Patient Stories - Guttenberg Hospital

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.

In May of 2020, while isolating during the COVID pandemic, Michelle Geuder discovered a lump on the side of her right breast during her routine shower protocol. At first, she thought it was an irritation from her bra, but something inside told her it was more. “Somehow, I already knew what it was,” she recalled. When Dr. Smith called with her mammogram results, she wasn’t too surprised that something had shown up on the scans. Since the next day was her birthday and wedding anniversary, Michelle waited until Monday for the follow-up appointment. An ultrasound and a biopsy confirmed that she had ER positive, PR positive, Her2 negative Breast Cancer.

Dr. Smith encouraged Michelle to get a second opinion, which she obtained at Mayo Clinic in La Crosse, WI, from an oncologist who had been recommended by her sister, through first-hand experience. The results were confirmed. Michelle returned to GMHC to consult with surgeon, Dr. Mansfield. Because she was at Stage 1A, her options included a lumpectomy or a mastectomy. Wanting the best results for her and her family, Michelle chose the mastectomy. Michelle’s brother-in-law stepped in to work with her insurance company until they agreed to let her be treated at Mayo. The July 1 (2020) surgery took place at Mayo Clinics in La Crosse. Her husband was allowed to be there but waited in the car during surgery because of the pandemic guidelines.

Michelle’s mastectomy included removal of most of the lymph nodes in her right arm, and several from her left arm, which thankfully, showed no cancer. Michelle and her husband both learned a lot following her surgery, including how to empty her four drains. Her follow-up treatment began in August (2020) with 16 weeks of chemotherapy (every other week) in La Crosse. Her husband was a great help during this time, driving her to appointments and being supportive.

Although Michelle’s oncologist wanted her pre-chemo appointments (also every other week), like COVID tests, blood tests, and cleaning of her port, to be done at Mayo, Michelle insisted on going to GMHC for these services saving her time, miles, and money. She commented, “I really wanted to have as much done here, as close to home, as possible. It was helpful for me to be assisted by people I was familiar with, like Jeannie Funk in the surgery department, and Lana Troester and Heidi Bolsinger from Patient Accounts, who served as my patient advocates with insurance questions and pre-authorizations. They were all a great help!”

When radiation was delayed in January of 2021, again due to insurance, Michelle’s radiation doctors worked with the insurance company to get her treatment covered. For thirty days straight, excluding weekends, Michelle drove herself to Mayo in La Crosse for radiation treatment. “The trip to La Crosse is a two hour drive each way, so this was a difficult time,” Michelle admitted. The radiation was very rough on her skin. She was expecting a sunburn-like redness and peeling, but it was much worse. When the treated bandages came off, so did her skin, and it was like starting over every day. Consequently, the healing time from the radiation took much longer than normal.

The extensive damage to Michelle’s skin caused the reconstructive surgery date to be postponed twice; in August 2021 and January 2022. Radiation and inactivity with her right side had left a stiff, numb, lumpy mass of skin, and prompted concerns that the surgery may not even be possible. Her radiation doctors and the plastic surgeon suggested Lymphedema Therapy to regain some movement and decrease her swelling to improve the feeling within and around her surgery site.

Prior to this time, Michelle had read an article about Physical Therapist Kimberly Franzen’s certification in Lymphedema Therapy. At the time, she didn’t think it applied to her condition, but a referral from Dr. Smith allowed Michelle to see Franzen in January. Franzen was able to use Lymphedema Therapy to perform manual lymph drainage on the tissue and increase circulation, helping Michelle regain feeling, movement, and overall improved health at the surgery site.

All of Michelle’s care providers were impressed at the level of improvement after only four weeks of therapy. In March of 2022, Michelle felt much better, both feeling and seeing the therapy results, and was finally able to schedule the reconstructive surgery. “I recommend Kim Franzen to everyone who might need lymphedema therapy. She walked me through the steps and taught me how to do it myself, and my lymphedema continues to improve. Kim is so personable and really cares about her patients,” said Michelle. “It was incredible to see the therapy making such a difference even in the appearance of the skin, which helped me push past some of the devastation I was feeling after surgery. I had no idea that lymphedema therapy could do that!”

