Journeys | Winter 2015

WINTER 2015

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

Tackling challenges head on

JOURNEYS

New at Bryan

WINTER 2015

01 FROM OUR PRESIDENT 02 PATIENT EXPERIENCE

Successful surgery brings Steve home for the holidays 05 CONTINUING LEADERSHIP

We benefit from the insights of past chiefs’ experience 06 NEW AT BRYAN

Ankle replacement remedies severe arthritis: Dwight’s active again 08 BRYAN FOUNDATION 09 PULMONARY MEDICINE

Empowering COPD patients to take action 10 PULMONARY REHABILITATION

Paco achieves many milestones on personal journey to better health 12 BRYAN LUNG CANCER CENTER

Highlighting newest developments in the fight against lung cancer 14

15

18

BRYAN HEART Cardiologists team with pulmonologists: Trial tests sleep apnea treatment MEDICAL STAFF SPOTLIGHT Ask the doctor: Can a pulmonologist resolve my sleep issues?

MEDICAL STAFF UPDATE Welcome these colleagues to the Bryan medical community

20 NEW AT BRYAN

Renaissance system guides successful spine and brain surgeries 22 BRYAN LIFEPOINTE

Class helps Diane deal with Parkinson’s 24 VOLUNTEERS & CUSTOMER CARE

Pediatrics welcomes ambassadors 26 CRETE AREA MEDICAL CENTER 28 EARLY DETECTION CENTER 29 BRYAN COLLEGE OF HEALTH SCIENCES

Treatment for migraines, cluster headaches and trigeminal neuralgia

T

he doctors of Advanced Radiology at Bryan Medical Center offer SphenoCath, the most advanced treatment to relieve headache and trigeminal neuralgia pain.

This simple, effective outpatient treatment: • Takes only 15 minutes — and there’s no needle.

• Offers immediate and ongoing pain relief.

• Is safe for children, adults and pregnant women.

• Is affordable and covered by most insurance.

Migraines, cluster headaches and trigeminal neuralgia pain can be debilitating — taking you away from your work and daily activities. This new treatment effectively blocks the pain, allowing you to enjoy life.

I have my life back Rebecca, one of the first patients to receive the SphenoCath treatment for her migraines, shares her experience “I had no idea of the constant pain I was carrying around daily in my head until it was gone. The day I came in for the treatment, I had a migraine. After the procedure, my migraine was gone. The treatment is not a cure, and will need to be repeated over time, but it is so worth it. I have my life back.”

The treatment can last three-six months, giving patients lives free of migraine, cluster headache and trigeminal neuralgia pain and the ability to work and enjoy daily activities. Repeat treatments, as needed, provide ongoing pain relief. n Learn more Visit bryanhealth.org/migraine-treatment, or schedule a consultation to find out if the SphenoCath treatment can help you. Call the Bryan Scheduling Center at 402-481-5121.

31 ACHIEVEMENTS 32 BRYAN STERLING CONNECTION 33 COMMUNITY CALENDAR

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 quarterly to our employees, physicians, volunteers and the communities we serve.

ON THE COVER Surgeon John Fallick, MD, used an unusual procedure to save patient Steve Winter: See Page 2.

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 the Bryan Foundation at 402-481-8605, or write to us at:

Bryan Foundation 1600 S. 48th St. Lincoln, NE 68506

Kimberly Russel President & CEO, Bryan Health John Woodrich President & COO, Bryan Medical Center Gary “Gus” Hustad, MD Chief of Staff, Bryan Medical Staff Bob Ravenscroft Vice President of Advancement & CDO Edgar Bumanis Director of Public Relations Paul Hadley Editor

FROM OUR PRESIDENT

“Let us make a special effort to stop communicating with each other so we can have some conversation.”

— Mark Twain, writer and humorist

M

r. Twain was on to something. Little did he know what relevance these words would have in today’s world. When was the last time you put down your smartphone or tablet or switched off Skype just to look someone in the eyes, face to face, and hear about their day?

We answer a similar question in health care.

When you take the time to visit patients, shake hands and have a conversation about their care, you gain a wealth of information that makes your hospital better. Safer. And trusted.

My colleagues on the senior management team at Bryan Health have joined me in making such visits a regular part of our work weeks. Without exception, we cherish this time on our patient care units — it connects us to our mission and reminds us why we pursued careers in health care. We also get to meet incredible people, as I did the day I was introduced to Beatrice

residents Steve and Janie Winter. We’re honored to have been part of Steve’s journey, and you can read his story on Page 2.

The art of listening. It’s a hallmark of a team that works together for positive change. From the most trusted and familiar, to new models for delivery and access to care, we’re here to meet your family’s health care needs. Put the power of teamwork to work for you.

Bryan Health. Forward. Together.

Kimberly A. Russel President and Chief Executive Officer Bryan Health

Bryan Medical Center President John Woodrich (right) joins Leslie Hayes, RN, and orthopedic surgery patient Ronald Johnson of Norfolk on a walk while rounding at Bryan Medical Center on the Bryan East Campus.

Bryan Journeys 1

After Steve Winter’s long hospitalization in 2013, he and Janie Winter especially enjoyed the 2014 holiday season.

2 Winter 2015

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

Successful surgery brings Steve

Home for the holidays

L

ast year, Steve and Janie Winter spent the holidays in Lincoln — Halloween and Thanksgiving at Bryan Medical Center on the Bryan East Campus, Christmas and New Year’s at Bryan Medical Center on the Bryan West Campus. But this year, they are home in Beatrice with their family, grateful for the Bryan team that saved Steve’s life and brought their family closer.

Six weeks after retiring from a 32-year career as an insurance agent, Steve was preparing to mow the lawn when he started shaking and sweating and then became very weak.

Steve called 911 and was transported to Beatrice Community Hospital and Health Center, where he underwent testing and was diagnosed with advanced pancreatitis.

Critical situation After being called to the hospital from Southern Public Schools in Wymore, where she is a social studies teacher, Janie went home and researched Steve’s diagnosis on the Internet.

The implications of his condition worried her as it did Beatrice surgeon Blake Butler, MD, who sent Steve by ambulance to Bryan. In the time Janie grabbed some extra clothes, ran to the bank and drove to Lincoln, Steve’s condition had become critical.

“We knew immediately that Steve was profoundly ill and rushed him to surgery — there was no time to sugarcoat the situation,” says surgeon John Fallick, MD. “I told the family up front they should buckle up, as this is going to be the first of many steps in what will be a long journey ahead.”

Doctors believe a gallstone released and lodged in Steve’s common bile duct, causing gallstone pancreatitis, but then evolved into necrotizing pancreatitis, a severe exacerbation of what is typically a mild event.

“This is a very rare problem, but when it hits with this kind of fury you know it is going to be a rough ride,” Dr. Fallick says. Not many surgeons have had experience with this very difficult situation; fortunately, Dr. Fallick had operated in these instances, the first time during his residency at the Mayo Clinic in Rochester, Minn.

The surgery involves delving down very deep into the recesses of the abdomen to remove damaged tissue. In Steve’s

case, the amount of inflammation and swelling was so profound that there was danger of reaching a point where the abdominal cavity could not handle the pressure and would begin to diminish blood flow to his heart.

Dr. Fallick alleviated the pressure and left Steve’s abdomen open so subsequent surgeries could continue to reduce the infection during the next two months. Steve was in the intensive care unit (ICU) on a ventilator for three weeks, during which the physician team grew, as specialists in infectious disease, critical care, nephrology and cardiology joined the fight to help Steve’s lungs, kidneys and heart return to normal function.

“Bryan is particularly adept at dealing with very sick patients — the nursing, anesthesia and operating room staff really excel in such challenging situations,” Dr. Fallick says. “I can’t emphasize enough that this is a great place to be if you are critically ill.

“I was impressed right away that Janie and her family grasped the urgency of the situation, quickly realizing the road ahead was not going to be easy. Janie was a real trouper as she was able to adapt and deal with the roller coaster ride.”

Strong bond Janie has difficulty talking about Dr. Fallick without becoming emotional. “The man was a Godsend,” she says. “And he was so unconventional and willing to try anything it took to save Steve. And the care Steve received from everyone at Bryan was exceptional beyond words.”

ICU nurse manager Mona Reynolds says everyone enjoys working with Dr. Fallick. “He trusts us to take care of very sick patients who have long, drawn-out stays. Our nurses here do such a good job staying focused and goal directed, realizing they need to set short-term goals within the long-term goal of patient recovery,” she says.

Steve doesn’t remember much about his ordeal from Sept.

24, when he became ill, up until Thanksgiving when he started becoming “Steve” again.

“What I remember most is the closeness that Janie established with the nursing staff,” he says. “Mona was amazing, and the nurses in the ICU — Sherri, Candy, Lindsey, Kaitlin,

Bryan Journeys 3

PAT I E N T E X P E R I E N C E Courtnie and Natalie — were my family. They would laugh with me; they would cry with me; they would hug me. I developed such a close bond and am still in contact with several of them.”

“When you have patients who are that sick, you really get engaged with their families, and both the patients and their families stay embedded in your minds forever,” Mona says.

“Janie was right there for Steve, and she had wonderful support from her family, both of which were absolutely critical in Steve’s recovery.”

Recovery and appreciation In mid-December, Steve was admitted to Bryan Medical Center’s Inpatient Rehabilitation Center on the Bryan West Campus to begin working on regaining his strength.

“The facility is wonderful and is a true rehabilitation environment,” Janie says. “And I appreciated that the hospital was there if you needed it, which we, in fact, did when Steve ended up in the ICU the day after Christmas.”

Even though Dr. Fallick was enjoying the holidays at his neighbors, he came in and stayed with Steve in the ICU that

Assistant nursing manager Candy Melcher, RN, (left) and Natalie Schultz, RN, joined Dr. John Fallick in welcoming Steve and Janie Winter (center) to the intensive care unit during a return visit to Bryan.

4 Winter 2015

night until he felt he was out of the woods.

“That’s just the kind of guy he is,” Janie notes.

