Thrive guide 2017

Spring 2017

Health Guide Spring 2017

SOCIAL WELLNESS Balancing social and personal time  P. 4 CYCLING SAFETY Tips for two-wheel

travel  P. 8

WOMEN’S HEALTHCARE A publication of the

Fredericksburg S tandard Radio Post

Hospital expands OB department

 P. 24

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6 H Hardison Chiropractic Wellness Center................................................16 Health Pathways.....................................25

Heritage Place...........................................2 Hill Country Advance Foot & Ankle.......31 Hill Country Memorial................3,11,15,32 Hill Country Neurology, PA....................27 Hoerster Family Dentistry......................11 Holmes, Darin W., DDS...........................14 J Joseph Financial Partners.......................22 K Kerrville Oral & Maxillofacial Surgery..............................................14 Knopp Healthcare.....................................5 Kovar, Lance, DDS..................................25 L Lizard Dreaming Yoga.............................19 Love, C. Lance, MD..................................6 LPL Financial.............................................9 M Main Street Urgent Care..........................6 Majors Dermatology...............................16 Mid-Texas Health Care Assn...................19 Mills & Associates Physical Therapy..............................................19 MRI Now.................................................40 P Pedernales Medical Group.....................20 Precision Dentistry & Implants...............20 Prescription Lab......................................28 S SM&PT....................................................17 Stehling, Will, DDS....................................7 T Texas Hill Country Orthopedics & Sports Medicine................................27 Texas Sleep Docs....................................31 V ValuMed Pharmacy.................................11 W Walker, Michael, MD ..............................13

Article Index

Socializing ............................................................ 4 Cycling safety ..................................................... 8 Good Samaritan Center ................................ 12 Dental health .................................................... 15 Volkssporting ................................................... 16 Mammograms ................................................. 18 Joint restoration .............................................. 20 Farmers’ market .............................................. 22 HCM Gala ........................................................ 24 Student health ................................................. 26 County Extension programs ....................... 29 ON THE COVER: Cyclists from all over the country pedal around the Hill Country during the spring season. These cyclists took part in a recent Hell Week event. ­— Standard-Radio Post file/Ken Esten Cooke

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Jacob Gaskins relaxes at Marktplatz and checks his messages, while a few others chat on benches. Psychologists say going to public places and engaging in social interaction can provide a person with outlets for stress reduction. — Standard-Radio Post/ Richard Zowie

‘Let’s get social’

By Richard Zowie Some people are natural extroverts. They are outgoing and expressive. In social gatherings, these gregarious types often become the life of any party they attend. They love being around people.

Others who are natural introverts are shy and often reluctant to socialize. They find public gatherings challenging, since their instinct is usually to be alone in their own thoughts. At a party, they might often wonder how much longer they have to stay.

Whether an introvert is a child, adolescent

Improving social skills can provide benefits

or adult, local psychologists offer tips on how they can nudge their boundaries and improve their social skills. By doing so, it can also be beneficial to their health.

Children and socializing For some children, socializing comes naturally. For others, it’s a learned trait due to being an introvert or having a dislike for crowds.

Dr. Daniel O’Loughlin, a licensed psychologist who specializes in child and adolescent psychology, said how much a child engages socially depends on how they are as a person,

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how they were raised and the environment in which they live.

“For example, some children are inherently timid, shy and reserved which may lead to social discomfort and avoidance,” O’Loughlin said. “Whereas, other children are temperamentally outgoing, animated and engaging, which usually results in an active social life.”

The psychologist said when anxious children are raised by anxious parents, overprotection can limit a child’s sense of independence and hinder their social development.

“Unfortunately, some children also lack opportunities for enhancing their social skills

5 and growth due to environmental, cultural, and financial factors,” he said. “It can be a significant challenge to change a child’s maladaptive social behavior and often professional help outside the family is needed.”

O’Loughlin said if a child persistently refuses or avoids social interaction, or is defiant, uncooperative or aggressive to others, or lacks interest in others or has deficits in social skills and a parents’ efforts to change these behaviors haven’t been O’Loughlin realized, then it’s time to seek professional help.

“Parental concern for a child’s maladaptive social behavior and a desire for change is the first and most important step, “O’Loughlin said.

“Rarely do children or teenagers have the insight, motivation, or ability to bring about change on their own without parental assistance. Parents can seek out informal advice through various sources such as family members, school personnel and the Internet, and then apply learned principals that target their concerns.”

The psychologist is glad to see that Fredericksburg offers many opportunities for children to socialize, including mother’s day out programs, organized sports activities, church youth groups, school clubs and organizations

and community education activities.

“If the child’s social behavior does not improve, then it’s time to seek professional help,” he said.

By improving their socialization skills, one benefit is it can improve a child’s mental health.

“Children and teenagers are social beings and need interaction with others,” O’Loughlin said.

“Parents who value and teach their children pro-social behaviors in the home are providing a valuable skill set that is essential to their child’s success outside the home.”

O’Loughlin believes good social skills pave the way for building and maintaining relationships with family, teachers, peers, employers and others and enhance a child’s sense of wellbeing and self-esteem.

“Strong peer friendships and positive relationships with parents and supportive adults in the community (such as teachers, coaches and youth ministers) buffer children and teenagers from life stresses and promote good social adjustment and good overall mental health,” he said.

Another benefit of socialization is an improvement of a child’s physical health.

Children, teenagers and adults are all prone to stress-related illnesses.

“Social interaction with peers and supportive adults outside the home is beneficial and can provide outlets for stress reduction,” O’Loughlin said. “In this day and time, Parents often have to push children outside to play due to the

tremendous appeal of video games and other electronic devices. I support parents in their efforts to encourage less ‘electronic time’ and more ‘people time’ for children. While the same is true for most teenagers, some added discretion is needed.”

