How to talk with your children about tragedy

The Springfield community has come together to cope with the recent tragedy and loss of 10-year-old Hailey Owens. If you have children, you may be wondering the best way to discuss this situation with them (and/or tragedy and death in general). Chances are, your child has already been exposed to some details at school and may have brought up the topic. If you have yet to address it, here are a few tips for discussing the recent event with your children, courtesy of OCH psychologist Dr. Erin Golden:

  • Find out what your child knows & doesn’t know about the situation. As this situation has been widely publicized, there is a large chance that your child has already heard about it. If you are apprehensive about bringing up the topic, allow your child to mention it first; or casually bring it up if it is apparent the child has been exposed to the information such as watching the news with the family.  Make sure to address the facts and correct their misconceptions.
  •  Make sure what you share is age appropriate. Until kids are about 5 or 6 years old, their view of the world is very literal. So explain the death in basic and concrete terms.  Also remember that kids’ questions may sound much deeper than they actually are. For example, a 5-year-old who asks where someone who died is now probably isn’t asking whether there’s an afterlife. Rather, kids might be satisfied hearing that someone who died is now in the cemetery. Kids from the ages of about 6 to 10 start to grasp the finality of death, even if they don’t understand that it will happen to every living thing one day.  Often, kids this age personify death and think of it as the “boogeyman” or a ghost or a skeleton. They deal best with death when given accurate, simple, clear, and honest explanations about what happened.  As kids mature into teens, they start to understand that every human being eventually dies, regardless of grades, behavior, wishes, or anything they try to do.  As your teen’s understanding about death evolves, questions may naturally come up about mortality and vulnerability. A teen who asks why someone had to die probably isn’t looking for literal answers, but starting to explore the idea of the meaning of life. Teens also tend to experience some guilt, particularly if one of their peers died.
  •  Don’t use euphemisms: Although you want to keep your conversation age appropriate, using terms such as “she went to sleep,” or “she is visiting someone,”  or even that she is “lost” to describe what happened can do more harm than good. Because young children think so literally such euphemisms can make them more fearful, as they may then become afraid to “sleep,” or be afraid that mom and dad may “go to sleep” and never wake up; or that if a person leaves they make never return.
  •  Be honest with kids and encourage questions. This can be hard because you may not have all of the answers. But it’s important to create an atmosphere of comfort and openness, and send the message that there’s no one right or wrong way to feel. You might also share any spiritual beliefs you have about death.
  •  Validate your child’s feelings. Are your kids feeling scared? That’s okay. This is a normal reaction. Are they nervous? Worried? Ensure them that it’s okay for them to feel this way, don’t downgrade their emotions.
  • Watch their media exposure. There has been a lot of coverage on about this incident over the past few days, and it’s going to continue. Overexposure to the incident can do more harm than good as your child copes.
  •  Review basic safety reminders with your children. Now is a good time to remind your kids not to walk up to vehicles, wander off alone, or talk to strangers. If you feel as if your child should be exposed to more education on self-defense, there are local martial arts locations are offering free child self defense classes for parents who feel this is necessary.
  •  Maintain your routine. Amidst a tragedy, it’s best to keep up with your child’s usual activities (school, extracurricular activities & social events) to help the child maintain a sense of normality. This is the healthiest thing for kids.
  • Know when to seek additional help. Counselors are on staff at local school to talk with children on a temporary basis. After a few weeks, if your child is still have nightmares and/or is having difficulty coping with their normal routine (hiding behind parents, afraid to go to school or hang out with friends, afraid to play outside), it may be time to seek additional counseling help.  

