Boone Health FALL 2020
Identifying
RI S K A New Era of Preventative Screening for Mid-Missouri Women
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Bounce Back
As a critical care physician, I work with very sick patients. The entire care team has to be highly trained and skilled when situations become difficult. When you are at your most vulnerable, you need a team you can trust. I believe in Boone.
Osaze Edo-Ohanba, MD
Your Critical Care Team
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President Jim Sinek Director of Marketing & Public Relations Ben Cornelius Communications Consultant II Jessica Park Digital Communications & Marketing Consultant II Madison Loethen Marketing Consultant I Erin Wegner Photography Sadie Thibodeaux Contributing Writers Hunter Blume, Maria Bickell, Kate Mirly, Tiffany Schmidt
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Please submit comments or feedback to erin.wegner@bjc.org or call 573.815.3217 1600 East Broadway Columbia, MO 65201 573.815.8000
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A Note from Jim
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Iron Constitution
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Hospital Headlines
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What’s Up, Butternut
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Filling a Need
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5 Questions & Answers
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Identifying Risk
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Remember
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Get to Know a BHC Provider
Cancer Screenings
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Get to Know a BHC Nurse
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Bounce Back
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A Cardiac Tune-Up
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A Life-Saving Journey
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Foundation News
About Immunizations
Working inside of a hospital can be stressful and challenging. I need to be in a place where I am comfortable and confident in my team. When I am here, I know I am providing the best care available. I believe in Boone.
Vidhi Patel, DO
Your Hospitalist Care Team
A NOTE FROM JIM
Farewell Note from Jim six years. No other mid-Missouri hospital has been rated higher than three stars. • Opened the Nifong Medical Plaza, a substantial ambulatory medical center, to serve the growing population in Southwest Columbia • Partnered with Stephens College to begin the newest, most innovative Bachelor of Science accredited nursing program in Mid-Missouri. The inaugural class began this fall. • Grew the Boone Medical Group from approximately 20 providers to more than 50 providers, located in approximately 17 clinics and 10 communities throughout Mid-Missouri.
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his will be my final “Note from Jim” in My Boone Health magazine before I retire from my position of president on December 31, 2020. That date also represents the conclusion of BJC HealthCare’s lease agreement with Boone Hospital Center. As Boone Hospital Center’s president for over the last seven years, I look back with pride on the accomplishments we have achieved, the friendships I’ve developed, and the incredible talent, leadership, and compassion each Boone Hospital Center employee exhibits. What differentiates Boone Hospital Center is that each individual team member, during every minute of every shift, produces “great” results — not just ”good” results. Their individual decisions drive better patient safety outcomes, higher patient satisfaction, a friendlier and more enjoyable work environment, and overall excellent clinical outcomes. All hospitals have facilities, equipment, supplies, and technology, but only Boone Hospital Center has the secret ingredient: the Boone "employee leader". This band of Boone brothers and sisters, some 1,800 strong, have led this organization to accomplish many recent significant achievements, including: • Being ranked the #1 hospital in Mid-Missouri and among the top five hospitals in the state of Missouri for six consecutive years by U.S. News & World Report
• Received the American Heart Association/American Stroke Association’s Get with the Guidelines Stroke Gold Plus Achievement award and the Target Stroke Elite Honor Roll award. • Received the American Heart Association/American Stroke Association’s STEMI Gold Plus recognition award based on achieving top performance standards. Above are just a few of the accolades and achievements that BJC and the Boone Hospital Team have earned and received during the time I’ve been privileged to be their president. I want to give my sincere thanks and acknowledgment to each of my Boone teammates, medical staff members, BJC colleagues, and our volunteers for their dedication, passion, and commitment to achieving excellence. This consistent leadership and drive toward perfection has been successfully demonstrated during my tenure at Boone Hospital Center. And finally, thank you to the people and communities of Mid-Missouri for supporting the Boone Hospital Team, my family, and me. May the historical success Boone Hospital Center has achieved continue into Boone Hospital’s next phase as an independent hospital. Take care and stay healthy,
• Our fourth consecutive designation as a Magnet® hospital by the American Nurses’ Credentialing Center — the highest achievement for hospital professional nursing • Earning the highest rating of five stars by the Centers for Medicare and Medicaid Services (CMS) for the last
Jim Sinek President, Boone Hospital Center
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HOSPITAL HEADLINES
Boone Hospital Center Recognized As No. 1 Hospital In Mid-Missouri By U.S. News & World Report For Sixth Year In A Row
Boone Hospital Center Receives Major Awards From The American Heart Association/American Stroke Association For the sixth year in a row, Boone Hospital Center was the top-ranked hospital in midMissouri by U.S. News & World Report. It also ranked #4 in the state of Missouri, up one position from last year. Boone Hospital Center was rated High Performing in orthopedics and seven procedures or conditions: aortic valve surgery, chronic obstructive pulmonary disease (COPD), colon cancer surgery, heart bypass surgery, heart failure treatment, hip replacement surgery, and knee replacement surgery. For the 2020-21 ratings, U.S. News evaluated more than 4,500 medical centers nationwide in 10 procedures and conditions. Fewer than a third of all hospitals received any high-performing rating, and only 37 earned this rating in all 10 Procedures and Conditions. The state and metro-area rankings recognize hospitals that received high-performing ratings across multiple areas of care. The U.S. News Best Hospitals methodologies in most areas of care are based largely on objective measures such as risk-adjusted survival and discharge-to-home rates, volume, and quality of nursing, among other care-related indicators. Best Hospitals was produced by U.S. News with RTI International, a leading research organization based in Research Triangle Park, NC. For more information visit: health.usnews. com/best-hospitals/rankings
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Boone Hospital has received the American Heart Association/American Stroke Association’s Get With The Guidelines®-Stroke Gold Plus Quality Achievement Award, Target: Stroke Elite Honor Roll Award, Mission: Lifeline® Gold Plus Receiving Quality Achievement Award, and the Mission: Lifeline® NSTEMI Gold Quality Achievement Award. The Get With The Guidelines®-Stroke Gold Plus Quality Achievement Award recognizes the hospital’s commitment to ensuring stroke patients receive the most appropriate treatment according to nationally recognized, research-based guidelines based on the latest scientific evidence. Boone Hospital additionally received the Association’s Target: Stroke Elite Honor Roll Award. To qualify for this recognition, hospitals must meet quality measures developed to reduce the time between the patient’s arrival at the hospital and treatment with the clot-buster tissue plasminogen activator, or tPA, the only drug approved by the U.S. Food and Drug Administration to treat ischemic stroke. “Boone Hospital Stroke Program’s mission is to provide the highest standard of care for stroke patients throughout central Missouri. This recognition from the American Heart Association for the second year in a row speaks to the dedication of our staff to achieve this goal. I could not be more proud of the collaborative efforts from this multidisciplinary team in order to improve our patients’ outcomes, and it is nice that they have earned this recognition for their hard work,” says Boone Hospital Center Stroke Program Coordinator, Chris Benne, BSN, RN, CEN. Boone Hospital received the Mission: Lifeline® Gold Plus Receiving Quality Achievement Award for implementing specific quality improvement measures outlined by the American Heart Association for the treatment of patients who suffer severe heart attacks. Boone Hospital also received the Mission: Lifeline® NSTEMI Gold Quality Achievement. It earned the award by meeting specific criteria and standards of performance for the quick and appropriate treatment of NSTEMI heart attack patients by providing emergency procedures to re-establish blood flow to blocked arteries when needed.
