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OXFORD T H E G O O D L I V I N G M A G A Z I N E F R O M M C C U L L O U G H - H Y D E | T R I H E A LT H

FALL 2019

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TRIHEALTH.COM

SAVING A COLLEGE STUDENT’S LIFE THE BEST FLU PREVENTION QUALITY CARE CLOSE TO HOME

A HEALTHY SCHOOL YEAR Oxford_Fall19_final.indd 1

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New President and Chief Operating Officer Michael Everett with Oxford area leaders at the Oxford Music Festival.

SERVING THE

COMMUNITY

THE NEW PRESIDENT AND COO OF McCULLOUGH-HYDE MEMORIAL HOSPITAL SHARES HIS VISION FOR THE FUTURE. MICHAEL EVERETT was raised to value the importance of service to his country and his community. “My mother was a nurse with compassion for others, and my father was a fire captain who believed in serving the community,” says Everett, Certified Professional in Patient Safety (CPPS), who recently joined TriHealth as the President and Chief Operating Officer of Bethesda Butler Hospital (BBH) and McCullough-Hyde Memorial Hospital (MHMH). “I consider it a blessing and an opportunity to serve others through healthcare.” In June, Everett, who is married with three children, relocated to Butler County from Scottsburg, Ind., where he spent almost six years as Chief Executive Officer at Scott Memorial Hospital. Prior to that, he was the Assistant Administrator at Lake Cumberland Regional Hospital in Somerset, Ky. But Everett says the best preparation for his new role is the seven years he spent in the U.S. Marine Corps. That experience helped him develop the organizational skills, Michael Everett leadership traits and commitment to

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service that has enabled him to succeed as a healthcare executive. “As a sergeant, I served in the Marine Security Forces and the infantry, and I was trained to be a leader,” says Everett. “I transitioned into healthcare because it was an opportunity to make a difference in people’s lives.”

IMPROVING ACCESS TO HEALTHCARE In his new position at TriHealth, Everett will be responsible for providing leadership in the delivery of the strategic, financial, operational and quality/safety objectives of both hospitals. What drew Everett to TriHealth was the system’s focus on the community. “I was impressed with the hospitals’ values,” he says. “I look forward to helping members of our communities with their healthcare needs.” Everett’s long-term goal for the future of MHMH is to help as many people as possible obtain the care they need. “I want to create more access points for our community members,” he says. “I also want to remove barriers that prevent people from achieving wellness or improving their health. My goal is to provide resources that will allow people to get quality healthcare close to home.”

FALL 2019 | TRIHEALTH.COM/MHMH

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Patient Logan Estes participates in physical therapy at conveniently located Ross Medical Center.

QUALITY CARE CLOSE TO HOME A PATIENT RECEIVED TOP-NOTCH TREATMENT FOR A SPORTS INJURY JUST MINUTES FROM HIS HOME. SOME MAY SAY LOGAN ESTES has led an action-packed life. The 36-year-old special education teacher from Ross served in the 82nd Airborne Division in the U.S. Army, which specializes in parachute operations. But years of parachute jumps put a strain on his knees, and on April 20, he heard a “pop” in his right knee while participating in an alumni basketball tournament at Ross High School. “I went down, and I knew it was a significant injury,” he recalls. Logan was in pain and couldn’t walk. Knowing he could face a long wait for an appointment with an orthopedist at the VA hospital, he was glad when he learned that he could see a physician just two days later at Ross Medical Center, a full-service

ambulatory care facility. A bonus? It’s just a few minutes down the road from his house.

A QUICK DIAGNOSIS Matthew Daggy, MD, a sports medicine specialist at TriHealth Orthopedic & Sports Institute, examined Logan’s knee and sent him for X-rays and an MRI at the on-site imaging center the same day. “I received the results in less than 48 hours,” says Logan. The scans showed that Logan had suffered tears in the anterior cruciate ligament (ACL), medial collateral ligament (MCL) and the meniscus of his right knee. The ACL controls back and forth motion of the knee, and the meniscus, which consists of cartilage, cushions the joint. The MCL is located on the side of the knee. These tissues provide stability to the knee

