Ben Mendola was praying for a heart attack. His marriage had ended, he’d lost his home and despite surgery, chronic pain continued to chip away at his happiness and health.

“I was a pedestrian in a motor vehicle accident. I’ve been in pain for the last six years,” he said. “First I was prescribed hydrocodone with physical therapy, and then morphine for four years. But everything was temporary, like putting a Band-Aid on a shark bite. I couldn’t focus at work and I was afraid I’d get fired because it just wasn’t working for me.”

And neither was the Xanax he was soon prescribed. One morning before work, Mendola’s daughter found him passed out on a bedroom floor. “That was it. I quit cold turkey and went back to work…but everything came back. Because I have a degenerative disc disease, doctors told me I couldn’t have another surgery. It got so bad, I was praying for my life to be over.”

Mendola’s doctor referred him to Dr. Deborah Kukal, lead psychologist with Mercy’s multidisciplinary pain management program in Springfield. Nearly 20 years ago, Dr. Kukal was part of a team that saw a growing need for specialized physical therapy, and looked at pain management from a new perspective. “If someone gets an injection or surgery and it fixes their problem, great. Move right along. But so often that’s not the case,” she explained. “So often it turns to this, then that, and another thing, until you’re falling down a rabbit hole and don’t know your way out.”

Today, Dr. Kukal is one of three chronic pain psychologists who lead intense, six-week group sessions that include two six-hour days a week. “We do meditation, guided imagery, relaxation techniques, and breathing exercises – all to teach the brain how to calm down and reorganize perception,” she said. And it has paid off for more than 1,200 people who have traveled from across the Midwest to learn about chronic pain management at Mercy. “We are pretty rare. It’s very integrated and very intense. We are going to work with you and give you all our time and attention. Some people stay all night in the hospital because they come from two hours away.”

The most common patients have fibromyalgia, post-laminectomy syndrome (also known as failed back syndrome), chronic low back pain, complex regional pain syndrome or even headaches. “But it turns out the biggest hurdle is the fear to join us,” said Dr. Kukal. “People think they’re being sent to a psychologist, therefore everything must be in their head, but that’s not true at all. That’s why I always ask them what’s in their head. It’s their brain! It’s not mind over matter. It’s mind and brain interacting for the sake of your body.”

Pain doesn’t just hurt; it can even cause the brain to shrink and age. A study in the Journal of Pain showed that women with high levels of pain from fibromyalgia had reduced brain gray matter – which controls sensory perceptions like decision making, self-control and memory – and their brains appeared to age rapidly. However, the same study found that patients undergoing treatment similar to Mercy’s multidisciplinary pain management program recovered significantly and built back gray matter while experiencing more control over pain.

“They begin to think more clearly, and they can function better in their everyday life,” added Dr. Kukal. “With patients who have learned to experience more control over what’s going on with their body, and react with ways that are supportive, we have found that their all-cause emergency room visits drop 90 percent. They don’t need to go as much because they can manage and calm things down.”

After 15 years of living with neuropathy, Cathrine Rhodes of Climax Springs, Mo., knew something had to budge. Now she and Mendola are pain management graduates. “It’s truly been a blessing,” she said. “Everyone has been very pleasant and helpful. Just going into the chapel in the evening after class changed everything around me completely.”

“Of course, I was very reluctant,” recalled Mendola. “I knew there has to be something out there for me. And the information I began getting made total sense. The meditation turned out to be one of the best drugs in my life.” Today, Mendola doesn’t resemble his former self. “I played basketball with my son on Thanksgiving. This was the first time I had a ball in my hand for years. I had a blast. It was fun and didn’t hurt. And that was my main fear after telling him no for months. I know that I’m not cured, but now I know that I can do something about it.”

Mendola is looking forward to continuing his education with eye movement desensitization and reprocessing (EMDR), a process used for soldiers or anyone with post-traumatic stress disorder. He and Rhodes have also signed up for advanced classes.

“We encourage patients to continue the methods they learned in these sessions,” said Dr. Kukal. “Many patients continue on different medications, but they’re not on that spiral where they’re not in control of their body.” Mercy’s multidisciplinary pain management program is also developing a mobile app that allows patients to self-direct based on a series of questions about stress level, meditation frequency or other needs. “The key is to remember that if you always do what you always did, you will always get what you always got.”

To enroll in the chronic pain management sessions, patients must be referred by a physician. “We have many patients who have come at their own instigation,” explained Dr. Kukal. “So ask your doctor if you think we can help. Physicians are very glad to make the referral. It’s valuable support for managing complex patients.” Doctors can call Terri Valbracht, RN, at 820-2170 or 820-6609, for specific information on how to make the referral.

“More people need to go to this class. It changed my life, and it can change theirs as long as they know about it,” added Mendola. “I’m not afraid to go out there and live my life. I can be myself again.”

As temperatures plummet and heating bills rise, people may turn to alternate sources of heat – and that’s prompting a warning from doctors at Mercy.

“Carbon monoxide is a colorless, odorless gas created by incomplete combustion that’s lethal even at low levels,” explained Dr. Kenneth Larson, Mercy trauma surgeond. “While it can come from your regular gas heater, it seems to be more of a problem with space heaters, fireplaces and wood stoves. Symptoms include headache, nausea, confusion, lethargy and finally coma and death.”

According to the Consumer Product Safety Commission, about 170 people die each year in the United States from carbon monoxide (CO) produced by consumer products. To protect your family, remember these three things:

• Inspection - A yearly and professional inspection of all fuel-burning appliances is vital for detecting possible CO leaks that can’t be seen with the naked eye.
• Location - Never use a generator, grill, camp stove, or other fuel burning device inside a home, garage, basement or crawlspace. Locate the device away from doors, windows or vents that might allow CO to creep back indoors.
• Installation - Install a Carbon Monoxide alarm in a central location and on all levels outside of sleeping areas.

Make sure to test the CO alarm monthly. If the alarm sounds, exit the area to a location of fresh air and call for help. Remain there until emergency personnel arrive to assist you.

