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Health Matters: Providence Saint John's Health Center | 5 A wakened by a medley of soft voices, Penny White, 70, slowly opened her eyes. White was emerging from anesthesia after a procedure to remove a cancerous tumor in her left lung. What she saw brought her an immediate sense of warmth and comfort. "When I opened my eyes, I saw eight people standing in a semicircle at the foot of my bed talking among themselves," the Westwood resident recalls. "It felt to me like a rainbow at my feet, made up of people who took care of me and saw me through this really difficult time in my life. It was a great feeling." The "rainbow" consisted of Providence Saint John's Health Center clinicians led by internationally renowned thoracic surgeon Robert McKenna, MD. The discussion centered on White's care plan following a video-assisted thoracic surgery (VATS)—a leading-edge minimally invasive surgery to remove diseased parts of the lung. The lobectomy had been a success and, because of the earlier persistence and diligence of her cardiologist, Steven Levine, MD, White was on the mend for the second time in less than a month. A SURPRISE FINDING Just two weeks earlier, White had undergone another state-of-the- art procedure: a transcatheter aortic valve replacement (TAVR). TAVR exchanges a thickened aortic valve that can't fully open (aortic valve stenosis) with a manufactured valve to restore adequate blood flow to the body. But during the routine presurgical workup, White's care team discovered the lung cancer. "I'm extremely lucky they found it when they did, because they were able to completely remove the tumor," says White, who avoided chemotherapy and radiation as a result. "It was incredible how the two teams coordinated my care, allowing me to do the VATS only a couple weeks after the TAVR, which I know is hard to do. I felt like I was their only patient." Performed by interventional cardiologist Peter Pelikan, MD, medical director of Providence Saint John's Cardiac Catheterization Laboratory, the TAVR went equally well for White, who says she "somehow knew it was successful" the minute she woke up. "The TAVR was coordinated urgently because of her symptoms and the need to remove the malignant lesion," nurse practitioner Alysa- Marie Sia explains. "It's hard enough to deal with aortic valve stenosis, let alone knowing you have cancer, so we did everything we could to ease her way and make sure she received timely treatment." A LENGTHY MEDICAL JOURNEY While White lauds her care at Providence Saint John's, getting to that point was anything but easy. Her journey started 10 years earlier at another area hospital and involved multiple consultations before she found Dr. Levine. "When I was 60, I had open heart surgery elsewhere to replace a congenitally defective aortic valve with a new, manufactured valve," White recalls. "It was not a good experience. I contracted a life- threatening bacterial infection called endocarditis, which is one of the risks of open heart surgery. That new valve could have lasted 15 years, but it gave out in 10, probably due to damage from the infection." When White went back to see that surgical group at 70, "with a repeat of the same symptoms—radiating chest pain and shortness of breath— they couldn't find anything wrong and dismissed what I was saying." For six months, as her condition worsened, she was unable to visit her daughter, son-in-law and much-adored one-year-old grandson in Denver. Desperate to find an answer, White turned to her internist of 35 years, Ronald Sue, MD, who connected her with Dr. Levine. Following weeks of tests, Dr. Levine diagnosed her with severe aortic stenosis. EMPATHY AND UNDERSTANDING "I am so grateful to all of my doctors, especially Dr. Levine, who always listened to me, never gave up, and made me feel included in my care," White says. "For 25 years, I taught a course called 'Doctoring' to UCLA medical students. I utilized my training and experience as a hospital social worker to teach them how to develop rapport with patients and to communicate effectively with empathy and understanding—everything the health care professionals at Saint John's do extremely well." Thanks to the minimally invasive approaches of TAVR and VATS, White's recovery did not take long. Six weeks after her second surgery, she boarded a plane for the Mile High City to reunite with her family. "My daughter is having another baby boy this fall," she says, "and thanks to everyone involved in my care, I get to be a very hands-on grandmother for both kids. And I'll see them grow up. Both Dr. Pelikan and Dr. McKenna say I'm going to live to be 100," she laughs. "Dr. Levine says I'm going to dance at my grandchildren's weddings. It's miraculous how it all played out."

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