Daughter, 13: These holding hands honor her mother

On what was one of the most difficult days of Skeeter “Dee” Durnil’s life, a team of caregivers embraced her family and honored her final wishes.

By T.J. Banes, IU Health senior journalist, tfender1@iuhealth.org

It’s been said that a mother holds her child’s hands for a while, but her heart forever. For Kaylee Durnil, 13, that image of her mother holding her hand lives on – even after her mother’s passing.

It was the end of August and Skeeter “Dee” Durnil was closing in on 50 days spent at IU Heath University Hospital. She was not recovering from a diagnosis of nonalcoholic steatohepatitis (NASH). She was being cared for in ICU for severe liver damage.

“She got very close to all the staff – the nurses and even the food service folks,” said her son Chris Durnil. So it was no surprise that when Dee made a final wish to go outside, her caregivers leaped into action.

“I took care of her every night for a month. When she said she wanted to go outside, I thought it might lift her spirits. I had seen her angry; I’d seen her scared and when she went outside, for one of the first times I saw her content. She was holding her daughter’s hand and smiling,” said Lisa Dunnivant, an ICU nurse. During Dee’s stay at University Hospital, Dunnivant watched Hallmark movies with her and listened while Dee talked about her family including sons Chris Durnil, 35, Jacob Durnil, 22, and daughters Caitlin Durnil, 26, and the youngest, Kaylee Durnil, 13.

Dunnivant had clocked out for the day when she got the call that Dee wanted to go outside. She returned to the unit and joined the family as they gathered around her hospital bed in a little outdoor enclosure.

“I love them so much. They’re like family to me,” said Dunnivant. “I’d do it all again in a heartbeat.”

That wasn’t the only thing that happened on that final day. As Dee held her youngest daughter’s hand for what would be one of the last times, IU Health Art Therapist Lisa Rainey offered to make a mold of the two hands.

“I work with many patients and families who are faced with a terminal illness and I want to be able to help those patients cope through the dying process. Often times I’ve worked with the patient for months before their disease progresses to a point where comfort measures and maximizing quality of life replace those treatments that were once curative. I pride myself on the individual relationships that are built with each patient,” said Rainey, who works with IU Health Simon Cancer Center’s CompleteLife Program. “Art therapy is a largely non-verbal form of psychotherapy and counseling; however patients are always invited to share their hopes, desires, and life stories. I’m honored to get to know each and every one of my patients. I make sure they know that I am never in a rush, am 100% present, and truly interested in learning their life story,” said Rainey.

On this day, the timing was critical.

A social worker contacted Rainey and CompleteLife Program & Cancer Resource Center Coordinator Lindsay Syswerda in the morning with the news that Dee was transitioning to comfort care. If there would be a hand mold made it needed to be immediately.

“When we arrived to do the hand mold, Dee was sitting up, smiling, and talking with her family members. I had not seen her that awake, alert and engaged in quite some time,” said Rainey. Close by was Dee’s youngest daughter, holding back tears knowing that her mother’s life was coming to an end.

“Mother and daughter locked hands and then placed them in the casting alginate. They held hands for about five minutes while the alginate cured, and created the impression that I would pour plaster into to create the final piece of artwork,” said Rainey, who lost her mother when she was ten.

“I wish that I had a cast of her hand to touch and hold when I think of her or want to communicate with her. I’m so happy to be able to provide this creative intervention to those terminal patients who have young children,” said Rainey.

Dee passed that evening and the mold was displayed at her funeral as a reminder of her love for her children. The reminder lives on for her youngest daughter, Kaylee Durmil.

The teen, a student at St. Thomas Aquinas School, likes social studies, language arts and robotics. She hopes to one day become a criminal psychologist for a Behavioral Analysis Unit of the FBI. Her mom was a big influence on that decision – they spent hours watching crime shows together and trying to predict the plots.

Now the hand she once held for more than a decade is a forever memory – a symbol of her mother’s love that will remain in her heart forever.

“It sits on my desk in my room,” said Kaylee. “Seeing it every day reminds me of the Sally Hanson red nail polish my mom wore on that day.”

School nurse – A one-person clinic that cares for kids

On any given day, Tiffany Lindsay never knows who will walk through her door – an eight-year-old with asthma, or a seven-year-old who lost a tooth. It keeps her on her toes.

By T.J. Banes, IU Health Senior Journalist, tjbanes@iuhealth.org.

She’s a mom, she studied child development in college, and she later became a nurse working in adult trauma care.

