2016 July/August Newsletter

Pathways to Wel lness JULY/ AUGUST 2016 Proud ly Supporting Our Employee Veterans! Michael Williams I graduated from Geneva High School in 1985. I enlisted in December 1984 and left for basic training at Lackland AFB in Texas after graduation. I moved to Sheppard AFB in Wichita Falls, TX for Crew Chief and was then stationed with the 33rd TFW in Eglin AFB, Florida. From Florida I was transferred to 81st TFW RAF, Bentwaters, England. I also spent somePictured left to right: Jenee Blundell, Kim Gaston, Michael Williams, time in Saudi Arabia during Desert Shield/Storm. My wife, Joy, and I are both employees at FCH, where I have workedKim Taylor, and Tyler Gewecke for 10 years. We live in Geneva and have a daughter whoJenee Blundell attends Fillmore Central Middle School.I signed up for the Army National Guard right before graduating Kim Taylorhigh school. In 1998, I went to Fort Jackson, SC for basic train- I enlisted in the Air Force in 1986 at age 21, after completinging and AIT. I became a 71 Lima, an administrative specialist, two years of college. Air Force roots run deep in my family,and spent the rest of my time in the guard helping out at Offutt which influenced my decision to proudly wear blue! AfterAirforce base in Ashland, NE working in the medical records basic training at Lackland AFB in San Antonio, TX, I was sentdepartment. I have worked in long term care since 1996, start- to Kiesler AFB in Biloxi, MS for training in Electronics anded as a LPN at Fillmore County Medical Center three years Navigations Systems. There, I met my husband, Matt, whomago and occasionally help at the Heritage Crossings. I have I married after six weeks of dating to be assigned together toalso been on the volunteer Geneva Rescue squad for around the 552 AGS unit at Tinker AFB in Oklahoma City, OK. We6 years where I assisted the EMT’s and in 2013, got my EMT worked in support of the Airborne Warning and Control Sys-license. Being able to care for others is a very rewarding thing tem Aircraft (AWACS) until 1990, when we chose to separate from the USAF so Matt could work for the NE State Patrol.for me. Kim Gast on Tyler GeweckeI enlisted in the Army National Guard in 1992, during my junioryear in high school and attended basic training the following After graduating from Fillmore Central High School, I servedsummer at Fort Jackson, SC. After graduation I attended AIT in the United States Air Force from July 2001 to July 2005.at Fort Sam Houston, TX to become a Medical Specialist and I attended basic training at Lackland AFB in San Antonio,was eventually trained as a transportation specialist. I have TX and Financial Management training at Sheppard AFBworked with units out of Scottsbluff, Lincoln, and Omaha. I in Wichita Falls, TX. I was stationed at Scott AFB in Illinois,re-enlisted one time, but decided to leave the military when my where I worked for the 375th Comptroller Squadron. My wifehusband, Chad, and I decided to have children. In 2001, I went Megan and I live in Geneva and both work at the hospital,back to college to become a nurse. We moved to Geneva in we are expecting our first child in November. I work in the IT2008 with our three children. I have worked for FCH for one Department and have worked for FCH for 10 years.year in the Inpatient Behavioral Health Department. www.myfch.orgTumor Tacklers Evidence-Based Treatment for PTSD Page 2 Page 5

O ur SERVICES Tumor Tacklers Team Captains: Valerie Poppert and Kim Gewecke Hospital Services For the last 9 years, the Fillmore Coun- is outstanding. Not only do the employ- Acute Care ty Hospital Relay for Life team, Tumor ees donate fundraising items but the Aquatic Therapy Tacklers, has been raising money for the employees then buy the majority of items Behavioral Health fight against cancer. The Tumor Tacklers from our fundraisers. Also, because the Inpatient Behavioral Health team was started in the fall of 2007 by FCH Board allows the employees to Outpatient Behavioral Health Kim Gewecke and Valerie Poppert in participate in payroll deduction, the team Medication Management order for the hospital to have a pres- has been able to raise thousands of Cardiac Rehabilitation ence at the Fillmore County Relay in the dollars each year. Emergency Services summer of 2008. The team of 12 raised Labor & Delivery $2785 for the Relay, set up camp for 2016 will be another great year for the the all night event, and had a great time Tumor Tacklers as the Bake Sale and Laboratory participating in the activities, socializing, Basket Auction raised over $7000 and Observation Care and WALKING!! our payroll deduction is on track to Occupational Therapy raise over $5000. As always, we have Physical Therapy In 2009, the Tumor Tacklers were on a luminaries for sale each year, honoring Pulmonary Rehabilitation mission to donate more than in 2008, so those we’ve lost and celebrating those Puzzle Pieces Pediatric Therapy they had a Basket Auction, which has who have won the fight and the Tumor now become an annual event and has Tacklers make luminaries for all past and Radiology incorporated a Bake Sale. The annual present hospital employees who have CT Scan Bake Sale and Basket Auction take fought cancer. Come join us this year Echo/Doppler place the Thursday before Easter and at the Fillmore County Relay for Life on Mammography have become the team’s largest fund- July 30th and help us CELEBRATE the MRI Scan raiser, generating $5000 to $7000 per lives of those we have lost