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CONNECT On the cover

Dr. Loyal Stierlen and patient Dan Towers with a da Vinci surgical robot. Photo: Paul Gates

Contents FALL 2014

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Ask the Doctor

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Look Closer

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Image Makeover

10 12 About this publication Health Connect is published three times a year for residents of central Iowa by Mary Greeley Medical Center. For more information about Health Connect, please contact the Mary Greeley Medical Center Community Relations Department at 515-239-2038. 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

A psychiatrist offers tips for recognizing and dealing with depression. Also: New providers.

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A GI doctor brings new skills for cancer treatment to Mary Greeley.

New MRI provides more services and comfort for patients.

Location, Location, Location Why an expectant woman living in St. Kitts opted to deliver at Mary Greeley.

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 800-994-6610 or e-mail 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 Marty Greeley Medical Center has played a significant role in shaping your medical center. To learn

Hernia patient learns how robot-assisted surgery means less pain and faster healing.

Zach and Ian Go to the Hospital A GI doctor brings new skills for cancer treatment to Mary Greeley.

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Sister Act A fateful read leads to a life-changing decision for two families.

Men and Machines

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2014 Innovation and Excellence Winners Four are honored for their contributions to the quality of care at Mary Greeley.

Grateful Foundation program offers opportunities to recognize excellent care.

Schedule of Events and Clinics & Classes

more, contact the Mary Greeley Medical Center Foundation at 515-239-2147 or visit www.mgmc.org and click Giving to Mary Greeley Medical Center. President and CEO Brian Dieter Director of Marketing and Community Relations Steve Sullivan Editors Steve Sullivan Stephanie Marsau

Tha nk y

ou!

Medical Advisor Steven Hallberg, MD Design Scott Thornton, www.designgrid.com Photography Bob Elbert Paul Gates Tim Hoekstra Rick Stowell Video Producton Jason Mortvedt

HEALTH CONNECT | Fall 2014 | www.mgmc.org


PRESIDENT’S WELCOME

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ave you seen our CyclONE City statue yet? It’s one of 29 that have been placed around town as part of an Ames Chamber of Commerce Leadership Ames community project. (Mary Greeley is a Leadership Ames sponsor.) Iowa State’s legendary mascot inspired this colorful collection of statues. Our statue, on the corner of Duff Avenue and 11th Street, was sponsored by the medical center and McFarland Clinic. It’s called “Anatomy of a Cyclone.” One half looks like the Cy we all know and love, while the other provides an inside view of the character –

Mary Greeley and Iowa State have a strong and long-standing relationship, which is why we were thrilled to sponsor [David Cheney’s] design. literally. It exposes his impressive muscular structure. The eye-catching Cy was created by David Cheney, an Ames native who earned a degree in biological and premedical illustration from Iowa State. Mary Greeley and Iowa State have a strong and long-standing relationship, which is why we were thrilled to sponsor David’s design. In this issue of Health Connect, for example, you can read about some recent Iowa State graduates who have become

By Brian Dieter, Mary Greeley President and CEO

familiar faces around here thanks to the talents they are contributing to our continuous improvement efforts. They started working with the hospital while still students and have now launched their own consulting business. But the ISU-Mary Greeley relationship is demonstrated in many others ways: • Mary Greeley now offers EpicCare Link, which will provide Iowa State’s student health center medical staff with secure access to Epic electronic health records for students to whom they provide care. • During the football season, Iowa State Cyclone football players visit our patients on the Friday of home game weekends. To get a sense of the excitement these visits generate, just look at the photos posted on Mary Greeley’s Facebook page. • We sponsor the Cyclone Medical Minute, which features McFarland orthopedic surgeons Dr. Bryan Warme, Dr. Peter Buck and Dr. Thomas Greenwald offering expert insights on orthopedic care during Cyclone football and basketball games. These three surgeons also provide care for Cyclone athletes. • At Iowa State events, including football and basketball games, you’ll see Mary Greeley paramedics on hand ready to respond to emergency needs. Yes, there are staff members at Mary

Greeley who cheer on that team to the east, but deep down, we are Cardinal and Gold and proud of it. “Anatomy of a Cyclone” and all the other CyclONE City statues will be on display throughout Ames through November. Be sure to check them out. Mary Greeley President Brian Dieter with “Anatomy of a Cyclone.”

PHOTO: RICK STOWELL

A Special Relationship

Thank you to our sponsors Sustaining Sponsors Ames Tribune McFarland Clinic PC 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 Danfoss JE Dunn Construction Kinzler Companies MB Financial Party Time Special Events

Caretaker Sponsors Jester Insurance Services REG Renewable Energy Group Wells Fargo Sponsors Adams Funeral Home Alfred’s Carpet & Decorating, Inc. Alpha Copies & Print Centers Ames Ford Lincoln Bankers Trust Celebrations Party & Rental Store Dentistry at Somerset, Jason Niegsch, DDS, FAGD Deb & Bill Fennelly Gateway Insurance Services Heuss Printing

www.mgmc.org | Fall 2014 | HEALTH CONNECT

Integrity Construction Services Iowa State University, Division of Student Affairs Knapp Tedesco Insurance Kreg Tool Company Mittera Group Nyemaster Goode, PC Karen & Bob Shirk Sign Pro Storey Kenworthy US Bank VisionBank George & Mary Wandling Wolfe Eye Clinic

Grand Rounds Lifesaver Sponsors First American Bank Great Western Bank Mileage Club Lifesaver Sponsor REG Renewable Energy Group Mileage Club Pacemaker Sponsor Iowa Subway Development

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the Doctor: Depression

It is estimated that 1 in 10 adults in the United States suffer from major depression, making it one of the country’s most common mental disorders. In fact, according to the Centers for Disease Control, major depression is the leading cause of disability for Americans between

Q

Is there a certain demographic that seems to be more prone to depression than others?

Women are almost twice as likely to be diagnosed with depression as men. Other risk factors for developing depression include being divorced/separated/widowed, being middle-aged, having a lower socioeconomic status and having certain chronic medical conditions. The lifetime prevalence of developing major depressive disorder is approximately 17% in the United States.

Q

It seems as though some people have issues believing that depression is an actual illness. Medically speaking, what allows it to be classified as such?

Part of the human experience is to have varying emotions, both ups and downs. Those downs cross the line into depression when the symptoms are persistently present for two weeks or longer with other associated changes. These other changes can include loss of interest in prior activities, changes in sleep, appetite, and energy, guilt, moving and thinking more slowly, poor concentration, hopelessness and thoughts about ending one’s life.

Q

What should someone who is depressed do to get better? Or if they don’t recognize it, how can other people in their lives help them?

There are many different variations of depression, so to simplify, we will focus on major depressive disorder. There are actual changes that occur in the brain and body with depression. Major depressive disorder has been associated with changes in a person’s endocrine system, brain anatomy and physiology. There is also a strong genetic link. Thus, many people with depression have first-degree relatives with depression as well.

Major depressive disorder can be treated with antidepressant medications, psychotherapy, or a combination of the two. Primary care providers can often treat depression effectively; however, seeking out more specialized services of a psychiatrist or other mental health professional may be necessary for more complicated cases. Living a healthy lifestyle with a well-balanced diet, exercise, adequate stress relief and strong support systems are also very important in attaining and maintaining a normal mood.

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What are some indicators that someone has crossed the line from being in a funk to suffering from depression?

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the ages of 15 and 44. So how can we tell the difference between depression and just being a little blue? And how does seasonal affective disorder fit in? We asked Dr. Kacey Strosahl, a psychiatrist on Mary Greeley’s Behavioral Health Unit, to help us sort through it.

With winter quickly approaching, let’s talk about seasonal affective disorder (SAD). Is that a form of depression?

Seasonal affective disorder used to be an independent diagnosis, but recent updates to the classification of mental illnesses has changed it to a specific form of major depressive disorder – major depressive disorder with seasonal pattern.

Q

Everyone seems a little bit more lethargic and a little less enthusiastic during the winter months. What would indicate that it’s major depressive disorder with seasonal pattern at work?

To be diagnosed with seasonal depression, the symptoms must be demonstrated during the same season (usually late fall/winter) for two consecutive years. There also must be a period between those same seasons where the person’s mood is normal (usually spring/summer). The severity of the symptoms can also be an indicator. The further from the Equator a person lives, the more prevalent major depressive disorder with seasonal pattern is likely to be. Therefore, many Iowans have at least some symptoms by late winter. We all would like to stay in our warm cozy beds certain days in those cold February mornings; however, the winter blues become of medical concern when they start to affect a person’s functioning. If a person’s mood and associated symptoms are impairing his/her ability to perform his/her work or personal functions, it may be time to seek the advice of a medical professional.

HEALTH CONNECT | Fall 2014 | www.mgmc.org


NEW Faces Taylor Drake, DO

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How is it treated and if a person has it one winter, will they have it every winter thereafter?