On Jan. 16, Steve was released from Bryan Medical Center and returned home to continue outpatient therapy in Beatrice.

He was hospitalized three more times between that dismissal and the end of March 2014, but he continues to work his way back to his previous level of stamina.

After missing a season of football and basketball, Steve, who is an avid sports fan, has begun to attend Beatrice High School and Nebraska Husker basketball games. But another passion, golfing, will have to wait until Steve’s strength is completely back, and his much-anticipated retirement really begins.

“We are so thankful for Bryan,“ Janie says. “And though I wouldn’t recommend that anyone go through what we did, it made us appreciate each other so much more. It’s like we have fallen in love all over again.” n To learn how you can support the work of Bryan Health, please call the Bryan Foundation at 402-481-8605.

CONTINUING LEADERSHIP

Everyone benefits from the insights of past chiefs’ experience

T

here are many challenges that come with leading a health care organization. It’s important to have a network of mentors as part of your leadership journey.

Past Chief of Staff and pulmonologist John Trapp, MD, believes in leveraging the education and experience of those who have gone before him.

“As a chief of staff, you play an integral role in the way health care is delivered,” he explains. “You’re responsible for multiple modalities of patient care across a wide variety of specialties involving hundreds of staff members. Being able to tap into the wisdom from previous leaders is an amazing opportunity.”

The Past Chief of Staff Advisory Council was introduced in 2011, while Dr. Trapp was serving as chief of staff at Bryan Medical Center. Since each chief returns to a career specialty after a two-year term, the goal of the council is to keep past leaders engaged through events where they discuss current challenges, new procedures/advancements and opportunities at Bryan Health.

“We’ve discussed procedures for treating plantar fasciitis and migraine headaches.

We’ve also learned about Transcatheter Aortic Valve Replacement (TAVR), which allows physicians to use a small catheter to replace a diseased aortic valve without openheart surgery,” says Dr. Trapp.

Hospital leaders are involved, too, seeking to implement relevant suggestions and feedback from the council.

In 2013, a council member presented compelling suggestions to make it easier for referring physicians to directly contact a hospitalized patient and obtain information about laboratory results, consultations and

At a recent luncheon meeting, former Chiefs of Staff David Dyke, MD, (standing at left), John Trapp, MD, Glen Lau, MD, Ron Craig, MD, Charles Gregorius, MD, Gene Stohs, MD, Timothy Lieske, MD, and John Baldwin, MD, (seated) and Monte Scott, MD, met with current Chief of Staff Gary Hustad, MD. the ongoing care of hospitalized patients.

The Bryan Health leadership team listened to the council’s feedback and implemented recommendations related to the community affiliate status for physicians.

This type of feedback has a direct correlation to a higher level of care at Bryan.

“Many of these leaders are respected in their field of expertise. Their feedback is very valuable,” says Dr. Trapp.

Past Chief of Staff and anesthesiologist Charles Gregorius, MD, also appreciates

the council’s efforts to keep past leaders involved.

“Those who have served as medical chief of staff have typically been leaders in a variety of other settings, both inside and outside the medical environment,” Dr. Gregorius notes.

“They bring a wealth of experience, along with an innate desire to serve, so it’s wise to keep such people in the loop as advisors to both the medical staff and the hospital.” n

Bryan Journeys 5

NEW AT BRYAN

Ankle replacement remedies severe arthritis

Dwight’s active again

L

ike so many patients with severe ankle arthritis, Dwight Johnsen of Cordova spent years trying various solutions for his debilitating, chronic ankle pain. After reading about ankle fusion surgery performed at Bryan Medical Center by surgeon Joshua Vest, DPM, FACFAS, of Capital Foot and Ankle, Dwight met with Dr. Vest to see if that procedure was right for him.

“Ankle fusion certainly would have solved Mr. Johnsen’s pain problem,” says Dr. Vest, “but I knew we could provide him with something even better.

“Although he did have severe ankle arthritis, he had also previously been very physically active and even at 79 years of age was otherwise quite healthy. As ankle fusion results in a rigidly fixed ankle that limits mobility, he and I decided that the newest generation of ankle joint replacement was ideal for him because it

Dwight Johnsen says he’s “110 percent satisfied” with his ankle replacement surgery, which allows him to be active without joint pain.

6 Winter 2015

provided both extensive pain relief and full ankle mobility.

“Ankle replacement procedures have gone through a lot of changes in recent years. The first few generations had problems and a high failure rate, so ankle fusion was the gold standard for patients with severe ankle arthritis at that time.”

Newer ankle implants have, however, flipped that scenario, and replacement is now a viable option for many patients. Fusion is still the most common procedure — there were 16,000 ankle replacements versus 80,000 ankle fusions performed worldwide in 2014 — but this trend likely will change as replacement procedures become increasingly more sophisticated.

“The most significant recent change is that the newest generation of ankle replacement procedures utilizes CT scanning to generate a computerized image of the patient’s ankle,” says Dr. Vest. “An exact replica of the ankle and a surgical template are

NEW AT BRYAN

then created by a 3-D printer, and we use the replica and template to prepare for the procedure before entering the surgery suite.

“The main benefit of this new approach is that there are fewer surprises. This reduces guesswork and problem-solving at the time of surgery and can decrease surgery and anesthesia time by about 50 percent, compared to previous-generation replacements.

Patients also have significantly less radiation exposure with the newer approach because there is less need for intraoperative X-ray.“ He adds, “One advantage of ankle fusion is that it is performed only once in a patient’s life, while replacement ankle joints wear out over time. But they can be repaired, often by simply replacing a spacer in the implant. We typically leave in the rest of the device, resulting in a much shorter second surgery. In the future, advancements will undoubtably be made in materials used in the artificial ankle, so replacements will last longer and likely can become a one-time procedure for most patients.

“A significant drawback of ankle fusion is that patients must stay off the operated ankle for 8-12 weeks, so they require considerable help at home after the surgery. And, up to 10 percent of patients experience delayed bone fusion, so they end up with an unstable, nonfused ankle joint that typically requires reoperation.

In contrast, patients with ankle replacements are able to move the joint immediately after surgery and return to weight-bearing on the operated ankle in as little as two weeks.”

Dwight says he is “110 percent satisfied” with his ankle replacement.

“I have no pain in the joint now, and I’m able to flex it all around. I stay quite active — always mowing or doing something in the summertime, and I don’t worry about spraining my ankle, so I don’t have to baby it. I feel my ankle is like when I was younger — so much stronger than when I first went to see Dr. Vest,” he adds.

“It’s exciting to have this new generation of ankle replacement available here,” Dr. Vest says. “Before that, some patients were traveling outside Lincoln or even out of state for the procedure.

That this is unique to Bryan is one more example of the quality of care offered by Bryan Health.” n

Dr. Joshua Vest holds a replacement ankle like the one created for Dwight Johnsen.

To learn how you can support the work of Bryan Health, please call the Bryan Foundation at 402-481-8605.

To watch a video about the new ankle replacement procedure at Bryan, go to www.bryanhealth.org/ankleVIDEO replacement-surgery.

Bryan Journeys 7

BRYAN FOUNDATION

Bryan staff members are among our best ambassadors The driving purpose of the Bryan Foundation’s work is to partner with individuals, foundations and organizations to help Bryan Health advance the exceptional care it provides people throughout Nebraska and in surrounding states.

In the past year, more than 2,600 generous donors made gifts and commitments totaling $6.3 million to enhance how Bryan impacts people’s lives. Watch for full details in our annual report on giving that will be part of the summer edition of Journeys magazine.

Leading the way were Bryan Health employees. In 2014, these co-workers gave $500,000 to the Bryan Foundation to be reinvested into the care of our patients.

In the accompanying story, you’ll read about our supply chain director, Jeff Burg, and his wife, Amy. It’s inspirational to see how someone who daily shares his skills and materials management experience to make Bryan better, takes his commitment a step further to ensure future generations will benefit from Bryan programs and services.

Employee donors, like Jeff, who have embraced our vision for Bryan truly are our greatest ambassadors.

— Bob Ravenscroft, Bryan Vice President and Chief Development Officer

8 Winter 2015

Estate planning brings peace of mind to Burgs

L

ike many people, Jeff and Amy nursing school,” Amy says. “We saw family Burg had put off their estate members go through it and want to help planning. When the opportunity others in that situation.” arose for them to make it a focus They also have great regard for the by working with Thompson and Associates, Bryan Employee Caring Fund, which was the couple took the plunge. Now, they say, established to help employees in crisis. it feels like a weight has been lifted.

“This fund is really important,” Jeff Thompson and says. “I’ve seen it in Associates’ Johni action, how it can Hayes helped Jeff and impact someone’s Amy narrow down life. I feel that the the things that were Employee Caring important to them Fund is something and what kind of that sets our legacy they wanted organization apart. to leave. They say it Employees who are was not taken lightly, in a place to help but rather it was a their co-workers in process of discovery need — that is very and reflection. powerful, and it’s Designating some part of what makes of their estate toward Bryan so special.” health care was an The Burgs easy decision for the encourage others to Burgs. Not only have start planning their the two worked in own legacy. hospitals — they met Amy and Jeff Burg have included Bryan “We had a few College of Health Sciences and the Employee while working at a medical scares and hospital in Michigan, Caring Fund in their estate planning. losses recently, and where they’re both it hit home that life from — but also because they have family is unpredictable,” Amy says. “We realized members who are nurses, physicians and we needed to get our affairs in order and a physician assistant. Jeff now is Bryan’s make sure our legacy was how we wanted director of supply chain. it to be.”

Part of their gift has been set aside as Adds Jeff: “The whole planning process a scholarship for a Bryan College of Health was a great experience, and we would Sciences student, and the other portion will recommend it to anyone.” n go to the Bryan Employee Caring Fund.

