Fall 2021
CEDAR RAPIDS
STROKE SURVIVOR
Teen recovers after stroke
MINIMALLY INVASIVE MITRAL VALVE REPAIR St. Luke’s doctors offer alternative to open heart surgery
TRIPLE THE LOVE Mom delivers surprise triplets
ASK THE EXPERT Do I need a flu shot?
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WHAT’S INSIDE 1
Health Clips
2
Second Opinion, Second Chance
Health news you can use.
An Iowa City woman receives a brighter outlook with a second opinion at the Nassif Community Cancer Center.
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Sudden Cardiac Death
Lifesaving care in St. Luke’s ER saves a Marion man’s life after his heart went into a fatal heart rhythm.
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A Perfect Birth Story
After two traumatic births a Dubuque mom finally has her perfect birth at St. Luke’s.
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Minimally Invasive Heart Procedure
A catheter-based procedure repairs the heart valve and improves survival and quality of life.
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Triple the Love
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The Right Place. The Right Team.
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Local mom delivers surprise triplets at St. Luke’s.
LARGEST, MOST COMPREHENSIVE HEART CARE PROGRAM IN CEDAR RAPIDS As many know, St. Luke’s Hospital has the largest, most comprehensive heart care program in Cedar Rapids. In fact, we treat more heart patients than any other hospital in Cedar Rapids and perform more advanced heart procedures so you don’t have to travel out of town. Know the facts when it comes to your heart care – more people choose St. Luke’s because of our long legacy as the Heart Hospital. Experience matters. See why St. Luke’s is the best place for your heart. St. Luke’s
Mercy Medical Center
43 years
3 years
Dedicated, Comprehensive Heart Center
Yes Since 2000
No
More Heart Care Experts Cardiologists, cardiothoracic surgeons, ARNPs and PAs
31 (17 cardiologists)
21 (7 cardiologists)
6
2
Treats the Most Heart Patients in Cedar Rapids*
52.4%
47.6%
Top 50 Heart Hospital in America Ranked by Truven Health Analytics/IBM Watson Health Company
6 times
1 time
Yes
No
Longer-Tenured Heart Care Program
More Outreach Clinics Providing care close to home
ER Chest Pain Center Accreditation From the American College of Cardiology, based on rigorous on-site evaluation of the staff’s ability to evaluate, diagnose and treat patients who may be experiencing a heart attack
ER and heart team help one of their own after a team member has a heart attack at work.
Fastest-ever-recorded time from ER arrival to opening of blocked arteries St. Luke’s average is 59 minutes
13 min.
26 min.
Teen Recovers From Stroke
First Transcatheter Aortic Valve Replacement (TAVR) Minimally invasive, catheter-based aortic valve replacement procedure that doesn’t require open-heart surgery
2016
2018
Transcatheter Valve Certification From the American College of Cardiology, for demonstrated expertise and commitment in treating patients receiving transcatheter aortic valve replacement (TAVR) and repair procedures
Yes Only hospital in Iowa
No
Watchman for Afib Device that acts as a barrier when inserted (via catheter) into the part of the heart where clots are most likely to form; alternative to open-heart surgery
Yes
No
ECMO Advanced Life-Support Machine Specialized life-support machine that adds oxygen to the blood and removes carbon dioxide
Yes
No
MitraClip for Mitral Valve Repair Catheter-inserted device used to correct mitral regurgitation (a leaking mitral valve); no open-heart surgery required
Yes
No
Shockwave Procedure to Open Blocked Arteries State-of-the-art catheter procedure that uses sonic pressure waves to fracture calcified plaque and reopen blocked arteries
Yes
No
An Eastern Iowa teenager recovers after a stroke during track practice.
Ask the Expert Do I need a flu shot?
For Your Health
Timely health and medical news.
Fall 2021 LiveWell magazine is produced by UnityPoint Health®. P.O. Box 3026 | Cedar Rapids, IA 52406 (319) 369-7395 | unitypoint.org
*Source: Iowa Hospital Association
HEALTH CLIPS U.S. NEWS & WORLD REPORT NAMES ST. LUKE’S AMONG THE BEST IN IOWA St. Luke’s Hospital is among the nation’s Best Regional Hospitals, according to U.S. News & World Report. St. Luke’s is ranked third best hospital in Iowa in the U.S. News & World Report 2021-22 edition. The annual rankings, for 32 years, have recognized hospitals that excel in treating the most challenging patients. St. Luke’s was high-performing in nine adult procedures and conditions: stroke, aortic valve surgery, heart bypass surgery, heart attack, heart failure, colon cancer surgery, kidney failure and hip and knee replacement. HIGH-PERFORMING U.S. News & World Report evaluates approximately 5,000 hospitals nationwide on common IN NINE ADULT inpatient procedures and conditions. The Best Hospitals methodologies include objective PROCEDURES & measures such as patient survival, number of patients, infection, adequacy of nurse staffing CONDITIONS and more. The rankings can be found at health.usnews.com/best-hospitals.
ST. LUKE’S FIRST AND ONLY HOSPITAL IN IOWA TO TREAT POSTPARTUM HEMORRHAGE WITH JADA SYSTEM St. Luke’s Birth Care Center has a new tool aimed at making childbirth safer. Earlier this year St. Luke’s became the first and only hospital in the state to use the Jada System for controlling and treating postpartum hemorrhage (abnormal uterine bleeding). Uncontrolled bleeding after childbirth is an emergency requiring immediate intervention. Mothers welcoming babies at St. Luke’s will now have the option to be treated with Jada in the event they experience postpartum hemorrhage (PPH).
At St. Luke’s, approximately 5% of mothers experience PPH. Nationally this number is around 11%, according to the Centers for Disease Control and Prevention (CDC). Left untreated, PPH can result in blood transfusions, surgery including hysterectomy and even death. Additionally, research indicates women of color are disproportionately affected, experiencing three to four times more maternal deaths than white women, regardless of income or education. Read more about Jada at St. Luke’s, visit bit.ly/STLJada.
