Freeman Medical Musings Blog

Spinal pain can impact your day-to-day activities. Some patients who experience this pain might be apprehensive or delay seeking treatment for the fear that treatment might involve surgery and a lengthy recovery. The good news is many patients with back pain and spinal problems do not require surgery. In fact, Freeman NeuroSpine offers a specialized non-surgical spine treatment service for patients.

Many factors can cause back pain, including age, genetics, strains, occupational risks or skeletal irregularities. Common problems our team treats include bulging discs, degenerative disc disease, certain muscle and ligament injuries and sciatica.

Our comprehensive services provide patients with:

• Non-narcotic pain management options
• Prescription medications
• Physical therapy
• X-ray/CT/MRI imaging
• Surgical assessment and referral for fast-tracking
• Education
• No referral necessary

There isn’t a one-size-fits all treatment for spinal pain. What might work for one patient might not work for another. That is why we offer a variety of non-surgical treatment options to our patients. There are several benefits to seeking non-surgical treatment including avoiding surgery and recovery time and being able to still go about your day-to-day activities while receiving treatment.

Exercise is an important tool to use for chronic back pain treatment. Physical therapists teach patients proper exercise techniques to help relieve back pain. Maintaining the exercise routine at home is also a key to successful treatment. Physical therapy treatment might include retraining your posture, stretching and flexibility exercises and core strengthening.

Other non-surgical methods of treatment include occupational therapy, heat and cold packs, over-the-counter pain medications, electrotherapy and massage therapy.

To learn more about other non-surgical spine treatment options visit freemanhealth.com/neuro. Call today for an appointment 417.347.7200. No referral necessary.

If your child’s favorite food belongs cake-and-cookies food group, you’re not alone. While children do naturally have a bit of a sweet tooth, many of their eating preferences are learned and changeable. And that’s great news for parents trying to raise healthy kids.

The American Association of Pediatrics (AAP) recommends that children eat two to four servings of fruit and three to five servings of vegetables each day. Beyond reducing the risk of childhood obesity, these foods provide essential vitamins and minerals that help ensure your child’s health and development.

Here are some steps you can take today to help set your child up for a lifetime of healthy eating:

• Make healthy foods easy to access in your home. Just like adults, kids are more likely to reach for the snack that’s ready to eat than the one they have to prepare. Make healthy choices easy by keeping fresh fruit in a bowl in the kitchen and having ready-to-eat vegetables (like carrot sticks, snap peas or cherry tomatoes) on an easy-to-reach shelf in the fridge.
• Limit juice and fruit snacks, and opt for whole fruits instead. Juice and fruit snacks might seem like a good way to help your child reach their daily recommended servings of fruit, but they contain a lot of added sugar and almost none of the fiber of whole fruits. Children younger than one should not drink juice at all. Children ages one to three should have no more than four ounces of juice daily, and kids ages four to six should have no more than four to six ounces daily. Even after age six, fruit juice should be limited to eight ounces a day.
• Try different preparation methods. Some children like their veggies raw and crunchy, but others may prefer the softer texture of cooked vegetables. Find what your child prefers.
• Eat together as a family. Set a positive example for your child by eating your meals together so your child can see you enjoy a balanced diet.
• Keep mealtimes positive. Forcing or nagging your child to eat healthy food can actually create negative feelings about the food, making it less likely that they’ll eat it. Try to focus on the positive aspects of the meal. If your child does not like a food, that’s okay. Give it some time and try offing that food again later.
  
  If you are concerned about your child’s nutrition, reach out to your family’s pediatrician for advice that is tailored to your child and your family.

Visit freemanhealth.com/pediatrics for more information about pediatric services at Freeman Health System. You can also visit healthchildren.org for more information about AAP recommendations.

This can lead to blood clot formation that can lead to stroke. It affects about five million people in the United States, and a treatment option for some of these patients is the Watchman® procedure. 

The Watchman is a device for patients who are at a high risk for stroke due to atrial fibrillation and need an alternative to blood thinners. Freeman Heart & Vascular Institute was the first in the region to offer Watchman. 

To determine if a patient is a candidate for Watchman, a team of Freeman physicians will evaluate your risk for stroke as well as bleeding. A transesophageal echo is performed to identify if this is the right treatment option for you. During the Watchman procedure, the physician inserts a narrow tube through the femoral vein. The physician then guides the implant, which is about the size of a quarter, into the left atrial appendage of the heart. It excludes the left atrial appendage, so no blood clot can form in it, thereby reducing the risk for stroke and simultaneously eliminating the need for a blood thinner.

The hour long procedure is done under general anesthesia, and most patients go home the next day. 

