2019 Doctor’s Day A Doctor’s Day tribute to physicians of the North Platte region.
Doctor’s Day 2019
A grandmother’s love spans time, oceans and politics
In February, Great Plains Health neurologist Anil Kumar, MD, traveled toWashington, D.C., to talk to lawmakers about healthcare issues close to his heart. Dr. Kumar’s compassion for patients with debilitating neurological conditions began at his childhood home in India. He grew up in Mirchpur – a small village in India with fewer than 9,000 residents. When he was eight, his grandmother, Gyano Devi, developed crippling spinal cord compression. “It changed everything,” says Dr. Kumar. “She was in a lot of pain. She couldn’t walk. Doctors there didn’t have MRIs or other capabilities. They couldn’t help her.” Two years later, his grandmother died at age 62. “She held my hand before she died,” he says, “and said, ‘Son, I think you’re smart and hardworking. If possible, study this spine condition and find answers.’”
“My parents couldn’t afford the education I would need, but I was determined to find a way. At age 11, I took the exam for state-sponsored scholarships.”
Turning a page “Jawahar Navodaya Vidyalayas (JNV) Khunga-Kothi – a boarding school 50 miles from home – selected me with full scholarship,” says Dr. Kumar. “My parents visited monthly. I studied there from sixth through 12th grade, and won a 100 percent attendance award every year.” Dr. Kumar eventually pursued postgraduate study. “I had special interest in neuroscience. I wanted to learn what happened to my grandmother,” he says, “and contribute to neuroscience. In med school, I learned that the USA was the best place for that.” Dr. Kumar earned his neuroscience PhD in Virginia, followed by a neurology residency and neurophysiology fellowship in Pennsylvania. During a 2005 trip back to India, his friends introduced him to future wife, Renu Kadian. They married that year. Renu finished medical school before joining her husband in the USA, where both earned advanced medical degrees. In 2014, the graduates moved to Nebraska, drawn by its countryside – reminiscent of his hometown in India. “My wife liked it here, and so did I,” he says. Renu is a physician at Great Plains Health. “At Great Plains Health, I work as a neurologist and also serve as the medical director of the stroke program,” says Dr. Kumar, “I see patients with devastating, life-changing conditions. My life’s goal is to improve and prevent brain and spinal cord injury.” Grandmother Devi goes to Washington Inspired by compassion for patients and his grandmother’s plea, Dr. Kumar joined leading American neurologists for “Neurology on the Hill.” Each February, doctors meet with congressional representatives to promote key issues.
2019 Doctor’s Day National Doctor’s Day on March 30 provides the Great Plains Health team and our region’s communities another opportunity to show our appreciation for the many fine physicians who serve our region. We are truly grateful for the commitment to exceptional medical care that our physicians provide and for the many miles they travel to ensure that the people of our region receive quality care as close to home as possible. This special publication is a tribute to our physicians, who spend countless hours making a significant impact on the health of our community. In an age of increasing regulation, reimbursement reductions and change, the healthcare industry has become a highly complex environment to deliver care. Our physicians work tirelessly to stay in step with these complex changes while keeping patients at the center of care, always. Our physicians not only care for local residents, but they are community leaders, neighbors, soccer coaches and friends. We salute these fine men and women who have dedicated their careers to improving the lives of others. As we carry out our mission to inspire health and healing by putting our patients first – ALWAYS – and move forward to our vision to be the region’s most trusted healthcare community, we are honored to partner with the physicians of the North Platte region.
