My Boone Health Spring 2017 by My Boone Health

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What To Expect When Youâ&#x20AC;&#x2122;re Expecting A

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Table Of Contents Boone Hospital Center’s mission is to improve the health of the people and communities we serve.

Jim Sinek President

Ben Cornelius Communications and Marketing Manager

Jessica Park Marketing Coordinator

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Madison Burke Multimedia Marketing Specialist Photos By

Madison Burke L.G. Patterson Contributing Writer

Jacob Luecke

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1600 East Broadway Columbia, MO 65201 573.815.8000

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A Note From Boone Hospital President Jim Sinek

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Hospital Headlines

Boone Hospital Center Joins Siteman Cancer Network

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Happy Ending

My New Normal

14................................................................................................................... Back In The Game For a free subscription, call 573.815.3392 or visit myBooneHealth.com and click on the subscription link on the right side of the page.

16.............................................. What To Expect When You’re Expecting A Boone Baby 20................................................................................................................. Ready ... Set ... Run! 22............................................................................................................... A Smoothie For Two 24..............................................................

Get To Know Boone’s New General Surgeons

26....................................................................... Prediabetes: A Road Sign For Your Health 28............................................................................................................................... Life Is Good 30................................................................... News from the Boone Hospital Foundation BOONE HOSPITAL CENTER Spring 2017

A Note From Jim

From Vision to Reality

oone Hospital Center’s strategic vision is not only integral to our mission of improving the health of our patients and communities in mid-Missouri, it’s designed to support you and your health care needs. But how does our strategic vision transform from a paper document to reality? Strategic vision: Increase access to BJC and Boone health care services.

Jim Sinek President Boone Hospital Center

Boone Hospital has established a strategic vision and worked as a team to make each vision a reality.

We turned this vision into reality by • Opening our new outpatient center, Nifong Medical Plaza, in south Columbia • Adding seven Boone Medical Group primary care providers and opening three new clinics in midMissouri • Bringing Know Your Numbers screenings and health education to 25 mid-Missouri communities with our mobile health clinic. We screened about 7,500 people and touched 17,000 lives through our WELLAWARE services, including cholesterol, blood glucose and skin cancer screenings; CPR instruction; presentations; flu vaccines; health challenges, 5Ks and our Kids on Track program. • Expanding our services and technology including TAVR, a new heart valve replacement procedure; ECMO, a new life support technology; our second surgical robot; and home sleep study services. Strategic vision: Partner and collaborate with other high-quality health care providers to improve health. We turned this vision into reality by • Becoming the first hospital to join the Siteman Cancer Network, combining the expertise of world-renowned Siteman Cancer Center with the #1 ranked hospital in mid-Missouri • Supporting Boone Hospital’s affiliations with Fitzgibbon Hospital, Pershing Memorial Hospital and Samaritan Hospital • Maintaining a significant leadership role in the support of the Central Missouri United Way, exceeding our 2016 employee campaign goal by 25% • Supporting the Family Health Center in Columbia, which serves the health care needs of the uninsured and underinsured

Strategic vision: Continue the development of Boone Hospital Center as an employer of choice in mid-Missouri. We turned vision into reality by • Significant investment in our staff compensation and recruitment efforts, strengthening our management rounding, implementing monthly Team Boone Days, and enhancing communications • Increasing support for our first-year nurses through the establishment of a nurse residency program • Celebrating our teammate’s successes with our Employee of the Month program, Spoonhead Awards, annual employee service awards, and fun team activities throughout the year • Implementing stay interviews to proactively reduce employee turnover Strategic vision: Strengthen Boone Hospital Center’s relationship and aligned interests with our medical staff to ensure high quality care and sustainability. We turned this vision into reality by • Recruiting BJC Medical Group general surgeons to provide Boone Hospital patients access to inpatient and outpatient surgical services, 24 hours a day, 7 days a week • Entering professional service and co-management agreements with Missouri Heart Center; Women’s Health Associates; Neurology, Inc.; GI Associates; Tiger Pediatrics; and Mid-Missouri Neurosurgery to support and grow these specialty services • Creating a business development department to establish and maintain relationships with all Boone Medical Group and independent practice providers, to keep physicians informed of Boone’s current events and to address their needs and concerns when they refer patients to Boone Hospital Center Boone Hospital has established a strategic vision and worked as a team to make each vision a reality. Increased access to BJC and Boone health care services, partnering and collaborating with other health care providers, improving our work environment, and building strong, aligned relationships with our medical staff all are ingredients in Boone’s recipe for continued success.

BOONE HOSPITAL CENTER Spring 2017

Hospital Headlines News From Boone Hospital Center

oone Hospital Center and Boone Medical Group are excited to welcome three new general surgeons who will practice full-time on the hospital staff. With the addition of these providers, Boone Hospital Center is able to perform every inpatient and outpatient general surgery procedure, 24 hours a day, seven days a week. Anne Petersen, MBA, MD, FACS, is a boardcertified general surgeon and joins Boone Medical Group after practicing for nearly 11 years in Jefferson City. She received her medical degree in St. Louis in 2001 and went on to complete her general surgery residency in 2006. While practicing full-time, she also received her Master of Business Administration in 2009. Dr. Petersen enjoys the surgery specialty because it combines all of her passions, including math, science, and mechanical skills. “Operating on someone can make me feel as though I have made a real difference in their life, especially when I can see an instant change in their health in just a few hours,” she says. “I also enjoy getting to know my patients and their families and helping them navigate all of their health options.” Outside of work Dr. Petersen enjoys reading, playing the piano and cello, and trying new foods, both at restaurants and in her own kitchen. Reggie Vaden, MD, FACS, FACRS, is a board-certified colorectal and general surgeon. She joins Boone Medical Group with nearly 17 years of experience as a colorectal surgeon. She received her medical degree in 1993 and went on to complete her residency in general surgery in 1998 and a colorectal surgery fellowship in 1999. Dr. Vaden enjoys the relationships she creates with her patients and clinical staff as well as her ability to provide care to patients with her specialty. “I have always wanted to be a doctor,” Dr. Vaden says. “My mentor was a colorectal surgeon when I was in residency, which is when I realized that I really enjoy the type of cases and the variety that comes with the colorectal surgery specialty.” Outside of work, Dr. Vaden enjoys running, cycling and riding horses. Ly Phan, MD is a board-certified general surgeon who believes in treating each of his patients like family. He says, “The ability to 6

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use my head, my heart, and my hand to help people from suffering an ailment is what attracted me to surgery.” Dr. Phan says he decided to become a doctor as a child after watching his father being cared for after a stroke. “Being in a small rural village, good health care was hard to come by. The good doctor would travel to our house and care for my dad. I would watch him examine my dad, sterilize the syringe and needle over the boiling water, and give him medicine, and slowly but surely rehabilitate him back to where he can walk again. That image stuck with me and shaped who I am today,” says Dr. Phan. Outside of work, Dr. Phan enjoys spending time with his family, fishing, and meditating. Boone Medical Group – Surgery is located at 1601 E. Broadway, Suite 240 and can be reached at 573-815-8145. For more information, please visit boonemedicalgroup.org or boone.org/ surgery.