Those qualifiers alone could put Tiffany Linsday at the head of the class as a school nurse. But she’s learned over time there are no two patients alike – especially in a school that represents 17 different countries, 12 different languages, and a large population of students who receive free and reduced lunches.

On any given day she can see as many as 150 students. Their needs include diabetic blood checks, asthma treatments, and first aid for scrapes and cuts.

Lindsay began working for IU Health in 2006 as a unit secretary. After high school she attended Purdue University studying child development but eventually felt it wasn’t her calling. At IU Health her co-workers encouraged her to go back to school for her nursing degree. She completed her degree in 2017 and began working at IU Health Methodist Hospital with adult trauma critical care patients.

A back injury lead to on-the-job restrictions and when she could no longer lift patients, she began searching for alternate paths to pursue a career she loves. Married to Nathan Lindsay for 20 years, the couple has three children attending Washington Township Schools – Adeline, a junior and Gavin a freshman at North Central High School and Garrett a first-grader at Allisonville Elementary.

IU Health provides 12 nurses throughout Washington Township Schools – including eight elementary schools, a developmental preschool and three middle schools.

Lindsay works at Fox Hill Elementary in an office that displays a poster of a hand-drawn roll of Lifesavers and several colorful candies. The sign reads: “Mrs. Lindsay, thank you for taking such good care of us. You’re a lifesaver.” The rest of her office is decorated in bright colors – encouraging students to eat a rainbow of colors. She changes the theme throughout the year to drive home other messages: Heart health, appropriate sleep and summer safety.

On any given day, her office is a flurry of activity. She answers the phone “Good Morning, Fox Hill clinic,” and proceeds to answer parent questions. One student comes in with a tooth that has just fallen out. Lindsay helps her wash up and then places the tooth in a necklace, puts the necklace around the little girl’s neck and sends her on her way. There are other students who come in regularly for blood sugar checks and asthma treatments. A teacher comes in to have a burn bandaged.

To keep track of the youngsters in her care, Lindsay keeps a notebook and also records activity electronically. At the end of last year, the notebook was so full she couldn’t close it.

“It’s just like nursing at a hospital – you triage with ABC – airway, breathing and circulation,” said Lindsay, who also spends a lot of time talking with parents and helping educate them when a child has a chronic condition such as asthma or diabetes. With 100 fewer students in the school this year, she’s not as busy as the previous year but there is limited downtime.

“We want the kids to be successful. When you get medicine from the drugstore they don’t give it to you in Burmese or Swahili. We have a very diverse student population here so I spend a lot of time working with parents and helping them understand their child’s ongoing cough is not just a cough, it’s symptoms of asthma,” said Lindsay. All the school nurses work closely with IU Health’s Rebecca West, the district manager to help connect families with additional resources. “If I have ten kids I’m worried about, she knows all ten kids,” said Lindsay. If the family needs to see a specialist such a pulmonologist, the nurses help connect them and refer them to IU Health physicians.

The nurses meet twice yearly to talk about primary concerns such as allergies. Many students have never been exposed to certain foods and parents aren’t familiar with allergies. The nurses often become the first line of contact.

“I’ve had parents bring younger siblings in. We joke that it’s like urgent care. Parents have me look at something on them because they have nowhere else to go. As a nurse you get asked a lot of questions,” said Lindsay. She takes it all in stride and manages her day with a cadence filled with smiles and words of encouragement.

Fox Hill Elementary serves children in Kindergarten through Fifth Grade. Lindsay’s goal is to help the older students – with chronic conditions – learn to manage their treatments. Last year she had 60 scheduled medicines and treatments a day – every one of them organized in a secure file cabinet. The same cabinet houses a red medic bag that she grabs every time there is a fire drill or emergency. She is ready for whatever comes her way.

Each Friday she gives out prizes to the students who have ongoing medications. They are rewarded for their compliance at a time in their lives that they’d rather be playing with friends and ignoring treatments.

“It’s not always fun being called out of class for meds. I have students with diabetes who have to miss gym if their sugar levels are too high and I have students with asthma who can’t go outside if the temperature is above 80 or below 40. That’s a lot of time they spend in my office,” said Lindsay. To help them pass the time she provides books and drawing materials and sometimes employs their help making ice packs. Her prize box is filled with stuffed animals, pencils, books and bracelets.

When a little girl fell and broke her arm last year, it was one of those stuffed animals that helped soothe her until her parent arrived at school.

Lindsay has also used the prizes to motivate students with difficult health issues. Last year she helped nurse a young student who was born prematurely and was underweight. He just wasn’t eating and his mom often called or sent text messages to Lindsay seeking advice.

