covid 19- grocery store

How to Protect Yourself from COVID-19 When you Need to Go Out

Many in the community are practicing social distancing and getting out as little as possible. As the confirmed cases of COVID-19 rise in Comanche County, you may be getting nervous about having to be out for errands you cannot completely avoid such as occasional grocery shopping. Although feeling apprehensive about going out is understandable, there are several steps you can take to protect yourself while you are out. Here are a few:

 

 

Limit going inside businesses as much as possible

 

Many businesses, especially restaurants, are offering curbside delivery or drive-thru options as dining in is not an option right now. If you’re unsure if the business you need to visit is offering such services, it does not hurt to call and ask them if they would mind accommodating you.

Also, consider having essentials delivered or take turns running errands with a friend. The fewer people out on any given day, the better! If you are elderly or in the high-risk category for contracting COVID-19 due to health reasons, you may wish to reach out to a friend or neighbor. He or she would probably love to help you out. If you know of someone who is unemployed due to the outbreak, he or she could probably use some extra cash in exchange for helping you out as well. Lawton Family YMCA is also offering to pick up groceries for seniors who order groceries through the Walmart grocery app.

 

 

Make use of technology

 

You may wish to ask simple things like documents to be mailed or emailed to you instead of visiting a business. Take advantage of video chat options like FaceTime, Skype or Zoom to conduct business whenever possible.

If you have a non-urgent medical need, call your physician first to see what your options are. Many people also have access to free telemedicine services through the insurance provider. Memorial Medical Group is also providing access to telemedicine through many of our clinics.

 

 

Make a protective masks

 

When you do go out, try to wear a protective mask. Please remember our people working on the “front lines” of this epidemic. Our health professionals, restaurant workers, grocery clerks, etc., need masks and gloves more than anyone. Protecting them protects us all as they will likely be exposed to more carriers of COVID-19 than most of us.

However, you can find instructions on how to sew a homemade mask. Even if it isn’t the N-95 masks that provide the best protection, it can still keep you from touching your face which in return could possibly keep you from contracting the virus.

Think outside the box on how to protect your hands. Don’t touch items you don’t intend to buy. Use another type of plastic besides gloves. There have been people using bags used to clean up after their dogs when they take them outside to “take care of business!”

 

 

Sanitize your hands often

 

Sanitize your hands before going in and after leaving a business. If you can’t find sanitizer, you can make your own using alcohol and aloe vera gel.

 

 

Change your clothing as soon as possible

 

Before entering your home, remove your shoes and spray them with disinfectant. Remove clothes as soon as you enter and put them directly into the washing machine. You can wash them later if needed, but this keeps you from having to pick them up again before washing.

 

 

Sanitize items and let them sit

 

The COVID-19 virus can last hours to days on items depending on what material the item is made of. If possible, seal the bag grocery items are in to protect them, spray with disinfectant spray, and let it sit for a few days.

 

 

Wipe down surfaces touched by new items entering your home

 

If you can’t find disinfectant wipes in stores, you can make those too using paper towels and rubbing alcohol to wipe down surfaces.

 

 

Don’t allow anyone else to put items purchased away

To limit exposure to others living in the household, only the person who picked up items should put them away. This will help limit the exposure to any germs lingering on the items from others who have not yet touched them.

 

 

Have other questions about COVID-19? Visit ccmhhealth.com/covid-19-resources.

 

Disclaimer

The Comanche County Memorial Hospital website does not provide specific medical advice for individual cases. Comanche County Memorial Hospital does not endorse any medical or professional services obtained through information provided on this site, articles on the site or any links on this site.

Use of the information obtained by the Comanche County Memorial Hospital website does not replace medical advice given by a qualified medical provider to meet the medical needs of our readers or others.

While content is frequently updated, medical information changes quickly. Information may be out of date, and/or contain inaccuracies or typographical errors. For questions or concerns, please contact us at contact@ccmhhealth.com.

coronavirus annoucement

Public Health Announcement: Coronavirus

Update 3-25-2020

COMANCHE COUNTY MEMORIAL HOSPITAL ANNOUNCES TWO POSITIVE CASES FOR COVID-19 IN COMANCHE COUNTY

CCMH healthcare officials received COVID-19 test results back this morning of two patients who have tested positive for the coronavirus (COVID-19) in Comanche County.
One patient tested through hospital screening protocol at CCMH and the other patient was screened and tested at the Assessment drive-through Center. Both patients and staff that have been in contact with these patients have been notified and all safeguards remain in place.
CCMH is in direct contact with the Comanche County Health Department who is taking the lead in the case investigations.

These two positive test results came in after the daily numbers are reported to the Oklahoma State Health Department and may not reflect in today’s report that is released.

Since January, Comanche County Memorial Hospital has been working diligently to take precautionary measures for the COVID-19 pandemic. We will continue to follow the CDC guidelines and use best practices to protect our patients, staff and community.

As a reminder, NO visitors are permitted in the hospital with very few exceptions such as end-of-life situations.

If you have general questions about coronavirus please call the Oklahoma State Department of Health call center at 1-877-215-8336.

If you have minor symptoms please call your primary care provider. (If you do not have a primary care provider you can call our referral line at 510-7030.)

If you are experiencing shortness of breath, respiratory conditions or fever please call the Emergency Department a head of time to let them know you are on your way.

Here are steps you can take to protect your health and the health of those around you:

  • Wash your hands with soap and water.
  • Avoid touching your eyes, nose, or mouth.
  • Avoid close contact with people who are sick.
  • Practice social Distancing.
  • Stay home and away from others if you become sick with respiratory symptoms like fever and cough.

For more information about COVID-19 (Coronavirus Disease 2019), please visit the following sites:
www.ccmhhealth.com
www.coronavirus.health.ok.gov
www.cdc.gov

 

Update 3-23-2020

New Hospital Visitor Restrictions Start March 24

The new policy further limits visitors to the CCMH facility. Starting Tuesday, March 24, NO visitors will be allowed for patients in the hospital with a few exceptions. One adult visitor will be permitted for labor and delivery, NICU and pediatrics for the entire length of the hospitalization. Exceptions will be made for Emergency Surgeries during the time of the procedure, and once the patient awakes, visitors will need to leave. Exceptions are also being made for end-of-life situations. These visitors will still be screened in the hospital’s front lobby. These new restrictions on patient visitation are in place to protect our patients, their families, and our CCMH healthcare providers and staff, and to mitigate the potential transmission of COVID-19.

