Tag Archives: Alegent Creighton Health

To Tanzania with Love

January 15, 2014 by
Photography by Bill Sitzmann and provided by Alegent Creighton Health

Life-changing work by Alegent Creighton Health in Tanzania is the focus of a forthcoming documentary from a one-time Omaha television news personality. When former KMTV anchor-reporter Mary Williams and videographer Pete Soby travel to the African nation in February, their main point of contact will be ACH’s man-on-the-job there, Bob Kasworm, whose life has been transformed by the calling he follows in that distant land.

Kasworm, a biomedical engineer and devout Christian, combines career and faith in Tanzania, his home the last 10 years.

“This was never in my plans,” says Kasworm. “I really wasn’t thinking I would ever go to Africa or have a life of service,” he says.

He first visited in 2001 on a Nebraska Synod of the Evangelical Lutheran Church of America-sponsored trip. He went to evaluate the potential of Alegent assisting hospitals, dispensaries, and public health programs there.

The pull of Africa began then.

“From the very first trip there was never a day and rarely an hour when Africa was not on my mind,” he says. “Yes, it was the poverty and the need, but it was more than that. Somehow Africa just got into my blood.”

He made a dozen or so additional visits in a three-year span as Alegent committed itself to working with the evangelical church and various health and civic partners in Machame, an area on the southeastern slope of Mount Kilimanjaro. He cultivated and coordinated the growing relationship between the partners and implemented various initiatives.

The organization’s efforts there include training medical staff at Machame Hospital, developing Machame Nursing School, providing nursing scholarships, and delivering medical equipment and supplies. Kasworm leads the Homes for Health program that uses local laborers to build new, cleaner, safer homes for residents.

At the end of 2004 Kasworm decided to live in Tanzania full-time. He says it was then his wife “realized that what she thought was just a temporary ‘mid-life crisis’ was something I was powerless to resist.”

He’s since learned Swahili well enough to speak it fluently.

Machame Lutheran Hospital, founded some 110 years ago by German missionaries, is at the center of much of Alegent’s 
work there.

“We have the hospital with about 120 inpatients and many outpatients and clinics,” he explains. “We also have a Clinical Officer Training school and now the nursing school. There are about 20 homes for staff.”

The campus is on a rare paved road. There’s running water (“usually”), electricity (“much of the time”), and internet access (“slow”).

Bob Kasworm in Tanzania

Bob Kasworm in Tanzania

Progress is plodding but rewarding.

“The most satisfying thing is that, in many cases, if not for our efforts and involvement many would simply not get help,” he continues. “A child with a club foot would become an adult with a club foot. The nursing student would not have had a chance to study. It is not like you can just go down the street to an alternative. There is no safety net. We do it, or it won’t happen. We can now point to a number of successes.

“There is such a shortage of trained healthcare workers that our efforts in education may well be our biggest legacy. If you educate one nurse they will care for thousands over their career.”

Williams, who interviewed Kasworm on one of his periodic visits to Omaha, describes him as a “strong, driven” man who “sees opportunities where others don’t.”

ACH mission integration consultant Lisa Kelly says, “He’s so embedded in that culture now it’s amazing. He’s definitely a problem-solver, which is huge in that country. Everything from unloading containers of things we send to fixing machines to keeping a water source going or getting an internet connection set up…you name it, Bob is the guy who figures out how to do it.

“He has to navigate what’s possible in the developed world with what’s possible there in that culture and that setting. So you have to think of medicine in a whole new way and what he has been able to do is to bridge that gap.”

Williams and Soby are eager to capture the story from a grassroots perspective.

“You can’t really tell the story without talking to the people on the ground who are being helped, and that would start with the patients coming through the door,” says Williams. “You cannot tell the story without talking to all the players—the patients, the nurses, the young women who have a fighting chance now. We can’t tell the story unless we go past the borders and see how exactly the people live and the challenges they face every day. We’re going to experience that first-hand. It doesn’t get any better than that.”

When Williams left KM3 in 2009 and launched her own marketing and media production company, she set her sights on telling stories that engage people’s hearts and minds. From reporting medical news she knew Alegent had compelling stories to be told and she wanted to be the storyteller that shared them.

Kasworm and a villager inspect the bounty of harvest.

Kasworm and a villager inspect the bounty of harvest.

