This Labor Day Weekend, Don’t Forget to pack your “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!

*This post was updated Friday, August 29, 2014*

IMG_7261 resizeChristopher Spinelli DO, FAAP, is a pediatrician at the OCH Evergreen 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 417-823-2900 or visit http://www.OCHonline.com. 

Back-to-school health isn’t just for kids

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The dog days of summer are at their tail’s end and fall is rapidly approaching; families are flocking to Wal-Mart to purchase back-to-school supplies and wardrobes, teachers rush to prepare for the influx of students, and fall health & flu prevention begins.

Each year, around 50,000 people in the United States die from vaccine-preventable diseases according to Centers for Medicaid and Medicare Services (CMS.gov). Influenza, pneumococcal pneumonia and hepatitis B, diseases with available vaccines, account for over 250,000 hospitalizations on an average year.

The good news? Medicare covers vaccinations for each of these diseases. Medicaid and CHIP covers the influenza vaccination along with other vaccinations needed for children.

But it’s not just for kids. Influenza claims an average of 36,000 lives a year. People 65 and older make up a large amount of that statistic. The same goes for invasive pneumococcal disease. Of all the deaths caused by the bacterial pneumonia, greater than half are 65 years of age or older.

This fall, schedule a “time-out” from watching fourth-string scrubs play football or visiting shopping rallies at the mall and take the first step. Contact your health care provider or a local clinic to find out more about vaccines and immunizations.

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For more information on vaccines and preventable diseases, visit: http://www.cdc.gov/vaccines/vpd-vac. For more information on what vaccinations are covered by Medicare and Medicaid, visit http://www.cms.gov/Medicare/Prevention/Immunizations/.

The Vaccination Debate: Q&A with the Authors

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OCH Pediatrician Christopher Spinelli, DO and Maryann Karinch, a human behavior specialist, recently published a book titled The Vaccination Debate: Making the right choice for you and your children with New Horizon Press. The book is described as:

Rational approach to discussing the science of vaccines in the context of everyday life. As Spinelli and Karinch examine the schedule of vaccines from birth through adolescence, the authors shed new light on this timely and controversial issue, writing with a tone that a pediatrician would use with curious, concerned parents. (Goodreads, 2015)

Prior to publication, the authors sat down and answered some frequently asked questions in the “vaccination debate.” Read their answers to the questions below:

  1. How safe are vaccines?

For people with healthy immune systems, they are generally completely safe. We say “generally” because in rare cases, a genetic abnormality makes a vaccine unsafe for the individual with that condition. Yet, despite the rigorous testing of vaccines to ensure their safety and effectiveness—often decades of research and testing—89 percent of the people who participated in the C.S. Mott Children’s National Poll on Children’s Health rated “vaccine safety” as the most important topic in children’s health research today. Anecdotal “evidence” about adverse reactions has a profound effect on public opinion, despite the overwhelming scientific evidence that vaccines are safe for almost everyone.

A slight fever in response to a vaccine is normal; it doesn’t mean the vaccine is unsafe. Nearly all vaccines can induce fever since they rev up the immune system and fever is a feature of the immune system.

  1. Why do we give vaccinations to kids for diseases that we rarely or never see anymore?

The short answer is: Because you don’t want to see them ever again. The vaccine for smallpox was removed from the schedule in 1980 when smallpox was considered eradicated globally. It would be great if we eradicated other diseases and no longer needed those vaccines, either. But the reality is that diphtheria, polio, measles, mumps, chickenpox, whooping cough and other diseases that many people have never seen still exist and are potentially fatal.

  1. What about “herd immunity”—doesn’t that protect us?

Herd immunity means that enough people have immunity to a contagious disease that the people who don’t have immunity are safe. If people didn’t travel outside of their communities, it would be fairly easy to achieve herd immunity for a lot of vaccine-preventable diseases like measles and mumps. But we do travel and people without immunity are vulnerable.

Herd immunity is generally defined in terms of 90-95 percent of a population being immune to a particular contagious disease. Think about how fast those numbers can tumble downward when just a few new unvaccinated kids enter your local elementary school, or one new family without immunity joins your church.

