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IOWA CITY area

Promoting Healthier Living in Your Community • Physical • Emotional • Nutritional

MAY 2012

FREE

HealthyCells www.healthycellsmagazine.com

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M A G A Z I N E

AMT of IOWA

Driven by Compassion:

A Medical Transport Service that Delivers

page 14

Women’s Health Tissue Bank

Promotes Pregnancy, Childbirth Research page 17

Flat Feet:

Great Options for a Common Problem page 18 Cheering for Success at Genesis Pediatric Therapy page 22


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D A T A A N D M E S S A G E R A T E S M A Y A P P LY. May 2012 — Iowa City — Healthy Cells Magazine — Page 3


MAY

2012 Volume 1, Issue 2

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Awareness: Distracted Driving

6

Emotional: Anger and Perfectionism

This Month’s Cover Story:

AMT of IOWA

Driven by Compassion: A Medical Transport Service That Delivers page 14

8

Nutritional: Pump Up the Produce

10

Physical: Hope for Advancement Through Use of Clinical Trials

12

Grief Recovery: When a “Less Than Loved One” Dies

17

Research: Women’s Health Tissue Bank Promotes Pregnancy, Childbirth Research

18

Foot Care: Flatfeet: Great Options for a Common Problem

20

Planning & Care: Dealing with Back Pain In the Garden

21

Healthy Homes: 4 Overlooked Spots To Spring Clean

22

Advanced Treatment: Cheering for Success at Genesis Pediatric Therapy

24

Advanced Medical Transport of Iowa EMT Shawn Mercer prepares for a scheduled transport. Cover and feature story photos by Jonathan David Sabin. For information about this publication, contact Laurie Hutcheson, owner at

563-650-1876, ICHealthycells@gmail.com Healthy Cells Magazine is a division of:

Prostate Health: Our Cancer Nightmare Comes True

1711 W. Detweiller Dr., Peoria, IL 61615 Ph: 309-681-4418 Fax: 309-691-2187 info@limelightlink.com • www.healthycellsmagazine.com Healthy Cells Magazine is intended to heighten awareness of health and fitness information and does not suggest diagnosis or treatment. This information is not a substitute for medical attention. See your healthcare professional for medical advice and treatment. The opinions, statements, and claims expressed by the columnists, advertisers, and contributors to Healthy Cells Magazine are not necessarily those of the editors or publisher. Healthy Cells Magazine is available FREE in high traffic locations throughout the Iowa City area, including major grocery stores, hospitals, physicians’ offices, and health clubs. Healthy Cells Magazine is published monthly and welcomes contributions pertaining to healthier living. Limelight Communications, Inc. assumes no responsibility for their publication or return. Solicitations for articles shall pertain to physical, emotional, and nutritional health only. Mission: The objective of Healthy Cells Magazine is to promote a stronger health-conscious community by means of offering education and support through the cooperative efforts among esteemed health and fitness professionals in the Iowa City area. “I wish to thank all of the advertisers who make this magazine possible. They believe enough in providing positive health information to the public that they are willing to pay for it so you won’t have to.” Laurie Hutcheson


awareness

Distracted Driving

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n today’s overwhelmingly busy society, with ever increasing demands on our personal and professional time, learning to juggle multiple tasks at once is something we all must face on a daily basis. While it is not clear whether or not multitasking is effective or if it costs more time than it saves, multi-tasking while driving has sparked a national debate about distracted driving and the latest statistics prove that not focusing on the road can be deadly. One of the most widespread forms of distracted driving, cell phone usage, has some alarming statistics. According to a Carnegie Mellon study, driving while using a cell phone reduces the amount of brain activity associated with driving by 37 percent, and a report from the National Safety Council reported that 28 percent of traffic accidents are caused by people talking on cell phones or sending text messages. “Stopping distracted driving is a major initiative that we are undertaking, and one that we believe will make our roads significantly safer. While there are many forms of distracted driving, an obvious distraction for most people is using a cell phone while driving,” said LaHood. “We are working with states across the nation to pass legislation that authorizes law enforcement to stop and cite drivers who are texting while driving—one of the most dangerous forms of distracted driving.” Texting is of heightened concern because it combines three types of distraction – visual, taking the eyes off the road; manual, taking the hands off the wheel; and cognitive, taking the mind off the road. According to the Insurance Institute for Highway Safety, drivers who use hand-held devices are four times as likely to get into crashes serious enough to injure themselves. While cell phones are a major focus of the distracted driving campaign, the National Highway Traffic Safety Administration (NHTSA) is encouraging

people not to do any other task while driving, as distracted driving is any non-driving activity a person engages in that has the potential to distract him or her from the primary task of driving and increases the risk of crashing. This can include using a cell phone, eating and drinking, grooming, tuning the radio or even talking to passengers. In 2009, nearly 5,500 people lost their lives and almost 450,000 people were injured in police-reported crashes in which at least one form of driver distraction was reported on the police crash report. To tackle this ever-increasing problem, NHTSA is focusing on ways to change the behavior of drivers through legislation, enforcement, public awareness and education—the same tactics that have curbed drinking and driving and increased seat belt use. “Decades of experience with drunk driving and getting people to buckle up has taught us it takes a consistent combination of education, effective enforcement, a committed judiciary and collective efforts by local, state and national advocates to put a dent in the problem,” said LaHood. NHTSA’s message is simple—“Put It Down”; and it’s one that isn’t going to go away anytime in the near future. With supporters ranging from President Obama to Oprah and legislation passing across the nation to discourage distracted driving, drivers will hopefully get the message loud and clear, just like with the drunk driving and seatbelt campaigns that have helped make the roads safer. So the next time you are pressed for time, and you consider multitasking while you’re driving, remember that the best multitasker knows that some things require your undivided attention, and you must know when you should put other things aside and focus your energy on the task at hand. Driving is definitely one of those times. May 2012 — Iowa City — Healthy Cells Magazine — Page 5


emotional

Anger and By The FlyLady, Marla Cilley

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hen you finally have reached the absolute bottom and you think there is no place to go, there is always two more places. You can give up entirely and be planted six feet under or you can scream out for help and start pulling yourself up! You have a choice. The difference is you have to get mad and scream and not give up. Anger is not a bad emotion. As women we have been taught to just take it and not explode with anger. Exploding with anger is rage and rage is not OK, but giving yourself permission to be upset and angry is a good

“So anger can free you if you use it sparingly. Focus your justified anger toward what is making you angry and not at yourself.” Page 6 — Healthy Cells Magazine — Iowa City ­— May 2012


Perfectionism thing. When you keep it in it is like poison. So what do we do to ourselves? We turn anger into sad and we feel sorry for ourselves for being mistreated. Then WHAT? The anger goes to sad and then to depression. We eat to make the hurt go away or we sleep to not have to deal with what is. It is all our perfectionism again sandwiched with that procrastination that paralyzes us into depression. I can see you all shaking your heads at me. “How can perfectionism be the foundation to my feeling bad.” Well here is how it all fits together. When something goes wrong in our lives and we can’t fix it; what do we do? We can’t fix it to make it right again or we can’t change the other person; we want everything back the way it was. Do you see the perfectionism rearing its ugly head? We do everything in our power to CONTROL THE ISSUES — and make it all better — only to be shot down time and time again! So if we can’t do it right what do we do? We were taught to do nothing!! I wish that was all we would do, but we have to turn it inward to abuse ourselves. When we are unable to fix things we begin to feel guilty because of our inability to make things right or perfect. We then start to beat ourselves up. It is bad enough when we have been abused by others but now we are abusing the only person that cares for you: YOU! This is why anger is good! It is focused toward someone else and not yourself. Now it is not good to be angry all the time because you are in fight or flight mode and when you really need to scream out for help you will not be able to. Adrenalin is an amazing body chemical. It is a power surge that supplies the energy right when you need it. This is how a mother can lift a car off of a child. I have said it many times, “Too much of a good thing can be bad for you.” Try eating a whole chocolate cake! I have a good supply of adrenalin now. At one time I was totally depleted of my resources. I used them all up by always being upset and walking on eggshells. The adrenalin kept me from feeling what was happening inside my own body. It was a drug. So anger can free you if you use it sparingly. Focus your justified anger toward what is making you angry and not at yourself. Do what you need to do to take care of the situation. Don’t turn it inward to punish yourself when you can’t fix it. You are not responsible for anyone but you. Let go of the guilt, pain and stress and be good to yourself by getting angry at the right person. Then let it go and get on with your life! If you stick around the breeze will come your way and you will set out on your journey. Life is a journey not a destination. So what anger have you been turning inward? For more help getting rid of your CHAOS, check out her website and join her free mentoring group at www.FlyLady.net or her book, Sink Reflections published by Random House and her New York Times Best Selling book, Body Clutter published by Simon and Schuster. Copyright 2010 Marla Cilley Used by permission in this publication.

