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Boone Health WINTER 2019

DR. NICOLE SPENCER ANSWERS YOUR WEIGHT LOSS SURGERY QUESTIONS PG. 2 2

P G. 14 R E A L I S T I C E X P E C TAT I O N S F O R N E W PA R E N T S


You demand value from your vendors. Why not your health insurance? The Priority Access Health Plan, available now to businesses with 5 or more employees, benefits patients, employers, and physicians. The plan offers 24/7/365 access to your primary care team via text, voice or video, primary care appointments within 24 hours and specialist appointments within a week.

The Priority Access Health Plan offers higher quality care at a lower cost by teaming local private practice physician offices with primary care providers and specialists from Boone Hospital Center’s medical staff, including Tiger Pediatrics, Columbia Orthopaedic Group, Missouri Heart Center, Women’s Health Associates and many others.

573.499.6541

PriorityAccessHealth.com


Table of Contents 20

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 Madison Loethen Jessica Park Sadie Thibodeaux Contributing Writers Kelsie Knerr Nicole Flood

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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

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A Note from Jim

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Kids on Track

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Hospital Headlines

Weight Loss Surgery

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Lymphedema Therapy

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Get to Know a BHC Doctor

RAPID Technology

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Get to Know a BHC Nurse

Fixing Heart Failure

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Bringing Up Boone Babies

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Assisted Exercise

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Family Wellness

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Core Exercises

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Screen Time Tips

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Foundation News MyBooneHealth.org

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The Region’s Premier Heart Hospital In sports, in music and in medicine, the more you do something, the closer you can come to perfection. At Boone, we do more heart procedures than any other hospital in the region. More expertise, more experience, more compassion. That’s the Boone Touch.

boone.org/heart


A NOTE FROM JIM

network that provides a higher level of quality care at a lower cost than other health care providers in midMissouri. The Priority Access Health Plan supports our 2019 resolutions for growth and continued high-quality care by providing better access to Boone Hospital Center’s services. • Finally, Boone Hospital Center resolves to continue our legacy of improving health and providing high quality clinical outcomes for our patients. Patients desire and deserve health care providers who produce high quality, safe care and excellent patient satisfaction.

Our New Year’s Resolution

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he new year has begun, and I hope that everyone has spent a wonderful holiday season with friends and loved ones. During the holidays, Boone Hospital Center continues to care for patients and their families. Caring for patients around the clock requires many Boone teammates to take time away from their loved ones. Their dedication and commitment to our mission of improving the health of the people and communities we serve is extraordinary. Like many of you, Boone Hospital Center has a few New Year’s resolutions. Boone Hospital’s resolutions for 2019 include growth and continued high-quality results for our patients. We plan to keep expanding our cardiology and cardiothoracic surgery services to include procedures not currently available in mid-Missouri. We’ve planned to grow our Level 1 Stroke and Inpatient Rehabilitation programs; offer expanded and more convenient laboratory services; and further growth in our primary care network throughout mid-Missouri. With the support and leadership of our medical staff, we’ll also focus on increased surgery volumes, particularly in general surgery and bariatric surgery; expanded pain management services; and new diagnostic and health screening services. In 2019, Boone Hospital Center, as a participating provider in the Priority Access Health Plan, will welcome employers and employees who have selected this plan for their health care needs. This plan brings together Boone Hospital Center and our medical staff into a

• In 2018, several well recognized organizations identified Boone Hospital Center as achieving the level of care that patients need and prefer: • For the fourth consecutive year, U.S. News & World Report ranked Boone Hospital Center as the #1 Hospital in mid-Missouri. Boone Hospital Center was rated High Performing in six of the nine categories aortic valve surgery, heart bypass surgery, heart failure treatment, colon cancer surgery, hip replacement surgery, and knee replacement surgery. • For the second year in a row, Centers for Medicare & Medicaid Services (CMS) 2018 rated Boone Hospital Center as the only 5-Star (Highest Ranking) Hospital in mid-Missouri. • Boone Hospital Center was recognized by the Columbia Daily Tribune’s 2018 Readers’ Choice Awards as Best Overall Hospital, Best Emergency Department and Best Place to Have a Baby. • The American Heart and Stroke Association designated Boone Hospital as Gold Plus Achievement. These hospitals are recognized for two or more consecutive calendar years of 85% or higher adherence on all achievement measures applicable and 75% or higher adherence with additional select quality measures in heart, stroke and/or resuscitation. In 2019, Boone Hospital Center resolves to maintain our high standards of care. Our resolutions for growth and continued high quality reflect our commitment to you. The entire Boone family wishes you and your family a healthy and prosperous new year. We thank you for choosing Boone for your health care needs.

Jim Sinek President, Boone Hospital Center

MyBooneHealth.org

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HOSPITAL HEADLINES

NICU Reunion Boone Family Birthplace’s annual NICU reunion brings NICU grads, their families, and their nurses together to celebrate their continued growth and progress. This year’s superhero-themed event included face painters, a magician, a balloon artist and bounce house.

Boone Hospital Center’s Neonatal Intensive Care Unit (NICU) is a level III intensive care unit for infants. This means that seriously ill newborns can receive all of the support and treatment they need right here at Boone Hospital Center. Families need not be separated by distance when their baby is born too early. The NICU is located next to the Postpartum Suite, so mothers and fathers can visit their newborns as often as they like, day or night.

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Boone Hospital Center Named Missouri Breastfeeding Friendly Worksite By Missouri Department of Health and Senior Services

Boone Hospital Center joined a growing number of Missouri businesses by becoming a Missouri Breastfeeding Friendly Worksite. Breastfeeding friendly employers proactively support employees who choose to breastfeed their infants. They provide time, space and other benefits to maintain breastfeeding after a mom returns to work. Employers who provide these supports see a positive impact on their business’s bottom line. Employers that provide lactation support services report higher employee retention, lower absenteeism, higher morale, greater productivity and reduced health care costs. Many studies have also shown improved shortand long-term health of the breastfeeding mother and her child. Over 70 percent of Missouri mothers choose breastfeeding as the optimal form of infant feeding. Yet, many of these women do not meet their breastfeeding goals. The Centers for Disease Control and Prevention (CDC) has identified returning to work as a major reason why many women stop breastfeeding. The Missouri Breastfeeding Friendly Worksite Program was created by the Missouri Department of Health and Senior Services (DHSS) in 2013 to bring an increased awareness about the importance of worksite lactation support. The program recognizes employers with policies supportive of their breastfeeding employees. Such policies provide a flexible work schedule for milk expression breaks; offer a private space, other than a bathroom, where the employee can pump or breastfeed; and ensure easy access to a safe water source and place to store milk. “We want our employees who are new mothers to know that we support their decision to continue breastfeeding. That is why we created a comfortable room dedicated just for breastfeeding mothers to use while they are at work. We also work with their schedules to make sure they have ample breaks to pump or breastfeed. At Boone Hospital Center, we are dedicated to meeting the needs of all of our employees. Encouraging new moms is just one way we do that,” says Boone Hospital Center Vice President of Human Resources Michelle Zvanut. Missouri Breastfeeding Friendly Worksites represent a wide range of employment sectors, settings and worksite sizes.


