Health Connect Summer 2018 by Mary Greeley Medical Center

SUMMER 2018

CONNECT

CLEAN& READY Exclusive: How Mar y Greeley makes surgical instruments safe for patients.

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‘My Wife is Having a Stroke’ 

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A Special Place for Women’s Pelvic Health

One Family’s Bad Knees

CONNECT

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Q&A Mary Greeley chaplains announce a new Alzheimer’s caregivers support group and discuss their personal experiences with the disease. Plus: New McFarland Clinic providers.

All the Right Moves When his wife, Rebecca, had a stroke, Dr. Tony Ellis had to make some fast decisions, including what hospital to take her to.

Contents SUMMER 2018

The Family Knees

Finding Gratitude

‘You Got This’

When a grandmother, a daughter and a grandaughter needed new knees, each turned to the same surgeon.

Be inspired by a Mary Greeley cancer patient’s acts of appreciation for the care he received.

A Mary Greeley therapist creates a comforting, private space for women dealing with incontinence, sexual pain and other pelvic ﬂoor issues.

Clean Room: Inside the SPD Patient safety is the focus in Mary Greeley’s Sterile Processing Department. Get an exclusive look at our complex, multi-step surgical instrument sterilization process.

Volunteers of the Year We recognize the hundreds of people who offer their time and talents to help make sure everyone at Mary Greeley has a great experience. SPRING 2017

Prime Time Alive & More Clinics & Classes

CONNECT

Health Connect is an award winner – see page 23.

FIGHTERS

Taking on diabetes and cancer, with Mary Greeley’s help.

About this publication Health Connect is published three times a year for residents of central Iowa by Mary Greeley Medical Center. For more informa tion about Health Connect, please contact the Mary Greeley Medical Center Community Relations Department at 5152392129. Visit us on the internet Learn more about Mary Greeley Medical Center’s programs and services at www.mgmc.org. Contact us Individuals are encouraged to contact Mary

Greeley Medical Center if they have any concerns about patient care and safety in the hospital that have not been addressed. If the concern continues, individuals may contact The Joint Commission at One Renaissance Boulevard, Oakbrook Terrace, IL 60181. You may also call 8009946610 or email complaint@jointcommission.org. Opportunity for support Your contributions can help us care for those who come to us at every stage of life. Charitable giving to support Mary Greeley Medical Center has played a signiﬁcant role in shaping your medical center. To learn

more, contact the Mary Greeley Medical Center Foundation at 5152392147 or visit www.mgmc.org/foundation.

Medical Advisor Steven Hallberg, MD

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Surgical site infections: what you should know  Cancer Navigator expands reach  Volunteers in action  How to spot a stroke

Design Scott Thornton, www.designgrid.com

President and CEO Brian Dieter Director of Marketing and Community Relations Steve Sullivan

Photography Paul Gates Justin Connor Tim Hoekstra

Editors Steve Sullivan Stephanie Marsau

HEALTH CONNECT | Summer 2018 | www.mgmc.org

PRESIDENT’S LETTER By Brian Dieter Mary Greeley President and CEO

n May, our Home Medical Equipment (HME) department received a call from a patient whose oxygen machine’s alarm was going off. John Reger, HME representative, immediately went to the patient’s home to check on the machine. John found that the machine’s oxygen flow was turned way up, which was why the alarm was sounding. John quickly realized that the patient wasn’t doing very well. He suggested the patient call 911 and waited until an ambulance arrived. The patient ultimately needed heart surgery. John’s recognition of the patient’s condition and his response may very well have saved this person’s life. These sorts of stories are not uncommon at Mary Greeley, and they are easy to overlook because the bulk of our care is provided within the walls of the medical center. As healthcare evolves in this country, what we do outside of the medical center will become just as important as what we do inside of it. Mary Greeley is well positioned for this future. Our highly trained paramedics, of course, are a familiar and welcome presence at medical emergencies. Our HME staff and even our Meals on Wheels volunteers provide thoughtful sets of eyes when they visit people in our community—

Deb Swanson, BSN, RN, with Mary Greeley Home Health Services, assists Kate Uthe.

people who often have few visitors during the course of a week. For decades, our Home Health and Hospice Services nurses have provided in-home care to patients within a 50-mile radius of Ames. Their role has grown considerably in the last few years. We are providing more visits to help people transition home after a stay at the hospital for health issues related to pneumonia, COPD, heart attack, congestive heart failure, and sepsis. In 2016, we started doing free postsurgical visits for colon surgery patients. In 2017, we expanded this service for patients who have had hip, back, and knee surgery. The goal behind this is to reduce the potential for surgical site infections and, subsequently, readmissions to the hospital. Our Home Health Services staff help ensure patients understand their discharge instructions and medications.

They also check on surgical sites and show patients how to properly care for wound dressings and avoid situations that can lead to infections, such as exposing a wound to pet hair. Since initiating these free visits, our Home Health Services staff have visited more than 60 percent of patients who have had these types of surgeries. We also offer pre-surgery visits, helping patients prepare for surgery the night before, including showering and making sure the bed has clean linens. Mary Greeley is more than a building. We are skilled, observant professionals who work together to provide outstanding care each and every day—inside and outside of these walls.

Thank you to our sponsors McFarland Clinic

The Mary Greeley Foundation would like to thank these sponsors who provide annual support for the William R. Bliss Cancer Center, Mary Greeley Hospice, Mary Greeley Mileage Club, and Grand Rounds. Presenting Sponsor McFarland Clinic Sustaining Sponsor NOW 105.1 & 1430 KASI Lifesaver Sponsors Ames National Corporation and afﬁliates Boone Bank & Trust Co., First National Bank, Reliance State Bank, State Bank & Trust Co.

Pacemaker Sponsors Ag Leader Technology NAI Electrical Contractors Caretaker Sponsors Banker’s Trust Great Western Bank Henkel Construction & Accord Architecture Co. Jester Insurance Services Sponsors Adams Funeral Home Alfred’s Carpet and Decorating, Inc. Ames Ford Lincoln Celebrations Party & Rental Dentistry at Somerset, Dr. Niegsch & Dr. Garman

www.mgmc.org | Summer 2018 | HEALTH CONNECT

Hanger Clinic Integrity Construction Services Kindred Healthcare Kevin & Yvonne Kinzler Knapp Tedesco Insurance Agency Kreg Tool Company MB Financial Bank Mittera Group (ColorFX) Nyemaster Goode, PC Steve & Randi Peters ShiveHattery, Inc. Sigler Sign Pro US Bank Wandling Engineering Wells Fargo Austin Woodin – Edward Jones Financial Advisor

Mary Greeley Mileage Club Renewable Energy Group – Sustaining Sponsor 3M – Lifesaver Sponsor Danfoss – Pacemaker Sponsor HyVee – Caretaker Sponsor Grand Rounds First American Bank – Lifesaver Sponsor Green Hills Health Care Center – Pacemaker Sponsor

MORE INFORMATION

Q&A A

ALZHEIMER’S SUPPORT GROUP

Mary Greeley is reforming an Alzheimer’s care giver support group, which will be conducted by Randy Allman, M.Div., and Katherine Werner, M.Div., Mary Greeley chaplains who both have personal experiences with the disease. Allman serves as a chaplain for Mary Greeley Medical Center and Hospice, a position he has held since 2015. For the past 18 years, he has served both as a local pastor and as staff chaplain for regional medical centers and hospices. Werner serves as chaplaincy services coordinator for Mary Greeley. She has been in the department for more than 12 years and has served in various parish and campus ministry settings in Michigan, Illinois, and Iowa. Here they talk about the benefits of support groups and their own experiences coping with loved ones who lived with Alzheimer’s disease. For more information, contact the Mary Greeley’s chaplain’s office at 515-239-6862 or 515-239-2502.

Randy Allman

Katherine Werner Why are support groups beneficial? Randy Allman: Support groups create a safe, confidential, supportive environ ment or community and a chance for participants to develop methods of informal mutual support and social relationships. Participants learn that they are not alone in their emotional, physical, and practical caregiving challenges. Katherine Werner: Support groups can help participants going through a similar experience feel less judged by or isolated from others. They help improve coping skills plus help reduce anxiety or distress, and they help paint a picture of what to expect down the road. It is important to note that support groups are not a substitute for professional counseling. 2

What is the value in particular for Alzheimer’s caregivers? RA: We’re partnered with the Alzheimer’s Association, so we are able to provide education, information, and resources about the disease, current research, and treatment methods. In addition to developing problemsolving skills, support groups encourage caregivers to maintain their own personal, physical, and emotional health; plus the setting provides a needed break from caregiving responsibilities. You both have personal experience with Alzheimer’s. RA: I lost my wife, Dana, to Alzheimer’s last December, following an 11year struggle with the earlyonset variety of the disease. The lessons I learned from that journey have been invaluable in helping others struggling with providing care for a loved one. Losing someone you love—a little bit day by day—rips at your very soul. Each day indeed becomes 25 hours long and each week seems like eight days. You cannot sleep soundly, family gatherings lose their celebratory feeling, friends back away, and suddenly you find yourself very much alone with someone who no longer knows who you are but depends on you completely. Shared pleasures atrophy; hopes for

Mary Greeley’s Alzheimer’s caregiver support group is for family caregivers of those living with Alzheimer’s disease. It will meet the second Thursday of each month from 6:30 to 8:00 p.m. The group will meet in Atrium B, near the secondfloor skywalk, starting in September. In November, the group will meet in Atrium A, also located near the secondfloor skywalk. There will be no meeting in December. The meetings will start with a halfhour educational presenta tion by professional community resources, addressing medical, financial, emotional, and daily living challenges that will both in form participants about dementia and help them develop methods and skills to solve problems. The final hour of the sup port group will be a chance for participants to discuss caregiving issues, challenges, and successes in a supportive and confidential environment.

