Health and Wellness

By Autumn Barrett, PA-C – Sheridan Memorial Hospital Internal Medicine

October 2019

Your body, like mine and everyone else we know, certainly wasn’t made to last eternity… obviously. However, there are steps that can be taken to help with the nicks and pains that come up as we get older. Being proactive about osteoporosis can certainly help with that pain later in life.

The basic definition of osteoporosis (“porous bone”) is the decrease in bone density and bone quality. Bones are active tissue, which means they constantly break down and rebuild themselves. Up until about the third decade of life, the body is building bone faster than it is breaking it down; then this slowly declines after about age 35. With osteoporosis, however, the regeneration of new bone does not keep up with the rate at which bone is breaking down. Over time, bone quality and strength degenerates. Bones become weak and brittle, leaving individuals more susceptible to a fracture (broken bone.) In fact, when osteoporosis is present, a fracture can occur without a major fall or trauma, sometimes just by sneezing, coughing or carrying groceries.

Osteoporosis affects men and women in all ethnicities, but some individuals are at increased risk:

Unchangeable Risk Factors

• Gender: more common in women than men
• Ethnicity: more common in White and Asian populations, less common among Black and Hispanic
• Thin, small-framed body structure
• Age
• Family history

Other Risk Factors

• Hormones: lack of estrogen or being menopausal for women and lack of testosterone for men
• Untreated thyroid disease
• History of bariatric surgery
• Eating disorders, for example anorexia
• Medications: long-term use of oral corticosteroids (i.e. Prednisone)
• Smoking
• Excessive alcohol use, more than 2 alcoholic beverages per day
• Sedentary lifestyle

Fractures commonly occur in the spine, hips and wrists. Generally speaking, there are no obvious signs or symptoms associated with osteoporosis until a painful fracture occurs. However, osteoporosis can be found as part of a preventative health screen. Routine screening typically begins around age 60-65 for women and 70 for men unless other risk factors are present. So, if you have increased risk for osteoporosis, it is important to talk to your primary care provider to see if screening should be considered earlier.

The most common test for detecting bone loss or diagnosing osteoporosis is a DEXA scan or bone density test. The scan consists of a low-radiation x-ray, most often to the spine and hip area. (DEXA scans are available at Sheridan Memorial Hospital by order from a medical provider.)
There are a number of medications used in the treatment of osteoporosis. Bisphosphonates such as Fosamax (Alendronate), Actonel (Risedronate), and Boniva (Ibandronate) are the most common. In the usual five-year treatment plan, these medications help stop bone breakdown, thereby increasing bone density. Side effects may include abdominal distress (pain, nausea, diarrhea, ulcers) and on rare occasions osteonecrosis of the jaw (rare but serious condition when cells in the jaw bone die). Depending on the medication chosen, risk of fracture can be reduced by 30-50%. Medications in this class can be taken orally or given by IV infusion.

Another medication used for treatment of osteoporosis is denosumab (Prolia). This injection stops bone breakdown. Fracture reduction with this medication can be up to 70%. It is administered every 6 months by subcutaneous injection, which ideally may alleviate gastrointestinal side effects often seen with oral options. Osteonecrosis of the jaw still remains a possible side effect.

In select cases, hormone therapy may also be considered.

To prevent osteoporosis, it is important to maintain a healthy and nutritious diet with adequate amounts of calcium, vitamin D and protein. Vitamin D is necessary to help the body absorb calcium from the diet. 1200-1500mg of calcium is recommended (from dairy products or supplementation if necessary) and 800-1000IU of vitamin D3 per day. Individual recommendations may vary. Weight-bearing activities such as walking and resistance training (weight lifting) are important to delay osteoporosis. 30 minutes of physical activity on most days of the week is ideal. Avoidance of smoking and minimal alcohol use will help prevent the development of osteoporosis. Also, chronic use of ibuprofen or naproxen can contribute to bone loss over time, so use these medications sparingly.

Please review your risk factors for osteoporosis with your primary care provider. It is an important part of preventative health maintenance for your long-term benefit.

September 2019

This month we have selected the entire Home Care / Hospice Team as our “Employee of the Month.”

Teamwork is strong in the Homecare / Hospice Department at Sheridan Memorial Hospital. The group has developed an ability to work together toward a common vision… “Alone we can do little, but together we can do so much.” Two years ago, several staff members decided that they would participate in the hospital’s “Maintain Don’t Gain” challenge. The result of that first challenge prompted the development of a very strong team atmosphere. They began meeting in the mornings to walk, joined other team challenges, shared recipes and health information with one another, and continue to encourage one another to stick with their personal goals.

As a team, they have become very competitive and want to win in Wellness. They are a team from start to finish and each of them take that commitment seriously. Home Care Manager, Ann Aksamit encourages each one of them to vow that even if they don’t take a lunch break, they need to go for a walk and regroup to be ready for the afternoon. Their break table is now filled with fruits and vegetables rather than cookies and cakes.