“Jada is a fast, effective solution that can dramatically improve the experience of mothers who develop postpartum hemorrhage,” said Joy Olson, MD, OB-GYN Associates. “I’m glad to have it as a treatment option for our patients, and it is another example of St. Luke’s commitment to patient care.”
AT ST. LUKE’S, APPROXIMATELY 5% OF MOTHERS EXPERIENCE PPH. (NATIONALLY 11%)
DON’T WAIT. VACCINATE. Make an appointment today with a UnityPoint Health provider to schedule a flu shot or any needed vaccine. During the COVID-19 pandemic some individuals may have missed routine wellness checks – now is the time to call your clinic and catch up on any vaccinations that are out-of-date. Also, to protect yourself, your loved ones and your community, all individuals 12 and older should get the COVID-19 vaccine. In August, the U.S. Food and Drug Administration (FDA) approved the Pfizer-BioNTech COVID-19 Vaccine, Comirnaty, for those ages 16 and older. It’s also available under emergency use authorization (EUA), for individuals 12 through 15 years of age and for the administration of a third dose in certain immunocompromised individuals. All UnityPoint Clinics are offering the vaccines during office hours. Patients may call their clinic to schedule a vaccination appointment. Learn more about the COVID-19 vaccine at bit.ly/UPHVaccine. If you don’t have a healthcare provider, find one today at unitypoint.org/findadoctor.
LiveWell Fall 2021 | 1
CANCER
SECOND OPINION, SECOND CHANCE
In early 2019, Angela Fitzgerald of Iowa City started feeling “off.” She kept picking up colds and had a hard time kicking them. She initially attributed this to her work environment, as she had recently started a new job at an assisted living facility, and thought her immune system needed some time to catch up. Then one day Fitzgerald felt a lump in her breast. “I thought, ‘This isn’t right,’” said Fitzgerald. “I called my gynecologist first thing Monday morning and she sent me right over for a mammogram and ultrasound.” That ultrasound led to a biopsy, and results showed stage 1B triple-negative invasive ductal carcinoma. Triple-negative breast cancer, meaning the cancer cells don’t have estrogen or progesterone
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receptors and also doesn’t contain much of the protein called HER2, differs from other types of invasive breast cancers. Triple-negative breast cancer grows and spreads faster, often requires treatment with chemotherapy or immunotherapy and typically results in worse outcomes.
Starting Treatment Upon her diagnosis in March, Fitzgerald elected to receive treatment in Iowa City, where she completed eight rounds of chemotherapy followed by a bilateral mastectomy. There was still quite a bit of cancer in the mass that was removed, so Fitzgerald once again met with her oncologist who put her on an oral chemotherapy. A couple of rounds in, she noticed a lump in her lymph nodes. Fitzgerald underwent a CT scan, which
Angela Fitzgerald at Terry Trueblood Recreation Area in Iowa City.
doctors said showed masses in her lungs as well. It was at this point her doctors told her there wasn’t anything they could do to cure her cancer, and she had two years to live.
Second Opinion Brings New Hope During her initial round of treatment, Angela had sought out a second opinion with the Nassif Community Cancer Center and Rasa Buntinas, MD, Physicians’ Clinic of Iowa (PCI) Hematology and Oncology in Cedar Rapids. Though she had ultimately decided not to change doctors in the middle of treatment, Fitzgerald never forgot the compassion Dr. Buntinas showed during her visit.
“I was really impressed by her. I felt she really cared,” said Fitzgerald. “But being in the middle of treatment, I decided not to switch.” However, after hearing this latest news from her doctor in Iowa City, Fitzgerald made another appointment with Dr. Buntinas for another second opinion. Dr. Buntinas ordered additional testing, and even called Fitzgerald with the results on a Friday night outside of business hours, so she wouldn’t be thinking about it all weekend. Fitzgerald received a more positive prognosis from Dr. Buntinas and decided to make the switch in November 2019. “When Angela came to us for a second opinion and we reviewed her most recent test results, I thought there was more we could do for her,” said Dr. Buntinas. “After doing some additional testing, Angela’s results showed her cancer recurrence was limited. This meant we were able to offer her a more aggressive curative approach to her treatment, giving her a new, brighter outlook for her cancer journey going forward.”
A Team Approach to Cancer Fitzgerald also received support on her cancer journey from the team at the Nassif Community Cancer Center in Cedar Rapids. Angela met with Matt Schmitz, cancer exercise specialist, who assisted her with the wellness side of things, including pre-surgery assessment and creating a plan to regain her strength post-surgery and through treatment. Fitzgerald also worked closely with Nancy Yeisley, oncology social worker, during her treatment. Yeisley helped her navigate the financial challenges that come along with a cancer diagnosis. With help from the rest of the team, she was able to identify programs and resources to assist Fitzgerald and her young family with support for daily living expenses and ways to celebrate and be together as a family. She was also there to just listen when Angela needed it.
“It was a blessing to know that there’s always somebody there to come down and just listen,” said Fitzgerald. “There’s so much compassion from the whole team at the Nassif Community Cancer Center.”
Worth the Drive Fitzgerald recently started immunotherapy treatments to keep her cancer in remission. She makes the drive to Cedar Rapids each time because of how the team makes her feel. “I didn’t feel like I was just another number walking through the door,” said Fitzgerald. “I needed to be with a team who cared about me and made me feel like a person.” Dr. Buntinas and her team did just that. “I would drive to see her no matter how far away.”
Whether you’ve received a cancer diagnosis elsewhere and would like to meet with a member of our team to review your case, or you’re already in treatment and would like more information on how our extensive offering of support services can help you through your cancer journey, call the Community Cancer Center at (319) 558-4876 or visit communitycancercenter.org.
