Halloween: Kids and teenagers get dressed up in the most creative costume they can find, candy is everywhere, face paint ends up on coat sleeves or (somehow) the furniture, houses are decorated with fake cobwebs and carved pumpkins, and old pillowcases are pulled out from cabinets to be used as candy receptacles. Halloween is fun, but Halloween can also be spooky and dangerous if kids and parents aren’t careful.

Even though we often trick-or-treat in familiar neighborhoods and go out every year without fear, consider safety precautions to ensure Halloween remains fun for everyone.

Stay with your crew

There is safety in numbers. Travel with a group and stick with your group as you go around to different houses. Don’t let anyone else leave the group either. Mapping out your trick-or-treating adventure beforehand can help make sure everyone hits their favorite houses and stays together.

Go where you know

To avoid getting lost, visit houses and neighborhoods you are familiar with. This can also help you avoid strangers. Also stay out of the road and only use sidewalks and crosswalks.

Be seen

Bring flashlights or glow sticks and use them while you walk. Beware of that odd crack on the sidewalk or dropped curbs so you don’t trip! It’s getting darker earlier, so being able to see what’s in front of you is important. Using flashlights or glow sticks also help motorists and other vehicles see you.

Keep those hands clean

Bring some hand sanitizer along with you on trick-or-treating adventures. Freeman pediatricians see a lot of sick children after Halloween because everyone shares germs reaching into those candy bowls!

Wear the right attire

When choosing a super stellar outfit, you also need to consider the safety of your Halloween apparel. To avoid trips and falls, wear good, sturdy shoes and costumes and masks that fit.

Check your candy

We don’t want to take candy away from ourselves or from kids, but check the candy in bags before digging in. Some candies are dangerous for tots, like Skittles® or Everlasting Gobstoppers®, and not all kids can eat every candy safely due to allergies. Throw out any candy that may be dangerous or has an open wrapper, and avoid eating homemade goodies.

Freeman wants you and your loved ones to be as safe as possible this Halloween. Get dressed, heed these tips and have FUN!

Dr. Beth Garrett has been a pediatrician at Freeman Children’s Clinic for nine years. She is a member of the Missouri American Academy of Pediatrics (MOAAP) and is currently the membership committee chair. Dr. Garret also serves on the planning committee for MOAAP and is on the Bill & Virginia Leffen Center for Autism diagnostic team. She loves watching her patients grow and develop, and watching families thrive. She is located at Freeman Children’s Clinic, 1030 McIntosh Circle, 417.347.8750.

Veterans’ Day calls us to remember the heroism of the brave women and men who sacrificed their lives while serving our country.

Some veterans and current active service women and men may have experienced a traumatic event as the result of combat. The trauma may be re-lived in nightmares and through flashbacks.

Veterans may find themselves avoiding certain people, places, smells, textures and sounds to prevent an increase in anxiety and memories of the trauma. They may avoid stores because having people behind them in line makes them feel uncomfortable, or they may avoid fireworks because they remind them of a bomb or gun going off.

One form of evidenced-based treatment for individuals who have experienced a traumatic event is virtual reality therapy (VRET). VRET is often used in the course of treatment to specifically treat symptoms of posttraumatic stress disorder (PTSD). VRET can be used alone as a treatment for anxiety and other related fears.

While VRET can be used to treat a variety of fears - including public speaking, heights, storms and flying - it can also be used to treat PTSD. Bravemind, is offered at Ozark Center. It is available specifically for veterans or active duty service women and men who have PTSD and served in Afghanistan or Iraq. It includes scenarios like foot patrol, convoys and medical evacuations via helicopters. Therapists can customize the VRET environment to include explosions, firefights, insurgent attacks and roadside bombs with visuals and sound effects.

The virtual environment helps individuals feel as if they are really in the situation they fear, teaching them how to cope with that fear and anxiety by allowing them to interact with harmless virtual representations of traumatic stimuli to reduce their fear response. They can then learn how to decrease their negative response to the traumatic memory by being in the virtual environment while retelling their traumatic memories to a therapist who is guiding them through the process. After repeatedly doing this, the stress response, fear and anxiety will decrease or disappear due to the individual learning they are in a safe place.

