Kootenai | Kootenai Health | Issue 4, 2023

Health KH .ORG ISSUE 4 | 2023 Facing cancer as a couple: Overcoming a doubly difficult challenge Fighting through heart failure Brian Marlow survives a widowmaker 40 years of philanthropy Celebrating four decades of community partnership and heartfelt generosity

KH.ORG 3 WHAT’S INSIDE Issue 4 | 2023 16 The finer points of fiber 12 Facing cancer as a couple 10 Future nurses can get on the fast track 6 Fighting through heart failure Follow Us 14 Surviving the odds: A heart attack with a happy ending 5 Connected care Kootenai Health and MultiCare Health System make medical care better than ever. 8 Meet our new providers Join us in welcoming three new caring experts to the Kootenai Health team. 18 Idaho-born and cared for Our NICU and pediatric teams handle fragile babies with the utmost care. 20 Forty years of philanthropy Kootenai Health Foundation celebrates four decades of community partnership and heartfelt generosity. 22 Ask the expert Kootenai Clinic neurologist Ramsis Benjamin, M.D., explains the six signs of stroke.

4 Health 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 Dave Bobbitt, Secretary and Treasurer Cindy Clark, Trustee Thomas deTar, M.D., Trustee Liz Godbehere, Trustee Steve Matheson, Trustee Robert McFarland, M.D., Trustee Chris Nordstrom, Trustee Administration Jon Ness, Chief Executive Officer Michelle Bouit, Chief Financial Officer Karen Cabell, D.O., Chief Physician Executive Cyndy Donato, Executive Vice President, People and Culture Kelly Espinoza, Chief Nursing Officer Jeremy Evans, Chief Operating Officer Joel Hazel, Chief Legal Counsel Cara Nielsen, Kootenai Health Foundation President Ryan Smith, Chief Information 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. 2023 © Coffey Communications, Inc. All rights reserved. Community Is at the Heart of Who We Are This fall the Kootenai Health Foundation held a reception for many of its long-term donors. To kick off the evening, Cara Nielsen, the Kootenai Health Foundation president, encouraged the more than 100 guests to be part of an interactive exercise. Guests were invited to use their cellphones to text in one word that came to mind when thinking of Kootenai Health. Their words appeared on a screen, creating a “word cloud.” The more frequently a word was mentioned, the larger it appeared on the screen. I was pleased to see how often the word “community” was mentioned. One definition of community describes it as “a feeling of fellowship with others, as a result of sharing common attitudes, interests and goals.” Surely one of the most important attributes of exceptional care is having a health care team that shares your interests and goals for your personal health. Higher levels of care Over the past 10-plus years, the community Kootenai Health serves has been expanding. We are now the regional referral center for higher levels of care for all of northern Idaho. Patients throughout the region regularly come to us seeking care for cardiology, oncology, neurology, complex surgeries and more. Recently, our work to expand the Kootenai Health Heart Center has helped ensure we have the capacity to continue providing that care. In the past year, the Heart Center served more than 3,200 patients, and all indications are that the need is only increasing. As we finalize the expansion, this year’s Festival of Trees will provide an opportunity for our community’s generous donors to join us and identify additional opportunities to help even more patients in need. Kootenai Health began in the 1960s as a community hospital. Although our community has grown, that feeling of community and all it means is still at the heart of who we are. Whether we are hiring more physicians, adding new specialties or working to ensure every cardiac patient can receive safe, timely care, we are here for you. Wishing you good health, Jon Ness

KH.ORG 5 Connected Care Kootenai Health and MultiCare Health System make medical care better than ever By Kim Anderson Getting care for an ear infection, a UTI, a sprained ankle and a dozen other urgent but relatively minor ailments just got easier. Earlier this year a new urgent care clinic, Indigo Urgent Care, a partnership with Kootenai Health and MultiCare Health System, opened in Coeur d’Alene. Families and individuals of all ages can be seen at Indigo Urgent Care for their unexpected minor health conditions. The clinic offers online appointment booking and virtual visits in addition to traditional walk-in visits. Patients needing follow-up care or referrals can be seamlessly connected to their Kootenai Health primary and specialty care providers. This joint venture is not a move toward a merger or acquisition. Although they are working collaboratively, both organizations are independent, nonprofit, community-based health care providers. Kootenai Health and MultiCare have worked together before, on projects such as Kootenai Health’s adoption of MultiCare’s Epic electronic health record, group purchasing efforts and behavioral health initiatives. Convenient access to care Kootenai Health operates three Kootenai Urgent Care locations in Kootenai County, and MultiCare has 40-plus Indigo Urgent Care clinics in Washington state, including seven urgent care clinics in the Spokane area. As the population of Kootenai County continues to grow by an estimated 7,500 to 10,000 people annually, urgent care clinics are an important point of access to care for many residents. “Kootenai Health exists to ensure people in northern Idaho have access to the care they need close to home,” said John Weinsheim, executive vice president of Kootenai Clinic and a member of Indigo Coeur d’Alene’s executive steering committee. “Partnering with MultiCare to bring Indigo here is a creative way to meet the community’s need while both organizations are also working to restore their financial strength.” In addition to having a modern, convenient location on Ramsey Road near WinCo Foods, Indigo provides another way to receive care that is connected to Kootenai Health and Kootenai Clinic. Visit us online! KootenaiUrgentCare.com IndigoHealth.com. Readily available records Indigo Urgent Care and Kootenai Urgent Care are connected to the same electronic health record as Kootenai Health, all 21 Kootenai Clinic practices, Kootenai Outpatient Imaging and Kootenai Outpatient Surgery. This means the physicians, providers and care teams at all these locations can see patients’ medical records for care received at every other location. Records of prescription medications, imaging, lab work and medical history are all readily available. Patients using the Epic MyChart mobile app or website can also see records of their care—as well as reminders for regular health screenings and more—through MyChart. Together, Indigo and Kootenai Urgent Care are available to provide the care you need when you need it right away.

