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1401 West 5th St. Sheridan, WY — 307.672.1000

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Health and Wellness

Funds Available to Help With Cost of Cancer Screenings
Sometimes it can seem overwhelming when it comes to your own personal healthcare. But there are resources out there to help those in need.
Rehab can help Patients Before, During and After Cancer Treatment
Wyoming Rehab’s Cancer Rehab Program is appropriate for anyone who has been diagnosed with cancer. Special considerations are made based on diagnosis.
Gun Safety Info & Tips
With hunting season upon us, the Trauma Team at Sheridan Memorial Hospital provides these tips for Gun Safety.
Stay On Your Feet This Fall
More than one out of four older adults fall each year. These falls are NOT a normal part of aging and are serious and costly, causing broken bones
Support for COVID-19 Patients Admitted at SMH & Their Families
We know how important you are in the healing of your loved one. The following guide is intended to
Stacy's Story
Stacy Windon was a recent patient in Sheridan Memorial Hospital. Below is her experience in her own words.
Back To School Safety Checklist
With school starting, It is extremely important to take proper safety precautions when transporting your children to and from school.
CDC Recommends a Third COVID-19 Vaccine Dose for Certain Patients
The CDC is now recommending a third COVID-19 vaccine dose for certain patients with
Preventing Archers Shoulder
The fall season is rapidly approaching and for many Wyoming residents, that means hunting season.  Hunting with archery equipment
New Audiology Services at Sheridan Memorial Hospital’s Ear, Nose and Throat Clinic
Trouble hearing? Learn about our new audiology services and what options might be available to help you.
Preventing Heat Stroke and Heat Exhaustion
Urgent Care physician, Dr. David Nickerson, offers up these keys to preventing heat stroke and heat
The Transitional Care Team – Preparing Patients for a Successful Transition Home
Sheridan Memorial Hospital’s (SMH’s) Transitional Care Unit (TCU) is a hospital-based short-term
Urgent Care Physician Receives FAA Aviation Medical Examiner Certification
David Nickerson, MD, urgent care physician at SMH, has completed the necessary training through the Federal Aviation Administration (FAA)
Medical Device Recall Notification - Sleep and Respiratory Care Update from Philips Respironics
Sheridan Memorial Hospital has been advised of a
Testosterone, to treat or not to treat?
The use of natural testosterone and testosterone supplements has skyrocketed the past few years. Dr. Christopher Prior offers his insights on this
SMH COVID-19 Testing moves to Urgent Care on Burton Street
Sheridan Memorial Hospital’s Covid-19 testing is now being done at the hospital’s Urgent Care
COVID-19 Vaccination Facts For Parents
Wyomingites ages 12 and up can now receive the COVID-19 vaccine, following a thorough review and decision by the FDA and CDC. More families have the ability to protect their children and return to the activities and people they love.
New Addiction Medicine and Recovery Clinic Opens at SMH
Dr. Jason Ackerman has been practicing medicine in Sheridan for the past 8 years and has been a mainstay in the Sheridan Memorial Hospital
Stroke Awareness – What can you do? Know the risk factors.
In our country, someone experiences a stroke every 40 seconds. This debilitating and deadly injury to the brain causes a U.S. death every 3.5
Transitional Care Expansion - Approaching the Fundraising Finish Line
Due to the generous contributions over the past seven months, The Foundation is nearing the finish line of the Transitional Care Expansion Campaign.

Sometimes it can seem overwhelming when it comes to your own personal healthcare. But there are resources out there to help those in need. One such resource is the Sheridan Memorial Hospital Foundation Cancer Screening Fund. These are funds available locally for those in need of, or think they can’t afford, cancer screening. We recently sat down with Cashlee Cates, Patient Financial Advocate with Sheridan Memorial Hospital (SMH), to learn more about this amazing funding source for those in need in our community.

Q:        Tell us about the SMH Cancer Screening Fund.

A:        This fund was set up by the SMH Foundation to provide those in need with critical access to cancer screening. We have so many great philanthropists in our community and this is just one example of how their donations are being used to help with direct patient care.

Q:        How are the funds for this program generated?

A:        The funds are generated through various efforts by, and donations through, the SMH Foundation. Contributions that go toward The Link Partners in Pink and the Welch Comfort Care Fund can be used for numerous cancer screenings. Events like the Link Partners in Pink, Bingo Night at Blacktooth Brewery, andgifts from generous donors directly to cancer screening make up this fund. They work extremely hard to make sure we have dollars available for cancer screenings.

Q:        Who administers the funds?

A:        The funds are administered by the Patient Financial Advocate team here at the hospital. We have six (6) advocates who work with prospective patients to make sure they qualify. We also work very closely with our Foundation as they are the entity working with donors to make sure the funding is always available.

Q:        How do I know if I qualify for the funding?

A:        Each patient wishing to access the funds must fill out an application with one of our financial advocates. The most cirtical criteria is the patient must not exceed 300% of the federal poverty level ($52,260 annually or $4,355 per month).The application process only takes a few minutes to know if you qualify.

Q:        What screenings does the funding cover?

A:        The cancer screening funds cover mammograms, breast ultrasound, breast biopsy, genetic testing, prostate cancer screening and low dose lung screening. The really nice thing about this program is the funds will cover the entire cost for any of these services. If you have questions on another screenings not listed above, or aren’t sure if they’d qualify, we encourage community members to still meet with an advocate. Our goal is to provide healthcare to our community, so we will look for all options available to help our patients.

Q:        If I need multiple cancer screenings, do I have to apply for funds to cover each separate screening?

A:        No. Once you apply and are qualified, your qualification status lasts for one full year from your approval date.

Q:        Who do I contact to apply for funding?

A:        The best way to start the process is to reach out to one of our Patient Financial Advocates at 307.675.4620 or by email at financialadvocates@sheridanhospital.org. They will set up an appointment with you to walk through the application process.

For Donors

If you are interested in learning about becoming a donor to the SMH Cancer Screening Fund, please contact Ada Kirven at 307.673.2417 or via email at adakirven@sheridanhospital.org.

By Charlotte Walter, PT, DPT, ATC – Physical Therapist at Sheridan Memorial Hospital’s Wyoming Rehab

Sheridan Memorial Hospital’s Wyoming Rehab provides a variety of rehabilitative services – each tailored to the patient’s specific needs.

