Life After Cancer: Kristy Elsberry
New program offers cancer survivors a helping hand.
Since her diagnosis, Kristy Elsberry has been fighting to beat cancer and keep it from coming back. That's why the 53-year-old wife, mother and grandmother joined Lake Regional's Re-Live program.
"There's no pill for me to take after chemo and radiation to help prevent the cancer from coming back," says Elsberry, who had triple-negative breast cancer. Other breast cancers can be treated for years with tamoxifen or Herceptin pills. "The only treatment I have left is to take out my risk factors, and diet and exercise will help me do that."
What Is Re-Live?
Re-Live is a new rehabilitation program at Lake Regional customized to the needs of patients who are receiving or who have completed cancer treatment.
According to the American Cancer Society, physically active cancer survivors have a lower risk of cancer recurrence and higher odds of cancer survival than those who are inactive. Exercise can also improve fatigue, cardiovascular fitness, muscle strength, anxiety, depression, self-esteem, happiness and other quality of life factors in cancer survivors.
"When we surveyed patients who had completed treatment at Lake Regional Cancer Center, they told us fatigue is their No. 1 challenge," says Lake Regional Cardiopulmonary Rehabilitation Director Jennifer Newman, R.N., CEN, cPT. "We developed the Re-Live program to help these survivors get their lives back."
Re-Live is an individual—not a group—program. Patients begin with an evaluation to determine their exercise regimen. Usually, the regimen includes a mix of using an exercise bike, arm bike (pedaled with the hands/arms), treadmill and weights.
"As their endurance improves, we increase the intensity and duration of their exercise, with the ultimate goal being 45 to 60 minutes of continuous exercise," Newman says.
Patients have medical oversight throughout the program, an important benefit for those who have completed treatment and who might go months before seeing a doctor.
"We are seeing those patients continuously and checking their vitals every time," Newman says. "That means we can see early signs of problems and help them connect with their doctors to get the care they need, whether that's a simple antibiotic or something major. This can help patients avoid hospitalizations."
More Than Physical Strength
At her first Re-Live appointment, Elsberry was surprised she couldn't complete her exercises.
"I thought, I've got to get back to good so I can garden this spring," she says. "Some people are writers, some are artists—everybody's got a God-given gift. Mine is in the garden."
Elsberry is a trained University of Missouri Extension Master Gardener. She creates beautiful landscaping at her home outside of Iberia, but last spring and summer, her treatments left her unable to use her gift. The sight of her neglected flower beds and vegetable garden saddened her, and she was determined to give them loving attention this spring.
She made progress her first couple of weeks at Re-Live, but then missed two weeks because of respiratory illness. She got in another week and then was sick again and missed two more weeks.
Such adversity is typical, Newman says.
"We expect patients who have undergone cancer treatment to have these setbacks, and we help them work through them," she says. "Also, evidence shows that being in a program like Re-Live can help patients come back from those illnesses sooner and stronger than they would otherwise."
Elsberry continued in the program and found it gave her more than physical strength. The continued care, she says, has also helped her manage cancer's mental and emotional tolls.
"I feel like I'm doing something for myself," Elsberry explains. "It might sound strange, but when my radiation ended, I felt like somebody had taken my umbrella on a rainy day. I thought, now what am I going to do? Well, I can do this. Modern medicine has done all it can for me, and now it's up to me to follow my doctor's advice."
Get Financial Help
Lake Regional Cancer Center patients with financial need may receive their first three months of Re-Live for free. To learn more about the financial assistance application, call Cancer Resource Navigator Nichole Stephens, LBSW, at 573.302.2752. Funding is provided by Lake Regional's Hope Program.
In the Fight: Robert Trokey
"Nobody can believe I've gone through this."
Robert Trokey was having a good time visiting with family at his brother's place on June 30, 2012, when suddenly, he felt faint and passed out. He quickly revived, but his niece, a registered nurse, still called an ambulance.
"I told her, 'No, I'm OK now,' but she insisted," says Trokey, who was 80 but in great shape. "I wasn't pleased at the time, but as it turned out, it was a good thing she did."
Once at Lake Regional, Trokey had a lung X-ray, which indicated a problem with his left lung. A CAT scan revealed a mass.
Because Trokey is a veteran—he served in the Military Police Corps between 1952 and 1956—he went to the Harry S. Truman Veterans' Hospital in Columbia for care. Further testing revealed he had small-cell lung cancer. He received chemo at Truman, but he came to Lake Regional Cancer Center for radiation therapy, which he needed every day, Monday through Friday, for six weeks.
"I couldn't have gone 120 miles to Columbia every day," explains Trokey, who amazed his care team by continuing to work as a night security guard at The Club at Old Kinderhook throughout his treatment. "Lake Regional was close, and that made things much easier."
Trokey's treatment lasted from Aug. 22, 2012, to Oct. 2, 2012. The treatments were successful, and for more than two years, Trokey was cancer-free. But in early 2015, a tumor appeared on his left lung. Testing revealed it was not a recurrence of his first cancer, but a different, non-small-cell lung cancer.
"For my second round of treatment, Lake Regional was able to work it out with the VA so that I could receive both my chemo and my radiation here," Trokey says.
In May 2015, Trokey became one of the first Lake Regional Cancer Center patients to receive radiation therapy with the center's new, state-of-the-art linear accelerator. The new equipment enables therapists to focus higher radiation doses on targeted cells, while minimizing doses to surrounding healthy tissue. Although this is the same kind of treatment—intensity modulated radiation therapy—delivered by the Cancer Center's previous linear accelerator, the new accelerator offers enhanced imaging and greater speed, both of which improve accuracy and further limit radiation to healthy tissue.
Receiving radiation, Trokey says, was easy and painless. He lay still on a table for about 12 minutes while the radiation was delivered. Later, he did develop some temporary blistering at the radiation site, a common side effect.
Throughout his care, Trokey found the Lake Regional care team to be exceptionally helpful and kind.
"I am so tickled I got to have them," he says. "They are very serious about their job, but there's also levity from time to time, and I like that. It's a heck of a lot more pleasant than working with stern people."
Less than a month after Trokey's final treatment, his Lake Regional radiation oncologist, Mark Bryer, M.D., said Trokey will receive regular checkups every few months to monitor for recurrence but at present, is considered without any evidence of disease.
