October is Breast Cancer Awareness month. Jody shares her story.

Jody BrownBy Jody C. Brown, Director for Lee’s Summit Physicians Group.

Cancer. We hear that word all the time. I’m pretty confident that the majority of people reading this blog have either themselves been affected by cancer or know someone who has been affected by it.

My family and I are no different. I was diagnosed with breast cancer at 39 years of age, with no family history at the time.

Getting the call that something is “abnormal” is jolting to say the least.

I remember going for my biopsy. At the end of the procedure, my doctor asked me if I would like to hear her thoughts on whether or not it was cancer. Or if I would prefer to wait until the following week for the biopsy results. I’m a very matter of fact person so of course I wanted to hear what she had to say.

She believed it was cancer.

I would hear this information on a Friday and my husband and I would spend that weekend in a state of shock. But by Monday when we got confirmation that it was cancer, we’d already been able to process the information. We were ready to take on the fight.

I could go into the details of all the appointments that would start to be scheduled. And the very heavy decisions that would need to be made. Like telling our families, trying to stay positive for our school age boys, trying not to Google mastectomy and breast cancer and all those other scary words.

But I don’t want to talk about that today. I want to talk about the upside to a cancer diagnoses and treatment.

Breast cancer ended up being a bit freeing for me.

Breast Cancer Awarenss MonthI have a fairly thick head of naturally curly hair. When I learned that I would indeed need chemo, I burst into tears at the very thought of being bald.

What could possibly be worse than being bald??? It turns out there are a million things worse than losing your hair. When I started chemo, they told me I would begin losing my hair 14 days after the first treatment. They were spot on.

14 days exactly.

My husband and I were in San Antonio, TX on a trip on the 14th day. That morning, as I began fixing my hair, I pulled out a big clump. That was startling, and then I couldn’t keep my hands out of my hair. I kept pulling clumps of hair off my head. By the time we made it back to Kansas City that very same night, I knew I would have to “do the deed” (have my head shaved) immediately.

That night, at 11pm, I made my husband get the electric razor and shave my head. But I made him put a “one guard” on because I was not ready to face being completely bald at that moment. I looked rough, I’m not going to sugar coat it. The places where I’d pulled my hair out were completely bald. The rest of my head still had a very short layer of hair.

I went to work the next day with a hat, and a coworker met me there with some scarves that she had used during her battle with breast cancer. By the following weekend, I was ready to have my head shaved completely. I went to a friend’s house and she shaved my head clean.  My middle son had accompanied me on this errand. I will never forget what he said as we left her house. He said, “well, at least you don’t look like you have mange any more!” and I burst out laughing. He was so right, I’d totally looked like I had mange!

I found that being bald was actually a blessing.

I could now cook bacon inside my house on a night that wasn’t a “wash night”. I could sit out at a bonfire any night I wanted to. It was wonderful to ride in a car with the windows down. Getting up, showered and out the door in 5 minutes was fantastic. I could drastically change my appearance regularly by wearing a different wig, or a scarf or nothing at all on my head.

The thing I noticed most is that everyone was nice to me… all the time! Perfect strangers would be so kind to me. They would hold doors for me, let me go before them in line, and not get irritated if I happened to unknowingly cut in front of them. I probably could have stolen someone’s coveted parking space and when they saw my head (I generally wore scarves, a sure sign that someone is battling cancer) they would just let me go with no confrontation.

Losing my hair, once thought to be the worst thing that could possibly happen to me (okay, that’s a slight exaggeration… slight!) would end of freeing me in so many ways.

My hair grew back.

JoJo's ArmyGrowing my hair back was actually more painful than being bald. There were some really rough “bad hair days”. But even during that time there were blessings. We had moved to Kenya two months after I completed treatment. My hair was just beginning to grow back. No one in Kenya had ever seen me before, so they had nothing to compare my appearance to and no one ever said a word about it! By the time we came back to the States my hair was well on its way to being exactly like it was before, curls and all.

My story had a successful conclusion. Many do not. It’s important to understand what going through breast cancer can feel like for a woman. Compassion and support are important things to give someone you know facing breast cancer. My family and coworkers surrounded me during my battle and it really helped. So as we recognize October as Breast Cancer Awareness Month, thank you for reading my story. And I am so thankful to be able to share it with you!

What you need to know about Medical Marijuana in Missouri

By Dr. Emily Robb

Medical MarijuanaMissouri has approved the use of medical marijuana for appropriate patients who are residents of Missouri. There are still a lot of questions about medical marijuana. The internal medicine department of LSPG would like to help you understand the current state of medical marijuana in Missouri.

Is medical marijuana legal?

Medical marijuana is legal in Missouri for persons that obtain a Missouri medical marijuana patient identification card. Federally, marijuana is still illegal. Missouri residents that are found with marijuana in a state that has not legalized medical marijuana could be charged with possession of an illegal substance. Legal questions are best addressed by a lawyer.

Is medical marijuana safe?

