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• One Step at a Time
• Best Hospital In North Dakota
• Keeping it in the Family
• Mayo Clinic Care Network World Class Care Close
to Home
I was born and raised on a small dairy farm near Fergus Falls, Minnesota.
Although it was a great place and environment in which to grow up, our
family was “poor” by economic standards. Dental care was one of the
areas that suffered due to the economy. I was reminded of that recently
when I had to have an older dental implant removed and replaced. I
was impressed with the new dental techniques, tools, and pain-reducing
drugs. We have made tremendous improvements in dental surgery since
I was growing up. I can absolutely say the same for medical care.
COVER PHOTO
Kaitlyn Hayes, the first person in
North Dakota to have Cartiform
used for articular cartilage repair.
In this edition of Under the Arch we introduce you to a patient who
benefited from the use of Cartiform for articular cartilage repair. It was a
first for care of this nature delivered in North Dakota. Yes, we have made
tremendous advances in care.
Gary P. Miller
President and CEO
Dr. McDonough’s article chronicles her professional relationship with a
young couple during the growth of their family. This reminds me that
exceptional care comes down to skilled and compassionate people
dedicated to helping those who seek healing in their lives. I am very
proud to represent “the best” hospital in North Dakota!
Enjoy the stories.
CONTRIBUTORS
Jeremy Fettig
Julie Jeske
Julie Skaret
DESIGN
Donna Volk-Weigel
Dona Glick
PHOTOGRAPHY
Portraits by Amanda
COMMENTS
Comments about Under
the Arch can be sent to:
Jeremy Fettig, editor
St. Alexius Medical Center
P.O. Box 5510
Bismarck, ND 58506-5510
jmfettig@primecare.org
(701) 530-7051
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FYI Blog on st.alexius.org.
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Henri Nouwen, a Roman Catholic Priest and author, talks about his
visit with a trapeze artist in his book Our Greatest Gift: A Meditation
on Dying and Caring. “One day, I was sitting with Rodleigh, the leader
of the troupe, in his caravan, talking about flying. He said, ‘As a flyer, I
must have complete trust in my catcher. The public might think that I
am the great star of the trapeze, but the real star is Joe, my catcher. He
has to be there for me with split-second precision and grab me out of
the air as I come to him in the long jump.’ ‘How does it work?’ I asked.
‘The secret,’ Rodleigh said, ‘is that the flyer does nothing and the catcher
does everything. When I fly to Joe, I have simply to stretch out my arms
and hands and wait for him to catch me and pull me safely over the
apron behind the catchbar.’ ‘You do nothing!’ I said, surprised. ‘Nothing,’
Rodleigh repeated. ‘The worst thing the flyer can do is to try to catch the
catcher. I am not supposed to catch Joe. It’s Joe’s task to catch me. If I
grabbed Joe’s wrists, I might break them, or he might break mine, and
that would be the end for both of us. A flyer must fly, and a catcher must
catch, and the flyer must trust, with outstretched arms, that his catcher
will be there for him.”
This story emphasizes the trust of the flyer and the responsibility of the
catcher. If we translate Nouwen’s story into our life at St Alexius, we see
that our patients/families give evidence of their trust in us as they enter
under our arch; they place themselves into our healing hands. We, in turn,
are here for them, ready to “catch” them 24/7. We welcome patients and
families with our value of Healing Presence. Healing Presence is more than
giving a pill, removing a cancer or reconstructing a joint. Healing Presence
is “walking with” others, “being there” for them, “catching” them.
When someone enters under our arch they can expect to meet associates
who look them in the eye, smile and greet them. They can expect that
we will offer them the most up-to-date procedures, techniques and
medicines available to us. They can expect that all of us at St Alexius
will walk with them during their stay with us. They can expect us to be
a Healing Presence in their lives, and they can expect that they are in
North Dakota’s “Best Hospital,” thanks to our associates who "catch" our
trusting patients.
Sr. Mariah Dietz, OSB
Vice President of
Mission Effectiveness
Two Years Running: U.S. News & World Report Names
St. Alexius Best in North Dakota
T
he annual U.S. News Best Hospitals rankings, now in their 25th year, recognize hospitals that
excel in treating the most challenging patients. For the the second consecutive year, St. Alexius
was named The Best Hospital in North Dakota.
St. Alexius President and CEO, Gary P. Miller, said receiving this recognition for two straight years is
a testament to the quality of care St. Alexius associates provide. “These rankings acknowledge our
dedication to providing outstanding medical care to the patients and families we serve.” St. Alexius was
recognized for being high-performing in eight areas: cancer, gastroenterology and GI surgery, geriatrics,
ENT, gynecology, orthopedics, nephrology and pulmonology.
