News From Grace Cottage

Need Basic Resources? I Can Help!

| Graceful Health
Jane Wheeler

By Jane Wheeler, Grace Cottage Patient Resource Advocate
as originally appeared in the Brattleboro Reformer’s Graceful Health series, November 18, 2016

It’s getting cold out there. This is the time of year when people stockpile wood, fill their oil or propane tanks, and put extra food in their cupboards and cellars. With winter coming on, everyone has resource challenges that need to be addressed.

Winter also brings on health challenges, as colds and flu go around, and slippery conditions make accidents more likely.

Read more

At Grace Cottage, Good Food is Good Medicine

| Graceful Health
Staff With Local Produce

By Denise Choleva, CDM-CFPP, Grace Cottage Dietary Director
as originally appeared in the Brattleboro Reformer’s Graceful Health series, November 4, 2016

You hear the phrase a lot these days: “Food is medicine,” and it makes a lot of sense. We know there are plenty of foods that can make us sick because they have too much sugar, artificial ingredients, or fat. So the opposite has to be true too, that food can help make us well.

Healthy food in a healthcare setting makes good sense, for patients as well as for employees and community visitors. That’s why I signed the “Healthy Food in Healthcare” pledge in 2012, and that’s why I’ve been so committed to using the freshest, locally produced food here ever since.

Did you know that the Vermont legislature has made a commitment to local foods? In 2009, a law was passed creating the “Farm to Plate Investment Program.” This was in response to a report that showed how dependent Vermont was on food imports (food from outside of Vermont or beyond 30 miles of the border). The report said that Vermont was producing 5% of its food, with imports amounting to 95%.

Among other things, the “Farm to Plate” program set a goal to increase reliance on local foods to 10% by 2020. Last year, at the midpoint, the statewide average was up to 6.9%.

I don’t like to brag, but I’m proud to say that over the last four years, Grace Cottage’s Dietary Department has increased its reliance on locally sourced foods to over 36%! And we’re still working to raise that number. Grace Cottage is not a large hospital, but we are “going local” in a big way.

As my mentor Annie Harlow, Farm & Food Marketing Consultant for the statewide effort, told me, “A commitment this big is hard for a small hospital. You don’t have a big team to help you do the research and make the connections, but you do have a big heart, and you’re working hard to make a difference. You’re doing a fabulous job!” We’re proud of what we’ve been able to do in such a short time.

Annie helps to oversee our statewide Healthy Food in Healthcare workgroup, where I can network with other hospital food service directors to get ideas and support. Annie also helps us track our numbers so we can see our progress, by quarter and year-over-year, and she helps us find opportunities to increase local and healthy options.

Grace Cottage’s efforts to increase access to locally-produced food helps us strengthen the economic health of Vermont’s food and agricultural system, and that makes me feel good.

We’re also helping the environment by reducing the amount of fuel needed to transport food long distances.

But more importantly, local foods are healthier for our patients, our employees, and the many community members who stop in for lunch in the Grace Cottage cafeteria. Because it’s local, it’s fresher. And many Vermont farmers grow their food organically, so that’s a big plus.

It’s truly amazing to see how the Vermont food industry is growing, through the encouragement of the Vermont Farm to Plate movement. The 2015 Farm to Plate report says that non-farm jobs for those working in the food system are up 9.7% since this initiative began, compared to a 3.2% increase in employment overall. The way I can tell this is true is that I have so many more options for local foods now than I did when I started working at Grace Cottage in 1998.

I recently made a list of the local companies where we buy our food products. We now have connections with over 20 different local farms and producers. Some items come to us directly from the farm. For example, Fire Belly Farm in Brookline calls me every week to tell me what he has that’s fresh. I place my order, and it arrives the next day.

Food Connect’s “Windham Farm & Food” network helps us connect to local producers. So do some of our other suppliers. True North Granola supplies our granola and porridge, and our yogurt comes from Commonwealth Dairy; both of these are made in nearby Brattleboro. We serve antibiotic and hormone-free chicken, pork, and ground beef; nitrate-free hot dogs; fresh and sustainably harvested seafood; and fair trade coffee.

