My hobby outside of work is triathlons. This July, I concluded my biggest triathlon adventure yet – I completed 140.6 miles in one day at my first Ironman Triathlon. I learned a lot about my body while training for this race. For instance, I learned just how much I could push the limits. More importantly, I learned the importance of rest and recovery. Even beyond the world of triathlons, the significance of rest and recovery often gets overlooked. It is human nature to think more activity is better and sitting still is counterproductive; I have treated many patients that have this same mindset when it comes to rehabilitation.

Rehabilitating from a surgery or an injury is, in many ways, similar to training for a triathlon. There might be a bit more time commitment with training for a competition, but the end goal is still the same – making the body stronger and healthier, which helps better prepare us for the challenges that life brings.

The human body is amazingly adaptable. It is possible to get stronger and healthier; exercise plays a big role in helping make these changes. It does this by creating positive stress in the body. Exercise, when performed in the right amount and right intensity, can serve as positive stress to the body. Lifting weights can increase muscle size and help reduce the effects of osteoporosis. Running can improve the health of the heart and blood vessels, reducing the risk for stroke or heart attack. Hobbies that increase heart rate can improve brain and nerve health, helping to reduce the risk for disorders such as Alzheimer’s disease. All these examples are “stressors” that can create very positive changes in the body. When done in excess, however, they have the potential to create negative change. At this point exercise adds negative stress to the body. When this happens, the body will respond to exercise similar to what it does with lack of sleep, excessive life stress, poor diet, emotional instability, etc.

When training for my triathlon, I had to really watch how much stress I was putting my body through. I needed to exercise a lot (sometimes up to 20 hours/week) to be strong enough to finish my race. I also needed to make sure I was eating right, getting enough sleep and making time to relax and enjoy activities. I knew that my body could only handle so much stress. More exercise and more training did not always bring me the best outcomes. I think that these same principles hold true for anyone that is rehabilitating from an injury or who suffers from a chronic pain condition. Exercise and medication can help, but they aren’t the entire solution. Any kind of negative stress from life will affect outcomes. Sleep matters. Diet matters. Stress from work matters. It all matters. Don’t overlook the importance of rest and recovery.

After a year of training, I knew I was finally ready for my race. I was strong, healthy and ready for my challenge. On July 27, 2014, I crossed the finish line with a time of 13 hours and 49 minutes after swimming 2.4 miles, biking 112 miles and running 26.2 miles.

Summer barbeques and picnics can offer many tempting food choices that are high in calories and sugar. Knowing how to create a well-balanced meal helps keep your blood sugar level as close to normal as possible. Here are some summer tips to help you keep your cool:

Choose lean, grilled meats. Bypass the fried chicken and go for lean meats such as a grilled chicken breast, turkey burger or fish.

Veg out. Grill up some veggie kabobs or sliced vegetables in foil for a low-carb entrée or side. Raw veggies with hummus or other low-fat dip are great for snacking.

Bring a dish to share. Attending a party? Offer to bring a green salad or fruit salad to share. That way, you can be certain there is something healthy for you to eat, and your host will thank you for helping out.

Drink responsibly. If you decide to drink alcohol, drink in moderation. It is recommended that women with diabetes have no more than 1 drink per day and men are limited to 2 drinks per day.

Drink water, not sugar. It is important to stay hydrated, but many of our favorite summer quenchers are full of sugar and calories. Water is really the best drink to prevent dehydration.

Don't skip meals. Saving all your carbs or calories for a summer outing may make it harder to manage your blood sugar.

Have fun! Making healthy eating choices can make summer gatherings even more fun in the sun.

We have all heard the saying “the family that plays together stays together.” This really holds true, but living a busy life often means it is necessary to cut something out. You may be tempted to cut down on playtime. Yet, cutting out playtime means cutting out an opportunity for the many health benefits that family togetherness provides.

Playing together helps open up the lines of communication in the family. In this day and age, we often communicate through social media and email. It’s important to remember that actually talking to each other is the best and most healthy way to connect.

Spending time together as a family creates a sense of belonging for everyone. Knowing that you have someone who understands and supports you to come home to at the end of the day can get you through a tough day. Additionally, spending time together creates life-long memories that family members will cherish. Try getting the family together this weekend for a fun day in the park or a game of toss football in the backyard.

One of the best things about playing together is that it allows us to get the physical activity we need. We need to get 30 minutes of moderate physical activity most days of the week. So why not make one of those days a family day? Ask each family member to choose the physical activity for a day and alternate each week. You may find yourself doing things you haven’t done since grade school such as jump rope, play hop scotch or ride bikes, which should bring a smile to your kids' or grandkids' faces, and a laugh or two. After all, we've also heard the saying “laughter is the best medicine!”