More study is needed to fully answer this question, but there are some risks with use. These risks include, but are not limited to, addiction, breathing trouble, intractable vomiting, dizziness, impaired memory/concentration, slower reaction times/impaired driving, worsening of mental health disorders (increased anxiety, depression or schizophrenic tendencies) and withdrawal with abstinence of use. Marijuana will interfere with certain drugs and may require close monitoring by your physician.

Is medical marijuana effective?

Again, more study is needed. Currently we know it is very effective for certain types of seizure disorders. There is some evidence it can help with pain and anorexia associated with cancer and cancer treatments. We recommend you talk to your physician if you feel that medical marijuana would be helpful treating your medical issues.

What are qualifying conditions in Missouri?

  • Cancer
  • Epilepsy
  • Glaucoma
  • Intractable migraines unresponsive to other treatment
  • A chronic medical condition that causes severe, persistent pain or persistent muscle spasms, -including but not limited to those associated with multiple sclerosis, seizures, Parkinson’s disease, and Tourette’s syndrome
  • Debilitating psychiatric disorders, including, but not limited to, post-traumatic stress order, if diagnosed by a state licensed psychiatrist
  • Human immunodeficiency virus or acquired immune deficiency syndrome
  • A chronic medical condition that is normally treated with a prescription medications that could lead to physical or psychological dependence, when a physician determines that medical use of marijuana could be effective in treating that condition and would serve as a safer alternative to the prescription medication
  • A terminal illness
  • In the professional judgment of a physician, any other chronic, debilitating or other medical condition, including, but not limited to, hepatitis C, amyotrophic lateral sclerosis, inflammatory bowel disease, Crohn’s disease, Huntington’s disease, autism, neuropathies, sickle cell anemia, agitation of Alzheimer’s disease, cachexia, and wasting syndrome.

How does a qualifying Missouri resident obtain a patient identification card?

The Missouri Department of Health and Senior Services website has excellent information on how to obtain a patient identification card as well as a list of qualifying conditions.

Please go to this website for complete information: https://health.mo.gov/safety/medical-marijuana/how-to-apply-pi.php

Part of the certification process requires a physician certification form. The internal medicine department of LSPG is willing to fill out physician certification forms for our current patients that meet appropriate criteria.

  • The applicant must have been an established patient with LSPG for at least 2 years. Care with LSPG must have been established by June 30, 2017. Any patients that began care with LSPG after June 30, 2017 do not qualify and we will not sign your form.
  • The applicant must have been treated for, or currently receiving treatment for, one of the qualifying conditions listed above. In addition, the patient must have failed or had a sub therapeutic response to conventional treatment.
  • The applicant must be at least 21 years old and a Missouri resident.
  • The form must be filled out and signed by a medical doctor. Our nurse practitioner is unable to fill out forms.

Your LSPG physician will require you to schedule an office visit to discuss appropriate use and risks of medical marijuana prior to filling out your physician certification form.

Patients currently taking opiate medication for pain will be closely monitored and will be required to taper down or off their opiate pain medications if they are going to proceed with use of medical marijuana to treat their pain.

LSPG charges $100 per physician certification form. LSPG will only fill out paper forms. We do not fill out forms online. You will need to print out the physician certification form and bring it to your appointment.

The form is available at this website: https://health.mo.gov/safety/medical-marijuana/pdf/physician-certification-form.pdf

If you have already met with your physician and established a care plan involving medical marijuana, you are able to drop your form off at the office for completion. Otherwise, an office visit is required to complete the form. Please allow five (5) business days for completion. The form fee will be due at the time the form is picked up from the clinic. You will need to upload the paper form to your medical card online application as a PDF. If you do not have access to a scanner, you should be able to take a picture of your form and upload the image.

Be aware, once the form has been signed by your physician, you have 30 days to complete and submit your application with the state of Missouri.

The importance of organ donation. A personal story from Cindy’s family.

By Cindy Aldrige, F.N.P., Provider for Lee’s Summit Physicians Group.

Have you ever been asked about organ donation… maybe at the DMV? Do you have a lot of questions about the process? I’ve worked in the Emergency Department for years and as an EMT on an ambulance and I have a lot of experience with this topic from the medical/caregiver point of view. I was always in favor of donation, but a personal experience just made me affirm my decision even more!

Let’s talk about some concerns people have when the topic of being an organ donor comes up.

Organ DonationLet’s face it, when even discussing this topic for possible publication we had someone say, “well I’ve heard that if I sign up as an organ donor, they won’t try to save me.”

This so, so far from the truth. Health care providers work to resolve every problem/concern EVERY TIME. They try to save YOU, NOW… they’re not looking to save someone in the future.

In healthcare, workers have a very strong code of ethics. We do everything in our power to help and knowledge is what we all strive for. Plus, working together as a team, if anyone forgets or messes up, the others are not afraid to step up and correct them.

Organ donation, from a healthcare prospective, is something that is thought about after someone has been given every opportunity and there is no hope for recovery or has already died.