Each of them find motivation in different ways. Shannon Stellingwerf and Casi Morgareidge not only want to be good examples for their kids, they want to actively participate in family activities in a fun and enjoyable way. Jacki Cornell has seen the muscle strength she lost come back and feels better physically, mentally, and emotionally. Ginette Aasby rides her bike to work and Jill Hegy is motivated by her girls and walking her 11 year-old blind dog every day.

Changes in their lifestyles have happened over a period of time. Jill has a saying tacked on her mirror that she reflects on daily. It reads, “If you think you want to be healthy for the rest of your life — today is the first day of the rest of your life.” Don’t wait for tomorrow, start now. Shannon, can proudly say that she has lost 100 pounds by eating less carbs, (especially sugar and soda), watching her portion sizes, and becoming more active. She exercises at least 5 times/week and takes the stairs instead of the elevator. Casi has found success in doing Weight Watchers and walking every day. Jacki has made some major changes in her food choices and she and her daughter Micah Cornell, who works in the IT department, exercise on a regular basis. Most importantly, she takes time in the morning for reflection and meditation.

Advice from the Team…

• It is the power of choice that enables us to make positive changes in our life.
• Be stronger than your strongest temptation!
• Read health and wellness books to get yourself in the correct mindset.
• Take time for yourself – take a walk, bike or run even if it’s only for ½ hour.
• Start somewhere – Start with just ONE small change.
• Set small goals and celebrate yourself when you achieve them
• Let your goal be a lifestyle change by choosing to make better choices.

August 2019

Basketball and running played a major role in Chuck Burgess’ life at Tongue River High School and at the University of Wyoming. He never considered it “working out” because he loved the game.  The motivation was easy and he saw the benefits of his activity in all aspects of his life from an increase in his production levels to an overall wellbeing.

In his early thirties, Chuck was diagnosed with hip dysplasia.  The physician gave him a couple of choices.  He could have surgery or modify his activity. Because he had such a young family, he chose to modify his activity with hopes of putting off surgery until later in life.  No one can fully understand the impact that something like that can have on one’s life until it happens.  He never had to worry about his weight or focus on portion sizes due to his level of activity. 

Chuck is the director of finance and supply chain at Sheridan Memorial Hospital, yet he dedicates a large portion of his time to his kids.  He and his wife have three children and are in the process of adopting another.  You can find Chuck on the sidelines coaching his youngest son in soccer or on the basketball court coaching his oldest son and daughter.  His children have developed a love of sports through encouragement and the great examples that he set before them.

Unfortunately, due to his decrease in activity and increase in family demands, Chuck found that it was not as easy to keep the weight off.  He realized that in order to maintain his lifestyle he would have to make some changes.  Those changes were motivated by two important challenges in his life.  One…he knew he was getting close to turning 40 and most importantly … for every 1 pound he gained, it was like adding 4 weight bearing pounds to his hip.  His goal is to try to hold off having hip surgery for another 10 years.  Therefore, he has chosen to modify his diet by eating clean and cutting back on unhealthy carbs and working out on the elliptical machine making sure that he puts in over 10,000 steps / day. 

His words of advice are to:

• Set reasonable goals and make sure that you hold yourself accountable to them.
• Track your food and activity in My Fitness Pal.  It gives you a very realistic picture of where you are at on a daily basis.
• Get enough Sleep – Sleep is important to maintain your energy levels and to help manage your stress.

The reward comes when you feel better, are happier and less stressedThe most difficult challenge of all is to change negative habits. It can take up to 6 months to make certain changes and when change is hard, we immediately wonder why we should put ourselves through all that pain.  A resource that Chuck uses frequently and has made an impact in his life is a book by Charles Duhigg, called The Power of Habit. “Motivation is what gets you started. Habit is what keeps you going.”

Chuck has used his FitBit and My Fitness Pal to hold himself responsible since 2012.  It allows him to track his activity, calories taken in and the calories burned.  He loves to set up groups to challenge friends and family so they can hold each other accountable to their goals.

July 17, 2019

Written by Sandy Fuller, Wellness Coordinator at Sheridan Memorial Hospital

Are you getting enough water every day?  In the hot summer months, keeping your body hydrated can improve your overall health.

As the temperatures begin to rise, it’s important for you to ask yourself if you are getting enough water each day. If not, it may be taking a toll on your overall health. Keeping the body hydrated is crucial for your well-being but most of us do not consume enough fluids on a daily basis. Drinking water can help with weight loss, disease prevention, increasing your energy level as well as flushing toxins out of the body. Our bodies use water to maintain core temperature, help the heart pump blood throughout the body and increase the functionality of our muscles.

Human beings lose large amounts of water through strenuous exercise, perspiration, and urination. Think of water as a key nutrient that we must continually replace throughout the day.

These are a few additional benefits of staying hydrated:

Improves Physical Performance – Staying hydrated during exercise will help you perform better, have more energy and improve overall endurance.

