A health guide for the Texas Hill Country

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HEALTH IS PARAMOUNTHIP TABLE OF CONTENTS

An Unexpected Miracle 4Stroke Prevention 6Blood Drives Save Lives 8Train Like an Athlete 10Top 10 Healthiest County 12Cancer Resource Center 13Back in the Saddle 16New HCM CEO 21Good Samaritan Center 22Body-Mind-Whole 2612 Simple Steps 30

We came up with lots of ideas for a revisioned version of the annual Health Guide. We hope you like the new look and format of H.I.P. — Health Is Paramount.

We strive to be a partner with the community in health issues. Whether it is little things like eating right to help take care of ourselves, or larger things such as organ and blood donation, there is much we can do to inspire a better and healthier lifestyle in ourselves and in our towns.

The Hill Country is a great place to live. So here’s wishing all our readers good health.

Fredericksburg Publishing Company Fredericksburg Standard-Radio Post

712 W. Main St.P.O. Box 1639

Fredericksburg, TX 78624

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By Lisa Treiber-Walter

Jacob Krebs, the 18-year-old who died last month after a drowning incident in Fredericksburg, lives on.

His last gesture of generosity — his gift of organs and tissues — has saved numerous lives and affected an un-told number of people in the past month.

“God is allowing Jacob to live on in other people and that is our sav-ing grace,” said Mary Krebs, of how she and her husband, William, are coping these days following the loss of their only son and relying on the strength of their faith to help their 13-year-old daughter, Julie, through the loss.

Jacob, a senior at Harper High School (HHS,) was a child of direction, discipline and devotion.

From the time he was young, Jacob knew he wanted to be a United States Navy SEAL, Mary said.

“As soon as he turned 17 and got our per-mission, we went down and signed the pa-pers,” she said. “He was technically enlisted and he was to ship out in June in the U.S.

Navy” just two weeks after crossing the stage with his fellow HHS Class of 2013.

“He wanted to be a SEAL more than any-thing,” she said. “We always told him, ‘You do what you love and you love what you do

and I support you in what you do.’,” she said.

In the hopes of training for a SEAL contract, Jacob had been undergo-ing the PST (Physical Screening Test) portion of the process, which involved swimming, running, push-ups, sit-ups and pull-ups.

The idea is to set a benchmark and then try to surpass it each time. SEAL candidates can com-pare their numbers with others

online to see how they lined up.Jacob, a two-time UIL state cross

country runner, loved to run and stay phys-ically fit. “He was determined to get his SEAL contract. He was an over-achiever. Any chance he got, he wanted to go to the (Hill Country Memorial) Wellness Center and swim,” Mary said.

Part of the physical training in the swim-ming portion was to learn how to hold his breath. “That was my biggest fear – that

An unexpected miracle

ADVENTURER — Harper High School senior Jacob Krebs was a disciplined runner who had enlisted in the U.S. Navy. He was training to become a SEAL when he was in a drowning incident March 26. His death a few days later would not be without meaning because Jacob was a registered donor and his gift saved numerous lives through transplantation. Cont. on page 5

Mother of drowning victim Jacob Krebs shares how he lives on, helps warriors through the ultimate ‘gift of life’

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he would drown,” she added.

Jacob, who was used to testing himself “to the limit,” exceeded his limits on Tuesday, March 26.

That day, he report-edly told another swim-mer he planned to work on holding his breath and, after swimming his hard laps, set about working on his drills.

“It’s my understanding that one of the witnesses actually saw him looking at his watch under water. Then, the next thing they knew, he was at the bottom of the pool,” Mary said.

Bystanders pulled him from the water and two eyewit-

nesses, plus Wellness Center employee Leigh Dempsey, performed CPR on him, Mary said.

Jacob was transported to the hospital and loaded onto a helicopter life flight, but had to be taken back off when he went into cardiac arrest.

CPR was performed once again and medication was ad-ministered to stabilize him, Mary said. He was then flown to University Hospital in San Antonio, where he would never regain consciousness.

“We had prayed and prayed and prayed for a miracle that God would heal his lungs and his heart. We weren’t even thinking about his brain. We were just thinking, ‘He’s got to keep breathing, his heart has to keep going’,” Mary said.

“We want to thank and give credit to Leigh and the guys at

the Wellness Center and then at Hill Country Memorial who did CPR, because if they hadn’t done what they did, then we would not have been able to donate his organs,” she said.

Jacob’s lungs cleared and his heart beat fine, but doctors informed family that he was brain dead on Easter Sunday, March 31.

“We remembered that Jacob was an organ donor and told the hospital this is what we wanted to do,” Mary said, re-calling how the topic of organ donation had been discussed the previous year when he had gotten his driver’s license.

“He asked if he could be an organ donor and I said, ‘Jacob, I think that would be awesome. Because that’s just another way to give back’,” she said.

“He was always like that. We love to volunteer and to give back to the community or give back to somebody and that’s what he wanted to do,” Mary added.

It was nice to know his wishes ahead of time, she said, and encouraged others to have the discussion with their own family members even if they don’t think they’ll ever need to know that — because no one ever thinks it will be their own child.

“Jacob also loved the Wound-ed Warriors program,” Mary said. When he enlisted in the Navy, he knew he would try for the SEAL contract, but she encouraged him to have a “Plan B.”

For him, that meant putting down “hospital corpsman” as his career path in the Navy. “If he couldn’t be an actual SEAL, he still wanted to be able to help them and heal them,” she said.

The family decided to dedi-cate his organs and tissues to

An unexpected miracleCont. from page 4

Cont. on page 31

‘STOMPER’ — Krebs, a member of Harper High School’s Class of 2013, loved participating as the Longhorns’ mascot.

He asked if he could be an organ donor and I said, ‘Jacob, I think that would be awe-some. Because that’s just another way to give back.’” — Mary Krebs

“5

Stroke preventiona life saver for locals

By Phil Houseal

It was the day before Easter in 2011, and Nuri Lopez was busy putting together lunches for customers at the Sunset Grill in Fredericksburg.

Except for experiencing a slight headache for a few days, Nuri was excited about the upcoming holiday, which she spends with her husband, Luis, and their two children.

Suddenly, Nuri felt dizzy and began staggering around the kitchen. Her coworkers at first thought she was trying to make them laugh. Then they realized it was not funny: Nuri was hav-ing a stroke.

Within minutes, Nuri was in the Hill Country Memorial (HCM) Emergency Room. She was being diagnosed when her husband, Luis, arrived.

“The doctor told me to ask my wife to move her left hand

or leg,” Luis recalled. “My wife said, ‘What hand? What leg?’ She couldn’t feel them. I was scared.”

That’s when the staff told Luis, “We are going to talk to a doctor on the Internet.”

That “doctor on the Internet” is actually Specialists on Call (SOC), a telemedicine technolo-gy at HCM that is changing the face of stroke treatment.

This story actually began sev-eral years earlier, when HCM’s Chief Medical Officer, Dr. James Partin, saw an opportu-nity to add a needed service to treat stroke patients.

“Prior to April of 2011, we had never treated an acute stroke care patient in the HCM Emer-gency Room,” Partin said. The treatment — if a patient quali-fies — is a clot-busting drug called TPA. “HCM ER doctors were concerned about the use of

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Stroke preventionCont. from page 6

this drug without the supervi-sion of a stroke neurologist.”

Even with a neurologist on staff, the challenge was having them available 24/7 for stroke events. “One million brain cells die for every minute of delay in treatment,” Partin said. “If you don’t treat a stroke patient within 180 minutes, there is no treatment at all.”

So Dr. Partin formulated an acute brain attack protocol, and he brought in an online “stroke neurologist.”

“We hired Specialists on Call, a telemedicine firm,” Partin said. “They placed interactive video conference technology in HCM’s Emergency Room, and we developed a stroke preven-tion protocol to reduce the time factor every step of the way.”

The protocol couples CT scans and a video conference evaluation with the online neu-rologist.

When a stroke is suspected, the local medical team goes into action as soon as the patient is

picked up by EMS or nears the ER door. An immediate call to the HCM Imaging department prepares the CT scanner. Blood is drawn, the scan is completed, and lab results are sent instant-ly to the Specialist on Call unit.

The SOC unit through its in-teractive video puts the HCM medical team in contact with a neurologist. When the proto-

col is activated, the neurologist on call 24/7 will be avail-able during those magic minutes. The goal at HCM is to determine and deliver the proper treatment within 45 minutes of arriv-al to the emergency department.