Most likely the person will continue to have repeat episodes if he/she has had the disorder several consecutive years; however, the severity may vary from year to year. If a person is diagnosed with the illness and feels that the severity warrants treatment, there are several options. One of the most effective for the winter variety is actually bright light therapy. This is exposure to a specific light for 30 to 60 minutes each morning. This helps to reset the internal clock and basically provides artificial sunlight. Antidepressant medications may also be used if the depression is severe enough or if bright light therapy is ineffective. Dr. Kacey Strosahl is a psychiatrist who works with Mary Greeley’s Behavioral Health Unit.

Taylor Drake, DO, joined the McFarland Clinic Pediatric Department in Ames in August. Dr. Drake received her Doctorate of Osteopathic Medicine from Des Moines University and completed her Pediatric Residency and Blank Children’s Hospital. For more information, contact the Ames Pediatric Department at 515-239-4404.

Stephanie Donnelly, DO Stephanie Donnelly, DO, joined the McFarland Clinic Anesthesiology Department in September. Dr. Donnelly completed her Anesthesiology Residency at Mayo School of Graduate Medical Education in Rochester, Minn. She received her Doctorate of Osteopathic Medicine from Kansas City University of Medicine and Biosciences College in Kansas City. For more information, contact the McFarland Clinic Anesthesiology Department at 515-239-2182.

Timothy Hansen, MD Timothy Hansen, MD, joined the Mohs Surgery Department in August. Dr. Hansen graduated from the Indiana University School of Medicine in Indianapolis, Ind. He then completed a Dermatology Residency at Penn State Milton S. Hershey Medical Center in Hershey, Penn. followed by a Mohs Surgical Fellowship at MD Anderson Cancer Center in Houston, Texas. For more information, contact the Dermatology/Mohs Surgery Department at 515-239-4492.

PHOTO: RICK STOWELL

Meera Gangam, MD

www.mgmc.org | Fall 2014 | HEALTH CONNECT

Meera Gangam, MD joined the McFarland Clinic Rheumatology Department in September. Dr. Gangam completed her Rheumatology Fellowship and Internal Medicine Residency at Louisiana State University Health Science Center in Shreveport. She received her Medical Degree from Gandhi Medical College in Hyderabad, India. For more information, contact the McFarland Clinic Rheumatology Department at 515-239-4775.

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n emerging technology called endoscopic ultrasonography (EUS), is providing physicians at Mary Greeley a more detailed look at gastrointestinal cancers, cysts and lesions. Dr. Jeremy Fields, a McFarland Clinic gastroenterologist, has special training in the use of the technology and says when it comes to identifying and staging cancers of the esophagus, rectum and pancreas, this level of detail is invaluable. “Cancer staging is much more accurate with the high resolution offered by this technology,” Fields says. “We can evaluate how deep a tumor invades prior to cancer treatment to increase the likelihood of cure, while minimizing unnecessary side effects.” Cancer staging refers to the process of determining the progress of a patient’s cancer diagnosis. An easy way to think about it is with the acronym TNM:

PHOTO: BOB ELBERT

Treatment Plan

EUS in primarily used for the staging of cancers affecting the gastrointestinal tract. Accurate staging allows oncologists, surgeons, other specialty physicians and the care team to develop an appropriate plan of action for treating the cancer. In addition, EUS can be used to gather

high-quality images of non-cancerous cysts and lesions in the esophagus, stomach, rectum and pancreas. In some cases, it can be used to study other nearby organs including the lungs, liver and gall bladder. During the exam, Fields uses a thin, flexible tube called an endoscope – similar to that used in traditional colonoscopy and endoscopy procedures – with a small, built-in ultrasound probe. The endoscope is passed through the mouth or anus to the area being examined. Fields then uses the ultrasound to create sound waves that provide high resolution images of the area. “Because the ultrasound is on the tip of the scope, it can be guided very close to the area we want to examine,” Fields says. “With ultrasound, the closer the probe is to the area you are examining, the better the images you can gather. “This technology also allows us to obtain needle biopsies of lesions or lymph nodes that are deep in the body.”

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McFarland Clinic gastroen terologist Dr. Jeremy Fields with one of the tools of his specialized trade.

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T for tumor size; N for whether or not the lymph nodes are affected; and M for whether the cancer is metastatic. Staging helps physicians plan for appropriate cancer treatment, as well as predict a patient’s prognosis.

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Endoscopic ultrasonography enhances cancer treatment at Mary Greeley

HEALTH CONNECT | Fall 2014 | www.mgmc.org


In the case of a biopsy, analysis can be provided in real-time. “We have an excellent team of welltrained pathologists who provide immediate in-room evaluation of biopsy specimens,” Fields says. “This increases the yield of diagnostic specimens while decreasing the risk of complications.” Minimally Invasive

While EUS is invasive – meaning the endoscope has to go inside the body to obtain images, unlike traditional ultrasound, CT scans or MRI – Fields says risks and side effects are minimal. “Complications are always a concern but fortunately are rare,” he says. “This is a technology that has been used routinely for years now.” The procedure is most often performed on an outpatient basis, and requires similar preparation and feels much the same as a conventional GI tract exam. It typical-

ly takes a bit longer than a colonoscopy or upper endoscopy, and the patient is usually discharged after an hour or so in the recovery room. Fields says it is of great benefit to patients to have this technology available in Ames. “It is more convenient for patients and their families to have services like EUS closer to home,” he says. “In the past, patients would have to drive long distances to get this type of test.”

New Manometry Technology Helps Patients with Swallowing and other GI Issues Mary Greeley Medical Center further expanded the scope of its gastrointestinal diagnostic capability with the addition of high resolution manometry which is used to diagnose the significance of swallowing and defecation disorders. While the technology has been around for decades, high resolution manometry is just emerging. “It offers us more information and makes the test much faster and easier for patients,” says Dr. Jeremy Fields. “The new equipment has many more sensors and the software does a much better job of providing graphic analysis. This allows us to diagnose problems quicker and more precisely.” Esophageal and anorectal manometry use a similar short, slim catheter with pressure sensors along it. In the esophageal test, which measures swallowing function, the catheter is inserted into the nose, down through the esophagus and into the stomach. The patient then sips water and the device measures the strength of the muscles of the esophagus as the water is swallowed. In the anorectal test, which measures for muscle factors triggering fecal incontinence or chronic constipation, the catheter has a small balloon on the end and is inserted through the anus and into the rectum. The patient, lying on his or her left side, performs squeezing maneuvers and then tries to push the catheter out. The device measures the strength of the muscles. The graphic analysis allows the care team to develop a comprehensive care plan. “With this technology, we can now serve patients locally who were having to go to larger medical centers and spending hours on the road for diagnosis and therapy,” says Fields.

OK CLOSER BY ANDREW ZALASKY

www.mgmc.org | Fall 2014 | HEALTH CONNECT

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Registered radiation technologist Rachel Burnside, RT(R)(CT)(MR), assists a patient being examined on Mary Greeley’s new advanced MRI.


image makeover

Mary Greeley’s new MRI expands services while significantly improving patient comfort. By Deb Gibson

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PHOTO: BOB ELBERT

ancy Manke is a retired nurse so she knows how vital an MRI is to patient care. But that doesn’t mean she actually likes the thing. The Nevada woman, like many people, has trouble with confined spaces, which is why she’s very happy about Mary Greeley’s new MRI. A recent MRI on her spine and hips left her far less stressed than previous such tests. “I actually thought the whole experience was wonderful,” she said. “I was   


PHOTOS: BOB ELBERT, STEVE SULLIVAN

The magnet for Mary Greeley’s new MRI is hoisted by a crane and then lowered into the MRI room through a removal section of the roof.

Registered radiation technologist Amanda Akers, RT(R), looks over images provided by the new MRI.

placed in the MRI feet first, and there was plenty of clearance above my head. I had earplugs, even though this machine is much quieter, and I was very comfortable for the 45 minutes I was there. Before this, I’d always have to go to an open MRI because I have claustrophobia.” Sliding into an MRI (magnetic resonance imaging) machine can trigger anxiety in the calmest of patients. Though the equipment can capture minutely detailed information regarding our body’s organs through a magnetic field, its ambiance can leave a bit to be desired. So when Mary Greeley Medical Center purchased a new MRI machine earlier this year, radiology department leaders and medical staff saw an opportunity to ensure greater patient comfort. The new equipment’s opening, or “bore,” is significantly wider than its predecessor 8

and shorter in length. The loud banging noise typical of MRI machines is quieted to a more tolerable level. The wider table allows the machine to accommodate larger patients, up to 500 pounds. And the new apparatus allows patients to enter the machine either head first or feet first. Increased Capability While an open MRI, which doesn’t have the circular bore, may calm patients, its image quality is far less compared to a closed MRI. And in the case of the Mary Greeley’s new MRI, its laser-like precision is a huge selling point. For instance, because of the MRI’s increased resolution capabilities, technologists now capture significantly sharper images, especially in the areas of the brain, bone, joints, abdomen and breast. “The magnet’s design is by far greater

than before,” said Scott Cue, MBA, BS, RT(R)MR, clinical supervisor in Radiology. “That means we can now image with greater detail. That results in better image quality and the opportunity to find things sooner.” With the new MRI, Mary Greeley now offers enterography, which provides high quality views of the small intestine and all the loops of the small bowel. This means that disorders like Crohn’s disease and ulcerative colitis are now visible without the need for radiation. Previous small bowel studies required a patient to drink up to four cups of a liquid containing barium, then wait several hours for the liquid to work through the digestive system. X-rays were used to track the barium. Mary Greeley’s MRI has improved this exam by shortening the testing time and reducing the amount of radiation, in most cases to zero.

