July 16, 2018 | Rodney Morrison of Hot Springs has a story to tell, and if it wasn’t for the part UAMS played in it, he might not have been able to tell it.
UAMS recently became the first and only health care provider in Arkansas to be certified as a Comprehensive Stroke Center by The Joint Commission, which accredits nearly 21,000 health care organizations and programs in the United States for meeting certain performance standards.
Luckily for Morrison, when he had his stroke in March, the efforts to achieve certification were well under way.
“As a comprehensive stroke center, we have the ability to take care of patients not only with stroke but all cerebrovascular disease, 24/7,” said Martin Radvany, M.D. “We have the intensive care, neurosurgical, neurology, and radiology teams in place to provide this care. UAMS Medical Center is the only hospital in the state that has the comprehensive stroke center designation. This is the best place for cerebrovascular care.”
The start of that day was relatively ordinary for Morrison. He said nothing was unusual about it until he got to his workplace, a heating-ventilation-and-air conditioning company in Hot Springs where he works in sales and service. He spoke to a coworker who was walking by the doorway of his office. When Morrison verbally greeted him, the words and sounds he spoke didn’t make sense. He started experiencing paralysis on one side of his body and when his coworker stopped to see what was wrong, he managed to get out the word, “Hospital.”
After being taken to a Hot Springs hospital, Morrison next was transported by a helicopter air ambulance to UAMS Medical Center. When the care team landed with him, they brought him in through the Emergency Department, and it was clear on the CT images that the carotid artery in his neck was blocked along with other blood vessels in his brain. A large portion of the brain also was at risk for further stroke unless fast action was taken.
“His stroke was caused by a tear in the carotid artery, which was unusual, but we do see this a few times a year,” Radvany said. “The notable thing about his case is how young he is, 43. It was really important that they got him here in a timely manner to treat him. He had none of the risk factors we see in older patients like high blood pressure, diabetes or smoking. There was no known trauma or event that caused the tear.”
Radvany performed a thrombectomy, a surgical procedure used to extract the clots from Morrison’s blood vessels. The procedure was successful, and shortly after, he was able to move his foot again. Morrison recovered most of his motor functions within 24 hours, but he still had trouble finding words and some weakness. However, by the time of his first speech therapy appointment, even his ability to speak was normal. The therapist assessed his vocal ability and told him he needed no additional visits.
“I came in on a Wednesday, and I was able to get up and go home on Friday,” Morrison said. “I went back to work a little more than a week later. It was the response that impressed me, how quickly everyone responded to me. The care they gave me. This situation couldn’t have turned out any better for me. When you’re having a stroke, time is essential, and the quicker you can get treatment the better the outcome.”
Only 3 percent of hospitals achieve comprehensive stroke center designation that UAMS recently earned, Radvany said.
“I believe I got the best medical care that could have been provided for me,” Morrison said. “Dr. Radvany was great. I couldn’t have gotten any better care anywhere else. I’m grateful that the ER doctor in Hot Springs got me to where I needed to be. That’s right here at UAMS.”
July 13, 2018 | UAMS Medical Center has become the first and only health care provider in Arkansas to be certified as a Comprehensive Stroke Center by The Joint Commission.
The Joint Commission is an independent, not-for-profit organization that evaluates and accredits more than 20,000 health care organizations and programs in the United States.
“Achieving the standard of care required by The Joint Commission to be certified as a Comprehensive Stroke Center means a stroke patient at UAMS has a better chance here than anywhere else in the state of not only surviving but leaving our care with the best possible health outcome,” said Martin Radvany, M.D., a professor and chief of Interventional Neuroradiology at the University of Arkansas for Medical Sciences (UAMS).
According to the Joint Commission, the certification is the most demanding accreditation and is designed for those hospitals that have the specific abilities to receive and treat the most complex stroke cases. It also means certified hospitals can provide endovascular procedures and post-procedural care and has an Emergency Department with a dedicated stroke-focused program.
“Achieving Comprehensive Stroke Center designation places UAMS among the top stroke centers in the country that have the resources and highly skilled health care teams with advanced training to handle the most complex stroke cases,” said UAMS Chancellor Cam Patterson, M.D., MBA. “I am extremely proud of our medical center and our stroke team for their dedication to achieving this designation to provide Arkansans with access to the most advanced stroke care possible.”
“This is truly an extraordinary accomplishment that will save lives,” Patterson said.
In July 2017, UAMS formed a team to work on getting the Medical Center ready for the Comprehensive Stroke Certification. A gap analysis was performed to show what points of care needed to be addressed for certification. Multiple aspects of the stroke program had to be documented as well.
