My Boone Health Summer 2019

Boone Health SUMMER 2019

Comeback SEALed Retired Navy SEAL uses lessons from training to recover from stroke.

PG. 12

PG. 16

Safe sleeping habits for your baby

We believe in Boone.

Virginia and Norm Stewart | Missouri Legends

Table of Contents 10

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

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

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

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A Note from Jim

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Hospital Headlines

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For Your Health: Teen Tanning

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Spaghetti Squash with Quick Marinara

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Weight Loss Couple

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Robotics

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Get to Know a Dr.

12

Navy Seal Therapy

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Get to Know a Nurse

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Barriers to Living Healthy

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Cushing’s Syndrome

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Bringing Up Boone Babies

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Fit for Delivery

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Wellness: Fiber

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Foundation

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I believe in Boone.

Jennifer Roelands, MD | OBGYN, Women’s Health Associates

A NOTE FROM JIM

Growth at Boone

T

he Boone Hospital team continues to grow our services to meet the needs of our patients and the residents in mid-Missouri, and to address the changing local health care environment. We have recently added six full-time primary care providers to our Nifong Medical Plaza primary care and Convenient Care offices. The providers identified below are – and will be – ready and able to accept you as your primary care provider or to take care of your immediate health care needs at our Convenient Care walk-in clinic.

Dr. Joni Bramon, DO • Family Medicine • Nifong/Parkade Convenient Care • August 1, 2019

Dr. Tim Soncasie, MD • Internal Medicine • Nifong Medical Plaza • August 1, 2019

Dr. Sneha Chum, MD • Internal Medicine • Nifong Medical Plaza • October 1, 2019

Kim Pfeiffer, NP • Family Medicine • Nifong Medical Plaza • February 1, 2019

Carla Maylee, NP • Family Medicine • Nifong Medical Plaza • February 1, 2019

N. Marieme Ndiaye, NP • Family Medicine • Nifong Medical Plaza • March 1, 2019

Boone Hospital’s laboratory team has increased its presence and reference lab business by 128% over the last six months!

We now have convenient lab draw stations located in Broadway Medical Plaza 2, Suite 220 and Broadway Medical Plaza 4, Suite 270, in addition to the locations at the main Boone Hospital campus and the Nifong Medical Plaza located at the corner of Nifong and Forum in Southwest Columbia. There has been significant demand for this service after a local laboratory company sold their reference lab business to a national chain laboratory. If you need a blood draw or other laboratory tests,

consider Boone Hospital Center’s lab for exceptional service with convenient locations.

Boone’s cardiology service line continues to grow with the addition of two new services: MitraClip and the Pritikin Program. MitraClip is a new procedure option for patients with mitral regurgitation or a leakage of blood back through the mitral valve of the heart, causing incorrect blood flow. These are typically patients who have been medically managed for mitral regurgitation. Since introducing this procedure at Boone, we have already performed five cases.

Secondly, Boone Hospital Center is the first hospital in mid-Missouri and only 1 of 36 hospitals nationwide now providing the Pritikin service. The Pritikin Program is approved

by Medicare for reimbursement under a new benefit class called Intensive Cardiac Rehabilitation (ICR). ICR brings the exercise component of our traditional cardiac rehab program together with comprehensive lifestyle-change education. This program offers an opportunity for better outcomes for our patients. The program includes video-based education that can accommodate a patient’s busy schedule. Sessions include exercise, nutritional counseling and cooking workshops, behavioral health sessions and overall health education. By motivating and educating patients on three key pillars of Pritikin – nutrition, exercise and healthy mindset – we will help patients rehabilitate their lifestyle and steer themselves towards a healthier future.

The results of these and other growth strategies have facilitated Boone’s 2019 year to date admissions, average daily census, outpatient tests/visits, and financial results to be better than budgeted. On behalf of the entire Boone Hospital family, I want to thank you for choosing us to care for you and your loved ones!

Finally, I wanted to share a heartwarming experience Jessica Gracchi, one of our volunteers, had at Boone Hospital Center that reflects the Boone environment of caring, compassion, gratitude and family. It was told to me by Jessica this way: “This was the first time I had ever seen a United States soldier dressed in camouflage at the Boone Hospital gift shop.

He was tall, young and in the 101st Army Airborne.

“I went towards him and welcomed him home. His mom was standing behind him off to the side waiting for his dad to arrive.

Once his dad arrived, we told him that someone wanted to see him. As he turned around and unexpectedly saw his son, he ran to him, hugs were given, and many tears shed.

“The staff in the gift shop witnessed this event of love and family united again. All volunteers and staff shared tears of happiness.”

Jim Sinek President, Boone Hospital Center

MyBooneHealth.org

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HOSPITAL HEADLINES

BP Gold Award Boone Hospital Center is honored to announce that the American Heart Association and American Medical Association have recognized us for achieving 70% or greater blood pressure control among our patients and have awarded us with the Target: BP Gold award. We are one of only seven hospitals in Missouri and the only hospital in the mid-Missouri area to have achieved this award.

Pictured (from left to right) Jim Sinek, Amy Begemann and Patti Ross from Boone Hospital receive the BP Gold award from Leanne Geiss with the American Heart Association.

Morgan Lewis is presented the BEE Award with members of the Emergency Department team and hospital administration.

BEE Award Patient Care Tech Morgan Lewis from the Emergency Department has received our first ever BEE Award! Boone Hospital Center presents the BEE Award to recognize patient care staff members who support registered nurses in delivering exceptional care to our patients and uphold our standards of excellence.

In 2018, Boone Hospital started the DAISY Award for registered nurses. Just as the daisy cannot survive without the bee, nurses cannot survive without the outstanding teamwork provided by other health care professionals.

Like the DAISY Award, BEE Award winners can be nominated by patients, families, employees and more. Find BEE nomination brochures wherever you find DAISY nomination forms throughout the hospital, or nominate on our website: boone.org/bee.

DAISY and BEE Awards are sponsored by the Boone Hospital Foundation.

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Employee Recognition Our 2018 Employee and Leader of the Year awards were announced at Boone Hospital’s Service Awards Fiesta on Friday, March 15. Our 2018 Employee of the Year is April Bernhardt, Social Worker. Our 2018 Leader of the Year is Amy Begemann, Cardiology Service Line Director. The Latinthemed celebration also recognized our 12 employees of the month in 2018 and celebrated employees’ service milestones, including six employees who achieved 40 years of service in 2018! The program concluded with a tasty dinner, plus dance lessons and live music by LaMovida Band.

April Bernhardt celebrates with her family and members of administration.

Off and Running Kids on Track kicked off on May 4 at Cosmo Park. Over 600 kids have signed up to run a cumulative marathon over the course of the summer. There will be group runs at Cosmo Park on June 22 and July 13 at 9:30 a.m. They will cross the finish line on August 3 and will receive a medal.

Kids on Track participants were given hats, shirts and other prizes at the kickoff event.

MyBooneHealth.org

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FOR YOUR HEALTH

The Blistering Truth About Teens and Indoor Tanning

P

art of being a teenager is feeling a sense of youthful invincibility.

The health concerns of middle age are just that – concerns of middle age – and are so far away that it’s hard for teens to even think about them, let alone want to take steps to avoid them.

