Love at BVMI: A Two-Way Street
Everyone at BVMI looks forward to days when Katarina and Sebastian come in. Married for 58 years, they are old souls whose love lights up BVMI the moment they walk through the doors. At the core of their marriage is the belief that laughter is the key to staying in love. Joy follows them wherever they go.
They describe themselves as a tag team. “I help him get here and write down what the doctors say. He helps me cook and clean,” says Katarina. “We don’t just put up with each other – we support each other.”
“Well, sometimes we put up with each other!” jokes Sebastián.
“Our love for each other pales in comparison to the love that the doctors and nurses show all of the patients. When we come here, we feel so respected and valued. We actually enjoy going to see the doctor!” says Sebastian.
Health, Family, and Love
“I do it for my boys,” says Santiago with a smile as he eagerly shows off pictures of Mateo (15 years old) and Samuel (14 years old). “They’re Irish twins! Or should I say Guatemalan twins?”
When Santiago first came to BVMI, he was showing all the classic signs of Type II diabetes. He had blurry vision, frequent hunger and a need to use the bathroom often. “I would be spending time with my family and I would always have to disrupt beautiful moments to go eat or go to the bathroom. My wife was so worried about me.”
Thankfully, his wife Clara took notice and started to look into their options. Like many of BVMI’s patients, Santiago had once had insurance through his employer. After 30 years at the same company, he was laid off. Santiago was then without a job – and without insurance. It seemed nearly impossible that Santiago would be able to see a doctor.
Clara, a nanny, told her co-worker Alex about Santiago. Alex had been in similar situation, working as a maid and without insurance. Then she found BVMI. She told Clara, and before the end of the day, Santiago and Clara were scheduled to come in for an eligibility screening.
“It is a blessing to have BVMI – most people can’t afford medical care in the US without having some insurance to offset the costs. If I had gone to the doctor after I lost my job, it would have put my family in debt. It is amazing that there are volunteers who provide this incredible care and selflessly give their time.”
While Santiago is looking for a job, he is working as often as he can as a landscaper and as a mover. “At the end of the day, I am so lucky to have a wonderful family to share my life with. It’s not about the money. As long as we can provide for our boys, health, family, and love are all I need.”
Improving His Health, One Step at a Time
When you meet Henry, he immediately shows off pictures of his beaming family: his wife, three successful children and three delightful grandchildren. Despite the smiles, Henry’s life has not been easy, and he has often sacrificed his health for the sake of his family.
Originally from Kosovo, Henry and his wife, Mary, first came to the U.S. so that she could have emergency brain surgery. At first, they struggled financially, and for many years, Henry went without seeing a doctor so that they could pay for Mary to see one.
Five years ago, Henry discovered BVMI and has been coming here ever since. His doctor discovered that something was not functioning properly with his prostate, and, after a series of tests, diagnosed prostate cancer. After a long battle, and supported by the BVMI healthcare team, Henry beat his cancer.
Henry has had a lifelong struggle with healthy eating. His job as a cook made it easy to snack throughout the day, in addition to eating a portion of whatever was being served for lunch or dinner. Early this year, he was under a great deal of stress as he helped his son open a new restaurant. At his annual exam, it became clear that stress and poor eating habits were taking a toll: Henry weighed in at 225 pounds, his blood pressure was dangerously high and he was pre-diabetic.
Dr. Josef Machac, Henry’s volunteer physician, spent a lot of time with Henry discussing his lifestyle and suggesting some positive changes he could make. Henry recalls, “Dr. Machac was so patient with me – he explained everything. And he didn’t give me so much to do that I felt like I was going to fail.”
Dr. Machac also arranged for Henry to see Holly Homa, BVMI’s certified diabetes educator, that same day. Holly sat down with Henry and taught him how to manage his pre-diabetes so that it didn’t progress to diabetes. “I knew I was overweight but I didn’t know how to manage it. I left BVMI that day knowing I was in good hands.”
