Regional Report - Gundersen Health System

Regional Report
Information for healthcare providers in the Tri-state Region
Fall 2009 Volume 24 - No. 4
3D Imaging Lab comes to life
at Gundersen Lutheran
Imagine being able to examine a patient’s heart as if you
were holding it in your hands or being able to ride down the
coronary arteries to look for plaque buildup. Gundersen
Lutheran’s 3D Imaging Lab, established in January 2009, offers
more innovative images of the heart, bones and vessels than
ever before.
“3D imaging is becoming the standard in larger
organizations where computed tomography (CT) scans are
routinely conducted,” says Steve Schreiner, clinical manager,
Interventional Radiology and CT. “Our CT scan technologists
used to spend many hours a day post-processing images. Now,
we have two imaging specialists who are dedicated to
maintaining standard protocols and manipulating the 3D
images. Technologists can spend more time with patients and
physicians can make the best use of information from CT
scans,” explains Steve.
How does 3D imaging work?
After a patient undergoes a CT scan, a set of stacked crosssectional
images are sent to the 3D Imaging Lab where imaging
specialists rearrange the data to produce life-like images.
“Using a volumerendering
technique, we
can rotate objects and
even fly through them,”
says 3D imaging specialist
Nicole Blackbourn, who
helped establish the Lab.
“We can remove bones or
muscles that are
obstructing our view to
better identify the
3D Imaging works by converting a set of
stacked cross-sectional CT images into
3D life-like pictures.
problem areas. For
instance, when looking at
a pelvic fracture, we can
segment the pelvic bone
from the hip to show each part’s surface detail. It’s pretty
remarkable,” states Nicole.
3D imaging is also a very helpful tool for surgical planning.
For example, surgeons can examine bone detail before and after
surgery to see how well a fracture is healing. Likewise, it allows
Continued on page 2
Total ankle replacement
offers hope for chronic
sufferers of ankle arthritis
La Crosse native Roxanne Smothers has always had a
high-energy personality. She loves riding motorcycles,
swimming and scuba diving. But in 1981, her life changed
when she sustained serious foot and ankle injuries in a
motorcycle accident.
“My foot and ankle were crushed, and I had seven
reconstructive surgeries following the accident,” Roxanne
recalls. “I tried to maintain my mobility through herbal
remedies, biofeedback and limited weight-bearing exercise, but
the pain continued to return.”
In 2007, Gundersen Lutheran podiatrist James Ringstrom,
DPM, referred Roxanne to David Caldarella, DPM, FACFAS,
who specializes in complex foot and ankle disorders and
reconstructive foot and ankle surgery. “Dr. Caldarella is an
exceptionally talented physician; I realized this from the day I
What’s Inside
David J Caldarella, DPM
Specialty: Podiatric Medicine and Surgery
MD Degree: University of Osteopathic Medicine
and Health Sciences, Des Moines, Iowa
Residency: Emory-Northlake Regional Medical
Center, Atlanta, Ga.
Fellowship: University of Washington School of
Medicine, Seattle, Wash.
Continued on page 4
Renal dialysis in Richland Center.............................. p. 2
When to have a mammogram .................................. p. 3
Research supports breast MRIs.................................. p. 3
MedWatch: Robotic prostatectomy............................ p. 4
Movement Disorder Center ...................................... p. 5
Forensic pediatrics tackles abuse ................................ p. 6
Cardiology outreach in Whitehall.............................. p. 6
New Practices ............................................................ p. 7
Glaucoma specialist .................................................. p. 8
MedLink (800) 336–5465 1 In La Crosse 775–5465

3D Imaging Lab – continued from p. 1
surgeons to point out to patients what will occur during surgery.
“Patients appreciate being able to recognize the anatomy and
understand what their doctor is explaining. With cross-sectional
pictures from a CT scan, this is challenging,” says Becky Freier, CT
scan technologist.
So far, the most common uses of 3D imaging are bone anatomy,
vessel analysis, fractures and trauma cases. As Nicole points out, “It’s
important to know exactly what structures the ordering provider is
looking at so we can create images that are the most efficient for the
radiologist.”
For questions or to learn if your department could benefit from
3D imaging, contact Nicole Blackbourn via MedLink. RR
With advanced
computer technology,
imaging specialist can
now remove bones
(such as the femur) to
get a better look at the
fractured hip socket.