There wouldn’t be a Tanzania story without Kasworm, whose year-round presence in that county makes the Alegent Creighton mission model unique. Much emphasis is placed on building relationships and making connections through ministry and medical mission trips organized by ACH and the Nebraska Synod of the ELCA.

For Williams, whose only previous overseas assignment was covering local airmen serving in Desert Storm, it’s an opportunity she couldn’t pass up.

“I’m sure it’s going to be a life-changing experience.”

She and Soby expect to complete the 30-minute documentary in the spring.

Kasworm sees the project as another vehicle to foster awareness between Tanzanians and Americans.

“Our experience lets us serve as a bridge between the cultures and reduce misunderstandings. It seems much of our important work has not come from analysis or needs assessment. The work has just found us. I am sure more will present itself.

“As long as the doors keep opening and my health stays good, I hope to continue.”

 Read more of Leo Adam Biga’s work at leoadambiga.wordpress.com.

Food Allergies Abundant in a Purell Society

August 16, 2013 by

Food allergies are on the rise, and there are many theories as to why.

“We are too clean,” says Carlos Prendes, M.D., family medicine physician with Alegent Creighton Clinic. “We do not let our immune system do its job. Anything that comes in that is not a part of our routine, our body will attack and protect us against.

“Food allergies were very rare in the 1900s (and Purell did not exist). As we have developed a more antiseptic society, we are also developing more allergies. There is something to be said for a bit of dirt in your life.”

There are eight foods that are responsible for 90 percent of food allergies. The “big eight” are milk, eggs, peanuts, tree nuts, soy, wheat, fish, and shellfish.

“Many common food allergies for kids (milk, soy, wheat, and eggs) are not major allergens for adults. Adult food allergies tend to be lifelong and potentially severe. Many childhood allergies can be ‘grown out of,’ but adult allergies tend to stick,” says Dr. Prendes. “Most kids outgrow an allergy to milk and eggs by age six (this is different than being lactose intolerant).” However, he adds, this is not the case for peanuts.

“We are too clean. We do not let our immune system do its job.” – Carlos Prendes, M.D., family medicine physician with Alegent Creighton Clinic

Think you have a food allergy? “Symptoms usually begin within two hours after eating. If you develop symptoms shortly after eating a certain food, you may have a food allergy,” says Dr. Prendes. “Key symptoms of a food allergy include hives, a hoarse voice, and wheezing.” Other symptoms may include abdominal pain, diarrhea, difficulty swallowing, nausea, and stomach cramps.

“Any food allergies can be very serious,” says Dr. Prendes. “And mild reactions in the past do not always mean mild reactions in the future. If you are allergic to something, you cannot eat it; subsequent exposures can make the allergic reaction worse.”

There is a lot being done to make life with food allergies a little easier. The FDA requires by law that “the big eight” allergens are labeled on packages, even if the food does not contain any of “the big eight” but is produced in a factory that also produces any of these common allergens.

Schools and daycares are working to maintain peanut-free and milk-free zones or lunch tables, and to notify other parents that there is an allergy in the classroom.

Dr. Prendes recommends that the child takes responsibility for his or her allergy. “It is very important that the child is aware of their food allergy and cannot take a break from it. If you are at a birthday party and you are allergic to milk, you cannot have the ice cream. The sooner that they are aware of this allergy and that it is part of their life, the better off they will be.”

There are a lot of emerging ideas on how to reduce your risk of developing a food allergy. Some of the recommendations from the American Academy of Pediatrics—no cow’s milk until age 1 or peanuts until age 3—may be changing. “It is hard to tell parents to get their kids dirty more often,” says Dr. Prendes. “We have to figure out a balance to avoid developing these allergies and keeping people healthy.”

Shingles

June 20, 2013 by

Most of us weathered childhood chickenpox years ago with no worse than some intense itching and a few missed days of school. But for approximately one out of three people who’ve had chickenpox—99 percent of us, according to the U.S. Department of Health and Human Services’ Centers for Disease Control and Prevention—that’s not the end of it. A painful viral infection called shingles can show up years later.

“It’s pretty common. About 30 percent of Americans will get shingles at some time in their lifetime; it turns out to be one million cases a year,” says Dr. Michael Walts, a family medicine physician with Alegent Creighton Health. “Usually shingles only occurs once. In most cases, it’s self-limiting; it goes away, and you don’t have any further problems.”

