St. Luke's Hospital Healthbeat Winter 2011

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Emergency! Student saved by expert care PAGE 2

Beating the odds Surviving two medical emergencies PAGE 8

Cancer care excellence St. Luke’s earns prestigious designation PAGE 10


What’s Inside 1

Health Clips

Health news you can use.

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Emergency!

CPR and expert ER care save a student’s life.

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A minimally invasive approach in heart care

New cardiac catheterization procedure is more convenient for patients.

6 - 7 Doubly blessed

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8 -9 St. Luke’s

healthbeat Vol. 16 No. 1  winter 2011 healthbeat magazine is produced locally by St. Luke’s Marketing Communications for the community and friends of St. Luke’s Hospital P.O. Box 3026 Cedar Rapids, IA 52406-3026 319/369-7395

NICU care saves tiny twins.

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Beating the odds

Palo man survives two emergencies.

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A new standard in cancer care

Cancer diagnosis doesn’t slow Marion woman.

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Ask the expert

When should I go to the doctor for a cold or the flu?

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For your health

Timely health and medical news.

Cover

Samuel Gordon is back in class after collapsing last summer.

stlukescr.org  |  m.stlukescr.org

Missed the last issue? A better place to be

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All stories from Healthbeat, Fall 2010, are available at stlukescr.org.

Connect with St. Luke’s at stlukescr.org


Health Clips Caring for smiles There are many more smiles in eastern Iowa thanks to St. Luke’s Dental Health Center. Since its opening in 1976 the goals have remained the same – to provide quality, low-cost dental services to infants, children and adolescents in need of financial assistance and developmentally disabled adults. “There is a definite need for these services in eastern Iowa,” said Rhys Jones, DDS, MS, director of St. Luke’s Dental Health Center. Last year, we provided dental care to 4,200 patients – most of them children, which amounted to about $800,000 worth of work. Since the 2008 flood, St. Luke’s Dental Health Center has seen about a 20 percent increase in need for its services.” To keep up with community needs, St. Luke’s Health Care Foundation spearheaded a fundraising campaign “Spark a Smile” to raise money to pay for the clinic’s expansion, renovation and equipment updates. The total cost of the project was $730,000. The project added almost 600 square feet. Since it opened St. Luke’s Dental Health Center has cared for over 120,000 individuals.

St. Luke’s Health Care Foundation continues to raise money for the “Spark a Smile” campaign – individuals who wish to donate may call the Foundation at 319/369-7716 or log on to stlukescr.org.

Advanced Newborn Intensive Care According to new state guidelines St. Luke’s is now considered a Level II Regional Neonatology Center, a more advanced category – up from a Level II Regional Center. What this designation means is that St. Luke’s manages high-risk pregnancies and babies under 34 weeks gestation (40 weeks is full term); St. Luke’s Newborn Intensive Care (NICU) cares for babies at 23 weeks gestation and up. Care is provided on a continuous (24/7) basis, neonatologists and a pediatric cardiologist are active on staff, neonatal diagnostic imaging and laboratory capabilities are available round-the-clock, as are advanced critical care nurses, respiratory therapists, certified lab technicians, X-ray technologists and ultrasound technicians with neonatal experience. Nurses working at a Level II Regional Neonatology Center also have specialty certifications or advanced training.

A level II Regional Neonatology Center also maintains an active neonatal transport team, a NICU developmental follow-up clinic and a community outreach program. “The Iowa Department of Public Health is recognizing with this designation what we have been doing for a long time: a strong commitment in terms of our manpower, experience, training and technology in providing the best neonatal care available anywhere,” said Dennis Rosenblum, MD, St. Luke’s NICU medical director. The bottom line? Babies cared for at St. Luke’s will have the best care available in Cedar Rapids should they need NICU care.

To learn more about St. Luke’s NICU log on to stlukescr.org.