The Watchman procedure is a team approach. Freeman cardiologists Dr. Vigyan Bang, Dr. Ryan Longnecker, Dr. John Swartz and Dr. Darwin Jeyraj specialize in this procedure.

For more information about Freeman Heart & Vascular Institute – and to learn about types of heart conditions, early detection, risk factors and more helpful resources – visit freemanhealth.com/hearts or call 417.347.5000.
 

We observe not only Valentine’s Day but also American Heart Month, and there is no better time to be reminded of the importance of keeping your heart healthy. 

According to the CDC, heart disease accounts for approximately 1 in every 5 deaths annually in the United States, totaling approximately 697,000 deaths a year. Every year approximately 805,000 Americans suffer a heart attack. 

Fortunately, a few simple changes you can lower your risk of heart disease, keeping your heart healthy and improving your quality of life. To keep your heart healthy, follow these health tips:

1. Eat healthy
2. Get active
3. Quit smoking
4. Control your cholesterol and blood pressure
5. Maintain a healthy weight
6. Manage stress
7. Have regular health screenings

Eating foods low in cholesterol and saturated fats can significantly reduce your risk for heart disease. Though your favorite foods often include ingredients to avoid, you can eat right and still enjoy your meals if you follow a few simple guidelines: 

• Limit your cholesterol intake to 300 milligrams per day and total fat to less than 30% of a day’s calories, including no more than 10% of calories from saturated fats. Check food labels for fat content.
• Cholesterol is found in animal products such as meat, eggs and cheese. Saturated fats, those that remain solid at room temperature, are most commonly found in fatty cuts of meat, whole milk products, butter, and palm and coconut oils.
• Eat plenty fruits, vegetables, whole grains and legumes, such as dried peas and beans. These foods are rich in vitamins and can also help keep your cholesterol levels down.
• Know that it’s okay to use butter and dressing as long as you use them in smaller portions. Also, give low-fat or nonfat products a try.
• Additionally, it’s important to know the symptoms of a heart attack so you can act right away. The signs of a heart attack aren't the same for everyone. For some, symptoms are sudden and intense. For others, the symptoms are mild and begin slowly. Know the warning signs and act quickly – by calling 911 or going to the nearest emergency room – if you think you're having a heart attack.

It’s also important to know your risk factors, be aware of your blood pressure and cholesterol, exercise regularly and avoid smoking to decrease your risk of a heart attack. Above all, listen to your body, and if something isn’t right, talk to a doctor.

For more information about Freeman Heart & Vascular Institute – and to learn about types of heart conditions, early detection, risk factors and more helpful resources – visit freemanhealth.com/hearts or call 417.347.5000.
 

That’s why cardiothoracic surgeons and cardiologists at Freeman Heart & Vascular Institute take a different approach by inserting a replacement valve in the aorta through a vein in the upper thigh. 

Freeman was the first health system in the area to successfully perform transcatheter aortic valve replacement (TAVR). Since June 2017, Freeman has successfully performed over 300 TAVR procedures. The minimally invasive technique gives hope to four-state patients who suffer from severe aortic stenosis but who are not ideal candidates for a complex open-heart surgery.

TAVR is a minimally invasive procedure in which a folded valve is slipped into a catheter, inserted through the groin and threaded up to the heart through the arteries. When the valve reaches its destination near the heart, a balloon inflates to open the valve and secure its position in the artery. 

This procedure is done while the heart remains pumping, eliminating the need for a heart-lung machine and takes an average of 45 minutes to two hours. Freeman’s median length of inpatient stay post-procedure is 2.06 days.

Patients go through a comprehensive screening process with the structural heart team prior to the procedure, and then that same team of physicians place the patient’s new heart valve.

The Structural Heart Program features:

• Collaborative team of interventional cardiologists, cardiothoracic surgeons and echocardiologists.
• Diagnosis and treatment of conditions affecting the valves and other vital structures of the heart.
• Personalized, coordinated care and comprehensive range of medical and surgical treatment options for patients throughout the region.

For more information about Freeman Heart & Vascular Institute – and to learn about types of heart conditions, early detection, risk factors and more helpful resources – visit freemanhealth.com/hearts or call 417.347.5000.
 

This year consider helping your community by donating blood. Every two seconds, someone in the US needs blood and/or platelets. Blood is essential for helping treat patients who undergo surgeries, cancer treatment or experience traumatic injuries. Although the need for blood donation is great, only 37% of the US population is eligible to donate, and less than 3% do.

Freeman Auxiliary works with Community Blood Center of the Ozarks (CBCO) by hosting mobile blood drives routinely throughout the year. CBCO is responsible for providing blood to 44 local hospitals (including Freeman) in 40 counties and needs to collect 200 – 250 units every day to meet their needs.

