Boone Health SUMMER 2022
CARE Mother Nikki Stallworth heals from within after traumatic experience.
A Family of Boone Nurses
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Table of Contents 8
Erin Wegner Marketing & Communications Consultant I COPY EDITOR
Jessica Park Communications Consultant II CONTRIBUTING WRITER
Madison Loethen Digital Communications & Marketing Consultant II PHOTOGRAPHY
Charles Bruce III, Chris Padgett, Sadie Thibodeaux ADDITIONAL CONTRIBUTING WRITERS
Beth Frazier, Courtney Murphy, Hannah Robertson, Jennifer Tveitnes, Jenny Workman
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A Note from Troy
A Family of Boone Nurses
The Chamber of Healing
Freedom From Infection
Wellness Beneﬁts Outdoors
Shedding Pounds Without Surgery
Traveling with Your Baby
Get to Know a BHC Doctor
Get to Know a BHC Nurse
Reducing Food Waste
Core Strengthening During Pregnancy Foundation News
A NOTE FROM TROY
Guest column by Chad Pew, FACHE, Sr. Vice President, Provider Services, Boone Health
t Boone Health Medical Group – or BHMG – we not only believe everyone should have easy access to world-class care; we’re also taking steps to make it happen. We continue to collaborate with Boone Health Laboratory Services to open more lab draw locations. This year, we’ve cut the ribbon on new sites in Moberly and Osage Beach. With eight of our ten primary care clinics located outside Columbia, it makes sense to extend convenient access to our full-service lab to patients in these communities. We opened a new specialty clinic, Boone Health Plastic Surgery. Giorgio Allegra, MD, a Mizzou alumnus, has
returned to Columbia from Italy. He’s currently seeing patients and has won over everyone who’s had the chance to meet him. If you’d like to get to know Dr. Allegra, check out his proﬁle in this issue of My Boone Health magazine. Our Diabetes & Endocrinology, Foot & Ankle, and Infectious Disease clinics share a new space in Broadway Medical Plaza 4. Podiatrists play an important role in the care and management of diabetes patients. People with diabetes are also more susceptible to infections. Bringing these three specialties together under one roof makes it easier for our providers to communicate and collaborate on care plans, leading to better outcomes for our patients. Change and growth takes effort from many people and Boone is fortunate to have an outstanding team of staff, advanced practice providers and physicians. We believe it’s important that
the people who care for you have a say in how we run our primary and specialty care clinics. During our transition to independence last year, we established an Operating Committee to provide governance for the medical group. We currently have eight BHMG physicians and one advanced practice provider on the committee. We include physicians from different areas and stagger term lengths to provide balanced representation and to continually introduce new voices and ideas. I’d like to thank the founding members of our Operations Committee: Dr. Anne Petersen, Chair; Dr. Rebecca Llorens, Vice Chair; Dr. Angela Yuen, Secretary-Treasurer; Dr. Paul Schoephoerster; Kelli Cash, NP; Elizabeth Crews, NP; Dr. Blake Welschmeyer; Dr. Kate Grossman; Dr. Sonya Addison; and Dr. Bud Murphey. These providers shouldered additional responsibilities during a stressful time – COVID didn’t take a time-out while we worked through the transition – to ensure that Boone Health Medical Group provides midMissourians with excellent care. It’s hard to express how much I appreciate this team. I’m proud of what everyone has accomplished in a little over a year. It’s been exhausting at times, but we’re still standing, and we have brighter days ahead of us. The ﬂexibility to provide the care our patients need was a major factor in our decision to go independent. We knew this path wouldn’t be easy, but we knew it was best for the people who matter most – our patients. Finally, I’d like to congratulate BHMG Group Administrator, Kyndal Rifﬁe, for being named Boone Health’s 2021 Leader of the Year. Kyndal was not only essential to getting us through our ﬁrst year of independence; she played an instrumental role in getting COVID vaccines to our employees, providers, and community members. She exempliﬁes Boone Health’s goal to improve the health of the people and communities we serve, and she is truly deserving of this honor.
A New Space For Care The following Boone Health Medical Group clinics relocated to a new space at 1705 E. Broadway, Broadway Medical Plaza 4, Suite 300: • Sonya Addison, MD, and Conne Dunn, NP, with Boone Health Diabetes and Endocrinology (www.boone.health/diabetes) • Jason Blanchard, MD, with Boone Health Foot & Ankle (www.boone.health/foot) • Phillip Beck, MD, with Boone Health Infectious Disease (www.boone.health/ID) The new location enhances synergy between the three practices and allows for future growth opportunities.
Lab Draw Opens in Centralia
Boone Health Opens Plastic Surgery Clinic
Boone Health Medical Group recently cut the ribbon on its Centralia clinic. The remodel includes a new stand-alone lab draw clinic with all new equipment. The lab will be open 8 a.m.-5 p.m. every weekday with no appointments needed. The remodel also enhanced the attached ambulance space and emergency responder living quarters to support the 24/7 Boone Health Emergency Medical Service operation in Centralia. The Boone Health clinic is located at 1021 East Highway 22 Centralia, MO 65240.
Giorgio Allegra, MD, has joined the Boone Health Medical Group. Dr. Allegra is board certified in both general and plastic surgery, and he is a member of the American Society of Plastic Surgeons. Dr. Allegra has practiced in Atlanta, Chicago, Dallas, New York, Dubai, and Milan, and brings more than 27 years of experience to Mid-Missouri. Dr. Allegra offers comprehensive plastic surgery services including breast augmentation, breast reconstruction, face lifts, body lifts, tummy tucks, mommy makeovers, body contouring, liposuction, and anti-aging. Boone Health Plastic Surgery will open its new permanent location at 1601 E. Broadway, Broadway Medical Plaza 1, Suite 260 in early August. For more information, call 573.815.5310 or visit www.boone.health/plasticsurgery.
Boone Health Heart Surgery Team Recognized Boone Health earned a distinguished three-star rating from The Society of Thoracic Surgeons (STS) for its patient care and outcomes in isolated aortic valve replacement (AVR) surgery. This is the highest possible honor, and it places Boone Hospital Center among the elite in the U.S. and Canada when it comes to AVR surgery. The heart team also earned a STS three-star rating for isolated coronary artery bypass grafting (CABG) procedures. The STS star rating system is one of the most sophisticated and highly regarded overall measures of quality in health care, rating the benchmarked outcomes of North American cardiothoracic surgery programs. The rating is calculated using a combination of quality measures for specific procedures performed by 3,800 STS Adult Cardiac Surgery Database participants from January 2019 to December 2021. Historically, approximately 4%-8% of participants receive three-star ratings for isolated AVR surgery and 20% for CABG.
