Listen to her singing here:

A visit in 2009 is a perfect example. Just as Mrs. Rauschert was about to undergo a colonoscopy, her husband, who was along for moral support, experienced a racing heartbeat.

“I mentioned it to a person at the front desk,” recalls Mr. Rauschert. “About three seconds later, I was in cardiology, and they were taking care of me.”

Mrs. Rauschert was kept abreast of what was happening to her husband. “Just before my exam, the nurse told me my husband was being seen by a cardiologist. When I woke up, they told me he was OK, and then wheeled me to him right away.”

The Rauscherts say this scary experience shows the incredible caring atmosphere they’ve found at Mayo Clinic in Florida. Over the years, they have sought care here for kidney disease, breast cancer, heart ailments and joint problems.

The couple traveled to Jacksonville for their first visit via a 42-foot sailboat, their winter home.

They recall it was a bit of a challenge to schedule the initial visit. “I had to call several times just for that first appointment because weather impacts your travel plans so much,” Mrs. Rauschert says.

The first visit impressed the Rauscherts. “When I walked in the front door, a woman was waiting there for me,” recalls Mrs. Rauschert. “It was the same woman that I’d been talking to on the phone about my appointment. She said, ‘I just had to meet you because we had so many fun conversations.’”

Though the practice and staff have grown tremendously, the couple still marvels at the convenience of a multidisciplinary practice and the compassion of the staff. “I’ll never forget the look on my doctor’s face when he told me I had breast cancer,” Mrs. Rauschert says. “He’s more than my doctor. He’s my friend. He was just grief stricken, but because of our relationship, it was easier to hear the news from him.”

Looking back on their Mayo Clinic experiences gives the Rauscherts hope for whatever adventure is next. Says Mr. Rauschert, “We know we can rely on Mayo Clinic for anything in the years to come.”

(This story comes to us from the Sharing Mayo Clinic print publication.)

New imaging technology helps determine cause, treatment for heart symptoms

Many surfers fear sharks. But not Mike Politowicz, 45, a seasoned surfer with 30 years of experience. “Surfing is a form of relaxation,” he says. 

Relaxation, that is, mixed with a little adrenalin and heart-pounding anticipation of a good ride. But on Aug. 7, 2010, as Politowicz paddled out for a wave on a Florida beach, his heart sensation was something else altogether.

He began feeling sick to his stomach. He tried to paddle through it but soon realized something was terribly wrong.

“It felt like someone was driving a hot spike through the middle of my chest,” says Politowicz, of Longwood, Fla.

He took the next wave in and trekked a half-mile up the beach to call 911. Physicians at a local hospital confirmed he had a heart attack caused by a blood clot.

Politowicz had been diagnosed with a heart blockage six years earlier by a cardiologist in the Orlando, Fla., area. After having several stents placed, he continued to lead an active lifestyle without issue. Later, he learned that a change in his medication may have caused the new clot.

At a follow-up visit with his cardiologist, Politowicz was told his overall heart health had taken a turn for the worse. But he was skeptical. “I thought they were crazy,” he says. “Despite what happened, I felt like I was in the best shape of my life.” He opted for a second opinion and turned to Mayo Clinic cardiologist Brian P. Shapiro, M.D.

Cardiac MRI

Instead of relying on traditional diagnostic methods such as a stress test, echocardiogram and heart catheterization, Dr. Shapiro ordered a cardiac MRI (cMRI), a relatively new test designed to provide a more precise view of the heart.

“This technology takes the diagnosis and treatment process to a whole new level,” Dr. Shapiro says. “We can clearly see the exact areas in the heart that have issues and quickly define the best therapeutic strategies for each patient.”

Thanks to the clarity of the cMRI, physicians can assess the size and function of the heart’s chambers, thickness and movement of the walls of the heart, the extent of damage caused by heart attack or heart disease, structural problems in the aorta such as aneurysms or dissections, and the buildup of plaques and blockages in the blood vessels.

An additional benefit of cMRI is helping patients understand their condition and the therapy they need, says Dr. Shapiro. “Showing a patient the images from their cardiac MRI allows them to see what they have only heard about before,” he says. “It makes their condition more real.”

Help for heart damage

For Politowicz, it meant confirming the damage to the heart muscle was so severe, it was unlikely to be reversed.

Politowicz says that seeing the images from the cardiac MRI gave him a better understanding of what was happening since he could see the damage — what was pumping and what wasn’t. And he admits he was shocked. “I’d never been anxious before, but now I could see it, and I was very worried,” he says. “My dad died when I was 5, and I don’t want to do that to my son.”