About the Author
Dr. Stephanie Terrell, Licensed Clinical Psychologist, practices at the Ozark Center. Dr. Terrell specializes in the treatment of PTSD using prolonged exposure and virtual reality therapy. She also has extensive experience in psychological evaluations and is trained in smoking cessation and biofeedback. Additionally, Dr. Terrell provides treatment for a variety of other outpatient and inpatient clinical concerns. She has over eight years’ experience in the mental health field.

There is a striking correlation between the temperature and our desire to exercise outdoors; as the mercury on the thermometer moves lower, so does our want to exercise outside. While exercising outside in warmer weather is preferable, exercising outdoors is very healthy for our brains in any temperature.

Outdoor exercise in nature results in consistent improvements in energy, motivation and well-being. People who exercise outside, as compared to inside, have less tension, less anger and less depression¹. Outdoor exercise seems to help stimulate our brains to produce chemicals that play important roles in gratification, clarity of thinking and motivation. Happiness is also shown to improve when we have a variety of stimulation with exercise².

Our body benefits from being used at different angles and speeds, which is afforded by the luxury of exercising outdoors. Even the wind helps give us random degrees of challenge, pushing at times for increased effort and resistance or pulling us along the path faster than usual. Overuse injuries are related to a lack of variety that can come from always doing the same workout in the same way, at the same angles, over and over. Moving from trails, to grass, to asphalt, to gravel provides variety for your body, and you also may find yourself with more energy and motivation to exercise outdoors than when you are inside running on a treadmill.

In addition, outdoor exercise is generally not expensive. We – in the four-state region – are blessed to have a great many natural areas and wonders to explore, many of them nearby and free of charge. Whether kayaking on the creek, running a trail, bicycling in the neighborhood, climbing hills or swinging from trees, outdoor exercise has something for everyone. 

1 J Thompson Coon, K Boddy, K Stein, et al. Environ Sci Technol. 2011. Mar 1:45(5):1761-72.

2M Khazaee-Pool, R F Majilessi, R Saghedi, et al. J Psychiatr Ment Health Nurs. 2015. Feb;22(1):47-57.

About the Author

Chris Peterson is a physical therapist at Freeman Rehabilitation & Sports Center. He helps patients recuperate from injuries, illnesses and surgery. He works with patients to help them manage pain and reclaim their lifestyle and momentum. Freeman Rehabilitation & Sports Center features a sports performance section, basketball performance court, balance testing and treatment, sports concussion testing and the only aquatic therapy program in the area. To learn more, visit freemanhealth.com/sportsmedicine or call 417.347.3737.

Eating healthfully during the holidays seems like an impossible task. What is “healthful eating” anyway? It means no white foods, drink only kale smoothies, and if it tastes good, don’t eat it, right? Wrong. There is a great deal of misinformation about what it means to eat healthy.

Healthful eating is not a restrictive diet plan filled with tasteless, joyless foods, but a mindset and lifestyle that incorporates a balance of all foods. Healthful eating means balance and establishing a healthy relationship with food. Love the donut and love the apple, shamelessly and guilt-free. 

Many times, my clients are so worried about gaining weight during the holidays, and because they are so weight focused, they miss out on the joy of eating. Take the taboo out of your holiday favorites and allow yourself to enjoy them mindfully. Meaning, allow yourself to eat a moderate amount until you are comfortably full. Don’t feel that you can’t have a taste –   deprivation leads to overeating. However, don’t feel you must try everything you’re offered to appease a family member. It’s OK to say, “No thank you – I am full.”

Food is a fuel, and sometimes our bodies need different types and amounts of fuel from day to day. I encourage you to pay attention to your hunger and fullness cues. Eat when you are hungry, and stop when comfortably full. Look for ways to increase fruits, vegetables and legumes. Most of us need more of these, and they do much for our bodies.

I challenge you to be present this holiday season as you spend precious time with loved ones. I encourage you to whip up some of your favorite holiday treats and share them with friends and family. Take time for yourself and reflect on the meaning of the holidays. Eating healthy is much more than weight alone and you are so much more than your weight alone.