But more and more, evidence shows us that certain behaviors early in life can be particularly important to health risks later on, and one of those behaviors is indoor tanning.

Indoor tanning – the use of a tanning bed, tanning booth or sun lamp – increases the lifelong risk of skin cancer, including deadly melanoma. This means the younger that people are when they start indoor tanning, and the more they do it, the higher the risk.

Melanoma is the fifth most common cancer in the U.S. and is one of the most common cancers in young adults, especially in young women. Rates of the disease have been rising for many years, likely in part due to indoor tanning.

“People who tan indoors more than 50 total hours are two to three times more likely to develop melanoma than nonindoor tanners,” said Dr. Lynn Cornelius, chief of dermatology at Washington University School of Medicine in St. Louis. The use of popular bronzer lamps, which are much more powerful than the noonday sun increases risk even more, “over four times,” Cornelius adds.

Yet, even with its dangers, indoor tanning remains popular with many teenagers in parts of the Midwest.

While only around 4% of high school boys and 8% of high school girls tanned indoors in the past year in the U.S., close to 13% of 12th grade girls tanned indoors. For Caucasian girls who are high school seniors, this number can climb to more than 20%.

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In Missouri, a recent survey found that 21% of 11th grade girls and 30% of 12th grade girls have tanned indoors.

“That’s more than double the national average,” Cornelius said. “It’s alarming.”

For parents hoping to help protect their kids from the dangers of indoor tanning, a good first step is to take some time to really understand its risks and talk to their kids about them. Cornelius draws parallels to smoking, pointing out that indoor tanning devices are classified as Class 1 carcinogens by the World Health Organization – the same as tobacco and arsenic.

“I think many parents don’t understand the risks – that indoor tanning is not the same as going out in the sun,” she said. “There’s a reason why states are banning ultraviolet radiation from artificial devices for kids 18 and younger.”

Research has shown that rates of indoor tanning by youths are lowest in states with the most restrictive policies, such as total bans of tanning by minors, as is the law in Illinois, Kansas, Minnesota and 16 other states. Weaker policies, such as requirements for parental consent for minors to tan, have been found to be mostly ineffective at curbing youth tanning.

While indoor tanning can seem a lesser concern compared to some of the other challenges of the teenage years, it’s certainly not something to ignore. Like other risky behaviors, it can have an important and lasting impact on kids’ health

for years to come. So, as parents or guardians or simply concerned adults, it’s important to make an effort to talk with teenagers about the risks of tanning beds, to support strong policies that curb teen tanning and to model good behavior yourself by not tanning.

“It all comes down to education,” concludes Cornelius.

“That, and protecting teenagers from the dangers of indoor tanning by putting good laws in place that restrict access, just like we do with cigarettes.”

It’s your kid’s health. Take control. By Dr. Graham A. Colditz, Siteman Cancer Center Dr. Graham A. Colditz, associate director of prevention and control at Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine in St. Louis, is an internationally recognized leader in cancer prevention.

As an epidemiologist and public health expert, he has a long-standing interest in the preventable causes of chronic disease. Colditz has a medical degree from The University of Queensland and a master’s and doctoral degrees in public health from Harvard University’s T.H. Chan School of Public Health.

MyBooneHealth.org

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Helping

HANDS Patients experience rapid recovery through the use of robot-assisted procedures.

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I

n 2008, Boone Hospital Center added a new technology to its repertoire, da Vinci, a robotic system that allows surgeons to perform surgeries with minute precision. These systems are operated through hand and foot controls that surgeons use to guide the slim robotic arms during procedures.

Since offering the da Vinci Surgical System as an alternative to traditional “open” surgery, Steven Dresner, MD has performed over 500 laparoscopic procedures alone. The majority of these surgeries have been radical prostatectomies, the removal of the prostate used to treat early or localized, aggressive prostate cancer, but other urologic surgeries on the kidney, bladder, ureter, adrenals, and lymph nodes can be done as well.

Boone also offers patients the option of robotic-assisted laparoscopic hysterectomies.

How does a surgeon perform a laparoscopic procedure?

Laparoscopic surgery is a minimally invasive technique. The procedures, which may be full-sized surgeries, are done through small puncture marks instead of large incisions. Small tubes fit into the punctures and small instruments fit through the tubes and accomplish the surgery. Full-sized surgery without the fullsized incision!

Robotic assistance takes laparoscopic surgery to the next level. The very small instruments have full range of movement, like a human wrist, and are controlled by a “robotic” or computerized link from the surgeon’s hands to the instrument, like a video game avatar.

In regular laparoscopic surgery, “what the surgeon controls with his hands are relatively simple tools that point straight forward, and they tweeze, cut, cauterize, or hold,” says Dr. Dresner. “The robotic instruments are wristed, meaning they move in four different degrees of freedom, so that when the surgeon puts his hands in the robotic console, every single movement the surgeon does with his hands in space is precisely imitated or replicated by the tiny little instruments inside the patient.”

This means that the robotic instruments can reach into places that can’t be reached with regular surgical instruments. Dr.

Dresner explains that typical surgical instruments are great for places like high in the abdomen where there is plenty of space to work, but also surgeries down deep in the pelvis, underneath the pelvic bone. Closed-off spaces also greatly benefit from the increased mobility and agility that robotic assist can provide.

“With early detection and diagnosis, my treatment with Urology Associates had me back playing golf in two weeks after my surgery.”

After Undergoing a Laparoscopic Procedure

A farmer drove his combine six days after surgery because he had to get his crops in.

- TROY LOWERY What’s the recovery time look like?

In addition to giving surgeons extra mobility in tight quarters, the laparoscopic camera provides a magnified view in three dimensions allowing for better visualization, meaning the surgery is more precise, with less blood loss and a more intricate repair. The recovery is drastically easier on the patient, taking about a third to a half of the time it would take to recover if there was an open incision.

Patients are typically in the hospital only one day, and are back to full activity in about a month, rather than two or three months. Patients also report much lower pain levels after surgery. Dr. Dresner has even had one patient go home the same day as the procedure.

“It is important to note that even though there is less blood loss and more precision, the doctors who perform open surgery will eventually see the same results, including rates of cancer control or cure,” says Dr. Dresner. “The recovery period, however, doesn’t really compare. Patients feel so much better so much faster with laparoscopic surgery.” By Tiffany Schmidt

A golfer played 18 holes of golf and carried his own bag just 10 days after surgery.

A bicyclist rode in a 450-mile bike race in the Rocky Mountains six weeks after surgery.

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Determination of a SEAL Physical and occupational therapists help a retired Navy SEAL recover from a stroke.

Retired United States Navy SEAL Curtis “Curt” Barrett says he gained his perseverance and determination during his extensive military training, and it was those skills that helped him recover from a life-changing stroke.

Curt received part of his SEAL training in Alaska, which he said was ironic to him because he knew he was headed to Vietnam. While serving in Vietnam, Curt was injured by a hand grenade, which left remaining grenade fragments in his chest and knee.

He recovered from that injury remarkably quickly and was back on duty in just two weeks.

