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Tales of Triumph

by Matt Cosentino, Amanda Hamm Hengel, Liz Hunter, Rachel Morgan and Peter Proko; Photo by Gary Mattie

The world of medicine in South Jersey never ceases to amaze. Thanks to cutting-edge technology, skilled doctors and world-class facilities, those in need of medical care have never been in better hands. From cancer treatments to cardiac advancements, breakthroughs are happening all across our area. The following stories are about healing and hope. They are about selfless physicians and eternally grateful patients. They are, quite simply, stories about lives being touched.

Beatrice Sankey
Dr. Reginald Blaber, vice president of Cardiac Services and executive director of the Lourdes Cardiovascular Institute, had cared for Beatrice Sankey for more than a decade. They even live not far from one another, crossing paths in the neighborhood from time to time. So it was both as her physician and a friend when Blaber confronted Sankey to let her know that her aortic valve stenosis could soon present major health issues, possibly even death. Immediate treatment was recommended, but Sankey wasn’t in the state of mind to worry about herself.

At the time, Sankey was caring for her husband who was suffering from Alzheimer’s as well as her daughter who had recently become diagnosed with bone cancer. With her family as the priority, Sankey put her own needs on the backburner.

Six months after her husband passed away peacefully at home, Sankey was ready to worry about herself again. She found herself once again in front of Blaber, but this time he was not alone.

Dr. Steven Kernis, interventional cardiologist and director, Structural Heart Program, Lourdes Cardiology, came to discuss a revolutionary procedure called transcatheter aortic valve replacement (TAVR) that he felt would help save her life.

The procedure entails taking an animal heart valve and attaching it to a stent. What makes this procedure so different is that rather than opening up the chest cavity, stopping the heart and putting the patient on a bypass machine while a surgeon goes in and cuts out the old valve, they were able instead to go in through an artery in the groin area and snake the stent up into place.

“When the stent opens, you have a fully functional heart valve,” Kernis says.

At the time, the FDA was only allowing TAVR to be used on the sickest of patients.

Sankey was considered because she had been diagnosed with breast cancer more than four decades prior and the radiation treatments had made it virtually impossible for them to open up her breast bone for surgery. Currently, TAVR is becoming more widespread, something that Sankey thinks is of great benefit to others given her experience and positive outcome.

“When I was in my room afterward, I was about my senses. By the end of the day, I was walking around and within three days I was home,” she says.

Today, Sankey moves with ease and smiles frequently. She is overwhelmingly grateful for her new lease on life—allowing her to go to dinner with friends, or spend time playing with grandchildren. On this particular day she is lockstep with her daughter, both smiling wide.

“I feel like I’m 21,” the 81-year-old says. “I’m overwhelmed at how this all went and this is the point where I cry because I’m just so grateful, in particular for these two wonderful physicians.”

Kernis believes the TAVR technology will replace the surgical valve replacement in the near future and he uses Sankey as his biggest success story.

“I call Bea my home run because her valve was one of the worst ones I’ve seen. Knowing that she was going to be in really big trouble, this was just tremendous. She is my poster patient,” he says.

Having treated Sankey for so many years, Blaber can’t help but reflect on their time together and what it has meant to him to be able to help her reclaim a sense of normalcy.

“I have daughters who are thinking about medicine and they ask me, ‘How many lives have you saved?’” Blaber says. “I say, ‘It’s not how many lives you save, it’s how many lives I’ve touched.’ And in Bea’s case, we have been together so long she’s touched my life as much as I’ve touched hers.”

Ken Stepsis
When Ken Stepsis and his fiancée Aileen settled in for dinner at one of their favorite restaurants on a spring night in 2014, they had no idea that disaster would strike before their entrees even arrived. Luckily, Ken Peyre-Ferry—who they now both refer to as their “angel”—also had a hankering for Applebee’s that night.

Just seven weeks removed from a heart attack that he believed he was recovered from, Stepsis went into cardiac arrest at his table. Aileen tried to administer CPR, but was starting to panic.

That’s when Peyre-Ferry—an off-duty Virtua paramedic dining with his two children—stepped in to help.

“He started chest compressions and he did not leave his side until they got him stable enough to move him,” Aileen says. “He’s an angel—he really, truly is. If not for him being there that night, we would not be here today. And we would not have been married a month ago.”