Promotes Weight Loss – Adequate hydration reduces hunger, can raise your metabolism and is a substitute for higher calorie beverages.

Boosts your Mood – Individuals who consume water regularly tend to have better moods.  They experience less fatigue, confusion and anxiety.

Prevents Headaches – Dehydration is a common cause for headaches and can trigger migraines.  Be sure to stay well hydrated, especially if you are prone to migraines.

Boosts your Brain Power – Studies have shown that people who drink more water can improve their cognitive performance and stay focused on difficult tasks.

The recommended amount of water needed each day varies from person to person depending on how active they are, how much they sweat, the climate, different medications and so on.  The general guidelines have dramatically increased from the old standard of 8 cups of water a day. Now the daily recommendation is that women should drink at least 91 ounces (over 11 cups) and men should drink 125 ounces (over 15 cups) per day.  For most people, water is the best thing to drink to stay hydrated, but non-alcoholic fluids, and fresh fruits and vegetables count as well. It is best to avoid drinks that are high in calories and sugar as well as caffeinated drinks, which act as diuretics and can dehydrate you.

The bottom line is that water is important to every part of your body. Set a goal for yourself and try to consume the recommended levels every day.  It just may improve your overall health.

July 17, 2019

Congratulations to Sarah Sommers, Registered Dietitian for being selected as the July Working on Wellness Employee of the Month! Sarah is a passionate wellness educator, motivated marathon runner, and sets an outstanding example of wellness for her peers and friends.

About Sarah
Growing up, Sarah Sommers had an active and healthy lifestyle. She grew up in Colorado, watching her mother run marathons and watching her dad set records in powerlifting meets. Growing up with that kind of influence motivated her to stay active through her lifetime and to push herself to achieve goals. Sarah played sports and ran recreationally when she was young and became inspired to pursue long-distance running after college. Without the challenge of school work or team sports, running long distance races became the next challenge to conquer. Sarah has run multiple marathons since she started long-distance running. During one race that she was running with friends, Sarah “accidentally” qualified for the Boston Marathon when her friends encouraged her to push on and run ahead of the group. Sarah competed in the 2019 Boston Marathon and finished with a great time.

Setting an Example of Wellness
Living a healthy lifestyle has always been important to Sarah, and it became essential to her to lead by example. She found that asking others to make changes to their lifestyle to improve their overall health was so much easier when she was doing the same. Sarah also shares this passion for staying active by coaching youth soccer and cross country.

Working at a hospital also motivates Sarah to set an example of wellness for her patients. Sarah is a committed member of the Sheridan Memorial Hospital Employee Wellness Committee, and she is a Certified Diabetes Educator Dietitian. Sarah compassionately works to help patients with diabetes and other illnesses establish habits that can reduce their symptoms and improve their quality of life. At times, Sarah’s patients feel hopeless because they can’t control their situation and find it difficult to make changes toward a healthier lifestyle. This is inspires and motivates her to set an example and continually strive to live a healthy lifestyle.

Sarah’s Advice to Others:

1. Start by setting small goals. “Achieving small goals gives you the confidence and ability to achieve big goals.”
2. It’s critical to understand the realistic timeline of your goals. You may be setting a goal that takes a long time to achieve. Accept the timeline and stay diligent.
3. If your wellness goal is weight loss, remember that being active, eating nourishing foods, and having a low-stress life is more valuable than being within your goal weight. You’ll be happier and more confident that you can achieve your goals.
4. If you’re finding it difficult to set goals for yourself because you don’t know what you’re capable of, find a healthy habit that you enjoy and make doing that consistently your goal.

Resources Sarah Loves:
Garmin GPS Watch to track mileage during training runs and races
– I’ll Have Another with Lindsey Hein Podcast 
– Marathon Training Academy Podcast
– Diabetes Self-Management Magazine 
-A motivating group of people that hold her accountable to her goals
-Friends who race with her in marathons

Congratulations to Sarah Sommers for being selected as the July Working on Wellness Employee of the Month!

Congratulations to Kimberly George, RN in Nursery/Women’s Health for being selected at the June Working on Wellness Employee of the Month! Kim is a knowledgeable wellness role model for her peers, friends, and family.

About Kim
Kim is originally from Pocatello, Idaho where she grew up as an athlete playing volleyball, basketball, and tennis. After high school, she studied Exercise Physiology, combining her education with what she loved to do most, be physically active. Kim’s passion for Exercise Physiology lead her to become a personal trainer and health educator at Campbell County Hospital. She didn’t stop there. Over time, she became interested in a career in nursing and ended up at the University of Wyoming studying for her Bachelors of Science in Nursing. Today, Kim works as a nurse in Nursery and Women’s Health at Sheridan Memorial Hospital.

Even though she is thoroughly educated in the concepts of health promotion, Kim is still motivated to improve her personal wellness more every day so that she can keep up with her two young daughters and set the example of what a healthy lifestyle looks like. Kim’s lifestyle is centered on maintaining a healthy mind, body, and attitude.