Lyse S Strnad, MD John F Stamler, MD, PhD Stacy L Thompson, MD Board Certified Eye M.D.s

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We are celebrating that over 156,000 patients were admitted to our Centers last year! That is a big number. Each box of cereal has approximately 1500 pieces, the 103 Heartland is rooted in the boxes ofHealth cerealCare on Center display– Moline represent the 156,000 patients that chose Heartland Health Moline community providing nursing90% and rehabilitation Care for their post acute skilled stay. Over of our admissions return to their“Life”after services for those transitioning their rehabilitation stay. from hospital to home as well as long-term care services for those no longer able to manage atThank home.you Our is proud to touch lives of fordedicated choosingteam Heartland Health CaretheCenter for your post acute care. The boxes of cereal willday. be donated to the food bank on March 20th. hundreds of patients every Heartland Health Care Center – Moline 833 Sixteenth Avenue • Moline, IL 61265 309.764.6744 • www.heartlandnursing.com

May 2012 — Iowa City — Healthy Cells Magazine — Page 7


nutritional

Make YourPlate Look Like MyPlate:

Pump Up the Produce By Cathy Gehris, RD, LD, Hy-Vee Dietitian

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oes making meals look like the MyPlate symbol seem very foreign and unimaginable to you? Is the very thought of eating half a plateful of vegetables or a vegetable/fruit combination make you and your family cringe, thinking “there is no way this is going to happen?” Adding more produce items to your meal can sometimes feel like a chore, but as with all healthy habits, the benefits are worth the effort. Soon you may be wondering what the fuss was all about! Summer may seem like the easiest time to get your fruits and veggies in, but don’t despair as the mercury still hovers in the jacket temperature range here in Eastern Iowa. Pumping up the produce for half of your plate is very possible any time of year. Though your garden may not be in bloom or even planted yet, do not discount fresh produce this time of year as grocers carry a wide variety of fresh fruits and vegetables in every color of the rainbow year-round. Late winter and early spring vegetables include asparagus, avocados, cabbage, cauliflower, lettuce, mushrooms, parsnips and spinach and other greens. Aim for seasonal fruits like most citrus, pears, strawberries and grapes. Page 8 — Healthy Cells Magazine — Iowa City ­— May 2012

Take some time familiarizing yourself with frozen fruits and frozen or canned vegetables; they are a convenient as well as economical way to pump up your plate when seasonal selections are limited or too expensive for the family budget. Aim for frozen fruit with no added sugar and canned fruits packed in water or non-concentrated fruit juice. Look for frozen and canned vegetables with minimal added sodium or sauces that may add unwanted fat calories. Consider this common dinner: spaghetti, pasta sauce and garlic bread. Most of the calories are provided by the grain group (pasta and bread), with only one serving of vegetable provided by ½ cup of pasta sauce. Pump it up with a few simple changes. Saute some additional onions, green pepper pieces, mushrooms, zucchini or other vegetables and mix into the sauce as it heats. You can also be sneaky if you have picky eaters in the family by blending your choice of sautéed vegetables and stirring the pureed mixture into the sauce so the smooth texture is not changed! If that doesn’t seen do-able, add vegetables for a side dish such as a salad or some steamed asparagus or broccoli. Grilling or roasting yellow and red bell peppers for a beautiful, eye appealing


1 (14 ounce) can Muir Glen™ diced tomatoes with Italian herbs 8 cups baby spinach 1/2 teaspoon crushed red pepper, optional 3/4 cup part-skim ricotta cheese, divided

accompaniment is another suggestion. Finally, don’t forget the fruit. Top a thin slice of angel food cake with frozen berries, thawed, and a dab of Greek yogurt with a sprinkle of cinnamon for dessert. Easy ways to “pump up the produce”: • Try single-serve frozen vegetables from Green Giant and Birds Eye. • Add frozen chopped spinach to soup. • Toss frozen Asian blend vegetables into brown rice as it cooks. • Stir no-salt-added canned vegetables into pasta salad. • Blend your fruit smoothie with a few leaves of frozen spinach. • Cool hot oatmeal – and thaw frozen berries – by adding the fruit to your bowl as it comes out of the microwave or off the stove top. • Blend fresh or frozen fruit into a puree, then refreeze in ice cube trays for a colorful and nutritious addition to beverages.

Preparation Bring a large pot of water to a boil. Add pasta; cook until just tender, 8 to 10 minutes or according to package directions. Drain and transfer to a large bowl. Meanwhile, heat oil in a large nonstick skillet over medium heat. Add onion and garlic; cook, stirring, until soft and beginning to brown, about 3 minutes. Add mushrooms, salt and pepper; cook, stirring, until the mushrooms release their liquid, 4 to 6 minutes. Add tomatoes, spinach and crushed red pepper (if using). Increase heat to medium-high; cook, stirring once halfway through, until the spinach is wilted, about 4 minutes. Toss the sauce with pasta and divide among 4 bowls. Dollop each serving with 3 tablespoons of ricotta.

For a new produce-packed entrée, try this Inside-Out Lasagna:

Inside-Out Lasagna

(serves 4, about 1-1/2 cups each) Source: Eating Well, Inc.

Nutrition Facts, Per Serving: 364 calories, 81 calories from fat, 9 g total fat, 3 g saturated fat, 14mg cholesterol, 588 mg sodium, 55 g carbohydrate, 7 g fiber, 16 g fiber

Ingredients 8 ounces Hy-Vee whole-wheat rotini or fusilli 1 tablespoon Grand Selections extra-virgin olive oil 1 small onion, chopped 3 cloves garlic, sliced 8 ounces sliced white mushrooms (about 3-1/2 cups) 1/2 teaspoon salt 1/4 teaspoon freshly ground pepper

AMTof IOWA

ADVANCED MEDICAL TRANSPORT

Information is not intended as medical advice. Consult your health care provider for individual guidance. For more information on healthy eating, contact your local area Hy-Vee dietitian.

Your partner in health.

