Your health is important to you. Do you know if you are at risk for future health problems? Knowing your risk of a disease can help you take the right steps to prevent or manage it.

Freeman Health System provides several free Online Health Risk Assessments to help you have a better understanding of your risk for disease. Freeman offers assessments for breast cancer, diabetes, stroke, heart problems and weight-loss surgery. Assessments can be downloaded and printed to your physician.

Breast Cancer Risk Assessment

The Breast Cancer Risk Assessment is a quick, seven-question assessment. In 2018, an estimated 266,120 new cases of invasive breast cancer are expected to be diagnosed in American women and 2,550 new cases in American men. If you answer yes to any of the questions, you may be at an increased risk of breast cancer. Please call Wes & Jan Houser Women’s Pavilion at 417.347.7777 to schedule an in depth high-risk assessment.

Diabetes Risk Assessment

According to Centers for Disease Control and Prevention (CDC), 30.3 million American adults have diabetes, 7.2 million of those adults are undiagnosed. Many factors, such as family history and diet, play into a person’s risk of diabetes. The Freeman Diabetes Risk Assessment can help you learn your eight-year risk of developing diabetes. Once the assessment is completed, you’ll receive a personalized report outlining information about your health. Contact Freeman Diabetes Education at 417.347.5700 for more information.

Stroke Risk Assessment

Stroke is the fifth leading cause of death in the United States. The Freeman Stroke Risk Assessment can help you learn about your stroke risk, risk factors associated with stroke and steps to take to reduce the risk. Once you complete the assessment, you’ll receive a personalized report outlining information about your health.

Heart Health Assessment

Every 44 seconds someone suffers a heart attack. Equipped with the right tools you can control factors that lead to heart disease, which include monitoring cholesterol and blood pressure, quitting smoking and managing stress. The assessment takes 10 – 15 minutes to complete. For more information contact Freeman Heart & Vascular Institute at 417.347.5000.

Weight-loss Surgery Assessment

Discover if weight-loss surgery may be an option for you. The Weight-Loss Surgery Assessment helps determine your weight category and if you should lose weight. Additionally, it identifies your weight-related issues and conditions. For more information about Freeman Bariatric Center, call Janice at 417.347.1266.

All Freeman Online Health Assessments can be found here. An assessment is intended for informational purposes only. Please contact your healthcare provider if you believe you are at risk of a disease.

About the Author

Shelby Allen, RN, BSN, has led the Freeman Prevention & Wellness team for more than 20 years.  The team consists of Freeman Screen Team, Freeman WellBalance, and wellness programming to area schools and businesses.  She is a nurse and certified wellness director, bringing prevention and detection to the community.  For more information, call Freeman Prevention & Wellness at 417.347.5646. 

Many people are lucky enough to move freely throughout their lives – walking through their home, exercising, playing with children, all normal activities they often don’t need to think twice about. For those with spasticity, those normal activities are much more difficult. Spasticity is a movement disorder caused by an imbalance between signals that inhibit or stimulate the spinal cord. This results in muscles that are tight and make movement difficult – it can also cause involuntary movements and even fixed range of motion. Spasticity affects 1 million people in the United States, often adults and children with conditions such as multiple sclerosis, cerebral palsy, stroke, spinal cord injuries or brain injuries. 

Spasticity is nearly always bothersome and sometimes painful. Daily movements can become nearly impossible and muscle spasms can disrupt sleep. With little movement and poor sleeping conditions, spasticity begins to affect the overall physical and mental health of an individual. 

The first line of defense for spasticity is regularly stretching, exercising and rehabilitation. When spasticity affects only a few muscles, injections of botulinum toxin (BT) have been found helpful.

BT, commonly known as brand name Botox®, is a medication derived from a neurotoxin made by bacteria. This toxin is purified and can be used safely to treat spasticity in different muscle groups. BT works by blocking a nerve impulse. Usually, the brain sends messages to the muscles so they can contract and move, but BT impedes part of that process. It blocks the chemical signal between nerves and muscles, which carries the message from the brain and activates muscles. Since BT blocks these chemicals, the muscle doesn’t spasm. This provides relief from pain and muscle stiffness. 

