In This Edition

Butler CountyHealth Care Center

Are You Feeling Tired?...................................................................1-2Compassionate Care In Nursing Careers......................................3-4Electrical Stimulation Therapy............................................................4New Personal Trainer.........................................................................5Foundation Fundraising Efforts..........................................................5Cardiac Rehab Celebrates 30 Years.................................................6Alcohol Use This Summer.................................................................6AARP Driver Safety Course...............................................................7Picky Eaters Club...............................................................................7Parkinson’s Disease Support Group.................................................7Discrimination Notice.........................................................................8

ww

w.b

chcc

net.o

rg

June

201

7

Health ConnectionsCompassionate Care

Health Connections is published by Butler County Health CareCenter and Future Generations Health Care Foundation.Editor is Laura Daro. Health Connection provides informationon healthy lifestyles and news of interest to our community. It isnot intended for the purpose of diagnosing or prescribing.Please consult your physician with specific medical questions.

1Health Connection

Vision StatementButler County Health Care Center’s vision is to help people to

achieve and maintain good health.

Are You FeelingTired?

oc, I'm tired!" Thisis a complaint I hearweekly, if not on a

daily basis. Although I mayrespond with "that makes twoof us", there are a variety ofreasons why you could befatigued. The seriousness ofthese various causes fallsalong a wide spectrum andsome causes of fatigue arealso more treatable thanothers. Admittedly, there are

times when it is difficult to pindown a patient’s cause for fatigue. There is a variety ofblood work and other tests that may be ordered toevaluate the cause of the fatigue.

The first and most common cause to consider is simplya lack of sleep. Erratic schedules and anxiety regardingpersonal and professional responsibilities can contributeheavily to a lack of restful sleep. Many people havedifficulty keeping a consistent sleep pattern. Perhapsthey go to bed at variable times or wake up at erratictimes. Overnight shift work is especially hard on ones’sleep schedule. Oscillating between daytime andnighttime sleeping patterns is extremely difficult on aperson’s circadian rhythm. The national sleepfoundation states that the average adult needs 7-9 hoursof sleep nightly. Creating good sleep hygiene is the firststep in trying to improve sleep schedules and fatigue.Keeping a consistent bedtime schedule as well as aconsistent schedule to wake up is important. One shouldalso avoid caffeine later in the afternoon and evenings;caffeine can interfere with sleep. Avoiding alcohol,especially in large quantities is necessary as well.Alcohol, which may help one fall asleep faster, causesfragmented sleep and interruption of REM sleep whichis very restorative sleep. Furthermore, keep in mind thatbed is for sleep; not to read or watch television. In theage of smartphones, it can become routine to check ouremail and messages on social media while we lay inbed. Making it a point to take care of those thingsbefore bed and keeping your bedtime routine focused on

relaxing your body as well as your mind is a path togood sleep hygiene.

Stress and depression are also a common cause forfatigue and interrupted sleep. Most people do not givethis enough consideration in my experience. We knowthat anxiety and depression both affect an individual’ssleep patterns. They will not sleep as restfully.Depressed patients often find it difficult to fall asleepand stay asleep. They will subsequently try multiplesleep aids to help them get some sleep. Often timestreating the depression and anxiety are much morehelpful though. Multiple safe medications can beprescribed for anxiety and depression. Counseling isalso very helpful and often not utilized by patients. Notonly do mood problems affect our sleep but they alsomake us feel tired. This is very common in depression.Seasonal affective disorder is a type of "pseudo-depression" which is related to the weather. After a longwinter of cold days, lack of sunshine, and shorter days,peoples' mood can be affected. Medications can behelpful for this as well as taking advantage of thosewarmer sunny winter days by getting out of the house.

Another cause for fatigue is sleep apnea. Sleep apnea isa medical condition that many people have heard of andin general is under diagnosed. It is estimated that theprevalence of sleep apnea in North American males is20-30% and in females 10-15%. Sleep apnea is acondition where a person does not achieve deep restfulsleep. In general, sleep apnea occurs because themuscles in our neck and mouth which support ourairway structures relax as we drift off into deeper sleep.As this occurs, the weight of the neck and tongue startto impinge on the airways. This makes it more difficultto breath and results in snoring and pauses in breathingfor short periods of time. These episodes are called"apneas." As we stop breathing, oxygen levels drop andour brain senses this. As the brain wakes us up slightly,we will start to breathe better again, and our oxygenlevels will rise. As a result though, we can never go intodeep levels of restorative sleep.

