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Archive for August, 2016

Life After A Double Lung Transplant

Andrea Mayberry

Andrea Mayberry

I was diagnosed with cystic fibrosis (CF) at birth. I was in and out of hospitals my entire life.

As my disease progressed, doctors said I would not live to be 16-years-old. I was put on the double lung transplant list at Nebraska Medicine – Nebraska Medical Center at the age of 12. I was on the waiting list for over two years.

I received “the call” in July of 1996 — I was almost 15. My mom got the call at 3:00 p.m. on a Friday and I was in surgery by 3:00 a.m. The surgery lasted 12 hours and all went smoothly. I was in the hospital for three weeks after surgery, which was half the time my previous stays were becoming. I was lucky to have lived so close to the med center, as I know many have to travel far for treatment.

Nebraska Medicine became my second home. All the staff including doctors, nurses, respiratory therapists, x-ray technologists and lab techs all knew me by name and were all part of my support system. Many continue to be part of my “family.” After my transplant, I still had appointments with my doctors. Luckily, my transplant coordinator was amazing at keeping things going and keeping everyone on the same page.

Before my transplant, I was on oxygen 24/7 and had multiple breathing and physical therapy treatments throughout the day — just to maintain my rapidly declining health. The way it was going, I would have been lucky to graduate high school, let alone attend college or get married. I am blessed to say that I did graduate high school, I graduated college with a bachelor’s degree in Medical Imaging and am engaged to my fiancé, Merl!

I have worked at Nebraska Medicine as a mammographer for over 11 years now. Life is amazing. I have the med center and its staff to thank, but most importantly, I have my donor and their family. I will forever be grateful to Nebraska Medicine for the care I received then — and continue to receive. They will always be family to me and I’m thankful to live so close to such an extraordinary medical center.

Surgeon’s Legacy Continues, 45 Years after First Kidney Transplant in Nebraska

Richard Steenburg, MD was destined to be a physician from the time he was a child, following in the footsteps of both his father and his grandfather. “My grandfather was a horse and buggy doctor who provided health care for a 60-mile radius covering most of the middle of the state of Nebraska. My father was a Harvard-trained general surgeon,” he recalls.  “From an early age, all I ever thought about doing was becoming a surgeon. In fact, by 10 years of age, I would go after school and observe my father in surgery.”steenburg2

Richard Steenburg, MD (left) performed the first kidney transplant in the state of Nebraska. In his 17-year career at Clarkson Hospital, he performed more than 500 transplants.

 

A graduate of Aurora Public Schools, Dr. Steenburg attended Stanford University, Harvard Medical School and completed his surgical training at the Peter Bent Brigham Hospital. Early in his career, he served on the faculty at Johns Hopkins and became chief of surgery at Baltimore City Hospital, as the first transplant program in Maryland was developed. In 1970, he moved back home to Nebraska, where he built a transplant program from the ground up, and where his education, training and passion continue to have an impact on patients and families today.

“He trained with the best of the best. It was amazing he was willing to come back to the Midwest and get the program started,” says Tavi Baker, who worked for Dr. Steenburg in the 70s and 80s and continues to serve as a nephrology coordinator at Nebraska Medicine.

“He taught us everything. You watched and listened; he talked and explained,” remembers Mary Ellen Krobot, a kidney/pancreas transplant coordinator, who also worked with Dr. Steenburg throughout his 17-year career at Clarkson Hospital. “It’s how I learned the basics. He was a great teacher and wanted people to understand what’s going on.”

Much has changed since 1970, when Dr. Steenburg performed the first kidney transplant in Nebraska. “At the time local surgeons weren’t trained in the proper technique of recovering organs,” he says. “On many of the first transplants, I would fly or drive to hospitals in outlying areas and recover the organs.” Once the kidneys were tissue typed, the team would identify the most appropriate recipients and have them come to the hospital. Then, the patients would receive dialysis, a blood transfusion and be prepared for surgery. “The typical transplant usually took about three hours. Between recovering the organs, preparing the patients and then transplanting the kidneys into the recipients, it wasn’t uncommon to work 24-30 hours straight,” Dr. Steenburg says.