Let me tell you my family’s experience.

I have a cousin that was living in Key West when she was riding home from work on her motorcycle one night. A car didn’t yield to traffic signs and ran right into her. She was taken to a trauma center in Miami, Florida and they did everything they could to assess her and take care of her. Her sister lived nearby and rushed to the hospital. My parents were visiting central Florida so they responded as well. The rest of the family flew down as soon as they could get flights.

The medical staff cared for her for days, but she was not improving. They determined that she was brain dead. Her other organs were working fine, but her brain would never improve. She was on a ventilator and tubes to sustain her life. She had many experts and tests that were ran and re-ran in hopes that she would show signs of improvement, but she was never going to get better.

Our family knew her wishes in advance… which is key in making these tough decisions. We knew there would be no question as to what Angie would want done – to help as many people as possible since there was no hope for her improvement. When the topic of organ donation came up, we knew what the next decisions were going to have to be. It’s never easy, but knowing her wishes in advance made the decision to disconnect life support a bit easier. We knew she wouldn’t want to continue in a lifeless state, having to be cared for with no quality of life.

The support team and hospital staff were very supportive. Our family was able to control decisions, decide the time frame and get all our questions answered before any further action was taken.

I’ve experienced this on a professional level as well when families have made the difficult decision to help others through organ donation.

I’ve seen families make this incredibly difficult decision. The medical staff takes the person off life support, monitoring their response, just as they would anyone that was taken off life support that wasn’t donating organs. After they’re pronounced dead, the talented team of experts begin to work to save as many lives as they can with the viable tissue and organs that can be used. They coordinate getting recipients into other operating rooms awaiting the transplanted organs and they update families. They coordinate hospital staff and flights for organs that can be used.

Organ DonationWhat a glorious day when learning well over a year after we said our goodbyes to my cousin Angie, that Angie’s kidney had saved a family from having to sell their home to pay for medical expenses. The man that got Angie’s kidney is now able to work and spend time with his many children, all because Angie and her family were so generous to save other lives! Angie’s kidney is in Iowa today, thriving and doing well, taking care of that young family and allowing children to grow up with a father that can be active with them.

We were contacted by letter from this man, so grateful for his gift of life. Many other people have benefited from Angie’s gift as well, but we know the kidney story and we know the happy ending. Everyone that knows me or reads this will understand that I’m an organ donor. I will do everything in my power to help people even after they sign my death certificate!

Thank you for letting me share our personal organ donation story with you.

If you still have questions, I would be happy to speak to you. You can also learn more here where the Mayo clinic talks about the most common questions asked about organ donation.

I’ve also included a couple of other links about organ donation and end of life care. Please, please make your wishes known and fill out the paperwork and sign up on the organ donation registry so your family can honor YOUR wishes rather than have to make tough decisions in a time of crisis.

Additional Resources

 

Jody’s Trip to Africa – “Do I have to drink goat blood?!??!”

By Jody C. Brown, Director for Lee’s Summit Physicians Group.

My husband took his first trip to South Africa in 1989. That trip would spark a life-long love affair with the country, and other African countries would eventually be added to that list.

We took our boys to Kenya, Africa for the first time back in 2006.

Jody's Kenya TripThey were ten, nine and seven at the time. It had long been a dream of ours to expose our boys to another culture for a longer time than the normal two week vacation so this trip was a “fact finding” trip to see if they (and we) could handle a year living in Kenya.

Prior to our trip, we had talks with our boys about different cultural situations they might find themselves in and how they should respond during those times. Mainly that conversation had to do situations like eating at someone’s house or a church gathering. I explained the kinds of foods offered may not be something they were used to, it may not be something they particularly liked and it may be something that we weren’t even sure what it was!

We didn’t want to offend anyone.

We explained to them that we did not want to offend anyone and therefore there would be no “I don’t like that” or rolling of the eyes or any other comments that might offend our hosts. I was explaining all this to them, but it was a personal reminder as well. There were a couple of customs I was aware of that I knew if I were faced with them, it would be a real struggle for me!

I knew the boys had taken our conversation to heart when we were leaving a remote village where we’d been served a delicious lunch that included a meat we were not familiar with (it turned out to be goat meat). On the drive back, my youngest and pickiest son told me that his meat had hair on it. I had been sitting beside him the entire meal and had no indication that he was having any issues whatsoever.

We had an amazing time, met wonderful people who remain our friends to this day, and ultimately realized that even though it wouldn’t be easy, we could definitely live there for a year. Unfortunately, the timing wouldn’t be right for our family to make the move for several more years, but we would eventually make our way to Kenya!

That time came in November 2014

Jody's Kenya TripWe were supposed to go to Africa for a year, but due to some unforeseen circumstances prior to our departure, we were only able to stay for eight months. But what an amazing eight months they were! I’ve been back to Kenya twice since that time, the most recent being June 2019. Remember when I said earlier that there were a couple of customs I would have a hard time participating in if I were faced with them? One of those situations presented itself to me on this last trip.

