Archive for October, 2014

Answered prayers

My nephew has a new kidney!

Jeffery Spellman, the young man I told you about earlier this year, has a beautiful new, fully functioning kidney as of June 2.

We are grateful and indebted to the incredible generosity of an unknown donor and their family and will always be praying for them.


Lisa Spellman and her nephew, Jeffery

They will never know the magnitude of this gift.

But we do. I do. And so do total strangers to whom I have spontaneously blurted out the good news.

“My nephew just got a kidney transplant and it’s working perfectly!”

The looks of surprise quickly turn into smiles and hearty congratulations.

Happiness is definitely infectious.

We have a lot to be happy about. And the transplant team couldn’t be happier with how perfectly matched the donor kidney is to Jeffery. You can’t get better than 100 percent, with zero antigens.

Jeffery had 99 out of 100 antigens and finding that one person whom he would be compatible with, well, it took two years. For others, the wait is much longer.

This transplant was definitely orchestrated by a higher power.

Jeffery should have waited 10 years for a kidney, his transplant surgeon, Alexander Maskin, M.D., told us.

The best part was when he said the kidney began producing urine immediately. It’s as if it woke up the moment it touched Jeffery’s body.

As for the surgery, which we were sure would last well into the night, it only lasted two hours and 39 minutes.

We were amazed by how quickly things went.

Dr. Maskin seemed to think it took longer than the usual hour procedure.

“He was a very difficult transplant,” he said explaining the length of time to Jeffery’s wife Ashleigh and other family members in the waiting room that night.

As Dr. Maskin explained the surgery he spoke of a potentially fatal infection that he discovered in Jeffery’s bladder that would have destroyed the new kidney.

Someone was definitely looking out for Jeffery and his precious new kidney.

Jeffery will be just fine.

And I can breathe again.

UNMC hosting largest study ever done on rare movement disorder

More than 50 patients from around the world have come to Omaha
It’s a debilitating disorder that causes people to feel like they are going to fall down when they are standing.

It’s called primary orthostatic tremor (OT), and this week the University of Nebraska Medical Center is hosting more than 50 OT patients from around the world in what is the largest study ever done with OT patients.

“It’s a very rare condition, so it’s quite an achievement to get so many patients to congregate in Omaha,” said Diego Torres-Russotto, M.D., a movement disorders specialist at UNMC. “OT is a miserable disease. Hopefully, this study will help us come up with some answers for these people.”

Dr. Torres-Russotto, who is an associate professor in neurological sciences, said patients will be coming from Spain, England, Canada, Australia and the United States.

The International Orthostatic Tremor Meeting started Monday evening and will run through Friday. This marks the second time Omaha has hosted the event, with the previous Omaha meeting held in 2012. Last year, the meeting was held in Australia.

The patients will each undergo a two-hour physical examination by a movement disorder specialist and a physical therapist, as well as electrophysiological studies. The goal of the study will be to determine if the patients really do have postural instability and to assess the presence of ataxia, a neurological sign consisting of lack of voluntary coordination of muscle movements.

In addition to Dr. Torres-Russotto, the research team in neurological sciences includes: John Bertoni, M.D., Ph.D., professor, and Amy Hellman, M.D. and Danish Bhatti, M.D., both assistant professors.

Collaborators from UNMC’s hospital partner, The Nebraska Medical Center, include: Jen McKune, Lori Schmaderer and Katie Blacketer — Physical Therapy Department; and Cindy Penke, Regan Iske and Bobbi Roeder – case managers in the Movement Disorders Department.

Dr. Torres-Russotto said participants in this year’s study will go through four new features:

  • They will undergo an electroencephalogram (EEG) test, which records brain waves in an effort to determine the place in the brain that is causing the problems. Najib Murr, M.D., assistant professor, neurological sciences, will be performing and analyzing the EEG arm of the study.
  • They will test a smart phone app that can be used to diagnose the disease by measuring tremors in the legs.
  • They will receive specialized video analysis developed at Massachusetts Institute of Technology.
  • They will receive psychiatric assessment by a UNMC psychiatrist, Mark Fleisher, M.D., that will attempt to measure their level of suffering.
    OT is characterized by high frequency tremors of the legs when in a standing position and an immediate sense of instability. Because of the speed of the contractions, OT is often not recognized as a tremor when compared to essential tremor or Parkinson’s disease.

Dr. Torres-Russotto said OT is greatly underdiagnosed and often misdiagnosed as other neurological problems such as Parkinson’s, essential tremor or psychogenic problems.

“People with OT do not typically complain of tremors,” he said. “Their biggest problem is the sudden disabling event that occurs when they stand. They feel unsteadiness and imbalance while standing. They can only stand for a short period of time, in some cases only seconds. There might be a feeling of panic. They need to sit down or start walking to relieve their symptoms.”