Wound Healing Center Earns Distinction Boone Health’s Wound Healing Center received the 2021 Center of Distinction award by Healogics®, the nation’s largest advanced wound care service provider. Our Wound Center achieved outstanding clinical outcomes for 12 straight months, including a patient satisfaction rate higher than 92%. Achieving Center of Distinction reflects the Boone team’s unwavering commitment to an excellent patient experience. Even with the extraordinary circumstances presented by the pandemic, Boone Health Wound Healing Center has persevered with a people-first, patient-centered approach to care. The Wound Healing Center is a member of Healogics’ network of 600-plus Wound Care Centers®, offering highly specialized wound care to patients suffering from diabetic foot ulcers, pressure ulcers, infections, and other chronic wounds that don’t heal in a reasonable amount of time. Advanced wound care modalities provided by our experts include negative pressure wound therapy, biosynthetic dressings, growth factor therapies, and hyperbaric oxygen therapy. Congratulations to the Wound Healing Center team for its commitment to our patients!
Boone Health First In Area To Offer CryoBalloon Procedure Boone Health is now offering the C2 CryoBalloon™ Ablation System to patients who suffer from chronic gastroesophageal reflux disease (GERD), the first hospital in Mid-Missouri to do so. The C2 CryoBalloon Ablation System uses extreme cold to destroy unwanted tissue. A balloon probe, which is connected to a catheter, comes in contact with the wall of the target tissue. Upon activation by a physician, the balloon probe is cooled and inflated with nitrous oxide. The extreme cold eradicates the precancerous or abnormal lesions along the esophageal lining without harming the healthy tissue. The procedure can be performed in just 15-30 minutes. The procedure uses freezing therapy instead of burning therapy and patients generally experience less pain and a quicker recovery. “There have also been studies to show that there have been some positive immunologic response from the body when you freeze tissue because you don’t degrade the proteins as much as when you burn them,” says Kevin Halsey, MD, of Boone Health and Gastrointestinal Associates, LLP.
A FAMILY OF
One nurse retires, opening a spot for her granddaughter to step in and help deliver her cousin’s baby.
rowing up, Danielle Major would hear her cousin Grace Westfall talk about how much she wanted to become a nurse, just like her Grandma LeAn Smith. From a very young age, this was what Grace wanted to do, and she never wavered on her desire to become a nurse. Grace’s Grandma, LeAn, worked in Boone Hospital Center’s Maternal Child Health department for 43 years, delivering several family members’ babies during her time at the hospital. When she was younger, Grace would beg her grandma to take her to the hospital so she could see the babies in the newborn nursery. That was always a special trip for them. After spending a lot of time at the hospital with her grandma growing up, Grace graduated from high school with plans to go straight to MACC – Moberly Area Community College – to become a nurse. MACC was the same place where her mom, Lisa Smith, earned her RN license, and her grandma received her LPN. It was known as MATC then, Moberly Area Technical Center. After that, LeAn went to Columbia College for her RN license. When Grace started the nursing program, her cousin Danielle was pregnant with her first daughter. This gave Grace an opportunity to train by asking her cousin questions about her pregnancy. Before Grace finished school, Danielle got a job at MACC as the Administrative
LeAn Smith with her daughter Lisa Smith and her granddaughter Grace Westfall.
Danielle Major with her daughters Evelyn and Addisen.
Assistant to Dean of Health Sciences. This allowed Danielle to help get everything finalized for Grace’s graduation, including a very special award. At her graduation ceremony in December 2021, Grace received the Clinical Excellence Award for her graduating class. What made this moment special for Grace and her family is that both her mother and grandmother had also received the Clinical Excellence award for their respective graduating classes. When Danielle found out she was pregnant with baby number two, she asked Grace where she planned to work, and Grace told her she was trying to get a job at Boone Hospital. Grace joined Boone Hospital in January 2022. Even though she wouldn’t get to work side-by-side her Grandma who retired the previous August, Grace felt her Grandma retired so that she could step in and take her place. “When I found out she got the job at Boone, I was figuring out where she would be on my due date,” says Danielle. “Knowing there was a good chance that I would have Grace as my nurse on either Postpartum or Labor & Delivery, I told her I’d like for her to be on Labor & Delivery if at all possible.” Starting her first 12-week orientation, Grace began her training on the Postpartum floor, while the other half of her group had their orientation in the Labor & Delivery unit. “Nurses are trained to work in all three areas; Labor & Delivery, Postpartum and the Newborn Nursery. The benefit to nurses being able to work in all areas is the flexibility it gives us for staffing. A nurse can start their shift on Labor & Delivery and then after mom delivers, the nurse can transfer mom and baby to the Postpartum
floor and continue to care for her patient and the baby that she helped deliver,” says Sherri Barnes, BSN, RN, Maternal Child Health Patient Care Manager. The day Danielle was scheduled to get induced was Grace’s first day on the Labor & Delivery floor. “I was more excited than nervous,” Grace says. “Obviously, I was nervous to a degree, because it was my first day on a different floor, but I was excited because I knew that I was going to be taking care of my cousin Dani.” For several weeks before her cousin was induced, Grace would ask Danielle, “Are you sure you’re okay with me seeing everything and being there?” Without hesitation, Danielle would say, “I wouldn’t want anyone else!” “This was Grace’s first vaginal delivery she’s ever seen. This was the first baby she’s been able to have hands-on experience with and help deliver,” Danielle says with a smile. Danielle also knew Grace wouldn’t have the extra stress of a new mom going through labor for the first time. Danielle also got to watch as the nurse who was helping Grace walked her through everything and explained why they did things a certain way. “It’s just been an amazing experience to watch and be a part of Grace’s entire process of becoming a nurse,” Danielle says. “Having the generations passed down, with her grandmother delivering a lot of babies in my family, then getting to watch and experience Grace deliver her little cousin like her grandmother would have, was just special.” By Erin Wegner
CARE Mother Nikki Stallworth heals from within after traumatic experience.
