Most of us would agree that there’s nothing better than a good night’s sleep. A stressful day at work or long hours doing yard work and housework can be repaired with a nice, long slumber. You awake feeling calm, refreshed and ready for anything that a new day brings.

Yet millions of people do not get enough sleep and many suffer from lack of sleep. People who are sleep deprived can have difficulty regulating hormones that control appetite, metabolism and blood sugars.

There is plenty of evidence to suggest that those who are sleep deprived or who suffer from sleep disordered breathing are at higher risk for high blood pressure, heart attack, stroke, diabetes, auto acci-dents and more.. Surveys conducted by the National Sleep Foundation reveal that at least 40 million Americans suffer from over 70 different sleep disorders and 60 percent of adults report having sleep

problems a few nights a week or more. Most go undiagnosed and untreated.

Vernon Memorial Healthcare (VMH) is pleased to announce that sleep stud-ies are now being performed in Viroqua. The new service began April 23rd. Ver-non Memorial Hospital is partnering with Whitney Sleep Diagnostics and Consul-tants of Detroit Lakes, Minnesota.

Whitney Sleep Diagnostics and Con-sultants is an American Academy of Sleep Medicine accredited program that diag-noses and treats all 84 known sleep dis-orders.

VMH Chief Operating Officer, Kristy Wiltrout, says two sleep observation rooms have been created on the south wing of the hospital’s second floor. These rooms will allow patients to spend the night sleeping so that doctors and sleep technicians can measure the quantity and quality of a patient’s sleep in order to diagnose and treat sleep disorders. Pa-

tients who feel they may have a sleep dis-order are encouraged to schedule a clinic visit with their local health care provider to talk about their symptoms. A simple one page screening form can often help determine the need for an overnight s l e e p study.

Do you snore? Are you keeping your loved ones awake at night? Do you feel tired in the morning after sleeping all night? Do you feel drowsy while at work?

Take our short sleep quiz on page two to see if you

should talk with your primary care provid-er about scheduling

a sleep study. sleep, p2

S�otlightS�otlightOn HealthSpring 2013

Vernon Memorial Healthcare

vernon Memorial now off ering Sleep StudiesStOP cOuNtiNG SHeeP & Get SOMe SleeP

1

When VMH opens its doors to its new, four-bedroom, Bland Bekkedal Center for Hospice Care in-patient resi-dence in Viroqua in late summer 2013, the facility will fill a desperately-needed health care niche while fulfill-ing a longtime dream of this nonprofit hospice that has served Vernon and surrounding counties for three-plus decades.

Located on 6.3 acres at 705 Arena Drive, Viroqua, VMH’s hospice house will offer a warm, tranquil envi-ronment where patients and their loved ones can spend their last days together. With an R.N. on duty around the clock, patients will enjoy the quiet peacefulness of their private room, bathroom and patio, plus indoor and outdoor amenities.

VMH Hospice Manager, Donna Nelson states, “We have arrived full circle from our inception in 1982 when our team of pro-fessionals and trained hospice volunteers first began caring for terminally ill patients. Twenty-five years later, in 2007, the concept of offering a homelike environment for pa-tients to live in comfort, safety and withdig-nity became a part of VMH’s strategic plan.”

Currently, only two freestanding hospice residences exist in our area, the closest being in Madison and Tomah. Our Hospice House extends our VMH Hospice mission of help-ing people have a peaceful life-through-death experience by offering a welcome end-of-life home for those who need it most.”

VMH will provide all levels of hospice care within the residential setting, with an

emphasis on those with the highest level of need. Cli-ents will be accepted based on a physician order and on Medicare regulations regarding appropriateness for hospice. Through a holistic combination of continuous symptom control, integrative therapies, spiritual sup-port, respite care, family counseling and assistance with the practical tasks of daily living, VMH’s Hospice House team of staff and volunteers will create a program to suit the individual needs of each resident.

The VMH Foundation embarked on a Capital Cam-paign to support building and ongoing operating costs for The Center for Hospice Care in May 2011. Nelson says, “Significant funds are needed to fill the sizable gap between what insurance covers and what patients need.” Nelson, along with Campaign Co-chair, Jana Dregne and members of the Capital Campaign Committee have met with individuals, busi-nesses, foundations and other organiza-tions to present diverse giving opportu-nities in accordance with the wishes of the donor. Nelson says, “I invite people to contact me at 608-637-4362 to make an appointment to discuss additional giving opportunities .”

Bland Bekkedal Center for Hospice Care nearing CompletionlONGtiMe dreaM tO BecOMe a reality

in This issueVmH investigates...Your Lab Results Are In...Investigated by: VMH Laboratory Manager, Gary Tricker

page 5

Trainer’s CornerTeaching you DIY fitness tips to keep you healthy!

page 4

VmH spotlight on HealthWe look forward to hearing your comments about the Spotlight On Health. Please send all comments to:

pubrel@vmh.org (608) 637-4219

priorities“all in a good night’s sleep”Dr. Deborah Prior discusses how important a good night’s sleep really is to our systems.

page 6

gardening pain?VMH Occupational Therapy shares tips for making your gardening season pain free and more enjoyable.

page 8

The Bland Bekkedal Center for Hospice Care (above) will have a walking path and gardens for patients and families to walk if they seek fresh air and solitude.

2

Spring 2013 • Vernon Memorial Healthcare • Spotlight On Health

Medical Staff activeemergency MedicineYvonne Brault, M.D. Anthony L. Macasaet, M.D.Paul Mariskanish, M.D.Patrick Scott, M.D.family PracticeBen Agar, M.D.Paul Bergquist, M.D.David Chakoian, M.D.James DeLine, M.D.James R. Feltes, M.D.Joann Fouts, D.O.David Hubbard, M.D.Michael Kalinosky, D.O.Duane Koons, M.D.Richard E. Long, M.D.R.A. Macasaet, M.D.John Porter, M.D.Lucas Readinger, M.D.Jon Radcliffe, D.O.Elizabeth Roberts, M.D.Shawn Sedgwick, M.D.Brian Woody, M.D.General PracticeBill Calkins, M.D.Deborah Prior, M.D.General SurgeryR.A. Macasaet, M.D.Michael Thorstenson, M.D.Alexander Wade, M.D.OrthopaedicsJeffrey Lawrence, M.D.Mark Romzek, D.O.PediatricsJeff Menn, M.D.