 

Starting Today All Employees Are Being Screened For Temperatures

All CCMH, MMG and LCHC employees will be screened for temperatures when arriving to work. Most employees will be screened in their departments. Others will be screened at the front lobby entrance, Outpatient Center entrance, and the TMC entrance. Please check with your supervisor or manager to find your screening location.

 

Text Alerts for Clinic Visits

Patients can now send a text message to a specific phone number that will be listed on each clinic’s door that they have arrived for their appointment. The clinic will acknowledge the patient and tell them to wait in their car until they get a text for them to come in. Each clinic will be calling and letting patients with upcoming appointments know that this texting capability is available.

 

Televisits Available

Memorial Medical Group is excited to announce that we are now able to offer televisits. Your provider may be contacting you to reschedule your appointment to be done via telemedicine if medically appropriate. These visits can be done from your home computer with a webcam, or from our HEALOW App on your cell phone or tablet. When your appointment is changed to a televisit, you will receive an email with instructions on how to join your visit all from the comfort of your home.

 —

 

Update 3-20-2020

Weekend hours for the Assessment drive-through Center are 2pm-4pm!

Saturday and Sunday hours for the CCMH and LCHC Assessment Drive-Through Center are 2pm-4pm at 3811 West Gore.  The drive-through clinic is for those who are experiencing a fever.  We are asking people to please self screen first – if you do not have a fever, please do not visit the clinic at this time.  People will be screened in their vehicles throughout the entire process for everyone’s safety.  Signage will be posted on the corner of Gore and Arlington.  Drivers will follow around the back side of the Lawton Community Health Center Clinic by using Arlington street.  Directional signage will also be posted on where to enter for step one screening.  Initial screening will include temperature checks and other vitals to determine if you will move on to the next screening station.  Registration will take place for those moving through the process; this process may include a flu test if necessary and, for those who meet the criteria, a specimen for COVID-19 may be collected and sent for testing.  COVID-19 testing is still not widely available for everyone who wishes to be tested.  Please bring your identification and any insurance information with you to the Assessment Drive-Through Center.  It will be open from 2pm – 6pm during the week as long as supplies last.

Elective, non-urgent surgical procedures postponed

Comanche County Memorial Hospital continues to take precautionary measures to safeguard our patients, staff and community from the coronavirus (COVID-19). CCMH Administration has decided to postpone elective, non-urgent surgical procedures that can be rescheduled and will not significantly impact a patient’s health.

This recommendation comes from both the Surgeon General and the Centers for Disease Control and Prevention (CDC). The decision was not taken lightly as we know it will inconvenience patients, impact our staff and providers. The reasons for postponing are two-fold: helping in our efforts to preserve supplies and personal protective equipment and reducing the risk of coronavirus spread.

Emergency and urgent surgeries and procedures will continue. These cases include any procedures that should be done right away or within a 4-week time period because postponing could negatively affect the patient’s health. Staff will be contacting patients as their cases become eligible for potential postponement.  You can still enter The Outpatient Center for routine blood work. Thank you for your understanding and patience as we continue to fight the spread of COVID-19.


 

Update 3-18-2020

Assessment Drive-Through Center opening tomorrow at 2pm at 3811 West Gore

Starting March 19 at 2pm until 6pm Comanche County Memorial Hospital and Lawton Community Health Center will open up an Assessment Drive-Through Center at 3811 West Gore for those who are experiencing a fever.  We are asking people to please self screen first – if you do not have a fever, please do not visit the assessment center at this time.  People will be screened in their vehicles throughout the entire process for everyone’s safety.  Signage will be posted on the corner of Gore and Arlington.  Drivers will follow around the back side of the Lawton Community Health Center Clinic by using Arlington street.  Directional signage will also be posted on where to enter for step one screening.  Initial screening will include temperature checks and other vitals to determine if you will move on to the next screening station.  Registration will take place for those moving through the process; this process may include a flu test if necessary and, for those who meet the criteria, a specimen for COVID-19 may be collected and sent for testing.  COVID-19 testing is still not widely available for everyone who wishes to be tested.  Please bring your identification and any insurance information with you to the Assessment Drive-Through Center.  It will be open from 2pm – 6pm daily as long as supplies last.

Comanche County Memorial Hospital continues to monitor the ongoing coronavirus situation. We are following all guidelines and recommendations from local and state agencies and reputable sources of best practices. While we have restricted visitor access to the facility to one support person per patient for most patients, we continue to work with our community to ensure our patients feel protected but not alone.

Following Mayor Stan Booker’s proclamation yesterday, we have closed our dining room to further promote social distancing in the facility. Our dietary employees are continuing to provide a wide variety of food options in a to-go format. The cafeteria is not open to the public at this time, but remains ready to serve our employees and support persons of our patient population.

Updated 3-16-2020

CCMH Visitation Restrictions starting Tuesday, March 17th.

Comanche County Memorial Hospital remains committed to serving our community’s needs while keeping our patients, staff and visitors safe during the coronavirus (COVID-19) outbreak.

Beginning Tuesday, March 17th at noon, Comanche County Memorial Hospital will be restricting visitation to all patients in the hospital. Each patient will be allowed one support person who will be welcome to visit between the hours of 8 AM and 6 PM. Outside of these hours, visitation exceptions will be made for some situations, such as during end-of-life. These support persons will be screened at the point of entry into the facility for symptoms. If they are symptomatic, they will not be allowed entry into the facility. We encourage family and friends of our patients to utilize phone calls and video calls during this time to support the emotional well-being of their loved one.

Employees are encouraged to check their temperature daily prior to coming to work. If an employee has a temperature greater than 100.4, or develops respiratory symptoms such as coughing, they should stay home and contact their manager. All Outpatient Services such as appointments and procedures are still taking place.

In preparation for the potential spread of the coronavirus (COVID-19) in our area, we also implemented precautionary measures to our Emergency Department last Friday. To help reduce the potential transmission of any respiratory illness, we designated two areas for check-in at our ED. Upon entrance to the ED, individuals with flu-like symptoms will be directed to the west lobby and all other emergencies will be directed to the east lobby.

Due to recent CMS guidance, McMahon Tomlinson Nursing and Rehabilitation Center is restricting all unnecessary visitors (including families) from entering the facility with exceptions to end-of-life situations. Our Silver Linings inpatient unit has also restricted all visitors as well.

