Methodist’s Kathy Hendershot: ‘I Could Never Have Left This Place’

The young woman was running an errand to the grocery store. Just a routine trip to grab bread and milk or maybe baby food or fruit.

She was hit doing that everyday errand, in a horrific accident, and she was brought to IU Health Methodist Hospital’s emergency department.

There in the department working that night nearly 30 years ago was a young bedside nurse named Kathy Hendershot.

This woman with the brain injury was the most severely injured patient Hendershot had ever seen.

“I remember thinking, ‘Oh my, she’s my age. She has children my age,’” Hendershot says. “And she was completely intubated. I kept thinking, ‘Oh my gosh. This poor woman. She was just trying to go to the store.’”

The neurosurgeon came down. He needed to get the patient upstairs immediately to evacuate the clot. The woman was whisked away.

Hendershot tried to move on to take care of other patients, tending to their needs. But that night in those wee hours, she couldn’t get that woman off her mind.

She was so concerned that at 4:30 a.m., Hendershot called up to the neuro unit to see if that woman had made it, to see if she was there.

She’ll never forget the nurse’s answer: You’re not going to believe this, Kathy. We extubated her and she’s sitting up talking.

“I just get chills thinking about it,” says Hendershot, 64, director of nursing operations at Methodist Hospital. “Just to see that happen? And you see that kind of thing happen all the time here.” 

For 30 years, Hendershot has watched those unbelievable things happen. She worked her way up from bedside nurse in the emergency department in 1987 to her role now, overseeing all of the emergency department and behavioral health, among plenty of other duties.

People have often asked Hendershot why she stayed all these years at Methodist. Why she never left to do something else, to try something different.

“I could never have left this place. It draws such wonderful people,” says Hendershot. “This is it for me. There was nothing else.”

***

The signs came very early – that Hendershot was a nurturer.

There was the nest of baby rats she found in the old barn in Franklin, Ind., where she was raised. They were orphan rats, really. The dad had killed their mom. Hendershot couldn’t stand it.

She put those rats in a shoebox and covered them up. She brought them into her room. She would nurse those tiny babies to health, at least she wanted to. Her mom discovered those rats, wasn’t fond of the idea of live-in rodents and had Hendershot promptly dispose of them.

It didn’t surprise anyone in the family. That’s how Hendershot had always been, since she was a tiny little girl. A caregiver, tending to the chickens, cats, dogs and the pony that lived at her country home. 

She didn’t stop at animals, though. Hendershot was the third oldest of seven children – the other six all boys. When she was 7 years old, her baby brother was born.

He was hers to take care of.

“I got to have this real live baby,” she says. “All the other kids had dolls. Not me. I had a bouncing baby boy that I would carry around, feed him and he was pretty. He was just the cutest.”

A year later, at 8 years old, Hendershot had settled on a career. She would be a nurse. It was the career her stay-at-home mom had always dreamed of for herself.

Her mom gave Hendershot a Florence Nightingale book. She read it over and over and over and over again, dreaming of one day being a nurse.

She still has that book. And her dream came true.

***

Hendershot headed off to Marian University in 1972, part of a new program with Indiana University School of Nursing. She spent two years at Marian and then was accepted to complete the other two years at IU in Indianapolis.

When she graduated, she landed a job as a night shift, post partum nurse at a hospital in Franklin. It was a small world. The nurse retiring, the one Hendershot would replace, had been her delivery room nurse when she was born.

Hendershot loved the hospital. She loved her years there – in the nursery, labor and delivery and then supervisor. It opened her eyes to a whole new world.

But then when she decided to scale back a bit and do supplemental work filling in where needed?

“I started working the ER,” Hendershot says. “There was a hole and that’s when it all started.”

When she fell head over heels for life in the ER.

***

As she picked up shifts in the ED, Hendershot worked alongside residents from Methodist – hired to cover nights at the little hospital in Franklin.

“They would tell me stories and I would just be mesmerized by all these stories about the big hospitals, the trauma centers,” Hendershot says. “I just wanted to learn more.”

And she wanted to learn it in the big city at a big-time hospital. She started working 12-hour shifts in the Methodist ED in June of 1987.

“I was just thrilled to death,” she says.

Every week, she would see something she had never seen before. She would think to herself that there was no way to top that. And then, the next week, something would top that.

“It was just such an amazing experience for me. And it was really hard work,” she says. “But I liked working hard. I loved working with the physicians, working with the residents.”