Merry Christmas and happy holidays!

About the Author

Haley Brannan, RDN, LD, is a clinical dietitian for Freeman Diabetes Education. Freeman is the only local hospital with diabetes educators that are certified through National Certification Board of Diabetes Educators and certified insulin pump trainers. To learn more visit freemanhealth.com/diabetes or call 417.347.5700.

Suffering people visit healthcare providers every day with complaints of pain, poor sleep, anxiety and fatigue. Imagine if we could make a medicine with minimal side effects that not only quickly helped these issues, but also improved blood pressure, immune function, memory, problem solving and heart health, and, decreased risk of cancers and dementia. Imagine a pill that would literally help you age less quickly. What if it could help make life after 50 feel healthy and have less disease? This medicine exists, and these results are supported by the United States Department of Health and Human Services (HHS). How much would you pay? What if I told you it would save you an average of $1,500 a year? The medicine is movement and physical activity.

New guidelines set by HHS clearly show that moderate-to-vigorous physical activity and less sitting are associated with all of the above benefits. Even people with chronic medical conditions can enjoy improved quality of life and function. Exercise keeps us younger by protecting the DNA that keeps cells alive and reducing inflammation throughout the body. The most exciting part of the new guidelines is the knowledge that even small amounts activity are beneficial. We now understand that any increase in the level of physical activity confers significant health benefits.

It is important to start small, and with gradual increases our bodies will adapt and strengthen. Eventually, exercise gets easier and a person can progress toward the ultimate recommendation of two and half hours a week of moderate-to-vigorous exercise where substantial health benefits accrue. The goal is to get a little short of breath, where you can talk but not sing. There is additional benefit to muscle strengthening exercises twice a week and balance activities for older adults improve bone health, function and decrease fall risk. For those facing significant barriers to exercise, a health professional can help work through the various issues and find enjoyable, sustainable ways to keep moving. There is plenty of room for us as a country to improve because less than 30 percent of Americans are currently getting recommended amounts of exercise and movement.

While exercise is safe for almost everyone, a few precautions can lessen the risk of injury. Choose safe environments, wear protective gear as needed, and make good choices about when and how to be active. Increase the chances for success by setting goals monitoring the goals, and seeking social support. Make goals that are meaningful to you, and engage in activities you enjoy. Consider an exercise partner or group to help keep you on track and celebrate each other’s successes. We do advise seeking the counsel of a healthcare practitioner in the case of chronic conditions or symptoms to help start exercising safely and working through barriers. However, anyone can start by just getting out of the chair more often. Today is a good day to start moving more.

About the Author

Chris Peterson is a physical therapist at Freeman Rehabilitation & Sports Center. He helps patients recuperate from injuries, illnesses and surgery. He works with patients to help them manage pain and reclaim their lifestyle and momentum. To learn more, visit freemanhealth.com/sportsmedicine or call 417.347.3737.

March is National Colorectal Cancer Awareness Month. There is no better time to schedule a screening and learn the facts about colorectal cancer, also known as colon cancer. With that being said, colon cancer is highly preventable and treatable.

The colon and rectum are part of the gastrointestinal system, often referred as the digestive system, and together make up the large intestine. Colon cancer occurs in the colon or rectum – first beginning as a polyp on the inner lining. These irregular growths may become cancerous if not removed. If cancer begins to form in a polyp, it may eventually grow into the wall of the colon or rectum. Once the cancer cells are in the wall, the cells have the potential to grow and travel to nearby lymph nodes or other parts of the body.

According to the Colon Cancer Alliance, colon cancer is the third most diagnosed cancer and the second leading cause of cancer death in men and women combined in the United States. Men and women of all racial and ethnic groups 50 years and older are at a higher risk of colon cancer. The average age of diagnosis is 72. For several decades, colon cancer survival rates have increased in both men and women. More than likely, this is because of increased awareness and screenings.

