Kootenai | Kootenai Health | Issue 4, 2022

Unthinkable heart trouble An ‘unlikely’ heart attack highlights the importance of acting fast Health K H . O R G Stay well this winter With Jack Frost around the corner, be prepared for common illnesses Get festive Glad tidings—the Festival of Trees will be in-person this year! ISSUE 4 | 2022


KH . ORG 3 WHAT’S INSIDE Issue 4 | 2022 16 Colorectal cancer screening saves lives 18 Put your best foot forward 5 Dialysis with more comfort 6 Unthinkable heart trouble Follow Us 10 Meet our new providers Join us in welcoming 12 newcomers to the Kootenai Health team. 22 Ask the Expert Kootenai Health pediatric hospitalist Emily McCarty, M.D., shares advice on teaching children habits for keeping their hands clean and germ-free, plus tips on dealing with common winter illnesses. 24 Fall flavors Kootenai Health’s executive chef serves up his recipe for apple, dried cranberry and spinach salad with balsamic garlic chicken. 20 Festival of Trees kicks off the season

4 Adapting to a New Challenge “If you always do what you always did, you’ll always get what you always got.” —Henry Ford Over the past year, we have worked to be very transparent about Kootenai Health’s financial challenges, which have been driven by a national nursing shortage and the high cost of traveling nurses. These challenges are not unique to Kootenai Health; every health care organization across the country is competing for qualified health care workers. For more than 10 years, Kootenai Health has met or exceeded its budget targets with year-over-year financial growth. We have an exceptional track record of strong financial performance and we know our vision, mission and strategic plan are still on target for meeting our community’s growing health care needs. That being said, we are in an environment in which the demand for employees has simply overwhelmed the supply. So we are aggressively changing our approach to the challenge. This year Kootenai Health’s leadership has been working on a variety of strategies to significantly reduce our reliance on traveling nurses, take a thoughtful approach to all labor costs, reduce operating expenses and increase revenue without burdening patients. The plan includes more than 200 individual tactics, with work occurring throughout the organization. While some might look at our challenges with fear, that’s not how we work. Kootenai Health has an excellent history of strong financial performance, strong local leadership and innovative problem solving. Yes, we are changing our approach to solving this new problem, but we are doing so while continuing to take advantage of the cultural traits that have brought us historic success—strong work ethic; collaborative partnerships; and, above all, a deep commitment to the patients we serve. When everything in the environment has changed, success depends on your ability to adapt and find new ways to thrive. Ironically, our adaptability, which brought us through COVID-19, will be the strength that brings us through this next challenge as well. Wishing you good health, Jon Ness, CEO Kootenai Health 2003 Kootenai Health Way Coeur d’Alene, Idaho 83814 KH.org (208) 625-4000 Kootenai Hospital District Board of Trustees Katie Brodie, Chair Robert Colvin, Vice Chair Teri Farr, Secretary and Treasurer Dave Bobbitt, Trustee Cindy Clark, Trustee Thomas deTar, M.D., Trustee Liz Godbehere, Trustee Steve Matheson, Trustee Robert McFarland, M.D., Trustee Administration Jon Ness, Chief Executive Officer Karen Cabell, D.O., Chief Physician Executive Kelly Espinoza, Chief Nursing Officer Jeremy Evans, Chief Operating Officer Cara Nielsen, Kootenai Health Foundation President Ryan Smith, Chief Information Officer Kim Webb, Chief Financial and Administrative Officer John Weinsheim, Executive Vice President of Kootenai Clinic Executive Regional Editor Kim Anderson Regional Editor Shannon Carroll Cover photo Katrina Walker Published as a courtesy of Kootenai Health four times a year. Models may be used in photos and illustrations. If you have any concerns or questions about specific content that may affect your health, please contact your health care provider. Kootenai Health complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Translation assistance services, free of charge, are available to you. Please call (877) 746-4674. Si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al (877) 746-4674. Ako govorite srpsko-hrvatski, usluge jezicke pomoci dostupne su vam besplatno. Nazovite (877) 746-4674. 2022 © Coffey Communications, Inc. All rights reserved. Health Kootenai Health Pharmacy Manager J.R. McCurdie, Night on the Palouse

KH . ORG 5 By Shannon Carroll Tonnie Hoisington knew something was wrong when she became severely winded when walking the short distance from her bathroom to her kitchen. She was already a regular recipient of dialysis treatment for her kidney disease and had been through several health scares—the latest of which was causing her shortness of breath, ultimately leading to open-heart surgery at Kootenai Health. While recovering from surgery in the intensive care unit (ICU), Tonnie received her regular dialysis treatment from the comfort of her hospital bed. “It used to be that patients would have to be moved to a room specifically plumbed for dialysis,” said Debbie Callins, RN, director of Critical Care and Pulmonology Services at Kootenai Health. “We can now treat patients with an innovative, portable machine, called the Tablo® Hemodialysis System. Tablo allows us to bring dialysis treatment directly to a patient’s bedside, rather than move them. Anything we can do to make their stay as comfortable and worry-free as possible is always a top priority.” Effortless andeffective In hospitals across the nation, Tablo has quickly become a sought-after treatment option for patients with acute and/or chronic renal failure. Introduced in hospitals in 2017, it gained popularity in 2020 when it was cleared by the U.S. Food and Drug Administration for in-home dialysis treatment, which was a crucial option during the pandemic. “It’s been such a great tool to add to how we care for dialysis patients while they’re in the hospital,” said Innovative care To learn more about the Tablo Hemodialysis System, visit the Outset Medical website at outsetmedical.com/tablo. Dialysis With Tonnie Hoisington was able to stay in her ICU bed and relax without changing rooms for dialysis. Debbie Callins, RN Matthew Queral, RN, Kootenai Health Dialysis Program coordinator. “It has a lot of features that make treating patients seamless, helping to not only keep them comfortable, but also save crucial time and resources.” Tonnie received her dialysis treatments throughout the night while recovering at Kootenai Health. “It was a nice, relaxed environment, and I was able to fall asleep easily. The Tablo is very quiet, and I was comfortable the whole time,” said Tonnie. “I’m really grateful to that team for their attention and skill, and I’m really happy with how effortlessly I was able to receive my dialysis while recovering.” Comfort New technology brings treatment to the bedside