and are often torn in sports that involve sudden stops and changes in direction. Bryan McCullough, DO, an orthopedic surgeon at McCullough-Hyde Memorial Hospital (MHMH), recommended repairing Logan’s torn MCL and performing ACL reconstruction using cadaver tissue. “He said that would provide the fastest recovery time,” recalls Logan. Moving quickly, Dr. McCullough helped Logan schedule his surgery. “Before I had the surgery, I was fitted for a brace and started physical therapy to help stabilize my knee,” says Logan. Logan had surgery on May 22. Afterward, he was able to return to Ross Medical Center for his rehabilitation. “We have a physical therapy and rehab program at Ross with board-certified orthopedic specialists,” says Neil Kamphaus, Director of Business Health and Practice Administrator at MHMH. “It’s convenient for local patients to have physical therapy so close to home.” At press time, Logan was attending physical therapy once a week. This fall, he will be able to start running again, and he expects to return to other activities— maybe even basketball—this winter. “My recovery is going great,” says Logan.

MEETING YOUR MEDICAL NEEDS Ross Medical Center provides care in the following areas: • Sports Medicine • Occupational Medicine • Urgent Care • Imaging (CT, MRI, general imaging and mammography) • Physical Therapy • Pain Management • Oxford Pediatrics • Orthopedics & Sports Medicine • Outpatient Laboratory Services

ROSS MEDICAL CENTER IS LOCATED AT 2449 ROSS MILLVILLE ROAD. FOR MORE INFORMATION ON MHMH/ TRIHEALTH SERVICES AT ROSS MEDICAL CENTER, PLEASE CALL KRYSTAL LOVE AT 513.856.5945.

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PROVIDING THE BEST

PATIENT CARE McCULLOUGH-HYDE MEMORIAL HOSPITAL NURSES ARE WORKING TOWARD THE HIGHEST HONOR IN THE FIELD.

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THE NURSES at McCullough-Hyde Memorial Hospital (MHMH) always strive to deliver the best patient care. Now they’re going above and beyond to achieve Magnet® designation, which recognizes nurses for excellence in several areas, including patient care, leadership, innovation and patient outcomes. Fewer than 8 percent of the nation’s more than 5,000 hospitals have attained Magnet status, which is administered by the American Nurses Credentialing Center (ANCC). “Magnet status shows that a hospital cares about its nurses and invests in their training and education,” says Jackie Woodruff, BSN, RN, CAPA, a same-day surgery and post-anesthesia care unit nurse and a professional excellence champion for the Magnet program at MHMH. TriHealth earned Magnet recognition, which is valid for four years, for the

FALL 2019 | TRIHEALTH.COM/MHMH

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Magnet “champions,” including Jackie Woodruff, RN, second from left, will be seeking national recognition for nursing excellence for the first time.

a happy nurse—one who is satisfied with her job—he or she is willing to go the extra mile,” says Woodruff. “That increases patient satisfaction and decreases infection and mortality rates.”

NURSING EXCELLENCE

MAGNET STATUS SHOWS THAT A HOSPITAL CARES ABOUT ITS NURSES AND INVESTS IN THEIR TRAINING AND EDUCATION.” —JACKIE WOODRUFF, RN

first time in 2012 and achieved its first redesignation in 2017. It’s one of only two healthcare systems in Ohio—and one of 27 in the nation—to achieve system-level designation. TriHealth is currently applying for its second redesignation in 2021, and MHMH will be joining this effort and seeking Magnet status for the first time. There are many benefits to achieving Magnet status. For instance, it helps hospitals attract and retain the most talented nurses; advances nursing standards and practice; and helps to improve patient care, safety and satisfaction. Research shows that Magnet hospitals have improved patient outcomes, including lower rates of falls and pressure ulcers. “When you have

To qualify for Magnet status, a hospital must meet certain standards of nursing excellence, says Amy E. Keller, MSN, RN-BC, Professional Excellence Specialist in the TriHealth Nursing Administration. An organization must demonstrate excellence in each of the five components of the Magnet Model: Transformational Leadership; Structural Empowerment; Exemplary Professional Practice; New Knowledge, Innovations and Improvements; and Empirical Outcomes. Transformational Leadership refers to the ability of TriHealth’s nursing leadership to create a shared vision for the future. Transformational leaders advocate for nurses and are approachable. Structural Empowerment refers to the structures and processes that allow nurses to flourish. Through a concept called “shared decisionmaking,” nurses are encouraged to solve problems that affect patient care. At TriHealth, professional development is encouraged and valued. This includes advancing education, specialty certifications and professional organization involvement. For instance, nurses may want to pursue their Bachelor of Science in Nursing degree if they don’t already have it. Exemplary Professional Practice emphasizes best practices in care delivery and encourages nurses to contribute to developing policies and budgets. New Knowledge, Innovations and Improvements focuses on evidencebased practice, research and quality improvement projects. Nurses can join a “Journal Club,” in which they read current literature and discuss the implications for their unit. They can also design their own studies. “If we have falls on a unit, for instance, we can do

