The New Year is upon us and has brought with it the season of resolutions – an endless barrage of messages demanding that we improve our lives. Although some resolutions stem from a desire to improve our overall health, they are often deeply rooted in the belief we are not good enough to reach our dreams. Changes which come from criticism or shame are not sustainable in the long-run and will not lead to the health we are seeking.

The reality is we are already perfect, but we are surrounded by messages that we are not enough. They teach us our bodies are problems to be solved and our worth is contingent on reaching the unattainable.

Ask yourself: Why do you want to set this resolution? Do your motives come from criticism and shame? If the answer is yes, just remember no decision made from these beliefs will lead to health.

The solution is not in learning how to create more realistic resolutions but in shifting the beliefs behind them. You don’t need to be changed or bettered – you only need to see yourself more clearly.

What could happen if you are able to release these limits and begin to treat yourself as already precious and worthy? The threat to your humanity disappears and you are able to freely embrace the possibilities.

Consider these questions:

• How do I want to feel?
• What makes me come alive? How can I bring more of this into my life?
• What do I need to fulfill my true purpose?
• What message do I want to send through my everyday life? What legacy do I want to leave?
• What prevents me from loving myself as much as I deserve? How could I remove some of these obstacles?

Approach these questions with curiosity and use them to define a new kind of resolution – an intention to stop caring about your body and others’ perceptions, and start caring for yourself. This year, usher in an era of saying “yes” to what calls to your heart and honors your authentic self. Give yourself permission to seize the moment and live your life to the fullest.

About the Author

Dr. Jenny Copeland, Clinical Psychologist, practices at Ozark Center in Joplin, MO. Dr. Copeland specializes in the treatment of eating disorders. She has extensive experience in psychological assessment and treatment of people with diverse clinical concerns. Visit ozarkcenter.com to learn more about Ozark Center services.

Flu vaccination can keep you from getting sick, and, if you do get sick, it can make your illness milder. Getting vaccinated isn’t just about protecting yourself – when you are vaccinated, you are also protecting the people around you who may be more vulnerable to serious flu illness than you are, such as older adults, people with chronic health conditions and young children (especially infants younger than 6 months old who are too young to get vaccinated). Taking steps to prevent the spread of flu helps ensure that you and your loved ones may enjoy a happy and healthy winter season.

What do we need to know about this year's flu season?
First, know the steps that you can take to prevent the spread of flu! Second, know that the timing of flu is unpredictable. It strikes at different times each season, and it may not hit every region of the country at the same time. Typically, most activity occurs between October and May, with a peak between December and February. Best practice is to prevent the spread of germs all year long.

Third, know that you may be able to pass on the flu to someone else before you know you are sick. Symptoms usually start between one and four days after the virus has entered the body, but most healthy adults can infect other people starting a day before any symptoms develop. Some infected people experience no symptoms at all, but they are still able to spread the virus to others. After becoming sick, adults may be contagious for up to seven days (while children may be contagious for even longer). This is one reason vaccination is so important!

Who should get a flu shot?
It’s recommended that everyone 6 months and older get an annual flu vaccination, with rare exceptions. Children under 6 months of age are too young for a flu shot. The shot is also generally not appropriate for people with severe, life-threatening allergies to flu vaccine or any ingredient in the vaccine (such as gelatin or antibiotics).

What about people with egg allergies? Should they get vaccinated against flu?
Most, but not all, types of flu vaccine contain a small amount of egg. People who have ever had a severe allergic reaction to eggs generally have two options. Those over the age of 18 may get recombinant flu vaccine, which is 100% egg-free, or they can get the regular flu shot, but have it administered by a medical doctor with experience in managing severe allergic conditions.

People who have had a mild reaction to egg – that is, one which only involved hives – may get a flu shot with additional safety measures. Recombinant flu vaccines are an option for these individuals as well if they are 18 years or older and they do not have any contraindications to that vaccine.

As always, tell your doctor or healthcare professional about any of your allergic reactions.

Who is most susceptible to the flu?
People with the highest risk of complication from influenza are those with asthma, diabetes, heart disease, HIV, AIDS or cancer; those who have experienced a stroke; those who are pregnant; those who are over 65 years old; and those who are under 5 years old (especially those under 2 years old).