6 By Shannon Carroll Widowmaker. Few words instill more fear in a person. A widowmaker heart attack happens when there is a full blockage in the heart’s biggest artery. Immediately life-threatening, the blockage makes it impossible for blood to move through the vessel that provides 50 percent of the heart’s blood supply. In October of last year, Brian Marlow knew the pressure in his chest was nothing he had experienced before, so he called 911. “I woke up two weeks later, after being put in a medically induced coma,” Brian shared. “I had suffered a widowmaker— my chance for survival was 50/50.” Cancer and kidney issues had plagued him over his 59 years, so fighting through serious health issues was nothing new to him. “I definitely knew I was in for a long fight, but I felt extremely well cared for by everybody at Kootenai,” he said. During Brian’s ordeal, Kootenai Health helps Brian Marlow survive a widowmaker his kidneys shut down and he required dialysis. “The machine was brought right to my room, so I could receive my treatment without a lot of movement or interruptions. I could just stay in my bed and remain comfortable,” he said. ‘I am so grateful’ But Brian’s body could only recover from so much, and one of his heart valves was leaking. Kootenai Heart Clinic cardiologist Eric Wallace, D.O., quickly determined that Brian’s best chance for survival was immediate repair. “Kootenai Health has long-standing partnerships across the region to connect patients with precise, specialized treatment necessary for some cases, like Brian’s,” said Dr. Wallace. Brian needed a mitral valve clip on his damaged valve and was immediately airlifted to the University of Washington. After a successful procedure, he was brought back to Kootenai Health, where he remained in the intensive care unit for two weeks and had a particularly profound experience there. Fighting Through Heart Failure

KH.ORG 7 Eric Wallace, D.O. Casey Cotant, M.D. Charles Cui, M.D. Michele Murphy Cook, M.D. Shannon Miller, PA-C “My dad was terminally ill at the time. He and I had rooms right next to each other and shared the same amazing nurses,” Brian said. “He passed away, but I am so grateful to have had that time with him, and our bond with our care team was really special.” ‘Everyone was phenomenal’ After dedicating himself to eating healthy and exercising regularly through the clinician-monitored Kootenai Health cardiac rehabilitation program, Brian was healthy enough to receive an implanted cardioverter defibrillator in July of this year. “Dr. Murphy Cook and Dr. Cui were great with me during this process, too, just like Dr. Wallace was before,” he said. “Dr. Cui still personally calls me to see how I’m doing. My kidney doc, Dr. Cotant, has literally helped my kidneys function better than they have in my entire life. Everyone was phenomenal—the doctors, nurses, transportation, nutrition staff, rehab and Shannon Miller, who I see regularly at the Kootenai Health Heart Failure Clinic. All of these people came together to give me the best shot at staying here for my mom and my daughter.” Kootenai Health’s cardiac rehabilitation program helped Brian Marlow get back on his feet. See our expanded Heart Center! Thanks to the generous donor support of the Kootenai Health Foundation, a 41,000-square-foot expansion to the Kootenai Health Heart Center opened its doors in August of this year. The facility offers innovative equipment, procedures and specialists dedicated to serving the region’s most complex cardiac cases. Kootenai Heart Clinics includes 40 physicians and advanced practice providers specializing in general and interventional cardiology, electrophysiology, and cardiothoracic and vascular surgery. For more on heart care at Kootenai Health, visit KH.org/heart-services.

