Continued on page 2

Continued on page 2

May 25, 2012

KellyBlecha,

Continued on page 62

Dan Leversen

September 13, 2013

Dan receives minimallyinvasive robotic surgery:Borgess Heart Institute team offers newhybrid approach to coronary artery disease

When Dan Leversen, 53, suffered chest pains in his Dowagiac home onMarch 3, 2013, he certainly desired less-invasive care. In fact, like somany people who suffer initial chest pain, Dan wanted to dismiss the

heart attack symptoms altogether. Fortunately Dan’s wife, Stacy, insisted he seekmedical attention.

“I’m stubborn,” said Dan, an auto businessman.

"I was a little worried about his discomfort and suggested that he go to the ER," saidStacy Leversen, "but he didn't seem to have all the classic heart attack symptoms."

Dan Leversen was soon transferred from Borgess-Lee Memorial Hospital to theBorgess Heart Institute, where he received a combination of new and moretraditional coronary care.

Dan received his wish for less-invasive care.

Dan underwent a new, minimally invasive heart bypass surgery toreplace a completely clogged heart artery–the first patient insouthwest Michigan to receive this surgical technique. He thenreceived a drug-eluting stent to fully re-open a partiallyoccluded heart artery.

“This hybrid approach to revascularization of coronaryartery disease can combine advantages of new, less-invasive heart surgery techniques with other minimallyinvasive heart care like balloon angioplasty and stent-ing,” said Jerry Pratt, MD, Medical Director, ThoracicSurgery, Borgess Heart Institute. “It can mean lesspain, less hospitalization, and a quicker recovery andreturn to normal activities for appropriate patients.

“Single-vessel small thoracotomy (SVST)

Important benefit programchange information fornonunion associatesA number of nonunion associatebenefit program changes will occureffective January 1, 2014. Thechanges are necessary based oncompliance with the Patient CareAffordability Act (ACA), alignmentof Borgess policies and systemswith Symphony prior to targeteddeployment dates and externalmarket comparisons.

Programs that will be impactedinclude:

� Paid Time Off� Healthcare Benefits� Retirement ProgramsIn order to share specific changes andprovide opportunities for associates toask questions about how they may beimpacted, detailed information willbe shared during presentations,teleconferencing opportunities,recorded sessions, and question andanswer sessions.

Please refer to the Borgess HumanResources site on the Borgess Intranetpage for a complete listing of livepresentations. To ensure sufficientseating for live presentations, associ-ates must register for the session oftheir choice via Ascension HealthUniversity (instructions on the regis-tration process are available on theHR Intranet site).

Please be sure to access one of theseopportunities to remain informedregarding how these changes mayimpact your personal situation.

Additional questions may be directedto the Human Resources Call Center,(269) 226.8400.

Heart failure is the subject of a freeconference for health care providerstaking place next month at BorgessMedical Center.

“From Heart Failure to Life Success:Evidence-based Practice Care Across theContinuum” will be held from 7:45 am to4:30 pm, Monday, October 7, 2013, in theLawrence Education Center. The confer-ence will feature presentations on heartfailure from numerous Borgess physiciansand nurses. It is sponsored by the BorgessHeart Institute.

This activity has been planned and imple-mented in accordance with the EssentialAreas and policies of the Michigan StateMedical Society Committee on CMEAccreditation through the joint sponsor-ship of Western Michigan UniversitySchool of Medicine (WMed) and BorgessMedical Center. WMed is accredited bythe MSMS Committee on CMEAccreditation to provide continuing med-ical education for physicians. WMed des-ignates this live activity for a maximum of7.0 AMA PRA Category 1 Credit(s)™.Physicians should claim only the creditcommensurate with the extent of their par-ticipation in the activity.

Borgess Health is an approved provider ofcontinuing nursing education by theWisconsin Nurses Association, an accred-ited approver by the American NursesCredentialing Center’s Commission onAccreditation.

Conference participants must register inadvance by Monday, September 30. Forconference information or to register, visitwellness.borgess.com, or call TheProfessionals at Borgess at (269)226.8135 or (800) 828.8135.

