Winter 2019
CEDAR RAPIDS
BABY TREATED BEFORE BIRTH Routine Check-up Discovered Fast Heart Beat
ROBOTIC SURGERY HELPS NEW MOM Minimally Invasive Surgery = Faster Recovery
NORMAL DAY TO LIFE-THREATENING From Diagnosis to Treatment in 60 minutes
ASK THE EXPERT What Do the New Cholesterol Guidelines Mean for Me?
unitypoint.org
WHAT’S INSIDE 1
Health Clips Health news you can use.
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Unborn Baby Treated Before Birth A routine check-up discovered an abnormally fast heart beat in an unborn baby and allowed her to receive treatment before birth.
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Robotic Surgery Returns Quality of Life A robotic hysterectomy returned a Monticello mom back to chasing her toddler in no time.
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Normal Day to Life-Threatening in Minutes A Cedar Rapids man is grateful for the fast thinking ER team and surgeons who saved his life when his “normal day” turned into a medical emergency.
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Minimally Invasive Heart Repair Prolongs Life A minimally invasive procedure for individuals with failing heart valves, that are not candidates for surgical valve replacement.
10 Pregnancy Over 35 = Advanced Maternal Age Our Maternal Fetal Medicine medical director talks about the trend towards older first time moms and whether it’s cause for concern. 11 Meet our Neurosurgeon Welcome Dr. Ahmad Bader to the UnityPoint Health team. He talks about what a neurosurgeon does and why he loves his job. 12 Ask the Expert What do the new cholesterol guidelines mean for me?
Know the Signs of a
Heart Attack Having a heart attack is a life and death emergency. Every minute counts. Never ignore symptoms or warning signs. Some heart attacks come on suddenly with intense pain and discomfort. Many times the discomfort may start slowly and the pain may be mild. CALL 911 IF YOU HAVE THE FOLLOWING SIGNS: • Chest discomfort or uncomfortable fullness, pressure, squeezing or pain in the chest that lasts more than a few minutes. It may go away and come back again. The discomfort may range from feeling mild to unbearable. • Upper body discomfort in the shoulders, jaw, one or both arms or the back or upper part of the stomach. • Fullness, indigestion or a choking feeling, which may feel like heartburn. • Shortness of breath, with or without chest discomfort (this could be your only symptom). • Breaking out into a cold sweat, having nausea (feeling sick to your stomach) or sudden dizziness or lightheadedness. FOR WOMEN Signs of a heart attack for women may include any of the above signs but many times women may not have chest discomfort. Some additional signs for women may include: • Upper back, shoulder or jaw pain. • Unexplained tiredness or weakness (sometimes for days). • Discomfort in the upper part of the stomach, feeling like indigestion. Discomfort in one form or another almost always accompanies a heart attack. The symptoms of heart attack may occur alone or in any of the following combinations:
Middle to upper chest
Mid-chest, throat and jaw
Winter 2019 LiveWell magazine is produced by UnityPoint Health®. P.O. Box 3026 | Cedar Rapids, IA 52406 (319) 369-7395 | unitypoint.org Copyright ® 2019 UnityPoint Health. All Rights Reserved. ® SM trademarks of UnityPoint Health.
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Chest, throat, jaw and inside arms
Mid-chest and inside arms. Left arm and shoulder pain more frequent than right
Throat and jaw
Inside arms, often more severe in left arm and shoulder
Upper abdomen
Between shoulder blades
Health Clips Easier & More Convenient Care There are two ways for you to conveniently receive care with UnityPoint Health.
St. Luke’s Receives Magnet® Redesignation
UnityPoint Clinic Urgent Care offers walk-in care for minor illness and injury. With four convenient clinic locations in Cedar Rapids, Marion, Anamosa and Hiawatha, you have easy access to care when you need it.
St. Luke’s Hospital has succeeded in achieving Magnet® recognition for a third time from the American Nurses Credentialing Center (ANCC), signifying successful implementation of the national Magnet standards for nursing excellence.
Check in online at any of the urgent care locations and we'll reserve your place in line — until your estimated visit time.
Less than 10 percent of registered hospitals in the U.S. have earned this recognition. St. Luke’s was Magnet-designated in 2009 and received its first redesignation in 2014.
After the urgent care clinics are closed: St. Luke’s Emergency Room (ER) has an option for individuals with minor illnesses and injuries. It’s called ER Check-in. It allows you to choose a time that works for you, allowing you to wait in the comfort of your own home. Then when it’s close to your time, head over to the ER to be seen by a provider. If your condition is life threatening, you need to call 911 or go immediately to UnityPoint Health — St. Luke’s ER.