n March 24, Nicole “Nikki” Stallworth opened her eyes. She looked around and saw that she was in a hospital room, and specifically, an Intensive Care Unit (ICU) room. She racked her brain for her last memory. The last thing she remembered was being in her postpartum hospital room after having her daughter, Millee, via C-section. She quickly found out from her parents and her husband that six weeks had passed since her daughter’s birth. The barrier that is supposed to form between the placenta and mother’s uterus formed incorrectly, so when the placenta was removed during the C-section, she experienced serious bleeding issues and eventually multiple organ failure. Nikki was in such a dire state that at one point, her mom, Joyce, was told that Nikki may not make it. Joyce was crying in the ICU waiting room when Boone Health Lead Chaplain Kimberly “Kim” Leon introduced herself and asked if she could help. “I was walking through the ICU waiting room, which I do sometimes, just to check if there is anyone in there who may need support. I saw Joyce and went up to her and introduced myself and asked how she was doing. She explained that her daughter was in the ICU and asked if I would go pray for her. I went to Nikki’s room, and she was sleeping at that time. I prayed for her, and when Joyce came in a few minutes later, I encouraged her to let me know if there was anything else I could do,” says Kim. 10
When Nikki woke up and was aware of what happened and how much time she had missed with her newborn and 3-year-old son Bo, Kim comforted her. “I was away from my daughter for her first six weeks of life, and I really had to grieve that. I went through all five stages of grief over that time missed while I was in the hospital and Kim helped me work through it all,” says Nikki. Kim visited Nikki daily while she was in the ICU, then still regularly when she moved to the rehabilitation floor. “She did a lot of listening to me and let me talk about how I was feeling. I was always so grateful when my children were able to visit me, but it was terrible when they had to leave,” says Nikki. Nikki sometimes felt discouraged at her progress, especially while she was on the rehabilitation floor. Kim helped Nikki work through those emotions. “I encouraged her to express her feelings, listened, and validated that all of the feelings she was having were normal for her situation. I affirmed her progress and encouraged her to look at how far she had come since she entered the hospital instead of comparing herself to where she was before she entered the hospital,” says Kim.
For more information on our Spiritual Care services, please visit boone.health/spiritual-care or call 573-815-3888
Nikki and Kim would like to encourage any patients or family members to reach out to Spiritual Care services if they need support. “We are here to provide compassionate, support for patients, families, and staff of all faith backgrounds and those who are nonreligious. Our Chaplains are clinically trained clergy who provide services including nonjudgmental listening, emotional support, grief support, prayer, and other religious/spiritual services and resources,” says Kim. Nikki was discharged and was able to continue her recovery at home with her husband DeShawn and her children. DeShawn is in the military and was set to be deployed in June, so the family spent as much time together as possible before he left. By Madison Loethen
THE C HAM BE R OF
HEALING Hyperbaric Oxygen Therapy at Boone
hen you walk into a hospital, specifically a wound clinic, the last thing you expect to smell are fresh baked goods. But if you were visiting Boone Hospital Center’s Wound Healing Center on the same day as Perry Leslie, that’s just what you may find. Perry made a habit of treating the staff to his homemade cookies and scones during his treatment period. Perry currently enjoys retired life with his wife, Janet, who he has known since attending Helias Catholic High School together in Jefferson City. He first visited Boone’s Wound Healing Center under the advisement of his urologist, Michael Cupp, MD. Perry is a cancer survivor, having first been diagnosed with prostate cancer 12 years ago. The radiation therapy used to treat his cancer would cause Radiation Cystitis. According to the National Library of Medicine, “Radiation Cystitis describes the side effect of Perry and his wife Janet. inflammation and subsequent destruction to the normal anatomy of the urinary bladder at the cellular level after the use of radiation in the treatment of multiple cancer types.” The damage that results can Simply put, oxygen plays a huge role in the internal wound-healing vary from person to person. process and hyperbaric oxygen therapy helps transport more For Perry, one persisting symptom was short bladder spasms, healing oxygen throughout our body. lasting 10 to 15 seconds but occurring 20 to 30 times throughout The air pressure inside a hyperbaric oxygen therapy chamber is a day. Perry eventually had his bladder cauterized, but it was not greater than normal atmospheric pressure. This causes the blood healing correctly, so to the Wound Healing Center he went. vessels to constrict, which helps to reduce swelling and improve Just as the name implies, the Wound Healing Center specializes blood flow. in treating non-healing wounds. Every wound is different, just as Hyperbaric oxygen therapy has become a more prevalent form every patient is, so the staff creates specialized treatment plans for of noninvasive treatment for radiation cystitis in recent years. every individual. For Perry, and up to 18% of wound care patients, The therapy stimulates angiogenesis, or the development of new the treatment plan would involve hyperbaric oxygen therapy. blood vessels, which reestablishes blood flow in the area and helps Hyperbaric oxygen therapy involves breathing pure oxygen in maintain bladder functionality. By experiencing hyperbaric oxygen a pressurized, enclosed environment; typically a chamber. Inside, therapy, Perry had the opportunity to heal his bladder from the patients gather more oxygen with every breath. The now oxygencauterization and find symptom relief from his radiation cystitis. rich blood carries 15 to 20 times the normal amount of oxygen The hyperbaric chamber is a clear, glass tube which patients throughout the body, which helps combat bacteria and promotes healing by stimulating the release of growth factors and stem cells. lay horizontally inside of on a gurney. Perry says seeing through
For more information on the Wound Healing Center, visit boone.health/woundhealing
The Wound Healing Center team at Boone Health uses an advanced multi-disciplinary team approach to wound healing, that offers benefits to both individuals and other healthcare providers.
