“One person caring about another represents life's greatest value.” – Jim Rohn, author and motivational speaker

During this season of giving, I often think about those across the country who are providing long-term care to a family member. The Centers for Disease Control and Prevention reports that an estimated 21% of households in the United States are impacted by caregiving responsibilities. The report shows that caregivers have difficulty finding time for themselves (35%), managing emotional and physical stress (29%), and balancing work and family responsibilities. Many caregivers do not get adequate sleep or physical activity. They don’t take the time to see their own doctor or get their own preventive screenings. Caregiving can be emotionally taxing, resulting in abuse of alcohol tobacco, or other drugs to deal with stress and depression.

Caregivers – give yourself the gift of self-care this holiday season! Try these tips:

• Care for yourself first. Imagine yourself on a plane that is experiencing turbulence. If the oxygen mask falls down, you are instructed to put it on yourself first so you can help others, including your children. When you take care of your needs first, you can more effectively help your loved one.
• Accept help when it is offered. The next time loved ones offer to help, let them do so! Make a list of responsibilities that others could help you complete, such as picking up groceries or prescriptions or staying with your loved one so you can take a 15-minute walk. Call someone who has asked to help in the past and take him or her up on the offer.

If you are not a caregiver but know someone who is, give him or her a call or stop by and donate your time. What better way to celebrate the holiday season than by truly giving to others?

Keeping a personal health history is important. Not only can it save you time and money by avoiding unnecessary tests and procedures, it could also save your life.

Keep a card or sheet of paper in your purse or wallet with the following information:

Past medical history: Include all diagnoses that you've received from a medical provider such as high blood pressure or thyroid problems. Also include any history of stroke and record of childbirth. No problem is too minor – for example, knowing that you have dental decay is important because cavities can increase risk of heart disease.

Past surgical history: Include minor procedures such as cataract removal and colonoscopy/endoscopy as well as major procedures such as hysterectomy, cardiac stents and gallbladder and appendix removal. By knowing what has been done, you can help avoid unnecessary tests such as a gallbladder ultrasound for abdominal pain when you've already had your gallbladder removed.

Family history: Include important things such as diabetes, heart attacks, stroke, cancer and thyroid disorder. Also include inherited diseases such as muscular dystrophy or cystic fibrosis because these can give doctors clues to diagnoses that are not initially considered.

Prevention services: Include dates and results of last Pap test, mammogram, PSA, colonoscopy and bone density testing. This can also help you avoid redundant testing and enhance prevention of life-threatening diseases.

Medication allergies and intolerances: Include a list of medications that you cannot tolerate and be sure to list the reason why you cannot take each medicine. In some cases, the drug "allergy" may actually be an intolerance, and knowing this could save your life if a certain medicine is needed to treat a disease, such as a drug-resistant bacterial infection.

Current medications: Include dose and frequency, reason for taking medicine, how long you have taken the medicine (months and years), name of the prescribing physician and your pharmacy name and phone number.

Contact numbers: Include the name and phone number of your emergency contact person, the person who has your power of attorney, and primary care physician. If applicable, be sure to include your advance medical directives, which may include instructions such as "do not resuscitate" or "do not intubate."

Having this information available makes check-in easy with each and every doctor visit. Additionally, having it accessible in your wallet or purse could save your life in an emergency situation. If you need help composing your health history, ask your family doctor for help; he or she should be able to provide you with needed information.

In the United States, approximately 6.5 million people are affected by chronic wounds (wounds that fail to heal) each year. As a wound healing expert I am often asked, “Why do some wounds heal without any trouble and others not heal?”

Several factors determine whether a wound will heal or not:

• The wound must get adequate blood supply
• The wound must be free of dead tissue
• The wound must not have any active infection
• The wound should be managed with moist healing techniques

If all of the above criteria are met, then the wound should eventually heal. If you have a wound that has not healed completely in 2-4 weeks, we would consider it a chronic – or problem – wound that needs specialized care.

If you have a problem wound, I encourage you to call and make an appointment at Freeman Wound Care. No referrals are needed. To make an appointment, call 417.347.4800 or request an appointment online.

For good mental health, it’s important to anticipate reactions to the anniversary of a traumatic event. For children, the timing can be about a specific date something happened (for example, May 22, 2011), a key event that happens on an annual basis (a birth date or specific holiday) or seasonal (visual cues in nature or decorations people may use during the time frame). The anniversary of events such as these serve as a strong reminder — it may renew early feelings and spark worries that a similar event may happen in the near future.

Understand that each child attaches his or her own meaning to the original event. Therefore, one child may be more reactive to information or reminders about the event than another. Around the anniversary of a traumatic event, your child may become irritable, anxious, withdrawn or even aggressive.

• Young children tend to express fears at home, such as fears of sleeping alone or worries about the safety of their loved ones.
• School-aged children may acquire new fears because they are imagining worse-case scenarios; everyday situations may now be perceived as risky.
• Adolescents may respond to an anniversary with more reckless behavior and by acting out.