Why call AMT of Iowa? Advanced Medical Transport’s EMS professionals are trained and equipped to deliver specialized medical transports throughout the state and region and are known for an uncompromising dedication to patient care. At AMT, we are: • Compassionate • Impeccably professional • Quick to respond • Cost-wise • Technologically advanced

Call 319.341.7799 today to learn more! AMTofIowa.org • 319.341.7799 • 2228 Heinz Road • Iowa City, Iowa 52240 May 2012 — Iowa City — Healthy Cells Magazine — Page 9


physical

Alzheimer’s Association’s® 2012 Alzheimer’s Disease Facts and Figures Released

Hope for Advancement Through Use of Clinical Trials Submitted by Alzheimer’s Association®

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very 68 seconds someone in America develops Alzheimer’s. According to the Alzheimer’s Association’s ® 2012 Alzheimer’s Disease Facts and Figures, we see the number of people with the disease growing which translates to higher costs for care. Caring for people with Alzheimer’s and other dementias will cost the United States an estimated $200 billion in 2012, including $140 billion paid by Medicare and Medicaid. Medicare payments for an older person with Alzheimer’s or other dementias are nearly three times higher while Medicaid payments are 19 times higher than for seniors without Alzheimer’s and other dementias. Unless a concerted effort to change the trajectory of the disease is made today, costs for Alzheimer’s and other dementias will soar from $200 billion this year to as high as $1.1 trillion dollars in 2050. This dramatic rise Page 10 — Healthy Cells Magazine — Iowa City — ­ May 2012

includes a 500 percent increase in combined Medicare and Medicaid spending and 400 percent increase in out-of-pocket spending for families. “With aging baby boomers and the nation facing unprecedented economic challenges, it is more important than ever for America to deal with the Alzheimer’s crisis,” said Kelly Hauer the executive director of the Alzheimer’s Association’s East Central Iowa Chapter. “The impact of Alzheimer’s on Iowa cannot be underestimated, with as many as 69,000 living with the disease now and an estimated 77,000 living with it by 2025 – it is clear every effort must be made to address Alzheimer’s disease today.” Since its debut during the Alzheimer’s Association International Conference 2010, Alzheimer’s Association TrialMatch has matched


more than 3,000 people to Alzheimer’s clinical trials based on their diagnosis, preferences and location. The internet (www.alz.org/trialmatch) and phone-based (800-272-3900) service provides comprehensive clinical trial information and an individualized matching service for people with Alzheimer’s disease or related dementias, their caregivers, family members and doctors. “One of the greatest obstacles to developing the next generation of Alzheimer’s treatments is recruiting and retaining trial participants,” said Hauer. “Alzheimer’s Association TrialMatch was launched in 2010 as a user-friendly and individualized guide to Alzheimer’s clinical trials. If we can fill the trials faster, we will get answers faster and get closer to finding better treatments and a cure for Alzheimer’s.” Currently, Alzheimer’s Association TrialMatch lists 131 research studies with 545 local trial sites nationwide. The strength of this service is its comprehensive, constantly updated database of Alzheimer’s, mild cognitive impairment and other dementia trials taking place across the U.S. Specialists at the Alzheimer’s Association’s national Helpline – available 24-hours a day – assist in the process of matching individuals to clinical trials for which they are eligible based on study criteria, diagnosis, treatment history and location. They answer questions about the trial process and connect individuals with trial sites based on their unique profile. Patients and caregivers are encouraged to share their trial matches with their healthcare professionals to help decide whether a clinical trial is appropriate. According to the Alzheimer’s Association report, there are 5.4 million Americans living with Alzheimer’s disease, including 5.2 million people age 65 or older and 200,000 people under the age of 65. Individuals who have Alzheimer’s and other dementias are high

consumers of hospital, nursing home and other health and longterm care services, which translate into high costs for Medicare, Medicaid and for millions of families. While only 4 percent of the general population will be admitted to a nursing home by age 80, for people with Alzheimer’s, 75 percent will admitted to a nursing home by age 80, posing significant economic challenges to state Medicaid budgets. As families struggle to survive in a challenging economic environment and states grapple with budget shortfalls, Alzheimer’s disease threatens to overwhelm them both. The new report reveals there are 15.2 million friends and family members providing care for individuals with Alzheimer’s and other dementias, including 134,338 Iowa caregivers. In 2011, these caregivers provided $210 billion dollars worth of unpaid care nationally, and more than $1.8 billion in Iowa. Most people survive an average of four to eight years after an Alzheimer’s or dementia diagnosis, but some can live as long as 20 years with the disease. This prolonged duration often places increasingly intensive care demands on family members and friends who provide care. Caregivers take on a tremendous financial, physical and emotional toll to help care for a loved one with Alzheimer’s. Sixty-one percent of family caregivers of people with Alzheimer’s and other dementias rated their emotional stress of caregiving as high or very high. The physical and emotional impact on Alzheimer’s and dementia caregivers is estimated to result in nearly $9 billion in increased health care costs in the United States. To view the full text of the Alzheimer’s Association’s 2012 Alzheimer’s Disease Facts and Figures or to learn more about the Alzheimer’s Association, visit www.alz.org/eci.

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Maria Teresa Ferrer, who has a Doctorate in Physical Therapy, provides highly specialized treatment for youngsters with orthopedic and neurologic conditions using: n Dynamic Casting n TheraSuit n Universal Exercise Unit (“Spider Cage”)

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May 2012 — Iowa City — Healthy Cells Magazine — Page 11


grief recovery

When a “Less Than Loved One” Dies

Page 12 — Healthy Cells Magazine — Iowa City — ­ May 2012


Healthy Cells magazine is pleased to present the second in a series of feature articles on the subject of Grief ❣ Recovery®. The articles are written by Russell P. Friedman, Executive Director, and John W. James, Founder, of The Grief Recovery Institute. Russell and John are co-authors of WHEN CHILDREN GRIEVE - For Adults to Help Children Deal with Death, Divorce, Pet Loss, Moving, and Other Losses - Harper Collins, June, 2001 - & THE GRIEF RECOVERY HANDBOOK - The Action Program For Moving Beyond Death, Divorce, and Other Losses (Harper Perrenial, 1998). The articles combine educational information with answers to commonly asked questions.

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ast month we talked about grieving and completing our relationships with loved ones who have died. While the death of a loved one is painful, we are often complete with loved ones. That is to say that we have communicated our feelings about them, to them. We believe that they knew how we felt and that we were understood. When a loved one dies we may be overwhelmed with conflicting feelings, we may feel disoriented and confused, and we may feel robbed of one last chance to say I love you and goodbye. Even though we are often essentially complete when a loved one dies, after the death we usually remember some things that we wish we’d had a chance to say. We need to discover those unsaid things and say them. The appropriate methods for communicating the unsaid things are detailed in The Grief ❣ Recovery® Handbook. What happens when a “less than loved one” dies — perhaps a parent or a sibling, someone with whom we should have had a more loving relationship? We are almost always incomplete when a less than loved one dies. Almost always we are left with the awareness that our hopes and dreams of someday having the relationship become pleasant and happy have ended. Even if our hope is simply not to be tormented anymore, the death often exaggerates the torment rather than diminishing it. That is when many of us report being “ruled from the grave.”

“The process of Grief ❣ Recovery® helps grievers identify and complete the undelivered emotional communications that keep them tied to past painful experiences with people who have died or with relationships that have ended or changed.” Many people labor under the misapprehension that once someone has died there is no way they can complete any unfinished emotional business. Gladly, this is not true, or they would have to stay incomplete forever. The process of Grief ❣ Recovery® helps grievers identify and complete the undelivered emotional communications that keep them tied to past painful experiences with people who have died or with relationships that have ended or changed. This process obviously does not require that the person we are incomplete with be a living or willing participant. Often our attempts to communicate with our “less than loved ones” failed, not because of our unwillingness, but because the other person was unable to listen to or talk about the things that we wanted and needed to talk about. Quite often our attempts to communicate

