Kettering Health | Strive | Fall 2022

How Connie found inspiration on her cancer journey FOR YOUR BEST HEALTH FALL 2022 GO, TEAM! Behind the scenes of emergency medicine at Paycor Stadium POWER UP Antioxidants offer better health with every bite Courage Through Community

Fall 2022 STRIVE is published three times a year by Kettering Health, 3535 Southern Blvd., Kettering, OH 45429, to improve the health literacy of the community and connect readers to health information and services. CEO Fred Manchur Managing Editor Carrie Bebris Art Direction Kelly Long Photography AGI Studios, John Rossi, Lee Ann Yahle, and Kettering Health staff Writing Carrie Bebris, Addison Griffin, Leigh Hall, Erin Laviola, Ben Riggs, Katlyn Stechschulte, Alexis Wisler, and Kettering Health staff /KetteringHealth @KetteringHealth /KetteringHealth Connect with us 4 Fad or Fabulous: Is apple cider vinegar the new cure-all? 5 Ask an Expert: “Why do I need annual screenings?” 6 Six screenable cancers 8 Event medicine ramps up with stadium-sized care 11 Embarrassed to Ask: The 411 on number two 12 Courageous Beauty empowers women with cancer 15 Provider profile: Robin Lensch, athletic trainer 16 Health Hacks: The power of antioxidants 18 Back pain got you down? 20 Good, Better, Best … breakfast! 22 At Our Best for the community 8 16 12 Information in STRIVE comes from a wide range of medical experts. Models may be used in photos and illustrations. If you have any concerns or questions about specific content that might affect your health, please contact your healthcare provider. 2022 © Kettering Health and Coffey Communications, Inc. All rights reserved. 2

Can cracking your knuckles cause arthritis? We asked James Willey, MPAS, PA-C, whether “cracking” joints is merely a bad habit or if it poses more serious health risks. Q: What happens when I “crack” a joint? A: The “popping” or “cracking” sound that happens when you crack your knuckles or other joints is caused by gas bubbles in your synovial fluid. Q: Can cracking my knuckles, back, wrists, neck, or other joints cause arthritis? A: It doesn’t appear that cracking your knuckles or wrists can cause arthritis. However, cracking your neck may lead to inflammation around nerve roots and lead to long-term issues. Cracking your back habitually may cause instability at the segmental level and lead to arthritis over time. Q: Is it safe to crack my joints, or should I avoid it? What are some healthier ways to find relief from “tight” joints? A: Cracking your knuckles is not a healthy behavior, but occasionally cracking your knuckles or joints is generally not a major health threat. The problem arises when this type of behavior becomes habitual or obsessive. Other ways to find relief from tight joints include stretching, yoga, Pilates, physical and occupational therapy, and massage therapy. FASTFIVE Tips to prevent osteoarthritis Osteoarthritis is a disease that occurs when the cartilage (the soft tissue that cushions your joints) breaks down and leads to pain, swelling, stiffness, and decreased range of motion. More than 32 million adults in the United States are affected by osteoarthritis. Reduce your risk of developing it with these tips from James Willey, a Kettering Health physician assistant and orthopedic advanced practice provider: 1 Maintain a healthy weight. 2 Participate in non-weight-bearing exercise. 3 Avoid contact sports and repetitive actions. 4 S eek medical treatment for pain that lasts longer than three weeks. 5 P artner with a primary care provider. Regular well-visits keep you at your healthiest. FACT OR FICTION STAY WELL One of the best ways to prevent future injury and disease is to invest in your health today. To find a primary care provider, visit primarycare or call 1-888-981-9456. 3

We spoke with Nicklaus Hess, DO, a family medicine physician with Kettering Health, to find out if it lives up to the hype. “There are a variety of potential health benefits associated with apple cider vinegar,” says Dr. Hess. “However, I strongly recommend you consult with your primary care provider before initiating any new treatment regimens. “Though not a substitute for diet, lifestyle modification, and exercise, apple cider vinegar has been shown to positively affect lipid profiles, fasting blood sugar, and insulin sensitivity,” Dr. Hess continues. “It may also decrease appetite and body weight.” How to use it One of the best ways to gain the health benefits of apple cider vinegar is by adding it to your diet. You can include it in meals as a marinade or in salad dressings, swallow it in pill form, or dilute it with water as a drink. “A common recommendation for oral administration of apple cider vinegar is one to two tablespoons diluted in eight ounces of liquid daily,” says Dr. Hess. Apple cider vinegar can also be applied topically. “Equal parts apple cider vinegar and warm water applied to the ear canal can be used to treat excessive earwax or an outer ear infection,” says Dr. Hess. “This home remedy can be helpful because apple cider vinegar has antimicrobial properties.” Know the risks Apple cider vinegar can weaken tooth enamel, which can lead to increased sensitivity, cavity formation, and tooth decay. In some people, the acidic properties of apple cider vinegar can cause nausea or vomiting. The biggest risk of using apple cider vinegar as a home remedy is missing a serious health issue. The safest and most effective way to detect and treat any health condition is thorough medical evaluation and diagnosis. The bottom line? You might benefit from apple cider vinegar’s natural healing properties, but talk with your doctor before incorporating it into your life. Is apple cider vinegar the new cure-all? NEED A PROVIDER? Visit or call 1-888-796-9704 to schedule an appointment. OR FABULOUS? Despite becoming the latest trend in natural remedies, apple cider vinegar has been used to improve health for thousands of years— even by Hippocrates in 400 B.C. But is apple cider vinegar truly effective in today’s modern world? 4