BT is given as an injection into the muscle during an outpatient visit. There are no activity restrictions after a patient receives an injection, but the effect isn’t usually felt until a few days after the injection. Relief from spasticity symptoms by BT generally lasts between two and six months, so most injections are repeated every three months. To maximize the benefits of BT, physicians also recommend supplemental physical or occupational therapy

Using BT for spasticity has a number of benefits. It is usually effective in relaxing the injected muscles, provides a stable effect for several months, is usually well tolerated and improves range of motion. BT also shows a significantly improved gait pattern in patients, greater ease in stretching and tolerance of braces, and also a possible delay of surgery. 

For those suffering with spasticity and trying to take part in normal, everyday activities, BT is an option to help you get there.

Dr. Amanda Price earned her medical degree at Boston University School of Medicine and started as a physiatrist at Freeman NeuroSpine in September 2017. A physiatrist is a physician who reduces pain and restores function lost due to illness or injury and treats a wide variety of medical conditions affecting the brain, spinal cord, nerves, bones, joints, ligaments, muscles and tendons. Dr. Price is part of a team that specializes in spinal care services for patients. For specialized spinal care services, call 417.347.7200.

Having highly trained and educated nurses is a priority at Freeman Health System. The Nursing Education Fund is available to eligible Freeman nurses who want to further their nursing education. Money from the fund can be used for advancing a degree, a specialty certification (which can help an RN achieve a higher level in TAPP), healthcare projects or conferences that may be too expensive to attend without assistance. 

In 2017, I received funds to assist with my pursuit of a Master's Degree in Nursing – Neonatal Nurse Practitioner at the University of Missouri, Kansas City. I used the funds to help pay for tuition and reduce the amount of student loans I needed – and I could use the funds as I saw fit. 

Donating to the fund helps promote the profession of nursing. Nursing has developed from a technical trade to a body of science that is based in research, theory and the art of healing. Nurses are a vital piece in the healthcare system, providing quality, safe care with skills in bedside care, informatics, quality improvement, administration, education and community health services –  just to name a few. For the profession to grow, we as nurses need to invest in ourselves, and the Nursing Education Fund helps us do that. We hope you consider making a contribution today.

To learn more about giving options, visit freemanhealth.com/give-to-freeman.

Obstructive Sleep Apnea (OSA) can do more to your body than just wake you up in the middle of the night. OSA is the most common sleep-related breathing disorder. It is caused by repetitive episodes of apnea – repeated breaks in airflow. While men are more commonly affected by this disorder, women suffering from OSA are at a higher risk of heart failure[1]. Studies have found a link between OSA and heart-related problems such as hypertension, coronary heart disease, cardiac arrhythmia and heart failure.

Hypertension and OSA commonly go hand-in-hand with one another. Hypertension – high blood pressure – develops over many years and can worsen if you do not get enough sleep. OSA can keep you from getting enough rest to help keep your blood pressure down to healthy levels.

More severe cases of OSA have been linked to coronary heart disease, and in a few instances, heart failure. Coronary heart disease occurs when the coronary arteries begin to narrow, which restricts the amount of blood that reaches the heart. OSA can keep you from being healthy in your day-to-day life by keeping you from getting enough sleep to feel energized, which leads to exercising less and eating unhealthy foods more. These issues can compound on one another until heart failure occurs.

How can you tell if you’re affected by OSA? A few of the symptoms of OSA are:

• Excessive daytime sleepiness
• Loud snoring
• Observed episodes of breathing cessation during sleep
• Morning headache
• High blood pressure

The current universal treatment for OSA is the continuous positive airway pressure machine, more commonly referred to as CPAP. The CPAP eliminates apnea and the hemodynamic – change in flow of blood to organs and tissue – changes during sleep. Long-term CPAP treatment positively affects blood flow throughout the body and daytime blood pressure levels.[2] According to the American Academy of Sleep Medicine, treatment for OSA has resulted in an improvement in quality of life with 54 percent seeing improved respiratory function, 49 percent report improved mental health, 41 percent of patients seeing an improvement in blood pressure and 31 percent seeing improved HbA1c – average blood glucose – levels.

