Tag Archives: Nebraska Medicine

The Influenza Virus and the Elderly

November 4, 2019 by

Each year as fall rolls around, people start hearing the call to get vaccinated for the flu. But does one need to get the flu vaccine every year? The simple answer is yes.

The influenza shot is the best way to prevent the flu, which can have serious and even fatal consequences, especially in the elderly.

The Centers for Disease Control (CDC) estimates there are more than 20,000 deaths from the flu each year and more than 200,000 hospitalizations. Most of these deaths occur in the elderly and the very young.

“Older adults have a high risk of complications and even death due to the flu because their immune systems are weaker,” says Dr. Alberto Marcelin, family practitioner at Nebraska Medicine. “It is estimated that 50 to 70% of flu-related hospitalizations occur in patients 65 years or older and approximately 90% of flu-related deaths occur in people over 60 years old.”

Getting the flu vaccine not only boosts a person’s immune system in protecting against the influenza virus but also decreases their chances of obtaining other serious infections. “If you don’t get vaccinated and get a severe influenza infection and end up in the hospital, you are more likely to contract other serious infections with organisms like methicillin—resistant staphylococcus aureus (MRSA),” says Dr. Renuga Vivekanandan, infectious disease specialist at CHI Health. “The flu can also make other chronic conditions like heart disease, emphysema, or asthma even worse.”

The effectiveness of the vaccine varies each year depending on the strain of flu circulating in the community and how well a person’s body responds to the vaccine. “Even if you acquire influenza after vaccination, the severity of your illness will be lessened if you get the influenza vaccine,” Vivekanandan says. “The flu vaccine primes your body so the body can create antibodies and is ready to fight against the circulating strain.”

It’s also important to note that the flu vaccine does not cause the flu. “It’s impossible to get the flu from the vaccine,” Vivekanandan says. “It is an inactivated vaccine. There is no live virus present to replicate and cause infection.”

Someone who has been recently vaccinated may develop redness, mild muscle aches, and even a low-grade fever for a day or two following administration of the shot, but these symptoms are nothing in comparison to influenza, which can cause high fevers and severe debilitating muscle aches, and usually lasts three to five days.

Determining how bad the illness will be each year is basically a guessing game. “The flu is predictably unpredictable,” says Dr. Anne O’Keefe, senior epidemiologist at Douglas County Health Department.

“Every spring, scientists try to determine what the flu virus is going to be based on what’s circulating in other parts of the world. If it’s a strain that hasn’t changed and has been around for a couple years, you will have better immunity. However, if it is a completely new strain, like the swine flu we experienced in 2009, it can quickly become a pandemic. An early winter can also increase the number of flu cases,” she says.

This year, the vaccine has been prepared to protect against the A and B strains and it was recently updated to be more effective against these strains, notes O’Keefe.

Those who are 65 years and older should get the flu vaccine in early September, or as soon as it becomes available, O’Keefe says. It takes about two weeks for the body to respond to the vaccine and develop protective antibodies—so people want to get the vaccine a couple of weeks before fall hits.

People in this age group should also ask for the high dose vaccine, which has been shown to be more effective and offer greater protection to those over age 65, Marcelin says.

Other preventive measures include practicing good hygiene and using a hand sanitizer when soap and water are not available. Avoid environments where other people are ill. Children should also be vaccinated early as they are often incubators of the flu and may hasten the spread of the virus.

Those who think they have been exposed or begin to develop common flu symptoms such as fever, chills, cough, sore throat, body aches, or rapid heart rate should talk to their doctor about getting the antiviral medication called Tamiflu. This medication can reduce the severity and duration of the influenza infection. Those who are exposed to someone with influenza can also request Tamiflu as a prophylaxis to prevent the infection from developing, Vivekanandan says.

While the flu vaccination is especially important for the elderly and the very young, everyone should get the vaccine. “When you get your yearly influenza vaccination, you are not only protecting yourself but also protecting the people you love, and people in your community who are at higher risk for serious complications like the elderly and the young,” Vivekanandan says.


This article first appeared in the November/December 2019 edition of 60PLUS in Omaha MagazineTo receive the magazine, click here to subscribe.

Shingles Vaccinations

September 26, 2019 by
Illustration by Derek Joy

Ekhorn resident Angie Jorgensen, 52, wasted no time getting a shingles vaccine upon turning 50. “I knew I would get the shingles shot the minute I turned 50 because my mother, who didn’t get the shot, got a horrifying case of it.”

Jorgensen’s mother, Connie Gonyea, contracted shingles around six years ago in her late 60s, and is still dealing with the effects.

“She got her shingles outbreak on her head of all places,” Jorgensen says. “She has sensitivity in an area on her scalp still, years later. She also has some nerve damage from it. Even combing her hair bothers her in certain places.”

Like many people age 50 and older, Jorgensen acquired chicken pox as a youngster. Many people retain vivid memories of chicken pox. The viral infection caused an itchy rash that blistered, and was often accompanied by fever, headaches, loss of appetite, and malaise. Chicken pox, however, rarely left nerve damage or sensitivity.

Those who acquired chicken pox need to be aware of shingles. The shingles virus results from varicella-zoster—the same infection that causes chicken pox—and resides in anyone who experienced chicken pox.

“The virus hides out in the nerves and decades later can reactivate and form shingles,” explains Dr. Rae Witt of Nebraska Medicine.

Shingles is not life-threatening, Witt says, “but can cause serious side effects.” Those affected can expect some burning pain and a dermatome [rash] on one side of the body that lasts around a week. “Most people fully recover, but around 20% of people aged 60-65 experience residual pain for months to years.” That number increases to 30% in people over age 80.

Shingles typically presents first as pain, or as Witt describes, “a weird burning on the skin,” followed by the dermatome, usually on the back or chest.

“Untreated, it will go away on its own,” Witt says. An anti-viral drug reduces the time affected and the severity of the pain. For best results, it is important to seek treatment as soon as people suspect they have shingles.

Shingles are not inevitable for those who had chicken pox earlier in life. “Lower immunity allows for an increased risk of shingles,” says Witt, adding that lifestyle choices such as “significant alcohol use, poorly controlled diabetes, high levels of stress for long periods of time, and even some medications” can increase the odds of shingles developing.

People over 50 should get a shingles vaccination, Witt says. Anyone who skips the vaccine because they don’t remember ever having chicken pox are putting themselves at risk because, as Witt explains, “it’s impossible to say someone never had chicken pox.” Since chicken pox presents in a spectrum of severity, it’s possible for someone to have chicken pox and never realize it, especially as a child.

The vaccine is a weakened virus, which helps the body recognize and fight the virus. “Over time, the body loses the ability to recognize the virus,” says Witt, explaining why the virus can lie dormant for so long within the body.

Shingles rarely reoccurs, and if that happens, Witt says doctors will “look for an underlying cause.”

She says there are two approved shingles vaccines: Zostavax and Shingrix. According to the Centers for Disease Control, Zoster vaccine live (ZVL, Zostavax) has been in use since 2006 and is approved for people over age 60. It is given in one dose, which gives protection from shingles for about five years.

The recombinant zoster vaccine (RZV, Shingrix), has been in use since 2017 and is recommended by ACIP as the preferred shingles vaccine. In fact, the CDC suggests that even those who previously received the Zostavax vaccine get the Shingrix vaccine, as long as they wait at least eight weeks after receiving a Zostavax vaccine. Shingrix is approved for people over the age of 50. It requires two doses that are given two to six months apart, and has a higher risk of side effects.

Donna Gilbert, 66, of Papillion, experienced minor side effects. “I got sick after the shot,” she says. “[It was] nothing terrible, and they warned me that might happen.”