“I got my ‘no-quit’ attitude from the SEALs. That has stuck with me throughout my life,” says Curt, who also returned to college at 50 years old to earn his bachelor’s degree in education.

Late last year, Curt suffered a severe stroke that left him hospitalized for a month.

“I couldn’t walk or talk, and the right side of my body was paralyzed. I was at Boone Hospital Center, and I started working with physical therapy and occupational therapy just after the stroke.” Curt completed inpatient therapy and rehabilitation, and upon discharge from the hospital, began outpatient therapy at Boone Therapy.

When Curt left the hospital, he was able to walk short distances with a walker, but still largely relied on a wheelchair for his mobility. He did not have control over his right arm or his right leg, and he struggled particularly with using his dominant right hand.

“I couldn’t pick up small objects or write anything,” says Curt.

With the help of physical therapy, Curt was able to discontinue using his wheelchair and began walking more frequently with a walker. Now, Curt is using a

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Hear from Curt and Elsa on YouTube.com/BooneHospital

PHOTO CAPTIONS Top left: Curtis and Elsa walk to one of his occupational therapy appointments.

Top Right: Curtis practices his writing with his wife Cindy. Cindy has been with him every step of the way.

Left: Elsa helps Curtis practice picking up objects using a playing card therapy board.

cane and sometimes even walks without any assistive device.

“I have a greater appreciation for toddlers just learning how to walk, after going through this,” Curt jokes.

Curt’s occupational therapist, Elsa Oestreich, has helped him regain the use of his right hand and arm. His right hand, elbow and shoulder exhibits high muscle tone, or hypertonicity, a common impairment after a stroke. Elsa stretches his right arm to decrease tone prior to working on functional activities.

“We first worked on being able to reach for objects, and then progressed to grasping and releasing objects,” says Elsa.

“When he started to master those skills, we transitioned to increasingly precise movements like tying shoes and writing with various utensils.”

After several sessions, Curt mentioned that he still was not able to sign his name on documents. Elsa gave Curt the homework of simply tracing a straight line with a highlighter. Curt found he was able to do that with accuracy, so he decided to surprise her by also writing down her name and bringing it into the next therapy session.

“She was really happy to see that I wrote a whole word, but then she made it harder for me and we started working on sentences,” says Curt. Elsa was so

impressed that she still has the worksheet hanging at her desk as a reminder of Curt’s constant dedication.

Elsa says that Curt’s willpower and eagerness to improve has aided his progress in therapy.

“He’s always ready to work, here and at home,” says Elsa. Outpatient therapy encourages patients to complete home exercise programs in addition to in-house therapy sessions, and Curt went the extra mile in both areas.

Curt will soon graduate from physical therapy and occupational therapy, as he has met most of his goals for recovery. Curt says he is extremely grateful to his entire therapy team for helping him increase his functional abilities and getting him back to enjoying life. By Madison Loethen Learn more about Boone Therapy at boone.org/therapy

MyBooneHealth.org

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BREAKTHROUGH! Tips to overcome common barriers to leading a healthy lifestyle.

A barrier is an obstacle that prevents movement or access. With healthy living, a barrier is anything that is keeping you from living the healthiest life you can.

Barriers to healthy living can be caused by habits we’ve formed, our circumstances, or even how we were raised. But any barrier will affect how we live our daily lives. Some common barriers to living a healthy life with a balanced diet and regular exercise include not having enough time or money, not enjoying healthy food, and not knowing what to do or how to start.

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If any of these barriers prevent you from leading a healthier lifestyle, it’s important to recognize your barriers. And it’s equally important to have a plan in place to get around, over or through your barriers.

Some barriers will be easier and faster to overcome than others. If it takes time to build a habit, it may take even more time to break. In our fast-paced world, it’s understandable to want to see a change immediately, but it is important to remember that habits don’t change overnight.

TIME

COSTS

If you don’t already plan a portion of your day for physical fitness, time can be a huge barrier – and it can be hard to plan time for exercise if you’re not already in the habit. Your goal should be to get 150 minutes of exercise a week – that’s 30 minutes a day for 5 days a week.

If you don’t have 30 minutes for exercise today, here are some tips for getting in more physical activity:

When you think of working out, you may immediately picture a personal trainer and a gym membership, which can both be expensive. But walking is good exercise that requires no special equipment and can be done anywhere.

• Use the stairs at work.

• If you have an hour before your child’s practice is over, use this time to walk around.

TIPS: • Walk on trails.

• Walk around your neighborhood or office building.

• Use canned foods as dumbbell weights at home.

NOT KNOWING HOW TO COOK TIPS • Buy a pre-made dinner from the grocery store.

• Start by picking a simple recipe.

Read the directions beforehand and have all of your tools ready. Pre-measure and chop ingredients before you start.

• If a recipe calls for a step that you have not done before, look up what the direction means online, so you know what to do.

• Play some music while you cook.

Make cooking fun, not stressful!

• During commercials, try jogging in place, doing crunches, squats or lunges.

• Do leg raises while you brush your teeth or cook on the stove.

• Do calf stretches while waiting for and riding in elevators.

Healthy eating also takes time to plan, shop and prepare. Time management plays an important role here. Setting aside time to plan a week’s worth of meals and snacks can get you started in the right direction. Meal planning may even save you money, as you learn which meals create leftovers or share similar ingredients.

TIPS: • Reserve time in the kitchen right after you get home from the grocery store.

• Wash, chop and separate snack-size portions of fruits and vegetables.

• Plan ahead – make a grocery list before you go to the store.

• Grow your own garden.

• Keep a well-stocked pantry.

• Make double portions.

NOT LIKING VEGETABLES Just because you don’t like vegetables doesn’t mean you shouldn’t eat them.

The great thing about vegetables is that they can be prepared in different ways.

Find what works for you.

TIPS: • Try preparing vegetables in different ways: steamed, boiled, baked, sautéed or even grilled.

• Use herbs and spices to season vegetables to suit your tastes.

• Grind or chop vegetables into small pieces and add them to casseroles, protein shakes or soups.

NOT KNOWING WHAT TO DO OR HOW TO START Leading a healthy lifestyle can be hard, especially with so much confusing and overwhelming information out there. Start slowly and make one small, simple change at a time.

Small changes you can start making today: • Drink at least 64 ounces of water a day.

• Get some form of exercise for 30 minutes a day, 5 days a week.

• Adjust your meals to include lean protein, high fiber, wholegrain, low-fat dairy and fruits and vegetables. By Erin Wegner

MyBooneHealth.org

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BRIN GIN G UP BO O N E BABIES

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STEPS TO HELP BABY SLEEP SAFELY Nothing can fully describe the feeling of bringing your brand-new baby home with you for the first time. Many parents desire and seek some sort of daily routine. It may take a while to adjust, as parents often get advice from many different sources. Unfortunately, one topic that isn’t usually discussed nearly enough is safe sleep practices.

Did you know that the most vulnerable time for sleeprelated infant deaths is between two and four months old?

This is usually when parents are just starting to feel like they’re settling into their new life with a newborn. While sleep-related infant deaths cannot always be fully prevented, these 10 steps can help parents understand the common factors that can create the perfect storm for this to occur.

