Freeman Medical Musings Blog

Life can have its dark moments. For some, these moments can lead to a crisis, at which time an individual reaches her or his breaking point and suicide may seem like the only escape from the emotional pain.

Each year, we lose approximately 48,000 Americans to suicide, or approximately 134 lives a day. Here in Missouri, those numbers are indisputably headed in the wrong direction: We lost 1,177 individuals to suicide in 2021 and more than 1,200 in 2022. 

That said, suicide is among our most serious public health crises and a leading cause of death in America. The collateral damage is sweeping, with social, emotional and economic consequences. 

However, it’s also the most preventable type of death.

September is National Suicide Prevention Month, and anyone can take action to help prevent suicide. Regardless of how significant our actions may seem, we can provide hope to those who are in crisis and might be contemplating suicide – provided we’re willing to listen and talk openly about those dark moments.

Conversations about emotional well-being can be difficult. However, for a person in despair, simply articulating that fear or sadness to a supportive listener can help him or her share that burden, feel relief and regrasp hope. So if you notice someone struggling, tell them they’re noticed, because your acknowledgment could save a life. 

On an individual level, there are simple ways we can identify and manage common life stressors in ourselves. The Centers for Disease Control recommends these practices for handling discontent and despair:

-    “Breaks” from watching or reading the news
-    Healthy eating
-    Getting plenty of quality sleep
-    Regular exercise
-    Taking time to unwind
-    Talking to others
-    Connecting with community- or faith-based organizations
-    Avoiding drugs and alcohol

If your situation isn’t improving, or you’re trying to help someone else through a rough patch, local resources are ready. 

The 988 crisis line Ozark Center – one of 200 nationwide 988 call centers, takes calls 24 hours a day, seven days a week. Regardless if the situation seems life-threatening, any individual in crisis or a concerned other can dial 988 to reach a trained crisis specialist for support. This support includes brief supportive counseling, referrals and education, and there is no charge for seeking help from a 988 professional or at the local crisis center.

People do care, and we can help. 

Debbie Fitzgerald is Director of Crisis Services for Ozark Center, which has been active in suicide prevention for more than 20 years. For more information, call 417.347.7720 or visit ozarkcenter.com.
 

September is Prostate Cancer Awareness Month, and prostate cancer is the most common non-skin cancer in America – one in nine men will be diagnosed in his lifetime. Men over 55 years old, black men or men whose fathers or brothers have been diagnosed with prostate cancer are at especially high risk.

Unfortunately, prostate cancer does not usually have early warning signs. A tumor growing in the prostate generally does not push against anything to cause pain, so without regular prostate exams, the disease can go undetected for years.

The best defense against prostate cancer is to be screened for it. The American Cancer Society recommends that men over 50 with average risk (or men over 45 who have risk factors listed above) should talk to their doctors about getting screened for prostate cancer.

One of the most common ways to screen for prostate cancer is the prostate-specific antigen (PSA) blood test. PSA is a substance made by both normal cells and cancer cells in the prostate gland. Men without prostate cancer usually have a PSA of less than 4 nanograms per milliliter (ng/mL) of blood, but elevated PSA levels do not automatically signify cancer. Enlarged prostate, age and even bike riding can cause an increase in PSA. Even so, men with PSA levels above 2.5 ng/mL should be retested each year, whereas men with lower PSA levels may be tested only once every two years.

Another common screening for prostate cancer is a digital rectal exam. In this test, a doctor inserts a gloved, lubricated finger into the rectum to feel for bumps on the back of the prostate, where cancer often begins. This exam may be uncomfortable, but it is not painful and only takes a short time. While other digital rectum exams are not as effective at finding cancer as PSA counts, they can enable doctors to find cancer when PSA levels are normal.

With proper treatment, according to the American Cancer Society, cancer patients have a 10-year relative survival rate of 98 percent. The earlier prostate cancer is discovered and treated, the better. This National Prostate Health Month, make it a goal to talk to your doctor about getting screened, or encourage your father, brother or husband to make an appointment.

James Frogge, MD, is certified by the American Board of Urology. Frogge has practiced urology for 24 years and joined Freeman Urology Associates in 2014.
 

Childhood vaccinations save approximately 4 million deaths each year worldwide. It’s no surprise, then, that history books commonly label immunizations as one of the greatest success stories of modern medicine. 