Is it safe to exercise during pregnancy?
Exercising during pregnancy is safe and recommended. The rule of thumb is: in a normal healthy pregnancy, the exercise that you did before becoming pregnant can usually can be continued throughout the pregnancy, with modifications as the pregnancy progresses. Moderate exercise is recommended for 30 minutes a day, 4 – 5 times each week; strenuous exercise can be performed in pregnancy with physician supervision. Complicated or high risk pregnancies should avoid exercise in pregnancy. As always, talk with your doctor before starting your exercise program. You’ll also need to reassess your exercise program with your doctor on a regular basis as your pregnancy progresses.

What are the benefits of exercise during pregnancy?
Exercise in pregnancy helps you maintain a healthy weight, reduce discomfort and improve sleep. Additionally, it may help decrease your risk of developing diabetes or high blood pressure.

What types of exercises are best for pregnant women?
Most exercises are safe in pregnancy. Yoga, Pilates and stretching exercises can be easily modified for each trimester of pregnancy. Aerobic exercises (e.g., walking, running, swimming or aerobic classes) are recommended to maintain a healthy weight and cardiovascular health. Weight lifting can be performed, typically with the recommendation of more repetitions and less weight. Supine exercises, such as lying on your back for sit-ups, can be performed, but should be used with a hip roll after the first trimester in order to avoid low blood pressure. While sit-ups are okay in pregnancy, as the pregnancy progresses, patients are often so uncomfortable in the sit-up position that it is not reasonable to continue that type of exercise.

Do pregnant women need to consume extra calories on days they're exercising?
Mild increases (200-300 calories) in caloric intake are recommended for all pregnant women, whether they are exercising or not. Pregnant women who are exercising should ensure that they’re increasing their water intake – this is crucial.

What types of exercises should pregnant women avoid?
Exercising in a temperature-neutral environment is important. “Hot yoga,” for instance, would not be recommended for women who are pregnant. Pregnant women should also avoid working out in a gym without adequate cooling mechanisms and running for long distances in the heat of the day. Remember to stay well-hydrated and cool off when needed!

What are the warning signs that a pregnant woman is pushing her body too hard?
Listen to your body! That is the best advice for a woman in pregnancy. If you feel too hot or short of breath, it's time to stop and rest. Other warning signs are: feeling faint, headache, nausea/vomiting, leg pain, chest pain, vaginal bleeding, or contractions/abdominal pains that are painful. Complicated or high risk pregnancies should avoid exercise in pregnancy. For example, patients with a heart condition or high blood pressure may need to avoid certain activities. Consult your physician about your specific condition. Remember: stay hydrated, don’t get too hot and pay attention to your body’s warning signs.

As adults "pour" into the lives of children, adults can serve as a resource to fill children with the capacity to reach adulthood as happy, safe and healthy individuals. We have the explored areas of time management and emotional stability with this metaphor; those blog posts contained a key principle that can be applied in a variety of ways: adult leadership cultivates child followership.

Adults help developing minds track time on a clock, through history and into the future. As long as a child feels safe (due to adult guidance), he or she will feel more secure to learn and approach new experiences. This high-quality role modeling results in young people internalizing a positive view of the world and then living it as they grow up. This key principle – adult leadership cultivates child followership – flows over into other areas of children’s lives as well, such as spiritual connections, finances and ethics.

We can define spirituality as a connection to other people across time and space. Adults can help children develop this important life skill. For example, parents can talk about people who have positively influenced our society as part of that “connection.” For example, simply referring to a picture of a stovepipe hat evokes the connection to Abraham Lincoln for some people. When we are careful to leave the walking path clear of litter, we are demonstrating our connection by considering those who came on the path before us and those who will tag along later. Adults can be considered the best supplier for hope as well; children need to receive frequent doses of hope and optimism in our connection with others.

Children need parental guidance on financial topics, too. This subject holds potential for some uncomfortable life lessons, but parents can help by encouraging children! Just as some would say there is never enough time, some folks say it is also true of money. Thus, this area is a vital “pour” for children!

The obvious benefits of learning to manage finances are learning how to budget, plan and set financial goals. The more subtle advantage is that children will also learn the meaning of money. A simple rule of thumb is to help them distinguish between choices: “Should I save, share or spend?” and “What percentage will I allow for each category?” Adults can help children slow down and discuss the values between the choices of saving, sharing and spending. For example, it may be uncomfortable to wait for the savings to accumulate to the amount needed to purchase an item, but adults can “pour” in patience! Sharing with others can bring a mixture of feelings – children may be glad to help and sad to watch dollars leave. Spending choices help a child practice thinking through cause-and-effect, developing morals and delaying impulsivity. With continued leadership, children will follow their parents’ examples into adulthood.

