st. joseph's magazine

ST. JOSEPH’SmagazineA magazine for the friends of St. Joseph’s Hospital and Medical Center Volume 3, Issue 1, 2007

TUMOR ABLATIONFor some patients, it can be a life-saving

alternative to traditional surgery

New Esophageal Disease CenterPhysician detectives work to prevent

cancer of the esophagus

As most of you know, Arizona is one of the fastest growing states in the country. At St. Joseph’s,we often take care of the toughest medical conditions in the state, so to keep pace with thisgrowth, we continue to expand our high-quality care by hiring new physicians from around thecountry to complement the expertise of our local volunteer physician base. This issue will featuresome of those extraordinary physicians and the groundbreaking medical procedures they under-take. You also will read stories of their patients and how these new technologieshave helped to improve their quality of life.

The other challenge of a fast-growing area is adequately serving children. As thesecond largest provider of pediatric services in Arizona, St. Joseph’s routinely han-dles the state’s most challenging medical cases. In this issue you’ll read about howwe are making great strides in pediatric genetics research as well as expanding ourcommunity outreach to serve expectant mothers and new parents.

One positive trend we have seen with our population growth is an increase incharitable giving. People are finding all sorts of creative ways to contribute theirtime, energy and talents. Whether it is playing the Health & Wealth Raffle, hosting a special eventto raise funds for the hospital, or giving to an area of special interest or concern, each person hasmade it his or her mission to support our mission. And for that we are indeed, very grateful.

So enjoy this edition of St. Joseph’s Magazine. We hope you learn more about all the new thingswe are doing and the many hard-working people who come together to help us every day. Theirstories are inspiring and will make you feel good about your connection to St. Joseph’s.

Linda HuntPresidentSt. Joseph’s Hospital and Medical Center

P.S. – Please help us as we begin to develop more efficient and cost-effective ways of com-municating with our donors and friends. Fill out the enclosed postage-paid card or email yourinformation to [email protected] in St. Joseph’s Foundation. Please be sure toinclude your name, address, phone number and email address. In the coming months, wehope to make news from St. Joseph’s available via email to those who prefer it that way.Thanks for your help!

OPENING THOUGHTS

3 Beyond SurgeryTumor ablation gives doctors a less invasive way ofdestroying tumors.

6 Esophageal Disease SleuthsNew center helps patients get to the root of their problem.

9 St. Joseph's Performs Valley's First Lung Transplant

10 Spring 2007 Health & Wealth RaffleRaffle's impact felt throughout St. Joseph's and Barrow.

12 The Road Less TraveledCRS neurosurgery patients in Yuma say goodbye tolong trip to Phoenix.

13 Genetic PuzzleResearchers hope to unravel the mystery of tuberoussclerosis complex.

16 Finally Free of PainRare new surgery relieves pelvic pain in men and women.

19 New MOMobile Coming Down the RoadThanks to the Virginia G. Piper Charitable Trust, Steve andShelby Butterfield, and the BHHS Legacy Foundation

22 Why We GiveAngelita’s Amigos funds family-friendly rooms for children.

25 Golf GalaLou Grubb and friends gather for 18 holes and more.

28 Past, Present and FutureFriends of Mercy reconnect at annual dinner.

30 News

ST. JOSEPH’SmagazineA magazine for the friends of St. Joseph’s Hospital and Medical Center Volume 3, Issue 1, 2007

contents

Catherine [email protected]

Justin DetwilerArt Director/Designer

Jackie Mercandetti, Roger MonroeJeff NoblePhotography

Panoramic PressPrinting

Linda Hunt, PresidentSt. Joseph’s Hospital and Medical Center

Mary Jane Crist, CFRECEO, St. Joseph’s Foundation

• H o w t o R e a c h U s •St. Joseph’s Magazine is published twice a year by St. Joseph’s Foundation. We welcome your comments, suggestions and requests to beadded to or deleted from ourmailing list. Call 602-406-1041, email [email protected] or sendmail to St. Joseph’s Magazine, Office ofPhilanthropy, St. Joseph’s Hospital andMedical Center, 350W. Thomas Rd., Phoenix, AZ, 85013. Please include your name, address and day-time telephone number in all correspondence. Visit us online at www.StJosephs-Phx.com.

S T . J O S E P H ’ S M A G A Z I N E2

Editor’s note: Monique Mendoza underwent a lungtransplant in 2004 at the University of SouthernCalifornia. She was a patient of several of the lung-transplant specialists now at St. Joseph’s, includinglung-transplant pulmonologist Tony Hodges, MD;lung-transplant surgeon Michael Smith, MD; andlung-transplant coordinator Brandi Krushelniski.“Monique has cystic fibrosis and was on a non-inva-sive ventilator three years ago before her transplant,essentially unable to walk,” says Dr. Hodges. InJanuary, the Lung Transplant Program at St. Joseph’sHeart & Lung Institute received the email below aboutMonique’s preparations to compete in the LavamanTriathalon in Hawaii to benefit the Leukemia andLymphoma Society. Monique finished the triathlon infive hours and 10 minutes, and raised $5,700.

I pray that this letter finds you and your familywell!

I’m in the midst of a whirlwind of training for mytriathlon, beating my body to be in the bestshape of my life by April 1st!

Don’t let the date fool you! I’m hoping to encour-age everyone that there is abundant life to liveafter a transplant! Please help me finish the raceset before me and donate to the Leukemia &Lymphoma Society.

I have already committed my own finances tomake this happen, but am still short $2,128.50 tostart the race, having already raised $3,271.50!

Over the hill, but not quite to the finish line!

Since I “recommitted,” I now have until March16th to raise the rest.

Thank you all for your love, support, finances,prayer & words of encouragement! Theymean more than you know.

Love always, Monique

I can do all things through Christ whostrengthens me!

LETTERS

S T . J O S E P H ’ S M A G A Z I N E 3

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Arelatively new method ofdestroying tumors that is sig-

nificantly less invasive than surgeryis being used successfully at St.Joseph’s Hospital, promising quick-er recoveries and another option forcancer patients, especially those whoare poor candidates for surgery.

Eric vanSonnenberg, MD, chair-man of St. Joseph’s RadiologyDepartment, brought radio-frequen-cy ablation (RFA) to the hospitallast year.

“It offers an alternative to ther-apy that previously didn’t exist, andthat’s either for palliation or forpatients who might be cured by sur-gery but who aren’t surgical candi-dates,” Dr. vanSonnenberg says. Theradiologist, who co-authored a book

by Melissa Frederick Morrison

Eric vanSonnenberg, MD,displays several probes usedin tumor ablation.


about the technique, Tumor Ablation: Principles andPractice, used RFA for five years at Harvard’s Brigham& Women’s Hospital, Children’s Hospital, and theDana-Farber Cancer Institute before coming to St.Joseph’s.

In RFA, a needlelike probe, guided by a CT scan orultrasound, targets the tumor, zapping it with nearlyboiling-hot heat, while leaving the surrounding healthytissue undisturbed. Most patients who undergo RFAneed only an overnight hospital stay.

RFA has proven effective for destroying solid tumorsin most organs, including the liver, which is difficult tooperate on because too much healthy tissue can bedestroyed in the process. RFA also has been used todestroy tumors in the lungs, kidneys, adrenal glands,and breasts, as well as on bones, including the spine.

Michelle’s storyTumor ablation

has proven especiallypromising for patientswho are risky surgerycandidates, such asMichelle Michaud.The 38 - year - oldPhoenix prosecutorwas diagnosed with arare cancer when shewas 13 years old.Pheochromocytoma,or pheo, is a tumor ofthe adrenal glands.Normally, it is benign.Michelle, however, wasone of only seven peo-ple in the countryknown to have amalignant version.Doctors told her shewouldn’t live to graduate high school.

After an initial surgery, her tumor reappeared, thistime in her liver. Surgery was no longer an optionbecause of the risk to the organ. Instead, Michelleunderwent years of grueling experimental chemother-apy. It kept her alive, but it also made her miserable. Shequit chemo after three years, vowing never to repeat theexperience, regardless of the consequences.