BY MARIA BICKELL, RN, BSN, IBCLC, BOONE FAMILY BIRTHPLACE

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NEED MORE SUPPORT? 1. Control the risk factors that you can control, starting with pregnancy.

It’s simple – visit your doctor for regular prenatal care visits, then visit your pediatrician once baby arrives. Early identification and prevention of risk factors, such as low birth weight, prematurity and birth spacing, can help protect your baby 2. Give your baby a healthy start by breastfeeding for as long as possible.

Consider offering a pacifier when putting baby to sleep, but if you’re breastfeeding, wait until after your baby is one-monthold. These steps have been shown to be protective against Sudden Infant Death Syndrome, or SIDS. 3. Make sure your baby always sleeps alone. If possible, share your bedroom, but never your bed! Each and every baby (including multiples) should have their own separate place for sleep that is always sleep-ready. Remove all bumper pads, stuffed animals, toys, pillows, blankets, and wedges or sleep positioners – these present a suffocation risk.

4. Baby should always be placed flat on their back to sleep. Side-sleeping is unsafe for a newborn. Contrary to popular belief, on-back positioning actually prevents reflux or aspiration (accidental ingestion of stomach acid or other substances into the lungs) and offers better positioning of the baby’s trachea (windpipe) and esophagus (swallowing tube to stomach).

5. Baby should sleep in a clutter-free crib with a firm surface and a tightly fitted sheet. Never lay your baby to sleep on a water bed, sofa or any other soft surfaces.

Car seats, swings and baby suits are not suitable for sleeping. Crib mattresses should

never be placed against a wall – this can present a trap hazard for baby. Remember: Your baby should sleep alone in their crib with nothing else.

6. Don’t smoke. (Or at least be as smokefree as possible.) This includes not smoking during pregnancy. Also, don’t allow others to smoke around your baby.

7. Help your baby avoid overheating during sleep. Dress your baby in light clothing for sleep. Keep the room temperature at a comfortable level, just as you would for an adult – usually between 68 to 72°F. A light sleep sack or wearable blanket is okay, but never use loose blankets.

A sleep sack with swaddle feature is okay for babies under two months.

8. Give your baby plenty of supervised tummy time while awake. Tummy time is essential for your baby’s development.

Once your baby has become accustomed to it, usually around four or five months old, they will assume their own sleep position. A baby who is unaccustomed to tummy sleeping is at risk! A good way to see if your baby is ready is to reposition your baby to lie on their back the first three times you notice they’ve rolled onto their tummy in bed.

9. Make sure all of your baby’s caregivers know and follow these important steps, so your baby is as safe as possible during sleep.

10. To keep your baby safe while sleeping, remember your ABCDs: • A is for Alone • B is for Back (Think “tummy to play, back to sleep”) • C is for Crib (and Clutter-free) • D is for Don’t Smoke and Don’t Overheat

Bringing Up Boone Babies is a monthly support group provided by Boone Family Birthplace.

We meet on the third Thursday of each month at 10 a.m. at Boone Hospital Center. Each hourlong session is led by a Boone Family Birthplace nurse and includes a short presentation on a different topic, followed by open group discussion.

This support group is free and open to all parents of newborns, infants, and toddlers – and you’re welcome to bring your baby with you! No registration is required.

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

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WELLNESS

FILL ‘ER UP! Fiber is a beneficial – and often overlooked – nutrient that can help you lose weight, lower your cholesterol and more.

RECOMMENDED DAILY AMOUNTS OF FIBER TODDLERS (Ages 1-3)

19g KIDS

(Ages 4-8)

25g GIRLS

(Ages 9-18)

26g BOYS

(Ages 9-13)

31g TEEN BOYS (Ages 14-18)

38g

W

e count, measure and obsess over calories, sodium and carbohydrates, but fiber is the one nutrient that most of us don’t get enough of. According to the Institute of Medicine, only 5% of people in the United States meet the daily target of 25 grams for women and 38 grams for men. But why aren’t we getting enough fiber in our diets?

It’s safe to say that many of us do not spend time in the kitchen planning and preparing our meals and snacks for the day. Instead of filling our plates and snack containers with fruits, vegetables, beans, nuts or seeds, many of us eat a high amount of processed foods. With your busy schedule, think about how many times you’ve used the convenience of a drive-through.

Compared to a high-fiber lunch or dinner, how much fiber is in a double cheeseburger, fries and Mountain Dew? A diet rich in fiber not only helps those of us who wish to shed a few pounds, but is also incredibly beneficial to our gastrointestinal

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health, lowering LDL (the bad cholesterol) and regulating blood sugar levels.

So, what is fiber and why is it so important?

Fiber comes from plant-based products that we eat – fruits, vegetables, nuts, seeds, oatmeal and whole-grain products to name a few. It is essential for our digestion and our health. Fiber is a complex carbohydrate and our digestive system can’t directly digest it, meaning our intestines are not able to break it down into small enough units for our body to absorb. As a result, fiber helps us feel full sooner, adds bulk to stools and aids in regular bowel movements.

Fiber includes both soluble and insoluble fiber. Both are essential to our health and provide their own benefits.

Soluble fiber dissolves in water and forms a gel-like substance as it passes through the body.

Soluble fiber is beneficial to the body because it makes you feel full. It also slows down digestion, which helps regulate blood sugar levels. Adding soluble fiber to your meals can

ADULT WOMEN

(Ages 19-50)

25g ADULT MEN (Ages 19-50)

38g SENIOR WOMEN (Ages 50+)

21g SENIOR MEN (Ages 50+)

30g

WOMAN

MAN

CHILD

BREAKFAST

BREAKFAST

BREAKFAST

• 1 cup steel cut oats (5.4gm) • 1 cup berries (3gm) • 1 cup skim milk = 8gm fiber LUNCH

• Salad –– 2 cups spinach (1.3gm) –– 1 small tomato (1.1gm) –– ½ medium green pepper (1gm) –– 1 oz baby carrots (.8gm) –– 1 egg –– 1 oz turkey –– 1 oz cheese (4.2gm) • 6 Triscuit (3.4gm) = 7.6gm fiber SNACK

• ¼ cup whole almonds = 4.5gm fiber DINNER

• 4 oz chicken breast • 1 cup brown rice (3.5gm) • 10 asparagus spears (3gm) = 6.5gm fiber TOTAL

Calories: ~1500 Fiber: 26.6gm Meal plans provided by Jennifer Anderson, RD, CDE, Diabetes Education and Nutrition Supervisor

• Breakfast sandwich –– 2 eggs –– 1 oz cheese –– 2 oz sausage –– whole wheat English muffin (2.6gm) –– 1 tsp butter • 1 cup skim milk • 1 medium apple (4.4gm) = 7gm fiber LUNCH

• 1 cup Vegetable Beef Soup (4.1gm) • 1 cup tossed salad • 1 tbsp ranch dressing (.7gm) • 6 Triscuits (3.4gm) • 1 cup grapes (1.4gm) = 9.6gm fiber SNACK

• 2 tbsp cashews (.5gm) • 1 medium orange (3.1gm) = 3.6gm fiber DINNER

• 5 oz Ribeye • 1 medium potato with skin • 1 tsp butter • 1 tbsp sour cream (3.8gm) • ½ cup cooked carrots (3.4gm) • 1 cup broccoli (5.5gm) = 12.7gm fiber

• 1 ½ cup cheerios (3.9gm) • 1 med. banana (3.1gm) • 1 cup skim milk = 7gm fiber LUNCH

• Peanut butter and jelly sandwich: –– 2 slices whole bread (4.3gm) –– 1 tbsp Jelly • 1 medium apple (4.4gm) • 10 baby carrots (2.9gm) = 11.6gm fiber DINNER

• 1 cup macaroni and cheese (2.3gm) • ½ cup broccoli (2.5gm) • ½ cup mandarin oranges (0.9gm) = 5.7gm fiber TOTAL

Calories: ~1400 Fiber: 24gm

TOTAL

Calories: ~2000 Fiber: 33gm

help keep your blood sugar from spiking after a meal to crashing an hour or two later. Soluble fiber also aids in lowering LDL by absorbing the bad cholesterol and removing it through your stool, which can decrease your risk for heart disease.

