Boone Health WINTER 2024
Advancements in
ROBOTIC SURGERY
The advancement of robotic assisted surgery has changed the game for many surgeons and patients. PG. 10
PG. 16
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Table of Contents 8
MANAGING EDITOR
Erin Wegner Marketing & Communications Consultant I COPY EDITOR
Jessica Park Communications Consultant II CONTRIBUTING WRITER
Madison Loethen Digital Communications & Marketing Consultant II ADDITIONAL CONTRIBUTING WRITERS
Jason Anderson; Hayden Legg; James Liesen, DO; Jenny Workman CONTRIBUTING PHOTOGRAPHERS
Madi Green; Madison Loethen
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Please submit comments or feedback to erin.wegner@boone.health or call 573.815.3217 1600 East Broadway Columbia, MO 65201 573.815.8000
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5
A Note from Brady
6
Hospital Headlines
8
Valuing Experience
10 Advancements in Robotic Surgery
20 Ear Infections in
Babies and Children
22 Dr. To Know 23 Nurse To Know 24 Know the Symptoms
12 Relief from Pain
26 Cranberry Roasted Pork
14 Staying Motivated
28 Simple and Effective
16 A Partner in Education
30 Foundation News
in the Winter
Home Exercises
Board of Directors CHAIR
Jerry Kennett, MD
VICE CHAIR
Bob McDavid, MD
S E C R E TA RY
Control your reflux for good.
Jan Beckett
TREASURER
William “Barry” Orscheln
MEMBER
Judy Starr
Charles P. Bondurant, MD, FABNS, FACS
Dianne M. Lynch, Ph.D.
Randy Morrow
Stacye Smith
Gary W. Thompson, MBA
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A NOTE FROM BRADY
A
s I get established both in my new role at Boone Health and in my new home in Columbia, I have more than a few priorities. I want to thank Boone Electric Cooperative, Ameren Missouri, and Columbia Water & Light for making the process of establishing services easy. As always, when I move to a new city, my top health priority is to get set up with a new primary care provider and schedule my annual physical. I believe an annual physical or wellness exam is the best first step you can take for your health. A yearly visit can offer countless benefits, including time to discuss your concerns one-on-one with your provider and the opportunity to get a clear picture of your current state of health. It’s one of the best ways to ensure early detection of health conditions. Knowing your cholesterol or blood pressure today can help you spot any changes before they develop into serious health problems and encourage you to take steps toward a healthier lifestyle. Annual physicals also help your primary care provider recommend the appropriate follow-up care and work with you to develop a personalized care plan. “During an annual physical, my priority is to get as much information as possible about my patient’s health and their personal, family, and social history so I can provide them with appropriate suggestions and guidelines and help them make informed decisions that they are comfortable with,” says Ayaaz Habibullah, MD, a physician with Boone Health Primary Care-Nifong. “Determining a patient’s family history is crucial because this can change the age they should get certain screenings – for example, colonoscopies usually start at 45 but are recommended sooner if there’s a family history of colorectal cancer. Understanding a patient’s risk factors helps me determine if they need special screenings – for example, if I’m seeing a male smoker over 65, I’ll recommend an ultrasound of the abdomen to look for signs of an aortic aneurysm. Understanding their current chronic illnesses helps me determine if they’re on the right type of medication
or if they need follow-up testing. Understanding their goals for long term health helps me provide guidelines and suggestions for lifestyle modification such as diet and exercise.” Dr. Habibullah adds, “Even if you’re a healthy individual, annual exams are crucial for long-term health. These visits help us potentially catch diseases in early stages, before they cause serious long-term complications, or even prevent these illnesses from occurring.” In recent years, there’s been a decline nationwide in the number of adults who schedule an annual physical with a primary care provider. While COVID may have caused some people to put off wellness visits, it’s important we don’t miss out on the positive impact an annual physical can make on our overall health and well-being. This year, I’m not making a resolution to schedule my annual physical, I’m making a pledge to myself and to my family to get it done. I encourage you to do the same for yourself and your loved ones. Schedule an appointment today with your primary care provider – even if it’s been a few years since your last visit, they’ll be glad to see you again. If you need a primary care provider, Boone Health Medical Group has 11 primary care clinics including clinics in Ashland, Boonville, Centralia, Columbia, Glasgow, Hallsville, Mexico, Moberly, and Osage Beach. To learn more, visit www.boone.health/primarycare.
Brady Dubois CEO, Boone Health
I believe an annual physical or wellness exam is the best first step you can take for your health. Boone.Health/My-Boone-Health
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HOSPITAL HEADLINES
United Way Pacesetters In October, Boone Health hosted representatives from 29 organizations that have together raised $1,552,141 this year for Heart of Missouri United Way. Pacesetter organizations meet high standards for employee participation and donation goals. Of this year’s Pacesetters, Boone Health contributed the largest amount with $85,000. This is the 25th year in a row that Boone has hosted the Pacesetter Breakfast.
Boone Heart Surgery Team Achieves Milestone Boone Health Heart Surgery recently completed their 600th TAVR procedure at Boone Hospital. The team includes Richard Mellitt, MD, Joss Fermamdez, MD and colleagues at Missouri Heart Center, including Trung Tran, MD, Michael Brown, MD, Sudhi Tyagi, MD and Steven MacKay, DO. Transcatheter aortic valve replacement (TAVR) is a minimally invasive surgery to replace a narrowed aortic valve and restore blood flow from the heart to the body. This procedure presents a safer option for patients who are not good candidates for open heart surgery, including older patients, and has a shorter recovery period. Boone began performing TAVRs in January 2016 and was the first hospital in Missouri to receive TVT accreditation from the American College of Cardiology (ACC) for transcatheter valve replacement and repair procedures. According to the ACC, “TAVR has become the standard of care for patients with symptomatic heart disease due to severe native calcific aortic stenosis who are judged by a Heart Team, including a cardiac surgeon, to be at intermediate or greater risk for open surgical therapy.”