8 Trace Heavener, D.O., MBA Kootenai Clinic Gastroenterology Tell us a bit about you and your family. I grew up in a farming community in rural Oklahoma. My family loved to hunt, boat, hike and ski every chance we had. I met my wife, Hannah, while attending college, and we have been married for 17 years. Hannah is a registered nurse and loves to claim credit for making me into the doctor I am. We have four children—Teagan (14), Leah Kate (13), Eliza Belle (9) and Gabe (7)—and two Boston terriers, Luna and Lola. We are very close and enjoy spending time together traveling, playing games, cheering at sports events and all things outdoors. I enjoy re-creating positive memories of my childhood with my own family. Where did you receive your medical degree? I attended medical school at Oklahoma State University in Tulsa; did my internal medicine residency at Baylor Scott and White Hospital in Temple, Texas; and my gastroenterology fellowship back with OSU in Tulsa. I spent a year working as a hospitalist in Bolivar, Missouri, at Citizens Memorial Hospital in between residency and fellowship. I’m happy to be starting my career as a gastroenterologist with Kootenai Health. Why did you pick your specialty? The boring answer is that I have always found the digestive system to be interesting. However, the more accurate answer would be that I understand the simplicity of an “in” and “out” plumbing system. This specialty allows me the dexterity to interact with patients and perform technical scoping skills. I’m never bored. Meet Our New Providers What can patients expect when they first meet with you? I treat every patient like I would my own family. I will be kind, provide down-to-earth and simple explanations that anyone can understand and give them drawn-out pictures to explain procedures and dysfunctions. I welcome their input to create a care plan that fits their needs. What are some of your hobbies? I am an avid runner, competing in many ultramarathons and trail races. I love doing my own home renovation projects, especially those that allow me to buy a new power tool. I have a great sense of humor and share lots of “dad jokes.” What drew you to Kootenai Health? Initially the beautiful location in Coeur d’Alene drew me to the position. Once I met the staff and saw firsthand the importance of the hospital in the community, I felt confident that my career would have value here. As a competitive person, I appreciate being a part of the “best” in the Inland Northwest. My wife and I always wanted land in a location with a small-town feel, and this is it. What is your favorite healthy tip? Constipation is so prevalent, and hydration is the first step in addressing the issue. That’s why it’s important to stay hydrated by drinking at least 8 cups of fluids per day. Benjamin Milam, M.D. Kootenai Clinic Internal Medicine Post Falls Tell us a bit about you and your family. I am a native Texan, born and raised in San Antonio. I met my wife in medical school, and we have two beautiful children. Where did you receive your medical degree? I am board-certified in addiction medicine and internal medicine. I graduated from medical school at the American University of the Caribbean. I did my residency in internal medicine at Eisenhower Health in Southern California, and I did my fellowship in addiction medicine at the University of California, Riverside. After Kootenai Clinic Appointment Center: Need to nd a physician and schedule an appointment? Call the Appointment Center at (208) 625-6767 or request an appointment online at appointmentcenter.kh.org.

KH.ORG 9 graduating from my fellowship, I worked as faculty physician for the addiction medicine fellowship at UCR until moving to Coeur d’Alene. Why did you pick your specialty? Becoming an addiction medicine physician has allowed me to be a beacon of hope and healing in the lives of individuals who are crippled with one of the most challenging and stigmatized health issues of our time. I have a unique opportunity to make a profound difference in the lives of those affected by addiction, guiding them toward recovery, rebuilding families and restoring futures. Through my expertise, compassion and dedication, I can not only help provide stability but also contribute to breaking the cycle of suffering and transform communities for the better. What can patients expect when they first meet with you? My patients vary widely. When patients come to meet us for the first time, they will notice that we have a fantastic team that truly respects and cares for them. Our goal is to provide comprehensive, tailored medical care that focuses not just on the current affliction, but also on treating the underlying condition with an emphasis on safety and comfort. What are some of your hobbies? Skiing, hiking, biking, getting out on the water or just playing a board game with my family. What drew you to Kootenai Health? Characteristics attributed to Kootenai Health are its patient-centered care, strong team culture, and policy of empathy and caring for their patients. What is your favorite healthy tip? Exercise and play sports or anything that gets the heart rate up. Do it for 30 minutes three times a week. Play games that make you think, like board games, puzzles or whatever you like. Together they keep the mind and body healthy and happy. Brooke Potratz, M.D. Kootenai Clinic Family Medicine, Rural Health Tell us a bit about you and your family. I grew up in Sandpoint, Idaho (“Go Bulldogs!”). My husband, Wes, is also a northern Idaho native. We returned to Coeur d’Alene in 2020, when I started residency at Kootenai Health. We have a golden Lab, named Bodhi. We enjoy being close to family and friends and adventuring in the great outdoors. Why did you pick your specialty? I attended the University of Washington School of Medicine as part of the Idaho WWAMI class. I completed my first two years in Moscow, Idaho. During my third year of medical school, I participated in an outpatient longitudinal clerkship in Sandpoint, where my love of family medicine developed. I am passionate about caring for patients at all stages of life, especially developing relationships with patients. I am particularly interested in rural medicine, point-of-care ultrasound and hospital medicine. What can patients expect when they first meet with you? It is important to me to listen to patients about their lifestyle and their medical history. I believe patients are ultimately responsible for their health, and it is my goal to support them in being their healthiest selves. I tend to be a direct communicator and hope to clearly talk to patients about their medical concerns and questions. I also understand that the medical system can be confusing and challenging, so I try to support my patients as they navigate the medical system as a whole. What are some of your hobbies? My husband and I enjoy the lake, the mountains, home renovations and outdoor activities, including skiing, hiking, cycling and boating. I also delight in spending time with family and friends, cooking, and reading. What drew you to Kootenai Health? Before medical school, I worked in the imaging department at Kootenai Health. During that time, I saw the residency program start and develop into a great training program. As a native to the area, I was very fortunate to be able to return to Kootenai to complete my residency. The culture of Kootenai Health has always been positive and encouraging. It is a large enough system to meet patients’ needs and yet small enough where you are able to know people from many different areas within the organization. What is your favorite healthy tip? Any lifestyle change is a “work in progress.” Lasting changes take time. Wellness is the most important investment you can make in your life. Strive for the best health you can have in all areas of your life by making mindful, healthy choices.

