Freeman Medical Musings Blog

An outbreak of the measles in rural regions of Texas – exploding from just two cases to nearly 300 and now spreading to Oklahoma, New Mexico and beyond – has caused widespread alarm.

Measles is among the most contagious viral infections and can be extremely dangerous for babies and young children due to its ability to quickly spread from person to person. Humans are the only known hosts for measles.

Measles is a clever virus – it lingers in the air for a couple of hours, even after an infected person leaves the vicinity, and can continue to live on surfaces for a long time, enabling it to spread both through the air and as tiny droplets.

Measles starts off as a severe cold – watery eyes, congestion, coughs, a rash on the back of the cheeks. Unlike infections in which danger has passed by the time a rash appears, a measles rash signals that you are contagious. The window usually begins four days before the rash appears and ends four days after the rash.

As we’ve seen in Texas, measles can spread like wildfire. One in three kids in 1,000 who get measles will pass away due to complications from the viral disease. There’s a reason we vaccinate for it – it’s not just a mild childhood infection we’re talking about here. It can be very serious and even deadly.

To keep measles at bay, we need vaccination rates of 95 percent or higher. When those vaccination rates drop, preventable illnesses like measles – the latter considered eliminated in the U.S. in 2000 thanks to high vaccination rates – begin to make their way back.

The safest way to prevent measles is vaccination with MMR – measles, mumps, and rubella. Because infants and small children are so vulnerable to measles, the first measles MMR vaccination dose is given at 12 to 15 months, and it is very effective – 93 percent. After a second MMR dose is given when a child is between 4 to 6 years old, overall protection then increases to 98 to 99 percent. It’s an extremely effective vaccine. Getting both vaccine doses is the safest way to protect yourself and your family from measles.

Most exposed and at risk are our “littles,” who are too young to be vaccinated. After six months we can give a travel dose of MMR. This dose doesn’t count toward their vaccine series, but it can provide some level of protection. That said, if you have littles age six to 11 months, who won’t be getting their one-year shots anytime soon, and you’re going to be traveling, consider the travel MMR dose. It provides a level of coverage for the measles. We want to travel and experience new places and if there’s a layer of protection we can give our babies, we want to obviously do that.

When we vaccinate per the Center for Disease Control and Prevention’s vaccine schedule, children will have the best antibody response and receive on-time protection. When delaying vaccines or altering the vaccine schedule, it puts the child at risk for infections like we’re now seeing. Vaccines are safe and effective, and we know they save lives. If we want the measles outbreak to stop, we need to vaccinate.

Dr. Beth Garrett is a pediatrician affiliated with Freeman Health System and based at Freeman Children’s Clinic at 1030 McIntosh Circle Drive, Suite 1. The clinic’s number is 417.347.8750.

Volunteering can make a big difference in the lives of those we serve, but did you know that volunteering can benefit your health as well? Research shows that volunteering affords significant health benefits, especially for older adults. It also fosters self-worth and strengthens personal relationships.

Boost physical and mental health. Volunteer activities keep people moving and thinking at the same time. Research has found that volunteering among adults, age 60 and over, provided benefits to physical and mental health.

 Volunteers report better physical health than non-volunteers. Research also has shown that volunteering leads to lower rates of depression and anxiety, especially for people 65 and older. It helps minimize stress and increase positive, relaxed feelings by releasing dopamine. By spending time in service to others, volunteers report feeling a sense of meaning and appreciation, both given and received, which can have a stress-reducing effect.

 Reduced stress further decreases the risk of some physical and mental health problems, such as heart disease, stroke, depression, anxiety and general illness. In addition, people who volunteer have lower mortality rates than those who do not, even when controlling for age, gender and physical health.

Gain a new sense of purpose. The work that volunteers provide is essential to everyday activities, giving volunteers a sense of purpose, especially when giving their time and talent in the areas they find meaningful. Older volunteers experience greater increases in life satisfaction and self-esteem.

Nurture new and existing relationships. Volunteering increases social interaction and helps build a support system based on common interests. One of the best ways to make new friends and strengthen existing relationships is to participate in a shared activity.

In many cases, volunteers have diverse backgrounds, which helps expand their social network and allows them to practice social skills with others. People volunteer for different reasons, such as exploring careers, sharpening skills, staying active during retirement, meeting new people and serving their communities. Yet all volunteers share a common desire to improve the health and welfare of people in their communities.

