story and photo by Traci Chapman

As healthcare becomes more complex and treatment more expensive, patients of all ages and conditions have found themselves in a no man’s land where they find more questions than answers.
That’s where care management can lift the mists obscuring the answers those patients – and their families – are searching for, helping them improve their health, while avoiding at least some of the stressors that come with high medical bills and navigating the healthcare system.
What is care management?
Case managers are tasked with helping patients, caregivers and families find the most effective way to manage health conditions, while also focusing on potential medical cost savings. Several studies found in the U.S. National Library of Medicine, overseen by the National Institutes of Health, concluded care management can improve patients’ quality of care in the long-term, as well as positively impacting the cost of that care.
University of Oklahoma Health Sciences Center Fran and Earl Ziegler College of Nursing’s Care Management program has been providing community-based healthcare management services since 1995.
Seniors and Disabled Patients
OU’s Nursing Care Management program provides care management services to patients of all ages, conditions and income levels. For Karissa Maddox, RN, BSN, CMC, many of the people she’s spent the last 15 years of her career treating and guiding through the healthcare maze are seniors, elderly and disabled individuals who are deemed ADvantage-eligible by Oklahoma Department of Human Services. Maddox is also the program’s private care management services supervisor.
Oftentimes, multiple doctors treat patients, who also might be facing a myriad of conditions. That’s where a case manager comes in, serving as a central information hub and helping to coordinate care, Maddox said.
“It just relieves the stress and helps the family try to live a normal life, especially if loved ones live at a distance,” she said. “We are often the ‘professional advocate’ helping manage care – while communicating with family members and providers, in addition to coordinating all health care needs.”
OU Nursing case managers first provide an assessment, allowing them a comprehensive look not only into a patient’s medical issues, but also other challenges facing that patient – and their family. As hospital stays get shorter, Maddox said these assessments are crucial, providing the proper care plan and a bridge to medical providers, while also allowing patients to save money.
“You see the education you provide, the stability you provide – and being an advocate for them is huge,” she said. “Sometimes people don’t have anybody else to speak for them.”
OU Nursing Care Management has four office locations in Oklahoma City, Tulsa, Lawton and Elk City, providing services across Oklahoma to patients and their families.
Maternity Coaching and Education
OU Nursing recently unveiled new services geared specifically for pregnant women and new or expectant parents. This service provides supportive coaching and education to clients to help with the life transitions that come with the addition of a new baby, their communications with health care providers — also helping them to determine the best resources for their individual needs.
“The focus is on the client and personalized according to what is most important to her,” said Margaret Back, RN RLC, ANLC, maternity coach and consultant. “The tailored plans and education materials prepare the client to anticipate changes and to minimize the stress of transitioning through the stages of pregnancy and the ‘4th Trimester’ of life with a new baby.”
Services also benefit anyone feeling overwhelmed or uncertain about maternity health-related issues, Back said. “New or single parents working through the transition back to work and adoptive parents or grandparents caring for their grandchildren can also find support, guidance and assistance,” she said.
While services offered by Maternity Coaching and Education are not a substitute for a doctor, midwife, lactation consultant, childbirth educator, therapist or doula, those will be accessible to participants, Back said. It offers Bump to Baby & Beyond Bundles, as well as a la carte options, all designed for flexibility and to address the changing needs of individuals and families, both during pregnancy and after childbirth.
“I am very excited about the opportunity to share the knowledge and experience I have acquired during the past 30 years as a nurse,” said Back. “I truly enjoy helping expectant mothers and new parents navigate through the exciting but sometimes overwhelming transition to parenthood and newborn care.”
Teri Round, MS, BSN, RN, NE-BC, executive director of clinical operations, cited OU Nursing’s multi-faceted approach to care management, which allows patients to move through every chapter of their life – and healthcare – with support and guidance.
“We have been in the business of providing care coordination for more than 20 years – Our case managers are experienced professionals who are able to care for others across their lifespan, but who specialize in the care of seniors and helping them age in place,” Round said. “We have developed other business lines, which work to support care transitions using CTI, an evidence-based model that helps individuals control their chronic conditions at home versus hospitalization or ER; with OU Physicians in the Bedlam L Clinic, in a team effort to improve quality of life in those with little or no insurance and chronic conditions; private care management performing all of the above; and maternal-child health, our newest addition to our group of services.”
For more information or a professional consultation for private care management, contact Lisa Macias at 866-416-4980 or via email at [email protected].