Introducing Boone Health CEO Troy Greer On Monday, August 31, Troy Greer started his first day as chief executive officer for the Boone Health System. Troy will be responsible for leading Boone Health in meeting the health care needs in the system’s 26-county service area. He will also lead transition planning for the new independent Boone Hospital Center, while Jim Sinek will continue to serve as president and lead the hospital’s dayto-day operations until his retirement at the end of the year. Prior to joining the Boone team, Troy served as the CEO of Lovelace Medical Center in Albuquerque, New Mexico, a 318-bed, two-hospital campus, which includes the Heart Hospital of New Mexico at Lovelace Medical Center. “We are excited to have someone of Troy Greer’s stature and accomplishments lead us as we embark upon our mission as an independent community hospital system,” said Dr. Jerry Kennett, chairman of the Boone Hospital Board of Trustees, in an announcement released in July. The Trustees led a deliberate selection process that initially attracted nearly 200 qualified applicants. After reviewing the detailed biographies of 11 applicants and conducting follow-up phone interviews with eight individuals, Troy was one of three final
candidates to visit Columbia to meet with the Trustees, medical staff, hospital leadership and employees, and community members. “The opportunity to be part of such an exciting transition spurred my initial interest,” Troy says. “As I learned more about the incredible teamwork, quality, and service, it proved to be an opportunity I could not pass up. I believe in Boone!” Troy says his first priority is “to work on establishing relationships and acclimating to the Boone community. It is an honor to be a part of an organization with so many accolades, and I want to listen to those who have worked diligently to make Boone a success. It is crucial we protect the culture of exceptional quality, service, and dedication to our community and fellow team members.” Troy was born in South Ruislip, U.K., where his father was stationed with the U.S. Army, but calls Huntsville, Alabama, his hometown. He received his Bachelor of Science in health care management from the University of Alabama, then went on to earn both an MBA and a Master of Science in health administration at the University of Alabama at Birmingham. He and Mandy, his wife of 25 years, have two adult children. 22-year-old Caldwell is currently completing his Army basic training at Fort Benning, Georgia, and 21-year-old Victoria is a senior at the University of Alabama. Troy says he especially looks forward to “bringing together the many voices who have been a part of Boone to shape our future together. This is truly a unique experience for a new beginning — even after 100 years of service to Mid-Missouri.”
Boone Hospital Center Ranked in Top 10 For Customer Loyalty Boone Hospital Center was named to the third-annual NRC Health Top 100 Consumer Loyalty list, the first and only loyaltybased hospital rankings that recognize the top U.S. healthcare organizations for earning exceptional loyalty ratings from their patient populations. Boone Hospital’s ranking was based on results from NRC Health’s Market Insights survey, the largest database of healthcare consumer responses in the country. From April 2019 to March 2020, NRC Health surveyed more than 310,000 households in the contiguous U.S. to measure consumer engagement with community healthcare brands. The winning organizations on the 2020 Consumer Loyalty list achieved remarkably high scores on NRC Health’s Loyalty Index, a composite of seven different critical aspects of consumer loyalty, including Access, Engagement, Experience, and Net Promoter Score. “Boone Hospital and the other hospitals recognized in this year’s Consumer Loyalty Awards are at the forefront of delivering patient-centric care, which is more important than ever in this new normal in healthcare,” says Helen Hrdy, Chief Growth Officer at NRC Health. “We are proud to recognize these industry-leading organizations and the commitments they hold to their patients and
improving the complete care journey now and moving forward.” For nearly four decades, NRC Health has helped healthcare organizations Consumer illuminate and improve the moments Loyalty that matter most to patients, residents, A W A R D BEST physicians, nurses and staff. CLASS “Boone Hospital Center’s dedication to its patients and community is proven through this recognition and the countless other national awards and rankings that Boone achieves. That dedication has driven our patient care results to be among the best in the country. Providing our patients and Mid-Missouri excellent care has always been our mission. It is an honor that our patients and communities continue to believe in Boone,” says Jim Sinek, Boone Hospital Center president. Winning organizations were publicly announced on Monday, August 24, during the virtual 26th Annual NRC Health Symposium. A complete list of winners can be found at nrchealth.com/NRCHealthTop100Loyalty. IN
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Filling a Need
Over 25 years and four locations, Boone Plaza Pharmacy has served Boone employees and now patients.
Filling a new prescription can be worrisome. We wonder, what questions should I ask the pharmacist? How do I take the medication properly? How will it make me feel? What if I forget to ask? For 25 years, Boone Hospital Center’s outpatient pharmacy has answered these questions and many others, with priority on making sure the patient is comfortable and understands the medications they’ve been prescribed before leaving the pharmacy. Chris Janicek, RPh, Boone Plaza Pharmacy Supervisor says, “Anytime we
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have a customer with a new prescription, we go over how to take the medication properly. We want the patient to know if their medication needs to be taken with food or on an empty stomach, what the side effects are, and if there are any drug or food interactions. When a patient is discharged after surgery, our pharmacists will counsel the patient on when and how to take the pain medication. Our pharmacists also want the patient to be aware of what is in the pain medication, for example, whether the prescribed pain medication has Tylenol. ” Boone Hospital Center’s first outpatient pharmacy broke ground on May 8, 1995. Boone Plaza Pharmacy, so named because it was originally located in Broadway Medical Plaza 1, allowed the pharmacy to fill prescriptions for both employees and patients. Before then, they could only fill employee prescriptions. This year, the outpatient pharmacy is celebrating its 25th anniversary. Since
opening its doors, the pharmacy has moved three times. In 2006, Boone Plaza Pharmacy relocated across the street to the hospital’s Nifong wing. In 2008, it moved next door to the inpatient pharmacy. And in 2017, Boone Plaza Pharmacy cut the ribbon on a prominent new location in the hospital’s main lobby. Chris and Pharmacists Amy Welch and Carma Pohl have all been with the pharmacy for every move. Chris says: “Moving every few years has kept things interesting. It’s exhausting and a lot of work. Since we’re dealing with prescription medications, we’re concerned with security. The Missouri Board of Pharmacy regulations only allows personnel registered through the Board of Pharmacy to handle the medications. So no one from outside the pharmacy department was allowed to help us with the moves.” Carma agrees: “I definitely remember all of the moves as exhausting. The challenge
Meet the Boone Plaza Pharmacy Team • Stephanie Lumley-Hemme, RPh, MBA Director of Pharmacy Services • Chris Janicek, RPh Supervisor and Pharmacist • Amy Welch, PharmD Pharmacist • Carma Pohl, RPh Pharmacist • Kurt Morgan, RPh Pharmacist • Alicia Swartz Certified Pharmacy Tech • Christina Cross Certified Pharmacy Tech • Tyler Dunlap Pharmacy Student Intern
came from having to set up a new workspace that functions for safe and quick workflow, all over a long weekend.” Director of Pharmacy Services Stephanie Lumley-Hemme shares, “The business model at Boone Plaza Pharmacy has changed over the past few years. Our focus is for Boone Hospital Center patients to have their needed medications in hand before leaving the hospital.” A few years ago, the pharmacy began providing bedside delivery of medications to patients waiting to be discharged, saving patients and their families an extra stop after leaving the hospital. Prescriptions are brought to the patient’s room by a pharmacy team member, and patients can pay for their medication at the bedside. Stephanie adds: “When the patient has the medication before they leave the hospital, we know the patient has what they need to begin the road to recovery and healing after. Studies suggest that patients having their medication before leaving the hospital may reduce readmission rates, because the patient is able to ask questions of both the pharmacist and nurse while still at the hospital.” Sometimes, providers may prescribe medication that isn’t available in a hometown pharmacy. The medication may be too expensive to stock or be prescribed so rarely that it would expire on the shelf. When the patient fills their prescription at Boone Plaza Pharmacy before leaving, the medication is available. It’s also easy to transfer a patient’s prescription to their hometown pharmacy if refills are needed. The pharmacy also helps sell presurgery nutritional supplements and individual bandages, so patients don’t have to buy an entire box. It’s also stocked with a wide variety of overthe-counter items that could be useful for employees, patients and visitors. Stephanie also credits the Boone Plaza Pharmacy’s quarter-century of success to its staff. She says: “Patients are loyal to the pharmacy because they trust the staff and know we have our patients’ health in mind. We also look out for our patients’ pocketbooks by trying to find additional savings on medications.”