HEALTH CONNECT | Fall 2014 | www.mgmc.org


Perfect Combination New MRI and risk calculator tool benefit breast cancer treatment. While Mary Greeley’s new MRI machine offers high-quality breast imaging capabilities, not all patients who may need the tests have convinced their insurers to cover them. Thanks to a Mary Greeley team, that is beginning to change. When Sarah Heikens, RN, MSN, OCN, director of Oncology Services, attended a conference in late 2013, she learned more about established breast cancer risk assessment tools, including one that calculates the Gail Score. (To take the test, go to www.cancer.gov/bcrisktool/) Patients who score higher than 20 may be candidates for an insurance-covered breast MRI. Upon her return, Heikens turned over her information to Scott Cue, clinical supervisor in Radiology, and Melissa Kacmarsky, MBA, BS, RT(T), clinical supervisor in Radiation Oncology. The trio initiated the use of the Gail Score tool for every patient undergoing a mammogram at Mary Greeley and McFarland Clinic – and one of the first to qualify for the breast-imaging MRI was co-worker Melissa Peterson, an oncology clinical resource nurse. “My maternal grandmother was diagnosed with breast cancer at 40 and died at 47,” Peterson says. “In February, my sister was diagnosed with breast cancer for the second time and had a double mastectomy. Those two factors led to my Gail Score of 38.6, which is my lifetime risk of having the disease.”

Likewise, patients now undergoing abdominal MRIs benefit from the machine’s enhanced software. In the past, patients were expected to hold their breath for long periods of time during these tests. That requirement has been cut in half. According to Cue, patients needing breast imaging are more comfortable with the new, softer positioning devices, along with more options for comfortable arm positions. Technologists and radiologists are working side by side to perform MRI-guided breast biopsies with more precision than ever before. For the first time, the hospital’s MRI can detect and diagnose prostate tumors with greater detail, and are able to assist in prostate radiation treatment planning. Craig Mack, director of Radiology Services, sees this new technology as a great enhancement to the medical care

Peterson’s subsequent mammogram showed a suspicious area, and an ultrasound was inconclusive. Fortunately, the MRI uncovered only scar tissue from previous lumpectomies. But because of those risk assessment results, Peterson is now assigned to an oncologist, and will alternate between receiving a breast ultrasound or an MRI every six months for the rest of her life. In her role as a patient educator, Peterson shares her personal experiences to tout both the importance of annual mammograms and the sophisticated MRI technologies available to Mary Greeley breast cancer patients. “This program will save lives,” she says with conviction. Oncology clinical resource nurse li P i i i i

of people throughout central Iowa. “Our new 1.5T MRI scanner allows us to offer a wider variety of exams to patients,” Mack said. “We can image from the head to the feet and everything in between. This is necessary for the best patient care, whether it is inpatient or outpatient.” More Precision The MRI’s ability to work in tight spaces benefits patients needing muscular skeletal detective work. For instance, McFarland Clinic orthopedic surgeon Dr. Bryan Warme looks to the MRI machine to provide much more comprehensive images of hip joints before he determines if a patient requires surgery. In another first, the hospital’s MRI technologists can perform angiography, tests that look inside the body’s arteries and veins without the use of contrast,

www.mgmc.org | Fall 2014 | HEALTH CONNECT

eliminating the need for IVs. The new MRI replaces a 15-year old model, Cue said, with both the old and the new transported by crane through a skylight in the hospital’s roof. The room housing the MRI also was modified to accommodate the new equipment. As much as Cue revels in all the new diagnostic opportunities the machine provides, he is most pleased with the heightened comfort options he can offer the hospital’s MRI patients. “We’re seeing a great reduction in patient anxiety, as well as flexibility in the size of patients we can treat,” he said. “This allows us to be more geared toward patient care. We’re trying hard to take the ‘scary’ out of the MRI.” MRI appointments are available from the same day up to three days from the request, Cue said, and can be made by calling 515-239-2131.

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Sister Act A Health Connect story gives birth to an amazing offer.

By Stephanie Marsau

PHOTOS: BOB ELBERT

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Sisters Jen Sisson (right) and Stephanie Seelow (left) smile at Stephanie’s daughter Posey. Jen served as a surrogate for her sister after Stephanie and her husband had problems conceiving.

en and Adam Sisson welcomed their first child, a son named Rowan, in September 2012 at Mary Greeley Medical Center. It was a moment met with great joy and, for Jen, a bit of sorrow. “I was feeling amazed and overwhelmed by what a miraculous gift our son was,” recalls Jen. “But at the same I was sad because my sister, Stephanie, and her husband, Jason, were going through so much, attempting to conceive a child, but with no luck.” Shortly after returning home with Rowan, Jen picked up a copy of Mary Greeley’s magazine, Health Connect. A friend of hers was on the cover of that Fall 2012 issue. The cover story was about robot-assisted surgery at Mary

Greeley, but it was another story that changed Jen and her sister’s lives. Inspirational Reading

A story entitled “Special Delivery” told of an area woman named Staci Mason who had been the gestational carrier for the daughter of a family friend. (See sidebar.) “It really resonated with me because of what our family was experiencing,” says Jen. “At the time, Stephanie and Jason were going through fertility treatments and we were all hopeful those would work. I just kept the idea tucked away and didn’t mention it to anyone, except my husband who was totally supportive.” In late 2012, Stephanie and Jason decided to discontinue fertility treatments.

“We had been trying to conceive for about 2½ years,” Stephanie recalls. “Thankfully, Dr. (Lynne) DeSotel, my doctor at McFarland Clinic in Marshalltown, was proactive in making sure everything was on track when we told her we were trying to conceive. Because of that we knew right away we would have obstacles. But after multiple failed attempts, we felt the chances of conceiving weren’t good and the medical expenses just kept piling up.” It was then that Stephanie’s younger sister, Jen, stepped in and dropped her bombshell. “I offered me carrying their baby as an option,” says Jen. “She was happy and grateful, but also cautious because of all the disappointment and loss they had

HEALTH CONNECT | Fall 2014 | www.mgmc.org


Baby Book

Gestational carrier te

lls the story of her un

Staci Mason was featured in a Fall 2012 Health Conn ect story, “Special Delivery,” which chronicled the jou rney she went through as a gestational carrier for Ian and Jamie Wolds. The Wo lds are a California couple wi Staci Mason th Iowa ties who could not ha ve children due to Jamie’s ute rine cancer. In July 2012, Staci delivered the couple’s healthy twins – Hannah and Carson. Sh e has now written a book about the experience. Q: Let’s start with the boo k, Helping Jamie. What ma de you want to write it? A: The story I was a part of was extremely unique, and I des ired to raise awareness among peo ple who had suffered through infe rtility. Even for some people who have gone through a trau ma tic health crisis like Jamie, having biological children could still be a possibility. Reality televisi on shows seem to be so pop ular and our society is fascinated by the lives of complete stra nge rs. I wanted to provide an opportu nity, much like the reality sho ws do, for someone to get wrappe d up in the emotions of a rea l life story that is positive, full of joy, full of frustrations - happy one moment, sad the next.  Our sto ry has a happy ending, though there was heartache along the way. It's real life.

experienced up to that point.” “We were hopeful, but we had just experienced a failed in vitro fertilization (IVF) and it became very real to us that we might never have children,” says Stephanie. “IVF is a complete gamble and extremely expensive. We had actually talked about other options and had considered asking Jen to be a surrogate, but we just weren’t ready to ask.” A Perfect Birthday

Rowan was only a few months old at that point, so the families decided to wait a little bit to allow Jen to continue breastfeeding and heal from the C-section she’d had. Eventually the two families had to go through a number of legal, psychological and medical steps before

ique experience.

Q: Do you still keep in tou ch with Jamie and her fam ily? A: We do! We text and email and Jamie sends pictures of the twins all the time. Right afte r the babies were born we wou ld FaceTime about once a month . It was fun to see them changi ng and growing. They were, and still are, so healthy and I am gra teful for that. Jamie was able to com e back last summer and aga in this summer for a short stay . Our families were able to see each other both times. With both of us busy raising our familie s and the distance between us, see ing each other is difficult. Soc ial media certainly makes it eas y to stay connected. Q: You actually met Jen Sis son and Stephanie Seelow through a mutual friend. Ho w did it make you feel to kno w a story you were a part of helped shaped their story? A: I was overcome by how our story impacted their family. A precious baby was born becaus e Jen was brave enough to hel p her sister – just thinking about it I have to fight back tears. I will probably never fully know the ripp le effect that my and Jamie's stor y had, and I am grateful Mary Greeley did the story and allo wed us to encourage other people face d with the heartache of infertili ty. Staci’s book, Helping Jamie, can be purchased at www.h elping jamie.com and as an e-book on amazon.com.