Gundersen Lutheran renal dialysis unit comes to Richland Center
Gundersen Lutheran provides outpatient renal dialysis in a
number of regional locations—the newest is in the Center
Creek Professional Building in Richland Center, Wis., in
partnership with the Richland Hospital and Richland
Medical Center.
A registered nurse serves as a care manager for each dialysis
patient and the care team also includes licensed practical nurses,
technicians, social worker and registered dietitian. An on-call
nephrologist is always available.
Because of their complex medical problems, it is important
for dialysis patients to see a nephrologist every month. So
Gundersen Lutheran nephrologist Kumari Usha, MD, sees
dialysis patients in Richland Center.
Dr. Usha also provides outreach services at the Richland
Medical Center, seeing patients with chronic kidney disease or
conditions such as hypertension and diabetes which can lead to
renal problems.
“Our goal is to catch potential problems early so patients can
avoid dialysis,” Dr. Usha explains. “Early referral to a
nephrologist is important in managing a patient’s chronic
kidney disease. Early intervention is also helpful in managing
anemia and bone disease associated with kidney disease.
Outpatient services also include evaluation of patients with
acid-base abnormalities, electrolyte disturbances, difficult-tocontrol
blood pressure, urinary abnormalities such as blood
and/or protein in the urine and metabolic work up for patients
with recurrent kidney stones.”
“We work with the patient’s primary care provider to
establish an individualized disease management program,”
explains Gundersen Lutheran nephrologist Fadi Ghandour,
MD, Nephrology section chair, who also provides outreach and
telemedicine services.
Kumari Usha, MD
Specialty: Nephrology
MD Degree: Government Medical College,
Netaji Subhash Chandra Bose, Jabalpur, India
Residency: University of Texas Medical School,
Houston
Fellowship: University of Missouri Hospital,
Columbia
“We provide patient education about hypertension and
managing other diseases related to kidney failure and kidney
disease,” Dr. Ghandour continues. “Education also helps
patients make informed decisions about different options for
dialysis as well as kidney transplantation if they progress to
end-stage kidney disease.” Currently, Gundersen Lutheran
Nephrology offers in-center hemodialysis, home peritoneal
dialysis and home hemodialysis as therapy options for patients
with end-stage kidney disease.
For a consultation or more information about outreach
programs, contact Nephrology via MedLink. RR
Gundersen Lutheran Nephrology Outreach
Black River Falls, Wis.: Gundersen Lutheran Outpatient Dialysis Center in
Black River Memorial Hospital
Prairie du Chien, Wis.: Gundersen Lutheran – Prairie du Chien Clinic and
Dialysis Unit at Prairie du Chien Hospital
Richland Center, Wis.: Gundersen Lutheran Outpatient Dialysis Center in
the Center Creek Professional Building and Richland Medical Center
Sparta, Wis.: Gundersen Lutheran – Sparta Clinic
Tomah, Wis.: Gundersen Lutheran – Tomah Clinic
Viroqua, Wis.: Dialysis Unit at Vernon Memorial Hospital
West Union, Iowa: Gundersen Lutheran – West Union Clinic and West
Union Dialysis
MedLink (800) 336–5465 2 In La Crosse 775–5465

Gundersen Lutheran disagrees with new
mammography recommendation
Women should continue to have annual mammograms
starting at age 40 according to the clinical breast radiologists at
Gundersen Lutheran’s Norma J. Vinger Center for Breast Care.
An announcement by the U.S. Preventive Task Force has
caused a stir, suggesting women don’t need screening
mammograms until age 50, and then every other year, rather
than annually.
“Early detection is the key to saving lives, and annual
mammograms give women the best chance for early detection,”
said Jeannette Gasal-Spilde, MD, a Gundersen Lutheran
clinical breast radiologist.
“Screening women age 40-49 is reducing their risk of death
from breast cancer by 15 percent, but because women in their
40s are at lower risk of breast cancer than women 50 and
above, the U.S. Preventative Task Force says the actual number
of lives saved isn’t enough for widespread screening. We
disagree,” said Richard Ellis, MD clinical breast radiologist and
co-director of the breast center at Gundersen Lutheran.
“If this is about saving money, Gundersen Lutheran has a
better solution,” he adds. “If our team approach to caring for
breast cancer patients was implemented on a national scale it
could save $4.15 billion in healthcare costs.” The model is
centralized and coordinated meaning breast tumors are detected
when they are 24 percent smaller, and the discovery-totreatment
timeline is 2.5 times faster, resulting in 35 percent
lower treatment costs.
