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Tailored Treatment for Head-and-Neck Cancer Mystery

Fri, 15 Sep 2017 17:27:13 +0000

Treatment Terms Head and Neck Cancer Overview Rob Vaughn found a lump on his neck that turned out to be cancer that had spread from somewhere else in his body. The trouble was, doctors couldn’t find the original site of the cancer. That made his treatment decisions difficult -- until two Duke specialists offered him options, including the option for watchful waiting instead of extensive treatment. Hero Image 20170914_robvaughn_neckcancer_005.jpg Preview Image Content Blocks Header A Search for the Source of Cancer Content Vaughn, a Charlotte, NC, father of two, was 47 and in good health when he felt the lump on his neck, just above his left collarbone.  It turned out to be a tumor in a lymph node. He had it removed, and the pathology report showed it was squamous cell carcinoma -- a type of cancer that usually starts on your skin or in your mouth or throat. Tests also showed that the cancer had spread beyond the lymph node, so Vaughn would need follow-up treatment. Knowing where the cancer had started could help doctors determine the best way to treat it. Vaughn traveled to some of the best-known cancer centers in the U.S., undergoing tests and looking for answers. He even had his tonsils removed as a preventive measure. “Nobody seemed to know where the cancer started,” he said. “So there were differing opinions on what course of treatment to pursue.” Still unsure but wanting to take the most cautious approach, Vaughn scheduled surgery followed by radiation at a cancer center far from home. Because there was no specific cancer site to target, the radiation would cover a large part of Vaughn’s mouth and throat. Section Features Text Content Section Header Image/Video 20170914_robvaughn_neckcancer_003c.jpg Section Features Images/Media Text Content Header Teaming Up to Find the Right Treatment Content Together the doctors searched for the primary cancer. Each time, Vaughn’s tests came back negative. At that point, the doctors theorized, “as likely as not, this was a skin cancer that either originated in the location where Mr. Vaughn first felt it, or it started somewhere on his face and spontaneously regressed -- which can happen,” said Dr. Brizel. If it was a skin cancer, removing and testing additional lymph nodes in Vaughn’s neck might be the only treatment he needed. Dr. Lee performed the surgery, removing 30 lymph nodes. None tested positive for cancer. That was good news, but it meant Vaughn had a choice to make in terms of what to do next. He could choose the typical approach for “unknown primary” cancer: extensive radiation with the potential for long-lasting side-effects. Or he could choose active surveillance in the form of frequent imaging tests. “We felt that, whatever the cancer was, it was very small,” said Dr. Lee. “With our current technology and PET scans, we could follow where this primary cancer might show up. If it ever did show up, we could catch it very early.” Section Features Text Content Header The Choice to Watch and Wait Content Drs. Brizel and Lee explained the potential risks and benefits of each option. Vaughn was particularly struck by the fact that a radiation oncologist was suggesting he consider not having radiation therapy. Dr. Brizel says that’s essential to his role. “Whether you’re a radiation oncologist or a surgeon, it’s mandatory that you know how to do what you’re trained to do extraordinarily well,” he said. “But it’s equally important, whatever specialty you’re in, to know when not to do something.” Ultimately, Vaughn chose active surveillance. “I went back every couple of months at first, did some PET scans, had some other X-rays, and started alternating between seeing Dr. Lee and Dr. Brizel -- which I st[...]