Witt says there is currently no shortage of either vaccine, leaving no reason to avoid getting immunized. There is, however, a high demand for Shingrix. GlaxoSmithKline (GSK), the manufacturer of Shingrix, delivered about 8.3 million doses in 2018, and the CDC says production of the vaccine is being ramped up in 2019 in an effort to keep up with demand.

The best way to acquire the vaccine is to schedule an immunization through a doctor’s office. On the day the first dose is given, the second dose should be scheduled to avoid a waiting period. The vaccine may be available via a pharmacy, but it can be difficult for many places to acquire the vaccine, so those interested in being vaccinated may want to call ahead and check availability at their preferred location. In some cases, especially at pharmacies, there is a waiting list for people to get the immunizations.

It is always a good idea to check with one’s regular physician before getting the vaccine. The CDC says that someone who has a severe allergic reaction to gelatin or the antibiotic neomycin should not get the vaccine, but as this equates to about 0.1% of the population, it is extremely rare. Those with a weakened immune system due to cancer treatments or HIV/AIDS will also want to check with their doctor before getting either vaccine.

Shingles shots are sometimes covered by insurance, so those who are age 50 or older and have not yet been immunized should check with their plan to find out their best option for getting the shot.


This article was printed in the October 2019 edition of 60Plus in Omaha Magazine. To receive the magazine, click here to subscribe.

2018 March of Dimes Nurse of the Year

January 16, 2019 by

Nursing is the largest profession in health care, and one of the most recognizable.  Professionals from psychiatrists to surgeons use nurses each day to help care for patients with tasks from administering medicines to handing them tools of their trade.

Nurses labor tirelessly, often for 12 or more hours at a time. On Nov. 15, 2018, the March of Dimes took an evening to thank those vital professionals taking vital signs, and Omaha Magazine was in attendance as an event partner.

Nominations are blinded, then scored by the volunteer committee. Scores were based on credentials, certifications, their proudest outcomes, leadership, professional associations, and achievements. The Nurse of the Year is determined by the nurse with the highest overall score.

We again thank the nurses nominated for the March of Dimes awards, for taking care of us, each and every day.

Nurse of the Year Committee

Nicole Caswell, CHI Health Immanuel

Teresa Hultquist, UNMC College of Nursing

Cindy Mirfield, Methodist Women’s Hospital

Wendy Muir, Bryan Health

Christine Murphy, Nebraska Medicine

Sue Nuss, Nebraska Medicine

Melissa Schmaderer, Madonna Rehabilitation Center

Kris Stapp, VNA

Lisa Strasheim, CHI Health

Judy Thomas, Children’s Hospital & Medical Center

Judy Timmons, Children’s Hospital & Medical Center

Susie Ward, Methodist College

Chrissy Wilber, Boys Town National Research Hospital

March of Dimes Staff

Mackenzie Hawkins, Development Specialist

Kristin Schemahorn, Development Manager

Kristina Debus, Development Manager


Nurse of the Year

Jean Armstrong-Methodist Jennie Edmundson Hospital, Family Resource Center and Shaken Baby Task Force

Jean Armstrong has been devoted to creating and implementing a Shaken Baby Task Force. She has developed an educational curriculum, organized a conference, and created multiple educational videos. Her efforts were first recognized on a national level in 2000 when First Lady Laura Bush made a stop at her hospital.

Armstrong has helped Iowa Senator Amanda Regan support Senate Bill 349 to establish a Shaken Baby Syndrome Prevention Program through the Iowa Department of Health.

This Nurse of the Year was also instrumental in creating the only national 24-hour Crying Baby Helpline in the U.S.

 

Rising Star

Family Choice Award

Excellence in Academics


Betsy Miller-Methodist Hospital, Cardiac Care

Miriah Jansonius-Methodist Women’s Hospital, Labor & Delivery

Judi Dunn-Clarkson College, Continuing Education

Excellence in Advanced Practice

Excellence in Advocacy

Excellence in Clinical Excellence

Judy Placek-Nebraska Medicine, Plastic Surgery/Burn Surgery

Maria Lander-Nebraska Medicine, Solid Organ Transplant Unit

Sylvia Hanousek-CHI Health, Labor & Delivery, Post Partum and Mother-Baby

Excellence in Informatics

Excellence in Leadership & Mentoring

Excellence in Pediatrics

Ryan Zulkoski-Children’s Hospital & Medical Center, Nursing Education/Nursing Informatics

Anne Thallas-Methodist Hospital, Medical Surgical

Megan B. Sorensen-Children’s Hospital & Medical Center, Transport

Excellence in Pediatrics in School Health

Excellence in Research & Evidence Based Practice

Excellence in Service to Veterans

Twlya Kleen-Storm Lake Community Schools, Elementary School Nurse

Bernadette Vacha-Nebraska Medicine, Lung Transplant

(No Photo Available) Lisa Crouch-Veterans Health Administration, Ambulatory Care

Spirit of Nursing Award

Spirit of Nursing Award

Spirit of Nursing Award

Lindsey Ayles-Nebraska Medicine, Cardiothoracic Surgery Joan Blum-Clarkson College, Oncology Nursing Michelle Brester-Children’s Hospital & Medical Center, Pediatric Surgery

Spirit of Nursing Award

Spirit of Nursing Award

Spirit of Nursing Award

Cathrin Carithers-UNMC College of Nursing, Kearney Division

Tiffany Keller-CHI Health Creighton University Medical Center, Post Partum—Lactation RN

Jaki Kenney-Nebraska Medicine, Werner Special Care Unit

Spirit of Nursing Award

Spirit of Nursing Award

Spirit of Nursing Award

(No Photo Available)Jennifer Lantis-Great Plains Health, Infection Prevent

Kimberly Marsh-Children’s Hospital & Medical Center, Neonatal Intensive Care Unit

Barbara Petersen-Great Plains Health, Quality

Spirit of Nursing Award

Spirit of Nursing Award

Spirit of Nursing Award

Kimberly Peterson-Children’s Hospital & Medical Center, Performance Improvement

Julie Sundermeier-Nebraska Medicine, NICU

Danielle Treska-CHI Health Lakeside Hospital, ICU

Spirit of Nursing Award

Anne Wilber-UNMC College of Nursing, Northern Division (Norfolk)

Student Nursing Award

Student Nursing Award

Student Nursing Award

Taira Anderson-University of Nebraska Medical Center College of Nursing, Northern Division

Dania Cervantes Ayala-College of Saint Mary

Racheal Dawn Daigger-UNMC College of Nursing, Kearney Division

Student Nursing Award

Student Nursing Award

Student Nursing Award

(No Photo Available) Katherine Glaser-Creighton University College of Nursing

Sara Glaser-Bryan College of Health Sciences

Sarah Henry-Purdue University Global School of Nursing

Student Nursing Award

Student Nursing Award

Student Nursing Award

Kathryn Noble-Nebraska Wesleyan University

Tiffany Pardew-Clarkson College

Megan Reiten-Nebraska Methodist College

Student Nursing Award

Student Nursing Award

Student Nursing Award

Jiosajandy Garcia Reyna-University of Nebraska Medical Center College of Nursing

Stephanie Shoning-College of Saint Mary

Breanna Swanson-Bryan College of Health Sciences College of Nursing

Student Nursing Award

Ashley Tagart-College of Saint Mary

Nurse of the Year Nominees

Boys Town Clinics

  • Sara Pfeifer, Pediatric Clinic

Boys Town National Research Hospital

  • Kayla Gentrup, Pediatric Gastroenterology
  • Stephanie Hernandez, Surgical Floor
  • Nerissa Imada, Surgery Center
  • Autumn Rowe, Surgery Center
  • June Root, Pediatrics – Inpatient

