Tag Archives: Nebraska Methodist Hospital

Jodi Saso’s 
Heart for Running

February 18, 2014 by
Photography by Bill Sitzmann

For many avid runners, qualifying for the Boston Marathon is considered the pinnacle of their running career. For 35-year-old Jodi Saso, completing the Boston Marathon was that and so much more.

Not only did it mark a major feat in her running career, but Saso crossed the finish line just 10 weeks after undergoing major heart surgery. Completing the marathon was a personal confirmation that she had risen above her heart condition and could continue “life as usual,” despite this unexpected setback.

“I didn’t want to be a victim of my circumstances and lay around feeling sorry for myself,” says Saso. “It was all about determination and not wanting to live that life. I figured I had one shot to do this, and I wasn’t going to let my surgery get in the way.”

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This is all even more amazing when you consider the fact that Saso had taken up running just several years ago when she decided she need to do something to get herself and her dog into shape. The pounds began to fall off, running became easier, and it wasn’t long before Saso had developed a new passion.

Saso found running to be a natural fit, and before long, she had started training for marathons. By 2012, she had run eight marathons in one year in addition to several half marathons and a 50-mile run. She was hooked and breaking her own records with each race. Saso felt wonderful physically and emotionally.

But an annual check-up with her doctor told her otherwise.

When Saso was very young, her pediatrician suspected that she might have Marfan syndrome, a rare genetic disorder that affects the connective tissue. The most serious complications of Marfan are defects of the heart valve and aorta. However, Saso never received a firm diagnosis. When she began seeing a new family practitioner in her late 20s, he too suspected Marfan syndrome and recommended they monitor her heart on a regular basis. A heart echo performed at her 2012 visit revealed an aortic aneurysm—a stretched and bulging section in the wall of the aorta.

“When the aorta becomes stretched, there is a big risk of the aorta dissecting or tearing or, even worse, rupturing and causing death,” says Traci Jurrens, MD, cardiologist at Nebraska Methodist Hospital, who performed the echocardiogram. “Jodi’s aorta had reached the threshold for repair.”

Because of the difficulty of the procedure, most cardiac surgeons replace both the valve and aorta during surgery, which requires lifelong anticoagulation with the blood-thinning drug called Coumadin, explains Dr. Jurrens. Coumadin can have a host of side effects, including easy bruising and bleeding.

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“Since she was so young, we determined that it would be worthwhile for Saso to go to the Mayo Clinic, where cardiac surgeons were able to perform the surgery without removing her own valve,” notes Dr. Jurrens.

Saso’s surgery was scheduled for Jan. 31, 2013. The timing could not have been worse. She had qualified for the Boston Marathon the spring before. The run was scheduled for April 15, just 10 weeks after her surgery. It was a dream she was not willing to let go so easily. “I asked my doctors if there was any way that I could still run the race,” she says. “They were doubtful, but they said it was contingent upon how the surgery and recovery went.”

Following surgery, Saso says she was in so much pain that she thought she would never leave the hospital. “Before I left the hospital, they told me that I had to walk the entire floor six times a day,” she says. “That first day, I could barely walk 10 feet.”

But that’s when Saso’s determination kicked in. “My goal was to run the Boston, and I was going to do everything I could to make that happen.” By day three, she was off pain medications. By day five, she was doing two laps instead of one six times a day and was released from the hospital to go home.

Encouraged by her quick recovery, Saso was on a fast track from then on, she says. By two weeks, Dr. Jurrens had released Saso to return to work. Four weeks after surgery, Saso finished an entire stress test—Dr. Jurrens’ first patient to do that. Jurrens cleared her to run the Boston as long as she promised to run it over four hours.

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Donning a T-shirt that read, “I had open heart surgery 10 weeks ago. Let’s do this!” Saso proudly crossed the finish line in 4:08:15.

“I felt amazing,” she says. Luck continued to be on Saso’s side. Having mistakenly booked her return flight extremely close to the race finish time, she had no time to hang out and celebrate. Instead, she left the race immediately to catch her flight. A short time later, she heard about the 2013 Boston bombings. “Someone was looking over me,” she says.