Partin describes the process as “quite interactive.”

“It is like having a neurologist at your bedside,” he

said. “Basically the neurologist is doing the exam with our medical team acting as his ‘arms.’ The patient feels the sense of urgency, as the process is streamlined with no wasted steps.”

On the day of Nuri’s stroke, ER Supervisor Marvin Rusche, RN, estimates the HCM team was treating her within 30 min-utes of the appearance of her

symptoms. “By the time she was back from her CT scan, her re-sults were being read and dis-cussed by all three physicians, including the tele-neurologist.”

Once the physicians deter-mine whether the stroke is hem-orrhagic or non-hemorrhagic, the appropriate protocols are put in place. If indicated, TPA, which is a “clot busting” medi-cation is administered. The physicians then decide whether the patient needs to be admit-ted to HCM, or transferred to another treatment facility.

In Nuri’s case, the HCM med-ical staff interacting with SOC made the decision to transport her via life flight helicopter to Austin. By the time her hus-band, Luis, arrived in Austin by car, Nuri was already regaining the use of her arms and legs.

“I started crying,” Luis re-called. “She asked me why, because she didn’t remember what had happened. I went out-

Cont. on page 28

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Community steps up to challengeof blood needs in a big way

By Yvonne Hartmann

Donating blood is giving the gift of life.And it’s a gift that can be used by anyone

— young or old, friend or stranger.“Every day, children and adults are faced

with challenging medical procedures that require transfusions of red blood cells, platelets or other blood components,” ac-cording to the South Texas Blood and Tis-sue Center (STBTC).

Among the many people who rely on an adequate source of blood are patients with cancer, Hemophiliacs, premature infants, recipients of organ or tissue transplants, those with sickle-cell anemia and trauma patients.

“In spite of what modern science has ac-complished, there is still no substitute for human blood,” the STBTC said.

The South Texas Blood and Tissue Cen-ter is a not-for-profit community blood center specializing in blood, blood com-ponents, tissue services and specialized testing.

It was founded in 1974 by the Bexar County Medical Society and supplies blood to hospitals in 43 South Texas coun-ties, including Gillespie.

Local donorsBlood donors come from all walks of life,

and Gillespie County is fortunate to have people who are committed to donating blood on a regular basis.

Gordon Klein of Stonewall is one such individual.

Klein started donating in 1973, and es-timates that he has probably donated the equivalent of 17 gallons.

A native of Stonewall, Klein would carpool to Fredericksburg to the blood drives with other regular donors, includ-ing James Eckert, Rodney Eckert, Harvey Eckert, Hilmar Nebgen and Herb Nebgen.

Klein said he became a blood donor to help others. “They need blood and I want to do my part to help,” he said.

In addition, Klein said that he used to get severe headaches. After donating blood, his headaches disappeared and he just felt physically better.

David Woodward is another long-time

blood donor after starting in 2001.He said, “I donate because people need

it and I can. And, because people contin-ually need blood.”

For the past 36 years, Kelton Duecker has been a familiar face at the community blood drives.

Duecker started donating blood in 1977 when he was a junior in high school. He remembers having to get permission from his parents at the time.

Give-or-take a few units, Duecker esti-mates that he has given about 19 gallons.

Duecker originally started giving blood when he heard of a person who was in need of blood and a drive was held in the old Community Savings building.

Now, he says, he continues to donate Cont. on page 9

Blood drives save lives8

IT’S A BIG DEALThe South Texas Blood and Tissue Center reports that about 40,000 units of blood are used each day in the United States and that less than 10 percent of the eligible population donates.

blood to help those individuals who are specially listed and are asking for dona-tions. Also, it’s his way of helping those where natural disasters have occurred, those who are fighting diseases/illnesses that require a lot of blood transfusions and to help military personnel.

“Anyone who is in good health and able to donate should do so since they never know if they themselves might be in need of blood or someone they love needs it,” Duecker said.

“It doesn’t cost anything except 30 min-utes to an hour of your time,” Duecker said.

He added, “It’s not painful.”As an added bonus, donors often receive

an appreciation gift such as a T-shirt or gift card.

And, Duecker said, “Don’t forget the homemade cookies/desserts from the church ladies who volunteer their time and talent to assist the South Texas Re-gional Blood and Tissue Center.”

“Donating blood is just one way an in-dividual can show their appreciation and thanks for their good health while saving the life of another person,” Duecker said.

Cont. on page 24

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Blood drives Cont. from page 8

A LIFELINE — Giving the gift of life, Fredericksburg High School student Ann Blackmon donates blood during a recent visit by the South Texas Blood and Tissue Center. Blood drives are held throughout the year at the American Legion Hall, Walmart, Hill Country Memorial Hospital and at FHS. — Photo courtesy FHS Campus Comet

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Cont. on page 11

Train like an athleteBy Matt Ward

From the moment they step into the gym for their first workout, they’re no longer just average Joes, they’re athletes.

It’s the way local trainer Dwayne Fowler views them, and it’s certainly the way he trains them.

One recent session at Fred-ericksburg’s CrossFit 830 gym followed the “Fight Gone Bad” workout regimen designed for former UFC mixed martial arts fighter B.J. Penn to the letter.

“If you’re here working out, you are an athlete. You may come straight from the couch, but if you’re doing this, you’re an athlete,” Fowler said. “I’ve always said that if you want to look like an athlete, you have to train like one. They’ve (Cross-Fit) taken that theory and ap-plied it to the general public and I think it works pretty well.”

A Comfort native who moved to Fredericksburg four years ago, Fowler has over 25 years’ experience in the fitness indus-try in a variety of fields, from running gyms, physical therapy and rehabilitation, to personal and small group training.

“Five or six years ago, I heard about this CrossFit thing that was going on and when I start-ed looking into it, I was like ‘Oh wow, that’s the things that I’m

doing right now,’” Fowler said. “I was already training people in that style, but I just didn’t call it CrossFit.”

He started CrossFit 830 in October with just a handful of participants and now has over 60 “ath-letes” in the program just eight months later.

“We’ve got people any-where from their teens all the way up to their 60s (in the pro-gram), both men and women,” Fowler said, noting that the program’s training is unique for each participant.

Even if a single pull-up seems impossible, matching the work-out to the participant’s skill level makes the impossible pos-sible, he said.

“Most (first time participants) that come in here can’t do one pull-up. That does not mean that you can’t do the workout though,” Fowler said. “What-ever skill level you’re at, you’re able to do any of the workouts that we have.”

Offered five times a day in hour-long blocks, CrossFit workouts change daily, giving participants the ability to work out as much as five days a week.

“If you want to see results, three days a week is going to

be the minimum,” Fowler said. “You’re able to do four or five days a week because we work different muscle groups in dif-ferent ways every day. Every workout is different so you’re

allowing recovery for dif-ferent muscle groups.”

Al-though there

is a wide array of exercises at Fowler’s disposal when creating a workout, participants joining CrossFit after working out at other gyms find one thing miss-ing at the local facility: exercise machines.

“We don’t have anything that plugs in. We don’t have

anything that you have to pull a pin,” he said. “This is all pow-ered by you. The people are the machines in here.”

While weight loss is a benefi-cial side effect of the program, CrossFit focuses on “gen-eral physical preparedness,” he said, with equal emphasis on strength, cardiovascular health, agility and balance.

“Weight loss is a great side effect for the physical abilities that participants have devel-oped. They’re so much more agile; they have so much more energy, feel better and their flexibility has improved,” Fowl-er said. “You’re going to get a lot stronger. We can see people jumping in leaps and bounds.”

His background in sports nutrition helps Fowler develop

If you’re here working out, you are an athlete. You may come straight from the couch, but if you’re doing this, you’re an athlete.”

— Dwayne Fowler

“

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individualized diets for each participant in the CrossFit program, but he insists on writ-ing each diet with the participant, not for the participant.

“If I told them that they needed to follow a strict paleo diet where they can only eat meats and vegetables and they hate vegeta-bles, I’m simply setting them up for failure,” he said. “Just like the physical fitness side of it, your nutrition has to be something you fol-low for the rest of your life. You have to find something that works for you.”

Maintaining a consistently high level of athletic training is the biggest obstacle in improving physical health through the pro-gram, Fowler said, but the goal needs to be a lifetime of improved health, not a temporary weight loss regimen.

“The hardest part is getting here. Once you’re here, then the results are self-moti-vating,” he said. “If you’re doing something and see results, that is going to be the biggest motivator.”