tomorrow are tempered by the reality of this fatal disease. Being able to meet with, share with, and learn from those who were walking (or had walked) this burdenfilled path was a brief but life giving respite for me. Now it is time for me to give back to others. It often seems as if you are all alone, but there are many others right here in this community facing the same challenges, frustrations, and distress. Coming together in a safe and supportive environment was such a comfort and relief. By sharing with others, I learned vital and practical tips on how to deal with everyday challenges like transportation, clinic visits, housing options, and legal/financial issues. KW: My fatherinlaw was diagnosed with Alzheimer’s disease when I was pregnant with my first child. My own father had died just a few years prior, and I feared my children would never know any grandfather, depending on the pace of this journey. One particularly poignant memory for me was about four years after initial diag nosis when my children were ages 2 and 3. He and my motherinlaw came to our home one day a week then and watched the kids while I went to work. Mostly Grandma dragged Grandpa along, as she couldn’t leave him home alone. He didn’t have conversations with anyone and just getting a one or twoword response

HEALTH CONNECT | Summer 2018 | www.mgmc.org

from him was an accomplishment on the days it did occur. His face was usually downcast and he looked at the ground, occasionally lifting his head and giving a small smile when spoken to. When I returned home one day, however, my son and daughter were in booster seats at the kitchen table for snack time with Grandpa at the end. They were looking at a picture book of animals, and Grandma was asking them what sound each animal makes. I stopped on the threshold between the family room and kitchen for a few moments and just watched what was unfolding. Grandpa was making animal sounds with my children—HIS grand children. And he was smiling, beaming actually, for when he said ‘Mooo!’ they would respond with ‘Mooo!’ and then start giggling that contagious toddler giggle, their faces locking eye to eye with their grandpa’s, his head raised as his gaze met and received theirs. They continued this ritual through at least half a dozen animals. Best of all, one could feel and see the energy, the relationship connection between Grandpa and his youngest two grandchildren—children he’d never have a conversation with before he died, but with whom that day spirits were bound in sharing a simple joy in one another’s presence. Why are chaplains uniquely qualified to do this? KW: Most of the Alzheimer’s support groups currently running in central Iowa are not facilitated by chaplains. We just happened to be aware of the history of a former such support group at Mary Greeley. When Randy was asked by the Greater Iowa Alzheimer’s Association to consider facilitating a group since he had been a participant prior to his wife’s death, I shared knowledge of our former group here. We both took the training and felt hosting a group at Mary Greeley made the most sense given the fluidity of referral sources with McFarland Clinic as patients become diagnosed and begin the dementia journey. We are hoping this setting will provide ample opportunities for a variety of professional resources as the educational component of each meeting. If there is anything that makes us qualified to facilitate such a group from our daily work, it’s the ability to walk with people on a journey—often a slow, arduous, painful journey. It’s what we do as chaplains. And the hospice work we do with patients and families would speak to that particularly well. www.mgmc.org | Summer 2018 | HEALTH CONNECT

NEW Faces Joy Carroll, MD Joy Carroll, MD, will join the McFarland Clinic Ophthalmology Department in August 2018. Dr. Carroll completed an ophthalmology residency at Vanderbilt University Medical Center in Nashville. She received her medical degree from the University of Iowa Carver College of Medicine. For more information, contact 515-239-4460.

Brandon McNew, MD Brandon McNew, MD, joined the McFarland Clinic Pediatrics Department in May 2018. Dr. McNew completed a pediatric hematology/oncology fellowship at the University of Iowa and a pediatrics residency at Helen DeVos Children’s Hospital in Grand Rapids, Michigan. He received his medical degree from Michigan State University in East Lansing. For more information, contact 515-239-4404.

Sean Sturm, DO Sean Sturm, DO, will join the McFarland Clinic Anesthesiology Department in August 2018. Dr. Sturm completed an anesthesiology residency at Northeast Regional Medical Center in Kirksville, Missouri. He received his doctorate of osteopathy from A.T. Still University in Kirksville. For more information, contact 515-239-2182.

Mara Syring, DO Mara Syring, DO, joined the McFarland Clinic Pediatric Hospitalist Department in February 2018. Dr. Syring completed a pediatric residency at the Phoenix Children’s Hospital. She received her doctorate of osteopathic medicine from A.T. Still University in Kirksville, Missouri. She received her bachelor of science degree from the University of Wisconsin–Milwaukee. For more information, contact 515-239-6855.

Amy Terhaar, ARNP Amy Terhaar, ARNP, joined the McFarland Clinic Hospitalist Department in April 2018. Amy received her master’s degree in science and nursing from Allen College in Waterloo. She received her bachelor’s in science and nursing from Grand View University. For more information, contact 515-239-6992.

Rebecca and Tony Ellis faced the biggest health crisis of their nearly four decades together.

ALL THE RIGHT

ony Ellis’ wife was having a stroke. He raced to her place of work and got her in the car. Worried and anxious, the Ames man, a physician himself, then had a choice to make. Turn left and head south to a big hospital in Des Moines? Turn right and in minutes be at Mary Greeley Medical Center? His wife was having a stroke and time was of the essence, but could a community hospital deliver the care she needed? 4

M VES A stroke changes the lives of an Ames couple, and their feelings about a hospital. By Steve Sullivan He made a fast decision, and, as he and his wife, Rebecca, quickly learned, it was the right one. Shock

Rebecca Ellis, a nurse at ChildServe in Ames, was working with children who

have special healthcare needs when she felt something like an electric shock in her neck. Her left side went flaccid and she couldn’t lift her arm. “I didn’t have the face droop or slurred speech, but when my nursing supervisor came in, I said, ‘I think I’m

HEALTH CONNECT | Summer 2018 | www.mgmc.org

CERTIFIED STROKE CENTER

Mary Greeley program recognized by American Stroke Association. Mary Greeley Medical Center has earned and maintains Primary Stroke Center (PSC) certification from DNV, a nationally recognized certification organization. Certification is based on established criteria of the American Stroke Association and the Brain Attack Coalition. A PSC has to meet several criteria, including the following: • A designated nurse stroke coordinator • A stroke team available 24 hours a day, seven days a week • CT scan of the head completed within 20 minutes of patient arrival • Neurosurgery available within 2 hours

having a stroke,’” she remembered. Rebecca called her husband, Tony, who works on contract at hospital emergency rooms in Iowa and Los Angeles. He’s often out of town, but was fortunately nearby that morning. He rushed to his wife. “He immediately hugged me, and I said, ‘Tony, is my face OK? Is my smile OK? I was walking through all the FAST stuff,’” she said, referring to the acronym used to spot stroke symptoms (see sidebar). A health scare like this is obviously a shock, and even more so in Rebecca’s case. She is in her mid-50s and over the past year had lost 70 pounds thanks to diet and exercise. “I’m in the best shape I’ve ever been in,” she said. Tony wasn’t sure a local community hospital would have the skills and resources his professional experience told him his wife would need. His work primarily involved large hospital systems and urban medical centers. His hesitation about Mary Greeley was also personal. Yes, he had volunteered here to cover prerequisites for medical school. Yes, one of his and Rebecca’s children had been born here. Yes, they lived just a few blocks away. But a dear friend—the man who had introduced Tony and Rebecca and was the same age as Tony—had recently died at Mary Greeley following a serious illness. Tony felt the pain of that loss every time he drove by the medical center. “I knew this was serious, something potentially devastating,” he said. “I was

Research has shown that patients cared for in a PSC have better outcomes. PSC status signifies Mary Greeley Medical Center’s commitment to quality stroke care. Mary Greeley also earned a Get With The Guidelines®– Stroke Silver Quality Achievement Award from the American Stoke Association. The award recognizes Mary Greeley’s success in providing stroke patients the most appropriate treatment according to reported measures based on nationally recognized, research-based guidelines. The award measures performance over a 12-month period.

thinking, do I stop at the house and get aspirin? Do I go to Des Moines, where she will mostly likely be transferred?” Deep Bond

Rebecca and Tony have been married for 36 years. They met as teenagers when she traveled to Iowa from Minnesota to work as a summer volunteer at a facility near Tony’s central Iowa home. Their connection was intense and immediate. Rebecca went home to Minnesota, but eventually returned to Iowa to reunite with Tony. They ultimately married, though before either had reached the age of 20. “We basically grew up together,” Tony joked. He was farming when they got married. When that career path didn’t work out, Tony decided to become a doctor. Because, why not? Rebecca went on to earn her nursing degree. They have three grown children and five grandchildren. Their bond is deep and they are devoted to each other. Tony and Rebecca are the first to admit that their lives together have been blessed and eventful, which made the events of that Friday the 13th in April all the more distressing. ER Response