Balanced Lifestyle
Each morning, Kim starts the day with some Foundation Training to wake up her mind and set her body up to move in the best way all day long. On days when she’s not working hard to take care of patients, she does one of her favorite activities, going to the gym. Kim actually met her husband at the gym, so they obviously encourage each other to stay active and strong. Kim’s focus at the gym isn’t about what she looks like, but about staying strong as well as pain and injury free. At meal times, Kim tries to teach her daughters to have a balanced diet, with lots of fruits and veggies instead of processed foods. Before having kids, Kim struggled with this concept herself, but she tries to stay consistent, and remind herself and her family that eating nourishing foods is beneficial to all parts of the body and mind.

Kim’s advice to others:

1. Instead of saying, “I don’t have time,” say, “It’s not a priority” and see how that feels. If living a healthy lifestyle is a priority to you, you will find a way to make it happen.
2. Watch your habits and not your weight. “Health is not about the number on the scale, but about the majority of your habits. If you have good habits, then a healthy body and mind will follow.”
3. “Try to focus on what you should be eating and not on what you should not be eating. If you’re more focused on what’s going to fuel and nourish your body, it will make eating healthy so much easier.”
4. Moderation! “It’s all about moderation. You can still indulge in things you love, but in moderation.”
5. If you work 12 hours shifts, you don’t have to sacrifice exercise. “Start off by making it your first priority on your days off and then go from there.”

Resources Kim loves:

• Foundation Training has guided exercise videos that you can subscribe to and follow along to help you establish better posture and a mindful attitude. 
• Podcasts – “There are tons of great podcasts about every health topic out there.”
• Food Diary – Keep track of what you eat for 7 days. Then, look at how you can subtract processed, sugary foods and replace them with nutrient-rich fruits and vegetables.
• Exercise Diary – Keep track of your workouts by recording how far you ran, how much weight you lifted, your level of discomfort, etc. so that you can track your progress and success over time.
• Health Professionals – Personal Trainers, Registered Dietitians, online streaming workouts, and your business’s wellness program or committee are all excellent resources to use. “There’s a lot of bad information about health on the information. If you have questions or need help, reach out to a health professional who you can trust.”

If you see Kim around town or at the hospital, congratulate her on setting an excellent example of living a simplified, wellness-focused lifestyle.

May 22, 2019

Congratulations to Jenny Heuck, RN Case Manager for being selected as the May Working on Wellness Employee of the Month! Jenny exhibits wellness and balance in every way.

Jenny grew up in Eastern Montana on a cattle ranch and she lived and breathed cattle ranching until she moved to Sheridan in 2001 to teach nursing at Sheridan College. She retired for a short time but decided to go into nurse case management part time last August.

Jenny grew up in a family that was very physically active, but it wasn’t until she started a family of her own and moved next door to an avid runner that she decided to take up purposeful, daily exercise. She has been running and exercising consistently since then and one thing that motivates her are the words of that neighbor- “there are always going to be days when it is too_____ for a run. It will either be too rainy, too hot, or too early for a run. It shouldn’t be a matter of the conditions, but a matter of when.”
When it comes to nutritional wellness, Jenny shares, “when I think about wellness I think about every aspect. A healthy diet is the most important part for me.”

Jenny maintains a healthy diet by following these words, “Eat food, not too much, mostly plants” from Michael Pollen’s book “The Omnivore’s Dilemma.”

When it comes to mental wellness, feeling creative, involved and satisfaction is of high importance.
“I have made sure to live a satisfying life that contributes to others. Working gives me satisfaction and a happy, healthy mentality. I also love to be part of a community. I believe people are healthier when they have a good support system.”

Jenny certainly has a great support system. Most days her daughter Sarah Jo and son-in-law Cody show up at her door to pick her up for an early morning CrossFit class or to go for a run. She appreciates the support and loves to challenge herself right alongside her family. In fact, she plans to climb Cloud Peak this summer with three generations of family members and the run the Michelson Trail Half Marathon with her daughter. Talk about challenging one another!

Jenny Heuck (left) and her daughter Sarah Jo (right).

Jenny’s advice to others looking to have a balanced lifestyle:

• Be consistent
• Do something every day to promote your personal wellness
• Be physically active every day
• Once you have a goal, don’t stop.
• Keep doing something that you love and incorporate it into your daily life or until it becomes a habit

Some resources Jenny uses to stay well are:

• Map My Run app when she is training for a race or going for a long run
• The book “The Omnivore’s Dilemma” by Michael Pollen

Written by Kristopher Schamber, MD – Sheridan Memorial Hospital’s Internal Medicine Practice
April 17, 2019

A medical appointment is one of the most important interactions a person has in any given day, and most visits are complicated with a great deal of information flowing from the patient, to the physician or other provider, and back. The list below provides important tips to help you prepare for your visit and take an active role once it is upon you, so that you get the most out of the appointment.