For 2014-15, U.S. News evaluated hospitals in 16 adult specialties and ranked the top 50 in most of the
specialties. “The data tells the story – a hospital that emerged from our analysis as one of the best has
much to be proud of,” says U.S. News Health Rankings Editor, Avery Comarow. “A Best Hospital has
demonstrated its expertise in treating the most challenging patients.”
U.S. News publishes Best Hospitals to help guide patients who need a high level of care because they
face particularly difficult surgeries, challenging conditions or extra risks because of age or multiple
health problems. Objective measures such as patient survival and safety data, adequacy of nurse
staffing levels and other data largely determined the rankings in most specialties.
The specialty rankings and data were produced for U.S. News by RTI International, a leading research
organization based in Research Triangle Park, N.C. Using the same data, U.S. News produced the state
and metro rankings. The rankings are freely available at health.usnews.com/best-hospitals and appear in
the U.S. News “Best Hospitals 2015” guidebook.
“A Best Hospital
has demonstrated
its expertise
in treating the
most challenging
patients.”
St. Alexius Medical Center paid a
licensing fee to Wright’s Media in
the amount of $25,000 to publish
the ranking completed by U.S.
News & World Report.
Upcoming Health Events – For a full listing, visit st.alexius.org.
COMMUNITY EVENTS
Auxiliary Jewelry Sale
Monday, October 20, 7 a.m. - 5 p.m.
Tuesday, October 21, 7 a.m. - 3 p.m.
Boniface Auditorium
Auxiliary Bazaar
Friday, November 7, 7 a.m. - 3 p.m.
Boniface Auditorium
Living Grand
Sleep and Aging
Thursday, October 9, 10 - 11 a.m.
Technology and Education Center
Free, call 530-7700 to register.
Breastfeeding Basics
October 14 , 7 - 9 p.m.
November 11, 7 - 9 p.m.
December 9, 7 - 9 p.m.
Technology and Education Center
Cost: $40 Call 530-7700 to register.
Childbirth Preparation Weekend Classes
October 10 - 11, November 7 - 8
December 5 - 6
Technology and Education Center
Cost: $40 Call 530-7700 to register.
Weekday evening and refresher classes are
available. Call 530-7700 for more information.
AARP Smart Driver Course
Thursday, November 13, 8:30 a.m. - 12:30 p.m.
Technology and Education Center
Cost: $15 for AARP members and
$20 for non-members
Call 530-7700 to register.
What About Me? Sibling Class
Sunday, October 26, 2 - 3:30 p.m.
Boniface Auditorium
$15 for first child, $5 each additional child
Call 530-6026 to register.
Encourage Your Soul: Create
Thursday, December 11, 10 - 11 a.m.
Technology and Education Center
Free, call 530-7700 to register.
Alzheimer's, Dementia and Memory Loss
Support Group for Caregivers
Tuesday, October 21, 1:30 - 3 p.m.
Technology and Education Center
Meets third Tuesday of each month
For more information, call 530-7755.
Pregnancy and Infant
Well Baby Clinic
(Free for babies born at The Birth Place)
Weekly - Wednesday, 12 - 2:30 p.m.
Technology and Education Center
For more information, call 530-4270.
Support groups
Tuesday, October 21, 6:30 - 8 p.m.
Cafeteria Meeting Room 3
Meets third Tuesday of each month
For more information call 530-7755.
Caregivers Cancer Support Group for Men
Tuesday, October 21, 5:30 p.m.
Bismarck Cancer Center
Meets third Tuesday of each month
For more information, call 222-6100.
Diabetes Support Group
Wednesday, October 22, 4:40 - 5:30 p.m.
St. Alexius Mandan Clinic - North
Meets fourth Wednesday of each month
For more information, call 530-7860.
Gluten Intolerance Support Group
Monday, October 6, 6:30 p.m.
Topic: Soups and chili
Cafeteria Meeting Room 1
For more information, call 400-3607.
Parkinson's Support Group
Thursday, October 9, 3 - 4:30 p.m.
Cafeteria Meeting Rooms 1, 2 and 3
Meets second Thursday of each month
For more information, call 663-2177.
Stroke Support Group
Wednesday, October 8, 4 - 5 p.m.
Cafeteria Meeting Room 3
For more information, call 530-8220.
Surgical Weight Loss Support Group
Tuesday, October 7, 6 - 7:30 p.m.
