PATIENT INSIGHT ONLINE MORE PHOTOS & MAKING A

DifferenceSUMMER 2016

A small

miracleTEAM EFFORT HELPS UK NURSES AND THEIR HIGH-RISK BABY BEAT THE ODDS

SURVIVING ORGAN FAILURE, TRANSPLANT & CANCER

HEART DISEASE BUILT A RELATIONSHIP

UK HEALTHCARE ACHIEVES NURSING’S HIGHEST HONOR

A news magazine featuring the people and patients of UK HealthCare. SUMMER 2016 | 1

MAKING A Difference

SUMMER 2016 UK Transplant Center team Michael Karpf, MD HEAR THE STORY & PATIENT INSIGHT INSIDE ONLINE Visit ukhealthcare.uky.edu/ making-a-difference  HIGHLY COMPLEX CARE 2A STELLAR SUPPORT SYSTEM REQUIRES A NEW APPROACH Congenital disease sent 45-year-old Teresa Schladt into liver failure. A liver transplant seemed to save ON THE COVER: UK nurses Alan and Natasha Hendren the day, then Teresa was diagnosed with advanced cradle 10-month-old Natalan – initially TO COLLABORATION cancer. Now what? given the smallest chance of survival. Baby and parents are making it through this most difficult of journeys with the This issue of Making a Difference the care team must collaborate By doing so, we will be: illustrates the difficult cases our care with the rest of the care team in support of co-workers and an entire • Creating more integrated, network of caregivers. teams face daily. a thoughtful, deliberate way to multispecialty teams. ensure the best evidence-based • Teresa Schladt came to us first treatment plan is developed to • Adding value through quality, with a genetic condition that 10 A SMALL MIRACLE meet patient and family needs. patient experience and increased was leading to organ failure; UK nurses Natasha and Alan Hendren found out efficiency. how extended their “family” is when Natasha’s transplantation and then Last July we began implementing routine pregnancy took an unexpected turn. • Working to manage the patient unexpectedly stage IV cancer a new strategic plan that has as across their entire continuum of would follow. its foundation patient- and family- care – spanning episodes of care. • The joy of centered care. All of our strategies Making a Difference is a publication of Natasha and Alan UK HealthCare® Corporate Communication. Hendren, both members of and aspirations revolve around In short, we will be delivering For information, write: 2333 Alumni Park our nursing staff, turned to delivering the very best care at today’s best medical care and Plaza, Suite 330, Lexington KY 40517 despair when Natasha’s routine every touchpoint in the patient and holding true to our brand promise – pregnancy became high-risk with family’s journey. The Power of Advanced Medicine. 16 A MATTER OF HEART Editor Digital/Online only a small chance for a good Thinking back over years of great care at UK, Jan Taylor Carla Yarbrough Jennifer Wirtz After reading these stories, I think To our highly skilled and deeply Reuben Ligon made certain that when he Writers outcome. needed a new heart, he would not have to go Vickie Mitchell Photography you’ll understand why we are caring teams, thank you for your • Heart failure patient Reuben anywhere else. Lynne Anderson Shaun Ring now changing the way we deliver commitment to our patients and Ligon, faced with the need Graphic Designers Natasha & Alan Hendren care to account for the increasing their families. To our patients, we Janet Ligon Cheryl Conrad for transplant, rejected other CJ Cruz complexity of our patients and are honored by your trust in us and James Carr options and placed his faith the need to support so many pledge to continue our quest for in a relationship built with his Copyright 2016, University of Kentucky. All rights different specialists and roles improvement. reserved. An equal opportunity university. caregivers over decades. working together as a team. We are No part of this publication may be reproduced without written permission of UK HealthCare Corporate continuing our development efforts Sincerely, 24THE LATEST AT UK HEALTHCARE Communication, 859-257-5424. As you read their stories, the on a service line operating model  complexity of each case comes Achieving Magnet status, nursing’s highest honor that will support teams working   through clearly. Each needs not Our promise to you: The Power of Advanced Medicine efficiently and effectively around  just one specialist but multiple UK Dermatology expands at Turfland patient and family. Michael Karpf, MD  A new statewide health care collaborative specialists. And each member of Executive VP for Health Affairs UK HealthCare® / University of  Avoiding the Zika virus UK HealthCare supports SOAR Kentucky UK HealthCare and the University of Kentucky BACK COVER are proud sponsors of SOAR (Shaping Our  Online access to your UK clinician’s notes Appalachian Region). We support SOAR’s goals of increasing educational opportunities, improving health and creating jobs for the citizens of Eastern Kentucky.

SUMMER 2016 | 1 With feet connected to the earth and hands reaching to the heavens, Teresa Schladt painted herself leaping through space surrounded by stars representing members of her support system. The painting was completed through the Body Mapping Art Therapy program. A STELLAR SUPPORT SYSTEM Surviving end-stage organ failure, a liver transplant and cancer takes an extraordinary team

Teresa Schladt’s life-size self- Bishop of Nicholasville, also has for a transplant; based on the portrait, painted in 2013 during the disease and six years ago had results, she was placed on the an art therapy project for organ a double-lung transplant at UK transplant list in March 2007. transplant patients at UK Chandler Hospital. Chandler Hospital, shows the As she waited for a new liver, Lexington woman springing into For a decade after her diagnosis, transplant advanced practice a star-filled, midnight-blue sky. Schladt, a Lexington native, lived provider Michael Cooper, PA-C, Inside each star is the name of an active, near-normal life. “I MPAS, monitored Schladt’s liver someone who supported her was symptom-free for so long,” function during visits to the through her 2007 liver transplant she said. She and her husband, Transplant Center clinic. The and cancer treatment and in the Tom, raised three children in Schladts and Cooper, an Air Force days since. There are many, many a farmhouse they restored off veteran, found common ground – stars and many, many names, Harrodsburg Road. Teresa, a UK the Schladts’ son Michael was among them family, friends and graduate and chemical engineer, joining the Air Force, and Cooper more than a few UK HealthCare started her own environmental was happy to tell about the time medical professionals. engineering firm. he had spent in the military.