There’s so much compassion from the whole team at the Nassif Community Cancer Center.
Request a Mammogram Today Early detection is the best prevention when it comes to breast cancer. If you’re 40 or older, now is the time to be proactive about your breast and bone health. Request a mammogram appointment today at unitypoint.org/requestamammogram. Walk-in Mammograms Available St. Luke’s Breast and Bone Health also offers walk-in appointments, so women can fit their screening mammogram into their busy schedules at times that work for them. Walk-in appointments are available Monday – Friday from 9 a.m. to 3 p.m. with a doctor’s order. Simply walk into any of our three convenient locations and receive a mammogram at a time that works for you. * priority is given to those with a scheduled appointment.
PCI Medical Pavilion 202 10th St. SE, Ste. 265 Cedar Rapids, IA (319) 369-7216
Marion Campus 2996 7th Ave, Ste. A Marion, IA (319) 286-4344
Westdale Campus 4325 Williams Blvd. SW Cedar Rapids, IA (319) 369-8255
Rasa Buntinas, MD, Physicians' Clinic of Iowa Hematology & Oncology
LiveWell Fall 2021 | 3
HEART
SUDDEN CARDIAC DEATH Norm McElwain knows what it feels like to have a heart attack. At 81, the Marion man has had four previous heart encounters. “I felt like this one was the big one,” shared McElwain. “I was totally convinced any delay on my part and I would be dead. It turned out to be very accurate.” Last May, McElwain felt intense pain in his chest. He said it was different than what he had previously felt when he had heart issues. He and his wife Carolyn rushed to St. Luke’s ER. He doesn’t remember anything after he walked into the hospital. “He was in triage when somebody called for help and he just died at the check-in,” recalled Nathan Harmon, MD, UnityPoint Health – St. Luke’s Emergency Department. “There were three or four of us in the ER that ran to triage and started CPR immediately. We knew what to do and our team worked efficiently to save his life.” “As Nate was performing CPR, Norm was moved to one of our trauma rooms in the ER,” shared Ryan Dowden, MD, St. Luke’s Emergency Department. “We had to deliver two electrical shocks to restart his heart and get it into a normal rhythm. We also gave several lifesaving medications. Our team of experienced emergency nurses and doctors worked efficiently to bring him back to life.” McElwain was transported to St. Luke’s heart catherization lab as soon as he was stable.
Norm McElwain walking the track during cardiac rehabilitation at St. Luke's Heart Center.
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Fatal Heart Rhythm
Experienced Team
“Norm had sudden cardiac death,” explained Richard Kettelkamp, DO, St. Luke’s Heart Care cardiologist. “It’s a fatal heart rhythm. Sometimes without warning this will happen to individuals who have a history of heart artery disease or weakened heart muscle. And if you don’t receive a shock to the heart and advanced cardiac life support, it can be fatal. In Norm’s case he was fortunate to receive lifesaving care in our ER quickly. He went to the cardiac cath lab where he received the Impella pump.”
“From guest services representatives, flight paramedics, emergency nurses and physicians to the cardiologists and heart center staff; the care team at St. Luke’s is highly skilled and experienced in taking care of all types of cardiac emergencies,” Dr. Dowden said.
The Impella is a tiny heart pump, which acts as a temporary artificial heart – pumping blood throughout the body and maintaining blood flow during a cardiac procedure. It also gives the heart time to recover. “Once it was determined there was no heart blockage and he stabilized, Norm had a defibrillator implanted,” Dr. Kettelkamp explained. “Norm’s care was wellorchestrated by our team. Everyone knows their job and took care of things quickly. I believe he’s around today because we have excellent ER doctors and a team who knows exactly what to do to save people’s lives.”
“St. Luke’s is a fantastic example for the nation,” said McElwain. “Without the incredible teamwork from the doctors and nurses at St. Luke’s, I’d be dead. They saved my life.” McElwain’s recovery at St. Luke’s also included physical and occupational therapy at St. Luke’s Physical Medicine and Rehabilitation (PMR) unit. He worked with the PMR team to regain strength and mobility before returning home. He’s currently participating in St. Luke’s cardiac rehab. “I’m doing well,” shared McElwain. “The strength in my legs is about 90 percent and my balance is 95 percent. Endurance is at probably 80 percent, so I am working on that. Everyone at St. Luke’s has been great. They push and encourage but are compassionate and sensitive. It’s a team approach in everything. They are darn good."
St. Luke's is a fantastic example for the nation. Without the incredible teamwork from the doctors and nurses at St. Luke's, I'd be dead. They saved my life. Stay on top of your heart health. Partner with a trusted UnityPoint Health provider. If you don’t have a healthcare provider, find one today at bit.ly/RequestUPH. Nathan Harmon, MD, UnityPoint Health – St. Luke’s Emergency Department
Richard Kettelkamp, DO, UnityPoint Health – St. Luke’s Heart Care Clinic
Ryan Dowden, MD, UnityPoint Health – St. Luke’s Emergency Department
Catch Heart Attack Warning Signs Early Heart attacks have beginnings. If recognized in time, treatment can begin before the heart is damaged. Early heart attack symptoms include: C hest pressure, squeezing, burning, aching, tightness or discomfort
ausea N Pain that travels down one or both arms
Jaw pain Fatigue A nxiety
If you or someone you know has any of these symptoms, call 911 or go to St. Luke’s ER.
LiveWell Fall 2021 | 5
BIRTH CARE
after a r u a L Kari & g birth. givin
Laura ,K for a ari & Luke first p photo ose .
le. d d u c a r u Kari & La
A PERFECT BIRTH STORY After two traumatic births, Kari Lammer finally had her perfect birth story. The Dubuque mom of two, and husband Luke, welcomed Laura to their family on June 14. The couple’s road to delivering Laura was a thoughtful, deliberate and calculated plan. It was made possible they say thanks to the dedicated, supportive team of doctors and nurses at UnityPoint Health – Cedar Rapids. “Our first child, Noah, was born via C-section. Anna, our second child, was a VBAC (vaginal birth after C-section),” said Kari. “During labor she receded from the birth canal and a vacuum was used to help get her out. Immediately after delivering I had complications.”
