Author: Amy Speed

“Guttenberg,” Cathy said without hesitation to the paramedics. It was an easy decision. Her doctors were there, and she was already familiar with the quality care she would receive there. 

It was a very rainy morning on April 22, 2022, when Cathy Wiskus stopped on the way to work for gas in New Vienna. She was walking to the entrance of the store to pay when an SUV hit her on the right side of her body. She recalled being up in the air for a bit before landing on her left side, and noticing that her leg had flopped over. She couldn’t move it. Several people came to attend to her needs, cover her with a coat and call 911. The ambulance quickly arrived, and she was on her way to her requested hospital, Guttenberg Municipal Hospital. 

The accident happened near the end of COVID, when getting a hospital to take on new patients was very difficult. Cathy stayed in the ER at GMHC for most of the day as staff made her as comfortable as possible with a broken femur until they could get her transferred. Finally, she was accepted at the University of Iowa and was transferred there promptly.

Surgery was postponed for four days because the break in her femur was at a difficult angle. The surgeon decided to put in a plate and two screws instead of a rod. Soon after the surgery at UI, physical therapy was started so Cathy could keep active, but not a lot could be done yet with the injured leg.

Shortly after the surgery, she was given the good news that she could return to GMHC, but after testing positive for COVID, the trip would have to wait. What might have been a shorter stay at the U of I turned into a much longer one. Visitors were limited to one per day at that time, so her husband and son had to decide who could see her, and with limited visitors, it was a long and tough stay for Cathy. Her friends helped lift her spirits with frequent calls to check on her progress.

After returning to GMHC as an inpatient for skilled care and seeing her primary care provider, Dr. McCaw, Cathy told him how much she missed the special care that GMHC delivers. “I don’t know where I would be if I couldn’t have received that care here, close to home, from people I know,” she explained, “It was hard being in a big hospital away from family during that time.” He answered Cathy with, “Sometimes a big hospital can do what a little hospital can’t, and other times a little hospital can do what a big hospital can’t.”  

On Mother’s Day, Cathy was still in quarantine, and was worried what kind of day she would have. The nurses were still able to make it a special Mother’s Day for her. “And Lynn, the social worker called me every day in my room to see how I was doing. She couldn’t always come in because of visiting restrictions, but she at least always called.” Cathy added.

Physical Therapy was started when Cathy was in skilled care on the patient care unit, and the realization that it would be a long road to walking again sometimes got her down. But the therapists knew how to keep the mood light while still requiring the needed work of rehabilitation. One day when she looked out the window and saw someone walking across the parking lot, Cathy was especially emotional because at the time, that seemed so out of reach for her. Amber, her Physical Therapist Assistant for the day, reminded her that she would get there one day, too, but she would have to go through the small steps to reach that goal. She told Cathy, “Right now, this is part of your journey, and some day you will be able to reflect on it with more understanding.”

A while later, while working with Physical Therapy Assistant, Sydney, Cathy was asked to walk through the parallel bars without holding them, and when she reached the end, Sydney said, “Keep going and walk alone!” Cathy commented, “She gave me confidence and knew how to make me feel good. Really, the people here have hearts of gold.”

Released from skilled care, Cathy returned to her home in Colesburg in June. Occupational Therapist, Karla, and Amber, PT Assistant, went along to make the home as accessible and safe as they could for Cathy. The ramp was a little hard to navigate with her walker, so a friend lent them a wheelchair so she could be at home to recover.

Sometimes, doing her therapy at home was difficult, just like it could be when she was working with the Physical Therapists, but Cathy’s husband helped her stay motivated so she could reach her goals. During this period of rehab, she had one long-distance visit via the computer with her surgeon in Iowa City. In December, she had an in-person visit with him and he said that she wouldn’t need to come back. He was pleasantly surprised at how well and completely the bone had healed.

Cathy has returned to work and other normal activities with only a lifting pound restriction. She tells others about the care she receives at GMHC, adding, “Everyone knows how I feel about GMHC, because I am always talking about it, and recommending it to others. GMHC is my go-to place for local healthcare!”

“I hadn’t really tried anything for the pain,” she replied. “I was just living with it.”