First Use of Cadaver Nerves to Repair Corneal Anesthesia Shows Promise

Fri, 08 Sep 2017 18:56:54 +0000

Treatment Terms Corneal disease Overview A new, minimally invasive procedure that replaces damaged corneal nerves with a donor nerve restores feeling in the cornea and halts progressive eye damage caused by a condition known as corneal anesthesia. The use of the donor nerve, an advance pioneered at Duke, may help people recover faster after surgery and could impact how other chronic eye conditions are treated. Content Blocks Header What Is Corneal Anesthesia? Content Corneal anesthesia -- the medical term is neurotrophic keratopathy -- is a potentially devastating condition that can arise after certain viral infections of the eye, brain tumors or surgery, diabetes, contact lens abuse, and other causes. It occurs when the nerves to the cornea are damaged, leaving the eye unable to feel sensation when injured. “Without the ability to sense pain, the eye cannot protect itself from, or heal properly after, scratches and injuries,” said Ilya Leyngold, MD, a plastic and reconstructive eye surgeon at Duke. This can lead to severe infection and vision loss. Until recently, treatments for corneal anesthesia focused on protecting the eye from further damage -- using drops to keep the eye lubricated, wearing a protective hard contact lens, or having the eyelids stitched together -- but didn't treat the problem. Several years ago, doctors considered replacing the damaged corneal nerves with a healthy nerve found underneath the eyebrow. However, because the extensive procedure required a large surgical cut from ear to ear, it was rarely considered as an option. Section Features Text Content Header Transferring Nerves with Smaller Incisions Content Doctors began experimenting with a new way to repair the damaged nerve, using small incisions to transplant a segment of nerve -- called a graft -- from a patient's leg. The minimally invasive procedure treated corneal anesthesia but carried an additional risk of complications at the site in the leg where the nerve graft was removed. Section Features Text Content Header Replacing Patient’s Healthy Nerves with Cadaver Nerves Content Nerves harvested from cadavers have been used extensively to regenerate damaged nerves elsewhere in the body, and research showed they are comparable to a patient's own nerves. Dr. Leyngold thought they could be an option for treating corneal anesthesia as well. The new option is less invasive, as a nerve would not need to be removed from the patient's leg. This would minimize the risk of complications. Initial surgeries have been successful. A clinical trial is about to get underway, which will allow Dr. Leyngold to further test this method. Ideally, Dr. Leyngold said, the new approach will allow people with corneal anesthesia to be treated earlier -- hopefully as soon as it is diagnosed. This could halt its progression before serious eye damage occurs. Said Dr. Leyngold, "Because the use of the cadaver donor nerve involves less surgery, less downtime, and potentially fewer complications, it's my hope that we can increase the number of patients we can help, and someday offer this procedure to people who have only partial loss of corneal sensation such as seen in other chronic eye conditions, including certain types of dry eye." Section Features Text Content CTA Button Corneal Disease Care at Duke CTA Header Learn More About Hero Image 20170825_leyngold_eye_03.jpg Preview Image Featured Doctors and Providers Ilya M. Leyngold, MD Body [...]



Surgery, OT Restores Hand Function After Devastating Injury

Wed, 30 Aug 2017 20:16:30 +0000

Treatment Terms Hand pain and injury Physical and occupational therapy Author Hallie Potocki Overview Beth Hufner’s body was shattered and her left hand hung motionless after she was struck by a truck during a morning run near her Hillsborough neighborhood. Duke orthopaedic specialists used complex surgery and extensive rehab to help her regain the use of her lifeless hand. Hero Image 20170815_bethhufner_arm_01.jpg Preview Image Content Blocks Header Her Hand Hung Like a Rag Doll Content It was 6:30 on a crisp North Carolina morning in December 2016 when Hufner, 39, was struck by a pick-up truck that had veered out of control along Highway 57. Hufner had just reached mile 10 of a 14-mile pre-marathon practice run. “I woke up in a roadside ditch," said Hufner, who is a wife, mom, and part-time fitness trainer. Her injuries included a broken pelvis and foot, neck fracture, three broken ribs, a leg gash, and a left arm completely broken in two. Her left hand, Hufner said, “just hung there like a rag doll.” An ambulance transported Hufner to Duke University Hospital, a Level 1 Trauma Center where trauma teams and specialists treat the most severe injuries. Section Features Text Content Section Header Image/Video bethxray.jpeg Section Features Images/Media Text Content Callout I assured Beth that our entire orthopaedic team was in her corner, and we would do everything possible to get her active quality of life back.  Callout Image Callout Source Grant Garrigues, MD Section Features Quoted Callout Section Header Image/Video 20170815_bethhufner_arm_07.jpg Section Features Images/Media Text Content Section Header Image/Video 20170815_bethhufner_arm_03.jpg Section Features Images/Media Text Content CTA Header Learn More About CTA Button Hand Pain and Injury Treatment Patient Name Beth Hufner Patient Photo Gender Female Patient Story Quote I’m still working on improving my grip strength, but I’ve got my life back. Featured Doctors David S. Ruch, MD Grant E. Garrigues, MD Julie A. Lunich, CHT, OTR/L Sidebar Box Sidebar Box Header Learn More Sidebar Box Text Discover how Duke Orthopaedics treats hand injuries across the Triangle. Sidebar Links Link Hand Pain and Injury Treatment Desktop Only Do not display phone numbers Related Locations Duke University Hospital Body [...]