OCH joins the Springfield community in mourning the loss of Hailey Owens. Below is a list of opportunities to show your support:

  •  Saturday, February 22, there is an all you can eat pancake breakfast at Applebee’s on E. Primrose.  The cost is $5 and all proceeds go to the Owens family.
  • There is also a candlelight march in memory of Hailey this Saturday, February 22, at 8:00 pm at Commercial Street and Campbell in Springfield.  
  • Hailey Owens Benefit Poker Tournamen11am Sunday, February 23, at Dennis’ Place, 921 W. Sunshine in Springfield  Sign up starts at 11:00 a.m with the first deal promptly at noon. 
  • FUND FOR OWENS FAMILY: Empire Bank has set up a memorial account in Hailey’s name to help the family with expenses. Donations can be made at any branch.  You can also mail contributions to:

Empire Bank
C/O Hailey Owens Memorial Fund
P.O. Box 3397
Springfield, MO 65808

  •  And the Missouri Department of Health is asking everyone to wear pink and purple on Friday, February 21, for Hailey.

goldenErin Golden, PsyD is a psychologist at OCH Christian County Clinic in Nixa. She offers evaluation and counseling for adult and pediatric patients. Dr. Golden worked as a psychologist in Arkansas since 2011. She received her education from the University of Michigan and the Forest Institute of Professional Psychology. Dr. Golden is currently a member of the Missouri Association of Play Therapists and the American Psychological Association.

Trick or Treat, Safe and Neat

This post was originally published on October 9, 2012; but as Dr. Spinelli offered such useful tips, we wanted to re-share as a reminder this year for all trick-or-treaters! 

Halloween brings a holiday filled with candy, costumes and chaos. It can also bring a variety of safety hazards for the unprepared. Before embarking on your evening of adventure, review these safety tips from OCH pediatrician Christopher Spinelli, DO, FAAP. With a little preparation, you can guarantee your family’s favorite spooky holiday goes off without a hitch:

With Halloween coming up, it’s important to remember a few safety tips for your children when trick-or-treating or consuming their treasure chest of candy post-trip:

1. Costume Fit & Safety: When choosing a costume, make sure the costume fits your child well enough so he or she can see out of any masks. It is also important to make sure the costume is short enough to prevent tripping and to double check that the item is non-flammable.  Please make sure that there is some sort of reflective or other visible device so your child can be seen by cars at nighttime.

2. Parental Supervision: Always have an adult with your child. As an added bonus, it is good to have some sort of communication device such as a cell phone or walkie-talkie so you can get help if needed.

3. Watch Out for Food Allergies: If your child does have food allergies, inspect the candy prior to consumption in order to avoid any adverse reactions.  If your child has anaphylaxis to certain foods such as peanuts, it may be wise to carry an EpiPen with you during trick-or-treating.  If any candy packages are already opened,  discard prior to consumption.

4. Hidden Choking Hazards: Avoid hard candies, suckers, or other choking hazards for smaller children.  Remember, not all candy is created equal from a dental standpoint!  Gummies and caramel can stick between the teeth and cause increased risk for cavities.  Receiving and distributing packages of pretzels (or other less sugary items) is also better for teeth.

5. Overconsumption of Candy: Consuming too much candy can cause a stomach-ache.  Parents may consider regulating how much candy children to consume or freeze the rest for later use. Families may also donate to local groups which can distribute the candy to less fortunate children.  

The Halloween Industry Association does have some additional safety tips listed online, to view click the following link:  http://www.hiaonline.org/index.php?module=Pagesetter&func=printpub&tid=3&pid=3

From all of us at Ozarks Community Hospital, we hope you have a safe and happy Halloween!

Christopher Spinelli DO, FAAP, is a pediatrician at the OCH Northside Clinic in Springfield, MO. Dr. Spinelli is also currently a Major in the United States Air Force Reserve. After completing an undergraduate degree from Truman State University, Dr. Spinelli graduated from Kirksville College of Osteopathic Medicine and completed his Pediatric residency at Keesler Medical Center in Biloxi, MS.

Quick Video Recap: What are Health Insurance Marketplace penalties?

In 2014, most Americans will be required to have health insurance. As a part of this mandated process, the Affordable Care Act has created a new type of online resource for purchasing health insurance coverage. This online resource is called the “Health Insurance Marketplace.”

