Tag Archives: cardiologist

Groovy Gravy

January 12, 2017 by
Photography by Bill Sitzmann

UPDATE (Jan. 12, 2017) : After the publication of the January/February issue of Encounter Magazine, Cask Republic announced that it would no longer sell poutine.

“We realize that the food aspect, especially the poutine, was not financially viable,” says Ryan Frickel, co-owner of Cask Republic. Snacks will soon be available, and the bar allows patrons to bring in food from several area restaurants.

* * * * *

Foodies generally regard the 1950s as the nadir of 20th century cuisine in North America. It brought us TV dinners, jello salads, and tuna casseroles. However, it also brought us a Canadian dish that, depending on your disposition, is either a trinity of salty, starchy, fatty goodness, or a cardiologist’s dream for stirring up new business (in truth, it’s probably both).

Poutine is, essentially, french fries topped with gravy and cheese curds. Like the Reuben sandwich, there’s been a few claims to its origin, but the general consensus is that it came from rural Quebec in the late 1950s. It’s a prominent staple for restaurants downtown (Block 16) as well as Benson (1912, Benson Brewery). For the Cask Republic bar in Dundee, it’s their primary focus.

Co-owners Ryan Frickel and Craig Lundin opened Cask Republic this past summer in the former home of the popular French Bulldog restaurant. Frickel came to the decision to focus on poutine after eating it in Benson last year. Frickel says there have been poutine-focused eateries sprouting up on the West and East coasts for the past few years. Frickel wanted to be the first in Nebraska to have such an eatery.

“Who doesn’t like meat and potatoes in Nebraska?” Frickel says.

poutine1For their version of poutine, the Cask Republic double-fries their french fries to get them crispy enough to withstand the heavy coating of gravy. Their beef gravy (they also have chicken and vegetarian variations) is a combination of homemade beef stock, spices, herbs like rosemary, and some chicken. Finally, their cheese curds, served at room temperature, top the dish. When you bite into one of the curds, it should sound faintly like a dog toy.

“If it’s not squeaky, then people in the poutine world get super pissed off,” Frickel says.

Like other greasy spoon staples such as hamburgers and hash browns, there have been plenty of high-end takes on poutine. 1912 has a variation that includes duck. Block 16’s gravy incorporates a red wine reduction. The Cask Republic has poutines that include burnt ends, and even “seasonal” poutines, including turkey for the holidays. Still, focusing your menu on dish that’s basically french fries and gravy is risky. Frickel, however, compares poutine to other dishes that are now commonplace around Omaha.

“[We] kind of likened it to sushi, where 20 years ago, people in Omaha either didn’t know what sushi was or never tried it. But on the coast, it was starting to explode,” Frickel says.

Of course, if you’re going to clog your arteries with starch, cheese, and gravy, you might as well go all out and wash it down with a brew. That’s where beer comes in at Cask Republic. Frickel and minority- owner Alex Gunhus are both beer enthusiasts; they traveled to breweries throughout the United States to come up with their beer menu. Frickel says he eventually wants to build his own brewery inside the Cask Republic.

“There’s nothing like that in the Dundee area, which blows my mind,” Frickel says. “We want to be the first to do that.”

Visit facebook.com/caskrepublic for more information.

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.”

20131211_bs_7474

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.

20131211_bs_7453-2

“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.

Boston-2013-2

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!”

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.”