Circulation Exercises to Keep you Warm

Exercises to keep you warm through the winter.

Winter is in full swing in The Ozarks! These frigid temperatures may cause significant circulation issues for many individuals. As we age, our body systems have to work increasingly hard to supply our body with all the nutrients and oxygen that it requires to perform the vital functions that we all need.

“Impaired circulation may cause significant issues with elderly individuals when you combine poor circulation with things like heart disease, diabetes or a lack of exercise. With the use of the above exercises you can help give your body the boost it needs to make it through this winter season.”

  • Dr. Brittany Wright, Physical Therapy

Here are three simple circulation exercises that have been shown to increase blood supply to assist with improved day-to-day health.

#1 – Supine Ankle Pumps – Begin lying on your back with your legs straight. Slowly pump your ankles by bending and straightening them. Try to keep the rest your legs relaxed while you move your ankles.

Supine Ankle Pump

# 2 – Supine Quad Set – Begin lying on your back with one knee bent and your other leg straight with your knee resting on a towel roll. Gently squeeze your thigh muscles, pushing the back of your knee down into the towel. Make sure to keep your back flat against the floor during the exercise.

Quad Set

#3 – Supine Glute Set – “Penny Pinchers” – Begin lying on your back with your hands resting comfortably. Tighten your buttock muscles, then release and repeat. Make sure not to arch your low back during the exercise or hold your breath as you tighten your muscles.

Glute Set

The above exercises have been recommended by the OCH physical therapy department as an easy and convenient way for adults to help pump blood through their body. This is not medical advice.



#TransformationTuesday: OCH upgrades radiology equipment to better serve patients

Ozarks Community Hospital has transformed radiology equipment systemwide to better serve patients and offer increased services. OCH of Gravette in northwest Arkansas, OCH of Springfield and OCH Christian County Clinic in southwest Missouri have added new updated equipment to increase options for physicians, better evaluate patient conditions and provide further health direction.

As a health system, OCH continues to provide the same quality care but with greater capabilities. The OCH mission is to provide a high quality of care to everyone, regardless of insurance coverage. In fact, more than 80% of patients have governmental insurance or are self-pay. The ability to provide high-quality and technologically advanced radiology services will help OCH better serve its patient population and the surrounding communities.

Springfield & Nixa

OCH of Springfield and the OCH Christian County Clinic also received upgrades to their equipment. The OCH of Springfield hospital received a new SOMATOM Perspective 64-Slice Scanner and ACUSON S2000 ultrasound. With these updates, OCH of Springfield hospital now has radiology equipment directly comparable to nearby hospitals. The OCH Christian County Clinic in Nixa upgraded its CT Scanner to a SOMATOM Emotion 16-Slice CT Scanner.

The new equipment at OCH of Springfield provides expanded services including:

  • Coronary Computed Tomography Angiography (CCTA): A heart imaging test that helps determine if plaque buildup has narrowed a patient’s arteries.
  • Low Dose Lung Screening: This screening meets CMS guidelines for a lung cancer screening. These are recommended annually for high risk populations/patients and have shown to contribute to a 20% reduction in mortality.
  • Cardiac Calcium Scoring: This is a quick, painless, noninvasive procedure to accurately determine the degree and severity of hard plaque within the coronary arteries. These are recommended for anyone at risk of coronary artery disease, including healthy males over the age of 40 and females over the age of 45.

 AR before after


The new equipment makes OCH of Gravette the only all-digital radiology department in its region. OCH of Gravette received massive upgrades and updates including a new SOMATOM Perspective 64-slice CT Scanner, a Siremobil Combact L (C-ARM), a Multix Select and Multix Fusion x-ray machines, a portable Mobilett Mira x-ray machine, and ACUSON S2000 and ACUSON Freestyle Ultrasound System.

