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“If you have men who will exclude any of God’s creatures from the shelter of compassion and pity, you will have men who will deal likewise with their fellow men.” Francis of Assisi

janet-stoefens-greyhounds-2Janet Stoefen doesn’t stop providing health care when she leaves her role as nursing supervisor at Genesis Medical Center in Davenport.

Some days she is a nurse 24/7.

When she puts aside the nursing of humans for the day, she still has patients like Cryo, Pep Boy, Beau, Holler, Fat Sam and a cast of other four-legged characters waiting for her in her home in Davenport. At times, there are nearly enough dogs K-9 baseball team.

In 1999, the dog lover thought she was adopting a springer spaniel and Labrador retriever mix. The veterinarian informed her otherwise. The dog she had just taken in was a greyhound.

Sixteen years and dozens of greyhound rehabilitation projects later, Stoefen is well-known in greyhound racing for her impressive winning record with rehabilitation and placement of retired racers. Often using her nursing skills, she helps the dogs recover from injuries that ended their track careers and then works diligently to place them with loving owners.

“Being a nurse has been such an asset,’’ Stoefen said. “People call me and tell me about a dog that has a fracture. I change splints twice a week, and dressings, sometimes more often, increase their exercise gradually and get them ready to have a home again.’’

Nursing Continues at Home

Her house is lovingly filled with dog beds, cages, medications, bandages, food and treats and lots of blankets needed for the temporary care of the greyhounds. The greyhounds showed some of their athletic abilities on a recent day when they romped in the fenced back yard. Each has a different personality.

“They give a lot more to me than I’ve ever given to them,’’ said Stoefen, a 38-year veteran of nursing care. “When I’ve had a long, stressful day in my job, they are all here waiting for me to come home.

“Dog owners are healthier. They live longer. And we have so much fun doing this.’’

Stoefen’s first greyhound, the one she thought was going to be a lab and retriever mix, saw her through uterine cancer. “She was my best buddy,’’ Stoefen said. “She just had unconditional love for me. That was when I started wanting to give back to these animals.’’

Stoefen and Cinda German, a surgical nurse at Genesis Medical Center in Silvis, Illinois, are affiliated with Central Illinois Greyhound Adoption Association, a non-profit support group that moves greyhounds from tracks and breeders in Iowa, Florida, West Virginia and New York to adoption groups in the United States and Canada. Stoefen often takes in dogs with broken legs or other injuries. She nurses them back to health and readies them for adoption.

“The most common injuries are fractures of the left, back leg. That is the leg they plant on when they are racing,’’ she explained. “But some greyhounds we get are just retiring. Either they aren’t competitive any longer or they turn five years old, which is the mandatory retirement age for greyhounds from racing.’’

Stoefen, German and Robert Fischer, who helps out Stoefen, frequently pick up and deliver dogs throughout the Midwest. The road trips, Stoefen says, are an adventure with several dogs usually moved at the same time. Along the wayy, they’ve become experts on dog-friendly hotels.

Holler, one of Stoefen’s most recent acquisitions, needed vet care on the first day she had him. She has a network of Quad-Cities veterinarians who give her discounted care because of her frequent visits and the role she plays in the dogs’ lives.

Stoefen’s experience as both a nurse and patient have made her better with her dogs. “I just have a sense about them. I’ve been told I’m the dog whisperer. Someone will tell me a dog is a problem child. I look at them and talk to them and usually can figure them out. I think this is why I’m a 20-year survivor of uterine cancer. I’m meant to be here for these animals.’’

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The Schaedig family of Shell Rock (Teri Egts Photography)

Lindsey and Chris Schaedig of Shell Rock found out that they were expecting a child on July 5, 2015 and later that same month that it was fraternal twins.

“Our girls Whitney (age 6) and Brooklyn (age 2) were born at Waverly Health Center (WHC), so it was a natural choice to want our twins to be born there as well. I really liked the comfort of the spacious rooms and that all of the equipment for delivery was cleverly disguised in the birthing suite,” stated Lindsey. “It only took a couple minutes to transform the room for delivery.”

The Schaedig’s chose Dr. Stephen Styron, WHC Women’s Clinic, to deliver because of his 34 years in obstetrics and gynecology and his extensive experience with twins.

Week 19:
Baby A – 13 ounces
Baby B – 12 ounces

Starting at 19 weeks, Lindsey had ultrasounds each month at the University of Iowa Hospitals and Clinics, High-Risk Obstetrics Care Clinic in Waterloo. Measurements were taken each time to determine their size and position.

“I knew there was a chance they could be born early, possibly with health problems. If they were born early, I’d need to go to a hospital that had a neonatal intensive-care unit. The doctors at WHC did a good job of calming my concerns. They would remind me that all my medical tests were where they needed to be, and that I had already carried two healthy babies to term.”