Shingles is so common because it’s caused by the varicella-zoster virus, the same virus that causes chickenpox, he explains.

“Although the [chickenpox] rash goes away, the virus doesn’t. It crawls into your spinal column, where it goes to sleep, maybe forever,” Walts says. “But maybe, for most reasons we don’t know, the virus wakes up and will crawl down one nerve of the spinal cord and into the skin. Wherever that nerve is going to, that’s where the shingles rash will show up.”

And unlike chickenpox, this rash is more than just annoying.

“The most significant risk factor for the development of shingles is age. The reason we think that’s the case is that the immune system, like everything else as we get older, just doesn’t work as well.” – Michael Walts, M.D., family medicine physician with Alegent Creighton Health

“You’ll have pain first, and then all of a sudden the rash appears…It can be excruciatingly painful,” Walts says. And for some, the pain is long-lasting, even permanent.

“One of the most significant complications of shingles, a small percentage of time, is that even after the rash goes away, the pain doesn’t,” Walts explains. “The condition is called postherpetic neuralgia, or PHN.”

Shingles is more common after age 60, Walts says. “The most significant risk factor for the development of shingles is age. The reason we think that’s the case is that the immune system, like everything else as we get older, just doesn’t work as well. And the older you are when you get shingles—if you do—the more likely you are to get postherpetic neuralgia.”

It’s even possible that people who’ve been immunized against chickenpox can still get shingles later, he says, and it also strikes people who believe they’ve never had the chickenpox.

“People will say ‘I got shingles, but I never had chickenpox as a kid,’ and my response to that is, ‘Yeah, you did. You just didn’t know it,’” Walts says. “Maybe you had a bump or two that nobody ever even noticed, or maybe you had a rash that somebody said was contact dermatitis, because there’s no way you can get shingles unless that virus is living in your spinal cord.”

It’s not all bad news. A single-dose vaccine called Zostavax may prevent shingles altogether or prevent a recurrence. And if a person suspects shingles, especially when a rash appears on only one side of the body, he or she can still see their physician for treatment.

“(Anti-viral) medication does help. It does speed up the resolution of the pain and the rash, so go to your doctor and make sure it’s shingles,” Walts says. “We’re not sure about this, but one of the theories is that maybe treatment will not only decrease the amount of time you’re symptomatic, but it might decrease your risk for that postherpetic neuralgia. That’s all the more reason to get treatment, because, boy, anything you can do to prevent that side effect—even though it’s not common—you ought to try.”

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.

Smoking Cessation Aids

March 25, 2013 by
Photography by Bill Sitzmann

The old saying “third time’s the charm” didn’t work so well for Laura Adams when it came to quitting smoking.

“Every time I quit, I’d be good for about six months,” she says. “Then I’d get stressed about something and decide to have just one. Well, once you start up again, it’s all over. It’s an all-or-nothing thing.”

Adams is not in the minority. Most smokers will try quitting multiple times before they are successful. There’s a lot more to smoking than meets the eye, say local smoking cessation experts. “There’s an addiction to nicotine, the actual habit, and the emotional dependence that all need to be addressed,” says Laura Krajicek, a smoking cessation coordinator for Nebraska Methodist Health System.

A smoker for more than 20 years, smoking had become a crutch for Adams. “It helped me deal with daily stresses,” she explains. “When I had a cigarette, that was my relaxation time, my ‘me time.’ Coffee, cigarettes, and break time all went together. It was hard to have one without the other.”

Adams knew that it wasn’t a “pretty habit,” nor one she was proud of. With a campus-wide no smoking policy at her place of employment, Alegent Creighton Health Immanuel Medical Center, Adams would have to “sneak” to an off-site parking lot to smoke. To mask the nasty smoke odor, she would slip on a different coat, pull her hair back in a ponytail, wash her hands, and coat herself with body spray before returning to the office. “It was an embarrassing addiction,” she recalls.

“When I had a cigarette, that was my relaxation time, my ‘me time.’” – Laura Adams, former smoker

When Adams learned about Alegent Creighton Health’s smoking cessation program, Tobacco Free U, she decided this might be the extra push she needed to help her quit for good. The program focuses on the use of group or individual counseling in combination with a smoking cessation aid such as nicotine patches, nicotine gum, or medications.

According to the Cochrane Review, an internationally recognized reviewer of health care and research, combining counseling and medication improves quit rates by as much as 70 to 100 percent compared to minimal intervention or no treatment.