Now 83, the cancer survivor is enjoying life. He takes care of his 25 acres near Climax Springs and frequently entertains friends and family.
"I feel good," Trokey says. "Nobody can believe I've gone through this. I'm very pleased with Lake Regional. They have treated me very well and are continuing to look out for me."
Strong Survivor: Roseann Dzurko
Roseann Dzurko did not want to lose her hair. In fact, that was the first thing she said when she learned her breast cancer required chemo.
But when clumps of her brown, chin-length hair began falling out, Dzurko also did not want people feeling sorry for her. So one night when her husband was out of the house, she shaved it all off.
“When I was done, I thought, ‘You know, this doesn’t look too bad,’ ” she said.
Refusing to feel pitiful and instead doing what she could to feel empowered sums up Dzurko’s response to stage 3 breast cancer.
“It was rough,” said the 63-year-old wife, mother and grandmother, “but I wasn’t going to let it get me down. You have to have the right attitude because if you don’t, it will consume you.”
Motivated to Fight
Dzurko’s breast cancer story began with an annual mammogram — something she always did every year in December. In 2016, the screening detected a mass in her left breast. Surgery and testing revealed she had hormone-receptor positive breast cancer. It had not spread throughout her breast, but it was in nearby lymph nodes. That meant Dzurko needed both radiation and chemotherapy.
It also meant she needed to find a cancer center closer to home. Dzurko and her husband, Al, had moved to Sunrise Beach in 2007 but had always gone back to Illinois for their health care. She received her diagnosis in Illinois, as well as surgeries to remove the cancer from her breast and 17 lymph nodes — five of which had cancer. But she did not want to stay in Illinois for her radiation and chemo.
“When we visit Illinois, we stay with our daughter,” Dzurko explained, “and I didn’t want my grandsons seeing me like that.”
Those grandsons — Matthew, 9, and Colton, 7 — were Dzurko’s greatest motivation for beating cancer.
“Everybody’s got their bucket list,” she said. “For me, it’s being here to see those two grandsons of mine grow up and become fine young men. That’s all. Just a few years to see them grow.”
Making the Battle Plan
Dzurko checked out Lake Regional Cancer Center at the recommendation of a friend, who received treatment at Lake Regional for lung cancer. The support Dzurko found was “incredible,” she said.
“The staff is so great, just wonderful,” she said.
Dzurko also was pleased with the treatment plan Lake Regional Oncologist Michael Wang, M.D., created for her. Instead of scheduling eight sessions of chemo across the standard 24 weeks — as her doctor in Illinois had suggested — Dr. Wang recommended scheduling eight sessions across 16 weeks, a “dose-dense” treatment plan.
“If the patient can tolerate it, dose-dense chemotherapy is better — it’s associated with better survival,” Dr. Wang explained.
Dzurko also preferred the more intense pace because it meant she completed her treatment two months earlier.
A Victory Shared
During treatment, Dzurko found keeping active helped her maintain a positive attitude.
“I tried to keep busy, but sometimes, it just kicked my butt,” she said. The worst part, she added, was when her bones ached. “I tended to do my crying alone in bed. And this,” she said pulling a rosary out her purse, “helped me a lot. I prayed a lot. People would call and encourage me. And seeing my kids — that always helped.”
Dzurko finished her chemo on June 22, 2017, and her radiation on August 23, 2017. Now cancer-free, she is on a five-year maintenance regimen of the breast cancer pill letrozole. She also receives regular checkups.
A grateful survivor, she hopes her story motivates other women to prioritize their annual mammograms.
“When I hear women say, ‘I haven’t had a mammogram in five years,’ I get a sinking feeling,” she said. “If I hadn’t had my mammogram, I don’t know where I’d be right now. My doctor said I never would’ve felt the lump because it was too deep. But the mammogram found it.”
Return to the Finish Line: John Wolfe
An avid runner finds his footing after a serious heart scare
John and Jill Wolfe have made a lot of memories running together.
“Our whole family runs, our son and daughter and their spouses, too,” John says.
The family has entered several races, from 5Ks to half marathons. Lake Regional’s 2016 Fun Run/Walk is one run none of them will soon forget — because it came less than three months after John had triple bypass surgery.
“He could’ve run it,” Jill says of her husband . “He slowed down for us.”
Signs and Symptoms
John’s incredible recovery followed a terrible scare. In January 2016, the then-48-year-old was running four to six miles a day to train for the Bridge & Dam Half Marathon in Lake Ozark. He became concerned when he noticed he was getting slower and more out of breath.
“I thought I had the flu,” he says. “I felt achy and had bronchial symptoms and chest pains.”
He took a week off and then went to his treadmill. But his first workout triggered severe jaw pain, chest pain and a strange headache. Jill insisted he go the next day to see his doctor, Lake Regional’s James Neill, M.D.
John easily agreed. Despite being a runner and in great shape, he knew his heart could be in trouble. Several of his family members — including two siblings, a parent and two grandparents — had experienced a heart attack or needed heart surgery, or both, by the age of 40.
Aware of this history, Dr. Neill referred John on to Lake Regional Cardiologist Zubair Khan, who ordered an echocardiographic stress test to check John’s heart’s function. Irregular results prompted Dr. Khan to order an angiogram to get more information about the blood flow to John’s heart.
With the ordering of the second test, John expected to hear he had a minor blockage, or blockages, that would require one or more stents, a minimally invasive procedure. But the results revealed a more serious situation.
Three of John’s arteries into his heart had significant blockages. That meant he needed open heart surgery to create three new paths for blood to flow to his heart — or triple coronary artery bypass grafting.
Getting Up and Getting Out
The first emotion John felt when Dr. Khan delivered the diagnosis was anger at himself.
“Because I had been working hard the last 10 years not to be in that position,” he explains, adding he had started running to avoid heart problems. He also had been careful with his diet.
Dr. Khan understood John’s frustration and assured him all of his effort had not been for nothing.
“His heart disease is genetic, so no amount of exercise was going to prevent it,” Dr. Khan explains. “But, it was still good that he had exercised. For one thing, if he hadn’t exercised, he likely would’ve had problems earlier. Second, because he was in good shape, his surgery risks were lower. And third, he was in better shape for recovery.”