Herd immunity only works if we keep vaccinating against diseases we rarely see anymore—and then only stop when we never see them anymore.

  1. What’s wrong with alternative vaccination schedules, so that babies don’t get so many shots at once?

The success of vaccinations in controlling and eradicating disease involve both the science of antigens and the science of timing. The schedule reflects the science of timing, meaning that vaccines are given at times in a child’s life when preventing the disease is vitally important to help the child thrive. For example, if a child of one year old or under contracts measles, the chances that the disease leads to very series health issues or death are much greater than if an older child contracts measles. For that reason, the vaccine is scheduled when a baby hits the one-year mark. Also, studies show that children have more anxiety about vaccines (even infants) if they are subjected to multiple “shot visits” with fewer vaccines each time instead of multiple shots a fewer visits.

  1. Why not just let kids catch “childhood diseases” to build immunity—like people used to do?

Parents who believe it’s better for a child to get a disease that probably isn’t life threatening—and these typically include measles, mumps, chickenpox, flu, rotavirus and whooping cough—seem comfortable with ideas that don’t make sense to most doctors and nurses. Exposing a child to these diseases is not just a matter of mortality, but a matter of morbidity; the disease is accompanied by symptoms that can be awful for a child. Secondly, in treating the disease after the child gets it, medications are generally involved. These can include antibiotics, cough medicine, anti-diarrheal medication and more. In the case of chickenpox, there may be permanent scarring. The third consideration is the younger sibling, perhaps an infant, who is far more vulnerable to devastating effects of the disease than an older brother or sister.

Here’s a final thought: Most parents who push this theory that it’s better to let the child get the disease have never seen the bad outcomes; they have not experience them firsthand. Ask parents who have experienced the bad outcomes of vaccine preventable disease and see what they say about this question.

  1. How effective are alternatives to vaccines, like breastfeeding and homeopathic medicines?

Babies are continually getting extra antibodies from their mothers’ breast milk. (Formula-fed kids are lacking in this extra immunity.) But while the advantages provided by breastfeeding are long-lasting, they don’t last forever. Breastfeeding is a superb complement to vaccination.

The argument to avoid vaccines in favor of homeopathically prepared preventative solutions is deeply flawed—and we say that with all due respect to homeopathy as a source of remedies for problems that already exist. Leading spokespersons for homeopathy assert that the reason that solutions with undetectable amounts of active ingredient work is that, when the body has a need for a substance, that need creates hypersensitivity. When the body senses that what it needs is nearby, it takes advantage of it. Knowing this, how would a homeopathic formula work as a prophylactic since, at least in theory, it’s administered while the body is healthy and not in need of the substance?

  1. Why are things like aluminum and thimerosal in vaccines?

Vaccines contain more than the virus or bacterium that serves as the main ingredient because some are used as preservatives, some are suspending fluids, some serve as culture material to grow the bacteria or virus, and some are enhancers that help improve the vaccine’s effectiveness.

Aluminum is an enhancer, also known as an adjuvant. The intended role of adjuvants is to provide more antibodies and prolong the vaccine’s protection by boosting the immune system’s response to the virus or bacteria agent. The inactivated type of vaccine requires adjuvants to stimulate an immune response. This is partly why it’s possible to reduce the number of actual antigens from the viruses and bacteria needed to make the vaccine, but still get effective protection. In the 1960s, there were about 3,000 antigens in a pertussis (whooping cough) vaccination. Now there are five.

Thimerosal is a preservative. Preservatives and stabilizers enable vaccines to remain unchanged when they’re exposed to heat, light, acidity or humidity. Preservatives are not, by their nature, “good” or “good for you,” and research continues to try to determine the most benign preservatives for medical applications.

  1. What’s the link between vaccines and autism?

No cause-and-effect link has been proven based on a large body of studies, but that is not the same as saying with certainty there is no link between vaccination and the onset of autism symptoms. The bulk of evidence points to a pattern of autism spectrum disorders that runs in families—meaning the cause of autism appears to be genetic. But—and this is an important “but”—scientists are currently trying to determine the extent to which metabolic, bio-chemical, neurological, and environmental factors affect the emergence of autism.