Amy E. Keller, MSN, RN-BC, Professional Excellence Specialist, is committed to nursing excellence.

a study to determine why there are so many falls, or learn how to reduce our fall rate,” says Woodruff. “This empowers our nurses to speak up and say, ‘This needs to be changed’—and ultimately helps our patients.” Empirical Outcomes focuses on measuring and reporting patient outcomes.

HAPPIER NURSES, HEALTHIER PATIENTS Woodruff, who is one of several Magnet “cheerleaders” at MHMH, attends monthly meetings with the hospital’s Magnet committee and works with her unit of 21 nurses to determine if they’re meeting standards and how to address any gaps. The deadline for submitting Magnet documentation is April 1, 2021. ANCC surveyors will conduct a site visit in the fall of that year to confirm the information submitted in the application. MHMH hopes to receive a decision by the end of 2021, says Keller. The path to Magnet status requires a commitment from the hospital and nursing staff, but in the end, “it’s rewarding,” says Woodruff. “When patients come to McCullough-Hyde, they will know that they’ll receive excellent nursing care.”

IF YOU’RE A NURSE AND ARE INTERESTED IN WORKING AT McCULLOUGH-HYDE MEMORIAL HOSPITAL, VISIT TRIHEALTH.COM/MHMH AND CLICK ON McCULLOUGH-HYDE CAREERS TO APPLY.

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SAVING KERRI THANKS TO EXPERT MEDICAL CARE AND THE QUICK ACTION OF FIRST RESPONDERS, A COLLEGE STUDENT’S LIFE WAS SAVED.

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FALL 2019 | TRIHEALTH.COM/MHMH

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ON MAY 7, Kristy Peterson received the call every parent dreads. It was the Oxford paramedics, and they told her that her daughter, Kerri, a Miami University freshman, was at McCullough-Hyde Memorial Hospital (MHMH). She was unconscious and breathing slowly, with a rapid heart rate and fever around 107. Kristy wasted no time. She got in her car and started the seven-and-a-half-hour drive from Buffalo, N.Y., to Oxford. “I was in constant contact with Kerri’s roommate as well as the ER staff regarding her condition,” says Kristy. “I was so upset that I listened to the same two songs the entire trip.”

A LIFE-THREATENING DIAGNOSIS It was a Tuesday morning a week before final exams. Kerri had been feeling ill all weekend, and that morning she awoke with a headache, fever and chills. She thought she had the flu, but she dragged herself out of bed for a math quiz. That decision may have saved her life. “We were told that if she had not gotten up to go to class, she could have died in her sleep,” says Kristy. “Or, if she had left her dorm a few minutes later, she could have fallen down the stairs in the building.” On her way to class, Kerri suddenly began running, flailing her arms and making strange noises. Then she collapsed. The campus police and the Oxford first responders arrived on the scene quickly. Kerri barely stirred from the paramedics’ attempts to rouse her. They weren’t sure what was wrong with her, but they realized she met the criteria for sepsis, in which the immune system stops fighting foreign invaders such as bacteria and turns on itself, causing tissue damage and organ failure. Chris Meador, Captain of the Oxford Fire Department, was so concerned about Kerri that he joined paramedic Jared Baker in the ambulance for the seven-minute ride to MHMH. At MHMH, Alexa Sabedra, MD, an Emergency Medicine physician, assessed Kerri. She ran through the possibilities: seizure, illegal drugs, inadvertent exposure to a toxin, infection. “She was one of the sickest people I had ever seen,” she recalls. Dr. Sabedra quickly ordered comprehensive tests to determine if Kerri was septic. Meanwhile, Kerri’s roommate arrived and told Dr. Sabedra that Kerri had had an infection three weeks earlier. Kerri seemed to have gotten better, but she had experienced intense chills and a slight fever over the weekend. She and Kerri had assumed it was the flu. Dr. Sabedra prescribed multiple antibiotics and fluids and put Kerri on a respirator to help her breathe. Meanwhile, she continued to update Kristy. “She was so far away, and I couldn’t imagine what it was like for her to be in the car, not knowing what she would be walking into,” says Dr. Sabedra. When the test results came back, they showed Kerri was in septic shock—the most severe form of sepsis, in which blood pressure drops to dangerous levels—and the antibiotics Dr. Sabedra had given her were starting to work. But whenever the nursing staff repositioned her, her blood pressure dropped.