Chris says: “We are all a team and share the workload. You can find a pharmacist at the cash register as often as you would see a technician.” Carma agrees, “We have a strong and experienced team, and we are good at evolving!” Like other patient care areas in the hospital, the pharmacy is not exempt from tension-filled days and busy workloads. To relieve stress and share some laughs as a team, the pharmacy team uses humor to break up those moments, and has learned as a team to keep the work environment lighthearted. The Boone Plaza Pharmacy team agrees the hospital lobby is the perfect location. When the plan for the pharmacy’s move was finalized, Stephanie remembers telling everyone, “It’s like having beachfront property! Being in the lobby meant the pharmacy would be busier due to traffic flow.” Chris says: “Before we moved to the lobby, we used to give patients a map in order for them to find us. It was like following a pirate’s map — X marked the spot! Now, we are centrally and conveniently located. We are close to the Emergency Department, and visitors and patients come right past us to go home.” Alicia Swartz, a certified pharmacy tech who has been with the team for six years, couldn’t agree more: “I feel that this is where we were truly supposed to be this whole time. We are visible to the public and easy to find. Plus, the view of the Healing Garden is wonderful. But we do joke that being so close to the coffee shop is both a blessing and a curse!” Chris says: “We get to interact more with staff, physicians, volunteers and family members. That is an important part of the services that we provide. We love getting to know other people and hope to provide excellent service for anyone that we can. We get to know people’s names, employees, volunteers, doctors — we get to know them and get to know their stories. We feel like we’re a small-town pharmacy in a mid-sized town.” By Erin Wegner
MyBooneHealth.org
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Identifying Risk The Boone Hospital Center’s High Risk Breast Clinic and Harris Breast Center usher in a new era of preventative screening for women in Mid-Missouri.
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n the United States alone, one in eight women will develop breast cancer through the course of their lifetime. It is the number one cause of cancer in women, and while lung cancer is the leading cause of death due to cancer in women, breast cancer is expected to overtake that number within the next 10 years. To help change these statistics, Terry Elwing, MD, director of the Harris Breast Center, and Anne Petersen, MD, are leading the charge by formalizing the screening process at the High Risk Breast Clinic. The Harris Breast Center has been providing women with breast health services at high-volume for years. The High Risk Breast Clinic takes the work a step further, seeking to identify patients and families with elevated risks of developing breast cancer. The High Risk Breast Clinic is run by Dr. Petersen, along with Nurse Practitioner Tiffany Carmichael. The clinic provides patients with an indepth assessment of their lifetime risk of developing breast cancer. The clinic runs six different statistical models that are designed to compare the population risk for developing breast cancer. The information is recorded with stateof-the-art technology and stored in a database for comparison. Advancing age, dense breast tissue, and hormonal factors, such as late pregnancy, are general risk factors; however, a family history of breast or ovarian cancers can often be one of the most telling indications of a high-risk patient.
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Starting at age 40, every woman should get an annual mammogram. “Hopefully we can identify families, so that we can find the patients in their 20s or 30s who may need to be screened earlier than your standard patient in their 40s,” says Dr. Elwing. A patient who qualifies as “high-risk” determines whether additional imaging, such as an MRI, will be recommended. “The average person has a 12% chance of developing breast cancer throughout their lifetime, while a high-risk patient has anywhere from 20% to 60% chance,” says Dr. Elwing. A patient’s score will be determined based on their responses during their consultation. Those who fall into the high-risk category may need additional genetic testing, or we may offer medications to decrease risk. Lifestyle is another main focus at the clinic. Exposures to certain foods or hormones, diet, weight, or alcohol intake can all affect a person’s risk of developing breast cancer. “We discuss changes that a patient can make to reduce the risk of cancer,” says Dr. Petersen. “Sometimes, these outside influences have a greater impact on developing breast cancer than those that we carry inside our body.” Once the genetic assessment is complete, the clinic then works on an individual basis with each patient to help create a plan for diet and exercise or preventative testing options. The clinic also works with patients to navigate insurance and payment costs that work for their care plan. “We are here to partner with women to see what works for them,” says Dr. Petersen. “All of these things are just the beginning of a conversation and a starting point for how women can help to improve their health.”
Cynthia Chick says the physicians at the High Risk Breast Clinic were “very straightforward and informative about what to expect and what my options were.”
Early Detection
For Cynthia Chick, it was of no surprise to hear that she was a high-risk patient. Female cancers had long plagued her family, with her mother beating breast cancer twice, and multiple cousins and aunts who were diagnosed with ovarian or uterine cancers.
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Given her history, Cynthia had her first mammogram at age 30, but wasn’t considered a high-risk patient until after her daughter was born. Because of her high-risk status, Cynthia would complete an MRI each year with a follow-up exam shortly after. With female cancers almost normalized within her family, Cynthia was admittedly bad about remembering and making appointments. “I had actually forgotten about my MRI, and the clinic called to check in and immediately rescheduled,” says Cynthia. “December 4 was the day I found out. That day, I’ll never forget.” “The goal of screening is to catch the cancer early, and while it’s still curable,” Dr. Elwing explains. In Cynthia’s case, early detection gave her the ability to choose from two treatment options: a lumpectomy or double mastectomy with reconstruction. With the lumpectomy, Cynthia would be able to keep her breasts, but would be required to complete both chemotherapy and radiation treatments, while the double mastectomy would remove both of her breasts, yet would greatly reduce her potential for future cancer. “Dr. Petersen was very straightforward and informative about what to expect and what my options were,” says Cynthia. Due to her family history, they agreed that a double mastectomy was the most proactive route. Concerned about the potential for aggressive growth, Dr. Petersen quickly scheduled a double mastectomy for January 2019. The cancer was about 7 millimeters when it was originally found. Once in surgery, it was discovered that the tumor was much larger than expected. After the surgery, chemotherapy was added to her treatment plan to help combat any remaining cancerous cells. “I think I cried harder when I started to lose my hair than I did when I found out I had cancer,” Cynthia says. The treatment and recovery process is a tumultuous journey that has taken Cynthia from one end of the emotional spectrum to the other, “I’ve cried, I’ve been angry,” she explains, “Most days I’m okay with it — I know they found it early before my lymph nodes were affected and before it was too advanced.” Cynthia’s tumor sat on the chest wall, making it nearly impossible to detect through self-examination, and wouldn’t have been found through a mammogram. Without the MRI, the cancer may have gone undetected for quite some time. Cynthia is currently completing reconstruction. Looking back to the start of her journey less than a year ago, “I’d tell myself just to be patient — you will come through it,” Cynthia says. “There were some days after my mastectomy where I thought I’d never be able to pick up my arm again,” she adds. “Also, this too shall pass — mine passed like a kidney stone, but it passed.”
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Preventative Treatment
The knowledge of your genetic makeup is a powerful tool, but for some, it may feel like a double-edged sword. As a young mother and former professional dancer, Amanda Hulen was aware of her family history, but didn’t feel a strong urge to complete genetic testing due to her age and healthy lifestyle. “I just thought, ‘What would I do with that information?’” she says. Upon being diagnosed with breast cancer, Amanda’s mother had tested positive for the BRCA2 gene, meaning there was a 50% chance that Amanda, too, would be positive. While not all individuals with a BRCA2 mutation develop breast cancer, those who are positive are at a much higher risk. Though she didn’t get the genetic testing done, Amanda tried to stay proactive by keeping an open dialogue with her physicians. After mentioning her family history during a gynecologist appointment, she was directed to the High Risk Breast Clinic, where she was screened for her standard risk factors and family history. At the time of her appointment, Amanda was still breastfeeding her son, so Dr. Petersen suggested an MRI where the clinic noted a suspicious area in her breast. After a follow-up mammogram and biopsy, it was confirmed that she did, in fact, have some cancerous cells. “You hear those words ‘breast cancer,’ and you automatically think the worst,” says Amanda. “Everyone was shocked because, at 36, you don’t think cancer happens to people that young.” At this time, she knew it was time to proceed with genetic testing, which confirmed that she was BRCA2 positive. Luckily, due to the early diagnosis, the presence of the cancer had been caught before the cells had even formed a lump. Because of her confirmation of the BRCA2 gene, Dr. Petersen encouraged preemptive treatment. “In my case, it was a matter of when, not if,” says Amanda. “There are times when a woman could qualify for a mastectomy with reconstruction as a way to prevent breast cancer,” says Dr. Petersen. As a former professional dancer, Amanda struggled most with the potential loss of physical activity and appearance. Since she fit the criteria in both physical health and genetic makeup, she worked with her doctors to create a treatment plan for a double mastectomy with immediate reconstruction. As her team quickly mobilized in preparation for the surgery, Amanda received some unexpected news due to the appearance of high glucose levels during her routine blood work. “Not only did I get a breast cancer diagnosis, but I was also diagnosed with Type 1 diabetes,” she says. Without the bloodwork, her diabetes could have gone unchecked for years.