In other words, evidence strongly suggests that autism is genetic in nature, so vaccines wouldn’t make a child autistic, but some scientists believe that vaccination might trigger a negative response.

  1. What’s the profile of people who choose not to vaccinate their children?

The profiles are so different that it’s shocking. Basically, it’s well-educated people who tend to be liberal politically and shop at places like Whole Foods as well as people with a libertarian orientation who feel that an individual parent’s right to determine what’s best for a child should supersede any government mandates. Caught in the middle are parents who have been exposed to disturbing anecdotal evidence about vaccines and are inclined to take a “modified schedule” approach to vaccinations.

In short, the profile tends to be people whose lifestyle choices, ideology, and fear override scientific evidence.

  1. What are the prospects for vaccines for diseases like cancer, HIV, and Alzheimer’s?

Very good. New ways of developing vaccines have been developed and those new methods open the door to an array of vaccines against diseases like cancer, HIV, and Alzheimer’s, as well as malaria, Ebola, and other diseases that have been a particular threat in Africa—where a child dies every minute from malaria according to the World Health Organization.

Some of these new methods of development have resulted in DNA vaccines, which rely on genetic material to prevent disease. Some of the diseases targeted by researchers developing DNA vaccines are cancer, HIV, malaria, and typhoid.

References

Goodreads. (2015). The vaccination debate. Retrieved from https://www.goodreads.com/book/show/24886662-the-vaccination-debate

Tummy Time & Your Baby’s Development

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Tummy time plays a large role in your baby’s overall health and development. But when should you start? And how long should your baby spend on his or her belly each day? Ozarks Community Hospital/Advantage Therapy physical therapist Jennifer Witt shares specifics below and offers tips to help make tummy time more enjoyable for baby and mom.

“Tummy time.” If you are the parent of an infant, you probably hear this phrase all the time and you probably have questions. Why? When do you start? How long? What if they cry/get mad? These are questions I deal with frequently and here are some of the answers I give parents.

Why Practice Tummy Time

There are too many babies that sit in car seats, cribs, and lay on their backs for too many hours of the day. Needless to say, there are numerous reasons to implement tummy time into your infant’s daily routine!

  • It helps babies achieve developmental milestones (i.e., holding head up, rolling, sitting).
  • It strengthens muscles of the neck and back when infants have to hold their heads up against gravity.
  • It prevents flat spots on the head and allows for proper head shape development.
  • It allows infants to explore their environment from a different perspective.

When You Should Start

Tummy time should be started as soon as possible; even as soon as you get home from the hospital. The earlier you implement it into their daily routine, the less likely they will be to fight against it.  Place your infant on their tummy for short periods of time initially, gradually building up the amount of time they are spending in that position.

Need for Tummy Time Increases with Age

Tummy time should be a daily activity for infants. Again, this routine should be started as soon as you bring your baby home from the hospital. Here is a guide for how long babies should be spending time on their tummies.

  • First couple of weeks: 5 minutes per day
  • 1 month old: 20 minutes per day
  • 2 months old: 30 minutes per day
  • 3 months old: 60 minutes per day
  • 4 months old: 81 minutes per day

Sometimes babies cry during tummy time. Usually, I tell parents not to pick the infants up, unless there is some harm to the little one. I recommend setting a timer for 5 minutes and then the baby can be picked up when the timer goes off.

Making Tummy Time Fun

Nothing makes my little ones cry more than placing them on their bellies! Some babies do great, others, not so much. Again, tummy time should be started as early as possible to get them used to being on their bellies. Here are some ideas for keeping it fun.

  • Get down on the floor with them! It encourages engagement and bonding between the two of you.
  • Place fun toys around them so that they have fun stuff to look at and eventually play with!
  • Use mirrors (baby-proof, of course)! Every baby knows they’re super cute, so they really enjoy looking at themselves in the mirror.
  • If your infant has reflux, try propping them up on a pillow or boppy to take pressure off their tummies.
  • Place the baby on your chest while you’re lying down. This way, they can “talk to you” and still get tummy time.