Comanche County Memorial Hospital is currently working to establish an Assessment drive-through Clinic off campus later this week to help reduce the spread of the coronavirus.  More information to come on this initiative.

To date, there have been no positive test results for the coronavirus at CCMH.

Yesterday, the Oklahoma State Department of Health removed the pre-authorization requirement for coronavirus (COVID-19) testing. There are also several more third party labs coming online with the ability to test for coronavirus. This means testing is now more accessible than ever before.

With the increase in testing nationwide, we will begin to see a spike in cases. We want to stress that this increase in cases is normal and expected with an increase in testing. Testing is a critical piece of containment strategy. It is important to know who may be infected so the spread can be contained. We want to assure the public that we have been anticipating this increase in positive cases and have plans in place to care for those who need medical care.

We would like to remind our community that you do not need to come to the hospital to be tested. This can be done on an outpatient basis in coordination with county and state department of health. For those who have questions or concerns about coronavirus, or who think they may need to be tested, the state department of health has set up a hotline 877-215-8336.

For more information and the latest updates on COVID-19, you can visit coronavirus.health.ok.gov and www.cdc.gov.

 


Updated 3-14-2020

At Comanche County Memorial Hospital, Memorial Medical Group, Lawton Community Health Center clinics and McMahon Nursing and Rehabilitation Center, we continue to monitor the rapidly changing coronavirus (COVID-19) situation. As we partner with the Centers for Disease Control, the American Hospital Association and the Oklahoma State Department of Health, we are prepared should a case of COVID-19 present at one of our facilities. However, we are asking for the public’s help to prevent the spread of the virus in our communities!

 

We are asking that anyone experiencing flu-like symptoms (Primarily fever above 100.4, cough or shortness of breath) to call your healthcare provider BEFORE physically heading to a clinic or the Emergency Department. We will work with you on the best way to be seen for care without potentially exposing other patients and families during your visit. This type of social distancing has shown to lower the exposure rate and will help us curb contamination that could affect others visiting our facilities for care.

 

If an individual is seriously ill and requires urgent attention because of significant respiratory symptoms (severe shortness of breath) or other critical symptoms, please seek immediate medical attention at our Emergency Department.

 

We also want you to know that we have changed the Triage in our Emergency Department. We are separating patients with flu-like symptoms into one area. Other patients will be seen in a different portion of the Emergency Department. We believe these changes will also further safeguard patients and staff.

 

Because of the National Declaration of Emergency status for COVID-19, we may need to expand our bed and care capacity. We are considering options for this. We will keep you informed. Our community depends upon our talents and expertise. It is our desire to remain the Healthcare Facilities of choice for excellence in healthcare!

 

IN THE FUTURE:

We are also encouraging the limitation of visitors to patients that are in the hospital. We do not want our patients to be exposed to additional germs. We are encouraging all visitors to park in our garage and will be asking staff NOT to use the parking garage for ANY parking. All levels of the garage should be used for visitors. We will be encouraging visitors for hospital patients to enter through the Main Lobby.

 

We want you to know how important you are to maintaining healthcare in our facilities!

     · Please take care of yourself;
     · Get adequate sleep.
     · Avoid large crowds.
     · Please plan for daycare.

 

 

Scott Michener, MD, CMO

Chris Ward, RN, MSN, CNO


 

 

 

Updated 3-10-2020

Comanche County Memorial Hospital remains committed to serving our community’s needs while keeping our staff, patients, and visitors safe. We have screening and isolation protocols in place for patients who may present with concerning signs or symptoms. These protocols are being continuously refined as new information comes in from our national, state, and local health partners. Communication is ongoing between senior leadership, infection prevention specialists, and staff on new developments and recommendations. We remain ready and able to provide care to patients and families with a wide variety of health concerns.

Our partnership with the community is vital to our success as the leading healthcare organization in our area. We encourage those who feel they may have been exposed to coronavirus (COVID-19) to first seek advice from their primary care physicians by telephone. Testing is available through the Oklahoma State Department of Health for individuals who meet criteria, but it is not necessary for this testing to be performed in a hospital setting. The Oklahoma State Department of Health has established a hotline for members of the general public who are concerned they may have been exposed and may require testing. This call center will help guide individuals on current CDC recommendations. The call center is open Monday through Friday, 9 AM to 7 PM, and Saturday, 9 AM to 3 PM. Their phone number is 877-215-8336.

When possible, if you are seeking medical attention and have respiratory symptoms and/or a fever, and have recently traveled to a geographic area that has community spread of coronavirus, please call ahead and notify the clinic, urgent care, or emergency department of your impending arrival. This will allow these medical facilities to appropriately prepare a place for you so as not to expose others.

Comanche County Memorial Hospital is working tirelessly to keep our community safe and informed.

 

 


March 5, 2020

 

COVID-19, otherwise known as the latest novel coronavirus, is on everyone’s mind (and news) these days. At Comanche County Memorial Hospital, we have been intensively preparing for this new illness, both internally and with our community partners. We are ready to serve the community’s needs and also to help you, our community family, navigate these concerning times.

While the standard advice for keeping yourself healthy is still in place (wash your hands, avoid sick people and large crowds where possible, and stay home if you are sick), the following is additional advice related to seeking care when you think you may have been exposed to COVID-19:

 

Stay Home

 

Many people are under the impression you must go to the hospital if you have or think you have, COVID-19. This is not the case. If you are not sick enough to be hospitalized, home is the safest place for you! In the event you need to be tested for COVID-19, this can be done without you having to come to the hospital. If you have been exposed to someone with COVID-19 but have no symptoms, seek advice from your primary care provider.

 

Call Ahead

 

If you are sick and need to be seen, please call your primary care provider first. Your primary care provider can assist you with symptoms over the phone, and determine if you need to be seen for further follow-up. If you choose to seek treatment at an urgent care center, please call before arriving and tell them of your concerns (such as recent travel to a high-risk area or exposure to someone with COVID-19) so that they are prepared for your arrival. If you do not have a PCP then you can call our physician referral line to get a provider at 580-510-7030.

 

When to Seek Emergency Care

 

If you are having trouble breathing, chest pain, or are suffering similar emergent symptoms, please seek emergency care.