Gundersen Lutheran is one of only two organizations in the
country with every available accreditation for the full scope of
Research conducted at Gundersen Lutheran further explored
the use of a simple blood test that may help reduce the number
of repeat scans and non-diagnostic exams some women
undergo. The research, which was published in the December
issue of the American Journal of Roentgenology, focused on
women who do not have normal menstrual cycles who needed
to have a breast MRI. Breast MRIs are sometimes used to help
diagnose and detect breast cancer and other breast
abnormalities.
“Normally, we try to schedule a woman’s breast MRI
between days three and 14 of her menstrual cycle. This is the
time we can get the clearest images, making it easier to detect
breast cancer,” explains Richard Ellis, MD, the lead author of
the study and a clinical breast radiologist in the Norma J.
Vinger Center for Breast Care at Gundersen Lutheran.
However, many premenopausal women do not have normal
menstrual cycles. “Doctors often perform a breast MRI on
these women without considering the timing of the patients’
hormonal cycle,” he says. “This can result in images that don’t
MedLink (800) 336–5465 3 In La Crosse 775–5465
Richard L Ellis, MD
Specialty: Breast Cancer
MD Degree: Southern Illinois University
Medical School, Springfield
Residency: University of Wisconsin Hospitals and
Clinics, Madison
Fellowship: Howard Hughes/NIH, Bethesda, Maryland
and University of Alabama, Birmingham
Jeannette M Gasal Spilde, MD
Specialty: Breast Cancer
MD Degree: University of Texas Health Science Center,
San Antonio
Residency: University of Wisconsin in Madison
Fellowship: Lynn Sage Breast Center, Northwestern
Memorial Hospital, Chicago
breast care, diagnosis and treatment from the American College
of Radiology. The La Crosse-based breast center has two
fellowship-trained clinical breast radiologists—Drs. Ellis and
Gasal-Spilde. Dr. Ellis is a Fellow in the Society of Breast
Imaging, one of only 100 in the nation. Gundersen Lutheran
was also the first in the nation to achieve the highest level of
distinction from the National Quality Measures for Breast
CentersTM Program.
A white paper highlighting Gundersen Lutheran’s Norma J.
Vinger Center for Breast Care and their innovative approach to
providing better care for breast cancer patients while reducing
costs is available online at gundluth.org. RR
Research may help some women avoid repeat breast MRIs
allow for a diagnosis, which means a need for repeat scans.”
Using what is known about the hormones released during a
woman’s cycle and their effects upon breast tissue, Dr. Ellis
reasoned that a simple blood test could be use to determine the
optimal time for the breast MRI. He used the blood test to
time the exam in 11 women with irregular menstrual cycles.
None of the women required a repeat breast MRI.
“This is good news for the ever increasing number of women
who need a breast MRI to help in a breast cancer diagnosis or
who need the scan because they are at a high genetic risk for
breast cancer,” Dr. Ellis comments.
Dr. Ellis’ research was supported by the Norman L. Gillette,
Jr. Breast Cancer Research Fellowship of Gundersen Lutheran
Medical Foundation. Gundersen Lutheran’s work in breast
cancer research, treatment and outcomes has positioned the
organization as a national leader in breast cancer care. For more
information on research and breast cancer care at Gundersen
Lutheran, go to gundluth.org. RR

MedWatch
Gundersen Lutheran Medical
Foundation is dedicated to advancing
quality healthcare by focusing on research, medical
education and community health outreach. MedWatch highlights the
work of the Foundation, as reported by A. Erik Gundersen, MD, retired cardiac surgeon
and vice chairman of Gundersen Lutheran Medical Foundation Board.
Robotics offer another option for prostate cancer surgery
Beginning in late 2008, the Gundersen Lutheran Urology
department introduced a significant technical advance for the
treatment of prostate cancer, robotic prostatectomy. Since that
time, nearly all prostate cancer surgery has been done in this
manner. By November 2009, more than 120 cases have been
performed.
Robotic prostatectomy is one of several choices available at
Gundersen Lutheran for patients with prostate cancer. After a
diagnosis of prostate cancer, a urologist will discuss all of the
options with the patient along with the risks and benefits of
each.
For patients with prostate cancer and no evidence that it has
spread beyond the prostate gland, the two most common
choices are robotic prostatectomy and radioactive seed
implantation. Both procedures have advantage and
disadvantages.