The psychologist considers telephones and the Internet to be the primary modes of social connection for many teenagers.

“Excessive restrictions placed on these devices can have a profoundly negative impact,” he said.

“Yet, moderation in their use is advised.”

Adolescents, adults and socializing Learning to socialize can be a challenge for adolescents and adults, especially if strong habits or lifestyle patterns have already formed.

“Sometimes, lack of socializing stems from a personality trait. Some tend to be introverted,” said Dr. Ron Rickerhauser, a provisionally licensed psychologist, licensed specialist in school psychology, and a licensed professional counselor-intern supervised by Eric Cardwell, a licensed professional counselor supervisor.

“Sometimes it can be anxiety-induced or a genuine fear.”

Being able help a person develop social skills, Rickerhauser said, depends a lot on that person. If the lack of socialization causes distress and they have a genuine desire to change, then See SOCIALIZING page 6

6

SOCIALIZING

Cont. from page 5

there are therapy methods to help them improve.

“I take a cognitive approach and think about the thought processes to help them look at and evaluate why they are reluctant,” he said.

If it’s not but simply a product of a personality trait (introversion), then therapy isn’t really warranted. If it doesn’t cause stress, then the lack of socialization probably won’t negatively impact a person’s mental health.

The psychologist prefers to work in small steps, particularly if the person’s lack of socialization is anxietyinduced.

“We work with them through systematic Rickerhauser desensitization,” said Rickerhauser, who’s also a licensed chemical dependency counselor.

“We expose them to anxiety-induced surroundings in small doses and then gradually increase it. Then, they develop an increas-

ingly growing level of comfort.”

If a person fears being in a grocery store, Rickerhauser may have them start going during slow business hours, such as late evening or at night for one that’s open 24 hours per day.

“Or, we may start smaller like with a convenience store, or have a companion go with them,” he said. “It helps reintroduce them to the environment.”

Rickerhauser believes socialization is related to a person’s mental health, primarily because humans by nature are social creatures.

“That’s how we’re designed,” he said. “We seek companionship with similar groups.

Just because someone’s a loner or introvert doesn’t mean they’re without companionship. They differ in the size of the group they choose to engage in. Some might prefer a single friend or a couple of individuals. They may find themselves uncomfortable in larger groups.

“When individuals are outside of their comfort levels, such as introverts finding themselves in large social groups or extroverts finding themselves with a lack of social

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opportunities, stress can occur, which can be is related to both physical and mental health,” Rickerhauser said.

As for improving physical health through socializing, the psychologist said he isn’t sure there’s a direct correlation, but states that stress, which can be caused when an individual’s social desires and social life are incongruent, can be directly related to both mental and physical health.

“That’s how we’re designed,” he said. “We seek companionship with similar groups.

Just because someone’s a loner or introvert doesn’t mean they’re without companionship. They differ in the size of the group they choose to engage in. Some might prefer a single friend or a couple of individuals. They may find themselves uncomfortable in larger groups. This is all related to level of distress, which can be related to both physical and mental health.”

As for socializing improving physical health, Rickerhauser isn’t sure there’s a direct correlation. Sometimes, some wish to expand their circle but can’t deal with the anxiety. In turn, that might cause physical stress.

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Cyclists’ safety tips while spinning through the Texas Hill Country

By Scott Allen

As the seasons get warmer, the weather will provide ample opportunities for bicyclists to get out and enjoy the many miles of the backroads in Gillespie County.

The sun is hot, the wind is mild and the hills are plentiful, but cyclists (and motorists, alike) should remember to be safe while grinding the pavement.

“The Hill Country is a bicycling mecca,” said Shannon Maenius, cycling instructor at the Hill Country Memorial Wellness Center. “It’s one of the best places to ride in the world. Don’t forget that when you get on a country road, there could potentially be a big group of cyclists around every turn. Every cyclist is a motorist, but not every motorist is a cyclist.”

Motorists should maintain caution when on the backroads, but it’s also up to the cyclist to make sure they are visible to the vehicles.

“You can see the car, but the car can’t always see you,” Maenius said.

“Wear bright colors and have blinking back, red lights, and a flashing headlight when it’s dark. Also, it’s good to have cycling mirrors so you know what’s behind you and follow all traffic rules that pertain to a motorist.”

Some of the cyclist rules that shadow motorist laws include riding in the same direction as cars, using turn signals (hands) when turning, riding defensively and not texting and riding.

Also “don’t run red lights or stop signs,” said Josh Allen, owner of Jack and Adam’s Bicycles of Fredericksburg. “I see cyclists do this a lot and it’s very dangerous. Stop as if you would if you were in a car.”

Another important tip for cyclists is to make sure they ride two people abreast while on roads.

“They can ride side-by-side as long as they don’t impede the flow of traffic,” Allen said. “I’ve heard of sheriffs giving tickets if cyclists don’t follow that rule.”

Additionally, vehicles passing bikes should maintain a three-foot buffer zone.

The right gear Good gear can be the difference between a fun bike ride and a not-sofun ride.

Some important emergency gear includes a helmet, lights, a flat kit,

Cyclists start their ride during a recent Gran Fondo bike race in Fredericksburg. Cyclists should ride a maximum of two abreast when on the back roads of Gillespie County. — Standard-Radio post file photo

spare tube, pump, phone, water, sunglasses, a light jacket and reflective vests.

“My number one is helmet. Always wear a helmet,” Allen said. “Cars win 100 percent of the time. Also hydration is really important. I drink a bottle every 45 minutes to an hour. That’s 20 to 24 ounces.”

In order to maintain intensity, Allen said riders should carry gels and energy bars.

Video recording gear is also suggested for long rides.

“A lot of the riders now ride with their GoPros just in case something happens, they have video evidence of their ride,” Maenius said.

