My Boone Health - Spring 2022

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Boone Health SPRING 2022

A PREMATURE

Blessing When baby Peyton arrived 8 weeks early, the Boone Health Foundation was there for Josh and Carlene. PG. 20

PG. 14

Early Detection



Table of Contents 8

MANAGING EDITOR

Erin Wegner Marketing & Communications Consultant I COPY EDITOR

Jessica Park Communications Consultant II CONTRIBUTING WRITER

Madison Loethen Digital Communications & Marketing Consultant II PHOTOGRAPHY

Sadie Thibodeaux ADDITIONAL CONTRIBUTING WRITERS

Tara Phillips, Hannah Robertson,

Jennifer Tveitness, Jenny Workman

Follow us Check us out on Facebook, Twitter, Instagram, Pinterest and YouTube.

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Please submit comments or feedback to erin.wegner@boone.health or call 573.815.3217

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1600 East Broadway Columbia, MO 65201 573.815.8000

For a FREE subscription, call 573.815.3392 or visit boone.health/my-boonehealth and click on the subscription link on the right side of the page.

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A Note from Troy

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A Premature Blessing

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Hospital Headlines

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Tips for Safe Baby-Wearing

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Angie and Her Boone Angels

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Get to Know a BHC Doctor

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Getting His Voice Back

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Get to Know a BHC Nurse

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Early Detection

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Hello, Avocado!

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Lab Tested

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Physical Activity at Any Age

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Medication Disposal Tips

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Foundation News

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Go after the life

you want.

You’ve got big dreams. We admire that. Discover a culture that embraces hands-on, immersive learning, values critical thinking, and empowers women’s leadership and personal success.

Take advantage of our state-of-the-art Center for Health Sciences which features high-tech classrooms and a complete anatomy lab. Experience the new vision of nursing education through our innovative partnership with Boone Hospital Center. Earn your Bachelor of Science in Nursing in just three years with early access to clinical experiences. We offer innovative, research-centric degrees in Integrative Human Biology, Health Science, Human Development and Psychology. Explore all that the School of Health Sciences has to offer at stephens.edu.


A NOTE FROM TROY

A Season of Growth

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t Boone Health, safety is our #1 priority, but it’s not our only priority. Our patients benefit from the high quality of care reflected in our scores and numerous awards, but they don’t choose Boone based solely on data. They choose our hospital, primary care clinics, and outpatient services because they know we will treat them and their loved ones with dignity and compassion. I believe our culture is why Boone receives excellent ratings from groups like U.S. News & World Report or Centers for Medicare and Medicaid services. Our employees don’t take excellent care of their patients because they want higher HCAHPS scores – they do it because they’re motivated to provide the best care. They make safety and compassion their priorities because it’s the right thing to do. A caring and friendly culture can’t be as easily quantified as readmission rates, but it’s reflected in what our patients, staff and physicians say about Boone. Our culture is also why people choose to work at Boone Health. Ask any Boone employee why they love working here, and they’ll tell you, “It’s the people.” We know that, over the last 2 years, we have had to make decisions that were necessary to protect our patients, visitors, and employees from COVID-19, but which also conflicted with our culture. As one employee told me, we’ve had to do things that are “not Boone.” For example, visitor restrictions were not an easy decision to make, but were made with patient and staff safety in mind. Even as we made the decision, we understood restrictions would be frustrating for our patients and the people who trust Boone to care for their families. While necessary, the restrictions weren’t popular with our employees, either. They didn’t like telling family members that they couldn’t be at their loved one’s bedside.

They didn’t like putting patients in the position of choosing who could visit them that day. Our nurses have missed face-to-face interactions with their patients’ families. Not only do they usually get important information on a patient’s health from family members; they love being able to listen, offer support or just be there. And a spontaneous “thank you” from a grateful family member can make a difference in an employee’s day. Our Boone Family Birthplace staff has missed seeing children eager to visit Mom and meet their new brother or sister on the Postpartum floor. Our Community Wellness nurses miss hitting the road in our Mobile Health Unit to provide free screenings across mid-Missouri. Our employees have missed gathering to celebrate with their coworkers. They’ve missed hugs, group selfies, and carry-ins. And while they understand why protective gear is necessary, Boonies don’t like how masks conceal their smiles. In short, we miss what makes Boone special as much as you do. But while the culture of Boone might have been restricted by the pandemic, it

remains strong. It thrives in the hearts of our employees, physicians, volunteers, patients, families, and communities. Recovery is often described as a journey, not a destination. There can be setbacks along the way, but a positive mindset and continuing to move forward – even if they’re small steps – helps significantly. As we all recover physically, mentally, and spiritually, it’s important we do our best to stay positive and continue making progress. Recently, as I observed the bare trees around our campus, I thought about how dormant phases are a part of growth not just for plants but for people and for communities. Winter can be harsh, but it doesn’t last forever. Spring is a season of renewal and hope. I look forward to seeing Boone Health and the people and communities we serve enjoy renewed growth and energy.

Troy Greer CEO, Boone Hospital Center

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HOSPITAL HEADLINES

Laura Noren Returns to Boone Health as Interim CNO Monica Smith, MSN, RN, NE-BC, FACHE has made the decision to focus exclusively on her role as Boone Health’s Chief Operating Officer. Since 2015, Monica has served as our Chief Nursing Officer. In 2017, she also became Boone Hospital Center’s Vice-President of Operations and Ancillary Services. During the transition to independence last year, she became Boone’s Chief Operations Officer. Monica has been highly successful in both roles, guiding Boone Health to fully implement a Shared Decision-Making model to support our nurses’ professional practice, serving as incident commander through the COVID-19 pandemic, transition to independence, and achievement of our fourth Magnet hospital designation. A nationwide search is underway for a new Chief Nursing Officer who meets the advanced requirements necessary to lead patient care services and to achieve and maintain Magnet status. To ensure Boone Health meets Magnet standards and keeps its current level of support to all nursing areas, Laura Noren, MBA, BSN, RN, NE-BC will return on as interim Chief Nursing Officer. Laura served Boone for 28 years before retiring in December 2020. In 2019, she became our first Executive Director of Patient Care Services. Her experience and knowledge of the organization will allow Boone Health to maintain a high standard of professional nursing during the search process.