If you have traveled to a high-risk area recently and are concerned you may have COVID-19, or if you have been exposed to someone with confirmed COVID-19, and you decide to seek medical attention, please notify the staff at the location where you are seeking medical care IMMEDIATELY upon your arrival so that proper precautions to not spread the infection to others may take place. Public health is everyone’s responsibility!
woman with high blood pressure

High Blood Pressure Management

Untreated, hypertension (high blood pressure) can lead to serious problems such as heart attack and stroke. 

If you’re one of the one in three Americans suffering from this condition, 1 lifestyle plays an important part in treating your high blood pressure. Some patients are able to successfully control blood pressure with a healthy lifestyle. Committing to such a lifestyle may help you delay, reduce, or even remove the need for medication.

Here are some lifestyle changes you can make to control hypertension.

 

Eat a healthy diet

Make smart choices in your diet including fruits, vegetables, low-fat dairy products, and whole grains. Avoid cholesterol, sodium, processed foods, and saturated fat as much as possible. 

Keeping a log of what you eat even for a little while to gain insight into how much and what you’re consuming. There are a variety of apps out there that can help log meals and break down the nutrients for you. 

Make a plan before you go out to eat or to the grocery store. Proper planning can help you avoid making unhealthy decisions. 

Potassium is also an important nutrient. It may lessen the effects of sodium on your blood pressure. The best way to receive potassium is food, not supplements. Discuss with your doctor to learn the potassium level that’s best for you.

 

Limit alcohol 

Drink alcohol only in moderation. The recommendation is no more than one drink per day for women or two drinks per day for men. Drinking above the recommendation not only raises blood pressure by several points, but it also may reduce the effectiveness of medication for hypertension. 

 

Lose weight if needed 

Weight loss is very effective for controlling blood pressure. Losing even a small amount of weight may reduce your blood pressure. 

Besides weight loss, keep an eye on your waistline. Men with a waist measurement greater than 40 inches generally have hypertension. Women are at risk if they have a waist measurement above 35 inches.

 

These numbers do vary among ethnic groups. Ask your doctor what is healthy for you. 

 

Exercise regularly

Regular physical activity, 150 minutes a week, can lower blood pressure. It’s important to be consistent. Blood pressure can rise again if you stop exercising regularly.

 

Quit smoking

The benefits of not smoking are numerous.  Quitting reduces your risk of heart disease and improves your overall health and may lengthen your life.

 

Cut back on caffeine

Caffeine doesn’t affect everyone the same. In fact, those that regularly drink coffee may not notice a rise in blood pressure. 

Take your blood pressure before and after having caffeine. If your blood pressure increases by 5 to 10 mm Hg within 30 minutes of caffeine consumption,  you may be sensitive to caffeine. 

 

Reduce stress

Chronic stress may contribute to hypertension. More research is needed to determine the effects of chronic stress on blood pressure. If you respond to occasional stress in unhealthy ways such as drinking alcohol, smoking or overeating. 

Take some time to think about what causes you to stress and consider ways you can reduce or eliminate stress. This may include activities like exercise, hobbies, and finding quiet time alone. 

 

Monitor your blood pressure regularly 

Regular visits with your doctor help manage hypertension. Your doctor may suggest checking your blood pressure daily with an at-home monitor. If you’ve had a recent medication change, your doctor may recommend that you check it beginning two weeks after starting the medication. 

 

 

Learn more about our advanced cardiac care at ccmhhealth.com/heart-and-vascular.

 

Sources 

 

1 Merai R, Siegel C, Rakotz M, Basch P, Wright J, Wong B, Thorpe P. CDC Grand Rounds: A Public Health Approach to Detect and Control Hypertension. MMWR Morb Mortal Wkly Rep 2016;65(45):1261–1264.

 

Disclaimer 

 

The Comanche County Memorial Hospital website does not provide specific medical advice for individual cases. Comanche County Memorial Hospital does not endorse any medical or professional services obtained through information provided on this site, articles on the site or any links on this site.

 

Use of the information obtained by the Comanche County Memorial Hospital website does not replace medical advice given by a qualified medical provider to meet the medical needs of our readers or others.

 

While content is frequently updated, medical information changes quickly. Information may be out of date, and/or contain inaccuracies or typographical errors. For questions or concerns, please contact us at contact@ccmhhealth.com.

worst foods for heart

10 Foods That Destroy a Healthy Heart

February is Heart Month. There’s no better time to make a decision to keep your heart and cardiovascular system healthy for years to come than right now! Here are 10 foods that you should save for occasional treats or find healthy swaps whenever possible: 

 

Deep-fried foods

Fried snacks, fried chicken, French fries, etc.  increase your risk of heart disease. Conventional frying methods create trans fats. Frans tats are a type of fat that raises bad cholesterol and lowers good cholesterol. 

If you crave fried foods, look for alternative recipes. Examples include recipes that bake, air fry or use healthier oils. Many of these recipes also use mock “vegetable” versions or alternate batters. 

 

Cured and processed meats 

Meats such as sausage and bacon are often high in saturated fat. Even low-fat options, however, tend to be very high in sodium. A few thin slices of deli meat may have half your daily recommended amount of salt! 

High sodium intake is linked to high blood pressure, and avoiding extra salt can greatly improve it. 

 

Fast-food burgers

Saturated fats may contribute to heart disease, their relationship isn’t entirely clear. In general, however, saturated fats from animals, especially in combination with carbohydrates, appear to have a negative effect on heart health. Fast- food restaurants tend to use lower quality ingredients as well as unhealthy cooking methods. Avoiding them is a good way to be kind to your heart. 

 

Candy

Diets high in added sugar may help contribute to inflammation, obesity, diabetes, high cholesterol, all of which are risk factors for heart disease.

 

Juices and soft drinks

Check your beverage labels carefully. Many soft drinks and juices contain a ridiculous amount of sugar!

 

Diet soda

You would think the fat-free and zero-calorie version of your favorite soft drink may be a good solution. It may be fat-free and zero-calorie, however, some research suggests that the chemicals in diet soda may alter gastrointestinal bacteria. Altered gut bacteria makes people more prone to weight gain. 

 

Pastries and cookies

Baked goods, especially commercially produced ones, are full of sugar. They also likely contain saturated fats or trans fats.

 

Sugar filled cereals 

Like drinks, breakfast cereals often contain sugar. The consumption of refined carbohydrates and sugars in the morning produces inflammation. This in return makes blood sugar go up and down, increasing sugar cravings throughout the day.  

 

Meat-lovers pizza

Pizza is a food that often contains too much sodium (salt) according to the American Heart Association. The more meat and cheese you add, the worse it gets. When eating pizza, limit yourself to one or two slices and opt for veggie-filled varieties. 