Center of Excellence - Telemedicine Room
Meets first Tuesday of each month
For more information, call 530-5189.
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1
One Step At a Time
W
e all have life changing moments. For 18-year old
Kaitlyn Hayes, February 16, 2013 was hers. Kaitlyn
had a history of kneecap (patellar) dislocation; the first one
occurred in 2010 when she was holding her dog. “I pivoted
and my kneecap popped out of place.” The injury caused
a stretching of Kaitlyn’s tendon. “Even the simplest of
movements would dislocate my knee cap.”
Fast forward to February 16, 2013. Kaitlyn was scheduled
to work the morning shift at her certified nursing assistant
(CNA) job. “Being a CNA was my dream job.” Kaitlyn
navigated her way along the ice, but she fell. “I couldn’t
feel pain, yet I couldn’t get up.” Kaitlyn crawled along the
driveway to the back of her stepdad’s truck and called
for help. “My stepdad picked me up and put me in the
vehicle.” Kaitlyn’s mom drove her straight to St. Alexius’
Emergency Room. An evaluation with Dr. Timothy Juelson,
a board certified orthopaedic surgeon with The Bone
& Joint Center, later confirmed the loose body, patella
instability, malalignment, and need to surgically repair the
damage done to her knee.
On April 9, 2013, Kaitlyn underwent arthroscopic surgery
on her left knee. Dr. Juelson, stated, “Kaitlyn’s injury
resulted in an approximate 4-square centimeter, fullthickness, patellar lesion down to the bone.” In essence,
Kaitlyn had no cartilage under her kneecap. During surgery
Dr. Juelson removed cartilage floating around the knee
and collected cartilage cells to be grown and implanted
in Kaitlyn’s knee at a later date. The goal was to find a
permanent fix to Kaitlyn’s patellar lesion.
Kaitlyn’s harvested cells were to be transplanted in June,
but that was cancelled due to insurance difficulties. Adding
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insult to injury, Kaitlyn had to give up her CNA job, as
she could not perform the physical requirements. “Kaitlyn’s
life was on hold,” said her mom Donna Hanson. “As a
parent, I felt helpless.” Throughout the year, Dr. Juelson was
in constant contact with Donna and Kaitlyn about finding
another option for restoring Kaitlyn’s cartilage. During that
time, Kaitlyn experienced continued kneecap dislocations,
occasional falls and pain.
When she started college, Kaitlyn wanted to be free of
limitations. “I knew I would have to be non-weight-bearing
for six to eight weeks following surgery.” Kaitlyn set May
26, 2014, as her surgery deadline, but that day came and
went. However, a phone call from Dr. Juelson gave Kaitlyn
new hope. There was a product that has the cellular and
molecular components for articular cartilage repair. Kaitlyn
would be the first person in North Dakota to have this
product implanted. Cartiform could provide the permanent
fix Dr. Juelson wanted for Kaitlyn’s knee. With nothing
to lose and everything to gain, Kaitlyn and her mother
consented to the surgery.
The day of surgery was full of emotions for Kaitlyn. “It
was very hard. I cried and had a panic attack. I was excited,
apprehensive, yet scared.” Kaitlyn said to Tanya, Dr. Juelson’s
nurse, who volunteered to stay with her during the surgery.
The surgery lasted four hours. Dr. Juelson commented that
Kaitlyn literally seemed like another person the day after
surgery.
It could take 12 to 18 months before Kaitlyn experiences the
full benefits of the cartilage transplant. In the meantime, she
does physical therapy daily at home, in addition to seeing
a physical therapist once a week. “Kaitlyn will continue
working on building strength and transitioning to other
activities,” stated Dr. Juelson. However, she’s not putting
her life on hold anymore. “I had hoped to be rid of my
crutches when college started, but I’ll need to use them for
two to three weeks after classes start.” In the future, Kaitlyn
just wants to be self-reliant. “My family, especially my mom,
has supported me throughout this journey. I just wanted to
get my life back.”
Dr. Juelson previously completed an Orthopaedic Surgical
Sports Fellowship at the prestigious Andrews Institute
working with world experts in articular cartilage restoration.
To schedule an appointment with Dr. Juelson or any of
the orthopaedic specialists at The Bone & Joint Center,
call (701) 530-8650 or toll free at (866) 900-8650.
Timothy Juelson, MD
Orthopaedic Sports Surgeon
The Bone & Joint Center
Keeping it in the Family
A
s a young adult,
Stephanie Gerhardt, of
Mandan, needed a routine
physical before heading off
to college. “It was just by
chance that the scheduler
set me up with Dr. Denise
McDonough,” she says.
