. Velvet Meers, RN, BSN, BC is the nurse residency program coordinator and can be reached at 573.815.3823 or firstname.lastname@example.org.
Kids on Track Keeps Mid-Missouri’s Youth Active Over the Summer For its sixth year, Kids on Track, a community youth program sponsored by Boone Hospital Center, Boone Medical Group and the Boone Hospital Foundation, brings the joy of physical activity to mid-Missouri children. The Kids on Track program encourages youth 12 years of age and under to be physically active by accumulating 26.2 miles of physical activity. They can complete the marathon at their own pace over the course of the summer by walking, running, biking or even roller skating. This year, nine area towns are participating in the event: Ashland, Boonville, Brookfield, Centralia, Columbia, Hallsville, Macon, Mexico and Moberly. The program has come a long way from 2012, when it began in Columbia. Over the past few years there has been tremendous growth as the program has gained popularity with children and families alike.
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Each town has its own kick-off event in May where participants receive a printed track to record their progress over the summer. Each town also has its own finale event in August where participants receive a free T-shirt and medal for their success in being active over the summer. To further encourage children along the way, local businesses become Mile
Sponsors. These businesses sponsor different miles along the 26.2 mile track and reward the kids for their progress. “Even though the program is targeted at youth, Kids on Track really gets the entire family moving and making better choices as a family,” says Erin Wegner, who has coordinated the program since 2012.
Boone Hospital Center Recognized for Efforts to Change Lives by Saving Sight
Haley Lyne, left, from Saving Sight presents the Excellence in Eye donation award to Monica Smith, VP of patient care services, and Boone Hospital nurses Heidi Burris, Heather Blakeman and Mikahayla Schrimpf.
oone Hospital Center received Saving Sight’s 2016 Excellence in Eye Donation Award. This marks the third year the hospital has been honored for achievements in providing the gift of sight to those needing a cornea transplant. Overall, the hospital achieved a 46 percent consent rate for eye donation in 2016. Staff at Boone Hospital Center helped to facilitate 29 eye donation cases, which resulted in 30 individuals receiving restored sight through a cornea transplant. Created in 2014, the Excellence in Eye Donation Award recognizes hospitals that demonstrate an outstanding commitment to eye donation. Fewer than 15 percent
of Saving Sight’s partner hospitals in Missouri, Kansas and Illinois will be recognized with a 2016 Excellence in Eye Donation Award. Partner hospitals that achieved an eye donation consent rate exceeding 45 percent with at least 10 donors during the 2016 calendar year will receive the award. “Children see to learn, parents watch their children grow and older adults maintain independent lifestyles thanks to the vision made possible through corneal transplants each year,” says Tony Bavuso, CEO of Saving Sight. “We are grateful to our partners at Boone Hospital Center who believe in our mission to change
lives by saving sight and work with our courageous donors and donor families to make the precious gift of sight possible for countless individuals.” With the help of hospital partners like Boone Hospital Center, Saving Sight provided corneas for more than 2,900 corneal transplant recipients in 2016. Each year around 48,000 individuals in the United States require a cornea transplant to restore vision that has been lost due to disease, disorder or injury. For more information or to learn about becoming an eye, organ and tissue donor, please visit donatelife.net.
LOVE Manicured with
Boone Hospital Center volunteers provide manicures to patients staying at the hospital.
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Want to volunteer to give manicures? Call Mandy at 573.815.6064
77-YEAR-OLD Carmen Koebbe sat back in her hospital room recliner. Her nurse and daughter had encouraged her to spend some time sitting up, promising that it would aid with her recovery. Still, just a few days after having heart surgery, it was no easy task. That’s when Carmen heard a knock on the door. Longtime Boone Hospital volunteer Anne Elfrink walked into Carmen’s room and introduced herself. She asked Carmen if she would like a manicure. Carmen lit up. As a former Mary Kay rep, her unpolished nails had been bothering her for days. Of course, Carmen said she would love one, and Anne got to work. Anne asked Carmen all about her life and her family as she gently cleaned Carmen’s hands. She proceeded to massage Carmen’s hands for several minutes. Carmen felt instantly relaxed, and all of the pressure of having to sit up out of bed seemed to melt away. Carmen told Anne how she had come several hours from her hometown of Salem, MO. to have surgery at Boone. She said she has loved the doctors and nurses who have treated her here, but it was hard to be so far from home. She also mentioned that her daughter and son-in-law had been staying at a local hotel so that they would be able to see her while she was in the hospital. When the massage was over, Anne asked Carmen to pick out a color. Carmen chose a light pink and smiled when she saw how nice it looked on her nails. Anne took her time with the manicure and ended up spending about an hour just talking to Carmen and pampering her. By the time Anne left, Carmen’s spirits were greatly lifted. She even said she wanted to do something nice to someone else soon, just as Anne had done something nice for her. The manicure program was started almost 20 years ago by Boone Hospital’s supportive care program coordinator Dorreen Rardin, RN. When Dorreen started the supportive care program in 1998, she asked for volunteers to give manicures to supportive care patients. “Human touch can be so healing. So can being pampered. Getting a hand massage and nails painted can really encourage patients. We started doing the manicures for supportive care patients, but now we give them to any Boone patient that we think it might help,” says Dorreen. Boone currently has two volunteers who give manicures to patients. If you or a loved one are a patient at Boone Hospital and would like a manicure, just ask your nurse. By Madison Loethen
Pictured: Carmen Koebbe
Parents of preemies pay it forward.