6 By Kristina Orrego It was a rainy night in June of this year when Michael Delfino and his family were camping 15 miles outside of Coeur d’Alene. Michael woke up in the morning to the family puppy crawling on his chest. While trying to get the puppy off, he felt his chest suddenly tighten. “I thought I broke a rib trying to get the dog off me,” said Michael. “I leaned up, stretched my shoulders back and tried to stretch my ribs out. It wasn’t giving me any relief.” Despite the excruciating pain, Michael could still think straight. He and his wife, Jenny, rationalized that he might be having a panic attack, which he had seen her have in the past. “He kept saying he needed to stretch,” said Jenny. “But his eyes didn’t look right, and I could tell that something was very wrong.” Swift action They realized every minute was precious and quickly drove to Kootenai Health’s emergency department. When they arrived and the emergency medical team heard Michael’s symptoms, they wasted no time. Michael, who was 34 at the time, was experiencing the seemingly unthinkable for a young, healthy person: He was having a heart attack. “When I walked in, I just told them my heart really hurts,” said Michael. “The team instantly took action—putting me in a wheelchair and rushing me back to the cath lab.” Before Michael knew it, the nurses had removed his shirt and shoes, attached electrocardiogram (EKG) pads to his chest to monitor his heart and started an IV drip. He was also given a blood thinner and medication to help relieve the chest pain. The pain showed no signs of stopping. Michael was now going into ventricular fibrillation, or VFIB—a condition that causes the heart to beat faster and out of rhythm. “They had to shock me and do CPR,” said Michael. “I woke up not knowing what happened, but I felt perfectly fine after that.” During this ordeal, Kootenai Heart Clinics cardiologist and surgeon Ronald Jenkins, M.D., performed an emergency A heart attack seemed unlikely for a young man in good health—but he and Kootenai Health didn’t wait to act on it HEART TROUBLE Unthinkable Michael Delfino led a healthy lifestyle even before having a heart attack at age 34.

KH . ORG 7 thrombectomy, placing a catheter in Michael’s left artery to open it up. Dr. Jenkins was then able to successfully remove a blood clot, the cause of Michael’s heart attack. “In Michael’s case, the clot became lodged in the artery, split off and then moved, blocking the ends of two other arteries,” said Dr. Jenkins. “Most of the clot came out during the thrombectomy. Once the clot was cleared, Michael’s chest pain went away, his EKG went back to normal and his heart damage was minimal.” ‘We’re really lucky’ Michael’s recovery after his heart attack has gone smoothly. He spent three days in the hospital and rested at home for the next two weeks. After the Fourth of July, nearly a month after his heart attack, he started to feel back to normal. “We’re really lucky to have been at Kootenai Health,” said Michael. Michael and his family had always led an active and healthy lifestyle, and this scare led them to finely tune those healthy lifestyle choices even further. He has reduced his stress, bumped up his activity level and adheres to an even more healthy diet. They took CPR classes and purchased an at-home AED (automated external defibrillator) kit. Jenny also keeps CPR masks with her in case of an emergency. “I’ve let a lot of things go the last couple of weeks that would have normally made me angry,” said Michael. “Life happens. Jenny and I are tracking what we eat. She teaches exercise classes, so she’s already doing a lot of cardio. I’ve started riding my bike even more.” While a nutritious diet and regular physical activity are key to optimal heart health, Dr. Jenkins stressed the importance for everyone—even those as young as 20 to 50—to monitor their blood pressure and cholesterol and be open with their primary care physicians about a family history of heart conditions. Michael’s father had died due to a combination of health issues, but it was discovered after he’d passed that he’d had an enlarged heart. “Unfortunately, it sometimes takes a health scare for young people to take their heart health seriously,” said Dr. Jenkins. “If there’s a family history of heart conditions, young people should not wait until their first heart attack to be on top of their heart health.” Phenomenal care Jenny will never forget the kindness the entire medical staff showed her and her family on that day. “The whole team at Kootenai was phenomenal in how they took care of everything,” said Jenny. “Volunteers even brought our 8-year-old daughter, Mackenzie, a coloring book while we were with Mike in his room.” Jenny is convinced that the swift actions of Kootenai Health’s emergency team saved Michael’s life. “I’ve never seen a group of people work so quickly in complete unison,” said Jenny. “It was a beautiful thing.” Heart care close to home Kootenai Heart Clinics are located in Coeur d’Alene, Post Falls, Sandpoint and Lewiston, plus in satellite locations across northern Idaho and in Libby, Montana. Visit KH.org/heart-services/kootenai-heart-clinics for details. TIPS TO TAKE CARE OF YOUR HEART We can all take key preventive steps to make sure our hearts are in tip-top shape at any age. Avoid smoking. Smoking accelerates the risk for vascular diseases because it damages key heart and blood vessels. Manage your weight. As a person’s body weight increases or they become overweight, they are much more likely to develop conditions like diabetes that affect the heart. Adopt a heart-healthy diet. Limit fatty red meat and replace it with lean meat whenever possible. Be sure to include fresh fruits and vegetables and avoid overconsuming sugary soft drinks and alcohol. Maintain an exercise routine. Regular physical activity helps lower blood pressure while increasing high-density lipoprotein, or HDL (“good” cholesterol). Exercise also helps reduce stress hormones that can strain the heart. Discuss family history of heart conditions with your primary care physician. “People should be very aware of their family’s history of heart disease and whether they have a chance of inheriting the same genes that produce heart disease in their relatives,” said Ronald Jenkins, M.D.

