Journeys | Spring 202

JOURNEYS “Destiny is not a matter of chance, it is a matter of choice” – William Jennings Bryan

Bonds build trust

SPRING 2020

JOURNEYS

Volunteers win college scholarships

SPRING 2020

1 FROM OUR PRESIDENT 2 PATIENT EXPERIENCE Bond of trust transcends barriers to care 6 WHAT’S NEW AT BRYAN Past and present shape his future 8 BRYAN HEARTAWARE Awareness lets AJ stand out in the crowd 10

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PATIENT EXPERIENCE Perfectly coordinated emergency care: Teamwork saves Amber BRYAN HEART Welcome, Dr. Kapalis

Undergraduate students Roarick Schollmeyer, Tessa Kingsley, Jaelynn Williams and Tara Geiser received scholarships this winter.

15 TRANSFORMING SURGERY 16 MEDICAL STAFF UPDATE

New faces at Bryan / Remembering our colleague /

Dr. Gross leads Bryan Medical Staff

The Bryan Volunteers and Customer Care Advisory Council 20 BRYAN BARIATRIC ADVANTAGE recognized volunteers Roarick

For Terri, losing weight results in big gains in life Schollmeyer, Tessa Kingsley, Jaelynn 23 BRYAN INDOOR TRIATHLON Williams and Tara Geiser with college scholarships. They all plan to 24 YOUTH MENTAL HEALTH

Youth in crisis find treatment options go to medical school someday.

Schollmeyer is a junior at the 27 CRETE AREA MEDICAL CENTER

Local students benefit from mental health assessments University of Nebraska-Lincoln. He’s a double major in biochemistry and 28 FIRST TIME PARENTING microbiology as well as in biological 30 ACHIEVEMENTS science. He wants to become a 33 COMMUNITY CALENDAR neurologist or neurosurgeon.

The other three students are biomedical sciences majors at Bryan College of Health Sciences.

Kingsley is a junior and plans to enroll in a physician assistant program or medical school.

Sophomores Williams and Geiser are certified nursing assistants. Williams wants to become a physician assistant, and Geiser plans to practice in rural Nebraska after earning a medical degree. n

T H A N K YO U, B RYA N F O U N D AT I O N 2 0 1 9 - 2 0 2 0 E V E N T PA R T N E R S Sampson Construction Union Bank & Trust Air Methods Capitol City Electric Cornhusker Bank

Davis Design DuTeau Chevrolet-Subaru Eakes Office Solutions Holmes Murphy HomeServices of Nebraska

Inpatient Physician Associates Liberty Lawn & Landscape, Inc. Lincoln Marriott Cornhusker Hotel LincOne Federal Credit Union Lockton Companies

ALL ABOUT JOURNEYS

STAY IN TOUCH

Statesman William Jennings Bryan, one of the original benefactors of Bryan Health, said:

We welcome your comments. For more information about Journeys, contact the Advancement team by calling 402-481-8674.

To learn more about Bryan programs and services, visit us online at bryanhealth.org.

“Destiny is not a matter of chance, it is a matter of choice; it is not a thing to be waited for, it is a thing to be achieved.”

Journeys tells our story of how Bryan chooses to achieve. This free publication is mailed three times a year to the communities we serve.

ON THE COVER Dr. Jess Heckman’s practice reaches out to those who may be hesitant to seek medical help. See Page 2 for this story.

OPPORTUNITIES TO SUPPORT Your contributions help us care for those who come to Bryan at every stage of life. To find out how you can participate, call 402-481-8605, or write to us at: Bryan Foundation

1600 S. 48th St., Lincoln, NE 68506 You can learn how to help and make a gift online at bryanhealth.org/bryan-foundation.

Mapes Industries, Inc. Midwest Medical Transport NRC Health Runza VTI Security

Russ Gronewold President & CEO, Bryan Health John Woodrich President & CEO, Bryan Medical Center, and Executive Vice President, Bryan Health Ken Gross, MD Chief of Staff, Bryan Medical Staff Bob Ravenscroft Vice President of Advancement & CDO Edgar Bumanis Director of Public Relations Kevin Rummel, MD Medical Editor Paul Hadley Editor

FROM OUR PRESIDENT

“Always do right. This will gratify some people and astonish the rest.”

– Samuel Clemens (Mark Twain)

I

see Mr. Twain’s advice being followed at Bryan every day.

From inpatients at our medical centers to outpatients at our clinics, our workforce of 5,000-plus co-workers is creating experiences that comfort and heal.

And yes, many times astonish. Because we’ve stayed true to our mission, more people are turning to Bryan — to work, to practice and to receive care. As John Woodrich and I assume our new roles, we thank my predecessor, Kim Russel, for inspiring all of us at Bryan to always do right.

I also witness this integrity personified in the dedication of our medical staff, especially those providers who have devoted their careers to serving our communities.

Below, you see four such heroes, who are among the group that recently received our Bryan Medical Staff Executive Committee’s Distinguished Career Award. The

physicians and advanced practice providers serving this region are second to none.

And I see it in our future. When a Nebraska-governed, nonprofit organization like Bryan Health strategically plans for how we’ll care for our patients in coming years, we seek wisdom first to ensure we make good decisions. It’s the right thing to do, and why we’ll spend much of this year reaching out to our stakeholders. In our fall edition of Journeys I’ll share what we’ve learned and where our focus will be in the coming years.

We look forward to keeping your family healthy for generations to come. Bryan Health. Forward. Together.

Russ Gronewold President and Chief Executive Officer, Bryan Health

Congratulations!

Retiring physicians Gene Stohs, MD; Gary Hustad, MD; Jo Kinberg, MD; and Michael Schmidt, MD, were among 11 recipients of Distinguished Career Awards from the Bryan Medical Staff Executive Committee. Other honorees were David Bingham, MD; Anup Chakraborty, MD; Deborah Davidson, DO; Peter Davidson, DO; Tim Lieske, MD; Christopher Masada, MD; and Bruce Taylor, MD. Bryan Journeys 1

PAT I E N T E X P E R I E N C E

Bond of trust transcends barriers to care

J

essica “Jess” Heckman, MD, is a family practice doctor at Family Medicine of Lincoln, which is part of the Bryan Physician Network.

She spends much of her day doing traditional family medicine, seeing multiple generations of families with common medical problems. Her medical practice is unusual, though, in that she also specializes in treating two groups of patients who often avoid medical

care — refugees from war-torn countries and persons from the LGBT (Lesbian, Gay, Bisexual, Transgender) community.

“These groups are similar in an important way,” explains Dr. Heckman. “Both often don’t fully share information about their lives because they worry they’ll be judged. My view is that everyone deserves an equal amount of respect, and it’s important that everybody has a safe environment for care. I work to have a bond of trust with my patients so that can happen.”

Interpreter Samia Ahmed helps Dr. Jess Heckman communicate with refugee Murad Nassir during an examination at Family Medicine of Lincoln.

2 Spring 2020

PAT I E N T E X P E R I E N C E

Bryse and Allan Patz-Masters say Dr. Heckman treats them as if they’re part of her family.

Native-born Nebraskan, small town roots

to museums and children’s zoos in Lincoln and Omaha. She says, “We’re also tight-knit with our family back in Hebron — we go home often, and we meet up to do group vacations..

“I’m also lucky and pleased to have my mom living in Lincoln, just one block from my office. We have regular family dinners and get to do things together like going to the museum and the ballet. I can’t emphasize enough how good it is to have a grandparent nearby.”

Dr. Heckman, a Lincoln native, has family roots in Hebron.

She says, “The family doctors in Hebron really impressed me growing up, so that’s what I decided to become.”

After undergraduate school at Vassar College in Poughkeepsie, New York, and medical school at the University of Nebraska Medical Center in Omaha, Dr. Heckman returned to Lincoln for her medical residency. “I knew I wanted to come home to Lincoln because of our amazing community. I wanted that for my kids growing Serves refugees up,” she says.

Dr. Heckman believes one of her key Along with her husband Scott Handelman, – Jessica Heckman, MD roles as a physician is to help patients who a math and computer teacher at Lincoln Southexperience barriers to good medical care. west High School, and daughters Charlotte, 7, “In college, I thought a lot about the and Quinn, 5, Dr. Heckman likes staying active as experience because I spent a year translating letters of refugee a family. They’re often at the gym and doing day trips, especially

“Everyone deserves an equal amount of respect.”

This story is brought to you by Sampson Construction.

Bryan Journeys 3

PAT I E N T E X P E R I E N C E Albert Einstein, the famous physicist and a war refugee from Europe,” she says. “Refugees have in common worries about language barriers, social stigma, safety and how welcome they will be in their new country.

“Those I care for now may have, in addition, untold amounts of trauma — many who have been my patients for years have only recently shared their traumatic experiences.”

Arabic language interpreter Samia Ahmed has worked with Dr. Heckman since she first opened her practice in Lincoln 15 years ago. Dr. Heckman has over 200 Arabic-speaking patients who came to Lincoln as refugees fleeing wars in the Middle East and Sudan.

“An important thing for her patients is that Dr. Heckman thinks about the whole person — not just her patient’s physical well-being, but their emotional support and mental health.

All have been traumatized by war and only slowly reveal their stories,” says Samia. “Dr. Heckman treats all her patients kindly, spending a long time talking about questions and concerns.”