OCH is a Certified Application Counselor site in Springfield, MO and has counselors located throughout Missouri and in Gravette, Ark. As a healthcare facility, we know there are a lot of questions surrounding the insurance changes scheduled for Fall 2013, and we’re here to help!

In order to provide a resource for our patients and the community OCH is answering frequently asked questions about the Health Insurance Marketplace. For additional info visit http://www.OCHonline.com or email info@ochonline.com.

To start, we’ve created the following video (above) explaining the penalties associated with not signing up for the Marketplace. Stay tuned for additional videos!

This Labor Day weekend, don’t forget to pack ‘common sense’

Summer is nearly over and families are headed out for a final weekend of fun before fall hits! Before you throw “caution to the wind” and rush head on into the holiday weekend, don’t forget the basics. Check out pediatrician Dr. Spinelli’s list of simple (yet essential) safety reminders for you and your family: 

Labor Day is coming up and families will be outside more as kids and parents alike are off for the long weekend.  Here are a few simple safety tips to help ensure your weekend is enjoyable and not spent in the emergency room!

LABOR DAY SAFETY TIPS

TIP #1: Water safety.  Many families will choose to go to pools and/or lakes (or stay home to enjoy a pool in the back yard).  Vigilance is important, especially around small children who cannot swim. Always make sure that a competent adult is paying attention to those in the water. It  is very important that the supervising adult does not have his/her attention divided between too many things, as this affects their ability to truly watch the children.  It is also important, if your family is headed to a lake or river, to encourage children to wear a life jacket at all times (not just while in the water, but when they are anywhere near the water as there is sill a potential danger).  Even the most agile athlete (such as Michael Phelps) can benefit from wearing a life jacket if participating in a boating activity/sport; as a serious accident could render him unconscious (if you lose consciousness, you cannot swim!) Most boating accidents are accidents, but it never hurts to be prepared, as you may not be able to swim once in the water.

TIP #2: Burn precautions.  Often times, grilling or cooking occurs during holiday weekends.  Make sure small children (and even older children) are aware when there is a hot surface and are not ducking under or playing too close to hot surfaces.  Sunburns can also be a significant issue. Always make sure that you and your family are wearing sunscreen if you plan on being outside more than 20 minutes.

TIP #3: Food safety.  If you are sharing a large meal, try to be aware how long the food has been sitting out prior to consuming.  Food poisoning is a frequent companion of holiday gatherings.  If you’re not sure, just don’t eat it.  Monitor for choking hazards as some foods may cause issues for smaller children.

TIP #4: Bike safety.  If you are going on a family bike ride, don’t forget the helmets and water bottles! As always, stay safe and enjoy the holiday weekend!

IMG_7261 resizeChristopher Spinelli DO, FAAP, is a pediatrician at the OCH Northside Clinic in Springfield, MO. Dr. Spinelli is also currently a Major in the United States Air Force Reserve. After completing an undergraduate degree from Truman State University, Dr. Spinelli graduated from Kirksville College of Osteopathic Medicine and completed his Pediatric residency at Keesler Medical Center in Biloxi, MS. To contact Dr. Spinelli, call 417-837-4003 or visit http://www.OCHonline.com. 

How to recognize eating disorders in teenagers

Eating disorders are a common chronic condition among adolescent girls. OCH psychologist Erin Golden, PsyD takes a closer look at two: anorexia nervosa and bulimia nervosa. In the the following post Dr. Golden breaks down the similarities and differences between each eating disorder, while also sharing recognizable signs and symptoms: 

Anorexia nervosa is a disorder characterized by:

  • An unrealistic fear of weight gain;
  • Self-starvation, or refusal to maintain body weight at or above normal weight;
  • A distortion of body image
  • And absence of at least three consecutive menstrual cycles (in women of appropriate age and health).