8 Me e t o u r n ew prov ide r s Kootenai ClinicAppointment Center Need to nd a physician and schedule an appointment? Start here: (208) 625-6767. The Appointment Center can help you: • Determine the type of physician you need • Find an appointment that ts your schedule • Explain what to expect at your appointment Call the Appointment Center at (208) 625-6767 or request an appointment online at appointmentcenter.kh.org. David Becerril, M.D. Kootenai Urgent Care Tell us abit aboutyou andyour family. I was born in Sacramento, one of nine children, and both of my parents are from Mexico. My dad often took the family water skiing and snow skiing. We had a ski boat and water-skied in the Sacramento River and Folsom Lake. We snow-skied around Lake Tahoe. My parents were sticklers for doing well in school. Whydidyoupickyour specialty? I picked family practice to be of service to the most people in the least expensive way. What canpatients expectwhen theyfirst meetwithyou? I focus on providing expert care gained through 40 years of experience. Evelyn Considine, NP Kootenai Clinic Nephrology Tell us abit aboutyou andyour family. I started my nursing career at Archbold Medical Center in Thomasville, Georgia. My husband is a retired U.S. Air Force veteran, and our 20-year-old daughter is studying clinical psychology at Brigham Young University. I have been working at Kootenai Health for almost three years. What are someofyour hobbies? Jogging, swimming, playing classical guitar, listening to classical music, traveling, alpine and cross-country skiing, and water skiing when I can. What drewyou toKootenai Health? The beauty of the area, the full spectrum of medical care provided by Kootenai Health and the Epic medical record system, which I have used for the past 20 years. What isyour favoritehealthy tip? Sleep eight hours a day; exercise three to five days a week; and eat healthy, unprocessed foods. Wheredidyou receiveyourmedical degree? I graduated from the University of California, Berkeley, as an undergraduate and went to UC San Francisco Medical School. Whydidyoupickyour specialty? I worked in nephrology/dialysis as a patient care technician for almost four years and then as a dialysis nurse for over 20 years. My patients can benefit from my experience in serving them as a nurse practitioner (NP). Nephrology/dialysis patients are a special group of patients who are dear to my heart. What canpatients expectwhen theyfirst meetwithyou? All my patients will be treated with great respect; provided with high-quality, patient-focused care; and treated like my own family.

KH . ORG 9 —Continued on page 10 Charles Cui, M.D. Kootenai Heart Clinics Tell us abit aboutyou andyour family. I grew up in Louisville, Kentucky, and went to the University of Kentucky, where I became an avid basketball fan. I had the pleasure of meeting my wife in medical school and went on to complete my internal medicine residency and cardiology fellowship in Virginia. My grandfather was the dean of a medical school in China, and I come from a line of physicians that includes both of my parents. Growing up, I never considered any other profession. Whydidyoupickyour specialty? What drew me to cardiology, in particular, was the advancements in our medical and procedural techniques in the last decade. With modern medications and stent technology, we are able to restore blood flow during heart attacks and send patients home only a few days later. What canpatients expectwhen theyfirst meetwithyou? My goal is always to address patients’ concerns in a succinct and honest manner. Patients, myself included, often have trouble with eating a good diet or taking all their medications on time. I hope to facilitate a relationship of trust so we can work together and find a middle ground—preferably with fewer medications and maybe more vegetables. What are someofyour hobbies? I enjoy tennis, swimming and snow skiing, with some wakeboarding and slalom skiing on the side. Whenever I’m driving long distances, I tend to turn on country music and sing along poorly. What drewyou toKootenai Health? The growth of the population here in Coeur d’Alene and Kootenai Health’s heavy investment in cardiology were strong reasons I elected to work here. My wife works in Spokane, and we are both happy to now be in the Northwest. What isyour favoritehealthy tip? Please do not ignore the symptoms of new chest pain. Often patients come to us too late, when a lot of heart damage has occurred that we are unable to repair. The key is to find a good cardiologist that you trust and stick with them. You might live a little longer. Wheredidyoureceiveyourmedicaldegree? I received my medical degree at the University of Louisville. I went on to train at Virginia Commonwealth University and completed my cardiology and interventional training at Virginia Tech Carilion School of Medicine. What are someofyour hobbies? I am a workaholic and consider my job as one of my hobbies, along with yard work, working out, hiking, spending time with my family and cooking good food. What drewyou toKootenai Health? Kootenai Health has been wonderful to me while working as a chemotherapy and nephrology nurse. I have worked with the best teams—and more importantly, I want to be part of the best nephrology team in the Inland Northwest: Kootenai Clinic Nephrology! What isyour favoritehealthy tip? Drink plenty of water to keep those kidneys healthy, do not sweat the little stuff, smile and be happy! Where didyou receiveyourmedical degree? I earned my NP degree from South University in Savannah, Georgia. I am proud to say that being an NP in nephrology is my first role as a provider!

