Archive for the ‘Patients’ Category

New Radiosurgery Technology Provides Improved Speed and Accuracy

Advancements in radiosurgery technology continue to improve the speed and accuracy in which radiation treatment can be delivered to treat challenging malignant cancer tumors. Nebraska Medicine recently became the first in the region to adopt the Varian TrueBeam STx radiosurgery system, which opens the door to new possibilities for the treatment of difficult to treat cancers like those in the brain, spine, lung, liver, pancreas and prostate.


“This technology is designed to do stereotactic radiosurgery and stereotactic body radiation therapy with greater speed and precision than possible with other systems,” says Charles Enke, MD, radiation oncologist at Nebraska Medicine. “This is two generations beyond our current Novalis stereotactic system with accuracy measured in increments of less than a millimeter. While most radiosurgery systems use up to two targeting systems, our institution has added a total of four additional targeting technologies to improve treatment accuracy.”

The TrueBeam STx can deliver treatments up to four times faster than other radiosurgery systems. Radiosurgery treatments that may typically take 30 to 60 minutes to administer, may now take just five to 20 minutes, depending on the type and location of the tumor being treated, notes Dr. Enke. This provides a more comfortable experience for the patient and less chance for tumor movement during the treatment. “Ongoing studies are showing that higher doses per treatment delivered over fewer treatments may be more effective,” says Dr. Enke, “especially in areas such as prostate and lung cancer.”

For tumors that are subject to movement such as in the lung, liver and prostate, the system offers a respiratory-gated treatment feature that allows the machine to deliver a continuous treatment of radiation while rotating around the patient and compensating for movement of the tumor while the dose is being delivered. The radiation beam is shaped and reshaped as it is continuously delivered from many different angles, improving accuracy and reducing treatment time. It also uses a more sophisticated method of calculating radiation dose which is much more accurate than current dose calculation algorithms. This is very important when treating sensitive areas such as in the head and lung.

“While we offer single fraction intraoperative breast radiation for appropriately-selected patients, this is an excellent option for women with left-sided breast cancers who are not eligible for intraoperative breast radiation,” advises Dr. Enke.

The system also provides other benefits to breast cancer patients. Not only can TrueBeam STx shorten the treatment course by half, but it also offers a dependent breast positioning technique that allows the patient to lay on her stomach rather than her back. This enables the system to deliver radiation while the breasts are falling away from the patient, which can help minimize radiation to healthy tissues and organs like the heart and lungs, says Dr. Enke.

“The TrueBeam STx represents a significant advancement in radiation technology this is specifically designed for to deliver radiation very quickly and in fewer treatments with greater precision than we have ever had at our disposal,” says Dr. Enke. “We believe this will result in better outcomes for our patients.”

Hope for Stroke Patients: Recent Treatment Advances Offer Better Chances for Recovery

Stroke is a severely debilitating disease that can permanently change the lives of patients and their families. Everyone knows a family member or a friend whose life has been permanently changed by stroke. Stroke is a very common disease around the world. Every year more than 795,000 people in the United States will suffer a stroke and more than 130,000 will die as a consequence of stroke. In Nebraska, stroke is the fourth leading cause of death and more than 36,000 people live with stroke. Despite these frightening numbers there is hope for stroke patients.

Stroke prevention

The best way to prevent a stroke is to take care of yourself. More than 90% of strokes are the result of poorly controlled medical conditions. Avoid tobacco, control your weight, watch your diet, exercise and follow up regularly with your primary care physician. Work closely with your doctor to control your high blood pressure, diabetes, high cholesterol or heart disease. Just by reducing your blood pressure by 10 points you can decrease your chance of having a stroke by one-third. Controlling the other risk factors will decrease your chances even further.

Sudden signs of stroke: remember them easily with “FAST”

Stroke can present in many different ways: confusion, severe headache, dizziness, double vision, facial droop, difficulty swallowing, arm or leg numbness or weakness, sudden loss of balance, inability to speak and slurred speech all are symptoms of stroke. One easy way to remember the sudden signs of stroke is by using the F.A.S.T. acronym. F is for facial droop, A is for arm weakness, S is for speech difficulties and T is for time to call 9-1-1. If you think you or a loved one is having a stroke, the best course of action is to call 9-1-1. Patients who call 9-1-1 arrive faster to the nearest hospital capable of treating stroke and have better chances of receiving treatment.
Stroke types and treatments

There are two major types of strokes: ischemic and hemorrhagic. Ischemic strokes are by far the most common type in the United States and in Nebraska. An ischemic stroke is usually the result of a blockage in a blood vessel, whereas a hemorrhagic stroke is due to a blood vessel rupture. Treatment is different for each type; however rapid treatment is essential in both.