How To Get Involved

 There is a wide variety of volunteer opportunities in every community, whether you're interested in youth, environmental, health, religious or community causes. Check with local nonprofit and cultural organizations, schools, faith communities, or hospitals for options.

 Or consider joining Freeman Health System’s team of volunteers and making a difference in the lives of patients and staff. For more information, call Freeman Volunteer Services Manager Danae Taylor at 417-347-4603.

Kidney disease is one of the fastest-growing noncommunicable diseases in the United States, according to the American Kidney Fund. Nationwide, roughly 15% of American adults – 37 million people – suffer from chronic kidney disease.

Acting chameleon-like, chronic kidney disease’s signs and symptoms go unnoticed in a vast majority of patients until a diagnosis occurs.

Many people don’t realize their chronic kidney disease is something they may already have or have been at risk for quite some time.

The kidneys are vital organs that perform a variety of key functions: they filter blood for toxins, remove the body’s excess waste and fluids and regulate blood pressure, balance important electrolytes and minerals and stimulate red blood cell production.

When our kidneys are compromised in their ability to carry out any of these tasks, the consequences can be debilitating and even life-threatening. Chronic kidney disease progresses from stage 1 to stage 5, after which point patients require kidney replacement therapy in the form of dialysis or kidney transplant. Unfortunately, many patients are at-risk progressing very quickly toward kidney failure, whereas others can maintain stable kidney function very gradually.

Disease progression, experts say, can often be slowed when patients take an active role in making permanent, healthy lifestyle changes.”

The most common causes of chronic kidney disease in Americans are diabetes and high blood pressure. Roughly 37% of the US population have either diabetes or pre-diabetes, and 45% suffer from high blood pressure. Both diseases are perpetuated by unhealthy lifestyle choices.

Making strides towards more disciplined food selections, portion control, increasing physical activity and eliminating smoking will help decrease the risk of chronic kidney disease. These healthy lifestyle choices can also slow the disease’s progression. Even small changes can make a big difference.

Always let your doctor know if you are taking additional supplements or over-the-counter medications. Be sure to take medications only as prescribed. Many medications can be affected by chronic kidney disease if the kidneys cannot process those substances due to being damaged. Likewise, some medications contribute to developing kidney disease such as antacid medications and the nonsteroidal anti-inflammatory drugs.

People are encouraged to meet regularly with their healthcare provider to screen for risk factors for kidney disease.

At Freeman Kidney Center, highly skilled, board-certified nephrologists treat conditions such as acute renal failure, chronic kidney disease, hematuria or blood in the urine, and proteinuria or excess protein in the urine. With appropriate intervention, kidney patients can work and live normal lives. For details, called 417.347.8570.

Spring officially begins on March 20, but you don’t have to wait until then to get out and enjoy the warmer weather and set the tone for spring and eventually summer with regards to your outdoor exercise routines. 

There are many benefits to exercising outdoors, among them being the boost your body receives from the sunlight and natural Vitamin D absorption, which can lead to an improved mood. Other benefits also include your overall cardiovascular health, as well as kicking that nasty seasonal affective disorder which can keep you down in the winter months. 

March is National Nutrition Month and utilizing the warmer weather that is coming is an excellent way to kickstart your well-being. Below are some key benefits and important considerations for your outdoor exercise routines. 

Sunlight can lead to a Vitamin D boost which is crucial for bone health and immune function.

Spending time outdoors and in nature has been shown to have a positive effect on mood, while reducing stress, lowering anxiety and elevating serotonin levels. 

Warmer temperatures help loosen muscles and allow for a greater range of motion, improving flexibility. 

Outdoor exercise offers a more diverse range of activities than what you can find in a gym or in your own home. 

Getting yourself out in the sun during exercise can help to regulate your sleep patterns, not to mention we all know how much better children sleep after they’ve had a fun workout. The same strategy works for us too!

While exercising outside it is also important to consider some tips for warmer weather. 

Make sure to remain constantly hydrated, while also making sure to apply sunscreen. Think about your clothing as lighter selections make navigating your workout easier with warmer temperatures. 

A gradual increase to your workout regimen is highly recommended and helps your body adjust to the heat and above all – listen to your body. Look for the signs of exhaustion, dizziness, nausea and heavy sweating and seek shelter if you need it. 