OT is a repeating cycle that happens all through the day, he said. It is life-changing and unrelenting.

“It is an incapacitating disorder,” Dr. Torres-Russotto said. “It impacts your life in just about every way imaginable and makes routine tasks such as going to church, standing in line at the grocery checkout, even going to the bathroom a major challenge.”

Some other facts about OT include:

·        It is more common in females.

·        There’s usually a 10-15 year lag between onset of symptoms and diagnosis.

·        Onset typically occurs around age 40.

·        It won’t kill you, but it typically gets worse over time.

·        Diagnosis is confirmed through electromyography, or EMG, a test that measures the electrical activity of muscles.

·        By touching something, the feeling of falling improves.

The UNMC study will be blinded, Dr. Torres-Russotto said, as half the participants will have OT and the other half will have no balance issues.

He hopes the study will lead to further research and treatment options.

For more information on OT, go to http://www.orthostatictremor.org/.

Through world-class research and patient care, UNMC generates breakthroughs that make life better for people throughout Nebraska and beyond. Its education programs train more health professionals than any other institution in the state. Learn more at unmc.edu and follow us on social media.

State of Nebraska Certifies The Nebraska Medical Center as a Comprehensive Level Trauma Center

The state’s largest hospital becomes its only certified Comprehensive Level center

Less than one month after beginning to offer full-time trauma coverage, The Nebraska Medical Center has earned Comprehensive Level status with the State of Nebraska. State inspectors visited the medical center in July, just before it began offering 24/7 trauma care. Among the medical center’s strengths cited in the report: the development of a full-time pediatric trauma program, close working relationships with local rehabilitation facilities and regional education and outreach programs.

“This certification from the state truly validates the work we’ve been doing in recent years to become the region’s premiere comprehensive trauma center,” said Paul Schenarts, MD, trauma medical director at The Nebraska Medical Center. “The expertise and experience of our fellowship-trained surgeons, subspecialist physicians, nursing care and other health care support from hundreds of our other team members is unparalleled in this region.”

In years past, The Nebraska Medical Center shared its Comprehensive Level status with the Omaha Trauma System which was made up of The Nebraska Medical Center and Creighton University Medical Center (now part of Denver-based CHI Health). Until August 1, each hospital had a set schedule of days when it was the city’s designated trauma center. Since August, each hospital has offered its own independent trauma service.

“We have seen a real increase in the number of trauma patients in the six weeks since we began offering 24/7 care,” said Rosanna Morris, chief operating officer and chief nursing officer of The Nebraska Medical Center. “Fortunately, we were prepared for the increase and welcome these new patients. We truly see it as a reflection of the public’s trust in the extraordinary care our staff provides.”

The Nebraska Medical Center will next seek certification from the American College of Surgeons (ACS), which is only available to hospitals offering full-time trauma care. Medical center leaders plan to begin the application process for ACS certification later this year. The ACS review and inspection process typically takes about one year to complete.

Virus-free, Dr. Sacra leaves med center

by Taylor Wilson, The Nebraska Medical Center

Rick Sacra, M.D.

As UNMC Chancellor Jeffrey P. Gold, M.D., put it, Nebraska 1, Ebola 0.

Rick Sacra, M.D., pictured below, the patient who has been treated at The Nebraska Medical Center for the Ebola virus over the past three weeks, has left his room in the Biocontainment Unit and will soon head home. The CDC confirmed that two separate blood samples taken from Dr. Sacra 24 hours apart show the virus is no longer in his bloodstream.

“I am so grateful,” Dr. Sacra said. “Just so incredibly grateful to have gotten through this illness! Many were praying for me, even people I did not know personally. During the time I was here, there was a growing confidence that God was answering those prayers, and that I was steadily improving. Thanks to God and to the team here at The Nebraska Medical Center!”

“It was very gratifying for the entire team that treated Dr. Sacra to see him walk out the doors healthy again,” said Phil Smith, M.D., medical director of the Biocontainment Unit at The Nebraska Medical Center and professor of internal medicine/infectious diseases at UNMC. “When he arrived three weeks ago, he was extremely ill with a virus the world doesn’t have a lot of experience treating. To know that we were able to play a role in helping his body fight off the virus so he could be reunited with his family and continue doing the work he’s so passionate about makes the years we’ve spent training and preparing for something like this more than worth it.”