• Write down a list of questions and concerns before your exam, and prioritize them.
• Update your doctor on any major changes in your healthcare – recent ER visits, hospitalizations, or medication changes by other providers.
• Bring a list of all your prescription drugs, over-the-counter medicines (OTC or non-prescription), vitamins, and herbal remedies or supplements, including the dose and timing of each dose.
• Ask your doctor or other member of the care team for an updated medication list at the end of your appointment.
• Bring a copy of your advanced directives (living will, power of attorney, POLST (Physician Orders for Life-Sustaining Treatment) form)
• Bring your insurance cards and the names and phone numbers of your other doctor(s)
• Consider bringing a close friend or family member with you.  This person can help to remember questions you had for the doctor, record information during the appointment, and help you remember the information afterwards.
• Speak your mind. Tell your doctor how you feel, including things that may seem unimportant or embarrassing.
• If you don’t understand something, ask questions until you do.
• Take notes about what the doctor says, or ask a friend or family member to take notes for you.
• Ask for written materials related to the issues discussed during your visit.
• Remember that other members of your health care team, such as nurses, pharmacists, physical or occupational therapists and others can be good sources of information.
• Don’t be afraid to call or email your doctor, or use the online patient portal (MySheridanHealth.com).

April 17, 2019

Congratulations to Lisa Mohatt, Physical Therapist at Wyoming Rehab for being selected as the April Working on Wellness Employee of the Month!   

Lisa Mohatt is a Physical Therapist at Sheridan Memorial Hospital’s Wyoming Rehab and is an outstanding example of someone who knows how to maintain a healthy balance in all areas of life. Lisa has been passionate about wellness from a young age. She grew up in Sheridan, playing sports, played basketball during her undergraduate program at Gonzaga, and then finished her graduate studies in Physical Therapy. Even though she was immersed in health science study materials in college, Lisa continues to be a student today, learning how to maintain a healthy, balanced lifestyle for herself and her family.

Lisa’s greatest motivation to be well so she can enjoy life to its fullest. Her four and half-year-old son JP helps her do that. Since she and her husband had their son later in life, she shares, “We knew that he would make us feel older or he would keep us young.” Lisa wants to make sure she can keep up with JP and show him what exceptional spiritual, physical and mental wellness looks like.

Lisa keeps her focus on three central ideals when it comes to wellness:

1.    Spiritual wellness is of the utmost importance to her. Spiritual wellness means that she centers herself with Bible reading, and respects, loves and uses her body as the incredible gift that it is to honor God.
2.    Physical wellness is another focus for Lisa. She consciously chooses to move in a way that makes her body function well for the moment and for the future.
3.    Preventing illness and injury is her third focus. She tries to eat foods, exercise, and rest in a way that will help her enjoy a long, healthy, life.

Lisa’s advice to those interested in living a similar lifestyle are:

–    Set your exercise clothes and shoes out the night before. “This way you can throw your clothes on before your brain even realizes you’re going to exercise,” Lisa says.
–    Schedule your exercise. You have to think of exercise like brushing your teeth. Brushing your teeth prevents cavities. Wellness prevents you from being injured or sick.
–    Listen to your body and your mind for what it’s asking from you. Rest when you need to rest, move when you need to move.
–    Treat your body as your most prized possession. Lisa says, “God gave us this body, and it is something we are responsible for our entire life.”

Some resources that Lisa uses to stay well are:

–   The Bible – It helps Lisa with her spiritual well-being.
–   YMCA – This provides Lisa with lots of wellness activities for herself and her family
–   Community trail system – This is a great place to get outside, enjoy nature and be active.
–   Apple Watch – Lisa says her husband keeps her up to date on the latest tech with her Apple Watch. She likes it because it gives her reminders to get up and move if she has been sitting for too long.
–   Physical Therapy training, books, seminars, etc. to stay current on illness and injury prevention and health promotion.

Congratulations to Lisa Mohatt for being selected as the April Working on Wellness Employee of the Month!

March 20, 2019

To Dr. Addlesperger, wellness encompasses doing a myriad of activities that help you feel good, stress less, sleep better, and connect with others. He says, “Incorporating a healthy lifestyle can have a hugely positive effect on our health. I stay active and eat well to decrease the effects of aging so that I can be healthy and enjoy life to its fullest when I retire.”

Dr. Addlesperger has always enjoyed being active.  When he was young, he aspired to be a professional football player.  It wasn’t until he was older that he realized that no matter how good he was, he was too small to play.  He started finding other activities like climbing, backpacking, skiing, and hiking that he could enjoy and help him stay in great shape.  “I would have people ask me to go climbing or skiing with them and I wanted to be in shape so that I could do whatever anyone asked me to do.” 

Now, Dr. Addlesperger maintains that discipline and commitment are what it takes to stay active and maintain an effective exercise program.  He uses himself as an example.

“If I find myself too busy to exercise, I need to take a step back and assess why I’m not doing it and then figure out how to make it happen.”

