Southern Nevada residents who need emergency medical care for a stroke may benefit from the Mayo Clinic “telestroke” program that is now available at all three Dignity Health – St. Rose Dominican campuses. A recent agreement between St. Rose and Mayo Clinic in Arizona means the service featuring a portable, self-propelled robot has begun in southern Nevada. St. Rose Dominican is the first system in Nevada to partner with Mayo Clinic, and the service compliments and augments the already robust certified stroke centers at all three campuses.
In telestroke care, a telestroke robot located in a hospital lets a stroke patient be seen in real time by a neurology specialist at Mayo Clinic located in Phoenix. The Mayo stroke neurologist, whose face appears on the screen of the robot, consults with emergency room physicians and evaluates the patient.
Patients showing signs of stroke can be examined by the neurologist via computer, smart phone technology, portable tablets or laptops. In addition to assessing the patient, the neurologist can view scans of the patient’s brain to detect possible damage from a hemorrhage or blocked artery.
“The excellent, capable emergency physicians at Dignity Health – St. Rose Dominican can ring the telestroke hotline and be instantly connected with Mayo Clinic’s stroke experts,” said Bart Demaerschalk, M.D., Professor of Neurology, and medical director of Mayo Clinic Telestroke. “Urgent and immediate virtual care can be provided to patients – collaboration between stroke neurologists and physicians at the remote sites has resulted in 96 percent accuracy in diagnosing stroke.”
Brian Brannman, senior vice president of operations at Dignity Health Nevada, stated, “Our mission is to provide quality health and wellness services where the patient, family, and community come first. This newly formed partnership with the Mayo Clinic is another step toward achieving that mission. In collaboration with the stroke neurologists and our Emergency Room physicians, immediate, life-saving interventions can begin shortly after the patient enters the ER. This new service provides possible stroke patients care in a collaborative setting and will ultimately save lives. We are very excited to be able to offer this service to the communities we serve.”
Mayo Clinic was the first medical center in Arizona to do pioneering clinical research to study telemedicine as a means of serving patients with a stroke and today serves as the “hub” in a network of 16 other “spoke” centers, with most in Arizona. To date, more than 1,500 emergency consultations for stroke have taken place between Mayo Clinic stroke neurologists and physicians at these spoke centers.
Melanie Baldwin considers herself a “walking, talking research and development project 50 years in the making.” Born with a congenital heart defect – still the leading cause of death in children – Melanie says she is “a product of determination, good fortune, and amazing technology.”
“I was born with a hole in my heart and a defective aortic valve, and I have had five open heart surgeries through the years,” says Melanie. “I am currently on my fourth pacemaker.”
Melanie had two surgeries while she was still a young child then another when she turned 19 to replace a defective aortic valve with a mechanical one. The new valve was meant to last 15 years, but in exchange, she would have to take Coumadin to keep her blood thin. This arrangement worked well until she married and decided her life was not really complete without a child.
Almost 25 years ago, Melanie became pregnant, and after moving to San Diego, she went to check in with her new doctor. That doctor’s appointment turned into a month long hospital stay because she had developed a blood clot just outside of her heart; if it moved, both she and the baby were at risk of dying.
Although Melanie knew her pregnancy was considered high risk, she did not expect to be told that she would have to terminate her pregnancy in order to have surgery to remove the clot. While she was on complete bed rest, doctors spent a month trying to convince her that was the best option. She adamantly refused and insisted they do the surgery while she was pregnant, which they did, reluctantly. At 26 weeks pregnant, Melanie’s clot was removed and her mechanical valve was
replaced with a pig valve.
“Not only did I survive, so did my daughter,” says Melanie. “I gave birth to her in July 1990, and I have never regretted my decision. Cardiovascular disease is a family affair. It affects everyone you know and love.”
Melanie’s mom, Carol Payne, agrees. “Ours has been a normal life for the most part, interspersed with moments of horror, heart-wrenching sorrow, and desperation,” says Carol. “But there were also euphoric moments when Melanie’s amazing positive spirit and tenacity helped overcome what should have been life-ending events.”
Melanie suffered cardiac arrest in June 2013 and spent 10 days in the hospital. She walked out of the hospital, but the incident put her in line for an AICD (automatic implanted cardioverter-defibrillator) to replace her third pacemaker. An AICD differs from a pacemaker in that its defibrillator has the ability to shock the heart out of a life-threatening heart rhythm abnormality. “Luckily, Melanie was resuscitated by her husband when she had her cardiac arrest,” says Dhiraj Narula, M.D., FACC, a board certified cardiac electrophysiologist. “We changed her pacemaker to a pacemaker-AICD combination to protect her in the event she had another cardiac arrest.” The procedure was done at the end of August 2013, and she spent another five days at Dignity Health – St. Rose Dominican’s Siena Campus.