In this post, we focus on Cancer Rehab: a comprehensive treatment approach aimed at improving the function of individuals who are experiencing cancer.

Wyoming Rehab’s Cancer Rehab Program is appropriate for anyone who has been diagnosed with cancer. Special considerations are made based on diagnosis (e.g. breast, colon, lung) as necessary. To determine an appropriate starting point for therapy, we conduct a thorough evaluation of strength, balance, flexibility, gait, endurance, pain and fatigue levels.  Then to further individualize the patient’s therapy program, we discuss current levels of function, goals and concerns with the patient and their care team as needed.

In the past, patients with cancer were told: “go home and take it easy.” This is no longer the case. More and more, research shows that exercise is an essential component of cancer treatment.  Supervised, structured exercise programs have shown increases in aerobic capacity, leg strength, bone mineral density at the spine, and lean body mass when compared with individuals who have not had this type of care/rehab. Exercise is a safe and effective addition to a patient’s cancer treatment plan.

Research also shows that individuals benefit from targeted exercise prior, during, and following cancer treatments. Therapy prior can increase functional strength and endurance before undergoing an intense cancer treatment regimen. Therapy during can enhance cancer treatment approaches, tolerance to treatment, and reduce cancer-related fatigue. Therapy after can rebuild muscle strength, develop compensation strategies around neuropathy or limb loss, manage lingering pain, reduce cancer-related fatigue, and prevent recurrence.

Individuals who have completed or who are currently undergoing cancer treatments may also experience difficulty with recall, memory or focus: also known as “chemo brain.”  Our speech therapists can perform a cognitive evaluation to determine deficits and create a treatment plan to help ease some of these symptoms.

If you feel you would benefit from this specialized program at Wyoming Rehab, consult with your physician.  Learn more about Wyoming Rehab’s Cancer Rehab HERE Or call 307.674-1632.

September 2021

With hunting season upon us, the Trauma Team at Sheridan Memorial Hospital provides these tips for Gun Safety.

  1. Treat every gun as if it is loaded!
  2. ALWAYS keep the gun pointed in a safe direction!
  3. ALWAYS keep your finger off the trigger and keep the safety on until ready to shoot.
  4. Know your target and what is beyond – Never fire in a direction in which there are people or any other potential for mishap. Think first. Shoot second.
  5. Know how to use the gun safely – Before handling a gun, learn how it operates. Know its basic parts, how to safely open and close the action and remove any ammunition from the gun or magazine. Remember, a gun’s mechanical safety device is never foolproof. Nothing can ever replace safe gun handling.
  6. Use only the correct ammunition for your gun and wear ear and eye protection as appropriate.
  7. Never use alcohol, over the counter drugs, or prescription drugs before or while shooting.
  8. Keep guns out of the reach and out of sight of children by storing them securely. Leaving guns unsecured – on a nightstand, table, or other place where a child can gain access – can lead to injuries and fatalities.
  9. Store guns unloaded and secured with effective, child-resistant gun locks in a locked container out of the reach and sight of children.
  10. Store ammunition in a separate locked container out of the reach and sight of children.
  11. Use combination locks and safes, or safes that use fingerprint recognition locks. Keep the combinations carefully hidden.
  12. When a gun is not being stored, keep it in your immediate possession and control at all times. Otherwise, store the gun unloaded, locked and separate from ammunition.
  13. If you carry a gun in your car, make sure to outfit your vehicle with a lockable container so you can securely store the gun when you exit the vehicle.
  14. If a visitor has a gun in a backpack, briefcase, handbag or an unlocked car, provide them with a place to store it securely (locked, unloaded, and separate from ammunition) while they are in your home.
  15. If a family member or loved one is in crisis and may be a risk to themselves or others, consider temporarily removing firearms from your home. Such crises can involve people who are depressed, suicidal, or abusing drugs or alcohol.

For more information go to:

https://gunsafetyrules.nra.org/

https://www.safekids.org/tip/gun-safety-tips

By Charlotte Walter, PT, DPT, ATC – Physical Therapist at Sheridan Memorial Hospital’s Wyoming Rehab

Falls Prevention Awareness Day is coming on September 22,  and I’d like to take this opportunity to remind folks why falls prevention is so important. According to the Centers for Disease Control and Prevention (CDC), more than one out of four older adults – those 65 and older – fall each year. These falls are serious and costly, causing broken bones or head injury. In fact, falls are the most common cause of traumatic brain injuries. Falls can lead to reduced mobility, decreased independence, and an increased fear of falling, all of which profoundly affect an individual’s quality of life. However, less than half of people who do fall tell their doctor.

Falls are not a normal part of aging and can be prevented. Four key steps to falls prevention include speaking to your doctor, staying active, getting your eyes checked and making your home safer.

As mentioned above, many people who fall do not tell their doctor. However, your physician plays a crucial role in keeping you safe. They can evaluate your risk for falling, review your medications to see if any may cause dizziness or drowsiness, and offer suggestions for vitamin D supplementation, seeing a physical therapist, or seeing a podiatrist if needed. Another concern to bring up to your doctor is how frequently you get up at night to use the bathroom. Research shows that individuals that get up more than 2-3 times per night have a significantly higher risk of falling. Your doctor may suggest medications or pelvic floor physical therapy to help address this.

Simply staying active can play a major role in fall prevention. Older adults should engage in regular, intentional physical activity that builds balance, strength, and flexibility. Unfortunately, the COVID-19 pandemic put most in-person exercise classes on hold, but many offerings through the Hub on Smith and the YMCA have returned. Online exercise class options via Zoom are also being offered. Contact these organizations for more information on current class schedules. Keep in mind that physical activity does not have to happen inside a gym. Strength training can be performed using objects around the home. Clear some space and dance to your favorite music to get your heart rate up. Exercise videos can be found on YouTube. Sheridan residents are fortunate to have an abundance of trails and parks available for walking, bicycling and hiking. Gardening and yard work are also forms of physical activity that don’t require exercise equipment. In short: sit less, move more.

If health conditions or physical limitations are preventing you from being physically active, ask your doctor about physical therapy. Physical therapists are highly trained health care professionals with expertise in movement and exercise. Physical therapy is not just for after a surgery or injury, but also an excellent way to prevent injury, falls or deconditioning. A physical therapist can evaluate your strength, balance and endurance and create an individualized plan to help meet your goals for physical activity. Not sure of where to start? Wyoming Rehab provides a free screening for individuals looking for treatment recommendations that do not require a physician referral. Don’t let a small barrier become a wall that continues to limit your physical activity.  