With robotic prostatectomy the entire prostate gland is
removed through several small incisions. Pain and blood loss
are generally minimal and there is usually only an overnight
stay. Patients are able to start resuming normal activities after
two weeks.
Most patients regain full continence within several months.
Those patients with normal erectile function before surgery
have a 60-70 percent chance of regaining erectile function. As
with any treatment, there is a chance the cancer may recur after
surgery, but if it does, most patients could have radiation as a
secondary treatment option.
The robotic prostatectomy surgical program began at
Gundersen Lutheran less than two years ago; consequently
long-term follow up is not yet available. However, large studies
have shown it to be as effective for controlling cancer as
traditional open prostatectomy with faster patient recovery.
So, who makes the choice for the patient’s treatment? At
Gundersen Lutheran the urologist and the radiation oncologist
work with the patient to choose a treatment option that is best
for him. RR
Total ankle replacement – continued from p. 1
met him,” says Roxanne. “He suggested a two-staged approach,
including a Total Ankle Replacement ® —a procedure which
preserves ankle motion.”
According to Dr. Caldarella, the ideal candidates for the
procedure are individuals with advanced arthritis of the ankle,
those who have not responded to previous treatment options,
and patients who are not excessively overweight, neuropathic or
have metabolic bone disorders. Roxanne fit the description
perfectly, but first she needed a repositional triple arthrodesis to
straightened her foot alignment.
Dr. Caldarella completed the triple arthrodesis surgery at
Gundersen Lutheran and then worked alongside board-certified
orthopedic surgeon Gregory Berlet, MD, at the Orthopedic
Foot & Ankle Center, (Ohio State University) Columbus, Ohio,
to perform Roxanne’s Total Ankle Replacement. Following the
surgery, Dr. Caldarella handled the follow-up care at Gundersen
Lutheran.
The result, Roxanne says, has been life-changing. “I cannot
remember the last time I walked without ankle pain, and my
quality of life has improved drastically.”
Roxanne even shocked Dr. Caldarella this past June when she
announced she had completed a triathlon. “It was fun but very
challenging,” she
admits. Despite
having to use crutches
for part of the 5K, she
finished and says,
“Just wait until next
year!”
Dr. Caldarella is
committed to
providing an
evidence-based
treatment algorithm
that incorporates
emerging trends in the
management of severe
ankle arthritis. He
recently became
credentialed in Total
Roxanne was just six months post-operative at
the time of this picture.
Ankle Replacement surgery and is now offering this service at
Gundersen Lutheran Medical Center.
If you have a patient who might be a candidate for this type
of surgery, please contact Dr. Caldarella via MedLink. RR
MedLink (800) 336–5465 4 In La Crosse 775–5465

Challenges of treating movement disorders also bring rewards
Despite the complexity and challenges of Parkinson’s disease
and other movement disorders, Jason Aldred, MD, says getting
to know patients is part of what drive him as a physician.
Dr. Aldred recently joined Gundersen Lutheran
Neurosciences as director of the Movement Disorders Center.
Prior to joining our organization, he completed a two-year
fellowship in Parkinson’s disease and movement disorders. He is
also a board certified vascular neurologist. Using his expertise in
these specialty areas, Dr. Aldred has quickly established himself
as a leader in the Movement Disorders Center.
Dr. Aldred specializes in the diagnosis and management of
complex movement disorders; botulinum toxin injection for
movement disorders; deep brain stimulation patient selection,
surgery and post-op programming; electromyography and nerve
conduction studies; and educational talks for providers and
patient groups in the region.
“I’m excited to help build a comprehensive center for
Parkinson's disease and movement disorders in the region. It’s
always rewarding to know that I have tried my best to solve a
problem, used all available resources to maximize my patients’
abilities to function and made a difference in their quality of
life,” says Dr. Aldred.
A movement disorder such as essential tremor, dystonia or
Parkinson’s disease can have a significant impact on a patient’s
quality of life. There’s not only the physical and functional
limitations, but also social interaction, communications,
confidence and self-esteem can be negatively affected. That’s
why Gundersen Lutheran established the Movement
Disorders Center.
The Center is a collaborative effort between Neurology,
Physical Medicine & Rehabilitation, Neurosurgery, Physical
and Occupational Therapy, Speech Pathology and Social
Services. The goal is to provide comprehensive, coordinated
medical and surgical care for improved quality of life, including
diagnosis, rehabilitative services and continued medical
management for complex movement disorders. Be sure to look
for upcoming provider and patient seminars from the
Movement Disorders Center.