He likes to diversify his workouts incorporating climbing, skiing, biking skiing, and even the elliptical machine to keep it fun and interesting. To maintain a good balance, you have to begin making good judgment calls. Ask yourself, “Am I going to work more or do I do what I need to do to stay healthy and more productive?”

Dr. Addlesperger gives this advice:
-Enhance your wellness by hanging out with wellness-minded people
-Say “yes” to wellness-centered activities
-Invest in a good pair of running shoes and a bike, and you’ll be able to go anywhere.

Wellness Goals
His aspiration for wellness has led him to engage in an exciting adventure with his daughter. This summer they hope to start an Organic Farm and eventually turn it into a productive business. “There is a huge demand for locally sourced fruits and vegetables within our community, and we hope that we could encourage the farm-to-table movement with local businesses.”  Flowers are something that they are also considering to help sustain their farm.

Favorite Resources
Favorite wellness book: Younger Next Year: Live Strong, Fit, and Sexy by Henry S. Lodge and Chris Crowley. The book highlights that by staying well you can turn back your biological clock. Dr. Addlesperger jokes, “When you hit 50, and you’re not healthy, life can be difficult.”

Favorite Tech: He loves his Fitbit. “I have a small competition with my daughter.” The two of them keep track of their steps and work just a little harder when one is leading the other. It keeps them motivated and challenged to keep up with the other. “I’ve got to have my data….It gives me the motivation to get up and get out the door.”  He keeps a monthly calendar and marks the days when he is active and when he is not active. “It helps me visualize my accomplishments.”

Congratulations to Dr. Addlesperger for earning the honor of being the Working on Wellness Employee of the Month. He certainly sets a great example for both employees and patients at SMH.

February 19, 2019

By Darrin Goyn, Physical Therapist at Sheridan Memorial Hospital’s Wyoming Rehab.

Parkinson’s disease is a progressive neurological disease. The disease is due to a loss of dopamine, which is a chemical messenger responsible for transmitting signals within the brain. With Parkinson’s, movement becomes slower and smaller over time. The more notable symptoms include hand tremors, slowness of movement, problems with balance, or a shuffling gait. In addition, the voice becomes weaker, and the ability to function in everyday life becomes limited.

There is no cure for Parkinson’s disease. However, there is help for those who suffer from its effects, regardless of the stage or severity of a person’s condition. Treatment for the disease includes medications, deep brain stimulation, and exercise.

Wyoming Rehab uses two evidence-based treatment programs called LSVT (Lee Silverman Voice Treatment) BIG and LSVT LOUD proven to promote strength, motor learning, functional movement and voice quality. The LSVT BIG program improves an individual’s ability to accomplish tasks in everyday life and boosts independence. The LSVT LOUD program enhances the ability to speak at a more normal volume. It makes living with Parkinson’s easier. Another great thing about LSVT BIG and LSVT LOUD is that it is never too late to get started!

LSVT BIG combines physical therapy with a home exercise plan to help Parkinson’s patients regain function. Treatment plans take each person’s individual needs and goals into account. The program focuses on the issues patients face on a daily basis. 

In the physical therapy sessions, we reteach functional movement patterns to accommodate any activity. We train how and when to apply bigger motions to mimic normal body movements. Basic motor skills for self-care, such as the ability to button clothing, get up from a seated position and get in or out of bed becomes easier. Walking and balance improve.

Once a person completes LVST BIG, they can join our LSVT BIG FOR LIFE, which is a community-based exercise group for those people who want to stay active and fit.

Our speech therapist provides LSVT LOUD, the treatment program that improves voice and speech quality. Frequently, people with Parkinson’s may think their voice volume is normal when they may actually be speaking quietly. The LSVT LOUD program teaches the person to know how loud or soft they sound to other people and works to restore their ability to vocalize at a more normal volume.

A person with Parkinson’s will typically not realize their movement patterns are becoming slower and smaller. Family members or caregivers are often the ones who notice the signs of functional limitations. It is best then to seek advice from a medical professional.

Wyoming Rehab offers the full continuum of therapy services:

•    Prehab prepares you for surgery
•    Inpatient rehab supports your hospital recovery
•    Transitional Care assures your return home is safe and successful
•    Outpatient rehab optimizes your function
•    Health and Fitness keeps you going strong

https://www.sheridanhospital.org/medical-services/rehabilitation-services 
Wyoming Rehab: 307.674.1632

February 15, 2019

At Sheridan Memorial Hospital, it is part of our vision for this organization to maintain a Culture of Kindness. From interactions with patients we aid or the community members, we interact with while having lunch; it’s the little things that make a huge impact. February 17th was Random Acts of Kindness Day and we hope you made a conscious effort to participate and acknowledge the small acts of kindness you experience every day.

As the temperatures dropped and the snow piled up, many of us would walk out after an appointment or long day and see the snow all over our cars. While our Maintenance, Facilities and Grounds team does an incredible job of taking care of our lots and sidewalks all year round, it truly is winter when their acts of kindness go above and beyond the call of duty. Daily, our teams were found in freezing temperatures jump starting cars, digging out vehicles that got wedged in just right or helping to push them out of the unforeseen drifts! Along with many other, it isn’t in their job description, but they take such good care of this facility many of us visit every single day.