s the saying goes, it takes a village to raise a child. For Lucas and Victoria McCain, the parents of newborn preemie twins, two villages came together to support their girls from the start — their rural Missouri hometown of Clarence and the Boone Hospital NICU. Now, the McCains provide that support for other NICU families. In late September 2016, Victoria, who was 27 weeks pregnant, noticed swelling in her feet and was diagnosed with dangerously high blood pressure. She was admitted to Boone Hospital and, over the next few days, developed a severe case of pre-eclampsia, a condition in pregnancy characterized by high blood pressure, sometimes accompanied by fluid retention. “Pre-eclampsia is hard on both the mother and the baby,” Lucas says. “The doctors did what they could to maintain the pregnancy, but one of our daughters, Clara, had a complication with the way her umbilical connected to her placenta. This caused her to have to work extra hard to get the necessary nutrition.” Eventually, Victoria’s blood pressure reached a point where maintaining the pregnancy was too much of a risk for her life, and the doctors performed an emergency cesarean section. “All of our doctors did an amazing job explaining everything to us and being honest with us,” says Lucas. “They told us what was happening, what the options were, why they made the decisions they made and what the risks were. I think there’s comfort in
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To donate or provide support, visit spf365.org
knowing, and I never felt like I didn’t know what was going on.” Abigail and Clara McCain were born September 30, 2016, 12 and a half weeks before their due date of December 26. Two pound Abigail and 1 pound, 8 ounce Clara were immediately rushed to the NICU. “The NICU staff was absolutely amazing to us and to our girls,” Victoria says. “Everyone was so caring and genuinely wanted to help me when I was going through the hardest time of my life. Every doctor, every nurse and every other staff member made our situation so much better and easier to handle. The doctors made sure to let us know every single day what they were doing treatment-wise and made sure that we understood fully and were comfortable with everything.” Clarence is an hour and 20-minute drive from the hospital. Lucas travels for his job and would visit the twins as often as possible, while Victoria, who owns her own business, would make the drive to visit them every day of their 78 day stay in the NICU. During the twins’ hospitalization, many of the nurses became more like friends than caregivers. “They took an interest in getting to know us as people rather than patients,” Lucas says, “and that made us feel a little more at ease. Many of them would come back and visit us on their next shift, even when they weren’t assigned to us. It just made us feel cared for.” Friends and family pitched in to help ease the financial burden with gift cards and showed emotional and spiritual support with visits to the NICU. “We had so much support from our small community, and we felt like every family in the NICU deserved the same,” Victoria says. “Whether it was a gift card in our mailbox
Victoria, Clara, Abigail and Lucas McCain
or a greeting card saying, ‘Hey, we’re thinking about you,’ it was all just so helpful. We really wanted to pay it forward and help the families who don’t have that kind of support system.” In February, Lucas and Victoria started Supporting Preemies Families 365, or SPF 365, a nonprofit organization founded to offer support to parents who have children in a NICU. “We knew we would never be able to pay back all those who have helped us, and we knew they didn’t want us to,” says Lucas. “We thought the best way for us to pay them all back would be to pay it all forward. We started this nonprofit to share the same support we had with families who are going through without it.” Thus far, SPF 365 is proving to be a success, with several donations made ranging from $10 to $500. Lucas says the funding is a little slower at times, but the McCains have faith that SPF 365 will continue to grow as an organization, and they continue to give back to families in need.
“We have gotten a lot accomplished in a very short amount of time,” says Lucas. “We have more than 500 people across the world following us on Facebook and sharing our posts, and some of our posts have been viewed by more than 10,000 people. We have been very encouraged by the support.” Using the donations, SPF 365 has been distributing boxes containing gift cards. In each box is a $200 Visa gift card to help with paying bills, a $25 gas card and a $25 gift card to an upper-end restaurant for a break away from the hospital. “During our time in the NICU, we received a lot of financial, emotional and spiritual support from our family, friends, work associates and many other people,” says Lucas. “We discovered we had this huge network of people who rallied around us to help us get through such a hard time. We received so much, and we were so grateful. It would have been much harder to get through it all without that help.” By Jordan Milne
Watch Joseph’s story at youtube.com/BooneHospital
The Boone Hospital Center Pain Management Clinic provides a war hero relief from back pain.
nited States Army Veteran Joseph Toepke says he was privileged to live his dream of being an Army helicopter pilot for more than two decades. But it was his dream that left him in extreme back pain, something that eventually forced him to retire from the military service. Joseph joined the US Army in 1992 with the goal of becoming a helicopter pilot. In 1995, he became a commissioned officer and was sent to a yearlong flight school. When he graduated, he spent some time in the Missouri National Guard before several deployments, two in the Middle East. Joseph remembers his back pain becoming a real problem in 2006 and 2007 when he was stationed in Iraq. “Some of my flights were 8 hours long, and I would be in so much pain that I couldn’t even lift my duffel bag over my shoulder,” says Joseph. Joseph says he fought through the pain for years, but by 2014 he was no longer able to pass the Army’s medical tests and was sent home for treatment. Joseph tried physical therapy, injections and several different medications, but nothing was giving him the relief he hoped for. “I would have to take opioids a couple times a day just to function,” says Joseph. That’s when the Department of Veterans Affairs (VA) recommended he see pain management specialist Bradford Noble, DO, at the Boone Hospital Center Pain Management Clinic. “Dr. Noble and his team were so great. They really listened to what I had to say,” says Joseph. Dr. Noble says treating veterans is a passion of his, “Of course it’s an honor and privilege to take 14
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US Army Veteran Joseph Toepke
care of all of my patients. However, when I’m working with a veteran, it presents a unique opportunity to give back to an individual who has made a great personal sacrifice to protect our country.” After hearing Joseph’s story and evaluating his condition, Dr. Noble recommended that Joseph undergo a procedure called spinal cord stimulation. Spinal cord stimulation involves a thin metal wire that is placed in the spine. The wires are connected to a small device that
Dr. Noble welcomed inventor of spinal cord stimulation Dr. C. Norm Shealy to the Pain Management Clinic this spring. The two talked about the latest pain management technology and Dr. Shealy observed Dr. Noble with a spinal cord stimulation procedure on another army veteran.