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U.S. News & World Report Names Boone Hospital Among Best Hospitals for 2023-2024 Boone Hospital Center has been named the #1 hospital in mid-Missouri and #7 hospital in the state of Missouri by U.S. News & World Report in its 2023-2024 Best Hospitals report. Boone has held the top spot in mid-Missouri since 2015. U.S. News evaluated more than 4,500 hospitals across 15 specialties and 21 procedures and conditions; only 12% of evaluated hospitals earned a Best Hospitals ranking. Hospitals awarded a “Best” designation excelled at factors such as clinical outcomes, level of nursing care and patient experience. Hospitals are ranked from 1 to 50 in each specialty, with only 10% of all rated hospitals receiving a designation of “high performing.” Boone Hospital Center ranked “high performing” in abdominal aortic aneurysm repair, aortic valve surgery, back surgery, colon cancer surgery, heart attack, heart bypass surgery, heart failure, hip replacement, knee replacement, leukemia, lymphoma, myeloma, prostate cancer surgery, and stroke.
Boone Health Recognized for Its Care for Heart Attacks Boone Health has received the American Heart Association’s Mission: Lifeline® NSTEMI Gold achievement award for its commitment to offering rapid, research-based care to people experiencing a specific type of heart attack known as a non-ST elevation myocardial infarction (NSTEMI). It also received the American Heart Association’s Mission: Lifeline® STEMI Receiving Center Gold recognition for its commitment to offering rapid, research-based care to people experiencing an ST elevation myocardial infarction (STEMI), a type of heart attack known to be more severe and dangerous than other types of heart attacks. Mission: Lifeline is the American Heart Association’s national initiative to advance the system of care for patients with high-risk, time-sensitive disease states, such as heart attacks. The program helps reduce barriers to prompt treatment for heart attacks – starting from when 911 is called, to EMS transport and continuing through hospital treatment and discharge. Optimal care for heart attack patients takes coordination between the individual hospital, EMS and health care system. “When someone experiences a heart attack, American Heart Association guidelines call for specific actions in the hospital, as well as appropriate medications and cardiac rehab activities following a hospital stay,” said James G. Jollis MD, volunteer for the American Heart Association’s Get With The Guidelines® - Coronary Artery Disease Systems of Care Advisory Work Group and cardiologist with The Christ Hospital Physicians – Heart & Vascular in Cincinnati. “Organizations like Boone Health are recognized for consistently providing patients with guidance, medication and rehabilitation opportunities that give the patient the best chance of preventing another cardiac event.” The Mission: Lifeline achievement award is earned by hospitals that demonstrate a commitment to treating patients according to the most up-to-date research-based guidelines for heart attack care as outlined by the American Heart Association.
Boone Heart Team Receives Distinguished Rating From The Society of Thoracic Surgeons Boone Hospital Center has 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 and isolated coronary artery bypass grafting (CABG). The three-star rating, which denotes the highest category of quality, places Boone Health among the elite for AVR surgery and for CABG in the United States and Canada. This is also an improved rating for isolated AVR – Boone Health last received a three-star rating for this procedure in 2022. 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 cardiothoracic surgery programs in the United States and Canada. The star rating is calculated using a combination of quality measures for specific procedures performed by an STS Adult Cardiac Surgery Database participant. Historically, approximately 4%–8% of participants receive the three-star rating for isolated AVR surgery, and approximately 20% of participants receive the three-star rating for isolated CABG surgery. Boone Health also received twostar ratings for CABG with AVR and isolated mitral valve replacement and repair (MVRR).
Boone.Health/My-Boone-Health
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VALUING EXPERIENCE Boone surgical team welcomes experienced nurse Julie Brown, BSN, RN. Caroline Siener, BSN, RN, Julie Brown and Skylar Gooch, BSN, RN
J
ulie A. Brown BSN, RN, CAPA, CPAN is known for being a fabulous nurse by her patients and her coworkers. “I've been doing this a long time, and I take the 'mom approach' I think,” says Julie, “If a patient or a coworker needs a hug, I give them a hug. If they need a little pep talk, I give them a little pep talk.” Joining the Boone Health team in 2022, Julie’s team was thrilled to have an
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experienced nurse like Julie join them. “I spent 38 years at a different hospital and the last couple of years, I just didn’t feel valued. Leadership felt distant or they did not value experience,” says Julie. Working in the surgical services department, Julie quickly felt at home. “The first day I was so impressed. They have ‘Boone Beginnings’ where leadership came and introduced themselves to us.
Then my manager Galina had lunch with me, and I got to know her and learn about the team,” says Julie. On her first day on the floor, Julie met her fellow nurses, the support staff, and the medical staff she would be working with. Julie found everyone to be very friendly, and she instantly liked the team approach to patient care. As she went throughout her day, she also found the
Rachael Kaminski, PCT/CSA and Julie Brown.
experience she brought with her to be very valued by her coworkers. They enjoyed hearing her thoughts and learning from her. “Julie cared for perhaps thousands of patients throughout her nursing career, and she continuously shows empathy to each patient, making a true effort to put herself in her patients’ shoes. Also, Julie is taking the opportunity to enjoy the downtime and incorporate a lighthearted attitude. She has a great sense of humor which helps spread positivity to her peers, doctors, patients, and their families,” says Galina RasputinaSimmons BSN, RN, MBA HM. Julie says she loves her new team and how well everyone works together. “We all work together to take care of our patients and each other. We are quick to offer help if it is needed. Galina and my director Sara Rush are wonderful leaders. They really support and listen to us,” Julie shares. Sara Rush, MSN, RN, CNOR says she appreciates Julie’s attitude
"I am kicking myself that I didn’t leave my old hospital and join Boone earlier. This is such a wonderful place to work and to be a nurse."