“D

Dr. Matthew Summers

2Health Connection

Because of this, one will feel extremely tired during theday. It is common for those with sleep apnea to not feelrested even upon getting up first thing in the morning. Itseems, no matter how much sleep you get, you are nevergetting restful sleep. Sleep apnea is most commonlytreated with what is called a CPAP machine. This is amask and machine that blows constant positive pressureon the airways. This keeps them from collapsing andkeeps a person breathing more easily during sleep.Although it takes some adjustment, people that have truesleep apnea will swear by these machines. There areother more uncommon treatments for sleep apnea such assurgical interventions and dental appliances that eitherholds the lower jaw forward or the tongue out.

Disruption of sleep and poor sleep can also be caused bya condition called restless leg syndrome. This is asensation of ones legs “needing to move” when you’retrying to relax. Loved ones may even notice that youkick them while you’re falling asleep. Restless legs cancause difficulty both falling asleep and staying asleep. Inmore severe cases, this does cause disruption of sleep.There are medications that can be used to treat this.

Inactivity and lack of exercise is also a cause of fatiguethat people don't seem to pay much attention. Exerciseincreases endorphins in the brain which elevates ourenergy levels. It also elevates mood and improvesdepression. Furthermore, studies have shown that peoplewho exercise regularly sleep better. In people with sleepapnea, exercise can lead to weight loss which willimprove sleep apnea. I understand it is difficult after along day of work to exercise; however, it is important,and can go a long way to making one feel better.

I often have people come into the office who claim theyhave difficulty losing weight and they feel their lack ofenergy is because of a thyroid problem. Thyroiddisorders are not uncommon in the general population.Studies show the incidence of hypothyroidism isanywhere from 1% to nearly 10% of the population.However, in my clinical experience, treating peoples'hypothyroidism rarely really makes them feelsignificantly better. The thyroid gland is a gland in theneck that produces thyroid hormone. Thyroid hormone isinvolved in a variety of bodily processes from the growthof our hair and nails to our metabolism and our energylevels. Hypothyroidism, or an under functioning gland, ismore common than an over functioning gland and morelikely to lead to fatigue. Other signs of hypothyroidismcan be cold intolerance and constipation. Certainly,hypothyroidism is easy to determine as it is a simpleblood test, yet, treating it may not make you feel better.

Another condition that we commonly screen for when apatient presents with fatigue is anemia. Anemia isdefined as a low amount of red blood cells. A low redblood cell count can have many different causes. One of

the more common causes would be chronic blood loss ascan be seen in women who continue to have menstrualcycles that are heavy, or gastrointestinal blood lossescaused from bleeding ulcers, bleeding diverticuli, andpossibly bleeding polyps or colon cancer. Anemia canalso be seen in alcoholism, chronic kidney disease,vitamin deficiencies of B12 and folate which are fairlyrare, and people who are undergoing chemotherapybecause of its effect on the bone marrow. Treatment ofanemia depends on the underlying cause.

Heart disease can also cause fatigue. This generally isnot an overall feeling of tiredness but more so fatiguewith exercise. I have had patients that come to me andsay they have difficulty walking across the yard withoutfeeling extremely tired. This might be something thattwo years ago they could do easily. They may not haveshortness of breath nor have any chest pain, merely afeeling of fatigue with activity. When a heart has severalplugged arteries there will be a lack of blood flow. Whenput under stress such as exercise, that lack of blood flowputs strain on the heart. It is possible that thepredominant symptom in these cases is simply fatiguewith exercise or ambulation. Certainly, this is a moreserious cause that requires intervention which couldinclude surgery, stents, or medication therapy.