10 Bryce French, M.D. Kootenai Clinic Vascular Surgery Tell us abit about youandyour family. I grew up in the Tacoma, Washington, area and went to Western Washington University, where I met my wife, Annie. We have three young children: Claire (7), Charles (5) and Callen (1). Whydidyoupickyour specialty? I enjoy the variety vascular surgery offers— both open and endovascular options to treat disease—the interaction with other specialties, and the long-term follow-up with patients. What canpatients expectwhen theyfirstmeetwithyou? I have a calm, relaxed personality and want to help the patient see both their current condition and changes that can be made to improve their vascular health in the future. What are someofyour hobbies? I enjoy the outdoors, hiking, swimming, weightlifting, watching football and spending time with my family. What drewyou to Kootenai Health? Kootenai has a busy vascular practice with great senior mentorship as I begin my career. What isyour favoritehealthy tip? Try to walk, run or bike places instead of going on short car rides. Wheredidyou receiveyour medical degree? I received my medical degree from The Ohio State University. I did my general surgery residency at Swedish Medical Center and my vascular and endovascular surgery fellowship at the University of Washington. —Continued from page 9 Matt Low, M.D. Kootenai Clinic Vascular Surgery Tell us abit aboutyou andyour family. I grew up in Columbia, South Carolina. My wife and I met when I was in medical school and she was in physician assistant school in Charleston. She grew up in Lewiston, Idaho, so we traveled back and forth over the past decade and fell in love with the Pacific Northwest. Coeur d’Alene offered everything we were looking for to raise our children, and we were excited for the opportunity to be part of this community. Whydidyoupickyour specialty? I had known from a young age that I wanted to be a surgeon. I spent the majority of my early training pursuing cardiothoracic surgery, but when I did vascular surgery, something clicked. It offered the opportunity to be in a cutting-edge field and to use both surgical and endovascular skills. It also created an environment where I was able to do surgery and participate in the complete health and wellness of my patients. What canpatients expectwhen theyfirstmeet withyou? My mission as a vascular surgeon is to provide the care and compassion I would want for my family and myself. This is the foundation on which I base my practice and what I want my patients to experience. Vascular surgery demands a holistic approach because diet, lifestyle, exercise and medicine all play an integral part of patient care and well-being.

KH . ORG 11 What are someofyour hobbies? My family and I are avid skiers and enjoy spending our free time outdoors. I also enjoy photography, travel and the entire experience that is drinking coffee. What drewyou to Kootenai Health? As I searched for a place to start my practice, I was able to visit many health care systems. Kootenai Health stood out because of the people. When I was walking around town, different people would talk about how great a place it is to work. This was confirmed with every person I met. It is a privilege to join their mission and to serve patients across northern Idaho. What isyour favorite healthy tip? Having a healthy lifestyle begins in the kitchen. Food has an impact on everything we do. Wheredidyou receiveyour medical degree? I graduated from the Medical University of South Carolina and completed general surgery and vascular surgery training at Prisma Health, Upstate South Carolina. —Continued on page 12 Shannon Miller, PA-C Kootenai Heart Clinics Tellusabitaboutyouandyour family. I was born and raised in a small town in Washington. I went to the Chicago area to raise my family and do physician assistant (PA) training and work from the 1990s through 2020. Having moved back to the region two years ago to be near my elderly mother, I am now privileged to be working for Kootenai Heart Clinics. I have two adult sons and four young grandchildren. Whydidyoupickyour specialty? One of my early positions was working in a cardiology fellowship in the Chicago area, and I was hooked. Focusing on this area of health is exciting in that there are many different aspects and diagnoses. It also highlights the need for excellent lifestyle education for patients and the need to encourage compliance. This is a favorite niche of mine that I enjoy in patient care. What canpatients expectwhen theyfirstmeet withyou? I am friendly and personable and tend to ask a myriad of questions! What are someofyour hobbies? Kayaking, paddleboarding, hiking, boating, snowshoeing and relearning the acoustic guitar. I absolutely love Idaho! What isyour favoritehealthy tip? Stay as active as you can and learn to enjoy healthy food on a daily basis! Wheredidyoureceiveyourmedicaldegree? After my undergraduate degree was completed at the University of Washington, I eventually completed physician assistant training at Cook County Hospital’s PA program in Chicago. I practiced in the Chicago area from 2001 to 2020, with a two-year stint in the Philadelphia area between 2016 and 2018. My last position before coming here was as a cardiology physician assistant at Central Washington Hospital in Wenatchee. Finding an opening at Kootenai Health has been an incredible blessing!

12 —Continued from page 11 Kevin Peters, PA Kootenai Heart Clinics Tell us abit aboutyou andyour family. I was born and raised in Chicago, where my family still resides. My fiancée, Kirsten, and I recently moved to northern Idaho after visiting and being so impressed with the natural beauty of the area. Whydidyoupickyour specialty? I’ve always been mechanically inclined and always loved working with my hands, so I was drawn to the surgical specialties from the beginning. I also gravitated toward cardiac physiology while in school. Cardiac surgery provided the opportunity to be hands-on in the operating room while also caring for high-acuity patients in other settings. Ashley Otto, DNP Kootenai Clinic Cancer Services Tell us abit aboutyou andyour family. I have an amazing husband and three incredible children. I was born here in Coeur d’Alene, so I am also blessed to be surrounded by my parents, sisters and their families, and uncles we are all close with. Whydidyoupickyour specialty? I started as a nursing assistant in the inpatient oncology unit at Kootenai Health over 10 years ago. I went on to obtain my nursing degree while dealing with my own diagnosis and treatment of thyroid cancer. Then I went on to work as an oncology-certified nurse for numerous years before being accepted into doctoral school. I was fortunate to complete 400 clinical hours of my doctoral education with the providers at Kootenai Clinic Cancer Services. I have always felt an amazing connection with my oncology patients and their families. I consider myself blessed to be able to aid them in one of the biggest challenges of their lives and see their resilience. What canpatients expectwhen theyfirst meetwithyou? I want to get to know you and develop a rapport with you and your family or caregivers. Oncology care can be scary and overwhelming, but we are a team navigating your journey together. What are someofyour hobbies? Reading—I missed reading for fun during my years of school! My family and I are very active patrons of our local libraries. Additionally, I enjoy being active in my children’s lives by attending music recitals, sports practices and games, baking for them, hiking, swimming, doing escape rooms, going to local plays—whatever you throw at us! We love to travel and see the world. What drewyou toKootenai Health? I was born and raised here in Coeur d’Alene and had previously worked at Kootenai Health as a nursing assistant. Ultimately what drew me to Kootenai Health for this role was my experiences and interactions during my doctor of nursing practice (DNP) hours with the team and Kootenai Clinic Cancer Services. The oncologists here are top-notch, and I am grateful to be part of their team. What isyour favoritehealthy tip? I would say diet is such an important part of our lives that is overlooked. Stay away from processed foods and focus on whole foods, such as fruit, vegetables and lean meat. Also, shop at your local farmers markets! Wheredidyou receiveyourmedical degree? I obtained my DNP degree at the University of Mary in Bismarck, North Dakota. Thankfully, the program was a hybrid program. While the basis of education came from Bismarck, my clinical experiences took place here in the community, including at Kootenai Health.