10 Idaho State University and Kootenai Health have joined forces to help anyone with a bachelor’s degree become a nurse in as little as 12 months By Lee Ann Waldron and Kim Anderson Idaho State University and Kootenai Health have joined forces to bring ISU’s Accelerated Bachelor of Nursing (ABSN) undergraduate program to the Coeur d’Alene area. Through the program, people who have earned a bachelor’s degree in another subject can go through a 12-month training program that prepares them to take the National Council Licensure Exam (NCEX-RN) and move directly into practice as a registered nurse. The program is currently offered at ISU’s main campus in Pocatello and its satellite campus in Meridian, with 90 seats available between the two southern Idaho locations. Plans are for the new cohort in Coeur d’Alene to offer 10 seats for its initial 12-month program. Additional seats can be added for future cohorts, depending on demand. “We are pleased to be home to ISU’s accelerated BSN program in northern Idaho,” said Kelly Espinoza, Ph.D., RN, chief nursing officer for Kootenai Health. “We are committed to providing a learning environment that leads to the utmost success for these students, which ultimately translates into improved patient care for those we serve.” A critical nursing shortage Hospitals, physician practices and many other health care settings across Idaho have experienced difficulty filling vacant positions because of a nationwide nursing shortage. This shortage has been especially hard-hitting in rural communities, including many in the north. Temporary, traveling nurses have been hired as a stopgap solution, but because wages are high for traveling nurses, this solution is too expensive to be sustainable. The Idaho Nursing Workforce Center at the Idaho Center for Nursing has reported that Idaho’s shortage of registered nurses ranges between 106 and 523 annually. Although the COVID-19 pandemic both highlighted and compounded the nursing shortage, FUTURE NURSES Can Get on the Fast Track

KH.ORG 11 it wasn’t the only contributing factor. Idaho’s nursing profession also faces retirements of a large number of the incumbent workforce. Currently, 29 percent of Idaho’s nurses are 55 years or older, and 3 percent of those are 65 years or older. While the number of nurses has declined, the need for nurses has only increased. According to the U.S. Department of Health and Human Services, more than 10,000 people turn 65 years old every day nationally, which further increases the demand for compassionate and caring nurses. An innovative program Increasing enrollment in ISU’s program is one key strategy to address the nursing shortage. The ABSN program at ISU offers the opportunity for individuals who hold a bachelor’s degree in another discipline to make a career change and enter the nursing profession. The program is three semesters in length, including one summer semester, so it can be completed in one year. Courses in Coeur d’Alene will be delivered at the Kootenai Health campus, and clinical learning opportunities will be provided to students across the panhandle region, including placements in urban and rural settings. Kelly Espinoza, Ph.D., RN Teresa Conner, PT, Ph.D., MBA Anyone with a bachelor’s degree in another discipline is eligible to enter the program. Depending on the individual’s field of study, additional prerequisite courses may be needed to ensure they are ready to succeed in the accelerated program. Prerequisite courses may be taken through ISU or another accredited college or university. Because every situation is unique, the best way to learn what is needed is by reaching out to Idaho State’s school of nursing advisor directly at sonadvis@isu.edu. Once any needed prerequisite classes are complete, students are eligible to enter the program. Applications are due in November of each year, and applicants are interviewed the following February. By March, applicants are informed of their acceptance into the program, and classes begin in May. Although the application deadline for the 2024 session has passed, now is a perfect time for interested students to reach out and begin the process of having transcripts reviewed and learning where and how to begin completing any needed prerequisites. Support and collaboration The accelerated BSN program started on ISU’s Meridian campus in 2002 and has consistently expanded to meet the program’s growing demand. Over 550 students have graduated from the program since its inception. Graduates of the program have a high rate of passing the NCLEX-RN national examination for registered nurses, which speaks to the quality of the program. Many of these nurses have remained in the area, helping fill Idaho’s need for nurses and patients’ needs for quality, compassionate care. “We are excited by this partnership with Kootenai Health and understand that we could not have offered this innovative program without their support and collaboration,” said Teresa Conner, PT, Ph.D., MBA, dean for the College of Health at ISU. “It truly opens doors for accelerated nursing education and the ability to address the critical nursing shortage in northern Idaho.” Students in Idaho State University’s accelerated BSN program work with their instructors to learn hands-on skills. Advance your career Learn more about the ABSN program at Kootenai Health at KH.org/ABSN.

12 FACING CAN By Kim Anderson Facing a cancer diagnosis is a challenge for anyone. The emotional toll on the patient as well as their caregiver is intense. For Mike and Jane Walker, the situation was doubly difficult. Following months of fatigue and other symptoms, the longtime Post Falls couple was each diagnosed with cancer over the course of a year. Jane, an activities director at a senior living facility, had been feeling rundown. She thought she might be experiencing a urinary tract infection, but her symptoms kept getting worse. It was February 2022 when Mike took her to the Kootenai Health emergency department. Jane was admitted to the hospital. A series of tests over the next five days determined she had myelodysplastic syndrome, a condition affecting bone marrow where the body no longer makes enough healthy, normal blood cells. One spouse with cancer is devastating. Mike and Jane Walker experienced cancer diagnoses and treatment together.