Lastly, a very uncommon cause of fatigue is narcolepsy.Narcolepsy occurs due to a lack of certain chemicals inthe brain that are released during times of wakefulness.This can be quite difficult to diagnose. Other thanfatigue, other symptoms of narcolepsy include cataplexywhich is sudden weakness usually triggered by laughteror other strong emotion, or the inability to move for oneor two minutes immediately after awakening or justbefore falling asleep.

One last, fairly common cause of fatigue is simply a sideeffect of medication. There are many medications thatcause fatigue including a class of blood pressure pillscalled beta blockers, some allergy medications, andmedications like lorazepam and alpraxolam which areoften given for anxiety. It is important for you and yourphysician to reviewr your medication list and see if youare on any of these medications and if they can bechanged or eliminated.

As you can see, there are numerous reasons for fatigue.This is a common problem and one you should talk toyour doctor about. Although it often occurs simply due tolack of sleep, there are other reasons that need to bediagnosed and treated. Some may be more serious thanothers, and at times there may not be an easy answer.None the less, it is important to talk to your physician asthere are many treatable causes that can be addressed.

3Health Connection

Compassionate Care In Nursing Careers

he demand for nursing professionals is robust and theneed will continue to rise. According the Bureau ofLabor Statistics the demand for all nursing jobs will

skyrocket 19% by 2022, due to Americans getting older andliving more active and longer lives. Thus making a nursingdegree one of the best educational investments. However,nursing is a unique health care profession in that it hasmultiple educational paths.

The Registered Nurse (RN) is one of the most commonnursing degrees. There are several education levels toconsider when becoming a RN. The quickest path tostarting your nursing career is by becoming a RN with anassociate’s degree. An associate’s degree RN completes an18-24 month program in nursing at an accredited college.

RN’s that hold their BSN are eligible for more nursing jobsthan nurses with only an associate’s degree. Some of whichinclude non-clinical occupations in nursing administration.For example Kristin Hartman, RN, BSN spent 12 years as afloor nurse at BCHCC. She explains, “I was able toadvance my career by becoming the Quality Improvementand Patient Safety Coordinator for the last 6 years. This ismore of an administrative role that focuses on ensuringpatients are receiving the highest quality of care based onbest practices.”

A BSN is a four year degree that combines learning in theclassroom with clinical training. There are some BSNprograms available that allow you to earn your degree inless time if you already are an experienced RN with anassociate’s degree or a Licensed Practical Nurse (LPN).

Rebecca Hecker is a RN at Butler County Health CareCenter. She explains, “I received my Bachelors of Sciencein Nursing at College of Saint Mary. BCHCC gives me theopportunity to work in the community that shaped myvalues professionally and personally while working in somany different areas of nursing, such as general nursing, theemergency department and labor and delivery.”

A Master of Science in Nursing (MSN) is another option formaximizing your nursing career. This degree allows you tobecome a nurse practitioner (NP). In order to work inadvanced nursing practice or a clinic nurse specialist, aMSN is mandatory. Some MSN programs have the optionof a specialized track or focus.

The highest level of nursing degree is a doctor of nursingpractice (DNP). A bachelor’s degree is required to enter theDNP program; most people also have their MSN. TheAmerican Association of Colleges of Nursing nowrecommends that an advanced practice nurse earn theirDNP. This is also required in order to teach nursing in a

university or conductextensive research.While 13 percent ofnurses hold a graduatedegree, fewer than onepercent have a doctoraldegree, according toNurse Journal. Nurseswith doctorates areneeded to teach futuregenerations of nurses.

Licensed Practical Nurse(LPN) and LicensedPractical Nurse Certified(LPN-C) are othercommon nursingprofessions. The LPNprogram usually takesabout a year to complete.Community colleges,vocational colleges andtrade schools usuallyoffer LPN programswith online courses andclinical work experience.A LPN-C is a LPN whohas taken additionaleducation and passed anexamination to obtaincertification in anadvanced role permittingthem to provide limitedservices in intravenoustherapy (IV). Over thenext five years, allLPN’s in the state ofNebraska will need tocomplete the LPN-Ccertification.

Like RN’s, LPN’s havethe opportunity toadvance their nursingcareer through excellededucation programs inorder to move from anLPN to RN or LPN toBSN. An LPN within thehospital setting can befound assisting RNs andphysicians.