“Success rates rise drastically when you combine the two,” says Lisa Fuchs, a certified tobacco treatment specialist at Alegent Creighton Health. The counseling portion helps people tackle the behavioral addiction, and the smoking cessation aids help with the nicotine addiction.

Which smoking cessation aid is recommended depends on how heavy a smoker, health conditions, as well as what seems to be the best fit for that person’s lifestyle, notes Fuchs. These aids are most successful in individuals who have been counseled on how to use them appropriately. The most common aids include:

Nicotine patch – The patch is a long-acting therapy that delivers a steady dose of nicotine over a 24-hour period and is designed to curb a person’s cravings for nicotine. This may be appropriate for very heavy smokers. The dosage is gradually lowered to wean a person off the nicotine habit.

Nicotine gum or lozenges – Gum and lozenges are short-acting therapies that deliver smaller doses of nicotine and can be taken as needed to curb the nicotine urge. Tom Klingemann, certified tobacco treatment specialist at The Nebraska Medical Center, recommends that smokers schedule the doses so that they maintain a steady state of nicotine in the body to avoid the nicotine cravings and temptation to smoke. In general, he is opposed to short-acting nicotine replacement therapies because “they keep people looking for a chemical fix even though they may not be smoking anymore.” They are also very expensive, and most people trying to quit can’t afford the $40 a week price tag they would cost if used appropriately.

e-cigarettes – These work by heating up a liquid nicotine substance that is inhaled as vapor. The product is not regulated by the Food and Drug Administration (FDA) and many still have a lot of chemicals that may not be any healthier than actual smoking, notes Klingemann. “These are not intended to help people quit but keep them addicted to nicotine,” he says.

Medications – The two primary prescription medications used for smoking cessation include Zyban and Chantix, with Chantix being the preferred of the two, says Fuchs. “Zyban is an anti-depressant and may be recommended for a person with mild depression to help with moodiness as well as decreasing cravings and withdrawals,” notes Fuchs. It is believed to work by enhancing your mood and decreasing agitation related to trying to quit.

Chantix is a newer drug and works by binding to nicotine receptors in the brain and blocking them so that nicotine can no longer activate those receptors, causing a person to get less satisfaction from smoking. At the same time, it also triggers a small release of dopamine, the reward neurotransmitter in the brain. It appears to be safe and quite effective, notes Klingemann. Krijicek says that her clients have seen the most success with this aid.

“Success rates rise drastically when you combine [counseling and medication].” – Lisa Fuchs, certified tobacco treatment specialist at Alegent Creighton Health

Adams used Chantix, which she said helped curb her nicotine urges. But what helped the most, she says, was to change the habits that she associated with smoking. For instance, instead of coffee and cigarettes in the morning, she reached for coffee and orange juice. Because she normally smoked while driving, she changed the route she drove to work. She also replaced the time she would have spent smoking with more positive habits like walking her dogs, running, bicycling, and swimming.

“Once I quit, I started making healthier decisions in other parts of my life as well,” she says. “I started eating better, drinking less caffeine, and exercising more. I feel better now.”

“For 90 percent of smokers, the addiction is behavioral,” notes Klingemann. “It’s all of the other stuff that drives the smoking addiction. Until you start changing your behaviors and routines, it’s really hard to quit.”

From Patients to Caregivers

February 25, 2013 by
Photography by Bill Sitzmann

Margaret Ludwick spends her days sitting in a wheelchair at a senior care center in Elkhorn. She never speaks. The only expressive motion involves her hands—she constantly puts her long, tapered fingers together like a church steeple. Her big blue eyes stare straight ahead but focus on nothing. No one can reach her anymore, not her daughters, not her husband.

Alzheimer’s, the most common form of dementia in adults 65 and over, robs even the most intelligent people of their brain and eventually destroys their body. There is no cure. There is no pill to prevent it. There’s not even a test to definitively diagnose it. Effective treatments have proven as elusive as the disease, itself.

“We do have medications that may help with symptoms in some patients, especially in the early stages of Alzheimer’s,” says Dr. Daniel Murman, a specialist in geriatric neurology at The Nebraska Medical Center. “But they don’t truly slow down the disease process.”