Soon enough, John realized Dr. Khan was right. He had surgery on a Sunday morning, spent three days in the ICU — “The whole ICU staff was amazing,” he says — and went home that Wednesday.
“One week after I was released, I was walking three miles,” he says. “That doesn’t mean it was easy. It would’ve been very easy to just sit in the recliner. But the more I did, the better I felt. Being a runner, I knew the hardest part is getting up and getting out the door.”
The morning of the 2016 Lake Regional Fun/Run Walk, John and Jill were joined by their entire family — their son and his wife, their daughter and her husband, and their two grandsons — and to John’s surprise, everyone had matching shirts.
“I was really touched,” John says. “I’m blessed to have a family that would stick it out with me. They’ve been there every step.”
Now more than a year after his surgery, John is doing great, with no symptoms. This past summer, he even took a 10-day backpacking trip in Colorado with his son and a friend.
“I am just living my life without worrying about heart trouble slowing me down,” he says.
Join the Fun Run/Walk!
The 10th Annual Lake Regional Health System Fun Run/Walk, benefitting Cardiopulmonary Rehabilitation, is Saturday, May 6. Click here for details and to register.
Close to the Heart: Bob Bueltmann
Bassing Bob shares his heart story.
Bob Bueltmann was having lunch with his son Robbie and friend Marcus Sykora when the chest pain started.
"We were out on the deck, overlooking the lake, and talking about some fishing event coming up," says Bueltmann, an avid angler known around the lake as Bassing Bob.
The pain felt similar to esophageal spasms, which had previously bothered Bueltmann, so he took a nitroglycerin to ease the contractions. Five minutes later, he took another. Then another. And a few minutes later, still another. When 30 minutes passed and the pain had not eased, Sykora told Bueltmann he was taking him to Lake Regional Hospital.
"I knew we had good care right down the road, and I just don't take any chances," Sykora says.
Lake Regional Cardiologist Zubair Khan, M.D., FACC, says it was a good thing Bueltmann did not wait.
"He was having a small heart attack but was on his way to a big heart attack that could cause permanent damage to the heart muscle," Dr. Khan says. "It was imperative that he receive care."
Bueltmann was already a patient of Dr. Khan's, having established care with him at Lake Regional Heart and Vascular in 2012. Bueltmann had moved to the lake from St. Louis after retiring at age 55 from a successful career in technology sales and business development.
Not ready for a full retirement, Bueltmann decided to combine his passions for entrepreneurship and bass fishing. He launched BassingBob.com, now a popular website for Lake of the Ozarks anglers.
Bueltmann quickly found a local cardiologist because he had a history of cardiac problems. Between 2009 and 2010, while still in St. Louis, he had multiple stents to improve blood flow in minor arteries. Six months after he began seeing Dr. Khan, he received another stent.
When Bueltmann arrived at the Emergency Department on Sept. 2, 2015, his chest pain was at a nine. An electrocardiogram, or EKG, taken within minutes of his arrival showed that although he was not having an acute heart attack, his heart was not receiving enough oxygen. The care he received in the ED was "phenomenal," Bueltmann says.
Just 37 minutes after arriving in the ED, Bueltmann was taken to the catheterization lab, where Dr. Khan discovered that Bueltmann's ramus artery—a branch of the left main coronary artery—was 99 percent blocked. Dr. Khan placed a stent to restore the artery's blood flow. He also saw that Bueltmann's right coronary artery was 90 percent blocked; he did not place that stent then but scheduled a second procedure for Sept. 22. Bueltmann was able to go home from the first stent about 24 hours after he had arrived in the ED. For the second stent, he spent one night at the hospital. Both procedures went well.
Throughout his care, Bueltmann says, he took great comfort from the personal connections he felt with the Lake Regional care team.
"It was easy to build a rapport with people," he says. "I love that about this hospital. I grew up in St. Louis and had gone to much larger facilities. I would never say those doctors didn't care—it's just not the same feeling I have here. There's this community here."
Having witnessed Bueltmann's care, Sykora reports similar feelings.
"It was comforting to see the professionalism and care that we have right here, locally," he says. "It's so reassuring, and we're thankful to have Lake Regional here to help us."
1 Surgery, 2 New Knees: Kristi McGrew
Local teacher has both knees replaced at Lake Regional
Kristi McGrew, a reading teacher at School of the Osage Heritage Elementary School, had an unusual summer project.
“While school was out, my summer project was to get new knees so I can keep up with all of the kids,” says McGrew, who has served School of the Osage for 20 years. “Anytime I was on my legs for an extended period, they would get so sore and achy.”
Early Signs of Knee Trouble
McGrew’s knee troubles began with a torn ACL when she was 25. She had surgery, but as often happens with ACL tears, the knee eventually developed osteoarthritis. As the cartilage in her knee wore away, McGrew experienced increasing pain and loss of movement.
Then last December, her left knee began to have similar problems. That’s when she began to wonder if a woman in her 50s could be a candidate for knee replacement surgery.
There are pros and cons to replacing joints in mid-life, says Jeff Jones, D.O., a board-certified orthopedic surgeon at Lake Regional Orthopedics.
“In the past, hip and knee replacements were performed only on patients ages 65 and older,” he says. “That’s because the new joint won’t last forever — in general, 20 years is a good expectation. But many people don’t want to wait until they are 65. Many decide, ‘I want good quality years now, and if needed, I’ll deal with a second surgery later.’”
That made sense to McGrew.
“For quality of life, I decided to go ahead,” she says.
2 Replacements, 1 Summer
Hoping to use up just one summer, McGrew was happy to learn she could have both knees replaced at once. And “at once” meant exactly that — Dr. Jones asked his fellow Lake Regional board-certified orthopedic surgeon Rick Walker, D.O., to operate alongside him, with each of them replacing a knee. The main benefit of this approach, Dr. Jones says, is a shorter anesthesia time.
“That’s a little safer for the patient,” Dr. Jones says.
To get ready for her surgery, McGrew attended Lake Regional’s Total Joint Camp. This two-hour class helps patients know what to expect before, during and after total hip or total knee replacement surgery. The camp includes tips from the orthopedic surgeons, as well as from physical and occupational therapists, dietitians and social workers.
“It took away a lot of the worry and fear because I knew what to expect,” McGrew says.