Medical affiliateS StaffNurse MidwifeKim Dowat, MSN, CNMJennifer Eissfeldt, CNMNurse PractitionerBernadette Adams, FNPKris Brueggen, RN, MSN-CS, FNPSheila Kupersmith, MS, RN, FNPSusanne Mlsna, RNC, MSN, FNP, WHNPKelly Scheder, APNPPatricia Swasko, FNP, APNPErin Uhe, APNPOptometryAndrew Nahas, O.D.Kenneth Purdue, O.D.Physician assistantTom Franke, P.A.-CColin Kratochwill, P.A.-CRandy Mickelson, P.A.-CTamsen Morgan, P.A.-CJuliane Nevers, P.A.-CTammy Pedretti, P.A.-CAnn Sherry, P.A.-CLisa Varnes-Epstein, P.A.-CBehaviorial HealthRandall Kahn, MAKevin Schmidt, MSWPaul Schmidt, MSSW, LICSW, CADCNurse anesthetistBrian Miller, CRNAArnold Nomann, CRNAGreg Sauer, CRNADennis Stalsberg, CRNA

cOurteSy StaffaudiologyAngela Manke, Au.D.cardiologyKristen Andresen, M.D.Mary Jo Burke, APNPJayne Laylan, NPJanice Schroeder, NPRajah Sundaram, M.D.Julie Wypyszynski, APNPcardiothoracic SurgeryPrem Rabindranauth, M.D., FACSdentalSteven Solverson, D.D.S.dermatologyJames Hogan, M.D.endocrinologyArnold Asp, M.D.GastroenterologyKenneth Horth, M.D.James Groskreutz, M.D.Steven Schlack-Haerer, M.D.General PracticeCarol Dinges, M.D.HematologyJohn Farnen, M.D.Kaye Johnston P.A.-CNeurologyMary Goodsett, M.D.Gregory Pupillo, M.D.NephrologyMargaret Myhre, MSNBalaji Srinivasan, M.D.OB/GynecologyDeborah Simon, M.D.OncologyKurt Oettel, M.D.OphthalmologyPaul Kuck, M.D.Oral SurgeryDavid Ludington, D.D.S.Otolaryngology(ear, Nose, throat)Edwin Overholt, M.D.PathologyDaniel Schraith, M.D.PodiatryHeather Chestelson, D.P.M.PsychiatryDavid Van Dyke, M.D.PulmonaryScott Skibo, M.D.rheumatologySharon Barnhart, MSN, APNPradiologyCarl Decker, M.D.Barbara Knisely, M.D.Paul Leehey, M.D.Brian Manske, M.D.Anna Myklebust, M.D.John Pape, M.D.Ewa Plagman, M.D.Cameron Roberts, M.D.Jedadiah Schaller, M.D.Lonnie Simmons, M.D.Paul Stanton, M.D.Daniel Wolbrink, M.D.urologyMarvin VanEvery, M.D.

BOard Of directOrSLee CunninghamTim GaskellRoger JohnsonDr. Robert KnadlePhyllis MalinRon MoilienJerry MoranEnid NeubauerBonnie RathJudy SchmirlerTrudy Wallin

adMiNiStratiONChief Executive OfficerKyle BakkumChief Operating OfficerKristy WiltroutChief Financial OfficerMary Koenigassistant administrator ofclinic OperationsDan Nelson

Dear VMH, I would like to take this opportunity to express my gratitude to Vernon

Memorial Hospital, Dr. Jeffrey Lawrence, Dr. Richard Long and all the staff, especially those on the 2nd floor that took care of me when I had a total knee replacement on January 14, 2013. The one thing my wife Deb and I noticed was that you all seem to work together as a team and that every-one is important to that team. Pat yourselves on the back as it does take everyone to make a stay at the hospital a pleasant one.

Most generally, hospital food isn’t the best. Yours is the excep-tion! Not only was there variety, it was delivered piping hot! I was also impressed that for $5.00 I was able to get a meal brought to the room for my wife. She also enjoyed going to The Grille where the food was exceptional and the people were so pleasant.

I had the most caring, excellent and personable care at Vernon Memorial Hospital. Everyone introduced themselves, asked how I was and would all ask if I needed them to get anything for me or my wife. My wife always says, “How beautiful a day can be when kindness touches it!” That is how we felt all the time during our stay.

I was impressed with the information I received from the nurse anesthetist before, during and after my procedure. He made me feel safe and comfortable even before giving me medication. I was so comfortable, I watched the surgery. Watching the surgery was the best thing I ever did. It provided me a chance to ask ques-tions which Dr. Lawrence so patiently answered. It provided me a better understanding and knowledge of the procedure being performed on me.

Nurses and CNA’s are extremely important to Dr. Lawrence. He is putting his patient into their care after he does what he has to do. They all were exceptional and you knew they enjoyed working at Vernon Memorial Hospital as they had nothing but kind words to say about their jobs. Everyone knew what they had to do which made the change of shifts such a smooth transition. Thank you to each and every one of you for taking such good care of me!

Now to the people who make rehabilitation so important, occupational and physical therapy. These two entities were top notch! They transfer their passion toward their jobs to the patient in caring for them and teaching them to make their rehab at home a happy experience.

Last but not least, Dr. Lawrence. VMH can be so proud of this exceptional physician. He talks to you like he is your best friend, yet he is teaching all the time.

Having only been in the hospital twice in 63 years, it was so comforting to know that so many were interest-ed in my well being. Your commitment to educate and provide a safe environment for the patient is commend-able. For this, I will always be grateful and thankful.

Sincerely,John Rima - Decorah, Iowa

Send Us Your Story!Do you have a special story about a VMH experience or

one of VMH’s staff? We’d like to hear from you!

Please email your story to:pubrel@vmh.org

You may also send your story via mail, please send to:

vMH Marketing507 South Main

viroqua, Wi 54665

VMH Mail Call!

sleep, from p1

Do YoU Have a Sleep DiSorDer?Take this short quiz to see if you should ask your provider about scheduling a sleep study at Vernon Memorial Healthcare.

do you snore?

are you excessively tired during the day?

Have you been told you stop breathing during sleep?

do you have a history of hypertension?

is your neck size >17 inches (Male) or > 16 inches (female)?

do you wake up to use the bathroom more than twice a night?

