Cardiac rehabilitation is an important step in recovery after almost any cardiac event. It doesn't change your past, but it can help prolong your future.

"If I didn't do any cardiac rehab, I would seriously doubt I'd have the life expectancy I have now." Mike Pesky has been through cardiac rehab four separate times.

"There's always a possibility you know, when you have heart problems," Pesky said after class. "I got nine stents in me and there's always a possibility of more down the line."

"You only get one heart and we have to take care of it from youth on up." ~ Ruth Ann McKeever, RN

Inside the Cardiac Rehab Center at MercyOne Siouxland, a team of medical specialists helps Siouxlanders through a cardiac rehabilitation program designed just for them.

"We look at lots of things, what their history is, what their ejection fraction is, how well their heart muscles able to pump blood out to their body, what their symptoms were if they had arrhythmias and if that caused their event what was going on?" Ruth Ann McKeever, a registered nurse in the cardiac rehab center said. "So each person is individualized and we look at them individually."

"They care about you as an individual. And it's not like oh, okay, do your workout and we'll see you next time. It's, Do you have questions? Is there anything bothering you? Kind of thing and if you have like depressed, you can feel free to talk to them. And sometimes that's all it takes," said Pesky.

Cardiac Rehabilitation is important for anyone who is recovering from heart surgery, had a heart attack, or is suffering from other heart conditions like coronary artery disease, angina or heart failure.

Because your heart is a muscle and needs to be taken care of. "And once you lose your heart muscle, if you drop your ejection fraction, there's no going back," McKeever said. "The older we get, the more likely we're going to have to have an event or to have something happen."

Exercise uses your entire cardiovascular system, but while the room may look like a gym, cardiac rehab involves more than a workout. "That heart muscle is weakened," McKeever said. "And so you need to start slow and gradually build that heart muscle back up again."

This is also a chance for participants to learn more about their heart and how heart health impacts every aspect of their life.

"Once a week they have education and so we go over a different topic of education with them once a week, so that they continue to learn about their heart and heart-healthy habits," said McKeever.

But while this room may look like a gym, cardiac rehab involves more than a workout. It's also a chance to learn.

"Heart is one thing but the heart and the mind go together. ~Mike Pesky" Changing the way a person thinks about their life, their stress, and other triggers is an important part of the process. "It's not just getting the heart. That's only a part of it," said Pesky. "You got to get the mind is well and that's one thing I have liked all the way through."

Because you only have one beating heart. "So we have to really take care of that heart muscle," McKeever said, "because you don't always get a second chance."

Pesky can't say enough about the team at MercyOne. "These gals care and it shines like the sun outside, it shines through," he said. "And you know I am been very, very blessed to have the nurses here and through my years of coming, to have them here and I can't say enough good things about them."

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I was 50 and this was October 13th I believe.

​Aurelio Hernandez is counting his blessings. Just 5 months ago, at age 50, he had a heart attack. One with a scary name, the Widow Maker.
"So, heart attacks are all bad," said Dr. Mir Subla with MercyOne Siouxland Medical Center. "Usually, we talk about Widow Maker, we are talking about the artery that supplies the left ventricle. That's the chamber of the heart that pumps the blood."

There are three main arteries in the heart, one on the right and two on the left. The Widow Maker occurs in the left anterior descending artery which supplies blood to a large portion of the heart.

"In the Widow Maker, what happens is this artery gets blocked, there is a plaque in the wall and that ruptures and a clot forms in the artery and an artery gets blocked and there's no blood flow," said Dr. Subla.

A Widow Maker feels like any other heart attack, with symptoms like shortness of breath, chest pain and heaviness.

"It was actually during work, felt a little tired so I figured I'd go home while the texture was drying," Hernandez recalled about the day he had his heart attack. "I was gonna try to take a nap but then I felt pain across the chest. I actually started on one area and kind of gradually started moving. I didn't think anything of it until it started all the way across, and then my breathing kind of got a little difficult."

Hernandez went to a nearby ER and they sent him to MercyOne Siouxland. Because when it comes to matters of the heart, time is critical.

"Nowadays, it has improved a lot," said Dr. Subla. "Fatality rates have dropped if they receive care in what we call "door to balloon time", or "contact to balloon time".

Dr. Subla says the standard time from first medical contact to balloon time or the point where doctors open the artery, is 120 minutes, or 2 hours.

"It's usually fatal if not treated. People can develop heart failure because that portion of the heart doesn't get any blood and the part of the muscle dies. - Dr. Subla"

Hernandez got treatment in time, but he also knew what to look for.

"Just watching what happened to my brother, passing away at the same age of 50 and leaving four kids," Hernandez said. "I guess it wasn't actually surprising because of my family history of it. But at that time, you know, I was always active. I know my lifestyle of working all the time and not eating right and all had something to do with it but it was a to where I can't believe this is happening to me."

By the time Hernandez arrived at MercyOne last October 13th, the cardiology team was ready.

Dr. Subla recalls that day, "we took him immediately to the catheterization laboratory, his Widow Maker was 100% blocked and we opened up with a balloon and a stent and it had good flow at the end. He was symptom-free and his heart muscle did not suffer any damage."

READ MORE - HEART MONTH: Rehabbing your heart with MercyOne Siouxland Cardiac Rehab Center

He is one of the lucky ones, especially in a time when many are not seeking treatment because of COVID-19.

"It's what we call timeless muscle," said Dr. Subla. "So the more you delay, the more muscle will die.

And even if you survive, if you don't come to the hospital, you will have heart failure and we see a lot with those patients especially in COVID times, people didn't want to come to the hospital for obvious reasons. And we see a lot of heart failure patients."

When I met Hernandez, he was graduating MercyOne's cardiac rehab program. Leaving with a new lease on life and a vow to teach his kids and others around him that heart attacks aren't for the faint of heart.

"So you change your outlook on a lot of things. So there's not like what I don't care if it happens to me, now you got to what does it matter if it just happens to you, but everybody else behind you to it, you know, it affects them as well," Hernandez said after graduation.

His one tip for Siouxlanders?

"Just be careful. You know, know your signs, figure it out, you know, if you don't feel something right, you know, there are issues there and it's not fun. It's not fun at all."

Hernandez says he plans to keep up his workout routine and healthy eating habits, with a focus on overall heart health.

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It's smaller than the tip of your finger but powerful enough to open the arteries of your heart.

​Millions of Americans receive stents each year, but what are these tiny, life-saving devices?

If you have a blockage or narrowing of an artery around your heart, you may be told you need a balloon angioplasty and a stent placed.

"This is called balloon and stenting and this is a very common procedure that has been done in the entire world millions of times already," said Dr. Gary Chan with MercyOne Siouxland's cardiology team. "So actually the rest is pretty safe."

"Most of the times stents do a wonderful job and the patient doesn't have to go through a huge surgery," explained fellow cardiologist, Dr. Mir Subla.

Stents are common and a lot smaller than you may think, fitting on the tip of your finger.

It's typically a minimally invasive procedure where a tubing is inserted into the blocked artery.

"And this tubing has some special features to it. It has a little saucer-shaped balloon attached to it so that when it's inflated, it will push the cholesterol blockage up against the wall, opening it up temporarily," explained Dr. Chan. "But then this is only a short-term solution. To really prevent it from coming back in we have to deflate that balloon, withdraw the entire tubing, put another tubing across the lesion.

The next piece is the stent itself which looks a bit like chicken wire.

READ MORE: Surviving a widow maker heart attack - Aurelio's story

"But then in addition to the balloon, it has a metal scaffold attached to it so that when it's inflated, and then the balloon is deflated," said Dr. Chan. "The macro scaffolds stay behind keeping it up, keeping the arteries open for a long time."

Patients can have multiple stents and they are permanent.