Bryan Health

  • Christie Bartelt, Rehabilitation
  • Julie Bratt, Care Management

CHI Health

  • Sarah Barker, Family Birth Center
  • Susan Brill, Intensive Care Unit
  • Rebecca Gardner, Good Samaritan
    Surgery Department
  • Sylvia Hanousek, LDRP: L&D, Post Partum, and Mother Baby
  • Katelyn Henriksen, Orthopedics
  • Jennifer Lemmons, Hospital
  • Debra Saldi, Behavioral Serivces
  • Rebecca Seier, Infection Prevention
  • Lowellyn Steinkraus, Plainview Hospital Specialty Clinic
  • Heidi Gall, Rural Health clinic

CHI Health CUMC – Bergan Mercy

  • Aaron Allen, ICU
  • Kara Aldana, NICU
  • Alicia Buechler, HVI – Cardiac Universal Unit
  • Kara Johnson, Obstetrics
  • Tara Kiichler, NICU
  • Sarah Kumm, Neonatal Intensive Care Unit
  • Rhonda Meyer, Heart and Vascular
  • Tracy Meyers, NICU
  • Donna Myers, NICU
  • Emily Oppel, Intensive Care Unit
  • Elena Oquendo, NICU
  • Erin McQuinn, House Operations
  • Guylah, Med/Surg/Ortho/Intermediate/Dialysis
  • Heather Reese, ER

CHI Health Creighton University Medical Center

  • Tiffany Keller, Post Partum-Lactation

CHI Health Good Samaritan

  • Kelsey Daake, Leadership
  • Del Miller, Orthopedics/Oncology

CHI Health Immanuel

  • Hannah Baldwin, PCCU
  • Crisann Hannum, Critical Care
  • Mandy Iverson, Labor and Delivery
  • Mandy Iverson, Obstetrics
  • Mandolyn Klinkhammer, Labor and Delivery
  • Cynthia Lesch-Busse, Nursing Administration
  • Kay Maguire, Medical Surgical
  • Carrie Meyer, Labor and Delivery
  • Jaclyn Seiboldt, Medical Surgical Oncology
  • Elizabeth Steadman, Critical Care
  • Christy Todd, Labor and Delivery
  • Lisa, Labor and Delivery

CHI Health Lakeside Hospital

  • Christine Enterline, Surgery
  • Emily Mass, Med/Surg/Oncology
  • Jordan Novak, Med-Surg/Oncology
  • Katie Swanson, Med-Surg/Ortho
  • Danielle Treska, ICU
  • Jill Yosten, Ambulatory Infusion Center
  • Hanah Zehnder, Float Pool
  • Aysha Classen, ED

CHI Health Mercy Corning

  • Chimene Cobb, Outpatient Specialty Clinic

CHI Health Mercy Council Bluffs

  • Marie Baker, Critical Care Unit
  • Ranita Hiller, Post Critical Care
  • Lori Woodrow, Psychiatric Nurse

CHI Health Midlands

  • Vicki Gall, Medical/Surgical
  • Julie Nichols, Surgical Services

CHI Health Missouri Valley

  • Jodi Potts, Rural Health clinic

CHI Health St. Elizabeth

  • Emily Bachman, Ortho/PEDS
  • Lori Birdzell, Observation
  • Nicole Ragon, Critical Care Unit
  • Tricia Topolski, Emergency
  • Christine Vogt, OBGYN
  • GayAnn Wagner, NICU
  • Kelly Watton, Primary Care

CHI Health St. Francis

  • Darla Cleveland, Medical Oncology
  • Lacey Pavlovsky, Quality Management-Infection Control

CHI Health St. Mary’s

  • Loree Mort, Labor and Delivery

Children’s Hospital & Medical Center

  • Carol Beare, Med-Surg 6 – Nursing Informatics
  • Alicia Bremer, Performance Improvement
  • Michelle Brester, Pediatric Surgery
  • Erin Hartman, Emergency
  • Chase Hinzmann, Critical Care Transport
  • Jill Jensen, Performance Improvement
  • Vanessa Le, NICU, Nursing Informatics
  • Kimberly Marsh, Neonatal Intensive Care Unit
  • Katherine McCollough, Dialysis
  • Kimberly Peterson, Performance Improvement
  • Kathy Powers, CARES/PACU
  • Katherine “Kitty” Rasmussen, 5 Med-Surg
  • Megan B. Sorensen, Transport
  • Ryan Zulkoski, Nursing Education/Nursing Informatics

Children’s Physicians—Bellevue

  • Nicole Wallin, Lactation

Children’s Physicians—Plattsmouth

  • Rebecca Robbins, Pediatrics

Children’s Physicians—Gretna

  • Amy Wortmann, Pediatrics

Clarkson College

  • Joan Blum, Oncology NursingJudi Dunn, Continuing Education

Craig HomeCare

  • Amy Lauby, Pediatric Home Health Care

Fremont Health

  • Desa Clark, NursingTerese Moore, Labor and Delivery

Great Plains Health

  • Jennifer Lantis, Infection Prevention
  • Jill Stevenson, Joint Replacement-Orthopaedics
  • Wendy Ward, Quality-Risk Management
  • Barbara Petersen, Quality

Madonna Rehabilitation Hospital

  • Jane Bilau, Traumatic Brain Injury Rehabilitation
  • Mari Ramsey, Acute Rehab

Methodist Hospital

  • Jean Beumler, Palliative Care
  • Ashley Colburn, Rehabilitation
  • Rachael Coufal, Progressive  Care Unit
  • Carrie Kelseth, Cardiac Care
  • Kelly Menousek, Emergency Department
  • Betsy Miller, Cardiac Care
  • Tiffany Pettit, Ortho-Neuro
  • Mandy Stockdale, Rehabilitation
  • Anne Thallas, Medical Surgical
  • Catherine Wolpert, Medical Surgical

Methodist Jennie Edmundson Hospital

  • Jean Armstrong, Family Resource Center and Shaken Baby Task Force

Methodist Women’s Hospital

  • Miriah Jansonius, Labor & Delivery
  • Sheri Kimmey, NICU/Outreach
  • Shonda Knop, High Risk Obstetrics
  • Amy Rapp, GYN, Postpartum

Nebraska Medicine

  • Megan Armbrust, Women’s and Infant’s Services
  • Lindsey Ayles, Cardiothoracic Surgery
  • Claire Baweja, Emergency Department – BMC
  • Lindsie Buchholz, Enterprise Practice Support
  • Ashley Carne, Medical ICU
  • Barabara Cowden, Werner Intensive Care Unit
  • Lyndie Farr, Critical Care Anesthesia
  • Stephanie Floth, UNL Student Health Center
  • Caitlin Hagen, Cardiology-Progressive Care
  • Terri Heineman, Oncology Treatment Center at Werner Cancer Center
  • Samantha Jordan-Schaulis, Pediatric ICU
  • Jaki Kenney, Werner Special Care Unit
  • Teresa Kerkman, Medical ICU
  • Susan Knutson, NICU
  • Margee Langer, Oncology
  • Maria Lander, Solid Organ Transplant Unit
  • Riley Lyons, Werner Progressive Care Unit
  • Courtney Marshall, Nursing Development Specialist
  • Megan Myers, Medical ICU
  • Denise McGrath, Women and Infant Services
  • Sarah Newman, NICU
  • Sara Neumann, Cardiology
  • LeaAyn Norton, Clarkson Family Medicine Clinic
  • Megan Pierce, Women’s Services
  • Judy Placek, Plastic Surgery/Burn Surgery
  • Lori Schmida, Kidney/pancreas transplant
  • Michael Schrage, Emergency Department
  • Danielle Schulz, Emergency Department
  • Carmen Shannon, SICU
  • Amy Steinauer, Community & Corporate Relations
  • Angie Strain, Heart and Vascular
  • Julie Sundermeier, NICU
  • Gisele Tlusty, Specialty Care Unit
  • Tina Twymon, Clarkson Family Medicine Clinic
  • Bernadette Vacha, Lung Transplant
  • Lisa Wulf, Emergency

