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Stories from patients, family, friends and Mayo Clinic staff

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2 days ago · Successful Cancer Treatment Leads to a New Career

After lengthy treatment for metastatic colon cancer, not only did Don Guillot emerge with the disease in remission, he also came away inspired to pursue a future in nursing.

After lengthy treatment for metastatic colon cancer, not only did Don Guillot emerge with the disease in remission, he also came away inspired to pursue a future in nursing.


The coming year is going to be an exciting one for Don Guillot. In 2018, he’s getting married, and he’s graduating from nursing school as an oncology nurse — a career choice heavily influenced by his own recent journey through cancer.

Diagnosed with advanced colon cancer, Don faced a treatment regimen that included multiple rounds of chemotherapy and several major surgeries that required the expertise of specialists at Mayo Clinic. But through it all, Don maintained an upbeat attitude. Today, with the cancer in remission, Don is eager to head into his future.

“Don’s story is an inspirational one, especially his perseverance and positive attitude over the course of a tough battle,” says Mayo Clinic medical oncologist, Kabir Mody, M.D. “It also demonstrates the importance of management of a complex disease by a multidisciplinary team of experts.”

Stunned by an alarming diagnosis

In November 2014, the now 31-year-old resident of Port St. Joe, Florida, began having intermittent diarrhea and abdominal pain. Those symptoms increased, and he started noticing blood in his stool. Then working as a medical assistant in Lady Lakes, Florida, Don went to see a local gastroenterologist in January 2015. That led to a colonoscopy. Don was shocked when the doctor shared the results with him.

“I had two tumors in my colon, 14 centimeters up from the rectum,” Don recalls. “The doctor said, ‘I’m 99 percent sure it’s cancer.'”

A PET-CT scan confirmed the diagnosis and also revealed that colon cancer had spread to Don’s liver, as well as to lymph nodes outside the rectum. Because of this complicated diagnosis, Don was referred to Mayo Clinic.

Forging ahead with a novel surgery

At Mayo Clinic’s Florida campus, Don met Dr. Mody, who further explained the diagnosis and outlined Don’s treatment options. Dr. Mody also recommended Don consult with Mayo surgeon Horacio Asbun, M.D.

“Dr. Asbun has such a positive vibe,” Don says.

Dr. Asbun recommended Don have six rounds of chemotherapy followed by a procedure known as ALPPS to remove the 10 tumors that were on his liver. ALPPS stands for associating liver partition and portal vein ligation for staged hepatectomy. The procedure is usually only recommended for people who have advanced liver cancer.

During the two-part procedure, surgeons cut off the blood supply to the side of the liver with the tumors. The liver tissue is then partially divided to prevent blood flow crossover between the two sides.


“The ALPPS procedure is reserved for centers like Mayo Clinic that have a high volume of liver surgeries and a multidisciplinary team that can jointly decide which patients are good candidates for the procedure.” — Horacio Asbun, M.D.


“It is believed that partially dividing the liver provokes the secretion of growth type tissue factors that stimulate faster growth of the healthier part of the liver,” Dr. Asbun says.

Once that growth takes place, the patient undergoes a second surgery, which consists of completely removing the side of the liver affected by cancer.

“The ALPPS procedure is reserved for centers like Mayo Clinic that have a high volume of liver surgeries and a multidisciplinary team that can jointly decide which patients are good candidates for the procedure,” Dr. Asbun says.

Don went through the first surgery in June 2015 and then had another round of chemotherapy. On Sept. 7, 2015, his care team moved forward with the second surgery and removed the right side of Don’s liver. That was followed by six more rounds of chemotherapy.

Continuing the journey to remission

After the cancer was removed from his liver, Don went to see Mayo colorectal surgeon Ron Landmann, M.D., in January 2016 to discuss how to deal with the cancer in his colon. During that appointment, Dr. Landmann shared with Don that he had reviewed images taken during a flexible sigmoidoscopy, and they showed a positive response to the chemotherapy.

“I was really excited that the chemo worked,” Don says. “The side effects are really hard on the body, and sometimes you wonder, ‘Is this even worth it?'”


“During my chemo, I got this huge respect for the nurses because they are just top-notch.” — Don Guillot


A multidisciplinary tumor board met to review Don’s case and voted in favor of colorectal surgery. On Feb. 10, 2016, Dr. Landmann removed part of Don’s colon and performed an ileostomy — the construction of an opening in the abdominal wall where the end of the bowel is placed and a bag attached for eliminating waste. Of the 11 lymph nodes removed during surgery, one was positive for cancer, so Don underwent another four rounds of chemotherapy through the end of May.

By November 2016, it seemed Don’s treatment was done. During a follow-up scan in March 2017, however, Dr. Mody found a small lesion on Don’s liver. Blood work confirmed his tumor markers were rising. Dr. Asbun met with the tumor board once again. The board recommended Don undergo an ablation procedure to destroy the lesion. Since that procedure in April 2017, three follow-up scans have been clear of any sign of cancer.

Pursuing a new path

Prior to finding out he had cancer, Don was thinking seriously about becoming a physician assistant. But the nurses who helped him get through the many rounds of chemo inspired him to choose a different route.

“I started getting interested in the nursing profession,” Don says. “The nurses talked to me about all the directions you can take with nursing, and I decided to apply to nursing school.”

He’s planning to look for a position as an oncology nurse after he graduates in May.

“The nurses are there throughout really holding your hand. The chemo nurses walked me through all the medications and explained what to do and what not to do,” Don says. “During my chemo, I got this huge respect for the nurses because they are just top-notch.”   