Have you ever fallen asleep while driving?

yeS NO

________ ________

________ ________

________ ________

________ ________

________ ________

________ ________

________ ________

Answering “yes” to two (or more) of these questions may be a positive screen for Obstruc-tive Sleep Apnea. Consider talking with your primary health care provider about a referral for a sleep evaluation or sleep study at Vernon Memorial Healthcare.

Patients who receive a provider referral to undergo a sleep study at VMH would typically arrive at 8:00 pm and stay until 6:00 am the following day. Bathrooms and shower facilities are available.

After the sleep study, patients will receive follow up from a Board Certified Sleep Special-ist who will review the results of the study with the patient and initiate therapy as needed.

CLIP IT & TAKE IT! "

Students pursuing careers in health care are invited to apply for over $12,000 in schol-arship awards being offered this year by the Vernon Memorial Healthcare Foundation and Friends of VMH.

The applicant must be a student currently enrolled (and accepted) in a degree program at an accredited college, university or tech-nical school pursuing a degree in a medical, nursing, or health care related field. The ap-plicant must be entering their final academic year of a technical, certificate, or associate

degree program or completed at least two years of study in a bachelor de-gree program.

The ap-p l i c a n t

m u s t

have achieved a grade point average of 3.0 (on a 4-point scale), or equivalent, for the academic year immediately prior to appli-cation. Previous scholarship recipients and applicants may reapply for further financial assistance.

The 2013 application is now available online at www.vmh.org under Giving Back, Foundation Scholarships. Questions regard-ing the scholarship program may be ad-dressed to Julie Steiner at 608-637-4219 or jsteiner@vmh.org.

A personal essay, three letters of recom-mendation, a current grade transcript and recent photograph are required to be sub-mitted with the completed application. The application deadline is July 1st, 2013.

3

Spring 2013 • Vernon Memorial Healthcare • Spotlight On Health

Health Care Scholarships available to College Students

s p o r t s p e r f o r m a n c e

conditioning|acceleration|mobility|plyometrics

C.A.M.PC.A.M.PSports Performance CAMP (for-

mally Summer Sports Conditioning) is a redesigned and improved sum-mer camp for middle school, high school, and collegiate athletes.

Participants should be prepared to work hard as they condition their body, improve mobility, and enhance their general athleticism during this 6 week summer camp. Athletes will also be taught techniques to decrease their risk of injury during practices and games.

VMH Athletic Training and Well-ness Center staff are excited to offer this program in two locations. “By offering this program in Viroqua and La Farge, we’re hoping to help a greater number of our local youth prepare themselves for the sports they’re passionate about.” said Ni-cole Robinson, VMH Athletic Trainer.

Interested participants may com-plete the registration form below to register for the 6 week program at ei-ther Viroqua High School or La Farge High School.

la farge caMP will be held Mon-days and Wednesdays, 9-11 a.m. from Monday, June 17 - Wednesday, July 24.

Participants should register by June 2nd if interested in the La Farge CAMP.

viroqua caMP will be held Tues-days and Thursdays, 9-11 a.m. from Tuesday, June 18 - Thursday, July 25 (no session July 4th).

Sports Performance CAMP invest-ment: $125 for new participants

$25 off for past participants of “Summer Sports Conditioning” or mulitple participants from one household. Limit one discount per person.

VMH Athletic Training and Well-ness Center staff look forward to bringing the participants a fun and high quality program that enhances their future athletic goals.

Please contact Nicole Robinson at 637-4385 or nrobinson@vmh.org if you have questions.

participant infoParticipant first Name: ________________________________________________________

Participant last Name: _________________________________________________________

School Participant attends: ___________________________________________________

Grade in School: _______________________________

address: __________________________________________________________________________

city: _________________________________ State: ___________ Zip code: _____________

email: ___________________________________________ Phone: ________________________

sports HistoryPlease list the sports you participate in and how long you have been participating in them:

______________________________________________________________________________________

______________________________________________________________________________________

please circle your answers to the following:t-Shirt Size (adult sizes): Small Medium large X-large 2X-large

Please register the above participant for the following caMP:

la farge caMP location Or viroqua caMP location

i have enclosed the following payment to complete my registration:Please circle: caSH Or cHeck for the amount of: ____________________

if you prefer to pay with a credit card, you may register online at: vmh.org > Classes & events > scroll to June 17 or 18 for instructions

C.A.M.PreGiStratiON

please complete the following form for the Camp of your choice

and mail to: VmH marketing 507 south main st.Viroqua, Wi 54665

CLIP IT & SEnd IT! "

4

Trainer’s Corner Get acquainted with the VMH Wellness Center - Certified Personal Trainers. Check this area each Spotlight on Health to find exercise tips, new ways to tone up, and what we do to stay fit! Questions? Let us know! We’re here to help you! Call the VMH Wellness Center @ 637-4290 to start your new workout routine today!

Spring 2013 • Vernon Memorial Healthcare • Spotlight On Health

Teaching you DIY fitness tips to keep you healthy!

overhead presses are a great way to build shoulder strength and stability, as well as targeting those hard to tone triceps. **Please note, if you have shoulder mobility issues it is recommended that you talk with a trainer before adding these exercises to your routine.

CLIP IT & KEEP IT! "

HeartSaver cPr $40The Heartsaver CPR course trains lay rescuers to

recognize and treat life-threatening emergencies with adult, child, and infant victims. It includes sections on CPR and relief of choking in adults and children, as well as infant CPR and relief of choking. It supports the Heartsaver CPR course for responders who require a credential for completion.

June 7 • September 13 • 8 a.m.

HeartSaver firSt aid $30The Heartsaver First Aid course provides training in

basic first-aid procedures – including the first-aid skills recommended by OSHA – in a format that can be deliv-ered in a single day. It also offers elective modules in CPR, AED, and environmental emergencies.

The Heartsaver First Aid course is specially designed to train anyone who might be the first to respond in the workplace or community. The course can be tailored to address the needs of a specific workplace or group of employees.

June 7 • September 13 • 11:00 a.m.

cOMMuNity cHOleSterOl ScreeNiNGJune 5 • 6:30 - 7:30 a.m.June 19 • 7:30 - 9:30 a.m.July 3 • 6:30 - 7:30 a.m.July 17 • 7:30 - 9:30 a.m.August 7 • 6:30 - 7:30 a.m.August 21 • 7:30 - 9:30 a.m.Total Cholesterol and glucose(non-fasting) fee: $20lipid panel (12 hour fast required) fee: $40

TeaCHing YoU HealTH & wellneSS aT vMHCheck www.vmh.org for a complete list of classes and health screenings offered by VMH Health Educators and providers. Register online for your next BLS Recognition class or sign up your 11-year old for the next session of Safe Sitter! Questions? please call 637-4298 for more information.