When they arrived at Mary Greeley’s Emergency Department (ED), all Tony had to do was announce, “My wife is having a stroke.” When a possible stroke patient arrives in the ED, the front desk im-

www.mgmc.org | Summer 2018 | HEALTH CONNECT

mediately alerts the care team. Rebecca was taken to a treatment room where Dr. Sherri Flugrad, McFarland Clinic, began her examination. Ashley Jones, BSN, RN, told Rebecca, “we don’t yet know if you’re having a stroke, but we are going to treat you as if you are.” ED staff go through stroke care training, learning the National Institutes of Health’s stroke scale that is used to assess stroke patients. “We call a stroke code to ensure that Radiology has a CT (computed tomography) scanner ready so a scan of the patient’s head can be done as soon as possible,” said Jones. “Rebecca’s symptoms had started less than an hour ago, so we had time, and you don’t want to waste any time with a stroke because time is brain.” There’s also a four-hour window to administer tPA, a clot buster medication. That’s where Sharon Ellrich, MSN, RN, Mary Greeley stroke program coordinator, comes into the Ellis story. Rebecca’s symptoms were mild, she said, but “even mild symptoms may be life changing.” “A stroke can happen to anyone at any age, and the trend in the United States has been that the age of onset of stroke has gotten younger,” said Ellrich. “Early recognition and early treatment is incredibly important. Many people wait to come to the hospital; Rebecca, fortunately, did not.” Ellrich responds whenever there is a stroke call. She assists ED nurses in assessment, helps educate family, assists in the administration of tPA, and mon5

itors the patients for the first 24 hours. “tPA is a medication that we give that helps break up an existing clot. About 87 percent of all strokes are caused by blocked blood vessels in the brain,” Ellrich explained. “The sooner we can treat a stroke, the better a person’s chance to recover function.” Tony, in full husband mode despite his extensive experiences in emergency medicine, was on hand to observe everything. “I didn’t know he was a doctor until halfway through the process,” Jones said. “It wouldn’t have changed how I cared for her.” Dr. Selden Spencer, a McFarland neurologist, also arrived. He was a friend of the Ellises and a welcome site to the stressed couple. “It was comforting that the hospital has a neurologist available, just across

WHAT’S FAST?

ACRONYM HELPS IN RECOGNITION OF STROKE SYMPTOMS.

FAST is an acronym to help remind people of the signs of stroke. The familiar formula has recently been modified by Intermountain Healthcare as BEFAST: • BALANCE: Loss of balance with sudden onset. • EYES: Sudden change or loss of vision, particularly in part of the visual field. • FACE (facial droop): Have the person smile to see if one side droops. • ARMS: Have the person hold their arms up like carrying a pizza box; watch for one arm to drift downward. • SPEECH: Have the person say a simple sentence such as “no ifs, ands, or buts about it.” Listen for slurring of speech. • TIME TO CALL 911. Stroke is an emergency and the EMS providers are trained to recognize and care for stroke patients. They also can alert the ED to prepare to evaluate and care for the person experiencing stroke symptoms. 6

Dr. Tony and Rebecca Ellis in Mary Greeley’s Emergency Department surrounded by a few members of Rebecca’s care team: (from left) Dr. Cari Low, McFarland Clinic hospitalist; Sharon Ellrich, MSN, RN, coordinator of Mary Greeley’s stroke care program; and Ashley Jones, BSN, RN, Emergency Department nurse.

the street, and that we knew each other,” Tony said. Comfort

Scans indicated that Rebecca had suffered an ischemic stroke. It results from an obstruction within a blood vessel providing blood to the brain. Rebecca was taken to the Intensive Care and Cardiac Unit. By that time the tPA was doing its work and her condition was stabilizing, though she still felt the stroke’s effect on her left side. The next day she was transferred to a room in Mary Greeley’s west patient tower. Dr. Cari Low, a McFarland hospitalist, became part of Rebecca’s care team. “We knew from the moment we met that Dr. Low has something special,” Tony said. “It was most apparent on Saturday morning. We had such improvement in Rebecca’s legs and anticipated that the arm would improve just as fast.” That was not to be the case, though. “I was very tearful and telling her ‘my arm, my arm isn’t back.’ Dr. Low sat on the edge of my bed and looked me in the eyes and went through everything that they’d seen in the ED and then detailed what all the improvements were,” said Rebecca. “She was so gentle. She became our cheerleader. She was there every day.” The first few nights in the hospital were scary for Rebecca, but she found comfort in the presence of her family.

Then came an improvement. “One night I woke up at 3 a.m. and looked over to see my daughter and grandson asleep in my room, and I suddenly realized that my arm was back,” she said. “I had no numbness, no tingling. It was an emotional moment for me. I was at peace, and I laid there for another hour watching my daughter and grandson sleep.” The Ellises continue to seek medical advice on what may have caused Rebecca’s stroke and how to avoid another one. (Statistically, about 25 percent of people who experience strokes will have another.) Rebecca participated in Ellrich’s stroke support group. She also did hand therapy with Linda Power, MS, OTR/L, a certified hand therapist with Mary Greeley’s Rehab & Wellness. “We knew so many people all the way. We had connections through work, church, and our family,” said Tony. “There was a close feeling, a feeling of safety. The whole experience changed our image of Mary Greeley and how fortunate we are to have this place.” When Tony drives by Mary Greeley, he still remembers his late friend. He also now remembers the experience his wife had here after her stroke. He knew she got the care she needed. He knew they made the right turn that day.

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HEALTH CONNECT | Summer 2018 | www.mgmc.org

‘You GOT this’ Inspiring new treatment room at Mary Greeley helps women facing deeply personal issues related to pelvic pain, incontinence. indy was with a group of long-time friends who had gathered to celebrate a birthday. It had all the makings of a great night. Soon the women were laughing so hard, tears began to stream down their faces. The fun ended abruptly for Cindy, though, when she wet her pants. She left immediately.

Statistics show that as many as one out of every two women know exactly how Cindy felt that night, because they have suffered from the same condition of urinary incontinence. It’s more than just embarrassing or even inconvenient. It can rule and ruin everything. Incontinence is just one symptom of pelvic floor dysfunction, or PFD.

Cindy, like many other women coping with these symptoms, turned to Mary Greeley Wellness & Rehab physical therapist Katie Albrecht, MPT, PT, and a new Women’s Treatment Room for help. Life-altering Symptoms PFD refers to any problem affecting the

BY SUSAN FLANSBURG www.mgmc.org | Summer 2018 | HEALTH CONNECT

Mary Greeley therapist Katie Albrecht, MPT, PT, specializes in issues related to women’s pelvic health, including problems with incontinence and sexual pain. She’s shown here in front of an inspiring chalk board in Mary Greeley’s new Women’s Treatment Room.

“Physical therapy is a first-line treatment for many women [for urinary incontinence]…know you aren’t alone.” – KATIE ALBRECHT system of muscles, nerves, and tissues supporting the organs of the pelvis, including the bladder, bowel, uterus, and vagina. This can cause problems with urination (having to go urgently/ frequently or leaking urine), and/or bowel function (constipation/difficulty going or leaking stool). It can also contribute to pain or pressure in the area of the vagina and lower abdomen. For some women, sexual intercourse is painful. Causes are hard to determine. Risk factors may include obesity, genetic predisposition, and trauma. Albrecht has 16 years of experience 8

treating PFD, and she published a PFD evaluation and treatment guide for physicians in the Clinical Obstetrics and Gynecology medical journal. “A patient with PFD needs input from their primary care physician, physical therapist, and other consulting specialists, and often a psychologist,” said Albrecht. “Physical therapy is a first-line treatment for many women. I work with many women who have incontinence issues, as well as problems related to pelvic pain and sexual pain. “These are all sensitive issues and often interconnected. Pelvic pain and sexual pain can be particularly

challenging for a woman because they impact them personally, as well as their partners.” Be Prepared PFD erodes quality of life, selfconfidence, and identity. Cindy’s a good example. She used to think of herself as independent, spontaneous, and joyful. So much has changed. There’s no such thing as spontaneity in Cindy’s life anymore. Wherever she goes—whether to work or shopping— she often carries an extra set of clothes. And that’s just the beginning. “I have to think ahead,” she said.

HEALTH CONNECT | Summer 2018 | www.mgmc.org

Women with pelvic health concerns can contact Katie Albrecht at Mary Greeley’s Rehab & Wellness department, 515-239-6770. “I drink less liquid before I go anywhere. The first thing I do is look for the bathroom. I need to plan when and how to get to one in time.” Once a world traveler, Cindy said her condition has “definitely stopped” her from doing what she wants to do. “I live four hours from my hometown and I can tell you where every bathroom is along the way,” she said. “If I go to a play or concert, I sit at the end of the row so I can leave as fast as possible. People sometimes say, ‘But you just went.’ It’s embarrassing.” The fact that 50 percent of women share Cindy’s condition might make them more sensitive to the possibility of incontinence, but women who have it tend to suffer in silence. “It’s a constant source of anxiety,” she said, ticking off questions she must answer wherever she is. “Is the bathroom in working order? Can I get there on time? Do I have all the supplies I need?” Finally, Cindy broke her own silence and asked her doctor for help. She was referred to physical therapy for treatment. Albrecht gave her the exercises, education, and encouragement she needed to treat her condition. Then, two months ago, Cindy landed in the emergency room. Pain “I felt like I had fallen on the bar of a bike,” she said. “I’ve never had that kind of pain. I couldn’t sit. I couldn’t drive. I couldn’t control my bladder again.” Cindy underwent tests for everything from a blood clot to a urinary tract infection. Finally, she was diagnosed with pudendal neuropathy, another disorder under the PFD umbrella. It meant that somehow a nerve had become entrapped, creating constant and nearly unmanageable pain. Cindy was given medication and a special cushion to relieve the pressure she felt when sitting. When she

returned to her physical therapist, she was near tears. Albrecht welcomed her patient back with open arms. “Katie is so calm and caring,” Cindy said. “She helps normalize the situation. She encourages me that down the road I will feel better, but I have to take it one day at a time.” “There’s an emotional component to all pain, but when a condition also affects your self worth, it’s so much worse,” she said. “You think, ‘Am I going to have to wear diapers?’ ‘Can I leave the house?’ ‘No one will want to be with me. I’ll never be able to have a child.’ These are enormous weights to carry around. It would be unusual to not be emotional.” Such fears often compound a patient’s physical pain, creating a loop of grief and hopelessness. Cindy can relate. So Mary Greeley’s new Women’s Treatment Room is not only a place to meet with Albrecht, it’s part of the treatment itself. Cindy calls it the “extra touch” she needs. “It’s so calming and private,” she said. “It’s got soft lighting. It’s wonderful. It’s not clinical at all.” Cindy said she can relax and share her concerns honestly while focusing on what she’s learning. “At least half of what I do is educate,” Albrecht said. “The new room is a much larger and more inviting place to be than the room we used to use. We can pull up chairs and have a good conversation. There’s room for family members or partners too.” There’s also what Albrecht calls her “virtual support group,” a message board on which patients can write words of encouragement to other patients. “Patients have walked into the room and burst into tears as they look at it,” Albrecht said. “These women are isolated, alone, embarrassed. So when they see someone else with the same diagnosis writing to them, it’s very impactful.”