Dr. Sacra said he also felt fortunate to be in the hands of the team caring for him at The Nebraska Medical Center. “My care team was excellent,” Dr. Sacra said. “They were compassionate, patient and provided an incredibly high level of care.” He said as he started to feel better and was waiting to be allowed to leave the unit, those caring for him did everything they could to keep him entertained. “They brought me books to read, played chess with me and we had conversations about dozens of different topics,” Dr. Sacra said. “My only worry is that I may not recognize them when I am out of the unit, since I only know them by their eyes and their voices!”

The doctors caring for Dr. Sacra say they feel privileged to contribute to the world’s fight against the Ebola virus. “We’ve been in constant contact with the CDC, the World Health Organization and a member of the White House medical staff,” said Angela Hewlett, M.D., associate medical director of the Biocontainment Unit and assistant professor of internal medicine/infectious diseases at UNMC. “We have been sharing everything we’ve learned about caring for Dr. Sacra and we will continue to do so as we have the opportunity to examine all of the data related to his treatment. It is an honor to not only help save our patient’s life, but to potentially save the lives of others fighting this disease around the world.”

Dr. Gold called the Sacras a remarkably courageous family and praised their care team at the med center — the members of the team in the biocontainment unit who put in long hours in a stressful situation, the rest of campus for continuing to perform their duties while helping ease fears of others in the community, and those in the research and clinical areas, a partnership he said “made all the difference.”

Dr. Sacra contracted the Ebola virus while treating patients in West Africa. He works for SIM, an international mission group that responds to areas of need worldwide. “I would like to offer a heartfelt ‘thank you’ to the exceptional doctors, nurses and staff at The Nebraska Medical Center for your caring hearts, keen minds and gifted abilities with Rick and Debbie,” said Bruce Johnson, president, SIM USA. “May God multiply your work, that it will result in the survival of thousands in West Africa who may become infected with Ebola.”

Dr. Sacra became the first patient in The Nebraska Medical Center’s Biocontainment Unit on Sept. 5. Dr. Sacra received a research drug called TKM-Ebola, which inhibits the virus’s ability to replicate. He was also treated with plasma from Ebola survivor Dr. Kent Brantly, along with other supportive care. Doctors say it’s not clear yet if it was a single factor or a combination of all of them that helped Dr. Sacra survive.

“I just want to say thank you to everyone who got me through this,” said Dr. Sacra. “Everyone made me feel so welcome that I am now an official lifetime Huskers fan!”

New cancer screenings available

by John Keenan, UNMC public relations


Jennifer Sanmann, Ph.D., Tanner Hagelstrom, Ph.D., and Amber Carter.

The UNMC Human Genetics Laboratory at the Munroe-Meyer Institute has developed a new set of hereditary cancer tests that can pinpoint genetic mutations that predispose people to certain types of cancer. These tests are now available to providers across campus.

Panels are available to detect familial forms of breast, ovarian, uterine, colorectal, pancreatic, renal, neuroendocrine, and nervous system neoplasms.

“Our laboratory is pleased to offer a service that helps not only with diagnosis but also with treatment management, risk assessment, and familial screening,” said Warren Sanger, Ph.D., laboratory director. “We anticipate that these hereditary cancer tests will be a valuable tool for physicians and their patients at the Fred & Pamela Buffett Cancer Center.”

Associate laboratory directors Jennifer Sanmann, Ph.D., and Tanner Hagelstrom, Ph.D., led the effort to internally develop and validate these panels for clinical use in close collaboration with the Fred & Pamela Buffett Cancer Center.

“We started small, launching a six-gene, high-risk breast cancer panel last November,” Dr. Sanmann said. “With the addition of six new hereditary cancer panels, our services now encompass a wider range of hereditary cancer types.”

The lab has been working closely with Sarah Thayer, M.D., Ph.D., associate director of the Fred & Pamela Buffett Cancer Center, chief of surgical oncology and program leader for cancer services in the clinical enterprise to ensure that physicians in many departments and divisions will find the tests useful.

“Physician input is critical to our laboratory’s test development,” Dr. Sanmann said. “We continually strive to expand our laboratory services in ways that are meaningful for patient care.”

Dr. Thayer praised the collaboration between the Human Genetics Laboratory and the Fred & Pamela Buffett Cancer Center, saying the newly developed panels will advance insights into people who may have familial cancers.

“Genomic characterization of tumors, as well as patients who get these tumors, is really going to be at the forefront of cancer diagnosis and treatment, and hopefully prevention, as well,” she said.

Licensed and certified genetic counselors are available through the Fred & Pamela Buffett Cancer Center’s Hereditary Cancer Clinic to help navigate the complexities of the testing process and to discuss the genetic results with patients. The test can be ordered through the OneChart ordering system, under “genetics” and “hereditary cancer panels.”

For more detailed information about the specifics of each of these hereditary cancer panels, visit the Human Genetics Laboratory website.