Does it matter if a patient gets the shot or the mist?
The flu shot and the mist protect against the flu. However, the mist is not approved for all people, including those who are younger than 2 or older than 50. Other people who cannot get the spray include:

• People with a history of severe allergic reaction to any component of the vaccine or to a previous dose of any influenza vaccine
• People who are allergic to eggs
• Children 2 years through 17 years of age who are receiving aspirin therapy or aspirin-containing therapy.
• Pregnant women
• People with weakened immune systems (immunosuppression)
• Children 2 years through 4 years who have asthma or who have had a history of wheezing in the past 12 months
• People who have taken influenza antiviral drugs within the previous 48 hours
• People who care for severely immunocompromised persons who require a protective environment (or otherwise avoid contact with those persons for 7 days after getting the nasal spray vaccine)

Talk to your doctor if you have asthma; chronic conditions like lung or heart disease; kidney, liver, neurologic/neuromuscular or metabolic disorders or Guillain-Barre Syndrome.

What steps can we take to prevent the spread of the flu?
To help stop the spread of germs:

• Get your flu shot
• Wash your hands often with soap and warm water for 20 seconds. If soap and water are not available, use an alcohol-based hand rub
• Cover your mouth and nose with a tissue when you cough or sneeze
• Avoid touching your eyes, nose or mouth
• Stay home when you are sick
• Avoid close contact with people who are sick

Also, remember to practice other good health habits: clean and disinfect frequently touched surfaces at home, work or school, especially when someone is ill; get plenty of sleep; be physically active; manage your stress; drink plenty of fluids and eat nutritious food.

As I get older, each new year seems to come sooner than the one before. Time really does fly! With the new year come traditional New Year’s resolutions, such as losing weight, getting physically fit, spending less money and quitting smoking, to name a few.

This year, resolutions include opting to spend more face-to-face time with family and friends instead of communicating through social media. Others are making resolutions to be more grateful or give their time by volunteering. Some people are choosing one-word themes for the year – empower, believe, courage and freedom, for example.

It has been reported that 44 percent of Americans make resolutions but only 8 percent of those who make resolutions actually succeed at keeping them. So, what can you do to increase your odds?

Determine what motivated you to create your resolution and why it’s important. Maybe your goal is to lose weight because you are preparing for a vacation on the beach or your wedding. Maybe your physician told you to lose weight to lower your risk of heart disease or diabetes. 

Remind yourself daily of your goal. Write it down, and put it on your mirror or the refrigerator. Create a visualization board with pictures of what you hope to accomplish in 2016 and place it where you see it each day.

Plan for obstacles and how you will overcome them. If your goal is to prepare for a 5K in the spring and your training begins in January, you will need to have a back-up plan for inclement weather. If you normally run outside, you will need to have a treadmill or inside track available.

Reward yourself for accomplishments along the way. If you lose 10 pounds toward your 40-pound goal, treat yourself to a massage, pedicure or manicure.

Partner up with someone with similar goals. We all know that being accountable to someone else makes us less likely to give in to the temptation to hang it up.

Plan ahead. Make your lunch the night before or schedule your workouts on your calendar.

Finally, believe in yourself and give yourself permission to succeed. You’ve got this. Here’s to your best year yet!

Resources:
Forbes, Jason Selk, January 2016
Inc., Gretchen Rubin, December 2015

High blood pressure, also called hypertension, affects about 80 million Americans. Known as the silent killer, hypertension wreaks havoc on hearts, kidneys and extremities for many years before symptoms suggest its presence. For this reason, physicians have been aggressive in attempts to get their patients’ blood pressure to safe levels. The problem is in defining blood pressure safe levels.

Two years ago, the American College of Cardiology issued guidelines that greatly relaxed the targets for blood pressure control. These new guidelines, citing targets of systolic pressure of 140 in most adults and 150 in the older population, were met with some skepticism in the medical community. Most physicians felt lower targets were more appropriate.

The Systolic Blood Pressure Intervention Trial (SPRINT), funded by the National Institutes of Health, recently formed to study whether lower blood pressure reduces the risk of heart and kidney diseases, stroke or age-related declines in memory and thinking. Approximately 10,000 patients ages 50 and over who were at high risk of heart disease or had kidney disease participated in the study. The study was expected to conclude in 2017, but it was halted early because a significant advantage was demonstrated in the group whose blood pressure targets were lower. Keeping blood pressure at or below 120 led to a statistically important decrease in heart attack and stroke, with an acceptable risk of side effects. Not surprisingly, the downside includes a larger number of medications necessary to reach lower target levels. The increased cost of additional prescriptions and side effects of each prescribed medication were offset by the gains in reduced heart attack and stroke.

Although adoption of the newly recommended blood pressure targets has not yet urged a reissuance of new guidelines, the trend will certainly be toward tighter pressure control for all patients. This will especially be viable for patients with known heart, brain or vascular disease. Cardiovascular disease is still the leading cause of death in the United States and lower blood pressure goals can reduce overall mortality rates.