 

Margarine

Trans fats are common in sticks of margarine which are often marketed as a healthier alternative to butter. To be on the safe side, select a soft, spreadable margarine that contains no partially hydrogenated oils. Olive oil is also a better alternative. 

Our CCMH providers commit to helping you live a healthier lifestyle! Find a list of them by visiting CCMHHealth.com/Providers

 

Disclaimer 

The Comanche County Memorial Hospital website does not provide specific medical advice for individual cases. Comanche County Memorial Hospital does not endorse any medical or professional services obtained through information provided on this site, articles on the site or any links on this site.

Use of the information obtained by the Comanche County Memorial Hospital website does not replace medical advice given by a qualified medical provider to meet the medical needs of our readers or others.

While content is frequently updated, medical information changes quickly. Information may be out of date, and/or contain inaccuracies or typographical errors. For questions or concerns, please contact us at contact@ccmhhealth.com.

woman with coronavirus

Coronavirus: What Oklahomans Need to Know

Concerning health news broke in late December as coronavirus, discovered in Wuhan, China reached the public’s ears. The number of those affected rose swiftly, reaching several countries because of international travel. As of today, January 28th, more than 4,600 cases of coronavirus have been confirmed in China with 106 deaths reported. 1

 

Why is China so greatly affected? 

 

The virus is a novel coronavirus – a member of the coronavirus family previously unknown. Coronaviruses originate in animals. Many of those infected in China frequented the wholesale seafood market in Wuhan. This market sells both live and freshly slaughtered animals. New viruses that raise concern among health experts often start with an animal host. Examples of such illnesses include Ebola and flu.

 

What is a coronavirus?

 

Coronaviruses cause common colds and other upper respiratory infections. These viruses are called zoonoses. Certain animals are affected, and they spread the virus to other animals. Coronaviruses have the potential to affect humans. This occurs more commonly when a mutation in the virus occurs. 

 

The particulars of how this form of coronavirus spreads are not fully known. However, coronaviruses usually spread through droplets of large particles that can only be suspended in the air for three to six feet before dissipation. Varicella (chickenpox) or measles spread through smaller droplets and over much greater distances. Some coronaviruses have also previously been discovered in the stool of certain patients.

 

Given this knowledge, coronavirus is likely spread through sneezing and coughing. At this time, we do not know whether another route of transmission such as fecal-oral contact could spread the virus.

 

What are the symptoms of this new coronavirus from China?

 

From those affected in China, we can confirm that the virus can cause pneumonia. Symptoms include fever, cough and difficulty breathing. Some early cases reported non-respiratory symptoms like vomiting and diarrhea. 

 

Most affected recover in a few days. Those at risk for experiencing pneumonia and other complications include the very young, elderly and those with compromised immunity. Many of the fatal cases of the virus occurred in patients who were already in poor health.

 

How do I prevent coronavirus?

 

All the typical steps to preventing illness apply to preventing this virus: 

Wash your hands regularly. 

Cover coughs and sneezes with your inner elbow. 

Avoid touching your nose, mouth or hands. 

Stay clear of those with symptoms such as coughing, sneezing and a runny nose. 

Stay home if you have a fever.

 

At what point should I go to the doctor if I have coronavirus symptoms?

 

Treat any normal, minor respiratory symptoms at home unless you have recently traveled to China or come in contact with someone who has. It is not necessary to visit a doctor unless you have a persistent cough or additional symptoms such as difficulty breathing, chest pains, or feel very unwell.

 

How is coronavirus treated?

 

Chinese health authorities have added the virus’s full genome in international databases so scientists can study it further. There are no approved antivirals for this type of coronavirus. 

 

When needed, care in an intensive care unit (ICU) can be lifesaving for seriously ill patients. Such patients receive fluids and support for their lungs. 

 

How does coronavirus compare to other viruses?

 

It is unknown how serious coronavirus is at this time. Based on numbers from China alone, the mortality rate is less than 1%. Even 1% is likely an overestimate since data may not include cases that are unreported from those who recovered without seeking medical care. 

 

To compare, flu typically also has a mortality rate less than 1% worldwide. The death rate of Sars, another coronavirus from the early 2000’s, was more than 10%. 

 

Should I be concerned about coronavirus? 

 

Oklahomans, as with all US residents have a very low risk of catching this form of coronavirus. Two Oklahoma residents who recently traveled to China are among the more than 100 being tested for the virus in the US. The results have not yet been made available to the public. 

 

We are much more likely to come down with the flu. Consider receiving the flu vaccine if you have not done so. Reducing flu cases will reduce the burden on health services should the outbreak turn into a larger problem. Although you are not guaranteed to remain flu-free, studies demonstrate that hospitalization, complications, ICU admission, and death are less likely to occur in flu patients who received the vaccine. 

 

Healthcare professionals may be at risk if they treat a patient who traveled to China recently. 

 

Soon, we will learn exactly how contagious the coronavirus is. Cases of death due to coronavirus will likely climb due to travel and the rapid spread the illness has seen, but this does not mean we should panic. 

 

As more information becomes available from public health organizations like the Centers for Disease Control (CDC) and the World Health Organization (WHO), we will share this information to help you and your family remain healthy. 

 

Travel to China has greatly decreased to help stop the spread, and New Year’s celebrations in the country have mostly been canceled. The city of Wuhan, Hong Kong, and some other Chinese cities are on lockdown.

 

As always, our CCMH Providers are here for you if you have any concerns.

 

Source

1 Helen Regan, Steve George, Adam Renton, Amy Woodyatt and Meg Wagner. CNN. Hong Kong closes China borders as Wuhan coronavirus spreads. 28 Jan. 2020.

 

Disclaimer 

The Comanche County Memorial Hospital website does not provide specific medical advice for individual cases. Comanche County Memorial Hospital does not endorse any medical or professional services obtained through information provided on this site, articles on the site or any links on this site.

Use of the information obtained by the Comanche County Memorial Hospital website does not replace medical advice given by a qualified medical provider to meet the medical needs of our readers or others.

While content is frequently updated, medical information changes quickly. Information may be out of date, and/or contain inaccuracies or typographical errors. For questions or concerns, please contact us at contact@ccmhhealth.com.

