Top Neurosurgeon Brings Expertise and Experience to the Quad Cities

The first cranial neurosurgeries ever performed in the Quad City region took place recently at Yavapai Regional Medical Center (YRMC). The two successful surgeries— Ventriculoperitoneal (VP) shunting procedures—were performed by accomplished neurosurgeon, Harvey G. Thomas, MD, FRCFC, who joined YRMC six months ago.

“There is a need in the community for VP shunting,” Dr. Thomas said. “Now that this important service is available here, people who require it can remain close to home with support from family and friends.”

VP Shunting Surgery Performed at YRMC

VP shunting is performed to relieve pressure on the brain due to surplus cerebrospinal fluid, which may occur in people suffering from dementia, brain tumors or other conditions. This excess fluid can cause people to suffer from stroke-like symptoms. VP shunting re-routes the fluid, relieving the pressure on the brain and alleviating the patient’s symptoms.

During a VP shunting surgery, Dr. Thomas creates a small opening in the patient’s skull. He then inserts reed-thin tubing and directs it to the patient’s abdominal cavity. Dr. Thomas also places a dime-sized pressure valve under the skin behind the patient’s right ear. The tubing and valve together re-direct the fluid away from the brain to the abdomen where it can be reabsorbed into the body. The pressure valve is programmable and may be adjusted—opened for additional flow or closed tighter—even after the surgery by using a computer with specially designed software. The amount of cerebrospinal fluid around the brain is measured during CT scans of the patient’s head approximately four weeks after surgery and again six weeks post-surgery.

“A build-up of cerebrospinal fluid on the brain can cause forgetfulness, lack of concentration, problems walking and even incontinence,” said Dr. Thomas. “This procedure can relieve those symptoms for many people. And now, folks who need VP shunting don’t have to travel outside of our community for it.”

YRMC Prepares for VP Shunting

Before YRMC’s first VP shunting surgery, the hospital diligently prepared for the surgery by providing training for its nursing staff and purchasing special equipment for the surgical suite.

“VP shunting is the foundation for the hospital's entire Intracranial Neurosurgery program,” said Diane Drexler, RN, BSN, MBA, FACHE, YRMC’s Chief Nursing Officer. “The efforts we took to prepare for this surgery have established a strong foundation for the program going forward.”

YRMC’s nursing staff participated in classroom sessions led by Dr. Thomas and Physician Assistant Jeremy Platt, PA, PA-C. During these sessions, Dr. Thomas and Platt highlighted the role of the nursing team before, during and after VP shunting surgery. YRMC nurses also visited another hospital as part of their training program to prepare for VP shunting surgeries. From the pre-admission work the nursing staff pursues with patients, through surgery and recovery, YRMC’s nursing team was prepared to care for neurosurgical patients.

“Dr. Thomas has a great relationship with the nursing team,” Drexler said. “They know both Dr. Thomas and Jeremy are available to them as resources. This is so critical to a successful program.”

YRMC Launches Neurosurgery Program

Building the Neurosurgery program has been a collaborative effort between YRMC’s leadership—the executive team and its Board of Trustees—and Dr. Thomas.

“Every decision about the Neurosurgery program has been made with our community and patients in mind,” said Tim Barnett, YRMC’s President and CEO. “We are extremely pleased the program includes Dr. Thomas, who is an exceptional neurosurgeon, and a great addition to our community.”

Dr. Thomas, who is affiliated with YRMC PhysicianCare, came to the Quad Cities from the Phoenix-area, where he helped found Arizona Spine and Joint Hospital. He also served as that hospital’s Chairman of the Board. Before that, Dr. Thomas was Surgery Department Chair at Chandler Regional Medical Center. Dr. Thomas is board certified as a neurosurgeon by the American Board of Neurological Surgeons. In 2010, he was selected as a “Top Doc” by Phoenix Magazine.

Yavapai Regional Medical Center (YRMC) is among six healthcare organizations nationwide—four of them hospitals—to receive the CNA Leadership in Safety Award since it was initiated by CNA HealthPro in 2009. The award was presented to YRMC leaders in December by CNA HealthPro executives.