“We found out that he didn’t have a pulse, so we started CPR right away,” Peyre-Ferry says. “All the pieces clicked in place. There was a rapid notification of 911, a rapid response from the mobile intensive care unit and the fire department and the police. It was a collaborative effort that was pretty impressive.”

Using an automated external defibrillator (AED) provided by the police, Peyre-Ferry was able to jump-start Stepsis’ heart. Virtua paramedics then arrived and performed rapid sequence intubation (RSI)—a procedure that uses a sedative and neuromuscular blocking agent to secure an adequate airway in the patient. Virtua is the only paramedic program in New Jersey that is approved to do RSI without consulting a doctor first, which allows its paramedics to save crucial minutes in the field.

“In a case like this, where you have a patient who is not breathing and also has a clenched jaw, that makes it impossible to insert the endotracheal tube,” says Scott Kasper, assistant vice president of emergency services at Virtua. “The paramedics have to be able to administer those medications as quickly as possible, and for us to save four, five or six minutes in order to do that, really helps when we get the patient to the hospital.”

Stepsis was transported to Virtua Marlton, where he received an emergent cardiac catheterization and angioplasty. Dr. Randy Mintz, the director of Virtua’s cath lab, says the care Stepsis received in the field was vital to him eventually making a full recovery.

“All of the emergency efforts go toward protecting and maintaining oxygen and blood circulation to vital areas, including the brain and heart,” Mintz says. “If they can better protect oxygen in the patient quickly, without having oxygen deprivation, the patient has a much better chance of saving their life, protecting their heart and protecting their brain.”

More than a year later, Stepsis is now healthy and has even returned to Applebee’s.

He also has a deeper appreciation for people like Peyre-Ferry.

“He was an angel on my shoulder,” Stepsis says. “I feel so blessed that all of them were there for me. I appreciate them more now for the job they do. They save peoples’ lives, and not everybody can say that.”

Daysun Weber
Pennsville’s Daysun Weber came home from football practice and something didn’t feel right. He was running awkwardly and complaining of pain. The then 10-year-old’s family took him to get X-rays and that’s when it was discovered that he had a large cyst on the top of his femur bone, near the hip. What seemed like a nagging injury suddenly turned into talk of surgery.

“There was a risk for him to break his hip,” says Dr. Joseph Rosenblatt with St. Christopher’s Hospital for Children. “A lot of bone cysts don’t require surgery, but where Daysun’s was, it was in an area that had a higher risk of him breaking his hip, so we had to jump on top of it and take care of it before it was a real problem.”

Following a bone graft procedure, Daysun was put in a body cast from his chest down to his toes. “It was scary at first,” the now 12-year-old admits, before flashing a smile that lights up the room.

A little under two years later, however, the cyst returned and a second surgery was in the works. Fortunately, in the little more than a year that has passed since then, Daysun has had no return symptoms and is back to playing baseball, basketball, football—even wrestling.

And while there’s still a chance the cyst could return and Daysun remains under the doctor’s watchful eye, going from a full-body cast to running the bases this summer at an all-star baseball game is largely seen as a success.

“The second time was a charm,” Rosenblatt says.

Debby Madiraca
One week before her baby shower, Westmont’s Debby Madiraca felt a lump on her breast. She didn’t immediately become concerned, chalking it up to her changing body, but mentioned it at her next weekly OB appointment. She went for an ultrasound to have it checked, and when the doctor was called in to review it, she knew something wasn’t right.

“They told me to call my doctor immediately,” says Madiraca. “I asked her, ‘Is it bad?’ and she said, ‘It isn’t good.’” Her OB set up appointments with physicians from the MD Anderson Cancer Center at Cooper, including Dr. Kristin Brill, director of its breast program, and Dr. Generosa Grana, head of hematology and oncology and director of the MD Anderson Cancer Center at Cooper.

After Madiraca’s biopsy results were in, Brill confirmed the cancer in her breast. “When she told me, I started crying, but the nurse, Helen Nichter stayed in the room with me and told me she was a survivor. Seeing her standing there—alive—that was a game changer for me,” Madiraca says. “From that moment on, I only wanted to hear and read stories of hope and inspiration. They helped keep me going.”

She met with Grana to discuss treatment, but there was the matter of the baby to consider. Dr. Elyce Cardonick, who specializes in treating cancer in pregnant women, helped decide which options would be safest for mother and baby. “They felt I was far enough along in the pregnancy for Amelia to be delivered safely so I could start chemo right away,” says Madiraca. Amelia was born July 30, 2013.