Since 1996, the only FDA approved treatment for acute ischemic stroke has been to administer alteplase. This is a medication that is given to patients with an ischemic stroke who arrive to the Hospital within 4 ½ hours from the onset of symptoms. Patients who receive this drug have a 33% increased chance of being independent or less disabled at three months after their stroke, when compared with people who did not receive the drug. In the last six months there have been significant advances in the treatment of acute ischemic stroke. Five new studies show that patients who suffered a large stroke and were treated with new devices called stent retrievers – within 6 hours of onset, in an experienced stroke center – have a 33% to 71% percent chance of regaining independence or experiencing less disability at three months.

New, advanced treatment options available at Nebraska Medicine

Nebraska Medicine has the capacity to offer these novel treatments to stroke patients who qualify. We are also working to make these crucial advancements in treatment options available to more people in Nebraska and neighboring states by establishing a telestroke network with hospitals throughout the state. Telestroke brings neurology expertise to bedside of community hospitals. Working together, the neurologist and emergency department physician collaborate on the most appropriate treatment for the stroke patient. This program will provide local emergency rooms with 24- hour access to stroke neurology expertise and the advanced treatment options available at Nebraska Medicine.

‘Raise that beam!’

by John Keenan, UNMC public relations

A Kiewit representative helps Emily Stephenson, 3, and sister Julia, 5, signal for the beam-raising as their mom, Amy Stephenson, looks on with UNMC Chancellor Jeffrey P. Gold, M.D.

“Raise that beam!”

With that cry from 3-year-old Emily Stephenson — echoed by her 5-year-old sister, Julia — the first signed beam was raised to the top of the Fred & Pamela Buffett Cancer Center.

For a photo album of the beam raising, click here.

Emily Stephenson, who her mother said is being treated at Nebraska Medicine for a blood disorder, may have been the tiniest VIP in attendance, but she was as enthusiastic as any of the other cancer center supporters.

See beam signings throughout Nebraska here.

Omaha Mayor Jean Stothert was on hand to extend congratulations on the construction milestone, saying the tower cranes on the Omaha skyline point to “a future of growth.”

See campus leaders discuss the impact of the Fred & Pamela Buffett Cancer Center here.


The signed beam, with the U.S. flag attached, is hoisted to the top of the Fred & Pamela Buffett Cancer Center.

Calling the project “a commitment to save lives,” Mayor Stohert said the Fred & Pamela Buffett Cancer Center will provide important job opportunities before and after the building is completed, adding $500 million to the local economy.

Speaking before the beam-raising, UNMC Chancellor Jeffrey P. Gold, M.D., welcomed faculty, staff, donors and local officials, including Mike Yanney and Gail Walling Yanney, M.D.; Ruth Scott; representatives from the Cattlemen’s Ball; Omaha City Council members Pete Festersen, Chris Jerram and Ben Gray; state Sens. Jim Smith, Merv Riepe, Sue Crawford, Al Davis, Bob Hilkeman, Rick Kolowski and Mark Kolterman; and former U.S. Sen. Ben Nelson and others.

“This is truly a great day for our campus,” Dr. Gold said. “This facility represents how health care will be delivered in the future, and also how our campus will integrate clinical care, discovery and education, all for the benefit of our patients. It’s really an exciting day.”

Ken Cowan, M.D., Ph.D., director of the Fred & Pamela Buffett Cancer Center, pointed out that it would only be 18 more months before the group gathered again for the center’s opening.

signed0812Nebraska Medicine staff and UNMC faculty, staff and students, came out — along with donors, campus and community leaders and other supporters — to sign the beams and see them raised.
“Tremendous progress has been made, and every day we are closer to this state-of-the-art cancer center that will really transform Nebraska, the region and the country,” Dr. Cowan said.

Nebraska Medicine interim CEO Rosanna Morris said that when the Fred & Pamela Buffett Cancer Center opens, “it will have everything our cancer center patients need, all in one place. How do we know? Because we’ve involved physicians, reseachers, staff members and — most importantly — cancer patients in every aspect of the design of the facilities.

“We know, and they know, that curing cancer is not just about eradicating cancer cells,” she said. “It’s about so much more. It’s about treating the whole person – mind, body and spirit.”