For several years, the pheo remained quiet. Michelleindeed graduated high school, then college, then law

school. She got a job with the City of Phoenix prose-cutor’s office, and—defying yet another “never” fromher early doctors—had a baby.

When her son, Christopher, was 2, however, shegot a nagging feeling that something had changed. Avisit to her oncologist confirmed her suspicions: the pheoin her liver had awoken. Over the next few years,Michelle and her doctors watched and waited. Thetumor eventually doubled in size. It was time to takeaction.

“It’s incredible to think that, 10 years ago, to get thistumor inside of me out would be full-on liver sur-gery,” she says. “Twenty years ago, it may not have evenbeen possible. And 30 years ago, it would have been tan-tamount to a death sentence.”

Destroying the tumor, not her healthThis time, RFA offered a means of destroying the

tumor withoutdestroying Michelle’shealth. In December2005, Dr. vanSonnen-berg and GregoryStringfellow, MD,guided by a CT scan,used RFA to target theliver tumor. Subse-quent tests have shownthat the tumor wasindeed neutralized.Over time, Michelle’simmune system willdigest and remove thedead tissue.

RFA can be usedalone or to supple-ment traditional can-cer therapies, such aschemotherapy and

radiation.For patients whose cancer is too advanced for cure,

RFA can reduce the pain caused by large tumors byreducing their size and thus their pressure on nerves.

RFA’s risks are minimal. They include the possibil-ity of infection, bleeding and accidental perforation oforgans. RFA is not for everyone. It cannot be used onthose with cancers, such as leukemia, where the growthsare diffuse or on patients with tumors near blood ves-sels (which carry away the probe’s heat) or major nerve

In tumor ablation, the physician maneuvers a probe, such asthe ones pictured above, into the tumor and then deploys fin-gers into the tumor that zap it with nearly boiling-hot heat.


centers (which can inadvertently be destroyed).But for most other cancers—including some, such

as Michelle’s, that previously had few effective thera-pies—RFA can literally be a lifesaver.

“I’ve been dealing with this since I was 13,” saysMichelle, whose son is now 8. “My dad used to say hedidn’t want his kid to be the last one to die before theyfound the cure. ... For me the thing to kick this has mostrecently been RFA.”

Michelle Michaud with her son, Christopher, andhusband, Randy.

“It’s incredible to think that,

10 years ago, to get this

tumor inside of me out

would be full-on liver

surgery. Twenty years

ago, it may not have

even been possible.

And 30 years ago, it

would have been

tantamount to a

death sentence.”

Michelle Michaud

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Above, Sandi Nagawa, NP, andRoss Bremner, MD, examineimages of a patientʼs esophagusin the Esophageal Disease Center.Right, Mary Lou Dinoffria, RN,measures a patientʼs swallowingcontractions with what may be theValleyʼs only high-resolutionesophageal manometry.


by Melissa Frederick Morrison


Esophageal cancer is rising faster than any other typeof cancer in the Western world, according to some

experts. The Esophageal Disease Center (EDC) at St.Joseph’s Hospital and Medical Center opened last year tofocus on preventing and treating such cancer, along withother diseases related to the esophagus and stomach,

such as gastroesophageal reflux disease (GERD).

“The most outstanding feature of the EDC is that itis a comprehensive center, dealing with all aspects ofesophageal disease, from common GERD to complex can-cer surgery,” says Ross Bremner, MD, PhD, a thoracic sur-geon and the center’s director. “Part of our success is wereally enjoy helping patients get to the bottom of theirproblems.”

One-stop shoppingWith a staff of two surgeons, a gastroenterologist, a

nurse practitioner, endoscopy nurses and nurses who runthe center’s dedicated lab, the EDC has what is basical-ly a group of medical detectives. Nurse practitionerSandi Ogawa calls the center’s approach “one-stop shop-ping.” Patients can see all the specialists related to theirdisease here, get most of their tests done and benefit fromthe time that staff are able to devote to the non-medical,as well as medical, aspects of treatment.

“They were willing to give me their private cell-phone numbers,” says Mesa’s Linda Cochran, who hadgastroesophageal surgery in December. “Dr. Bremnertreated me like I was a person, not a situation.”

Before she arrived at St. Joseph’s, Linda, who hadsuffered from severe reflux for several years, had seen avariety of surgeons around the Valley and undergone abattery of tests that required her to bounce betweendifferent hospital departments and facilities.

“I was getting, “Run here! Run there! Run here! Runthere!’” says Linda, 47, an administrative secretary whohad to take time off from her new job for every medicalappointment. “It made me crazy.”

That changed at the Esophageal Disease Center. “I didall the testing right there at St. Joe’s,” she says.

Interpreting unusual symptomsMore importantly, she found medical professionals

who didn’t disregard her unusual symptoms as signs of

unrelated medical problems, as others did. After yearsof enduring a burning sensation in the back of herthroat—a familiar sign of acid reflux—she began suf-fering at ight-en ingin herc h e s tt h a twas sosevere that she at first feared she was having a heartattack. She also began experiencing chronic vomiting anddiarrhea.

“I couldn’t count on what my day was going to be like,”she says. “I could wake up in the morning perfectlyhealthy, ready to kick butt, then drive in to work and I’msick as a dog.”

By focusing specifically on esophageal disease, the cen-ter’s staff has the resources and experience to interpretsubtle or unusual symptoms. For Linda, the solution wasredoing an operation she had had six years earlier to repairthe flawed valve between her esophagus and stomach.Since Dr. Bremner performed the surgery in December,her vomiting and diarrhea have disappeared.

“I told him today, I didn’t realize how sick I was untilI felt better,” Linda says. She is now able to sleep normal-ly, rather than sitting upright, as she had been forced todo before the operation. She takes medication for occa-sional reflux on an as-needed basis. “I anticipated Iwould feel somewhat better, but this was more than Icould ever have expected.”

Preventing esophageal cancerAccurately identifying and treating reflux disease is

key to preventing esophageal cancer. One reason for theincreased rate of such cancer is more reflux disease,which is exacerbated by a lifestyle typical of Westernnations.

“Overeating and drinking alcohol and smoking andthose sort of things contribute to weakening of thevalves, and patients end up with bad reflux,” Dr. Brem-ner says. Reflux disease is associated with Barrett’s esoph-agus, a pre-malignant condition. Identifying and treat-ing such precursors is paramount.

Identifying and treating acid

reflux disease is critical to

preventing esophageal cancer.

“We have what we call typical symptoms and atyp-ical,” Dr. Bremner says. “A lot of people may complainof heartburn but may not be having reflux, and a lot ofpeople having reflux may not have any symptoms.”

Heartburn is caused when the stomach’s highly acidicdigestive juices escape up into the esophagus, the tubethrough which food passes after it’s swallowed. Refluxis basically chronic heartburn and indicates a problemwith the valve that controls food’s entry to the stomach.Determining whether a bout of reflux is nothing toworry about or a symptom of a more serious problemis part of Sandi’s job.

“Heartburn is very common,” she says. “Most peo-ple say, ‘I’ve had heartburn for years, I never thought aboutit.’ Somebody like me, who is used to seeing that type ofsymptom, knows how to take those subtle things and askthe right questions: Is it getting worse? Is food comingup? Or just acid? Are you having a lot of chest colds?”

Specializing in Barrett’s surveillanceOther symptoms are even wilier—including a lack

of them. A hallmark of Barrett’s esophagus is that the bodymay adapt to constant acid baths by changing fromthin, sensitive squamous cells to thicker, cushier col-umn-shaped cells. This causes symptoms to disappearso that patients no longer suffer from irritation andbelieve their problem has disappeared as well.

In fact, Barrett’s patients have twice the chance of devel-oping cancer. That’s why it’s crucial that they be regu-larly monitored.