FIND THE CARE THAT’S RIGHT FOR YOU! To access urgent care check-in, go to unitypoint.org/ urgentcare. To access St. Luke’s ER Check-in, visit unitypoint.org/ercheckin.
“Achieving Magnet for a third consecutive time is truly a celebration of the culture that has been created over many decades at St. Luke’s,” said Carmen Kleinsmith, UnityPoint Health – St. Luke’s vice president and chief nurse executive. “A real source of pride is our ongoing commitment to excellence and our desire to be an organization that others are drawn to. This honor is a validation of our efforts in creating a culture of safety for our patients and team members and that we are committed to supporting them in doing their best work.” Magnet is a road map for nursing excellence, which is based on evidence and research. According to ANCC, Magnet hospitals consistently outperform non-Magnet organizations with better patient outcomes and higher patient satisfaction rates. St. Luke’s is only one of six hospitals in Iowa that has achieved Magnet status. To watch a video of our announcement, go to bit.ly/SLMagnet.
How Healthy is Your Heart? Did you know half of the people who die of heart disease have no prior symptoms? Heart disease remains the leading killer in America. UnityPoint Health — Cedar Rapids Heart & Vascular Institute is your partner in heart health. Take proactive steps to take control of your heart health by eating healthier, exercising and finding out your heart disease risk with St. Luke’s Heart Check or Heart Scan.
$195. All tests are performed at St. Luke’s Hospital during one appointment. Heart Scan helps identify your risk for heart disease by taking X-ray pictures of your heart and detecting plaque in the arteries. The results help your doctor determine your risk of heart disease. Heart Scan is $99. It is for men and women between the ages of 40 and 70. All that’s needed is a doctor’s referral.
Heart Check is a screening of five tests to assess your heart Start your journey to a healthier heart by scheduling your and vascular health, as well as your risk for stroke. The cost Heart Check or Heart Scan today, call (319) 369-8129 or for all five tests, plus consultation with a heart care expert is learn more at unitypoint.org/heart. LiveWell Winter 2019 | 1
Pediatric Cardiology The Coughlin family in their Cedar Rapids home.
Doctors Treat Rare Heart Disorder in
Unborn Baby Emery Coughlin had a team of doctors at St. Luke’s caring for her before she was even born. When her mother, Hayley Coughlin, was 30 weeks pregnant (40 weeks is full-term) she went to see her obstetrician for a regular check-up. However, her appointment was far from routine. “The doctor was listening to Emery’s heart and she heard an arrhythmia (irregular heartbeat),” recalls Hayley. “I was referred to Dr. Bhurtel, a pediatric cardiologist. During the initial visit with Dr. Bhurtel, Emery’s heart rate skyrocketed twice to 250 beats per minute (160 is typical). I remember he told me I was going to need to be admitted to the hospital right away. I was shocked.”
“Emery’s case is very rare. Of the one to three percent of babies in utero with irregular heartbeats, very few have SVT.” “A heart arrhythmia or irregular heart beat is not uncommon during pregnancy, but most of the time it is a few random beats here and there,” explains Dilli Bhurtel, MD, UnityPoint Clinic – Pediatric Cardiology. 2 | unitypoint.org
“In those instances, we periodically monitor the baby and the extra beats resolve. In Emery’s case her irregular heart beat was extremely high, which warranted further monitoring. During an ultrasound, Emery went into an SVT (supraventricular tachycardia) episode with heart rates reaching 254 beats per minute.”
WHAT IS SVT? SVT is an abnormally fast heart beat that originates above the ventricles (bottom chambers of the heart). Dr. Bhurtel explained to Hayley and her husband Justin that he wanted to see how often Emery’s heart was going into SVT and how long each episode lasted. It would help determine if Emery needed treatment before birth. The only way they could accomplish this was to continuously monitor Emery in a hospital setting. During Hayley’s hospitalization, one of Emery’s SVT episodes lasted two hours. “Emery’s case is very rare,” explains Dr. Bhurtel. “Of the one to three percent of babies in utero with irregular heartbeats, very few have SVT. Emery’s SVT was likely in the beginning stages; otherwise she would have had other symptoms like decreased
heart function and fluid around her heart and lungs. We were fortunate to catch this early, as leaving SVT untreated can have dire consequences for the mother and baby.” Fetal SVT is different and unique because you must give the mother medication to treat the baby in the womb.