He added that the CrossFit program can seem overwhelming to newcomers not used to its short, intense workout structure.

“I’m not going to lie, it’s tough. It doesn’t matter if you’re an Olympic athlete or straight off the couch, everybody’s on the floor afterwards,” Fowler said. “Some people might be a bit intimidated by it, but once they get here, they realize that anybody can do it.”

Training like athletesCont. from page 10

UPLIFTING CHALLENGES— One-on-one interaction with each participant allows CrossFit 830 trainer Dwayne Fowler to ensure correct techniques in exercises and develop workout programs that give par-ticipants the best chance to succeed. — Standard-Radio Post/Matt Ward

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Gillespie among Lone Star state’s healthiest counties

Gillespie County ranks as the eighth healthiest in the state of Texas, according to a report issued by the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Insti-tute.

The neighboring county of Kendall was also ranked in the top 10, reaching the fifth best in the Lone Star State. Other contiguous counties to Gillespie included Llano (which came in 63rd), Blanco (76th), Mason (84th), Kerr (156th), and Kimble (228th).

There are 254 counties in Texas.The findings, known as the County

Health Rankings and Roadmaps, take into account various factors such as health behaviors (which include tobacco use, diet and exercise, alcohol use, and sexual activity), clinic care (access to care and quality of care), social and economic factors (education, employment, income,

family and social support, and commu-nity safety), and physical environment (environmental quality and built envi-ronment).

The rankings also examine such issues as the rate of people dying before age 75, high school graduation rates, unemploy-ment, limited access to healthy foods, air and water quality, income, and rates of smoking, obesity and teen births.

The CHRR report shows a state-by-state breakdown of nearly every county in the nation. Some counties, including 22 in Texas, did not participate in the survey for any number of reasons.

More information about the County Health Rankings and Roadmaps proj-ect, including comparisons of Gillespie County to the state, can be found on the Internet website:

www.countyhealthrankings.org.

Things like an active farmer’s market and ex-ercise offerings can contribute to the overall health of a community.

TOP10

The people of Gillespie County and the surrounding Hill Country have access to a wealth of knowledge on the subject of cancer and how to cope with the disease, all located under one roof and called the Health, Hope and Healing Cancer Resource Center.

The center is located on the first floor of the Brune Profes-sional Building, 808 Reuben Street, north of Hill Country Memorial’s main campus.

Visitors to the center get the opportunity to be pro-active when it comes to cancer. People can learn about cancer prevention, screening, treat-

ment and survivorship issues.Resources available at the

center include internet-based computer access; information on a variety of cancers; books, videos and educational ma-terials; referrals to treatment information; connection with support groups; and audio/visual equipment.

Many tools for coping with the disease can also be found at the Cancer Resource Cen-ter, including:

•Art and music therapy for healing;

•Nutrition tips and cook-books;

•Suggestions for caregivers;•Personal record-keeping sys-

tems;•Relaxation techniques;•‘Look Good … Feel Better’

sessions;•Wigs and head-covering al-

ternatives;•Symptoms management;•Uplifting survivor stories;•Support groups; and,•Some support materials in

Spanish.

Jay B. Lindsay, D.D.S. Thomas E. Schmidt, D.D.S.

Family DentistryCosmetic Dentistry • Dentures

Oral Surgery • Root Canals • Implants Crowns/Bridges

814 South Milam • Fredericksburg830-997-7232 • Toll Free 877-833-8401

Visit us at www.fredericksburgdentistry.com

New Patients Always Welcome!Early Morning & Evening Appointments Available

Financing Plans Available

FREDERICKSBURG DENTISTRY, PLLC MID-TEXAS HEALTH CAREFAMILY MEDICINEYvonne Haug, M.D.David Cantu, M.D.

Accepting New Patientsplease call for an appointment

•wellchildexams •adultphysicals •immunizations •familyplanning •newborncare •hospitalcare

1305 N. Milam St.830-997-7626

Serving the Hill Country since 1986

AcceptingmostinsurancesincludingMedicare

13

Get informed at HCM Cancer Resource Center

Located in the Brune Professional Building, 808 Reuben Street, the Health, Hope and Healing Cancer Resource Center offers the public state-of-the-art information on the disease. — Standard-Radio Post photo

Cancer Resource Center

Open from 8 a.m. to noon and 1-5 p.m., Mon-day through Friday.

More information is available by calling 990-6648 or by going to the internet website: www.hcmhs.org.

ALLERGY tracy A. Byerly, II, MD205 W Windcrest, Suite 210(830) 997-4000

Michael L. Walker, MD, FACS206 W Windcrest(830) 997-0252

ANESthESIA thomas C. Gunning, III, MDJohn D. Westfall, MDFredericksburg Anesthesia Consultants203 Hale St(830) 997-8858

CARDIoLoDY Kevin M. Gallagher, Do, phDAustin Heart, P.A.205 W Windcrest, Suite 230(830) 990-9994

Mell C. Jackson, Jr., MD, FACCAustin Heart, PA205 W Windcrest, Suite 230(830) 990-9994

Michael B. Melucci, MDSouth Texas Cardiovascular Consultants205 W Windcrest, Suite 140(830) 997-0296

A. Charles Rabinowitz, MDSouth Texas Cardiovascular Consultants205 W Windcrest, Suite 140(830) 997-0296

Javier Roman-Gonzalez, MDSouth Texas Cardiovascular Consultants205 W Windcrest, Suite 140(830) 997-0296

Jeffery N. Whitehill, MD, FACCAustin Heart, PA205 W Windcrest, Suite 230(830) 990-9994

DENIStIStRY Jamie B. Lindsay, DDSthomas E. Schmidt, DDS814 S Milam(830) 997-7232

DERMotoLGYMichael W. Braden, MDCynthia olfers Clegg, MDMichael J. Majors, MD95 E Highway St(830) 997-0898

EMERGENCY MEDICINE peter A. Coldwell, MDRamon A. Garcia, MDoliver A. Williams, MD1020 S State Highway 16(830) 997-4353

ENt (otoLARYNGoLoGY) Charles J. Ballay, MD1331 Bandera Hwy, Suite 1A Kerrville (830) 896-8001

tracy A. Byerly, II, MD205 W Windcrest, Suite 210(830) 997-4000

Michael L. Walker, MD, FACS206 W Windcrest(830) 997-0252

FACIAL pLAStIC SURGERY Michael L. Walker, MD, FACSHill Country Facial Plastic Surgery Center206 W Windcrest(830) 990-8384

FAMILY MEDICINE Charles E. Burg, MDFredericksburg Clinic1308 S State Highway 16(830) 997-2181

David A. Cantu, MDMid-Texas Health Care1305 N Milam(830) 997-7626

Rebecca W. Daley, DoFredericksburg Clinic1308 S State Highway 16(830) 997-2181

Roger W. Gildersleeve, MDCarrie A. Culpepper, FNp-C205 W Windcrest, Suite 130(830) 990-1404

Yvonne K. haug, MDMid-Texas Health Care1305 N Milam(830) 997-7626

Matthew J. hoermann, MDCornerstone Clinic200 W Windcrest, Suite 100(830) 997-0330

Jeffrey R. holt, MDFredericksburg Clinic1308 S State Highway 16(830) 997-2181

todd R. howell, MDHill Country Urgent Care212-C E Austin St(830) 997-0390

J. Rad Kothmann, MDFredericksburg Clinic1308 S State Highway 16(830) 997-2181

Ramsey Clinic208 Haley Road, PO Box 349 Johnson City (830) 868-4033

John D. Weaver, MDBlanco Regional Clinic825 4th St, PO Box 1629 Blanco (830) 833-5581

FAMILY MEDICINE / oB Karen G. Cornett, MDCornerstone Clinic200 W Windcrest, Suite 100(830) 997-0330

Mark D. Eden, MD205 W Windcrest, Ste. 250(830) 997-9497

John p. Ramsay, MDCornerstone Clinic200 W Windcrest, Suite 200(830) 997-0330

Nancy M. Rickerhauser, MDCornerstone Clinic815 Front St Comfort (830) 995-563

Lisa A. Rouse, MD 707 Hill Country Dr, Suite 106 Kerrville (830) 896-0404

Kristi A. Stafford, MDCornerstone Clinic200 W Windcrest, Suite 100(830) 997-0330

GAStRoENtERoLoGY Lindy t. Rachal, MD, FACpHill Country Gastroenterology 205 W Windcrest, Suite 100(830) 997-1031

the Rema r ka b l ehCM providers

Fredericksburg, Texas

2012 & 2013

HCM is a

top 100 US Hospital

hCM is:

*Centers for Medicare & Medicaid Services

1st in Texas and 4th in the Nationfor Customer Experience*

#4444#1

Remarkable Health Care

Charles W. Randall, MDDavid L. Stump, MDGastroenterology Clinic of San Antonio1009 S Milam, No 3(210) 615-8308

GENERAL MEDICINE Good Samaritan Center140 Industrial Loop, Suite 1(830) 990-8651

GENERAL SURGERY Gregory D. Andreassian, MD205 W Windcrest, Suite 220 A(830) 997-6773

Lance Love, MD820 Reuben St, Suite A(830) 997-6000

Jay S. Stauffer, MDHill Country General and Oncology Surgery Associates205 W Windcrest, Suite 220 B(830) 997-8833

hoSpItALISt pamela D. Cantu, MDJames R. partin, MDKenneth terrell, MD1020 S State Highway 16(830) 997-4353

INtERNAL MEDICINE pamela D. Cantu, MDPedernales Medical Group205 W Windcrest, Suite 310(830) 990-0268

Melissa A. George, MDHill Country Medical Clinic816 Reuben St(830) 997-2745

Felice h. howard, MDPedernales Medical Group205 W Windcrest, Suite 310(830) 997-1436

philip J. Maple, MD Fredericksburg Clinic1308 S State Highway 16(830) 997-2181

Jennifer K. Mayben, MD, MphFredericksburg Clinic1308 S State Highway 16(830) 997-2181

Nancy K. thompson, MDPedernales Medical Group205 W Windcrest, Suite 310(830) 997-5668

Leo C. tynan, III, MDFredericksburg Clinic1308 S State Highway 16(830) 997-2181

NEURoLoGY Leigh Anne Bains, MD205 W Windcrest, Suite 120(830) 997-3283

theresa S. Wiginton, MDPedernales Medical Group205 W Windcrest, Suite 310(830) 990-9101

Ronald A. Stotz, MD1009 S Milam, No 4(830) 990-0064

oB / GYN Michael Campbell, MD820 Reuben St, Suite B(830) 997-3038

Jennifer Woerner Dulaney, MDWomen & Children First816 Reuben St(830) 997-3132

oNCoLoGY Mark C. DeLeon, MDCancer Care Centers of South Texas204 W Schubert(830) 990-0255

ophthALMoLoGY (EYE) Anne C. pluenneke, MDMartha A. Walton, MDFredericksburg Eye Associates755 S Washington(830) 997-6535

John Shore, MDLocation: Fredericksburg Eye Associates755 S Washington(512) 458-2141

oRthopEDICS Joseph M. Cohn, MDTexas Hill Country Orthopaedics & Sports Medicine, PA204 W Windcrest(830) 997-4043

J. Steven hoerster, MDTexas Hill Country Orthopaedics & Sports Medicine, PA204 W Windcrest(830) 997-4043

Daniel B. Robertson, MD205 W Windcrest, Suite 340(830) 997-2936

p. Charles Romanick, MDTexas Hill Country Orthopaedics & Sports Medicine, PA204 W Windcrest(830) 997-4043

pAthoLoGY Shari L. Addington, MDCarl R. Evans, MDDavid N. henkes, MDWilliam W. hinchey, MDGeorge W. Reichel, MDCliff M. Richmond, MDBrian D. towell, MDFoundations, Inc. / Pathology Associates of San Antonio, LLP1006 S State Highway 16, Suite G(830) 997-1327

pEDIAtRICS Andrea C. Bray, MDWomen & Children First816 Reuben St(830) 997-3132

Rick M. Dulaney, MDWomen & Children First816 Reuben St(830) 997-3132

Felice h. howard, MDPedernales Medical Group205 W Windcrest, Suite 310(830) 997-1436

Nancy K. thompson, MDPedernales Medical Group205 W Windcrest, Suite 310(830) 997-5668

poDIAtRY Roger G. Moblad, DpMLocation: Fredericksburg Clinic1308 S State Highway 16(830) 997-2181

Angela L. Schladoer, DpM, CWSEdelweiss Podiatry, PLLC307 S Washington(830) 997-7779

pSYChIAtRY Michelle L. Cantu, MDLocation: Pedernales Medical Group205 W Windcrest, Suite 310(210) 615-5230

Susan K. Wynne, MDLocation: Pedernales Medical Group205 W Windcrest, Suite 310(210) 615-8900

RADIoLoGY W.E. (Gene) Bishop, MDtyson D. hale, MDRobert R. Murray, MDJoe M. pruneda, MDR. Gayle Williams, MD1020 S State Highway 16(830) 997-1268

RhEUMAtoLoGY Chelsea I. Clinton, MDCI Clinton Rheumatology, PPLC1009 S Milam, No 3(210) 591-0688

SURGICAL ASSIStANCE (Board certified urologist - retired / scheduled through your surgeon)William A. Freeborn, MD1020 S State Highway 16(830) 997-4353

URoLoGY Michael C. Jones, MDHill Country Urology703 S Adams(830) 997-9507

Andrew p. Rockwood, MD213 E San Antonio(830) 997-0813

VASCULAR SURGERY Andrew N. Bowser, MD, FACSJoseph F. Vinas, MD, FACSTexas Hills Vascular Specialists205 W Windcrest, Suite 350(830) 997-7138

WoUND hEALING Marshall W. Cunningham, MD, FACSAngela L. Schladoer, DMp, CWSHill Country Memorial Hospital1020 S State Highway 16(830) 997-1265

hILL CoUNtRY MEMoRIAL SERVICE LINESRemarkable CareBIRthING CENtER

BREASt CENtER

CANCER RESoURCE CENtER

CARDIoLoGY

CARDIopULMoNARY

EMERGENCY DEpARtMENt— 24/7 Physician Coverage

ENt / ALLERGY / hEARING

GAStRoENtERoLoGY

hoME CARE

hoSpICE

INFUSIoN thERApY

IMAGING

LABoRAtoRY SERVICES

qUICKDRAW—Low Cost Blood Lab

oRthopEDICS

REhAB CENtER

REStoRE— The Remarkable Joint Center

SLEEp LAB

StRoKE CARE

SURGERY— Inpatient / Day Surgery

VASCULAR

WoMEN’S hEALth

WoUND hEALING CLINIC

CommunityhCMh FoUNDAtIoN

hCM thRIFt Shop

hCM WELLNESS CENtER

WIC—Women, Infants & Children

hillcountrymemorial.org

Back in the

Donna Swope is back to doing things she loves without constant knee pain after a successful surgery and physical rehab process. — Photo courtesy Marc Bennett

By Lisa Treiber-Walter

“Restore” — Hill Country Memorial’s joint replacement program — is in the business of getting people back to their lives — faster and with less pain than ever before.

Joint replacement therapy is an elec-tive procedure sought by patients with painful, disabling knee or hip joints who have reached a point where they cannot get satisfactory results from less invasive types of procedures, including medica-tion, physical therapy or joint fluid sup-plements.

“The deciding factor for me was when I no longer could comfortably walk or ride my horses,” said Donna Swope, 54, a teacher in Llano County who also enjoys barrel racing and training young horses.

Under the care of Dr. Daniel Robert-son, she had replacement for a “bum” knee last June after her joint had degen-erated over the decades following an ini-tial knee surgery she underwent at the age of 16 years.

Dr. Robertson is the medical direc-tor and Marilyn Sweeten the program director of HCM Restore, while other orthopedic surgeons involved in the pro-gram are Dr. Peter Romanick, Dr. Steve Hoerster and Dr. Joseph Cohn.

In the past, Swope sought out relief from the degeneration and painfully large bone spurs through injections, which helped for about five years. But, eventually, they weren’t enough.

“The final blow was when I was in tears from the pain as I finished a barrel race run. I knew I had to do something,” Swope said.

“I decided that my quality of life would be so much better with a new knee, so I set my mind on total success,” she said.

With apprehension and fear of what was to come, Swope sought out Hill Country Memorial’s Restore program and hasn’t regretted her decision since.

“When I finally gave up the pain battle and talked to Dr. Robertson about hav-ing a knee replacement, he signed me up for the pre-surgery seminar. I went with dread in my soul and left with a positive attitude about the upcoming surgery,” Swope said.

