UnityPoint Health LiveWell Magazine Winter 2022

FAMILY HISTORY IMPACTS HEART ATTACK RISK

An Eastern Iowa woman takes action to protect her heart

BABY BORN AT

28

WEEKS

Family travels to St. Luke’s for high risk pregnancy and NICU care

TRAUMATIC SPINAL CORD INJURY

How therapy and support help patients move again

ASK THE EXPERT

Why are more young people receiving a colon cancer diagnosis?

WHAT’S INSIDE

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 HOSPITAL EARNS HIGHEST-LEVEL RECOGNITION FOR CHEST PAIN CARE

St. Luke’s Hospital was recognized by the American College of Cardiology (ACC) in the 2022 "Best Hospitals" issue of U.S. News & World Report for its dedication to heart patients.

St. Luke’s Hospital received ACC’s National Cardiovascular Data Registry (NCDR) Chest Pain - MI Registry Platinum Performance Achievement Award, the highest-level chest pain award.

The award recognizes St. Luke’s commitment and success in implementing a higher standard of care for heart attack patients by meeting aggressive performance measures. It also signifies St. Luke’s consistently treats heart attack patients according to the most current, science-based guidelines and aligns with national standards for improving the quality, safety and outcomes of heart attack patient care.

St. Luke’s also received ACC Chest Pain Center and Transcatheter Valve Accreditations and is the only hospital in Cedar Rapids with those honors. The hospital is listed in four NCDR registries.

PUBLIC ART FOR HEALTHY HEARTS

Caring for hearts has been a focus at St. Luke’s since 1978 when the hospital’s open heart surgery program began. Since then, St. Luke’s has built a legacy as Cedar Rapids’ Heart Hospital treating more heart patients than any other hospital in Cedar Rapids and performing the most advanced heart procedures locally.

will spark a positive thought if someone is worried or dealing with a situation that didn’t come out the way they had hoped. Whether they bring peaceful happiness or comfort, that’s what I’m hoping these hearts will do.”

GET VACCINATED AND BOOSTED AGAINST COVID-19

UnityPoint Health team members have spent the past two years fighting the COVID-19 pandemic.

First Transcatheter Aortic Valve Replacement (TAVR)

Minimally invasive, catheter-based aortic valve replacement procedure that doesn’t require open-heart surgery

Winter 2022

LiveWell magazine is produced by UnityPoint Health®

P.O. Box 3026 Cedar Rapids, IA 52406 (319) 369-7395 | unitypoint.org

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

*Source: Iowa Hospital Association

To bring attention to February as American Heart Month and to uplift patients, their families, healthcare workers and the community, St. Luke’s is sharing “Public Art for Healthy Hearts,” featuring work by Cedar Rapids artist, Laura Saylor Smith. Her original paintings are on display in St. Luke’s SurgiCare lobby and windows, on area billboards, advertisements, and other public locations in the community.

Smith hopes her paintings for Public Art for Healthy Hearts are uplifting and provide comfort.

St. Luke’s chose to share Smith’s artwork to uplift the emotional hearts of healthcare workers and the community, while also shining a light on the importance of physical heart health.

Learn more about preventing heart disease at unitypoint.org/ cedarrapids/heart

Our healthcare workers are hoping their firsthand accounts about the overwhelming patient volumes, as well as a continual wave of avoidable suffering will help reignite the urgency to care for healthcare workers once again and encourage people to be part of the solution. Our teams had a lot to say about the pandemic and now UnityPoint Health is sharing their important messages.

We encourage you watch the video, and more importantly, take their words to heart.

• Get vaccinated against COVID-19.

• Get your booster.

• Encourage any family and friends who are unvaccinated to do the same. Watch the video at bit.ly/UPHSoundingTheAlarm.

Yes No

“I hope they give people a sense of calm,” Smith said. “Maybe they

U.S. NEWS & WORLD REPORT 2022 "BEST HOSPITALS"

ATYPICAL SYMPTOMS LEAD TO WOMAN’S HEART ATTACK, SHOCKWAVE PROCEDURE

heart. It involves inserting a catheter and emitter through an artery in the wrist or leg, and when activated, the device sends a pulse into the vessel walls to break down the hardened material. Shockwave, also known as intravascular lithotripsy, is based on the process used to safely break up kidney stones. St. Luke’s is the only hospital in Cedar Rapids to offer this advanced procedure for patients with severely blocked arteries (atherosclerosis) or very weak heart muscles and who may not be good candidates for open heart surgery.

“After Shockwave, I was able to expand the region and implant a stent (a metal mesh tube that helps keep the artery open),” Dr. Halawa said. “She needed a total of two – the one I put in the vessel causing the heart attack, and a second one in the front side of the heart, which Dr. Wagdy (St. Luke’s interventional cardiologist) put in the following morning.”

“After the first stent, I felt so much better,” Young recalled. “I went home the next afternoon, after they put in the second one.”

Different Heart Attack Symptoms in Women

classic symptoms like chest pain, nausea and vomiting, but there may also be jaw, back or arm pain, as well as fatigue, lightheadedness, shortness of breath or, like in Tracy’s case, blurred vision.

“It’s important to be vigilant about your health,” Dr. Halawa pointed out. “If you’re experiencing any of these symptoms, don’t ignore them. If something comes and goes once, it’s fine. But if it keeps coming back or you have more than one symptom, there’s something going on. We have a number of tests we can use to determine the cause and can take steps to prevent a heart attack.”