Mercy will be among six health care organizations to receive an Intelligent Hospital Award at this year’s Healthcare Information and Management Systems Society (HIMSS) conference Feb. 24 in Orlando, Fla.

Given by RFID in Healthcare Consortium (RHCC), a global not-for-profit focusing on the safe and effective use of wireless-based technologies in health care, the award recognizes leaders in advanced technology solutions. Mercy will receive the award in the category of Most Innovative Use Case, reflecting Mercy’s work with Harvard University on a U.S. Food and Drug Administration grant for a Unique Device Identification (UDI) system – a global tracking initiative for implanted medical devices.

“With 8,000 new medical devices flooding the market each year, it’s critical that we find ways to track them so we can ensure better patient safety,” said Dr. Joseph Drozda, Mercy’s director of outcomes research. “We piloted a tracking system in our heart cath labs that harnessed our electronic health record (EHR) to not only track the devices but capture vital research data that helps assess whether devices are working as they should.”

Currently, no such tracking system exists in health care. For millions of patients around the world with implanted devices, from heart pacemakers to artificial knees, a UDI will improve patient safety, identify product problems quicker and better target recalls.

With a UDI label – a scannable bar code – on implanted devices important information is readily available, such as product name, expiration date, reference and lot numbers, manufacturer information, bar code, details and an illustration of the item. Ultimately, a UDI helps improve patient safety, identify product problems more quickly and better target recalls.

Following the success of Mercy’s cath lab pilot, plans are already underway to pilot the tracking system in Mercy’s operating rooms. Besides greater patient safety, the pilot proved other benefits, many of which were unexpected byproducts of the work, and included:

• Time savings for clinicians. Directly increased bedside patient care because the electronic health record automatically tracked device inventory rather than caregivers having to manually track.
• Reduced medical errors, specifically due to the ability to pull expired devices from inventory
• Reduced cath lab labor hours in re-order and inventory management
• Precise knowledge of device location
• Automated manual processes, driving significant savings with inventory management

“A UDI tracking system that is linked globally is vital to patient safety but in order to move this forward, we need further research, a spotlight on the importance of this worldwide and greater support,” said Dr. Drozda, who is also chair of the Healthcare Transformation Group’s (HTG) Research and Development Team – a group of physicians and clinical researchers from Geisinger, Intermountain Healthcare, Kaiser Permanente, Mayo Clinic and Mercy who have joined forces to develop a global UDI system in health care.

The following highlight the importance of better identifying implanted medical devices:

• In the U.S. alone, more than a half million people each year undergo knee replacements, knees being the most frequently replaced joint in the body.
• In 2010, one of the leading artificial hip companies recalled 93,000 artificial hips implanted worldwide. The recalled joints failed in one out of eight patients after only five years. The devices that failed, in addition to requiring a new hip replacement, left some patients with fragments that became focal points for infections, nerve and vessel damage, and led to some deaths.
• Some other widely implanted devices include heart stents, artificial eye lenses for cataracts and metal screws, pins, plates and rods for bone fractures – one of the most common injuries across all ages.
• More than 2.5 million people in the U.S. each year have cataract surgery and more than a half million have heart stent implants. While stents have saved many lives, they can come with complications, including clots and blood-vessel blockage.

Mercy is the sixth largest Catholic health care system in the U.S. and serves more than 3 million people annually. Mercy includes 33 acute care hospitals, four heart hospitals, two children’s hospitals, two rehab hospitals and one orthopedic hospital, nearly 700 clinic and outpatient facilities, 40,000 co-workers and more than 2,100 Mercy Clinic physicians in Arkansas, Kansas, Missouri and Oklahoma. Mercy also has outreach ministries in Louisiana, Mississippi and Texas. 

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For the third time, the USDA has awarded Mercy a $382,748 grant which will ultimately provide greater access to health care in some of Mercy’s most rural communities in Arkansas, Missouri and Oklahoma.

“Almost half of the communities Mercy serves in our four-state geographic footprint are in some of the most remote rural areas,” said Dr. Tim Smith, vice president of Mercy Research. “These residents don’t have access to the level of care found in larger cities, and in some of these communities, they have no medical care. This grant will allow us to hardwire school districts, medical clinics and one community hospital with telemedicine technology so we can provide round-the-clock emergency coverage, access to hundreds of Mercy medical specialists and even greater access to primary care.”

The USDA’s Distance Learning and Telemedicine Grant is specifically designed to meet the educational and health care needs of rural America. Previously, the USDA awarded Mercy two rural telemedicine grants – totaling nearly $1 million – to improve rural access to health care. With this grant, Mercy will target three school districts, six medical clinics, one critical access hospital, as well as pilot a new concept, Mercy Healthspot Clinic in Geary, Okla.

The new “Healthspot” concept will provide a walk-in medical kiosk that reinvents a visit to the doctor. A medical assistant will help patients interact with a board-certified physician via two-way high-definition audio/video equipment and a variety of medical devices that will stream biomedical information in real-time.

The grant targets needs in communities with populations under 5,000 residents and includes: Booneville, Coal Hill, Mansfield and Waldron, Ark.; Ava, Mountain Grove and Shell Knob, Mo.; Geary, Healdton and Stilwell, Okla.

“If you live in Shell Knob, Mo., and you are pregnant and you need specialized care due to a high-risk pregnancy, you have to travel 63 miles one-way to Springfield, Mo., the nearest urban area to see a perinatologist,” said Dr. Smith. “Specialized physicians live and practice in highly populated areas. Communities like Coal Hill, Ark., Mountain Grove, Mo., or Geary, Okla., don’t have the luxury or the resources to provide this level of care. But with the use of high-tech, powerful cameras providing live video, a second grader in Waldron, Ark., 48 miles from the nearest urban area, can be virtually seen by a Mercy doctor at the district-owned clinic in the middle of a school day.”

Some of the grant money will go to Mansfield Elementary School in Mansfield, Ark., Waldron School District Clinic in Waldron, Ark., and Westside High School in Coal Hill, Ark. While the telemedicine equipment will be housed in one place, it will serve schools throughout all three districts. Patients accessing care through the clinics, the hospital in Booneville, Ark., and “Healthspot” kiosk will be “seen” by highly specialized Mercy medical teams, representing primary care and specialty care such as cardiology, perinatology and psychiatry.