The pre-surgery session “is an incred-ible class,” said Jessica Gardner, MSW, a growth and innovation advisor for HCM.

“It empowers patients to have knowl-edge” and the class educates them, not only on the joint replacement procedure itself, but also what they can expect af-terward — in surgical recovery and months down the road, Gardner said. “This is a year-long commitment,” she said.

HCM’s Restore is a dedicated unit with its own nursing staff, taking up residence in a second-floor wing of the hospital. It can accommodate up to 10 joint replacement surgery patients per week, all of which are cared for in pri-vate rooms with plenty of room for fam-ily members who are encouraged to stay with them and serve as personal coaches during the initial stages of rehabilita-tion.

Surgeries are conducted on Mondays and Tuesdays, and “the patients are up and moving the next day” before swell-ing can making recovery slower and more painful, Gardner explained.

Pain management is so much better than in years past, Gardner explained. Advances in anesthesia care and pain management medications tailored for the individual means less post-surgical pain, allowing patients to get up and moving faster and getting released to home sooner.

The average stay at Hill Country Me-morial for Restore patients is around two and a half days — much shorter than the 3.7 days on the national average.

While in their early post-surgical stag-es, patients engage in group physical therapy in the Avery Gym.

Experience has shown that patients do better in group settings such as this be-cause they bond, Gardner said. “They’re very encouraging for each other — it can be a very positive environment,” she said.

“Restore Champions,” their personal coaches and their newfound fellow pa-tient friends join for a farewell lunch on Thursdays. But, it won’t be the last chance to get together for the group as a reunion is held sometime between six weeks and two months after their sur-gery.

That reunion gives them a chance to continue their support of one another, as well as provide feedback to the staff and the program.

“Overwhelmingly it has been so posi-tive,” Gardner said.

Having been on the patient’s side of the experience, Swope agreed. “I had had surgeries in Hill Country Memorial before so I knew the care was exception-al there, but I had no idea what special treatment or how special the care givers were in the Restore unit until I experi-enced it first-hand,” she said.

“From the moment I awoke from sur-gery, I was cared for to the utmost level. Every person, from the cleaning ladies to the nurses were kind and professional. The physical therapists were patient, yet purposed, and knew how to deal with all of the different (physical and emotional) levels of patients,” she said.

“Each patient was dealt with appro-priately according to their pain levels,” Swope said, adding that she had adverse reactions to normal pain medications, but the nurses and doctors worked to find medications she could tolerate.

“Rehab at home was great for me. I

saddle

Cont. on page 20

RIDING FREE — Llano teacher Donna Swope is back to barrel racing — pain-free — after undergoing knee replacement surgery in Hill Country Memorial’s “Restore” program. — Photos courtesy Hill Country Memorial/Marc Bennett

17

J. Steven Hoerster, M./D.P. Charles Romanick, M.D.

Joseph M. Cohn, M.D.Board Certified by

The American Board of Orthopaedic Surgery

Texas Hill Country Orthopaedicsand Sports Medicine

Fredericksburg, Kerrville, Brady, Marble Falls & Llano

(830) 997-4043thcosm.com

18

Family MedicineCharles E. Burg, M.D.Rad Kothmann, M.D.Jeff Holt, M.D.Rebecca W. Daley, D.O.

Internal MedicineLeo C. Tynan, III, M.D.Philip J. Maple, M.D.Jennifer K. Mayben, M.D., M.P.H.

Mid-Level ProvidersKathy Fryburger, P.A.-CLoretta Keese, M.P.A.S., P.A.-C

1308 South State Hwy 16 • 830-997-2181800-880-0024 • Fax: 830-997-4453

www.fredericksburgclinic.com

FredericksburgClinic

Board Certified in Sleep MedicineKathy Wilson, MD

seeing patients for symptoms of:vDaytime Sleepiness

vSnoring

vDifficulty Falling or Staying Asleep

vFeeling “Skin Crawling” at Night

vUnrestful Sleep

vNot Breathing While Asleep

ask your doctor for a referral or

call 830-792-1132

Peterson Hospice

To learn more about Peterson Hospice call us at 830-258-7799.

Your Life. Our Calling.Peterson Hospice1121 BroadwayKerrville, Texas 78028830-258-7799

Peterson Hospice helps individuals in our community with pain and symptom management- offering the best in quality of life. Our team will assist with navigating through personal healthcare choices; addressing physical, emotional and spiritual needs for both the individual and their family and loved ones. Please call us if you have questions. Our staff is here to assist you, respecting your wishes and the right to make choices that are best for you.

19

Dr. Michael Walker has twenty three years experience rejuvenatingthousands of satisfied cosmetic patients from across the globe.

He is recognized in Texas Monthly, The Beauty Makers, and noted asone of the top facial plastic surgeons by the Consumers Research Councilof America.

Dr. Walker is distinguished as an officer and member inover ten professional organizations. Experience yourmakeover in a Fredericksburg B&B atmosphere withattentive staff and a state of the art accredited surgicalsuite for your safety, comfort and privacy.

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Raymond “Dr. Ray” Knuppel Jr., DDS408 South Adams Street • Fredericksburg, TX 78624

• Joint replacement pa-tients experiencing mild to no pain when walking af-ter recovery — 98 percent at Hill Country Memorial, 82 percent nationally.

• Patients who have mild to no difficulty with stairs — 99 percent from Hill Country Memorial, 79 per-cent nationally

• Days spent in recovery from joint replacement

surgery — 2.5 days with Hill Country Memorial, 3.7 days nationally

• Patients going directly home instead of a rehabili-tation facility or nursing home — 91 percent

• 10 — up to 10 joint replacement surgical pa-tients can be accommo-dated each week

• 400 — approximately the

number of joint replace-ment surgeries completed at Hill Country Memorial last year

• 5 star recipient from web-based Healthgrades for joint replacement sur-geries

• Top 5 percent — in Unit-ed States for “Medical Ex-cellence in major orthope-dic surgery” by Carechex Quality Rating.

Back in the saddleCont. from page 17

had a great physical therapist. I actually got on and rode one of my horses four and a half weeks after surgery. I was back barrel racing two months after surgery and have had no pain at all,” Swope said.

“I now have more range of motion and more strength in the new knee than I have had in 10 years!” she said.

“My advice to anyone thinking about a joint replacement is: Do not put it off. Do not be afraid. The quality of life after surgery is well worth a little pain and hard work,” Swope said.

“The Restore program and Dr. Robertson are the reasons I am happy, healthy and enjoying my active life again,” she said.

Gardner said that is the pro-gram’s primary emphasis: “get-ting people back to what they want to do.”

“Basically, you should be going to your doctor when your pain is ongoing and is interrupting your lifestyle,” Gardner said. “This is about getting well!”

20

Hoerster Romanick RobertsonCohn

RESTORE BY THE NUMBERS

All the gain without the pain!We don’t believe therapy should be painful, so we use gentle yet very effective therapy solutions to assist you. If your body is not allowing you to live your life to the fullest, please come see us. We can help.

Frank Mills, PTMelinda Mills, PTCarol Johnson, PTKaren Sweet, PTAutumn Holland, PTA

We are located at 712 W. Main St., Suite A (within the Fredericksburg Standard-Radio Post building)

Hours: Mon.-Fri., 7 a.m. to 6 p.m.Phone: 830-997-3781; Fax: 830-997-3786

Mills & AssociatesPhysical Therapy

Our PromiseNobody will work harderto help you or your family

21

A deeper focus

New hospital CEO looks to engage and empower

By Ken Esten Cooke

A hockey stick stands in the corner of new Hill Country Memorial Chief Executive Of-ficer Jayne Pope’s office.

While the equipment seems out of place in the Texas Hill Country, the Canadian-born Pope may hope it comes in handy to skate through the upcoming maze of new healthcare regulation, while maintaining the hospital’s reputation as an industry leader.

Though it won’t be without challenges, Pope and her administrative team are ahead of the curve for upcoming challeng-es. Federal reimbursements will migrate from being admissions-based to relying on quality metrics.

That’s where HCM stands out, having garnered Truven Top 100 Hospital awards two years running.

“We want to be a model for others, wheth-er it is other community hospitals or larger hospitals,” Pope said. “But knowing where healthcare will be tomorrow, we have to deepen our commitment to patients and families because they are driving the chang-es.”

Pope said consumers are now more in-formed than ever and demand quality out-comes. There are online reviews of hospi-tals, just like those of restaurants. With so-cial media, both good and bad experiences can spread through the Internet quickly. Also, patients simply have more access to information than ever before.