Vaccines work as invisible shields inside your child’s body. When your child is exposed to a disease in vaccine form at a very early age, their immune systems begin producing much-needed antibodies that protect them from becoming sick when first exposed to that disease, whether it’s influenza, chickenpox, hepatitis or tetanus. 

Vaccines start very early – at two months old. The reason we start so early is because a baby can get very sick from diseases and they need that protection right away. Thanks to vaccines, babies now live much longer and healthier lives. Vaccines, in fact, are the main reason why so many babies survive into adulthood.

With area schools opening this month, a lot of kiddos need updates to their vaccinations to stay safe and healthy inside the classroom. In fact, most parents associate vaccine booster shots with their kindergarten-aged children. At that age they require polio, measles, influenza, diphtheria and chickenpox shots, among others. Most clinics combine these various vaccines into just two shots so there’s less stress on the child and parents. Booster shots are also needed for older students entering junior high and senior high school. 

Sadly, we are seeing a decrease in immunization rates nationwide. With that, some diseases are making a comeback, such as mumps and measles. We don’t want these diseases showing up in our clinics or our communities. The best way we protect against that happening is to keep immunization rates high.

To ensure your child’s germ-fighting defenses remain strong, maintaining yearly wellness health appointments, usually at the time of your child’s birthday, is paramount. This not only keeps your child safe from diseases, but it prevents a potential disease outbreak or public health emergency from happening. 

Remember, vaccines can prevent common diseases that at one time seriously harmed or even killed infants, children and adults. Without vaccines, your child is at risk of becoming seriously ill or even dying from childhood diseases such as measles and whooping cough. Routine immunizations can prevent that. 

According to the Pew Research Center, 27% of veterans struggle to adjust to life at home due to physical or emotional trauma from anxiety, depression and insomnia. Finding healthcare solutions to these issues can be time consuming and, at times, overwhelming. 
This is where 20-year retired U.S. Army veteran Roger Koch can step in to help. He works as a Military Liaison for Ozark Center’s Veterans Integration Program (VIP). 

“Ozark Center understands that military service can be physically, emotionally and mentally traumatic for military veterans and their families,” Koch said. “They also understand the transition from military to civilian life is not always an easy transition, often overwhelming them.”

VIP places an emphasis on the needs of military veterans and their families by pairing veterans with veterans who understands their needs at every level of care, providing a single point of contact to services provided by Ozark Center, Freeman Health System and local Department of Veterans Affairs clinics.

“For me, having the opportunity to assist fellow veterans is a very fulfilling experience,” Koch said. “Being a military veteran myself, I can relate to several of the struggles that keep fellow veterans at bay. And though every military veteran has their own individual military experiences and stories to tell, being a retired military veteran gives me the opportunity and ability to better understand, connect and assist fellow veterans with various life struggles.”

Koch served in the U.S. Army, seeing combat during Operation Iraqi Freedom from 2003 to 2004, before retiring in 2005.  

“We work solely and specifically with veterans to help integrate them into society and into our community,” Koch said. “I have been able to assist approximately 600 individual military veterans and their families by way of counseling, peer support, employment opportunities and connecting with other veteran resources within the community.”

VIP includes individual and group counseling, peer support, case management, medication management, substance use treatment, employment services and help navigating housing assistance, along with connecting with other veteran resources in the community. It is also a key contributor to the Jasper and Newton County Veterans Court System. 

“I think being able to help fellow veterans with any and all struggles they might face is a very beneficial part of our program,” said Koch, who joined Freeman Health System in 2018 and VIP one year later. “Our number one goal is to assist and be there for the military veteran.”

To learn more about VIP, call 417.347.7989 or visit ozarkcenter.com/VIP.
 

As a physician, there are several key points I would like to stress to people – especially parents of children – regarding fireworks safety. Fireworks can be a source of excitement and joy, but they can also lead to serious injuries if they’re not handled properly. It is crucial to prioritize safety to prevent unnecessary accidents and visits to the emergency department.

One of the most common types of injuries seen in the emergency department related to fireworks are burns. Fireworks produce high temperatures and can cause severe burns if they come into direct contact with the skin. These burns can vary in severity, from minor first-degree burns to more severe second or third-degree burns that may require extensive medical treatment.

