Even after practicing medicine for more than 30 years, I am always amazed by the rejuvenating power of Spring. Here in southern Indiana right now, Spring is awakening nature in a burst of life and color. Regardless of our age, spring vividly reminds us of life restored and new beginnings – and spring in southern Indiana is an especially beautiful time.

As a long-time physician, I offer a free prescription that holds many potential benefits: whenever possible, go outside on upcoming mild days of our 2024 spring and lift your spirits, perhaps filling your mind with the following three thoughts.

Spring brings a living message of resilience. From time-to-time, we all face challenges. Sometimes the winter months can seem to magnify any difficulties that we may face. But each spring season tells us this: despite winter blahs or even harshness, life finds a way to bounce back, even pushing up through the last days of seasonal snow.

A real benefit of spring comes with mild sunny days, where we can shed our winter coats and get a little bit of warming sunshine. It’s a medical fact that sunlight triggers the natural production of Vitamin D. The natural creation and application of Vitamin D by just being outside provides real benefit for bone health, our immune systems, and even our personal outlook and quality of mental health. 

Breathing in fresh air with a bit of sun can strengthen our resolve and resilience to press on. And if spring is here, great summer days can’t be far off!

Spring brings new opportunities for growth. I enjoy hearing from my patients about the marvel of fresh natural flowers and budding trees and bushes, and their delight in seeing new growth everywhere. As we in our Crawford County SICHC clinics  appreciate, it’s an inspiring season to see here in southern Indiana. 

As the weather improves, so do our opportunities to strengthen our physical bodies and our mental outlook. A short daily walk can bring a host of benefits in the improvement of blood circulation, a boost of personal energy, enhancement of mood, and as a helpful remedy for stress, anxiety and even mild depression. 

Spring also brings growth opportunities in the form of gardening, whether flower, vegetable, or both. Our region has a number of community garden patches available, many with experienced gardeners who can offer tips. The taste of fresh vegetables that you have grown yourself is a most satisfying experience – and doubles down as a healthy one! And don’t forget some fresh-cut wildflowers to brighten the inside of your home.

Spring promotes vitality. A little bit of sustained exercise and elevated outlooks can bring a new dimension of vitality to your life. As days get longer, we wake up to sunshine and get off work while the sun is still shining. We may feel the desire to do a little spring cleaning, which does more than just declutter our living and working spaces. Getting things in order and freshened up can declutter our minds and elevate our mood.

And while we’re talking about spring cleaning, our bodies can benefit from drinking more water, eating fresh leafy greens and consuming antioxidant-rich foods like broccoli, spinach, carrots, cabbage, squash and more. Fresh strawberries and blueberries make their presence in these spring months, which offers additional good-tasting and healthy options.

Remember, physicians and medical providers always encourage people to take their medicine as prescribed, so don’t wait – your suggested prescription is to enjoy this spring season and its potential benefits of renewal, growth, and vitality!

A board-certified family physician, Dr. Curtis Thill has practiced medicine in the Crawford County region for more than 30 years.

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Stout, who has led broad efforts to address and treat substance use in the greater Orange County Indiana area, has spearheaded efforts to elevate the quality of healthcare available to those facing substance use. Instead of treatment only being available through substance use and other treatment centers, Stout and Southern Indiana Community Health Care now increasingly integrate substance use treatment into family healthcare services.

This includes the local administration of MAT (medication-assisted treatment) options, where people facing substance use can be prescribed Suboxone or Vivitrol without having to travel to a specialty clinic (MAT treatment also typically includes a combination of counseling and behavioral therapies).

Properly administered, Suboxone can blunt intoxication from using drugs like heroin, oxycodone and other opiates, reducing cravings and allowing people an opportunity to transition away from a life of substance use. Injectable Vivitrol is also available through a MAT program, which use blocks euphoria or ‘high’ that alcohol and opioids produce. Vivitrol has also proven effective in helping people with substance use issues recover.

“There is still a stigma around substance use, and this stigma serves as a barrier to seeking treatment for those who need it,” Stout said. “By integrating MAT options within family medical treatment, this provides several advantages, including helping those facing substance use issues with improving their general health and also addressing issues like diabetes.”

(Recognizing that physical health and mental health go together, Southern Indiana Community Health Care utilizes an integrated care model. For more information, please visit https://sichc.org/mental-health/)

People with substance use issues can go to a typical facility like SICHC’s Valley Health clinic in West Baden Indiana and confidentially receive treatment. “My MAT patients sit in the same lobby as patients seeking healthcare for other reasons,” Stout said. “They don’t have to drive a long distance to a specialty clinic or face the stigma of publicly going to that clinic.”

