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.

During National Suicide Prevention Awareness Month in September, it is important to remember lives lost to suicide, as well as to provide information about available resources for individuals who may be struggling with severe depression.

According to the American Association of Suicidology, a suicide attempt is made every 30 seconds in the United States. That means that every 12.3 minutes someone takes his/her life, accounting for 117 individuals each day or 42,773 suicide deaths annually. In southwest Missouri (Barton, Jasper, Newton and McDonald counties), 49 lives were tragically lost to suicide in 2014. That same year, Missouri ranked 17th in the nation in the number of suicides; statistics show that 1,017 Missouri citizens took their lives in 2014.

Missouri loses more lives to suicide than auto accidents, yet the topic is seldom discussed. Suicide is a heavy subject for those contemplating self-injury. Stigma attached to mental illness causes individuals to be ashamed of their thoughts and feelings. Individuals suffering remain silent about their thoughts, and those around them dare not ask if they are ok.

When suicidal individuals end their life, to end their pain, they pass their pain on to loved ones left behind; leaving them to make sense of the loss and navigate the tragedy. Research shows that approximately 18 people are impacted by each death. In our own community, at least 882 people have experienced this horrific loss and life disruption. 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. Mental health professionals can provide effective ways to help cope or survive the crisis. The best thing a person can do to help someone struggling with a possible life-threatening depression is to become educated about the warning signs of suicide and know what community resources are available.

Warning signs can include 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 and 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.

Ozark Center Crisis Services operates a free 24-hour hotline staffed by highly-trained mental health professionals. Crisis services are available by telephone at 417.347.7720 or 800.247.0661, as well as by text message at 720.7.TXTOZK. The National Suicide Prevention Lifeline is also available 24 hours per day at 800.273.8255. For a list of all services offered by Ozark Center, visit ozarkcenter.com. Help is readily available for anyone needing guidance or assistance.

To learn more about warning signs of suicide and how you can help someone, Ozark Center is holding a FREE community training workshop Saturday, September 10, 2016, at Freeman Business Center, 3220 McClelland Boulevard, Joplin. The sessions begin at 1:00 pm and end at 3:00 pm, with a balloon release to honor community members lost to suicide. Workshop sessions are open for adults and youths (grades 5–12). Fun activities for children younger than 5th grade will be provided. Reserve your spot by calling 417.347.7720.

When it comes to using and managing your medications, it is important to play an active role in your own healthcare. Because health risks accompany all medications, talk to your doctor or pharmacist about your medicines. According to the U.S. Food and Drug Administration (FDA), a drug is approved and considered safe enough when the benefits outweigh the known risks. To reduce risks and receive the most benefits, especially when taking multiple medications, the FDA encourages you to practice SAFER:

• Speak up
• Ask questions
• Find the facts
• Evaluate the choices
• Read the label and follow directions

Speak up during your doctor appointments. It is important for the healthcare team to know your medical history along with the medicines and treatments used. If possible, you should prepare and provide a written list of your medications and treatments to your doctor. It is also a good idea to keep a copy for yourself. The list should include any prescription medicines, over-the-counter medicines, dietary supplements and vitamins, as well as any allergies or problems you have experienced with a particular medicine or ingredient. You should also include any issues that may affect your use of medicine, such as trouble swallowing or trouble remembering to take your meds or if you are currently pregnant or trying to become pregnant.

Ask questions regarding your medications. Take notes on drug risks and usage during your doctor appointments or when picking up your prescription at your pharmacy. If you do not understand, always ask.

Find the facts about a prescription or over-the-counter drug by learning and understanding as much as possible. This may include brand or generic drug name, active/inactive ingredients, uses, side effects, directions or storage instructions, to name a few.

Evaluate your choices by weighing the benefits and risks you have learned about the medication. It is important to weigh the helpful effects versus the possible unwanted effects. Speak with your healthcare team when making these decisions.

Read the label and follow directions of both prescription and over-the-counter medicines. Before leaving the pharmacy with your prescription, double-check you have the correct medication, know the right dosage and know how to use it. When purchasing an over-the-counter medicine, read the label carefully. If you have questions or problems, contact your pharmacist or your doctor. Lastly, follow directions on the label and directions from your doctor and pharmacist to ensure you receive all the benefits while keeping risks low. Save the packing insert information, if available.

Managing your medications can be overwhelming, but it is possible. Practice SAFER, always talk to your doctor and pharmacist, and always play an active role in your own healthcare.  

Greg Cobble, RPh, earned his pharmaceutical degree from Southwestern Oklahoma State University in Weatherford, Oklahoma. He currently serves as the pharmacist-in-charge at QuickMeds Pharmacy^® at Freeman Hospital West and Freeman Outpatient Pharmacy Coordinator.

