IN THIS ISSUE:

MAY 2013 | DUBUQUE, IOWA | W W W.MERCYDUBUQUE.COM
IN THIS ISSUE:
>Russell Knight discusses Medicaid reform
>Register for summer autism programming
>Meet the newest OB/GYNs
UPCOMING EVENT:
Presentation on Dementia
If you’d like to learn more about dementia,
including the signs and symptoms to
recognize, attend the free class on May 22.
See page 4 for details.
JOHN’S STORY: Surgical option for broken ribs eliminates
pain and speeds healing
On an early morning in January, when it was still dark, John
Horkheimer stepped outside to feed the birds. Heading down
the deck stairs, he hit some ice.
“Both feet went straight up in the air and I came down and
landed on the corner of the steps,” he recalls.
The hard fall knocked the wind out of him, and he laid there
for probably 10 or 15 minutes. When he finally made it back
into the house, he asked his son to look at his back—and it
had already turned black and blue.
“I could feel something moving around inside, and I just knew
my ribs were broken,” he says. “I thought, well, they don’t do
anything with broken ribs anyway.” And so he was just going
to deal with it. As an avid bowler, he figured he was done for
the year.
John can tolerate a lot of pain. He’s broken both his legs and a
shoulder, he’s had disc surgery, he’s gotten his hand caught in
a milling machine, and the list goes on – those injuries never
bothered him.
“Pain doesn’t bother me,” he says. “But this did. This was bad.
It was the worst pain I’ve ever felt.”
The pain became so severe that he couldn’t cough, couldn’t
breathe, could hardly blink without it hurting.
John went to Mercy’s emergency room, and his suspicions
were confirmed: He had four rib fractures, of which three were
dislocated.
What he didn’t expect, though, was a solution.
Medical Associates Clinic thoracic surgeon Warren Gall, MD,
offers a new surgical procedure for repairing dislocated broken ribs. Instead of
leaving ribs to heal by themselves, which
takes several months, Dr. Gall can screw
metal plates to the broken bones to help
speed up the healing process and alleviate
pain.
After dislocating three ribs,
John Horkheimer had a new
surgery at Mercy to repair his
ribs, resulting in a quick and
pain-free recovery.
“The plates are made out of lightweight
titanium and are screwed onto the ribs
on each side of the fracture,” explains
Warren Gall, MD
Dr. Gall. “They are customized based on
CT scans and fit the contour of the ribcage. This is the same
procedure that’s being done at Mayo Clinic, Madison and Iowa
City.”
Patients go home within two to three days and have minimal
pain.
“The day after the operation, I could have done anything I
wanted,” John recalls. “I couldn’t believe it. There was no pain
whatsoever. I could’ve gone bowling if Dr. Gall would have let
me.”
Dr. Gall confirms that the operation offers a much faster
recovery than traditional treatment.
John heeded Dr. Gall’s advice and waited a month before
bowling again. “I had no problem at all. No pain, no nothing.”
Instead of dealing with months of pain while his four broken
ribs healed, John was back to his normal routine within a month.
“It’s amazing what that operation did for me,” he says. “I’m not
trying to blow it out of the water – it’s just true. And I’ve told
everybody I know.”
John
Horkheimer
A LETTER FROM THE PRESIDENT
Russell M. Knight, President and CEO
Even the most casual observer of Iowa politics can’t
help but notice that one of the most controversial issues of the year – right up there with education and
property tax reform – involves health care: Should we
or shouldn’t we expand Medicaid eligibility to those
with incomes below 138% of the federal poverty level
($15,856 for a single person or $32,488 for a family of four)?
A year ago, this was for all practical purposes a settled matter, because the
Affordable Care Act included a provision enabling the federal government to
punish states that refused to expand Medicaid eligibility by withdrawing the
federal portion of their Medicaid funding. It was presumed that no state could
withstand such pressure and that all would comply. However, in its landmark
decision last June the Supreme Court labeled this “economic dragooning” and
ruled it was a violation of the Constitution, leaving states the right to determine whether to expand Medicaid or not.