WHC would be able to care for the twins as long as they made it to 36 weeks (mid-February). Once that date was reached, the plan would be to induce Lindsey or perform a Caesarean (c-section) in late February.

Week 32:
Baby A – 4 pounds, 11 ounces
Baby B – 4 pounds, 7 ounces

Starting her third trimester, Lindsey also had weekly ultrasounds and non-stress tests at the birthing center at WHC. “The babies were changing positions often. I didn’t think this was possible with how big I was getting, but they found room to flip and would kick the monitor off my belly!” she continued. “We found it amazing that you could actually see their hair in the later ultrasounds! The hair showed on the pictures as little white spikes, which we thought was very cool.”

“Two weeks before my due date, Baby A flipped to a breech position. I was a little scared as this meant I would need a C-section and I had never experienced that before.”

Week 37:
Baby A – 7 pounds, 9 ounces
Baby B – 7 pounds, 5 ounces
(margin of error of 1 pound)

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Blake and Carver Schaedig (Teri Egts Photography)

Lindsey had her last high-risk ultrasound on February 19 in Waterloo. One of the babies was still in the breech position. The doctor there told her that since the babies were a healthy size, she did not need to wait until 38 weeks (February 25) to deliver. On February 22, Lindsey received a phone call from Dr. Styron to let her know he had made arrangements to perform the c-section the next morning.

“Only our bosses knew that the day was moved up, so we were able to surprise our family and friends. I’m still amazed that I was able to work full-time through the entire pregnancy,” stated Lindsey.

Birth Data:
Carver Paul – 8 pounds, 2.9 ounces; 19.5 inches
Blake Christopher – 7 pounds, 6.2 ounces; 19.75 inches

“Dr. Styron was great and so sweet. After the birth, he came over and held my hand as he congratulated me on two healthy boys. I just kept squeezing his hand in relief that it went so well. I was surprised that they weighed more than the ultrasound predicted. I asked why they were so big and was told ‘they had good growing conditions.’”

“I have never delivered twins this size in 34 years of doing obstetrics,” stated Dr. Styron. “Lindsey was an ideal patient, despite it being a complicated pregnancy, the normal rapid growth of twins and being larger than a singleton pregnancy.”

“I truly appreciate all the birthing center staff that took such good care of us. Sharee, Jess, Amber and all of the nurses did a super job. They even let my kids help give the boys their first bath. My older kids had a bath night in the Jacuzzi in my room at the hospital.”

“The twins continue to grow into their own look and personalities,” Lindsey said last summer. “They like to be together and will cross arms or hold hands if they are next to each other. At four months old they weighed 15 and 14 pounds.”

The Schaedig’s are adjusting pretty well at home thanks to so many great family and friends. Whitney, Brooklyn and Owen (age 4, who the Schaedig’s adopted last year) were helping feed the twins, holding them and give lots of hugs and kisses. Nicole, (age 19 – whom the Schaedig’s fostered for nearly two years and consider their daughter), was off at college, but stopped by often to help out or take the older kids for an outing.

“We are working on potty-training Owen and Brooklyn so we currently have four kids in diapers or pull-ups,” Lindsey said “We go through about 30 per day.”

“We get asked a lot about how we handle five kids that are ages six and under. Our response is that we don’t think about it, we just do it. We have lived in a world full of chaos for many years, so the twins just blend right in. Having two newborns doesn’t seem to be as much work as it might sound like. We just do our best to take care of everyone so all needs are met at the end of the day. Most days go smoothly.”

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(From time to time, the blog features recipients of the IHA Iowa Hospital Heroes Award. These outstanding hospital employees come from across the state and work at hospitals of every size. They exemplify the courage, caring and community focus that are the hallmarks of the hospital mission in Iowa.)

berryinpatient600It’s not unusual for a doctor to be referred to as a “hero.” They save lives on a regular basis, sometimes in dramatic fashion in an emergency room, sometimes by way of monitoring chronic health conditions. Dr. Elaine Berry, a family medicine physician at the Atlantic Medical Center, is no exception. For those “routine” acts alone, Dr. Berry could easily be designated as a Hospital Hero.

But the only “routine” thing about Dr. Berry is her time in the primary care clinic where she sees patients four days a week. However, clinic time is just the tip of the iceberg in her far-reaching medical practice. She spends countless hours caring for her hospitalized patients, providing coverage in the emergency department and rounding with patients in long-term care facilities.

berrysmallDr. Berry is also quick to volunteer for leadership roles and committee work. She has actively participated in the selection and implementation of new electronic medical record systems. Dr. Berry has served as the medical director of home health care since 1990. She has served as the local hospice medical director for 26 years and in 2008 became the only physician in southwest Iowa to earn certification in hospice and palliative care.