"Patients can have multiple stents and they can be overlapping they can be the side branches," said Dr. Subla. "If a patient has stents and they decide to have bypass surgery as the disease progresses, they can still have bypass surgery down the road."

If you have a stent placed, it's typically managed with medication and a few lifestyle modifications and can help prevent a bigger heart surgery down the road.

"The stents remain open with the medications and little follow-ups with the cardiologist and it reduces the huge burden of surgery for the patient," said Dr. Subla. "And the stent just takes is one hour at least and they can go home the next day."

Once a stent is placed, tissue will begin to grow around the area, completely covering the device like a layer of skin.

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I just knew something was not right.
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Stephen Lordemann had his wife take him to the hospital in 2008. He'd been helping his daughter move when he started to not feel well. His heart was racing. His wife, an EMT, couldn't count his heartbeats when feeling his pulse.

Lordemann was in AFIB or atrial fibrillation, which is an irregular and often rapid heart rhythm.

"So in atrial fibrillation, the top chambers of the heart are beating erratically, said Dr. Gary Chan with MercyOne Siouxland Medical Center. "And because of that, blood is not being moved efficiently from the top chamber to the bottom chamber."

AFIB is fairly common and some who experience it don't have any symptoms at all. So how can you tell if you could be in AFIB?

"For the patient, for the general population, the easiest way to tell will be to feel their pulse. And if they feel that from one pulse to the next one, and if the duration is different then they are in AFIB," said Dr. Chan.

While AFIB isn't usually life-threatening on its own, ignoring it could lead to more life-threatening issues like blood clots and increase the risk of heart failure or stroke.

"In atrial fibrillation, the top chamber is, instead of pumping effectively, is actually quivering," said Dr. Chan. "So blood stays there not moving well, and as a result, blood clots can form. And the end result is that if the blood clot flows down to the bottom chamber, and pump up to the brain, it can cause a stroke."

So how do doctors treat AFIB? There are a few ways. Medication might be enough to get the heart pumping in rhythm again and in some cases, shocking the heart might be needed.

"And we can either give them an electrical shock, that brings it back to that sort of reset the heart and then get it back to normal or give them medicine to bring them back to a regular rhythm," said Chan.

Many patients who experience AFIB end up on blood thinners, at least for some time. Age is a big factor in those who experience AFIB, other risk factors include obesity, high blood pressure, smoking and heavy drinking.

"If there are structural abnormalities such as the top chambers are dilated, they are at increased risk. If they have an issue with the valve, that could also increase the chance of having AFib in the first place," said Chan.

"I've experienced twice," Lordemann said, regarding AFIB. "Then had two heart attacks. Both of them had stents."

Lordemann credits his MercyOne cardiology team for getting him where he is today with a few lifestyle changes and a little cardiac rehab, he and his heart are doing great.

For Dr. Chan, his one piece of advice is if you feel something could be wrong don't wait to seek medical care. "But then sometimes times does matter," Chan said, "especially when it comes to matters of the heart."

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"I had had a heart attack on July 6th and had been having some problems with passing out. And finally, Dr. Ciuffo said he was going to fix it." Gloria Lordemann had experienced issues with her heart before. "I'd had a bypass a couple of years before that. And then this was something new and different," she said.
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She had a problem with her mitral valve, something fairly common for women.

"If you take a sample of the population between the age of 25 and 40, one woman out of six has what we call mitral valve prolapse," said Dr. Giovanni Ciuffo with MercyOne Siouxland Medical Center. "It's like sort of a redundant amount of tissue."

But what is a mitral valve and how does it work in your heart?

"The heart has four valves and they work as one-way valves. You have two on the right side which is the side of your heart that pumps into the lungs, oxygenates the blood and then it goes back to the left side of the heart," explained Dr. Ciuffo. "Mitral valve is in a pumping chamber, when the heart squeezes the mitral valve closes to make sure there's not backflow into the lungs and it flows into the main pipeline in the body that carries oxygenated blood all over the body."

There are two main problems a person can develop with their mitral valve; it can leak causing blood to flow backward into the lungs, or it can struggle to open properly leading to a buildup of blood and pressure in the lungs.

"In severe degrees, mitral regurgitation will really make your life miserable, swollen legs, very short of breath," said Dr. Ciuffo. "You can't even go to a supermarket and push a cart, it gets that bad."

The surgical procedure to fix a mitral valve used to mean open heart surgery. Now, it is a minimally invasive procedure.

"But for the last 20 years, I was able to implement a minimally invasive technique, such as the one I use in this patient, where you can actually make a small incision on under the skin fold of the right breast and you go between the fourth and the fifth rib. That's what we call minimally invasive," he explained. "You don't break any bones. It's minimal amounts of bleeding."

This also means a quicker recovery. But why do doctors see more mitral valve issues in women than men?

"They actually would tell you that probably one of the most common things is, that's sort of a far-fetched theory, there are moments in a woman's life where soft tissue becomes loose," explained Dr. Ciuffo. "One classic thing is when during pregnancy is a natural adaptation because you have to deliver a baby and having the extra loose stations it makes it easier. But other than that, I would say there are certain features that belong to one sex or the other the general."

For Gloria and her husband who also receives cardiac care here, making the drive to MercyOne for their heart health was a no-brainer.

"I've had the best of luck here with mercy. they've handled all my problems and taken great care of me," Gloria said.

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In the early days of the COVID-19 pandemic, doctors didn't know how to treat the sickest patients. Everything about the virus and how it interacted with the body was unknown. But when ICU specialists and the cardiology team at MercyOne Siouxland Medical Center came together in the fall of 2020, they discovered that a piece of equipment in their arsenal was just what they needed.

"We learned a lot about managing COVID patients. You know, our first wave was truly disheartening because it was sort of a new disease that we had to deal with. And our therapeutic options were pretty limited." Dr. Giovanni Ciuffo wasn't used to working with Intensive Care Unit staff. "Intensive Care Unit specialists don't interface much with a heart surgeon but that became a necessity," he recalled.

That necessity began when the first wave of COVID-19 hit Siouxland and doctors had to use everything at their disposal to save lives.

Doctors turned to an external oxygenation device, something cardiologists typically used for patients who suffered cardiac issues.

it's a modular cooler, heater-cooler, that circulates water through these pipes and it controls the temperature in the patient," Dr. Ciuffo explained. "You can hook it up to the machine and dial the machine and say bring the patient back to a normal body temperature 98-99."

This machine can essentially oxygenate your blood for you. Something many otherwise healthy people were struggling to do after testing positive for COVID-19 and ending up in the ICU fighting for their lives.

When the MercyOne team first began using this machine to treat COVID-19 positive patients, they were among the first in the nation to do so.

"You know, when we started doing this, we were among the first guys doing it in the country. Here was a brand new concept where, well let's try to bail these patients out," Ciuffo said.

But they worked in cooperation with hospitals nationwide in finding a new way to care for patients with an unknown virus.

"You can see there's an oxygen tank here. And in addition to that, there's an oxygen rate regulator, see the air oxygen mixer," Dr. Ciuffo said as he walked me through the large machine. "And we can basically modulate how much oxygen is put through the oxygenator while the machine flows so that I can control the patient's temperature, how much I'm flowing."

This machine takes your blood, oxygenates it, and gives it back, taking work away from your body and giving it a chance to heal.

"And what you do with his machines, you actually connect them to veins and arteries in the body and circulate the blood into an oxygenator something that basically is replacing your lungs," Dr. Ciuffo said. "You oxygenate the blood, give it back to them and that will give them the break they need to get through the COVID infection until the lungs recover their ability to oxygenate."

The oxygenator is used to help those who have suffered a massive heart attack, pulmonary embolism, or blood clots, and those whose heart has stopped because they got too cold. This machine can help bring their temperature back up and help bring them back to life.

