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Archive for January, 2018

New Procedure Stops Fatal Bleeding

When it comes to treating trauma patients, seconds matter. Trauma is the leading cause of death in individuals ages 50 and younger. Uncontrolled bleeding is the number one cause of preventable death from trauma. For the first time in Nebraska, a minimally invasive procedure created in the military, has successfully been used to stop one of our trauma patients from bleeding to death.

“It is a true game-changer for the state of Nebraska. The potential is endless,” says Lisa Schlitzkus, MD, trauma surgeon and associate trauma medical director, who performed the technique for the first time at Nebraska Medicine – Nebraska Medical Center. “This catheter allows us to stop blood flow in the main blood vessel, preventing further bleeding and directing precious blood and oxygen to the brain and heart in a critical situation.”

PryTime’s ER-REBOA Catheter is specifically designed to control bleeding for patients in traumatic arrest and hemorrhagic shock states. The catheter is inserted through the patient’s femoral artery, opening a balloon in the body’s main artery. The balloon material is designed to support inflation while minimizing injury to the vessel.

Prior to this technique being available, Nebraska Medicine trauma surgeons would stop blood flow through a large incision on the chest, which can create a painful wound and place the patient at further risk of damage to other structures and hypothermia. With the catheter, surgeons can stop uncontrolled bleeding less invasively and faster.

From left to right, trauma surgeons Charity Evans, MD, and Lisa Schlitzkus, MD, and vascular surgeon Jason MacTaggart, MD, discuss the new procedure at a news conference on Jan. 24.

“Traditionally, when a patient arrives in critical condition, we have no way to stop internal bleeding other than in the operating room or with interventional radiology. Mobilizing these teams does take time,” explains Dr. Schlitzkus. “This catheter, which can be placed within minutes of arrival, gives us the ability to stop or slow the internal bleeding from the liver or pelvic fractures for example. The catheter is not a definitive treatment; the patient will have to have the bleeding addressed. However, the extra time means we can potentially gather more data about how to best treat the injury, allow time for critical decision making, and arrange for specialized treatment without the risk of the patient arresting or physiologic decompensation.”

The ER-REBOA Catheter was inspired by balloon-tipped catheters for cardiovascular patients, which have been used for decades. Military doctors with experience in vascular surgery created the first balloon-tipped catheter for soldiers with injuries to the lower body. The military prototype was approved by the Food and Drug Administration in 2016 and used on the battlefields in Iraq and Afghanistan. PryTime Medical, a company from San Antonio, Texas, manufactures the ER-REBOA Catheter.

Currently, more than 200 trauma centers in the United States are using the catheter. In late 2017, Nebraska Medical Center became the first trauma center in Nebraska to successfully use it on a patient. The chance of survival is greatest if treatment is given within the first hour following a traumatic injury. Trauma surgeons are hopeful this new catheter will have an impact on the entire state of Nebraska – especially in rural areas.

“Traditionally, these patients would die at a rural hospital,” says Dr. Schlitzkus. “Emergency medicine physicians, while trained to make that life-saving incision on the chest, cannot perform it unless they have a surgeon backup to immediately repair the injuries. Also, if the physician recognized how sick the patient was and transported the patient right away, the patient could decompensate en route. This gives the rural provider a tool that could save lives, stabilize the patient and allow time for transport.”

To schedule an appointment with a specialist at Nebraska Medicine, call +1-402-559-3090 or OIHS@nebraskamed.com.

Named Top 100 for Great Women’s Health Programs

Nebraska Medicine Only Health System in Nebraska to Make the Prestigious List for 2017

Laura Cudzilo, MD, is seen checking in with one her patients. The Olson Center for Women’s Health offers full-service, well-women care.

Nebraska Medicine is honored to be named to the 2017 edition of “100 hospitals and health systems with great women’s health programs” by Becker’s Hospital Review. The hospitals included on the list support award-winning programs in women’s health, breast cancer diagnosis and treatment, gynecology and women’s heart care. Nebraska Medicine is the only health care system in Nebraska to be included on the list.