Colorectal cancer screenings are one of the most powerful weapons to fight colorectal cancer. Because of screenings, colorectal polyps are found more often and removed before becoming cancerous. If cancer is already present, earlier detection decreases the risk of cancer progression and treatments are more likely to succeed. Colon screening methods vary, but each screening ultimately views the colon to identify any abnormal areas – looking for colorectal polyps and cancer. Starting at age 50, men and women should have routine colon screenings. The average colon screening takes less than 30 minutes, involves virtually no pain and includes little risk. Some colon screenings require dietary restrictions beforehand to prep and clean the colon.

One of the most common colon screenings is a colonoscopy, which uses a scope with a light and camera viewing the entire colon to detect polyps. If a small polyp is found, it may be removed that moment with a wire loop and sent to a lab to be evaluated for cancer. The suggested frequency for this screening is 10 years, depending on results. Other colon screenings include fecal immunochemical test (FIT) and fecal occult blood test (FOBT). FIT and FOBT test for blood by swabbing a stool sample. Additional testing may be necessary if blood is found. FIT and FOBT should be conducted annually. Lastly, a sigmoidoscopy is encouraged every five years. Like a colonoscopy, this test also uses a lighted tube with a camera but is only able to view roughly one-third of the colon. Talk to your doctor about the right screening for you.

If colon cancer is detected, your doctor will evaluate the location of the tumor and the stage of the disease. Treatment may involve surgery, chemotherapy, biological therapy, liver-directed therapy or radiation therapy. When colon cancer does develop, it has very few, if any, symptoms. Some symptoms may include:

• A change in bowel habits
• Persistent abdominal discomfort
• Rectal bleeding
• Weakness or fatigue

Because colorectal cancer may not initially cause pain or symptoms, it is important to be proactive and talk with your doctor. Schedule your colorectal cancer screening today!

About the Author

David Baker, DO, earned his medical degree from Kansas City University of Health Sciences College of Osteopathic Medicine, Kansas City, Missouri. Board-certified in general surgery, he completed his residency at Doctors Hospital, Columbus, Ohio, and completed an internship at Freeman Health System, Joplin, Missouri. Dr. Baker joined Freeman Health System in 2009. To schedule a colon screening at Freeman Center for Digestive Health or for more information, please visit freemanhealth.com/colon or call 417.347.8636.

Freeman Health System held its first recognition ceremony in conjunction with the DAISY Foundation program. The DAISY (Diseases Attacking the Immune System) Award is an international recognition program that honors and celebrates the skillful, compassionate care nurses provide every day. The DAISY Foundation was established in 1999 by the family of J. Patrick Barnes. Patrick died at the age of 33 from complications of an auto-immune disease. During his eight-week hospital stay, his family was impressed by the care and compassion his nurses provided, not only to him, but to everyone in the family. They created the DAISY Award in Pat’s memory to recognize those nurses who make a big difference in the lives of many people.

A few months ago, Freeman began requesting DAISY Award nominations from patients, fellow nurses, volunteers, physicians, staff or visitors. The nominee was to describe a situation in which the nurse demonstrated at least one of these principles:

P – Passion/compassion for nursing and the care provided to the patient and family
E – Empathy in the situation
T – Trust and teamwork with families, patients and teammates
A – Admirable attributes possessed
L – Loyalty to patients, families and hospital
S – Selflessness

It was no surprise Freeman received an abundance of nomination forms recognizing the compassionate care and clinical expertise of registered nurses. With the help of the Shared Governance Nursing Coordinating Council, Freeman selected three nurses to be honored at its first quarterly DAISY Award presentation.

The first recipient, Stacy Pryor, RN, from Freeman Emergency Department. Stacy was  nominated by a visitor whose 13-year-old son, James, needed medical attention. James had  viral encephalitis and needed to be transferred to a children’s hospital in Kansas City.

 The mother writes: “Stacy was empathetic and warm, yet professional. She was professionally  proficient and communicated with us effectively and in a timely manner. Her calm demeanor  and excellent nursing skills were noticed and appreciated. James is doing wonderfully now,  due  in large part to the care he received at Freeman’s Emergency Department. Thank you!”