Cardiac Rehab Creates Better Habits

Young said she feels better and has more energy now. She has made a commitment to a healthier lifestyle since her heart attack and is participating in St. Luke’s Cardiac Rehab. She’s also eating better and has lost 25 pounds.

“The nice thing about rehab is we talk about different aspects of heart disease, like how everything you eat affects not

only your heart, but your arteries,” Young said. “I’ve learned so much from that. I love to cook and try new recipes, but since my heart attack, I’m more careful about what I make.”

Young hopes others read her story, so they recognize and take action sooner than she did. Earlier intervention can prevent a heart attack and subsequent damage to the heart.

If you or someone you know experiences any symptoms of a heart attack, call 911 immediately. If you have a history of heart disease, talk to your primary care doctor or contact St. Luke’s Heart Care Clinic at (319) 364-7101 to talk to a cardiologist.

One Friday around 12:30 a.m., Tracy Young, 67, awoke from pain in her arms and could hardly lift them. Thinking it was from overuse or a sign of age, she applied a menthol pain-relief cream and went back to bed. However, not long after crawling in, she began experiencing other symptoms.

“My jaw felt funny and my chest started to hurt,” Young said. “I got up and walked around, then tried laying down again, but it got worse. I thought ‘could this be a heart attack?’ So, I woke up my husband, found my phone and dialed 911.”

Young was taken by ambulance to St. Luke’s Hospital Emergency Room (ER), where the team was prepared for her arrival.

“I couldn’t believe it,” Young said, “They knew was going to be there, and everyone was ready. They had already called the cardiologist and said he would be there in a few minutes. Before I knew it, I was in the cath lab. Everyone was awesome all the way around, and I felt really confident I was being well cared for.”

Shockwave to Open Blocked Arteries

Subhi Halawa, MD, St. Luke’s interventional cardiologist, was on call that night. “Tracy’s EKG suggested a heart attack involving the posterior (back side) of the heart,” Dr. Halawa explained.

“We urgently took her to the cath lab and discovered blockages that were extremely calcified (hardened). I had to use Shockwave to break through.”

The Shockwave procedure uses sonic pressure waves to fracture the buildup of calcified fats and cholesterol (plaque) to improve or restore blood flow to the

“Looking back, I realize there were signs I ignored,” Young continued. “When I got home, I was reading online about what happened, and I now know I was having symptoms for at least a couple of weeks or longer. I had a sharp pain in the middle of my back, but I figured it was just a sign of getting old. Sometimes my jaw or arms would hurt. But the biggest one was blurred vision. For probably a month before my heart attack, I couldn’t read the closed captions on my TV. When I came home from the hospital, they were crystal clear.”

Dr. Halawa says ignoring or not recognizing symptoms is common, especially for women. “Women’s symptoms for heart attacks may be a little different,” he said. “They can present as

Not everyone experiences the same symptoms of a heart attack.

Women in particular may present with different indicators. If you experience one or more of these symptoms, call 911 immediately:

• Chest pain, pressure or squeezing

• Nausea or vomiting

• Jaw, back, neck, arm or upper abdominal pain

• Fatigue or inability to maintain usual activity or workout

• Lightheadedness

• Shortness of breath with or without chest discomfort

• Unexplained blurred vision

• Cold sweats

• Anxiety or fear of impending doom

Tracy Young experienced unusual heart attack symptoms and received the Shockwave procedure at St. Luke’s to clear blockages in her arteries. She’s changed her cooking habits and wants others to be proactive about heart health and recognize early heart attack warning signs.

Everyone was awesome all the way around, and I felt really confident I was being well cared for.

Mary Ann Railsback recently had a catheterbased TAVR procedure to replace her aortic valve and went home the next day. She is pictured here with her husband, Monte, and their new puppy.

HEART PROCEDURE FIXES ONE VALVE, IMPROVES TWO OTHERS

Mary Ann Railsback, 79, has been a patient at St. Luke’s Heart Care Clinic for a long time. In fact, she and her husband, Monte, 83, see the same cardiologist and have standing, dual appointments. Monte had a heart attack and open-heart surgery at St. Luke’s more than 20 years ago, so he continues to see his heart doctor for preventive care. Mary Ann has had AFib (short for atrial fibrillation, which is an irregular heartbeat) for several years but recently started having other heart problems.

“I’ve known Monte since the late 1990s,” said Keith Kopec, MD, St. Luke’s Heart Care Clinic cardiologist who cares for the Railsbacks. “I’ve seen Mary Ann for about 10 years. She was just kind of cruising along without a whole lot of cardiac problems until recently.

“Not everyone comes in with a big heart problem,” Dr. Kopec continued. “We see a growing number of people for preventive care. They may have some family history, so we focus on modifying risks and taking a proactive approach. Mary Ann

developed congestive heart failure problems, which is not unusual for a 79-year-old woman with chronic AFib.”

Congestive Heart Failure

Congestive heart failure occurs when the heart doesn’t pump blood as well as it should. Causes include coronary artery disease (buildup of plaque in the artery walls), high blood pressure and disorders of the heart valves. Mary Ann was dealing with the latter.

“I knew and had been monitoring Mary Ann’s heart valve issues for a number of years, but they got worse,” Dr. Kopec explained. “They started causing repeated hospitalizations, so we had to be more aggressive in searching for the reason. What was challenging was three of her four heart valves were not functioning properly. We had to figure out which one was most likely contributing to her problems.”