“My goal was to encourage him to eat and by the end of the year he was eating chicken nuggets and pizza. He’d gained eight pounds,” said Lindsay. She works closely with teachers and the school social worker in situations where student conditions are more than just a scrape from a playground fall. She even keeps a box of clothes for when a child needs a quick change.

“That mom instinct comes out a lot. When I have a student coming in frequently with an upset stomach, I start asking questions about a break up with a boyfriend or what’s going on at home,” said Lindsay. When a student complains of heartburn she asks what he ate on his way to school. All students receive free breakfasts at Fox Hill but there are always backpack snacks that they grab from home.

“A big one is those hot Cheetos and corn chips. When they eat those we might Google heartburn and then have a full conversation about healthy snack choices,” said Lindsay. “We look at the lunch menu together and I help guide them to make the best choices.”

In addition to the daily care of the students, Lindsay arranges vision screenings with the Lions Club for third- and fifth-graders and any other student recommended by staff members. She also coordinates a visit by a mobile dentist, Big Smiles.

“We have so many who need these services. Last year we had them once, this year my goal is every six months,” said Lindsay. The dental care includes cleanings and she is working to also get fillings for the students. “Last year we had kids referred for root canals. Can you imagine sitting in class and trying to learn and being in so much pain and then trying to eat a healthy lunch of carrot sticks and still feeling the pain,” said Lindsay.

She sees her role as not only a caregiver, but also a nurturer. Like the teachers in her building, Lindsay doesn’t clock out when the buses leave for the day.

“I absolutely love this job and connecting to the kids. I am here to help them learn by managing their physical health – that impacts so many areas of their lives,” said Lindsay. “Last year we had 800 students and I could call 700 of them by their name. Either I had seen them in the clinic or I knew their face. They all mean the world to me.”

Photos by Mike Dickbernd, IU Health visual journalist, mdickbernd@iuhealth.org

Sepsis escape room simulation underscores the risks of a “silent killer”

Methodist emergency department staff get a refresher course in identifying and treating a deadly infection.

By Maureen Gilmer, IU Health senior journalist, mgilmer1@iuhealth.org

The patient wasn’t real, but the scenario playing out in IU Health Methodist Hospital’s emergency department last week was all too realistic.

A team of nurses and doctors gathered around a “patient” who was disoriented, feverish and in pain. With little patient history information to go on, they worked together to quickly recognize the signs of sepsis, “a silent killer,” and treat the patient with fluids and antibiotics.

Every year across the United States, more than a quarter-million people die in hospitals as a result of sepsis, defined as a medical emergency caused by the body’s overwhelming response to infection, which can lead to tissue damage, organ failure, amputations and death.

Last year, more than 3,500 Hoosiers died in hospitals from sepsis, according to Indiana Hospital Association data.

As part of Sepsis Awareness Month, teams of nurses and physicians came together in an escape room-type simulation at Methodist to treat a patient who displayed signs of sepsis.

Symptoms include fever, difficulty breathing, low blood pressure, fast heart rate and mental confusion. It can be hard to diagnose because it shares many symptoms with other conditions, but fast treatment often is the difference between life and death.

In this case, the patient was a mannequin brought over from the Sim Center in Fairbanks Hall. As Dane Rogers controlled the mannequin’s voice, Methodist emergency physician Dr. Steven Wipprecht relayed critical information to visiting med student Elizabeth Ogunsanya and nurses taking part in the drill.

In just over 6 minutes, the team had identified and begun treatment for the life-threatening infection. The risk of death from sepsis increases by as much as 8% for every hour that treatment is delayed.

Dr. Wipprecht, who organized the drill and conducted the training outside his regular shift in the emergency department, said his passion is for resident and med student education.

“This is a new cutting-edge way to educate our folks in the department while still getting to do so in a collaborative environment with nursing.”

Stressing the need for active, close-looped communication among doctors and nurses, he said most patient complaints and errors come from missed opportunities for communication. And often, he said, it is nurses who save the day.

Still, three out of 10 people diagnosed with sepsis die. That’s why it is critically important that staff always be alert to the signs of sepsis. Delaying diagnosis and treatment by even 15 minutes can affect mortality.

“Some of our patients are here for weeks, which is why it’s important we do this education on the floors, in the ICUs, because the earlier we get antibiotics in, the mortality rate decreases,” he said.