“This means access to primary and specialty care unlike anything these communities have seen before,” said Dr. Bob Bergamini, Mercy’s medical director of innovative care.

In 2011, the USDA awarded Mercy a $495,926 USDA telemedicine grant for a three-year tele-home project that provided medical care to 900 people in some of the nation’s most hard-to-reach rural areas. Targeting patients with the most chronic ailments, including diabetes, heart disease and respiratory disease, Mercy’s first grant provided monitoring devices so patients could electronically transmit results directly to their physician from home via computer or telephone line. The second grant, totaling $500,000, provided telemedicine access to 12 hospitals in rural areas.

Mercy’s virtual care program, the driver behind the telemedicine projects, creatively combines people and technology to extend Mercy’s reach and services well beyond the walls of doctors’ offices, hospital campuses and other traditional facilities. By studying the impact of new approaches and then putting new technologies to the test, Mercy ultimately hopes to provide better care through more convenient and lower-cost locations.

Mercy is the sixth largest Catholic health care system in the U.S. and serves more than 3 million people annually. Mercy includes 33 acute care hospitals, four heart hospitals, two children’s hospitals, two rehab hospitals and one orthopedic hospital, nearly 700 clinic and outpatient facilities, 40,000 co-workers and more than 2,100 Mercy Clinic physicians in Arkansas, Kansas, Missouri and Oklahoma. Mercy also has outreach ministries in Louisiana, Mississippi and Texas. 

Mercy’s four-state area is reeling after the abduction and murder of 10-year-old Hailey Owens. She was taken by a stranger while walking near her Springfield, Mo., home. As we all try to come to terms with what happened, parents are also challenged to talk to their kids in an appropriate manner. Mercy Kid’s behavioral health experts have some advice for this situation and other tragedies that may leave kids with questions about their own safety.

1. Avoid watching too much news, and with younger children, turn it off. As Mercy psychologist Dr. Joyce Noble, Ph.D., explains, they may not understand the event only happened once. “The more they see it, the more they think something like this is common. It isn’t. So we as adults need to find out what their fears are and help them make a realistic risk assessment.”
2. Talk to your kids. If you aren’t sure whether they know what happened, ask a general question like, “What was everyone talking about today at school?” If they know what happened, you need to address it. “Provide simple, but honest information,” suggests Mercy psychologist Dr. Angel Gill-Taylor, Psy.D. “There may be things they don’t know or don’t need to know. Just remind them if they have further questions they can come to you, but don’t overwhelm them with too many facts at first.”
3. Realize how important an ongoing dialogue is. Mercy psychologist Dr. Bobbi Craigmyle, Psy.D, has studied sociopathic behavior and says perpetrators usually begin with minor offenses. “Sometimes they practice by being just a little inappropriate with children for whom they are responsible. That way they can deny any wrongdoing and are more likely get by with it.” So tell your children to let you know if anyone makes them feel uncomfortable, even an adult who’s supposed to be in charge.
4. Use this as a time to talk about safety rules.“It can help kids feel more in control if they have a plan in place,” advises Dr. Noble. “Reassure them they’re safe and you will do everything you can to keep them safe, but that they can help themselves, too. Talk to them about running away from strangers who try to talk to them or where to hit someone if grabbed . Remind them to tell you if something happens they don’t feel was right – even if it happened while they were breaking a rule. And create a code word in case someone they know has to pick them up unexpectedly. Tell them not to get in the vehicle unless the person knows the code.”
5. Encourage your child to use creative ways to express their emotions.“They may not have the words to express what they’re feeling,” explains Dr. Gill-Taylor. “So drawing or imaginative play may give them a good outlet.”
6. Keep your routines as normal as possible.“Kids will judge the severity of what has occurred and how likely it is to occur again by how much their routines change,” advises Mercy Kids psychologist Dr. Gahan Fallone, Ph.D. “Things that aren’t safe for kids to do now probably weren’t safe for them to do before this happened. So you can always say, ‘It’s never been safe for you to do that.’”
7. Spend some quality time with your kids. Dr. Fallone suggests an activity that doesn’t involve an electronic screen. “Bake something, color, play a game. Let them know you are there and you care. If they ask why you’re doing this, tell them, ‘I just enjoy spending time with you.’”
8. Do something positive for others. Events like these can often leave us all feeling like the world is a dark and scary place. Do what you can to brighten it. “It’s a great idea to encourage your kids to think of a project that can help spread kindness to others,” says Dr. Noble. “Most communities have multiple non-profit agencies that do work for children in need. Let your kids choose one and make a plan for how they would like to help.”

By ROi's Kathie Woehrmann

McLeod Health, based in Florence, S.C., has signed a strategic supply chain agreement with ROi (Resource Optimization & Innovation), Mercy's supply chain organization.

“McLeod continues to look for ways to be good stewards of health care finances,” explained Dale Locklair, vice president of procurement and construction for McLeod Health. “We recognize the opportunity that exists in the health care supply chain to eliminate waste and capture more savings as we improve the quality of our care and focus on the needs of our patients.”

McLeod Health becomes the second provider in the state of South Carolina to partner with ROi. In September 2012, Spartanburg Regional Health System signed an agreement and continues to benefit from ROi’s strategic supply chain services including the ROi Custom Pack Solutions program, which utilizes a transparent, activity-based pricing model for custom packs containing up to 70 percent of all supplies needed for a surgical procedure.

“We have realized significant savings through our strategic partnership with ROi,” explained Bruce Holstien, president and CEO of Spartanburg Regional Healthcare System. “As more providers collaborate around the supply chain, which makes up a considerable amount of a health care system’s total cost base, we can drive greater efficiencies and make transformational change happen in our industry.”

ROi was founded in 2002 by Mercy, the nation’s sixth largest Catholic health care system.  Today, ROi serves more than 15 partners outside of Mercy, including Franciscan Missionaries of Our Lady Health System (FMOLHS) in Baton Rouge, La.