started new and larger battles which may have been added to our list of unfinished or incomplete emotional events with them. Even after they have died, as we replay the events, we keep winding up hurt and helpless. We do not know how to end the vicious cycle. We may attempt to NOT think about them, but then a reminder will appear, outside of our control. We may see someone in the mall who looks like them, or a car similar to the one they drove. These reminders will often send us back into the pain caused by the incomplete emotional relationship. Most of you will realize that it is not possible to eliminate someone from your memory. You most assuredly cannot control the stimuli that cause you to remember a less than loved one. Even attempts at total isolation rarely work, as even dreams can rekindle painful memories. When a “less than loved one” dies we are often left with an extremely lopsided memory picture, almost exclusively negative. It seems as if we have become the victim of these painful, negative memory pictures. We are also confused by our relationship to the painful memories that keep recurring. We must grieve and complete our relationship to the person as well as to our relationship with the pain we generate when we think about or are reminded of the person. And, we must grieve and complete our unmet hopes and dreams and expectations. You must become willing to re-experience some of the painful events, and finally communicate what you would have said had you been allowed to, or if you had known how. It may seem frightening to root around where there has been so much pain. Perhaps it would be more helpful to be frightened of the alternative, a life of restriction and limitation caused by staying incomplete. The alternative is to keep the pain forever, by trying NOT to remember, and by trying to avoid any circumstances or events that remind you of that person. Many people today talk of giving away their power. There is no clearer or more painful example of that then to have your life’s actions and reactions ruled by the painful memories of someone who is no longer here. Question: The above article relates to a less than loved one who has died. What about less than loved ones who are still living? Answer: The exact same principles apply when the “less than loved one” is still living. In fact, it is probably even more essential that you complete your part of that relationship as soon as you can. If not, you may live in constant fear of any kind of interaction with or reminders of that living person. Completion of your part of a relationship with a living person does not imply that the other person will or should change. Most likely they will continue to be just who and how they are. The difference is that you will be able to live a life of meaning and value, not limited by painful reminders that a relationship did not live up to hopes, promises, dreams or expectations. Next Month: “Am I Equipped For Happiness?” For information about programs and services, write to The Grief Recovery Institute, P.O. Box 6061-382 Sherman Oaks, CA 91413. Call 818-907-9600 or Fax: 818-907-9329. Please visit our website at: www.grief-recovery.com.

May 2012 — Iowa City — Healthy Cells Magazine — Page 13


feature story

AMT of IOWA

Driven by Compassion: A Medical Transport Service that Delivers By Leah Wilson

Cover and feature story photos by Jonathan David Sabin.

Our people make us successful. If you assemble a star team, the rest is easy.—Tom Geraci, CEO, AMTI.

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et’s face it. Few of us really want to know what the inside of an ambulance looks like. Seeing them on the road is enough to evoke images of people in dire circumstances. But ambulances are not just there when your life hangs in the balance. The growing field of medical transport includes scheduled ambulance services for those needing to get to and from medical appointments; to the hospital during non-emergencies where extra medical support is needed; or for scheduled wheelchair transportation. These are the specialties of an emerging nonprofit in Johnson County—Advanced Medical Transport of Iowa (AMTI). Pamela Young, a tenant of Melrose Meadows in Iowa City remembers her last trip: “It was late in the evening when it happened … I just stood up the wrong way and, SNAP, broke my leg. AMTI was very quick. I think they beat my husband in getting here! They first eased me onto a stretcher, then into the ambulance—all very quickly and painlessly. I was nervous, because I was afraid they were going to hurt my leg in the process, but they were very good about moving me very carefully.” Page 14 — Healthy Cells Magazine — Iowa City — ­ May 2012

Advanced Medical Transport (AMT), AMTI’s parent company, got its start in 1991 in Peoria, Illinois, when three area hospitals took measures to improve the quality of emergency medical services. The specific aim of the new program was to provide consistently professional, compassionate medical transport that was on-time and cost-wise. Though based in Illinois, AMT frequently arranged transport to and from the Iowa City VA Health Care System and UI Hospitals and Clinics, and over the years, AMTI developed meaningful relationships in Johnson County. “We really grew to love the community,” said AMTI CEO Tom Geraci. AMTI has been headquartered in Iowa City for over a year now, and is quickly establishing itself as a provider of choice for medical transportation. “Our focus is always on the patient,” says Tom. “Every day I remind our staff that the reason we’re here is to serve the people of Johnson County with more expertise, professionalism, and real compassion.” Jody Thomas is an administrator at Melrose Meadows, a registered nurse and an AMTI board member.


“AMTI is very professional. Their responders are always here within a few minutes, ready to go. And they are very courteous to our tenants and staff. When they are en route, they call us to let us know how things are going. We often didn’t receive that level of service with previous transport companies. AMTI just has a truly extraordinary group of people.” Excellence in patient care “When your goal is to deliver exceptional service, you have to start at the beginning,” says Tom. “Our people make us successful. If you assemble a star team, the rest is easy.” Tom began his career with AMTI in 1991 as an EMT. He said it didn’t take long before he was “bitten by the EMS (Emergency Medical Service) bug.” He fell in love with his work, and was eager to learn the ins and outs of the medical transport business. He quickly advanced from EMT to paramedic, to critical care paramedic, to training & research coordinator, then operations coach. Another jump and he was manager of applied technology, and finally in 2010, he became CEO of the Iowa non-profit. “I think starting out as an EMT has helped me better understand what my employees experience on the job, and what they need to be consistently at their best.” Think that calling a medical transport company for a non-emergency is like hailing a cab? AMTI believes that providing highly-trained staff and top-notch technology is important. The EMTs and Paramedics at Advanced Medical Transport are trained to transport patients in accordance with protocols and guidelines established by medical directors. While most scheduled ambulance transports involve medically stable patients, some individuals may require a higher level of care. EMTs and Paramedics can quickly assess a patient’s condition, and perform emergency medical procedures if needed to keep a patient stable during transport. AMTI also employs nurses for special transports providing critical care. “They were able to start the IV in the ambulance,” recalls Pamela. “I didn’t have to wait to get to the hospital, and that was a plus.” If you’re wondering what the word “Advanced” stands for in the AMTI name, Tom will tell you it is really about providing advanced care. And that means having the best equipment and technology. The AMTI fleet consists of ambulances, vans and secure cars. Tom says they work hard to have the right resource for every need. He believes that being a nonprofit helps AMTI stay ahead of the technology curve.

AMTI Services • Scheduled ambulance transportation from basic life support to critical care • Demand response service for VA Hospitals • Scheduled wheelchair transportation

Every Ambulance is Equipped With • Zoll’s E-series Cardiac Monitor/Defibrillator • Bio-Med Crossvent Ventilator • Braun IV pumps • GPS navigation • In motion Gateway communications interface • Motion’s Tablet PC communications tool • Driver monitoring system • Panasonic Toughbooks with Zoll’s Tablet PCR documentation software Learn more: www.AMTofIowa.org, 319-341-7799. AMTI is certified by the Iowa Department Health, Bureau of EMS to the level of Critical Care paramedic Transport Service.

Every dollar earned is invested in improving service and invested in the community. “All of our vehicles are brand new, and AMTI continues to provide us with the latest technology … it’s a very good thing, says Geoff Burman, paramedic.” AMTI is always searching for high-energy, detail-oriented medical professionals who love people. And AMTI employees seem lavish in their praise of the company. Scott Adkins has over 10 years experience as a paramedic, and he spoke at length about the spirit of service at AMTI: “My work here is very rewarding,” he begins. “We’re a very transparent organization that believes in patient advocacy, and we stand out because we do the little things that others don’t do.” Geoff echoed many of Scott’s sentiments and mentioned other key attributes: “AMTI is patient-oriented, instead of business-oriented … and that’s something I believe in. Everyday I feel like I’ve touched somebody’s life.” Commitment to community AMTI is an Iowa nonprofit organization that is all about community. For Tom, that commitment is truly the company mantra. “We serve the community in everything we do—not only by providing the best medical transportation possible, but by partnering with other nonprofits to create a healthy, vibrant place to live.” AMTI supports The United Way of Johnson County, the Alzheimer’s Association and Shelter House, a non-profit organization that has provided housing and other supportive services to the homeless of Southeast Iowa since 1983. AMTI also participates in the Johnson County Livable Communities Elderly Consortium, Johnson County Transportation Committee and the Johnson County Chamber of Commerce.