TREATMENT PLAN “Once it was determined they needed to treat Emery for SVT, they transferred me to the cardiac unit at St. Luke’s,” shares Hayley. “Dr. Bhurtel explained they wanted to give me medicine to help regulate Emery’s heart. In order for Emery to receive this medicine, I had to take a higher dose than they would normally give to an adult with this condition and they wanted to monitor both of us. The first medicine didn’t fully control Emery’s SVT, so I started taking a second medicine.” “Dr. Bhurtel and the nurses at St. Luke’s were really great and took such good care of Hayley,” remembers Justin. “I remember Dr. Bhurtel explaining if the second medicine didn’t work and control Emery’s SVT they would need to deliver early to prevent damage to her heart. It was scary.” “The medicines we give to control the fast heart rate can create heart issues in the mother, so we had to make sure Hayley was tolerating the medicines,” explains Dr. Bhurtel. “That’s why we needed her to stay in the hospital for nearly a week. Once we determined she was doing fine on both medications, Hayley was able to go home. After that we continued to monitor her as an outpatient every one to two weeks.” “Everything seemed to settle down until I hit 36 weeks in my pregnancy,” shares Hayley. “At that point I developed preeclampsia (high blood pressure). This was a totally separate issue. Doctors put me on bed rest but a week later they decided to induce me at 37 weeks.” Emery arrived Nov. 2, 2018. She weighed five pounds, two ounces and was 19 1/4 inches long.
SURROUNDED WITH CARE “Right away they moved her to St. Luke’s NICU,” shares Justin. “We knew this would be the plan before she was born. The doctors were able to monitor her and get her started on SVT medicine right way. Dr. Bhurtel and the whole St. Luke’s team
worked well together. Emery was in good hands and was in the NICU for a week.” “It was a great team effort,” shares Dr. Bhurtel. “Besides myself, we had a UnityPoint Health cardiologist, St. Luke’s neonatologists and the obstetrician caring for Hayley and Emery. We were pleased to keep her close to her home in Cedar Rapids. It was also exciting as this was the first known case of fetal SVT at St. Luke’s.” Emery’s future looks bright. She remains on medication for SVT, but babies usually grow out of it within their first year. In some cases, babies may stay on the medication until they are a little older and have a procedure to correct the issue. For now, Emery sees Dr. Bhurtel every six weeks for continued monitoring. “At the end of our journey I wondered, ‘why me?,’” shares Hayley. “Up to 30 weeks I had a fantastic pregnancy but then everything started happening so unexpectedly. I’m just glad I found Dr. Bhurtel and was able to receive this great care close to home. Dr. Bhurtel is passionate about what he does, and we love him. He and all of the nurses at St. Luke’s that took care of us were fantastic.” To speak with Dr. Bhurtel at UnityPoint Clinic – Pediatric Cardiology, call (319) 558-4951.
When to See a Pediatric Cardiologist If your child’s pediatrician or healthcare provider suspects a heart defect or problem, they will refer you to a pediatric cardiologist. Some heart defects may be evident at birth and will require immediate care and evaluation, while others may be detected later in the child’s life. Contact your doctor if these signs are present in your baby or child: • • • • • • •
Bluish tinge or color to the lips, tongue and/or nail beds. Difficulty breathing or an increased rate of breathing. Small appetite or trouble feeding. Weight loss or failure to gain weight. Chest pains, heart murmurs or palpitations. Dizziness or sweating. Reduced strength of a baby’s pulse.
To watch a video about pediatric cardiology, go to bit.ly/UPPedCardio.
LiveWell Winter 2019 | 3
Robotic Surgery Robyn and Chuck Luensman are able to enjoy more play time with their son, Max, after Robyn’s robotic hysterectomy last December.
Robotic Surgery
Helps Mother Get Back to Active Lifestyle Robyn Luensman jokes that she is in a “permanent state of
MOST ADVANCED SURGICAL ROBOT
tired.” The 45-year-old Monticello mother lovingly blames her
Luensman did some research and ultimately decided to have
16-month-old son, Max, for her exhaustion. When in reality
a robotic hysterectomy at St. Luke’s. The hospital was the first
something else was also causing her fatigue.
in Cedar Rapids to install the da Vinci surgical robot in its
“I noticed I was having irregular and prolonged menstrual
operating rooms in 2005. Since that time surgeons at St. Luke’s
cycles,” explains Luensman. “It was really slowing me down and causing quality of life issues for me. I knew I had to do something. I wanted to remain as active as I’ve always been
have performed 7,550 robotic surgeries. The hospital is also a robotic training center for other surgeons across the country. St. Luke’s recently installed the fourth generation da Vinci X
and didn’t want anything to prevent me from doing everything
Surgical Robot, which is the most advanced in Cedar Rapids.