“McLeod is a recognized leader in the South Carolina market and we are honored to be partnering with them,” said Gene Kirtser, president and CEO of ROi. “Like all providers, McLeod is facing significant market pressure and we look forward to our strategic collaboration in supply chain as we work together to achieve significant clinical, operational and financial results.”

About McLeod Health
Based in Florence, S.C., McLeod Health, a regional presence and predominant health care organization, is dedicated to patients and their families. Founded in 1906, McLeod is a locally owned, not-for-profit institution which features the strength of more than 650 physicians and 6,200 employees, in addition to modern facilities; premier technology; and a dedication to improving the health of people of the community. The 15-county area McLeod Health serves has a population of more than one million.  Visit www.mcleodhealth.org.

About ROi
Based in St. Louis, Mo., ROi believes in the power of provider collaboration to transform health care.  A recognized leader in health care supply chain management through our fully integrated supply chain model, we were founded more than a decade ago by Mercy, the nation’s sixth largest Catholic health care system, and now serve customers across the country who share a passion for supply chain excellence.  As a provider-born company, our insights and goals are uniquely aligned with today's health care organizations, who all must find new ways to provide better care at lower cost.  Visit www.roiscs.com.

About Mercy
Mercy is the sixth largest Catholic health care system in the U.S. and serves more than 3 million people annually. Mercy includes 33 acute care hospitals, four heart hospitals, two children’s hospitals, two rehab hospitals and one orthopedic hospital, nearly 700 clinic and outpatient facilities, 40,000 co-workers and more than 2,100 Mercy Clinic physicians in Arkansas, Kansas, Missouri and Oklahoma. Mercy also has outreach ministries in Louisiana, Mississippi and Texas. 

She’s only 15 years old, but Sophia Greenwalt has raised and given away thousands of dollars in just the past few years. Through a school project, Sophia has supported a teacher with cancer, the Honor Flight program for World War II veterans and the Make-a-Wish Foundation. She was even named the Youth Volunteer of the Year for Missouri, which earned her $1,000 in prize money and a trip to Washington, D.C. - but a surprise diagnosis put an end to those travel plans; she and her family found themselves in need of others’ generosity.

 “We thought she had bronchitis,” said Sophia’s mother, Nettie Greenwalt. “Then we found out it was leukemia.”

The family’s world started to spin out of control. Because of their insurance coverage, they were referred to a doctor four hours away in Kansas City. “We literally lived out of suitcases for eight months,” said Nettie. “I was with Sophia and my husband was with our son. It was such a toll – we are such a close family.”

The battle against cancer was proving tough. The chemotherapy caused a stroke, but Sophia recovered. Then excess fluid made it necessary for her to have open heart surgery. Nettie and Sophia were handling it all, but it was tough without the rest of the family nearby. Finally, a nurse in Kansas City told Nettie she should at least see if they could get care in Springfield at Mercy Kids’ St. Jude-affiliate clinic.

“I knew our insurance didn’t cover Mercy, but I called anyway,” said Nettie. She learned they could transfer Sophia’s care to Springfield without paying more. “I couldn’t believe it. It was such a relief and such a blessing.” Their drive time dropped from four hours to 45 minutes – just in time for Thanksgiving and Christmas.

“It’s so nice to be close to home,” said Sophia. “Whenever I am admitted I’ll get to see my family now and I like the clinic a lot. I especially like the teen room for kids my age. It’s just a lot less overwhelming.”

Despite difficulties with chemotherapy that have led to trouble walking, headaches and vomiting, Sophia’s specialist says she is always smiling and is easy going. “She’s that type of teenager that any parent would wish to raise,” said Dr. Zaher Naji, Mercy Kids hematologist – oncologist. “She is sweet as can be and doesn’t even argue with her mom!”

In fact, her mom beams with pride to be able to say, “The crazy thing is, she’s still raising money for others.” It’s true. Sophia took half of her $1,000 prize winnings and donated it to her hometown’s Thanksgiving dinner, something she has supported for the past three years. “I just felt like I needed to help around Thanksgiving and I like helping out every year,” she explained.

Sophia’s battle against cancer isn’t finished yet, but she’s already making plans for the future. First on the list: she’ll take that trip to Washington, D.C. After that, she’ll turn her focus back to helping others, with the ultimate goal of becoming a pediatric oncologist-hematologist so she can help kids who are just like her.

Most family reunions don’t happen in a hospital hours away from home after a specialized surgery. But for two sisters with new right knees who hadn’t seen each other in years, it’s been a wonderful experience.

Judy Howell works for Walmart in Bentonville, Ark., and was days away from scheduling a knee replacement surgery when she learned that she could have that surgery, with no out-of-pocket costs, two hours away in Springfield. At the same time, her sister, Jan Senkbeil, who works for Lowe’s in Ypsilanti, Mich., had been putting off a knee replacement for three years.

“As soon as I read the email at work that said we could get knee and hip replacements for no additional costs, I texted my husband,” said Senkbeil. “I told him, ‘I’m getting my new knee for free!’”

The benefit took effect on Jan. 1, 2014, after Walmart and Lowe’s joined the Pacific Business Group on Health Negotiating Alliance to enhance the medical care their employees receive while reducing costs. Employees and dependents who are enrolled in the companies’ medical plans are eligible for no-cost knee and hip-replacement surgeries at one of four hospital systems that have been named “Centers of Excellence.” Those included in this first of its kind national COE network are Mercy Hospital Springfield in Springfield, Mo.; Johns Hopkins, Bayview Medical Center in Baltimore, Md.; Kaiser Permanente Orange County Irvine Medical Center in Irvine, Calif., and Virginia Mason Medical Center in Seattle, Wash. Along with no out-of-pocket medical costs, the coverage also pays for travel, lodging and living expenses for the employee and a caregiver.

 “When I found out this took effect on January first, I was on the phone on January second,” said Howell. Meanwhile, Senkbeil started faxing in her paperwork. But the sisters hadn’t told each other about their surgery plans. It took a post on Facebook for them to realize they were taking advantage of the same benefit at approximately the same time. “At first I wasn’t sure if that was her status or if she liked my status,” laughed Howell. They hadn’t seen each other since 2009.