With the federal removal of certain data waiver requirements, MAT treatment became a viable option to integrate within more typical medical services. This is now more important than ever, according to Stout, as new illegal drugs in pill form that “look like” opiates are becoming more available on the street. “Dealers mix up illegal and highly dangerous combinations of fentanyl, heroin and other drugs, and illicitly press them in pill form to ‘look like’ oxycodone or other opiates,” she said.

The dangerous illegal and increased use of fentanyl has tragically resulted in additional deaths by overdose, Stout explained said. When prescription opiate availability decreased, people who used opiates turned to heroin as a substitute, opening the door for dangerous fentanyl.

Southern Indiana Community Health Care began exploring MAT treatment options in 2018, when tests showed opiate use among the obstetric population. Initial success of the program promoted SICHC to roll out integrated treatment options to the general public in 2019.

Stout noted that overdoses still tragically occur often. She emphasized that free opioid rescue kits are available without prescription or social contact. Life-saving Naloxone can be administrated by nasal spray or other means in an emergency overdose situation.

“There are many Naloxone Boxes and free distribution points around Indiana,” Stout explained, encouraging any with an opiate issue (or anyone with a family member or friend with an opiate issue) to secure a free, confidential supply at NaloxBoxes around the area. (NaloxBox locations and distribution points can be found at https://www.overdoselifeline.org/naloxone-indiana-distribution/). Several churches, public libraries and facilities, and recovery centers are host to free and accessible opioid rescue kits.

Recovery from substance use takes time and can include complications. In addition to seeking quality medical care, people with substance use are encouraged to take advantage of local peer support groups and 12-step recovery programs like Alcoholics Anonymous and Narcotics Anonymous. Safe Haven Recovery Engagement Center in Orange County offers several options. Interested people can also visit https://www.indianarecoverynetwork.org/

Together with a patient in recovery, Stout presented details about the MAT program and its integrated value during the recent Indiana Rural Health Associations annual state conference in French Lick.

The post Innovative Hope For Those Facing Substance Use Issues appeared first on Southern Indiana Community Health Care.

While school-based health care does cover the basics, it really provides so much more for students, especially those who, for various reasons, don’t have access to healthcare providers or specialists. 

This year, SICHC, in cooperation with Orleans School Corporation, has established a School-Based Health Center Service Site (SBHC) to expand patient access to comprehensive, accessible, and continuous community health center services and respond to the needs of the Orange County community. In this post, we talked with Katarina Koch, SICHC’s Fund Development Manager, about school-based health care at Orleans Community Schools in Orange County.

Let’s start with an explanation of school-based health care and how it works. 

The goal of school-based health centers (SBHC) is to meet the needs of students and families in the community by providing a full range of age-appropriate health care services. SBHCs often operate as a partnership between the school and a community health organization, such as a community health center, hospital, or local health department. 

Prevention, early intervention and risk reduction are integral components, with students counseled on healthy habits and prevention of injury, violence and other threats. Nearly 2,000 school-based health centers operate nationwide, with most open every day school is in session.

Why did SICHC choose Orleans Community Schools and Orange County as the SBHC location?

Early this year SICHC began talking to all three Orange County school systems and surveyed parents and staff about their interest in school based health care for their community. We chose Orleans Community Schools because we had already established a partnership with the superintendent and school board to provide mental health services in the high school. Additionally, out of the three school systems in Orange County, Orleans is the most rural with the least industry, resources, and services available within the community.

 Orange County is considered one of the least healthy in the state according to County Health Rankings. Orange County consistently has higher rates of children living in poverty (21%) compared to Indiana (17%) and the U.S. (10%) and higher rates of alcohol, drugs, and prescription opioid use compared to the state. Also troubling is that nearly 30% of Orange County youth already have ACE (Adverse Childhood Experiences) scores of 4 or higher, and 70% of child removals from the home were due to alcohol abuse and/or drug abuse by parent(s).

Orange County is also considered a Medically Underserved Population, and Orleans is considered a primary care and mental health National Health Provider Shortage Area (HPSA), meaning the population to provider ratio is substantially higher compared to the state and the nation. All these factors showed a dramatic need for collaboration. When the schools, health care teams, including behavioral health, communities and parents work together, we all can promote healing and resilience.

SICHC does not currently have a clinic located in Orleans. Having a SBHC will help counter community challenges related to accessing healthcare during and after school hours and provide children and their families with the medical and psychological care they need.

What are some of the services that will be provided?

SICHC began mental health and tele-medical services in Orleans Jr. Sr. High School this August, with plans to begin a SBHC for medical care in the elementary school the summer of 2022 at a building donated by Orleans Community Schools. Mental health at the elementary school is already provided by a Youth First Social Worker, with SICHC mental health providers at the high school collaborating with Youth First for support at both locations.