Samia adds, “Emotional health is a particular challenge for refugees. People fleeing war often suffer mental health effects from trauma, but if they are from traditional cultural backgrounds they may only want to talk about this with family. Here, if they are without family, it is very hard. Dr. Heckman encourages patients’ awareness of their emotional health and is very supportive.

“She helps them understand that treatment is available.”

Steadfast support for LGBT patients Allan and Bryse Patz-Masters fell in love in 2011 and got married five years later.

Allan, originally from Hastings, moved to Lincoln in 2007 to attend the University of Nebraska-Lincoln. Today he works at CenterPointe mental health and addiction treatment services in Lincoln as an admissions specialist. Bryse, who grew up in Beatrice, moved to Lincoln in 2011 for work, and is general manager of a student housing complex in Lincoln.

“We had differing levels of support when we came out as being gay,” says Bryse. “I came out at age 13 to mostly supportive friends and family.” Allan, who waited years later to come out in college, had a different experience. He says, “Coming out was a rough time for me, with not a lot of support. It took time for my family to be accepting, although they’re great now.”

“Living your life honestly is very important for your mental health, but coming out isn’t always an option,” Allan explains.

4 Spring 2020

PAT I E N T E X P E R I E N C E

Jess and Scott enjoy exercising with Quinn and Charlotte at a local gym.

Dr. Heckman takes her fitness routine seriously — lunchtime often includes a brisk walk on the treadmill in her office.

“As a young gay person, not having supportive people in your life is like being lost at sea. You feel overwhelmed, like you’re drowning.

“Having a doctor like Dr. Heckman, knowing they’re accepting, that conversations are confidential and you can talk about questions and problems — that’s priceless. Because even if you have no one else, you have her, and she will listen, care and advise you.”

“We would like our patients to think of our office and those of other LGBT primary care specialists as safe places to talk, become educated and receive care,” says Dr. Heckman. “That includes people who are thinking about gender transitioning.

They can ask questions and talk about our team-based treatment

approach to doing this, which includes endocrinologists, psychologists and others.”

Allan says as a young man he could not have imagined the life he lives today. “I thought as a gay man I might not be able to have things other people want,” he shares. “But we’re doing so great — we’re married with good careers, we’ve bought a house, and soon we’ll be adopting a baby into our family.”

“With Dr. Heckman,” adds Bryse, “it’s like she’s more than a doctor, she’s like family. For people who have been unfortunate enough to lose their families when they came out as gay, that kind of support is huge.” n To learn how you can support the work of Bryan Health, please contact the Bryan Foundation at 402-481-8605.

Bryan Journeys 5

WHAT ’S NEW AT BRYAN

Past and present shape his future

R

uss Gronewold was promoted from chief financial officer to Bryan Health’s newest chief executive officer in January.

In the following interview, Russ touches on what made him the leader he is today, and he discusses the health care future he hopes we can build by working together.

How do you describe your leadership style?

It’s important that we’re being the best at the basics. In health care, there are things we need to do right every single time because that’s what this vital, technical, caring environment demands.

We also need to remember that this is a people business first.

No matter how technical or business-like health care becomes or no matter how much technology is involved, if we’re not good with people, we’re not going to be better.

So, you’ll see me wandering around the medical center because we senior managers have to be present just like clinicians are face to face with their patients to recognize needs and prepare for changes.

What about your formative years? Where did you grow up?

I’m a small-town kid from Adams, which is about 30 miles southeast of Lincoln. Middle child of three boys; I played eight-man football, and we considered Beatrice the Big City.

Chores and responsibilities? I was a farm kid, so I put up hay, walked beans, scooped pens and spent hours and hours and hours on tractors. I loved that life and wish my kids could have experienced it, too.

Adventures? My brothers and I earned enough money one summer to buy a small Honda dirt bike, which we rode the five miles on back roads between the farm and Adams.

It was actually street legal, so we had sort of unofficial permission from the local police that as long as we didn’t get too crazy on our rides into town, we could keep doing that. So my mom encouraged us to use it for errands, such as playing piano at the local nursing home.

That little motorcycle stood for freedom and opportunity.

What about your childhood? You say the Gronewold boys were competitive — but remain proud of each other and fiercely loyal.

We’re very different. My older brother started out on the farm but then owned a real estate appraisal firm before joining the Army National Guard — eventually becoming a general.

6 Spring 2020

My other brother is a year younger than I. He was a firefighter in Lincoln until retiring and is now back on the farm.

We’re different in a lot of ways, but we’re very similar in terms of values, and we still enjoy getting together.

Which life events shaped your destiny in health care?

I went to Midland University in Fremont, because I wanted to play some college football, but they also had a really good accounting program. After graduating, I ended up at the Arthur Anderson CPA firm in Omaha, which at the time seemed like New York City to me!

That’s where I got my first taste of the health care industry, auditing hospitals of all sizes all over Iowa and Nebraska and into Missouri.

I taught in college for a few years, then got back into health care as director of finance at Immanuel Medical Center in Omaha.

I began negotiating contracts and setting up managed care relationships and eventually ran their physician business. I had the same role at Children’s Hospital before becoming the chief operating officer of several retirement communities. I returned to the finance world and was involved in innovation when I got a call 10 years ago to consider becoming Bryan’s chief financial officer.

What about marriage and your family?

Jane and I met at a concert through some mutual friends. We started dating soon after and just a little over a year later, we were married.

Now we have four grown children, whom we love dearly.

Our son is an engineer and our daughter-in-law is a labor and delivery nurse in Los Angeles. We have a daughter who’s a reporter for Politico in New York, another daughter who’s a dental hygienist and married to the owner of a lawn and landscape business, and our youngest daughter is in the restaurant business in Arizona.

They’re settled in different geographic areas and are just about as different as they can be.

They are liberal and conservative, holding manual labor and white collar jobs. When we get together, we talk about all of the things you’re not supposed to, such as politics and religion and current events. It can get raucous, but we have great conversations around the table, and we’re very respectful afterward.

I think that’s because we have a family motto: “Don’t be frustrated, be fascinated.” Rather than be frustrated with how

WHAT ’S NEW AT BRYAN different we are, be fascinated about why we are the way we are, be fascinated about others’ perspectives.

That’s allowed us to keep some real family unity, and we kind of take that into our other roles.

So, this works on the job, too?

Absolutely. For example, we might be working with a physician who has a different perspective from a clinician who has a different perspective from someone in the support areas. We really have to step back and ask, “Gosh, I wonder why they’re reacting this way. I wonder how I can take this not as a frustration but as an opportunity to learn something about that person and see how we can make this work.”

Russ Gronewold enjoys meeting co-workers from throughout Bryan, such as these Labor and Delivery Unit staff nurses.

What’s in the future for you? For Bryan?

Now that we’re empty nesters, Jane and I love to travel — mostly to see our kids — and we love reading and golfing together.

As for Bryan, I’m really confident in our current leadership team!

How might our role in the community change? We’ve always been an important safety net provider whether it’s in trauma or behavioral health or neonatal intensive care or other areas. Now we’re being asked how we will connect with providers, the school system, businesses, the health department and other constituents to bring better health to the larger community.

We have to think ahead. We owe this to all the folks who rely on us. We are a community hospital for Lincoln, but we’re also a tertiary hospital for other parts of Nebraska and bordering states.

Health care is changing a lot, so we’re looking at what it takes to be a leading-edge provider. Maintaining strong relationships with independent physicians and communities is essential. Being a leader also involves Bryan researching all the ways to help Crete Area Medical Center and Merrick Medical Center serve their communities, and it means continuing to establish new programs and facilities, such as a Cancer Center coming to south Lincoln, improving our medical center campuses and adding new office buildings and Bryan Urgent Care centers elsewhere in the city.

We’re looking at technological progress in areas such as artificial intelligence and machine learning, and telemedicine is helping us partner with rural communities in ways not imagined just a decade ago. Again, we’re investing without forgetting what it means to be a community hospital.

I want to understand what makes us tick. Why do people love Bryan? And how do we get even better? I’m excited to find out, and I’m excited to be working with all of you as your Bryan Health CEO. n

VIDEO

To watch an interview with Bryan Health CEO Russ Gronewold, go to bryanhealth.org/about-us.

Bryan Journeys 7

BRYAN HEARTAWARE

Awareness lets AJ stand out in the crowd

AJ Matthies (6014) used his HeartAware results as motivation to change his lifestyle. He ran in the Good Life Halfsy in 2018 and the next year finished the Lincoln Half Marathon!

AJ

Matthies wasn’t planning on becoming a long-distance runner as an adult. He had played soccer and football in high school but, like so many of us, once he started a career, he didn’t make exercise a priority.

In December of 2017, AJ participated in the HeartAware screening program through Bryan Health. His employer, redthread creative advertising, had invited Judy Arnold, RN, to meet with its employees for a free screening in the company’s Haymarket office. Judy, who coordinates the Early Detection Center at Bryan, walked them through the 30-minute screening process.

At the end, participants were given a “heart age” to help them gauge their heart health. AJ was 26 when he took the screening — but his heart age was 32.

AJ says, “My numbers weren’t ideal, and I felt it was time to start setting some goals.”

He considered his options and

8 Spring 2020

noticed what other friends had done to be successful. He decided to sign up for a half marathon.

“The most I’d ever run before was a mile or two,” he says. “Half a marathon seemed insurmountable, but I knew I needed to do something where I really had to push myself. If it was any shorter, I don’t know that I would have worked as hard for it.”