Geoff Burman, AMT paramedic May 2012 — Iowa City — Healthy Cells Magazine — Page 15


feature story

(continued)

Serving Those Who Served Us

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Juli Kennedy, director of resource development for United Way of Johnson County and Tom Geraci, CEO, AMTI “Most of the time, we’re the ones reaching out,” says Juli Kennedy, director of resource development for United Way. “But AMTI calls us up and says, ‘What can we do for you?’” In AMTI’s first year of business in Johnson County, United Way selected the company as a pacesetter for their campaign. Pacesetter businesses work with the United Way to launch corporate campaigns before the general campaign even begins. In only two days, every AMTI employee made a contribution, and that early success helped United Way gain the momentum it needed to finish a strong campaign. Scott was very excited and proud to be a part of such a cohesive community effort. “I think we bring a very new and refreshing dynamic to Johnson County.” I think the community is hungry for involvement.” Since AMTI is a nonprofit, it works hard to keep costs of service affordable for everyone in the community. “Cost-wise, they’re on the lower end compared to other agencies we’ve used. It’s very economical, says Jody.” And since AMTI is governed by a local board of directors, they have the ability to draw upon a well of expertise that helps them be their best. Carol Watson, PhD, RN, serves as the board chair for AMTI. “With almost 25 years of involvement in the governing boards of ambulance service, I’m pleased that Advanced Medical Transport of Iowa has brought their team of highly skilled professionals to Iowa City and the surrounding area. Pairing those highly skilled professionals with a fleet equipped with state of the art technology and equipment equals the highest level of medical transportation services for this community.” Partners in health A new goal for the AMTI company, or perhaps it’s a culmination of all of the things they strive for, is to serve the community as a partner in health. “We believe that healing can happen at every step in the health care process, including those often critical times when a patient is being transported for care. So, whether you are a patient, nurse, care facility administrator or a physician, we work with you to promote wellness,” explains Tom. It’s a philosophy that has been firmly planted in the hearts and minds of AMTI employees. Shawn Mercer, EMT says, “I often think to myself… that could be my Mom. And I’d want her to have the best care possible. I feel good knowing that at AMTI, I can provide just that.”

For more information about Advanced Medical Transport of Iowa visit www.AMTofIowa.org or call 319-341-7799. AMTI is certified by the Iowa Department Health, Bureau of EMS to the level of Critical Care paramedic Transport Service. Page 16 — Healthy Cells Magazine — Iowa City — ­ May 2012

n the day I turned 21, I joined the army,” recounts Anna Marie Urban. Now an energetic 91, Anna Marie resides at Melrose Meadows in Iowa City. The year was 1942, and the world was at war. “People in my neighborhood asked, ‘Why did you join the army?’ And I said, ‘because I am patriotic.’” Anna was an Iowa farm kid, growing up as the only girl among four brothers. She graduated from high school in Mt. Pleasant and then went on to business school in Burlington. When the war broke out, all four of her brothers joined the military; 3 went into the army and one joined the Navy. Anna worked as a recruiter. “I have wonderful memories of service,” she says. It was really hard work, but it was my forte. Anna remembers proudly that her time spent as a woman in the mili-

Anna Marie Urban, tenant at Melrose Meadows and John Scully, EMT for AMT of Iowa. tary was part of a larger movement of women into the workforce, often taking the jobs typically performed by men. As she put it, “We’d take the desks, so the men could take the rifles.” By all accounts, Anna Marie is a strong, vibrant woman. But not long ago, she found that her health took a turn for the worse. Anna has COPD, which stands for Chronic Obstructive Pulmonary Disease, a lung disease that can limit airflow. “I must have been getting the flu. I was very sick, and knew I needed help.” The staff at Melrose Meadows responded quickly by calling AMTI, which arrived in minutes to transport Anna to the Veterans Affairs Hospital in Iowa City. “AMTI came quickly… I turned around and they were there! I was so sick, I couldn’t get my breath. But these fellas were very, very kind, and they worked well together. Inside the ambulance, everything was new! I like new things. They’re the best, and I’ve had a lot of ambulance rides.”


research

Women’s Health Tissue Bank Promotes Pregnancy, Childbirth Research By the University of Iowa Hospitals and Clinics

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esearchers studying pregnancy-related problems are turning to cord blood and tissue banking to help them find answers, patterns and new information regarding a wide variety of diseases in pregnancy. Though the use of stem cells in research is widely known, the use of cord blood – the blood that comes from the umbilical cord – is still relatively new. “The cord blood bank has been around for a long time, and its utility is growing. Researchers in pregnancy, cancer and immunologic disease have used the banked samples,” said Mark Santillan, M.D., associate professor of maternal-fetal medicine in the Department of Obstetrics and Gynecology and a high-risk obstetrician at University of Iowa Hospitals and clinics. Raising awareness and promoting research is an ongoing event, Santillan said, as the need for cord blood increases. In comparison to other disciplines, he said research into maternal-fetal conditions and high-risk pregnancies is still in its infancy globally. “The true molecular causes of many obstetric diseases such as preterm labor, preeclampsia, and gestational diabetes are not well understood,” he said. “We need to be able to understand these causes in order to effectively prevent, treat and potentially cure some of these diseases.” Santillan and his wife, Donna Santillan, Ph.D., Assistant Research Professor in the Department of Obstetrics and Gynecology at University of Iowa Hospitals and Clinics, coordinate the Women’s Health Tissue Repository, a tissue bank designed to help researchers study a variety of issues affecting women’s health. There are three banks within the repository: A maternal fetal tissue bank; a reproductive endocrinology and infertility tissue bank; and the long-standing oncology tissue bank. A fourth bank, a well women’s tissue bank, is planned for the near future. All of the banks use blood or tissue retrieved at the time of clinically necessary tests such that there are no extra blood draws or no extra invasive procedures. For example, there are multiple routine blood tests that occur throughout pregnancy. Most women receiving obstetric care at UIHC are eligible to be a part of the Maternal Fetal Tissue Bank. If potential participant consents to being part of the Maternal Fetal Tissue Bank, the bank has approval to take “a little extra” blood, urine, or any specimen from a clinically necessary test. At the time of birth, cord blood, maternal blood, and placenta are also collected. “The stem cell bank had been available, but we decided we needed to collect other samples in order to have the complete picture during pregnancy to allow us to focus on both the health of the mother and the child,” Donna Santillan said. “In comparison to other areas of research, there is really little research on pregnancy and maternal health, even though everyone in the world is affected by the pregnancy.” “Our goal with the maternal fetal tissue bank is to focus on the health of women and their babies during pregnancy because it is an incredibly under-studied area that is a very critical time in development,” she said. Donors for the cord blood bank are women who have chosen UI Hospitals and Clinics for prenatal care and delivery. Samples are drawn at the same time regular blood samples are taken throughout the pregnancy – at the first visit with an obstetrician, during the screening in

the second trimester and at glucose testing at 28 weeks. There are no extra “pokes” with a needle. Samples are stored with a study number, but are not identifiable for researchers using the bank. To maintain privacy, researchers are given relevant clinical information pertaining to the sample, but they cannot trace it back to a particular person. Donna Santillan said the bank is strictly for research and not for personal use. In other words, she said, families aren’t able to store tissue to withdraw later in the case of a medical emergency. “Women who choose to participate are giving a great gift by really helping with research that may not benefit them now, but could help in our understanding for future generations,” she said. The bank is growing over time; in its first year 532 women had consented to donate tissue to the banks, with more than half those consents coming in the first half of 2011. For more information visit http://www.healthcare.uiowa.edu/ programs/cordblood/