“Basically I’m a great proponent of what’s called Bar-rett’s surveillance,” Dr. Bremner says. “We know if we fol-low those patients and endoscope them every year or two,we can watch the progression and protect them beforethey get esophageal cancer.”

The center also plans a Barrett’s Registry, a nationalcompendium of Barrett’s cases, so that the most effec-tive treatments can be evaluated on a grand scale.

The center boasts many high-tech tools with whichto monitor disease and make diagnoses, including whatmay be the Valley’s only high-resolution esophagealmanometry, whichmeasures swallowingc o n t r a c t i o n s .Catheterless pH test-ing determines theacid content of refluxin the esophaguswithout the patientenduring a tubedown his or herthroat. And contin-uous digital esopha-gography provideswhat is basically areal-time movie of apatient’s swallowing.

The combinationof tools and expert-ise—and a detective’szeal for unravelingmedical mysteries—is at the heart of St.Joseph’s EsophagealDisease Center.

“We delight in sorting out different problems patientshave with the esophagus and have the tools at our dis-posal for working them out,” Dr. Bremner says.


“We know if we follow

these patients and

ensdoscope them

every year or two,

we can watch the

progresion and

protect them before

they get esophageal

cancer.”

Ross Bremner, MD

Foundation supportPhilanthropy will be critical to building the EsophagealDisease Center. For information about how you can help,call St. Joseph’s Foundation at 602-406-3041.

Linda Cochran escaped a crazy schedule of runningfrom one doctor to another for answers to heresophageal problems when she landed atSt. Josephʼs Esophageal Disease Center.

The Heart & Lung Institute (HLI) at St. Joseph's Hos-pital and Medical Center recently performed the

Valley's first lung transplant.Ann Wylie, 61, of Scottsdale became St. Joseph's and

the Valley's first lung-transplant recipient after under-going a double lung transplant at the hospital on April20. Ann suffered from advanced COPD (chronic obstruc-tive pulmonary disease) and was placed on a transplantlist in San Diego in February. After hearing of St. Joseph'srecently approved lung-transplant program, Ann choseto receive her medical care locally. Within one week ofbeing placed on the transplant list in Phoenix, Annreceived two new lungs.

“I'm so thankful for the care that I've received at St.Joseph's,” says Ann. “Instead of being flown to San Diegofor the transplant, I was able to stay in my hometownand receive excellent medical care.”

Lung transplants are among the most complicatedmedical procedures. The hospital selects candidates whoare eligible for lung transplants and places them on theUnited Network for Organ Sharing (UNOS) transplantlist. Surgeons have approximately six hours to trans-plant a lung once one is retrieved. Following the surgery,lung-transplant recipients must receive lifelong care,

including regular check-ups with lung-transplant spe-cialists.

“Before St. Joseph's began offering lung transplants,local residents had to travel out of state for care,” says RossBremner, MD, PhD, surgical director of the Center forThoracic Disease at St. Joseph's. “St. Joseph's lung- trans-

plant programallows Valley resi-dents in need oflung transplantsto receive theirmedical care local-ly.”


ST. JOSEPH’S PERFORMS VALLEY’SFIRST LUNG TRANSPLANT

by Carmelle Malkovich

Top photo: St. Josephʼs lung-transplant team includes surgeonRoss Bremner, MD, PhD; pulmo-nologist Tony Hodges, MD; sur-geons Michael Smith, MD, andJohn Nigro, MD; pulmonologistRajat Walia, MD; and programcoordinator Brandi Krushelniski.Above, lung-transplant recipientAnn Wylie is shown with her sur-geons, Dr. Nigro and Dr. Bremner.


The impact of the Health & Wealth Raffle on research,medical education and patient care at St. Joseph’s

Hospital is enormous. In the last three years, the Raf-fle has contributed an average of $10 million a year toSt. Joseph’s Foundation and Barrow Neurological Foun-dation, greatly expanding the number of projects, pro-grams and services the foundations can support.

Many programs at St. Joseph’s and Barrow Neuro-logical Institute have received funding from the Rafflesince the mega home raffle began in 2003. Proceeds fromthe Health & Wealth Raffle have helped fund:

• Research into a wide range of diseases—epilepsy,brain tumors, Alzheimer’s disease, multiple sclero-sis, trauma, Parkinson’s disease, stroke and others.

• A new fast-track nursing program on the hospitalcampus.

• A high-end monitoring system for the Nursery ICU,which cares for the most critically ill newborns.

• Several endowed chairs, which enable St. Joseph’s torecruit and retain top physician-scientists.

• New research laboratories. • The new Heart & Lung Institute.

HEALTH & WEALTH RAFFLE’S IMPACTFELT THROUGHOUT ST. JOSEPH’S

by Catherine Menor

Yvette and Robert Standoval, Gilbert, won GrandPrize #1 in the Spring 2007 Health & Wealth Raffle.


• High-tech equipment for research, medical educa-tion and patient care, including a rapid prototypingmachine, a flow cytometer, endovascular simulationdevices, and an immersive multi-media educationsystem.

• A tissue bank that collects and stores donated humantissue for future research use.What makes the Raffle particularly important to the

hospital is the fact that Raffle funds can be invested ina variety of programs and services beneath the umbrel-la of research, medical education and care for those inneed.

“Proceeds from the raffle are treated much likeunrestricted funds. While restricted funds must beused for very specific purposes, Raffle funds can be usedfor many different programs and services, giving usmuch more flexibility,” says Mary Jane Crist, chief exec-utive officer of St. Joseph’s Foundation and BarrowNeurological Foundation.

“We can invest these funds where they are neededmost. For instance, Raffle dollars helped establish thenew Heart & Lung Institute, which has brought much-needed cardiothoracic services, including lung trans-plants, to the Valley.”

Winning NumbersHealth & Wealth Raffle 2003-2007

Health & Wealth Raffles . . . . . . . . . . . . . . . . .8Prizes awarded . . . . . . . . . . . . . . . . . . . .71,990Homes awarded . . . . . . . . . . . . . . . . . . . . . .19Vehicles awarded . . . . . . . . . . . . . . . . . . . .264Trips awarded . . . . . . . . . . . . . . . . . . . . . . .255Cash awarded . . . . . . . . . . . . . . . . .$8,005,900Total retail value of prizes . . . . . .$43,649,703

Celeste Schaumburg ofApache Junction won GrandPrize #2 in the Spring Raffle—a house, car and cash.


For Yuma pediatric neurosurgery patients enrolledin Children’s Rehabilitative Services (CRS), a med-

ical trip to see their physician in Phoenix is no longeran all-day travel event. Now, a follow-up exam with pedi-atric neurosurgeon Harold Rekate, MD, takes just min-utes with the help of long-distance technology—andsome medical ingenuity.

The Telemedicine Program, which was launched in2004, is held three to four times a year on the lastWednesday of each month at Yuma Regional MedicalCenter, according to Carmen Sprague, the programcoordinator. On average, between five and eight pedi-atric neurosurgery patients are evaluated during theinteractive clinics, which are administered throughCRS at St. Joseph’s Children’s Health Center.

“Before the program was launched, Dr. Rekatewould travel to Yuma a couple of times a month, whichcaused a backlog in Phoenix. It was cumbersome. It wasalso difficult for many families to make the drive fromYuma,” Carmen explains.

Real-time medicineUsing a two-way television system, Dr. Rekate con-

trols cameras during the exam, interviewing the patientwhile a pediatric nurse in Yuma assists with the assess-ment simultaneously.

“All questions can be asked and answered in realtime—a real benefit to the family,” Dr. Rekate says ofthe video-conferencing equipment.

Dr. Rekate’s long-distance exams are aided by elec-tronic X-rays, computer scans and peripheral devices,such as stethoscopes attached to the computer.

The technology is limited to certain diagnoses andis not used for complex neurological cases. The vastmajority of pediatric patients participating in the pro-gram have had surgical procedures, such as shunts,according to Dr. Rekate.