KH . ORG 13 Edward Rooney, M.D. Kootenai Clinic Orthopedics Tell us abit aboutyouandyour family. I was born and raised in Clarkston, Washington, where my parents still reside. I traveled out east to Michigan and North Carolina for my medical training and could not wait to get back to the Pacific Northwest to begin my career. I have a beautiful fiancée, Kelly, and a wonderful golden retriever, named Jerri. Whydidyoupickyour specialty? I have always been interested in putting things together, like puzzles, and working with my hands in general. When I first encountered orthopedic surgery, it was a match made in heaven. What canpatients expectwhen theyfirst meetwithyou? My job as a surgeon is to make surgery a last resort. Heading to the doctor is no small feat, and I know very few people who look forward to it. My goal is to make you feel well cared for and happy you took the time out of your day to come get the answers to what is ailing you and have a concrete plan in place for treatment moving forward. What canpatients expectwhen theyfirst meetwithyou? Patients should expect a warm and welcoming personality and a provider who truly listens to their concerns. I prioritize establishing a good rapport in order to enable open communication and efficient problem-solving. What are someofyour hobbies? Anything outdoors! Alpine and cross-country skiing, mountain biking, dirt biking, moto trials, sailing, hiking, backpacking, golfing, fishing, hunting—the list goes on. What drewyou toKootenai Health? Being from a large city, it’s easy to appreciate smalltown values. This is evident in the pride the community has in its hospital system. Everyone I’ve talked to has had nothing but good things to say about Kootenai Health. We look forward to further establishing our family in this beautiful and welcoming community. What isyour favoritehealthy tip? Eat real food and eat less of it. Get your heart rate up a few times a week. Enjoy life and do good things for other people. Wheredidyou receiveyourmedical degree? I received my master’s degree in physician assistant studies from University of St. Francis in Albuquerque, New Mexico. For the four years prior to coming here, I practiced in a busy cardiac surgery program in Rockford, Illinois. What are someofyour hobbies? Hiking, golfing, tennis, pickleball, reading books for pleasure, walking the dog and taking care of the yard. What drewyou toKootenai Health? I appreciate the community environment with excellent health care professionals in every specialty and a desire to create an inclusive environment for healing. What isyour favoritehealthy tip? Take a look at your shoes. If the sole is getting worn down or worn unevenly, you need a new pair of shoes or possibly an insert to balance you out. It can be as simple as a good supportive shoe to start making your feet feel better. Wheredidyou receiveyourmedical degree? I did my medical school at Wayne State University in Detroit and orthopedic surgery residency at the University of Michigan. I completed a one-year fellowship in foot and ankle orthopedic surgery at OrthoCarolina in Charlotte, North Carolina. —Continued on page 14

14 —Continued from page 13 Cameron Shumway, D.O. Kootenai Clinic Cancer Services Tell us abit aboutyouand your family. I grew up in Utah and attended college locally. While there, I met my wife, who is from central Washington. She is a registered nurse and currently works full time as a mom to our three young kids, ages 2 to 7. We have lived in several regions of the country but are excited to be back in the Northwest and become part of the community here. Whydidyoupickyour specialty? When I was younger, my father was diagnosed with an advanced stage of colon cancer. As I watched him struggle with his disease, I saw how much of a difference his oncology team made to his experience. I saw moments where they truly connected and addressed his concerns and others when this was done to a lesser degree. It was then that I decided to pursue oncology as a career in hopes of making others’ cancer journey a little easier by taking time to listen, identify concerns and address each one in a way that hopefully makes sense for the patient. What canpatients expectwhen theyfirst meetwithyou? A cancer diagnosis is as stressful as almost anything I can imagine. I hope that at the end of their first visit, each patient will feel a little more control over the situation as they gain a better understanding of their disease, treatment options and potential outcomes. After reviewing all this information, I want to share the decision-making process with each patient as they determine how to move forward, depending on their personal values and goals. What are someofyour hobbies? I love hiking, camping, fishing and all sports. At this point in life, most of my spare time is spent with my wife and kids, riding bikes, swimming, playing outside and visiting cousins. What drewyou toKootenai Health? The more I have gotten to know Kootenai, the more impressed I am with the balance they strike between providing high-quality care while maintaining a feel of community and connection with patients. What isyour favoritehealthy tip? As an oncologist, I feel obligated to recommend that everyone complete screening mammograms and colonoscopies. Beyond that, I would just encourage everyone to stay active. It makes all parts of life easier and all treatments more tolerable. Wheredidyou receiveyourmedical degree? I graduated from Lincoln Memorial University in Tennessee and then completed my residency in internal medicine at McLaren Greater Lansing–MSU, followed by a fellowship in hematology-oncology at Michigan State University. Clinton Thurber, M.D. Cardiac Electrophysiology Tell us abit aboutyou andyour family. I grew up in Texas but did my heart rhythm training in Boston. My wife and I and three boys love the outdoors and are thrilled to plant roots here in northern Idaho. Whydidyoupickyour specialty? I have had a lifelong interest in cardiovascular health, but the electrical circuitry of arrhythmias has become particularly fascinating to me. The field is rapidly advancing, and there is new technology developed every year to address arrhythmias—it is exciting to be a part of it!