The new equipment offers additional testing capabilities including:

  • Coronary Computed Tomography Angiography (CCTA): A heart imaging test that helps determine if plaque buildup has narrowed a patient’s arteries.
  • Low Dose Lung Screening: This screening meets CMS guidelines for a lung cancer screening. These are recommended annually for high risk populations/patients and have shown to contribute to a 20% reduction in mortality.
  • Cardiac Calcium Scoring: This is a quick, painless, noninvasive procedure to accurately determine the degree and severity of hard plaque within the coronary arteries. These are recommended for anyone at risk of coronary artery disease, including healthy males over the age of 40 and females over the age of 45.
  • QCT Bone Density Test: This is a CT scan with special software used to diagnose or monitor low bone mass. Bone density testing is recommended for anyone at risk of or with evidence of osteoporosis.

In January 2015, the Association for Medical Imaging Management (AHRA) announced that OCH of Gravette was one of six recipients of the AHRA and Toshiba Putting Patients First grant to improve the safety, understanding and comfort of pediatric radiology procedures. This KidSTRONG pediatric safety program at OCH of Gravette is a coinciding compliment to the comprehensive technology upgrades. The radiology department has been completely renovated due to the state of the art radiology equipment, with an emphasis on pediatric-friendly facilities and a comforting experience for families.

“The KidSTRONG pediatric safety and education component paired with the complete overhaul of our radiology department in Gravette increases community resources,” says Ronda Kruetzer, radiology manager at the hospital. “These upgrades have enabled OCH to provide safe, quality and worry-free care for the region’s residents right in their hometown,” says Ronda.

Autism FAQ’s

In honor of World Autism Day on April 2nd, speech language pathologist Shannon Locke of the Ozarks Area Autism Clinic (OAAC) answers FAQ’s about autism spectrum disorders. Find out notable symptoms, who it affects and resources to help.

1. What is an Autism Spectrum Disorder (ASDs)?

ASDs are lifelong, behaviorally defined developmental disabilities in which an individual demonstrates disturbances in each of three areas:

  • Communication
  • Social interaction
  • Repetitive or restrictive and unusual behaviors

ASDs are a part of the broader category of Pervasive Developmental Disorders (PDD) which includes Autistic Disorder, Asperger’s Disorder, and Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS). Symptoms of ASD vary greatly between individuals, but all will demonstrate varying degrees of disturbance within each of the three areas, that cannot be explained by other differential diagnoses. 

2. Who is at risk?

According to the National Institute of Health, the true incidence of Autism Spectrum Disorders is likely to be within the range of 30-60 cases per 10000.  ASDs occur in males significantly more often than in females; however, ethnicity does not appear to play a significant factor. 

This is an increase from early projections which is largely a consequence of improved ascertainment and a considerable broadening of the diagnostic concept. However, a true risk assessment is yet to be identified, although environmental risk factor cannot be ruled out and there have been preliminary studies indicating some familial tendencies. Empirical data do not support hypotheses of causation from dietary sources; however, good diet remains proven as a contributing factor to overall good health for all individuals. 

3. What are the signs?  

As suggested above all individuals with Autism Spectrum Disorders present differently, but below are a few common signs:

  • Underlying resistance/difficulty with social communication (like using common gestures and engaging in back-and-forth interaction with others, for example, Patti-cake games)
  • Difficulty greeting others independently or initiating interaction
  • Lack of eye contact to engage others or get attention purely for the purpose of “showing” something
  • Resistance to change or adherence to specific routines with no functional purpose

Here are a few examples of what it could look like if your child is demonstrating disturbances in social interaction and communication:

  • If your child doesn’t show you things or give you things to get you to play with him/her
  • If your child always prefers to “play” alone and will even outwardly resist your presence in his/her activities
  • If your child doesn’t seem able to say “hi” or “bye” to others with words or by waving without you constantly prompting him/her
  • If your child pulls you by the hand or arm to get things, but never looks at you to get your attention in the process
  • If your child has certain routines or ‘scripts’ that he/she will repeat over and over again even when the routine doesn’t seem to be appropriate to what’s going on, like imitating a line from a children’s program repeatedly throughout the day or insisting on toys being arranged in a certain way to avoid tantrums

As always, if you have any medical concerns for your child speak with your child’s pediatrician openly about your concerns and don’t be afraid to ask questions. Your pediatrician or nurse practitioner is your first stop resource for support, diagnosis referrals, and intervention services for your child.  

