Time Out For Moms

When she wasn’t walking her year-old son, Elliott around the room, Rebecca Courtot was sitting in a circle with other moms chatting about familiar topics. 

Sleep. Lack of Sleep. Teething. Crawling.

IU Health childbirth educator and pediatric nurse practitioner Cindy Love facilitates the weekly support groups – Toddler Time and Mother Connection. Topics vary for each group ranging from “Sibling Rivalry” to “Perinatal Moods.” And there is ample time for moms to talk, play, and ask questions.

“What is the right age for baby to begin crawling?”

“How do I calm him down when I’m trying to change his diaper?”

“He won’t go to sleep at night. What do I do?”

The moms come to learn and to find support. Courtot attended a recent west side meeting at its new location – the Avon-Washington Township Public Library. The groups also meet at IU Health North. 

“It’s nice to have something to look forward to every week and to meet other moms with children around the same age as Elliott,” said Courtot. “It’s also nice to learn things I didn’t know from a reliable source.”

Love who has been a nurse with IU Health for nearly 20 years says she bases her topics on guidelines from the American Academy of Pediatrics.

“I think right now, all new moms have questions. There is no book out there that gives them the ins and outs so the topics are important and more than anything these moms are getting support for what they are doing,” said Love.

In a recent Toddler session she offered practical advice on tantrums, sibling rivalry, sharing, and conflict resolution.

“One of the things about having a sibling is that it helps the older child learn empathy – to develop a relationship with their sibling,” Love said. 

And as she talked to new mother’s about self-care Love offered tips on coping with anxiety: Exercise, proper nutrition, sunshine, and adequate sleep.  She also reminded moms to ask for help when they need it.

“I want moms to feel comfortable and have confidence in the staff at IU Health that we are here to help them in their transition to motherhood.”

For a list of support groups, dates, times and locations log onto: https://iuhealth.org/find-medical-services/maternity.

— By T.J. Banes, Associate Senior Journalist at IU Health. Reach Banes via email at

 T.J. Banes or on Twitter @tjbanes.

Doctor Duo – Focus on Transplant

They grew up in Montreal, Canada met in high school and had what some might consider a few unusual first dates – reviewing histology slides and discussing the workings of the human body.

They both earned their medical degrees from McGill University Faculty of Medicine Hospital in Montreal, and have been married for more than 20 years.

Dr. Fridell is Chief of Abdominal Transplant Surgery and has been with IU Health since 2002. Dr. Schwartz is a hematologist who specializes in bone marrow and stem cell transplantation and has been with IU Health since 2003.  She is also the Assistant Dean for Medical Students Education Phase 2 at IU School of Medicine.

Dr. Schwartz said she’s known since Kindergarten that she wanted to be a doctor. “It was a fundamental calling. When I visited my family physician, I liked his caring and his warmth. I wanted my chance to help people and make them better. People ask if taking care of patients with blood cancers is difficult and I tell them it’s my honor to help patients as they progress through the ups and downs of treatment. Their strength inspires me every day.” Like his wife, Dr. Fridell also thrives on walking with his patients throughout their journey – before, during and after transplant.

“Right after transplant people are often very emotional. When they say ‘thank you’ I remind them they have an opportunity to write a letter to their donor family – that somewhere, someone has gone through something terrible and has given them a chance at a new life,” said Fridell.

Here is more from Drs. Schwartz and Fridell:

What do you like best about your fields?

Dr. Schwartz: I thought the blood was fascinating in medical school. When I was in high school my mom was diagnosed with breast cancer. She overcame it and then in my second year of medical school she was diagnosed with secondary leukemia. Due to her previous chemotherapy and despite many treatments, she died. The thing that I had found fascinating became the thing I wanted to fight.  It’s still so amazing to look at the immune system as a partner to help fight the disease. While my passion comes from having lost her to it what continues to draw me to it are the patients – they are amazing. I think I can empathize with the patients because I’ve sat on the other side of the desk when the news wasn’t so good. I’ve ridden that roller coaster so I think I can understand some of what my patients and their families are going through ”

Dr. Fridell: “I wanted to be a plastic surgeon. Everything I did in medical school was geared toward that. Then I was in my intern year of general surgery and we had a woman in ICU who had advanced cirrhosis and was dying of liver failure. We temporized using an ex-vivo pig liver (like dialysis) to bridge her to transplant and then she received a liver transplant from Toronto. I spent two years in the lab researching this event. It was a turning point for me to see what transplants could do. What I realize when I’m doing reconstructive surgery for the abdomen is that where most surgeries cut away and take out, we are putting in. Transplantation has the potential of being magic. I really enjoy being a doctor. I enjoy the challenges of medicine and one of the special things of transplant is you get to do difficult operations but you have to be at the top of your game because there are always medical challenges related to the necessary immunosuppression medication and the underlying comorbities. I consider this one of the most grateful patient populations.”