To learn how you can support the work “Health care is a good, honorable of Bryan Health, call 402-481-8605. profession, and we understand the struggles of someone trying to get through

PULMONARY MEDICINE

Empowering COPD patients to take action

C

hronic obstructive pulmonary disease (COPD) is a serious, increasingly widespread respiratory problem — and it’s the third-most common cause of death in the U.S., behind heart disease and cancer. The term “COPD” encompasses lung diseases that make breathing difficult, often causing shortness of breath and fatigue, which limit daily activities such as exercising, yard work and shopping.

Emphysema, chronic bronchitis and asthma are the most common causes of COPD. In emphysema, air sacs (alveoli) at the end of many of the smallest airways in the lungs are destroyed, often by exposure to tobacco smoke. In chronic bronchitis, inflammation and narrowing of the large airways (bronchi) cause difficulty in moving air into and out of the lungs.

In addition, patients with severe asthma can develop COPD when long-standing inflammation of the airways results in permanent narrowing. In all of these diseases, airway narrowing and damage to lung tissue lead to decreased blood oxygenation, causing a sense of “air hunger,” shortness of breath and fatigue.

“Although COPD can’t be reversed, the right medical therapy can reduce symptoms,

improve quality of life and prevent further damage to lung tissue,” says Douglas Fiedler, MD, a pulmonologist and critical care specialist at Nebraska Pulmonary Specialties.

“Optimal treatment combines steroid medication, bronchodilators and oxygen therapy as appropriate, smoking cessation and pulmonary rehabilitation therapy.

“Patients learn exercises during rehabilitation that help them empty air more fully from their lungs, because air trapping is a very significant problem with COPD. Our program helps patients plan their future medical care — they take active roles — and we support them as they transition to using supplemental oxygen. Some worry that a portable oxygen tank will be inconvenient, but nearly all of our patients feel improvement after this, because good blood oxygenation helps them feel better, reduces their shortness of breath and allows them to more easily do what they want and need to do in life.”

“At Bryan, we take a comprehensive approach to COPD treatment to reduce complications and enhance quality of life,” adds clinical services director Marcy Wyrens, RRT. “The key to this approach is involvement of COPD case manager Chris Plies, RRT, CPFT, who makes

Pulmonologist Douglas Fiedler, MD

regular phone contact with patients to check on their symptoms and confirm they’re taking their prescribed medications.

“We also very strongly encourage our patients to begin pulmonary rehabilitation.

This therapy is a real life saver for people with COPD because it reduces their risk for readmission to the hospital, increases their energy level, reduces shortness of breath and teaches them to breathe more efficiently and to control their coughing.

“In short, pulmonary rehabilitation keeps our patients with COPD healthier and helps them live longer, better lives.” n For more information about pulmonary rehabilitation and other services provided by Bryan Health for patients with COPD, contact COPD case manager Chris Plies, RRT, CPFT, at 402-481-5627 or Janis Howlett, RRT, at 402-481-6387.

Bryan Journeys 9

PULMONARY REHABILITATION

Paco achieves many milestones on personal journey to better health

I

f you have a conversation with Paco Martinez, you’ll quickly discover that “journey” is one of his favorite words.

“I spent more than 25 years in the travel industry,” he explains. “It only seems natural to talk about change as a journey.”

With eyes that twinkle when he smiles, you might think Paco is a natural optimist, with his glass half full; but he’ll tell you that his sunny disposition hasn’t always been so apparent. His past hides a dark shadow.

“I’ve struggled with depression and have even tried to take my own life,” he says, softly. “It’s difficult to talk about, but that’s what makes my journey even more amazing.”

Many years ago, as depression took its hold on Paco, the stress of his career began adding pounds to his small frame, as well.

With these factors, plus a 25-year history of smoking, it was only a matter of time before he began having pulmonary issues with difficulty breathing, low energy and sleep apnea.

“I went to see my pulmonologist, Dr. Sean Barry, who told me I needed to be on a CPAP machine,” says Paco. “That was not easy for me to use, so they moved me to oxygen. I did not want to use it — it was a major inconvenience for me.”

Dr. Barry told Paco that he could consider moving off of the oxygen if he began exercising to improve his functional status and lose weight.

As a result, Paco started the pulmonary rehabilitation program at Bryan LifePointe, but only lasted a few sessions before giving up. He said he wasn’t ready for that journey.

However, in 2010, he returned to give it one more go-round.

10 Winter 2015

Paco Martinez (center) appreciates the structure that Jon Cook and Janis Howlett provide at Bryan LifePointe.

Through the pulmonary rehabilitation program at Bryan LifePointe, patients like Paco go through a series of education and exercise classes where they learn about their lungs, how to exercise and how to live better with their lung condition. The goal is to have these patients graduate into a long-term exercise and strength-training program that can be maintained for the rest of their lives.

Dr. John Trapp, medical director for the pulmonary rehabilitation program, emphasizes the multidisciplinary approach of the program.

“Patients work with multiple specialties to better manage their respiratory disease.

These may include pulmonologists, respiratory therapists, physical therapists,

pharmacists, exercise specialists and others,” he says. “Research has proven that education and exercise therapy lead to a better quality of life and decreased hospitalizations.”

Janis Howlett, pulmonary rehab specialist at Bryan LifePointe, says many people enrolled in the pulmonary rehabilitation program are smokers, but her team also works with individuals who are non-smokers or former smokers who have COPD, asthma, interstitial lung disease or pulmonary hypertension. Following an initial intake process, Janis confirms the pulmonary rehabilitation patient understands what he or she wants to achieve as a result of the program.

“You have to know what your goals are,” she says. “For many people, they simply want to be able to experience less shortness of breath. They want to be stronger, able to do more without getting fatigued.”

Paco knew what he wanted to accomplish — to increase his strength and endurance, walk/run a mile without being short of breath, and get his blood sugar under control.

Janis says the Bryan LifePointe team can help patients build strength and endurance during the program, but disease management is a lifelong commitment.

“When I first came to the program, I was very depressed,” says Paco. “Janis helped me push through, and after a couple of months I started to see results. Yes, I was about to be taken off my oxygen, but I also was feeling better about myself and started to be much happier.”

Battling Type II Diabetes as well, the Bryan LifePointe staff helped Paco manage his blood sugar, providing access to juice or

PULMONARY REHABILITATION

Pulmonologist Sean Barry, MD, and Michelle Tyser, PA, helped Paco on his journey. other high glycemic foods if he started to feel faint during his workout.

The pulmonary rehabilitation program typically runs 18 weeks, and at the end of the program, participants are encouraged to continue with their exercise plan. Paco chose to continue at Bryan LifePointe, expanding his horizons into fitness classes, cardio and weight machines, even jogging around the track.

“Before I came to Bryan LifePointe, I had never even used a treadmill!” he exclaims.

“When I finished rehab, I had lost 10 pounds.

I was so happy. I told Janis that I needed to buy her a bouquet of roses for helping me get better — I had to keep going.”

This is the point of the journey where Paco meets the individual he deems responsible for the majority of his recent transformation — Jon Cook.

Jon is a health coach and trainer at Bryan LifePointe and regularly works with clients like Paco who have transitioned out of a medically supervised rehabilitation program into a structured fitness program.

“I’ve been privileged to witness Paco’s entire transformation from rehab patient and fitness client, to a strong and centered individual in charge of his own health,” says Jon. “He’s a completely different person!”

Paco sings Jon’s praises to everyone.

“Jon pushed me to be better,” says Paco.

“He makes programs for me, and I just do what he says. I’m 54 years old, and I just started exercising four years ago!”

He’s even a regular participant in Jon’s boot camp classes.

Exercising is a big part of Paco’s new life, as he transitions from former rehab patient to being in charge of his own health.

Better health brings a smile to Paco.

“When I finish working out, I’m exhausted, but I’m getting stronger. My spirit feels good,” Paco says.

He continues adding to his goal list. The newest step in his journey? Learning how to swim.

“I go to the pool now once a week or when I’m having a bad day,” says Paco. “I love to kick with the kickboard around the pool. But you know, I will learn how to swim without it one day!”

Other goals on his list include riding a bike and learning to tango.

Based on his track record of success, he’s sure to accomplish both.

And soon. n To learn how you can support the work of Bryan Health, please call the Bryan Foundation at 402-481-8605.

Bryan Journeys 11

BRYAN LUNG CANCER CENTER

Highlighting newest developments in the fight against lung cancer

Medical oncologist Nathan Green, DO, summarized current studies and treatments during the Shine a Light on Lung Cancer event at Bryan last fall.

I

n 2014, lung cancer accounted for 27 percent of all cancer deaths — more than colon, breast and pancreatic cancers combined. Each November, patients, physicians, and families gather for the Shine a Light on Lung Cancer event to share stories of those who have been affected by the disease, while highlighting medical advancements and new procedures designed to improve the detection and treatment of lung cancer.

Here are some of the recent developments discussed at that event.

The study was prompted by the case of a patient who had a CT scan for abdominal pain in which a lung nodule was noted on the radiology report. Since the nodule was unrelated to the patient’s present condition, follow-up was not ordered. A year later, the patient was found to have lung cancer that had already spread.

Based on the results of this study and experience in the diagnoses of late stage lung cancer, the Bryan Integrated Thoracic Program has developed a systematic review process to more effectively detect cancer in its early stages, giving patients a better chance for survival.

Through a partnership with pulmonologists from Nebraska Pulmonary Specialties and Lincoln Pulmonary and Critical Care, all reports of CT scans involving the head, neck, chest and/or abdomen with incidental lung nodules or other findings are reviewed weekly.

“Up to 300 scans are reviewed each week, and about 18 percent of those warrant further review due to incidental findings. We also discovered the patient’s primary care provider is often unaware the CT scan was done or of the findings and patients might not have been informed of the incidental nodules,” says Ruth Van Gerpen, RN, APRN-CNS, nurse navigator at the Bryan Lung Cancer Center. “It’s too

Safety net program for incidental lung nodules Cardiothoracic surgeon Richard Thompson, MD, director of the Bryan Lung Cancer Center, says that late detection remains the biggest challenge.

A study conducted at Bryan earlier this year discovered that a significant number of patients having CT scans for conditions unrelated to lung cancer or follow-up of known lung nodules possessed incidental lung findings — pulmonary nodules, masses or lesions.