An application for the certification was sent to The Joint Commission in August. In May, two commission surveyors conducted the comprehensive survey over the course of two days. They toured all areas that cared for stroke patients. In addition, the surveyors reviewed files and chart reviews and interviewed staff and patients.
“This effort elevated the requirements of 24/7 coverage for all stroke providers at UAMS,” said Matthew Mitchell, director of the UAMS Stroke Program. “It took everyone working in the program using all their experience and energy to achieve the highest possible certification. It was the culmination of years of work. We will keep giving our all to maintain this standard and to provide the best care for the state’s stroke patients. Dr. Radvany, Dr. Day and I along with everyone at UAMS couldn’t be prouder of our stroke team.”
J.D. Day, M.D., is the chairman of the UAMS College of Medicine’s Department of Neurosurgery and director of the neurosciences clinical program that includes the stroke service and multidisciplinary team leaders.
To be a comprehensive stroke center, a hospital or clinic must be able to provide 24/7 care for patients suffering from a stroke and any cerebrovascular disorder, including ruptured brain aneurysms and bleeding into and around the brain. The Joint Commission requires the provider hospital or clinic to have the following available to do that: an acute stroke team, neurointensive care unit beds for complex stroke patients, the ability to meet the concurrent needs of two complex stroke patients, and have neurosurgical services. A center must be able to offer comprehensive diagnostic services; on-site coverage by a neurospecialist for its neurointensive care unit; participate in patient-centered research that is approved by an institutional review board; and track, monitor and report performance measures.
July 10, 2018 | Mark Hagemeier, managing associate general counsel with the UAMS Office of General Counsel, believes in the power of teamwork. He also believes it’s important to be prepared, whether he’s in an office or courtroom handling legal issues or unwinding after hours on his bicycle.
So it’s not surprising he’s volunteering to help other UAMS employees interested in participating in the 2018 UAMS Myeloma Institute’s Ride for Research, held in conjunction with the Big Dam Bridge 100 on Sept. 29.
“It’s a great cause,” said Hagemeier, who joined UAMS in 2008.
He has scheduled an orientation ride at 6 p.m. July 13 for UAMS employees, relatives, and friends 18 and older who are considering joining Ride for Research this year.
This will be the second year for Ride for Research and the first time the institute and UAMS has been a sponsor of the Big Dam Bridge 100, which draws 3,000 riders annually and continues to grow.
“It’s not a competition,” Hagemeier said. “It’s so much fun to ride a bike and I’m a firm believer that we must take charge of our own health. What better way to do that than to help others participate in a fun, healthy activity?”
To participate, riders must register for the Big Dam Bridge 100 and choose to ride 14, 26, 50, 68, or the full 100 miles. All routes begin and end along the Arkansas River in downtown North Little Rock. Riders then can visit https://myeloma.uams.edu/ride-for-research/ to sign up for the UAMS team. Those who aren’t riders can assist by making donations or holding fundraisers on behalf of the institute.
Last year more than 80 patients, supporters, family members, friends and employees rode to recognize and honor patients of multiple myeloma and related blood cancers. The event raised $75,000 for research and increased awareness of the disease within the community.
Hagemeier said his July 13 orientation ride will be 10 or 15 miles to test the waters. It will be a no-drop ride, meaning there will be someone in the back to ensure the slowest person in the group makes it back with the group.
“This will just be a great opportunity to take a bike out,” Hagemeier said. In addition to teaching bike handling skills, he will discuss what to wear, how to stay hydrated, how to keep electrolytes balanced, and how to ride in a group. He’ll also address how to slowly increase distances by 10 percent each week during training.
“You have to be able to successfully complete at least 75 percent of the total distance you’re attempting during the actual ride,” he said of the training.
Hagemeier took up cycling as an adult in 1984 with an aluminum-framed Cannondale but put it temporarily on hold during his early years of parenting.
In 2013, when his daughter graduated from high school and he could see an empty nest on the horizon, he bought a Trek Madone 4.5 and has been cycling regularly ever since. He averages 3,500 to 4,000 miles annually. In addition to cycling about four days a week, Hagemeier swims the other three days.
He’s participated in the Big Dam Bridge 100 for four years, completing the 100-mile route three times and the 68-mile one last year. This will be his first year to ride in the institute’s event.
Once he holds his initial training session, Hagemeier will assess the skill levels of attendees, decide on a regular training schedule, and possibly create smaller groups for varying abilities. He may direct the more experienced cyclists to other local riding and training groups more appropriate for them.