Many people view OSA as a sleeping disorder than can keep you or your loved ones awake at night. However, OSA is much more than that, and the results can be much more damaging.

About the author

Jason Maxfield, MD, is a board-certified sleep medicine specialist and an American Academy of Sleep Medicine diplomate. Dr. Maxfield has worked at Freeman for four years and is the Medical Director of Freeman Sleep Center. To learn more about sleep disorders, visit freemanhealth.com/sleepmedicine or call 417.347.8688 to make an appointment.

[1] Mehra, Reena. “Obstructive Sleep Apnea and Cardiovascular Disease in Adults.” UpToDate, 19 Dec. 2017, uptodate.com/contents/obstructive-sleep-apnea-and-cardiovascular-disease-in-adults.

[2] Lattimore, Dee L. “Obstructive Sleep Apnea and Cardiovascular Disease.” Egyptian Journal of Medical Human Genetics, Elsevier, 3 May 2003, sciencedirect.com/science/article/pii/S0735109703001840.

The beginning of summer means warm weather, more daylight, swimming pools and sneezing. With summer in full swing, allergy sufferers all over the country are feeling the effects of allergy season. Allergies occur when your immune system reacts to a foreign substance such as pollen, pet dander or a synthetic chemical. Everyday tasks such as running errands, doing yard work and going for a walk can become exhausting due to high pollen counts, dander and other factors that trigger allergies.

Many people try to ignore their allergies and instead choose to “tough it out.” However, it could come to a point where your allergies become unbearable or even life threatening, and a visit to the doctor’s office is needed. Not addressing the allergy typically leads to watery eyes and runny noses, but more severe cases can lead to anaphylaxis – a severe allergic reaction.  

The first step to ridding yourself of the woes of allergies is to get tested. Allergy testing is used to find out what substance, or allergen, may trigger an allergic response in a person. The two most common types of allergy testing used are skin testing and a serum-specific IgE (immunoglobulin) antibody test. Once the allergy has been identified, the proper course of treatment can be issued.

Just as there are various kinds of allergies, there are various ways to treat them – and while there is no cure for allergies, symptom management through treatment is possible. These treatment options include:

• Antihistamines – to treat the “itchy,” “sneezy,” “allergic” component of allergies
• Anti-inflammatories – to treat the swelling, inflammatory component of allergies
• Environmental modification – making changes in flooring, air conditioning or humidity
• Allergy desensitization – used to gradually expose the patient to increasing doses of the allergen to eventually “desensitize” them to the allergen
• Allergy injections (immunotherapy) – generally used for indoor/outdoor environmental allergens
• Sublingual tablets – a new treatment option that can be used for some indoor/outdoor environmental allergens
• Drug desensitization – used in the case of drug allergy
• Sublingual immunotherapy

Don’t let your allergies keep you from enjoying your summer. With so many different treatment options, no one has to suffer through another summer full of scratchy throats and watery eyes.

About the Author

Nathan Box, DO, FAOCO, is an allergy specialist at Freeman Ear, Nose & Throat Center and is board certified by the American Osteopathic Board of Otolaryngology-Head and Neck Surgery. To learn more about allergies and treatment options, visit freemanhealth.com/allergy or call 417.347.8405 to make an appointment.

We all know we should make a doctor’s appointment as soon as we notice a persistent pain or a mole that changes color. What we may not realize, though, is that the same holds true for our mental health. When you notice something is not right – that you no longer enjoy things you used to love, or your emotions become intense, overwhelming and difficult to manage – it is better to get help than to wait and see.

Now, thanks to Ozark Center and the launch of its walk-in clinic, it is easier and faster than ever to get an appointment with a licensed mental health professional.

Ozark Center began the walk-in clinic to give our community access to screening and assessment as soon as possible after a need is identified. The clinic’s goal is to meet the patient’s high level of motivation to get help with easy access to highly trained and credentialed staff.

Ozark Center’s Walk-In Clinic provides same-day appointments for patients with issues ranging from depression and anxiety to eating disorders and substance use. With a team of 14 therapists, including psychologists, social workers and counselors, patients can be matched to a mental health professional who will meet their needs and who they can see on a regular basis after their initial walk-in appointment.