They’re also challenging step therapy protocol, which requires patients to fail on a lower-cost drug before insurers subsidize original prescriptions. “This may work for milder conditions,” says Dr. Kumar, “but for severe conditions, it’s life- threatening.” He urged support for a bill establishing commonsense step-therapy exceptions. Neurologists also advocated for the NIH BRAIN Initiative (Brain Research through Advancing Innovative Neurotechnologies), plus an outcomes-research institute that evaluates therapies. Promising science Dr. Kumar says osteoporosis contributed to his grandmother’s condition, and that improved expertise, technologies and approaches, with nutritional support, could have helped her. He treats diverse conditions, from stroke, dementia and multiple sclerosis to migraine headaches. He’s excited about new research, including neuroprotective therapy after spinal trauma. “After injury, spinal cord nerves are like broken wires,” he explains. “When surrounding connective support tissue is injured, it forms scar tissue that inhibits nerve healing.” “One hypothesis is to find a way to stop or slow tissue growth so both neurons and tissue grow at the same rate,” he says. “We need to find biomarkers and therapies that could help achieve this.” Early mouse studies of “astrocyte ablation” – using chemical, radiation or other therapies to slow post-injury connective tissue growth – shows promise. Dr. Kumar sees hope for injured accident victims, veterans and others. Shared connections Dr. Kumar and Dr. Kadian have been married 13 years. Daughter Anushka is eight, and son Aaryan is five. Their shared interests include caring for the kids, cooking, biking and attending local festivals. In 2014, Dr. Kumar’s parents and brother Satish came from India to celebrate Aaryan’s first birthday. For his family and patients, the future seems hopeful. He’s sure Grandmother Devi would approve.
Mel McNea, MHA Chief Executive Officer Great Plains Health Narayana Koduri, MD Chief of Staff Great Plains Health
Doctor’s Day 2019
GET TO KNOW OUR “HOMEGROWN” PHYSICIANS
Great Plains Health physicians come from all over to care for our communities — and we appreciate each one of them. This year, we want to highlight the doctors who grew up in Nebraska and chose to come back home to practice medicine in the North Platte region.
13 RESIDENCY AND FELLOWSHIP LOCATIONS:
Aurora Health Care Program Akron General Medical Center Creighton University Medical Center Iowa Lutheran Hospital Medical College of South Carolina Medical College of Wisconsin Phoenix Integrated Surgical Residency Temple University Hospital University of Florida University of Oklahoma Health Science Center University of Nebraska Medical Center Virginia Commonwealth University of Kansas School of Medicine
Univ. of Nebraska College of Medicine 65%
Creighton Univ. School of Medicine
MEN 77% 23% WOMEN
Indiana Univ. School of Medicine and Kansas City University of Medicine and Biosciences,among others
HOMEGROWN DOCTORS These Great Plains
28% of Great Plains Health doctors are GRADUATES OF A NEBRASKA HIGH SCHOOL
Health physicians are graduates of Nebraska high schools: Kent Allison, MD Michael Bianco, MD Jeffrey Brittan, MD Raymond Carlson,DO Jason Citta, MD Evan Correll, MD Clark Diffendaffer, MD Wendy Gosnell, MD
University/Medical College of Virginia
Kristin Lake, MD Leland Lamberty, MD Stephanie Marcy, DO Naomi Matthews, MD Dan Mosel, MD Melissa Mosel, MD Shawn Murdock, MD Timothy O'Holleran, MD Michael Simonson, MD James Smith, MD
31% Family medicine
12% General surgery
David Hatch, MD Steven Hinze, DDS Todd Jensen, MD Emily Jones, MD Benjamin Klug, DO Ladd Lake, MD
Other specialties * 45%
Douglas States, MD Paul Travis, MD Jacob Wiesen, MD
* Anesthesiology • Dermatology • Emergency medicine • Internal medicine Obstetrics and gynecology • Oral and maxillofacial surgery • Orthopaedics Pediatrics • Rheumatology
We surveyed our homegrown doctors, and here’s what the participants had to say.
WHAT DOCTORS LIKE THE MOST ABOUT LIVING & WORKING IN THE NORTH PLATTE REGION:
OUR DOCTORS ARE PARENTS. Of those surveyed:
Think it’s a great place to raise children
37.5% have THREE CHILDREN
25% have FOUR CHILDREN
12.5% have ONE CHILD WITH ANOTHER ON THE WAY
25% have TWO CHILDREN
Like being near family and friends
THESE PHYSICIANS ARE ACTIVE IN THE COMMUNITY.
62% volunteer with their CHURCH
Prefer living away from the “big city” 43% Love that skiing is close by 6.5%
THEY ALSO SERVE: The North Platte Children’s Museum West Central District Health Department 100 Women Who Care
31% are involved in SCHOOL & YOUTH MENTORING
Nebraskaland Days Cody Calvary Bridge of Hope Great Plains Health Care Foundation
WHAT ABOUT PETS?