www.mgmc.org | Summer 2018 | HEALTH CONNECT

Cindy said it’s the first thing she looks at when she goes to her twice-weekly appointments. “I love the message board,” she said. “It gets me through. I sometimes think, ‘I can’t do this.’ But then I see, ‘You got this.’ It’s real patients writing to other patients like me.” Not Alone Cindy’s treatment will take time but, as the message said, she will get through it. The pain is now manageable and the cause will eventually—with Albrecht’s help—abate. “I know it will take time to heal,” Cindy said. “It didn’t happen overnight. I have no idea what caused it. I did fall at one point; maybe that did it. But Katie encourages me to have patience and go slow. I know I’m on the right track.” Albrecht loves hearing that. Cindy “is a very special person to me,” she said. “She’s had quite a go with this. She’s making great progress.” What would she say to all the women who are suffering from PFD but not seeking help? “First, know you aren’t alone,” Albrecht said. “One in five women have pelvic pain, which can affect you during sexual intercourse, or even when you sit down. How do you go to lunch if you can’t sit down? It’s hard to explain that you can’t sit because your bottom’s on fire. “Second, urinary incontinence is no laughing matter. Even though we say things like, ‘Don’t make me laugh because I’ll pee my pants,’ it’s real and disturbing. “Third, most people don’t know anything about PFD. It’s hard for everyone to talk about. “Finally, there are people here to help you. Do talk to your doctor. Ask to see a physical therapist. You can get better.”

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CLEAN ROOM: INSIDE THE SPD Take an exclusive tour of our Sterile Processing Department, a fascinating area that plays an “instrumental” role in patient safety. B Y STEPHA N I E MARSAU

Sterilized instruments are packaged and ready for the next round of surgeries at Mary Greeley.

nother surgery-packed day at Mary Greeley Medical Center. In operating rooms, trays of pristine surgical instruments draped in blue cloth are about to be put to beneficial use by surgeons. In one operating room, an orthopedic surgeon begins a shoulder scope by using a scalpel to make a small incision in a patient’s shoulder. The surgeon inserts a tiny camera called an arthroscope into the incision. This provides a view of the shoulder from inside the patient’s body. The surgeon

then uses an instrument called a duckling, which can get inside the shoulder joint and slice up unwanted tissue, such as scar tissue, into tiny pieces that can be suctioned out. The skills of the surgery team— surgeon, anesthesiologist, nurses, and technicians—are vital to a successful surgery. What’s equally important are those instruments. The complex process of getting instruments ready for surgery involves Mary Greeley’s Sterile Processing Department (SPD). This department has a roomful of sterilization

equipment overseen by highly trained Mary Greeley staff whose work plays a central role in patient safety. This team got those instruments ready for that shoulder scope. When the procedure is over, any nondisposable instruments, such as the duckling, will return to the SPD to be cleaned and prepped for another round of surgeries. SPD prepares literally thousands of instruments each day. All this happens in the lower level of Mary Greeley. In many ways, it’s an out-of-sight/out-of-mind operation. In reality, though, the SPD is the

HEALTH CONNECT | Summer 2018 | www.mgmc.org

SPD FAST FACTS ~ Busiest day: Wednesday (This is the day cataract surgeries are performed. This procedure often takes no longer than 10 minutes.) ~ Number of instruments processed in a week: 29,990 ~ Number of staff: 12 ~ Surgery with least amount of instruments: Open carpal tunnel release uses just 6 instruments. This procedure releases pressure on the median nerve and relieves the symptoms of carpal tunnel syndrome. ~ Surgery with most amount of instruments: A total knee replacement uses 275 instruments. ~ Length of time it takes to sterilize: 4 minutes to sterilize, 50 minutes to dry ~ Temperature at which sterilization occurs: 275 degrees ~ Amount of time needed for the entire cleaning process: 5–6 hours

An endoscope reprocessor is used to disinfect endoscopes and accessories. foundation of Mary Greeley’s efforts to avoid surgical site infections and other adverse outcomes. Here’s an exclusive look at the SPD process—a process that is crucial to our surgical program and one that few people get to see.

Every surgical instrument has a sterilization life cycle. Although instruments have different parts to play in any surgical procedure, each goes through the same five stages: • Point of Use • Decontamination/Cleaning • Inspection, Assembly, and Packaging • Sterilization • Storage

container of sterile water. This prevents bioburden, or biofilm, from drying on the instruments. So what is biofilm? Let’s go back to that shoulder scope procedure. When those instruments go inside the patient’s body, they get blood on them. If the instruments don’t remain moist during the surgery and aren’t cleaned with sterile water, that blood begins to dry on them. That dried stuff is what we call biofilm. The problem with biofilm is that the more it dries, the harder it becomes to clean. With our focus always being on the patients we serve, it is imperative that decontamination starts at the point of use for the sake of our patients’ safety.

Point of Use

Decontamination/Cleaning

It’s important to note that decontamination actually begins in the operating room (OR). Instruments must remain moist during a procedure. After an instrument is used, it is placed into a

That shoulder scope is finished. The patient goes to recovery. The doctor heads to the waiting room to talk to the family. The instruments are sent to the basement. (It should be noted

Life Cycle

here that not ALL the instruments used head to the basement. Some instruments, such as scalpel blades, are single use. They are removed from the scalpel handle and are properly disposed of after one surgery.) The first stop for instruments that make it to the basement is the decontamination room, where they are soaked and precleaned. Brushes, sponges, and smaller instruments make their way here and are manually cleaned. Instruments then travel across the room to undergo ultrasonic cleaning. In this area, instruments are put into an ultrasonic cavitation machine. This machine uses low-frequency sound waves to create tiny bubbles. When these bubbles come in contact with the surgical instruments, they implode and remove any remaining biofilm. Then it’s time for the instruments to be mechanically cleaned. It’s not as simple as just loading the dishwasher and pushing start. There are very specific parameters for all of the surgical

Instruments in special containers are loaded into a sterilizer.

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(Clockwise from upper left) After initial cleanings, instruments are inspected and placed on trays. An ultrasonic cleaner uses sound waves and bubbles to clean instruments. A laproscopic camera is decontaminated. instruments that are based on manufacturer guidelines. It’s important that these guidelines are followed because it allows the instruments to maintain their integrity, which helps keep our patients safe. Inspection, Assembly, and Packaging

Once the instruments have been through the wash cycle, they come out the other side of the washer into a different room where they are inspected, assembled, and packaged. That may sound like a fairly straightforward process, but there is a lot to it. Every load that comes out of the washer includes a washer indicator. The indicator is a small device with a substance that mimics blood. When the wash cycle is done and the indicator comes out clean—or “blood 12

free”—the SPD staff knows the load was properly cleaned and the instruments are safe to be assembled and packaged. The instruments are then taken to stations where they are sorted and inspected to make sure they are still working properly. Most of the time, instruments come down from a surgery and all stay together. That’s not always a guarantee though, so prior to assembling a set of instruments, SPD staff are able to call up guidelines for the specific instrument set they will be putting together. For example, if an SPD technician is assembling an instrument set for a shoulder scope, the tech will open the corresponding guidelines and go through the instruments. If one is missing, it will be replaced with a new instrument. It is important that all

instruments are accounted for because once instruments are packaged in the next step, the actual instruments aren’t seen again until the package is opened in the OR. Once assembled, instrument sets are then placed into a mesh basket. That basket is either placed into a rigid container or is wrapped with a special material called “blue wrap.” Both options allow the instruments inside to be sterilized. They also allow the instruments to remain sterile once they are moved to the storage area. Sterilization

There are several different types of sterilization, and most surgical instruments are sterilized using steam. Once items have been packaged in the previous room, they are loaded onto a cart and are taken to the sterilizing

HEALTH CONNECT | Summer 2018 | www.mgmc.org

WATCH THE SPD IN ACTION Want to get up close and personal with the cleaning process? Check out our behind-the-scenes video at www.mgmc.org/clean.

SPD EMPLOYMENT Interested in working in the Sterile Processing Department? Qualified candidates should be a high school graduate or equivalent. They must have gone through Basic Life Support for Healthcare Providers (BLS) training, or do so within 90 days of hire, and must maintain it throughout their employment. Being a graduate of an accredited Surgical Technologist program is preferred, but is not necessary. Candidates should: ~ Have the ability to understand and communicate oral and written English, ~ Be able to pursue and foster a sense of team and partnership across all disciplines, ~ Be able to function promptly and appropriately under stressful conditions, and ~ Become certified within three years of hire. For more information, visit www.mgmc.org/careers. www.mgmc.org/careers.