“When women come to Nebraska Medicine, they can have peace of mind that they’re receiving the highest level of care,” says CEO Dan DeBehnke, MD, MBA. “Our specialists have the proven experience and expertise to guide women through every stage of life, including preventive care and the most advanced medical care when issues arise.”

The list also recognizes hospitals with forward-thinking labor and delivery departments and recognition for their maternity care. Many are high-volume referral centers for their community, servicing women with health care needs across the spectrum.

“Women from all over Nebraska and the region rely on our comprehensive team of board-certified specialists,” says Carl V. Smith, MD, chairman of Obstetrics and Gynecology. “From gynecologic issues to high-risk pregnancies, mental health and cancer screenings, we have the most advanced and compassionate medical care. Patients can be confident they’re in good hands.”

Women’s health services are available at a variety of Nebraska Medicine locations including Bellevue, Village Pointe and Nebraska Medical Center, which houses the Olson Center for Women’s Health, a full-service health center designed around a woman’s needs. The Olson Center promotes wellness, education, research and exceptional clinical care for general OB/GYN, internal medicine, breast care, high-risk pregnancy, lactation consultation, genetic counseling and much more.

“For annual exams, 3-D mammograms or other serious concerns, women will see top doctors who are leaders in medicine and research,” adds Dr. Smith.

To develop this list, the Becker’s Healthcare editorial team selected hospitals and health systems based on national rankings and awards received from several institutions including U.S. News & World Report, which named Nebraska Medical Center as the #1 rated hospital in Nebraska for 2017 and nationally ranked its Gynecology program. Becker’s Hospital Review also named Nebraska Medicine to its “100 hospitals with great heart programs” list for 2017.

To schedule an appointment with a specialist at Nebraska Medicine, call +1-402-559-3090 or OIHS@nebraskamed.com.

Hip Replacement Relieves Patient’s Physical, Mental Anguish

Beau Konigsberg, MD, checks Cathy Sickler’s range of motion in her right leg, during her one-year checkup after having her hip replaced.

You know that short walk you take to get your mail, or the steps you take from one end of the grocery store to the other? We complain about it being too cold outside or the crowds of people we have to maneuver past, but Cathy Sickler isn’t complaining – not anymore.

“Every day when I get up and walk and feel myself walking normally again, in my heart, I am so thankful for this moment,” Sickler says during her one-year post-operation checkup. “I don’t feel like I have very many limitations at all.”

It has been one year since Sickler’s quality of life began to improve after having her right hip replaced. Leading up to her procedure, she had been experiencing hip discomfort for years, due to a labrum cyst, arthritis and ligament strain.

“The pain was so bad that I couldn’t get groceries, had a hard time going up and down my stairs to let my dogs out. I started getting depressed and thought it would never stop hurting,” she remembers.“I was a train wreck.”

When there were no other options but to have her hip replaced, she put her trust in the hands of orthopaedic surgeon Beau Konigsberg, MD, and the rest of her health care team at Nebraska Medicine.

Dr. Konigsberg, goes over Cathy Sickler’s most recent X-rays during her follow-up appointment after having her right hip replaced.

Leading up to the procedure, Sickler was anxious about everything from potential anesthesiology side effects to making sure her legs were both the same length after the hip replacement. She was comforted by the expertise and reassurance she received from her care team.

“I can’t stress enough about how much it was a total team here of people working together to make sure everything leading up to the procedure and after was a success,” she says. “They really seemed to tailor everything to a personalized plan.”

Sickler adds that the time spent by Dr. Konigsberg with her leading up to the procedure was invaluable and helped give her confidence that everything would go as planned.

“Dr. Konigsberg took the time to figure out who I was and what I was about and it helped him understand how to best communicate with me,” she says. “He realized I had to really be sold on the best option and told me like it was, and I really appreciated that transparency and honesty.”

