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KODE Medical Focus: Change Aspirin Guidelines

KODE — Countless patients worried about their heart health have been taking a baby aspirin daily as a step toward prevention.

But the guidelines about who should and should not be taking that are changing.

“You know, taking a baby aspirin a day keeps the cardiologists away,” said Dr. Robert Stauffer, Interventional Cardiologist.

So the saying has gone, but Dr. Robert Stauffer says that was before the experts weighed the risk to benefit potential.

“I think we know a lot more about it now, not as benign as we thought it was. And, may actually be one of the drugs that causes the most bleeding of all the anticoagulants,” said Dr. Stauffer.

So if you don’t have coronary disease or are generally at a low risk, he says it may be better to skip the medication, especially for elderly patients.

“The highest bleeding risk, but you know, anybody probably over 60. Some are more high risk than others, but for anybody over 70, the warning is to probably not take that unless you have a definitive reason for that such as an underlying stent, cardiovascular disease, bypass valves, that kind of thing. Between 40 and 60, there may not be as much risk but the benefit may not be that great either,” said Dr. Stauffer.

He adds if you’re unsure, consult your doctor.

“If you’re a diabetic and you’re at very high risk, or you have elevated calcium scores, a lot of people get these cat scans now that say maybe baby aspirin outweighs the risk of bleeding. If you’re an older woman that’s 85 years old, 82 years old, you should probably get off it,” said Dr. Stauffer.

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KODE Medical Focus: Pre-Diabetes

KODE — Diabetes can cause a host of health problems for a patient. And now growing concern for young patients, as more and more teens are falling into the pre-diabetes category.

“Pre-diabetes is kind of nebulous thing where they say that your body is not handling insulin like it should and so, you’re on your way to being diabetic. And what they’re really talking about is obesity,” said Dr. Paul Petry, Freeman Pediatrician.

The focus is 12 to 19-year old’s whose body mass index falls in the 95th percentile or higher.

Freeman Dr. Paul Petry points out that takes a tolls on your body.

“Things are happening on the microscopic level in your body that you’re not aware of. Things are happening to your blood vessels. Things are happening in your brain. And eventually it takes a toll and you may be 40 or 50 before it really catches up with you,” he said.

The goal is to identify the problem and help patients make changes while they’re still young.

“It’s not one thing. It’s how this interaction of your genes and your body and you and your brain responds to your environment and the foods you have. And it’s very complex. It’s not easy. It’s not calories in and calories out. It’s much more complex than that,” Dr. Petry added.

He says it’s a good idea to minimize processed convenience foods and focus on nutrition goals like five servings of fruit and vegetables a day.

“By the way, diet sodas are not good for you and they are not a weight loss tool. Water and water and then try to eat three meals and a couple snacks a day. Watch your portions and I think the biggest advice, the best thing you can do for yourself and for your family for your kids is to plan ahead,” he said.

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KODE Medical Focus: Cartilage Regeneration

KODE — One out of four adults suffer from chronic knee pain, according to the National Institutes of Health.

Many of those patients could benefit from cartilage regeneration surgery.

“So basically if someone has knee pain, what we do is evaluate them with an MRI. And sometimes we discover that they have a problem with their cartilage, which is the surface of the knee joint,” said Dr. Thomas Sanders, Orthopedic Surgeon.

And when there’s a problem with cartilage, that patient may be a candidate for cartilage regeneration surgery.

“We take a biopsy or a sample of their cartilage cells. We take those cells, we send them to one of our labs, and they grow those cartilage cells. So that at a second surgery, we can go back in and replace and regenerate that damaged cartilage with their own cartilage cells.”

After surgery, it’s up to those cartilage cells to grow.

“If the cartilage cells grow successfully, which happens about 90 to 95% of the time, it’s almost as if the injury never happened in the first place,” continued Dr. Sanders.

It’s a big improvement from earlier options.

“Previously, what would happen is you may have surgery, they may smooth out the damage but there was no way to to reverse it. Then came using cadaver cartilage, cadaver tissues to go in and replace that cartilage now we know that tends not to last as long because it’s a graft or donor tissue.”

The procedure works best on patients with a specific area of damage, but not general cases like arthritis.

“The goal of this surgery really is to restore the knee and specifically the cartilage back to where it was before the injury,” Dr. Sanders said.

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KODE Medical Focus: Stop the Bleed

KODE — We’ve all had to rush for a band-aid to deal with a cut finger or scraped knee. But sometimes the bleeding is much more serious, prompting a call to 911.

You can help jumpstart treatment if you’re trained in what’s called “stop the bleed.”

“Any way that you can prevent blood loss you prevent someone from going into shock,” said Dr. Kevin Christian, Freeman Surgeon.