Throughout this very difficult journey when Michelle thought about complaining, she would remind herself that she was lucky to be breathing, which helped her keep things in perspective. She was even able to stop at a few of her daughter’s basketball games while traveling home from appointments, which gave her something to look forward to. Michelle said, “I feel as though I’m a strong person, but I also have a strong support system.” Family and the tight-knit community stepped up to help, donated money, and had a fundraiser for her. Michelle remained working, which helped her place focus on something besides her health. Her boss was very understanding about her needs and allowed her to keep a flexible work schedule.

Michelle will continue her monthly injections along with taking a daily pill for the next three years to complete her treatment. Every October, during Breast Cancer Awareness month, she urges others to have their yearly mammogram to help catch problems early, and she is an advocate for self-checks.

When asked how she would describe the care she received at GMHC, she replied, “The care here was stellar! It is on-par with any treatment you would get at a bigger hospital, and without all the hassle. My primary care doctor at GMHC communicated easily with my oncologist because they are on the same computer network. I can’t say enough about the quality care I received here, and how thankful I am that it is only two blocks from my home.”

In closing, Michelle reflected, “In April of 2020, when we were all isolated and shut down, I drove by the hospital, and thought to myself, ‘I’m glad that at least I’m not in there right now’…and then I was… It turns out that this was a very good place for me to be!”

On October 1, an ambulance pulled away from the Edgewood Convalescent Home, with Kathie Meskimen inside. She was having an increasingly difficult time breathing, and knew it was time to make a visit to the Emergency Room at GMHC. “I’m just thankful for the great job the care center did in getting me ready and transporting me to the hospital,” said Kathie.

“My breathing problems had been slowly getting worse, but I finally was to the point that I could hardly breathe at all,” Kathie replied, “I had to do something. It is a very scary thing, to not have enough air.”

Kathy explained that she just needed to have some help getting back to her usual regimen so her breathing could improve. Being hospitalized for six days at GMHC was just what she needed. In that time, she saw staff from several departments, and had many visits with the respiratory therapists to get her breathing back on track.

When asked what she would be doing differently after returning home, she said she would keep doing her breathing exercises, follow the instructions from the doctors and take her medications so she could stay healthy!

“I have always doctored at GMHC unless I absolutely had to go elsewhere. My daughter was born here, and my mother came here, too.” Kathie said. “In fact, a lot of people around here like to come to GMHC; they always have. The nurses did everything I asked and answered all my questions. They were very helpful. We are blessed to have care available right here in Guttenberg. I am extremely thankful to everyone for everything they have done for me to help me breathe easier.”

Augie Petsche brings a little sunshine when he rolls up to the hospital front doors in the Blooming Branches van to deliver flowers to a patient or an employee. This unassuming gentle giant always has a smile and kind words for those he greets at GMHC. Recently, though, GMHC delivered care to Augie after he injured his foot while climbing his stairs in his sandals. His left knee gave out causing his big toe and the one next to it to scrape the cement. He didn’t think much of it at the time, but about a week later, his toes had become red and very sore. Between that, and the fact that he has diabetes, he figured he better visit the ER at GMHC.

Blood work was ordered and the results showed he had gout. However, given the recent injury the doctors felt additional testing was needed. The next day, an MRI was ordered revealing he had an infection in the bone of his toe. Auggie was advised to return to the hospital immediately to start antibiotics.

Augie reported for this unexpected hospital stay and the team got to work hooking up an IV and getting him settled in. He said, “They wasted no time getting an intravenous antibiotic started.” He knew they were worried because diabetes makes infections more dangerous.

Dr. Dikkers offered Augie several options to treat the infection, and one of the options might involve partial amputation. However, they would begin by treating him with the antibiotic, serving him a diabetic diet and monitoring his situation closely. During his stay, it was also discovered that he had a spot on his other foot that could be treated with an ointment, so that was also started.

While at GMHC, Augie saw several different doctors and all the PCU (Patient Care Unit) nurses. He said the care from everyone was outstanding, and that they all did their best to help him with whatever he needed.

“It is great to be treated in my hometown, where they know me by name. Although it is a small town, Guttenberg has a great hospital, doctors and nurses to care for us. They care for me here with more of a personal approach because it isn’t too big. The services are great, and many of the specialists come here. A lot of towns our size don’t have a hospital, so we are very lucky,” commented Augie.

