Archive for the ‘Medical Professionals’ Category

10/10 Finding Balance

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The pain that Rachel Smith felt just under her breastbone was like no pain she had ever felt before. It was debilitating pain; pain that caused her to drop to the floor unable to stand pain. On a scale of one to 10, it was a 10.

That’s how Smith remembers her first pancreatitis attack. It landed her in the hospital for six days.

Doctors diagnosed her with acute pancreatitis and sent her home on a liquid diet, pain medications and instructions to eliminate all alcohol consumption.

 

Story_Vertical_Balance2RACHEL SMITH

But the pain continued. One week later, Smith was back in the hospital for eight days, then two weeks later for nine days and then another two weeks later for two weeks. During this last visit, she was put on a feeding tube. She was not allowed to eat or drink anything as doctors tried to determine the source of her pain. Her doctors were stumped. They tried more pain medications. One suggested removing her gallbladder. But even more frustrating, no one seemed to listen or take the 22 year old seriously. It was a frightening and frustrating time, Smith says.

Everything changed, however, when a friend of Smith’s mother suggested she visit The Nebraska Medical Center’s Comprehensive Pancreatobiliary Disorder and Autologous Islet Transplantation Clinic. The only clinic of its type in the region, the clinic specializes in non-malignant pancreatic and biliary diseases and offers a full array of diagnostic and therapeutic modalities. The most common conditions the clinic treats include benign neoplasms of the pancreas as well as acute and chronic pancreatitis.

A Standing Ovation

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Cora Christensen describes her care at The Nebraska Medical Center like that of a well-rehearsed symphony — a welcome relief when much of her health over the past 30 years has been more like an opera with its share of tragic moments.

Having the right care in competent and experienced hands not only saved her life but has given her a sense of peace and harmony. “It’s so much more fun being alive now that I know I have a team of doctors who can take care of me if something goes wrong,” says the 60-year-old Christensen. “I’m not scared anymore.”

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Curtis Hartman, MD

Scene 1 of Christensen’s story begins at age 33 when she was diagnosed with familial cardiomyopathy. A condition characterized by thickening of the heart muscle, this can impede blood flow and worsen with age, leading to a host of problems including arrhythmia, shortness of breath, dizziness, fatigue and heart failure. For some 15 years, Christensen treated the condition with medications.

By the time Christensen had reached her late 40s, the drama began to unfold. She started to experience fatigue, occasional dizziness and arrhythmia. The arrhythmias became more frequent and, at age 53, Christensen underwent surgery to have an implantable cardioverter defibrillator (ICD), a device that continuously monitors your heart. If it detects a life-threatening rapid heart rhythm, it sends an electric shock to your heart to restore a normal rhythm. Although the ICD did its job, saving Christensen from serious arrhythmias in numerous instances, Christensen’s condition continued to worsen.

The arrhythmias became more severe and bouts of dizziness, shortness of breath and fainting spells made it difficult to work. A teacher at Metropolitan Community College, she eventually had to quit. At the same time, Christensen was also going to school to get her master’s degree, a goal she refused to give up on.

Then she had a heart attack. Subsequent tests showed her heart was barely functioning. Her doctors sent her to The Nebraska Medical Center’s Heart Failure Clinic where she was diagnosed with end-of-life-cardiac failure. “I was barely cognitive,” recalls Christensen. “They said my ejection fraction was only 7 percent.”

Keeping Hope Alive | Personalized Brain Cancer Treatment

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No one wants to hear the word cancer. But if there is one cancer that you would least like to hear come from your doctor’s mouth, it would probably be brain cancer.

While brain cancer is very rare, affecting less than 1 percent of the population, it also has one of the least favorable outcomes.

Craig Harrison, RN, is very familiar with these facts. Not only is he a nurse, but he often cares for brain cancer patients on the neuro intensive care unit at The Nebraska Medical Center.

Story_Vertical_HarrisonCraig Harrison

 

In 2012, when Harrison was just 26 years old, brain cancer became a very intimate part of his life.

Harrison was working in the neuro intensive care unit at The Nebraska Medical Center, doing a little home remodeling on the side and playing golf in his free time. He was planning to go back to school to become a nurse anesthetist and had dreams of having a family of his own and traveling the world. At 26 years old, life was carefree and full of hope.