“If you’re intrigued by this, come on out,” Hagemeier said. “Cycling is a great way to be healthy and get fit. You’ll find you lose pounds, eat better, sleep better, and it’s also great for the brain.”
July 10, 2018 | As a musician, 37-year-old Paul Campbell generally keeps a busy schedule.
If he’s not playing live music with a band, he’s producing in a studio, instructing students as an adjunct professor at Arkansas Baptist College or serving as a career coach at the University of Arkansas Pulaski Tech.
Campbell even took his talents to Africa where he spent a month traveling the continent and playing music.
About six years ago, Campbell noticed congestion in his left nostril, but he’d learned to cope with it.
“I knew I probably needed to get checked out, but when you’re living life, keeping a schedule, traveling, it just gets put off.”
Campbell soon had trouble sleeping. He would regularly wake up every 20 minutes at night because he couldn’t breathe. He’d experience blurry vision while on a plane and noticed his memory was off. But at the time, he didn’t connect any of that with what was happening in his nose. He thought it was stress.
“I thought it was just something going on with me,” Campbell said. “I reached out to my pastor, Rev. Phillip Pointer at Saint Mark Baptist Church.”
Campbell says Pointer was understanding and expressed concern for his spiritual, mental and physical wellness.
“He recommended I talk to a therapist.”
Pointer’s encouragement helped him overcome initial embarrassment of seeking mental health counseling. The therapist asked him questions about his schedule and about the possibility of anxiety. He told her about his sleep deprivation, headaches, and the difficulty he sometimes had focusing on tasks.
“One of the homework assignments she gave me was to get my nose checked out,” Campbell said. “I did some research and found Dr. Kanaan. From there, everything just got better.”
Kanaan examined the inside of Campbell’s nose using a tiny scope with a lighted camera. She immediately noticed blockage on his right side.
Campbell remembers Kanaan saying he may be able to simply take antibiotics depending on the results of a CT scan.
“But when she looked at my left side she told me right then I would need surgery.”
Campbell had nasal polyps which blocked 100 percent of his left nostril. Kanaan says polyps are typically caused by a chronic inflammation, chronic infection or allergies. In some cases, they can be treated with medication. Campbell needed surgery.
“With the technology now available, we’re able to go through the nose with a camera,” Kanaan said. “It is a pretty benign outpatient procedure. We don’t have to make an incision on the face. The recovery time is about a week to 10 days.”
Kanaan said they also use a navigation machine that works a lot like a GPS. It allows the surgeon to see a scan of the patient’s nose to further ensure she’s staying in a safe zone away from the eyes or brain while removing the polyps.
When Campbell woke up in the recovery room he said he initially panicked.
“But the nurse told me to just breathe. I did. And I literally had not felt that feeling in years.”
Campbell said a trip to the mall after the surgery brought about a nostalgic feeling.
“I felt like I’d gone back in time,” he said. “Every store in the mall has its own unique smell. It had been so long since I had experienced that. I totally forgot about those little things. Sometimes I would be walking with my mom next to me and I just stop and say, ‘Ma! Smell that!”’
Before surgery Campbell had to ask his friends about new colognes and smells. Now, he can smell for himself. He no longer has headaches or runny nose and is sleeping much better.
“So many things improved that I didn’t even realize were associated with this,” Campbell said. “It blew me away.”
Kanaan says it’s a good idea to seek medical attention if you can’t breathe through your nose, experience a loss of smell, facial pressure or pain, and recurrent sinus infections. Another indicator, she says, is more than four or five sinus infections a year.
If left untreated, the polyps can grow and sometimes develop into something more serious.
“Some people get allergic fungal sinusitis,” Kanaan said. “That’s a sinus infection due to allergy to mold. The fungus can grow inside the sinus cavity and push on important structures like the eyes or the brain and can later cause problems ranging from meningitis to spinal fluid leak or severe infection.”
Since his surgery, Campbell says he’s committed to making his health a priority.
“Sometimes we get so caught up in doing what we’re doing that we neglect our personal health. We find ways to cope and continue on until it gets worse,” Campbell said. “Playing music is great, but it doesn’t matter if you can’t be at your best. This changed my whole life.”
June 25, 2018 | Each visit to UAMS to see cornea surgeon David Warner, M.D., is a joyous occasion for Cindy Jones.
That’s because with each visit in the year-long recovery after her cornea transplant, her vision improves.
“Each time it was better and better,” said Jones.