KH.ORG 13 NCER Nathanael Gay, M.D. Kevin Webb, M.D. David Chambers, M.D. and gallbladder through your pancreas to your intestines. Surgical procedures to correct the problem can range from a relatively simple bypass to a complex operation known as a Whipple procedure. The Whipple procedure involves removing the head of the pancreas, the first part of the small intestine, the gallbladder and the bile duct. Dr. Gay referred Mike to a surgeon who specializes in procedures for the digestive system: Jennifer L. Pasko, M.D., at Providence Liver and Pancreas. By this time, Jane’s condition had deteriorated to acute myeloid leukemia, a cancer of the bone marrow and the blood. On Dec. 9, 2022, she was back in the hospital at Kootenai Health. As if things couldn’t get worse, she was diagnosed with COVID-19. Once over COVID-19, Jane began her induction chemotherapy. “Over seven days, I watched the light go out in her eyes. Her fight was gone,” Mike said. “I was really worried about her. We were talking and (both) said she really needed a turnaround.” An inspiration It came in a most unexpected way. That night as Jane was sleeping, she had a spiritual encounter. “It was about 1 in the morning, and Jesus walked into my room,” Jane said. “He said, ‘I understand you want a turnaround day. When would you like that to be?’ I told him I’d like it to be tomorrow—I don’t know why —Continued on page 14 I didn’t tell him I wanted it today! He said, ‘Tomorrow you’ll have your turnaround day.’” The following morning, Jane wanted to get out of bed to use the bathroom, something she had been unable to do for some time. Mike saw the light was back in her eyes. Jane had her turnaround, but now it was Mike’s turn. Mike’s 6-foot tall, 195-pound frame had dropped to 155 pounds as a Couple “It has been a true privilege and pleasure to care for and provide the highest level of cancer care for Jane and Mike.” —Nathanael Gay, M.D. “While we were in the hospital we met with Dr. Nathanael Gay,” Jane said. “He’s an oncologist and also a hematologist, and I was scheduled for my first follow-up appointment.” “We were given the address for Jane’s treatment, but we didn’t know the name of the location,” Mike said. “When we pulled in to the parking lot, we were at the Kootenai Clinic Cancer Center. That was hard. We sat in the car for a long time before we went in.” Many patients with blood disorders receive care at Kootenai Clinic Cancer Center. Its on-site pharmacy and infusion center with comfortable chairs and trained staff are ideal for patients who need medication infusions for a variety of conditions. Another bombshell Over the next several months, Jane continued to receive treatment, but her condition wasn’t improving. It was mid-October when the next bombshell hit. Mike noticed his urine looked discolored. He wisely reached out to his longtime family physician, David Chambers, M.D., at Ironwood Family Practice, and was referred for testing. Mike ultimately went to Kevin Webb, M.D., at Kootenai Clinic Gastroenterology and Endoscopy, where he was diagnosed with a clogged bile duct. Bile ducts, also known as pancreatic ducts, are vessels that carry bile from your liver

14 A heart attack has a happy ending, thanks to some good fortune By Tolli Willhite “True miracles occur every day. They just happened to happen to me,” said Learon Tidwell, 72, from Newman Lake, as he described a day that will forever remind him how fragile life really is. Like many of us do, Learon and his family had company in town, and they were eager to show them the beauty of northern Idaho. They rented a pontoon boat and headed out to enjoy a lovely Sunday in June on Lake Coeur d’Alene. “Pops is going swimming too,” Learon promised his grandchildren. Those are the last memories he has of that day. After going for a Surviving the Odds swim and climbing back in the boat, he slumped over on his daughter Charlsie’s shoulder. “Call 911. Dad is having a heart attack,” Charlsie, an echocardiographer in the Heart Center at Kootenai Health, calmly informed her family as she began CPR on her dad. “She immediately jumped into action,” said Peggy, Learon’s wife and Charlsie’s mom. “Having Charlsie with us that day was the first of many blessings.” Counting their blessings While the pontoon boat made its way to Beauty Bay Marina as instructed, a jet skier on the lake noticed the commotion and came to help. Her name was Cindy, a certified nursing assistant vacationing from Alaska. Cindy and Charlsie took turns administering CPR. This was the second blessing of the day. East Side Fire District Deputy Chief Charlotte Pegoraro was off-duty but in the area when she heard the call come over her radio. She was in her command vehicle equipped with an automated external defibrillator unit and oxygen. This was the third blessing of the day. Within 30 minutes from the initial call to 911, agencies from across our region responded to assist, including Kootenai County Sheriff’s Office, Kootenai Country Fire and Rescue, Coeur d’Alene Fire Department and Medic 32. “So much happened during those 30 minutes, and with seamless integration of all these agencies,” Pegoraro said. “Everyone knew exactly what they were supposed to be doing and executed it amazingly well. It speaks volumes about the quality of emergency medical services in Kootenai County.” —Continued from page 13 when he went in for surgery on Jan. 10. Dr. Pasko had explained that option A would be a routine bypass surgery, but they would be prepared for option B, the Whipple procedure, if necessary. Mike woke up following surgery to a smiling Dr. Pasko. During surgery, she found he had pancreatic cancer and was able to remove it using the Whipple procedure. Because pancreatic cancer often goes undetected, it is frequently not diagnosed until it is very advanced and extremely difficult to treat. Mike’s bile duct surgery allowed for an early diagnosis and treatment that very likely saved his life. “Cancer is a formidable opponent, and diseases like myeloid leukemia and pancreatic cancer are two of the most difficult to treat,” said Nathanael Gay, M.D. “Despite the tremendous challenges they have faced, the Walkers have shown unwavering determination, positivity and support for each other throughout their treatment. They have been an inspiration to me and our staff. It has been a true privilege and pleasure to care for and provide the highest level of cancer care for Jane and Mike.” The Whipple procedure involves removing the head of the pancreas, the first part of the small intestine, the gallbladder and the bile duct.