Turns out, the two had the same coordinator and medical navigators making all their arrangements, so they mentioned the coincidence. “That’s when they did some real coordination to make sure we could overlap for at least part of the time,” explained Senkbeil.

The sisters both started researching Mercy Orthopedic Hospital Springfield and the doctors who were assigned to their surgery. They traded notes, and read everything they could get their hands on to make sure this was the best decision for both of them. “When I found out this facility really was one of the best in the nation, I was sold,” said Howell.

Howell had her surgery on Thursday, Feb. 20, while Senkbeil’s surgery took place on Tuesday, Feb. 25. Both are recovering well and looking forward to a better quality of life, which is exactly why the program was designed: to provide the best care while reducing employees’ medical expenses.

Family reunion aside, the sisters agree going away for surgery was actually easier than having it done in their home towns. Mercy arranged everything from transportation to hotel accommodations and medical appointments. “There were no logistics to worry about, other than getting someone to cover for me at work and stocking the refrigerator for the house sitter,” said Senkbeil.

Howell agrees. “I’ve felt like a celebrity! Plus, being out of the home setting allows you to focus on what you’re here for.” Senkbeil added, “At home you do what needs to be done, but this is all about me and I love it.”

Howell works in program management for Walmart’s information system department, and says she knows a good process when she sees one. “This really is a Center of Excellence. They had a vision for what a facility could be and here it is. Plus, they have the right team in place to make it all happen.”

The sisters aren’t only pleased with the program and their surgeries, they have a real appreciation for the employers who made it all possible. “Lowe’s is very forward-thinking, and this is a really great benefit to offer associates. When you give great benefits, you get great employees,” said Senkbeil. Howell chimed in, “Walmart has found an appropriate way to control costs for its associates while making sure the care is the absolute best. I think it’s great.”

After this experience, both sisters think other companies should look into destination medicine agreements. “I think it’s the future of health care in the U.S.,” said Howell. The impromptu family reunion was a great bonus, too. “We got to catch up on the nieces and nephews,” Howell said with a smile.

If you think your children won’t listen to your warnings about drugs and alcohol, maybe they will listen to those who see the effects first-hand.

Mercy is hosting a free forum for teens and parents called, “Straight Talk About Drugs.” It’s set for Tuesday, Aug. 20 from 5:30 to 7:30 p.m. at the Hammons Heart Institute Auditorium in Springfield, Mo. Participants will hear from Dr. Kendra Morrison, a Mercy emergency department physician, and from Officer David Snider with the Springfield Police Department. They have both seen how drugs can wreck – and even end - young lives.

“It’s always difficult to have to put a 15 or 16-year-old on life support because of an overdose and watch the family suffer because of their bad choices,” said Dr. Morrison. “It’s worse when we have to tell them we were unable to do anything and they will have to make funeral arrangements instead of planning for college.”

Officer Snider encourages parents to be active in their kids’ lives and maintain an open line of communication. “Take the time to be involved with your kids and educate them on the bad things they can put into their bodies,” he said.

For more information on the forum, just call (417) 888-8888. Registration is not required, and the forum is free. Refreshments will also be provided.

By Mercy's Tina Rockhold

Surprise! Oranges have more potassium on average than bananas.

“Reach for the orange,” suggests Mercy Clinic’s Dr. Brendon McCollom, a family medicine physician who specializes in sports medicine.

After an intense workout, oranges help replenish potassium and electrolytes. Normal levels of potassium in the body keep muscle cramps at bay, plus help the heart beat regularly, and reduce the risk of kidney stones and bone loss. 

Low potassium levels (hypokalemia) can wreak more havoc than a pain in your backside.  Fatigue, confusion and problems with muscle coordination can also be attributed to low levels of potassium.

While oranges tend to have more potassium, both are good sources of potassium.

Labor Day may mark the end of summer, but there’s still time for tick bites unless families take precautions. 

The end of summer and beginning of fall are a great time for outdoor activities, but that means keeping company with outdoor pests, including those creepy, crawly external parasites known as ticks. Rocky Mountain spotted fever, ehrlichiosis, tularemia and Lyme Disease are common tick-borne illnesses in the Midwest. They can affect kids and adults, although some may have a more potent effect on kids.

Tick bites can lead to rashes, fevers, chills, aches and pains with a severity and duration ranging from mild to serious. Recently, two cases of a new tick-borne illness, the Heartland Virus, made headlines. The virus is characterized by low white blood cell counts, fever, chills and diarrhea.

“The risk of acquiring a tick-borne illness really depends on what type of tick bit you and how long it was attached,” said Mercy Clinic pediatrician Marissa Stock, MD. “If a rash develops at the site where the tick was, or you get a fever in the days or weeks after a tick bite, you should see a doctor.”

Dr. Stock recommends that families take precautions to avoid tick bites. “You can reduce your chances of getting a tick-borne illness by using repellents, checking yourself and your little ones for ticks and showering after being outdoors,” she said. 

These recommendations are from the Centers for Disease Control and the American Academy of Pediatrics:

• Use a repellent with DEET and follow package instructions. Repellents containing 20 percent or more DEET (N, N-diethyl-m-toluamide) can protect for several hours. The American Academy of Pediatrics recommends using a product with less than 30 percent DEET on children. Insect repellents are not recommended for children younger than 2 months of age.
• Do not use products that combine DEET with sunscreen. Using the products together can overexpose a child to DEET and the DEET may make the sun protection factor (SPF) less effective.
• Use products containing permethrin to kill ticks on clothing and outdoor equipment. Permethrin can be used to treat boots, clothing and camping gear and remains protective through several washings. Permethrin-containing products should not be applied to the skin.
• After being outside, check clothing for ticks, and run clothing through the dryer on high heat for about an hour to kill any ticks that might have been missed.
• Take a shower. Showering within two hours after being outside has been shown to reduce risks for Lyme disease and helps wash off unattached ticks.
• Check for ticks after being outdoors.

