Inside Columbia's 2017 Medical Guide

INSIDE COLUMBIA’S

MEDICAL GUIDE 2017

BE SUN SAVVY Page 42

AN EMERGENCY GUIDE TO CPR Page 28

WHAT’S IN A FIRST-AID KIT Page 18

2017 || Inside Columbia’s Medical Guide

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CONTENTS 16

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An Inside Columbia Publication January–December 2017: Volume 4

Publisher Fred Parry fred@insidecolumbia.net Associate Publisher Melody Parry melody@insidecolumbia.net Chief Executive Officer Cathy Atkins catkins@insidecolumbia.net

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Copy Editor Brett Dufur brett@insidecolumbia.net Editorial Assistant Peg Gill peg@insidecolumbia.net Contributing Writers Peg Gill, Kristen Herhold, Morgan McCarty, Hilary Weaver

Graphic Designers Shelby Finch Shelby@insidecolumbia.net Joe Waner joewaner@insidecolumbia.net

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Photo Editor L.G. Patterson lg@insidecolumbia.net

Columbia’s Medical Network /Health Care Numbers To Know Beyond 911

Operations Manager Adam Brietzke adam@insidecolumbia.net

Columbia’s Favorite Doctors 2017 Tips For Choosing A Physician

Marketing Representatives Joshua Huber josh@insidecolumbia.net

Emergency Room Versus Urgent Care: Where Should You Go?

Marketing Representatives Matt Melton matt@insidecolumbia.net

First-Aid Tips What’s In A First-Aid Kit

Marketing Representatives Alex Stear alex@insidecolumbia.net

Facts About Organ Donation Deciphering Special Diets The Steps For CPR

Finance Manager Chad Morrow cmorrow@insidecolumbia.net

How To Preform The Heimlich Bacteria Vs Virus Knowing Your Vaccines Sun Safety Walking To Wellness

Inside Columbia magazine Zimmer Strategic Communications 3215 Lemone Industrial Blvd., Suite 200 Columbia, MO 65201 Office: 573-442-1430 Fax: 573-442-1431 www.InsideColumbia.net

Identifying A Heart Attack Is This A Stroke?

Inside Columbia’s Medical Guide || 2017

Please Recycle This Magazine.

2017 || Inside Columbia’s Medical Guide

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For Your Information

Medical Center

Columbia’s vast medical network means residents and visitors have easy access to high-quality health care — and one of the highest number of hospital beds per capita in the country. The city’s hospitals, cancer centers and rehabilitation facilities contribute to a growing economy, attract top-notch professionals, and provide patients with progressive and specialized services.

Boone Hospital Center, part of BJC HealthCare, opened in December 1921 as the first public hospital in Boone County. Today, Boone Hospital serves 25 mid-Missouri counties and employs approximately 2,000 staff members, with 350 physicians on its medical staff. The 397-bed full-service hospital excels in cardiology, neurology, oncology, surgical and obstetric services, and numerous other specialties.

Boone Hospital opened the Virginia and Norman Stewart Cancer Center in January 2014. The center incorporates the latest in health care design for the comfort and safety of cancer patients and their families, and encompasses all of Boone Hospital’s cancer services.

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health care numbers to know BOONE HOSPITAL CENTER 1600 E. Broadway 573-815-8000 www.boone.org

LANDMARK HOSPITAL 604 Old 63 N. 573-499-6600 www.landmarkhospitals.com

ELLIS FISCHEL CANCER CENTER 1 Hospital Drive 573-882-2100 www.muhealth.org

HARRY S. TRUMAN MEMORIAL VETERANS’ HOSPITAL 800 Hospital Drive 573-814-6000 www.columbiamo.va.gov

FAMILY HEALTH CENTER 1001 W. Worley St. 573-214-2314 www.fhcmo.org

BOONE MEDICAL GROUP SOUTH 900 W. Nifong Blvd #101 573-499-9009 www.boone.org/nifong

MISSOURI PSYCHIATRIC CENTER 3 Hospital Drive 573-884-1300 www.muhealth.org

RUSK REHABILITATION CENTER 315 Business Loop 70 W. 573-817-2703 www.ruskrehab.com

MISSOURI REHABILITATION CENTER 600 N. Main St., Mount Vernon 417-466-3711 www.muhealth.org

UNIVERSITY OF MISSOURI WOMEN’S AND CHILDREN’S HOSPITAL 404 Keene St. 573-875-9000 www.muhealth.org

UNIVERSITY HOSPITAL 1 Hospital Drive 573-882-4141 www.muhealth.org

university of missouri health care (includes University Hospital and Clinics, Ellis Fischel Cancer Center, the Missouri Orthopaedic Institute, the Missouri Psychiatric Center, and MU Women’s and Children’s Hospital, all in Columbia, plus the Missouri Rehabilitation Center in Mount Vernon) employs 5,371 people. With more than 569 beds, the health system employs more than 600 physician specialists who treat more than 76,977 emergency patients, perform more than 23,439 surgical operations and deliver more than 2,058 babies each year. University Hospital is also home to mid-Missouri’s only Level I trauma center. Clinical specialties include comprehensive care for patients with cancer, cardiovascular, neurological and gastrointestinal diseases. Services include orthopaedic surgery, primary care, behavioral health, trauma and acute-care surgery, women’s health, neurosurgery, and pediatric and neonatal intensive care.

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For Your Information

Beyond 911

Here are the numbers you need to know.

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f you need to reach a health professional, but it’s not an emergency, don’t clog the 911 lines and distract the attendants from actual emergencies.

You should call 911 only if you are experiencing a serious, life-threatening problem, so it’s important to know health numbers beyond those three digits.

Local Hospitals Knowing the numbers of local hospitals allows you to quickly call for advice on a health matter. If you are visiting a loved one at a hospital, you can call ahead to find out the patient’s room number, which will allow you more time with the patient when you arrive.

Boone Hospital Center: 573-815-8000 University Hospital: 573-882-4141 Harry S. Truman Memorial Veterans’ Hospital: 573-814-6000 Landmark Hospital: 573-499-6600 Rusk Rehabilitation Center: 573-817-2703

Urgent Care Calling ahead to an urgent care center will let you know the wait time of the particular center. Some centers can put you on the waiting list.

Providence Urgent Care: 573-874-6824, 573-818-6500 University Physicians Urgent Care: 573-882-1662 Broadway Urgent Care: 573-777-5880 Boone Convenient Care: 573-874-0008

poison control Dial this toll-free number to reach an expert concerning contact with and exposure to poisonous materials. This includes treatment for stings and bites, and exposure to nonprescribed medications, household products, pesticides, chemicals and other toxins.

BY KRISTEN HERHOLD

The Poison Control Center takes 10,830 calls each day, and 72 percent of all exposures to poisons can be handled over the telephone. This saves the money and time of going to the emergency room. 800-222-1222

Columbia Police Department If you need to contact the police and the situation is neither urgent nor an emergency, call the station directly, and officers will be dispatched when they are not focusing on more pressing matters.

573-442-6131

Columbia Fire Department As with the police station, clogging up the phone system with an unnecessary 911 call to the fire department can get in the way of real emergencies.

8 a.m. to 5 p.m.: 573-874-7391 After 5 p.m. and weekends: 573-874-7450

pharmacy Knowing your local pharmacy’s number will ensure you can order your medications immediately after you receive your prescription. Call in, and your prescription will be waiting for you when you arrive to pick it up.

Pharmacy Telephone No.

relatives and neighbors Keep these numbers close to the phone.

Any time you need a helping hand, you can easily reach nearby relatives and neighbors. This will save you the time of looking up numbers you should have programmed on your phone.

Name Telephone No. Name Telephone No. Name

physician and dentist

Telephone No.

People should keep the number of their physicians and dentists stored in their cell phone. Your physician is the doctor who knows you best, and calling to receive advice from and make an appointment with your own personal doctor is more beneficial than going into another clinic with a doctor who is not familiar with your needs or medical history.

If you have problems with your teeth or mouth, it’s best to contact your dentist’s office, which will likely be able to schedule an immediate appointment.

Your dentist can help you with dental emergencies much better than a doctor in an emergency room can.

Doctor Telephone No. Dentist Telephone No.

Name

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Telephone No.

ice If faced with an emergency, responders commonly look for your emergency contact in your cell phone, which should be stored as “ICE” (in case of emergency).

Saving your loved one’s number as ICE will ensure he or she is reached in case you do find yourself in an emergency, unable to contact him or her on your own.