For more information, visit boone.org/hbc
“I’m now a huge proponent and advocate for checking yourself and knowing your family history,” says High Risk Breast Clinic patient Amanda Hulen.
During the surgery, it was found that because the cancer cells had been identified so early, they had not spread to her lymph nodes; however, when they received the pathology report some days later, it was determined that she would need radiation to complete her treatment. “Sometimes, I feel like I didn’t earn the ‘Survivor Card’ because my journey was comparatively easy — I was diagnosed, a month later, had surgery, then just the six weeks of radiation. But then I remember I did have a body part amputated,” Amanda laughs. On September 16, 2019, less than a year after her cancerous cells were discovered, Amanda was officially able to refer to herself as cancer-free. Because she opted for the double mastectomy, she has little-to-no risk of another breast cancer diagnosis. In addition to breast cancer, the BRCA2 gene also runs a higher risk for ovarian, skin, and pancreatic cancers. Amanda and her husband are currently meeting with doctors to discuss the options of a prophylactic hysterectomy. “Looking back, I wish I had been a little more open to doing things a little more proactively,” Amanda says. “I’m now a huge proponent and advocate for checking yourself and knowing your family history. It can help you ask questions and be aware.”
Rapid Response
“From the start, it’s a very quick process; our radiologists are on-site, and we can usually provide the patients with their results the same day,” says Dr. Elwing. “It all happens very quickly and smoothly — it’s a team process.” Cynthia and Amanda agree that their breast cancer journeys were successful largely in part to the early detection and treatment of their cancer. “If my story can help even one person get early diagnosis, then this all feels worth it,” says Amanda. The key factor is time. “All breast cancer is treatable,” says Dr. Elwing. “Seeing our patients frequently allows us to catch the cancers when they are a stage that is still curable, which is the whole goal of the screenings.” By Tiffany Schmidt
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Remember Cancer Screenings (and other important health care) By Dr. Graham A. Colditz, DrPH, MD, MPH, Siteman Cancer Center After a few months that felt like summer, we’re heading into a fall that will be different than most of us imagined. The coronavirus outbreak continues to impact our daily lives, and, unfortunately, will likely do so for a while. So, as we keep up our efforts to stay safe from COVID-19, it’s important that we not forget to look after other aspects of our health as well. This means keeping up with things like exercising, eating healthy food, connecting (virtually) with friends, and getting enough sleep. It also means getting back on track with any medical care we’ve missed. Since the coronavirus outbreak took hold in the U.S., there’s been a major drop in the number of people getting cancer screenings, vaccinations, and other key care. That’s not surprising, of course. In March and April, doctors’ offices and hospitals across the country stopped or limited non-essential care to curb the spread of the virus and to prepare to treat infected patients. At the same time, many people have avoided appointments to try to reduce their risk of infection. And, now, with new spikes in COVID-19 in parts of the country, we’re seeing some variations of this play out again. Yet, we know that missing regular medical care can impact health, especially the longer it’s delayed. Skipped cancer screenings can lead to the disease being diagnosed later when it’s harder to treat. Missed vaccinations can make children and adults more susceptible to serious infectious diseases. And delayed follow-
up for chronic conditions like unhealthy blood cholesterol, diabetes, and high blood pressure can increase the risk of heart attack and stroke. “It’s important to make sure you still get recommended cancer screenings, even during the pandemic,” said Dr. Jean Wang, professor of medicine at Washington University School of Medicine in St. Louis. “Taking action now to prevent cancer and other serious illnesses will help keep you much safer and healthier in the long run.” The specifics of doing that, though, can vary from person to person and from region to region, depending on the status of the COVID-19 outbreak and the capacity of facilities to see patients. The best approach is to contact your health-care providers and, together, discuss plans for safely getting back on track with the care you need. This may mean scheduling in-person appointments, meeting remotely through telehealth, or checking back with them sometime in the near future. Importantly, any urgent concern about your health should be addressed immediately. “If you are having symptoms, do not delay getting care,” Wang says. “Since hospitals have adapted to the coronavirus epidemic by taking necessary precautions, it is very safe to come in to get evaluated.” If cost of care is an issue because of a lost job, lost health insurance or other reason, some resources may help. Healthcare. gov has information about eligibility for Medicaid or health plan enrollment.
Another option, Wang adds, includes federally qualified health clinics, “which are available all across the country to care for people regardless of their ability to pay or their insurance status.” Contact your providers, hospital, or local health department, or visit findahealthcenter. hrsa.gov, for additional information on accessing care. While much of our focus remains on combating the coronavirus outbreak, let’s not lose sight of the important goal to stay healthy overall. Cancer screenings and regular medical appointments can be an essential part of that. So, for ourselves and our families, it’s a good time to make a plan to get back on track. It’s your — and your family’s — health. Stay in control.
Dr. Graham A. Colditz, associate director of prevention and control at Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine in St. Louis, is an internationally recognized leader in cancer prevention. As an epidemiologist and public health expert, he has a long-standing interest in the preventable causes of chronic disease. Colditz has a medical degree from The University of Queensland and a master’s and doctoral degrees in public health from Harvard University’s T.H. Chan School of Public Health.
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BounceBACK
How resiliency helps us get through and grow from life’s challenges. You probably don’t know anyone whose life hasn’t been impacted by the 2020 pandemic. Our jobs have changed. Our social and family lives have changed. We worry about things we didn’t a year ago. We may ask ourselves, “How will I get through this?” Resiliency describes our ability to adapt and learn from adversity. Everyone has some resiliency, but people with stronger resiliency find it easier to cope with difficult situations. “I think of resiliency as the ability to grasp the larger picture and find your own peace in the midst of chaos,” says Kimberly Smith, MSW, LCSW, CEAP, and Boone Hospital Center senior EAP consultant. Kimberly has been with the hospital’s Employee Assistance Program for nine years where, she says, “I teach people how to become resilient.” Resiliency isn’t a personality trait, but a set of skills that you can learn, practice, and develop. There’s no single clinical definition of resiliency, but experts agree that resilient people are strong in several key areas, including meaning, self-awareness, relationships, self-care, and optimism. We may be stronger in one area than another — someone who finds meaning from helping others might spend hours volunteering, but not give themselves time to get enough sleep.