Far left: Kerri Peterson with Chris Meador, Captain of the Oxford Fire Department. Above: Kerri with her mother, Kristy, and the first responder team who helped to save her life.

Dr. Sabedra arranged for a transfer that afternoon to the Bethesda North Intensive Care Unit.

TURNING THE CORNER A few hours after arriving at Bethesda North, Kerri was weaned off the ventilator. Four days later, she was discharged. Before heading home to Buffalo, mother and daughter visited the firehouse and the nurses and physicians who cared for her. “We felt it was important to personally thank the first responders and medical staff,” says Kristy. At the firehouse, the entire EMS team came to see her. When Chris Meador saw Kerri, “My jaw dropped,” he recalls. He was thrilled to see her progress and to share with Kerri and Kristy what had happened less than a week earlier. “Everyone was very excited to see Kerri, and we were grateful to have the opportunity to meet the first responders and thank them,” says Kristy. The next stop was MHMH, where Kristy and Kerri thanked the staff, including the Emergency Department nurse who treated Kerri when she first arrived at the hospital. “She was surprised and happy to see Kerri, and she told us about her condition,” recalls Kristy. “It was a very emotional visit.” Today, Kerri has fully recovered and returned to Miami for her sophomore year. “I’m grateful to everyone who helped me,” she says. Kristy echoes that sentiment. “We couldn’t have asked for better care,” she says. “Kerri was surrounded by caring and talented professionals, and words can’t express how thankful we are to each and every one of them.”

FOR 24/7, HIGH-QUALITY EMERGENCY CARE, VISIT McCULLOUGH-HYDE MEMORIAL HOSPITAL’S EMERGENCY DEPARTMENT.

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WHERE TO GET THE VACCINE

STEER CLEAR OF THE FLU WHY THE BEST TIME TO GET YOUR FLU SHOT IS NOW.

THE VIRUSES THAT CAUSE the flu circulate year-round, but the number of people who contract them spikes dramatically in the fall. That’s because viruses spread more easily when people begin spending more time indoors. “Flu shots are typically available starting in October,” says Amanda Masheck, RN, the infection preventionist for McCulloughHyde Memorial Hospital (MHMH). Everyone is at risk for the flu, but for some people, the outcome can be deadly. Last year’s flu season was among the worst in a decade, with up to nearly 43 million Americans contracting the illness, according to the Centers for Disease Control and Prevention. The flu contributed to as many as 61,200 deaths last year. “If you get the flu, it can lead to other dangerous illnesses, like pneumonia,” says Masheck. “Thousands of people die from

Ready for your flu shot—or need to see a doctor because you’re experiencing symptoms? Visit Oxford Urgent Care at 5151 Morning Sun Road. This walk-in clinic is open seven days a week and offers everything from vaccinations and lab tests to diagnosis and treatment of common illnesses. Appointments aren’t necessary. “We welcome the community to stop by to get their flu shots,” says Neil Kamphaus, Jr., Director of Urgent Care and Practice Management at McCullough-Hyde Memorial Hospital.

flu-related causes every year, and while they affect people of all ages, they are most dangerous for young children and people over 65.”

REDUCING YOUR RISK It’s important to get vaccinated annually because the viruses that cause the flu are constantly changing. Every year around February, the five World Health Organization Collaborating Centers for Reference and Research on Influenza determine which flu strains will be most common for the upcoming flu season so that the vaccines can be prepared ahead of time. For the 2019-2020 flu season, there will be a trivalent (three-component) vaccine that protects against two influenza A (H1N1 and H3N2) viruses and one influenza B virus. A four-component

Greg Calkins, MD Medical Director Oxford Urgent Care

Stephanie Martin, NP Nurse Practitioner Oxford Urgent Care

(quadrivalent) vaccine will provide protection against an additional influenza B virus. Flu vaccines reduce the risk of contracting the illness by about 40 to 60 percent. “Even if you do wind up catching the flu, getting vaccinated can often reduce the severity of the illness,” says Masheck.