Insoluble fiber doesn’t dissolve in water and travels through our body without much change. Insoluble fiber helps food travel through our digestive system and adds bulk to our stools, making it good for problems with constipation, diarrhea and hemorrhoids.

Both soluble and insoluble fiber benefit our bodies, so it’s good to get a mixture of both in your diet. Adequate fiber intake has been shown to reduce the risk of colon cancer and can be beneficial for a healthy weight. By feeling fuller longer, you’re less likely to overeat at meals or have unnecessary snacks throughout the day.

This can lead to weight loss, which lowers your risk for certain diseases associated with obesity, including heart disease, stroke, high blood pressure, diabetes and cancer.

Add fiber to your diet gradually. Start by adding 5 grams (g) of fiber a day. Increase your water intake when you increase your fiber intake to prevent abdominal discomfort caused by gas, bloating and abdominal cramps. By Erin Wegner If you need help adding fiber or other nutrients to your diet, Boone Hospital Center offers outpatient nutrition counseling with registered dietitians. To learn more or to schedule an appointment, please call 573.815.3870.

MyBooneHealth.org

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“Spaghetti” Squash with Quick Marinara Recipe courtesy of Siteman Cancer Network

INGREDIENTS SERVES 4

1 spaghetti squash, 4 to 5 lbs, halved and seeded 5 tbsp olive oil, divided 1/2 cup sweet yellow onion, finely diced 4 cloves garlic, minced 1/4 cup dry white wine 1 28 oz can San Marzano whole peeled tomatoes 1/4 cup water 2 to 3 tsp fresh thyme leaves 1/4 tsp chile flakes 1/2 tsp kosher salt 10 fresh basil leaves, divided (6 chiffonade, 4 whole) kosher salt fresh ground black pepper

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INSTRUCTIONS 1. Preheat oven to 400˚F. 2. Brush both halves of squash with 2 tbsp olive oil; season generously with salt and pepper.

3. Place cut side down on a lipped baking sheet and roast for 40 minutes. Remove, flip over and let cool slightly until able to handle.

4. While squash is roasting, add remaining 3 tbsp olive oil to 12-inch skillet set over medium heat. Add onion and cook until tender, about 4 minutes. Stir in garlic and cook until fragrant, 30 seconds. Add wine and bring to a bubble; cook for 2 to 3 minutes.

5. Add tomatoes and surrounding juice, mashing with potato masher to incorporate. Fill can with 1/4 cup water

and slosh around to gather remaining tomato juice; add to mixture. Stir in thyme leaves, chile flakes and salt and bring to a boil; reduce heat and let simmer for 25 minutes, stirring occasionally, until thickened. Stir in chiffonade basil and simmer for 5 more minutes.

6. Once squash is cool enough to handle, scrape each half from side to side with a fork to make spaghetti noodles. Transfer to clean kitchen towel, gather up sides and wring squash over sink to release excess moisture.

7. Place in large serving bowl and season to taste, using tongs or your hands to lift and separate “noodles” and fluff.

8. Divide onto plates and serve with Quick Marinara; garnish with remaining basil leaves.

MyBooneHealth.org

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Keeping On KEEPING IT OFF How one couple successfully maintains their weight loss years after bariatric surgery.

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racy and Don Frevert of Columbia both had weight loss surgeries in 2012 and 2014, respectively, losing nearly 300 pounds combined. We wanted to find out what it was like for them to have the surgery, how they’ve been able to keep their weight off and what life is like after having bariatric surgery.

In their free time, Don and Tracy Frevert enjoy fishing, traveling and dancing to ‘80s cover bands. These are things that are easier

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to do and a lot more enjoyable since they’ve lost 295 pounds collectively as a couple.

“She started all this,” Don begins.

Tracy noticed that she was starting to have a few health concerns. Her blood pressure was high, and she was struggling with sleep apnea. Knowing that she needed to lose weight, Tracy had tried conventional diets and an array of exercise programs.

With each attempt, she would lose weight.

But over time, she would gain the pounds

back that she had lost, plus a few more.

Tracy realized that she wouldn’t be able to do this on her own and needed help.

Bariatric surgery was something that Tracy had known about and had been interested in. She’d thought about having surgery many times. But, at the time, her insurance wouldn’t cover the surgery and gastric bypass surgery was the only option for surgery. but wasn’t yet available in Columbia. So, she had put off the thought of surgery for a few years.

Tracy then got a new job with the City of Columbia. While attending a health fair for city employees, she found herself at the Boone Hospital Center Health and Wellness table, holding a brochure for gastric banding surgery.

“Finally,” she thought. “The surgery for me.” She asked the staff some questions, learned about the weight loss surgery seminars, and went from there.

In December 2012, Tracy came to Boone Hospital Center, where surgeon James Pitt, DO, performed a gastric band procedure.

This procedure is the least invasive and is the only adjustable weight loss surgery option. This option is performed as an outpatient procedure and requires patients to make follow-up visits to the clinic to have their band adjusted.

Bariatric surgery can be done in a number of ways; gastric band, sleeve gastrectomy or gastric by-pass. These procedures reduce the size of the stomach. The sleeve gastrectomy and gastric bypass are permanent, while the gastric band is the least invasive and is not permanent. Tracy chose the gastric band procedure for these reasons.

Gastric band patients typically experience the slowest weight loss, but can expect to lose 40 to 45% of their starting weight.

Tracy started her bariatric surgery journey at 250 pounds. It took Tracy around 18 months to lose the weight. She currently weighs 135 pounds, meaning she lost 46% of her weight.

While Don was supportive of Tracy’s surgery, he was not ready for surgery of his own yet. It was two years after Tracy’s surgery before Don says he was ready and had the mindset: “It’s time to do something about this and get it under control.”

Don’s first obstacle was saying goodbye to his comfort foods: spaghetti, pizza, soda and

beer. But he did. To prepare for surgery, he said goodbye to all of them, knowing that this was the last time he was going to eat and drink those foods. Even now, Don will take a bite of pizza and think, “How did I like this?”

Bariatric patients are given guidelines and suggestions of foods to eat after surgery.

Don’s comfort foods are only suggested in moderation, because they wouldn’t aid in his weight loss journey.