Nebraska Methodist College

  • Alice Kindschuh, DNP

Omaha Public Schools

  • Sharon Wade, School Health

Saunders Medical Center

  • Patricia Kucera, Long Term Care

Skinner Magnet Elementary School

  • Shannon Cunningham, Health Office

Storm Lake Community Schools

  • Twlya Kleen, Elementary School Nurse

UnityPoint Health St. Luke’s

  • Christi-Ann Bullock, NICU
  • Brenda Crank, Mother Baby

UNMC College of Nursing

  • Cathrin Carithers, Kearney Division
  • Anne Wilber, Northern Division (Norfolk)

Veterans Administration Health Care

  • Lisa Crouch, Ambulatory Care

VNA of the Midlands

  • Jennifer Dannen, Maternal Child

West Holt Memorial Hospital

  • Jessica Thomassen, Med/Surg, ER, Surgery

West Central District Health Department

  • Brandi Lemon, Outreach Director

This list was printed in the January/February 2019 edition of Omaha Magazine. To receive the magazine, click here to subscribe.

Gifts of Life

January 4, 2019 by
Photography by Bill Sitzmann

To describe life with cystic fibrosis, Dan Gerdes starts by talking about a frog. Specifically, a frog put into a pot of water that’s slowly brought to a boil.

“It creeps up on you,” Gerdes says. “You just get slowly and slowly sicker and sicker and you never realize how far you’ve come from point A.”

For Gerdes, point A came when he was diagnosed with cystic fibrosis as a baby. Back then, his mother could dislodge the mucus collecting in his lungs by cupping her hand and patting his back. As the disease advanced, Gerdes had to use a long-handled percussor, then a vest that inflated to force loose the thick substance blocking his airways.

The water grew warm, then hot.

Gerdes had to use inhalants. The mucus collected in his stomach, requiring medicine to aid digestion. It attacked his pancreas, and Gerdes became diabetic at age 15. Infections that rooted in his lungs forced occasional hospital stays. By 2012, Gerdes was taking antibiotics intravenously every other week and enduring hour-and-a-half long treatments three to four times a day. He was coughing up more than a liter of mucus each day.

The disease ravaged his body, then his spirit.

“At first, I was pretty positive. I was involved in all kinds of sports and stuff. I wasn’t going to let it beat me,” Gerdes says. “But as it got worse and worse, it got darker and darker. Like to the point where I just felt worthless because I couldn’t contribute anything.”

The water was nearing a boil. Gerdes was dying.

The only way he could live, though, was if somebody else died. Gerdes needed that person’s lungs to replace his own diseased ones.

This life-saving exchange happens quite often. In the United States, 34,770 organ transplants were performed in 2017 (244 of those in Nebraska) according to Nebraska Organ Recovery.

Dr. Alan Langnas, a transplant surgeon at Nebraska Medicine and director of the Center of Transplantation for the University of Nebraska Medical Center, has performed more than 1,000 liver transplants in his 30-plus-year career. With each operation, he is mindful of the deep sacrifice that made it possible.

“At the end of the day, what makes this incredibly special is the deceased donor and families making difficult decisions at a difficult time,” Langnas says. “Or living donors making donations and willing to lay on an operating table and give people an organ for someone they don’t know.”

Currently, more than 114,000 people in the U.S. are waiting for a life-saving organ transplant—400-plus in Nebraska. This year, more than 7,000 of them will die.

Gerdes is among the fortunate. His story, and others, illustrate the good that can come from grief, life from death.

Lungs for Dan Gerdes

Gerdes was dying, but he kept telling himself that “I was not that bad.” So when doctors in 2014 told him he needed a lung transplant, “It kind of broadsided me.”

His reaction after that might surprise some.

“For a long time I told myself that I never wanted to get a transplant because of that really dark aspect of my life that I just thought…I wasn’t producing anything with my life,” Gerdes says. “That I didn’t deserve it.”

But during yet another hospital stay, Nebraska Medicine doctors convinced him to begin the long process of testing to see if he was a viable recipient candidate. On Aug. 4, 2016—Gerdes’ 27th birthday—he was put on a waiting list for a set of lungs.

Just five days later, he was called to the hospital—new lungs were waiting for him. The transplant was successful. Today, Gerdes breathes easy. “It’s night and day,” Gerdes says. “There’s really no comparison. I don’t have to do those treatments, and I have more energy than I ever did since I was a child.”

It was the loss of someone else’s child—Bryan Clauson—that gave him life. An IndyCar driver, Clauson died from injuries sustained during a national midget car dirt track race in Kansas. He died at Bryan Medical Centre in Lincoln, Nebraska. He was 27.

Gerdes first heard of Clauson a few days after his transplant. A friend had learned of Clauson’s death and organ donation. He called Gerdes to ask if he now had “race car driver lungs.”

“I thought he was kind of trolling me,” Gerdes says. “I hadn’t heard anything about Bryan Clauson.”

Soon thereafter, Clauson’s family wrote an introductory letter to Gerdes. But Gerdes’ mother, in the hecticness of the operation and a move to Bellevue to be closer to her son, misplaced the unopened letter. She found it about a year later. Gerdes read it on Dec. 24, 2017. The next day, Christmas morning, he sent a Facebook message to Clauson’s father, Tim. Four months later, Gerdes met the Clausons at a charity walk in Bellevue.

“It was kind of nerve-wracking to an extent, because the event still I struggle with,” Gerdes says. “How do you tell somebody thank-you that has given you your entire life back but at the same time it was somebody they loved an extreme amount? It’s really hard to tell them thank-you enough.”

He thanked them in part simply by breathing. A nurse who had been with Clauson at his death also was at the reunion. She brought the stethoscope used to listen to Clauson’s heart and lungs during his final moments. Clauson’s family used it to listen to Bryan’s lungs pumping strong and steady in Gerdes.

“One of the first things I explained to them is how it sounded really clear,” Gerdes says. “Before that my cystic fibrosis lungs would have sounded like a lot of cracking and popping.”

It was the sound of life.

Bryan Clauson’s Family

Life changed irrevocably for Diana Clauson and her family the day her son, Bryan, died. “You just sit there and it’s stuck in your face a lot, death in general,” she says. “Especially when you’re not prepared.”

That said, the Clausons have talked frequently about how different—in a worse way—their lives would be had Bryan had not been an organ donor.

“As tragic and as devastated we were as a family, when we left that hospital knowing he was going to help five lives continue, that was this little light at the end of a very, very dark tunnel. I think what turned my corner was just knowing that he was able to help these people continue their life. Otherwise, I think I’d still be in a pretty dark place.”

The Clausons since have devoted themselves to turning Bryan’s selfless act into thousands of other selfless acts as they encourage others to become organ and tissue donors. His sister, Taylor, now works for the Indiana Donor Network, which started the organization Driven2SaveLives to promote organ donations as a partnership with IndyCar driver Stefan Wilson (whose brother, Justin Wilson, died in a racing accident in 2015). Bryan was the second driver honored through the program. His parents have also become active advocates for organ donation and often speak at races and other events.