When Henry came back a few weeks later, he’d lost almost 10 pounds! Dr. Machac encouraged him to continue making changes, but to up the ante a bit. So instead of walking a few days a week for 20 minutes, he started walking every day for 30 minutes. He began eating more fruits and vegetables and less pasta and red meat.
At his most recent appointment, Henry weighed in an amazing 35 pounds lighter. His blood sugar and blood pressure were nearly normal. “I am feeling great now because of Dr. Machac and Holly. I enjoy walking for an hour everyday and feel good when I eat healthy foods. I know I have the power to take control of my health and change in my life.”
A Culture of Caring is Sometimes the Best Medicine
Mary Granholm, BVMI’s nurse practitioner, wasn’t expecting anything out of the ordinary when Sara came in for a routine check-up to monitor her arthritis. During the exam, Mary was surprised to see a blood pressure reading of nearly 200/100, dangerously high for someone who usually had a normal reading.
Instead of writing a prescription, Mary spent some time talking with Sara to see if there was something unusual going on. She conducted a thorough physical exam and asked Sara to share what was happening in her life. Normally upbeat, Sara loved to chat about anything from the weather to her family. This time, she burst into tears.
Her only daughter was pregnant with her first child, and had just been told the baby was at high risk for Down’s Syndrome. Her son-in-law was adamant that she have an immediate abortion, and she and her daughter were distraught and anxious.
Mary recommended that Sara talk with her daughter about having an amniocentesis to confirm
the diagnosis. Neither the mother nor the daughter could pay for the test, so Mary continued to help them explore their options. Eventually, Sara and her daughter borrowed money from friends and family to have the test done, which showed no evidence of Down’s Syndrome.
Just a few weeks ago, a beaming Sara walked into BVMI with her daughter and newborn granddaughter for a follow-up visit to check her blood pressure, which was normal.
No prescriptions, no pills, no medications. All Sara needed was a loving, attentive ear.
“Because of BVMI, I am limitless”
If you met Laura Mack today, you would never know that she is emerging from the most difficult point in her life. Laura remembers her first visit to BVMI well: it was on August 4, 2014, her sister’s birthday. She knew something felt wrong, but couldn’t tell why. She left her appointment that day feeling better that doctors were now looking into her symptoms, and went on to celebrate her sister’s birthday later that evening.
Two days later her life was forever changed: on August 6, Laura found out she had ovarian cancer. One moment she was celebrating a normal life event, the next she entered into the hardest, longest battle of her life.
If you haven’t already heard her story and would like to, you can listen here.
A few months ago, Laura got the news that she had been wishing for since she first got her diagnosis: she is in remission. These days, her concerns no longer are about getting to chemotherapy, attending doctor’s appointments, and having enough downtime. Laura instead spends her days thinking about what games she’ll play with her nieces, what time she’ll grab a cup of coffee with her dad, and what classes she should take next semester.
This past April, Laura enrolled in an Occupational Therapy program at Eastwick College. For Laura, her mom’s training as an Occupational Therapist was crucial to her healing. Her mom was able to help her learn how to open bottles of water and tie her shoes at a point when Laura was so weak from chemo that day-to-day tasks seemed impossible. Laura now wants to be able to help other cancer patients in the same way that her mom did.
Laura had hardly completed her chemotherapy before her classes began. She felt sick and weak. “Although it was nice to go back, it was incredibly difficult. I had so many symptoms as a result of the chemo. Forgetfulness was huge; it was practically a disability. I could read a paragraph and then look up and have no clue what I had just read. I thought to myself, ‘how am I supposed to get through this?’” At first, Laura did not want her cancer to define her. However, she came to the realization that her experiences were her strength. “The first professor I had at Eastwick was spectacular; I was meant to be in that classroom. He supported me and understood me. The class was about anatomy and physiology.” Laura felt that the class was therapeutic: “I got to see and understand how miraculous and spectacular the body is and can be. It was so hard to talk about child-bearing when the realization that I could never have kids was still so raw. It hurt. But, it helped heal me.”