From the nurses that escort patients and their families outside upon discharge to the friendly patient access staff that will help you grab the door when your hands are just too full, we are surrounded by random acts of kindness every day.

 How you can practice random acts of kindness: 

• Let someone go in front of you in line
• Give a stranger a compliment
• Participate in a fundraiser or make a donation
• Hold open the door for a stranger
• Pay for food or coffee for the person in line behind you
• Shovel a neighbor’s driveway when it snows

January 23, 2019
By Jennifer Graslie, a Physician Assistant with Sheridan Memorial Hospital Big Horn Heart Center

Heart failure is a prevalent disease affecting 3.7 million Americans. It is more prevalent than all forms of cancer combined.  Heart failure occurs when fluid accumulates in the body because the heart is not able to pump efficiently. High blood pressure, diabetes, coronary artery disease, and age can all contribute to causing this illness. Symptoms of heart failure can include fatigue, shortness of breath and swelling. As our population becomes older and more sedentary, we expect heart failure to become more widespread.

Prevention is the most effective measure for counteracting the risk factors that can lead to developing heart failure. There is ample medical evidence proving that a person can lower or prevent such risk factors as high blood pressure, diabetes, and coronary artery disease. It requires maintaining a healthy weight and diet and modifying certain lifestyle habits. If a person already has one or more risk factors, tight control of blood pressure or blood sugar and coronary artery disease can help prevent or delay the onset of heart failure. Even modest weight loss and an increase in cardio-respiratory fitness can significantly improve heart health.

There is some good news for those patients with a diagnosis of heart failure. Many medications, including certain beta-blockers, ACE inhibitors, angiotensin receptor blockers, aldosterone antagonists and Entresto, are producing wonderful results. Patients with heart failure are experiencing fewer symptoms, and some are living longer. Other patients are benefiting from special pacemakers that synchronize the heart, allowing it to beat more efficiently. These special pacemakers can further reduce patient symptoms and improve survival.

When heart failure progresses to an advanced stage or warrants hospitalization, it becomes an identifying marker for patients who will require more intensive follow up care for the rest of their life. As a cardiology office, we routinely see patients with a heart failure diagnosis. In the past year, Sheridan Memorial Hospital implemented several initiatives to improve heart failure care in its clinics and inpatient setting. Our focus is on providing up-to-date medical management for heart failure. The program involves providing in-depth patient education and having patients monitor their weight, blood pressure and sodium intake daily. Patients must also watch for and report these early warning signs: feet and ankles swelling more than usual, breathing that becomes more difficult, or a weight gain of 3 pounds in two days. These signs might indicate that fluid is building up in the body. Early intervention ensures on-going symptom management and overall wellbeing.

With heart failure becoming more widespread over the next few decades, our understanding of how to prevent and treat this disease will also continuously improve.

January 23, 2019

Many people in this community know the name, Mark Ferries and recall him as a fourth generation undertaker with the former Ferries Funeral Home. However, there are fewer who realize he is a competitive team roper. Mark was a latecomer to the cowboy arena; he started roping just 16 years ago after he turned 50. 

“Becoming a cowboy was what I always wanted to do,” says Mark. “I grew up around farming and livestock – we always played at being cowboys when I was little. I had ponies when I was in junior high school. I finally bought my first roping horse in 2000.”

As is often the case with competitive sports involving horses and riders, Mark is no stranger to Sheridan Memorial Hospital’s Emergency Department. His last trip to the Emergency Department involved a serious accident, which occurred while he was starting a three-year-old colt.

Watch the video interview with Mark here.

“I was out working with the colt in the early morning on July 1, 2016,” says Mark. “The colt had been making good progress. I was riding him around inside the round pen when he turned skittish and bucked me off. When I hit the ground, my right shoulder dislocated, and my rotator cuff and bicep were completely torn off.”

At the time of the accident, there was no one around except Mark’s 11-year old grandson who was still sleeping. Fortunately, his wife, Colleen was volunteering in the surgical waiting room at the hospital that morning. Pushed onward by that knowledge, Mark removed tack and saddle from the colt and let all of his horses out to pasture entirely on his own. He then rustled his grandson who got Mark buckled into the driver’s seat and started the truck’s engine for him. Together they made the longer-than-ever-before five-mile journey into town.

By the time Mark got to Sheridan Memorial Hospital’s Emergency Department, his pain was intolerable. Morphine was administered, but it didn’t even faze Mark’s pain. It wasn’t until X-rays were completed and doctors popped the shoulder back in place that he began to feel a measure of relief. Mark’s injury still required surgery.