They’ve been wildly successful, too. In the two years since Bryan’s death they’ve had more than 8,000 people sign up to become donors—a huge number in the industry.

Really, though, the Clausons only needed one life saved to have realized healing from the tragedy of Bryan’s death. That came with their first encounter with one of the five people who received one of Bryan’s organs, Dan Alexander of Papillion.

“It was pretty overwhelming,” Diana Clauson says. “Hearing Brian’s heart beating again…that was probably the best part of it all.”

A Heart for Dan Alexander

Dan Alexander, heart recipient

A retired lieutenant colonel with the U.S. Army Signal Corps and a veteran of Operation Desert Storm, Dan Alexander has a particular fondness for the military credo, “Leave No Man Behind.”

Bryan Clauson, Alexander says, did just that:

“I told Bryan’s dad, ‘Every breath I take, I try to honor Bryan for what he did.’ He did not leave me behind. He could have. He could have not checked that box. But he didn’t. He’s my hero.”

Alexander, who was physically fit, had needed a new heart since July 2013, when he suffered a massive heart attack. “What some people call a widow maker,” he says. The medical team fought four hours to keep him alive. Three times, his heart stopped. When he awoke from a coma 10 days later, he was told it was a miracle.

Another miracle was to come.

Alexander lived for nearly three years with his heart regulated by a left ventricular assist device. He also was put on the waiting list for a new heart. On Aug. 9, 2016, Alexander got the call—it was time to get a new heart. The surgery went well and his recovery has been “incredibly good.” He was out of the hospital in nine days and has not been back for a stay since.

He’s also become a racing car fan.

Clauson’s family first met Alexander in April 2017 at Alexander’s house. An ESPN film crew was on hand to document the moment. Diana Clauson listened to her son’s heartbeat inside what until then was a stranger.

“Incredibly beautiful. Satisfying. Lots of tears of joy,” says Alexander, 65. “There were a lot of stories told that afternoon. What I took away from that day is we’re committed to each other.”

Living Organ Donors & Kidney Chains

Sue Venteicher, kidney donor

Gerdes’ worry that he wasn’t worthy of a transplant echoes in what people asked Sue Venteicher when they learned she was giving up one of her kidneys—to a stranger.

“I’ve had people ask me, ‘What if you found out it went to someone who was in prison?’” Venteicher says. “I said, ‘So they should be in pain and their family should have to worry about them dying?’ One person is not more important than another person.”

Venteicher sparked donations impacting not just one person, but 18. In February 2016, she was part of the largest living-donor kidney transplant chain in Nebraska history. A kidney chain matches donors with compatible recipients. Venteicher started the chain when she decided to donate her kidney in memory of a friend’s son who had died from kidney failure. Nine patients received kidneys from nine living donors over five days of surgeries at Nebraska Medicine.

Venteicher, a wife, mother of seven, and grandmother, was home two days after the surgery and felt fully recovered within two months. “In some ways, I’m healthier than I was two years ago,” says Venteicher, who recently retired after a long nursing career. She hates water but drinks more of it than ever to make sure her one kidney filters efficiently. She’s lost 20 pounds. “I think I appreciate my body a little bit more.”

So does Dennis Molfese of Bennet, Nebraska—the man who received Venteicher’s kidney. Molfese had been on a kidney transplant waiting list for more than three years. But he was running out of time. Molfese’s kidney was functioning at 4 percent. His blood pressure was running 240/180. If he didn’t die from kidney failure, it could have come from a devastating stroke.

Molfese’s friend, David Hansen, offered his kidney, but was not a match. In stepped Venteicher.

“She is my hero,” Molfese says. “An incredibly selfless individual who literally put her life on the line for someone else. In Susan’s case, I was a stranger, not even a name. Just someone in need of a special part of her body that she decided to give away, even at the risk of her own life.”

Hansen’s kidney went to another recipient in the 18-person chain. The 18 donors/recipients met five months after the transplants. Molfese and Venteicher didn’t get to speak a lot that day, which included a press conference and perhaps 200 or more family members in attendance. “I was thrilled to see he looked so well,” Venteicher recalls.

Molfese already had written a letter to Venteicher. “He wrote that the hardest thing about being sick was to look into his wife’s eyes and see the pain and the worry and concern every single day. Now, since he had his kidney, he sees nothing but joy in his wife and excitement for the future.”

They’ve become friends. When Molfese received an award related to his work as a neuropsychologist at the University of Nebraska-Lincoln, he invited Venteicher to the ceremony. She sat with his family.

“Without Susan, I definitely would not have been alive to be nominated or to receive such a once-in-a-lifetime honor,” Molfese says.

The Gift That Keeps Giving

Cindy Schabow, heart recipient

Cindy Schabow missed out on her cruise, but she would have missed out on a lot more had she not received a heart transplant in May 1987.

Her own heart had been slowly dying since 1981 when it was weakened by a virus. The damage was discovered while she was pregnant. Schabow gave birth to a daughter and lived with relatively stable health for the next five years. “I continued to work and live life and take some medicine but really didn’t think much about it,” she says.

But then her heart began to weaken, requiring a pacemaker. That went well for about a year before her heart became enlarged and sicker. Her cardiologist said she needed a new heart.

“I said, ‘We’re going on a cruise this summer, and when I get back we’ll talk about it,’” Schabow recalls. “She said, ‘You will die by the end of the summer if you don’t get a new heart.’

“The idea of a heart transplant was so beyond anything I ever thought about. That got my attention.”

On Memorial Day 1987, Schabow flew to Baylor St. Luke’s Medical Center in Houston to wait to have the procedure. But she grew sicker and sicker. She was put into ICU. “I  could pretty much tell we were toward the end of the line,” she says. After eight weeks of waiting, Schabow was notified that a heart had been donated—and just in time.

“They told me I wouldn’t have lived for 24 hours without the transplant,” she says. “It was immediate joy. I’m going to get to live to see my daughter grow up. At the same time, profound sadness since I knew the only reason this could happen was someone lost somebody very precious to them and had made this amazing, generous decision to let me have this heart.”

The heart came from a 15-year-old Louisiana boy who had died in a swimming accident. “I didn’t find out much more than that,” Schabow says. She wrote the family on occasion but never heard back. When she reached 30 years with her heart, she decided to write again and let the donor’s family know the heart, amazingly, is still going strong. She did a bit of detective work and was able to connect with the donor’s sister.

They talked on the phone, texted, and became Facebook friends. They’re planning to meet one day soon.

“They were happy to hear a part of him still lives,” Schabow says. He was athletic and a talented football player, Schabow’s been told. He was friendly and outgoing.

He would be a middle-aged man now. Had he not donated his heart, he’d only be remembered by his family. Maybe a few friends.

Instead, after 31 years, he is still remembered as a hero across state lines in Nebraska. Schabow will never forget him. Neither will her daughter or grandchildren.

“I’m just very, very privileged to carry on his heart,” she says.


Organ Donor Reasons

One deceased organ donor can save up to eight lives. One tissue donor can improve the quality of life or save an additional 100 people. Nebraskans appreciate this. Research conducted by Nebraska Organ Recovery in fall 2016 indicated that 98 percent of Nebraskans support organ and tissue donation, but only about 56 percent of eligible Nebraskans are registered. Why aren’t more individuals registered?