Best Hospital for Urology Care – Right Here

U.S. News and World Reports recently ranked Nebraska Medicine as one of the best hospitals in the country for its expertise in six adult specialties: cancer care, gastroenterology and GI surgery, nephrology, neurology and neurosurgery, pulmonology and urology. This is the best performance for the hospital in terms of national recognition in these rankings.

In a series of blog posts, the experts from each nationally-ranked department will highlight what makes Nebraska Medicine a leader in providing care to its patients.

It’s gratifying to see U.S. News & World Reports lists Nebraska Medicine among the best hospitals in the nation for urology. The report ranks us 25th among the 1,570 programs evaluated in our specialty.

Chad-LaGrange-Urology-300x199Chad LaGrange, MD

We’ve taken several steps to reach this high level of patient care. It’s critical for patients living in this region to have the best urological care close to home—so they don’t have to travel long distances.

Their lives are disrupted enough when they deal with urologic conditions, including cancer. We take pride in offering the best in minimally invasive urologic surgery—both standard laparoscopic and robot-assisted laparoscopic prostatectomy.

In the past year, we’ve expanded our service significantly. Several urologists have joined our team, which allows us to treat a wider array of urological problems. Our surgeons are now performing procedures we could not offer in the past—like robotic cystectomy for bladder cancer, urethral reconstructive surgery and penile prosthetics.

You may have noticed that I mentioned “robotics” a few times here. Our patients have various misconceptions about robotic surgery.

What exactly is robotic surgery?

I’m sure our patients know there’s no robot in the surgical suite. But they may not realize that the “robotic” part involves the tools the surgeon uses.

Robotic tools are built to function like a surgeon’s hands. They allow us to perform very delicate surgery with far more precision. The surgeon’s skill and experience is still very important, and that’s a critical factor in this type of surgery. It’s our hands doing the surgery, aided by these very precise instruments.

I can explain it more when I see you, but you should know that robotic surgery helps ensure a very positive result—with far less blood loss, pain and recuperation time.

Lots of robotics experience

Of course, we perform the typical robotic prostatectomy to remove cancer from the prostate. But not many centers offer the more complex procedures—like radical cystectomy, which involves removing all or part of the bladder.

The average urologist performs only one cystectomy (maybe none) in a year’s time. At Nebraska Medicine, we do five of these complex procedures every month–a very high-volume center for bladder cancer and cystectomy. Only the top urology centers in the country are doing that. We’re proud to provide that level of expertise.

“Patient-friendly” is still a priority

With all this technology, we still pride ourselves on being friendly.

When a patient first calls our department, a “real person” will answer the phone. We don’t want people to navigate their way through lengthy phone menus. Our patients have enough stress in their lives after getting their diagnosis. We want to help relieve that stress.

We also make every effort to get a patient in to see us right away. Our patients shouldn’t have to wait long for appointments and surgery.

Our department has the exceptional nursing. Our nurses are great, very dedicated. Patients quickly form strong relationships with our nursing staff, and rely on them for support during difficult times. Our nurses take a very personal approach to patient care; they always put the patient first.

Our multidisciplinary oncology clinic is another step in that direction. Our patients can have all their appointments in one visit—radiation oncologist, medical oncologist, urologist. This makes it much easier for patients; they don’t have to travel around to get their questions answered.

With this approach, we coordinate the patient’s care more easily. We get all their physicians in the same room, which greatly improves the communication. We doctors learn a lot from each other—and as a result, our patients get better care.

We’ve also opened up new clinical trials to provide vaccine therapy for metastatic kidney cancer. The drug is in a Phase 3 trial, and results thus far are very optimistic.

These are all advantages when you are treated in an academic environment like Nebraska Medicine. And it’s all right here, close to home.

My Transplant Team is Part of My Family

Harry Danner recounts his long journey to wellness and the team who helped him get there.

I retired from the US Air Force in 1982 where I was an Electronics Warfare Specialist. Upon retirement, at age 37, I started my own electrical business. In August of 1983 I suffered a massive heart attack that left me with a heart that was barely functioning with a 10% ejection fraction.

Harry-Danner-and-FamilyHarry with his mother and sister in 1986

Needless to say, this caused many financial hardships to the tune of hundreds of thousands of dollars. Much of this was covered by my veterans’ benefits but I was still left with a huge debt. Nothing but uncertainty was ahead for me and my wife, Judy. She was my rock through everything!

Doctors were able to keep me alive with my damaged heart for two and a half years. But in 1986 they were unable to do anything else as my heart had become too weakened to keep me going much longer. In April of that year, I learned about an experimental heart transplant program at the Veterans Affairs Medical Center in Richmond, Va. Our oldest daughter flew to Plattsmouth, Neb., where we lived at the time, to help take care of the home and our youngest daughter. I was placed on the transplant list and waited for three weeks before an organ became available.