In addition to burns, fireworks can also cause injuries such as eye trauma. The eyes are particularly vulnerable to damage from flying debris or sparks produced by fireworks. Eye injuries can range from corneal abrasions and foreign body injuries to more serious conditions like retinal damage or even permanent vision loss.
To prevent firework injuries, it is essential to prioritize safety measures. Here are some key recommendations:

• Attend public fireworks displays: Instead of handling fireworks at home, consider attending professional fireworks displays. These displays are managed by experts who follow strict safety protocols, minimizing the risk of accidents.
• Follow local laws and regulations: Be aware of the laws and regulations regarding fireworks in your area. Some regions prohibit the use of certain types of fireworks altogether, while others have specific guidelines on when and where they can be used.
• Keep a safe distance: If you decide to use fireworks at home, make sure to maintain a safe distance from people, buildings, and flammable materials. Follow the manufacturer's instructions and keep in mind the recommended safety distances for each type of firework.
• Adult supervision: Never allow children to handle fireworks. They should always be under the close supervision of responsible adults. Even seemingly harmless fireworks like sparklers can cause serious injuries in young children.
•  Protective eyewear: Consider wearing protective eyewear when handling fireworks to protect your eyes from potential debris or sparks.
•  Fire extinguisher and water source: Keep a fire extinguisher or a bucket of water nearby in case of emergencies. This can help prevent small fires from spreading and minimize the risk of injuries.
• Alcohol and fireworks don't mix: Avoid alcohol consumption when handling fireworks. Alcohol impairs judgment and coordination, increasing the likelihood of accidents.
   

Arthritis is caused by degeneration or damage to the cartilage surface of the bone. Cartilage is the tissue that cushions the bone and helps the joints glide smoothly. If the cartilage is damaged or wears out over time, this is referred to as arthritis. 

As the damage to the cartilage becomes more severe, people begin to feel pain in their knee, which can range from a dull ache to a sharp pain. This is also usually associated with swelling or the sensation of catching when bending the knee. Typically, this pain is worse with increasing activities such as prolonged walking, exercise or participating in sports.

Often, your doctor will diagnosis this problem by examining your knee, taking an x-ray, and possibly performing an MRI of the knee. The MRI may show evidence of damage to the cartilage. The damage may be localized in one area of the knee or may be more diffuse, affecting different parts of the knee joint.  

Treatments for mild cartilage damage involve avoiding painful activities, physical therapy, and anti-inflammatory medications such as ibuprofen. For more severe cases, treatments range from a steroid injection to surgery. For patients with localized arthritis, a surgical procedure known as knee arthroscopy can be performed. This is a minimally invasive procedure used to evaluate cartilage damage, which typically appears as an area where the cartilage has been damaged or worn away, leaving just the bone below. Sometimes, damage to the cartilage occurs in only one area of the knee. In this situation, a sample of the surrounding cartilage can be taken. This allows us to use a new technology for cartilage repair known as MACI (Matrix Associated Autologous Chondrocyte Implantation).

MACI technology uses the cartilage sample to isolate and grow (multiply) the patient’s own cartilage cells. The cartilage cells are then transferred to a special membrane that can be inserted into the area of damage. This is like using a patch to fill up the hole left behind by cartilage damage. However, the patch is made from the patient’s own cartilage cells. The transferred cartilage cells then grow, which creates healthy cartilage and reverses the original damage. This procedure has been shown to significantly reduce pain and may be an alternative to knee replacement for certain patients with arthritis. 

Thomas Sanders, MD completed his medical education at the University of Texas Medical School in San Antonio, TX. He completed his orthopaedic surgery residency and sports medicine fellowship at the Mayo Clinic in Rochester, MN. Dr. Sanders serves as the orthopaedic team physician for Webb City High School. 
 

June is Men’s Health Month, a time to offer men awareness of preventable health problems and encourage early detection and treatment for men of all ages. The tendency of some men is to “tough it out” – putting off doctor visits, ignoring symptoms or signs of illness and neglecting their health. 

This kind of procrastination, however, can prove fatal in some situations. Regular checkups, screenings and vaccinations are crucial for men to stay healthy and active, even if they’re feeling good and are symptom-free. Preventative care helps men and their doctors to remain proactive and increase their chances of avoiding health issues, and to effectively treat medical situations before they worsen and become more serious.

As men age, their bodies become more prone to certain diseases and conditions. Cardiovascular disease, for example, is the leading cause of death in men. Men are also more prone to developing symptoms of low testosterone and prostate cancer. Regular wellness checkups will help identify any deficiencies that may be causing other health-related issues, such as erectile dysfunction or high blood pressure. A Freeman primary care doctor can help men develop a personal wellness program to fit their lifestyle and address each aspect of their life – ranging from nutritional guidance and exercise to weight management.