the chamber helped him feel less confined and more relaxed. Each session was about two hours long each, which was the perfect amount of time to watch a movie. Luckily, the wound healing center has many DVDs for patients to choose from to pass the time. For Perry, this is a highlight of the experience. “Really, it was like going to the movies. All I was missing was the popcorn!” he joked. Perry experienced 60 treatments in total; three treatments a week, for 20 weeks. When Perry finished his treatment, he gathered up many DVDs from his home collection and donated them to the center to pass it forward. Though the staff surely misses his homemade treats, and he still copes with some pain, the hyperbaric oxygen therapy successfuly healed the cauterization wound on his bladder and stopped the bleeding. The staff at the Wound Healing Center develop treatment plans suitable for each individual. With so many different causes
of poor wound healing (pressure, trauma, edema, infection, etc.), and systemic factors such as body build, hyperbaric oxygen therapy certainly isn’t for all. When a patient visits, the clinic’s multidisciplinary staff assesses wounds and determines the best course of action based on advanced medical technology. Ask your doctor about visiting Boone’s Wound Healing Center if you have a wound that hasn’t healed in 30 days, has become infected, or has increasing pain, redness, swelling, or odor. If you’re anything like Perry, you may find both healing and friends in the staff at Boone’s Wound Healing Center. By Hannah Robertson
Freedom F RO M I NFE CTI ON
Collecting eggs leads to serious infection. 14
Hear from Stephanie and Dr. Beck on YouTube - www.youtube.com/boonehealth
tephanie Baker loved animals. She worked as a Veterinary Technician, and she sometimes watched other peoples’ animals while they were out of town. However, when a strange illness seemed to take over Stephanie’s body, she decided to take a break from work. “I was having night sweats and vomiting. I didn’t have an appetite, so I was dropping weight quickly. I also had very swollen, large lymph nodes,” says Stephanie. At first, Stephanie’s doctors did a biopsy on her lymph nodes, fearing it could be Hodgkin’s lymphoma. Her results were negative for cancer, but it did identify the source of Stephanie’s issues: Disseminated Histoplasmosis. Histoplasmosis is an infection of the body caused by breathing in fungus spores found in bird and bat droppings. A person can become infected by just breathing in the air near soil contaminated by the droppings. The disease becomes Disseminated Histoplasmosis when it spreads through the body and infects the blood and organs. “In my case, I had been working with chickens. Likely when I was out collecting eggs, I breathed some spores in. I didn’t realize at the time the GI medication I was on for Ulcerative Colitis made me more susceptible to getting the disease,” says Stephanie. Stephanie was very sick when she first met Infectious Disease physician Phillip Beck, MD, of Boone Health Medical Group – Infectious Diseases. “When coming up with a treatment plan for Stephanie, it was important to be aggressive from the very beginning. We used a strong antifungal medication called amphotericin to control the disease,” says Dr. Beck. Stephanie spent several weeks in the hospital getting her amphotericin through an IV. When Stephanie went home, she continued to take an oral antifungal that patients generally take for 6-12 months. But due to the severity of Stephanie’s symptoms, Dr. Beck recommended she take it for a whole year. He also worked with Stephanie’s GI doctors to change her GI medication to something that didn’t increase her risk of developing Histoplasmosis. “We switched her to something that stayed more localized to the gut and did not affect her immune system. That way we can cure the fungus and make sure it doesn’t come back,” says Dr. Beck. Stephanie continues to have regular visits with Dr. Beck to check her progress. “I am doing so much better. I’m able to enjoy my life again,” says Stephanie. By Madison Loethen
Boone Medical Group Infectious Diseases is staffed by Phillip Beck, MD. Dr. Beck earned his medical degree from MU, where he also completed his residency in Internal Medicine and his fellowship in Infectious Diseases. Services Include: • Bone/joint/skin infection • Device/hardware infection • Intra-abdominal infection • Chest infection (lung, heart valves) • Infection associated with diabetes, cancer • Fungal infection • Mycobacterial infection (MAC, TB) • Viral hepatitis B/C • HIV, PrEP • Sexually transmitted infection • Travel medicine Location: 1705 E. Broadway Broadway Medical Plaza 4, Suite 300 Columbia, MO 65201 For more information on Infectious Diseases, please visit www.boone.health/services/id/ or call 573-815-3550. Boone.Health/My-Boone-Health
Wellness Benefits of
Being Active in the
Outdoors By Jenny L. Workman
tudies have shown that nature has helped people cope with isolation over the past year. There are several health benefits that scientists continue to explore linking the great outdoors to our wellness. With summer, we can now look forward to the many wellness benefits associated with being outdoors. “The physiological response to being outside in nature is real, and it’s measurable,” said Michelle Kondo, a research social scientist with the USDA Forest Service’s Northern Research Station. “There are many physical and psychological benefits of nature that scientists have observed, which can better help us understand how nature supports wellness in the body, mind and community.”
HELPS YOU GET VITAMIN D It’s important for bones, blood cells, and immune system. It also helps the body absorb more of certain minerals, like calcium and phosphorus. Our bodies need sunlight to make it, but you don’t need much. In the summer, just getting sun for 5 to 15 minutes, 2 or 3 times a week, should do it.
STRONGER IMMUNITY Better vitamin D production because of more sunlight is already good for your immune system. But the outdoors seems to help in other ways. Many plants put substances, including organic compounds called phytoncides, into the air that seem to boost immune function. Sunlight also seems to energize special cells in our immune system called T cells that help fight infection.
LESSENS ANXIETY Even a simple plant in the room, or pictures of nature, can lesson anxiety, anger, and stress. But it’s better if we get outside. Exercise is good for anxiety too. But it’s even better if we do it outside, compared to inside a gym. Sunlight helps keep serotonin levels up. This helps raise energy and keeps our moods calm, positive, and focused.
SOCIAL When getting outside the house, it’s not only Mother Nature we see. We also connect more with the people and places in our community. Human contact and a sense of community are important to our mental health. Plan a walking route to a friend’s house, and then to a park to do some exercise. Socialize while hiking, cycling or walking on a trail. You might be surprised how good it makes you feel.
IMPROVES SLEEP The outdoors helps set our sleep cycle. Cells in our eyes need enough light to get our body’s internal clock working right. Early morning sunlight seems to help people get to sleep at night. This may be more important as we age. When we get older, eyes are less able to absorb light, and will be more likely to have problems with sleep.
HELPS US FEEL BETTER ABOUT OURSELVES As little as 5 minutes of outdoor activity can help improve our selfesteem. This is especially true if near water or green space. And it’s not necessarily high-intensity exercise that does it best. More relaxed activity like a walk, bike ride, or work in the garden seems to work even better.
IMPROVES FOCUS Even a little bit of exercise while outside can help with focus. Some studies have shown that it’s not just the activity, it’s the “greenness” of the outdoor space.
BOOSTS YOUR CREATIVITY Do you have a problem you can’t solve? Struggling with writer’s block? Spend time outside. Studies show that time in nature can boost our creative problemsolving abilities. This is partly because the outside world engages our attention in a quieter way that allows our attention refocus. The more time we spend, the bigger the benefit, but even just “getting out for some air” can nudge our brains into a new thought pattern.