“They took great care of me, and the nurses were always asking if I needed anything, so I finally asked for a cup of coffee, which they brought right away. One day they served roast beef, mashed potatoes & gravy and beets that were very tasty and reminded me of how my mom used to make them. I mentioned that the beets were so good, that I could almost go for a second helping. Of course, within a few minutes, the nurse came in with the second helping. I might be old-fashioned, but that was important to me. My folks are not here anymore,

and my sister and brother-in-law live in Arizona. They were able to talk to my doctors to get updates, and that helped. It gives them a lot of comfort to know that I’m getting such good care here,” he reflected.

After his two-week stay in the hospital, Augie was released to go home. Augie was given home care tips which included continuing the use of the oral antibiotic that was prescribed, using the ointment on his other foot, changing his socks daily and wearing diabetic shoes to protect his feet. Although the infection was going away, he was to monitor his feet for any returning signs of infection, which would require immediate evaluation at GMHC.

Soon after his return to work half-days, Augie’s infection also returned and he was re-admitted to GMHC. He joked, “I love this place so much, I just couldn’t stay away!” The antibiotic alone was not able to keep the infection out of his bone permanently, so surgery was performed to remove part of his toe. Our providers coordinated with his podiatrist to make it happen. Currently, Augie is at home healing, and looking forward to returning to his routine again.

Augie concluded, “I know it sounds weird, but I enjoyed my time here; I was being taken care of very well and didn’t worry about anything. I can’t stress enough how good the nurses were to me. If anyone needs a local doctor or hospital, they should come here, because they will be well taken care of and can stay close to home to get that care.”

Augie, it is great to see you back on your feet and we thank you for your work delivering sunshine to the halls of GMHC!

On a recent visit to the Physical Therapy department at Guttenberg Municipal Hospital & Clinics, Carolyn Clefisch began experiencing dizziness, or vertigo symptoms. Her therapist, Kim Franzen, asked if she would like to have her symptoms checked out using Frenzel Goggles, a helpful evaluation tool. Carolyn agreed to the treatment and was already familiar with the goggles, as she had used them at another facility for treatment. “I was very happy to know that GMHC had the video Frenzel Goggles, because I knew I wouldn’t have to drive so far to be treated,” Carolyn mentioned. “We acquired the goggles in midyear 2020. Our staff has taken continued education courses on the use of the goggles for vestibular rehabilitation,” commented Amy Sitzmann, Therapy Services.

Frenzel Goggles come in two styles, optical and video, and are used to help with the evaluation of a patient who is experiencing dizziness, or vertigo. The basic (optical) Frenzel Goggle allows the therapist or provider to see the eye magnified and the very small movements, which are usually undetectable to the observer’s naked eye. The more advanced (video) Frenzel Goggles not only magnifiy the eyes, but they record these tiny eye movements in both eyes at once, as well as the patient’s movement in the treatment room. The recording can be replayed later and viewed as many times as needed. Video Frenzel Goggles can also be used with the light on, or they can block out all the light, depending on what the evaluator is looking for.

While the patient wears the goggles, the therapist can change the position of the patient’s head or assist them in going from a sitting to a lying position, or vice versa. As this is happening, the therapist observes the changes that take place in the magnified eyes by watching them on a screen or a laptop, where the movements are large and easier to see.

GMHC has the video style Frenzel Goggles to help in evaluating vestibular (balance) problems and helping to determine their source. A common symptom of vestibular problems is vertigo, which can result from certain movements such as rolling over in bed or moving the head quickly. These movements can cause the patient to feel dizzy or off balance, or they may feel like the room is spinning. They may also feel nauseous and can even have trouble with vision or hearing.

In Carolyn’s case, her dizziness was due to BPPV (Benign Paroxysmal Positional Vertigo). Franzen used a positional treatment called the Epley maneuver to correct the issue. “In BPPV, tiny calcium crystals, or ‘rocks’ come loose in the inner ear from their normal position and can cause dizziness, vertigo, or balance problems,” Franzen explained. Sometimes, vertigo symptoms can be corrected in only one therapy session. Other times, 3-4 sessions may be needed to help relieve symptoms. Should vertigo return later, a different sequence of movements may be needed, as the crystals do not always move to the same place in the ear. It is best to be seen by your therapist again if the vertigo returns.

In addition, other, more serious causes of dizziness can also result from various types of medical triggers, like stroke, high blood pressure, concussion, head and neck injuries, or medications. For this reason, it is very important to have symptoms like dizziness checked by your provider. The video Frenzel Goggles are a very valuable evaluation tool that allows us to see the smallest of movements in the eyes at the same time, helping to clearly define the problem the patient is experiencing. Having this tool right here will also benefit patients by saving them travel time and money.