Planning it out Having an idea of where to bike is key in having a safe ride, Maenius said.

See CYCLING page 10

We would like to thank Hill Country Memorial as well as the specialists and dentists who help us help the uninsured in our community. You are the living embodiment of the Good Samaritan.

For more information about our medical and dental services for uninsured families and individuals, please contact us Monday through Thursday at 830-990-8651, or visit us on the web at www.goodsamfbg.org.

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CYCLING

According to biketexas.org, which follows the “rules of the road” based on Texas Transportation Code statutes: —Bicyclists have the rights and duties of other vehicle operators (551.101):

Cont. from 8

“I always pre-drive the cycling routes so I know if there’s construction or water crossings,” Maenius said. “It helps you know if there’s any hazards along your route. And wear Road ID as well.”

Riders should always try to ride with a friend.

“It’s nice to have someone there with you in case something goes wrong,” Maenius said. “For group rides, I always meet with the group first and discuss plans of action, who’s going to be riding in the front, etc.”

• Stop at stop signs and red lights, but cars are required to yield right-of-way to a bicycle when appropriate.

— Ride near the curb and in the same direction as traffic (551.103): • Near the curb is subjective, but the law gives a cyclist the right to take the lane when necessary for safety.

—At least one hand on the handlebars (two are safer) (551.102c): • One when signaling but two when turning works well.

—Use hand and arm signals (545.107): • Point the way you are going, let the other operators know what you want to do.

—One rider per saddle (551.102a): • Don’t let your friends share your bike while riding unless you’re both on a tandem.

—You may ride two abreast as long as you don’t impede traffic (551.103c): • Racing and taking the lane are special cases.

—Must have a white light on the front and a red reflector or red light on the rear (for riding at night) (551.104b): • The light is primarily so people can see you coming from the side, where their headlights do not shine on your reflectors.

As of September 2001, a red light can replace a red reflector.

— Brakes capable of making the braked wheel skid (551.104a):

A cyclist stays on the shoulder of Ranch Road 648 near Doss as a truck goes to pass. Cyclists should stay on the right side of the road, when possible, and motorists are reminded to provide three feet of buffer space when passing a cyclist. — Standard-Radio Post file photo

• Don’t test that front brake to see if the wheel will skid while riding, especially downhill.

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Making a difference for someone Good Samaritan Center, community partner to offer access to affordable healthcare They are a true community partner.

•Medical Specialists: If we In early April, a patient at The didn’t have the different speGood Samaritan Center needed cialists who come to us, we $10 to pay for the two chronic would just be seeing people medications she was picking up with colds and monitoring at the front desk. She thought she blood sugars and high blood was picking up one medication pressure. and only had $5 on her. Before she But did you know that could figure out what to do about just about every specialist in the second medication, a fellow town offers services to our patient standing at the front desk patients at an affordable rate? gave her the other $5.

Then there are several That week, I told this story in dentists and hygienists who a thank you letter to a donor. It close their practice half a touched him so much that he day each month to come as brought us an envelope with 20 volunteers to see patients in five dollar bills to keep at the front our building. desk in case we run into that situIf there is a medical service The Good Samaritan Center is located at 140 Industrial Loop. The ation again. available in Fredericksburg, center’s mission “is to provide quality, coordinated and affordable I told my wife those two stories we can probably secure it for health care, as well as health and wellness education and informaat dinner the night the donor our patients. This includes tion to our patients in a Christ-centered, safe environment.” — came in. She said, “You have a access to complicated tests, Submitted photo pretty great job.” She’s right. I do. specialized treatments, and Healthcare in our country is an even surgeries. unpredictable mess right now, and it seems the only certainty is that, at •Volunteers: We have about 90 volunteers come to us each month to the end of the day, our patients will still not have an obvious pathway to help us serve nearly 1,500 unduplicated individuals a year through our affordable healthcare without us. medical, dental and mental health counseling programs.

But what makes The Good Samaritan Center more than just a pragThe first voice a patient hears on the phone when they call and the matic answer to our community’s healthcare needs is the way the first face they see when they walk in the door is often that of a volunteer. community comes together to give our patients coordinated access to Those who work inside give half a day each week. The landscaping affordable healthcare: volunteers come every month to ensure our patients get to seek medical •Hill Country Memorial (HCM): It all starts with HCM. care in the nicest doctor’s office in town.

They recognize that supporting our work helps keep unfunded •Donors: Last year, we had nearly 850 donors give us over $600,000 patients out of the emergency room and from being admitted into the toward our $900,000 budget. hospital, but they also go out of their way to proactively reach out to When we combine those donations with patient fees, private foundapatients through us and through their own initiatives to help create a tion grants and rental income from extra space in our building, we are healthy community, regardless of a person’s income level. able to operate more efficiently by not receiving any state or federal

By John Willome Executive Director

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We receive donations as small as $5 and as large as five figures. These donations come from generous individuals who have decided that part of their calling in our community is to reach out to our patients in this way.

All of these people choose to do what they do for our patients because they love knowing they are making a difference in someone’s life.

No one knows (not even Congress) what tomorrow holds for access to healthcare in our country, but because our community comes together in such a robust way, this is one thing our patients don’t need to worry about.

If you have never been to The Good Samaritan Center, I hope you will come to visit us Monday through Thursday for a tour.

And if you think you or a friend might need our help, please give us a call.

Our number is 830-990-8651 and our web address is www.goodsamfbg.org.

John Willome serves as executive director of The Good Samaritan Center, located at 140 Industrial Loop. — Submitted photo

The Good Samaritan Center is a faithbased charitable clinic providing medical, dental and mental-health services, as well as diabetes management training and wellness education for low-income families with no health insurance.