Because early recognition and timely care are key to improving survival, the Methodist ED “escape room” gave providers, registered nurses and patient care assistants an opportunity to develop a plan and deliver appropriate care in a lifelike circumstance where the clock was ticking.

Emergency medicine intern Becky Yuan said she found the simulation eye-opening.

“It was nice to have the practice in a sim setting before real patients,” she said. “It’s surprising how many patients sepsis affects and the mortality rate. It’s a lot higher than I thought.”

For Methodist RN Jennifer Burchett, the training was valuable, even if just a reminder of the critical work nurses do every day.

“We do really good work here,” she said. “Sepsis isn’t sexy, but it’s not all car accidents and shootings (in the ED). There’s a lot of great work we do that’s not on the highlight reel.”

Dr. Wipprecht ran 10 simulation cases with different teams from the emergency department in one morning. It was the first simulation of its kind for sepsis, but the plan is to go campus-wide with it, he said.

Participants weren’t graded on their performance, but they were encouraged to compete for the best time against other teams. The winning team received Starbucks gift cards.

And all walked out with stickers declaring them “sepsis heroes.”

Photos by Mike Dickbernd, IU Health visual journalist, mdickbernd@iuhealth.org

The Perfect Smile with Oklahoma City Orthodontist

Sky Ortho is an orthodontist based out of Oklahoma. They successfully serve their patients from the entire Oklahoma City area. Sky Ortho has extensive experience with all different types of patients. Their patients range from children to adults. They have been known to help patients in need of orthodontic services such as braces and Invisalign. With a range of techniques to achieve the best results for patients, they have been successfully recommended for their gentle but effective treatments. Obtaining the best smile is the goal of any patient, and with the right orthodontist in Oklahoma City, this is made possible. 

 

Dr. Larson at Sky Ortho knows how to treat patients and help them achieve their optimal smile. The office helps advise families at the right time for adolescents to get braces. There are many different tips and techniques that only qualified orthodontists know from their training and real-life experience. Speaking with a qualified orthodontist will enable you to understand and evaluate the best options for your child’s smile. An alternative way to straighten teeth in addition to traditional braces is Invisalign. 

 

The technology of Invisalign is unique. The process begins with an initial digital scan of the teeth. Once a digitals scan is performed, the next step is to create a customized plan for the patient. Once a personalized plan has been outlined, the next step is to create the custom, BPA-free aligners. Invisalign allows patients the ability to straighten their teeth without the look of traditional braces. Many patients may be self-conscious about their teeth and therefore may not want to receive traditional braces. Invisalign works by inserting aligners that are virtually invisible into the patient’s mouth. The patient wears these retainers for most of the day, and therefore this method effectively straightens teeth. Every few weeks, the patient receives new trays that help their smile become straighter. 

 

This is an exciting process as patients can watch their smiles transform with each tray. Teeth typically can move 0.25mm per each tray that is used. Invisalign allows patients to remove the trays when they eat and therefore reinsert them when they are finished. It’s a simple process that enables patients to go about their daily routines with ease. This is a fantastic alternative to traditional braces for interested patients. The office can help patients and families decide which method of teeth straightening is best.

 

Sky Ortho also treats adults. Many individuals think an orthodontist is only needed for young adults and adolescents. However, this is not the case. Many adults require orthodontic services to achieve a straighter smile. Sky Ortho helps patients to create their best smiles. Patients can feel confident and secure about their smiles. Treatment at Sky Ortho is convenient and straightforward. The process of achieving a straighter smile does not need to be complicated. With the assistance of the skilled associates at Sky Ortho, making the perfect smile is possible.

Contact US:

Sky Ortho

Address:717 S I-35 Service Rd
Moore, OK
Phone: 405-378-4774

Back home again in Indiana

She grew up in Indiana and moved to California with her husband. Now Kymberli DeWitt is back home again and a patient at IU Health Simon Cancer Center.

By T.J. Banes, IU Health Senior Journalist, tfender1@iuhealth.org

Four years ago when Kymberli DeWitt was diagnosed with Myelodysplastic syndromes (MDS) she was undergoing treatment for severe ulcerative colitis.

She was living in California at the time with her husband of 26 years, Scott. At a hospital close to home, she underwent a proctocolectomy with ileal pouch-anal anastomosis, or j-pouch surgery. The procedure surgically creates an internal reservoir from the small intestine.

It was during that procedure that her labs came back questionable and doctors diagnosed her with MDS. The conditions occur when blood-forming cells in the bone marrow become abnormal. She received a stem cell transplant in California. When the transplant began to fail she developed leukemia and received a “touch up transplant” again in California.