Dr. Shapiro also discovered that Politowicz’s arteries were again severely blocked and surgery would be needed.

“The imagery helped us see the extent of damage and then make the best decisions for Mr. Politowicz,” says Dr. Shapiro.

Due in part to the cost of the equipment and training requirements, the use of cMRI is generally limited to large facilities and academic medical centers. Dr. Shapiro says that although the use of cardiac MRI as a diagnostic method is not yet commonplace, he expects it will become a valued tool in the future.

“With this technology, we can evaluate and provide treatment for high-risk patients sooner and hopefully prevent heart attacks,” says Dr. Shapiro.

In March 2011, Politowicz successfully underwent surgery to open blocked arteries. Doctors also implanted a defibrillator due to the severity of his heart attack. Now, he’s back riding the waves.

He still doesn’t worry about sharks. He says he hits the water with a renewed spirit, an appreciation for his healthier heart and the knowledge that the heart pounding he feels is all about the ride.

“There is not much in life that a good surf can’t put in the proper perspective,” he says. “Jobs can’t surf, bills can’t swim, and my problems seem to end at the water’s edge.”

(This story comes to us from the Sharing Mayo Clinic print publication.)

He would be the fourth person to receive a triple transplant at Mayo Clinic and only the 11th in the United States.

The organs for transplant didn’t arrive without a glitch. A storm delayed their arrival via plane for a few hours. Watson and his wife, Rita, watched the thunder and lightning from the window of the hospital room while they waited.

“It was magnificent. Mother Nature put on quite a show,” says Watson, who lives in Westminster, Colo. “This great display in the sky seemed parallel to the frenzy of activity going on in the operating room to prepare for my surgery. All we could do was remain calm, enjoy the time together and continue to wait until it was time.”

Watson went into the operating room at midnight. Halfway through the next day, his surgery was complete.

Watson has hereditary amyloidosis, a relatively rare blood disease that develops when protein builds up in organs and tissues. Affected areas can include the heart, liver, kidneys, spleen, digestive tract and nervous system. Hereditary amyloidosis often is not diagnosed until significant organ damage has occurred. The symptoms can be confused with other conditions.

Watson first had symptoms in 2002. He was exhausted and had inexplicably gained 30 pounds. He was diagnosed with a viral heart condition and told he would need a heart transplant. For several years, he says his physicians in Colorado were able to maintain but not improve his condition with medication. In the last few years, Watson’s day-to-day activities had become significantly limited. He’d had to quit working as a deputy sheriff in Boulder, Colo.

In 2008, a DNA test confirmed Watson had hereditary amyloidosis. His aunt was diagnosed with the disease at about the same time. She was one of the previous triple transplant patients at Mayo Clinic.

“Not many doctors around the country know much about our disease, so my doctors referred me to Mayo Clinic, too,” says Watson. “I was evaluated at Mayo in January 2010 and returned in October to wait for a transplant. By that time, I was pretty depleted. My energy was nonexistent, and I’d been fainting. I knew I wouldn’t be leaving Minnesota unless I received a transplant.”

Watson remained in the hospital for 12 days immediately after the transplant and in Rochester at the Gift of Life Transplant House for several months, post-transplant having cardiac rehabilitation three times a week.

“I can feel my body rejuvenating,” he says. “Before my surgery, my extremities were blue-tinged due to poor blood flow. Now, they’re pink like they should be.” He expects to return to normal activities within 12 to 18 months.

“I’m grateful for the organ donation,” he says. “It’s a selfless act for the donor and his family.”

At least 10 other members of Watson’s extended family also have been diagnosed with hereditary amyloidosis. Whether the disease will require treatment or transplant remains to be seen.

“Mayo seems to be the place with expertise in hereditary amyloidosis,” says Watson. “They helped my aunt, they helped me, and I’ve met other people at Mayo who are getting help. I’m confident that will continue to be the case.”

(This story comes to us from the Sharing Mayo Clinic print publication.)

It was — and her vision was at risk.

On that day in September 2010, Mackenzie went to school as usual. She mentioned the spotty vision to her teacher, who sent her to see the school nurse. The nurse performed a vision test, which was normal, and sent Mackenzie home with a note alerting her parents about the eye screening.