This experience sent me and my wife on the biggest adventure of our lives together. On May 11, 1986 (Mother’s Day) a heart became available. During this waiting period my wife and I went through every imaginable scenario of consequences.

The transplant turned out to be a great success. Of course, due to the inexperience of medical personnel in the field of heart transplants, I went through many episodes of major and minor rejection. The normal hospital stay after the transplant was about 90 days at that time. After I had been there for 89 days I was released and we returned to Plattsmouth, Neb. Until 1998 I returned to Richmond, Va. on a regular basis for follow up care. This was the year that the transplanted heart began to fail. For the next five years I went through just about every procedure that can be done to a heart to keep it functioning. I had developed, in laymen’s terms, what is called small vessel disease. I ended up with approximately 10 stents in my heart along with having a bypass performed on my heart.

It was by pure luck that I met Dr. Ioana Dumitru in December, 2003, at the Veterans Affairs Medical Center in Omaha, Neb. Through a very frank discussion, she explained to me that my only viable option was another heart transplant. After all the pain and procedures that I had endured over the last five years, I had pretty much come to the same conclusion. I had a bi-ventricular defibrillator implanted and Dr. Dumitru, along with her transplant coordinators, made arrangements with the University of Utah Medical Center to be evaluated for another transplant. I was accepted into the heart transplant program and it was the beginning of another trek for Judy and me.

This time things took a little more time. Although the wait time was only two and a half months, it seemed like forever to us. We kept ourselves busy by volunteering at the transplant house where we were living. Since both of us are very skilled people we were able to accomplish quite a lot in our short stay.

Harry-Judy-DannerJudy and Harry Danner

On September 3, 2004 (Labor Day) we got the call that a heart had become available. This time, we were just too nervous to drive ourselves to the hospital. The owner of the transplant house offered to drive us. We gladly accepted.

Between the time we got the notification and the time we were told to come in, Judy and I notified our family back in Nebraska and Iowa. Through some sort of miracle all three of our daughters were able to get on a plane and make it to Salt Lake City, Utah before the surgery. I was able to spend about 15 minutes with my girls before having to be taken to the operating room.

Exactly six hours later the transplant surgeon notified my family that the transplant was completely successful. After this, I was transported to the Intensive Care Unit (ICU.) Although I still had all the tubes in my neck and arms, I was still able to be brought to a completely upright position the first day after the surgery. With the bed in an upright position I was able to walk in place. I felt amazing!

By the fourth day after my transplant, I was walking up and down two flights of stairs and being transferred to a regular post transplant room. I would spend the next three days in that room. I was discharged after only seven days in the hospital back to our temporary residence.

I was supposed to spend the next six months in Utah for follow-up. But since I had a transplant team eagerly awaiting my transfer back to Omaha, I was cleared to go home after just three months. Judy and I returned home in December of 2004 and began a long and successful relationship with Dr. Dumitru, Margie Chartrand and the rest of the transplant team at The Nebraska Medical Center.

After my massive heart attack in 1983, I’ve seen many dramatic changes in the heart transplant field. Through all the changes, I believe I have the best transplant care team in the business at The Nebraska Medical Center. They are more than just a team, they are a part of my family.

Nebraska Medicine a National Pancreas Foundation Center

by Jenny Nowatzke, Nebraska Medicine

Nebraska Medicine has been nationally recognized as a National Pancreas Foundation Center (NPF) by the National Pancreas Foundation, a nonprofit organization that provides support, research and education for those suffering from pancreatitis and pancreatic cancer. Nebraska Medicine is the only hospital in Nebraska to receive this prominent designation, joining 29 other institutions across the United States.

“Our team is thrilled to be named the only NPF Center in the state of Nebraska,” said Nebraska Medicine pancreatic surgeon Luciano Vargas, M.D., an assistant professor in the UNMC Department of Surgery. “Our pancreas program provides multidisciplinary, patient-centered care for patients with different pancreatic disorders. The program has been made possible by a strong commitment and support from Alan Langnas, D.O., and the leadership at Nebraska Medicine.”

NPF Centers are awarded after a rigorous audit review to determine that an institution’s focus is on multidisciplinary treatment of pancreatitis, treating the “whole patient” with a focus on the best possible outcomes and an improved quality of life.

“We are very humbled and proud of this achievement,” said Rosanna Morris, interim CEO at Nebraska Medicine. “Having the NPF Center designation will help distinguish us as an institution whose focus is on providing the best and most innovative care possible for those suffering from pancreatitis.”