In a city, you mostly see strangers. It is a brief adjustment to take care of family and lifelong friends, but there isn't anything I can think of that is more rewarding.
62.5% HAVE DOGS
Most agree that the opportunity to work at Great Plains Health and be part of a welcoming community are reasons to love this area.
25% have no pets
100% ARE UNIVERSITY OF NEBRASKA CORNHUSKER FANS (0% are fans of Ohio State University)
Among those surveyed: One has both a cat and a rabbit, and one claimed their two small children have some animal tendencies.
The medical staff of Great Plains Health
Naomi Matthews, MD
Edith Newsome, MD
Forrest Ragland, MD
Ravishankar Kalaga, MD
Georgy Kaspar, MD
Olena Dotsenko, MD
Azariah Kirubakaran, MD
Richard Markiewicz, MD
Julie Query, MD
Rick Heirigs, MD
Daniel Mosel, MD
Renee Engler, MD
Marc Hyde, MD
Todd Jensen, MD
Jim Smith, MD
Paul Travis, MD
Kent Allison, MD
Jeffrey Brittan, MD
Jason Citta, MD
Wendy Gosnell, MD
Emily Jones, MD
Leland Lamberty, MD
John Mihailidis, MD
Jesse Dunn, MD
Douglas States, MD
Shawn Murdock, MD
David Lindley, MD
Michael Simonson, MD
Amulya Abburi, MD
Timothy O’Holleran, MD
Kasia Wolanin, MD
Sidrah Sheikh, MD
Nish Navaratnarajah, MD
Eduardo Freitas, MD
Jovanka Vuksanovic, MD
Raj Goje, MD
Renu Kadian, MD
MEDICAL ONCOLOGY / HEMATOLOGY
Demytra Mitsis, MD
Loretta Baca, MD
Kartik Anand, MD
Avinash Pasam, MD
Pushkar Kanade, MD
Anil Kumar, MD
Raymond Carlson, DO
The medical staff of Great Plains Health
OBSTETRICS & GYNECOLOGY
Michael Bianco, MD
Chris Johng, MD
Benjamin Klug, DO
Amy Short, MD
Kristen Burwick, MD
Steven Hinze, DDS, OMS
Evan Correll, MD
John Eitzen, MD
John D. Hannah, MD
Roger Simpson, MD
Pinak Shukla, MD
Mark McKenzie, MD
Nathan Jacobson, MD
Elaine Fitzpatrick, MD
Philip Fitzpatrick, MD
Stephanie Marcy, DO
Grishma Parikh, MD
Lyle Barksdale, MD
Bryon Barksdale, MD
Delane Wycoff, MD
Aleeta Somers-Dehaney, MD
Kathy Lopez, MD
Melissa Mosel, MD
Soogandaren Naidoo, MD
PULMONOLOGY/ CRITICAL CARE
Narayana Koduri, MD
Geetanjali Sahu, MD
Dusty Christensen, DPM
Richard Raska, DPM
Todd Hlavaty, MD
Caroline Sorenson, MD
Guido Molina, MD
Jefrey Start, DO
Henrik Mike-Mayer, MD
Kristin Lake, MD
Clark Diffendaffer, MD
David Hatch, MD
Rick Kukulka, MD
Ladd Lake, MD
Dwayne Collier, MD
Jose DeGuzman, MD
Clinton Schafer, DPM
Millie Erickson, MD
Doctor’s Day 2019
A foot-tapping career and lifestyle
Dr. Christensen loves healing foot and ankle pain, but the best part of his day is being welcomed home by Cadence, his one-year-old girl. “I love walking in and getting the big squeal,” says Dr. Christensen. “She’s so excited that I’m home.” Cadence’s name was inspired by a beloved uncle with a shared passion for music – especially Bruce Springsteen and his legendary saxophonist, Clarence Clemons.
“Uncle Chris, my childhood hero, got me into music, including Clemons, who influenced my music early on.”