I wanted to accomplish — especially when it comes to spending
To date, Jerry Rozeboom, MD, OB-GYN Associates, has
time with Max. He was a big motivation to do something.”
performed 2,900 robotic surgeries. He estimates nearly 98 to 99 percent of all the hysterectomies he performs are robotic.
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with ber.
“I believe over 90 percent of gynecological procedures should be done by some form of minimally invasive surgery,” explains Dr. Rozeboom. “I chose the robotic approach. In other parts of the country this is not always offered. The rate of open hysterectomy surgeries is around 25 to 30 percent in other communities. Open surgery involves a bigger incision, which usually equates to more recovery. I believe women should be aware there are minimally invasive options.”
“Robyn had a condition called adenomyosis, which is a form of endometriosis.” In December, Luensman had a robotic hysterectomy at St. Luke’s. Dr. Rozeboom performed the operation with Owen McCarron, MD, also of OB-GYN Associates, assisting. The procedure took less than an hour and she stayed one night at St. Luke’s. “Robyn had a condition called adenomyosis, which is a form of endometriosis,” explains Dr. Rozeboom. “All of the symptoms she was experiencing were due to this condition. Having the hysterectomy alleviates these troubles. It will also eliminate her
“Surgery took care of all the problems I was experiencing,” shares Luensman. “I figured since I was in good shape overall and healthy this was the best time to go ahead with surgery
potential for uterine and cervical cancer.”
rather than waiting to see if there would be any improvements
“The nurses were great, and everyone was really attentive,”
it. I just want to be the best I can be for Max and my husband,
shares Luensman. “I’ve had C-sections, so this was so much
Chuck, and this allows me to do that.”
in my condition. It was definitely a good choice. I am glad I did
better. I was feeling tired for a couple of days after the surgery and I never needed any of the pain medication Dr. Rozeboom prescribed. I was able to control the discomfort with over-thecounter medicine whenever I felt I needed it.”
FAST RECOVERY Three days after surgery Luensman was back chasing after Max and resuming her active lifestyle — just the way she planned it. “Robyn is practically the poster child for minimally invasive surgery,” Dr. Rozeboom shares. “She had no problems, very
Watch a Robotic Hysterectomy
procedure, with a fast recovery, with little pain control needed
We take you inside St. Luke’s operating room for a robotic hysterectomy. Watch as Drs. Jerry Rozeboom and Owen McCarron from OB-GYN Associates give you step-by-step descriptions during the procedure.
and they are back to normal activities quickly.”
Go to unitypoint.org/roboticsurgery to view the procedure.
little discomfort. She really exemplifies the vast majority of patients having robotic surgery. They do so well after the
LiveWell Winter 2019 | 5
Emergency Room Care Kevin Northway is thankful to remain active and is back riding his bike after undergoing emergency surgery in late 2017.
From a Normal Day to
LifeThreatening in Minutes Over the last 14 months Kevin Northway of Cedar Rapids has enjoyed a vacation with his wife, Pam, in Ashville, North Carolina for one of their “bucket list trips,” playing with his granddaughter, Harriett, who is 20 months old and spending quality time with his adult children and other close friends. These are life’s moments that Northway may have somewhat taken for granted before Dec. 19, 2017. That’s the day his perspective changed. “It was a normal day,” explained Northway. “I worked as usual. I left the office, got into my car and headed home. I was about to turn out of the drive from work when something felt odd in my abdomen. Then I started to feel a pinching in my shoulder and the first thing I thought of was, ‘well, maybe this is what a cardiac event feels like.’ I’m usually one of those guys who says, ‘OK, this will go away.’ But this just felt different than the usual aches and pains and I thought, ‘I need someone to check this out.’” Northway immediately drove himself to St. Luke’s Hospital Emergency Room. He parked his car and walked in and told the woman at the ER check-in desk he thought he was having a heart attack. “I must not have looked well because someone grabbed a wheelchair and put it behind me and I sat down or passed out
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because that was all I remember until sometime later when I
passed out in his car, maybe been in an accident and he would
woke up and I was in a trauma room with lots of doctors and
not have made it. It was a true emergency and he’s very lucky.”
nurses working on me.”