“Once an institution receives this designation, our foundation can recommend with confidence that patients will receive quality care at these designated centers,” saed Matthew Alsante, executive director of the National Pancreas Foundation.

An approved NPF Center has to meet the criteria that were developed by a task force made up of invited subject matter experts and patient advocates. The criteria includes having the required expert physician specialties such as gastroenterologists, pancreas surgeons, and interventional radiologists, along with more patient-focused programs such as a pain management service, psychosocial support and more.

“It’s an honor for me to work with such a wonderful team of physicians,” said Sarah Ferguson, nurse coordinator for the Pancreas and Biliary Disorders Clinic at Nebraska Medicine. “Their dedication, expertise and compassion towards helping patients with pancreatitis is truly deserving of this national recognition.”

For a full listing of the criteria, click here.

The Special Meaning of April 17th


Dave Eggers

April 17, 2015 marks the 17th Anniversary for Dave Eggers’ liver transplant at Nebraska Medicine.

It was in January of 1988, right in the middle of a rewarding Air Force flying career, when I was told that I had a serious bile duct disease in my liver. I would need a liver transplant to save my life. Being a person who enjoyed perfect health my entire life (up to then), I knew nothing about transplantation and what my family and I would be going through.

The Air Force wisely sent me to the Nebraska Medicine transplant team for a complete liver transplant evaluation. They took a great amount of time to help me understand that because of the tremendous shortage of donors, coupled with the slow progression of my disease, I would need to be a lot sicker to get placed on the liver transplant list. Obviously, this wasn’t very positive information for me or my family. In short, we were scared.

It turned out that the liver experts were right. I was placed on the transplant list nine years later, in June of 1997, and the difficult experience of waiting began.

Dave currently works at the Lied Transplant Center, helping patients and their families through their own transplant journeys.


Dave currently works at the Lied Transplant Center, helping patients and families through their own transplant journeys.

In 1998, the month of April became very special for me and my family. In the early morning of April 17th, I was awakened in my hospital room at Nebraska Medicine to be told that the liver I had been praying and waiting ten years for had finally arrived! My family and I, while elated at the news, knew that the donor’s family was grieving the loss of their loved one. Even though my operation was difficult and lasted 12 hours, I recovered quickly and was home six days later! I was blessed with a tremendous donation from a man I never met.

My Air Force career was over, but as luck would have it, I ended up joining the Nebraska Medicine staff in March of 1999 when the Lied Transplant Center opened. For the past 16 years I have had the honor of helping many organ transplant patients and their families get through their own transplant journeys.

I am living proof that transplants work. Lots of life experiences have happened to me during the past 17 years. A total stranger gave me and others the “gift of life” on that early morning of April 17th. My family and I will be forever grateful to this person for what he and his family did for me. Please, get the facts about organ donation and then tell your family about your decision about being an organ, tissue, or eye donor.

A Rising Star in the Wild West – Neurology @ Nebraska Medicine

U.S. News and World Reports recently ranked Nebraska Medicine as one of the best hospitals in the country for its expertise in six adult specialties: cancer care, gastroenterology and GI surgery, nephrology, neurology and neurosurgery, pulmonology and urology. This is the best performance for the hospital in terms of national recognition in these rankings.

In a series of blog posts, the experts from each nationally-ranked department will highlight what makes Nebraska Medicine a leader in providing care to its patients.


We’re delighted with the news – that US News & World Report has given our division a #31 ranking among the best hospitals in America. It means our neurology and neurosurgery division is in very good company.

Some people might be surprised. They don’t expect to find excellent neurological care here in Nebraska. They think of institutions on the east coast—the famous hospitals with long histories.


Matthew Rizzo, MD Chief of Neurology and Neurosurgery

Well, it’s no surprise to those of us who chose Nebraska Medical Center for our medical practice. We recognize the top-notch individuals in this group. I like Nebraska and the Wild West mentality. The people here have a can-do attitude. We know that Nebraska Medicine is a rising star. The Department of Neurological Sciences and our partners in neurosciences make up an equally premier service on the rise—a very broad, comprehensive program involving mind, body and health.

Let me tell you about our neuroscience specialists — trained in neurology, neurosurgery, psychiatry, psychology, anesthesia and pain/palliative treatment. They treat the full range of neurological conditions—tumors of the brain or spine, epilepsy, Alzheimer’s or dementia, stroke, psychiatric disorders, multiple sclerosis, Parkinson’s disease, amyotrophic lateral sclerosis (ALS), spinal disorders, traumatic brain injury, degenerated or herniated disks, pain syndromes, vascular malformations and aneurysms.