to cancer and Ultrasound year. CELEBRATE our survivors!! X-Ray Since 2008, the Tumor Tacklers have Skilled Care donated over $85,000 to Fillmore County Sleep Study Relay for Life with the majority of the Speech-Language Therapy money raised coming from hospital em- ployees. In addition to the annual Bake Surgery Sale and Basket Auction, the team has Touchstone Orthopaedics had numerous other fundraisers includ- ing; Denim Days, Box Luncheons, Cake Specialty Clinics Walks, Garage Sales, T-Shirt fundraisers and payroll deduction. The generosity of Audiology & Allergy Clinic the Fillmore County Hospital employees Cardiology Dermatology Pictured Left to Right: Jess Bruguera, Tawnia Lee, Julia Bruns, Kati Babik, April George, Amaly Reinsch, Virginia Johnson, Lisa Hopken, Amber Hedden, Jeanne Ackland, Cindy Kahler, Shari Ear, Nose, and Throat Care Michl, Peggy Casey, Valerie Poppert, and Melea Walters. Not pictured: Kim Gewecke, Annalisa Endocrinology Knutzen, Brianna Steinacher, Lisa Pollock, and Ashlee Martin. Hematology/Oncology Interventional Radiology Neurology Obstetrics & Gynecology Ophthalmology Orthopaedic Podiatry Pulmonology Urology Vascular Care Wound Care2 Fillmore County Hospital

Begins August 1, 2016 Friday, August 5, 2016“An ounce of prevention is worth a One of Fillmore County Hospital’s Clinic, and Fillmore County Coalition initiatives for promoting wellness in the to host the Path 2 Prevention 5K. Thispound of cure.” Okay, yes it’s true, community is to encourage physical ac- year’s theme is ‘Super Cool’ which aimsBenjamin Franklin was referring to fire tivity. Regular physical activity is one of to inspire everyone to “be your own su-safety when he first coined this phrase. the most important things a person can perhero when it comes to your health!”However, you’d be hard pressed to find do to stay healthy. Studies show that The event, which was established toa better phrase to describe our current individuals who exercise regularly have help raise funds for a public walkingstate of health in America. a lower risk of heart disease, stroke, trail on the FCH and FCMC campus, obesity, diabetes, musculoskeletal prob- will take place on the evening of Friday,According to the Centers for Disease lems and some cancers (CDC). August 5th with the mile run starting atControl (CDC), it is estimated that 70 7:00 PM and the 5K at 7:15 PM.percent of deaths in America are linked Two Fillmore County Hospital spon-to preventable conditions, including sored events that promote physical “Last year we had over 150 participantsheart disease, stroke, chronic lung activity are the annual Step It Up Chal- and we are hoping to see an even bet-disease, diabetes, and some forms of lenge and Path 2 Prevention 5K. ter turnout this year” said Jenni Hoarty,cancer. Yet most of our time and money Fillmore County Hospital Wellness Co-is spent on treating disease rather than The 5th Annual Step It Up Challenge, ordinator. “This event is for runners andpreventing it. which will begin on August 1st, is a six- walkers of all skill levels and ages.” week voluntary team program. FCH en-The number one prescribed treatment courages local organizations to register Participants are encouraged to dressfor preventing or reducing the risk for and form teams. The challenge includes up as their favorite Superhero withdeveloping chronic disease is healthy each member wearing a pedometer and prizes being awarded to the top threelifestyle changes. Improving your tracking their daily steps. Team steps costumes. There will be cool-off stationshealthy lifestyle behaviors has the po- are averaged and compared to other throughout the race and cold treats fortential to greatly reduce the risk factors participating organizations. The winning race finishers.that lead to chronic diseases, slow their team receives bragging rights and a tro-progression, and improve overall health. phy to display at their place of business. For more information on either event,Four major risk factors that you could please contact Jenni Hoarty at jhoarty@start changing today include: physical Challenge participants are encouraged myfch.org.activity, nutrition, tobacco use, and alco- to work towards a goal of 10,000 stepshol consumption. per day. Why 10,000 steps you ask? These popular events are a great way 10,000 steps daily is approximately 5 for FCH to reach out to its staff andIn recent years, Fillmore County Hos- miles and is a rough equivalent to the community and reinforce the impor-pital has become more proactive in Surgeon General’s recommendation to tance of being proactive and buildingpromoting wellness rather than fo- accumulate 30 minutes of activity most healthy habits even when it’s not conve-cusing solely on providing reactive days of the week. Unless you have a nient. Healthy habits are an “automatic”medical treatment after a person gets very active lifestyle or profession, you defense against most illnesses and cansick. “We feel it is our responsibility to probably don’t reach 10,000 steps on provide us a long, healthy – and thusbe a resource, a tool, and a solution a given day without putting some effort happy – life.to our citizens for reaching a path to into your activity.better health” said Paul Utemark, CEO 3Pathways to Wellnessof FCH. “In the day and age we live 2016 marks the 4th year that FCH hasin, there are few investments that will teamed up with the Fillmore Countyreturn a higher payback than taking Foundation, Fillmore County Medicalownership in your health.”

