Coordinated Care to Treat Complex Cases

An Extraordinary Environment at National Jewish Health

When Sondy Knitter’s lungs became so inflamed that she had to have a breathing tube, her doctor in Abilene, Kansas, and National Jewish Health pulmonologist Joshua Solomon, MD, decided it was time she come to Denver – quickly. She was airlifted to Rose Medical Center where National Jewish Health physicians manage and staff the intensive care unit. She was put into a medically induced coma for four days, as a team of National Jewish Health pulmonologists, critical care specialists, and rheumatologists worked together to address her complex and serious condition.

Sondy Knitter

“My doctor in Kansas has told me several times that when she put me on that plane, she thought she would never see me again,” said Sondy Knitter. “She still gets choked up about it.”

Sondy’s case was complex. She has rheumatoid arthritis, was suffering an acute lung injury of unknown cause, and had deteriorated so far that other systems had begun to fail. It took a team to treat her.

“Every morning I was amazed at the group around Sondy’s bed,” said her husband, Jeff. “Pulmonologists, rheumatologists, the ICU staff, pharmacists were all discussing her case.”


Vital Information

“It was vital for us all to trade information as we planned Sondy’s treatment,” said Dr. Solomon. “Before treating her pneumonia, I had to check with rheumatologist Aryeh Fischer, MD to see how treatment might affect her rheumatoid arthritis. Then we both had to talk to critical care doctors caring for her in the ICU to learn if she was stable enough to begin treatment. At the same time, the critical care doctors had to understand how their treatments might affect her rheumatoid arthritis.” After four days, Sondy had recovered enough to remove the breathing tube and wake her up. After she was released from Rose Medical Center, Sondy began outpatient care at National Jewish Health under Dr. Solomon’s supervision. He continued to consult with Dr. Fischer about her care.


Walk Down the Hall

Steve Frankel, MD, Joshua Solomon, MD and Aryeh Fischer, MDAt National Jewish Health, doctors don't refer a patient to another specialist in another facility who might see her in six weeks; they walk down the hall, discuss the case with their peers and, if necessary, arrange an appointment that day or the next. Then they receive immediate feedback that can guide care.

"It is an extraordinary environment here at National Jewish Health," said Dr. Solomon. "Not only do I work with some of the best pulmonologists, allergists, immunologists, rheumatologists, cardiologists, and gastroenterologists in the world, I see them every day, consult with them, and learn from them."

When Sondy returned to Kansas, still on oxygen therapy, she began pulmonary rehabilitation to regain her strength and improve her lung function. Sondy’s primary care doctor in Kansas continued to consult with Dr. Solomon about the best course of action for Sondy.

Today, despite the pain from her rheumatoid arthritis, Sondy lives an active lifestyle. She no longer needs oxygen therapy, she rides her bike six miles every day, and swims several times a week. She is also writing a book about the team effort that saved her life.

Together, Sondy, the doctors at National Jewish Health, and her local physician formed a team that gave Sondy her breath, and her life, back.  



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