Johnny Myers, APRN-CNP, is a primary care nurse practitioner with Kettering Health Prevention and early detection are the best ways to fight illness. We asked Johnny Myers, APRNCNP, a primary care nurse practitioner with Kettering Health, about preventive steps, such as screenings and vaccinations. Q: Which tests do adults need annually and at what age should patients start getting them? A: Most screenings can be performed at your primary care provider’s office during a yearly exam. Adults as young as 20 should get a skin assessment, blood pressure screening, vision exam, and (men) self-testicular examination. Women should schedule a Pap smear at least every three years. By age 30, annual tests should include a blood glucose screening for diabetes, thyroid stimulating tests to check for under- or overactive thyroid, and cholesterol screenings to test for heart disease. We recommend annual mammograms by 40; prostate and colon cancer screenings starting at 45. Bone density screenings and hearing examinations should begin at 50. Q: What about vaccines? A: Get a flu shot every year and a Tdap booster (which protects against tetanus, diphtheria, and pertussis) every 10 years. Add the shingles vaccine by 50 and the pneumonia vaccine by 65. Individuals with numerous health conditions may need to receive some of these vaccines sooner. Q: How does my family medical history factor in? A: Preventive care plans vary from patient to patient. Individuals with a family history of heart disease, certain cancers, diabetes, and other health conditions may need to have screening procedures completed at a younger age. Q: I feel healthy. Do I still need annual screenings? A: Screenings are designed to detect illness before you have symptoms. It is important to understand that even if you feel healthy, there could be an underlying problem. Q: Why is early detection important? A: Early diagnosis drastically improves patient outcomes because, at that stage, the disease hasn’t spread to other parts of the body yet. The last thing you want is to skip routine screenings and later discover you have a disease that could have been more easily treated if it had been detected sooner. A KEY CONVERSATION Talk with your primary care provider to develop a preventive care plan that meets your individual needs. Don’t have a provider? Visit or call 1-888-726-2372 to make an appointment. ASK AN EXPERT Why do I need annual screenings? 5

Types of screenings Providers can spot breast cancer with a mammogram and lung cancer with a low-dose CT scan. Both are standard X-ray imaging procedures. A colonoscopy is also an imaging procedure. Providers insert a camera into the colon to look for abnormal growths. The patient is usually sedated. Cervical cancer screenings involve cell samples collected from the cervix during a routine Pap smear. Experts analyze the cells under a microscope to look for significant changes. Prostate cancer screening involves a blood test to check for rising or elevated prostate-specific antigen (PSA) levels. Your primary care provider or a dermatologist will perform a visual examination of your skin for moles, pigmentations, or other irregular marks to determine skin cancer risk. When to start screenings The American Cancer Society recommends yearly breast, colon, and prostate cancer screenings by 45 and regular Pap smears by 21. (Kettering Health and the American College of Radiology recommend mammograms by age 40.) Annual lung cancer screenings are recommended starting at 50. However, age is only one part of the equation. Family medical history and personal risk factors are just as important. “As we get older, cancer becomes more common, but there is no one-size-fits-all answer for when to start screening,” explains E. Ronald Hale, MD, MPH, the medical director for Radiation Oncology at Kettering Health. “There can be nuances that indicate specific screenings should begin at a younger age.” For example, if a woman has a family history of breast cancer, she may schedule annual mammograms beginning in her 30s instead of waiting until 40. Cigarette smokers are advised to begin lung cancer screenings at younger ages, too. YOUR BEST DEFENSE Talk with your primary care provider about cancer screenings. Visit to learn more about your options. SCREENABLE CANCERS Early detection can make all the difference when diagnosed with cancer. Routine screenings can identify six forms in their earliest stages: breast, cervical, colon, lung, prostate, and skin cancer. Preventive care 6

Don’t panic over a callback When a screening pinpoints an abnormality, patients are called back for additional testing. Dr. Hale reassures patients that “the majority of the time, the irregularity is not cancerous. It’s easy for your mind to go to a bad place, but the reality is that abnormalities tend to be incidental and harmless.” He stresses, however, that it’s important to show up for the follow-up testing: “Nailing it down is good because then it’s in your library of known abnormalities, which helps inform future screenings.” Regular primary care check-ins are key As the first line of defense against cancer, Dr. Hale strongly advocates establishing a trusting relationship with a primary care provider. This is the person, he explains, best equipped to “identify, mitigate, or eliminate cancer risks over time.” Regular check-ins and screenings are vital, even for healthy patients. “Cancers can occur sporadically,” says Dr. Hale. “Don’t be afraid to get tested. Detecting a problem early can make the treatments a lot easier and may save your life.” Intercepting cancer Kettering Health and the Cincinnati Bengals are partnering to intercept cancer. The NFL’s Crucial Catch mission is to fight cancer through early detection and risk reduction. Kettering Health is committed to providing people the tools they need to help them better understand detection and ways to reduce their cancer risk. Find more information about Crucial Catch at 7