With all that said, even if you don’t have a plan to work out, do your body a favor and simply get outdoors. Enjoy the sunlight and be active. It’ll do wonders to your health and mental well-being. 

Aging is inevitable, but how we age is largely within our control. While genetics play a role, research shows that lifestyle choices significantly impact our health, function, and quality of life as we grow older. The good news? Small, consistent changes can make a big difference.

The Problem with Our Current Approach to Health

Our healthcare system excels at treating disease but falls short in preventing it. A staggering 80% of chronic health problems in the U.S. are driven by lifestyle factors, including:

• Tobacco use

• Poor diet and inactivity (both linked to obesity)

• Excessive alcohol consumption

• High blood pressure and cholesterol

The key takeaway? Many of these risk factors can be improved or even reversed with healthy habits.

More Function = Less Aging

Aging is often associated with decline, but it doesn’t have to be. Research suggests that maintaining function—through movement, diet, and social engagement—can slow the aging process and enhance overall well-being.

Regular exercise, for example, supports heart health, brain function, and mobility as we age. Cardiovascular fitness is linked to a lower risk of cognitive decline, and strength training helps combat sarcopenia (age-related muscle loss), which can affect independence.

The Brain-Heart Connection

Cognitive decline, including Alzheimer’s, is strongly influenced by lifestyle. The numbers speak for themselves:

• 53% reduction in Alzheimer’s risk with proper nutrition  

• 40% lower risk of Alzheimer’s with regular exercise  

• 30% less brain shrinkage with effective stress management  

• 70% lower dementia risk with improved sleep  

• 48% reduction in Alzheimer’s risk with social and mental stimulation  

Maintaining a healthy heart also benefits brain function. A 40% reduction in dementia risk has been observed in individuals who prioritize heart health through diet, exercise and stress management.

Strength, Aging, and Longevity

Loss of muscle mass is a common part of aging—adults can lose up to 30% of muscle between ages 35 and 65. This impacts strength, balance, and even lifespan. Research shows clearly that strength and muscle growth are achievable at any age!

Charles Eugster, a 93-year-old fitness enthusiast, put it best: "You can have a beach body at 90! If you eat right and exercise properly, you can be that guy at any age."

Diet and Aging: Food as Medicine

We eat nearly 800 pounds of food per year, so what’s on our plate matters. Diets high in ultra-processed foods increase the risk of cognitive decline by 16%, whereas a diet rich in whole, unprocessed foods lowers the risk by 12%.

The Mediterranean diet, rich in whole grains, vegetables, nuts, and healthy fats, is one of the best options for heart and brain health.

Final Thoughts

Aging well isn’t about avoiding birthdays—it’s about maintaining function and enjoying life to the fullest. By making small, intentional changes in movement, nutrition, sleep, and stress management, we can significantly improve our quality of life.

Are you ready to take control of how you age? Start today with small, sustainable steps toward a healthier future!

Checkups Can Help Provide Better Results
“I feel healthy, so do I really need to get screened?” This is a question we may be tempted to ask. However, even when we’re feeling our best, health screenings are vital because they bring to light conditions or diseases we may have even if we’re not currently showing symptoms.

In most cases, the earlier a problem is detected, the more effective the treatment will be. Health screenings also give us a baseline of our current health, which can be helpful for comparison in future settings.

Early Detection Screenings are more in-depth screenings. They include:

Stroke Screening/Carotid Artery
Plaque buildup is an abnormal collection of calcium and cholesterol on the artery walls. Blocked carotid arteries can restrict blood flow to the brain or break off and become lodged in a blood vessel, resulting in a stroke. Through ultrasound technology, carotid arteries are scanned along each side of the neck to detect narrowing or blockages. Early detection will allow you to take an appropriate course of action that may reduce future risk of stroke or other health concerns.

Abdominal Aortic Aneurysm (AAA) Screening
An abdominal aortic aneurism – a ballooning of the wall in the abdominal aorta – is most often caused by plaque buildup. Noticeable symptoms of an AAA are uncommon, and you may never know you have it. Early detection can increase your survival rate by 50% or more compared to emergency treatment after a ruptured aneurysm.

Peripheral Arterial Disease (PAD) Screening
Peripheral arterial disease mainly affects the arteries located in arms, legs, and feet. When fatty deposits build up in the inner linings of the artery walls, blood flow is restricted. PAD often goes undiagnosed until painful symptoms start. Early detection could also help prevent future heart attacks and stroke.