Since the Supreme Court ruling last June, most states have opted to expand
Medicaid eligibility and accept federal taxpayer money to pay for it – 100%
of the additional cost
during the first three
Hospitals support Medicaid
years, declining to
90% over time. A few
reforms that improve quality,
states, including ours,
have not yet accepted
affordability, and access.
the deal. Although
the Iowa Senate has
approved a Medicaid expansion plan, Governor Terry Branstad has expressed
concerns about its affordability and sustainability in an era when the federal
government is running annual deficits around $1 trillion.
As an alternative, Gov. Branstad has proposed something he calls the Healthy
Iowa Plan, which is designed to add coverage for 89,000 people (vs. 150,000
under the Senate plan), while seeking also to introduce payment incentives
that he feels will reward hospitals and doctors for helping to make Iowans
healthier and “personal responsibility mechanisms” intended to encourage
Medicaid recipients to adopt healthy behaviors and be more cost-conscious
consumers of care.
Hospitals support Medicaid reforms that improve quality, affordability, and
access. We understand the need for payment systems that reward efficiency
and effectiveness. We endorse the movement toward greater accountability
at the institutional level and greater responsibility at the personal level. We
would also like to see more people gain access to coverage and be able to use
the hospital of their choice, anywhere in the state.
While there are clearly important differences of perspective and opinion
among our political leaders, it appears there may also be ample common
ground on which the Senate plan and the Governor’s plan both rest. Is it
possible to find a creative way to use the already-allocated federal funds to
restructure the Medicaid program so it meets the shared goals of both political parties and elevates our state to a higher level of health? It may not be the
case that every problem is solvable, but it seems the solution to this one might
well be within reach.
SPOT A STROKE
FAST
FACE
DROOPING
ARM
WEAKNESS
SPEECH
DIFFICULTY
TIME
TO CALL 911
Know the Symptoms of Stroke
A stroke occurs when a blood vessel that carries oxygen and nutrients to the brain is either
blocked by a clot or bursts. When that happens, part of the brain cannot get the blood (and
oxygen) it needs, so it and brain cells die.
Stroke is the number-four cause of death and a leading cause of disability in the United
States.
Recognizing the signs of stroke can save a person’s life. The most promising treatment for
ischemic stroke is the clot-busting drug called tPA. If given within three hours of the symptoms beginning, tPA can significantly reduce the effects of stroke and reduce permanent
disability. That’s why it’s incredibly important to call 911 as soon as a stroke is suspected.
FAST is an acronym that can help you recognize a stroke:
F: Face drooping
A:: Arm weakness
S: Speech difficulty
T: Time to call 911
Medical Associates Clinic neurologist Preeti Joseph, MD, will give a free presentation on
stroke Wednesday, May 15. See page 4 for information.
Autism Center Summer Programming
A Collaborative Program with Hills & Dales
Are you looking for a way for your child to maintain and learn new
skills over the summer? Check out the following programs:
Camp Mercy HD (preK – 3rd grade)
Camp Mercy HD is a five-week summer program where
children are able to maintain and continue to build motor, language and social skills in a camp-like setting.
• 1.5-hour sessions twice a week: July 8 – August 8.
See the complete schedule at www.mercy-autism.com.
Camp Mercy HD (4th – 5th grade)
Camp Mercy HD for older elementary students is a twoweek summer program focused on improving a child’s social interactions
and skill-building in the community. The group will meet for structured social interactions and five community outings.
• 2-week session: June 10 – June 21, Monday – Friday, 1:30 – 3:00 p.m.
Aspire HD (middle and high school)
Aspire HD is a two-week summer program where teens learn and maintain appropriate
social language and interactions.
• 2-week session: June 10 – June 21, Monday – Friday, 3:30-5:00 p.m.