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3 days ago · Relishing Motherhood After Battling Advanced Breast Cancer

When she found out her breast cancer had come back, Luciana Farfalli faced an uncertain future. But care at Mayo Clinic put the cancer in remission and has allowed Luciana to turn her attention back to the family she adores.

When she found out her breast cancer had come back, Luciana Farfalli, M.D., faced an uncertain future. But care at Mayo Clinic put the cancer in remission and allowed her to turn her attention back to the family she adores.


“I’m so grateful for Andresito. He is the source of life for me,” Luciana Farfalli, M.D., says of her 2-year-old son. “The best part of my day is when he wakes up, comes looking for me and gives me a big hug.”

Luciana, a pediatric dermatologist originally from Argentina, says traveling back to her home country with her husband and son for Andresito’s baptism, and being able to spend time with family and close friends during the trip, was an amazing gift. It was one she wasn’t sure she’d receive after being diagnosed with metastatic breast cancer in March 2016 and receiving a dim prognosis.

But a second opinion at Mayo Clinic with surgeon James Jakub, M.D., turned it all around for Luciana and her family.

“Dr. Jakub was the light at the end of the tunnel. He was very warm and kind,” Luciana says. “I was so tired of hearing about what stage of cancer I had and what my life expectancy was. He was the first one who told me, ‘We’re going to get rid of that cancer.’ I’ll never forget those words.”

A frightening turn of events

When she was 26 years old, Luciana was diagnosed and treated for stage one breast cancer. For five years after that, she received follow-up care, and there was no sign of the cancer coming back. During that time, Luciana met her husband, Andres Cruz, M.D., who was a resident in dermatology at Mayo Clinic’s Rochester campus, while she was on a visiting physician rotation there. They began dating and eventually got married. Their son, Andresito, was born in September 2015.

The following January, Luciana started to feel pain in her right shoulder while breastfeeding. The pain got worse and kept her up at night. She couldn’t feed her baby or push the stroller. An MRI revealed a large mass under her arm. It was aggressive recurrent breast cancer. Surgeons in San Diego, where the family lives, told them Luciana’s cancer had spread to her liver, and she was not a surgical candidate.

“I was looking at being a single parent,” Andres says. “It was all happening quickly.”


“He was the first one who told me, ‘We’re going to get rid of that cancer.’ I’ll never forget those words.” — Luciana Farfalli


Several of Andres’ family members had been treated at Mayo Clinic for cancer, so he got in touch with Dr. Jakub, chair of the Division of Breast, Endocrine, Metabolic and Gastroenterologic Surgery, for a second opinion. When they arrived at Mayo Clinic, additional tests revealed that most of the spots on Luciana’s liver that had lit up on a PET scan in San Diego were actually hepatic angiomas — benign blood vessel growths, and not cancer.

“We headed to Mayo in March 2016 with the baby thinking, ‘Luciana has liver cancer,'” Andres says. “When the liver biopsy came back benign, we were so relieved.”

During a physical exam, however, Dr. Jakub could feel an area at the base of Luciana’s neck that concerned him. He told the Luciana and Andres he thought the cancer may have spread to a lymph node. His suspicion was confirmed with a needle biopsy. Further imaging showed the tumor under her arm was obstructing the axillary vein, which drains the arm, and it was pushing against the artery and nerves.

A path to remission

Luciana would need several rounds of chemotherapy to shrink the tumor away from the important nerves and blood vessels under her arm and treat other cancer cells. After that, Dr. Jakub would assemble a multidisciplinary team from breast imaging, medical oncology, radiation oncology, vascular surgery, and plastic and reconstructive surgery in preparation for the procedure to remove Luciana’s tumor.

“We needed a plastic surgeon because we were going to have to remove a piece of a nerve that was involved with the tumor — a nerve that went to one of her back muscles — and the plastic reconstructive surgeon would need to repair it,” Dr. Jakub says.

In August 2016, after four rounds of chemotherapy, a PET scan showed the tumor in Luciana’s neck was gone. She had surgery on Sept. 27, 2016, to remove the mass in her armpit. She then completed six weeks of radiation treatment on her neck and armpit. The treatment achieved its goal, and Luciana’s cancer is now in remission.

A time to move forward

With treatment behind her, Luciana has spent 2017 delighting in her son’s emerging personality — most recently his infectious sense of humor and his love for singing along with music.

“We went to Disneyland with my sister and Andresito’s cousins. Watching him laugh and run and jump around just filled my heart,” Luciana says. “Andresito’s energy and love enable me to see the light and breathe each and every day.”

In April, Luciana also fulfilled a lifelong dream to see Celine Dion perform live. “I’ve loved her music since I was 15,” she says. “The concert, and our whole trip to Las Vegas, was amazing.”


“Mayo Clinic is like a five-star hotel in terms of the medical care you receive.” — Luciana Farfalli


The exceptional care Dr. Jakub and the rest of her team provided gives Luciana an added sense of gratitude for these memorable times.

“I don’t think I would have had those experiences were it not for the entire medical team that treated me. Mayo Clinic is like a five-star hotel in terms of the medical care you receive,” Luciana says.

“I’m also extremely grateful for the support and care I got from my family,” she adds. “My husband never left my side. My mother traveled from Argentina and stayed with us for six months to take care of me and help care for Andresito. If there is a silver lining to all of this, it was the strong bond that they formed.”

Knowing that Luciana has been able to move forward and find joy in her family and her life after cancer treatment gives her care team great satisfaction.

“The pictures Dr. Farfalli sent of her son’s birthday and the family’s New Year celebration mean the world to me,” says Dr. Jakub. “Those are the things that make me enjoy doing what I do.”