Joint Commission Accredits Boone Health Services Primary Stroke Center Survey

The Boone Hospital Advanced Primary Stroke Center completed their two-year cycle recertification through The Joint Commission (TJC). TJC performed a virtual survey in December 2021. The virtual survey was a success and Boone received two findings. Both findings were related to Meditech documentation components which can be resolved through optimization and staff education. The surveyor was complimentary of the entire team and the excellent care that is provided through the Stroke Program. Special thanks to Dr. Goble, Stroke Medical Director, Dan Hartgrove, Stroke Coordinator, and Michele Sprague, Oncology/Neurology/Stroke Program Manager for their preparation and leadership. The Stroke Program is a service which upholds our mission to improve the health of the people and communities we serve. It is the outstanding delivery of care and service from the entire Boone Health team which makes this program successful. Thank you for making a difference in many lives.

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Boone Health Home Care & Hospice

Boone Health Home Care & Hospice has earned The Joint Commission’s Gold Seal of Approval® for Deemed Status Accreditation by demonstrating continuous compliance with its performance standards and CMS Conditions of Participation for Medicare certification. The Gold Seal is a symbol of quality that reflects a health care organization’s commitment to providing safe and quality patient care. Boone Health Home Care & Hospice underwent a rigorous, unannounced onsite review. During the visit, a team of Joint Commission reviewers evaluated compliance with standards and Federal health and safety requirements spanning several areas including environment of care, infection prevention and control, leadership, medication management, and rights and responsibilities of the individual. The Joint Commission’s standards are developed in consultation with health care experts and providers, measurement experts and patients. They are informed by scientific literature and expert consensus to help health care organizations measure, assess, and improve performance. The surveyors also conducted onsite observations and interviews. Congratulations to the Boone Health Home Care & Hospice team.


BHC Cath Lab Makes Room for Patients

Hickman Athletic Booster Club

Boone Hospital Center’s Cardiac Cath Lab is open after an extensive renovation and expansion. Construction began in February 2021 to enhance Boone Health Cardiology’s capability to meet the needs of our patients and community in the present and future. Changes include a new lobby and waiting area, the addition of a fifth procedure room, 15 patient holding rooms, and new nursing areas with increased visibility between nurses and patients. These changes offer our patients more space, privacy, and safety, and will allow our Cardiology Service Line to continue to support mid-Missouri’s health care needs.

Thank you to Hickman Athletic Booster Club for their generous donation to Boone Hospital Foundation in support of Harris Breast Center. To learn about how your organization can support Boone Health, visit boone.health/foundation.

Missing Photo Caption The January 2022 issue of My Boone Health was missing a photo caption for the cover image: In August 1972, Boone County Hospital breaks ground on a two-story wing to add room for patients. From left to right: Dr. James Baker; Patterson Bain, trustee; Mrs. John Brinegar, auxiliary member; Mrs. Roland Kaiser, auxiliary president; W.B. Smith Jr., trustee; and hospital employee Woodrow Lee. (Note: First names could not be found for Mrs. Brinegar and Kaiser.)

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ANGIE AND HER

BOONE ANGELS

When Angie Lewis’s COVID fight landed her in the ICU, her Boone Health teammates were there for her.

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oone Health Pulmonary Clinic Patient Service Representative Angie Lewis was doing one of her favorite things in the world – spending time with her family – when she became concerned that one of her family members was becoming ill. “I was worried about him, so I took him to Boone Convenient Care to be checked out. They did a COVID test, and it came back positive,” says Angie. It wasn’t long before Angie and her husband Steve began having symptoms. They visited the Boone Medical Plaza 1 Lab Draw location to get tested and soon received the news that they were COVIDpositive. Angie’s symptoms quickly became severe and left her bedridden. “The headache was the worst for me. It was just terrible,” says Angie. Jeannie Grant, BSN, RN is Team Lead of Boone Health’s Employee Health department – and Angie’s close friend and neighbor. Jeannie regularly came to check on Angie at her house and was the one to tell her when she needed to go to the hospital.

Angie and her sister Lisa Baker

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PHOTO CAPTIONS

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1 & 2 - Angie hugs her husband after being released from isolation. 3 - Friend and Boone nurse Jeannie Grant visited Angie daily. 4 - Jeannie presents Angie with a gift basket of items donated by coworkers. 5 - Jeannie decorates Angie’s room for Christmas. 6 & 7 - Angie calls her nurses her “angels.” 8 - Angie had many Facetime sessions with family while in the hospital. 9 & 10 - Patrick Remis, BSN, RN takes Angie on a tour of the hospital to see the Christmas decorations. 11 - Angie reunites with her grandchildren.

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“Angie – or Mimi, as I call her – and her entire family are like family to me. They have always been there for me whenever I have needed anything. I love them so much and would do absolutely anything for them. It was on a Sunday that I started to get worried. I told Steve he should probably stay home from work Monday to keep an eye on her. When I got home from work Monday and went to check on her, her vitals had dipped, and I knew she needed to go to the hospital,” says Jeannie. Jeannie and Steve took Angie to the Boone Hospital Center Emergency Department. “It turned out I had double pneumonia and low blood oxygen. I went right from the Emergency Department to the ICU,” says Angie. Angie describes her first week in the ICU as a total blur. “After that first week, I remember that hardest part for me was being away from family, friends, and human touch. My family and I would do group Facetimes whenever we could,” says Angie. Jeannie visited Angie daily and was always taking care of her. Since Jeannie is a Boone Health nurse, she was able to put on full protection gear and visit Angie in her room. She would bring Angie water her favorite way, with lots of ice, and she washed her hair for her. Since it was December, Jeannie even decorated Angie’s room for Christmas. “Everyone just thought I had the prettiest room!” says Angie. During one of Jeannie’s visits, she told Angie to go look out the window. When she did, she saw her Boone Health coworkers all holding encouraging signs and cheering for her, including Boone Health CEO Troy Greer. Jeannie also gave her a gift basket they had put together. “It was so touching to see my friends and coworkers. Troy even came! The gift basket was also so thoughtful,” says Angie. Jeannie says she and Angie’s other coworkers had been brainstorming ways to encourage Angie and knew that this would lift her spirits. “She was in the hospital around the holidays which we knew was so lonely. We wanted to remind her how loved she is,” says Jeannie.

Angie's coworkers gather outside her window to send a supportive message.