“Thank you GMHC for providing this great service close to home, and for the excellent treatment of my vertigo symptoms,” said Carolyn.

The year 2020 was difficult for most people, but particularly so for Richard Guyer. Richard….struggled….to….breathe. He needed a lung transplant. That decision was reached after a lengthy period of seeing multiple doctors and undergoing many diagnostic tests. During that time, Richard’s lungs were quickly getting progressively worse, and his breathing was only helped some by the oxygen tank he was carting around. Richard suffered a great deal of stress that went along with having no diagnosis or treatment in the near future, especially when he couldn’t breathe.

Richard was admitted to GMHC as an inpatient in late 2020. His symptoms were shortness of breath, a dry cough, and an increase in oxygen needs. Richard’s primary doctor, Dr. Smith, gave him a second referral to the University of Iowa because no diagnosis had yet been reached. Finally, it was determined that he had Idiopathic Interstitial Lung Disease, a rare disease that affects less than 200,000 people a year in the United States. The diagnosis is so difficult because so many disorders fall into this category, the signs and symptoms of many conditions can mimic this disease, and doctors must rule those conditions out before making a definitive diagnosis.

The cause of Idiopathic (unknown or undetermined cause) Interstitial (occurring between the air sacs) Lung Disease, or ILD for short, is unclear. The reality is a shortness of breath that gets worse as the disease progresses. This disease belongs to a group of lung conditions that cause progressive scarring (or fibrosis) of lung tissues, affecting your ability to breathe and to get enough oxygen into your bloodstream. By the time symptoms appear, irreversible lung damage has often already occurred. Medications may slow the damage of this disease, but most never regain full use of their lungs, and the end stage is respiratory failure. Treatment is not always effective in stopping the ultimate progression. A lung transplant is a viable option, as it was for Richard.

Dr. Eberlein (University of Iowa Hospital) put Richard on the transplant list in mid-January of 2021. In December of 2020 Richard went from requiring low flow oxygen to being dependent on high flow oxygen 24/7. Due to the severity of his lung condition, Richard remained as an in-patient at the University of Iowa Hospital until he received his new lungs on March 1, 2021.

Post-operative therapy following a lung transplant is intense and requires close monitoring, so patients remain in the hospital during this first phase of recovery. There were also some setbacks with blood clotting during this period. This proved to be the most difficult time for Richard, as it occurred during the COVID-19 pandemic, which meant that he could have no visitors when he really wanted and needed them. “The pain was really bad, and I just wanted to see my family,” he explained. Richard remained very determined to take care of himself and said, “I had to put the lungs before everybody.” During this phase of recovery, he kept telling the nurses that he was going to walk by the second week… and he did! He replied, “I just convinced myself that I’m going to do it.” Richard also expressed great thanks to Dr. Smith and Dr. Eberlein for the great care they gave him.

After he was able to leave the U of I hospital, he stayed in a nearby hotel during the next level of treatment. Finally, Richard was with his father and received some of the support and family time he had been missing. “It helped a lot to be able to see my dad and stay with him,” Richard commented.

Next came the really good news, Richard could return to his home in Hawkeye, IA! In June of 2021, Richard began pulmonary rehab at GMHC, and although it was a distance to drive, he preferred to continue working with the people who he already knew, and who knew him. When he first arrived, he could only walk for 10 to 12 minutes without needing to stop. Gradually, he kept improving and was then able to walk for 30 minutes without a break. Currently, he is walking on a treadmill during therapy for 25 – 30 minutes… at an incline! He also lifts weights during his therapy sessions, and once a month does a spirometry lung function test along with a nebulized medication. The therapists also monitor his blood pressure and his oxygen saturation during his workouts. Richard said, “I am very grateful for the people who take me to my appointments; I like coming to GMHC for my rehab work, because it is close to home, I am familiar with the therapists I work with and I am comfortable with everyone here. The long struggle with Richard’s lung condition and eventual transplant left him with a fair amount of stress, and he commented, “It is very important for me to have a regular, comfortable place to go for rehab work. It was hard at first, but the therapists here know how to help me stay calm and in my comfort zone.”

Richard visits the University of Iowa every two months for follow-up testing. He enjoys telling others about his journey through his lung-transplant experience, and adamantly relays the importance of becoming organ donors to others. “Without a transplant, I wouldn’t be here!” he concludes. Richard’s goal is to walk in the German Fest 5K and show everyone just how far he has come!