After ultrasonic cleaning, trays of instruments are mechanically cleaned. An SPD technician holds small tubes of biological indictors. area where they are loaded into the sterilizer. Everything that goes into the sterilizer is tagged with a special tape that resembles white masking tape. This is no ordinary tape, though. When the items come out of the sterilizer, that tape should have dark diagonal lines on it. This allows staff to know at a glance that the sterilization process was successful. Indicators are also included inside the instrument sets so that surgical staff can tell upon opening them in the OR that they were indeed sterilized. Sometimes a second indicator— a biological indicator—is included on sterilizer loads. This miniature test tube holds live spores. When the sterilization process is successful, the spores die, which results in a color change from green to purple. Instruments are considered

sterilized after four minutes at 275 degrees. They remain in the sterilizer to dry and then are removed to allow them to cool down. Storage

Once something has made it all the way through the cleaning process, it is moved into the sterile storage area. Imagine a grocery store, but one that only stocks surgical instruments and at any given time has an inventory worth millions of dollars. In fact, some SPD staff are tasked with getting things ready for the next day’s surgical procedures. They use a checklist and walk up and down the aisles, locating the items needed for the next day’s surgeries or any emergent surgeries that may come in that same day. Once the items have been located,

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they are loaded onto case carts and moved into the staging area. It’s fairly easy to tell what the next day’s caseload will be like based on the number of case carts in the staging area. The next morning, case carts are taken up to the OR in preparation for the day’s surgical procedures. Full Circle

We’ve now come full circle. Soon the case carts and all of the instruments will head to the lower level and the sterilization process begins again. Day in and day out, SPD staff handle hundreds of instruments, ensuring each has gone through the meticulous sterilization process to ensure the safety of every single patient that comes into our operating room.

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THE FAMILY KNEES

ibby Steinfeldt discovered she had a bad knee during a tornado drill about 10 years ago. She had been crouching in the hallway of Alden Elementary School with her students. When the all-clear bell sounded, her students had scrambled back up with ease, but Libby’s right knee had stuck. “I thought ‘What’s this?’” Libby, who was 36 at the time, remembered. “My knee wouldn’t bend. From then on, it was in terrible shape.” Libby hadn’t known it at the time, but she had been on a crash course with her knee since birth, having inherited some troublesome genes. She had some other risk factors, too, including the fact that she was female and had played many sports in high school. Now Libby would follow Eva Wampler, her grandmother, and Pat Follett, her mother, through the nearly crippling experience of knee osteoar-

Pat Follett, Eva Wampler, and Libby Steinfeldt show off their new knees.

A grandmother, a daughter and a granddaughter needed new knees. Here’s why each turned to the same surgeon. B Y S U S A N F L A N S B U R G

thritis, taking over-the-counter pain medications that eventually quit working and leaning on whatever would help hold her up.

More Women Libby, her grandmother, and her mother were in good company, joining 78 million other Americans who have been diagnosed with arthritis. More women than men develop it—it occurs in 13 percent of women and 10 percent of men—and it can be triggered by trauma (or repetitive motions like squatting and kneeling), genetic predisposition, and being overweight. Its most common symptoms include joint pain and stiffness, a reduced ability to climb stairs, and decreased walking distance. “My life revolved around ‘Where can I sit down?’” Libby said. “I looked like I was 100 years old. It was horrible.” The pain finally drove Libby to contact the orthopedic surgeon who had

helped two generations of her family before her. She made an appointment with Dr. David Sneller of McFarland Clinic. But not for surgery. “I absolutely did not want to have surgery,” she said, echoing the initial attitudes of her grandmother and mother. Both had chosen other methods of pain management— including anti-inflammatory injections—for years.

Time for Surgery Sneller said that he has a number of treatments available for the knee, and that surgery is the last on the list. “Iowans are tough,” he said, describing Libby, Eva, and Pat. “They don’t choose even to make an appointment until the pain is awful.” Although Libby’s grandmother had pain as a young woman, she put off knee replacement until the pain got so bad that she could no longer go to the Iowa State Fair or on bus trips with her

HEALTH CONNECT | Summer 2018 | www.mgmc.org

group of widowed friends. Eva was 85 years old. She had both knees done in 2009, though several months apart. “I wasn’t ready to sit still,” Eva said. She’s in her 90s now, having moved off the farm two years ago to a place in Eldora. “I had both my knees replaced. Everything I do is better now. I can walk to the post office. I can do a little gardening. I can go to lunch.” She’s doing so well, she said with a laugh, because Dr. Sneller gave her a special knee. “He told me quietly one day that he had put my knees in backward so I could kick my own butt!” Pat—Eva’s daughter and Libby’s mom—said she loves Dr. Sneller’s “neat sense of humor,” but chose him because “he’s excellent.” She had her right knee replaced four years ago at the age of 68. Like Eva, Pat’s knee hurt for decades before she considered surgery. “I took a lot of Tylenol and ibuprofen,” Pat said. She said antiinflammatory injections helped for a while as well. Eventually, though, her years of climbing aboard tractors and grain trucks got the best of her. “When I got up in the middle of the night and cried all the way to the bathroom, I knew it was time to have surgery.”

Quality of Life Sneller noted that not all knee patients are candidates for knee replacement. “Pain can be caused by other factors, including meniscus tears, bursitis, and even obesity,” he said. “We discuss available treatments after diagnosis. If it’s osteoarthritis, I tell patients I can let them know when they are medically ready to have surgery, but they have to tell me when they are mentally ready.” Eva, Pat, and Libby didn’t request surgery until their quality of life was nearly shot. “If you can’t climb the bleachers for your grandkids’—or kids’—games, that’s quality of life for a lot of people,” Sneller said. With a young athlete in the family (Libby’s daughter), that measure applied to Eva, Pat, and Libby, despite their different ages. Libby was just 47 when she had her surgery.

“Knee replacement used to only be done on elderly people, with the idea that they wanted it to last their lifetime,” Sneller said. “The philosophy has changed, though. Now we’re doing it on much younger people, because they want to be active.” And that’s the message from Eva, Pat, and Libby, three generations of Iowa women who waited decades for help. Make an appointment now for a diagnosis, and begin the treatment to restore your quality of life. “Don’t be afraid of it,” Pat said. “I have a lot of friends with new knees. They’re happy they got it done. There’s no reason to wait like I did.” Libby said her life has improved immensely since surgery in late February 2018. “My knee already feels 95 percent better,” she said. “I look two inches taller because I’m not leaning anymore. “What would I tell my 36-year-old self about knee replacement? Fix it now.” That’s advice Dr. Sneller himself may one day need to take. “Everybody in my family has had a knee replacement,” he said. “My grandpa, my dad, and others. I’m possibly going to need it someday.”

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“Knee replacement used to only be done on elderly…the philosophy has changed…now we’re doing it on much younger people because they want to be active.” – Dr. David Sneller

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TOTAL KNEES AND MEDICARE New guidelines impact how long a patient is in the hospital. On Jan. 1, 2018, Medicare changed its guidelines in relation to funding total knee procedures. Medicare now reimburses on an outpatient (as an outpatient extend ed service) or inpatient basis for these procedures. However, to bill Medicare for inpatient, the patient must meet inpatient criteria. Criteria for Inpatient Stay: • Expected hospital stay to be greater than two midnights, AND • High anesthesia risk • History of significant medical diagnoses • No family members at home who can assist patient after discharge Criteria for Outpatient Stay (Outpatient Extended Stay—Will stay overnight in a regular hospital bed and most likely will be discharged the next day): • Expected hospital stay to be less than two midnights, AND • Low anesthesia risk • No history of significant medical diagnoses • Family members at home who can assist patient after discharge There may be circumstances where you are admitted as an outpatient extended stay but not tolerating the procedure as well as we would like. At this time, you may be switched to an inpatient stay. Since the new guidelines went into effect, about half of all total knee surgeries at Mary Greeley have qualified for inpatient stay. Skilled Nursing Facility Care If you need skilled nursing facility care after you leave the hospital, Medicare will only cover this care if you have been in the hospital for three midnights, you have a medical necessity for skilled care, and you meet the inpatient criteria noted above. Thus, if you are admitted as an outpatient stay (outpatient extended stay), you will not qualify for skilled nursing facility care because you are not considered an inpatient. 15

Finding Gratitude Cancer survivor ﬁnds many ways to express his thanks to Mary Greeley.

ying still, while nurses and technicians meticulously adjusted instruments in order to administer radiation treatment, Larry Northup focused on the illuminated panel of blue sky and green trees just above his head. The ceiling of the radiation oncology treatment room at Mary Greeley offered Larry a calming view as he faced the harsh realities of prostate cancer. Larry’s cancer journey unfolded two years ago, and it

ultimately put him on a different sort of journey—a personal journey of gratitude. Bad News Larry had gone in for a routine physical when his doctor noticed that his PSA levels were high. A biopsy was ordered and cancer was found. Although receiving a cancer diagnosis brought Larry into a state of uncertainty, he took the news in stride and made treating and surviving cancer just two

B Y K AY L A H I L L I A R

more items to be checked off his to-do list. After the initial discovery, Larry’s doctors worked quickly to establish a medical treatment plan. He was to receive treatment at Mary Greeley’s radiation oncology department ﬁve days a week for nine weeks. Upon entering the treatment room and lying down on the table for the very ﬁrst time, Larry noticed the vibrant images of clouds and trees above him—a bright view that allowed his thoughts and whatever

HEALTH CONNECT | Summer 2018 | www.mgmc.org

Larry Northup and Whitney Garwood, radiation oncology supervisor, share a moment on Mary Greeley’s garden patio. After receiving outstanding care during cancer treatment, Larry began volunteering in radiation oncology and provided support for an education fund for department staff.