Jennifer works at OCH in Springfield, Missouri and at OCH Christian County Clinic in Nixa. She received both her Bachelor of Science in Psychology and Doctorate in Physical Therapy from Missouri State University. She has experience in inpatient, outpatient, home health and pediatric  settings. Her primary interest in physical therapy is pediatrics, specifically the 0-3 age group covering a variety of diagnoses.

Maximize Outdoor Play

Here are 10 fun and inexpensive play ideas to promote fine and gross motor skills, strength, balance, and coordination in children.maximize outdoor graphic

  • Get to the Park: What kid doesn’t love to go to the park? Playground equipment provides an excellent opportunity to work on strengthening with all of the climbing that has to be done.
  • Make a Hopscotch Course: Draw out a course with chalk on an asphalt or concrete surface. Have your child help draw the course to promote fine motor skills and let them “decorate” it to encourage artistic expression. Jumping is a great activity for kids and hopscotch helps with balance and coordination.
  • Videogames, What?: In today’s world of DS’s and Play Stations, a lot of kids don’t know how to have fun with out a controller. Go old school and play games like “Mother May I?,” “Red Light, Green Light,” and “Simon Says.” These are great for learning to follow directions as well as encouraging motor skills.
  • Hoola Hoop: Nothing works on coordination more than trying to spin a hoop around your waist! Mix it up a little and try have your child spin it around their arms, or for older kids, spin it around one foot while jumping over it with the other.
  • Make an Obstacle Course: You can find all kinds of things around the house to use in an obstacle course. Jump ropes, step stools, brooms, books, toys, tunnels, pillows, etc. can all be used to make an obstacle course. Incorporate activities like jumping, standing on one foot, crawling over, under, and around objects, walking on a line, even push ups and sit ups. Make it even more fun by playing follow the leader or timing how long it takes to get through.
  • Be an Artist: Encourage fine motor skills by drawing with sidewalk chalk or take a coloring book outside and have your child lay on their tummy on a blanket. Tummy time is very important for babies, but is also important for toddlers.
  • Have a Zoo in the Backyard: Ok, not really, but have your kids crawl around the backyard like different animals! Do a crab walk, bear crawl, snake slither, frog hop, bunny hop, flamingo stance, any kind of animal. Make a game out of this; yell out different animal names, hold up signs, etc.
  • Have a Ball: Ball skills are important for hand-eye coordination. Have balls of different sizes available. Throw at targets, play catch, throw into baskets, play kickball, use empty water/pop bottles as bowling pins and knock them down by rolling the ball toward them.
  • Play Tug of War: This is great for upper body strength and tons of fun for kids!
  • Have Fun and be Safe: Kids have a great imagination, if you can provide them with props and a few ideas, they will usually think of games to play on their own. Just make sure to get them up off the couch and play! As always, safety is always important, so keep a close eye on the kiddos!

Content provided by Jennifer Witt, DPT. Jennifer works at OCH/Advantage Therapy in Springfield, Missouri and at OCH Christian County Clinic in Nixa. She received both her Bachelor of Science in Psychology and Doctorate in Physical Therapy from Missouri State University. She has experience in inpatient, outpatient, home health and pediatric settings. Her primary interest in physical therapy is pediatrics, specifically the 0-3 age group covering a variety of diagnoses. To contact Jennifer, call OCH/Advantage Therapy at (417) 777-4749. For more information about OCH/Advantage Therapy visit www.advantagetherapyonline.com

OCH Community Health Worker Shares Some Love with the Community

VenrunYou don’t have to work in direct patient care to impact patients’ lives in a big way. Ciara Day’s job is testament to that. While a medical degree helps doctors attend to medical conditions, Ciara works to mend the heart. Her entire job is based on the OCH mission of offering assistance in an atmosphere of compassion, respect and dignity. The stories that make up her every day speak to the passion OCH employees have for its patients.