All of this good food is therapeutic for our patients. It’s also helping our employees and visitors. Did you know that the Grace Cottage cafeteria is open to the public? At $8 for a bountiful buffet with salad bar, it’s a great bargain! Not only that, it’s good for you. So stop by any weekday for lunch, and you’ll get a healthy taste of our community!


Denise Choleva earned her diploma in culinary arts from the Franklin County (MA) Technical School in 1981, but her training began much earlier, while helping her grandmother with her catering business. She earned her Certified Dietary Manager-Certified Food Protection Professional credential in 2001 and has served as president of the Vermont Association of Nutrition and Foodservice Professionals since 2010.

Older Patients Urged to Get Flu Vaccine

| News

flu-person-in-bed-538x218-2As of November 13th, 799 out of 1759 Grace Cottage patients aged 65 and older, or 45%, have received a flu shot. That’s not a bad percentage, in fact it’s respectable, but we wish it was even higher.

The national Centers for Disease Control and Prevention recommends that everyone six months of age and older get a yearly flu vaccine. People over age 65 or those with any chronic disease, such as diabetes or COPD, have a higher risk of contracting the flu and are especially urged to get the shot.

Those who are allergic to eggs or who have a history of Guillain-Barre Syndrome should consult with a physician before getting a flu shot.

Grace Cottage is administering the quad flu shot, which protects against four strains of the flu virus. The cost will be covered by most insurance. To make an appointment for a flu vaccination at Grace Cottage, call 802-365-4331. Same-day appointments are usually available.

For more information about flu shots or the flu in general, visit the national Centers for Disease Control and Prevention website (, the Vermont Department of Health website (, or call the Vermont helpline at 2-1-1.

Living Well Through the Ages

| Graceful Health

By Dr. Jesper Brickley, Grace Cottage Family Health
As originally appeared in the Brattleboro Reformer’s Graceful Health column October 21, 2016

Fall is a time to reflect on transitions in life. In the words of Albert Camus, “autumn is a second spring, when every leaf is a flower.” It is a time of transition and reflection. The measure of time bears little importance compared to what fills the time being measured. We pass through time like rays of light through crisp autumn trees. We are enriched by the process of aging and reflect that which we absorb and find meaning in.

Grace Cottage’s Healthy Aging Conference, to be held Nov. 15-16 in Grafton, Vermont, will give us time to reflect on these ideas and to share a wealth of information about how to celebrate the accumulation of years and to age healthfully.

The conference presentations will focus on mental outlook, nutrition and exercise, strength and balance, medications management, advance planning, finances, and housing. Also, free massage, Reiki, Zero Balancing, Yoga and Tai Chi are being offered. There will be important offerings for aging individuals as well as for the family members supporting them.

My presentation, scheduled for Tuesday morning, is titled “Feeling Good Never Grows Old.” The main themes I will be focused on are the importance of having a positive outlook as we age and having active engagement in one’s health. Being positive and staying hopeful about aging can not only make each day more enjoyable, but can also have tangible health benefits and can increase longevity. Researchers at Yale studied a group of people age 70 and above over the course of ten years and found that those with positive attitudes experienced less illness and debility. Positive individuals also responded better to stress and tended to live longer, by an average of 7.6 years. We will explore how a positive outlook coupled with a daily awareness of gratitude has proven time and again to influence health in many positive ways.

How do you stay positive in the later stages of life? Staying physically active and socially engaged are two key elements to maintaining positivity. Finding new hobbies, serving as mentors, joining clubs, or volunteering to help those who are less fortunate are helpful things elders can do to stay engaged and positive. Such active community engagement also helps to maintain mental clarity, a sense of connection, and a feeling that your long-life experiences have value to the communities in which you live. As a physician, my approach to health care for both aging and younger populations includes promoting active involvement in activities beyond just physical and social pursuits; I try to engender in my patients a broader understanding of, and connection to, our own bodies, minds and spirits.

We know that disease is caused not only by genetic make-up and environmental factors, but also by one’s lifestyle choices and personal disposition. I like to engage patients in an active dialogue about all aspects of their lives to try to uncover all of the things that could be triggering their symptoms and promoting a state of less than optimal health. I view my patients as partners on the same team, working together to identify patterns, tendencies, and connections to promote a more comprehensive and rewarding sense of healthfulness.