Commented GMHC Respiratory Therapist, Catie Dean, “We started doing pulmonary function tests (determines lung volume) on Richard about a year before his lung transplant. We could see the gradual decline in his lung volume until he was to the point he had to be admitted to the hospital. It is so nice to continue to work with Richard and see the improvements in his health and his attitude since his lung transplant.”

Living with a lung disease was restricting and defining Donna Simon’s way of life. Although she had just renewed her license, she stopped driving (for fear of causing an accident), stopped shopping for groceries, going to sporting events, even taking care of her grandkids. She was basically staying at home and only going out to go to doctor appointments. As a mother who raised seven children, four of whom participated in the Dubuque Colt’s Drum and Bugle Corp, it was a sad day when she couldn’t go see a local performance with her daughter. Donna had been oxygen-dependent for over three years, and it was robbing her of the life she knew.

Donna came to GMHC for pulmonary rehab to see what breathing she could regain. Respiratory Therapist Amanda Miller, noted that during Donna’s therapy sessions her oxygen levels would drop immediately, causing severe shortness of breath and increasing her heart rate and blood pressure. This is typical for patients with lung disease, but the progress they had hoped to make just wasn’t happening. In fact, it was all they could do just to maintain her current level of breathing. Her lungs were in a serious condition.

Donna had been a patient of Dr. Schope (now retired) in Dubuque, who had diagnosed her with COPD in 2012. Although she tried to quit smoking then, it took her until 2018 to stop for good. During a visit with her new pulmonologist, Dr. Powers, it was suggested that Donna might want to consider getting a lung transplant. She discussed it with her family and with the medical staff at GMHC, and everyone in both cases was supportive of that decision. It would not be an easy road, but she was willing to try it.

To be placed on the transplant list, Donna would have to undergo almost 6 months of testing. Dr. Hoffmann and Dr. Powers sent her records to the University of Iowa, and the testing began. She had to have a colonoscopy, CT scans, MRIs, and even a checkup with dermatology, among other tests. All her immunizations had to be up to date. There had to be absolutely no signs of cancer, skin or otherwise, because the medications taken for cancers could cause scarring in the lung and could also cause any existing cancer to grow more rapidly.

Saying that Donna was a trooper through all the testing and trips to Iowa City was probably an understatement, as she had to complete all of this while she still felt miserable and could hardly breathe. Finally, on August 10, 2020, she was put on the lung transplant list, and six months later, on February 25, 2021, she received her new lungs.

Immediately after surgery, a lung transplant patient is required to stay in Iowa City for intensive care and therapy before they can leave the hospital. Following this first round of therapy, she was transferred to St. Luke’s in-patient rehab department in Cedar Rapids. After a reaction to a medication, she had to return to UIHC for two weeks before completing her therapy at St. Luke’s, where she remained until they were able to get her up and walking. After this accomplishment, she was able to return home to Guttenberg with her husband and dog! She began pulmonary rehabilitative therapy here at GMHC. She commented, “That was huge for me, to be able to come home and go to therapy nearby. It made such a difference in my recovery.”

Donna still needed to make some trips to Iowa City for post-surgery tests and checkups, but her doctor allowed her to do the frequent and necessary lab work at GMHC and have the information forwarded to U of I. “That made it much easier for me and saved us a lot of travel,” she commented. During her therapy at GMHC and recovery at home, Donna was sure to celebrate the little milestones along the way. At first, her husband had to help her get up out of the chair by lifting her at the back side of her pants waistband. “I got tired of all the wedgies he was giving me!” she joked. When she was finally able to complete this task alone, she announced, “Look at me, I can to this without anyone here!” And “I couldn’t have done this without the great rehab I was receiving.”

Donna had some work to do to regain her confidence in driving, as it had been 3 long years since she had been behind the wheel. But lately, she is taking full advantage of her newfound freedom. She is driving again, shopping for groceries, meeting friends for lunch and even driving herself to her appointments in Iowa City. Perhaps best of all, she recently was able to watch her grandkids again, and even made a trip to Redfield to celebrate birthdays for two of them. After seeing her for so long with an oxygen line attached, her grandson asked, “How are we going to be able to find you Grandma, without your cord?” When asked to describe how all of this makes her feel, she exclaimed, “It is great! It’s basically like having a new life!”