But in late 2006, her health took As months passed, there were “I am one of the a turn. The private-practice warning signs that Schladt’s liver luckiest people you gastroenterologist who had long was failing rapidly, including monitored her AAT deficiency esophageal varices, a life- have ever met. I am referred her to the UK Transplant threatening condition in which happy with life. “ Center. “I was pretty healthy, but blood vessels in the esophagus – Teresa Schladt it hit me hard and fast,” she said. bulge and then burst. “She had lots of trips to the UK emergency AAT is far down the list of As the 55-year-old looks at the room to tie off the veins in her reasons for transplantation, painting and considers the life she esophagus that were bleeding,” ranking probably sixth or seventh, has, she is quick to remind others said Tom Schladt. “Her liver was said Roberto Gedaly, MD, who and herself, “I am one of the turning into a rock, and the blood performed Teresa’s surgery luckiest people you have ever met. flowing through the liver had to and remains her doctor. The UK I am happy with life.” find a way to get out.” Transplant Center sees only a few cases of AAT deficiency a By July, there was visible evidence DIAGNOSED WITH GENETIC year, he said. According to the On days off, Teresa and Tom Schladt of DISORDER AT 35 Lexington enjoy coffee and a newspaper Schladt was diagnosed at age 35 Alpha-1 Foundation, some 100,000 together, thankful for the family, friends with alpha-1-antitrypsin (AAT) Americans have the disorder. HEAR MORE and medical professionals who have FROM TERESA supported Teresa through liver failure, deficiency, a genetic disorder In January 2007, Schladt began transplant and cancer. Teresa calls that can damage the liver and Visit ukhealthcare.uky.edu/ herself, “...one of the luckiest people you the required tests and screenings making-a-difference have ever met.” lungs. Her younger brother, David

2 | | MAKING MAKING A A DIFFERENCE DIFFERENCE SUMMER 2016 | 3 that Teresa Schladt was in end- percent of the time at UK, kidney cancer, Nexavar, was being stage organ failure. “I was turning according to Gedaly. “It is what used off-label in some liver cancer yellow,” she said. we call incidental hepatocellular cases after liver transplantation. carcinoma (HCC).” There was little data to show it was The call that a liver was available effective in cases like hers, but both came on June 9, 2007, as Schladt, Today, according to Gedaly, it doctors felt it was worth a try. Joanne Dabit-Shadeh manages the Circumstances make for a tight bond her husband and their two happens far less often because Transplant clinic’s front desk. She has between transplant coordinator and daughters watched “Pirates of of changes in screening methods. DeSimone pulled no punches. greeted Schladt many times after her patient. Such is the relationship between the Caribbean II” at a movie “Now we use MRIs, and it is Schladt had two choices: Nexavar surgery. “They know patients’ families, Schladt and Jennifer Watkins, RN, CCTC their history,.... It is personal, and they (right). Even though Watkins now works theater near their home. Within less and less common for liver or no treatment. go out of their way to be that way,” in a different area, the two easily pick up 30 minutes, they were at Chandler transplant recipients to have liver Schladt said of her and others. right where they left off. Hospital. cancer incidentally found.” “She was nice and appreciative of what I was trying to do,” said Schladt opted to take Nexavar Long-term Cancer Survivorship Schladt. “Joanne and Marva were A CANCER DIAGNOSIS Because Schladt’s cancer DeSimone, “even though there was in pill form. The six-month Program (see sidebar, p. 9). Most always genuinely happy to see me. ON THE HEELS OF A was advanced, with multiple little, really no data, to show if it chemotherapy regimen left her sick of her care, though, is through They wanted you to succeed.” LIVER TRANSPLANT lesions, Gedaly referred her to [the treatment] was either good or Schladt’s transplant went well, and weak, but she has no regrets the Transplant Center. She visits Philip DeSimone, MD, a medical bad. But you need to be aggressive but 10 days later, tests on the and has remained cancer-free. every other month for blood tests Dabit-Shadeh, now a senior patient oncologist at the Markey when you have spent so much removed liver revealed 10 small and for an annual checkup with services coordinator, considers Cancer Center. “There was so time and so much effort in saving cancerous lesions. “It was a shock “Did it help save my life? I don’t Gedaly and his team. herself a patient advocate. much disease, we wanted to do someone’s life.” to everyone,” said Gedaly. In those know,” said Schladt. “But for me, something, which is why I called during that time, I felt I needed Like other transplant patients, She’ll track down doctors and days, despite screenings, liver DeSimone also warned the Schladts Dr. DeSimone.” to give the best effort and that much of Schladt’s time at the nurses if patients have urgent cancer would be discovered in that it was not a question of if her included Nexavar.” Transplant Center has been spent needs or serious problems; she’ll an explanted liver 10 to 15 Both Gedaly, whose research area cancer would return, but when. in the waiting room. She applauds try to squeeze in tests so patients is liver cancer, and DeSimone, Since Schladt’s surgery, the “He was straightforward,” said receptionist Joanne Dabit-Shadeh with long drives do not have to whose practice areas include liver, connection between the two Surgeon Roberto Gedaly, MD, Tom Schladt, “but that is really all and the late Marva Paris, LPN, make an extra trip back to the performed Schladt’s liver transplant, pancreatic, gastrointestinal and specialty areas – transplantation we are looking for in a doctor – supported her through cancer colorectal cancers, knew that and cancer – has become even treatment, and still follows her a drug used primarily for straight answers.” as a transplant patient. more structured at UK HealthCare with the creation of a Liver Tumor Board whose members No matter the question from transplant, oncology, or concern, transplant radiation oncology, radiology and gastroenterology discuss every coordinator Jennifer patient with liver tumors. Watkins, or the coordinator

“Cancer is like transplant in that on call, was always there multidisciplinary is the way to go, for the Schladts. with a lot of people thinking from different perspectives,” said Gedaly.

MOVING FORWARD WITH A UK MEDICAL TEAM who were there to greet her center. When patients have trouble As a transplant recipient and through most of the years. walking or standing, she and her cancer survivor, Schladt remains staff take paperwork out to them under the care of a team of “They know patients’ families, and sit and visit as the paperwork medical professionals at UK their history, they greet everybody. is filled out. “I do whatever it HealthCare. She has consultations It is personal, and they go out of takes to get the patient what they with the Markey Cancer Center’s their way to be that way,” said need,” Dabit-Shadeh said.