Dr. Kopec consulted and ultimately referred Mary Ann to his colleague Aref Bin Abdulhak, MD, St. Luke’s interventional and structural cardiologist. An interventional cardiologist is specially trained to perform catheter-based heart valve repair and replacement, among other advanced structural heart procedures.

“In order to determine which valve to focus on, we did multiple imaging and cardiac CT scans,” stated Dr. Bin Abdulhak. “We determined her aortic valve was the one causing her problems. She had double aortic valve disease – aortic stenosis, which is the narrowing of the valve, and the valve was leaky. I believe it was also causing her mitral and tricuspid valves to leak. Because of this, and due to her age, I recommended the TAVR procedure.”

Valve Replacement Without Surgery

TAVR, short for Transcatheter Aortic Valve Replacement, allows the interventional cardiologist to implant a new aortic valve through a catheter instead of requiring openheart surgery. The catheter is typically inserted through an artery in the groin, but it can also be delivered to the heart through an artery in the neck or arm. For Mary Ann, Dr. Bin Abdulhak used the arm entry point because the artery in the groin was not large enough to accommodate the catheter.

“After the procedure, Mary Ann spent one night at St. Luke’s, which is typical with a TAVR,” Dr. Bin Abdulhak reported. “The alternative would have been opening her chest, so the TAVR procedure greatly improved her survival and quality of life.”

Monte went through open-heart quadruple bypass surgery more than 20 years ago, which required a much longer recovery period. He was grateful his wife had an easier experience.

“With my surgery, I was out of work for a long time,” Monte said. “But with today’s modern technology, Mary Ann’s valve replacement was slick as a whistle.”

“Everything went wonderfully,” Mary Ann concurred. “I had no pain after surgery, and I went home the next day. I feel great and am back to my usual activities around the house, working outside in the yard and spending time with my family and new puppy.”

“We just can’t say enough about St. Luke’s and the doctors at St. Luke’s Heart Care Clinic,” shared Monte. “You’ll never meet another guy with as good a bedside manner as Dr. Kopec. And Dr. Bin Abdulhak is a great cardiologist. We all know St. Luke’s is the Cedar Rapids Heart Hospital. These doctors are beyond anything you could wish for; I believe Jesus works through their hands.”

For more information about TAVR and the other advanced procedures only available at St. Luke’s, visit unitypoint.org/ cedarrapids/heart. To schedule care with a cardiologist, call St. Luke’s Heart Care Clinic at (319) 364-7101

Ms Carmen Kleinsmith SVP, Chief Nurse Executive St. Luke's Hospital 1026 "A" Avenue N.E Cedar Rapids, Iowa 52406

Ms Kle nsmith,

I am writing you about the outstanding care my wife Mary Ann Rai sback (1-9-42) has received at S Luke's Hospital, espec ally on the fourth floor. Her lates stay was to have her aorta valve rep aced, however she has had previous stays on the fourth floor and the treatment has been outstanding Everyone on that floor from the housekeepers, food servers to the nurses a e pleasant and k nd and want to know how you are doing and if you need anything

It is really difficul for the s af with the census h gh due to COVID yet they continue to perform the r duties in a cheerful manner Some pat ents don t real ze tha they are not he only patients n the hospital and a nurse can't in errupt a procedure with another patient to attend to them.

I don t know what the appropriate awards are, whether it is the Daisy Award, Guardian Ange Award or some other award, the staff on the fourth floor needs to be recognized. Mary Ann has had nurses who were no in charge of her care stop in and see her when they heard she was a pa ient on the fourth floor.

Mercy advertises tha it is the Heart Hospital but we all know better and St Luke s doesn need to advertise it. had quadruple bypass 24 years ago and continue to do wel as Mary Ann and I are both patients of Dr. Kopec.

S ncerely,

Monte L. Railsback MSgt, USMC (Ret)

FAMILY HISTORY IMPACTS HEART ATTACK RISK

Marie Hunt can’t help but wonder ‘what could have happened’ if she didn’t follow her gut and go to St. Luke’s Hospital last April.

“Initially, I thought I was experiencing indigestion,” explained Hunt. “I get an upset stomach occasionally, so I wasn’t really concerned. I woke up one night and had chest pains, and I thought, ‘what did I eat?’ I went into our kitchen and got a glass of water because it usually goes away when I drink something. It didn’t go away, but I was able to go back to bed.”

Hunt and her husband, Bill, live on a farm near Hopkinton. The following day, they made a few stops in nearby Manchester to get ready for Easter, which was a few days away. While shopping at a fabric store, Hunt felt short of breath. She was wearing a mask at the time, removed it briefly to catch her breath and recovered. When she mentioned the episodes to Bill, he encouraged her to call her doctor.

“I thought it was my gallbladder and had a doctor’s appointment coming up in a few days and I knew I could get checked then,” Hunt explained. “However, the next day I was in Marion watching my grandchildren when I had another spell. I thought, ‘I don’t know what is going on here, but I better find out before I drive home.’”

Hunt’s son David stopped by his sister’s house to see his mom. When his sister returned, Hunt asked David to take her for a ride.