St. Luke’s on the go! St. Luke’s is the only hospital in Cedar Rapids to post real-time ER and urgent care wait times online in an effort to help you make informed decisions. Both St. Luke’s ER and our urgent care clinics update wait times every two hours. Times reflect the time it takes to get from the waiting room to an exam room. The average wait time from arrival to a private room in St. Luke’s ER takes less than eight minutes. And to help individuals on the go – St. Luke’s has created a mobile site for easier access to wait times and other hospital information. You can find it at m.stlukescr.org. St. Luke’s healthbeat  |  winter 2011  |

1


CPR and expert ER care save student’s life I

t’s probably safe to say that Coe College Freshman Samuel Gordon learned more in his first week of college than most of his classmates. “A medical emergency can happen to anyone – and just because you are young doesn’t mean you are invincible,” said Gordon. “I’m living proof and thankfully I am here to talk about it.” In late August Gordon had just finished playing tennis with one of his dorm mates and decided to go for a run at a nearby track. After that things get a little fuzzy for the 18-year-old. “I guess I started running but stopped and sat down on the bleachers, fell backwards and lost consciousness,” said Gordon. “Several people rushed to help me. Someone called 9-1-1 and others started cardiopulmonary resuscitation (CPR).” Dr. Josh Pruitt, St. Luke’s Emergency Room (ER) doctor and Lifeguard Air Ambulance medical director credits the Coe College women’s soccer team members and a student trainer who got Gordon the help he needed quickly.

Quick thinking “Those kids at Coe did a great job,” said Dr. Pruitt. “They called 9-1-1 when they determined Gordon wasn’t breathing and started performing CPR right away. They did all of the right things – and it led to a much better outcome for Samuel.”

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When Gordon arrived via ambulance at St. Luke’s ER his pulse rate was extremely high, he was non-responsive, sweaty and had a dangerously high temperature of nearly 104 degrees. “At that point we weren’t exactly sure what was going on; if he was septic, if he had heat stroke or if he had some sort of overwhelming infection,” said Dr. Pruitt. “Plus the complicating factor was that he had somehow arrested.” Gordon was moved to one of St. Luke’s critical care rooms, which is equipped with all of the latest technology like wireless electrocardiograms (EKGs) and heart monitors, allowing multiple doctors and nurses to work on a patient in the ER. “Samuel was not breathing on his own and one of the Lifeguard nurses intubated him,” said Dr. Pruitt. “We started an IV to give him fluids. We quickly determined since he had been exercising the most obvious medical issue could be heat stroke so we packed several areas of his body with ice to cool him down and also worked to stabilize his pulse.” Samuel Gordon on the Coe College campus in Cedar Rapids.


In addition to heat stroke Gordon, who suffers from asthma, went into respiratory arrest when he was exercising.

St. Luke’s CCU provides expert one-onone nursing care for some of the most critical patients.

“Samuel is from Colorado and had been at Coe for less than a week,” said Dr. Pruitt. “His body was adjusting to a more humid and hot climate. The day of his collapse was one where it wasn’t so hot but it was extremely humid. Samuel comes from a totally different climate and his body got into trouble.”

“Samuel spent three days in CCU,” said Brown. “It was satisfying for me to see this 18-year-old who was just starting college recover as well as he did and not have any issues as a result of this medical emergency. We also worked to accommodate his mother who traveled to Cedar Rapids from Colorado – we wanted to provide as much support as possible. It’s our mission at St. Luke’s to provide the care we’d want our loved ones to receive…and that’s what we did for Samuel.”

Full recovery Once Gordon was stabilized he was transported to St. Luke’s Cardiac Care Unit (CCU). “I remember waking up a few times with a tube down my throat,” said Gordon. “I was in and out of consciousness. I remember seeing my mom with red eyes and crying. I remember people stopping to see how I was, faculty members and a couple of the soccer girls who saved my life.” “As the day turned into night, Samuel’s condition improved,” said Robin Brown, CCU registered nurse. “I think he did so well because of what was done for him right away after he collapsed at Coe and in St. Luke’s ER.”

“I am thankful for those soccer girls who started CPR,” said Gordon. “I’m thankful for all of the doctors and nurses at St. Luke’s. I probably wouldn’t be here if it wasn’t for them, they all saved my life.” To get a behind the scenes look of St. Luke’s Emergency Department log on to stlukescr.org and watch Inside St. Luke’s ER.

“They were very nice at St. Luke’s,” said Gordon. “They really took an interest in me and wanted to make sure I got back on my feet quickly. I also had a lot of visitors from Coe and the hospital staff was very accommodating.” “This is one case I will never forget, ever,” said Dr. Pruitt. “When I was working on him I just kept thinking here is this 18-year-old who is really trying to die and he has all of these issues going on. Thankfully he pulled through and made a full recovery, which is just remarkable.” Josh Pruitt, MD, St. Luke’s Emergency Room

Save a life, learn CPR – The following summarizes the steps to perform adult CPR: ➊ Make sure the scene is safe. ➋ Shake the victim’s shoulders and shout to see if they respond.