4 | MAKING A DIFFERENCE SUMMER 2016 | 5 “I see Teresa every three to four Liver and kidney transplant months and she has one of the dietitian Susan Ibanez, RD, LD, (left) delivers nutrition education best attitudes of anybody I to patients like Teresa Schladt see,” said Stakelin. “She is very before and after transplant. She finds Schladt both informed and proactive in taking care of herself, proactive about taking care of and she researches things. She her new liver. doesn’t wait for us, but she is very reasonable in what she researches and what she is willing to do.” “People don’t realize how important it is for the front-desk staff As a patient, Schladt appreciates to interact with patients and the time Stakelin spends with her. families” she continued. “I am the first person they see and the “That is actually one of the things last person they see. We make an as a physician that I am the “Transplant is a change in the way often people who fell through the impression.” biggest advocate of: for patients you live your life,” said Watkins. cracks. Now, I see every patient, to be well informed and well Until Jennifer Watkins, RN, CCTC, “It is not as if you come in and get which helps continuity of care. educated about why we are using moved into quality assurance a new liver and see us a couple of which therapies or why we think “Usually, I have seen patients five and performance improvement in times and you are done. In some one therapy will work better than to six times before transplant and 2013, she was Schladt’s transplant way, we are connected to you another,” Stakelin said. “I feel like I follow them closely in the clinic coordinator. forever.” when patients understand ‘why’ after transplant. They often have they are much more likely to follow No matter the question or concern, DIETITIAN IS PART OF THE problems in those early weeks through. It also gives them some CARE TEAM Watkins or the coordinator on with poor appetite, nausea and input into the treatment. I think Schladt is also connected to the call, has always been there for the weight loss. Then sometimes, a Transplant Center through liver when people are offered choices Schladts. Tom Schladt never left year later, I see them because they and kidney transplant dietitian his wife’s side during her 10-day have gained too much weight.” Susan Ibanez, MS, MBA, RD, LD. “I have had so many post-transplant hospitalization; he Schladt’s transplant was done The new process results in more was actively involved in her care people say, ‘Thank before Ibanez came on staff, but comprehensive care, Ibanez and recovery. “Jennifer was the one since Ibanez was hired eight years believes. “Now, I can develop a you for listening; who helped my husband the most,” ago, she has seen Schladt in the rapport with patients and work nobody is sitting Schladt said. center’s clinic. Teresa and Tom Schladt walk their dogs Madame with them on the post-transplant and listening to me Curie and Sir Isaac Newton through their side as well.” downtown neighborhood. Teresa is president of “Transplant is a “The main part of my job,” like that.’” their condo homeowners association and her life said Ibanez, “is to work with As a patient, Schladt has been – Kristen Stakelin, MD is active, full of family, volunteer work and art. change in the way all patients, before and after informed and proactive, Ibanez you live your life… transplant. I tell patients they said. “Teresa is passionate about and they feel empowered to have a and listening to me like that,’ In some way, we are have me as their dietitian from taking care of the organ.” say in their therapy, they are much which makes me sad that we have start to finish. This includes more proactive to take care of progressed to that as a medical connected to you ONSET OF TYPE II DIABETES providing nutrition education themselves and be compliant. community – where patients are forever.“ and tips to help improve their RAISES OTHER CONCERNS Diet has become even more not feeling heard and we are just – Jennifer Watkins, RN overall nutrition and maintain “When you get to take the time critical for Schladt since she trying to rush everyone through. If their strength so they can better with patients – and yes, that If Schladt falls ill and must go developed Type II diabetes, the you have someone who will listen, withstand transplant.” makes me run behind in clinic – to the emergency department, result of antirejection medications even if I can’t change anything for it makes a difference. It makes them, just getting to talk is often the first call she makes is to her In 2015, transplant requirements and family history. patients feel valued. I have had therapeutic.” transplant coordinator. “Anytime changed. It is now mandated In 2010, the Transplant Center so many people say, ‘Thank you she enters the UK HealthCare that the dietitian see patients referred her to diabetologist for listening; nobody is sitting A FULL, FULFILLING LIFE system, we smooth the path before they are placed on the Kristen Stakelin, MD. Working Even as Schladt contends with for her,” Watkins said. “We let transplant list. “This process was with Stakelin, Schladt got off continuing health problems admitting know that she is one of implemented in the UK Transplant insulin and now controls her caused by AAT deficiency, she is our transplant patients.” Clinic in July, and it is a good Diabetologist Kristen Stakelin, MD, diabetes with other medications, living a full life, with few limits. change for patients,” said Ibanez. takes time to listen and spends the time It is also the role of the transplant exercise and diet. needed to ensure patients understand “Previously, I saw patients on a their treatment plan. She has worked Most days, she and a friend coordinator, as well as floor nurses, consult basis, and there were closely with Teresa Schladt to manage venture to Fayette Mall to walk. to educate transplant patients. the Type II diabetes that has developed since her transplant. “The older people, they pass me,”

6 | MAKING A DIFFERENCE SUMMER 2016 | 7 ART EVENT CELEBRATES CANCER SURVIVAL Program for long-term she says, ruefully. On those walks This spring, Teresa Schladt bought a large canvas, pulled out her paint and others of length, Schladt uses and brushes and created a painting for Expressions of Courage, the supplemental oxygen. AAT has Markey Cancer Center’s (MCC) annual celebration for cancer survivors. survivors of cancer expands started to impact her lungs, just as the disease has now started to A grassroots event created by UK HealthCare staff, Expressions of Cindy Robinson, APRN, greets The detailed history of a patient’s By 2019, all of Markey’s cancer impact her brother’s liver. Courage invites cancer survivors to use art to express their cancer cancer survivors like Teresa Schladt cancer care becomes a handy survivors who are treated with experience. with a smile and a survivorship reminder and reference. “They curative intent will receive a care She takes her dogs, Madame Curie care plan, a hefty, two-ring binder are given so much information at plan when their cancer treatment is and Sir Isaac Newton (“Can’t you Paintings, photographs, quilts, jewelry and other works of art made by that contains the history of their the beginning of their treatment completed. During the preceding tell Tom and I are both engineers?” survivors are displayed; survivors also tell their stories through music, cancer treatment and educational that it is hard to retain it all,” said years, the survivorship clinics will she asks.) for walks; she and Tom dance, stories and poetry. information on healthy living. Robinson. incrementally increase capacity for walk downtown to the movies, care plans that are given. This year, First held in 2014, to dinner and to the High Street The care plan is an important The care plan is a complete 25 percent of survivors will have Expressions of Courage YMCA, where they take tai chi. aspect of the Markey Cancer history of cancer treatment – from plans; in 2017, it will increase to was organized by Cindy She keeps up with her three adult Center’s Cancer Survivorship the size of a tumor and type 50 percent; by 2018, 75 percent. Robinson, APRN, who children: Michael, an engineer; Program. Robinson spends around of chemotherapy to the long- To handle the expansion, this year oversees the MCC Breast Nicole, in law school at Emory 45 minutes with each cancer term effects of treatments and UK HealthCare and Markey added and Multidisciplinary Long- University; and Rebecca, an survivor, counseling and reviewing medications they received. The three advanced practice providers Term Cancer Survivorship engineering major at UK. their treatment summary and plan also includes information (APPs). Like Robinson, they will Program, and three of her discussing other aspects of their about symptoms that could develop and review care plans Schladt is also active in the wider colleagues – Carla Repass, health care. indicate the survivor is having with cancer survivors. community. For the past two MCC assistant director for heart failure, lymphedema or years, she’s been a member of the administration; Mincha “When I first see a patient in the other health issues that can be Although the Markey Cancer Markey Cancer Center Patient Parker, APRN; and Valeria survivorship clinic, I make sure they aftereffects of cancer treatment. Center has provided personalized Advisory Group. She’s proud that Moore, RN, practice have a primary care provider and survivor care plans for several the group got benches placed manager. counsel them as to the importance years, that effort is being expanded between the parking lot and the of following routine prevention in light of growing numbers of center’s buildings. “Now there are “The Markey Cancer guidelines, such as having people surviving cancer and in places to sit down as you go to Center had just gotten its mammograms, colonoscopies keeping with the best evidence- your car if you have to,” she said. National Cancer Institute and other recommended cancer based practice. The Commission “I hope I am helping make the designation, and I wanted to screenings. We also talk about on Cancer (CoC) requires all cancer lives of cancer patients a little do something special and health maintenance, such as centers it accredits to provide more comfortable.” honor survivors,” Robinson said. She chose a date adult immunization schedule, cancer survivors with a care plan, Teresa Schladt painted “76 Falls” for the The 2013 Body Mapping art 2016 Expressions of Courage event. It in June, National Cancer the importance of daily walking, and the National Cancer Institute therapy project at UK reawakened was inspired by the 76 Falls located on Survivor Month. stress reduction and eating (NCI) highly favors such plans. Cumberland Lake and captures the vertical healthy,” she said. a long-dormant interest in art, movement of the water as it falls. and she spends time painting The celebration has grown Providing for the needs of the in her downtown condo. Its each year, and Robinson Each binder is tailored to the whole person – from prevention architecture makes it a natural art expects that growth to continue. “We expect it to be larger this year, survivor who receives it. If the to diagnosis, treatment, follow studio, with a two-story wall of and even larger next year.” survivor is a smoker, for example, up and survival – is a hallmark of glass facing west, toward UK. Robinson includes information the nation’s best cancer centers. All past and current cancer patients of Markey are invited, along with about smoking cessation programs; The Markey Cancer Center is the During the day, the sun beams in. their family and friends, to next year’s celebration in June. For more for a postmenopausal woman, only cancer center in Kentucky At night, she sees stars, a shining information, call 859-323-6542, email [email protected] or there will be recommendations for with NCI designation and will seek reminder of the stellar support visit the Markey website, ukhealthcare.uky.edu/markey. maintaining bone health. accreditation for comprehensive system that has seen her through status in 2018. the last nine years. n