A special day long seminar will help persons losing their sight or blind and their families and friends. The Heartland Council of the Blind will present the Coping with Vision Loss Seminar on Saturday, August 19, 2017 in Oklahoma City.
Vice President of the Heartland Council of the Blind is Sandi Webster of Oklahoma City who lost her vision in 2002. Sandi said the seminar will provide essential tools and encouragement for persons losing their vision and their families and friends. “These people go through the stages of grief, but there is help,” Sandi said.
A previous seminar participant says she used the provided helps right away. “It was like attending a one stop shop. We met Vision, Mobility and Technology Specialists and were introduced to Support Systems. Break-out sessions are: Advocacy, Training for Family/Friends, Just for Men, Just for Women, Technology, Deaf/Blind Information and Visual Services Information. Cost of $20 for the seminar includes lunch, a Resources Notebook and a CD. Registration forms are available at www.hcbokc.org. Or register by calling Heartland Council of the Blind President Frances Poindexter at 405-642-1068. Registration must be received by Wednesday, August 16th. The seminar will be at the New Hope United Methodist Church at 11600 N. Council Rd., OKC, from 9 AM to 4 PM. Check-in begins at 8:30 AM.

Article provided by: Cancer Treatment Centers of America at Southwestern Regional Medical Center.
Tulsa, OK

As seniors draw closer to retirement, being strong and as healthy as possible to enjoy their new “free time” becomes ever more important.
According to Dr. Sagun Shrestha, a medical oncologist at Cancer Treatment Centers of America in Tulsa, you are never too old make a few lifestyle changes to improve your daily health and help reduce the risks of future illness, including cancer. She recommends: Lather up.
From gardening to shopping, use 30 SPF or higher sunscreens. Broad spectrum lotions protect you from the sun’s harmful UVB rays. 1
Load up on fruits & veggies.
Eating brightly colored vegetables, berries and fruits is helpful in maintaining a healthy weight and contributes to lowering your risk of some cancers by as much as 30 percent2! So fill your grocery basket with fresh fruits, seek out seasonal berries, and order a side of veggies with your next lunch or dinner.
Keep moving.
Did you know that up to one-third of cancers may be prevented by just staying fit? That doesn’t mean you have to sign up for a marathon (unless you want to), but you should get moving for at least 30 minutes a day3. Find something you enjoy, grab a friend and get moving.
Drink up.
Staying hydrated benefits every organ of your body and has also been known to help you stay more trim. According to scientific reports from the American Institute for Cancer Research/World Cancer Research Fund International, drinking coffee in moderation may help to lower the risk for two cancers, endometrial and liver4. Follow that during the day with several glasses of water and your body will thank you.
Make a date…with your health care provider.
Just as important as planning a family birthday or holiday get-together, you should make a date with your health care provider for regular check-ups. Routine medical exams increase your chances for early detection of cancer or other health problems and provide a good time for updated information on prevention steps and screenings.
Ready, set, go!
Dr. Shrestha encourages her patients to take “baby steps” when implementing a new, healthy change. “Set a reasonable goal and stick to it,” she adds. “And, if it’s too much of a challenge, revise your plan with a smaller step. The most important thing is to at least start making healthier options.”
To learn more about cancer prevention, visit cancercent.com/tulsa.