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6 days ago · Complex Heart Surgery Keeps Panama Native on the Greens

When persistent fatigue began to slow down Ricardo Henriquez, an evaluation at Mayo Clinic revealed he needed surgery to fix his heart valves and correct an irregular heartbeat. Since undergoing the procedure, Ricardo is delighted to be feeling better as he resumes his passion for golf.

When persistent fatigue began to slow down Ricardo Henriquez, an evaluation at Mayo Clinic revealed he needed surgery to fix his heart valves and correct an irregular heartbeat. The procedure also allowed him to again pursue his passion for golf. 


The goal that April afternoon was simple. Sink the putt and win the tournament. But as Ricardo Henriquez lined up his swing against the afternoon sky, he knew his journey to that moment was anything but simple.

Ricardo and his golfing partner, Ken Dye, a physician assistant at Mayo Clinic, had bested everyone they faced during the tournament’s preceding three days. And now there they were, on the final hole of the fourth and final day of play, their hopes clinging to the swing of Ricardo’s putter.

And there was also the matter of Ricardo’s heart.

“A very slippery slope”

 Nine months earlier, during a visit to Mayo Clinic’s Florida campus, Ricardo had learned he would need a complex heart surgery to even make it into 2017.

“Three of the four valves in Ricardo’s heart were essentially nonfunctional,” says Kevin Landolfo, M.D., the heart surgeon who operated on Ricardo. “He was on a very slippery slope that would have led to heart failure and death very quickly.”

For 40 years, Ricardo, a native of Panama, had battled atrial fibrillation and other related ailments. But in the summer of 2016, with fatigue seeming to set in a bit more, his wife, Barbara, felt it was time to get checked at Mayo Clinic.

“We were moving to our new home, and I could see the exertion was taking a toll on him,” Barbara says. She sent his medical records to Mayo, and within a week they had an appointment.

A thoughtful approach

Ricardo went through a battery of tests and met with several staff members in the Department of Cardiovascular Medicine. “It was like a clock,” Ricardo says of his experience. “Everyone was on time and so thorough. I’ve never experienced anything like it.”

Cardiologist Gary Lane, M.D., met with Ricardo and his family to share the test results and recommendations. Surgery was on the list. The family’s next meeting was with Dr. Landolfo, who explained how his team could surgically correct Ricardo’s heart and help him maintain his vitality.


“His whole recovery was amazing, and I believe it was a direct result of Mayo’s approach.” — Barbara Henriquez


“I felt if we could repair Ricardo’s heart valves, instead of just replacing all of them, we could give him the best chance of recovering quickly and getting back to the life he enjoys,” Dr. Landolfo says.

Three-valve surgeries are rare in general — and even more so in a person of Ricardo’s age, in his 70s — but Dr. Landolfo says he was confident because Ricardo was still relatively healthy. The nine-hour procedure also included an atrial maze procedure to correct Ricardo’s atrial fibrillation. In the end, Dr. Landolfo and his team were able to repair two of Ricardo’s valves, but the third valve required a replacement.

Ricardo awoke from surgery feeling better than he had anticipated. Two days later, he was walking around his hospital unit. In less than a week, Ricardo was out of the hospital and going through cardiac rehabilitation.

“His whole recovery was amazing, and I believe it was a direct result of Mayo’s approach,” Barbara says. “They didn’t overload him with pain medication, and they wanted him up and moving quickly. It’s unlike anything we’ve seen, and we’ve had a lot of experience with health care through the years.”

A return to the links

As Ricardo went through rehabilitation, he had two goals in mind. The first was swinging a golf club as soon as possible. And the second goal was to play in a tournament with Ken Dye, whom Ricardo had gotten to know during a follow-up visit at Mayo Clinic.

“We struck up a conversation one day, and we discovered we had a lot in common,” Dye says. “So we agreed we’d play a tournament some time together, and we kept in touch.”

As Ricardo’s rehabilitation progressed, he was surprised at the strength of his heart. “I didn’t have any of the shortness of breath or other symptoms,” he says.


“It’s like a new life, and I’m here, enjoying life, because of Mayo Clinic.” — Ricardo Henriquez


And there he was, in April, going through competition after competition in the four-day tournament. The tension made his heart race, and a few times he asked Dye to look him over. But he stayed strong and true to the last putt. The ball went straight to the bottom of the cup. Ricardo Henriquez and Ken Dye were winners — in more ways than one.

“It was such a tremendous achievement for me,” Ricardo says. “It’s like a new life, and I’m here, enjoying life, because of Mayo Clinic.”

Watch Ricardo’s story:


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Thu, Dec 7 5:59pm · Swift Action Saves Skier After Heart Attack on the Water

Quick thinking and high-quality care helped Brian Kanable recover after what could have been a deadly medical emergency. 


Brian Kanable of La Crosse, Wisconsin, could just as easily have been mowing his lawn or taking a walk with his wife, Julie, on the morning in late August when he had his heart attack. But he wasn’t. The 53-year-old was waterskiing. As a result, Brian not only suffered life-threatening cardiac arrest, he also nearly drowned.

Fortunately for Brian, a host of factors came together to save him. The quick thinking of his waterskiing buddies, the life-saving measures of emergency responders, and the expertise of his care team at Mayo Clinic Health System – Franciscan Healthcare in La Crosse all helped him survive the dual traumas he suffered that day.

“The thing that was remarkable about Brian’s success was that it was a fantastic interplay with all of the people involved,” says Brian’s cardiologist Charles Cagin, D.O. “It’s a demonstration of what happens when everyone from the community all the way through the hospital does their job the way they’re supposed to.”