The latest news boone.org

B Boone Hospital Provides Groundbreaking Treatment for Pain

oone Hospital Center is trialing a groundbreaking new device that uses electrical impulses to block pain signals from traveling from the spinal cord to the brain, potentially eliminating the need for pain management drugs like opioids. It is the first hospital in mid-Missouri to do so. Brad Noble, DO, FAOCPMR, a physician at Boone Hospital’s Pain Management Clinic, has made the device, Nevro Senza, available to his patients. Dr. Noble is a quadruple board-certified pain management physician. It is estimated that 100 million people in the Unites States suffer from persistent pain, with the majority of painful conditions affecting the back and legs. This technology offers a drug-free treatment option to longtime sufferers. Unlike traditional spinal cord stimulation devices, which deliver low-frequency electrical pulses to mask chronic pain with paresthesia — sensations commonly perceived as tingling, prickling, vibrating,

or pins-and-needles. Nevro Senza’s highfrequency HF10 therapy delivers pain relief without these sensations. Additionally, the FDA’s approval of HF10 therapy came with a label of superiority over traditional spinal cord stimulation therapy — the first and only device of its kind approved with this rating. “This new high-frequency stimulation represents a big leap forward in the management of persistent pain,” Dr. Noble says. “As a pain management specialist, I’m extremely excited to bring this new spinal cord stimulation treatment to bear on conditions such as neck and back pain, arm and leg pain, diabetic peripheral neuropathy, complex regional pain syndrome, and chronic pain following neck and back surgery.” The CDC recently has determined that the use of chronic opioids is not supported in medical literature as an effective therapy for long-term treatment of persistent pain. HF10 therapy provides an opportunity to reduce or potentially eliminate the need for chronic opioid use.

Boone Hospital Meets Highest Standards for Obstetrics

oone Hospital Center has been named as one of America’s Best Hospitals for Obstetrics by the Women’s Choice Award®. The award signifies that Boone Hospital Center is in the top 17 percent of 2,815 U.S. hospitals offering obstetrics. The methodology for America’s Best Hospital for Obstetrics Award is unique in that it combines national accreditations, Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey results, and hospital outcome scores with primary research about women’s health care preferences. It is the only award recognizing excellence in obstetric services based on robust criteria that consider patient satisfaction and clinical excellence. The America’s Best Hospitals for Obstetrics distinction is based on the following criteria: • The percentage of patients reporting through the HCAHPS survey that they would definitely recommend the hospital, • Patient safety ranking based on 11 Centers for Medicare and Medicaid Services’ measures of infection and complication rates

• Presence of a level III or level IV neonatal intensive care unit on site (NICU), Low rates of early elective deliveries (between 0 and 1 percent). “Pregnancy is one of the most special times in a woman’s life,” said Delia Passi, founder and CEO of the Women’s Choice Award. “Our award gives a woman the confidence that her choice of a hospital for her delivery will be the best in terms of quality care and patient safety for her and her baby. As the trend of women waiting longer to start their families continues, having the Women’s Choice Award seal is especially important for older moms who face increased risks and need a top hospital to provide her care.” Boone Hospital Center is one of 484 award recipients representing the hospitals that have met the highest standards for obstetrics across the U.S. BOONE HOSPITAL CENTER Spring 2017

Boone Hospital Center Joins Siteman Cancer Network Collaborative Effort Aims To Enhance Cancer Care, Prevention In Mid-Missouri

oone Hospital Center and its Stewart Cancer Center have joined the Siteman Cancer Network to improve the health of mid-Missouri residents and communities through cancer research, treatment and prevention. Stewart is the first member of the network, which is affiliated with Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine in St. Louis. Together, the institutions will provide access to cancer prevention and control strategies, clinical trials and genomic and genetic testing. “Boone Hospital Center is committed to providing mid-Missouri and our patients the very best in cancer care, as close to home as possible,” says Jim Sinek, president of Boone Hospital Center, part of BJC HealthCare. “As a Siteman Cancer

Network affiliate, we’ll work to lessen the burden of cancer on individuals, families and the entire region.” As a network member, Boone Hospital Center and Siteman Cancer Center will work together to assess cancer’s impact on mid-Missouri, and develop a plan to lessen the overall burden and measure results. Possibilities include a greater emphasis on reducing smoking rates and promoting cancer screening and other healthy activities. These and other efforts also are expected to increase the number of people who are screened for cancer, which should result in earlier detection and improved health outcomes. “Siteman Cancer Center and Boone Hospital Center — through the Siteman Cancer Network — are committed to preventing cancer and transforming patient care in the communities we serve,” says

About Boone Hospital Center

Timothy J. Eberlein, MD, director of Siteman Cancer Center. “Together, we’re working to build a healthier Missouri.” Missouri Cancer Associates, a private practice, will continue to be the exclusive provider of medical oncology care at the Stewart Cancer Center at Boone Hospital. Through this relationship, the physicians and patients of the Stewart Cancer Center will have seamless access to necessary prevention, diagnosis and treatment resources available through Siteman Cancer Center, with coordinated care to ensure a convenient, comfortable experience for the patient. “With the physicians of Missouri Cancer Associates, the Stewart Cancer Center at Boone Hospital provides top-level cancer care,” Sinek says. “In becoming a member of the Siteman Cancer Network, we are only adding to the care delivery and treatment options for the residents of mid-Missouri.”

Boone Hospital Center is a 397-bed, full-service hospital located in Columbia, Mo. The hospital provides progressive health care programs, services and technology to residents in 25 mid-Missouri counties. Boone Hospital Center has been named the top hospital in mid-Missouri by U.S. News & World Report for 2015 and 2016, and is designated as a Magnet® Hospital for Nursing Excellence by the American Nurses Credentialing Center. The hospital is affiliated with BJC HealthCare in St. Louis. The Stewart Cancer Center, a state-of-the-art, 32-bed inpatient cancer unit, is a collaboration between Boone Hospital, and Virginia and Norm Stewart. Many people know Norm for his hall-of-fame career coaching the University of Missouri men’s basketball team. Norm is also a cancer survivor and founder of Coaches vs. Cancer. He and his wife, Virginia, chose to work alongside Boone Hospital on this project to help raise awareness of cancer and encourage mid-Missourians to get screened.

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What This Means For Our Patients: • A patient navigator to help patients get highly specialized care, including clinical trials, at Siteman Cancer Center in St. Louis for especially complex cases. • Genomic and genetic testing helps identify more personalized, targeted treatments for patients.

• Sharing of best practices to improve patient care, such as how nurses and radiation therapists are trained to care for oncology patients, and implementing industry guidelines for survivorship, screening and genetic counseling programs. • New cancer prevention strategies, such as interactive tools, e-books, videos, individual coaching and online cancer risk assessment tools. • Development of targeted interventions to reduce cancer risk and of evaluation tools to measure success.

About Siteman and the Cancer Network

• Development of a database where patients can choose to include their information to improve clinical care, research and patient outcomes. Siteman Cancer Center is designated by the National Cancer Institute (NCI), the principal federal agency for cancer research, as a Comprehensive Cancer Center. This means Siteman not only delivers cutting-edge cancer care at its main location and three satellites, but also is a national and international leader in cancer research and translating scientific discoveries into the next generation of patient care. Siteman does this through its partners at Barnes-Jewish Hospital and Washington University School of Medicine in St. Louis. Siteman also is a member of the National Comprehensive Cancer Network (NCCN), a nonprofit alliance of the nation’s leading cancer centers dedicated to improving the quality, efficiency and effectiveness of cancer care. As an NCCN member, Siteman plays an integral role in developing resources that present valuable information to cancer patients, health care providers and other groups by creating guidelines for treatment and clinical practice, distributing clinical trial information and planning educational conferences and literature. As the only NCI-designated cancer center and NCCN member in Missouri, Siteman is committed to collaborating with other health care providers to help improve the health and well-being of Missourians. Through the network, Siteman Cancer Center will expand access to cancer prevention and control strategies, clinical studies and genomic and genetic testing, all aimed at reducing the burden of cancer on our neighbors and communities.