“Every day, I see people throughout YRMC demonstrating their commitment to the hospital’s Total Healing Environment,” said Tim Barnett, YRMC President and CEO. “However, when representatives of an organization outside of YRMC observe our values in action and then feel compelled to recognize us, I can’t help but feel extremely proud of the YRMC team.”
Chicago-based CNA is a major provider of professional liability insurance for hospitals and other healthcare providers throughout the country. The CNA HealthPro representatives with whom YRMC works nominated the hospital for this award.

“YRMC’s patient-centered approach to delivering care demonstrates its ongoing commitment to the community it serves,” said June Leigh, CNA HealthPro Assistant Vice President, Risk Control. The CNA Leadership in Safety Award recognizes healthcare organizations that have exhibited excellence in patient safety.

“We work with many outstanding healthcare organizations, but only a select few are recipients of this award,” Leigh said. “The award represents organizations with enterprise-wide patient safety and quality improvement programs – dedicating their resources to achieve measurable results focusing upon outstanding customer service.”

Physician Introduces Neurosurgical Specialty to Quad Cities

When Harvey G. Thomas, MD, FRCFC, joined YRMC PhysicianCare in September, he brought outstanding credentials, an exceptional team and years of experience. He also brought a much-needed medical service to the Quad Cities.

“With Dr. Thomas’ arrival, we welcomed one of Arizona’s finest neurosurgeons to our community,” said Don Bolin, MBA, CMPE, Executive Director of YRMC’s employed physician network, YRMC PhysicianCare. “Today, residents in need of delicate back surgery have access to this extraordinary neurosurgeon.”

Dr. Thomas comes to the Quad Cities and YRMC PhysicianCare from the Phoenix-area, where he helped found Arizona Spine and Joint Hospital in Mesa and also served as its Chairman of the Board. Before that, Dr. Thomas held the prestigious post of Surgery Department Chair at Chandler Regional Medical Center. Dr. Thomas is board certified as a neurosurgeon by the American Board of Neurological Surgeons. He also is active in the American Association of Neurosurgeons and the Royal College of Physicians and Surgeons.

“I’m delighted to join YRMC PhysicianCare and YRMC,” he said. “The staff is very impressive. They know how to care for critically ill patients. They also were very eager to begin a neurosurgical program. With that kind of enthusiasm, there was no question about whether or not I would join the team.”

Dr. Thomas—an expert on solutions to chronic back pain and cranial procedures—is a sought-after speaker for national medical conferences. He also publishes extensively in professional journals. One of his most prized recognitions, however, came in 2010 when he was selected as a “Top Doc” by Phoenix Magazine.

“The ‘Top Docs’ are selected by a vote of physicians, your peers,” he said. “That was quite an honor to me.”

Originally from Canada, Dr. Thomas received his medical degree from the University of Calgary. He pursued an internship at Edmonton General Hospital in Edmonton, Alberta, Canada and a residency in neurosurgery from Foothills Hospital in Calgary, Alberta, Canada.

When he re-located his neurosurgical practice to the Quad Cities, Dr. Thomas’ wellestablished team joined him.

“This was a group decision,” he said. “My core staff members and our families collaborated on the decision. In the end, the answer was a unanimous and enthusiastic yes!”

That core staff includes physician assistant Jeremy Platt, PA, PA-C.

“The addition of Dr. Thomas and his team is a boost to our entire community,” said Tim Barnett, President and CEO of Yavapai Regional Medical Center. “He brings extraordinary experience and also expands the scope of medical specialties available to the people of the Quad Cities.”

Dr. Thomas may be reached at:
YRMC PhysicianCare
820 E. Ainsworth Drive, Suite B
Prescott, AZ 86301
928-445-4818

When he is not caring for patients, Dr. Thomas likes to mountain bike on nearby trails.

“Even before we moved to the area, we visited nearly every weekend. This is such a welcoming community. It’s a joy to call it home now.”