Just a few months after the incident, Brian is not only back on his feet, he’s amped up and eager to get back on his skis. “I’m going back to the life I was in the day before my heart attack, and it’s hopefully better because I have a new heart now,” Brian says.

But after his experience that day, he says he won’t “take life for granted.”

Life-changing moment

It was a typical August day when Brian and two long-time waterskiing friends took to the Black River north of La Crosse for an early morning ski. For years, the men had been meeting three to five days a week before work in the summer to ski the river.

“It’s fun getting together. It’s a tremendous workout,” Brian says. “It’s a neat experience to ski at that time in the morning because you actually see the sun coming up.”

Brian was the first to ski. He jumped in, grabbed the ski rope, and was quickly up and skimming the water. He hadn’t gone far when, according to his friends, his face began to change, and he unexpectedly let go of the rope. Brian was wearing a life vest. But as he sunk into the water, his body leaned forward and his face went underwater.


“One thing we’ve always been is safety-conscious, which is quite honestly why I think I am alive.” — Brian Kanable


His friends immediately turned the boat around and got back to Brian. One jumped in and began supporting Brian’s head. He also grabbed the tow rope. The other drew the rope, along with the two men, back toward the boat, and they hauled Brian onboard. The men, who always carried a phone with them on the boat, called 911 and raced toward the marina where the emergency dispatcher directed them.

“One thing we’ve always been is safety-conscious, which is quite honestly why I think I am alive,” Brian says.

The ambulance was waiting when they arrived at the marina. First responders started chest compressions immediately. Brian received four rounds of defibrillation before his heart began beating on its own again.

“They literally revived me, lost me and brought me back,” Brian says. “They worked on me for about 25 minutes before they could transport me back to Mayo.”                                

Life-saving medicine

At Mayo Clinic Health System, physicians in Emergency Medicine quickly assessed Brian and the damage caused by his heart attack and near-drowning.

“He had multi-system organ failure,” Dr. Cagin says. In addition to his heart, Brian’s lungs and kidneys had stopped functioning after he was pulled from the river. Brian’s brain was deprived of oxygen for a brief time, which caused some issues with Brian’s memory and his ability to think clearly during his month-long recovery.

After Brian was stabilized, he was taken to the Catheter Lab, where five stents were placed in the coronary blockages that had led to his heart attack. From there he was transferred to the Critical Care Unit, where he spent the next 16 days. During that time, he was put on continuous renal replacement therapy, a temporary form of kidney dialysis, and placed in a medically induced coma.


“I felt like there was nobody there that didn’t do a good job and wasn’t pleasant. It felt like they were there because they love their jobs.” — Brian Kanable


About six days after his heart attack, Brian started to make small movements and opened his eyes. A week later, with Brian experiencing more chest pains, his team implanted five additional stents to improve blood flow through his vessels.

“Brian had multiple-vessel coronary disease, so you open up the ones that have acutely closed, and even though other ones are narrow, you don’t put those vessels in jeopardy,” Dr. Cagin says. He notes that the stenting process carries risk of vessel tearing or dissection. “That’s the reason you stage it. It’s a decision made at the time.”

After the second round of stents, more of Brian’s functions returned. His memory began to come back, but most of the days he spent in the ICU are lost to him.

“It’s like I went into a long dream. From the time I had the heart attack, I was out of it for two solid weeks,” Brian says. “My first recollection of coming around was basically squeezing hands, asking for a cold drink of water, and giving people hugs.”

Uplifting care

When Brian was transferred out of the ICU at day 17, he began a rigorous regimen of physical therapy and cognitive speech therapy. Every step along his way to recovery, Brian says he was met with energetic staff eager to help him.

“I felt like there was nobody there that didn’t do a good job and wasn’t pleasant,” he says. “It felt like they were there because they love their jobs. I don’t know if you get that in every hospital. The care is just awesome.”

Brian says his providers not only showed great care to him, but to his wife, Julie, as well.

“The whole entire complex is like a family,” Brian says. “No matter where we went, every day they were supportive of her and making sure she was taken care of. My wife would say, too, of the whole Mayo program, the bottom line is they really do care.”


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Wed, Dec 6 8:48pm · Mayo Clinic saved my life. Not once, but twice.

Kent Larson’s visits to Mayo Clinic have involved multiple surgeries, some of them nearly 50 years apart. Here Kent shares his story of the life-changing care he’s received. 


Written by Kent Larson

Before my liver and kidney transplant at Mayo Clinic’s Florida campus on April 23, 2017, I had been very ill for more than a year.

My symptoms started in January 2016. I was weak, my legs were swollen, and my blood pressure was low. I had no idea what was wrong with me. I went to my primary care doctor, a cardiologist and then a gastroenterologist. For several months, the GI doctor thought he could reverse damage to my liver, which showed signs of hepatitis. But by September, I was in liver failure, and he referred me to Mayo Clinic’s Liver Transplant Program.

Although test results confirmed I needed a new liver, the number used to determine my place on the list as a viable candidate for a transplant was low. While I waited, my health continued to decline. In addition to retaining a lot of fluid, which required weekly removal known as paracentesis, my hemoglobin was extremely low. Several times my organs nearly shut down, and I went from getting one unit of blood weekly to needing three units each week.

By December, the stress on my kidneys was too much, and they failed as well. I was on dialysis three times a week, which I grew to hate because I always felt horrible for a day or two afterward.