Name Telephone No. Name Telephone No.

things you should take with you to the doctor ❏❏ List of medications you’re currently taking ❏❏ Medical history ❏❏ Changes to your medical history ❏❏ Journal of symptoms and questions ❏❏ List of allergies ❏❏ Insurance information

Be sure to keep handy a list of allergies that affect you and your family members.

2017 || Inside Columbia’s Medical Guide 11

Top Docs

Columbia’s Favorite Doctors 2017

Introducing our annual list of Columbia’s MVPs (most valuable physicians).

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hen we decided to put together a list of Columbia’s top doctors, we didn’t consult cold statistics or some out-of-town list maker.

We asked the people who know best: their peers. We put out a call for nominations last November and were overwhelmed by the response. More than 100 physicians took the time to complete an online survey and nominate their fellow doctors.

1. Allergy/Immunology

15. Infectious Disease

28. Pathology

41. Cardiovascular Surgery

53. Otolaryngology/Head and

Wes Stricker – Allergy &

William Salzer – University

Grant Darkow – Boyce &

Richard Mellitt – Missouri

Neck Surgery

Asthma Consultants

of Missouri Healthcare

Bynum Pathology Labs

Heart Center

Jeff Jorgensen – University of

2. Anesthesiology

16. Internal Medicine

29. Pediatrics

42. Colon and Rectal Surgery

Missouri Healthcare

Quinn Johnson – University

Douglas Vogt – Boone

Nathan Beucke – University

Erik Grossmann – Columbia

54. Pediatric General Surgery

of Missouri Healthcare

Hospital

of Missouri Healthcare

Surgical Associates

Venkataraman Ramachan-

3. Burn Treatment

17. Maternal-Fetal Medicine

30. Physical Medicine and

43. General Surgery

dran – University of Missouri

Jeffrey Litt – University of

(Perinatology)

Rehabilitation

Arthur Rawlings – University

Healthcare

Missouri Healthcare

Dan Jackson – University of

Greg Worsowicz - University

of Missouri Healthcare

55. Pediatric Orthopedic

4. Cardiac Electrophysiology

Missouri Healthcare

of Missouri Healthcare

44. Laparoscopic Surgery

Surgery

Greg Flaker – University of

18. Medical Toxicology

31. Podiatry

Arthur Rawlings – University

Daniel Hoernschemeyer

Missouri Healthcare

Robert Cheek – Boyce &

Ben Summerhays – Missouri

of Missouri Healthcare

– University of Missouri

5. Cardiovascular Disease

Bynum Pathology Labs

Orthopeadic Institute

45. Maxillofacial Surgery

Healthcare

Arun Kumar – University of

19. Neonatology

32. Psychiatry

Adam Andrews – Office of

56. General & Reconstructive

Missouri Healthcare

John Pardalos - University of

Angela Del Priore – Univer-

Columbia Oral & Maxillofa-

Plastic Surgery

6. Dermatology

Missouri Healthcare

sity of Missouri Healthcare

cial Surgery

Stephen Colbert – University

Jon Dyer – University of Mis-

20. Nephrology

33. Pulmonary Disease

46. Neurological Surgery

of Missouri Healthcare

souri Healthcare

Ramesh Khanna – University

Harjyot Sohal – University of

Charles Bondurant – Mid-

57. Plastic (Abdominoplasty)

7. Emergency Medicine

of Missouri Healthcare

Missouri Healthcare

Missouri Neurosurgery

Gregory Croll

Matthew Robinson – Univer-

21. Neurology

34. Radiology

47. Ophthalmologic Surgery

58. Plastic (Breast Augmen-

sity of Missouri Healthcare

Raghav Govindarajan –

Julia Crim – University of

Carisa Petris – University of

tation)

8. Endocrinology

University of Missouri

Missouri Healthcare

Missouri Healthcare

Lin Puckett – University of

Stephen Brietzke – Univer-

Healthcare

35. Reproductive

48. General Orthopedic

Missouri Healthcare

sity of Missouri Healthcare

22. Nuclear Medicine

Endocrinology

Surgery

59. Plastic (Facial Surgery)

9. Fertility

Amolak Singh – University of

Gilbert Wilshire – Mid-Mis-

Todd Oliver – Columbia

David Chang – University of

Gil Wilshire – Mid-Missouri

Missouri Healthcare

souri Reproductive Medicine

Orthopedic Group

Missouri Healthcare

Reproductive Medicine

23. Obstetrics and Gynecology

36. Rheumatology

49. Orthopedics (Foot &

60. Podiatric Surgery

10. Family Medicine

Courtney Barnes – University

Celso Velazquez – University

Ankle Surgery)

Ben Summerhays – Missouri

Amanda Allmon – University

of Missouri Healthcare

of Missouri Healthcare

Brian Kleiber – Columbia

Orthopeadic Institute

of Missouri Healthcare

24. Occupational Medicine

37. Sports Medicine

Orthopedic Group

61. Surgical Oncology

11. Gastroenterology

Kevin Komes – University of

Aaron Gray – University of

50. Orthopedics (Hand

Kevin Staveley-O’Carroll

Matt Bechtold – University of

Missouri Healthcare

Missouri Healthcare

Surgery)

– University of Missouri

Missouri Healthcare

25. Ophthalmology

38. Urgent Care

Matthew Jones – Columbia

Healthcare

12. Geriatric Medicine

Geetha Davis – University of

Karli Urban – University of

Orthopedic Group

62. Trauma Surgery

Paul Tatum – University of

Missouri Healthcare

Missouri Healthcare

51. Orthopedics (Spinal)

Jeffrey Coughenour –

Missouri Healthcare

26. Otolaryngology (Ear,

39. Urology

Christina Goldstein –

University of Missouri

13. Hematology/Oncology

Nose, and Throat)

Mark Wakefield – University

University of Missouri

Healthcare

Donald Doll – University of

Jeff Jorgensen – University of

of Missouri Healthcare

Healthcare

63. Vascular Surgery

Missouri Healthcare

Missouri Healthcare

40. Bariatric Surgery

52. Orthopedics (Sports

Paul Humphrey – Boone

14. Hopitalist

27. Pain Management

James Pitt – Columbia Surgi-

Medicine & Arthroscopy)

Hospital Center

Kevin Clary – University of

Ebby Varghese – University

cal Associates

Seth Sherman – University of

Missouri Healthcare

of Missouri Healthcare

12 Inside Columbia’s Medical Guide || 2017

Missouri Healthcare

2017 || Inside Columbia’s Medical Guide 13

Choices

Choosing A Physician

Use care when selecting a doctor. BY HILARY WEAVER

where he or she completed residency training. By looking into a physician’s qualifications, you can feel more comfortable that you’ve found the right fit.

How to find who you need Sometimes, the best research can be conducted within the confines of your own social circle. Ask your friends about the doctors who work best for their families or their own needs. Consider your friends’ opinions but place what you need above what others tell you.

Check to make sure a particular doctor participates in your insurance plan.

How to find the facts

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randma’s home remedies may not do the trick when something more than chamomile tea is in order. For those rare urgent medical emergencies, you need to have the right doctor for the situation. Here are some simple guidelines with advice from the U.S. National Library of Medicine to help you choose the best physician for your family.

How to know who you need The first thing to consider is the size of your family. This factor will help

decide what kind of physician you need. Do you need a primary health care provider or a physician whose expertise is less broad and involves a particular area or condition?

Once you know the type of doctor you need, consider a doctor’s personality (commonly known as bedside manner). Find out how he or she approaches communication and if he or she has a conservative or aggressive approach to treatment. Find out where the doctor went to medical school and

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Do your research. Considering where a doctor went to school is important, but a degree from a top school doesn’t always mean the individual is a quality, caring physician.

After selecting a physician who meets your requirements, find out more about his or her specialty or areas of expertise. Make sure the doctor is in good standing with state licensing agencies.

If possible, set up an interview with the physician and ask some pointed questions about his or her practice.

Doing some homework now will help ensure the right physician is there to help when your family’s health is in the balance.

2017 || Inside Columbia’s Medical Guide 15

Choices

ER vs. Urgent Care

Different circumstances call for different care environments. BY MORGAN McCARTY

T

he difference between visiting an emergency room and an urgent care center can be expensive, timely and potentially life-saving.

The National Association for Ambulatory Care offers this guide to knowing when to go to the ER, and when to visit an urgent care center.