WHAT TO WATCH OUT FOR Protect yourself from the sun with long sleeves, sunglasses, and a hat. Use broadspectrum sunscreen, SPF 15 or higher, even when it’s cloudy. Try to let people know where you go, especially if you’re going alone into a wilderness area. Dress according to the weather forecast and charge your phone in case you need a map or to call someone. Remember, your phone may not work in some areas, especially in the woods.
The outdoors serves as a venue to come together with friends and family and connect with the larger community.
There are so many opportunities to do outdoor activities and close to home: Check out Leisure Times for Spring/Summer como.gov/parks-and-recreation/leisure-times-program-guide Show Me State Games: smsg.org Missouri State Parks: mopark.org Katy Trail: mostateparks.com/park/katy-trail-state-park Rock Bridge: mostateparks.com/park/rock-bridge-memorial-state-park
Untangled A complex treatment regimen gets Aaron back home.
aron Eckman was working on his Paris, Missouri family cattle farm when he began having vision issues. “All of the sudden when I would focus on an object, the object would start moving. It would last 5 to 30 seconds each time and it kept happening,” says Aaron. Aaron decided to take a break. He went inside, washed his face off and rested a bit. He otherwise felt fine, but when the vision problems continued, he decided to visit his local family care practitioner.
“My doctor examined me and didn’t find anything wrong. He recommended that I see an eye doctor,” says Aaron. Thankfully, Aaron was able to see an eye doctor rather quickly. Aaron had 20/20 vision, but because of the movement in his vision, the physician recommended Aaron get an MRI. “By now, my wife and I were getting pretty concerned. She works in the medical field and so within a day she had my MRI appointment scheduled,” says Aaron.
Aaron underwent the MRI, and soon after, his family practice doctor called with the results. “He told me I had an AVM,” says Aaron. An arteriovenous malformation, or AVM, is an abnormal short-circuit between arteries and veins that creates a tangle of vessels in the brain or spinal cord. In Aaron’s case these were stealing blood from other parts of the brain, causing his symptoms. AVMs can cause seizures or convulsions or burst and leak blood in and around the brain, which is known as a bleeding stroke. “We were really worried. We knew I needed to see a neurosurgeon so right away, I called our son’s pediatrician
For more information on Neurosurgery, please visit boone.health/neuro or call 573-815-3242.
Aaron and his son Connor, at their home in Paris, MO and on their cattle farm.
Holly Bondurant, MD. We have a close relationship with her, and knew her husband is neurosurgeon Charles Bondurant, MD,” says Aaron. They were able to make an appointment with Dr. Bondurant. “When Dr. Bondurant looked at the MRI, he agreed it was an AVM, and he also noted that it was very close to my brain stem,” says Aaron. Dr. Bondurant went over the different AVM treatments with Aaron.
“Multiple treatment options exist for AVMs. Some are treated with surgery, some are treated with radiation, some are treated by clogging the short circuit with glue and some are treated with a combination of therapies,” says Dr. Bondurant. Because Aaron’s AVM was so close to his brain stem, Dr. Bondurant suggested a combined glue and radiation treatment plan. For the gluing procedure, Dr. Bondurant joined efforts with Boone Health
Interventional Radiologist, Andrew Getzoff, MD, and a small catheter was guided through Aaron’s vessels into the AVM. A slurry of medical glue was then slowly injected into the lesion, working to clog the abnormal vessels feeding the lesion while also allowing the normal vessels to remain open. “This decreased the size of the AVM and thereby decreased the lesion’s ability to steal blood from Aaron’s brain,” says Dr. Bondurant. Though Aaron’s AVM was smaller and his symptoms had improved after the gluing procedure, residual AVM has the ability to regrow with time. With this in mind, Dr. Bondurant recommended following up with radiosurgery. Radiosurgery has the ability to shrink and destroy the residual AVM. During the radiation procedure, focused beams of radiation from different angles were directed at the AVM to concentrate radiation in the remaining abnormal vessels. Aaron was monitored for years as the radiation slowly turned the abnormal vessels into scar tissue. However, some residual AVM still remained, so Aaron underwent a second dose of radiation to get rid of the remaining AVM. “Every year, I was getting an MRI done to see how things were progressing. One year, Dr. Bondurant was out of the country when I had my MRI done, and he still called me with the results,” says Aaron. Aaron’s evaluations also included arteriograms. During his arteriograms, a small catheter was guided through Aaron’s vessels and Xray contrast was injected and watched as it flowed. “This last November, after an arteriogram, Dr. Bondurant came to see me in my hospital room, and I saw him kind of dancing in the hallway. He told me that my AVM was gone!” says Aaron. Now you will find Aaron back at the Paris Vet Clinic business, working on his family farm, or spending time with his wife and son. He says he will always appreciate the care he received from Dr. Bondurant and Boone Hospital during his health journey. By Madison Loethen
SHEDDING POUNDS Without Surgery
Galina Rasputina-Simmons found success with Boone’s medically supervised weight loss program.
For more information on our Bariatric Services, visit boone.health/weightloss
alina Rasputina-Simmons, a manager of a recovery room at Boone Hospital Center, found herself in a position so many of us do. Slowly, over years of balancing work, life with her husband Reginald and their three daughters Alissa, Aleena and Aliyah, along with the stress that comes with it, she had begun to gain weight. She tried to lose the weight on her own many times, in a variety of ways, but nothing was working. Eventually, she stopped stepping on the scale and gave up trying to lose weight entirely. “Really, I had given up on myself.” As a result, Galina now had high cholesterol which she needed medication to control. This medication came with the side effect of myalgia, leaving her with painful muscle aches and tired the majority of the time. Being prescribed the medication was like a wake up call. Galina suddenly realized the serious consequences her eating and lifestyle habits could have, as high levels of cholesterol increase a person’s risk of heart disease. “I was scared something would happen to me, like a heart attack, and I would leave my kids without their mother,” she thought. This fear, as frightening as it was, was just the motivation Galina needed to make a change. She first heard about the the nonsurgical medically supervised weight loss program from a co-worker at Boone, where Galina has worked since 2014. The weight loss program is non-surgical and is medically supervised by a physician and dietician. This team provides each individual with personalized counseling and meal planning to help them reach their specific goals. Another co-worker had already started the program, so after learning about the option and hearing their experience Galina quickly made an appointment for herself. Galina started the weight loss program and had her first visit with the physician and dietician on January 25, 2021. The program’s mission is to “help individuals make the best choices to reach their goal weight and give them the tools needed to successfully manage their weight for the rest of their lives.”