One of those customs is drinking curdled milk. The process of curdling milk involves burning the inside of a large gourd then adding goat or camel milk and letting it curdle before drinking it. My oldest son was on a trip to a remote village when he was given the “opportunity” to partake of this drink. I’ll give it to him, he was braver than I would have been. He attempted to drink some, but when he felt the first “curd” of milk, he nearly tossed his cookies and that was the end of it. Thankfully, he hadn’t offended anyone by not being able to drink it, in fact, the Kenyans got a good laugh out of it.

On our trip in June we were invited to a village by a remote tribal group that is trying to attract more tourists.

We were the first outside visitors to this village and they greeted us so warmly with their tribal dances, singing and their traditional tribal clothing. When we walked into the village, I saw a goat tied up and knew it would be our lunch. I also later spotted them preparing the goat to put on the fire. When I was grabbed by the hand by one of the tribal ladies and walked in the direction of the now dead goat, I knew my biggest fear was about to be realized and I was in panic mode.

I knew it. I was going to be asked to drink some of the goat’s blood.

Jody's Kenya Trip Jody's Kenya Trip

As we were being led to the goat, I passed by my husband who was sitting under a tree just watching this all take place. As I passed by him I said, “they’re going to make me drink the blood?!?! Are they going to make me drink the blood?” He got up as if he was going to save me, but he didn’t. Sure enough, we were led over to the goat and a young lady who was with us was the first to be offered a piece of raw meat… she declined. They laughed. I was offered the meat/blood. I declined. They laughed. And I nearly collapsed with relief!

Never have I been so far outside my comfort zone as I was on that day, but it was a great day. It was an honor to be warmly greeted as the first guests to this village. They spoke to us through translators, their children sang songs for us, they proudly showed us their hand-built huts and invited us in to see them. I could go to Kenya one hundred more times and I will never cease to be moved by the happiness of these people who live so simply, yet have so much joy.

If you don’t have an Advanced Directive… keep reading.

Advanced DirectiveBy Cindy Aldrige, F.N.P., Provider for Lee’s Summit Physicians Group.

Do you wonder why every medical facility asks for an advanced directive, living will or DPOA when you check in? Do you even know what that is? Do you know why it’s important? Do you know why every adult (18+) should have one? Do you know how to get one?

In short, an advanced directive documents your health care wishes in the event you’re unable to tell others how you want to receive care.

According to AARP, an advanced directive is a general term that refers to the various documents that includes phrases like living will, instruction directive, health care proxy, durable power of attorney (DPOA) and health care power of attorney.

Advanced Directives are FREE or nearly FREE!!!

Does that get your attention? It’s easy to get advanced directive health documentation taken care of at low or no cost to you at all. You don’t have to have an expensive lawyer to be able to have this part of your healthcare information enacted. All you have to do is fill out a form, then have it notarized (this may be minimal cost but generally less then $5.)

A notary can be found at places of employments, banks, financial institutes, real estate agencies, hospitals etc. I often joke with parents that they should pass out Advanced Directive forms at their next family gathering and have everyone above the age of 18 fill it out. It can always be revised later, voided or a new one executed as life circumstances change (marriage, deaths, children become adults etc.)

Important Terms to Understand

Living Will

A living will (or instruction directive/advanced directive) tells health care professionals and your family what you want or don’t want done concerning your health care needs if you are unable to voice or make your own health care decisions. This has nothing to do with your will of your possessions that an attorney helps with (Uncle Joe gets my boat, etc.)

An example of a situation that you might use the health care directive/living will is while you are sedated for surgery and an emergency or new problem arises and someone has to make a decision, but you are sedated and not available to make it for yourself. Another example is you are in a car accident and hit your head and you can’t make decisions for yourself until the swelling goes down and the breathing tube is taken out. This is when family and medical professionals can look at your advanced directive (health care directive) to answer some of these questions.

Durable Power of Attorney

Durable power of attorney (DPOA/health care proxy) is someone (one or two people) designated to know your wishes and make decisions on health care situations only in the event you are unable to make those decisions. Often it’s a spouse, family member, or trusted friend. The idea is that you have discussed your wishes and desires about your health care BEFORE the need to make those decisions arises.

Talk to your family about if you would want to be on a ventilator for longer than a month, would you want antibiotics and feeding tubes if there was no hope of you getting better, do you want CPR if you are brain dead. These are all difficult conversations for some, but growing up in a healthcare family, these were all things we talked about on a casual level, maybe at the dinner table.

I’ve been told several times, “I don’t want that paperwork filled out because I want them to do everything possible to make me better if I’m ever in that situation.” Just because you have an advanced directive filled out doesn’t mean the hospital will not care for you or provide every opportunity for recovery, it just means they have YOUR opinions about certain situations in writing in case any of them arise.