“I didn’t know anything
about her when I walked
into her office.” Little did
she know, Dr. McDonough
would become a big part
of her life.
15 years later, Stephanie
and her husband, Steve,
have seen Dr. McDonough
many times; so have their four sons, which Dr. McDonough
delivered. “I always say that Dr. McDonough is a part of our
family,” says Stephanie.
“I’m very humbled,” says Dr. McDonough. She says it’s
really special and important to her when she can treat the
whole family. “When I know the medical history of all
family members, it helps guide me to a diagnosis.”
There have been many diagnoses throughout the years for
the Gerhardt’s. When one of the boys came in with MRSA,
a bacterial infection, she quickly diagnosed and treated it. A
short time later when another one of the boys came in with
boils on his body, Dr. McDonough knew right away what
she had to do first. “I needed to test this boy for MRSA. The
test came back positive, and I began treatment right away.”
“I try to treat patients as I would like to be treated. I make
sure to really listen to what they’re saying, and then I
address their concerns,” says Dr. McDonough.
Dr. McDonough has had to refer their second oldest son to
Fargo and Minneapolis to see specialists. Stephanie recalls,
“I once had this gut feeling that a physician we had seen
had missed something. I called Dr. McDonough right away,
and asked her if she could immediately review the medical
notes. She did and got us another specialist who gave us a
second opinion.” It was that second opinion that saved their
son’s life.
Keeping up with Dr. McDonough hasn’t been easy, but
Stephanie says it’s been worth it. “As she’s moved to
different facilities, I’ve had my family’s medical records
moved with her. I always feel extremely comfortable with
her, and I trust her with my family’s lives.”
Dr. McDonough no longer delivers babies but still provides
full pre-natal care for women. “I love my job because I
never know what’s going to walk through the door each
day,” says Dr. McDonough. “Serving the community at
Mandan Clinic - North is an honor.
To schedule a appointment with Dr. McDonough call
St. Alexius Mandan Clinic – North at (701) 667-4600.
Mandan Clinic – North is located at 2500 Sunset Drive
NW in Mandan, just west of Walmart.
Denise McDonough, MD
Family Medicine
St. Alexius Mandan Clinic - North
“Our boys have had some serious medical issues,” says
Stephanie. “Dr. McDonough is never afraid to tell us that
something isn’t within her area of expertise, but she’ll find
us someone who can help.”
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3
Mayo Clinic Care Network - World Class Care Close to Home
I
t was a crisp November day in 2013 when Terry Stickel’s
life would take an unexpected turn. Terry - a husband,
father, grandfather, and avid hunter - was gearing up to
go deer hunting. While packing, he started to feel a slight
pain in his chest. The pain was mild, and while not severe
enough to cause alarm, it made him feel uncomfortable.
His wife Cindy persuaded him to get medical clearance
before he ventured out into the wilderness. Thinking it
would be some routine tests, they went to a walk-in clinic.
The physician conducted an electrocardiogram (EKG) to
test his heart. Wanting a further evaluation, the physician
recommended they go directly to the emergency room
in Dickinson for further testing. Having found nothing to
indicate a serious problem, the attending physician was
about to sign the discharge papers when the monitors
started going off. Terry was experiencing atrial fibrillation
(A-fib), an irregular, rapid heart rate. He was transported
to St. Alexius’ Cardiac Unit where he was started on a
treatment plan and monitored for a few days. Soon his
heart went back into normal rhythm.
Terry returned to normal life in Dickinson. Unfortunately,
a few months later the same kind of chest pain returned.
Again, he figured that it would require the same attention
as before so Terry went back to see his physician. After
some cardiac tests, the doctors realized that he was not
experiencing A-fib this time. They recommended he see a
cardiologist to get to the bottom of what was going on, so
Terry made an appointment. However, he never made it to
that appointment; in less than 24 hours, Terry and Cindy
made the decision to seek care at St. Alexius’ Emergency
Room after a fitful night that he describes as the worst night
of his life.
Finding the Cause
While at St. Alexius, Dr. Norman Eshoo, cardiologist at
St. Alexius Heart & Lung Clinic, diagnosed Terry with
pericarditis, a condition where the pericardium, the
fluid-filled sac that covers the outer surface of the heart,
gets inflamed. In some cases, excess fluid collects in the
space between the inflamed layers and causes buildup of
additional fluid around the heart. Pericarditis can develop
suddenly and may last up to several months. Most common
cause of pericarditis is a viral pericarditis but certain
autoimmune diseases, such as lupus and rheumatoid
arthritis can also cause inflammation of the lining of the
heart.
