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Father and Daughter Receive Expert Multidisciplinary Care

May 26, 2020

When 55-year-old Kathleen Cannady received a devastating diagnosis, she sought options and hope. The Independence, Missouri, woman turned to The University of Kansas Health System, well known to her family for providing expert, multidisciplinary care for her father.

"I knew we had to talk to someone at the health system," says Jo Reimal, Kathleen's mother. Jo was no stranger to the health system. Her husband, Don, former mayor of Independence, first sought treatment there a decade ago. He was diagnosed with Parkinson's disease, a progressive neurodegenerative disorder.

Jo never imagined her husband's ongoing treatment would help save their daughter's life.

The doctors [out-of-state] were willing to treat Don, but they mentioned that we had a world-renowned specialist right here in Kansas City. – Jo Reimal

Developing a relationship in health

Don had initially visited out-of-state doctors with a strong reputation.

"The doctors there were willing to treat Don, but they mentioned that we had a world-renowned specialist right here in Kansas City," Jo recalls. "There really wasn’t any need to travel so far."

The physicians recommended the Reimals meet neurologist and movement disorder specialist Rajesh Pahwa, MD, director of the Parkinson's Foundation Center of Excellence at the health system. That meeting grew into a long-term relationship. Don visits Dr. Pahwa every 6 months to monitor, evaluate and adjust his treatment.

Don's ongoing treatment includes medications and physical activity.

"We always look at a combination of things to keep our patients as functional as possible for as long as possible," Dr. Pahwa says. However, a heart attack and subsequent coronary bypass surgery in 2016 complicated Don's treatment.

"Cardiac issues are a challenge even when a patient doesn't have a chronic disease like Parkinson's, and it probably took him a bit longer to get back on his feet because of it," says Dr. Pahwa. "Don is doing well despite the progressive nature of his disease and his other health issues."

A network of care

Don's heart attack gave Jo a first look at how the couple's initial contacts at the health system could provide potentially lifesaving assistance for other medical conditions. In conjunction with Don’s treatment, Jo and Don attend a Parkinson's disease support group facilitated by Kelly Lyons, PhD, director of Parkinson's disease research and education at the University of Kansas Medical Center. When Don's heart health demanded prompt attention, the Reimals turned to Dr. Lyons for a referral.

Dr. Lyons put the Reimals in touch with the health system's heart care specialists, and the next day a team, led by cardiothoracic surgeon Jeffrey Kramer, MD, performed Don's bypass surgery. Jo remembers talking with several specialists about how Don's Parkinson's disease affected anesthesia and monitoring. "A nurse kept me apprised of what was going on throughout the surgery," Jo says. "The whole team made me feel much more comfortable, and they went the extra mile to do that."

Meanwhile, Dr. Pahwa received information about Don's cardiac treatment, allowing for coordinated ongoing care.

"It's important for Parkinson's disease patients to stay on top of their other medical issues and make the lifestyle changes needed to remain as active as possible," Dr. Pahwa says. "Don is still getting around, and we will continue to oversee his care."

Seeking answers and tapping the network

While the Reimals continued Don's treatments and health monitoring in summer 2019, their daughter began to wonder if she had a form of early-onset dementia.

"I couldn't say the words I wanted to," Kathleen says. "I could think of the word, but I just couldn't get it out of my mouth. My husband said it was probably just age-related, but it seemed like more than that to me."

Having trained for a second career as a teacher after working in the telecommunications industry, Kathleen was interviewing for middle-school teaching positions and noticed increasing difficulty expressing herself.

"On my first professional work day at my new school, none of my words would come out, and I couldn't even text what I wanted to say," she recalls.

Deeply alarmed, Kathleen went to a local emergency department where stroke was suspected. However, the CT scan of Kathleen's brain instead revealed a tumor located near her brain's speech center.

A biopsy indicated stage 4 glioblastoma multiforme (GBM), a common but aggressive form of brain cancer. She recalls being told that her doctors could provide no treatment and she might have 6-12 months to live.

Faced with this devastating news, Jo again called Dr. Lyons, this time asking for a referral to a brain tumor expert. Dr. Lyons recommended a health system specialist, and Kathleen soon had an appointment.

Kathleen visited Michael Salacz, a board-certified neuro-oncologist. Within 72 hours of that visit, she had surgery to remove the tumor.

"I asked about my prognosis, considering what I'd already been told," she says. "Dr. Salacz told me he didn't like to make those kinds of predictions, but that with treatment I could have 5-10 years – and who knows what new treatments may become available between now and then."

Kathleen had hope.

Aggressive treatment

It was neurosurgeon Roukoz Chamoun, MD, who removed the tumor from Kathleen's brain.

"The treatment for GBM is aggressive because the disease is aggressive," he explains. "We remove as much of the tumor as possible in order to get a clean MRI scan showing no remaining malignancy. Surgery is typically followed with radiation and chemotherapy, and that was the case with Kathleen."

Dr. Chamoun was honest with Kathleen before her surgery.

"I told her, with the tumor affecting the part of her brain that controls speech, there was a risk that she would lose her speech permanently," he says. "It was a tricky location, which made the surgery complex and challenging, but it was clear that this was her best chance for longer-term survival."

Kathleen recognized the difficulties of her situation and chose to take the risks. The outcome was exactly what she and her medical team hoped for. Kathleen's speech returned. She completed 6 weeks of postsurgical radiation and chemotherapy. While she continues a lengthy 12-month course of chemotherapy, involving 1 week per month of chemo through November 2020, her brain scans are so far clear.

"I wouldn't be alive right now without this medical team," Kathleen says. "They look at what they can do and even what clinical trials might be available, and they give you the best chance for a longer life."

Caring for the whole person and the whole family

Jo is passionate about her experiences with The University of Kansas Health System.

"They care for the whole person, not just a body part or a disease," she says. "And they're there when you need them. I can't stress enough how much they care about us and what amazing healthcare they've provided to our family."

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