Adults can respond to anniversaries by validating the child’s vulnerability and apprehension. Try saying, “I can see why you feel that way”. Then, let children acknowledge the anniversary in their own way. Some children may express a lot of interest, while others may choose to ignore the anniversary altogether. Don’t force children to either acknowledge or ignore the anniversary.

Be prepared that internally, the children are wondering, “Could the event happen again”? While the answer may be “Yes” you can help by emphasizing the importance of having a plan and being in control of the situation — this helps build resilience and coping skills. For example, be clear about what the routine will be during an emergency. Show your child where and how to use emergency kits. Practice for an emergency during a calm time and reinforce the message that it’s important to be prepared, whether or not an emergency occurs.

Adults can prepare themselves by detecting distress signals from the child. Protect your children from unnecessary exposure to troubling reminders, such as news stories. When your child expresses a concern or worry, respond in a calming and reassuring manner. It may be helpful to talk about current sadness as well as what has gone well since the event.

If the event is disrupting eating, sleeping or physical/emotional well-being, please seek help from a mental health professional.

On the wall in my office, there is a photo of a woman running across the desert. The word DETERMINATION is written at the top, and the quote below reads: “A journey of a thousand miles begins with a single step.” - Lao Tzu. Although these words shared by Lao Tzu, ancient Chinese philosopher and poet, were spoken many years ago, the message still rings true.

The thought of beginning an exercise program may still seem unreachable in today’s busy world. However, please know that getting back to the gym or beginning an exercise routine doesn’t have to be overwhelming. Remember to start slowly – begin with a single step.

If you are ready to start a physical activity program, here are some strategies to help you get moving!

Set specific, manageable goals. You don’t have to begin by running a mile. Instead, you could try going for a walk on your lunch break each day for 20 minutes.

Tell someone about your goals. Your loved ones can help motivate you and help you hold yourself accountable for sticking to your plan. If you have a friend or family member who also wants to get healthy, invite him or her to exercise with you.

Switch it up. To keep boredom at bay, try multiple types of exercise. One day, go for a bike ride – the next time, try swimming.

Reward yourself, but not with food. Once you’ve reached a goal, reward yourself – you’ve earned it! Because rewarding yourself with food can derail your healthy momentum, instead, treat yourself to a nonfood item such as new clothes or a massage once you’ve reached your goal.

What is one of the first things a runner does when he or she is injured? More often than not, the runner performs an online search before seeking care. This search is performed in hopes of learning what is wrong and what can be done to get rid of symptoms. The one thing that is missing from this approach is that the internet typically cannot tell someone why he or she was injured. Sometimes, similar injuries can be caused by very different factors, and seemingly different injuries can be caused by similar circumstances. The internet might be able to tell runners about their injuries, but there is no way of helping them figure out why they were injured in the first place.

Many injuries heal with appropriate rest and care — however they may recur in the future. Research shows the biggest risk factor for injuries is having prior injuries. Even when these injuries occur on different parts of the body, it is likely these injuries were caused by very similar factors if the root of the original problem was never addressed. For example, tight heel cords can lead to injuries in other locations of the body. A person who has tight heel cords may finally get over a case of plantar fasciitis (pain and inflammation of the tissue that runs across the bottom of the foot, connecting the heel bone to the toes) only to develop knee pain several months later.

The question that should always be asked first is, “Why was the runner injured?” In physical therapy, we use movement to help determine this. Many runners often come to our clinic with a variety of different movement problems. Some have too much movement at certain areas of the body, while others don’t have enough. Some have specific muscle groups that are underactive, while others have certain muscle groups that are overactive.

One of the best ways to know if you have a movement problem is to be assessed by a physical therapist. A typical physical therapy evaluation takes about an hour. The evaluation usually involves a full body assessment that looks at overall global movement (e.g., how well someone squats, lunges and balances on one leg) as well as local movement (e.g., how well specific joints move and the strength and flexibility of certain muscle groups).

Video running analysis is another useful assessment that can be performed during a physical therapy examination. Movement problems, which often affect how a person runs, can be detected in a video analysis. This analysis helps your physical therapist get a better understanding of all the factors that might contribute to your injury. Knowing a diagnosis is one thing, and knowing what caused it is another. Looking beyond that initial internet search might just be the key to preventing future injuries caused by the same underlying problems!

Word Pictures

Posted by Dr. Kimberly Fielding

From my earliest memories, I have been an “explainer.” Some people called it long winded and others referred it as a teaching ability. This trait has not decreased as I’ve gotten older. All the earlier descriptions about me can still be true sometimes, and I’ve gained a few additional labels — not all bad. My favorite compliment is from a friend who says I’m the “queen of metaphors.” For myself, I think in pictures and then use words to help communicate my thoughts so others can see what I’m thinking — I call them “word pictures.”

Specializing in children’s mental health, all those metaphors come in handy in my work with children and child-serving professionals. Embarking on the series of blog posts ahead, my plan is to inform and perhaps entertain through these word pictures. Most importantly, I hope you will remember the teaching points and be encouraged to apply them in life — especially to benefit the children in our community. The reason I’m so passionate about helping children can be explained by providing my first blogging word picture: the five-gallon jug!