Boone Hospital Center Becomes First to Offer MitraClip®

Monica Smith to Present at ACHE Annual Congress

Boone Hospital Center is first hospital in mid-Missouri to offer the MitraClip® for mitral valve repair, a procedure for patients with mitral regurgitation. In patients with mitral regurgitation, the heart’s mitral valve leaflets don’t close tightly, causing blood to flow backwards from the heart’s left ventricle into the left atrium. This causes the heart to work harder, causing shortness of breath and fatigue, and worsening heart failure. Mitral regurgitation patients often cannot undergo traditional mitral valve surgery due to age, health and other factors. The MitraClip procedure is a minimally invasive alternative. During the procedure, the device is inserted by a catheter. The clip is placed on the valve leaflets so they can close properly, reducing mitral regurgitation. The device is permanently left in place. Most patients can leave the hospital two days after the procedure. Treatment with MitraClip can provide almost immediate symptom relief. Clinical data has proven patients who undergo the MitraClip procedure have reductions in mitral regurgitation and fewer hospitalizations for heart failure. “For patients who are too high-risk for open heart surgery, the MitraClip can offer symptomatic relief and decrease heart failure hospitalizations,” says Mozow Zuidema, MD of Missouri Heart Center.

Boone Hospital Center’s Chief Nursing Officer Monica Smith MSN, RN, NE-BC recently completed the American College of Healthcare Executive (ACHE) Senior Executive Program. This program prepares senior health care leaders for a complex, ever-changing healthcare environment and inspires them to solve challenges, improve health care and advance the field. The five-month program includes three intensive in-person sessions plus virtual learning activities. Program participants are required to complete and present a thought-provoking improvement project to be evaluated by other participants. The top three presenters are then invited to present their innovations at the next annual ACHE Congress on Healthcare Leadership in Chicago. Monica’s presentation, describing process improvement changes made in Boone Hospital Center’s Emergency Department, was the top-ranked presentation, earning her the privilege of sharing her presentation at the ACHE 2019 Annual Congress. Congratulations to Monica for her hard work and success in her continued professional development!

Patient Handoff Team Recieves DAISY Award On October 9, 2018, Boone Hospital’s Emergency Department Patient Handoff Team was recognized by the DAISY Foundation and Teletracking for their outstanding contributions towards driving excellence in patient flow and patient satisfaction. The team was awarded Honorable Mention for improving the hand-off process between the Emergency Department The Patient Handoff Team was recognized by the DAISY Foundation for their excellence in patient and nurses receiving inpatient flow and patient satisfaction. admissions. The implementation of this new process led to a 27% reduction delivering compassionate, high-quality care focused on the in Emergency Department throughput time; an increased unique needs of individual patients and their families during this Quality of Care rating from 14.1% to 84%; and improvements in highly dynamic process. appropriate patient placement. “We are so pleased to shine a spotlight on the important work The DAISY Award for Extraordinary Nurses in Patient Flow that nurses do behind the scenes to ensure every patient receives recognizes both individual nurses and teams of care providers the care they need and deserve,” says Bonnie Barnes, DAISY led by a nurse for their hard work and commitment to ensuring President and Co-Founder. “Our panel of judges recognized these patients have access to the right bed, at the right time, in the nurses for their compassion, drive for results, leadership, change right setting. The award also recognizes the commitment to and resource management, and clinical knowledge.”

MyBooneHealth.org

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It’s Worth

DOING Boone Therapy helps people with lymphedema successfully manage their condition.

Shirley Padgett, of Marceline, Mo., was born and raised in nearby Laclede. “Laclede is the home of General John J. Pershing,” she notes, referring to the commander of the American Expeditionary Force in World War I. As a girl, Shirley had spent time in the Pershing home, when it was still a private residence and hadn’t yet been designated a historical site. The homeowners had no children and welcomed Shirley into their house, where she had explored and played dress-up in garments that once belonged to the general’s daughter. Shirley has fought her own battles as a breast cancer survivor. About 13 years ago, she underwent a mastectomy and had lymph nodes removed from under her left arm. Years later, her left arm began to swell. It didn’t hurt, but it felt tight and heavy. And the swelling wouldn’t stop. “My arm ballooned to three times the size of my other one,” Shirley says. Lymphedema causes swelling in the arms or legs, on one or both sides. The swelling results from a blockage or disruption in the lymphatic system, which plays a role in our immune system. Lymph fluid builds up in the arms or legs, making them swell.

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Lymphedema frequently affects cancer survivors and can occur months to years after treatment. Cancer treatments, like surgery or radiation therapy, can affect the lymph nodes and lymph vessels. Breast cancer treatment is a common cause of upper-extremity lymphedema, because lymph nodes near the breast must be removed to see if the cancer has spread. According to Elsa Oestreich, a Certified Lymphedema Therapist and Occupational Therapist with Boone Therapy, some people who have lymphedema are born with decreased lymphatic system function. Elsa explains, “When someone is born with it, it is called primary lymphedema. When someone, like Shirley, develops it after a surgery or lymph node removal or radiation, it is called secondary lymphedema.” Lymphedema isn’t painful, but the swelling can be uncomfortable or restrict movement. If left untreated, lymphedema can lead to infections and, in very rare cases, a kind of cancer called lymphangiosarcoma. Shirley’s primary care doctor referred her to Boone Therapy in Columbia to treat her swollen arm. During her appointment, Shirley relaxes on the therapy table as Elsa massages her

left arm. Elsa explains that this therapeutic massage, called manual lymphatic drainage, “directs fluid from Shirley’s arm to different areas of the body, where she has more viable lymph nodes.” The manual lymphatic drainage lasts about 40 minutes. To prevent the fluid from returning into Shirley’s arm, Elsa follows up by wrapping the arm with compression bandages. Elsa also gives Shirley instructions on buying fabric compression sleeves she can wear on her arm. “Shirley will bring the sleeves next week, so we can ensure they fit well and she knows how to put them on correctly,” Elsa explains. Most patients with lymphedema usually benefit from about 8 to 12 sessions of occupational therapy, where they receive treatment in the clinic and learn ways to care for their condition at home. “I usually spend a lot of time educating the patient and family on good skin and nail care to avoid infections of the arm or the leg. There are also a few things they can do to avoid more swelling, so we talk about risk reduction and infection prevention,” Elsa says. Occupational therapy sessions also include therapeutic exercise to further help the patient drain excess fluid from their affected limb.


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

Certified Lymphedema Therapist Elsa Oestreich treats Shirley Padgett with therapeutic massage to reduce fluid buildup in her arm.