What does life look like at the Fridell/Schwartz home on a typical evening?

Dr. Schwartz: “We have two daughters ages 11 and 10. Probably like most families you have work, home and kids’ activities. It could be soccer or dance, and we just have to be strategic about when we need help. In the evenings we do homework and talk about our day. We’re really a typical family.”

Dr. Fridell: “Mornings are the usual hustle and bustle of most homes with kids. We always take the girls to school. That’s our thing. With transplant you don’t know when you’ll get called in but we try to plan as much as we can. We also love to travel. We just took the kids to New York for the first time.”

If your daughters decided to go into medicine, what would you say?

Dr. Schwartz:  “I would tell them to do what they love. We have one daughter who loves math. She saw the movie ‘Hidden Figures’ and she wants to work for NASA. The other one loves to dance and wants to be a teacher.”

Dr. Fridell: “There’s no doubt our daughters have been exposed to our careers. One of them was about four or five and talking about being dehydrated and using words like ‘trachea.’”

One of you is a Star Wars fan, correct?

Dr. Schwartz: “He is a collector. I’m not to that point but growing up as a kid I had action figures and I loved Star Wars.”

Dr. Fridell: “She likes Star Trek and James Bond more. I definitely like Star Wars more”.

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

HIV and Mental Health: “We Meet Them Where They Are.”

An evolution in holistic care – that’s how long-time staff members at LifeCare at IU Health Methodist Hospital see the attention given to clients with human immunodeficiency virus (HIV).

First it was care for just the patients but in the past 25 years that care has extended to family members – caregivers, spouses and domestic partners. The care has expanded from end-of-life care to a focus on testing and preventing the disease. The care for HIV patients and families has evolved from coping with a diagnosis to living life with a diagnosis.

Clients come to LifeCare from all walks of life – all genders, sexual orientations, and ethnicities. Today the program serves about 1,300 clients spanning the ages of 18 to 80, making it the largest HIV medical provider in the state. 

This month marks the 28th anniversary of the death of Ryan White – a young man who, at the age of 18, became the face of the disease that infects about 50,000 Americans a year. 

And as research and treatment evolves, LifeCare continues to expand its focus and outreach to clients. The program recently received a $1.1 million grant from the Indiana State Department of Health to allow for expanded behavioral health treatment, outpatient substance abuse treatment and medical case management.

“For 25 years we’ve been providing our clients with holistic care. Now we’re taking it to a new level, recognizing that behavioral health is primary health, and adding a psychiatrist to our program,” said Kyle Bonham, Ambulatory Manager of LifeCare. In the past, clients needing mental health services were referred to outside agencies. Now they will work with an in-house team that includes a newly contracted board certified adult psychiatrist Tracy Gunter, clinical social worker Linda Santoro, who has served as a case manger for LifeCare for 17 years, and pharmacist Jake Peters.

“We’re privileged to hear people talk about their lives,” said Santoro.  “When we work in collaboration with people and remain curious and open about how problems are affecting them, we also hear stories of possibility and change.”

Gunter, who is with IUHP Psychiatry and Behavioral Science, is also a board certified forensic psychiatrist. She first worked with HIV patients in the early 90s during an internship in her home state of South Carolina.

“One of the things that was happening at that point is people who had contracted HIV were coming home to die. When I learned of the opportunity to work with LifeCare, it was exciting because the disease that was a death sentence is now managed as a chronic disease. LifeCare patients are referred to mental health for various reasons ranging from addictions to anxiety and mood problems to crisis counseling.

“This clinic serves a lot of people who have had a lot of trauma. I’ve learned that you listen more than you talk and you stay willing to meet them where they are as opposed to demanding they meet you where you are,” said Gunter. “So far, clients have said, ‘I’m glad you are here.’ When they want to know what they should say or how they should come in I tell them ‘until you show up, until you trust us enough to see you good or bad, it will be hard to get started.’ Having the willingness to listen to the truth of their life experience goes a long way.”