“Jodi has done remarkably,” says Dr. Jurrens. “It is quite a difficult procedure, but Jodi had excellent results. Because Jodi was in such great shape, she was able to get through surgery very well. In general, great functional capacity prior to surgery predicts better recovery from cardiac surgery. That being said, we really do not know what is safe for Jodi in regard to running, and we do discourage excessive exercise. But running is Jodi’s life, and she is going to make her own decision in regard to running.”

Saso completed five marathons in 2013 but says she is planning to slow down the pace for her own health benefits. “I’m going to do just two marathons a year in the future,” she says. “I want to be smart about this, and I really don’t want to have surgery again.”

The pace may be slower, but her determination to live life as usual is stronger than ever, says Saso. She recites one of her favorite quotes, which she says she applies both to running and life: “The body does not want you to do this. As you run, it tells you to stop, but the mind must be strong. You can always go too far for your body. You must handle the pain with strategy…it is not age. It is not diet. It is the will to succeed. Let’s do this!”

Young and Surviving Cancer

May 25, 2013 by
Photography by Bill Sitzmann

It was just eight weeks after Amberly Wagner-Connolly had given birth to twins when she received the devastating news that she had breast cancer. She was just 29.

“I knew that life as I knew it would never be the same,” she recalls. “I was so shocked. Why me? Why would I have these beautiful kids and then so soon after find this out?”

As it turns out, the experience has come to be one of the most positive things that has happened in Wagner-Connolly’s life. It also became the springboard that put her goals in motion.

“It has helped guide me in my life and my career,” she says. “It opened my eyes to how much worse things could be and inspired me to do more with my life. Through cancer, I realized that I wanted to go into public health where I can help others. I know I am a better mom, friend, teacher, nurse, wife—everything. All of my roles have been affected in a positive way because of [cancer].”

On March 1, Wagner-Connolly celebrated her four-year anniversary of being a cancer survivor, and while she has managed to make it a positive in her life, she acknowledges that it was also one of the most difficult and trying times in her life.

“It has helped guide me in my life and my career. It opened my eyes to how much worse things could be and inspired me to do more with my life.” – Amberly Wagner-Connolly, survivor

The number of young adults who are diagnosed with cancer is very low, usually less than 5 percent, depending on the cancer, says Margaret Block, M.D., a medical oncologist at Nebraska Cancer Specialists. But for those who do receive the disturbing news, it can be a very emotional and stressful journey.

Like many young cancer patients, Wagner-Connolly experienced the challenges and emotional turmoil common among people her age. She struggled with the shock of being diagnosed at such an early age; she feared not being around to see her children grow up; and she grew weary from juggling two tiny twins and a four-year-old daughter when she could barely take care of herself.

Her family and friends and people she didn’t even know became her biggest supporters. Her husband worked nights and was able to help as much as he could during the day. Her mother and mother-in-law also provided help when they could and were there for emergencies.

Her co-workers at The Nebraska Medical Center held a fundraiser for her. Several friends of her sister who work at Lincoln Financial Group also organized a fundraiser/auction and raised more than $6,000 to help her with her medical bills.

This touched Wagner-Connolly greatly and was a turning point that helped her keep fighting. “It made me see the good in the world,” she says. “When complete strangers reached out to help me, I became determined that I had to do something with my life to make an impact like they had for me.”

“The number of young adults who are diagnosed with cancer is very low, usually less than 5 percent, depending on the cancer.” – Margaret Block, M.D., medical oncologist with Nebraska Cancer Specialists

Determined to not let her surgery and chemotherapy treatment slow her down, Wagner-Connolly was able to continue her master’s studies, finishing on her target date. She also kept a challenging work schedule as a nurse at The Nebraska Medical Center.

Being able to maintain some control over other parts of her life was important to her mental well-being. There were days during her six-month chemotherapy regimen when she felt as if she couldn’t go on. “I just had to take it day by day,” she recalls. “I did a lot of reality checks.”

Having goals—such as seeing her children grow up, completing her master’s degree, and wanting to live to make a difference in the world—fueled her will to keep fighting.

“Amberly did an amazing job,” says Peggy Jarrell, LCSW, OSW-C, a licensed clinical social worker and a certified oncology social worker at Nebraska Methodist Hospital, who worked with her during her treatment. “Motherhood can be stressful enough…put cancer on top of that, and you have a lot to deal with. [She] was able to maintain her own and still stay active in the outside world.”