PROJECTED Source: Office of Cancer Survivorship, National Cancer Institute, 2013

8 | MAKING A DIFFERENCE SUMMER 2016 | 9 Natasha Hendren marvels at how her tiny baby knitted together such an incredible network.

Natasha and Alan Hendren led a many important people into the accumulation of blood between quiet life. The young couple met Hendrens’ lives. the uterus and the placenta. seven years ago working at UK Subchorionic bleeds usually Good Samaritan Hospital. They So when September 3, 2016 – resolve on their own, and women married five years ago, worked, Natalan’s first birthday – arrives, go on to have normal pregnancies. went to school – Natasha, now 29 the guest list for her party will and an RN, to finish her bachelor’s be long. Natasha was relieved, and even degree, and Alan, 28, and a more so when she had a discharge “There are going to be so many nursing tech, to earn his nursing a few weeks later and saw not people to invite to the party,” said degree. Beyond work, they mostly blood but clear fluid. The couple Natasha, who marvels at how her kept to themselves. thought the hematoma had finally tiny baby knitted together such an resolved. Little did they know that “We used to joke that if we wanted incredible network. “Now that we leak signaled a much more serious to have a party, who would we have these people, well, I know if problem. invite?” said Natasha. something happened, they would be there for us.” ULTRASOUND SHOWS LACK Then along came baby Natalan, OF AMNIOTIC FLUID named for both of her parents, EXCITEMENT TURNS TO FEAR Natasha and Alan got back to the The Hendrens were elated born at 30 weeks and 2 days, fun of being expectant parents. when they learned Natasha was weighing 3 lb., 6 oz. She’s been They planned a family get-together pregnant with their first child in called a miracle baby by more to “reveal” if the baby was a boy March 2015. They made a pact to than one of the seasoned medical or girl, and headed to a business keep the news to themselves, but professionals who had a hand in that does ultrasounds at 16 weeks within hours, Natasha had told her her care at Kentucky Children’s so parents can learn their baby’s mom and Alan had told his sister. Hospital’s Neonatal Intensive gender. The ultrasound tech there started the exam, then stopped and Care Unit (NICU). The efforts Just a few weeks later, their by High-Risk Obstetrics and excitement turned to fear when Maternal Fetal Medicine to keep Natasha began bleeding. Obste- The pink elephant – a gift from Ten-month-old Natalan Hendren, in Natasha safe during a difficult the arms of Enrique Gomez, MD, was tricians at the UK Birthing Center co-workers – reminds all just how admired by Nirmala Desai, MD, and pregnancy and of Neonatology triage determined that she had small Natalan was at birth. Birth was parents Alan and Natasha during her first to save Natalan’s life brought only the first of many hurdles she visit to the Neonatal ICU Graduate Clinic. a subchorionic hematoma, an would overcome.

A SMALLTeam effort MIRACLE helps UK nurses and their high-risk baby beat the odds