Thyroid Ultrasound Screening
Thyroid ultrasound screening is a sound wave image. Thyroid ultrasounds can be used to detect tumors, cysts, goiters or abnormal lymph nodes of the thyroid gland.

Osteoporosis Risk Assessment
Osteoporosis is a disease in which bones become fragile and more likely to break. Men and women 55 years and older are at greater risk for osteoporosis, but it can occur at any age. Poor diet and lack of exercise can contribute to an osteoporosis diagnosis. Early detection allows a physician to start appropriate treatment.

Although you might feel fine, it is a good idea to check your numbers. This includes blood pressure, cholesterol, glucose, and weight. Also having a few in-depth screenings can give you even more information about your health and receive treatment right away if needed. Screenings are a simple way to check your health.

Southwest Missouri experienced a notable decrease in the number of overdose deaths in early 2024 – dropping from 130 deaths through the first six months of 2023 to 100 during the same timeframe in 2024.

Statewide, 802 people died from all drug type overdose during the first six months of 2024, down 23 percent from the 1,048 overdose deaths recorded during the same period in 2023. 

According to a 2024 report from the Missouri Department of Health and Senior Services, opioid involved deaths dropped from 777 deaths to 523 deaths statewide – a 30 percent drop. Fentanyl-involved deaths, according to the report, dropped from 732 to 472 deaths. 

There are several factors why the state has seen such a dramatic drug overdose drop, and it’s partly due to the availability of the live-saving drug naloxone. Naloxone, also known as Narcan, is a medication used to reverse opioid overdoses by blocking the effects of opiates on the brain and restoring breathing, preventing harmful drugs from slowing or stopping the victim’s breathing that can lead to death.
 
Getting Narcan in people’s hands is pivotal. While safe and effective, the reversal drug only works if a person has opiates in their system. Educating people on the proper use of the drug has proven key and encouraging providers to have it readily available has been a huge benefit.

Educating both medical providers and the community as a whole helps to reduce stigma and can encourage people who are suffering to seek treatment. The availability of medication assisted treatments, including medications like the synthetic opioid buprenorphine helps treat opioid cravings – and has also proven beneficial. 

Remember – education is the best way to keep overdose deaths down and to reduce stigma.
 

We know our children are having fun, but to adult ears, the noise is all but overwhelming. 

While children are certainly drawn to sensory-stimulating toys that light up and makes noises, these toys take away from the social engagement that play is meant to provide, meaning parents and children alike talk less when electronic toys are in use. Even toys marked as educational elicit “fewer adult words, fewer conversational turns [and] fewer parental responses than during play with traditional toys or books,” according to the American Academy of Pediatrics. Like sugar, these toys light up the reward centers in our children’s brains without providing any real value to help them grow.  

So, what’s a parent to do with Christmas around the corner and all the shiny, new, battery-powered toys on display? Our advice is to go old-school! And if that makes you think of wood grain building blocks and tinker toys, remember there are plenty of non-electronic toys that are also fun and exciting! Here are some examples:

Pretend play toys: Think Barbies, action figures, animals and dinosaurs. Many franchises have their own line of toys, including low-tech options, that your child will get excited about. These are a great option for toys that have a “wow” factor while still giving children the opportunity to use language and stories to learn about the world around them.

Manipulative toys: While this category does include those wood grain blocks, it also includes things like Legos, building kits, puzzles and trains. These toys foster children’s fine motor skills, and some can build early math skills, as well.

Art supplies: Crayons, markers, coloring books and paints all make great gifts that children can have fun with while building their creativity. If you want something more elaborate, art supply stores often have kits for activities you can do with your child. 

Experience gifts: Does your child love sea creatures? Give them tickets (or even a membership) for a nearby aquarium. Are sports more their thing? Consider tickets to a game. Art classes, martial arts classes, concert tickets or a “ticket” for a camping trip can all make great gifts that your child will be excited about!

In short, choose toys that spark your child’s imagination, give them the chance to explore their world and bond with others in their family. (And of course, make sure the toy is age-appropriate for your child.) In the process, you can save your sanity from the roar of noisy toys.

For more information about play and development, visit healthychildren.org for American Association of Pediatrics recommendations. Visit freemanhealth.com/pediatrics for more information about pediatric services at Freeman Health System.