“If you find a tick, be careful about how you remove it,” Dr. Stock said. “The best way to remove a tick is to use tweezers to grasp the tick as close to the skin's surface as possible, pull it straight out and then clean the bite area with soap and water.”

People can take additional precautions by keeping yards trimmed, deterring wildlife and using bug sprays as directed. Family pets should be on flea and tick preventatives to keep them from tracking pests into the home.

The Centers for Disease Control and Prevention estimates that one in every four deaths in the United States can be blamed on heart disease. Prevention and the development of new treatments are key to our fight against failing hearts.

It’s why Mercy Hospital Springfield is evaluating an innovative device to fight coronary artery disease, which is characterized by blockages of fat and cholesterol in the vessels that supply blood to the heart. Doctors have been treating those blockages in the heart for decades with things like balloon angioplasty and metallic and drug eluting stents, which push the blockages out of the way and restore blood flow.

The latest innovation is a temporary device that eventually dissolves into the body. Absorb is an investigational device that is referred to as a bioresorbable vascular scaffold (BVS). It’s a small mesh tube made from polylactide, a material that’s commonly used things like dissolvable stitches.

“It’s called a scaffold because it’s truly temporary,” explained Dr. Robert Merritt, Mercy cardiologist and the site’s principal investigator in the trial. “It basically evaporates from the body. Since there isn’t a metal stent left behind, patients who need treatment in the future can get another stent. Right now, a patient with several metal stents in one area of an artery may have no choice but open heart surgery.”

This is a randomized study, so patients don’t know if they are receiving a metal stent or the new Absorb scaffold. The trial will enroll approximately 2,250 patients, and researchers will determine the safety and effectiveness of the Absorb BVS as well as how much natural motion may return to the vessel after the stent dissolves. Absorb leaves behind two pairs of tiny metallic markers, which will help doctors see where it was placed.

“If the Absorb scaffold works, it could represent a significant leap in the treatment of coronary artery disease,” said Dr. Merritt.

Absorb was developed by Abbott, which is the first company in the world to begin testing a bioresorbable vascular scaffold in patients in the United States. If you are interested in participating in the study, please call Mercy Medical Research Institute at (417) 841-0250.

It may be the first opportunity some Americans have had to get health insurance, but the Oct. 1 opening of the Missouri Health Insurance Marketplace could be confusing to those trying to access the system for the first time.

Mercy is ready to help. With a $573,000 grant from the Missouri Foundation for Health (MFH), Mercy has hired 17 Certified Application Counselors (CACs). Those counselors will work directly with Missourians to help them understand and choose the most appropriate insurance coverage for their families. They will be available for in-person appointments at Mercy hospitals in St. Louis, Washington, Jefferson County, Springfield, Lebanon and Joplin. To get started, just dial toll-free 1-855-900-4140.

“This effort aligns with Mercy’s values to seek out and put the needs of others first,” said John Young, executive director of Access for Mercy. “We know that many who don’t have insurance put off going to the doctor because they worry they can’t afford it. That often leads to unnecessary complications. Our hope is that we can help people get coverage so they feel comfortable accessing the care they need.”

This grant is part of Cover Missouri, a larger education effort, funded by MFH to expand health care coverage. MFH estimates 17 percent of Missourians are uninsured, and the goal is to reduce that number to 5 percent in five years.  Cover Missouri’s mission is to promote quality, affordable health coverage for every Missourian. The Cover Missouri Coalition, which includes Mercy and more than 160 other organizations around the state, aims to reduce the rate of uninsured Missourians to less than five percent in the next five years. Members work to build awareness, facilitate enrollment and increase health insurance literacy. Along with the grants that fund the CACs, the coalition has an interactive, nonpartisan website: www.covermissouri.org.

While many questions won’t be answered until the marketplace opens on Oct. 1, Young says one thing is clear. “Mercy will be here to guide you through the process and provide the help you need. The initial enrollment period lasts for six months, and we’ll work to get you scheduled with a counselor as soon as possible. Just call our toll-free number to get started.”

Are you tired or hurting all the time? Don’t let chronic health problems drive what you can and cannot do.

Mercy is sponsoring free, six-week workshops across several Ozarks communities to help people manage chronic conditions. Each program, developed by Stanford University by the Patient Education Research Center, will include the following goals:

• Improve your knowledge of living a healthy life with a chronic condition
• Identify and learn the latest pain management approaches
• Learn to manage fatigue and stress more effectively
• Find solutions to problems caused by your condition
• Identify ways to deal with anger, fear, frustration, depression
• Discuss the role of exercise and nutrition in chronic disease management
• Learn new ways to communicate with family and friends
• Learn how to form a partnership with your health-care team

Classes will begin April 7 inside room 4B at Mercy Surgery Center (1229 E. Seminole St.) in Springfield, Mo., and will continue every Monday through May 12, from 1-3:30 p.m. While the class is free, you do need to register. Just call (417) 888-6787.

Classes will also be held at St. Agnes Cathedral (533 S. Jefferson Ave.) in Springfield, Mo., every Thursday morning from April 24 through May 29. They’ll run from 8:30-11 a.m. Pre-registration is required; call (417) 888-6787.

In Mountain View, Mo., classes will start Wednesday, April 2, in the Sisters Dining Room of Mercy St. Francis Hospital (100 W. US Highway 60). The 10 a.m. to noon classes will continue weekly until May 7. Call (417) 934-7000 to register and get more information.

The Polk County Senior Center, located at 1850 W. Broadway St. in Bolivar, Mo., will host weekly classes beginning April 3. They’ll run from 12:30-3 p.m. each Thursday through May 8. Call (417) 326-5570 to register.

Classes will also be held Wednesdays from 9-11 a.m. at the West Plains Senior Center (416 E. Main St.) beginning April 23. The workshops will continue weekly until May 28. Call (417) 256-4055 to register.

Classes will also be held at the Mountain Grove YMCA (1 YMCA Dr.) every Thursday from April 24 through May 29. Each session will run from 10 a.m. to noon. Call (417) 683-4409 to register.

The $20 fee for each course has been waived, thanks to a grant from the Missouri Department of Health and Senior Services. Participants will also receive a free book, “Living a Healthy Life with Chronic Conditions.”