On a beautiful fall day in September 2012 Harrison met his friends to play golf. The game came to an abrupt end, however, when at the par 3, 2nd hole, Harrison felt a strange sensation pass through his body before falling to the ground.

“All I remember from that point was trying to tell my friends that something wasn’t right, but I was unable to speak to them and unable to move,” recalls Harrison. “The last thing I remember is falling over, and then waking up on my back looking at the bright blue sky above and hearing peoples’ voices telling me that I had had a seizure.”

His friends called 911 and Harrison was taken to The Nebraska Medical Center. After undergoing a series of tests, doctors determined that Harrison had suffered a seizure that they suspected may have been triggered by a primary brain tumor — difficult news to swallow for a 26 year old with a full life ahead of him.

Fear initially engulfed him, Harrison says. But that eventually subsided when he met neuro-oncologist Nicole Shonka, MD, who would lead his treatment and care plan. “I was very comfortable with her from the first time we met and confident in her care,” he says. “She immediately put me at ease and I weighed her advice very heavily in my decisions.”

Grant will help lab’s efforts to battle ovarian cancer

by John Keenan, UNMC public relations

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Cheng Wang, Ph.D.

Cheng Wang, Ph.D., assistant professor, obstetrics/gynecology, recently received a grant to study the initiation and progression of ovarian cancer.

The $70,000 grant came from Colleen’s Dream Foundation and local community efforts in Harlan, Iowa.

About the Foundation

Colleen’s Dream Foundation started in 2012 and supports research for early detection and improved treatment for ovarian cancer. Based in Phoenix, the foundation is named after Colleen Drury, who died of ovarian cancer after a five-year battle. NFL kicker Billy Cundiff, a member of the board of directors and Colleen’s son-in-law, is a former Harlan Cyclone. For more information on the foundation board, click here.

Dr. Wang, in collaboration with Jixin Dong, Ph.D., of the Fred and Pamela Buffett Cancer Center, is investigating whether the hippo signaling pathway drives migration and proliferation of the cancer cells. His studies show that a recently-described new cell signaling pathway which controls organ size and how rapidly cells divide, may be responsible.

“The disruption of the Hippo pathway transformed these cells,” he said.

Suppressing the Hippo pathway, or overexpression of the YAP pathway, can lead to organ overgrowth or tumor growth. But whether the pathway contributes to the initiation of ovarian cancer cells is currently unknown.

In addition, Dr. Wang will be investigating whether, as some recent studies have conjectured, the Fallopian tube is the primary site of origin for ovarian cancer.

“This is important, because it was previously believed ovarian cancer came from ovarian surface epithelial cells (OSE), and it possibly may originate from fallopian tube secretory epithelial cells (FTSEC),” Dr. Wang said.

Still, there is no direct evidence, for now. Dr. Wang’s project also may provide molecular evidence to show that ovarian high-grade serous carcinoma originates in the fallopian tubes.

“This has important clinical implications,” Dr. Wang said. “Early cancer screening tests may allow surgical removal of malignant cells, preventing them from colonizing ovarian tissue.”

“Understanding how the tubal cells colonize the ovary may facilitate the development of methods to prevent cancer cells invading the ovary.”

The implications are especially important because despite the rapid progress made in ovarian cancer research in the past several decades, the mortality rate of patients with ovarian cancer remains very high. It is the most lethal female cancer in the U.S. In 2014 alone, the American Cancer Society estimates that 21,980 new cases will be diagnosed.

“If the diagnosis is made early, 90 percent of the women are saved,” Dr. Wang said. “With a later diagnosis, the survival rate is less that 40 percent, and at stage four, it’s 10 to 20 percent. Early detection is very important.”

Nebraska Medicine named to 100 Great Hospitals list

by Nebraska Medicine public relations

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For the second straight year, Becker’s Hospital Review has named Nebraska Medicine, UNMC’s primary clinical partner, to its list of “100 Great Hospitals in America.”

The prestigious list includes some of the most prominent, forward-thinking and focused health care facilities in the nation.

Becker’s list

To see the complete 2015 list of “100 Great Hospitals in America,” click here.

Hospitals included on the list are home to many medical and scientific breakthroughs, provide best-in-class patient care and are stalwarts of their communities, serving as research hubs or local anchors of wellness. A version of this list has been published each year since 2011.