The Center’s team consults on, evaluates and/or treats
patients with a wide range of movement disorders, including:
• Parkinson’s disease
• Tremors of any type
• Cervical dystonia
• Generalized dystonia
• Blepharospasm and facial spasm
• Dyskinesia
• Corticobasal degeneration
• Progressive supranuclear palsy
• Multiple system atrophy
• Normal pressure hydocephalus
• Gait and balance problems
• Huntington disease
MedLink (800) 336–5465 5 In La Crosse 775–5465
Jason Aldred, MD
Specialty: Neurology
MD Degree: University of Tennessee Health
Science Center, Memphis
Residency and Fellowship: Oregon Health &
Science University, Portland
• Tourette’s syndrome
• Ataxia
• Other non-specified movement disorders
The Movement Disorders Center team works together to
maximize comfort and control with treatment options such as
medication; physical, occupational and speech therapy; surgery
or deep brain stimulation if appropriate; braces and other
assistive devices; and more.
You should consider a consultation or referral to the
Movement Disorders Center if you have a patient who was
recently diagnosed and wants to better understand treatment
options and what to expect as the disease progresses. We can
also help those with new or worsening symptoms, especially
when speech, mobility or strength are affected. There is also
support for patients who need help coping with a progressive
disease and maintaining their independence.
After the teams meets with your patient, a follow-up letter
will be sent to you as the patient’s primary care provider with
findings and recommendations. For more information, a
consultation or referral, contact Dr. Aldred via MedLink. RR
News Brief
New hematology-oncology
fellowship program receives approval
The Accreditation Council for Graduate Medical Education recently
approved Gundersen Lutheran's application for accreditation of a new
Gundersen Lutheran Medical Foundation-sponsored fellowship program in
hematology-oncology. Alcee Jumonville, MD, is the program director and
Ronald Go, MD is the associate program director.
“This is a significant milestone for our post-graduate medical education
programs at Gundersen Lutheran,” says David H. Chestnut, MD, director,
Medical Education for Gundersen Lutheran Medical Foundation. “This
program will not only strengthen our existing medical education and
research programs, but it will also increase the visibility of our clinical
programs in hematology-oncology and enhance the quality of care for
our patients.”
“We are very fortunate to have the full commitment and support of
Gundersen Lutheran Medical Foundation and Gundersen Lutheran
Executive Committee to give us the opportunity to train future
hematologists and medical oncologists. This is especially important because
of the expected shortfall in the United States by 2020,” says Dr. Go.
The addition of the new hematology and medical oncology fellowship
furthers the commitment of Gundersen Lutheran Medical Foundation. It
not only is a major advancement for Gundersen Lutheran medical
education, but it will also advance cancer research. Ultimately, the entire
Tri-state Region will benefit with better patient care and community health.

Forensic pediatrics tackles child abuse and neglect
Forensic pediatrics sounds like a topic for a CSI-style
television drama, but it’s an important medical discipline
rooted in cold, hard reality. Pediatricians like Kelly Hodgson
Kline, MD, of the Gundersen Lutheran – Tomah Clinic and
her colleague, pediatrician Ann Budzak Garza, MD, at
Gundersen Lutheran in La Crosse provide medical expertise for
the diagnosis, documentation and follow-up care for cases of
abuse and neglect involving children.
Dr. Hodgson Kline has special training to provide a
consistent quality standard of care in child abuse and neglect
issues. She serves as an advocate for the child, often working in
conjunction with law enforcement, Child Protective Services
and the District Attorney’s office.
“In cases of suspected physical or sexual abuse or neglect, we
do the physical exam, collect evidence, take pictures, review the
child’s medical history and/or evidence collected by law
enforcement, testify as an expert witness and help coordinate
services such as crisis counseling,” Dr. Hodgson Kline explains.
Dr. Hodgson Kline encourages any healthcare provider who
suspects abuse or neglect in a child—from birth through young
adult—to contact her; Dr. Budzak Garza; or Carolynn Devine
a social worker with Gundersen Lutheran Social Services. They
can consult, answer questions or help connect the child and
family with the necessary resources.