Since the Telemedicine Program began, the num-ber of patients being examined in Yuma has doubledeach year. “It is occasionally necessary for patients totravel to the Valley for studies or difficult decision-making, but for general screening, it is ideal,” he says.

Just like being thereWhile the sensory characteristics of a traditional

exam, such as hearing and touch, are lost in the Telemed-icine exams, Dr. Rekate says the onsite nurse adds a greatdeal to the visual process by performing some of theinvestigations on the child.

And, according to Carmen, a recent survey to assessthe program indicated that the lack of a doctor’s touchwasn’t a concern. “Parents love it. Most families are sat-isfied with the program and felt they received the sametreatment and interaction with him and were able toask questions as if they were in the same room,” she says.

The greatest benefit of the Telemedicine Program,says Dr. Rekate, is that travel time for patients, fami-lies and the doctor is reduced significantly, which leadsto an increase in patient satisfaction and physicianefficiency.

“The advantage is that there is no need to travel fiveto six hours to see follow-up patients for 10 minutes.I would always prefer to see a patient face to face, butthis situation saves a great deal of energy on everyone’spart.”

What is CRS?Children’s Rehabilitative Services (CRS) is a state-and federally-funded outpatient and managed-care pediatric service operated by designatedmedical facilities, including St. Joseph’s Chil-dren’s Health Center. Its mission is to provide med-ical treatment, rehabilitation and related sup-port services to medically qualified individuals,primarily children, who have certain medical,disabling or potentially disabling conditions thathave the potential for functional improvement.

CCRRSS PPEEDDIIAATTRRIICC NNEEUURROOSSUURRGGEERRYY PPAATTIIEENNTTSS SSAAYY GGOOOODDBBYYEE TTOO LLOONNGG TTRRIIPP TTOO

PPHHOOEENNIIXX

by Sally J. Clasen

THE ROAD LESS TRAVELED

Harold Rekate, MD, follows up with some pediatric neuro-surgery patients in Yuma via a two-way television system.


CCHHIILLDD NNEEUURROOLLOOGGIISSTT HHOOPPEESS TTOO UUNNRRAAVVEELL TTHHEE MMYYSSTTEERRYY OOFF TTUUBBEERROOUUSS SSCCLLEERROO--

SSIISS

by Catherine Menor

Piper Dutcher and her father,James, are a medical mystery

that child neurologist VinodhNarayanan, MD, and researchersGarilyn Jentarra, PhD, and GabeRice, MS, hope to unravel in theDevelopmental Neurogenetics Lab-oratory at St. Joseph’s.

Piper was born in March 2004with heart problems, including aslow heart rate and premature ven-tricular contractions. A CT scanfound tubers in the infant's brain—tangles of disorganized neurons—and tumors in her kidney. She alsohad white spots on her skin. All aresigns of tuberous sclerosis complex(TSC), a genetic disorder that caus-es abnormal growths in the eyes,heart, kidney, skin, brain, lungs andother organs. One in 6,000 babies isborn with TSC.

Piper's doctor ordered DNA test-ing and confirmed that Piper hasthe genetic mutation that causesTSC. Then, the infant's parents,Amanda and James Dutcher, under-went DNA testing, and learned thatJames, too, has the genetic muta-tion for TSC although he has nosigns of the disorder.

GENETIC PUZZLE

Piper Dutcher with her mother, Amanda


Mutant versus normal genesLike all genetic disorders, TSC is caused by a change,

or mutation, in one of the approximate 30,000 genesthat make up the human genome. A mutant gene isunable to direct production of a specific cellular pro-tein correctly and, thus, causes a disruption in normaldevelopment or functioning. Mutations in one of twogenes, TSC1 or TSC2, cause tuberous sclerosis complex.Every human being has two TSC1 genes, and two TSC2genes; one of each pair is inherited from the fatherand the other from the mother.

Piper received a normal TSC2 gene from her moth-er and a mutant TSC2 gene from her father. In somegenetic disorders, both parents must contribute amutant gene in order for the genetic disorder to showup in the child (“recessive” conditions). But in the caseof TSC and other “dominant” conditions, the mutantgene dominates the normal gene, causing the geneticdisorder and its symptoms.

So how can two people—both with one mutantand one normal TSC gene—be so different? James hasno symptoms of TSC, while Piper exhibits its classicsymptoms.

“There's something influencing whether someonehas a mild form of the disease or a more severe form.That 'something' is what we hope to identify in ourresearch,” says Dr. Narayanan, who conducts researchinto TSC and other rare genetic disorders.

Gene expression may be the answer Dr. Narayanan and his research associates believe the

difference between Piper and James' conditions may liein the protein expression of the mutant gene and thenormal gene in each individual.

“Perhaps in the person with little or no symptoms,the normal gene produces proteins at a higher level thanthe mutant gene so that the effect of the mutant pro-tein is minimized,” explains Dr. Narayanan. “On theother hand, in the person with more severe symptoms,it may be the mutant gene that is expressing the major-ity of the protein. Thus, several members of a family

“There’s something influencing

whether someone has a mild form

of the disease or a more severe

form. That ‘something’ is what we

hope to identify in our research.”

Vinodh Narayanan, MD

Gabe Rice, MS, (left) and Vinodh Narayanan, MD, and Garilyn Jentarra, PhD, (right) are conducting researchinto the genetics of tuberous sclerosis.


could have the same mutation but be affected differ-ently, depending on the relative level of expression ofthe normal and mutant genes.”

The Dutchers have agreed to participate in a researchproject that will examine the level of protein expres-sion for the mutant and normal TSC genes, and com-pare those levels to the severity of the disorder.

“Our goal is to determine if the levels of gene expres-sion correlate with the severity of the disease,” says Dr.Narayanan.

If the levels of gene expression do correlate with theseverity of the disorder, the research may prove valu-able in treating future patients with TSC.

“If we can diagnose these patients in infancy and atthe same time do a blood test that tells us the level ofprotein expression from the two genes, we can moreeffectively treat the patient,” he says.

“For instance, if we find that a child with TSC hasa high expression of the mutant gene and low expres-sion of the normal gene, then we would conclude thatthat person is at higher risk for a severe form of the dis-ease and we would treat that patient more aggressive-ly.”

Improved quality of lifePiper is an example of the value of an early diagno-

sis. Because she was diagnosed in infancy, she receivedearly treatment, including anti-seizure medication forepilepsy caused by the tubers in her brain. Today, sheis seizure free, and her only deficit is a speech delay. Shereceives care from specialists in neurology, urology,cardiology and genetics at St. Joseph's Children's Reha-bilitative Services.

Dr. Narayanan has been a blessing, says Piper'smother. “He's answered my questions about every-thing that's going on in her brain. His experience withtuberous sclerosis has given us confidence.”

The Developmental Neurogenetics Laboratory isapplying for grants to fund the TSC research project.Donors interested in helping can contact St. Joseph'sFoundation at 602-406-3041.

The research Barrow isconducting into tuberoussclerosis may improvecare for children likePiper. One family has contributed $15,000 to Dr. Narayananʼs research.If you are interested inhelping, please call St. Josephʼs Foundation at 602-406-3041.


FINALLY FREE OF PAINRRAARREE NNEEWW SSUURRGGEERRYY RREELLIIEEVVEESS

CCHHRROONNIICC PPEELLVVIICC PPAAIINN IINN MMEENN AANNDD WWOOMMEENNby Sarah Padilla

For many people, there’s nothing more relaxing than sitting down to watch tele-vision after a long day. But for Ramona Valyou and Pat Synder, there was a time

when the simple act of sitting on a couch would cause the most excruciating painthey had ever known.


The two women suffered from pudendal neuralgia,injury to the pudendal nerve most commonly causedby entrapment of the nerve (PNE). After undergoinga rare surgical procedure by St. Joseph’s Michael Hib-ner, MD, to correct the condition, both women are noweasing back into lifestyles they once thought theywould have to give up for good.