With his busy work schedule, finding time to train wasn’t always easy. He made it a priority, and he said his work team has been supportive of his goals. He was able to work in runs by flexing his schedule, and co-workers who also ran offered him encouragement and advice.

AJ’s hard work paid off. On October 28, 2018, he ran the Good Life Halfsy in Lincoln.

“I finished, and I thought, ‘I can’t believe I signed up for that,’” he recalls. “Everybody has these stories of it feeling amazing to participate, but honestly, for me that didn’t

feel great,” he says with a laugh.

A few weeks after AJ completed the Good Life Halfsy, Judy returned to redthread to do their annual HeartAware screening.

When AJ got his results, he was happily surprised to see that despite being a year older, he had dropped his heart age to 31.

Judy applauds AJ for taking the information he received through the screening and using it to make improvements to his health.

“So many people think heart fitness isn’t important when you’re young, but it is,” Judy says. “By the time you get to be 50 or 60 years old, sometimes it’s harder to change. AJ recognized that maybe things weren’t going in the right direction and realized that if he continues on the same path, things may not be all that great when he gets older. He was very proactive in taking that information and making some positive changes.”

BRYAN HEARTAWARE AJ says that after his first half marathon, he vowed he’d never do another, but in May of 2019, he found himself signed up for the Lincoln Half Marathon.

“I knew I would need to take a break after the first half marathon, but the break turned into something too long,” he explains. “I realized I needed another goal, and I wanted to make sure the first one wasn’t a fluke. And after a while, it definitely felt great.”

AJ ran the Good Life Halfsy again in October, this time with a co-worker. He’s considering future runs, including possibly doing a destination run that goes through New Orleans’ French Quarter. He’s also thinking about joining friends on a hike this year to the summit of Longs Peak in Colorado. AJ was surprised to hear his brother mention that he might sign up for a run, as well.

AJ and his redthread cohorts met in their office to take the HeartAware screening with Judy Arnold.

“I’m kind of hoping my brother runs one,” says AJ. “We’re both pretty competitive, and if he does it, I’d want to do it, too.”

The HeartAware screening is free and available to anyone. Participants start by completing an online questionnaire and receive a report that includes their heart age and risk factors. They can then choose to schedule a free consultation with a nurse, who checks the participant’s cholesterol, blood sugar, blood pressure and heart rate.

At the end, they receive a printout with their results. Approximately 1,000 individuals participate in the HeartAware screening each year.

Judy also brings this screening to workplaces for free. Depending on the number of employees receiving screenings, she’ll bring one or two nurses with her to assist with the profiles.

“It’s a really good way for smaller companies to offer some health screenings for their employees because it is completely no cost,” Judy says. She invites companies to contact her if they have an interest in scheduling the HeartAware screening.

AJ says the program is very convenient.

“It only took about 15 minutes out of my day, which was really nice. And it’s always great to hear an expert like Judy talk through your results with you,” he says.

For individuals who take the HeartAware screening and are concerned with their results, Judy says Bryan offers additional screenings and tests to determine what, if any, additional action may be needed.

AJ says he appreciates that his employer partnered with Bryan to provide this wellness training for its employees. In 2019, redthread received both the Governor’s Wellness Award and the Catalyst Safety and Wellness Award from the Nebraska Safety Council.

“It’s really nice to be in a company that supports wellness and is more proactive,” he says.

AJ acknowledges the nudge the HeartAware screening gave him to focus on his health. Since he started running, he says he has more energy and feels confident in his ability to set and meet personal goals.

He encourages others to take a few minutes to do the screening.

“Your personal overall health is so important, and heart health is such a big part of it,” he says.

“Being aware of the condition of your heart will allow you to make more informed decisions and set yourself up for success in the future.” n To take the HeartAware screening, go to bryanhealth.org/online-screenings.

Companies may contact Judy Arnold to schedule a screening for their employees by calling VIDEO 402-481-8018. Learn more at bryanhealth.org/heartaware.

Bryan Journeys 9

PAT I E N T E X P E R I E N C E

Thanks to extraordinary care at Bryan, art teacher Amber Reining is back in the classroom at West Lincoln Elementary School.

10 Spring 2020

PAT I E N T E X P E R I E N C E

Perfectly coordinated emergency care

Teamwork saves Amber

A

mber Reining, 40, of Lincoln, suffered a medically complex heart attack in the Emergency Department at Bryan East Campus last August, which caused her heart to stop for four hours.

Bryan doctors and nurses resuscitated Amber with such precision that six months later she feels well — a rare medical success for someone whose heart stopped for so long. A mother and elementary school art teacher, Amber is now back with her young children and family, back at work, back to her life.

regain full function for several days.

Not giving up Maxine Turvey, RN, met Amber as she walked through the door that day. Within a minute or so, Amber collapsed into her arms. “I lowered her to the floor and found she had no pulse.

My nurse manager and I immediately began chest compressions and rescue breathing on her to start cardiopulmonary resuscitation,” Maxine says.

“CPR continued under the direction of Dr. Meyer,” says Emergency Department nurse manager Mona Reynolds, RN. “We also activated our ‘cardiac alert’ protocol, which lets our Subtle symptoms preceded severe chest pain emergency and cardiac catheterization teams know that a Amber woke early that day with patient has had a heart attack, and it vague chest pains and a sense something brings a cardiologist and other key staff wasn’t right. Her husband Eric took her to the scene right away.” to a local urgent care medical clinic, but The team responding to the alert like many women in early stages of heart included Bryan Heart cardiologist attack, her symptoms were not obvious, Matthew Johnson, MD, and nurses and and her initial electrocardiogram (ECG) staff from the cardiac catheterization heart testing results looked normal. lab, surgery, pastoral care and perfusion “During a heart attack, women’s services. Over the next four hours, symptoms are typically more subtle than more than 20 doctors, nurses and other men’s,” says Bryan emergency medicine staff worked non-stop in the cath lab physician Jay Meyer, MD. “Women’s heart to save Amber’s life, delivering chest – Amber Reining attack symptoms can start with something compressions, rescue breathing, shocks as mild as chest discomfort or nausea, and intravenous medicines in a steady then become more like men’s typical effort to restart her heart. symptoms of severe chest pain over a Mona says, “We were absolutely period of hours.” determined to save Amber, and we were not giving up.”

Amber went home to rest, but her chest pain returned, far worse this time. Eric quickly drove her to see their family nurse Extraordinary intervention practitioner, who found Amber’s ECG heart testing results now “Amber’s heartbeat came back briefly, only to stop again were abnormal and sent her to the Emergency Department at and again,” says cath lab manager Lynn Fitzgerald, RN. Bryan East Campus for further evaluation and treatment.

Eventually her heart stopped responding entirely — a As Eric parked the car, Amber walked into the Emergency state in which blood and critically essential oxygen and rescue Department. Then, her heart stopped beating. It would not medicines reached Amber’s brain and the rest of her body

“I’m forever grateful and am making the best of each new day I’m given.

It is truly a gift.”

This story is brought to you by Union Bank & Trust.

Bryan Journeys 11

PAT I E N T E X P E R I E N C E

Maxine Turvey, RN; nurse manager Mona Reynolds, RN; Jay Meyer, MD; Shirley Mohr-Burt, Bryan Heart APRN; and assistant nurse manager Dan Benson, RN, were among the first to respond to Amber’s emergency. only through the CPR compressions the Bryan team performed on her heart.

Extraordinary intervention was now needed to save Amber’s life.

Aware that her heart might be too damaged by her heart attack to ever beat normally, Dr. Johnson made the key decision that Amber’s best chance at survival might be heart transplantation, if a suitable heart was available.

Dr. Johnson placed Amber on extracorporeal membrane oxygenation (ECMO), a treatment in which a complex machine, similar to that used in openheart surgery, pumps and oxygenates a

12 Spring 2020

patient’s blood outside the body, allowing the heart and lungs to rest. With the ECMO machinery in place, Amber was urgently transferred to the University of Nebraska Medical Center (UNMC) in Omaha for consideration for heart transplantation.

Amber’s happy ending Two days later, Amber’s story took an unusual, happy turn.

“Because of our rapid use of ECMO,” explains Dr. Johnson, “her heart was able to recover to full function.”

Amber’s heart began to beat on

its own again. She didn’t need a heart transplant.

After her long ordeal, Amber’s first memory was of waking up in the intensive care unit at UNMC with her family at her bedside. The greatest concern for Amber’s doctors and family was whether her cardiac arrest affected her brain function, but her first words put this worry entirely to rest.

“I remembered it was my Mom and Dad’s wedding anniversary that day and said, ‘I’m so sorry you spent your anniversary here with me in the hospital.’ I think they cried and laughed

PAT I E N T E X P E R I E N C E at the same time — it was a huge relief that I woke up and that I was thinking pretty normally considering all I’d been through.” she recalls.

“Now, six months later, I’m feeling surprisingly well after the heart attack and the whole long resuscitation. I don’t feel I’ve had any bad effects, and I’m functioning normally, with all my long-

term memories.

“The heart attack was due to damage that developed in one of my large heart vessels. My doctors are controlling the problem with medication and reevaluating me often and planning further treatment.”

But that wasn’t the end of Amber’s care at Bryan.