The well-known craftsman was shipping his patchwork state by state when a heart attack put his hobby on hiatus. “One day, I didn’t think I was going to live. I came into the kitchen to get a cup of coffee, then sat back down and went limp in the chair. I knew something was wrong.” Mercy’s network of care took it from there, eventually bringing Norris to Springfield for a quadruple bypass.

“They worked with his doctors in Berryville very nicely, sending his blood samples and coordinating his records. It was seamless,” said his daughter, Debbie Hooten. Norris stayed in Springfield for about a month, slowly regaining strength. “But after his surgery, his blood pressure got really low and his heartbeat was irregular, so he needed more monitoring.”

“Of course, I was ready to go home and get back to normal, but I really needed some extra help getting to that point,” said Norris. “I was not going to the nursing home whatsoever, so the folks at Mercy told me I could do some rehab closer to my house, and I decided to stay at Mercy’s Berryville hospital for about a week.” Norris was provided a private room as Mercy staff helped him patch up his strength and rebuild his independence with around-the-clock skilled care. “They were extremely nice and even helped with my exercises. They’d walk me twice a day until I got to the point where I was doing the walking.”

Many others have walked the same path as Norris. Mercy’s skilled care is available for patients who have undergone joint replacements or strokes, or who have suffered various types of injuries. The 24-hour nursing services, rehabilitation therapies and education include:

• IV medications
• Daily injections
• Feeding tube adjustments
• Respiratory treatments requiring adjustments
• Complex wound care
• Physical, occupational and speech therapies
• Patient and family education for new conditions, such as diabetes or colostomy care
• Nutritional counseling

“It’s very good for someone who needs short-term rehab,” said Carolyn Bosshardt, RN-BC, skilled care coordinator at Mercy Hospital Berryville. “If you have someone who is normally at home and not out driving, it’s depressing to end up in a long-term care facility. Sometimes that can make you backslide and not progress.”

Norris was home within days; nurses and therapists made weekly trips to Norris’ home to help with follow-up therapy. “And I’m back to doing what I love. I’m quilting and not just sitting idle in the house. I’m taking care of myself.” He’s already made 20 quilts for the patients in the nursing home next door to Mercy Hospital Berryville. “And I just shipped a baby quilt out to somewhere in Arkansas.”

“We made no mistake sticking with Mercy,” said Hooten. “If you get a Mercy physician and you have everything connected – and they talk to each other – everything is connected and one hand knows what the other hand is doing. That’s what I love about it.”

“It’s a great group of people,” said Norris. “I wouldn’t trade my time with Mercy for a million bucks.”

Skilled care is offered at each regional hospital in the Mercy Springfield Communities. In addition to your physician’s referral, you might need to be in the hospital for at least three nights before being transferred to skilled care. Contact your local program coordinator for additional qualifications, as they may differ based on your insurance provider.

After 17 years of service in Springfield, Mercy pediatrician and president of Mercy Hospital Springfield, Dr. Robert W. Steele, has announced he’s heading home. He’s accepted the position of chief strategy officer at Arkansas Children’s Hospital in Little Rock, Ark. It’s the hospital where his father served as a pediatric infectious disease doctor and where Dr. Steele spent summers doing research in the lab – developing his love for science and medicine.

“I love Mercy, and I have really enjoyed my time here. But when an offer came to work alongside a childhood friend, in a city I consider to be ‘home’ - and where my wife has family - I just couldn’t turn it down.”

During his time as president of Mercy Hospital Springfield, Steele has overseen the opening of the new children’s hospital and the construction of Mercy Rehabilitation Hospital Springfield. “Dr. Steele has been a strong leader and outstanding clinician during his time here,” said Jon Swope, president of Mercy’s Central Region. “He is a strategic thinker who brought so many talents to the organization; his upbeat personality and skill set will be missed.”

Dr. Steele will be with Mercy until May 2. Swope will assume interim duties as president of Mercy Hospital Springfield during the transition period, while continuing his role as president of Mercy’s Central Region. Dr. Alan Scarrow will continue his role as president of Mercy Clinic Springfield, and Jay Guffey will continue to lead as senior vice president and chief operating officer for Mercy Hospital Springfield.

“I will deeply miss my patients and the Springfield community,” said Dr. Steele. “I have enjoyed working with the outstanding leadership team, co-workers and physicians at Mercy, who strive everyday to meet the needs of our patients. It has truly been an honor.”

Are you at risk of having diabetes, heart disease or other chronic conditions? It may be time to “Know Your Numbers,” the focus of two health fairs coming to Mercy hospitals in Cassville and Aurora next month.

The public is invited to attend either event. The first is planned for May 6 at Mercy Hospital Cassville; the second is May 8 at Mercy Hospital Aurora.

Participants can expect free blood sugar and albumin screenings, as well as tests for body mass index (BMI), waist measurement, blood pressure and pulse oximetry, which helps detect heart problems. There will also be balance screenings using Biodex to identify fall risks.

The following reduced-cost lab screenings will be offered:

• Comprehensive health panel (complete metabolic profile, lipid profile, complete blood count), $15
• PSA Test (prostate cancer screening), $5
• Hgb A1c (average blood glucose), $5
• EKG (heart screen), $10
• PFT (lung screen), $10
• TSH (thyroid test), $5

“If detected early, a lot of conditions could be prevented,” said Judy Carver, certified diabetes educator and registered dietitian. “So this event is also educational on how to live a healthier life.”

The “Know Your Numbers” health fair Tuesday, May 6, will run from 6-10 a.m. at Mercy Hospital Cassville’s Jack Byrd Wellness Center, located at 94 Main St. The health fair on Thursday, May 8, will last from 6-10 a.m. inside the Carol Morris Conference Room at Mercy Hospital Aurora, located at 500 S. Porter Ave.

No registration is required for either health fair; participants will be screened on a first-come, first-served basis. Also remember to fast for 12 hours prior to having your blood drawn. Healthy refreshments will be provided. For more information, call 417-847-6000 (Cassville) or 417-768-7800 (Aurora).

