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The Epidemic Within the Pandemic

June 29, 2020 by Derek Dillon

UNO Professor Examines Loneliness

In 2019, researchers and the media began sounding alarm bells about a “loneliness epidemic” — a rise in people reporting feelings of isolation that could become a health crisis, leading to increases in heart disease or even shorter life spans.

And that was before COVID-19. Before the world shut itself indoors and government leaders mandated, and pleaded, for everyone to stay at least 6 feet apart.

Isolation and social distancing are terms the world is all too familiar with now.

“I have, for years, been trying to come up with ways to make people more aware,” said Todd Richardson, Ph.D., an associate professor in the University of Nebraska at Omaha Goodrich Scholarship Program who is researching loneliness. “And then this comes around and does it for me.”

What researchers like Richardson have warned of — fraying social connections and the ways people arrange their lives to perpetuate isolation — rocketed to the world’s collective consciousness as COVID-19 spread rapidly across the globe. As cities, states and countries shut down, everyone felt the pain of isolation. People kept friends and family members at bay. They missed play dates, barbecues, birthday parties and graduation ceremonies. They missed the rush and roar of live music, the shared excitement of home runs and 3-pointers. They wondered if the “sea of red” would ever wash over Memorial Stadium in quite the same way.

And everyone felt those things, together.

“It’s ironic that the experience of loneliness unites us, but I think it can in this moment,” said Richardson. “We’re all under threat from something that doesn’t discriminate between human beings. This is an extra-human threat. So we can bond as humans and realize we’re working together in order to resist this. And I think there’s something really, really beautiful in that.”

But there’s a flip side to that potential beauty. The longer people stay apart, the harder it becomes to return to one another.

“There is a period where you acknowledge the loss in your life, and you lament it, and you try and fill it in whatever way you can,” Richardson said. “But the longer you’re away from other people, the less trust you have for other people, so the harder it gets to break out and to reach out. And at that point, loneliness starts feeding in on itself. It becomes a self-perpetuating kind of cycle.”

Richardson said social interaction influences people in ways they’re not even aware of. Seeing another person express emotions, such as joy and pain, sparks a mirror response in the brain.

“The mere fact of making eye contact with them, or being in the same physical space as them, connects us to them in important ways,” he said. “It makes us acknowledge them as people, as fellow humans, as entities worthy of respect and autonomy.”

Fundamentally, Richardson said, it teaches people empathy.

“The longer we retreat from one another,” he said, “the longer we don’t share that physical space, the less empathetic we get, and the less we care about other people.”

There is also risk in social interaction, and humans are inherently risk-averse, Richardson said. People may want to avoid not just the risk of disease, but the risk of shame, embarrassment or rejection that comes with putting themselves out there in the world. The longer people stay protected, the more comfortable they may become.

“I think that when this abates, we’re going to have a lot of work ahead of us reacclimating and coming to terms with the fact that we need one another,” he said, “and that is worth the risks that we take.”

High Stakes for the State’s Youngest Citizens

March 11, 2020 by Derek Dillon

Commission tackles one of most complex, pressing issues facing Nebraska

Sara Renken has never wanted to do anything else. She’s a third-grade teacher at Eagle Elementary School in Eagle, Nebraska. “I’ve always had a natural connection with kids,” she said. “I knew I made the right choice a few years into my career. It just felt right.”

Renken said she loves her job mostly because of the relationships she builds with kids and their families in this small village of about 1,000 people in Cass County.

Renken said teaching kids feels like a calling. But she also has challenging days and ongoing battles.

Not enough time and increasingly high expectations from federal and state governments are her No. 1 issues.

“You have little human beings that walk through your door,” she said. “They’re not just a number, they’re a person.

… We do so much more than just trying to get them to learn words, science, math. My job is to help them grow up, to help them be the best that they can be.”

Early childhood educators are crucial to young children’s learning and development. Yet, these teachers are the most likely to leave their professions.

Renken is one of the lucky ones. She teaches in a public school system and has never considered leaving her profession. Many early childhood educators, however, teach at private child care centers or preschools that don’t have the resources to pay staff sufficiently or provide benefits, such as health insurance or retirement savings. In fact, many early childhood teachers barely scrape by.