Whether it’s climbing into a combine to harvest the wheat or walking into a congressional meeting to discuss farm policy, Francie Kucera Tolle remains focused on one goal—“It’s the legacy of it.”
Rather than a legacy of how Tolle will be remembered, this is one centered on how others will value and appreciate agriculture as a result of her family’s stewardship.
Having been born on a family farm and now farming with her husband Chuck, Tolle knows the importance of agriculture. She has been a resident in Grant County her entire life and laughed as she reminisced growing up on a farm with her three sisters.
“My dad brought a bottle calf home one time and we thought it was the greatest thing ever and asked for a few more. The next day we had 30 bottle calves and would be mauled when we got to barn,” said Tolle. “A year later we wanted some feeder pigs and my dad brought home a whole truck load. Next, we thought we would like some sheep and our dad said, ‘Really?’ We changed our minds pretty quick.”
Tolle spoke about the daily life lessons that were learned among the cattle and in the wheat fields. The greatest of these was work ethic and faith.
“You have to have faith because there is no telling what the weather will be,’’ said Tolle. “You use your work ethic and do everything you can but in the end you have to have faith.”
Growing up, Tolle did everything the hired hands did on the farm, saying it was expected of her and her sisters. She started driving the combine when she was 12 and basically lived in the barn with the stocker cattle during the winter. She went on to college with no plans on returning home. But as fate would have it she started dating a local farm boy and married him in 1990.
“I didn’t really have plans on marrying a farmer,” laughed Tolle. “I was a business major and liked marketing. But then I started dating Chuck and I came back to agriculture pretty quick.”
They moved and started their own operation in 1992 in Grant County with a quarter of land, mainly growing wheat and running a cow-calf and stocker cattle operation. Their little operation began to grow as Tolle had two boys, Clint and Cole.
Tolle laughed and said her boys never wanted to drive the combine growing up because that was her thing. Now her boys are growing up and making their own legacy. Clint is married and will graduate college soon, with plans on returning to the farm. Cole just graduated high school and is beginning embark on his college journey studying construction management.
In addition to raising two boys and operating a farm, Tolle also works tirelessly to carry on the legacy of her dad, who taught her the importance of agriculture through policy.
“I got my love for policy from him,” said Tolle. “He never went to college but he was the smartest man I ever knew.”
It was not uncommon for Tolle and her father to be talking about world trade, farm policy and commodity markets. This sparked her interest and she began her work in farm policy in 2003 as Director of the Oklahoma Wheat Growers Association.
From here, many doors began to open for Tolle as she served as Agricultural Liaison to Congressman Brad Carson, Director of Agritoursim, Legislative Policy Analyst for the Oklahoma Farmers Union/American Farmers and Ranchers, State Director of Farm Service Agency and is now currently the Regional Director of the Risk Management Agency serving Oklahoma, New Mexico, and Texas.
When asked about her most rewarding experience, there was no hesitation as she recalled the implementation of the Livestock Forage Program, which resulted in paying over a billion dollars to farmers and ranchers in Oklahoma affected by the three year drought.
“I saw people literally cry because they were saved… I will never forget. That was pretty impactful,” said Tolle.
Although she stays busy with policy and farming, she never forgets why she does it. Tolle is proud to say that she is only the second generation born in the United States.
“It’s the legacy of it. My grandparents came here for this reason. Here I am fulfilling the dream they had. I don’t want it to die,” said Tolle.
Again, even though Tolle has left a legacy in what she does, this was not her goal in an individual sense. Instead, she hopes that through her work, people will know and understand the complexity of farming and in agriculture in general.
“It’s not easy,” said Tolle. “Yes it is rewarding but it is the hardest job you will ever do. If you don’t love it, you won’t do it. There is not another job where you work as hard as you do with farming.”
Tolle is also quick to give credit to her husband for all of her success saying he is extremely supportive of everything she has done. Even with all of her accomplishments, her greatest one is building a legacy with her husband to make sure that others will value and appreciate agriculture as a result of their stewardship.
“My goal is to leave a legacy,” she said.