In November 2022, Judi Althoff, Surgery Receptionist at GMHC, had been experiencing pain in her lower back that just seemed to come out of nowhere. It was a very debilitating pain that caused her to have to get ‘psyched up’ just to get out of a chair. “I would then have to get my bearings and I couldn’t walk without pain and limping, so it took me a long time to get anywhere,” Judi added. “I walk for exercise, and it was taking me 25 minutes to walk a mile.” 

Judi had never had back pain in her life before this, and since there is a pain clinic right here at GMHC where she works, she decided to see if they could help her. They first started with trigger points by placing a needle with steroids and numbing medicine in the area that hurt.

Judi then had an MRI which showed a bulging disc and arthritis in her back. An epidural steroid injection was given to treat the pain in these areas but would take 10-14 days to take effect. Once that pain was under control, a different pain emerged in another area of her lower back. For a while, it was treated with Tylenol and Ibuprofen. Lumbar X-rays revealed that a facet joint in her spine was pressing on a nerve and causing the pain.

The next step was to test her left side, since there was more pain on that side which also traveled down her leg. A numbing agent was injected that lasted for 3-4 hours. If her pain stayed away, the test would be repeated. After two successful attempts to keep the pain controlled, she was a candidate for radio frequency treatment (RF).

For the RF treatment, needles were inserted into the nerve that was causing pain, the nerve was “burned” and the pain disappeared. After about a week, Judi’s pain was completely gone. That was in March 2023. Now in October 2023, she remains pain-free. If the pain should return within two years of treatment, she can have the RF again without going through all the pre-testing.

“It is so nice to have this treatment available,” Judi commented. “It has helped me significantly because I am no longer living with all that pain and discomfort. I would recommend anyone with unwanted pain to check out the Pain Clinic at GMHC.” 

April is Organ Donor Awareness month. Former GMHC employee, and current GMHC volunteer, Mary Waterman, recently shared a touching story about her mother, an organ donor, who was from the Greeley area.

Doris (Bissell, Dingbaum) Malicoat, otherwise known as farmwife, mother, and even “the cake lady” (Dorie’s Cakes), left quite an unexpected legacy…that of being an organ donor. Even though she had it clearly marked on her driver’s license for many years, the ripple effect was not fully felt by others until after she died. 

In her early life, Doris worked in a department store when her kids were small. They moved to a century farm near Petersburg where she did a lot of work, including all the morning milking, and raising her four children. She began making cakes for the kids’ birthdays, and then started collecting Wilton pans (365 of them) and selling her cakes. In her busiest year, she baked and decorated 366 cakes! She was featured in the Gazette for her cookies, cakes and collection of cake pans! 

Later in life, she mainly baked cookies for sale and to give away. She would ask the care center what they needed, and then make it and drop it off. The patients and staff at the Veteran’s Hospital enjoyed trays of her cookies at Christmas time, too. Her favorite cookie to decorate was a Santa face cookie. She would always go to her 10-year class reunions with a cake to celebrate and attended the last one with the only other two remaining classmates. 

In 2018, when Doris died, the family honored her by including her cookie recipe in the thank you cards they sent after the funeral. Although none of her grandkids have picked up the cake decorating knack yet, she handed down another thoughtful practice to her offspring. Many of her children and grandchildren signed up to be organ donors by designating it on their licenses. The decision to donate skin is not something that a person can designate ahead of time.

Years ago, when speaking about organ donation, Doris said, “Someone might as well have what they can use, because when I’m gone, I won’t be able to use it anymore!” As she neared the end of her life, her comment was, “They probably won’t even want anything now, because nothing works anymore!” Little did she know…this kind, caring woman who had lived 88 years would still be helping dozens of people, even after her death. 

A letter from the donor network arrived at her son’s home about six months after Doris had died. Mary learned that her mother’s organ donation—mostly skin and tissue—had helped 61 different people! Her family was astonished! They knew that her donation would make a difference for a handful of people, but they had not imagined that it would be so many. Dorie’s selfless act provided skin and tissue for breast reconstructions following mastectomies and temporary ‘skin bandages’ for burn victims, allowing their own skin to regenerate underneath. Other uses for harvested skin include replacing skin and tissue that has been severely traumatized or infected, or tissue that needs to be replaced because of skin cancer.  