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Tips for taking care of teeth

Dr. Zachary Hoerster gives Kenneth Treibs a checkup. The dentist said regular dental checkups can help a person preserve their smile. — Standard-Radio Post/Richard Zowie

Regular checkups, no tobacco both preserve dental health Having a nice smile goes a long way for those who value their teeth. The teeth are like other part of the body: to keep them, they must be maintained and properly cared for. This means regular dental checkups, getting any needed work done and following a dentist’s instructions.

Dr. Zachary Hoerster of Hoerster Family Dentistry offers the following dental care tips: 1. Brush twice a day for two minutes; brush longer, not harder especially around gums.

2. Floss daily.

3. Eat and drink healthy by limiting sugary and acidic foods.

Rinse with water and brush after.

4. Having a dental check-up very six months is recommended for a clean and healthy mouth.

5. Avoid tobacco products.

6. Get children in to meet the dentist early in life to build a trusting relationship and good hygiene habits.

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Volksporting in Fredericksburg Volkssportverein Friedrichsburg brings health, fellowship together in the area Volkssporting is an international sports environment that promotes personal physical fitness and good health by providing fun-filled, safe exercise in a stressfree environment through self-paced walks and hikes, bike rides, swims, crosscountry skiing, and snowshoeing.

Walking – also called “volksmarching” (people’s walk) — is the most popular of all the volkssporting activities.

Walkers may choose their time to start within the start/finish “window” and participate in the sport at their own pace. Where possible, accommodations are made to allow participation by the physically challenged.

The volkssporting movement began in Germany in 1968 and is now in more than 40 countries worldwide.

Volkssporting in America started in Fredericksburg in 1976 for the Bicentennial with the establishment of the first American Volkssporting Club (Volkssportverein Friedrichsburg) by the late Kenn Knopp.

It was quickly adopted by military families who had participated in such events in Germany.

Since then, it has grown to about 300 clubs in the United States (about 10 percent in Texas alone), with more than 3,000 volkssport events per year.

However, one does not have to be a member of a club to walk.

At least two walking distances are normally offered at each walking event (five and ten kilometers, equaling 3.2 and 6.4 miles), with longer walks at some events.

Zarena Post, left, and Terry Post of Austin walk along one of the trails during a Vokssportverein Friedrichsburg event Feb. 11 at Wildseed Farms. — Standard-Radio Post file photo

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17 “Traditional Events” are held on a specified weekend.

Walkers may choose a time to start within the start/ finish “window” and participate in the sport at their own pace.

There are also “Year Round Events” — established walk routes that can be walked throughout the year whenever a walker wishes.

The Fredericksburg Club hosts three Traditional Events a year in the area and five Year Round Events (LBJ State Park and LBJ Ranch, Enchanted Rock, and three in Fredericksburg).

The Fredericksburg club held a Traditional Event at Wildseed Farms in February, at which 156 walkers participated.

The next events will be the morning of Aug. 19 at the LBJ State Park and Historic Site and LBJ National Historical Park in Stonewall and the evening of Dec. 2 at the LBJ National Historical Park Visitor Center for the Johnson City Christmas lights.

In addition, there are clubs as close as Kerrville, Comfort, Austin, New Braunfels and San Antonio that host events throughout the year.

Many people adopt volkssporting as part of their lifestyle and have completed hundreds of events and thousands of kilometers.

While many begin walking for fitness, most continue because of friendships and social benefits provided by the local clubs.

The average volkssporter is a “baby boomer” in his or her mid-50s, and usually an “empty-nester” either approaching or beginning retirement. The ratio of female to male participants is about 60 percent to 40 percent.

Approximately 25,000 volkssporters are members of local clubs, with thousands more regularly walking each year. Surveys indicate 84 percent travel out of state (or even out of country) on a regular basis to participate in events and that they participate for enjoyment of the outdoors, exercise, health, travel and to enjoy the fun and social aspects of volkssporting.

For additional information, visit the American Volksporting Association website at ava.org or on Facebook, or contact local club president Dave Roberts at dlroberts34.hotmail.com or 992-7584.

Hill Country Dermatology 95 East Highway Street • Fredericksburg

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18

Stay abreast of mammogram myths Susan Bacon, RRT, director of the Hill Country Memorial Breast Center, discusses myths, misconceptions and the value of annual mammograms.

Myth: I don’t need a mammogram if I maintain annual check-ups and monthly self-exams.

Fact: Even if you or your doctor don’t feel a lump or change in your breasts, you should still get a mammogram. The mammogram shows greater detail than you can feel or see with the naked eye.

Myth: Mammograms are uncomfortable.

Fact: Today’s mammograms are much more comfortable and faster. As the technologist positions you, she will tell you everything she is doing. We also offer comfort pads upon request.

Ask questions and please speak up if you experience discomfort. We want you to have the best experience possible.

Myth: I need a doctor’s referral for a mammogram.

Fact: If you are 40 or older, most doctors do not require a referral to get a routine screening mammogram. You can schedule it yourself.

If you feel a lump or other change in your breast, call your doctor. He or she will decide on the most appropriate imaging exams and send an order to the Breast Center.

We can request your prior mammogram images and help you navigate this process.

Myth: I don’t need a mammogram because I don’t have a family history of breast cancer.

Fact: Eighty-five percent of people diagnosed with breast cancer do not have a family history of breast cancer.

You owe it to yourself and your family to get a mammogram.

Technologist Emily Ottmers begins the mammogram by positioning each person for image clarity and personal comfort.

— Submitted photo

Myth: I don’t need to get a mammogram after 60.

Fact: Age is the second greatest risk factor for breast cancer, and most invasive breast cancers are found in women 55 and older.

If you are over 60, healthy and active, you should continue to have annual mammograms.

If you are not healthy and active, work with your doctor to determine the best screening plan.

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19 Myth: 2D mammograms are as good as 3D mammograms.