MONDAY, OCTOBER 7, 2013

7:45 amRegistration, Continental Breakfast andInformation Stations

8 amWelcome, Introductions

8:15 amPathophysiology and Clinical Presentation ofHeart FailureAnthony King, MD, and Susan Manifold, NP

9:45 amPharmacological Therapy in Managing Heart FailureMichael Michutka, PharmD

10:30 amBreak, Vendors

10:45 amAdvanced Therapies in Managing Heart FailureJerry Pratt, MD

11:45 amCase Study Presentation of Heart FailureAnthony King, MD, and Susan Manifold, NP-C

12:15 pmLunch and Virtual Tour of Practice Settings

1 pmAcute Care to Outpatient Care:Heart Failure ClinicSandra Pratt, RN

2 pmBreak and Information Stations

2:15 pmPalliative Care Perspectives in Heart FailureJeanette Meyer, MD

3 pmManaging Heart Failure at HomeJoseph Nuncio, RN

3:45 pmThe Heart Failure JourneyAmy Shaffer, RN

4:15 pmEvaluation and Education Credits

4:30 pmConference Concludes

Clothing and accessoriesclearance sale September 27The Seasons Gift Shop is holding aclothing and accessories clearance sale7:30 am to 4 pm, Friday, September 27,in Lawrence Education Center room123. For more information, call(269) 226.7380.

From Heart Failureto Life SuccessA Heart Failure Conference forHeart Care Providers

Monday, October 7, 2013Lawrence Education Center

Jan Redman plans anactive retirementJan Redman will retire on September 30after 38 years of service in BorgessPhysical Therapyand MedicalRecords. Redmansaid everyday atBorgess was anadventure, and shewill miss making herpatients, colleagues,and associateslaugh. She hopes tobe remembered with a smile. Redmanplans to take retirement one day at atime, working on her bucket list,which includes zip lining acrossLake Michigan.

Craig Greenberg, MD, and StephanieFangman, PA-C, have joined the BorgessDiabetes & Endocrine Center.

Dr. Greenbergearned his medicaldegree and com-pleted an internalmedicine residencyat Loyola-StritchSchool of Medicine,Chicago. Followingresidency, hecompleted anendocrinologyfellowship atUniversity ofIllinois HealthSciences Center.Dr. Greenberg isboard certified inEndocrinology andMetabolic Diseasesand specializes incaring for individu-als diagnosed with diabetes.

Fangman is a graduate of the Universityof Iowa, and is a board-certifiedphysician assistant. She providesspecialized diabetes care in collaborationwith Borgess Diabetes & EndocrineCenter physicians.

Craig Greenberg, MD, andStephanie Fangman, PA-C,join Borgess Diabetes &Endocrine Center

Craig Greenberg, MD

StephanieFangman, PA-C

Jan Redman

Year-round energy efficiencyA unique, energy efficient water tower is being installed at Borgess Medical Center to allowyear-round use of chilled water for cooling purposes and energy savings.

Anupdated Borgess GraphicStandards manual, as well astemplates for Borgess fax, memo,

letterhead and PowerPoint presentationsis posted on the Borgess Intranet. Theseguidelines are useful and helpful foreveryone communicating BorgessHealth messages.

A powerful asset

“Our graphics identity is our visualvoice–an important way that wevisually connect Borgess Health-relatedinformation to others,” said Tom Comes,Director, Borgess Marketing andCommunications. “When used consistent-ly and appropriately, this graphic identityis a powerful asset.

“For instance, properBorgess graphic stan-dards on a sign mayhelp a patient moreeasily locate a

Borgess Health service on a busy street,”Comes said. “A hallway poster providesthat same Borgess connection to patients,visitors and associates. And if a Borgessassociate presents a PowerPoint locally ornationally, it reflects best on Borgess ifthe proper graphic standards template isused to help create the appropriateBorgess Health message.

“Cooperatively adhering to theBorgess Graphic Standards manual canbenefit patients, visitors and associates,”Comes said. “It helpsBorgess Health distin-guish itself from otherinstitutions by convey-ing a look that is easilyrecognizable and

uniquely our own. We can also reducecosts associated with the duplicationefforts that can occur in the absence ofeasy-to-adopt materials.”

