This story appears in the Fall 2014 edition of My Boone Health magazine. Click here to request a free subscription.
by Jacob Luecke
There were plenty of good reasons for Steve Downes to get a lung cancer screening at Boone Hospital Center this spring.
For starters, Steve, 54, was a smoker for most of his life before quitting a couple of years ago. His decades of smoking put him at risk for cancer.
Another good reason to get screened was that the procedure would cost him nothing. The Stewart Cancer Center lung screening had been paid for by donations to the Boone Hospital Foundation.
Steve could have also felt compelled to get screened due to his longstanding friendship with Norm and Virginia Stewart—the leading local voices in the fight against cancer through their charitable work and as the namesakes of the Stewart Cancer Center.
But for Steve, one other reason trumped all the rest.
“I did it to make my wife happy,” he says.
Steve is the kind of guy who avoids medical care if possible. In fact, prior to his screening, he hadn’t seen a doctor for 10 years. He figured if he felt good, why bother?
So it took some convincing by his wife, Janice Downes, to get Steve to agree to the screening. Janice even called Boone Hospital herself to make Steve’s appointment. Then she called again when he missed that first appointment.
After all, why not get screened when the technology at Boone Hospital can detect cancer early on, when it is tiny?
But Steve’s screening ended up detecting something big—and it wasn’t cancer.
“Walking time bomb”
As the nurse navigator at the Stewart Cancer Center, Mung Chin helps guide people through the complexities of a cancer treatment plan.
She’s also the person who calls patients with the results of their lung cancer screenings.
On the morning of May 14, Mung was reviewing Steve’s report before calling him. The report came back clear for cancer. However, Maxwell Lazinger, MD, the radiologist who read the scan, noted that Steve did have an abdominal aortic aneurysm.
When Mung called Steve, she gave him the good news about cancer, but also shared the aneurysm finding. She said she would send him information about how to get that checked out.
But after the call, Mung decided to go a step further. She was concerned the aneurysm might be serious.
“Although I am not a vascular nurse, from my experience working with Oncology patients—some could be really sick when they come to the hospital—I learned to be more cautious when it comes to a medical condition,” Mung said. “As a health care provider, one cannot simply assume that the person understands the severity of the problem and will take care of it as recommended. What’s more, it seemed that an aneurysm this size warranted some immediate attention.”
So she researched abdominal aortic aneurysms. She then reached out to Angelee Geisler, a nurse practitioner who works closely with Boone Hospital cardiac surgeon Joss Fernandez, MD, of Missouri Heart Center.
They decided Steve’s problem might need immediate attention. Angelee offered to have Steve see Dr. Fernandez the next day.
So Mung called Steve once more, discussed the potential severity of the aneurysm and offered the appointment with Dr. Fernandez.
The urgency caught Steve off guard.
“It was kind of scary,” he says. “I’ve been healthy all my life. I’ve broken bones through sports and stuff, but I’ve never had any kind of issues at all, ever. It was a shock.”
However, Steve knew that aneurysms could be serious. His father, Ed Downes, twice had surgeries to fix aneurysms. His grandfather had died from an aneurysm.
“All of the sudden, I was a walking time bomb,” he says.
The next day, Steve was back at Boone Hospital where he had a CT scan, this time focusing on his abdomen. The scan determined his aneurysm measured 6.4 centimeters.
Left alone, an aneurysm that size has a 14 percent chance of rupturing per year, Dr. Fernandez said. If a rupture occurred, Steve would likely die.
Dr. Fernandez wanted to act quickly, scheduling a surgery for the following week.
Steve also consulted his friend, cardiologist William Woods, MD, who agreed with the assessment and advised that Dr. Fernandez was the best surgeon for the job.
A week later, Steve was back for the surgery. During the procedure, Dr. Fernandez placed a stent to reline Steve’s aorta, keeping blood from entering the aneurysm.
The surgery went smoothly.
“His prognosis is excellent,” Dr. Fernandez said. “I get great satisfaction from turning a life-threatening, scary situation into a friendly and comforting experience.”
As he recovered at Boone Hospital, Steve was very pleased with the care he received.
“Everything was as peaceful and as calm as it could be throughout the procedure,” he says. “Everybody in the hospital was great.”
He was also impressed by Dr. Fernandez.
“Not having a lot of experience with doctors as a patient, I was extremely happy,” Steve says. “He was a nice guy, straightforward, told me exactly what was what.”
Steve’s experience also stands as an example of how the collaborative environment between disciplines at Boone Hospital leads to quick, life-saving treatment.
“At other medical centers I have worked at, getting another specialist to see your patient requires setting up an appointment through their staff and sending medical records, which leads to delays,” Dr. Fernandez said. “The coordination between disciplines at Boone is as simple as a cell phone call direct to the doctor or nurse coordinator.”
So while Steve’s lung cancer screening didn’t find cancer, it still saved a life.
“If it wouldn’t have been for that lung screening, I would have never found the aneurysm,” Steve said. “I probably wouldn’t be here.”
In his job, Steve Downes inspects roofs, estimates damage and sells repair work.
Not long after the surgery to repair his aneurysm, he found himself inspecting Norm Stewart’s roof.
“I got to thank him for basically saving my life,” Steve says.
Boone Hospital Foundation
The lung cancer screening that detected Steve’s aneurysm was funded by donations to the Stewart Cancer Center—named for Norm and Virginia Stewart—through the Boone Hospital Foundation. The service to the Stewart Cancer Center is just one aspect of the foundation’s many roles inside Boone Hospital, where it works to enhance the care and create a more comfortable healing environment for patients.
To learn more about the foundation’s work or to make a donation, visit boone.org/foundation.