Safe Sitter $40 (1 day course) - $65 (2 day course)

As a babysitter you take on a very important role. Babysitting can, and should be fun. But accepting a babysitting job also means accepting the responsibility for a child’s life. Students must be 11 years old by the date of the course to participate. Other June dates avail-able, please contact VMH Health Education for more in-formation.

June 18 & 25 (1 day course) • 9:30 a.m. - 3 p.m.June 11-12 (2 day course) • 9:30 a.m. - 3 p.m.

(Day two: 9:30 - 11:30 a.m.)

BaSic life SuPPOrt fOr tHeHEaltHCarE PrOviDEr (BlS) $40June 21 • July 19 • august 16 • august 308 a.m. recognition • 12:30 p.m. renewal

ParEnt-tOt Swim $30Parent-Tot Swim provides a relaxing, warm water

environment for parent-child interaction. Children ages 6 months to 3 years are welcome.

6 week session: September 12 - October 175-5:45 p.m.

cHildBirtH educatiON $45 Childbirth Education classes present prospective

parents with practical lessons on the labor and delivery process as well as breathing and relaxation techniques which can ease discomfort during birth. Included are discussions on nutrition and diet, the use of medication and anesthesia during labor, caesarean birth, post par-tum emotional and physiological changes, maternal and newborn care after delivery, parenting, and a tour of the VMH Birthing Center.

July 30 - august 13 • 7-9:00 p.m.BreaStfeediNG iS BeSt $10

Breastfeeding is Best is a course taught by Certified Breastfeeding Educator, Tara Berg. You will learn tech-niques to make the breastfeeding experience rewarding and healthy for you and your baby.

august 20 • 6:30-8:00 p.m.

vMH SWiMMiNG leSSONS $30Children ages 3-10 years old will gain the knowledge

of pool and water safety while learning how to swim in a safe environment.

October 21 - 254:30-6:30 p.m.

The following courses are for individuals in the health care field. For complete descriptions and reg-istration information please visit: www.vmh.org.aDvanCED CarDiaC liFE SUPPOrt (aClS) renewal (1 day) 8:00 a.m. • June 27 • $200recognition (2 day) 8:00 a.m. • Oct. 17 & 18 • $225

Beginner: seaTed Keep abs tight, feet on floor, butt on bench, and back against pad. Elbows should be under and slightly in front of bar. Press bar over head, think: bi-ceps to ears.Keep wrists strong and knuckles to the ceiling.

avOid pressing bar in front of head (pictured at right). this is poor form and could result in injury.

Pediatric advaNced liFE SUPPOrt (PalS) $225September 5 & 68 a.m.

ecG/PHarMacOlOGy $75June 38 a.m.

intermediate: sTanding Keep abs and glutes tight, stand tall. Elbows should be under and slightly in front of bar. Press bar over head while keeping your abs tight. Do not hyperex-tend your lumbar spine (lower back) as you press the bar over your head.

avOid pressing bar in front of head (pictured at right). this is poor form and could result in injury.

advanced: hAndSTAnd PUShUP **always use spotters and a trainer when learning the handstand pushupIn handstand position, keep hands flat, and a straight line between ankles, knees, hips, shoulders, elbows, and wrists. Keep abs tight, look at wall or object in front of you to maintain neutral cervical spine (think good straight posture). Lower yourself until top of head touches mat.

avOid looking at the ground causing hyperextention of the spine (pictured at right).

POOr fOrM

POOr fOrM

POOr fOrM

Spring 2013 • Vernon Memorial Healthcare • Spotlight On Health

We as health care professionals affect the lives of our patients in a multitude of ways. Whether it’s the man with the frac-tured neck that was kept from permanent paralysis; the child that was pulled from a grain slant box that had the breath of life

restored to her; the office worker with an allergic reaction who was administered epinephrine in time to keep him breathing or the teenager extricated from an over-turned vehicle, each of these events had a successful result made possible by ap-propriate training, experience and proven procedures. These are hands on experi-ences from 30 years of first line health care as an EMT.

These events, while not insignificant, pale in the face of the number of chal-lenges encountered on a daily basis in

our VMH laboratory. Every specimen we handle represents a piece of someone’s life. We do our best to ensure that we are providing the right test at the right time with the right specimen in order to make a positive contribution to the future of the patients entrusted to our care.

Statistics show that 70 percent of all patient diagnosis and treatment is based on laboratory results. We apply training, experience, ethical principles and proven procedures to ensure that every test re-sult is the highest quality data that we are able to produce. The pre analytic portion of the testing process is where the majori-ty of mistakes can occur. Incorrect or mis-leading test results due to error could end up causing major problems in the future treatment of the patient.

It is our responsibility as laboratory professionals to use our expertise and resources to help our medical providers choose the appropriate test for the pro-posed diagnosis. Assuring that a speci-men is collected at the right time is very

important. Metabolic factors (the bio-chemical processes involved in the body’s normal functioning) can change the con-centration or activity of a given compound and cause misleading lab results and an incorrect diagnosis or treatment.

A mislabeled specimen, collecting the wrong type of specimen, not collecting the appropriate volume of sample or not following the correct collection or storage procedure could result in a specimen that is not appropriate for testing.

The analytical portion of the testing process has its own set of testing condi-tions that need to be met before a test result can be reported. This is the most tightly controlled and automated part of the process. Controls are performed on a regular set time frame helping to mini-mize the variation present in the testing system. Modern testing equipment has been proven to provide more consistent and accurate results than manual proce-dures performed by technologists. The goal is to make any variation in a given pa-

tient’s history traceable to a change in the patient’s condition caused by either biol-ogy or the behavior of the patient. This is not about just having a result, but having the right result!

The post analytic stage is another step fraught with error. Getting the result to the medical provider is a process with its own set of obstacles and barriers. The loss of the test data in the exchange of communication between the lab and the provider does occur. This part of the pro-cess is constantly under review by mul-tiple departments in order to minimize disruptions to patient care.

Medical laboratory professionals play a vital role in every aspect of health care to ensure that patients receive the right tests, the right diagnosis, and the right treatment. By doing so we can without a doubt say that we have done our part to ultimately save someone’s life.

vMH inveSTigaTeS...if you have a question, TV show, or news article you’d like one of our VmH experts to investigate, email: pubrel@vmh.org or write to: VmH marketing, 507 s. main st., Viroqua, Wi 54665

Your lab results are in...