In collaboration with our pediatrics colleagues at the Monroe Meyer Institute, we also treat children with autism and attention deficit disorders. And, we treat both adults and children with neurological problems related to diabetes and cancer.

Many, many people are affected by neurologic conditions for decades. These chronic conditions can be very debilitating. That’s why Nebraska Medicine stays on top of the latest treatments—and why we conduct ongoing research to uncover the best treatments. We aspire to be the best neurological service in Omaha, in the Heartland and in the world.

These specialty clinics are crown jewels in our neurology division:

Movement disorders clinic

Midwesterners don’t brag much, but maybe we should. In Neurology, we’ve brought on board many top experts, including Diego Torres-Russotto, MD, a specialist in movement disorders. Dyskinesia, for example, is characterized by a slight tremor or involuntary muscle movements. This is a symptom for several medical conditions, and requires a specialist to determine the cause. Dr. Torres-Russotto is an expert at this type of complex diagnosis and outlining the best treatment.

He is also a specialist in diagnosing orthostatic tremor, a neurological condition that involves the legs and trunk. Very few doctors recognize the symptoms or know how to treat this condition. With Dr. Torres, you’re in very good hands.

If you’ve got a tremor that is affecting your everyday life, it’s important to see a specialist who can recognize the subtlest clues—and who can make a correct diagnosis. That’s the only way to assure you’ll get the best treatment.

For example, we’ve found that Botulinum toxin is a very successful treatment for severe intractable tremors and a variety of neurological conditions—blepharospasm, cervical dystonia, writer’s cramp, spasticity, hemi-facial spasm and cerebral palsy. Many of these conditions are otherwise incapacitating.

While people didn’t know what to think about Botox a few years ago, we’ve found it to be an excellent treatment with very minor side effects. Botox is just one treatment we can offer our patients—to give them relief from debilitating problems.

Epilepsy clinic

We also have great expertise in treating epilepsy—including the really complex, difficult cases that require surgery. Deepak Madhavan, MD, is our epilepsy specialist, and he gives hope every day to patients whose lives are paralyzed by this disorder. He knows the difficulties that epilepsy causes—and he presents patients with medical and surgical treatments that can bring real relief.

In just a few years, the science and treatment of epilepsy has advanced tremendously—and patients can actually live seizure-free. That’s right, your hope is now more than a dream. We now have sophisticated diagnostic tools such as magnetoencephalography (MEG) under the expert guidance of Dr. Tony Wilson, PhD., to localize epilepsy in the brain. That allows us to determine the best treatment.

In Dr. Madhavan’s very capable hands, you can get on with your life, your work, your education with the security knowing that your seizures are under control.

Memory disorders clinic

Certainly, Alzheimer’s is a memory disorder we see every single day. Researchers say that if we live long enough, most of us are likely to develop dementia and Alzheimer’s, Parkinson’s disease or a related condition.

Many people come to us when they’re concerned about a family member. They see signs of a faltering memory, and they’re not quite sure whether to be concerned or not. We invite them to come in, and we provide the appropriate evaluation tests.

We can rule out treatable conditions that look like Alzheimer’s but really aren’t. Even hearing loss can make someone seem as if his or her thinking is impaired.

There may be a thyroid or sleep problem, or depression, which also affect memory and decision-making. Older people are often taking one or three or five medications – all prescribed by a well-intentioned doctor — but when taken together, memory can be affected.

In fact, prescription medicine for sleep problems or heart disease may cause slower thinking—making it look as if something is wrong. It may just be a too-high dosage, or it may be the patient needs a different pill.

After they are diagnosed, our patients receive the medications that help control symptoms. They also can enter a rehabilitation program for stroke or traumatic brain injury. Very often, we link patients with community resources and support groups. Also, our patients can participate in clinical trials and have access to new drugs long before they are widely available.

Our psychology and neuropsychology experts, under David Cates, PhD, are top-notch in diagnosing disease—which helps us begin early treatment, then gauge disease activity and improvement over time. Our goal is to help people age successfully at home, with healthy minds and brains, as long as possible.

Telemedicine and telehealth

This corner of the world — Nebraska and our nearest neighbors in the northern Great Plains — is a wide-open space. Many patients live in remote areas interspersed with small pockets of urban development. It’s a burden for them to drive to our clinic; they have to spend a lot of windshield time just to get to the doctor’s waiting room.