With the baby out, Madiraca was able to have a PET-CT (PET scan) to get a better idea of what was going on. This testing revealed the cancer had spread to Madiraca’s liver, which meant she was now diagnosed as Stage IV.

Because of the limits on scans during pregnancy, Grana says they could not have known until after the baby was born that it had spread. The abnormality in the liver meant considering a new treatment plan. “If the cancer is limited to the breast and underarm we’re able to cure many of those … but if it spreads elsewhere, the bones, lungs, the liver, however, is not so common, the cure rates are less. It changes the playing field.”

There was a bit of good news, though. Special genetic testing revealed that Madiraca’s cancer was estrogen receptor positive (HER2). “If there is a good type of cancer, this is it,” says Grana. They were able to target the cancer with new drugs that have proven effective in those with the HER2-positive cancer.

Madiraca spent her maternity leave going to chemotherapy treatments, the first round lasting six months. “Having Amelia made me fight harder because it wasn’t about me, it was about her growing up with a mom,” she says.

After the first round, Madiraca had a lumpectomy to remove tissue where the tumor was. Soon after, she received news that her pathology test was clear—there were no signs of cancer.

“With chemotherapy your goal is a complete response and eventual complete disappearance,” says Grana. “When the disease is in the liver, you may only achieve complete disappearance in 20 to 30 percent, and for those who do achieve it, it’s not always permanent, but each scan gives us hope.”

Madiraca’s scans have been clear for nearly two years. She still receives drug treatment every three weeks, but she says it’s not a drag to be there because the whole team at the MD Anderson Cancer Center has become part of her family. “I’m not cured, I know it’s not guaranteed, but I know cancer won’t kill me,” Madiraca says, “… it’ll probably be the day my daughter starts driving.”

Paul Bechtelheimer
Washington Township resident Paul Bechtelheimer thought he had the flu. The tall, former Division I college athlete—like many men—avoided the doctor like the plague (no pun intended.) But after his symptoms persisted for more than a week in March 2014, he went to a local urgent care, where they immediately transferred him by ambulance to Kennedy—Washington Township’s ED.

Once at Kennedy, Bechtelheimer was put under the care of Dr. Neelesh Parikh, and RNs Diana Ohaus and Christina Goehringer, among many others who provided him care during his illness.

Parikh immediately realized the severity of his patient’s condition, which met the criteria of sepsis.

“When you see two words [describing a patient]: fever and confusion, there’s only a few things that go through your head as an emergency room physician. And you have to act on it very aggressively and very quickly, because time is very important at this stage,” Parikh says.

Bechtelheimer’s reluctance to seek treatment also played into the diagnosis. “When you have a patient that is reluctant to come, I know the severity of that illness is that much higher, and I know this guy is sick. So that staff moved on him very aggressively and very quickly,” Parikh says.

Doctors immediately began administering Bechtelheimer several liters of IVF and IV antibiotics. They also performed various tests to rule out other illnesses, such as meningitis. They ultimately arrived at a sepsis diagnosis.

“It’s a life-threatening condition related to an infection, whether it’s viral or bacterial,” Ohaus explains. “The infection is so severe, it causes total body failure. So your kidneys shut down, your liver shuts down, your brain starts to get less oxygen. … You get blood clots; your fingertips get black; you lose circulation. … Fifty percent of the people who come in with sepsis die. And of the 50 percent of people who live, in a year, 50 percent of those people die. That’s how severe it is.”

Bechtelheimer was transferred to the ICU, where he spent a week, requiring mechanical ventilation and blood pressure support. He doesn’t remember much about his stay, but learned of the severity of his illness after reading a journal kept by his wife, Chris.

“I didn’t know sepsis. I’m a dumb jock. I get cut, hurt, I just jump up and go after it,” he says. “But a couple weeks after my recovery, I had to go back to the kidney doctor, I had to go back to the urologist, I had to go to the heart doctor. And I’m saying to myself, ‘I must have been pretty [sick].’”

And while the source of infection was later determined—a kidney stone that Bechtelheimer didn’t even know he had—he still had some unfinished business at the hospital. He had spent his 60th birthday in the ICU, so for his 61st, Paul went back. He wanted to thank his doctors and nurses—and celebrate that milestone birthday, albeit a year late.

So they set the party up, brought two sheet cakes, one for ICU and one for the ER doctors. “And the next thing you know, I get there and there had to be 70 people in the room, singing happy birthday to me,” he says.