People quickly noticed Hendershot’s love for her work. She was good at her job, really good.

Within a year of coming to Methodist, Hendershot was asked to be a patient care manager. She accepted. And she kept climbing the ranks – manager then director and about two years ago, she took on the role she has now.

Hendershot has seen a lot in her more than 40 years of nursing. There were fewer women doctors when she started. Patients could smoke in their rooms. And medical procedures were done that are unheard of today.

She knows she’s been through a lot, after all, some of her residents are retiring.

But she is forging on.

“I’ve never wanted to be anyplace else,” Hendershot says. “This is the greatest job I’ve ever had.”

More with Kathy Hendershot

Personal: Hendershot lives in Bargersville and is married to Denny, a plumbing contractor. They have three grown sons, two granddaughters, three grandsons and another grandson on the way. 

Education: She graduated with a master of science in nursing degree in 1993, specializing in primary care.

Outside of Methodist: She calls herself a “real homebody.” She is an avid reader and loves to can and garden – carrots, beets, potatoes, tomatoes. She also enjoys camping and riding horses.

Advice to young nurses: “Don’t just look for the money. Look for what’s going to fit you. Be bold. Look around. You don’t have to do what’s traditional.”

— By Dana Benbow, Senior Journalist at IU Health.

   Reach Benbow via email dbenbow@iuhealth.org or on Twitter @danabenbow.

Got a Halloween Hangover? How to Bounce Back After a Sugar Binge

It’s that time of the year—the one where we get captivated by candy. And while we try our best not to derail your diets, each year, most of us have a moment (or more) where we cave, inhaling handfuls of candy corn or chocolate until we lose count.

Sound familiar? You’re not alone. Many people get a little wobbly on the diet wagon this time of year, explains Danica Crouse, registered dietitian at Indiana University Health. “The important thing to keep in mind is that tomorrow is a new day, with new and healthier decisions to make and that needs to be an important focus at times like this.”

Still, suffering from a ‘Halloween hangover’ aka sugar binge, isn’t fun. “Consuming large amounts of processed sugar, like those in Halloween candy, can make quite an impact on a person’s blood sugar,” Crouse explains, “it can cause some to feel jumpy or get the jitters, making their heart rate go up. Yes, you get a quick burst of energy, but then you inevitably crash into a sugar slump.”

Her advice: To avoid this kind of candy-induced rollercoaster, consider indulging in treats in a more mindful way. “Be more aware of what you plan to eat and then really enjoy the experience. So, sit down and think ‘I’m going to have 3 pieces of candy’ and then really savor each. Or spread your three treats throughout the day. This enables you to celebrate the holiday but not beat yourself up later,” she says.

What you don’t want to do: Give yourself a free pass to go crazy, Crouse says. “Some people put themselves on strict diet to ‘save up’ for holidays like Halloween but that isn’t healthy. Deprivation can be destructive. Instead, just practice good mindful eating habits.”

And what can we do to shake of the inevitable sugar slump we often feel after a binge? Get up and move, suggests Crouse. “Even if it’s just walking for 15 minutes. And drink water to keep yourself hydrated and fend off fatigue”

One last thing: According to Crouse, the day after Halloween can be just as dangerous to our diets. “It’s often when we all have leftover treats everywhere,” she says. Her advice: After your kids have had their fill, consider candy buy back or donation programs or just remove any extra treats from your environment if you’re feeling like you may not have the self-control.

“When it doubt, always toss it out,” Crouse says.

— By Sarah Burns

A Tough Man’s Story of Breast Cancer: ‘It Was Embarrassing’

Darrell Skaggs was in the military, drafted in the U.S. Army in 1970 during the Vietnam War. He spent three years of active duty in Germany.

He was gritty. Brave. Manly.

Skaggs went on to work in the security field. His job was to be a protector, to take down bad.

He was brawny. Macho. Stalwart.

“I always thought of myself as a tough guy,” says Skaggs, 66. “One of those manly guys.”

So what happened seven years ago was something Skaggs never in his life would have imagined.

He was at the emergency department of IU Health West Hospital having issues with his gall bladder. A CT scan was done. The doctor came into the room.

“Darrell, I don’t want to alarm you, but I found a mass in your left breast.”

Days later, after a mammogram, an ultrasound and then a biopsy of the mass that was about the size of a quarter, Skaggs got the results: Stage 2 breast cancer.

“This kind of thing didn’t happen to men,” Skaggs says. “Being told you have breast cancer, what in the world is that all about? It was embarrassing for me.” 