BOONE HOSPITAL CENTER Spring 2017

Look for Dana’s story on YouTube.com/BooneHospital

A Happy Ending Dana Wilson And Her Family Enjoy A Happy Ending After She Beat Cancer

ana first noticed a lump in her neck when she was singing in the car. She was driving alone and casually scratched an itch on her neck. Her first thought was that it must be another infection causing her lymph nodes to swell, just like one that happened earlier that year. But instead of going down over time, the lump got bigger. Following the advice of her family, the 20-year-old went to urgent care during her lunch break from her job as a preschool teacher. Much to her surprise, the provider advised she get an ultrasound of the lump. She got the ultrasound and also got the area biopsied. All results came back inconclusive. Dana was advised to get the lump removed and she agreed. “It had been on my neck so long at this point. I didn’t know what it was, but I just wanted it out,” Dana says. Dana had her surgery to remove the lump at Boone Hospital Center one snowy December day. Her then-boyfriend Josh Wilson, along with her parents and sisters, stayed with her at the hospital. “Our relationship was pretty new when all of this happened,” Dana says of Josh. “He was so supportive.” Dana and her family left the hospital, and she vividly remembers getting the phone call at home that would change her life forever. “I got a call and was told I have cancer — Hodgkin’s lymphoma,” Dana says. “I immediately worried about going bald. I know it’s crazy, but my 21st birthday was coming up. I also started worrying about dying. Josh and I were doing so great, and I wanted to have a future with him.”

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Dana made an appointment at Missouri Cancer Associates (MCA) and met Joe Muscato, MD, and his nurse, Robin. There was an instant connection. “When I met Dana, she was so scared, and I just wanted to help her,” Dr. Muscato says. Robin added, “I just felt for Dana. I was there for emotional support just as much as I was for medical support.” Dana’s cancer was in both her shoulders, her neck and her spleen. Dr. Muscato’s treatment plan involved chemotherapy with hope for a cure. Dana started chemo right away. Dana cut her hair short before she started chemo, something that was difficult to do. “I had really long hair, so it was hard to see it go,” she says. “I was so fortunate to have such a supportive family and boyfriend around me.” Dana remembers being sad about her hair during one of her chemo sessions and MCA nurse Denise saying to her, “It’s your hair or your life.” “That really put things in perspective for me,” Dana says. At one point, Dana had to be hospitalized during treatment. She came to

“Dr. Muscato and the [Missouri Cancer Associates] staff are like our family now. We wouldn’t have it any other way.” — Dana Wilson Boone Hospital where she says her doctors and the Boone nurses took great care of her. “Boone is such a good hospital,” Dana says. “People really care about you there.” While Dana was in the hospital, Josh spent every moment by her side. “I just cared for her so much and wanted to be there for her in any way I could,” Josh says. While Dana was undergoing treatment, she completed her bachelor’s degree in elementary education. She hoped to become a third grade teacher. After finishing chemo, Dana went into MCA to find out if she was cancer free.

“I was so nervous I thought I was going to throw up,” Dana says. Dr. Muscato told her that her cancer was gone. “I didn’t cry in the office, but in the car with my mom on the way home I just started bawling,” Dana says. “I was so happy and just kept thinking about how my hair’s going to grow back.” Dr. Muscato says he was overjoyed with Dana’s success as well. “As a provider, these kinds of stories just warm your heart,” he says. “I truly care for Dana and am so happy to see her doing well.” Dana went on to become a third grade teacher, just like she dreamed, and her relationship with Josh continued to grow. Josh decided he would propose during one of Dana’s follow-up appointments at MCA. He chose the appointment scheduled on the two-year anniversary of Dana finding out she had cancer. “Dana’s cancer and recovery was such a big part of our relationship, I thought this would be a special way to propose,” he says. Dana and her mother arrived at the appointment. At first, Dana was disappointed that her nurse, Robin, was supposed to be out of the office that week. But she was overjoyed when Robin, Dr. Muscato, Josh, and their dog, Gracie, walked into the room. The ring was tied around Gracie’s neck and Josh asked Dana to marry him. Of course, she said yes! “We were all so excited for them,” Robin

says. “We love Dana and Josh very much.” Dr. Muscato was a guest of honor at Dana and Josh’s wedding. He was given his own boutonniere and was even listed in the program. “Dr. Muscato and the MCA staff are like our family now,” Dana says. “We wouldn’t have it any other way.” After a couple years of marriage, Dana and Josh began talking about having kids. They were aware Hodgkin’s lymphoma can make it difficult to conceive. “I really wanted to be a dad,” Josh says. “I was nervous that we could have trouble conceiving.” “I wanted kids too, but in the back of my mind I was nervous my cancer would come back and Josh would have to raise them alone,” Dana says. Much to Dana and Josh’s joy, Dana was able to conceive right away. She gave birth to a healthy baby boy at Boone Hospital. “I’ll never forget the tech, Tami, who helped me during delivery,” Dana says. “She was shouting ‘You can do this, you can do it!’ It motivated me to keep pushing even though I was so tired.” Little Graeme received visits from Dr. Muscato and Robin after he was born. “They really are family to us,” Dana says. The family is thriving and Dana is still cancer-free. She says she wants her story to be an encouragement to others going through similar situations. “There really can be a happy ending,” she says. By Madison Burke

BOONE HOSPITAL CENTER Spring 2017

My New Normal Winter months are notorious for cold and flu season, and in February 2016, Emily Hawkins was sick. Without a primary doctor, she went to an urgent care center. Within nine days, she returned to the clinic five times, walking away with diagnoses of strep throat and thrush – but found no relief for her malaise or the headaches and fatigue she felt. Emily went to Boone Hospital Center to have some tests done.

n February 18, Emily was told she had acute myeloid leukemia. She remembers feeling lonely while her parents were still driving from their home in Iowa to Columbia, knowing their daughter was sick, but not knowing how sick. “That day I heard three words that would change me forever,” Emily says. “‘You have leukemia.’” Battling for her life, suffering from a greatly compromised immune system, she didn’t leave Boone Hospital Center for the next 25 days. “I wanted to know why,” Emily says. “I wanted to know what had happened to cause this.” The answer was that they don’t know what causes leukemia. She hadn’t done anything that caused her to develop the disease. In fact, AML in someone Emily’s age is a rarity – the disease most often afflicts young children or those older in age. That day she met people who would soon become staunch allies in her fight against cancer, including Mark Tungsevik, MD from

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Missouri Cancer Associates (MCA) and Mung Chin, her nurse navigator (now a nurse at MCA), who would become one of her best friends through the course of her journey. Dr. Tungsevik immediately ordered a bone marrow biopsy. Friends from her job as operations manager at Caledon Virtual came to Boone Hospital to see her. She called her parents in the car and told them the news. “It was shock and whirlwind,” Emily says. Twenty-four hours later, the biopsy results confirmed the initial leukemia diagnosis and put chemotherapy treatment immediately into motion. Mung explained the side effects that seven straight days of chemo may have – hair loss, nausea and vomiting. “The staff at MCA and Boone got me through everything,” Emily says, looking back over the past year. “I spent a total of more than 65 days at the hospital, developing relationships with the doctors, nurses and staff that truly did help save my life. The team knew me and my family so well and treated us with incredible care and love that we will never forget.”