 

 

girl needing vitamin d

How to get More Vitamin D in the Winter

Getting sufficient vitamin D is important for your health. A simple blood test ordered by your doctor can confirm your body’s levels. According to a study referenced by U.S. News and World Report, as many as 91% of Americans working indoors are not receiving enough of this vitamin! 1

 

Depending on where you live in the world and what kind of lifestyle you lead, you may be at greater risk of vitamin D deficiency. Some of those at increased risk include people with dark skins, older adults who are housebound, pregnant and breastfeeding women and those with certain medical conditions including, cystic fibrosis, liver disease, Crohn’s disease, and celiac disease.

 

Vitamin D levels drop in the winter 

 

Vitamin D aids in developing a healthy immune system, bones, and supports cognitive functioning. It is known as the “sunshine vitamin” because the easiest method of obtaining it is to spend some time in the sun. Anyone who wears clothing that covers most of their skin when outdoors may not be getting enough sun exposure to make their own vitamin D.

 

Vitamin D is also an important steroid that functions like a hormone in the body. It regulates the functions of more than 200 genes.

 

Though using sunscreen is normally the safest way to enjoy the sunshine, going without it for short periods of time is the key to making your own vitamin D. Sunscreen with SPF 15 decreases the synthesis of Vitamin D by 99% when used as directed, so wait a moment or two before applying when outdoors.

 

Many of us avoid spending much time outdoors in the winter due to cooler temperatures, however. Thankfully, there are other ways to get this essential vitamin even when the sun isn’t shining. 

 

How can we obtain vitamin D without sunlight?

 

There are two main forms of vitamin D. Vitamin D2 is from plant sources. Vitamin D3 is a more active form from animal sources. Both animals and plants receive vitamin D from sunlight exposure. Vitamin D3 may be consumed by eating meat or other animal products such as milk and cheese.

 

Oily fish is a great source of vitamin D to add to your diet. Oily fish includes flounder, Sockeye salmon, sole, tuna, sardines, mackerel, swordfish, sturgeon, whitefish, and rainbow trout. Just a palm-sized serving of these fish may help get anywhere from 75%- 100% of your recommended daily amount of vitamin D. 

 

Though mushrooms are actually fungi, they are the only non-animal source of naturally occurring vitamin D. Wild mushrooms, especially those exposed to UV light have the greatest content of this essential vitamin.  Around 1 cup of raw UV-exposed mushrooms meets or exceeds your daily needs.

 

Many grocery store items have also been fortified in vitamin D. Such items include milk, orange juice, soy milk, and yogurt. 

 

Cod liver oil in liquid form or gel capsules is another great way to receive Vitamin D. Lastly, a supplement may also be needed to achieve healthy Vitamin D levels. Before taking supplements, always discuss them with your doctor. Find a list of our physicians at CCMHHealth.com/providers/.

 

Source 

 

1 Howley, Elaine K. U.S. News and World Report. What’s the Connection Between Vitamin D and Breast Cancer? 27 Jun. 2017.

 

Disclaimer 

 

The Comanche County Memorial Hospital website does not provide specific medical advice for individual cases. Comanche County Memorial Hospital does not endorse any medical or professional services obtained through information provided on this site, articles on the site or any links on this site.

 

Use of the information obtained by the Comanche County Memorial Hospital website does not replace medical advice given by a qualified medical provider to meet the medical needs of our readers or others.

 

While content is frequently updated, medical information changes quickly. Information may be out of date, and/or contain inaccuracies or typographical errors. For questions or concerns, please contact us at contact@ccmhhealth.com.

always sick child

Should I be Worried if my Child is Always Sick?

This time of the year, some parents may grow concerned that they are spending all their time at their pediatrician’s office or the pharmacy. Many young children seem to constantly battle colds, respiratory infections and every “bug” that goes around. Although any loving parents would worry, chances are there is little reason to be concerned. If you’re a parent fighting this battle, here are a few answers to the questions you have to ease your mind. 

 

Is it allergies or a cold?

 

Signs of allergies in a child over two include:

 

constant nose rubbing

clear mucus running from  nose for over a month

excessive sneezing 

 

These symptoms definitely point to allergies if they occur during the spring or fall when pollination occurs.  Depending on what the allergy is to, however, these symptoms may occur year-round. Your pediatrician can help you discover the cause of your child’s allergies. 

 

What is the cause of my child’s cold?

 

You may worry your child lacks vitamins or the cold outdoors is causing their illness. Colds do not occur due to a lack of vitamins or a poor diet. Weather conditions also do not affect illnesses as we discussed in our blog, 5 Winter Health Facts

 

Colds are an unavoidable part of growing up. You can’t prevent them other than avoiding coming in contact with cold germs. Although, you really shouldn’t hope to avoid colds completely. They help build up your child’s immune system. 

 

So although it is hard to see your child under the weather, be thankful they are getting this immunity boost at a young age. Most children, even those that seem to always struggle with illness, will greatly improve by mid-elementary school. So the “good news” is your child should miss more of their less academically challenging school days during their preschool and kindergarten years as opposed to their more academically advanced years.  

 

How many colds per year is normal for kids?

 

Most children start to get colds after about six months of age. This is when the immunity they received from their mom fades. After that, they have to build up their own immune system.

 

Babies, toddlers, and preschoolers may get as many as seven to eight colds a year! At school age, they average five to six colds a year. Teenagers and adults may have as many as four colds a year.

 

If you’re a parent though, you know it isn’t the only illness your child has to deal with, unfortunately. Children may have a diarrheal illness, with or without vomiting, two to three times a year too! Some children get high fevers with their colds. They may also have a sensitive tummy and develop diarrhea with cold symptoms.

 

What about ear infections?

 

If your child gets a lot of ear infections it doesn’t mean that your child has a serious health problem. This only means that the tubes in the ear aren’t draining properly. And if your child has repeated ear infections, talk to your child’s pediatrician to see if they need to see an ears, nose, throat specialist. Ear tube surgery is a simple procedure that can help many children while others will outgrow this problem before age two. 

 

What is a sign I should be concerned about frequent child illnesses?

 

Consider your child’s overall health. If he is gaining weight and robust, you shouldn’t worry. Your child is no sicker than the average child of their age. Children get over colds by themselves. Although you can reduce the symptoms, you can’t shorten the course of each cold.

 

Many parents worry that their child has an underlying disease because they get a lot of colds. A child with health concerns does not look well in between illnesses, will experience hospitalizations and not gain weight.