As leaves fall and the air turns cooler, we know the holidays are fast approaching. In my house Christmas cheer has already begun as we put out our holiday village.

All the special treats and extra gatherings shared with loved ones may make eating during the holiday season a bit tricky while having diabetes. Remember the importance of striving towards feeling our best and keeping blood sugar under control throughout the holiday season. Keep healthy goals in mind and make the holidays more with respect to being with the ones we care about and enjoying the season overall versus focusing only on the food. There is so much to enjoy over the holidays and keeping diabetes controlled can be easier than you may think.

Some suggestions for navigating the holidays:

•    Avoid skipping meals or snacks before holiday gatherings, this may sabotage your goals.
•    Choose the foods you have looked forward to and enjoy them mindfully.
•    If you want more than one serving, consider portion size and take the second serving to go.
•    Enjoying more movement on days you are eating holiday favorites, such as a morning or evening walk.
•    Take time for yourself during the busyness of the holidays. Read a book, craft, listen to holiday music, or take a drive and look at holiday displays.
•    Be kind to yourself; do not judge or feel guilt when wanting things that taste good.
•    Test blood sugar often so you are aware of how the holidays are affecting your blood sugars.

Diabetes Plate Method
Use the Diabetes Plate Method to navigate your meal and keep carbohydrate portions in check while still enjoying them. Divide your plate into 3 sections, ½ the plate for non-starchy vegetables such as green beans, carrots, broccoli, and salad. The rest of the plate is divided into quarters. Fill one quarter with lean meats such as turkey or ham. The other quarter is for carbohydrate rich foods such as potatoes, stuffing, and cranberry sauce.

Remember what your personal blood sugar goals are. Continue to take medications as prescribed.
Try to remake a family favorite recipe or dish as a diabetes friendly version.

Replace one starchy food choice with a non-starchy vegetable on your holiday table.

Stay Moving...
Remember to include physical activities during the holidays with family and special friends. Physical activity does not only have to be going to the gym or exercising, being active can include many ideas. Going to a park or holiday display in your town and walking around or attend an outdoor Holiday Market. Look for activities and find events in your area to get out and about. There is also usually a Holiday Turkey Trot race or walk in many towns, sign up! Consider taking a family walk after a holiday meal, throwing the ball in the yard with children and grandchildren, a WII dance off, or playing active board games such as PICTIONARY. Memories are made through many moments.

Follow this link for more ideas and a step-by-step guide to managing your holidays.
https://diabetesfoodhub.org/blog/your-diabetes-friendly-holiday-toolkit

It’s no secret that one of the most recognizable faces in the Joplin region, Freeman Health System President and Chief Executive Officer Paula Baker, is a natural cook. She finds the activity relaxing, often drawing recipes from her private collection of 300-plus cookbooks. With the holidays approaching, Paula Baker has taken time from her busy schedule to publicize some of her favorite holiday recipes.
She hopes you enjoy them!

Happy Holidays!

Pumpkin Bread
5 eggs
1 1/4 cup vegetable oil
1 can (15 oz.) solid-pack pumpkin
2 cups flour
2 cups sugar
2 pkg. (3 oz. each) cook and serve vanilla pudding mix
1 teaspoon baking soda
1 teaspoon ground cinnamon
1/2 teaspoon salt

In a mixing bowl, beat the eggs. Add oil and pumpkin, beat until smooth. Combine remaining ingredients; gradually beat into pumpkin mixture. Pour batter into 5 greased 5x 1/2x2 inch loaf pans. Bake at 325 for 50-55 minutes or until a toothpick inserted near the center comes out clean. Cool in pans 10 minutes before removing to baking racks to cool completely. May also be baked in 2 greased 8x4x2 inch loaf pans for 75-80 minutes.

Baked Santa Fe Dip
1 8.75 oz. can whole kernel corn, drained
2 cups shredded cheddar cheese (8 oz.)
1 cup shredded M-J cheese (4 oz.)
1 4-oz. can diced green chili peppers, drained 
1/2 cup mayonnaise
2 teaspoons finely chopped canned chipotle chili pepper in adobo sauce
1/4 teaspoon garlic powder
1/2 cup chopped, seeded tomato (1 small)
1/4 sliced green onions (2) 
Tortilla chips and/or vegetable dippers

Preheat oven to 350. In a large bowl, stir together corn, cheddar cheese, M-J cheese, green chili peppers, mayonnaise, chipotle pepper and garlic powder. Spread mixture in an ungreased 9-inch pie plate. Bake, uncovered, about 25 minutes or until heated through. Meanwhile, in a small bowl, combine tomato and green onion. Sprinkle tomato mixture over baked cheese mixture. Serve with chips and/or vegetables. Yields 14 servings.