Dr. Hibner, director of St. Joseph’s Division ofGynecologic Surgery and the Arizona Center forChronic Pelvic Pain, has always had a special interestin diagnosing and treating chronic pelvic pain. Afterwatching his wife suffer from a herniated disk sever-al years ago, the cause became even more important

to him. “I believe in doing one thing and doing it well,” he

says. “And when it comes to surgery for something asspecific as pelvic pain, I believe that you need extra sur-gical training to be able to perform the procedures well.”

Recently, Dr. Hibner became one of only a hand-ful of surgeons in the world to specialize in treatingpudendal neuralgia, a condition from which an esti-mated one out of 100,000 people suffer.

The pudendal nerveThe pudendal nerve runs from the lower sacral

region into the perineal region and affects the pelvicorgans, pelvic floor muscles and external genitalia.Entrapment of the nerve, which is similar to whatcauses carpal tunnel syndrome, may be caused by aninjury during gynecologic surgery or pregnancy orby a traumatic injury, or it may develop from anunknown cause. It’s not limited to women; about 20percent of those with the condition are men.

The most common symptom is severe pain in thegenital area. The pain usually only occurs when sitting

due to compression of the nerve; standing or lying downusually helps alleviate the symptoms. The pain, whichrarely responds to medication, gets progressively worseover time.

Because it is rare, pudendal neuralgia is often mis-diagnosed. On average, it takes four years and up to30 physician visits to receive an accurate diagnosis. Frus-trated and in agonizing pain, many of Dr. Hibner’spatients admit to being suicidal when they finallymake it to his office.

Both Ramona, 61, and Pat, 53, began to experiencesevere pain after a surgery. Ramona’s pain began sev-eral years ago after she had surgery to remove a largetumor; Pat’s began after a partial hysterectomy in2005. Both women saw countless doctors and were toldthat there was nothing wrong with them before meet-ing Dr. Hibner.

“I sat in his office crying from pain, and I wastelling him how I just couldn’t do this anymore,” saysRamona. “He said, ‘You can do this because I’m goingto help you.’ No one had said that to me before. WhenI left his office, I knew I was going to be okay. Some-thing in the tone of his voice told me that he meantit. And he did.”

Special training in FranceIn June 2006, Ramona became one of the first

patients to undergo the unique surgery performed byDr. Hibner. The previous year, the doctor had spent sev-eral weeks in France learning the procedure from neu-rosurgeon Dr. Roger Robert. Dr. Robert has performed

Only a few surgeons

worldwide specialize in

treating pudendal neuralgia.

One of them is St. Joseph’s

Michael Hibner, MD.

FINALLY FREE OF PAIN

Ramona Valyou and her daughter, Krysten.


the surgery more than 1,500 times in the past 16 years. In the procedure, an incision is made in the but-

tock, and a ligament is severed, allowing surgeons toaccess the pudendal nerve and remove the cause ofentrapment. Most surgeons leave the original liga-ment severed, but Dr. Hibner has created a modifiedapproach in which he uses tissue from a cadaver toreconnect it.

To date, Dr. Hibner has performed the surgery on11 patients and says that 10 of those patients are painfree. Today, Ramona is back to doing everything sheused to do, and Pat is on the road to recovery. As wordspreads, another 10 patients are already scheduled forfuture surgeries.

Surgery—a last resortDr. Hibner prefers to save surgery as a last resort.

He conducts a thorough diagnostic work-up, whichmay take months. One of the most useful diagnostictools is a series of CT-guided steroid injections, whichare performed by St. Joseph’s radiologist Eric van-Sonnenberg, MD. If a patient’s pain improves temporar-ily following an injection, it is usually a good indica-tion they have pudendal neuralgia. For some, thesteroid is enough to significantly improve their painand eliminate the need for surgery.

Others may benefit from behavioral changes orphysical therapy. Dr. Hibner frequently refers patientsto two Valley physical therapists who specialize inwomen’s pelvic pain. Another integral part of the teamis nurse practitioner Patti Stoffers, who helps educateand support patients along the way.

These days, Dr. Hibner has his sights set on whatelse can be done for these patients before they reachsuch a hopeless state. For example, he’s working withDr. vanSonnenberg on several experimental proce-dures, such as using Botox to help break up adhe-sions that compress the nerve. And ultimately, hewould like to work with Barrow to develop a compre-hensive pudendal neuralgia center at the hospital.

“Not enough people know about this condition,”he says. “I’d like to help change that.”

“I sat in his office crying

from pain, and I was telling

him how I just couldn’t do this

anymore. He said, ‘You can

do this because I’m going

to help you.’ No one had

said that to me before.

When I left his office,

I knew I was going

to be okay.”

Ramona Valyou

Michael Hibner, MD, andPatti Stoffers, NP, in theArizona Center for ChronicPelvic Pain at St. Josephʼs


Margarita Villa and Antonieta Salomon spend nearly150 days a year cruising around together in an RV—

and they get paid for it. The women are part of the extremely dedicated team

behind St. Joseph’s Maternity Outreach Mobile clinic,known affectionately as the MOMobile, which provides freeprenatal care to pregnant women who otherwise might nothave access to such services.

Three days a week, the MOMobile travels to Valley com-munities that are considered at-risk for prenatal care. Theypark the unit in safe and accessible locations, such as acommunity resource center in Mesa, a church in centralPhoenix and a church in Goodyear.

The team—which includes two nurse practitioners, a cer-tified nurse midwife, a clinical coordinator and an outreachcoordinator—serves as the primary care provider to hun-dreds of pregnant women who then have the option of deliv-

NEW MOMOBILE COMINGDOWN THE ROAD

THE VIRGINIA G. PIPER CHARITABLE FOUNDATION,STEVE AND SHELBY BUTTERFIELD, AND THE BHHSLEGACY FOUNDATION MAKE DREAM A REALITY

by Sarah Padilla

“We’ve talked about getting

a new unit for years, and

this time it’s really going to

happen.”

Gail Brown, RNC, WHNP

Barbara Garcia received prenatal carefrom the MOMobile for her children,Sofhia and Sebastian.


ering their babies at St. Joseph’s. The team also workswith various community agencies to ensure that the fam-ilies’ other needs are met as well.

Since its inception in 1995, the MOMobile hasbecome known among community agencies as anexample of community benefit at its finest, says MarisueGarganta, St. Joseph’s director of Community HealthIntegration.

In 2006 alone, the MOMobile had 2,330 patientvisits, and 170 MOMobile babies were born at St.Joseph’s. Their average birth weight of just over 7pounds, 3 ounces mirrors the national average. Since1995, there have been more than 25,000 recordedpatient visits and 1,500 MOMobile babies born at St.Joseph’s.

“Other agencies are always looking at our outcomesand wondering how we’ve made this work so well,” saysMarisue.

A $300,000 custom-built MOMobileWhen it comes to healthy moms and babies, the sys-

tem is definitely working. But the MOMobile, an 11-year-old converted RV, is showing signs of its success.Most RVs aren’t built to withstand more than 10 yearsof heavy use, and factors such as driving in the heat, car-rying heavy medical equipment, and constant foottraffic have led to more-than-average wear and tear.

Luckily, relief is in sight. After five years of fundrais-

ing, St. Joseph’s Foundation has secured $300,000 to pur-chase a brand-new, custom-built unit. Donationsinclude $100,000 from private donors Steve and Shel-by Butterfield, a $50,000 grant from the BHHS Lega-cy Foundation and a $150,000 grant from The VirginiaG. Piper Charitable Trust. The hospital and the Foun-dation will continue to fund the operational and main-tenance expenses for the unit, including salaries and sup-plies.

“I think this is the most excited I’ve ever seen theteam,” says MOMobile manager Gail Brown, RNC,WHNP. “We’ve talked about getting a new unit foryears, and this time it’s really going to happen. Now wecan start thinking on a much broader scale.”

While the new unit is still about a year away, thewomen’s eyes gleam as they talk about details they’vediscussed with the builder—an upstairs area that willinclude a bathroom and a small staff lounge, an awningoff the side of the unit to allow shade for family mem-bers, an updated lab area and central heating.