8 Tony Alexander feels the thud of a kick drum shake his chest. Amplified guitar riffs follow, echoing throughout Paul Brown Stadium (now Paycor Stadium). On the field below, the sound check concludes before Friday night of the Cincinnati Music Festival. Stadium staff anticipate 34,000 people. Tony adjusts the volume on his radio. Behind him, concertgoers gather outside Gate C. The gate, tonight’s main entrance, is a few steps away from the Plaza, the largest of Kettering Health’s five first-aid stations in the stadium. He looks the way one might expect Kettering Health’s director of Emergency Management and Outreach to look: a walking mission-control center who communicates through a radio and has an earpiece connected to his cellphone to cover all the bases alongside face-to-face conversations. He turns to four nurses, two of whom are wearing ambulance-red and neon-yellow backpacks filled with 20 pounds of medical gear. “Take care of yourselves,” he reminds them in a fatherly tone. “It’s hot.” Snapping into action Today’s temperature hovers at 95 degrees, nearly 110 on the field. Add the weighted blanket of humidity, and the stadium is equal parts concert venue and sauna. Patient story Emergency Outreach CARE Stadium-sized Event medicine ramps up while the heat is on Tony Alexander directs two of the roaming teams as concertgoers arrive.

Tony walks into the Plaza. Inside, an air conditioner the size of a small car roars. Water, ice (lots of ice), and medical supplies—organized on large roller carts—are made ready before the gates open at 6:30 p.m. The room holds three patient beds, separated by curtains, and two cots to transport patients to ambulances outside. Tony talks with Nancy Pook, MD, tonight’s on-site physician. A digital wall clock reads 6:21. A wave of heat cuts through the artificially cooled air as the Plaza doors open. Stadium staff bring in two women who collapsed outside the gate—and the room snaps into action. 1,400 hours of preparation The Cincinnati Music Festival is the second stadium event for Kettering Health’s Emergency Outreach team since the Bengals announced Kettering Health as their official healthcare provider in May 2022. As part of the partnership, the Outreach team provides pre-hospital services to concertgoers and fans in the stadium. Four days after the announcement, the Outreach team arrived for their first stadium event: a weekend of Garth Brooks concerts. But weeks before Brooks took the stage, they needed to create protocols, transport supplies, and learn the ins-and-outs of the 1.8-million-square-foot stadium. “We put in 1,400 hours of preparation,” says Tony. This included meetings among Outreach team leaders such as Tony, the Department of Homeland Security, the FBI, Cincinnati Fire and Police departments, and stadium staff. As Bill Mangas, Kettering Health’s executive director of Emergency and Trauma Outreach, put it, “We did in six weeks what would normally take six months.” Event medicine is nothing new for the Outreach team, who have served at many local events, such as the Dayton Air Show and the Air Force Marathon. But preparing to provide care on a scale the size of a football stadium requires experience and ingenuity. “The challenges are different at a stadium versus a 26.1-mile course,” explains Tony. “At the stadium, nearly 70,000 people are confined in a small space. You’re preparing care for a small city.” —Continued on page 10 Baptism by rainwater Ready as they were for the Garth Brooks concerts, Tony’s team unexpectedly found their preparations—and themselves—baptized by rainwater. That Saturday night, severe weather forced the stadium’s leadership to issue its first-ever “shelter in place” order, flooding the stadium’s tunnels with 80,000 people—more than the populations of Kettering and Centerville combined. It offered an unexpected test of the team’s planning and communication. They exceeded expectations. “This was the largest event we’ve had at the stadium,” says Steve Johnson, managing director of Paycor Stadium. “At that capacity, with the weather, they were where they needed to be, and their communication remained clear and effective.” 9 “At the stadium, nearly 70,000 people are confined in a small space. You’re preparing care for a small city.” —Tony Alexander Katie Ball, RN, assesses one of the night's first patients.