The chemotherapy side effects turned out to be of less concern than how sick and fatigued she felt because of her compromised immune system. She spent more than two weeks being able to eat or drink very little and receiving so many blood and plasma transfusions that she lost count. “When people think about cancer, they might think about chemo and radiation – going and getting treatment at a clinic,” she says. “That’s not what I went through. There were no decisions to be made, no time to set a plan or consider options. We just did it.” Twenty-five days after being admitted to Boone, Emily was finally able to go home, but her treatment wasn’t over. She prepared herself for what she expected to be the next step, a bone marrow transplant, and arrived with “There were no decisions her parents at Siteman Cancer Center in St. Louis to be made, no time to for a meeting with Peter set a plan or consider Westervelt, MD, PhD, a options. We just did it.” bone marrow transplant and leukemia specialist. — Emily Hawkins Emily was ready to stay in St. Louis for 30 days, which the transplant would require, but at Siteman, she received a lesson in relinquishing control. “I went there with one idea – bone marrow transplant,” Emily says. A planner by nature, she was upset at first to learn that the bone marrow transplant she expected wasn’t the recommended course of action. Instead, she began a four-month journey on consolidated chemo, with the knowledge the treatment held a 35-to-40 percent chance of success. The next four months unfolded into regular cycles of consolidated chemo rounds, returning home, getting sick and heading back to the hospital. “My body was amazing, like clockwork,” Emily says. On July 19, 2016, she finished her last round of chemo. She was an emotional mess. “When it was over, I was not okay,” she says. “I was trying to figure out what to do next.” By mid-August, she was back at work. The 35-to-40 percent success rate for the consolidated chemo hung over her head. She waited for the cancer to come back. A month later, she said something “finally clicked.” Today, a year later, Emily has come through to the other side of cancer treatment: remission. Grateful for those who helped her along the way, she says she’s learned to trust life again – through a journey that started with a whirlwind and taught her lessons in acceptance and taking things as they come. She’s now back to work full time at Caledon Virtual, in a new relationship, and enjoying life. She gives thanks to her parents, Norm and Shelley Hawkins, for their support through her journey. “They put their lives on hold to help save mine,” she says. She also expresses gratitude for the staff at MCA and Boone Hospital. By Missouri Cancer Associates

BOONE HOSPITAL CENTER Spring 2017

Back in the Game Boone Hospital Team Treats Rare Neurological Disorder

oseph Wilbers was well on his way to accomplishing one of his life goals — seeing every Major League Baseball stadium. Each summer, Joseph, 69, joined his wife, children and grandchildren for a sports-centric vacation. Over the years, they had visited about 20 of the nation’s 30 baseball stadiums. For 2016, the family planned to travel from their Wardsville home to see the oldest and most famous baseball stadium of them all: Fenway Park in Boston, home of the Red Sox. But as the trip approached, Joseph noticed his health was on the decline. He was falling regularly and having trouble just getting around. As he walked, he would stare at the ground, shuffling his feet in a manner that quickly wore out the soles of his shoes. “It was almost like he had aged 20 years in six months,” says Joseph’s wife, Janet Wilbers. As his health continued to worsen, Joseph told his family that he couldn’t make it to Boston. It was the first time he had ever missed the family vacation. “I felt like I’d be holding them back the whole trip,” Joseph says. In some ways, Joseph’s symptoms pointed toward Parkinson’s disease, an incurable nervous system disorder. The possibility that he might have Parkinson’s became a major concern for Joseph. He had to cope with the thought that he might never get better. Janet saw him becoming depressed. “With his illness, he would just sit in a chair and have no interest in doing things,” she says. “It seemed like there was nothing up ahead for him.” 14

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Joseph Wilbers shows off some of his baseball memorabilia.

The sudden change in Joseph’s health was hard on the whole family, even his 3-year-old grandson Sawyer. Ever since he was a baby, Sawyer had spent his weekdays with Joseph and Janet. The boy had a close relationship with his grandfather. It saddened both Joseph and Sawyer that the two couldn’t play together any more. “I couldn’t really do anything with him,” Joseph says. “It really bothered me that I couldn’t get down and play with him anymore.” Janet remembers watching Sawyer set toys on his grandfather’s lap. Sometimes,

he would just stand beside Joseph and hold his hand. When Joseph continued to worsen, his doctor sent him to Boone Hospital Center to see neurologist Justin Malone, MD, with Neurology Inc. At their first meeting, Dr. Malone saw that Joseph’s movement problems did roughly resemble Parkinson’s disease, but it wasn’t a perfect match. Joseph didn’t have problems with shaking, a hallmark symptom of Parkinson’s disease. “That was another clue,” Dr. Malone says. While he couldn’t rule out Parkinson’s,

Joseph Wilbers and his family have visited 20 of the 30 Major League Baseball stadiums. Pictured from left: Coors Field in Denver, Colorado; Great American Ballpark in Cincinnati, Ohio; Yankee Stadium in Bronx, New York Dr. Malone also suspected that Joseph might be suffering from a rare neurological disorder called normal pressure hydrocephalus — a problem Dr. Malone had treated only a handful of times during his career. To help make the diagnosis, Dr. Malone sent Joseph home with a prescription for medicine that fights the symptoms of Parkinson’s disease. If the medicine helped, it would indicate Joseph had Parkinson’s. But two months later, Joseph was back and the medicine had not helped. Now, with Parkinson’s disease no longer a possible diagnosis, Dr. Malone needed to confirm whether normal pressure hydrocephalus was the cause of Joseph’s problems. Normal pressure hydrocephalus is not fully understood. Its symptoms are caused by a build-up of extra spinal fluid in the brain. That extra fluid places pressure on the brain, causing problems with walking and incontinence. If the pressure is relieved, these symptoms can improve. But left undiagnosed, patients can experience dementia, a symptom that can become permanent. Dr. Malone says that both CT and MRI scans of Joseph’s brain appeared to show signs of normal pressure hydrocephalus. To confirm the diagnosis, Joseph was admitted to Boone Hospital for further testing. While Joseph was at the hospital, his wife, children and grandchildren spent many hours with him in his hospital room. Janet says the caregivers helped make the family feel welcome. “The staff was awesome,” Janet says. “They were all present and very tied into what they were doing as a unit. I was very

impressed with the quality of the work and the quality of the staff.” Janet says even 3-year-old Sawyer was comfortable. “There was no fear; there was no sense of concern,” Janet says. She says Sawyer even accompanied her to Boone Hospital’s newly renovated chapel to pray. During this time, Dr. Malone tested how Joseph’s body would respond to having excess spinal fluid drained from his body. For three days in a row, caregivers drained fluid, then watched for changes in Joseph’s walking and balance. They found that when the spinal fluid pressure was relieved, Joseph showed improvement. It was finally clear that Joseph was indeed suffering from normal pressure hydrocephalus. With the mystery solved, Joseph was quickly scheduled for brain surgery. During the procedure, neurosurgeon Charles Bondurant, MD, installed a ventriculoperitoneal shunt inside Joseph’s body. It’s a device that allows excess spinal fluid to drain from Joseph’s brain into his abdomen. Before his surgery, Joseph expected that he would wake up after the procedure with a terrible headache. But when he awoke, he was shocked that he felt fine. He didn’t even need pain medicine. “I felt great,” Joseph says. “I could walk. I just couldn’t believe it.” The next day he was released from the hospital and returned home to Wardsville. Joseph’s homecoming came just before the holidays.