T

Kristin Hartman, RN

Rebecca Hecker, RN

Krissy Johns, LPN-C

Health Connection 4

BCHCC Speech Therapy ProvidesElectrical Stimulation Therapy

ummer is here, which means many of us are gearingup for cookouts and family gatherings. All of theserequire one specific, everyday action – swallowing.

However, for some people, the thought of eating in front ofothers is dreadful, due to their difficulty swallowing, alsoknown as dysphagia.

According to the American Speech-Language and HearingAssociation, approximately one in 25 adults willexperience a swallowing problem in the United States.Symptoms can include the following:drooling, food and/orliquid remaining in oral cavity after the swallow, foodand/or liquid leaking from oral cavity, food and/or liquidleaking from the nasal cavity, sensation of food “sticking”in throat after swallow, sensation of a “fullness” in thethroat after swallow, wet or gurgly sounding voice duringor after eating or drinking, coughing during or right aftereating or drinking, difficulty coordinating breathing andswallowing, recurring aspiration pneumonia/respiratoryinfection and/or fever, extra effort or time needed to chewor swallow, changes in eating habits such as avoidance ofcertain foods/drinks, weight loss or dehydration from notbeing able to eat enough.

There are a variety of treatment options available to helpreduce and/or eliminate these dysphagia symptoms. Onetreatment option in particular is eSwallow ElectricalStimulation. According to recent research, electricalstimulation therapy has proven to be the most effectivetreatment for dysphagia. Electrical current is used tostimulate key muscles while the patient practicesswallowing. The result is greatly improved swallowingfunction though muscle re-education.

Butler County Health Care Center speech therapist, RachelKoch, MS, CCC-SLP is certified in eSwallow ElectricalStimulation Therapy. “I have seen positive results withpatients who have completed electrical stimulation therapy.For instance, a patient was avoiding meat due to difficultyswallowing. After about eight weeks of therapy, the

patient is no longer avoiding meats,” explains Rachel. Sheexplains that electrical stimulation therapy triggers themuscles in the throat to increase strength which then leadsto improved swallowing.

Rachel is a native of Clarkson, NE, graduating fromClarkson High School in 2008. She received her Bachelorof Science in Speech-Language Pathology and Audiologyin 2011, followed by her Masters of Science inCommunication Disorders in 2013, from the University ofNebraska-Lincoln. Rachel married Jarrett Koch. Theyhave a one year old son, Cru.

If you have questions about possible dysphagia symptomsor your treatment options, contact the speech therapydepartment at Butler County Healthcare Center.

Krissy Johns, LPN-C at Butler County Health Care Centerreceived her nursing degree from Columbus CommunityCollege. "BCHCC is a great place to work. Being in asmall town, we go above and beyond for our patients,” sheexplains. “I chose to work as a LPN-C because it is a hugeasset in a small hospital. I know my role is very importantin providing exceptional patient care."

Regardless of which route is taken take to become a nurse,you need to pass the National Council LicensureExamination (NCLEX). The NCLEX exam is astandardized exam that each state board of nursing uses todetermine whether or not a candidate is prepared for entry-level nursing practice.

Butler County Health Care Center employs registerednurses, nurse practitioners, licensed practical nurses andcertified nurse assistants. There are several careeropportunities for nurses within various areas of the hospitalsuch as: inpatient, outpatient, emergency, surgical, clinicaleducation and training and administrative. Butler CountyHealth Care Center and Future Generations Health CareFoundation both offer tuition assistance programs. Formore information about a nursing career at Butler CountyHealth Care Center please call Andra Vandenberg, HRDirector at 402-367-1372, andra@bchccnet.org or SueBirkel, RN at 402-367-1202, sue@bchccnet.org.