People with high blood pressure should not panic. High blood pressure takes it toll slowly, and the good news is that there are hundreds of medicines with widely varying mechanisms of action that can be used for control. You and your healthcare provider will likely be able to find a program that can safely and effectively reach your goal.

As we begin a new year, pledge to lose weight, stop smoking, exercise and begin to lead a healthier lifestyle that can help lower your blood pressure.

Take our free online heart health assessment today.

Every winter physicians see an increase in the number of patients with heart attack symptoms. From November to April, the number of patients with heart problems is almost overwhelming for hospital emergency departments. Research shows there is a 50 percent increase in heart attacks in winter, and twice as many heart attacks a day in January compared to July. The reason behind this increase is that cold weather affects the heart in multiple ways. Exposure to cold temperatures causes blood vessels to constrict and can reduce blood flow and oxygen supply to your heart. Cold temperatures can cause a rise in blood pressure and put undue stress on the vascular system. This can lead to chest pain, heart attacks and heart failure.

Hypothermia occurs when the body cannot produce enough energy to keep the internal body temperature warm enough. Besides cold temperatures, high winds, snow and rain can rob the body of internal heat. Wind is especially dangerous because it removes the layer of heated air from around your body. Hypothermia symptoms include mental confusion, slowed reactions, lack of coordination, shivering and feeling sleepy. Elderly people and children are at most risk because they may not be able to understand what is happening and not realize they are in danger. Hypothermia can kill a person!

People who live a sedentary lifestyle often experience chest pain when shoveling snow or participating in other exertional outdoor activities. Sometimes, walking through heavy, wet snow is enough to put a strain on the heart.  Also, the stress of pneumonia and other respiratory illnesses often further stress the heart. If you feel chest pain or pressure with exertion, especially if it is worsened by cold weather, please check it out. As the old adage goes, it is better to be safe than sorry.

Follow these guidelines to minimize your risk of winter-related heart problems:

• Wear layers of clothing to trap air between layers to keep you warm when going outside. Wear a hat; heat can be lost through your head.
• Don’t drink alcoholic beverages before participating in strenuous outside activities because alcohol increases your sensation of warmth and will cause you to underestimate the extra strain on your cold body.
• Stretch or take a 5 to 10-minute slow walk before shoveling snow or participating in strenuous outdoor projects.
• Take frequent rest breaks so you don’t overstress your heart.
• Caffeine and nicotine put a burden on a stressed heart; don’t smoke or have a cup of coffee when taking rest breaks.
• Learn CPR. Provided immediately after sudden cardiac arrest; CPR can double or triple a victim’s chance of survival.
• When in doubt, call 911 and get yourself checked out.

Know your physical limitations and listen to your body when shoveling snow or doing any type of outside physical activities. If in doubt, hand the snow shovel to your kids. You can supervise from the window.

Take our free online heart health assessment today.

I am often asked what athletic trainers do to help athletes remain healthy, get stronger and perform at their peak. Athletic trainers keep athletes safe with preventative measures, and help them return back to their game as safely as possible.

People also often confuse athletic trainers with personal trainers. Athletic trainers are board-certified healthcare professionals who collaborate with physicians to assess, treat and prevent athletic injuries. We provide emergency care, therapeutic intervention and rehabilitation of injuries and illnesses. Athletic trainers work in a variety of locations including schools, workplaces, physician offices and hospitals.

Once an athletic trainer has completed a bachelor’s or master’s degree from an accredited professional athletic training education program, he must pass a comprehensive test administered by the Board of Certification.  More than 70 percent of athletic trainers have a master’s or a doctorate degree and must pass national certification exams in addition to their state licensure exams. An athletic trainer must meet ongoing continuing education requirements in order to remain certified.

Athletic trainers have many job duties and responsibilities:

• Establish athletic training programs at assigned high schools, colleges or universities
• Provide injury assessment/first aid/treatment/rehabilitation for student athletes
• Attend at-home athletic events and provide services, as needed
• Communicate with team physician regarding an injured student athlete’s condition
• Assist coaching staff in implementing conditioning programs
• Create a safe-playing environment by monitoring environmental risks
• Provide educational in-services for school nurses, coaches, and parents relative to athletic training and the recognition of concussion symptoms and other illnesses
• Perform administrative tasks such as keeping records and writing injury and treatment reports

Many hospitals and physician clinics, including Freeman Sports Medicine, offer free or low-cost pre-participation sports physicals each year. Injuries or illnesses are often detected during these annual exams to alert students and their parents about medical conditions that may require further examination from a family practice physician or a specialist. Athletic trainers assist physicians and nurses in making sure injuries and illnesses are detected and recorded.

