Modern Medicine

This month, we bring to you the medical marvels making a marked impact in our community one patient, program or surgery at a time.

Hypothermia Saving Lives

Russell Sova remembers eating lunch with his family on August 4, 2010. Suddenly it’s a day later and the 66-year-old Kaukauna man is lying in a hospital bed where he will soon learn that a medical miracle has saved his life.

“We were just talking, then my daughter said, ‘What’s wrong with Dad?’” remembers his wife, Deb Sova, 52. “She called 911, and I went over and shook him. He woke up at that time… then it happened again. His heart had stopped.”

Russell––who has suffered from heart failure, or a weakened heart, for nearly four years––had what medical experts call sudden death.

It took a Kaukauna first responder and emergency medical technicians (EMTs) nearly 25 minutes to get a heartbeat, something doctors say normally causes serious neurological consequences. “The longer the time it takes to resuscitate, the worse the outcome,” says Dr. Patrick Gregory, cardiologist with Affinity Medical Group, who had been treating Sova for his heart condition. “The part that’s interesting is what took place next.”

Gregory’s colleague, Dr. Bradley Lauderdale, a pulmonary and internal medicine provider with Affinity, was on duty and instituted a cutting-edge hypothermia protocol on Sova that spared his neurological system.

By essentially inducing hypothermia for 12–24 hours in sudden-death victims, experts have found significant neurological improvement. Sova woke without injury, feeling mostly normal. Gregory says this is a prime example of a modern-day miracle, where every step of the way everyone did the right thing. First, Deb recognized her husband’s condition and called 911; second, having a well-trained first responder who performed high-quality CPR; and lastly, the introduction of the hypothermia protocol.

“It’s wonderful, the technology that they’re learning nowadays,” marvels Russell Sova, whose memory is still devoid of the event and who now has an Implantable Cardioverter-Defibrillator (ICD) that monitors his heart rhythm for signs of sudden death.

“This is helping a lot of people,” he goes on about the hypothermia protocol. “For me, it really helped. If not for that, I might not be here right now.”

New Hope for Depression

Northeast Wisconsin patients who suffer from major depression may find hope in one technological wonder that has arrived in Appleton.

ThedaCare Behavioral Health is the only facility in the area now offering NeuroStar Transcranial Magnetic Stimulation (TMS) therapy, the first non-invasive, FDA-approved treatment for severe depression. The device is available to patients who are unresponsive to medications and other treatments, such as electroconvulsive therapy (ECT).

“We have a lot of good treatments for depression, but there are always people for whom our treatment is not sufficient,” says Dr. Thomas Beld, staff psychiatrist with ThedaCare Behavioral Health.

Developed by Neuronetics, Inc., TMS uses highly focused, MRI-strength magnetic pulses to stimulate nerve cells in the left prefrontal cortex––an area of the brain linked to depression. Trained ThedaCare Behavioral Health providers administer the pulses in 30- to 50-minute outpatient sessions, without anesthesia or sedation, every day for about six weeks. Patients are awake and the only side effect reported has been mild scalp discomfort at the area of treatment, which notably dissipates after the first week.

TMS therapy research began on the east coast at Harvard Medical School’s Beth Israel Deaconess Medical Center. Since then, patients nationally have noticed positive changes within a few weeks of beginning NeuroStar therapy.

ThedaCare spent more than two years analyzing data, research and treatment before bringing NeuroStar to Appleton.

“Patients are desperately hoping for something new,” Beld explains. “What we want ideally is for people to have remission from their disease, which is difficult to achieve. But this is something that could help in that way.”

Revolutionizing Spinal Surgery

Minimally invasive surgery (MIS) techniques are revolutionizing spinal surgery recovery. Ten years ago, most patients undergoing spinal fusions, disk repairs or deformity corrections faced up to a week’s stay in the hospital and one year of recovery. Today, patients can typically go home the day after surgery.

“Everything is turning toward smaller incisions, shorter hospital stays, less blood loss, and that’s what occurs in minimally invasive spinal surgery,” says Dr. Andrew Greene, a spinal surgeon with Neuroscience Group in Neenah.

For example, traditional lumbar fusions (performed usually to relieve pain, numbness, tingling or weakness, to restore nerve function or stop abnormal motion in the spine) called for a large midline incision where the surgeon would lift the spinal muscles off the bone to graft the area and put in screws and rods. In the process, ligaments are often removed or destroyed.

“Studies have shown that (surgery) leaves the muscle without a blood supply,” Greene explains. “The muscles can be ‘dead’ and become a source for chronic pain.”

With MIS, the surgeon makes smaller incisions slightly off to the side and uses a 90-millimeter tube to go in and remove bone and place in the screws and rods. It creates significantly less injury to nearby muscles.

In the two and a half years Greene has been performing MIS, he has never had to transfuse a patient or seen infection, the latter of which he says is everyone’s worst nightmare.

“I’m a firm believer in this,” Greene says. “Anybody who qualifies for surgery on their spine can have this done, and for the most part my patients have been very pleased.”

Back to Work Sooner After Surgery

Cubital tunnel syndrome is one of the most common nerve compression syndromes, second only to carpal tunnel. The symptoms are comparable: numbness, tingling to the fingers and weakness.

Relieving these symptoms used to mean a long incision at the elbow, anywhere from one to 12 centimeters in length, and up to 8 weeks off work. But today, modern technological advances are changing the way these surgeries are performed.

In Northeast Wisconsin, Dr. Loren M. Potter, orthopedic surgeon with Aurora Health Center in Oshkosh and Fond du Lac, recently became the only doctor in the area to use an endoscopic surgical method for cubital tunnel release. The procedure allows for a much smaller incision––about 20 millimeters––while allowing long decompression of the nerve. It results in far less post-surgical pain for patients and drastically reduces recovery time.

“There are a lot of sensory nerves in the skin that cannot be avoided during traditional, open-incision surgery. Endoscopic surgery avoids all of those nerves,” Potter says. “People are much happier with a two-week return to work and full activity.”

Considering tough economic times, minimally invasive procedures like this are an alluring new option. “There are a lot of people who are willing to have surgery on a Thursday or Friday, and they can go back to work Monday or Tuesday. By two weeks, they’re swinging a hammer,” he notes. “It not only makes their employer happy, but they’re not losing income.”

Medical Marvels: A Team Effort

Cardiologist Gregory knows all too well how rapidly developing medical advances can affect lives. He says a big part of moving forward together comes down to, as a society, looking out for each other. “As a physician, it’s very rewarding to be part of,” he says. “But it’s a team effort starting with family, first responders, paramedics, and all the researchers.”

Whether it’s a scheduled, ground-breaking new surgery or a completely unexpected medical event, staying informed on the latest technology is key.

Research is where Deb Sova urges people to begin. “Be informed about what your condition is and what you need to know,” says Sova, whose first-aid training helped her respond in the emergency situation with husband Russell. “And be prepared; that’s all you can do.”
Whether it’s unprecedented new technology or a cutting-edge combination of treatment and protocol, one thing is certain: at any time, today’s medical marvel can become tomorrow’s modern miracle.

—By Sarah Owen

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