➌ If the victim does not respond and is not breathing or not breathing normally, yell for someone to call 9-1-1 and get an automated external defibrillator (AED), if available. • If you’re alone, call 9-1-1 and get an AED if available. Follow the AED’s voice prompts. • If no AED is available, immediately start CPR, beginning with compressions.

COMPRESSIONS BREATHING ➍ Push hard and fast on the center of the ➏ Pinch the victim’s nose closed. chest 30 times, at a rate of at least 100 compressions a minute. Push down at least two inches with each compression. If you haven’t been trained in CPR, continue to give compressions until an AED arrives or trained help takes over.

AIRWAY ➎ If you have been trained in CPR, continue CPR by opening the airway with a head tilt–chin lift.

Take a normal breath and cover the victim’s mouth with your mouth, creating an airtight seal. Give two breaths (one second each). Watch for the chest to rise as you give each breath.

➐ Keep giving sets of 30 compressions and two breaths until the AED arrives or trained help takes over. Source: American Heart Association

St. Luke’s healthbeat  |  winter 2011  |

3


A minimally invasive approach

in heart care

Roy Venzon, MD, Cardiologists, L.C.

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argaret Clark is active. The 71-yearold Belle Plaine woman walks two miles, four times a week with her daughter. She also cares for her sixmonth-old great-grandson once a week and runs after her other grandchildren and great-grandchildren. So when she had persistent chest pain she chalked it up to acid reflux. “It didn’t occur to me initially that it could be something to do with my heart,” said Clark. “I mentioned it to my family doctor and he suggested we check it out. I had a stress test and an electrocardiogram (EKG). Both tests indicated there were no heart troubles. But the pain persisted.” “Stress tests and EKGs are good tests but they are not always 100 percent accurate,” said Roy Venzon, MD, Cardiologists, L.C. “In 10 to 20 percent of cases people have a normal stress test but end up having a heart attack.”

The chest pain continued. Clark felt a tightening in her chest and had shortness of breath any time she walked upstairs. It was impacting her everyday activities. “A couple times I was out walking and the pain was pretty severe and I would have to stop,” said Clark. “In retrospect I now think to myself ‘gosh I could have had a heart attack’ thankfully we found the trouble before it was too late.” Clark’s cardiologist, Dr. Venzon suggested Clark have an angiogram, which is an X-ray that uses a special dye and camera to take pictures of the blood flow to the heart. It is used to look for blockages.

It’s all in the wrist “Dr. Venzon told me he was doing a fairly new procedure to perform the angiogram using a cathether through the wrist,” said Clark. “He checked my pulse and a few other things and we set a date.”

Understand your risk for a heart attack Several factors increase the risk of heart disease and heart attack.

Increasing age

About 82 percent of people who die of heart disease are 65 or older.

Gender

Men have a greater risk of heart attack than women, and they have attacks earlier in life.

Heredity Children of parents with heart disease are more likely to develop it themselves.

Smoking

Smokers’ risk of developing heart disease is two to four times that of nonsmokers.

High blood cholesterol

As blood cholesterol rises, so does the risk of heart disease.

High blood pressure

High blood pressure increases the heart’s workload.

Physical inactivity 10 |   stlukescr.org 4

An inactive lifestyle is a risk factor for heart disease.

Obesity and overweight

People who have excess body fat – especially around the waist – are more likely to develop heart disease and stroke.

Diabetes

Diabetes seriously increases your risk of developing heart disease.

Stress

Some scientists have noted a relationship between heart disease risk and stress. Source: American Heart Association


“Over the past year at St. Luke’s we’ve started using the transradial cardiac catheterization approach,” said Dr. Venzon. “This approach uses the wrist, not the transfemoral or groin, for catheter insertion. This procedure has been around for a number of years but most doctors are trained in the transfemoral approach. In recent years the transradial approach has gained a wider acceptance because of improvements in equipment.” “Heart disease runs in my family,” said Clark. “My father and brother had heart problems. My brother also had a cardiac catheterization. His doctor used the approach through the groin. It was more invasive and he had an overnight hospital stay. I didn’t want that.”