Jen could attempt to get pregnant with Stephanie and Jason’s baby. But with those steps completed, Jen became pregnant in October 2013. “I can recall everything about the day we found out she was pregnant,” says Stephanie. “We were thrilled, but still cautious. We didn’t tell anyone outside of our parents for three months.” Jen enjoyed an uncomplicated pregnancy and on June 27, 2014, Posey Jennifer Seelow was born. Her arrival was well-timed as June 27 was Stephanie’s birthday, as well. “Everything is going great,” Stephanie says ecstatically. “I thought I had tons of experience with my nephew, but it’s very different when it’s your own child. My husband and I both say we are blessed to

www.mgmc.org | Fall 2014 | HEALTH CONNECT

have a happy, healthy and very easygoing baby!” Jen is glad she was able to help her sister, but says she feels like being a surrogate was a very uneventful thing. “Everyone says, ‘Oh, how sacrificial and kind of you,’ but it really doesn’t seem like a big deal,” she says. “My sister has always been much more generous and thoughtful than me in all the everyday kind of ways, which is so much harder to do than a nine-month, one-time act of being a surrogate. I’m just grateful God gave them a baby – that’s the miraculous part.”

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Location, location, location Tropical island or central Iowa? Guess where this new mom decided to deliver her first child?

Landon

By Stephanie Marsau

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he suspected the baby might come early. Early deliveries run in her family. So the big question for Alicia Gifford was where to be when the big moment came: the Caribbean island where she and her husband, Austin, were living; Arizona, where she had family; or Iowa, where the Giffords would soon be moving. It was an important decision, and in the end, Alicia knew she’d made the right one. From St. Kitts to Ames

Alicia and Austin, both from Arizona and married for eight years, moved to St. Kitts in 2012 so Austin could attend veterinary school at Ross University. Just over a year later, in November 2013, Alicia discovered she was pregnant. In May 2014, the couple received news that Austin had been placed at Iowa State University for his clinical year in veterinary medicine. The problem was that

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James G

ifford

ARRIV AL

Ames, I o St. Kitts wa via , Caribb ean

Alicia’s due date was July 18, and Austin couldn’t be in Ames until August. “My mom had delivered early with both of my sisters, and my younger sister had just delivered my nephew at 27 weeks on May 1. I knew there was a strong possibility of me delivering early, so I immediately started looking into the area and the hospital,” says Alicia. “I knew I didn’t want to deliver in St. Kitts, but I wasn’t sure if I should have the baby in Arizona with all my family and then move in August with a one-month old baby, or move to Iowa while 34 weeks pregnant so I could get settled before the baby came, but deliver alone. The more I researched, the more confident I felt about moving to Ames and delivering at Mary Greeley.” Alicia left St. Kitts at the end of May, stayed in Arizona for a couple weeks to see family and drove to Iowa in early June with her mom and uncle.

“My mom watched a video on how to deliver a baby in the car, and we brought a ‘delivery kit’ on our three-day drive to Ames, just in case. Luckily, we didn’t need it,” Alicia recalls. After getting settled, Alicia decided to attend Moms In Motion, a water exercise class offered by Mary Greeley Rehab & Wellness for women before and after pregnancy. “I had already attended a breastfeeding class and gone on a hospital tour and was very impressed with both,” Gifford remembers. “I wanted to try the Moms In Motion class to meet other expecting moms and also to get some exercise and relief. I had just left an island after all and was missing being in the water!” With Alicia being a new class participant, Lyn Robinson, physical therapy assistant and Moms In Motion instructor, had everyone go around and introduce themselves. “The moms couldn’t believe

HEALTH CONNECT | Fall 2014 | www.mgmc.org


PHOTO: BELLA BABY PHOTOGRAPHY

Austin Gifford reunites with his wife Alicia and sees his new son, Landon, for the first time in Birthways at Mary Greeley.

the courage that Alicia showed with moving away from her husband to deliver their baby,” says Robinson. “At the end of the class, several of the moms along with myself, gave Alicia contact information in case she needed anything.” Born on the Fourth

Alicia attended Ames fireworks on July 3 and later that evening her water broke. She arrived at Mary Greeley shortly after midnight on July 4. “The first nurse I had was so sweet and had such a calming presence,” she remembers. “She got me through all the contractions until I got an epidural and started pushing around 6:30 a.m.” Throughout the process, Gifford’s communi husband, Austin, had been communicating with the Birthways staff. Since it takes nearly 36 hours to get from St. Kitts to Ames, there was no way he was

going to be there for the birth of his first child. Around 9:30 a.m., Austin asked if he could FaceTime with Alicia on his iPhone when it was time to deliver. “Another nurse came in to FaceTime from my phone since at this point I was more focused on getting the baby out than anything else. I do remember Dr. Swanson helping the nurse figure out FaceTime though, while he was in the process of delivering the baby,” she says, smiling. Landon James Gifford was born at 10 a.m. on July 4. As suspected, he arrived two weeks early, but he was 20 inches long and weighed 7 pounds, 4 ounces. “As much as I thought I needed Austin to be there for the birth, when I was going through it I felt totally taken care of and I never felt alone,” says Alicia. “I felt so supported by the Birthways staff deciand am confident I made the right deci sion by delivering at Mary Greeley. The services available at the hospital were

www.mgmc.org | Fall 2014 | HEALTH CONNECT

amazing, and I am sure that breastfeeding would not have been such a success had I not met with the lactation consultants.” A Priceless Picture

Austin was finally able to see his new son when he arrived in Ames on July 5. His timing was perfect as a photographer from Bella Baby Photography was there to capture the moment. “I knew from the hospital tour they would be coming to take pictures, and they were just packing up when Aus Austin arrived, so they asked if they could stay and take pictures now that the dad was here. Naturally, we said yes,” Alicia remembers. “The pictures they took literally capture Austin’s face the first moment he met Landon. It’s such a sweet memory and was just another reminder that everything happens for a reason, and it worked out better than I could have planned on my own.”

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Greene County Conservation Director Dan Towers on the job.

PHOTO: JASON MORTVEDT

MEN AND 14

How a skilled surgeon with a robot tackled a Greene County man’s hernia.

HEALTH CONNECT | Fall 2014 | www.mgmc.org


MACHINES By

Dan Towers has vivid memories of his first hernia surgery. It was in 1984 and resulted in a six-inch scar and weeks of pain. “For the first few days I didn’t want to cough or laugh,” he recalls.

www.mgmc.org | Fall 2014 | HEALTH CONNECT

Steve Sullivan and Jason Mortvedt

Flash forward to 2014. Towers once again is facing hernia surgery but this time the outcome is much, much different. Hardly any scar. No pain. The difference? This time around, Towers, 15


›› McFarland Clinic surgeon Dr. Loyal Stierlen and his team get the robot arms in place.

PHOTOS: JASON MORTVEDT

›› Dan Towers is brought into the OR room where he will undergo robot-assisted surgery to repair a hernia.

like so many hernia sufferers, had robotassisted surgery at Mary Greeley Medical Center. Minimally Invasive

As Greene County Conservation director, Towers operates tractors to maintain conservation areas, cleans boat ramps, revs up a chain saw on occasion, and does a variety of other chores that involve heavy lifting. This is an active guy who doesn’t have time to be laid up with another hernia. “I didn’t really have any discomfort, but there was a bulge that would come out from time to time that I could pop back in,” says Towers describing the reoccurrence of his ailment. “I have a history of hernias. I had a repair in 1984 and another one in 2004 so I just assume it’s a hereditary thing, weak abdominal walls or something. It wasn’t a single incident that caused it.” A hernia is a weak spot or a hole in what’s called the fascia, which is the strong layer of connective tissue in the abdominal wall. An inguinal hernia, which Towers suffered from, is a weak spot in the groin area and is often genetic. “That weak spot gets bigger and bigger over time and stuff from inside your abdomen starts to push out that opening or weak spot. So then you get a bulge down in your groin,” explains Dr. Loyal Stierlen, a general surgeon with McFarland Clinic who did Towers’ surgery. Stierlen, an Ames native who joined 16

the McFarland staff in 2013, has been doing hernia surgeries for years. He started doing traditional open surgery repairs and then went into minimally invasive laproscopic surgery. He’s now using the da Vinci robot at Mary Greeley. “I’ve found that all along this path, the reason why I switched approaches was less pain,” Stierlen explains. “With the robotic repairs, both the anterior abdominal wall and the inguinal hernias, we’re having so much less pain than

“You can do so many different things using the robot because of the articulating or moving hands and the quality of the visualization. The instrumentation is just amazing.”

era, are inserted through the ports. The surgeon manipulates the instruments at a console that provides hi-def, 3D images from inside the patient’s body. Single-site robot-assisted surgery involves a small incision in the naval. “You can do so many different things using the robot because of the articulating or moving hands and the quality of the visualization. The instrumentation is just amazing,” says Stierlen. “You’re able to do the things you do with your hands in a normal situation, like tie knots. Except now you’re doing it, using an instrument inside the abdomen. It really increases our ability to be able to do much more complicated procedures through much smaller incisions.” no pain

– DR. LOYAL STIERLEN

we’ve seen in the past with previous approaches.” Like laproscopic surgery, robotassisted surgery is minimally invasive but patients usually experience less bleeding and pain, and a quicker healing period. Robot-assisted surgery involves three small incisions in the abdominal area. A surgeon makes the incisions and inserts ports through them incisions. Surgical instruments, including a cam-

Towers had two previous surgeries to treat hernias, both open surgeries. The hernia on the left side of his groin has reoccurred. Using the robot, Stierlen dissected away a section of colon attached to the hernia, which was causing Towers some problems. Using mesh, Stierlen was then able repair the new hernia. The robot enabled Stierlen to repair Towers’ hernia without having to cut through scar tissue from the previous surgeries, which would have caused considerable pain. “It’s such a nice repair,” Stierlen says of the procedure. “People have been extremely happy with it. I’ve had more than a few patients come back and tell me they never need any pain medication

HEALTH CONNECT | Fall 2014 | www.mgmc.org


›› Via the console, Stierlen manipulates surgical instruments to place mesh over the hernia repair area and suture the area.