Once the elementary school SBHC is open, high school students needing medical care will be transported to the clinic there, while still able to access in-person mental health care at the high school. Telehealth for general primary care will be available, connecting students and school staff to an SICHC primary care provider at one of our four SICHC offices. 

By 2023, services will be available to the broader population at the in-person health center. Patients needing services that aren’t available at the SBHC will receive a referral to appropriate care that can be made directly from the school site.

In general, SICHC will provide all the comprehensive services that are offered at our other primary care clinics located in Paoli, West Baden, English, and Marengo. We’ll also be working with local partners including Lifespring Health System and the Indiana University School of Social Work. These types of collaboration and partnerships enable us to offer continuous and comprehensive care and make health care more accessible to the community and underserved vulnerable populations. 

How many students do you expect will use SBHC?

Based on reports from other health centers, we expect about 40% of the student body will use SBHC services for both virtual and in-person visits. The nearest SBHC to Orleans is West Washington Schools in Campbellsburg; they shared their experience, best practices, and utilization data with SICHC as we planned our program. In addition to providing all the comprehensive services that are offered at our other primary care clinics, SICHC will also have a sick bay, where sick children can rest, thereby reducing the risk of exposure to other students and help parents and guardians who can not leave work early.  

Why is having school-based health care so important?

A SBHC can address the under-utilization of healthcare services. Research has shown that 60% of people on Indiana Medicaid do not take advantage of child wellness exams and 34% of Orange County kids do not have proper preventative care or immunizations. 

In Orleans, some of the barriers parents cited included the difficulty in getting a medical appointment, the inability to take time off from work, and the cost of healthcare itself. With a SBHC, an ill child can see a provider and have any needed medication delivered directly to the school, without the parent having to leave work to take the child to the doctor’s office.

Having a SBHC increases access to these types of services—both primary care and mental health—while reducing barriers for families and the community.

The post What to Know about School-Based Health Care appeared first on Southern Indiana Community Health Care.

At the beginning of the COVID pandemic spring 2019, we pledged to help keep our community informed so that they could make wise decisions. Now 1 1/2 years later, we are all tired of hearing about it. Despite that, we think you need to know what we are seeing as local medical providers.

The delta variant surging across the central part of the US is rapidly spreading in our own communities at rates similar to our highest peaks last year. Below is the Indiana map showing the current surge.

And we are seeing it too. Sick people who feel awful. Hospitals filling back up again with those who are short of air. …..and with people too young to normally be in a hospital. People who had Covid last year are now getting it again.

It’s hard to describe how we as health care providers feel when people we care for become seriously ill with something they might have been able to prevent……. its best described as grief mixed with horror that we are where we are. Imagine watching a tsunami wave in the distance, and yelling down on the beach to warn people of what is coming…..and they hear you but don’t move…..and then you watch that wave go around some people but wipe others out. And then you play that same scene all over again with the next wave.

Nation-wide – over 95% of the people in the hospital with Covid are unvaccinated. Yes, vaccinated people can get COVID too and even pass it to others. That’s why masks are important again for everyone during this delta flare-up. But vaccinated people are MUCH less likely to get seriously ill from Covid.

Many people have waited to get the vaccine for a variety of reasons but mostly due to the newness and concern about side effects. Dr. Sanjay Gupta’s recent article addresses this concern as follows………”As far as safety goes, more than 4 billion doses of coronavirus vaccines have been administered worldwide. In the United States alone, more than 347 million doses have been administered. These are some of the most widely used medical products on the planet, and as a result, there is a remarkable amount of real-world data.

Throughout the vaccination campaigns, the number of side effects has been and remain consistently and extraordinarily low. The CDC is constantly searching for side effects. That is how the agency was able to confirm 28 cases of rare blood clots among the 8.7 million doses of the Johnson & Johnson vaccine administered in the US. The side effect monitoring system is very sensitive and the news has been good. Overall, side effects have been minuscule.

What is not minuscule is the number of deaths caused by Covid-19: more than 4.2 million deaths worldwide, including more than 610,000 here in the United States”. (written by Dr. Gupta) 56 of those deaths were among our citizens of Orange County. 17 from Crawford County. In addition to the deaths, we’ve seen strokes and lung clots in middle-aged people. And there are many others affected by “long-haulers” Covid symptoms of shortness of breath, fatigue, and memory trouble that goes on for months. These are not fake numbers. These are people we know.

Please get the vaccine.