In between Shirley’s appointments at Boone Therapy, she had some homework. Elsa gave Shirley instructions showing how to wrap her arm with the compression bandages. Shirley says her grandson, Tim Akin, helps her every day with the wrapping. “It’s hard, but I know it’s worth doing,” Shirley says. Tim, who also drives Shirley from Marceline to her appointments, says he’s glad that his grandmother didn’t have any pain during her therapy sessions and says that her arm looks better. “For lymphedema treatment, we measure both arms or legs to compare the affected to the non-affected side. Then we measure the circumference of the affected limb to confirm progress,” Elsa says, noting that since Shirley first came to Boone Therapy, her arm has shrunk by 30 centimeters in circumference. Shirley loves the care she’s received and says her time at Boone Therapy is definitely worth the 3-hour round trip to Marceline. Once she arrives, she’s never kept waiting for her scheduled appointment. “I’ve appreciated the kindness and the punctuality,” Shirley says. “And Elsa has become very special to us. I wouldn’t trade her for 10 other people!” By Jessica Park

MyBooneHealth.org

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TIME IS BRAIN Boone Hospital Center’s Level 1 Stroke Center adds cutting-edge technology.

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To learn more visit boone.org/stroke

Boone Hospital Center’s distinction as a Level 1 Stroke Center sets it apart in mid-Missouri for the level of stroke care provided to patients. With the addition of a new interventional suite and implementation of the RAPID neuroimaging platform, the stroke program continues to add advancements to the treatment options for those suffering from stroke. “Boone has always had a great stroke program and it keeps getting even better,” says Donna Pond, BSHA, RN, SCRN, CEN, Stroke Program Coordinator. “In June 2018, a new interventional radiology suite was installed at Boone Hospital, giving Boone radiologists the most state-of-the-art equipment available anywhere, a perfect match for the RAPID software, providing midMissouri patients with unrivaled stroke care,” says Myles Goble, MD, Medical Director of Boone Hospital Center’s Level 1 stroke program and President of Neurology Institute of MMG (Missouri Medical Group). “We have a state-of-the-art suite that lets us image the brain in two planes simultaneously. This allows us to retrieve brain clots and open arteries in the brain as quickly as possible. It has improved our ability to see the clots and improved our treatment speed,” says Andrew Getzoff, MD. Dr. Getzoff is a boardcertified neuroradiologist and has served as the physician leader of interventional stroke services at Boone since 2009. He is also a member of the Boone Hospital Stroke Committee, and is a partner with Radiology Consultants, Inc., which provides radiology services at Boone. Starting January 1, 2019 he will serve as Chief of Staff at Boone Hospital Center. Stroke Explained There are two main forms of stroke. Embolic strokes are caused when an artery in the neck or brain becomes blocked with a clot. A hemorrhagic stroke is a bleed into or around the brain, which can be caused by a ruptured brain aneurysm. “A stroke occurs when blood flow is interrupted to a part of the brain, usually because a blood clot, or thrombus, is

blocking an artery. When a patient with a stroke comes to the ER within 4.5 hours of symptom onset, they can be given tPA, a medicine that’s infused directly into their IV to help dissolve the thrombus that’s blocking the flow of blood to that part of the brain,” says Dr. Goble adding that ‘time is brain.’ If you are experiencing symptoms of a stroke, get to the nearest local hospital or stroke center as soon as possible. RAPID Neuroimaging As Pond shares, the RAPID neuroimaging platform is the software used in research studies done to increase the endovascular treatment time window from 7.3 hours to 24 hours from the last time the patient was known to be well or at their normal functioning. “The RAPID CT perfusion software allows the ER physician, neurologist, and radiologist to quickly assess patients’ brains for areas that are not receiving enough blood supply to survive, but that still could be salvaged if blood flow is restored as soon as possible,” says Dr. Goble. “This is useful for treatment of strokes where large arteries are blocked in the brain, especially when the patient comes in more than 4.5 hours from when their symptoms started or in cases where they don’t know when the stroke occurred, such as when they wake up with their stroke symptoms. Before we started using the RAPID software, we couldn’t do anything to help restore blood flow to patients who woke up with stroke symptoms, but now, we can tell if that blood-deprived part of their brain is still living or if it’s already too late to attempt to restore the flow of blood.” Dr. Getzoff adds, “It provides us with color maps of the brain that show blood flow, blood volume, and blood travel time through the brain tissue. Before we start an interventional procedure, we know exactly the volume of brain tissue we are trying to save. If there is a clot blocking blood flow to a part of the brain, RAPID can show that. RAPID shows us if the affected brain tissue can be rescued. In other words, it shows us how much brain tissue is already dead vs how much brain

tissue is dying but can be saved if we open the artery up with a catheter. Often our patients regain function in their arms and legs or regain their ability to speak if we can do this. While not everyone is a candidate for stroke treatment out to 24 hours, the RAPID software helps us decide which patients are candidates.” RAPID enables Boone Hospital Center to provide cutting-edge stroke care that is often not available in smaller cities like Columbia. “Boone Hospital is the go-to place for stroke treatment in mid-Missouri. While we try to educate our community members that “time is brain” and stroke victims need to come in as soon as possible, this doesn’t always happen,” explains Dr. Getzoff. “Extending the treatment from 6 hours to 24 hours greatly expands the ability to help our patients. Most hospitals don’t have this ability. We accept emergency patient transfers from all over mid-Missouri.” Dr. Goble notes that Boone Hospital Center is the only stroke program in mid-Missouri to have this capability. The impact for those suffering from stroke is huge. “Practically speaking, this means that some patients with devastating strokes may be able to live on their own again, like they did before their stroke, and not rely on caregivers for activities of daily living, such as eating, walking, or using the toilet,” says Dr. Goble. “I’ve personally seen patients in the ER who cannot speak or move one side of their body and just days later, they are completely back to normal. The fact that Boone Hospital has this capability means that mid-Missouri patients don’t have to go far to receive the most advanced stroke treatment available anywhere.” Interventional Radiologists at Boone Hospital Center The 4 interventional physicians in the stroke center enable the team to provide 24/7 care to their patients. In addition to Dr. Getzoff, Max Lazinger, MD, Rafael Marroquin, MD and Randy Olsen, MD serve as interventional radiologists. “They are all highly experienced in the most advanced clot retrieval techniques available,” says Dr. Goble. By Nicole Flood

MyBooneHealth.org

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FIXING HEART FAILURE Nelson Wilson of Mexico, Missouri benefitted from Boone’s top of the line heart failure program.

Missouri Heart Center’s Mark Stampehl, MD helps Mexico, Missouri native through his journey with congestive heart failure. 12

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Hear from Nelson and Dr. Stampehl at youtube.com/boonehospital

80-year-old Nelson Wilson of Mexico, Missouri was doing some contracting work in Louisiana this past fall when he noticed being short of breath. He figured it could just be because of the muggy weather. However, when he got home, he noticed the shortness of breath was just getting worse. He decided to make an appointment with this primary care doctor to see what might be going on. Nelson’s doctor recommended that he see a cardiologist. Nelson’s daughter works at Boone Hospital Center and told him he should go to a Boone doctor as soon as possible. Nelson’s daughter’s coworkers recommended Mark Stampehl, MD, with Missouri Heart Center. Nelson promptly got an appointment. “As soon as Dr. Stampehl walked in the door, I knew I liked him. He just had that aurora around him that made you like him. He got right to work and we started doing some tests,” says Nelson. Dr. Stampehl found that Nelson was experiencing atrial fibrillation, an irregular heartbeat that can cause poor blood flow. “Dr. Stampehl explained to me that my atrial fibrillation was probably caused by something more serious. He said he was going to find the root cause of all this. I really appreciated how through he was being,” says Nelson. After more testing, Nelson was diagnosed with congestive heart failure. Dr. Stampehl specializes in heart failure and the treatment of heart failure patients. He began developing a treatment plan for Nelson right away. “We set out to evaluate what was going on with the structure and the function of the heart and ultimately found a serious problem that led to his heart becoming very weak. We began decongesting the body with medicines to help him get rid of excess fluid, and we went to the source of the problem with the most advanced medicines to get the heart stronger.” Nelson was also found to have a blockage in his coronary arteries, so two stents were placed to restore blood flow back to the heart muscle. Nelson says he is already feeling much stronger and is very grateful for the care team that helped him. “I really liked that I was able to see a heart failure specialist who has done lots of research about my condition. It made me know I was getting the best care possible. I’m already feeling so much better,” says Nelson. By Madison Loethen

Dr. Mark Stampehl of Missouri Heart Center specializes in the treatment of heart failure patients.

