Category: Patient Stories

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!

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.” 

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