“Where is my seat?” In the Plaza, Katie Ball, a Kettering Health Hamilton emergency nurse, sits with one of the overheated women from Gate C. Katie speaks softly while remaining audible over the air conditioner and the clamor of the concert muffled by the doors. After some rest and water, the patient stands with Katie’s help. Katie then grabs her heavy medical backpack and walks toward the doors. She and Harley Paxon, a Kettering Health Miamisburg emergency nurse, are one of three roaming teams tonight. Like the other 30 team members, they wear gray shirts with “MEDICAL TEAM” across the back, pants with cargo pockets holding stethoscopes, and tennis shoes. When the concert ends at 12:45 a.m., they’ll have walked more than eight miles in six hours. “It’s overwhelming and exciting,” says Katie. “But I love being among the community.” They roam portions of the stadium, responding to anyone needing care. Dehydration burdens most patients, even those in the shade of the concessionstand tunnels where the humid air is popcorn-scented. As more people enter, Katie, Harley, and the other roaming teams increasingly encounter tonight’s most popular—and unanticipated—question: “Excuse me, where is my seat?” A mass casualty incident “Event medicine is a juggling act,” says Tony. “There’s always an element of chaos, but you try to control what you can.” That chaos may include directing hundreds of attendees to stadium staff for help finding their seats. Or it might be the challenges of torrential rain or oppressive heat. At 11 p.m., the Cincinnati Fire Department declares downtown an MCI—mass casualty incident—because of the heat. Doing so funnels resources to area hospitals, helping them stay on top of the blistering number of heat-related emergencies coming from the concert and a nearby Reds game. With almost 30 years’ experience, Tony has seen event medicine grow more challenging, even dangerous. He knows his role is to care for those at an event by caring for his team—preparing them to care for others during both normal and critical situations. “Failure to plan is failure on my part,” says Tony. “You’re only a leader in a moment of crisis. Other than that, you’re just in charge.” 34,000 people unaware Tony walks toward the Plaza as the night’s last act finishes. On his way, he pauses, taking in the concert’s final minutes. As the stage and stands glow purple and blue, the artist’s voice and the crowd’s singing meld together to become a 34,000-person choir. Most of them sing unaware of the canopy of care around them, until they need it. For Tony, that’s how it should be. He and the team wait to leave until the stadium is empty of concertgoers. Hitting the road at 1:30 a.m., Tony starts his two-hour drive home. In fewer than 12 hours, he’ll return to lead another team of Outreach coordinators and nurses for Saturday night. Janet Jackson is headlining. Stadium staff expect 40,000 people. And the heat index is projected to be 102 degrees. —Continued from page 9 Emergency Outreach WHO DEY? To learn more about Kettering Health’s partnership with the Bengals, visit to sign up for monthly updates on our events with the Bengals and the community. 10

EMBARRASSED TO ASK? No one likes to talk about what happens while they’re on the toilet. However, it’s best to pay attention to your bowel movements: They offer clues about intestinal health. What’s normal? Healthy stool is soft enough to easily pass, is often shaped like a sausage, and won’t stink excessively. Shades of brown are considered normal, but their appearance will depend on what you ate that day. A range of three bowel movements per day to three per week is ordinary. When to see your doctor Stress, food intolerances, medications, and infections can affect bowel movements. Persistent changes lasting more than a week may indicate a more serious underlying issue, such as chronic inflammation, autoimmune disorders, thyroid conditions, and cancer. Pale-colored stools that float and smell foul may be a sign of small bowel, liver, or pancreatic disease. Bloody stool may indicate severe infection, inflammation, or colon cancer. If the stool is black, and especially if there are other symptoms like fatigue, weight loss, and abdominal pain, call your doctor for an urgent evaluation. If there is rectal bleeding, go to an emergency room. Patients with medical issues such as heart disease, diabetes, and kidney disease should seek immediate medical attention for acute diarrhea. This also applies to patients taking certain medications such as diuretics, ACEI/ARB, and metformin because dehydration increases the toxicity of drugs like these. Khadija Ahmed, MD, is an internal medicine specialist at Kettering Health The 411 on number two Your doctor will ask about the severity and timeline of your symptoms, medications, and family history. Depending on the individual case, you can expect a physical exam, blood tests, and imaging procedures. I highly recommend patients start colon cancer screenings at age 45. Your doctor may advise earlier screenings if you have an inflammatory bowel issue or a family history of colon cancer. Support your digestive health We can control certain factors to help keep our intestinal systems healthy: • Eat a balanced diet rich in fiber, fruits, and vegetables. • Drink plenty of water. • Limit red meat intake. • Avoid processed meats, foods rich in fat, excess caffeine, alcohol, and tobacco. • Take a multivitamin. • Exercise regularly and try to reduce stress. DON’T IGNORE TROUBLING SYMPTOMS If you notice something unusual, contact your primary care provider. If you don’t have one, visit or call 1-888-981-3524 to schedule an appointment. 11

