Loss and the holidays

Annual holidays can be a very difficult time for people who have experienced the death of a loved one. Holidays force us to realize how much our lives have been changed by loss. This can be particularly difficult for children because the magic of the holidays is usually more exciting for children than for adults. While adults can play an important role in helping children grieve, the more that children are actively involved in their own grief process, the greater the opportunity for healing. If your child or a child you know are mourning a loss of a loved one this year, here are some important things to keep in mind:

  1. After a death, the best way to find out what the kids would find most comforting and meaningful for each holiday is to ask them. This sounds simple, but you would be surprised at how often it is overlooked. Children often take their lead from adults. How you are handling things can determine in part, how they will handle things. However, their grief reactions can often be expressed as anger in children. They may say things or act in ways that can be hurtful. This is extremely difficult to handle if they were directed toward you, especially when your emotions can be stretched to the limits by your own grief. Young children may not be able to verbalize their feelings and needs. Having children draw how they feel can help express those things that are hard for them to express verbally. Be specific with good memories. With teenagers, all those dynamics that make it difficult for adults to communicate with them under normal circumstances are intensified while grieving so instead of drawing as with younger children, teens may chose to write down what they are feeling and what they need.
  1. Have fun. Children need to take breaks in their grieving. In other words they will not grieve continuously, every day, all day long. Let them laugh and kid around. It is okay to laugh. Laughter releases good endorphins in the brain.
  1. Special mementos. Let them have a photo or small memento to carry with them. It helps them feel close. During the holidays, allow the children to keep pictures of their loved one from past holidays. Visit about how the holidays will be different but also how some traditions will be the same. Allow the children to have a loved one’s shirt or other article of clothing to sleep in. You can even spray the item with perfume or aftershave that smells like their loved one.
  1. Keep some routine but accept changes. Remember your children’s world may be in chaos; they need structure (e.g., wake-up times, bed, meal, school, homework and television times). Christmas can be especially hard as they watch other families celebrate and as everyone’s schedules tend to be interrupted over the holidays. While routines are important some changes will have to be made. Allow children to help make decisions about holiday plans. Children will feel like they have more control over the situation when they help make decisions, even small ones.
  1. Create a new tradition or ritual that accommodates your situation. Some people find comfort in the old traditions. Others find them unbearably painful. Discuss with your family the activities you want to include or exclude this year. Some examples of new rituals and traditions that you can include the children in include:
  • Announce beforehand that someone different will carve the turkey.
  • Create a memory box. You could fill it with photos of your loved one or written memory notes from family members and friends. Young children could include their drawings in the memory box.
  • Make a decorative quilt using favorite colors, symbols or images that remind you of the person who died.
  • Light a candle in honor of your absent loved one.
  • Put a bouquet of flowers on your holiday table in memory of your loved one.
  • Visit the cemetery and decorate the memorial site with holiday decorations.
  • Have a moment of silence during a holiday toast to honor your loved one.
  • Place a commemorative ornament on the tree.
  • Write a poem about your loved one and read it during a holiday ritual.
  • Play your loved one’s favorite music or favorite game.
  • Plan a meal with your loved ones’ favorite foods.

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.

The good and bad of cholesterol

Cholesterol is often negatively portrayed in eyes of the public, but it’s not all bad! Everyone needs cholesterol to live; and it is both good and necessary, in the right quantity, much like everything else in our bodies.

Cholesterol is important for brain and nerve function and is the building block of all our hormones, such as testosterone and estrogen. However, cholesterol does have a downside. Because it is a waxy substance, it can build up in blood vessels and cause lots of problems with heart, brain and arteries. This can lead to high blood pressure and even erectile dysfunction.

Here’s what you need to know about testing and risk factors to help maintain a healthy level cholesterol:

Although healthcare providers test for cholesterol levels if patients have high blood pressure or issues with their heart, it is recommended that individuals start testing cholesterol levels between the ages of 25 to 35 years (for men) and ages 35 to 45 years (for females).

Testing is usually done first thing in the morning, prior to an 8 hour period without eating, or “fasting lipid panel.” Tests measure total cholesterol, triglycerides, low-density lipids and high-density lipids. Here are a few ideal measurements:

  • Total cholesterol should be below 200.
  • Triglycerides should be less than 150.
  • Low density lipids (LDL) are known as “lousy” lipids and should be low. High density lipids (HDL) are “happy” lipids and are beneficial when they are up. Note: HDL’s help clean up when there is excess cholesterol in the blood, which is why the ratio of HDL to LDL is a predictor of good health.

Testing is recommended if an individual has a family member with high cholesterol or heart problems. Also, men and women who smoke and/or have diabetes have an increased likelihood of having high lipids and should be routinely tested. Each individual is different and may require additional testing every 3, 5 or 10 years.