Moral development can progress when children have caring adults in their lives. Ethics are the “character” that guides a person, group, community, nation and world. Ethics are the center question of credibility, and all else weaves around it. Parents can share valuable customs, beliefs and practices with their children. In adulthood, these manifest as character traits like common sense, moral reasoning and goodwill. For example, I heard an older gentleman explain why picked up loose pennies. He would tell his grandchildren that the pennies were like people and “everyone’s worth picking up.” He also took young people with him during volunteer opportunities. He showed the way during clothing and food drives. As a result, many young people internalized his example.

While children can understand ethics as “right” and “wrong,” adults should remember not to be too rigid or too flexible in the rules. It’s important to learn how to effectively problem solve when dilemmas occur. Ethics help a child know what values to hold firmly, and which ones have some room for negotiation. The older gentleman mentioned earlier poured ethics from his five-gallon jug by showing that his character gave him the energy to help – even when he didn’t feel like it and when the weather wasn’t pleasant. What a “pour” into the young lives in his circle of influence!

In summary, the five-gallon jug metaphor involves valuing caring adults’ contributions in children’s lives. Most importantly, it involves valuing children, who are the needful recipients of such giving. Good mental health is correlated to good physical health. Therefore, adults have significant opportunities to support children’s good mental and physical health through positive contributions.

Enjoy the “pour”!

In 1942, nutritionist Victor Lindlahr published You Are What You Eat: How to Win and Keep Health with Diet. Dr. Gillian McKeith published the book You Are What You Eat: The Plan That Will Change Your Life in 2005. What you eat continues to be just as important today as it was in the 1940s.

Nutritious food is the key to good health. If you exercise but don’t fuel your body correctly, you’re not going to get the physical results you desire. No matter what diet you follow, knowing what is in your food and how it is processed is just as important as the food itself. If you eat whole, healthy and fresh foods, your body, skin and soul will radiate health and you will have more energy!

Take control over what you allow into your body by following these basic clean eating rules:

Eat plants. Eat food that comes straight from nature, as close as possible to the way nature made it. Eat mostly foods that come from a tree, bush, plant or vine, and you’ve pretty much got it covered. Try to stay away from food that has been altered in any way.

Choose meats straight from the farm (and organic if possible). Don’t buy pre-packaged meat products, because you never know what’s in them. When possible, buy whole meats and grind them yourself or ask the butcher to do it.

Enjoy grains. Eat grains that are still complete and haven’t been broken down into “glue”. Stick to brown rice, quinoa, and other whole grains.

Eat fewer ingredients. Try not to purchase foods that have more than 3-6 ingredients in the ingredient list. And be sure you recognize each and every ingredient. If it’s anything other than honest-to-goodness herbs and spices, avoid it! And remember, if you can’t pronounce it, it probably shouldn’t go into your body.

Don’t feel like you have to make all the changes at one time. Pick one area to try to improve for a week and then after it has become part of your healthy lifestyle, make another change. Eating healthy is a way of life, not a diet. So, give yourself some time and enjoy how great the whole foods taste when they are in their natural state.

This blog post was written by Kris Drake RN, CHPD, Freeman Health System Wellness Coordinator, in collaboration with Shelby Allen, RN, BSN, Freeman Prevention and Wellness Supervisor.

A couple years ago, I was trying a new fitness workout that included quite a bit of one-legged jumping. I don’t really do a lot of jumping anymore, but it felt pretty good until I felt something shift in my back. I couldn’t stand up straight almost immediately, and gradually got more and more sore. Fortunately, I take care of issues like these every day at Freeman Rehabilitation & Sports Center. I knew I would be fine in a few days or weeks at most, and within three days my pain did go away. What I had never fully appreciated though, was how uncoordinated I would become due to the injury and how long that would last. I laughed every time I stood up from a chair because I was still moving like I was hurting. This change in coordination after an injury happens to everyone and is often persistent long after the tissue has healed.

We each have maps of our body in our brain to plan and execute movement. Our brain maps allow us to move without thinking of every muscle and joint involved. The pattern of movement is formed by our experience and pain will quickly change both our movement and our map for movement. Research tells us that people who experienced extreme pain or long-lasting pain may permanently keep poor compensatory movement strategies.

These new compensatory movement patterns can be problematic in their own way. The major risk factor for sustaining an injury is a prior injury, even if it the injury occurred in an unrelated body region. We believe that risk is due to poor movement patterns. The risk of injury can be mitigated by training movement to get back to pre-injury levels or better. Recovering from pain doesn’t always mean that someone is recovered from the injury. Health professionals – such as athletic trainers, physical therapists or occupational therapists – can help ensure that people continue to stay active and avoid injury by teaching and training more ideal movement patterns.