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Kari had a uterine rupture. Recommendations vary on having another baby after a rupture. About two years after Anna’s birth, the Lammers drove to Cedar Rapids to meet with Stephen Pedron, MD, MBA, UnityPoint Clinic Maternal Fetal Medicine, to discuss the possibility of getting pregnant again and whether having another VBAC was possible. It was a second opinion for the couple after they were advised to have a C-section. “Kari wanted what many women want and that is to fulfill the dream of a natural birthing experience,” explained Dr. Pedron. “You just can’t replace that. Once it’s been taken away from you, it’s traumatic. And to replace that, with a positive experience, I think helps to
diminish some of the trauma and fulfill their dream. The Lammers were seeking something that was considered outside the box but we are always open to a thoughtful approach.” “We learned that uterine ruptures are on a spectrum,” explained Luke. “Dr. Pedron provided clarity on the types of ruptures, the severity and the nature of them. Our conversations led us to a discussion of a vaginal birth plan for a third baby. If Kari’s rupture would have been one of the more severe cases it may not have been possible. Dr. Pedron was open to figuring out what proper medical care was needed when others were not.”
Shared Decision Making
Patient-Centered Care
“Dr. Pedron cared about what I wanted,” Kari said. “He was agreeable to a shared decision on how Laura would be born once we got pregnant. It wasn’t just a doctor saying to me, ‘this is how you’re going to have your baby and it’s going to happen to you.’ I wanted to be included in the conversations and make the decision along with a team. Luke and I found the supportive team we were looking for.”
Both doctors recommended the Lammers deliver at St. Luke’s because of the experienced birth care team and because an obstetrics physician is in the hospital 24 hours every day and readily available to deal with any emergent situation. St. Luke's NICU is also the area’s only Level III Maternal and Neonatal Center as determined by the American Academy of Pediatrics (AAP).
Dr. Joy Olson from OB-GYN Associates agreed to work with Dr. Pedron and the Lammers and was open and accepting around the shared decision making. “Having a vaginal birth was something Kari was interested in if it was reasonable,” Dr. Olson shared. “We met many times during her pregnancy. She had a number of ultrasounds to evaluate the uterus, to assess the area of prior rupture and the thickness of the C-section scar. We wanted to make sure throughout her pregnancy the uterus thickness remained adequate for a safe VBAC attempt. We agreed to not make any final decisions until we had all the information and then believed it was safe to proceed with a VBAC. We were partners in the decision-making.” “I never wanted to risk my life or the baby’s life,” explained Kari. “But I felt confident this was a safe option for us. We took it one day at a time.”
On the eve of Laura’s birth, Kari started having contractions. The couple headed to St. Luke’s in Cedar Rapids – calling ahead to alert the team. She went into labor naturally at 38 weeks gestation (37-40 weeks is full-term). And just like they had hoped and planned, Kari delivered Laura naturally and most importantly safely, without any complications. “I had a vision where I, as the birthing patient, was actually part of the team and didn’t have to fight to have a voice or choice in how I would deliver,” explained Kari. “My hope is that all patients can experience this collaborative, patient-centered care and actually know their hopes, wishes, dreams, desires do matter. It was very special.” “It was perfection,” shared Luke. “I was confident it was going go well, but I didn’t expect it to go as perfectly as it did. Everyone was exceptional and we couldn’t say enough about how the team supported us and made our experience as amazing as it was.”
Laura I Find your supportive and experienced team to welcome your baby into this world. Schedule your personal tour of St. Luke’s Birth Care Center by calling (319) 369-8129.
Stephen Pedron, MD, MBA UnityPoint Clinic Maternal Fetal Medicine
Joy Olson, MD, OB-GYN Associates
My hope is that all patients can experience this collaborative, patient-centered care and actually know their hopes, wishes, dreams, desires do matter. It was very special. LiveWell Fall 2021 | 7
HEART
NEW HEART VALVE WITHOUT OPEN HEART SURGERY It’s been a year since Roger Kromminga, 70, found out he had stage 4 prostate cancer. Last spring, he saw his doctor for what he thought were symptoms of COVID-19, and test results led to the discovery of cancer. He’s now in remission, but at his final chemotherapy visit, he mentioned having trouble catching his breath, and his legs were swollen. The nurse also noticed he had an irregular heartbeat. “Toward the end of my cancer treatments, I suddenly started retaining fluid, and I could hardly walk the 80 yards to my mailbox without stopping to rest,” Kromminga said. From oncology, Kromminga was promptly taken to St. Luke’s Heart Care Clinic to meet with Cardiologist Boothapuri Venkatesh, MD, who discovered a problem with one of Kromminga’s heart valves and
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immediately involved the interventional cardiology team. “Roger was admitted to the hospital with congestive heart failure, due to a severely leaky mitral valve,” explained Aref Bin Abdulhak, MD, St. Luke’s interventional and structural cardiologist. “The mitral valve connects the left upper chamber of the heart to the left lower chamber, and the leak was responsible for his heart failure symptoms. “Additional tests showed the valve had degenerative changes that caused it to leak,” Dr. Bin Abdulhak continued. “The first option in this situation would normally be open heart surgery but given the comorbidity of his prostate cancer, he was deemed high-risk, so we recommended the MitraClip.”
Roger Kromminga, 70, recently received a MitraClip to repair his heart’s leaking mitral valve. The catheter-based MitraClip procedure is only available in Cedar Rapids at St. Luke’s. It greatly improved Kromminga’s quality of life and saved him from open-heart surgery, which reduced his recovery time.