KH.ORG 15 Comprehensive and compassionate See how Kootenai Clinic Cancer Center can help you. Visit KH.org/cancer. Today, Mike and Jane are excited about what feels like a new beginning. Mike is working on a book, and they are planning a “victory cruise” with their family. Learon Tidwell and his granddaughter, Savannah On July 31, 2023, a bone marrow biopsy showed Jane has no evidence of leukemia. Just two days later, on Aug. 2, Mike was invited to ring a special bell in the Kootenai Clinic Cancer Center reserved to help celebrate those who have finished their cancer treatment. “God blessed us with the most amazing people throughout our medical journey,” Mike said. “Dr. Gay and physician assistant Megan Whitmore are top of the line, and our nurses, the people doing our intake, the people at the front desk, and the volunteers were amazing. They were all so patient and kind.” Today, Mike and Jane are excited about what feels like a new beginning for them. They are planning a “victory cruise” with their family. A published author, Mike is looking forward to his second book. “I feel like everything has been on hold, and now it’s like when I was a kid at the playground standing by the merry-go-round,” Jane said. “We’re looking for that space to jump back on.” LifeFlight transported Learon to Kootenai Health, where he was immediately intubated and admitted to the ICU. After stabilizing him, Eric Wallace, D.O., medical director of interventional cardiology at Kootenai Health, performed a cardiac catheterization. “It’s important for the public to know CPR,” said Dr. Wallace. Without Charlsie’s intervention, “her dad would have died.” ‘God was there with us’ Two days later, Robert Burnett, M.D., medical director of cardiothoracic surgery at Kootenai Health, performed an open-heart coronary artery bypass graft on Learon in the cardiovascular operating room. “Kootenai Health has a whole team of cardiologists, CT surgeons, cath lab team and more on call 24/7. Our staff works well with each other, placing each patient’s needs above everything else,” said Dr. Wallace. “We have capable medical facilities that are up to date and available for medical emergencies, which is something our recent Heart Center expansion accomplishes.” Today, Learon is at home resting with his wife of 48 years by his side. “Our 50th wedding anniversary is coming soon. I had to stick around for that,” a tearful Learon joked. Learon and Peggy are eager to thank their entire care team at Kootenai Health. “Everyone was so incredibly generous, kind and attentive,” said a grateful Learon. “I’ve told Dr. Burnett that ‘thank you’ is so inadequate for what he did for me.” “We’ve gone over and over it again so many times,” said Peggy, describing how everyone was in the right place at the right time to save Learon’s life. “God was there with us the whole time. There’s just no other explanation.”

16 By Kim Anderson We’ve all heard that adding fiber to our diets is a good thing. What isn’t talked about as often is the fact that there are different types of fiber and how each benefits the body in different ways. Knowing the differences and how each type works can help guide your choices and make a world of difference in your health. Insoluble fiber Insoluble fiber does not dissolve in water and will pass through the stomach and intestines (gastrointestinal, or GI, system) relatively intact. Insoluble fiber is not a source of calories because the body does not have the enzymes needed to break it down. It is important to recognize that the degree of processing (fine The Finer Points of Fiber vs. coarse particles) determines the effect of insoluble fiber on constipation. For example, coarse wheat bran particles can stimulate fluid secretion from the colon and relieve constipation. However, when finely ground, small particles of the same wheat bran no longer stimulate fluid secretion in the colon and the effect in treating constipation is lost. This is one reason why highly processed foods are typically less beneficial compared with more natural foods, even if the label advertises fiber content. Soluble fiber Soluble fiber can also treat constipation, but it does so in a different way, by attracting water and keeping it in the colon to soften stool. The most effective fibers for treating constipation, such as psyllium, found in Metamucil, work in this way—by holding on to water. This is why fluid intake is so important. “If you are going to increase fiber, you must also increase fluids,” said Leslie Wall, RD, LDN, CNSC, Kootenai Health registered dietitian and manager of clinical nutrition. “Too much fiber and not enough fluids can actually worsen GI symptoms, so increasing fluids along with fiber is very important.” Soluble fiber attracts water and turns to a gel during digestion. One benefit of soluble fiber is in slowing digestion and the rate at which carbohydrates and other nutrients are absorbed in the bloodstream. Slower absorption can help control the level of blood glucose, often referred to as blood sugar, and prevent rapid rises, or “spikes,” in blood glucose following a meal. What to know about this mighty material before adding more to your diet