“I feel so fortunate,” shares Northway. “I feel like I dodged a
“Kevin initially presented and said he had chest pain that
bullet and it wasn’t my time. The ER team at St. Luke’s made me
radiated into his back,” recalls Donald Linder, DO, St. Luke’s
feel like I was going to be just fine. It was a well-oiled machine
ER. “When we hear that, worst case scenario is a thoracic,
that took such great care of me.”
intrathoracic or intraabdominal aneurysm. He was extremely pale and passed out — so we went on the assumption that is
EXPERIENCE MATTERS
what we were dealing with. All of these added up to a vascular
“I remember Kevin,” shares Dr. Linder. “These cases are very
catastrophe. I immediately called vascular surgery to put them
rare. Our ER team trains for this. We complete continuing
on standby. I performed a quick ultrasound and saw there was
education for cases like this. It is why we do what we do and
fluid where it shouldn’t be. I couldn’t see where it was coming
to see outcomes like this. We worked well as a team along
from so after resuscitating him, we sent him to get a CAT scan.
with the surgeons. Our experience and what we do matters,
In the meantime, I had vascular and general surgery on their
especially for patients like Kevin.”
way in. The imaging indicated it may be some sort of aneurysm but there was so much fluid it was hard to tell where it was coming from.”
EMERGENCY SURGERY Northway went to surgery within an hour of his arrival at St. Luke’s ER. The general and vascular surgeons worked
Northway stayed at St. Luke’s for several days after his surgery. He was able to go home on Christmas Day and celebrate with his family. Probably the best Christmas gift he could ever ask for. The mass doctors found in Northway was a pancreatic neuroendocrine tumor. His prognosis is good, and he is undergoing treatment.
together to find out what was causing his internal bleeding.
“Doctors will continue to monitor me,” explains Northway.
Turns out it wasn’t an aneurysm but a mass by his spleen and
“Another mass has started to develop in a different location but
pancreas about the size of a softball.
it’s very small. It’s a slow-growing mass. It’s treatable and for
“The ER team at St. Luke’s made me feel like I was going to be just fine. It was a well-oiled machine that took such great care of me.”
that I feel so fortunate.” These days Northway remains active riding his bike, spending time with family and he and Pam are already at work planning their next vacation out west. He’s relishing everyday moments more than ever.
“The type of mass they found in Kevin was slow growing,” shares Dr. Linder. “When the mass gets to the point where it is heavy enough it can stretch or pull those blood vessels that are feeding blood to the mass. The weight of the large mass pulled enough that it separated, and he started bleeding internally. There was nothing he did that day that caused this to occur. It
When you have a medical emergency every minute counts. St. Luke’s Emergency Room is open 24/7. We offer the most experienced hospital ER team in Cedar Rapids, who are specially trained to respond rapidly, appropriately and efficiently to any healthcare emergency.
would have happened one way or another because the mass
Certain conditions like Northway’s require a trip to the
had grown so large. Thankfully Kevin went to St. Luke’s when he
ER. Learn more about when you should go to the ER at
did. If he had waited even 10 minutes he probably would have
bit.ly/ERWhentoGo.
LiveWell Winter 2019 | 7
Heart Care
Minimally Invasive Heart Repair
Prolongs Life Harold Klinsky felt better immediately after having a TAVR procedure at St. Luke’s last year.
Harold Klinsky, 89, had a quadruple bypass surgery at St. Luke’s
since it was first mentioned to me, but it wasn’t an urgent
14 years ago. The Hiawatha man remembers his long recovery.
problem initially. So in the meantime I started doing some
So when doctors told him several years later that he might
research and learned about a procedure called TAVR, which
need to have open-heart surgery once again — this time to fix
wouldn’t require open heart surgery. When St. Luke’s started
his aortic valve, which was starting to close — he wasn’t anxious
offering TAVR a couple of years ago, I was pleased I could have
to repeat the surgery.
it close to home.”
“When a person develops symptomatic aortic valve stenosis, their two-year mortality is 50 percent. It’s a very serious medical problem.”
TRANSCATHETER AORTIC VALVE REPLACEMENT
“I was told I had aortic stenosis,” shares Klinsky. “It was causing my aortic valve to close over time. Every year my cardiologist would run tests to monitor my valve. Several years had passed
TAVR stands for transcatheter aortic valve replacement. UnityPoint Health – Cedar Rapids Heart and Vascular Institute began its TAVR program in late 2016. Since then doctors have performed 129 procedures. TAVR is best suited for individuals with moderate to high risk aortic stenosis (failing heart valves), that are not candidates
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for surgical valve replacement. TAVR valves are inserted via a
According to Maybanks, patients from Iowa and Illinois have
catheter typically through the femoral artery, without open-
had their TAVR at St. Luke’s. The TAVR team collaborates with
heart surgery. This minimally invasive surgical procedure
the patient’s cardiologist during the full continuum of care.
repairs the damaged valve by placing a replacement valve into the aortic valve.