“When I awoke the next morning, after a six-and-a-half-hour surgery performed by Kristopher Croome, M.D., I remember thinking what a miracle it was that everything worked beautifully.” — Kent Larson


Kidney failure caused me to accumulate even more fluid, and I began twice weekly paracentesis. At each appointment, nearly 20 pounds of fluid were extracted from my body.

By the beginning of 2017, I had lost 75 pounds, had no energy or stamina, minimal appetite and was constantly cold. My doctors discussed using a feeding tube to address my malnutrition. The days became weeks and months. While I kept a positive attitude, I knew I was on the cusp of death

On April 22, 2017, around 11 p.m., I received a call from Mayo letting me know a liver and a kidney from the same donor had become available. My sister Marci, who was my caregiver, and I were cautiously optimistic because we had received three calls in the prior months where the organs that became available were not suitable for me.

Fortunately everything lined up, and I went into surgery. When I awoke the next morning, after a six and a half hour surgery performed by Kristopher Croome, M.D., I remember thinking what a miracle it was that everything worked beautifully. I spent six days in the hospital before being discharged home.

Today, five months later, I am doing well, humbled to be alive and thankful for every day. Throughout this journey, the support I received from the doctors, nurses and technicians at Mayo Clinic was incredible. They became my second family.

Surprisingly, this was not unlike my first experience at Mayo Clinic, nearly 50 years ago. Living in rural North Dakota, I was just 14 years old and was severely injured in a tobogganing accident. My sled hit a tree, and the side brace had come loose and penetrated my abdomen, severing my ureter and urethra, and tearing my colon. After an emergency surgery in my hometown, I was sent to Mayo Clinic’s Rochester campus and had four additional operations to repair the damage.


“I’m excited about living life to the fullest and enjoying the natural beauty of our country. There is no doubt in my mind that if I had not gone to Mayo I would not be here today.” — Kent Larson


Mayo Clinic has saved my life twice now. I am very grateful for this second chance, and I have written a letter to the donor family to tell them how wonderful a gift they’ve given me.

Moving forward, I plan to volunteer at local organizations to raise awareness about the importance of blood, tissue and organ donation. I also share my story with everyone I meet, hoping to encourage someone else to be an organ donor.

I love travel and am looking forward to exploring new places. Next February I’ll be visiting the Hawaiian Islands for the first time with my sister. One of my goals is to visit all the U.S. national parks. I just got back from the Grand Canyon and am planning a trip to Yosemite National Park next year.

I’m excited about living life to the fullest and enjoying the natural beauty of our country. There is no doubt in my mind that if I had not gone to Mayo I would not be here today.


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Fri, Dec 1 8:00am · New Heart, New Hope and a Real Chance at a Future

After years of struggling with cardiomyopathy, a heart transplant at Mayo Clinic renewed Thomas Kim's health and rekindled his confidence in the future.

Thomas Kim, left, with his sons Lucas and Pablo, and Jose Diaz-Gomez, M.D., and his son, Andres Diaz-Mira.

After years of struggling with cardiomyopathy, a heart transplant at Mayo Clinic renewed Thomas Kim’s health and rekindled his confidence in the future.


Thomas Kim had all but forgotten what it was like to make long-term plans. With his wife, Yona, by his side, the 48-year-old spent years focused on trying to figure out what was causing his extreme fatigue and shortness of breath, what treatment he needed, and how to maximize his chances of seeing his four children grow up.

Thomas, a native of South Korea, was fairly healthy most of his life. But at age 38, he developed type 2 diabetes and high blood pressure. He experienced fatigue and shortness of breath. In 2009, Thomas ended up in an emergency room in Panama City, Panama, where the couple then lived.

He was referred to a cardiologist who diagnosed him with dilated cardiomyopathy, a disease where the heart’s left ventricle stretches and dilates, so it can’t pump blood as well as a healthy heart. The condition often causes heart failure, and in some people it can be life-threatening.

“I was living day to day because I knew I could die at any minute,” Thomas says.

But after seeking care in the United States and undergoing a life-changing heart transplant at Mayo Clinic, the Kims are making plans again. They’re looking forward to a family trip to South Korea and are eager to mark milestones with their children.

“I want to see my youngest son graduate college,” Thomas says. “I feel confident now that I’ll be able to do that.”

Searching for answers

As his health deteriorated, Thomas consulted with many doctors in Panama and Colombia in 2012 and 2013. Most told him he could manage his condition with medication. Neither Thomas nor Yona were confident that was the case, especially because one of Thomas’ family members had died a few years earlier from the same disease.

“We sought second, third and fourth opinions,” Yona says. “One of the doctors in Panama told us Thomas would need a defibrillator.”

People in Thomas’ situation, whose hearts have a low ejection fraction — a measurement of the percentage of blood leaving the heart each time it contracts — often need a defibrillator to prevent sudden cardiac death.


“I knew that if he was asking me for help, I had to help, especially after knowing more about Mr. Kim’s case.” — Jose Diaz-Gomez, M.D.


In October 2014, family friends in Colombia suggested Thomas and Yona consider Mayo Clinic. The friends had gone to college with Jose Diaz-Gomez, M.D., now chair of Critical Care Services at Mayo Clinic’s Florida campus. At that point, the Kims had never heard of Mayo Clinic, but they allowed their friends to reach out and share Thomas’ story.

“I hadn’t talked to my dear colleague and friend in 10 years. So his phone call surprised me. I knew that if he was asking me for help, I had to help, especially after knowing more about Mr. Kim’s case,” Dr. Diaz-Gomez says. “I gave my friend my word that I would help Mr. Kim get the care he needed.”

About a month later, after some additional research and discussions, Thomas flew to Florida to meet with Mayo Clinic cardiac electrophysiologist Fred Kusumoto, M.D.