Angie says the surprise did make her feel very loved. She also says she will always be grateful for the care she received while at Boone Hospital Center. “My pulmonary doctors Dr. Grossman, Dr. Abu-Salah and Dr. Wilson were just amazing. I love every one of them. We have a very close relationship,” says Angie. When enough time had passed, Angie was released from isolation and was able to receive visitors. “After I got off isolation, I couldn’t wait to hug and spend time with my husband, daughter and sister. Once my husband was allowed in my room, we held each other and cried for what seemed like forever. My daughter Cassie and sister Lisa took turns spending time with me. We watched movies, colored, made jewelry and Facetimed family,” says Angie. Angie calls the nurses who took care of her “angels” and lights up when she talks about them. She says her nurse Cheyenne Lehr, RN, was a huge encouragement to her. “She would listen to me and was so compassionate,” says Angie.

Patrick Remis, BSN, RN knew Angie was feeling sad about being away from her family during Christmastime. When she was released from isolation, he took her around the hospital in a wheelchair to see the holiday decorations. “He even wheeled me out to see the big tree out front. We just waited and looked at it for a long time,” says Angie. Angie also tells how Brian Campbell, RN, comforted her and kept her family informed when she had to return to the ICU after being moved to the Stepdown unit. “He’s right here in my heart,” says Angie. Angie slowly but surely improved and is now recovering at home. She still uses supplemental oxygen and is fighting fatigue and brain fog. She is seeing specialists about the damage done to her heart and lungs. However, she says she is just so grateful to be able to be with her family. “I just saw my grandkids again, and it was so special. I missed them so much,” says Angie. By Madison Loethen

Boone.Health/My-Boone-Health

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GETTING HIS

VOICE BACK

When Parkinson’s caused Gary to lose his voice, Boone Therapy helped him take it back.

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fter Gary Cannaday was diagnosed with Parkinson’s disease two years ago, his voice became raspy and quiet. He noticed people had a hard time understanding what he was saying. He was also noticing new difficulty organizing his thoughts and maintaining conversations with friends and family. One of the scarier things he began to experience was difficulty swallowing his pills. He first spoke to his physical and occupational therapists who suggested he try speech therapy – this is how he was introduced to the SPEAK OUT!® Program at Boone Health.

Ceres Neff is a Speech-Language Pathologist at Boone Therapy.

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For more information on the SPEAK OUT!® program, visit www.boone.health/therapy or call 573-815-3868 and ask to speak to a Speech-Language Pathologist. “SPEAK OUT!® was founded by the Parkinson Voice Project® which is a nonprofit organization based out of Richardson, Texas,” says Ceres Neff, SpeechLanguage Pathologist. “This therapeutic program was specifically designed for patients with Parkinson’s disease and other movement disorders that mimic Parkinson’s. The mission of this program is to preserve the speech and communication of these individuals through speech therapy, follow-up support, research, education and community awareness.” This Parkinson’s specific speech therapy program utilizes a two-part therapy approach to strengthen and retrain the muscles used for speaking and swallowing by combining individual speech therapy sessions, referred to as SPEAK OUT!® with ongoing, weekly group therapy, referred to as The LOUD Crowd®. The SPEAK OUT!® program includes one-on-one outpatient speech therapy sessions with a speech-language pathologist, or SLP. Working together, the patient and SLP go through a series of speech, voice, and cognitive exercises, emphasizing speaking with intent to convert speech from an automatic function to an intentional act. “Intentional communication is the focus of training, as purposeful movements are less reliant on dopamine, a chemical in the brain that depletes with Parkinson’s disease,” says Ceres. Individuals diagnosed with Parkinson’s disease, Progressive Supranuclear Palsy, Multiple System Atrophy, Corticobasal degeneration, or Essential Tremor who have noticed a change in their speech or voice may be appropriate for SPEAK OUT!®, and are encouraged to seek an order for speech therapy from their doctor. “The program is specifically designed for strengthening and maintaining speech and voice, but by encouraging not only speaking with intent, but living with intent, we often see positive effects in patients swallowing and cognitive function as well,” says Ceres.

During Speech Therapy, Ceres helps patients strengthen their voice by speaking with intent.

Gary initially decided to try SPEAK OUT!® because he felt his voice was no longer satisfactory to him, and he figured he didn’t have anything to lose. He says, “I’ve got to say, I’ve been really surprised how much of a difference it has made and am glad someone told me about this program.” Since his sessions with Ceres, Gary can swallow his medicine without feeling like he’s choking, and his voice is back to more than 85% of his previous ability. “I still have some problems,” Gary says, “But I work on them every day, because I have seen the benefits of doing so.” “Early intervention serves this population best. All patients can make meaningful progress through speech therapy, but we have found that those who start treatment early into their diagnosis get ahead of the game and are able to use the strategies we teach to preserve their optimal function even longer,” Ceres says.

“I have seen the remarkable effects of the SPEAK OUT!® program time and time again,” she adds. “I find that most patients who get referred for speech therapy following a Parkinson’s diagnosis are rather leery about what I can do for them. I think this comes from not knowing what options they have and worrying that their voice will never be ‘normal’ again. I hope to spread awareness that you do not have to settle with the speech, voice, swallowing, or cognitive changes that can accompany Parkinson’s disease. You can absolutely take back control of your communication and swallowing if you are willing to put in some work while learning how to live with Intent.” As Gary reflects, “I now know how to fight the effects of Parkinson’s. Speech therapy has helped me develop ways to take back my life.” By Erin Wegner

Boone.Health/My-Boone-Health

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Early DETECTION Veterans United employee Travis Fitzgerald caught his skin cancer early by attending a corporate health screening on the Mobile Health Unit.