Here are answers to some misunderstandings/misconceptions (provided by Nebraska Organ Recovery):

  • I’m too old to register/donate. Anyone 16 or older can register for deceased organ donation. There are no upper age restrictions.
  • I have a health issue that prevents me from registering/donating. There are no medical conditions that restrict someone from registering as a donor.
  • I’ve used illegal drugs and/or I smoke and drink alcohol regularly. Use of illegal drugs and excessive smoking or drinking does not disqualify someone from donating. Drinking and drug use can impact specific organs, but oftentimes other organs and tissues are still viable.
  • I can’t give blood, so I can’t donate. The majority of individuals who are restricted from giving blood can still donate organs and tissues.
  • I can’t afford donation. There is no cost to the donor’s family for donation.
  • I can’t have an open-casket funeral if I’m a donor. A viewing or open-casket funeral is almost always possible following donation. Surgical incisions are covered by clothing and great care is taken to ensure the donor’s appearance is as normal as possible.
  • I can only register at the DMV. Although the majority of individuals register while obtaining their driver’s license, anyone can register (or update their registry) online anytime at nedonation.org.

Living Donations

In 2017, 6,187 people in the United States were living donors. In Nebraska, a living donor must be at least 19 years old. There is no fee for an individual to be screened for living donation. To be screened for living donation in Nebraska, contact Nebraska Medicine at 800-401-4444 or 402-559-5000.

Below is a list of organs that can be donated, and the number of patients waiting for them in the United States and Nebraska (in parentheses):

  • Kidney: 102,701 (204)
  • Liver: 14,034 (152)
  • Pancreas: 903 (14)
  • Kidney/Pancreas: 1,669 (6)
  • Heart: 3,900 (58)
  • Lung: 1,458 (1)
  • Intestine: 248 (19)

Visit nedonation.org for more information.

This article was printed in the January/February 2019 edition of Omaha Magazine. To receive the magazine, click here to subscribe.


Correction: the print edition of this article incorrectly attributed the creation of Driven2SaveLives to Bryan Clausen’s family and the Indiana Doctor Network. Although the Clausens are active with the organization, Bryan was the second IndyCar driver and organ donor to be honored through the program (not the first). Driven2SaveLives started as a partnership between the Indiana Donor Network and IndyCar driver Stefan Wilson after his brother, Justine Wilson, died in a racing accident in 2015. 

Summer!

August 11, 2016 by
Photography by Bill Sitzmann

The symptoms of heat exhaustion can develop swiftly and suddenly. If you are age 60 or older, not only does your risk for developing heat exhaustion intensify, but the symptoms can develop more rapidly and become more serious.

“Older people are especially prone to heat exhaustion because their bodies don’t adjust to heat as well,” says Dr. Mark Ptacek, a family practitioner at Nebraska Medicine. “Chronic medical conditions, as well as certain types of medications, can impair your ability to regulate your body temperature and perspire.”

HealthHeat exhaustion results from prolonged exposure to high temperatures, usually in combination with dehydration. The risk for heat exhaustion increases when the heat index—a combination of the temperature and humidity—rises to 90 degrees. A relative humidity of 60 percent or more hampers sweat evaporation, which hinders the body’s ability to cool itself, says Dr. Ptacek.

Heat exhaustion causes the skin to feel hot and moist, and to appear flushed. Other possible symptoms include heavy sweating, faintness, weakness, rapid pulse, low blood pressure, nausea, low-grade fever, headache, and dark urine. “If you are no longer sweating, your condition has grown more severe,” notes Dr. Ptacek.

If you or someone you know is experiencing signs of heat exhaustion, Dr. Ptacek recommends going to a cool place, sitting in front of a fan, removing extra clothing, rehydrating with cool water (iced or cold water can cause cramping), spraying or sponging with cool water, resting for two to three hours, and staying out of excessive heat for about a week. If you are nauseated, throwing up, or are very dizzy or light-headed, you should be taken to an emergency room, he says.

Dr. Ptacek recommends these tips to keep yourself well-hydrated during the summer:

  • Drink plenty of fluids. “We are a quart low on water when we wake up in the morning, so start your day with two glasses of water. Continue to drink lots of fluids throughout the day, even if you don’t feel thirsty. As you get older, you begin to lose your sense of thirst, and therefore you may already be at a fluid deficit.”
  • Drink before you feel thirsty. When your body begins expressing thirst, this means you are starting to get behind your body’s fluid needs.
  • If you are exercising and perspiring a lot, drink fluids with extra electrolytes such as sports drinks.
  • Avoid drinking alcohol, which acts as a diuretic, causing your body to lose fluids and desensitizes your body’s needs for water.
  • Avoid caffeine, which decreases your body’s blood volume and also acts as a diuretic, making you more dehydrated.
  • Exercise in the early morning or late evening.
  • Avoid sugary drinks, which can cause your body to lose more fluid.
  • Wear light-colored and loose-fitting clothing.

Sixty-Plus

Geriatric Nurses

April 21, 2016 by
Photography by Bill Sitzmann

Some people just don’t get it when it comes to the health of older adults. Many believe that elderly people are always tired. But that’s a myth.

“It’s also not true that an older person doesn’t have a brain that works as well,” says Sara Wolfson, geriatric nurse practitioner for the University of Nebraska Medical Center (UNMC) Home Instead Center for Successful Aging.

Myths such as these lead to ageism that can affect how older adults are treated (or under-treated) for illnesses.

A geriatric nurse can sort it out. This registered nurse specialist has the skills to recognize what’s normal for older adults versus what’s abnormal.

Beth Culross

Beth Culross

“We are really focused on looking at the process of aging and how we can help older adults maintain their  health and prevent health problems as they age. What is normal at age 80 might not be normal for 40 or 50,” says Dr. Beth Culross, an R.N. with a Ph.D. in gerontology. She teaches undergraduate gerontology at the UNMC College of Nursing in Omaha.

Geriatric nurses often function as case managers who help patients live with chronic illnesses, giving them a greater chance of staying independent and active.

“With case management, there are a lot of phone calls, checking on them, answering questions about medication, seeing how a visit to the ER went,” Wolfson explains.

She says it’s important to keep older adults out of hospitals. “Being in the hospital weakens people. It takes longer to recover. Some get confused. Older people have less reserve when they get sick.”

Geriatric nurses can be found working in hospitals, clinics, physicians’ offices, long-term care facilities—and in patients’ homes.

Senior Assist, a home-visit program for patients ages 65 and older whose primary care physician is with Nebraska Medicine, is available at no cost through the Home Instead Center for Successful Aging. Home visits give the nurse a look at the person’s living environment, and consequently gives them a clue to what is going on with their physical and mental health. 

“One nurse went to the home of a patient who was constantly coming here because of congestion and found she wasn’t using her nebulizer,” says Wolfson. “Home visits give a heads-up if someone is having a problem.”

UNMC’s Home Instead Center for Successful Aging offers seniors a wellness center, outpatient clinic, assessment, and education in topics as diverse as fall prevention,  nutrition, arthritis, and tai chi. Nurses provide education as mandated by Medicare—information about medications, like blood thinners, or about general health and nutrition, like cutting back on sodium.

“We’re a center for people who are aging well and people who have a lot of chronic illnesses that need to be managed,” Wolfson says. “We take walk-in patients. They might have a cold, feel dizzy or tired.”

The center also provides dementia evaluation and diagnosis.

“We wouldn’t diagnose dementia on the fact that their memory is bad. It’s based on function. Are they still independent?  Taking medications?  Or are they not bathing? Are their clothes tattered?” says Wolfson, who points out that there are other geriatric clinics available in the area.

As people live longer and the number of people over age 65 increases, more nurses specializing in geriatrics are needed.

By 2030, one in five adults—88 million people—will be 65 or older, according to the U.S. Census. About 10,000 adults turn 65 every day.