National Substance Abuse Awareness Month

Published: 10/15/2014

Posted by James Childers, MS, LPC

It has been said that necessity is the mother of invention and unfortunately this is true in all areas of life, including the field of substance abuse. As we begin to gain ground in one area of treatment, if seems that another area begins to gain momentum in the opposite direction. The landscape in this field is constantly shifting, making it difficult for non-substance abuse professionals to stay current with warning signs for each of the various areas of potential concern; because of this, New Directions is actively involved in celebrating recovery and informing the public on the dangers of addiction and substance abuse.

October is National Substance Abuse Awareness Month and a great opportunity to help spread awareness about substance abuse. New Directions will be participating in the Downtown Joplin’s Third Thursday festivities alongside Freeman Health System. Our booth will have plenty of information on the services we provide at New Directions and passersby will be able to participate in a “skittles party” and get educated on this dangerous activity that is prevalent in the lives of teens as a form of “partying”. We will be providing warning signs for parents and friends to look for. We will also provide information for attendees to share with loved ones battling substance abuse to help support and encourage them to consider treatment as an option. In addition to Third Thursday, we are supporting Red Ribbon Week from October 23 to October 30 in conjunction with Mothers Against Drunk Driving (MADD). During that week, we’ll be handing out red ribbons so people can display them to show their support for staying clean and sober as well as saying NO to drinking and driving.

New Directions has been providing substance abuse treatment for more 40 years and we are proud to have highly qualified staff that can offer a variety of treatment services to meet our clients’ needs. Services we offer include:

• Substance abuse screenings and assessments
• SATOP (Substance Abuse Traffic Offenders Program) screenings and initial assessments
• SATOP treatment services – Offender Education Program (OEP), Adolescent Drug Education Program (ADEP), Clinical Intervention Program (CIP), Weekend Intervention Program (WIP), Serious Repeat Offender Program (SROP)
• Inpatient and outpatient substance abuse treatment
• Modified medical detoxification
• Alternatives to Violence program
• Anger management program
• Trauma and post-traumatic stress disorder counseling
• Drug court services in Jasper, Barton, Newton and McDonald counties
• DWI court services in Jasper, Newton and McDonald counties
• PTSD treatments including prolonged exposure and virtual reality therapy
• Bio-Feedback therapy
• Gambling addiction treatment
• Smoking cessation services

If you or someone you know would like additional information regarding any of our services, please feel free to contact our main office in Joplin at 417.347.7730, Monday through Friday between 8:00 am and 5:00 pm. On evenings and weekends you may contact us at 417.347.7700.

I think we have all found ourselves looking to a future event or accomplishment to make us happy. We may think that losing that last 10 pounds or making more money will make us happy, but the truth is that happiness isn't dependent on a future situation. Rather, it can be found in the here and now.

As adults, how do we learn to come back to the present moment when our thoughts begin to wander? We can begin by watching kids play. Children are absorbed in the present moment and think only of playing they’re playing. They become so involved in their activity that a parent may have to remind them it's time to come in and eat dinner.

Try practicing mindfulness when you wake up. Bring mindfulness to your routine activities – pay attention when you are brushing your teeth or eating your breakfast. Use all of your senses to experience things that normally take place while you are on autopilot. Notice the smell of coffee brewing or the beautiful fall colors of the leaves on the trees. You may be surprised by things you see on your way to work that you never noticed before.

Another way to bring mindfulness to your day is to practice while you are waiting in line. Instead of being frustrated because the line isn't moving fast enough, slow down and concentrate on your breathing. Let your thoughts and feelings of impatience be replaced with a sense of peace in the moment.

Set aside a few minutes each day to just be in the moment. Let your thoughts go where they want to go. You may even want to sit outside or sit by a window to see the beauty around you. Don’t miss another moment of happiness.

Get your flu shot
Influenza (the flu) is a very contagious disease, easily spread through coughing and sneezing. While anyone can become infected with the flu, children, older adults, pregnant women and people with chronic medical conditions have an increased risk because of serious flu complications. Freeman considers yearly flu vaccinations the most important step in preventing the spread of the flu. Vaccinations are recommended for everyone 6 months or older. Get your flu shot at QuickMeds Pharmacy™!

Commit to quitting smoking
Smokers across the nation will be marking their calendars for the Great American Smokeout on November 20. The Great American Smokeout is a great opportunity for smokers to plan ahead to quit smoking on that date, even if for just one day. Will you join them?

If you need help quitting smoking, Ozark Center also provides smoking cessation classes. Smoking cessation classes provide participants with support, resources and materials at no charge. To learn how to sign up, please call 417.347.7730.

Practice mindfulness
With the holidays just around the corner, it can be hard to be mindful and present through all the planning, shopping and traveling. In this blog post, Freeman Wellness Coordinator Kris Drake, there offers several great tips to help you practice mindfulness and stay in the moment. Read more.