Richard Thompson, MD, says the Bryan Integrated Thoracic Program helps physicians detect cancers earlier, so treatments can begin sooner.

12 Winter 2015

BRYAN LUNG CANCER CENTER Stereotactic radiosurgery For patients whose condition is too risky for surgery due to age or other health problems, a new form of radiation called stereotactic radiosurgery may be the answer.

According to medical oncologist Nathan Green, DO, stereotactic radiosurgery can be used to target and treat an abnormal area by focusing high-power energy on a small area of the body without damaging nearby healthy tissue.

Cancer survivor Teresa Fitzgerald of Malcolm says cooperation among her primary care physician, pulmonologist, surgeon and the Bryan Lung Cancer Center has been instrumental to her continuing recovery.

early to measure the true impact of this approach, but we’ve already obtained a significant amount of positive feedback from patients and providers.”

The CT scan report is sent to the primary care provider, along with recommendations for follow-up of the nodules, masses or lesions based on evidence-based guidelines. Patients receive a letter about the abnormal findings that encourages them to follow-up with their primary care provider. Also included is information about lung nodules, what that means, and what next steps need to be taken.

According to Dr. Thompson, this process serves as an awareness tool that may trigger additional actions such as a visit to a pulmonologist, a biopsy or a regular CT scan every six to 12 months.

Video-assisted thoracic surgery Far less invasive than traditional thoracic surgery, patients typically experience less pain and shorter recovery times with video-assisted thoracic surgery (VATS). This procedure enables doctors to view the inside of the chest cavity without having to cut through the major muscle groups, the ribs or sternum.

During the procedure, a tiny camera and surgical instruments are inserted into the chest through several small incisions. The camera transmits internal images onto a video monitor to guide the surgeon performing the procedure. Surgeons are then able to remove masses close to the outside edges of the lung to test them for cancer.

Advances in molecular diagnostics There is a growing importance of genetic biomarkers in the diagnosis and treatment of lung cancer. Biomarkers can help with cancer treatment in many ways, including the diagnosis, aggressiveness of the cancer and how well a patient will respond to treatment. Through molecular testing, oncologists are able to guide treatment for a significant portion of patients in a way that they never could before. While this methodology continues to evolve, it could certainly transform the way oncologists approach therapy for years to come.

Electromagnetic navigation bronchoscopy Electromagnetic navigation bronchoscopy (ENB) is an exciting new outpatient procedure driven by a technology similar to a car’s GPS system. Nebraska Pulmonary Specialties was among the first in the region to utilize this technology, notes pulmonary and critical care specialist Bill Johnson, MD. ENB combines a CT scan, patient markers, an electromagnetic field and computer-generated software to navigate a small set of catheters deep into the lungs. The software guides the physician through the lungs with the help of markers to distinguish the path to the lesion or nodule.

“Many times, a traditional bronchoscopy cannot reach the distant regions of the lung, where many lung lesions are found,” Dr. Johnson says. “ENB allows us to diagnose and treat lesions using a much safer procedure, with a lower risk of pneumothorax.” n To learn how you can support the work of Bryan Health, please call the Bryan Foundation at 402-481-8605.

VIDEO

Interested in current treatments for lung cancer?

Go to www.bryanhealth.org/lung-cancer. A video related to the Bryan Lung Cancer Center also is planned.

Bryan Journeys 13

BRYAN HEART

Cardiologists team with pulmonary specialists

Trial tests sleep apnea treatment

I

n brief: Sleep apnea occurs commonly among patients with cardiovascular disease (CVD) and is associated with a striking increase in mortality among those with heart failure.

Respiratory rhythm management, which

involves electrical stimulation

of the phrenic nerve resulting

in a diaphragmatic response,

is an innovative treatment

for central sleep apnea that Q: You have said that sleep is associated with apnea is a commonplace, often

normalized breathing deadly, and highly treatable

patterns among condition among patients with patients in early heart disease. clinical trials.

That’s right. Sleep apnea

Cardiologist Steven is strongly associated with Krueger, MD, of cardiovascular disease — it Bryan Heart happens in 30 percent of CVD

provides patients and up to 75 percent

information of patients with heart failure.

about this new It has serious adverse effects

treatment.

on morbidity and mortality and is closely correlated with hospital readmission and reoccurrences of cardiovascular events. Fortunately, sleep apnea (stopping breathing) also is quite treatable. Current treatment includes positive airway pressure therapy, mandibular splinting and surgery.

Q: Bryan Heart is part of an international study pioneering a new treatment for patients who have central sleep apnea, with or without heart failure. What does this study involve?

About 40 percent of people with heart failure have central sleep apnea, in which

14 Winter 2015

temporary suppression of the central respiratory drive causes breathing to stop for seconds to minutes. Bryan Heart currently is a clinical site for testing the remed¯

e System, an innovative respiratory rhythm management device that monitors patients’ breathing, then provides electrical pulses to the phrenic nerve to stimulate the diaphragm as necessary to normalize breathing.

Q: Safety and efficacy results from preliminary trials of the remed¯e System have been promising. What is the goal of the current trial?

The goal is to replicate the promising findings of preliminary studies in a larger trial involving 320 patients, and we have the opportunity to include patients from Lincoln and surrounding communities. This larger trial, called the remed¯e System Pivotal Trial, is enrolling qualified patients for evaluation and treatment for central sleep apnea using the remed¯

e System.

So, the remed¯

e System is a promising new treatment that may be a key new development for lowering morbidity, mortality and readmissions among our patients. n

MEDICAL STAFF SPOTLIGHT

Ask the doctor:

Q: How many hours of sleep do we really need?

The actual number varies from individual to individual, but the overall average is between 7.5 to 8 hours of sleep. However, there are instances where people require much less, as well as some instances where people require much more than this. It is important that sleep be undisturbed throughout the sleep cycles, as well.

Can a pulmonologist resolve my sleep issues?

Q: What happens to the body and mind when we do not get enough sleep?

Many people think that you can become physically ill if you do not get enough sleep. Those of us who work in the sleep field do not necessarily agree with that statement. While we may not feel well or even feel ill when sleep deprived, there is very little evidence to support the idea that you can develop an upper respiratory infection or a heart attack or any other kind of medical problem just because of lack of sleep. Certainly, our ability to function during the day is impaired if we do not get enough sleep or enough of the right kinds of sleep, but the physical illness does not usually occur. To expand more on the functionality aspect of sleep, our ability to function in terms of doing complex cognitive activities during the day such as mathematics, critical thinking, and these kinds of things are greatly impacted by the quality and quantity of our sleep.

In addition to that, reaction times are slowed somewhat if we do not get enough sleep similar to how reaction times are affected if we consume alcohol and then try to do some of these activities.

This includes driving or operating heavy machinery and so forth. In fact, some studies have concluded that chronic sleep deprivation may impair cognitive ability almost as much as alcohol.

Timothy Lieske, MD, discusses the role of sleep in maintaining good health.

Q: How did you decide to become a pulmonologist?

While in medical school and residency, I became very interested in the physiology of the lungs and found it very fascinating. That, and the fact that pulmonologists are involved in the care of critically ill patients, are the primary reasons why I went into this field.

The intensive care unit (ICU) is a very intense atmosphere where decisions are made quickly that impact the lives of patients. I enjoy this challenge a great deal.

Q: What do pulmonologists do?

In addition to our work in the intensive care unit, we also take care of patients with asthma, emphysema, chronic bronchitis, lung cancer and sleep issues such as apnea (where breathing is shallow or temporarily stops). We are involved in the evaluation and treatment of these patients. We do diagnostic procedures such as bronchoscopy to help diagnose various lung conditions, and we evaluate patients in the sleep lab at Bryan West Campus. This is the side of pulmonology that is not as acute and stressful, but it is certainly very enjoyable, as well.

Q: How prevalent are sleep issues today?

Statistics on sleep issues, such as sleep apnea, vary quite a bit.

As far as sleep apnea in patients who receive medical evaluation, some studies say it is about 10 to 15 percent. I suspect that it is actually quite a bit higher than that. We are all very well aware of the epidemic of obesity in this country, and certainly this is greatly impacting issues such as sleep apnea. Our lifestyle plays an important role in sleep apnea.

Q: Why is getting a good night’s rest so important?

In addition to the above answer, our sense of well-being is affected by how much sleep we get and the quality of that sleep. Certainly there is no substitute for getting a good night’s sleep.

Q: Is it possible to catch up on one’s sleep?

In a sense we can catch up on sleep just as we can acquire a sleep debt. If we get one less hour of sleep per night than we should, by the end of seven or eight days the cumulative affect is equivalent to being awake for a solid 24 hours without any sleep. Often we try to “catch up” on sleep over the weekends, and while sleeping in does feel good and does tend to repay the sleep debt, it does tend to also affect our sleep hygiene in a way that it makes it more difficult to stay on schedule. Keeping a sleep schedule is important,

Bryan Journeys 15

MEDICAL STAFF SPOTLIGHT so probably the best way to “catch up” on sleep is to keep that schedule and allow enough time each night for an adequate amount of sleep.

Q: What are the trends in sleep problems for children and youth as regards to school schedules affecting sleep?

One of the most important trends for sleep problems in children and youth is the epidemic of obesity, the result being that we are seeing obstructive sleep apnea at much earlier ages. This is not a good trend. Healthy eating, exercise and maintaining an ideal body weight are some of the ways parents can prevent this.

Early school schedules can greatly affect the ability of students to learn and be alert in school. Children and even high schoolaged individuals, by nature, tend to have a different type of sleep schedule than adults. They are what we call “phase-delayed,” meaning they like to stay up longer and wake up later. This is at odds with the way school schedules are set up. Many activities are very early in the morning, with school days ending earlier. As you can see, this is the direct opposite of the way most school-aged individuals sleep.

My advice to parents is to try to maintain a set sleep schedule for their children. Make sure children get enough time in bed to at least try to get the amount of sleep that they need.