“This work is so important because I am able to give any
child a ‘voice’ even if they are too young to speak for
themselves or too frightened to tell the truth,” Dr. Hodgson
Kline reveals. “While it can be emotionally challenging,
forensic pediatrics is a service I’m proud to offer especially in a
regional setting where access to these services can be limited.”
Gundersen Lutheran is committed to providing patients
with quality care and personal relationships—close to home.
Sampoornima Setty, MD, who is board certified in cardiology,
nuclear cardiology and echocardiography, is helping that
mission become a reality at the Gundersen Lutheran –
Whitehall Clinic.
Dr. Setty sees patients on the first and third Wednesdays of
every month. She provides consultations for newly referred
patients as well as routine follow-up care. “It is my pleasure to
offer cardiology outreach in Whitehall and ensure continuity of
care for patients who have received inpatient care at Gundersen
Lutheran in La Crosse,” she says. Making the 100-mile
roundtrip drive to La Crosse can definitely be a burden for
some patients, and Dr. Setty continues to hear how much
patients appreciate this convenience.
Dr. Setty hopes to expand the services she currently offers.
“In the near future, I plan to offer echocardiograms, contrast
MedLink (800) 336–5465 6 In La Crosse 775–5465
Kelly Hodsgon Kline, MD
Specialty: Pediatrics, Forensic Pediatrics
MD Degree: University of Wisconsin-Madision
Residency: De Vos Children’s Hospital,
Grand Rapids, Mich.
Ann Budzak Garza, MD
Specialty: Pediatrics, Forensic Pediatrics
MD Degree: University of Wisconsin-Madision
Residency: Lutheran General Hospital, Park Ridge, Ill.
According to Dr. Hodgson Kline, referrals come from many
sources. “As a healthcare provider, you should watch for subtle
signs of child abuse such as behavioral changes, suspicious
bruising and fractures, bizarre marks or patterns on the skin
and injuries that don’t match the story that is given to you,”
she says.
Dr. Hodgson Kline also works with child protective services
in Monroe, Juneau and Jackson counties in Wisconsin. She is a
member of the American Academy of Pediatrics’ Section on
Child Abuse and Neglect and is involved with the La Crosse
County Child Protection Taskforce and Stepping Stones Child
Advocacy Center.
For more information, contact Dr. Hodgson Kline or
Dr. Budzak Garza via MedLink. RR
Heart Institute now offers cardiology outreach in Whitehall
Sampoornima Setty, MD
Specialty: Cardiology
MD Degree: Madurai Medical College,
Madurai, India
Residency: St. Barnabas Medical Center,
Livingston, N.J.
Cardiovascular Fellowship: Newark Beth Israel
Medical Center, Newark, N.J.
echocardiograms, exercise stress tests and other non-invasive
procedures,” she says. “I also look forward to adding
telemedicine cardiac care as well.”
To refer a patient to Dr. Setty or for more information on
the services she provides, call the Gundersen Lutheran –
Whitehall Clinic at (715) 538-4355 or (888) 775-0516. You
can also contact Dr. Setty for a consult via MedLink. RR

New Practices
Neurology
Jason Aldred
Residency and Fellowship: Oregon
Health & Science University, Portland
Practice Location: Gundersen
Lutheran, La Crosse
Internal Medicine
Amit Aneja, MD
Residency: Weiss Memorial
Hospital, Chicago, Ill.
Practice Location:
Gundersen Lutheran –
Whitehall Clinic
Family Medicine
Godfried Arthur, MD
Residency: Anderson Memorial
Hospital, Anderson, S.C.
Fellowship: Korlebu Teaching
Hospital, Accra, Ghana
Practice Location: Gundersen
Lutheran – Tomah Clinic
Physical Med. & Rehab.
Rodric Bell, MD
Residency: Univ. of California –
Irvine
Practice Location: Gundersen
Lutheran, La Crosse
Internal Medicine
David Bleidorn, MD
Residency: Hennepin
County Medical Center,
Minneapolis, Minn.
Practice Location: Gundersen
Lutheran, La Crosse
Family Medicine
Richard Cayasso, MD
Residency: Univ. of Oklahoma
College of Medicine, Tulsa
Practice Location: Gundersen
Lutheran, La Crosse
Family Medicine
Kimberly Coyne, MD
Residency: David Grant Medical
Center, Travis Air Force Base, Calif.
Practice Location: Gundersen
Lutheran – Onalaska Clinic
Radiology
Darin Damstra, MD
Residency: Geisinger Medical
Center, Danville, Pa.