AORTIC STENOSIS “Aortic stenosis is slow progressing,” explains Richard Kettelkamp, DO, UnityPoint Health – St. Luke’s Cardiology Clinic. “There are some people who are predisposed to aortic valve stenosis but in most cases it's just a product of wear and tear on the valve, which happens over time. It tends to happen in
“The program is going well,” says Dr. Kettelkamp. “We’ve hit our stride. There are a lot of team members involved to make these procedures successful and we work well together. This program is a perfect example of what the Heart and Vascular Institute offers − lots of different heart specialists providing expertise that allow us to offer these new procedures. There are many areas of growth that we anticipate in the days ahead for the structural heart program.”
patients as they get older and a lot of our patients are in their
As for Klinsky, he was happy TAVR was offered at St. Luke’s.
80s and 90s. There are some younger, but the majority are
He stayed one night in the hospital and had no restrictions
elderly.”
following his procedure. He noticed an improvement in how he
“I started to experience chest tightness and discomfort,” shares
was feeling immediately.
Klinsky. “I was even feeling light-headed at times and my
“It was sure a lot different from when they opened me
doctor said it was time to do something about my aortic valve.
up for heart bypass surgery many
I went ahead and had the procedure in February 2017. It was a
years ago,” says Klinsky. “It was
simple procedure. All I had was a small incision and that’s it. It’s
worth it. If you are hesitant I
amazing. You don’t have any pain. I have not been sorry I had
would say go for it.”
the TAVR procedure.”
Learn more about TAVR and
“Symptomatic aortic valve stenosis is a bad thing,” says Dr.
watch a video at
Kettelkamp. “When a person develops symptomatic aortic
unitypoint.org/CRTAVR.
valve stenosis, their two-year mortality is 50 percent. It's a very serious medical problem. Once you develop symptoms you need to act quickly. It's time to do something about it because time is of the essence. With this particular set of patients who are high risk for open heart surgery — their prognosis is about 50 percent at one year — so it’s even more critical.” “We want to see patients before their condition worsens,” explains Katie Maybanks, Structural Heart and Valve Program nurse practitioner at UnityPoint Health – St. Luke’s Cardiology Clinic. “We would like to see them with either no symptoms or mild symptoms because their outcome will be so much better. That’s why routine physicals and tests with their family doctor or cardiologist are important to spot these issues early.” Richard Kettelkamp, DO, UnityPoint Health – St. Luke’s Cardiology Clinic LiveWell Winter 2019 | 9
Pregnancy
Pregnancy Over
35 =
The age of first-time mothers continues to climb as more women are waiting to have a baby. According to data from the Centers for Disease Control and Prevention (CDC) National Center for Health Statistics, the average age for a first-time mother has increased from age 21.4 in 1970 to 26.6 in 2016. That’s an average increase of five-years in the last four decades. Many women are waiting even longer, postponing pregnancy until their mid-30s and older. “There’s no doubt women are waiting longer to have their first child,” shares Steve Pedron, MD, UnityPoint Clinic – Maternal Fetal Medicine medical director. “There are many reasons a woman may wait. It may be culturally, professionally or financially motivated. It’s such a personal choice.” As a maternal fetal medicine (MFM) specialist, Dr. Pedron specializes in caring for expectant mothers and their unborn baby who may have health concerns before birth or after delivery. “Advanced maternal age is clinically described as age 35 and older,” explains Dr. Pedron. “Historically this term started because of the increasing risk a woman has for genetic disorders as they age. This is the age when testing is recommended for screening.”
Advanced Maternal Age
HEALTHY MOM, HEALTHY BABY Dr. Pedron contends that advanced maternal age really isn’t as important as it used to be. What really matters is the individual health of the mother. “There are perfectly healthy 45-year-olds who are able to sustain a pregnancy,” says Dr. Pedron. “Whereas there are young women who have multiple health concerns. They may have diabetes, obesity, lupus and other health concerns, which would put them at greater risk for complications during pregnancy.”
“If you want to have a baby it’s best to fix the issues before you get pregnant — no matter the woman’s age — if that’s possible.” If it’s possible, Dr. Pedron suggests, that women identify any health issues they may have before they decide to get pregnant. For example, quitting smoking, reducing alcohol consumption, losing weight and exercising more before they conceive. Excellent maternal health and fitness are often associated with better maternal outcomes. “If you want to have a baby it’s best to fix the issues before you get pregnant — no matter the woman’s age − if that’s possible,” says Dr. Pedron. “I know real patients have real problems. If the issue isn’t fixable and the woman is pregnant we will do our best to treat the issue to get her through the pregnancy. Same goes for the baby. If the infant has a problem, we will work to address the issue. I am here to help her have a healthy pregnancy no matter her age.” Learn more about Dr. Pedron and UnityPoint Clinic – Maternal Fetal Medicine or request an appointment at
Steve Pedron, MD, UnityPoint Clinic – Maternal Fetal Medicine medical director 10 | unitypoint.org
bit.ly/PedronMFM.