February is American Heart Month, a nationwide initiative to raise awareness in the effort to combat heart disease and educate communities on prevention and treatment options.
Melanie, her mom, and her daughter are sharing their stories at the American Heart Association’s Go Red Luncheon on Friday, Feb. 27. “Our family has obviously learned a lot about cardiovascular disease over the years,” says Melanie. “My mom is my hero. She’s been right beside me every step of the way, as has my daughter who has accompanied me through my cardiac ‘journey’ and is now a registered diagnostic cardiac sonographer.”
“You can’t control what challenges life throws your way, but you can control how you choose to deal with those challenges,” says the upbeat, ever joyful, Melanie.
A Mother’s View
“My daughter is the hero,” says Carol. “When Melanie was born, my doctor told me there was a problem, so I was amazed that there was nothing visibly wrong, and this has really been true all of her life. Melanie has never looked sick, and she has always had a happy, positive disposition.
When Melanie was 3 years old, we went to the hospital for her first surgery. It was supposed to be the only surgery she would need … the one that would fix whatever was wrong, but after the surgery, we learned that doctors had found other problems with her heart.”
At 7, while living in San Diego, further surgery was recommended to open Melanie’s aortic valve. “She was comforting me as she went into surgery,” says Carol, “telling me that she would be fine and I wasn’t to cry.” At 19, Melanie was told she needed further surgery, this time to replace the aortic valve. She was told the night before surgery that the surgeon would be using a mechanical valve, so she would need to take blood thinners, which meant having children was not an option. “We had always felt tremendous gratitude that technology and medicine could save Melanie’s life,” says Carol, “but now the quality of her life would change. She was devastated.”
Melanie later married, and Carol was not surprised when she decided to have a child against all odds. “She had survived a ruptured appendix and cardiac arrest shortly after her surgery at 19, so when she said she could handle pregnancy while taking blood thinners, I believed her. The result is our beautiful Kate.”
A Daughter’s Perspective
As an ultrasound technician, Kate Eggington works with people who have heart problems every day. “I chose this career partially because of my mother,” says Kate and Melanie, with friend Ronrico Hawkins, at the AHA’s annual Heart Walk in 2014. Kate. “But it wasn’t until I completed my schooling that I realized how serious her condition is. I almost wish I could go back to my days of ignorance because knowing the full depth and consequences of what she was born with is scary.”
Even knowing about her mother’s heart condition, it wasn’t until June 15, 2013, that Kate was forced to accept that “my mother wasn’t as invincible as she seemed and that I could lose her at any point without any notice.”
Kate’s parents were having a normal day at home. “Luckily, my stepfather happened to be home for one of the 10 weeks of the year he doesn’t travel,” she says. That afternoon, Kate’s mother’s heart stopped without any warning. She collapsed and went into cardiac arrest. For the next two days, she was put into a coma and therapeutic hypothermia was used (her body temperature was lowered) to slow her metabolism, decrease the amount of oxygen she needed, and prevent brain damage.
“None of us could function. I couldn’t eat, I could barely sleep, I was inconsolable,” says Kate. “During the times I could actually bring myself to sit by her bed, I couldn’t call her mom because the sound of my voice made her reach out, trying to pull at the IV and breathing tube she had in. On the third day, they slowly warmed her back up, and when they took her out of sedation and she spoke, my stepfather broke down. We hadn’t lost her. After 10 days in the hospital she finally came home to us.”
“Although that was the most terrifying experience of my life,” says Kate. “I now cherish my mother … every lunch with her, every hug, every time she says I love you.” Heart disease kills more women each year and is more deadly than all forms of cancer. Melanie is a true advocate for raising awareness of the threat of heart disease – she’s been actively involved with the American Heart Association for 15 years. Arm yourself with information. To learn the facts about heart disease and what you can do to prevent it, visit goredforwomen.org. For more information about cardiac services provided at St. Rose Dominican or to find a St. Rose cardiologist, visit strosehospitals.org/heart.
When Josh woke at his home in Henderson in the middle of the night unable to walk, paramedics rushed him to St. Rose Dominican’s Rose de Lima Campus. After spending two weeks in the hospital getting his health stabilized, the Inpatient Rehabilitation Facility (IRF) staff took over and helped Josh walk out the front doors.