Patient story HEAR US Courageous Beauty is more than skin-deep 12

When her mother got sick, Connie put her own life on hold to take care of her. This meant skipping her annual mammogram appointment in September 2021. Connie noticed she felt fatigued during the winter but focused on her mother instead. Finally, the following March, she decided to schedule all her annual appointments before her birthday at the end of the month. Connie’s mammogram appointment began like any other. One more appointment to cross off her list, she thought. But her doctor noticed something abnormal. Connie’s fatigue wasn’t due to winter weather or taking care of her mother. She had a tumor in her left breast. “It was very shocking,” she says. “I didn’t even know what to think.” Connie returned for an ultrasound, followed by a biopsy. Instead of celebrating her 61st birthday, she awaited her diagnosis. The anticipated test results arrived: triple-negative ductal carcinoma, an aggressive form of breast cancer. “I remember sitting there thinking, ‘Wow—why me?’ And then thinking, ‘Why not me?’” Because of the fast-spreading nature of her cancer, Connie and her doctors scheduled treatment to begin on May 17. An encouraging community Before her first day of treatment, Connie and her daughter visited the Renew Boutique and Spa, located in the Kettering Health Cancer Center. Connie looked around the store, browsing the scarves and wigs she might soon wear, while her daughter spoke JOIN US The Courageous Beauty class is offered on the third Monday of each month for patients in active cancer treatment. This single-session class is free and includes a free personal cosmetic care kit. You do not have to be a Kettering Health patient to participate. To learn more about the class or to register, visit or call 1-844-802-9410. to the store manager. As they left, her daughter revealed she had signed up Connie for Courageous Beauty, a free class funded by the Kettering Health Foundation. The class aims to empower women by teaching them to embrace and care for their changing appearance throughout treatment. Connie, a former model in high school, says she loved discussing makeup and skin care in the class. It gave her a sense of control to take care of herself at a time when her body seemed to work against her. “Making sure that your skin is good and clean and moisturized is a lot,” she says, “especially when you don’t feel good.” The best part of the class, Connie says, wasn’t the skin care or makeup but talking with other women going through the same journey. “It let me know that I was not just a number or a patient,” she says, “but that I was a part of a big network of women who have walked the walk and can talk the talk.” Jaime Testa, manager of Renew Boutique and Spa, says it amazes her to see women who attend the class come together and support one another. “It’s been really neat to see the community that it builds within the women,” she says. “It’s not so much about the facilitator and what they bring to the table, but more of the camaraderie between the women that are sitting together.” Courage to face her future For Connie, meeting women in various stages of treatment helped her prepare for her own treatment. “There were some girls there who hadn’t lost their hair yet—I was one—and then there were some that had already begun to lose their hair,” she says. “To listen to their journeys was encouraging. Aside from the —Continued on page 14 Connie Miles typically spends March celebrating her birthday. March 2022, however, was anything but typical for her. 13

cosmetics, that was really awesome because we got to hear their stories, and that gave us hope.” She remembers one woman who had lost her hair and did not wear a hat or wig, an act that gave Connie the courage to face her future. As for the name of the class, Connie says it perfectly described the women she met. “When I think of ‘courageous’ I think of a lion. I think of something strong, something that doesn’t give up,” she says. “These women are courageous.” The day after attending Courageous Beauty, Connie began chemotherapy. Seven reasons why Connie admits she never imagined herself going through chemotherapy. She never pictured losing her hair or getting weaker as the treatment gets stronger. But one thing—or rather, seven—keeps her fighting through it all: her grandchildren. Connie’s seven grandchildren range in age from 4 to 19. She often looks at photos and cherishes her memories with them. She remembers them popping popcorn, snuggling up in her king-sized bed, and watching movies late at night. This became a tradition, what they call “midnight picnics.” “To clarify,” she adds with a laugh, “they weren’t at midnight, but they didn’t know.” Patient story —Continued from page 13 Staying present in their lives remains her greatest goal. “I’ll do whatever I can,” she says. “That’s my why. In those infusion chairs, that’s my why.” Highs and lows Connie’s favorite place to be is the ocean. After beginning treatment, she planned a trip to Florida with her family. Because of her chemotherapy, her oncologist warned her about excessive sun exposure, but Connie was determined to spend quality time with her loved ones. With SPF 50 sunscreen and UV-protective clothing, she took a dip in the ocean with the kids. Connie had taught all her grandchildren how to swim, so swimming in the ocean with them was a special moment. After enjoying the warm seawater, she retired to the shade of her cabana. Connie soaked in the perfection around her—the sun, the waves, her family—satisfied that she hadn’t let her diagnosis stop her from making memories. She felt in control. And then, while still on vacation, she began to lose her hair. Connie looked at herself in the bathroom mirror and watched the cancer remind her of its existence. She felt hopeless but thought about the brave women she met before beginning treatment. “I remembered those ladies in that class, being courageous lions, and that’s what I want to be,” she says. Connie found the courage inside of her to enjoy the rest of her vacation, despite losing her hair. The best medicine With the support of her loving family and hope from Courageous Beauty, Connie continues treatment and tries to make memories every day. She shares one piece of advice, something that keeps her moving forward throughout this journey: “Take those photos, take those videos of the people that you love the most,” she says. “Because when you’re not feeling so good, you can reflect back, and it’s the best medicine ever.” 14 15 Provider profile Athletic Trainer Robin Lensch grew up playing sports, but it wasn’t until college softball tryouts that she had her first sports-related injury. Robin sprained her ankle and needed an athletic trainer’s help. The experience revealed Robin’s calling. “The atmosphere of the training room and the staff’s motivation to help really sparked my passion for athletic training,” Robin recalls. High-stakes decisions Robin’s desire to serve others led her to a school environment. She spent two decades at Fairmont High School, where she led the way in caring for more than 800 student athletes. “I loved being a resource for the community,” Robin says. “Whether an athlete was down on the field or a parent in the stands needed help, I appreciated the opportunity to serve.” Robin credits her sports background for helping her connect with the athletes, especially football players: “If you’re going to cover a sport, you have to know the jargon to get some street cred with the players!” Athletic training also requires the ability to make highstakes decisions quickly. “Wrestling is a perfect example of this,” she explains. “You have an athlete on the mat who may have a concussion. You have 90 seconds to decide whether it’s safe for the athlete to continue. You could be making or breaking this athlete’s chances to compete at a higher level. It’s a lot on your shoulders.” GET BACK IN ACTION Is chronic pain or injury keeping you on the sidelines? Visit to learn how we can help you achieve your best. Robin Lensch, athletic trainer Hall of Famer loves making a difference Robin’s skill and compassion earned her a spot in the Ohio Athletic Trainers’ Association Hall of Fame. She was one of only two inductees in 2022. A valuable team player After 25 years, Robin stepped away from the sidelines and into the stands to cheer for her own teenage children. She now cares for patients at an orthopedic Kettering Physician Network practice, where she works with Blake Daney, MD, a sports medicine orthopedic surgeon. “The number of lives Robin has helped impact through transitioning her athletic training skills into the orthopedic clinic is immeasurable,” says Dr. Daney. “I’m blessed to have her on my team.” “As athletic trainers and in medicine overall, we want to get people back to the activities that make them happy,” Robin says. “It’s been so rewarding, and I love making a difference for my patients.”