KH . ORG 15 Matthew Womeldorff, M.D. Kootenai Clinic Neurology Tell us abit aboutyou andyour family. My wife, Kayla, and I both grew up in Coeur d’Alene. We met in high school. We both went to the University of Idaho for undergraduate, and we were married after my first year in medical school. We have a 9-month-old son, Henry, and a cat named Nova. Whydidyoupickyour specialty? I developed an interest in neuroscience early in my college education, and in medical school I gravitated toward neurology because of the intellectual and complex nature of the specialty. Having the opportunity to work with neurology patients and their families through vulnerable moments is a rewarding privilege. What canpatients expectwhen theyfirst meetwithyou? A warm, welcoming and open-ended discussion. I enjoy listening to patients’ stories and asking directed questions to best understand and serve their needs. We will work diligently and efficiently together toward excellent, comprehensive care for their neurologic concerns. What are someofyour hobbies? I enjoy reading, hiking, exercising, trying new restaurants, traveling and spending time with my wife and son. What drewyou toKootenai Health? We were hopeful to someday return to the beautiful Pacific Northwest. I chose Kootenai Health because of its commitment to excellent patient care and outstanding support to physicians. We are excited to have the opportunity to come back to our hometown. What isyour favoritehealthy tip? Staying hydrated can help you feel your best. Keep a water bottle with you to drink from throughout the day. Wheredidyou receiveyourmedical degree? I received my medical degree from the University of Utah School of Medicine in Salt Lake City. I completed both my residency in adult neurology and fellowship in clinical neurophysiology at the University of Rochester Medical Center in western New York. Kootenai Health is my first position after fellowship. What canpatients expectwhen theyfirst meetwithyou? Visiting one-on-one with patients in clinic is one of my favorite things to do. Patients can expect to make important, personal decisions while I act as their guide and source of information, including what all of the most up-to-date research tells us on the topic. What are someofyour hobbies? I enjoy backpacking, snowboarding, travel and music. What drewyou toKootenai Health? Besides the beautiful northern Idaho scenery, I was compelled by the collegial atmosphere at Kootenai. There is evidence of teamwork everywhere, and people who genuinely enjoy spending time together both during and after work. What isyour favoritehealthy tip? Prevention is the best medicine—come visit us early for your heart health! Wheredidyou receiveyourmedical degree? I went to medical school at the University of Texas. Most recently, I completed my subspecialty training in heart rhythm disorders at Harvard Medical School in Boston.

16 By Shannon Carroll “Does anybody have Dave’s mailing address?” read the text to a group of my former co-workers. Though we’ve not worked together for nearly 10 years, we have remained in contact. As I read the series of texts coming in from my old friends, I realized there was a big piece of information that I hadn’t received. “It’s just terrible,” read one. “It doesn’t even seem real,” read another. COVID-19 had put a bigger gap in our already infrequent visits, so I had a bad feeling from the tone of the exchange. “Wait, what happened?” I asked. I could tell from the delay in a response that nobody wanted to tell me. Finally, a text came in that shared the news. “Christine died this morning. It was colon cancer. They didn’t tell many people, and it happened very quickly.” My heart sank as I remembered Dave’s beautiful wife, Christine— 50 years old and by all accounts an active, healthy woman with many decades ahead of her. I remember attending their wedding and seeing their adventures together play out over the years. They had a love story that was inspiring and enviable. Colorectal Cancer The news of Christine’s death could not have been more timely. I had just had my annual checkup and, based on my age of 49, my provider suggested I take an athome test that screens the stool for evidence of precancerous polyps or colon cancer. After the news about Christine, I didn’t hesitate. At-home tests are aneasy, convenient option My provider prescribed an easyto-use at-home screening kit that was delivered to my door. Simple instructions outlined how to collect a stool sample and return it to the laboratory where it would be tested for blood and abnormal DNA. After about a week, I received a message from my provider—the test came back positive and I would need to get a colonoscopy. I couldn’t help but think of my friend. I soon had a colonoscopy appointment with Kootenai Clinic gastroenterologist David Johnson, M.D. Throughout the entire process, he and his care team made me feel at ease and I knew, whatever the outcome, I was in good hands. Most colorectal cancers begin as a polyp, or abnormal growth in the colon or rectum. Some types of polyps can change into cancer over time, but not all polyps become cancer. Removing polyps is a way to prevent cancer from developing. “Colorectal cancer is the secondleading cause of death from cancer in the United States, yet it can be prevented by removing polyps or cured with surgery when detected at an early stage,” said Dr. Johnson. “Several types of tests can be used—visual tests (colonoscopies) and stool tests that you can administer easily at home. The most important thing is to get screened.” HITS Prevention and early detection are so important: Learn your screening options and take charge of your health today Kootenai Clinic gastroenterologist David Johnson, M.D., and family medicine physician Ryan Gilles, M.D. Christine Gill Flowers HOME In loving memory of Christine Gill Flowers