Law Enf orcement and Mental Healt h Gerry Merck, Outpatient Behavioral TherapistLaw Enforcement Officers listen as Gerry On June 2nd, Law Enforcement Officers danger to self and others, and appropri-Merck teaches them techniques to reduce ate community referral resources.risk when mental health issues are encoun- from York, Saline, and Fillmore countiestered in the community. came together for a day long training to Chief Deputy, Steve Roemmich of the explore the unique challenges they face Fillmore County Sheriff’s Department, when dealing with mental health issues coordinated the event as one of the de- in the community. partment’s ongoing educational require- ments. Deputy Roemmich praised the The workshop, entitled Law Enforce- hospital’s efforts and called the work- ment and Mental Health, was spon- shop a huge success. “In our line of sored by Fillmore County Hospital’s work,” he said, “we see all sorts of peo- Integrated Behavioral Health Program ple and all kinds of behavior. It makes and presented by Educational Co- our jobs easier if we can be informed ordinator and Outpatient Therapist and understand what we are dealing Gerry Merck. The course covered with and what we can do to better serve four common mental health concerns: the people of our communities.” depression and mood disorders, anxiety and panic disorders, dementia, and Prior to the workshop, Law Enforcement delusional disorders. Law Enforcement staff met with Hospital Administrator, staff learned the signs and symptoms Paul Utemark, and Integrated Health of each disorder, common encounter Program Director, Stephanie Knight scenarios, and techniques designed for refreshments and a tour of Fillmore to reduce risk and manage problem County Hospital’s new Behavioral behaviors. The course also included Health wing. suicide risk management, assessing Independence Day Trivia 1. What year was the Declaration of Independence signed? a. 1802 b. 1776 c. 1796 d. 1810 2. How many people signed the Declaration of Independence? a. Thirteen b. Thirty c. Fifty-Six d. Twenty-Six 3. How many colonies were declared independent when the Declaration was signed? a. Thirteen b. Ten c. Five d. Eight 4. Who were the American’s fighting for independence from? a. France b. Mexico c. Great Britain d. Russia 5. Where does the original Declaration of Independence reside now?a. White House b. National Archives c. Pentagon d. National Museum of American History 6. How many were on the committee to write the Declaration of Independence? a. Two b. One c. Five d. Thirteen Answers: 1 - b. 2 - c. 3 - a. 4 - c. 5 - b. 6 - c.4 Fillmore County Hospital

Evidence-Based Treatment f or P T SDGerry Merck, Outpatient Behavioral TherapistThe risk of exposure to trauma has been a part of life through- the current situations that trigger dysfunctional emotions, beliefs and sensations, and the positive experience neededout history. Attacks by saber tooth tigers produced the same to enhance future adaptive behaviors and mental health.psychological responses in human beings 10,000 years ago During treatment various procedures and protocols are usedas 21st century terrorism does today. A well-known phenom- to address the entire clinical picture. One of the proceduralenon, Shakespeare’s Henry IV, appears to meet many, if not elements is “dual stimulation” using bilateral eye movements,all, of the diagnostic criteria for Post-traumatic Stress Disor- tones or taps. Patients generally experience the emergenceder (PTSD), as have other heroes and heroines throughout of insight, changes in memories, or new associations.the world’s literature. Selective Serotonin Reuptake Inhibitors (SSRIs) are a typeIt was not, however, until 1980 that the American Psychiatric of antidepressant medication that is used to treat the symp-Association added PTSD to the third edition of its Diagnostic toms of PTSD as well as other conditions like depressionand Statistical Manual of Mental Disorders classification sys- and anxiety. Chemicals in your brain affect the way you feel.tem. At that time, PTSD was a controversial concept because Excessive Stress and Trauma cause the brain to use moreof its contention that the cause of the problem behavior was serotonin than normal. When you have PTSD or depression,outside the individual (a traumatic