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Meaning People tend to feel happier when they have a strong sense of purpose and live in alignment with their core values. Our values may include family, helping others, learning, faith, or teamwork. When our actions don’t reflect our values, we can feel uneasy or anxious. Identifying your core values and how you reflect them in your thoughts and actions can help you better navigate difficulties. Even if you can’t see ahead of you, you still know who you are. “We need to be able to follow our own values, mission or code of honor — whatever guides us — and we need to stick as close to that as possible, both professionally and personally. That’s going to help us more than many other coping mechanisms,” Kimberly says. Self-Awareness Our thoughts don’t appear out of nowhere — they’re habits shaped by our beliefs and experiences. And they’re not always correct — we can experience cognitive distortions, or ways of thinking that reinforce negative thoughts. If a coworker seems less friendly than usual, you might immediately assume they’re upset with you, only to learn later that they’re distracted by worries about a loved one. Self-
awareness helps us step back and recognize inaccurate and unhelpful thoughts before we act on them. People with strong self-awareness find it easier to see their problems realistically and look for solutions. Relationships Humans are naturally social — we need other people. At the same time, other people can be a source of conflict. Resilient people enjoy positive interactions and healthy relationships with their family, friends, coworkers, and community. They can accept support from others and give support to others, building a strong support system that can make a big difference in a crisis. People with strong relationship skills are more likely to set healthy boundaries, express gratitude for others, and develop good communication skills. Self-Care Self-care means tending to our own physical, emotional, and spiritual needs. We can forget to make self-care a priority, especially when we focus on caring for other people. But a lack of self-care makes it harder to handle our own problems and to help others. Self-care is often compared to putting on your own oxygen mask first before helping someone put on theirs. Stress can drain our energy, but making time to exercise, rest, eat a healthy meal, meditate or pray recharges our batteries. “Everybody needs to keep their energy and ability to focus on the activities and responsibilities of daily living. We have to start with ourselves, then work our way out to make changes we want to see in our life, our community, and our world,” Kimberly says. Optimism Optimism doesn’t mean minimizing difficult situations and emotions. In fact, a positive outlook on life can actually help us see a situation more realistically. Optimism gives us hope and builds confidence in our ability to get through rough patches, but it doesn’t come naturally for most of us. Our brains look constantly for potential threats, but they can be too vigilant. We may react to a conflict with a coworker — or possibility of a conflict — the same way we’d react to seeing a shark swim towards us. We may fear that a conflict at work could lead to losing our job, then losing our
home, health, or loved ones. Constantly fearing the worst outcome makes it harder to act on our core values. Kimberly sees optimism as having a “mature perception” and understanding what you can control, like your feelings, actions, and words. She says: “Most of us would like to think we have more control than we do. Many things that happen are things we’re not in charge of. But if we understand ourselves, we recognize what we can feel in charge of. For example, we may learn to measure our self-worth with external things, like our job title or income. Someone who bases their self-worth on their job may find it harder to handle an unexpected layoff in an economic downturn than someone who bases their self-worth on how they live their core values. Kimberly says: “People with strong resiliency have a more internal locus of control. They have a sense of understanding of who they are, which is more to do with what’s inside of them than what’s on the outside.” People with less resiliency are at higher risk for burnout and depression. When we lack resiliency, our problems can make us feel overwhelmed and powerless. Kimberly explains that when less resilient people face obstacles, “They may become paralyzed and don’t know what to do. They find it harder to function or focus.” Strengthening our resiliency doesn’t require a gym membership — there are simple exercises we can practice at home or on break. But it’s important to be intentional and to commit to regular practice. “Cultivating resiliency skills is like planting a garden,” Kimberly explains. “You won’t see growth right away, but if you keep at it, you might see it pay off months later.” Kimberly practices what she teaches. “Yesterday, I had to make a lot of calls. So,
I sat down, took five minutes, and practiced my own resiliency skills — deep breathing and calming my mind, instead of having all the chaotic thoughts rolling around. Some days, deep breathing may not be enough, and I’ll need to do additional work.” “I recognized that it was critical for me to practice resiliency to allow me to get up when life seemed too hard,” says Employee Health Nurse Cindy Brengarth, BSN, RN. “I choose to promote resiliency at Boone because it’s made a huge difference in my life, and I hope I may affect someone else in a positive way.” Resiliency is necessary for health care professionals who frequently experience stressful situations. Despite receiving excellent care, a patient may have adverse outcomes, or their condition could change unexpectedly. Health care professionals can have difficult encounters with patients, family members, or colleagues. Building resiliency empowers caregivers to take better care of themselves, so they can better take care of their patients. Cindy shares a monthly message with Boone employees about different areas of resiliency, each with a resiliency-building exercise. She says, “Resiliency may help reduce burnout, increase empathy and compassion, and reconnect health care workers with the joy and purpose of their practice.” Resiliency doesn’t mean never experiencing stress or painful emotions, but it can help us survive them and, more importantly, to learn and grow from them. When we talk about a difficult situation in our past, we may tell it as a story about how we became stronger or wiser. We’re actually telling a story about our resiliency. “At the end of a hard day, we can all find the strength to face a new one,” Kimberly says. By Jessica Park
Hard times can make anybody feel anxious or depressed. These feelings don’t mean you’re "crazy" or weak, but if anxiety or depression interferes with your activities, relationships, health, or quality of life, don’t be afraid to ask for help. Your primary care provider can help you explore options to manage anxiety or depression. More mental health counselors now offer appointments over the phone or a secure video chat. Check-in with your support system and look for resources at your job or church. Remember, you deserve to feel your best.
MyBooneHealth.org
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A LIFE-SAVING JOURNEY The Road Our Blood Travels From Donation to Transfusion
E
very year, over 5,000 blood products from the American Red Cross, including whole blood, plasma, platelet, and Power Red donations, are used to help Boone Hospital Center patients. Boone Hospital has hosted blood drives for the American Red Cross for 16 years. These blood drives are one way we support Red Cross, which delivers blood products to hospitals all over the country. The American Red Cross is broken into regions all over the United States. “Boone County and Boone Hospital are part of the Missouri-Illinois Blood Services Region. This is part of a 64-hospital network that we provide blood to. In order to provide blood year-round to our 64-hospital network, we have to collect over 214,000 blood donations yearly,” says Joe Zydlo, external communications manager for American Red Cross. Blood can be donated at Red Cross blood drives or at a Red Cross donation center. There are also several types of donations you can make to help patients.
Whole Blood • Whole blood donation is what you typically give at a blood drive. The benefit of whole blood is its versatility — it can be transfused into a patient or separated at the processing center into red cells, plasma, and platelets. • Whole blood transfusions are usually given to trauma and surgery patients.
Power Red Donation • Power Red donations can also be done at a blood drive. As you donate, your red blood cells are separated from the other blood components, and your plasma and platelets are put back into your body. This donation takes a little longer than whole blood.
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William Moore, Plant Operations Coordinator donates blood at a blood drive held at Boone Hospital.
• Power Red donations are usually given to trauma patients, newborns and birthing mothers, people with sickle cell anemia, and patients suffering from blood loss.
Platelet Donation
also separates your blood, but keeps the plasma and returns your red blood cells and platelets. • Plasma transfusions are usually used to stop bleeding in emergency and trauma patients.
• Platelet donations must be done at a Red Cross donation center using a special apheresis machine. Platelets are important, tiny cells in our blood that help us stop bleeding by forming clots. As blood is drawn from your arm, the apheresis machine keeps the platelets and returns your red blood cells and plasma.
After your donation, your blood goes on a life-saving journey.
• Platelet donations are usually given to surgery patients, cancer patients, organ transplant patients, and others with life threatening injuries.
• After your donation is completed, your donated blood and test tubes are labeled and kept on ice. “Blood is a perishable product, so it is very important to do this so that the products don’t spoil,” says Joe.
Plasma Donation • Plasma donations must be given at a donation center. A special machine
STEP ONE: DONATION • When you donate at a blood drive or Red Cross donation center, they will collect one pint, plus several test tubes of your blood.
• Your blood is driven to St. Louis for testing.
To make an appointment, visit redcrossblood.org
STEP TWO – TESTING • Testing is an important measure done with every blood donation. The test tubes go to a laboratory where several tests are done to look for infectious diseases and to verify blood type. • If there are any positives for infectious disease, donors are confidentially notified that their donation cannot be used.
Blake Barbour, MLS, ASCP prepares a blood unit for transfusion.
STEP THREE – PROCESSING • Once donated blood arrives at the processing center, whole blood donations are spun in centrifuges, which separate the blood into red blood cells, plasma, and platelets. • The standard measurement for blood is a unit. Each component of donated blood that can be used is packaged as a unit, then stored.
STEP FOUR – STORAGE • Once a unit is ready to be used, it may either be packed on ice and delivered to a hospital or stored at -2° in the Red Cross cooler until it is needed.
STEP FIVE – DISTRIBUTION • “Blood is available to be shipped to hospitals 24 hours a day, seven days a week,” says Joe. The Red Cross has volunteer transportation specialists who deliver blood units to the 64-hospital network.
STEP SIX - TRANSFUSION • A doctor determines that a patient needs a transfusion and what blood product is required. • Boone Hospital’s Blood Bank keeps over 130 units of various blood types and products on hand to ensure we can care for our patients. Orders are placed daily with the Red Cross to maintain inventory levels. Special blood products can be ordered for patients as needed. • Once a transfusion order has been received, the blood is picked up from the Blood Bank by a clinician and delivered to the bedside.