When was the last time you had your eyes checked? Quality of vision is important to provide your brain with accurate information about your position in space. Conditions like cataracts and glaucoma limit your vision. If your eyeglass prescription is outdated or no longer appropriate, that can negatively affect your balance ability. The current recommendation is to have your eyes checked by an eye doctor at least once a year.

Another way to prevent falls is to make your home safer. Take a look around and ask yourself the following questions: Are there papers, shoes, books, or other objects on the stairs? Is a stairway light bulb burnt out? Are there handrails on both sides of the stairs? Are there throw rugs on the floor? When you walk through a room, do you have to walk around furniture? Is your step-stool sturdy? Is the light near the bed hard to reach? Is there a clear path from the bedroom to the bathroom? Is the tub or shower floor slippery? Do you need support when getting off the toilet or out of the shower?  It’s time to consider these and other obstacles that can intensify someone’s fall risk in their own home.

Some easy tweaks can make a big difference.  Want to learn more? Some excellent online resources include the CDC, National Council on Aging and National Institute on Aging websites. Here, you can find articles, action plans, infographics, exercise suggestions, exercise videos and more information on staying active and preventing falls.

Here in Sheridan, we are lucky to have many resources available to older adults, both in-person and online. Take the steps to keep yourself safe, active, and healthy this fall!

Do you have a condition or impairment preventing you from reaching the recommended amounts of physical activity? Don’t continue to put your health at risk. Find out how physical or occupational therapy may help. Reach out to Wyoming Rehab at 307.674.1632 if you would like to schedule a FREE Screen/Treatment Recommendation for a Non-Emergent Physical Impairment or Injury.

Learn More about Wyoming Rehab and their free screenings for non-emergent physicial impairments or injuries by clicking HERE or following the link https://www.sheridanhospital.org/medical-services/rehabilitation-services/

Stacy Windon was a recent patient in Sheridan Memorial Hospital. Below is her experience in her own words.

My fiancé and I both work at VA. When the COVID-19 vaccinations became available, I was adamant he receive the vaccine due to his COPD. I was insistent because I thought it was easier for him to get sick and that he could be extremely sick if he contracted COVID.

At the time, I didn’t get vaccinated, I was hesitant because the vaccine had not been FDA approved, I was leery; plus, I was healthy.

In early August (4th & 5th) we both tested positive for COVID. The difference in our experiences is that he was back to work by the 9th due to being vaccinated; I was in the hospital by the end of the week and had to stay for nine (9) days.  I was shaking, I couldn’t breathe, I couldn’t move, I was not always coherent; it was the scariest time in my life.

Everyone at the hospital was wonderful; the kitchen staff, housekeepers, nurses, CNAs and the doctors. They treated me with respect, never like I was in danger, and I learned a lot from all of them about this virus.

Now, based on instructions from my physician, I have to wait 60 days until I can get the vaccine. In the meantime, I have to make sure I don’t get sick again.

I’m sitting here at home, I can’t get a good breath, I’m on oxygen, I can’t really get around my house. I tried cleaning house recently and the next day I paid for it. I’m carrying a 50 foot air hose everywhere I go in my house.

My advice to those who are questioning the vaccine, if you’re scared, research it. Listen to other people who have had it. Please, please ask questions and make an informed decision. This is not minor by any means. Stacy Windon

With school starting, It is extremely important to take proper safety precautions when transporting your children to and from school. Here’s a checklist to keep kids safe.

Back to School Safety Checklist pdf –Download

August 17, 2021

The CDC is now recommending a third COVID-19 vaccine dose for certain patients with compromised or suppressed immune systems who received their first two doses of an mRNA COVID-19 vaccine (Pfizer or Moderna vaccines).

Studies have shown a third dose is safe and can provide added protection from severe illness or death from COVID-19 in those who have a weakened response to being vaccinated due to certain medical conditions or medications. Statement from CDC Director

Sheridan County Public Health is currently providing third COVID-19 vaccinations to eligible patients.

Third doses of the COVID-19 vaccine aren’t being recommended at this time for healthy individuals. No additional doses are currently being recommended for those who received a dose of the Johnson & Johnson (Janssen) COVID-19 vaccine.

We will provide updated information here as it is available.  For other COVID-19 Information and Resources click HERE or visit https://www.sheridanhospital.org/community/coronavirus/

By Mike Duncan, Physical Therapy Assistant III at Sheridan Memorial Hospital’s Wyoming Rehab

The fall season is rapidly approaching and for many Wyoming residents, that means hunting season.  Hunting with archery equipment or bow hunting thrills many Wyoming hunters.

Archery is truly an amazing sport.  Saxton Pope summarized it perfectly when he said this, “Here we have a weapon of beauty and romance. He who shoots with a bow, puts his life’s energy into it. The force behind the flying shaft must be placed there by the archer. At the moment of greatest strain he must draw every sinew to the utmost; his hand must be steady; his nerves under absolute control; his eye keen and clear. In the hunt he pits his well-trained skill against the instinctive cunning of his quarry. By the most adroit cleverness, he must approach within striking distance, and when he speeds his low whispering shaft and strikes his game, he has won by the strength of arm and nerve. It is a noble sport.”

If you think about the basic actions of shooting a bow – pull back with the fingers or wrist and arm, rotate through the shoulder, hold, and release – it probably becomes clear why upper extremity conditions are some of the most commonly diagnosed injuries among bow hunters. The drawing back of the strings demands a lot from the smaller muscles of the rotator cuff, forearm, wrist, and fingers. Plus, repetitive target practice to improve aim, timing, and other hunting skills can easily result in chronic pain or injury from overuse, referred to as Archers shoulder.

Injuries to the rotator cuff are archery’s most common problem. The rotator cuff is a complex system of muscles and tendons in your upper arm that is used to draw a bow and to raise and rotate your arm. Rotator cuff injuries include tendinitis, bursitis, and, in severe cases, a rotator cuff tear.  Tendonitis is a condition that results from the rotator cuff tendons becoming irritated or damaged.  Bursitis involves the fluid-filled “pillow” that acts as a cushion between the rotator cuff tendon and shoulder blade, which may become irritated or inflamed.  A torn rotator cuff tear may put you out for the season but is not always easy to diagnose.  Symptoms include having trouble lifting, raising your arm, pain when moving, shoulder weakness, or a clicking sound in your shoulder when moving it. If you have any of these symptoms, stop shooting and seek competent medical advice. Through skilled rehabilitation, most archers recover and resume shooting upon completing physical therapy.