Lymphedema Program at YRMC Helps
Breast Cancer Survivors Cope with the Aftermath

Susan G. Komen for the Cure Grant Reaches Low & Middle Income Women

Diane Bauer and Jeanne Hines have a powerful bond, even though they have never met. The two Quad City residents are breast cancer survivors who struggle with lymphedema. Both women have found relief through The Lymphedema Management Program at Yavapai Regional Medical Center (YRMC).

“Unless you have experienced lymphedema,” said Bauer, “it’s hard to understand its impact.”

Lymphedema is a side effect of cancer treatment that approximately 25 percent of breast cancer survivors experience. Its first signs may be as inconsequential as a heavy feeling in an extremity, a ring that seems tight, or even a watchband that doesn’t rest properly on the wrist. Initially, the swelling subsides at night but within weeks or months it becomes chronic and more intense. For some with lymphedema, the affected area can expand to several times its normal size. Lymphedema can limit mobility and affect how people feel about themselves.

“My arm began to get larger, especially the upper arm, and it was painful,” recalled Hines. “It felt like it was tearing on the inside. My hand began to swell, too. We called it my fat baby hand because it was chubby like an infant’s hand.”

That was in 2001, several years after Hines had undergone treatment for breast cancer. Bauer’s initial experience with lymphedema was different, but the results were similar. Her arm began to swell “fast and huge” when she began radiation therapy for breast cancer in April.

“I had never heard of lymphedema,” Bauer said. “I learned that it was something that could be treated but that it would always be with me, which is sad.”

Today, both women work every day to control their lymphedema. Thanks to The Lymphedema Management Program at YRMC—and a grant from Susan G. Komen Phoenix Affiliate—they have the knowledge and tools necessary to control their lymphedema. The tools are custom compression bandages and garments that are provided through a grant that YRMC received from Susan G. Komen Phoenix Affiliate this year. The grant targets low and middleincome women suffering from breast cancer-related lymphedema.

A Phased Approach to Treating Lymphedema

Donna Hannah, OTR/L, CLT-LANA, leads The Lymphedema Management Program at YRMC. Hannah is the only lymphedema therapist serving Yavapai County and one of eight in Arizona. Hannah—an occupational therapist who is certified by the Lymphology Association of North America (LANA)—has reached the highest level of accreditation in this specialized area. She sees firsthand the impact of lymphedema on breast cancer survivors.

“At first, they wonder if their cancer has returned and the whole experience of breast cancer tumbles back on them,” she said. “In the beginning, we talk about how lymphedema is a chronic condition, but one that can be controlled. Once they understand they can control lymphedema, we get to work.”

That work includes two major treatment phases, which typically last a total of four to six weeks or 16-20 visits. During the first phase, Hannah evaluates the patient’s condition and develops an individualized treatment plan. Plans may incorporate:

• Manual Lymph Drainage (MLD)—Lymphedema patients undergo intense manual lymphatic drainage, which Hannah teaches them so they can continue the practice after their treatment concludes. MLD is a massage technique that helps open working lymph nodes so they can help drain the affected areas. According to the Journal of the National Cancer Institute, combined with other therapies, MLD can reduce fluid up to 73 percent in breast cancer patients.
• Compression Therapy—Bandaging the affected area after an MLD session also reduces lymphedema swelling. Hannah instructs women on how to apply short-stretch compression bandages during the first phase of treatment.
• Exercises—Hannah works with patients on exercises that promote lymphatic flow and reduce swelling.
• Skin Care—Keeping the skin clean and moisturized and preventing trauma, such as cuts and scrapes, can lessen the chances of skin infection that can cause lymphedema to get out of control.

According to both Bauer and Hines, Hannah goes beyond the mechanics of treating lymphedema to help support and encourage patients.

"Donna has so much training and experience," Hines said. ¡§She¡¦s also incredibly compassionate. She helped calm me when I needed it."

Hannah is committed to educating patients about lymphedema so they can recognize it and seek early treatment. Lymphedema, for example, has stages:

• Stage l -- The area (arm, hand or leg) is swollen and feels heavy. Pressing on the swollen area may leave a dent.
• Stage II -- The limb is swollen and feels spongy. A condition called tissue fibrosis may develop and cause the limb to feel hard. Pressing on the swollen area does not leave a dent in this stage of lymphedema.
• Stage II -- In this advanced stage, the swollen extremity may drain lymphatic fluid, in addition to the other symptoms outlined in the earlier stage.