Jarrell says it’s very important for cancer patients to establish a good support network of people and friends who can help them through this period. She also recommends having a designated support person who can accompany them at appointments and act as their second set of ears. Many hospitals now provide nurse navigators to help patients “navigate” the health care system.

Stacy Patzloff, RN, BSN, a certified oncology nurse navigator at Alegent Creighton Health, says nurse navigators work closely with the patient and the cancer support team to make sure everything is coordinated. They’re there to attend appointments with them and to act as a support person who is available 24/7.

“Motherhood can be stressful enough…put cancer on top of that, and you have a lot to deal with.” – Peggy Jarrell, licensed clinical social worker and certified oncology social worker with Nebraska Methodist Hospital

Support is key, agrees Dr. Block, whether it’s family, friends, a support group, or seeking the help of a psychologist or psychiatrist. Exercise can also be a good thing and may help you get through chemotherapy with less fatigue, she notes.

Other tips that may help young patients get through treatment and recovery include:

  • Don’t be afraid to ask for help from others.
  • Take time for yourself if you’re having a bad day.
  • Eat a healthy diet. Seek the nutrition advice of dietitians on staff at the hospital where you are receiving treatment.
  • Take care of your physical well-being. Programs like Alegent Creighton Health’s Image Recovery program provide cancer patients with wigs and helps them deal with hair, nail, and skin problems that are unique to cancer patients.

Today, Wagner-Connolly is very active in a number of projects to help other young victims of cancer. She started the group Survivors Raising Kids for young parents who need help with childcare during treatment and recovery. She is on the board of Camp Kesem for kids who have had a parent with cancer. She is also a nursing instructor at Clarkson College where she teaches public health and is pursuing a doctorate in global health.

“I know how lucky I am,” she says. “I want to make a difference in this world. No one should have to face cancer and certainly not a young mom.”

And for those who do, Wagner-Connolly is committed to easing that journey.

Surviving Heart Disease

January 25, 2013 by
Photography by Bill Sitzmann

As a young woman of just 38 years old, Dionne Whitfield didn’t fit the typical description of a heart disease patient. But there she was, standing in front of the cardiologist, still tired and breathless after undergoing a treadmill test, trying to grasp the news that she had three major blockages.

She didn’t hear much after that. All she could think about was that she didn’t want to become a mere statistic. That she still wanted to have a family and live to see her potential children grow up. What was going to happen to her, she thought.

One week later, in August of 2012, Whitfield was back in the hospital undergoing triple bypass surgery. Today, Whitfield is doing great, and with age on her side, she is determined to take control of her health and her life again.

Looking back, she knows now that her unhealthy lifestyle habits were bound to catch up with her eventually. At 352 pounds, she ate whatever she wanted, often grabbing fast food along the way. She rarely exercised, and she had settled for the fact that she was overweight and nothing was going to change that. She was also African-American, a population that tends to have greater prevalence of risk factors for heart disease than Caucasian women.

“This has been a big eye-opening experience for me, and I don’t want to go back.” – Dionne Whitfield, heart disease patient

Whitfield’s attitude about her weight and health has done an about-face since then. Her attitude actually started to change with several warning signs shortly before the news of her blockages. In early January of last year, she learned that she was borderline diabetic. Concerned, Whitfield began attending group exercise classes and the pounds began to fall off. Motivated by her success, she began to make exercise a priority.

Then came her second warning. In July, she started becoming so short of breath that she could barely make the short walk from her office to the car. When things didn’t get better, she consulted with her doctor, who referred her to cardiologist Edmund Fiksinkski, M.D., at Nebraska Methodist Hospital, who performed the cardiac testing in which the blockages were found.

Whitfield’s surgery was performed by John Batter, M.D., cardiothoracic surgeon at Nebraska Methodist Hospital. After surgery, she underwent six weeks of supervised cardiac rehabilitation. Whitfield exercises on her own now but is still considered in a recovery phase for the next year and follows a moderate exercise program while her arteries heal.