HEAR MORE FROM NATASHA Visit ukhealthcare.uky.edu/making-a-difference

10 | MAKING A DIFFERENCE SUMMER 2016 | 11 Two members of the High-Risk Obstetrics team: John O’Brien, MD, delivered Natalan at 30 considered viable. If Natasha Beyond the checkups, there look back on this,” Natasha said. “I weeks by emergency cesarean reached that point without going were no interventions or tried not to let it show, but I was section; Wendy Hansen, MD, could read Natasha’s moods like into labor or having a serious medications for the condition. so scared. I felt like, ‘Am I carrying no one else, knowing what to do infection, she would be admitted Natasha returned to work. And this baby this whole time and it is or say to lift her spirits. to UK Chandler Hospital, where to everyone’s surprise, including just going to die?’” she would be on bed rest until the hers, she reached the 24-week baby arrived. mark and checked in for her When Natasha did get out of bed, stared at her screen. There was a prescribed bed rest. “I felt like I she often bled and each time that problem, she said. In the meantime, her doctors had won the lottery,” she said. happened, she would be rushed to instructed Natasha to take her the labor hall, where she would Natasha and Alan went straight temperature twice daily, watch spend the night, only to return to UK Birthing Center triage, SIX DIFFICULT WEEKS for signs of infection, and return OF WAIT AND WORRY to her room for more waiting where another ultrasound showed Given the circumstances – the loss I was going to put it in God’s to the hospital for a weekly check Even though she had never been and worrying. Doctors gave her that Natasha had had a preterm of fluids so early in the pregnancy hands.” up. “We checked fluids and heart hospitalized, as a nurse Natasha a round of antibiotics to protect premature rupture of membranes and the fact that there had been tones and made sure everything knew how to be a good patient. against infection and steroids to (pPROM), a complication that no reaccumulation of fluid, the They requested a second opinion looked stable. Once a month, “I decided I was going to get up, help encourage whatever lung occurs in roughly 3 percent of outlook was not good, Playforth and within a day met with high- we would check growth,” said make my bed, walk the halls.” tissue the baby had to develop as pregnancies. In a large number of said. “Could the baby make it?” risk obstetrician Wendy Hansen, Playforth. But those plans went by the fully as possible before she was cases, women go into labor soon Natasha asked. Playforth sadly MD, at the time chief of Maternal wayside as she became depressed born. after their membranes rupture. shook her head. Fetal Medicine, now chair of and despondent. Her days were obstetrics and gynecology. filled with worry. To console Hansen tried to brighten her HIGH-RISK PREGNANCY “Our world just stopped,” said Natasha Hendren cradles Natalan, herself, she started an Instagram patient’s spirits in small ways. SPECIALISTS DISCUSS The Hendrens felt an immediate home finally after a 72-day stay in Natasha. “I thought it was all over.” #babyhendrensjourney. “I thought OPTIONS connection with her. “She came the Neonatal ICU at Kentucky “She saw a change in me that no Patients like Natasha see a team Children’s Hospital. maybe if I lose her I might want to Playforth encouraged the couple in, patted my leg and said, ‘You one else saw,” said Natasha. “She of physicians who specialize to take time to think about guys have had a hard week,’” said would go and get the ultrasound in high-risk pregnancies. Over how they wanted to proceed. Hendren. machine and come in and take the next two days, two of the Termination of the pregnancy was pictures for me to keep. She specialists from Maternal Fetal an option, she said. Like Playforth, Hansen believed knew I needed every little bit of Medicine would meet with a good outcome was a long shot. happiness I could get.” the Hendrens to explain the She estimated the baby’s odds of complications posed by pPROM “Our world just survival at 10 percent. Two weeks before Natalan and lay out the options. stopped, I thought it was born, Hansen sat down on But she also offered something Natasha’s bed to talk. The first doctor they saw, Karen was all over.“ the Hendrens needed to hear – S. Playforth, MD, had seen other – Natasha Hendren that no matter their decision, they “She said, ‘We all hope this is a cases of pPROM, but none as miracle baby, you know that. But I Initially, the Hendrens considered would have the support of the early as 14 weeks, which was want you to remember this can still it, but after an evening of prayer, high-risk pregnancy team. when Natasha’s membranes had be a very bad situation.’ I think she discussion and some research that ruptured. “It was the earliest, “Dr. Hansen said, ‘Your chances was trying to prepare me.” turned up little to help them, they and the worst case I had seen,” aren’t good, but if you decide to go agreed that unless Natasha’s life Playforth said. ahead with the pregnancy, I will BABY NATALAN ARRIVES was in danger, they wanted to go On September 3, 2015, Natasha support you and do everything forward. went into labor and was rushed to “She explained to us that babies I can to take care of you,” said use the fluid to make their lungs the labor hall. She had reached 30 Looking at the ultrasound, Hendren. “And for the first time, develop, ” said Natasha, “and it weeks and two days. John O’Brien, Natasha had seen a perfectly I felt like it wasn’t us against the also allows them to move so that MD, a member of the high-risk formed baby. “And when I could world.” their musculoskeletal system gets obstetrics team, had talked to see nothing else, I could see a strong.” Without it, Playforth MOTHER’S HEALTH Natasha two weeks earlier to heartbeat,” she said. “I did not give explained, the baby could be IS THE PRIORITY explain how the cesarean section her a heartbeat; it wasn’t my place born with little or no lung tissue Natasha’s health would be the would go, but because the baby’s to take it away. I was willing to and have mobility issues or even high-risk obstetrics team’s focus heart rate dropped, Natasha had accept that she might not live or cerebral palsy. Natasha would be until the pregnancy reached an emergency C-section. she might be born with disability. at risk for infection. 24 weeks, when fetuses are

12 | MAKING A DIFFERENCE SUMMER 2016 | 13 Introduced by Virginia Apgar, MD, in 1952, APGAR SCORE 0 1 2 the Apgar is a quick test performed on a BLUE OR PALE BLUE EXTREMITIES, baby at one and five minutes after birth. APPEARANCE PINK ALL OVER It examines breathing effort, heart rate, ALL OVER BUT PINK TORSO muscle tone, reflexes and skin color. Out of a possible 10, Natalan scored a 1. PULSE NONE < 100 > 100

WEAK GRIMACE CRIES OR PULLS AWAY GRIMACE NO RESPONSE WHEN STIMULATED WHEN STIMULATED

SOME FLEXION OF ARMS FLEXED, LEGS When O’Brien delivered Natalan, ACTIVITY NONE ARMS RESIST EXTENSION she was handed over to the WEAK, IRREGULAR RESPIRATIONS NONE STRONG CRY Neonatal Intensive Care Unit OR GASPING (NICU) resuscitation team. Because the baby was not breathing, the team intubated her and It was all hands on deck; we didn’t room. Before long, news came performed CPR. Her heart was sit down for hours,” said Hacker. that Natalan had made a barely working, her limbs were “360-degree turnaround” the contracted and her condition was The team that handled Natalan’s staff could not explain. Natasha grave. “Her Apgar score was 1; the care those first difficult days remembered, “One nurse said, best is a 10,” said Alan Hendren of included two neonatology ‘I think the Hendren family was the evaluation system used to rate physicians, a neonatal fellow, praying.’” the wellness of newborns minutes four advanced practice providers, In his training in the NICU, Gomez after they are born. a pharmacist, a respiratory therapist and multiple staff has seen babies’ conditions rapidly and inexplicitly improve Neonatology fellow Enrique nurses. They ordered medications, or decline. “It is why we tend to Gomez, MD, and Janell Hacker, placed central lines, inserted give these kids a chance, because MSN, APRN, were among those chest tubes, reviewed labs and kids can surprise you and Natalan involved in Natalan’s resuscitation test results, and made minute-by- RN, CNML, Natasha’s supervisor, is one of them,” said Gomez. and initial care. “The first day, minute decisions. and Theresa Crossley, BSN, RN, Natalan was critically ill, one of the After that turnaround, Natalan CNML, Alan’s supervisor, were Gomez and Hacker agree that sickest babies we see in the NICU. “seemed to never look back,” said at the hospital when Natalan Natalan’s successful care was her mother. She did have other was born and visited her nearly the result of a team that worked problems, but none as traumatic as every day. The Hendrens made together. “With UK being an those in the first days of her life. them the only two people allowed academic institution, there are to visit the baby without being a lot of people involved,” said Their baby was in the NICU over accompanied by the parents. Hacker. ”It is not one person two months, but the Hendrens making a decision. All of us were found comfort in the NICU nurses’ “We were really rooting for a putting our heads together to care. Dawn Waldrop, RN, would good outcome and wanted to be come up with the best solution.” take photos of Natalan and send supportive through their hard them to the Hendrens. She put time. I found it incredibly brave of For the next three days, Natalan’s bows in Natalan’s hair. Ellyn both of them,” said Crossley. fate was uncertain and the Willmarth, BSN, RN, did much the constant ups and downs were “We cared for [Natalan] as a family same. and other items needed for the torturous for the Hendrens. “One member would – we got to hold baby’s room. Top: Items gifted by family and friends, thing we say to the parents is that “It was hard going home at night, her, change her diapers and feed including gifts from their extended this is an hour-to-hour situation,” her,” said Forman. On day 72, when Natalan was UKHealthCare family, can be found knowing that she might die alone throughout Natalan’s room. said Gomez. “One hour the baby without us,” Natasha said, “but it finally discharged, Forman was With the Hendrens’ permission, the Below: Co-workers and Natalan’s might be a little better, one hour helped knowing that there were there to help Natasha and Alan two let others at Good Samaritan nursing team offered support worse, one hour the same, so just nurses there that loved her and take Natalan to their car. She shot throughout, sending photos and know how Natalan was doing. don’t lose all hope.” that Natalan loved. It was those a video to mark the landmark supportive messages and making Other co-workers had prayer scrapbooks for the family. While kind of people who really helped occasion. It was hard not to. Natalan’s circles, held fundraisers and set Natasha has always taken great pride us get through it.” in working for UK HealthCare, this condition became so grave that up a GoFundMe page. When they A YEAR LATER, opportunity to see how caring staff and NICU staff told the parents learned that Alan and Natasha had physicians are has given her even more A NETWORK OF FRIENDS A HAPPY FAMILY pride in her work and in those she Natasha was comforted by the NICU they should be prepared to say had no time to prepare Natalan’s Now, more than a year since nursing care, which included loving Throughout the long stay, the works alongside. touches like bows for Natalan’s head goodbye. Alan and Natasha Hendrens’ co-workers lightened nursery, they bought furnishings Natasha’s troubles began, the and photos taken for the parents. prayed together in Natasha’s the load. Jennifer Forman, MSN,