The second DAISY Award winner is Shelly Shoemaker, RN, from Freeman Medical/Oncology,  was nominated by staff member, Linda Bailey. Linda was delivering a dinner tray to a patient  who wouldn’t respond and was breathing strangely. Linda quickly contacted Shelly who  discovered the patient was trying to cause harm to himself and intervened.

 Linda writes: “Shelly saved his life. She responded quickly when I expressed concern for him.  She was very professional in her duties and showed him great compassion and  encouragement in the following days during his stay. She is a hero in my eyes.”

The final DAISY Award winner for this quarter is Megan Dirteater, RN, from Medical/Oncology.  Megan was nominated by a visitor whose mother was receiving care.

 The nomination reads: “Every time Megan came into the room she had a smile on her face! She   was full of compassion and treated my mother as family. Megan brushed my mother’s hair and  rubbed lotion on her back to help her feel at ease at bedtime. My mother has dementia, and  even if my mother doesn’t remember her tomorrow, I will never forget the care Megan provided. The care she provided was truly exceptional.”

Congratulations to all of Freeman’s DAISY Award winners! Each honoree received a certificate commending her or him for being an extraordinary nurse, a DAISY Award pin, a sculpture called “A Healer’s Touch” and a box of Cinnabon® cinnamon rolls.  Shelly, Stacy and Megan are heroes who demonstrate excellence through clinical expertise and compassionate care. They serve as outstanding role models for the nursing profession.

Do you know a nurse deserving of the DAISY Award? Complete an online nomination form today!

April Bennett, MSN, RN, is Vice President of Nursing Services at Freeman Health System. April earned a Master of Science in nursing education from University of Missouri Kansas City and a Bachelor of Science in nursing from Missouri Southern State University. Providing care for nine years at Freeman, April has a passion for providing quality, compassionate and safe care to every patient, every time. 

“Life is a bowl of cherries. Some cherries are rotten while others are good; it’s your job to throw out the rotten ones and forget about them while you enjoy eating the ones that are good! There are two kinds of people: those who choose to throw out the good cherries and wallow in all the rotten ones, and those who choose to throw out all the rotten ones and savor all the good ones.” – C. JoyBell C.

Over the past few months, I have noticed many articles that arrive in my in-box are in reference to positivity and well-being. At a wellness forum hosted by the American Heart Association in St. Louis, two of the four speakers’ topics reflected these themes, which prompted me to do a little research of my own.

Merriam-Webster defines positivity as “the quality or state of being positive.” Oxford Dictionary defines well-being as “the state of being comfortable, healthy or happy.” Having a healthy well-being includes a well-rounded comprehensive experience of life. An individual who has a healthy well-being finds a balance between their social, physical, mental and spiritual health. Some qualities of a healthy well-being are:

• Self-acceptance
  To truly have self-acceptance, one needs to make peace with their past, realize some situations are beyond their control and find contentment in who they are.
• Self-growth
  Individuals who have a healthy well-being continue to learn and grow throughout their lives.
• Purpose and Meaning
  Well-being involves having something to get up for each day, whether it is your job or your relationship with others. You feel that what you do matters to others and helps make the world a better place.
• Autonomy
  Standing on your own two feet and owning your own unique opinion can help you develop autonomy and realize you don’t have to be the same as anyone else.

A healthy well-being isn’t something that happens overnight. We go through life events that can change the way we picture ourselves, and at times, our state of balance is not what we would like it to be. But as the quote above shares, the more we throw out the rotten cherries that we are exposed to and savor the good ones, we will find ourselves in a more comfortable or happy place.

About the author
Kris Drake RN, CHPD, is the Wellness Coordinator at Freeman Health System. As coordinator of Freeman’s employee health program, Kris works tirelessly to improve the work-life balance of more than 4,500 health system employees. Since October 2002, Drake has developed an array of programs to empower Freeman employees to reach their personal goals.

For the teacher whose speech becomes slurred or the outdoorsman who can no longer walk steadily through the woods, a stroke is a devastating and life-changing event, even if the resulting physical damage is minimal.

According to the American Stroke Association, someone in the United States has a stroke every 40 seconds, and someone dies from one every four minutes. All it takes is a blood clot no bigger than a pencil eraser to block an artery in the brain, interrupting blood flow and causing brain cells to die. The longer the blood flow is interrupted, the more brain cells die and the more extensive the resulting disability.

