Roger Edwards had always been a kidder. So when his wife, Jackie, found him on the floor next to the bed, she thought it was another prank. But she quickly realized that Roger wasn’t moving. Nor was he responding. Jackie picked up the phone and called 911.

An ambulance arrived immediately and took him to the nearest hospital – UnityPoint Health – St. Luke’s in Sioux City, Iowa. “I tried to stay calm and not panic,” recalls Jackie. “But when the hospital ER staff asked me if I wanted to send him to Omaha or let him go, I knew it was serious.”

Roger had suffered the most severe form of stroke – a basilar artery occlusion stroke. With this type of stroke, the blood clot blocks the largest vessel that supplies the brainstem. It carries a high risk of mortality, or severe disability, if you survive.

“It’s one of the types of stroke we fear the most,” says Michael Pichler, MD, Nebraska Medicine neurologist. Dr. Pichler was the neurologist on call that day at the Nebraska Medical Center. St. Luke’s is one of eight Nebraska hospitals that are part of the Nebraska Medicine Telestroke Program. As members of this program, these hospitals have immediate access to the Nebraska Medicine stroke team for quick assessment of stroke patients who come to their hospital. After the Nebraska Medicine stroke team was contacted, Dr. Pichler immediately remoted in via video monitors. Within a few minutes, he had assessed Roger and recommended administration of tPA (a blood thinning drug that helps dissolve the clot) to buy him time to make the air transport to Nebraska Medical Center for emergency stroke surgery.

“As soon as I saw the results of his CT angiogram, I could see that a large segment of his basilar artery was completely blocked, and as a result, would be a candidate for thrombectomy,” says Dr. Pichler. “But he needed to get here fast.”

Mechanical thrombectomy is an advanced vessel-opening procedure performed by trained endovascular neurosurgeons. Using high tech imaging equipment, the procedure involves threading a catheter through the femoral artery to the site of the clot. The stent is used to remove the clot so blood flow can be restored to the brain.

When Roger arrived at Nebraska Medical Center, the stroke team was waiting. Daniel Surdell, MD, a Nebraska Medicine cerebrovascular and endovascular surgeon, performed the mechanical thrombectomy procedure. “Once we received word that Roger was being transferred here, our stroke team was deployed and ready,” says Dr. Surdell. “Time is critical when it comes to stroke. Our goal is to treat the patient quickly and appropriately to reduce the amount of damage caused by the stroke as much as possible.”

“I was amazed at how quickly they got things going,” says Jackie. “They immediately took him into surgery and shortly after the procedure, he was moving around and answering questions. The next day while he was in the intensive care unit, he even gave one of the nurses a high five!”

“The first memory I have is walking down the hallway, carrying my walker instead of using it,” says Roger. “Even the doctors said they were amazed that I had made it and was doing so well.”

Performing the thrombectomy procedure probably saved his life, or at the very least, has allowed him to enjoy quality of life,” says Dr. Pichler. “This type of stroke can leave a patient completely paralyzed in all extremities and unable to communicate.”

Drs. Surdell and Pichler are backed by a team of health care providers whom have a wealth of experience and stroke expertise. The team also includes two additional vascular neurologists, a neurohospitalist, stroke nurse and neurointensivist. They are part of the only certified Comprehensive Stroke Center in the region, the highest level of stroke certification available. It is the only stroke team in the area equipped to handle the most complex stroke cases and provide specialized around-the-clock treatment 24 hours a day, seven days a week.

“We have seen a lot of success stories due to the telestroke program,” says Dr. Pichler. “This program allows small hospitals that do not have neurology or stroke neurology on staff to have access to 24/7 stroke expertise through Nebraska Medicine. It allows us to quickly assess and appropriately diagnose patients and provide potentially life-saving interventions.”

Because of the quick diagnosis and treatment performed by the Nebraska Medicine stroke team, Roger survived his stroke and has recovered remarkably well. Aside from driving, due to a blind spot in each eye caused by the stroke, Roger says he can do just about everything he could before the stroke.

“Whatever they are doing, they need to keep doing it,” says Roger. “They did an excellent job and as a result, they gave me a second chance.”

This story was provided to the foundation courtesy of Nebraska Medicine.

Winnie knew something wasn’t right. But she just didn’t understand what her body was trying to tell her. It was a variety of symptoms that gradually grew worse. First, there was the reflux. It was so bad that sometimes she would throw up after meals. Then her legs and feet began to swell. Her lungs became so congested at night that she had to prop herself up with six pillows or more so she could breathe. She was growing more tired and weaker all of the time.

“I just kept ignoring the symptoms and telling myself that I was sick or it was my heartburn,” says Winnie. Then her son noticed a pulsating mass on the side of her neck. That was the last straw, she recalls. It was time to see a doctor.

A visit to her doctor and an echocardiogram revealed that her ejection fraction (a measurement of how much blood the heart pumps out with each heartbeat) was severely reduced to just 10% to 15%(normal is over 50%). Winnie was referred to Douglas Stoller, MD., Nebraska Medicine advanced heart failure specialist and transplant cardiologist. Nebraska Medicine is the region’s leader in heart failure. The Nebraska Medicine Heart Failure Program is the largest and only Joint Commission-certified heart failure program in the state.

“Winnie was in advanced stages of heart failure,” says Dr. Stoller. “While more than half of heart failure cases are caused by coronary artery disease, in Winnie’s case, she had non-ischemic heart failure, meaning her heart failure was not caused by coronary heart disease but by other factors or conditions that may have predisposed her to heart disease.

“Winnie’s presentation was quite unique. The pulsating mass on the side of her neck was a condition called jugular venous distention (JVD). The jugular vein is like a water gauge for the body. The degree of distention is based on how much extra fluid you have in the body. While this condition is common in heart failure patients, in Winnie’s case, it was remarkably distended and obvious. She was in fluid overload.”