Patient benefits “The main benefit of using the transradial versus the transfemoral approach is that it’s a lot more convenient for patients,” said Dr. Venzon. “The groin procedure requires people to typically lay flat on their back and leave their legs still for at least three hours after the procedure to let the incision heal. If we perform the wrist procedure patients do not have bed rest and can sit up or walk immediately.”

Dr. Venzon. “In some patients like Margaret – it’s possible for them to forgo an overnight hospital stay. She had an uncomplicated case. She was doing fine and able to go home.”

Shorter hospital stays “I went to my church the day after my procedure and everyone looked at me wondering why I was there,” Clark said. “They thought I would still be laid up.”

out,” said Clark. “I was very lucky I didn’t have a heart attack, I would tell others to get it checked out as soon as possible – don’t wait.” Find out if you have heart problems with St. Luke’s Heart Check, a series of five tests to assess your heart, vascular and stroke health. Call 319/369-8129 for more information or to schedule your appointment.

“Studies have shown using the transradial approach actually shortens the hospital stay,” said Dr. Venzon. “It is because people don’t have to be on bed rest afterwards.” “While I had wonderful care at St. Luke’s I’m just glad I didn’t have to stay overnight – I’d much rather be home,” said Clark. “St. Luke’s has always been our hospital.” These days Clark is back to her regular walks and offers a bit of advice. “I waited about a year and a half to get my chest pain checked

Transradial cardiac catheterizations typically have less complications and less risk of bleeding or problems with the artery following the procedure. Both procedures take about the same amount of time. Each patient has a very small incision about two or three millimeters. Doctors are able to do all of the same things with either approach; take pictures of the heart, angioplasty or stent placement. “I had my procedure on November 16,” said Clark. “I went in around 7 a.m., had the procedure and was sent home around 4 p.m. It was great. I had no pain and was able to walk around after the procedure.” “Margaret had a severe blockage in one of her arteries and I placed a stent,” said

Margaret Clark watching her great-grandson in her Belle Plaine home.

St. Luke’s healthbeat  |  winter 2011  |

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Doubly blessed NICU care saves tiny twins

The contractions didn’t stop and Holly developed a fever. It was determined she had an infection. Both babies started showing signs of distress – especially Eli who was seriously impacted by the infection.

Emergency C-section Anna Bruns, nearly six months old.

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hen Holly Bruns learned she was pregnant with twins last year she knew St. Luke’s would be where she would bring them into the world. Holly’s pregnancy was considered high risk because of previous pregnancies. She and her husband Wes knew St. Luke’s Newborn Intensive Care Unit (NICU) would provide their son and daughter with the best possible care if anything “unexpected” happened. At 21 weeks gestation (40 weeks is full term) Holly was put on home bed rest. Then at 25 weeks and four days along the “unexpected” happened. Holly woke up not feeling well on June 29, 2010.

The Brunses were told to prepare for an emergency C-section and rushed into one of the operating rooms at St. Luke’s Center for Women’s & Children’s Health. Eli was born at 8:07 p.m. weighing 1 pound, 14 ounces, sister Anna followed a minute later at 8:08 p.m. weighing the same as her brother. “They said if Holly had not delivered the babies when she did we would have lost both of them,” said Wes. “Eli was given antibiotics to help him fight the infection and St. Luke’s neonatologist Andrew Nordine, MD, worked to save his life.” “Both Eli and Anna were very sick when they were born,” said Scott Nau, MD, St. Luke’s NICU and Cedar Rapids Pediatrics. “Both babies needed help breathing and eating, which is common in premature

“I started having contractions,” said Holly. “I called my doctor and he told me to head to St. Luke’s. The hospital staff determined I was in labor and I was given medications to try and stop the contractions.”

“You can’t do this job and not get attached. I can’t imagine not doing this job because I enjoy it too much.” Scott Nau, MD, St. Luke’s NICU and Cedar Rapids Pediatrics

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babies. Eli was much sicker than Anna. He had many of the same complications that many preemies have.” “Because I was recovering from the surgery I wasn’t able to see Eli and Anna until around midnight,” said Holly. “However I think the reality of what happened didn’t really hit me until the next day when I saw them hooked up to all of those machines. We met with Drs. Nordine and Nau about what the twins needed and knew we had a long road ahead.”

Long road

things the twins had to do before they could go home was drink from a bottle within a 48 hour period. Both kids passed with flying colors.”

Eli Bruns, nearly six months old.