14 | MAKING A DIFFERENCE SUMMER 2016 | 15 HIGH-LEVEL CARE FOR HIGH-RISK BABIES CONTINUES AT NICU GRADUATE CLINIC

Natalan Hendren’s ties to UK HealthCare did not end the most multidisciplinary teams at UK HealthCare. the day her parents took her home from her 72-day stay in the Neonatal Intensive Care Unit (NICU) at Kentucky “Our focus is on growth and development,” said Desai. Children’s Hospital. She then became a patient at the “These children can have multiple issues, the first year NICU Graduate Clinic, a multidisciplinary practice mainly motor and speech and feeding problems, but as that follows former NICU patients and other babies the child grows older, language and behavior problems recommended for developmental care. can also become issues.” Hendrens are enjoying parenthood. story of incredible determination As medical problems are resolved They both still work at UK, and and tenacity by a mom and a really Keegan Smith, PT, DPT, (far left) works with Natalan practicing visual tracking. during that first year, visits taper off. Alan has graduated from nursing good outcome.” (Above) Alan Hendren practices head Babies are typically seen at three school. Natasha works weekends at and neck control exercises that can be months, six months, one year, two When Playforth did her residency done at home. UK Chandler Hospital. They make years and three years of age. A baby’s and fellowship in New York frequent trips to Lexington for Natasha says her experience has chronological age is adjusted to City, most of the women she Natalan’s medical appointments. made her a better nurse. “As I’m correspond to his or her gestational saw there with pPROM elected Like most premature babies, her taking care of patients now I keep age; in other words, a baby who is six to terminate their pregnancies. development is behind schedule but in mind that you never know what months old but born three months “Here, in Kentucky, the culture is through the care she is receiving their family is going through. UK is premature is considered a three- different,” said Playforth. “Over the at the NICU Graduate Clinic (see all about patient-centered care but month-old in terms of developmental last six years back in Kentucky, sidebar. page 17) she is catching up. now I think about the family as a expectations and recommendations. the interactions I’ve had with whole.” The Hendren family has taught wonderful people like Natasha has Much of the clinic’s work involves those around them a number of made me appreciate more and more She also hopes her family’s story educating parents and involving them things. that it is important to respect the will give others hope when things in their child’s care. For example, an patient’s wishes and their views, seem hopeless. “Natalan is such occupational therapist might show “It is,” said Hansen, “a remarkable to give them the information they an inspiration. I want people to parents of a fussy baby how to console need to make decisions, and then know not to give up. God put the him through massage and other support them in that decision.” right people, the right support in techniques. A dietitian could cover Natasha Hendren and Nirmala Desai, our lives. MD, see each other again for the first nutritional issues with parents of a time since Natalan’s discharge from child who is gaining too little or too the NICU after being a patient for “I never believed in miracles. But I much weight. 72 days. Natalan will be followed am a firm believer now.” n by Desai in the NICU Graduate Clinic for three years. Clinic staff discuss developmental milestones. “We try to teach parents how to attain the next milestone,” said Desai. In addition to instruction, parents receive handouts and other helpful materials. “We talk about how they can help get the baby to roll over and those kinds of Nirmala Desai, MD, and an entire team see premature babies like Natalan Hendren at the NICU Graduate Clinic where their things,” Desai said. focus is on growth and development. “Every part is education and through education, we are “Any baby born early doesn’t develop as normally as empowering them. These parents have to deal with other babies,” said neonatologist Nirmala Desai, MD, ongoing challenges. It is hard.” who has run the clinic for more than 40 years. “Some delay in development is very common.” The clinic has two locations, the UK Family Care Center at 1135 Red Mile Road in Lexington and the UK Center For the first three years of their life, babies are seen for Excellence in Rural Health in Hazard. For more at the NICU Graduate Clinic by a team that includes a information about the NICU Graduate Clinic, call neonatologist, a nurse, a speech language pathologist, 859-323-6469 or visit ukhealthcare.uky.edu/kch/ an occupational therapist, a physical therapist, a dietitian services/NICU-Graduate-Clinic. and a social worker. The NICU Graduate Clinic is among