Fact: 3D mammograms are the best tool in the fight against breast cancer, especially for women with dense breast tissue.

3D mammograms produce clearer images of dense tissue that help identify any areas of concern.

If you don’t know your breast density, ask your doctor or call the Breast Center if you’ve had a mammogram with us before.

Myth: I’ve had normal mammograms in the past, so I can put it off for a year or two.

Fact: Most breast cancers grow slowly. However, there are aggressive kinds that can show up within a year.

Don’t risk your future health.

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Just like a flu shot or a check-up, a mammogram should be part of your routine health care every year.

Myth: I can’t get an appointment that fits my schedule.

Fact: The HCM Breast Center offers 7:45 a.m. and 5:15 p.m. appointments and appointments until 8 p.m. on the second Wednesday of each month.

Those who schedule from 5-8 p.m. on this day receive a voucher for a free medium pizza from West End Pizza Company.

For more information and to schedule your mammogram, call the HCM Breast Center at 830-990-6181. The center is located in the Brune Professional Building at 808 Reuben Street.

Mills & Associates Physical Therapy

Frank Mills, PT, Owner Melinda Mills, PT, Owner Autumn Holland, PTA Carol Johnson, PT (not pictured) Kay Wright, Office Manager Roger Trinkle, Office Coordinator Chris Swanner, ATC/LAT PTA Alice Hahn, DPT, CMTPT

20

Joint ventures: Team works to ‘restore’ patients

By Lindsey Bertrand HCM Marketing

It’s a typical Monday for Hill Country Memorial’s “Restore” team.

Amid a buzz of activity and anticipation, the nurses and patient care technicians prepare to receive that morning’s patients who have had knee, hip or shoulder total joint replacement surgery through HCM’s remarkable joint replacement center.

“Joint replacement patients have their surgeries at the beginning of each week, and they come prepared, thanks to pre-operative education,” said Marilyn Berry, RN, Restore program coordinator. “We empower patients and caregivers with knowledge about joint replacement which leads to better outcomes.”

Patients are brought to their private rooms with their coach on the dedicated Restore wing of the hospital. It is here that the patients continue to recover with family at their side, meet their team and begin physical therapy.

“All patients are up and out of bed, walking and sitting in their chairs on the day of surgery,” said physical therapist Kelly Schneider. “Faster mobility leads to overall improved outcomes for a better recovery.”

Every Monday at 1 p.m. individuals who are ready for knee or hip replacement as determined by their orthopedic physician arrive to learn about the Restore surgery experience. The two-hour class walks participants through the joint replacement process from strengthening exercises, preparation for surgery, and post-operative care.

Future patients and coaches ask questions and take notes in their Restore guidebooks.

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Hill Country Memorial’s Restore coordinator Marilyn Berry, R.N., demonstrates how a knee works after joint replacement at a pre-operative class in March. — Submitted photo

On Tuesday, the current Restore patients begin their group physical therapy.

After breakfast they gather in the Avery Gym, a dedicated room in the Restore wing. Schneider then leads the group through low-impact exercises to increase strength and flexibility while their coaches assist and

21 provide encouragement.

“Patients and their coaches participate in group therapy twice a day,” Schneider said. “This allows them to work together, and it gives patients a chance to encourage each other. It brings out their competitive sides, too.”

Between therapy sessions, occupational therapists Brooke Eckert and Wendy Trousdale teach patients how to adapt to daily activities — like putting on socks and shoes — with their new joint.

On Wednesday, the patients and their coaches prepare to go home.

Thanks to advances in surgical technique and post-operative pain management, most joint replacement patients can go home within two to three days of surgery.

After morning group therapy, everyone gathers for a “graduation lunch” to celebrate the end of their hospital stay. Then, patients and coaches attend a “discharge class” designed to prepare them for the next phase of their recovery. This class, like other aspects of Restore, is unique to HCM and helps patients stay on track for a successful recovery.

After patients are discharged, their Restore journey continues.

Physical therapists from HCM Home Care will oversee patients’ physical therapy exercises in their homes, or patients can continue their physical therapy at the HCM Rehab Center.

All of the physical therapists are trained to administer exercises specific to Restore patients.

One to two months after surgery, patients and coaches are invited back to HCM for a “reunion luncheon” to discuss their recovery experiences and share their feedback. Armed with their comments and suggestions, the Restore team members use the feedback to improve the program for future patients.

“What makes Restore remarkable,” Berry said, “is everything the team does throughout the entire process to make sure you start smart and finish strong.”

To learn more about HCM’s Restore program, call (830) 990-6134.

Occupational therapists Brooke Eckert and Wendy Trousdale demonstrate tools to help joint replacement patients with daily tasks as part of the “Restore” program at Hill Country Memorial. — Submitted photo

22

Farmer’s Market keeps it fresh Super Soups Five years into the Farmer’s Market business, Clements was approached by Hill Country Fresh is the name of the game at the Memorial Hospital to have a booth at the weekly Fredericksburg Farmer’s Market. event.

Husband and wife team David Clements Clements was hesitant at first but after connectand Cynthia England have been organizing ing with John (J.P.) Phelps, he knew that it would the Fredericksburg Farmer’s Market for the be just one more way to create a healthier compast 10 years, bringing in over 20 vendors munity in Fredericksburg. to sell vegetables, proteins, wines and even “We became a part of it when there was a dispizzas. cussion that the hospital wanted to be connected The two were surrounded by markets with the market,” Phelps said. while living in the mid-west and knew that The idea would be to sell soups made from bringing fresh foods to Fredericksburg was last week’s Farmer’s Market ingredients and then important. provide the recipes so they could be made at “The fact of the matter is we don’t always home. The recipes would also include a nutriknow where our foods are coming from,” tional breakdown so again, the community knew Clements said. “By putting people in the role what they were eating. of knowing where your food comes from, “It’s been a funny response and a great response,” you have a better knowledge of what you Phelps said. “Most people say ‘Oh that’s hospital are eating.” food, it’s probably pretty standard,’ but what they Clements also believes that when a shopdon’t realize is that these recipes are simple and per picks out the food fresh, it makes the may get them to use something they never knew cooking experience more enjoyable. how to use.”