Josh was diagnosed with Guillain-Barre (pronounced Gē-yän Bä Rā) Syndrome, a rare, serious autoimmune disorder that damages the nerves, causing muscle weakness and paralysis. The Centers for Disease Control and Prevention (CDC) says the syndrome affects one out of every 100,000 people.
“Doctors think I had a virus that locked on to my nerve endings,” says Josh. “So after fighting off the virus, my body thought the nerve endings were still part of it, and it just kept attacking.” With Josh bedridden, doctors turned to the hospital’s IRF and its new robotic technology for answers.
Fortunately for Josh, the IRF had recently received three new robotic rehabilitation therapy machines made by Hocoma® Products: the Erigo®, Lokomat Pro®, and Armeo®Power and Hand Therapy robot. According to Dr. Tony Chin, Medical Director of the IRF, the hospital is the first in the southwest United States to receive the equipment.
Erigo® - The Erigo® (shown right) is a robotic mobilization and electrical stimulation support system that helps patients stand again after long periods of lying down. Named Apollo Zen by the IRF (“Apollo” for god of the sky and “Zen” for health), it gradually moves the patient into an upright position, allowing them to gain the strength to stand. Robotic foot pedals help patients improve their blood circulation while doing passive, active or resisted exercise. The system also uses functional electrical stimulation to assist in muscle contraction, which speeds strengthening.
“The whole idea is to get the muscles to contract so we get blood flow back to the heart,” says Dr. Chin. “With good blood flow, the heart starts to pump, and we can slowly tilt the patient upright while maintaining their blood pressure. If they’re able to maintain blood pressure, they’re able to do therapy.”
A few days after Josh was admitted to Rose de Lima, the Erigo® arrived. He was the first patient to test out the new technology. “The Erigo® was amazing,” says Josh. “It got me moving again. I’ve been on my feet ever since.”
Lokomat Pro® – The IRF’s Lokomat Pro®, a customizable robotic gait training system that helps patients walk again, has been nicknamed “Optimus Yung” (Optimus, a robot character in the movie “Transformers” that helps humans, and Yung, the Chinese word for “courageous”). The name is fitting because it takes a lot of courage for a patient to get on the machine and try to walk again after a stroke or traumatic injury.
The machine (shown left) hoists patients upright using a harness that moves up and down and side to side to simulate the natural “bob” of a walking person. Robotic legs attach to the patient’s hips, knees, and ankles to guide them as they move forward on a treadmill, and a hip attachment feature allows natural hip movement. A video screen facing the patient offers games that encourage and provide instant feedback.
The Lokomat Pro® has both automatic and manual settings. New patients are typically placed on an automatic setting so they can experience concise and repetitive movements to form new muscle memory. The settings are gradually moved to manual as the patient improves. “The movement has to be precise and accurate,” says Dr. Chin. “If not, they will learn a bad pathway.”
After stabilizing his blood pressure using the Erigo®, Josh used the Lokomat Pro® to regain his ability to walk. “The machine got me started,” says Josh. “I went from not being able to walk to moving my legs to being able to hold my weight to walking all over again. Now, I feel like I can almost jump again.”
“It’s like the old expression, ‘You never forget how to ride a bike,’” says Josh. “Well, you never forget how to walk either.
Sometimes it just takes a while to get it down the way you did before, but the amazing staff here at the IRF helps you do it.”
giving lives back.
Armeo®Power – The Armeo®Power (shown right) is an upper body robot that helps patients regain the use of their arms. Dr. Chin says the machine focuses on repetition to increase strength and improve mobility of the shoulder, elbow, and wrist. Like the Lokomat Pro®, it uses video games to encourage patients and give them instant feedback.
“Our Armeo®Power is named Rosie Chern,” says Dr. Chin. “’Rosie’ after Rosie the Riveter (an American icon during World War II representing women who worked in factories), and Chern, the Chinese word for being successful.”
Former patient Lana Million experienced the machine’s success after suffering from a debilitating stroke in July 2014 that caused her entire left side to become numb. After spending two weeks recovering at St. Rose Dominican’s Siena Campus, Lana was transferred to the Rose de Lima IRF to rehabilitate using the Armeo®Power. “My fingers and arm would move, but I couldn’t control them,” Lana says. “The Armeo helped me learn how to squeeze things, and it gave me the whole range of movement back in my arm. I can’t imagine having better therapy.”