Cardiovascular technologist Austin Byleen, interventional cardiologist Matthew Johnson, MD, and Cardiovascular Specialties RN Katelynn Danek used an ECMO system to oxygenate Amber’s blood because her heart wasn’t beating on its own.

“In addition to everything related to the heart attack, another medical scare had me returning to Bryan,” she says.

“About three weeks after returning home, I had chest pains. So I was worried I was having a second heart attack! We went back to the Emergency Department, and I was relieved to find out the pain was due to gallstones.”

Because of the severity of her symptoms and to avoid chest pain confusion going forward, her gallbladder was removed when she was strong enough for surgery.

“It’s a rare success after the kind of lengthy cardiac arrest Amber suffered for a person to feel and function as normally as she does. That’s because patients often have some degree of brain injury if oxygen didn’t reach their brain when their heart stopped pumping. This is a great concern for patients who’ve gone through CPR,” Dr. Johnson adds.

“Amber beat these odds partly because she has youth and health on her side, but also, and of key importance, because we started her resuscitation instantly, with perfect coordination between our team members, right up to her transition to ECMO. It worked liked clockwork and is an excellent success story.”

“I’m in awe at how the doctors and nurses at Bryan worked so tirelessly to save my life, refusing to stop,” says Amber. “I can’t put into words how thankful I am to all of them for their extraordinary care. I’m forever grateful and am making the best of each new day I’m given. It is truly a gift.” n To learn how you can support the work of Bryan Health, please contact the Bryan Foundation at 402-481-8605.

Bryan Journeys 13

BRYAN HEART

Welcome, Dr. Kapalis

E

strategies that work for one lectrophysiologist Matthew person’s philosophy that Kapalis, DO, joined Bryan don’t work for another’s, so Heart this winter. it’s extremely important that Dr. Kapalis grew up in eastern patients and physicians both Iowa. He earned a bachelor’s are comfortable with the in biology and psychology from choices we make together,” he Luther College in Decorah in 2003 says. and completed the Doctor of Dr. Kapalis notes cardiac Osteopathic Medicine Program at electrophysiology has changed Des Moines University in 2008. dramatically in recent years.

His medical training includes “Now we can safely and an internal medicine residency effectively eliminate fast heart at the University of Minnesota, rhythms because we have Minneapolis, and fellowships in better tools to map out the cardiovascular disease and cardiac heart and the areas where bad electrophysiology at the University heart rhythms come from,” of Nebraska Medical Center he explains. “In addition, (UNMC), Omaha. we have new and smarter He served as an assistant pacemakers and defibrillators professor at UNMC and Creighton that protect people from lifeUniversity and is Board certified in threatening heart rhythms cardiovascular disease and clinical while dramatically improving cardiac electrophysiology. quality of life.

“I practiced as a clinical cardiac “I was excited to join Bryan electrophysiologist in the Omaha Heart because I already know area for the past five years,” he several physicians who work says. “As I learned more about here, and I appreciate their cardiology, I became fascinated by dedication and enthusiasm for the interplay with the structure of New Bryan Heart physician Matthew Kapalis, DO, enjoys what they do.” the heart as well as the electrical spending time with his wife, Molly, and their son, Nikolas.

He adds, “Bryan Health has function of the heart.” an excellent reputation. I’m He notes, “As an electrophysiproud to be a part of Bryan Health because of its commitment ologist, I see patients who have issues with fast or slow to the community as well as to patients across Nebraska and its heart rhythms. There are times where people need help with neighboring states.” pacemakers or defibrillators, and I do those procedures. Others How does he enjoy his free time? require specific interventions, such as medicines or procedures “Outside the hospital, I love to spend my relaxing time with known as ablations, in which we actually get rid of areas of the my wife, Molly, and our son Nikolas and our dogs.” n heart that are causing abnormally fast heart rhythms.”

Dr. Kapalis says he’s fortunate to treat patients from a wide variety of backgrounds, ages and perspectives.

To learn how you can support the work of Bryan “My philosophy is that our decision making is based on Heart, call 402-481-8605. To watch an interview VIDEO sharing information and ideas. There are some treatment with this physician, go to bryanhealth.org/DrKapalis.

14 Spring 2020

TRANSFORMING SURGERY

There’s a lot going on behind the scenes of our renovation of Bryan East Campus.

These workers are installing seating benches in the new 1st Floor waiting room.

1

2 3 Crews completed the obelisk (3) in January after cranes made their final lifts to the roof of the surgery addition, clearing the way for capping off this distinctive structure.

The supportive obelisk rose alongside the renovation. Here’s how it looked (1 and 2) as multi-ton blocks were added in December.

The new operating rooms on 2nd Floor are nearing completion. Eleven of these surgery suites open in April.

To learn more about this construction and renovation project on Bryan East Campus, go to bryanhealth.org/transforming-surgery.

Bryan Journeys 15

MEDICAL STAFF UPDATE

New faces at

Bryan

Welcome these colleagues to the Bryan medical community Jordan Bowling, MD, general surgery, is associated with Bowling Surgical Associates.

Dr. Bowling earned his medical degree from Howard University College of Medicine in Washington, D.C., in 2011.

Dr. Bowling completed a residency at Mount Sinai Hospital in New York and a trauma and critical care fellowship at Children’s Hospital, Los Angeles.

Dr. Bowling is a Lincoln native. In addition to medicine, he has a passion for mentorship and hopes to start a program to encourage children from disadvantaged backgrounds to pursue interests in math, science and health care.

Sara Brown, MD, anesthesiology, has joined Associated Anesthesiologists, 402-489-4186.

Dr. Brown earned a Bachelor of Science in microbiology at the University of Florida in 2010. She then completed medical school at Penn State Hershey College of Medicine in Hershey, Pennsylvania, in 2014.

Dr. Brown finished an anesthesia residency at Penn State Milton S. Hershey Medical Center and an anesthesia cardiac fellowship at the University of Nebraska Medical Center, Omaha. She is certified by the American Board of Anesthesiology.

Dr. Brown’s father was in the military, so she grew up in Arizona, Nevada, South Dakota, Virginia, Florida and

16 Spring 2020

Pennsylvania. Dr. Brown joined Associated Anesthesiologists in October 2019.

Elizabeth Friesen, MD, internal medicine/hospitalist, joined Inpatient Physician Associates, 402-481-8566.

In 2002, she earned a medical degree from the University of Nebraska Medical Centre College of Medicine, Omaha, where she also completed a residency.

Dr. Friesen is certified by the American Board of Internal Medicine.

Thomas Harbert, MD, orthopedics, is associated with Premier Orthopaedics, 402-219-3873.

Dr Harbert graduated from the University of Nebraska Medical Center College of Medicine, Omaha, in 1991. He completed an orthopedic surgery residency at the University of Oklahoma Health Science Center, Oklahoma City, in 1996. He has received Compassionate Doctor Recognition as well as awards for On-Time Doctor and Patients’ Choice.

Dr. Harbert is Board certified in orthopedic surgery.

Torri Janecek, DO, obstetrics and gynecology, is associated with Bryan Women’s Care Physicians, which is part of the Bryan Physician Network, 402-483-8630.

Dr. Janecek is a Nebraska native who graduated from Des Moines University College of Osteopathic Medicine, Des Moines, in 2007. She completed her obstetrics and gynecology residency at the University of Texas Health Science Center, San Antonio.

Dr. Janecek is certified by the American Board of Obstetrics & Gynecology. She is married and has two children. As a former University of Nebraska at Kearney track athlete, Dr. Janecek enjoys running, travel and spending time with her family.

MEDICAL STAFF UPDATE Matthew Kapalis, DO, cardiac electrophysiology, is associated with Bryan Heart, 402-483-3333.

Dr. Kapalis graduated with honors from the Doctor of Osteopathic Medicine Program at Des Moines University, Des Moines, Iowa, in 2008.

He completed a residency at the University of Minnesota Medical School, Minneapolis, as well as fellowships at the University of Nebraska Medical Center, Omaha, in cardiovascular disease and clinical cardiac electrophysiology.

Dr. Kapalis is certified by the American Board of Internal Medicine with subspecialty certifications in cardiovascular disease and clinical cardiac electrophysiology.

Ashley Marcuccio, DO, psychiatry, joined Bryan Heartland Psychiatry, 402-483-8555.

She graduated from the Kansas City University of Medicine and Biosciences, Kansas City, Missouri, in 2015 and completed a residency at the University of Kansas Medical Center, Kansas City, Kansas, and fellowships at the Greater Kansas City Psychoanalystic Institute, Kansas City, Missouri, and the University of Kansas Medical Center.

She is certified by the American Board of Psychiatry and Neurology.

Lee Merritt, MD, orthopedics, is associated with Premier Orthopaedics, 402-219-3873.

Dr. Merritt graduated from the University of Rochester School of Medicine and Dentistry, Rochester, New York, in 1980.

She completed an orthopedic residency at the National Naval Medical Center, San Diego, followed by a Louis A. Goldstein Spinal Fellowship at the University of Rochester.

Dr. Merritt is certified by the American Board of Orthopaedic Surgery and also in anti-aging and regenerative medicine.

Elizabeth Noordhoek, MD, emergency medicine, joined Nebraska Emergency Medicine, 402-481-3142.

Dr. Noordhoek earned her medical degree from Chicago Medical School at Rosalind Franklin University, Chicago, in 2000. She completed an emergency medical residency at Denver Health Medical Center, Denver.

Dr. Noordhoek is certified by the American Board of Emergency Medicine.