produces electric current that stimulates the spine, potentially relieving even the worst back pain. Dr. Noble specializes in spinal cord stimulation and has done more of these procedures than any other doctor in the Midwest. Some common reasons to consider spinal cord stimulation are for those suffering from chronic neck and arm pain, back and leg pain, peripheral neuropathy and persistent pain following back surgery. “I read all the materials they provided for me, and I decided to give it a try. I really wanted to avoid back surgery, so this seemed like a great option,” says Joseph. Joseph got the procedure done right in the clinic and was able to go home the same day. “The very first evening with the device I was able to get a full night’s sleep. I hadn’t had that in years,” says Joseph. Joseph says his life has completely changed since meeting Dr. Noble and getting spinal cord stimulation. He says he is now able to help out around the house, something very important to him, as he hates having to sit back and not pitch in. He is also able to do more activities with his wife and two daughters. He can even take his dog Parker on walks and play with his two cats, Ivanka and Dixon. “I will always be grateful to the pain management clinic team for the relief they provided me,” says Joseph. By Madison Loethen
To find out more about pain management procedures, call 573.815.2700 MyBooneHealth.org
LESSONS OF THE HEART A Boone Hospital service line director knew cardiac calcium scoring saved lives, but didn’t expect what happened next. 16
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hen Amy Begemann was promoted to service line director for Boone Hospital Center’s cardiology and cardiovascular and thoracic surgery department in February 2016, she knew she would work with an amazing team of health care professionals, nurses and physicians. What Amy didn’t know is how closely she’d get to see them care for a patient. And Amy didn’t expect that patient to be her husband, Richard, who, at 66, seemed to be in great shape. He had always been and was still active, tracking daily, miles-long walks on his Fitbit and lifting weights at the YMCA. He had a history of high blood pressure and high cholesterol that had been medically managed, but experienced no chest pain or shortness of breath. “I was doing 100 push-ups every morning,” Richard says. He did start noticing pain in his left shoulder, but thought it might be from stress on his rotator cuff from weightlifting. “That was actually a symptom,” Richard says. “But we didn’t know that yet.” Amy’s new role made her aware of the importance of cardiac calcium scoring screening, a diagnostic test to detect heart blockage in people who haven’t previously been diagnosed with coronary artery disease but have major risk factors, such as high blood pressure, high blood cholesterol, obesity, diabetes or a family history of heart disease. The test uses a CT scan to check for calcium deposits in the walls of the coronary arteries, which may indicate early development of coronary artery disease and stenosis, or narrowing, of the coronary arteries. These build-ups of calcium can develop before a person has any symptoms. Given her husband’s history of high blood pressure and cholesterol, Amy recommended that Richard ask his primary care physician to have the test done. Richard’s physician, Susan Johnson, MD, with Boone Medical Group, referred Richard to Boone Hospital Center, where he had the cardiac calcium scoring exam. The screening involves a non-invasive CT scan to take images of your heart in its resting state while an EKG records your heart activity. The next day, as they packed for their vacation, the Begemanns received the call with his results. His calcium score was very high -1088.5, indicating a high degree of stenosis. Further testing was required. “We were going to Florida for St. Louis Cardinals spring training and were going to be gone for almost a week,” Amy says. “I asked them, ‘Do we need to cancel our trip?’” The vacation plans were still a go, but Richard was scheduled to undergo a nuclear stress test – the next step in diagnosing blockage — and had an appointment with a cardiologist at Missouri Heart Center after he returned.
“We didn’t get to keep that appointment,” Amy says. While on vacation, Richard began complaining about his shoulder pain. He was also unusually fatigued. Amy says, “The day we flew back to Missouri, he said, ‘Something’s not right.’” His condition grew worse after they landed in Saint Louis. Before the family made it home, they stopped at Boone Hospital Center’s emergency department, where Richard received an EKG and the physician pulled up his cardiac calcium scoring results. “The doctor told Richard, ‘I don’t feel comfortable letting you go home,’” Amy says. Richard was admitted that evening and underwent cardiac catheterization to check for blockage in his arteries the next day. “I thought they’d put a few stents in his arteries, and then we’d be on our way,” Amy says. “When the doctor came out to the cath lab waiting room to talk to me, I almost fell out of my chair.” Richard didn’t just have severely blocked coronary arteries, he had one of the most severe kinds of blockage. “They call it the Widowmaker,” Richard says, referring to the blockage in his heart’s left anterior descending artery (LAD). An LAD blockage can stop blood flow to the entire left side of the heart, the side which pumps oxygenated blood into the rest of the body and, if not detected and treated, frequently results in sudden and fatal heart attack. (Despite the nickname, women can also have LAD blockages.) Richard’s artery was about 80% blocked. He was discharged and scheduled to return to Boone Hospital on Monday for triple bypass surgery. He recovered and was able to return home that Thursday. Richard says all the nurses and techs who cared for him in the ICU and cardiology units were excellent and that he couldn’t have asked for a better surgeon than Richard Mellitt, MD. Amy was with her husband as he went through multiple areas of the cardiology service line, including EKG, echo testing, cardiac catheterization, the cardiology inpatient unit, and then cardiac rehabilitation visits following his surgery. Richard also received follow-up care from Boone Hospital Home Care. “I had no doubt we were in the right place. I was fully confident in all of the staff and
Amy and Richard Begemann and their son Richie were on vacation when Richard began having shoulder pain.
knew our physicians were rock-solid. It was definitely an experience,” Amy says. “If I hadn’t had this job, we would not have known to have the cardiac calcium scoring screening. And as much as Richard does with our son – taking him to school and to practice, the what-if factors were exponential,” she continues. “He really is the poster child for early detection — I thought the early detection would be more down the road, not a week and a half!” Cardiac rehabilitation physiologist Greg Thackery agrees. “Richard is a good example of how the cardiac calcium scoring test helps.” Richard has attended cardiac rehab sessions for three times a week since reaching the appropriate place after his surgery. During his sessions, he receives heart health education and exercises under supervision while his heart rate is monitored. “I told Greg I’m like a well-oiled machine, except I’m broken!” Richard jokes while pedaling on an exercise bike. He’s eager to recover and resume his regular activities, including his mowing business, which his sons and neighbor assist with while he recovers. “He’s not used to being dependent,” Amy says.