All programming will be held at Hills & Dales Community Center and are under the
direction of licensed occupational therapy staff, licensed speech therapy staff, and/or
behavior specialist. Cost for each program is $200, which must be paid in full on the first
day of the program. Register online at www.mercydubuque.com/events.
For more information, visit www.mercy-autism.com or call Laura Keehner or
Alyson Beytien at 563-589-9035.
> MEET THE DOCS
Drs. Tara Holste and Lisa Kramer are two
of our community’s newest OB/GYNs,
having joined Medical Associates Clinic
last July. Here they share a few thoughts
about their field.
Why did you choose a career as an
OB/GYN?
Holste: I quickly fell in love with the field
after experiencing my first delivery and
further reinforced my desire as I learned
I was an advocate for women’s health. I
make it my responsibility to assist women
in living happy, healthy lives both physically and mentally.
Kramer: I chose to be an OB/GYN because I had a few amazing mentors while
a medical student at the University of
Iowa. During a very inspiring rotation at
UIHC, one of the more senior OB/GYN
physicians mentioned to me that women
always remember the doctor who delivered their babies. I felt it was an amazing
privilege to be able to be a part of women’s lives in both the very happy and the
very challenging times.
What is your general philosophy of
care?
Holste: I have been blessed with the
ability to attend medical school and
residency to acquire the knowledge and
skills needed to participate in the field
of OB/GYN. I will provide this knowledge
and deliver these skills to all my patients.
I feel that good health cannot be forced
upon a patient but rather discussed and
encouraged. With teamwork and patience
all things can be achieved, even health.
A fun variety of
gifts and home
decor is available at
the MERCY
GIFT SHOP
Mon. Thurs. & Friday
10 a.m. - 5 p.m.
Tuesday & Wednesday
10 a.m. - 7:30 p.m.
Sat. 10 a.m. - 3 p.m.
All proceeds support programs and services
for children in Mercy’s care. As always,
there is no sales tax. Managed and
staffed by volunteers from the
Mercy Service Club.
A Q& A with Tara Holste, DO, and Lisa Kramer, MD
Kramer: My general philosophy of care
is to treat every woman as I would treat
my daughter, sister, mother, etc. A lot of
medicine is following protocols and practice guidelines; it takes a true physician
to exude the empathy that is the right of
every patient.
Why is it important for patients to
select a physician, particularly an
OB/GYN, with whom they feel comfortable?
Holste: The care received from and OB/
GYN can provoke vulnerability through
difficult exams and questions. The best
quality care can only be received if a
patient feels comfortable trusting their
physician with these intimate details. I encourage all patients to select a physician
that allows them to give full disclosure.
Kramer: It is vital that patients select a
physician with whom they feel comfortable because oftentimes issues vital to
one’s health can also be exceedingly
personal in nature. I hope to provide an
environment in my office where women
can share their histories and concerns
without feeling self-conscious or withholding information that can be integral
for safe and comprehensive care.
What’s on the forefront of OB/GYN
care?
Holste: I am very excited about the
advances in minimally invasive surgery
using robotic assistance. I believe we have
only begun to establish the great benefits
to the patient with this type of surgery.
Kramer: I am very excited to be a part
of the development of minimally invasive
surgery in OB/GYN. Seeing the difference
in post-operative experience between
patients on whom I have done open procedures in the past versus those who undergo laparoscopic or robotic procedures
and how quickly they return to their daily
lives is very rewarding. I look forward to
continuing to integrate new technology
into my practice here in the Tri-States.
What health care advice would you
like to share with women?
Holste: I find often women allow themselves to neglect appropriate yearly
screening. As women, we are built to
care for our families prior to ourselves. I
encourage all women to take 20 minutes
once a year to put themselves first. We
can strategize on how to balance healthy
living with family requirements. I believe
knowledge is power.
Kramer: As an OB/GYN, a wife, and a
mother of two busy little girls, I would
advise women to remember to make
their own health and well-being a priority
whether that be regular preventive visits
with your physician, making time for
healthy diet and exercise for yourself, or
taking time for stress relieving activities.
