Author: Guttenberg Municipal Hospital & Clinics

GMHC was “home away from home” for 65 days!

It was a long overdue but welcomed sight. Guttenberg Municipal Hospital and Clinics staff, friends and family watched 76-year old COVID-19 patient Royce Hansel of Elkader, leave what had been his ‘home away from home’ for 65 days. Balloons, well-wishing signs, and music filled the hospital halls as tears of joy filled the eyes of those witnessing this medical miracle. 

From Royce’s diagnosis of COVID-19 on November 8, 2020 to his admittance to GMHC several days later having developed COVID-19 related pneumonia, to his release on January 15, 2021 it was a constant uphill battle to regain his health. 

The first month was the most critical in his long stay, as his lungs had closed on themselves and he fought dropping oxygen levels whenever he exerted himself. The long road to recovery would involve several departments at GMHC beyond our Patient Care Unit, including Respiratory Therapy, Physical Therapy, and Occupational Therapy. Once Royce was strong enough to begin rebuilding his strength to go home, he was transferred to a skilled level of care for rehab. Royce was able to receive uninterrupted care from all departments during all stages of recovery within the walls of Guttenberg Municipal Hospital.   Royce proved to be a hard-working and determined patient who didn’t complain even when the road ahead was uncertain. 

The decision to allow Hansel’s wife Janan to visit, despite strict hospital visitation rules due to COVID-19, proved to be a turning point in his recovery. Respiratory Therapist and hospital Rehabilitation Manager Amy Sitzmann felt if Royce could see his wife and hear her voice, it may give him the strength and determination he would need to complete his therapy and return home, and she was right. It brought Royce great comfort and a sense of calmness when his wife was visiting. He said it motivated him to work harder to be home with her, and many other family members, including a great-grandson who was born in November and he had not yet met, and that this was what kept him going.  

“All the staff of GMHC treated Royce like he was a part of their family”, commented Janan. His hospital stay spanned Thanksgiving Day, his birthday on December 3, Christmas, and New Year’s Day. Both Royce’s family and hospital staff worked to keep his spirits up and make the holidays special. Janan could tell that just before Christmas, her husband had begun making significant improvement. All of the therapy and hard work was paying off. 

Before his release, Royce’s family underwent detailed training on using medical equipment that would enable his continued therapy at home. A grateful Royce commented on more than one occasion, “I don’t know how to thank you all; the only thing I can say is thank you from the bottom of my heart”. His family also gave their repeated thanks to the staff. Finally it was time to be discharged on January 15, 2021!

When GMHC’s longest-staying COVID-19 patient left for home, he was escorted by wheelchair to his car, which at the time was clearly necessary. On a follow-up visit with Dr. Mark Janes in Dubuque, his doctor commented that Royce had received excellent care during his hospital stay, which had been critical for his recovery. Later, when he jaunted in and out of GMHC for follow-up appointments with pep in his step and using only a cane, Royce was barely recognizable. Hospital staff were truly stunned to see the improvement. 

Indeed, Royce, you are remarkable!

Audrey is a bright-eyed spunky toddler who lights up a room. Like most children, Audrey’s first words were “Momma” and “Dadda”.

When “Momma” and “Dadda” were the only two words in Audrey’s vocabulary, and she began using them less and less after she turned one, her parents, Kayleen and David LaShelle, were concerned.

At Audrey’s 18 month well-child checkup, Kayleen expressed their concerns about Audrey’s lack of speech to her primary care provider, Dr. Michele Dikkers. Dr. Dikkers confirmed that a child Audrey’s age should be using at least 6 to 10 words consistently and referred her to speech therapy at GMHC for an evaluation.

The purpose of a speech and language evaluation is to determine a child’s strengths and challenges in their skills to communicate effectively with others. The assessment may include: oral motor assessment (how the mouth and face move while speaking), standardized assessment for expressive language (words the child produces), receptive language (what the child understands), speech production (articulation), social skills, and feeding and swallowing abilities.