Emergency Room Visit the emergency room only when you have a life-threatening situation. »» Chest pain »» Abdominal pain »» Sudden or severe pain »» Difficulty breathing »» Severe bleeding or head trauma »» Loss of consciousness »» Sudden loss of vision or blurred vision

Urgent Care Center Most urgent care centers have extended hours and are the best option to treat non-lifethreatening conditions. »» Minor burns or injuries »» Sprain and strains »» Coughs, colds and sore throats »» Ear infections »» Allergic reactions (non-life-threatening) »» Fever or flu-like symptoms »» Rash or other skin irritations »» Mild asthma »» Animal bites »» Broken bones When in doubt, call ahead. If the urgent care clinic of your choice can’t properly treat your condition, the staff will advise you to go to the nearest emergency facility.

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local emergency rooms

601 Business Loop 70 W. Parkade Center, Suite 275 573-874-0008

UNIVERSITY HOSPITAL 1 Hospital Drive 573-882-4141

BROADWAY URGENT CARE 2003 W. Broadway, Suite 100 573-777-5880

BOONE HOSPITAL CENTER 1600 E. Broadway 573-815-3501

PROVIDENCE URGENT CARE 202 E. Nifong Blvd.

573-874-6824 403 N. Stadium Blvd. #104 573-818-6500

local urgent care centers

CONVENIENT CARE AT BOONE HOSPITAL CENTER

URGENT CARE AT UNIVERSITY PHYSICIANS 1020 Hitt St. 573-882-1662 573-882-4141

First-Aid

First-Aid Tips

Be prepared to handle life’s mishaps. BY MORGAN McCARTY

Treating Burns

»» »» »» »»

Run cold water over the affected area or place a cold compress on it.

Once cooled, apply antibiotic ointment over the area.

Leave the injured area uncovered to breathe.

If the burn is severe, covers a large surface area, is on the face or close to the mouth, or begins to blister, visit an emergency center.

Treating Bee or Wasp Stings

»»

»»

Treating A Minor Cut

»»

»»

»» »» »»

Thoroughly wash the injured area with warm water and soap.

If you use hydrogen peroxide, first dilute the solution 50 percent with water to prevent irritation.

After cleaning, place pressure on the cut to stop the bleeding.

Once the cut has stopped bleeding, place an adhesive bandage over it.

If the skin is fully split (lacerated), or the bleeding doesn’t cease, visit an emergency center for further treatment.

Treating Breathing Difficulties

»»

»» »»

»»

If the individual cannot talk or breathe, and skin color is turning blue or dusky, he or she may be choking.

Try to dislodge the object with a combination of abdominal thrusts and back blows (see Page 28).

If the individual is not breathing due to a possible heart attack, stroke or other sudden emergency, call 911 and check for a heartbeat.

If no heartbeat is detected, immediately begin to perform handsonly CPR (see Page 28).

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If the individual is allergic to bees or wasps, act immediately with EpiPen or the appropriate countermeasure; if allergy medication is unavailable, take the victim to an emergency center.

If no allergy is known to you: 1. Apply ice immediately.

2. Use tweezers to remove the stinger (if visible to you).

3. Apply antihistamine cream to the site and administer Benadryl orally (liquid or capsule) to prevent any type of allergic reaction.

4. Monitor individual for signs of extreme swelling, itching or difficulty breathing.

5. If any of the above symptoms develop, take the individual to an emergency center.

Treating Suspected Broken Bone

»»

»» »»

»» »»

Construct a brace using household items such as large popsicle sticks or a piece of stiff cardboard.

Place material on either side of the suspected break.

Wrap the material together using an ace bandage or any long piece of cloth such as a scarf or dish towel.

Seek care from a medical professional.

It is less obvious when a child breaks a bone. If he or she complains about pain for several days, take the child to the doctor.

Treating Knocked-Out Teeth (PRIMARY ADULT TEETH) »» Place primary tooth in milk. »» Visit emergency center to have it reattached.

Treating Poison Ingestion

»»

»»

If an adult or child has ingested a foreign object or substance, call Poison Control immediately at 800-222-1222.

Determine the danger of the ingestion with the poison-control specialist.

Treating Animal Bites

»» »» »» »»

Treat most animal bites as you would a cut.

Find out as much information about the animal as you can.

If it is a pet, ask if it has had its shots.

If the animal is wild, take note of its behavior and call your physician or take the victim to the emergency room immediately.

Don’t forget to do an annual medicine cabinet cleanout.

Throw out expired medicine and restock accordingly. The same goes for your first-aid kit. See Page 18 to learn what to keep in your first-aid kit.

2017 || Inside Columbia’s Medical Guide 19

First-Aid

What’s In Your First Aid Kit?

Learn what to have on hand for an emergency situation.

BY MORGAN McCARTY • PHOTOS BY L.G. PATTERSON

K

eep a well-stocked first-aid kit handy and you’ll be ready to treat life’s little emergencies.

Make sure to take inventory of your kit frequently so that you’re never out of the essentials. Boone Hospital Center suggests stocking the following:

Trauma pack

Gauze dressing pads Antiseptic pads

Burn relief pack Fabric bandages

Bandages:

»» »» »» »» »» »» »» »» »» »»

Adhesive tape Butterfly bandages Elastic bandages Hypoallergenic tape Sling (triangularshaped cloth) Sterile cotton balls Sterile eye patches Sterile gauze pads (4by-4 inch) Stretchable gauze roll Waterproof tape

Cotton balls Adhesive

Ibuprofen tablets

Instruments:

»» »» »» »»

Bulb syringe Scissors Thermometer Tweezers

Plastic bandages

tape roll

Alcohol cleansing pad

Aspirin tablets

Cotton-tipped

Forceps

applicators

Calamine lotion

Wood finger splint Cortizone lotion Bulb syringe

20 Inside Columbia’s Medical Guide || 2017

Matches

Hand sanitizer

Emergency blanket

Red Cross First Aid Guide

Hydrogen peroxide

Tweezers

Check your first aid kit at least once a month to make sure the medications haven’t expired and to restock supplies. Leave an index card inside the kit and mark it with the inspection dates.

Thermometer

Flashlight

Instant cold compress Exam gloves

Medications:

»» »» »» »» »» »» »» »» »» »» »» »»

Acetaminophen Antacid Antibiotic ointment Antidiarrheal medication Antihistamine Antiseptic ointment Aspirin Calamine lotion Decongestant Hydrocortisone cream Ibuprofen Sugar or glucose solution

Miscellaneous Items:

»» »» »» »» »» »» »» »» »» »»

Alcohol (rubbing, 70 percent) Alcohol wipes Blanket Candles Chemical hot packs or hot-water bottle Chemical ice packs or ice bag Cotton swabs Disposable gloves (nonlatex if you or a loved one has a latex allergy) Emergency contact numbers Face mask for cardiopulmonary resuscitation (CPR)

»» »» »» »» »» »» »» »» »» »» »» »» »» »»

First-aid book Flashlight Insect repellent Insect sting swabs List of allergies Matches Measuring spoons Paper and pencil Paper cups Safety pins Soap Sunscreen Tissues Tongue blades

2017 || Inside Columbia’s Medical Guide 21

DECISIONS

Beginnings From An End Know the truth about organ donation.

F

or someone waiting for an organ transplant, hope is tempered with the knowledge that the gift they so desperately need will come only when someone else’s life ends. But for the families of donors, knowing their loved one’s organs are helping someone else live on can be a tremendous comfort.

“The idea of organ donation used to kind of creep me out,” says Lauren Helmreich. When her mother, Carla, died several years ago, Lauren gained a new perspective. “It’s cool knowing that while my mom isn’t here, she’s living on through someone else. Now that I’ve seen the impact, I’ve become an organ donor myself.”

According to Brooke Connell, marketing and public relations specialist with the Midwest Transplant Network, approximately 22 people die each day waiting for an organ transplant, and a new name is added to the national waiting list every 10 minutes.

Based on information provided by the United Network for Organ Sharing, there currently are 1,897 people in Missouri awaiting life-saving organ transplants.

Although there’s a tremendous need for organ donors, some common myths keep many people from registering. Connell says she thinks “some television shows and movies perpetuate the myths associated with organ donation,” adding that MTN tries to address the myths through its community education effort and with its marketing.

“With our marketing campaign, we try to show that regardless of what you look like, how healthy you are or what age you are, you could still potentially be a donor. It’s a chance for you to extend your legacy and change someone’s life for the better.”

BY PEG GILL

Common Myths About Organ Donation Myth: “If I’m an organ donor the hospital staff won’t work as hard to save my life.”

Truth: The medical team treating you is separate from the transplant team, and its goal is to save your life. MTN is not notified until all life-saving efforts have failed.

Myth: “The hospital might jump the gun and declare me dead when I’m really not, because it wants to use my organs.”