I work with patients to set goals," Hannah said. "One patient with advanced lymphedema said, "I have not been able to reach over my head for 20 years. I want to be able to screw in a light bulb.' We got her there."

During the second treatment phase, treatment in the clinic is less frequent as patients are now more independent and capable of in-home maintenance, such as self-administered MLD and exercise. They also graduate from using only compression bandages to wearing a compression garment during the day. For some patients, Hannah may recommend separate day and night-time compression garments. Ideally, these are custom-made for the patient.

"By phase two, patients should be getting back to their normal activities," she said. "If they like to make pottery or lift weights, we ramp up slowly to monitor what their systems will take."

Support from Susan G. Komen Phoenix Affiliate

 
For patients like Bauer and Hines, the Susan G. Komen Phoenix Affiliate grant provides customized bandages and garments, which health insurance typically does not cover. Customized garments can cost as much as $1,200. Hines, for example, has a customized sleeve ($200), a nighttime garment ($700) and a compression glove ($150) for a total cost of $1,050.

"When you live with lymphedema, infections are very scary. I am so grateful that Susan G. Komen has allowed me to get the garments I need to stay healthy and avoid infection. I never could have afforded to buy customized bandages and garments," Hines said.

The Susan G. Komen Phoenix Affiliate grant will help approximately 18 patients purchase customized garments and also allow YRMC to purchase educational materials on lymphedema.

“YRMC is very committed to building awareness about lymphedema and encouraging early treatment,” said Peter Brennan, director of philanthropy at YRMC. “With the support of Susan G. Komen Phoenix Affiliate, we know we can make a difference to women struggling with lymphedema.”

YRMC’s Lymphedema Support Group

Hannah founded a Lymphedema Support Group to provide information and allow lymphedema patients to learn from one another. Support group members range in age from 40 to over 70, but the common bond is their commitment to managing their lymphedema.

The approximately 20 regular attendees at the monthly Lymphedema Support Group meetings hear presentations from medical experts: genetic oncologists, dietitians and other healthcare professionals. They also spend time sharing information.“

Those women will take a new support group member by the hand and tell her to listen to Donna and work hard,” Hannah said. “They understand what it feels like and know what needs to be done to control it.”

Lymphedema management is a way of life for both Bauer and Hines. When asked what advice she would give breast cancer survivors in the community experiencing the early signs of lymphedema, Bauer said, “Run, don’t walk, to your doctor and get a referral to The Lymphedema Management Program at YRMC.”

Diane Drexler, RN, BSN, MBA, FACHE, Takes Chief Nursing Officer Post

Growing up, Diane Drexler considered the idea of a nursing career. However, it was while observing the nurses who cared for a critically ill high school classmate that she decided to pursue the profession.

“When I visited my friend,” she said, “I was always impressed by the nurses who cared for her. I thought, ‘That’s what I want to do with my life.’”

Drexler understood then that she wanted to help people through illness and provide support to their family members and friends. She’s been doing that for more than 20 years, first as a caregiver and then in management and executive-level positions. In April, Drexler joined Yavapai Regional Medical Center (YRMC) as its new Chief Nursing Officer (CNO), the hospital’s top nurse executive in charge of patient care services on both campuses.

“What has impressed me most is that everyone at YRMC—from staff members to board members—embraces the hospital’s mission,” Drexler said. “It’s more than a plaque on a wall; everyone is completely committed to it. I am thrilled and grateful for the opportunity to be part of this organization and community.” Before joining YRMC, Drexler served as Vice President of Patient Care Services for Cancer Treatment Centers of America at Western Regional Medical Center (WRMC). She helped open the hospital, located in Goodyear, Arizona, in 2008. Drexler also launched WRMC’s “acuity adaptable unit,” the first such licensed unit in the state. The acuity adaptable unit design allows patients to remain in the same room throughout their hospitalization.