The median salary for child care workers in Nebraska was $22,870 in 2015, according to information shared by the Buffett Early Childhood Institute at the University of Nebraska. That’s half of the median salary for public school teachers and below the federal poverty line for a family of three.

Not surprisingly, there is high turnover within the field — up to 26 percent annually in licensed child care settings — and a critical shortage of quality educators. A 2016 Kids Count report said that roughly 84% of Nebraska counties with child care centers report being unable to meet demand.

Frequent teacher turnover and inconsistent care, especially in the early, formative years, can have devastating effects on children and the learning process. But for the past three years, the Nebraska Early Childhood Workforce Commission, which Renken serves on and was convened by the Buffett Institute, has been working to tackle the most complex and pressing challenges facing Nebraska today — expanding and strengthening the state’s early childhood workforce to meet children’s needs throughout the first eight years of life.

Susan Sarver, director of workforce planning and development at the Buffett Institute, said there are many factors that keep early childhood teachers from earning enough to stay in their positions. One is perception. Not that long ago, the role of child care providers was viewed as relatively passive, but now science has caught up to what many knew intuitively. Those early years are crucial in a child’s development.

According to information on the Buffett Institute’s website, nearly 90% of the brain’s growth happens during the first five years of a child’s life. More than 1 million new neural connections are formed every second. These are the connections that build brain architecture — the foundation upon which all later learning, behavior and health depend.

Children who do not receive high-quality education in their early years are far more likely to drop out of school later on, be placed in special education and not go to college — and even 70% more likely to be arrested for a violent crime. The stakes are high.

“We know now from science that birth through third grade is a unique developmental period,” said Sarver. “That infant or toddler teacher needs to be just as competent as a teacher for older students. Their needs are just different. We know better now, so we’re trying to be better.”

Another problem is cost. The younger the children, the more teachers are needed per student. At child care centers and private preschools, Sarver said those costs eat up as much as 80 percent of the budget.

“Home-based providers often say they would like to raise their rates, but they know they can’t,” she said. “Parents are stretched. They can’t pay any more. The cost of putting an infant in child care costs more than college tuition.”

Consistent standards for teacher training also present a challenge. “It’s kind of a historical artifact,” Sarver said. “They began as two different systems. K-12 has a very clear path. 0-5 started a little differently.” Unlike for teachers of older students, there are no set requirements for early childhood educators, and requiring advanced degrees across the board is not necessarily the answer.

Determining the best way forward is a monumental task. But the commission formed by the Buffett Institute brought together about 40 people from diverse backgrounds in the public and private sectors to tackle it.

“It’s the unusual suspects,” Sarver said. “The department of labor, the chamber of commerce … it’s a unique collaboration.”

All those groups, along with the departments of education and health and human services — two divisions that exist in silos in many states, hold pieces of the puzzle. The hope is the more they collaborate, the more the big picture will come into view. Sarver said people across the early childhood spectrum are committed to moving forward together. They’re invested, she said, and, importantly, they get along.

“Nebraska nice really comes through,” she said. “It’s a small enough group that we’re able to tackle the hardest questions.”

The commission published a report in late January that details the challenges Nebraska faces and makes recommendations on how to address them. Sarver said she expects the University of Nebraska system to play an important role as the state moves forward in implementing the commission’s recommendations, given the research, knowledge and competencies that are housed there and that are required to make the changes that are needed. Many others will also be involved, including state and local governments, the early childhood community, K-12 education, businesses and private philanthropy.

“This is not a unique problem,” Sarver said. “We see this everywhere. The advantage we have in Nebraska is there are a lot of really good things going on in the state. We want to build on those strengths.”

Renken said she hopes the commission can raise awareness and help people understand the value of her profession.

“When the public knows the need and the value for good, quality care for our young kids, that’s when we’re going to see change,” she said. “One voice can be heard. But a lot of voices can start to make a difference. We’re still growing — but we’re becoming a little more vocal, a little louder.”

The Buffett Early Childhood Institute was created in 2011 and emerged from the shared vision of the University of Nebraska leadership and Susie Buffett, a longtime philanthropist and champion of early childhood education and development. More information about the institute and the Nebraska Early Childhood Commission report can be found at earlyyearsmatter.org/workforce.