Daniel Owen, MD, family medicine, joined Lincoln Family Medical Group, 402-488-7400.

Dr. Owen earned a medical degree from the University of Nebraska Medical Center College of Medicine, Omaha, in 2016. He completed the Lincoln Family Medicine Residency Program through the Lincoln Medical Education Partnership in 2019. Dr. Owen is certified by the American Board of Family Medicine.

Christina Peacock, MD, pediatrics, joined Lincoln Pediatric Hospitalists, 402-473-3898.

She graduated from the University of Missouri-Kansas City School of Medicine in 2005 and completed a residency at Children’s Mercy Hospital, Kansas City.

Dr. Peacock is certified by the American Board of Pediatrics. She practiced in Lawrence, Kansas, and Kansas City, Missouri, before moving to Nebraska.

Anne Perlman, MD, FACP, internal medicine/hospitalist, is associated with Inpatient Physician Associates, 402-481-8566.

Dr. Perlman, a native of Lincoln, graduated in 1997 from the University of Nebraska Medical Center College of Medicine, Omaha, where she also completed an internal medicine residency. She has

Bryan Journeys 17

MEDICAL STAFF UPDATE been practicing in Lincoln since completing her residency.

Before joining Inpatient Physician Associates, Dr. Perlman was a hospitalist at CHI Health, including 10 years as medical director of CHI St. Elizabeth Inpatient Medicine Service. She served as the CHI National Sepsis Champion and was on the Executive Committee of the CHI National Hospitalist Service Line. She is a fellow of the Physician Leadership Academy.

She has served on the boards of the Lancaster County Medical Association and Partnership for Healthy Lincoln.

Sean Pietrini, MD, interventional radiology, is associated with Advanced Radiology of Grand Island, 308-675-3211.

Dr. Pietrini graduated from the University of Minnesota Medical School, Minneapolis, in 2012. He completed a residency in diagnostic radiology at Creighton University Medical Center, Omaha, and an interventional radiology fellowship at the University of Washington School of Medicine, Seattle.

Dr. Pietrini is dual certified in diagnostic and interventional radiology by the American Board of Radiology. He has published in the official journal of the European Society of Sports Traumatology Knee Surgery and Arthroscopy (ESSKA) and the American Journal of Sports Medicine.

Irfan Vaziri, MD, hematology and oncology, joined Nebraska Hematology-Oncology, 402-484-4900.

Dr. Vaziri graduated from Aga Khan University, Karachi, Pakistan, in 1990.

He completed a residency at the University of North Dakota, Fargo, and fellowships in hematology/oncology at the University of Nebraska Medical Center, Omaha, and in infectious disease at the University of Texas Health Science Center, San Antonio.

Dr. Vaziri is Board certified in hematology and oncology.

He has been practicing in North Platte and serving as medical director of the Callahan Cancer Center for the past 14 years. n

18 Spring 2020

Remembering our

colleague John Dewey Baldwin, MD, of Lincoln, died December 11, 2019. He was 89.

Born in Omaha, Dr. Baldwin earned his medical degree from the University of Nebraska Medical Center College of Medicine, Omaha, in 1955. In 1963, following two years of service at Oklahoma’s Altus Air Force Base and a residency at the Nebraska Psychiatric Institute, Omaha, he began a 50-plus-year career as a Boardcertified psychiatrist in Lincoln.

Dr. Baldwin served on the attending staff of Bryan Memorial Hospital and Lincoln General Hospital (before they merged to become Bryan Health). He was chair of Bryan’s psychiatry department from 1965 to 1974 and again in the 1990s. He sat on the Medical Staff’s executive committee for 20 years and was chief of staff in 1977-1978. He also served on the Bryan Board of Trustees from 1976-1982.

Dr. Baldwin also was an associate professor at UNMC from 1975 to 1990. He was awarded a Distinguished Life Fellowship by the American Psychiatric Association in 1994 and again in 2003. The Nebraska Medical Association honored him with a 50-Year Certificate in 2005.

He enjoyed fishing, poker and golf. An active community member, Dr. Baldwin served on boards of the Family Service Association, Houses of Hope and other organizations. He explored over 40 countries on five continents and visited nearly every state in the union.

Dr. Baldwin is survived by daughters Stella Archer, Erica Baldwin, Elizabeth Wolf and Alexandra Baldwin, sonin-law Steven McFadden, five grandchildren and six greatgrandchildren. n

MEDICAL STAFF UPDATE

Dr. Gross leads Bryan Medical Staff

Dr. Ken Gross Ken Gross, MD, of Associated Anesthesiologists is the new chief of staff of the Bryan Medical Staff. He succeeds Darla Eisenhauer, MD, of Gynecology & Fertility.

Dr. Gross graduated from the University of Nebraska Medical Center College of Medicine, Omaha, in 1988 and completed an anesthesiology residency at Brigham and Women’s Hospital, Boston. He was an instructor at Harvard Medical School, Boston, from 1992-1996 before joining Associated Anesthesiologists.

He was chair of the Professional Practice Evaluation Committee and served as Hospital-based Department chair and Anesthesia Division chair and secretary/treasurer.

Dr. Gross says, “I’m looking forward to this opportunity and want to recognize the important contributions of Dr. Eisenhauer during her term as chief of staff. Nothing of course is accomplished alone, and I fully expect

Dr. William Johnson the Medical Staff Executive Committee to continue its role in helping shape the future of health care in our community.

“We also should note several former Bryan chiefs of staff retired in 2019 — Dr. Tim Lieske (who served consecutive terms in 1999-2000 and 2001-2002), Dr. Gene Stohs (2006-2007) and Dr. Gary Hustad (2014-2015). We certainly appreciate their service.”

William Johnson, MD, of Nebraska Pulmonary Specialties, succeeds Dr. Gross as vice chief.

Dr. Johnson also is chair of the Medical Subspecialty Department and the Clinical Integration and Collaboration Committee and is director of the Intensivist Program at Bryan Health.

Dr. Johnson graduated in 1990 from the University of Nebraska Medical Center College of Medicine, Omaha, where he also completed an internal medicine residency. He then fulfilled a pulmonary and critical care fellowship

Dr. Robert Oakes at the University of Iowa Hospitals and Clinics, Iowa City.

Robert Oakes, MD, of Bryan Heart was elected secretary/treasurer.

Dr. Oakes earned his medical degree from the Harvard Medical School, Boston, in 2002.

He completed a general surgery residency at Stanford University Medical Center, Palo Alto, California, in 2009 and a cardiothoracic fellowship at Brigham and Women’s Hospital affiliate of Harvard Medical School in 2011.

He joined Bryan Heart in 2011 as a cardiothoracic surgeon. He has been the division chief of Cardiothoracic Surgery since 2014 and served as an at-large member of the Medical Staff Executive Committee from 2015-2017.

Dr. Oakes completed Bryan’s Physician Leadership Academy course at UNL Business School in 2017. He also has served on the Professional Practice Evaluation Committee since 2018. n

Bryan Journeys 19

BRYAN BARIATRIC ADVANTAGE

For Terri, losing weight results in big gains in life

I

n 2019, Terri Krause was ready for a change. For years, she had battled multiple sclerosis, type 2 diabetes and thyroid disease. She also had atrial fibrillation, which put her at increased risk of blood clots, stroke and heart failure. Terri knew she needed to lose weight, but despite her multiple attempts, she wasn’t making progress.

“In the past I tried diet pills from the doctor as well as all sorts of programs as seen on TV — I’ve tried them all — and nothing was working for me,” she says.

That was the turning point Her turning point came one day as she was talking with her great-nephew.

“I had been helping take care of him after school, and he said he wanted me around for 30 more years,” she recalls.

“That made me decide that I needed to get this weight off.”

Terri knew several friends who had had success with weight loss surgery, and she wanted more information. Her primary care doctor, Paul Wolfe, MD, of Family Health Associates, referred her to Bryan Bariatric Advantage. At her initial evaluation, Terri learned about her options and what she would need to do to prepare for surgery.

Bryan Bariatric Advantage nurse practitioner Tara Wenta, APRN, says patients go through several steps to ensure that they’re ready to make

20 Spring 2020

the lifestyle changes necessary to be successful after surgery, such as learning to stay hydrated and make healthy food choices. Patients also meet with an exercise physiologist to help incorporate physical activity into their daily routine.

Undergoes robotic assisted surgery Terri was hopeful as she went through the process. “My big goal, especially because of my MS, was to be able to get

Here’s Terri before losing more than 100 pounds.

rid of my cane and my walker and stop using motorized carts,” she says.

Terri’s surgeon, Benjamin Hung, MD, of Surgical Associates, has been practicing in Lincoln for 18 years and has performed more than 1,400 bariatric surgeries. In March of 2019, he began using the da Vinci Surgical System during laparoscopic gastric sleeve procedures, which reduce the size of the stomach. Dr. Hung has used this robotic device for the last five

Dietitian Liz Wray measures Terri’s body mass index.

BRYAN BARIATRIC ADVANTAGE

Liz and Terri meet with Dr. Benjamin Hung and nurse practitioner Tara Wenta at Bryan Bariatric Advantage. years for other types of surgeries, and he says it offers several advantages.

“The robot allows you to be even more precise, which helps minimize risks for patients,” says Dr. Hung. “Also, patients generally experience less pain after the procedure.”