Dr. Berry has mentored many young people interested in medicine. In 2009, she received the Volunteer Clinical Faculty Award by the Iowa Chapter of the Alpha Omega Alpha Honor Medical Society. She also makes time to be a community leader, serving as Cass County coroner since 1988 and as a member of the Cass County Emergency Preparedness Team. Dr. Berry has served as medical director for local emergency medical services for 20 years, has assisted local immigrant families in their transition to living in Iowa and has participated in four medical mission trips abroad.

Dr. Berry came to the Atlantic Medical Center (now a part of Cass County Health System) as a young physician fresh out of residency training. From the beginning, she has been unwavering in her pursuit of providing compassionate, safe, intelligent care to her patients while fulfilling so many roles within our health system and community. She truly is a hero among us.

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(This article was provided by Kaiser Health News.)

Throughout the campaign, President-Elect Donald Trump’s entire health message consisted of promising to repeal the Affordable Care Act.

That remains difficult with Democrats still commanding enough power in the Senate to block the 60 votes needed for a full repeal. Republicans could use fast-track budget authority to make some major changes to the law, although that could take some time. In the short term, however, Trump could use executive power to make some major changes on his own.

Beyond the health law, Trump also could push for some Republican perennials, such as giving states block grants to handle Medicaid, allowing insurers to sell across state lines and establishing a federal high-risk insurance pool for people who are ill and unable to get private insurance.

But those options, too, would likely meet Democratic resistance, and it’s unclear where health will land on what could be a jam-packed White House agenda.

Still, there are several health issues the next Congress and the new administration will be required to address in 2017, if only because some key laws are set to expire.

And those could provide a vehicle for other sorts of health changes that might not be able to clear political or procedural hurdles on their own.

Here are some of the major health issues that are certain to come up in 2017: 

The Affordable Care Act

If the GOP could not repeal the law and Trump were to turn to Congress to address some of the issues associated with it, it’s not clear if the executive and legislative branches could work together to respond to rising insurance premiums, declining insurance company participation or other unintended impacts of the health law. Nonetheless, some aspects of the law are unavoidable next year. For example, Congress in 2015 temporarily suspended or delayed three controversial taxes that were created to help pay for the law.

One of those taxes, a fee levied on health insurers, is suspended for 2017, while a 2.3 percent tax on medical devices was suspended for 2016 and 2017. Both industries lobbied heavily for the changes — arguing that the taxes boosted the prices of their products — and would like to permanently kill the taxes.

Also on hold is the most controversial health law tax of all, the so-called “Cadillac Tax” that levies a 40 percent penalty on very generous health insurance plans. The idea is to prevent consumers who pay little out of pocket because of their coverage from overusing health care services and driving up overall health costs.

The tax was technically put off from 2018 to 2020, but experts say pressure will begin to mount next year for reconsideration because employers will need a long lead time if they are to change benefits to avoid paying it. While economists are virtually unanimous in their support for the tax on high-end health plans, business and labor both strongly oppose it.

Children’s Health Insurance Program

The Children’s Health Insurance Program (CHIP), a federal-state partnership that Hillary Clinton helped set up in negotiations with Congress during her husband’s administration, is up again for renewal in 2017. CHIP covers more than 8 million children from low- and moderate-income households and has made a huge dent in the number of uninsured children. According to the Census Bureau, nearly 95 percent of children had insurance coverage in 2015.

When the federal health law passed in 2010, many policymakers thought CHIP would quietly go away because most of the families whose children are eligible for the program became eligible for tax credits to help them purchase plans for the entire family in the health law’s marketplaces. But it turned out that CHIP in most states remained more popular because it provided better benefits at lower costs than did plans through the ACA.

In 2015, Congress compromised between those arguing to extend CHIP and those who wanted to end it, by renewing it for only two years. That ends October 1, 2017. In practice, if Congress wants to extend CHIP, it needs to act early in 2017 because many states have fiscal years that begin in July and need lead time to plan their budgets.

Prescription Drug And Medical Device User Fees

Also expiring in 2017 is the authority for the Food and Drug Administration to collect “user fees” from makers of prescription drugs and medical devices.

The Prescription Drug User Fee Act, known as PDUFA (pronounced pah-doof-uh), was originally passed in 1990 in an effort to speed the review of new drug applications by enabling the agency to use the extra money to hire more personnel. The user fees were later expanded to speed the review of medical devices (2002), generic copies of brand-name drugs (2012) and generic biologic medicines (2012).