›› Stierlen operates the robot via a console that provides hi-def, 3D images of the patient’s anatomy.

VIDEOS: MEET THE PATIENT AND SURGEON Meet patient Dan Towers and follow him through his hernia-repair surgery experience at Mary Greeley Medical Center, plus hear more from Dr. Loyal Stierlen, the surgeon who did the repair at www.mgmc.org/hernia.

SKILLED HANDS, STRONG TECH

Robot-assisted general surgery grows in popularity. Mary Greeley’s robot-assisted surgery program began in 2010 when the hospital acquired a da Vinci robotic surgery device. In the beginning there were a handful of gynecologists who were certified in robotic surgery. Now, there are also two urologists and four general surgeons. McFarland Clinic’s Dr. James Partridge was one of the first general surgeons in the state to be certified to perform singlesite robot-assisted surgery. Dr. Jay Swanson, a McFarland gynecologist, recently became certified to perform single-site hysterectomies. The number of robot-assisted surgeries has grown every year, particularly in the general surgery area. More than 1,000 robot-assisted surgeries have been performed at Mary Greeley. The first one was in July 2010. That year there were 53 surgeries, all gynecological. In 2011, there were 172, both gynecological and urological. In 2012, there were 282, including 31 general surgeries. In 2013, there were 250 robot-assisted surgeries performed at Mary Greeley. In the first six months of 2014, there have

been 138, with more than half being general surgeries. Hernias are a common form of robot-assisted general surgery. Surgeons at Mary Greeley have also used the daVinci robot for splenectomies, colon resections, and procedures that address reflux and hiatal hernias.

Mary Greeley Medical Center surgeons certified in robotassisted surgery: General Dr. James Partridge, McFarland Clinic Dr. Loyal Stierlen, McFarland Clinic Dr. Mark Taylor, McFarland Clinic Dr. Mark Vandenberg, McFarland Clinic Gynecology Dr. Bonnie Beer, McFarland Clinic Dr. James Downard, McFarland Clinic Dr. Ann Gessner, Doran Clinic Dr. Tim Leeds, Doran Clinic Dr. Afshin Malaki, McFarland Clinic Dr. Jay Swanson, McFarland Clinic

WATCH THE ENTIRE SURGERY We take you inside the operating room where you can watch full-length actual surgeries using the da Vinci robot at www.mgmc.org/roboticsurgery. See Dan Tower’s hernia repair surgery, as well as a single-site robot-assisted gallbladder removal surgery.

afterwards.” After the surgery, Towers looked at his three incisions, each less than an inch long, and knew he wouldn’t be experiencing the discomfort of the previous surgeries. “And I didn’t,” he says. “I never took any pain pills. There were some prescribed, but I really didn’t need them. I was very surprised. Dr. Stierlen said it would be like this. But still, I don’t believe it until I see it. But there was really was no after-effects of any kind. After two weeks, I pretty much started doing things as normal.” Well, to be honest, Towers couldn’t resist getting back to his usual routine a little bit sooner. “I don’t know if I want to tell Dr. Stierlen this, but I take care of a cemetery on the side, and there was a burial coming up,” he confesses. “I wanted to at least mow the part of the cemetery where this was, so 24 hours after the surgery, I was out there on the riding lawn mower. I took it slow and easy, but I really didn’t have any effects from that. That’s something I never would have dreamt of doing 30 years ago when I had that surgery.”

Urology Dr. Damon Dyche, McFarland Clinic Dr. Garrett Korrect, McFarland Clinic

www.mgmc.org | Fall 2014 | HEALTH CONNECT

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PHOTO: PAUL GATES

Zach and Ian go


to the hospital How Iowa State students are improving patient experiences at Mary Greeley.

P Recent Iowa State graduates Zach Clarey (left) and Ian Colpaert stand in front of a flow chart used in process improvement projects conducted at Mary Greeley.

eople traditionally come to the hospital to get better. Sometimes, though, people come to make the hospital better. Case in point: Zach Clarey and Ian Colpaert. These two recent industrial engineering graduates of Iowa State University had planned to work in manufacturing. That all changed when a class project at Mary Greeley Medical Center launched their new careers as healthcare consultants and roles with the hospital’s continuous improvement efforts. Their class project, conducted in the fall of 2013 with classmate and colleague Josh Adams, involved a time study in the Radiology department. Patient comments indicated that there was a lengthy wait time between the scan being complete and transport coming to pick them up. The students went through the same routine as the patients and realized that the length of wait time was more a case of perception than reality. “I remember sitting in the hallway looking at my watch thinking, ‘We’ve been here for at least 10 minutes,’” Clarey says. “Then I realized that we had only been here for three.”

By Stephanie Marsau

Clarey, Colpaert and Adams presented their findings to a roomful of hospital managers and supervisors. It was a potentially intimidating setting for a group of college kids, but it led to big things. CALL BUTTON CLARITY

After their presentation, the students were approached by Brian Dieter, president and CEO of Mary Greeley, who suggested they work on another project. “When Brian first approached us that morning, we didn’t even realize who he was. We just got caught up in how enthusiastic he was about the project, and it made us excited,” recalls Colpaert. “A few minutes later, I glanced at his nametag and put two and two together. I think that’s when we first realized how different the culture at Mary Greeley is than a lot of other organizations.” The student team took a look at responsiveness of hospital staff, which is a question on the HCAHPS survey. HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems), is a standardized survey that captures patient opinions and provides information on hospital quality.   


FAST LEARNERS

Rapid-improvement events transform patient experiences.

For their project, the student team became part of the environment on the Oncology floor. There they worked closely with Sue Scoles, director of Inpatient Nursing, Amanda Engnell, RN, and Dani Eaton, PCT. “The team worked long hours on the Oncology unit – side by side with our nursing staff to understand the workflow and clinical decision making of our nurses,” says Scoles. The team did patient interviews to find out what they thought about the response times. The patient surveys the team conducted indicated concerns about how long it took nurses to respond to call lights. Just as the students had learned in their first project, some of this was perception. A change in language was recommended. “The disconnect lies when a nurse says, ‘I’ll be right in.’ Some patients might think that means the nurse literally will be in within a few seconds, others might be okay if that nurse takes 10 minutes to show up,” explains Clarey. “We decided to try and have the nurses tell the patient exactly how long it would take them to come to the room. Saying you’ll be there in two minutes versus saying you’ll be right in, and then actually showing up in two minutes, builds trust with the patient and helps establish a relationship.” Clarey and Colpaert also suggested that a nurse ask a patient, “What is one thing we can always do for you so you don’t have to push your call light?” The answer is then noted on the patient’s communication board. “There are some things that can be done for a patient prior to leaving the room if the staff is aware of them,” says Colpaert. “By adding a spot to the existing communication boards on the Oncology floor for a patient priority, staff entering the room can now see what this priority is and can take 20

care of it, eliminating the need for the patient to push the call button.” A NEW VENTURE

Last spring, Clarey, Colpaert and Adams were talking about their hospital projects and a question arose among them: “Do you think we could start a business doing this?” Two days after graduation, they created their consulting company, O3 X (www.o3xculture.com). Not long after that, Mary Greeley signed on with the company. “The team’s successes validate the experiential learning within our two required industry project courses,” says Dave Sly, professor of practice with Iowa State’s Industrial and Manufacturing Systems Engineering program. “During the past spring semester, our 36 students generated over $1.4 million in client-stated impact. The fact that Zach, Ian and Josh started their own company is icing on the cake.” The trio gives Karen Kiel Rosser, vice president and quality improvement officer at Mary Greeley, credit for their success. “Zach, Ian and Josh definitely bring a new set of eyes to our ongoing organizational learning,” says Kiel Rosser. “Their ideas are well thought out, and they embrace the philosophy of engaging those closest to the work to come up with solutions to make the work processes truly patient centered.” The young business owners have big expectations for the future, including developing a process that would eliminate the need for a call button unless of a patient emergency. “We want to take critical access hospitals to the elite level and help elite hospitals become even more elite,” says Colpaert. “We are 100 percent positive we can do that.”