After surgery, McGrew spent four days at Lake Regional Hospital. The care, she says, was a perfect balance of professional and personal.
“Professional because everybody really knew how to do their job, and I felt safe,” she says. “And then also personal because I never felt like anybody was just doing their job. I felt like they really, genuinely cared about me. People were always asking, ‘Can I do anything for you?’ Not only the medical professionals — the techs, nurses, physicians — but also the housekeeping personnel and volunteers. I felt really thankful.”
After being discharged, McGrew decided to spend seven days at the Lake Regional Skilled Nursing Facility, located within the hospital. She received physical therapy twice a day and occupational therapy as needed.
“The best thing about the Skilled Nursing Facility was that I had an extra week to focus — just focus — on getting better and getting stronger,” she says.
At first, McGrew needed help to walk short distances. A couple of days later, she just let staff know when she’d be walking.
“Then the last couple of days, I could get up and walk around as I pleased because I was safe to do that,” she says.
Expert Care Close to Home
For the rest of her summer, McGrew went to the hospital three times a week for physical therapy. She switched to twice a week when school started.
“My physical therapists are wonderful about helping me with practical aspects of life,” she says. “They ask me what is challenging me and then show me exercises and other tips to help make these tasks easier and to help me get stronger and more flexible. There is some stiffness, but I have no pain in my joints. I am able to go up and down stairs and am getting faster when walking. I was still using a cane for the first week back to work but abandoned it the second week.
“I know a lot of people think they have to go to a bigger city to get good hospital care, like somehow, right here at home, it’s not going to be good enough,” she adds. “I didn’t experience that at all. My surgeons used the latest methods, and along with that professionalism, I had the personal aspect because I had nurses who were parents of kids I’ve had in school. I had people from the community I know, and that means a lot to me, to be in my community, where I know the people who are taking care of me.”
Moving Again: A New Hip for Whitney Nepote
Kansas woman chooses "wonderful" Lake Regional team for hip replacement
Whitney Nepote of Paola, Kan., could have had her hip replaced closer to home, but she chose to make the three-hour drive to Lake Regional Orthopedics.
“My son lives in Sunrise Beach, and he said, ‘You need to come down here,’” Nepote says. “His wife had two hip replacements with Dr. Jones, and my son said: ‘He’s wonderful. He does the surgery a new way that has a faster recovery time. Come down here, and we’ll take care of you.’”
A Better Approach
Jeff Jones, D.O., is a board-certified orthopedic surgeon at Lake Regional Orthopedics. He and his fellow Lake Regional board-certified orthopedic surgeon Rick Walker, D.O., perform total hip replacement surgeries, like Nepote’s, using a hana ® table. This high-tech surgical table has moving parts that enable surgeons to access the hip joint from the front of the hip. The traditional, back approach requires cutting muscles and tendons, but with the front, anterior approach, surgeons can work through the natural gap between the muscles.
“Using the traditional, posterior approach, after we finished replacing the hip, we had to surgically repair the muscles and tendons we had cut,” Dr. Jones says. “Because no cutting and repair is necessary with the anterior approach, patients recover much more quickly and with less pain.”
The hana ® table also allows for X-ray imaging during the surgery, which improves outcomes “because we can see precisely what we’re doing during surgery, instead of taking an X-ray after we’re done,” Dr. Jones says.
Nepote was glad to go to the surgeon who had taken excellent care of her daughter-in-law and found her own care to be excellent, as well.
“I spent two days in the hospital, and the staff was wonderful, always coming in to see if I needed anything,” Nepote says. “Even the cleaning staff was caring. It was outstanding. I’d recommend it to anybody.”
After leaving the hospital, Nepote spent two weeks at her son’s home. Lake Regional Home Health helped care for her, and Nepote reports the nurses and therapists were “wonderful.”
Nepote continued her therapy back home in Kansas and six weeks after her surgery is excited at the changes she sees.
“Before I had the surgery, I hurt terribly, and it got to where I couldn’t even walk,” she says. “Now I’m able to drive, go to the store, clean our house, do laundry — I do everything.”
Total Joint Camp
Lake Regional’s Total Joint Camp, offered the second and fourth Wednesday of each month, helps patients know what to expect before, during and after total hip or total knee replacement surgery. The camp includes tips from physical and occupational therapists, dietitians, and social workers. Plus, participants are welcome to ask questions.
To register, call Lake Regional Rehab Therapy at 573-302-2230.
Thumbs Up for Exceptional Care: Tyler Delaney
Hyperbaric treatment helps 13-year-old keep his thumb.
At a reunion with Lake Regional Wound Healing Center staff members, 13-year-old Tyler Delaney was happy to give his former caregivers two thumbs up. After all, if not for the effort of orthopedic surgeon Scott Hofer, D.O., and the wound care team at Lake Regional, Tyler would likely be missing one of those thumbs today.
What was supposed to be a fun-filled vacation for Tyler's Wisconsin family nearly turned into a tragedy when Tyler's hand became entangled in a tow rope after a day of wakeboarding on the Lake of the Ozarks.
"As he was picking up the rope, the jet ski was still running," Tyler's father, Shawn Delaney, explains. "The rope got caught in the prop and got pulled in, which then wrapped around his thumb and dislocated it and almost pulled it off."
"When it immediately happened I thought I had lost my thumb," Tyler recalls. "As soon as I was told that I still had my thumb, I wasn't as worried, but I was still worried I could lose it."
Tyler's father rushed him to Lake Regional Hospital, where Emergency Department staff took immediate action to stabilize the wound and called in Dr. Hofer to determine if the thumb was salvageable.
"He sustained a circumferential laceration going around the finger with a fracture through the growth plate to the thumb," Hofer says. "He essentially nearly amputated the finger."
Initially, Dr. Hofer felt there was a 50-50 chance that Tyler might lose his finger. Half of the thumb had good circulation, but the nerve and blood vessel on the other half looked as though they were damaged beyond repair.
Fortunately for Tyler, youth was on his side.
"Kids heal a lot better than adults do," Dr. Hofer says. "Oftentimes, things that don't look salvageable are."
After cleansing and assessing the wound, Dr. Hofer realigned and stabilized the fracture by inserting a pin through the growth plate. He then repaired the skin lacerations with absorbable sutures.