Q: What is the difference between over-the-counter and prescription medications to aid in sleeping?

Most of the over-the-counter medications are a form of antihistamine. One that is commonly known is Benadryl; they are used because of their sedative aspects. As far as taking such medications for the long term, it usually is not helpful.

These medications can lose their effect over time, with the end result that more will be needed to get the same effect.

These medicines also can cause a “hangover” the next day.

I feel pretty much the same about prescription sleeping medicines. While they have a more direct affect on the sleep/wake centers in the brain, there is still the question of the person’s ability to tolerate the drug. Plus, some of these drugs can be habit-forming. My personal recommendation is to not use sleeping aides very often or for long periods.

Q: Can anyone use them if they are not sleeping well?

People commonly think: “I will just go get an over-the-counter medication or ask my physician about getting a sleep aid.”

But if sleep problems have been going on for longer than one to

16 Winter 2015

Tim Lieske, MD, of Lincoln Pulmonary and Critical Care Associates, says cardiovascular health has a big impact on whether patients develop conditions such as sleep apnea. Dr. Lieske has practiced in Lincoln since 1984. He is a former Bryan Health Board of Trustees member and chief of the Medical Staff and currently serves as a trustee at Crete Area Medical Center.

MEDICAL STAFF SPOTLIGHT two months, a physician evaluation could really help to determine if the person has apnea, insomnia for a number of reasons, or whether this is a short-term issue associated with stress, for example. Continued use of sleep medications without a definitive diagnosis or an evaluation is not recommended.

Q: If I snore does this mean I have apnea?

Not necessarily. There are people who snore and do not have apnea just as well as there are people who do not snore and do have apnea. There are many signs and symptoms of apnea, such as loud snoring, unrefreshed sleep, or spouse or significant other recognizing interrupted breathing at night. Severe daytime sleepiness is usually a symptom, but that can be a symptom of other disorders, too. However, if there is loud snoring, restless sleep, and the witnessed interrupted breathing at night, this is a pretty good indicator of apnea.

A full evaluation is the best way to know for sure.

Q: What are the main causes of sleep apnea?

The tendency for sleep apnea increases as we get older. Weight plays a significant role in the development and continuation of sleep apnea. However, there are other developmental and anatomical factors that are causes of sleep apnea.

Q: Does sleep apnea affect cardiovascular health?

It may not be very well known, but obstructive sleep apnea is now the No. 1 cause of hypertension in this country, especially in males. It plays a significant role in hypertension in females, too, but seems to be a larger concern in males.

Rhythm disturbances in the heart, such as atrial fibrillation, also are very closely associated with obstructive sleep apnea. Congestive heart failure interestingly enough can be both a cause and an effect, meaning that in some cases congestive heart failure can cause or worsen obstructive sleep apnea just as obstructive sleep apnea can cause congestive heart failure, so we are working very closely with colleagues at Bryan Heart to sort

out more of these issues

and try to come up with some very good therapies.

(Please refer to the related article on Page 14.)

Q: If I need a nasal CPAP machine, will I always have to use it?

A continuous positive airway pressure (CPAP) machine is basically a compressor that blows air into the posterior portion of the oral cavity and helps splint open the airway so that air can flow freely into the lungs. At this point, nasal CPAP is the best therapy we have for obstructive sleep apnea. Surgery is effective in only very limited and isolated instances. In rare instances, patients who have significant weight loss can come off the nasal CPAP machine. I take the approach that CPAP is not forever, but it is indefinite.

Q: What are some healthy habits that will help me sleep better and avoid the need for a nasal CPAP machine?

First of all, you must maintain an ideal body weight by getting enough exercise and eating right. Again, it is always good to maintain a set sleep schedule. We are creatures of habit, and our sleep falls into fairly rigid categories in terms of how much we need, when we should go to bed, when we should get up and so forth. We should maintain these habits, as this will help make our sleep more efficient and more restful.

Q: How will I know if it is time to ask a sleep specialist?

If sleep problems, whether they are insomnia, loud snoring, fatigue, sleepiness, etc., do not have a well-defined end, you should see a sleep specialist or contact your physician to see if a referral to a sleep specialist is in order. Things like family stress, a death in the family and other life-changing events can cause shortterm sleep issues. However, if the sleep disturbance associated with these types of events persists, then you should see a sleep specialist. If issues such as loud snoring or excessive daytime sleepiness continue or do not resolve with weight loss, then a sleep referral would be indicated. There are many other sleep disorders, such as narcolepsy, restless leg syndrome and periodic limb movements, that may require evaluation by a sleep specialist.

No matter the sleep problem, if it persists for more than a month or two and there is no obvious inciting event or resolution, consider a sleep referral.

To find out if you would benefit from a sleep evaluation, take our free online Sleep Aware screening. Go to www.bryanhealth. com/SleepMedicine and get started today.

If you have questions about pulmonary conditions, contact your physician.

Bryan Journeys 17

MEDICAL STAFF UPDATE

New faces at

Bryan

Welcome these colleagues to the Bryan medical community Jennifer Ahlers, MD, anesthesiology, has joined Associated Anesthesiologists, 402-489-4186.

Dr. Ahlers received an undergraduate degree from Cornell College of Mount Vernon, Iowa, and in 2006 earned a medical degree from University of Nebraska Medical Center College of Medicine, Omaha. She completed her residency at University of South Dakota Sanford School of Medicine, Sioux Falls, South Dakota, and University of Nebraska Medical Center, Omaha.

Abhijeet Basoor, MD, cardiology, has joined Bryan Heart and practices at Bryan Heart Mary Lanning Cardiology in Hastings, 402-460-5555.

Dr. Basoor earned his medical degree from NSCB Medical College and Hospital in Jabalpur, Madhya Pradesh, India, in 2004.

He served as a staff member in general surgery at the college until 2006. Dr. Basoor completed residencies at St. Joseph Mercy Oakland in Pontiac, Michigan, in preliminary surgery and internal medicine and also

18 Winter 2015

served as chief fellow in cardiovascular medicine. In 2013 he completed a fellowship in interventional cardiology at St. John Hospital and Medical Center in Detroit.

Jonathan Cramer, MD, pediatric and adult congenital cardiology, is associated with Children’s Hospital, Omaha, 402-955-4350.

Dr. Cramer is an internal medicine and pediatrics-trained cardiologist who specializes in the care of children and adults with congenital heart disease. His interests include simple and complex congenital heart disease (single ventricle), congenital valvular heart disease and the transition from pediatric to adult cardiology.

He received his Bachelor of Science from Creighton University, Omaha, and in 2006 earned a medical degree from the University of Nebraska Medical Center College of Medicine, Omaha. He completed his residency in internal medicine and pediatrics at the University of Louisville, Louisville, Kentucky.

Before joining Children’s Hospital, Dr. Cramer was an instructor in pediatric cardiology at Children’s Hospital of Wisconsin and Medical College of Wisconsin, Milwaukee.

Robert Dugas, MD, orthopedics, is associated with Nebraska Orthopaedic and Sports Medicine, 402-488-3322.

He earned a bachelor’s degree from Louisiana State University, Baton Rouge. Dr. Dugas completed his medical degree in 1983 at Louisiana State University, New Orleans, where he also completed an orthopedic residency. He has practiced in Alabama, Nebraska and Louisiana. Dr. Dugas also served in sports medicine in Baton Rouge and New Orleans and was the resident director of orthopedic surgery at Lafayette General Medical Center in Lafayette, Louisiana.

He returns to his practice with Nebraska Orthopaedic and Sports Medicine after serving as director of Orthopaedic Resident Education with the Louisiana State University Orthopaedic Department. He also will direct Orthopaedic Sports Medicine care at the University of Nebraska-Lincoln.

MEDICAL STAFF UPDATE Michael Gartner, MD, emergency medicine, is the principal investigator for Celerion, 402-476-2811.

Dr. Gartner completed his undergraduate degree at the University of Nebraska-Lincoln; in 1987, he earned his medical degree from the University of Nebraska Medical Center School of Medicine in Omaha.

He fulfilled a residency in emergency medicine at Michigan State University College of Human Medicine in Grand Rapids, Michigan.

Dr. Gartner served as an emergency staff physician in Michigan and Kansas. He is an instructor for the United States Department of Homeland Security.

Prathima Jasti, MD, endocrinology, has joined Nebraska Endocrinology Specialists, 402-484-3440.

Dr. Jasti completed her medical degree in medicine and surgery at Rangaraya Medical College in Kakinada, Andhra Pradesh, India, in 2004. She completed an internal medicine residency at Saint Joseph Hospital, which is affiliated with the University of Chicago.

Before joining Nebraska Endocrinology, Dr. Jasti was on the medical staff at Cleveland Clinic, Lakewood Diabetes and Endocrine Center, Lakewood, Ohio.

Kara Krejci, DPM, podiatry, has joined Prairie Shoulder, Elbow and Hand Center, 402-489-4700.

Dr. Krejci earned a bachelor’s degree at Midland Lutheran College in Fremont. She received her medical degree in 2010 from the Des Moines University College of Podiatric Medicine and Surgery, Des Moines, Iowa.

Her medical and surgical residency was at Community Medical Center in Scranton, Pennsylvania. In 2014, she completed the Pennsylvania Intensive Lower Extremity Fellowship at Pennsylvania Orthopaedic Center in Malvern, Pennsylvania.

Derek Miller, DPM, podiatry, has joined Capital Foot and Ankle, 402-483-4485.

Dr. Miller completed his undergraduate degree at Nebraska Wesleyan University, Lincoln. He earned his medical degree in 2011 from the Des Moines University College of Podiatric Medicine and Surgery, Des Moines, Iowa.

Before moving back to Lincoln, Dr. Miller completed his residency at DePaul Health Center in St. Louis.

Darren Splonskowski, MD, internal medicine, has joined Nebraska Hospitalists at Select Specialties Hospital, 402-917-5489.

Dr. Splonskowski received his Bachelor of Science from Creighton University in Omaha and earned his medical degree in 2003 from the Creighton University School of Medicine.