Dr. Hung encourages patients to do their research and learn about all of the options available to them. Bryan Bariatric Advantage offers information sessions to help individuals explore different weight loss options, and they also offer

information on their website.

Bryan Bariatric Advantage is accredited through the American College of Surgeons Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program. To maintain accreditation, the program is annually reviewed to ensure patient care, safety, success and follow-up meet the strict criteria required.

After six months of preparation, Terri had her surgery in May. She’s amazed at how well her recovery went.

“I had absolutely zero pain,” she says.

She’s making progress Since the surgery, Terri has made impressive progress toward improving her health.

“I’m no longer diabetic,” she says. “I just watch what I eat, and my blood sugar has been perfect.”

Before the surgery, she was on two medications for diabetes and three for hypertension, and she used a CPAP (continuous positive airway pressure)

Bryan Journeys 21

BRYAN BARIATRIC ADVANTAGE machine to help her breathe while sleeping.

Now, other than one medication to control her atrial fibrillation, she’s been able to go off all medications and devices.

She’s lost more than 100 pounds and gone from a size 28 to 18. Terri walks three miles a day — without a cane — and enjoys working out at the gym daily.

“My energy has gone way up. I like going to the gym now, and my friends can’t believe how fast I can jump up and go across the room,” she says.

Terri also loves that she can now do activities with her nephew.

“Before, he wanted me to get up and play soccer with him, or go bowling, and I couldn’t,” she says. “Now I can actually join in and do activities. Last week I took him bowling, and I actually bowled with him.

“Before, I would have just watched.”

From her experience with bariatric patients, Tara says those who are successful like Terri have one thing in

common: they use weight loss surgery as a tool, not a solution.

Committed to improvement “Terri made the lifestyle changes and dietary changes that have helped to ensure that she was successful,” says Tara.

“Anybody who comes into the process with their reason for surgery being more intrinsic — such as having more energy for personal relationships or addressing diseases — usually sees better success than those with extrinsic reasons, such as wanting to fit into a dress or wanting to look better for a wedding or reunion.”

Tara says the biggest patient successes she sees go beyond weight loss. Like Terri, they have more energy for their families or jobs, they make better food choices and get out to exercise, and they feel more comfortable and confident, which can impact their social lives. They often see major improvements in conditions such as diabetes, high blood pressure, sleep apnea and unhealthy cholesterol levels.

Change Your Life Surgical & Non-Surgical Weight Loss Options

Learn more & see how others have changed their lives.

View: bryanhealth.org/patient-stories Call: 402-481-5490

Bryan Bariatric Advantage

22 Spring 2020

“They’re able to increase their wellbeing overall. It’s not just about losing weight,” she says.

After surgery, patients come in for multiple follow-up appointments to help track their progress and receive any support they might need. Patients can see the dietitian at any point if they feel they’re getting off track, and the staff members encourage patients to reach out if they have concerns between appointments.

Terri says she’s grateful to the team who helped her on her weight loss journey.

“I’m so thankful for Dr. Hung and everyone at Bryan Bariatric Advantage,” she says. “They’ve all been absolutely wonderful and so supportive. I love that I have the energy to do things again.” n Go to bryanhealth.org/bariatrics for more details or see bryanhealth.org/patient-stories VIDEO for others’ experiences.

Are you ready to change your life?

Learn more about weight loss surgery options from a surgeon with Bryan Bariatric Advantage.

Attend a free information session: n Tuesday, March 3, 6-7 p.m. or n Tuesday, April 7, 6-7 p.m.

These sessions are at Bryan West Campus, Gregorius Conference Center A, 2300 S. 16th St. Find out if weight loss surgery is right for you — and talk with experts who are here to help you!

To learn more and register, visit bryanhealth.org/bariatrics or call 402-481-5490.

BRYAN INDOOR TRIATHLON

It’s another TRI-umphant event More than 200 athletes competed Jan. 26 in the annual indoor triathlon at Bryan LifePointe Campus.

Beth Whitaker proudly says so far she’s participated in every Bryan Indoor Triathlon. This year’s event on January 25 drew 112 athletes to Bryan LifePointe Campus. In the photo below, Korben Ockander extends his lead over his mom, Megan Ockander.

You got this! Kimberly Havranek exhorts cyclists Lindsey Sample (left) and Kendra Piening. Top Triathletes included Wade Fornander, MD, (Male Individual); Becky Mantonya (Female Individual); Die Tri-ing (All Female Team) of Nicole Dreeszen, Kaitlin Thalken and Michaela Geiser; and NRC Health (Coed Team) of Jared Carlson, John Hanseling and Nicki Hanseling.

Whether cycling, swimming or running, most participants found time for smiles!

See our Bryan Indoor Triathlon photo album at facebook.com/ BryanHealth.

Bryan Journeys 23

YOUTH MENTAL HEALTH Daisy Mejia (left) and Abby enjoy everyday activities, like spending time with Molly the poodle. About a year ago, Daisy brought Abby to Bryan’s Mental Health Emergency Department when her daughter was in crisis. Today Abby is healing and says she knows where to find help when she needs it.

24 Spring 2020

YOUTH MENTAL HEALTH

Youth in crisis find treatment options

M

ental health issues and suicide are on the rise among Nebraska’s young people.

“Suicide is the second-leading cause of death among teens and young adults,” says counseling and program development manager Dave Miers, PhD, LIPC. “We can clearly see that many of our young people are experiencing serious mental health crisis situations. Treating youth in crisis, including those who are suicidal, is therefore an essential part of what we do at Bryan’s Youth Mental Health Services.

“We’ve had a longtime devotion to the mental health of youth and support of their families. In 1986, Bryan began a youth inpatient treatment program and in 1993 created Nebraska’s first Mental Health Emergency Department.”

24-hour emergency services for youth and inpatients He notes, “Our Mental Health Emergency Department is open 24 hours a day, every day. Each year more than 6,500 patients receive this vital service, including 2,000 youth.”

“We see patients 5 to 18 years old who often come in with feelings of wanting to harm themselves or others,” says Youth Mental Health Services nurse manager Linda Kimminau, MSN, RN. “We’re well-equipped to keep these patients safe and provide treatment specifically for their needs.”

To expand these vital services, Bryan began offering telemedicine mental health emergency services in other Nebraska communities in 2016. Today, Bryan collaborates with hospitals to offer this care in Beatrice, Columbus, Crete, Neligh, Tecumseh, Valentine and Wahoo.

“Our Mental Health Telemedicine service provides expert mental health evaluation quickly to young patients in their own communities,” says Dr. Miers. “Youth and families can stay close to home, near relatives and friends, and avoid a long drive to Bryan’s Mental Health Emergency Department for crisis assessment because telemedicine connects their local hospitals with providers at Bryan.”

Treatment options meet patient needs Patients needing hospitalization are cared for in Inpatient Youth Mental Health Services by an interdisciplinary team.

“This includes a psychiatrist, social worker/therapist, nurses and a teacher. Inpatient care usually lasts two to four days, stabilizing patients so they can be cared for at home,” Linda says.

“Therapy can be continued under Bryan’s Partial Hospitalization Program or our Outpatient Counseling Center to keep providing treatment and support.” Patients who have previously worked

Therapist Sandra Breach and nurse manager Linda Kimminau are part of the team helping youth navigate crisis situations. with a therapist in the community continue seeing that therapist in follow-up appointments.

Therapy insights become Abby’s strengths Daisy Mejia of Tecumseh became very concerned about her 11-year-old daughter Abby in the Fall of 2018. “She had persistent crying spells and sadness, and I just couldn’t pull her out of it,” Daisy recalls.

“I was upset and I felt I didn’t belong,” Abby says. “I just wanted to sit in my room, and I didn’t feel any interest in anything.”

Over several months, Abby and Daisy worked with an outpatient counselor. “But in January, 2019,” Daisy says, “Abby hit an all-time low. She was in a very dark place, with thoughts of suicide. Her school counselor suggested Bryan’s Mental Health Emergency Department.

“Abby was hospitalized at Bryan for five days, and once more in April 2019. There, and through outpatient counseling, we found the perfect balance of therapy and medication treatment, and Abby began to make progress.”

Working with Daisy, Abby’s treatment team made a decision that led to an important breakthrough in her healing.

Abby’s counselor, mental health therapist Sandra Breach, Bryan Journeys 25

YOUTH MENTAL HEALTH LICSW, of the Bryan Outpatient Counseling Center, says, “Daisy and I felt it would be helpful for Abby to have detailed mental health testing, which showed severe emotional stress earlier in her life that we hadn’t known about.”

That stress, in turn, was what was causing Abby’s depression, anxiety and suicidal feelings.

“We used this new insight in her therapy,” Sandra says.

“Working with her mother and me, Abby used her creativity and imagination to solve problems causing her stress, and began to move forward. For example, we identified what triggered her stress at school, and she developed better ways of managing these

Dave Miers, PhD, LIPC, stands next to one of the suicide prevention signs he helped design with assistance from the Bryan Advancement Department and the Bryan Safety Committee.

problems, like talking over disagreements rather than just feeling upset.”

“When your child is facing mental illness,” Daisy adds, “it’s important to let them know they’re not fighting that battle alone.

Parents have to show your child you care, that they’re worth it, and fight for them.”

Be the best of who you are Abby says she’s learned a lot while working with her therapist.

“I understand now that we’re all doing the best we can,” she says. “I also know there will always be people out there who will bring you down, but you don’t have to listen to them.