BBoorrggeessss GGrraapphhiiccss SSttaannddaarrddss ccaann bbee eeaassiillyyvviieewweedd uunnddeerr ““IIddeennttiittyy SSttaannddaarrddss”” oonn tthheeBBoorrggeessss IInnttrraanneett HHoommee PPaaggee ((bbhhaa--hhoommee..bbmmcc..bboorrggeessss..ccoomm)).. QQuueessttiioonnss aannddrreeqquueessttss ffoorr aassssiissttaannccee iinn ppeerrssoonnaalliizziinngg ffoorrmmssffoorr ssppeecciiffiicc ddeeppaarrttmmeennttss ccaann bbee ddiirreecctteedd ttooPPaattttii NNeerraacchheerr,, 222266..66996633 oorr ppaattttiinneerr--aacchheerr@@bboorrggeessss..ccoomm..

Our visual voice: Borgess Graphics Standards

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5 YearsLaura AlexanderTina AndersonTerri AshKelly AsselmeierTammy AustinSherry BarnhartDebra BauerAmy BeachShenaye BeachWendy BeamBrian BeasleyArlene BecktonDora BenavidezJennifer BergJanet BierleinPaul BirchmeierChristine BladesTricia BlakesleeKatie BonitaAmy BotelhoTabitha BoulterAmy BowerBret BowmanJulie BradfordTonya BraggSade BrownSherlock BrownAmy BurrLeslie BurrowLeah ButlerDouglas CampbellScott W CampbellStacy CampbellPatricia CatellierBarbara CeruBrandi CharronMary ChildsVeronica CloptonTheresa CoatesJennifer CookElizabeth CooperHector CortesSusan CowelsSean CrabtreeJennifer CrapoffKathryn CreekApril CrossJoseph CulpStephanie CurticeRyan CurtisTrevah DalrympleJulie DanielsRobin DavisVeniece DavisDeborah DematteisKimberly DrobnyRebecca DrummondDonna DugganLedesha DuniganKathleen DunnJesse DuranceauLauren DutkiewiczMartha DykstraPaul DziepakSallie EdgerlyBrenda ElliottDamian ElrodDawn EssixRenae EvinkAmanda FarmerDorothy FishShefecia FlowersDorothy ForsheyAlayna FroelichKristen FrohriepTheresa GailhouseLura GariepyCharles GentryRobert GilmoreLorry Girkebelka

Penny GoffBlair GoheenRebecca GowanElwood GrassiMary GrayAllison GriggLynsey GrimesBrad GrueterVishal GuptaTimothy HainesAndrea HammondNicole HammondKatherine HanoverKimberly HarveyKristy HasperJames HendersonRaeann HermanDiane HeyboerMichelle HillKate HoffmannDawn HoggAmber HoldwickLorie HolewaKendra HooperAngel HopkinsVicky HortongrahamCindy HowesLatonya HunterTristin IlgTravis JagerKaitlyn JamesAaron JamisonJudith JansenAileen JarrellAngela JohnsonHajaratu JusufbanguraJeanete KellyKeisha KerstenSharon KikElizabeth KitchenKimberly KnaufNatalie KolbergLinda KowalskiLora KroneGail Kueffner-HawLyndsey KuiperJason LadwigKaylee LadwigRhoda LamarMarsha LambfletcherKathryn LancasterAmber LangfordJuanita LarkinDeanna LebarreDeborah LeeekbladJodi LippDaniela LitjensKathleen LougheadCindy MackenzieRichard MackeyStephanie MaddenAmy MainsChristina MajszakMatthew William MalickiMaria MarifosqueAlison MarshallJoseph E MasseyLynn MccormickKrista McguireNorris MckinneyBeverly McveighSharon MeadowsKathleen MiedemaChristopher R MihelichKimberly MikelTammy MillerAngelina MoraleslopezMichael MorganTracy MorsmanLuke Myers