Know Before You Donate • Before you donate blood, you must be feeling well. If you feel sick the day of the blood drive, reschedule your appointment. • You will need to complete a medical history, including medications you have taken. A few medications require a waiting period after your final dose before you can donate. • If you have visited or lived in some areas of the world, you may need to wait before you can donate. • When you donate blood, it’s important that your body can replace the lost blood. A finger prick is used to check your blood’s hemoglobin level. Iron is an essential part of hemoglobin and helps our bodies produce and replace red blood cells. To ensure you have enough hemoglobin for a blood donation, eat a diet with foods high in iron and vitamin C for weeks before you donate. (Learn more about iron and vitamin C on page 20). • If you’re unable to donate blood, you can support the American Red Cross by volunteering or making a financial donation. Visit redcrossblood.org for details.
• The entire transfusion process must occur within four hours of pickup. Many checks and balances take place along the way — these essential steps ensure patients receive compatible blood products.
Today, you can even track where your blood goes when you make an appointment through the Red Cross Blood Donor App or online at redcrossblood.org. Joe says: “You’re made aware of when and where your blood donation was delivered. I know it always makes me feel better knowing where my blood went.” You may receive emails or hear radio advertisements from the Red Cross stating there is an urgent need for blood. Someone in the United States needs blood every two seconds, and the only way to get blood for patients is through donations. Because blood is an essential resource that can only be provided through donors when donation drives aren’t successful, hospitals suffer. Peggy Martin, medical technologist and Blood Bank specialist at Boone says, “Since the American Red Cross supports hospitals all over the country, people may not understand that our blood supply here, locally, decreases when other blood drives across the nation do not occur.” A single blood donation can save the lives of up to three people. If you are able, please consider donating blood. You can make an appointment to donate at a nearby drive or collection center using the Red Cross Blood Donor App, online at redcrossblood.org or by calling 1-800-RED-CROSS. By Erin Wegner
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I R O N CONSTITUTION
WELLNESS
Keep your body strong with a diet rich in this essential mineral.
H
ave you ever tried to donate blood only to be told, “Your iron is too low — please try again next time?” Unfortunately, this is often how people discover that they may have iron deficiency anemia. Iron plays an important role in your body. Iron is used to produce hemoglobin, a protein in your red blood cells that helps them deliver oxygen throughout your body. Two common symptoms of anemia — tiredness and shortness of breath — are easy to overlook because these symptoms can be caused by many other reasons. Anemia can be difficult to recognize or suspect without having your iron levels checked with a blood test by your health care provider. If left untreated, iron deficiency anemia could result in complications and severe health problems. Women, infants, children, and frequent blood donors may be at an increased risk of iron deficiency anemia. Vegetarians can also have an increased risk because the body can absorb iron from meat, poultry, and seafood more easily than iron from plant-based foods like spinach, beans, grains, and iron-enriched foods. Vegetarians can still get enough iron through their diet, but may need to be more mindful about their food choices to ensure adequate intake. To boost your iron intake through food, make sure you meet your recommended daily intake by including iron-rich foods in your meals, pair iron-rich foods with foods high in vitamin C, and avoid eating iron-
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rich foods in combination with calciumrich foods. Vitamin C helps your body better absorb iron from the foods you eat. Foods high in vitamin C include broccoli, brussels sprouts, citrus fruits, cantaloupe, cauliflower, sweet potatoes, strawberries, tomatoes, and turnip greens. Calcium can interfere with iron absorption. Because calcium-rich foods are also part of a balanced diet, finding a good way to fit both iron-rich and calciumrich foods in your diet is important. For example, you can eat calcium-rich foods like milk, yogurt, or fortified orange juice for breakfast, and then choose iron-rich foods at lunch while avoiding dairy products and other foods rich in calcium. Calcium-rich foods include dairy products, fortified cereal and oatmeal, fortified orange juice, almonds, some greens, and soybeans. Avoid taking antacids at the same time as you eat iron-rich foods. Most antacids contain calcium carbonate that can also interfere with iron absorption. If you think you have symptoms of iron deficiency anemia, or are unable to improve your iron levels with a balanced diet with more iron-rich foods, talk to your physician or a registered dietitian before you start supplementation. Because it is possible to get too much iron from supplements, which can cause other health problems, talking to a health care professional can help you make sure you take a safe supplement that’s right for your needs. By Boone Hospital’s Nutrition and Diabetes Clinic
How Much Iron Do I Need? Recommended Dietary Allowance (RDA) of Iron
Children (1-3) 7 mg Children (4-8) 10 mg Children (9-13) 8 mg Males (14-18 ) 11 mg Females (14-18) 15 mg Males (19+) 8 mg Females (19-50) 18 mg Females (51+) 8 mg
To make an appointment at Boone Hospital’s Nutrition and Diabetes Clinic, please call 573.815.3870
FOOD
SERV ING
IR O N
100% iron-fortified ready-to-eat cereal
¾ cup
18 mg
Grits, instant
½ cup
7.1 mg
Cream of wheat
½ cup
5.2 mg
Oatmeal, instant
½ cup
5 mg
Soybeans, cooked
½ cup
4.4 mg
White beans, canned
½ cup
3.9 mg
Lentils
½ cup
3.3 mg
White rice
1/3 cup
3 mg
Spinach
½ cup cooked, 1 cup raw
3 mg
Beef tenderloin
3 oz
3 mg
Baked beans
1/3 cup
3 mg
Vegetable or soy burger
1 patty
2.9 mg
Soy milk
1 cup (8 oz)
2.7 mg
Chickpeas
½ cup
2.5 mg
Kidney beans
½ cup
2.5 mg
Sardines
3 oz
2.5 mg
Nuts: almonds or pistachios
¼ cup
1.3 mg
Brussels sprouts, cooked
½ cup
1 mg
Egg
1 whole
1 mg
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WELLNESS
WHAT’S UP,
Butternut?
It’s easy to prepare delicious butternut and other winter squashes. Winter squash — a misleading title for these versatile vegetables since some are available year-round or in season starting in early fall — includes spaghetti, butternut, acorn, and turban squash, to name a few! Most winter squashes have a tough outer rind that becomes firmer as the squash matures, making them hearty vegetables that can last for months off the vine and hold up through the winter. Many people use winter squash both as fall decorations and in the kitchen. When it comes to winter squash recipes, pumpkins are usually the star of the show. There are festivals and events revolving solely around this orange gourd. However, another orange squash has been gaining in popularity — butternut squash. Butternut squash can be found yearround in grocery stores, but its peak season is from early fall to winter. When buying a whole squash, look for a heavier product with a fat neck and small bulb. A squash with a bigger bulb and small, thin neck is likely to have more seeds. Use the knock test to check for ripeness: a hollow sound when knocking means the squash is ripe, and a dull sound means the squash is either under or over-ripe. Butternut squash is a great source of vitamin A, vitamin C and fiber. Vitamin A in the form of beta-carotene makes the flesh of the squash a dark, vibrant orange. One cup of cubed, baked butternut squash contains greater than 450% of your daily requirements for vitamin A.* It’s also a good source of potassium, magnesium, and vitamin B6. Due to its rich flavor profile and natural sweetness, butternut squash can pair with both sweet and savory dishes. Many restaurants will puree the squash for soup. These soups are thick and delicious, but
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they tend to be loaded with brown sugar and butter. Other recipes use butternut squash in place of sweet potatoes. The squash can even be eaten raw on top of salads. With so many options, it’s easy to prepare butternut squash in the comfort of your kitchen. Safety tip: Winter squashes have a thick rind that can be difficult — and sometimes dangerous — to peel and cut. Practice good knife skills, and take safety measures when preparing these vegetables. Using a fork or paring knife, poke holes in the squash’s rind, then microwave the squash for 2 to 4 minutes to soften it before cutting or peeling. You can then use a vegetable peeler to easily remove the skin, which is helpful if you plan to cube the squash. You can also use this softening method when cutting the squash into halves to be roasted with the skin. By Kate Mirly, MS, RDN, LD, Boone Hospital Center Registered Dietitian *Based on USDA FoodData Central
Roasted Butternut Squash INGREDIENTS
DIRECTIONS
• 1 whole butternut squash
• Preheat the oven to 400°F.