“You begin to appreciate your food more,” Each week, the hospital offers one flavor of he said. “When you eat healthy, you shop Deeny Haertlein of Fredericksburg finds the soup made from ingredients most in season. healthy.” perfect vegetables at the Engel Farms stand On average, the booth sells 10 gallons a Over the past 10 years, the couple has seen at the Fredericksburg Farmer’s Market. The a great sense of community. market begins May 4 and runs every Thursday week. A 16-ounce container is $4 for vegetable soups and $5 for soups with meat.

“The community now has the opportu- from 4-7 p.m. at Marktplatz.

More recently, they have also started serving nity to be involved as we have created a lifeAgua Frescas. These are waters infused with style around healthy foods,” he said. “Buyers can talk directly with the people who grew it and develop relationships fruits and other vegetables for $2 for a 16-ounce serving.

Like Clements, Phelps is also amazed by the reaction from the commuaround food.”

Clements and England carefully select local vendors. They make sure nity.

“Being out in the community and really finding the connection with wineries sell wine produced with 100 percent Texas-grown grapes.

They allow baker-extraordinaire Josh Raymer to serve pizzas made from those people, and to be there to show them that the hospital is out promoting a healthy lifestyle, is really important,” Phelps said. fresh, locally-sourced ingredients.

The Farmer’s Market will begin Thursday, May 4 at the Kinderhalle pavilThis year, a retired-Methodist pastor will serve his hot sauces made from ion at Marktplatz. the spiciest peppers. Items that will be sold weekly include: The market continues every Thursday from 4-7 p.m. Live music will also Fruits in season, lettuces, kale, beets and meats like chicken, pork and be offered. For more information visit fredericksburgfarmersmarket.com. beef.

By McKenzie Wedel

23

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24

Keeping up with a growing community HCM Obstetrics to undergo expansion, renovation

By Chesney Dunning HCMH Foundation

In 2001, the Hill Country community recognized a need for quality obstetrics care at Hill Country Memorial Hospital.

Thanks to the generous giving of community members and foundations, HCM successfully completed construction of the HCM Obstetrics (OB) Department in 2003.

For 14 years, this facility has met the needs of a continually growing and changing community through four dedicated Labor, Birthing, Recovery, and Postpartum (LBRP) suites.

Today, Hill Country Memorial seeks to meet the challenges of the present and future by expanding and renovating the HCM OB Department to better accommodate the growing needs of the community.

The current OB Department has reached its capacity. The goal of this project is to anticipate and better manage increases in the volumes of patients that the facility sees on a recurring basis,

Ribbon cutting ceremonies were held in 2003 for the Hill Country Memorial Obstetrics Department. Among those on hand for the ceremony were, in front from left, Mike Tomforde, Dr. Joel Kneitz, Lisa Muniz, Vanya Keyser, Nancy Golden, Teresa Ferguson and (in back) Jodie Wanner; Melissa Stockbridge, R.N.; Connie Falk, R.N.; Bonnie Magee; Steve Kadin, and Mark Peterson. — Submitted photo Hill Country Memorial’s Obstetrics Department was completed in 2003.

Gala XVII: Delivering Our Future, which will be held in October, will benefit the project. — Submitted photo

Fredericksburg Clinic, PA

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25 thereby guaranteeing a seamless experience for Hill Country mothers.

During periods of high demand, women are often transferred between a LBRP and a dedicated postpartum room, which interrupts their recovery and occupies staff time.

Outpatient visits (antepartum) are also especially challenging for the current facility, which sees 60-80 antepartum outpatients per month, all through a small space that was not designed to manage such high outpatient demand.

In addition to the small size of this outpatient space, the room also lacks a private bathroom, and is unable to accommodate more than one outpatient at a time.

With a projected six percent increase in the number of women of childbearing age in Gillespie County by 2020, coupled with the facility’s current capacity concerns, the need for an expanded OB Department is paramount to continue to offer quality obstetrics care to the growing community.

The HCM Obstetrics Department Expansion and Renovation project will double the total number of LBRP suites from four to eight, introducing two new antepartum rooms to better accommodate outpatient demands, as well as aesthetic transformations for the four existing LBRP suites to better meet the needs of women throughout the birthing process.

The bulk of the expansion involves the conversion of the three existing postpartum rooms into two new LBRP suites and the new construction of two additional suites, for a total of eight LBRP suites. The conversion from the specialized postpartum rooms to full LBRP suites will allow new mothers to remain in the same suite throughout their entire stay, resulting in a much more enjoyable and private experience.

Plans also call for the four new LBRP suites to be outfitted with hydrotherapy tubs for pre-labor comfort, allowing expectant mothers to mitigate discomfort naturally, while maintaining the privacy of stay-

ing in the same room.

Additional amenities such as healing artwork, flexible storage options, and multi-functional furniture for seating and sleeping will create a more intimate, home-like atmosphere in which to share the joy of new life with loved ones.

The HCM fundraising campaign is already underway to raise $2.5 million toward the HCM Obstetrics Department Expansion and Renovation project.

In October of 2017, HCM will hold Gala XVII: Delivering Our Future, benefitting the project.

When full funding is in place, construction is anticipated to begin in early 2018 and span approximately 12 months to completion.

To learn more about underwriting opportunities and to contribute to the project, visit http://hillcountrymemorial.org/page/hcmh-foundation/ or call the HCMH Foundation at 830-997-1297.