Several times a year, Mary Greeley Medical Center takes on rapid improvement events aimed at enhancing patient care. These intensive, three-day projects involve teams of employees from clinical and nonclinical departments that come together to make improvements to a specific process. “These rapidimprovement events involve employees from all areas of the hospital because we recognize that those who do the work are the ones who have the knowledge to improve it,” says Ron Smith, performance improvement coordinator. “These events also help to educate our staff, which is why we have a sampling of both clinical and non-clinical employees. They learn from each other and end up having conversations about how they can help one another.” Past events have included developing more efficient operating room schedules, improving response to patient dietary orders, and improving patient satisfaction in the Emergency Department. The process involves several steps: • Voice of the customer: Determining customer needs through patient survey responses and patient interviews. • Current state: Understanding how the process currently under study is operating, and determining inefficiencies and indentifying opportunities for improvement. • Standard work: Creating new steps in the process or modifying current steps with the goal of reducing variation and ensuring more consistency in respect to safety, quality and service. “Implementation is always the hardest part, but these teams really buy into implementing their solution because they helped create it,” says Smith.

HEALTH CONNECT | Fall 2014 | www.mgmc.org


PAGING DR. ARBULU

A frequent collaborator is named this year’s winner of the Innovation and Excellence for Medical Practice Award.

PHOTO: RICK STOWELL

Dr. Ricardo Arbulu and Dr. Jotesh Chug, a hospitalist, discuss a case in Mary Greeley’s Intensive and Coronary Care Unit.

B

ecause of his specialty in infectious diseases, McFarland Clinic’s Dr. Ricardo Arbulu is often sought out as a consultant by his colleagues. That role contributed significantly to his selection as Mary Greeley’s 2014 Innovation and Excellence (I & E) in Medical Practice Award. In an award nomination a fellow physician praised

www.mgmc.org | Fall 2014 | HEALTH CONNECT

Arbulu for being “consistently open to urgent consults be it on the phone or in the hospital.” Another nomination noted that Arbulu’s “inpatient consults are highly valued by peers, and (he) routinely goes above and beyond his specialty niche in caring for his patients.” Arbulu took an interesting path to his McFarland Clinic practice. Born in

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Peru, Arbulu earned his medical degree from Cayetano Heredia University in Lima, did his residence at Henry Ford Hospital in Detroit, and then did an infectious disease fellowship at the University of Illinois at Chicago. He joined McFarland in 2011. Just three years later, Arbulu finds himself the recipient of the I & E honor. In this Q & A, Arbulu talks about the attraction of infectious disease, the attention generated by fecal transplant, and how he and his wife are helping senior citizens back home in Peru. Q. How did a native of Peru end up practicing medicine in central Iowa? A. I did my infectious disease training in Chicago, where I fell in love with the big city. I looked for nearby places to practice. Obviously, I went a bit out of range when considering Ames. I learned about McFarland Clinic from a fellow physician from Peru who also specializes in infectious disease. I looked into the opportunity and was attracted by the fact I’d be working with colleagues from many specialties, have freedom to steer my practice to fulfill my professional interests and fill a gap in this community. Q. Based on comments in your I & E nominations you’ve clearly found opportunities to practice your specialty at McFarland. What attracted you to infectious disease? A. The close relationship between McFarland Clinic and Mary Greeley offers plenty of opportunities to practice my specialty. I am a public health type of guy and find great value in reviewing treatment protocols, practices and trends in order to get ahead of the infectious diseases. I am always interested in making medicine more efficient and in finding a way to prevent problems before they happen. A great part of the infectious diseases specialty is doing that. Working with my colleagues is also 22

“Working with my coleagues is also immensely satisfying … What they ask from me as an infectious diseases physician is how to achieve the best results for their patients.” – DR. RICARDO ARBULU

immensely satisfying. Most doctors are comfortable prescribing antibiotics. What they ask from me as an infectious diseases physician is how to achieve the best results for their patients. My specialty entails detective work. Many times I am called in by a fellow physician when the cause of a patient’s problem isn’t immediately clear. I want to help them find out what is going on. This involves a lot of discussion back and forth with other physicians, as well as with patients and families. I enjoy the process – gathering all the diagnostic information, making all the logical points and presenting them to patients and other physicians. I also like teaching. I always have. I love educating a patient on their disease, providing reassurance and involving them in the decision-making process. Q. You and Dr. (Bryan) Graveline are earning attention for your work in using fecal transplant to treat a serious intestinal infection commonly referred to as C. diff. What kind of reactions are you getting to this unusual but innovative treatment? A. It’s been fun. People ask about it a lot, mostly out of curiosity. The article in Health Connect (Winter 2014) turned out to be a great conversation starter to educate people. It is displayed prominently in my office and has become my educational material for patients whom

we discuss fecal transplant with. We also did a television interview. We have had a lady come from Des Moines in response to this. Previously we had somebody who is a relative of an employee come from the East Coast to receive the treatment. The main reason why this has worked out so well here is because of the method – using frozen samples, saving a lot of time and cost – and because the administrative barriers have been efficiently tackled by a well-organized multidisciplinary team. This has been a remarkable team effort and exemplifies how Mary Greeley “rolls” well to make things happen. Q. Your impact on health care goes beyond central Iowa. You and your wife have developed a program to assist elders in Peru. Can you tell us about that? A. The credit goes to my wife, Maria Isabel. Her father developed Alzheimer’s. He was living by himself back in Peru, after her mother died. She rushed back and spent several months trying to find all sorts of stuff for him to be able to live well. She had little family support and this was very hard. She realized there was nothing really helpful online to help senior citizens in Peru find what they need – from caregivers, to places to live, to activities. This made it very hard to coordinate things from here in the U.S. She came up with this idea, which at its most basic form is a web directory for the elderly, with services and products available in Peru. The idea is also to provide professional advice tagged to the products and services, and to allow people and professionals to review them. Believe it or not, such a basic thing does not exist. We presented this project to the Talent and Innovation Competition of the Americas, which is sponsored by the Young Americas Business Trust and the Organization of American States. It won in the category of social entrepreneurship.

HEALTH CONNECT | Fall 2014 | www.mgmc.org


2014 Innovation & Excellence Award Winners Each year, Mary Greeley Medical Center employees nominate their colleagues for Innovation & Excellence Awards in the areas of leadership, nursing and service. Here are this year’s winners talking about what working at Mary Greeley means to them. You can hear their thoughts in videos at www.youtube.com/marygreeleymedctr.

Scott Carlson

Director, Information Systems

BSN, RN, CNOR Clinical Resource Nurse, Operating Room

Rhonda Carney

Kelli Clemens

 Leadership Award

 Nursing Award

 Service Award

T

A

I

his is a great place to work. There’s a lot of change, a lot of technology. But mostly there’s a great group of people both in our department and across the medical center.

The IS department is a special de department. We have a lot of variety, a lot of systems that we care for. It’s a great group of people. They all share the same passion. They just love their work. They are dedicated to their jobs. They are simply awesome. They are basically what keep me coming to work every day. Really, this award reflects the department, not me. It’s a positive department. There’s camaraderie. The best thing we have in our department is when we sit around and brainstorm about ideas. We have a whiteboard, and we come up with new solutions to things the medical center needs. That entire positive attitude they have and the ability to get along, not only in our department but elsewhere in the medical center, is just awesome.

s the OR clinical resource nurse, I help staff with orientation, getting their certification and going on to further their education. There is a lot to learn in the OR. We have new equipment, new physicians that come in who bring new procedures that require new technology and so we are constantly learning and changing what we do. I want to be there as a support to the staff and to assist staff through changes. If I can help to make the change go more smoothly or provide staff with the resources that they need to do their jobs and feel less stress, that brings me a lot of satisfaction I think Mary Greely is unique. Whenever I get a chance to attend any nursing association conferences, I like to see

how other hospitals and departments compare to other facilities. I usually feel that we are right on target or ahead of what other facilities are doing in best practices. We really are doing what’s right in our facility because we strive to meet those goals and what our patients need when it comes to quality care. We are an excellent group of nurses, and I feel very privileged to be recognized as one of them.

www.mgmc.org | Fall 2014 | HEALTH CONNECT

Unit Secretary, Wound Healing Clinic

love working at Mary Greeley. I think that the employees are awesome. We try really hard to make a patient feel special, to let them know that we want to meet their needs. I always try to know their names and to greet them by their first name. If they have told me something about their family or their situation, the next time

they come in I ask them about that … just trying to be a friend to them. Our patients come back a lot. They come sometimes several times a week for several weeks, several months. Because of that I have an opportunity to get to know these people, build a relationship with them. All of us in the Wound Healing Clinic celebrate their victories, as well as struggle with them when they are having a hard time. I come to work every day and do my job to the best of my ability. To be recognized for that is an honor.