“It is a huge honor to again be included on this list,” said Rosanna Morris, interim Nebraska Medicine CEO. “Our health care professionals strive every day to provide serious medicine and extraordinary care to each of our patients. It’s gratifying to see that the work we’re doing here is being recognized and is paying off.”

To develop the list, Becker’s Hospital Review’s editorial team conducted research and evaluated reputable hospital ranking sources, such as U.S. News & World Report, Truven Health Analytics, Healthgrades, Magnet designation by the American Nurses Credentialing Center, The Leapfrog Group and several other resources. The final result is a group of 100 hospitals that are leaders in their region, their state and the nation in terms of high-quality patient care.

“This is a testament to the extraordinary patient care we provide at Nebraska Medicine,” said Brad Britigan, M.D., Nebraska Medicine interim president and dean of the UNMC College of Medicine. “It’s also evidence that the cutting-edge treatment we provide is on par with what is being delivered at the most high-profile medical facilities in the country.”

UNMC ranked in top 10 for primary care, PA programs

by John Keenan, UNMC public relations News0311 UNMC Chancellor Jeffrey P. Gold, M.D., center, and Paul Paulman, M.D., professor of family medicine, right, with medical students in the simulation lab. UNMC’s primary care program jumped two slots and is now ranked No. 4 in the country in the 2016 ranking of the nation’s top graduate schools by U.S. News & World Report. In addition, UNMC’s physician assistant program also cracked the top 10 and is now ranked No. 9 by U.S. News, up seven spots from when the magazine last ranked PA programs in 2011. In other rankings, 60th-ranked in research, up four spots from last year, and 39th in public health. “UNMC continues to be recognized for the excellence of its primary care program, which is a testament to the work of our medical students and faculty,” said UNMC Chancellor Jeffrey P. Gold, M.D. “It is exciting to see both the primary care and physician assistant program counted among the best in the nation, and to see continued growth in the national recognition of our College of Public Health and our research programs. This is truly the result of clear focus and hard work.” U.S. News surveyed 130 medical schools and 26 schools of osteopathic medicine during 2014 and 2015 while compiling the rankings, which were released Tuesday. Schools surveyed were accredited by the Liaison Committee on Medical Education or the American Osteopathic Association. “These rankings offer a reason to take pride in UNMC,” said Dele Davies, M.D., vice chancellor for academic affairs. “Our educational mission at UNMC is a vital part of what we do, and these rankings for primary care and the physician assistant program emphasize our strong commitment to that mission.” The primary care ranking included indicators such as student admission statistics (MCAT, GPA and acceptance rate), the percentage of graduates entering primary care residencies, peer assessment, assessment by residency program directors and other factors. The research ranking included the total dollar amount of NIH research grants and the average amount of those grants per full-time medical school science and clinical faculty member. (For more on U.S. News’ methodology, click here.) The rankings of the physician assistant programs, where UNMC placed ninth, are based on the results of peer assessment surveys sent to physician assistant programs accredited by the Accreditation Review Commission on Education for the Physician Assistant. Although new rankings for 2015 weren’t available in all health care categories, UNMC continues to be ranked in three other programs:

  • 93rd in biological sciences (last ranked in 2014);
  • 32nd in pharmacy programs (last ranked in 2012);
  • 34th in physical therapy programs (last ranked in 2012).

 

Officials to join Biocontainment Unit anniversary event

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Nebraska Gov. Pete Ricketts, Rep. Brad Ashford and Omaha Mayor Jean Stothert will be among the guests Friday as the UNMC/Nebraska Medicine Biocontainment Unit celebrates its 10th anniversary.

From the U.S. Department of Health and Human Services, Assistant Secretary for Preparedness and Response Nicole Lurie, M.D., also will attend.

Students, faculty and staff of UNMC are invited to celebrate a decade of preparation and the ongoing accomplishments of the UNMC/Nebraska Medicine Biocontainment Unit team at the event. Attendees are encouraged to show up early to sign a “Congratulations” banner that will be presented to the team.

Rick Sacra, M.D., the first Ebola patient treated at the Biocontainment Unit, also will speak at the event.

UNMC/Nebraska Medicine has one of three biocontainment units in the nation that have treated Ebola patients. Having drilled for countless hours since the unit opened in 2005, the Nebraska biocontainment team was uniquely qualified to answer the call. The original team was soon joined by other experts on campus.

In February, President Barack Obama said the center had delivered “world-class care” to Dr. Sacra.