and proficiency. “Julie is an incredibly positive force on our team. Not only is she positive but she contributes a wealth of knowledge to everyone around her. Boone is a better place because of nurses like Julie!” Julie does a garage sale every year to raise money for the Boonville Band Boosters in honor of her late son. She mentioned it at work and Galina and several coworkers offered to donate items. They all said they would again next year as well. “I was so touched,” says Julie. Julie has been very impressed with the medical staff. “The physicians are wonderful, and they really respect the nurses here. They listen to us and value what we have to say.” Julie says she loves her job, and she hopes to have a long career at Boone. “I am kicking myself that I didn’t leave my old hospital and join Boone earlier. This is such a wonderful place to work and to be a nurse.” By Madison Loethen
Boone.Health/My-Boone-Health
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Advancements in Robotic Surgery T
he advancement of robotic assisted surgery has changed the game for many surgeons and patients. Robotic surgery has been around since 2001. The surgeries performed are minimally invasive which means minimal trauma for the patient. Incisions are smaller, blood loss is less, and pain and recovery times are shorter. Boone Hospital Center added its first robot, the da Vinci in 2008. Now equipped with two 2 da Vinci XI robotic surgical systems, Boone Hospital has recently added the Mako robotic-arm assisted surgery for total joint replacement. “It's becoming more common place,” says Sara Rush, Director of Surgical Services. “Many fellowships are offering robotics training.” THE DA VINCI XI Inside, there’s a 3-dimensional camera that allows the doctor to see things in 3D. It’s not like a 3D movie where objects are coming at you. Instead, the 3D gives the surgeon depth perception. The camera in the robotic system is much stronger, allowing the surgeon to see the patient in a very magnified way. The robot also offers 360-degree movement of the instruments which give the surgeon full range of motion. They are able to mimic how they would naturally move their hands and fingers. This allows the surgeon to move in a much more natural way. During surgery, the patient lays on the patient bed. The da Vinci is a tall machine with robotic arms that extend. Its arms are what hold the instruments that are used in the patient. Once the instruments are in place, the surgeon sits at the surgeon console during the operation. The surgeon puts their fingers in the hand instruments, and this is how they control the movement of the instruments. The foot pedals are how they control the camera, they can cauterize the cut and adjust the instruments. HOW IS THE ROBOT USED FOR SURGERIES? Gynecologic Oncology Sara Crowder, MD is a gynecologic oncologist and has been performing robotic surgeries for 12 years. Dr. Crowder treats cancers of the female reproductive
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The da Vinci arms extend and hold tiny instruments
Dr. Crowder at the Physician Console.
Dr. Rollison
Dr. Vaden
tract. Through robotic surgery, she can perform hysterectomies, remove ovaries, lymph nodes and other abdominal tissues to determine if a cancer has spread. In October 2023, Dr. Crowder performed seven gynecologic robotic cases in one day. The manufacturer of the robot does not know of any other time this has been done. And these weren’t short easy cases either. “In order to have been able to accomplish this,” Dr. Crowder says, “it comes from having a good team. It comes from having a team where everyone knows what their role is and having a consistent team, reducing the amount of things that need to be explained. And experience. When you’re having surgery, I think experience is the most important thing. A surgeon who’s experienced and a team who is experienced.” Lung Resection Joss Fernandez, MD of Boone Health Heart Surgery has recently started using robotic assistance with lung resection. As Dr. Fernandez explains, “It reduces the size of the incision and reduces post operative pain. It also prevents us from having to spread the ribs so we can get direct access. This enables us to dissect lymph nodes looking more meticulously for cancer that way.” The patient benefits by having smaller incisions, less blood loss, less pain, and a faster recovery. Colon and Rectal Surgery Reggie Vaden, MD of Boone Health General Surgery has been performing colorectal surgeries for 25 years. 5 years ago, she started doing these surgeries with the robotic system. “The robot makes us able to do things that were very difficult to do laprascopically,” Dr. Vaden explains. “The robotic system helps us do them minimally invasively where we had to do them open before.” Types of surgeries performed treat colon and rectal cancer, diverticulitis, and inflammatory bowel disease. Using the robot for these types of surgeries
shortens the patient’s length of stay in the hospital by a couple days. Prostatectomy Philip Fish, MD of Urology Associates of Central Missouri uses the robotic surgical system to perform prostatectomies. This is surgery that removes part or all of a prostate gland. This procedure is used to treat conditions affecting the prostate, such as prostate cancer. With the use of robotics, the surgeon can make small incisions in the lower abdomen to remove part of or all of the prostate depending on the need of the patient. Hernia Repair Lisa Rollison, DO of Boone Health General Surgery uses robotic surgery to repair hernias. A hernia is a hole or weakness in the abdominal wall or groin. Robotic surgery allows the surgeon to make small incisions. The robotic instruments cause less trauma which results in less pain and reduced hospital stay. MAKO ROBOTIC-ARM ASSISTED SURGERY SYSTEM Alexander Wendling, MD joined Columbia Orthopaedic Group in the fall of 2023. With his addition to Boone Health’s surgical team, Dr. Wendling is able to perform knee replacements with the use of a robot. Different from the da Vinci, Dr. Wendling is right by the patients’ side while he’s performing surgery. A CT scan is first taken of the knee and used to create a 3D virtual model. The model is loaded into Mako’s software and creates the surgical plan for that patient. The surgeon then uses the robot arms to remove arthritic bone before inserting the knee replacement. “The mako allows us to accurately plan for each individual patient’s surgery using a CT scan that they obtain prior,” explains Dr. Wendling. “We can then place components and fine tune adjustments to give us a consistent outcome so the patient’s happy with their knee replacement.” By Erin Wegner
Dr. Wendling reviewing a CT scan before surgery. Boone.Health/My-Boone-Health
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Relief from Pain
Neurosurgery with Charles Bondurant, MD of Mid-Mo Neurosurgery gave Laura the relief she’d been waiting for.