On Nov. 20, 2014, Thomas had a defibrillator implanted at Mayo Clinic. He began a regimen of several medications including beta blockers, ACE inhibitors and other drugs that can improve survival for people with cardiomyopathy.

During the trip, Thomas also met with Daniel Yip, M.D., medical director for Heart Failure and Heart Transplant at Mayo Clinic.

Weighing options

For the next three months, Thomas traveled back and forth to Mayo Clinic for follow-up appointments and further testing. In February 2015, Thomas returned to Mayo for a cardiopulmonary stress test and cardiac catheterization. Both studies suggested that his long-term outlook would be better with a heart transplant or a ventricular assist device than if he continued with medical therapy. Dr. Yip told Thomas a heart transplant was his best option, and he should begin the transplant evaluation soon.

“The word transplant scared us,” Yona says. “We never imagined that would be a decision we would have to make.”

Shortly thereafter, testing revealed Thomas had developed pulmonary hypertension. Dr. Yip explained that if Thomas waited too long to make a decision about moving forward with a transplant, the high blood pressure in his lungs would become permanent, and he wouldn’t be able to survive the surgery. Dr. Yip also told Thomas he would need to have a ventricular assist device implanted as a bridge to transplant.


“Dr. Yip is so knowledgeable. He always had answers for us and was able to give us a long-term view of my condition and what we could expect in the future.” — Thomas Kim


“This device is the best therapy we have to reduce pressure in the lungs, so you become a suitable candidate for transplant,” Dr. Yip says.

“Dr. Yip is so knowledgeable,” Thomas says. “He always had answers for us and was able to give us a long-term view of my condition and what we could expect in the future.”

Still, Thomas was apprehensive about open-heart surgery.

A member of his care team, transplant surgeon Juan Carlos Leoni Moreno, M.D., suggested Thomas speak with another patient from Panama in a similar situation who also had a ventricular assist device and was awaiting a heart transplant.

“Talking with him and hearing what his life was like helped to allay some of Thomas’ fears,” Yona says. “But he was still not ready to move forward with the procedure, and we returned to Panama.”

Making a move

In December 2015, as Thomas’ health continued to decline, the Kims made the decision to leave their four children, ages 16, 13, 6 and 4, with their grandmother in Panama and travel to the U.S. where Thomas would have the assist device implanted, and they would wait for a heart transplant.

“I wanted to see my kids grow up,” Thomas says. “It was a difficult decision, but at that time my health was our family’s top priority.”

Thomas began to see the benefits of the ventricular assist device soon after it was placed.


“The team of doctors we had was incredible. They always showed us the light at the end of the tunnel. We had absolute confidence in them from the very beginning.” — Yona Kim


“Before the surgery, I was constantly short of breath,” he says. “Just two days after the surgery, I could breathe normally and had much more energy.”

Knowing Thomas still might have a long wait ahead for a heart, the family decided it was time to reunite. In June 2016, the children arrived in Jacksonville to join their parents.

“It was wonderful to be able to spend time with them and have enough energy to play with my two young boys,” Thomas says. “We felt a great void without the kids.”

Receiving the gift of a lifetime

A year and a half after moving to Florida, on Father’s Day, Thomas got the best present he could ever hope for  a new heart. Mayo Clinic heart transplant cardiologist Parag Patel, M.D., called the Kims to let them know the organ was available.

“Dr. Patel explained everything to us and walked us through every step of this journey. He was so kind and reassuring,” Thomas says. “When you know this is your only option, and you have confidence in the team of doctors treating you, it’s a lot easier to go through this whole journey.”

After cardiothoracic surgeon Erol Belli, M.D., completed the transplant, Thomas’ health improved significantly — a fact that is a source of satisfaction for Dr. Diaz-Gomez.

“Each time I see him, he looks stronger and happier,” Dr. Diaz-Gomez says. “When I think of how he’s celebrating his life and is healthy enough to enjoy his family, it makes me very happy.”

For all the doctors and everyone involved in Thomas’ care team at Mayo Clinic, the Kims are extremely grateful.

“The team of doctors we had was incredible. They always showed us the light at the end of the tunnel,” Yona says. “We had absolute confidence in them from the very beginning.”


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Wed, Nov 29 8:00am · Microsurgery Provides Much-Needed Relief to Teen With Lymphedema

Hobbled with painful ankle swelling for a year, Amanda Garrett finally found answers and a solution at Mayo Clinic.

Hobbled with painful ankle swelling for a year, Amanda Garrett finally found answers and a solution at Mayo Clinic.


Amanda Garrett’s ankle was painful and extremely swollen, and for a year, no one could tell her why. The 18-year-old went from specialist to specialist to determine what was causing her left ankle to swell up to 16 inches in diameter. She had six MRIs and went to consults with nearly a dozen specialists, including infectious disease doctors, endocrinologists, cardiologists and rheumatologists.

“Some doctors thought I had an autoimmune disease, and others didn’t know the cause,” Amanda says.

The turning point came when Amanda went to Mayo Clinic.

“We heard from several friends that Mayo had a wide variety of doctors who specialized in rare conditions, so we thought we could find answers there,” says Kim Garrett, Amanda’s mom.

Much to their relief, they did find answers and the solution Amanda needed at Mayo Clinic’s Florida campus.

On May 30, 2017, with a needle thinner than a human hair, Mayo Clinic plastic and reconstructive surgeon Antonio Forte, M.D., Ph.D., created new connections between lymphatic vessels and veins in Amanda’s left leg, allowing the excess fluid causing her swelling to drain. It took nearly seven hours, but the lymphovenous bypass allowed Amanda to walk normally and be pain-free for the first time in nearly two years.