Most people have seen those big blue water cooler jugs — either at the office or at the water-filling stations in the front of the local supermarket. I see a connection between these water jugs and the way that adults can invest in the lives of children, who start out so empty and dependent. Adults are like a full five-gallon jug, full of resources such as time management, emotional stability, physical energy, spiritual connection, financial potential and ethics. Then, as they invest, or “pour,” into children, adults act as a resource to fill children with the capacity to reach adulthood as five-gallon jugs of happy, safe and healthy citizens in the community.

My blog posts in the near future will elaborate on this metaphor to explore it from various perspectives, all in hopes of equipping adults to better invest in the lives of children. Some examples I have planned involve enhancing the “pour.” Some have to do with clarifying what it is that we are pouring. I prefer to think in “can do” ways, so we can even approach the uncomfortable perspectives of the jug from an encouraging point of view. (By the way, the “can do” is a hint that there is a related metaphor in the wings — the traffic light of words!)

In the meantime, explore one of those five-gallon jugs. Take a look. Reflect. I invite you to check back to see what discoveries may emerge in this metaphor. Our word picture has some explaining to do…

Many have heard the old adage, “You are what you eat,” and perhaps the response, “Then I want to eat a skinny person!” While this is a humorous sentiment, the facts surrounding the joke’s punch line aren’t so funny:

• 65% of Missourians are overweight, which is consistent with the national average
• Employers spend an estimated $73.1 billion among full-time employees on healthcare costs
• Heart attack, diabetes and high blood pressure are health conditions that employers spend the most dollars on and are all directly linked back to obesity

Many people know the basics of proper nutrition: choose lean protein, eat plenty of fruits and vegetables and minimize or eliminate consumption of processed foods. The best way to determine the nutritional value of a food is to educate yourself by reading the product’s nutrition label. Reading and understanding nutrition labels can help you make healthy decisions about what and how much to eat.

Freeman OccuMed clinics performed more than 8,000 physicals in 2013. As part of the physical, we spend time educating the patient on the importance of a healthy diet and how that affects his or her overall well-being. In doing so, we hope to play a part in bringing Missouri’s obesity statistic below the national average.

Let’s decode a nutrition label to help you make more informed food choices that contribute to a healthful diet.

Cooking Flavorful Meals Without Adding Calories

Published: 06/25/2014

Posted by Kris Drake, RN, CHPD

I ran across this quote from Andy Rooney that you may relate to, “The biggest seller is cookbooks and the second is diet books – how not to eat what you've just learned how to cook.”

It may not seem possible to prepare a great tasting meal without adding a lot of extra calories, but healthy meals don’t have to lack flavor. With local farmers markets open, now is a great time to prepare meals with locally grown, fresh produce, which adds both flavor and interest to your meals.

Healthy meals include a variety of fruits and vegetables, which are readily available at a farmers market and naturally low in calories. Choose from a rainbow of food colors to ensure that your family gets the nutrients they need – for example, try tomatoes, beets, carrots, lettuce, spinach, green onions, Swiss chard, radishes, strawberries, broccoli and cauliflower.

You could also try adding a new herb to your recipes to spice things up without adding calories. Culinary herbs such as rosemary, parsley, basil, sage, mint, oregano, lemongrass, mint, fennel and chives are popular herb choices at farmers markets.

Freeman offers a farmers market on Wednesdays and Thursdays during the summer. I hope you will stop by and check out the locally-grown produce.

Summertime brings barbeques, parties and trips, but it can also bring unhealthy foods and habits. The good news is that you can enjoy summer fun and stay on track with your healthy living goals. Try these tips!

Lose excess body weight. Every pound of excess body weight lost improves your overall health. A modest weight loss of 7% can improve your blood sugar and reduce your risk of developing diabetes by 60%.

Become more physically active. Regular exercise is an important component of diabetes management. Your exercise plan should include both aerobic and strength training. Examples of aerobic exercise include brisk walking, bicycling, jogging and dancing; examples of strength training include free weights, resistance bands, pushups, sit ups, squats and lunges.

Watch for added calories and carbohydrates. Pay attention to condiments when eating summer meals. Just two tablespoons of ketchup or relish can add an additional 10 grams of carbohydrates each – for a healthier option, try adding mustard instead. Also, include low-carbohydrate vegetables such as asparagus, summer squash, tomatoes, onions or zucchini in your grilled meals.

Keep carbohydrates under control. Carbohydrate counting is a very effective way to control blood glucose levels and manage weight. Use the diabetes plate method to help plan your meals:

• Place an imaginary line down the middle of a nine-inch dinner plate.
• Divide one side in half again so you have three sections on your plate.

• Fill the largest section of the plate with non-starchy vegetables such as broccoli, cauliflower, spinach, carrots, tomatoes, green beans or cucumbers.
• Add lean protein such as skinless chicken, turkey, beef, fish, eggs, tofu or low-fat cheese to one of the smaller sections of the plate.
• Add starchy foods such as pasta, rice, potatoes, peas, squash, beans/lentils, grits or tortillas to the other smaller section.
• Add a serving of fruit or dairy and a low-calorie drink to complete your delicious and healthy meal.