HEALTHHACKS As the leaves change this autumn, take a note from nature and add a splash of color to your day, starting with your dinner plate. With vibrant, plant-based meals as part of your daily diet, you can benefit from the disease-fighting power of antioxidants and improve your health— one bite at a time. What are antioxidants? Antioxidants are naturally occurring chemicals that provide essential protection against cell damage. While some antioxidants are produced in our bodies, we rely on vegetables, fruits, and grains to provide other essential antioxidants, such as vitamins C and E. “Antioxidants can protect cells against free radicals, a natural byproduct of chemical processes in the body,” explains Karen Feldmeyer, MSA, RDN, an oncology dietitian with Kettering Health. “While free radicals are created in our bodies during certain processes like breaking down food, Better health with every bite “The combination of healthy eating plus exercise, social time, and plenty of rest is great for overall health and well-being.” —Karen Feldmeyer, MSA, RDN THE POWER OF 16

they are also created through exposure to sun, pollution, and tobacco smoke. “In high concentrations, these unstable chemicals may cause cell and tissue damage,” Karen continues. ”And damage over time can lead to certain diseases, including cancer, plaque buildup within arteries, rheumatoid arthritis, and neurodegenerative diseases.” First line of defense To help protect against cell damage, one of your first lines of defense might be as simple as what you put on your fork. While there are no absolutes in disease prevention, eating a diet rich in antioxidants can help the body protect itself against free radicals and may reduce the risk of certain chronic diseases and illnesses. Plus, antioxidant-rich foods contain other essential nutrients that all work together for the benefit of overall health. “It is important to remember that there is not just one element that reduces risk of developing chronic disease,” Karen says. “Eating a diet rich in vegetables, fruits, and whole grains—which contain antioxidants—is very beneficial. And a diet that also includes lean sources of protein, is low in fat, and is low in fast foods and processed foods is most beneficial. “The Academy of Nutrition and Dietetics supports that all foods can fit into a healthy diet, so even sweets or fried foods can be enjoyed occasionally,” Karen says. “It’s important to remember that the combination of healthy eating plus exercise, social time, and plenty of rest is great for overall health and well-being.” Reach for the rainbow Filling your plate with colorful, plant-based meals could help protect your body and reduce your risk of disease. Foods packed with antioxidants provide essential protection for your cells. It is also important to vary the types of fruits, vegetables, and grains you eat to maximize the benefits of different types of antioxidants, as well as other nutrients that are beneficial to the body. Additional source: Mayo Clinic COOK WITH COLOR SHOPPING LIST Visit to find delicious ways to use antioxidant-rich ingredients in your meals. Fruits Apples Blueberries, cranberries, raspberries, strawberries Cherries Grapes Mangoes Oranges Plums Nuts and seeds Walnuts Pecans Sunflower seeds Flaxseeds Extras Cloves Dark chocolate Peppermint Grains Whole-grain breads and cereals Buckwheat Quinoa Vegetables Artichokes Beans Broccoli Beets Carrots Bell peppers Eggplant Tomatoes Deep green lettuce Spinach Collards Sweet potatoes Kale • 3-5 cups of vegetables • 1-2 cups of fruits • 4-6 servings of whole grains AIM FOR GENEROUS PLANT-BASED PORTIONS EACH DAY: 17 Cut and save