“Dionne has done great,” says Susana Harrington, a nurse practitioner at Nebraska Methodist Hospital, who worked with Dionne throughout her recovery. “She really owned it and became more determined than ever to lead a healthy lifestyle.”

“This has been a big eye-opening experience for me, and I don’t want to go back,” says Whitfield. She continues to work out regularly, watches what she eats, and even reads labels now before putting food in her grocery basket.

She has also lost more than 72 pounds and is determined to double that. “I feel so much better now,” says Whitfield. “I’m not breathless now, and exercising is getting easier.”

 “She really owned it and became more determined than ever to lead a healthy lifestyle.” – Susana Harrington, nurse practitioner at Nebraska Methodist Hospital

What women need to learn from this is that the development of cardiovascular disease is a lifelong process and that prevention is a lifelong effort, says Amy Arouni, M.D., cardiologist at Alegent Creighton Health. Controlling your risk factors very early in life can help prevent the development of heart disease later. This includes quitting smoking if you smoke, maintaining a healthy weight, exercising regularly, eating a diet low in saturated fats with lots of fruits and vegetables, and watching your blood pressure and cholesterol. In fact, women can lower their heart disease risk by as much as 82 percent just by leading a healthy lifestyle, according to the National Institutes of Health.

Prevention is important because heart disease is the No. 1 killer of all women, claiming the lives of approximately a half million women each year.

The main difference between men and women is that women are more likely to develop heart disease in their 60s and 70s, about 10 years later in life than men.

That’s because after menopause, risk factors tend to rise in women, especially blood pressure and cholesterol levels and rates of obesity, says Eugenia Raichlin, M.D., cardiologist at The Nebraska Medical Center. Other risk factors such as smoking, diabetes, and family history also raise a woman’s risk.

“The longer you wait, the greater the potential to suffer significant damage to the heart.” – Amy Arouni, M.D., cardiologist at Alegent Creighton Health

The consequences of heart disease also tend to be more severe in women. For instance, “a greater number of women die of sudden cardiac death before their arrival at a hospital (52 percent) compared to 42 percent of men,” says Dr. Raichlin. “Women often require more hospitalizations compared to men, have lower ratings of general well-being, and limitations in their abilities to perform activities of daily living. As a result, heart disease in women presents a unique and difficult challenge for physicians.”

In addition to prevention, women should also be aware of the symptoms of heart disease and the subtle changes in their bodies, says Dr. Arouni. “Unlike men, women’s symptoms tend to be more vague and atypical and may include mild neck, shoulder, upper back, or abdominal discomfort; shortness of breath; nausea or vomiting; sweating; lightheadedness or dizziness; extreme fatigue and/or a jaw ache that travels down the neck,” she says. “Because the symptoms tend to be vague, oftentimes, women will stay at home and ride it out.”

This is one of the key areas where women go wrong. “Getting help quickly is critical,” says Dr. Arouni. “The longer you wait, the greater the potential to suffer significant damage to the heart.”

While the development of heart disease in a woman’s 30s is less common, it does happen, especially when other risk factors are involved such as family history, obesity, or diabetes.

Whitfield feels fortunate that she and her doctors took her symptoms seriously and that she sought help early on. Now, she hopes she can help other women avoid the same fate by taking control of their health at a young age. “I feel very grateful to my family and friends and to the doctors and nurses that helped me get through this,” she says. “When you’re young, you don’t think anything can happen to you, but now I know differently. I don’t take my health for granted anymore.”

Bipolar Disease

November 25, 2012 by

“My husband didn’t know if he was going to come home to Cruella Deville or Dolly Levi from Hello Dolly.” That’s how Jane Pauley, broadcast journalist and former co-host of the TV morning show Today, described her battle with bi-polar disease in a interview on Healthy Minds, produced by New York Public Radio. “Who knows what provokes it, but it was like a swarm of bees that wants a target,” she says.

Being diagnosed with bipolar disease was a shock, recalls Pauley, but getting a diagnosis and subsequent treatment, however, allowed her to regain some normalcy in her life again.