I’m glad they caught my heart problem and I had the procedure done, I’m a pretty active person. I really enjoy being outside, working on my tractors and gardening. The MitraClip has made a world of difference in helping me get back to the things I enjoy.
An alternative to open-heart surgery, MitraClip is performed via catheter through a vein in the groin to deliver the device to the heart. The clip is attached to the two leaflets of the mitral valve, helping them close more completely and reduce the amount of blood flowing backward into the lungs. The MitraClip procedure improves patient survival and quality of life as demonstrated by large and wellconducted clinical trials. “With MitraClip, we didn’t have to open his chest,” said Dr. Bin Abdulhak. “We were able to dramatically improve his quality of life with this procedure. He was able to go home in few days (most patients are able to go home the next day), and he had less recovery time than would have been required with open heart surgery.” Kromminga participated in Cardiac Rehab at St. Luke’s following his procedure and has since graduated. He’s thankful for the level of care he received from St. Luke’s heart team, and he’s been able to return to most of his normal activities. “I’m glad they caught my heart problem and I had the procedure done,” Kromminga said. “I’m a pretty active person. I really enjoy being outside, working on my tractors and gardening. I also own a 20-acre timber with my brother, so I’m often out cutting lumber and building things for my kids. The MitraClip has made a world of difference in helping me get back to the things I enjoy.” St. Luke’s is the only hospital in Cedar Rapids that offers MitraClip. It is one of the many advanced procedures St. Luke’s Heart Care experts have pioneered in the area, so there’s no need to travel out of town. More people choose St. Luke’s because of its long legacy as the Heart Hospital. Experience matters, which is why St. Luke’s is the best place for heart care. For more information about St. Luke’s Heart Care, visit UnityPoint.org/CedarRapids/Heart. To schedule an appointment with a cardiologist, call St. Luke’s Heart Care Clinic at (319) 364-7101.
ADVANCED STRUCTURAL HEART PROCEDURES ONLY AT ST. LUKE'S St. Luke’s Hospital has the largest and most comprehensive heart care program in Cedar Rapids. It includes the area’s only advanced structural heart team and is one of only a few in the state with such experience. That means patients have access to advanced procedures in Cedar Rapids and don’t need to travel. St. Luke’s Structural Heart Disease Program Medical Director Aref Bin Abdulhak, MD, is one of five interventional cardiologists on St. Luke’s Heart Care team who treat patients suffering from blocked arteries, valve diseases and structural abnormalities of the heart – all without the need for open-heart surgery. Interventional cardiologists are specially trained to perform catheter-based procedures, such as stent placement to treat heart attack; heart valve repair or replacement; closing holes in the heart; and placing special devices that help the heart function properly. St. Luke’s structural heart team has introduced several cutting-edge procedures to Cedar Rapids over the years. Among them: itraClip (see accompanying story), a catheter-inserted device to M correct a leaky mitral valve, also known as mitral regurgitation. Transcatheter aortic valve replacement (TAVR), a procedure done via catheter to replace a faulty or failing aortic valve, for which St. Luke’s is the only hospital in Iowa to receive the American College of Cardiology Transcatheter Valve Certification. hockwave, a state-of-the-art procedure that uses sonic pressure S waves to fracture calcified plaque and reopen clogged arteries. Left atrial appendage (LAA) closure using WATCHMAN, a device that acts as a barrier when inserted (via catheter) into the part of the heart where clots are most likely to form. Patent Foramen Ovale (PFO) closure, a catheter-based therapy to repair a hole in the heart, which may decrease the risk of recurrent stroke in certain populations. These life-saving procedures greatly improve a patient’s survival and quality of life. They can only be performed by interventional cardiologists, St. Luke’s Heart Care Clinic. Individuals with a heart-valve or structural heart condition who would like to be evaluated by a cardiologist from St. Luke’s Structural Heart Disease Program, please contact St. Luke’s Heart Care Clinic at (319) 364-7101.
Aref Bin Abdulhak, MD, Interventional and Structural Cardiologist/Medical Director of Structural Cardiology, St. Luke’s Heart Care
LiveWell Fall 2021 | 9
NICU
MOM DELIVERS SURPRISE TRIPLETS About seven weeks into her pregnancy, Jen Wright, 26, and her husband, Zach, 28, went to their doctor for a routine, prenatal ultrasound. The soon-to-be firsttime parents were excited to see images of their baby but were shocked at what they saw. They were pregnant with not just one baby; they were having triplets. “It was definitely a surprise for us,” Jen shared. “Multiples don’t run in either of our families, and we didn’t have any fertility assistance.” Their obstetrician, Sunny Zhang, MD, OB-GYN Associates, was equally surprised. “We were so shocked when we discovered Jen was having triplets,” Dr. Zhang said. “In my 21 years working in this practice, I’ve only taken care of six triplet pregnancies. All of those moms had taken fertility medications. Jen had natural triplets.” “For the most part, my pregnancy was pretty typical,” Jen described. “I had some nausea in the beginning, and we started out with monthly doctor appointments, then began going in every other week.”
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“I told Jen and Zach to expect more frequent visits in order to closely monitor for potential complications related to triplet gestation,” Dr. Zhang explained. “Jen had a very positive attitude toward her triplet pregnancy. It put a lot of burden on her little body, but she was very fit going into the pregnancy. She coped with everything very well, including the many aches and pains that went along with her growing tummy, at three times the speed of a singleton pregnancy.”
More Experience at St. Luke’s “When it came time to choose a hospital, I recommended they deliver at St. Luke’s,” Dr. Zhang continued. “It was because of the level of NICU care St. Luke’s can provide, since Jen had a high likelihood of delivering very early.” According to the Centers for Disease Control (CDC), 60 percent of moms pregnant with multiples (twins, triplets or more), experience preterm labor – delivering at less than 37 weeks. For triplets, Dr. Zhang said it averages around 34 weeks.