Eleven-Year-Old Boy Receives Kidney for Christmas at Duke

Thu, 24 Aug 2017 18:39:17 +0000

Treatment Terms Pediatric Kidney Transplant Author Hallie Potocki Overview After battling kidney disease his entire young life, 11-year-old Kaleek Beatty got the best present he could ask for, just five days before Christmas 2016. Duke Children's Hospital called to say they had found a kidney for him. Hero Image kaleekbeatty_blog.jpg Preview Image Content Blocks Header Born with Kidney Disease Content Ask a typical 11-year-old, “What do you want to be when you grow up?” and you’re likely to hear “sports superstar” or “rock musician.” Ask Kaleek Beatty, though, and his unhesitating reply is, “kidney transplant doctor.” “I want to be able to help other kids the way the doctors at Duke helped me,” answered Kaleek, reflecting the same upbeat, can-do attitude of his mom, Latisha, and dad, Corey. Latisha added, smiling, “If Kaleek says he’ll be a doctor helping kids with kidney disease one day – count on it.” Kaleek was born with posterior urethral valves (PUV), a condition that affects about one in 8,000 boys and occurs when a boy is born with extra flaps of tissue in the urethra, the tube that leads from the bladder to the tip of the penis. The flaps block normal urine flow, which can cause painful and frequent urination, recurrent urinary tract infections, and urinary backflow (when urine flows backward from the bladder into the kidneys). This can lead to tissue damage and chronic kidney disease.  Section Features Text Content Header Living a Normal Life Despite Kidney Disease Content For the first 10 years of Kaleek’s life, Duke pediatric nephrologists and urologists worked together to tailor his treatment.  This included constant monitoring, dietary choices, and medications to control his blood pressure, balance his electrolytes, and strengthen his bones. He also had surgery to address the blockage in his urinary tract. When he was four, a small opening was created in Kaleek’s bladder through the abdomen to allow urine to flow more easily. The procedure let Kaleek grow and develop as normally as possible, and delayed the progression of his chronic kidney disease. The strategy worked. Kaleek lived a relatively normal life until about a year ago.  Section Features Text Content Header Time for a Kidney Transplant Arrives Content Kaleek’s team -- including pediatric nephrology, urology, and transplant -- knew he would eventually outgrow his damaged kidneys. “Our doctors’ long-term strategy and collaborative effort enabled Kaleek to avoid dialysis and at the appropriate time move directly toward kidney transplantation,” said Dr. Eileen Tsai Chambers, MD, medical director of Duke’s Pediatric Kidney Transplant Program. “Increasingly, my son could walk only short distances before he’d get tired,” said Corey. “If he played basketball on Saturday morning with his team, it would take the rest of the day to get his energy back. More and more, Kaleek needed frequent restroom breaks. He even asked me, ‘Dad, how come I’m different now?” “Kaleek was born with chronic kidney disease. As puberty nears, many of these children outgrow their limited-functioning kidneys and require either dialysis or kidney transplantation,” Dr. Chambers said. In Kaleek’s case, the time for a kidney transplant had arrived. To prepare his bladder for the transplanted kidney, his kidney specialists used an innovative balloon catheter, developed at Duke, to close the small opening in his bladder. Kaleek was placed on the transplant waiting list. Section Features Text Content Header A New Kidney for Christmas Content “My heart almost stopped when Dr. Chambers said[...]