“Certain foods, such as tough meats, simple sugars and soft breads, are typically not tolerated as well after surgery by many people,” explains Nicole Spencer, DO, of Columbia Surgical Associates.

Before his surgery, Don also struggled with health concerns. He took medication for his blood pressure, had to use a CPAP machine when he slept, and was on Celebrex for pain in his knees. Don’s starting weight was 383 pounds. He had his surgery in October 2014 and, like his wife, it took him 18 months to lose all of his weight. Don’s current weight is 203 pounds – a 47% weight loss.

How have Tracy and Don successfully kept their weight off so many years later?

First, they both had the correct mindset that this surgery was a tool for their weight loss and not a magic pill. Tracy says bariatric surgery was something that she chose as a preventative measure for her health.

The couple fully understood that having weight loss surgery meant they would have to change their lifestyle for it to work.

Getting on the same page in the kitchen helped them tremendously. They learned which foods were good for them and which ones weren’t.

Tracy and Don’s new favorite dinner is grilled steak served with fresh zucchini, yellow squash and asparagus. They enjoy cooking and using herbs and spices for flavor. Don loves to grill, and he grills all year long. If Don grills two steaks, that can feed them for 8 to 12 meals – most bariatric patients have a stomach capacity of 4 to 8 ounces per meal per day. Four ounces equals ¾ of a cup, and 8 ounces equals 1 cup.

Tracy also loves what she calls her “mystery meals” for lunch at work. She puts leftovers in small plastic containers, then puts them in the freezer. When she gets to work, she doesn’t find out what’s she having until it’s defrosted.

Together, Don and Tracy Frevert have kept off almost 300 pounds.

Second, both Tracy and Don were ready to change their lifestyle and make exercising a part of their life. Because Don had problems with his knees, they did several years of water boot camp. They enjoy water aerobics, because it’s easier on their joints. They also enjoy walking together and plan walking dates.

Don says, “We’re always trying to do some type of movement. The band would do so much for you, but you still have to do your diligence in doing the exercise with it, to make it stick.”

Third, the couple attended the hospital’s weight loss surgery support group. The group meets once a month. Some people in the group have also had a gastric band, some have had sleeve or gastric bypass procedures and some haven’t had surgery yet. Tracy says the group has been helpful because people “share experiences and stories and reaffirm that there’s other people in the same situation you are.”

Tracy and Don celebrate the little things that they couldn’t do before they each had weight loss surgery. For Tracy, it’s being able to paint her toenails without taking a break after each toe or crossing her legs – something that she couldn’t do before.

For Don, it was shopping and traveling.

Before his surgery, there was only one store Don could shop at and a pair of size 56 jeans cost him $54 dollars. Now in a size 34 to 36 waist, he can buy three pairs of

jeans for the price of one, and he can shop wherever he wants. With a smile, he says, “Clothes get so much cheaper when you are a smaller size.”

Don also celebrated the first time he flew in an airplane and didn’t have to use a seat extension. And after losing weight, Don had a follow-up sleep study and found out he didn’t need to use a CPAP anymore. He is also off of his blood pressure medication.

Another celebration the couple enjoys is when they go out to eat. Before their surgeries, if there was only a booth available at a restaurant, they had to wait for a table. Now they celebrate getting to sit wherever they want.

Both Tracy and Don are glad they made the decision to have weight loss surgery.

“I am appreciative because my health in general is better,” Don says. “I wish I hadn’t been so hard-headed and waited two years!”

“We have zero regrets and would do it again in a heartbeat,” Tracy says. “It truly was lifesaving.” By Erin Wegner If you’re thinking about weight loss surgery, take the first step with a free weight loss surgery seminar at Boone Hospital Center.

To register for our in-person and online seminars, visit boone.org/ weightloss or call 573.815.3870.

MyBooneHealth.org

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GETTING TO KNOW A BHC DOCTOR

Troy Scheidt, MD Why did you get into the health care field? My exposure to physicians prior to medical school was limited to my pediatrician, Dr. Robert Harris, and the physicians who cared for my grandparents, but each of them had positive impacts on my desire to pursue medicine. I was also a fire fighter and emergency medical technician with the Boone County Fire District. When I entered medical school, I thought I would do pediatrics or emergency medicine.

What interested you in your particular specialty?

Both the physicians, particularly Dr. Templer and Dr. Davis, and the patients that I developed a relationship with during medical school heavily influenced my decision. Otolaryngology; or head and neck surgery; ear, nose and throat (ENT), offers a lot of diversity that makes every day interesting. Half of my practice is pediatrics and half is adults. There’s also a balance between problems that are treated purely with medical care and those with surgery. A lot of ENT involves improving quality of life, including helping patients hear better with cochlear implants or other ear surgeries, treating sinus problems to restore sense of smell or breathing through the nose or treating voice disorders to restore effective vocalization. It also involves treating benign and cancerous tumors of the salivary glands, thyroid and parathyroid glands.

What is the most rewarding aspect of your job? I feel a tremendous amount of personal reward from the appreciation my patients offer when I see them for follow up, both in terms of their outcome from treatment as well as the compliments they give to everyone involved in their care. It truly is a frequent occurrence that patients compliment the entire team at Boone Hospital, as well as the team in my office. They really appreciate the compassion and competency of the entire team.

What is the most challenging aspect of your job?

Unfortunately, there are medical conditions that cause some patients significant problems that do not have any desirable or effective solutions. I find one of the more challenging aspects of being a physician is to effectively explain why we don’t have solutions when the problem is significant, even though we want to have one.

What do you see changing in health care in the next five to 10 years? I don’t have a prediction of how it is going to change, but I think the cost of health care is one of the biggest challenges we have in health care right now. Hopefully, we will see some significant efficiencies develop in the near future.

What advice would you give someone looking to become a doctor? Education and training to be a physician is a relatively long road, with four years of undergrad, four years

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of medical school and typically three to seven years of residency.

Certainly, there will be some unpredictable changes in medicine from when you start to when you finish your education and training. But after completing the training, medicine is a very rewarding career, with the opportunity to see the impact of the care you provide on the patients you treat.

What do you enjoy doing outside of work? Most of my time outside of work is currently dominated by my kids’ activities.

They are both in high school. My daughter plays golf and runs cross country and track, and my son plays baseball and football. I bike and run regularly with friends and my wife. My family and I enjoy traveling to outdoor vacations typically involving the ocean or mountains.

GETTING TO KNOW A BHC NURSE

Jennie Collins, RN Resource Nurse, PACU

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am originally from Clarksville, Tennessee. I started nursing school right out of high school, but put my education on hold when I got married and travelled

with my husband, who was in the military at the time.

I returned to school after his retirement. I became an LPN

through Columbia Career Center in 1995, then returned to school and graduated from Columbia College’s ADN

program in 1998 at the age of 36. My husband and I are blessed with three beautiful daughters – one recently graduated with her RN degree!

Why did you get into the health care field?

I’ve always wanted to be a nurse from a young age. I can’t remember anything else I’ve wanted to do. I’ve always loved helping people.

What interested you in your particular specialty?