A year removed from having her hip replaced, Sickler has regained her independence back and is back to being able to do more physical activity.

“Before, I couldn’t walk to the mailbox. Now, I could walk five miles I had to. When I walk into the gym, I walk like a boss,” she says with a laugh. “I don’t have a big enough word to describe what this entire experience has meant to me. I’m just so grateful to Dr. Konigsberg and everyone at Nebraska Medicine who helped me.”

To schedule an appointment with a specialist at Nebraska Medicine, call +1-402-559-3090 or OIHS@nebraskamed.com.

Paying it Forward: Husband Donates Kidney to a Stranger

When Tim Nowak’s wife, Judy, needed a kidney transplant, it started a chain reaction that no one saw coming. Pictured are back row, left to right: Tim Nowak (donor), Mark Howard (donor) and Joey Large (recipient), front row, Amanda Canning (recipient), Colette Tesar (recipient) and Regina Pederson (donor).

After His Wife Received a Kidney Transplant, Nebraska Man was Inspired to Give Back in Multiple Ways

When Tim Nowak’s wife, Judy, needed a kidney transplant, it started a chain reaction that no one saw coming. Especially Amanda Canning – a wife, mother and hairstylist from Ogallala, Nebraska, who received a surprising offer inside the local Walmart.

“Tim walked up to me and said, ‘I really want to donate my kidney to you,’” says Canning. “I started bawling inside the store. Tim and I knew each other from church, but that was it.”

In November 2016, a few weeks prior to the Walmart conversation, Judy received a kidney transplant at Nebraska Medical Center. Originally, Tim planned to donate his kidney to Judy – but later learned he wasn’t a good match. Eighty-four days after being placed on the transplant waiting list at Nebraska Medicine, Judy received a kidney from a deceased donor.

“The fact that she got her kidney is a miracle,” explains Tim. “Based on her biological makeup, they thought it might take seven to 10 years before they found a match.”

“It’s a blessing,” says Judy. “I feel amazing. My life has completely changed, all thanks to my new kidney.”

After witnessing Judy’s transformation, Tim knew he wanted to donate his kidney to someone in need. The Nowaks read on Facebook that Canning was sick and needed a kidney transplant. When Tim approached Canning in Walmart, the rest of the pieces started falling into place.

Nebraska Medicine’s kidney-transplant team asked Tim if he’d be interested in starting a living-donor transplant chain, in which an anonymous donor comes forward to donate a kidney to someone they do not know, starting a chain of events where patients with incompatible donors swap kidneys for a compatible one. Kidney transplants from living donors last much longer and tend to do better postoperatively.

“I told them I’d be willing to donate – but I also wanted Amanda to get a kidney too,” says Tim.

In April, Canning received a phone call from the transplant team. They found a match. Canning would officially be part of the living-donor kidney transplant chain – all started by Tim. Surgery was slated for May.

“From the word ‘go,’ this has been an unbelievable experience,” says Canning. “If not for Tim and Nebraska Medicine, I don’t think I would be where I am today.”

Joey Large, a farmer and rancher from Wauneta, Nebraska, finally meets his kidney donor, Tim Nowak, and thanks him.

Even after the surgeries were finished, Tim took his love for helping others a few steps further. While recovering on level six of the Lied Transplant Center, Tim showed a nurse an image on his phone of a butterfly fluttering its wings, causing ripples in the water.

“To me, organ donation is a beautiful thing that starts a ripple effect that never ends,” says Tim. “I took that photo and put it on a canvas – then gave it to Dr. Hoffman, who plans to hang it in the Multi-organ Transplant Clinic for other patients to enjoy.”

Through the help of a generous friend, Tim also arranged for a Caregiver Bed to be donated to the Lied Transplant Center. The bed is retractable and offers care partners a comfortable place to sleep inside the patient’s room. Tim hopes to one day raise enough money for 10 more beds.