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May 2012 — Iowa City — Healthy Cells Magazine — Page 17


foot care

Flatfeet: Great Options for a Common Problem Dr. Bradly Bussewitz, Professional Foot and Ankle

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latfoot also known as pes-plano-valgus, is one of the more common foot deformities for both the young and old alike. A flatfoot can develop in one or both feet. When a child is born with flatfeet it can be caused by boney malformation or from ligament and tendon imbalances. Late onset flatfoot or adult flatfoot usually progresses from a tendon which becomes weak or torn and the surrounding ligaments begin to stretch and fail. As the arch begins to collapse arthritis within the joints can develop causing a permanent deformity. Pain can develop early with the tendon and ligament failure or later when the joints deteriorate. Often times as the deformity worsens, not only pain but also functional changes can occur as the foot becomes ineffective and the knee, hip, and back become painful. Treatment options depend on the severity of the deformity and the parts involved. The earlier it’s treated the less invasive the correction. As a child ages, the bones grow and mature and they can “outgrow” the deformity. If pain is present, custom made orthotics (shoe inserts)

• Reconstructive Surgery • Implants • Diabetic Foot Care • Sports Medicine/Orthotics www.ProfessionalFootAnkle.com Dr. George Sehl

Two Locations: 805 S. Gilbert St., Iowa City Coral West Health Center 2769 Heartland Dr., Coralville

319.337.2021 Page 18 — Healthy Cells Magazine — Iowa City — ­ May 2012

Dr. Brad Bussewitz

Fellowship Trained Foot & Anke Surgeon

or various supports can offer great pain reduction and prevent disease progression. In the adult/elderly we grade the deformity based on the Johnson and Strom (1) scale: Grade I foot has pain along the inside of the foot near the tendon that supports the arch, at the posterior tibial tendon. Classically, there is little to no deformity at this point but the tendon is asking for help as it tears and stretches. The foot functions normal but pain can limit ones activities. Anti-inflammatories and support are at the heart of treatment. “If I can get my hands on grade I flatfoot we can often times stop or slow the progression and avoid surgery” Dr. Bradly Bussewitz says. Grade II deformity describes a progression from grade I. The pain can increase but the hallmark of this stage is a flattening of the arch and the heel bone everts or angles outward. “The patient usually has a supple, reducible foot that can be positioned normal while sitting in the exam chair” says Dr. Bussewitz. The treatment may be support and/or physical therapy as we try to have the tendon respond to conservative efforts. “I may use additional imaging beyond x-ray to determine the extent of damage. If there is tendon tearing or continued pain I perform joint sparing procedures to repair the tendon and may have to slide the heel bone back under the body,” says Dr. Bussewitz. This procedure is tolerated very well. It is performed as an outpatient procedure with gradual return to activity as healing progresses. Attacking the problem at this stage allows joint preserving procedures and prevents escalation of deformity. Grade III deformity has progressed beyond the tendon to affect the joints. The longstanding deformity has led to joint arthritis and rigidity of the flatfoot deformity. The foot is no longer reducible and supple at some of the rear-foot and mid-foot joints. The pain can occur along the inside of the arch or aching deep inside the joints themselves. “At this point we are left with more aggressive bracing to help support the


Grade II Pre-operative flatfoot Xray

Grade III Pre-operative flatfoot

Grade II Pre-operative flatfoot Xray

Grade III Post-operative corrected flatfoot

painful areas. If bracing fails the procedures involve removing the arthritis and repositioning the foot and then knitting the bones together in the corrected position,” says Dr. Bussewitz. This is usually performed as an outpatient procedure at the surgery center or hospital. Grade IV deformity has all the characteristics of grade III with the addition of ankle involvement. The deformity has been present long enough and has been severe enough to wear out the ankle as well. “Repositioning the flatfoot and addressing the ankle with one of many corrective measures is necessary at this point,” Dr. Bussewitz adds. “There is no need to panic, we really have some great treatments to alleviate pain and if needed recreate a normal arch to the foot. During residency and fellowship I worked to perfect the advances in surgical technique to reduce healing time and the chance of complications. The patients I’ve treated in eastern Iowa have done great. My ability to treat this deformity has been aided by technology advancements in tendon repair and transfer devices as well as plates and screws that allow the bone to heal faster and stronger. I often use stem cells harvested from the bone itself to speed recovery,” Dr. Bussewitz concludes. Dr. Bussewitz has a love for foot and ankle care and is excited to be back in the Iowa City/Coralville area offering conservative and surgical treatment for bunions and other foot and ankle pain. For more information on understanding bunion or other foot and ankle pain and the various treatment options, visit www.ProfessionalFootAnkle.com or call (319)-337-2021 for an appointment. Dr. Bussewitz is a Fellowship trained foot & ankle surgeon practicing in Iowa City and Coralville. References: 1) Johnson KA, Strom DE. Tibialis Posterior Tendon Dysfunction. Clin Orthop 1989;239:196-206.

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May 2012 — Iowa City — Healthy Cells Magazine — Page 19


planning & care

Dealing with Back Pain

In the Garden U

p to 80% of American adults complain of acute back pain at some time in their lives, but for 5-10% of the population the pain is chronic and severe. For workers under 45 years old, back injuries are the most common cause of disability. Construction workers, nurses, and machine operators are at especially high risk for lower back injury. Herniated disks, osteoarthritis, compression fractures, and spinal deformities are among the most common causes of chronic back pain. Although bending, lifting and twisting are movements which often exacerbate the problem, gardeners with “bad backs” do not have to pack away their watering cans and trowels. Bring the Plants to You By raising your workspace from ground level to waist-high, you will drastically reduce the amount of bending required to care for your plants. This will help alleviate any stress to chronic back pain sufferers. Consider building a raised bed on stilts or on a table.

Most plants can thrive with only 6-8” of a good soil mix, but root vegetables may require more depth. When designing your raised bed, remember that the deeper the soil level, the heavier the bed will be. Make sure that your bed is supported and provide adequate drainage. Sufferers of chronic back pain will not be able to crawl into the bed. Do not make your bed too large, or you will not be able to reach the middle – a general rule of thumb is that no part of your waist-high garden should be more than two feet away from an open side. Because they are off the ground, tabletop gardens will dry out more quickly than their traditional counterparts. Be prepared to water more often, as much as twice a day during dry spells. It is difficult, though not impossible, to over water an above ground garden. This high water throughput tends to leach out valuable growth minerals. Raised gardens may need more fertilization to thrive, so keep a careful eye on your plants to determine if supplemental treatments are needed throughout the growing season. If the idea of a large, tabletop bed does not appeal to you, consider a bank of containers. Pots are available in a large variety of sizes and styles to accommodate nearly any plant and décor. By arranging your container garden on a shelf, railing or table, you will not need to bend as much to care for your plants or harvest your crops. Like above ground beds, container gardens will need good drainage and frequent watering. Good Choices for Bad Backs If your taste or budget requires a ground-level garden, consider choosing plants that will make your job easier. Delicate microgreens that require constant harvesting are tasty, but a firm head lettuce that only needs to be picked once will require less bending. Compact mounds of low-growing annuals will be harder to keep tidy and attractive than a flowering vine growing up a trellis. How you grow garden favorites can also affect the impact on your back. Instead of letting tomatoes, melons, beans and cucumbers spread across the ground, install a length of sturdy fencing and train the vines to grow upwards. Not only will your crops be more visible and less likely to blight, but you will save yourself the pain of bending and crawling at harvest time. Appropriately sized tools can also keep you gardening despite chronic back pain. Choose a hoe, cultivator and rake that you can comfortably maneuver without bending. Plastic extenders are available to help you reach your work while keeping a straight back. With planning and care, chronic back pain does not have to keep you from gardening. Remember your back when you layout your garden, choose plants and purchase tools this year. For more information visit www.Garden-Fountains.com, a place for all your garden décor needs.