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ravis Fitzgerald has always spent a lot of time outdoors. He grew up in Southern California and says sunburns were part of everyday life for him as a kid. Now he is a married father of 3 and his family loves to spend time together outside. Getting checked for skin cancer was something Travis had thought about but just kept putting off. “My dad had carcinoma so I knew I should really go get checked out, but that would mean finding a dermatologist and making an appointment and I just hadn’t gotten around to it,” says Travis. One day at his job as a Senior Learning and Development Specialist at Veterans United he received an email that VU was going to have Boone Health’s Mobile Health Unit on campus to provide skin cancer screenings to employees. It is recommended by the American Academy of Dermatology to see a dermatologist annually because skin cancer is the most common form of cancer. Boone Health’s skin cancer screening on the Mobile Health Unit is a corporate service that allows a company’s employees to easily check the box when it comes to their annual dermatology appointment. However, most people do not make the effort to see a dermatologist annually because of the inconvenience of setting up an appointment. On average, employers lose a half day to a full day of work for each appointment an employee makes with a doctor. “We have the ability to see anywhere from 40 to 60 patients per day. We book dates with

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For more information on corporate and community screens, go to boone.health/community-wellness or call 573-815-3263.

companies based on how many employees work there. With Boone’s Mobile Health Unit, employees take 20-30 minutes out of their day to see our certified nurses and get their annual skin exam,” says Community Wellness Manager Jenny Workman. If a questionable mole or lesion is found during a screening, the individual is advised to follow up with their primary doctor or a dermatologist as soon as possible. Education regarding what to watch for and strategies to prevent skin cancer are the two primary goals. Travis says he was excited at the convenience the screening would bring to him and he quickly signed up. “On the day of the screening, all I had to do was walk right outside my building,” says Travis. For the screening, a full body screen is conducted by a certified nurse by appointment only with the goal of educating community members about the importance of early detection and skin health. The visual exam is painless and only takes a few minutes. “The nurse saw something on my back and recommended that I see a dermatologist. It kinda confirmed my fears that I could have something wrong,” says Travis. Since the spot was on Travis’s back, it was not something he often saw or thought about. “My wife had actually mentioned it once, but I hadn’t thought of it again,” says Travis.

Travis with his wife Jessica, and their kids Kira, Bridget and Henry.

Travis visited a dermatologist who had a sample taken. The results came back positive for melanoma. “I was really lucky it had not spread,” says Travis. Melanoma is the most dangerous type of skin cancer. It spreads quickly and can spread to any organ. Early detection is key to treating melanoma. Fortunately, in Travis’ case, his melanoma had not yet spread and was able to be removed. Travis had the removal and is now cancer free. He says he always protects his skin when he is outdoors and follows up every 6 months with his dermatologist. “I am very grateful I got screened when I did and we caught my cancer when I did,” says Travis. By Madison Loethen

Boone.Health/My-Boone-Health

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LAB TESTED

Boone Health Lab Services adapts to continue serving our community.

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n January 2020, Drew Wilkinson, Director of Boone Health Laboratory Services, Ambulance Services and Emergency Department, had one thing on his mind – bringing Boone lab services to more communities. New outpatient draw sites were scheduled to open in Columbia and work was about to start on a location in Mexico, Mo. “Everything was going fine and dandy,” Drew recalls. “And then COVID hit.” Despite the challenges of the pandemic, the Lab Services team worked together to meet testing needs while giving more Boone patients easy access to our services. Boone Health Lab Services is a 24-houra-day department headquartered at Boone Hospital Center, but their employees are

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everywhere, inside and outside the hospital. Couriers pick up samples from Boone clinics throughout the day and bring them back to the hospital for testing. “We’re a full-service lab, which means we do practically everything on site,” Drew says. “Practically everything” includes core lab tests, microbiology, blood banking, histology and pathology. Microbiology techs analyze samples for bacteria, fungi and viruses, such as COVID-19. Blood banking ensures that donated blood is safe and that the right blood is given to the right patient. Histology and pathology prepare and examine tissue samples to diagnose medical conditions. Having many services under one roof means patients and physicians spend less time waiting on results.

For uncommon lab tests, Boone Health partners with the Mayo Clinic. Samples are sent overnight to Minneapolis and results are usually ready the next day. Adapting to COVID Drew remembers the meeting on March 16, 2021, where the need to offer COVID testing to the community arose – along with questions on how to do that: “I took that as a challenge and said, ‘Yes, we can do it.’ I brought it back to the Lab Team and we rallied our resources.” Three days later, the first drive-through test site opened in the parking lot near the Emergency entrance. Drive-through testing made it easier to keep patients and employees safe. The Mobile Health Unit, on hiatus from community screenings, served as an office to receive doctors’ orders, process insurance information, and prepare samples for testing. Drew says the biggest challenge was setting up phones and computers in the mobile unit: “We knew how to take care of patients, but we needed help with data and power. Our fantastic Support Services and Information Services teams made sure we were up and running.”


The full-service laboratory at Boone Hospital Center is open 24 hours a day to run tests, including microbiology, blood banking, histology and pathology.

“At first, when testing supplies were limited, we prepared samples and sent them to another lab until we could do tests at Boone,” says Heather Theberge, SM (ASCP), Technical Coordinator in the Microbiology Lab. It didn’t take long for Heather and her colleagues to be able to perform tests on-site – and demand was rising. “At this point, I can’t estimate how many COVID tests I’ve given. Whenever we’ve had a surge, I could easily test over 100 people a day,” says Sanitra Gibson, a Lab Associate III in the Boone Hospital outpatient lab draw site. Sanitra collects blood and specimens from patients of all ages and has done a lot of pre-op COVID testing for people about to undergo surgery. Pre-op testing is done because COVID-positive patients could Boone Health’s Mobile Health Unit was repurposed as a temporary COVID testing site.

have more difficulty recovering from surgery. Sanitra stays busy with patients, but she enjoys the work: “I’m a people person, so I enjoy it. I try to give each patient 200 percent.” Children occasionally look surprised when they first see Sanitra in her mask, gown, gloves and face shield, but most patients are now familiar with her personal protective equipment (PPE) and the process. She says, “I always ask people first if they’ve had a COVID test before. By now, most of my patients have.” Boone lab associates have similarly become familiar with collecting COVID test samples. A nasopharyngeal – or NP – swab is inserted in one nostril to collect cells from the nasopharynx, or naval cavity. In people with COVID, the virus is more concentrated in the nasopharynx than in the

throat. NP swabs give more accurate test results than throat swabs. Some lab associates started with limited experience taking NP swabs, but over time, Sanitra and her colleagues found ways to improve the experience for patients, like having patients tilt their head back or recline, and keeping tissues at the ready. Sanitra says, “At first, patients would see the swab and ask me, ‘Are you going to go to my brain?’ Now most of them tell me ‘That was the best swab I’ve had!’” Whenever COVID surged in midMissouri, the drive-through site saw as many as 300 people a day. These tests landed on top of the lab’s standard workload. “We had so many COVID tests at one point, we literally had no time to run them all. Each test takes about an hour, and we have a set number of machines that can analyze samples. We can only go as fast as the analyzers let us,” Heather says. It occasionally became necessary to enlist help from an outside lab, but the Lab Services team also found ways to manage the influx of tests, like cross-training lab staff to help with the COVID testing process. Drew says, “We had to creatively repurpose roles to focus on our biggest needs. When our outpatient sites were seeing fewer patients, some lab associates moved temporarily to the drive-through testing site. It was a big ask of them, and we greatly appreciated it. “It really did take all of us to get the results out. Sometimes, our supervisors and managers were up all night to pitch in and ensure tests were completed because we know how much timely results mean to our patients and physicians!” Despite the challenges, Lab Services has adapted well. In January 2022, when the Omicron variant caused a spike in testing needs, Drew and his team quickly set up a dedicated testing site at Nifong Medical Plaza. “It was like getting back on a bicycle. We knew what we needed to do, we just had to pull together and get it done,” he says. In this March 2020 photo, Boone lab associates wait for patients at the first drive-through COVID testing site outside the hospital’s Emergency Room entrance.