That’s why we’ve started a telemedicine program for stroke, Parkinson’s disease and multiple sclerosis (MS) patients. With high-speed internet and excellent technology, these patients can work with their local doctors—with the aid of consultations from our experts here in Omaha.

In fact, we have some specialists driving to these remote clinics—or even making house calls. Our patients love this personalized service. The specialists really enjoy doing this; it feels like you’re doing the right thing for your patients.

Many of these people wouldn’t get the medical treatment they need if we didn’t offer these telemedicine services.

The future for neurology services

We’ve very excited about the strength of our Neurology program and all our Neurosciences services—and about the opportunities that lie ahead. We continue to bring in specialists from the top institutions as well as the best technology, and foresee strong opportunities to improve.

We want to serve Omaha—as well as our neighbors throughout Nebraska, Kansas, the Dakotas, western Iowa and northern Missouri. We want to reach out across the country and around the world to connect with patients. We can offer them the best-quality neurology care available, while conducting premier research—and while training the next generation of healthcare experts to carry on.

Thanks, US News & World Report, for the great ranking—which we plan on surpassing in short order.

World-Class Digestive and Liver Care – Close to Home

U.S. News and World Reports recently ranked Nebraska Medicine as one of the best hospitals in the country for its expertise in six adult specialties: cancer care, gastroenterology and GI surgery, nephrology, neurology and neurosurgery, pulmonology and urology. This is the best performance for the hospital in terms of national recognition in these rankings.

In a series of blog posts, the experts from each nationally-ranked department will highlight what makes Nebraska Medicine a leader in providing care to its patients.


Mark Mailliard, MD | Chief of Gastroenterology and GI Surgery
Alan Langnas, MD |  Chief of Transplant Surgery
Jon Thompson, MD |  Colon and Rectal Surgery

We’re ranked as the 29th best hospital in the country for Gastroenterology (GI) and GI Surgery, according to this year’s U.S. News & World Report’s Best Hospitals in America report.

That’s excellent news!

If you’ve been diagnosed with a digestive or liver disorder, it’s important to know you’re seeing the “best of the best” when you come to our clinic. Our specialists diagnose and treat all GI problems—including inflammatory bowel disease, pancreatic disease, cancer of the GI tract and motility disorders.

We have special expertise with the most complex disorders—intestinal failure, pancreatic disorders, chronic liver disease, cirrhosis complications, liver tumors and viral hepatitis, especially hepatitis C.

When we added specialized endoscopy to our liver service, we brought a level of care unique to this region. Endoscopy of liver bile ducts and liver transplant are mainstays in our referrals.

Our colleagues around the world tell us they would send family members to Omaha if they needed a liver transplant. We heartily agree!

A revolutionary new therapy

We have another gem in our practice—an innovative therapy drawing international attention. Perhaps you’ve heard about it in the news. It may sound “different”—but it’s been tremendously successful in helping very sick patients.

Fecal microbiota transplantation therapy is proving to be an excellent treatment for patients who are fighting a bad intestinal bug–Clostridium difficile, or C. diff. Alex Hewlett, DO, is leading the  team to provide this novel therapy.

Here’s how the problem develops—and how fecal therapy works:

When patients are prescribed antibiotics too often, the drugs can wipe out the beneficial bacteria in the gut. That leaves the intestine vulnerable to attack by C. diff bacteria, which invade the intestine. Patients get very sick, with bloody diarrhea and dehydration. The colon can be damaged; some patients have died.

In many cases, C. diff can be controlled with antibiotics, but at times that fails. Fecal therapy is the only treatment that has been shown to work for 88 percent of patients treated.

What exactly is fecal therapy? It involves taking a watered-down stool from a healthy person (often a relative) and transferring it into the patient’s digestive tract via a tube down the mouth or nose, or into the colon. This “new” healthy bacteria helps to repopulate the digestive tract to combat the C. diff overgrowth.

With fecal therapy, these very sick patients have a chance to get well. The results can be very dramatic—even life-saving. In medicine, we view it as another way for the body to naturally heal itself.

Our international reputation

These complex digestive and liver problems require a robust, comprehensive team with the best medical, nursing, diagnostic, surgical and therapeutic resources—which many hospitals simply don’t have.

For patients who need this level of diagnostics and treatment, we serve as a referral and second-opinion hospital. Physicians need a destination for their sickest patients—and that’s where we excel.

Nebraska Medicine is known nationally and internationally for our work. Patients come here from all over the U.S. –North Carolina, New York City, California—even as far away as the Middle East. We offer a language translation service for those patients, to help them feel comfortable in their interactions here.

