Coordinated, Collaborative Emergency Care [Les Howard]

My name is Les Howard. I live just outside of Brookings, a few miles. I'm a retired financial advisor. And in the last three years, my wife and I have started a new business called Rustic Reclaim where we salvage old barn wood. I build rustic furniture and decor, and she up purposes old furniture.

What symptoms brought you to the Avera Clinic?

During the morning, my arms just felt really heavy, which I thought was something different. And I had a pain in the middle of my back, but I always had some back problems. So, I didn't think a whole lot about that. But then I did have a real tight chest. And just when I walked in the office, my phone was ringing, my cell phone. And I picked it up, and it was my doctor's nurse, it's Dr. Ahlers' nurse, Ally. And she called me just to set up a follow-up appointment. And I told her, "Well, I'm kind of glad you called because I just don't feel so good." And she asked me to explain my symptoms, and I did. And she says, "Well, can you be in here? Can you come to town right away?" So, I said, "Sure." So, that's kind of what brought me in.

What was your initial diagnosis?

The nurse met me pretty soon and took me into the office. And then from there, they took me to draw blood, and then to get chest X-rays. The PA, Tara Hines, was on call that day. She came in and told me to crawl up on the exam table, and she gave me a nitroglycerin pill. So, I knew something was going on then. And that's when she told me that she thinks I might have had a heart attack. We're gonna ship you to Sioux Falls to the heart hospital. And I said, "That's fine," because they had me at the ambulance in no time and loaded up, and we were heading down the road. I didn't have any sense of urgency or panic. It just, like, I felt like, "Well, I'm in the right place and they're gonna take care of me, so."

How was the ambulance ride to the heart hospital?

It was good. I'd never been in an ambulance before. It took me 66 years to get into an ambulance, and they were very good. I had two attendants there, one young lady and one middle-aged guy. And the whole time, they were putting ports in my arms and getting ready for me to get right out of the ambulance at the emergency room up to where I needed to be at the Heart Hospital. So, no, we were just chatting and discussing things all the way down there. And it was fine.

How did Brookings Health's ambulance crew treat you?

They were very calming. They were both... Well, I guess, probably three, including the driver. But no, there was nothing there that gave me any anxiety. I was confident in what they were doing and how they were handling me, and how they were prepping me. They were telling me what they're doing this for and what they're doing this for. So, no, they were very good, right, clear to the trip into the emergency room.

How was your heart treated?

They fixed the problem that was identified here in Brookings, as I had a blockage and I needed a stent. So, they proceeded with putting the stent in, and I was out of the hospital in...I think the whole thing was less than three days. And that all went really well.

How was your cardiac rehab experience at Brookings Health System?

When I was at the Heart Hospital before I got discharged and they said somebody from the cardio rehab program will be contacting me and you need to do this in two or three weeks. And sure enough, I got a call from Louise, one day at home. It was a good experience. I mean, the folks up there, Jesse, and Louise, and Anne, and Meredith are just the best people in the world. They have a way to make you feel real comfortable because you don't know exactly what you're getting into or what you can do or can't do. I liked it because it gave me an opportunity to come in and get my vitals all officially checked, make sure my blood pressure and heart rate was okay. And they worked with you to get a plan put together that worked for you, because I've got a bad knee, so it's hard for me to do some things.

And so it was a good experience. And I've known Louise since we were kids. We're both from the Pierre area, and we were in 4-H together. They're just really, really friendly and encouraging while you are on a machine. They're there visiting with you. And I'm sure they're finding out things while they're talking to you. So, it's a great program. And it's nice to have those records too because whenever you have an appointment down at North Central heart or the Heart Hospital, you can take those results with you. And then you've got a really good record of what your blood pressure was and your heart rate and what you're doing. So, it comes around to help you in a lot of different ways.

Why did the heart hospital refer you to Mayo Clinic?

They did another angiogram, and then an MRI the next day. And that's where they got some really good pictures. And what they saw then was I was suffering from the growth and hardening of the heart muscle. And there is a procedure, there's a surgery for it, but they didn't feel comfortable doing it at the Heart Hospital. So, they started talking to the doctors at Mayo.

What did you learn about care collaboration?

I didn't realize that you could come to Brookings Health System and get tied into Mayo Clinic. Because when I left here to go to the Heart Hospital, I didn't do anything. I just went. So, it was easier than me trying to do any of these things myself. And then with the portals, I can send messages to North Central Heart, and to the Heart Hospital, and to my own doctor, to Dr. Ahlers is my physician here, and Ally. The communication is just great. And that's the one thing that I learned, you know, people say, "Well, you don't want to go there. Maybe you should go to Mayo or go to Rochester, all these things." If you come here, if you need to be there, you're gonna be there. And that relationship, I didn't know existed. And it worked out extremely well.

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