KH . ORG 17 Different screening options “It’s necessary for primary care providers to make their patients aware of the importance of colorectal cancer screening and the different options available to them,” added Kootenai Clinic family medicine physician Ryan Gilles, M.D. “Colonoscopies are still the gold standard for detecting precancerous polyps, but at-home stool tests are also very effective. They are a great option for those who may have a hard time getting to a medical center that performs colonoscopies or have general reservations about the procedure. What matters most is that patients get tested so we can detect and remove precancerous polyps before they become cancer.” To Dr. Gilles’ point, Dr. Johnson was able to pinpoint and remove precancerous polyps during my colonoscopy. I now know to schedule regular colonoscopies as an ongoing preventive measure for my colorectal health. “There is a big difference in the survival rate among those with stages I to II colorectal cancer and those with stages III to IV,” said Dr. Johnson. “We see a lot of colon cancers that could have been prevented, had abnormalities been detected early. We strongly recommend you talk to your health care provider about screening options, including a colonoscopy or an at-home test, and call us at the first sign of symptoms.” Dr. Gilles added, “It’s so important to take charge of your own health. As physicians, we’re here to work with you to provide you with the preventive tools you need to live your best life.” Checkups are amust I am one of the lucky ones. My provider knew I should take steps to monitor my colorectal health, including cancer screening; exercise; and a diet rich in vegetables, fruits and whole grains. If you are age 45 or older, talk to your primary care provider about the colorectal cancer screening option that works best for you. David Johnson, M.D., performs a colonoscopy. You have options. For answers about colorectal cancer screening, visit KH.org/gastroenterology or call (208) 625-4595. Colorectal Cancer Q&A Q:What symptoms should I be concernedabout? People do not always have symptoms, especially in early stages—that’s why it is important to get tested. Contact your health care provider if you notice any unusual symptoms, such as blood in your stool; abdominal pain, aches or cramps that don’t go away; changes in stool characteristics; or unexplained weight loss. Q:Whenshould I start getting screened? Both men and women should start at age 45. Talk to your primary care provider for screening options. Q:What types of tests screen for colorectal cancer? • Stool test (done in the privacy of your own home): You will not need sedation, special preparation or time off from work or regular activities. • Colonoscopy (visual test, done in a doctor’s office): This test uses a tube with a tiny camera to look inside your colon and rectum to identify and remove polyps and/ or cancerous-looking tissue. Dedicate a day to prepare and a day to recover. Requires sedation. Q: Howdo I pay for a screening test? Most insurance plans, including Medicare, cover all of the tests listed above. Check with your insurance company about your coverage.

18 PUT YOUR Best Foot Forward By Shannon Carroll Many of us know the relief of taking off a pair of tight shoes after a long day. While sky-high stilettos or fancy loafers can make year-round fashion statements, it’s important to be aware of the potential damage that some shoes can do to our feet. Kootenai Clinic foot and ankle orthopedic surgeon Ed Rooney, M.D., said one common condition that can occur from ill-fitting shoes is a hammertoe—when the big toe encroaches on the second toe, causing it to elevate and hammer down toward the ground. Hammertoes can also occur due to arthritis in the toe, a high foot arch or bunions. “A hammertoe occurs when toe muscles that are responsible for straightening and bending the toe tighten and cannot stretch out,” said Dr. Rooney. “When toes become bent at the middle joint, they can curl upward—in the shape of a hammer—and can potentially overlap and affect other toes.” Foot care As a hammertoe progresses, toe muscles become unable to straighten the toe entirely, even when there is no confining shoe. Women who frequently wear high heels are more susceptible to hammertoe because a higher heel forces the foot down and crams the toes against the shoe, increasing the pressure and the bend in the toe. “After a while, the tissue underneath the toe will become stretched, and the toe will drift further up,” Dr. Rooney said. To prevent a hammertoe, Dr. Rooney recommends avoiding frequently wearing narrow-toed Simple tips to prevent painful foot ailments Hammertoe Kootenai Clinic physical therapist Lucas Hammond treats a patient.

KH . ORG 19 shoes: “You can certainly wear your flashy shoes, but don’t make them the mainstay of your footwear.” At the onset of a hammertoe, doing toe-flexing exercises or using a strap that provides a cushioned barrier between the toes and shoe can help. “When it comes to overall foot care, a stiffer-soled shoe with a wider toebox is better,” said Dr. Rooney. “Shoes with a cushioned midsole provide shock absorbency and added comfort, which can help protect your joints. Over-the-counter orthotics from drugstores and custom orthotics can provide helpful support for flat feet or high arches.” Surgical relief Hammertoe surgery is considered a last resort, but if a hammertoe has worsened to the point of requiring surgery, Dr. Rooney will consider if the toe’s deformity is flexible or rigid. “A flexible deformity involves moving the tendon from the bottom of the toe to the top of the toe,” Dr. Rooney said. “A rigid deformity requires fusing the affected joint with pins, screws or other implants to keep the toe straight.” Kootenai Clinic physical therapist Lucas Hammond, who treats patients after foot and ankle procedures, typically sees patients a few weeks after hammertoe surgery. “We’ll work on mobilizing the joint while surgical incisions heal and ensure we’re not stressing those surgical sites,” Lucas said. “As time from surgery increases, we’ll focus on dynamic, more advanced exercises to help with walking and weight-bearing.” Steps togoodhealth Lucas said at-home exercises can help strengthen the feet and toes and help prevent conditions such as hammertoe. “It’s helpful to stretch your toes out with your hands,” said Lucas. “To improve the foot’s overall strength and balance, stand on one foot, place a hand on the counter to steady yourself and make a circular motion in the air with your other foot. Repeat this for 30 seconds three times on each side.” Whether treating toes, feet or ankles, Dr. Rooney approaches his practice by considering a patient’s entire story, not just the pain they are experiencing. “I care about my patients,” said Dr. Rooney. “I want to know their stories, their backgrounds and what led them to this point. Our feet are such an important part of maintaining an active, healthy life. Helping patients regain good foot and ankle health is the best part of my practice.” Hammertoe Relief You Can Try at Home Dealing with the pain and stiffness of hammertoe? There are three at-home exercises you can do to strengthen and increase the flexibility of your toes: Toe crunches with a towel. This exercise is done by laying a towel flat on the floor and gathering it beneath your toes 10 times, then pushing the towel outward 10 times. Flatten the towel and repeat this series three times. Toe raises. Place both feet side-by-side and slowly raise your heels, keeping your toes on the ground. Hold for four seconds. Repeat three sets of 10 for each foot. Toe taps. Gently extend your big toe toward the floor and flex your other toes upward. Hold this position for one second, then bring the raised toes back down to the floor. Repeat this 10 times. Round out the exercise by doing the inverse motion: Bring the big toe up as you keep the others on the floor and hold for one second. Repeat another 10 times. Leg and feet expertise In addition to foot complaints, Dr. Rooney specializes in ankle arthritis, lower extremity deformity, ankle replacements, flatfoot or high-arched feet, bunion surgery and many other ailments affecting the lower leg. To schedule an appointment with Dr. Rooney, call Kootenai Clinic Orthopedics at (208) 625-6111 or the orthopedics office in Post Falls at (208) 625-6700. Ed Rooney, M.D.