If you aren’t taking good care of yourself,
it’s difficult to truly take care of everyone
else!
Drs. Holste and Kramer are offering
a free class about robotic surgery. See
page 4 for details.
WE STRIVE FOR QUALITY
Our goal is to provide safe, high-quality care.
We want to know if you have any concerns
about patient care or safety in the hospital.
We encourage you to discuss any such
concerns with members of the team caring
for you or a representative of the hospital’s
management. If your concerns are not
resolved, please contact Jacquie Brunssen,
the hospital’s risk officer, at 563-589-8086
or by e-mail at [email protected].
If your concerns are still not resolved, you may
also contact the Joint Commission’s Office of
Quality Monitoring at 1-800-994-6610 or by
e-mail at [email protected].
Featured in this story:
Tara Holste, DO
:
Lisa Kramer, MD
> EDUCATION + EVENTS
register online at www.mercydubuque.com/events
Please register early. All programs and
events are subject to change and/or cancellation due to low registration and/or
circumstances beyond the control of Mercy
Medical Center. For the latest information
on program status, please check our Facebook page or call 563-589-8000 to avoid any
inconvenience.
CLASSES
Mercy Weight Loss Program
This unique program uses the technology of the
MedGem indirect calorimeter (as seen on the
NBC program The Biggest Loser) to determine
each participant’s calorie needs. Based on your
caloric needs, a plan is tailored just for you to
help achieve your weight-loss goals. Learn the
foundation of basic nutrition and how to create
simple, flavorful dishes to reach and maintain your new healthy lifestyle. Eight weekly
sessions with Mercy Clinical Dietitian Holly
Paulsen, RD, LD, followed by four cooking
demonstration sessions co-instructed by Holly
Paulsen and Mercy’s Executive Chef Cory Evans (meal included with the cooking sessions).
Wednesdays, May 1 – July 24 (no class
July 3). Register for the Noon – 1 p.m.
class or the 5:15 – 6:15 p.m. class.
Mercy Sixth Floor Auditorium
250 Mercy Drive, Dubuque
Fee $249. Registration required online or at
563-589-9600.
Is Loud Snoring Keeping You Awake?
If you’re ready to kick your spouse to the
couch because of loud snoring, he or she might
have sleep apnea. Attend our class to learn more
about diagnosis and treatment of this serious
disorder so that everyone can get a better night’s
sleep. Presented by Carol Marinko, RPSGT,
Mercy neurodiagnostic services coordinator.
Tuesday, May 7, 6:30 – 7:30 p.m.
Mercy Sixth Floor Auditorium
250 Mercy Drive, Dubuque
No fee. Registration required online or at
563-589-9600.
Robotic Surgery for Gynecology
Until recently, many gynecologic surgeries included large incisions and a prolonged hospital
stay. Robotic-assisted surgery offers decreased
pain and blood loss, shorter hospital stay, and
quicker recovery. Please join us to learn about
the procedures offered and what you can
expect following surgery. Presented by Medical
Associates Clinic gynecologists Tara Holste, DO,
and Lisa Kramer, MD.
Thursday, May 9, 6:30 – 7:30 p.m.
Mercy Sixth Floor Auditorium
250 Mercy Drive, Dubuque
No fee. Registration required online or at 563589-9600.
Transition Workshop Series: Taking the
Next Step – Planning for Success in Postsecondary Education
This series of workshops are to help families,
professionals, and persons with disabilities
understand the transition process from high
school to adulthood. The workshops are a
partnership of ASK Resource Center and the
Mercy Service Club Autism Center.
Tuesday, May 14, 6:30 – 8:30 p.m.
Mercy Sixth Floor Auditorium
250 Mercy Drive, Dubuque
No fee. A limited number of $15 parent stipends are available (1 stipend per family per
training while quantities last). To register for
the workshops or apply for a stipend, please
contact ASK Resource Center at 515-243-1713
or [email protected].