He completed a four-year residency in internal medicine at Creighton; during his fourth year he was the chief resident.

Before joining Nebraska Hospitalists, he practiced in Omaha.

Rachel Swim, MD, obstetrics and gynecology, has joined Women’s Clinic of Lincoln, 402-434-3370.

She received her undergraduate degree from the University of Nebraska-Lincoln.

Dr. Swim earned her medical degree from the University of Nebraska Medical Center College of Medicine, Omaha, in 2010.

She completed an obstetrics and gynecology residency at the University of Missouri in Kansas City, Missouri.

Bryan Journeys 19

NEW AT BRYAN

Precision in surgery

Benjamin Gelber, MD, was instrumental in bringing Mazor’s Renaissance System to Bryan.

20 Winter 2015

Neurosurgeon Benjamin Gelber, MD, and orthopedic surgeon Robert Vande Guchte, MD, recently began using Mazor’s Renaissance System, a new, FDA-approved, robotic surgical guidance system, for procedures on the spine and brain.

F

or Phyllis Stice of Lincoln, making the acquaintance of a surgical robot was unexpected, but very good news indeed. Last winter, Mrs. Stice, a very active 76 year old, fell on the ice in her driveway, fracturing three bones in her spine and leaving her nearly unable to walk because of constant back pain.

“I’ve done Jazzercise for 28 years and was always out doing something, so I wasn’t used to being that laid-up,” she says. “My doctor — pulmonary specialist Lisa Mansur — referred me to Dr. Benjamin Gelber, and since physical therapy and everything else had already been tried, he decided that surgery to place screws into the injured part of my spine was the best treatment for me.”

Mrs. Stice laughs and adds, “The thing that surprised me was that there was going to be a robot involved in the surgery. It all made perfect sense, though, when Dr. Gelber explained that the robot is a tool he uses to place the surgical screws exactly where they need to be.”

After her surgery, Mrs. Stice experienced complete relief of her back pain. “I’m quite happy with my surgery,” she says, “and I’d recommend Dr. Gelber to the world. He knows exactly what to do, cares about his patients, and pays individual attention to each of us, which is important because none of us are alike.”

“I use the Renaissance robotic system most often for placing screws in the spine during treatment of patients who’ve experienced spine trauma or degenerative spine disease,” explains Dr. Gelber. “We’ve so far used it very

NEW AT BRYAN

Renaissance system guides successful spine and brain surgeries successfully during spine surgery on about a dozen patients, and it performed quite well during a recent brain biopsy, as well.

I’ll also use it soon to target placement of electrodes that will provide deep brain stimulation for treating patients who have essential tremor or Parkinson’s disease.

“Bryan is the first hospital in the United States outside of research sites to use the Renaissance system to treat brain disease.

The system is highly innovative because it uses CT and MRI imaging and computer modeling to create three-dimensional views of patients’ spine and brain anatomy that allow extreme precision in the use of surgical instruments.”

As with all robot-assisted surgeries, surgeons using the Renaissance system are totally in control of the operations at all times; the purpose of the robot is

Phyllis Stice says surgery with the Renaissance guidance system at Bryan helped eliminate her back pain.

Robert Vande Guchte, MD, is the first orthopedic surgeon in Lincoln to use the Renaissance system. simply to act as a targeting tool, a kind of “computerized pointer” to calculate how to most precisely get to the surgical target.

“One thing that makes the Renaissance system so distinctive is its high level of precision, as it’s accurate to less than 1.5 millimeters,” Dr. Gelber notes. “As a result, all the screw placements we’ve used it for have been perfectly on-target.

“Renaissance is a very sophisticated, high-tech tool that I believe we’ll use more widely to enhance precision of many types of surgical procedures. As far as future developments of this technology go, robotic surgical guidance systems like Renaissance might one day be used to

precisely deliver medications to specific areas of the brain to treat localized problems such as infection or stroke.”

Robert Vande Guchte, MD, the first Lincoln orthopedic surgeon to work with the Renaissance system, shares his experience.

“I’ve used Renaissance to successfully place surgical screws to stabilize thoracic and lumbar spines of patients with traumatic injury or degenerative spine disease, and I’ll soon use it for cervical spine procedures,” he says. “The unique element of Renaissance is that it lets us plan the placement of surgical screws to exactly fit each patient’s individual spinal anatomy, which lets us achieve the most accurate spine surgery instrumentation that’s currently possible.”

Dr. Vande Guchte adds, “I think the Renaissance system will be useful for almost all patients who require surgical stabilization of the spine because of injury or degenerative conditions, including both long-incision (open) and percutaneous surgical procedures. I’m pleased to say that Bryan Health has been committed for a long time to providing spine and neurologic surgery at the highest technologic level possible.

“The fact that Bryan has introduced the cutting-edge Renaissance system to Nebraska and the rest of the U.S. is no surprise, as it’s right in keeping with that philosophy.” n To learn how you can support Bryan Health, please contact the Bryan Foundation at 402-481-8605.

Bryan Journeys 21

BRYAN LIFEPOINTE

Class helps Diane deal with Parkinson’s

L

ucky are those who get through life without having at least one curve ball thrown their way. But when you’re not so lucky, and fate throws a couple of them at you that are completely life altering, you have choices to make. Diane Kacvinsky chose to take a positive road, and fight for a balance in her life.

In 2011, she suffered a severe concussion while on a mission trip in Tanzania. The concussion left Diane, a former accountant, with extensive memory loss and a 5th-grade-level math comprehension. It changed everything that she was, and made her feel like a completely different person.

“I battled what the concussion was doing to me,” recalls Diane, who currently works part time in the laundry and locker rooms at Bryan LifePointe and volunteers for Bryan Medical Center. “Not only my memory, but my dancing was affected.

I used to dance five days a week before the concussion, doing ballet, jazz, tap and pointe. It was a lifelong dream of mine as a young girl to learn to dance.”

Despite intensive outpatient therapy to improve her memory and movement — and the love and support of her husband Bob and their two children — things were not getting better and by September 2012, Diane started having suicidal thoughts.

“The depression was overwhelming,” she says. “Because of the concussion, I wasn’t really capable of accepting that that was what my life was going to be — that it had changed that much.”

But that wasn’t the end of the lifealtering changes to come her way. In 2013, came a diagnosis of Parkinson’s

22 Winter 2015

disease. This wasn’t a total shock to Diane because she had felt symptoms for some time — 15 years to be exact — but had not received a diagnosis.

Thanks to Bryan LifePointe’s Fitness Counts, Diane Kacvinsky improved her health and outlook on life.

Given these hurdles, Diane now considers her regular sessions at the Bryan Counseling Center a lifeline. She also feels that way about the Fitness

BRYAN LIFEPOINTE

Yoga and meditation are important parts of Diane’s wellness plan.

Counts classes at Bryan LifePointe, which are exclusive for those with Parkinson’s disease and multiple sclerosis.

Still, when she was approached about this class offering, she questioned whether it would be beneficial since she was still dancing a couple of days a week, and her Parkinson’s was not terribly advanced.

“I talked with the instructors quite a bit before I signed up — they promised they’d work with me at my level and others at their level. We did strength training and endurance and balance exercises, and it turned out to be a good thing for me,” she says. “I was flexible from all of my years of dance, but I really noticed an improvement in my endurance.

Fitness Counts gave me confidence, such that I felt like I had control over the disease. It did not have control over me.”

Friendships developed among the class participants. So much so that many plan to take the class again when it’s

offered again in February. Diane is one of them, although that wasn’t the plan initially. Diane thought she could do the exercises on her own, but found that not to be the case.

“I learned that I’m not capable of keeping up that pattern on my own.

“The class is a long commitment. It’s 12 weeks, three days a week, but I don’t think you would get the same benefit if it was shorter. The class was too beneficial to me not to do it. I almost feel like I don’t have a choice,” she says with a smile.

She also needed the camaraderie of her classmates. “Having the group there was important,” Diane says. “We did a lot of laughing. I learned I really needed the social aspect. We were all there for each other. We understood that we all have good and bad days. One person might fall during class, but you learn that it’s OK to

fall; we’ll help you get back up, and life goes on.

“Keep moving and stay positive — that’s the key.” n The next 12-week Fitness Counts class begins Feb. 10. This class provides tools and training to improve the quality of life for those with Parkinson’s disease or multiple sclerosis.

Activities include balance training, resistance training, gait and coordination exercises, and endurance activities.

Participants must be cognitively alert with minimal mental dysfunction and must be able to walk independently or with a cane. A physician’s clearance and preassessment are required before the first class. (See Page 33 for details.)

To learn more, call 402-481-6300.

Clinical exercise physiologist Kristi Beyer helps Diane improve balance and endurance.

Bryan Journeys 23

VOLUNTEERS & CUSTOMER CARE

Pediatrics welcomes ambassadors

I

magine that you’re visiting a child in pediatrics on the Bryan East Campus. You follow a long hallway where a series of silhouettes of silver storks keep directing you to the Women’s and Children’s Health unit. You enter an open area where large beautiful black and white photos of babies cover the walls. Then you see the sign for pediatrics and are buzzed in. Someone greets you immediately — that’s a new position, the volunteer unit ambassador.

“We had an identified need for a volunteer,” says Kim Dierks, nurse manager of Pediatrics and Women’s Health. “The RNs would be charting and sharing reports in patients’ rooms, so the phone on the desk would be left unattended at times. Even greeting visitors was a need because it’s important to greet everyone who comes to a nursing unit.

We thought if we brought in volunteers, it would be a win-win.”

“We’ve always had volunteers in patient care,” says Ellen Beans, director of Volunteers and Customer Care. “But the volunteers were working independently.”

Kim says, “Ellen had a vision: She wanted a place where teamwork could happen, and she had the staff to do it.”

Volunteer coordinator Ann Bauer adds, “Kim got her staff to commit to the idea.”

So the two departments, pediatrics and Volunteers and Customer Care, embarked on a journey to create a volunteer position that would meet needs in the pediatric unit.