 

 A child with an immune system disease doesn’t get more colds than the average child. They will, however, experience numerous serious infections every year such as pneumonia before they are even a year old. In addition, a child with a serious disease does not gain weight very well or look well between infections.

 

When can my child return to school after illness?

 

The first five days of a virus are the hardest.  Cold symptoms can often linger for two to three weeks. As long as your child is fever free for 24 hours, there is no reason she cannot attend the majority of her normal activities. Sports and gym activities may need to wait for a few additional days until he feels up to it. 

 

Parents, hang in there! Winter bugs will be gone before you know it! If you have concerns about your child’s health, however, please reach out to a CCMH Pediatrician today. 

 

Disclaimer 

 

The Comanche County Memorial Hospital website does not provide specific medical advice for individual cases. Comanche County Memorial Hospital does not endorse any medical or professional services obtained through information provided on this site, articles on the site or any links on this site.

 

Use of the information obtained by the Comanche County Memorial Hospital website does not replace medical advice given by a qualified medical provider to meet the medical needs of our readers or others.

 

While content is frequently updated, medical information changes quickly. Information may be out of date, and/or contain inaccuracies or typographical errors. For questions or concerns, please contact us at contact@ccmhhealth.com.

woman with resolutions

Why We Can’t Keep Our Resolutions

A new year (and especially a new decade) causes many of us to find new resolve to make changes in our lives. Whether your New Year’s Resolution involves common resolutions such as weight loss, or reading more books, or something more unique and personal, you may be wondering if you’re really going to meet your goal. 

 

Well, research says that the majority of us won’t keep our resolutions. Somewhere between 8 and 20% of us will meet our goal based on past statistics. Although that number isn’t encouraging, this, of course, does not mean that it is impossible to succeed. 

 

We hope that by discussing why we can’t keep our New Year’s resolutions, you will be prepared and more likely to proudly enjoy your success in 2020!

 

Here are seven reasons why we can’t keep our New Year’s Resolutions:

 

We didn’t mentally prepare 

 

Changing ingrained habits is not a simple task. How often do we not give resolutions a second thought until December 31st? Often, we make very lofty goals under the influence of holiday cheer and the influence of others. 

 

It is important to step back and consider the possibility of achieving our resolution. We’re not saying you shouldn’t make big goals, but that focusing on smaller changes is a way to help you work up to bigger goals. If you want to save $200 extra every month but only managed to save about $20 each month this year, $200 might be a huge jump. Saving $40 may be more realistic. Next year you can increase the number or even mid-year if it is going well. 

 

We didn’t make specific goals 

 

“Exercise more” is not a good goal! You may be surprised to hear a healthcare organization make such a statement, but less specific goals are more commonly abandoned. 

 

When we don’t make specific goals, it is easier to back out and not achieve them. It is better to think of our bigger goal as the result of following smaller, more specific goals. 

 

For example, if we set a specific measurable goal of completing a certain workout for a certain number of minutes for a certain number of days per week, we’re more likely to reach our goal of exercising more. 

 

We didn’t think about what we truly want 

 

We can get hung up on other’s goals or what we feel society says we should do. We live in a world that lives on social media and the majority of us aren’t portraying life in a completely realistic way. This can leave us feeling depressed, inadequate and like we should be doing more or behaving differently. 

 

Don’t jump on the latest fad diet or take up the latest trend for fear of missing out. If you recognize that you’re struggling with the expectations of others, perhaps finding new ways to celebrate what you love about yourself is what you truly need to do. 

 

Practice self-care by treating yourself to a relaxing massage every month. Discover a deeper appreciation of your talents by cultivating new hobbies. Finding happiness in who you are will cause you to make better decisions and “grow” more efficiently into someone who is happy and better able to meet goals. 

 

We didn’t think of the goal as a true lifestyle change 

 

It’s ok to want to lose a certain number of pounds before bikini season. Sometimes focusing too much on a specific date can be detrimental, however. If we realize that we aren’t going to lose weight by a specific date, we may give up long before the date arrives. 

 

Consider if what you want is truly a change you can stick to long term. Make smaller goals that build on one another. Know you may have mess-ups along the way, but don’t ever lose sight of your goal. 

 

We didn’t give it a good shot 

 

According to an article in Psychology Today, it takes an average of sixty-six days to form a good habit, and much less repetition to form a negative one. How we begin also seems to have an effect on our habit forming outcome. 1 Commit to following through with your resolution at least every day for a month no matter what. If you truly want to ditch it after that, do. However, more likely than not, you will decide it is worth it and be on your way to forming a new habit soon. 

 

We didn’t make a positive goal 

 

Have you ever told yourself not to do or think about something? The next thing you know, it’s all you can think about! Instead of making a goal to “not blow your money on coffee from the coffee shop every morning”, make a goal of “drinking coffee at home.”

 

Do you see what happened? These are essentially the same goals. However, by thinking of it in a positive light, you’re more motivated to want to follow through. Instead of dwelling on your favorite overpriced drink, now you’re thinking of ways you can get your “fix” at home. 

 

We didn’t replace the bad habit with a good one 

 

As we have discussed, we are “creatures of habit.” Getting rid of a bad habit is even more challenging if we aren’t replacing it with something good.

 

 If we want to try to put an end to an unhealthy eating habit, we need to have a healthy alternative ready to grab when the urge hits us. If we are trying to give up soda, for example, we may want to have another beverage readily available like bottled tea or flavored water. 

 

In the end, remember that January 1st is simply a day on the calendar. You may have setbacks, but do not quit. You may need to modify your goals due to circumstances beyond your control, but do not quit. You may mess up horribly tomorrow, but do not quit. 

 

 If you are considering making a change, it’s never too late! Don’t let a date on the calendar dictate you living a healthier, happier life. Take the time to consider your goals, plan, and crush them in 2020! 

 

Happy New Year! 

 

Source 

1 Rubin, Gretchen. Psychology Today. Stop Expecting to Change Your Habit in 21 Days.  21 Oct. 2009.

 

Disclaimer 

 

The Comanche County Memorial Hospital website does not provide specific medical advice for individual cases. Comanche County Memorial Hospital does not endorse any medical or professional services obtained through information provided on this site, articles on the site or any links on this site.

 

Use of the information obtained by the Comanche County Memorial Hospital website does not replace medical advice given by a qualified medical provider to meet the medical needs of our readers or others.