What’s your favorite summertime memory? Village on the Park

I’ve got a lot but it would be the day I got married when I was 18. Kathy Ream

Going fishing about anywhere. I fished Texhoma and Eufaula when they were coming in. Raymond Leetrammell

I rode my horse every afternoon around our ranch. Evelyn Wilcoxson

Visiting my grandfather in Chandler. We would hitch the horse to the wagon and he would give us a quarter for a movie, popcorn, and a coke in town. Helen LaFevers

Victoria Burdine was not raised with her grandparents. They were deceased, she said, regarding her childhood in Louisiana. Burdine always was the family member who cleaned house and cared for elderly people in her neighborhood in a little town named Rayne.
“I enjoyed it,” said Burdine, LPN, ADON and wound care nurse at Tuscany Nursing Center in Oklahoma City.
Burdine has been a nurse since 2009 and has always served in long-term care. She was a proud CNA for 15 years. Becoming a CNA was a smooth adjustment for Burdine after cleaning neighbors’ homes and running errands at the store for them.
“That’s my passion. A grandmother I could talk to and a grandmother — I didn’t have that,” she said. “So I take these residents here as my grandparents.”
She began working at Tuscany Nursing Center on the day it opened. There was one resident and Burdine was working the night shift, she said. Burdine was the LPN on the floor, and four months later she was asked to become the wound nurse. In early July she added the credential of certified wound nurse to her resume. Certification required rigorous study and taking a test.
“I started at 7 p.m. Sunday night and finished at 3 a.m. in the morning,” Burdine said. “So I am a board certified wound nurse.”
There were a lot of things she was already doing as a wound nurse, but she also learned a lot, she said. The extra education was valuable for her and also added job security to her career, she said.
Burdine said she admires that the nursing staff works well together as a team. At 3 p.m. everyday a few of the residents join her in her office for coffee and cookies. She loves it and said there is something about them that reflects her passion for the elderly.
Residents are of all ages. Some of them are in their 30s and 40s and she loves them, too. Some have been in accidents.
“You never know. It’s sad. I have a few that’s younger than me,” she said. “It is true that back in the day our grandparents would be in a nursing home, but these days it’s really young people, too.”
Burdine said it’s important to let the residents have choices. If they don’t feel like taking a bath at a certain time they can choose a later time.
“If there are certain things they want to eat – let them do it,” she said. “Just give them that freedom of choice. That plays an important role.”
Every once in a while Burdine will work in the skilled nursing unit when needed. Skilled nurses need to pay attention to detail and understand their role as a nurse, she said.
“There’s some hard work back there,” she said.
For long-term care a nurse needs to be compassionate, Burdinecontinued. Nurses without compassion and a love for their job will burnout and not make it in the industry.
“I love my job and I’m very compassionate,” Burdine said. “There’s things I do for a couple of people out of my pocket. Ladies like wigs. They like makeup. Some of them do have family and their family does not come. So I take out of my money and I buy them what they want.”
“If you’re here for the money it’s the wrong place to be.”
One of the residents has a 90-year-old mom that called Burdine from Las Vegas. She wanted to say how appreciative she is of Burdine for taking the time for her daughter to pay attention to small things.
“That means a lot,” Burdine said. “In my mind, the one thing I keep saying is, ‘This may be me one day.’ You know I wish somebody would take the time out if that happens to be me.”
“I want that same person like I am today to be caring. Take a little minute and just listen.”
Burdine tells the CNAs that the residents could be their kids. Across the U.S. nurses and CNAs need to stop what they’re caught up in life and pay more attention to detail, she said.
“Just listen because really that’s all they want you to do,” Burdine said. “So I always say this could be me.”
Currently Burdine is also caring for her mother who came to Oklahoma from Louisiana. She visits Burdine in the summertime.
When returning to Tuscany Village her residents are glad to see her. One of the residents called her at home and Burdine was happy to bring her a hamburger.

St. Anthony Hospital is pleased to welcome Shoaib Ahmad, M.D., to St. Anthony Physicians Group Pulmonary Medicine.
Dr. Ahmad is board certified in pulmonary medicine. He earned his medical degree from Nishtar Medical College in Pakistan, and completed a residency in internal medicine and a fellowship in pulmonary and critical care medicine, at the University of Oklahoma Health Sciences Center.
Dr. Ahmad’s office is located at 608 N.W. 9th St., Suite 3110, in Oklahoma City. To schedule an appointment please call 405-772-4400.