Page 20 — Healthy Cells Magazine — Iowa City — ­ May 2012


healthy homes

4

Overlooked Spots To Spring Clean

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s your spring cleaning routine sufficient? Or do you suspect dirt may be lurking in places you’ve never even put on your to-do list? If you’re like most Americans, chances are you forgot some of these often overlooked spots while spring cleaning: In the Kitchen Most people hit the stove, fridge and the microwave. But there are more places in the kitchen needing your attention. All cupboards and pantries should be cleared and re-stocked at least once yearly to dispose of expired food and guard against insects and rodents. Also make sure you clean your can opener! This often used, rarely cleaned tool can be a trap for bacteria and spores. Use Q-Tips and soapy water to wipe down every nook and cranny, including the gears. In the Laundry Room Have you noticed an unusual funk coming from your washing machine? This may be because the new, high-efficiency washers use less water than traditional ones, causing residue buildup from dirty clothes, detergent and hard water minerals. If so, it’s time to clean your machine. Something as simple as Tide’s Washing Machine Cleaner, which comes in a small packet you drop into a normal cycle without clothes, can keep your machine smelling fresh. Once you’ve got your washing machine clean, next focus on what you put in it. With spring and summer whites sure to be washed this time of year, consider switching to a detergent with both stain fighting and whitening power, such as Tide plus Bleach Powder. And look for a new

concentrated version, which not only gives you the same cleaning with 1/3 less detergent, but helps save you space and helps save the planet by reducing packaging. In the Bedroom Spring cleaning usually involves a change of bedding, but how about those decorative pillows or stuffed animals in children’s rooms? Because of their soft, uneven surfaces, they’re prime locations for dust and allergens. Sticking them in plastic bags and then in the freezer for four hours will kill dust mites. Then use a vacuum to suck up dead carcasses. You should also pay attention to ceiling fans, crown moldings and even the walls. It’s best to use a damp cloth to wipe down all surfaces. Dry feather dusters tend to kick up dust and allergens, which settle back down in the same place. In the Living Room Window treatments and lampshades attract dust and germs as much as any other home surface, but are easily cleaned using removable vacuum attachments, such as a combo brush or crevice tool extension. And don’t skip floor vents, door jams, and window sills. These areas are often overlooked and can collect years of grime. Of course, regular cleaning is the best way to minimize your spring cleaning. To find products that can help make cleaning less of a chore, visit www.tide.com. Then get to it! After all, a clean home is a happy home. May 2012 — Iowa City — Healthy Cells Magazine — Page 21


advanced treatment

Cheering for Success at Genesis Pediatric Therapy By Genesis Pediatric Therapy Center

Scooting down the hallway on a scooter board at Genesis Physical Therapy is part of the therapy for Lynsey Stevenson (left) and Madi Ramirez (right). Physical therapist Katie Snyder is helping them with balance and leg strength skills they need as members of the Integrated Cheer Experience, an initiative of Eastern Iowa All-Stars Cheerleading.

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ix-year-olds Madi Ramirez and Lynsey Stevenson have new motivation to jump in the heated therapeutic pool and build their balance and leg strength during therapy sessions at Genesis Pediatric Therapy. They’re cheerleaders. They have pom-poms to wave, letters to spell with their arms, and human pyramids to top. Despite their physical disabilities, Madi and Lynsey are among several Genesis Pediatric Therapy patients who are part of Integrated Cheer Experience, or ICE. In its first year, the program pairs students who have cognitive and physical disabilities with competitive cheerleaders from Eastern Iowa All-Stars Cheerleading. With the help of their older partners, Page 22 — Healthy Cells Magazine — Iowa City — ­ May 2012

girls with special needs participate in feats they never expected they could do. Genesis Pediatric Therapy Center is a team sponsor. Recently, the ICE team cheered during half-time of the Harlem Globetrotters game at the i wireless Center in Moline. This Saturday, they will cheer in a competition at Pleasant Valley High School. The experience has been a confidence-builder for Madi, who has a progressive neuromuscular disease called spinal muscular atrophy, and Lynsey, who was born with spina bifida, a birth defect that involves the incomplete development of the spinal cord or its coverings. Each is paired with an Eastern Iowa All-Stars cheerleader, who helps them accomplish moves their bodies can’t and showcase the ones they can.


When the girls aren’t at practice, Genesis physical therapist Katie Snyder guides them through physical therapy that will help them be more successful when they cheer. “Both girls work to improve their balance and lower-extremity strength,” Snyder says. “Madi can stand independently but is not able to squat. Lynsey is working on balance and would love to be able to jump. Improving their balance helps when the cheer team uses them as fliers to top a pyramid, for example.” Like the other girls Madi’s mother, Megan Ramirez of LeClaire, is a coach and coowner of Eastern Iowa All-Stars. The ICE team formed at the request of high school girls on the All-Stars’ highest competitive team. The All-Star youth plan practices, contact parents, and create routines. Cheerleading has enhanced her daughter’s life; it means a lot to Madi to be able to go to cheer practice with her two older sisters. “Madi’s mobility is limited. She can walk short distances but she also has a wheelchair,” her mother says. “When they put her in a stunt, she waves and smiles and thinks she’s a star. They help move her arms; carry her around the floor; and, move her from spot to spot. When they do jumps, they lift her up because Madi can’t jump.” Madi’s mother adds, “Every little girl wants to be a cheerleader. She gets to come and have fun and forget about her disability for a little while. No one is judging her. She smiles and has a good time.” Lynsey’s mom, Tammy Stevenson of LeClaire, recalls her daughter’s excitement at getting to perform at the Harlem Globetrotters event. “Lynsey has wanted to perform at the i wireless Center since she was 2 years old,” she says. “The fact she and

the cheer team performed at half-time was a big deal for her. She thought she was the main event.” She adds, “Lynsey talks about being the only one at school with spina bifida. When she’s with other girls with special needs, she can be herself. She doesn’t have to be self-conscious that she’s ‘the only one who can’t do it.’ “ Both mothers can’t say enough about the progress their daughters have made at Genesis Pediatric Therapy. They appreciate the center’s therapists for their hope and positive attitudes. Instead of the predicted slow decline in her condition, Megan Ramirez has seen weekly evidence that Madi’s gaining strength and mastering more. She and her husband, Tom, weren’t given much hope when they learned Madi’s awkward crawl at age 2 stemmed from spinal muscle atrophy. At the time, doctors told them Madi would never walk. Lynsey has been going to the center for four years. Therapy is so much fun, “she thinks she’s going to Genesis to play,” her mother says. “She’s always wanted to jump and is thrilled to climb a footstool in the pool and jump off it. She also is working on standing on one foot at a time. It may sound trivial to anybody else, but it’s so important to her. She can’t do it on land yet, but it makes her happy to do it in the water. She’s doing things we never thought she would be able to do.” The Genesis Pediatric Therapy Center and its team specialize in programs that meet the needs of children requiring physical, occupational and speech therapies. For more information, call the Genesis Pediatric Therapy Clinic at 319-853-0596.

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May 2012 — Iowa City — Healthy Cells Magazine — Page 23


prostate health

Our Cancer Nightmare Comes True The second in a series of excerpts from “Making Love Again” By Virginia and Keith Laken The subject matter of this book is of a personal and explicit nature and may not be suitable for younger or ultra-conservative readers.