Prevent the Effects of Stroke
Fast treatment of stroke is essential for a good
outcome. Learn how to recognize the signs and
symptoms of a stroke, along with the available
treatment options. Presented by Medical Associates Clinic neurologist Preeti Joseph, MD.
Wednesday, May 15, 6:30 – 7:30 p.m.
Mercy Sixth Floor Auditorium
250 Mercy Drive, Dubuque
No fee. Registration required online or at
563-589-9600.
Is It Dementia?
How do you know if symptoms are related to
dementia or simply getting older? Learn about
the many types of dementia, diagnosis and
treatment. Presented by Medical Associates
Clinic psychiatrist Umesh Chakunta, MD.
Wednesday, May 22, 6:30 – 7:30 p.m.
Mercy Sixth Floor Auditorium
250 Mercy Drive, Dubuque
No fee. Registration required online or at
563-589-9600.
Just for You Weight Loss Program
Metabolism is an important factor in your
ability to lose weight. Have your metabolism
measured and accurately calculate how many
calories your body burns each day using the
MedGem indirect calorimeter (as seen on The
Biggest Loser). Based on your body’s unique
needs, our dietitians will create an individualized, nutritional weight-loss plan for you that
promotes healthy and lasting weight loss.
This program is managed by the Registered/
Licensed Dietitian team at Mercy – Dubuque.
Choose from a 1-hour session for $99 or add
a 30-minute follow-up session for $125. To
schedule your session, call 563-589-9655.
SCREENING
Stroke Detection Plus Detect your risk for stroke with three different
non-invasive tests. Screenings for carotid arteries blockage, abdominal aortic aneurysm and
peripheral vascular disease plus osteoporosis
are $45 each or all four for $135.
Tuesday, May 21, 8 a.m. – 5:30 p.m.
Mercy Ground Floor, 250 Mercy Drive, Dubuque
Appointments are required. Call Stroke
Detection Plus toll-free at 1-877-732-8258.
EXERCISE
Interval Strength Class
Alternate walking and lifting dumbbells with a
certified instructor.
Six Tuesdays and Thursdays,
4:45 – 5:45 p.m. or 6:00 – 7:00 p.m.
Mercy Wellness Center, Professional Arts Plaza
3rd floor , 200 Mercy Drive, Dubuque
Cost: $84 for a session of 12 classes
Begin your session of 12 classes at any time.
Arrive early for your first class to register.
OUTREACH CLINICS
Children’s Hospital of Iowa Outreach
Pediatric Cardiology Clinic
Friday, May 3, 10, 17, 24, 31, 8:30 – 11 a.m.
Mercy Ground Floor, 250 Mercy Drive,
Dubuque. Call 1-877-891-5350 to schedule an
appointment.
Children’s Hospital of Iowa Outreach
Pediatric Gastrointestinal (GI) Clinic
Tuesday, May 14, 9 a.m. – 1:30 p.m.
Mercy Ground Floor, 250 Mercy Drive,
Dubuque. Call 1-877-891-5350 to schedule an
appointment.
Children’s Hospital of Iowa Outreach
Pediatric Genetics Clinic
Thursday, May 16, 8:30 a.m. – 5 p.m.
Mercy Ground Floor, 250 Mercy Drive,
Dubuque. Call 319-356-2674 or 1-800-260-2065
to schedule an appointment.
SPECIAL EVENTS
Fred Holmquist: Addiction and Recovery
Mercy Turning Point Treatment Center invites
you to an evening with Fred Holmquist, lodge
program director at Hazelden Foundation in
Minnesota.
Thursday, May 2, 7:30 – 8:30 p.m.
Mercy Sixth Floor Auditorium
250 Mercy Drive, Dubuque
No fee. Reservations encouraged at 563-5898291 or [email protected].