“There was an article in a popular retire-ment magazine about what patients need to look for in a safe hospital room of the fu-ture,” she said. “No one knows the patient

experience better than the patient. So we seek out all kinds of opinions from patients, from wayfinding (signage), to comfort in the rooms, to the noise level at night.”

Empowerment

HCM’s stated vision is “Empower Others. Create Healthy.”

Though not much of healthcare has been focused “outside the walls” of hospitals, Pope said she and her team will focus on engaging and empowering doctors, nurses and other hospital staff, while coordinating patient care wherever possible.

HCM also will focus on informing and encouraging the community to take up

healthy habits, from informational publica-tions to sponsorship of events like the Wild-flower Run 5K.

While keeping people healthy may seem counterintuitive to the way healthcare has been sustained for the past four decades, it’s the right thing to do, Pope said.

And even with a renewed focus on health, more than one in three Americans still lives with at least one chronic disease, accord-ing to the Centers for Disease Control, so healthcare demand will continue to be high.

“While we focus on holistic disease man-agement, 75 percent of healthcare spending is on chronic disease care for 133 million people in the U.S.,” Pope said. “Our focus is going to be on keeping them well so they don’t need to enter a hospital, and we are looking at ways we can serve our patients and care for them in their homes, yet to still be here as a hospital when we are needed.”

That will require using dollars in the most efficient way possible. “We could care for someone in home healthcare for the same amount of money that might not even get them in the hospital door,” she said. “We will be using those resources as strategically as we can in order to care for people and keep them well.”

None of the navigation of healthcare changes will be easy, Pope said. In fact she jokes that it’s like having two canoes in the water, with one foot in each. But as she takes the helm at a facility that has been a leader in rural healthcare, Pope said while the focus will deepen, it won’t change.

“Patients and families have always been at the center of HCM, and we always try to create care systems around them,” she said.

Jayne Pope

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22

Good Samaritan Center marks

21 yearsCenter serves area’s needy

with basic careBy John WillomeExecutive Director,

Good Samaritan Center

In 1991 and 1992 Sara Allerkamp, a local ICU nurse at the time, found herself talking to several people with a similar problem.

Each of them had high blood pressure, diabetes, asthma or some other chronic disease, and none of them were getting care.

They were not taking medica-tions.

They didn’t have a doctor monitoring them.

When she asked them why they did not manage their health, the answer was always the same: “I can’t afford the doctor visit and I can’t afford the medications.”

Inspired by God at a Chris-tian conference in Dallas in 1992, Sara came home and ral-lied medical and lay volunteers to start the Fredericksburg Free Clinic.

She simply wanted to give people with chronic medical problems a chance in life.

Over the last 21 years, the clinic, now The Good Samari-tan Center, has seen thousands of Hill Country residents and helped them not only with their chronic diseases, but also with acute problems that can leave them in crisis.

Of course, The Good Samari-tan Center does not do its work in isolation. We do our best to be a symbiotic part of our over-all medical community.

Thanks to the generosity of our local specialists, family practice doctors, Hill Country Memorial and other nonprof-its such as the Hill Country Community Needs Council, if a

patient with insurance can get help for their ailment in Fred-ericksburg, then the odds are good that we can find a low-income, uninsured patient help here, too.

In 2004, the Fredericks-burg Free Clinic gave way to The Good Samaritan Center, a charitable clinic that charges nominal co-pays to patients as opposed to giving services for free.

As The Good Samaritan Cen-ter, the services grew to include specialist referrals for medi-cal patients; a trained diabetes educator to meet one-on-one with diabetic patients; a den-tal clinic that provides fillings, extractions and cleanings, and a mental health counseling program to help patients strug-gling with various life issues.

In 2013, the center expanded its services to include a pro-gram to provide chronic medi-cations to patients for no more than $5 for a 90-day supply.

“The Good Samaritan Cen-ter has been a key partner with Hill Country Memorial in cre-ating healthy in our commu-nity,” said Jayne Pope, hospital CEO. “They are a crucial link in the health care chain for those who need it the most.”

One priority for the center’s board of directors is that the center remain free of state or federal funding to ensure its autonomy and operational ef-ficiency.

One of the questions the board asked when they inter-viewed me in 2005 was how I felt about state and federal grants. I told them what I found in my experience was that it is hard to make those grants make financial sense because

Cont. on page 23

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23

of the conditions, paperwork, and occasional instability that accompanies them. They all appreciated that answer be-cause they felt the same way.

In order to support its $650,000 budget, the center relies mainly on donations from the community at-large.

The patient fees fund about 20 percent of our budget.

We receive about five per-cent of our income from space we lease to Hill Country Me-morial and the incoming Fed-erally Qualified Healthcare Center and about 10 percent from private foundation grants.

That leaves the other 65 per-cent coming through dona-tions from the general public.

Last year, we had over 700 families and organizations donate to the center, and hav-ing that broad base of support makes us that much more sus-tainable.

The center also relies heavily on its volunteer workforce.

There are nine paid employ-ees, but nearly 90 volunteers.

Volunteers staff nearly every area of the clinic. They per-form front desk, back office, medical assistant, medication room, dental, and landscap-ing functions.

Our volunteers are really

the soul of who we are as an organization. A lot of them have been here longer than any of the staff, and they offer a tremendously compassion-ate spirit to the patients who come in each day.

With large parts of the healthcare reform legislation looming for 2014, I often find myself answering questions about its impact on the center and its patients.

First, it has no impact on our dental patients.

And as for our medical pa-tients, because Texas declined the federal government’s offer to expand its Medicaid pro-gram to include many of our patients, the line I use with people is, ‘The same people who were uninsured in Texas in 2009 will be uninsured in 2014.’

The Good Samaritan Center welcomes the opportunity to give tours to anyone interest-ed in being a patient, volun-teer or donor.

For more information, call 830-990-8651 or visit www.goodsamfbg.org.

Willome has served as ex-ecutive director of the Good Samaritan Center since 2006.

A patient at The Good Samaritan Center turns her head while Becky Walch, RN, draws blood for lab work. Over the years, the center has helped thousands of Hill Country residents with their medical care. — Standard-Radio Post Photo

Good Samaritans Cont. from page 22

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Student blood donorsStudents at Fredericks-

burg High School are also encouraged to donate blood when they are eli-gible.

To promote blood dona-tions and make it easy for the students to get in-volved, three blood drives are usually held at FHS each school year.

The first drive will be held Oct. 23 from 8:30 a.m.-3:30 p.m.

“We have three drives a year and many students are brave and generous in giv-ing,” said Nanette Tisdale, who teaches the health sci-ence classes at FHS and is the HOSA: Future Health Professionals advisor.

She said, “Our hope is that students will have a positive experience and be-come life-long donors.”

Tisdale added, “I am always impressed by the number of students who want to give and face their

fears to do so.”The drives are sponsored

by the Fredericksburg High School HOSA: Future Health Professionals.

Sponsoring the drives gives the HOSA students the opportunity to organize and implement an event, Tisdale said.

To help promote the blood drives at FHS, the students put up posters in the hall and information is given out over the an-nouncements.

Tisdale said that students are encouraged to sign up in their English classes.

Students who give blood six times during their high school years are given a red cord to wear at graduation.

Tisdale noted that stu-dents can donate blood during the summers as well as at the drives at school to meet the six-unit require-ment.

Blood drives Cont. from page 9

Blood drivesBecause the South Texas Blood and Tissue Center relies on

donations to keep an adequate supply, community blood drives are held throughout the state, including in Fredericks-burg.

• Three community blood drives are scheduled at the American Legion Hall. Hours are 11 a.m. to 7 p.m. and drives are scheduled for June 3, Aug. 5, and Oct. 7.

• Four Hill Country community blood drives have been scheduled for the Walmart parking lot from 1-7 p.m. on June 27, Aug. 27, Oct. 29 and Dec. 30.

• Blood drives will also be held at Hill Country Memorial Hospital and at Freder icksburg High School. At HCM, a drive will be held on July 25 from 9:30 a.m. to 3:30 p.m. and on Nov. 12 from 9 a.m. to 3:30 p.m. Next drive at FHS will be held on Oct. 23 from 8:30 a.m. to 3:30 p.m.