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felt guilty when I walked into Keith’s office, thinking I had let him down and not been there for him when Dr. Barrett called. But Keith was talking on his business phone. Surely, I thought, the fact that he’s back to work means he received good news! As I walked toward Keith, he handed me a piece of paper filled with handwritten notes. At the top of the page was the title “PHONE CALL WITH DR. BARRETT.” I began to read…biopsy is positive…adenocarcinoma…left lobe… probably confined…come in next week to discuss options…suggest surgery and taking of pelvic lymph nodes… Suddenly I felt faint. I fell clumsily into a chair, and was grateful to hear Keith’s voice, as if from a distance. “I’ve gotta go now. I’ll call you back later.” My stomach began to cramp. I could feel the color drain from my face. Keith reached for my hand and held it gently. His eyes reflected concern. Keith always gets upset when he sees me hurting. “How do you feel about this?” I whispered, dragging my focus back to Keith. “I’m numb,” he replied in a level tone. “I can’t take it all in.” Keith paused. “I guess I knew it all along, but when I heard the words I couldn’t believe it. I just stopped feeling.” “How could you go on?” I asked, incredulous. “Make your phone call and do business?” “What else was I supposed to do?” Keith answered quietly. “I can’t do anything to change this.” Keith asked me to be the one to call the children and my mom. I reached out to hold him, and Keith’s voice murmured in my ear: “I don’t want to talk to anyone about it right now.” Beth took the news in her typical stoic manner. “Mom,” she told me, “our family can handle anything.” Steven was equally supportive, but more outwardly emotional. Fighting back tears, he said he’d fly out to be with us anytime we needed him. The call to Mom was difficult. Hearing of Keith’s cancer, I knew, would remind Mom of her own battle with stomach cancer — a topic she tried her best to avoid discussing. It wasn’t surprising, therefore, that Mom said little more than to tell us how sorry she was. The next morning, my first waking thought was of cancer. I looked at Keith, still sleeping, his hair rumpled and his face smooth. “Cancer is eating away at Keith’s body,” I thought, horrified. At breakfast, Keith told me he felt “unclean.”

Laptop Notes. January 23, 1995 Tomorrow is my appointment at Mayo to “discuss options”. Still thinking of doing nothing, waiting to see how things develop. Prostate cancer is generally slow growing. We may have some time. Not that I want to take risks. Page 24 — Healthy Cells Magazine — Iowa City — ­ May 2012

I have a dream of sitting on a porch swing with Gin when we’re in our eighties, watching the family around us. I want Duncan to know his Grandpa, to remember that I took him fishing and flying. And Beth and Care say they’re planning a big family. I can’t miss that. But I also can’t risk this surgery.

Journal Entry, January 23, 1995 Dear God, please let Keith say yes to the operation. Let him agree to get this cancer out of his body so he can be well again… so we can have our old life back. Now that we know for sure we have to get rid of it… At our appointment with Dr. Barrett he talked about the characteristics and progression of prostate cancer, and reminded Keith of the seriousness of his condition. Of all the treatments available for prostate cancer, the urologist preferred surgery. This option, he said, offered the greatest possibility for a cure. Keith listened intently while Dr. Barrett spoke of recovery time and outcome. Only when he paused did Keith ask the questions that overshadowed all other input for him: “And what about the possibility of becoming impotent?” “That risk is low…about 30%. And you’re young. The odds are in your favor.” Keith then questioned Dr. Barrett about the nerve-sparing technique of prostate surgery, pioneered at Johns Hopkins University Hospital by Dr. Patrick Walsh. “Do you use this procedure here?” Keith asked. “I do,” the surgeon replied readily. “But you can’t assume it guarantees an escape from impotence. There are other factors besides nerve damage that can affect a man’s ability to achieve an erection, such as blood loss and arterial damage. Those causes are almost impossible to predict.” “Look Keith, if you do become impotent, don’t worry. We can easily treat it. These days we have excellent methods for creating erections. We’re using a new injectable medication that gives a man an erection just like the natural thing. So don’t be concerned.” Neither of us spoke as we left Dr. Barrett’s office and headed across the street for our next appointment. Dr. Barrett had recommended we talk to Nick, a man around Keith’s age who had survived prostate cancer thanks to the same surgery he wanted us to consider. Nick had been diagnosed with prostate cancer at the age of thirtynine, and had elected to have a prostatectomy (prostate surgery in which the prostate gland is removed). He told us it had now been seven years since his operation and, in his experience at least, it had been a blessing. He was still disease-free and doing great.


January 15, 1995 — TO ALL EMPLOYEES In an effort to dispel any rumors you may have heard recently, I would like to share some facts with you about my personal health… Should you have any questions about my schedule, projects, or condition, please stop by. I am very open about the subject and willing to explain to whatever detail you may want. Thanks for your support, Keith Laken Laptop Notes, January 28, 1995 When I sent out my memo, I didn’t expect much response. But saying I was willing to answer questions must have opened the floodgates. For two days I haven’t gotten any work done. People have been in my office constantly, some wishing me well, others with questions. The amazing thing was how many told me about their fathers, brothers, and uncles who had prostate cancer, and how worried they were about them. Some people hugged me. Some even cried. It was really embarrassing. I didn’t know people cared so much.

When Keith asked him if “doing great” meant “great in all areas,” Nick grinned coyly and nodded. “I can assure you that I function just like I did before the surgery. No problems whatsoever.” As we walked back to the Clinic, Keith unexpectedly took my hand, and, like a happy schoolboy, began swinging it back and forth. “That was really good for me to hear,” he said as we crossed the street. I looked up. Keith was grinning that wonderful half smile of his. It felt so good to be seeing that smile again! Our final appointment that day was with Dr. Phyliky. Our family doctor for over seven years, Dr. Phyliky wanted to meet with us to discuss any concerns we might still have. Dr. Phyliky began by asking Keith what he had learned from Dr. Barrett and Nick, and how he was now feeling about his situation. Keith quickly summarized the two earlier meetings, then very casually concluded: “…and I’ve made up my mind to go ahead with the surgery.” I couldn’t believe it! I wanted to leap up and smother him with kisses. To laugh. Shout for joy. Cry with relief. Dr. Phyliky nodded and smiled approvingly. “I’m very pleased that you’ve elected to have surgery. Like Dr. Barrett, I feel it gives you the greatest possibility for a cure. I must tell you that my father died with prostate cancer. Prostate cancer kills many men,” Dr. Phyliky stated soberly. “And believe me, it’s not a good way to die.”

Journal Entry, January 14, 1995 I was SO surprised when Keith said He’d decided to have the surgery…for the first time in days I feel like I can take a deep breath…. Keith’s going to have surgery! Prayers are indeed answered!

Laptop Notes, February 3, 1995 Tomorrow I go under the knife. My first operation, and I’m really nervous. I don’t like putting my life in someone else’s hands, but that’s what has to be done. Now I just want to get the whole thing over with. It was a tough decision to have this surgery, but I won’t second-guess myself. I never do.

Journal Entry, February 3, 1995 Tomorrow Keith has his surgery. God, I’m scared. I know he needs this operation, but I’m still so worried. Something could go wrong. Tonight Keith wanted to make love “for old-times sake,” but I just went through the motions. I couldn’t concentrate. I really don’t know how Keith can do it. How can he have a climax at a time like this??? Keith’s been so concerned about being impotent, I’m sure that’s why he wanted to make love tonight. But I just couldn’t get into it. It’s not important to me that we have sex. I don’t care about that. I JUST WANT KEITH TO LIVE.

Next month: Keith Goes Under the Knife

The book Making Love Again: Hope for Couples Facing Loss of Sexual Intimacy is available at Amazon.com and many major book sellers. You may contact the Lakens at KLAKEN@aol.com

May 2012 — Iowa City — Healthy Cells Magazine — Page 25


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Page 26 — Healthy Cells Magazine — Iowa City — ­ May 2012


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