Archive for March 2017

HCHS receives Helmsley E-Pharmacy Grant

Funding Connects Rural Patients to Pharmacy Specialists

Patients of Harlan County Health System will benefit from the latest technological advances that expand patients’ access to quality pharmacy services, made possible through a grant from The Leona M. and Harry B. Helmsley Charitable Trust. The Leona M. and Harry B. Helmsley Charitable Trust has awarded Harlan County Health System $165,875 for ePharmacy, a program that gives physicians immediate access to pharmacists 24 hours a day. The grant will be used to purchase equipment that connects local physicians with pharmacists.

Harlan County Health System will receive equipment to implement ePharmacy. ePharmacy provides 24-hour access to hospital-trained pharmacists, making it possible for all prescriptions to be reviewed prior to the patient taking the medication, even when the on-staff pharmacists are not available.
“This incredible gift gives local physicians and health care workers an immediate connection to pharmacists even if they live in rural areas that have fewer physicians and health professionals,” says Manuela Wolf, RN, MHA, Chief Executive Officer. “This keeps patients close to home during treatment.”

The Harlan County Health System hospital is a 19-bed Critical Access Hospital providing emergency, outpatient, inpatient, specialty clinic and surgical services from a spacious, modern facility. Adjoining the hospital is Heartland Family Medicine, a professional medical clinic staffed by a physician and two physician assistants. Heartland provides day-to-day medical care for patients of all ages from throughout the area. Visiting specialists travel to the HCHS regularly to provide cardiology, orthopedic, pulmonology and podiatry services.

The Helmsley Charitable Trust

The Rural Healthcare Program of The Leona M. and Harry B. Helmsley Charitable Trust began awarding grants in 2009. The Helmsley Trust has awarded more than $298 million in grants to nonprofit organizations in the region through the Rural Healthcare Program. The Helmsley Charitable Trust, established in 1999, supports a diverse range of organizations with a major focus on health and medical research, human services, education, and conservation. To date,  The Helmsley Trust has announced more than $1.7 billion in grants to charitable organizations since 2008.



Marisa Gulizia, PT, CSCS, RYT200

Many who attend sports events or watch them on TV have heard this phrase quite frequently and know what it means.  BUT, did you know there are several people trained in concussion testing located at Harlan County Therapy Center at Harlan County Health System (HCHS) and that HCHS actually sponsors the testing for both Alma Public Schools and Southern Valley Schools?  Drs. Finkner and Durr; PAs Stemper and Taylor; plus, Marisa Gulizia are certified by the IMPACT program.

Let me introduce Marisa, PT, DPT, CSCS, Rehabilitation Director for New West Inspire Therapy located at HCHS.  Marisa, her husband, Tony, and two children, Kortlyn and Kensley, reside in Alma.  Marisa has extensive training in concussions.  She attended the following training sessions:  Advanced Vestibular Course (University of Pittsburgh, PA); IMPACT Testing; Sport Concussion Institute Training in Atlanta, GA; Spearheaded Concussion Focus Website and Lead Concussion Focus Team of Physicians, Athletic Trainers, Physical Therapists, and Sport Medicine Directors in Omaha, NE for three years; and was a guest speaker at the “Managing Concussions . . . a Team Approach” seminar hosted by UNMC in 2014.

Concussions are very serious and if not treated properly or gone undetected can result in other major medical issues down the road.  Solid links have been made between concussions and mental illnesses, which lead to severe depression and higher suicide rates.  A concussion is a type of brain injury that can damage both physical and mental wellbeing.  Although concussions usually are caused by a hit to the head, they can also occur when the head and upper body are violently shaken, as well as a fall or a blow to the body.  The bump, blow, or jolt to the head can change the way the brain normally works, due to the impact causing the head and brain to move quickly back and forth.

Sports related concussions are most common in football and girls’ soccer.  Common signs of a concussion are:  Headaches, Decreased Cognitive Function, Lack of Coordination, Pupil Dilation, Nausea, Blurred Vision, Bruising, Emotional Outbursts, Slurred Speech, and Disrupted Sleep Patterns.  Due to the traumatic impact concussions have had on many notable athletes, concussion testing is mandatory for players to return to the game.

Marisa noted most athletes are IMPACT tested their freshman and junior years at their respective high school to have a baseline for each student if a concussion should occur.  The concussion testing process would then follow:

  • Immediate Sideline Assessment by Athletic Trainer/Coach or other Medical Staff.
  • Evaluation by the Athlete’s Family Physician.
  • IMPACT Neuromuscular Retest.
  • If concussion symptoms persist – evaluation and treatment by a Physical Therapist (PT).
  • PT will assess symptoms, ocular motor system, vestibular system, balance, and reaction/coordination.
  • Athletic Trainer/Coach/PT will use a “return to sport” protocol for concussions, which measures heart rate as athletes increase their activity level to ensure no return of symptoms with a heart rate that he/she would reach in practice or a game.
  • Athletes can’t return to sports until released by a healthcare provider.