Donating bloodIndividuals planning to donate blood are reminded to eat a

full meal within four hours and to stay well hydrated.The donation process begins with each donor filling out a

donor form that includes medical history and lifestyle ques-tions, followed by a mini-physical that includes blood pres-sure, blood iron level, temperature and pulse checks.

The STBTC stressed that everything used during the dona-tion, including the needle, is new, sterile and used only one time. “There is no risk of disease transmission to a donor,” the STBTC said.

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Sometimes we take better care of our cars than we do ourselves

By Debra Gunter Integrative Health Coach

A popular definition of insanity has been playing in my head this week — “doing the same thing over and over and expecting different results.” It has been on my mind because of areas in my life that need some real change.

So how does this apply to health and wellness?

Here in Texas, we love our cars. We care for our cars, take them in for regu-lar check-ups, change the oil and fuel them with what is needed to make them run as efficiently as possible. In response, they take care of us, too. Yet if they ever break down we can exchange them for a newer model.

Every day we also drive another vehi-cle. Do we fuel it properly? Do we lubri-cate it and keep it in motion so it stays strong and doesn’t rust at the joints? Is the computer system working? The vehicle to which I am referring is, of course, our body, and, unlike our cars, we are only given one. Along with so many other functions, this one body has an amazing capacity to protect and heal itself.

So, which vehicle do we give the bet-ter care? As Americans, we may be able to plead this kind of insanity when it comes to the expectations we have and the choices we make for our own bod-ies.

We want to be healthy. We want to lose weight. We want sharp minds. We want to live long, full and vibrant lives. And yet, we want our coffee, muffin and sugary juices for breakfast. We want our doughnut and more coffee at our mid-morning break. We want our value meal and soda at lunch, our vending machine snack to stave off the mid-afternoon stupor and that hearty meat and potato dinner with maybe a side of pie and ice cream for dessert.

We have lost movement in our lives. Our entertainment is passive. Our work

is sedentary. Our sports are spectator. Why, then, are we surprised when we

are tired, weak, stressed and overweight or when that miraculous vehicle — our body and mind — fails?

According to the Center for Disease Control, “chronic diseases — such as heart disease, cancer and diabetes — are the leading causes of death and dis-ability in the United States. Chronic diseases account for 70 percent of all deaths in the U.S., which is 1.7 million each year.” Chronic disease is continu-ing to rise and it is directly linked to lifestyle choices.

It is time to ask, “Why do I continue to do what I have always been doing and expect to have different results?” The good news is that we don’t have to settle for much of the pain and illness in our lives.

As a nation, a state, a community and a people, it is time to put an end to the insanity and we, the people, need to take back our health. Not only can we begin to make changes in ourselves but also we can take measures to create a healthy community. We can begin to treat our bodies and minds at least as well as we treat our cars.

Small changes can set off a ripple ef-fect of wellness. Start by asking, “What step can I do today to move myself to-ward a healthier life?” Set an intention that you can do today.

For instance: Hydrate. Drink one glass of water be-

fore you drink your soda or coffee. Make it a priority to find a way to

move more — stretch, walk, swim, ride or dance.

Play with your children. Spend some time outside in this beau-

tiful town or in one of our area parks. Find time to be fully present for the

people you love. Commit to your intention only for to-

day and when today is done, be grateful and celebrate whatever steps you took … then, tomorrow … just for one more day … do it again.

Live well, live whole!

Debra Gunter is a Certified Integrative Health Coach. She received her training at the Institute for Integrative Nutrition in New York City, is certified by the American As-sociation of Drugless Practitioners, and is a member of the International Association of Health Coaches. www.bodymindwhole.com.

26

Body+Mind+Whole

Eating mindfully can help reduce a variety of ills. We know this, yet Integrative Health Coach Debra Gunter asks why do we continue to eat poorly?

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27Healthy kids make for healthy adultsBy Sam Erickson

It’s no secret that there’s an obesity epidemic in this country. Experts say this is the first generation in American history whose life expectancy could be shorter than their parents’. This puts a premium on good fitness and nutrition habits for kids. Once established, those habits can help children make new friends and maintain a healthy weight for the rest of their lives. These are just a few of the ways that you can instill healthy habits in your kids that will stick with them through adulthood. Be a good role model. It’s very tough for children to hear they should be eating broccoli and tofu when their parents are eating cheeseburgers and pizza. Remember, you can eat just about anything you want, as long as it is in moderation. There’s nothing wrong with the occasional treat or a special celebratory feast, but feasting on a regular basis instills bad habits in kids. You can also serve as a role model when it comes to exercise. It might be very difficult to come home from work, take care of the kids and then engage in some physical exercise, but even a few minutes of a

game or playing outside can solidify these habits in children. Another way to instill good fitness habits is to get kids started in physical activities when they are young. Most cities have a variety of youth sports leagues to join at minimal costs. If they aren’t into team sports, there are individual activities like tennis they can start. There are also things like dance classes, swimming lessons and even parkour for kids these days. Physical activity releases hormones in the body that naturally make people feel good, and children are no exception. Many adults see activity as a chore, but if children can learn to see it as something fun and amusing, they are much more

likely to continue it. Stay away from processed and fast food. Given the tremendous advertising campaigns from fast food companies, it can be difficult to keep kids away, and their ubiquitous presence in the American landscape makes them the easy choice. For those dealing with single parenthood or extremely busy schedules, these prepared foods are an attractive option. The problem is that they have less nutritional substance than home-cooked meals. Frozen pizza has higher fat and salt content than pizza made at home, for example. If you make these fun foods at home, you can control the amount of bad ingredients that go into them, and you might even be able to get your kids to help you out in the cooking process. There are many ways to go about keeping kids healthy, but the basic idea is that the trends established in childhood will be the trends that people follow as adults. If they get most of their meals from processed or fast food and exercise very little, those habits will be much harder to break as an adult. Of course, the opposite of that is true as well. Good fitness and nutrition habits created in childhood will endure.

Good health in kids starts with snack choices.

Stroke prevention Cont. from page 7

side and prayed. I was very, very happy.”

HCM is now gathering data to apply for Joint Com-mission Stroke Accredita-tion, targeted for the fourth quarter of 2013. When the accreditation is finalized, EMS from nearby coun-ties, such as Kerr, may de-liver stroke patients to Hill Country Memorial, if time permits.

“This now gives a level of stroke care to Hill Country Memorial patients that pre-viously only could be found in major medical centers,” said Partin. “And patients at HCM who qualified for TPA treatment had total resolu-tion of their stroke symp-toms.”

Today, the Lopez family believes it was nothing short of “un Milagro” – a miracle.

“Without that medicine, Nuri could have died, or lost feeling in half her body

forever. It was a second chance for us,” said Luis. “I was scared and didn’t know what to do. My wife was 43 years old, and I kept won-dering, what is going on?”

These days, Nuri is back at work at the Sunset Grill, fol-lowing her doctor’s advice and making changes that help her lead a normal life. She walks regularly, takes her medications, and has added more fish and vege-tables to her diet. According to her husband, the couple appreciates life a lot more.

“It is incredible how lucky we were to get to Hill Coun-try Memorial in time, and get the medicine right away, and have Nuri recover so fast,” Luis said. He smiled. “Somebody was looking over us from heaven — and from the hospital’s ER team, too.”

28

WHAT PATIENTS SAY

“Dr. Gildersleeve is an exceptional physician. He listens and he is compassionate.

I feel so fortunate to be under his care.”

­—Barbara­Locher­/­Kerrville

Roger W. Gildersleeve, MD

WHAT I TELL FAMILY & FRIENDS

You­are­in­charge­of­your­health.­The­most­important­element­in­health­is­the­knowledge­that­you­are­the­one­in­control­of­your­life.­

NEED A DOCTOR?

HCM’s Dr. Gildersleeve is accepting new patients.

FAMILY MEDICINE

(830) 990-1404 / Toll-free 1 (888) 899-7256

1331 Bandera Hwy, Suite 3 / Kerrville

205 W Windcrest, Suite 130 / Fredericksburg

MAKE AN APPOINTMENT

BEST PART OF MY WORK

I­enjoy­forming­and­developing­relationships.­I­am­so­interested­in­people’s­individual­stories.­I­find­it­very­rewarding­to­ help­patients­and­families­formulate­and­achieve­their­personal­health­goals.

Accepting new patients in Fredericksburg and Kerrville.

• Adult, Adolescent, and Pediatric Care

• Annual Wellness Exam

• Management of Chronic Diseases

• Diabetes Care

• Geriatrics

• Nursing Home Care

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ACTIVITIES I ENJOY

Swimming,­yoga,­and­playing­music.­

Se Habla Español.