Truth: Actually, people who’ve agreed to be organ donors undergo more tests (at no charge to their families) before they’re pronounced dead than those who haven’t signed up to be donors.

Myth: “I’m not healthy enough to be an organ donor.”

Truth: At the time of death, MTN will review medical and social histories to determine donor suitability on a case-by-case basis.

Myth: “I’m probably too old to donate.”

Truth: The decision to use organs is based strictly on medical criteria, not age. There have been donors as old as 93.

Myth: “My religion doesn’t approve of organ donation.”

Truth: Most major religions have no problem with organ donation, typically considering it a generous act that is the individual’s choice.

Myth: “I’ll have to have a closed-casket funeral.”

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Truth: The donor’s body is clothed for burial, so no signs of organ donation can be seen. Bones that are donated are replaced with rods, while donated tissue is taken from the donor’s back. No one will be able to tell that you were an organ donor when viewing your body.

Myth: “I’m not 18, so I’m not allowed to donate.”

Truth: Legally, that’s true. But your parents can authorize the decision. Let them know that you want to be an organ donor and they can give their consent.

Plenty of children are in need of organ transplants and they usually need smaller organs than those of an adult.

Myth: “My family will have to pay if I donate my organs.”

Truth: The person receiving the transplant pays the costs for organ removal. The family of an organ donor is never charged.

Myth: “People who are wealthy or famous get preferential treatment when they need an organ transplant.”

Truth: A person’s financial situation is never considered; neither is celebrity status.

Although there can be a lot of publicity generated when someone rich or famous receives a transplant, they are treated no differently than the average person.

Myth: “I heard you can get paid for donating your organs.”

Truth: Absolutely not. It is against the law. Congress passed the National Organ Transplant Act in 1984 to outlaw the buying and selling of human organs in this country.

Steps To Becoming An Organ Donor 1. Sign up at the Missouri Organ Donor Registry. To confirm your intention to be an organ donor, begin by registering with the state organ donor database at Donate Life Missouri.

It takes just a few minutes to register online.

After your death, medical personnel will search the state donor registry and easily locate your wish to be a donor. In Missouri, you can also register by mail.

2. Use your Missouri Driver’s License to show you are an organ donor. When you get a new driver’s license in Missouri, you will be asked whether you would like to be an organ and tissue donor. If you say “yes,” a red heart with a green banner will appear on the front of your license, and your information will be forwarded to the state organ donor registry.

(This means that, if you’ve used your driver’s license to indicate that you want to donate, you don’t have to register online.) When you receive your license, you should sign the back with permanent marker and have two witnesses sign it, too.

3. Include organ donation in your durable power of attorney for health care. In addition to signing up with the Missouri Organ Donor Registry and using your driver’s license to indicate that you want to be an organ donor, it’s a good idea to include your desire to donate in your important estate planning documents, especially your durable power of attorney for health care. (It’s not always helpful to include your organ donation wishes in your will, because it may not be found and read until it is too late to donate.)

Covering these bases helps to ensure that your wishes will be known and followed.

4. Tell others that you are an organ donor.

If you’ve documented your wishes to be an organ and tissue donor, your wishes must be honored whether or not others agree with your choice. Nevertheless, to avoid confusion or delays, it’s important to tell others that you feel strongly about donating your organs. Consider discussing the matter with family members, your health care providers, clergy and close friends.

If you don’t document your intention to be an organ donor, these conversations are critical, because your next of kin will make the decision about whether or not to donate your organs.

2017 || Inside Columbia’s Medical Guide 23

Special Diets

Deciphering The Diets Special diets can be a lifestyle choice or a life-saver.

BY PEG GILL • ILLUSTRATIONS BY TREVER GRISWOLD

F

or some, embracing a restrictive diet is about following a hot trend or making an environmental statement, but for others, a special diet is essential to ongoing good health. Learn what is and isn’t allowed for some of the most common special diets.

Eating gluten-free Gluten causes inflammation in the small intestine of people with celiac disease or who have a high degree of sensitivity. This means avoiding all food and drinks containing barley (malt, malt flavoring and malt vinegar are usually made from barley), rye, triticale (a cross between wheat and rye), and wheat. Fortunately, many healthy foods are naturally gluten-free, such as fruits, vegetables, lean meats, poultry, fish, eggs, beans, legumes, soy, nuts, as well as the grains amaranth, buckwheat, corn, rice, teff and quinoa. There are also a number of gluten-free flours made from almond meal, chickpeas and garbanzo beans, brown rice, coconut, potato, sorghum, tapioca and white rice. Gluten-free versions of many popular products are becoming more widely available.

Go Low Fat, Low Sodium For Heart Health High blood pressure is the leading cause of stroke. A heart-healthy diet can help reduce the risk. There are some simple steps to take. Limit your intake of saturated fats and trans fat.

Drink and eat only fat-free or low-fat dairy products. Pick lean meats over fattier cuts.

Keep protein sizes in check, and eat only the recommend serving sizes.

Keep your daily sodium intake to 1,500 milligrams or less. Look for foods with labels that say no salt added, unsalted, reduced sodium, lower sodium or sodium free. Avoid labels that say food is in brine, cured, pickled, smoked or marinated.

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Following A Vegetarian Diet Many people eat vegetarian diets for moral, cultural, or religious reasons, but there are also many health-related reasons for the diet. Research has shown that vegetarians are at lower risk for heart disease, diabetes, hypertension, colon cancer and prostate cancer.

Vegetarians don’t eat meat, and mostly eat foods that come from plants, like grains, fruits, vegetables and nuts.

Some stricter vegetarians, known as “vegans,” also avoid animal products such as milk and eggs. There are two important nutrients to watch if you follow a vegetarian or vegan diet — iron and vitamin B12. To make sure you get enough iron, include plenty of green vegetables, whole grains, beans, peas and nuts in your diet.

SPECIAL ADVERTISING SECTION

Columbia’s Favorite Doctors

Erik Grossmann, MD Colon & Rectal Surgery

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ince joining Columbia Surgical Associates in 2006, Dr. Erik Grossmann has built a reputation of excellent patient-centered care. “My mentors taught me to treat the patients as if they were part of my own family,” he said. “When you teach yourself to think that way, the right choice often becomes apparent.”

Board-certified in both general surgery and colon rectal surgery, Grossmann’s practice cares for patients with colon and rectal cancer, Crohn’s disease and ulcerative colitis.

“I am lucky enough to be part of a great team that rescues people from pain and suffering every week,” Grossmann said. “I can’t think of a more fulfilling way to serve the people of Boone County.”

Born and raised in St. Louis, Grossmann graduated from Mizzou with a bachelor’s degree in biology. In 1992, he entered the MU School of Medicine as one of the first Conley Scholars – a pre-admission program that allowed qualified high school students to be pre-admitted to medical school.

Grossmann spent six years as a general surgery resident at Saint Louis University. During this time he completed a fellowship and narrowed in on his specialty of choice.

“I always wanted to help people with cancer, and colorectal cancer is the second most common life threatening cancer in the United States,” Grossman said.

With his decision made, he went on to complete a colon and rectal surgery residency in Shreveport, Louisiana. Since then, Grossmann has authored numerous articles in scientific literature as well as several chapters in textbooks on colon and rectal disease.

When it comes to providing excellent surgical care, experience matters, and the board-certified specialists at Columbia Surgical Associates offer patients the benefit of over 100 years of combined experience.

Columbia Surgical Associates 3220 Bluff Creek Dr. #100 573-443-1082 www.columbiasurgical.com

Peanut Allergy Know-How

Benefits Of A High-Fiber Diet Eating a high-fiber diet is thought to help prevent constipation and its related problems. It may lower blood pressure, improve cholesterol levels, and help control blood sugar levels. And it may help with reaching and staying at a healthy weight. The U.S. Institute of Medicine says men ages 19 and older should strive for 38 grams of fiber a day while women ages 19 and older should strive for 25. Some of the best bets for fiber are beans, lentils, chickpeas, 100-percent bran cereal, pears, apples with skin, cooked bulgur, almonds, and cooked wholewheat spaghetti.

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For people with a peanut allergy, eating peanut protein in any amount can lead to a life-threatening condition called anaphylaxis. This means avoiding any foods that contain cold pressed, expressed, or expelled peanut oil, ground nuts, mixed nuts, Nu-Nuts® artificial nuts, peanuts, peanut butter and peanut flour. People who are allergic to peanuts must be careful not to consume anything that might have been prepared on the same equipment as a peanut-containing product, and therefore cross-contaminated, as even the smallest amount of peanut protein can cause a reaction.