Bulimia nervosa is an eating disorder where the main feature is binge eating followed by unhealthy behaviors to compensate for such binge eating in order to prevent weight gain (e.g., purging). This includes:

  • Binge eating
  • Eating in a discrete period of time an amount of food that is larger than most people would eat during a similar period of time and under similar circumstances
  • A sense of lack of control over eating during these periods
  • Compensatory behavior in order to prevent weight gain such as: self-induced vomiting, misuse of laxatives, diuretics, enemas or other medications, fasting or excessive exercise;
  • This eating pattern occurs at least twice a week for three months (or longer)
  • A distorted body image.

Onset of anorexia nervosa starts mostly between 14 and 18 years, while for bulimia onset is around the time of transition from adolescence to early adulthood in adolescent and adult females, especially in female athletes, ballet students, fashion models and culinary students.  Anorexia nervosa is the third most common chronic condition among adolescent girls in the USA, after obesity and asthma. Although the occurrence of eating disorders is infrequent the outcomes of eating disorders are serious. Approximately 25–33% of patients with anorexia or bulimia nervosa develop a chronic disorder.

Eating disorders often co-occur with substance abuse disorders, depression, and anxiety disorders. Because anorexic females typically deny that any problem exits, treating the disorder is difficult. Hospitalization is often necessary to prevent life-threatening malnutrition.  Family therapy, aimed at changing parent-child interaction and expectations is the most successful treatment; still, only about 50% of anorexics fully recover. Bulimia is usually easier to treat than anorexia, using therapy focused on support groups, nutrition education, and revising eating habits and thoughts about food.

erin golden psychologistDr. Golden sees patients at OCH Christian County Clinic in Nixa. Her focus includes the evaluation/testing; individual and family therapy; adult and pediatric patients with depression, anxiety, adjustment disorders, eating disorders, and behavioral issues. Dr. Golden worked as a psychologist in Arkansas since 2011. She received her education from the University of Michigan and the Forest Institute of Professional Psychology. Dr. Golden is currently a member of the Missouri Association of Play Therapists and the American Psychological Association. Dr. Erin Golden can accept Medicaid, Medicare and UHC Military insurances. To contact her, call the Nixa clinic (417) 724-3100 or fax (417) 725-7380.

Let’s Go for a Walk

OCH neurologist Dr. Sharlin recently published the following article “Let’s Go for a Walk,” in a local publication known as Greene Magazine (August 2013). For more information about Greene Magazine, visit: http://greenemagazine.com/.

Recently, I found myself sitting and thinking about…well, sitting and thinking.  It had been a typical day: up at 6:30 am, shower, dress, breakfast, off to work where I spend a good deal of my day at my desk sitting–typing on the computer, talking on the phone, and attending the occasional administrative meeting.  I am an active person, so while I try to squeeze in some running or bicycling or a visit to the gym in the evenings, frankly, I am pretty tired.  I push through, I do.  But by the time it’s 8:30 pm I am in my PJ’s and on the sofa with my iPad or enjoying a favorite television program.  Why am I sharing these details with you?  Recently, I viewed a TED talk presented by Nilofer Merchant that was filmed this past February.  If you have not discovered the TED talks (TED means Technology, Entertainment, and Design) they are a huge treat for the brain.  Dubbed “riveting talks by remarkable people free to the world” this talk by Nilofer Merchant was no exception.  Nilofer Merchant is sort of a modern day Stephen Covey (of “7 Habits” fame), an expert on the dynamics of group collaboration, within the high tech field.  Ms. Merchant’s subject for the TED talk “Got a meeting?  Take a walk,” put me on my feet.  Here are some statistics:

A study of walking habits of Americans in the October 2010 issue of the Journal of Medicine & Science in Sports & Exercise found that Americans walked significantly less (about 5,000 steps per day) compared to counterparts in Japan, Australia, and Switzerland where the average was nearly twice as many steps.  In 2008 the American Journal of Epidemiology published a study of sedentary behaviors among Americans.  The paper reported, overall, participants spent 54.9% of their monitored time, or 7.7 hours/day, in sedentary behaviors. The most sedentary groups in the United States were older adolescents and adults aged ≥60 years, and they spent about 60% of their waking time in sedentary pursuits.  It turns out that most of us spend more time sitting (generally a negative thing) than sleeping (generally a positive thing), and very little time moving (well, you know).  Sedentary behavior is associated with all sorts of health risks, including heart attack, stroke, certain cancers, and loss of range of motion, mobility, and balance among older adults that may, in turn, raise the risk of critical falls.  To repeat an oft quoted expression: “Sitting is the new smoking.”