I have been fortunate in nursing that I have been able to hold several awesome positions, including staff nurse, charge nurse, director, outcomes coordinator, employee health nurse, nurse educator and now the resource nurse for Pre-op.

What is the most rewarding aspect of your job?

Being the resource nurse in our busy pre-op area has been a very rewarding experience. We are caring for patients when they are at their most vulnerable. It is rewarding when we can make them and their families feel at ease or less afraid before undergoing their surgical procedure. We try to offer them comfort, encouragement and reassurance about their procedure.

What is the most challenging aspect of your job?

Being in a busy surgical department, our challenge is making sure patients are ready for surgery in a timely fashion while at the same time not making the patient feel hurried or rushed.

We want to provide safe, competent care for our patients, but sometimes we are on a strict time restraint.

What has changed in your field since you started practicing? When I first started nursing, patients were admitted the day before their procedures, and the staff would prep the patients for their procedure – my, how things have

changed! Patients are now expected to do their own prep at home or come in for pre-op testing, X-rays and EKGs as an outpatient prior to their surgery.

What do you see changing in the next five to 10 years? With our aging population, I think families will have to be more involved with caring for their loved ones in the home setting.

What do you enjoy doing outside of work? Outside of work, I like reading, crocheting and gardening.

What advice would you give to someone looking to become a nurse? Nursing is not always easy, but is very rewarding in many ways. Stick with it. It’s worth it. I’ve never met a nurse who regretted their decision to enter the field.

MyBooneHealth.org

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Cause and Effect Bria Arnel had no idea she had a rare condition until she came to Boone.

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n July 2018, when Bria Arnel’s smart watch began sounding a frequent alert that her heart rate was extremely high, she says, “I thought maybe my watch wasn’t working properly.”

Bria, who grew up and lives in Jefferson City, and works for the Missouri Department of Economic Development, had never been seriously ill before, although she’d noticed some recent changes. She grew tired easily and began to sweat more than usual. She had also gained weight and noticed her face looked red. But she didn’t think it was anything serious.

“I was thinking I’m almost 40, so this could be early menopause,” she says. She had planned to talk to her OB/GYN about it at her next screening appointment.

Then Bria’s smart watch began going off again, this time to tell her that her blood pressure was also too high. She immediately went to a clinic in Jefferson City, where she received medication to control her heart rate and blood pressure, along with a referral to Boone Medical Group to be seen by Michael Daly, DO. “My appointment was set up for the next day. It was really fast,” Bria says.

Dr. Daly ordered labs for Bria that revealed her cortisol levels were, in her words, “off the charts.” He then referred her to Sonya Addison, MD, an endocrinologist at Boone Medical Group Diabetes and Endocrine clinic, to find the cause of her increased cortisol.

Bria says Dr. Addison knew the cause immediately: “She took one look at me and she knew I had Cushing’s.”

Cushing’s syndrome, or hypercortisolism, is a hormonal disorder where the adrenal glands produce too much cortisol. The most common cause is a non-cancerous (or benign) tumor on the pituitary gland, located on the base of the brain, that makes the gland produce a hormone that

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Bria Arnel saw her doctor after her smart watch alerted her to a high heart rate and blood pressure.

makes the adrenal glands produce too much cortisol. Other causes include a history of oral or injectable corticosteroids, like prednisone; tumors in other endocrine glands; or another disease affecting the adrenal glands. In rare cases, Cushing’s syndrome can be inherited.

Cushing’s syndrome is rare but has a distinct set of symptoms, including facial redness, acne, fat pads on the back and shoulders and striae, red-purple marks similar to stretch marks on the abdomen and other parts of the body. Other symptoms include fatigue, weakness, excess sweating, menstrual irregularities, high blood pressure and bone loss. Some people with Cushing’s syndrome may have depression or irritability, though Bria says she didn’t have these symptoms.

Without treatment, Cushing’s syndrome may lead to diabetes, hypertension, heart disease, or osteoporosis, which can cause weak bones that fracture easily.

Bria’s lab tests confirmed what was plain to her endocrinologist, but they still had to find the cause of her syndrome. She received an MRI at Boone Hospital Center, which revealed a tumor on her pituitary gland.

“I was scared at first,” Bria says. “I’ve had colds and the flu before, but I’ve never actually been sick. When they say you have a tumor, you’re thinking the worst.”

Bria met with Terry Ryan, MD, a neurosurgeon with Mid-Missouri Neurosurgery, who explained the treatment options. Dr. Ryan

“They were all looking out for me.” recommended she have surgery to remove the tumor. In most cases and with an experienced surgeon, surgery to remove a pituitary gland tumor, which is often done by going through the nose, is a successful option.

“Dr. Ryan was really nice,” she says. “He called me twice to go over everything with me. Then he called me into his office and met with me and my husband. I was scared, because I’d never had surgery before, but Dr. Ryan eased my mind.”

Bria’s husband, Jeff, also accompanied her in February 2019 when she came to Boone Hospital Center for her surgery.

“He stayed at the hospital the entire time I was there,” she says. “He thought everyone at Boone was just great.”

Bria also appreciated the care and compassion she received from everyone at the hospital. She was nervous when she first arrived, but the pre-op staff who prepared her for surgery were thoughtful and explained what they were doing every step of the way.

“I was in the ICU for two days, and the staff was just wonderful. When they checked in on me, they weren’t just coming in the room to make sure my blood pressure was okay. They had conversations with me, too. They got to know me as a person.”

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1. Bria Arnel, one day after pituitary tumor surgery 2. One month after surgery, Bria no longer has symptoms 3. With niece Haley Arnel, two months after surgery 4. With nieces Maggie, Jayme and Annie Sprat 5. Celebrating Haley’s graduation, three months after surgery

Bria laughs, “I remember one ICU nurse telling me I looked too good for someone who just had brain surgery. I didn’t feel good, but I was glad to know I looked good!”

Dr. Ryan also visited Bria after her surgery. In the recovery room, she remembers him telling her, “We’ve got it.”

A follow-up MRI showed the surgery was successful. A benign 2-millimeter tumor had been removed from her pituitary gland. Bria will have another MRI in October and then a scan once a year for the next five years, to make sure the tumor doesn’t return.

Bria was out of work for a month as she recovered from surgery – with help from Jeff – but has since resumed her favorite activities, which include spending time with her nieces, traveling with Jeff to Branson and following the

Saint Louis Blues during their winning season. She feels better and enjoys having more energy.

One thing Bria isn’t doing anymore: receiving health alerts from her smart watch. She’s been able to stop the medication for her heart rate and high blood pressure, too.

“I want people to know about Cushing’s syndrome,” she says. “You might have the symptoms and – just like me – think it could be menopause, but it could be something else!”

Bria is grateful for the care she received from her team of Boone Hospital physicians, nurses and health care professionals. She says, “They all made sure that I was getting the best care that I needed. They were all looking out for me.” By Jessica Park

MyBooneHealth.org

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LIVING WELL

6 Easy Exercises To Get Fit for Delivery When you’re participating in an athletic event, it’s best to train your body with a specific set of exercises. Having a baby is no different. These simple and quick exercises can help you to get fit for delivery, by stretching and strengthening the appropriate muscles to help your body during labor and delivery. These exercises can also help alleviate some of the pain associated with pregnancy and assist in your post-partum recovery. Best of all, these exercises can be done in the comfort of your own home and don’t require specialized equipment. They are easy, painless, and should feel good!