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For a complete listing of Boone Health Lab Draw Sites, visit www.boone.health/lab Troy Greer, CEO; Drew Wilkinson, Lab Services Director; Janna Schremmer, Operations Manager; and staff from BHMG-Mexico cut the ribbon on the lab draw site in August 2021

Serving the Community The COVID pandemic delayed but didn’t halt Lab Services’ plans to open new lab draw sites. “We had a few delays with construction, but we opened our new locations at Broadway Medical Plaza 1 and Keene Street. We didn’t have a ribbon cutting for either, but we still had a successful opening,” Drew says. In August 2021, the Lab Services team was able to cut the ribbon at their lab draw site in the Boone Health Mexico Medical Plaza, bringing the current total to eight lab draw locations, including six in Columbia and one in Moberly. Work is in progress for new sites in Centralia and Osage Beach, both of which are slated to open later this year. These new locations will make it easier for patients of Boone Health Medical Group primary clinics in Centralia and Osage Beach to have samples drawn for lab testing. “When I became the Lab Services director, we only had one outpatient draw site at the hospital,” Drew says. “We serve 25 counties, so that isn’t convenient for a lot of our patients. Our physicians also wanted their patients get their labs done at Boone, because they know we hold ourselves to high standards and deliver timely results. Instead of making people come to us, we decided to go to them.” Drew says the lab draw sites have been popular with patients: “We get a lot of positive feedback that I share with the team. Patients tell us how much they appreciated the staff and share their great experiences. For example, a patient who had a history of challenging blood draws and bruising told us how Sanitra drew their blood, and they didn’t have a bruise later. Even when they’re half an hour away from the hospital, our lab draw employees are the face of Boone and part of our team.” To keep a lab running at all hours and adapt to changing needs requires a cohesive team and excellent communication.

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The Lab Draw Site at Columbia Medical Plaza, which opened in 2020, includes a designated space for young patients.

“We’re a family in the Lab,” Sanitra says. “We help each other out. For example, I’ll call Heather in Micro to give her a heads’ up if a same-day surgery patient needs a rapid COVID test. Everyone works together to get the job done.” Heather agrees, “Everybody supports each other at Boone. If you need help, you can ask for it and receive it, even from other departments.” In February 2022, when a snowstorm was approaching, Lab Services staff didn’t

hesitate to ensure there’d be enough people on site, making plans to sleep in the department on air mattresses and to cover for coworkers who lived farther away – all before Drew even saw the forecast. “They came together and perfectly planned it,” Drew says. “I’m amazed at how our team always succeeds at something that seems unachievable. We’ll always face challenges, but with the right people and processes, we’ll come through.” By Jessica Park


For more information, visit fda.gov/DrugDisposal

Spring Cleaning FOR YOUR MEDICINE CABINET Clear space and keep your home safe by disposing your unused medication.

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f your daily prescriptions share space with medicine you stopped taking years ago, it’s time for a clean sweep! A shelf of half-empty pill bottles doesn’t spark joy and could be dangerous. Medicine can expire as its ingredients break down over time, making it less effective. Some expired medicine can even host bacteria. Keeping unused medication in your home poses a safety hazard for children, pets, and other adults. According to the CDC, more than 50,000 children visit the ER each year after finding and taking an adult’s medicine. Cleaning your medicine cabinet could bring you peace of mind! Don’t forget over the counter, or OTC, medicines like ibuprofen and cough syrup. Set aside anything expired or anything you don’t take anymore. Labels usually include best-by or expiration dates. Drug Take Back programs are the safest way to dispose of unused prescription drugs. The DEA hosts National Take Back days in April and October when designated temporary collection centers across the country will accept unused prescriptions. There are also year-round collection sites, including pharmacies. To find a year-round collection site or Take Back Day in your community, visit dea. gov/TakeBackDay. In general, it’s best not to flush unused medicine down your toilet; however, the FDA does have a list of prescription medications that should be flushed immediately when no longer needed. These medicines, including opioid pills and transdermal patches,

have high potential for abuse and could be fatal after just one dose. You can find the full flush list at fda.gov/DrugDisposal. Most medications that aren’t on the flush list can be prepared to discard with your household trash. First, mix the medicine with coffee grounds, sawdust, cat litter or dirt. Don’t crush tablets or pills as you mix. Place the mixture in a sealable bag or container, seal inside another container or heavy bag, then place in your trash. Scratch out any identifying information on prescription labels before tossing bottles or packaging. If you live in Columbia, you can take unused medication to the Household Hazardous Waste Collection Facility. Visit como.gov to find collection facility hours and details. Outside of Columbia, check with your city or county for similar services. Medication that is inhaled or injected may require special disposal methods. Inhalers and sharps don’t belong with curbside trash. Inhalers can be dangerous if punctured or incinerated. Used sharps should always be kept in a sealed container before disposal. Ask your doctor or check the instructions included with your prescription if you’re unsure. You can find instructions for all FDA-approved prescription and OTC medicines at fda. gov/DrugsAtFda. The FDA does not recommend donating or giving away unused medicine. Your prescriptions were written for you based on your health

BONUS TIPS • If you keep your medicine behind the bathroom mirror, move it to another room. The heat and moisture from daily showers could make your medicine expire sooner. Most medications should be stored in a cool, dry and dark place, like a kitchen cabinet that’s not close to your stove. • If you have young children or visiting grandkids, store all medications, vitamins and supplements out of reach and out of sight. If you carry medicine with you, keep your purse, bag, or coat where small hands can’t reach.

conditions, medical history, and other medications you take. Other people may have a bad reaction to medication that helps you. Also, other people can’t guarantee that donated medications were stored properly. By Jessica Park

Boone.Health/My-Boone-Health

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A P R E M AT U R E

BLE S S IN G The Moore family’s experience at Boone’s NICU.