Neurosurgery
Meet Ahmad Bader, MD Neurosurgeon, UnityPoint Clinic Neurosurgery
Ahmad Bader, MD, joined the UnityPoint Health family in January. He is a neurosurgeon, which is a doctor that deals with brain and spine disorders. Neurosurgeons work along with neurologists to manage different neurological disorders. However, neurosurgeons have the skills to perform surgeries on the brain, spine and spinal cord. Dr. Bader grew up in East Jerusalem, Palestine. He completed his medical degree at Al Quds University and worked in Jerusalem for two years. From there Dr. Bader moved to Vancouver, Canada, where he spent six years completing his residency in neurosurgery at the University of British Columbia. “Vancouver is a very large city and I gained a lot of experience during my training there,” shares Dr. Bader. “During that time, I focused a lot on surgeries involving brain tumors and spine disorders. I have gained experience in spine instrumentation for degenerative spine diseases and spine trauma. I always liked the mixed work of cranial and spine surgeries and that’s why I decided to pursue a general neurosurgery practice. So I moved with my family to Kearney, Nebraska. Dr. Bader spent three years in Nebraska. It was a position he enjoyed and where he gained a lot of experience.
and there were many motor vehicle accidents. I did a lot of emergency neurotrauma during my time there.” In January, Dr. Bader and his family moved to Cedar Rapids where he joined Jeannette Liu, MD, at UnityPoint Clinic – Neurosurgery located in St. Luke’s Hospital. “I chose UnityPoint Health – St. Luke’s Hospital and the Cedar Rapids community because it offers opportunities to make a difference for residents in need of neurosurgery,” says Dr. Bader. “One of the many things I enjoy about being a doctor is working closely with patients to accomplish a desired goal. I am a partner with the patient. I aim to provide each individual with accurate information about their condition or diagnosis and work together to solve their issue.” In addition to seeing patients in the clinic, Drs. Bader and Liu will care for patients that present to St. Luke’s Emergency Department (ED). “Dr. Liu and myself have extensive experience in neurotrauma and we will work closely with the ER, Intensive Care Unit, intensivists and other team members at St. Luke’s to care for patients in need of emergency neurosurgery.” Dr. Bader is welcoming new patients at UnityPoint Clinic – Neurosurgery. “Individuals can see me through a referral from their family doctor or I also accept patients that self-refer. I feel fortunate when a patient entrusts me with their care,” shares Dr. Bader. “It’s an honor to make a difference in someone’s life through my work as a neurosurgeon.” Go online to learn more about Dr. Bader or to schedule an appointment at bit.ly/BaderMD.
“I worked at a hospital where we saw a lot of trauma,” explains Dr. Bader. “Kearney was along Interstate 80
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Ask the Expert
What Do the New Cholesterol Guidelines Mean for Me? New recommendations from the American College of Cardiology (ACC) and the American Heart Association (AHA) allow for more personalized treatment for individuals who are at a high risk for heart disease or have elevated cholesterol. “Instead of using absolute levels we are basing treatment on a combination of information,” explains Ankur Vyas, MD, UnityPoint Health – St. Luke’s Cardiology Clinic. “We look at your cholesterol levels, but we also include other risk factors, such as family history, chronic conditions or if you smoke, to name a few. If you fall into a high-risk category, then we are going to be more aggressive in knowing your cholesterol and trying to reduce it by at least 50 percent. To do this we would go straight to a high-intensity statin, which is the chief blood pressure and cholesterol lowering medications that we use.”
“ We look at your cholesterol levels, but
we also include other risk factors, such as family history, chronic conditions or if you smoke, to name a few.
”
Dr. Vyas stresses individuals should take an interest in their health and work with their healthcare provider to determine when they should have their cholesterol tested for the first time and establish a baseline. From there they can determine how often they should be tested year to year. Some individuals with elevated cholesterol levels may be able to lower their heart disease risk with lifestyle modifications.