January was designated as National Blood Donor Month (NBDM) by President Richard Nixon in December 1969. The designation recognizes donors and encourages new ones to donate. January is also a time when blood centers typically see less donations. Causes range from people being busy during the holidays, getting sick during cold and flu season or blood drives being canceled due to inclement weather. 

On average, eligible donors give two times or less per year when they could donate once every 56 days, which is up to six times in a year. According to CBCO, if those one-time donors gave just one more time a year, local hospitals would have over 17,700 additional units of blood available to help patients!

To encourage people to donate more this year, CBCO is bringing back the 56-Day Challenge. Last year’s challenge ran from January to April and donors could win a $1,000 VISA gift card. This year donors have the opportunity to win up to $15,000 in VISA gift cards.

"Thanks to the generous donations from Adam Swenka Team at Flat Branch Home Loan and The Giving Branch, we are able to make the challenge even bigger and better this year and reward some lucky donors who go above and beyond by donating more than the average blood donor," said Michelle Teter, CBCO Media Relations representative.

How the Challenge Works:

• Donate blood, plasma or platelets at any CBCO blood drive or donor center in January. The next Freeman Blood Drive is 9:00 am – 5:00 pm Friday, January 20, at Freeman Hospital West, Conference Rooms 1W – 4W. Donors will receive a free hoodie while supplies last.
• Donors can then commit to take the 56-Day Challenge by filling out and completing the form by February 28.
• Donors who then make a second donation by April 6 at any CBCO blood drive or donor center will be entered to win a $1,000 VISA gift card. 

Those who donate throughout the year by the deadlines, will have chances to win $2,000, $3,000, $4,000 and $5,000 Visa gift cards. And yes, a donor could win more than once. Learn more about the challenge at www.cbco.org/56day.  

Commit to the challenge at the January Freeman Blood Drive. Appointments are strongly encouraged to manage donor flow. Schedule your appointment here. Photo identification is required. Please eat well and drink plenty of fluids prior to donating. 

The drive could take anywhere from 45 minutes to an hour or even two hours to get to the appointment. What should be a quick, easy visit turns into half a day of travel and missed work.

Freeman is committed to providing an answer to this problem. Freeman continues to expand its footprint for the residents in Southeast Kansas by offering primary care and several specialty services to Southeast Kansas communities. 

Patients can see several specialists at one convenient location. At Freeman Specialty Clinic of Pittsburg, located at1606 N. Broadway, Freeman offers nephrology services from Dr. Muhammad Muneeb, Dr. Abdul Nagaria and Dr. Rama Challapalli; pulmonology services from Dr. Grant Pierson and Dr. Navid Zaidi; pain management services from Dr. Roger Misasi; and endocrinology services from nurse practitioner Jessica Verheyen.

Freeman has also brought oncology services closer to Southeast Kansas residents with the addition of oncology and hematology services in Pittsburg at Freeman Physician Group in Pittsburg Oncology Services, 1201 E. Centennial Drive. 

Dr. Boban Mathew, Freeman hematologist/oncologist, has practiced oncology in Southeast Kansas for almost 25 years and brings his expertise to Freeman, where he and his staff continue to provide leading-edge cancer care.

Freeman Orthopaedics & Sports Medicine 
The team at Freeman Orthopaedics & Sports Medicine of Pittsburg is there to get patients back to doing the activities they love. The team provides athletic injury assessment, treatment, rehabilitation and follow-up evaluations.

Dr. Michael Zafuta is the Pittsburg State University (PSU) official team physician and sports medicine director for surrounding high schools in southeast Kansas. Dr. Ryan Sorell, specializing in sports medicine and primary care, serves as an assistant team physician to PSU athletes. Dr. Sorell also treats sprains, fractures, muscle and joint issues, and other orthopaedic conditions that don’t require surgery. The ortho team also sees patients at Freeman Fort Scott Clinic, located at 401 Woodland Hills Blvd.

Additionally, patients don’t need to leave town if surgery is needed. Freeman Surgical Center of Pittsburg, located at 100 N. Pine St., in Pittsburg, is a 20,000+ square foot, state-of-the-art, multi-specialty ambulatory facility.
 
Primary Care Services
Although yearly preventive screenings are often put on the back burner, they can make a big difference for your health. That’s why seeing a primary care provider on a regular basis is so important. 

Dr. William Sullivan; Dr. Sorell; Patricia Sullivan, DNP, NP-C; and Jessica Hartzfeld, NP, at Freeman Internal Medicine and Family Practice, 608 Willard St., Frontenac, see patients for health screenings, physical exams, well-woman, well-man and well-child visits, immunizations and care for chronic medical conditions. 