In her spare time, Laura coaches a softball team consisting of pre-teen and teenage girls. Her sister, father, and she make a dynamic trio. “I get to tell these girls what I wish I had known when I was their age,” Laura elaborates, “I tell them ‘Learn from me! Life is short; don’t make the same mistakes I did.”
While Laura was battling her cancer, her sister was pregnant with her first child. Laura realized that because she was never going to be able to have children that this child, her niece, was going to be special. Reagan was born when Laura was at her weakest point emotionally and physically during her battle: she had just lost her hair and was far along with her chemotherapy treatment. “Reagan was and still is my rainbow in my raincloud,” says Laura. Today she spends her days watching both Reagan and Avery, her sister’s second child, born just a few weeks ago. For Laura, these bonds are both strong and strengthening. They are one of the reasons why Laura went back to school. “How could I tell them ‘go to college, get a degree’ when I dropped out? If they are already mimicking what I am saying, I can’t even imagine what behaviors they are taking in and observing. Everything I do, I do for them.”
Inspired by the care that BVMI gave her, Laura is looking into launching her own foundation: Tell 10 Women. Laura is working closely with Dr. Sharyn Lewin, the oncologist to whom she was referred by BVMI. BVMI is fortunate to have a network of practitioners made up of people like Dr. Lewin, individuals who agree to see BVMI patients for free and typically provide services that our healthcare center cannot offer on-site. Laura’s goal with Tell 10 Women is to further educate women, particularly college-aged students, on women’s health. For Laura, this is important because there were questions she never thought to ask her general practitioner or her gynecologist. Because of the care and education Laura received at BVMI, she now knows how important it is to ask doctors certain kinds of questions. “I want to impact as many lives as possible,” Laura says, “In my situation, so many people touched me. People have incredible strength, incredible kindness. Everything I do now is for everyone that saved me: BVMI, Dr. Lewin, my family. Failure is not an option. Everything is for the people who got me here, to where I am today.” Laura believes that Tell 10 Women is about doing for others like what others have done for her.
One of Laura’s goals with Tell 10 Women is to get the word out about BVMI. Laura wishes that everyone knew about organizations like BVMI. “Everyone falls on hard times at some point, I know I did,” Laura describes, “I am so thankful to everyone at BVMI, from the women who filed my eligibility paperwork, to Dr. De Simone, who was the one that discovered the cancer.” Laura believes that there are not many people like the ones you find at BVMI. “Not only do the doctors and nurses give their expertise, they give their time – precious time away from family, friends. There are no words to describe the extent of this selflessness and this generosity. The people at BVMI have made me more mindful of how I want to donate my time and to give more of myself to others.”
When Laura found out she had cancer, she thought she was never going to feel joy again. “Look at everything I came from. I have never been so happy in my life. I have never felt this way,” Laura explains that this newfound happiness comes from the kindness that others have shown her. “This whole new life is mine, is because of BVMI. Why do people ever say that the sky is the limit? It’s not true. Because of BVMI, I am limitless.”
Special Treatment Gets Results
When Gerardina woke up on a Saturday morning with a rash on her face, she went to the Emergency Room because BVMI was closed. Even after her ER visit, the rash didn’t go away, so she made an appointment to see nurse practitioner Mary Granholm, MSN, RN, APN-BC, her primary care provider at BVMI. Mary was concerned because the rash persisted.
Fortunately, BVMI has a volunteer dermatologist – Dr. Corey – who sees patients at BVMI twice a month. Mary referred Gerardina to Dr. Corey, who prescribed medication that successfully treated the problem.
“We are incredibly fortunate to have many specialists who come in to BVMI to see patients. For people without health insurance, seeing a specialist is prohibitively expensive and probably just wouldn’t happen. That’s when a little rash can become a big problem,” said Mary.