A native of Anderson, Ind. DeWitt graduated from the former Highland High School and was a member of the Marching Scots. When her husband took a job transfer, they decided to move back to Indiana – closer to her family and also close to IU Health. The couple has three children Danielle Fowler, 31, Nicolas Eicks, 30, Victoria DeWitt, 25.

“Truthfully, we needed a job near a transplant facility. Facilities like IU Health aren’t everywhere,” said DeWitt. Since March she has been coming to IU Health for transfusions to help control complications of aplasia, a bone marrow disorder characterized by a decline of red blood cells. The condition manifests in severe bruising. She is under the care of IU Health oncologist/hematologist Dr. Jennifer Schwartz. “It’s such a difference here – so much more one-on-one time with the nurses and it’s really a personal approach,” she said.

DeWitt smiles as she talks about her condition and the road back to Indiana. Long sleeves and pants hide the bruises. She is upbeat and tells about her hobbies – gardening, reading, and exploring new places with her husband.

“I’ve always worn makeup and a smile because I want to put my best foot forward, even on the worst days,” said DeWitt. “A good friend often sends me a text that says, ‘you’ve got this,’ and really I believe I do. I believe in the power of being positive.”

Celebrating – Donor chain changes eight lives

In honor of her birthday one kidney donor recently celebrated the gift of life that resulted in a chain of eight IU Health patients.

By IU Health Senior Journalist, T.J. Banes tfender1@iuhealth.org

The way Bill Eiler remembers it he was watching an episode of the popular ABC-TV series Grey’s Anatomy when he had an “a-ha moment.” The episode was about living donors.

“I like doing nice things to help people,” said Eiler, a resident of St. Paul, Ind. So he decided to donate a kidney – not to anyone in particular. Eiler is known as an “altruistic donor,” someone who donates to a transplant waiting list. Some people also call him a “Good Samaritan.”

Donate Life reports there are 100,000 people in the United States awaiting a kidney transplant. The average wait time is three to five years. Kidneys from living donors offer an alternative to dialysis for patients living with renal failure. On average a living kidney can function for 12 to 20 years – sometimes longer. In August, IU Health surgeons performed 18 adult kidney transplants and one pediatric transplant. The kidney transplant program performs more than 200 kidney transplants a year making it one of the top programs in the country.

When Eiler reached out to donate his kidney he said he wasn’t sure he would be a viable donor. Throughout his life he had been treated for polio, hepatitis, and melanoma. It turns out his kidneys remained healthy and he became the first in a group of eight people – one of IU Health’s first organ transplant chains.

Eiler’s kidney went to a woman. That woman’s son became donor number two. His kidney went to a second recipient. That recipient’s husband became donor number three. His kidney went to another man. That man’s niece, Jessica Journey became donor number four. Her kidney went to a young man.

Recently, to commemorate her birthday, Journey hosted a 10-year celebration of the chain of life. Eiler was there to celebrate with her – the bookends of the chain.

Journey said she felt called to help her uncle but she knew she wasn’t a good match.

“I always had a feeling that there was something more. It just all made sense, when I was told about the possibility of a chain during a phone call with my coordinator at the hospital,” said Journey, who recently joined IU Health Foundation as the manager of donor relations.

Known as Kidney Paired Donation (KPD), the chain occurs when a recipient has a willing living donor who is incompatible (a poor match). Most recipients and donor pairs are entered into a KPD program because of blood type or Human Leukocyte Antigen (HLA) incompatibility or both. Other pairs may enter if they are seeking a donor better matched in age, size or some medically suggested reason.

So on Sept. 22, 2009 Eiler became the first donor in the chain.

Retired from the US Postal Service Eiler spends his time volunteering with CASA, the Kiwanis Club, and teaching archery and fishing to youth attending Flat Rock YMCA Camp. He’s also seen on stage with the Shelby County Players.

“I was the only one in the chain who didn’t have anyone I was related to,” said Eiler, whose transplant coordinator was Kelly Coffey. “I know some people probably thought I was crazy, but it was really no big deal. If I had another kidney, I’d do it all again.” His eyes water when he tells about his recipient’s response to his gift of life.

“She said ‘thank you for giving me my life back.’” That was all it took to know I’d made the right decision,” said Eiler.

Journey’s transplant recipient was 15 at the time and is now 25. “We keep in touch. We appreciate each other,” said Journey. “It’s different than any other connection because it’s our shared kidney story that connects us.