MyBooneHealth.org

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BRIN GIN G UP BO O N E BABIES

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REALISTIC EXPECTATIONS FOR BRAND-NEW PARENTS As a nurse, certified lactation counselor, and childbirth and breastfeeding educator at Boone Family Birthplace, I have the pleasure of caring for new parents in the hospital, in the classroom, and at our monthly Bringing Up Boone Babies Support group. Every new parent has questions about how they can best care for their baby. While each family is different, I’ve noticed that new parents often share the same questions and concerns. I’ve found that having realistic expectations for you and your baby will help you feel more confident whenever caring for an infant presents challenges -- and let you enjoy your time with your baby! BY EMILY NUSBAUM, RN, CLC

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1.

4.

2.

5.

Breastfeeding takes a lot of time. Breastfed babies need to eat 8 to 12 (or more) times in 24 hours. On average, a feeding takes 30 to 45 minutes in the first few weeks. With time, breastfeeding will usually go faster.

It takes several weeks for mom and baby to learn how to breastfeed well. It is normal and expected to have some good feedings and some not-so-good feedings during your first several days (and maybe more) of breastfeeding. Don’t judge your ability or your baby’s ability to breastfeed based on one feeding.

3.

Babies cry. Some babies cry a lot, and some cry a little. Either way, crying is normal and okay. Sometimes, crying means something is wrong, and sometimes it means your baby is grumpy. With time, you will learn to know the difference.

Visitors to your postpartum suite can be nice, but sometimes they can interfere with important things like learning to breastfeed or getting rest. If possible, limit postpartum visitors to short periods (about 30 minutes) or ask them to visit you and baby after you return home.

No one does parenting, breastfeeding or baby care perfectly. Be kind to yourself, your partner and your baby. It is okay and normal to not know everything. Learn what you can, and always be open to learning more.

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 hour-long 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.

6.

Ask for help. Boone Family Birthplace’s staff is knowledgeable and here to help. We are happy to answer your questions, and we don’t expect you to know everything. Learn what you can. You may get a different answer to your question from every person you ask, which means there might be more than one way to do something!

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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Boone Hospital’s Family Wellness Program supports families looking to lead a healthier lifestyle.

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arents want the best for their children, including good physical and emotional health. But busy schedules, tight budgets, and an overload of conflicting information can make it hard for anyone to get more exercise or eat healthier, even when they want to. Boone Hospital Center’s Family Wellness program understands these challenges and is here to help parents find easy ways for the entire family to lead a healthier lifestyle. Parents play a significant role in their child’s development of healthy habits and can set a positive example. “Parents not only set an example, but they control the home environment, too. They’re the ones shopping, preparing and serving the food. If the parents don’t have healthy habits around diet and exercise, usually the children don’t, either,” says Jennifer Tveitnes, RD LD, a registered dietitian and Family Wellness program coordinator. Family Wellness is a healthy lifestyle program for families with at least one child age 8 to 12. Together, the family learns to make healthier lifestyle choices. Setting goals, exercising regularly and healthy eating can make a positive impact on your entire family’s health and self-esteem. We know every family is different, so before the program begins, each family meets individually with a registered dietitian and exercise specialist. This

2019 Sessions February 7 – April 4 (no meeting on March 28)

June 6 – August 1 (no meeting on July 4)

Boone Hospital’s Family Wellness Program is open to all families with a child between age 8 to 12. Each session meets once a week for 8 weeks, on Thursday evening from 5 to 6 p.m. The program costs $50 per family for the entire 8-week session, plus a one-on-one meeting with our program coordinators. If you’d like to register your family for an upcoming session or have any questions, please call us at 573.815.3870. gives the team a chance to get to know your family better and to understand your family’s unique needs and goals. Families participate in one-hour group sessions, once a week for 8 weeks. Each of the eight sessions highlights a different topic to help families learn to stay healthy – physically and mentally. These topics include family communication, body image, stress and coping, hunger signals, aerobic vs anaerobic activity, meal preparation and planning. Each week includes instruction from an exercise specialist or registered dietitian, promoting physical activity, good nutrition and mental health. In the Family Wellness Program, parents and children work, learn and play as a team. To encourage everyone to learn more about exercise and a healthy diet, each session includes group activities and games, including a grocery store tour. “The goal is for families to learn how to stay healthy physically, nutritionally and mentally,” Jennifer says. While the Family Wellness Program equips families with the knowledge to maintain a healthy weight, it isn’t a weight loss program. Our health professionals instead encourage and

educate families on making lifelong changes in eating and physical activity. “We don’t focus on weight loss or diets,” says Jennifer. “It’s important that children continue to meet their nutritional needs for healthy growth and development.” The program also provides a supportive environment to promote confidence and empower everyone to make the best choices for their health. Families who participate in the Family Wellness program should be prepared to participate – the more they participate, they more they’ll get out of the program. Wear loose-fitting clothing and athletic shoes and be ready to move. An open mind is also important. “Each session involves a different activity, lesson or exercise,” Jennifer says. “If one activity isn’t somebody’s favorite, we ask that they do their best and be considerate.” Above all, families who complete the Family Wellness Program should be ready to use what they learn in the Family Wellness Program in their everyday life. When it comes to making changes for a healthier lifestyle, Jennifer says, “A family commitment is necessary.” By Erin Wegner

September 5 – October 24 MyBooneHealth.org

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SCREEN TIME TIPS

A health care professional and mother discusses this hot topic.

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creens are everywhere, not just in our living rooms, but our bedrooms, offices, cars, purses and pockets. And everybody’s using them, even children. According to national surveys, in the United States, children between ages 8 and 18 spend an average of 7-and-a-half hours each day viewing media, and children under age six spend nearly two hours daily. As a health care professional and the mother of an almost 2-yearold, I can’t help but wonder how much screen time is too much, and what effects excess screen time can have on young children. Development and Bonding Screens are often a soothing go-to for flights or doctor’s offices, but overusing screens as a calming strategy could lead to problems with a child’s ability to manage their own emotions. For children under 3, research demonstrates that screen media are a poor tool for learning language and vocabulary and may actually be linked to delayed language acquisition. It is easy to treat the TV as a break from being “on” all the time as a parent, but when used in the best way, screen time should include human interaction. However, research shows even watching TV with your kid engages with them less than doing a screen-free activity together. Having a TV on in the background can lessen the amount of interaction.