And Dr. Kevin Christian adds excessive blood loss can lead to the loss of an arm or leg, or even a patient’s life. And that’s where the “Stop the Bleed” campaign can make a huge difference.

“What can you do in that emergency setting, to control bleeding, to be able to buy time to get someone to a hospital or a higher level of care where that can be more appropriately addressed?”

There are three primary steps, starting with knowing when to step in. And that includes calling 911.

“You see a car accident happen, somebody’s bleeding. You we want you to be able to act, we want you to go ahead and apply pressure to that wound,” said Susan Garrison, Freeman Ed. Coor.

But just applying pressure may not be enough.

“We’re going to pack that wound. If it’s a deep wound we want to pack that with some gauze and then again continue to apply pressure,” added Garrison.

A serious injury to an arm or leg may call for a tourniquet.

“They may not have an actual tourniquet available. They may need to go and get if they have a belt on take a belt off, take a shirt off, wrap it around the leg, whatever we need to do to apply something that stops the blood flow to that site. So you’re going to put that above the site of the womb to stop the blood flow down from the whether it be a leg and arm you’re going to stop that blood flow at that point,” Garrison said.

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KODE Medical Focus: Well Child Exams

KODE — When your child is sick, you’re probably hoping to get them to see their doctor ASAP. But when they’re healthy, it’s still important to stay in touch.

“They’re so important. First of all, it lets me know what your kid looks like when they’re healthy and what their baseline is. This is their medical home and a pediatrician needs to know how your child looks healthy,” said Dr. Beth Garrett, Pediatrician.

And it might just catch a problem before it’s serious.

“Things like hernias, we may catch developmental disorders we may catch height growth issues, weight issues. We catch a lot of depression and anxiety right now. Parents also bring in questions during those times may have issues with asthma and allergies,” she said.

It’s also a good way to stay current on vaccinations and update baseline conditions.

“I’m always looking at a child’s coloring, how they’re acting. Are they acting fatigued from how they normally act if they’re normally coming in here and they’re very active, when they come in and they’re really acting very tired.”

The frequency of wellness visits will depend on a number of factors, including your child’s age.

“In the first couple years of life, we’re seeing kids very frequently and we are watching those developmental milestones and looking at developmental scales and asking parents a lot of questions is your child doing this, this and this, and really, from the first newborn check, and through ages six and seven until we switch the focus more into like emotional, we are asking all kinds of developmental questions to make sure that kids are meeting their emotional development, their physical development, their social development,” said Dr. Garrett.

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KODE Medical Focus: Seasonal Allergies

KODE — It’s that green film covering your car — or sometimes a nearly invisible cloud of pollen hovering in the air. Springtime can be tough for patients with allergies.

“You can all see the tree pollens blowing everywhere. It’s not going to start covering the cars,” said Dr. Nathan Box, Allergy Specialist.

And for some allergy sufferers, that can mean itchy, watery eyes, sneezing and a runny nose.

This time of year, tree pollen is to blame.

“So you want to go ahead and you take in anti-histamines such as Zyrtec, Allegra, Claritin, Zyzal before you’re gonna go out about half an hour before you go outside to go enjoy the outdoor weather,” continued Dr. Box.

Those over the counter medications will help with many moderate cases of allergies. There are other options when that’s not enough.

“My biggest suggestion and recommendation for people, especially nasal allergy sufferers. The best medication class out there is by far and away topical nasal steroid sprays such as Nasacort or Flonase. And you can buy those over the counter also without prescription it’s a two to three puffs each nostril once a day.”

If your symptoms are severe, you may want to consider immunitherapy.

“People who need to come to my office for allergy skin testing, and allergy shots or people that their allergy symptoms just aren’t relieved by the over the counter medications such as antihistamines that you take by mouth or nasal steroid sprays. It’s where they’re really affecting activities of daily living,” said Dr. Box.

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KODE Medical Focus: Sciatica

KODE — You’ve probably heard of, or dealt with sciatica, but knowing the difference from hip pain and how to treat it can be tough to pin down.

“Sciatica is a term that refers to pain felt along the path of the sciatic nerve, which is the main nerve that supplies the leg. It can be irritated a variety of ways typically. And people will typically feel that pain in more of the buttock or gluteal region that radiates down the back of the leg,” said Dr. Thomas Sanders, Orthopedics.

The top cause is the irritation of those nerves coming from the spine itself.

“Most commonly, it’s coming from the back you can have arthritis or a bulging disc that irritates those nerves But if you have another joint problem, a hip problem or knee problem that can change the way you walk in such a way that it irritates that nerve enough to cause pain.”