With his thumb intact, Tyler was discharged into the care of his father. The pair hoped to salvage what was left of their time at the lake. But a follow-up visit to Dr. Hofer once again changed their vacation plans.
The tip of Tyler's thumb began to look dusky, and Dr. Hofer was worried the tip might die. He hoped the oxygen-rich environment of Lake Regional Wound Healing Center's hyperbaric chambers would improve oxygenation to the tissue and promote the healing process. Since opening in April 2009, the Wound Healing Center has used hyperbaric oxygen therapy to treat a variety of ailments, including diabetic wounds, bone and skin infections, and acute trauma arterial insufficiency.
"By increasing the oxygen in the atmosphere, we're improving the oxygenation of the tissues [even though there is not a good blood supply]," Dr. Hofer says.
Tyler ultimately spent the remainder of his vacation doing 10 two-hour stints in the clear, comfortable confines of a pressurized hyperbaric chamber—making him the youngest patient to receive hyperbaric treatment at Lake Regional. He passed the time watching movies and enjoying plenty of father-son bonding time with his dad sitting on the outside of the chamber.
"I had a different picture in my head from what the chamber was," Shawn says. "To see that...I could see him and he could see out was great."
After Tyler finished his treatments at Lake Regional, the family returned home to Wisconsin. However, Lake Regional made sure he would have the appropriate follow-up medical care. After an exhaustive search, Wound Healing Center Program Director Laurie Lowther was relieved to locate a center close to Tyler's home that had a pediatric surgeon on staff.
A year later, Tyler has full use of his thumb and is brushing up on his favorite musical pastime—drumming. For the Delaneys, it's a return to normalcy that would not have happened without the efforts of Lake Regional's doctors, nurses, technicians and support staff.
"They helped me out so much that we just had to come back and say thank you," Tyler says. "I'm sure we will be coming back for years to come."
Family Birth Center
Ireland's Arrival: Danielle and Aaron Ellsworth
Couple's nerves turn to joy with birth of first baby.
Wearing a bright pink headband and an ear-to-ear smile, Ireland Ellsworth flits from one person to the next during a reunion with the Lake Regional Family Birth Center staff. The 1-year-old seems eager to chime in as her parents share the story of her arrival.
"This was our first pregnancy, our very first baby, our first delivery," says Danielle Ellsworth. "I had no idea what to expect."
Nearly two weeks past her due date, Danielle was experiencing contractions but had no sign of dilation. As midnight became mid-morning, Danielle and her husband, Aaron Ellsworth, found comfort in knowing the doctors and nurses of the Family Birth Center were keeping a close eye on mother and baby with the help of fetal heart monitors.
"Fetal heart monitors are our eyes into the womb," says Lake Regional Family Birth Center Nurse Manager Mary Lou Gamm, RNC-OB. "We are in touch with what is going on with that labor every minute, regardless of whether we are standing right beside the mother's bed or watching the information on computers in the doctor's office or the nurse's station."
"It was very reassuring," Danielle says. "Hearing Ireland alive and well and her heart beating strongly was incredible."
As the hours crept by and Danielle still was not dilated, information from the fetal heart monitors became increasingly important. Danielle's obstetrician, Robert Nielsen, D.O., initially considered inducing labor, but the results of the monitoring indicated that it would put increased stress on baby Ireland.
"The nurses monitored her all night, and as my wife would have contractions, the baby's heart rate would drop," Aaron says.
Concerned, Dr. Nielsen decided the best course of action was to deliver by cesarean.
"Around 10 o'clock that morning, the doctor called for a cesarean section, and our daughter was born at 10:42," Aaron says. "It all happened very quickly."
More than a year later, the proud parents chuckle as Ireland toddles around the room in sparkly ballet slippers. They express gratitude for the Lake Regional care that helped them safely deliver their daughter.
"They were professional and dedicated to their job," Aaron says. "They took great care of my wife, and we have a beautiful daughter."
"It was a wonderful experience," Danielle agrees. "The nurses, Dr. Nielsen, all the staff—they were incredibly helpful. I can't say enough great things."
Breast-Feeding Success: Jessica Rozier
Jessica Rozier thanks Family Birth Center for a great experience.
In February, Lake Regional Family Birth Center earned designation as a Show Me 5 hospital. This recognition from the Missouri Department of Health and Senior Services goes to hospitals that adopt five evidence-based maternity care practices that support breastfeeding.
Jessica Rozier, a breastfeeding mom who had her first son, Brooks, in October 2012 and her second son, Liam, in September 2014, says her two deliveries at Lake Regional show the difference these practices make to moms and babies. With Brooks, Rozier had to explain to her care team that he should not be given pacifiers or formula. She also had to let them know that she wanted him in her room at all times.
Even then, he was taken out for his hearing test, and she worried he might get hungry and be given a pacifier.
But by the time Rozier had Liam, the Family Birth Center team was well on its way to being a Show Me 5 facility, and she could hardly believe the difference in support.
"Liam was placed on my chest immediately after birth, and he breastfed right away," she says. "I didn't even have to request that Liam be in my room—it was a given. I wasn't scared he'd be given a pacifier or that I would be told to supplement. He didn't even have to leave the room for the hearing test.
"This mama was very pleased to have a natural birth and a chance to really bond with my son in those crucial first few days," she continues. "I was wary about being able to have those moments in a hospital, but the staff at Lake Regional made them all possible."
The Show Me 5 Practices
- Help mothers initiate breastfeeding within the first hour of birth
- Practice "rooming-in," allowing infants to stay in the room with their mothers
- Give breastfeeding infants no other liquid, unless medically indicated
- Do not give pacifiers or artificial nipples to breastfeeding infants
- Foster the establishment of breastfeeding support groups and refer mothers to them on discharge
Big Care for Little Patients: Jennifer Hollingsworth
Lake Regional Family Birth Center nursery keeps family together.
When Jennifer Hollingsworth first heard that her 6-day-old daughter, Helen, needed to be readmitted to the Lake Regional Family Birth Center to gain weight, she felt a little panicked. Helen was expected to be fine, but to stay with her, Hollingsworth thought she'd have to be separated from Helen's twin brother, Quill. And she was breastfeeding both.