The 34-year-old physician has played alto and tenor saxophone and rhythm guitar with backup vocals at events and venues. His favorite song is Springsteen’s “Rosalita,” which he played as a member of the Artichokes – an Indiana band named for its lead singer Art. “It’s heavy on saxophone,” he says. “I love playing that, and the crowd loves it, too.” In addition to music, Uncle Chris loved fitness and cycling. His nephew followed suit. A few years ago, Dr. Christensen lost his uncle to cancer. “When we were expecting our baby girl, I recalled how my uncle often joked about his name – Chris Christensen – being C-squared,” he says. “We thought about his sense of humor and the importance of his musical influence. So, in remembrance of him, we considered a music-themed, ‘C-squared’ name for our baby and chose Cadence.”
Changing chords As a high school senior, Dr. Christensen anticipated a music career but changed his tune after a practicum in Germany. He spent a year doing hospital work while staying with a host family.
“Working in surgery and closely with the nurses on the hospital floor sparked my interest in medicine,” says Dr. Christensen.
He speaks German and remains close to his host family. “My wife, Sarah, and I love traveling. For my 30th birthday she surprised me with a trip to Germany.” They stayed at his host family’s home and celebrated Karneval – the countrywide Mardi Gras–style festivities.
“At Great Plains Foot & Ankle we see clinic patients for routine treatments and then go to the operating room for ankle repairs or reconstructive foot surgery.” He’s treated babies with clubfoot and a six-month-old brought to the ER late at night with hair tourniquet syndrome. “Tangled hair mats cling to clothing,” he said. “Strands in her footie-pajamas wound tightly around her little toe, blocking blood flow – a limb-altering risk.” Dr. Christensen performed surgery on the baby’s foot and was able to save her toe.
Disneyesque proposal Dr. Christensen and his wife have always shared a fondness for Disney, so he plotted a surprise during a trip to Disney World with his parents in 2011. “I enlisted a caricature artist,” he explains. “After he sketched my image I said, ‘Let’s have him draw us together!’ so Sarah sat down, and he finished the picture. “As he turned the easel, Sarah saw the caricatured image of me holding a ring, asking, ‘Will you marry me?’ while I was down on one knee holding the ring. She was so surprised!” Sarah said, “Yes!” Today, in addition to Cadence, they have “fur babies” – a Great Dane named Walter after Walt Disney, plus Ollie, a rescue Beagle. Sports, trauma and medicine “Since I love cycling, fitness and sports, sports medicine – specifically foot and ankle – interested me,” he says. “A lot of mechanics go into pedal strokes, cycling shoes and pace. I like podiatry because of the mix of everything from skin to bone. Podiatry used to consist of mainly small, in-office procedures, but training now consists of a three-year surgical residency focusing on reconstructive foot and ankle surgery. “Training under the team orthopedic surgeons for the University of Notre Dame Athletic Department during residency continued to grow my passion for sports medicine and trauma surgery.”
He treats pediatric to geriatric conditions, including tendinitis, fractures and other trauma, deformities, wounds, vascular disease and arthritis.
“Our clinic is the one-stop shop for foot- and ankle-related issues,” he says.
A new community Dr. Christensen joined Great Plains Foot & Ankle Specialists in January after practicing three years in Kansas City, Missouri. “We both grew up in Laramie, Wyoming. Her parents still live there, and mine live in Rapid City, South Dakota. We are excited about being close to all of Cadence’s grandparents and making North Platte our home.” He has a master’s degree in healthcare administration and management. “I look forward to applying that, including hospital and community outreach, and foot and ankle health education.” He plans to get involved in their new community in many ways. In addition to music, he loves to draw and paint, and hopes to promote the arts in schools and the community. “Sarah and I love animals, too, and would like to volunteer at an animal shelter or find other ways to help.”
They’re also anticipating Cadence’s first Disney World visit during its 50th anniversary in 2021.