What to Expect at a Visit to the Walk-In Clinic

Patients will first meet with an admissions specialist to complete initial paperwork and then will meet with a therapist to communicate their needs, explore treatment options and develop a plan of action to get the help they need. No referral is required at the Walk-In Clinic.

If possible, Ozark Center asks that clients call ahead so they can be matched with a therapist that meets the requirements for their insurance and/or to check if they qualify for financial assistance. Patients should plan to arrive by 3:00 pm to ensure they can be seen before the end of the day.

For more information, including what to bring with you for your walk-in appointment, please call 417.347.7567 or visit ozarkcenter.com/WalkInClinic.

Jacob Hefner, EdS, LPC, is Ozark Center Director of Adult Outpatient Services. He has received specialized training in the fields of substance use disorders, first-episode psychosis and mental health treatment. He has over 12 years’ experience in the mental health field.

Otolaryngologists, more commonly referred to as ear, nose and throat (ENT) doctors, cover a broad spectrum of ailments including tonsillitis, sinus and ear infection, neck pain, skin cancer and more. While many of these ailments appear minor at first, ignoring the symptoms could lead to debilitating medical issues. Since we tend to ignore much of the pain associated with these medical issues, we need to know when it’s time to see an ENT doctor.

Tonsillitis, the inflammation of the pharyngeal tonsils located in the back of the throat, most commonly affects children ages 5-15. Viruses and bacterial infections are typically the cause of tonsillitis. Symptoms of tonsillitis include sore throat, enlarged tonsils, bad breath, tender neck and headaches. You should consult a physician if you or your child experience a sore throat lasting longer than 48 hours, experience painful or difficulty swallowing, or experience extreme weakness or fatigue. Ignoring these signs could lead to more pain and difficulty breathing and talking.

Sinus and ear infections often go hand in hand. Treatment for most sinus and ear infections typically comes in the form of over-the-counter medication. However, if ignored for long periods of time, the infection can spread throughout the body leading the hospitalization. Seeing a doctor may become necessary if you are running a fever or have pain in your head, face or ear that continues to linger after using non-prescription medication.

Neck pain comes in several varieties and from a number of sources. Most neck pain stops after a few days and requires no additional medical treatment. However, although rare, severe head and neck pain could be an early indicator of cancer or an infection. If your neck pain has been bothering you for more than six weeks or the pain continues to worsen, you should see a doctor.

With summer in full swing, many people are searching for the perfect tan. In this pursuit they tend to forego the application of sunscreen and instead decide to absorb as much sunlight as possible. Although this does lead to a sun tan, it can also lead to skin cancer. While the survival rate for skin cancer stands at 99 percent, the longer you wait to seek treatment the greater the decrease in the survival rate. Left unchecked, skin cancer can spread to lymph nodes and vital organs, drastically decreasing the chances of survival.[1] If you notice unusual skin growths that won’t go away, patches of pale skin or rapidly growing moles, you should visit your physician. 

More often than not, the ENT problems we face are resolved quickly and require little or no medical attention. However, it’s always better to be safe than sorry.

About the author

Scott McClintick, DO, is an otolaryngologist at Freeman Ear, Nose, & Throat Center. Dr. McClintick is board certified by the American Osteopathic Board of Otolaryngology-Head and Neck Surgery. He attended medical school at Kansas City University of Medicine and Biosciences in Kansas City, Missouri, and completed his internship and residency at Freeman in 2005 and 2006, respectively. To learn more about the services provided by Dr. McClintick, visit freemanhealth.com/ent or call 417.347.8301 to make an appointment.

Someone in the United States attempts suicide every 29 seconds.* Every 11.7 minutes, someone successfully ends their life. The Four States is no exception. In fact, Missouri loses more lives to suicide than car accidents, yet for many of us, an unspoken code of silence surrounds the issue.

Suicide is a heavy subject, and the stigma attached to mental illness keeps many from talking about their thoughts or feelings. These individuals suffer in silence, and many times, those around them are afraid to ask if they are OK.

Although suicidal thoughts can affect anyone regardless of age, gender, religious beliefs and/or background, tragedy can be avoided if the person struggling reaches out to a trained mental health professional. The best thing you can do to help someone struggling with possible life-threatening depression is to become educated about the warning signs of suicide and know what community resources are available.