According to researchers, the number of Americans living with Alzheimer’s will triple in the next 40 years, which means 13.8 million will have the disease by 2050 (Chicago Health and Aging Project research as reported by nbcnews.com).

Awareness of symptoms is crucial for early intervention.

“Memory loss and changes in behavior are not a normal part of aging,” stresses Deborah Conley, a clinical nurse specialist in gerontology at Methodist Health Systems who teaches other nurses and caregivers about Alzheimer’s. “I would urge family members to take [their loved one] to a family physician first, seek as much information as possible, and start making your plans.” An assessment that includes the person’s medical history, brain imaging, and a neurological exam can result in a diagnosis that’s about 85 percent accurate for Alzheimer’s.

Ludwick, a registered nurse, who worked at Immanuel Hospital for years, never received an extensive workup.

 “I would urge family members to take [their loved one] to a family physician first, seek as much information as possible, and start making your plans.” – Deborah Conley, clinical nurse specialist in gerontology at Methodist Health Systems

“I first noticed something was wrong about 15 years ago, when Mom was 70,” explains Ludwick’s daughter, Jean Jetter of Omaha. “It was the day I moved into my new house. Mom put things in odd places, like a box labeled ‘kitchen’ would wind up in the bedroom. And she stood smack in the middle of the doorway as the movers tried to carry large pieces of furniture inside, and she just stared at them.”

As Ludwick’s behavior grew worse, Jetter begged her father, Thomas, to get her mother help.

“He didn’t want to hear it. He kept saying, ‘This will get better.’ He had medical and financial Power of Attorney. Dad worked full-time, and she was home alone. This went on for eight years.”

Ludwick’s steady decline rendered her unable to fix a meal or even peel a banana. She lost control of bodily functions. After she was found wandering the neighborhood on several occasions, Jetter was finally able to call Adult Protective Services and get her mother into an adult daycare program. After breaking a hip two years ago, Ludwick arrived at the Life Care Center of Elkhorn.

“This is such a sad, but not unfamiliar case,” says Conley, who began working with Alzheimer’s patients in the mid-’70s. “Even in 2013, people do not know what to do, where to turn.”

Dr. Murman adds, “There is still a stigma attached to Alzheimer’s. People don’t like to hear the ‘A’ word. But it’s much better to be open and specific about it.”

A specific diagnosis may rule out Alzheimer’s.

“Depression can mimic the symptoms of Alzheimer’s…symptoms like mistrust, hallucinations, apathy, social isolation,” explains Dr. Arun Sharma, a geriatric psychiatrist with Alegent Creighton Health. “But we can treat that. We can treat depression.”

Dr. Sharma helped establish a 22-bed, short-term residential facility called Heritage Center at Immanuel Hospital to better diagnose the reasons for a person’s memory loss. Once a patient is stabilized and receives a proper care plan, they can return home. The more doctors learn, the faster a cure will come.

“I see something exciting in the next five to 10 years,” says Dr. Sharma. “If we identify and isolate the protein believed responsible for Alzheimer’s, perhaps we can do a blood test to catch the disease early.”

 “There is still a stigma attached to Alzheimer’s. People don’t like to hear the ‘A’ word. But it’s much better to be open and specific about it.” – Dr. Daniel Murman, specialist in geriatric neurology at The Nebraska Medical Center

But what about a cure? With 78 million Baby Boomers coming down the pike—10,000 of them turning 65 each day—this country faces an epidemic. And what about the psychological, financial, and emotional toll on the caregivers, who are very often family members? They, too, feel isolated.

“It was an impossible situation for me. I couldn’t get her the help she needed,” says Jetter, who bore the brunt of the family crisis since her married sister lives in Dallas. “Now that Mom is at [the nursing home], I can take a breather and concentrate on Dad, who also has mental issues.”

In recent weeks, her father, Thomas, has been admitted as a permanent resident of Life Care Center of Elkhorn as well.

What about her own family?

“I have no one. No husband, no boyfriend. I mean, what boyfriend would put up with all this?” asks Jean, who’s been shuttling between one parent and the other for years, all the while trying to run her own business. The situation has obviously taken a huge personal toll.

Conley has two words for anyone facing similar circumstances: Alzheimer’s Association. The Midlands chapter has support groups, tons of information, and can gently guide the adult child or spouse. They even have a 24/7 hotline: 800-272-3900.

For anyone dealing with Alzheimer’s, that number could become a lifeline.

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.”