There are other forms for those that choose not to have a breathing tube, CPR etc. done that is usually referred to as a DNR meaning “DO NOT RESUSCITATE”. Again, this is only put in affect if you’re not breathing or your heart has stopped. To be blunt, you’re already dead by clinical definition, it’s just if you want techniques and machines used to help possibly bring you back to life.

Every medical provider will do everything in their power to help you unless there is strict paperwork filled out that mandates that they omit certain care/treatment!

Many forms have all the above terms/information included in a single form, so you don’t have to fill out a bunch of separate paperwork. You fill out what you want filled out, you don’t fill out what you don’t want to address.

These forms sometimes have a location on them related to organ donation wishes. All adults should consider organ donation. I will be writing another blog in a few weeks about DNR and organ donation. That may answer some questions and tell you about our family’s personal experience with organ donation.

Until then, get your advanced directive filed out and notarized and then give a copy of it to family, your primary care provider and take with you with any hospitalization/surgery.

AARP is another source of more information on this topic or the state of MO website: ago.mo.gov.  Information can be found at http://livingwillforms.org/mo/

Preparing for Launch: Life Changes When Your Child Goes to College

By Jennifer M. Sauer, M.D.

In the words of Thomas Rhett’s song “Life Changes”

“Ain’t it funny how life changes
You wake up ain’t nothing the same and life changes
You can’t stop it just hop on the train
You never know what’s gonna happen
…And I wouldn’t change it for the world, the world, oh no”

Preparing for Launch: Life Changes When Your Child Goes to CollegeA monumental “Life Changes” moment is about to happen for this Pediatrician Mom. There will be dorm bedding and decorations to buy, books to order and making sure she can check her tire pressure of her car. But this blog is about how I get to prepare for the emotional launch of a college child first-hand.

Come August, we’re going to move the girl we’ve been so focused on for 18+ years into her dorm room three hours away.

This is something that we all know will happen when we bring a baby into the world, but it sneaks up on us parents. The saying “the nights are long, and the years are short” is very apparent to me right now. I could be saying “Houston, there is a problem.” But the child (the rocket) is ready to fly. The goal is to raise functioning, independent members of society, but when it gets right down to it, it’s hard to let go.

So am I nervous? Yes, but also excited.

I know that perspective of a situation is what we can control. If you think about being nervous, our heart rate and blood pressure go up and we can’t sleep. When we are excited, our heart rate and blood pressure go up and we can’t sleep.

Research conducted at Harvard University (Journal of Experimental Psychology: General © 2013 American Psychological Association 2014, Vol. 143, No. 3, 1144–1158) showed  “Individuals can reappraise anxiety as excitement using minimal strategies such as self-talk (e.g., saying “I am excited” out loud) or simple messages (e.g., “get excited”), which lead them to feel more excited, adopt an opportunity mind-set (as opposed to a threat mind-set), and improve their subsequent performance.

Fear of the unknown can be looked at as scary or as a new opportunity.

I’ve preached to my kids over the years, and they say I should just have a book of one liners:

  • “If I don’t have expectations for you, who will?”
  • “With great gifts comes great responsibility.”
  • “Perfectionism is NOT an obtainable goal. Work hard but you can also learn from failure.”
  • “You are resilient.”

Thomas Edison said, “I have not failed. I’ve just found 10,000 ways that won’t work.” So as a parent, we’ve been preparing for days, weeks, years before the moment we help launch our child into a new phase of their life. We hope that we have instilled our knowledge into them over the years so they can pull from the life lessons they’ve already experienced. These are tools in their toolboxes to deal with what is yet to come.

Preparing for Launch: Life Changes When Your Child Goes to CollegeAt our daughter’s recent college orientation, there were “lectures” for the parents while the students were whisked off to set their first semester schedules (no parents allowed for that process).

Topics that were discussed included Eustress- moderate or normal psychological stress interpreted as being beneficial for the experiencer. The student will need to have new experiences to grow instead of just interpreting the outside world as big and scary. There will be stress with this new chapter of all of our lives (both her and the family left behind in Lees Summit) but we need to teach our kids that they are resilient (resilient is my favorite word in the whole dictionary).

If I were actually doing a VLOG, I am told by my to be college freshman that I would be talking with my hands and emphatically saying, “SEE?!?! STRESS IS NORMAL! IT’S EVEN HEALTHY!”

Her college is now the one that will preach to her on a daily basis and they expect self-authorship.

Kids need to take control of the wheel with us in the background. In turn, they get the chance to show how resilient they really are, but also to relish in THEIR own accomplishments. Will I cry when I leave our daughter in her dorm room? I’m sure I will, but to quote Dr. Seuss, “Oh the places you’ll go”.

I am labeling this new adventure of life as exciting and look with positive anticipation of what is to come. The countdown has begun.

The importance of taking vacation: Travel pics from Wendy, Julie and Rhonda.

By Cindy Aldrige, F.N.P., Provider for Lee’s Summit Physicians Group.

Have you ever wanted to just get away on a vacation? Did you know that vacation and mental breaks away from day-to-day stressors are actually healthy? Yes, you can take a vacation for your health!!!