“It means so much that Larry thinks so highly of us that he gives not only his time, but also funding to help improve our patient and staﬀ experience in any way possible.” – Whitney Garwood, MBA, RT, radiation oncology supervisor

concerns he might have to fade away. Day after day, week after week, Larry returned to Mary Greeley. The staff became his friends. Larry knew these people truly cared about him and were invested in seeing him through to the end of his treatment. On his final day, Larry left Mary Greeley as a patient, only to return soon as a volunteer. From Patient to Volunteer Since retiring from 40 years of service as an engineering professor at Iowa State University, Larry has spent a great deal of his time giving back to his community as a volunteer—something that was instilled in him early on growing up on a farm near Audubon, Iowa. He recalls watching his father help neighbors get their crops in or raise a new barn when needed. When he first began searching for volunteer positions, he chose installing Life Lines in people’s homes for Mary Greeley as a way to give back to his community. He stepped away from that responsibility shortly before he was diagnosed with cancer. After spending all those weeks at Mary Greeley getting radiation treatment, Larry decided it was time to return to work as a volunteer and found an opening at the information desk of Mary Greeley’s north addition, near the radiation oncology department, for Monday afternoons. He welcomed the opportunity to see his “old friends” again. Larry now fills in as a volunteer in the radiation oncology waiting room as well. He sees patients dealing with the difficult reality of cancer just as he did. He says for those patients he experiences a great deal of empathy and compassion, and he wants

to be there to help in whatever way he can. Sometimes that means listening as a patient conﬁdes in him, other times it means offering a quiet nod and a pleasant smile, helping a patient check in and directing them to the refreshment station available to all in the waiting room lobby. Many Gifts Larry is proud of this refreshment station because he and his wife, Sherry, helped make it possible through funds they donated to the Mary Greeley Foundation. Health, wellness, and hydration are keys to a successful treatment. This refreshment station offers each patient a bump in energy and the opportunity to be hydrated before treatment. However, Larry still wanted to do more. As Sherry explains, “When you go through something like this, you look at life differently.” She witnessed an increase in her husband’s charitable and volunteer attitude after he was a patient. Larry was so grateful for his experience with the staff during his treatment that he wanted to make another gift that would directly impact them. After collaborating with the Foundation staff, Larry and Sherry decided to establish an education fund for members of the radiation oncology staff that would allow them to receive special training and education. His gift was generated out of respect and gratitude for the staff. Larry credits them for the success of his treatment and recovery. “Without them doing what they did, I might not be here,” he said. Larry returns to Mary Greeley each week

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as a volunteer and witnesses the impact the staff at Mary Greeley has on their patients. His gift of gratitude is a constant reminder to all the staff that what they do every day truly matters and leaves a lasting impression on the people and communities they serve. “It means so much that Larry thinks so highly of us that he gives not only his time, but also funding to help improve our patient and staff experience in any way possible,” said Whitney Garwood, MBA, RT, radiation oncology supervisor. “He has a calm demeanor and nurturing ability. He’s just a wonderful presence to have here and has such a positive inﬂuence on staff and patients.” Share Your Story Larry’s story of becoming a grateful patient is just one of many at Mary Greeley. “We are impacted every day in some way by people who are grateful for their care, and that gratefulness often results in a charitable gift,” said Melissa McGarry, Mary Greeley Foundation executive director. “We take every step to ensure donors know their gifts are used to fund an area they care most about.” Thanks to the generosity of donors, the staff members at Mary Greeley are able to continuously provide the quality care with a personal touch that they are known for to patients each and every day. For more information on how you can share your story with the Foundation or how you can make a gift, please call 515-239-2147 or visit www.mgmc.org/ mgmcfoundation/donate.

HAPPY atwork

Hundreds of volunteers help ensure that patients and visitors have an excellent experience at Mary Greeley Medical Center. They also provide outstanding support for medical center staff. Here are just a few examples of how our volunteers make every day at Mary Greeley just a little bit better.

Bev McMahon prepares to deliver mail to our patients.

(Above) Karen Strehlow and Peggy Carr prepare a display at the Auxiliary Gift Shop. (Left) Diana Schwendinger fields a phone call, a task that many volunteers help with at Mary Greeley.

(Left) Harris Seidel, a Meals on Wheels volunteer, loads up lunches that will be delivered throughout the community. Mary Greeley and Heartland Senior Services cosponsor the program, which provides meals throughout Story County.

HEALTH CONNECT | Summer 2018 | www.mgmc.org

MARY GREELEY VOLUNTEER 2017 STATS • Oldest male volunteer: 95 • Oldest female volunteer: 98 • Youngest volunteer: 12 • Number of volunteers: 464

• Families assisted by Family Escort volunteers: 940 • Total number of volunteer hours: 38,130

• Volunteer hours in Emergency Department: 1,684 • Meals delivered by Meals on Wheels of Story County volunteers: More than 24,000

James Pollard is one of several summer youth volunteers who help Mary Greeley’s valet parking crew.

Pet therapy dogs and their owners are some of our popular volunteers. The dogs frequently visit Acute Rehab patients. (Above) Zosia brings some cheer to patient Craig Jones. Zosia belongs to Kinsey Phillips, a pet therapy volunteer who also works at Mary Greeley. (Right) Deb Owens has two wonderful boxers who are part of the pet therapy program. Here Vixen hams it up with patient Shari Gillespie.

(Right) Ann Espinosa comforts a baby in Mary Greeley’s Neonatal Intensive Care Unit. Volunteers are trained as “cuddlers” for babies who benefit from extra attention.

Zoe Sirotiak, one of Mary Greeley’s younger volunteers, helps a patient with a warm blanket in the Emergency Department’s waiting area.

BECOME A VOLUNTEER

Learn more at mgmc.org/volunteer.

Volunteering at Mary Greeley is a wonderful to way to give back to your community while contributing to the positive experiences patients and visitors have at the medical center. In addition to the experience you will gain and the satisfac

tion of knowing you are helping others during their time of need, volunteering comes with several benefits, including a discount in Mary Greeley’s cafeteria, free flu shots (subject to supply availability), and more.

Volunteers Reach 2017 Milestones

More than 38,000 hours of volunteer service provided in 2017. 100 Awards Sandra Andersen Julia Apple-Smith Megan Beck Rod Brink Donna Carlson Jan Collins Gary Cooper Candelas Deluca Emily Erickson Tanja Frye Richard Gardner Tyler Gathman Dina Hamouche Bruce Hardy Blake Heimann Edward Kannel Marjorie Kannel Anne Krapfl Lois Lehmkuhl Jermaine Prescott Jeanne Rogert Harris Seidel Benette Sherman Zoe Sirotiak Nicholas Stead Patricia Tuberty Karen Twedt Chrys Velky Elizabeth Wade Antoinette Whitman Joyce Wirth Gretchen Zitterich

103 107 116 175 150 142 173 100 101 103 140 109 124 223 156 149 149 115 264 105 160 189 359 250 124 148 101 121 105 105 104 158

500 Awards Samaneh Azarpajouh Delwyn Bluhm Catherine Burns Peggy Carr Kenneth Dunker Deb Fennelly

551 618 510 830 948 561

Mary Lynn Franco Martha Hennager Richard Lang Larry Northup Kathy Ridnour Paula Sunday 1,000 Awards Mary Ann Black Sandra Gartz Laurie Kearney Mary Perry Bonnie Trede Judy Whitney

552 635 572 863 604 517

1,015 1,004 1,033 1,046 1,019 1,214

1,500 Awards Janet Beer Linda Claussen John Greve Cynthia Shriver Elizabeth Snella Neil VanSlyke

1,554 1,558 1,530 1,691 1,605 1,575

2,000 Awards Jeanne Gehm Dixie Magden Cynthia Paschen Sarah Terrones Michael Wright

2,149 2,110 2,016 2,303 2,015

2,500 Awards Robert Cole Darrel Rensink

2,543 2,532

4,500 Awards Garry Alexander Judy Madsen

4,766 4,534

3,000 Awards Virginia Dobbs

3,034

5,500 Awards Donald Withers

5,534

3,500 Awards Paul Dasher Nancy Fausch

3,698 3,763

8,500 Awards Pat Frette

8,514

9,500 Awards Betty Jackson

9,670

4,000 Awards Craig Beer Jeanine Cole Pauletti Lasley

4,016 4,038 4,022

13,000 Awards Mary Engstrom

13,255

Ellen Sander greets a patient at the Radiation Oncology information desk.

(Left) Sandi Austin massages a patient’s hands in the William R. Bliss Cancer Center’s waiting room. This popular service was launched five years ago. (Above) No volunteer story would be complete without mention of Mary Engstrom, who has the most volunteer hours at Mary Greeley. Here she explains information desk duties to Masha Lebedeva, a member of our summer youth volunteer program.