Sara Wolfson

Sara Wolfson

“Most of the hospitals in the Omaha area have started recognizing this,” Culross says. “These hospitals have special designations around the need for care for older adults.”

There is a shortage of nurses in general and—because the number of aging adults is increasing—there is especially a need for certified geriatric nurses.

Almost half of all patients admitted to hospitals are over 65, but only 1 percent of registered nurses and 3 percent of advanced practice registered nurses are certified in geriatrics, reports the American Geriatric Society.

Adults over 65 account for nearly 26 percent of all physician visits, 47 percent of all hospital stays, 34 percent of all prescriptions, 34 percent of all physical therapy patients, and 90 percent of all nursing home stays, according to the Eldercare Workforce Alliance.

By 2030, 7.7 million people will have Alzheimer’s disease, up from 4.9 million in 2007.

“The fastest growing segment of the population in the United States are people 85 and over,” Culross says.

Recognizing what’s normal and what’s not for an aging adult is important for a geriatric nurse. So is listening. Allowing patients to talk about their experiences and life stories tells where they are now and how she can help, says Culross.

“I learn as much from my patients as they do from me. My husband tells me I’m really good at it because I like to talk.”

Fighting the World’s Worst Diseases

February 20, 2015 by
Photography by Bill Sitzmann

Originally published in March/April 2015 Omaha Magazine.

When patients with ebola flew into the heartland, the Nebraska Biocontainment Patient Care Unit activated for the first time.

Local healthcare workers are now helping hospitals nationwide to prepare for the next generation of infectious diseases.

As the Ebola epidemic worsened in West Africa last summer, a Nebraska nurse-turned-administrator wondered if Omaha might receive any patients. Shelly Schwedhelm wasn’t scared. She was ready.

“We were watching what was happening in Africa and started to gear up,” she says, speaking from her office inside Nebraska Medicine’s labyrinthine hospital cluster in Midtown at 42nd and Dewey.

Schwedhelm, 54, oversees the Medical Center’s biocontainment unit. She leads administrative, nursing, and logistical support for the unit’s 40-person staff of nurses, physicians, respiratory therapists, and patient-care techs. Few biocontainment units exist in the United States. The Med Center unit is especially rare, housing the nation’s largest hazardous patient capacity. It consists of five rooms and 10 beds, isolated behind security-card locked doors, and a decontamination room on the seventh floor of University Tower.

Before Schwedhelm knew any Ebola patients might arrive, she made sure all safety protocols were in place. The unit’s self-contained air ventilation system and autoclave—a pressurized heat chamber used to sterilize large amounts of waste—operated without flaw. Ebola can cause uncontrollable vomiting and diarrhea; any potential pathogens would be contained and decontaminated behind sealed doors. The unit opened with federal, university, and hospital funds made available in the aftermath of the September 11 terror attacks. The 2003 outbreak of SARS (Severe Acute Respiratory Syndrome) in Asia and Canada added impetus to local, state and federal coordination. It went online in March of 2005.

“We’re centrally located,” Schwedhelm says, explaining the logic for an Omaha site in case of a national health emergency. “We’re about as close as you can get to being smack dab in the middle of the country.” March is the unit’s 10th anniversary. Schwedhelm has managed the operation for approximately eight years. She credits the establishment to Medical Director Dr. Phil Smith.

Her career with Nebraska Medicine spans 33 years. She started working in the emergency room as a nurse, but she quickly transitioned into leadership positions. She has managed the Post-Anesthesia Care Unit, operating room, and emergency room before assuming her current title, Executive Director of Emergency Preparedness. Schwedhelm first learned about Ebola during her nursing studies. At the time, Ebola was a virtual unknown, a mysterious killer that could wipe out entire villages. Even today there is no proven treatment or vaccine, though UNMC staff are working on some leads.

In 1976, the viral hemorrhagic fever known as Ebola first emerged in Zaire (now the Democratic Republic of the Congo). The virus took its name from a local river. In subsequent decades, rare and isolated outbreaks persisted in central Africa due to human contact with contaminated primates, bushmeat, or bats. West Africa’s crisis started in Guinea, spreading unnoticed in early 2014. By spring, Ebola reached Sierra Leone and Liberia. Doctors Without Borders declared the epidemic “out of control” in June with a global tally of 528 cases and 337 deaths.

The outbreak gained momentum fast. By Aug. 22, the disease struck 2,615 people with 1,427 deaths. In stark contrast, the world’s previous worst Ebola outbreak occurred in Uganda with 425 reported cases in 2001. By the year’s end, West Africa’s epidemic would surpass 20,000 cases and 7,800 deaths. The epidemic has continued into 2015. The World Health Organization reported on January 19 that 21,759 had fallen sick and 8,668 died from Ebola in Guinea, Liberia, and Sierra Leone.

African jungles where Ebola originated are a far cry from the rolling cornfields of northeast Nebraska, the land of Schwedhelm’s birth. She grew up on a dairy farm near Pender. Nursing has supplanted agriculture as her family’s occupation. Two of her sisters, her husband, and her brother-in-law work in nursing.

For the past decade, her biocontainment team trained regularly for infectious disease scenarios ranging from novel strains of influenza to coronaviruses such as SARS or MERS (Middle East Respiratory Syndrome), smallpox, or potential biological warfare by terrorists. Ebola has been on the unit’s list of disaster scenario drills from the beginning. But the hospital had not been tested with real-world activation. One near-activation roughly six years ago turned out to be a false alarm, malaria. “The unit has sat idle from the standpoint of patients, but we’ve always remained in a state of readiness,” she says.

Then in August 2014, she received the phone call that confirmed her premonitions. A representative from the State Department was coming. He arrived, toured the facility, and asked questions about logistics, transport, and protocol. Suddenly, the Nebraska Medicine joined two East Coast hospitals on a list of destinations for repatriated Americans with Ebola. “At that time it became very real to us,” Schwedhelm says. Preparations went into overdrive. “We spent the next month fine-tuning details, enhancing our staff, running through all the motions of testing all those things that we had tested for so many years.”

The State Department began a rotation: Emory University Hospital in Atlanta, collaborating with CDC headquarters. The National Institute of Health’s hospital in Bethesda, Maryland. Then came the Nebraska Medicine’s turn.

Omaha’s first patient arrived on Sept. 5. Dr. Rick Sacra had contracted Ebola in Liberia. The 51-year-old doctor was working for the Christian missionary group SIM. He flew from Africa to Omaha. “We had been in touch with our Emory colleagues, to gain insights on how they had dealt with their patient,” says Schwedhelm, “but we really didn’t know what to expect.” Text, e-mail and phone alerts buzzed biocontainment staff wherever they were. Kendall Ryalls received the notice while traveling with her fiancé. A programmed robotic voice broke the news to the registered nurse, “Biocontainment unit has activated. Please call.” She rushed back to Omaha.

Ryalls changed from street clothes into special scrubs. She donned personal protective equipment with the help of a colleague: booties tied up to her knee, an isolation gown wrapped around her body from neck to knee, blue hood draped over head and neck, clear face shield, white respiratory mask, three layers of gloves, etc. Then she took her temperature. Ready to go.

Sacra was non-communicative, very ill, severely dehydrated, depleted of electrolytes. Gradually, he improved with a cocktail of experimental drugs and a blood transfusion from a fellow doctor who had recovered from Ebola. “You are with the patient one-on-one for hours and weeks at a time,” Ryalls says. “You are with them so much. You don’t have that with any other nursing job.”

