Miland E. Knapp Rehabilitation Center celebrates 50 years of teamwork

Hennepin Healthcare’s Miland E. Knapp Rehabilitation Center is celebrating its fiftieth year of helping patients return to their homes after severe injury or illness. To mark the occasion, the nationally recognized Center is holding an open house on Sunday, July 14 from 2-5pm at Hennepin Healthcare’s Clinic & Specialty Center, 715 South 8th St. in Minneapolis.

The Miland E. Knapp Rehabilitation Center (Knapp Rehab) is an acute inpatient specialty program of Hennepin Healthcare serving adolescent and adult patients who have been traumatically injured or disabled.

“Our legacy of caring for patients began in an area with only four rooms shared by four patients each,” explains Geoffrey Roe, RN, Nurse Manager of Knapp Rehab. “Of course the center itself, therapies and interventions have changed over time, but the commitment to providing state-of-the-art, compassionate care has remained the same.”

Current and former patients, families and staff are invited to attend the event that will include a short program, refreshments, and time for listening to patients share stories of how they overcame dramatic physical and emotional barriers with the support of Knapp Rehab professionals. Continue reading “Miland E. Knapp Rehabilitation Center celebrates 50 years of teamwork”

Did you wake up with high blood pressure on Monday? 

doctor is protecting heart  with hands. Cardiovascular diseases  concept

Were you one of several million Americans who woke up with high blood pressure on Monday? The American College of Cardiology and the American Heart Association released new blood pressure guidelines on November 13, 2017.  The goal is to enhance awareness about elevated blood pressure and emphasize the importance of managing elevated blood pressure through healthy lifestyle changes and medications with the ultimate goal of reducing the risk of heart disease and stroke (cardiovascular disease). The guidelines have lowered the threshold for the diagnosis of high blood pressure (hypertension) and this change will impact the care of several million Americans.

“I like the excitement and the call-to-action raised by the guidelines,” explains HCMC cardiologist Dr. Woubeshet Ayenew, “and I give it a score of A for the educational aspect; however, I have to give it a lower grade when it comes to the practicality of properly measuring blood pressure and implementing the guidelines in daily clinical practice.” Continue reading “Did you wake up with high blood pressure on Monday? “

Hennepin Stroke Center at Hennepin County Medical Center Awarded Certification for Comprehensive Stroke Centers

Stroke for blog r3

Hennepin Stroke Center at Hennepin County Medical Center (HCMC) has earned The Joint Commission’s Gold Seal of Approval® and the American Heart Association/American Stroke Association’s Heart-Check mark for Advanced Certification for Comprehensive Stroke Centers. The Gold Seal of Approval® and the Heart-Check mark represent symbols of quality from their respective organizations.

With this certification, HCMC joins an elite group of health care organizations focused on highly-specialized stroke care. To be eligible, hospitals must demonstrate compliance with stroke-related standards as a Primary Stroke Center and meet additional requirements, including those related to advanced imaging capabilities, 24/7 availability of specialized treatments, and providing staff with the unique education and competencies to care for complex stroke patients.  Continue reading “Hennepin Stroke Center at Hennepin County Medical Center Awarded Certification for Comprehensive Stroke Centers”

Removing clots provides additional benefits for stroke patients compared to medications alone

HCMC patients enrolled in study that shows clot-busting medications aren’t the only options in stroke care

Rick and BearTaking his dog out for a walk left Richard Juergensen speechless – but thanks to a life-saving technique and the quick actions of a neighbor, the 55-year-old survived a stroke and is already back to work.

On the chilly -8 below evening of Tuesday, March 4, Juergensen and his chocolate lab, Bear (see photo) began their evening routine going outside for a walk. After Bear made a pit stop in the front yard, Richard remembers his arm suddenly going numb. “I grabbed hold of my arm and it was just kind of flopping around,” he explains. “Then my right leg went numb, too. A neighbor saw me and asked me what was wrong, but I couldn’t answer him. I knew what I wanted to say, but couldn’t say it.”

His neighbor quickly called 911 and Hennepin EMS paramedics recognized his symptoms as a likely stroke so notified the hospital of a “Stroke Alert” and transported him to Hennepin County Medical Center, where he was evaluated by their stroke team. “When I was in the emergency department I felt like giving up because people were asking me questions and I knew the answers, but couldn’t articulate them,” said Juergensen. “It was very scary.”

He was found to have an occlusion – a clot – in one of the branches of the middle cerebral artery in his brain and was immediately taken to an interventional radiology suite, where the clot was removed using a Solitaire™ stent retriever and a special suction device called Penumbra™. Because Juergensen was on blood thinners, he could not receive the clot-busting medication, alteplase (also known as tPA), leaving him mechanical thrombectomy as his only treatment option.

“As the only Minnesota hospital to enroll patients in any of four recent research studies about whether clot removal using state-of-the-art devices is as beneficial as IV tPA, we were in a perfect position to treat Mr. Juergensen,” explains HCMC’s Dr. Bharathi Jagadeesan. “The research trials demonstrated that this technique works, and that clot-busting medication isn’t the only answer.”

In fact, if mechanical thrombectomy (blood clot removal) is performed, patients have a longer window of time to receive treatment and more patients have a good outcome when compared to clot-busting medication therapy alone.

“IV tPA, or clot-busting medication, is still our first-line therapy; however, it must be administered within 4.5 hours of the onset of stroke symptoms and is not safe in patients with a significant bleeding risk, like Mr. Juergensen,” said Dr. Jagadeesan. “So if the patient cannot be given IV tPA or if stroke symptoms persist after tPA is started, it’s great to know that we have the specialized equipment and highly skilled interventional team that are needed to successfully perform mechanical thrombectomy.”