Specific exercises and stretches from a qualified professional at Wyoming Rehab will alleviate and can prevent the common conditions associated with Archers shoulder and return you to the range or to the hunt.  Call us today to set up a free screening for non-emergent physical impairments or injuries – 307.674.1632.

Learn more about Wyoming Rehab services by following the link sheridanhospital.org/medical-services/rehabilitation-services/

By Pattie Visscher, Au.D., Audiologist

I’m excited to join the hospital staff as the new audiologist at Sheridan Memorial Hospital’s Ear, Nose and Throat (ENT) clinic.  As an audiologist, I am a healthcare professional who can help prevent, diagnose and treat hearing and balance disorders in people of all ages.   Audiologists help people improve their communication with others around them by offering those with listening difficulties increased access to auditory information via amplification options as well as communication and listening strategies.

I have been practicing audiology for more than 25 years, with an emphasis on pediatric care.  I began my professional career at the Colorado School for the Deaf and the Blind in Colorado Springs.  That experience gave me knowledge of Deaf culture, many types of amplification (traditional hearing aids, bone-anchored hearing aids, and cochlear implants), as well as the opportunity to become fluent in American Sign Language (ASL).  My husband and I moved to Sheridan this summer and are so happy to be here.  

I look forward to offering the Sheridan community comprehensive audiologic care.  At our office, the focus for audiology is diagnostic testing, both to support Dr. Cheryl Varner, our otolaryngologist, and to work with patients directly to monitor hearing status and investigate the need for amplification, possibly with hearing aids. Our diagnostic services include complete hearing evaluations and a variety of testing techniques that specifically determine the status of the middle ear, inner ear and the auditory neural pathways. 

Individuals with hearing loss commonly report feeling they misunderstand others or miss out on important conversations around them.  They have trouble understanding others when in noisy environments such as restaurants.  They have difficulty following dialogue on television programs, and many experience a ringing sound in one or both ears.  Some people report a feeling of pressure or fullness in their ears and many report concerns with balance. Sometimes people suffer from dizziness or vertigo. Knowing and understanding your hearing status gives you the information you need to make informed decisions regarding your hearing.

Dr. Carol Flexer is a well-known professional in the field of audiology.  She is famous for saying, “we hear with our brains,” calling our ears the “doorway” for sound to get to the brain.  She emphasizes the sensory importance of the ears to deliver information to our brains so we can understand and organize auditory information.  Good hearing is so important during childhood development in order for a child to hear and understand and know the difference between mom saying, “good morning” or “no, no, that’s hot, don’t touch.”  Good hearing remains important throughout the lifespan.  Much research has been devoted to examining the connection between cognitive decline and impaired hearing.  Remaining engaged in communication keeps your brain active.  Hearing impairment can lead to withdrawal from social interactions and decreased communicative interactions. 

In today’s world, dealing with hearing loss while attempting to communicate with someone wearing a face covering or mask can be especially difficult.  Many individuals wearing hearing aids have reported difficulty removing a mask without a hearing aid flying across the room.  Shortly after mask mandates began, hearing aid manufacturers saw a spike in claims for hearing aid replacements or repairs due to loss or damage associated with wearing a mask and hearing aids.  There are face covering styles that may work better for individuals with hearing aids, including masks that tie behind the head.  Another option is the use of mask extenders that may reduce fatigue from pressure on your ears and redirect the mask ear loops.  

YouTube has videos with suggestions regarding Face Masks and Hearing aids:

https://www.youtube.com/watch?v=wuPZAjhT_cQ

https://www.youtube.com/watch?v=FLP5CwiZn3I

Here are some hearing-related statistics from the NIDCD (National Institute on Deafness and Other Communication Disorders) that demonstrate how prevalent hearing concerns are in the United States:

  • Approximately 15% of American adults (37.5 million) aged 18 and over report some trouble hearing.
  • Roughly 10% of the U.S. adult population, or about 25 million Americans, has experienced tinnitus lasting at least five minutes in the past year.
  • Five out of 6 children experience an ear infection (otitis media) by the time they are 3 years old.

In the near future, the hospital’s ENT will offer hearing aid services, including consultation, sales, fitting and follow-up.  We plan to offer hearing aids from major manufacturers, including Phonak, Oticon, Resound and Starkey.  Selection and fitting of custom earmolds for hearing protection will also be offered. Audiology’s future goals include offering aural rehabilitation services, where a plan is developed to help target a hearing impaired individual’s specific listening and communication needs.  This may also include aural rehabilitation group activities.  I am also particularly interested in using my previous experience to partner with our local pediatric professionals.

If you are experiencing listening difficulties or suspect you have hearing loss, there are options to help you manage these issues.  Your first step should be to ask your primary care provider if they feel you should see an Audiologist.  A referral to our office is not necessary, but before making an appointment without a referral, you should check with your insurance company to see what is required. 
To make an appointment, call 307.675.4646.

Resources you can check out for more information about Audiology are:

https://www.asha.org/public/hearing/

https://www.nidcd.nih.gov/health/hearing-ear-infections-deafness

To learn more about our Ear, Nose & Throat Clinc here at Sheridan Memorial Hospital and our new Audiology services, click HERE or visit sheridanhospital.org/medical-services/clinics/ear-nose-throat

Summer weather calls many of us to spend more time outdoors.  While this time of year brings a welcome respite from our cold Wyoming winters, it also brings higher temperatures and risk for heat-related illnesses and heat stroke.  As the body’s temperature rises and gets too hot, some of the first symptoms that occur are excessive sweating, cool clammy skin, nausea and vomiting and muscle cramps.  This is known as heat exhaustion, and can occur with or without heat cramps or heat syncope (passing out).

However, if your body’s temperature continues to rise to 104 degrees Fahrenheit or higher, you can progress to heat stroke.  Symptoms of heat stroke include balance difficulties, hallucinations, confusion, passing out, seizures and other complications involving the central nervous system.  Heat stroke can cause permanent brain damage and is life-threatening.

There are several myths regarding heat stroke that should be dispelled.  A common misconception is that you stop sweating when heat stroke occurs.  In reality, heat stroke often occurs during extended exertion in the heat, so people are almost always still sweaty as they enter the territory of heat stroke. 