“Our emergency rooms save lives,” says Teressa Conley, President/CEO of the Rose de Lima Campus, “but life-saving
technology is just part of the picture. After trauma, accident, or stroke, it is only through rehabilitative services that patients really get their lives back. Regaining the ability to do something as simple as combing your hair or brushing your teeth or something incredibly difficult, such as learning to walk and be independent again, is truly life-saving.”
In the past, residents had to travel out of state for care beyond traditional therapy. Now that Rose de Lima has the Hocoma® technology, residents can recover in their own community.
The robotic technology offered at the IRF now allows patients to have the best of both worlds: the most current technology
and the support of friends and family. For Josh, staying close to home was important because it allowed him to visit with his two small children every other day. “If I was out of state, that wouldn’t have been an option,” Josh says. “It was hard not being able to hold my kids when they were sitting right next to me, but having them visit was motivation. It kept me pushing, and it kept me moving forward. I did it for them.”
At a recent unveiling of the new equipment, Conley agreed. “We are proud to be the leader in rehabilitative services for our region,” she says. “Residents of southern Nevada should not need to leave the community to get the best medical care available.” To learn more, visit StRoseHospitals.org/IRF.
At St. Rose Dominican, we strive to ensure that humankindness drives every interaction we have with the people we serve. During the week of January 26-30, St. Rose is encouraging employees to take part in The Great Kindness Challenge, which includes a suggested 50-item Acts of Kindness checklist to complete by January 30.
St. Rose is working in partnership with the Josh Stevens Foundation, a local nonprofit organization that helps schools, businesses, and youth organizations across the nation recognize and celebrate heartfelt acts of kindness. With their help, more than 100 Nevada schools are participating in this year’s Great Kindness Challenge. Participating schools are giving their students the 50-item checklist and encouraging them to complete that checklist by January 30. Students who complete the checklist will receive a gift from the Josh Stevens Foundation.
Globally, the Great Kindness Challenge is currently on target to have more than two million students enrolled for 2015, which will amount to 100 million acts of kindness in schools nationwide. In addition to serving as a presenting sponsor of the Great Kindness Challenge, many of Dignity Health’s more than 65,000 executives, employees, and physicians are taking the Great Kindness Challenge alongside the students, effectively “matching” their good deeds in hospital, clinic, and office settings.
“St. Rose is committed to practicing humankindness every day in our hospitals and care centers,” said Brian Brannman, senior vice president of operations for Dignity Health Nevada. “We are focused on putting policies in place that strengthen the human connection with our doctors, nurses, and caregivers so every guest feels welcome, safe, comfortable, listened to, and respected. Our mission calls us to collaborate with organizations that share the same goals and help spread the word about the power of kindness, especially within schools.”
For more information on The Great Kindness Challenge and Kids For Peace, go to http://www.greatkindnesschallenge.org. For more information on the Josh Stevens Foundation, please visit http://www.joshstevensfoundation.org.
The Centers for Disease Control and Prevention (CDC) estimates that one in three U.S. adults has prediabetes. That’s 79 million Americans over 20 years old, and the majority of these people who have prediabetes don’t know it.
If you have prediabetes, it means your blood sugar levels are higher than normal but not high enough for a diagnosis of diabetes. Prediabetes is a serious health risk that increases your risk of developing type 2 diabetes, heart disease, and stroke. Without lifestyle changes, 15-30 percent of the people with prediabetes will develop type 2 diabetes within five
You may be at risk for prediabetes or type 2 diabetes if you:
• are 45 years of age or older
• are overweight
• have a parent with diabetes
• have a brother or sister with diabetes
• have a family background that is African-American, Hispanic/Latino, American-Indian, Asian-American, or Pacific Islander
• had diabetes when you were pregnant of gave birth to a baby weight 9 pounds or more
• are physically active less than three times a week.
The good news? You can prevent type 2 diabetes by making healthy lifestyle changes, and Dignity Health – St. Rose Dominican has a new program that can help.
The new CDC-led National Diabetes Prevention Program is an evidence-based lifestyle change program offered by St. Rose Dominican that is aimed at preventing type 2 diabetes.
In this program, you will work in a group with a trained lifestyle coach to learn the skills you need to make lasting changes. You will learn about healthy eating, adding physical activity to your life, staying motivated, and solving problems that can get in the way of healthy changes.
“If you have prediabetes,” says Aidee Flores Fernandez, Community Education Program Specialist at St. Rose Dominican, “this National Diabetes Prevention Program offers a real chance to prevent or delay the onset of type 2 diabetes by helping you adopt a healthier lifestyle.”
What is diabetes?