But then, Skaggs got to thinking. His diagnosis was so much bigger than a tough guy’s ego.

“You need to tell men,” says Skaggs, of Brownsburg, “because men are dying of this.”

And that’s when Skaggs decided to open up and not worry about anything other than helping others.

***

Each year, more than 252,000 women in the United States are diagnosed with breast cancer and more than 40,500 die. That gets a lot of attention, a lot of press.

For men, just 2,470 are diagnosed annually and 460 die. Very few men ever think about it happening to them.  

Breast cancer in men is usually detected as a hard lump underneath the nipple and areola. Men carry a higher mortality than women do, because they are less likely to assume it is breast cancer and seek treatment right away.

Skaggs, who was 59 at the time, never had any symptoms. He never felt a lump. He was lucky his gall bladder was giving him trouble or his breast cancer may never have been found.

And even after the mass was discovered, “I really didn’t think it was going to be anything,” Skaggs says.

He’ll never forget the day when he found out it was.

The call came while Skaggs was at work — from the doctor. It was breast cancer.

“I’m stunned,” says Skaggs, who is married to Wanda and has two grown sons and four grandchildren. “I’m like, ‘Whoa, this can’t be happening to me.” 

That was at noon. Skaggs ended up at home, but doesn’t remember how he got there. His mind was racing; everything was a blur. His wife didn’t get off work until 5 and he didn’t want to tell her over the phone.

So, Skaggs sat in his house alone. He sat there for hours. Wanda walked in and could see her husband was visibly upset.

“What’s wrong?” she asked him.

***

Of course, dying always enters the mind when a person hears the word cancer. Skaggs started researching for the best of the best.

He found Mary Kay Turner, M.D., a surgeon at IU Health. Within two days, he was in her office. On March 30, just 19 days after his diagnosis, Skaggs was having surgery at IU Health Methodist Hospital for breast cancer, gall bladder and a hernia.  

The next day, the news wasn’t good. More cancer had been found in the lymph nodes. On April 9, Skaggs had another surgery.

After four rounds of chemotherapy and plenty of ups and downs, Skaggs’ youngest son talked his dad into telling his story.

Since then, he has been the face of a male breast cancer survivor, part of national breast cancer awareness campaigns and a support system for other men.

When the American Cancer Society gets a call from a man diagnosed with breast cancer, Skaggs reaches out to be a support. He’s talked to men all over the United States, from California to Minnesota to Indianapolis.

“They just like to hear somebody’s voice, another man’s voice, who’s had breast cancer,” Skaggs says. “God got me through this and he put me in this position to be able to tell other men and support them.”

His biggest piece of advice to men is that if they feel any soreness or tenderness or anything unusual on their breasts, get it checked out.

“Men do get this,” Skaggs says. “They do get breast cancer.”

— By Dana Benbow, Senior Journalist at IU Health.

   Reach Benbow via email dbenbow@iuhealth.org or on Twitter @danabenbow.

Therapist Helps Heal Wounds

On a recent weekday, physical therapy students from the University of Indianapolis spent time with Laura Rinehart learning about her role in wound care management. The first-hand experience was important to Rinehart. It’s where she got her start in physical therapy. It’s where she got her start in wound care.

“When I was in high school I shadowed a physical therapist who worked in wound care. When I saw her cleaning a wound, I liked how she was able to practice those skills and work with the patient on mobility,” said Rinehart, who has worked in wound care at IU Health for nearly a decade.  She remembered when she was 10 and her little brother burned his hand on a grill and received wound care to help facilitate his full recovery. Later in life she saw how physical therapy helped her grandmother following multiple strokes.

“When students come here, they aren’t necessarily aware of the wound care aspect of physical therapy. It may be their first exposure and I want to make sure they understand the impact we have on patients,” said Rinehart, 37.

In the basement of Methodist Hospital in the outpatient wound clinic, Rinehart joins other physical therapists, a wound ostomy nurse practitioner, a medical assistant, and a case manager, in working with outpatients to provide a full assessment and plan for healing.

The team collaborates with physicians in various specialties to provide a cohesive plan of care for complex wounds like cellulitis, lymphedema compression-related edema, and deep tissue injuries. Treatments include exercise, compression wraps, wound drainage, and therapeutic technologies such as low-frequency ultrasound; high-voltage pulsed current and negative pressure wound therapy.