event) rather than an you may not have enough serotonin. Studies have showninherent individual weakness (a traumatic neurosis). The key that SSRIs improve symptoms of non-combat-related PTSD.to understanding the scientific basis and clinical expression SSRIs can help more types of symptoms than other med-of PTSD is the concept of “trauma.” The person diagnosed icines can. Nevertheless, some studies are mixed aboutwith PTSD has been exposed to an event that is considered whether SSRIs work as well for veterans with combat-relatedtraumatic. However, experience has shown us that there are PTSD.individual differences regarding the capacity to cope withcatastrophic stress. Therefore, while most people exposedto traumatic events do not develop PTSD, others go on todevelop the full-blown syndrome.There are several evidence-based treatments for PTSD. Research has told us a lot about how well people with PTSDThese include Cognitive Processing Therapy (CPT), Pro- will respond to these treatments. A recent Meta-Analysislonged Exposure Therapy (PE), Eye Movement Desensiti- was published by the National Center for PTSD, U.S. De-zation and Reprocessing (EMDR), and Selective Serotonin partment of Veterans Affairs in 2012 describing the effects ofReuptake Inhibitors (SSRIs). each treatment studied. An effect size of 0.2 is considered small - The person might notice a change. An effect size ofCognitive Processing Therapy (CPT) is a type of psychother- 0.5 is considered medium - the person would notice it, and soapy in which negative patterns of thought about the self and would friends and family. An effect size of 0.8 is consideredthe world are challenged in order to alter unwanted behavior large - everyone would notice it. The results from the me-patterns or treat mood disorders such as depression. ta-analysis are in the table below.Prolonged Exposure Therapy (PE) is a form of behavior INTERVENTION EFFECT SIZEtherapy and cognitive behavioral therapy combined to treat 1.91 (very large)post-traumatic stress disorder. It involves re-experiencing Prolonged Exposure (PE) 1.89 (very large)the traumatic event through remembering it and engagingwith, rather than avoiding, reminders of the trauma (triggers). Eye Movement Desensitization and 1.81 (very large)Sometimes, this technique is referred to as flooding. Reprocessing (EMDR) 1.64 (very large)Eye Movement Desensitization and Reprocessing (EMDR) Cognitive Processing Therapy (CPT) 0.798 (medium)is a therapeutic method that utilizes the back and forth eyemovements that normally occur during REM (Rapid Eye Selective Serotonin ReuptakeMovement) sleep to be used during therapy to activate Inhibitors (SSRIs)structures in the brain and body that hold memories of painfuland traumatic experiences. This enables the brain to process Other Treatmentsmaterial stuck in the emotional, reactive part to access andconnect with the rational and meaning-making parts. EMDR Evidence-based treatments for PTSD work. All of the treat-is recognized as an effective form of trauma treatment in nu- ments ---CPT, EMDR, PE, and SSRIs---help people withmerous practice guidelines worldwide. It addresses the past PTSD more than no treatment at all and more than alterna-experiences that have set the groundwork for pathology, tive treatments that are available in the community. For peo- ple with PTSD, the best bet for recovery is evidence-based treatment. 5Pathways to Wellness

Endocrinology C linicLisa Kuechenmeister, PA-C, Leslie Eiland, MD, and Jody Degenhardt, RNDr. Leslie Eiland, a physician with the Department of Internal imbalance include diabetes, thyroid conditions, some sexual problems, some neurological problems, appetite and obesity,Medicine at Nebraska Medicine (UNMC), joined the Fillmore bone problems, cancer, etc.County Hospital Specialty Clinic in September 2014. Sheis an Assistant Professor in the Division of Diabetes, Endo- Dr. Eiland’s areas of expertise include the following:crinology and Metabolism at UNMC. Dr. Eiland obtained a • all aspects of diabetes and general endocrinology,Bachelor of Arts degree in Anthropology from the University • evaluation and treatment of pituitary disease,of Notre Dame. She attended medical school and complet- • treatment of thyroid conditions including thyroid cancer,ed her internal