After Skull Base Tumor, Dancer/Model Takes on Law School

Wed, 23 Aug 2017 17:49:33 +0000

Treatment Terms Skull base tumor Author Karen Doss Bowman Overview Victoria Vesce had surgery and 28 rounds of radiation for rare tumors in the base of her skull and in her neck. Four days after her last radiation treatment, she started law school. Hero Image 20170809.vesce_.victoria.03.blog_.jpg Preview Image Content Blocks Section Header Image/Video vesce_honeybee_blog.jpg Section Features Images/Media Text Content Section Header Image/Video vesce_blog_secondary3.jpg Section Features Images/Media Text Content Header A Regional Destination for Rare Head and Neck Tumors Content Patients from throughout the Southeast come to Duke Hospital for treatment of rare head and neck tumors. Having an experienced team of surgeons and cancer specialists offers patients a chance for recovery and a positive outcome. As for Vesce, she’s feeling great and ready to tackle the world. Though the tumor caused a permanent loss of about 90 percent of her hearing in her right ear, she grateful for what she’s learned through the experience. Vesce credits her faith, family, and friends for seeing her through uncertain times. And no one was more patient and comforting than her “fur baby” Daisy, a French bulldog-Boston terrier mix. “I’m more patient with myself, and even more patient with others,” said Vesce. “Now, when I see someone with a disability, I have empathy and a heart for them. I’ll never clearly hear again, but I’m not going to let that stop me. You’re not promised tomorrow, you’re not promised your health. I’m seizing every moment and not letting obstacles define my life.” Section Features Text Content CTA Header Learn More About CTA Button Skull Base Tumor Treatment at Duke Patient Name Victoria Vesce Patient Photo Gender Female Patient Story Quote I’ll never clearly hear again, but I’m not going to let that stop me. I’m seizing every moment and not letting obstacles define my life. Featured Doctors David M. Kaylie, MD, MS Ramon M. Esclamado, MD, MS Ali R. Zomorodi, MD John P. Kirkpatrick, MD, PhD Related Blog Posts Treating skull base tumors Related Locations Duke Otolaryngology, Head and Neck, ENT, Oral Surgery Body [...]



View the Eclipse Safely with These Expert Tips

Fri, 04 Aug 2017 12:22:36 +0000

Treatment Terms Eye care Retinal disease Author Sarah Avery Overview As excitement about the Aug. 21 solar eclipse builds, it’s important to know how to safely view the event and understand how even everyday exposure to the sun can damage vision. Duke retina specialist and ophthalmologist Lejla Vajzovic from the Duke Eye Center shares her insights. Content Blocks Header How does the sun damage eyes? Content Anytime you stare at the sun, you risk damaging your eyes, because the sun causes a physical burn at the back of the eye. The retina is essentially an extension of the brain, and it’s made up of very thin cells, and when you stare at the sun, this can burn those sensitive cells. The damage might not be immediate – you could stare at the sun and your vision might seem fine for the rest of the day – but then the next morning awake and be shocked that your eyesight is impaired or even gone. Section Features Text Content Header Are some people more susceptible to damage? Content People who have any kind of macular degeneration – which affects the central part of the eye – need to be especially cautious with any sort of sun exposure. And anyone who has retinal dystrophy/degenertation, cataracts, or skin cancer should also take care to protect their eyes when outdoors.  Section Features Text Content Header Couldn’t I just fleetingly look at the eclipse and avoid problems? Content If you are in one of the parts of the United States that is in the path of the total eclipse, there will be a brief moment when the moon will appear to completely cover the sun. For that very little bit of time, it would be safe to look. But you don’t want to risk looking too long, so it would be best not to. And most people will not be in the path of the total eclipse, and will instead see a partial eclipse. So at no point would it be safe to look at the event without protective eyewear. Section Features Text Content Header Could I wear dark glasses or a good pair of UV-protective sunglasses? Content No. Not even high-quality sunglasses or very dark lenses are adequate to protect your eyes if you want to view the eclipse. The only “eclipse glasses” sufficient for viewing this event include special-purpose solar filters. They must meet a very specific worldwide standard known as ISO 12312-2 (international safety standard), and any eyewear purchased for viewing the eclipse must have this designation.  According to the American Academy of Ophthalmology and the American Astronomical Society, only four manufacturers have certified that their eclipse glasses and handheld solar viewers meet international safety standards: Rainbow Symphony American Paper Optics Thousand Oaks Optical TSE 17 Another option is to view the eclipse through #14 welder's glass, which is much darker than the shades arc welders typically wear. Section Features Text Content Content The American Academy of Ophthalmology and the American Astronomical Society teamed up to offer this additional advice: Inspect your solar filter before the eclipse, and don't use it if it's scratched or damaged. Use solar filters on camera lenses, binoculars, and telescopes.  Do not use solar eclipse glasses to look through a camera, binoculars or a telescope. The sun can melt the filter and damage your retina Section Features Text Content CTA Button Eye Care at Duke CTA Header Learn More Hero Image eclipse2photo.jpg Preview Image Categories Helpful tips [...]