Christina NelsonLisa NessTheresa NickelsonJulie NiedzielskiMark NoffsingerTamara NogleBridget NolanDeborah NorthrupMicah NullAssia OulmaneKevin PackardAmber PaggeotKelly PaschAmy PattersonPriscilla PedrazaJill PentyJasmine PettaliaJoshua PettigrewRobin PollensKimberlee RackleyTodd ReamJanis RedmanLaura ReynaRenee RiceJennifer RiceChantelle RobbeJimmy RobertsJose RodriguezMichele RoeEun RohrThomas RyanDavid RyderKatherine SchaferJennifer SchultzMichelle SchwartzBrianna SegrovesElizabeth SheelyRaina SkeelsJesse SlocumAmy SmendikSarah SnapeMary SnyderJennifer SquiresMailvaganam Sridharan

10 YearsJoy AmundsonQuerrida AndersonJoel AndersonKali BarrowMatthew James BeadleChristine BeckerJulie BertchAmanda BesseyKendra BickingsMaryann BlinkCarrie BlokAndrew BorisMary BoulnemourChristine BreedenChelsea BrownKimberly BruystensMary BryerCandice ChokerandersonShane ClippingerVictoria CollinsCarrie CurbeyJessica DoonanRachelle DragooEfrim EnglishDeette EnglishCarolyn FagalyErica FinedellJoshua FoxSuzanne FriesnerJennifer GatesCecilia GawartCherie GensonLaura GeresyStephenie Gillespie

David HalleyJeanne HansenPaul HansenTommy HarmonConstance HarterLydia HartmanJessica HaySusan HellengaPatricia HetzlerKaren HoldridgeJocelyn HorrillenoPatricia HoverLisa HummelBrittani HuntChristine HuotTeresa KindschyAnne KlokKristy KlusmanMary LafountaineMichelle LambertSamantha LamorandierCheryl LangLaura LeeMichael LennonJulie LindsleyElizabeth MaldonadoGina MartinezLisa MatthewsRebecca McCormackBelinda McDougalPeggy McKelveyHeather MillerVickie MillerArnesha MooreMaria MoralessalazarAlbert MossAmy MudayVictoria MuterspaughSara NewcombSabrina NewtonKeri NoeskeJulie NoteboomRusty PattersonBarbara PawlowskiTodd PetersonDeborah PhilleyAlexandra PinaScott PritchardLeslie RaffertyLeanne ReardonJulie RogersSynthia RoseJames RossSuzette RossSherrie RuggKenneth SampsonSherry SanfordRichard ScheibeKari SchmidtAshley SchneiderBobby ShellKaren ShulerShawn ShulerJoseph SindenVictoria SmithBud SmithTeresa SnellDavid SoderquistAmie SokolowskiSharon SorrellPamela StaffordLaura StrehlowCheryl SullivanRonald ThargeDeborah TregoMichael TrexlerVictoria TriemstraMelissa UnderwoodKatherine VanderPloegAutumn VanliereMichael Varricchio

Hilary WadeHeidi WarnezRochelle WashingtonBreanna WealWendy WeberDavid WeirKaren WheelerSharon WhiteCathy WickwireJohn WieseJohnny WilliamsRebecca WorthingtonShaun YoheyTamela ZieglerJose Zuniga

15 YearsRodney Charles Ackerman Kathleen Allen-StoufferDebra BagleyLinda BakerRebecca BarronCatherine BilekBenjamin BladesChristine BontragerJulie BoumaJeffrey G BryantTeresa CarpenterKimberly ChandlerRonald George CozartTerry L CushmanLynne DresslerEarl DuttonChristine FarrellJudith Foote-JuryEmily FredericksenJarita GilmerRona GoodrichKristi GraceyDawn GrantMichael HardimanKrystal HarrisonLori HawkinsRebecca HeintzkillRebecca HemmerAnita HeymanDavid HopkinsThomas JosephHoogerheideKathy HornbeckErin HuntMiriam JacksonBeverly JacobsPhyllis JonesLori KelloggKathy KolligDenna LiggettJennifer LucasKarensue MackalusoTimothy MeekerBryan MorfordPatrick NelsonDeborah NobleArisleida PadleyDianna RichardsonCheryl RogersErica RogersThomas RohsLinda RootLori RoyAmy RustenholtzJoyce ScottMarieta ScottSheri L ShermanAmy ShipleyDelphis Stokes, Sr. Tonya StreetJeffrey StreetChristine TateFrances Terry