PDUFA gets reviewed and renewed every five years, and its “must-pass” status makes it a magnet for other changes to drug policy. For example, in 2012 the renewal also created a program aimed at addressing critical shortages of some prescription drugs. Earlier renewals also included separate programs that gave pharmaceutical firms incentives to study the effect of drugs in children.

Some policy-watchers think this year the bill could serve as a vehicle for provisions to help bring down drug prices, although it is not clear how well many of the ideas currently being floated would work.

“I think [Congress] will talk a lot about it and do very little,” said Robert Reischauer of the Urban Institute, who called the drug price issue “incredibly complex.”

Medicare’s Independent Payment Advisory Board

One more issue that might come up is a controversial cost-saving provision of the federal health law called the Independent Payment Advisory Board, or IPAB. The board is supposed to make recommendations for reducing Medicare spending if the program’s costs rise significantly faster than overall inflation. Congress can override those recommendations, but only with a two-thirds vote in each of the House and Senate.

So far the trigger hasn’t been reached. That’s lucky because the board has turned out to be so unpopular with both Democratic and Republican lawmakers, who say it will lead to rationing, that no one has even been appointed to serve.

The lack of an actual board, however, does not mean that nothing will happen if the requirement for Medicare savings is triggered. In that case, the responsibility for recommending savings will fall to the secretary of Health and Human Services. Medicare’s trustees predicted in their 2016 report that the targets will be exceeded for the first time in 2017.

That would likely touch off a furious round of legislating that could, in turn, lead to other Medicare changes.

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(The following is excerpted from the inaugural address provided at last week’s meeting of the IHA House of Delegates by Board Chair Michael Myers, CEO of Veterans Memorial Hospital in Waukon).

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Mike Myers addressing the IHA House of Delegates.

Why did I get into health care? To help people, to save their lives, but I quickly learned that it’s not about saving lives, it’s about enhancing them. Why do I stay in health care? It’s because of the lifelong learning that occurs each and every day in all of our institutions that keeps me staying in health care.

I would like to share with you a few examples of the lifelong learning and you may or may not think it has anything to do with health care, but I think it has everything to do with health care. As a new graduate hired in an emergency room, I went from being scared to being cocky. I envisioned myself wearing a t-shirt that said lifesaver, like the candy only better. Until one day I walked up to an oncologist who was admitting a patient in the emergency department and I said “I don’t know how you do it, all of your patients are dying,” and he calmly put down his pen and he looked up at me and he said, “Mike, we’re all dying, some just know it sooner than others.”

It was my first exposure to the true meaning of health care, not saving lives but enhancing them. I learned that sometimes when we make a difference in a person’s life we don’t always know it. We’re never told, but that person will tell others.

When I was on one of my last days at one of my early jobs, a nurse came in and she was in tears and I said, “What’s the matter?,” and she said, “I just had a patient’s family talk to me.” At that time my first thought was, “Oh good, somebody complained.” Instead she said to me, “You’ll never know what a difference you made to our father.” And it dawned on me: day in and day out miracles occur, acts of kindness and compassion, and we never hear whether or not it made a difference, you never hear how it impacted lives, but on that day she knew and it touched her deeply.

I learned the true meaning of leadership recently and it touched me deeply when I went back to an organization I haven’t had anything really to do with in over 20 years. And yet when I came back people that I used to work with and manage kept coming up to me and saying, “I remember when you told me this and you taught me that and I still do that today.” I learned about the power of our deeds and actions as a leader. It impacted me so greatly that on my drive home I took the long way home. I didn’t have the radio on, I drove along roads I’d never been on and I thought about what it meant to me as a person to have such a positive influence on people that I worked with and it happens every day.

And finally, the greatest lesson that I think anybody can learn and I first got exposed to it in health care is what true love means. I learned it at the bedside of a 16-year-old girl who was dying. After all of the family had come in and visited, I sat down and I held her hand and pretty soon I hear a squeak and the door opens. It was her father and he said, “I can’t leave her like this” and I said I understood.

But I really didn’t understand what he was feeling and going through until I got married, until I had kids and you understand that at any given moment you would sacrifice everything you owned or had to ensure the health of your wife and children. Sometimes that lesson gets tested. Say for example your wife is diagnosed with cancer and you see her in pain and in suffering and you walk off and you say to anybody who you think might be listening, “Hey, give it to me, if not for good, at least for an hour. Let her feel good, let her feel like she used to.” You’d do anything.

And just when you think nobody is listening, all of a sudden these people come into a room, they may be doctors or nurses or therapists and for a few moments in time, maybe a few hours, she does feel better and it reaffirms your belief and your lesson on enhancing lives.

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