“I told him to drop me off at St. Luke’s ER,” Hunt shared. “He had his children with him so they couldn’t all go in. I let him know what was happening and asked him to call his dad. When I walked into St. Luke’s, they put an EKG on me and had me in a bed practically the minute stepped in the door. They worked fast. They were running all these tests. Dr. Dowden came into my room and said everything looked OK, but then he asked if I had any family history of heart disease.”

“Marie shared that she has several relatives with heart issues and that information concerned me enough to recommend we admit her to the hospital for observation,” explained Ryan Dowden, MD, St. Luke’s Emergency Room (ER). “My recommendation was based on clinical guidelines, which help us determine the safest next steps for patients based on not only the patient’s EKG, but also lab results, risk factors like family history and symptoms, among other things.”

Heart Blockage

“Dr. Dowden’s decision to admit me to St. Luke’s probably saved my life because I had a couple more spells overnight.

They took me into the heart cath lab where they determined one of my arteries was 95 to 98 percent blocked and placed a stent to open the blockage,” Hunt said.

“Marie has a troublesome family history of heart disease,” explained Keith Kopec, MD, St. Luke’s Heart Care Clinic cardiologist. “When we look at family history, first degree relatives are most significant - mom, dad and siblings. Aunts, uncles are less significant. Marie was aware of this family history and had previous visits and tests. We tend to think of cholesterol as slowly building up in one’s heart over time. That does happen, but most acute events like Marie’s are caused by a process called plaque rupture. That’s when a small plaque of cholesterol in the wall of a blood vessel ruptures, creating a severe blockage. This leads to a heart attack. This process often explains how one can feel well today and have a heart attack tomorrow. We’ve come a long way in trying to prevent plaque rupture. Cholesterol medicines have helped us significantly lower this risk, but it’s not 100 percent solved.”

Thankfully Hunt’s blockages were identified before she had a heart attack and she now takes cholesterol medicine and others to help keep her heart health in check. She participated in cardiac rehab at Jones Regional Medical Center in Anamosa and continues regular exercise at home.

When in Doubt, Get Checked

“The care was great at St. Luke’s,” shared Hunt. “The doctors and nurses went above and beyond. I am thankful I went to the hospital that day. Living in the country, on a farm, it’s hard to say what could have happened to me. I tell everyone – if you have concerns it’s best to get them checked out. I am glad I did. I guess I could say I truly had an Easter blessing.” The faster you seek treatment for heart concerns, the better outcome you can expect. If you have shortness of breath, chest pain, discomfort in other areas of the upper body or other signs of a heart attack, call 911 or go to the ER.

SCANNING FOR HEART DISEASE

St. Luke’s Heart Scan takes X-ray pictures of your heart and detects plaque in the arteries. The results can help your doctor assess your risk of heart disease and determine which steps to take to avoid serious heart complications.

The $99 Heart Scan is for men and women between the ages of 40 and 70. All that’s needed is a doctor’s order. To learn more about St. Luke’s Heart Scan, call (319) 369-8909.

Marie Hunt on her farm near Hopkinton.

BABY BORN AT 28 WEEKS NICU CARE FOR EARLY BIRTH

In week 24 of her pregnancy, Chloey Wood thought she and her husband Austin had plenty of time to get ready for their baby to arrive, but baby Gabriella had other plans for her parents.

“I’m a kindergarten teacher, and was getting ready for school one day and I started feeling sick and then I felt a gush,” recalled Chloey. “I was really scared, we’d had three miscarriages before her, and I just felt thankful and lucky to get to 24 weeks when this happened.”

The couple rushed to UnityPoint Health – Allen Hospital’s ER in Waterloo, where they live. Doctors told her she was starting to dilate and, because Chloey was so early in her pregnancy, she needed to go to St. Luke’s Hospital in Cedar Rapids. An ambulance transported her to St. Luke’s.

“I knew they were making the right call in sending us to St. Luke’s,” shared Austin Wood. “They were sending Chloey to a higher level of care for her and our baby where they have the best equipment and people to care for them.”

St. Luke’s Neonatal Intensive Care Unit (NICU) ranks among the best hospitals in the world in providing care for very low birth weight babies (babies born weighing less than 3 lbs. 5oz.).

St. Luke’s NICU team includes Cedar Rapids’ most experienced neonatologists and staff. St. Luke’s welcomes transfers from other hospitals to care for premature babies.

Eastern Iowa NICU Resource

“St. Luke’s has great partnerships among area hospitals,” said Krista Husemann, St. Luke’s neonatal nurse practitioner. “These partnerships are very important because it’s always more beneficial to transfer the pregnant mom to St. Luke’s rather than transferring a preterm baby.”

“When I arrived at St. Luke’s, I was dilated about two and a half centimeters,” said Chloey. “They told me wasn’t going anywhere for a while and they would monitor me 24/7. They gave me medicines to try and stop or at least slow down my labor and told me I was officially on bed rest.”

“She was on bed rest at St. Luke’s for about a month,” explained Austin. “It was difficult because I would come from Waterloo to be with her, and she would have these episodes and sometimes I was trying to decide whether or not to leave to go to work or school because we weren’t sure what was going to happen.”

“Austin had been with me overnight and left to go to class and work,” explained Chloey. “I had just eaten lunch, and all of sudden I felt dizzy, the room started spinning and was really warm. I pressed my call button, and when the nurse came in, she said, ‘you do not look good.’ My temperature was 101 and my blood pressure was skyrocketing. They told me to call Austin and tell him to return to St. Luke’s.”