20 By Shannon Carroll Over the past two years, many event planners were forced to rethink how to engineer their gatherings. Social distancing and the threat of the pandemic created the need for virtual and drive-thru events. While traditionally unconventional, these ended up being special and festive in their own way. Kootenai Health Foundation’s Festival of Trees was one such event that had to adjust with the changing times by limiting attendance and creating a virtual way to view the trees. Now in its 34th year, we are excited to announce that the 2022 Festival of Trees will once again be a live, in-person event! “The Festival of Trees is just a special event,” said Cara Nielsen, Kootenai Health Foundation president. “It’s one of these beloved celebrations that not only brings the community together to enjoy something special during the holidays, but it helps provide resources to ensure our community hospital can continue to provide quality care for our growing region.” Holidaycheerandthespiritofgiving The Kootenai Health Foundation raises funds throughout the year that help expand and grow services and cover costs of patient and caregiver programs. The Foundation has been supporting the hospital with patient and caregiver resources since the Foundation was established in 1983. “Without the Foundation, we wouldn’t be able to provide the same level of care that our community has become accustomed to,” Cara said. “Our donors are the lifeblood of this community. Their support directly impacts programs and services the hospital wouldn’t be able to offer without their contributions.” For over three decades, families have been enjoying this event, and it’s become as strong a holiday tradition as driving by neighborhood light displays, photos with Santa and lighting the menorah. Cara Nielsen, Kootenai Health Foundation president Kick Off the Season & SUPPORT COMMUNITY HEALTH CARE FESTIVAL OF TREES IS BACK TO ENJOY IN-PERSON THIS YEAR!

“We are proud to support the Festival of Trees and Kootenai Health in their mission to provide quality health care for our community.” —Michael and Gayle Stegmann The Festival takes place at the Coeur d’Alene Resort on Nov. 25 and 26 this year. See the Festival of Trees ad on the back cover of this magazine for details and a list of events! Purchase your $5 raffle tickets by Nov. 26 at KH.org/festival. Each year, community organizations and businesses donate elaborately decorated trees that are adorned with gifts, each with a value of at least $2,000! They are then beautifully displayed at the Coeur d’Alene Resort for visitors to view—this year on Friday, Nov. 25—as part of a huge community kickoff to the holidays that includes a lighting ceremony, parade and fireworks. Raffle tickets can be purchased to win one of the Festival’s stunning trees. The rest are auctioned to the highest bidders. Santa is also there and loves getting his photo taken with anyone who stops by! Funding theHeart Center With every Festival, fundraising is focused on one particular area. This year, all proceeds from the event will benefit the 41,000-square-foot Heart Center expansion underway at Kootenai Health. “As community health care needs grow across the region, Kootenai Health needs to keep pace in our surgical and heart center capacity,” said Jeremy Evans, chief operating officer of Kootenai Health. “We’re very proud of this addition. Expanding the Heart Center will enable Kootenai to offer more complex, higher-acuity services and quicker access to its operating rooms. This is one of the major steps we’re taking to position the hospital as a national leader in cardiovascular care.” Help support this important expansion to our community hospital while enjoying one of the most anticipated events of the year in our community! Filling aVital Need Since 1989, the Festival has brought in just over $8 million for the endowment fund, emergency services, new cancer centers, women’s and children’s services, cardiac care, innovative advancements to our neurosurgery program, employee support initiatives and much more. The beneficiary of the Kootenai Health Foundation’s 2022 Festival of Trees is Kootenai Health’s Heart Center Expansion Project. NEED: Kootenai Health serves a region that has grown exponentially over the past decade. Our specialized Heart Center has seen a significant increase in the patient population over its 18 years, and that continues to grow. Ongoing capacity constraints ultimately led to an exciting expansion project that will further advance our care for our community. GOAL: This project will add one cardiac catheterization (cath) lab, one electrophysiology (EP) lab and 10 pre- and post-procedure rooms to grow surgical treatment capacity. The expansion will help us treat 1,500 more patients per year in the cath lab and 100 more in the EP lab. VISION: Through the Heart Center expansion, Kootenai Health will improve access to critical cardiac services, reduce patient wait times and position ourselves to accommodate rising cardiovascular service needs well into the future. This important work will not be possible without your support. How to give For more information on supporting Kootenai Health’s Heart Center, visit kootenaihealthfoundation.org. Join in the merriment KH . ORG 21