The safety of student athletes is always a top priority for athletic trainers. As emphasis is placed on today’s student athletes to become bigger, faster and stronger; the chance for injury increases. It is our responsibility to make sure injuries are assessed and treated so a student athlete can return to the game he/she loves and do so without further physical harm or injury.

Remember the good old days when you worshipped the sun with your body soaking in baby oil and iodine? Your golden bronze skin and tan lines were the envy of all your friends. If you spent your summers as a teen laying out in the midday sun, you might be one of the baby boomers who is now experiencing skin damage and susceptibility to skin cancer.

Skin cancer among senior citizens is on the rise; in fact, between 40 and 50 percent of people 65 and older will have at least one skin cancer. The average age for people diagnosed with melanoma is 61. According to the American Academy of Dermatology, older adult males have the highest risk of developing melanoma. As skins ages, it loses its ability to protect itself and becomes more vulnerable. It is important that older adults protect their skin and limit exposure to the sun.  

Sunburns are not the only causes of skin damage and skin cancer. Tanning beds were introduced in the United States in 1978 and remained unregulated until 1988. Many people overused tanning beds, not knowing the damage they were causing to their skin.

When you go outside, especially during the summer, try these tips:

1. Don’t try to get a tan. Tans increase your risk of getting skin cancer.
2. Find shade in your outside environment. If you can’t find a shade tree or a covered porch, use a large golf umbrella.
3. Stay inside between the sun’s peak hours of 10:00 am and 4:00 pm.
4. Use sunscreen (SPF 30 or higher) on any exposed skin regardless of how long you are in the sun.
5. Wear long pants and long sleeved shirts, when possible. Don’t forget a wide-brimmed hat to protect the top of your head, ears and neck.
6. Protect your eyes with UV-blocking sunglasses.
7. Use moisturizer daily to keep skin from becoming dry.

You should also check your body monthly for moles that are changing in color or size. Look for ragged edges on moles or moles where one half does not match the other half. If any mole is larger than a pencil eraser or changing in color, shape or size, see your family physician. He/she can advise whether a mole needs further examination. If you are over 50 years old, you should have annual skin cancer screenings with your doctor to check for moles, skin patches or blemishes.

You can enjoy the outdoors and the warm summer months-just take extra caution to protect yourself and stay safe.

Jill Endicott, FNP-C, completed her medical education at the University of Arkansas for Medical Sciences in Little Rock, Arkansas. She is certified by the American Nurses Credentialing Center as a Family Nurse Practitioner. Jill is the Nurse Practitioner at Freeman Seneca Family Medicine Clinic.

If I asked you to close your eyes and visualize what someone with an eating disorder looks like, you would probably imagine a white, adolescent female from a middle to upper-class family. The reality is eating disorders do not discriminate. You are not too fat to have an eating disorder; your size neither determines your diagnosis nor illustrates the severity of your illness. You are not too old to have an eating disorder. Research suggests that the fastest-growing portion of our society diagnosed with eating disorders is middle-aged women. People of color are not protected from negative body image by their race or ethnicity. Recovery may even be more difficult for them if they experience racism in daily life. Lack of available and/or accessible, respectful treatment options hinder recovery. All people can and often do experience body shame. How eating disorders develop and how a person experiences it will very likely be different depending on gender identity, size, race, ethnicity, age, sexual orientation, religion, physical ability, financial stability, genetics, family history and locale.

Nearly 20 million women will suffer from an eating disorder in their lifetime. Girls between the ages of 15 and 24 are twelve times more likely to die from this illness than any other cause of death. Medical complications include multi-organ failure, infertility, decaying teeth, heart attack and stroke. In spite of these staggering statistics in modern society, harmful myths and stereotypes often keep people from realizing they may need help. The disturbing nature of this illness is that it isolates those suffering from loved ones who can often help with recovery.

Eating disorders are not a choice. Someone does not choose to have an eating disorder any more than he/she would choose to have cancer. Girls as young as six years of age are expressing concerns about their weight and appearance. More than 80 percent of 10 year-old girls are afraid of being fat and nearly half of girls between the ages of 9 and 11 often diet to lose weight. These behaviors can and often pave the way for eating disorders at a young age.