L
aura Hutton woke up before work one early February morning and knew something was wrong. Terrible pain was coming from her neck and shooting pain was going down her arm. “I knew something was very wrong, but I decided to try to go to work anyway. The pain had started the evening before when I turned my head sharply, and I guess I just kept hoping it would go away,” Laura explains. Laura took a couple of Advils and then headed to her job as a social worker. “Once I was at work the pain was terrible. It was so hard to work. I ended up taking off the next day. It was the first day I missed for illness in over 5 years,” says Laura. Laura’s symptoms were very painful from the left side of her neck by her ear, all the way through her shoulder and down into her arm and hand. She also did not have much feeling in her fingers. “I was able to get an MRI and was told I had herniations along with chronic degenerative changes in a significant portion of my cervical spine, and the MRI stated ‘consider surgical consult if not already obtained.’ My stomach sank when I read that,” says Laura. Laura made an appointment with a pain management physician and requested a referral to Dr. Bondurant of Mid-Mo Neurosurgery. “Everyone told me that surgery was what I needed to do, but I just didn’t want surgery. I had never had a major surgery and I was scared by the thought of it. For months I kept taking Advil every day,” says Laura.
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For more information, visit boone.health/neurosurgery or call 573.815.8242
She also started going to physical therapy and got a cervical epidural steroid injection, which provided some temporary relief. Her symptoms, however, continued to interrupt her everyday life. In April, Laura had her appointment with Dr. Bondurant, and he went over Laura’s injury with her and discussed her options. “I told him how I’d like to avoid surgery and continue with PT for now and he was totally supportive. He scheduled another appointment for June but told me to call before then if anything changed,” says Laura. Just a couple weeks later, Laura reinjured her neck at home and the pain was so terrible she ended up going to the emergency room. “The ER doctor told me she read Dr. Bondurant’s note and she said, ‘I know you don’t want surgery but it’s time for surgery,’” says Laura. So Laura made another appointment with Dr. Bondurant. “At that appointment, my symptoms were so severe that Dr. Bondurant offered to do the surgery the next day. Because my husband and parents were out of town, I decided to wait until the next week. I ended up having surgery the day after my birthday. It wasn’t how I planned to spend my birthday, but I did think the timing was kind of cool because I was born at Boone Hospital. I’m a Boone Baby!” Laura says with excitement. Dr. Bondurant performed a laminaforaminotomy and diskectomy surgery. A laminoforaminotomy is when bone spurs are removed from the spine. A diskectomy is when the damaged part of a disk in the spine is removed. Laura’s surgery was successful, and her medical team worked to help her with the pain and nausea she experienced after her surgery. “They all listened to me to help get my pain and nausea controlled. The day after my surgery, I knew my nurse Chandra because we used to work together. It was reassuring knowing a familiar face,” says Laura.
”Dr. Bondurant saved my quality of life.” Laura’s recovery went well with the first few days being the hardest. “I did have to manage the pain at first but after those first few days, I really started to improve. It’s been several weeks since my surgery now, and I have so much movement back, and I never have to take Advil anymore,” says Laura. Laura is now back to taking walks around her neighborhood with her basset hound Thunder. “It feels so good to take those walks and one day I hope to golf again. I’m so glad I had the surgery because I think it may be possible now. Dr. Bondurant saved my quality of life,” says Laura. By Madison Loethen
Boone.Health/My-Boone-Health
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For more information on Community Wellness services, visit boone.health/community-wellness or call 573.815.3263.
HOW TO STAY MOTIVATED During the Cold Winter Months When days grow shorter and the temperature drops, it’s not uncommon to experience a dip in motivation during the cold winter months. The desire to stay cozy indoors can often override our enthusiasm for pursuing our goals and maintaining a productive lifestyle; however, with the right mindset and a few strategic tips, you can beat the seasonal slump and stay motivated throughout the winter season.
Set Realistic Goals
It’s essential to set achievable goals during the winter season. When you’re faced with challenging weather conditions and reduced daylight, consider breaking large goals into smaller, manageable tasks. By focusing on attainable milestones, you’ll experience a sense of accomplishment, boosting your motivation to keep going.
Find Winter-Friendly Activities
Let There Be Light
Limited daylight in winter can lead to a drop in both our motivation and mood. Combat this by maximizing your exposure to natural light. Open your curtains during the day, take breaks outside whenever possible, and consider investing in a light therapy lamp to mimic sunlight’s effects. Adequate light exposure can help regulate your circadian rhythm and boost your energy levels.
Winter offers a unique set of activities you can enjoy to stay active. Whether it’s ice skating, snowshoeing, hiking, or even building a snowman with friends or family, embrace the seasonal opportunities around you. Engaging in these activities not only provides a break from the routine but also helps maintain your physical and mental well-being.
Stay Connected
Create a Winter Routine
Winter can be an excellent time to set new goals and aspirations. Use this period of reflection to re-evaluate your long-term objectives and make plans for the year ahead. By setting exciting new goals, you can reignite your passion and enthusiasm, keeping your motivation alive throughout the winter.
Structure can be a powerful motivator during the winter months. Establish a daily routine that incorporates your goals, exercise, and self-care activities. A consistent schedule will help you stay focused and on track, even when the winter blues threaten to derail your plans.
Wintertime isolation can contribute to feelings of sluggishness and low motivation. Combat loneliness by staying connected with friends and loved ones. Social interactions, even virtual ones, can provide the support needed to stay on track with your goals.
Set New Goals
Practice Self-Care
Taking care of your physical and mental well-being is crucial during the winter months. Prioritize self-care activities like meditation, exercise, and warm baths. These practices can help you reduce stress, increase energy levels, and maintain a positive outlook.