“The first thing he said when we got home is, ‘Do you think we can have Christmas here?’” Janet says. “I said, ‘We’ll make it work.’” When Christmas came, dozens of family members joined Joseph and Janet for the celebration. While he was still beginning his recovery, his relatives were already amazed to see the old Joseph was coming back. “There were a lot of hugs and just a sense of, ‘we’ve got you back,’” Janet says. In his field, Dr. Malone says he often spends his days helping patients cope with symptoms of disorders that can’t be fixed. In helping Joseph, he was happy to have helped a patient find a cure. “It’s always refreshing when you are taking care of a patient and there is a disease that you can actually make better,” Dr. Malone says. “I’m just really happy we were able to recognize the disease and get Joseph the appropriate help that he needed so he could get back to having a more normal life.” Joseph continues to go to physical therapy, and he says he’s always improving. “Every day it’s getting a little better,” he says. He hopes to get back to his old routine this summer, which includes working in his garden and push-mowing his two-acre yard. He’s also eager to continue his pursuit of visiting all the baseball stadiums. This summer, he and his family plan to check five stadiums off their list during a visit to California. He credits his caregivers with giving him his life back. “It was just a great experience for me,” Joseph says. “Boone Hospital is just something else. By Jacob Luecke BOONE HOSPITAL CENTER Spring 2017

Watch Shanna’s full baby story at YouTube.com/BooneHospital

What to Expect When You’re Expecting A

B O O N E B A B Y !

Having a child is a beautiful thing; you’re bringing new life into the world and growing your family. But if you don’t know what to expect, it also can be stressful, especially your first time around. When you have a Boone Baby, you can expect to build a special relationship with your private practice physician and the staff at Boone Hospital Center. New Boone baby mom Shanna Watson and Jennifer Roelands, MD, of Women’s Health Associates give you a rundown of typical events in the progression of a pregnancy, from pre-conception, to delivery and the interactions you will have with your doctor.

Spring 2017 BOONE HOSPITAL CENTER

BEFORE CONCEPTION Make an appointment with your primary care physician or obstetrician/gynecologist (OB/GYN) to discuss any health issues, medications or concerns about conceiving. The doctor likely will suggest you start taking prenatal vitamins and will make sure you are up to date on all your vaccinations. This is a good time to improve healthy lifestyle habits, including eating a balanced diet and participating in regular exercise, and to stop nicotine and alcohol use. “Some vaccinations can’t be given once a woman is pregnant, so we like to see if there are any due before a woman conceives.” – Dr. Roelands

FIRST 14 WEEKS After you get a positive pregnancy test at home or at the doctor’s office, you should make an appointment with an OB physician. The doctor will perform a complete physical and pelvic exam to make sure you and your baby are healthy. An ultrasound may be performed to help determine a due date. You may choose to have a first trimester screening, between 11 and 13 weeks, to provide you early information about your baby’s risk for certain chromosomal conditions. “We like for you to call and make an appointment right after you take a positive test. If you are high risk or have had any losses before, we want to monitor you closely.” – Dr. Roelands Routine Physician Visits 16-28 weeks

Monthly

28-36 weeks

Every two weeks

After 36 weeks

Weekly

20 WEEKS At 20 weeks, you will have another ultrasound to look at the baby’s growth, development and anatomy. This is when the doctor can usually see if you’ll be having a boy or a girl.

16 WEEKS At 16 weeks, you have the option to have your blood drawn for AFP and Quad Screen. AFP screens for spina bifida and the Quad Screen tests for Down Syndrome, trisomy 18 and spina bifida. After 16 weeks, see the doctor once a month for brief visits to test your urine and to measure your blood pressure, weight and uterine growth. The doctor will also listen to your baby’s heartbeat.

Shanna and her husband, David, were thrilled to find out their third child would be a boy — their first son and little brother to their two daughters.

Boone Baby mom Shanna Watson often asked her OB, Dr. Roelands, questions during her monthly checkups. Doctors want mothers to feel free to ask questions and share their concerns.

24-28 WEEKS During this time, you will be tested for gestational diabetes. Gestational diabetes is a type of diabetes that develops during pregnancy and can be harmful to the baby. During this test, you will be given a glucose beverage to drink, then your blood sugar will be tested an hour later. If your blood sugar is in a certain range, your doctor will discuss treatment options with you. “Pregnancy is hard. It is exhausting. There are a lot of changes that happen to your body. It can be unnerving at times. I tell my patients to give themselves a break. Try to do things nice for yourself. Remember that you need to get rest. Get a massage. Take care of yourself!” – Dr. Roelands Begin discussing your choices to breast or bottle-feed and what you want at the time of delivery. A birth plan is not required, but if you have specific desires, it’s good to develop a birth plan with your physician. Calling now to reserve a place in childbirth preparation or breastfeeding classes will ensure you get in the classes you want later. To register or for more information about The Birthing Center’s Family Life Education programs, please call 573.815.6400 or 800.872.9008.

BOONE HOSPITAL CENTER Spring 2017

28-32 WEEKS

32-36 WEEKS

35-37 WEEKS

This is the best time to view your baby using 3D/4D ultrasound technology.

This is an ideal time for you and your partner to attend our Family Life Education classes. The Prepared Childbirth series and Childbirth in a Day classes offer detailed childbirth preparation in a small group setting. Topics include physical and emotional changes during pregnancy, and what the labor and birth process will be like. The class integrates massage, breathing and relaxation methods to be used during labor. A tour of the Boone Family Birthplace also is included.

Your physician will test you for Group B streptococcus or GBS. This involves a pelvic exam. GBS is fairly common in pregnant women. If you test positive, you will receive antibiotics during your labor to reduce the risk of transmission to your baby.

You’ll also be instructed to obtain a Tdap vaccination. Receiving this vaccination at this point of your pregnancy will give your baby time to develop antibodies to protect against whooping cough in the first few months after birth. Other adults who’ll routinely be around your baby should also receive the Tdap vaccine.

For those planning to breastfeed, the Better Beginnings with Breastfeeding class is a wonderful resource. While breastfeeding is natural, it is a learned skill. This class is designed to provide breastfeeding education, support and guidance.

“This testing is required. If a woman tests positive, we need to administer antibiotics to make sure the baby doesn’t contract pneumonia.” – Dr. Roelands It’s a good idea to have your hospital bag packed and ready to go at this time. You will see your doctor weekly after 36 weeks. You should choose a pediatrician for your baby before delivery. You can find a pediatrician online at boone.org. Boone Family Birthplace nurses will contact your pediatrician when the baby is born.

LABOR AND DELIVERY When you begin having strong contractions every four to five minutes for one to two hours, it may be a good idea to head to the hospital. You should also go to the hospital if your water breaks, the baby is not moving, or you have heavy vaginal bleeding. “ You can always call our on-call physician to ask questions if you’re unsure if you should come in or not.” – Dr. Roelands. Upon arrival, you’ll be given a room at Boone Family Birthplace where your doctor and nurses will work together to follow your birth plan. If you choose to have a low-intervention birth, there are several tools, such as birthing balls and bars, to assist you. You also may have the option of using a special maternal fetal monitor that allows you to be up in the room and walking in the halls. We realize that delivering a child is a very personal experience, so we make sure your team remains small and consistent throughout the process. In the rare event that you or your baby need additional care due to complications, you can feel safe knowing that Boone Family Birthplace is a part of a full-service hospital. Everything that could be needed is close at hand, including C-section rooms, a level-III NICU, interventional radiology, or an ICU, if required for mom. 18

Spring 2017 BOONE HOSPITAL CENTER

Shanna chose a lowintervention birth. Because she did not receive an epidural, she spent time laboring standing or leaning against her bed. The Boone Family Birthplace offers tools to help with labor such as birthing balls.

AFTER DELIVERY Skin-to-skin contact between mother and baby is recommended immediately following birth. Your Boone Family Birthplace nurses will assist you with this important bonding.

What To Put In Your Hospital Bag • List of your current medications. Be sure to include the dose and when you last took the medicine. • Robe • Slippers

Boone was born strong and healthy! He is now home with his mom, dad and two adoring sisters.