Speech Pathologist Beth Mescher evaluated Audrey and determined that she had challenges understanding language. Mescher developed a treatment plan and in February 2019, Audrey began weekly speech therapy sessions with Beth to build a foundation for her language skills. Sessions included activities to increase Audrey’s attention span, turn taking skills, pointing, playing, making gestures, and using sign language. After building this foundation, Beth introduced activities to help Audrey model words and to increase her understanding of those words, growing her vocabulary. 

Kayleen attended every session.

“It is necessary to have a parent attend each session to learn the specific language building strategies so they can pratice at home,” said Beth Mescher, “this is significant to the success of the child.”

“Beth was great! She recommended toys, and gave us tips for home, and reassured us that Audrey would get caught up,” said Kayleen. “We’re so happy with Audrey’s progress. She’s now pulling five-word sentences together and her vocabulary has increased to over 300 words.”

“After one full year of speech therapy, Audrey has made great gains in meeting developmental milestones and her communication skills continue to improve daily,” reports Beth. “If parents are concerned about a child’s delay in speech, I encourage them to visit with their primary care provider right away. Please don’t “wait and see.” Communication milestones develop quickly during the first years of a child’s life. The earlier children can be assisted in developing language skills if a delay is identified, the quicker they’ll reach their age-appropriate goals.”

Holy Cross native, David Errthum, recently visited with members of the GMHC trauma team who assisted in saving his hand after an accident this past May.

On the afternoon of Wednesday, May 22, David Errthum was at home putting the final touches on a family room remodeling project. His youngest daughter’s graduation party was at their home that Saturday and he only had two pieces of trim to add to complete the room. 

David was sawing the wooden trim with a 12” chop saw, when the wood moved. Focused on the cut of the board, David reached his left arm over to hold it, when he sawed through the wood and then nearly severed his hand.

David yelled for his wife and daughter, who called 911. Knowing he was in trouble, he wrapped his arm in dishtowels and kneeled on the steps of his deck, applying pressure.

When the Holy Cross ambulance crew arrived, they placed a tourniquet on Dave’s arm and had him hold it on ice as they rushed him to Guttenberg Municipal Hospital & Clinics (GMHC).

The ambulance gave GMHC notice that they were to arrive shortly with a severely injured man. The trauma team was activated and was waiting in the Emergency Department when the ambulance arrived. The injury was assessed as a nearly complete amputation of David’s left hand. Only about an inch of tissue kept his hand attached to his arm.

While waiting for the medical helicopter to arrive to transport him to Iowa City, further evaluation was done. Dr. Daniel Mansfield, general surgeon, wanted to do whatever was possible to give David the best chance of saving his hand. 

“We gently released the tourniquet and were able to control the arterial bleeding. Then we were able to see if there was any flow from the other artery making it to the hand. And amazingly there was! We knew that this would give him the best chance to save his hand,” said Mansfield.

David’s hand and arm were stabilized in a splint and he was prepared for helicopter transport.

A surgical team at the University of Iowa spent nearly eight hours reconstructing and reattaching David’s hand. 

When David awoke, he was surrounded by his wife and all four of his daughters. He was released two days later, on Friday, May 24. 

With the overwhelming help of his friends and family, the graduation party for his daughter went on as planned the next day, becoming an appreciation party too. 

David recently had an opportunity to visit with the trauma team at GMHC who helped him. “Thank you,” said David gratefully as he showed them his arm. “My surgeons in Iowa City were very impressed with the response time and work done here at GMHC. They credit you all for saving my hand.” 

David’s arm is still in a compression glove and a splint, and with continued physical therapy, he anticipates full use of it once again.

When reflecting on the accident, David was overwhelmed with gratitude for everyone who has assisted him during his recovery. 

“I’m a pretty independent guy,” he said. “I’m not good at having to rely on others, but this accident gave me so many opportunities to spend time with my family and friends because I had to depend on them. I’m humbled by all who have helped me and will be forever grateful.” 

By Dr. Michele Dikkers, Physician at Cornerstone Family Practice and GMHC, Chair of Clayton County Board of Health

Growing up we had to be about dead before we went to the doctor.  Slap a bandage on it, put menthol vapor rub on your chest or put an ice bag on it.  A runny nose, sniffles or a cough was no reason to stay home.