Confirming the cause is key to feeling better.

“The main thing is finding that source of the pain and identifying it and then placing our treatments around that area,” added Dr. Sanders.

Which can vary.

“So generally the best treatments for sciatica are anti inflammatory medications, sometimes a steroid injection in the back can be very helpful.”

But before that, think prevention.

“Having strong abdominal muscles and lower back muscles helps support a healthy spine alignment which can help reduce the pain from sciatica,” said Dr. Sanders.

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KODE Medical Focus: Sexual Assault Program

KODE — April marks “National Sexual Assault Awareness Month.”

This year, the focus is on the risks that start online.

“In this case, she had befriended someone in a chat room. She was lonely,” said Gretchen Tyree, RN, Freeman SANE.

But Freeman Nurse Gretchen Tyree said in that case, it led to contact in person, in a motel room.

“This is a common story of drinks being spiked even today because you trust someone. That drink gets loaded and this person has absolutely had no clue what happened to her between then and when she drove herself home,” said Tyree.

Then later to the hospital and a Sexual Assault examination.

That kind of online risk is a big part of Sexual Assault Awareness Month this year.

“One of the things I think is really that’s really important, is that people be very careful about what they post online, about themselves, how much they reveal about themselves and also that they take anything that they find posted online with a big grain of salt because you don’t really know if what that other person is saying or posting is true,” added Karen Scott, RN, Freeman SANE.

They recommend watching out for red flags – like later meeting in person in isolated situations like a motel. Also never leave a drink unattended if you do meet.

“The other thing that we sometimes see is texting, sometimes the perpetrator will text and try to dissuade them or talk or you know, make excuses or you know, so the texting thing is also a factor,” said Scott.

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KODE Medical Focus — Innovative Solutions

KODE — Behavioral health is front and center as Ozark Center kicks off a monthly program to help educate the community.

“Innovative Solutions is a series of educational opportunities, interactive in nature, that really has its focus on the fact that the community has a huge role to play in being able to help individuals overcome whatever challenges they might have, other mental health or substance use nature,” said Del Camp, Ozark Ct. Chief Clinical Ofc.

The goal is both to build understanding of these issues but also to share the resources that are available to help patients who need them. The first session focused on substance use disorders.

“Tonight we talked about, why can’t you just quit and those who suffer from a variety of substance use disorders. It could be the key, the answer to that question couldn’t be the key to support those that we, we think so much about and love in our families and friends,” he continued.

Topics will range from eating disorders and autism to addiction and veterans mental health.

“I think it’s really designed for people who are important to you. So it could be a spouse, it could be a child in your family. It could be a good friend, could be a colleague or co worker,” Del Camp added.

The monthly program will take place on Thursdays from 6 p.m. to 7:30 p.m., generally at Hope Spring or Will’s Place.

For more information follow this link.

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KODE Medical Focus — Rural Healthcare

KODE — Health experts worry a shortage of doctors is growing, a number that could grow to 40,000 or more by 2030.

And those challenges can be even worse in rural areas.

“So we’re a half an hour plus from any major hospital,” said Gary Wasson, Rural Patient.

So Gary Wasson of Anderson is thrilled a new doctor is based in his hometown.

“So to have a family practice doctor that can handle anybody from the baby up to the grandma and kind of do everything there is absolutely wonderful,” added Wasson.

Dr. Justin Dillingham is now working out of the Freeman Clinic of Anderson.

“I’m originally from a small town in Oklahoma. So to me, it feels like going back to where I came from. And I’m already liking it quite a bit seeing people that just live in their daily lives and help them be as healthy as they can be,” said Dr. Dillingham.

He points out a diagnosis for his Anderson cases can fall in a wider range due to the patients he’s seeing.

“Whereas even in a city like Joplin or Springfield, more people are maybe seeing more specialists for each of their conditions instead of one doctor that’s handling more things. So it’s a little higher acuity, I would say complexity, so you wouldn’t expect in a smaller town but a lot of times you Dukes peoples don’t want to drive that far. They can’t drive that far,” added Dr. Dillingham.

But he’s not the norm. The Association of American Medical Colleges estimates a need for 40 to 104,000 more doctors by 2030, with the shortage especially affecting rural areas.

“Practitioners. Yes, sure. Yeah. So generally speaking, rural areas are lacking in available healthcare providers. There’s not a great deal of draw to a rural setting because many providers choose to go into a larger academic setting. And for different reasons, different passions, they decide to go into an area that is greater in resources with medical providers. So the rural community is a challenge in itself in providing health care to an underserved population, but it’s also very challenging to find providers who desire to work in a rural community.” said Renee Denton, Freeman Neosho COO.