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Newer technologies like electronic books are less likely to encourage the adult-child interactions that promote literacy and generate creativity, compared with traditional printed books, which require more of children. Less than half of children in the U.S. under age 2 are read to daily. Physical Health Tracking our activity with wearable devices and scheduled gym visits is great, but we should also be aware of our inactivity level. When we get home from our desk jobs or school, screens promote more sedentary activity. Research supports decreasing sedentary activity to prevent and treat obesity in children. Less inactivity may be more helpful than increasing structured physical activity. Food advertising and snacking while using screens can promote obesity. For each hour of TV that children watch, they consume an additional 167 calories on average. The average hour of television features approximately 20 minutes of commercials, and half of the advertisements are for food. Hours spent watching television are linked to irregular sleep patterns in infants and toddlers and sleep disturbance in preschoolers and children ages 6 to 12. Time spent playing video games is also linked to sleep disturbance in children.


TIPS FOR MANAGING SCREEN TIME SET SCREEN-FREE ZONES • Rearrange the focus of your living room to encourage more interaction. • Promote sleep quality by keeping bedrooms screenfree. Charge your devices in another room. Turn off all screens at least 1 hour before bedtime. • Establish times or locations, such as family mealtimes, where screens are not allowed. USE YOUR DEVICES • Screen Time, on iOS devices like iPhones and iPads, provides daily and weekly reports showing total time spent in each app and how often you pick up your device. Another iOS feature, App Limits, lets you set a time limit for app use and gives you a warning when your time is almost up. To set this up, go to Settings, then Screen Time.

RECOMMENDED AMOUNT OF SLEEP FOR CHILDREN (PER 24-HOUR PERIOD) Source: American Academy of Pediatrics

INFANTS

(4 to 12 months)

12 to 16 hours, including naps TODDLERS (1 to 2 years)

11 to 14 hours, including naps PRESCHOOLERS

• Night Shift, on iOS devices, lets you set a time of the day when your screen emits less blue light, which suppresses melatonin levels, making it harder to fall and stay asleep. To set up Night Shift, go to Settings, then Display & Brightness, then Night Shift.

10 to 13 hours, including naps

• Apps like Freedom and Onward, available for iOS and Android phones, help you limit screen time, block distracting apps or websites, and set a schedule.

(6 to 12 years)

(3 to 5 years)

GRADESCHOOLERS 9 to 12 hours

GET INVOLVED • Encourage younger children to do outdoor activities or indoor play, like play dough or a sensory bin that they can dig in for little trinkets. Having short simple activities prepared ahead of time like dot markers and poster paper or pipe cleaners and beads can help during busy transitions when caregivers need to be productive with something else. Reading or board games are also good substitutes, because they encourage interaction and ultimately lead to active play. • Helping older kids decrease screen time can be more difficult, especially when screens are needed for homework. Parents may struggle to determine which screen time is necessary and which is not. To be successful, your older child needs to be engaged in their own behavior change process. Use a combination of self-monitoring, alternative activities and media limits for the whole family. SET A GOOD EXAMPLE • How are you doing with your own screen use? Are there times of the day when screens are more prevalent than others, like mornings or mealtimes? Are screens taking the place of more important things in your life, like relationships, sleep, exercise or healthy eating? Even the best screen activities out there, if used to excess, lose their value and can harm healthy growth and development.

Now the Good News! Screen time can be a fine activity for kids 2 and up, as long as the content is appropriate, and the time spent with it is moderate. Good media content can promote positive social behaviors and contribute to learning, especially when a caring adult is actively involved. The American Academy of Pediatrics encourages parents of children between 2 and 5 years old to choose high-quality programming. Check out Common Sense Media’s quality screening suggestions for different ages and topics at commonsensemedia.org/tv-lists. Watch media with your children to help them understand and apply what they’ve learned. Try your best to get involved with your children before, during, and after any screen activity. When using screens, take activity breaks during TV commercials. How much screen time is moderate? Try to limit screentime to about one hour a day or less. If, after monitoring your screen use, you or your family are way above this target, set a goal to start decreasing how much time you spend with screens. By Kelsie Knerr, RD LD Sources: Common Sense Media, CommercialFreeChildhood.org, American Academy of Pediatrics

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THE

Balloon Race Lilah looks forward to Kids on Track every year.

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“The balloon race,” 7–year–old Lilah’s name for Boone Hospital’s Kids on Track finale, is the highlight of her year and has been since she started the program at 2 years old. Lilah was introduced to physical activity at an early age. As dog owners, her parents have taken Lilah on walks every day. Now she happily runs alongside them. Both of Lilah’s parents enjoy running, and they have been very influential to her. Lilah says, “Our family runs because we believe it helps keep us fit, healthy, and helps our heart!” Even at the dinner table, Lilah’s parents, Kathryn and Chris, talk about how many steps they’ve taken that day and set goals for completing more steps for the next day. Lilah is with them for their evening walks, where she proudly says, “So, I kind of helped you guys, too!” Lilah’s 20-year-old brother James has also been a great role model. James was always an active kid, but really loved cross-country and track in high school. He also completed his first marathon this year in St. Louis. When Kathryn saw a post about Kids on Track on Boone Hospital’s Facebook page in 2012, she knew the program would be a perfect fit for their active family. Lilah has no problem accumulating her miles for Kids on Track, as one of her favorite things to do is run. Lilah says she loves running because it makes her feel like she is free and makes her feel like she is flying. And, with all of her practice, Lilah can easily run a mile. Her favorite part of the Kids on Track program is the finale, where the participants get their T-shirt and medal, and get to play in bounce houses. Lilah’s favorite part is to run her last mile through the balloon arch. One of her favorite stories to tell is about a particular time when her parents ran with her. “Funny story! One time my Mom and Dad came to the balloon race and I was 4. They were in their work clothes, and they

7-year-old Lilah and her mother, Kathryn, enjoy staying active together.

Lilah has been participating in Kids On Track since she was two.

Kids on Track is Boone Hospital Center’s community youth program for children 12 or younger. Participants are challenged with accumulating 26.2 miles of physical activity over their summer months. They can do this through running or biking. As kids become more sedentary, the Kids on Track program encourages, rewards and motivates kids to be more physically active.

thought they were going to walk it, but I had different plans, and they had to run in their work clothes. My Mom had to run in high heels!” says Lilah. Exercise is just as important for younger kids as it is for adults. Kids who get physical activity on a daily basis are at less risk of becoming overweight, have better sleep habits, are better able to handle physical and emotional challenges, and enjoy many health benefits. Encouraging kids to exercise at an early age sets them up for success in the future. By Erin Wegner

“Our family runs because we believe it helps keep us fit, healthy and helps our heart!” - Lilah MyBooneHealth.org

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EVERYONE’S JOURNEY IS ABOUT

BALANCE

If you’ve been considering weight loss surgery to improve your health, Boone Hospital Center’s weight loss surgery program supports you every step of the way, before, during and after your surgery, to help you meet your goals and lead a healthier lifestyle. Our team of health care experts, including registered dietitians, nurses and physicians, helps you develop and follow a weight loss surgery plan that’s just right for you. Nicole Spencer, DO, and James Pitt, DO, both with Columbia Surgical Associates, perform laparoscopic and robotic RNY gastric bypass, sleeve gastrectomy, and adjustable gastric banding at Boone Hospital Center. Below, Dr. Spencer answers some frequently asked questions about weight loss surgery. How do I know which surgery is the right one for me? Each patient is unique – the decision on what surgery you have will be made between you and your surgeon based on your goals for surgery, your past medical history, and your past surgical history. How long will I have to take off work? It is recommended to take approximately 2 to 3 weeks off after surgery, but that time may be longer or shorter, depending on which surgery you get and what type of job you have. For example, someone with a manual labor job may need more time off than someone with a desk job. The recommended amount of time off work will be decided upon between you and your surgeon.