If a person truly wants to remain healthy for as long as possible, it’s not enough to diagnose a disease and prescribe a medicine to suppress and manage the symptoms. A better, long-term approach is to look for underlying causes. This systematic approach means the provider and patient may talk about nutrition, physical activity, stress and worries, household resources, mental and spiritual outlook, and the status of relationships in order to see how these may be influencing health.

Because each patient’s circumstances are unique, decisions about how to maintain or improve health will also be different for each person. All of the information gathered will be used to design a care plan that suits that particular individual. Just as each person’s circumstances are unique, so are there particular issues at each stage of life.

There’s no denying that aging has its own special challenges. The older we get, the more likely it is that some physical function will be lost. Energy levels change. And there is a greater tendency to think about the end of life. Anticipating and planning for end of life stages requires an openness to and acceptance of change and a willingness for self-exploration.

When patients approach changes in health status with openness and have an awareness about their health and illness tendencies, strategies for prevention and early detection can be more effective. Modest lifestyle changes can have dramatic effects – there are hundreds of studies that have shown that small changes in diet, exercise, nutrition, and response to stress can improve day-to-day function in old age and extend lifespan. According to the American Academy of Anti-Aging Medicine, longevity can be improved by as much as 20 to 800%.

Aging is not optional. Sooner or later it happens to all of us who are lucky enough to reach the later stages of life. But aging well is optional. You can take charge of your journey through aging by taking an active role and never giving up on being a student of life. I’m happy to share more about this at Grace Cottage’s Healthy Aging Conference, as well as with patients at my clinic at Grace Cottage Family Health and Hospital in Townshend, Vermont.

Bio: Dr. Jesper Brickley is a graduate of The Evergreen State College in Washington State and of the Western University of Health Science in California. He completed his residency at Rose Family Medicine in Colorado. He joined the staff of Grace Cottage Family Health in 2015.

Grace Cottage Adds Lymphedema Therapy

| Graceful Health
Abby Abbot

abby-abbott-headshotBy Abigail Abbott, Grace Cottage Physical Therapist
as originally appeared in the Brattleboro Reformer’s Graceful Health series, October 7, 2016

The bad news first, and then the good news: most women dealing with breast cancer are so focused on getting rid of the cancer, thinking if they achieve that, it will be the end of the experience. Lymphedema is probably the furthest thing from their minds. But there’s a high probability they’ll have to deal with this disease, as high as 50-50, according to the National Cancer Institute.

The good news is that specially trained physical therapists can make this experience much less traumatic. And further good news: help is nearby! Grace Cottage now has two physical therapists certified to provide this therapy, Cindy Kenyon and me.

In order to explain what is involved with Lymphedema therapy, it is helpful to first understand what causes Lymphedema.

Lymph is a fluid that moves through the body in order to remove impurities and infections. The lymph nodes filter the lymphatic fluid with the help of white blood cells and are part of the system that keeps the fluid moving. When lymph nodes are removed as part of a cancer treatment, or are damaged by radiation, there is potential for the lymphatic fluid to build up, causing a swelling called Lymphedema.

Lymphedema can also be congenital, meaning you can be born with the tendency; this type mostly affects the lower extremities. It can also be caused by chronic venous insufficiency (improper functioning of the valves in leg or arm veins). Whatever causes it, the treatment includes the same techniques.

The bad news is that, once it appears, Lymphedema is always permanent. Sometimes it shows up fairly quickly after cancer treatment; sometimes it doesn’t show up until years later. It usually begins slowly and progresses in intensity. If allowed to progress, it will cause significant debilitation.

The good news is that, when caught early and treated with special therapy, the effects of Lymphedema can be minimal. So it’s important to know what signs to look for.

In the earliest stage, Lymphedema may be experienced as a swollen limb that feels heavy, with skin that feels tight, and perhaps there’s a sense that clothes, watches, rings, bracelets, or shoes are becoming too tight. Those who have been treated for cancers other than breast cancer may have this feeling in their feet and legs, while those dealing with breast cancer usually experience it in their hands and arms.

It’s important to consult your medical provider if you are noticing any of these symptoms so that the diagnosis of Lymphedema will be accurate. There are other things that can cause swelling, and it is important to rule these out first.