“When a patient gives or receives an organ, they must have a care partner with them. This person offers medical, emotional and every day support,” explains Arika Hoffman, MD, transplant surgeon. “The donated bed makes a huge difference for care partners who spend the night at the hospital. We are extremely grateful for the selfless gifts Tim has given. He’s a remarkable person with a big heart.”

On Dec. 22, Tim was honored during a special ceremony at Nebraska Medicine’s Multi-organ Transplant Clinic. Several other donors and recipients who participated in May’s living-donor kidney transplant chain were in attendance, including Tim’s recipient, Joey Large, a farmer and rancher from Wauneta, Nebraska. The two men exchanged letters and spoke on the phone, but have never met in person.

“I have a feeling it will be pretty emotional,” says Tim. “This entire journey has been a blessing. If it weren’t for Judy’s transplant, none of this would have happened. I’m just happy we were able to pay it forward.”

Each year, the number of patients needing kidney transplants increases while the number of deceased donors has remained about the same. If you’d like more information about becoming a living kidney donor, visit NebraskaMed.com/kidneydonor.

 

To schedule an appointment with a specialist at Nebraska Medicine, call +1-402-559-3090 or OIHS@nebraskamed.com.

FDA Learns from UNMC’s Orthopaedic Implant Lab

Ten FDA staffers visit UNMC to study orthopaedic implant testing techniques and developments. They are pictured with Hani Haider, PhD, professor and lab director, center, and Joel Weisenburger, research engineer, left.

Ten implant reviewer experts from the FDA’s Center for Devices and Radiological Health (CDRH) visited Omaha Dec. 6 to 7 to study the orthopaedic implant testing techniques and innovative developments at UNMC’s Biomechanics and Advanced Surgical Technologies Laboratory.

The group included reviewers and supervisors for hip, knee, shoulder, ankle, joint replacement and spinal devices.

“We work hard to develop new testing methods for regulatory purposes and we work with the FDA and the orthopaedic industry for these to become industry standards,” says Hani Haider, PhD, professor and lab director. “The FDA could have gone anywhere, but chose our lab for this topic because of UNMC’s area of excellence. We help shape how the world pre-clinically tests implants.”

In Omaha, the FDA had six one-hour lecture/seminars delivered by Dr. Haider and approximately 10 practical lab demonstrations on various aspects of cutting-edge technology and procedures for implant wear testing.

The FDA group also met with Orthopaedic Department adult reconstruction, shoulder and spine surgeons to exchange ideas on the clinical perspective of implant longevity and regulatory procedures for patient safety.

“The FDA experts who visited Nebraska represent the best that our federal government offers,” adds Dr. Haider. “They are the guardians to screen for badly designed implants, and their excellent work helps most joint replacement patients today enjoy a renewed pain-free life.”

Hani Haider, PhD, professor and director of UNMC’s Biomechanics and Advanced Surgical Technologies Laboratory, shows FDA visitors wear testing equipment.

One of the world’s largest academic, non-profit, industry-neutral facilities for orthopaedic implant wear testing, the lab occupies 4,400-square feet of space directly adjacent to UNMC’s Orthopaedic Surgery Department. On a non-profit basis, the lab has conducted more than 75 orthopaedic implant testing contracts for more than 26 different orthopaedic companies and university labs in the U.S. and internationally.

Knee and hip simulators developed by Dr. Haider allow the lab to perform in vitro implant tests, mimicking lifelike complex forces and motions of the human body, to investigate the function and longevity of artificial joints.

“Our work has firmly engraved the name of Nebraska as a haven for innovative excellence in the world of orthopaedic implant technology testing,” Dr. Haider says. “Year after year, I see the rest of the world’s regulatory authorities from China to Brazil emulating how the U.S. FDA screens implants for their own patients. This helps the U.S. to cement its categorical lead in this arena, helps the U.S. economy, and, most importantly, helps patients worldwide.”

To schedule an appointment with a specialist at Nebraska Medicine, call +1-402-559-3090 or OIHS@nebraskamed.com.

 

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