The anesthesiologist assigned to Mark’s case used an interscalene nerve block under ultrasound guidance with Exparel, a long-acting anesthetic and the most advanced form of anesthesia available today. The use of a long-acting pain anesthetic reduces the amount of oral narcotic medicines a patient would typically receive, resulting in a much more comfortable experience after surgery.  Anthony Quinn, MD, board-certified orthopedic surgeon with Sheridan Orthopaedic Associates performed Mark’s surgery at Sheridan Memorial Hospital.

“Mark’s injury was much more involved than the average rotator cuff tear,” says Dr. Quinn. “It is not uncommon for us to treat rotator cuffs with one, two or three torn tendons. Mark’s injury was a complete disruption of all four of the rotator cuff tendons in conjunction with a shoulder dislocation. There was nothing attached to his humeral head.”

A few days after surgery, Mark began outpatient rehabilitation at Sheridan Memorial Hospital’s Wyoming Rehab Department with Physical Therapist, Tony Smith. From the start, Mark told Tony that he wasn’t going to stop rehab until he got his roping shoulder back.

“I’ll admit that I was somewhat skeptical that Mark’s goal was achievable,” says Tony. “It’s not always possible to regain full function after a severe injury like his. However, Dr. Quinn did a remarkable job repairing Mark’s injury, and Mark was dedicated and committed to complying with the physical therapy program that we designed for him. Those two factors made all the difference.”

An upper extremity injury with a small tear typically takes about four months of rehab to regain full function. Due to the degree of Mark’s injury and repair, Mark was in rehab three times a week for ten months.

“Rehabilitation for a bad tear involves some pain and a lot of hard work,” says Tony. “I admire Mark for his determination and perseverance.”

Mark is back to swinging a rope again and plans to competitively rope in the future.
“I don’t want to quit because I was thrown from a horse. I’ve been thrown by a horse on more than one occasion – accidents that could have potentially been deadly,” says Mark. “I just appreciate that God always seems to be watching out for me.” 

January 23, 2019

The ups and downs of life happen to everyone and at times it can bring us a lot of stress. For Nury Quevedo, an Administrative Assistant at Big Horn Mountain Medicine and Nursing Student, her biggest stress reliever is focusing on her personal wellness. In 2016 Nury had surgery on both of her feet. She was unable to walk for 6 weeks and had to depend on her children to help her. During this time she realized how difficult it was not to be able to walk and take care of her kids and so she promised herself that when she was cleared to walk again, she was going to stay as active as possible. After 20 weeks of recovery she was able to run 6 miles in 41.42 minutes (under 7 minute mile). Nury used running as big stress reliever until she met a friend who was a power lifter and introduced her to the weight room. He introduced her to a nutritionist and also a mind and body strategist who both helped her create specific wellness goals.

Before setting wellness goals, Nury would run 30-42 miles per week with the mentality that she could run in order to eat whatever she wanted. After setting wellness goals she now eats to nourish her body and perform well. I eat according to my goals. If I want to lose fat, gain muscle or just maintain my weight I can do that now. “I do love pizza and chocolate caramel cake so I treat myself once in a while.” Now Nury competes in body-building competitions. At first it took a lot of guidance, but she worked hard to learn the science behind fitness and nutrition and she is able to plan her own nutrition, workouts, and rest on her own. Her hard work paid off because she has won every body-building competition that she has entered in.

Now that she’s been working hard at those wellness goals for a few years now, she is primarily motivated by her kids. “I have four kids. I need to be emotionally, mentally, and physically healthy for them,” she said. Nury still exercises as a stress reliever but she’s gained a broader perspective: that eating well, exercising hard, and resting enough will improve all areas of her life. She hopes that when her children are older they will be able to use that same perspective to take care of their stress.
Nury’s advice to others is:

• Treat your body the way you want it to perform. If you want to have a healthier body, you need to respect, fuel, challenge and love your body.
• When it comes to achieving goals, you have to be disciplined and determined
• Set attainable goals and take baby steps to get there. Self-improvement is a slow process, so be patient with it.
• Plan how you will achieve your goals. Schedule time to exercise, and rest. Plan and prepare meals ahead of time. It is time-consuming, but well worth it.
• Don’t be scared of your food. It’s ok to treat yourself and don’t punish yourself if you mess up. Start every day fresh and focus on loving your body.

Wellness Resources that Nury uses:

• MyFitnessPal – I use this app to track the macronutrients in my meals to make sure that I am eating the right proportions according to my goals.
• Polar Beat Heart Rate Monitor – I wear this in all of my workouts (cardio and strength). This helps me set goals and watch the improvements in my fitness level.
• Fitness friends – I was able to start chasing big goals because I saw people in my gym who worked really hard (Navy Seals and Power Lifters) and so I just asked them to help me out. Having people who can teach you and support you it very motivating. 

Congratulations to Nury for earning the honor of being the Working on Wellness Employee of the Month. If you see Nury around the hospital or Big Horn Mountain Medicine, congratulate her and wish her the best as she works to get her Associate’s and Bachelor’s degrees in Nursing at Sheridan College.