A long-awaited diagnosis

As she went from one doctor to another during her long search for help, Amanda lived in daily discomfort.

“It felt like I had a really heavy weight on my leg,” she says. “I also had a shooting pain, which caused me to limp a lot.”

Then Amanda was referred to Dr. Forte at Mayo Clinic. He suspected she might have lymphedema in her leg and ordered a lymphoscintigraphy — a test in which radioactive dye is injected into the body to see how it moves through the lymphatic system. The test confirmed Amanda did, indeed, have lymphedema due to an accumulation of lymphatic fluid in her lower calf and shin.


“After a couple of weeks, I could see the improvement. Two months later, I could fit into my shorts and wear clothes that most teenagers wear.” — Amanda Garrett


“Dr. Forte was very knowledgeable,” Amanda says. “He was the light at the end of the tunnel.”

Dr. Forte talked to Amanda about the possibility of using lymphovenous bypass to treat her condition. During this microsurgical procedure, a surgeon re-routes part of the lymphatic system to improve fluid flow and reduce swelling. Because lymphatic vessels can measure less than one millimeter, the surgeon uses a unique microscope for the surgery that offers magnification 15 times higher than normal.

Before moving forward with surgery, Dr. Forte suggested Amanda first try a less-invasive approach. She wore a compression stocking, regularly elevated her leg, and restricted sodium in her diet to see if those steps would reduce the swelling and improve the lymphedema.

A big step forward

Unfortunately, after seven months using nonsurgical therapies, Amanda saw only minimal improvement. During a follow-up consult with Dr. Forte in April 2017, Amanda decided to move forward with surgery.

“Dr. Forte was informative and honest,” Amanda says. “He said surgery would maybe improve the swelling 30 to 40 percent.”

The surgery was scheduled two weeks after Amanda’s high school graduation. Once the procedure was complete, her situation began to look up.

“After a couple of weeks, I could see the improvement. Two months later, I could fit into my shorts and wear clothes that most teenagers wear.” Amanda says. “I love Dr. Forte so much for helping me. It’s hard to put into words. Now I can be a normal teenager.”


“I not only look better, I feel better. And that’s given me a lot of confidence.” — Amanda Garrett


Amanda continues to wear a compression stocking five to six days a week to help keep her condition well-managed. Four months after undergoing surgery, the results were significant, with the swelling in her leg reduced by 70 percent. That’s made a big difference in Amanda’s day-to-day life.

“I can see a change in her personality because she has more freedom,” Kim says.

Amanda, who’s now a linguistics major and wants to be a government translator one day, is looking toward her future with enthusiasm.

“It was really exciting for me because I lost 10 pounds after the surgery,” she says. “I not only look better, I feel better. And that’s given me a lot of confidence.”


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Mon, Nov 27 4:45pm · Finding Blessings in My Battle With Leukemia

Janie Magruder reflects on her cancer diagnosis and treatment, including a crucial stem cell donation from an unlikely source that helped to save her life.

Janie Magruder reflects on her cancer diagnosis and treatment, including a crucial stem cell donation from an unlikely source that helped to save her life.


Written by Janie Magruder

I must have looked like a deer caught in the headlights.

“You’re going to be fine,” whispered my nurse after getting me settled in my hospital room at Mayo Clinic in Phoenix, Arizona, on Feb. 20, 2016.

“This is a marathon — an ultra-marathon — but it is curable,” reassured one of my doctors.

“We’re going to get you through this.”

“This” was acute myelogenous leukemia, a blood cancer that I knew little about, and that, as risk factors go, I wasn’t likely to get. I wasn’t old enough. (Most patients are at least 65.) I was the wrong gender. (Men are more likely to be diagnosed with AML.) I had no other blood disorders. I’d never been treated for previous cancer with radiation or chemotherapy. I hadn’t been around benzene or other dangerous chemicals, and there was no exposure to a nuclear reactor incident in my past. In fact, I’d been so healthy all my life, I could count on one hand the times I’d been hospitalized.

My husband, Jack, and I were shocked and terrified at the news. But it turned out I was very blessed. Here’s how …

My faith

My parents raised me to believe in God, and I’ve never lost that faith. I believed, too, that he had a plan for my life, that he was the ultimate healer, and that he would never leave my side. Many nights in my hospital room, I clutched my late mother’s “Jesus rock,” as she called it. It just fit in the palm of my hand, as it had in hers. I prayed a lot, and I had a team of prayer warriors in my family, my church and around the country who were praying for me, too. I clung to my faith.

My family and friends

Nobody diagnosed with cancer knows how to deal with it, nor do their family members or friends. There’s no training for such devastating news. What do you do, say, think? What should you read and what should be avoided?

That said, you would not have known that my husband, Jack, was not schooled in cancer-patient caregiving. From the first, Jack didn’t let on how scared he was. He simply bravely carried on. He kept working. He kept caring for our home, our youngest son, and our two dogs. Jack kept showing up. I don’t know how he did it.


“Nobody diagnosed with cancer knows how to deal with it, nor do their family members or friends. There’s no training for such devastating news.” — Janie Magruder


He and I agreed we would take everything one day — sometimes one hour — at a time. He visited me every day, sometimes twice a day, and kept in touch with our family members and friends. We promised we would try to maintain a positive outlook about my treatment and recovery, not just to convince ourselves that things were going to be OK, but also for our children.