One to two hours after birth, your baby’s weight and measurements, vital signs, and blood sugar will be screened at the bedside. Your baby also will be given a bath. Your baby will receive daily weight screenings, a hearing test, and consistent vital sign monitoring. Your baby’s doctor may recommend additional testing. Your nurses will ensure you have support, information and care you need to recover from delivery. Our family-friendly care allows your baby to remain with you, and there’s a nursery if you need a little time to yourself to rest. Boone Hospital Center’s lactation specialist is available to provide support if you choose to breastfeed.

• Camera • Extra pillow(s) Shanna and her baby, Boone, spent one hour skin-to-skin. Boone was named Boone because Shanna and David started their family in Boone County and had all their babies at Boone Hospital!

• Imagery object for labor • Snacks for your support person • Change for vending machines • Diversional items (playing cards, book, handheld game, etc.) • Toiletry items (shampoo, hair care products, hair brush, deodorant, etc.) • Picture outfit for your baby • Going home outfits for mom and baby • Nursing bras, if you plan to breastfeed • Comfortable clothing for mom (pajamas, nursing gowns, etc.) • Clothes/toiletries for your support person

DISCHARGED FROM HOSPITAL Your doctor and your baby’s pediatrician will oversee your release from the hospital. You must have an age-appropriate car seat when you leave. Once you’re settled at home, you may want to attend our Breastfeeding Clinic for one-on-one consults with a lactation consultant. You also can call 573.815.6290 and our lactation consultant will answer your question within 24 hours. At Boone Family Birthplace, the support continues after your baby is born, with our Bringing Up Boone Babies group. These monthly, free sessions meet on a weekday morning to offer support to new parents. The hour-long classes are led by a Boone Family Birthplace nurse and cover mother and baby wellness topics, followed by a group discussion. And you can bring your Boone baby with you! By Madison Burke For a list of upcoming dates and class topics, please visit boone.org/BringingUpBooneBabies.

BOONE HOSPITAL CENTER Spring 2017

Ready ... Set ... Run! 5 Tips For Your First 5K

Get shoes and gear that fit.

Come up with a plan.

Stick with the plan.

Show up on the race day.

Buying the right running gear is important, both for comfort while running and to help prevent injury.

Check the newspaper and search the internet to find the perfect race. Remember, you are there to complete, not compete!

We’ve provided a sample 6-week 5K training schedule. If it doesn’t work for you, look for plans online or in running magazines – there are hundreds out there!

If you a miss a day, no biggie! Just pick up where you left off. Don’t get discouraged; we all miss a day here and there.

You can do it. Even if you didn’t quite live up to the training regimen, or aren’t exactly where you want to be, you can still do it!

Spring 2017 BOONE HOSPITAL CENTER

SAMPLE TRAINING PLAN

Lee Pfefer memorial Wellaware 5k Thursday, May 4 • 6 p.m. at Stephens Lake Park $25 Pre-registration • $30 Late registration • $15 Boone employees

For registration information, call 573.815.5050. Proceeds go to Boone Hospital Center’s Kids On Track Program For your safety, please park in the west parking lot in the park. Additional parking is available behind the Missouri Cancer Associates building. Parking by the start and finish line will be limited, and parking on the grass is prohibited.

BOONE HOSPITAL CENTER Spring 2017

A Smoothie For Two How does a registered dietitian keep her body healthy during pregnancy? Boone Hospital dietitian Kelsie Knerr, who’s expecting her first child, shares one of her favorite ways.

hen considering a smoothie recipe, I look for one balanced in protein, carbohydrates, and healthy fats. A lot of smoothies are mainly carbohydrates, and they don’t stick with me very long. Dairy products and whole fruits, vegetables and grains are fantastic ways to get carbohydrates, but I typically stay away from adding juices in smoothies, because I want my fiber! During pregnancy, a woman’s carbohydrate requirements increase from 130 grams a day to 175 grams a day. Fiber intake of 28 grams a day is recommended for pregnant women, which, along with adequate fluid intake, may help prevent or reduce constipation. This smoothie recipe is lower in carbs, but I typically don’t have any issues getting in carbs in my diet! I like to keep my carbohydrate intake balanced throughout the day at snacks and meals to maintain steady blood sugar control and keep up my energy level. The cocoa powder adds a rich flavor and color to your smoothie. Cocoa powder also

helps to open up your blood vessels and provides valuable minerals and antioxidants. It isn’t necessary to use a protein powder; you can add protein to smoothies with ingredients such as Greek yogurt, cottage cheese, milks, nuts and seeds. I like this recipe because it lets me get in a little more than 1/3 of my protein needs for the day. When I start my day with a good amount of protein, it helps me spread out my intake throughout the day. It’s common in the American diet not to get much protein at breakfast and then go overboard at dinner. Your body uses protein better in smaller amounts rather than all at once. Institute of Medicine recommends pregnant women take in about 1.1 grams per kilograms of body weight in protein each day, which is moderately higher than the rate recommended for adult women who aren’t pregnant – 0.8 grams per kilogram a day. This recipe has milk, which helps me get calcium. The Recommended Dietary Allowance (RDA) for calcium is 1,000 mg per day for any woman who is 19 to 50 years old, whether you’re pregnant,

breastfeeding, or neither. The Dietary Guidelines Scientific Report estimates that 24 percent of pregnant women in the U.S. consume less than 800 mg of calcium a day. While your RDA doesn’t change, it’s still important to focus on getting enough calcium and other nutrients through your food while you are pregnant (and always).

Protein Smoothie Ingredients

Options

3/4 cup skim milk

• Add 1 cup spinach. It’s only 7 calories and would add Vitamins A, C, K, and folate and help you get in more vegetables. The goal is about 3 servings or more a day for pregnant women.

1/2 frozen banana 2 tablespoons nosugar-added peanut butter 1 tablespoon dark cocoa powder 1 scoop chocolate whey protein powder 1 cup ice

Spring 2017 BOONE HOSPITAL CENTER

• Use a powdered nut butter like PB2 instead of peanut butter to cut back on calories. • Ground chia or flax seeds add additional fiber, protein and healthy fats. • Switching out dairy milk for almond or cashew milk will decrease the calories in this smoothie, but also the proteins, carbohydrates and vitamin D.

Nutrition Facts: Servings 1.0 Amount Per Serving Calories 430 % Daily Value * Total Fat 17 g 26 % Saturated Fat 3 g 14 % Monounsaturated Fat 9 g Polyunsaturated Fat 5 g Trans Fat 0 g Cholesterol 4 mg 1 % Sodium 346 mg 14 % Potassium 666 mg Total Carbohydrate 35 g Dietary Fiber 5 g Sugars 11 g Protein 35 g Vitamin A Vitamin C Calcium Iron

19 % 12 % 19 % 71 % 1 % 12 % 39 % 13 %

Q&A Get To Know Boone’s New General Surgeons

LY Phan, MD

Anne Petersen, M BA, MD, FACS

Tell us about yourself. ANNE PETERSEN: I am general surgeon and have been in private practice for over 10 years. I LOVE my job! I enjoy operating very much, and I enjoy getting to know my patients and their families. LY PHAN: I have been practicing for over 11 years, since graduating from medical training in Morgantown, West Virginia. I’m an old-fashioned guy who believes in delivering health care one patient at a time and that each patient that I encounter is treated like he or she is part of my family. I believe medicine is an imperfect science, so the compassion that we show our patients helps make up for some of that imperfection. REGGIE VADEN: I have always wanted to be a doctor; I really never wanted to be anything else.

Reggie Vaden, MD, FACS, FACRS

Why did you get into the health care field?