"So this one is basically what will keep your patient alive and well. While they go into the next level of treatment if it's available to them." While the outcomes were initially unknown when treating COVID-positive patients, they saw positive results.

"In medicine, you always had to strike a balance between what's reasonable to help someone and what's just far fetched," Ciuffo explained. "In those patients that we use this machine on really he was not far fetched. They survived. So it was well worth all the effort we put on it."

For Dr. Ciuffo, and others in the fight to save lives, it's all about giving people a 2nd chance at life.

"Human Physiology, this complex beautiful machine we call the human body with lungs and kidneys and heart and brain and electrical system and all that is incredibly complex."

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A catheterization laboratory may look like a scary place with a big name, but it's a common stop for patients entering the hospital with possible cardiovascular problems.

"In the Cath Lab, what happens is patients will be brought into the cath lab such as this, and their heads will be up here near the imager and their feet down here," said Dr. Gary Chan, a cardiologist with MercyOne Siouxland Medical Center.

In the Cath Lab, cardiologists use diagnostic imaging equipment to visualize the arteries and chambers of the heart.

"Now there are two ways to do the cath. One is to the wrist and another one is through the groin." During the procedure, the patient will be moderately sedated to help calm the nerves and ensure they can lay still for 45 to 90 minutes.

"They will put a fine tube in a way very similar to an IV but then the tubing is way longer because it has to be long enough to go all the way up to your arms to your heart or from the groin so that they can inject some contrast to it," said Chan. "And then with that, they can visualize the three coronary arteries in the heart and see if there's any blockage."

Dr. Chan says there are generally four outcomes from a cath procedure. The first, nothing is wrong and the issues the patient is feeling are not related to a blockage in the heart.

"Outcome number two is the patient does indeed has some blockage and that can be fixed by a stent," said Chan.

The third outcome is when a stent doesn't work and the patient will be referred to a cardiothoracic surgeon to see if they qualify for bypass surgery.

"In a bypass surgery, what happens is they either use your own blood vessel in your chest wall area, or harvest a piece of veins in your legs, and then just sew it across the blockage, that's why it's called bypass," said Chan. "The earlier we open a blockage, blood vessels supply the heart the more recovery the heart can retain the functions we can prevent loss of functions of the heart."

The 4th outcome, if a stent or bypass is not an option, is medical management.

"The last outcome is then also not a candidate for this and that will be managed medical management," said Chan. "Only meaning that we keep them we give them the medicine that will help prevent further progression of the disease."

Dr. Chan says health risks in the cath lab are minimal, with possibly some minor bleeding at the insertion site or a drop in blood pressure.

"If this is an elective procedure is generally safer than someone coming in with a cardiac arrest or having an acute heart failure flown in from a rural area," said Chan. "So this is totally different. The risks are totally different."

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Winter weather typically means snow and ice which also means shoveling snow and bitterly cold temperatures, but did you know that combination could lead to a heart attack?

"It is comparable to if we got on one of these treadmills and we're running full speed." Bridget Hayes Beck is a Registered Nurse at Mercyone Siouxland's Cardiac Rehab Center, "it just shocks people that when they go out and shovel their walks in their driveways that how much stress that puts on their heart."

She's helped Siouxlanders recover after suffering a heart attack in the winter and has a word of warning for Siouxlanders.

"If we could get the word out to the public, that is very dangerous to just go out and start shoveling the walk and the driveway."

But why are heart attacks common in the winter months? Simple... the cold.

"It does really wear on the heart, that cold air coming into the lungs, into the heart can constrict down the coronary arteries and that's where people have problems," she said. "It will cause those coronary arteries that are smaller than drinking straw to constrict down. And at that point, some people do have a heart attack meaning that the heart cells do not get oxygen and do not get the blood that they need."

There are a few things you can do to stay a little safer while shoveling snow or working in the cold, like taking frequent breaks.

"It's very important to warm up. It's very important not to have a big meal beforehand," she said. "And then when you do go out there take small breaks."

And this is especially true for Siouxland farmers, who spend hours outside working at a time.

"Now if you try to tell that to a farmer who's going to be out there for three hours, no take your breaks," she said. "Especially let a family member know that you're out there."

When in doubt, take a break, and if something doesn't feel right, seek medical assistance right away.

"But the most important thing is to make that phone call or have your family member make the phone call for you."

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Heart attacks and heart disease can present differently in everybody.
​
"In women, in particular, especially older women, the symptoms are typically unusual," said Dr. Glynne Edwards. "It can be breathlessness and just shortness of breath, unusual sweating episodes, sometimes a toothache, even belching, unusual belching symptoms."

Signs and symptoms of heart attacks, heart disease or coronary artery disease can manifest with pain or pressure in the chest, which typically moves toward the left side of the body.

But what can cause these life-threatening events?

"A very common thing is high blood pressure and high blood pressure has a lot of effects on the heart that, if unchecked, you know, heart failure relationship," said Dr. Edwards.

Another common denominator? Genetics.

"Knowing your family history of heart disease is also important," said Dr. Edwards.

So how can you stay heart healthy?Regular exercise is a good place to start.

"The American College of Cardiology has a recommendation for 120 minutes of aerobic exercise in the seven-day period," said Dr. Edwards.

Watching what you eat is important, too, as well as staying away from tobacco use.

"Smoking is the number one modifiable risk factor for the use of hierarchy disease animalism formation, vascular disease in the legs and the stroke."

At the end of the day, staying active, eating a balanced diet and knowing your family medical history can be a good start in keeping your heart healthy each and every day.

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"Smoking is probably the number one most important preventable risk factor when it comes to heart disease." We've all heard the warnings about smoking and your lungs, but did you know it's just as bad for your heart? Not only heart disease but coronary artery disease and many other life-threatening health issues.

"There is increased risk of strokes, increased risk of blockages in the leg arteries and damage to the major arteries of the heart and the body, in particular, the aorta which can become involved forming an aortic aneurysm," said Dr. Glynne Edwards. "And in these cases, these always require emergency surgery. So, an ounce of prevention is better in this in this instance."

Smoking and tobacco use can cause your arteries to shrink, "and what we call vasoconstriction, where the arteries actually shrink from this size to 1/3 of the size in response to these toxic chemicals," said Dr. Edwards.

Not only that smoking and tobacco can also cause plaque build-up in the arteries feeding your heart.
"In some instances, the narrowing may not be acute but so severe that it weakens the heart muscle to the extent that you develop what is called heart failure," said Dr. Edwards. "Overall, it triples or quadruples your risk of getting a heart attack. If you're under 50. That risk is increased sevenfold. more than doubled your risk of having a stroke."

And if keeping yourself healthy isn't motivation enough, think of the health damage it can cause to those around you.

"The only thing I want to mention is that secondhand smoke also tripled your risk of having heart disease and we've actually looked at data for folks who have been exposed to secondhand smoke over a lifetime 20-30 years, their risk of developing coronary disease even though they didn't smoke themselves, is three times higher than folks who are not exposed to secondhand smoke."

While this is probably something we've all heard before, the best thing you can do is put that cigarette down.

"So generally the advice in anyone who smokes and who has heart disease would be to find a way to try to quit."
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As the weather gets colder, illnesses start appearing including RSV. It's a common illness among infants and the elderly but for some can be very serious and require hospitalization.
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The frustrating thing about RSV and a lot of these respiratory viruses is there's no effective treatment to kill it or shorten the course Dr. Jeremy Granger is a pediatrician with UnityPoint Health. "Even without knowing for sure that it's RSV. The things to look out for are the same things you would look for in general with any respiratory virus, primarily, difficulty breathing, rapid breathing, labored breathing, and signs of dehydration."