S

Rachel Koch, MS, CCC-SLP demonstrating ElectricalStimulation Therapy

Health Connection 5

New Personal Trainer JoinsBCHCC Wellness Center & Downtown Fitness

utler County Health Care Center welcomes newpersonal trainer, Courtney Betzen. Courtney joinsEric De Wespelare and Joslynne Alms in

providing personal training services through theWellness Center

Courtney Betzen is a native of David City, graduatingfrom David City High School in 2011. She receivedher certification as a personal trainer through theNational Academy of Sports Medicine in 2015.Courtney has completed educational courses throughthe University of Nebraska Lincoln for proper liftingform and exercise techniques. She has experience inteaching group fitness classes, developing personaltraining regimens for teens through geriatrics andpreparation training for physique competitions.

“My goal as a personal trainer is to inspire others toreach their fitness goals and maintain a healthylifestyle through lifting weights and proper exercise.It is motivating and rewarding to watch clients

discover their newmuscle definitionand/or reach theirweight loss goals.”Personal training isone of the fastest,easiest and mostsuccessful ways toimprove yourhealth and fitness.Personal trainersare not just forathletes; everyoneof all fitness levelsand ages canbenefit from apersonal trainer. For more information about personaltraining services through the Wellness Center andDowntown Fitness please visit www.bchccnet.or orcall 402-367-1256.

B

uture Generations Health Care Foundation hasdedicated fundraising efforts in 2017 to assist in thepurchase of a C-Arm Fluoroscopy Unit for Butler

County Health Care Center. Fundraising started in Marchwith the Foundation’s Annual Dinner and Auction. Thisevent raised over $39,000. The Foundation will host its20th Annual Golf Tournament on Friday, June 23, 2017.These funds will also go toward the C-Arm FluoroscopyUnit.

The C-Arm Fluoroscopy Unit is a mobile medicalimagining device that is based on x-ray technology. Thename is derived from the C-shaped arm used to connect thex-ray source and the x-ray detector to one another. It usesfluoroscopy in real time, which is like an x-ray movie. Thisis done while a contrast die moves throughout the part ofthe body being examined. A continuous x-ray beam ispassed through the body part and sent to a video monitor sothat the body part and its motion can be seen in great detail.Because the C-Arm is mobile, it is often times used in theoperating room for procedures such as catheter placementin the chest or gallbladder surgery.

The Foundation kicked off its 4th annual raffle June 23rd,in an effort to raise $26,000. Only 400 tickets will be soldat $100. The winning recipient has his or her choice of oneof the following prizes: John Deere Camo Gator, $7,500cash, Eight 1- ounce $50 Gold Eagle Coins, Alaska CruiseTour for two people with a $1,500 Visa gift card or a trip toMaui for two people with a $1,000 Visa gift card. There

are six additionalcash prizes: two$1,000, two $500and two $250.

The raffle drawingwill take place athalftime of the EastButler versusJohnson-Brock highschool footballgame on Friday,September 15, 2017in Dwight; need notbe present to win.A list of rules andconditions areavailable fromFuture GenerationsHealth CareFoundation uponrequest. Tickets areavailable at ButlerCounty Health CareCenter or bycontacting EdMeysenburg at 402-367-1370 oredm@bchccnet.org.

FFoundation Raises Funds For

C-Arm Fluoroscopy Unit

he Cardiac Rehab Program is a medically supervisedprogram designed to help improve yourcardiovascular health if you have experienced a heart

attack, heart failure, angioplasty or heart surgery. ButlerCounty Health Care Center began the Cardiac RehabProgram in 1987. Since opening, this program has helpedover 566 patients who have suffered from heart diseaseand has held national certification for the program.

There are three parts to the Cardiac Rehab Program:exercise, education and counseling. Exercise gets yourheart pumping and your entire cardiovascular systemworking. You will learn how to get your body moving inways that promote heart health. Cardiac Rehab patientsexercise in the Wellness Center under the supervision of aregistered nurse during the program. “My job is tomonitor the patient during exercise to track their heart;seeing if their heart will keep up with what physicalactivity they are wanting to do. I am checking thepatient’s heart rate and rhythm, blood pressure and howthey are overall feeling during this time,” explains CindyYound, RN, RRT, CCRP Cardiac & Pulmonary RehabCoordinator.