Here is How You Helped John Land Back on His Feet
John G., a 19-year-old student, injured his ankle while wrestling in January, 2016. Thinking his injury would improve on its own, he didn’t seek treatment. After hobbling around for months, his mother made an appointment for John to see Dr. Karen Latimer, a volunteer physician at BVMI. Dr. Latimer ordered an X-ray of the ankle and then referred John to Dr. Peter Carbonara, a volunteer orthopedist who comes to BVMI a few times a month. When Dr. Carbonara pulled up John’s X-ray, he invited Adonis Castillo, a volunteer interpreter and recent medical school graduate, to review it with him. He diagnosed a ligament injury, and advised John to wear an ankle support. He reassured him and his mother that he will improve with time and a return visit was scheduled in two months.
Adonis says “Dr. Carbonara told me that, since he only had an X-ray and not an MRI, there are certain maneuvers a physician can use to help diagnose an injury without actually needing an MRI. This is not something I was taught in medical school, so it’s great to have the opportunity to work and learn from an experienced physician.”
For his part, Dr. Carbonara is grateful to be at BVMI not only as a physician but also as a mentor to younger volunteers like Adonis. “Being at BVMI is one of the best parts of my week. Working with patients like John is so important and having the opportunity to mentor the next generation of physicians – Adonis included – is one of the many reasons I love being here.”
“You can’t do anything if you can’t breathe.” These words from BVMI Nurse Practitioner Mary Granholm hit home for Alma, who has asthma. She came to BVMI about a year ago, after losing her medical insurance.
She was using a ‘”rescue inhaler” as a daily medicine, instead of for short-term needs. BVMI prescribed a short-term oral steroid and provided a sample of the right type of daily medication. They added dose of asthma education; for example, Alma learned that something as simple as breathing through a scarf in cold weather can be an act of kindness to the lungs.
During frequent follow-up visits, BVMI discovered that Alma was still having episodic attacks because she’d been trying to stretch her twice-daily asthma medication (and her budget) to a once a day. “Alma needed more help, so we provided emergency treatments when she needed them and helped her apply for pharmaceutical patient assistance.” She obtained a one-year supply of maintenance medication which will hopefully be renewed if Alma needs it again.
These days, Alma is in better health — and much better spirits. She still comes to BMVI for wellness visits, and is breathing easier in more ways than one.
Carmelina and Miguel do everything as a couple – even coming to BVMI – and both are very grateful for the care they receive. When they’re here, they always see the same doctor for primary care, but in the event they have other medical needs, BVMI’s has many onsite specialists who can often take care of them. BVMI’s onsite volunteers specialize in cardiology, gynecology, podiatry, dermatology, gastroenterology, nephrology, diabetes and even general surgery.
This approach has benefited both Carmelina and Miguel, who say they feel “like family” when they come to BVMI. They also appreciate being able to have most of their healthcare needs taken care of in one place, so their time out of work is kept to a minimum.
“BVMI is, first and foremost, a primary care facility,” said Dr. Arthur De Simone, BVMI’s medical director. “But we are very fortunate to have many specialists who donate their time and talent to keep our patients healthy.”
Sixty-five year old Felix has struggled for years to manage his Type 2 diabetes. When he came to BVMI last year, his healthcare team helped him understand how to regulate his disease. Holly Homa, BVMI’s Certified Diabetes Educator, knows how important it is to provide coaching and information in his native Spanish so he understands what foods he can eat, how to manage his medication and test his blood sugar, and the importance of exercise.
In just one year, Felix’s hemoglobin A1c decreased by 30%, a major improvement that shows his dedication to improving his health. Felix says he loves coming to BVMI and is feeling better than ever!
“Alone we can do so little, together we can do so much.” – Helen Keller
Teamwork is an essential part of what we do at BVMI, where staff and volunteers work together to create the warm and caring environment that our patients love so much.