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DIET AND EXERCISE “Diet and exercise are important for overall health,” shares Dr. Vyas. “Individuals should aim for at least 30 minutes of exercise, three to four times a week, at moderate intensity. Your diet should include vegetables, low-fat dairy, whole grains, nuts and fruits. Limit red meat and anything with high sugar content.” Cholesterol may also be moderated by incorporating exercise into daily living. “Regular exercise has been shown to reduce and improve how well people do long-term,” says Dr. Vyas. “The benefits may help reduce cholesterol and improve overall health in many ways. And if you succeed in lowering your cholesterol it also provides benefit to your overall health and reduce the possibility of having future cardiovascular events.” Overall the guidelines encourage providers to lower cholesterol levels for those high-risk individuals and reinforces the importance of statins. If it’s been a while since you saw your healthcare provider, now might be the perfect time to schedule a visit and take control of your health. UnityPoint Health wants to be your partner in health. We make it easy for you to schedule an appointment. Go to bit.ly/RequestUPH to find a healthcare provider who is right for you and start your wellness journey today!
HIGH
LOW
RMAL NO
CHOLESTEROL
For Your Health
OVER
50?
IT’S TIME FOR A COLONOSCOPY
Did you know colon cancer is a leading cause of death in the U.S., but it’s often prevented when detected at an early stage? Most insurance plans cover colonoscopies at no cost to you. It’s time to schedule an appointment if you are over the age of 50 and haven’t had a colonoscopy in the past 10 years. Or, if a close relative has had colon cancer, screening earlier than age 50 may be appropriate. Your health matters to us! Schedule your screening colonoscopy with St. Luke’s – Gastroenterology at (319) 366-8695.
Manage Your Health Online Access your medical records through MyUnityPoint, a personalized, safe website for you to manage your healthcare and communicate with your care team. What can I do with MyUnityPoint? • View your health summary. • See lab and radiology test results. • Read care instructions from your doctor. • Find trusted health information resources. • Schedule medical appointments. • Refill prescriptions. • Communicate with your doctor. • Make a payment. Visit chart.myunitypoint.org to sign up today!
Heart Healthy Dinner Suggestion
Lemony Chicken with Broccoli on Cauliflower Rice Serves four, three ounces chicken, ¾ cup broccoli and one cup cauliflower rice per serving
INGREDIENTS
DIRECTIONS
1 12 ounce bag frozen cauliflower rice ½ C water 3 C fresh broccoli florets or 10 ounces frozen broccoli florets Cooking spray 6 boneless, skinless chicken all visible fat discarded ½ C fresh lemon juice 1 tsp ground cumin ½ tsp salt ¼ tsp cayenne 3 tbsp coarsely chopped fresh cilantro or parsley 1 large lemon, cut into four wedges (optional)
1. Prepare the cauliflower rice using the package directions, omitting salt and margarine. 2. Meanwhile, in a large skillet, bring the water to a boil over high heat. Add the broccoli. Reduce the heat and simmer, covered, for three minutes, or until crisp-tender. Transfer to a colander. Drain well. 3. Dry the skillet with paper towels. Lightly spray the skillet with cooking spray. Heat over medium-high heat. Cook the chicken for four minutes. Turn over the chicken. Cook for two to four minutes, or until no longer pink in the center. Transfer to a cutting board. When the chicken is cool enough to handle, cut it into bite-size pieces. 4. Spread the cauliflower rice on a serving platter. Place the chicken and broccoli on the rice. 5. In a small bowl, whisk together the lemon juice, cumin, salt and cayenne. Pour over the chicken, broccoli and cauliflower rice. Sprinkle with the cilantro. Arrange the lemon wedges around the edge of the platter.
NUTRITION ANALYSIS (PER SERVING) Calories..............................................180 Total Fat............................................3.5 g Saturated Fat................................0.5 g Trans Fat........................................0.0 g Polyunsaturated Fat.....................0.5 g Monounsaturated Fat..................1.0 g Cholesterol................................... 73 mg Sodium.......................................465 mg Carbohydrates....................................9 g Fiber................................................4 g Sugars.............................................2 g Protein..............................................28 g Dietary Exchanges: Two vegetable, three lean meat Recipe credit: American Heart Association
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YOUR FAMILY MEANS THE WORLD TO YOU. YOU MEAN THE WORLD TO US.
At UnityPoint Clinic, getting you healthy and keeping you that way is our top priority. That’s why we make it easier for you to live well every day. From annual exams and preventive care to treatment for illnesses and injuries, your primary care doctor manages your ongoing care. We want you to be your healthiest, because what matters to YOU is important to us.
Find your partner in health today. Call (319) 558-4858 or visit unitypoint.org/findadr.