Back pain is one of the most common reasons people seek medical care. Up to 85% of adults in the United States will experience back pain at some point in their lives. But what causes back pain? And what can you do about it? Causes of back pain “One of the most common reasons for back pain is related to an inciting strenuous event, such as lifting heavy objects or bending and twisting the spine, especially with poor body mechanics,” says James Dunlap, MD, orthopedic spine surgeon with Kettering Health. Sometimes, this pain is sudden (acute), especially when it’s related to a specific event or injury. Other times, the pain lasts for months or even years, which is called chronic pain. You may be more likely to develop chronic back pain if you have • A sedentary lifestyle • Obesity • Poor eating habits How to prevent back pain The good news is that most people can lower their risk of developing back pain with a few simple lifestyle changes: Brain & Spine What to do and when to see a doctor Back pain got you DOWN ? • Reduced flexibility • A weak core 18 19 What does good posture look like? Many people’s daily habits add up to a lifetime of poor posture. Continually hunching to look at your phone, straining to see your computer, or carrying a heavy purse can lead to rounded shoulders and a hunched back. Take control of your posture by making a few simple adjustments: 1 Be mindful of your nutrition, focusing on eating lots of fruits, veggies, lean protein, whole grains, and healthy fat. You can work with a dietitian if you need extra support sticking to a healthy eating plan. 2 Exercise regularly, including aerobic activities, core strengthening, and flexibility exercises. A physical therapist or athletic trainer can help you increase your activity levels safely. 3 Maintain good posture as often as possible. This may mean adjusting your workstation by raising your computer monitor height or investing in a new chair. When to visit your doctor You might not need to see a doctor immediately. Sometimes, resting, icing your back, and stretching can relieve your symptoms. However, Dr. Dunlap advises that if acute pain lasts for more than a week or two, it’s time to see your primary care provider (PCP). “Your PCP will take a history of the event and perform a physical exam. This helps them determine what the inciting factor may be, your response to previous treatments, and possibly form a new treatment plan.” Dr. Dunlap says that physical therapy is usually a good starting point for most patients. Others may also benefit from treatments such as muscle relaxants, chiropractic spinal adjustments, or medical acupuncture. Do I need medical treatment for back pain? “The vast majority of patients with back pain will improve with nonoperative measures,” says Dr. Dunlap. But if noninvasive treatments aren’t effective, you might see a pain management specialist. At Kettering Health Brain & Spine, pain specialists help you improve back pain through treatments such as steroid injections. If needed, our team of spine surgeons also offers multiple surgery options to treat any underlying conditions and improve your quality of life. HEAL THE HURT If you’re experiencing sustained back pain, schedule an appointment with a Kettering Health orthopedic and sports medicine physician. Call 1-877-930-9354 today. 1 Stand with your feet shoulder-width apart. 2 Avoid locking your knees. 3 R oll your shoulders back and keep your head in line with your body. 4 Pull in your belly slightly. 5 Distribute your weight evenly across your feet. 6 Let your hands fall naturally at your sides.

The morning rush can make it easy for breakfast to slide down your priority list. You don’t want to be late, so you grab something on your way out the door, or you tell yourself coffee will keep you going until lunch. Does missing this meal, touted as the most important, really matter? The mental benefits of eating breakfast are known: Eating breakfast is associated with improved memory recall in adults1 and better performance in school for kids.2 But the physical risks of missing breakfast aren’t as widely discussed. “Usually, skipping breakfast leads to hunger, which can induce someone to graze before lunch, hit the break room for sweets, or make poor lunch choices,” says Michele Geiger, RD, registered dietitian and certified diabetes care and education specialist at Kettering Health. Beyond inconvenient hunger pangs, habitually skipping breakfast is associated with a higher risk of GOOD BETTER BEST breakfast Boost your health with 20

