ASPEN 2018 Nutrition Science and Practice Conference

Registered dietitians Anne Woodbury, of Utah Valley Specialty Hospital, and Jill Marshall, of Northern Idaho Advanced Care Hospital, recently were selected to present a poster on an initiative regarding how nutrition affect patients on ventilators at the national ASPEN 2018 Nutrition Science and Practice Conference in Las Vegas.

Titled “Nutrition Administration and Ventilator Weaning in Long-Term Acute Care,” the abstract also was published in the January 2018 Journal of Parenteral and Enteral Nutrition supplement.

These dietitians have been working on data collections and how nutrition promotes successful ventilator weaning.

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Northern Idaho Advanced Care Hospital celebrates 10 years of helping patients with serious respiratory conditions

(photo) Dr. David York, a pulmonary and critical care physician, and Diane Joralmon, a respiratory manager at Northern Idaho Advanced Care Hospital in Post Falls help patients achieve better breathing outcomes.

The beep worried Linda Sprenger.

As she drove her husband, Mike, to their home in Moscow — *Beep!* — from North Idaho Advanced Care Hospital in Post Falls, thoughts began to weigh on her mind. What if the machine stops working? *Beep!* What if the machine stops working and Mike stops breathing? *Beep!*

Linda got home. The white knuckle drive was over. But a new stress of caring for her husband of 28 years was just emerging. Mike has ALS, or amyotrophic lateral sclerosis, is a progressive neurodegenerative disease that affects nerve cells in the brain and the spinal cord. He now relies on a ventilator to keep him alive.

“It’s scary,” said Linda. “I don’t have a huge amount of people to take care of him. You’re alone and you’ve got this machine and you’re looking at it every time it makes a sound.”

Not that it’s much consolation, but Linda isn’t alone. Every day, an average of 15 Americans are newly diagnosed with ALS — more than 5,600 people per year. As many as 30,000 Americans may currently be affected by ALS. Annually, ALS is responsible for two deaths per 100,000 people. The average life expectancy of a person with ALS is two to five years from time of diagnosis.

Mike, 51, has had the disease for five years. He can’t speak or move without the assistance of a wheelchair. Yet he is able to text messages, and they celebrated the birth of their first grandchild on Christmas Eve.

“He’s doing really well,” said Linda. “I am so grateful.”

Last August, the couple experienced a scare when Mike got pneumonia. He was own to Spokane for a tracheotomy. Eventually he was transferred to Northern Idaho Advanced Care Hospital as part of his recovery. He spent 35 days at the Post Falls hospital.

“It was one of the most amazing hospitals I have ever been in,” said Linda. “They were with us 24 hour hours a day and they really cared for us.”

The hospital, which celebrates its 10-year anniversary on Feb. 17, provides long-term acute and critical care services to patients throughout the Inland Northwest who are recovering from serious illnesses or injuries. To date, Northern Idaho Advanced Care Hospital has served more than 4,000 patients. Often these individuals need care for medically complex conditions such as trauma, infectious diseases, wound healing, cardiovascular disease, stroke, and amputations, and respiratory failure.

“They provided all the training I needed,” said Linda. “I know how the machine works, how to clean it and when to call a technician.”

For ALS patients, respiratory issues become a matter of life and death.

“Respiratory failure occurs when there isn’t enough oxygen passing from the lungs into the body’s bloodstream,” explained Dr. Kevin Strait, Medical Director of Northern Idaho Advanced Care Hospital. “Oxygen-rich blood is needed to help the body’s organs – such as the heart and brain – function properly. Respiratory failure also can occur if a patient’s lungs can’t remove carbon dioxide from the blood. Carbon dioxide is a waste gas that also can harm a body’s organs.”

The 40-bed facility, at 600 Cecil in Post Falls, features all private patient rooms, and an 8-bed high- observation critical care unit.

Northern Idaho Advanced Care Hospital is the first hospital in Idaho, and the fifth in the nation to receive the Joint Commission’s disease-specific certification for Respiratory Failure. The Joint Commission, an independent, not-for-profit organization, accredits and certifies nearly 21,000 health care organizations and programs in the United States. Joint Commission accreditation and certification is recognized nationwide as a symbol of quality that reflects an organization’s commitment to meeting certain performance standards.

All patient rooms include cardiac monitoring equipment and mechanical ventilators. The hospital also features a 2,590-square-foot therapy gym with private therapy rooms and a heated aquatic therapy pool.