Spring 2017 BOONE HOSPITAL CENTER

PETERSEN: It always interested me. When

I was younger, I watched a TV show about a veterinarian who operated on tigers and elephants. I wanted that job. As I grew older, that became someone who could operate on people.

PHAN: I got interested in medicine at an

early age — 6 years old — when my dad was stricken by a stroke. Living in a small, rural village, good health care was hard to come by, so the good doctor would travel to our house and care for my dad. I would

watch him examine my dad, sterilize the syringe and needle with boiling water and give him medicine, and slowly but surely rehabilitate dad back to where he could walk again. These images have stuck with me and shaped who I am today. VADEN: When I was a general surgery resident, my mentor was a colorectal surgeon. I realized I really enjoyed the type of cases and the variety.

What interested you in your particular specialty? PETERSEN: It’s a combination of math

and science with using your hands and mechanical skills — the things that I enjoy. Operating on someone can make you feel like you’ve made a real difference in their life. Very few specialties see the type of instant change in their patients that I see — someone will be very sick with appendicitis and then much, much improved in just a few hours.

PHAN: I fell in love when I saw the operating room when I volunteered at a local hospital. The ability to use my head, my heart and my hand to help people suffering from an ailment is what attracted me to surgery.

What is the most rewarding aspect of your job? PETERSEN: Surgery is a team sport.

The relationships that I form with my coworkers — from the support in the OR

with the nurses and techs and anesthesia providers, to the office staff who get to know the patient, arrange their operation and insurance coverage, and help with post-operative calls and concerns — can last a lifetime and are the key to doing things well. When you add the patient as part of the team, now you have real rewarding relationships. This is what makes even the toughest days brighter and makes it all worthwhile. PHAN: The most rewarding part of my job

is to see the fear and the pain disappear from my patient’s face as they wake up from surgery.

VADEN: I would say the most rewarding part and, at the same time, the most challenging part of my job is all of the relationships one develops with patients and coworkers.

What is the most challenging aspect of your job? PETERSEN: Sometimes surgery can be scary.

It can be hard to help people navigate through their options for operations and a new diagnosis of cancer. Patients and families have different dynamics and we can see them at some of the most difficult times in their lives.

PHAN: The challenging part of my job is dealing with the complications of surgery and the long process of helping my patients through the whole ordeal.

What do you see changing in health care in the next five to 10 years? PETERSEN: I wish I knew, then I could

plan for it! I think that the surgical world will remain much the same at heart. The politics of insurance and providers and coverage seems to be a constantly changing

landscape. However, the care provided in the U.S. is really second to none, and I believe will remain so.

a really cool hobby, but I don’t. I’d like to travel and see the world, but I seem to get sidetracked — perhaps someday!

PHAN: The challenge of health care is the balance between innovations and progress on the one hand and cost containment of health care on the other. It’s kind of like the yin and the yang.

PHAN: I enjoy spending time with my family, waiting for the annual cherry blossoms, and spending quiet time fishing and meditating.

VADEN: I think we will likely move toward

some type of universal health care to better care for everyone.

What advice would you give someone looking to become a doctor? PETERSEN: Come check it out and join us;

there is no greater job in life! All of the commotion and craziness of the world falls away when you focus on taking care of an individual and a job well done. When things go well, we are on Cloud 9. Things don’t always have a happy ending, but even during the hard times there are small things that we can each do that makes that experience less painful and more rewarding.

PHAN: For those contemplating entering the medical field, make sure your heart is in the right place and that what flows from your heart is consistent with the neuronal signals coming from your brain. VADEN: I would say make sure nothing but medicine will make you happy, because it requires an uncommon degree of commitment.

What do you enjoy doing outside of work? PETERSEN: I’m just a big nerd. I like to read,

play video games, knit, play the piano and cello, and try new foods, both at restaurants and cooking. I wish I was an athlete or had

VADEN: I enjoy running, cycling and spending time with my horses.

What advice would you give to someone who is going to be a patient in a hospital for a period of time? PETERSEN: Patients need lots of patience!

Being in the hospital is frustrating. The only times most people are in the hospital now are when they are really sick. Otherwise, you go home. And when you do not feel well, everything is just harder. Things take time to move forward; the body takes time to heal. Some people bring a lot of things to do and a suitcase full of clothes, but less is more! If it doesn’t fit in a bag that could easily fit under the seat on an airplane, it’s best to leave it at home. You could have another bag or two at home that a loved one could bring if and when you feel up to it. Otherwise, the basics are all provided by the hospital. PHAN: Trust in your health care provider and believe in yourself are two things you must do if you’ve fallen ill. Without trust, whether you’re at a rural hospital or the Mayo Clinic, no provider will be “good enough” for you. You have to believe in yourself and that you can overcome adversity. Health care providers will help find the problem and help you heal, but the healing part is all up to you! VADEN: Be vigilant about your care, and patience is a virtue.

BOONE HOSPITAL CENTER Spring 2017

A ROAD SIGN FOR YOUR HEALTH

DIABETES AHEAD

Some adults are at greater risk for developing prediabetes. Risk factors include: Being older than 45 Being overweight or obese African-American, American Indian, Asian American, Pacific Islander, or Latino descent Having a parent or sibling with type 2 diabetes History of gestational diabetes or giving birth to a baby weighing more than 9 lbs Being physically active less than 3 times a week High blood pressure HDL cholesterol lower than 35

• • • • • • • •

ver 29 million people in the United States live with type 2 diabetes and about a million new cases are diagnosed every year. There are even more people with prediabetes and most of them don’t know it. According to the CDC, 86 million American adults have prediabetes – that’s 1 in 3 adults. Most of them, however, don’t know they have it – only 10% of these people have been diagnosed, which is unfortunate because being diagnosed with prediabetes can help you be pro-active and take steps to avoid being diagnosed later with diabetes. Prediabetes means your blood sugar is higher than normal, but not high enough to be diagnosed as type 2 diabetes. It’s also called impaired glucose tolerance or impaired fasting glucose, depending on the kind of test that detects it. Prediabetes has no symptoms and is often only detected by a glucose tolerance or hemoglobin A1C blood test. If left unaddressed, up to 30% of adults with prediabetes are diagnosed with type 2 diabetes within 5 years. “You can have prediabetes for quite a while before being diagnosed. The bigger concern is that your pancreas is working overtime, which increases your risk for diabetes,” says Jennifer Anderson, a registered dietitian and supervisor of Boone Hospital’s diabetes education and nutrition program.

See your doctor if you meet these risk factors or have a family history of type 2 diabetes to discuss having your blood glucose or glucose tolerance tested. The good news is that, even with these risk factors, having prediabetes doesn’t necessarily mean you will get diabetes – that is, if you take charge of your health. Weight loss is one of the most effective ways to prevent prediabetes from becoming diabetes. About 90% of adults with type 2 diabetes are overweight or obese. “When you’re overweight, you tend to be more insulinresistant. Your body has a harder time using insulin, so your pancreas tries to make up for it by making more insulin, which, over time, wears out the pancreas,” Jennifer explains. You don’t need to lose a lot of weight to benefit, either. Losing about 5 to 7% of one’s current weight is enough for most people to see improvement in their blood glucose levels. If you weigh 200 pounds, that’s only 10 to 14 pounds, which most people can achieve through lifestyle changes over a few months, like eating a healthier diet and regular exercise. Getting 30 minutes of physical exercise 5 days a week, can also help you manage your blood glucose levels. “Exercise helps ease that insulin resistance and helps your body use insulin better,” Jennifer says. Lowering your risk for diabetes also puts you at lower risk for heart disease, stroke and complications of diabetes, including blindness, kidney disease, diabetic neuropathy and premature mortality. With a sustained, healthier lifestyle, a prediabetes diagnosis can actually be a useful sign advising you to take control of your health. By Jessica Park