At 3:30 that afternoon, Mackenzie was still seeing spots. But 90 minutes later, she could no longer see out of her left eye. Her father, Chad Chicos, took her to urgent care at Mayo Clinic Health System in Owatonna. Providers there sent her to the Emergency Department.

Miguel Mulet, M.D., an ophthalmologist, examined Mackenzie and performed a series of tests, which led to the diagnosis of legal blindness in the left eye due to subretinal bleeding (hemorrhage) caused by an unknown type of tumor. The bleeding had caused the spots and subsequent loss of vision. Mackenzie would need to see a specialist at Mayo Clinic’s Rochester campus — about 50 miles away — for further testing and treatment.

At 8:15 the next morning, Mackenzie’s mother, Gwen Chicos, received a phone call from Mayo Clinic asking how quickly she could bring Mackenzie in to be examined. By 10 a.m., Mackenzie was in Rochester for an exam with retina specialist Jose Pulido, M.D.

“They were on top of everything,” says Gwen about how quickly her daughter saw Dr. Pulido. After a day of tests in Rochester, Mackenzie was diagnosed with a choroidal osteoma, a rare, benign, bonelike tumor in the choroidal blood vessel layer beneath the retina. It’s most common in young women. There is no direct treatment for choroidal osteomas, only treatment for the hemorrhage.

Mayo Clinic doctors used laser photocoagulation, which focuses a laser on the affected blood vessels to stop the bleeding. In addition, Mackenzie had three injections of bevacizumab (Avastin) into her eye over two months to close off the blood vessels.

A follow-up appointment in December showed the bleeding had stopped. “That was our Christmas present,” says Gwen.

By February 2011, Mackenzie’s vision in her left eye had improved markedly. Since then, Mackenzie has continued to retain good vision. Dr. Pulido says that a combination of factors worked to restore the child’s vision: Mackenzie’s persistence in reporting her symptoms, her parents quickly seeking medical care, the timely referral by Dr. Mulet and effective treatment at Mayo Clinic.

The family is very thankful for the care her daughter received. “We were told that Mackenzie is the first child they had seen with a choroidal osteoma whose vision has come back so well,” says Gwen. “For Dr. Pulido’s office to call me 15 minutes after they opened and then be able to work her in right away that morning was so wonderful.”

Mackenzie will continue with regular checkups to monitor for changes in the tumor. As for Mackenzie, “she’s a normal kid again,” says Gwen.

(This story comes to us from the Sharing Mayo Clinic print publication.)

Kristi Coody had suffered migraine-like headaches for three months, but this time the pain was more intense. She lay down on the living room floor of her Orange City, Fla., home and let her girls play around her. Her husband found her there when he came home from work that evening.

“This headache was much different than before and lasted approximately 16 hours before it broke,” Coody recalls.

She started keeping a log of her headaches and realized the episodes had become more frequent, more intense and longer lasting than before. She talked to one of her doctors.

“When I was going over it with him, I realized that I’d had nine severe migraines within 14 days,” Coody says. She asked her doctor to order a CT scan “to see if something was going on.”

That proactive approach paid off. Within four hours of her initial CT scan, Coody found out she had an aneurysm, a life-threatening bulge in one of the blood vessels in her brain. Her aneurysm was about an inch in diameter. With two small children, Coody, age 40, wasted no time finding a solution.

Coody went online and researched medical centers with expertise in brain aneurysms. Mayo Clinic in Jacksonville, Fla., was at the top of her list and was a two hour drive away. Within a week, Coody met with Mayo Clinic neurosurgeon Ricardo Hanel, M.D., Ph.D., who told her about a new device being tested to divert the flow of blood from an aneurysm and stop the ballooning of blood vessels. The device — known as a flow diverter — was available to patients at Mayo Clinic’s campus in Rochester, Minn., as part of a clinical study evaluating the new technology.

“It seemed like the right choice,” Coody says.

In January 2011, Coody and her husband traveled to Rochester for the minimally invasive surgery. Dr. Hanel traveled to Rochester, too, to perform the surgery. He worked alongside Rochester colleagues, neurosurgeon Giuseppe Lanzino, M.D., and neuroradiologist David Kallmes, M.D.

“These new flow diverters have a tight mesh that covers about 35 percent of the aneurysm. When placed in the artery, the flow diverter forces the blood to flow around the aneurysm and helps it to dissolve into itself,” explains Dr. Hanel.

The new technique reduces the recurrence of aneurysms as compared to other endovascular procedures. Recovery time is shorter, too, because the device is implanted through a vein in the groin, eliminating the need for open surgery. Long-term results are promising. “Six months later, the images are showing the aneurysm is completely gone,” says Dr. Hanel.