Then we learned about COVID.  Now we stop and wonder.  Could it be a cold? Influenza? Strep throat? Mono? COVID?  Oh my.

Since COVID-19, the guidelines have changed.  If you are sick, stay home.  Get tested.  Wait until you are well, then return to the world.  Like any habit, it is difficult to make change.  But there are good reasons for the changes in our thought process.

Symptoms can be similar initially, but the outcomes can be very different.  They can all start with cough, body aches, fever, headache and sore throat.  But influenza and COVID may have a more serious end result.

Incubation time (time from exposure until symptoms start) is typically 1-4 days, unless it is COVID, then it can be 2-14 days.

With most of these illnesses, you can be contagious for 2 days prior to illness and for 3-5 days after illness starts.  With COVID, you may be contagious from 2 days prior to illness and up to 10 days after illness onset (up to 14-21 if with persistent symptoms or severe illness).

Symptoms last for 3-7 days, with the exception of COVID.  Symptoms of COVID, on average, last 1-6 weeks.  There can be long term symptoms that may last months after the acute illness is over.

When it comes to hospitalizations, 2% of those diagnosed with influenza will be hospitalized for 4-7 days, compared to 19% of the COVID diagnosis’ needing hospitalizations for 2-3 weeks.

Fatality rate of influenza is 0.1%, while the fatality rate of COVID-19 is nearly 3%.

Treatments for these illnesses vary.  There are antivirals for influenza, antibiotics for strep throat, monoclonal antibodies for COVID and, coming soon, the new oral medication recently developed to help decrease hospitalizations and deaths from COVID.  All depend on starting treatment sooner than later.  Treatment for influenza should be started within the first 72 hours.  Treatment for COVID-19 should be within the first 7 -10 days.  Treatment for influenza and COVID are to decrease severity of symptoms and won’t cure it but can significantly reduce need for hospitalizations and death as an outcome.

So, rethinking how we think about cold symptoms, the new recommendations are to stay home if you have any symptoms.   Be seen by your medical provider and get tested.  Getting tested allows for the best treatment options to be offered and improve outcomes.

Continue to be vigilant and continue to avoid getting sick.  Stay home if you are sick, continue with good hand washing, cover your nose and mouth when you cough and sneeze, wear a mask when you are in public places and update your vaccines.

Stay safe, be well and be kind to each other.

We congratulate Physical Therapist Kimberly Franzen, PT, DPT, CLT on her recent certification as a Certified Lymphedema Therapist (CLT). 

Kim’s certification included 135 hours total with 75 hours of online work and 60 hours of in-person class and hands-on work. Kim was in Minneapolis for the class from October 13th to the 20th for the in-person class, but all online class work was completed prior to attending. Both a written test and hands-on practical was passed for the certification. 

What is Lymphedema? Lymphedema is known as an abnormal accumulation of protein rich fluid that can occur gradually over time with increasing complaints of tightness or heaviness. Lymphedema increases one’s risk of infection or cellulitis. Typically lymphedema affects only one arm or leg, but can affect both as more commonly seen in the legs.

The certification consisted of learning the full CDT (Complete Decongestive Therapy) which includes not only performing manual lymph drainage (MLD) to reduce the amount of fluid accumulation, but performing and teaching/educating the patient on application of compression bandages or garments, exercise, nail & skin care, and other self-cares to assist with overall management of their condition.

Kim is now able to treat our patients who have lymphedema, lipidemia, or lymphedema which can occur due to other medial issues such as obesity, chronic venous insufficiency, lipo-lymphedema, or after a trauma or orthopedic surgery.

“Most people have not heard of or know much about lymphedema until they have been diagnosed with it,” said Kim. “I’m pleased to be able to offer this service to our patients who are diagnosed with this condition.”

Stay close to home, and receive your therapy and rehabilitation services with the experts at GMHC. For more information call 563-252-1121.

Guttenberg Municipal Hospital & Clinics is pleased to announce a collaboration with WELL Health Inc. to implement automated appointment reminders through secure two-way, multilingual messaging in the patient’s preferred communications channel: texting or telephone.

If GMHC has your cell phone or home phone in its system, patients will receive automated appointment reminders seven days, two days and one day before their appointments. Patients have an opportunity to respond or to opt-out of this service.