St. Luke’s is the only Level III Maternal and Neonatal Center in Cedar Rapids and the only facility in the area equipped to care for babies born earlier than 32 weeks and who weigh less than 3.3 pounds. “St. Luke’s NICU is able to care for babies as little as 13 ounces,” said Dr. Zhang. “They have a neonatologist onsite 24/7, and their nursing staff, physicians and nurse practitioners are all very experienced. They have won my full trust in the past 21 years. When patients are admitted for medical conditions that may need preterm delivery, we usually arrange a consultation so they are comfortable with the NICU and understand the level of care needed for preterm babies.” St. Luke’s Level III facility is outfitted with special, smaller-size instruments for delivery. It also includes items such as incubators to help premature babies maintain appropriate body temperature; CPAP machines to help them breathe; and a special body-cooling device that reduces the risk of death or disability in infants who sustain brain injuries
from lack of oxygen during birth. All this equipment means premature babies can stay in Cedar Rapids for their care. Jen and Zach’s triplets were able to do just that. Jen went into labor without induction at 32 weeks, which was a little earlier than Dr. Zhang had hoped. “If possible, we try to slow down or stop preterm labor,” she said. “We want to give the babies as much time as possible to develop inside the uterus. However, after a certain point, labor cannot be stopped. Although some twins can be safely delivered vaginally, triplets are currently always delivered by C-section in the U.S.” On April 25, Jen’s labor had progressed far enough that delivery became unavoidable. She welcomed her triplets at 32 weeks – a girl, Selah (4 lbs., 0.1 oz), and two boys, Asher (3 lbs., 13.7 oz) and Kepler (3 lbs., 14 oz). They were perfectly grown for their gestational age, but because of their premature condition, the triplets spent 19 days in St. Luke’s NICU. During that time, Jen and Zach spent nearly all their time at the hospital, with Jen pumping to provide supplemental breastmilk and nursing when possible. As new parents, they also had to learn about infant care.
Family-Centered Care “St. Luke’s was so great,” Jen shared. “They really took care of not only the babies, but us. Everyone was always asking if we needed anything or needed help, and they were always checking in to see if I was OK – from breast feeding, to pumping and even learning how to take care of preemies.” “Neither of us had much experience with kids, especially newborns,” Zach added. "St. Luke’s definitely helped make sure we knew what we were doing before the babies came home. They made a hard situation a lot better, and they made us feel like more than patients – like we were family.” Home now, the Wright household is full of activity. Jen and Zach recently hired a nanny to help with childcare, and they are getting used to feedings, changings and naps, times three. They’re also looking forward to all the firsts for each of their children. “It’ll be interesting to see who smiles first and talks first,” Jen said. “With triplets, there’s so much more to look forward to. Pretty soon, we’ll have them competing in crawling races.”
Jen and Zack Wright at home with their triplets.
For more information about St. Luke’s Birth Center, to schedule a virtual tour or to pre-register for your stay, visit unitypoint.org/ cedarrapids/ maternity or call (319) 369-7264. Sunny Zhang, MD, OB-GYN Associates
Jen and Zach Wright chose St. Luke’s to bring their children into the world because St. Luke’s is known for its experience and family-centered care.
UnityPoint Health – St. Luke’s Hospital Birth Care Center
1,567
TOTAL BIRTHS FROM JANUARY – AUGUST
825 742 BOYS
GIRLS
Jan. – Aug. 2021
BABY WEIGHT
BUSIEST DAY JANUARY 13
15
LARGEST
11 LBS. 1.1 OZ
1 LBS. 4.5 OZ
BIRTHS
SMALLEST
TWINS
TRIPLETS
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HEART
THE RIGHT PLACE. THE RIGHT TEAM. Larae Wenzel at St. Luke's Cardiac Rehabilitation with Andrea Welter, RN.
As a long-time housekeeper in St. Luke’s Emergency Department, Larae Wenzel never imagined she’d be on the receiving side of that expert heart care she’s witnessed during her nearly 24 years working at the hospital. “I was in the middle of my shift when I felt pressure in my chest,” explained Wenzel. “I thought it might be gas or acid reflux, so I took a gas tablet. The pain just kept getting worse. I went to the head nurse and told her what was going on. She immediately walked me over to triage and it wasn’t long before I was up in the heart catherization lab.”
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“When she approached me with her symptoms, I told her she needed to have it checked out because they sounded like cardiac symptoms,” explained Angie Kramer, St. Luke’s ER nurse supervisor. “She was quickly moved from triage to one of our ER rooms where we hooked her up to a heart monitor and started an IV. I asked her if she wanted me to contact anyone and she asked me to get ahold of her children.”
Heart Attack “Larae was having a heart attack and her blood pressure was high,” shared Subhi Halawa, MD, St. Luke’s Heart Care
cardiologist. “She went straight to the cath lab where one of her vessels was blocked with a large clot and I placed a stent. Some of those clot pieces broke off and went to another vessel downstream and we cleaned it up as well.” “I was able to get ahold of her son to let him know what was happening and that his mom was okay,” shared Kramer. “I explained what was going on and the plan for his mom. After talking with Larae it became clear her son needed a ride to St. Luke’s. I went and picked him up and we arrived back at the hospital just in time before her procedure.”
“Going into the procedure I was scared,” said Wenzel. “I fully expected them to say I was having a heart attack because of the way I was feeling but I thought 'what would happen if I didn't survive? What happens to my kids?' The ER and heart teams all knew what they needed to do for me and they did it well.” Wenzel immediately noticed a difference after her heart procedure.
Brand-New Person "I felt one hundred percent better,” shared Wenzel. “I was like a brand-new person. Looking back in the months leading up to my heart attack, I realize I was experiencing symptoms. I just chalked it up to not sleeping enough and stress. What I felt at work that day was different from what I had previously felt. That day, I felt really deep chest pressure and it went into my ears and jaw.”