For those with Lymphedema, any structural damage to the lymphatic system caused by the cancer treatment cannot be cured or permanently repaired, but the effects of this damage can be improved by the various aspects of Lymphedema therapy.

First, a Lymphedema therapist can help by performing and teaching a patient to perform a mild form of massage called “lymphatic drainage,” which is a very gentle touch therapy. This helps to drain any build-up of fluids. It is important to get instruction before doing this, as the technique must be performed correctly in order to help, rather than hurt, the situation.

Patients will also be fitted for compression garments, the cost of which are usually covered by medical insurance. Unfortunately, at present, the bandages, also required for treatment, are not usually covered. Bandages and compression garments help to keep the swelling down.

Patients need to be aware that this first phase of treatment can be intense, requiring an hour or two of therapy per day for up to two weeks. It requires commitment, but it is the only effective treatment for Lymphedema.

After the initial two weeks or so of therapy, the patient will be prepared to self-manage the disease. They will know how to perform the lymphatic drainage massage on themselves, and they will know how to use the bandages and compression garments. At this point, less frequent office visits will be needed.

In addition to these important treatment techniques, Lymphedema therapists teach their patients several lifestyle approaches that can help. For example, because the lymphatic system that helps to remove infection has been weakened, it is important for patients to take good care of their skin so that it does not dry out and crack, thereby allowing infections access into the body. Also, certain exercises can be done in moderation to help keep lymphatic fluids moving. And weight loss can help to reduce the effects of Lymphedema for some patients.

A diagnosis of Lymphedema can seem like a low blow for those who are already dealing with the profound complications of a cancer treatment. It is important for them to realize that there are caring and specially trained therapists ready to support them and to provide help.


Abigail Abbott joined the Grace Cottage Rehabilitation Department staff in 2015. She has a Bachelors in Russian language and literature from Columbia University and a Masters in Physical Therapy from Boston University. She is a Certified Lymphedema Therapist, trained by the Academy of Lymphatic Studies.

Cindy Kenyon, PT, has been a member of the Grace Cottage staff since 2008. She earned her CLT certificate from the Dr. Vodder School International.

Healthy Fast Food — Smoothies

| News
Cheryl Shaw

By Cheryl Shaw, Grace Cottage Hospital Health Coach
as originally appeared in the Brattleboro Reformer’s Graceful Health series, September 23, 2016

Who doesn’t love a smoothie? They’re easy to make, so they can give a new, healthy meaning to the words “fast food” – if you choose good ingredients.

You probably already know how to make a smoothie: just chop up the larger ingredients, throw everything into a blender, and turn it on. Super easy.

Here is a list of my top favorite smoothie ingredients to inspire you. Organic options are always best, but do what you can. Mix them up and have fun creating!

  1. Start with a Base: Here are some healthy ideas: Nut or seed milk (almond, hemp, cashew), unsweetened coconut water, plain yogurt or kefir (if you tolerate dairy; good for probiotics/cultures!), cooled green tea, or pure water.
  2. Bananas: Use half of a ripe banana to sweeten any smoothie. Affordable and full of potassium.
  3. Liquid essential fatty acids: Consider cod liver oil, liquid fish oil (made from salmon, sardines, anchovies), or flax oil. These EFA’s have numerous health benefits. Choose a quality, pharmaceutical grade oil that is third-party tested for removal of contaminants and toxins (no mercury, PCBs, binders, filler, dyes, etc.). These are required to be 99% pure.
  4. Extra virgin coconut oil: A healthy fat that contains medium chain triglycerides (MCTs), found to have benefits to weight loss, decreases in abdominal fat, increased metabolism, increased HDL (good cholesterol) and helpful for the brain and thyroid gland.
  5. Fresh or frozen berries: Blueberries, raspberries, blackberries, cranberries, strawberries, pomegranate seeds, and tart cherries are all good choices, full of health promoting substances and antioxidants. Berries are a low glycemic fruit.
  6. Protein powder: Options include unsweetened hemp protein, pea protein or whey protein powder. Choose brands with only one or two ingredients. Avoid sweetened and artificially sweetened products (especially sucralose, which has found its way into many sports drinks, flavored waters and whey protein powders).
  7. Raw nuts and seeds: Great source of healthy fats, protein, vitamins and minerals. Try raw walnuts, almonds, cashews or pecans. Raw seeds such as flax, chia, pumpkin, hemp and sunflower also deliver a healthy serving of essential fatty acids.
  8. Apples: green apples are a low glycemic fruit that are a great source of fiber.
  9. Powdered green superfoods or green algae: Wheat and barley grass, chlorella and spirulina all have health-enhancing benefits, if you are brave enough to add them!!
  10. Leafy greens: Consider adding romaine lettuce, spinach or kale. All are nutrient dense. Add mint for flavor.
  11. Avocados: These add healthy fats, protein, vitamins and minerals. They also can add thickness without an overbearing taste.
  12. Raw cacao nibs or powder: unsweetened cacao powder gives a chocolate taste to your smoothie; it will be bitter without a sweetener, so complement it with ½ a banana or a bit of raw honey. It contains magnesium and other essential minerals and vitamins. It also contains polyphenols, which are antioxidant rich flavonoids.