St. Luke’s team not only cared for her, but they made sure we were comfortable as well. The care was wonderful, and the Ronald McDonald Family Room at St. Luke’s was like an oasis.

Emergency C-Section

St. Luke’s Birth Care team decided to do an emergency C-section and started prepping Chloey for surgery. Austin made it to St. Luke’s just in time for his daughter’s birth.

Gabriella was born about 12 weeks early on Feb. 10, 2021 at 7:05 p.m. She weighed two pounds, four ounces and was 14 ½ inches. St. Luke’s NICU team was standing by during her delivery and immediately transported her to the NICU.

“Gabby had had some initial respiratory distress, which is common for her age group,” explained Husemann. “She was placed on Continuous Positive Airway Pressure (CPAP) after delivery and briefly required increased breathing support. Gabby remained on CPAP for about one month. Not only did we provide respiratory support to Gabby, but she also needed nutritional support and phototherapy for a couple of days in the first two weeks of life.”

“We couldn’t hold her for a few days, which was hard,” recalled Chloey. “Slowly we were able to do more for her. It was nice being able to be in the room with her. St. Luke’s team not only cared for her, but they made sure we were comfortable as well. The care was wonderful, and the Ronald McDonald Family Room at St. Luke’s was like an oasis. We could eat meals there and use the sleep room.”

Gabby was at St. Luke’s for three months. Most of her time was spent eating and growing. On May 10 she was finally able to go home, a belated Mother’s Day present for Chloey.

“There were times when I cried and thought we would never go home,” Chloey shared. “I want other parents in this position to know there is light at the end of the tunnel. Use all the great resources St. Luke’s NICU team offers. They know what they are talking about, they know what they are doing. They will help you and your little one. Gabby is a happy, healthy baby and is hitting all her appropriate milestones. We are thankful for all they did for us.”

Find out why three out of four moms choose St. Luke’s Birth Care to deliver their baby. Our experienced labor and delivery nurses and NICU team are ready to provide family-centered, expert care. To schedule your personal meeting and virtual tour of St. Luke’s Birth Care Center, call (319) 369-8129.

Chloey and Austin Wood with their daughter, Gabby, in their Waterloo home. Gabby spent three months at St. Luke’s NICU after she was born premature.

RESTORING LIFE AFTER A TRAUMATIC SPINAL CORD INJURY

Scott Kallemeyn spent Saturday, Sept. 19, 2020, like many Eastern Iowans following the August 10 derecho - he was doing yard work and planting a tree.

“We had recently moved to a home in the country, and I was working with my boys outside,” recalled Kallemeyn. “It was a nice fall day. I was moving a pile of dirt with the lawn mower and trailer. I was driving down a hill, it wasn’t very steep, but the grass was slightly wet in the shade and my tires lost traction. I started to slide, and the lawn mower jackknifed, and I was flipped on the ground.”

The trailer landed on Kallemeyn, pinning him. Thankfully, his sons were not near the lawn mower when the accident occurred.

“Right away, I couldn’t feel my feet or legs,” shared Kallemeyn.

“I knew my injuries were pretty traumatic, but I was fully conscious. My boys checked on me, and I told them to get our neighbor and call 911, but I realized still had my phone in my pocket. I was able to pull it out and called 911. I talked to them right away.”

St. Luke's LifeGuard Air Ambulance was dispatched to Kallemeyn’s home. The team flew Kallemeyn to the hospital where he had emergency spine surgery. After surgery he spent a week recovering in the hospital, he was cleared to begin rehabilitation, but the accident left him with paraplegia.

Intense Therapy

“I work at St. Luke’s,” shared Kallemeyn. “I knew St. Luke’s Physical Medicine and Rehabilitation (PMR) is the best in the state. My body went through so much trauma that even the most basic things were hard at first. I knew this team would provide exceptional care and get me moving again.”

“Scott had a traumatic injury to his spine or power cord,” explained Stan Mathew, MD, St. Luke’s PMR medical director. “When I first saw Scott, he had little movement below his waist. We were able to get his pain controlled and then our team created a comprehensive plan, which included physical and occupational therapy. It started with an intense strengthening process.”

“It’s a phenomenal team,” Kallemeyn shared. “They had me use different exercises to strengthen my upper body and re-fire the muscles in my lower extremities. They used a lot of different approaches and equipment, which was important to my recovery. I’m very fortunate my injury was low enough on my spine that I still had upper body and arm functions. They made my experience the best it could be given the circumstances.”

Upbeat. Positive. Focused.

“Scott spent seven weeks as a hospitalized patient at St. Luke’s Physical Medicine and Rehabilitation,” said Kevin Komenda, St. Luke’s PMR senior physical therapist. “At the end of his stay, he was able to walk approximately 40 feet using leg braces. He wasn't walking as his main mode of motion, he used the wheelchair, but he had progressed to being completely independent from the wheelchair level. He was no longer dependent on others for assistance. This progress was due to Scott's unrelenting desire to get stronger, and our in-patient rehab staff aiming that desire in the correct direction by working on strengthening/stretching, pain reduction, nutrition, counseling and functional mobility training. He was always upbeat, positive and focused on his future.”

Since his release from the hospital, Kallemeyn has continued his therapy at St. Luke’s as an outpatient. He continues to make progress and recently hit a personal goal.