During the first visit, the medical team performs an initial assessment which allows them to create a diet and exercise program tailored to the individual’s specific lifestyle and dietary needs. The program combines nutrition, pharmacology, and physical activity to correct patients’ metabolisms which leads to a decrease in appetite, an increase in energy, and typically weight loss. It can be a lot of change at once; but the team works hard to make sure it is doable for the individual, and the regular check-ins help to monitor effectiveness and change course as needed.
she eats, and the nutritional facts from the food daily. If nothing else, it helps to keep her conscious of what she puts in her body and to eat on schedule (the app will remind her if she skips). Since the beginning of her journey in January 2021, nearly a year and a half ago, Galina has lost around 60 pounds; dropping from a size 14 to a size 2. She has been able to lower her cholesterol and no longer needs medication for it. Galina says that losing weight through the program “hasn’t been that hard at all” thanks to the support of her family, the
“I was scared something would happen to me, like a heart attack, and I would leave my kids without their mother.” Throughout the appointments, she recalls checking her weight, discussing with the dietician about her struggles, cravings and the reason for her weight gain. They also discussed what support she was looking for, how to make healthier choices, what replacements could be made and how to manage stress. The last was very important for Galina, as she found her emotional state related directly to eating. “I would celebrate with food; and I would grieve with food,” she said. One of the most useful tools Galina has found through the program is using an app to support her weight loss journey. There are many options available, but Galina likes to use MyFitnessPal. This allows her to track her goals, the times she eats, what
staff at Boone, and her fellow coworkers who were also in the program and holding each other accountable. The most difficult part, she says, is making the choices to break habits, but that’s what leads to true lifestyle change. According to Galina, one of the best results has been that she’s able to motivate others and give them hope. She’s seen positive changes in her own family as they follow her diet, and she encourages anyone else interested in a non-surgical weight loss options to give the program a try. “Find a support group or person, make sure you’re emotionally and physically ready to change your habits, set realistic goals, and go ahead and try - make that appointment!” she advises. By Hannah Robertson
BRIN GIN G UP BOO N E BABIES
BABY ON BOARD
TIPS FOR SAFE & SANE TRAVEL WITH YOUR BABY
Planning your first vacation with your new baby can be exciting and presents opportunities to make wonderful memories. These travel tips can help ensure your child’s safety and reduce stress for both of you. BY COURTNEY MURPHY, RN, ADN, BOONE FAMILY BIRTHPLACE
BEFORE YOU GO • Babies require a lot of stuff, but there are ways to shorten your packing list. When booking a hotel or vacation rental, look for places that provide cribs or pack ‘n’ plays. There may be services at your destination that rent strollers and other baby equipment. Some rental car companies provide car seats at an additional cost. • Bring hand sanitizer and sanitizing wipes to clean surfaces and limit germ exposure. Pack portable baby-proofing items if you’re staying in hotels or with family who aren’t used to little ones around the house. • Protect your baby from the summer sun. Both the FDA and American Academy of Pediatrics recommend keeping infants under 6 months old out of direct sunlight. Using sunscreen on infants younger than 6 months is not recommended because there’s a higher risk of your baby developing a rash or some other bad reaction. Use sun hats, rash guards, sunglasses and stick to shady areas when outside. And don’t forget to pack the bug spray! TIPS FOR CAR TRIPS WITH YOUR BABY • When traveling by car, stop every 2-3 hours and take your baby out of their car seat. If you’re traveling at night and your baby is sleeping, you may go a little longer before stopping. • Plan your trip in advance. Map out your route and find places where you can easily pull off to stretch your legs, take your baby out of the car seat, and eat. • Pack an easy-to-reach car bag with extra diapers, wipes, clothes, food, or bottles.
formula. If you don’t have a portable bottle warmer, most gas stations have hot water you can use to warm milk or formula. • If your baby is on solids, pack food and a travel highchair. • When staying in a hotel, ask for a corner room if one is available. • Bring a travel bassinet that can fit inside a larger crib or pack ‘n’ play. TIPS FOR FLYING WITH YOUR BABY • Due to their immature immune system, it’s recommended you wait until your baby is at least 3 months old before traveling by plane. And don’t forget sanitizing wipes!
• Sit in the backseat so you can easily watch and interact with your little one. Entertain them with songs, games, books, and toys!
• The safest way for a baby to fly is with an FAA-approved car seat or airplane harness.
• If possible, drive at night during your baby’s normal sleep time. For daytime stretches, bring travel blackout curtains or a blanket that can safely cover the car seat during naps.
• Try to book a direct flight or a flight with a longer layover. If you can, book a redeye flight so that your baby will sleep for most of it – and pay for extra leg room!
• Bring extra breastfeeding supplies or
• Prepare for the airport. Bring your baby’s
birth certificate with you. Pay extra for TSA pre-check or curbside check-in to cut time spent waiting in line. • You can bring a diaper bag, pumping bag, car seat and stroller onto the plane for free. You can also bring as much breastmilk, formula, and water as you need, but the TSA is required to check the contents. • Pack extra outfits for you and your baby in your diaper bag in case you need an urgent change of clothes. • Before boarding the plane, use the restroom and change your baby’s diaper. • During takeoff and landing, breastfeed, bottle-feed, or give your baby a pacifier with gripe water to relieve ear pressure. Remember to be patient with your baby. You’re throwing them off their normal routine, and mishaps will occur. Your baby will cry, be loud, and do all the things babies do, but babies are allowed to go on vacations, too. Don’t let others make you feel like your baby is a bother. Most importantly, have fun and create wonderful memories with your little one! Boone.Health/My-Boone-Health
GETTING TO KNOW A BHC DOCTOR
PierGiorgio Allegra, MD
Plastic and Cosmetic Surgery, Boone Health Medical Group Plastic Surgery
grew up in Florence, Italy. My parents were both teachers. After I graduated from medical school, I started my residency in Plastic Surgery at the prestigious University of Padua in Italy, which was founded in 1222. I later transferred to the United States as a research fellow to pursue my lifelong dream to train as a surgeon in North America, starting with a General Surgery residency at the University of Missouri-Columbia. After 35 years, my return home to Columbia is the perfect conclusion for a wonderful professional trajectory.