“We (Respiratory Therapy Staff) are very proud of Donna throughout her road to recovery. It was truly amazing to witness her reclaim her life and get back to being a busy grandma!” replied Amanda Miller, RT.

A surgery that occurred over seven years ago may have been the beginning of lymphedema, a condition that Ron now lives with.

Immediately after his surgery to repair a large abdominal aortic aneurism (a bulge in the aorta in the abdomen), Ron noticed a difference in the size of his legs, with some swelling in the right leg. It was not clear at that time, or even later, what the swelling was coming from. Gradually it got worse, and eventually Ron also noticed tightness in his legs. He was admitted briefly as an inpatient at GMHC in March of 2021 for cellulitis (a bacterial skin infection).

A few months later, in September, Ron developed cellulitis again, along with venous stasis ulcers on his legs, which are open wounds that “leak” excess protein-rich fluid from the body. After working to control the swelling and sores with Unna boots to promote healing of his venous stasis ulcers for several months, Ron’s primary care provider, Dr. McCaw, decided to refer him to a wound care specialist for more extensive treatment; however, there was a two month wait to be seen. Because GMHC’s Physical Therapist Kimberly Franzen, PT, DPT, CLT, had been recently certified to treat lymphedema, Dr. McCaw decided to refer Ron to her. That decision has been life-changing for Ron.

Lymphedema can occur as an abnormality at birth, primary lymphedema, or secondary lymphedema that develops after an injury, surgery or radiation treatment. Lymphedema is a protein-rich fluid buildup in the arm(s) or leg(s) that causes swelling, discomfort or achiness in the extremity and decreased mobility of the joints that can make it very hard to move your limbs to complete daily activities. Lymphedema symptoms include increased tightness and size of the arm or leg, skin changes including texture and color and increased difficulty with use of the arm or leg with daily cares such as dressing. Lymphedema increases the chances of recurring infection. At GMHC, we treat lymphedema to help reduce the size of the arm or leg, heal wounds, improve health of the skin and improve the patient’s quality of life. Because there is no cure for lymphedema, it is very important to treat it and learn to manage the symptoms.

Franzen began therapy with Ron in December of 2021 and treated both of his legs. She used all the techniques learned during her certification in Complete Decongestive Therapy for lymphedema, including manual lymph drainage, to aid in his healing. The results were amazing—the wounds were almost gone in three days! To maintain these results, and further decrease the lymphedema, intensive treatment began at 5 times per week for two weeks, and then tapered to 2-3 times per week for the remainder of his treatment. Franzen used multi-layer short stretch bandages to wrap Ron’s legs, which provided greater compression to reduce the lymphedema.

Each case of lymphedema is very different, and so is the individual treatment plan. Usually, the course of treatment is from 1-2 months. In Ron’s case, he experienced a few setbacks, and needed just over two months of intensive therapy. During this time, he also learned some valuable lessons in the precautions he needed to take to ensure his health. Franzen reported that during his therapy, Ron was mobile and doing all that he could to care for himself.

Franzen’s 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 build-up, but teaching/ educating the patient how to apply compression bandages or garments, exercise, nail & skin care, and other self-cares to assist with overall management of their condition. The successful treatment of lymphedema includes a lifetime commitment to control and manage the symptoms.

Ron described the difference it made for him to have the swelling more controlled in his legs, “Before, when I was using the exercise bike, my legs could only go for about 7 minutes, but after my course of treatment, I was able to go for about 20 minutes,” and, “now when we are walking around while shopping, my legs don’t really get tired, just a little heavy—so I stop to rest my legs for a few minutes and I’m ready to go.”

Following the intensive therapy, Ron received instruction on transitioning to self-care, where he would monitor his own situation and only need to receive treatment if conditions would get worse again. Ron said that after living with this condition, he now knows what signs to watch for that would require a visit to his health care provider.

Franzen taught Ron and his wife how to bandage his legs on the days he didn’t have treatment. Because the course of treatment was effective in controlling the lymphedema, an accurate measurement was taken for custom compression socks, which he will regularly wear during the day, along with a custom-fit Velcro garment at night.

When asked what he looks forward to being able to do again, Ron replied, “I hope to walk the course when I go golfing again. It will also be nice to wear dress pants instead of sweatpants, and regular shoes instead of extra-wide ones!”

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!

Category: Patient Stories