Continued Therapy and Progress

“I knew it would be challenging for me to regain everything, but my one-year goal was to walk using only ankle braces and forearm crutches, and I hit my goal. I primarily do this during my physical therapy sessions, but I can do it outside of PT. I also am able to stand for periods of time. It’s been helpful at home and I also am able to drive using a modified vehicle.”

“Hospitals from all over Iowa send their most complex patients to St. Luke’s Physical Medicine and Rehabilitation because we have the expertise to care for them better than anywhere else,” said Dr. Mathew. “We have an exceptional multidisciplinary team, with years of experience ready to help and support patients who have experienced a traumatic event or serious illness. We come alongside them to help restore their lives.”

“I have been back at work at St. Luke’s for a little over a year now,” Kallemeyn said. “It’s still a definite struggle, I love being outdoors, camping, hiking and helping coach my kids' sports. I miss it and can participate, but it’s different. I am learning to balance this transition. I am grateful to be alive. I am thankful for the unbelievable support not only from my hospital care team but from everyone at St. Luke’s, our friends, church, neighbors and of course, my family.”

Take a Virtual Tour of St. Luke’s PMR

When a health condition leaves you or a loved one needing rehabilitation, St. Luke’s Physical Medicine and Rehabilitation team is committed to helping individuals reach their fullest potential.

Take a virtual tour of our facility at bit.ly/PMRTour.

Scott Kallemeyn with his children, Lauren, Ethan and Levi outside his Swisher home.

Scott Kallemeyn works with Megan Andresen, Sr. Physical Therapist, in St. Luke’s PMR gym.

COVID-19 REFLECTIONS

Why did you want to start working at a hospital during a pandemic?

“I started working at St. Luke’s about a year into the pandemic. I wanted to work at this hospital, because I have friends who are nurses here and only had good things to say about St. Luke’s. I really enjoy it here. I have never worked someplace where there are so many friendly people who genuinely care about you.”

- Josh Deggendorf, Maintenance Mechanic, Plant Operations

What do you wish for?

“I wish our patients would not be sick for so long. It’s hard to see people here for weeks and months, with varying outcomes. Having the pandemic continue this long is a little bit defeating, you just don’t know if things are going to ever end and at the same time you just come in, square your shoulders to the work that must get done and dig in. It’s frustrating because we are still working through this and everyone else is living their life like normal. We want to be able to live our lives like normal again too.”

What are you grateful for?

As the COVID-19 pandemic enters its second year, it remains a difficult challenge especially for healthcare workers. As patient volumes rise and fall, St. Luke’s team members are stretched and tired but continue to provide exceptional and selfless care on the front lines and behind the scenes.

What I remember when COVID-19 first arrived…

“It's hard to believe we are going on two years in a global pandemic. I remember the first time I went to our designated COVID unit. I stopped and told myself ‘this is here, this has really hit us.’ It was surreal to see something you heard about all over the news, devastate our community. It was a moment I will never forget. Now it is our daily life, life as we currently know it. It's unpredictable.”

What are you grateful for?

“It takes a team effort to get through times like these, and I am thankful for every team member working together through this. I am especially thankful for my friends, family and colleagues, for being a support system through the emotional and physical stress this has put on the healthcare system. I am looking forward to the day our lives go back to a new ‘normal’ and we can enjoy large gatherings, and all the things we used to enjoy pre-pandemic. Until then, my hope is that people take this seriously and do what they can to protect themselves, their communities and their families.”

- Heather Houg, Medical Assistant, Laboratory

What I remember when COVID-19 first arrived…

“I was worried about getting infected. When we first heard about it, we didn’t know much about the COVID virus, so I was scared. I remember all the PPE (personal protective equipment) we had to put on before we could clean rooms. It was something I will never forget.”

“My team members are amazing. We have the best people at St. Luke’s. Great teamwork, amazing physicians, and respiratory therapists. We are very blessed at this hospital that we are able to care for the sickest patients and we don’t have to send them elsewhere for care. Patients can have the best care right here at St. Luke’s.”

- Katie Moltzan, RN, ICU Supervisor

What are you grateful for?

“I am grateful to the nursing and the respiratory therapy staff without whom we would not have come along this far in this pandemic.”

- Vijay Gogineni, MD, UnityPoint Clinic Multi-Specialty Pulmonologist

What are you grateful for?

“I’m grateful for my work mates. There are very good people here.”

- Jeanne Nyirazuba, Housekeeper, Environmental Services

From the left, Josh Deggendorf, Dr. Vijay Gogineni, Heather Houg, Jeanne Nyirazuba and Katie Moltzan

CARE AFTER COVID-19

diarrhea. Dehydration is common, and it is very difficult to maintain adequate hydration and nutritional intake needed to support their needs. During acute illness our bodies are working hard to fight and recover from disease. As disease severity increases, such as when pneumonia develops, COVID patients spend even more energy particularly to maintain their increased work of breathing.”

“I was just so tired,” shared Wiley. “I could hardly get out of bed to use the bathroom. I’ve never experienced that kind of fatigue. I was a little out of it but the nurses and staff at St. Luke’s were good about telling me what they were doing to care for me. At one point I remember one of the doctors telling me they might have to put me on dialysis if some of my numbers didn’t improve but thankfully, they started to get better, and I went home.”

Wiley's return home was short-lived. During a virtual follow-up doctor’s appointment, it was recommended she return to St. Luke’s because she was having trouble breathing.