$99 HEART SCAN Heart disease can go undetected for years. St. Luke’s Heart Scan identifies calcified plaque in the coronary arteries and assesses heart’s health. There are no injections, treadmills or pre-test fasting. The heart scan is for men and women between the ages of 40 and 70. All that’s needed is a doctor’s referral. Call (319) 369-8909 for St. Luke’s $99 Heart Scan.
“Women’s heart attack symptoms are not always the typical chest pain,” Dr. Halawa explained. “They may not experience that elephant sitting on their chest sensation many people report. Women may have back or jaw pain, shortness of breath, nausea, or lightheadedness. It’s important when they start to experience these symptoms, they need to get to the hospital right away.” Wenzel is completing cardiac rehabilitation at St. Luke’s three days a week. She’s also returned to working part-time. “The ER team is always asking me how I’m doing and making sure I am alright,” shared Wenzel. “I’m thankful this happened when I was working. I would have probably ignored it if I had been at home and I would probably would not have survived. I was at the right place, at the right time.” If you are experiencing a heart attack, call 911 right away. The faster a heart attack is treated, the less the heart is damaged and the better patient outcome. Visit bit.ly/AttackSigns to learn the signs of a heart attack.
Subhi Halawa, MD, St. Luke’s Heart Care Cardiologist
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ER
TEEN RECOVERS AFTER STROKE
Reegan Lueken is back to riding her bike after recovering from a stroke last spring.
To say Reegan Lueken’s first track practice did not go as planned is an understatement. The now 13-year-old Prairie Middle School student collapsed about 20 minutes into practice. “I felt light-headed,” recalled Reegan. “I just laid down on the ground and couldn’t get back up. I thought I was going to pass out. I didn’t really notice I couldn’t move the left side of my body. My dad, came and picked me up and we went to the hospital.” “I initially thought she might be dehydrated,” Ben Lueken, Reegan’s dad explained. “But when I arrived at the school, Reegan couldn’t sit up. Right away, I knew it wasn’t dehydration. I immediately picked her up, put her in the car and drove to St. Luke’s ER. Everyone at the hospital said it looks like she is having a stroke, which is nuts, which is crazy. Kids don’t have strokes, but she had all the
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classic symptoms of a stroke. The doctors told me, ‘we are going to do a scan and see.’ And I was just shocked. Strokes are for old people, not a 12-year-old.” “Strokes don’t discriminate,” said Brian Shedek, DO, St. Luke’s Emergency Room physician. “Anyone of any age, race, ethnicity and gender can be at risk. Reegan was so brave and positive, and her father remained so calm, which made it easy to explain what was going on and receive consent for treatment.”
‘Time is Brain’ At St. Luke’s, Reegan received a medicine called tPA (tissue plasminogen activator) to break up the blood clot, which was causing the stroke and reducing blood flow to the brain. “In the ER we say, ‘time is brain,’” shared Dr. Shedek. “This means when dealing with critical stroke patients the success of
their outcome is often how quickly they are treated with tPA and other procedures, which are time-dependent. With each passing minute, a stroke progresses, and functional outcomes worsen. Teamwork was key in a successful outcome for Reegan. Our pharmacists, neurologists, radiologists, nurses, radiology technicians and ER providers all did an amazing job of working together to diagnose Reegan’s problem quickly, determine tPA dosing and arrange rapid transport via LifeGuard Air Ambulance to a higher level of care to remove Reegan’s blood clot.” “I appreciated the doctors,” Maria Lueken, Reegan’s mom shared. “They talked to us about tPA and did a good job of explaining what it is and how it’s not commonly used in children but told us they thought it was her best chance. They did a nice job of staying calm and explaining things along the way.”
the physical side of things. We have an excellent team of therapists who work with all ages, including children. Our team is very collaborative and meet once a week to discuss patient goals and plan how to get each person back home and maximize their recovery.” Reegan spent 36 days at St. Luke’s Physical Medicine and Rehabilitation. She went home last May and was able to attend the last couple of weeks of school for part of the day. St. Luke’s therapists worked with Reegan’s school to make the transition smooth and safe.
Looking Ahead Maria, Reegan, Ben and Rylee Lueken outside of their Ely home.
Maximizing Recovery Ten days after her stroke and treatment, Reegan was ready to begin her recovery. She returned to St. Luke’s Physical Medicine and Rehabilitation unit. “When she arrived at St. Luke’s, Reegan could not move her left arm and hand,” shared Laura Decker, St. Luke’s Physical Medicine and Rehabilitation senior physical therapist. “She had no active movement in her left ankle and her left knee and hip were very weak. She had impaired balance and when she walked, she would drag her left foot and snap her knee back because of the leg weakness. We provided her
with 50 percent help to walk 100 feet and despite her small size we needed two therapists to help her to go up and down four steps and a curb. Reegan also needed assistance with dressing and getting in and out of bed.” “It’s pretty uncommon for a child of that age to have a stroke,” shared Nick Appleby, DO, St. Luke’s Physical Medicine and Rehabilitation physician. “I would put Reegan’s stroke in the moderate to severe category. However, she was able to communicate well, which isn’t often the case when individuals have a stroke. She was doing well cognitively so we were able to focus on
“It’s been a night and day difference for Reegan,” Ben explained. “She went from barely moving to now riding her bike. It’s phenomenal. The work she did at St. Luke’s with the therapists and us at home helped her accomplish so much. There were many things we took for granted
before, like getting dressed. Reegan has regained her independence.” “I’d love to get back to diving or doing sports again,” Reegan said. “I am continuing my therapy two times a week at St. Luke’s.” “There hasn’t been a day since I treated her in the ER that I haven’t thought about her, wished her well and prayed for her,” shared Dr. Shedek. “It’s uplifting to hear she’s doing so well.” “The team at St. Luke’s helped save her life,” said Maria. “The speed at which they diagnosed Reegan – it was a great balance of speed but also being meticulous and making sure they were taking the right steps. They also gave her a warm welcome upon return. Everyone was great.” Call 911 or go to St. Luke’s ER immediately if someone is showing signs of stroke.