Education about heart-healthy living is a key element ofcardiac rehab. Cardiac Rehab patients are educated abouttheir heart disease such as what the causes are and how tomanage risk factors. Patients are educated on nutritionand will learn healthier eating habits. They also receivemedication education and resources to quit smoking, ifapplicable.

Counseling is the third part to the Cardiac RehabProgram. During counseling, staff will help identifyeveryday stresses as well as ways to overcome thesestresses. Family members are encouraged to participate inthe counseling portion of the program.

The Cardiac Rehab Program does not cure someone ofheart disease but it does help improve the future of theirhealth. The benefits of the Cardiac Rehab Program are:helps lower risk of a future cardiac event, teaches healthyeating habits and promotes weight loss. The programstrives for patients to be able to return to work in aquicker manner and better engaged in daily activities.

The Cardiac Rehab Program, in conjunction with FutureGenerations Health Care Foundation, has honoredcommunity members and organizations with the Heart ofButler County from 2002 to 2016. This award was giveneach year to an individual or organization that has had animpact on health care in the Butler County Area. Pastrecipients of this award are: Dr. Kaufmann, David CityPark & Recreation Organization, Meals on WheelsVolunteers, Blood mobile Volunteers, Cindy Yound, CPRInstructors, Blue Valley Community Action Center, Dr.Rudolph, Butler County Ministerial Association, DavidPlace and St. Joseph’s Villa & Court, Back Pack Program,Vickie Kerkman, Robert Bell, David City Rotary and JohnKlosterman.

For more information about Butler County Health CareCenter Cardiac Rehab Program please contact CindyYound at 402-367-1249 or cyound@bchccnet.org.

6Health Connection

BCHCC Cardiac Rehab ProgramCelebrates 30 Years!

T

ummer is here and so are good times outsideenjoying the beautiful weather and sunshine.Sometimes these outdoor events such as picnics, ball

games, barbeques, holiday parties, and neighborhoodfunctions are all opportunities for having an alcoholic drinkor two. Maybe even more? This summer, take some timeto think about your drinking habits and learn some tips onlowering the amount of alcohol that you drink.The standard size of an alcoholic drink has about 14 gramsof alcohol. Types of alcoholic drinks have different amountof sizes, just like food. One drink of beer is 12 ounces, onedrink of wine is 5 ounces, and hard alcohol like Vodka,Rum and Whisky is just 1.5 ounces. For men, too muchalcohol use can be 5 or more drinks at one time or 15 ormore drinks per week. For women it is 4 or more drinks atone time and 8 or more drinks per week. Any alcohol usedby pregnant women is too much because of the risks to theunborn baby. Also, any alcohol use by those under 21 yearsof age is too much.

Drinking too much can lead to harmful health problemssuch as different types of cancer, Dementia, or heart disease.Also, many don’t realize that drinking in the summertimeheat can quickly lead to dehydration and even heat stroke.Alcohol use also can contribute to risky behavior. Caraccidents, falls, and drownings can happen when someonedrinks too much alcohol. Also, risky sexual behavior canlead to unwanted pregnancy or sexually transmitteddiseases. Violence like homicide, suicide, or sexual assaultmay even happen.Instead of fruity summertime alcoholic treats, try some tastyalcohol-free choices. As an added benefit, these drinksusually don’t pack as many calories and can help keep yoursummertime figure. Four Corners Health Department encourages you to be safethis summer and enjoy all the fun opportunities that warmweather and playing outside can bring. For moreinformation: cdc.gov/alcohol/, talkaboutalcohol.org, andfourcorners.ne.gov.

SHow Much Is Too Much This Summer?

Alcohol Use:

7Health Connection

AARP Driver Safety Course

At Butler County Health Care Center

ne of the most significant demographic factorschanging in our nation’s future is the aging of thepopulation. The number of people age 50+ has grown

significantly in the past decade and this segment willcontinue to increase more rapidly than other age groups inthe United States. The U.S. Census Bureau estimates that bythe year 2030, one in four drivers will be 65+ whichtranslates into more than 30 million drivers.