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he greatest blessings in life arrive when we least expect them. That was the case for the Moore family, whose latest addition arrived almost 8 weeks before her December 19 due date. Carlene Moore was taking a shower after a day of Halloweenrelated activities on October 24 when she first started feeling contractions. Hours before she was carving pumpkins with her husband, Josh; now she was being rushed to Boone Hospital Center. Once there, the Moores learned that their baby girl was coming regardless of whether they were ready for her arrival. It came as quite a surprise, given there had never been any complications or signs of potential problems throughout the pregnancy. This being her first pregnancy, Carlene wasn’t sure what to expect. Naturally, she had fears of what would happen next and if the baby would be healthy. Upon their arrival in the Labor and Delivery room, the couple was comforted when the doctors and nurses who would be assisting them, introduced themselves. They patiently, kindly answered every one of the understandably nervous soonto-be parents’ questions, so the couple never felt “in the dark about anything.” After a strenuous two days of labor, Peyton arrived on October 26, 2022. The first things Carlene heard about her baby girl from Elizabeth Wilson, MD was that she had red hair just like her dad. The day she was born, Peyton weighed 4 pounds and 1 ounce.

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Donations to the Boone Family Birthplace NICU can be made through the Boone Hospital Foundation.You can donate items like infant hats, preemie clothes, blankets, gift baskets, or donate money to the Foundation’s nursery fund, which allows Boone Family Birthplace to purchase privacy panels, kangaroo chairs and sleep sacks.


She would have to stay in Boone Health’s neonatal intensive care unit, or NICU, where staff would help Peyton to eat on her own and gain weight. It was no easy feat – at her smallest in the NICU, Peyton weighed 3 pounds and 13 ounces. She also experienced a brain bleed and short heart rate drops that would last for about 10 seconds before spiking. During Peyton’s time in the NICU, her parents spent at least 14 hours each day by her side, driving the hour back and forth from Mexico to Columbia to see their baby girl. It weighed on Carlene and Josh not to know what would come next or when they would be able to bring their daughter home. Noises in the hospital – fluorescent lights buzzing, monitors beeping, nurses whispering – made Carlene feel like something was always wrong. The new parents also felt helpless. Carlene says, “You can help her by being there, but really, you can’t.”

Despite their fears, the couple fondly remembers the emotional support they received from Boone nurses whenever they visited. Even nurses who didn’t work in the NICU would recognize Carlene and Josh walking down the hallway and stop to say “Hi” and ask how Peyton was doing. “They were nurses doing their job, but they comforted you like they were family,” Carlene recalls. On November 24, a month after Carlene had her first contractions and one day before Thanksgiving, Peyton was finally able to come home. A week later, the Moore family received a card signed by every Boone Health nurse they’d met with a message that they enjoyed taking care of the family and hoped everything was going okay. It’s a step the staff didn’t have to take, but it meant so much to Carlene and Josh. At four months, Peyton fits into newborn clothes and has just started holding up her

head and smiling. She is the same little fireball the NICU nurses remember. Most of the time, she quietly observes the world, but she lets everyone know how she feels when necessary. Her personality is beginning to shine through, and the couple agrees “she’s just like her mama.” Carlene’s biggest piece of advice for other parents who have a child in the NICU is to trust the staff and take time for yourself as needed. She says, “You want to be there all the time, but it’s okay to step away and check on yourself mentally and emotionally. Just know they’re in really good hands at Boone.” By Hannah Robertson To learn more, visit boone.health/ foundation or contact Barb Danuser, Foundation Executive Director, at barbara.danuser@boone.health or Bree Anderson, Foundation Coordinator, at bree.anderson@boone.health

Boone.Health/My-Boone-Health

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BRIN GIN G UP BOO N E BABIES

TIPS FOR SAFE

BABY-WEARING Baby-wearing is not only popular; it’s beneficial for your newborn. But with so many options out there, it can be hard to know which is best for wearing your baby. Before you buy a carrier, check out these tips! Baby-wearing has been proven to decrease crying time, regulate your baby’s temperature, and improve bonding, especially with newborns. Skin-to-skin contact while baby-wearing can also increase a breastfeeding mother’s milk supply. You can find a wide array of baby carriers, including soft wraps, ring slings, soft-structured and framed carriers. Before you buy, research! Read reviews of different carrier styles and brands. Be aware that different carriers have weight requirements and limits for safety reasons. Read the carrier instructions carefully before you wear your baby for the first time. If you have questions or concerns about safe carrying, ask your baby’s primary care provider first. Whatever carrier you use, keeping your baby safe is your top priority.

BY TARA PHILLIPS, RN, IBCLC, BOONE FAMILY BIRTHPLACE NURSE AND LACTATION CONSULTANT

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To remember the guidelines for safe baby-wearing, think TICKS.

T I C

Tight

If you wear a wrap, make sure it’s tight enough to keep your baby secure and prevent falls. Your baby should be in proper alignment and in contact with you. However, you don’t want too tight a fit – you should still be able to slide your hand between your baby and the carrier.

In-View

You should always be able to see your baby’s face while wearing a carrier. This lets you see your baby’s mood, check for breathing problems, and make eye contact with your child.

Close

When you wear your baby, they should be close enough that you can kiss the top of their head. If you can’t, move your baby or reposition the carrier. Some carriers include a newborn insert to set your baby at the correct height.

K

Keep Baby’s Chin Off Their Chest

S

Support Your Back

RECOMMENDED Thighs spread around the mother’s torso and the hips bent so the knees are slightly higher than the buttocks with the thighs supported. Source: hipdysplasia.org/baby-wearing

Just like a car seat, proper alignment in a carrier is critical for your baby’s safety. Babies tend to tuck their chin if they don’t have the right support. When babies tuck their chin, it can block their airway and make it hard to breathe. You should be able to slide 2 fingers between your baby’s chin and chest at all times.