Living With Lactose Intolerance Lactose intolerance occurs when a person’s small intestine lacks the enzyme lactase, which is necessary to digest the sugar lactose.

Symptoms include gas, bloating, diarrhea and upset stomach. Those who are lactose intolerant need to avoid any product containing milk, milk solids, milk powder, malted milk, cream, butter, whey, curds or margarine. Check the ingredients on prepared breads, grains, meats, vegetables, fruits and desserts to ensure lactose wasn’t added during the preparation process. Lactose also is present in some prescription medications, such as birth control pills and over-thecounter medications, such as some tablets for stomach acid and gas.

SPECIAL ADVERTISING SECTION

Columbia’s Favorite Doctors

James B. Pitt, DO Bariatric Surgery

“M

y patients are the whole reason I’m here,” said Dr. James Pitt, bariatric surgeon at Columbia Surgical Associates. “My goal is to make their lives better.” Unlike some specialties where patients go through treatment to get back to the way they were before, Pitt says he enjoys helping patients create a better future: “Basically, their whole life can be transformed.”

Pitt joined Columbia Surgical Associates in 1993 and built a large general surgery practice at his Osage Beach office. In 2000, he joined the Columbia office and led the development of the bariatric surgery program.

“I started in this specialty field because of the tremendous need and the large segment of the population that we can help,” he said.

Pitt can easily relate to his patients because he, too, has had weight-loss surgery. “When I tell a patient I understand what they are experiencing, in general, I do,” he said. Pitt practices Lap-Band surgery, laparoscopic sleeve gastrectomy, laparoscopic gastric bypass surgery and the Orbera intragastric balloon program. In addition

to weight-loss surgery, he specializes in advanced laparoscopic procedures, including laparoscopic antireflux surgery, laparoscopic hernia and gallbladder surgery.

Pitt not only cares for his patients during surgery, he develops lasting relationships with them. “I intend to care for them for the rest of their life,” he said.

A native of Iowa, Pitt graduated from Northeast Missouri State University and attended Kirksville College of Osteopathic Medicine where he received his doctorate in 1988 then served his internship and general surgery residency. He is board-certified in general surgery.

When it comes to providing excellent surgical care, experience matters, and the board-certified specialists at Columbia Surgical Associates offer patients the benefit of over 100 years of combined experience.

Columbia Surgical Associates 3220 Bluff Creek Dr. #100 573-443-1082 www.columbiasurgical.com

First-Aid

The Steps For CPR Learn to perform CPR with and without mouth-to-mouth.

BY MORGAN McCARTY

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ardiopulmonary resuscitation is a technique that helps revive people whose hearts have stopped beating suddenly, according to the American Red Cross. If you witness someone having a heart attack or who has fallen unconscious, check the victim’s vital signs, call 911, and then provide care via CPR. The actions of CPR help supply blood containing oxygen to the brain and other vital organs. In all cases, perform CPR on a firm, flat surface.

For each instance, position your hands by placing the heel of one hand on the person’s sternum (breastbone) at the center of the chest. Place your other hand directly on top of the first hand.

Try to keep your fingers off the victim’s chest by interlacing them or holding them upward. If you feel a notch, move your hands toward the head. While performing CPR, do not stop except in one of these situations: »» The obstructing object is removed and the chest clearly rises when you give rescue breaths. »» The person starts to breathe on his or her own. »» Another trained responder or emergency medical service personnel takes over. »» You are too exhausted to continue. »» The scene becomes unsafe. »» If giving rescue breaths makes the chest clearly rise, quickly check the victim for breathing

CPR for an adult or child who isn’t breathing: 1. Compress an adult’s chest 30 times to a depth of at least 2 inches; compress a child’s chest 30 times to a depth of about 2 inches.

2. Compress at a rate of at least 100 chest compressions per minute; the

30 chest compressions should take about 18 seconds to complete.

3. Look for a foreign object.

4. Open the person’s mouth.

5. If you see an object, remove it with a finger.

6. Give two rescue breaths. Each breath should last about one second.

7. If the breaths do not make the chest clearly rise, repeat cycles of chest compressions, foreign object check/ removal and rescue breaths.

Do not stop CPR unless you witness an obvious sign of life such as breathing, an automated external defibrillator is ready for use, a trained responder appears, you are too exhausted to continue, or the scene becomes unsafe.

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Get CPR certified by attending a certification class at the MidMissouri American Red Cross Branch. Visit www.redcross-midmo.org or call 573-445-9411.

CPR for an infant who isn’t breathing: 1. Give 30 chest compressions at a rate of at least 100 chest compressions per minute.

2. Each compression should be about 1½ inches deep.

3. Look for a foreign object.

4. If you see an object, remove it with your little finger.

5. Give two rescue breaths.

6. If the breaths do not make the chest clearly rise, repeat cycles of chest compressions, foreign object check/removal and rescue breaths.

Hands-Only CPR If you see a teen or adult suddenly collapse in a nonhospital setting such as at home, at work or in the park, the American Heart Association suggests “Hands-Only CPR” to combat cardiac arrest. To conduct Hands-Only CPR: 1. Call 911.

2. Push hard and fast at the center of the chest to the beat of the classic disco song “Stayin’ Alive.”

How To Give Rescue Breaths

When a teen or adult suddenly collapses, his or her lungs and blood contain enough oxygen to keep vital organs healthy for the first few minutes with the addition of high-quality chest compressions.

According to the American Red Cross, rescue breaths for adults and children older than 1 entail the following: ❏❏ Tilt back the victim’s head and lift up the chin. ❏❏ Pinch the nose shut, then make a complete seal over the adult or child’s mouth. ❏❏ Blow into the mouth for about one second to make the chest clearly rise. ❏❏ Continue with rescue breaths, one after another. ❏❏ If the chest does not rise with rescue breaths, retilt the head and give another rescue breath.

For infants: ❏❏ Tilt back the child’s head and lift up the chin. ❏❏ Make a complete seal over the infant’s mouth and nose. ❏❏ Blow into the mouth for about one second to make the chest clearly rise. ❏❏ Give rescue breaths, one after the other. ❏❏ If the chest does not rise with rescue breaths, retilt the head and give another rescue breath.

2017 || Inside Columbia’s Medical Guide 29

First-Aid

How To Perform The Heimlich

This simple maneuver could save someone’s life.

BY MORGAN McCARTY

Choking Signs People who are choking typically grab for their throat with one or two hands. Other signs of distress include: ❏❏ Bluish skin color ❏❏ Panic ❏❏ Difficulty breathing ❏❏ Inability to cough, speak, cry or breathe ❏❏ Loss of consciousness if blockage is not removed ❏❏ Noisy breathing or high-pitched sounds while inhaling ❏❏ Coughing, either forcefully or weakly

Give Five Back Blows

T

he Heimlich maneuver is an emergency technique performed when an individual’s airway/windpipe becomes blocked by a piece of food or other object. It can be used safely on both adults and children, but most health experts don’t recommend the Heimlich for infants younger than 1 year old. You can also perform the maneuver on yourself. According to the American Red Cross, this is the procedure for performing the Heimlich maneuver.

For a conscious choking adult or child who is sitting or standing: Ask, “Are you choking? Can you speak?” If the person is coughing forcefully and is able to speak, DO NOT perform first aid. A strong cough may dislodge the object. If they cannot speak, try a combination or five back blows followed by five abdominal thrusts, which can be an effective way to clear the airway obstruction.

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1. Position yourself slightly behind the adult. Stand or kneel behind the child, depending on his or her size.

2. Provide support by placing one arm diagonally across the chest.

3. Bend the person forward at the waist until the upper airway is at least parallel to the ground.

4. Firmly strike the person between the shoulder blades with the heel of your other hand.

Give Five Abdominal Thrusts 1. Position yourself behind the person.

2. Reach your arms around his or her waist.

3. Place your fist, thumb side in, just above the person’s navel and well below the breastbone.

4. Grab the fist tightly with your other hand.

5. Pull your fist abruptly upward and inward to increase airway pressure behind the obstructing object and force it from the windpipe. Continue sets of five back blows and five abdominal thrusts until: »» The object is dislodged. »» The person can cough forcefully, speak or breathe. »» The person becomes unconscious.