Warning signs

• Withdrawing from life
• Displaying extreme mood swings
• Sleeping too little or too much
• Increasing use of alcohol or drugs
• Feeling hopeless with no reason to live
• Feeling trapped
• Having unbearable emotional pain
• Wanting to die or kill oneself

If you recognize these warning signs in yourself, a friend, a co-worker or a loved one, be the change needed to break the code of silence. Talk directly and openly about your concerns. Help the individual get professional counseling treatment to avoid another life lost to suicide.

If you or someone you know is contemplating suicide, Ozark Center’s highly-trained mental health professionals can help. Call the Ozark Center Crisis Line at 417.347.7720 or 800.247.0661 for immediate assistance, day or night. You can also send a text message to 720.7.TXTOZK for an anonymous, two-way counseling session via text message. The National Suicide Prevention Lifeline is also available 24 hours a day at 800.273.8255.

*American Association of Suicidology

About the Author

Debbie Fitzgerald, EdS, LPC, NCC, is director of crisis services at Ozark Center. She has 34 years of experience in the mental health field, and for the past 30 years, she has served the community through her work at Ozark Center. She has certification from the National Board of Certified Counselors, and crisis worker certification from the American Association of Suicidology.

As we move out of summer and into fall we begin to see the weather cool, leaves turn and trash cans fill with tissues. Flu season is here, and while thoroughly washing your hands, using hand sanitizers and avoiding large crowds can help you avoid getting the flu, the best way to stay healthy is to get an annual flu shot.

While the flu shot is not the end-all-be-all of preventing the flu, it helps considerably. According to the Centers for Disease Control and Prevention (CDC), in 2016-2017 flu vaccinations prevented an estimated 5.3 million influenza illnesses, 2.6 million influenza-associated medical visits, and 85,000 influenza-associated hospitalizations.[1] Additionally, the CDC reports that 59 percent of vaccinated patients are less likely to be admitted to the ICU.[2] The flu vaccine is recommended for anyone age six months or older.

Receiving the flu vaccination is especially pertinent to those at risk of serious complications from influenza. Factors that could leave you at a higher risk of serious complications include asthma, cancer treatment, diabetes, kidney or liver disease and obesity. The flu vaccination has been associated with lower rates of cardiac events among people with heart disease, especially those who have experienced a cardiac event in the past year.[3] Even if you get sick with a different strain of influenza after receiving a vaccination, the flu vaccine can help lessen your symptoms.

Getting a flu vaccination goes beyond just protecting yourself. Getting vaccinated benefits your family, your friends and even the community. With more and more people receiving the vaccination, the threat of contracting influenza for those who who cannot receive the vaccine – due to an allergic reaction, age or personal reasons – is greatly reduced.

Many doctors’ offices have the flu vaccinations readily available. However, if you don’t have a regular family physician, you can receive the vaccine at health clinics, pharmacies, urgent care clinics, hospitals and other medical facilities. Some employers even offer the flu shot in the workplace.

Missed time from work and school, plans being cancelled and time spent laying around at home while you recover from the flu can be avoided with the help of the flu vaccine. Avoid the misery of getting the flu by getting your flu shot this year.

About the author

Dennis A. Estep, DO, is the Chief Medical Officer at Freeman Health System. Dr. Estep served as the Freeman OccuMed Medical Director for more than 23 years before taking over in his current position at the beginning of 2018. Dr. Estep is board-certified in Occupational Medicine by the American Board of Preventive Medicine and was named a Fellow by the American College of Occupational and Environmental Medicine.

[1]  Centers for Disease Control and Prevention. (2018, September 06). Influenza (Flu). Retrieved from https://www.cdc.gov/flu/prevent/vaccine-benefits.htm

[2] Centers for Disease Control and Prevention. (2018, September 06). Influenza (Flu). Retrieved from https://www.cdc.gov/flu/protect/keyfacts.htm

[3] Centers for Disease Control and Prevention. (2018, September 06). Influenza (Flu). Retrieved from https://www.cdc.gov/flu/about/qa/vaccineeffect.htm