First his mother, then his wife is patient’s transplant donor

As he recently prepared for his second kidney transplant, Alan Wilson began mapping out a plan to help advocate for other patients with kidney disease.

By T.J. Banes, IU Health Senior Journalist, tfender1@iuhealth.org

Resting in a hospital bed, his wife at his side, Alan Wilson talks openly about his kidney match – not once but twice.

On Jan. 27, 2009 his mother, Lori Miller donated a kidney to Wilson. When his body began rejecting the kidney his wife Danielle was tested and was a match.

Wilson explains his health with a blanket term – FSGS, focal segmental glomerulosclerosis. The condition causes nephrotic syndrome and kidney failure. A single disease does not cause it; it can have many different causes including infection, medication or an illness.

Raised in Kosciusko County, Ind. Wilson worked for a time in auto parts and then at Maple Leaf Farms – a poultry company. He and Danielle met through mutual friends and were married June 7, 2008.

Since before his first transplant Rick and Danielle have made it their mission to help educate others about all aspects of kidney disease and transplant. He received his second transplant from his wife earlier this month.

“When I went through this the first time it was 11 months from diagnosis to transplant to back to work,” said Wilson. “I tell people, ‘yes, it’s a big part of my life but it doesn’t define me.’”

He relates how his candid approach to his disease has bridged relationships.

The couple was recently checking out at a local grocery store when Rick engaged in a conversation with the cashier. Within minutes they found common ground – the woman related how she had lost a daughter to kidney disease a few years ago. She walked out from behind her register and gave the Wilsons hugs when they shared their story.

“We have gone from being guarded about our story to being completely open and it has opened doors for others,” said Wilson. Back home in Warsaw, Ind. they started a support group where people with end stage renal failure, family members, and caretakers talk about various topics. The conversations include insurance coverage, finding a living donor, and coping with guilt.

“When my wife found out she was a compatible donor, she was over the moon but I felt guilty,” said Rick Wilson. “How do you ever begin to thank someone for such a tremendous gift – from someone so close to you like your mom and your wife?”

Nephrology nurse – her job is about family

This week is Nephrology Nurses Week. Darby Sturtevant talks about how her work includes not only patient care, but also family care.

By T.J. Banes, IU Health Senior Journalist tjbanes@iuhealth.org

Darby Sturtevant describes the nephrology world as a small world.

“Patients see the same techs and nurses,” said Sturtevant. She started at IU Health seven years ago working with the transplant program. Five years ago she became a nurse practitioner working with dialysis patients in the outpatient setting.

“When you see the same patients weekly you get to know them and know their families. You hear about grandbabies being born, you see pictures, and you share in their life,” said Sturtevant. Nephrology nurses are trained both in dialysis but also in educating family members and caregivers.

“We work with patients who have a chronic condition and it impacts so much of their life. They spend 12-16 hours a week in the clinic and that doesn’t include how worn out and tired they are when they go home. They are only able to live normal lives a few days a week and then there are so many restrictions with diet and exercise,” said Sturtevant, who grew up in Fishers. She is married to Sam Hunter. They have one daughter, Coralyn Hunter, 2, and are expecting a second child in January.

“Nephrology sort of chose me. I loved working with transplant patients and seeing an immediate result –patients switching from being sick to becoming healthy,” said Sturtevant. She hadn’t seen the other side of kidney disease until she shadowed another nurse. She estimates she has 120 patients that she sees weekly.

The American Nephrology Nurses Association (ANNA) designates the second full week in September at “Nephrology Nurses Week.” It’s a time to recognize nurses who are dedicated to caring for patients with kidney disease. Nephrology nursing is a specialty, and can be taught on the job.

“The nephrology nurses are the backbone of nephrology care for our patients,” said IU Health Dr. Brent W. Miller, clinical chief of nephrology. “They manage the care of very difficult conditions. The quality of the physician I am is directly related to the quality of our nephrology nurses.”

One minute she was fine, the next her heart was failing

“I’ve taken my donor everywhere. She’s given me life; the least I can do is to show her the world.”

By Maureen Gilmer, IU Health senior journalist, mgilmer1@iuhealth.org

Alexis Pavlopoulos had just gotten off the elliptical machine to get a drink of water when she blacked out.

She remembers waking up on the gym floor to the sight of EMTs standing over her.

Her heart was beating wildly – 216 beats per minutes – as medics struggled to slow it down. A normal resting heart rate for adults ranges from 60 to 100 beats per minute.

It was Jan. 13, 2014. Pavlopoulos was 24 years old. She’d always been active, a four-season athlete throughout high school.