1. PMC4863263/ 2. breakfastforlearning-1.pdf 3. 4. info-2017/skipping-breakfast-hurts-hearthealth-fd.html heart disease and cardiovascular death.3,4 Making a habit of eating a healthy breakfast doesn’t have to take a lot of time. The key is knowing which foods give your body the fuel it needs to function at its best. What to look for “It is important to have all of the macronutrients (carbohydrates, protein, and fat) at each meal,” says Michele. “Complex carbohydrates, like whole grains, fruits, or dairy, are the best options. “Lean protein is recommended, as well as a vegetable source of fat like nuts, seeds, avocado, mayonnaise, or vegetable oils,” Michele continues. “Any time vegetables can be added to breakfast, they can help to promote fullness.” What to avoid “I suggest avoiding liquid meals like smoothies,” says Michele. “They pass through the stomach rapidly, leading to hunger before lunch.” If you decide on a smoothie, Michele suggests one with low-sugar almond milk or 1%–2% regular milk, berries, some type of vegetable (kale or spinach), and a scoop of protein powder. Refined or sugar-sweetened cereals with milk can also pass through the digestive system quickly. Wholegrain cereals will sustain you longer. Finally, “I highly recommend adults avoid juice,” says Michele. “Sugar in liquids passes through the digestive system quickly and leads to a rapid elevation of blood glucose and storage in fat cells. A better choice Breakfasts to fit your lifestyle Whether you’re running out the door, have a few minutes to eat at home, or are enjoying a leisurely weekend breakfast, try these dietitian-approved suggestions for a healthy way to start your day. On-the-go At home Dining out GOOD High-fiber granola bar with 6–8 grams of protein A small bowl of whole-grain cereal with half a cup of low-fat milk or a milk alternative high in protein, such as Fairlife Milk or Carbmaster Milk Greek omelet with egg whites, spinach, feta, tomato, and toast BETTER Yogurt parfait made with Greek, low-sugar, or sugar-free yogurt, topped with fresh fruit and a handful of nuts Whole-grain toast with one tablespoon of nut butter; along with a lower-sugar Greek yogurt, lower-sugar fruit yogurt, or plain yogurt with berries Eggs with turkey bacon, a grapefruit or other fruit, and whole-grain toast or English muffin BEST A small banana, half a cup of steel-cut oats, and a hard-boiled egg Scrambled eggs with spinach, peppers, or other vegetables; whole-wheat toast; and a tangerine An omelet prepared with vegetables and reduced-fat cheese, topped with salsa; served with avocado toast on whole-grain bread and half a cup of cantaloupe would be a whole orange. However, a lower-sugar juice would be OK to include as part of a child’s breakfast.” RISE AND SHINE! Visit recipes for more healthy breakfast ideas. 21

Kettering Health is committed to providing the best care to our community. AT OUR BEST NEWSWEEK HONORS TOP MATERNITY HOSPITALS Newsweek has recognized both Kettering Health Main Campus and Soin Medical Center as Best Maternity Hospitals in 2022. “This award reinforces our commitment to provide safe, high-quality maternity care to expectant mothers and their babies,” says Miriam Cartmell, system executive director of Kettering Health Women’s and Children’s Services. The Newsweek award is a continuation of these two medical centers’ recognitions for excellent maternity care. Most recently, both were ranked as high-performing medical centers in maternity care for 2021–22 by U.S. News & World Report. FIRST TO OFFER NEW PET/CT FOR BREAST CANCER PATIENTS Kettering Health is proud to be the first in our region to offer Cerianna PET/CT for breast cancer patients. This new technology gives physicians another tool to diagnose breast cancer more easily and find the most effective treatment options. Cerianna is a substance called a radiotracer. Radiotracers are used during PET scans to highlight certain parts of or processes in the body. Cerianna specifically binds to estrogen receptor positive (ER+) growths, which may occur in some types of breast cancer or breast cancer that has spread. This new technology helps doctors find ER+ breast cancer lesions more easily. Our specialists have already performed their first scan using Cerianna. With the Cerianna technology, we identified an ER+ lesion in a patient who otherwise would have needed an invasive biopsy. Cerianna is just another example of our expansion in PET/CT capabilities. We recently added a new PET/CT digital extended-length scanner, which provides more accurate images with shorter scan times and less radiation exposure. This scanner is the first of its kind in the Dayton region and is already being used to research Alzheimer’s disease and brain tumors, with upcoming research for breast cancer. 22

AMERICAN HEART ASSOCIATION RECOGNIZES STROKE CARE This year marks the 15th year that the American Heart Association has awarded Kettering Health’s stroke program with the Get With The Guidelines®–Stroke Quality Achievement Award. This year, every Kettering Health emergency center earned recognition. This achievement shows that we give patients the most appropriate treatments according to nationally recognized guidelines, ultimately leading to fewer readmissions, shorter recoveries, and more lives saved in our community. OXFORD HEALTH CENTER NOW OPEN Oxford Health Center is now open at 5095 University Park Blvd., Oxford, Ohio. The new health center offers primary care, heart and vascular, women’s health, and general surgery services in a convenient location. UKRAINIAN STUDENTS ATTEND KETTERING COLLEGE This fall, Kettering College welcomed 50 students from Ukraine whose medical educations have been disrupted by war. In March 2022, as the Russian invasion began in Ukraine, the General Conference of Seventh-day Adventists created an Education Emergency Plan. Part of that plan provides education to students and refugees. “Whenever we talk about what can be done for Ukrainian students and refugees, Kettering College has done what no one else has, and others look up to you,” said Ivan Riapolov, education director for the Euro-Asia Division (ESD) of Seventh-day Adventists. 23

653 Strive small back cover Fall Issue.indd 1 9/14/22 5:17 PM Healthy On-the-go Breakfasts Find ideas on pages 20-21 Kettering Health is teaming up with the Cincinnati Bengals to find cancer in its earliest stages. Our breast centers feature the latest 3D mammography technology, in a spa-like environment that puts your comfort first. With 14 locations across western Ohio, our teams are ready to help you take control of your breast health and intercept cancer. Your best play is a yearly mammogram Schedule today at Kettering Health 3535 Southern Blvd. Kettering, OH 45429 Update or remove address by emailing Nonprofit Org. U.S. Postage PAID Walla Walla, WA Permit No. 44