And when you get the vaccine, remember that it takes 2 weeks of time after the final dose to be considered likely protected from serious infection….. so remember to mask up well with one that seals around your nose and mouth.

Sorry for the intensity in this post. It’s been a long year for everyone, including medical teams and the tone of this post reflects that reality.

We sincerely hope most of us can agree on one thing. That we don’t want to experience this virus smoldering on and on in unvaccinated people….and having more time to mutate into new variants….and keep causing havoc on so many levels. We can work together to change that.

Thanks for reading,
Yolanda Yoder MD
__________________________________________________________________
We have much gratitude for those who helped the community during this challenging time.
We especially thank Heather Nichols for her 1 1/2 year-long attention to keeping us informed with daily posts to this local Covid info page:

https://www.facebook.com/groups/580815819187936/posts/894050061197842/?notif_id=1627920591513449&notif_t=page_group_post&ref=notif

As posted by Dr Yoder on Facebook Wednesday August 4th, 2021.
https://www.facebook.com/SICHC1974/

The post Covid-19 Update appeared first on Southern Indiana Community Health Care.

While telemedicine (delivering medical care at a distance) and telehealth (the electronic and telecommunications technologies and services used to provide telemedicine) have been around for decades, COVID-19 has made remote care a more popular option to help reduce exposure for patients and healthcare staff. 

Having a Telehealth Virtual Visit at SICHC

Your Southern Indiana Community Health Care (SICHC) telehealth appointment can take place on your landline phone or with your computer, laptop, smartphone or tablet.

SICHC offers video and smartphone visits through FollowMyHealth, a secure message and video platform available through the FollowMyHealth App on your smartphone (Apple or Android), or through your computer’s web browser. 

Although having a FollowMyHealth account isn’t required. Just call any of our four offices and a staff member will help schedule you for the type of appointment that best fits your needs. (If you have a FollowMyHealth account, you can schedule your appointment through that portal.) 

Once your appointment is scheduled, a staff member will call you before your appointment begins to ask some routine questions, and, if needed, give you additional instructions. Your care provider will then start the visit (phone call or video).

TIP: If you’re using the FollowMyHealth App, you can supply much of this information prior to the virtual appointment. For example, you can upload a close up photo of a skin rash. Here is a link to the FollowMyHealth YouTube channel to get familiar with the platform.

What to Do Before Your Visit

• Find a quiet space. You want to be able to focus on your appointment without interruptions from children, pets or roommates. A separate room, going to a friend’s house or even sitting in your car (while it’s parked!) can give you the privacy you need. 

• Prepare your device (for video). Close other applications to prevent distractions and keep your internet speed from slowing down. Then position your device so you are visible on the screen and the lighting in the room doesn’t shadow your face. 

• Review any instructions or emails from your provider. These can include how to log on to the FollowMyHealth app or gather specific health information such as your temperature, blood pressure, blood sugar, or weight. 

TIP: If you need to download an app, do it well before your visit so you can road-test it and address any problems. 

• Compile your concerns. Make a list of any symptoms, questions or worries you want to discuss during the appointment. Has anything changed since your last appointment? Are your vaccines up to date? 

• Collect your meds. Make a list of prescription medications as well as any OTC (over-the-counter) medications or supplements you take on a regular basis. Do you need refills for any prescriptions? Have the bottle available and double-check the dosage instructions.

• Have a notepad handy. During the visit, you’ll want to take notes so have pen and paper at hand. If you prefer to use a device, don’t try to take notes on the same one you’re using for the telehealth appointment, but have a second one ready.

• Gather your health data. This includes your health history, recent vaccines, other healthcare providers and the phone number and location of your local pharmacy. 

What to Do During Your Visit

• Stay focused. Don’t eat or drink, take calls or check your email during your visit. Your full attention should be on the visit, just as though you were in the examination room.

• Ask questions. If you aren’t sure what the doctor said (sometimes there can be a problem with the audio) or you need additional details, don’t hesitate to ask for clarification. If the doctor orders bloodwork or other tests, confirm where they are to take place and when you can expect results.

• Review your treatment plan. Before you end the call, review the treatment plan your doctor recommended and ask what you should do if your problem persists.

What to Do After Your Visit

• Follow instructions. If you need to make another appointment (either virtual or in-person), change your current medication schedule or begin taking a new one, be sure to do so.

• Bring your notes. If your doctor advises you to see another physician or go to the ER, bring your notes from your telehealth call. 

• Track any changes. The doctor will want to know if your symptoms improve or if you notice any new changes.

Concerned About Insurance Coverage? 

Call your insurance provider beforehand to confirm coverage. Phone and video visits are billed to your insurance just like a regular office visit. If you do not have insurance, please call our Self Pay Department for more information at 812-723-7121 or visit our payment options webpage.