This teamwork was apparent one Sunday afternoon last October, when Dale Mottola, BVMI’s administrative director, picked up a message from Quest Labs reporting that an unnamed patient had a critical lab value. A quick phone conference with BVMI nurse manager Michelle Kaye, MSN, RN and BVMI’s Chartis Fellow nurse practitioner Mary Granholm, MSN, RN, APN-BC, determined the patient was Maria, who was being treated for high blood pressure. With a fasting glucose level of 402, it was imperative that Maria be directed to the emergency room immediately.
Because Maria only speaks only Spanish, Vicky Fliman, RN, our multi-lingual nurse navigator, also became involved. Unable to reach Maria, Vicky located the granddaughter and urged her to take Maria to the emergency room as soon as possible.
Maria went to the ER and was put on medication to regulate both her blood pressure and blood sugar levels. Mary and Vicky have continued to see her every two weeks to ensure that she understands how to monitor her condition and take her medication properly. Maria now checks her blood sugar and blood pressure at home and brings the logs to every visit. Her blood sugar is slowly decreasing, and we continue to supervise her closely.
No Need to Be Afraid
Nessa’s father died from colon cancer at the age of 67. Nessa’s own history of rectal bleeding prompted Dr. Lisa Ann Miller, BVMI’s volunteer gynecologist, to refer her for a colonoscopy last August, but the 44-year-old never followed through with the test. This past January, Nessa received another referral from her primary care physician, Dr. Jayant Kirtane, but refused to go.
Talking with Michelle Kaye, RN, BVMI Nurse Manager, Nessa admitted that, with a family history of colon cancer, she was afraid of finding out she had cancer, too. Michelle helped her understand how important it was to be tested, then contacted the NJ CEED (Cancer Education and Early Detection) program in Bergen County. Nessa was accepted into the program, which entitled her to a no-cost colonoscopy done locally, with transportation provided to the gastroenterologist’s office. Nessa agreed to go and had the test done in September 2015. The results showed no evidence of cancer. Soon after, she came to BVMI with a smile on her face, proud of herself and grateful to BVMI.
BVMI Social Worker Helps Patient Cope with Tragedy
How do you cope with a miscarriage? This is the question that faced Rosita, who lost her unborn child and strongly grieved for the loss. She became very fearful for her remaining child, forbidding her to play on the playground in case she got hurt and not allowing her to play with other children because she felt it was too dangerous.
Knowing that she needed help to process her grief, Rosita turned to BVMI and Women’s Health Social Worker Linda Steffe, MSW, LCSW. Linda shared strategies with Rosita to help not only her, but also her husband and remaining child. One way Linda helped was by giving Rosita age appropriate ways to answer her daughter’s question, “Where is the little baby you told me was coming?” Other community resources were also suggested and Rosita feels the family is moving forward. They are almost ready to consider another pregnancy.
8 Days in September
Azul is lucky to be a patient at BVMI. In fact, her life may have depended on it.
A patient since 2011, Azul was diagnosed with anemia. Despite recommendations, she consistently refused to have a gynecological exam. “I don’t need it,” she explained.
Things changed on September 1, when she came in for a routine blood test. Quest Diagnostics, prompted by the alarming results, called BVMI and alerted them to her very low hemoglobin and hematocrit levels. Dr. Howard Lipton, BVMI’s associate medical director, phoned Azul, who said “I feel fine.” Despite her protests, Dr. Lipton insisted that she come in, telling her that the test results were serious and she had to take action.
Finally, Azul agreed to come in for an exam. She mentioned that she had passed out that morning at work, and Dr. Lipton replied it was because she was profoundly anemic. Dr. Lisa Ann Miller, a volunteer OB-GYN, performed a second exam and Azul was rushed to Holy Name Hospital. After receiving an immediate transfusion of two units of blood, along with an iron infusion, Azul remained in the hospital for three days. Thankfully, her check up at BVMI on September 8 showed that she was doing much better, eliciting a heartfelt “thank you!” for the care – and extra push – she received from BVMI.