While wearing a baby, your hips should carry most of the baby’s weight, with the rest distributed between your shoulders and hips. Also, your baby’s hips and knees should be bent to promote healthy joint development. Boone.Health/My-Boone-Health

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GETTING TO KNOW A BHC DOCTOR

Rebecca Kelley, MD

Family Practice, Boone Health Medical Group Primary Care Moberly

I

was born in Richlands, Va. After graduating from Richlands High School in 1970, I attended Radford College (now University) and received a Bachelor of Science in Biology and Chemistry. During this time, I also married and had a son. We moved to Columbia, Mo. when my husband’s job transferred him. I attended the University of Missouri to receive my Bachelor of Science in Medical Technology. I became a medical technologist, supervised the immediate response lab, and welcomed a second son. In 1989, I started medical school at Mizzou and completed in 1994, then did my residency from 1994 to 1997 at the University’s Department of Family Medical. I then worked at a family healthcare clinic in Auxvasse for 24 years, before joining Boone Health Medical Group. I currently practice at the Moberly primary care clinic.

Why did you get into the health care field? I simply wanted to make sick people feel better. I grew up in southwestern Virginia in the 1950s and 1960s, when the biggest fears were polio, tuberculosis and smallpox. We all had measles, mumps, rubella and chickenpox as children. All we had available was aspirin – there was no Tylenol, Motrin or Aleve! There were few medications then to treat hypertension or diabetes, other than insulin. With a limited number of physicians where I grew up, people suffered without treatments, including my family members. As a child, I stood by, watching helplessly. What interested you in your specialty? I chose family medicine because I wanted to be able to treat all people from before birth until end of life. I worked in obstetrics until 2007, my oldest patient was 105 years old, and I’ve cared for people at every age in between! Family medicine also treats a multitude of medical problems. One exam room may hold a baby with an ear infection, the next room may hold an 85-year-old following up on hypertension, and the next may have a 45-year-old with an abscess. Family medicine offers a variety of ways to make a difference in a person’s life. What is the most rewarding part of your job? I find the relationships I make with my patients most rewarding. I have treated many families going back five generations – the children that I delivered now have children of their own! Not only do I know them medically, I know where they live, how they live, and their health and personal obstacles. I consider my patients to be like family. What is the most challenging aspect of your job? The most challenging aspect of my job is electronic medical records – I am a paper girl at heart!

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What do you see changing in health care in the next 5 to 10 years? Healthcare changes will focus on providing care more quickly and efficiently. Patients want care immediately and conveniently. What advice would you give someone looking to become a doctor? Being a doctor is not like what you see on TV. You need to work hard, learn as much as you can in medical school, then continue lifelong learning from continuing medical education and from your patients. The key is listening to your patients and caring for them as if they were your own grandparents, parents, or siblings. What do you enjoy doing outside of work? I enjoy traveling and playing with my high-energy, very athletic Labrador retriever. What advice would you give to someone who is going to be a patient in a hospital for a period of time? I was that patient in 2019! I was admitted to Boone Hospital at the end of April and discharged in early June. Be patient – that’s the hardest part. Follow the advice of your physician and healthcare team, including your nurses, your physical and occupational therapists, and other professionals. Participate in your own recovery. Have a good support system and have someone be your champion during your stay.


GETTING TO KNOW A BHC NURSE

Torin Brenner, BSN, RNFA, CNOR Cardiac Surgery

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’m from Wildwood, Mo. and am the “favorite” son of two wonderful parents. I also have three awesome sisters who I am very close with. We are close literally and figuratively because the four of us are all twenty-seven months apart. Growing up, we spent time together harvesting firewood, chasing after our golden retriever, and tromping around in the woods. I initially got a degree in Sustainable Development and soon after got my Bachelor of Science in Nursing. I’m licensed as a Registered Nurse First Assist, or RNFA, and I have a Certified Nurse in the Operating Room, or CNOR, certification.

Why did you get into the health care field? When one of my grandfathers was placed in hospice, my dad and I both recognized how much we appreciated and respected the work of his caregivers. That experience – and my wanting to play ultimate frisbee for another year – encouraged me to start completing prerequisites for nursing school. What interested you in your particular specialty? My mom made friends with an RNFA in her pottery class, and he let me shadow him while performing orthopedic procedures. I was immediately drawn to the inclusive teams he worked with and the degree to which he was involved in the surgery. While working at the University of Missouri operating room, the heart team needed more circulating nurses, so I landed there. I took whatever opportunities came my way and volunteered for everything that no one else wanted to do. This gave me a much more comprehensive education. I was proficient in many different services and I learned to scrub. Coincidentally, this experience prepared me well to pursue a license in first assisting. I learned how to first assist here at Boone Hospital with the cardiac surgery and general surgery teams. Both teams were very patient and helpful in fostering my education.

replacement has been a real benefit for patients who need heart surgery but are less likely to do well with a traditional openheart procedure.

What is the most rewarding part of your job? Working in surgery is very gratifying because we help people extend and improve their quality of life. For me, it’s also fulfilling to see the relationship that develops when experienced nurses, physicians and techs share their knowledge with someone new. The bond and respect built by these relationships creates a very diverse and resilient surgery team.

What advice would you give someone looking to become a nurse? Having transitioned from a different discipline into an accelerated nursing program and career was bumpy at times. Something I didn’t do but I wish I had would have been to work part time or volunteer in a supporting healthcare role during school. Some of my classmates did this and years later say the confidence they gained from that experience helped them more than anything else. Lastly, remember to assess and keep practicing. It was drilled into my head as a nursing student, but I got away from it because it would take too long, and the work would move on without me. When I practice, I get faster though. This means I am more helpful during the day-to-day stuff and I respond to emergencies effectively instead of with a knee jerk reaction.

What is the most challenging aspect of your job? Maintaining a work/life balance. What has changed in your field since you started practicing? The progress made in transcatheter aortic valve

What do you see changing in the next 5 to 10 years? Nurses will need to learn how to cross-train in other areas of the hospital so they can more effectively help in areas where staff are stressed or short on people. What do you enjoy doing outside of work? I enjoy exploring the outdoors with my wife, Jenny and our 2-year-old son, Wade. Activities include but are not limited to: Hide and Go Seek, collecting acorns and other finds while exploring the outdoors, vacuuming, spraying things with a squirt bottle, and playing PacMan, which he calls “NomNom.”

Boone.Health/My-Boone-Health

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Hello,

AVOCADO! Get to know this popular, versatile, nutrient-packed fruit.