She thought maybe she was just out of shape, but after being rushed to IU Health Bloomington Hospital one mile away, she learned she was suffering heart failure caused by viral cardiomyopathy – an infection had weakened her heart muscle.

The next days, weeks and months would be filled with challenges. Like when she had an ICD (implantable cardioverter-defibrillator) implanted to detect abnormal heart rhythms.

She had the flu and was home sleeping on the couch not long after that surgery. She remembers springing up and screaming once, then again and again. Her ICD had shocked her three times when her heart rate climbed close to 300.

After repeat episodes, it got to the point where she was afraid to go to sleep.

When she was sent to IU Health Methodist Hospital for evaluation in May of 2014, doctors discussed the possibility of a transplant but thought she wouldn’t need one for another 10 years. Less than two years later, they determined her heart was failing rapidly.

“THEY HAVE A HEART”

Pavlopoulos was put on the transplant list June 15, 2016. Fifteen days later, the phone rang at her parents’ home in Bloomington.

“I got the call at 9:24 in the morning June 30. I was lying in bed, getting ready to take a shower.”

A heart was available.

She struggled to process the news as fear welled up inside her. From her bedroom, she called down to her mom on the first floor: “Mom, it’s the hospital, they have a heart.”

Pavlopoulos and her family were caught off guard. They expected to wait months for this call, but now they were scrambling to get ready to make the hour-long drive to Methodist.

Before she was going anywhere, however, Pavlopoulos was going to take a shower and shave her legs.

“In that moment, that was the most important thing to me – that I had a shower and shaved my legs. They told me I’d be in the hospital for about 14 days post-transplant and I didn’t know when was the next time I’d be able to shower.”

They arrived at the Indianapolis hospital at about 11 a.m., and soon they would be joined by a host of nervous family and friends. Someone brought in bags of peanut butter sandwiches and M&Ms to keep people occupied.

Pavlopoulos did her best to keep the mood light. When the surgery was pushed back to 7:30 that evening, the medical team asked her if she needed a Xanax to calm her anxiety.

“I said, ‘No, but can you divide it up and give it to all these people?’ ” She still laughs at the memory.

A NEW LIFE

That night – June 30, 2016 – into the next day is when Alexis Pavlopoulos started her new life. The day a new heart began beating in her chest. She was 26 years old.

Less than a year earlier, when her future was uncertain, she had married her longtime sweetheart, George.

“I told him to run. He said he was in it for the long haul.”

Three-plus years have passed since her transplant, and Pavlopoulos, 30, is living a life that honors her multi-organ donor.

“I’ve taken my donor everywhere. She’s given me life; the least I can do is to show her the world.”

Chicago, Virginia Beach, Asheville (N.C.), Cabo San Lucas and last year – Greece, where Pavlopoulos met her husband’s family.

This summer, Pavlopoulos sat down to write the hardest letter she’s ever written – to her donor’s family. Following is an excerpt:

“I hope to live a life worthy of the precious gift I have been given. You and your loved one are never far from my thoughts. Thank you for your generosity and selflessness to choose to give another life. Thank you for making such a sacrifice in the deepest time of your family’s grief and saving my life. Please know that her spirit lives on. I hold her in my heart. And she is with me, literally, with every breath I take. I promise to take good care of her. I promise to honor her with everything I do.”

BEATING HEART IN A BEAR

The letter, accompanied by a bear with a recording of the donor’s heartbeat, was first sent to Pavlopoulos’ IU Health transplant coordinator, Alejandra Darroca, who then forwarded it to the Indiana Donor Network. That organization is responsible for sending it to the family, provided they are interested in hearing from their loved one’s organ recipient.

Darroca believes the bear (and letter) will be meaningful to the family because it is a gift from Pavlopoulos.

For privacy reasons associated with organ donation, organ recipients can’t divulge much personal information in their letters, said Darroca, who continues to coordinate all of Pavlopoulos’ medical care post-transplant, maintaining a vital link between her and her evolving healthcare team.

“Alexis is a very sweet girl, and the bear is a very small part of saying thank you. It’s not enough to say thank you, but I tell her the best thing you can do to thank your donor is to take care of yourself, be a good steward of your heart and help your community.”

Pavlopoulos, “the perfect patient,” is doing just that. She is eating right, working out and staying away from people during flu season as best she can. That can be hard for the self-described social butterfly.

She now is back to working full time in payroll for Indiana University, and she and her husband have bought a house. She uses her Facebook and Instagram pages to reach out to others going through similar health challenges, talking to people around the world.