4. Where can I get help?

Start with your child’s health care provider, discuss your concerns and ask questions. You child’s doctor can make referrals as needed for medical diagnosis and intervention. Other resources include:

  • The Ozarks Area Autism Clinic (OAAC) is housed in the OCH Christian County Clinic located in Nixa, MO. It is the only multi-disciplinary autism diagnostic clinic of its kind for children from 18months to 6years of age in Southwest Missouri.  In addition, the OCH Christian County Clinic Pediatric Therapy Department provides individual pediatric therapy treatment services for children of all ages, including Speech and Language, Occupational, and Physical Therapies.   
  • In addition, the Missouri Department of Elementary and Secondary Education (MO DESE) Special Education offers educational support for children from birth though age 21 as they are deemed eligible through your local school district special services and Missouri Early Intervention First Steps programming.  
  • Finally, the Missouri State Department of Mental Health, Division of Developmental Disabilities offers support, case management, and referral services for children with diagnosed disabilities locally through the Springfield Regional Office; as well as facilitate connection with TouchPoint Autism Services , which provides supports for children in Southwest Missouri with ASDs.

Contact for support through these agencies can help families navigate the multitude of information floating in cyberspace about Autism Spectrum Disorders, point families in the right direction for hands-on help, and assist in finding everyday solutions and needed services for children in Missouri.

Blog report compiled by Shannon Locke, M.S.-CCC/SLP, Director of Pediatric Therapy Services and co-creator of the Ozarks Area Autism Clinic at OCH.  Shannon has been treating ASDs for over 20 years in educational, vocational, recreational, and medical settings.  She received her Master of Science degree from Missouri State University in 1998 and Certificate of Clinical Competence and licensure, Speech and Language Pathologist in 1999 through the State of Missouri Department of Professional Registration.  Shannon has previously been certified as an In-district Autism Consultant through Greene County Special Education Cooperative and received the ACE Award from American Speech Language and Hearing Association for exceptional participation in Continuing Education. When Shannon is not working in the Nixa OCH Clinic, she enjoys time with her husband, Scott and 10 year-old daughter, Katie and their rescue pets, two dogs and one cat, as well as spending time exploring the great outdoors hiking, kayaking, biking, and sky-diving. 

Psychology of Becoming a Parent

Growing from a couple to a family is a significant change. For one, it’s a lot more stressful. But what about the other changes soon-to-be-parents aren’t aware of? OCH Psychologist, Dr. Annie Beatty expands upon a few elements that will come to surface in your new life as you make the transition to parenthood & offers tips to make sure you maintain a sane brain throughout it all.

Parenting is rewarding and challenging, not just with the daily responsibilities involved, but also the impact it has on your relationship with your spouse. When a child is welcomed into a family, the focus shifts from your partner to the newest member.  Although this is a natural process, it potentially could leave one or both partners feeling abandoned, neglected and stressed.  Research has shown stress changes a person physiologically and emotionally; it can also impair communication patterns and interfere with intimacy.  It is important to prepare for these changes and consider the necessary adjustments in all aspects of your relationship.  A few key points to consider and prepare for include:

  • Change in  daily routine (less alone time, less sleep, less time to engage in couple-related activities, less freedom to be spontaneous)
  • Potential impact on one or both careers (mothers  may feel the need to stall their careers while fathers may feel  pressure to work harder to support the bigger family)
  • Financial considerations (daycare, medical insurance, etc.)
  • Shift from being independent to focusing on family;  shift of now being responsible for someone other than yourself
  • Less privacy
  • More time and focus will likely be spent on your child than your spouse

The key to making this transition smooth is to prepare your relationship for the addition of children before it happens. As always, communication is the key to keeping your relationship healthy.