A

vocados have become a popular member of the produce section. They are versatile and can be used in a wide variety of ways, from traditional guacamole to avocado toast, or even as a substitute for oil in baked goods. Despite their popularity, there might be some fun facts you don’t know about the avocado. Avocados are a fruit – technically, the avocado is a berry, and the pit is a large seed. They grow on trees which take three to five years to begin bearing fruit. Avocados are also called “alligator pears” because of their shape and green, leathery skin. Avocados may be small, but they are packed with nutrition. One avocado has 10 grams of dietary fiber, which meets more than one-third of the daily requirement. They are also an excellent source of potassium, vitamin C, vitamin B6 and magnesium. One of the few fruits with a notable amount of fat, avocados are loaded with monounsaturated and polyunsaturated fats, which promote heart and brain health. Many people are lost when it comes to selecting an avocado at the store. When choosing an avocado, gently squeeze the fruit. If it is very firm and doesn’t give, it isn’t ripe yet. Firm avocados are ideal if you don’t plan to use them for several days. If the fruit gently gives to the touch, it is ripe. Purchase ripe avocados if you’re going to use them in the next day or two. If the avocado is overly soft and gives easily, it is likely overripe. Overripe avocados will bruise easily and may already have brown spots inside. You might be used to enjoying avocados in dips and on sandwiches, but the avocado’s creamy texture makes it ideal for pairing with fruit or using as an oil substitute in a dessert. If you’re looking for a new way to use avocados, try this vibrant and delicious smoothie bowl! By Jennifer Tveitnes, RD, LD, Clinical Dietitian, Boone Health Bariatrics

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Avocado Protein Smoothie Bowl INGREDIENTS (serves 2)

• 1 cup (8 oz) liquid protein shake (I used Fairlife Caramel) • 2 slices frozen banana • ½ ripe avocado

INSTRUCTIONS

1. In a blender, add the protein shake, banana, avocado and berries. Blend ingredients together.

• 1 cup frozen mixed berries

2. Pour half of the mixture into a bowl.

• Toppings (optional): fresh berries, chia seeds, chopped nuts

3. Sprinkle with your desired toppings and enjoy!

Boone.Health/My-Boone-Health

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Physical Activity It is never too late to get active – and reap the benefits!

I

f you’ve spent the first half of your life as a couch potato, and think it’s too late for exercise to do your body and mind any good, think again! Years of research studies confirm that exercise can lower risk for an early death, even if you wait until later in life. Anyone can begin exercising regularly at any age. Exercise is crucial to maintain a youthful and healthy body. Middle-aged individuals and seniors who do regular cardiovascular and strength training exercise are more likely to build bone and muscle, have stronger immune systems, more efficient lungs, better blood pressure, and counteract the weakness that comes with age. Those who exercise regularly can also ease the symptoms of arthritis, osteoporosis, pulmonary diseases, and Type 2 diabetes. By building strength, you will improve balance, stability, flexibility and overall quality of life. For most healthy adults, the Department of Health and Human Services recommends these exercise guidelines: AEROBIC ACTIVITY Get at least 150 minutes of moderate aerobic activity or 75 minutes of vigorous aerobic activity a week, or a combination of moderate and vigorous activity. The guidelines suggest that you spread out these minutes over a week. To provide even greater health benefit and to assist with weight loss or maintaining weight loss, at least 300 minutes a week is recommended. But even small amounts of physical activity is helpful. Being active for short periods of time throughout the day can add up to provide a health benefit. Moderate aerobic exercise includes activities such as brisk walking, biking, swimming and mowing the lawn. Vigorous aerobic exercise includes activities such as running, heavy yard work and aerobic dancing. STRENGTH TRAINING Do strength training exercises for all major muscle groups at least two times a week. Aim to do a single set of each exercise using a weight or resistance level heavy enough to tire your muscles after about 12 to 15 repetitions. Strength training can include use of weight machines, your own body weight, heavy bags, resistance tubing or resistance paddles in the water, or activities such as rock climbing.

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at

Any Age!

Short on long stretches of time? Even brief bursts of activity offer benefits. If you can’t fit in a 30-minute walk during the day, take a few 5-minute walks instead. Any activity is better than none – what’s most important is that you make regular physical activity part of your life. To learn more about how 30 minutes of walking every day can make a big difference, I encourage you to watch Dr. Mike Evan’s video “23 and ½ Hours: What is the single best thing we can do for our health” at bit.ly/bestthingin30. It’s also important to reduce your sitting time – the more hours you sit each day, the higher your risk of metabolic problems. Our bodies aren’t made to be sedentary. Even if you get the recommended amount of daily physical activity, sitting too much

can negatively impact your health and longevity. You don’t have to sign up for a gym membership if that’s not your thing. Find something that fits your interests, abilities and lifestyle. Try to get at least 30 minutes of moderate physical activity every day. If you want to lose weight, maintain your weight loss, or meet specific fitness goals, you may need to exercise for longer of more often. While you may not be a spring chicken, it doesn’t mean you can’t enjoy an active, healthy lifestyle. Take care of your body and it will take care of you. You do this by putting in the time and making exercise a habit. If you don’t do it for yourself, do it for those who love you! If you have questions about exercise or overall well-being, feel free to reach out at Jenny.Workman@boone.health. By Jenny L. Workman, Community Wellness Manager

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Thank you to Orscheln Industries for your unwavering support of our annual events. SPRING 2022

CALENDAR OF EVENTS APRIL 4 -APRIL 6

Collective Book Sale MAY 9

Boone Hospital Foundation Golf Classic MAY 25 - MAY 26

Scrubs on Site Sale 30

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Spring 2022


Nursing

at Stephens College

The Bachelor of Science in Nursing is a partnership between Stephens College and Boone Health. Practice your skills in a brand new hospital simulation lab, and be on track to become a working member of Boone Health after graduation. Our total tuition and fees are almost $9,000 lower than Mizzou’s nursing program, and Boone offers tuition remission for employees and their families. At Stephens, you’ll be a nursing student from day one (no secondary application), and graduate in three years into a high-earning profession.

Interested in the possibilities?

Schedule a quick virtual conversation about program costs, scholarships and your academic readiness.

Get started at stephens.edu/nursing

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800.270.9629 | pyapc.com

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Boone Hospital Center 1600 East Broadway Columbia, MO 65201 573-815-8000

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COLUMBIA, MO PERMIT 286


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