IF YOU NEED IMMEDIATE MEDICAL ATTENTION, HEAD TO OXFORD URGENT CARE. FOR MORE INFORMATION, CALL 513.524.5522 OR VISIT WWW.TRIHEALTH.COM/MHMH AND CLICK ON SERVICES/URGENT-CARE.

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FALL 2019 | TRIHEALTH.COM/MHMH

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WHAT’S YOUR FLU IQ? TAKE OUR QUIZ AND SEE HOW PREPARED YOU REALLY ARE FOR THIS YEAR’S FLU SEASON. Maybe the flu won’t strike you this year, with its fever, dry cough, sore throat, body aches and chills. But why take your chances? The Centers for Disease Control and Prevention (CDC) estimates that tens of thousands of people die from the flu and flu-related complications each year. Prevention is key. Take our quiz, which is based on the latest CDC information, and learn what to do to avoid the flu. 1. Which of these symptoms is more specific to the flu than to a common cold? a. Cough b. Body ache c. Congestion d. Sneezing e. None of the above

3. When you’re exposed to the flu, how long does it typically take for you to become ill? a. One to four days b. One week to 10 days c. An hour or two d. A month e. Instantly

6. Which of these is true about the flu? a. It is caused by being cold and wet b. It always comes with a fever c. It is caused by a virus d. It cannot be diagnosed through tests e. You can catch the flu from the vaccine

2. Which of these are good steps to take to avoid getting the flu? a. Avoid infected individuals b. Get a flu vaccine c. Drink lots of fluids and maintain a balanced diet d. Wash your hands often e. All of the above

4. Who is not among those at highest risk for developing serious complications from the flu? a. Pregnant women b. People 65 years of age and older c. People who work more than 40 hours per week d. People with chronic illnesses like asthma and diabetes e. Young children

7. What is the No. 1 step recommended by the CDC to avoid getting the flu? a. A flu vaccine at the start of flu season (usually October/November) b. Plenty of vegetables and fruits c. At least eight hours of sleep/night d. Staying away from populated areas e. Daily doses of aspirin

5. Which of these are recommended to help avoid the spread of the flu? a. Cough or sneeze into the crook of your arm b. Wash hands frequently with warm water and soap c. Stay away from work if you have symptoms d. Avoid touching your eyes, mouth and nose e. All of the above

YOUR FLU IQ: How many did you get right, and where do you rank? No matter your score, use the insights gained to reduce your future risk. 6–7: You’re flu-prevention smart 4–5: Your flu facts need a booster shot 2–3: The flu is likely in your future 0–1: You have no clue about the flu

ANSWERS: 1. b; 2. e; 3. a; 4. c; 5. e; 6: c; 7: a OXFORD HEALTH & LIFE | FALL 2019

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A HEALTHY SCHOOL YEAR HOW TO HELP YOUR CHILD FEEL HIS OR HER BEST—AND AVOID INJURY. START THE SCHOOL YEAR off right by following these simple tips from Sandra Flaishmakher, MD, a pediatrician at Oxford Pediatrics:

PROVIDE NUTRITIOUS LUNCHES AND SNACKS. • Serve brown, not white, starches. Brown rice, pastas and grains have more fiber than their white counterparts. “Fiber helps regulate digestion,” says Dr. Flaishmakher. • Prepare healthy snacks that can be eaten on the run. Place baby carrots in plastic bags and put them in the refrigerator. Slice apples and add lemon to the plastic bag to prevent browning.

SIDESTEP SPORTS INJURIES. • Make sure your child wears a helmet when biking, skating or participating in any activity that could lead to a head injury. • Avoid dehydration. “Up to age 9, kids should drink one cup of water for every year of life per day,” says Dr. Flaishmakher. “Older kids should drink eight 8-ounce glasses of water per day.” Avoid soda and other caffeinated drinks, which can lead to dehydration. To make water more palatable, flavor it with fruit, such as strawberries, grapes, lemons or limes. • Slather sunscreen on your child before he or she heads outside for a sports practice or a playdate.