Seek Inspiration
Winter offers a backdrop for creativity and inspiration. Take advantage of the cozy atmosphere to delve into hobbies you may have neglected. Whether it’s writing, painting, or crafting, pursuing your passions can reignite your motivation and make the winter months more enjoyable. Embrace the season, set realistic goals, create a routine, and prioritize self-care to maintain your motivation and wellbeing. By following these tips, you can not only survive but thrive during the winter season, turning it into a time of personal growth and productivity. By Jenny L. Workman
Boone.Health/My-Boone-Health
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A Partner in EDUCATION B
oone Hospital Center has had a partnership with Columbia Public Schools for almost 40 years. Becoming one of the first partners in the district, Boone Hospital joined Jefferson Junior High School ( JJHS) in 1984 as their sole Partner in Education. Partners in Education allows schools and businesses in the community to work together and share resources. “The partnership with Boone was established to increase community relations and involvement with Columbia Public Schools,” says Nancy Jones, former PIE chairperson for JJHS. When the PIE partnership started in 1984, Jefferson Junior High School taught 8th and 9th graders. In 2013, the school was converted to Jefferson Middle School ( JMS), and the grades changed to 6th, 7th and 8th. When it was JJHS, Boone was able to offer the 9th graders a chance to explore work opportunities at the hospital. The Volunteen Program accepted 25 9th graders each year. The students would be assigned to various departments, and it gave them a chance to see the inner workings of the hospital. Matt Borgemeyer, MD, an OBGYN at Women’s Health Associates was in the first volunteen program at JJHS. Job Shadowing was also available to the older students, and showed students that the hospital offered jobs that went beyond medicine. Students interested
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Dr. Borgemeyer was in the first Volunteen program at JJHS.
in security learned how expansive the hospital security system was. Through the PIE partnership, Boone Hospital was instrumental in installing security cameras at Jefferson Junior High School. “Long before horrendous school shootings and when school buildings were not locked from outsiders, Boone was concerned about people who cut through Jeff ’s halls. Our location between the business loop and downtown provided cut-through traffic that was most concerning. Boone had security
cameras placed in our main hall to help monitor those who might not have school business in the building,” says Linda Hutton, former PIE chairperson. While it was also a Junior High, Boone Hospital allocated funds for there to be a full-time nurse at school at all times. Boone worked with contractors in Columbia and helped renovate a portion of the building to take the nurse’s office from a tiny room to a nicer office for the nurse to work from. Boone Hospital regularly stocks the nurses office with supplies and snacks. Home Economics students used to hold Teddy Bear Teas. Each year around Valentine’s Day, faculty and staff from the school and any Boone employee could bring their children ages 3 through 6 with a Teddy Bear to the Teddy Bear Tea. There would be cookie decorating and crafts and the drama/speech students would perform puppet stories. Since 2005, there has also been a Boone Excellence in Education Award that is given to one JMS employee every year. The JMS faculty nominates teachers, and the winning teacher receives a $500 check that is given to them at the annual awards assembly held on the last day of school. Health Fair and Flu Shots for Teachers As part of the PIE partnership, Boone Health's Community Wellness
department, formerly known as WELLAWARE, started giving JJHS/ JMS teachers free health screens and free flu shots. Started in 2008, Community Wellness staff would come to the school in the spring and give staff free health screenings and would return in the fall to provide free flu shots. To date, Community Wellness has given 387 health screens and 817 flu shots. Other PIE partnership programs included: • EAP: faculty, staff and students had the opportunity to use Boone’s mental health counseling as needed • Art students would decorate the hallways and bridge over Broadway
• Decorations and caroling at holidays • Sponsored national junior honor society • Teach mini lessons on areas of interest related to each of Boone's academic departments • Served as judges for speech contests and conductors for immigration unit simulation “Our kids were so proud to be allowed to serve in some capacity. They felt so important to get to contribute to the hospital,” says Linda. “The partnership with Boone has been way more than just a financial backing.
It has more importantly been a sharing of interests, expertise and moral support to each other and our students and staff,” says Nancy. Additional Support for All Columbia Public Schools In 2018, many states started requiring high school students to learn CPR training in order to earn their high school diploma. In Missouri, Senate Bill 711 stated that this would begin in the 2017 – 2018 school year. The law states that, “This act requires high school pupils in public schools and charter schools to have received thirty minutes of CPR instructions and training in the proper performance of the Heimlich maneuver The Mobile Health Unit parked at Jefferson Middle School offering free health screenings to teachers.
In 2023, Mike Szydlowski won the Excellence in Education Award.
Emergency Department donated 1,000 pencils to JMS.
Jefferson Junior High School students supporting Pink Day.
Boone.Health/My-Boone-Health
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Community Wellness offered free CPR instruction to high school students.
or other first aid for chocking prior to graduation. The act also requires the training to be included in the district’s existing health or physical education curriculum.” Boone Hospital and our Community Wellness department were pleased to be able to offer this free CPR instruction to the 3 high schools. 4,063 students were CPR trained from 2017 – March 2020. When the pandemic hit in March 2020, CPS still needed to provide CPR training to students needing to graduate. Community Wellness made an instructional video that CPS’s health and physical education staff could use to continue to train and educate students. Athletic Activity Partnership Program Boone Health has also been an active supporter of the athletic and activities programs at Columbia Public Schools. When the economic recession hit in 2008, the CPS district was hit with financial decisions like many businesses were. Being faced with freezing salaries or freezing budgets, many activities had to seek funds from the community. David Eggon, the District Athletic Director for CPS said, “For a lot of our athletic and activities programs, they were still able to operate, but we were finding more and more programs going out and attempting to fundraise to supplement their budgets.” Columbia has shown itself to be a great community that supports the schools and supports their programs. However, businesses were being greeted with an abundance of fundraising inquiries. With many school programs reaching out for support, a business would get a request from one school's volleyball team and then another school's track team. And by the time the football team is asking for support, the business has no more money left to give.
