Archive for the ‘Patients’ Category

A Transplant’s Not the Only Alternative for Children With Intestinal Failure; Rehab is an Option for Most Patients


Our intestinal transplant program has a worldwide reputation. We’ve performed more intestinal transplants here at The Nebraska Medical Center than any other single hospital in the world. We helped pioneer the procedure.

But whenever possible we prefer not to do it.

Rehab for our pediatric intestinal failure patients is so successful, we don’t need to transplant very often. Rehab has become our default – with transplant as a wonderful backup plan, but no longer the only option.

Our patients come from all over the country and around the world. Many times, parents have been told that an intestinal transplant is the only treatment for their child. But when they arrive, we start with what they have – whatever the child’s condition and function – and go from there. It’s better to build on whatever they have than to start over. The family goes from having no hope to realizing that, very likely, their child will be able to live and eat normally.

When a child comes to our program, the family needs to be here four to six weeks. That sounds like a long time at first. But once they arrive, the families are so relieved and comfortable, often they don’t want to leave. Regardless of when they return home, they are part of the program for life.

Here’s what usually happens. The first week is evaluation with testing every day, and we make a plan. Next is an inpatient stay for a surgical intervention. Then it’s outpatient care for the next few weeks, attending weekly clinics and communicating almost daily with our team as we work on improving function in the intestinal tract, finding a pathway that will work for them and carefully moving toward our goal of eating and drinking by mouth.

When I tell parents that we hope their baby will one day go to kindergarten, carry a lunchbox to school and eat just like other kids, it blows their minds. But that is the goal, and we see our patients reach it all the time. It takes time and a dedicated team of experts guiding the way, but we get there working together. The family has been told to expect the worst; we let them know to expect the best.

There are times when we meet a child and we decide that the risks of taking time to work on intestinal rehabilitation are too high – that perhaps there has been too much damage done prior to their arrival.  There are other times when, despite everything we do, we cannot make progress and the risks of being on TPN begin to mount. These are the times when we turn to transplant, and in these cases it is truly lifesaving.

Rehabilitation and transplantation aren’t competitors with each other, but rather they work together so the right thing can be done for a child at the right time. When we can, we always prefer rehab, because successful intestinal rehabilitation doesn’t just delay the need for a transplant – it eliminates it.  When that goal can’t be achieved, transplant moves in to provide lifesaving therapy.

With these two complementary tools, the child with intestinal failure has a great chance to live a full, productive life.

NICU Team Saves Baby Diagnosed With Rare Condition

Genevieve was born with a rare condition called congenital chylothorax. She was hydroptic, collecting fluid in her body tissues and around her lungs.


Genevieve was born with a rare condition called congenital chylothorax.

“The miracle on 42nd Street,” is how Genevieve Wright’s family describes their strong, resilient little girl.

On February 19th, Genevieve was born at Nebraska Medicine – Nebraska Medical Center with a rare condition called severe congenital chylothorax. She was hydroptic, collecting fluid in her body tissues and around her lungs. Only two percent of babies born with this condition survive. Most die inside the womb, or moments after birth.

“We’ve done a lot of crying and praying,” says Genevieve’s mom, Shelly Wright. “Genevieve has been in the fight of her life.”


Shelly Wright enjoys cuddling with her 2-month-old daughter, Genevieve.

Over the last two months, Ann Anderson-Berry, MD, medical director of the NICU, inserted 14 chest tubes to drain the fluids from Genevieve’s body. Some days, the NICU team removed three cups of fluid. They also worked to replenish blood and electrolytes that Genevieve was losing. Dr. Anderson-Berry says, Genevieve’s case is unlike any other documented. There were no case reports that outlined a successful treatment plan. Most days, the NICU team wasn’t sure she’d survive.

“It’s been minute to minute,” says Dr. Anderson-Berry. “But, if you look at her now, you’d never know she was so critical. Genevieve is writing her own story.”


Dr. Ann Anderson-Berry, medical director of the NICU at Nebraska Medicine, speaks with local reporters about Genevieve’s condition.

This week, Genevieve will likely be discharged and go home to join her parents and three siblings in Lincoln, Neb. She’s off the ventilator and respiratory support. She’s acting like a normal newborn, smacking her lips, smiling and scanning the room with her eyes.

“I feel like all I do is stare at her,” says Wright. “Where there’s life, there’s hope. This medical team really gave it their all. You gotta give them a chance, even the two percenters.”

Collaboration impacts personalized cancer treatment

Babu Guda, Ph.D., associate professor and director of the Bioinformatics Systems Biology Core Facility at UNMC

The Fred & Pamela Buffett Cancer Center has partnered with IBM to conduct early testing and feedback for IBM’s Watson Genomic Analytics program.

The IBM program in minutes identifies relevant mutations and potential drugs that may be considered in a treatment regime — all based on the patient’s genomic profile and the specific mutations.

The Fred & Pamela Buffett Cancer Center at UNMC and Nebraska Medicine in Omaha, is one of 14 leading cancer institutes to partner on the project, which is part of IBM’s broader Watson Health initiative to advance patient-centered care and improve health while building on IBM research advancements.

Most of the 1.6 million Americans who are diagnosed with cancer each year receive standard treatment. When standard treatment fails and with genetic sequencing becoming increasingly accessible and affordable, some patients are beginning to benefit from treatments that target their specific cancer-causing genetic mutations.

Babu Guda, Ph.D., associate professor and director of the Bioinformatics Systems Biology Core Facility at UNMC, will be collaborating with Ken Cowan, M.D., Ph.D., director of the Fred & Pamela Buffett Cancer Center and breast cancer physician, to analyze cancer tumor genomes on the project.

“IBM has fed millions of research articles into the program, including biomedical research and clinical information,” Dr. Guda said. “The cognitive computer can keep track of the complex relationships among gene mutations, drug treatments and treatment outcomes.”

IBM describes cognitive computing as computers that learn and interact naturally with people to extend what either humans or machines could do on their own to help human experts make better decisions.

With each patient, the cancer center team is sequencing the genomes of normal and tumor tissues and identifying variations that are specific to the tumor tissues. Tumors can have many mutations, but some — “driver mutations” — are critical for the initiation and progression of cancer.

“Typically, we get several thousands (of variations),” Dr. Guda said. “Not every change is important, but some driver mutations or other serious mutations that alter cellular function may give a selective advantage for cancer cells to proliferate and spread the disease to distant locations,” he said.

Steve Harvey, vice president, IBM Watson Health, said Watson will help deliver personalized cancer care using the latest advances in science by integrating complex and disparate data in a cognitive system. “Ultimately, our goal is to create a solution that any oncologist in any location can use to identify personalized treatment options for their patients.”

10/10 Finding Balance


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


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.”


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


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


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


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


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.