Should You See a Chiropractor for Back Pain?

Wed, 28 Jun 2017 17:30:00 +0000

Treatment Terms Spine Overview Nearly everyone suffers from back pain at some point. One treatment option is chiropractic care, which includes spinal manipulation (also called manual manipulation). A review of research, published in the Journal of the American Medical Association, found that spinal manipulation can help relieve pain and improve function in people with acute low-back pain, one of the most common types of back pain. Content Blocks Content Duke chiropractor Eugene Lewis, DC, MPH, answers questions about how chiropractic care can help. Section Features Text Content Header What kinds of conditions does a chiropractor treat? Content I mainly see spine-related conditions. It could be pain in the low back, called the lumbar spine, or in the upper back, called the cervical spine. It could be an injury or it could be chronic. It could be related to a disc problem. It could involve leg or arm pain or headache in addition to back or neck pain. Chiropractors work with other parts of the body, too -- knee injuries, shoulder injuries, things like that -- but my main focus is on the spine. Section Features Text Content Header When can a chiropractor help with back pain? Content People often want to try the most conservative approaches first. So before considering treatments like injections or surgery for back pain, they may want to consider things like chiropractic care, physical therapy, or oral pain medications. Much of the time, back pain resolves with those kinds of treatments. Section Features Text Content Header What types of chiropractic treatments do you offer? Content I primarily work with patients using manual manipulation. That means I’m using my hands to try to improve mobility. If I can improve joint mobility in a certain area -- the spine, neck, middle back, lower back, pelvis -- then I may be able to reduce muscle tightness or the irritation of nerves that travel down the arm or leg, causing numbness or tingling, pain, or even changes in strength. I sometimes use ultrasound, electrical therapy, or traction as well, but the main service I use is manual manipulation.  Section Features Text Content Header What are some other aspects of chiropractic care? Content I spend about 20 to 25 percent of my time talking with and listening to my patients. We talk about flexibility; we talk about strength-building; we talk about balance. I look at your ergonomics: What do you do for work? How do you bend, turn, lift? Do you ride in a car all day? Sit in front of a computer? I try to understand what may be contributing to the pain. Often I’m trying to help patients by encouraging them: “Yes, you can do this,” or “When something like this happens, try to do this instead of that.” That way, they’re not anticipating pain and causing more pain and more muscle spasms. Pain scientists have found that anticipation of pain can lead to more episodes, more muscle spasms, more headaches, and so forth. So teaching patients that there’s another way is important. Our goals focus largely on returning people to the activities that are necessary in their lives, whether those are job-related, family or socially oriented, or recreational in nature. Active people are more healthy and more happy.     Section Features Text Content Header What should I expect at my first visit to a chiropractor? Content It won’t be a lot different from what you’re used to with o[...]



When Can a Doctor Help Your Back Pain?