“Our work involves both pain management and healing,” said Rinehart. “We are truly involved with the patient from the point the wound opens to its closing. We also want to make sure there is no reoccurrence so education is a big part of our therapy. We want patients to properly care for themselves, and to understand why it is important to be compliant.”

Rinehart says the best part of her job is seeing immediate changes with wounds from the interventions that are practiced, and the impact it has on the patients returning to their daily routines.

“I like developing the relationship with patients, and part of me is in awe of people putting trust in me. I take that seriously. It makes me want to be a better therapist because I know they trust me.”

More about Rinehart:

  • She grew up in Princeton, Ind. the second of four children.
  • She loves to travel and has visited more than a dozen countries including Israel where she assisted with an athletic education course for physical therapists and coaches in Bethlehem.
  • She sings in her church choir and plays the violin (but not in public). She especially loves playing Christmas music.
  • She is currently a board member of the IU Alumni School of Health and Rehabilitation Sciences.

— By T.J. Banes, Associate Senior Journalist at IU Health.
   Reach Banes via email at
T.J. Banes or on Twitter @tjbanes.

Advancements in the fight against breast cancer

COMMENTARY by
Carla Fisher, MD, IU Health Physicians General Surgery – Simon Cancer Center

While a breast cancer diagnosis is a sobering experience for women and their families, advancements in early detection and treatment continue to provide hope for those affected by the disease. Breast Cancer Awareness Month offers an opportunity for healthcare providers to share the latest recommendations and treatment options.

Early detection is important. Mammography has been shown to save lives based on its ability to identify breast cancer at earlier stages when treatment is most effective. Today’s digital 3-D technology generates sharp images that improve accuracy and make it easier for radiologists to see small tumors, especially in women with dense breast tissue. While this technology may not be necessary for everyone, it’s important for women to know what type of mammogram they are receiving and if they may benefit from 3-D mammography.

Although breast cancer screening recommendations differ, it’s generally advised that women begin receiving yearly mammograms at age 40. Recommendations may differ based on risk, age and other factors, therefore women should talk with their primary care doctor to determine the optimal screening recommendations for them.

Developments in treatment offer new options. For women facing breast cancer, personalized medicine, precision health approaches and surgical advancements result in improved treatment options. Sophisticated testing on individual tumors has enabled many women to successfully treat their cancer without chemotherapy. Oncoplastic surgery, which combines cutting-edge plastic surgery techniques with breast surgical oncology, allows women to retain the natural appearance and shape of the breast, while achieving the same overall treatment outcomes.

Women diagnosed with breast cancer are encouraged to consult with physicians who specialize in the disease. Referrals from friends and family members are often helpful. Women facing breast cancer and other life-changing diseases also should not hesitate to get a second opinion. Most doctors understand the need for patients to be adequately informed and to feel comfortable with their decisions about how best to treat this disease. Finally, establishing a trust-based connection with a doctor is valuable during what is often a challenging and uncertain time.

Trouble sleeping? You could be a candidate for a sleep study.

Are you a candidate?

First, it’s important to distinguish the difference between simple snoring and OSA, which are sometimes mistakenly used interchangeably. Not all people who snore mildly (a vibration in the throat tissues) have OSA, a condition that blocks the airways, halting breathing for up to a minute or more. If you’ve been told that you snore loudly or have stopped breathing, this is serious and should be treated.

OSA is potentially life threatening, especially if you have one or more other health conditions, including heart disease, high blood pressure, stroke, diabetes, and obesity (check your BMI  at https://www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmicalc.htm).

Neurological disorders can also affect your ability to get a good night’s sleep or, worse, result in physical harm. Abnormal movements, such as acting out your dreams, or nocturnal seizures can cause injury to you and your partner. 

IU Health Sleep Disorders Centers start with a questionnaire to help determine if you’re a candidate for a sleep study. You can access it here. Again, if you believe you may have OSA, that alone is reason to be evaluated.

What to expect from the study.

The sleep study usually involves an overnight stay at one of our Sleep Disorders Centers. We have a very informative video about the procedure posted on our website http://iuhealth.org/sleep-disorders. Look for “What to Expect” in the right-hand column of the page.

Possible treatments for OSA.

We always start with the gold standard of treatment, positive airway pressure therapy (PAP), and the most common form we use is continuous positive airway pressure (CPAP). This device works by gently blowing room air through the airway, via a mask, at a pressure high enough to keep the throat open.