Choking Causes Choking can be brought on by the following causes: ❏❏ Eating too fast, failing to chew food well, or eating with improperly fitted dentures ❏❏ Drinking alcohol (even a small amount of alcohol affects awareness) ❏❏ Inhaling vomited material while unconscious ❏❏ Breathing in small objects ❏❏ Injury to the head and face (swelling, blood, or a deformity can cause choking) Nonfood items that can cause choking: ❏❏ Baby powder ❏❏ Objects from the trash, such as eggshells and pop-tops from beverage cans ❏❏ Safety pins ❏❏ Coins ❏❏ Marbles ❏❏ Pen and marker caps ❏❏ Small, button-type batteries

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Not Child-Safe The American Academy of Pediatrics recommends that young children not be given round, firm foods such as hot dogs and carrot sticks unless they are chopped into small pieces, no larger than one-half inch. The AAP further recommends that the following foods meant to be chewed or swallowed be kept away from young children. »» »» »» »» »»

Hard, gooey or sticky candy Chewing gum Vitamins Peanuts Hard, smooth foods such as raw vegetables

If a conscious choking adult or child becomes unconscious: 1. Carefully lower the person to the ground.

2. Open the mouth.

3. Look for an object.

4. If you see an object, remove it with your finger.

5. If no object is visible, open the person’s airway by tilting the head and try to give two rescue breaths.

6. If the chest does not clearly rise, begin the modified CPR technique described below.

CPR For An Unconscious Choking Victim 1. Locate the correct hand position for chest compressions.

2. Use the same technique that is used for CPR (described on Page 26).

3. Give chest compressions.

4. Compress an adult’s chest 30 times to a depth of at least 2 inches.

5. Compress a child’s chest 30 times to a depth of about 2 inches.

6. Compress at a rate of at least 100 chest compressions per minute; the 30 chest compressions should take about 18 seconds to complete.

7. Open the person’s mouth and look for a foreign object.

8. If you see an object, remove it with a finger.

9. Give two rescue breaths. If the chest does not clearly rise, repeat cycles of chest compressions, foreign object check/ removal and two rescue breaths. Do not stop unless: »» The object is removed and the chest clearly rises with rescue breaths. »» The person starts to breathe on his or her own. »» Another trained responder or emergency medical service personnel takes over. »» You are too exhausted to continue. »» The scene becomes unsafe.

32 Inside Columbia’s Medical Guide || 2017

CPR For A Conscious Choking Infant If a conscious infant cannot cough, cry or breathe, you will need to give a combination of five back blows followed by five chest thrusts.

To give back blows: 1. Position the infant faceup on your forearm.

2. Place one hand and forearm on the child’s back, cradling the back of the head, and one hand and forearm on the front of the infant.

3. Use your thumb and fingers to hold the infant’s jaw while sandwiching the infant between your forearms.

4. Turn the infant over so that he or she is facedown along your forearm.

5. Lower your arm onto your thigh so that the infant’s head is lower than his or her chest.

6. Give five firm back blows with the heel of your hand between the shoulder blades.

7. Maintain support of the infant’s head and neck by firmly holding the jaw between your thumb and forefinger.

To give chest thrusts: 1. Place the infant in a faceup position.

2. Place one hand and forearm on the child’s back, cradling the back of the head, while keeping your other hand and forearm on the front of the infant.

3. Use your thumb and fingers to hold the infant’s jaw while sandwiching the infant between your forearms.

4. Turn the infant onto his or her back.

5. Lower your arm that is supporting the infant’s back onto your opposite thigh.

6. The infant’s head should be lower than his or her chest.

7. Place the pads of two or three fingers in the center of the infant’s chest just below the nipple line (toward the infant’s feet).

8. Use the pads of these fingers to compress the breastbone.

9. Compress the breastbone five times about 1½ inches and then let the breastbone return to its normal position.

10. Keep your fingers in contact with the infant’s breastbone.

Continue giving sets of five back blows and five chest thrusts until: »» The object is forced out. »» The infant begins to cough forcefully, cry or breathe on his or her own. »» The infant becomes unconscious.

If a conscious choking infant becomes unconscious: Carefully lower the infant to the ground, open the mouth and look for an object. If you see an object, remove it with your little finger. If no object is visible, open the infant’s airway by retilting the head and try to give two rescue breaths. If the chest does not clearly rise, begin a modified CPR technique used for an unconscious choking infant.

CPR For An Unconscious Infant Choking Victim 1. Locate the correct hand and finger position for chest compressions.

2. Use the same technique used for CPR (described on Page 26).

3. Give 30 chest compressions at a rate of at least 100 chest compressions per minute.

4. Each compression should be about 1½ inches deep.

5. Look for a foreign object.

6. If the object is visible, remove it with your little finger.

7. Give two rescue breaths.

8. If the breaths do not make the chest clearly rise, repeat cycles of chest compressions, foreign object check/removal and rescue breaths.

9. Do not stop unless: »» The object is removed and the chest clearly rises with rescue breaths. »» The infant starts to breathe on his or her own. »» Another trained responder or EMS personnel takes over. »» You are too exhausted to continue. »» The scene becomes unsafe.

10. If breaths make the chest clearly rise, quickly check for breathing.

If you are choking on something, you can perform the Heimlich maneuver on yourself: 1. Bend over and press your abdomen against any firm object, such as the back of a chair, a railing or the kitchen sink.

2. Alternatively, give yourself abdominal thrusts.

3. Make a fist.

4. Place the thumb below your rib cage and above your navel.

5. Grasp your fist with your other hand.

6. Press it into the area with a quick upward movement.

If a choking person is too large for you to reach around, or is obviously pregnant or known to be pregnant, give chest thrusts instead with your fist against the center of the person’s breastbone.

If a choking person is in a wheelchair, give abdominal thrusts.

2017 || Inside Columbia’s Medical Guide 33

First-Aid

Bacteria Vs Virus Knowing the difference can help you get the treatment you need. BY BY PEG GILL

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hen you wake up in the night feeling feverish and achy, you may not care whether you have a virus or a bacterial infection. You just want relief. But treating one when you have the other may only leave you feeling frustrated. Here’s the lowdown on these two misery-makers.

As you might suspect, bacterial infections are caused by bacteria, while viral infections are caused by viruses. Perhaps the most important distinction between bacteria and viruses is that antibiotic drugs usually kill bacteria, while they aren’t effective against viruses.

Bacteria are single-celled microorganisms that thrive in many different types of environments. Some varieties live in extremes of cold or heat. Others make their home in people’s intestines, where they help digest food. Most bacteria aren’t harmful to people, but there are exceptions. Infections caused

34 Inside Columbia’s Medical Guide || 2017

by bacteria include strep throat, tuberculosis, and urinary tract infections (UTIs).

Viruses are even smaller than bacteria and require living hosts such as people, plants or animals to multiply. Otherwise, they can’t survive. When a virus enters your body, it invades some of your cells and takes over the cell machinery, redirecting it to produce the virus. Diseases caused by viruses include chickenpox, AIDS, and the common cold.

Bacterial and viral infections have many things in common.

Both types of infections are caused by microbes — bacteria and viruses, respectively — and spread by things such as coughing and sneezing; contact with infected people, especially through kissing and sex; contact with contaminated surfaces, food and water; and contact with infected creatures, including pets, livestock, and insects such as fleas and ticks.

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Microbes can also cause short-lived acute infections; chronic infections that can last for weeks, months, or a lifetime; and latent infections, which may not cause symptoms at first but can reactivate over a period of months and years. Both bacterial and viral infections can cause mild, moderate and severe diseases.

The discovery of antibiotics for bacterial infections is considered one of the most important breakthroughs in medical history. Unfortunately, bacteria are very adaptable, and the overuse of antibiotics has made many strains of bacteria resistant to antibiotics. This has created serious problems, especially in hospital settings. Antibiotics are not effective against viruses, and many leading health organizations now recommend against using antibiotics unless there is clear evidence of a bacterial infection.

The 20th century brought another medical revolution: vaccines. Vaccines have drastically reduced the number of new cases of viral diseases such as polio, measles, and chickenpox. In addition, vaccines can prevent infections such as the flu, hepatitis A, hepatitis B, human papillomavirus (HPV), and others.

But the treatment of viral infections has proved more challenging, primarily because viruses are relatively tiny and reproduce inside cells. For some viral diseases, such as herpes simplex virus infections and HIV/AIDS, antiviral medications have become available. But the use of antiviral medications has been associated with the development of drugresistant microbes.

You should consult your doctor if you think you have a bacterial or viral infection. Exceptions include the common cold, which is usually not life-threatening.

In some cases, it’s difficult to determine the origin of an infection because many ailments — including pneumonia, meningitis, and diarrhea — can be caused either by bacteria or viruses. But your doctor usually can pinpoint the cause by listening to your medical history and doing a physical exam.