“I had the procedure on a Monday, was released from the hospital on Tuesday and I flew home on Thursday,” says Coody. Four months after the procedure, an image of her artery showed the aneurysm had disappeared. This “definitely met my expectations — that the flow diverter would reduce the aneurysm in three to six months. To learn at four months it was successful — I’m overjoyed,” says Coody, who was the 27th patient enrolled in the clinical study and one of the youngest.

The new technique is recommended for people with difficult-to-treat brain aneurysms because of the size, location or previous failed treatments, says Dr. Lanzino. The treatment was approved by the U.S. Food and Drug Administration (FDA) in spring 2011.

In the course of Coody’s treatment, doctors found three smaller aneurysms. “There was only a 1 percent chance that the smaller aneurysms could rupture, but my concern was that if any did rupture, the likelihood of survival is only 40 percent,” says Coody.

Coody wasn’t willing to take the chance. In June 2011, physicians at Mayo Clinic’s campus in Jacksonville inserted two flow diverters and used platinum coils on the third aneurysm, customizing the treatment to each aneurysm. Mayo Clinic in Florida was one of the first facilities in the country to offer the flow diverter procedures after FDA approval.

“We suspect that in December, when my next imaging is scheduled, we will find the same results that we did from the larger one,” Coody says. Although she still has headaches, Coody says they are manageable, and she has the support of a team of doctors who continue to care for her and monitor her healing process.

“Mayo Clinic has definitely changed our lives,” she says. “When we came here they showed me all my pictures from CT scans and arteriograms and explained things in so much detail.”

Dr. Lanzino says it’s important for patients to considerall of their treatment options. Flow diverters have been used for five years around the world and studied at Mayo Clinic for two years. “We’re still building evidence on long-term results,” he says.

(This story comes to us from the Sharing Mayo Clinic print publication.)

Adamson, who lives in Wilmer, Minn., had an atrial septal defect, a congenital heart condition in which a hole exists in the wall between the two upper heart chambers. The defect was detected in a routine pre-college physical exam. When listening to Adamson’s heart through a stethoscope, the physician heard a “whooshing” sound — a common sign of atrial septal defect. Over time, atrial septal defect would enlarge and weaken the right side of the heart.

Adamson had sought care and planned to have surgery at another medical center. Then a nurse acquaintance of his stepmother, Lisa Adamson, mentioned that Mayo Clinic offered a minimally invasive procedure. The family scheduled a consultation with Harold Burkhart, M.D., a cardiovascular surgeon at Mayo Clinic, who determined that Adamson was a good candidate for minimally invasive open heart surgery.

“The hole in Austin’s heart was quite large, requiring his heart to work much harder than normal,” says Dr. Burkhart. “Although he was not in immediate danger, his heart was enlarging and needed to be fixed sooner rather than later.”

Adamson was happy to learn the new surgery had a faster recovery.

“My parents and I trusted the doctors at Mayo Clinic, and they were confident this was a good choice for me,” he says. “I just wanted to play baseball over the summer.”

After completing final exams and the spring college baseball season at Northwestern College in Roseville, Minn., Adamson had surgery. The hole was repaired through an incision only 2.5 centimeters (1 inch) long. He spent three nights in the hospital.

Traditional open surgery with a sternotomy would have meant five nights in the hospital and four to six weeks of recovery. As it was, he went to a graduation party the day after he returned home from Mayo Clinic.

(This story comes to us from the Sharing Mayo Clinic print publication.)

Hayes’ suitcases had been empty and idle because of her severe hip pain.

Hayes had her hips replaced in two surgeries at Mayo Clinic in March and August 2010. Now, new hips in place, she’s making up for lost time.

“I’ve visited Texas and Savannah, Ga., since my surgeries and gone to concerts and weddings and ridden a motorcycle—all things I could not do when my hips became painful,” says Hayes. “I was living like an 80-year-old, and I wasn’t even 30 yet. It was exhausting just to go to the grocery store. Now, I’m completely pain free.”

Hayes’ case was unique because she has spondyloepiphyseal dysplasia congenita (SEDC), a bone growth disorder that results in short stature (dwarfism) and skeletal abnormalities. Hayes, 30, was born with the condition. She is 3 feet, 10.5 inches tall.