HELP YOUR CHILD GET ENOUGH SLEEP. • Kids ages 6 through 12 should sleep nine to 12 hours per night, and teens up to age 18 should get eight to 10 hours of sleep, according to the American Academy of Pediatrics. • Turn off electronics at least two hours before bed. Screens trick the brain into thinking it’s the middle of the day. • If your child is eating a large dinner, serve it to him or her at least two hours before bedtime. Otherwise, it could disrupt sleep. • If your child showers before bed, encourage warm—not hot— ones. A hot shower could keep him or her awake.

TO MAKE AN APPOINTMENT WITH SANDRA FLAISHMAKHER, MD, FAAP, AT OXFORD PEDIATRICS AT THE OXFORD OR ROSS OFFICE, CALL 513.523.2156.

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Sandra Flaishmakher, MD,

A NEW PEDIATRICIAN Oxford Pediatrics welcomes Sandra Flaishmakher, MD, FAAP, a board-certified pediatrician who joined the practice in August. Dr. Flaishmakher was a fellow in clinical neonatology and pulmonary biology at Cincinnati Children’s Hospital and did a post-graduate residency in general pediatrics at St. Barnabas Hospital in New York City. She earned her medical degree from Ben-Gurion University of the Negev in Beer Sheva, Israel.

FALL 2019 | TRIHEALTH.COM/MHMH

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{ POWER FOOD }

HOW SWEET IT IS VITAMIN-PACKED SWEET POTATOES LEAVE WHITE SPUDS IN THE DIRT. A PRIMARY SOURCE of nourishment for native Americans, early European colonists and soldiers during the Revolutionary and Civil Wars, sweet potatoes later were relegated to holiday tables, served as a complement to a Thanksgiving turkey or holiday roast. Today, sweet potatoes are making a comeback: orange-fleshed mashes, fries and tots are commonly found on restaurant menus and in the frozen-food aisle at grocery stores. Though fried potatoes of any color should be eaten sparingly, baked or boiled sweet potatoes offer exceptional health benefits.

POWER UP Considered one of the healthiest vegetables of all, sweet potatoes are the root of a tropical vine in the morning-glory family. Brimming with beta-carotene, fiber and vitamins A (five times the recommended daily intake), C and E, they’re a good choice when it comes to adding cancer-fighting nutrients to your diet and improving digestive health. Compared to white (also called Irish) potatoes, they have more vitamins, more fiber, fewer calories and fewer total carbs—despite having more sugar. They’re also fat-free.

50%

of U.S. sweet potatoes are grown in North Carolina

2X

Sweet potatoes have twice the fiber of a white (Irish) potato

BUY/STORE/SERVE When shopping, choose sweet potatoes that are firm and smooth, without bruises or discoloration. Store them unwashed in a cool, dry place and use within three to five weeks. Sweetness increases during storage. Don’t refrigerate—the cold turns the potato’s natural sugars to starch. Like white potatoes, sweet potatoes can be baked, grilled, boiled or microwaved. Lightly season with salt and pepper or highlight their sweet side by sprinkling with brown sugar and cinnamon. For healthy potato chips, slice thinly, brush lightly with olive oil and bake for 15 minutes at 350 degrees (or until lightly browned and crisp). Try adding thinly sliced, cooked sweet potato to your sandwich, or pop sweet potato slices on the grill until browned to your liking, then drizzle with lime juice. And, of course, you can mash them. You can also shred them onto a salad and eat them raw.

DID YOU KNOW? Sweet potatoes and yams are two different vegetables. Sweet potatoes offer more nutritional benefits and are more widely available in the U.S.

1

U.S. president was a sweet potato farmer (George Washington)

2,700+

Years humans have been cultivating sweet potatoes

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Close, Convenient Primary Care. Make an appointment. Get right in. TriHealth has the most primary care physicians in Butler County. And, at Oxford Internal Medicine we are connecting you with a collaborative team of primary care physicians who can help you navigate any health issue that comes your way. For over 60 years, we’ve stood by this community, adding and expanding our services to meet your changing needs.

Oxford Internal Medicine is welcoming new patients. Office locations: Oxford 12 West Church Street 513 523 4195

Brookville, Indiana 10058 Cooley Road 765 647 3557

West College Corner 121 West Liberty Avenue 765 732 3114 To find a doctor visit TriHealth.com/MHMH

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Oxford Fall 2019  

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