“You are the best sum of who you are, and when times are hard there are people out there who can help you feel better.” n Bryan offers free confidential online screenings to all ages.

Learn more about youth in crisis at bryanhealth.org/youthmental-health. To support the ongoing work of Bryan Mental Health Services, call 402-481-8605.

26 Spring 2020

Bryan placed more than 60 “You’re Not Alone” signs throughout its parking garages and in the Bryan College of Health Sciences.

The Lincoln Lancaster Suicide Prevention Coalition was formed to address suicide prevention. Dr. Dave Miers, who’s a member of the coalition’s leadership group, says one of its goals is to place similar signage in Lincoln’s public parking garages. Bryan and the local coalition collaborated to use grant funding to make 200 signs for city and University of Nebraska garages.

The signage has been effective in saving lives and connecting individuals to resources. Dr. Miers says the coalition heard about individuals and bystanders who reached out for help or connected others to help as a result of these signs.

If you have a concern, don’t hesitate to ask, “Are you suicidal?” and call the National Suicide Prevention Lifeline at 1-800-273-8255. The Mental Health Emergency Room at Bryan West Campus is available 24/7 for mental health emergencies. n

CRETE AREA MEDICAL CENTER

Local students benefit from mental health assessments

C

rete Area Medical Center is partnering with schools in situation, which made it difficult for teachers and counselors surrounding communities to make sure students have to help with follow-up care. access to mental health care when they need it.

Since partnering with Wilber-Clatonia in May of 2019, Last year, Crete Area Medical CAMC has invited schools Center CEO Rebekah Mussman in other Saline County attended a suicide prevention communities to participate, coalition hosted by Wilber-Clatonia including Crete, Dorchester and Public Schools. As she listened to Friend Public Schools. school counselor Amie Albrecht Amie says one of the biggest talk about the mental health needs barriers for families can be of students, Rebekah mentioned the cost of mental health care, that they would love to help in any especially for students who way they could. need long-term counseling.

She and Amie came up with To address this concern, Amie a program to help address some has been working with Bryan of the barriers that can prevent Telemedicine and CAMC to students from receiving the help install equipment that will allow they need. students to receive consistent Before, if parents or teachers counseling at the school. They were concerned that a student are applying for grants to help might be suicidal, parents were fund the project. given the option to either drive “Our teachers are grateful 40 miles to Bryan Mental Health that we’ll be able to continue Emergency Room for an evaluation, moving these students forward or keep their child at home and and get them the help they monitor them on their own. Crete need,” says Amie.

Area Medical Center, which is 13 Rebekah says the medical Rebekah Mussman of CAMC and school counselor Amie Albrecht developed a program to help Wilber-Clatonia miles north of Wilber, opened up center is excited about students who are experiencing mental health crises. mental health triage services to opportunities to partner with the youth through Bryan Telemedicine. schools.

Rebekah points out CAMC “I’m hoping that it makes provides the triage service free of charge to students. some kind of impact for these students as they grow up,” she She and Amie also developed an information packet that says. is handed out at the screening, and it gives parents the option “It’s been really nice to be able to collaborate with the to sign disclosure forms to allow the hospital to communicate schools and act as a positive bridge between the resources. with schools.

It’s developed into more conversations about needs and Previously, after a student was screened, the school access, and I think there’s definitely more to come as we wouldn’t receive any information about the student’s continue to work with the schools.” n

Bryan Journeys 27

F I R S T T I M E PA R E N T I N G

They’re enjoying life with new babies These new parents became fast friends while participating in “Life With Your New Baby.” Their group includes Dana Hatcliff with Maverick, Ashley Weyers with Kipten, Hunter Thorpe with Dakota, and Alan and Jaci Sinnett with Lilliana.

B

ryan Human Resources partner Dana Hatcliff and her husband Nick welcomed their first child — son Maverick — in 2019.

“There was an overwhelming excitement and joy with his arrival and a need to want to learn all that I could to prepare myself for situations, experiences and even emotions in the months that followed,” she says.

When anticipating how to best prepare for this new chapter of life and as a new mom, Dana learned about the “Life With Your New Baby” program offered through Bryan

28 Spring 2020

Women’s Care Physicians, which is part of the Bryan Physician Network.

“I thought it would be a great way to gain additional knowledge, hear firsthand from subject matter experts and connect with other new parents,” Dana says.

New program for new parents “Life With Your New Baby” was launched in May 2019. It’s free and available to new and expectant mothers (and fathers) who are patients of Bryan Women’s Care Physicians.

It includes four 60-minute classes, led by

nurses from Bryan Women’s Care Physicians.

Classes also feature guest speakers from dietitians and lactation consultants to therapists and yoga instructors. Topics range from coping skills and mood changes to breastfeeding, bonding with your baby, postpartum, self-care and diet.

“We provide access to experts that can give these new parents advice and support in a small group environment,” says Bryan Physician Network operations director Sara Morris.

“Dr. Alyssa Rutan, who’s also a certified

F I R S T T I M E PA R E N T I N G lactation consultant, offers an excellent session on breastfeeding and the benefits for not only baby but also mom. We invite expectant mothers to attend this one especially.”

Patients also have the opportunity to attend a session lead by Jill Brandl, a psychiatric nurse practitioner who has a special interest in the care of women and postpartum moms.

How the program started The program was developed by Bryan Women’s Care Physicians, having been inspired by a nurse who was also navigating life as a new mom.

“It’s important for us to come alongside mothers to do more in helping them adjust to life with a new baby,” says Megan Pleskac, RN, of Bryan Women’s Care Physicians. “Through this program, we’re providing additional education, support and connection.”

Relying on her own experience plus knowledge of guideline changes from the American College of Obstetricians and Gynecologists about 4th trimester care for mothers, Megan brought the idea to the

team, and “Life With Your New Baby” was born.

Hidden benefits Dana was one of several new parents to participate in the launch of the program.

“There were so many things I loved about it,” she says. “I had a chance to hear from subject matter experts on things that we could expect, things we may have been experiencing currently and how to navigate those areas, topics that were relatable to us in this new chapter of life and strategies that could assist us, all while having our babies right there with us as we learned!”

Learning wasn’t the only outcome of Dana and the other new parents attending the class. They quickly formed friendships, which blossomed beyond the class.

“We exchanged cell phone numbers and have continued to get together, which has been an added benefit from attending the program,” she explains.

Dana, Ashley Weyers, Hunter Thorpe, and Jaci and Alan Sinnett have kept in touch.

“We have been able to bounce ideas and questions off each other, share in the fun milestones that take place, in addition to

seeing each other in person, connecting and allowing the babies to play,” says Dana.

Continuing in 2020 The staff at Bryan Women’s Care Physicians is ecstatic about the results and looks forward to serving more new moms and dads in 2020 and beyond.

“Our team is so happy to see that this program is helping new parents,” says Megan. “We’re truly making a positive impact!”

From Dana’s perspective, it’s been a win for her family and something she’s quick to share with other new and expectant parents.

“I am thankful for the additional education offered through this class and for the connections that have been created and would recommend this to any new parent,” she says.

Individuals who’d like to learn more about the “Life With Your New Baby” program can pick up a flyer from the front desk at Bryan Women’s Care Physicians or talk with their nurse.

Patients also can email postpartum@bryanhealth.org or call 402-483-8630. n

Kipten, Dakota, Lilliana and Maverick have been buddies for most of their young lives!

Bryan Journeys 29

ACHIEVEMENTS

Dr. Brian Buhlke was honored for promoting rural health care.

Shannon Engler, RN, received a March of Dimes award.

Dr. Buhlke earns recognition

March of Dimes cites Engler

Brian Buhlke, DO, FAAFP, was honored November 11 during National Rural Health Day. Each year, the National Organization of State Offices of Rural Health shines a light on those who serve the vital health needs of the 57 million people living in rural America.

Dr. Buhlke is a family medicine physician who practices at Merrick Medical Center in Central City. His nomination notes Dr. Buhlke’s focus on advocating for appropriate care in rural Nebraska and his work to change policies related to affordable EMS services.

His story appeared with those of other nominees in the 2019 edition of the Community Stars book published by the national organization. n

During the 2019 March of Dimes Nurse of the Year Banquet, Bryan Mental Health Services director Shannon Engler, RN, was recognized in the Advocacy category.

“I was surprised, humbled and honored,” he says.

“Advocacy means to support and sometimes plead for better care — in my case, for those with behavioral health conditions who are among the most fragile and disenfranchised. I support the delivery of quality services to them because it’s the right thing to do.”

He adds, “I’m very fortunate to work with an outstanding array of people.

This recognition is the result of the work our staff, leaders and community partners do.” n

30 Spring 2020

Bryan Diabetes Center’s education team includes Ashley Larson, RD, LMNT; Kathy Helmink, RN, CDE; Jenna Mayers, RN, LMNT, CDE; Samantha Beckler, RN, CDE; and Mary Luebbert, RD, LMNT, CDE.

Bryan Diabetes Center achieves ADA recertification The American Diabetes Association (ADA) announced the successful recertification of the Bryan Diabetes Center through the Education Recognition Program.

The primary goal of this ADA recognition program is to assure high-quality education for its participants. Certification means educational services meet the national standards for Diabetes Self-Management Education and Support (DSMES).