• 2 Tbs olive oil
• With a fork or paring knife, pierce holes in the skin of the squash. Microwave whole squash for 2 to 4 minutes.
• Seasonings of choice to taste
• Use a vegetable peeler to remove the skin from around the squash. Cut the squash in half width-wise between the bulb (thicker part) and the neck (thinner part). The bulb should contain all the seeds. Cut the bulb in half and scoop out the seeds with a spoon.
Suggestions: Try a simple sprinkle of salt and black pepper, a savory combination of rosemary and garlic, or a sweet mix of cinnamon, nutmeg, and brown sugar. Add a dash of cayenne pepper with cinnamon for a warm flavor blend.
• Cut seeded, peeled squash into 1-inch cubes. • Toss the cubes in olive oil and seasonings of choice. Arrange the cubes in one even layer on a baking sheet. • Roast for 25 to 30 minutes.
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BRIN GIN G UP BO O N E BABIES
QUESTIONS & ANSWERS ABOUT IMMUNIZATIONS To vaccinate or not to vaccinate? The safety and efficacy of immunizations have been debated for many generations. When it comes to raising children, there are a lot of decisions to be made, which can lead to anxiety for you as a parent. However, information is power. The more informed you are, the easier it is to confidently make decisions for your children. BY MARIA BICKELL, BSN, RN, IBCLC, BOONE FAMILY BIRTHPLACE
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The following is a list of commonly asked parental questions and concerns. It is important, however, that you feel comfortable enough to speak openly with your child’s health care provider so that you can determine the risks and benefits for your individual children.
1. Is it necessary to immunize my child against vaccine preventable diseases that have not been around for many years? The reason these diseases have not been around for so long is because of widespread vaccination and herd immunity — an effect that occurs when enough people are vaccinated that people who can’t get the vaccine are also protected from a virus. Although it’s hard to imagine this benefit if you’ve never personally experienced or been witness to any potentially deadly diseases in your lifetime, vaccinations have proven to be the main cause of a person’s good health today in the U.S. The chance that these diseases would come back, however, could increase if a significantly smaller number of people are vaccinated. Vaccines not only protect your child, but many other people you care about.
2. Isn’t it better for my child to be exposed to the actual disease rather than develop immunity from a vaccine? Although the chance of your
child getting a vaccine-preventable disease is statistically low, there is an advantage in passive immunity, which occurs when you receive a vaccine, overactive immunity, which develops when you are infected with the actual virus. The major advantage of a vaccine is more immediate protection with a less severe physical response, fewer symptoms, and a lower risk of complications. As the Centers for Disease Control and Prevention (CDC) states on its website, “Your child might never need the protection vaccines offer. However, you don’t want them to lack the protection vaccines provide if they ever do need it.”
3. What about the side effects? The
most common side effects of vaccinations, if they do occur, are typically minor, regardless of the specific type of vaccine. These side effects may include pain or swelling at the injection site and a low-grade fever for one to two days following administration. Severe, long-lasting side effects or anaphylaxis (severe allergic reaction) is extremely rare. In addition, vaccines are continually monitored
for safety just like any other medication. Read the “Vaccine Information Statement” provided by your child’s health care provider or visit the CDC website for more detailed information about specific vaccines.
4. What about the time and money?
NEED MORE SUPPORT? Bringing Up Boone Babies is a support group provided by Boone Family Birthplace that is free and open to all parents of newborns, infants, and toddlers.
To join our Bringing Up
Boone Babies Facebook group, visit boone.org/
BringingUpBooneBabies
Most insurance companies cover vaccines at 100%. There is a federal program in place for coverage of children who are underinsured or uninsured. Not only do childhood vaccinations have minimalto-no cost, in the long run, they can also help parents by limiting the amount of time taken off work or the added health care expenses for having a sick child. The development of combination vaccines has also helped lower costs. Giving several vaccinations at the same time with a single needle stick also means fewer office visits and less trauma for your child.
5. What about the other substances in the vaccines? Vaccines today no longer contain
the preservative thimerosal, which once caused concern regarding exposure of an infant to a higher than recommended level of mercury. According to past and present scientific research, there is no relationship between vaccines (particularly MMR) and autism or between thimerosal and autism. Yes, there are trace amounts of other additives found in vaccines, but the substances that remain are already found normally in the human body. For more information about these ingredients, visit the CDC website. For more information about childhood immunizations, ask your child’s health care provider or visit cdc.gov/vaccines/ MyBooneHealth.org
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GETTING TO KNOW A BHC PROVIDER
Taylor Wesley, PA
Boone Medical Group-Moberly
I
’m from Alma, a small town in west central Missouri. I went to high school at Santa Fe, and have played sports most of my life. I met my wife at Mizzou while studying biology and moved to Little Rock, Arkansas, where I completed my Masters of Science in physician assistant (PA) studies. We are blessed to have two beautiful children, Shaylee and Landry.
Why did you get into the health care field? My interest in health care started in high school. I was always interested in science courses, especially Mrs. Keuhn’s classes. Caring for others and leading a team have also been major reasons for my joining the health care field. What interested you in becoming a physician assistant? I shadowed a wonderful physician assistant, Lindi Binder, at the University of Missouri who first introduced me to the profession in college. I was intrigued by the role of the PA in health care. I went on to shadow physical therapy, physicians, and pharmacists, but I chose PA as my field of interest. What is the most rewarding part of your job? The most rewarding part of my job is helping patients achieve their health goals. Whether that is feeling better from an illness, losing weight, or lowering blood pressure, I enjoy helping patients feel better both in the short and long-term. What is the most challenging aspect of your job? The most challenging aspect is balancing the insurance world and patient care world. We are not always able to prescribe the medications or order the tests that we would like without jumping through hoops. What do you see changing in health care in the next 5 to 10 years? I think medicine will change a lot due to technology over the next 10 years. I expect genetics research to play a major factor in pharmaceuticals and preventative medicine. I expect that access to tech-friendly applications will make it easier to communicate with patients and other health care professionals.
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What advice would you give someone looking to become a PA? My advice for anyone interested in becoming a PA would be to make sure that you understand the profession. There are still a lot of misconceptions about the PA profession in the general public. I spend time daily educating my own patients about my role. I would also encourage anyone interested to start the process because it was one of the best decisions I’ve ever made. What do you enjoy doing outside of work? I enjoy spending time with my family. We enjoy hiking, fishing, going to the lake, or simply staying home. I’m a big fan of the Royals, Chiefs, and Tigers. What advice would you give to someone who is going to be a patient in a hospital for a period of time? Know that the staff cares about you. Their jobs are to ensure you get the best quality health care possible. That said, don’t be afraid to ask as many questions as you need to make sure you have all the information necessary to make good decisions based on your needs and desires.
GETTING TO KNOW A BHC NURSE
Sadie Brimer, BSN, RN Surgical Specialties
I
was born and raised in Moberly, Missouri. After I graduated high school in 2011, I received my BSN from the University of Central Missouri in 2014. My husband, Seth, and I live in Boonville with our two sons Zander, 4, and Lincoln,1.
Why did you get into the health care field? I’ve always loved to help others, and when I took human anatomy in high school, I knew the medical field was where I belonged. I was fascinated by everything I was learning. What interested you in your particular specialty? My decision to work in Surgical Specialties was actually influenced by other nurses at Boone Hospital Center. They encouraged me to work on this floor when I was a new graduate nurse. I’m so happy that I took their advice. What is the most rewarding part of your job? It’s rewarding to see patients get better, understand their bodies, and ultimately return home to their families. Knowing that a patient may be terrified of all that is going on, but that I’m able to help them through it is a great feeling. What is the most challenging aspect of your job? Not being able to be in five places at one time! It’s always a challenge trying to help every patient manage their symptoms in a timely manner. What has changed in your field since you started practicing? Since our general surgery group has changed over the past few years, I have seen many changes in regard to how we help patients recover, especially in their diet orders. What do you see changing in the next 5 to 10 years? I expect more changes to happen in how we manage recovery for surgery patients and more changes to wound care processes.