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Hormone imbalances in men and women Chronic Fatigue and Autoimmune Disorders Food Allergies and Gut Disorders Metabolism & Obesity evaluations Ideal Protein comprehensive ketogenic weight loss program Nutritional DNA testing

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26

Keeping kids healthy

By McKenzie Wedel The earlier we start, the easier it is to avoid health problems.

Encouraging healthy eating and exercise habits and educating students on health are the primary goals of Judy Mayo, RN at Fredericksburg Elementary School.

Mayo, a 24-year nurse in the district, says that begins from day one when students register.

Before students step in the door, they are being tested to make sure they are healthy.

“The state requires that we test hearing, sight and for scoliosis,” Mayo said. “Before the year even starts, we can get these kids the help they need to be healthy for the rest of the year.”

If a student needs glasses, for example, Mayo or another representative for the school, can send them to the Lions Club to get a set of glasses or refer them to a local eye doctor.

“It’s a free screening, and if a student’s family can’t afford glasses, we can get them for free,” Mayo said. “We want to make sure they get checked and get treated.”

Exercise matters Children who don’t exercise regularly are most at risk for prediabetic symptoms, Mayo said. If Mayo sees signs of high blood sugar, a brown mark on the back of their neck (indicating diabetes) or signs of being overweight, she can screen the students and get them the help they need.

While the child is in school, teachers and staff also incorporate exercise into the daily schedule.

At Fredericksburg Primary School, there is a walking program on Wednesdays where students and their family members can walk around a path and earn prizes for completing a certain number of miles, Mayo said.

At the elementary and middle schools, students are welcome to arrive at 7:30 a.m. and run or walk the track.

“When they are in gym class they start by running across the gym in a specific pattern to get them to move,” Mayo said. “Then often times they go out a play more at recess or after school. We want them to get into healthy habits.”

At the middle school and high school levels, students are required to take either athletics or a gym class, according to the district’s “Course Guide Content.” The document lays out all the graduation requirements for Fredericksburg High School students and states that students must take at least one physical education credit in order to graduate.

While Mayo is confident most are getting the exercise they need, there are still a few who struggle with weight. That’s when Mayo steps in.

She works with a small group during the school day, educating them on healthy habits and providing them with the proper resources. She also sets them up with the Hill Country Memorial Wellness Center.

“It can be really hard at times because some don’t want to do it,” she said. “They would rather just sit on the couch in front of a screen.”

Nutrition In addition to exercise, healthy eating habits can make a difference in

FISD nurse Judy Mayo, RN, checks Harrison Langford’s ears at Fredericksburg Elementary School. Mayo and assistant Nicole Vasquez see an average of 100 students a day for everything from fevers, to scraps, to ear aches. —StandardRadio Post/McKenzie Wedel one’s lifestyle, Mayo said.

The state of Texas has made changes to the menus of schools the past few years, no longer allowing foods high in calories and sugars to be offered to students.

Fried foods are also no longer allowed, according standards set by the Texas Department of Agriculture.

When a student brings their lunch, they are not allowed to bring sodas in their lunch or foods high in sugar, Mayo said.

“We want to encourage healthy eating so our lunches always include a protein, a fruit and a vegetable,” Mayo said. “This way we know at least one meal a day is helping improve diet.”

Bringing in locals In addition to the efforts of Mayo and school teachers and staff, FISD also works with the community to bring in resources.

Mayo said first graders are given a talk about dental hygiene by the Fredericksburg Masonic Lodge No. 794, along with a toothbrush, toothpaste and floss.

See STUDENT HEALTH page 28

27

Hill Country Neurology 830-990-0064 • 108 N. Edison St. www.hillcountryneurology.com CLINICAL SPECIALTIES & INTERESTS Headache Disorders, Sleep Medicine, Memory Disorders, Parkinson’s Disease and Movement Disorders

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28

STUDENT HEALTH

Cont. from page 26

FHS Health Occupation Students of America or HOSA, come to the elementary school to talk about eating healthy, exercise and washing hands.

Mayo believes that washing hands after being outside and before eating can be the easiest, most simple way to prevent the spread germs.

“Even something as simple as coughing and sneezing into your elbow can make a difference,” Mayo said.

Everyday care Along with the extra services offered in the schools, all schools offer daily care to students.

At FES, Mayo may treat 100 students a day for cuts, scrapes, sore throats and fevers.

If a student needs care beyond what the school can offer, they are referred to local doctor to be treated.

“We will refer anyone who needs it,” Mayo said.

During the summers, Mayo sends kids to the Texas Lions Camp in Kerrville, where they can be educated on everything from using insulin, inhalers and more.

Mayo also has teamed with the Student Health Advisory Council which consists of parents, students and teachers to discuss ways to keep students healthy.

With the efforts of Mayo and the Student Health Advisory Council, students in Fredericksburg will eat healthier and exercise more. And that can lead to a lifetime of good health.

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Extension programs focus on health, education Texas A&M AgriLife Extension has a vision — Help Texans Better Their Lives.

And Gillespie County Extension Agent Shea Nebgen is helping make that goal a reality through a number of health and safety programs geared toward children and adults.

“We have a lot of information available on the different programs,” Nebgen said, “to help make a difference in people’s lives.”

While some programs focus on getting the message out about healthy choices to students, others are designed to help adults start making those small changes toward becoming healthier.

Among the programs offered through Texas A&M AgriLife Extension with the help of local collaborators is Walk Across Texas!, Balance Food and Play, Health Education, Better Living for Texans, Child Safety Seat Education, Child Care Education, Food Protection Management/Food Handler’s Program, Friend to Friend and 4-H Nutrition projects.

For more information on any of the programs offered by Texas A&M AgriLife, contact Nebgen at 997-3452.

Walk Across Texas!