Annie Beatty, PsyD works at Ozarks Community Hospital in Springfield and spends time at OCH Christian County Clinic in Nixa. She received her education from the Forest Institute of Professional Psychology and completed her residency at Burrell Behavioral Health. To contact Dr. Beatty, call (417) 875-4682 – Specialty Office, or (417) 725-8250 –  Nixa Clinic.


Top 10 Childhood Rashes – Part 1

Not all childhood rashes are created equal. Some are more contagious, others are life threatening. And, (of course) all are unpleasant! OCH pediatric nurse practitioner, Sandy Hinds shares the top 10 common rashes among children and offers a quick guide to identifying each of them. Learn the causes, symptoms, and treatment options available (Part 1). Take note, moms and family members, and stay tuned for the second set of common rashes to be posted next week. 


Hand-foot-and-mouth disease is always caused by a Coxsackie A-16 virus. It has no relationship to hoof and mouth disease of cattle. Symptoms include the following: small ulcers in the mouth and a mildly painful mouth, small water blisters or red spots located on the palms and soles and on the webs between the fingers and toes, five or fewer blister per limb and sometimes on the buttocks. Low-grade fever between 100 and 102. It mainly occurs in children 6 months to 4 years of age.

Image of Hand, Foot & Mouth

  • Expected Course: Fever and discomfort are usually gone by 3-4 days. Mouth ulcers resolve in 7 days, with the rash lasting 7-10 days. Only complication is dehydration from refusing fluids.
  • Home Care: Antacid solution: use for pain relief. Children under 4 yo. ½ tsp. antacid solution in the front of their mouth 4 times a day after meals. Children over 4 yo. 1 tsp. antacid solution after meals.
  • Diet: Soft diet for a few days and encourage plenty of liquids. Cold drinks, popsicles, sherbert. Avoid citrus, salty or spicy foods or ones that need much chewing.
  • Fever: monitor fever and administer fever reducer as needed.
  • Contagiousness: Quite contagious and usually some of your kids playmates will develop it at the same time. Incubation period is 3-6 days. Because the condition is harmless, these children do not need to be isolated. They can return to daycare when the fever is normal. Most children are contagious 2 days before to 2 days after the rash, but avoidance of other children is unnecessary.


Poison Ivy causes redness and blisters, eruption on exposed body surfaces. It is shaped like streaks or patches, very itchy, onset 1-2 days from being in a forest or field.


Image of poison Ivy


  • Cause: poison, ivy, sumac can cause the same type of rash. More than 50% of people are sensitive to the oil of these plants. The course usually lasts 2 weeks. Treatment reduces the symptoms, but doesn’t cure the disease. Prevention is the best approach.
  • Prevention: Learn to recognize these plants. Avoid all plants with three large shiny, green leaves. If exposed wash clothing and areas of skin with soap for 5 minutes, because after 1 hour it is of little value in preventing absorption of the oil.
  • Contagiousness: The fluid from the sores is not contagious, however, anything that has poison ivy oil or sap on it is contagious for about 1 week. This includes the shoes, or clothing worn as well as any pets that may have it in their fur. The rash begins 1-2 days after exposure.
  • Home Treatment: Cool soaks, Benadryl (weight appropriate dosage).


Ringworm is a ring-shaped pink patch, scaly, raised border, increases in size, clearing of center, mildly itchy. It is caused by a fungus infection of the skin, often transferred from puppies or kittens who have it.

Image of ringworm.

  • Contagiousness: it is mildly contagious. It requires direct skin-to-skin contact. It is only transmitted animal to human, not human to human. After 48 hours of treatment it is not contagious at all. Animals must be treated by their veterinarian.
  • Home Care: antifungal cream, Tinactin, Lotrimin cream applied twice daily to the rash.


This rash is characterized by bright red or rosy rash on both cheeks for 1-3 days ( slapped cheek appearance) , followed by a pink “ lacelike” or “netlike” rash on extremities. Lacy rash mainly on thighs and upper arms, comes and goes several times over 1-3 weeks. No fever or low grade fever – less than 101F ( 38.4). Fifth disease was so named because it was the fifth pink-red infectious rash to be described by physicians. The other four are: 1. Scarlet fever 2. Measles 3. Rubella 4. Roseola. Fifth disease is caused by the human parvovirus B19.