By MARC STEWART – Coeur d’Alene Press

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Northern Idaho Advanced Care Hospital helps patients recover from serious health issues

(photo) John Bierne nearly died from kidney failure, liver failure and congestive heart failure. He spent several months at Northern Idaho Advanced Care Hospital in Post Falls, recovering and rehabilitating. Photo by Marc Stewart.

John Bierne looks and feels like a new man.

The Twin Lakes Village resident nearly died from kidney failure, liver failure and congestive heart failure — at 39 years of age.

“I was 456 pounds,” said Bierne. “I kept gaining weight and I wasn’t feeling right. My breathing was off. I had sleep apnea. I should have gone to the doctor months earlier and gotten some simple blood work done.”

Instead, Bierne continued to make poor health choices and worked long hours as a project manager for a local construction company to help provide for his wife, Theresa, and their 3-year-old daughter, Kylie.

It all caught up with him March 19, 2015. Bierne collapsed while visiting his mother’s house. When paramedics arrived he wasn’t breathing. They managed to resuscitate him and get him to the hospital — where he hovered near death in the intensive care unit for weeks.

“The doctors told my family that I had about a 1 percent chance of living,” he said. “I’ve been told I coded several times, but I didn’t die. I don’t remember any of it. I don’t remember collapsing or being in the hospital.”

Doctors drained 131 pounds of uid from Bierne’s body, much of it around his lungs. They also discovered he had an enlarged heart and that his kidneys weren’t getting enough oxygen.

“I was prepared to be on dialysis the rest of my life,” he said. “I knew my life was going to be different from that point on.”

Bierne spent a month in the hospital, then was transferred to Northern Idaho Advanced Care Hospital in Post Falls to begin a long and difficult road of recovery.

Northern Idaho Advanced Care Hospital provides long-term acute and critical care services to patients throughout the Inland Northwest who are recovering from serious illnesses or injuries. Bierne had severe problems to contend with, given his weight and organs in severe distress.

“When I first saw John, he looked pretty rough,” said Kate Smead, lead therapist at Northern Advanced Care. “He was a big guy and he was hooked up to a ventilator with all kinds of tubes going in and out of his body. I wasn’t sure what he was going to be able to do.”

Diane Joralmon, respiratory therapy manager at Northern Idaho Advanced Care Hospital, said Bierne’s breathing quickly improved, but he faced long-term health challenges.

“He had trouble sitting up and he was on oxygen,” said Joralmon. “He did well with the lung therapy and responded to it. He’s feisty.”

John was weaned off the ventilator and began breathing on his own. However, one of his most pressing health issues was a nasty bedsore. Despite steadily increasing his mobility and strength once he reached Northern Idaho Advanced Care, months of lying in bed had taken its toll and his skin and muscles had deteriorated into a horrific state.

“John had a stage 4 pressure ulcer,” said Morgan Pitschka, wound management specialist at the hospital. “He was so sick, he couldn’t be moved. This led to a substantial bedsore. He basically had a gaping wound that would eventually require plastic surgery. ”

Treating his wound was delicate and required using negative pressure with a device that vacuums the injured area and treats it with medical foam. In addition, he was given a matrix of protein supplements to help his body build new tissue.

Bierne healed quickly with continuous supervision and care from his medical team. In short order, he was up and out of bed, ready for the next challenge. The medical team picked up on his macho attitude and used it as a motivator.

“I treated him like I was his drill sergeant and his friend,” said Smead, who designed his physical therapy sessions. “I gave him a hard time. I pushed him. Whereas other patients need to be treated with kid gloves, John needed somebody who wouldn’t back down when he got down or didn’t want to do something.”

Bierne spent about three months in Northern Idaho Advanced Care Hospital.

Despite the grim prognosis, he never believed he would die and tackled his rehabilitation with a vengeance. If he was asked to take 60 steps on the first day, he went for 180 steps. If he was told to go 10 minutes on the treadmill, he went 20…

Today, the 6-foot-1 man is 255 pounds and his caregivers at Northern Idaho Advanced Care Hospital describe him as looking “fantastic” and “amazing.” His kidneys are now functioning normally and his liver has bounced back. He exercises regularly and eats nutritiously. He was even able to go elk hunting in the fall — something that surprised his caregivers.

“I’ve been an athlete all of my life,” he said. “Death never entered my mind. I just took it day by day. I wanted to do more every day and keep improving. I am so grateful to everyone at Northern Advanced Care Hospital. They really saved my life.”

By MARC STEWART – Coeur d’Alene Press

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