“COVID-19 patients often experience profound fatigue and can become quite short of breath even with minimal exertion,” Dr. Edwards explained. “Activities such as getting out of bed to the chair for a meal or walking a few feet to the restroom can be quite challenging and requires increased respiratory effort. I counsel patients that nutrition, hydration and maintaining mobility are important aspects of their COVID recovery. Muscles follow the motto of ‘if you don't use it, you lose it’ and immobility leads to loss of muscle mass which can take weeks of therapy to recover.”

Transitional Care

Barb Wiley initially thought she ate something that didn’t sit well with her stomach when she experienced nausea and vomiting last July. The next day her upset stomach was followed by a headache and sore throat. Eventually the 67-year-old Shellsburg resident stopped drinking and eating.

“I just wasn’t hungry,” explained Wiley. “I was really tired, and after several days I wasn’t getting better, so I went to see my doctor. I tested positive for COVID-19. It was recommended I

go to the hospital because I was dehydrated. I went to the ER and was admitted to St. Luke’s.”

“Acute COVID-19 illness can leave even a previously healthy person very debilitated by the disease,” said Dianna Edwards, MD, St. Luke’s Hospitalist medical director. “The decline starts even before a patient enters the hospital. Commonly, COVID patients suffer from a lack of taste and smell, poor appetite and may experience symptoms such as nausea, vomiting or

Wiley had developed pneumonia and was at St. Luke’s a total of 12 days recovering from COVID-19. Afterward, she needed rehabilitation to help her regain strength and mobility, so she went to St. Luke’s Transitional Care Center. It’s a recuperative and supportive care center for patients to continue healing following an injury, surgery or serious illness. It’s designed for short-term rehabilitation, which includes daily, individualized therapy sessions to help patients regain their strength, stability and confidence to return home.

“Everything seemed to be finally going in the right direction,” said Wiley. “I was doing physical and occupational therapy at the center, and I was able to eat and drink again.”

After about eight days at St. Luke’s Transitional Care Center, Wiley went home.

“I was doing better but I wasn’t really confident yet,” explained Wiley. “I was able to walk short distances but not able to do stairs. You don’t realize how much energy everyday things take until you don’t have enough strength.”

Therapy for Strengthening and Conditioning

After a few weeks at home, Wiley reached back out to her UnityPoint Clinic provider, who recommended she go to St. Luke’s Physical Medicine and Rehabilitation outpatient therapy to help with additional strengthening and conditioning.

“When I first saw Barb, she was limited by shortness of breath and had low activity tolerance,” recalled Barb West, St. Luke’s Physical Medicine and Rehabilitation senior occupational therapist. “She needed a lot of rest breaks to complete tasks, and her heart rate would increase during activity. Each week we would work on new tasks, and she was able to gradually increase activities.”

“They did a great job helping me get my stamina back,” said Wiley. “If you were to tell me a couple of years ago that I would struggle just to fold laundry standing up, I wouldn’t have believed it. COVID just took such a toll on me.”

Wiley completed about five weeks of outpatient therapy at St. Luke’s twice a week and reports she is feeling about 90 percent back to normal.

“They really helped me a lot and thought of things for me to do to build my strength that I would never have thought to do on my own,” said Wiley. “They made a lot of difference for me and were really good. I am happy with where I am now.”

To learn more about St. Luke’s Physical Medicine and Rehabilitation, call (319) 369-7331 or email STL_PMR@unitypoint.org

ST. LUKE’S TRANSITIONAL CARE CENTER

St. Luke’s Transitional Care Center is designed to bridge the distance between a hospital setting and home. It's intended for short-term rehabilitation, which provides daily, individualized therapy sessions to help patients regain the strength, stability and confidence needed to function at their best.

St. Luke’s Transitional Care Center has nurse practitioners on-site five days a week, available to respond quickly to a patient's changing needs. The average length of stay is 14 days.

To learn more about St. Luke’s Transitional Care Center, call (319) 366-8701

Barb Wiley is feeling about 90 percent back to normal after recovering from COVID-19.

WHY ARE MORE YOUNG PEOPLE RECEIVING A COLON CANCER DIAGNOSIS?

Since the mid-90s, colorectal cancer (CRC) diagnoses have been increasing by over two percent a year for individuals under age 50. This same age group now accounts for about 10 percent of all CRC cases.

In response to this trend, the U.S. Preventive Services Task Force released new recommendations in May 2021 for colorectal cancer screenings to begin at age 45 instead of 50.

According to Dean Abramson, MD, UnityPoint Health –Gastroenterology, it’s estimated that 18,000 CRC cases will be diagnosed in individuals under 50 this year, many with advanced-stage disease. It’s the leading cause of cancer death for men under age 50.

“We are seeing colorectal cancer in people in their thirties and forties now, many without family histories of colon cancer,” explained Dr. Abramson. “Still, 90 percent of colorectal cancer patients are age 50 and older.”

Dr. Abramson says the reasons behind this shifting demographic are not entirely clear, often debated, but most believe poor diet, sedentary lifestyle, obesity and alterations in intestinal bacteria due to overuse of antibiotics are likely contributory. Dietary factors include inadequate fiber intake and excessive consumption of sugary drinks, artificial sweeteners, and red and processed meats.

Signs of Colorectal Cancer

“Symptoms of colorectal cancer may include any change in bowel habits, persistent abdominal pain or cramping, and visible blood in the stool,” shared Dr. Abramson. “There are also many people who have no signs or symptoms before their diagnosis. Unfortunately, having symptoms sometimes indicates more advanced disease.”