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

A Heroic Tale: 100 Yards From The Boston Marathon Bombing

2:49 p.m. – April 15, 2013: Inside a medical tent just 100 yards from the finish line of the Boston Marathon, Michael Emery, M.D., stood with a nurse. They were tending to a runner, who was dehydrated and cramping.

Surrounding Dr. Emery, a sports cardiologist with IU Health, were physical therapists, physicians, massage therapists and nurses.  

“We hear this big boom. Twelve seconds later, another big boom.”

The nurse turned to Dr. Emery and asked, “Was that thunder?” There were few clouds in the sky, no threat of bad weather.  

“I knew those weren’t normal sounds you would hear. I knew something wasn’t right.”

Dr. Emery texted his wife, Amy: “I’m fine.” He didn’t know, really, whether he would be fine. He didn’t know what had happened.

“But I had suspicions something bad had happened.”

A voice came over the intercom telling the crew to stay in their stations. About that time, someone came into the tent from around the corner with a devastating message.

Those booms they had heard were bombs.

Dr. Emery didn’t know it at the time, but those two homemade bombs that detonated 210 yards apart near the finish line, would end up killing three people and injuring several hundred.

He also didn’t know that, within minutes, he would be called to risk his life to save others.

And Dr. Emery would answer that call – in a major way 

***

ALL PHYSICIANS TO THE FINISH LINE, the voice blared over the intercom.

“All of us took off like a bat out of hell running toward the finish line. And that’s when we started seeing the smoke and the chaos and started smelling it. 

But the first image of a person, the first victim that Dr. Emery saw, was a man – with his legs blown off, being lifted into a wheelchair. 

That man was Jeff Bauman. A photo of Bauman being wheeled down the streets of Boston, with a man in a cowboy hat pinching his femoral artery, went viral. A movie about Bauman starring Jake Gyllenhaal, called “Stronger,” was released in 2017. 

But Dr. Emery didn’t have much time to focus, at first, on what was happening outside. People might still be inside the building, someone yelled, people inside the Marathon Sports store located next to where the bombing occurred.

Dr. Emery ran inside. 

“It hit me when I went in. Should I be in the building?”

Dr. Emery searched and yelled out. No answers. He found no one inside the store and so he emerged.

“Back out on the street, it was pure chaos. It was a war zone, literally pools of blood in the sidewalks and streets, and I’m standing in them. 

He rushed through the crowd of physicians performing CPR on victims, stopping the bleeding and comforting. Dr. Emery made his way to a victim —  to help with an automated external defibrillator. 

“The ambulances were trying to load people up. They were trying to clear the scene pretty quickly. They were still worried about another bomb.”   

***

There were thousands of marathoners still running when the bombing occurred. They were diverted to a different route.

Once the finish line scene was cleared, Dr. Emery and other medical volunteers – including his friend, the co-medical director of the marathon who had invited him to be part of the race – wandered Boston. They wanted to make sure those runners weren’t in need of medical care.

It was 6 p.m. when Dr. Emery finally made it back to his hotel room.

“And it didn’t really hit me what had happened until I got to my hotel room and started seeing the TV. What the hell did I just experience?” 

Dr. Emery was hungry. It hit him all at once. There was nothing to eat in the hotel. He would have to venture out again.

“Literally, as soon as I closed my hotel door, I had a panic attack. I was in sheer panic mode. I went to Qdoba, got a burrito and was in pure anxiety mode the entire time until I got back.”

When the sun rose the next morning, and in the light of day, Dr. Emery’s panic subsided. He walked the streets of Boston and saw a more settled scene.

There were still armored cars and automatic rifles. The bombers had not been apprehended yet.

Dr. Emery stayed in Boston until Thursday, several days after the tragedy —  and then he left Boston behind. At least he tried.

***

Back at home in South Carolina, where Dr. Emery practiced at the time, he felt alone.

People would ask him if he was OK, but he wasn’t. It was traumatic. He hadn’t gotten to have closure, go to the memorials or get the psychological support other volunteers – still in Boston – had.

“I remember that October, it was Halloween and I was eating breakfast. And a story came on about another volunteer at the marathon that was an athletic trainer. And I just broke down in the middle of breakfast.”

Dr. Emery knew he needed to find a way to heal. He found that healing in a return trip to the Boston Marathon.