Recovery from an eating disorder is difficult, but it is possible.  Although the illness was not your choice, recovery is your decision. You will not go through recovery alone; you will discover an amazing community waiting right by your side. Consider your dreams, for they are possible in recovery. Trust your soul, and it will show you the way to healing.

If you or a loved one has an eating disorder, consider taking this confidential, three-minute online screening from the National Eating Disorder Association: nedawareness.org/get-screened. Ozark Center has specialized treatment providers to help guide you through recovery.

Men tend to take very good of their vehicles and boats, but put off taking care of themselves. To get healthy and stay healthy for a long time, men need to develop the habit of taking care of their medical needs. Working a demanding job during the week and playing hard on the weekends doesn’t mean a man is healthy or without health risks. Compared to women, men are more likely to put off getting regular checkups and medical care, especially men who smoke, drink excessively or make other unhealthy or risky life choices.

Men are at high risk for certain diseases, including:

• Heart disease
• Prostate cancer
• Depression and suicide
• Diabetes
• Lung cancer
• COPD
• Unintentional injuries and accidents
• Liver disease
• Skin cancer
• Flu and pneumonia

Some of the diseases listed begin silently, without noticeable symptoms, until they have progressed to a serious point. Prostate and skin cancer are the most common cancers diagnosed in men and many times go undetected and undiagnosed for long periods of time. Many health risks men face can be prevented and treated with early diagnosis. Screening tests can find these diseases when they are easier to treat and cure. Some men hope symptoms they experience are just temporary and “will go away.” They put off seeking medical treatment until they are in great pain, or until a wife or female loved one insists on making a physician appointment for them.

Because men have a history of not taking care of themselves and not seeking early medical treatment, they die five years earlier than women, on average. Out of the leading causes of death, men lead women in all of them except Alzheimer’s disease, and this is probably because many men don’t live long enough to develop the disease.

Mental illness is another disease men do not like to talk about or admit to experiencing. Depression was previously thought of as a woman’s disease, but researchers believe this is because women seek help for depression and men tend to hide depressed feelings or express them differently than women. The National Institute of Mental Health reports at least six million men suffer from depressive disorders annually. Men who suffer with depression often turn to drugs or alcohol to suppress their feelings. This type of behavior and the stress associated with it can often lead to heart disease or certain types of cancer. Depression can also lead to suicide, the eighth leading cause of death among men.

Health issues can be scary, but avoiding them can be life threatening. Be a real man. Call your doctor. Make that appointment.

Jeffrey Grills, MD, completed his medical education at Washington University School of Medicine in St. Louis, Missouri, and his Internal Medicine Residency at Indiana University. Dr. Grills currently serves as Vice-President of Medical Affairs at Freeman.

World Breastfeeding month is August. This year’s celebration focuses on how our community and our world can support sustainable development through the protection, promotion and support of breastfeeding, which ultimately effects the health of our world and protects our resources.

We should strive to inform people how breastfeeding affects the health of our community – it builds immunity; protects against chronic illnesses, such as diabetes and some cancers; and provides the optimal nutrition for growth of not only babies’ bodies but also their minds.

Breastfeeding also offers a sustainable source of food security for most of the world’s population. It offers a sustainable, inexpensive source of optimal nutrition for those who struggle daily to meet their baby’s nutritional needs.

Women who are provided a place to pump during work hours tend to be more productive and take fewer sick days for their children. Breastfeeding also lowers insurance costs because babies are healthier. It is a good choice for employers to allow a time and place for women to pump to continue offering breast milk to their babies once they return to work. 

Breastfeeding affects our environment. There are no bottles or cans to create waste. Breast milk is a natural, renewable food. It is always ready and at the right temperature, taking no fossil fuel to produce, transport or warm. And, it is free – on the average the world spends an estimated $54 billion on formula each year, and formula cans produce tons of waste.

Increasing breastfeeding rates in our community and our world would provide optimal nutrition, improving health and well-being of our children; provide a step up from poverty as children grow up and have better jobs; lower the strain on our medical system; allow mothers to continue to work outside the home while still providing for their children; and put less strain on our natural resources. See what you can do in your corner of the world to promote a sustainable source of food for our children – breast milk.

For your convenience, we have added another lactation room at Freeman Hospital West, located on the sixth floor near the front desk. There is a refrigerator available in the room for your convenience. As always, if you need any assistance, please feel free to call Freeman Lactation Services 417.347.1067. 

Lorie Peterman is a certified lactation consultant at Freeman Health System. She helps new mothers learn to feed their babies. She also works with women experiencing problems with breastfeeding and helps babies who aren't gaining enough weight.