Cheryl Shaw is a licensed Physical Therapist Assistant, Certified Wellness Coach, and Certified Exercise Physiologist with over 17 years of fitness and wellness experience. She earned her Bachelor of Science degree in Health and Fitness from Springfield College.

Free Cancer Support Group at Grace Cottage

| News

Grace Cottage is offering a free support group for community members dealing with cancer. The eight-week group begins Monday, Oct. 17, meeting from 1 to 2:30 p.m. in the Grace Cottage Community Wellness Center (Heins Building), 133 Grafton Road, Townshend.

Hearing the news that you or a loved one has cancer can stir a range of emotional responses. While some people feel shock, disbelief and anger, others may experience sadness, fear and a sense of loss.

Cancer support groups are designed to help people cope with all aspects of a cancer diagnosis by providing a safe environment to share experiences and learn from others who are facing similar obstacles. These groups can have powerful benefits on the success of treatment and recovery. Studies have shown that patients who attend them have a higher quality of life than cancer patients who do not.

The group will be facilitated by Grace Cottage Behavioral Health Specialist Caroline Chase, M.S., Counseling Psychology. Pre-registration is requested by Oct. 3. With questions or to register, please call Chase at 802-365-3715 x6.

Grace Cottage Now Offers Pediatric Occupational Therapy

| News
Jen and Melinda

By Melinda Roy and Jen Studin, Grace Cottage Pediatric OTs
as originally appeared in the Brattleboro Reformer’s Graceful Health series, September 9, 2016

The word “occupational” might lead you to think that Occupational Therapy (OT) is job-related, but really, it’s much more than that. And when it comes to kids, OT is not focused on work at all — unless you consider it work for kids to learn to play, to take care of themselves, and to develop social skills.

OT helps people of all ages to attain and refine the skills they need to participate in daily life: things they need to do to take care of themselves, and things they do for enjoyment. Pediatric OT focuses on skills required to play, bathe and dress, interact with peers, and fulfill student and family responsibilities. Most kids learn these things naturally at school and at home, but for those with special developmental challenges, attaining these skills can be more work than play. That’s when a pediatric occupational therapist can help.

Grace Cottage has just added pediatric occupational therapy to the list of services it offers. Some details of this therapy service might help you determine if pediatric OT might benefit a child you know.

Children who may benefit from pediatric OT typically are those with birth defects, sensory processing challenges, learning difficulties, traumatic brain injuries, orthopedic injuries, fine motor coordination issues, autism, Down syndrome, cerebral palsy, or a range of chronic diseases. Anytime a child has trouble functioning at an age-appropriate and developmentally appropriate level, an occupational therapy evaluation may be beneficial.

Examples of typical difficulties a child might experience are low muscle tone or strength, coordination and balance issues, movement coordination problems, difficulties with grasping and using small objects like pencils or feeding utensils, behavioral or social skill challenges, decreased attention, learning difficulties, and aversion to sensory stimulation. Pediatric OTs teach fine motor control, gross motor coordination, visual perception, self-regulation, body awareness, age appropriate self-care skills, eye-hand coordination, cognition, and sensory modulation.

For example, a school-based occupational therapist might work with a child on handwriting skills or might help a child learn to aim and throw a ball. In a healthcare setting, a pediatric OT might help a child learn to deal with buttons and zippers; forks, knives, and spoons; or a toothbrush.