Another myth is that you must be severely dehydrated to develop heat stroke.  Dehydration may predispose you to heat illness, and can make it worse, but does not have to be present.  Heat stroke can occur after only 20 minutes of exertion and before you have lost much fluid.  The intensity of exertion and temperature are the main contributors.

Keep in mind that things are not always as they appear.  For instance, the most common ways to take your temperature are with an oral or forehead thermometer.  However, your body’s external temperature does not always match its core temperature.  In addition, people who are developing heat stroke may not appear dizzy, confused, or off balance initially while they are in the early stages of heat stroke and may then deteriorate rapidly as their body temperature rises further.

Certain factors can put you at higher risk of developing heat stroke.  These include high environmental temperature, intense exertion, being out of shape, equipment preventing heat loss (football pads, firefighter PPE, and multiple layers of clothes), obesity, sleep deprivation, dehydration, and fever.

Heat stroke is a risk for any age group.  For example, infants do not have the ability to change their environment or clothing on their own.  Children left in hot vehicles are at particular risk.  High school football players are also at risk from intense exercise, sometimes twice a day at the beginning of the season in August.  Working adults such as roofers and firefighters should be aware as they exert themselves in hot environments.  Finally, seniors are also predisposed to heat related illness, particularly if they do not have air conditioning, their air conditioning fails, or there is a power outage.

There are several steps that you can take to prevent heat exhaustion and heat stroke.  Be mindful of the weather forecast and be willing to adjust your plans for the day.  If it is going to be hot, don’t make big plans for exertion and plan to take frequent breaks.  Plan any exercise, hikes, or outdoor work earlier in the day, when it is not as hot. 

Avoid dehydration by drinking plenty of fluids such as water or sports drinks and avoid caffeine and alcohol.  Keep in mind that diarrhea, vomiting, and fever all increase your water loss and can also predispose you to dehydration and heat-related illnesses.  An easy way to track your hydration level is to monitor your urine color.  The darker the urine, the more dehydrated you are.  Hydrate to the point that your urine is pale yellow or clear. 

Also keep in mind that our vehicles are a particular risk for exposure to high temperatures.  A car in the sun can heat up by 20 degrees in only 10 minutes.  A study measuring temperatures in cars parked in the sun on a 95 degree found the average temperature reached to be 116 degrees.  Consider running your vehicle’s air conditioning for 10 minutes before entering and never leave a vulnerable adult or child in a hot vehicle.

If you plan to be outside in the heat, wear loose lightweight clothes and avoid wearing multiple layers that would keep your body from cooling properly.  If you feel that you are getting too hot, remove extra clothing and move to the shade or air conditioning if possible.  Taking a cool shower or bath can also be very effective.  If this is not possible, getting wet and sitting in front of a fan can cool you through evaporation.  Cold packs (or anything else cold such as a bottle of water from the refrigerator) can be placed on your neck and in your armpits and groin to cool you further.

However, if you or someone else continue to worsen despite these measures or begin to experience balance difficulties, confusion, hallucinations, passing out, or seizures seek medical attention immediately, even if you have to call 911.  Enjoy the summer weather, but do so safely.

Sheridan Memorial Hospital’s (SMH’s) Transitional Care Unit (TCU) is a hospital-based short-term care unit for medically complex patients who are transitioning after a hospital stay. This type of care is referred to as sub-acute care, or skilled care, and is a great option for patients who completed acute medical treatment, but still need therapy and assistance to regain their fullest functionality before going home or to next level of care.

Originally established in 2005, the SMH TCU is designed to provide rehabilitation and skilled nursing care to ensure patients meet their healthcare goals. It provides coordination and continuity between various providers, services and settings. The Interdisciplinary Team of professionals serving these patients may include: physical, occupational, speech, pulmonary and respiratory therapists; nurses; Case Management and social workers; dietitians; pharmacists; and physicians.

One of the services most beneficial to any person’s successful transition from a hospital stay to home is this Team. The Team meets regularly with each patient and/or their families and caregivers throughout their stay to ensure the TCU care provided is on track with individualized and established goals. After a serious illness or injury, it can be a challenge to make that transition back to normal life, especially if the “new normal” is different. That’s where TCU care also steps in. It allows patients to take their time adjusting to a new quality of life, emotionally and physically. Days of care in the TCU range anywhere from 3 to 100 days depending on individual patient circumstances and healthcare guidelines.

Our hospital’s Case Managers assist patients and their families when needed with the determination of the most appropriate setting for the next step or level of care. Individual needs are reviewed, discussed and assessed by the Team in conjunction with each patient. Many times this process may include a visit to the patient’s home to ensure it is safe and set up correctly for success. Or it may be an opportunity to connect and introduce patients with other support services available in our area. While TCU care is extensive in its approach, its main focus is to ensure quality, safe care and help patients return to daily environments with the highest level of strength and functionality possible. The TCU helps minimize the chance of a patient’s return visit to the hospital.

The expansion of our hospital’s TCU combines this unique care and the patient experience. Our new TCU on the 2nd and 3rd Floors of the 1954 hospital will ensure a quality stay for patients in a separated environment. Patient goals vary, but may include learning new skills, participating in activities, and socialization. This daily routine is also a big component to prepare for the transition back home. Some of the activities include: cooking and baking in the TCU kitchen, completing laundry tasks, improving mobility through exercise either in the therapy gym or outside on the beautiful SMH campus, practice entering and exiting a vehicle, and a beautiful group dining and activity area with views of the Big Horn Mountains.

The desire of every member of our SMH team is to provide excellent care close to home for our Sheridan community. The TCU Expansion greatly enhances our ability to meet the needs of the patients we serve every day.

To learn more about Transitional Care at Sheridan Memorial hospital click here:  https://www.sheridanhospital.org/medical-services/transitional-care/

David Nickerson, MD, urgent care physician at Sheridan Memorial Hospital, has completed the necessary training through the Federal Aviation Administration (FAA) to become an authorized Aviation Medical Examiner (AME) for second-and third-class pilots. Dr. Nickerson completed the FAA Aerospace Medical Certification Division training in Oklahoma City and has passed the national certification exam.

An AME is a physician designated by the FAA and given the authority to perform flight physical examinations and issue aviation medical certificates if the applicant meets FAA standards. There are approximately 6,000 AMEs nationwide; there are only 10 in Wyoming.