All the work was completed without modern electronic health records – or even computers. Baker and Krobot remember sorting through handwritten lab results and communicating with typed letters. Paper flow sheets were hanging on the walls outside patients’ rooms and Dr. Steenburg memorized many of each patient’s details. “All of the patient information, drug therapies and lab work was kept in paper copy in the patient’s chart,” he says. “But many subtleties of managing a patient were done using one’s head.”steenburg1

Richard Steenburg, MD with transplant coordinators Mary Ellen Krobot and Tavi Baker in 1989. Krobot and Baker continue to work at Nebraska Medicine, and describe Dr. Steenburg as a dedicated surgeon and teacher.

 

Before Dr. Steenburg retired in 1987, he performed 501 kidney transplants. Many of the transplant patients are still living, including some of the first patients from 1970 and his final transplant patient, who received a kidney in April 1987. “Historically, patients with renal failure requiring dialysis were kept on dialysis until their insurance ran out. We were able to provide these very needy patients a chance to live,” he says.  Because of Dr. Steenburg, teens were able to go to college, women were able to raise their families and older people were able to meet their grandchildren.

Dr. Steenburg’s impact continues to be strong today, as Nebraska Medicine treats more than 1,500 functioning kidney/pancreas patients following their transplants. Hundreds more are impacted by the Nebraska Organ Recovery System, which serves all of Nebraska and Pottawattamie County, Iowa. The basis of the nonprofit organization started in a closet of Dr. Steenburg’s operating room. Now, it handles the recovery, transportation and distribution of all organs and tissue for transplantation in the area.

Nearly 30 years have passed since Dr. Steenburg’s retirement, one thing that hasn’t changed – his patients adore him. “They looked at him as their lifeline,” says Baker. Children drew pictures of him, patients continue to ask about him and many participated in a card shower in honor of his 75th birthday fifteen years ago. “Patient satisfaction is probably the best indicator of performance. Hearing from so many patients so many years later led me to believe that we provided a high standard of patient care,” says Dr. Steenburg. That standard of care continues to be Dr. Steenburg’s legacy, more than four decades after his first, ground-breaking kidney transplant in Nebraska.

How Breast Cancer Research Saved My Life

In September 2015, Janet Tinney was diagnosed with breast cancer.

In September 2015, Janet Tinney was diagnosed with breast cancer.

As you listen to the news, read the paper, check Facebook or talk to others, you’re frequently made aware of someone that’s been diagnosed with cancer. You think about them often, pray for them and their family, but then go on with your day-to-day life. Until that one day, when you’re the one receiving the devastating phone call. Where they ask you to come back in – because something doesn’t look right.

Janet at her chemotherapy treatment.

Janet at her chemotherapy treatment.

Over the years, due to very dense breast tissue, I’ve had many calls asking me to return for further testing following a mammogram. I’ve even had a couple biopsies and other procedures. Fortunately, each time the extra tests were performed, I received a phone call with good news that everything was benign – until September of 2015. That’s the year I received a phone call, informing me I had breast cancer.

For the first few minutes, I was stunned and speechless. Then the tears came. My emotions got the best of me. Until you’re the one getting that phone call, you never truly know what it’s like. My father passed away due to cancer. I spent nearly two years going to appointments and treatments, waiting through every surgery. Even though the experience with my dad was unpleasant in the end, I knew I had been given the knowledge and strength to deal with my own cancer battle.

As a caregiver, my first thoughts were about my husband and children. I knew this situation would be tremendously stressful for them. At the time, I felt helpless, but knew my family and friends would be my rock.

The day I was diagnosed with cancer, I was sent to a local surgeon in North Platte, Nebraska. He was incredible, but knew I needed to see the very best.

I was referred to Nebraska Medicine surgical oncologist Edibaldo Silva-Lopez, MD, PhD. During the first visit with Dr. Silva in Omaha, I barely let him speak before peppering him with questions about my future. Did I need to get my things in order? If so, how long did I have? He looked me straight in the face and said, “that is not even a concern for you.” He was certain I would survive. My heart danced!

Edibaldo Silva-Lopez, MD

Edibaldo Silva-Lopez, MD

Dr. Silva’s recommended treatment plan for me was newly approved, but research showed the results were very positive. Within the next couple weeks, we began treatment at the cancer center in North Platte. Everything started to happen just like Dr. Silva said it would. He anticipated my cancer journey would be about a year long, barring any complications.