As a Community Health Worker in OCH’s Integrated Care department, Ciara works to empower patients and give them the tools to improve their lives. “Everyone is different,” Ciara says. She says patients need help that is not just limited to healthcare visits with providers: sometimes patients need a ride to the appointment, a shower to clean off the fleas so the patient can address real problems with providers, or basic needs like nutritious food, or a safe place to call home. “It’s my job to check in and make sure those voices are heard.”

When considering healthcare, the Integrated Care department works as a team to look at overall well-being, not just an exchange of symptoms and healthcare solutions. “Everything is a lesson,” Ciara explains. It could mean providing patients with lessons on meal prepping for a chronic illness and what your refrigerator should look like. “You have to meet them where they are. If a patient doesn’t have access to food stamps or their Medicaid gets shut off, we connect them to resources that can help them get access to those things and show them how to work what they have.” Sometimes this means working with patients for a long time, and that’s okay. Changes do not happen overnight and Ciara is dedicated to working long term to better patient lives.

“I’m not afraid to call a patient up and be like, ‘Your provider is worried about you and part of the process for following up is a home visit. When are you available?’” And that’s just what she does. Understanding where a patient is now helps her figure out what the next steps are.

I’ve been doing this in the community for nearly a decade. I was initially hired to help the highest utilizers of the ER. But those aren’t the people screaming for help. It’s the silent ones who need it the most.

Within the first two weeks of joining OCH, Ciara started compiling a pantry for patients. Her office has boxes filled with supplies and walls covered in clean clothes, hygiene products, towels, and now, diapers. “I’m so excited! We just got a partnership approved with the Diaper Bank and now we can get diapers and wipes whenever we need them. We haven’t even started getting food in yet.” Ciara and others in the Integrated Care department do whatever it takes to share a little love.

It’s all a learning process, for Integrated Care and the patient. It is a process of bettering lives and strengthening communities. Community events like HOPE Connection and Everyone Counts in Springfield are integral to the mission. “Getting that access is huge. It’s invaluable to provide access to healthcare and information about how to get signed up for the programs people need.”

Sometimes that learning process takes a long time, like in the case of Allison*. Allison started going to a provider at OCH for over a decade. A  few years ago, she incurred a major life event and a variety of severe health issues that left her on disability and Medicaid, unable to care for herself. The medication she was taking was not working which resulted in chronic pain and a distrust of the medical system. When she moved in with friends, she had a limited food supply and limited quality of life. Ciara worked with her to get her food and looked at housing options. Every trip to the grocery store or produce distribution center was a lesson. “Again, you work with what they have. You shop within their budget. You show them nutritious options they can afford.”

After working with multiple agencies and with the help of Ciara, Allison found an apartment. Ciara helped her move out of her friend’s house and into her first “home” in four years. She showed Allison how to cook the food she has. “Sometimes you just need to let them know what they can do. Boil a potato and don’t add too much butter or cream and you have mashed potatoes.” Teaching patients to have the confidence to take care of themselves is one of Ciara’s favorite parts of her job. “[Allison] called me earlier this week saying she worked for hours cooking onions and potatoes and she was running around her apartment like a crazy person with joy.” It’s always a learning process. One day you boil potatoes; the next, you fry them up with some onions. During the interview, Kristen, the Integrated Care manager ran in the room exclaiming, “I found Allison a couch!” It’s the little successes that show the Integrated Care department and Ciara’s dedication to the patients.

Ciara summed it up perfectly when talking about her own children. “I have three rules. One is care about others. Hold the door open for everyone, not just girls. Always be a degree better of yourself than where you are now.” Always treat others the way you want to be treated. You have to share the love.


Qualifications for the Integrated Care program simply include being a patient at Ozarks Community Hospital. To be eligible for the Primary Care Health Home program, the patient must be a current patient, have Medicaid as a primary or secondary insurance and have one (or more) chronic condition(s). If you or someone you know is an OCH patient and in need of assistance, contact Integrated Care. For more information about the Community Health Worker position, email Ciara Day at cday@OCHonline.com.

*Patient names and health information have been changed to protect patient confidentiality.