Here at Lee’s Summit Physicians Group, we recommend that our staff takes mental breaks by going on vacation and taking time away from the office. Three staff members have shared their recent adventures with us with pictures (for those of us who can’t afford to travel and want to live vicariously through their pictures!)

Wendy Johnson, Care Coordinator, is an adventurous type of person.

She and her husband love to travel and see new things. Thailand was one of her most recent adventures. When asked WHY there, her response was it has been on her bucket list. She has been intrigued by architecture and the countries amazing traditions. She enjoyed seeing an elaborate temple from the 14th century. Wendy said, “seeing the floating market where the local community pilots their little boats to the docks to sell their produce right out of the boats was really something worth seeing.” She even got to see them “cook in the little dug out boats.”

When asking Wendy what was unexpected about her adventures, she said the traffic in Bangkok. “Motorcycles are very common. At the red traffic light, they all make their way to the front of the line and take off as a pack when the light turns green.” Unfortunately, after eating off the food trucks, Wendy came home with food poisoning. She was not wanting THAT experience in her travels!

Wendy’s advice when traveling to Thailand is to walk the city streets and cut through the alleys so you can experience how the locals live. She also encourages the use of Groupon as this was her “best bargain trip” and it was that it was amazing. “Travel opens your eyes to how fortunate we truly are” so that we “appreciate even he small things.”

Vacation is Healthy: Thailand Vacation is Healthy: Thailand Vacation is Healthy: Thailand

Julie Gramlich, Insurance and billing supervisor took at trip with her son’s school class to Italy.

Her favorite part of the trip was the gondola ride in Venice! “I have always seen those on TV and thought it was really cool that I was getting to ride one!” One thing unexpected that she learned is how much she loves ice. In Italy, ice is rare and most locals don’t use it at all. Julie said she was surprised at how much she missed ice.

When traveling there, Julie recommends using guided tours. Tours give you special access to some places and keeps you on schedule. She would recommend to avoid summer time heat there. She experienced melting July heat. “The most beautiful place was Capri.” She describes the beautiful country side and said that the architecture was breathtaking.

Vacation is Healthy: Italy Vacation is Healthy: Italy Vacation is Healthy: Italy

Rhonda travels a little closer to home, Warsaw, MO, the spoonbill capital of the world!

Rhonda Pfaffly, Referral Coordinator for Lee’s Summit Physicians Group, likes going back to her hometown about 98 miles away from KC. She loves “being with old friends” and attending local events, allowing her t0 run into friends that she hasn’t seen in years.

Rhonda boasts of the many things to do in Warsaw, and it’s close to both Truman Lake and Lake of the Ozarks. Things to do include: fishing, water sports, bike trails, antique/flea market shopping and taking in the beautiful scenery. She recommends making the 1.5 hour trip from KC as a day trip or a nice, long weekend.

There are several wineries along the way from KC to Warsaw. One of the top things to see is the Missouri conservation fish hatchery. “Kids love this!” she adds.

In April Warsaw hosts the Benton County Wine Stroll featuring many Missouri wineries. June is Jubilee Days on the harbor with craft tents, carnival, parade, and live bands. During the summer boating and fishing is top of the list of things to do and many enjoy swimming and jet skiing as well. October is Heritage Days with craft tents and festivities at the Harry S. Truman Overlook. This event takes you back in time to experience an old school house, general store, soap making, blacksmith exhibits, root beer and kettle corn!

Vacation is Healthy: Warsaw

Rhonda’s favorite spots in Warsaw include:

  • The Landing Bistro & Lounge with “a great view of the Lake of the Ozarks with an awesome gift shop.
  • Nix Bar, a local favorite.
  • Red Wing Coffee, they grind their own special blends and make wonderful desserts to satisfy your sweet tooth!”

Rhonda would live in Warsaw again if she could… she said it was a “great place to grow up and a great place to go back home to.”

Vacation is Healthy: Warsaw Vacation is Healthy: Warsaw Vacation is Healthy: Warsaw

So here is to travel, staying healthy and enjoying the sights, sounds, smells of the world around us! Have a great summer!

How do you know if your child has a concussion?

By Cindy Aldrige, F.N.P., Provider for Lee’s Summit Physicians Group

Spring fling… for sports goers sometimes that’s more than just having fun. Spring brings more physical activity and sometimes falls and concussions. New standards and precautions are in place to keep brains healthier and ultimately happier.

Symptoms of Concussion

ConcussionSymptoms of head injury and concussion a few hours after an event is memory loss of what happened right before the injury. There can also be confusion, headache, dizziness or trouble with balance, nausea or vomiting, sleepiness, and being fussy/cranky.

Symptoms that can occur hours to days after the injury include trouble walking or talking.

Memory issues include problems paying attention, trouble sleeping, mood or behavior changes, vision changes or trouble with bright lights/sun or even noise.

If you notice these symptoms report them to the coach and seek treatment from medical professionals. Exams, testing and follow up is a must for a successful recovery.