HEALTH CONNECT | Summer 2018 | www.mgmc.org

2018 MARY GREELEY MEDICAL CENTER VOLUNTEERS OF THE YEAR Leadership Melissa Rowan Volunteer since 2012 Melissa Rowan is the kind of volunteer every nonprofit hopes for. She was an active and effective Mary Greeley Auxiliary Board member, serving as president, secretary, and in other leadership roles. She also has served on a variety of Auxiliary committees. In all of her roles, Melissa always provided thoughtful leadership and offered great insight, helping to guide the board and advance its initiatives. Melissa has attended several fundraising events supporting the medical center and Auxiliary, including the Hope Gala and Tailgate Trivia. Over the years, she also represented the Auxiliary and Mary Greeley at many high school ceremonies to award Auxiliary Health Career Scholarships. Although her service on the Auxiliary board is complete, Melissa remains committed to the mission of the Auxiliary and Mary Greeley Medical Center.

Auxiliary Recognition Award Peggy Carr Volunteer since 2015 Peggy Carr is passionate about Mary Greeley and the Auxiliary Gift Shop. She makes time each week, sometimes full eight-hour days, to merchandise the shop. Items are unpacked, priced, and replenished on the sales floor. Displays are “fluffed” and new walls or fixtures are crafted into attractive presentations that Gift Shop customers find hard to resist. Peggy attends the annual January gift market in Atlanta with Jen Ballantine, Auxiliary Gift Shop manager, spending countless hours selecting unique items that are fun and affordable. Ballantine notes that Peggy’s input on gift shop merchandise is fresh, current, and “on-trend” in the retail/gift industry, as she consistently “researches” other retailers. (And “research,” Peggy admits, means “shopping.”)

Commitment

Hospice

Dixie Magden Volunteer since 2003

Marsha Taylor Volunteer since 1998

Dixie Magden has positively impacted the patient experience on the Medical Telemetry Unit since the day she started as a unit support volunteer. She is friendly and kind and always has a smile on her face. Patients love that she takes the time to visit with them about their day while she is in their rooms doing her work. She positively impacts our patients by making them feel welcomed and special. Dixie also has a special relationship with the staff. She always stops to visit and ask about family, the weekend, holidays, etc. “Dixie is a ray of sunshine, a true member of the Medical Telemetry Unit team, and a shining example of a dedicated volunteer. We honestly can’t thank her enough,” said Shelly Nagel, BSN, RN, Medical Telemetry clinical supervisor, in her nomination for Dixie.

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Marsha Taylor represents the heart and soul of Mary Greeley’s hospice volunteer program. Marsha has been a hospice volunteer for 20 years and has served by volunteering at the Israel Family Hospice House, providing respite care in patient homes, visiting nursing home patients, and talking about her experiences during new volunteer training. Marsha is an advocate for hospice and palliative care in the community, and she excels at customer service. She always asks patients if there is anything else she can do for them. One time a patient said, “Yes, can you bring me a sandwich from Casey’s," and Marsha happily did. “I am so glad to have Marsha on our hospice team, and I know our hospice families have been so thankful for her kindness over the past 20 years,” states DeAnn Barnes, hospice volunteer coordinator.

Prime Time Alive & More PRIME TIME ALIVE

Created specifically for those age 50 and better, Prime Time Alive is a membership program (just $15 a year) that helps people live and age well. Learn about member benefits and how to join at www.mgmc.org/pta

Prime Time Alive programs are designed to help you achieve a vital balance of the physical, financial, emotional, and spiritual components in your life. Don’t miss all the fun and learning! You can become a member and register for events online at www.mgmc.org/pta or by calling 515-239-2423 or 800-303-9574. Preregistration is required for all Prime Time Alive programs.  Sleep Breathing Disorders and Unique Oral Health Issues Facing Seniors Today Tuesday, July 17, 2 p.m. Mary Greeley Atrium A Presented by John E. Clary, D.D.S., F.I.C.D., Expressions Dental. Dr. Clary will discuss sleep breathing disorders, including screening, diagnosis, and treatment. He will also discuss unique oral health issues that today’s seniors are facing and how to prevent and treat such issues.  Exploring Senior Living Options Wednesday, July 18, 2 p.m. Mary Greeley Atrium A Presented by Rod Copple, Green Hills Community Executive Director, and Linda Lauver, Green Hills Community Marketing Director. There is a lot to consider when you are planning for your life as a senior, and having a plan can give you more control and peace of mind. This program addresses costs, priorities, concerns, challenges, and lifestyle options that you will want to keep in mind. We will explore many choices, including staying at home, life care retirement communities, rental communities, cooperatives, equity communities, and living with your children. 22

 Overnight Trip: Northwest and North Central Missouri Wednesday and Thursday, Aug. 22 and 23 Join your Prime Time Alive friends on a trip to Missouri. Stops along the way include the Walter Cronkite Memorial and Museum, Pony Express National Museum, the boyhood home of Walt Disney, a step-on guided tour of St. Joe, and much more. Must be a Prime Time Alive member to attend. Please call Prime Time Alive at 515-239-2423 or 800-303-9574 for space availability.  Oh My Achin’ Joints Thursday, Aug. 30, 2 p.m. Mary Greeley Atrium A Presented by Sarah Bancroft, DO, McFarland Clinic Sports Medicine. Join Dr. Bancroft for a discussion on an evidence-based approach for osteoarthritis and it's nonsurgical treatments.  Appropriate Antibiotic Use Is Everyone’s Responsibility Wednesday, Sept. 5, 2 p.m. Mary Greeley Atrium A Presented by Gary Bailey, R.Ph., Staff Pharmacist and Antimicrobial Stewardship Pharmacist, Mary Greeley Medical Center. Like any medication, antibiotics carry certain risks. While critical for treating a wide range of infections, these drugs also carry risks and can have adverse responses such as an allergic reaction. Because of these risks, it is important to use antibiotics only when medically necessary. This program will discuss when antibiotics are useful and useless, potential risks of inappropriate antibiotic use, long-term consequences of antibiotic use, and antimicrobial stewardship at Mary Greeley Medical Center.

 Health Literacy: The Road Map for Your Healthcare Journey Thursday, Sept. 13, 2 p.m. Mary Greeley Atrium A Presented by Jo Kline, attorney and author of the 2017 book “The 60-Minute Guide to Health Literacy” and the 12-week Des Moines Register series “Health Literacy 101.” A perfect storm of aging demographics, dwindling resources, and lack of health literacy is approaching America. What’s essential to preserving patients’ rights and advocating for patient safety? Health literacy. It’s having the tools and information-gathering processes needed to be an empowered and informed medical decision maker. Managing healthcare for yourself or someone else is a challenging journey. Health literacy is your road map.

Auxiliary Gift Shop

Proceeds from the Gift Shop support Auxiliary scholarships, programs, and services of Mary Greeley Medical Center. For more information, call the Gift Shop at 515-239-2190.  Bed Linen Fundraiser Tuesday, Aug. 28, 7:30 a.m. to 4:30 p.m. Wednesday, Aug. 29, 7:30 a.m to 1:30 p.m. Atrium Conference Rooms A & B Before the chill of fall sets in, join us for the Geneva Distributing Bed Linen Fundraiser. Snuggle up with soft, luxurious bedding. Select from 800- to 1,200-thread-count sheet sets for all bed sizes, Sherpa blankets and throws, comforter sets, quilt sets, and memory foam pillows—all at great prices.

HEALTH CONNECT | Summer 2018 | www.mgmc.org

Art

Schedule

JULY Brenda Backman Charcoal, pastel, and inks Main entrance, west hallway Cindy Gordon Watercolors Main entrance, west extended hallway

Jan Baty Watercolors Main entrance, west extended hallway OCTOBER Judith Eastburn

Photography Main entrance, west hallway Stewart Buck Pastels and prints Main entrance, west extended hallway Art Ciccotti Glass West lobby display case

This fitness program is for people who are undergoing cancer treatment or have gone through treatment in the past year. The patient’s caregiver is also eligible. There is no charge for this program, which is cosponsored by the William R. Bliss Cancer Center Cancer Resource Center and Ames Racquet and Fitness Club (ARFC). The program begins with a 6-week course of exercise at Mary Greeley Medical Center. Participants can then choose to continue with a 12-week program at ARFC. Contact the Cancer Resource Center at 515-956-6440 for information.

HEALTHCARE

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 Genetic Counseling: Are My Family and I at Risk? Bessie Myers Auditorium Tuesday, Oct. 23, 7 p.m. Social and traditional media are filled with information about all the genetic tests available and the latest genes discovered by researchers. You can’t help but wonder whether you should be tested and what the results might mean. So where do you turn? Genetic counselors are the professionals who can help guide you. Join Sarah Azam, genetic counselor at the William R. Bliss Cancer Center, for an informative program.

SEPTEMBER Judith Eastburn Photography Main entrance, west hallway

COURAGE IN MOTION

The colors of fall will be on full display at the Auxiliary Gift Shop during our Fall 20% Off Sale. Shop our selection of everyday and seasonal home décor, candles, diffusers, napkins, and entertaining items, as well as apparel, accessories, and baby presents, and other gifts. Some exclusions apply.

Mary Greeley Medical Center regularly schedules programs to provide cancer education and support. For more information and to register for events, call the William R. Bliss Cancer Resource Center at 515-9566440 or 866-972-5477. Preregistration is required for all programs

Jan Baty Watercolors Main entrance, west extended hallway Linda Hardie Pottery West lobby display case

AUGUST Brenda Backman

 Fall 20% Off Sale Thursday, Sept. 13, 8:30 a.m. to 6 p.m. Friday, Sept, 14, 8:30 a.m. to 4:30 p.m.

Charcoal, pastel, and inks Main entrance, west hallway

Mary Greeley Medical Center’s Health Connect magazine has won an Aster Award, which honors excellence in healthcare marketing. Health Connect Connect, which is published three times a year and contains stories about patient care, new services, and new technology at Mary Greeley Medical Center, won a gold award in the annual competition.