All’s Well that Ends Well
Nina first came to BVMI three years ago when she was a senior in college. She couldn’t get rid of her abdominal pain or persistent fever. Consequently she was missing school and falling behind. Holy Name Medical Center directed her to BVMI and, once she became our patient, Dr. Don Weinstein, a volunteer, diagnosed her with ulcerative colitis.
BVMI then helped Nina obtain pharmaceutical assistance so that she could receive medication at a reduced cost. As a final precaution, Dr. Philip Micale, a physician in private practice who sees some BVMI patients pro bono, administered a colonoscopy.
Nina is now working and able to afford insurance but her mother and brother still come to BVMI. Her brother comes for wellness visits because, “he supports the family. We have to keep him healthy,” said Nina. “I am thankful that BVMI is here. Otherwise I would have fallen through the cracks and not be where I am today.
Why It Really Matters
What do you do when your patient says he can’t monitor his blood sugar levels because he can’t see the numbers on the machine?
This was the problem confronting Dr. Charlotte Sokol and Certified Diabetes Educator Holly Homa. Their patient, 57-year- old Emilio, worked irregular hours at a deli, sometimes 12 hours at a time. His crazy schedule and his cataracts kept him from being able to manage his diabetes, which was dangerously uncontrolled.
Knowing it was critical that Emilio monitor his blood sugar, Dr. Sokol asked Holly to contact ARKAY USA, Inc. to ask about their talking glucometer. John Walker, a company representative, felt their glucometer would be the perfect solution, especially because it spoke both Spanish and English. ARKAY USA generously donated three machines to BVMI, with one of them earmarked for Emilio. They also sent superb educational literature for BVMI to give to diabetic patients.
When Cultures Are Different
When Nurse Navigator Vicky Fliman, RN, steps into the exam room, she is prepared to talk with the patient in one of the five languages she speaks. What she must also be prepared for is the many cultural differences that exist. With patients hailing from more than 35 different countries, BVMI’s patient base is a microcosm of Bergen County.
Raul’s experience speaks for many.
Raul works in a restaurant and knew that he had diabetes. When he came to BVMI for help, the diabetes team prescribed insulin injections.
On a follow up visit, Vicky noticed that his numbers had not improved. “He began to shake when I asked him about his insulin,” Vicky recalled. Raul was not taking the life-saving medication as prescribed.
He told her that his niece in Mexico had taken insulin injections and was now in a vegetative state. “In the village where I come from, we believe that you will die if you take insulin,” explained Raul. Knowing that she could not persuade Raul to change his mind, Vicky instead recommended that his prescription be changed to an oral medication. Certified Diabetes Educator Holly Homa then worked with Raul to teach him how to monitor his blood sugar levels and improve his diet.
When Raul returned for his next visit, his tests showed improvement. His wife said that he was careful about what he ate, monitored his blood sugar levels and took his medication. Equally important is what Raul said, “Thank you for respecting my beliefs. I truly appreciate that I was not judged.”
At Last – Breathing Easy
Most low-income individuals without health insurance don’t have a doctor. They wait until they are very sick, then visit their local ER – an expensive way to handle a treatable condition. Many, like Teresa, don’t know there is another option.
Teresa, a cashier working two jobs, frequently relied on the ER to take care of her severe asthma. Sometimes she was too sick to work, resulting in a smaller paycheck. Then, she heard about BVMI and started to come here. “At times she was having difficulty breathing and we were seeing her constantly,” recalled Mary Granholm, Nurse Practitioner. “Finally, we realized she needed the next level of asthma meds and referred her to Dr. Hormoz Ashtyani from Hackensack University Medical Center. “
Dr. Ashtyani agreed with the diagnosis, created a long term plan and prescribed stronger medications. He also provided Teresa with free samples from his office – very helpful as asthma medications are expensive. “It’s a good outcome,” concluded Mary. “Teresa is getting the care she needs; she isn’t missing work and doesn’t need to use the ER. She knows BVMI is here for her.”