Jones, 44, has had a lifetime of vision problems. She was first prescribed glasses at 12 and was diagnosed with keratoconus at 14. The disease affects the cornea, progressively shifting and thinning the normally round cornea into a bulgy, cone-like shape. It can worsen until a person has difficulty seeing to perform daily activities.
“It’s a fairly common condition and a person usually falls into one of three categories with it,” said Warner. “Some have no progression and see well without glasses, others require hard contact lenses and avoid surgery. The third group usually has corneas that are so steep and bulgy it requires surgery.”
Jones tried glasses and contacts to no avail. She often squinted throughout the day to see better and relied on her daughter while driving at night to make sure she didn’t miss any turns.
It was an upcoming driver’s license renewal and eye screening in 2016 that brought the Cabot native to Warner, an ophthalmologist at the UAMS Harvey & Bernice Jones Eye Institute, assistant professor and director of the cornea service in the UAMS College of Medicine’s Department of Ophthalmology.
Warner said Jones would need corneal transplants in both eyes.
“She had a little different surgery than normal,” said Warner. “In one eye, we performed the traditional full thickness transplant, but the other eye received a more elegant approach, a partial thickness transplant.”
It removed about 95 percent of the cornea and allowed Jones to keep the corneal layer that prolongs the life of it, said Warner.
Both corneas came from the Arkansas Lions Eye Bank & Laboratory, housed in Jones Eye Institute.
“Because the eye bank is here, we have firsthand knowledge of how these tissues are recovered, evaluated and prepared for donation,” said Warner, the eye bank’s medical director. “It gives us great confidence that each patient receives an excellent graft.”
Recovery for a corneal transplant is about a year, said Warner.
“The grafts heal over the first six months, then we begin removing the sutures,” said Warner. “That happens two at a time until the astigmatism is almost gone or the sutures are gone, and we can correct the rest with contact lenses or glasses.”
Jones said she remembers being able to see better right away. The first few months required an eye patch and eye drops. Then, real change occurred with the first suture removals.
“I can see things I had never noticed before,” said Jones. “This is wonderful for me. I’m another one of Dr. Warner’s success story and I’m honored by that.”
The last of her sutures were removed in May. She will be fitted for glasses in June. Gone are Jones’ day of spotty vision.
“Being legally blind and then being able to see is phenomenal,” she said.
June 20, 2018 | As John Foster prepares for a summer of travel and merriment, he and his wife, Rebecca, are happy they have made health a priority.
Eleven years ago, Foster felt a lump in his neck while shaving. He said at first he thought little about it, assuming it may have just been a reaction to a mosquito bite.
“But it never went away,” Foster said. “When Rebecca felt it, she immediately said ‘We need to go to the doctor.’”
Rebecca Foster worked for 44 years as a registered nurse. She spent 24 of those years working at UAMS, 12 of those in oncology.
“As an oncology nurse, I knew how many people had successful outcomes from their cancer diagnosis,” Rebecca Foster said. “This gave me confidence and peace that Dr. [Brendan]Stack and UAMS would provide state-of-the-art medicine and that John would be telling of his successful outcome one day. For that, I am forever thankful.”
John Foster was diagnosed with stage 3 oropharyngeal cancer. The oropharynx includes the back wall of the throat, tonsils and the back of the tongue. He was treated by the UAMS team of medical and radiation oncologists, and his care was led by head and neck surgeon Brendan Stack Jr., M.D., who sees patients in the Head and Neck Oncology Clinic at UAMS.
“It was scary,” Foster said. “But I felt like I was in good hands. Dr. Stack is one of the
best in the world at what he does.”
Foster was ultimately treated with chemotherapy and radiation.
“Mr. Foster represents a typical head and neck cancer patient in that he was diagnosed, treated and came for follow-ups for five years.”
After being disease free for five years, Stack says patients “graduate” from routine follow-up appointments from the Head and Neck Oncology clinic. Foster continued to receive checkups from his primary care physician.
In September 2017, a lump in Foster’s left jaw prompted him to make an appointment with his primary care doctor at UAMS, Robert Lavender, M.D. Lavender referred him back to Stack who ordered a biopsy that confirmed there was a malignant mass in his largest salivary gland known as the parotid gland. Stack performed a parotidectomy in November and was able to remove all traces of cancer.
“I think the moral of Mr. Foster’s story is this,” Stack said. “You need to engage with your health care providers. Follow up as long as you are directed. And after routine follow up is concluded, always be on the lookout for new and unexplained symptoms in the area of your previous cancer. In this case, I think we were able to treat him very quickly because of his diligence and compliance.”