It's important that men of all ages regularly visit their doctors to screen for the following conditions.

All Ages:

• Annual wellness exam. A yearly physical with your general practitioner is important for preventive care. Visits may include vaccinations, disease screenings, referrals for blood work, a height and weight evaluation, and potential additional tests for any chronic conditions.
• Testicular cancer screening: While self-exams should be conducted monthly, the American Cancer Society recommends testicular cancer screenings also be performed at annual wellness visits.
• Skin cancer screening: Yearly visits to a dermatologist for skin checks are crucial for preventing skin cancer.
• Dental exam: A thorough dental exam and cleaning is recommended at least every 6 to 12 months for optimal tooth and gum health.

Age 20 to 39:

• Blood pressure: Beginning at age 20, men should have their blood pressure checked at least once every two years.
• Cholesterol: Beginning at age 20, most men should have their cholesterol checked every four to six years.
• Age 40 to 59:
• Eye exam: At age 40, men should have a baseline comprehensive eye evaluation even with no signs or risk factors of eye disease.
• Blood glucose test: Blood glucose tests are used to screen for diabetes and are recommended for men every three years beginning at age 45.
• Colonoscopy: Men who are at an average risk for developing colorectal cancer should have their first colonoscopy at age 45 and then, an additional screening every ten years.
• Prostate cancer screening: Beginning at age 50, men should talk to their doctor about beginning regular screenings for prostate cancer.
• Shingles vaccine: Men should be vaccinated to prevent shingles at age 50.
• Lung cancer screening: Men ages 55 to 80 with a history of heavy smoking (more than 30 packs per year) and who actively smoke or have quit within the previous 15 years should have a yearly lung cancer screening, even without symptoms of lung cancer.

Age 60 and up:

• Pneumonia vaccine: Men over 65 should be vaccinated against pneumonia yearly.
• Bone-mineral density test: Beginning at age 70, men should have the test at least once and up to as often as every two years depending on risk factors.
• Abdominal aortic aneurysm: A one-time screening is recommended for men between the age of 65 to 75 years who have a history of smoking.
• Yearly eye exam: Men 65 and over with no risk factors should have a comprehensive eye exam every one to two years to screen for cataracts, age-related macular degeneration and glaucoma.

Men can choose June as the month they play a protective role in their health journey. To learn how to conquer new heights to living healthier and enjoy a lifetime of wellness, schedule an appointment with a Freeman Primary Care Physician by calling the Freeman Physician Finder at 417.347.3767 or 800.297.3337 or visit freemanhealth.com.

May is Mental Health Month, making this a most appropriate time to consider suggestions for establishing and maintaining mental health. The world around us can be both positive and negative – bringing joy and sadness, hope and anxiety.

Look around, and look within: Take a moment to consider your surroundings. Do you feel safe? Do you have access to health care and other community resources? Does your home support you, both physically and mentally? 

Factors such as these can affect our mental health. Where we are born, live, learn, work, play and gather – in addition to our economic stability and social connections – all influence “Social Determinants of Health” (SDOH). The more SDOH factors work in our favor, the likelier we are to possess mental well-being. Conversely, when it seems like the world is working against us, the more our mental health may suffer. 

While many aspects of our environment are beyond our control, there are steps we can take to change our space and protect our well-being. 

One is housing. Safe, stable housing is a vital piece of the SDOH landscape. While financial stability, age and other factors dictate our living situations, there are places to seek assistance. State and local agencies, for example, help clients secure safe, healthy and livable housing arrangements. 

Once appropriate housing is secured, consider keeping your space tidy, sleep-friendly, and well-ventilated. Surround yourself with items that help you feel calm and positive. 

Next, bond with your community members by getting to know the neighbors, joining (or even spearheading) neighbors-helping-neighbors group, and patronizing local businesses.

Connect with nature by hiking, sitting in a city park, or simply bringing a plant inside and or keep the shades open to absorb natural light. 

If you’re taking steps to improve your physical surroundings but are still struggling with your mental health, you may be experiencing symptoms of a mental health condition. If you feel as though you are unable to maintain your mental health, numerous screening and treatment options are available in person and by phone or text.  

Ozark Center Crisis Intervention Services and its 988 crisis line offer 24/7 day per week services. Call 417.347.7720 or 800.247.0661 to speak to a mental health professional now. Translation and TTY/TDD services are available. For messaging service, text REGISTER to 720-7-TXTOZK (720.789.8695).