Diabetes programs apply for recognition voluntarily, and ADA certification can be renewed every four years — Bryan Diabete Center has been a recognized ADA program since 2000.

There currently are 21

sites across Nebraska affiliated with this program through the Heartland Health Alliance.

Kathy Helmink, RN, CDE, serves as the quality coordinator for Bryan’s DSMES program, including all of the statewide diabetes sites.

The Bryan Diabetes Center team provides many special programs, as well as individual consultations, to help patients focus on areas such as nutrition, exercise, lifestyle changes, carbohydrate counting, medications, insulin pump use and more.

For more information about diabetes education, call 402-481-6305. n

ALUMNI NEWS

Malerie Hixson receives her Diagnostic Medical Sonography diploma from Dr. Amy Knobbe, Dean of Healthcare Studies, and Bryan Health Executive Vice President John Woodrich.

Nursing graduates Alex Thomalla, Nikki Elgin and Josiah BeDunnah freeze a moment in time.

Welcome, newest alumni!

Bryan College of Health Sciences awarded 62 diplomas December 20 during commencement at Saint Paul United Methodist Church.

Pictured are the latest to earn Bachelor of Science in Nursing degrees.

Bryan Journeys 31

PUBLIC NOTICE

Discrimination is against the law

B

ryan Medical Center complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Bryan Medical Center does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.

If you have questions about the law, please contact our Corporate Compliance Officer. You can either call 402-481-8432, write to Bryan Medical Center, Attn: Patient Experience Department, 1600 South 48th Street, Lincoln, NE 68506 or email patientexperience@bryanhealth.org.

Bryan Medical Center Provides free aids and services to people with disabilities to communicate effectively with us, such as: • Qualified sign language interpreters • Written information in large print, audio, accessible electronic formats

or other formats Provides free language services to people whose primary language is not English, such as: • Qualified interpreters • Information written in other languages If you need these interpreter services, contact our Administrative Managers 24/7: 800-742-7844. You may also email a request for interpreter services: communicationassist@bryanhealth.org If you believe Bryan Medical Center has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: Patient Experience Specialist 2300 S. 16th Street, Lincoln, NE 68502 Phone 402-481-5761 – TTY 800-833-7352 – Fax 402-481-5711 patientexperience@bryanhealth.org You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, the Patient Experience Department is available to help you.

Please see the contact information above.

You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/ portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services 200 Independence Avenue, SW Room 509F, HHH Building Washington, D.C. 20201 1-800-368-1019 -TTY 800-537-7697 Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html.

32 Spring 2020

ATTENTION: If you speak English, language assistance services, free of charge, are available to you. Call 1-800-742-7844; TTY: 1-800-833-7352.

ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-800-742-7844; TTY: 1-800-833-7352.

CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số 1-800-742-7844; TTY: 1-800-833-7352. 注意：如果您使用繁體中文，您可以免費獲得語言援助服務。請致電 1-800-742-7844; (TTY: 1-800-833-7352）。

‫م لحوظة‬: ‫ اذك ر ت تحدث ك نت إذا‬،‫ل ك ت تواف ر ال ل غوي ة ال م ساعدة خدمات ف إن ال ل غة‬ ‫ب ال مجان‬. ‫ ب رق م ات صل‬Fa1-800-742-7844 (‫وال ب كم ال صم هات ف رق م‬: 1-800-833-7352).

1-800-742-7844 (TTY: 1-800-833-7352).

ATTENTION : Si vous parlez français, des services d'aide linguistique vous sont proposés gratuitement. Appelez le 1-800-742-7844; (ATS: 1-800-833-7352).

XIYYEEFFANNAA: Afaan dubbattu Oroomiffa, tajaajila gargaarsa afaanii, kanfaltiidhaan ala, ni argama. Bilbilaa 1-800-742-7844; (TTY 1-800-833-7352).

ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfügung. Rufnummer: 1-800-742-7844; TTY: 1-800-833-7352. 주의: 한국어를 사용하시는 경우, 언어 지원 서비스를 무료로 이용하실 수 있습니다. 1-800-742-7844; (TTY: 1-800-833-7352) 번으로 전화해 주십시오. ध्यान दिनह ु ोस ्: तपार्इंले नेपाली बोल्नह ु ु न्छ भने तपार्इंको ननम्तत भाषा सहायता सेवाहरू ननिःशल् क रूपमा उपलब्ध छ । फोन गनह ु ोस ् 1-800-742-7844; ु (दिदिवार्इ: 1-800-833-7352) ВНИМАНИЕ: Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода. Звоните 1-800-742-7844 (телетайп: 1-800-833-7352). ໂປດຊາບ: ຖ້າວ່າທ່ານເວົ້າພາສາລາວ,ການບໍລິການຊ່ວຍເຫຼືອດ້ານພາສາ, ໂດຍບໍ່ເສັຽຄ່າ, ແມ່ນມີພ້ອມໃຫ້ທ່ານ. ໂທຣ 1-800-742-7844 (TTY: 1-800-833-7352). ‫ئ اگ اداری‬: ‫ قە سە ک وردی زمان ی ب ە ئەگە ر‬،‫ي ارمەت ی خزمەت گوزاريەک ان ی دەکەي ت‬ ،‫ زمان‬،‫بەردە س تە ت ۆ ب ۆ بەخ ۆڕاي ی‬. ‫ ب ە پەي وەن دی‬1- 800-742-7844 (TTY (1-800-833-7352 ‫ب کە‬. ‫ت وجە‬: ‫ می گ ف ت گو ف ار سی زب ان ب ە اگ ر‬،‫راي گان ب صورت زب ان ی ت سه یالت ک ن ید‬ ‫ب ا شد می ف راهم شما ب رای‬. ‫ ب ا‬1-800-742-7844 (TTY: 1-800-833-7352) ‫ت ماس‬ ‫ب گ یري د‬. 注意事項：日本語を話される場合、無料の言語支援をご利用いただけます 1-800-742-7844; (TTY: 1-800-833-7352) まで、お電話にてご連絡ください

COMMUNITY CALENDAR

Spring into a Fresh You

Home Run for Health with the Lincoln Saltdogs

Friday, June 5 Haymarket Park Pregame Activities: 4:30-7 p.m.

• More than 30 exhibitors with interactive health and safety activities • Meet and greet with Lincoln Saltdogs players • Bounce houses and play area • One lucky child will be invited to throw the first pitch

Baseball Game: 7:05 p.m.

Lincoln Saltdogs vs. Sioux Falls Canaries

Spa & MedSpa Spring Event Saturday, April 4 9 a.m.-4 p.m.

Stop in for a free skin consultation with Rubab Husain, MD, or Carrie Kleinschmidt, PA-C. Plus, see live demonstrations of brow lamination and henna brow. Brow lamination is similar to a perm for your brows leaving them lifted for about 6 weeks. It gives the illusion of fuller, more defined eyebrows. Henna brow is a tint that helps strengthen and restore hair growth while improving the natural condition of the eyebrow hair. These two services can be combined for one fabulous brow treatment!

Discounted Services Purchase In-Store or Online April 4-10 • • • • • •

Massage & Body Treatments Botox Jeuveau Customized Liquid Facelift Laser Hair Laser Hyperpigmentation

• • • • •

Microneedling Waxing Peels Spray Tan Brows

Enjoy 20% off retail products all week long!

Learn More bryanlifepointe.com/spring 402-481-6321 ∙ 7501 S. 27th St.

Pamper yourself with a Flash Beauty Treatment!

Monday, April 6 3-7 p.m.

• Purchase an exfoliating peel for only $30 • Visit with an Eminence representative • Learn about new skin care products To schedule your appointment, call 402-481-6321.

The Spa Bryan LifePointe

Fish Oil Benefits: Breaking Down the Research Podcast with Keith Miller, MD, Bryan Heart cardiologist

Fireworks Show: Following the game

Tickets available May 1 at:

saltdogs.com/bryanhomerun • General Admission Berm Seat - FREE • Reserved Seat - $6 Both ticket levels include admittance to the Home Run for Health pregame activities.

Thank you to our presenting partners,

Can fish oil improve your health? Dr. Keith Miller shares information on recent studies including one with stunning results.

Listen now at: bryanhealth.org/podcasts

Bryan Journeys 33

Non-Profit Org. U.S. Postage PAID Permit No. 267 Lincoln, NE 1600 S. 48th St., Lincoln, NE 68506

Address service requested

New words for your next mammogram: Quick & Comfortable When it comes to mammograms, there’s lots of good news. Screening mammograms are covered by most insurance plans as part of preventive medicine coverage. Plus, with new technology at Bryan, your mammogram is faster and more comfortable.

Benefits for you: • 3D mammography at Bryan uses a very low-dose x-ray system that provides highly accurate and detailed images • 3.7 seconds of compression is all it takes to get your image • SmartCurve paddles make getting a mammogram more comfortable and are receiving rave reviews from our patients!

Talk to your doctor about getting a mammogram. Then, call Bryan to schedule at one of our three convenient locations – Bryan West Campus, Bryan Medical Plaza and Bryan Pine Lake Campus.

Learn more Visit: Call:

bryanhealth.org/3d-mammography 402-481-5121 to schedule your appointment

I had my first mammogram a year ago and was in pain the rest of the day.

BUT! Today was different. I tried out the curved paddles (along with 3D imaging) at Bryan Health. It was a total and complete breeze. I’ll be back next year for sure.

- Rebecca Tredway