Thankfully, Hollingsworth didn't have to choose between her newborns.
"The doctors and nurses assured me that Quill could stay overnight, too," she says. "I was so relieved. It would have been very hard emotionally to be separated from either of my babies."
Expert Care, Close to Home
Keeping families like the Hollingsworths together was one reason Lake Regional Family Birth Center became a level 2nursery in 2014. This designation allows the Lake Regional team to provide care for infants with acute needs, including infants who require antibiotics, IV fluids, respiratory support, help with feeding and much more. As a result, babies are only transferred to another hospital if they require neonatal intensive care.
"Providing additional acute care services helps ensure babies born at Lake Regional get the healthiest start possible," says Josh Brickner, D.O., a pediatric and internal medicine hospitalist at Lake Regional. "Staying at Lake Regional also means they can begin bonding with their families right away."
For Hollingsworth, a kindergarten teacher at Camdenton's Dogwood Elementary School, and her husband, Ryan, being close to home was an important draw to Lake Regional.
"We wanted to go somewhere close, and we've heard nothing but good things about the Family Birth Center," Hollingsworth says.
The Hollingsworths had already used Lake Regional Family Birth Center for the arrival of the twins' older sister, Abaigail, in 2009. When they returned six years later, they were pleased to find several of the same nurses still there.
"The nurses have an excellent bedside manner," Hollingsworth says. "They explained everything to me I wanted explained. And you could tell they all really liked babies."
During both pregnancies, Hollingsworth received care for high blood pressure, and with the twins, the condition forced her to go on bed rest at 28 weeks. Still, she managed to hold off their delivery until she was at 37 weeks and five days.
"I made it a really long time, and I know that's thanks to the care I received," she says.
She delivered the twins through a scheduled cesarean section on May 29, 2015. Quill weighed 6 pounds, 7 ounces, and Helen 5 pounds, 11 ounces.
The babies were in good health overall. Lake Regional Lactation Consultant Annie Havner, R.N., BSN, IBCLC, helped Hollingsworth and the twins get started with breastfeeding.
"The twins were losing weight before we left the hospital, so we were supplementing with formula," Hollingsworth says. "Annie showed me how to do syringe feeding and tube feeding [so a bottle was not introduced]. I was also given a hospital-grade breast pump to help encourage production. I was still able to bond and do skin-to-skin, which is important for breastfeeding and just establishing attachment in the beginning."
The babies were discharged on June 2 and came back the next day to check for jaundice and weight gain. That's when Helen's weight loss required her readmittance. She stayed one night.
"They made me feel very safe," Hollingsworth says about the Family Birth Center staff during Helen's stay. "I really wanted to breastfeed, and they did not force us to do the bottle right away. We tried other interventions first."
Although Helen did eventually need bottle supplementation from a high-calorie formula, the support Hollingsworth received enabled her to continue breastfeeding both Helen and Quill through Helen's short hospitalization and for several weeks after she returned home.
"The whole staff was positive and encouraging," Hollingsworth says. "Without that, I wouldn't have even tried to continue breastfeeding, and I'm so glad I did. The bond is almost magical. To know you're the one providing them with their nourishment—it's amazing."
Because Lake Regional offered level 2nursery services, Helen was close enough to home to make it easier for other family members, including Ryan and Abaigail, to continue bonding, too.
"I was allowed all the company I wanted and felt that staff was very accommodating," Hollingsworth says. "They were great with Abaigail and made her feel that her role as a big sister was very, very important. Abaigail also stayed until it was her bedtime."
Now, several months later, Helen and Quill are healthy and growing right on schedule.
"I am very happy that Lake Regional had a level 2nursery and was able to meet the needs of my family," Hollingsworth says. "I felt more comfortable knowing we would all be together."
Wake-Up Call: Stroke Survivor Paul Wilke
A near miss changed Paul Wilke's life - for the better.
Paul Wilke woke up at 4 a.m. Friday, May 27, 2016, unable to move his right arm and leg.
“I couldn’t get rolled over,” he says. “I thought my leg and arm were asleep.”
It lasted a couple of minutes. Then Paul got up, walked a bit and sat back on the bed. As he sat there, the numbness and weakness returned. His wife, Jill, woke up and asked if he was OK.
Paul knew he was not.
“I told her I thought I was having a stroke,” he says.
Paul knew what was happening because he had seen it hundreds of times. He is a retired paramedic, with 25 years of medical experience. And, Jill is a registered nurse.
They moved to the lake in 2014 from Wisconsin. Jill’s grandparents founded Wonderland Camp, and once Paul and Jill’s kids were grown, they decided to move back to her family’s land on the lake.
“He fishes all the time, and we like going out on the boat — just living that lake life,” says Jill, who serves as Lake Regional’s director of Palliative Care, Home Health and Hospice.
As soon as Jill heard Paul speak that morning, she knew his life was in danger. Not only was he having numbness and weakness on his right side, but he also was slurring his words. Jill tried to call 911, but the call dropped. Less than five minutes after the second attack began, it ended, and Paul could move and talk again.
Wasting no time, Jill drove Paul to Lake Regional Emergency Department. There, staff initiated Code Stroke, alerting all providers and departments involved in stroke care. Lake Regional Neurologist Philip Kurle, M.D., diagnosed Paul with crescendo transient ischemic attacks, or TIAs. Sometimes called ministrokes, transient ischemic attacks have similar symptoms as stroke but are brief, without lasting effects. The “crescendo” indicates Paul’s attacks were coming at a fast rate.
“If not treated, there’s a very high risk of these attacks progressing to a full stroke,” Dr. Kurle says.
Dr. Kurle’s treatment for Paul focused on improving blood flow through restricted arteries in Paul’s brain. Specifically, Paul received antiplatelet drugs, which prevent the formation of blood clots; aspirin; blood thinner; and fluids.
Next, Dr. Kurle ordered testing, including an MRI and cerebral angiogram. The results showed Paul had escaped a full-blown stroke. Dr. Kurle kept him in the hospital a little more than 24 hours for observation, and Paul had no more attacks.
“Having worked at a much bigger health facility in Wisconsin, we both were very impressed with the care Paul received here,” Jill says. “Dr. Kurle and the stroke team did everything right and saved him from progressing to a full stroke.”