Cardiac calcium scoring screening, while not covered by most medical insurance, is available through Boone Hospital Center for an out-of-pocket cost of $100. Richard says it was a very small price to pay for peace of mind and he’d gladly have paid five times that, knowing what he does now. Amy’s knowledge of the value of calcium scoring screening has also increased. “I should probably have the screening done now,” she says. Richard’s primary care provider, Dr. Johnson, was also amazed by the outcome. Richard says, “She told me to tell Amy that she saved my life, because I had no symptoms!” By Jessica Park
Just Say No to Joe? The Pros and Cons of Coffee Consumption
t’s warm, it’s smooth, it’s energizing, and it’s satisfying. And with a Starbucks on seemingly every other street corner these days, coffee is easily becoming modern man and woman’s most overlooked drug of choice. But isn’t coffee actually supposed to be good for you? Here we turn to the pros, two Boone Hospital registered dietitians, for answers. “There is some data on the benefits of coffee consumption, but it isn’t always one hundred percent applicable to the general public,” says Jennifer Tveitnes, registered dietitians. “There does seem to be a link between drinking coffee and a decrease in Type 2 diabetes, Parkinson’s disease and possibly Alzheimer’s and dementia.” Though studies are vague on the benefits of consuming coffee, there also doesn’t seem to be any conclusive evidence that it causes harm. The Scientific Report of the 2015 Dietary Guidelines Advisory Committee, administered by the U.S. Office of Disease Prevention and Health Promotion, states that, “Currently, strong evidence shows that consumption of coffee within the moderate range (3 to 5 cups per day or up to 400 mg/d caffeine) is not associated with increased long-term health risks among healthy individuals.” Good news — but these cold, hard facts are only applicable to plain, black coffee. “In today’s cultural environment, we hardly see black coffee advertised,” says Tveitnes. “We typically see increased sugar and increased calorie coffee. This contributes to weight gain, which is a big problem in our general population these days.” Jennifer Anderson, registered dietitians and diabetes education and nutrition supervisor, adds that when people are drinking coffee, they just don’t take calories into consideration. “You can consume a meal’s worth of calories in just one cup of a sweetened coffee,” says Anderson, “and it’s not very filling or satisfying.”
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Aside from the high calorie specialty drinks available via can or café, some newer trends of the at-home variety include adding a dollop of coconut oil or even pat of butter (!) to a cup. “If you like a little flavor in your coffee, try coconut milk or almond milk,” advises Anderson. “That way you still get some flavor but without all the calories of creamer. Keep in mind that coconut milk is higher in saturated fat.” Anderson suggests skim milk as a lower fat and lower calorie substitution for half and half, cream or flavored milks. She says that all sweeteners, natural and artificial, are considered safe in moderation. “If it takes five packs of artificial sweetener to sweeten your cup of coffee, that may be too much,” Anderson laughs. “If you want a more natural option, stevia is an herb that’s sugar-free. Honey and agave, though natural, are still sugar, so there’s not that much difference between those and sugar.” Additives aside, the acid, particularly in plain black coffee, can contribute to issues with heartburn. Adding fat, such as the fat found in dairy, is a traditional way to cut the acidity; but even lower acidity coffee is too much for some sensitive-stomached folks. And then, of course, there’s the caffeine. “There are certain people who have a sensitivity to caffeine consumption, and drinking coffee would cause them problems,” says Tveitnes. “Even decaf coffee isn’t 100 percent caffeine free and can cause problems for that select population.” Some potential signs that a person may be drinking too much coffee include jitteriness, nervousness, anxiousness, irritability, rapid heartbeat, heart palpitations, an inability to sleep at night and stomach issues, such as reflux.
“Coffee is a drug and a stimulant, so technically, if you rely on it to wake up and get started in the morning, you’re addicted,” says Tveitnes. “A coffee headache is a real, physical side effect of caffeine withdrawal.” Both dieticians agree that as far as a recommended serving (or limit) of coffee goes, there really isn’t any magic number. “It’s more about the caffeine than anything else,” says Tveitnes. “It’s individualized.” Anderson recommends that if you’re having any of the symptoms listed above, you may want to consider cutting back, but cautiously. “If a person is going to cut back on caffeine, they want to do so gradually,” says Anderson. “Maybe start out with half-caf to reduce the side effects of withdrawal.” Anderson also recommends eating healthy, exercising and staying hydrated by drinking more water. “Decaf coffee still has some caffeine in small amounts,” says Anderson. “If you still just want something warm, caffeine-free tea is a good alternative.” Instead of substituting coffee with other caffeinated or “energy” beverages, Tveitnes recommends eating three meals a day with high-fiber carbohydrates, lean proteins and vegetables. “Make sure you are getting all the vitamins, minerals, and protein needed,” says Tveitnes. “This will contribute to balanced, stable energy levels. Lots of people skip meals or consume high carb and fat foods, which can cause fatigue and sluggishness.” So there you have it — enjoy your cup (or two . . . or five) of joe, but mindfully. “Moderation is the key,” says Anderson. “Like popcorn, coffee itself is pretty healthy — except for all the things we add to it.” By Jordan Milne
WHAT’S IN A
SERVING? Check your favorite coffee add-ins.