medicine residency at Emory University in • evaluation and treatment of osteoporosis,Atlanta, GA, and completed her Endocrinology fellowship • women’s health issues, including diabetes in pregnancy,at UNMC. Her interests include telemedicine, rural health, • evaluation and treatment of female and maleand management of diabetes and thyroid disorders. She isinvolved in developing endocrine telemedicine programs in hypogonadism,Nebraska and Western Iowa. • initiation and management of subcutaneous insulin Endocrinology is the study of hormones. A hormone is a pump therapieschemical messenger from one cell (or group of cells) to an-other secreted from glands in the endocrine system through- Dr. Leslie Eiland provides services twice a month utilizingout the body. The release of hormones has a wide range of telehealth clinics for rural patients and plans to visit Fillmoreeffects on activities, such as growth, development, puberty, County Hospital once every three months for an on-site clinic.sleep, metabolism, appetite, bone growth, mood and more. To make an appointment with Dr. Leslie Eiland, call our Spe-Some major diseases that can be caused by a hormone cialty Clinic at 402-759-4924.Fun Fact : Dr. Eiland grew up in Columbus, Nebraska!! She enjoys spending time with her husband and two sons!6 Fillmore County Hospital

Fillmore County Hospital accepts VCP ServicesVeteran’s C hoice Pr ogram Inpatient Simple Steps to Follow: Acute Care1) Know the provider whom you would like to see. Inpatient Behavioral Health (Reference list to the right.) Outpatient2) Call Veteran’s Choice Program, 1-866-606-8198, Lab to make sure you qualify.3) The representative you speak with will then call Fillmore Radiology County Hospital to schedule your appointment for you. Sleep Study4) You will receive a letter in the mail from Healthnet (a third Therapies party of Veteran’s Choice Program) stating your appoint- ment date and time. Physical Therapy Chad Phinney, Maddie TaylorBe sure the Veteran’s Choice Program makesyour appointment. If they do not make your ap- Occupational Therapypointment, YOU may be financially responsible for Tara Voss, Heather Probasco, Meredith Rothservices provided. Speech Therapy Example of Front of Card Cindy Haggadone, Amy Nash Example of Back of Card Pulmonary Therapy Respiratory Therapy Outpatient Behavioral Health Patricia Lenz, Susan Howard, Kavir Saxena Specialty Clinic Cardiology - Anuj Jain, Keith Miller, Hosakote Nagaraj Dermatology - Geoffrey Basler, Brent Behrens Ear Nose Throat - Timothy Knudsen, Jenna Kenney Endocrinology - Leslie Eiland General Surgery - Ye Ye, Daniel Growney Hematology/Oncology - Mark Hutchins Interventional Radiology - Eric VanderWoude Neurology - Matthew Kniss OB/GYN - Angela Grone, Tyler Adam Ophthalmology - Vincent Sutton Orthopaedic - Travis Stoner, Patrick Hurlbut Orthopaedic Spine - Robert VandeGuchte Podiatry - James Lewandowski, Kara Krejci Pulmonology - Lisa Mansur, Matthew Stritt Urology - David Wiltfong Vascular - Steve Tyndall, Robert Hibbard Wound Care - Edmundo Rivera Surgeries Cataract Surgery Various Surgeries All Fillmore County Medical Center physicians are approved Jason Bespalec, MD . Alanna Beckman, MD Jeffery Hollis,MD . Aaron Lanik, MD Russell Coash, PA-C . Michelle Dorsey, PA-C Danielle Jaeger, PA-C . Keri Miller, PA-C Marirose Fox, PA-C 7Pathways to Wellness

trusted hearts, touching lives1900 F STREET, P.O. BOX 193GENEVA, NE 68361 wwewmH.SmeaigliyplnfvcUeuhsrp.soGifroogonr/n!tGheGreweosetlnoe!tter/ www.myfch.orgPathways to Wel lnessJULY/AUGUST 2016CHIEF EXECUTIVE OFFICER Paul Utemark IVBOARD OF TRUSTEES Deborah Hoarty, ChairDennis Kimbrough, Secretary Lucille Capek Alan Emshoff Richard Walter July August CALENDAR OF EVENTS CALENDAR OF EVENTS Wednesday 13th Monday 1st Breath of Fresh Air 9:00AM Step It Up Challenge Begins Monday 18th Monday 1st Still Going Still Growing 4:00PM Woman’s Issue’s Group 3:00PM Thursday 21st Fr iday 5t hCaregivers Support Group 3:00PM “Super Cool” Path 2 Prevention 5K 7:00PM Saturday 30th Wednesday 10th Relay For Life Event Breath of Fresh Air 9:00AMInterested in the Harmonica Class? Monday 15t h Please contact Heidi Cochran at 402-759-3167, ext. 590 for class Still Going Still Growing 4:00PM dates and times. Thursday 18th Caregivers Support Group 3:00PM