“We were very emotional when we left St. Luke’s NICU,” said Holly. “We were glad to be finally going home with both kids, but we were going to miss

A long road indeed – 117 days to be precise, that’s how many days Eli and Anna spent in St. Luke’s NICU. “The days were spent with multiple ultrasounds, tests and treatments,” said Holly. “It was overwhelming at times. But everyone in St. Luke’s NICU was very supportive and helped us through some tough times.” “They were not only concerned about Eli and Anna’s well-being but ours as well,” said Wes. “They would also ask about our daughters Allie and Grace who were at home. The doctors and nurses at St. Luke’s have become a part of our extended family.” “I bleed when they bleed,” said Dr. Nau. “You can’t do this job and not get attached. Both Eli and Anna continue to make progress and grow. I enjoy watching that progress. Seeing kids I cared for 25 years ago grow up – it’s hard to beat. I can’t imagine not doing this job because I enjoy it too much.” On October 23, 2010, Eli and Anna were released from St. Luke’s NICU. At home welcoming them were big sisters Allie, 6 and Grace, 3. Both girls were excited to have their new siblings at home. “I knew St. Luke’s NICU doctors and nurses had done everything they could for them and they would not have sent them home if they weren’t ready,” said Wes. “One of the

everyone who cared for the twins. It was bittersweet. I was scared because we had expert care 24/7 at St. Luke’s and at home it’s up to us. I had to get to a point where I had to have faith and let go a little bit.” “We’ve had several St. Luke’s NICU nurses call and e-mail us since we have been home from the hospital,” said Wes. “You really can’t find that kind of care anywhere – it’s unbelievable.”

Home at last Life at home today is very busy for the Brunses. The Cedar Rapids family is working on establishing a routine and adjusting to life as a family of six. The couple is thankful for the help of family and friends who have supported them through this lifechanging experience. They also enjoy seeing glimpses of each child’s personality unfold. “Eli is very laid back,” said Wes. “And Anna is our little fire cracker.”

“We are thankful for the expert care Eli and Anna received at St. Luke’s NICU,” said Holly. “They let us cry with them, lean on them during dark times and ultimately saved Eli and Anna’s lives – for that we are grateful.” For a personal tour of our birth suites or Newborn Intensive Care Unit call 319/369-8129 or log on to stlukescr.org for a video tour. St. Luke’s healthbeat  |  winter 2011  |

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Beating the odds Palo man survives two emergencies

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teve Blood beat the odds. The 53-year-old Palo man suffered a heart attack July 4 and a week later went into cardiac arrest and nearly died. He’s alive today because strangers performed cardiopulmonary resuscitation (CPR) and used an automated external defibrillator (AED). Most individuals who suffer cardiac arrest outside of a hospital have less than a seven percent chance of survival. Blood is a lucky man. “I realize now that I should never have waited as long as I did to seek help,” said Blood. “I honestly didn’t think I was having a heart attack.”

Blood and his wife Deb were celebrating the Fourth of July boating near McGregor when he started to feel chest pain. “The pains started on Sunday and lasted until Monday when I realized I needed to go to the hospital,” said Blood. “I made up every excuse I could think of except for my heart. I experienced a dull ache that radiated across my chest. When I got up and moved it went away but when I sat down it would start again. I thought it can’t be a heart attack, it should hurt more.” Blood sought help at St. Luke’s Emergency Room (ER) where it was quickly determined he was having a heart attack. He was transferred to the cardiac catheterization (cath) lab where doctors opened one of his arteries within 60 minutes of his arrival. “One of his coronary arteries was 99 percent blocked,” said Roy Venzon, MD, an interventional cardiologist, with Cardiologists, L.C. “A stent was placed

to open up the blockage and he stayed one night in a private room at St. Luke’s.” Following his release from the hospital, Blood started Cardiac Rehabilitation classes at St. Luke’s. “It’s a wonderful program that taught me about healthy eating and exercising,” Blood said. “I highly recommend it. I don’t think people realize a lot of what they eat is not good for them.”

Cardiac arrest Less than a week after Blood’s heart attack he and his wife, Deb went to dinner in Vinton. They were leaving the restaurant and were headed to a movie when Blood collapsed. “I went to get my glasses out of my truck and took two or three steps when somebody flipped the light switch and I fell,” said Blood. “I felt no pain, just a light, dizzy rush to my head. When I woke up they were loading me into a helicopter and flying me to Cedar Rapids.”