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www.mgmc.org | Summer 2018 | HEALTH CONNECT

The Aster Awards is one of the largest national competitions of its kind. The 2018 competition received thousands of entries from across the United States as well as several foreign countries. All entries are reviewed by a panel of industry experts and are scored on multiple criteria, including creativity, layout and design, functionality, message effectiveness, production quality, and overall appeal. Mary Greeley’s magazine is distributed throughout central Iowa. If you’d like to receive the magazine, please email sullivans@mgmc.com.

Clinics & Classes Clinics  Childhood Immunization Clinics Mary Greeley Medical Center offers childhood immunization clinics for Story County residents on the second and fourth Tuesday of every month from 4:30 to 6:30 p.m. at the Mary Greeley’s Home Health Care office located at 1114 Duff Ave. Upcoming dates include July 10, July 24, Aug. 14, Aug. 28, Sept. 11, Sept. 25, Oct. 9, and Oct. 23. Parents of children receiving immunizations are asked to bring previous immunization records with them. Even if a child has never received an immunization, he or she may start a program at any time. Call 515-539-6730 for more information.  Adult Immunization Clinics Mary Greeley Medical Center offers adult immunization clinics for Story County residents every week at Mary Greeley’s Home Health Care office located at 1114 Duff Ave. The clinics are held Monday and Wednesday from 8 a.m. to 12:30 p.m. and Friday from 10 a.m. to 2 p.m.

Senior Health Clinics

Mary Greeley Medical Center Senior Health Clinics offer foot care, blood pressure screening, blood sugar testing, and health education for Story County older adults. Call 515-239-6730 for more information. Mary Greeley will offer clinics at the following locations, dates, and times:

Story City Cedar Place Thursday, July 12, Aug. 9, Sept. 13, Oct. 11 1 to 4 p.m.

Regency V Apartments Tuesday, July 24, Aug. 28, Sept. 25, Oct. 23 10 to 11:30 a.m.

Story City Community Health Center Wednesday, July 25, Aug. 22, Sept. 26, Oct. 24 1 to 4 p.m.

Stonehaven Apartments Tuesday, July 24, Aug. 28, Sept. 25, Oct. 23 10 to 11:30 a.m.

Support Groups

The Waterford at Ames (Assisted Living) 1200 Coconino Rd. Wednesday, July 18, Aug. 15, Sept. 26, Oct. 27 1 to 3 p.m. Windsor Oaks Apartments 1100 Adams St. Thursday, July 19, Aug. 16, Sept. 20, Oct. 17 1 to 2:30 p.m. Collins City Hall Senior Meeting Room Tuesday, July 18, Aug. 21, Sept. 18, Oct. 16 9 to 10 a.m. Colo Community Center Tuesday, July 17, Aug. 21, Sept. 18, Oct. 16 10:30 to 11:45 a.m.

Ames Green Hills Health Care Center Tuesday, July 3, Aug. 7, Sept. 4, Oct. 2 1 to 3:30 p.m.

Huxley Nord-Kalsem Community Center Thursday, July 5, Aug. 2, Sept. 6, Oct. 4 1 to 2:30 p.m.

Heartland Senior Services Thursday, July 5, 12, 19, 26 Aug. 2, 9, 16, 23, 30 Sept. 6, 13, 20, 27 Oct. 4, 11, 18, 25 9:30 a.m. to noon

Nevada Senior Center Tuesday, July 10, Aug. 14, Sept. 11, Oct. 9 12:30 to 2 p.m.

Keystone Apartments Thursday, July 26, Aug. 23, Sept. 27, Oct. 25 1 to 2:30 p.m.

Northridge Village Wednesday, no July date, Aug. 1, Sept. 5, Oct. 3 1 to 2:30 p.m.

The Meadows Apartments Tuesday, July 17, Aug. 21, Sept. 18, Oct. 16 1 to 3 p.m.

 Grief Support Groups; Six-Week Group Summer support group meets Tuesday evenings, July 17 through Aug. 21, from 5 to 6:30 p.m. Fall support group will be held on Tuesday afternoons, Sept. 25 through Oct. 30, from 2 to 3:30 p.m. All groups meet at Israel Family Hospice House. For more information or to register, contact Teske Vance, Bereavement Coordinator, 515-956-6038 or vance@mgmc.com.  Living with Cancer Support Group Contact the William R. Bliss Cancer Resource Center for details. Call 515-956-6440 for more information.  Stroke Support Group The Stroke Support Group is free and open to the public. The group meets the third Tuesday of the month from 6:30 to 7:30 p.m. Location varies. Call 515-9562774 for more information.  Breastfeeding Support Group July 12, Aug. 2, Sept. 13, Oct. 4, Nov. 8, Dec. 6 10 to 11:30 a.m. Atrium A  Family Birthing Classes Register online @mgmc.org or call 515-239-2444 or 800-951-9222 for specific information and to register. Preregistration is required.  Big Brother, Big Sister Class Classes are offered for ages 2 to 4, mixed ages, and ages 4 and up. Ages 2 to 4: July 2, Aug. 2, Sept. 6, Oct. 1, Nov. 1, Dec. 6 Mixed ages: July 12, Aug. 23, Sept. 20, Oct. 11, Nov. 15, Dec. 10 Ages 4 and up: July 23, Aug. 27, Sept. 24, Oct. 25, Nov. 26, Dec. 17 Main Lobby

HEALTH CONNECT | Summer 2018 | www.mgmc.org

Childbirth Classes

Birthways offers a one-day and Tuesday series (two classes) childbirth class to help women in their seventh to eighth month of pregnancy and their support persons prepare for childbirth. A tour is included with the classes. $30 donation per class.  One-Day Childbirth Class Saturday: July 7, Aug. 11, Sept. 8, Sept. 15, Oct. 6, Oct. 13, Nov. 3, Nov. 10, Dec. 1, Dec. 15 8:30 a.m. to 3 p.m. Atrium A & B  Childbirth Class – Tuesday Class Tuesdays: July 3 & 10, Aug. 7 & 14, Sept. 4 & 11, Oct. 2 & 16, Nov. 6 & 13, Dec. 4 & 11 6:30 to 9 p.m. Atrium A & B  Birthways Tour Wednesday, June 27, July 25, Aug. 29, Sept. 26, Oct. 24, Nov. 28, Dec. 19 7 to 8 p.m. Atrium A Birthways offers tours of the hospital and unit for expectant women and their support persons  Breastfeeding Classes Monday and Thursday, June 14, July 9, July 19, Aug. 6, Aug. 16, Sept. 3, Sept. 13, Oct. 1, Oct. 11, Nov. 5, Nov. 15, Dec. 3, Dec. 10 6:30 to 8:30 p.m. Atrium A&B Donation $10  Breastfeeding Support Group July 12, Aug. 2, Sept. 13, Oct. 4, Nov. 8, Dec. 6 10 to 11:30 a.m. Atrium A  Baby Basics Class July 21, Aug. 18, Sept. 15, Oct. 20 North A&B (all dates) 9 a.m. to 1 p.m., Donation $5

Fitness Classes

Call for specific dates and times. Call 515-956-2731 for Ames classes or 515-733-4029 for Story City classes. Preregistration is required. Ames Classes  Moms in Motion Designed for prenatal women, this aqua class includes gentle stretching, strengthening, and mild cardiovascular exercises. Following guidelines from the American College of Obstetrics and Gynecologists, Moms in Motion prepares women for the physiological changes associated with pregnancy and develops stamina and strength for labor and delivery. Class participants enjoy a unique bond exercising with other moms-to-be.  Joints in Motion This 45-minute aqua class is designed for individuals with arthritis, fibromyalgia, and other related conditions. Using a wide variety of gentle exercises, the focus is on improving flexibility and range of motion, plus enhancing cardiovascular and muscular endurance.

 Power Hour Pump it up and join us for this total body strength training workout using free weights, bars, tubing, and more. This workout is appropriate for all fitness levels.  SilverSneakers Have fun and move to the music through a variety of exercises designed to increase muscular strength, range of movement, and activity for daily living skills. Weights, elastic tubing with handles, and a ball are offered for resistance, and a chair is used for seated or standing support.  TBW (Total Body Workout) The TOTAL package—cardio, strength, and interval training. Build metabolismboosting muscle and improve cardiovascular endurance in this fun, fast-paced, hour-long workout.  Tramp & Strength This fun workout will get your heart pumping by using the Urban Rebounder mini trampoline intermixed with strength intervals.

Story City Classes  50/50 Fit This class incorporates functional moves using a variety of equipment. Mix in some low-intensity cardio moves and you have a workout that improves your muscular strength and heart at the same time.

 TRX This small group specialty class uses the TRX suspension system to create unique exercises challenging your core, strength, stamina, and cardiovascular system. Class is limited to 10 participants. Please preregister at the front desk for each class you attend.

 Barre Concept Tone your arms, legs, booty, and abs in this 45-minute class.

 Yoga Combine traditional yoga postures with modern fitness moves for an excellent mind/body experience—perfect for those seeking strength, flexibility, stress reduction, and total relaxation. Bring your own yoga mat.

 Boot Camp Our boot camps provide you with the latest tools and strategies to take your fitness to the next level. Join us for fun and games as you rev up your metabolism and greet the day energized, ready to burn calories all day long.  Core Blitz Focus in on your core strength and stability in this 45-minute total core workout!

www.mgmc.org | Summer 2018 | HEALTH CONNECT

1111 Duff Avenue, Ames, Iowa 50010