If necessary, he or she also can order a blood or urine test to confirm a diagnosis, or a “culture test” of tissue to identify bacteria or viruses. Occasionally, a biopsy of affected tissue may be required.

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About Antibiotics There are well in excess of 100 antibiotics, which fall into seven different classes. Each is effective only for certain types of bacterial infections.

Your doctor will be able to compare your needs with the available medicines. Also, a person may have allergies that eliminate a class of antibiotic from consideration, such as a penicillin allergy preventing your doctor from prescribing amoxicillin.

In most cases of antibiotic use, a doctor must choose an antibiotic based on the most likely cause of the infection.

For example, if you have an earache, the doctor knows what kinds of bacteria cause most ear infections. He or she will choose the antibiotic that best combats those kinds of bacteria. In another example, a few bacteria cause about 90 percent of pneumonias in previously healthy people. If you are diagnosed with pneumonia, the doctor will choose an antibiotic that will kill these bacteria. Other factors may be considered when choosing an antibiotic. Medication cost, dosing schedule, and common side effects are often taken into account.

2017 || Inside Columbia’s Medical Guide 37

Prevention

Know Your Vaccines Vaccines are part of growing up healthy and strong, and it’s important for you and your family to be knowledgeable about the vaccination process and timetables.

BY MORGAN McCARTY

A

ccording to the National Vaccine Program Office in the U.S. Department of Health and Human Services, a vaccine is a product that produces immunity from a disease and can be administered through needle injections, by mouth or by aerosol. A vaccination is the injection of a killed or weakened organism that produces immunity in the body against that organism. An immunization is the process by which a person or animal becomes protected from a disease.

Below are the recommended immunization schedules for all ages by the U.S. Centers for Disease Control and Prevention.

Recommended immunizations for children from birth through 6 years old Birth HepB

1 Month

2 Months

4 Months

6 Months

HepB

12 Months

15 Months

18 Months

19-23 Months

2-3 Years

4-6 Years

HepB RV

RV

RV

DTaP

DTaP

DTaP

Hib

Hib

Hib

Hib

PCV

PCV

PCV

PCV

IPV

IPV

DTaP

IPV

DTaP

IPV Influenza (Yearly)

Shaded boxes indicate the vaccine can be given during shown age range.

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MMR

MMR

Varicella

Varicella HepA

a protective array »»

The varicella vaccine protects against chickenpox.

»»

The Diphtheria or DTaP vaccine protects against diphtheria.

»»

The Hib vaccine protects against Haemophilus influenza type b.

»»

The Hepatitis A/HepA vaccine protects against hepatitis A.

»»

The Hepatitis B/Hep B vaccine protects against hepatitis B.

»»

The Human Papillomavirus/ HPV vaccine protects against the human papillomavirus.

»»

The flu vaccine protects against influenza.

»»

The Measles/MMR vaccine protects against measles.

»»

The Mumps/MMR vaccine protects against mumps.

»»

The Pertussis/DTaP vaccine protects against pertussis (whooping cough).

»»

The Polio/IPV vaccine protects against polio.

»»

The Pneumococcal/PCV vaccine protects against rotavirus.

»»

The Rotavirus/RV vaccine protects against rotavirus.

»»

The Rubella/MMR vaccine protects against rubella.

»»

The Tetanus/Tdap vaccine protects against tetanus.

»»

The Zoster vaccine protects against shingles.

2017 || Inside Columbia’s Medical Guide 39

Recommended immunizations for children from 7 through 18 years old 7–10 Years

11–12 Years

13–18 Years

Tdap

Tdap

Tdap

HPV (3 Doses)

HPV (3 Doses)

MCV4 Dose 1

MCV4

MCV4 Dose 1

Booster at 16

Influenza (Yearly) PCV HepA Vaccine Series HepB Vaccine Series IPV Series MMR Vaccine Series Varicella Vaccine Series These shaded boxes indicate when the vaccine is recommended for all children unless your doctor tells you that your child cannot safely receive the vaccine.

These shaded boxes indicate the vaccine should be given if a child is catching up on missed vaccines.

These shaded boxes indicate the vaccine is recommended for children with certain health conditions that put them at high risk for serious diseases. See vaccine-specific recommendations at www.cdc.gov.

Recommended immunizations for adults by age 19–21 Years

22–26 Years

Influenza

27–49 Years

65+ Years

Get a Tdap vaccine once, then a Td booster vaccine every 10 years

Varicella

2 doses

HPV – Women

3 doses 3 doses

3 doses

Zoster (Shingles) MMR

60–64 Years

Get a flu vaccine every year

Tdap

HPV – Men

50–59 Years

1 dose 1 or 2 doses

PCV

1–3 doses

1 dose

MCV

1 or more doses

HepA

2 doses

HepB

3 doses Boxes this color show that the vaccine is recommended for all adults who have not been vaccinated, unless your health care professional tells you that you cannot safely receive the vaccine or that you do not need it.

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Boxes this color show when the vaccine is recommended for adults with certain risks related to their health, job or lifestyle that put them at higher risk for serious diseases.

Talk to your health care professional to see if you are at higher risk.

2017 || Inside Columbia’s Medical Guide 41

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2017 || Inside Columbia’s Medical Guide 43

Prevention

Be Sun Savvy Get smart about sun safety.

BY PEG GILL

It’s recommended by the American Academy of Dermatology that you should use sunscreen that is at least SPF 30.

Fair skinned people should use SPF 50.

M

id-Missourians may long to hibernate through the cold, wet winter, but when summer rolls around, that means plenty of fun in the sun. That increased sun exposure means an increased risk of sunburn.

The U.S. Centers for Disease Control & Prevention reports that more than one-third of adults and nearly 70 percent of children admit they’ve received a sunburn within the past year. Yes, sunburns will fade, but their long-term effects will not.

According to Trisha Taylor, a board-certified dermatologist with Central Missouri Dermatology, “It is dangerous to sunburn because it increases your risk for all types of skin cancer, but particularly increases your risk for the most deadly type of skin cancer, melanoma.”

So how can you protect yourself?

Remember that the sun’s rays are strongest between 10 a.m. and 2 p.m. If you’re out during those hours, try to stay

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in the shade. A handy rule of thumb: If your shadow appears shorter than you are, seek shade. Wear a long-sleeved shirt and pants, a broad-brimmed hat, UV-blocking sunglasses, and slather on the sunscreen.

When it comes to sunscreen, The American Academy of Dermatology recommends liberally covering exposed areas of skin with a broad spectrum, water-resistant sunscreen with a sun protection factor of at least 30.

“Very fair-skinned people might

benefit from SPF 50,” Taylor says.

A broad-spectrum sunscreen provides protection from both ultraviolet-A and ultraviolet-B rays.

Apply sunscreen about 30 minutes before going outside, and use it even on overcast days because UV rays can penetrate clouds.

“Reapply sunscreen every two hours, or more often if you’re sweating or swimming,” Taylor says.

Another thing to watch out for: Be extra careful near water, snow and sand. They reflect and intensify the damaging rays of the sun, which can increase your chance of sunburn.

Protecting children from the risks of sunburn can be challenging, because they’re so active. But the same guidelines that apply to you apply to them, too.

It’s likely that in spite of your best efforts, someone will end up sunburned.

“If you do get a sunburn, there are several things you can do to alleviate any discomfort,” Taylor says. “Apply fragrance-free moisturizing cream, particularly one with aloe or hydrocortisone, take ibuprofen for 48 hours as directed on the bottle, stay hydrated and apply wet, cool compresses.”

There are also some things you shouldn’t do, according to Taylor.

“Avoid putting heavy oils such as Vaseline or butter on a sunburn,” she says. “These products are too occlusive on an acute burn.”

When does sunburn merit a doctor visit? “Go to the doctor for a sunburn if you have blisters covering more than 20 percent of your body,” Taylor says, “or if you are getting dehydrated or you can’t regulate your body temperature.”

Taylor has some words of wisdom for sun-seekers who still may be tempted to tan and risk the rays. “There is no safe way to tan your skin unless it comes out of a bottle,” she says.

2017 || Inside Columbia’s Medical Guide 45

Fitness

Walking To Wellness An effective fitness program is as easy as putting one foot in front of the other. BY PEG GILL

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eed a good reason to tie on those walking shoes? Walking briskly can help you lose weight or maintain a healthy weight. It can also lower your risk of high blood pressure, high cholesterol and diabetes as much as running, according to a study conducted at Lawrence Berkeley National Laboratory, Life Science Division in Berkley, Calif. All three conditions are risk factors for heart disease and stroke — and you can do something about them.