KH.ORG 17 Soluble fiber can also interfere with the absorption of dietary fat and cholesterol. This helps lower lowdensity lipoprotein (LDL, or “bad”) cholesterol levels in the blood. This is one of the reasons oatmeal is often promoted as being good for heart health. “Soluble fiber can help with glucose control,” said Leslie. “If you think about the difference between white bread and whole-grain bread, Caleb Kelly, M.D., Ph.D., RD Leslie Wall, RD, LDN, CNSC the fiber in the whole-grain bread helps give it a much steadier rate of digestion and reduce spikes in blood sugar.” Soluble fiber is found in foods such as oats, barley, nuts, seeds, beans, lentils, peas, apples and blueberries. Metamucil is a common over-the-counter soluble fiber supplement. Some fiber supplements may not be appropriate for people with certain medical conditions, so if you have a condition such as celiac disease or diabetes, talk with your health care provider for guidance. Fermentable fiber Fermentable fiber is typically a subcategory of soluble fiber, but some insoluble fiber is also fermentable, meaning it can be processed by the gut’s microbiome. Although fiber passes right through the stomach and the upper part of the small intestine, it is in the large intestine that we see the added benefit of fermentable fiber. “Fiber is a nutrient that’s different from others,” said gastroenterologist and dietitian Caleb Kelly, M.D., Ph.D. “It doesn’t directly provide us with nutrition, but fermentable fiber provides nutrition to our gut microbiome. Our bodies don’t have the enzymes to break down fiber, but the microorganisms in the gut can break down fermentable fiber. This creates the production of short-chain fatty acids (SCFA), which can be used by the body as a source of nutrition and possibly even to prevent chronic diseases. For example, there is emerging research looking at how SCFA produced from fermentable fiber in the colon can regulate blood pressure in other parts of the body. SCFAs also have anti-inflammatory and anticancer properties, which may help explain why high-fiber diets are associated with lower risk of colon cancer.” Adding fiber to your diet If you are ready to begin introducing more fiber into your diet, plan to begin slowly. “The best approach to eating more fiber is to gradually increase over two weeks and drink more fluids along with the fiber,” said Leslie. “It’s similar to starting an exercise plan. Your gut needs time to adjust to the extra work it’s doing. Increasing fiber too quickly can leave you feeling bloated or give you a stomachache, so start with a small amount and increase it over a couple of weeks.” Whether you make a point of adding more fiberrich foods to your grocery list or finding a supplement that’s right for you, a small change can make a big difference in your health. Keep well A fiber-rich diet is one way to ensure colon health; another is through a screening colonoscopy. To learn more and watch an informational video about colonoscopies, visit KH.org/ gastroenterology.

18 By Caiti Bobbitt For most parents, the excitement of welcoming a new child into the world is unmatched. “From the moment you find out you are pregnant, you dream about meeting your baby,” said Gabby McDonald, “For me, I never imagined our reality would rob me of those first moments with my daughter.” When Gabby was 20 weeks pregnant, she started presenting signs of preterm labor. For over eight weeks, Gabby would do everything in her power to keep her baby girl where she needed to be—growing safely inside her. “I spent a lot of time with Gabby and her husband before she even delivered,” said Brook Lang, M.D., medical director of Kootenai Health’s neonatal intensive care unit (NICU). “I knew our NICU would be their baby’s first home, so it was important for me to have them feel like they could trust me when we were having really difficult conversations about their daughter.” New life in the NICU Gabby gave birth to her daughter, Freja, at 28 weeks and six days. She weighed just under 3 pounds at birth and was immediately admitted into the Kootenai Health NICU. “It was a very scary time for me and my husband, but it was made so much easier because of the incredible staff,” said Gabby. “We spent our first Christmas as a family of three in the NICU, and lived a lot of life during Freja’s 62-day stay. The staff became an extended part of our family.” Kootenai Health earned its Level III NICU designation in 2016, meaning the hospital could care for babies like Freja—as young as 28 weeks’ gestation Idaho-Born and weighing as little as 2 pounds. Since then, the NICU team has continued to work to be able to care for even younger and sicker babies. “The staff in the NICU have undergone a lot of training, and we were able to purchase some ventilator modalities needed to care for smaller babies,” Dr. Lang said. “Because of these advancements, we will now be able to care for babies as young as 26 weeks’ gestation and 1.5 pounds.” Prior to this work, the Kootenai Health NICU averaged five or six babies per day. Today, that number is closer to 10 to 12 babies. “A main goal of Kootenai Health and our NICU team is to be able to provide that higher level of care and also maintain the family-centered culture we have created,” said Dr. Lang. “As a mom, I know what it is like to look at Our NICU and pediatric teams handle fragile babies with the utmost care and Cared