The ceremony will be held at the Truhlsen Campus Events Center, located on the first floor of the Sorrell Center at 2 p.m. on March 27. Immediately afterwards, a reception in the foyer will follow.

The event will be tweeted live at the hashtag #NEbiounit10, and it will be livestreamed here beginning at 1:40 p.m.

Parking for those guests arriving from off campus will be available in Lot 36, northeast corner of 42nd and Leavenworth streets.

New Lung Transplant Program Expected to Begin Early Summer

By early summer, leadership plans to once again perform lung transplants.

 

3-9-Heather-Strah-215x142Heather Strah, MD, Medical director of Lung Transplantation

“There is definitely a need for a lung transplant program in this area,” says Heather Strah, MD, director of Lung Transplantation at Nebraska Medicine. “The nearest programs are almost 400 miles away. This creates quite a burden on the patient and family who must relocate for three months or more during the transplant process. Some patients are turned down because they are not able to relocate.”

The lung transplant program expects to perform 10 transplants in the first year and average 35 to 40 per year by the third year, says Dr. Strah, who we introduced you to in the March 4 issue of Now.

Approximately 1,800 transplants are done in the United States each year. Approximately 35 percent of these patients have end-stage chronic obstructive pulmonary disease (COPD), 15 percent have cystic fibrosis and 30 percent have interstitial lung disease or idiopathic pulmonary fibrosis. The remaining 20 percent have other conditions such as pulmonary hypertension or sarcoidosis.

Each patient must go through a thorough evaluation and screening process to make sure he or she is a good candidate. Lung transplants are generally reserved for individuals whose lung disease is in the most advanced stages and they are likely to die of their lung disease within one to two years despite maximal medical therapies, notes Dr. Strah. Good transplant candidates are in generally good health, other than their lung disease and have a good support system.

Lung transplants are usually performed on patients between the ages of 16 to 65. Younger patients typically fare the best, says Dr. Strah. Survival for the first year is 80 percent. Five years out, half of patients will have died due to complications related to the transplant.

“For those who have good outcomes, a lung transplant can be a life-changing experience,” she says. “I have seen patients who have been living 20 years or more with their transplant.”

Dr. Strah stresses the need to refer potential candidates early on. About half the people on the waiting list receive a transplant within a year.

“There is no such thing as a referral that is too early,” notes Dr. Strah, “but there are definitely referrals that come too late. The lung is a fragile organ and it can take a long time to find a suitable donor so early referral is best.”

Dr. Strah completed medical school at the University of Iowa Carver College of Medicine in Iowa City, an internal medicine residency at the University of Pittsburgh Medical Center and a pulmonary and critical care medicine fellowship at Washington University School of Medicine-Barnes Jewish Hospital. She also completed a post-doctoral research fellowship at Washington University School of Medicine in immunology. Washington University has one of the oldest lung transplant programs in the country and performs nearly 60 lung transplants annually.

Other members of the lung transplant team are thoracic and cardiac surgeons Michael Moulton, MD and Aleem Siddique, MD.

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Michael Moulton, MD, thoracic and cardiac surgeon

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Aleem Siddique, MD, thoracic and cardiac surgeon

UNMC to take part in Ebola treatment study

by Jennifer Routh and Vicky Cerino

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Andre Kalil, M.D.

UNMC researchers will take part in a clinical trial to obtain safety and efficacy data on the investigational drug ZMapp as a treatment for Ebola virus disease.

The study, run by the National Institute of Allergy and Infectious Diseases (NIAID) in conjunction with the Liberian government, is a randomized controlled trial enrolling adults and children with known Ebola virus infection.

UNMC expects to receive approval of the study, currently being reviewed by the Institutional Review Board, in a few weeks.

“Although ZMapp has been used to treat several Ebola-infected patients in recent months, we cannot determine if the drug actually benefitted those patients because it was not administered within the context of a clinical trial,” said Anthony Fauci, M.D., director of the NIAID, at the National Institutes of Health (NIH).

ZMapp, developed by Mapp Biopharmaceutical Inc., is composed of three different proteins called monoclonal antibodies. ZMapp is designed to prevent the progression of Ebola virus disease within the body by targeting the main surface protein of the Ebola virus.

“Our Biocontainment Unit research team has been actively involved in the development of this research protocol and looks forward to participating in the implementation of the research here in Nebraska,” said Christopher Kratochvil, M.D., UNMC associate vice chancellor for clinical research and vice president for research, Nebraska Medicine.