November is Palliative Care Month. What is palliative care? Palliative care provides relief to a patient with a serious illness through symptom and pain management. The goal of palliative care is to provide improved comfort to patients and families while maintaining the highest possible quality of life – even if a cure cannot be reached. The Freeman Health System palliative care team also supports patients and families with emotional and spiritual needs.

Palliative care at Freeman is provided by a specially trained team of registered nurses, Megan Spiering, Katie Adams, Patricia Johnson and me, and a palliative care physician, Dr. Christopher Black. Together, we educate patients and families about an illness or disease and strive to minimize symptoms while providing compassionate care and emotional support – encouraging the patient to live a meaningful life. Communication with patients and families is key. Through meetings and consultations, we hope the patient and family make timely, informed decisions. 

“One of the toughest yet most-rewarding times in palliative care is having a tough conversation with a patient and his or her family,” said Dr. Black. “Regardless of how difficult it is, when everyone comes to the same conclusion, we can focus on relieving a lot of pain and suffering for everyone involved.”

Some may assume palliative care is only used for patients with a terminal illness or end-of-life care, but it involves much more. After I joined Freeman in 2004, our team initiated and implemented the palliative care program. Since then, it has grown and become a valuable resource to many patients and their families, and we hope that continues. Working with many physicians and co-workers, we encourage palliative care to begin in the earlier stages of an illness – when patients often do not understand the options or possibilities for improvements. Palliative care provides understanding and yields a better and smoother transition for all in the future.

Not only do we work to relieve pain and suffering, we also work to reduce stress on patients, families and caregivers. The palliative care team serves as a resource to many others in the healthcare system, such as social workers, chaplains, nutritionists, rehabilitation specialists and so forth. We assist in coordination of complicated care plans across many departments to better clarify goals and priorities, helping with the understanding of treatment options and offering support, counseling and any other resources necessary. Providing comfort and guidance during all facets of an illness is what we do – this is how we provide care.

For more information on Freeman Palliative Care services, please visit freemanhealth.com/palliative-care or call 417.347.4094.

Gwynn Caruthers, RN, CHPN, earned her nursing degree from Pittsburg State University in Pittsburg, Kansas. She is not only a registered nurse but is also a Certified Hospice and Palliative Nurse. Gwynn joined Freeman Health System in 2004 after moving from Broken Arrow, Oklahoma. She started the palliative care program at Freeman – now serving as the Palliative Care Program Coordinator. Gwynn was named the Missouri Rural Health Champion for 2015 by Missouri Department of Health and Senior Services for her work with palliative care.

Keeping blood sugar controlled on a normal day can seem difficult and even stressful. Add the extra anxiety of holiday planning, travel arrangements, work schedules, holiday parties and gift-giving, and suddenly blood sugar maintenance feels even harder. Stress alone can raise blood sugar levels – and that’s without those sweet holiday treats! Find a sense of calm and good cheer this season with the following helpful tips:

1. Adjust expectations

No one is perfect. Expecting to eat perfectly, take medicine perfectly and have perfect blood sugar may lead to frustration and disappointment. Relax a little and understand that everyone makes mistakes. Instead of giving in to disappointment, accept grace and move forward – even if it feels like taking two steps forward, one step back most of the time. Remember to celebrate every success!

2. Take one day at a time

Staying healthy over the long term, requires making daily choices to stay healthy. Unhealthy choices add up over time and any short-term satisfaction gained from unhealthy choices can lead to long-term regret. Break that cycle before it starts and find alternatives to stay satisfied. Instead of reaching for the sweets or comfort food in times of stress, find something that feeds the soul instead – like a conversation with a friend, or a good book and a cup of hot tea (unsweetened or with a sugar-free sweetener, of course).  

3. Plan ahead

Before encountering those tricky holiday potluck parties or tempting cookie platters, think proactively. Planning ahead can help reduce stress when facing those tough situations. Pack a healthy snack to share instead of sugary or high-carb treats. Eat before the party or special event. Limit indulgences and take medicine appropriately. Decide beforehand what to tell people who ask about these lifestyle changes. Consider all the options and always keep positive goals in mind. If the plan includes indulging a little, prepare for what may happen in the event of a blood sugar spike.

4. Find support

Keeping blood sugar controlled and making healthy choices can be difficult. Support groups offer the opportunity to confide in others with similar challenges and struggles. Sometimes disappointment can lead to anxiety and even depression, making it difficult to eat well and take medications consistently. Speak to a mental health counselor who can listen and provide help.

About the author

Bethany Doak, RN, is a Certified Diabetes Educator for Freeman Diabetes Education. Having lived with type 1 diabetes since the age of 5, Bethany’s diagnosis inspires her every day to help others live well and take control of their health. Freeman offers a monthly Type 2 Diabetes Support Group and a quarterly Type 1 Diabetes Support Group for those living with diabetes, their families and friends. For more information on diabetes care, visit freemanhealth.com/diabetes.