5

in this edition of VmH investigates, gary Tricker, VmH laboratory manager, gives us a better understanding of how the Vernon memorial Healthcare laboratory works.

Disaster preparedness and manage-ment in health care has changed dramati-cally since September 11, 2001. Hospitals and clinics are “on the front lines” in inci-dents where nuclear, biological, chemical or explosive agents like those used at the Boston Marathon are deliberately used as weapons in our communities. Hospitals and health care facilities are key compo-nents of our communities’ disaster man-agement response.

Vernon Memorial Healthcare has a comprehensive emergency management plan in place in the event of a natural di-saster such as a tornado or flooding or a man-made disaster like an explosion, chemical release, or a rare infectious disease outbreak.

The purpose of a disas-ter plan is to prepare us to respond and recover from a natural or man-made disas-ter so that we may continue to provide treatment and pa-tient care in extenuating cir-cumstances. A VMH Safety/Disaster committee works closely with local public health officials, county emer-gency government staff and the state emergency manage-ment agency to ensure that emergency preparedness is a coordinated effort. VMH staff participate in yearly emergency response exercises like the disaster training which took place at the hospital on April 29th. Exercises such as these help VMH improve proficiency in executing its disaster response.

about the expert Gary Tricker serves as the VMH Laboratory Manager and is very involved in organizations connected to the medical/clinical laboratory field. He is Chair-elect of the Shared Health Services Lab Alliance and has been a member of the Executive committee of the Lab Alliance for the past 6 years. His laboratory leadership with Shared Health Services has afforded him the opportunity to serve as a member of a national Amerinet clinical lab member input group. Tricker is a 40 year member of the American Society of Clinical Pathologists. He was the 2012 President of the Coulee Region branch of the Wisconsin Society for Clinical Laboratory Science. Tricker served as an EMT for 30 years.

vMH prepared to respondiN tHe Wake Of BOStON MaratHON traGedy, vMH PrePareS

Romelle Heisel, VMH Infection Control Nurse explains disaster protocols to VMH staff.

VMH staff tour the decontamination tent used to clean patients from toxic, infective, caustic, or unhealthful substances.

All of us need sleep. We all have experienced times when we haven’t slept well or our sleep has been interrupted, making it difficult to function the next day. What is recognized more and more is how

sleep impacts our health. Sleep is restorative. It affects our

ability to think and store memory. It affects our body’s immune function and

ability to fight disease. Our metabolism and how we process food is altered by sleep or the lack of it. Risk factors for heart disease and high blood pressure have been linked to sleep disorders.

Good sleep habits help to improve the quality of sleep. Develop a routine before going to bed. Slow down. Don’t do your daily exercises right before bedtime. Use your bed for sleep, not screen time to play video games or to catch up on work or watch television. Make sure the room temperature is comfortable.

If your sleep is disrupted and you find yourself having trouble falling back to sleep, don’t fight it. Get up and do

something boring like folding laundry. Return to bed when you feel sleepy again. Avoid napping during the day. It can interrupt your circadian rhythm.

Certain health conditions can lead to sleep problems. Chronic illnesses like arthritis, congestive heart failure, or de-mentia can cause disturbed sleep. Some mental health illnesses like depression can cause sleep disturbances. Female hormonal changes during pregnancy or menopause may make it difficult to sleep.

We need to be sure that sleep inter-ventions are effective and safe. Research is teaching us more and more about sleep disorders

and how to improve the quality of our sleep. Sleep studies are now being per-formed at Vernon Memorial Hospital. A sleep study or polysomnogram electroni-cally senses and records specific activi-ties while we sleep. This information can be interpreted by a medical provider to aid in diagnosing and treating a sleep disorder, including snoring, sleep apnea, insomnia, sleep deprivation, and restless legs syndrome. If you are experiencing a sleep disorder speak with your medical provider. A good night’s sleep is worth it.

Take care and sleep well!

6

Spring 2013 • Vernon Memorial Healthcare • Spotlight On Health

Priorities all in a good night’s Sleepdr. deborah Prior, Hirsch clinic - vMHgET good SLEEP, doCTor’S ordErS!

Research-based programs performed by occupation-al, physical and speech therapists at Vernon Memorial Healthcare are impacting the quality of life for patients with neurological conditions such as Parkinson’s dis-ease. Speech therapists at VMH have used Lee Silver-man’s Voice Treatment (LSVT) LOUD program since 2011 to improve the voice and speech of patients. LSVT LOUD therapy focuses on strengthening vocal and respi-ratory muscles to improve voice volume, breathe sup-port and articulation.

Occupational and physical therapists at VMH were trained in 2012 in LSVT BIG, to address the unique movement impairments that patients with neurological conditions encounter. Therapists work with patients to improve motor skills like walking, arm and leg move-ment, and balance and hand manipulation skills such as writing or buttoning a shirt. The LSVT BIG approach helps improve a patient’s quality of life by stressing the importance of remaining active and using BIG movements to improve everyday tasks.

Diane Mamroe of Viroqua is grateful that a con-versation with VMH Occupational Therapist, Jen-elle Boyer, led to her provider’s referral and her participation in LSVT BIG. Mamroe, who was di-agnosed with Parkinsons Disease in 2006, felt she needed something to help her with her balance and coordination.

Mamroe spent four days a week for four weeks working with VMH Occupational Therapist Ilana Pescoe and physical therapist, Joe Willis. “It’s hard to explain,” Mamroe said, “but instead of hunching over I tell myself to use my limbs, walk with more strength and put more energy into my movement. It makes a difference. The exercises get me through some of the bad moments I may be experiencing with my disease, for instance if I feel clumsy.” Mam-roe recalls a time when she couldn’t pick up coins,

twist off a bottle cap or button a shirt. “Now I think about what my body, limbs, or fingers need to do and then I’m able to perform the various steps of the task,” she said. “It’s even helped me with my writing.”

“The debilitation of Parkinson’s can be discouraging,” Mamroe said, “I’m really happy that LSVT BIG is some-thing that I could do that would help. I would absolutely recommend it to other patients.”