“ When you have a cardiac arrest that means the heart goes out of rhythm, which causes people to collapse and most of the time is fatal.” Mohit Chawla, MD, Cardiologists, L.C.

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After Blood collapsed witnesses called 9-1-1 and started CPR. A Vinton police officer arrived and immediately used an AED. Blood was flown to St. Luke’s in Lifeguard Air Ambulance and immediately rushed to the cath lab where doctors determined there were no additional heart blockages. “His collapse was the result of cardiac arrest, which was caused by a heart rhythm problem,” said Dr. Venzon. “I referred him to one of my colleagues for further treatment.” “Rescue crews using the AED after his collapse essentially brought Steve back to life,” said Mohit Chawla, MD, an electrophysiologist with Cardiologists, L.C. “He had a ventricular arrhythmia, which is a life threatening rhythm problem. His was unusual because he probably had enough heart damage from his previous heart attack the week before that he had a moderate amount of scarring in his heart and that additional scarring made his heart more prone to having rhythm problems.”

Blood recognizes his good fortune. He credits the Vinton police officer, St. Luke’s Lifeguard Air Ambulance and many doctors and nurses at St. Luke’s with saving his life. “There’s no doubt I’m here because of quick thinking and expert care,” said Blood. “I feel extremely lucky. If you think you are having a heart attack don’t wait to go to the hospital like I did. The longer you wait the more potential there is

St. Luke’s is an Accredited Chest Pain Center with the Society of Chest Pain Centers (SCPC). This accreditation recognizes St. Luke’s higher level of expertise in dealing with patients who arrive at the hospital with symptoms of a heart attack. To learn more about St. Luke’s Heart Care log on to stlukescr.org.

for heart damage like what happened in my case.” Today Blood is watching what he eats and exercising more. The Palo man is also hunting and fishing. It’s a hobby that keeps him active and gives him great enjoyment – something he feels lucky to do once again.

Defibrillator implanted To prevent a future cardiac arrest Dr. Chawla placed a defibrillator through an incision in Blood’s left shoulder. The defibrillator monitors the heart and if he has another episode it will shock Blood’s heart back into a normal rhythm. “Steve is very lucky,” said Dr. Chawla. “Cardiac arrest is very different from a heart attack. A heart attack is when you have a blockage, no blood flows to the heart. When you have a cardiac arrest that means the heart goes out of rhythm, which causes people to collapse and most of the time is fatal. It was lucky Steve received help immediately.”

Steve Blood gets his boat ready for duck hunting season.

St. Luke’s healthbeat  |  winter 2011  |

9


A new standard in

cancer care

Cancer diagnosis doesn’t slow Marion woman

A

nn Bromley never let cancer slow her down. After receiving a breast cancer diagnosis in March 2009 the 71-year-old Marion woman went to lunch. It was a date she had on her calendar for some time. “I thought to myself ‘I’m not going to miss lunch with my friends’,” said Bromley. “They of course were of great comfort to me as I learned the news. A couple of my friends are breast cancer survivors.” According to the National Cancer Institute (NCI) approximately one in eight women will be diagnosed with breast cancer during their lifetime. Bromley’s breast cancer was found during her annual mammogram. “I was called back after my first mammogram,” said Bromley. “During the recheck they saw what they referred to as calcified crystals and said I needed a biopsy. A short time later I was diagnosed with breast cancer.”

Treatment options After her diagnosis Bromley met with Robert Brimmer, MD, Physicians’ Clinic of Iowa, P.C., Surgical Specialists. “I talked with Ann about her options,” said Dr. Brimmer. “Usually that involves staging the tumor, explaining where it is, how big it is and whether lymph nodes are involved. I want the patient to have all the information she needs to make an informed and educated decision about her care.” “Dr. Brimmer was wonderful,” said Bromley. “He explained that I could have a total 10 |   stlukescr.org

Ann Bromley participating in the St. Luke’s Cook Cancer Wellness Program.


mastectomy or a lumpectomy with radiation therapy.” “A total mastectomy is an operation that removes the entire breast,” said Dr. Brimmer. “Following surgery the patient may either use a breast prosthesis or consult with a plastic surgeon and choose breast reconstruction. A lumpectomy is surgery to remove cancer or other abnormal tissue from your breast. Radiation therapy always follows a lumpectomy after the patient is evaluated to identify the extent of disease including the size of the tumor and possible involvement of lymph nodes.” “I talked with my husband Bob and decided to have a total mastectomy,” said Bromley. “I knew I didn’t want to endure six weeks of radiation therapy, five days a week. I was too busy living and didn’t have time for that.” “It’s up to the patient what direction she decides,” said Dr. Brimmer. “Both options have identical survival rates.” Bromley’s mastectomy took place on April 14, 2009. She stayed in a private room at St. Luke’s for one night. “The care was wonderful,” said Bromley. “Everyone was great during my stay at St. Luke’s. They took really good care of me and even gave me special treatment when I asked for something that wasn’t on the menu.”