When Jessica Penrose learned she was going to have her second baby, she called her mom, then they both hopped in the car to tell her twin sister, Andrea Elliott. She thought she was the one delivering a surprise, but her sister had an announcement of her own.

“She said she was pregnant, too! My mom knew and wanted to go along to tell her so she could see the looks on our faces. It turns out we were due within days of each other,” said Penrose.

The two began the journey through their second pregnancies together. “Our pregnancies basically mirrored each others’,” explained Elliott. “We had the same kind of morning sickness and the same aches and pains. So I had someone to call who literally knew how I was feeling right then.”

As their due dates approached, their doctor had an interesting suggestion. “They were both past 39 weeks, so I offered to induce them on the same day,” said Dr. Christina Litherland, Mercy obstetrician/gynecologist. “Instead, they scheduled their inductions on separate days, hoping they could both make the others’ delivery.”

With their first sons, the sisters had been in the delivery room with each other. “Dr. Litherland let us have our husband and each other in the room with us,” said Penrose. Elliott had her first son on July 29, 2010. One year and a day later Penrose had her first son. The cousins have enjoyed joint birthday parties ever since – just like their moms.

When Elliott went into labor early Saturday morning, she called her sister. As the contractions got close enough together, she headed to Mercy Hospital Springfield. Penrose planned to follow a bit later to attend the delivery – but did not plan on what happened next.

“My water broke. Before I knew it, I was headed in to have my son, too.”

With both sisters in labor, Dr. Litherland went from room to room to keep an eye on her patients. “It was just amazing,” she said. Within just a few hours, Andrea and Jeremy Elliott were welcoming little Hampton. His new cousin was on the way just down the hall.

“I actually wheeled down there so I could be in the room with Jessica,” said Andrea. “How often do you get that chance?” About four hours later, Jessica and Brandon Penrose were getting their first look at Dawson.

The sisters can add another joint birthday party to their list of social events, and say while it wasn’t what they would’ve chosen, it turned out just right.

Pictured on left: Jeremy, Andrea and Hampton Elliott. On right: Brandon, Jessica and Dawson Penrose.

Being a doctor in a small town can have a big payoff. Just ask Mercy Hospital Aurora’s Dr. Joseph Bizek, who has decided to retire after 38 years.

Dr.  Bizek, a Chicago native, graduated from the University of Illinois College of Medicine in 1969 and completed his residency at Rush-Presbyterian-St. Luke’s Medical Center (now Rush University Medical Center), where he met his wife. “She’s also from a big city, but we wanted to be farther south where the weather was better,” he said.

So Dr. Bizek set his sights on Aurora, Missouri, where he began practicing in September 1975. At the time, he was fresh off a one-year stint in the U.S. Navy. “They were cutting back in funding and it was the end of the Vietnam War, so I was offered an early release. I took a chance and decided to start a practice in a small hospital.”

As the years went by, Mercy Hospital Aurora (then St. John’s) continued to grow, adding more family practitioners. “In the early 80’s, we built the facility we have across the street from the hospital, which Mercy bought about a decade ago,” added Dr. Bizek. His family also grew. “We built a home just south of Aurora in 1980 and we’ve been there ever since. Our three kids all went to Aurora schools and now we have grandchildren who are active in the Monett community.”

During his time with Mercy, Dr. Bizek offered a variety of services, including endoscopies, gynecological and laparoscopic surgeries and c-sections. By the fall of 2013, he’d been doing outpatient surgery part time, but he decided it was time to move on. “I’m going to miss the relationships I had with the people I worked with in the operating room,” he said. “There’s a special relationship with them. You can talk with them in ways you can’t with people outside that setting.”

So what is his advice for new doctors? “Don’t be afraid to practice in a small town. Don’t rule out that possibility. It can be very rewarding.”

To help Dr. Bizek celebrate his time with Mercy, a retirement reception will be held Friday, May 30, from 1:30-3 p.m. in the Carol Morris Conference Room at Mercy Hospital Aurora. The hospital is located at 500 S. Porter Avenue. Refreshments will be served.

MISSOURI – Pain, tingling and numbness in the feet and balance problems are common health issues for people with diabetes. The symptoms are known as diabetic peripheral neuropathy and can be serious if ignored.

As diabetes diagnoses rise, more people are suffering from diabetic peripheral neuropathy, a condition that leaves many vulnerable to falls, foot injuries and even limb amputation. It can occur whether a person has Type 1 (juvenile) diabetes, or the more common Type 2 (adult onset) diabetes.

“The majority of people with uncontrolled diabetes will eventually have at least some symptoms of peripheral neuropathy,” said Mercy Clinic endocrinologist Natalya Rukhman, MD. “It’s caused by prolonged high glucose levels in the bloodstream. Over time, the nerve fibers are damaged. The best defense is to manage blood-sugar levels, and that means managing diabetes.” 

While nerve damage is irreversible, people can take steps to prevent further damage. Along with managing blood-glucose levels with medications, weight loss and weight management, a restricted diet and increased activity, people with diabetes should take extra care of their feet and legs.

“People with diabetes should wear shoes, keep toes and feet clean and manicured, and immediately care for cuts and scrapes to avoid infections,” said Dr. Rukhman. “They should also be screened annually for diabetic peripheral neuropathy to catch early warning signs and try to prevent  nerve damage.”

The Centers for Disease Control (CDC) and Prevention reports that if current diagnosing trends continue, one in three U.S. adults will have diabetes by 2050. The CDC also lists diabetes as the leading cause of new cases of leg and feet amputations in adults unrelated to accidents or injury.

To raise awareness about the serious health issues surrounding diabetes, the Missouri Legislature recognizes the third week of June each year as Diabetic Peripheral Neuropathy (DPN) Week. In Missouri alone:

• As of 2012, 10.7 percent of Missourians were diagnosed with diabetes
• From 1999 to 2009, diabetes prevalence in Missouri increased by 43 percent
• Approximately half of all diabetics have DPN

Risk factors for diabetes include advancing age, obesity, family history and inactivity. Ask your Mercy Clinic physician if you might be at risk for diabetes or diabetic peripheral neuropathy.