So, the end of Doris’s life reflected the way she lived. She gave of herself to help others. What an honorable trait to pass on. 

__________________________

Following are some things you may not know about skin donation:

• Skin is the largest organ of the body.
• Skin can be donated within 6 hours of the time of death.
• There is a total of eight layers of skin, but only 1/8 (the uppermost layer of 0.3 mm) is harvested. 
• The skin is only taken from the back, thighs and legs and does not in any way disfigure the body.
• There is no bleeding from the site where skin is harvested from, and doctors bandage the parts where skin was taken.
• Donor skin can be effectively frozen and stored for up to five years.
• Blood, skin color or age do not have to be matched. Any person’s skin can be transplanted to another person. 
• Burn victims receive skin when over 50% of their body has been burned. In 80% of such cases, patients can be saved if sufficient skin is present in skin banks. 

April is Donate Life month. Please become an organ donor today!

https://www.iowadonornetwork.org/register

The before and after photos of Duaine Palas’ legs are hard to believe!

While reading the Spring 2022 issue of GMHC’s “Keeping You Well” newsletter, Duaine Palas realized there may be hope for his legs. The article featured a patient who had found relief for his legs through Lymphedema Therapy offered through the Therapy Services department at GMHC. Everything Duaine was reading described his condition, prompting him to call GMHC.

After first seeing Dr. McCaw at Cornerstone Family Practice for various testing, Duaine was referred for Lymphedema Therapy with Physical Therapist Kimberly Franzen, GMHC’s Certified Lymphedema Therapist. Lymphedema is chronic swelling that results from damage to the lymphatic system. The lymphatic system filters excess fluid through lymph nodes to remove bacteria and debris from the body. When the system is damaged, fluid can build up under the skin, usually in the arms and legs. 

Lymphedema can occur after cancer treatment, infection, surgery, venous insufficiency, or injury. Duaine’s may have resulted from an old farm injury. His swollen legs had been bothering him for years, but he didn’t know what to do about it. Duaine began his therapy sessions on July 7, 2022, and remembered doubting, “There’s just no way this is going to work with my legs, they are not going to respond to the therapy, they are just too far gone.”

But, Franzen proved him wrong. Duaine began therapy with 3 to 4 sessions per week. His treatment included manual lymphatic drainage, exercises and compression wrapping to help reduce swelling and return skin to a more normal condition. During the early stages of therapy, Franzen used short, flexible bandages (changed at every appointment) to wrap Duaine’s lower legs. As his legs became less severe, and reached a certain size reduction the wrap changed to a Velcro one, and as therapy progressed, compression stockings (from the toes to just below the knees) replaced the use of the bandages and the Velcro straps. 

Duaine’s therapy lasted through most of September and was an amazing success. Duaine continues to exercise, wear compression stockings to control the lymphedema, removing them at night and elevating his legs, and regularly checks the skin for ulcers. Since he learned how to take care of his lymphedema from Franzen during his therapy visits, he knows what the signs are that would require him to come for a re-assessment or for more therapy. He commented, “It was really nice to be able to wear my dress pants again. The only thing I could wear were sweatpants, and because my swelling was so bad, I could hardly fit into my shoes.” 

Picture this:  Duaine had an overall size reduction of 26.3% in his left leg, which was smaller to start with, and in his more severe right leg, the overall reduction in size was 34.5%! These numbers are truly amazing, and show just how much progress is possible with lymphedema therapy. 

Duaine is quick to thank Kim Franzen and Dr. McCaw for their careful attention to his care and commented that Franzen was very helpful and taught him a lot about self-care for his lymphedema. He commented, “This therapy was truly life-changing for me! I am active again, and I have a lot to be thankful for. I would encourage anyone who thinks they might have lymphedema to talk to their doctor and come to GMHC for their therapy.”

During this process, an additional health concern was discovered from tests that one of the providers ordered. Originally given to detect if the lymphedema was caused by a heart issue, the test found that Duaine had a 5 cm aneurism and a faulty heart valve. He will undergo surgery in May of 2023, to have it replaced with a biological valve. Duaine commented, “And just think, if I hadn’t come here for treating my legs, I would have never known about the problem with my heart.” Duaine complimented GMHC for the excellent care here, and for the thoroughness of the staff.