If a patient cannot get comfortable using the mask or has mild to moderate OSA, we can consider alternatives. One might be referring the patient to a dental specialist who can fit him or her with an oral appliance (much like a retainer) that opens up the back of the airway. Another alternative would be some form of surgical treatment performed by an ear, nose, and throat (ENT) surgeon.

The newest form of OSA treatment is a surgically implanted device called a hypoglossal nerve stimulator. It works by monitoring each breath you take while sleeping. Based on your unique breathing patterns, the system delivers mild stimulation to the hypoglossal nerve that controls the movement of your tongue and other key airway muscles. By stimulating these muscles, the airway remains open during sleep.

OSA is not the only condition our centers treat, but it can have serious cardiovascular consequences if left untreated. It’s also vital to treat any underlying condition, such as obesity. If you have any concerns about your sleep problems, please do not hesitate to contact me or one of our Sleep Disorders Centers.

Could IU Health Fitness Guru Be The Next J.K. Rowling?

The book is wonderful, amazing, splendid chaos.

Fantasy worlds come crashing together. Alice from Wonderland, Dorothy from Oz and Peter Pan from Neverland. Their lives collide in a place called Otherworld.

Hap is the main character of the book titled “The Empress of Otherworld,” a curious, husky, imperfect kid living with his 104-year-old quirky aunt.

He happens into Otherworld and the splendid chaos begins. The three super-powered kids Dorothy Gale, Peter Pan and Alice Liddell try to overthrow Prospera, the ruthless empress. Flying monkeys and flying moles wear combat hats battling in aerial combat.  

“We even drew in some Shakespeare,” says Bryland Sutton, co-author of the book and fitness coordinator for IU Health’s seven fitness centers. “We tried to draw in a lot of literature to make it encompass  the fantasy and magic that has been in books for hundreds of years.”

“The Empress of Otherworld” hits shelves on Halloween. And the book’s publisher is already talking sequel.

“New York Times” best-selling author Ben H. Winters calls the book “clever, whimsical, and confident, featuring delightfully off-kilter characters in smartly silly situations.”

Could this be the world’s next Harry Potter?

“Of course, we would love to be J.K. Rowling,” says Sutton, whose co-author is Corey Michael Dalton, a childhood friend and full-time writer and editor. “To be able to wake up each day and write would be amazing.”

Writing is what feeds his soul. Sutton’s passion is books. It all started more than three decades ago in a tiny Indiana town.

***

The two met in kindergarten at Jackson Township Elementary School in Brazil, Ind. They became fast friends. Both Sutton and Dalton loved to read and both loved English.  

Any time they could find to spend together, they did. They would finish their homework and then go off somewhere to take turns telling stories. By fourth grade, they were reading “The Lord of the Rings” and “The Hobbit.” 

But then in sixth grade, the two came up with a monstrous idea. They should write a book together and try to get it published.

Both smiled. They really liked that idea. They talked about it over the years. They smiled.  

But it wasn’t until years later that the idea came up again – seriously. Sutton and Dalton started hashing out the idea to bring together these fantasy worlds. In 2011, the writing began.

They would meet at Dalton’s house or at a little Italian restaurant. Dalton would write a few chapters then Sutton would take off from there writing a couple chapters. They would get together and tweak what the other had written.

In the end, they had a 224-page book, aimed at the middle grade reader, but already being snatched up by teenagers, young adults and beyond.  

The book is on pre-order sale now on Amazon. It’s available in the Kindle version as well. But Tuesday is the big day when two friends see a childhood dream come true.

“Getting published is kind of a big deal and a really big deal for us,” Sutton says. “It’s like winning the lottery.”

More With Bryland Sutton

Personal: He is married to wife, Kylee, and has two children, a 4-year-old son and a 2-year-old daughter. Kylee also works for IU Health.

What else have you written? “I’ve always written. I’ve had 12 or 15 children’s poems published in children’s magazines. I’ve always been interested, but you can’t really make a living publishing children’s poetry unless you are Shel Silverstein. I’ve just been publishing where I can and when I can.”

Is there fitness in the book? “I love fitness. It’s definitely a passion I have and helping other people achieve that. The only thing in the book that is fun about fitness is the little boy Hap is referred to as husky in the book. Corey and I can both relate to that. We were both kind of husky.”  

Why husky? “To have a character who is not perfect? To have a character who knows he is not perfect and have that self-doubt? We all come from a place like that.”

Could the book be made into a movie? “We wrote it with the lofty expectations that it could be a movie. I think it would be great as a movie.”