“When I woke up Wednesday morning, everything was back to normal,” said Juergensen. The night before I thought my life was changed forever. Now words can’t express how grateful I am for the care I received.”

Juergensen was discharged from HCMC on March 6, just 3 days after having what would most likely have been a major stroke if he hadn’t received emergency treatment. He returned to work a week later.

“Mr. Juergensen is an excellent example of the life-saving and life-changing outcomes that can be achieved with prompt and precise medical intervention,” said Dr. Jagadeesan.

The Hennepin Stroke Center at Hennepin County Medical Center is a national leader in the treatment of ischemic and hemorrhagic strokes with some of the fastest clot-busting drug delivery times in the U.S. HCMC is the only hospital in Minnesota who enrolled patients in the SWIFT-PRIME stroke trial which demonstrated improved outcomes in patients receiving IV tPA plus cutting edge endovascular therapy compared to patient’s receiving IV tPA alone. The Hennepin Stroke Center is nationally certified by the Commission on Accreditation of Rehabilitation Facilities (CARF) for rehabilitative care after a stroke occurs.

Is niacin breaking your heart?

Using niacin to improve cholesterol levels doesn’t reduce heart attack or stroke in high risk patients

We’ve all heard that lowering LDL or “bad” cholesterol levels and raising HDL or “good” cholesterol is good for the heart. When lifestyle changes have not been adequate, most treatment effort in the management of heart disease and stroke risk has focused on lowering the LDL or “bad” cholesterol using a class of drugs called statins. In recent years, the use of niacin – a vitamin B3 – in addition to standard statin therapy has been increasing in the U.S.   The main effect of niacin is in raising HDL or “good” cholesterol and this was hoped to result in improving heart attack and stroke prevention beyond what was obtained through the use of statins. But recently reported results from a large study state that the long-term effects of niacin do not lead to better outcomes.

Dr. Woubeshet Ayenew
Dr. Woubeshet Ayenew

“And in fact, niacin use may even be harmful,” explains Dr. Woubeshet Ayenew, a cardiologist at Hennepin County Medical Center, who is referring to a recent study in the New England Journal of Medicine that associated niacin with infections, skin problems, and diabetes complications. “While niacin can increase HDL levels and lower LDLs and triglycerides, these apparently favorable changes in the lipid levels did not reduce heart attack and stroke when high risk patients were followed on niacin over the long-term,” says Dr. Ayenew. “The effect or benefit of niacin on patients without prior vascular disease was not looked at in these studies.”

“In light of this research, high-risk patients with prior heart attack, stroke or diabetes with arterial blockages who are currently taking niacin with their statin should review their treatment plan with their provider.”

Dr. Ayenew also asserts that pursuing a healthy lifestyle is still the most beneficial and safest way to avoid cardiovascular disease.  If medications are needed to supplement healthy lifestyles, it does appear that statins are very effective and have a better safety profile compared to vitamin B3 or niacin.

Woubeshet Ayenew practices in HCMC’s Cardiology Clinic located in downtown Minneapolis, as well as HCMC’s Brooklyn Center Clinic.  He was the local principal investigator for the AIM-HIGH trial that looked at the impact of niacin on people with vascular disease. The cardiology clinic was recently identified as the number one rated cardiology clinic by patients for “overall provider experience” in Minnesota, according to results published by Clinician and Group Consumer Assessment of Healthcare Providers and Systems (CGCAHPS), a tool used by the Centers for Medicare and Medicaid Services to collect patient feedback.

 

 

Will more Americans benefit from cholesterol-lowering therapy?

In Nov 2013, the American College of Cardiology and the American Heart Association (ACC/AHA) introduced new guidelines to reduce heart attack and stroke through lifestyle changes and selective use of cholesterol-lowering  medications.

The ACC/AHA proposed changes to the guidelines for prescribing cholesterol-lowering medications called statins in accordance with the latest clinical study data available on the use of these drugs to reduce heart attack and strokes, due to the high prevalence of heart attack and stroke associated with high blood cholesterol.

Dr. Woubeshet Ayenew
Dr. Woubeshet Ayenew

“For years, the LDL or ‘bad’ cholesterol level was the basis for the initiation and follow up of statin therapy,” cardiologist Dr. Woubeshet Ayenew at Hennepin County Medical Center explains. “But the new guidelines de-emphasized the value attached to following the LDL level and instead recommended that the intensity of statin therapy match the risk of stroke and heart attack in an individual. For example, high-intensity cholesterol reduction is now recommended for those who have had prior heart attack or stroke, since the recurrence of such events is highest for those individuals.” Continue reading “Will more Americans benefit from cholesterol-lowering therapy?”

FAST assessment, care at Ridgeview saves 45-year-old from devastating consequences of stroke

Greg, Irja and Trevor Gardner

Irja Gardner of Mound is an early riser who likes to complete her workout routine before her son gets up for school.  But on Wednesday, June 6, her routine was cut short when she noticed that the readings on her X-Box exercise program monitor didn’t seem quite right.

“The X-Box said, ’40 percent complete’ when it usually says ’95 percent complete’ after the first set of reps,” said Gardner. “Then I couldn’t stand up anymore — I fell and ended up on the floor. I wasn’t sure what was going on, so I stumbled up the stairs and sat down on the couch for a while, thinking it would pass. I can’t remember too many details after that.”

Continue reading “FAST assessment, care at Ridgeview saves 45-year-old from devastating consequences of stroke”