16 | MAKING A DIFFERENCE SUMMER 2016 | 17 just did not want to leave UK and the great care that he – “Dr. Raj came back to us and told us he wanted us to and the entire family – had received there. stay,” said Ligon, choking up at the memory. “They made it work.” “I got great care, always. I couldn’t ask for any better doctors and nurses,” said Ligon. THE CALL THAT CHANGES EVERYTHING When Janet Ligon received the call Aug. 24, 2015, that He also did not want to think of his wife “up there all a heart had become available for her husband, “I could by herself,” he said. And, Ligon wanted the TLC (tender have just sat on the floor,” she said in describing her loving care) for Janet and the couple’s three grown surprise – and relief. children that they had received at UK as well. Transplant coordinator Donna Dennis explained that “They absolutely offer the best care so far as the she would have to talk to Reuben to proceed. Janet patient but also for the family,” said Janet Ligon, knew it would be hard to reach Reuben that day. He remembering the support, kindness and information was out with her father looking at diesel motors, and she received at UK many times over the years. cellphone service was spotty. She anxiously waited and kept calling her husband. A MATTER So, Ligon and his wife talked to his cardiologist, Navin Rajagopalan, MD, director of the UK Advanced Heart By the time Ligon heard the news and returned the Failure Clinic. Ligon wanted desperately to stay at UK. call to Donna Dennis, it was midday, Janet recalled. He The people, the trust, the care – he was scared to think accepted the surgery and the couple dashed to their OF HEART of leaving that. Rajagopalan could not have been more car to begin the two-hour journey to Lexington they comforting, the couple said. had made so many times. Only this time, the stakes were higher. This was a transplant – Alexis Shafii, MD, “He said, ‘We’ve been through a lot together, and pump for people with weakened hearts. His LVAD the surgeon who would perform the transplant, would we want to keep you here,’” Ligon remembered the Reuben Ligon had a broken heart coordinator, Amanda Hart, became like family to Ligon be cutting into Ligon’s chest, taking out his failing cardiologist telling him. for years. When it came time to and Janet. heart and replacing it with a healthy one. Rajagopalan then discussed options with medical and replace it with a transplanted “She called him ’Ruby,’ and there’s nobody that can financial colleagues at UK HealthCare. one, there was only one place he call him ’Ruby,’” said Janet. But Hart had helped Ligon would trust for the surgery: UK. through many medical challenges, Janet said, so if she wanted to call him Ruby, that was fine with him. Congestive heart disease had plagued Reuben Ligon Ultimately, there was no option for Ligon but a heart for almost 40 years. It limited his ability to work as transplant. His weakened heart was wearing out. He a diesel mechanic – a job he loves – and to enjoy time was put on the transplant list at UK. with his family, which includes two sons, a daughter “I got great care, and, now, six grandsons. Then came a small catch. His insurance company told always. I couldn’t It finally threatened his life. Ligon it would cover the out-of-pocket expenses for the surgery only if he went to a certain hospital in Ohio. ask for any better Doctors and nurses at the UK Gill Heart Institute and doctors and nurses.” later at the UK Transplant Center had taken care of Ligon did not want to go there. He stood firm. If his – Reuben Ligon Ligon, 59, and his failing heart for years, carefully life was on the line, there was only one place he would managing the progressive disease and the symptoms trust – and that was UK HealthCare. Doctors and it caused. Reuben and his wife Janet drove two hours, nurses there had taken excellent care of him for years, each way, from their home in Warsaw, Ky., to Lexington and there was no place else he would feel comfortable, UK cardiothoracic surgeon Alexis he said. Shafii, MD, with heart transplant and then back on more occasions than they can count. recipient Reuben Ligon. Ligon refused to go anywhere else for the surgery. In 2011, Ligon had surgery in which doctors implanted “I wasn’t about to go to Cleveland,” said Ligon. And it a left ventricular assist device, or LVAD, a mechanical was not that he had concerns about that hospital. He

18 | MAKING A DIFFERENCE SUMMER 2016 | 19 LVAD coordinator Amanda Hart met heart patient Reuben Ligon when she first started in the position and admits to getting emotional when it came time for his transplant.

HOURS LATER, REUBEN’S FAILING HEART IS EXCHANGED FOR A HEALTHY ONE Surgery was scheduled for 4:30 p.m. – only about four hours had passed since Reuben said, “Yes.”

“As soon as we got there, there’s a roomful of people,” Janet recalled. “And then at 4:30, they were wheeling him down the hallway into surgery.”

Ligon got “a little emotional” before surgery, his wife learned from Amanda Hart. Because he was already in the operating room, she could not be there to comfort him. But Hart was, so she held his hand.

Hart said she felt emotional, too. She had met Ligon when she first started her position “and I could tell right then how dedicated a person he was.”

“He’s very driven and motivated but at the same time, very humble. He would do anything for anybody. When he was rolling down the hall, he said, ‘Now if there’s anyone who needs this more than I do, let him have it instead,’” Hart recalled. Reuben and Janet Ligon with three of their six grandsons. Family care is just as important as patient care. In those tense moments, minutes turning to hours during surgery, information is vital for family and other loved ones. UK nurses provided updates just as sense of dedication to their patients that makes her said. Sometimes, a patient will feel sad and needs to often as Janet needed it. proud to be part of the team. grieve. Hart aims to respect the emotional needs of the patient as she meets their medical needs. “My motto is, “They would come in (to the waiting room) all the time. “I feel like it comes naturally with our program,” Hart ‘I will treat every patient like I’d want my family to be They’d update us. ‘We’ve got the old heart out now.’ said. “Our patients are our family. The empathy is real. treated,’” she said. ‘We’re implanting the new heart.’ There was always It’s genuine. What you get at UK is sincere.” someone coming out with an update,” Janet said. It’s a pervasive attitude, the Ligons believe. Hart and other members of the team strive to meet the needs of each individual patient and also each After Reuben’s surgery, the nurses were so attentive patient’s family. That’s particularly important with once he was settled in his room that the Ligons said “Our patients are our family. The transplant patients, she believes. they will never forget the surprising touches and empathy is real. It’s genuine. kindnesses they showered on them. As they look back, “It’s such an amazing experience to be in a room there were so many attentive nurses and aides they What you get at UK is sincere.” with a patient when they are about to undergo a could not even begin to count them. – Amanda Hart life-changing surgery. There can be a lot of anxiety,” Hart said. She makes sure to evaluate the needs of the “Even the people who clean the rooms all have a patient and to respond accordingly. special way about them,” said Janet. “You get the sense And Hart was there for her, too. that they really care.” Just as she held Ligon’s hand pre-surgery, she will “She was hugging me, telling me he was going to be sometimes talk quietly and reassuringly with other At one point a few days after surgery, Ligon was OK,” Janet said. And, he was. Ligon made it through patients. craving a biscuit and gravy. One of the nurses heard the surgery in excellent shape. him talking about one, and voila, the next day, she “I like to tell them that ‘We’re going to take great Hart said she felt honored to be there to support the appeared with a biscuit and gravy. care of you and I’ll see you when you wake up,” she Ligons. All members of the transplant team have a

20 | MAKING A DIFFERENCE SUMMER 2016 | 21 2016

25 Years of Heart Transplantation at UK HealthCare

Janet said that Rajagopalan told the couple, “‘I’ll make CELEBRATING 25 YEARS OF HEART it happen, even if I have to pay for your motel room,’” TRANSPLANTATION meaning that he would make sure Ligon would be out Visit ukhealthcare.uky.edu/making-a-difference of the hospital that Sunday, even if it was too late in the day for the couple to travel. The donor and the donor’s family will always be in “He emailed us throughout the day, saying everything’s their hearts and minds. great, we’re going to get you out,” said Janet. And he did. The Ligons spent the holiday with their children “He worries about the donor’s family,” Janet said. and grandchildren. “Someone lost their child. I tell him ‘God has a plan,’ and he wants to make sure he lives up to that plan. I LIFE WITH A NEW HEART don’t know if those parents will ever understand the In June, the Ligons went to Myrtle Beach for a gift they gave. But we do.” vacation with the grandchildren – the family’s first in a decade or more. Reuben Ligon promises that he, like his UK team of doctors and nurses, will make sure that the gift of life “We still look at each other and say, ‘Did you think this he received will not be in vain. n day would ever come?’” said Reuben.