Treating a Concussion

Treatment includes limiting activity until symptoms resolve which includes physical rest and mental/brain rest. In other words not going to school or work to avoid mental exercise/stress and not returning to exercise or activity that stresses the body. Also avoiding screen time until symptoms are resolved, then slowly introducing it back into daily life… YES. It means your PHONE and TEXTING or SOCIAL MEDIA TOO!

Oh, part of treatment is brain rest, so allowing the person to sleep is okay, just make sure that they’re checked on frequently, and when they do wake, that they are evaluated to make sure symptoms are not getting worse. Returning to school sports will also include notification to the athletic trainer or coach for retesting before returning to normal practice and game routine.

Be Careful Out There!

Be careful out there this spring/summer, but remember that activity is always important for healthy bones/muscles and brains/minds, so don’t use this article as an excuse to rest your brain and body for too long. Activity keeps us young and healthy.

Source: In part from the Up to Date patient handout: Concussion in children and adolescents.

Top 5 Insurance Related Tips for Making the Most Out of Your Next Office Visit

By Rhonda Pfaffly, Referral Coordinator for Lee’s Summit Physicians Group

Lee's Summit Physicians GroupThe following tips are the top five common questions we hear related to insurance and first visits with our providers.

What should I know, especially a new patient visit to make the most of my visit with my doctor?

The best thing keep in mind is KNOW your insurance. We, as your health care provider and staff, don’t know everything about your insurance. And please be prepared to pay your co-pay.

Educate yourself on your co-pay amounts for your Primary Care Physician and Specialists

If there’s anything you need to know about your healthcare coverage (besides which physicians are in your network), it’s your premium, deductible and copay amounts—call the number on the back of your insurance card to get this information. Be prepared to pay your co-pay and to present your insurance card and photo ID at every visit.

What will my provider need at my first visit?

Be proactive and have a list of medications, strengths and how you take them. Be prepared to list allergies, past surgeries, and past medical and family history. This will save the nurse time, and the faster they can get all this information entered into your chart, the more time you will have with your physician.

Make a list of questions for your provider. (*Note* They may not be able to address all of your issues in one visit.)  If you have a chronic condition such as Diabetes or hypertension, it would be helpful to keep a log of your blood sugars or blood pressure readings to make sure you are on the correct medication and dosage. Remember to be your own advocate!

How do I know if my insurance requires a referral?

The best way to know if your insurance requires referrals is to contact your insurance carrier directly. The phone number should be located right on your insurance card. Your insurance card may even indicate if you require a referral directly on the card itself. If this is the case, make sure the nurse is aware that you need an insurance referral so it can get to the proper staff that handles the insurance referrals.

Many specialists will need a physician-to-physician referral which will include a fax from our office stating why you are being referred to them. We normally fax the order, office notes, insurance information and labs, x-rays or anything else pertinent to why you are being referred to them. We do our best to make sure we are directing you to a physician that is in your network, but ultimately this is up to you to verify prior to your appointment with that specialist.

Learn which physicians and practices are in your provider’s network.

Even though you have health insurance, that doesn’t mean you can visit any doctor or hospital and be covered. We do our best to keep you within your network, but you’re responsible for knowing what hospital you can go to, specialists you may be referred to and what lab and pharmacy your insurance prefers.

With all this information, I hope your next visit to your physician’s office will be more efficient and informative for you!

KNOW your history! ASK questions! PROTECT your children! IMMUNIZE!

By Dena Pepple, R.N. for Lee’s Summit Physicians Group

I love to read, and historical fiction is my favorite subject. For Christmas, my wonderful sister-in-law gave me a Barnes & Noble Nook. Since then, I’ve probably read three books a week about wars, orphan trains, politics, and more. Oddly, in several of these books disease epidemics, that we now have vaccines for, were an integral part of the story. As a pediatric nurse who talks to parents daily about immunizations, I found this very interesting.

Many of these diseases I’ve never seen personally, yet statistics and history tell me of their toll on human life.

In the 1920’s, 10,000+ lives were lost for several years in a row due to diphtheria. Polio paralyzed or killed thousands in the 1940’s and 1950’s. At the height of the measles outbreak, prior to vaccination, an estimated half a million children per year got the disease, with many progressing to pneumonia, encephalitis, and death.   These, and many other diseases, were tragedies that today’s vaccines have saved us from.  Vaccines have protected us so much that most people, like me, have not witnessed the death and destruction that many of these diseases have caused.

Knowing this disease/vaccine history and having the lives-saved statistics of vaccines at our fingertips:

…I wonder why some parents choose not to immunize.

I think there are three main reasons.

ImmunizationFirst, we in the vaccine world are “victims of our own success”. Most of the diseases we vaccinate for have seen a 90%+ decrease in reported cases. We rarely hear about or see these diseases and think it won’t happen to us, or it’s only in other countries.

Second, some parents have had no information about vaccines, and have genuine fear.

