Her mother describes her as “upbeat.” Karina Ontiveros has been through more than many 24-year-olds.

By TJ Banes, IU Health Senior Journalist, tfender1@iuhealth.org

She had been working out and lost 50 pounds. Karina Ontiveros wasn’t overly concerned when she had some back pain. But when it began traveling up her neck, she thought something must be wrong.

Then she doubled over in pain.

“I thought I was having a heart attack. My arm was tingly and the pain was sharp,” said Ontiveros. At the time she was 23. She was working as a bartender, helping with her family’s restaurant, a wedding planner, and raising a toddler.

She saw three doctors and had three x-rays at healthcare centers near her Portage, Ind. home. She was given muscle relaxers and steroids and told to go home and relax. When she got a cough, she was told it was a side effect of the steroids. Ontiveros never took the muscle relaxers. She didn’t have a good feeling about them.

After her third x-ray she left thinking everything was fine. A few hours later she received a call from the urgent care doctor telling her to go to the ER immediately and ask for a CT scan.

“I waited a little because I had to settle this in my mind what was actually happening,” said Ontiveros. She went alone to the hospital, even though her fiancé had offered to accompany her.

“I honestly just thought I’d go in and they’d say everything is fine because I already had x-rays,” said Ontiveros. An hour later she learned she had a tumor behind her sternum. It had been hiding in previous x-rays. It was Dec. 16, 2023. She was transferred to a bigger nearby hospital for a biopsy and then waited.

Doctors initially described her cancer as a germ cell tumor. They referred her to IU Health Simon Cancer Center where Dr. Lawrence Einhorn specializes in germ cell tumors. She was in the hospital for three days and also underwent genetic testing. Her results wouldn’t be back for a few days so they sent her home for Christmas. Two days after Christmas she found she was pregnant and also had non-Hodgkins lymphoma, not a germ cell tumor.

Non-Hodgkins lymphoma starts in the lymphatic system, part of the body’s germ-fighting immune system.

“I had been trying to get pregnant for a year and had started taking progesterone pills. With everything going on, it hadn’t hit me that I hadn’t started my period,” said Ontiveros. “When I was in the hospital, I found out I had cancer and I was also pregnant. I was worried. I had already a CT scan with dye and a biopsy with other medications.”

With her new diagnosis, Ontiveros began her care with IU Health’s Dr. Rita Assi who specializes in cancer treatment at the IU Simon Cancer Center Hematology Clinic. She also has experience with women who are pregnant or trying to get pregnant.

“They said I had an excessive amount of fluid around my heart that needed to be drained before I could begin chemotherapy the beginning of January. They drained 50 millimeters and sent me home with a drain. Another 50 millimeters were drained and she returned to IU Health to begin treatment.

“I got an ultrasound, there was a heartbeat and they decided I was six weeks along. I couldn’t start chemo until I was 12 weeks pregnant,” said Ontiveros. “I wanted to get through this and there was no way I was going to have an abortion.” Not long after the ultrasound, Ontiveros miscarried the pregnancy.

She met with a fertility specialist at Riley Hospital and talked of freezing eggs; she looked at all options. “Dr. Assi was the sweetest. She knew my whole story and she has given me confidence that I can get pregnant again,” said Ontiveros.

She started chemotherapy the first week in February and will complete six cycles.

“At one point I wanted to be a doctor and now I’m seriously considering going back to school for nursing. The nurses here have been so supportive to me,” said Ontiveros.

“I feel like she’s been so positive through all of this. She speaks up for herself and is stronger than you can imagine,” said her mother, Angela Mendoza.

Nick Callahan has been living with a left ventricular assist device (LVAD) for more than two years. He recently had the idea to record an audition tape for the television show- Worst Chefs in America. “I just made a quick, 30-second video and sent it in,” said Nick, who’s goal is to show viewers that LVAD patients can still live a fulfilling life. “Before my operation I would have liked to see someone like me, like, here’s my device and here’s what I have to do.” Nick also wants to develop a signature dish he can pass down to his 14-year old son, Landon. While Nick waits to learn about his reality TV fate, REV Indy chef, Youssef Boudarine is showing Nick how to make the classic Moroccan breakfast dish, Shakshukka.

Bianca Taylor is the unit secretary for one of Methodist Hospital’s critical care units. Before stepping into this role she worked in environmental services for close to 20 years. “My supervisor asked me if I wanted to [make the move to unit secretary]. He thought I would make a good candidate and I just said yea, I’ll go for it.”

The City of Indianapolis recently awarded IU Health a $250,000 grant to establish an Opioid Engagement Team, consisting of an IU Health social worker and a police officer from IU Health’s Department of Public Safety. The new team, modeled on other cities’ crisis intervention team concepts, will pilot a program focused on immediate crisis response as well as long-term prevention and support efforts for people experiencing a substance use crisis or other emergencies in and around IU Health’s downtown Indianapolis medical campus. The program will prioritize people at high risk for overdose.