Susan ThomasTerry ThomasMaria TookerJanice WerbinskiThomas WhiteDanielle WillisNichole WorlineSaid Yehia

20 yearsTheresa BrummSusan ClementsCinda S CowenSherri J CrumMary DennanyKim DohertyRico EarlSusan FordNorena FreebergDebra GrohsLynann HammanCatherine HargerDonna HendersonBecky HenricksonKendra HuntEric JeskaJeanne JeskaSusan JulianusJames KellyJanice KlinestekerJoseph KulpaBecky LambertJennifer LawlerJulie MaleitzkeJulianne MathiasTracy MitchellNancy MoraJoann MortDaniel R RamlowMary RiddleSusan SalamunLanie SantosSara ScottTracey SilcoxMarcia StraubelKathryn StrehlHeather Ranee TaberCorall VanvolkinburgLaura VelsRobin WardenLisa WebberMartha WilburCatherine WileyClinton George Williams

25 yearsMary BeauregardLori CagneyFred DaviesJ. Patrick DysonLien HamannMachelle HarrisLisa KenzBarbara LadukeJanet LeonardTerri NuyenMonte PalmAlfred SantoroPeggy SichStewart TalbotMindyl VandykenBrenda WayneTammy Yeager

30 Years Robin BertolissiMaryellen ByrumDana L ColvinMarie Conroy

Katherine DennanyColleen DonnellyColleen FlynnKathy GrueterKenneth HolstPatricia KotwickiMarcia LashMark LueckJill MarksCheryl MckeeKristine MclaughlinDiana MulterDeborah PaysonRonda PierceJohn ReedKelly RowekampKevin SageJean SmithDeborah SpencerAnita StephensonKimberlyj VanderploegBeverly VanlandegentJune Versluis

35 Years Bonnie ArthurSandy BartsDeborah M BroszKimberli DehaanEdward DickensChristine DragooKathleen HallCynthia HerakovicMarcia HornJanet HuffRobert HurtekantKim JonesRosella KeyesMichael KucinichLouise LangworthyRosalind Lee-ElEmma LindnerJudith LooperSusan MeschkeDebra MinerRhonda MisiaszRobert NoteboomGrace RitsemaKathleen RoederSherril ShaneTerri SwansonBarbaraj VanderweeleEvelyn Whitmer

40 YearsKathleen BassBeatrice BothwellScott BundleKim DickensJeffrey DoolittleEloise GillandJanet GreenCarol KellyMaria KowalikLaura LentenbrinkLinda LeutzingerDeborah LintVirginia MasseyGary MazurRuth Nelson-RauchGeorgina ThomasDeberah TibbsLinda Veldt

45 YearsClaire CarpenterOra LeeSandra Spring

2013 BORGESS SERVICE AWARD RECIPIENTS

enables the cardiothoracic surgeon tooffer a bypass graft through a small inci-sion between the ribs,” Dr. Pratt said.“We use a robot (da Vinci SurgicalSystem) to harvest an artery to be used asa bypass graft. This method eliminates theneed to open the chest (sternotomy) or touse a heart-lung machine.

“Mr. Leversen underwent a balloon angio-plasty and stenting procedure the next day(performed by John Gustafson, MD,Borgess Heart Center for Excellence) toclear his other coronary artery thatrequired attention,” Dr. Pratt said. “Danleft Borgess three days later, withoutmajor scarring.”

Dr. Pratt has previously performed SVSTat the University of California DavisMedical Center. He is a highly decoratedAir Force Colonel who served as Chief ofCardiothoracic Surgery and Commanderof the Heart, Lung & Vascular Center atDavid Grant Medical Center, Travis AirForce Base, Fairfield, California. Dr. Prattserved tours of duty in Iraq andAfghanistan. Upon leaving active duty in2012, he opted to join the Borgess HeartInstitute because of its outstandingheritage with more than 20,000open-heart procedures since 1971.