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BOONE HEALTH
Winter 2024
"Every sport at every CPS school is represented within the staff at Boone," says Ben Cornelius, Marketing Director for Boone Health. "It was impossible to determine which teams to sponsor, because we couldn't sponsor them all individually." It strongly highlighted that CPS needed more of a comprehensive program that was rooted in equity and trying to ensure that all of their programs could benefit from community support. Bruce Whitesides, former District Athletics Director, lead the charge of bringing CPS’ athletic activities to the future. Joining forces with an organization, they were able to facilitate a plan of the school district combining marketing partnerships. So instead of sponsoring just one school, a business would be sponsoring all CPS athletics programs and activities. The proceeds collected from the partnership program would be distributed equitably to all of the programs; all the volleyball teams, all the soccer teams, all the cross country teams, etc. The goal was to reduce the need of teams fundraising and to also ensure that all CPS athletics programs would benefit from the partnership. It also offered equity to the community partners who were able to advertise at many different schools. “This decision made it much easier for Boone to have a blanket sponsorship where we were sponsoring all the athletic department activities,” Ben shares. “Boone has been phenomenal for us,” says Bruce. “There are 10-12 community partners who have been with us since year 1, and Boone is one of them. They’ve been with us since this started in 2011 and we’re just incredibly grateful for the support.” By Erin Wegner
Boone.Health/My-Boone-Health
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BRIN GIN G UP BOO N E BABIES
EAR INFECTIONS IN BABIES AND CHILDREN
BY JAMES LIESEN DO, PEDIATRICIAN WITH TIGER PEDIATRICS
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E
ar infections are one of the most common infections in babies and children, and are especially common in the winter. They can accompany many viral infections that are frequent this time of year. Ear infections also account for a large proportion of antibiotic use in children. It’s very important in this day of antibiotic resistance that your child’s health care provider accurately diagnoses an ear infection and makes sure they are treated appropriately to clear the infection without increasing their resistance to antibiotics.
Signs to Watch For
Most ear infections happen in babies and children before they can speak and tell you what hurts. Watch out for signs of infections to make sure your babies and children get diagnosed and treated early. Common signs and symptoms include: • Excessive fussiness and crying • Poor sleep with frequent wakening • Fevers • Discharge from ear • Poor appetite • Troubles with balance • Trouble hearing • Complaints about ear pain (from older children) Why Do Ear Infections Happen More Often in Babies and Younger Children?
Make sure your child is treated correctly to allow for improvement and reduce developing resistance to antibiotics. If you can’t make an appointment with your primary provider, an urgent care clinic is appropriate for treatment. Your provider will look at the child’s ear drum or tympanic membrane with an instrument called an otoscope and look for signs of infection like bulging, redness, and dullness. Treatment for Ear Infections
Typically, the treatment is a 10-day course of an antibiotic, usually amoxicillin. Amoxicillin is used because it is welltolerated, effective, inexpensive, and directly treats ear infections. Most children tolerate amoxicillin well but watch your child for signs of difficulty like rash, excessive diarrhea, or showing poor response. If these do happen, contact your primary provider for further instructions. If your child is allergic to penicillin or amoxicillin, alternative antibiotics can be used to clear the infection. If amoxicillin is not effective, often the provider will change the antibiotic to Augmentin ES which is a combination of amoxicillin and clavulanic acid. If neither amoxicillin or Augmentin ES is effective, antibiotics can be changed to clindamycin, levofloxacin, or even Rocephin injections. Typically, children are remarkably improved after 3 days of treatment, but it is very important to complete the full 10-
day course of the antibiotic to make sure the infection is cleared and to prevent future antibiotic resistance. Pain Control for Babies and Children
Tylenol, ibuprofen, or a combination of the two is most important for pain control. Infants with less pain sleep better, feed better, and are much less fussy. Discuss the proper weight-based dosing for each medicine with your primary provider. Topical agents for ears such as lidocaine and benzocaine are not licensed in the U.S. and have been associated with severe reactions in babies and small children. These should be avoided. Follow up as directed by your primary care provider to make sure the infection is cleared. If your baby or child is not dramatically improved after 3 days of treatment, contact your primary provider. Boone Clinic and Tiger Pediatric providers are happy to see your baby or child to resolve ear infections or other complications.
Dr. Liesen is a pediatrician with Tiger Pediatrics in Columbia. He is currently accepting new patients.
Babies and younger children have smaller eustachian tubes that don’t yet function as well as they do in older children and adults. The eustachian tube is a structure that sits behind the nose in the skull and equalizes the pressure of the ear space. When children have viral infections like an upper respiratory infection, inflammation and congestion allow bacteria to overgrow and infect the ear space. Babies and younger children also do not fight off viruses or bacterial infections well due to their immature immune systems. What to Do If Your Child Might Have an Ear Infection
Make an appointment with your primary provider as soon as you can. Many other infections and causes can look like an ear infection and need a different treatment.
Boone.Health/My-Boone-Health
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GETTING TO KNOW A BHC DOCTOR
Ryan Strain, MD
Bariatric (Weight Loss) Surgery, Boone Health Bariatrics
I
was born and raised in the Kansas City area and attended medical school at the University of Missouri-Kansas City. I did my surgical training at the University of Kansas and Bariatric Surgery fellowship at Mizzou. I have been practicing surgery for over 10 years and been a provider with Boone Health for 3 years.
Why did you get into the health care field? I decided to pursue a career in medicine for many reasons. I have a strong desire to help people and make a positive impact on their lives. I also have a passion for the science of medicine and enjoy the intellectual stimulation and challenges of the ever-evolving healthcare field. What interested you in your particular specialty? During my training I witnessed the toll that obesity has on individuals’ physical and emotional well-being. I saw the struggles, the pain, and the frustration that came with battling excess weight, and I realized the immense impact I could make in patients’ lives by offering a solution. What is the most rewarding part of your job? Bariatric surgery offers a life-changing opportunity for individuals struggling with severe obesity. We witness firsthand the profound impact our work has on patients’ lives as they regain their health, confidence, and quality of life. This sense of fulfillment and the gratitude expressed by patients serve as powerful motivators for me to continue my dedication to the field. What is the most challenging aspect of your job? The most challenging aspect of being a surgeon is the high level of precision and skill required during surgical procedures. Additionally, the physically demanding nature of surgery and long hours can add to the challenges of this profession. What do you see changing in health care in the next 5 to 10 years? I think there will be a continued trend towards patient-centered care, transparency in all aspects of treatment, and personalized management for each individual patient. What advice would you give someone looking to become a doctor? Being a doctor is a rewarding but challenging profession. The path to becoming a doctor is long
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and demanding and requires strong dedication to the field and your patients. It’s important to be passionate about healthcare and helping others, and these motivations will help drive your success. What do you enjoy doing outside of work? I enjoy spending time with my wife Molly, young daughter Scarlett, and dog Oliver. We enjoy spending time outside and with family and friends. What advice would you give to someone who is going to be a patient in a hospital for a period of time? I think one of the most important aspects of being a patient in the hospital is having good and open communication with your care team. Ask questions, seek clarification, and share any concerns. Having a support system of friends or family can also make a big difference in your emotional well-being while in the hospital and can provide comfort and help with communication.