In type 2 diabetes, the most common form, the body either doesn’t produce enough insulin or the cells ignore the insulin. Insulin allows the body to use glucose (sugar) for energy.
According to the American Diabetes Association, when there isn’t enough insulin or it doesn’t get used as it should be, glucose builds up in the blood instead of going into the body’s cells. When glucose builds up in the blood instead of fueling the cells, the body becomes starved for energy and, over time, may hurt the eyes, kidneys, nerves or heart.
Common Symptoms of Diabetes
• Urinating often
• Feeling very thirsty
• Feeling very hungry – even though you are eating normally
• Extreme fatigue
• Blurry vision
• Cuts/bruises that are slow to heal
• Weight loss – even though you are eating more (type 1)
• Tinging, pain, or numbness in the hands/feet (type 2)
Learn about the many diabetes-related programs offered through St. Rose by calling 702.616.4914
Dignity Health – St. Rose Dominican welcomes Larry Barnard as president and CEO of our San Martín Campus. Opened in 2006, San Martín is one of our three hospitals in southern Nevada. Barnard started in early December and reports to Brian Brannman, senior vice president of operations for Dignity Health Nevada.
Barnard brings an extensive and impressive range of health care administrative experience to his new role, including his most-recent position as chief executive officer of University Medical Center of Southern Nevada. Before he was appointed its CEO, he served as UMC’s chief operating officer for two years. Barnard was also Valley Hospital Medical Center’s associate administrator and acting chief operating officer, and the associate administrator at Summerlin Hospital Medical Center before joining UMC. He also worked in hospital administration at facilities in southern California and North Carolina.
“I am impressed with the diversity and complexity of Barnard’s past accomplishments, and his health care management acumen,” says Brian Brannman. “Larry is known for combining a focus on top-notch performance with compassionate, patient-centered care. He is also regarded for his skills as a team builder with physicians, community leaders, employees and peers. I am extremely pleased to welcome him to Dignity Health.”
Barnard graduated from the United States Military Academy at West Point and served as a U.S. Army captain for five years. He received an MBA from the University of Southern California’s Marshall School of Business.
Our San Martín Campus in southwest Las Vegas has received prestigious international recognition as an official Baby-Friendly Designated birth facility, the first in southern Nevada. Hospitals with the Baby-Friendly designation have a demonstrably higher level of expertise in support and education of mothers interested in breastfeeding their newborns.
The designation is conferred by the Baby-Friendly Hospital Initiative (“BFHI”), a global program sponsored by the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF), and implemented in the United States by Baby-Friendly USA. This initiative encourages and recognizes hospitals and birthing centers which offer an optimal level of care for breastfeeding mothers and their babies.
Based on the Ten Steps to Successful Breastfeeding, this prestigious international award recognizes birth facilities which offer breastfeeding mothers the information, confidence, and skills needed to successfully initiate and continue breastfeeding their babies. The Ten Steps to Successful Breastfeeding are:
- Have a written breastfeeding policy that is routinely communicated to all health care staff.
- Train all health care staff in the skills necessary to implement this policy.
- Inform all pregnant women about the benefits and management of breastfeeding.
- Help mothers initiate breastfeeding within one hour of birth.
- Show mothers how to breastfeed and how to maintain lactation, even if they are separated from their infants.
- Give infants no food or drink other than breast-milk, unless medically indicated.
- Practice rooming in – allow mothers and infants to remain together 24 hours a day.
- Encourage breastfeeding on demand.
- Give no pacifiers or artificial nipples to breastfeeding infants.
- Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital or birth center.
Becoming a Baby-Friendly facility is a comprehensive, detailed and thorough journey toward excellence in providing evidence-based maternity care, with the goal of achieving optimal infant feeding outcomes and mother/baby bonding. It compels facilities to examine, challenge and modify longstanding policies and procedures. It requires training and skill building among all levels of staff. It entails implementing audit processes to assure quality in all aspects of maternity care operations, enhances patient satisfaction and improves health outcomes.
“We are extremely proud of being named the first Baby-Friendly hospital in southern Nevada,” said Vicky VanMeetren, president and CEO of the Dignity Health – St. Rose Dominican, San Martín Campus. “The practice of breastfeeding has always been an important part of what we do here at San Martín and this designation is significant to the community.”
There are more than 20,000 designated Baby-Friendly hospitals and birth centers worldwide. Currently there are 175 active Baby-Friendly hospitals and birth centers in the United States. The Baby-Friendly designation is given after a completion of a rigorous on-site survey. The award is maintained by continuing to practice the ten steps as demonstrated by quality processes.