Finding his rhythm again: Omaha man reclaims his life after blood pressure breakthrough at Methodist

^{Symplicity Spyral Renal Denervation System Catheter
Photo Courtesy: Medtronic}

For more than a decade, Thomas Paukert, 44, lived with a force inside his body – literally.

“I could feel my heartbeat inside my eyeballs,” he said, describing the relentless pressure that consumed his days and drained his energy.

He recalled a day in 2020 when his blood pressure had climbed to a staggering 255/180 – a reading so dangerous that even a nearby urgent care clinic turned him away. 

“They told me to go straight to the ER,” he said. “I was not in good shape.”

Perseverance meets possibility

For three years, Paukert dealt with debilitating headaches and a persistent, overwhelming feeling of being unwell. Few things brought him joy anymore. Depression was setting in, and his hope for relief was fading.

He had already cycled through “six or seven different doctors,” each trying a new combination of medications that either didn’t work or made something else worse. 

“It felt like a never-ending search for answers – always asking the same question: ‘Can you help?’”

And finally, someone could.

In 2023, Paukert was referred to William Nester, MD, an interventional cardiologist with Methodist Physicians Clinic.

Over the next few years, Dr. Nester worked with Paukert on lifestyle changes while carefully modifying his medications. Paukert’s blood pressure eventually went from 220/140 to 160/110. The progress was meaningful – but still far from safe.

“Despite optimizing his medical regimen as much as he could tolerate and ruling out secondary causes, his blood pressure remained uncontrolled,” Dr. Nester said.

This, among a few other considerations, made Paukert a prime candidate for renal denervation – a minimally invasive procedure that uses radiofrequency energy to calm the overactive nerves around the arteries that supply blood to the kidneys. 

Team-based success

Methodist Hospital, one of the early adopters of renal denervation in the region, performed its first procedure in May using the *Symplicity Spyral system developed by Medtronic. Today, Dr. Nester is the only certified Symplicity Spyral specialist in Omaha, a distinction that reflects both advanced training and Methodist’s commitment to expanding access to innovative cardiovascular care close to home.

But he’s quick to emphasize that his work is not a one‑man effort.

Dr. Nester credits Meg Kinney, APRN, Neika Coughlin, APRN, and Lynn McElwain, RN, with the expertise, attention to detail and patient‑centered approach necessary for successful outcomes.

“The whole crew at Methodist – I just can’t say enough about them,” said Paukert, who underwent renal denervation in August.

His procedure with Dr. Nester took just an hour, and he was home the same afternoon.

More stability, more out of life

Not long after the procedure, Paukert’s blood pressure numbers – which he’s checked twice daily for years – began falling. 

“We’re down to 120/83,” he said. “But the fact that it stays right around there is the biggest benefit. It’s not a roller coaster anymore.”

And that’s exactly what renal denervation is designed to achieve. 

“Many patients experience not only lower blood pressure, but less variability,” Dr. Nester said. “That consistency is transformative.”

Paukert feels the transformation in his everyday life. 

“When my blood pressure was high, it was difficult to stay focused on anything – work, hobbies, even conversations,” he said. “Now, I can focus again. I’m not worried about passing out or my heart exploding. Because that’s what it felt like most days.”

He’s even returned to playing the drums – a hobby he’d abandoned for years. 

“It was just too physically demanding before. It feels good to pick up the sticks again.”

Rediscovering hope and happiness

Renal denervation – which is also offered at Methodist Jennie Edmundson Hospital – is not a cure, and it’s not meant to replace medication entirely. 

“It works through a mechanism that no medication targets,” Dr. Nester explained. “It provides continuous blood‑pressure lowering that doesn’t depend on remembering a pill every day.”

For patients who’ve spent years searching for answers, that can be life changing – a notion that continues driving Methodist's mission of advancing care.

“Renal denervation is just one example of how we approach cardiovascular care at Methodist,” Dr. Nester said. “We identify genuine clinical needs, carefully evaluate the evidence and bring proven therapies to our community through a coordinated team.”

Paukert continues to follow up with Dr. Nester, who has begun a deliberate process of very slowly and cautiously lowering the dose of several medications for his patient while closely monitoring his progress.

“I guess he doesn’t want to mess with success too quickly,” Paukert said with a laugh. “But he’s hopeful. That makes me hopeful.”

And hope, Paukert said, is something he hasn’t felt in years.

“I’m able to live my life again,” he said. “That’s the biggest thing.”

^{*Symplicity Spyral is a registered trademark of its owner, Medtronic Ireland Manufacturing Unlimited Company. Methodist is not affiliated with or endorsed by Symplicity Spyral.}