Dreams, Failures and Breakthroughs

October 9, 2019 by Derek Dillon

UNO students make advances in cancer research, discover their career passions along the way.

Jacob Robinson’s dream of being a major league pitcher didn’t pan out. Something better did: He teamed up with fellow University of Nebraska at Omaha biology graduate student Nik Stevenson and together, this past year, made a breakthrough in cancer research — one that could make a major impact in the lives of people around the world who are fighting a rare type of lymphoma. And along the way, the two say, they discovered passions that could make a major impact in their own lives and careers.

They credit the supportive culture at UNO.

“You can fail 10, 20, 100 times, and the faculty here will help you succeed. It’s an environment where you feel confident that even if you fail, you’re ultimately going to succeed, and that’s pretty important to help you flourish,” Stevenson says.

The cancer they’re studying is called splenic marginal zone lymphoma, or SMZL. It’s a type of white blood cell cancer that hasn’t been studied a lot because it’s so rare. SMZL cases have an overall survival prognosis after diagnosis of eight to 11 years, so it’s a rather slow-progressing cancer.

“People here, especially the science faculty, are so willing to help students that I really felt like my education here was great. Because I was willing to put in the effort, people were always willing to provide opportunities for me to go as far as I wanted to go."

Jacob Robinson

But anywhere from 10% to 15% of those cases progress to a much more aggressive form in which the overall survival prognosis drops to three to five years. Their research has shown promise in predicting how aggressive a person’s cancer will be based on specific genetic markers, a breakthrough that could lead to a way to more easily diagnose this cancer.

Stevenson did the “wet bench” side of their research — the hands-on work with the cancer cells themselves. Robinson did the big-data side, studying the genetic profiles of patients with SMZL and looking for patterns for this specific blood cancer vs. other similar lymphomas.

“It’s not a terribly lethal (cancer), unless it transforms,” Robinson says. “What my research did is, I found a grouping of markers that is pretty highly predictive for the basis of diagnosis for this SMZL patient.

“Instead of having to go through a bunch of different tests, ideally you would be able to just have this panel of genetic markers from a biopsy, and you’d say yes or no, this is the lymphoma that they’re afflicted with.”

If patients have the slow-growing type, they wouldn’t have their lives disrupted as much with frequent biopsies, along with the waiting around for results, which can be scary. It also would provide more accurate diagnosis and information on the outcome of the disease’s progression.

“It would allow them to pretty much have a better quality of life for the time being,” Stevenson says

The two conducted their research in Allwine Hall in the lab of Christine Cutucache, Ph.D., a rock star professor who holds the Dr. George Haddix Community Chair in Science at UNO. They call her “Dr. C.”

Dr. C, they say, gave amazing guidance and support (and coffee and doughnuts and a box overflowing with healthy snacks, which sits in the corner of the lab’s small conference room).

She served as the liaison between them and physicians and other medical professionals at the University of Nebraska Medical Center as they tried to determine the real-world usefulness of their research.

“It’s been sort of the perfect mix to have UNO as a home base but still be able to access a world-renowned med center right down the street,” Robinson says.

UNO, they say, helped them make major breakthroughs in their own lives, too.

Back in high school at Omaha North, Robinson says, he was mainly just interested in baseball, not school work. He struggled in chemistry. His dad connected him with a friend who was a retired UNO chemistry professor, James Wood, who became his tutor.

“He basically showed me how cool chemistry could be,” Robinson says.

That ignited his love for learning. (It also helped, Robinson says, smiling, that he fell in love with a great student his senior year — a young woman who is now his wife.)

At a UNO chemistry department awards night a few years back, Dr. Wood was given an envelope with a name inside. He was asked to open it and announce the chemistry student who’d be named the latest recipient of the James K. and Kathleen Wood Scholarship.

Dr. Wood didn’t know who it’d be.

It was Robinson, then a UNO junior.

Stevenson’s original dream for his career – to be a brain surgeon — also didn’t pan out.

He was a military brat, he says, born in Germany. He lived in Texas and South Dakota. He was only 8 years old and his family was living in Papillion, Nebraska, when his young mother was diagnosed with stage 4 breast cancer.

“It was everywhere when they first saw it,” he says. “It just socks you in the gut when you find out something like that.”