Judy Wubbenhorst of Westby has been dealing with the effects of an auto immune disease she was diag-nosed with in 2007. The disease, she referred to as Stiff Person Syndrome, causes progressively severe muscle stiffness typically in the spine and lower extremities. An evaluation by VMH Physical Therapist, Joe Willis brought forth his recommendation for the LSVT BIG pro-gram. In Wubbenhorst’s case, Occupational Therapist,

Ilana Pescoe explained that our nervous system is adapt-able and new nerve pathways and muscle responses can be stimulated with specific motion patterns.

Wubbenhorst opted in and enrolled in the intensive four week pro-gram. While not easy, Wubbenhorst admitted, “It’s the most wonderful program I’ve ever been involved with.”

As an LSVT BIG pa-tient, she traveled to VMH an hour a day, four days a week in addition to doing exercises pre-scribed for her at home. Wubbenhorst said she appre-ciated the visual contact and one- on-one attention she received. Since participating in the program, Wubben-horst is once again able to reach into upper and lower cupboards in her home, climb in and out of her car and walk with a cane versus a walker around her home. “I fully intend to be able to walk unassisted by this sum-mer,” Wubbenhorst said, “That’s something I haven’t been able to do in five years.”

Along with her neurological condition, Wubbenhorst also relies on VMH occupational therapists for treatment of her lymphedema. She struggles to keep her left arm from swelling since her lymph nodes were removed dur-ing breast cancer surgery.

Wubbenhorst said the relief she received from the specialized light massage treatment provided by Ilana Pestcoe, OTR and Andi Yttri, COTA was amazing. “The education and other treatment tips are invaluable,” she added. “What the occupational therapy staff at VMH knows about lymphedema is more than anyone can learn on their own. They are just easy to work with.”

lSvT Big & loUD program gives patients new life

VMH Physical Therapist Joe Willis (right) practices the LSVT BIG pro-gram with patient Judy Wubbenhorst (left). Wubbenhorst has seen a significant improvement in movement since starting the program.

VMH Physical Therapist Joe Willis (left) and Judy Wubbenhorst.

SleeP nuMberSfrom the Centers for disease Control and prevention:Sleep guidlines from the National Sleep Foundation have noted that sleep changes as we age. It should be noted that there is no ‘magic number’ because sleep needs vary.

newborns0-2 months 12-18 hours

infants3-11 months 14-15 hours

toddlers1-3 years 12-14 hours

Preschoolers3-5 years 11-13 hours

School-age Children5-10 years 10-11 hours

teens10-17 years 8.5-9.25 hours

adults18+ years 7-9 hours

How do your family’s sleep numbers compare?

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Spring 2013 • Vernon Memorial Healthcare - Memorials & Donations • Spotlight On Healthin memory/Honor ofDonorcardiac reHaB fuNdSons of NorwayHarlan seymourFriends of Harlan SeymourNaomi Seymourorrin paulsonHarold Sturgilllma smithGary & Judith Gilbertson

HOSPice HOuSeAutoTrader.com, Inc.John & Joanne BentzEcore Commercial FlooringJeanne & Steve MuellerDonald & Helen ParrAnna PetersKenneth & Mrs. Jane PurdueRoger & Marilyn ReinartSchmidt Goodman Office Products, Inc.Loretta SkorieGary & Lois StuelandViroqua Food CooperativeShirley Wuenschsusan abbeyJay CasperBobby Crumerineleon primmer, Jr.Thelma skrededonald WeberLarry & Annabel McGarryCarmen armbrusterdonald Bronsonedward Carrlillian Ciminoevelyn dainesedith egenessernest erlandsonrobert eversonBobby HaugeJean marcinkowskimargaret mcgregorBill mcguireleonard myerCarol odeendon saunderslinda skaalandThelma skredealma smithHomer TresnerDave & Jana DregneCarmen armbrusterlydia Berktoldemerson KoldaJoan JohnsonlaVerne Kilmerallen mooreBirger & Phyllis EklovTom arnesonroger Bolstadeddie Carrgordy ClementsBunny delaprobert guckedith egenesslarry eversonJeremiah HornbylaVerne Kilmerart lundellmargaret mcgregormary mockrudTony spaethLois Tryggestadlorraine Bjornstad-JohnsonCarol odeenSherman & Esther ErlandsonCelesta BurkumVirgil gilbeckBob guckowen Kochmons langhusdonald ostremorrin paulsonCarter Thompsonramona ThompsonKaren Allness

dortha drakearthur HareboJeff & Georgia Eversonrobert eversoned steinBeverly WallaceJeff & Georgia Eversonsusan gramsmary mockrudHomer TresnerFriends of Vernon Memorial Healthcareian airdLinda EversonTom & Pat FiskoJohn & Sharon GrimGarith & Julie SteinerJon & Julie WalbrunCarmen armbrusterEunice HillmanAlvin & Phyllis MalinAnn & Kevin Sherrystanley T. leerChet & Bea LeeClarissa BertlingLinda EversonJune CalkinsWilliam Calkinsedward CarrDave & Jana DregneCharles & Ruth LeeChet & Bea Leerichard ChristiansonSherman & Esther ErlandsonLori & Tony FordeCharlene Pedersonlillian CiminoSherry Yaungordon ClemmentGordon & Carol ClemmentPatricia Onshusregina ConnellyShirley Lathamevelyn dainesGary & Mary DainesAlvin & Phyllis MalinBunny delapCatherine Schlichtedith egenessRoland & Louise HillBob & Barb SolversonAlan & Joyce SolversonLaurence & Helen Stephenluella galstadDonald & Melanie Rolesusan gramsFrances BekkedalAlvin & Phyllis Malinray HartGreg & Crystal AndersonJoe & Ann BerraMarvalene BurtBobby HaugeMary Holteelva HetzelMarvalene BurtBonita DorschiedTom & Cate FrankeEunice HillmanWeston & Karen MackAlvin & Phyllis MalinJanet WilliamsJonathan HoffDoug & Nancy BeanJoe & Ann BerraJoe & Rachel Schroederdelma HoganDoris Sorensonelaine HorstmanCindy & Duane HansonTom JacobsonSteven & Barbara Burke