Dr. Granger has been seeing a rise in cases of RSV in Siouxland over the last few weeks. "About two weeks ago, it seemed to really pick up for us," he said. "September we saw a lot of just regular respiratory viruses and hand, foot and mouth. And then the last two to three weeks we're seeing RSV, influenza, Rhinovirus which is kind of always around. And then for the last two weeks a lot of para-influenza virus and adenovirus."

Dr. Granger says most babies with RSV can be treated at home with nasal saline, suction, and Tylenol. Some infants might do well with a nebulizer or a breathing treatment, but that's not the case for all. 

"Sometimes we will use breathing treatments, but not all children need breathing treatments and in fact, sometimes it can make it worse," Dr. Granger said. "So if your kid is breathing comfortably, even if they have a little bit of wheeze, many times we will not do any medicine because you know, we first want to do no harm."

"When we see children in clinic, we're making sure that they're breathing comfortably and that their oxygen is good," he continued, "but we don't routinely order x-rays. And those are national guidelines that come from national studies that have been done."

For babies with a fever, Dr. Granger says sometimes a high and fluctuating fever is a good sign.

"Fevers can make you feel uncomfortable. It will make your breathing hard and heavy and make your heart beat fast, but it's also a way that our body uses antibodies to kill off viruses," he said. "But if your child's 101-1-2 and they don't seem in much discomfort, you can let them simmer at that temperature. The body will bring that temperature back down and they'll cycle up and down every few hours. And that's the nature of fever. And that's not necessarily a bad thing. It's kind of like Last Man Standing. Our cells can tolerate temps around 106 without damage and viral particles start to kind of break down the protein at higher temps."

But if the fever does get too high, it's best to see a doctor. "If they have a fever, and they're uncomfortable, treat it. If they're over 104-105, they probably need to be seen."

 When it comes to nighttime care, have your child sleep on their back, or even in your arms, because nights can be scariest for parents. "So nighttime is the worst and generally days 3-5 are going to be your worst nights with RSV. So if you've made it past those nights, you're usually on the downhill slide."

During the winter months, it's also not uncommon for kids to have several viruses at one time. 'And it's not uncommon to find them positive for three to five viruses all at the same time," said Dr. Granger. "We call it viral stalking. You just get one illness after another."

Dr. Granger says RSV is so common, it's almost impossible to avoid. "With RSV, you're probably not going to avoid it. Everybody gets it at some point and adults can get it too."

"If you've had a cold through the winter, you probably had it so I wouldn't let the name scare anyone too much. Just pay attention to the symptoms and the child in front of you. And if your guts telling you it doesn't look right, bring them in and we'll take care of her from there. But everybody under the age of two gets RSV at least once so even if you don't know that your child had it, they probably did at least once through the winter."

Those who have RSV, even if they don't know it, can still shed the virus from 8 days to three weeks which makes this virus so contagious for everyone from infants to adults. 

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The month of October is Breast Cancer Awareness Month and while it's a great time to shine a light on the women who are fighting, have fought, and who have lost the battle to breast cancer, it's also a time to highlight the importance of prevention.
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Katie Couric is a familiar face to many. She woke Americans up every morning on NBC's TODAY Show from 1991 to 2996, became the first woman to anchor the CBS Evening News in 2006, and has been a longtime advocate for cancer research after losing her first husband to colon cancer. On September 28th, 2022, Couric announced her own health battle, with breast cancer.

"It was June 20th and because of the pandemic, I was 6 months overdue for a mammogram." Couric was just like many other women across the U.S. and put off her yearly mammogram. When she went in for her appointment in June, she took the camera with her to document the journey, much like she did in 2000 when she got a colonoscopy on the TODAY Show. But that appointment quickly took a turn when doctors found a concerning spot on her mammogram and ultrasound.

"I had a wire put in my boob, which is basically providing guidance for the surgeon because I have a little lump situation," Couric said in the video she posted on her Instagram page sharing she had been diagnosed with HR-positive, Her2neu-negative breast cancer on June 21st.

Women over the age of 40 are encouraged to get a yearly mammogram and because of COVID, many have put off this lifesaving screening, and for some, they haven't had a mammogram since the start of the pandemic. This is why medical providers are highlighting the importance of monthly self-checks at home.

"You're going to know before anybody else." Jeanne Rasmussen is an ARNP with UnityPoint Clinics and says these monthly self-checks can be quick and easy, and the first sign that something could be wrong.

"Boobs are like bags of rice and you're looking for a pee in there," she said of the checks It's also important to remember that breast tissue can be located up into the armpit.

It isn't just adults who should be doing self-checks, but teens as well, because getting familiar with your body and its ebbs and flows are an important part of your health.

"As soon as you start getting your period you're going to have breast changes or hormones. Even when you're pregnant. All of those things stress can cause changes," Rasmussen said. "And just to be aware of those and if you find something, that's concerning them to let us know."

Dr. Adnon Qualbani is a radiologist at MercyOne's Breast Care Clinic and says spending a few minutes on each side is all it takes.

"I think it's important to conduct the self-exams kind of the right way. Check up into your axilla as well. Some women have accessory breast tissue that hides up there," he said. "You want to move a motion from the outside and in toward the nipple, kind of like spokes on a wheel."

"We always check for any dimpling of the skin, like if it looks like an orange peel. That's something that you want to let your doctor know about," Rasmussen said. "If you have any redness, any soreness, any pain."

The best time to do these self-checks is 7-10 days into your menstrual cycle.

"If you check your breasts before you have your cycle, you're going to feel a lot more lumps and pain and so forth," said Dr. Qualbani. "If you do it a day seven to day 10, meaning the day your period starts you call that day 1, seven to 10 days out there's a window where your breasts are the most sort of calm and less lumpy, less painful. That's the right time to check."

Dr. Qualbani says if you find something unusual during these monthly checks, it is perfectly okay to wait a month to see if anything changes before you call your doctor.

If you do feel something it's perfectly okay to wait one menstrual cycle and then check again and see if it changes," he said. "If you check it every day or every week you'll go nuts wondering if that thing is real or is it changing?"

As for when a woman should start getting yearly mammograms, the recommended age is once you turn 40, but there are some stipulations. If there is a history of breast cancer in your immediate family, like a mother or sister, yearly mammograms should begin 10 prior to their diagnosis age. So if your mother was diagnosed at age 42, you'd begin yearly screenings at age 32.

At the end of the day, these medical providers say, you know your body best. If you feel something is wrong or concerning, call your primary care provider and get it checked out.

​SEE THE VIDEO

"I came in happy-go-lucky to see my own colleagues and have plans to have lunch with them and left thinking what's going to happen next?"

Andrea Roost turned 40 in January. in May.. she returned to MercyOne's Breast Care Center where she worked as a mammography tech for 12 years to get her first mammogram. It would also happen to be the last routine mammogram that she'd need.

Roost was diagnosed with breast cancer on May 5th. She did everything she was supposed to: self-examinations, conversations with her primary care doctor, and a mammogram at 40. Nothing led her to believe breast cancer was in her future until it was.

"I am the reason this is why we start screening at 40," she said, "because the cancer that I have would have killed me if I would have waited until 45. Or even 50."

Roost is grateful to have the team at MercyOne's Breast Care Center next to her through this journey, something these women do for all who walk through their doors, and a team she was part of for more than a decade.

"The heart behind every staff member in this office is 100% pure," she said. "They understand what these patients are going through. And they kind of change and flow with that patient with their needs."

For women needing a mammogram, the fear and anxiety of what the scans may show is real and something those in the breast cancer community calls scanxiety.

"It's in reference to the anxiety that you have before, during and after your scans, whether it's you know, engaging in chemo response or your follow-up," Roost said. "I think that's really relevant in the screening and diagnostic world as well. I counseled people on this when I was an active technologist."