Winter Health and Safety Tips

With the New Year and winter in full swing, now is a great time to remind yourself of how to stay safe and healthy with the cold conditions. OCH provider Angela Standefer, FNP-C offers some tips to make it through the winter:

  • Get IMMUNIZED! Anyone over the age of six months should get vaccinated against influenza. If you have a history of asthma, COPD or smoking it is recommended you also get your pneumonia and Prevnar vaccines. Talk to your doctor about vaccines for you.
  • Dress for the weather. A key to staying healthy this winter is knowing the forecast. Check the weather before getting dressed for the day to ensure you are prepared. Choose warm clothing. If it is wet, it is a good idea to wear a pair of water resistant shoes, hat and gloves, and a coat to avoid frostbite.
  • Don’t FALL victim to icy terrain. Watch your step when walking on wet and icy surfaces. The risk of falls can be greatly reduced by choosing appropriate footwear and using salt (or another kind of ice melting material) on the ground. Choose shoes that have traction so your feet are equipped.
  • Humidity isn’t always a bad thing. While humidity can wreak havoc on your hair, it can also prevent dry skin and nose bleeds. Use a humidifier in your home to avoid dry air. If you do catch the sniffles, humidifiers help your body stay hydrated.
  • Have an emergency kit in your car. Traveling even short distances can be hazardous in winter weather conditions. It is crucial to be prepared in case this happens. This includes:
    • Make sure your cell phone is charged so you can call for help.
    • Have a first aid kit in case you get hurt on ice.
    • Keep a blanket or extra coat in the car to keep yourself and the kids warm. While keeping the car running might sound like a good idea at the time, your battery could be depleted before help can arrive, causing further problems.
    • Munchies may be obvious for a long car trip, but they are also a good idea to keep in your emergency kit.
    • Kitty litter can give your car traction when stuck in ice or snow. Keep a cheap bag in your trunk to help you escape the conditions.
    • Keep an ice scraper in your car so if you get into unexpected bad weather, you can keep your windows clean for safe travel.

Depending on the conditions, it may take a long time for a tow truck to get to you in severe weather. Being prepared will allow you to survive the frigid conditions.

  • Carry a medication list with you. Include what medicines you are currently taking, medical allergies and emergency phone numbers on a small piece of paper in your wallet so it can be easily located. If you suddenly fall ill having this information will be helpful.
    • iPhone Hack: You can add your medical information to your iPhone that can be accessed without unlocking your phone.
      • To set up your Medical ID, open the “Health” app. Along the bottom menu, click Medical ID (far right). In the top right corner, click Edit and enter your health information. You can include Name, DOB, Medical Conditions, Medical Notes, Allergies & Reactions, Medications, Blood Type, Organ Donation status, Weight, and Height. Before hitting save, make sure to allow Emergency Access.
      • Your Medical ID can be viewed when the phone is locked by tapping Emergency, then Medical ID.
    • Wash your hands. Good hand washing is one of the most important things you can do to avoid colds and the flu. Covering your cough can also help from spreading germs to your family and friends.
    • Space heaters are convenient, but dangerous. While having a space heater may seem like a good alternative to cranking up the heat, they can also cause house fires or burns on both children and adults. Follow manufacturers’ directions. The safest options for space heaters have a safety mechanism in place that will turn the heater off if it falls over or gets too hot.
    • Chimney sweeps aren’t just for Mary Poppins. If you have a chimney, have it checked by a professional each year before use to make sure it is clean and safe.
    • Carbon monoxide isn’t just in car exhaust. If your home or apartment is heated with natural gas, make sure to have a carbon monoxide alarm to alert you if carbon monoxide levels are dangerously high. If it goes off, leave the home to get fresh air and call 911 from a neighbor’s home.
    • Don’t forget the sunscreen! The cold weather can trick us into thinking we are safe from sunburns. However, snow is a great reflector for the sun and you can still get a nasty sunburn in the winter.

Angela Standefer, FNP-C sees patients for family practice and hepatitis in Springfield in the OCH Medical Offices Clinic and in Bolivar at the OCH Polk County Clinic. She collaborates with Jackie Beene, MD and seeks to bring better health to the community.