Patients like coming to Omaha because of our world-class medical care—and because Omaha isn’t such a big city. They’ve heard it’s easy to get around. They’re right!

Caring for the sickest patients

Referring physicians need a clinic like ours to treat their sickest patients. We’re equipped to do that. But we know that medicine is far more than medical services and technology. We understand the stress our patients are feeling.

Every patient comes to us after receiving bad news from their local physician. They know it’s a potentially life-threatening medical problem. We do our best to allay their fears, address their concerns and provide reassurance and hope.

We want our patients to feel like we’ve wrapped a warm blanket around them. We want them to feel safe, warm and looked after during this very critical time in their lives.

We have a comprehensive team—a nurse coordinator, nurse practitioner, surgeon, physician, social workers, physical therapists, pharmacists – all focused on their care.

This team approach provides great continuity of care. From clinic to hospital to outpatient care to home—we make sure the patient’s care is seamlessly connected. We make sure each patient feels secure, and in expert hands, while facing critical health problems.

With world-class surgeons and physicians—and the best care possible—we give patients the best outcome possible. This is the mission we embrace every single day.

UNMC/Nebraska Medicine named national Ebola training, education center


UNMC/Nebraska Medicine, in collaboration with Emory University in Atlanta and Bellevue Hospital Center in New York City, have been awarded a $12 million grant by the U.S. Department of Health and Human Services (HHS) to establish and co-lead the nation’s National Ebola Training and Education Center (NETEC).

The three institutions will partner with the HHS Office of the Assistant Secretary for Preparedness and Response (ASPR) and the Centers for Disease Control and Prevention (CDC) to support the training of health care providers and facilities on strategies to manage Ebola and other emerging infectious diseases.

UNMC and its primary clinical partner, Nebraska Medicine, will receive $5.1 million of the $12 million federal grant – the largest share of the three collaborating institutions.

Regional Ebola treatment center 

UNMC/Nebraska Medicine is one of nine regional Ebola treatment centers recently named by HHS as part of a national network of 55 Ebola treatment centers with enhanced capabilities to treat patients with confirmed Ebola or other highly infectious diseases.

Ebola treatment centers are staffed, equipped and have been assessed to have current capabilities, training and resources to provide the complex treatment necessary to care for a person with Ebola while minimizing risk to health care workers.

“We are pleased to receive this designation as a national leader in the world’s fight against Ebola and other infectious diseases,” said Jeffrey P. Gold, M.D., UNMC chancellor and board chairman for UNMC’s clinical partner, Nebraska Medicine. “Our campus is in this position because we have selfless, talented individuals who prepared for a decade to care for the sickest of patients in our biocontainment unit. They did so valiantly over several months in 2014, and they also have shared their expertise to train countless others from around the world in preparation for the next highly infectious disease outbreak.

“I also want to thank our state’s congressional delegation for their support and work in helping us receive this significant designation.”

During the Ebola outbreak of 2014, UNMC/Nebraska Medicine was recognized as a national asset and referred to as the “gold standard” for treatment and development of safety protocols to handle Ebola and highly infectious diseases.

UNMC/Nebraska Medicine has the largest operational biocontainment unit in the nation.

UNMC/Nebraska Medicine and Emory University have worked with the CDC since December to train more than 460 health care workers from 87 health care systems, including 37 designated Ebola treatment centers, on all aspects of infection control and patient care for individuals with Ebola.


Philip Smith, M.D., medical director of the Nebraska Biocontainment Unit at Nebraska Medicine and professor, UNMC College of Public Health, is principal investigator of the UNMC/Nebraska Medicine grant from HHS.

UNMC and Emory are offering additional training opportunities this summer for up to 400 staff from Ebola assessment hospitals.
The new National Ebola Training and Education Center will expand on the success of this initial work and offer state health departments and health care facilities additional access to the clinical expertise and training capabilities offered by these institutions.

“The national center contributes to our nation’s health security by developing and teaching evidence-based practices of experienced providers and health care institutions in caring for patients with Ebola and other serious infectious diseases,” said Nicole Lurie, M.D., assistant secretary for preparedness and response for HHS. “While this training starts with Ebola, it also will help the health care community deal with other serious infectious diseases in the future.”

CDC Director Tom Frieden, M.D., said the ongoing Ebola epidemic in West Africa is proof “that a threat anywhere can be a threat everywhere; the United States must continue to prepare.

“Hospitals are often the first place where a new disease threat is recognized. This new center will help our hospitals and health care workers prepare to handle new threats and safely care for patients.”