Cook Cancer Wellness Program Today Ann Bromley is a nearly two-year cancer survivor. She recently started utilizing the St. Luke’s Cook Cancer Wellness Program, which is a free program that helps

St. Luke’s cancer program accredited The cancer program at St. Luke’s Hospital earned a three-year accreditation with commendation from the Commission on Cancer (CoC) of the American College of Surgeons. Only about 25 percent of hospitals receive this honor. In 2009, St. Luke’s cared for nearly 50 percent of Linn County cancer patients treated at a Cedar Rapids hospital. “St. Luke’s is dedicated to offering patients the very best cancer care.” said Robert Brimmer, MD, FACS, Physicians’ Clinic of Iowa, P.C. general surgeon and cancer liaison physician for the cancer care program at St. Luke’s. “Recognition by the Commission on Cancer affirms the quality of this comprehensive and

cancer patients improve their quality of life by providing physical, nutritional and psychosocial support. Use of the St. Luke’s Cook Cancer Wellness Program doesn’t end when the patient stops treatment. It’s available to individuals like Ann Bromley for as long as they need it. “I primarily take advantage of the exercise portion of the program,” said Bromley. “I meet with an exercise specialist once a week. I’m also interested in taking advantage of the nutritional information. It’s a wonderful resource to me and has provided me with great support.”

multidisciplinary program along with the spirit and efforts of many dedicated staff.” “This designation for St. Luke’s means the entire care team is dedicated to providing the very best in patient care for the entire community,” said Thomas Warren, MD, Iowa Blood and Cancer of Physicians’ Clinic of Iowa, P.C. St. Luke’s Cancer Care is experienced in treating many forms of cancer with the most common cancers being breast, lung, prostate, colon and bladder cancer.

“I thoroughly enjoy life and won’t let it slow me down,” said Bromley. “My husband and I love to travel but it’s always good to come home and know we can get great care at St. Luke’s – I wouldn’t have thought to go anywhere else for care.” To learn more about St. Luke’s Cancer Care call 319/369-7836 or to make a contribution to the Cook Cancer Wellness Program call the St. Luke’s Foundation 319/369-7716.

Bromley admits being a cancer survivor is always in the back of her mind but it’s not something she spends a lot of time dwelling on.

“I want the patient to have all the information she needs to make an informed and educated decision about her care.” Robert Brimmer, MD, FACS Physicians’ Clinic of Iowa, P.C.

St. Luke’s healthbeat  |  winter 2011  | 11


Ask the expert When should I go to the doctor for a cold or the flu?

L

ast influenza (flu) season a new and very different flu virus called 2009 H1N1 spread worldwide causing the first flu pandemic in more than 40 years. This influenza resulted in substantial illnesses, hospitalizations and deaths. Influenza is a contagious respiratory illness caused by flu viruses. It can cause mild to severe illness, and at times can lead to death. The Centers for Disease Control and Prevention (CDC) estimates that from 1976 to 2007, flu-associated deaths ranged from a low of about 3,000 to a high of about 49,000 people. The flu is different from a cold. The flu usually comes on suddenly with muscle aches – similar to those experienced the day after a strenuous workout.

mean you need emergency care,” said Dr. Shedek. “But if you have a fever, sore throat, plus one of the warning signs seek medical care immediately.” Most illnesses resolve in seven days and if you are still experiencing symptoms after this time period you should see a doctor even if you don’t have any of the warning signs. “The virus itself is basically spread through the mucus that resides in the back of your throat and it’s spread by sneezing or coming in contact with that mucus,” said Dr. Shedek. “So the best way to prevent a bacterial or viral infection is to frequently wash your hands.” Check St. Luke’s ER and Urgent Care wait times at stlukescr.org or on our mobile site at m.stlukescr.org.