Columbia Surgical Associates’ Dr. Nicole Spencer answers common questions about weight loss surgery.

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Will I have excess skin? There is often a possibility of excess skin after weight loss surgery. This usually depends on each person’s body composition before surgery. Resistance training is the best way to help tighten up loose or excess skin after surgery. If excess skin becomes burdensome to people, they may consult with plastic surgeons about removing it.


START YOUR WEIGHT LOSS JOURNEY WITH A FREE SEMINAR If you’re interested in weight loss surgery or want to learn more about the process, the first step is to attend one of Boone Hospital Center’s weight loss surgery seminars. Every seminar covers the process in detail, including surgical options, how surgical procedures are performed, risks and benefits, advantages and disadvantages, nutritional needs, activity and exercise requirements, and what to expect following surgery. A surgeon and dietitian lead each seminar and are there to answer your questions. In-person seminars are held once a month at Boone Hospital Center. We also provide an online weight loss seminar. To find upcoming seminar dates and to register, visit boone.org/ weightloss If you have questions about the seminar, please call 573.815.3870.

I believe that a positive attitude and a good support system ultimately are what make weight loss surgery patients most successful. Are there certain foods I won’t ever get to eat again? What about sweets or alcohol? There are often no absolutes in weight loss surgery. Everyone’s journey is about balance. There are no foods that you will never be able to eat, however, there are guidelines and suggestions on how to eat after surgery to help you achieve your weight loss goals and maintain a healthy lifestyle. Certain foods, such as tough meats, simple sugars and soft breads, are typically not tolerated as well after surgery by many people. Alcohol after surgery is possible in extreme moderation. You will be affected by alcohol more quickly after surgery , and alcohol is empty calories that will not help in your weight loss journey. How much will I have to eat to feel satisfied after surgery? We recommend that you eat about 4 to 6 ounces per meal. On average, most people will eat 3 meals a day with maybe a healthy snack in the morning or afternoon. What is the risk of having surgery? With the advancements in technology and surgical techniques, the overall risk of weight loss surgery is similar to that of hernia or gallbladder surgery. Will I have to take vitamins and minerals for the rest of my life? There is a chance of vitamin deficiencies with any weight loss surgery. Vitamin deficiencies are a

potential risk because portion sizes are smaller and, depending on the surgery, your body’s ability to absorb and use certain nutrients may change. Every weight loss surgery patient is advised to supplement with vitamins and minerals for the rest of their life.

What is the liquid diet like? The liquid diet in the pre-operative period, right before your surgery, consists of clear liquids (that you can see through) and protein shakes. Examples of clear liquids incude broths, Jell-O, popsicles and water. The diet often starts 10 days before surgery. Most patients say the first 2 to 3 days of the diet are the worst part, then it gets easier. What makes weight loss surgery patients most successful? I believe that a positive attitude and a good support system ultimately are what make weight loss surgery patients most successful. Patients need to understand that surgery is just a tool – it is not a magic wand. This is a lifestyle change and commitment to change for the rest of your life. Patients who understand that surgery is a tool, follow their diet, work out, and surround themselves with others who support their weight loss journey are the most successful. Boone Hospital Center offers a monthly support group, which many of our most successful patients have found helpful. The support group is a great opportunity to meet and talk with other people who are preparing to have or have already undergone their weight loss surgery. By Nicole Spencer, DO, Columbia Surgical Associates

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GETTING TO KNOW A BHC DOCTOR

Angela Yuen, DO, Hospitalist Why did you get into the health care field? More than anything else, I enjoy helping people. I went into medicine to directly help people in my community improve their health in order to live fuller lives. What interested you in your particular specialty? I’ve always loved internal medicine. We have many complex patients. I enjoy putting puzzles together, and internal medicine allows me to put together the puzzle of how to diagnose and treat each patient when they have a multitude of medical problems. What is the most rewarding aspect of your job? Instilling trust in patients and their families, and the appreciation and gratitude they exude. Seeing patients who are critically ill who you aren’t sure will make it improve so dramatically that you see them walk out the door. What is the most challenging aspect of your job? Having patients admitted to the hospital because they do not have the resources to adequately take care of themselves, whether it’s access to health care, lack of insurance or ability to pay for it. What do you see changing in health care in the next five to 10 years? Medicine is constantly evolving, with the rate of medical knowledge doubling nearly every few months. There will be continued considerable advances in medical therapy, which will change the way patients are treated. Additionally, there has been a push to create better access to health care, and I foresee a large increase in allied health professionals to help create this. What advice would you give someone looking to become a doctor? It may be a rough road, but this is an ever-evolving field that is incredibly rewarding and certainly worth the effort. What do you enjoy doing outside of work? I enjoy travelling to new places around the world with my husband, trying new foods, spending time outdoors with my dog, Ellie, and attending St. Louis Cardinals, St. Louis Blues, and Mizzou sporting events. What advice would you give to someone who is going to be a patient in a hospital for a period of time? Your medical team is here to help and has your best interests in mind. If you have questions about your care, we will be happy to explain exactly how we intend to help you. Be involved in your care, and attempt to understand your health issues and how they can be treated.

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GETTING TO KNOW A BHC NURSE

J.D. Williams, BSN, RN

I

have degrees in exercise science and exercise physiology. I was a full-time personal trainer and working part-time in Cardiac Rehab when I decided to go to nursing school. I have been in nursing for 12 years now and have worked in Boone Hospital’s Emergency Department, Labor & Delivery, and Outpatient Surgery units. I now work in the Post-Anesthesia Care Unit (PACU) and have done so for the past 9 years. I live in Clark, Mo., with my husband and 3-year-old twins.