Fellowship: Temple Univ.
Hospital, Philadelphia, Pa.
Practice Location: Gundersen
Lutheran, La Crosse
Radiology
Carl Decker, MD
Residency: Madigan Army
Medical Center, Tacoma, Wash.
Practice Location: Gundersen
Lutheran, La Crosse
Physical Med. & Rehab.
Jeffrey Derr, MD
Residency: Univ. of Wash., Seattle;
Univ. of Ill., Chicago; George
Washington Univ., Washington,
D.C.
Practice Location: Gundersen
Lutheran, La Crosse
Orthopaedic Surgery
Steven Klein, MD
Residency: Univ. of Missouri,
Kansas City
Fellowship: Florida
Orthopaedic Institute
Practice Location: Gundersen
Lutheran, La Crosse
Family Medicine
Bryan Pucik, MD
Residency: St. John's Hospital,
St. Paul, Minn.
Practice Location: Gundersen
Lutheran – Whitehall Clinic
Neonatology
Kathryn Richmond, MD
Residency and Fellowship: Univ. of
Wisconsin Hospital & Clinics, Madison
Practice Location: Gundersen
Lutheran, La Crosse
Radiology
Jody Riherd
Residency and Fellowship:
Univ. of Wisconsin Hospital
and Clinics, Madison
Practice Location: Gundersen
Lutheran, La Crosse
Rheumatology
Douglas White, MD
Residency: Parkland Memorial
Hospital, Dallas, Texas
Fellowship: Washington Univ.
School of Medicine, St. Louis, Mo.
Practice Location: Gundersen
Lutheran, La Crosse
Read Regional Report online
Go to www.gundluth.org and click on
the For Clinicians link in the
top right corner.
Hospice and
Palliative Care
Jackie Yaeger, MD
Residency: Univ. of Wisconsin
Family Practice, Wausau
Practice Location: Gundersen
Lutheran, La Crosse
MedLink (800) 336–5465 7 In La Crosse 775–5465

Ophthalmologist offers expert glaucoma treatment
If you have patients who require a higher level of care for
glaucoma, they can receive the assistance they need from
Gundersen Lutheran ophthalmologist Suzanne Falkenberry,
MD. Dr. Falkenberry specializes in the medical and surgical
treatment of glaucoma.
Prior to joining Gundersen Lutheran, Dr. Falkenberry
completed a glaucoma fellowship at Washington University in
St. Louis, Mo., where she gained advanced skills in all types of
glaucoma surgery and laser procedures, including:
• Trabeculectomy (traditional glaucoma filtering surgery)
• Express MiniShunt surgery (variation of trabeculectomy)
• Glaucoma drainage implants (Baerveldt and
Ahmed tubes)
• Laser treatment
Along with glaucoma, Dr. Falkenberry has special
interests in treating diabetic eye diseases, macular degeneration
and cataracts.
While her practice is based at the Gundersen Lutheran
Eye Institute in La Crosse, she also treats patients at the
Gundersen Lutheran Eye Clinic – Black River Falls where she
teams with optometrist Bruce Lahmayer, OD, and performs
surgery at the Black River Falls Memorial Hospital.
“Early treatment is key for patients who have eye diseases,
like glaucoma, which can damage their vision slowly and often
Suzanne Falkenberry, MD
Specialty: Ophthalmology
MD Degree: University of Wisconsin Medical
School, Madison
Residency: University of Colorado Health
Sciences Center, Denver
Glaucoma Fellowship: Washington University,
St. Louis, Mo.
with no symptoms. Preserving patients’ vision is an amazing
thing to offer them, and I’m pleased than I can provide my
services to patients both in La Crosse and Black River Falls,”
Dr. Falkenberry says.
She went on to say, “I look forward to partnering with
optometrists and primary care providers throughout the
Tri-state Region in caring for patients with eye disease and
helping our patients maintain a better quality of life. If you
have any questions or would like to discuss a potential patient,
please don’t hesitate to contact me. I would be happy to
consult with you at any time.”
To learn more about the services Dr. Falkenberry offers or
for a consultation, contact her via MedLink. RR
Information for healthcare providers in the Tri-state Region
Regional Report
Gundersen Lutheran Medical Center
1900 South Avenue
La Crosse, WI 54601
Non-Profit Org
U.S. Postage
PAID
La Crosse, WI
54601
Permit No. 395