But, after two rounds of chemotherapy, we were in for quite a surprise. During an ultrasound of my breast, the tumor was nowhere to be found. My radiologist was completely shocked. What a happy day!

I completed two more rounds of chemo, followed by a regimen of drugs. In January, Dr. Silva performed surgery, removing a margin of tissue where the tumor once was, along with 17 lymph nodes. About a week later, I received a phone call from Dr. Silva’s nurse, Carol, telling me all the tests performed on the removed tissue and lymph nodes were negative for the cancer! The treatment plan Dr. Silva gave me worked.

When this journey began, my husband and I both prayed for a miracle. That miracle was not for the cancer to just go away, but for me to be directed to the right physicians with the knowledge to cure my disease. In my opinion, my prayers were answered and my miracle was granted. Without cancer research and the dedication of physicians who put it to use, who knows where my journey would have led. But, because we are fortunate enough to have these services in Nebraska, I am able to look forward to a bright future.

I now pray for a financial miracle so that breast cancer research can continue to evolve at the Fred & Pamela Buffett Cancer Center for many, many years to come. I am living proof that this research does make a difference.

Janet-blog-2-1024x490

Computer Aided Detection: New tools to help your doctor find cancer

Neil Hansen, MD

Neil Hansen, MD

Prostate and breast cancer are two of the most common cancers around. Unfortunately, most people know someone who has one of these. Many doctors have spent their careers trying to design screening tests to find these tumors at an early stage when they are still curable. This usually means finding them when they are really small. That sometimes means smaller than a pea.

So, how do we find these cancers? For breast cancer, the standard screening exam for years has been mammography – taking an x-ray of the breast and looking for cancer. Recently, Nebraska Medicine Radiology has adopted a fancier version of this – tomography—which is a 3D x-ray. On mammography, finding cancer can be tough. It can be seen as only a few tiny dot sized areas of calcium—little blips of white on the screen. To help find these doctors use computer aided detection (CAD). This is a computer program that takes the mammogram and identifies these calcifications. Studies have shown that these programs allow doctors to find earlier cancers better, especially younger and less experienced doctors.

While CAD has been used in mammography for years, it is relatively new for looking at prostate cancer. Screening for prostate cancer has been controversial, but traditionally has relied on physical exam (the finger / glove test frequently dreaded by men) and a lab test called Prostate Specific Antigen (PSA). If one of these is abnormal, that leads to a biopsy. In the prostate, biopsies are often randomly aimed because we don’t know where the cancer is. If one of the biopsies is positive then you know there is prostate cancer, but not necessarily its stage. If the biopsy is negative, then the tumor might have just been missed. This is where prostate magnetic resonance imaging (MRI) comes into use.

Prostate MRI uses a powerful magnet to take pictures of the prostate. It is sometimes hard to differentiate cancer from an old infection on MRI. This is where CAD is used. We recently acquired DynaCAD at Nebraska Medicine Radiology. It is a new tool where a computer program helps us identify cancer based off of blood flow in the prostate and other imaging parameters. A similar program has been in use for breast MRI, and we just acquired the latest software package for this as well. Our use of these doesn’t cost patients anything extra. The goal in the future is to use this program to do targeted prostate biopsies of suspicious areas and avoid randomly missing tumors.

These exciting new products will help us find early stage curable cancers. They aren’t perfect though and still require an expert radiologist to interpret their findings. At Nebraska Medicine Radiology, our specialty trained radiologists are committed to apply our expertise and all tools available to provide extraordinary care to our patients.

Look How Far We’ve Come!

Cancer-Center-Nov.-20[1]Our skyline is changing! The photo to the left was taken Nov. 20, 2015 of the Fred & Pamela Buffett Cancer Center. It’s a dramatic comparison to the next photo, which was taken on July 15.

The new cancer facility, which is expected to open May 2017, will ensure Nebraskans and patients throughout the region will have convenient and quick access to the latest breakthroughs in cancer therapy. A joint project of Nebraska Medicine and UNMC, the Fred & Pamela Buffett Cancer Center will include three areas dedicated to cancer: a 10-story, 98-laboratory research tower named the Suzanne and Walter Scott Cancer Research Tower; an eight-story, 108-bed inpatient treatment center named the C.L. Werner Cancer Hospital; and a multidisciplinary outpatient center.7-19-Cancer-Center-picture-from-July-151-300x225

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