Why did you get into the health care field? Medicine has been an interest since my very early childhood. Thinking back, I must have had some imprinting by my family doctor, a wonderful and caring person. He was my godfather, and his name was Giorgio. As far back as I can I remember, I have always said I would be a doctor and go to the U.S. to train as a surgeon, which must have sounded peculiar coming from a little kid. Over the years my interest was reinforced at school by a strong inclination for science and human biology in particular. Eventually, life decides for us while we make plans.
What interested you in your particular specialty? My interest in plastic surgery started as a totally abstract idea back in my high school years. In Florence at the time, there were no plastic surgery services, so I had no practical examples. I was, however, a good portrait artist. It made perfect sense to me that blending surgery with art would equal plastic surgery. When I started medical school, I bought a plastic surgery textbook, and I loved the creativity of the specialty. What is the most rewarding part of your job? One, I like being effective in making my patients’ lives better. Well-being is both physical and psychological. Yes, plastic surgery can help us treat conditions, but it can also help us feel better about ourselves by improving or correcting something that makes us feel insecure. This is very important for younger adults – a procedure not only changes forever how you feel about yourself but how you feel in relation to others. Second, as a plastic surgeon, my conversations with patients are not only about clinical exams and results. Learning about my patients’ wishes and personality helps bring us together into a closely knit team. The satisfying relationships with my patients make me feel like a doctor even more than when I literally saved lives in trauma and emergency situations but had no time to get to know my patients.
What is the most challenging aspect of your job? What makes it challenging is exactly what makes it so interesting and never repetitive — customizing protocols and clinical guidelines for every single patient. Each individual is unique! What do you see changing in health care in the next 5 to 10 years? I hope that any amazing technological improvements are not counterbalanced with excessive dehumanization of health care and the loss of adequate contact between doctors and patients. Patients are human beings, not spreadsheets. What advice would you give someone looking to become a doctor? Be absolutely sure about the goodness of your motivations and follow that fire inside. Medicine is very hard work and must remain a vocation; otherwise, it’s going to be an empty, stressful life with a very high chance of burnout. What do you enjoy doing outside of work? Anything that satisfies my curiosity! What advice would you give to someone who is going to be a patient in a hospital for a period of time? If you can, choose your doctors carefully – then trust them! Second-guessing, internet shopping, and Googling for alternative treatments are a sure path to disaster. If a “solution” looks too easy and cheap to be true, it’s not true!
GETTING TO KNOW A BHC NURSE
Emmanuel Nana Amoako, BSN, RN, CCRN ICU
was born and raised in Kumasi, a city in Ghana, West Africa. I moved to Jefferson City about nine years ago, then to COMO three months ago. I received my bachelor’s degree in Nursing from Lincoln University. Boone Health is my second full-time nursing job since graduating, and I cherish every moment working there.
Why did you get into the healthcare field? As a child, I knew deep within that I would work in a healthcare field. As the years passed, I narrowed my choices either to be a medical doctor or a nurse. When I came to the U.S., I saw the exceptional job the nurses here are doing. I did my research and learned that nursing has been the most trusted profession in the country. At Lincoln, [I was] still undecided and taking my pre-med classes, and I applied and was accepted to the nursing program. What interested you in your particular specialty? I chose to work in the ICU because I was interested in the intensity and the skill set required to work there. I enjoy working in a fast-paced environment. What is the most rewarding part of your job? Most patients come to the ICU when they are fragile, afraid, or hopeless. It brings me joy to see them get better and reunite with their families. What is the most challenging aspect of your job? Occasionally dealing with difficult family members or even difficult patients. But I understand that pain has a voice and do my best not to take things personally. Another challenge is dealing with the death of a patient when you are emotionally invested. What has changed in your field since you started practicing? There hasn’t been much change since I started nursing, but I can say that COVID-19 has made nurses realize that we deserve better working conditions, incentives, and recognition.
What do you see changing in the next 5 to 10 years? In the next 5 to 10 years, I see more innovation and improvement in telehealth. What do you enjoy doing outside of work? I enjoy playing FIFA on my PlayStation 5, doing yard work and spending quality time with my family. What advice would you give someone looking to become a nurse? If your passion is helping people no matter how difficult the circumstances, then nursing will be a great profession for you. Sometimes it gets tough, and you might contemplate changing professions, but if it’s your passion and something you love doing, then that passion will keep you going.
5 Simple Steps for
Reducing Food Waste 26
ood waste is a significant issue in the United States. The U.S. Department of Agriculture, or USDA, estimates that approximately 31% of food is wasted by retailers and consumers. Throwing out so much uneaten food has many impacts. Safe food that could feed people facing food insecurity often ends up in landfills. Food waste uses up resources needed to grow, process, transport, prepare, store, and dispose of food, including land, water, energy, and labor. In landfills, rotting food gives off methane gas, a powerful greenhouse gas that affects climate change. And American households spend about an average of $370 per person each year on wasted food. Limiting food waste is good for the environment and our pocketbooks! There is a national initiative to reduce the amount of food wasted by Americans in half by 2030 – and you can help! These five simple steps can help you start reducing your food waste.
Build a weekly meal plan, then use it as a blueprint for your grocery list. Stick to the list when shopping to ensure everything you buy gets used. Avoid bulk purchases of anything that spoils quickly. To make sure you use vegetables and fruits before they can spoil, plan recipes that use fresh produce at the beginning of the week, then use frozen produce later in the week. When meal-planning, look at your schedule and be realistic about the time you have available. If Wednesday night is filled with activities and nobody will be home until late, it’s reasonable to plan to eat out that day. Purchasing food you won’t have time to prepare will lead to waste.
Shop your kitchen by looking in your freezer, refrigerator, and pantry. Take stock of items you already have that you can use for meals or that need to be used. This ensures you use foods you have before they go bad. If you have several different foods you need to use before they spoil, combine them into a creative dish! Use your favorite spices, seasonings, and sauces to make a unique recipe. Challenge household members to come up with creative ideas, too. You may be surprised at how delicious it turns out.
Skip Precut Produce
Produce spoils faster after it’s cut. Unless you plan to use produce in the next day or two, choose uncut produce in its whole form. At home, wait to cut produce until you’re ready to use it, if possible. Uncut produce also costs less than precut, saving you money!