Once holding the hand of those coming to the clinic, she is now leaning on her former colleagues to guide her through her own journey with breast cancer.

"It's okay to be scared. That's why we're here is to get you through that to talk you through that," Roost said. "The unknown is scary, but ignorance is worse. That's the best way I can put it."

Roost's cancer journey is just beginning but she hopes that sharing her story can shine a light on the importance of breast care.

"I still have a rough road ahead of me. I've finished chemo. I've had one surgery to remove the tumor and my lymph nodes. I still have a bilateral full mastectomy to do. So it's the worst is yet to come," she explained. "But I'll be looking back on this in a year and be smiling in here to continue to tell my journey."
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Receiving the news that you have breast cancer is shocking leaving most wondering, what do I do next? At Midlands Clinic in Dakota Dunes, they have a pair of dedicated women whose job is to help women through their breast cancer journey.
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"I would say the unique part about our offices, the coordinators, and the role they play in navigating care for those women from start to finish," said Dr. Craig Nemechek, a general surgeon at Midlands Clinic.

"We just help patients navigate through their journey," Nicole Trudeau is one of the Breast Care Coordinators at Midlands Clinic. She and Sophia Summervold play a key role in helping women navigate their new reality.

"We basically start the process of getting them post-diagnosis, getting everything lined up so that they can go through the next process or next part of the process," said Summervold. "They have so many different doctors that they're seeing. They don't know who to call, what do I do next? Who do I call? What's the next step? So we kind of take that and we do all of that in the background so that they don't have to worry about that."

They help women through the emotional journey the diagnosis brings, too.

"It's a big diagnosis, people are overwhelmed," Trudeau said. "It's a lot of terminologies that they don't know. It's a lot of tests that they've never had done before."

Trudeau and Summervold carry a cell phone, one that their breast cancer patients have a direct line to. "They can call a direct number instead of kind of going through the rigmarole of going through the office. So they can call us directly or text so we can talk to them directly and answer their specific questions," said Trudeau.

"Women are very different in how they react to that news," said Nemechek about the diagnosis, "and I think the nice part is that with our coordinators, they've seen all types of different reactions and they know very well how to handle those emotions."

"Everybody's breast cancer is completely different. So it's hard because some people know so and so who had it but they can't always rely on what that person had because it's very different for everybody," said Summervold.

"I just think it's important for people in Siouxland to know that there is a strong support system at many of our medical facilities dealing with breast cancer, not only as their physician but there's also other support staff who can help everyone through their journey," said Trudeau.

And for the month of October, their biggest message is this.

"Do your monthly screenings no matter what age you are," said Summervold, "and then also working with your primary care doctor to make sure you're getting your screenings is super important. Because the sooner that you can get that diagnosis, the sooner you can kind of get through it."

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The treatment for breast cancer has changed a lot over the years, and a Sioux City medical center has played a key role in that development.
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"We have actually been involved in trials that have actually changed how we treat breast cancer patients," Dr. Donald Wender, a physician at the June E. Nylen Cancer Center in Downtown Sioux City, has been one of the doctors on the leading edge of those advancements.

"There's a study looking at a test that who we should give chemotherapy or who doesn't need chemotherapy," said Dr. Wender. There's been a shift in treating certain types of breast cancer which have also led to a common misconception. "We're using less chemotherapy after surgery, so a lot of people think they are going to get chemotherapy and they don't."

Instead, thanks to clinical trials and medical advancements over the last several years, many types of breast cancers are being treated with more immunotherapies and fewer chemotherapies."

"And in the most recent advance in there as with immunotherapy," said Dr. Wender, "we know that there's with chemotherapy and immunotherapy we can get another a lot of them to get a complete response with chemotherapy before surgery."

Dr. Wender has been working with breast cancer patients throughout his career and involved in some major advancements in breast care. In fact, the way we standardly treat breast cancer patients we were involved in most of those trials.

According to the State Health Registry of Iowa, over 14% of all new cancer diagnoses in Iowa this year are projected to be breast cancer, the largest percentage for any type of cancer statewide. Sioux City is the lowest metropolitan area in Iowa with women age 40 and up who have skipped getting a yearly mammogram. And looking at data from a 12-year study from 2004 to 2015, the risk of developing late-stage breast cancer is higher in the Sioux City area compared to the 12-year state average. Which is why these new therapies and clinical trials are important.

The June E Nylen Cancer Center has played a big part in the advancement of breast cancer treatment and while there aren't as many clinical trials as in the past, Dr. Wender says the ones that are available, are working to answer the even harder questions.

"There are not as many trials but there are a bunch of trials looking at new approaches. And then, of course, we try to add immunotherapy," Dr. Wender said. "The clinical trials have slowed down. Before we had a lot of big questions that needed answered, you know, do you give chemotherapy, what chemotherapy do you give? Now we're trying to refine them down to new agents looking at things in metastatic disease."

The treatment for breast cancer has come a long way and the standard of care is constantly evolving. Thanks to the dedicated work of physicians like Dr. Wender and the team at the June E. Nylen Cancer Center.

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As the month of October of comes to an end and the pink ribbons come down, it's a good moment to remember what they stand for: our mothers, daughters, sisters and friends fighting breast cancer.
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"I also think it's a good month to remember the women that have done that had been through a battle with breast cancer or other breast ailment or disease and kind of remember those women as well and what they've gone through," said general surgeon, Dr. Craig Nemechek with Midlands Clinic.
Siouxland has a vast array of resources for women from breast cancer prevention to treatment to post-cancer care.

"I just think it's important for people in Siouxland to know that there is a strong support system at many of our medical facilities dealing with breast cancer," said Nicole Trudeau, a breast care coordinator at Midlands Clinic, "not only as their physicians, but there's also other support staff who can help everyone through their journey."

"We try to provide support, we try to answer questions as best we can. We try to give women a path, some knowledge that tries to ease their concerns," said Dr. Nemechek. "We can't obviously answer every question, but I think and I hope that women after that first visit have a better bit better understanding of what they're going to go through and what they can expect, and hopefully that can ease their mind."

One of the biggest pushes during the month of October is the importance of yearly mammograms for women beginning at age 40, or for some, sooner.

"Typically we start at age 40 unless there's a first-degree relative, that would be like your mother or sister," said Jeanne Rasmussen, an ARNP with UnityPoint Clinics. "And they begin having their (yearly mammogram) done 10 years prior to when they had breast cancer. So if Mom was 42 when she got diagnosed, at age 32 you would start getting screening mammograms."

Many women skip their yearly mammograms, and that is especially true after the COVID-19 pandemic.

"Some people, I think just kind of put it off because they're scared, but I think it's important to kind of face that fear because not everybody ends up having breast cancer," said Sophie Summervold, another breast care coordinator at Midlands Clinic, "but if you have a lump or a bump, it's important to address that with your primary care doctor or ask for that referral. Kind of be your own advocate to move on to the next step to see if you do need to be concerned."

There is also one piece of preventative care women of all ages can do right at home each month: self-checks.

"Get to know what your breast feels like, what your normal lumpiness feels like, what your cyclical changes feel like, and then you'll know if there's a change therein," said Dr. Adnan Qualbani, a radiologist at MercyOne's Breast Care Center. "There are all these things available for dealing with lumps that are even benign and sometimes just even getting a benign lump assessed to see what it is and then you know it's benign. It doesn't have to always be a suspicious lump you want to be checked, anything that bothers you is worth getting checked."

And if you feel something concerning it never hurts to get it checked out.

​SEE THE VIDEO

The month of September is Childhood Cancer Awareness Month but for families with a little one battling cancer, their fight isn't just for four weeks, but years.