“The invitation to participate in this research project once again recognizes the world-class facilities at Nebraska Medicine as well as the expertise of the researchers and staff of the Nebraska Biocontainment Unit.”

Andre Kalil, M.D., professor in the UNMC Department of Internal Medicine and infectious diseases physician at Nebraska Medicine, said that the “adaptive” clinical trial will provide answers about the safety and effectiveness of ZMapp and other potential treatments in patients with Ebola virus disease.

“This is really a very important study with an innovative approach,” said Dr. Kalil, who has been involved in the design of the study with Dr. Kratochvil. “We must scientifically and rigorously evaluate the experimental treatments that have been given to date to determine what is safe and effective to our patients. We will find out what is working and what is not while the clinical trial is ongoing and adapt the study based on patients’ clinical response.”

“The idea is to discover and offer the safest and best therapies in the shortest period of time,” Dr. Kalil said. “We look forward to working with our national and international research partners.”

Routine Colonoscopy Leads to Shocking Diagnosis

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It started on the first anniversary of 9/11. Duane Johnson, a retired schoolteacher, wanted to make a difference. He stopped by a local Red Cross blood drive and rolled up his sleeves. From there on out, it became a trend.

“I pretty much donated blood every 53 days or so,” says Johnson. “It’s easy, painless and so important to the recipients. I enjoyed helping.”

But, a few years ago, a routine visit to the Red Cross left Duane a bit concerned.

“They told me my iron count was low, which had never happened before,” explains Johnson. “A couple months later, same problem. They told me to go home, eat some spinach and steak and come back. But, when I did, the same thing happened.”

Johnson was due for his annual exam at Nebraska Medicine, so he scheduled an appointment with his primary care physician, Dennis Goeschel, MD, with plans to discuss this with him. In April 2014, hospital staff ran a series of tests, including a colonoscopy. Five days later, Johnson received a shocking call from his gastroenterologist, Gary Volentine, MD.

“They found lymphoma in my small intestine. I couldn’t believe it,” he recalls. “I was puzzled by my low iron count, and felt fatigued at times, but had no inkling that anything serious was wrong. At 69 years old, I just contributed it to getting older.”

Dr. Volentine told Johnson, finding the lymphoma explained his anemia. He was immediately referred to Nebraska Medicine oncologist/hematologist Philip Bierman, MD, who was also surprised by the diagnosis.

“Lymphoma is very uncommon to find during a colonoscopy,” explains Dr. Bierman. “Typically, when we perform a colonoscopy, we’re looking for the more common types of colon cancer. Lymphoma would be an unexpected finding.”

Dr. Bierman decided the best course for treatment would be six sessions of chemotherapy. Johnson lost his hair, along with his appetite.

“At first, chemo affected my taste buds and made me feel like a groggy doggy,” jokes Johnson. “By the third week, I was doing much better. I remember telling the staff, ‘it feels good to feel good.'”

After completing the six chemo sessions, Johnson had another colonoscopy in September 2014. This time, the results were much different. Johnson was cancer free.

“It was such a relief to hear those words,” says Johnson. “My wife and I were very optimistic throughout the entire process, and that’s because we knew I was at the right place. No doubt about it. We’re really fortunate that Nebraska Medicine is here in Omaha. They did a wonderful job.”

These days, Johnson enjoys gardening and taking long car rides with Clara, his wife of 40 years. Because of his cancer diagnosis, Johnson can no longer donate blood at the Red Cross. But, he’s found a new way to make a difference. He encourages others to get a colonoscopy – especially during March, which is National Colon Cancer Awareness Month.

“Starting at age 50, low risk patients should get a colonoscopy every 10 years. This includes men and women,” explains Dr. Volentine. “If you have a family history of colon cancer, it’s best to get screened earlier and have a colonoscopy every five years. Work with your doctor to develop an individualized screening plan.”

Nebraska Medicine is ranked by U.S. News and World Report for having one of the nation’s top gastroenterology programs. They offer two convenient locations for colon cancer screenings. To schedule an appointment, call (800) 922-0000.

“I cannot stress how important it is,” says Johnson. “Getting a colonoscopy saved my life. It’s the best, most thorough way of finding cancer cells. Without it, I may not be here today.”

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