— By Dana Benbow, Senior Journalist at IU Health.

   Reach Benbow via email dbenbow@iuhealth.org or on Twitter @danabenbow.

When A Mammogram Isn’t Enough

She holds a law degree, a pharmacy degree and worked at one of the world’s leading pharmaceutical companies and yet Carrie Cagnassola, 53, says she felt: “Stupid.”

That dirty six-letter word is paired with another dirty six-letter word that tells the story of a woman who fought to protect other women. That word is “cancer.”

Prior to her cancer diagnosis, Cagnassola received all her care through another Indianapolis hospital.  In July of 2014, Cagnassola, then 50, went to get her annual mammogram. She had no family history, and for nearly a decade the screenings showed no signs of cancer. But there was a catch; Cagnassola is part of a large group of women with dense breast tissue.

“Starting in 2011, I was having 2D mammograms every 6 months, each time with a ‘second look.’  The radiologist told me they were watching an ‘area of thickness,’” said Cagnassola. “Dense breast tissue” was never mentioned. About 40 percent of women who receive mammograms have dense breast tissue, but few know what that means or what the next step is.

“I had such a false sense of security. They just said they were watching an area of thickness and I feel so stupid that I never asked, ‘what does that mean?’” said Cagnassola, who worked in Quality Biometrics/Statistics at Eli Lilly and Company

until her recent retirement. Three years ago, as she sat in the waiting room, like she had done so many times before, while the radiologist read her images, she began to think about that next step.

“Here I am a health professional and I never thought to advocate for myself.  For all I knew, they could be giving me cancer with these repeat screenings. I trusted that the mammogram was the way to detect cancer. I don’t want to scare people because mammograms are important, but if you have dense tissue, or if you are told something you don’t understand, you need to push for answers. Doctors aren’t perfect, mammography is subjective and some women need more than a mammogram to detect abnormalities, said Cagnassola, who is married to Greg Cagnassola, an attorney. Together they have four sons.

***

The youngest child in her family, Cagnassola’s father taught her early in life the importance of standing up for herself.

“My dad was a Marine in WWII and played football for the University of Michigan. He was a teddy bear but also a tough guy. He said ‘if you have a problem, deal with it.’”

He died June 29, 2014, and the Monday after his memorial, Cagnassola went for next six-month mammogram.  After another “second look” mammogram she talked to her radiologist about her results, and an ultrasound was finally ordered – showing a 2cm mass, which was later determined to be stage 3a breast cancer.

She began digging deeper and researching dense tissue. That’s when she met Dr. Nancy Cappello, Director and Founder of Are You Dense, Inc., an advocacy group that helps educate the public about the risks and screening challenges of dense breast tissue to prevent missed, delayed and advanced stage cancer.

The organization was launched after Dr. Cappello’s advanced-stage breast cancer diagnosis within weeks of a normal mammogram. It was at that time that her healthcare providers informed her that her cancer was masked by mammography for years because of her dense breast tissue.

“Dr. Nancy Cappello informed me that an attempt at a breast density reporting bill was passed in 2013 but it contained subjective language that dense breast tissue disclosure would be limited only to women who the physician deemed required further follow up and testing,” said Cagnassola. “I wanted to ensure that all women who had dense tissue were notified of their condition and the limitations of 2D mammography to detect cancer in women with dense breast tissue.”

***

Cagnassola’s in-laws were in Jacksonville, Fl. So Cagnassola and her husband sought a second opinion and traveled to Mayo Clinic where her surgeon and oncologist coordinated treatment with IU Health oncologist Dr. Jennifer Morgan.  Cagnassola’s August 2014 procedure involved a double mastectomy. Twenty-eight lymph nodes were removed, and the final pathology revealed the cancer had spread to seven lymph nodes, resulting in her stage 3a diagnosis.  She continued her care with Mayo Clinic and with IU Health, including chemotherapy, radiation, and reconstructive surgery.

“When the final pathology report came back, it showed my whole breast was a mess. They could not have removed that mess with a lumpectomy and they couldn’t have felt that mess with a normal breast exam. I had it for awhile and the only chance at detection was proper imaging.”

It was enough to spur Cagnassola into action.

In March 2016, Indiana became the 25th state to enact a mandatory breast density notification law. The law became effective July 1, 2016.  Cagnassola is credited as a patient with a driving force behind that law. Essentially, what that means is that all women who have dense breast tissue are notified of this condition, the risks, and the need for additional follow up and discussion with their healthcare providers. 