Boone.Health/bariatrics
GETTING TO KNOW A BHC NURSE
Renae Crow, RN, BSN, VA-BC Infusion and Treatment Center
M
y husband Hector and I, and our two children Mason and Madison, moved to Columbia from a small town in northeast Missouri in 2010. I graduated from Moberly Area Community College in 2005 with an Associate Degree in Nursing and went on to earn my Bachelor of Science in Nursing in 2018 from Central Methodist University. I’ve also been Vascular Access BoardCertified since 2017.
Why did you get into the health care field? Growing up in a small town, job opportunities were very limited. I began working at the local nursing home when I was in high school. After graduation, still unsure of the career path I wanted to pursue, I became a certified nursing assistant (CNA) at the nursing home. After a couple years working as a CNA I’d discovered my calling, and so my Registered Nurse journey began. What interested you in your particular specialty? Vascular access is the most frequently performed invasive procedure in healthcare, from inserting a peripheral intravenous catheter in a clinic setting to central lines in intensive care. Patient safety is my top priority, and vascular access allows me to promote vessel health and preservation in a variety of patient care settings. What is the most rewarding part of your job? Seeing the relief and gratitude on my patient’s face after inserting a vascular access device in one stick! Many patients are very anxious when they need venipuncture. By the time I get to the room, their anxiety is usually through the roof as a result of multiple failed attempts. By acknowledging their anxiety, listening to their concerns and experiences, and talking to them through the procedure I can give the patient a sense of trust and confidence that I have their best interest at heart. What is the most challenging aspect of your job? To be honest, the lack of standardized education for vascular access in healthcare educational programs. This goes for all disciplines performing vascular access: nursing, physicians, respiratory therapists, radiology technologists, phlebotomists. We all access the same vascular system; however, the education we receive is very different and often lacking. What has changed in your field since you started practicing? The biggest change I’ve seen is that vascular access is becoming recognized as a true specialty. Vascular
Access Specialist RNs are inserting more advanced lines such as internal jugular catheters, tunneled dialysis catheters, and other procedures previously performed primarily by physicians. Advances in technology have also greatly evolved. Ultrasound, infrared technology and improved products such as securement devices and dressings have decreased complications for our patients. What do you see changing in the next 5 to 10 years? Healthcare has already experienced so many changes over recent years as a result of the pandemic, with telehealth being one of the biggest. I think we’ll continue to see big changes in our care delivery model as a result of shortages at the bedside in all disciplines. What do you enjoy doing outside of work? I enjoy being outdoors, except in the winter, and I’m not a big fan of the cold. I enjoy hiking, playing golf with my husband, and quiet time on my deck watching birds. As a new empty-nester, I am finding more free time and look forward to exploring new hobbies. What advice would you give someone looking to become a nurse? Keep an open mind, don’t settle on a specialty too early, explore and experience a variety of areas of nursing, and be ready for lifelong learning. You may be surprised at what you’ll discover!
Boone.Health/My-Boone-Health
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Know the
Symptoms
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BOONE HEALTH
Winter 2024
Men and Women are different, and so are their heart attack symptoms. Although men and women share many of the same signs for a heart attack, such as chest pain or discomfort, there are other signs that women need to remember. According to the American Heart Association (AHA), women often believe some symptoms they are experiencing may be other less life-threatening conditions like acid reflux, the flu, or normal aging. Knowing the difference in symptoms may save your life!
Heart Attack Symptoms Men • Sudden cold sweat • Pain in chest, arms, back, neck, jaw or stomach • Shortness of breath • Heartburn or indigestion • Nausea Women • Light headedness or sudden dizziness • Feeling unusually tired for no reason • Pressure, squeezing, fullness or pain in the center of chest • Pain or discomfort in one or both arms, the back, neck, jaw or stomach • Shortness of breath • Sudden cold sweat • Nausea or vomiting • Indigestion or gas-like pain • Heartburn
Know the Risk Factors that could prevent a heart attack: • Tobacco Use (www.lung.org or 1-800-QUIT-NOW ) • High Cholesterol • High Blood Pressure • Obesity • Diabetes • Unhealthy Diet Speak with your primary care provider about these risk factors today! If you don’t have a primary care provider, find a Boone Health Provider at www.boone.health/ primarycare or visit www.boone.health/ heart to learn more about heart disease and how Boone Health can help.