Doctor’s Day 2019
An early bird with good reasons to rise
Eye-opening symptoms Dr. Start treats conditions that literally keep people awake at night – whether it’s a mom with insomnia, a teen with narcolepsy or a husband with sleep apnea. “One of my goals at Great Plains Health is raising awareness of sleep/ wake disorders.” Symptoms include chronic yawning, restless nights, awakening with a sore throat or headache and daytime sleepiness. It may be difficult to focus during everyday activities. “We get referrals from primary care practitioners, as well as pulmonologists, neurologists, cardiologists and other specialists,” he says. “Diabetes, obesity, depression and anxiety can play a role. It’s common for partners or parents to refer a loved one.” Dr. Start notes that insomnia and sleep apnea often occur in families due to genetic vulnerabilities. Excess weight can also affect sleep, including sleep apnea – shallow or paused breathing lasting seconds or minutes, sometimes blocking airways. Not everyone who snores has sleep apnea, but people with this condition often snore loudly. A sleeper may snort or choke as breathing restarts. Conditions such as atrial fibrillation – abnormal heart rhythm – are common in people with untreated obstructive sleep apnea. Shut-eye solutions Treatments typically include lifestyle changes. Some patients use machine-based CPAP (continuous positive airway pressure) to keep airways open at night.
Every day, sleep medicine specialist Jefrey Start, DO, rises at 5 a.m. and turns in around 10 p.m. He understands the value of sleep routines and a good night’s rest. That’s easier now that he and his wife, Jayne, have fewer young ones at home. Their six children range in age from 10 to 31. Bob, the oldest, is in Switzerland, and Sam is finishing his doctorate at the University of Rochester in New York. He lives with his wife, Ami, a fifth-grade teacher. Joe and Julie attend Iowa universities, coming home for holidays and summers. High school sophomore Dan has a Tai Kwon Do black belt and dreams of becoming a Navy Seal. Andy, the youngest, excels at multitasking – especially if it involves video games, TV and Lego-building. “He has an amazing personality,” says Dr. Start. “I love hanging out with him.” Family plans and patterns Dr. Start left a multidisciplinary practice in Des Moines, Iowa, to direct the Great Plains Health Sleep Medicine Center in January. In addition to sleep center plans, Dr. Start looks forward to spring break. “We’re renting a ‘sleeps eight comfortably’ sized RV,” he jokes. “We’ll tour the Grand Canyon, Bryce Canyon, Hoover Dam and Petrified Forest National Park, and finish in Las Vegas.” Jayne is an expert quilter, balancing crafted handiwork with computer-aided design. She quilts for clients, friends and family, and is acquiring a long-arm quilting machine. Her creations range from a music-themed quilt for her husband who enjoys classic ’70s rock to a SpongeBob SquarePants quilt that keeps Andy warm. “We get together each Christmas,” says Dr. Start. “Bob and his girlfriend, Zinetta, come home each summer, too. They’re welcomed visits.”
Dr. Start encourages “sleep hygiene” – steps that improve sleep – including consistent routines.
“Poor exercise and nutrition along with sleep problems affect metabolism and circadian rhythms – the 24-hour internal clock controlling sleep/wake cycles,” he says. “Avoid bright lights and plan quiet activities, such as reading, before bed,” advises Dr. Start. “Keep bedrooms cool and dark, and spend time in a brightly lit room within minutes after waking. These and other steps will help.
“Sleep is very important,” says Dr. Start. “It affects blood pressure, heart and lung function, endocrine function, mental health and all other aspects of your health.”
Serving North Platte and neighboring communities Plans for the Great Plains Health Sleep Medicine Center include expanded sleep services, satellite clinics and outreach to underserved locations. “We want to serve communities 50 and 100 miles away,” he says. “We’ll integrate face- to-face evaluations and telemedicine.” Valentine, Ogallala, Gothenburg and other remote communities will have easier access to specialized care.
“Right now we have a two-bed sleep lab, with immediate plans for four beds,” says Dr. Start. “We’re also expanding our home sleep apnea diagnostic programs.”
Beyond work, Dr. Start has other priorities on his to-do list. “I enjoy fixing things around the home, including working on cars,” he says. “My family and I enjoy the great outdoors and watching wildlife.”
“I look forward to attending a Nebraska- style rodeo,” says Dr. Start. “The physical fitness and courage of these young athletes amazes me! I played lacrosse in high school and thought I was pretty tough too – but that’s nothing compared to riding a two-ton angry bull named ‘Wreck’n Ball’!”
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