"I ask people to take a second and just think about what it would be like to be sitting in an oncologist's office with your spouse waiting for a diagnosis, but that diagnosis isn't for you. It's for your four-year-old child," said Kay Koehler, President and CEO of CureSearch, a national organization with a mission to find a cure for childhood cancer.

While childhood cancer is rare, it is a harsh reality for many parents, including a Sgt. Bluff family whose young daughter is battling acute lymphoblastic leukemia.

"There are so many things that come with getting a diagnosis that your child has cancer," said Erin Edlund. We met the Edlund family, including their youngest Lolo who is in the midst of her cancer treatment, in the summer of 2021. Lolo's cancer journey brought her to Omaha's Children's Hospital, one of the few medical centers in the region that specializes in treating childhood cancer and other illnesses.
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When a child is impacted by cancer, that impacts the next the 70-80-90 years of their life," said Dr. Acquazzino. "There's just so much potential." Dr. Melissa Acquazzino and Dr. Jill Beck are two of the leading oncologists at Children's Hospital and have seen firsthand how current cancer treatments can ravage a young child's body.

Learn more about Children's Hospital of Omaha here.
"Oftentimes cancer in childhood is very aggressive and we use very intensive treatments to get them into remission and cure," said Dr. Aquazzino.

PART 1: Meet a Sgt. Bluff Family in the middle of the cancer fight, and some of the doctors who are on the leading edge of new treatments.

While treatments are advancing, those advancements are not happening fast enough. "We have made strides in terms of treatment and successes in curing," said Dr. Beck, "but it is still the highest cause of death by disease in children."

"Most people think about cancer research as cancer research and that adult cancer, probably those drugs are just applied to children and it doesn't work that way for many reasons," said Koehler. "(We focus) on driving new drug development for kids with cancer and we want those therapies to be less toxic than the current standard of treatment."

Childhood Cancer is different from adult diagnosis because children's bodies are still growing. While childhood cancer is considered rare, the treatments made specifically for their little bodies are even more so.

"You put chemotherapy treatment into a body that's four years old and growing," said Edlund, "that's a pretty terrifying prospect that you don't know what really effect that's going to have and for every kid, it's going to be different because we all grow at different rates."

"If your six-month-old is diagnosed with cancer, they can't take a pill," said Koehler. "How are you going to give them therapy, right? It's everything from the logistics to the treatments themselves."

CureSearch brings new treatments into clinical trials, from lab development to treatment deployment.

PART 2: Lack of funding stalls important advancements in treatment

"I think one of the challenges is that the treatments that we're using are still old and they have a lot of side effects," said Dr. Beck. "I think we are behind, in terms of pediatric cancer the average is about six years after a medication or a treatment is introduced in adults. That it is then introduced in kids."

Children's Hospital works with several clinical trials thanks to organizations like CureSearch and hospitals across the nation, with a shared goal of finding treatments, and a possible cure, for kids fighting these diseases. One of the biggest hurdles they face is finding the funding needed to get the research up and off the ground.

"In pediatric cancer research, we receive a very small percentage of the money that's out there that goes towards cancer research," said Dr. Acquazzino. "The majority goes to the adult world."

CureSearch is funded solely from donations and fundraisers and doesn't receive any federal assistance. Koehler says they are strict in where they put their resources. Each research study goes through a rigorous cycle before CureSearch puts funding behind it to get it to the clinical trial stage. They have a success rate of 60%.

"It costs about $800 million I've been told to bring a drug to market," said Koehler, "so we are solely dependent on donors who are interested in making an impact with their investment in childhood cancer."

Find out more about CureSearch here.
For the team at Omaha Children's Hospital, finding the right treatment and even a cure isn't their only goal. "What we're really working to do is kind of all sides of it," said Dr. Beck. "So decrease trying to figure out why kids get cancer and decreasing that, and then also working on the other side to get better, more effective treatments that have fewer side effects so that these kids can grow up to be happy healthy adults."

"Because pediatric cancer is rare, we band together and we work with the children's hospitals around the country to standardize how we treat kids with certain diagnoses," said Dr. Acquazzino, "and then to ask questions about how we can improve treatment both in terms of improving cure rates, but also in decreasing those long term late effects that we can see from our cancer treatment."

CureSearch not only wants to find the cure for cancer and develop treatments that aren't going to cause these kids more health problems down the road, leaving parents constantly looking over their shoulders wondering when the next shoe will drop.

"For us, it's about how do we move things along faster? How do we help children lead long and healthy lives when we're talking about an additional 60-70 years of life left for them?" said Koehler. 'We need to not just "cure" children and I use the word "cure" in quotes. We need to ensure that they don't have to look over their shoulders for the rest of their life wondering if they're going to have congestive heart failure at 23 years old. That's what we're focused on."

Children's works to get their patients into the best clinical trials possible, but they also strive to make the journey through a cancer diagnosis and treatment as easy as possible for the child and their family. For families of kids diagnosed with cancer, that diagnosis impacts everyone in different ways, from the parents to their siblings. This is why, at Children's, they take a team approach to treatment.

"I think one of the things with pediatric cancer, in general, is it really is a team sport and that that there is no one person in our group that can do this alone, other than the patient but that we're all here to support those kids," said Dr. Beck.

Dr. Acquazzino agreed, "We have a really big team of people that think about our patients head to toe and how we can support not only them but their families." A cancer diagnosis can often be hardest on the parents, both mentally and emotionally, seeing their child go through tough treatments and long stays in the hospital.

"I find that parents often don't know how to sort of trust their parenting anymore," said Dr. Beck, "not for any fault of their own. But because it's unexpected and it's rare and it's not on your radar until it's right there and happening to you."

"When I think a lot of what parents tell me is the club that they never imagined that they want to be in and that they would prefer not to have been a member of." That club is the reality for far too many families and the news that your child has cancer is just the beginning of an incredibly long journey," which the Edlund's are right in the middle of.

"While my daughter's hair is growing back and while we have gotten through probably the hardest part of her treatment, we are still in the midst of treatment," Edlund said. "Today is day 505 And we have 311 days to go. Her end date is August 6, 2023. We are not even close to being done with this journey. We will always live with the fear that she could face relapse.

"We will always live with the fear that the treatment may have caused her to have other underlying health conditions. And that's an enormous burden as well."
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You can get a glimpse of their life on the hit TV shows like Grey's Anatomy, Chicago Med or ER, but being a trauma nurse in a real-life emergency room can be a challenging, rewarding and exhilarating career path. 
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"It's not all fun and glory. There are sad days too," said Lea Mathison, who is the Trauma Program Manager at MercyOne Siouxland. "But though you think about the days that you really made an impression and how you really make a difference and that's just what being a nurse is all about. And an ER trauma really encompasses all of that."
Inside the emergency room at MercyOne Siouxland Medical Center, you'll find a Level Two Trauma Center, the 2nd highest certification a hospital can achieve for trauma response.

"We have a trauma surgeon on call 24/7, neurosurgeons, a certain level of radiology and imaging, OR, anesthesia, neurology, all that kind of stuff to have that response," said nurse Barbara Fitzgerald. "What the research has shown is that if you go to where that specialty is you have a better outcome."
Barbara Fitzgerald and Lea Mathison are two of the leading trauma nurses at MercyOne. They are part of a dedicated team that helps anyone who comes into the emergency room.

"And the ER, you know that it could be they checked in for a stubbed toe or they come in carrying their own leg like you had no idea what's gonna come in and you're just, you're just ready for anything," said Mathison. "You're just always on edge. You're always excited. you're always thinking that what am I going to do to be able to help these people."

For many trauma nurses, they thrive on the chaos and the unknown that each day and each patient can bring. 