Dr. Stoller initially started Winnie on diuretics to reduce fluid build-up. But Winnie’s symptoms continued to persist. Then one morning, she woke up and couldn’t get out of bed. “I felt so fatigued,” she recalls. “My body just wouldn’t respond. I couldn’t talk or walk or get up to take a shower. I felt like I was drowning in fluid.”

Winnie was admitted to the heart failure inpatient service at the Nebraska Medical Center, where she was placed on intravenous therapy (IV) to remove the excess fluid. After five days, Winnie left the hospital 15 pounds lighter, as a result of fluid removal.

Winnie was started on several heart failure medications and was referred to the Nebraska Medicine Heart Failure Optimization Clinic, designed to enhance the care of patients with heart failure and help them live longer. Using a multi-disciplinary approach of heart failure providers, pharmacists, nutritionists and nurses, the new approach follows guideline-directed medical therapy developed by the American College of Cardiology, American Heart Association and Heart Failure Society of America. Members of this team provided Winnie with education on medications, nutrition, and exercise to help her manage her disease more independently.

“This approach is designed for patients who have been hospitalized with heart failure in the past year or have a new heart failure diagnosis,” says Dr. Stoller. “Oftentimes, patients are started on heart medications, but they are not followed closely and their medications are not adjusted. Our goal is to follow them closely, start them on proven, guideline-directed medications, and slowly increase their doses until they have been optimized. There is solid evidence that patients who are treated aggressively with these guideline-directed medications, experience improved mortality and fewer hospitalizations caused by heart failure.”

After just a couple visits, Winnie says she had already begun to feel better. “When I started, I could only exercise for about five minutes,” she says. “After three weeks, I was walking and jogging, lifting weights and bicycling for 45 minutes. I couldn’t believe how quickly I started feeling better.”

“Close follow up and medication optimization is an important aspect of heart failure management,” says Theresa Diederich, NP, heart failure nurse practitioner. “Heart failure is one of the top diagnoses that cause patients to be readmitted to the hospital. Our goal is to keep them out of the hospital and feeling better again. Winnie was very engaged and motivated. When she arrived, she could barely walk a half block. Now she is doing so much better and has much more energy.”

Within a couple of months, Winnie’s ejection fraction had risen to 30% to 35%. “As we continue to optimize Winnie’s medications, I expect her heart function to improve,” says Dr. Stoller. “If Winnie had not been started on aggressive medical therapy and followed closely by our heart failure team, I don’t think she would be doing as well as she is today.”

“I feel so good now,” says Winnie. “I had read a story about someone with heart failure, but I never dreamed that was what was happening to me. I thought that was for old people. I just thank God that I was in the right hands. The care here has been just amazing. I felt like I was among family. When I first started going to the clinic they told me, ‘we want to make you better as soon as possible,’ and that’s what they did.”

This story was provided to the foundation courtesy of Nebraska Medicine.

Dakota Case was born with a rare heart defect. By the age of 25, he had lived through three open heart surgeries and had been listed for a heart transplant.

But the summer of 2015 would prove to be one of the most trying periods of his life. His heart was pumping at an extremely low output – too low to provide enough blood to sufficiently supply his organs.

Dakota spent that summer in the Intensive Care Unit (ICU) at Nebraska Medicine, and 40 days of it was on an extracorporeal membrane oxygenation machine (ECMO) machine to allow his lungs to grow stronger. ECMO takes over the work of a person’s own lungs and/or heart by delivering oxygen to the blood. As Dakota’s lungs grew healthier, he was able to receive a left ventricular assist device (LVAD), moving him closer to a heart transplant.

“It was touch and go for a whole month,” says his mother, Jennifer Case. Jennifer and husband, Chuck, who live in Sioux Falls, South Dakota, had to leave their home and business that summer so they could be with Dakota during that tenuous time.

The following spring, Dakota’s condition deteriorated again. This time he would be hospitalized until he received a heart transplant. Again, Jennifer had to leave her home and family business so she could stay with Dakota during that three-month period before and after the heart transplant.

None of this would have been possible without the help of Nebraska Medicine’s Patient Assistance Fund, says Jennifer. The Patient Assistance Fund provides assistance to hundreds of patients and their families each year by helping them with everyday needs such as lodging, meals, gas cards and transportation.

The fund provided Jennifer and Chuck with a place to stay and food cards during those long, difficult months in 2015 and 2016 when Dakota’s condition was the most fragile.  “The first summer we had nothing coming in,” says Jennifer. “I don’t know how we would have done it without the extra help. But being there for Dakota was so critical for his recovery. The first week in the ICU he was literally dying. If we had not been there, he would have lost hope.”

“Having their presence, comfort and that familiarity not only gave me hope, but optimism, strength and determination to keep fighting,” says Dakota.

“This fund can make or break it for some patients,” says Jasmine Silva, LCSW, licensed clinical social worker. “They literally wouldn’t be able to receive the care they need here if we weren’t able to use these funds to help them with some of the everyday needs of living. The Patient Assistance Fund is also another means that allows us to provide a whole person approach to care. It helps relieves the emotional stress that financial strains can have on a patient and family so they can focus on getting well.”

It’s exactly what the Case family needed. “To me this fund is just as important as the facilities here,” says Jennifer. “Because without it, many people wouldn’t be able to get the extraordinary care they need from the amazing doctors and nurses at Nebraska Medicine.”

Dakota has since gotten married and works at a hospital in Sioux Falls, South Dakota, as a cardiopulmonary patient care technician. “I like being a source of strength and comfort for others who are having similar health problems.”

This story was provided to the foundation curtesy of Nebraska Medicine.