Traffic statistics indicate that older adults overall are safedrivers with good driving records. However, medicalconditions, certain medications, and age-related changes inphysical and mental function can increase the risk of crashesand injury among older drivers. It is critically important thatolder drivers make driving safely a personal priority. AARPDriver Safety is committed to helping Americans 50+ sustain

mobility and safety as they age.The AARP Smart Driver course teaches valuable defensivedriving strategies and provides a refresher of the rules of theroad. Since 1979, the course has helped more than 15 milliondrivers learn research-based tips to adapt their driving tocompensate for physical and cognitive changes that mayoccur with aging. Plus, you may qualify for a multi-yearautomobile insurance discount by completing the course(check with your auto insurance agent for details).

Take the AARP Smart Driver course at Butler County HealthCare Center (Savannah Room) on Wednesday, July 12, 2017from 9:00 am to 1:00 pm. The classroom course costs $15for AARP members and $20 for non-members. Space islimited, so register now by calling Laura Daro at 402-367-1366.

he Picky Eaters Club is a feeding group that focuses onwhat makes picky eaters picky. This group will enhanceeach child’s unique feeding routines in an enjoyable

and supportive setting. The group will be instructed by anoccupational therapist and speech language pathologist withtraining in a wide variety of feeding-based therapytechniques including the use of the Sequential Oral Sensory(SOS) feeding protocol. The goal of the group is to not onlyexpand a child’s menu but also to allow for a child toobserve and interact with peers during a food-based activity.

The Picky Eaters Club is for children between the ages oftwo to six years. The group will meet Tuesday’s andThursday’s from 10:45 am to 12 pm July 11th- August 17thin the Occupational Therapy Department.

This group best suits children that:• Are limited to a number of foods•Do not tolerate specific textures• Demonstrating rigid diets and/or meal routines• Having trouble transitioning between food stages (ex.Pureed to solids)• Have a hard time trying new foods• Gag or vomit when they see and/or eat new foods• Unable to meet the nutritional requirements of their currentdiet

The Pickey Eaters club will allow children to be able to walkaway with skills that allow them to improve their ability toparticipate in family, school and snack time meals. It willalso provide appropriate social skill development withinthis feeding routine.

For more infomation or to regisiter for the Picky Eaters Clubplease contact Staci Worm MOT, OTR/L at 402-641-1501402-367-1200 as space is limited.

O

T

BCHCC Offers

Picky Eaters Club

Parkinson’s Disease Support GroupParkinson's disease is a chronic and progressivemovement disorder, meaning that symptoms continueand worsen over time. According to the Parkinson’sDisease Foundation, nearly one million people in the USare living with Parkinson's disease. The cause isunknown, and although there is no cure, there aretreatment options such as therapy, medication and/orsurgery to manage its symptoms.

Butler County Health Care Center Occupational andSpeech Therapies have formed a Parkinson’s diseasesupport group. This group will meet the third Tuesdayof the month beginning June 27, 2017 in the PioneerRoom. The Parkinson’s disease support group is forthose with Parkinson’s, family members and caregiviers.Each month there will be a different topic discussed.The goal of this support group is to provide a place toshare similar experiences and tips for living withParkinson’s disease.

For more information about the BCHCC Parkinson’sdisease support group please call HannahWurl,OTDR/L, CLT or Rachel Koch, MS, CCC-SLP at402-367-1200.

8Health Connection

Public NoticeDiscrimination is Against the Law

utler County Health Care Center complies withapplicable Federal civil rights laws and does notdiscriminate on the basis of race, color, national

origin, age, disability, or sex. Butler County HealthCare Center does not exclude people or treat themdifferently because of race, color, national origin, age,disability, or sex.

Butler County Health Care Center provides free aidsand services to people with disabilities tocommunicate effectively with us, such as:• Qualified sign language interpreters• Written information in other formats (large print,audio, accessible electronic formats, other formats)

Butler County Health Care Center provides freelanguage services to people whose primary language isnot English, such as:• Qualified interpreters• Information written in other languages

If you need these services, contact Jodi Prochaska,Corporate Compliance Officer at 402-367-1200.