“It is our hopes that this two-way communication will help improve our patient’s experience throughout their care at GMHC,” said Danelle Krapfl, Lab and Imaging Manager.

This new service will begin on October 5, 2021.


Robin Esmann, Director of Performance Excellence at Guttenberg Municipal Hospital & Clinics, was recently selected as one of the Iowa Hospital Association’s (IHA) Hospital Heroes.

“It is truly an honor and privilege to announce our Director of Performance Excellence, Robin Esmann, was named a hospital hero. Robin’s knowledge and expertise coupled with her compassion and commitment to our community absolutely make her a hero to us,” said Tim Ahlers, CEO. 

“Over the past year, Robin has worn many leadership hats including Nursing, Incident Command, Employee Health, Infection Control, Safety, Quality, and she is an EMS member” reflected Lisa Manson, Director of Ambulatory Services. “Robin’s training in quality processes was apparent during the past year. She never settles for just good enough.”

Robin took responsibility for spearheading the COVID-19 vaccination process in the community. She worked closely with county and state officials to procure an appropriate supply of vaccine. Robin also secured a site for the vaccination clinic that was close to the hospital. After establishing a call-in hotline, Robin and several volunteers began contacting thousands of people to make appointments. In addition, Robin took a clinic on the road to reach local manufacturing firms interested in vaccinations for their employees. She was relentless in assuring that everyone who was eligible and desired to be vaccinated could be accommodated. 

“Jim and I had the pleasure of working alongside Robin at most of the vaccination clinics,” said Sue Osterhaus, vaccination clinic volunteer. “In the face of an incredibly stressful pandemic, Robin acted with strength and integrity every day as she managed the clinics and answered countless emails, calls, and questions regarding the vaccinations.”

Commented Robin, “I am honored to not only be nominated for this award by my colleagues but to also be chosen for this award by the Iowa Hospital Association.  There is no doubt that this past year has been the most challenging of my career. I never imagined having to live through a pandemic and certainly not one of this magnitude.  Fortunately, we have a great team at GMHC and that team is still working tirelessly day in and day out to get us through this pandemic. I’m very proud of the work we do and all that we accomplish; everyone at GMHC plays a very important role on the team.”

“Robin has been a nurse for more than 30 years and has been dedicated to our organization and our community,” commented Tim Ahlers. “She has worked in many settings throughout the hospital as a bedside nurse, a quality expert and a leader, excelling in every role. Robin’s knowledge of infectious disease and her courage to lead us through the pandemic is inspiring. Her commitment to our community is heroic. Robin is kind. She is a collaborator. She is courageous. And she is a true leader.”

Since 2007, IHA’s Hospital Heroes program has celebrated employees who have acted courageously in a moment’s crisis or who have selflessly served their hospitals and communities throughout their careers. Last year, IHA recognized all hospital employees for their heroic efforts during the COVID-19 pandemic and in response to the derecho windstorm in August 2020. In 2021, IHA returned to recognizing 10 hospital employees who exemplify the passion and purpose of the community hospital mission every day.

Robin will be recognized at the IHA Virtual Annual Meeting in October.

Guttenberg Municipal Hospital & Clinics is pleased to announce a new partnership with Edgewood-Colesburg School District for Athletic Training services.  

Sydney Pirillo, Physical Therapy Assistant and Athletic Trainer at Guttenberg Municipal Hospital & Clinics is contracted for athletic training services two hours per week, and at home games as her schedule allows.

“The Edgewood-Colesburg School District has been looking for ways to provide athletic training services to our coaches and athletes for years.  One of the challenges has been finding the right partnership to meet the needs of the district. We believe that the partnership with the Guttenberg Municipal Hospitals & Clinics will provide the needed services for students and additional training for coaches.  We see this as an opportunity not only to help students recover faster from injuries but also to prevent injuries in the first place.” said Rob Busch, Edgewood-Colesburg CSD Superintendent. 