Drexler’s nursing experience also includes 15 years at Banner Health in the Phoenix area. In her most recent position at Banner, she was CNO of Banner Estrella Medical Center in Phoenix. Again, she undertook the job of opening the hospital, which in 2005 was among the nation’s first to introduce both an Electronic Medical Record (EMR) and Computerized Physician Order Entry (CPOE) system.

According to Tim Barnett, YRMC’s President and CEO, Drexler’s experience will be an asset to the hospital and community.

“She’s the right person at the right time,” Barnett said. “With the BreastCare Center at YRMC ready to open this fall and the transition to EMR that the federal government is requiring of hospitals, Diane’s knowledge and experience will be invaluable. Even more important, Diane is devoted to the nursing profession and a true advocate of patients. We are very fortunate to have her on our team.”

Drexler also is pleased to be part of the YRMC team. A successful nurse leader, she said, listens and develops relationships throughout the organization. However, as a nurse, she never forgets the most important relationships are with patients.

“I enjoy listening and talking to patients. I love hearing how we as nurses make an impact on their lives and how we can improve,” she said.

Drexler is a firm believer in both lifelong learning and sharing her professional knowledge. She earned a Bachelor’s of Science Degree in Nursing from the University of New Mexico at Albuquerque and a Master’s of Business Administration from Arizona State University West.

Drexler is a graduate of the Wharton Fellows Nurse Executive Leadership Program and she was also selected for the prestigious Robert Wood Johnson (RWJ) Foundation Executive Nurse Fellows program. Only 20 nurse leaders from throughout the country participate in this program each grant cycle. RWJ selects nurses who aspire to help lead and shape the U.S. healthcare system. Additionally, Drexler earned board certification in healthcare management as a Fellow of the American College of Healthcare Executives (FACHE). She has published many articles in nursing journals.

“I believe that if I have done something from which others can learn, I want to share my lesson learned,” she said.

Drexler and her family—her husband and two children—are enjoying the people of Prescott and the beauty of the area.

“For the first time, I know my neighbors and they know me,” she said. “We love to hike and kayak so we feel like it’s all at our back door now. It’s the best of all worlds.”

American College of Radiology Awards
YRMC Imaging Services Prestigious Accreditation

Yavapai Regional Medical Center’s (YRMC’s) Imaging Services has earned accreditation from the American College of Radiology (ACR). Known as the ACR Gold Standard of Accreditation, the gold seal signifies that the hospital has voluntarily pursued a rigorous review to ensure its radiology program meets or exceeds national standards.

“It’s difficult for patients to evaluate the quality of their MRI study, CT scan or other imaging studies or treatments,” said Mary Sterling, Director of YRMC’s Imaging Services. “With ACR accreditation, they are assured that the hospital’s radiologists and technologists as well as its medical equipment have been judged by a third-party to meet the highest quality standards for performance and safety.”

Unlike many other organizations, YRMC pursued and earned ACR accreditation of its entire Imaging Services program at the same time, including:

• CT (Computed Tomography)
• Mammography
• MRI (Magnetic Resonance Imaging)
• Nuclear Medicine
• Ultrasound

These services—available at YRMC West in Prescott and YRMC East in Prescott Valley—will be ACR accredited for three years, along with radiology services delivered at YRMC Del E. Webb Outpatient Center in Prescott Valley. YRMC Imaging Services also earned > accreditation in CT for pediatric imaging, demonstrating its commitment to providing pediatric patients with the safest imaging procedures possible.

“I’m proud, but not surprised, that YRMC’s Imaging Services earned ACR accreditation,” said Tim Barnett, YRMC President and CEO. “YRMC’s Imaging Services team is well known for its commitment to high quality imaging and safe services.”

According to the ACR, accreditation indicates that YRMC’s Imaging Services program meets or exceeds quality assurance and safety guidelines. Additionally, the Imaging Services program includes:

• Personnel who are well qualified—through education and certification—to perform and interpret medical images; and
• Medical equipment that is appropriate for testing and treatment.

For more information about YRMC’s Imaging Services contact (928) 771-5140. To schedule an exam, contact YRMC’s Central Scheduling at (928) 759-5860.