Therein lies the problem – immediate medical attention is vital for someone experiencing a stroke, but since strokes do not cause pain, symptoms are often dismissed as signs of fatigue or side effects of a medication. This results in people not seeking emergency medical care, increasing the risk of physical damage. In fact, Freeman Health System’s System Quality Improvement Department recently found that less than 20 percent of its stroke patients sought treatment within three and a half hours of the onset of symptoms.

Now for the good news. With prompt treatment, the effects of a stroke can be minimized. The American Stroke Association encourages the use of the acronym FAST as a learning tool to recognize the warning signs of stroke.

• Face – Is one side of the face drooping or numb? If the person is asked to smile, is the smile uneven?
• Arm – Is one arm weak or numb? If the person is asked to raise both arms, does one arm drift downward?
• Speech – Is speech slurred? Is the person unable to speak or are they hard to understand? If the person is asked to repeat a simple phrase, can he or she repeat it correctly?
• Time – Time is critical when someone is having a stroke. If you observe any of these symptoms, even if they go away, call 911 and get the person to the hospital immediately. Note the time when symptoms first appeared.

While strokes occur in both males and females of all age groups, the risk doubles every 10 years after the age of 55. Risks are higher for individuals with high blood pressure, high cholesterol or diabetes, as well as those with a family history of stroke.

If you experience any of the symptoms noted above or observe them in a loved one, remember to seek medical attention immediately. The sooner treatment is given, the better the chance of a full recovery.

Take our free online stroke assessment today.

About the author

Sharlyn Splean, RN, is a stroke care coordinator at Freeman Health System. She has been a registered nurse since 1993 and has worked for Freeman since 2008. With a Level II Stroke designation by the Missouri Department of Health and Senior Services, Freeman Health System works in cooperation with the area’s ambulance services to improve outcomes for patients with stroke. Freeman is the only Level II Stroke Center within 80 miles of Joplin. Freeman was recently recognized by the American Heart Association/American Stroke Association with a Silver Plus Achievement award for our accomplishments in the Get With The Guidelines™ quality program. To learn more about stroke and stroke education, visit freemanhealth.com/stroke or freemanhealth.com/stroke-assessment.

Choosing your pediatrician is an important decision – it is one of the biggest choices you will make before your baby is born. In fact, many women begin searching for their pediatrician in the second trimester of pregnancy. Before you start your search, it is essential to understand what this kind of doctor does to help you make the best decision and to know exactly what to expect when your new bundle of joy makes their way into this world.

A pediatrician is a doctor who specializes in the care of infants, adolescents and children as old as 21. From the common cold to sports physicals, you can count on your pediatrician for family-centered, comprehensive healthcare for your child from infancy through adolescence. Your pediatrician is the person who will help guide you through your child’s growth and development and will provide comprehensive preventive and medical care.

To take care of children, pediatricians provide well-child checkups – including vaccinations. They also diagnose and treat illnesses, infections and injuries; oversee growth and development; promote healthy lifestyles; and address behavioral issues.

Pediatricians are primed with extensive education that gives them special skills to take care of your child’s healthcare needs. In addition to graduating from medical school, pediatricians complete a three-year residency program in pediatrics and pass an exam administered by the American Board of Pediatrics to become board certified. To stay certified, pediatricians must meet regular continuing education requirements and take recertification exams.

Asking friends, relatives and your prenatal care provider for referrals is a good start when selecting your child’s pediatrician. Choosing a pediatrician may seem like a daunting task, but it is one all parents face. One thing to remember is that while many pediatricians have different approaches and styles, they have one thing in common – they want to help parents raise healthy children.

About the author
Kelly Gorman, MD, is a board certified pediatrician at Freeman Health System. Freeman is proud to offer the largest, most comprehensive group of pediatricians in the region. Our providers, specially trained in children’s healthcare, listen to you and address your questions and concerns. Your child’s health, nutrition and happiness are our top priorities. Learn more at freemanhealth.com/pediatrics.