"Here, we have no set routines," said Fitzgerald. "It's whatever walks in that door and it can be anything from the most minor injury to the most major, to very life-threatening and being able to take that and do a huge trauma where everything is just crazy and chaotic. And then turn around and go back in and do something much more simple like laceration and still kind of get that same. Like, let's go let's get it done. Let's get them taken care of," she continued. 

"But not only am I the right-hand person of the trauma surgery, ER doctor, but I do everything to help stabilize that patient, said Mathison. "And that just brings home to me of the success stories that I could bring. I contributed to that. I really made a difference in those patients' lives."
And both Mathison and Fitzgerald have had patients and families return to thank them for helping them through their toughest days. 

"I had somebody come back and thanked me for saving her life and thanking me for saving her dad's life even though her mom had passed away," said Mathison, "it was a very tragic moment, but it's very heartwarming at the fact that I was able to be there for her hardest time."

There are even moments when these nurses see their own loved ones brought through the ER doors. "Three years after I started here, my dad came in as a code red," said Fitzgerald. "He was flown in by helicopter. I tell you what, the ER nurses are amazing that they can turn around and you know, this person is going get taken care of to the best of their ability, they're getting the best treatment."

For those of us who don't work in an ER, what goes on inside may look unorganized and disordered, but it is actually a well-oiled machine where nurses and the rest of the team know what it takes to give their patients the best chance at going home beginning the moment they come through the emergency room doors.

"I think the biggest thing is that you've got to have that just that personality that kind of thrives on chaos and is able to roll with it and just kind of say, you know, 'this is me, we're doing it. I want something exciting," Fitzgerald said of the nurses who work on the ER floor. 

"If there's a chance and we can change it, we will," said Fitzgerald, "and that's what makes any ER nurse, that's what makes me want to be an ER nurse is being able to say, hey, we really made a difference this time." These nurses work at the top of their skillset doing everything from vital checks to chest tubes and prioritizing patients' emergent medical needs. "The ER is meant to be the safety net for society. If you don't know where to go, they come here," said Fitzgerald, "and that's what makes unfortunately sometimes your wait here longer or your run through here much longer."

"That's really what an ER nurse is," said Mathison, "is that somebody that's going to make a difference and think, think on your toes and just the critical thinking skills and the anticipation of what that physician is going to need and that's really what we do."

Because for the MercyOne trauma team, coming to work and owning up, means making a difference is saving lives each and every day.

"You don't know what you're walking into but you know that it's gonna be something new every day," said Fitzgerald. 

"We are life savers. We are incredible life-saving bodies and it's not just myself," said Mathison. "All of my nurses that are trauma nurses, they are phenomenal and they're lifesavers and they do wonderful things."

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SGT. BLUFF, Iowa — Last summer, we introduced you to Lolo, a young girl battling cancer and her sister Evelyn, who launched a blood drive in her honor. Now, they are going even bigger.
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"It's beneficial for not only our family but many families around the Siouxland area."

All this week they are hosting a birthday blood drive with LifeServe Blood Center. 5-year-old Lolo has been battling leukemia since May of 2021 and has required several blood transfusions during her journey.

"Lolo was diagnosed last May with B-Cell AL leukemia and she is 13 months in and the way our treatment plan is set up, we have another 13 months to go," said her dad, Jeff. "While she is medically in remission, she's still got a fight. We still have treatments to do and all sorts of different steps to take but we are on a positive path."

Blood transfusions are a key part of her treatment.

"Lolo is on her 9th blood transfusion this year and it is an amazing thing to see how she responds to that and how necessary it is for her treatment," Jeff said.

Her family says this is their way of helping others who may need blood just like Lolo.

"It's also important for not just Lolo, but everybody in Siouxland because there are thousands of cancer patients in the area and tens of thousands across the country," Jeff said. "So we need to have that for all sorts of reasons. And there's a shortage right now and we want to give back to a community that's given so much back to us."

The family has hosted four blood drives with over 350 liters of blood donated so far. Evelyn also uses her platform as a 4-H'er to encourage others to donate.

"The reason it's important for me to be a 4-H'er during these blood drives is because when I do my community service projects, it helps show the people who come and look at my project how important it is to do these things for people," Evelyn said.

Lolo's halfway through her cancer journey and her family hopes they can help others in the community with these blood drives, just like Siouxland has already helped their little girl over the last 13 months.

"She's doing really well," Jeff said of Lolo's cancer journey. "She's responded as planned and checked off all of the boxes. Even if we have had some hiccups where we've needed to go in for transfusions, they've done great and it really helps her out so she can keep fighting."

If you would like to donate in Lolo's honor, you can schedule an appointment at LifeServe Blood Center in Sioux City all this week by going to their website here.

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There are some new faces walking the halls of MercyOne Siouxland, but they are not really there for the patients but for staff and they are already leaving their mark on the hospital.

"I feel really honored to be invited to help take care of the staff because they're just as smart as I am. And we have that we walked the same walk and I'm an employee, too." Lex Woodbury is one of two Spiritual Care Chaplains at MercyOne Siouxland. "Because we know that our nurses and the staff work really hard. So our job is to put some air under their wings."

He and Matt Wentz have been walking the halls of MercyOne since February, interacting with staff or just giving a unit a little spiritual guidance.

"Must to be able to interact with them, from people in PICU to ICU to really anywhere," said Wentz. "I try to go everywhere in the hospital whether somebody that's you're working on staff and just to let them know what we're doing and that we care for them."

There has already been a change among the staff and Director of Inpatient Nursing Wendy Prins has seen it firsthand. "I think staff have already started to warm up to the chaplains," she said. "It could just be just a basic conversation. Some of them yes, are sharing more than others. And I believe that as they get to know and become familiar with them and see them on a regular basis, we'll start to see them open up and more conversations will happen."

These interactions are coming after some of the hardest years ever felt in healthcare with the COVID-19 pandemic.

"You know, COVID hit us for the last couple of years. I think healthcare in general, we just didn't realize how much of a toll is taken on our staff and family members and patients," Prins said of her team.

"And we are human beings, too and we need to be taken care of." Wentz says interacting with and getting to know MercyOne staff on a personal level is extremely rewarding. "Part of it is there's just a joy there really is an excitement among the staff when they find out what it is our job is and why we're doing it. They have big smiles on their face and they're like willing to share with us."

Lex and Matt aren't just there for the medical teams, but everyone on staff, for professional and personal guidance. "Because there are times I show up in the cafeteria area where they're taking care of and preparing food and doing the dishes and I just say hey, I'm here if you guys need anything, let me know and just to be able to visit with him," Wentz said.

"They're pretty delighted in that because they also have some concerns and some things that are weighing heavy on their heart." Woodbury agreed, "I can tell you that makes a difference. And sometimes somebody will come up and say, Well, I haven't really talked to you very much but I like to see you come by every night. It just gives me a feeling a good feeling of solidarity that you guys are here.

Because taking care of our medical staff means better care for us when we need them most," which is one reason why MercyOne Siouxland brought Lex and Matt on.

"In order for our patients or our employees to take care of our patients, they also need to take care of themselves," Prins said. "And this is a really big part of that having the chaplains here."

No matter your beliefs, what religion you practice, or if you even practice at all, sometimes all you need is a little faith.

"I've visited with lots of people from different faiths, different walks of life even and some of them don't have a faith and yet they share humanity with me," Wentz said, "and to be able to entertain and have that story kind of shared between the two of us. It's a really great thing."

Currently, Lex and Matt work late evenings and overnight, but MercyOne hopes to add more to their spiritual care team to cover all shifts and parts of the hospital.

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When you first meet Nicole Cleveland, you wouldn't think she has a rare medical condition.
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"So when they see me, they think oh, you're a normal human. There's nothing wrong. And I mean, that's a blessing in a way but also it's a curse because I do have days where I don't feel great." Cleveland has Turner Syndrome, a genetic condition that only impacts females and is considered rare.