 

While content is frequently updated, medical information changes quickly. Information may be out of date, and/or contain inaccuracies or typographical errors. For questions or concerns, please contact us at contact@ccmhhealth.com.

holiday arrangement

Bouncing Back After Holiday Eating

It takes a lot of discipline to control our holiday eating when there are sure to be multiple goodies around! If you gave up and overindulged, don’t beat yourself up about it! We’ve all been there! The start of a new year is always a great time to make a change. To help, here are eight tips to help you refocus on healthy eating. 

 

Get over the guilt

 

Continuing to dwell on it and punish your self does more harm than good. If negative emotions are a trigger for your unhealthy eating habits, this can start a tough to beat cycle. You may find yourself feeling guilty for overindulging, eating poorly to deal with the guilt, and then feeling guilty all over again. 

 

The best thing you can do is show yourself some grace. Acknowledging that you messed up and focusing on the reasons why you want to change are a great way to put your best foot forward. 

 

Stay busy 

 

Maybe you’re still enjoying some time off from work, or maybe the beginning of a new year just means a slower season for your particular career. Many of us overeat out of boredom. If this is the case for you, pay attention to what time of day this usually hits for you. Have some healthy snacks ready as well as a list of activities you can use to stay busy.

 

Plan for success

 

Finding time to plan out our meals is a struggle for many of us in our fast-paced world. However, meal prep can really add to your success. Planning your meals and grocery list will keep you from buying unhealthy snacks while in the store.  

 

Go easy on the social events 

 

If you find the temptation to overeat too great at events, now is a great time to say no to a few social events if you normally have a packed social calendar. If you can’t miss the event, plan out what you will eat if you know what’s on the menu. Is it something too caloric to take a chance on? Eat a good well-balanced meal beforehand and then practice saying, “No, thanks. I ate before I came” when offered something indulgent. 

 

Don’t let your hunger build 

 

 Starving yourself usually backfires! Don’t skip breakfast, and don’t go longer than 5 hours without eating. Beginning the day right with a healthy meal and well-spaced meals regulates your blood sugar, maximizes your metabolism, and evens out your appetite. 

 

Drink more water 

 

Water supports optimal metabolism. Some research shows it may naturally curb your appetite. It may also help you feel better faster. Drinking more water flushes out excess sodium. This quickly helps you de-bloat and gets your digestive system moving to relieve constipation. You should drink approximately half your weight in ounces of water. 

 

Don’t cut out carbs completely 

 

Carbs alone aren’t bad. It’s what you are getting your carbs from that matters. Not sure where to start? Start by pairing vegetables and lean proteins with a small amount of whole grains and a healthy fat. Avoid refined carbs such as sugar-sweetened beverages,  pastries, fruit juices, white pasta, white rice and white bread.

 

Make it part of your lifestyle 

 

Good intentions alone won’t cut it. A resolution alone won’t cut it. Healthy living happens when it is a habit. Take that new class at the gym you have been curious about, carry around that big cup full of water, and read up daily on some of your favorite fitness sites to keep your focus on healthy living. 

 

We wish you a very healthy and happy 2020! Have questions on how to meet your new health goals for the year? Reach out to a CCMH Provider

 

Disclaimer 

 

The Comanche County Memorial Hospital website does not provide specific medical advice for individual cases. Comanche County Memorial Hospital does not endorse any medical or professional services obtained through information provided on this site, articles on the site or any links on this site.

 

Use of the information obtained by the Comanche County Memorial Hospital website does not replace medical advice given by a qualified medical provider to meet the medical needs of our readers or others.

 

While content is frequently updated, medical information changes quickly. Information may be out of date, and/or contain inaccuracies or typographical errors. For questions or concerns, please contact us at contact@ccmhhealth.com.

girl outside in winter

5 Winter Health Facts

From the cold to the flu- we all do our best to avoid winter illnesses. Being cautious and taking measures to avoid these illnesses is always a good practice, but are some of the common steps we take unnecessary? Let’s sort out fact from fiction with these 5 winter health facts! 

 

You don’t get sick because it is cold 

 

The cold itself is not the reason for illness. How soon the temperature changes also has little effect on the spread of illness.  Therefore, habits your mother warned you against such as sleeping with wet hair won’t bring on an illness. 

In the colder months, we spend more time indoors and in close quarters with others and their viruses. This is what causes you to be under the weather.

 

You can’t get the flu from the flu shot 

 

There is no virus in the injection, so it won’t give you the flu. The nasal spray vaccine may cause mild flu symptoms, however. Although receiving the flu shot does not guarantee that you won’t get the flu, it will protect you from the most common strains of flu. Your symptoms won’t be as severe if you do get sick also.

 

You lose little heat through your head 

 

Any uncovered body part is going to lose heat, and you only lose about 10% from your head. Wearing a hat in the cold is always a good idea, but a hat alone is not enough to protect you from the elements. Be sure to appropriately clothe your entire body when out in the elements.  

 

Green mucus is not a sign of a bacterial infection

 

People often think when they cough up green mucus that they have an infection. This actually means that whatever illness you have is coming to an end, however.

Yellow mucus indicates that your body is still fighting whatever is making you sick. Clear mucus is often present at the beginning stages of illness.

 

Shoveling snow increases your risk of heart attack 

 

Although it sounds crazy, this is true! Thankfully, we don’t have to shovel snow very often around here, but this is how it happens: cold constricts your arteries, increasing the demands on your heart. Shoveling then adds to that demand. Shoveling is more stressful on the heart than most winter sports! In a matter of minutes, your heart rate reaches a dangerous point. 

If you are healthy and active, you should not be concerned. Many don’t know they have health problems like high blood pressure, diabetes or high cholesterol, however, so it is best to exercise caution if you need to shovel snow by using a small shovel and taking breaks. 

If you are 60 or older, discuss your winter activities with your doctor. 

 

Has a winter health issue got you down? Reach out to our CCMH Physician Referral Line to find an appointment today! 

 

Disclaimer 

 

The Comanche County Memorial Hospital website does not provide specific medical advice for individual cases. Comanche County Memorial Hospital does not endorse any medical or professional services obtained through information provided on this site, articles on the site or any links on this site.

 

Use of the information obtained by the Comanche County Memorial Hospital website does not replace medical advice given by a qualified medical provider to meet the medical needs of our readers or others.

 

While content is frequently updated, medical information changes quickly. Information may be out of date, and/or contain inaccuracies or typographical errors. For questions or concerns, please contact us at contact@ccmhhealth.com.

1 2 3 4