What do you enjoy doing outside of work? Outside of work, I enjoy spending time with my boys, playing games, or going on walks. I’m very family-oriented — I’m always trying to find a reason to visit my parents or mother-in-law, or to encourage a family board game night. What advice would you give someone looking to become a nurse? My advice is to find your reason why you want to be a nurse and don’t forget it. Nursing is not for the weak of heart — many days are stressful enough to wear you out. Knowing why you’re in this role and how your interactions will impact your patients’ well-being is important.
MyBooneHealth.org
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A Cardiac Tune-Up Learn how to keep your body’s engine running in top condition.
Your heart is the engine driving your body, making sure it has enough oxygen and nutrients to keep going. Much like the engine in your car, your heart requires regular preventative maintenance. Without it, we can run our hearts to the breaking point. To maintain a healthy heart, we must keep the pump strong, keep the blood thin, and cut unnecessary stressors. Your body’s engine needs healthy fuel, clean lines, and all cylinders firing. By actively managing your risk factors and making small changes towards a healthier lifestyle, you can keep your heart in good working order.
Exercise. Physical inactivity is the most common risk factor for heart disease. People who get less than 150 minutes a week of moderate physical activity are at a much higher risk than more active people. Regular exercise can help you manage your weight, blood pressure, and cholesterol and glucose levels. Just 30 minutes a day of lower intensity exercises, such
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as walking or bicycling, for five days a week can strengthen your muscles and heart. Building muscle increases your caloric expenditure, metabolic function, and ejection fraction, which is a percentage of how much blood the left ventricle of your heart pumps out with each contraction. And a stronger heart can pump more blood with less effort and pressure. Exercise can also reduce stress that contributes to high blood pressure.
Eat a balanced diet. You can also manage your weight, cholesterol, glucose and blood pressure by limiting your portion sizes, eating fewer saturated and trans fats (often found in hydrogenated oils and fatty meats), eating five to nine servings of vegetables and fruit a day, and adding more foods with omega-3s like nuts, seeds and fish.
Watch your cholesterol. Your blood lipids include total cholesterol, LDL cholesterol, and HDL cholesterol. Cholesterol is a waxy substance that
If you have questions, visit boone.org/heartcheck or call 573.815.8150
can contribute to atherosclerosis, or plaque buildup in blood vessels. High cholesterol increases your likelihood of heart attack or stroke. LDL cholesterol creates abrasions on arterial walls that plaque can stick to. HDL cholesterol beneficially helps remove LDL cholesterol from the bloodstream.
Kick the habit. In addition to its effects on your lungs, smoking negatively affects your blood lipids by lowering HDL cholesterol.
Check your blood sugar. If you have diabetes, unmanaged blood glucose can damage the blood vessels and nerves of your heart, making you more likely to develop cardiovascular issues, including congestive heart failure, heart attack, stroke, or peripheral artery disease. A good rule of thumb for blood sugar is a fasting value between 70 and 110 or a 2-hour post-meal value lower than 140.
Watch your body fat. People who have more adipose tissue — or fat — in their midsection are at higher risk of heart disease. A body fat percentage of less than 22% for men and less than 30% for women can significantly lower cardiovascular risk.
Cut the salt. High blood pressure is a common risk factor for an unhealthy heart, but can be managed by eating a diet with less sodium. The American Heart Association recommends we eat less than 2,000 milligrams (mg) of sodium a day. A good rule of thumb: Check the label. If a food has more mg of sodium than it has calories, it’s not a healthy choice.
Destress. People with high-stress levels experience a fight or flight response that releases hormones, which cause changes in the body, including weight gain, irregular blood glucose, and higher blood pressure.
Take your heart in for a check-up. Boone Hospital Center’s Heart Health Check tests your blood pressure, blood sugar, blood lipids, body fat percentage, and calcium score to assess your cardiovascular risk. To schedule your Heart Health Check, call 573.815.8150 or visit boone.org/heartcheck By Hunter Blume, BHC Exercise Physiologist
Boone Hospital Center
Heart Health Check Boone Hospital Center’s Heart Health Check program is designed to catch potential cardiovascular issues before they become a problem. Consider a Heart Health Check if you answer “yes” to any or all of these statements. I have high blood pressure or cholesterol, even if it is being medically managed. I have a family history of heart disease. I have Type 2 diabetes. I am a smoker or former smoker. What is a Heart Health Check? The Boone Hospital Heart Health Check includes: • Laboratory analysis to evaluate cholesterol and risk for developing diabetes which includes a full lipid panel and A1C. • A cardiac calcium score screening uses computed tomography (CT) to check for calcium deposits in the walls of your heart’s arteries. These deposits may indicate early development of heart disease. • An Advanced Body Composition® Assessment; a quick, low dose x-ray exam that measures fat versus lean mass in the body. It may help your health professional assess what is needed to maintain or improve your ratio which can minimize your overall cardiac risk. How does it work? • To schedule your Heart Health Check, call 573.815.8150. • Your appointment should take less than one hour. • Your appointment will be located at the Boone Hospital Nifong Medical Plaza at 900 W. Nifong, Columbia, MO. • You do not need a physician referral for an appointment, but you will need to designate a primary care provider to recieve your results. If you do not have a primary care provider, call 573.815.6400. • Insurance is not needed for a Heart Health Check. • At your appointment, you will be charged $200. This price includes all of the services mentioned above. • Your results will be sent to a Boone Hospital Center clinician. The clinician will call you to review your results and offer follow-up suggestions. Results will also be sent to your primary care provider. Questions? Call 573.815.2274 or visit boone.org/heartcheck.
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FOUNDATION NEWS
2020 Golf Tournament Sponsors The Boone Hospital Foundation annual Golf Tournament scheduled for Monday, July 20, 2020 was cancelled due to the pandemic. Many of our tournament sponsors asked Boone Hospital Foundation to keep their donations. Our community’s generosity and support enhance patient care, advanced technology, community health programs, and staff education at Boone Hospital Center. Thank you to our community members for sharing the gift of health!
Atkins
Central Missouri Autobody, LLC
Huron
Septagon Construction
Lenoir Woods
Shelter Insurance
Meyer Electric, Inc.
PYA
Mid-America Precast
TEAMHealth Tech Electronics, Inc.
BJC Home Care Services
Columbia Landcare, LLC
Boone Hospital Home Care & Hospice
Columbia Orthopaedic Group
Bob & Brenda Wagner
Commerce Bank
Millers Professional Imaging
Dr. Andrew & Kim Getzoff
Ron Netemeyer
Boone Hospital Center Administration Boyce & Bynum Pathology 30
BOONE HOSPITAL CENTER
Fall 2020
The Bank of Missouri UMB
Jill Harper
Orscheln Farm & Home
Will Electronics
Healogics
Phoenix Textile
Woodrail Centre
Y OU AR E INV IT ED T O T HE 2020 BOONE HOS PITAL F OUNDATION
2020
CALENDAR OF EVENTS
NOVEMBER 10 & 11 Stay home and seize the opportunity to invest in the #1 hospital in mid-Missouri and the #4 hospital in the state of Missouri!
Your generous gift ensures continued support for Boone Hospital Center’s programs and services to provide the best patient care available.
Invitations will follow. For more information, visit boone.org/Foundation/Gala or call 573.815.2801 Thank you helping Boone Hospital Foundation enhance lives and improve the health of our community!
Scrubs on Site NOVEMBER 7
Annual Gala DECEMBER
COMO Gives Campaign MyBooneHealth.org
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Boone Hospital Center 1600 East Broadway Columbia, MO 65201 573-815-8000
NONPROFIT U.S. POSTAGE
PAID
COLUMBIA, MO PERMIT 286
For the sixth year in a row, Boone Hospital Center was ranked the #1 hospital in Mid-Missouri by U.S. News & World Report. We were also ranked #4 in the state of Missouri. U.S. News ranks hospitals based on 12 specialties utilizing a mathematical model combining reputation, mortality rate, patient safety and care-related factors such as nursing and patient services.