BOONE HOSPITAL CENTER Spring 2017

Look for Darren’s story on YouTube.com/BooneHospital

Life Is Good Darren Gabbert is 51 years old and has been a patient at Boone Hospital Center often since he was a child. He has advanced Muscular Dystrophy and wrote his life story through eyebrow movements.

y name is Darren Gabbert, and I have an advanced form of muscular dystrophy called Type 2 – Spinal Muscular Atrophy. This genetic condition affects the nerves that control muscle movement. Type 2 of this disease is characterized by moderate onset and progressive weakness in arms, legs, lower torso, and respiratory muscles. I have never walked, but had reasonably good use of my arms through childhood. In the early nineties I lost most of the use of my arms and hands, and by 2004, I began controlling my power wheelchair through a single electromyographic (EMG) switch. From this EMG sensor I can navigate my wheelchair, adjust my wheelchair seating, activate environmental controls and operate all the features of my smartphone. My life has many challenges. And yet, God has given me much to work with. I have the blessing of being married to my best friend; we have three children and four grandchildren. I have worked for the University of Missouri’s information technology department for 28 years, and continue to do research and grant writing in the field of assistive technology. In 2013, I had a severe pneumonia that required a tracheotomy. Since that time I have relied on augmentative and alternative communication. My life’s journey has been filled with God’s grace, amazing people, technology innovations, exceptional medical care, and a lot… a lot of change. I am a born-again Christian, and firmly believe that God has a plan and a purpose for each of us. God does not ask anything of us that He is not ready to equip us for. It is my dogged faith in that that keeps me going forward.

Spring 2017 BOONE HOSPITAL CENTER

I cannot overstate the blessing I received from my mother and father. When they were 20, during the 1960s, they defied all the stereotypes and attitudes of their rural farm community, moved to town, and raised two disabled children — two children who would go on to earn college degrees, have successful careers and enjoy happy marriages. That said, chief among the amazing people in my life is my lovely wife, Denise. Without doubt, God brought us together. And together we have overcome many obstacles and have always managed to laugh each day. I see a lot of people with dysfunctional marriages, and I am thankful beyond measure to have a healthy one. We are of the Mennonite faith and enjoy the privileges and responsibilities of a faith community. We bear no burdens alone. The Mennonite faith and culture shows in practice that when one member suffers, all the members suffer with it; or one member be honored, all the members rejoice with it. We enjoy a great deal of security within our spiritual family. Technology is a fundamental part of my day-to-day life. Trusting technology is a little bit like trusting a cat. But overall, I have been very blessed to have access to life-changing technology innovations. For 20 years, I was a power user of speech recognition technology, which kept me very competitive in my early career. When I could no longer speak, my boss (and dear friend) never even questioned my return to work. And with the help of some colleagues from Georgia Tech and a technology company in Tulsa, Oklahoma, I was soon being productive again. I can honestly say that, over the course of my life, technology has increased my abilities at a faster pace than the muscular dystrophy has diminished them.

Darren Gabbert and his wife, Denise, visit the Healing Garden at Boone Hospital Center

My life has many challenges. And yet, God has given me much to work with. I am 51 years old, which speaks volumes to the level of health care that I have received. From the time we met, Denise has been devoted to my care. I admit I have sometimes questioned my sanity for marrying a social worker, but truly I would not be here without her policing every hospital stay. I have a great team of health care professionals at Mayo Clinic that have proactively kept me healthy and active. My main doctor there has treated me for nearly 30 years, and will answer my emails typically within 30 minutes. But as good as Mayo is, if I have pneumonia, there is nowhere I want to be more than Boone Hospital. The first time I was admitted to Boone I was in pediatrics

(yes, a long time ago). And the last time was this past November. I could text my doctor what was going on, and when I arrived the front desk had everything arranged for a direct admit to ICU, and the ICU nurse had recognized my name and had the room stocked for my unique needs. Health care doesn’t get any better than that. As I said, my life’s journey has been filled with God’s grace, amazing people, technology innovations, and exceptional medical care. And through it all we face change. We adjust to change. We accept change. Many challenges. Much to work with. Life is good! By Darren Gabbert

BOONE HOSPITAL CENTER Spring 2017

Learn more at boone.org/foundation or call 573.815.2800

NEWS FROM THE

Comfort Baskets The Boone Hospital Center Foundation provides comfort baskets to patients who go on supportive care at the hospital and patients who go home for hospice care. Each item in the basket has a special purpose to comfort patients and families at the end of a patient’s life. Hand lotion: We encourage the family to touch their loved ones. Massaging the patient’s hands or feet provides a familiar touch.

Deck of cards: Waiting by the bedside for several days is tiresome. Many people like to play cards with the patient or with other family members. Many families will say that the patient loved to play cards and do so in their memory.

Tissue is necessary during the dying process, whether we’re shedding tears of sadness or tears from laughing so hard over fond, funny memories of a loved one.

Teddy bear: Patients who are unresponsive like to hold on to something. The teddy bear is soft and pliable. Other patients like to leave the teddy bear to their grandchildren when they die.

Fleece blankets provide color to the room, are soft for the patients and keep them warm.

CDs: Music is a universal language and soothes patients and their families.

Hand sanitizer: Many of our patients are very ill or have infections. To prevent infection from spreading, we ask the family to use hand sanitizer before touching the patient and when entering or leaving the patient’s room.

Spring 2017 BOONE HOSPITAL CENTER

“Share Your Thoughts With Me” journal: Families and friends who come to visit can sign the journal and write some caring words. The journal can be used for patients and families to write questions down for the doctor or for the entire family to write about a special moment they had with the patient and how that moment impacted their lives. They can bring the journal to the viewing and funeral and ask their friends to add their special moments as well. Family can make copies of the journal for other family members to remember their loved one. “Approaching Death – Signs and Symptoms” booklet explains the changes your loved one may experience in the dying process, why these symptoms happen, and what family can do to help. This booklet is helpful, since during this time, many people can easily forget the conversations they’ve had with the patient’s care team at the hospital.

2017

CALENDAR OF EVENTS April

10 & 11

Common Goods Sale (Formerly Books are Fun)

May

14th Annual Golf Tournament

May

Uniform Sale

July â&#x20AC;&#x201C; August

Community Campaign

August

2&3

Uniform Sale

September

11-13

Common Goods Sale (Formerly Books are Fun)

October

Annual Gala

November

Uniform Sale

November

TBD

Jewelry Sale

B O O N E H O S P I TA L F O U N D AT I O N

2016 Distribution of Funds Stroke Center

6% Supportive Care

17%

Caregiver Education 19%

Other 4%

Community Benefit 12%

l a u n n 14th A

DATION N U O F L A T I ONE HOSP

c i s s a l golf c BO

Y1 A M , Y A MOND

B AT @ THE CLUTHORNE OLD HAW

Current Need 42%

TO REGISTER OR FOR MORE INFORMATION: The Boone Hospital Foundation would like to thank our 2016 donors. Your generosity allows the Foundation to continue to support Boone Hospital Center and its patients. To view a complete list of donors or to learn more about the Foundation and how you can make a difference with your donation, please call 573.815.2800 or visit our website at boone.org/foundation.

573.815.2800 ymg1825@bjc.org boone.org/foundation

BOONE HOSPITAL CENTER Spring 2017

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

NONPROFIT U.S. POSTAGE

PAID

COLUMBIA, MO PERMIT 286