KH.ORG 19 your child and see your heart outside of your body. The NICU is never a place we anticipate to be, and I always want families to know we are going to give the best care and advocate for their babies.” Today, Freja is a healthy 10-month-old baby who is busy keeping her parents on their toes. “She has always been sassy, from the second she was born,” said Gabby. Freja still has some respiratory issues that have led to near hospitalizations, but Gabby said if that were to happen, she knows her daughter would be in good hands. “I have a lot of confidence in the care Kootenai Health can provide my family. When you are there with your child, you can see that they are really caring for the entire family,” said Gabby. “Nothing prepares you for seeing your baby lying in a hospital bed,” said Kane’s mom, Darby Tingelstad. “As a Kootenai Health nurse myself, I have so much respect and appreciation for the care the pediatric team is able to deliver.” Kane’s first visit was at 5 days old for jaundice, following by four more hospitalizations for respiratory illnesses and, most recently, a tonsillectomy. “The team at Kootenai Health has always been so welcoming and have made being in the hospital less scary for him,” said Darby. “At this point, he just sees it as a place he can eat mac and cheese in bed, watch movies, and play with toys.” Much like the NICU, the pediatrics team has spent a lot of time increasing the level of patient acuity they are able to care for. The reason is simple: They know it is what is best for their patients. “Our goal from birth on is to keep kids in Idaho, receiving care close to their support system,” said Hinah Parker, M.D., medical director of pediatrics at Kootenai Health. “We have done so much work to build up our arsenal of tools here, and we are always looking for ways we can ensure the best patient experience and optimize all of our relationships and resources.” For moms like Gabby and Darby, it is reassuring to know that not only will their children be receiving incredible medical care, but their children will feel safe and taken care of. “We have a community feel,” said Dr. Parker. “I care for my children’s classmates, and we’ll see them in our day-to-day life at the grocery store or park. It means a lot to feel so involved in our patients’ lives, which is uncommon in an inpatient setting but something I really enjoy.” “I may not have had the ideal first moments with my daughter,” said Gabby. “But thanks to the care from Kootenai Health, I have my daughter here, and I know the best times are yet to come.” Happier birth days Learn more about the safe, comfortable care of our Family Birth Center at KH.org/birthing. For A home away from home Four-year-old Kane Tingelstad has had his fair share of hospital stays since he was born in November 2019.

20 By Britt Towery In 1983, a group of visionary community leaders recognized the need for a charitable foundation to directly support our community hospital. Little did they realize how much they would accomplish for the growing health care needs of northern Idaho over the next 40 years. of Philanthropy Celebrating 35 Fabulous Festivals! The Festival of Trees has raised nearly $9 million that enhance patient care are only possible because of our community’s generous donations to the Kootenai Health Foundation,” said Jon Ness, CEO of Kootenai Health. “Just as important as the financial component, however, is the opportunity to partner with people who are as passionate as we are about creating access to high-quality health care in our community. The difference we make when we work together is life-changing.” Working for and with the community As a not-for-profit hospital, philanthropic investments are critical to help the medical center meet its mission. The Foundation’s purpose is to steward donors’ investments and provide financial resources to Kootenai Health to impact patient care through the Over the course of the past four decades, the Kootenai Health Foundation has generated nearly $39 million in philanthropic support for the hospital. Major investments and projects include Cancer Centers in Coeur d’Alene and Post Falls, the Health Resource Center, the McGrane Center for Rehabilitation, the Heart Center, the emergency department expansion, the east wing hospital expansion, Neonatal and Children’s Services expansions, Critical Care expansion, the Walden House for patient and family hospitality, and the Cancer Patient Support Fund. “Many projects By Britt Towery The saying “It takes a village” rings true when looking back on the decades of support from local businesses, community members and hospital employees for The Festival of Trees events. Organized by the Kootenai Health Foundation, the annual, multiday fundraising event has raised almost $9 million for Kootenai Health. An event of this size and scale can only be accomplished with the passion, dedication and commitment of community members behind the scenes. The Festival Executive Committee is a group of dedicated volunteers that lead the event planning, while a multitude of other volunteers act as tree decorators, event staff, tree delivery angels and more to create a special occasion. 40 Years Kootenai Health Foundation celebrates four decades of community partnership and heartfelt generosity

KH.ORG 21 Also critical to the event’s success are longstanding partnerships with donors who support the mission of Kootenai Health—to improve the health of our region one patient at a time through compassionate and quality care. Mountain West Bank has been a steady supporter for 30 years; as the dinner’s premier sponsor, their employees greet guests and run the entire check-in and checkout process for the auction. “Our north Idaho team of bankers cherish the opportunity to volunteer at the annual Festival of Trees event expansion of facilities, best-practice clinical programs, state-of-theart equipment, and education and support services. Not only does the Foundation encourage private support from individuals, corporations, private foundations and other institutions, but it also partners with community members like you. Working alongside community partners, the Foundation’s board of directors and hospital leadership continue to ensure thoughtful investment of donor support in order to respond to the rapid changes in demographics and the health care needs of our community. The continual population growth of very active seniors and many young families relocating to the area requires high levels of emergency, neonatal and pediatric care. Philanthropic support ensures these higher levels of care remain strong and accessible to the people of our region. Shaping the future There are many ways you can support the Kootenai Health Foundation and become a partner in shaping the future of our hospital. Whether it be through donating your time and talent or giving money, the Foundation’s work would not be Giving changes lives To learn more about how you can make an impact, visit KH.org/foundation or call (208) 625-4438. and underpin our commitment to support the efforts of Kootenai Health Foundation,” said Mountain West Bank Chief Executive Officer Scott Anderson. We are grateful for the many decades of your partnership and investments. THANK YOU! possible without our generous board members, donors, volunteers, staff and community of friends. With immense gratitude we thank you. Your gifts change lives and support quality, compassionate health care in our community. We are humbled and awed by the generosity of our community over the past 40 years!