The cancer eventually spread to her brain, and she had brain surgery. Stevenson spent a lot of time in the hospital with her until she died when he was 12. He’d wanted to go to medical school, he says, but not getting in his first try made him reflect on that path, and he realized it wasn’t actually his main interest or career aim.

“That was a blessing in disguise because, through a little reflection, I realized I didn’t want to do that,” Stevenson says.

He met with Dr. C a year before applying to UNO and came to the university for his master’s degree because of the opportunity to join her lab.

Dr. C also runs a community outreach program called NE STEM 4U in which UNO students work to inspire middle school students in the community to consider careers in STEM fields down the road. (STEM is an acronym for science, technology, engineering and mathematics.)

Stevenson loves to coach soccer, too.

“Developing them as people, not just as athletes but just as people who can contribute to society, is a big thing I enjoy,” he says.

Dr. C noticed Stevenson’s strengths as a mentor and connected him to NE STEM 4U. He loved it.

He was its graduate adviser this past year and recently accepted a full-time job at UNO, where he will be doing science education research, continuing his role in the NE STEM 4U program and leading professional development opportunities for undergraduates and others.

“Developing people to excel in science so that one day they may pave the way for great development in the cancer research realm or in a plethora of other STEM fields,” Stevenson says, “is really my passion and my goal.”

He hopes to keep coaching soccer on the side.

This August, Robinson will start pharmacy school at the University of North Carolina-Chapel Hill.

Stevenson thinks he’ll stay in Nebraska.

“My fiancée is a farm girl from southeast Nebraska,” he says, “so I think we’re going to end up calling somewhere around Nebraska home.”

Stevenson smiles.

“Nebraska is pretty good.”

Quality of care is focus of new Nebraska Medicine, UNO collaboration

August 21, 2019 by Derek Dillon

University of Nebraska at Omaha (UNO) students who take advantage of on-campus health services this new academic year will benefit from streamlined access to the most comprehensive health network in the region.

Nebraska Medicine has assumed management of UNO Health Services in a new collaboration aimed at long-term enhancement of the quality of care available to UNO’s campus community. Nebraska Medicine is the primary clinical teaching partner for the University of Nebraska Medical Center (UNMC), which allows patients to benefit from one of the nation’s leaders in cutting-edge research and education. Nebraska Medicine also operates the University Health Center on the University of Nebraska-Lincoln campus.

“The time is right to make this exciting change,” says UNMC and UNO Chancellor Jeffrey P. Gold, MD. “The leaders at UNO, UNMC and Nebraska Medicine are dedicated to not only providing the best educational experience for students, but offering the highest-level quality of patient care.”

Nebraska Medicine – UNO Health Center remains in UNO’s Health and Kinesiology building and will continue its business hours of 8 a.m. to 4:30 p.m., Monday through Friday.

Apart from the new name, clinic staff says the most noticeable change will be the integration of an electronic patient health record system, which will allow patients to easily view medical records and request appointments. Patients will also experience increased ease of referral through the Nebraska Medicine health network.

“With more than 1,000 physicians, two hospitals and 40 specialty and primary clinics, we’re honored to bring the Nebraska Medicine-brand promise of ‘Serious Medicine. Extraordinary Care.’ to the UNO campus,” says Jill Lynch-Sosa, director of Student Health Operations. “Students and staff can have peace of mind, knowing we’re here to connect them with the services they need.”

Cathy Pettid, UNO assistant vice chancellor for student success and dean of students, says the change contributes to UNO’s ongoing efforts to support student wellness.

“We are fortunate to have access to the team at Nebraska Medicine, who not only bring tremendous expertise, but also an appreciation for higher education and a deep understanding of the specific needs of a campus environment,” Pettid says. “Our students’ health and well-being are very important to us and our students could not be in better hands.”

UNO’s Counseling and Psychological Services (CAPS) was not included in the Nebraska Medicine – UNO Health Services transition, and will remain a UNO-operated campus service.

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

Second chances: Telestroke Program offers critical expertise to small towns

August 13, 2019 by Derek Dillon

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.

New approach to heart failure helps patients regain quality of life

February 21, 2019 by Derek Dillon

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.

Patient Assistance Fund helps families stay together during treatment

January 3, 2019 by Derek Dillon

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.

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