Bypass surgery through three small holes

Unlike traditional open-heart surgery, acomputer and robot-aided, minimally-invasive coronary artery bypass isperformed by inserting tools throughthree small holes and a three- to four-inchincision in the patient’s chest. Instead ofopening the the sternum, a camera allowsthe surgeon to see inside the chest andmanipulate computer-aided tools tocomplete much of the bypass.

“Few surgeons perform the entire bypasssurgery with the robotic arms,” Dr. Prattsaid. “In Dan's case, the initial part of thesurgery was done with the robot and thebypass artery itself is stitched in the tradi-tional way.”

Dr. Pratt and his team moved Dan's heartup near the small incision for easieraccess to the mammary artery, which wasused for the bypass.

“Dan only needed one bypass,” Dr. Prattsaid, “and it was in the front of the heartand easy to bypass. Most candidates whoqualify for robot-assisted surgery areeither relatively healthy and want to getback to work and their lifestyle morequickly, or are too ill to toleratetraditional open-heart surgery.”

“I felt comfortable having Dr. Pratt do theminimally invasive surgery, even though Iwas the first one at Borgess,” Dan said. “Iwas a bit scared but not for me, it was formy kids–Adrian, 16, and Mary, 14.”

Stacy said that if there was a problemwith the minimally invasive procedure,Pratt and the OR team could immediatelydo the traditional open-heart surgery.

Dan was taken to the operating room at7 am, March 14, and Dr. Pratt came out at1 pm to tell Stacy that the procedure went“really well,” she said.

“He told me that Dan was doing great,”Stacy said. “When I saw him at 4 pm inthe recovery room, he already had thebreathing tube removed. The nurses saidthat was highly unusual.”

“I felt a little queasy when I woke up,”Dan said, “but really pretty good, a lotbetter than I expected.”

Three days later, Dan was home inDowagiac and soon began cardiacrehabilitation, which ended in June.

“I was really impressed with everybody atBorgess,” he said, “from the people whodo the maintenance to the people whodeliver the food to the nurses and othermedical staff. I was shocked by theamount of concern and compassion byeverybody, and the care was unbelievable.

“The fact that I was the first to have theminimally invasive surgery meant that Iwas visited by maybe 15 different nurseswho all wanted to see the small incision.I can be a critical guy, but I didn't findanywhere where there was a blemish.”

Cookies delivered in gratitude

He and Stacy were so pleased that theymade and delivered cookies to the staff.

Since the surgery, Dan has stopped smok-ing the occasional cigar and has lost 30pounds, which he fully intends to keepoff. He said the other patients he’s seen atcardiac rehab are all amazed at both thesmall size of his incision and the fact hefelt so good and recovered so quickly.

“I think about my kids, and if they keepmaking inroads like this, the future looksbright,” he said. “If my son, Adrian, inher-ited any potential for heart disease, I feelgood about what may be available to him.”

A hybrid approach to coronary artery diseaseContinued from page 1

Learn more about the hybrid approach to coronary artery diseaseJerry Pratt, MD, Medical Director, Thoracic Surgery, Borgess Heart Institute, (above) speaksabout Dan Leversen’s minimally invasive robotic surgery and hybrid heart care on WWMT “DocTalk.” It can be viewed by visiting the Borgess Health YouTube Channel, borgess.tv.

SSiinnggllee--VVeesssseell SSmmaallll TThhoorraaccoottoommyyIn a Single-Vessel Small Thoracotomy, there isno need to open the chest (sternotomy-shownon left). Instead, with the da Vinci SurgicalSystem robot, three incisions (right) allow thesurgeon to harvest an artery to be used as abypass graft. Through a small incisionbetween the ribs, the surgeon can performbypass surgery with direct vision of the surgi-cal site. In an endoscopic procedure, the sur-geon can also use a thorascope to view insidethe chest cavity. A heart-stabilization andexposure device allows the heart to continuebeating while the surgery is performed.