Although individuals may not be able to eat their way to a perfect cholesterol score; there are select cholesterol lowering foods that can help! These include walnuts and almonds (raw and unsalted), strawberries, apples, bananas, grapefruit, carrots, dried beans, garlic, cold-water fish, salmon and olive oil. Foods to keep to a minimum include: coffee, meats, dairy, fried foods and fast-food. Exercise also helps keep the body and cholesterol levels under control.

As always, talk to your individual healthcare provider about risk factors and testing.

EimanJ.D. Eiman, PA-C is a physician assistant at the OCH of Gravette Clinic. J.D. sees patients of all ages for primary care needs and is also certified to perform DOT physicals. She received her education and training from Texas A&M University and Harding University and is currently a member of the American Academy of Physician Assistants, Arkansas Association of Physician Assistants, Christian Medical and Dental Association/Fellowship of Christian Physician Assistants and the California Association of Physician Assistants. To contact J.D. at the clinic, call (479) 787-5221.



It is not easy to pinpoint whether or not an individual has Hepatitis C. Because of this, it’s important to be aware of potential risk factors. Here is a set of questions to double-check whether or not you or someone you know may be at risk:

1. Did you have a blood transfusion before 1992?

2. Did you receive blood products (immunoglobulin, Anti-Rh factor or platelets) before 1992?

3. Are you a Hemophiliac?

4. Have you ever shared personal hygiene items such as razors, toothbrushes, hair clippers, cuticle scissors or nail clippers?

5. Have you had kidney dialysis?

6. Did your mother have Hepatitis C?

7. Have you lived with someone who had Hepatitis C?

8. Have you ever used any intravenous or snorted drugs (even once)?

9. Have you served in the military?

10. Have you ever been a healthcare worker or been exposed to blood?

11. Have you ever been incarcerated (jail or prison)?

12. Have you ever played contact sports?

13. Do you have a tattoo that is over 5 years old or was done someplace other than a professional tattoo parlor?

14. Have you had any body piercing (including ears) that was not done by a professional?

15. Have you ever shared body piercing jewelry?

16. Have you had multiple sexual partners (20 or more in lifetime or more than 2 in past 6 months)?

17. Have you ever been exposed to blood during sexual activity?

18. Have you had any injection, surgery or dental work outside of the US?

19. Have you ever had abnormal liver enzymes?

Did you answer YES to any of these questions? It might be time for a Hepatitis C test. A correct diagnosis ensures both a prompt treatment and a better response to treatment.

Also, while chronic Hepatitis C may not show any symptoms, neither does chronic Hepatitis B. Both are equally damaging to the liver and can lead to cirrhosis or liver cancer if untreated. It is important to contact your healthcare provider to learn more about the testing and treatment options available.

Additional Resources:

  • Sign up for a local Hepatitis education class at OCH by calling: 417-837-4244.
  • For more information about Hepatitis treatment available, read Dr. Beene’s brochure on Hepatitis: http://goo.gl/4nS9vr
  • To view coverage on our Hepatitis Outreach event, click here: http://goo.gl/DMXCC8

New Services with OCH Neurology

In addition to his current services offered, Dr. Ken Sharlin has been busy incorporating new ways to help patients with epilepsy, peripheral neuropathy, and Alzheimer’s disease. Read below to find out more:

Extended Monitoring for Epilepsy Patients

Epilepsy is a central nervous system disorder (neurological disorder) in which the nerve cell activity in your brain is disturbed, causing a seizure during which you experience abnormal behavior, symptoms and sensations, including loss of consciousness. (via MayoClinic.org)

Dr. Sharlin is now working with a company called Neuro Quest to provide multi-day video EEG monitoring for epilepsy patients. This type of test involves video monitoring over an extended period of time. It is especially useful when it is unclear whether an anti-epileptic drug is appropriate for a given patient. Before this, OCH was only able to perform an 8 hour video-EEG in the OCH Sleep Lab.  The opportunity to work with Neuro Quest now allows him the ability to monitor patients continuously for up to seven days.

New Test for Peripheral Neuropathy

Peripheral neuropathy, a result of nerve damage, often causes weakness, numbness and pain, usually in your hands and feet, but it may also occur in other areas of your body. People generally describe the pain of peripheral neuropathy as tingling or burning, while they may compare the loss of sensation to the feeling of wearing a thin stocking or glove (via MayoClinic.org).

Dr. Sharlin can now offer Punch Biopsy of the Skin (a diagnostic test for skin disorders in which a circular blade is inserted and removed in order to obtain a tissue sample). This type of test is used to look at nerve fiber density. Nerve conduction studies can similarly be used; the downside being that they are only sensitive to large, myelinated sensory fibers, and in many cases of “burning feet” the pathology is limited to the small, unmyelinated C-fibers.