Dr. Abramson stresses it’s important for individuals to be proactive in their health and have a dialogue with their healthcare provider about family history of CRC to determine if screening is appropriate.

“Maintaining a healthy lifestyle is thought to be helpful in terms of prevention,” explains Dr. Abramson. “This means

individuals should exercise regularly, maintain a healthy body weight, and consume foods high in fiber and low in animal fat and known carcinogens (cancer-causing substances). It’s also important to be aware of any family history of colon cancer or advanced colon polyps in close relatives, parents or siblings. If there is family history, then high-risk screening should begin at age 40 or ten years before the age of diagnosis in that first-degree relative, whichever is sooner.”

Dr. Abramson stresses that for these high-risk patients a screening colonoscopy is recommended, rather than fecal testing. It’s also important to report any bowel changes to a healthcare provider sooner rather than later. And everyone should schedule colorectal cancer screening beginning at age 45 in the absence of symptoms or family history.

If you are age 45 or older, talk with your healthcare provider today to schedule your screening colonoscopy. If you don’t have a doctor, find one today at unitypoint.org/findadoctor

U.S. NEWS & WORLD REPORT NAMES ST. LUKE’S "HIGH PERFORMING" FOR MATERNITY

St. Luke’s Hospital has been recognized as "High Performing" in Adult Maternity Care (Uncomplicated Pregnancy) by U.S. News & World Report. This is the first time U.S. News has published a list of Best Hospitals for Maternity. To be recognized among the Best Hospitals for Maternity, hospitals had to excel on multiple quality metrics that matter to expectant families, including complication rates, C-sections, whether births were scheduled too early in pregnancy, and how successfully each hospital supported breastfeeding. Only one-third of the hospitals evaluated by U.S. News for maternity care earned a "High Performing" rating.

“High Performing” is the highest rating U.S. News awards for maternity care.

St. Luke’s is one of only two Iowa hospitals on this list and the only Cedar Rapids hospital to earn this recognition.

“We are thrilled to receive this recognition,” said Diane Seelau, St. Luke’s Center for Women’s & Children’s Health director. “We’ve always known our team provided exceptional care and this further demonstrates St. Luke’s dedication to the highest level of care for moms and babies. We are proud of our team and grateful for the honor.”

ST. LUKE’S LIFEGUARD AIR AMBULANCE RECEIVES ACCREDITATION

St. Luke’s LifeGuard Air Ambulance received a three-year accreditation from the Commission on the Accreditation of Medical Transport Systems (CAMTS).

CAMTS is an organization dedicated to improving the quality and safety of medical transport services. The Commission offers a voluntary evaluation program, and to obtain accreditation, a medical transport service must be in substantial compliance with the Accreditation Standards.

“We are incredibly proud of our LifeGuard flight team and this long-term program,” said Jordan Kelly, St. Luke’s LifeGuard program manager. “This accreditation demonstrates our commitment to excellence, safety and the steps we take to ensure high quality patient care.”

Thousands of individuals have been helped by St. Luke’s LifeGuard Air Ambulance since it came into service 40 years ago in 1981.

LifeGuard is one of five air medical programs in the state to earn CAMTS accreditation and among 162 in the U.S. and Canada.

ST. LUKE’S WITWER CHILDREN’S THERAPY EXPANDING

St. Luke’s is expanding its Cedar Rapids Witwer Children’s Therapy facility. The project is in response to a growing demand for its services, as patient visits have increased by more than 50 percent in the past decade. That includes a record number of visits in 2021, exceeding pre-pandemic records by 20 percent. Anticipated completion date is spring 2022.

Witwer Children’s Therapy operates two clinics, the one in Cedar Rapids and a second in Hiawatha. Both provide comprehensive services to children and adolescents through physical, occupational and speech therapies, along with nutrition and dietetics counseling. The expansion of the Cedar Rapids location at 3245 Williams Parkway Southwest will add 3,400 square feet of leased space, adding three new therapy suites. It will also include the purchase of specialty equipment, and the lobby and waiting areas will be remodeled to improve flow and increase capacity.

“The scope of patients Witwer serves is expansive and encompasses the largest and most comprehensive therapy provided in the area,” said Julie Gasway, St. Luke’s Witwer Children’s Therapy manager. “We treat children with autism, ADHD, developmental and learning delays, feeding and swallowing challenges, balance issues, seizure disorders, cerebral palsy, spina bifida, speech delays, auditory processing difficulties, hearing loss, cleft palate and newborn feeding. The expansion will give us the ability to see more patients to address the rising number of children with these and other needs.”

St. Luke’s Foundation provided initial funding for the project, raising $275,000 in less than three months, thanks to the Wayne and Nan Kocourek Foundation, a TransAmerica Grant and donations from private donors.

Dean Abramson, MD, UnityPoint Health –Gastroenterology

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Healthy Hearts has been the focus of St. Luke’s since 1978. Our long legacy as Cedar Rapids’ Heart Hospital and experience performing the most advanced heart procedures locally, are why more patients trust St. Luke’s with their hearts.

Take time to recognize the symptoms of a heart attack and adopt a healthy lifestyle today. Visit unitypoint.org/heart to learn more.

Wherever

see these hearts around the community, let them remind you to take care of your heart.

Artwork by Cedar Rapids Artist Laura Saylor Smith