Image of fifth disease.

  • Expected Course: The lacelike rash may come and go for 5 weeks, esp. after warm baths, exercise, and sun exposure. No treatment is necessary. The rash is harmless and causes no symptoms that need treatment.
  • Contagiousness: Over 50% of exposed children will come down with the rash in 10-14 days. The disease is mainly contagious during the week before the rash begins. Therefore, exposed children should try to avoid pregnant women, but that can be difficult. Once the child has ‘slapped cheeks’ or the lacy rash, he is no longer considered contagious and does not need to stay home from school. If a pregnant woman is exposed to a child with fifth disease, she should see her obstetrician. The doctor will obtain and antibody test to see if the mother already had the disease and is therefore protected.


Children ages 6 months to 3 years, presence of a fine pink rash, mainly on the trunk. High fever during the preceding 2-4 days that cleared within 24 hours before the rash appeared. Child only mildly ill during the time with fever, child acting fine now. Roseola is caused by the human herpesvirus-6. The rash lasts 1-2 days followed by complete recovery. Some children have 3 days of fever without a rash. No particular treatment in necessary. Roseola is contagious until the rash is gone. Other children of this age who have been with your child may come down with roseola in about 12 days. Call if the rash last more than 3 days, fever longer than 4 days or the spots become purple or blood-colored.

Image of roseola. All pictures courtesy of Instructions for Pediatric Patients, second edition, W.B. Saunders Company, 1999

Sandra Hinds, CPNP-PC works at the OCH Christian County Clinic located in Nixa, Mo. She received her education from the University Missouri-Columbia, the University of Missouri-Kansas City School of Nursing and the Vickie Millazzo Institute. Sandra is currently a member of the following professional organizations: National Association of Pediatric Nurse Associates and Practitioners, American Academy of Nurse Practitioners, Kansas City Nurse Practitioner Networking Association. To contact Sandra, call OCH Christian County Clinic at (417) 725-8250.

10 Ways to Maximize Outdoor Play

It’s time to shed your coat (but maybe keep those rain boots around for a bit longer) and embrace the sun! Take advantage of the great weather and spend some time outdoors with your kids. Not sure what to do with your cooped-up, crazy bunch? OCH/Advantage Therapy physical therapist, Jennifer Witt has a recipe for outdoor success:try one of these 10 activities to help promote healthy growth and brain development in your kids.  

Fingers crossed, warm weather is finally gracing us with its presence! It’s that time of year when the kiddos are bouncing off the walls after being cooped up all winter, and to tell you the truth, I kind of am, too.  That can only mean one thing; time to get outside and play! Here are 10 fun and inexpensive play ideas to promote fine and gross motor skills, strength, balance, and coordination in children.

  • 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

Eeny, meeny, miny, mo! How to choose my birth control?

Trying to choose a contraceptive is like staring at a long list of ice cream flavors: twenty-one options and they all sound good! Unfortunately, for most women, the real deal isn’t as easy as choosing between cookie dough and caramel chocolate delight; it’s a bit more daunting.

Providers Beverly Gann, WHNP and Krista Boyd, DO sat down with us to offer their insight on birth control and contraceptive options available for women today. Watch the videos to find out more information, but please note:  OCH providers do not endorse specific brands of birth control.

Beverly Gann, WHNP specializes in women’s health and is certified as a psychiatric and mental health nurse and childbirth educator. She received her training at the University of Missouri in St. Louis and at the St. John’s Hospital School of Nursing. Gann is currently a member of the Association of Nurse Practitioners in the Ozarks. She works in OCH’s Specialty Clinic and can be reached by calling (417) 837-4079.



Dr. Krista Boyd’s is board certified in family practice and works at the OCH Christian County Clinic in Nixa, Missouri. She received her training at the Kirskville College of Osteopathic medicine and is a member of the American Academy of Family Physicians. To contact Dr. Boyd, call (417) 725-8250.