For the first time, Volunteers and Customer Care staff members worked as unit ambassadors while creating a

24 Winter 2015

University of Nebraska student Megan Mihulka is among the first volunteer pediatric unit ambassadors at Bryan.

VOLUNTEERS & CUSTOMER CARE

job description from scratch. patient units to being part of the Volunteer coordinators Ann team, working collaboratively with Bauer and MaryBeth McWilliams the nursing unit staff, Ellen notes. worked at the nurses’ desk in “Because of our success with pediatrics and watched for tasks pediatrics, we’re adding the unit that volunteers could do. Besides ambassador position to mother/ answering phones and greeting baby (postpartum) and to the guests, they found ambassadors NICU (neonatal intensive care could greet physicians, organize unit). It’s our hope through this DVDs for the patients, stock collaborative model to build a supplies, answer patient’s solid base for the departments in requests for water or a blanket Women’s and Children’s Health,” and pick up meal trays. she says.

Kim, Ann and MaryBeth met Those involved see various weekly with Ellen and customer reasons why the collaboration care supervisor Sarah Carter to was a success. “It’s because Kim talk about what worked well. stepped up,” MaryBeth says. “And Gradually a job description it was her being willing to work developed. They determined with us.”

Colleagues who created the role of volunteer pediatric unit that the busy times needing a “It was the right time and the ambassador are (standing, from left) nursing managers volunteer were 7-9 a.m. when right people,” Ellen agrees.

Kim Dierks, Wendy Muir and Laurie Ketterl; Volunteers and physicians do rounds and from Sarah adds, “This was a whole Customer Care director Ellen Beans, customer care supervisor 6-8 p.m. new approach to working with a Sarah Carter, volunteer coordinator MaryBeth McWilliams; After the pilot program, unit.” and (seated) nursing manager April Deis and volunteer the group polished the job “Now we feel confident coordinator Ann Bauer. description, interviewed that this process could be used to learn.” candidates and trained the new throughout Bryan Medical Center.

Kim points out that another college pediatric unit ambassadors.

We’re counting on Kim to introduce student “had a final exam at 9 a.m. Yet Many college students are unit this new collaborative model to other ambassadors, and the job helps them learn she drove to Bryan to work at 7 a.m., then managers and support them through the drove all the way back in time for her final. what goes on in a nursing unit. process,” Ellen says.

They’re so motivated.”

One such student is Megan Mihulka, “When volunteers have had a Another volunteer tabulated patient who’s a junior at the University of wonderful experience, and they come back safety statistics from rounding records that Nebraska-Lincoln. She works around to Bryan to begin their career in the health helped pediatrics improve its pain scores. classes and homework to volunteer on care field, that’s a great reward.” n A physician liked the unit ambassador Mondays. She plans to go into nursing or If serving as a volunteer unit position so much he wanted to recruit sonography (medical imaging). ambassador appeals to you, please more volunteers.

“It’s definitely a great way to be contact Bryan Volunteers and Customer We have successfully moved from exposed to what it’s like on a nursing unit,” Care by calling 402-481-3032. performing independent tasks on the Megan says. “I’ve had more opportunities

Bryan Journeys 25

Mary Krupicka credits preventative care, including health fair screenings and regular visits with her physician and the staff at Crete Area Medical Center, with saving her life.

26 Winter 2015

CRETE AREA MEDICAL CENTER

A life saved

Through the power of preventative care

M

ary Krupicka never did get to ask about those triglyceride results that November morning.

That’s what she had made the appointment for at the Crete Area Medical Center. The results of her blood work from an earlier CAMC health fair had just arrived in the mail, and she felt at least one of the readings warranted a discussion with her doctor, Jason Hesser, MD. Just routine, the 74-year-old Mary thought. When she arrived, clinic nurse Stacy Pflanz greeted her, and they made small talk while Stacy checked Mary’s weight and blood pressure. Then the visit became decidedly abnormal.

Mary’s pulse was 30 beats per minute.

Thirty.

Dr. Hesser would later tell Mary that when renowned athlete Lance Armstrong was in the best shape of his life, his pulse was in the upper 30s. Most adults in their 60s and 70s can expect a resting heart rate ranging from 60- to-100 beats per minute.

CAMC personnel shifted smoothly into emergency medical mode without alarming Mary. It was a serious situation. Dr. Hesser says Mary was at high risk of going into ventricular fibrillation — the most serious cardiac rhythm disturbance — which occurs when the lower heart chambers quiver and the heart can no longer pump blood.

Anyone who has watched a television medical drama knows how the scene can play out, with doctors shouting “V-Fib,” and “Clear!” while grabbing the paddles of a defibrillator. In real life, doctors also worry if the patient’s brain is receiving enough blood.

But Mary was talking to her doctor and

nurse, and her blood pressure remained stable. Medical staff explained that her heart was not pumping properly; that an ambulance would take her to Bryan Heart in Lincoln and that she would likely be receiving a pacemaker soon.

Mary told them how cold she was.

She asked if she could call her part-time employer to say she couldn’t make her shift that day. (Don’t worry about that right now, they advised, as they brought her blankets.)

Couldn’t her husband, Melvin, drive her to Lincoln, Mary asked? (No, they answered nicely, but firmly.)

Mary left Crete in an ambulance shortly after 11 a.m., with a temporary external pacemaker in place for the trip. Her surgery for a permanent dual-chamber pacemaker to regulate her heartbeat was completed the same afternoon.

“I can’t believe how good I felt, considering. They (CAMC staff) deserve a lot of credit,” Mary notes, at her home in Crete a few weeks into her recovery. “Dr. Hesser, Stacy — everyone was so calm. That kept me calm and that’s probably why everything went so well.”

She says, “If not for them and their actions, I probably wouldn’t be here today and that’s not even what I went in for.”

The surgery also took care of some problems she hadn’t realized were related.

Looking back, the fatigue she had felt the previous month has lifted and the dizziness attributed to vertigo — now thought to be a symptom of her heart problem — has not returned.

Mary is an example of the power of preventative medicine, a core component of the patient-centered Medical Home approach CAMC is known for. Physicians

personally know their patients and advise them on preventative care. In Mary’s case, it doesn’t take much convincing. She and Melvin always go to CAMC’s health fairs. “I think the health fairs are the most valuable thing we’ve got. It’s valuable medical information every six months,” she says.

When they missed the local fair in October while traveling, they made sure to attend one in Wilber when they returned home.

Mary is healthy, walks for exercise faithfully, follows a healthy diet, and wellness guidelines and screenings, Dr. Hesser points out. Even so, an extra doctor’s appointment may have inadvertently saved her life. “With preventative medicine, we can sometimes find issues that are going on, ones that don’t have a lot of symptoms, which can be significant,” he says.

Mary will have a pacemaker the rest of her life, but knows how lucky she is.

She has a lot to be healthy for: Melvin, her husband of 57 years and the other half of the couple people refer to as “M&M”; their three children, Marilynn, Michael and Mark (who make them “The Five M’s”); their five grandchildren; traveling, camping and enjoying retirement.

From now on, Mary will carry an identification card for her pacemaker, have regular checkups to make sure the device is working properly and take a few precautions, like standing back from the induction cook stove when they camp, just to be safe.

“Sounds like a pretty good trade,” she says, laughing.

And her triglyceride results?

“Turns out it was nothing to worry about.” n

Bryan Journeys 27

B RYA N E A R LY D E T E C T I O N C E N T E R

Do you have BAV? Screen your family, too!

B

icuspid aortic valve (BAV) disorder is a common heart condition that can be hereditary. So, it’s important that family members of BAV patients be screened .

Bryan Heart cardiologist Keith Miller, MD, notes that up to 2 percent of Americans have this valvular heart disease, so close relatives of those diagnosed with BAV also are at risk for an aneurysm of the aortic root and ascending aorta.

“Early detection is critical,” he says, “since as many as 40 percent of BAV patients will experience complications by the time they reach their 50s.”

Such complications may mean they will need valve replacement surgery or aortic root repair.

An estimated 20,000 Nebraskans have life-threatening BAV, so American College of Cardiology/American Heart Association guidelines recommend that the patient’s parents, siblings and children also be screened.

“Familial clustering suggests this is a unique opportunity to detect additional patients by using appropriate screening echocardiograms,” says Dr. MIller.

“Clinical studies reported a 9 percent prevalence of BAV in first-degree relatives, and up to 30 percent of firstdegree relatives of BAV patients have enlargement of the aortic root, which places them at risk for aortic dissection and rupture. But with early detection, patients who have BAV can enjoy a normal life expectancy.”

Now you can schedule your loved ones for counseling and a screening at Bryan Health’s Early Detection Center.

28 Winter 2015

After Donette Shenk of Polk (seated) had surgery for bicuspid aortic valve disorder, she followed her cardiologist’s advice to have her family screened for BAV. Donette’s daughters, Angela Wiegert, Amber Ackerson and Andrea Adams, came to the Early Detection Center on the same day to have echocardiograms, and her sisters have since come to Bryan for the screening.

Early detection coordinator Bobbi Clinch, RN, says patients or families with known or suspected BAV-related heart abnormalities receive counseling and clinically indicated screening echocardiograms.

The center also offers screenings for heart disease, vascular disease and atrial fibrillation.

To learn more, ask your physician or contact Clinch at 402-481-8018, or email her at bobbi.clinch@bryanhealth.org.

Signs and symptoms of heart valve disease • •

• • • •

Shortness of breath.

Palpitations (rapid heatbeats or skipping heartbeats).

Swelling of ankles, feet or abdomen.

Weakness or dizziness.

Quick weight gain.

Chest discomfort.

Call your physician if you have any of these symptoms!

BRYAN COLLEGE OF HEALTH SCIENCES

B-SMART offers route to BSN

We remember Betty Suhr, house mother and secretary Former Bryan School of Nursing house mother and secretary Betty Suhr of Seward died March 17, 2014, at age 84.