The grant funding, secured by IU Health Foundation, will cover salaries, training and benefits for the police officer and social worker, plus a vehicle and additional equipment. The team will work 40 hours a week, during shifts to be determined by need.

“New approaches are desperately needed to treat opioid and other substance use disorders, instead of just sending people to jail,” said Cassandra Tice, Director of Grants at IU Health Foundation. “IU Health is grateful to the City of Indianapolis for its vision.”

In addition to addressing immediate health needs, the team will offer long-term services including detoxification programs and abstinence-based treatment, as well as wraparound services focused on social determinants of health such as inadequate housing and poor nutrition that result from addiction and related mental health challenges.

The team will work closely with internal and external partners to build relationships with referral partners so they can make appropriate recommendations to the people they encounter. They will also be trained to identify and understand cultural and systemic barriers that lead to distrust of law enforcement, particularly in historically marginalized communities. The project is funded for a year, with benchmarks and metrics established to gauge success and guide discussion of a broader implementation of the program.

To learn more about how government grants as well as individual gifts are helping to make Indiana healthier, visit allthedifferencein.org.

Written by Joni Fiscus, clinical dietician and certified diabetes educator at IU Health West

Living with diabetes requires a thoughtful and strategic approach to dietary choices, and a clinical dietician plays a pivotal role in guiding individuals towards optimal health and wellness. Understanding the dietary needs of someone with diabetes is crucial for managing blood sugar levels, preventing complications and enhancing overall well-being.

It’s all about balance.

One of the key principles in managing diabetes through diet is maintaining a balance between carbohydrates, proteins and fats. Carbohydrates directly impact blood sugar levels, and a dietician helps individuals with diabetes choose complex carbohydrates with a low glycemic index. This includes whole grains, vegetables and legumes, which provide sustained energy without causing rapid spikes in blood sugar. Portion control is emphasized, ensuring that meals are well-balanced and tailored to individual needs.

Proteins help the muscles.

Proteins play a crucial role in muscle maintenance and repair, but the source matters. Lean proteins such as poultry, fish, tofu and legumes are recommended, as they contribute to satiety without causing significant fluctuations in blood sugar levels. A clinical dietician assists in creating meal plans that incorporate the right balance of proteins, considering the individual’s preferences and dietary restrictions.

Not all fats are bad.

Healthy fats are an essential part of a diabetes-friendly diet. Dieticians educate individuals on incorporating sources of unsaturated fats, such as avocados, nuts, and olive oil, while limiting saturated and trans fats. This not only supports cardiovascular health but also aids in blood sugar management.

Don’t forget to count carbs.

Monitoring carbohydrate intake is a fundamental aspect of diabetes management, and dieticians educate their clients on the importance of counting carbohydrates to maintain blood sugar control. This involves understanding portion sizes, reading food labels and utilizing tools to track daily carbohydrate consumption. Dieticians work closely with individuals to develop practical skills for managing their diet in real-life situations.

Fiber is important.

In addition to macronutrient balance, a clinical dietician addresses the importance of fiber in the diet of someone with diabetes. Fiber-rich foods, such as whole grains, fruits and vegetables, contribute to digestive health and help control blood sugar levels. Dieticians guide individuals in incorporating a variety of fiber sources into their daily meals.

The dietary needs of someone with diabetes are multifaceted and require a comprehensive understanding of nutrition. A clinical dietician plays a vital role in empowering individuals to make informed choices, achieve a balanced diet and manage their diabetes effectively. Through personalized guidance, individuals with diabetes can embark on a journey towards improved health and well-being, fostering a sustainable and fulfilling lifestyle. To learn more, click here.

When Wayne Hasell arrived at Methodist Hospital he was in agonizing pain due to a flesh-eating soft tissue infection. Surgeons were able to save Wayne’s life, but he was left with a massive abdominal wound. “It was such a big area that I didn’t want to jump to using his own skin grafts because you want to make sure that when you use the patient’s own skin that it’s really going to work,” said Rachel Danforth, an IU Health plastic surgeon. “For him I decided to use a fish skin graft, [cod from Iceland]… that requires minimal processing because there is no risk of viral transfer from this kind of fish’s skin to humans. We put it on as a temporary thing and then we applied the patient’s own skin graft on top of that.”

Written by Trisha Palencer, director of chronic pain and chemical dependency at the IU Health West Addiction Treatment and Recovery Center

April is Alcohol Awareness Month, a time to raise awareness for alcohol abuse. Many families face difficulties when a loved one struggles with alcohol abuse. Supporting someone through this journey requires empathy, patience and a multifaceted approach aimed at both the individual and their support system.