In her search for an orthopedic surgeon who had experience with complex hip replacement procedures, she interviewed a handful of surgeons across the country. Hayes’ parents accompanied her to the consultations, and all three family members were convinced Mark Spangehl, M.D., at Mayo Clinic’s campus in Arizona was “the one.”

“Dr. Spangehl’s responses to our questions were straightforward,” says Hayes. “He helped us to have realistic expectations. We had no hesitation that he and Mayo Clinic were the right choice.”

Hayes’ original hips lacked the normal ball-and-socket structure, which caused her thighbones to turn inward. The pain she experienced was due to bone rubbing directly on bone. Dr. Spangehl and his team, which included fellow orthopedic surgeon Christopher Beauchamp, M.D., took numerous X-rays and CT scans and created models of Hayes’ femur, hips and pelvis. They practiced surgery on the models to determine the specifics of the custom parts that would be necessary to remodel Hayes’ complex anatomy.

“We reconstructed the hips to restore more normal anatomy, which also improved her gait,” says Dr. Spangehl. “We needed implants that were small enough to accommodate her small stature. We rehearsed Brooke’s surgery on the models of her pelvis and thigh bone before the actual procedure to determine how best to correct her anatomy and reconstruct her hips.”

Now, Hayes has normal hips for the first time in her life and says she has more flexibility than she has had in a decade. She has resumed exercising and doing other activities she loves. “We’re all very happy with the outcome, and it’s evident from Brooke’s smiles and attitude that she feels much better,” says Dr. Spangehl.

Hayes agrees wholeheartedly, calling Dr. Spangehl her “superhero.”

“I cried tears of joy after the first surgery because my hip pain was gone, and I could tell this was going to have an outcome that far exceeded my expectations,” says Hayes. “My friends say the light has returned to my face. Dr. Spangehl and his team did a phenomenal job. I don’t think he understands how great he is. He and Mayo Clinic gave me new life.”

(This story comes to us from the Sharing Mayo Clinic print publication.)

“Reaching that number is a remarkable milestone,” says Sawyer, “But what really matters is what got us there – focusing on each patient’s needs.”  Individual patient attention has been the pharmacy’s goal from the start.

“When we first opened, we were all consumed with delivering high value health care to each and every patient, as we knew Mayo Clinic had to establish itself in the south as the premier health care facility,” says Sawyer.

As the pharmacy’s only employee, Sawyer remembers wearing many hats. “I stepped onto the freight elevator carrying a large crate of supplies, and my boss, Carl Rider, happened to be on the elevator. He looked me up and down and asked me if that was what I was hired to do. I quickly replied ‘yes,’ as I didn’t want the physicians to leave patients to pick up supplies. He asked what I needed and I replied, ‘a pharmacy technician.’ He said, ‘you’ve got it,’ and one was hired. That was the beginning of our outstanding pharmacy team.”

The pharmacy has come a long way since it began in October 1986. There are now four pharmacists, six technicians and a cashier who fill about 1,500 prescriptions a week. Today’s director of Pharmacy, Deborah Crumb, says that individual attention to each patient is still what sets Mayo Pharmacy apart from others.

“We provide a patient consult each and every time we dispense a prescription,” says Crumb. “It’s not optional. Patients need to understand how and when to take their medication for it to be successful.”

Many prescriptions dispensed by the Mayo Pharmacy are “compounded,” meaning they are custom made for that patient’s condition. “The collaborative environment here at Mayo facilitates our ability to custom make medications specifically for a patient’s condition. We are in constant contact with patients’ physicians to be sure the medication will be effective.”

Mayo Pharmacy takes patient care and attention a step further with its medication therapy management program, a one-on-one conference with a Mayo pharmacist to go over all of their medications, possible contraindications, and how best to take their different medications. Transplant patients, who take multiple medications to prevent rejection, are among those who take advantage of the program.

“This goes further than a patient consult,” says Crumb. “Some of our patients take up to 30 different prescriptions; it’s very important they understand how best to take their medications so there are no adverse affects. Sometimes, we are able to eliminate a drug or find a less expensive alternative.” Patients who use an inhaler or a blood glucose monitor often seek a medication therapy management appointment so they are able to use their device on their own.

When the new Mayo hospital opened on the Mayo campus, the Mayo Pharmacy at Mayo merged with the St. Luke’s pharmacy. Volume has increased considerably with the addition of the new hospital, but the focus remains the same. “Patients can go to any pharmacy they want to,” says Crumb. “They come to us because we care and we work hard to do the right thing for our patients.”

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