It’s 832 miles across Texas, and participants in the eight-week Walk Across Texas! program are encouraged to Walk Across Texas.

The 2017 Walk Across Texas! program is wrapping up in Gillespie County.

Nebgen reported that this year, the program had 269 participants, making up 33 teams.

Participants log their miles each week and report them to Nebgen.

In return, she sends out healthy tips on Mondays to keep walkers motivated and then on Friday, she will send them recipes and cooking tips.

“We all have to remember that we have to start by making small changes,” Nebgen said. “It took us a long time to get the size we are or to our current activity level, but we can make small changes to get back to being healthy.”

Over the lifetimes of the 269 participants, it is estimated that 46 people could prevent the onset of diabetes through increased physical activity, Nebgen said.

Including the cost of lost wages and health care costs, the total potential economic impact for the 2017 team participants is approximately $3.5 million, she reported.

Gillespie County 4-Her Minot Frantzen learns basic cooking skills, food safety, health and nutrition and more as part of the Foods and Nutrition project. — Submitted photo Balance Food and Play Geared toward third graders, the Balance Food and Play program includes a set of 20 lesson plans, eight takehome reading assignments, four parent letters and a journal for each student.

This year, third grade teachers at Stonewall Elementary and St. Mary’s are using the curriculum which focuses on snacking on fruits and vegetables, drinking milk with meals and water with snacks, encouraging 60 minutes of physical activity each day and limiting screen time to two hours or less per day.

The program also includes the “My Plate” food guide system.

She said the curriculum was developed for third graders because “it seems to be the grade that you can impact the most with nutrition lessons.”

Along with the third-grade program, Nebgen also works with kindergarteners to help them understand the basic concepts of eating healthy.

Health Education Through this initiative, Nebgen often collaborates with other organizations to offer educational programs for youth and adults on how to make decisions that affect their own health.

“It is always exciting when the students see me outside of the classroom and they walk up to me and say ‘I am eating more fruit’ or ‘I am eating

healthy,’” Nebgen said. “I know that the messages I am teaching are being remembered by the students.”

Partnering with the Fredericksburg High School HOSA students, Hill Country Memorial Wellness Center, Methodist Healthcare Ministries — Wesley Nurse Program and the Fredericksburg Independent School District, health fairs are held on the Fredericksburg elementary, middle school and high school campuses on a rotating basis.

A variety of screenings are offered.

The “Winning with Nutrition” program was taught to sixth through eighth grade health classes at St. Mary’s School and among other topics, focused on the importance of eating correctly as athletes.

Better Living For Texans As part of the Better Living for Texans program, Nebgen partnered with The Good Samaritan Center to present the “Fresh Start to a Healthier You” program in Spanish.

Delia De La Cruz taught the class, which focused on the importance to eating well, cross contamination of food, cooking foods to the correct temperatures, eating the My Plate components and more.

“We are able to reach people we may not otherwise have,” Nebgen said.

Through a partnership with Walgreens and Methodist Healthcare, flu shots were provided for 42 people this past year in conjunction with the Child Safety Seat Checkup event.

Child Safety Seat Education Going hand-in-hand with health education, is Texas A&M AgriLife Extension’s Child Safety Seat Education.

Nebgen has been a certified child safety seat technician since 2003.

She said she became a technician after she washed her son’s car seat and realized she couldn’t put it back together again.

And, she said, “I was misusing it. I wanted to learn how to install it correctly for the safety of my child.”

Of the 68 seats expected, 97 percent of them were installed incorrectly.

“Kids always leave safer than when See EXTENSION page 30

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they arrived,” Nebgen said.

Child Care Education Working with other Texas A&M AgriLife Extension offices, Nebgen and a group of fellow agents offer a child care provider training conference each fall.

Last year, 148 child care providers and directors who provide care for 1,884 children enrolled in 31 centers or family day homes attended the conference and earned continuing education training.

Food Protection Management, Food Handler’s Program Because food safety is a concern among consumers, Texas A&M AgriLife Extension offers the Food Protection Management and Food Handler’s Program courses.

Nebgen explained that the two-hour food handler course is targeted toward front-line food service workers.

“Food Safety: It’s Our Business” is the curriculum for the two-day food manager’s certification training.

Friend to Friend Purpose of the Friend to Friend program is to encourage women to get reg-

ular mammograms and Pap are judged on their dish, tests for the early detection preparation and knowlof breast and cervical cancer. edge of foods.

Held at the Fredericksburg The Nutrition Quiz Bowl United Methodist Church, is a “Jeopardy”-like event, the program was offered in and teams are quizzed both English and Spanish, over all aspects of health and was attended by 104 and nutrition. women.

For the Food Challenge, Of that number, six were teams are given a bag of Nebgen referred for further testing. groceries, a list of ingredi“This program definitely ents but no directions and impacted some people’s lives,” she said.

40 minutes to create a dish. In that time, “Knowledge is key.” they must prepare and correctly plate a Collaborators included Hill Country dish that has been cooked to the right Memorial Breast Center, the Golden Hub temperature.

Senior Center, Methodist Healthcare In addition, they must give a fiveMinistries of South Texas, The Good minute presentation on how the recipe Samaritan Center and the Hill Country fits into My Plate, cost, food safety, nutriMemorial Hospital Marketing Team. tional value and healthy substitutions.

Students in these contests first com4-H Foods and Nutrition pete at the county level. Winners then Through the 4-H Foods and Nutrition advance to district, and from district, project, youth learn basic cooking skills, senior division winners have the opportufood safety, health and nutrition and nity to compete on the state level. more.

This year, a senior Quiz Bowl team and The projects include the Food Show, two senior Food Challenge teams will be Nutrition Quiz Bowl and the Food competing at the state contest in June.

Challenge.

Winners there have the opportunity to Youth participating in the Food Show advance to nationals.

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