While all pilots must receive some type of health assessment before flying, the levels of certification vary. Generally, the first-class certification is designed for airline transport pilots; second-class for commercial pilots, including corporate aviators, crop dusters and charter pilots; and third-class for student, recreational and private pilots.

For pilots seeking a flight physical medical certificate, the process requires a physical exam, in addition to testing to assess mental, neurological and general health. A vision and hearing test is also performed, as well as a urinalysis to check for diseases or other potential medical conditions.

Dr. Nickerson is board certified in Emergency Medicine and has worked in Emergency Medicine, Urgent Care, and Occupational Health at Sheridan Memorial Hospital for the past eight years.

To schedule your 2nd or 3rd Class Flight Physical with Dr. David Nickerson today, call 307.675.5850.

Sheridan Memorial Hospital has been advised of a worldwide voluntary recall of various continuous positive airway pressure machines (CPAP), BiLevel positive airway pressure machines (BiPAP) and mechanical ventilators that are manufactured by Philips Respironics. This recall is being conducted due to two issues related to the polyester-based polyurethane (PE-PUR) sound abatement foam used in these devices:

1) PE-PUR foam may degrade into particles which may enter the device’s air pathway and be ingested or inhaled by the user, and

2) the PE-PUR foam may off-gas certain chemicals. The foam degradation may be exacerbated by use of unapproved cleaning methods, such as ozone (see FDA safety communication on use of ozone cleaners), and off-gassing may occur during initial operation and may possibly continue throughout the device’s useful life.

Philips Respironics advises patients and customers to take the following actions:

  • For patients using BiLevel PAP and CPAP devices: Discontinue use of affected units and consult with physicians to determine the benefits of continuing therapy and potential risks.
  • For patients using life-sustaining mechanical ventilator devices: DO NOT discontinue or alter prescribed therapy, without consulting your physician to determine appropriate next steps.
  • Recommend that customers and patients halt use of ozone-related cleaning products, and adhere to their device Instructions for use for approved cleaning methods.
  • Additionally, Philips is reminding customers and patients to review the age of their BiLevel PAP and CPAP devices, as they are typically recommended to be replaced after five years of use.

BiPAP and CPAP machines are used to treat sleep apnea and other airway access disorders.

Devices that may be impacted by this recall have been manufactured before April 26, 2021 and could include the following models:

Continuous Ventilator, Non-life supporting:

  • DreamStation ASV
  • DreamStation ST, AVAPS
  • SystemOne ASV4
  • C-Series ASV
  • C-Series S/T and AVAPS
  • OmniLab Advanced+

Noncontinuous Ventilator:

  • SystemOne (Q-Series)
  • DreamStation
  • DreamStation Go
  • Dorma 400
  • Dorma 500
  • REMstar SE Auto

Continuous ventilator:

  • Trilogy 100
  • Trilogy 200
  • Garbin Plus, Aeris, LifeVent

Continuous Ventilator, Minimum Ventilatory Support, Facility Use:

  • A-Series BiPAP Hybrid A30 (not marketed in the US)
  • A-Series BiPAP V30 Auto

Continuous Ventilator, Non-life Supporting:

  • A-Series BiPAP A40; (not marketed in the US)
  • A-Series BiPAP A30; (not marketed in the US)

Products that are not affected may have different sound abatement foam materials, as new materials and technologies are available over time. Also, sound abatement foam in unaffected devices may be placed in a different location due to device design. Products not affected by this recall notification include:

  • Trilogy Evo
  • Trilogy Evo OBM
  • EV300
  • Trilogy 202
  • A-Series Pro and EFL
  • M-Series
  • DreamStation 2
  • Omnilab (original based on Harmony 2)
  • Dorma 100, Dorma 200, & REMstar SE
  • All oxygen concentrators, respiratory drug delivery products, airway clearance products.

This is very concerning and very difficult to maneuver. HMR is working directly with Philips Respironics to coordinate options for patients. All high-risk HMR ventilator patients have been transferred to a non-recalled machine. There are not any of these devices used in the hospital or inpatient areas. The impact is with HRM issued devices and the patients who use them.

Guidance from Philips Respironics includes:

  • Discontinue use of the device and consult with your physician regarding the most appropriate options for continued treatment. It is important to consult with your physician to determine if the benefit of continuing therapy with your device outweighs the risk.
    • If continuing use of the device is determined as the best treatment option by your provider, a Philips Respironics approved filter is available for an out-of-pocket, up-front cost through HMR.
  • Philips Respironics will be contacting every patient directly regarding repair or replacement
    • If a device is more than five years old, contact HMR to initiate a replacement
    • If a device is less than five years old, your device will be covered through Philips under manufacturer warranty and you will be contacted directly by Philips Respironics
  • With your device serial number on-hand, Visit their website at philipssrcupdate.expertinquiry.com for the device portal that can help determine if your unit is impacted.

Visit philips.com/src-update or call 1.877.907.7508 for assistance directly from Philips Respironics.

By Dr. Christopher M. Prior, DO, FAAFP – Physician at Sheridan Memorial Hospital’s Internal Medicine Practice

June is Men’s Health Month, and according to studies, 60% of men don’t consult their physician regularly and 33% are less likely to visit the doctor than women. But one area of men’s health is seeing a surge in activity.

Use of testosterone hormone as well as natural testosterone level boosting supplements has skyrocketed in recent years with people looking for treatment of fatigue, poor cognition, difficulty losing weight or gaining too much weight, and erectile dysfunction.  The most common cause of low testosterone is age related low testosterone.  Most adult males lose 1-2% testosterone annually after their mid-thirties.  Chronic diseases such as obesity, sleep apnea, drug and alcohol abuse, hemochromatosis (harmful levels of iron in the body), as well as exposure to radiation or chemotherapeutics are potential causes of low testosterone.  Rarely do genetic disorders lead to hypogonadism (a failure of the gonads, or testes, in men).

 Treating potential causes of hypogonadism before starting testosterone supplementation would be the most common recommendation.  Many people, however, seek over the counter supplements first. Unfortunately, some over the counter supplements can worsen symptoms or have adverse side effects.  For example, there has been an increased number of young men in their 20’s and 30’s diagnosed with secondary hypogonadism caused by taking testosterone boosting supplements or illegally using testosterone hormone.  Inappropriate use of testosterone can worsen sleep apnea, cause polycythemia (increases red blood cell count), elevate prostate specific antigen, increase cholesterol, as well as increase risk for stroke and heart attack.