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Grateful Foundation program helps family honor those who cared for loved one. BY ANDREW ZALASKY

to 93-year-old Frank, Frankee and husband, Jim, turned to Amber Sleeth Williams, RN, for advice and support. “We wanted to be the ones to share the news with my father,” Frankee says looking back. “But we needed someone to be there with us in case he had quesques tions we couldn’t answer. It turned out that Amber was there as much for Jim

PHOTO: RICK STOWELL

!

k you Than

F

rankee Oleson was filled with anxiety. She needed to deliver bad news to her father: The illness that landed him in the emergency room just two days earlier was terminal. When it came time to explain the diagnosis of advanced pancreatic cancer

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HEALTH CONNECT | Fall 2014 | www.mgmc.org


and me as she was for my father.” What Amber provided went far beyond moral support. Her quiet presence enabled Frankee and Jim to get through the difficult conversation with Frank, who would pass away just days later at the Israel Family Hospice House. Above and Beyond

“She just stood silently behind us and allowed us to steer the conversation,” Jim says. “At one point I looked over and saw her wipe a tear away. That showed us that Frank was more than just another patient.” “She was sincerely sympathetic,” Frankee adds. “She went beyond the call of duty over and over again.” The conversation was just one of several interactions during Frank’s stay that made an impression on the Olesons. There were so many instances of excellent care that Frankee began recording the names of those who stood out.

A few weeks after his death, the Olesons chose to recognize four of Frank’s caregivers with a gift to the “Beyond Expectations” program offered by the Mary Greeley Medical Center Foundation. The program allows grateful patients and family members to honor physicians, caregivers, staff members and volunteers who go above and beyond in providing care and service. Excellence Recognized

As a member of the Mary Greeley Medical Center Foundation Board of Directors, Frankee was familiar with the Grateful Patient and Family Program at Mary Greeley. She felt it was a perfect gesture to pay forward the excellent care they received, while also shining a spotlight on some of those who served them. “In that short period of time, we were touched by so many caregivers,” Jim says. The Olesons recognized four of those individuals with their gift including

Amber; Nick Wells, patient transporter; Cortney Runyan, PCT; and Brigette Lebeau Messa, RN. “It was as much about how they cared for us as it was about the way they cared for Frank,” Jim adds. “These professionals deal with sick people each and every day,” Frankee adds. “It would be easy for them to grow accustomed to it and to go through the motions. They didn’t do that. They showed us that they truly cared about all of us.” Jim says it felt good to be able to make a gift in their honor. “We just want these caregivers to know how wonderful they are and encourage them to continue to provide that level of service to others.”

To Say ‘Thanks’ ‘Beyond Expectations’ applauds excellent care. Many patients and families want to thank those who provided exceptional care so the Mary Greeley Medical Center Foundation established a Grateful Patient and Family Program. Making a gift in honor of dedicated professionals and volunteers offers an opportunity to recognize those who go “Beyond Expectations.”

Each staff member, physician and volunteer honored by a grateful patient or family member receives: • Recognition at a special “Beyond Expectations” ceremony. • A lapel pin to wear proudly. • A personal note recognizing their exceptional care. To learn more about the Grateful Patient and Family Program and

other giving options to the Mary Greeley Foundation, please contact Melissa McGarry at (515) 239-2147 or email mcgarry@mgmc.com. Information is also available at www.mgmc.org/grateful.

Jim and Frankee Oleson (center) recognized four Mary Greeley Medical Center employees through the Grateful Patient program after Frankee’s father received outstanding care. From left: Brigette Lebeau Messa, RN, Nick Wells, patient transporter, Amber Sleeth Williams, RN, and Cortney Runyan, PCT.

www.mgmc.org | Fall 2014 | HEALTH CONNECT

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Schedule of Events 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 or by calling 515-239-2423 or 800-303-9574. Preregistration is required.  Cooking Demonstration: Dishes to Get You Through the Holidays Tuesday and Wednesday, October 28 and 29, 2 to 4 p.m. (choose one day to attend) Cook’s Emporium 313 Main St., Ames Presented by Marg Junkhan, owner, Cook’s Emporium. Marg will make some quick and easy recipes that will delight your holiday guests. This demonstration will include a frittata, an appetizer, and one surprise dish. Must be a Prime Time Alive member to attend.  Aging and Fatigue: Is This Normal? Thursday, October 30, 2 p.m. Quality Inn & Suites, 2601 E. 13th St., Ames Presented by Ryan Grandgenett, MD, McFarland Clinic Family Medicine. This program is a discussion regarding fatigue and common underlying causes.

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 Skin Cancer: What You Need to Know Wednesday, November 19, 2 p.m. Quality Inn and Suites, 2601 E. 13th St., Ames Presented by Tim Hansen, MD, McFarland Clinic Dermatology. Skin cancer is the most common type of cancer in the United States. Learning about the medical care for skin cancer can help you take an active part in making choices about treatment. This program is co-sponsored by the Cancer Resource Center.  AARP Smart Driving Thursday, November 20, 8:30 a.m. to 12:30 p.m. Mary Greeley North Addition Room C Presented by Stuart Huntington, AARP Smart Driving Instructor. This one-day presentation covers driver’s safety. Learn about the normal changes of aging and the effects it may have on driving. Cost is $15 for AARP members and $20 for all others (make checks payable to AARP) and may entitle participants to an insurance premium discount.  Annual Holiday Gathering Wednesday, December 10, 1 p.m. Gateway Hotel and Conference Center Join your Prime Time Alive friends for holiday fun. There will be treats, entertainment, door prizes and an abundance of holiday cheer at the annual holiday gathering. Don’t forget you need to be an active Prime Time Alive member to attend. If you have not renewed your membership for this year or if you are not a Prime Time Alive member and would like to join us at the Holiday Gathering, call 515-239-2423 or 800-303-9574 to request a membership form. Preregistration is required by calling the phone numbers listed above. Watch the mail for a flyer with more information.

 An Overview of Alzheimer’s Disease Thursday, January 15, 2 p.m. Quality Inn and Suites, 2601 E. 13th St., Ames Presented by Selden Spencer, MD, McFarland Clinic Neurology. Join Dr. Spencer for a discussion on the signs, symptoms, pathophysiology, prognosis and treatment of Alzheimer’s Disease.  Introduction to Stress Reduction Techniques Thursday, January 22, 2 p.m. Ames Yoga Center, 327 Main St., Suite 3 (requires climbing one flight of stairs) Presented by Ruthann O’Brien Hadish, E-RYT, owner, Ames Yoga Center. Learn how and where people hold stress, and how they can learn to relax and unwind by using breathing techniques, gentle chair yoga and deep relaxation. Everyone is welcome to attend. No previous experience required.

Cancer Resource Center

Mary Greeley Medical Center regularly schedules programs to provide cancer education and support. For more information and to register for events, call 515-956-6440 or 866-972-5477. Preregistration is required.  The New Age of Vaccines Monday, December 8, 2 p.m. Quality Inn and Suites, 2601 E. 13th St., Ames Presented by Dr. Balaji Narasimhan, professor of chemical and biological engineering, Iowa State University. Researchers at Iowa State University are working to create a nationally recognized center for developing nanovaccines. Nanovaccines, unlike current vaccines, are based on tiny particles that can send pathogen-like signals to immune cells. They can prevent disease and they can boost the immune system’s own response to disease. This program is co-sponsored by Prime Time Alive.

HEALTH CONNECT | Fall 2014 | www.mgmc.org


 Oncology Nutrition Wednesday, November 19, 7 p.m. North Addition, A & B Eating well can improve the overall health and well-being of people living with cancer. The effect of diet and nutrition on cancer prevention and recurrence is an important healthcare topic. Join Lynn Maves, RD, who will discuss, how The William R. Bliss Cancer Center addresses oncology nutrition for the patients it serves.

Auxiliary and Volunteer Services

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.  HCI Fundraising $6 Sale Monday, October 27, 7 a.m. to 5 p.m. North Addition, A, B & C Start your holiday shopping early at the HCI Fundraising $6 Sale, coming to Mary Greeley for one day only! Perfect stocking stuffer items for every family member, including LED flashlights, watches, reading glasses, scarves, gloves, wallets, ISU and U of I collegiate items, CDs and much more.

 Holiday Cut-out Cookie Fundraiser Friday, November 21: 10 a.m. to 4p.m. MGMC Gift Shop front entrance Make your holiday baking a breeze by purchasing frozen sugar cookies at the fourth annual Holiday Cut-out Cookie Fundraiser. The Gift Shop will sell boxes containing 3 dozen frozen cut-out sugar cookies in shapes of trees, stars and snowmen for just $14 each. Frozen gingerbread men cookies, will also be available to purchase for just $14. These cookies are so YUMMY! Enjoy a sample while shopping during our Holiday Open House that same day!  Lionne Designs Jewelry Thursday, December 4, 9:30 a.m. to 4:30 p.m. North Addition Rooms A, B, & C Lionne Designs Jewelry comes to Mary Greeley for its first ever sale! Genuine silver and 14K gold-filled handcrafted designs for women and men will be featured. Shop hundreds of items ranging from $12 to $999, featuring real gems or natural stones that are backed by a lifetime guarantee. If you are unable to attend the sale, shop online through the co-branded website from December 4-31.