Peanut Butter Cake
2 cups flour
2 cups sugar
1 teaspoon baking soda
1/2 teaspoon salt
1 cup water
3/4 cup butter
1/2 cup peanut butter
1/4 cup canola oil
2 eggs
1/2 cup buttermilk
1 teaspoon vanilla
  
Preheat oven to 350. Grease a 15x1x1 in baking pan. In large bowl, whisk flour, sugar, baking soda and salt. In a small saucepan, combine water and butter; bring just to a boil. Stir in peanut butter and oil until blended. Stir into flour mixture. In a small bowl, whisk eggs, buttermilk and vanilla until blended; add to flour mixture, whisking constantly. Transfer to prepared pan. Bake 20-25 minutes or until a toothpick inserted in center comes out clean.

FROSTING
1/2 cup peanut butter
1/2 cup butter
4 teaspoons water
2 teaspoons vanilla
2 cups powdered sugar
Mix well and frost cooled cake

GLAZE OPTION
1/2 cup butter
1/4 cup creamy peanut butter
1/3 cup + 1 tablespoon milk
16 oz. powdered sugar
1 teaspoon vanilla   
Combine first 3 ingredients over medium heat. Bring to a boil. Remove from heat and stir in powdered sugar and vanilla, mixing until spreading consistency. Spread over warm milk.

Christmas Punch 
4 cups cranberry juice
2 cups pineapple juice
3 quarts Ginger ale, cold
1 tablespoon almond flavoring
1/2 cup sugar
1 teaspoon red food coloring (optional)
Combine all ingredients. Stir until sugar is dissolved and thoroughly mixed.

The Best Chicken and Dumplings
3/4 cup flour, divided
1/2 teaspoon salt
1/2 teaspoon ground pepper
1 broiler/fryer chicken (about 3 pounds) cut up
2 tablespoons canola oil
1 large onion, chopped
2 medium carrots, chopped
2 celery ribs, chopped
3 garlic cloves, minced
6 cups chicken stock
1/2 cup white wine or apple cider
2 teaspoons sugar
2 bay leaves
5 whole peppercorns 
DUMPLINGS
1 1/3 cup flour
2 teaspoons baking powder
3/4 teaspoon salt
2/3 cup 2% milk
1 tablespoon butter, melted
SOUP
1/2 cup heavy whipping cream
1 teaspoon minced fresh parsley
1 teaspoon minced fresh thyme
Additional salt and pepper to taste 

In a shallow bowl, mix 1/2 cup flour, salt and pepper. Add chicken, 1 piece at a time, and toss to coat; shake off excess. In a 6-quarrt stockpot, heat oil over medium-high heat. Brown chicken in batches on all sides; remove from pan. Add onion, carrots and celery to same pan; cook and stir 6-8 minutes or until onion is tender. Add garlic; cook and stir 1 minute longer. Stir in 1/4 cup flour until blended. Gradually add stock, stirring constantly. Stir in wine, sugar, bay leaves and peppercorns. Return chicken to pan; bring to a boil. Reduce heat; simmer, covered, 20-25 minutes or until chicken juices run clear. For dumplings, in a bowl, whisk flour, baking powder and salt. In another bowl, whisk milk and melted butter until blended. Add to flour mixture; stir just until moistened (do not overmix). Drop by rounded tablespoonfuls into a parchment-lined sheet; set aside. Remove chicken from stockpot; cool slightly. Discard bay leaves and skim fat from soup. Remove skin and bones from chicken and discard. Using 2 forks, coarsely shred meat into 1 to 1 1/2-inch pieces; return to soup. Cook, covered, on high until mixture reaches a simmer.  Drop dumplings on top of simmering soup, a few at a time. Reduce heat to low; cook, covered, 15-18 minutes or until a toothpick inserted in center of dumplings comes out clean (do not lift cover while simmering). Gently stir in cream, parsley and thyme. Season with additional salt and pepper to taste.