Understanding alcohol abuse

Alcohol abuse is a complex issue with multifaceted roots. It impacts not only the individual but also their relationships, work and overall well-being. Recognizing the signs, which may include increased tolerance, mood swings and neglect of responsibilities, is the first step in addressing the problem.

Open communication

Initiating open, non-judgmental conversations can pave the way for support. Express your concerns calmly, emphasizing care and understanding. Listening actively and without interruption fosters trust and encourages your loved one to share their struggles.

Educate yourself

Learning about alcohol abuse, its effects, and available treatments equips you to offer informed support. Understand that addiction is a complex disease, often requiring professional intervention.

Encourage treatment

Gently encourage your loved one to seek professional help. Offer to assist in finding resources, whether it’s counseling, therapy, support groups or an addiction treatment program. Highlighting the benefits of seeking help can alleviate the fear and stigma often associated with treatment.

Establish boundaries

Setting clear boundaries is crucial for both your well-being and that of your loved one. Enabling behaviors, such as covering up their actions or making excuses for them, can perpetuate the cycle of abuse. Express your support while maintaining boundaries that safeguard your own mental and emotional health.

Practice self-Care

Supporting someone with alcohol abuse can be emotionally taxing. Engage in self-care activities to recharge and maintain your own well-being. Seek support from friends, family, or professional counselors to navigate your own emotions and challenges.

Stay committed

Recovery from alcohol abuse is a journey with ups and downs. Stay committed to supporting your loved one through this process. Celebrate their milestones and remain a pillar of encouragement during setbacks.

Encouraging hope

Remind your loved one that recovery is possible. Share stories of individuals who have successfully overcome similar challenges. Instill hope and emphasize that seeking help is a courageous step towards a healthier, fulfilling life.

Remember, while you can offer support, the decision to seek help ultimately rests with your loved one. Encouragement and support are vital, but respecting their autonomy and readiness to change is equally important. If you or someone you love is struggling with alcohol abuse, you can call the IU Health West Addiction Treatment and Recovery Center at 317.217.2711.

Nancy Manuputy’s nearly 3-month hospital stay has taken a huge mental and emotional toll. “It’s just kind of destroyed my life for a while,” said Nancy, who credits art therapy for giving her something to look forward to in the hospital. “The art therapists help get your mind off of stuff… and art is theraputic, even if you’re lousy at it.”

Nursing is not Nick Geminden’s first career… or second… or third. After his military service Nick had several jobs, but deep down always knew he wanted to help save lives and make a difference. “There’s a lot of fear in change, especially when it’s a big career change, and financially in my other jobs I was fine. It just wasn’t very fulfilling. This career doesn’t feel like a job. It feels like more of a calling.”

Nothando Sibanda, RN, grew up over 8,000 miles away from Indiana, in the remote countryside of Zimbabwe. That’s where she found herself drawn to caring for others.

“I admired the volunteers who were offering home-based care services, family planning, and midwifery,” says Sibanda. “The determination shown by the nurses conducting monthly mobile clinics for immunization and treatment of minor illnesses, and the high degree of appreciation they received from the community ignited my passion to join the nursing profession.”

She turned to Westways Staffing Services for assistance with credential evaluation, NCLEX preparation, the VISA screening process, travel arrangements, job placements and more so she could join the International Nursing Program.

And in the summer of 2022, Sibanda was warmly welcomed by the IU Health Bloomington 3W team.

“Clinical Manager Suzanne Wright, MSN, RN, Clinical Advisor Kristy Todd, RN, NPD-BC, ONC, and many of her 3W co-workers have truly enjoyed helping her acclimate to Bloomington,” says Bloomington Director of Nursing Operations Lisa Aldridge, MSN, RN. “They’ve also reaped the rewards of being around the light Nothando exudes.”

Armed with a collection of material about the Bloomington community, including the bus transit system, restaurants, schools and recreational areas, Sibanda and her family started setting down roots in their new home.

“I enjoy the peaceful neighborhood around my place of residence. The people here are ever cheerful and friendly, and I love stopping to chat with them daily when taking a walk,” she describes.

Her son and daughter have made many friends at school, and her husband, a registered nurse, recently joined the 3W team as well. Even with her busy schedule, Sibanda has pushed herself to continue her education.

“We have all been so impressed as we have watched Nothando pursue her Bachelor of Science in Nursing (BSN) while working full time on nightshift as well as taking care of her beautiful family,” says Aldridge.

With her BSN in hand, Sibanda now plans to pursue a master’s program.

“We want to congratulate Nothando on her immense accomplishments,” says Aldridge. “And we are so grateful she will transition from our International Nurse program to being a permanent IU Health team member this summer.”

“My decision to join the IU Health Bloomington 3W team permanently was driven by the desire to work with a supportive and united team,” she explains. “I want to surround myself with people who wish me well and help me grow.”