In her role as Athletic Trainer, Sydney works with student athletes to keep them healthy and strong. She typically sees 5 to 10 athletes per week during her time at school, as well as checks in with coaches and parents if additional communication is needed about an athlete’s injury. She recommends strengthening and stretching exercises, wrapping/taping techniques and other conservative techniques to both athletes and their coaches.

“My number one goal is to work with student-athletes and coaches to prevent injuries,” said Sydney. “All athletes are encouraged to report injuries when they occur, big or small, to prevent the injury from worsening in severity and to help resolve the issue in a timely manner. When injuries are not able to be prevented, my goal is to get the athlete back on the playing field as quickly and safely as possible, keep them in school, and reduce the risk of long term affects. I know that dealing with an injury can be stressful and I work to ease this process by advocating for the athlete and collaborating with local physical therapist, chiropractors, and physicians to provide the best care. I am honored to be joining the Edgewood-Colesberg team and can’t wait to help student-athletes achieve their goals on and off the field.” 

Commented Alex Hanna, Activities Director, “We have loved having Syd in our building the last few weeks.  Her help diagnosing injuries, helping with exercises and treatment for our athletes, and keeping them accountable to their recovery has been invaluable.  In a school our size, keeping our student athletes healthy and doing what they love is more important than ever, so having a resource like her each week and at games is amazing for Ed-Co.  Syd has been very progressive with her outreach to our coaches and communication to keep them in the loop about what our athletes can and can’t do from week to week.  We have great support at Ed-Co from Administration and our Board, so their approval of this agreement should not come as a surprise.  We are very thankful that this partnership has been made and we hope that it will continue to grow in the future for the benefit of all of our athletic programs here at Ed-Co.”

On August 11, the Guttenberg Municipal Hospital & Clinics Imaging Department performed its first MRI in the new Seimens MAGNETOM Altea Open Bore system.

“One of our first patients said that the brighter room and the lack of noise was a great improvement over our previous MRI,” said Karen Pressley, Radiologic Technologist. 

The new Altea has a wider bore opening and is equipped with Quiet Suite and Turbo Suite to reduce the noise during the scan and enable a reduction in exam times by using advanced accelerated imaging techniques. These new features will help to reduce patient stress, making the exam more comfortable for the patient. 

“The images are beautiful,” commented Dr. Joshua McDonald from Radiology Consultants of Iowa. “Allow me to commend GMHC leadership in bringing this great technology to the community of Guttenberg. This is a state of the art MRI unit and will definitely enhance the healthcare for Guttenberg and the surrounding communities. I consider it a great privilege to work with the GMHC Imaging staff and the patients of Guttenberg.”

MRI patients have been very pleased with the updated technology at GMHC.

“We had a patient who tried to have an MRI at another facility, and was told that he wouldn’t fit. When he came here, he fit without any problems,” said Terri Koopmann, Imaging Coordinator. “Other patients are claustrophobic but have no issues with our new MRI. We are pleased to improve our patient’s MRI experience with reduced noise, a wider opening and advanced accelerated imaging techniques.”

Address: 200 Main St. Guttenberg, IA 52052

Phone: (563) 252-2141

College/Medical School: Bachelors in Biochemistry & PhD in Cardiovascular Pharmacology – University of Georgia. Medical School – Carver College of Medicine, University of Iowa

Board Certification: American Board of Family Medicine

Residency: NE Iowa Family Practice in Waterloo

Bio: Carol A. Gunnett, MD, PhD is board-certified in Family Medicine with 15 years of experience in the Cedar Valley Area. Dr. Gunnett comes from rural Pennsylvania. She was raised in a large family with 9 children, and has been interested in science and medicine since childhood. She earned a Bachelor’s degree in Biochemistry and PhD in Cardiovascular Pharmacology at the University of Georgia. In 1996, she came to the University of Iowa to do cardiovascular research. During her 10-year career in medical research, she won awards from the American Diabetes Association, the American Heart Association, and the National Institute of Health. Throughout her education and career, Dr. Gunnett has been interested in how other cultures treat illness. During her time at the Carver College of Medicine in Iowa City, she was a founding member of the Alternative Medicine Club and Career Fair in 2005. Dr. Gunnett loves a wide variety of music, is an avid reader and gardener, and likes to go camping with friends and family for relaxation.

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