“I was bald as a cue ball when I met with Senators (Patricia) Miller and (David) Long. They really invested the time to listen and understand the importance of this law,” said Cagnassola. As an attorney, Cagnassola was also prepared, and brought paperwork to the table. She had requested and received all of her results from past mammograms.

“When I went back and looked at all my medical reports, the radiologists shared with the physician they all said ‘dense tissue ultrasound may be required.’ I was never told I had dense tissue and I was never offered an ultrasound until my cancer diagnosis.  Changing the law means every women will objectively receive that same information saying she has ‘dense breast tissue.’”

***

Cagnassola doesn’t see herself as a hero. In fact, she says she is disappointed she didn’t ask the tough questions sooner.

“I was every other woman. I did what every other woman did. I have a trust in the system. I’m in healthcare but I’m always a strong advocate – for my sons, for my parents. Hopefully, no other woman will go through what I went through, despite following the screening protocol for women at average-risk of breast cancer,” said Cagnassola, who adds that she feels great now and that her recent screenings were tumor markers were normal.

 “If anything, I still feel stupid that I had so many mammograms and didn’t act for three years. I wonder if I hadn’t said anything at all would I be diagnosed with Stage 4 cancer while sitting in an emergency room?”

— By T.J. Banes, Associate Senior Journalist at IU Health.
   Reach Banes via email at
 T.J. Banes or on Twitter @tjbanes.

Physical Therapist Handles Touchy Subject

Amy Medley has a touchy job. She talks about subjects that few people want to broach.

“I tell people I treat pee, poop and sexual dysfunctions,” said Medley, who has been with Methodist Hospital five years. Her patients range in age from 20-80 years old. “There’s not an average age because it’s so skewed in both directions – it kind of depends on the diagnosis,” she said.

Typically, her patients come to her with issues that range from pain during sexual intercourse to bladder leakage, and are referred to her by urologists, colorectal and gastrointestinal surgeons, and obstetrician/gynecologists. 

“By the time they come to physical therapy they have ruled out things that omit surgery. Most of the time it comes down to a muscular function that controls the bowel or bladder. It’s not something related to a spinal cord injury or neurology. So therapy and muscle exercises are needed,” said Medley, who turns 34 next month.

The American Physical Therapy Association chose October as the month to celebrate the impact of physical therapists and physical therapist assistants. And Medley is on board when it comes to talking about issues that may not be in the forefront of the profession.

The area of pelvic floor dysfunction is not new, but talking about it openly and seeking physical therapy is relatively new, said Medley.

The pelvic floor is a group of muscles in the pelvic area that support the organs in the pelvis – including the bladder, uterus (women), prostate (men), and rectum. By contracting and relaxing these muscles, individuals control bowel and bladder movements. Pelvic floor dysfunction occurs when individuals are unable to control the muscles in the pelvic floor. Symptoms may include feeling the need to have several bowel movements during a short period of time, or inability to complete a bowel movement, constipation, frequent need to urinate, painful urination, lower back pain, ongoing pain in the pelvic region genitals or rectum, or, for women, pain during intercourse.

Symptoms are often talked about with products that help patients mask the dysfunction but not how to treat it. That’s one of the reasons Medley is open about her work and passionate about the therapy.

“My fear is there are products that say it’s ok to leak, but it’s not ok. We can do something about it. Thankfully it’s being talked about in a way that normalizes it,” said Medley, who obtained an undergraduate degree in business and uses that background to promote physical therapy. “People are talking about it more. I’ve spent a lot of time educating healthcare providers and making them aware that there are ways to treat this.”

When she speaks publicly, Medley is open and honest. She includes in her presentation a clip from the 1995 movie, “Billy Madison” where Adam Sandler declares: “You ain’t cool unless you pee your pants.”

She uses the same candid approach with patients: “I tell them, it’s not OK to pee your pants. We can help you. It’s about communicating openly. Sometimes we use our sense of humor but the main thing is they should know we are talking about professional topics and it might be uncomfortable, but they shouldn’t be embarrassed.”

In treatment, Melody, the mother of two children – ages 9 and 4 – incorporates props – soft plush toys shaped like organs, and a model of a plastic uterus – when explaining symptoms and therapy.

“The treatment is individualized because there’s not a cookie-cutter plan for everyone whether we are treating the shoulder or another body part,” said Melody. “It’s also based on their goals. If they want to bend over and pick up their grandkids without leaking, then we work toward that.