Exposing produce to water causes it to spoil faster. Washing fresh fruits and vegetables as soon as you get home could result in them going bad before you get the chance to eat them. If you must wash produce in advance, dry it as much as possible and store it in a container lined on the bottom with a kitchen towel or paper towel to absorb excess moisture and prevent spoilage.
For more tips on how to reduce food waste at home and in your community, visit
First In, First Out
Store your foods using the first in, first out method. When you buy new food items, put them in the back of your refrigerator or pantry and move any items already there up front. This encourages you to use foods you’ve had longer, lessening they’ll be forgotten and spoil. By Jennifer Tveitnes, RD, LD, Clinical Dietitian, Boone Health Bariatrics
Keep a Strong Core During Pregnancy D
uring pregnancy, many women try to stay as strong and healthy as possible. But they may hear conflicting messages regarding how safe it is for them to perform core exercises and how to do them. Keeping a strong core helps you move better further into your pregnancy, protects against low back and hip pain, and, when performed properly, may decrease your risk of developing diastasis recti, commonly called abdominal split or separation. To safely strengthen your core during pregnancy, perform an abdominal draw-in during all core exercises. Imagine using your abdominal muscles to draw your baby bump in and up toward the back of your ribcage. You should feel a gentle tension across the front of your lower abdomen. Avoid holding your breath or bearing down at any point. As your pregnancy progresses, you may need to modify core exercises. To protect against developing diastasis recti, check your adbomen for “doming.” Watch your belly or gently rest your hand on it as you exercise. If the center of your abdomen forms a tent-like peak, this means the exercise is too difficult, so avoid or modify it. If you feel shortness of breath or discomfort when lying on your back, skip core exercises in this position. Exercising a combined 150 minutes over 3-4 days each week can reduce the possibilities of pregnancy complications. A variety of aerobic exercise, strength training, yoga, and stretching are helpful, so try different routines and combinations to find activities you enjoy! By Beth Frazier, DPT, Women’s Health Physical Therapist, Boone Therapy 28
Bridges Lying on your back with your lower abdominals drawn, gently tilt your pelvis back to flatten your lower back to the ground. Lift your hips while keeping your pelvis tilted back to avoid arching your back. Hold for 5 seconds, then slowly lower yourself back to the start position. Do 20 repetitions. Modification: If you feel any shortness of breath or discomfort lying on your back, try this exercise with your shoulders resting on an exercise ball or couch. Lift your hips until your body is parallel to the ground, then lower them to the ground again.
For more information on Physical Therapy, please visit boone.health/therapy or call 573-815-3868
Side Plank on Knees Lie on your right side with your knees bent and your right elbow directly beneath your shoulder. Draw in your lower abdominals, then lift your hips high enough that your spine is in a straight line with your legs. Hold for 30 seconds. Do three repetitions on each side. Squats Stand with feet about shoulder-width apart. Draw in your lower abdominals. Slowly lower yourself as you begin bending at your hips, then at your knees. Maintain a neutral spine and keep your knees in line with the width of your feet. Return to the start position. Do two sets of 15-20 repetitions.
Kneeling Weight Passes Start in a tall kneeling position, with a 5-pound dumbbell or nearby household object. Draw in your lower abdominals. As pregnancy progresses, you may need to tilt your hips backward to flatten your lower back. Hold weight directly in front of you with both hands. With your core drawn in, move the weight directly to your right side with your right arm only. Return to start and repeat on the left side. Do 15 repetitions on each side.
Double Marches Lie on your back and draw in your lower abdominals. Lift right knee to a 90-degree position. As you exhale, lift your left leg to the same position. Lower your legs one at a time, keeping your core drawn in. Repeat for 10 repetitions. Do 10 more repetitions leading with your left leg. If your back arches off the ground or you notice any abdominal doming, perform the modification instead. Modification: In the same position, lift one leg at a time as demonstrated in photos 1 and 2 above. Move slowly and try to keep your hips from rocking as you go. Alternating legs, perform 15 repetitions on each side.
If you have any questions, ask your doctor about a referral to a pelvic floor therapist. Boone.Health/My-Boone-Health
2022 Golf Classic The Boone Hospital Foundation’s annual Golf Tournament took place on May 9, 2022 at The Club at Old Hawthorne. We are so thankful to our sponsors and teams that came out to support the Walter Johnson Supportive Care Program. Funds raised from the 19th Annual Golf Classic will provide resources to enhance care for Boone Health patients with life-altering or end-of-life illnesses. Examples of enhancements include massage therapy and special equipment.
Foundation Fan Sponsors: • Harold G. Butzer, Inc. • Hulett Heating & Air Conditioning • Morrison Healthcare • S.M. Wilson & Co • Veterans United Home Loans • Welltower Additional Sponsors: • American Document Solutions • Macadoodles • Shelter Insurance • The Club at Old Hawthorne Hole Sponsors: • Orscheln Industries • Woodrail Centre • TIG Advisors • Schindler • Coil Construction • Columbia Landcare • Boyce & Bynum Pathology • Septagon Construction • Environmental Engineering • Drewing Automotive • Bob and Brenda Wagner • Radiology Consultants • Pro Pumping & Hydrojetting 30
A special thank you to our generous sponsors.
P RE S E N T I N G S P O N S O R
COMMERCE TRUST Lyle Johnson, Steve Sowers, John Bechtold and Rockne Corbin
CALENDAR OF EVENTS ORSCHELN INDUSTRIES Marc Johnson, Nicholas Orscheln, Debbi Bruemmer and Wm. L. (Barry) Orscheln
Employee Champion Campaign JUNE 22-23
Linen Sale JULY 2022
Community Campaign AUGUST 2-4
Scrubs on Site Sale SEPTEMBER 12-14 COMMERCE BANK Jack Smith, Samantha Potter, Blake Stark and Josh Fletcher
Collective Book Sale OCTOBER 28
The return of Boone Hospital Foundation’s in-person gala! NOVEMBER 2-3
Scrubs on Site Sale DECEMBER 2022
COMO Gives Campaign
Boone Hospital Center 1600 East Broadway Columbia, MO 65201 573-815-8000
BOO N E H O SPI TA L F O U N D ATI O N
Gala S A V E THE DATE
FRID AY, OCTOBE R 2 8 T H CO UNTRY CLU B OF M I SSOU R I