So, here we are in Greene County, Missouri, a beautiful place to enjoy all the benefits of movement.  A visit to the Ozark Greenways website (www.ozarkgreenways.org) details 75 miles of trails in our area.  This does not include sidewalks, parks, and the Springfield Nature Center.  Encourage friends, family, and co-workers to walk, jog, run, or ride a bike.  Just move.  Spend more time standing at work.  Create a standing workstation, if possible.  Make meetings a walk in the park, literally.  When driving choose parking spaces that maximize walk distance across the parking lot and take stairs rather than elevators and escalators.  Enjoy healthful, nutritious meals, but then go for a walk.  A June 12, 2013, study published in Diabetes Care, involved people aged 60 or older who were at risk of developing Type 2 diabetes because of higher-than-normal levels of fasting blood sugar and their low levels of exercise.  The researchers found that short after-meal walks produced a significant decrease in the blood sugar levels of their test subjects.  As for me, I’ve had enough sitting and thinking; I think I’ll go walking and talking.  Hope to see you on the trails!

sharlinDr. Sharlin practices general neurology at Ozarks Community Hospital locations in Springfield and Nixa.  When he is not working Dr. Sharlin enjoys swimming, biking and running, and has completed two Ironman triathlons.  He is a graduate of Kenyon College where he earned his BA in English and studied the work of physician-writers, including the late Dr. John Stone, his mentor.  Subsequently, Dr. Sharlin earned his medical degree from Emory University and currently resides with his wife Valerie, also a triathlete, here in Greene County (Springfield), Missouri.

5 healthy habits to start at home with baby

OCH pediatrician Christopher Spinelli, DO, FAAP shares five baby basic essentials to help parents establish healthy habits at home: 

1. Keep offering healthy foods. It may take up to ten times offering a new food before your baby takes it. Don’t give up! Crying does not always mean your baby is hungry. Pick up your baby, check their diaper, and/or try soothing movements or music to comfort before feeding.

2.  The taste for healthy foods starts in infancy. Offer babies different choices of fruits and vegetables daily. No fruit juices until at least 6 month old. Limit fruit juices to 1/2 cup per day.

3. No television for baby (this includes video games, equipment or computers in a baby’s room). When your infant is in the room, turning off the television is ideal.

OCH pediatrics

4. Babies need free movement to develop their muscles. Place your child on a clean blanket and allow free movement of arms and legs. Babies should not be in walkers. Babies should not be kept in cribs, play yards, or swings for long periods of time.

5. Breast feeding is the best source of nutrition for the first year of life and may decrease the risk for overweight children. Here are a few tips on breast-feeding:

  • Only breast milk or formula for the first year. Cow’s milk starts after 1-year-old.
  • Continue to breast feed as long as you are able. Any amount is better than none during the first year.
  • Stop feeding when he/she acts full by pulling away from the breast or bottle.
  • No bottles in bed.

Dr. Spinelli says now is the best time to teach your child healthy habits that will last a lifetime!

Baby Basics Class OCHFor more baby basics tips, attend OCH’s reoccurring baby basics on the second Tuesday of each month from 2 to 4 pm! Parents and caretakers are invited to take the course to brush up on swaddling, crib safety, vaccine information, breast-feeding, car seat safety, and other essential infant and toddler health basics. To sign up for a class, call (417) 837-4147 or email ewhite@ochonline.com.