"About 70,000 women are diagnosed or girls are diagnosed every year or have in the United States," Cleveland said.

Turner Syndrome can be diagnosed as early as birth as in Cleveland's case. Others can be diagnosed into the teen and young adult years.

"I have a very mild case of it, but I still have some health complications where I have thyroid issues and hypertension," she explained. "If you don't get diagnosed with it at an early age, it could have severe health consequences."

Turner Syndrome occurs when one of the X chromosomes is missing or slightly altered and can present in a variety of different medical or developmental ways.

"I was put on what's called growth hormone and that is to help achieve somewhat of a normal adult height," Cleveland shared. "I'm five-one. If I did not have it, I would probably have been maybe four foot five, very, very short thing."

Cleveland says she's lucky because she hasn't had any major medical issues from Turner Syndrome. And she thanks her parents and medical professionals who have helped educate her and her family from the start.

"And they prepared my parents with the tools to be an advocate for me," she said. "And as I got older, my parents informed me when I was old enough to understand what was wrong. They were able to turn me into my own advocate."

She is sharing her story with the hope of making Turner Syndrome more widely known, not just in the public but in the medical community, too.

"I have to become more of an advocate for those that have Turner Syndrome because I am able to be an advocate where some who have it," she explained. "Unfortunately, they may have a more severe case where they can't be an advocate for themselves. So I became that advocate."

Iowa Representative Randy Feenstra highlighted Turner Syndrome this month on the House floor, introducing the Protecting Girls with Turner Syndrome Act to criminalize the abortion of any baby diagnosed with Turner Syndrome.

To learn more about Turner Syndrome or to donate to research, visit turnersyndrome.org.

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"When you see people and they are pre-diabetic, that can be a very life-changing moment."

Diabetes is a chronic health condition that affects how your body turns food into energy and impacts millions of Americans.

"We talk generally speaking about type one diabetes and type two diabetes. In the case of type one diabetes, it's a case of the pancreas not producing sufficient amounts of insulin," said Dr. Mahmoud Sharaf, an interventional cardiologist at UnityPoint Health - St. Luke's. He sees patients with heart conditions brought on by diabetes. "In the case of type two diabetes. The pancreas is producing the insulin but the tissues are insensitive to the effects of that insulin."

With Type 2 diabetes, there are warning signs that come before a full diagnosis, which alone can be life-altering.

Type 2 diabetes typically develops in adulthood and for those deemed "pre-diabetic", getting to that full diagnosis can be prevented with a few lifestyle changes.

"The biggest thing is is that they can really do something about it, that they can make a big change in their lifestyle, and they can really prevent further complications down the road," Cindy Powell Inman is an advanced registered nurse practitioner with MercyOne Siouxland. She treats several diabetic patients, many of whom live in rural areas, where the nearest Endocrinologist could be several miles away.

"In order to be diagnosed with diabetes, you have to have an A1C of 6.5 or greater," Powell Inman said, "an A1C is a long-range glucose test that looks at your average glucose over three months.

Those who are deemed "pre-diabetic" aren't on a road solely to a diabetes diagnosis, they can make changes to their everyday lives to hopefully prevent that next step.

At the Norm Waitt Sr. YMCA in South Sioux City, they offer a program to help do just that.

"The program is based around lifestyle change. So it's for anyone who's at risk for developing diabetes, with the idea of making some changes now to hopefully not be diagnosed with diabetes in the future." Wellness Director Jacque Perez brought the Diabetes Prevention Program to the Y several years ago. It's a national program through the CDC and has had years of success at the Y and other organizations nationwide," Dawn Welch - Diabetes Prevention Program Coordinator - YMCA

"It becomes like a support group," Dawn Welch is the Program Coordinator for the class and helps guide Siouxlanders through these lifestyle changes. "I'm very hands-off. The participants are very hands-on. So we want them to give each other support. We talk about recipes we talk about okay, what can you use instead of butter or what's working for you. So it's a very supportive, very interactive group."

This program has helped dozens of Siouxlanders learn to navigate life in a pre-diabetic stage, teaching them how to make healthy changes within their everyday lives.

"It's a full lifestyle change and we don't use the word diet. We call it a lifestyle change," Welch said.

For those who are diagnosed with Type 2 diabetes, those lifestyle changes still come into play.
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"First off, in the rural area, we have a lot of people that eat a lot of meat and potatoes," Powell Inman said, "they may raise their animals, you know, and raise their vegetables and that type of thing. And so there's some education regarding the types of diet you know, that they might have and decreasing the carbohydrates in the diet and watching those types. of things for rural you know, folks."

Now if you are wondering, how can I determine if I'm pre-diabetic? A blood test is a good place to start.

"I think routine blood checking is very important. You know, I think that you're going to your family doctor, you get the testing, you know what we call the random blood glucose, you know, looking for diabetes. That's very important," Dr. Sharaf said.

And it isn't just older adults that need to be mindful of their blood sugars.

Young people get lulled into a false sense of security. You know, it can't happen to me, but we're finding increasingly it can happen to them," said Dr. Sharaf. "So we see people in their late 20s and early 30s In my practice interventional cardiology, or coming in with acute heart attacks, and meeting stents and needing procedures like that. And part of that is diabetes.

In the end, while diabetes is a very manageable disease, staying on top of your health and making simple lifestyle changes, can make a world of difference.

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The holiday season can be a great time with family and friends, but for others, this time of year can bring some mental health challenges. 

"It's important to pay attention to how you're feeling." Janene Gorsett and Marie Sitz are with Trivium Life Services and are helping clients navigate the mental health challenges that can arise around the holidays.

"For somebody with a lot of anxiety," said Gorsett,  "going to large family gatherings can be very terrifying for them."

The COVID-19 pandemic has brought the topic of mental health into the spotlight, helping people see it's okay to set boundaries for themselves.

"This is a time for you to start becoming selfish," Sitz said about putting yourself first, "Be selfish in a positive way, but being selfish."

Putting your own needs and mental wellbeing first is important and it's okay to compromise, like joining that big family dinner by video call instead of in person.

"COVID has shown us a huge way to use technology with our family with our friends," Sitz said. "Some not even being able to see your family for months on end other than through through through a phone screen or a computer screen. So if you are feeling that guilt, talk about maybe ways that you can join in on the group gathering without actually being present."

If you are attending a large gathering or somewhere where your anxiety or even addiction is present, find a friend or relative you can trust and lean on if needed.

"I talk to (my clients) about having a buddy system," Gorsett said. "So if they're going to a family event and the family has wine or they have whatever alcohol available, talking to somebody else in the family that doesn't drink and is willing to be a good buddy to them."

It's also important to have a safe space, like a bedroom, to go to if you need a moment to yourself, and it's okay to be open and honest with your loved ones, as long as you feel comfortable doing so.
 
"Talk to them about where's the safe place for you? If you're going to your parents' house, do you have your own bedroom there? Or can you go to your parents' bedroom and just sit and kind of take a few deep breaths," Gorsett said, "do a little meditation if you need to, and just kind of get away from the crowd."

Sitz agreed, "utilized those coping skills that you may have learned when you were a child, the deep breathing, the grounding techniques, even just tapping yourself on your thighs with your fingers."

And if you have to back out of going to that party or need to leave early, remember the most important thing to do is what is best for you.

"It's okay to feel the guilt. But also remember that it's for yourself and to set those boundaries of who you are as a person." If you or someone you know is struggling and need help, there are many steps you can take, including seeking professional help locally, like with Trivium Life Services. 

You can also call the National Suicide Prevention Lifeline at 1-800-273-TALK or the Mental Health Referral Helpline at 1-877-SAMHSA7.

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