“I try to make it as functional as possible because I want it to be something they’ll stick with,” said Melody. “It may be as simple as an exercise they can do while brushing their teeth or climbing the stairs. The goal is to empower them to go home and work on caring for themselves.”

— By T.J. Banes, Associate Senior Journalist at IU Health.
   Reach Banes via email at
 T.J. Banes or on Twitter @tjbanes.

A Business Trip, A Flight Home, A Liver Transplant Months Later

He woke up in the hotel room, in the middle of the night. The room was spinning. Beds and desks and night tables were whirling in front of him.

The dizziness was so intense that as Derrick Feldmann got up to walk, he crashed into the wall.

Something’s not right at all, Feldmann thought to himself that February night.

Something definitely wasn’t right. Feldmann, a young and successful businessman, was bleeding internally.

But he didn’t know it then.

He flew home alone, from Australia to Indianapolis, intensely sick. His wife, Bis, rushed him to the hospital.                         

“And my liver,” Feldmann, 38, says. “It had progressed a little bit further than what they had anticipated.”

Not a little bit further. Feldmann’s liver was failing. Within days, he was on a wait list for a liver transplant.

He needed that new organ to save his life.

***

To call Feldmann a high-achieving go-getter is about right — and then some. He is a businessman with a work ethic and a mission to do good in the world.

Feldmann is the president of Achieve, a research and marketing agency for causes. He is also the author of two books and is an international speaker. That’s why he was in Australia in February.  

But his health journey started long before that dizzy night in a hotel room. It started 12 years before.

Feldmann was a healthy 26-year-old starting a company. As part of that process, he needed to get a health screening for insurance. He was sure he would whiz right through that screening, but he didn’t. He failed the liver portion. Surely, it was a fluke. 

He took it again and he failed it. He took it again. He failed it.

There might be something else going on. You should go get this checked out, he was told. Feldmann couldn’t believe it.

“Growing up, I was the healthiest guy ever,” says Feldmann, the father of two girls. “This was the first time in my life I ever had any health issue.”

The health issue, he soon found out, was primary sclerosing cholangitis. It was a chronic liver disease, an autoimmune disease. His bile ducts would close off and become inflamed.

“There is no cause,” Feldmann says. “It just happens.”

And for many people, it’s a disease they can live the rest of their lives with.

So, for the next 12 years after his diagnosis of PSC, Feldmann went on. He had stints put in his bile ducts. He had things cleaned out to make sure everything was flowing correctly.

But, as he soon found out, those were just stopgap measures. He wouldn’t be able to go on like this forever.

***

What happened that night in the hotel alarmed Feldmann. Although, deep down, he wasn’t all that surprised.

“I knew I was struggling,” he says. “But I said, ‘I can get through this.’ And I just kept going.”  

He was down to 150 pounds at 6-1. His skin was turning yellow. He headed to see a specialist at IU Health University Hospital.

Marco Lacerda, M.D., who specializes in gastroenterology and hepatology, told Feldmann he should get listed for a transplant. The disease was progressing. 

Feldmann went through the process to get listed. And then — he prepared to wait.

It was a Friday around noon when the call came. Feldmann was at home making lunch, ready to go on a business trip to Chicago.

His phone rang, from an unknown number. He didn’t answer. Bis was playing tennis. She couldn’t answer. Then, Feldmann’s sister-in-law called him.

“I got the call for you,” she told him. “You need to pick up the phone. They are going to call you back.”

There was a liver for Feldmann. He says he wasn’t scared. He was ready; he needed to do this. The next day, July 1, Feldmann received a new liver at IU Health.

When he woke up in the hospital, he couldn’t believe it. Over time, he had started feeling poorly, but didn’t really notice. It was his new normal. He slept a lot.

“Dr. Lacerda and the transplant team at IU, they said, ‘You won’t realize how good you will actually feel after this,’” Feldmann says. “And then I remember the day that I woke up, I thought, ‘Wow, I feel great.’”

Nearly four months post transplant, it’s tough to believe Feldmann was ever sick. As he sits in his downtown Indianapolis office, he is the picture of health.

Sometimes, it’s hard for Feldmann himself to believe where he was just a few months ago.

“I feel amazing,” he says. “Pretty amazing.”

— By Dana Benbow, Senior Journalist at IU Health.

   Reach Benbow via email dbenbow@iuhealth.org or on Twitter @danabenbow.