Turning Things Around
Leaving the hospital, Paul had mixed emotions. Although thankful to be walking out with no disabilities, he knew he was at increased risk for a future stroke. He also had been diagnosed with diabetes during his stay, and he was angry at himself for years of poor health choices. He wasted no time making changes.
“I quit smoking May 27,” he says, “and I started watching my diet, exercising and found a primary care doctor, Dr. Barnum, who I see regularly.”
Even with these changes, Paul struggled to manage his blood sugar levels, especially in the mornings. So, he enlisted the help of a Lake Regional dietitian and diabetes educator, Wendy Castle, MPH, R.D., L.D., CDE. She explained how Paul should mix his proteins and carbs, even when snacking. Paul followed her advice and saw his levels improve.
For exercise, Paul started walking and after a couple of months, began running.
“I don’t particularly like running, but it’s the best way for me to lose weight and stay active,” Paul says.
Because of his commitment to healthier living, Paul has lost 60 pounds and achieved a healthy blood pressure.
“He’s probably in the best shape of his life,” Jill says, adding he’s shown amazing willpower. Paul says he hears that often.
“A lot of people have asked, ‘How can you switch overnight?’” he says. “The answer is I thought I was going to die or be severely disabled. That gave me a different perspective. I realized that if I want to see my grandkids grow up, I had to change things. And I’m sticking to that.”
As a state-designated Level II Stroke Center, Lake Regional Health System offers comprehensive stroke care and recovery, including treatment from a board-certified neurologist, specially trained Emergency Department physicians and staff, around-the-clock emergency imaging services, a skilled nursing facility located in the hospital, rehabilitation services and home health services.
"Don't Ever Give Up": Stroke Survivor Lois Shipp
Lois Shipp lifted her left foot, set it on a low wooden box and grinned.
“There!” she said to Lake Regional Physical Therapist Assistant Ann Perry. “It came straight down, didn’t swing to the side at all. Did you see that?”
Perry grinned back at her. “I did,” she said. “Good job.”
Shipp, 83, has good reason to feel proud. She has come a long way since a stroke on Feb. 13, 2017, left her left side paralyzed. May is National Stroke Awareness Month, and Shipp shares her story to encourage others facing a stroke diagnosis.
“Don’t ever give up,” she said. “You can have a life after a stroke.”
From Depressed to Determined
Shipp wasn’t always so positive about recovery. After her stroke, she spent six days in Lake Regional’s Intensive Care Unit and then a day and a half on Lake Regional’s Medical/Surgical Unit. From there, she went to Lake Regional Skilled Nursing Facility for intense therapy. She couldn’t walk more than five feet with a walker, and even that required assistance from a therapist.
“She thought she was always going to be that way,” said her husband, Don Shipp, who is also a stroke survivor.
“I was depressed, and I didn’t want to get out of bed,” Lois Shipp said, adding she refused to do therapy the first two days. Then Jeanne Marie Loggins, an occupational therapist assistant, explained her options.
“That changed my life,” Lois said. “Jeanne Marie came into my room and said: ‘Lois, do you know that if you do not try to get some therapy, you will have to leave here in a couple of days and go live in a nursing home? If that’s what you want, that’s fine, but you know, we can help you.’ And there was something in her voice that sounded like she really cared. So I said, ‘Then let’s get at it.’”
And “get at it” Shipp did, impressing all of her caregivers.
“I worked hard and within two weeks, I could raise my arm above my head and was walking some with a walker,” Shipp said.
And within a month, she could walk 350 feet with a walker and go up and down stairs.
“She worked very hard,” Loggins said. “She wanted to be able to go home, and after 32 days in our Skilled Nursing Facility, she walked out of here with a walker.”
Grateful and Strong
In the weeks since, Shipp has continued her occupational and physical therapy on an outpatient basis, coming to Lake Regional Hospital three times a week. She has all of her movement back in her left arm and enough control in her left hand to lift a glass and take a drink without any spilling. Her left foot has been the slowest to regain movement and control, and she wears a special brace to help her not drag her toes. At home, she continues to use a walker to be safe, but with her therapists’ supervision, she walks with just a cane.
She continues to get stronger and is thankful for the therapists and other caregivers who have helped her recover.
“I could not have had a better team,” Shipp said. “They have been so good to me and have become like family to me.
“I hope if you ever have a stroke, you will think positive and work hard to get your life back,” she added. “You can do it, and it is worth all the hard work getting there. I worked as hard as I could, and by the grace of God, I’m where I am today.”
Stroke Care at Lake Regional
As a state-designated Level II Stroke Center, Lake Regional Health System offers comprehensive stroke care and recovery, including treatment from a board-certified neurologist, specially trained Emergency Department physicians and staff, around-the-clock emergency imaging services, a skilled nursing facility located in the hospital, rehabilitation services and home health services.
Suspect a Stroke? Act FAST
If you suspect a stroke, remember the word FAST.
F is for face — is it drooping?
A is for arms — can you lift them?
S is for speech — are you slurring your words?
T is for time — call 911 immediately because with stroke, time is brain.
Precious Progress: Mark McGrath
Born with health challenges, a young boy shines in pediatric therapy
Three-and-a-half-year-old Mark McGrath announces his plan before sliding his thumb and fingers into the scissors. He carefully opens the blades and inserts a pink straw between them.
“Close!” he says. He squeezes the scissors, and a piece of straw flies through the air. A moment later, another piece follows it.
“Great job!” cheers Mark’s occupational therapist, Lake Regional’s Danielle Baumgartner. Mark pauses to look at her and smile.
It’s easy to cheer for Mark. This playful, determined little boy has overcome many daunting challenges. Born with multiple abnormalities affecting his heart, brain, spine, palate and more, he has had so many surgeries that his dad and mom, Patrick and Marcela McGrath, have lost count. His many medical issues have led to various developmental delays, including in his speech and motor skills.
“His neurologist thinks by age 6 — with intensive therapy — he may be caught up,” Marcela says, noting Mark’s cognitive development is on target for his age. “He may not ever run the fastest, but he may be caught up and able to live an independent life.”
Helping Mark achieve his victories are his speech, occupational and physical therapists at Lake Regional Health System in Osage Beach. He sees his Lake Regional therapists twice a week, with back-to-back appointments. Being able to coordinate his care that way has been critical, Marcela says.