Wed, 28 Jun 2017 17:08:37 +0000

Treatment Terms Back pain Tags Back pain Sub-Title Answers to Common Back Pain Questions Overview More than eight in 10 people will experience back pain at some point in their lives. In most cases, the pain goes away over time. If your back pain is severe or does not improve, you may need medical care. Here are answers to some common questions about back pain and tips on when to seek help. Content Blocks Header Why Does My Back Hurt? Content There are various reasons why your back can hurt, including muscle pain, disc pain, joint pain, or nerve pain. In most cases, these are not harmful or dangerous. “There are some instances when pain can be a symptom of a more serious problem, such as a fracture, infection, or cancer affecting the spine,” said Anand B. Joshi, MD, MHA, a Duke physiatrist (physical medicine and rehabilitation doctor) who specializes in spine care. “Thankfully, these conditions are very rare and usually only affect people with special risk factors.”  Section Features Text Content Header When Should I See a Doctor for Back Pain? Content When your back first starts to hurt, try taking an over-the-counter pain reliever (for example, aspirin, ibuprofen, or acetaminophen) and applying ice. You may need to take it easy for a while, but “It’s best to stay as active as possible, and to avoid bed rest,” said Dr. Joshi. If your pain is severe, lasts several weeks, and keeps you from participating in normal, daily activities, see a doctor. You should seek medical care sooner if you have: Fever associated with back pain Back pain after trauma Loss of bladder or bowel function Loss of strength Unexplained weight loss associated with back pain Also, always be more cautious if you have special risk factors for cancer, infection, or fractures that may affect the spine. Section Features Text Content Header What Doctor Should I See for Back Pain? Content If your back pain is from a recent strain or mild injury, your primary care doctor can probably help. But if the pain is severe, ongoing, or accompanied by other symptoms such as numbness or tingling in your arms or legs, it may be time to see a back doctor. Start with someone who specializes in nonsurgical treatment for back pain. This can include a physiatrist, chiropractor, or orthopaedic physician assistant. They can evaluate your condition and offer appropriate treatment to help alleviate your pain. Depending on your circumstances, they might also refer you to another type of back specialist -- for example, a physical therapist, pain management specialist, or spine surgeon. Section Features Text Content Header What Happens When I Visit a Back Doctor? Content “We gather a full medical history of your back problems and perform detailed physical examinations,” said H. Michael Guo, MD, PhD, another Duke physiatrist who specializes in spine care. “That includes checking for tenderness, spine range of motion, strength, sensation, and reflexes. Depending on your symptoms, we may perform provocative tests to find out what triggers your pain. We may order imaging, such as X-rays, MRIs, or CT scans. We may order an electromyelogram, or EMG, which measures the electrical activity in your muscles, or a nerve conduction study, which can help identify nerve damage. We use all the information to help identify the cause of your back pain and recommend the most appropriate treatment for you.” Section Features Text Content Header What If I Don’t Want Surgery for My Back Pain? Content [...]



Scientist Gets an Assist with Hearing Loss

Fri, 23 Jun 2017 16:52:11 +0000

Treatment Terms Speech pathology and audiology Categories Aging health Family health Advanced treatments Sub-Title Discovers Hearing Aids Aren’t What They Used to Be Author MaryAnn Fletcher Overview Nobel Prize-winning biochemist Robert J. Lefkowitz, MD, had trouble hearing questions in large lecture halls -- until he tried today’s hearing aids. Hero Image lefkowitz_legs_desk_blog2.jpg Preview Image Content Blocks Content Dr. Lefkowitz, 74, has received some of the world’s most prestigious honors for his research, which has made possible the development of countless medicines. But, like many people, the Duke professor started to notice a decline in his hearing as he got older. “For a number of years, I have been aware of gradually reduced hearing acuity,” he said. At meetings with his lab group of about 20 researchers, he said, “More and more often I would have to say, ‘Could you say that again?’ While watching TV, I virtually always had the closed-captioning on.” Dr. Lefkowitz knew hearing aids could help, but he had misgivings. “My mother wore them for years. They were always misfiring and giving off this loud tweeting noise,” he said. Eventually, though, the frustration drove him to seek a solution. Section Features Text Content Section Header Image/Video lefkowitz.blog_.jpg Section Features Images/Media Text Content Header Technology Improves Hearing Aids Content “You can hardly see these,” Dr. Lefkowitz said of the tiny aids he now inserts in each ear -- far cry from the large plastic devices he remembers. “There are no batteries to replace. At night, you just put them into a charging box, they charge overnight, and then they’re ready the next morning.” His hearing aids also allow him to adjust for various environments and sound levels. “I have a remote control that allows me to, with a click, increase or decrease the volume,” he said. “If I’m giving a lecture and taking questions, I keep it in my pocket.  If somebody’s talking, and they’re a little too low, I’ll jack it up.” His hearing aids also have been customized based on the results of his hearing test, so they give a bigger volume boost to those frequencies he has the most difficulty with. Catalano says most modern hearing aids do this. “They’re programmed to each person’s hearing profile,” she said. “Then they’re pretty automatic, in that they adjust depending on your listening environment. So if you’re in a quiet room versus a noisy restaurant, if you’re speaking to someone who’s pretty soft-spoken versus someone who has a loud voice, the hearing aid automatically adjusts for you.” Overall, Catalano said, technology advances have made today’s hearing aid a better experience for users. “They sound more like people want them to sound, and they feel more comfortable on the ear,” she said. “They’re much smarter than they used to be, so the patient doesn’t have to do too much outside of putting them in and going about their day.” Section Features Text Content Header Breaking Down Barriers to Hearing Improvement Content Catalano noted that, like Dr. Lefkowitz, many people who might benefit from hearing aids put off getting them. Some never take that step at all. “There’s still a stigma that hearing loss is a sign that you’re aging,” she said. “Research shows that, from the point people are told they have a hearing loss, the average time until they do something about it is five to sev[...]