Now that she knows her letter and bear have been delivered, she hopes someday to hear from the family, but it’s enough that she has been able to share a little of what is in her heart.

“A lot of people have survivor’s guilt,” she said. “I don’t. In my support group, somebody said it best: This person chose to save a life in the tragedy of losing theirs. So you honor your donor. You live a life worthy of receiving that gift.”

To learn more about organ donation, contact Indiana Donor Network.

Transplant nurse: Her husband was the most compliant patient

During the 30 years she has been a transplant nurse Debra Beal has helped hundreds of patients toward recovery – including one she calls “her husband.”

By IU Health Senior Journalist, T.J. Banes, tfender1@iuhealth.org

It was September and pediatric transplant patients were wheeled around the halls of IU Health University Hospital – not Riley Hospital – in little red wagons. That was back when Debra Beal first started working at IU Health as a transplant nurse.

“When I first came on board, there were more kidney and liver transplants. Now pancreas transplants have increased. The patient stays aren’t as long and we don’t see pediatric patients anymore. They’re all at Riley,” said Debra Beal, a charge nurse and three-time Daisy nominee.

Over the past 30 years she’s seen the IU Health transplant program grow by leaps and bounds. She’s also seen the faces of countless patients turn from despair to hope.

One of those patients is her husband Mike. Not only does September mark 30 years of her service with IU Health, it’s also her birthday month and the date of her 21st wedding anniversary.

Beal grew up and graduated from the former Soldiers and Sailors Children’s Home, in Knightstown, Ind. The home was founded in 1865 with the original intent of providing care and education for orphaned children of Civil War veterans. Over the years the state-run facility – listed on the National Register of Historic Places – expanded to meet the needs of a diverse student population. The campus provided both a Core 40 curriculum and vocational training in such areas as culinary arts, veterinary science, and building trades up until it closed in 2009.

“I came from a family of five and after my mom passed from leukemia my father couldn’t handle raising the five of us,” said Beal. She was in the first grade and the fourth of the five children – all who graduated from the home. Two of her siblings remain in Indiana and two others live in Texas.

“Because I grew up at the home I always knew I wanted to have a profession and be self-sufficient,” said Beal. First she thought about becoming a teacher but when a family member suggested nursing, the idea took hold and she pursued her degree at Indiana University.

She had been working at IU Health for 10 years when she met her husband through a computer dating service sponsored by a local radio station. Mike Beal says a friend talked him into subscribing to the dating service. He grew up in Wannamaker, Ind. and attended Franklin Central High School.

Their first date was to a little restaurant along US 40 – close enough that Debra could get to work on time. She’s worked weekends almost since the time she started at IU Health.

Not long after their first date, Mike Beal says he was on vacation in Utah and knew he was in trouble.

“I called her and she missed my phone call and boy was she mad. I knew it was the real deal then,” said Mike. After the couple married he often brought his wife dinner at the hospital during her weekend shift.

There are so many things Debra likes about working weekends but she especially likes her patients. “I think the big thing is seeing the impact on patient’s lives,” said Beal.

On Feb. 1, 2006, that impact became very personal.

Mike Beal received a liver transplant after being diagnosed with nonalcoholic stealtohepatitis (NASH). The liver inflammation is caused by a buildup of fat in the liver. Debra Beal wasn’t her husband’s transplant nurse during his hospitalization but she never left his side and admits she couldn’t resist taking his vitals and keeping tabs on his progress.

“They called me for the transplant at 5 a.m. and I didn’t get the transplant until 14 hours later. Afterward I looked up at her and said ‘I didn’t think I’d come out of it. I thought I was going to die,’” said Mike Beal. “She just stood there smiling. She’d seen it before and she knew I was going to be OK.” At the time, Beal remembers IU Health Transplant surgeon Dr. Richard Mangus was a fellow who worked on her husband’s case.

“I never imagined that situation would come into my life. My husband needed a transplant,” said Debra Beal. “It definitely put a different spin on my job. I often wondered how families handled it and did it so well. And now I know first-hand what it’s like to take care of a patient who is your family member.”

Mike Beal said not only was his wife his best “transplant support group,” but she was also his encourager – reminding him daily that there is light at the end of the tunnel. They now celebrate that transplant anniversary with trips to Hawaii.

“Transplant is different for every patient and probably the hardest thing I’ve been through in my life,” said Mike Beal. “She reminds me when to take my meds even when I’ve taken them. She cares and she’s organized and I’m the most compliant patient there is because I have no choice with her as my wife.”