Marisa’s training in concussion testing will help athletes determine when it is safe to return to the game. So, “When In Doubt, Sit Them Out!”  Protect your children from the long range consequences a concussion may have on them.  One game is not worth the effect a concussion could have on the rest of their life.  For more information, please refer to the following websites: and/or



“Lace up and Hit the Road”

          Tora Knaus, PTA at HCHS Rehabilitation

Running is one of the easiest and most convenient forms of exercise as no expensive equipment or gym membership is necessary to begin to improve your health.  It is also the 2nd most effective exercise in terms of calories burned per minute!  Which means…..more benefits in less time!  And those benefits are impressive including…

                *Increases lung function

                *Boosts the immune system

                *Decreases your blood pressure             

                *Increases your metabolism and aides with weight control

                *Improves your mental health by decreasing stress and boosting your confidence

                *Strengthens joints and improves bone density


                This all sounds great, but how do you begin to avoid injuries and be successful?  Here are a few tips to help you get started on the right path.

  1. Invest in a good pair of running shoes.  You do not need the most expensive shoes on the market but you do need the appropriate size and support for your foot type.  Visit a running store and have a qualified person match to you the right shoe is very beneficial.  Running shoes need to be replaced every 300-600 miles.
  2. Start with a run/walk program. Build your running intensity and distance gradually.  According to the Journal of Orthopaedic & Sports Physical Therapy in October 2014, it is recommended to not increase your distance by more than 10% per week to avoid some common leg injuries.
  3. Warm up and cool down. You should prepare your body to run, even if it is just a brisk walk. After your run, a cool down walk and stretching can help reduce muscle pain and decrease your recovery time.
  4. Cross training and days of rest. Incorporate other forms of exercise into your workout plan.  Your body will need days of rest from the pounding forces of running.  Running muscles will get a break; but, you will still obtain the health benefits of a workout by including other options such as walking, biking, swimming, elliptical, etc. to your exercise plan. 
  5. Eat a nutritious diet. Eating a well-balanced diet will ensure your body has the energy it needs during your physically demanding workout.  Be sure this diet includes good hydration.  Drink your water!!
  6. Listen to your body. Running through pain, other than regular workout-related muscle soreness, is never a good idea.  Take time off to rest and gradually ease back into running, should you experience pain with your running activities.  Consult a physician if your symptoms do not diminish. 

These tips will help you get a good start on your way to a healthier you!





Parkinson’s Disease and LSVT BIG

  Mindy DeJonge, OTR/L, LSVT BIG

When we hear the term “therapy”, most of us think of an injury and utilizing therapy to get rehabilitated from that injury.  Therapy is being utilized for many illnesses as well, including Parkinson’s Disease (PD).  Studies have proven that Physical, Occupational, and Speech Therapy can greatly help/improve functions for those who are suffering from PD.  Parkinson’s Disease is a chronic and progressive neurological disorder affecting nearly one million people in the United States.  Symptoms impacting motor skills include impaired balance and coordination, tremors, stiffness, and decreased speed of movement.  People living with PD are at risk for increased falls and may find it difficult to complete daily tasks.  Although there is no known cure, LSVT BIG is a form of evidence-based therapy that has been shown to slow motor deterioration and improve quality of life for those living with PD.  LSVT BIG Programs were developed based on the effective speech treatment program LSVT (Lee Silverman Voice Treatment) LOUD.

LSVT BIG is a standardized form of therapy delivered only by occupational therapists and physical therapists certified in this method.  Harlan County Therapy Center located at Harlan County Health System is fortunate enough to have Mindy DeJonge, certified therapist for LSVT Big.  Mindy attended classes and completed her certification in Denver, Colorado in July 2016.  Mindy is originally from Macon, Nebraska and graduated from Creighton University with an Occupational Therapy Doctorate degree in 2010.  Prior to moving back closer to home, Mindy worked at The Nebraska Medical Center in Omaha, NE and has now been at Harlan County Health Systems for almost four years.

LSVT BIG treatment consists of 16 one hour long sessions, 4 consecutive days a week for 4 weeks.  Daily homework and carryover exercises are to be completed by the patient outside of therapy.  Treatments focus on amplitude or “bigness” of movement with high effort and intensity.  The protocol is customized to address the unique goals and needs of each patient.  Mindy is able to assist patients in any stage of the disease, across a wide range of disease severity and impairments.

Research about LSVT BIG has been conducted over the past 25 years with funding from the National Institutes of Health.  Results of these studies have indicated LSVT BIG patients have demonstrated improved balance, increased trunk rotation, increased walking speed with larger steps, and improvements in activities of daily living.  Currently, LSVT BIG is being delivered in almost 40 countries by over 10,000 certified clinicians.   For more information about LSVT BIG, visit or contact Mindy at 308-928-3002.  And remember to THINK BIG!





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