Stroke warning signs • Sudden numbness or weakness of the face, arm or leg, especially on one side of the body • Sudden confusion, trouble speaking or understanding • Sudden trouble seeing in one or both eyes • Sudden trouble walking, dizziness, loss of balance or coordination • Sudden, severe headache with no known cause Source: American Stroke Association
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ASK THE EXPERT DO I NEED A FLU SHOT? Medical experts encourage individuals to receive a flu shot this year since many public health measures that were put into place to combat COVID-19 have been discontinued. Actions like wearing a mask, practicing social distancing and staying home are believed to have helped with the significant reduction of influenza cases last year. According to the Centers for Disease Control and Prevention (CDC) the U.S. saw about 700 deaths from the flu last year. Previous estimates from the CDC indicate influenza has typically resulted in between 12,000 to 61,000 deaths annually since 2010. “Last year many people stayed home because of COVID-19,” said Richard Hodge, MD, UnityPoint Clinic - Urgent Care. “Typically, respiratory illnesses spread when people congregate together and that’s why it’s more important to receive a flu shot this fall because people are going to be out and about - interacting more with each other in the coming months.” Testing is Important Testing for influenza, COVID-19 and other illnesses will help healthcare providers with diagnoses but receiving vaccinations may also reduce the severity of an illness. “With children back in school we are treating more kids with rhinovirus, RSV and COVID,” shared Dr. Hodge. “We are also seeing a fair number of relatively asymptomatic patients who are testing positive for COVID-19. The flu isn’t usually as subtle. You will usually experience a high fever, cough,
congestion and body aches. These can be similar to what someone diagnosed with COVID-19 may experience but each requires different quarantine periods so testing will be important.” Some individuals with seasonal allergies are also surprised to learn they have tested positive for COVID-19. “I’ve seen several patients who say, ‘I think it’s my allergies, but I don’t quite feel the same as I do when I have allergy symptoms,’” said Dr. Hodge. “I’d say that’s the clue. If it feels even slightly over and above your usual allergy symptoms, please play it safe. Get tested for COVID-19 if symptoms persist after a day or two.” Individuals should also receive a COVID-19 vaccine if they haven’t yet. In August, the CDC granted full approval to the Pfizer and BioNTech’s COVID-19 vaccine for individuals age 16 and older. “These vaccines are safe,” said Dr. Hodge. “They save lives. I urge people to please get vaccinated, and if someone is not feeling well, our healthcare providers will take care of them and help determine what is making them feel bad. We have online appointments for urgent and express care and individuals can wait in their car until we are ready to see them. Our clinics are safe and ready to provide care.” To reserve a UnityPoint Clinic Urgent Care or Express time online, visit unitypoint.org/urgentcare.
Richard Hodge, MD, UnityPoint Clinic - Urgent Care
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FOR YOUR HEALTH NEW ONLINE RESOURCE HELPS INDIVIDUALS FIND ASSISTANCE There’s a new resource available to the community, which aims to help individuals find assistance with food, housing, transportation, employment and more.
NEW MEMORY/DEMENTIA CARE COMMUNITY COMING SOON UnityPoint Health – Cedar Rapids and Western Home Services, Cedar Falls, are building a memory/dementia-specific long-term care community in northeast Cedar Rapids. The new facility will offer specialized care for those with memory loss, dementia or Alzheimer’s in a secure, homelike setting. The community will be staffed by UnityPoint Health team members who will develop personalized care plans to improve quality of life through clinical care, cognitive engagement and daily living activities.
The online tool, called Together We Care, connects individuals to area organizations offering free and reducedcost social services and programs. The UnityPoint Health resource is completely free and can be accessed by visiting TogetherWeCare.UnityPoint.org. Quick Details: • Tool Name: Together We Care • How to Access: TogetherWeCare.UnityPoint.org
The new facility is being built near Council Street, north of Boyson Road and adjacent to the current St. Luke’s Transitional Care Center. The project includes three memory/dementia care cottages, each with 16-20 units.
• Who Can Use It: Anyone
The cottages provide long-term nursing care for residents diagnosed with dementia or memory-related issues. Using the household model of care means the focus will be on quality of life, dignity, purpose, choice and spontaneity. Residents will have their own personal bedroom and bathroom providing safeguards for infection control.
Once on the website, individuals can search for services by zip code or category. The tool then displays information and details about participating social care organizations, including how to contact them.
The anticipated opening of this facility is late 2022.
• Cost to Use: Free • Resources Provided: Free and reduced-cost social services and programs
UnityPoint Health joins organizations nationwide using the tool to help address the economic and social needs of its patients and communities.
FREE COUNSELING SERVICES UnityPoint Health - AbbeHealth Services in Cedar Rapids and Hillcrest Family Services in Dubuque have received additional funding from Mental Health/Disability Services of the East Central Region of Iowa to continue offering FREE mental health visits related to struggles people may be experiencing since the COVID-19 pandemic. Services are open to residents of Benton, Buchanan, Bremer, Delaware, Dubuque, Iowa, Jones, Johnson and Linn counties, regardless of income level. Anyone who is feeling “off” or overwhelmed, sad, burned out or wondering why they are not feeling better by this point of the pandemic may benefit from mental wellness visits. They can be held in-person, by phone or through telehealth. For more information about these FREE mental health visits or to schedule an appointment, contact Abbe Center for Community Mental Health at (319) 398-3562 or Hillcrest Family Services at (563) 207-5494.
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1026 A Avenue NE | P.O. Box 3026 | Cedar Rapids, IA 52406-3026
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