lorraine JohnsonJoyce MalinDonald & Melanie RoleBetty JohnstonJack & Bonnie RathWayne larsonJames Kingslien & Suzanne KellyJim ledmanLaVerne & Dolly LisneyClarence & Anna Jane NordinJames robert lynchSherry Yaunmargaret mcgregorTom & Cate FrankeAlvin & Phyllis MalinPatricia OnshusSandra Vold-BrudosShirley WuenschBill mcguireJames & Rebecca Larsonmary mockrudJune BurosLola FortneyJames & Rebecca LarsonLarry & Annabel McGarryTodd & Kathleen OverboMargretta OverboMarlene PieterickDennis & Ramona Skredeallen mooreLa Vonne EnghHelen PedrettiDonald & Melanie RoleLarry & Rachel Strangstalienallen & martha mooreAlvin & Phyllis Malinearl morkridSteven & Debra ClarkMadeline ClementsJames & Joanne HohlfelderSusanne Wedwickleonard myerTroy EversonLinda EversonConnie nelsonLaurence & Helen Stephenalice nerisonDonald & Melanie RoleLarry & Rachel Strangstalienorrin paulsonJoseph A. FortneyTom petersenSherry YaunKathryn petersonMarvalene BurtRoger & Grace PetersonCatherine Schlichtrod selinClass of 1952Harlan seymourThomas & Joyce DolanNettie & Mark BeyerLezlie Barrylinda skaalandDavid & Sherrie SeidelMark & Ann SkaalandSherry YaunThelma skredeFrances BekkedalMarvalene Burtalma smithFrances BekkedalLinda EversonMark & Susan JacobsonArnold & Coralie NomannClarence & Anna Jane Nordinroger ThompsonJames & Rebecca LarsonHomer TresnerVMH Gift Shoppaul VeumPatricia Onshus

Beverly WallaceRoger Johnsondonald WeberShirley LathamSusanne Wedwick

HOSPice PrOGraMRobert FeldeGary HagenRobert & Debra HofflandLaurie & Craig KellagherCindy TurnerWestby United Methodist Churchian airdregina ConnellyKim Littellrick Boldonelva HetzelJonathan HoffTom Jacobsonlucille JohnsonChuck reynoldsChristine rosalespaula & rich Herken’s 50th Wedding anniversaryPaul & Beverly JacobsonBernard delaplaVerne Kilmermargaret mcgregorJames & Tracy HansonThomas JacobsonConnie nelsonJames & Tracy Hansonart lundellBill mcguireorrin paulsongladys stafslien-petersonJames & Tracy HansonCarmen armbrusterMike & Marie CiminoLinda & Donald Dregnelillian CiminoMike Theiss Familygordon ClemmentAlan & Beverly AspensonRoland & Rebecca HoffEdward & Rachel Wrobelregina ConnellyEvelyn HatlanLavern & Betty KilmerBunny delapArnold & Coralie Nomannedith egenessKarla AmundsonNancy BongersWayne & Esther CookJan EgenessMarilyn & LeLand EkumMilo & Susan HelgersonLois HengelJoseph HengelJames HengelConstance JacobusMary Jane JacobusWayne & Gayle JohnsonCharles & Patricia KnowerDidi Lindvig-SpringbornWeston & Karen MackMary MarxBlair & Eunice McClurgArnold & Coralie NomannRichard & Bonnie RunningDiana SlackAlice SmithMark & Rondi SolversonMarilyn TeghtmeyerKaren & Douglas TraastadMark & Colleen TroyJean WalleserRichard & Peggy WrightVirgil gilbeckMarie Bergsusan gramsDuaine & Susan DregneJoe & Rita Menne

laVon HansenHalver’s Town TapBobby HaugeJames & Joanne Hohlfelderelva HetzelDavid & Debra AbtThomas & Jane BrennanDavid & Jodie BrownAnna Mae KrauseAvanelle MajorElizabeth MatthewsRuth MullerSherrill MunsonR. Barry & Linda NehringD. M. NehringClarence & Anna Jane NordinHannora ParrMark & JoAnn PfaltzgraffArlene PietschKip & Kristine Walkerroger hof�landRoger & Eleanor Zogglorraine JohnsonSusanne WedwickBrandon larsonCurtis & Jean GeierJim ledmanWyman & Carol CadeMava ClarkEarl & Arlene GilmanRoger JohnsonLorraine LawtonPieperlineAlice RasmussenJohn & Sara Youngmargaret mcgregorRoger & Mariam HatlemCarol odeenThomas & Gelynne MillerArnold & Coralie NomannRichard & Luann Schmidtrichard olsonAndy & Jeanne Skrederuth robertsonEvelyn HatlanThelma skredeArnold & Coralie NomannMary Tryggestadalma smithSusanne Wedwickora lee sovaRobelynn AbadieAmeritas Life Insurance Corp.David & Virginia ArmstrongKen BernsteinMarvin & Linda DeGarmoEagle Title CompanyRoxanne FeldeLewis KatcherMarjorie & Raymond LeeJan MarlotRev. James & Gail MummRuth RustKathryn SchroederSusan SieglerShirley SovaDarlene TimmerRobert & Mary Alice Wallaceed steinPaul & Beverly JacobsonHomer TresnerRoderick & Monica AspensonArlen & Mary EricksonJudy HohmannRachel IversonAnna Mae KrauseAvanelle MajorHannora ParrJack & Bonnie RathRobert & Janet Starrdonald WeberAlmon & Sonja FortneyRichard & Agnes Roberg

SteiNer cONtiNuiNG educatiON fuNdTom JacobsonlaVerne KilmerBill mcguiremary mockrudrichard rubaschHomer TresnerGarith & Julie Steiner

traNSPlaNt SuPPOrt fuNdChuck reynoldsMark & Bonnie AndersonGabrielle Kurth

uNreStricted Warren & Pat KlebigBob RobbinsSidney & Karen JeromeJohn & Deb RimaCarmen armbrusterJohn Armbrustergordon ClemmentJack & Bonnie Rathsusan gramsBob & Shirley GallagherJonathan HoffJeff & Georgia Eversonroger hof�landMarian Johnsondavid e. JohnsonCarol McLeeslaVerne KilmerFriends of Vernon Memorial Healthcarerobert & Jeanine mathis 50th Wedding anniversary Robert & Jeanine Mathismargaret mcgregorWilliam & Sandra Marohlmary mockrudMarlene Pieterickearl morkridRoger & Lynn Farrellorrin paulsonWillard & Ann Carlowiestyn James powellKay & Craig Starrora lee sovaMark RosenbaumDouglas SarbachHomer TresnerJames & Sue Ann Olson

verNON MeMOrial GueSt HOuSeMel ButikoferJoanne & Jerry CummingsKathryn & Marvin HohlJohn & Sara Wagner

Thank You “200 Women”

DonorsBev BjornstadCarol Odeen

HuBBard NaMed aS NeW KvmC-vmH PrOviDEr

Kickapoo Valley Medical Clin-ic-VMH welcomes David Hubbard, M.D. Dr. Hubbard will begin his practice in Soldiers Grove July 1st. Dr. Hubbard comes to Soldiers Grove from Boscobel.