Researchers analyzed 33,060 runners in the National Runners’ Health Study, and 15,045 walkers in the National Walkers’ Health Study. They found that the energy used for moderate-intensity walking or vigorous-intensity running resulted in similar reductions in risk for high blood pressure, high cholesterol, diabetes, and possibly coronary heart disease over the study’s six years.

The findings are consistent with the American Heart Association’s recommendations for physical activity in adults: we need 30 minutes of physical activity per day, at least 150 minutes of moderate activity per week or 75 minutes of vigorous activity per week to derive benefits.

Walking doesn’t require a lot of skill, or a lot of equipment.

It’s safe, the least expensive and has the lowest dropout rate

46 Inside Columbia’s Medical Guide || 2017

of any type of exercise. All you need to get started walking are comfortable clothes and supportive shoes. Layer loose clothing, keeping in mind that brisk exercise elevates the body’s temperature. Shoes designed for walking or running are best. Make sure you have a little wiggle room between your longest toe and the end of the shoe (about a ½ inch). Avoid cotton socks since they retain moisture and can promote blisters.

Begin with short distances. Start with a stroll that feels comfortable (perhaps five to 10 minutes) and gradually increase your time or distance each week by 10-20 percent by adding a few minutes or blocks. If it’s easier on your joints and your schedule to take a couple of 10- to 20-minute walks instead of one long walk, do it!

Keep your head lifted, tummy pulled in and shoulders relaxed. Swing your arms naturally. Avoid carrying hand weights since they put extra stress on your elbows and shoulders. Don’t overstrike. Select a comfortable, natural step length. If you want to move faster, pull your back leg through more quickly.

Breathe deeply. If you can’t talk or catch your breath while walking, slow down.

At first, forget about walking speed. Just get out there and walk!

Laura Grant, MD Healing for Intimate Female Conditions

Dr. Laura Grant began practicing Obstetrics and Gynecology in Columbia in 1994. Twelve years and hundreds of babies later, she made the decision to give up the practice of Obstetrics and focus exclusively on Gynecology and Women’s Health. Recognizing a need for a personalized and superlative approach to women’s healthcare, Dr. Grant co-founded Women’s Wellness Center in 2007, providing patients with an alternative and multidisciplinary model in a soothing, spa like environment – truly unique in the community.

Now focusing her practice on particular specialty services, Dr. Grant fills a unique role in women’s healthcare. She is pleased to provide non-invasive treatment for women who suffer from pelvic floor dysfunction – the root cause of many intimate, sometimes embarrassing conditions, including sexual or genital pain, chronic pelvic pain, chronic bladder pain (interstitial cystitis), and urinary or fecal incontinence. These have extreme effects on a woman’s quality of life, yet it may be difficult to find a specialist who understands how to heal these disorders in a way that permanently alleviates symptoms, while also avoiding medication side effects or surgery. Dr. Grant and her team accomplish this, while delivering care with the utmost compassion and professionalism to women with these distressing conditions.

Additionally, Dr. Laura Grant specializes in menopausal hormone health. She maintains the credential of NAMS Certified Menopause Practitioner, awarded by the North American Menopause Society (NAMS), the preeminent scientific organization focused on menopausal health. Thus, Dr. Grant is dedicated to improving health and quality of life through an understanding of menopause.

To learn more about pelvic floor dysfunction and hormone health, visit womenswellnessnow.com. Women’s Wellness Center is a unique multispecialty practice, providing healthcare with the whole woman in mind. To schedule an appointment, call 573-449-9355.

Women’s Wellness Center

1705 E Broadway #300 • 573-449-9355 • www.womenswellnessnow.com 2017 || Inside Columbia’s Medical Guide 47

Symptoms

Identifying A Heart Attack

Knowing the signs could save your life. BY MORGAN McCARTY ❏❏ Don’t smoke, and avoid second-hand smoke. ❏❏ Treat high blood pressure if you have it. ❏❏ Eat foods that are low in saturated fat, trans fat, cholesterol and salt. ❏❏ Be physically active. ❏❏ Keep your weight under control. ❏❏ Get regular medical checkups. ❏❏ Take medicine as prescribed. ❏❏ Control your blood sugar if you have diabetes.

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ccording to the U.S. Centers for Disease Control and Prevention, about 715,000 Americans will experience a heart attack this year. Heart attacks, according to the CDC, result from several types of heart conditions. The most common of these conditions is coronary heart disease, which occurs when plaque clogs arteries responsible for supplying blood to the heart. Heart attacks, angina, heart failure and arrhythmias can result from coronary heart disease.

While steps such as eating a healthy diet, maintaining a healthy weight, exercising regularly, monitoring blood pressure and more help prevent heart disease, everyone should be aware of heart attack symptoms. According to the American Heart Association, the following symptoms and warnings signs can alert you to the fact that you or a loved one is experiencing a heart attack. Should these symptoms arise, dial 911 immediately.

Heart Attack Warning Signs Some heart attacks are intense and sudden, but most start slowly with mild pain and discomfort. Some signs that a heart attack may be happening include:

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CHEST DISCOMFORT: Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain.

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DISCOMFORT IN OTHER AREAS OF THE UPPER BODY: Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach.

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SHORTNESS OF BREATH: Breathlessness can occur with or without chest discomfort.

Symptoms Of Heart Disease

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You may be experiencing cardiovascular problems if you notice that ordinary physical activity causes the following symptoms: »» Undue fatigue »» Palpitations — the sensation that your heart is skipping a beat or beating too rapidly »» Dyspnea — difficult or labored breathing »» Chest pain — pain or discomfort from increased activity

OTHER SIGNS: Additional symptoms may include breaking out in a cold sweat, nausea or lightheadedness.

The most common heart attack symptom in men and women is chest pain or discomfort; women are somewhat more likely than are men to experience some of the other common symptoms, particularly shortness of breath, nausea/vomiting and back or jaw pain.

48 Inside Columbia’s Medical Guide || 2017

“The whole-body approach of caring for a patient is something that I apply to my business. I listen to and validate my employees and my clients.”

Dan Latham prides himself on making good on his company’s motto of being “just a heartbeat away” from solving a client’s staffing problems.

Pulse Medical Staffing provides temporary supplemental staff and medical professionals to more than 300 hospitals and long-term care centers nationwide.

Latham and his employees provide 24/7 service and support to their clients.

The company pays personal liability and offers basic life-support certification and renewal courses for medical professionals.

Whether your facility needs supplemental, temporary or permanent professional staff, or you are a nurse, physician or other professional looking to feel the difference, Pulse Medical Staffing is ready to serve you.

PulseMedicalStaffing.com 620 N. Trade Winds Pkwy. Columbia, MO Telephone: +1-877-883-8677 E-mail: dan.l@pulsemedicalstaffing.com

Symptoms

Is This A Stroke?

Recognize the signs to save precious time. BY MORGAN McCARTY

A stroke is also called a “brain attack” and occurs when blood flow to the brain is interrupted.

Symptoms And Warning Signs Of A Stroke To a bystander, someone having a stroke may just look unaware or confused.

Stroke symptoms happen quickly. »» Sudden numbness or weakness of the face, arm or leg (especially on one side of the body) »» Sudden confusion and trouble speaking or understanding speech »» Sudden trouble seeing in one or both eyes »» Sudden trouble walking, dizziness, loss of balance or coordination »» Sudden severe headache with no known cause

What A Bystander Should Do

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trokes are the third-leading cause of death in the United States, according to the National Institute of Neurological Disorders and Stroke. To reduce the damage caused by a stroke, patients must recognize the symptoms of a stroke early on and get to a hospital quickly. Today’s treatments can go a long way toward mitigating the damage done by a stroke, but only if administered soon after the onset of stroke symptoms.

There are two major kinds of strokes: ischemic and hemorrhagic. Ischemic strokes are the most common type, caused by a blood clot that blocks or plugs a blood vessel or artery in the brain. Hemorrhagic strokes occur when a blood vessel in the brain breaks and bleeds into the brain. Strokes can affect the entire body.

Effects range from mild to severe and can include paralysis, problems with thinking or speaking, and emotional distress. Patients may also experience pain or numbness following a stroke.

50 Inside Columbia’s Medical Guide || 2017

If you suspect someone is having a stroke, you must act quickly. If he or she suddenly loses the ability to speak, move an arm or leg on one side of the body or experiences facial paralysis on one side, call 911 immediately.

Stroke Risk Factors

»» »» »» »» »»

High blood pressure Heart disease Smoking Diabetes High cholesterol

2017 || Inside Columbia’s Medical Guide 51

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