To learn more about Freeman services in southeast Kansas, visit freemanhealth.com/SEK.
 

Luckily, there is a solution to get you up and running again without the ache and pains. The nationally recognized, board-certified physicians at Freeman Orthopaedics & Sports Medicine use the most advanced techniques and procedures to get you back to your quality of life quickly.

Joints can be damaged due to injury or as a result of arthritis. Damaged joints can cause pain or make it hard to perform daily activities. In some cases, nonsurgical treatments like medications or physical therapy may relieve pain and help regain motion. However, when nonsurgical treatments are not successful, joint replacement surgery can be a solution. 

Joint replacement surgery involves removing parts of an arthritic or damaged joint and replacing it with a metal, plastic or ceramic implant to restore function, relieve pain, increase mobility and improve quality of life.

Types of Joint Replacement Surgeries
Freeman Center for Hip & Knee Reconstruction offers a wide range of joint replacement surgeries including:

• Total knee replacement
• Total hip replacement (posterior approach, anterior approach)
• Shoulder replacement
• Joint revision (knee, hip)

Most Common Joint Replacement Surgery
Knee replacement surgery is one of the most common joint replacement surgeries. During knee surgery, the knee joint is replaced with a prosthetic joint. After the surgery, patients typically spend a few days in the hospital before being released, and full recovery normally takes three to six weeks. While most patients who undergo this procedure are 50 – 80 years old, people of all ages undergo knee replacement surgery.

Recovery
Recovery from any total joint replacement surgery involves either in-home or outpatient physical therapy. Patients begin walking the day of surgery and generally resume their daily activities by four to six weeks after surgery. Most patients use a walker for balance for one to two weeks. Therapy is used after surgery to restore range of motion and increase strength.   

For more information, visit freemanhealth.com/ortho or call to schedule an appointment at 417.347.5400. No referrals needed!
 

The mask. The hose. The noise. The discomfort. Although a CPAP works for many people with OSA, other patients might not be able to tolerate it.
Many cannot use CPAP simply because of claustrophobia. Some people develop pressure sores on their forehead from the mask. Some are just embarrassed to use the machine with their spouse present.

Inspire® Upper Airway Stimulation, an innovative OSA treatment option for those who cannot use CPAP therapy, is now available at Freeman. Freeman is the first and only health system within a 70-mile radius of Joplin to offer Inspire. 

According to the American Sleep Apnea Association, OSA is the most common sleep apnea and roughly 22 million Americans are affected by it. OSA is caused by throat muscles relaxing during sleep, which in turn blocks your airway and causes you to repeatedly stop and start breathing while sleeping. This causes poor sleep and puts someone at risk for stroke, heart attack or heart failure.

The first and most common treatment for OSA is CPAP therapy. A plastic hose connects the machine to a face mask that you wear while sleeping. The machine pushes pressured air into your airway, keeping it from closing. Inspire is an alternative to CPAP that works inside your body while you sleep. No mask or hose is needed.

Inspire is a small nerve stimulator device that delivers mild stimulation to airway muscles. During an outpatient procedure, the physician implants the small nerve stimulator device and battery pack under the skin in the chest. The system includes two small electronic leads, with one connecting the device to the nerve that stimulates the tongue and the other to a space in the ribs near the diaphragm.

A lead on the chest senses when the patient breathes. An impulse is then sent to the nerve of the tongue to protrude the tongue just enough to open the airway, thus alleviating the airway obstruction. 

After the procedure, patients will return to the ENT surgeon’s office so the device can be activated. The patient controls Inspire with a small, handheld remote by turning Inspire on before bed and off in the morning. Patients can also pause therapy during the night or adjust therapy settings. 

Candidates for Inspire therapy are those who meet the following requirements:

• Diagnosis of OSA with an apnea hypopnea index (AHI) score between 15 – 65 on a sleep study 
• Body mass index (BMI) of 32 or less (36 or less for Medicare patients)
• Cannot use or get consistent benefit from CPAP
• 18 years of age or older

Inspire is FDA-approved and reimbursed by most major insurance providers, and Medicare reimburses the cost based on medical necessity.

Dr. Grant Pierson and Dr. Jason Maxfield evaluate and treat patients’ OSA, providing referrals to Dr. Kent McIntire for implantation of the Inspire device or patients can go to Dr. McIntire directly for an appointment and evaluation.

To schedule an appointment with Dr. McIntire, call 417.347.6767. To learn more about Inspire Therapy at Freeman, visit freemanhealth.com/ent.
 

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.