Pediatric OTs can help children with mental health and behavioral issues that affect the child’s ability to interact well with adults and peers. An OT might provide exercises to increase a child’s focus and attention span, or help the child develop strategies for dealing with noise, so as to avoid sensory overload. Pediatric OTs teach children ways to deal with negative emotions, providing strategies for times when they feel frustrated or angry. No matter how the difficulties manifest, Occupational Therapy can make a difference.

Occupational therapists not only work directly with the child, but also with the family, parents, caregivers and teachers in order to educate and reinforce specific skills and behaviors which will be used to improve and facilitate the child’s performance and functioning.

OTs help the child and the child’s caregiver develop strategies and solutions to overcome obstacles that interfere with successful everyday activities. Some of these strategies may include providing adaptive equipment for dressing, feeding, and bathing; developing a diet to aide in sensory modulation; providing hand splints and exercises to increase finger dexterity and improve fine motor control, and teaching family members behavioral and attention-getting techniques to increase a child’s successful participation with schoolwork, peers, and home life.

A doctor’s referral is required in order for pediatric OT services to be covered by insurance. Check with your particular insurance for details of what would be covered.

Occupational therapists must complete a master’s degree, do fieldwork, and then pass a national certification exam before they are qualified to conduct patient evaluations and to provide services.

Working with children and helping them to overcome obstacles is a challenging but highly rewarding career. Watching children as they learn and grow into independent people is the best reward for a pediatric OT!


Melinda Roy M.S. OTR/L obtained her Masters of Science in Occupational Therapy at Springfield College. She has worked in public elementary schools with students in pre-K through grade 8. Jen Studin B.S. OTR/L earned her Bachelors of Science in Occupational Therapy from the University of New England. Her pediatric experience includes school-based intervention with children of various ages and diagnoses and work with preschool autistic children.

New App Connects Patients to Providers

| News

Bruce Sweeter 003By Bruce Sweeter, Grace Cottage Clinical Analyst
as originally appeared in the Brattleboro Reformer’s Graceful Health series, August 26, 2016

Got a question for your doctor in the middle of the night, and afraid you’ll forget it by morning? No problem. Grace Cottage has an app for that.

This new feature is now part of “Grace Cottage Connections,” the HIPPA-secure patient portal that connects Grace Cottage’s medical providers with their patients.

The app works with Android and ISO-based devices. Once it’s loaded onto your phone or tablet, your health information and the direct messaging system to and from your care team are always available.

You can check on lab records and appointment times or request a prescription renewal at any time of day or night. You can send a message to your provider whenever you think of it, to ask a question, clarify instructions, or give an update on a problem. You can even upload documents or photos. And you can rest assured that you’ll have a reply within one business day. Regular email does not provide the same privacy protection as the patient portal.

The information available through Grace Cottage Connections is all taken directly from a patient’s electronic health record. This information includes visit summaries, appointment dates and times, insurance information, immunization records, allergies, and many test results. The information can be sent to a printer, copied to a flash drive, or pulled up on a mobile device if you are at a medical appointment elsewhere, making the patient record easily portable.

Anyone who sees a medical provider at Grace Cottage can enroll for access to the patient portal. It is offered to Grace Cottage patients free of charge. You need a device that connects to the Internet to get started.

To set up your portal account, call 802-365-3699, or provide your email address at registration when you come for an appointment. You will receive an email with step-by-step instructions and a link to set up a user name and password. Please don’t share this email invitation with anyone else, as this gives access to your private health information.

Once those steps are complete, you can log into your portal. At this point, if you are on a mobile device, you will see a banner on the top of the screen that you can click on to download the Healthelife app. If you already have a portal account, just go to the app store to download it.

In addition to providing easy access to your portal, if you receive messages from your provider, the app will show a red dot to let you know there’s a message.

If you have any questions about the medical information you see in your portal, please call Grace Cottage Family Health at 802-365-4331.

The Grace Cottage Connections portal is not to be used for urgent needs. If you are experiencing a medical emergency and need help, dial 9-1-1 immediately.

For non-urgent questions, the patient portal is an easy and convenient source of information. It’s easy to sign up. Grace Cottage Connections is only for Grace Cottage patients, but several of our providers are accepting new patients.