The biggest change will be that the new unit will notbe an RV, but rather a large, pull-behind trailer. Thistype of vehicle will be better able to withstand theMOMobile’s large amount of foot traffic and will allowmore space for patients.

The current unit’s worn-down benches accommo-date about six patients in cramped quarters that offerlittle to no privacy. The new unit will be able to holdabout 15 patients at one time. It will house two examrooms, and a third room will serve as an office that canbe used to better protect patient privacy.

“Our goal is to have a larger,

more technologically-updated

work environment so that we

have less unproductive time

and more time with our

patients.”

Gail Brown, RNC, WHNP

The MOMobile providesprenatal exams, educationand ultrasound testing atvarious locations in theValley.

“Now, I have to take patients into the bathroom ifwe need to have a private conversation,” says Antoni-eta Salomon, outreach coordinator.

Part-time pit crew membersThe team also hopes that the office will be outfit-

ted with computers with access to the hospital’s systems.Currently, their only link to the hospital when they’rein the field is the cell phones they carry. And, the girlsspend one day each week transferring data from papercharts into computers at the hospital.

“Our goal is to have a larger, more technologically-updated work environment so that we have less unpro-ductive time and more time with our patients,” says Gail.

Ultimately, they would like to see more patients, pos-sibly adding one more site a week.

That the team wants to expand their services speaksvolumes about their commitment to their patients—especially considering their behind-the-scenes duties.In addition to a laundry list of clinical responsibilities,they could add “pit crew” to their resumes. It’s notuncommon to find them loading water tanks, chang-ing tires, disposing of sewage or taking the unit to haveit emission-tested.

“It’s hard work,” says Margarita Villa, LPN, clinicalcoordinator. “You have to be very flexible. It takes a spe-cial team because you have to work together to makeeverything work.”

Marisue believes this is why the MOMobile hasbecome such a success.

“So much of healthcare today is focused on thebells and whistles and having the latest and greatest tech-nology,” says Marisue. “But really, that’s not what it’sall about. It’s about providing quality care where it’sneeded the most and making your patients feel safe andcomfortable. These girls have it down.”


MOMobile Wish List

While the MOMobile is not about the bells andwhistles, a few basics make any job easier. Most ofthose basics will be built into the new MOMobile,but the team will have to purchase some addi-tional equipment. Among the items on their wishlist are:• two new lightweight exam tables• two laptop computers with wireless

internet capability• a portable ultrasound machine• a portable fetal monitor• an acoustic stimulator• a TV and DVD player (for playing

educational videos)• a fax machine/scanner/copier.

If you would like to help with the MOMobile’s wishlist, contact St. Joseph’s Foundation at 602-406-3041.

Photo above: The MOMobileteam includes Margarita Villa,clinical coordinator; Gail Brown,RNC, WHNP, manager; andMariantonieta Saloman, outreachcoordinator.


WHY WE GIVECOUPLE’S FOUNDATIONFUNDS FAMILY-FRIENDLYROOMS FOR HOSPITALIZEDCHILDREN

Angela Olivas died in 1986 of leukemia. She wasnot quite four years old. Her parents, Joann and Bob,

stayed at her bedside 24 hours a day during severallengthy hospital stays in St. Joseph’s Children’s HealthCenter. Out of that experience, the Olivases decided todo something that would not only honor their youngestchild but also help families in similar situations.

Angelita’s Amigos was officially incorporated as a non-profit foundation in 1999. Shortly afterward, it openedthe first Angelita’s Amigos family-friendly room in theChildren’s Health Center at St. Joseph’s. Today there arefour Angelita’s Amigos patient rooms in the Pediatric Unit,and three such rooms in the Pediatric Cardiac CareUnit, plus two treatment rooms.

Bob and Joann met recently with Sharon Glanville,clinical director of the Children’s Health Center Inpa-tient Services, to discuss the legacy they are creating.

by Catherine Menor

St. Josephʼs Sharon Glanville withdonors Bob and Joann Olivas

“Angelita’s Amigos was

estabished because of

what we went through

when our baby was

hospitalized here.”

Bob Olivas


How did you come up with the idea of creating family-friendly rooms?

Bob: Angelita’s Amigos was established because ofwhat we went through when our baby was hospitalizedhere. We walked in the same shoes these people arewalking today. We know what they’re going through.

Joann: Every other month we were here. When shewent to the doctor’s office to take her chemo, we knewwithin three days we’d be here. Sure enough, just likeclockwork. We never left the baby by herself.

Bob: It was our time spent here at the hospital in avery, very small room that brought about the idea for fam-ily-friendly rooms. Every night that we stayed here, theroom got smaller and smaller. After a while, you find ithard to breathe.

When we started thinking about creating this room,we weren’t thinking about a hospital room. We were think-ing more about the Marriott. That’s what I wanted theroom to look like. Let’s pay more attention to the fam-ilies, the people who are really stressed out.

Anatomy of an Angelitas Amigos Room

DVD player

Stereosystem

Home-likeshutters,furniture,paint &artwork

Sofa that convertsinto a bed

Television

Refrigerator

Wood floor


Sharon, do the rooms really make a difference?

Sharon: Oh, I think they make a huge difference forthe parents and the child. In an Angelita’s Amigos room,you feel like you’re in your family room, your livingroom, your home environment. I can tell you that theserooms get nothing but rave reviews. Once we get a childin here, they request it when they come back. Absolute-ly it makes a difference.

Joann:My sister works with someone who had a fam-ily member that stayed here one time. They said, “Oh,it’s so comfortable. It’s so homey.”

How much have has Angelita’s Amigos raised through the years?

Bob:We’re over $125,000. When I first approachedSt. Joseph’s Foundation about building Angelita’s Ami-gos rooms, I told them, “I want to put every dollar wecan into the rooms.” And the dream came true. They kepttheir word. I think the Foundation is awesome.

Is your annual golf tournament Angelita’s Amigos sole fundraiser?

Bob: That’s it. We raise the money and then donateit to St. Joseph’s Foundation. I’m upfront with people.I tell them, “I want to hit you up for money once a year,and then I’ll walk away from you and you won’t see mefor 365 days, but when you do, bring your wallet, bringyour money.”

It’s a very cheap tournament—$85 a person at theWigwam on May 20th this year. It’s always the weekafter Mama’s Day. I keep telling the guys, “Take care ofmama. Take her out and then the following week, she’lllet you play golf.” We had 45 golfers at our first tourna-ment and 288 last year.

I’ve kept it inexpensive and run it like a mom-and-pop shop. Very basic, very down-to-earth, treat peoplevery cordially. Hit people through the heart, and if youdon’t have a heart, come with me to Pediatrics and you’llhave a heart when you leave.

What’s in the future for Angelita’s Amigos?

Bob: Our network of supporters is really growing. Ourplan is to continue raising money, so we can come backto you guys and say, “Here’s the dinero. Now go buildanother room.”

We’ve committed to building and furnishing a play-room in the new Pediatric Cardiothoracic Unit on the

seventh floor of the North Tower. Our goal for this year’stournament is to raise $35,000 for that new room.

Sharon: The new Pediatric Cardiothoracic Unit isscheduled to open in August. The playroom is going tobe great. It will have a movie screen that drops down. We’llmake popcorn and have movie days for the kids.

So the relationship between Angelita’s Amigos and St. Joseph’shas been very positive?

Sharon:Bob and Joann, we feel very much like we’repartners with you. You say what you want, we bringsamples, and we pick it out together. It feels like youdesigned this room. It’s worked really, really well.

You’re helping such a large number of children byallowing their families to be here 24-seven. And you’rehonoring your daughter’s memory. You’ve done an out-standing job.

Angelita’s Amigos annual golftournament and lunchSunday, May 20Wigwam Golf Resort and Spa

Proceeds will fund a playroom in the new PediatricCardiothoracic Unit due to open at St. Joseph’s inAugust.