Her family says she truly enjoyed working closely with student nurses and the Bryan employee family. Betty’s first day at Bryan, in January 1971, included driving from Seward through a snowstorm. Her 20 years of service ended in a similar way — her last day as a Bryan employee was during the Halloween snowstorm of Oct. 31, 1991.

Betty is survived by her husband Alvin Suhr; their daughters Linda (Larry) Zillig of Lincoln and Patricia (Larry) Stanton of Ft. Calhoun; and four grandchildren and seven great grandchildren — with an eighth due in February.

Registered nurses seeking a Bachelor of Science in Nursing would be smart to apply to the new B-SMART program at Bryan College of Health Sciences.

“Our RN to BSN completion option is attractive to candidates who already have full-time jobs or may be raising a family, because they need a program that has some flexibility,” says program coordinator Michelle Johnson, PhD, RN. “Ours is a hybrid option, in that about one-fourth of the nursing courses’ class time is face to face in a classroom setting — students are on campus three Fridays and Saturdays each semester — and the rest of class time is offered online or as independent study assignments, which is convenient for our students from across the state.”

B-SMART — which stands for Bryan Nursing: Starting My Academic Responsibility Today — involves core nursing courses over three semesters and one summer.

Students complete general education classes independently.

The Institute of Medicine set a goal of having 80 percent of America’s nurses earning a BSN by 2020. “So we’re seeing a lot of schools offering RN to BSN programs in response to this challenge,” Dr. Johnson says.

Ten Bryan Medical Center nurses are selected for $10,000 forgivable loans, which are forgiven when students make a threeyear commitment to Bryan Health following graduation.

“Lisa Vail, Bryan’s chief nursing officer, is a phenomenal supporter of nurses and their professional roles and responsibilities, including their continuing education,” Dr. Johnson adds. “We’re very proud to offer B-SMART, which accommodates our professional nurses’ needs. It’s a great combination of a classroom environment while allowing students to complete online courses from home, at times that are convenient for them.”

March 1 is the deadline to apply for courses that begin in the Fall 2015 semester.

Prospective students will be interviewed in April, with the next class of B-SMART students to be announced in May. For details about B-SMART, contact recruitment coordinator Jenny Lempka at 402-481-8863, or email her at jenny.lempka@bryanhealth.org. n To learn how your gift can support Bryan College of Health Sciences, please call the Bryan Foundation at 402-481-8605.

Bryan Chief Nursing Officer Lisa Vail, DNP, addresses the first class of B-SMART students.

Bryan Journeys 29

BRYAN COLLEGE OF HEALTH SCIENCES

Commencement Scenes from Dec. 19, 2014

Dr. James Wickless spoke, Dr. Marilyn Moore presented diplomas, and Dr. Kay Maize hooded master’s recipients, like Katie Sladky.

Joslin Stonacek (left) and her father, Troy, celebrated, and graduating senior Katelynn Synhorst (center) was all smiles as she approached the stage.

Congratulations to our 74 most recent graduates! The college awarded five master’s, 68 bachelor’s and an associate of science degree.

30 Winter 2015

ACHIEVEMENTS

NHA luncheon honors Wohleb, Swanson, Vontz Pharmacy director Jerome Wohleb, PharmD, MBA, received the 2014 Quest for Excellence Award during the Oct. 24 Nebraska Hospital Association Caring Kind Awards Luncheon. This award recognizes exceptional work in hospital quality and performance improvement.

Bryan Medical Center case management social worker Danielle Swanson, MSW, and Ashley Vontz, RN, of Crete Area Medical Center received Caring Kind Awards. According to the NHA, these star performers exhibit sincere kindness to patients and dedicated teamwork, ensuring that care is safe, quality-driven and cost-effective. n

Danielle Swanson (left), Jerome Wohleb and Ashley Vontz were recognized at the Caring Kind Awards Luncheon.

Dr. David Miers (left), Becky Loewe and Dr. John Hansen are in their respective alma mater’s Sports Hall of Fame.

Henricksen earns CRA

MOD salutes Wright

Radiology manager Danielle Henricksen passed the Certified Radiology Administrator (CRA) board exam in November.

The CRA designation attests to high standards of leadership attained by medical imaging leaders. It is the only credential specifically for radiology managers and focuses on managing human resources, assets, finance, operations and communications. n

Bryan College of Health Sciences nursing student Jackie Wright is a 2014 March of Dimes Nurse of the Year honoree.

Other nominees were Bryan College of Health Sciences Assistant Professor Nancy Hula, RN, MSN, Bryan Chief Nursing Officer Lisa Vail, DNP, and Bryan Medical Center registered nurses Amanda Fox, Leah Logan and Corey Sabatka. n

Three are Hall of Famers Three alumni of local colleges were named to the Hall of Fame in their respective sports this fall.

Emergency physician John Hansen, MD, was a standout linebacker for the Nebraska Wesleyan University football team in 1985-87. This allconference player also was an honorable mention NAIA All-American.

Mental health counselor and program development manager David Miers, PhD, was a defensive back on Nebraska Wesleyan University’s 1989 football team. That stellar squad was recognized for winning the conference championship in ’89 and NWU’s only postseason victory.

Events and marketing specialist Becky Ernstmeyer Loewe, Advancement, was named to Concordia University’s Hall of Fame.

Loewe was a top volleyball player from 1993-97, setting records for the Bulldogs and earning all-conference and NAIA recognition. n

Bryan Journeys 31

BRYAN STERLING CONNECTION

Your connection to fun and friends Adventures await in 2015 Visit bryanhealth.org/travel to download your brochures for these and other trips, or call 402-481-3355 or 800-742-7844.

Multiday tours Gulf Coast Discovery — March 21-30.

From a shrimping expedition to lighthouses, gorgeous Bellingrath Gardens and a dolphin cruise, you will see the best of the Gulf Coast.

Nova Scotia & Prince Edward Island — June 30-July 7.

Venture to the land of Green Gables. Learn about the rich maritime history of Nova Scotia and see the scenic Maine coast on this vacation.

THIS YEAR’S LEADERS Bryan Sterling Connection Advisory Board members are (standing, from left) Caroline Caawe, Karen Beek, Carolyn Henning, Lori Lee, Dorene Casey, Ken Majors, Theresa Hohmeier, Deanna Troxel, Diane Belschner, Paul Lommasson, Debbe Bundy, Gordon Bair, Diane Engelsma, Kathy Wolf and Pam Bly, and (sitting) Tom Beachell, Cathy Weichel, Bill Schuller, Norma Hyman and Mary Wit.

Smoky Mountains: Music, Majesty & Praise Tour — Oct. 19-28.

Travel to the heart of the colorful Smoky Mountains.

One-day trips Sandhill Cranes Migration — March 19.

Witness the annual migration of thousands of Sandhill Cranes as they make their way through the fly way of the Great Plains to the breeding grounds down south.

From Kolaches to Clay — May 5.

Come with us to Wilber — the Czech Capital of Nebraska — and discover the rich roots of its heritage on this fun one-day trip.

Glenn Miller Festival — June 12.

Glenn Miller fans converge in Clarinda, Iowa, for the annual celebration of the music and memory of this famous band leader. It will be a day filled with new and familiar music and a tour of Miller’s birthplace.

GOOD TIMES HAD BY ALL Ken Majors, a volunteer at Bryan and Bryan Sterling Connection Advisory Board member, pours coffee Dec. 14 at the Sterling Connection Holiday Social.

32 Winter 2015

Elephants to Pipe Organs —Sept. 24.

Visit the Henry Doorly Zoo and more!

COMMUNITY CALENDAR

Tribute to Trauma Champions Wednesday, April 22, beginning at 6:30 p.m. at the Embassy Suites, 1040 P St. Cost is $20. To learn more or to register, go to bryanhealth.org/calendar, under community events.

Fitness Counts A special class for those with Parkinson’s disease or multiple sclerosis Feb. 10-May 2, Tuesdays, Thursdays and Saturdays 10:30-11:30 a.m.

This class provides tools and training to improve quality of life for those with Parkinson’s disease or multiple sclerosis.

Fitness activities will include balance training, resistance training and gait and coordination exercises, as well as endurance exercises. Fitness Counts participants must be cognitively alert with minimal mental dysfunction and must be able to walk independently or with a cane. Physician clearance and a preassessment are required before the first class, which is taught by an exercise specialist.

To register or for more information, call 402-481-6300.

Cost: $275 for LifePointe members or $300 for non-members.

Where: Bryan LifePointe Campus, 7501 S. 27th.

This year we recognize trauma survivors Nicholas Boruch of Seward and Taylor Graham of Lincoln and honor the dedicated professionals from throughout the statewide trauma system who were involved in saving Nicholas and Taylor. Hear their remarkable stories and salute their caregivers at this annual event.

2015 Bryan Indoor Triathlon Saturday, Feb. 21.

First wave begins at 8 a.m., and a new wave begins every 35 minutes. The total triathlon event will be 75 minutes. n 10-minute swim in lap pool, n 10-minute transition, n 30 minutes on a spin bike, n 5-minute transition and n 20 minutes on a treadmill.

Not comfortable doing this alone? Find two friends and compete as a team! Teams are coed, all male and all female.

Cost: Individual is $25, or $75 for a team. Shirts are included

if you register by Feb. 8. Deadline to register is Feb. 15.

Where: Bryan LifePointe Campus, 7501 S. 27th.

To learn more, go to bryanhealth.cvent.com/2015tri, or call 402-481-8855.

Take a FREE 7-minute Online Risk Assessment Go online. Get checked. Save your life.

It’s quick, free and completely confidential.

If you are at risk, you’ll have the opportunity to meet with a nurse to discuss your health.

Go to: bryanhealth.org/online-screenings.

Bryan Journeys 33

1600 S. 48th St., Lincoln, NE 68506

Address service requested

Technology Dr. Benjamin Gelber is the first neurosurgeon in Nebraska to use the new Mazor Robotic Guidance System.

Helping you prepare for what’s next in your life will always be what’s next in ours. bryanhealth.org

PRSRT STD U.S. POSTAGE PAID LINCOLN NE PERMIT NO. 1299