Bruce Sweeter earned his Licensed Nurse Assistant certificate from the American Red Cross in 2012. He served as a Medical Assistant at Grace Cottage Family Health before joining the informatics staff in 2014. He is currently pursuing a Medical Assistant Associates degree and a Health Information Specialist certificate from the Community College of Vermont.

Is Your Child Developing Normally?

| Featured, Graceful Health
Natalie Harding

By Natalie Harding, Grace Cottage Hospital PA-C
as originally appeared in the Brattleboro Reformer’s Graceful Health series, August 12, 2016

Natalie HardingIt might seem like just another chore on the back-to-school task list, but there are plenty of good reasons why your child’s required yearly physical is a wise investment.

Children with chronic health challenges like asthma, allergies, or diabetes obviously need to be watched closely for any changes in their conditions, but “well” kids need watching too. The yearly physical provides a structure for regular check-ups to ensure that your child is developing normally.

What is normal? That’s a good question, one to be asked at each year’s physical. Answering that question thoroughly is a good reason for having a regular primary care provider. Someone who knows your child’s unique health history is better prepared to ask the right questions so that any abnormalities are noticed as soon as they arise.

The yearly physical is also an opportunity for you as the parent to receive guidance and support. It is wonderfully affirming to have someone assure you that your child is developing normally and that you are doing a good job!

Having a regular pediatrician or primary care provider for your child also means that someone is helping you keep track of immunizations and is making sure that records are submitted to the state-wide database. Immunizations are recorded in this database so that the information is readily available if your child goes to the ER or to another pediatrician.

It’s important to know that, as of July 1, 2016, the exemption from immunizations for philosophic reasons is no longer an option. Only exemptions for medical and religious reasons are allowed, and the proper paperwork must be filed to claim these exemptions. This means a catch-up schedule, or at least a plan, is necessary before school starts this fall for children who were not fully, or ever, immunized. This is a big adjustment for families who have opted out of shots in the past, so don’t hesitate to request information and have discussions with your child’s medical providers and to check with schools and the VT Department of Health regarding what is required. You can find information and forms at the VT Department of Health’s website, using the search term “school entry immunizations.”

Having an ongoing relationship with a medical provider also helps to build trust, so that there is a safe place to discuss private concerns. In this atmosphere, the provider can ask frank questions, especially as the child grows into adolescence. A provider who knows your child well has better intuition and is more likely to notice emerging problems with depression, sleeping, eating disorders, illicit behavior, and social interaction.

School physicals are an important time to check on a child’s physical growth and development. In addition, the provider assesses whether the child is at a healthy weight, and if not, advises the child about nutritional habits that can either increase or decrease weight.

According to the American Heart Association, approximately one in three of America’s children is overweight or obese, and that prevalence has increased steadily over the last forty years. Obesity often causes diabetes, high blood pressure and high cholesterol, and it can also have a huge impact on self-esteem, so this is cause for major concern.

The National Association for Sport and Physical Education has reported another sobering statistic about our children’s health: only one in three kids are physically active every day.

We adults could do a better job of mentoring healthy exercise habits. This same organization says that adult statistics match that of kids. Less than five percent of us engage in the recommended 30 minutes of physical activity each day, so one of the best things we could do for our children’s health is to take a walk together!

Of course, there are plenty of kids who are involved in sports. They may be getting enough exercise, but they also need check-ups. Sports physicals are required so that a provider can assess the function of heart, lungs, nerve reflexes, range of motion, flexibility, balance, and gait. If the child has a history of concussions or has had recent sprains, fractures, or other injuries, the progress of healing, the risk factors, and the safest approaches to conditioning will be discussed.

Time passes so quickly, and it’s easy to forget how long it’s been since the last check-up. With all of the benefits of regular yearly physicals in mind, the arrival of the school health form can be a welcome reminder, rather than another item on your to-do list.

It won’t be long before the routine of school and sports begins all over again. There’s no time like the present for setting up your appointment!


Natalie Harding is a Physician’s Assistant practicing at Grace Cottage Family Health in Townshend, VT. Natalie earned her Master of Physician Assistant Studies from Franklin Pierce College in New Hampshire. She worked in Greenfield, MA, before joining Grace Cottage Hospital in 2014.