Why did you get into the health care field? My mom is a retired nurse. I always thought I wanted to be one, but didn’t pursue that career initially. While working as an exercise physiologist in Cardiac Rehab, I realized that I preferred working with a clinical population. I felt I was more suited for a clinical setting, so I went back to school to become a nurse. What interested you in your particular specialty? The short time I worked in Outpatient Surgery sparked my interest in working in an area like the PACU. I love the fact that I get to take care of a variety of patients. I was also drawn to the quick turnaround-type flow of the PACU. I like the more fast-paced environment. Some patients are in our care for a while, but most of them are in and out of the PACU in a few hours. What is the most rewarding aspect of your job? Other than taking care of patients before and after surgery, I think being an advocate for a patient and their families is very rewarding. Having surgery can be a stressful experience. Being able to help patients and families through that by educating, talking and caring is a wonderful feeling. What is the most challenging aspect of your job? Sometimes the situation or outcome for some of my patients is very poor. It’s challenging to see people go through a difficult experience when there is nothing I can do to change it. I know I am not able to fix everything, but as nurses, we want to. Sometimes I have a hard time accepting that. What has changed in your field since you started practicing? The technology. There have been so many advances in health care technology, such as the way we chart, obtain vitals and administer medications. I believe most of these advances to be positive and may lead to better patient outcomes, but I have definitely had to adjust my approach to patient care to ensure my patient is always the focus. I also feel, as many do, that there are not enough nurses. It has been that way for a while, but I do not remember it being such an issue when I became a nurse.

What do you see changing in the next 5 to 10 years? I think with all of the advances in health care, the need and interest in clinical research will continue to grow. I think more and more nurses will gravitate towards that area as the number of studies and research opportunities for patients grow. I also hope that the opportunity for nurses in the community will increase. I feel there is a need for nurses in and outside of the acute hospital setting. What do you enjoy doing outside of work? I really enjoy spending time with family and friends. I love finding new and fun activities for my children to enjoy. They are still young, so I want to make the most of the time I have with them when I get to be at home. What advice would you give to someone looking to become a nurse? The sky is the limit in nursing – so have an open mind and be patient. Take the opportunity to learn as much as you can when first starting out, especially if you begin your career in a specialty you did not plan on. There will be good days and bad, but don’t be discouraged. Just remember why you became a nurse and make every day an opportunity to learn, grow and be the best nurse you can be!

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STAYING FIT WITH ASSISTANCE Boone Hospital’s Fitness Center assisted exercise program helps people with health conditions stay active. Meet Fern Fern Ray had difficulty walking and keeping her balance due to spinal stenosis, a condition that puts pressure on the spinal cord. When her primary care doctor recommended Fern get regular exercise, she was referred to Boone Hospital’s Community and Medical Fitness Center’s assisted exercise program. “She had a tendency to fall backwards and her balance was terrible,” explains Fern’s daughter, Linda Bean. Fern, 87, lives with Linda in Columbia. Meet Mike Mike Kane had received inpatient care, cardiac rehab, occupational and speech therapy at Boone Hospital Center, and was slowly recovering from his illness, when he told his wife, Katie, that he’d like to exercise at the Fitness Center. “I was comfortable here, and I have friends here,” he explains. Katie first met Mike not far from the Fitness Center. She was a Stephens College student when she met Mike on campus. (“I was acting like I was lost,” he says.) The couple recently celebrated 48 years of marriage and have 5 children and 3 grandchildren. They’ve lived in Columbia off and on over the course of Mike’s advertising career, where he worked on accounts for companies like Bell South, the California Raisins, and International Harvester. The family lived in Atlanta, Minneapolis, Memphis, Kansas City, and Saint Joseph, but kept returning to Columbia.

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Katie supported her husband’s desire to exercise at the Fitness Center, so she asked clinical exercise physiologist Doug McDowell, who told her about the assisted exercise program. Assisted Exercise Program The Fitness Center’s assisted exercise program provides a safe option for people who have chronic diseases, neurological disorders, orthopedic problems or other health conditions that make it hard to exercise independently and stay active. Clinical exercise physiologists help assisted exercise participants with getting on and off the equipment, setting and adjusting the machines, and using them correctly. They can also help with balance exercises to reduce participants’ risk of falling, and offer guidance, progression and variety to individual workouts. Assisted exercise programs are designed around the individual’s needs and abilities. “We’re trained in working with people who have chronic health conditions,” explains Patti Ross, Supervisor for Boone Hospital’s Fitness Center and Cardiovascular and Pulmonary Rehabilitation program. The Fitness Center’s exercise physiologists can monitor participants’ health, including checking their blood pressure, blood sugar and oxygen saturation during visits. “If we see something while working with a patient, we work with their family and let them know,” Patti says. “Family members

can feel comfortable knowing their loved ones are in a safe environment.” Both Fern and Mike visit the Fitness Center for scheduled exercise sessions. After they check in, an exercise physiologist helps them get set up safely for each exercise. Linda says that Fern was hesitant about going to a gym, but the Fitness Center’s supportive environment helped her mother look forward to exercising. “When Mom first started coming, she knew nothing about the equipment and wasn’t physically able to exercise. So they stayed with her a lot. Now they get her started on the machines, then they may assist somebody else, and come back. She’s never left alone for a long period of time, but she has more confidence.” Fern’s favorite exercise is the Nu-Step recumbent stepper. She says, “I do that for 15 minutes every time I come. Then they’ll show me how to do something else, which is real great.” “With assisted exercise, we work with two clients at a time. One will do cardiovascular exercise while the other does strength training or balance work,” Patti explains. “It’s like saucer spinning on The Ed Sullivan Show,” Mike jokes. “They get me started on one exercise. Then while I’m working out, they’ll help someone else get set up.” The Comfort Factor Fern enjoys working with the Fitness Center team. She says, “Doug and Heidi


For more information visit boone.org/fitness or call 573.815.3876

[Salter] help me stand on my two feet. They are both excellent people.” Linda loves knowing her mother is in good hands at the Fitness Center. She says, “No one can take care of Mom like I can. But when I leave her here, I know that Doug and Heidi are going to take good care of her.” Mike enjoys exercising at the Fitness Center because it’s close to home and full of familiar faces. He says, “I like the comfort factor. And the facilities here are as good as the private gyms.” Positive Results After a year of regular assisted exercise sessions, Fern and Linda both notice the results. Fern says she’s not so stiff, and she’s now able to walk using a walker. Exercise has helped her manage her condition better. “When she started, she wasn’t really able to leave the house because she couldn’t walk any distance,” Linda says. “I took her to Penney’s yesterday, and she went shopping with me, so I’d say that’s a positive! She told me her goal is to get on Dancing with the Stars next year!” “Wouldn’t that be wonderful?” Fern laughs.

Clinical exercise physiologist Doug McDowell observes as Mike Kane exercises.