Heavy Cream (1 Tbsp) 51 Cal / 5.4g Fat / .4g Sugar Half and Half (1 Tbsp) 18 Cal / 1.6g Fat / .6g Sugar 2% Milk (1 Tbsp) 8 Cal / 1g Fat / 1g Sugar Skim Milk (1 Tbsp) 5.5 Cal / 0g Fat / 1g Sugar Silk Light Vanilla Almond Milk (1 Tbsp) 4 Cal / 0g Fat / 0g Sugar Thai Kitchen Coconut Milk (1 Tbsp) 26Cal / 3g Fat / 0g Sugar Sugar (1 tsp) 15 Cal / 0g Fat / 4g Sugar Honey (1 tsp) 21 Cal / 0g Fat / 6g Sugar Stevia (1 tsp) 0 Cal / 0g Fat / 0g Sugar Splenda (1 packet) 0 Cal / 0g Fat / 1g Sugar Equal (1 packet) 4 Cal / 0g Fat / 0g Sugar
Drinking Your Calories Liquids pack hidden calories and do little to fill you up. Here are some tips to make healthier choices when it comes to your favorite beverages.
t can be tempting to drink our calories. Between frozen coffee drinks, flavored waters, sodas and smoothies, you can find liquid calories just about anywhere. Our taste buds are drawn to their high sugar content, making it quite a challenge to resist the constant temptation. When I counsel my clients, I encourage them to avoid drinking their calories. Why? Liquid calories are simply not filling. Calorie-laden beverages typically have poor nutritional value, meaning they lack fiber, protein, and important vitamins and minerals. When we work towards obtaining the same amount of calories from food, not only do we gain more nutrition, but we also feel more physically satisfied. Beverages are digested rapidly and don’t leave us feeling full. This rapid digestion means beverages leave our bodies, unaware that we consumed any calories and just as hungry as before we consumed the beverage. When you consume the same amount of calories from solid foods, you’re much more physically satisfied. You’re also able to consume a much larger volume of food, which can help you feel mentally satisfied, too. Here are a few sources of liquid calories and the comparable amount of solid food you’d have to eat to get a similar amount of calories:
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Starbucks Mocha Frappuccino
Serving: 16oz (approx. 2 cups) Calories: 400 Nutritional Information: Provides 10% of the daily value for calcium
Sonic Slush Base (No Syrup)
Serving: Large (approx. 250 oz / 3 cups) Calories: 390 Nutritional Information: No nutritional value
McDonald’s Caramel Mocha
Serving: 4.75 cups Calories: 400 Nutritional Information: Provides 17 grams of fiber, and 113% of your daily Vitamin C requirement
Serving: 4.5 cups Calories: 391 Nutritional Information: Provides 13 grams of fiber, and 30% of your daily potassium requirement which can help lower blood pressure
Serving: Medium Calories: 390 Nutritional Information: Provides 30% of the daily value for calcium
Serving: 13 cups Calories: 402 Nutritional Information: Provides 30 grams of fiber (your total daily requirement) and 46% of daily value for calcium
Serving: 20oz (approx. 2.5 cups) Calories: 240 Nutritional Information: No nutritional value
Serving: 4 cups Calories: 220 Nutritional Information: Provides 4 grams of fiber and 16% of your daily phosphorus requirement
Smoothie King Peach Slice Plus
Serving: 20oz (approx. 2.5 cups) Calories: 400 Nutritional Information: Provides 4 grams of fiber
Serving: 6.5 cups (sliced) Calories: 390 Nutritional Information: Provides 15 grams of fiber and 40% of your daily potassium requirement
As you can see, you’ll consume more than double the volume when you get your calories from solid foods instead of liquid beverages. And additional nutrition you receive from whole foods can’t be matched in their liquid counterparts. What’s the healthiest beverage, then? Water, of course, is always your best option. But what if you’re bored with water and want something more flavorful? Healthy options include:
• Flavor or infuse your water with lemons, limes, berries, pineapple, cucumber, herbs such as mint and basil. The combinations are endless. • Use calorie-free water flavoring packets or liquids. • If you wish to indulge in a coffeeflavored beverage, choose a smaller size, request skim milk, skip the whipped cream, and add sugar-free syrups when possible. • Choose diet soda over regular. If you must indulge in regular, get the smallest size possible, and skip the refills. • If you want a smoothie, make it at home: - Add a good source of protein, like Greek yogurt or protein powder. - Use whole fruits. - Skip the fruit juice and instead use skim milk, or unsweetened almond or soy milk, to provide additional protein, calcium and vitamin D. - Add ground flaxseed or chia seed for a good source of heart healthy omega-3 fats. - Experiment with incorporating greens, such as spinach. The combinations are endless!
By Jennifer Tveitnes, RD, LD
A Family Affair Childhood obesity affects 1 in 5 American children. Fortunately, the solution is right at home. BACK IN THE ‘80s, I was an obese child. I grew up in a household where junk food and fast food were plentiful and available nearly every day. I ate whatever my parents ate and, as I grew older, ate as much as they ate. Watching sci-fi movies was our main family activity. We didn’t go on hikes, ride bicycles or take walks together. The most activity I got was in mandatory PE classes, which were miserable for physical and social reasons – I hated being in last place, huffing and puffing in every weekly mile run, and was self-conscious about how I looked in my gym shorts. And I was frequently teased by other children and
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even some adults, affecting my self-esteem. Whenever I felt sad or anxious about it, I’d just do what my parents did – I’d eat. After my father retired from the Army in 1989, my family’s bad habits grew worse. So did our health. My father has coronary artery disease. My sister had gallstones. I had bone spurs and knee pain as a teenager. My mother died from heart disease when she was 48. I was 38 when I finally achieved a healthy weight through sustainable changes in diet and exercise. Now I snack on fresh fruit, choose steamed vegetables over French fries, and love going to my gym.