“We still look at Dr. Rajagopalan, as the medical director for heart each other and transplantation, was in their eyes the maestro Surgeon Alexis Shafii, MD, and cardiologist Navin Rajagopalan, MD, belong to a team that stresses say, ‘Did you think coordinating all details throughout. He calmed the communication with each other and with patients. Ligons when they were anxious or scared, and he took this day would time to answer every question they had. ever come?’” “everyone has a voice,” said Rajagopalan. “We want – Reuben Ligon “He’s this really big, tall guy. He has a big, strong everyone to know that their input matters,” he said. voice. But he talks to you person-to-person and makes sure you understand things,” said Janet. They also want the patient to know that his or her concerns matter. “WE REMEMBER OUR WORK IS NOT IN VAIN” Rajagopalan credits the entire transplant team, from “We explain, we answer questions, we take our time,” dietitian to social workers, to nurses and surgeons, as Rajagopalan said. If patients and their families have being very committed to the program. questions after-hours, they are encouraged to contact their doctors. “We’ve all seen people who have been saved from dying,” he said, “and we remember that. We remember Ligon was close to being ready for discharge in early our work is not in vain.” September 2015, and was hoping he could be home in time to spend Labor Day with his grandchildren. Kentuckians Reuben and Janet The team stresses communication, said Rajagopalan, Ligon vacationing with their six among its own members and with patients. At the Discharge after surgery always takes time, but grandsons at Myrtle Beach, N.C.– Tuesday morning staff meeting of doctors, nurses, their first family vacation in more particularly so after a heart transplant. Patients often than 10 years, made possible by dietitian and the various therapists who will help are discharged but then stay nearby so they can be Reuben’s new, healthy heart. to restore a patient to good health post-transplant, close to the hospital for follow-up care after surgery.

22 | MAKING A DIFFERENCE SUMMER 2016 | 23 UK HEALTHCARE Forming a statewide health care collaborative ACHIEVES NURSING’S In January, UK HealthCare joined nine other health care systems across the Commonwealth of Kentucky to form the Kentucky Health Collaborative. The collaborative’s primary objective HIGHEST HONOR is to raise standards of care across the state, address the Commonwealth’s poor health statistics and reduce the cost of care through greater operational efficiencies.

In February, UK HealthCare was Charter members are: notified that we have achieved Appalachian Regional Healthcare Magnet status – the highest Baptist Health institutional honor awarded for Ephraim McDowell Health (Danville, Ky.) nursing excellence. The recognition LifePoint Health came from the American Nurses Norton Healthcare (Louisville, Ky.) Credentialing Center. Owensboro Health UK HealthCare’s promise St. Claire Regional Medical Center Achieving Magnet status involves a rigorous and to you: The Power of (Morehead, Ky.) lengthy review. It shows a commitment to nursing St. Elizabeth Healthcare excellence and improving professional practice, along Advanced Medicine (Edgewood, Ky.) with a solid commitment to continuing education The Medical Center and nursing specialty certification. Magnet nurses How powerful is advanced medicine? At UK HealthCare (Bowling Green, Ky.) keep a laser focus on patient safety. it is seriously powerful. Life-changing powerful. UK HealthCare

“It is truly an honor resulting from the leadership In March we launched a new advertising campaign of our nurses, involving all of our caregivers, to keep built around our message of The Power of Advanced the focus on meeting the needs of our patients, their Medicine. The campaign showcases our role as families, and one another each and every day,” said Kentucky’s leading academic medical center. WHAT YOU SHOULD KNOW ABOUT ZIKA VIRUS THIS SUMMER Bo Cofield, vice president and chief clinical operations officer. “We are all proud to be one of less than From treating the most complex medical diagnoses to The CDC recommends Zika virus testing for: • Pregnant women should not travel to any area with Zika. 10 hospitals in Kentucky and less than 500 in the blazing new trails related to research and innovation, • Pregnant women who have recently traveled to an area • If you must travel to one of these areas, talk to your nation to have earned this distinction.” amazing things happen at UK HealthCare every day. with active Zika. doctor or other health care provider first and strictly • Anyone who has traveled and has symptoms. follow steps to prevent mosquito bites during your trip. CONGRATULATIONS TO THE UK HEALTHCARE Perhaps you’ve seen our TV commercial featuring several • Until more is known, pregnant women with male sex NURSING TEAM – YOU’RE THE BEST! of our programs and initiatives including orthopaedics, If you live in Kentucky and are not planning to travel this partners who have lived in or traveled to an area with cancer and Alzheimer’s research, as well as the new summer, your risk of catching Zika is very low. Zika virus should either use a condom every time they Sports Medicine Research Institute. If you have not seen have sex or abstain from sex throughout the pregnancy. it, watch it at youtube.com/ukhealthcare. The Zika virus is spread through mosquito bites or through sexual contact with an infected person. To prevent mosquito bites: Currently, virus transmission is happening in many • Wear protective clothes, including long-sleeved shirts Caribbean and Central and South American countries. and long pants. For extra protection, treat clothing with UK DERMATOLOGY Although many people who become infected have mild permethrin, a chemical that repels insects and kills or no symptoms, pregnant women who contract the mosquitoes and ticks when sprayed on clothing, tents NOW AT TURFLAND disease are at high risk for complications. Zika has been and other gear. linked to microcephaly in newborns, a potentially fatal The Dermatology Clinic has relocated to UK HealthCare • Use an EPA-registered insect repellent every day neurological disorder characterized by an abnormally at Turfland on Harrodsburg Road from its former containing one or more of the following active small head. location in the Good Samaritan Medical Office Building. ingredients: DEET, PICARIDIN or IR3535. Alan Fleischer, MD, formerly of Wake Forest University Currently, the only cases in the U.S. have been travel- • Use screens on windows and doors; use air “We are all proud to be one and chair of dermatology there 2003-2011, has joined associated. But concern is growing about the possibility conditioning when available. Stuart Tobin, MD, and Kate White, APRN-DNP, in the of less than 10 hospitals in of travelers spreading it to mosquitoes in the U.S., • Keep mosquitoes from laying eggs in and near expanded clinic. UK Dermatology provides treatments Kentucky and less than 500 in that can then infect people who have not traveled to standing water at your home. for various skin conditions such as psoriasis, skin countries with the active virus. the nation to have earned this cancer, parasitic and bacterial infections, and rashes. If you are pregnant and have concerns about exposure distinction.” Surgical dermatology services include treatments The Aedes aegypti mosquito, the main carrier of the virus, to the Zika virus, please talk to your doctor. for benign, precancerous and malignant skin lesions; can be found in the U.S. during the summer months, surgical removal of moles and skin growths; and including Kentucky. With no antiviral treatment or vaccine examination of surgically removed growths to aid in for Zika, the focus is on prevention and risk reduction. diagnoses. To schedule a dermatology visit, please call 859-257-3235 and choose option 9. The CDC recommends the following special precautions for pregnant women: 24 | MAKING A DIFFERENCE SUMMER 2016 | 25 Non-Profit Org. US Postage University of Kentucky PAID 2333 Alumni Park Plaza, Suite 330 Lexington KY Lexington, KY 40517 Permit #51 MAKING A Difference

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