The entry fee of $85 per person includes golf with acart, lunch, a prize bag, shirt and awards. More infor-mation, including registration, is available online atwww.AngelitasAmigos.com, or you can call BobOlivas at 602-290-1063.


Every year, the Lou Grubb Friends Fore Golf Committee works to raise the bar at their annual fundraiser for Bar-row Neurological Institute. Their 2007 golf tournament, dinner and auction—held April 19 and 20—accom-

plished that on several fronts.The tournament raised funds not only for Barrow but also for St. Joseph’s new Heart & Lung Institute. Sever-

al new sponsors supported the tournament, and more golfers than ever, 260 in all, participated in the afternoontournament held at McCormick Ranch Golf Club.

“We try to have fun for a good purpose,” says Lou Grubb, the founder of the popular golfing event.The two-day golfing extravaganza began Thursday at the Arizona Biltmore when 580 guests (another record!)

congregated for an evening of fun, fellowship and food. Guests competed for several outstanding prizes at the Put-ting Green, including a diamond watch donated by Schmitt Jewelers and a full set of men’s golf clubs, complimentsof In Celebration of Golf.

GOLF GALA

Young golf whizzes, Daffodil Sanchez, 13, andAndrew Proctor, 8, demonstrated their skills at the2007 Lou Grubb Friends Fore Golf tournament.

LOU GRUBB ANDFRIENDS GATHERFOR 18 HOLESAND MORE


The highlight of the live auction was bidding for atrip for four to the Master’s Golf Tournament in Augus-ta, Georgia. The package included airfare, lodging, din-ing and passes to the nation’s premier golf experience.

Activities on Friday began at 10 a.m. with another firstfor the tournament—a Women’s Golf Clinic led by pro-fessional golfer Tina Tombs. A record 24 women golfersplayed in the tournament.

At check-in for the tournament, golfers received a bagof goodies, including Fairway and Greene shirts. Afterthe tournament, they gathered for dinner and awards.

“This year’s tournament was a huge success,” says Deb-bie Castaldo, director of Annual Giving. “The commit-tee is already busy thinking about next year’s tournament.Since it will be the tournament’s 35th year, we plan toexceed all expectations with an unforgettable event!”

Above, golf pro Tina Tombs gives Karen Lovciksome pointers during the Womenʼs Golf Clinicheld before the tournament on Friday. Right,Dennis Sage co-chaired the event, along withLoui Olivas, PhD.

A guest at Thursday eveningʼsdinner tries her hand at thePutting Green. Below are LouGrubb and Roger Maxwell,long-time organizers of thetournament.


2007 Lou Grubb Friends Fore GolfCommittee and Sponsors

These folks are obviously having some fun.Take a look at the number of years members of theLGFFG planning committee have served:

L Don Brown . . . . . . .3 Mike Ford . . . . . . . . . .6 Cassandra Groh . . . . .1Lou Grubb . . . . . . . .34 Bill Hunt . . . . . . . . . . .4Stuart Kirk . . . . . . . . .6Gene L'Heureux . . . . .1 Bill Long . . . . . . . . . . .9Roger Maxwell . . . . .34Mike Medici . . . . . . . .6Loui Olivas, PhD . . . .4 Tom Reahard . . . . . . .6 Anne Robbs . . . . . . . .7Dennis Sage . . . . . . .12 Dennis Scully . . . . . . .1 Terry Tietzen . . . . . . . .1

Presenting Sponsor was edatanetwork.Event Sponsors were DPR Construction,

Kitchell Contractors, Panoramic Press, Renais-sance Companies, TriWest Healthcare Allianceand Xerox.

Clockwise from top photo:Anne Merete-Robbs teesoff; John Grubb preparesfor the shot-gun start;Budd and Kathy Eavesenjoy dinner with BruceRobbs (center); the Heart &Lung Institute is represent-ed by golfers RossBremner, MD, MichaelSmith, MD, Tony Hodges,MD, and Jeff Paul.


About 90 people with deep roots to St. Joseph’sHospital and Medical Center gathered on Febru-

ary 15 for the annual Friends of Mercy dinner. The guests—former hospital and foundation board

members, Women’s Auxiliary members and otherswho once had active roles at the hospital—took a walkdown Memory Lane, a display of memorabilia from thehospital’s past. They enjoyed hors d’oeuvres and din-ner, and then heard an update from Linda Hunt, pres-ident of St. Joseph’s.

But most important, they rekindled old friend-ships.

“One thing that makes my heart so happy is seeinghow excited people are to see one another,” says Sr.Madonna Marie Bolton, special assistant to the CEOof the foundations. “They have a real connection to eachother as well as to the hospital.”

Sr. Madonna, too, enjoys a deep connection to manyin attendance. After all, she worked at St. Joseph’s as anurse and administrator from 1971 to 1985, and again

PAST, PRESENT AND FUTUREFRIENDS OF MERCY RECONNECT AT ANNUAL DINNER

1 - Pat Gelinas, Joe Gelinas, David Eaton, CarolEaton, Babs Gordon, Sherri Koopot, Sister MadonnaMarie Bolton, Alan Gordon, MD, Linda Hunt, RaviKoopot, MD, Rachel Zemer and James Zemer, MD; 2 - Betty Kennedy and Jean Grady; 3 - David Eaton;4 - Dr. and Mrs. Alan Gordon

1

3

4

2

6

4


from 1987 to 1996. In 2003, she joined St. Joseph’sFoundation and Barrow Neurological Foundation inpart because of her long history at the hospital.

Sr. Madonna established the Friends of Mercy toreconnect with the many people who played instrumen-tal roles in the development of St. Joseph’s and Barrow.

“It began with former St. Joseph’s board mem-bers—people who gave many volunteer hours to thehospital during some very difficult times,” says Sr.Madonna. “We realized that we had lost contact with

people who were instrumental to our progress throughthe years.”

The dinner is a way to maintain those relation-ships, thank people for their contributions and keepthem informed about St. Joseph’s and Barrow today, Sr.Madonna says.

“We really appreciate what these incredible peoplehave done, and we never want to lose our connectionwith them.”

1 - Jane Buffmire and Pauline Bayless; 2 - Joyce Bonhert, Susan Kuberra,Bill Bonhert and Julie Karam; 3 - The late Sister Mary Assumpta was hon-ored at the dinner; 4 - Rachel Zemer, Judy Schubert and James Zemer,MD; 5 - John Ford, Myrna Brooks and Ellen Ford; 6 - Richard Brooks, MD,and Sister Madonna Marie Bolton; 7 - Sherri Koopot, JacquelineMichelson and Susan Erne.

3

5

2

1

7


Comprehensive Cancer Centerreceives accreditation

The American College of Surgeons Commission onCancer (CoC) has granted a three-year approval withcommendation to the Comprehensive Cancer Centerat St. Joseph's. St. Joseph's received CoC approval forits commendable level of compliance with one or morestandards that represent the full scope of the hospital'scancer program.

Receiving care at a CoC-approved cancer centerguarantees a patient will have access to comprehensivecare, the best treatment options, information aboutongoing clinical trials, access to cancer-related infor-mation, a cancer registry and continual improvementof care.

“CoC approval is indispensable to St. Joseph's andthe community because it ensures our Cancer Centermeets the same high standards set for teaching hospi-tals throughout the United States,” says Mary Schnei-der, director of the Comprehensive Cancer Center atSt. Joseph's. “Our mission is to provide excellence incancer care to our oncology patients.”

Approval by the CoC is given to facilities that havevoluntarily committed to providing the highest levelof quality cancer care and that undergo a rigorousevaluation process and review of their performance. Tomaintain approval, facilities with CoC-approved can-cer programs must undergo an on-site review everythree years.