If you’re on Medicare or Medicaid, know that Medicare has temporarily expanded its coverage of telehealth services, but you should check with your state regarding Medicaid coverage for telehealth services. 

Other helpful information to know before your virtual doctor visit. 

This checklist with tips from Telehealth.HHS.gov and American Academy of Allergy, Asthma & Immunology will help you prepare so you can get the most from your appointment. You can also watch this video from the Hawaii State Department of Health Genomics Section to learn more about what to expect from a telehealth visit.

The post Telehealth Checklist: Preparing for Your Virtual Doctor Visit appeared first on Southern Indiana Community Health Care.

By Teresa Faulkner, Licensed Clinical Social Worker

COVID-19 affects everyone, not just those who have caught the virus. Even if you haven’t been physically infected, you most likely have been affected by it emotionally in one way or another. And the longer the pandemic lasts, the more challenging it can be to find ways to cope with the feelings it has caused.

How you deal with COVID stress depends on your background, your level of social support and many other factors. But by using these five tips, you will be better equipped to deal with the current situation as well as other stressful times in the future.

1. Acknowledge your emotions.

It’s important to recognize and acknowledge what you’re feeling. It’s natural to feel anxious, afraid, frustrated or lonely. And don’t be surprised if your feelings change over time. One day you may feel full of energy and the next day be unable to focus. Accept how you are feeling and practice good self-care: eating healthy foods, exercising and getting enough sleep.

Feeling helpless? Remind yourself that there are steps you can take to reduce the odds that you will contract the virus, such as following the CDC guidelines: wearing a mask, practicing social distancing, avoiding crowds and washing your hands.

2. Take a breath and a break.

Take those deep breaths. It may sound like it’s too simple to really have any impact, but deep belly breathing not only gets oxygen into your body but can also slow your heartbeat and help stabilize your blood pressure. This counteracts the negative impact of stress breathing (short, shallow breaths) that can lead to symptoms like chest tightness, heart palpitations or dizziness.

Also, during the day, take periodic breaks and practice relaxation techniques. This will help generate a sense of calmness and relaxation.

3. Connect with friends and family members.

One of the biggest challenges with the pandemic is that it has increased feelings of isolation. No longer can you meet a friend for dinner to talk over your problems, since doing so would put both of you at risk. However, there are ways you can share how you feel with those you trust. Phone calls or video chats can help replace in-person get-togethers. Even occasional walks (with masks and practicing social distancing) can make you feel less alone. Sometimes when you share your emotions, you find out others feel the same way, too.

4. Develop a routine.

COVID-19 has undoubtedly disrupted your schedule and way of life, forcing you to try to adjust to a new “normal” that seems to change every day. When everything around you seems out of control, creating a routine can actually give you a sense of power. Make it simple and do-able—for example, eating and exercising at established times or setting small goals to work toward. While your COVID routine may bear no resemblance to the one you had pre-pandemic, the objective is to follow a schedule, which will then give you a feeling of security. An additional benefit is that by having a routine, you will also be taking better care of yourself.

5. Shut off the info flow.

While you may think it’s a good idea to stay on top of all the latest virus developments, this can actually increase your stress level. Periodically, give yourself a mental break by shutting off the info flow. Take breaks from watching, reading, or listening to virus news stories, including those on social media. Instead, seek out pockets of calm: read a good book, go for a walk, listen to music or find activities that engage your mind and body.

And when you are ready to catch up on pandemic news, make sure that you are getting it from a reputable source like the CDC. You’ll have a better understanding of the risks and will be less likely to spread misinformation.

Let Us Help You

While COVID-19 is unlike any health crisis we have faced before, it’s important to remember that it is a temporary situation. Thanks to medical research, vaccines are now available to combat the virus and new treatments have been developed to help those who contract it.

However, if you have trouble coping with your emotions, develop physical ailments that last for several days, or turn to unhealthy coping mechanism such as drinking or drug use, then consider seeking professional help.

Here at Southern Indiana Community Health Care, our offices include a mental health counselor as part of our care team. This allows us to treat the whole individual, physically and mentally. In response to the COVID-19 pandemic, SICHC has expanded our behavioral health services to include virtual visits, offering the same high-quality care from your trusted provider. We have also added two virtual group sessions: substance use and anxiety.

For more information, contact one of our four offices, and a staff member will help schedule you for the type of appointment that best fits your needs. You can also request appointments through your FollowMyHealth account.

Trust our team to help you through the emotional challenges caused by COVID-19. Reach out to us. We’re here to help you. Remember, we are all in this together.

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