“I’ve Got Him Back.” Mike’s illness had caused him to lose weight and muscle mass. Since he started assisted exercise, he’s rebuilt strength, regained weight, and improved his balance. Looking at her husband, Katie tells him, “I see you getting stronger.” She continues, “It feels great because I’ve got him back. I think this was a key to him getting better.” Mike says his goal for assisted exercise is “to keep on keeping on.” He adds, “I would recommend the Fitness Center to anyone, if you’re recovering or if you want to do a nice workout.” Katie agrees, saying that after hospitalization, rehabilitation and therapies, assisted exercise has made the difference. “I think it’s a fantastic program. It gets a definite thumbs up!” By Jessica Park

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WELLAWARE

Strong to the Core W

hen a strong core comes to mind, people instantly envision the stereotypical six-pack abdominal muscles. Although the abs make up a large portion of the core, many other muscles play a huge role in core stability. Our core is composed of the back extensors, lumbar spine, latissimus dorsi, psoas, and muscles of the abdominal wall. The core is very similar to the foundation of a house. Its muscles are responsible for assisting almost every action of everyday life, like walking, balancing, standing, sitting, and overall posture. For example, when you unload the dishwasher, bending over to lower the dishwasher door requires contraction of the core. Our back extensors prevent us from folding completely over and allow us to stand back up straight. Reaching overhead also requires help from the core muscles. Our posture is significantly affected by the strength of these muscles. To maintain proper curvature in the spine, and hold up the torso, our bodies require our core to carry the load. A common misconception with core training is that strengthening these muscles will help diminish unwanted body fat in the mid-section. We can’t actually spot-reduce – or remove fat – from a specific part of the body with resistance training. Our body uses fat for energy. Aerobic training, the most effective means to fat loss, uses fat deposits all over the body. We can’t burn just belly fat alone! Core strengthening exercises increase the amount of lean muscle tissue and tighten up your core, but a whole-body program with a balanced diet and regular exercise can reduce body fat and improve overall health! These exercises involve the main muscles of the core and can be modified to meet your needs and abilities. Start your workout with a 5-to-10-minute warmup, like walking, jogging or riding a stationary bike. Perform each exercise in a controlled manner, through a full range of motion. Breathe normally and discontinue the movement if you feel discomfort. Try each exercise for 2 to 3 sets. If possible, use weights or a resistance band that lets you perform 10 to 12 repetitions and makes you feel slightly fatigued. You can start using body weight alone. If you can do 15 repetitions with proper form, increase your resistance slightly or add 2 or 3 repetitions. By Hunter Blume, Clinical Exercise Physiologist, Boone Hospital Cardiovascular and Pulmonary Rehab Remember: Check with your physician before you start a new exercise routine. Consider working with an exercise professional for a good start.

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Lat Pull Down (Strengthens the Latissimus Dorsi muscles, used to extend your arms, pull downwards and rotate the shoulder.)

Tie a knot in the center of a resistance band. Place the knot in the top of a doorframe, then close the door, securing the middle of the band above your head. Take hold of the two loose ends of the bands, with your hands facing away from your body. Pull the bands tight, with arms fully extended overhead and 3-6 inches outside of shoulder width. Pull arms downward until your hands are at shoulder level. Squeeze shoulder blades together and hold for 1 second at the bottom. Slowly return arms to the starting position. Variation: For less resistance, use a broomstick instead of a resistance band.

Seated Knee Lifts (Targets deeper abdominal muscles.)

Sit on the front half of a stable chair that isn’t too high but allows you to place both feet flat on the ground. Inhale as you lift one leg off the floor about 6 inches, pulling knee toward your chest. Keep back straight, maintaining a natural curve in your spine, and your opposite foot flat on the floor. Keep abdominals pulled in, as if sucking your belly button back into the chair. Pause for a moment at the top of movement - slowly return your foot to the ground while exhaling. Repeat the movement, alternating legs.


Gluteal Bridge Front Raise (Targets the deltoids and serratus muscles, which assist in posture and scapular movement.)

With hands at thigh level, hold a resistance band, weights or broomstick with your palms facing your thighs. Hands should be at shoulder width, with elbows fully extended. Keeping back straight and elbows locked out, raise both arms until they are even with shoulder level. Do not exceed shoulder level. Pause briefly, then return to the starting position in a controlled manner.

(Targets the lower back and gluteus muscles.)

Start by lying flat on your back, with knees bent and feet flat on the floor. Place hands straight out on the floor next to your buttocks, with palms flat on the floor. Engage abdominals and lift your buttocks, keeping your shoulder blades flat on the floor. Hold buttocks 3-6 inches off the ground, keeping your body in a straight line from your collarbone to your knee. Hold position for 6 seconds, then return to starting position in a controlled manner. Do not arch back and keep pelvis neutral.

Rocking Chair (Targets the abdominal muscles.)

Sit on the front half of a chair. Place feet flat on the floor and keep a straight back. With arms crossed on your chest, lean back until you feel your stomach muscles tighten. Hold that position for 6 seconds. Return to the starting position.

Plank (Targets muscles of the gluteus and transverse abdominals.)

Start in a modified pushup position on the floor. Place forearms flat on the floor, with elbows directly under your shoulders, at a 90-degree angle. Engage abdominals, keeping back in a straight line from your heels to your head. Slightly tilt pelvis posteriorly, tucking your buttocks in, and pulling the front of pelvis toward your nose. Hold this position and keep an engaged core for 30 to 60 seconds. Variations: Place knees on the ground and maintain a straight back from your knees to your head. You can perform this exercise standing against a wall in a modified pushup position, on toes, 12-18 inches from wall, with forearms flat against wall. Just like on the ground, place elbows directly under your shoulders, bent at a 90-degree angle. Engage core, keeping back flat from your heels to your head, with a slight posterior pelvic tilt.

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FOUNDATION NEWS

Thank you for a Successful 2018! Thank you to all of our wonderful donors this past year. Your generosity allows Boone Hospital Foundation to continue to share the gift of health. To view a complete list of donors for 2018’s Community Campaign, Annual Golf Tournament and Annual Gala, or to learn more about the Foundation and how you can make a difference with your donation, please visit boone.org/foundation.

Purchased AccuVein devices for easier IV starts and fewer needle sticks for patients

nt Cardiac Began Outpatie hip Program Rehab Scholars

Began the DAISY Award program, giving patients the opportunity to recognize their outstanding nurses Provided scholarships for the Columbia College summer nursing camp

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Looking Forward to 2019

As we look forward to an exciting 2019, we hope you will join the Foundation in our mission to share the gift of health. Visit our website throughout the year for more information on all of our upcoming 2019 events.

The Annual Golf Classic took place on May 14, 2018. The tournament raised over $59,000 to benefit our Supportive Care Program.

2019

CALENDAR OF EVENTS JANUARY 23 & 24

Linen Sale FEBRUARY 19 & 20

Scrubs on Site Sale SPRING

Flower / Plant Sale MARCH 25–27

Collective Goods Sale APRIL 30 – MAY 1

Scrubs on Site Sale MAY 13

Annual Golf Tournament JULY

Community Campaign AUGUST 27 & 28

Scrubs on Site Sale SEPTEMBER

Book Sale OCTOBER

Jewelry Sale The Annual Gala took place November 3, 2018 and raised over $150,000 to benefit our Building on Excellence program.

NOVEMBER

Annual Gala NOVEMBER 19 & 20

Scrubs on Site Sale DECEMBER

COMO Gives Campaign MyBooneHealth.org

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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

presents the 3rd Annual

Molly’s Miles 5K/10K 04.13.2019 900 W. Nifong Blvd. Columbia, MO

A family-friendly walk/run that honors the survivors of fallen law enforcement officers. Proceeds Benefit Missouri C.O.P.S.

Prices go up after 500 registrants

.com/M ollysM iles

Run

www.MollysMilesRun.com

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My Boone Health Winter 2019  

My Boone Health Winter 2019