Superstition Paint Horses Open House raises $13,200 for St. Joseph's Pediatric ICU

Cameron T. Haselhorst, a four-year-old formerpatient of the Children's Health Center, and his fam-ily hosted their second annual charity event to bene-fit St. Joseph's Pediatric Intensive Care Unit. The Super-stition Paint Horses Open House, held April 7, includeda golf tournament, barrel racing, pole bending, kids'games, carnival booths, a live band, free lunch andauctions. It raised $13,200, twice the amount raised lastyear.

Cameron's family hosts the event to thank St.Joseph's for the care the child received in 2005. At onepoint, doctors said that Cameron's chance of surviv-

ing was only fivepercent. Today,Cameron is ahealthy, activechild.

Next year'sfundraiser isscheduled forMarch 22.

NEWS

Fry’s "Giving Hope a Hand" Pink TagCampaign gives $50,000 to Breast Evaluation Clinic

As part of its continuingleadership in supportingthe communities it serves,Fry’s Food Stores launcheda "pink tag" program instores in October to pro-mote breast-cancer aware-

ness. During the campaign, pink tabs were displayed onall participating products on shelves in Fry’s stores, and eachtime a customer purchased these items, a portion of the pro-ceeds went towards this important program.

As a result of this effort, Fry’s was able to present St.Joseph’s Foundation with a check for $50,000 to supportthe hospital’s Breast Evaluation Clinic. “ Fry’s is honoredto do its part to find a cure and provide support to help edu-cate women about early detection, diagnosis and treat-ment,” says Kendra M. Doyel, director of Public and MediaRelations at Fry’s.

Cameron's mom, Tiffany Haselhorst, farright, presents the proceeds from the 2007Superstition Paint Horses Open House to,from left, Brad Fiorito, MD, a Pediatric ICUintensivist; Stacy Youngkrantz, RN, PediatricICU supervisor; and Robert Hopkins, St.Joseph's Foundation vice president.

Fryʼs Kendra Doyel presents a check to St. JosephʼsEdward Donahue, MD; Gail Brown, NP; and MariantonietaSaloman.


Face in the Mirror provides free makeovers to St. Joseph’s cancer patients

For many people, looking good leads to feelinggood. That’s why the Comprehensive Cancer Center atSt. Joseph’s and the Face in the Mirror Foundationrecently expanded their services to provide personal cos-metic makeovers to hospitalized women with cancer.The program had previously been offered only to out-patients.

Every Monday morning, female cancer patientswho are hospitalized at St. Joseph’s are offered a freepersonal makeover to help them look and feel betterand to boost their confidence and energy. They alsoreceive a signature bag of botanical cosmetics along withan inspirational book of poetry and a CD.

“There is a correlation between a person’s physicaland emotional health,” says Mary Schneider, St. Joseph’sCancer Center director. “Face in the Mirror helps ourpatients heal by helping them look and feel better.”

The Face in the Mirror Foundation is a non-prof-it organization that encourages and promotes the psy-chological and outer well-being of cancer patients tohelp them overcome their illness. The foundation wascreated by Barbara MacLean in memory of her sister,who passed away from breast cancer in 2001. St. Joseph’sis the first hospital to work with the foundation.

St. Joseph’s offers e-newsletter toexpectant and new parents

St. Joseph’s Hospital and Medical Center is offeringa new weekly service to expectant and new parents—The Parent Review. The web-based service provides awealth of information about prenatal care, early child-hood development and parenting. The Parent Reviewis available in English and Spanish to everyone who logsonto St. Joseph’s website (www.stjosephs-phx.org) orthe review page (www.stjosephs-phx.org/parents). Par-ticipants don’t have to deliver their baby at St. Joseph’sto enroll.

After registering, parents receive a free weekly e-mailnewsletter, which provides expectant and new parentswith customized information about childhood devel-opment and parental resources. It also links to St.Joseph’s prenatal and pediatric services. Expectant par-ents can receive the tailored information as early as theirseventh week of pregnancy, and the service will con-

tinue until their childturns one year of age.

During pregnancy,the hospital’s e-newslet-ter includes week-by-week information aboutfetal development, well-ness tips and pregnancyresources. After the babyis born, messages focuson child development,baby care, health andsafety, and other topicsof interest to new par-ents.

“Becoming a parentis an important andexciting time. The ParentReview serves as aresource for parents whowant information aboutall the passages of preg-nancy, birth and earlychildhood,” says LindaHunt, president of St.Joseph’s. “Our goal is togive children and theirparents a healthy, happystart.”


GIFTS IN KIND

Benefactors sometimes ask us aboutsupporting the hospital with things

other than money. These so-called gifts-in-kind are often wonderful ways of express-ing one’s philanthropy, though making agift-in-kind involves one additional stepto writing a check: a valuation.

The legal definition is clear: the amountof the charitable deduction allowed for a giftof property or artwork or antiques is basedupon the fair market value of the donatedassets. Fair market value is defined by ourfriends at the IRS as the price at which theassets change hands between a willing buyerand willing seller, both having a reasonableknowledge of all the relevant facts.

That may be easier said than done, andthe IRS has specific rules for determiningthe value of these gifts. As you might expect,the rules cover every conceivable type of gift,or asset, including securities, mutual funds,life insurance, real estate, personal proper-ty and works of art. There are tax benefits,including capital-gains exclusions on prop-erty in many circumstances.

Saying that the fair market value (FMV)is the price an asset would sell for on theopen market sounds pretty reasonable andstraightforward, and in most cases it is.Sometimes there can be quite a gap between

what someone thinks something is worth,and what the true FMV is. Many people areexperiencing that harsh reality right now inthe housing market.

An appraisal will establish the FMV,and the Foundation can direct you to anumber of qualified appraisers. It’s mostimportant when the value of any proper-ty exceeds $5,000. That’s when the IRStakes an increased interest in amounts beingclaimed as deductions and the importantForm 8283 comes into play. This is theform that must accompany your tax return,signed by the appraiser and the Foundation,in order to secure the full deduction.

Service to others is one way to affirm thatour lives have value, and it’s not hard tomake decisions when you know what yourvalues are. We’re grateful that so many peo-ple believe in the value of what St. Joseph’sdoes and find so many creative ways tohelp.

If you’d like to talk to someone aboutyour ideas for supporting St. Joseph’s mis-sion, please feel free to contact me at 602-406-1037 or [email protected].

EVER WONDER WHAT IT’S WORTH?

by Robert HopkinsVice President

CREATE INCOME FOR TODAY.LEAVE A LEGACY FOR TOMORROW.

“We earn interest rates far, far higher than we could get from any CD ormoney-market fund, we get a very large tax deduction, and most of our annual income is tax-free. And, ultimately, Barrow, which we feel so strongly about, will receive money to grow and assist others.”

— Bill and Jane Ratsch

When you establish a lifetimeincome gift, you ensure thatSt. Joseph’s Hospital andBarrow Neurological Institutecontinue to grow and thriveinto the future, helping thou-sands of people every year.And, like Bill and Jane Ratsch,you’ll benefit with tax savingsand a dependable fixedincome for life.

Suggested AnnuityPayments for a $10,000 Gift*

Age Rate Annuity Tax Deduction_______________________________

60 5.7% $570 $3,105_______________________________

70 6.5% $650 $3,952_______________________________

80 8.0% $800 $4,905_______________________________

*These figures are for illustration pur-poses only. Minimum age: 50. Minimumgift: $10,000.

The deduction is variable and based onthe available IRS Discount Rate.

Consult your adviser about such a gift.

For a personalized proposal,please contact St. Joseph’sFoundation at 602-406-3041.

CHW ArizonaSt. Joseph’s Hospital and Medical Center350 W. Thomas Rd.Phoenix, AZ 85013

Nonprofit Org.U.S. Postage

PAIDPermit No. 685Phoenix, AZ

You’ve got mail!St. Joseph’s Foundation is developing more cost-effective and efficient ways of communicat-ing with our donors and friends. One of these methods is email. Please help us by sendingyour email address on the enclosed postage-paid postcard. Or simply email your informationto [email protected]. Please include your name, address, email address and phonenumber. Thanks for your help with this project!

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