Many urban areas have seen an increased number of low testosterone retail clinics.  Most of these are cash only, with no insurance coverage for medications, lab tests or the prescription supplementation frequently recommended.  Expensive blood work, estrogen blocking medications, pituitary stimulating hormones as well as testosterone supplementation can be cost prohibitive for most.  While some users claim to feel better, think better, sleep better, and lose weight, there is very little evidence to support these claims.

Recently, the two largest medical organizations in the United States, the American Academy of Family Physicians and American College of Physicians agreed that the only clear reason to treat low testosterone is erectile dysfunction.  While testosterone has been used to help bone density, cognition, anemia, overall well-being, and infertility—there are no articles suggesting benefits in these areas with testosterone supplementation. 

Routine screening of testosterone levels is not recommended for asymptomatic males.  When a patient has symptoms that may be related to hypogonadism they may be screened for low testosterone in addition to the previously listed chronic causes of hypogonadism.  If testosterone levels come back low, testosterone replacement therapy can be initiated, with appropriate monitoring regularly with blood tests and clinical symptoms. This is generally a mutually agreed upon decision by the patient and provider after a review of risks and benefits.

Talk to your primary care provider about your healthcare concerns.  If you don’t have one, check out Sheridan Memorial Hospital’s Internal Medicine practice or call: 307.675.2650

Sheridan Memorial Hospital’s Covid-19 testing is now being done at the hospital’s Urgent Care – located at 1435 Burton Street – one block south and one block west of the hospital – follow signage to Urgent Care.

Persons wishing to be tested for Covid-19 do need an appointment and should still call the hospital’s Covid-19 phone number: 307-672-1004. When a staff member calls them back to schedule their appointment, they will help the caller select the most appropriate test for their needs.

When people arrive for their appointment, they should remain in their vehicle and call to let the staff know they are there.  The notification phone number is posted in the Urgent Care parking lot.  Covid-19 tests are conducted Monday-Friday.

More information about Covid-19 can be found at https://www.sheridanhospital.org/community/coronavirus/

Dr. Jason Ackerman has been practicing medicine in Sheridan for the past 8 years and has been a mainstay in the Sheridan Memorial Hospital Internal Medicine Clinic. He is excited about opening an Addiction Medicine Clinic here in Sheridan. We sat down with him recently to get his thoughts on this new adventure in his career, why he is taking this leap into addiction medicine and what it means for the Sheridan community.

Q: Dr. Ackerman, tell us why you felt it was important to get this certification and open this clinic in Sheridan.

A: I started treating opiate addiction while I was in residency and continued that when we moved to Sheridan after residency. It was initially a very small part of my practice, but it began to grow more rapidly the last few years.  I came to realize how underserved and undertreated patients with addiction are in our community. When I had a chance to get boarded in Addiction Medicine it seemed like a good opportunity to broaden my knowledge base and start helping more patients with a variety of addiction problems.

While it’s been needed in Sheridan and our surrounding communities for a while, it’s also been one of the most rewarding aspects of my practice. Not only is it a chance to improve patients’ health, in many cases it is truly giving people a second chance at life. I have had homeless patients find housing and start working. I have had patients go back and get college degrees and others start new careers. Parents who have lost their children due to addiction have been able to get their kids back home. They see successes that they never thought were possible and it’s amazing to be a part of that.

Q: What does it mean to see a doctor/physician who specializes in addiction? Aren’t most internists focused on physical health?

A: That certainly is our primary training and focus. But internal medicine spans a broad range of specialties. One of the great things about practicing here is that we can find our niche and develop skills in our area of interest. There is a big component of mental health in addiction, but as research progresses in the field we are learning more and more that this is a true disease process and not simply a series of bad choices. The good news is that means there are medications and therapies that we can use to help people recover and succeed.

Q: Is this a pain management clinic? What services are offered through the new clinic?

A: This is not a pain management clinic, although we have certainly helped people taper off of pain medications. Our focus is treating the disease of addiction, whether it is opioid pain medications, heroin, alcohol, stimulants, gambling – it really runs the gamut of substances and behavioral addiction.

Q: Can you talk about medication assisted therapy and what exactly is suboxone?

A: Just as some people are able to treat their diabetes with diet and exercise while others need insulin and other medications, there are a number of ways to approach the disease of addiction. Some people do well with counseling or groups like Alcoholics Anonymous. But when we start looking at the process of disease, there are some medications that can significantly improve people’s chances of recovery. Medication assisted therapy is using evidence-based, targeted medications to help people achieve that recovery.  Suboxone is probably one of the best known and most effective medications. The primary component of it is buprenorphine, which is a partial opioid agonist. That’s essentially a fancy way of saying a medication that hits all the same receptors as opiates like pain medications or heroin, but turns on those receptors just enough that people do not have cravings or withdrawal symptoms. That allows people to not only remain clean and sober, but also increases their ability to incorporate all the important tools from other aspects of treatment – groups, counselors, etc. – and substantially increases the chances of long term sobriety.

Q: Are there specific areas of addiction on which you concentrate?

A: Not really. Part of that is that addiction is a broad field that seems to be evolving fairly rapidly at this point. The other part is that addictions don’t always come packaged quite as neatly as we used to think. Many people are able to get off of pain pills, only to develop an alcohol problem or a meth problem. There seems to be a genetic component and it can definitely run in families. Some people just seem to be wired to have problems and addictive tendencies with whatever substance crosses their path. I will say treating opiate addiction is very satisfying. We all see the headlines about skyrocketing fatalities from opiate overdoses. In clinic we see patients that have been using for years and cannot function without massive, potentially lethal doses of opioids in their system. They are literally a bad night or a tainted batch of pills away from dying. But when we can find the right doses and combinations of medications they are able to get clean relatively quickly. The patients frequently tell us that they feel “normal” for the first time in years.

Q: Do prospective patients need a referral to this new clinic? How does the process work?

A: We are always happy to take referrals, but you certainly don’t need one to get an appointment. People can just call us at 307.675.2674.

Q: If I have concerns about a family member or friend who may be addicted, how can I best help them?