I also recognized the significant role my family played in my obesity. My sister was also an adult when she made lifestyle changes for a healthy weight. We’ll talk about the sodas, snack cakes, ice cream and extra-large supreme pizzas that were family staples growing up and how we didn’t realize then that we were overeating or not getting enough exercise. We were just doing what our parents did. Our story is not uncommon; according to the CDC, about 1 in 5 children ages 6 to 19 in the United States are obese, more than triple the rate in the early 1970s. For children, obesity is defined as having a BMI
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Parents play a significant role in their child’s development of healthy habits and can set a positive example. Here’s how you can help your children and you make healthier choices. • Encourage healthy eating by providing your child with plenty of fruits, vegetables, whole grains, low-fat or non-fat dairy products and lean meats, poultry, fish and beans for protein. • Serve reasonably sized portions. • Encourage your child to drink more water and limit their intake of sugar-sweetened beverages. • Offer whole fruit or fresh vegetables as healthy snacks. Limit treats high in sugar and fat. • Encourage your child to exercise for at least an hour a day most days of the week. Lead by example and ask your child to join you as you get more exercise. Even taking a brisk walk together can benefit everyone. • Put a cap on your child’s screen time. Find things to do as a family that get you away from the TV or internet. • Boone Hospital Center’s Kids on Track program is free and available in 9 communities throughout mid-Missouri. Kids on Track encourages your children to stay active when school’s out, from May through August. If you missed this year’s events, sign up next spring! • Avoid negative comments about weight. Research shows that criticizing people of any age about their weight doesn’t motivate them towards healthier behaviors, but causes stress and depression that may lead to further weight gain. • Don’t put your child on a weight loss diet without first consulting with your family physician or pediatrician.
over the 95th percentile for children of the same age, height and sex. A BMI within 85th to 95th percentile is classified as overweight. Children with obesity are more likely to be diagnosed early with chronic health conditions like asthma, type 2 diabetes, sleep apnea, or joint and bone problems. They’re more likely to be obese as adults and at higher risk for heart disease, cancer and other conditions. And they’re more likely to experience bullying, depression, poor self-esteem and social isolation. Children can develop obesity due to genetics and metabolic issues, but their family and social environment or psychological issues also cause weight gain. A child’s diet and physical activity are influenced by their surroundings, primarily the home, but also school, child care settings, or wherever else they spend their time. “Children learn by example,” says Jennifer Tveitnes, RD LD, a registered dietitian and coordinator of Boone Hospital Center’s Head to Toe weight management program. “Parents not only set an example, but they control the home environment, too. They’re the ones shopping, preparing and serving the food. If the parents don’t have healthy habits around diet and exercise, usually the children don’t, either.” The upside is that parents can also be a positive influence on their children’s health – and improve their own in the process. While the Head to Toe program is for children ages 8 to 12, it’s all about family. The program helps kids and parents make healthier choices about food and exercise. The 12 weekly, hour-long sessions are led by a registered dietitian and WELLAWARE exercise specialist.
Each session features fun activities to accompany the lessons, whether it’s preparing a healthy snack, hula hooping, or learning how to decode a restaurant menu or nutritional label. “We do a lot of hands-on activities where the parents and kids work together as a team,” Jennifer says. Head to Toe is designed to help children take steps necessary for achieving and maintaining a healthy weight, but isn’t a weight reduction program. Gradual, lifelong changes in eating and physical activity are recommended by health professionals, rather than unsustainable short-term changes like restriction diets. This is true for adults and especially true for children. “We don’t focus on weight loss or diets,” says Jennifer. “It’s important that children continue to meet their nutritional needs for healthy growth and development.” The program also provides a supportive environment and addresses emotional and social concerns, to promote kids’ confidence and empower them to make the right choices. “We teach them about healthy body image and how to manage stress or cope with difficult emotions,” Jennifer says. The next Head to Toe program starts with an orientation session on August 17. The program has a $100 fee, but if the family attends all 12 weekly sessions, half of that is returned. (As someone who wishes her family had this program 30 years ago, I think $50 to set your family on a path towards better health is a great deal.) When it comes to preventing and addressing childhood obesity, Jennifer says, “A family commitment is necessary.” By Jessica Park
GETTING TO KNOW A BHC DOCTOR
Mark Tungesvik, MD
am a follower of Christ. I was born again five years into my oncology practice. I facilitate two small groups in our church. Practicing oncology for the past 11 years has been a great experience for me and has been an interesting journey at both a professional and spiritual level. I wrote a book, “The Song of the Bear,” several years back with the hopes of providing patients with a better framework to see their own cancer journey. I have been happily married for 29 years to my lovely wife, Nathalie, and have three wonderful children, all of whom provide a persistent source of joy for me.
Why did you get into the health care field? I was an attorney before I became a doctor. I made the shift out of a vaguely formed notion that I could be doing more to help people and had a responsibility to do so. What interested you in oncology? I was toward the end of my residency when I first walked onto an oncology floor. Going into oncology was not even on my radar. Within minutes, I fell in love with the patients. Many had prognoses measured in months. The superficialities that sometimes consume our thoughts were absent in their world. They were forced by their disease to face the reality of being human in a broken world head on. They were, for lack of a better term, more real. I did not choose oncology. It chose me.
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What is the most rewarding aspect of your job? Being allowed to share my patients’ journey is an honor that I cherish. There is not a day that I am not enriched by being a part of their lives. What is the most challenging aspect of your job? We get to know our patients well. They become like family. For some, I will share their journey with them for years. Because of the nature of what I treat, many will die in treatment. We have often times grown very close by that time. It can be hard at times. What do you see changing in health care in the next five to ten years? From a technologic perspective, the future is very bright. We have new anti-cancer drugs coming out every other month. Every year our treatments become more effective and less toxic. Many cancers are becoming more like chronic diseases as opposed to a diagnosis with a prognosis measured in months. At the person level, the practice of medicine faces some challenges over the next several years. There is a persistent push for doctors to become more like employees of a larger entity as opposed to practitioners of the art of medicine for which they were trained. As the years flow by the doctors of the future will need to be ever mindful that we are here to serve, and that the only way to truly serve a patient is to step into the boat with them and share their journey. What advice would you give someone looking to become a doctor? My oldest son graduated medical school this year. For him and all those entering into the practice, I would urge them to find a portion of medicine that you can be passionate about and follow that passion. For many, it will be the type of patient that you treat as opposed to the disease that you treat that will be the source of your passion. It is only by loving what you do that you will be able to take responsibility for the patient as a whole and “own” them. It will be a sense of ownership over the patient that will separate out the great doctors of the next generation. What do you enjoy doing outside of work? Spending time with friends and family are on the top of the list. I have been blessed with both. With respect to activities I enjoy golf and snow skiing. Nathalie and I enjoy traveling, and I hope we will be able to continue that for some time. What advice would you give to someone who is going to be a patient in a hospital for a period of time? Take each day one day at a time. Remember that the path that we are placed on is rarely the one we would choose. It rarely takes us where we would want to go but it always leads us to where we needed to be. Much of the anxiety that we experience in life comes from a failure to understand this simple reality.