Child Safety Seat Check and Installation
Sponsored by Dubuque Child Passenger Safety
Coalition
Saturday, May 18, 10 a.m. – Noon
Anderson-Weber, 3450 Center Grove Drive,
Dubuque
Reservations required. Call 563-556-3281 and
ask for a Car Seat Fit appointment. Held rain
or shine. Bring your vehicle, car seat, and child
if possible.
SUPPORT GROUPS
Laryngectomy Support Group
Monday, May 6, 1 – 2:30 p.m.
Mercy Conference Room 1A/B, 250 Mercy
Drive, Dubuque. Call 563-589-9035 for more
information.
SHARE Support Group
Support for loss due to miscarriage, stillbirth,
or infant death
Wednesday, May 8, 7:30 p.m.
Mercy Sixth Floor Boardroom, 250 Mercy
Drive, Dubuque. Call 563-589-9599 for information.
Brain Injury Support Group
Thursday, May 9, 7 p.m.
Mercy Conference Room 1B, 250 Mercy Drive,
Dubuque. Call 563-564-6392 for information.
Living Well: Heart Failure Support Group
Thursday, May 16, 2 – 3 p.m.
Mercy Conference Rooms 1A/B, 250 Mercy
Drive, Dubuque. Register at 563-584-3232 or at
the door at 1:45 p.m.
Autism Support Group
For individuals who support and love a person
with autism.
Tuesday, May 21, 6:30 – 8 p.m.
Professional Arts Plaza, Third Floor, Cardiac
Rehab Room, 200 Mercy Drive, Dubuque.
Please RSVP at 563-589-9456.
Compassionate Friends Support Group
For those who have lost a child.
Thursday, May 23, 7 – 8:30 p.m.
Mercy Sixth Floor Boardroom, 250 Mercy Drive,
Dubuque. Call 563-590-2292 for more information.
BIRTH EDUCATION
For more information, call 563-58-BIRTH
(563-582-4784) or 800-99-BIRTH. You may
attend our three most popular pregnancy
classes (Birth Preparation, Make Room for
Baby, and Breastfeeding) for only 1 fee of $30.
Natural Milk Network
Free drop-in support for breastfeeding mothers
Every 1st, 3rd, and 5th Wednesday, 1 – 3 p.m.
Upcoming dates: May 1, 15, 29
Mercy Sixth Floor Boardroom
250 Mercy Drive, Dubuque
Call 563-589-8553 for more information.
Birth Preparation for Expectant Parents
Three-session evening classes (Wednesdays
and Thursdays, 6:30 – 8:30 p.m.) or one-session Saturday class (9 a.m. – 3 p.m.)
Wednesdays, May 8, 15, 22
Thursdays, May 23, 30, June 6
Saturday, May 11
Sessions include a tour of the Birth Center.
Early registration is recommended as class size
is limited. Register online or call 563-582-4784
for more information.
Sibling Class
For children 3-10 years of age and their expectant parents
Second Monday of every month, 6:30–8 p.m.
Upcoming dates: May 13, June 10
Register online or call 563-582-4784 for more
information.
Breastfeeding Class
For expectant and new parents
Second Tuesday of every month, 6:30 – 8:30 p.m.
Upcoming dates: May 14, June 11
Register online or call 563-582-4784 for more
information.
Make Room for Baby
For expectant and adoptive parents, grandparents, and teenage siblings
Third Monday of every month, 6:30 – 8:30 p.m.
Upcoming dates: May 20, June 17
Register online or call 563-582-4784 for more
information.
Health Watch is published for the friends and staff of Mercy Medical Center. Our goal is to keep the Tri-state area informed of the latest in health care issues.
If you have any questions regarding health information that appears in Health Watch, please contact your personal physician. Patient admissions, room
assignments and patient services are provided without regard to race, creed, national origin, disability or age. President/CEO: Russell M. Knight.
Marketing Staff: Matthew J. Daughenbaugh, Jennifer Faley, Barbara J. Runde, Keri Gockel and Jill Miller. General information: 563-589-8000.