You can also visit Urgent Behavioral Solutions at 3230 Wisconsin Ave Suite A, in Joplin, provides mental health services 7 days a week and into the evenings. Walk-in services are offered during the week at most Ozark Center outpatient locations.

For more information, visit ozarkcenter.com.
 

Nurses are Freeman Health System’s backbone, demonstrating empathy and loving care as they diligently meet the healthcare needs of Freeman’s patients every single day.

Freeman’s nurses will be showered with treats, praise and more than a few hugs from Freeman officials during National Nurses Week. The special week kicked off Monday morning with a pancake feed and will wrap up this Friday with a birthday bash for Florence Nightingale – the iconic founder of modern nursing.

“Our leadership team absolutely loves showering our nurses with the love and respect that they deserve during this very special time of year,” said Jeanee Kennedy, Freeman’s Chief Nursing Officer.

“Each year, we celebrate nurses during the week of Florence Nightingale’s birthday. In celebrating Florence and the contributions she made to our field, we also celebrate the longstanding history of a profession rooted in trust, compassion and selflessness,” Kennedy said. “Nurses always answer the call to serve and heal the communities in which they reside. We are blessed at Freeman to have an amazing team of nurses.”

Remaining celebrations scheduled for both Freeman Hospital West and East include:

• Barbecue and the Blessing of the Hands ceremony, 11:00 am to 2:00 pm on Wednesday, May 10.
• Florence Nightingale’s birthday bash and nurses’ stations judging from 1:00 to 4:00 pm on Friday, May 12.

“The importance of nursing at Freeman cannot be overstated,” said Nicki Lopez, Freeman’s Clinical Compliance Specialist. “Our nurses are the lifeline of our health system. They not only care for their patients, but also for the patient’s family and their coworkers. They truly make a difference in Freeman as they empower patients with their knowledge, emotional support, and a caring touch.”

Without nursing, Lopez continued, “hospitals would be unable to function adequately.”

It goes without saying that most Americans lead terribly busy lives. People are so engaged, in fact, that on average a person has just four hours and 26 minutes of free time available to them each week. Despite this, nearly 25 percent of the U.S. population – 60-plus million people – find the necessary time to volunteer for a good cause.

The benefits of volunteering at Freeman Health System, however, go far beyond altruism; it harnesses the power to directly change lives.

“Helping others is something I always love, especially those in need; I think helping with even the smallest tasks can make a real difference in people’s lives,” said Eliana Lewis, current Freeman Auxiliary President who regularly volunteers at Freeman West Hospital.  “When I volunteer, I know I'll meet at least one person who will either touch my heart, make me smile or gives me something to reflect upon. It's rewarding when I can answer a question, solve a problem or just make a person feel less lonely.”

Volunteering can directly help people in need and the community as a whole. The benefits, however, are reciprocal. Volunteers can find new friends, connect with the community, learn new skills, or help advance personal careers.

“Whatever the age or life situation,” Lewis said, “volunteering can help take one’s mind off their own worries and add more zest to their life.”

Freeman Health System volunteer Earline Kelley, after working professionally in the medical field in California and Kansas City, returned to Joplin in 2005. She immediately began volunteering at Freeman West Hospital.

“Wow – where have the years gone?” she said with a chuckle. “I volunteer at Surgery Check In Desk and the ICU and I have always hoped that I have helped someone if they have a family member or friend that is a patient.”

For many men and women, the volunteer spark is kindled during a traumatic moment in life, when they briefly come into a contact with a volunteer who says something, or does something, that touches them deeply. In other words, volunteering gives men and women the opportunity to “pay it forward.”

Susan Carlsten, an 11-year volunteer at Freeman Neosho Hospital, decided to volunteer after what took place during one of Joplin’s darkest days – May 22, 2011. She, her husband and mother were caught in the path of the EF-5 tornado. When her mother suffered serious head trauma, she was transported and treated by Freeman physicians in neighboring Neosho.

“The care and concern shown to my mother at Freeman Neosho defies description,” Carlsten said. “The staff literally saved my mother's life.  As a way of saying ‘thank you Freeman Neosho,’ I am now a volunteer there.”

Over the years, the former Freeman Auxiliary President has volunteered all over the complex, from the hospital’s admitting area to its gift shop.

“The friendships I have made at Freeman Neosho are amazing.  It is like another family,” she said. “Eating lunch together in the cafeteria is always fun and entertaining.  You also get to know some of the patients.  It is wonderful to see them outside the hospital and be able to speak with them.”