Our three sons bolstered us with funny texts and snippets of news from their busy lives. For my birthday, which fell after three rounds of chemotherapy, they gathered at our home in Tempe. I was home from the hospital, and we played board games. I was struggling with pleurisy at the time and had to stand up most of the time to make the laughing at their jokes less painful. My guys colored pages in coloring books with me — something none had embraced much when they were young — and I hung the resulting art in my hospital room when I had to go back.

My medical care

Mayo Clinic’s reputation for being the best in the world, for focusing on the patient and providing comprehensive care, is deserved. I was so blessed by a rock star team of hematologists, compassionate nurses and accommodating, kind, staff members.

I met my primary hematologist, Dr. Jeanne Palmer, on Feb. 22, 2016. She wrote on the white board in my room the details of my induction and consolidation therapies in which chemotherapy would be used to kill every leukemia cell in my blood and bone marrow. I looked at that board a dozen or more times a day, trying to reassure myself about what was to come.

Dr. Palmer informed us that the best chance for my recovery was to have a stem cell transplant, and we didn’t second guess her. There would be more on that later, Dr. Palmer said. But for now, it was one day at a time. My first chemotherapy treatment began at 5:15 p.m. on Wednesday, Feb. 24.

When side effects from the chemotherapy struck, whether skin rashes or mouth sores or stomach pain, Mayo physicians arrived immediately to diagnose and treat. A Mayo ophthalmologist visited me in my hospital room on a Friday night to test my eyesight. An added bonus: he prayed for me after asking my permission. The nurses demonstrated their dedication every day. There are really too many examples to include here, but a few stand out.


“I was so blessed by a rock star team of hematologists, compassionate nurses and accommodating, kind, staff members.” — Janie Magruder


My first room had a small window with just a sliver view of a concrete courtyard below. When one of my nurses learned my initial stay would be for more than 30 days, she asked if I would like a room with a better view. I jumped at the chance. The next morning, the nurse manager wheeled me into a room with a window pointed at the McDowell Mountains. I sat in front of that window for hours, watching the birds in the mornings, the clouds roll in in the afternoons, and the headlights of cars on the freeway at night.

My nurses cheerfully cleaned me up when I got sick, or when I was too weak to take a shower or get to the toilet. They were attentive to my IV, and ultra-careful with my infusions and medication needs. Several noticed posters on my wall that were created by colleagues at Grand Canyon University. They shared stories of being a graduate of, or enrolled at, GCU’s fine nursing school. Some prayed over me, which meant everything.

When my long red hair began falling out on my pillow, a nurse gave me a buzz cut by the mirror in my room so that I could get used to my baldness gradually. They came when I called, and let me be when I needed it. They were attentive to Jack and our sons, offering warm blankets, crackers and juice, not just to me, but for them, too.

I can’t say enough about the staff at Mayo. The chaplain’s office offered spiritual guidance and blessed my transplant procedure. The young men who piloted me in my wheelchair to various procedures and tests were kind and funny. The people who cleaned my room were respectful and sweet. The business office patiently helped with insurance, and the bone marrow transplant office gave us a thorough tutorial on how they would find me a donor.

After I was released from the hospital, on June 2, 2016, the nurses and staff in the hospital’s infusion center treated me and my family with compassion, as have the doctors, nurse practitioners, phlebotomists, nurses and staff in the Cancer Center.

My donor

Mayo Clinic worked to find the best possible peripheral stem cells donor for me, first ruling out family members and then accessing Be the Match, the national bone marrow registry. By early spring, we found a donor candidate. His selection was based on HLA, human leukocyte antigens, that are markers on most cells in a person’s body. The immune system uses them to determine which cells belong in the body and which do not. My potential donor was a perfect match based on 10 HLA markers.

Following a series of tests that confirmed he was healthy enough, my donor received injections to increase his blood-forming cells. He later went to a hospital to have blood removed from one arm. The blood then passed through a machine that separated out those blood-forming cells. The remaining blood was returned to him through the other arm.

His bag of cells was transported to Phoenix, and, following a blessing ceremony by the chaplain, the contents were infused into the central line in my chest. About 100 days later, a blood test revealed that my donor’s cells were thriving in my body.

For more than a year, I knew very little about the young man who helped save my life because of Be the Match privacy requirements that protect the patient and the donor. But last July, he consented to sharing information, and that same month, we spoke on the phone. I didn’t know what to say, which doesn’t happen often.

Jack Milligan, now 21, is a senior at Texas A&M University in College Station, where he will graduate with a degree in economics this spring. He signed up with Be the Match in the fall of 2014 because it was the charitable cause of Delta Tau Delta, the fraternity for which he was pledging.


“As I approach the 18-month anniversary of my second chance at life, I am so grateful to God, my family and friends, my donor and Mayo Clinic. Every day being cancer-free is a gift.” — Janie Magruder


Jack, now president of Delta Tau Delta at A&M, told me recently that six other young men in the chapter have donated bone marrow to save people’s lives, and dozens more Aggie Delts have added their names to Be the Match. The fraternity’s commitment to saving lives is so extraordinary that Be the Match is planning to erect a billboard in honor of Jack and his brothers later this year in College Station.

“We are blessed. We are lucky,” Jack said about his fraternity. “This definitely feels like there’s some kind of magic to it.”

Jack said he was moved to donate his cells because of his mother.

“My mom is the most compassionate person I’ve ever met, and I’ve learned how to be more compassionate from her,” he says. “If this was to happen to my mom, I’d be devastated.

But I’d want to know that someone was there who was willing and able to save her life. Why would you not do that if you could?”

 As I approach the 18-month anniversary of my second chance at life, I am so grateful to God, my family and friends, my donor and Mayo Clinic. Every day being cancer-free is a gift.


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