“Influenza is typically a mild viral illness that can typically be managed at home and does not require an Emergency Room (ER) visit,” said Brian Shedek, DO, St. Luke’s ER doctor. “Occasionally these illnesses progress to more severe symptoms and become complicated by bacterial infections.” If you get sick with flu-like symptoms, you should stay home and avoid contact with other people. Most people with the flu have mild illness and do not need medical care. However, some people like young children, people age 65 and older, and individuals with chronic health conditions may need medical care if they get the flu. They should contact their family doctor to determine if medical care is needed. “Just because you have a fever and a sore throat or a fever and a cough – doesn’t

Brian Shedek, DO St. Luke’s Emergency Room

Go to St. Luke’s ER immediately if you or someone you care about has these symptoms: • Difficulty breathing or shortness of breath • Pain or pressure in the chest or abdomen • Sudden dizziness • Confusion or sudden behavior change • Lethargy

12 |   stlukescr.org

• Severe or persistent vomiting • Signs of dehydration (dry mouth, dizziness while standing, decreased urination) • Flu–like symptoms that improve but then return with fever and worse cough • Baby under three months with a fever (oral temperature above 100.4 F)


RoughRiders Go Red

For your health Alzheimer’s: Know the 10 Warning Signs

It may be difficult to know the difference between age-related changes and the first signs of Alzheimer’s. Early detection, diagnosis and intervention are vital because they provide the best opportunities for treatment, support and planning for the future. At this interactive workshop presented by the Alzheimer’s Association, we’ll separate myth from reality and address commonly-held fears about Alzheimer’s. Tuesday, January 25 • 7 – 8 p.m. St. Luke’s Hospital, 3rd Floor Heart Center Classrooms FREE Visit stlukescr.org or call

319/369-7395 to register.

The Stable will Go Red to fight heart disease during an upcoming Cedar Rapids RoughRiders game. Heart disease is the leading cause of death in the United States. St. Luke’s, the RoughRiders and the American Heart Association (AHA) are teaming up to bring about awareness of this deadly disease during National Heart Month. On Saturday, February 5 during the RoughRiders match-up against Des Moines, heart healthy messages will be featured throughout the game. The first 2,000 fans will receive red cow bells, a silent auction will be held and a portion of the ticket proceeds will be donated to AHA. Tickets can be purchased at ridertownusa.com or by calling 319/247-0340.

Cooking with a Cardiologist Join a doctor from Cardiologists, L.C. and a Hy-Vee registered dietitian to learn how to improve your heart health, and prepare a delicious, heart-healthy meal. Food samples and wine pairings will be provided. Each week will feature a different menu. • Thursday, February 3, 6 - 7 p.m., Edgewood Rd. Hy-Vee • Tuesday, February 8, 6 - 7 p.m., Johnson Ave. Hy-Vee • Wednesday, February 16, 6 - 7 p.m., Oakland Rd. Hy-Vee • Tuesday, February 22, 6 - 7 p.m., Marion Hy-Vee The events are free; however registration is required at least three days before the event and space is limited.

Matthew McMahon, DO Cardiologists, L.C.

Michael Muellerleile, MD Cardiologists, L.C.

Visit stlukescr.org or call 319/369-7395 to register.

St. Luke’s healthbeat  |  winter 2011  | 13


1026 A Avenue NE P.O. Box 3026 Cedar Rapids, IA 52406-3026

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healthbeat St. Luke’s

We apologize for mailing problems such as duplicate copies. If you have questions or concerns about healthbeat magazine, please call us at 319/369-7395 or e-mail stlukes@crstlukes.com. © 2011 by St. Luke’s Hospital, Cedar Rapids, IA

ST. LUKE’S

Saving lives. One heart at a time.

Heart disease and stroke risk often have no signs or symptoms. But St. Luke’s Heart Check is an easy and convenient way to assess your heart and vascular health. A series of five tests is performed by St. Luke’s heart care experts. In fact, you’ll find out your results at the time of your appointment so there’s no waiting and worrying. The cost for all five tests plus a consultation with a St. Luke’s heart care expert is $195. • Electrocardiogram (EKG) • Echocardiogram (ECHO) • Abdominal aortic aneurysm test • Carotid artery ultrasound

A comprehensive blood test is also available for $40.

• Ankle-Brachial Index test for Peripheral Arterial Disease (PAD)

Call 319/369-8129 to schedule or visit stlukesheartcheck.com for more information.


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