Clinical Trial Saves Baby’s Lungs

Fri, 23 Jun 2017 12:47:58 +0000

Treatment Terms Children's health Categories Clinical trials Family health Tags Patient story Sub-Title Baby Collier Proves He’s a Survivor Author Burgetta Wheeler Overview Collier Hart sat smiling in his crib repeatedly saying, “Wa wa.” Given a sippy cup of water, he threw back his head and drained it. He put his hands together, fingertips touching, and made the sign for “more.” None of this is unusual for a 2-year-old, but it is for Collier. He spent the first 15 months of his life at Duke Children’s Hospital after being born with severely underdeveloped lungs. Hero Image collier_hart_patient_experience.jpg Preview Image Content Blocks Header Against All Odds Content “All the odds were against this kid,” said William Malcolm, MD, a neonatologist and medical director of Duke's Special Infant Care Clinic. “He’s thriving, and the reasons he’s thriving are his parents, the amount of services we provided at Duke, and Collier himself. You get emotional about outcomes like this.” Before Collier was born, tests at Duke Children’s Hospital showed a problem with the baby’s lungs. When Natalie Hart went into premature labor, the neonatology team was ready. On July 3, 2014, Collier arrived at 32 weeks weighing 4 pounds, 3 ounces — and crying. No one expected him to be able to cry. Natalie and husband Eric Hart were ecstatic even as their new baby was whisked away to be placed on a ventilator. Collier’s lungs were “stiff and couldn’t expand,” Malcolm said. “His heart had to pump extra hard to put blood in there to be oxygenated, so he developed pulmonary hypertension.” Six months later, Collier had not improved. He remained on the ventilator, had a feeding tube, was on painkillers and sedatives. He was on a cocktail of medicines his mother, Natalie, recalled. “Doctors were talking about him possibly having infant delirium. He was out of it, shaking his head a lot.” Section Features Text Content Callout "He’s an example of a success story that would not have happened in most children’s hospitals across the country.” Callout Image Callout Source William Malcolm, MD, neonatologist Section Features Quoted Callout Section Features Images/Media Text Content Section Features Images/Media Text Content Header 24-7 Access to Pediatric Specialists Content Since Collier’s release from Duke Children’s Hospital, he has been readmitted to the hospital only three times, a return rate that Malcolm called astonishing. The doctor credited the Harts’ diligence and the hospital’s Transitions Medical Home Program.  The Duke program uses pagers to give parents of high-risk infants 24-7 access to their child’s doctors. If a child is in trouble, they can page a doctor to get advice, which cuts down on unnecessary emergency visits and hospitalizations, Malcolm said.  Babies with feeding tubes or heart monitors who previously would have had to remain hospitalized can go home, where they have a much better opportunity to thrive, he said. Collier thrived. Section Features Text Content Section Header Image/Video collier_hart_patient_experience_2.jpg Section Features Images/Media Header Typical Toddler, Remarkable Outcome Content Malcolm has high hopes that Collier will be weaned from ventilatio[...]