Bipolar disease is a serious mental illness that is associated with extreme mood swings from mania to depression. “It is one of the most serious illnesses we deal with because of the disruptive nature of the disease,” says Sharon Hammer, M.D., psychiatrist at the University of Nebraska Medical Center (UNMC). “It is more serous than depression or schizophrenia because it can lead to risky behaviors, such as drug and alcohol abuse, damaged relationships, and suicide. And because of the impulsive nature of the disease, there is often no time to intervene.”

The average onset of bipolar disease tends to occur in older teenagers and young adults ages 20 to 25 years old. “Many women may start to experience symptoms of depression in their teenage years followed by their first manic episode in college,” says Hammer. “This is a very risky time because the college years are often mixed with stress, sleep deprivation, and alcohol use, which are all triggers for episodes.”

“It is one of the most serious illnesses we deal with because of the disruptive nature of the disease.” – Sharon Hammer, M.D., psychiatrist at UNMC

Women with bipolar disease typically spend about 80 percent of the time in depression and 20 percent in mania. Episodes of mania are characterized by abnormal elevated moods that include irritability, being easily agitated, impulsivity, racing thoughts, and insomnia.

Many women tend to be in denial and don’t start taking it seriously until they have children, notes Hammer. Even then, it is often misdiagnosed as depression or anxiety due to the extended depressive states associated with the condition, and the fact that women are twice as likely to have depression than men. In fact, bipolar disease is the most under-diagnosed mental illness and the most challenging to diagnose, notes Hammer.

Misdiagnosis can create more problems because medications used for depression and anxiety are different than those used to treat bipolar disease and can make the condition worse.

In addition, untreated bipolar disease tends to gain momentum and become more malignant with time, says P.J. Malin, M.D., a psychiatrist with Alegent Creighton Clinic and an associate professor of psychiatry at Creighton University School of Medicine. “It can be very disruptive to other parts of your life. Approximately 60 percent of people with bipolar disease will develop substance abuse problems, and it carries a 15 to 20 percent suicide rate.

“Early treatment of the disease can help prevent the disease from getting more aggressive. Untreated bipolar disease, on the other hand, lowers one’s life expectancy by 10 years.”

If you are being treated for depression and are not responding to depression medications or you are experiencing negative or an unusual response, it is important to communicate this with your provider, adds Malin.

“Early treatment of the disease can help prevent the disease from getting more aggressive.” – P.J. Malin, M.D., psychiatrist with Alegent Creighton Clinic

You can also do your own test by taking the Mood Disorders Questionnaire (MDQ) online, which provides fairly accurate results and can help you and your clinician determine whether you are bipolar, notes Hammer.

Environmental factors and heredity appear to be the major risk factors for bipolar disease, says Malin. “There are different theories as to how the environment plays a role, but they include: obstetric complications, intra-utero viral infections, use of hallucinogenic drugs, and traumatic life events, such as the death of family or friends or abuse.”

Treatment typically involves a combination of medications and counseling that may be necessary over a person’s lifetime. “Counseling is huge for long-term success and stabilization,” says Robin Houser, a counselor for Nebraska Methodist Hospital’s employee assistance program, Bestcare EAP. “Bipolar disease is a lifetime problem, and counseling can help people learn coping techniques and avoid unhealthy thinking and unhealthy patterns of behavior. A lot of people think that once they have become stabilized that they don’t need medications or counseling anymore, but that’s when we’ll start seeing imbalances and manic episodes occur again.”

Women with bipolar disease are very sensitive to stress, lack of sleep, and environmental and seasonal changes, all of which can trigger an episode, notes Hammer. Practicing healthy lifestyle habits like getting regular exercise, adequate sleep, managing stress, and light therapy during the winter months can help keep the disease stabilized.

 “Counseling is huge for long-term success and stabilization.” – Robin Houser, counselor for Nebraska Methodist Hospital

Postpartum is also a common time to experience recurrences, probably because of sleep deprivation, says Hammer. There are medications that are safe to use during pregnancy, which are important to take to prevent a relapse. If a woman stops her medications during pregnancy, it can take up to six months to get the symptoms under control again, says Hammer.

“Newer medications as a whole have fewer side effects,” she says, “but it’s important that you are matched with the medication that works best for you and has the fewest side effects.

“Patients who are being followed and treated by a trained health care professional can function vey well and live a normal life.”