Lastly, there’s a HUGE amount of partial/mis-information easily available to us, and touted as the whole truth.

Of course, we don’t want to fix the first reason listed above, vaccine success. Keeping children healthy is what we are all about.

We can, however, work on the information problem. I tell parents, the most important thing for them to learn/do is: ASK QUESTIONS!!! If you have a worry, ASK!  If something does not make sense, ASK! If you have a sixth sense about something, ASK!

The second thing I advise is consider the source and check facts. A children’s hospital is most likely more thorough and reliable than your neighbor, or a random web site. Below is a list of some partial or mis-information statements I’ve heard, followed by factual clarification.

SERIOUS DISEASES LIKE POLIO ARE GONE, SO WE DON’T NEED TO VACCINATE AGAINST THEM.

While many diseases have been wiped out or rarely occur in our country, they are still present around the world and are only a plane ride away. If an unvaccinated or under vaccinated person travels and contracts the disease from an infected person, then brings it back home, he/she may infect others. This opens us up for further spread of the once thought to be gone infection.

This is happening now with measles. We have already had 5 outbreaks of measles here in the United States this year. If this rate continues, we will have 3 times more cases this year than last year.

Polio is prevalent in other countries as well, so it is only a plane ride away. My dad had polio in 1951. He “saw black” for 4 days, was in the hospital for over a week, had severe muscle ache/pain and was very weak for about a month. He was lucky. In 1952 >3,000 people died from polio, and >21,000 were paralyzed. Until the disease is eradicated worldwide, we NEED to vaccinate.

BABIES IMMUNE SYSTEMS CAN’T HANDLE THE NUMBER OF VACCINES GIVEN TODAY.

The infant is already exposed to thousands of germs on a daily basis, whether they are in child care or not. Even if he/she got 11 vaccines at the same time, he/she would only use 0.1 % of his/her immune system to respond. Therefore, they can easily handle the number of vaccines given at any one time.

The goal is to protect them as early as possible when they’re most vulnerable to these diseases. Also, even though the number of vaccines has risen over the years, the antigen (substance that induces an immune response) load has gone down due to the refinements in the vaccines. This means we can protect our little ones from more diseases, while having an overall lower antigen load than previous generations received in their vaccines.

DELAYED IMMUNIZATION SCHEDULES ARE SAFER THAN STANDARD ONES.

Some parents believe that too many vaccines at once can cause problems, including developmental issues. Study after study denies this. In fact, by delaying immunizations, their children are at greater risk of contracting these diseases. These diseases can cause numerous health problems, up to and including death.

NATURAL IMMUNITY IS BETTER THAN IMMUNITY FROM VACCINES.

Natural immunity may last longer than vaccine derived immunity, but that is why there are booster shots. The risks, symptoms, and complications associated with getting the disease (to get that “natural immunity”) can be far worse. When my children got chickenpox 25 years ago, it was a breeze. Their main issue was itching and I had a week off of work, but many aren’t so lucky.

One of my little 6 month old patients was admitted to the hospital with so many blisters he looked like he had 3rd degree burns. One of our nurse practitioners took care of an 8 year old with chickenpox encephalitis. This child had brain damage, and spent months in the hospital and rehab. Pneumonia, cancer, and death can and does occur as a consequence of this “natural immunity”. In addition, there are some diseases, like tetanus, that don’t provide natural immunity.

THERE IS FORMALDEHYDE IN IMMUNIZATIONS, AND THAT IS A POISON.

Yes, there is a small amount of formaldehyde used in the production of vaccines to prevent contamination. Most of it is removed at the end of processing, before packaging. Some are concerned that it is used at all, but formaldehyde naturally occurs in the human body. Our bodies are continually producing/processing/eliminating formaldehyde, with about 1.5 mg always circulating in a 15 lb baby. One banana has 20 times more formaldehyde and one pear has 600 times more formaldehyde than a single vaccine.

THERE IS NO SUCH THING AS HERD IMMUNITY AND IT DOES NOT HURT YOUR CHILD IF MY CHILD IS NOT IMMUNIZED.

Yes there is, and yes it does! Herd immunity is a form of immunity that occurs when a significant number of the “herd” (you and me) are vaccinated, which then provides protection for those in the “herd” who do not have immunity (newborns, immune-compromised, elderly, etc). This is usually achieved with an 85-95% vaccination rate.

The higher the percentage of vaccinated persons does two things: there are less people in the first place who are susceptible to the disease, and if you don’t get the disease-you can’t give it. The “herd” then cocoons those who are still vulnerable to the disease. If less children are vaccinated, it weakens the herd, leaves the unvaccinated vulnerable to disease, which they can then spread to those who are not immune.

Sir Winston Churchill once said, “Those who fail to learn from history are doomed to repeat it.”  The statistics and stories are in our history books.  I’ve read about them on my Nook. Let’s learn from our “history” and NOT repeat it.

KNOW your history! ASK questions! PROTECT your children! IMMUNIZE!