Healing at home

Mary Cronin knows all about aneurysms. She’s had three in her life, including two in her chest. This type of aneurysm, known as a thoracic aortic aneurysm, can burst suddenly, often leading to internal bleeding, stroke or even death.

Though usually caused by high blood pressure or hardening of the arteries, about 20% of cases are the result of a genetic condition.

“They run in our family. My mother died from a ruptured aneurysm when she was 92,” said the 78-year-old Cronin.

Thoracic aortic aneurysms affect about 15,000 people in the United States each year, but diagnosing one is difficult because there are no symptoms. In most cases, doctors take a wait-and-see approach.

A complicated procedure

For seven years, Cronin’s doctors in her hometown of Buffalo, New York, kept a watchful eye on the aneurysm in her chest. But in June 2021, they recommended surgery after an annual scan revealed it had grown more than a centimeter in diameter in less than a year.

Repairing an unruptured thoracic aortic aneurysm is a complicated procedure that includes replacing the weakened portion of the aorta with a graft to allow blood flow without causing a bulge. In October 2021, Cronin underwent an extensive open-chest repair at a hospital in Ohio. Following the surgery, she was discharged to a rehabilitation hospital.

The procedure took a toll on her kidneys, causing her to go on permanent dialysis. She also developed a severe wound infection. That’s when her eldest son, Rick Tresmond, decided to transfer her care to Baptist Health in Jacksonville.

“She wasn’t eating, her wound wasn’t healing and she was very depressed,” said Tresmond, who is also vice president of Supply Chain Management for Baptist Health. “I knew Baptist Home Health Care by BAYADA had the ability to take much better care of her in the comfort of her own home.”

Managed care for high-risk patients

Baptist Home Health Care by BAYADA is part of a growing trend in which health systems collaborate with home health providers to manage care for patients, like Cronin, who are at high risk of being readmitted to the hospital.

“This enables us to provide a wider array of in-home services to help people with multiple chronic conditions, as well as patients recovering from an illness, injury or recent hospitalization,” said Joe Mitrick, FACHE, president of Transitional Care for Baptist Health and hospital president of Baptist Medical Center Beaches.

Baptist Home Health Care by BAYADA serves a five-county area in Northeast Florida, caring for patients recuperating at home after hospital or nursing care stays, or referred by their physician following an office visit.

Among the many services provided are:

• Heart and cardiovascular
• Pulmonary
• Stroke and other rehabilitation
• Muscle, bone and joint
• Medication management and disease education
• Wound and ostomy

Continuous, coordinated care

After his mother relocated to Jacksonville, Tresmond started making the necessary arrangements for her continued care.

“Besides home health, I knew she needed a nephrologist to treat her renal failure and a plastic surgeon to operate on her chest wound,” Tresmond said. “I also knew she would need some form of care coordination.”

Anna Marie Barrett, a Baptist Ambulatory Care coordinator, made sure Cronin was aware of all of her doctor appointments and medications. Blair Sisisky, a manager in Baptist Social Services, facilitated Cronin’s post-surgery transition from rehab to home care.

“Coordinating the many aspects of health care in the outpatient setting can be an intimidating task for patients and families,” said Mary Leen, DNP, vice president of Clinical Operations for Baptist Physician Partners. “Anna and Blair worked closely with Rick to ensure his mom had all the services she needed.”

A grandmother of 15

Before she was healthy enough for reconstructive surgery, Cronin received regular in-home visits from Baptist Home Health Care by BAYADA nurses specializing in wound care.

In early February, Ankit Desai, MD, a plastic and reconstructive surgeon at Baptist MD Anderson Cancer Center, closed Cronin’s chest wound with back tissue known as a muscle flap, a common procedure in breast reconstruction surgery. She continues to receive dialysis three time a week, but no longer needs any additional wound care.

A grandmother of 15, she is looking forward to a reunion with her large extended family in the near future.

“I’ve always been very independent,” she said. “I hope I can get back to doing some of the things I love. The care I received from Baptist really saved me. I’m so much better now.”

Baptist Health’s collaboration with BAYADA provides enhanced in-home care services to patients in five Northeast Florida counties. For more information, call 904.202.4300 or visit baptistjax.com/services/home-health-care.