GETTING TO KNOW A BHC NURSE
Stephanie Whitbey, RN, BSN My particular specialty: I always wondered what took place in the ICU after I would help transfer a patient after a code or rapid response to the unit. This is what drew me to do my senior practicum in the MICU. The nurses I worked with, the patients, families and the high acuity patients kept me there. After about 10 years, a friend told me of an opening with pulmonary-critical care team. I always wanted to go back to school, so I thought it would be a great opportunity to work in this role. What I love about the job is the connections I make with patients and the brilliant physicians I work with. I also like to be a part of the assessment and planning, as well as managing the clerical side of the job, so that the physician can spend more time with patients and families. What is most rewarding: There are many rewarding aspects of this job. Some examples are when I see patients’ symptoms improve with treatment, when I form bonds with patients and their families and when I can follow along with a patient during their ICU stay, then as an outpatient.
am a nurse with Boone Pulmonary Medicine and am studying to become a nurse practitioner through Maryville University’s Acute Care Nurse Practitioner Program. In 2000, I started at Boone Hospital as a patient care technician on the surgical floor. I graduated with my nursing degree from University of Missouri in December 2003 and worked in Boone Hospital’s medical ICU for 5 years and in the post-anesthesia care unit. I later accepted a position with Boone Pulmonary Medicine.
Why I got into nursing: My mother is a nurse but, to be honest, growing up I didn’t think I wanted to go into nursing because I was stubborn and wanted to be different and blaze my own trail. When I was in high school, I decided to take a certified nursing assistant (CNA) course at the career center to help pay my way through college. It was in the nursing homes that I realized my passion for nursing. I really connected with patients and found myself wanting to make a difference in their lives. I realized following in my mother’s footsteps wasn’t such a bad thing after all! I then decided to enroll in the nursing program at the University of Missouri. I loved the academics and endless learning and knew this is what I was destined to do.
What has changed in the field: There are so many things that have changed in terms of evidence-based practice. A few things that immediately come to mind are the use of bedside ultrasound for diagnosis and line placement; electronic order entry; and a decrease in swan ganz catheter use. In the past, our medical, surgical and neurosurgical ICUs were all split on different floors. Now they’re all physically combined, which improves work flow. Also the hospital model has changed with the addition of hospitalists and intensivists. What do I see changing in the next 5-10 years: Epic will change my workflow in terms of dictating and order entry. I imagine that the use of mid levels in the acute care setting my increase. Outside of work: Anyone who knows me knows that I love watching my kids do what they love — baseball, softball and dance. Advice: My clinical experience and having my CNA helped me so much in nursing school, and my current position has helped prepare me for my master’s program. I would encourage a nurse to consider starting as a CNA, PCT or secretary in a health care setting to help with the transition. I would also advise following your passion, personal interests, strengths and long-term goals to help decide what area of nursing to go into.
Watch Bob tell his story at youtube.com/boonehospital
Life Saving Testing Early PSA testing allowed Bob Roper to live his retirement to the fullest.
73-YEAR-OLD BOB ROPER is living his retirement to the fullest. He is a retired attorney and investment executive who enjoys spending time with his wife Ellen along with their two kids and four grandkids whom they often travel to see in Texas and California. Bob is quick to tell you his life would be much different if he hadn’t gotten a PSA test several years ago. A PSA test, or prostate-specific antigen test, is a blood test that all men 45 and over are recommended to get once a year. Men whose tests reflect high or suspiciously rising PSA levels may have prostate cancer. Bob received the testing and was told his levels were high. That led to a biopsy which confirmed he did have prostate cancer. The cancer was caught early on, and it was treated before it had time to spread to the rest of his body. “People who get PSA testing early and manage to detect prostate cancer when it is small and in its early stages are shown to enjoy 50 percent more life years on average with treatment than people who are discovered to have prostate cancer after symptoms emerge. Screening really is valuable in terms of early detection and early detection has been shown in multiple studies to be valuable in prolonging survival,” says Bob’s doctor Steven Dresner, MD of Urology Associates of Central Missouri. Symptoms of prostate cancer include trouble urinating or painful urination, blood in the urine or semen, and swelling in the legs or pelvic area. Shortness of breath, fatigue, fast heartbeat, and dizziness may also be symptoms. A PSA test and possibly a digital rectal exam, or “DRE” are commonly performed if these symptoms are present. Bob now receives PSA testing every six months as a follow-up precaution. He says he is very grateful that he had the PSA testing done. “If I hadn’t gotten the testing, I wouldn’t have caught the cancer early, and I would likely have had a much greater problem,” says Bob.