Physician Associates Primary Care Physicians

www.hcmdocs.com

Remarkable Health Care

Accepting self-pay and most insurance including:

Tricare®, Medicare, and Medicaid.

eat the right kinds of fruits and veg-etables. While a potato might techni-cally be considered a veggie, it’s also a starch, which needs to be limited.

6. Stay hydratedWater is necessary for life, so keep-

ing enough of it in the body at all times is a “must” for any person, especially if strenuous exercise (which results in perspiration) is involved. She recom-mends drinking water throughout an exercise program to keep the body in good running order.

7. Screen the sunThe notion that a deep, savage tan

is a sign of good health was dispelled years ago as the increase in skin cancer cases became evident. Thornton advis-es using a sun screen with a high SPF value when exercising outdoors.

8. Sweet dreamsA good night’s sleep never hurt any-

body, and it goes a long way in helping the body remain strong and function-ing at a high level. She recommends seven to eight hours of restful sleep each night. This helps a person’s inter-nal chemistry come alive. The produc-

12 simple steps to better health

By Danny Hirt

Everyone’s list will vary. But there are certain tips that, if followed, can lead to a stronger, healthier body.

Kim Thornton, registered dietitian with the Hill Country Memorial Well-ness Center has a list of “things to do” to have the best chances at living a healthy lifestyle.

1. Keep muscles on their toesThornton recommends changing up

a work-out pattern occasionally so that the body’s muscles don’t get used to the same exercises day after day.

Throw in a few extra exercises every once in a while; keep the body guessing what’s happening next during regular work-outs. “You have to change a little bit for a more complete muscle work-out,” she said.

2. There’s an app for thatFor those who spend their time with

new technology, there is help in the form of cell phone app that can moni-tor a person’s health regimen.

Some of the websites to look up helpful monitoring methods include: myfitnesspal.com, livestrong.com, and loseit.com.

3. Count drink calories, tooWhile water is a universal thirst-

quencher following a work-out, sports drinks are also popular. But Thornton said some of these drinks can be high in calories, making their use seem counter-productive. As with food in-take, watch those calories.

4. Stretch out after working outWhile everyone is familiar with the

need to warm up the body before ex-ercising, it’s also a good idea to stretch the muscles after a good workout.

Thornton said this is because by this time the muscles are warm and provide for increased flexibility. “It’s another piece of the puzzle” to complete health.

5. Eat your fruits and veggiesMother was right! It is important to

eat fruits and vegetables every day — at least 10 servings. But it’s important to

tion of melatonin, which helps in the sleep process, “goes up when the room is dark,” said Thornton.

Meanwhile, a good reser voir of mela-tonin is con verted during the daylight hours into serotonin, a neuro-transmit-ter and anti-oxidant that helps give the body a sense of well-being.

9. Avoid those fadsPeople look for shortcuts when it

comes to exercising and eating right. But Thornton said not to become too reliant on new methods and medica-tions that come down the pike. Stay to the tried-and-true ways — cardiovascu-lar and weight-bearing exercises, and eating properly — that have worked throughout the decades.

10. Strength training is for everyoneWhile weight-bearing exercises have

been stereo typically considered some-thing only for men, Thornton reminds the public that weight-lifting is impor-tant to women, as well. Contrary to an often-held notion, lifting weights will not cause a woman to “bulk up.” In-stead, it will help mitigate ailments like osteoporosis by putting a demand on the bones to become stronger.

11. Meditation mediationThinking good thoughts and “going

to your happy place” seems to have a calming effect on the body and, in the process, helps reduce the harmful ef-fects of stress. The trick is to train the body to “focus on how’s my body feel-ing.” Stress is a common, but there are simple ways to deal with it, such as deep breathing.

12. Pay attentionAnother item on the health check

list is what Thornton calls “practicing mindfulness. Pay attention to what you are doing at the moment. Put your whole energy into that (whatever task is at hand).”

Stress resurfaces when it comes to doing too many things at once, thus taxing the brain and the rest of the body. “Too much multi-tasking is not healthy,” Thornton said. “Remove your-self from all that.”

At the top of everyone’s “staying healthy” list is exercise and its importance to maintaining a healthy body, as Hill Country Memorial Wellness Center regulars Eleanore Crump, foreground, and Jane Convery know. The center’s dietitian, Kim Thornton, also advises mixing up exercises to keep muscles in tone. — H.I.P. photo

30

830-990-9007License #132719

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Fredericksburg’s Newest Dedicated Memory Care Living!

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Certified to specialize in the care of persons with Alzheimer’s and other dementias, our specially trained staff provide 24 hour care in a secure environment. Personalized care is provided for Activities of Daily Living, Medication Supervision, housekeeping and laundry. Never serving more than 16 residents, personalized care is what you expect and sets us apart from the rest.

At Morning Star, we tailor a specialized activity program that enhances memory stimulation, while bringing enjoyment and recognition by blending activities they have enjoyed a lifetime. What did they enjoy? Perhaps a game of cards, cooking, golfing, reading, painting, exercising, dancing, entertaining family or watching the grandkids play.

An unexpected miracleCont. from page 5

military people in need first, and then non-military patients.

“At the time we realized that Jacob was brain dead, we prayed that God would keep him alive until such time as we could donate his organs,” Mary said.

“We were praying for this miracle and God said, ‘Here’s your miracle.’ It was just differ-ent than the miracle we thought it would be,” Mary said.

When the decision to donate fi-nally clicked, they were at peace. “God gave us this miracle and, actually, God gave the recipients the miracle and their families this miracle,” she said.

The Krebs were told that Ja-cob’s gift had the potential to pos-

itively impact up to 100 patients. “That is absolutely wonderful,” she said, adding that organ dona-tion was “just the right thing to do,” she said.

“We are a very close family. We are so proud of Jacob. If he would have died in a car accident or a tragic death that was sense-less, I think it might have been different. But, he died doing what he loved to do. I don’t find fault

in God, it is just something that happened,” Mary said. “Jacob was an adult. He knew what he was doing. He took it a little further. When things happen, it’s man’s doing, basically. A lot of people say, ‘Well, why would a good, loving God do this?’ Well, it’s not God that did it, it is just some-thing that happened. But, God is

going to help us get through this.”Jacob’s father, William made

the casket of pine and it was lined with camouflage. “It was a labor of love. It was absolutely beautiful,” Mary said, adding that their son was buried on the fam-ily ranch in Harper.

In the aftermath of Jacob’s death on April 1, the family felt an outpouring from the commu-nity and Harper School as they

mourned the loss of their high school mascot, “Stomper.”

She credits HHS Principal Chris Stevenson and cross country coach Will Reid as good role models for students.

Following in that leader-ship role, Jacob was an Eagle Scout. “He was always living

by the motto: ‘Do a good turn daily.’ And, so, by him giving for-ward in this way, it’s still doing a good turn daily.

“Jacob still ‘shipped out’ … just sooner than expected,” Mary said.

“He’s now in the Navy … and the Marines … and other war-riors. So, he made it after all,” she said.

We were praying for this miracle and God said, ‘Here’s your miracle.’ It was just differ-ent than the miracle we thought it would be.”

— Mary Krebs

“

VolunteerKrebs loved the military and enjoyed

volunteering as a World War II reenactor at the National

Museum of the Pacific War.

of Fredericksburg High School’s health sciences stu-

dents surveyed said they want to be organ donors, according to teacher Nanette Tisdale.

Those who have made the decision have been encouraged to discuss it with their families, so their wishes will be known in the event of an untimely death.

“It is stressed for them to talk to their parents now if they want to be a donor,” Tisdale said.

Her classes have followed the topic of organ donation closely for the past 12 years and stu-dents have become emotionally vested in a few local transplant recipients as they followed them through the entire process.

Just recently, the health sci-ences students completed a project on organ donation. Stu-dents did research and looked up information pertaining to organ donation and transplan-tation.

With their findings, they then made posters to be displayed in the school’s hallways — dispel-ling myths and further spreading word about the importance of organ donation.

95%

31

Bruce was hitting tennis balls six weeks after his total knee replacement surgery. Six months later he was playing in a singles tennis tournament. Bruce credits his quick return to the game to Restore’s rehab program in the Avery Gym. “It really made a big difference.”

Bruce BowmanTENNIS PLAYER / READER / BUILDS ROCK WALLS

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