If you believe that Butler County Health Care Centerhas failed to provide these services or discriminated inanother way on the basis of race, color, national origin,age, disability, or sex, you can file a grievance with:Jodi Prochaska, Corporate Compliance Officer, 372South 9th Street, David City, NE 68632, Phone: 402-367-1200, Fax: 855-297-3216,jprochaska@bchccnet.org. You can file a grievance inperson or by mail, fax, or email. If you need helpfiling a grievance, Jodi Prochaska, CorporateCompliance Officer, is available to help you.

You can also file a civil rights complaint with the U.S.Department of Health and Human Services, Office forCivil Rights, electronically through the Office forCivil Rights Complaint Portal, available athttps://ocrportal.hhs.gov/ocr/portal/lobby.jsf, or bymail or phone at:

U.S. Department of Health and Human Services200 Independence Avenue, SWRoom 509F, HHH BuildingWashington, D.C. 20201 1-800-368-1019, 800-537-7697 (TDD)

Complaint forms are available athttp://www.hhs.gov/ocr/office/file/index.html.

ATENCIÓN: si habla español, tiene a su disposiciónservicios gratuitos de asistencia lingüística. Llame al 402-367-1200

CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợngôn ngữ miễn phí dành cho bạn. Gọi số 402-367-1200.

��：如���用���文，�����獲�����

��。��� 402- 367- 1200.

ةدعاسملا تامدخ نإف ،ةغللا ركذا ثدحتت تنك اذإ :ةظوحلم مقرب لصتا .ناجملاب كل رفاوتت ةيوغللا402-367-1200.

402-367-1200.

ATTENTION : Si vous parlez français, des services d'aidelinguistique vous sont proposés gratuitement. Appelez le402-367-1200.

XIYYEEFFANNAA: Afaan dubbattu Oroomiffa, tajaajilagargaarsa afaanii, kanfaltiidhaan ala, ni argama. Bilbilaa402-367-1200

ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnenkostenlos sprachliche Hilfsdienstleistungen zur Verfügung.Rufnummer 402-367-1200.

주의: 한국어를 사용하시는 경우, 언어 지원 서비스를무료로 이용하실 수 있습니다. 402- 367- 1200번으로 전화해 주십시오.

ध्यान दिनुहोस्: तपार्इंले नेपाली बोल्नुहुन्छ भने तपार्इंको निम्ति भाषासहायता सेवाहरू निःशुल्क रूपमा उपलब्ध छ । फोन गर्नुहोस् 402-367-1200 ।

ВНИМАНИЕ: Если вы говорите на русском языке, товам доступны бесплатные услуги перевода. Звоните402-367-1200.

������: ����������������������,���� ��������������������,���� ��������, ����������������. ��� 402-367-1200

،تیەکەد ەسەق یدروک ینامز ەب رەگەئ :یراداگائۆت ۆب ،ییاڕۆخەب ،نامز یتەمرای یناکەیرازوگتەمزخ.ەکب 1200-367-402 ەب یدنەویەپ .ەتسەدرەب

تالیهست ،دینک یم وگتفگ یسراف نابز هب رگا :هجوتتروصب ینابزسامت 1200-367-402 اب .دشاب یم مهارف امش یارب ناگیار

.دیریگب

���項：���を�される場合、無料の����を

ご利用いただけます。

402- 367- 1200 まで、お��にてご連�ください。

B

Board of Directors

Mr. Jerry Roh, President

Mrs. Diane Moravec, Vice President

Mr. James M. Egr, Secretary

Mrs. Bev Struebing, Director

Mr. Jason Lavicky, Director

Board of Directors

Mr. Kent Grotelueschen., President

Mr. Jason Lavicky, Vice President

Ms. Linne Vavrina, Secretary

Matthew Summers, MD, Treasurer

Mr. Mike Eller, Director

Mr. Donald Moravec, Jr., Director

Mrs. Alice Jane Behrens, Director

Donald T. NaiberkAdministrator/CEO

Ed MeysenburgExecutive Director

Butler County Health Care Center

Future GenerationsHealth Care Foundation

Future Generations Health Care Foundation

372 S. 9th StreetDavid City, NE 68632

Your gift to the Foundation

makes a difference!

PRSRT STDU.S. POSTAGE

PAIDOMAHA, NE

PERMIT #484