No Need to Leave Town for Top-Notch Healthcare

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When the heart fails, minutes count not just for staying alive, but for quality of life in the years to come.

That’s why people in Michigan’s Upper Peninsula can be grateful that UP Health System-Marquette has an ever-ready helicopter service and, when it arrives, the hospital has a top-notch cardiac care team that’s about to get even better.

Dr. Bradford Blakeman, a cardiothoracic vascular surgeon practicing in Chicago, will join three other CV surgeons on staff in April. His services will be well used in the U.P. hub of cardiac care, says Bryan Breeser, senior director of the hospital’s heart and vascular services.

Perhaps unusual in a city the size of Marquette, population 21,355, the hospital can offer open-heart surgery.

“We’ll probably do about 250 open-heart surgeries a year,” Bryan says. “There’s almost no reason to go to a bigger city unless you need a heart transplant. … The next closest open-heart program is probably in Green Bay. That (distance) really poses an issue for family members who want to support the patients.”

Marquette is not the only regional city with medical options beyond what might be expected. We take a look at three state-of-the-art offerings at three area hospitals that can keep patients home or in their home region. And that stay-near-home care can make a critical difference in recovery.

“It’s pretty well-documented that family support and community support is helpful for recovery,” Bryan points out. When family must travel great distances to support an ill patient, that isn’t just a hardship. In our area, in winter, it might be an impossibility. “When the weather is bad, that makes the trip all that more difficult.”

An Open-Heart Option

UP Health System-Marquette has offered open-heart surgery for a number of years, but bringing Bradford Blakeman on board will up the team’s capabilities, Bryan says. Bradford, who began his medical career in academics, switched to private practice midcareer “to extend high-risk heart surgery to the community setting. Now every case short of heart transplant can remain in the comfort and efficiency of the local hospitals,” according to his online biography.

Bryan, himself a fairly recent transplant to the U.P., says the outdoor amenities of the region, the friendliness of the local people and the quality of staff at the hospital all make attracting top-notch medical talent easier. “It takes somebody special, who’s not going to run to Neiman Marcus on their lunch hour. For those who like the outdoors, it’s paradise here.”

UP Health also has been sharing its expertise, sending cardiologists to various locations around the U.P., such as in Houghton and Sault Ste. Marie.

“Literally thousands of times a year, people will make contact,” Bryan says. “Every day, we’re seeing lots of people with cardiac-related illnesses.”

Many emergency treatments for people suffering heart attacks do not require open-heart surgery. “We can do a lot of things through a catheter now,” Bryan says, referring to when a thin tube is passed through an artery or vein for diagnosis. Similarly, balloon angioplasty uses a tiny “balloon” inserted through a leg vessel that is fed to and positioned at a blockage, then inflated to allow blood flow. However, if these less invasive procedures will not work, the open-heart option is an important one.

“If we did not have that surgical program here, that might mean an urgent transfer,” Bryan says. “Imagine not having cardiac care in the U.P.”

A Savvy Scale

On the Iron Range in Minnesota, a savvy device is aiding patients with heart failure to keep them healthy in their homes.

After his open-heart surgery, Bill Schleppegrell, a retired German language teacher, needed regular monitoring for his chronic heart failure. That meant a 50-mile round trip every couple of weeks from his Hibbing home to Essentia Health-Virginia Clinic, with a heart center north of Duluth.

Today, though, Bill gets that monitoring daily, without ever leaving his home. All he has to do is answer a few questions and step on a scale.

The questions come from the electronic device with a friendly voice. “It’s a woman’s voice, very pleasant,” says Bill. The questions always follow the same line: Were you awake during the night from shortness of breath? Did you use extra pillows? Did you take all your medications? Is your appetite good? Are you feeling more tired? Are your ankles swollen?

Variations in Bill’s answers prompt additional questions until the final directive: “‘Now step on the scale,’ that’s the last thing,” Bill says.

For patients with heart failure, which can mean increased water retention, even slight increases in weight may indicate a need to adjust medications. After he weighs himself, the pleasant “lady” bids him, “Have a good day, your data is being transmitted” and the device transmits its information directly to the clinic.

There a team, including cardiology nurse practitioner Jennifer Kober, checks the data and decides if any adjustments are needed for Bill.

“That’s the nice thing about the telescale,” says Jennifer. “We can put them on the scale and have closer monitoring. It increases the consistency of care.”

The scale can be used for blood pressure, and for patients with pulmonary and lung trouble, too.

“It’s decreased our overall (hospital) readmission rates to virtually zero percent,” she says.

Jennifer, a lifelong Iron Range resident, appreciates this kind of system and the ability of the Virginia clinic to handle cardiac after-care. Since February, a cardiologist from Duluth also does outreach consultation three times a week clinic.

Elderly people from the Range don’t feel comfortable driving to or in Duluth, especially in winter, Jennifer says. Some will even delay getting medical testing, like a stress test, just to avoid the winter drive. Starting later this year, the Virginia Clinic will be able to give those tests, too.

As for Bill, generally within half an hour, he gets a call back from the clinic, sometimes with suggestions, like medication changes, or follow-up questions.

“It’s a great program because they’re right on top of me, right away,” says Bill. “It makes me feel really at ease that they are on top of things.”

Taking a ‘Dive’

At St. Luke’s Advanced Wound Care & Hyperbaric Center in Duluth, a medical device on a whole different scale offers new options for treating infections or non-healing wounds.

The center opened in February.

Dr. Leslie Cavazos, a specialist in physical medicine and pain management, calls it taking a “dive” into one of the two new hyperbaric chambers. The pressured chambers, the only ones in northern Minnesota, deliver 100 percent oxygen.

“This treatment was developed by the Navy,” Leslie explains. “They had determined that there were ailments that were getting better when people were diving under pressure.”

Diving is an interesting analogy since many recognize the hyperbaric chamber as a life-saver for accidents when divers develop the bends, although that is not the use for which these at St. Luke’s are intended.

For patients with non-healing wounds, the super-charged oxygen within the chamber, which compresses oxygen molecules, can infuse tissues with oxygen to aid healing. The chamber can also help with patients at risk of losing a limb.

The center team connected to the hyperbaric chamber and wound care, along with Leslie, includes Tania McVean, center director, the medical director Dr. Jarrod Buresh and Dr. Mark Eginton, physician’s assistant David LaBore, Cassie Iverson, a hyperbaric technician plus a highly trained group of wound care nurses.

People suffer from chronic wounds for a number of reasons, including diabetes, loss of mobility and vascular issues.

“Nationally wound care centers see about 200,000 patients a year,” Tania says. “Across the country there are 6.7 million people that can benefit from wound care.”

Use of the expensive equipment is not done casually, though, Leslie explains. “It’s 100 percent oxygen at pressure.” Each patient goes through individualized instruction prior to entering the chamber. Hyperbaric treatments are approximately 90 to 120 minutes, five days per week. “You could probably have anywhere from 30 to 40 treatments, depending on what’s happening,” Leslie says.

In the past, that would mean multiple trips to the Twin Cities for Duluth-area patients. Now they can stay in their home area.

It can play a supporting role for patients who might have trouble healing wounds during radiation or chemotherapy for cancer.

“Our oncology team was sending them to the Twin Cities,” Leslie says. “They are very happy to have the chambers here.”

With all of the equipment and expertise now available in Duluth, Leslie says there really should be very few instances when patients need to leave home for specialized care. “I wouldn’t go anywhere else.”