Boone.Health/My-Boone-Health
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Cranberry Roasted Pork with Cinnamon Mashed Sweet Potatoes INGREDIENTS (Serves 2) • 1 pork tenderloin • 3 tbsp Montreal steak seasoning • 1 bag fresh or frozen cranberries • ½ cup orange juice • ¼ cup pure maple syrup • Sugar, as needed • 1 log goat cheese • 1 cup honey • 1 bunch fresh thyme • 2 sweet potatoes • ½ cup brown sugar • 1 tbsp cinnamon • Pinch of salt • ¼ cup heavy cream • 3 tbsp olive oil
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Winter 2024
DIRECTIONS • Grind up your Montreal Steak seasoning to ensure that the seasonings sink into the meat deeper. • Trim the silver skin off the pork tenderloin to reach peak tenderness in your end result. • Add oil and Montreal steak seasoning to your pork tenderloin and let marinate for a minimum of 2 hours and up to overnight. • Warm your honey and fresh thyme in a sauce pot over the stove to infuse the thyme into the honey. • Preheat your oven to 350°F and bake your pork tenderloin for 30 minutes or until the internal temperature reaches 145°F. Pull out and let rest for 5 minutes. • Peel and cut your sweet potatoes into small pieces and either boil in a pot of water or steam for 20 minutes or until tender. • Put cooked sweet potatoes in a mixer and add your brown sugar, cinnamon, and a pinch of salt. As the potatoes mash, add cream a little at a time to reach desired creaminess. • In a saucepot on the stove over medium heat, add cranberries and orange juice and maple syrup until cranberries have popped and start to thicken. Once thick, add more sugar if desired. • Slice your tenderloin into desired thickness. • Time to plate! Put a large scoop of mashed sweet potatoes in a bowl then drizzle honey and sprinkle goat cheese. Then place tenderloin on top and finish with cranberry sauce and garish with parsley if desired. By Jason Anderson, Boone Health Chef
Boone.Health/My-Boone-Health
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Simple and Effective Home Exercises W
inter weather and busy holiday schedules are common obstacles to our exercise time. Driving to and from a gym when time is in short supply and the likelihood of winter weather causing slippery and dangerous roads can lead many people to skip their workout altogether. According to the Centers for Disease Control, only 28 percent of Americans are meeting appropriate exercise guidelines. If you’re one among the 72 percent struggling to get enough exercise, these simple, yet effective home exercises can be done year round with fewer obstacles.
Bicep curl: Sit or stand upright. Keeping your elbows in tight with your body, bend at your elbow and bring the weight up near your chest. Lower the weight in a controlled manner until your arm is straight again.
UPPER BODY Push-ups
The push-up is a great chest and triceps exercise that’s easy to modify based on your strength level. Start with your hands on the floor shoulder-width apart and fingers facing forward. Lower your body while maintaining a straight trunk. When your elbows reach a 90 -degree angle, simply push back up. To make this exercise easier, perform the push-up with your knees touching the ground instead of your feet. If getting down to and up from the floor is difficult, place your hands against a wall or sturdy object and perform the movement. The higher your hands and the greater angle your torso makes with the ground, the easier the movement will be. Progress by using objects closer to the floor, gradually decreasing the angle between your torso and ground and increasing difficulty.
Lateral raise: Sit or stand upright with your hands to your side and palms facing in toward your body. Keeping your arms straight, raise your hand until your arms are parallel with the floor. Slowly lower the weight down to the starting position.
Dumbbell exercises
A variety of upper body dumbbell exercises are simple to perform and can be done using household objects if you don’t own dumbbells. Objects like a can of soup can be used in place of a dumbbell as long as the weight is appropriate for the exercise. 28
BOONE HEALTH
Winter 2024
Make sure you don’t hurt yourself by using objects too heavy or difficult to hold. However, if you can’t find objects heavy enough to present a challenge, add extra reps or decrease rest time to increase difficulty.
LOWER BODY Goblet Squat
Stand with your feet shoulder-width apart. Press your hips back and lower your rear towards the ground, making sure your knees do not go past your toes. Try to get low enough that the top of your thigh is parallel to the floor or as low as you are able before returning to an upright position. To decrease difficulty, find a chair or bed with an appropriate height and squat till your backside touches the surface, then return to your upright position. To increase difficulty, you can hold a weight in your hands, or after returning to your upright position you can combine this exercise with an overhead press.
Burpee
Mountain Climber
Kettleball Swing
Lunge
Stand then step forward with one foot and drop your back knee towards the floor. Try to drop low enough that your front leg is bent at a 90-degree angle and your knee is directly above your toe. Keep an upright posture as you press your forward foot into the ground. Bring your feet together to return to starting position. To decrease difficulty, you don’t need to drop your back knee low enough for your front leg to reach a 90-degree angle, but make sure you don’t step too far forward. To increase difficulty, try holding a weight in your hands. To add variation, try adding backwards and side lunges.
Dumbbell Push Press
CARDIOVASCULAR EXERCISE
High-intensity cardiovascular exercises can easily be done in your home with minimal to no equipment. High Intensity Interval Training, or HIIT, lets you get a great cardiovascular workout in a short amount of time. Workouts typically last 15 to 25 minutes and include different exercises done in succession with a short recovery period – for example, 30 seconds of exercise followed by 30 seconds of rest for 5 sets. After 5 sets, rest for 1 or 2 minutes and repeat for 3 total cycles. Exercises that can be included in a HIIT plan include mountain climbers, burpees, kettlebell swings, dumbbell push press, and many more. HIIT plans can vary so much, we could write a separate new article on them! You can search online and find a HIIT training plan that works for you. If you’re new to exercising, talk to your physician before beginning an exercise training plan. By Hayden Legg, ACSM-CEP Boone.Health/My-Boone-Health
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FOUNDATION NEWS
THANK YOU TO OUR 2023 GALA SPONSORS!
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Winter 2024
Gene and Carol Meyer with Dr. Michele Kennett and Dr. Jerry Kennett.
Mark Miles, Rebekah Miles, Scott Mattson, Julianne Mattson, Matt Puthukulam, Sara Jeffrey, Dr. Sudhi Tyagi and Steven Jeffrey.
Boone Hospital Foundation’s annual gala was held on October 14, 2023 at The Country Club of Missouri. The program for the evening included hearing from hospital and board leadership, Boone Health’s amazing caregivers, as well as grateful patients. Thank you to all of our sponsors and attendees for their generous support allowing Boone Hospital Foundation to continue to provide services and enhancements to patient care at Boone Health. To make a gift to Boone Hospital Foundation, visit www.boone.health/foundation or simply scan the QR code above!
Drew Wilkinson and Betsy Vicente.
SAV E THE DATE
21st Annual Boone Hospital Foundation Golf Classic May 6, 2024 The Club at Old Hawthorne
Credit: ComoPhotobooth.com Boone.Health/My-Boone-Health
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Boone Hospital Center 1600 East Broadway Columbia, MO 65201 573-815-8000
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COLUMBIA, MO PERMIT 286