Dr. Eshoo started Terry on the usual treatment for possible
viral pericarditis but his symptoms persisted, which made
him suspect there was some underlying autoimmune
disorder. Terry was referred to Dr. Lisa Francis, a board
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certified rheumatologist at The Clinics of St. Alexius and
Fellow of the American College of Rheumatology. “Test
indicators showed that he had a significantly elevated
rheumatoid factor of 163,” stated Dr. Francis. “A factor
level of up to 20 is considered normal. However, Terry did
not have any joint pains or other symptoms suggestive of
rheumatoid arthritis.” Dr. Francis knew that Terry had an
autoimmune disease and that rheumatoid arthritis could be
a possibility. However, finding the exact cause would be
tricky. After additional test results and some research, Terry
was diagnosed with lupus, an autoimmune disease where
the immune system attacks healthy tissue. Lupus occurs
most often in women, and a diagnosis in men can be
extremely difficult. Dr. Francis started Terry on a treatment
plan using a combination of immunomodulating agents and
steroids to help manage his symptoms.
A Diagnosis Confirmed
Terry was relieved that everything was under control and
being managed. He was confident that Dr. Francis was on
the right course of action with his diagnosis. Although there
is no cure for lupus, it can be easily managed. Still, Terry
had a certain want…the same want a lot of patients have
after a medical diagnosis. His want was the confirmation
of a second opinion. “It was more to put myself at ease. I
am one of those guys who wants to know exactly what the
name of it is and how to treat it,” stated Terry. While having
a discussion with his sister, she mentioned that Terry should
get a second opinion using the Mayo Clinic Care Network.
“I knew of Mayo Clinic; however, I didn’t know that you could
have an e-consult to get another set of professionals to look
at your tests and medical records,” said Terry. A few weeks
later he got his results. The physicians at Mayo confirmed that
Dr. Francis’ lupus diagnosis was correct; he was on the right
course of treatment. “It was a great relief and a huge benefit
to do it so close to home. It was extremely helpful that my
wife and I did not have to take time off from work, have travel
expenses and so on,” said Terry.
The Mayo Clinic Care Network not only benefits
patients; physicians and staff also benefit from receiving
expert advice. Dr. Francis stated, “When we see more
complicated cases where traditional treatments may
not work, there is a good chance that Mayo Clinic has
To schedule an appointment with Dr. Eshoo or any
specialist at Heart & Lung Clinic, call (701) 530-7502
or toll free at (800) 932-8848.
experience with new medications, research and different
practices in treatment. Physicians like myself know that
through the Mayo Clinic Care Network our patients are
receiving the highest level of care that is available.”
The Mayo Clinic Care Network extends their knowledge
and expertise to St. Alexius’ physicians. Through this
membership, St. Alexius physicians have access to Mayobased research and expertise via the AskMayoExpert
database and are able to consult Mayo specialists on
questions pertaining to patient care. St. Alexius Medical
Center became a member of the Mayo Clinic Care
Network in 2012.
To schedule an appointment with Dr. Francis or any
specialist at The Clinics of St. Alexius, call (701) 530-6500
or toll free at (800) 422-1396.
Norman S. Eshoo, MD
Cardiology
Heart & Lung Clinic
Lisa Francis, MD
Rheumatology
The Clinics of St. Alexius
St. Alexius Medical Center Welcomes the Following Physicians:
Nicholas Bradbury, MD
Interventional Radiology
Daniel Tarver, MD
Interventional Radiology
Carmen Dargis, MD
Anesthesia
Tara Kraft, PhD
Adult Psychology
Diane Nelson, MD
Adult Psychiatry
Jake Reyman, DO
Hospitalist
Lindsey Reyman, DO
Hospitalist
Parveen Wahab, MD
Pediatric Hospitalist
Saurav Pokharel, MD
Pulmonology
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5
You Deserve the Best
For two consecutive years St. Alexius Medical Center in Bismarck
Recognized as
The Best Hospital in North Dakota
By U.S. News & World Report
St. Alexius
Medical Center
St. Alexius was recognized for being high-performing in: cancer, gastroenterology and GI surgery, geriatrics, ENT, gynecology, orthopedics, nephrology, and pulmonology.
St. Alexius Medical Center paid a licensing fee to Wright’s Media in the amount of $25,000 to publish the ranking completed by U.S. News & World Report.