Make sure you don’t hold your breath or bear down while exercising. Notify your physician before beginning an exercise program – they will let you know if you have any restrictions. If you experience any pain, dizziness, vaginal bleeding or fluid leakage, shortness of breath, chest pain, uterine contractions, or muscle cramps, stop the exercise and report these symptoms to your physician.

If you have questions about how to do these exercises properly, ask your physician for a consult with a physical therapist. A physical therapist can ensure that you are performing the exercises properly and help you with some of the painful parts of pregnancy, including low back pain, hip pain, leg pain, or other musculoskeletal issues. If you have these same problems after delivery, or experience urinary leakage, pelvic organ prolapse, or pelvic pain, Boone Therapy’s women’s health physical therapist is able to help with these conditions. By Katie Goodlet, PT and Ingrid Minge, PT, DPT, MBA 28

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Deep Squats Squats will help to relax and lengthen your pelvic floor muscles, as well as stretch your perineum. This will help to open up your pelvis, which will assist with your baby’s descent through the birth canal. It also helps increase the strength and range of motion of your hips, core muscles, and gluteals.

Start by standing with your feet shoulder width apart. Your arms should be outstretched to assist with balance. Squat down, allowing your knees to go around your abdomen. Your weight should be going through your heels, which will keep your heels flat on the floor. Be sure to keep your knees behind or in line with your toes. Hold this position for 5-10 seconds and then return to the standing position. Progress to performing three of these.

You can also have a partner hold on to your hands to assist with balance.

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Wall Slides As you progress throughout your pregnancy, your posture can change leading to a slouched posture. Performing this exercise will help improve your posture and stretch the muscles in the front of your chest that may have become shortened. This exercise is also great for improving your arm strength and preparing you for carrying your new little one around.

Start with your feet six inches away from the wall and lean against the wall.

To obtain your starting position, raise your arms up so that you have a 90 degree angle at your shoulders and elbows. Slowly slide your arms up the wall and then return to the starting position. Repeat this exercise 10 times.

For more information, visit boone.org/therapy DISCLAIMER: After 20 weeks of pregnancy, lying on your back for extended periods of time can cause you to become dizzy, nauseated, or short of breath. This occurs because the weight of your baby pushes down on a major blood vessel called the vena cava, which helps the blood return from your lower body to the heart. Performing these quick exercises on your back shouldn’t cause these symptoms, but if you do experience them, roll onto your side and discontinue the exercises.

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Pelvic Tilt with Head Lift This exercise can help to improve your posture, strengthen your abdominals, and alleviate back pain during pregnancy. Start by laying on your side and then rolling on to your back. Bring your knees up and place your feet flat on the floor about shoulder width apart. Wrap your arms around your abdomen and then flatten your back against the floor by tightening your abdominals. Lift your head slightly and hold for three seconds before returning your head back to the floor. Repeat this exercise 10 times.

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Bridge and Twist This exercise helps to stretch your hips and strengthen your core, gluteals and hamstrings.

It can also help provide gas and constipation relief. Start by laying on your side and then rolling on to your back.

Bring your knees up and place your feet flat on the floor about shoulder width apart.

Your hands should be down by your side.

Push through your heels and lift your hips off the floor while keeping your back straight. Twist your pelvis left and then right before returning to the starting position with your buttocks on the floor. Repeat this exercise 10 times.

Kegel Exercises The muscles in the pelvic floor act as a sling to support your uterus, bladder and bowels. Strengthening these muscles can help with after delivery complications. Start by standing or laying with your feet shoulder width apart. Tighten your pelvic floor muscles and hold for 5-10 seconds. If you are unaware of how to tighten your pelvic floor, begin by stopping and starting your flow of urine while trying to keep your buttock, abdominal, and thigh muscles relaxed. Once you have been successful stopping and starting your flow of urine, you know that you are using the correct muscles. When performing your Kegel exercises, pretend like you are trying to stop and start the flow of your urine. You will want to progress up to doing 100 of these throughout the day.

Butterfly Stretch This exercise will stretch the muscles in your back, thighs, and pelvic joints. It also helps to increase the blood flow to your lower body. To begin, sit either flat on the floor or with a pillow under your bottom. Your back should be against the wall using good posture. Bring your feet together and press your knees gently in to the floor until you feel a stretch in your inner thigh. Hold this for at least 30 seconds and repeat two or three times.

MyBooneHealth.org

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FOUNDATION NEWS

Event Highlights The Boone Hospital Foundation Golf Classic was held on May 13 at the Club at Old Hawthorne

2019

CALENDAR OF EVENTS JULY & AUGUST

Community Campaign AUGUST 27-28

Scrubs on Site Sale

Collective Goods Sale OCTOBER

Jewelry Sale NOVEMBER 9

Annual Gala NOVEMBER 19-20

Scrubs on Site Sale DECEMBER

COMO Gives Campaign 30

BOONE HOSPITAL CENTER

Gala BOONE HOSPITAL FOUNDATION

SEPTEMBER 16-18

Summer 2019

SAV E THE DATE S ATURDAY, NO VEMB ER 9 T H

Boone Hospital Foundation Golf Classic calendar of events

TO OUR SPONSORS July & August

Community Campaign

August

11

Uniform Sale

September

7, 8, 9

Fall Book Sale

October

17, 18

Fall Jewelry Sale

Ameren Missouri

Columbia Landcare, LLC.

Jack Smith Creative Services November

5

American Document Solutions

Columbia Orthopaedic Group

Lenoir Woods

10

BJC Home Care Services / Boone Hospital Home Care & Hospice

Commerce Bank Dr. Andrew & Kim Getzoff

Bob & Brenda Wagner

Dr. Bud Murphey

Boone Hospital Center Administration

Drewing Automotive

November

Macadoodles

Schindler Elevator Annual Gala Corporation

Uniform Sale

Septagon Construction

November

17, 18Shelter FallInsurance Jewelry Sale

Mid-America Precast

May 2017

1 Southern Golf Tournament Boone YMCA

Missouri Heart Center

TEAMHealth

MO Cotton Exchange

Tech Electronics, Inc.

Morrison Foods

The Club At Old Hawthorne Tiger Express Car Wash

Meyer Electric, Inc.

Boyce & Bynum Pathology

Environmental Engineering, Inc.

Brian & Gina Whorley

Evan & Dixon, LLC.

Officer Mechanical Contractors

Central Bank of Boone County & Central Trust Investment Company

Faultless Linen

Orscheln Farm & Home

Tim & Betsy Vicente

Fitzgibbon Hospital

Phoenix Textile

UMB

CMAB, LLC

FSA, LLC.

Priority Access Health Plan

Will Electronics

Columbia Insurance Group

Healogics

Reinhardt Construction

Woodrail Centre

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

NONPROFIT U.S. POSTAGE

PAID

COLUMBIA, MO PERMIT 286

Gala B O O N E HO SPITA L FO U N D ATIO N

S AV E T H E D A T E S AT U R D AY, N O V E M B E R 9 TH