“Because this is long-term,” she explains. “He needs intensive therapy at least until age 5, maybe longer. For this to be sustainable, I need to have all three therapies in one place.”
When Mark began at Lake Regional just after his third birthday, he was only saying, “Mama” and “Papa.” Six months later, he was constantly surprising his parents with new words. “The other day, he looked up and said, ‘Plane!’ ” Marcela says.
Cutting with scissors is another new achievement. He also has gone from a slow walk with lots of falls to a fast walk with fewer falls, and he can jump now.
“I’ve been very impressed with the therapists, and it’s not just what they do here,” Marcela says. “I love that they’ve given me ideas on how I can work with him at home.”
More Locations for Pediatric Therapies
Lake Regional offers pediatric physical, occupational and speech therapies at three area locations: Eldon, Laurie and Osage Beach. For more info, visit our Pediatric Rehabilitation Therapies page.
Excellent Care in an Emergency: Aadon Magruder
"She treated my son like he was her own"
Nine-year-old Aadon Magruder couldn’t wait to jump in the water. His family was vacationing at his great-great uncle’s lake house, and Aadon loves swimming. But as he started to jump, Aadon slipped on the dock and collided with a metal ladder.
And just like that, Aadon had a major laceration on his right shin.
Aadon’s parents, Aaron and Kristin, rushed him to Lake Regional Emergency Department. Aadon’s 4-year-old brother, Kason, also came along.
The care given to them all, Kristin says, was exceptional from the moment the receptionist greeted them until they were sent on their way — with 23 stitches on Aadon’s shin.
The first person to provide Aadon care was an ED triage nurse, Anne Wilson, R.N. She quickly packed and stabilized Aadon’s wound.
“Although most of the morning was a blur, I remember her thoughtfulness and kindness,” Kristin says.
Once in a treatment room, Kristin continues, Aadon was “enveloped with care” from nurses, radiology staff and “the angel in disguise” Nurse Practitioner Teresa Buol.
“When Teresa first entered the room, I knew Aadon was going to be OK,” Kristin says. “She treated my son like he was her own. She explained everything she was doing in ways that a 9-year-old would understand and made stitches sound cool. She repeatedly told him how brave he was and how proud she was of him. I was so impressed — just in awe. As a parent, watching my son go through something like this was horrible, but watching someone who actually cared and took time to make his leg look good and explain things to him to make him comfortable was worth the world to me.”
Kristin was so pleased with the care that she sent Lake Regional a note of thanks. She praised the various staff who helped them and ended the noted with: “You have a fantastic facility that I will recommend time and time again! This is the type of hospital that all hospitals should strive to be like. This is the kind of care that all patients should receive when they are ill. Thank you again for taking such good care of my son.”
And Aadon added a special PS:
Living Well with Lymphedema: Deborah Roehl
Occupational therapy helps relieve painful swelling
Deborah Roehl and Danielle Baumgartner, an occupational therapist at Lake Regional
Deborah Roehl had been free from uterine cancer for about a year when she noticed her ankle swelling. Her doctor prescribed Lasix and antibiotics, but the swelling and pain worsened — and then spread.
“In a little more than a year, I put on more than 100 pounds, and my leg was huge,” Roehl says.
Incurable but Treatable
Roehl had lymphedema. This condition occurs when the body’s lymphatic system has trouble circulating lymph, a clear fluid that surrounds cells and contains cell wastes. The poor circulation causes lymph to back up, resulting in severe, painful swelling.
Various diseases and conditions cause lymphedema, including congestive heart failure, chronic venous insufficiency and cancer. For Roehl, the trigger was radiation given to treat her uterine cancer.
Lymphedema cannot be cured, but it can be managed. Lymphedema therapy is one treatment that can help. Lake Regional occupational therapists provide this therapy, which uses a variety of techniques to improve lymph circulation. Manual lymph drainage uses gentle massage to draw fluid out of the tissues and back into the lymphatic system. Compression bandaging wraps the affected limbs to support circulation. And pneumatic pumps use inflatable “sleeves” to stimulate the flow of fluid.
“I’ve seen patients improve dramatically, from barely walking to living active lives,” says Lake Regional Occupational Therapist Katie Kelley.
Determined to Get Better
Before her cancer, Roehl was an active wife and mother who ran a daycare out of her home. After beating cancer, she was active again — until lymphedema. For more than 10 years, she struggled to manage the condition, but the swelling forced her to use a wheelchair. She continued to gain weight, and she had several bouts of cellulitis, a serious skin infection. In early 2015, the infection sent her to the hospital. Doctors weren’t sure she’d live.
“Hope is a powerful thing, and I had gotten to the point where I had lost my hope,” Roehl says.
Yet, knowing her life was in danger did something for Roehl. It took three weeks, but she left the hospital, determined to do whatever it took to get better. Roehl had been receiving therapy at Lake Regional Clinic – Eldon for a few years, but after her hospitalization, she came with a new attitude.
“She was different,” says Kelley, who had worked with Roehl since 2013. “She made a decision, ‘I’m going to do this this time.’”
That determination has brought results. Since July 2015, Roehl has lost 95 pounds and seen her whole life change.
“This last year has been awesome,” she says. “I’m more energized, more active. I’m walking all over the place. No more wheelchairs, no more hospital bed, no more blood pressure meds, no more diabetic meds. I’m doing things I’ve only dreamed of doing for 10 to 15 years. I can take care of my own house, fix my own meals — do everything myself. I’m excited to be alive again.”
Looking for lymphedema support? Check out these Lake Regional offerings:
Lymphedema: You Are Not Alone! This free support group, led by Lake Regional occupational therapists, meets at 5:30 p.m. on the third Wednesday of each month at Lake Regional Clinic - Eldon. Call 573.302.2230 for information.
Lymphedema 101. This free class at Lake Regional Cancer Center educates individuals who have lymphedema, as well as those at risk for developing the condition. Visit www.lakeregional.com/events or call 573.302.2772 for information.
Advanced Hearing Care: Susan Andres
After nearly two decades of struggling with single-sided hearing loss, Susan Andres found help thanks to the cutting-edge technology of the Oticon bone-anchored sound processor and the specialized care she received from Lake Regional ENT & Audiology.