By Madison Loethen
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Photo by Arrow Root Photography
I’D LOST MYSELF
A new mother knew something didn’t feel right, but didn’t know it was postpartum depression. MyBooneHealth.org
“For as long as I can remember, I’ve wanted to be a mom,” says Missy Nichols of Columbia, MO. When she and her husband, Spencer, learned they were expecting their first baby in 2014, they were overjoyed. But on a routine checkup, Melissa was diagnosed with severe pre-eclampsia. She was rushed to Boone Hospital Center and put on bed rest. Her daughter, Scarlett, was born a few days shy of 35 weeks’ gestation. “I was able to touch her long enough for one photograph, then she was rushed to the NICU,” Missy recalls. “So many emotions flooded over me then – instant love for this beautiful little girl, overwhelming fear about what having a preemie would mean for our family longterm, and somewhere, the strength to keep myself together for her.” While Scarlett was in the NICU, Missy was visited by a social worker who explained that postpartum depression, or PPD, was common in mothers of premature babies. But Missy didn’t think that applied to her. “I thought I was too strong to be affected by depression,” she says. “To
be honest, before I had depression, I never understood it was a real medical condition. I did not understand how overwhelming and crippling it is.” Missy was no stranger to adversity; she’d grown up in foster homes and overcome many obstacles, but relied upon her drive, resolve and resourcefulness. She also drew strength from her faith; she and Spencer are active members of their Assemblies of God church. “Life has not necessarily been kind to me, but I’ve never been one to sit and wallow in a situation,” she says. When Scarlett came home, after three weeks in the NICU, Missy says, “I thought I was home free.” But the relief and happiness Missy had expected to feel didn’t come. She worried constantly about Scarlett’s health and woke up frequently at night to check on the child. She felt guilty and blamed herself for the premature birth, even though her doctor told her she hadn’t caused the pre-eclampsia. Missy was also sad that Scarlett’s birth did not go as she had wanted – she missed out on pictures and visits from friends —
and mourned the time when she’d been separated from her baby. “Going home and leaving Scarlett in the hospital that first night was so hard,” Missy says. Over the next year, she would wake up with vivid, painful memories of that event. “The experience of having your baby in the NICU is emotional, and it does take a toll.” Patti Blanchard, MSW, a social worker with Boone Family Birthplace, has one thing she wants everyone to know about postpartum depression: “It can affect anyone.” Parents of premature babies are at higher risk. New mothers at Boone Family Birthplace are provided with information about perinatal mood disorders, which include PPD, and resources for follow-up. Social workers also check in regularly with parents of NICU babies. “When you have a baby who has to stay in the NICU or has a specific diagnosis, the stress of that situation increases the risk of depression in both parents. Dads can get it, too,” Patti says. About 1 in 7 fathers in the United States experiences post-natal depression in the year after a baby is born. Perinatal mood disorders can start during pregnancy and up to a year after the baby is born. The most common is called the “baby blues.” Up to 80% of mothers experience mood swings or crying spells the first week after childbirth, but they fade within 2 or 3 weeks. PPD, however, lasts more than 2 weeks and symptoms may include loss of energy and motivation, feelings of guilt or worthlessness, changes in appetite and sleep, loss of pleasure in activities you enjoy, lack of interest or negative feelings
If you have symptoms of postpartum depression that interfere with daily functioning and last longer than
two weeks, talk to your physician or a mental health professional.
You may also find help and local resources through Postpartum
Support International’s website (www.postpartum.net) or their
helpline, 800-944-4PPD. Depression
is a treatable health condition, not a weakness or personal failing.
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To be honest, before I had depression, I never understood it was a real medical condition. I did not understand how overwhelming and
towards your baby, and recurring thoughts of death or suicide. When Missy tried talking about her feelings of fear, guilt, and sadness, her friends assured her. It was just the baby blues — and totally normal. As a firsttime mother, Missy didn’t know what she felt wasn’t normal. “Over the months, there were definitely changes that I see now were not normal, but clear signs of postpartum depression,” Missy says. Her anxieties about Scarlett’s health and safety intensified. Her emotions felt hard to control. She was prone to sudden crying or angry outbursts. She also felt guilty about how bad she felt, knowing she had much to be thankful for. Missy experienced physical symptoms, including loss of appetite, weight gain, insomnia, fatigue and physical pain. She found it hard to do simple things like showering. Her motivation was gone. And Missy found it hard to enjoy the experience she had looked forward to all her life: “I had difficulty adjusting to my role as a mom. Many days I felt like I was just an empty machine changing diapers and churning out nourishment for my child. It was difficult to even enjoy holding my baby.” Missy knew something wasn’t right, but had difficulty expressing her feelings to her husband or friends. By Scarlett’s first birthday, Missy’s depression had become unbearable. She felt like she was losing her will to live. One Sunday evening at church, while
Missy with her son Thatcher.
crippling it is.”
leading worship, she couldn’t hold back anymore and broke down. Before everyone, she shared the painful feelings she’d struggled with. Her church family immediately responded with a show of support and love. “They reminded me there was hope. If nothing else, I knew I wanted to live for my daughter and my husband. I was reminded that God had a purpose for me and that alone was worth fighting for.” Missy made small, gradual goals towards self-care, trying to accomplish one or two things each day at first. She then focused on getting more nutrition and regular rest, taking walks, and letting her husband know when she wasn’t feeling well. Missy also attended counseling sessions through Lutheran Family and Children’s Services in Columbia. Being able to talk about her experience to someone who understood made a difference. Still, it took several months before Missy felt like herself again. Missy experienced PPD again recently, following the birth of her 5-month-old son, Thatcher, but having a support system in place, knowing the symptoms, and taking time for self-care made it easier to
manage. She says, “I’ve felt really good the last few weeks.” “If you’ve had PPD before, your risk is higher,” social worker Patti Blanchard explains. “But every pregnancy is different so not having a history doesn’t mean you’re not at risk. Again, it can happen to anyone.” “Postpartum depression was the worst experience of my life,” Missy says. “I have always been so strong but this thing completely broke me into pieces. I felt like I’d lost myself.” But as Missy’s drive and strength returned, she saw an opportunity to help other mothers. She has shared her story with several local groups and has made informing more people about PPD – health care providers and parents alike – part of her life’s work. She also praises the support she and others have received from Lutheran Family & Children’s Services. Missy says, “I want the world to know PPD is a real and legitimate medical problem that can be treated. I want us all to collectively understand the intense impact that pregnancy and motherhood has on a woman’s mind, body and spirit…We can all make sure that no one suffers through depression alone.” By Jessica Park MyBooneHealth.org
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Uniform Sale SEPTEMBER 11-13
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Hulett Heating & Air Imhoff Construction, Inc. Jack Smith Creative Services Landmark Bank Lenoir Woods Macadoodles Melissa Applegate
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