 Holiday Open House Thursday, November 20, 8:30 a.m. to 7:30 p.m. Friday, November 21, 8:30 a.m. to 4:30 p.m. The Gift Shop at MGMC Join us at the Gift Shop’s annual Holiday Open House and receive 20% off your gift purchase. Featuring home décor, candles, diffusers, ornaments, jewelry and other accessories, holiday greeting cards and much more! Get in the spirit, enjoying holiday music as you shop! Register to win the snowman to be given away each day.

www.mgmc.org | Fall 2014 | HEALTH CONNECT

Mallwalkers Update on Flu and Pneumonia Tuesday, November 4, 8 a.m. North Grand Mall Presented by Terri Olinger, RN, BSN, Story County Public Health Nurse, Mary Greeley Medical Center Home Health Services. Learn the current information on flu and vaccinations for flu and pneumonia. Flu and pneumonia shots will be available. Bring your Medicare B card. Flu shots available from 7:30 to 9 a.m. Mental Wellness to Enhance Your Senior Lifestyle Tuesday, December 2, 8 a.m. North Grand Mall Presented by Christine Krause, director, Mary Greeley Medical Center Behavioral Health Services. This program will discuss strategies to maintain “mental wellness” as we move through senior lifestyles. Population Health: A New Way to Manage Patient Care Tuesday, January 6, 8 a.m. North Grand Mall Presented by Ellen Owings, RN, Population Health coordinator, McFarland Clinic. In the ever-changing world of health care a new approach called Population Health is emerging. Population Health reflects a shift in our thinking about how health is defined. The idea is that health is a positive concept, signifying more than the absence of disease, and is a state of complete physical, mental and social well-being. Find out how doctors at McFarland Clinic are using Population Health to better treat their patients.

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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 Mary Greeley’s Home Health Care office located at 1114 Duff Ave. Upcoming dates include: Oct. 14, Oct. 28, Nov. 11, Nov. 25, Dec. 9, Dec. 23, Jan. 13, Jan. 27 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 515-239-6730 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.  Blood Pressures at Mall with Prime Time Alive Free blood pressure checks will be provided by Mary Greeley Medical Center from 7 to 9 a.m., on the first Tuesday of every month at North Grand Mall.

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: Ames Bickford Senior Living Thursday, Oct. 16, Nov. 20, Dec. 18, Jan. 15 1:00 to 3:30 p.m.

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Green Hills Health Care Center Tuesday, Nov. 4, Dec. 2, Jan. 6 1:00 to 3:30 p.m.

Nevada Senior Center Tuesday, Oct. 14, Nov. 11, Dec. 9, Jan. 13 12:30 to 2:00 p.m.

Heartland Senior Services Thursdays Oct. 16, 23, 30 Nov. 6, 13, 20 Dec. 4, 11, 18 Jan. 8, 15, 22, 29 9:30 a.m. to noon

The Meadows Apartments Tuesday, Oct. 21, Nov. 18, Dec. 16, Jan. 20 1:00 to 3:00 p.m.

Keystone Apartments Thursday, Oct. 23, Jan. 22 1:00 to 2:30 p.m.

Story City Story City Community Health Center Wednesday, Oct. 22, Nov. 26, Jan. 28 1:00 to 4:00 p.m.

Regency V Apartments Tuesday, Nov. 4, Dec. 2, Jan. 6 10:00 to 11:30 a.m.

Cedar Place Thursday, Nov. 13, Dec. 11, Jan. 8 1:00 to 4:00 p.m.

Stonehaven Apartments Tuesday, Oct. 28, Nov. 25, Dec. 23, Jan. 27 10:00 to 11:30 a.m.

Support Groups

The Waterford at Ames (Assisted Living) 1200 Coconino Rd. Wednesday, Oct. 15, Nov. 19, Dec. 17, Jan. 21 1:00 to 3:30 p.m. Windsor Oaks Apartments 1100 Adams St. Wednesday, Oct. 15, Nov. 19, Dec. 17, Jan. 21 10:00 to 11:30 a.m. Collins City Hall Senior Meeting Room Tuesday, Oct. 21, Nov. 18, Dec. 16, Jan. 20 9:00 to 10:00 a.m. Colo Community Center Tuesday, Oct. 21, Nov. 18, Dec. 16, Jan. 20 10:30 to 11:45 a.m. Huxley Walnut Grove Community Room Thursday, Nov. 6, Dec. 4 1:00 to 2:30 p.m.

 Bereavement Support Groups; Six-Week Group For more information on grief support groups, contact Mary Greeley Hospice Care at 515-956-6038 or 877-469-0079.  BRCA Support Group This group for women dealing with high risk cancer genes meets the second Tuesday of the month from 7 to 9 p.m. at the Cancer Resource Center. For information, call 515-956-6440.  Breastfeeding Support Group This group meets the third Thursday of each month from 1:30 to 3 p.m. in North Addition C. For more information, call Birthways at 515-239-2444.  Diabetes Support Group This group meets the first Tuesday of every month at 7 p.m in classroom 1 of the Diabetes and Nutrition Education Center, Third floor, North Addition. Call 515-956-2880 for more information.  Parkinson’s Support Group Call 515-239-2608 and ask for Susan Trevillyan for more information.

HEALTH CONNECT | Fall 2014 | www.mgmc.org


Art Schedule

OCTOBER Brenda Backman Fiber North Addition hallway

NOVEMBER Sonja Johnson Oils and Prints North Addition hallway

DECEMBER Sonja Johnson Oils and Prints North Addition hallway

JANUARY Mary Jo Hinds Oils North Addition hallway

Delores Frederick Watercolors North Addition hallway

Delores Frederick Watercolors North Addition hallway

Mary Jo Hinds Oils North Addition hallway

Rachel Sims-Fuzzi-Shu Glass Display case

Becky Lau Ekstrand Green Cards Display case

Becky Lau Ekstrand Green Cards Display case

Rachel Sims-Fuzzi-Shu Glass Display case

 Stroke Support Group The Stroke Support Group is free and open to the public. It meets the third Tuesday of each month. Call 515-2392323 for more information.

support persons. Wednesday: Oct. 29, Nov. 26, No Tour in Dec., Jan. 28. 7:00 to 8:00 p.m. Classroom North C

 Women for Women Support Group This group meets the third Tuesday of every month at 6:30 p.m. in the William R. Bliss Cancer Resource Center. Call 515-956-6440 for more information.

 Breastfeeding Classes Monday: Nov. 3, Dec. 1, Jan. 5 Thursday: Oct. 16, Nov. 13, Dec. 11, Jan. 22 6:30 to 8:30 p.m. North A&B $10 donation

Family Birthing Classes

Register online at www.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: Nov. 6, Dec. 8, Jan. TBA. Mixed ages: Nov. 10, Dec. 15, Jan-TBA. Ages 4 and up: Oct. 20, Nov. 17, Dec. 29, Jan. TBA. 5:30 to 6:30 p.m. Main Lobby  Childbirth Classes Birthways offers a one-day and Tuesday series childbirth class to help women in their seventh to eighth month of pregnancy and their support persons prepare for childbirth. Wear comfortable clothes. Bringing two pillows is suggested. A tour is included with the class. $30 donation per class.  One-Day Childbirth Class Saturday: Nov 1, Nov. 8, Dec. 6, Jan 10, Jan. 17. 8:30 a.m. to 4:00 p.m. North A&B  Childbirth Class Tuesday Eve: Nov. 4 & 11, Dec. 2 & 9, Jan 6 & 13. 6:30 to 9:00 p.m. North A&B  Birthways Tour Birthways offers tours of the hospital and unit for expectant women and their

 Baby Basics Class Saturday Oct. 11 (North C), Nov. 8 (North C) Dec. 13 (North C), Jan. 10 (North C) 8 a.m. to noon $5 donation

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.  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. Story City Classes  Yoga Combine traditional yoga postures with modern fitness moves for an excellent

www.mgmc.org | Fall 2014 | HEALTH CONNECT

mind/body experience – perfect for those seeking strength, flexibility, stress reduction and total relaxation. Bring your own yoga mat.  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.  H.E.A.T. If you want to take your fitness and fat loss to the next level – without spending more time in the gym – then H.E.A.T. could be exactly what you’re looking for. Push yourself to your limit with athletic-style cardiovascular exercises – both choreographed and drill-based. Get your metabolism fired up before most people are out of bed.  Zumba Ditch the workout and join the party! Zumba fuses hypnotic Latin rhythms and easy-to-follow moves to create a dynamic fitness program. Enjoy an exhilarating hour of calorie-burning, body-energizing, awe-inspiring movements meant to engage and captivate.  Power Pilates Combine the benefits of Pilates with the latest strength moves to create a leaner, stronger you. Build muscle and burn calories in this “best of both worlds” class.  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. 29


1111 Duff Avenue, Ames, Iowa 50010

Health Connect Magazine - Fall 2014  

Inside - High Tech Help for Hernias: Green County man enjoys benefits of robot-assisted surgery at Mary Greeley; A More Comfortable MRI; New...

Health Connect Magazine - Fall 2014  

Inside - High Tech Help for Hernias: Green County man enjoys benefits of robot-assisted surgery at Mary Greeley; A More Comfortable MRI; New...

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