Dr. Hubbard is no stranger to the area. He is a native of Norwalk, Wisconsin. His wife, a pharma-

cist, is from Ontario.

Dr. Hub-bard, who is board certi-fied in fam-ily practice, did his resi-dency at the Universi ty of Arkansas in Fayette-

ville. He obtained his medical education at Ross University.

Medicine is Dr. Hubbard’s sec-ond career. While working as a high school agriculture/ag me-chanics teacher, he spent time after school volunteering as an EMT. Hubbard says that’s when he discovered medicine was his true passion.

Dr. Hubbard looks forward to practicing medicine closer to home and being a part of Soldiers Grove. Hubbard is proficient at

managing diabetes and hyperten-sion, among other chronic dis-eases. He looks forward to the opportunity to get to know his patients and their interests so he can provide quality, personalized care. “By listening to my patients and becoming familiar with them, I feel I can provide great care be-cause I am aware of the unique conditions that may impact their overall health,” Hubbard said.

The Soldiers Grove area offers opportunities for Dr. Hubbard to pursue his hobbies. He enjoys traveling, fishing and bicycling. He also collects antique tractors.ScOtt JOiNS vMH eMerGeNcy dePartMeNt

Patrick Scott, M.D. has joined the Emergency Department at Vernon Memorial Healthcare. Dr. Scott, a 1987 graduate of the UW-Madison Medical School, com-pleted his residency at Gunder-sen Medical Center in La Crosse. Dr. Scott has worked as a general practice physician at Gundersen Lutheran primary care clinics in West Union, Decorah, Calmar, Prairie du Chien, Whitehall, Blair and Sparta. Since 1998 he has been an Emergency Medicine physician at Tomah Memorial Hospital, serving as Medical Di-rector there for five years. Dr. Scott began practicing at VMH on April 26th.

Dr. Scott says he likes the ex-citement that goes along with being an Emergency Department physician. “I like being able to quickly recognize and diagnose a wide variety of medical problems and then determine the most rea-sonable way to address the prob-lem,” Scott said, “I try to spend enough time observing and evalu-ating the patient to assure myself that there is nothing immediately life threatening.”

Dr. Scott said he appreciates the fact that Vernon Memorial is patient-focused while valuing the strengths of its staff. He enjoys Viroqua and the feel of the down-town.

Dr. Scott is married and has three chil-dren. His wife, Lydia is a regis-tered nurse who works in home health in La Crosse. He has one daughter in college and two mid-dle school and high school age sons.

Dr. Scott enjoys riding motor-cycle, cross country skiing and antiquing.

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Spring 2013 • Vernon Memorial Healthcare • Spotlight On Health

A Great Staff & Volunteers are our Greatest Strength

dr. david Hubbard

dr. patrick scott

If you would like to make a difference in your community, consider volunteering at Vernon Memorial Healthcare. Vol-unteering offers you the opportunity to use your skills to help others. Volunteers contribute countless hours of service to VMH each year.

They offer assistance with the non-clinical needs of pa-tients, working in reception areas to greet patients and visi-tors, providing directions and information, and assisting staff with a variety of tasks. We appreciate the extraordinary ser-vice they provide.

Prospective volunteers are required to complete an online application at www.vmh.org, participate in an interview and orientation, comply with Tuberculosis screening by having a PPD skin test (which is free of charge), and pass a security/background check.

The Volunteer Services Office is open Monday through Thursday from 9:00 a.m. to 3:00 p.m. For more information on how to become a VMH Volunteer contact Volunteer Coordina-tor, Judy Gilbertson at 637-4327 or jgilbertson@vmh.org.

Gardening season is here! Do you have pain or safety concerns while working in your garden? If so, you may be able to modify your gardening technique in order to continue gardening in a safe and fulfilling way.

Stretching and strengthening tailored to your joint problems can correct poor alignment and help prevent joint distortion so that you can keep growing your fruits and veggies for years to come.

Gardening , based on its popularity as well as its abili-ty to assist with increasing and maintaining physical and mental well being, is an activity that has been a strong focus of Occupational therapists.

According to the American Occupational Therapy As-sociation (AOTA) between 75% and 85% of households engage in gardening tasks. Occupational therapists are a great resource for those who want to continue gardening safely and without increased pain.

Occupational therapists at Vernon Memorial Healthcare are medically trained professionals who focus on task modification based on your anatomy

and knowledge about disease processes.While an occupational therapy assessment is recom-

mended for an individualized program, there are some basic joint protection recommendations and general rules. Here are some guidelines for healthy gardening techniques:

PrOtect yOur JOiNtS - Choose implements with padded or larger handles to protect joints in your hands and fingers from excess pressure and stress. Keep hoes and tools clean and sharp!

cONServe eNerGy - Sit while working to conserve energy and decrease stress on your back, knees and hips. Take rest breaks and stop work before you overtire. Try a stool or kneeling pad. Stools with long handles are avail-able in some garden catalogues.

liMit liftiNG - Watch out for those heavy bags of soil, mulch and fertilizer. Instead of moving the whole

bag, divide it into smaller, more manageable loads and use a cart or wagon to move materials. Fill your shovel halfway. When lifting, use the muscles, in your legs and not your back. Build a raised bed if possible or do some container gardening.

tHiNk SMall - Start with a small garden area that you can manage without excess exertion. Locate it near your house and water supply to reduce hauling long lengths of hose or put in drip lines when you plant.

MiX it uP - Vary your tasks to avoid overstressing any one part of your body. Change position frequently to keep from becoming stiff. Set a timer so you take a break every 20 minutes or ½ hour. Open your hands, stand up straight and move all your joints gently or take a short break and walk before you get back to work.

If you would like to obtain a more detailed personal as-sessment or more information on the services provided by VMH Occupational Therapy please contact 637-4385.

volunteersMaking a Diff erence in your community

gardening pain? we Can Help!vMH OccuPatiONal tHeraPy HelPS reduce PaiN WHile GardeNiNG

Thank you vMH volunteers!