This change affects patients who complain of numb, burning feet and whose nerve conduction study may be normal. For patients such as these, Punch Biopsy of the Skin tests can provide more accurate data to ensure correct diagnosis.

Diagnosis for Alzheimer’s Disease

Dr. Sharlin now has the ability to measure biomarkers in cerebrospinal fluid to more confidently make the diagnosis of Alzheimer’s disease (tau protein and a-beta 42).


About Neurology at OCH

Dr. Sharlin is board certified in Neurology. He received his education from Emory University School of Medicine and is currently a member of the American Academy of Neurology and the American Medical Association. Dr. Sharlin works at Ozarks Community Hospital and at OCH’s Christian County Clinic in Nixa, Missouri. To contact Dr. Sharlin call (417) 875-4665 (Springfield) or (417) 725-8250 (Nixa).

Summer Proof Your Kids: Part 1

This is the first installment of an ongoing series with helpful tips to ensure your kids have a safe and fun summer, courtesy of Dr. Christopher Spinelli.

School is out and summer break is upon us. Before everybody, kids especially, gets ready to step outside the door to have some fun and enjoy the weather, there are a few safety tips that might be helpful to consider.

Having a small first aid kit available, on your person or otherwise, will definitely come in handy. Simple things like Band-Aids, Cortisone cream, Benadryl and antiseptic wipes will help with the random cuts and scrapes, as well as the occasional bug bite, that can occur during a fun day in the sun. If your child does have allergies to bees or wasps, make sure you are prepared with Benadryl and an epinephrine pen, depending on the severity of the reaction.

The front door of your family home isn’t the only door put to good use during the spring and summer months. The clinic door to the ER is also active, to treat both trauma and injuries. If the kids are out riding bikes, scooters or skateboards, it’s always a good idea to wear a helmet and other protective gear, such as elbow pads and knee pads. Riding bicycles or skateboards in flip-flops is never a good plan.

As the days grow longer and the temperature rises, the pool and other bodies of water will become popular destinations. Drowning is as preventable as it is a frightening concept. First of all, if you can’t swim, drowning is a real problem. Drowning is a problem even if you can swim. Make sure to keep an eye on your children, especially those who are younger and smaller. Don’t rely on someone else to watch your children for you, if you can help it. Having a lifeguard around is helpful, but certainly isn’t 100% preventative of drowning. We live in an area with lots of lakes, so make sure that life-jackets are involved when enjoying time both on the boat or in the water. Oftentimes, teenagers may feel they don’t need life-jackets when skiing since they can swim, however, if they are knocked unconscious, swimming becomes difficult.

The water may provide some relief from the sweltering sun, but it shouldn’t be the only thing you do to make sure the kids have as much protection as possible. The sun can hurt your skin if there is too much exposure. For small children, this can be especially painful and even a medically threatening condition, if it’s exceptionally severe. Don’t. Forget. The Sunscreen. You can find a variety of SPF, anywhere from 15 up to 100 proof. High SPF or low SPF, reapply frequently, and even if the bottle says “waterproof”, consider the quotations, because no sunscreen is completely waterproof. If around water, make sure to apply even more frequently than if you are not around water.


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.

10 Tips for Making it Through This Allergy Season

Cassidy Giebler, FNP-C, shares ten helpful things to know about preparing for, dealing with and treating seasonal allergies.

1. Minimize outdoor activity when pollen counts are high. Check the National Allergy Bureau website at http://www.aaaai.org/global/nab-pollen-counts.aspx for local pollen counts. 

2. Take allergy medicines 30 minutes before going outside.  Consult your primary care provider to discuss allergy treatment and ways to minimize symptoms

3. For severe allergy sufferers, have someone else do yard work if possible

4. Avoid mowing grass and handling yard waste such as mulch, compost, grass clippings and leaves.

5.  If you must work outside, wear a filter mask to reduce exposure to allergens

6.  Shower after working outside and wash all work clothes

7.  Keep windows and doors closed and avoid using fans that draw air in outside air.  It is best to use an air conditioner to re-circulate indoor air

8.  Use high-efficiency particulate air filters (HEPA) in vacuums and furnaces and change them every 1-2 years

9.  Wash bedding weekly in hot water

10.  Wash pets weekly and keep them off furniture and out of the bedroom.  Pollen can collect on the fur of dogs or cats after being outside


Cassidy Giebler, FNP-C, specializes in family practice at Ozarks Community Hospital’s Primary Care Clinic in Springfield, MO. Cassidy received her education at the University of Missouri-Kansas City and Southwest Baptist University-Mercy College of Nursing.

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.