A: That’s an incredibly difficult position to be in. Ultimately, patients with addiction need to be ready to get better. Sometimes that readiness comes with the urging of friends and family, sometimes it happens spontaneously, and sometimes a person has to hit bottom before they see that change needs to happen. I think being supportive and encouraging them to get help is really important. And if they’re just not ready at this moment, don’t give up – they will need your support when they are.

Q: Tell us a little about the partnership with Northern Wyoming Mental Health (NWMH).

A: A few years ago we realized how much better our treatment for opiate addiction would be if we teamed up. At the time I was treating opiate addiction with suboxone, but had no real links with counselors. Meanwhile they were treating a number of patients with opiate addictions but nobody to prescribe suboxone or other medications. Since then the partnership has really expanded and blossomed and covers all aspects of addiction. We have been fortunate enough to secure grant funding that can help some patients with the cost of medications and visits. We are able to have an amazing peer specialist (an addiction counselor who has recovered from addiction partially with the help of our program) and a wonderful case manager in our clinic on our main addiction treatment days. The partnership also opens up all the resources of NWMH to patients going through our program, including various group therapies, relapse prevention groups, individual counselors, and vocational rehab. I think a lot of our success stems from being able to align ourselves with their team.

Dr. Ackerman and the team at the SMH Addiction Medicine and Recovery Clinic are ready to serve the Sheridan community. If you have questions or need to schedule an appointment, please call 307.675.2674. For additional information please click here.  

By Lynn Grady, RN, BSN – Sheridan Memorial Hospital Emergency Department and Intensive Care Unit Manager who also heads up the hospital’s Stroke Program

Every 40 seconds in the United States, someone experiences a stroke. Stroke is a debilitating and deadly injury to the brain that causes a death every 3.5 minutes in this country.  Often the death follows a lengthy illness that limits a person’s participation in the daily activities of life.

Fortunately, there are several things you can do to minimize the risk factors of experiencing a stroke. Managing health conditions such as atrial fibrillation, high blood pressure, high cholesterol, diabetes, and eliminating lifestyle risk factors such as smoking can significantly decrease your risk of experiencing a stroke. Other lifestyle changes one can make to decrease the risk of stroke include maintaining a healthy weight by eating a healthy diet and engaging in regular exercise regimens, minimizing alcohol consumption, reducing personal stress levels, and maintaining regular appointments with one’s healthcare provider. Despite the best efforts of the healthcare industry in providing education and resources, stroke remains the 5th leading cause of death in the US since 2015.

If you do experience signs and symptoms of a stroke, such as sudden numbness in the face, arm, or leg, especially on one side of the body, or sudden confusion, difficulty speaking, or loss of coordination, call 911 immediately or immediately get to the Emergency Department. If someone you know is experiencing these symptoms, a quick and easy way to determine if this person may be experiencing a stroke is the F.A.S.T. mnemonic.

F – Face: Ask the person to smile. Does one side of the face droop?

A – Arms: Ask the person to raise both arms. Does one arm drift downward?

S – Speech: Ask the person to repeat a simple phrase. Is the speech slurred or strange?

T – Time: If you see any of these signs, call 911 right away.

As a stroke can happen in several different areas of the brain, a patient may experience varying degrees of speech and motor symptoms. This is why it is important to immediately seek medical attention if you are experiencing even one of the symptoms above. Acting F.A.S.T is key to minimizing long-term effects that may be experienced due to a stroke. A quick diagnosis is critical to ensure that a patient receives the treatment and medication they need in order to regain as much function as possible.

At Sheridan Memorial Hospital, we are able to offer our community rapid brain imaging and access to a neurologist by using our Tele-Stroke services provided through Wyoming Medical Center. This provides our staff and patients direct access to stroke experts and optimal treatment options that would otherwise not be available in a community in the size of Sheridan. One of the potential treatment options is a medication called TPA, a powerful anticoagulant (blood thinner) that can be used to help dissolve the clot that is causing the stroke. We are able to provide this particular treatment in Sheridan so that our patients can stay home in their community alongside their families while receiving care. TPA, however, must be administered within 4 hours of the initial onset of symptoms — another reason why time is of the essence if you think you may be experiencing a stroke.

After the initial treatment of the stroke, our patients can then go on to receive physical and occupational therapy services offered by Sheridan Memorial Hospital’s Wyoming Rehab to ensure that they can regain as much strength and function as possible prior to being discharged. If TPA is not an option for the particular type of stroke a patient is experiencing, a treatment plan can be quickly determined between our physicians at Sheridan Memorial Hospital and the neurologists through Wyoming Medical Center.

If you have any questions regarding your potential stroke risk factors, you are highly encouraged to schedule an appointment with your primary care provider to address these concerns.  If you don’t have one, check out Sheridan Memorial Hospital’s Internal Medicine practice or call: 307.675.2650

Sheridan Memorial Hospital Foundation is working to connect the community with the Transitional Care expansion project. This expansion ensures our family, friends, and neighbors have a comfortable, private environment to heal and regain their strength and confidence to return home safely following a serious illness, injury, or surgery. The message has connected with so many people who understand the importance of having this care close to home.

The $8 million dollar project got a kick start toward the end of 2021 with a $2.1 million dollar grant from the State Loan and Investment Board (SLIB) to complete demolition and infrastructure work. Since then, The Foundation has steadily worked on raising the $4.4 million dollars that will allow Sheridan Memorial Hospital to start the final phase of construction to repurpose the 2nd and 3rd floors of the hospital for the 20 private Transitional Care rooms.

Due to the generous contributions over the past seven months, The Foundation is nearing the finish line of the campaign. A matching challenge in March was exceeded and The Foundation board stepped in to ensure that every gift received was matched. This opportunity helped The Foundation raise nearly $700k in March.

To date, gifts and pledges from our community of over $3.8 million dollars have been made to the Transitional Care expansion. This means the goal of raising the $4.4 million dollars by June 30, 2021, is within reach. Approximately one year from now, Sheridan will have a new Transitional Care Unit.

Foundation Board President and Campaign Co-Chair Richard Garber expressed his gratitude to our community and welcomed everyone to come see the vision for Transitional Care saying, “We appreciate the generous response from our community. Sheridan is a place where people take care of each other and share in a vision to ensure our community is a great place to live well into the future. This project will do just that and encourage everyone to come see the original 1954 hospital space that will soon be transformed for Transitional Care.”

To get the most up to date Foundation information and get involved in the Transitional Care Expansion Project, visit sheridanhospital.org/foundation.