When Sacra regained enough strength, he used a stationary exercise bike (to minimize muscle atrophy) in confinement. He and Ryalls are both avid cyclists. The nurse would sit in the room, wearing full-body biohazard suit, encouraging Sacra’s effort on the bike or just chatting. Ryalls’ dark brown eyes were the only distinguishable features behind her mask and visor. Three weeks later, Ebola cleared from Sacra’s blood. He was released. Ryalls could finally shake Sacra’s hand without layers of gloves. He instantly recognized Ryalls “from my eyes,” she recalls with a laugh.

“I’m now an official lifetime Huskers fan! Go Big Red!” he announced at a celebratory press conference. Sacra also reaffirmed dedication to his medical mission, planning a return to Liberia where he contracted the disease. Recovered Ebola patients are thought to have immunity.

Spirits soared in Omaha. The same day Sacra was discharged, disaster struck Texas. A sick Liberian national named Thomas Eric Duncan reported to a Dallas hospital. Duncan had Ebola. He infected two nurses before dying on October 8. It was the first case of Ebola diagnosed on U.S. soil.

“We felt like we were going really good, and then that happened. There were a lot of questions from the outside, ‘Could that happen here in Omaha?’” says Schwedhelm. She felt “an almost overwhelming responsibility to make sure that every precaution was taken.” She questioned herself, “was every conceivable safety feature in place?” And her answer was always the same. “Yes. The staff was confident, and I was confident,” Schwedhelm says.

After the Dallas story broke in national media, the staff started to feel pressure from the community. One biocontainment nurse’s daughter was disinvited from a birthday party. Another was excluded from a family Thanksgiving dinner. In contrast, others received letters applauding the hospital’s efforts and unconditional support from informed family members. Ryalls told a friend about her job in the hot zone. Before a scheduled meet-up, the friend left her one-year-old baby at home to be extra safe. Ryalls didn’t take it personally. “She was just being cautious. There are pretty scary numbers about the disease in the media.” But at the same time, Ryalls felt assured that strict protocol and safety gear would prevent possible contact with fluid. The virus can only spread via body fluid to mucus membrane contact.

“I think the entire country has stepped up because of all this. Unfortunately for Dallas, they were first in having someone randomly come in, but because of them, I think the country is better prepared at all entry points,” Schwedhelm says.

The next patient, Ashoka Mukpo, arrived in Omaha on October 6. He had contracted Ebola in Liberia. The 33-year-old cameraman for NBC tested Ebola-free 16 days later, adding another victory to the Med Center’s effort. The third patient, Dr. Martin Salia was gravely ill upon arrival. A false negative test in Sierra Leone had delayed his evacuation and treatment. He came off the airplane at Omaha Eppley on a ventilated isolation stretcher.

Up until Salia’s arrival, respiratory therapist Jean Bellinghausen had been helping the biocontainment team with donning and doffing protective gear. Salia’s urgent medical condition necessitated a breathing tube, and Bellinghausen transitioned into the hot zone. The 44-year-old Salia died two days later on November 17. “Deeply saddened would be an understatement,” Bellinghausen says, recalling the mood of the biocontainment unit. “We all felt like it was a great privilege to care for him. In that small window of time he shared his life with us.”

Biocontainment unit staff gathered to hold a memorial to honor the life of the U.S. immigrant who chose to serve his native Sierra Leone during a time of need. He was the chief medical officer and only surgeon at United Methodist Kissy Hospital in Freetown. His wife and two children live in Maryland.

After a lull, activation status resumed in the biocontainment unit. An anonymous medical worker in Sierra Leone had high-risk exposure to Ebola while caring for patients. The patient flew to Omaha for monitoring and requested privacy. No signs of Ebola showed after 21 days in isolation. The patient departed Omaha on January 22.

“Situations are getting better in West Africa all the time: better supplies, better support services, and better control of the environment,” says Schwedhelm. “We have a lot of military support there, but there is still a raging epidemic that we need to control.” While she suspects more Ebola patients could arrive in Omaha, the center is also leading U.S. hospitals to prepare for potential infectious disease outbreaks on American soil. Schwedhelm’s team has hosted four training courses in collaboration with the CDC in late 2014 and early 2015. Medical professionals and administrators traveled to Omaha from nearly 40 health systems nationwide. She says the CDC hopes to establish between 35 and 50 hazardous disease centers across the United States.

“We really weren’t ready, as a country, and that’s frightening,” she says. “If you have a novel virus, then we need more than three places that could care for patients and do it safely.”

Time magazine recognized “The Ebola Fighters” as the 2014 Person of the Year. Likewise, the Omaha World-Herald recognized Nebraska Medicine’s Ebola team as “Midlanders of the Year,” an honor reserved in past years for such luminaries as Husker legend Tom Osborne and then-U.S. Sen. Chuck Hagel.

Schwedhelm and her nurses—though humbled and honored by the distinction—are quick to deflect praise. “Those real heroes and ‘People of the Year’ are on the front lines fighting every day with limited supplies, working in dire circumstances,” she says.

Ebola continues to spread in West Africa. People continue to die. Doctors continue to risk their lives to squash the outbreak. Schwedhelm and Nebraska Medicine will continue doing everything they can to aid the effort until the goal is accomplished.

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Enlarged Prostate

January 16, 2015 by

Trouble urinating. Weak urine flow. Frequent urination or frequently getting up in the middle of the night. While many men chalk these symptoms up to “getting older,” they are often a sign of an enlarged prostate.

An enlarged prostate is one of the most common problems among men over 50.  The good news is that, in many cases, the symptoms caused by an enlarged prostate can be relieved with medical advice, says Chad LaGrange, MD, urologist at Nebraska Medicine. By age 60, about a half of men will have an enlarged prostate and by age 85, that number climbs to 80 percent.

Living with these symptoms can be uncomfortable, embarrassing, and can prevent you from getting a good night’s sleep, notes Dr. LaGrange. Some men may even avoid leaving the house for any longer length of time for fear of bladder leakage.

“Many men will put up with these symptoms for months until they become intolerable before seeing a doctor,” says Dr. LaGrange. “This can result in permanent damage to the kidneys and bladder. It’s always important to see a doctor early on to determine if it’s something that needs treatment and to rule out more serious problems like an infection or prostate cancer.”

The prostate grows throughout a man’s life. As it enlarges, the layer of tissue surrounding it stops it from expanding. This causes the gland to press against the urethra like a clamp, which can obstruct the flow of urine. Over time, the constant straining of the bladder muscle may cause it to become thicker and overly sensitive, causing it to contract with just small amounts of urine, resulting in the need to urinate frequently. Eventually, as the urethra opening becomes more restricted, the bladder cannot completely empty, which can lead to a urinary tract infection or kidney and bladder damage.

“Oftentimes, an enlarged prostate is not a serious problem and can be treated with lifestyle changes and behavior modification,” says Dr. LaGrange. “Medications are available that can shrink the prostate and relax the muscles in the prostate so the flow is better. Our goal is to avoid surgery until
absolutely necessary.”

Ultimately, treatment will depend on your symptoms, how severe they are, and whether you have other medical conditions, notes Dr. LaGrange. If you are not able to urinate at all, have significant bleeding, kidney failure, or are not responding to medical therapy, you may be a candidate for surgery. Resection of the tumor growth that is pressing against the urethra is the most common surgery for an enlarged prostate. The risks and benefits should be discussed thoroughly with
your physician.

“A lot of men think these problems are a normal part of aging and they just have to live with them,” notes Dr. LaGrange. “Just remember, if you are experiencing these symptoms, you are not alone, and in most cases, we can help you greatly reduce your symptoms with the appropriate medical therapy.”

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