And that thank you went a long way to his nurses and doctors. “One thank you makes me go for another 10 years,” Parikh says. “That’s all I need.”

Diane Anderson
Diane Anderson was diligent about keeping up with her annual mammograms after having a non-cancerous lump removed from her breast in the ’90s, and it just may have been that diligence that saved her life when, in 2012, she was diagnosed with Ductal Carcinoma In Situ, or DCIS.

“When I got the diagnosis, my surgeon had me meet with Dr. [Nicole] Simone and Dr. Simone took care of the radiation part of the treatment,” Anderson recalls. Not only did Simone, a specialist in radiation oncology at Jefferson University Hospital, guide Anderson through the medical portion of her treatment, but she also helped her through the mental part as well.

“It wasn’t just my cancer she was treating,” Anderson says. “I was never frightened about the radiation or about my outcome because I felt like Dr. Simone treated the whole patient. She was taking care of all of me and so because of that it just gave me a secure level of comfort.

“She was there all the time to answer my questions and I felt comfortable asking questions,” she continues. “I just felt like I didn’t have to worry and that she was doing what she had to do to get me the positive outcome we were looking for.” While Anderson is confident discussing her diagnosis and treatment now, Simone says she remembers how nervous Anderson was at their initial meeting.

“When I first met her she was a little nervous about treatment and about how everything would go,” she says. “Your life all of a sudden changes on a dime when you get a cancer diagnosis, and so you’re not only doing your regular job and taking care of your children and husband and everything else, but all of a sudden you have to throw cancer treatment into that and all the emotions that go with that as well.

“There is a lot of anxiety that goes along with that and during the conversations with Diane I realized how much stress she was under—she’s a woman on the go,” Simone continues. “And this cancer diagnosis gave her the reflection to go back and figure out, ‘Where am I in my life and what can I do to change things?’”

Simone says studies have found a strong correlation between weight gain and cancer outcomes, so she was sure to guide Anderson in the nutritional realm as well.

“It was like having a doctor and a friend to go through this with hand in hand,” Anderson says. “I did ask what I could do to help myself through this process and to keep myself healthy, and we talked about a lot of things, and when Dr. Simone got to know me, she realized stress was one of my biggest challenges and so we talked about ways of handling stress or maybe even limiting stress and then keeping a healthy diet. During radiation it’s a good idea to keep your calorie count on the lower side to have good success. We talked all about that and I felt like I had some control over things. I acted on her suggestions and I felt terrific then and I feel terrific now because of that.”

Samaria Alston
After her husband was stationed at Joint Base McGuire-Dix-Lakehurst last fall, Samaria Alston and her family moved from Virginia to the Garden State. The Bordentown resident, 44, had been undergoing mammograms every six months until May 2014 when her doctors told her it would be OK to resume them on an annual basis. That September she discovered a lump while doing a self exam.

Additional testing showed Alston did have invasive breast cancer. Once she met with Dr. Eduardo Fernandez, an oncologist at Burlington County Hematology & Oncology and affiliated with Lourdes Medical Center, Alston was ready to start treatment. “He made me feel comfortable and patiently explained things to me so I understood, which took away a lot of the fear,” she says.

“I remember, after I got over the initial shock, I went into fight mode,” Alston says. “I had my moments but I couldn’t see this being the end. I told Dr. Fernandez I wanted to grow old with my husband and see my daughter get married.”

Alston underwent four rounds of chemotherapy. “Her cancer was Stage II,” says Fernandez. “The microscopic positive in this was the fact that she was HER2-positive and we were able to treat it with Perjeta, which has become the standard of care for this disease.” However, side effects did cause them to stop treatment.

Alston made the decision to pursue surgery. She had a bilateral mastectomy (removal of both breasts) in hopes of preventing the cancer from returning. Recent pathology reports have shown no sign of cancer.

Had Alston not continued her monthly self exams, Fernandez says her outcome could have been much different. “Patients rely on physicians to find abnormalities during an exam and assume mammograms are infallible. But studies show 80 percent of the time, it’s the female patient who has appreciated the abnormality and brought it to the physician’s attention. Samaria shows how important it is for women to be proactive in monthly exams,” he says.

Photo (Gary Mattie): Dr. Reginald Blaber, Beatrice Sankey and Dr. Steven Kernis

Published (and copyrighted) in South Jersey Magazine, Volume 12, Issue 6 (September, 2015).
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