“I went back in 2014 because I needed to. And I took my family with me for the emotional support.”

He went to the site and saw the memorial. He got to have fun in the medical tent – to see what it was like to volunteer for the marathon without a tragedy.

And he went back again in 2015 and again in 2017.

“Even today, when I think about that day, it still gets me. It’s not something you ever get over. Or forget.” 

— By Dana Benbow, Senior Journalist at IU Health.
 Reach Benbow via email dbenbow@iuhealth.org or on Twitter @danabenbow.

Cheerleader Fell From Stunt, Now An EMT

Her petite frame was perfect for a basket toss, shoulder stand or the tiptop of a base stunt. Merideth Brooks had cheered on the sidelines of sporting events in elementary school and middle school. Her goal was to cheer throughout high school and on into college.

But those plans changed in seconds.

It was halftime of the Herron High School Achaeans basketball game Dec. 7, 2012. Brooks was 10-feet above the hardwood floor finishing a stunt when she fell, landing headfirst. The gym grew silent.

She lost consciousness and remembers waking up to emergency workers strapping her into a cervical collar and loading her onto a backboard. She remembers it was snowing outside. The rest is a blur.

“It’s a scary thing for a 13-year-old to hear they might be paralyzed. The EMT’s took good care of me,” said Brooks. She was rushed to IU Health Methodist Hospital where scans were conducted. It was determined there was no bleeding on her brain but she had suffered a concussion in the fall.

She was released into the care of her primary physician for ongoing testing every two weeks to determine the extent of the concussion. She failed the concussion test four times and the headaches that started early on began to intensify.

“I went from a normal busy teenager to barely being able to get out of bed. I couldn’t stand up without passing out,” said Brooks. “We went to every doctor – every specialist you can imagine – cardiologists, neurologists, psychologists – trying to find out what was wrong.” Her parents didn’t know it on that fateful December night but there would be more ambulance transports to ER in their daughter’s future.

It was those emergency transports that left her with such a powerful lasting impression of first responders. Now at the age of 19, she is in her final year studying for a degree in paramedic science and began working as a LifeLine EMT in December of 2016 – four years after her cheerleading accident.

“Working as an EMT has been the best thing that’s happened to me,” said Brooks. “For the longest time I didn’t even know if I’d graduate from high school. I didn’t even know if I’d get out of my wheelchair or live much of a life at all. To be on the other side is the greatest gift. I’m not a patient anymore I have patients of my own to care for.”

It wasn’t always like that.

In and out of Riley Hospital for Children, she missed school and continued to suffer extreme dizziness, headaches and nausea. At one point doctors thought her symptoms were psychological episodes triggered by a conversion disorder. Another time there was testing for allergies. After six months, the diagnosis emerged. Brooks has Postural Orthostatic Tachycarida Syndrome. Commonly known as POTS, the condition affects blood flow and is a form of orthostatic intolerance where symptoms develop when a person stands up from a reclining position. The primary symptoms are lightheadedness, fainting, and a rapid heart rate.

Many people develop POTS after an illness, serious infection or trauma such as a head injury.

For Brooks – the very sights and sounds that she now works with daily – bright lights and sirens – were triggers for her symptoms.

“A loud sound like a fire alarm can be perceived as a threat. My brain couldn’t connect the dots to tell me what was actually happening,” said Brooks. Before her diagnosis, she suffered seizures and spent a year in a wheelchair because her muscles were too weak for her to feel safe walking. Many times she spent a week’s time at Riley for symptoms resulting from a compromised immune system. 

It wasn’t until her senior year of high school that a strict medical regime helped treat the symptoms and retrain her brain.

“I spent so much time learning about medicine and the different parts of my disease that I really grew to like the emergency medicine side,” said Brooks. So the summer after her senior year she enrolled in an EMT class and began working at LifeLine after completing her certification.

Her experience and diagnosis has also led Brooks to public speaking and fundraising encouraging others to learn more about POTS and to raise awareness about concussions and traumatic brain injuries.

“When my accident happened we knew what a traumatic brain injury was, we just didn’t know what POTS was. I have learned so much,” said Brooks. “I say my story isn’t a sad story because of where I am today. It was unfortunate and I was unlucky but I’m so much more of a person now than I was six years ago – I see life in a completely different way and when I respond to an emergency where there is a head injury, I can relate. I know what it feels like to be strapped to a backboard, to wake up from a seizure, to be scared.” 

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