April 12, 2018 | UAMS patient C.M. McClain Jr. was not expecting to celebrate the final day of his treatment cycle with six NFL players, including a Heisman Trophy winner. But that’s exactly what he did.
The players came up one by one to shake his hand, introduce themselves and talk at length about his family, his treatment and why they have come back year after year to visit patients at the UAMS Winthrop P. Rockefeller Cancer Institute.
“One player told me that his mom had been a nurse at UAMS and taught him the importance of caring for others. Another player and I talked about race relations. We had some great conversations,” said McClain, a former college football player who is being treated in the Cancer Institute’s Infusion Clinic 1 for chronic inflammatory demyelinating polyneuropathy.
This was the fifth year that Denver Broncos defensive tackle and Jacksonville native Clinton McDonald organized his fellow players to visit the UAMS Cancer Institute.
“Coming back every year gives me perspective. The ultimate goal in life is good health, but cancer can affect anybody. We need to understand what other people are going through so we can make a difference in their lives and stay focused on what’s important in our own,” he said.
Accompanying McDonald on his visit were Jameis Winston, Heisman Trophy winner and Tampa Bay Buccaneers quarterback; Demetrius Harris, fellow Jacksonville native and Kansas City Chiefs tight end; Dante Wesley, Pine Bluff native and retired Carolina Panthers and Detroit Lions cornerback; Michael Johnson, Cincinnati Bengals defensive end; and Joseph Anthony “Red” Bryant, retired Seattle Seahawks defensive tackle.
“Every time I come back, it’s a blessing. Anything we can do to relieve someone’s stress and make them smile is worth it,” said Johnson, who has accompanied McDonald for the past four years. “Clint is one of the best people I know. If he’s involved in something, I want be involved in it too,” he said.
The group stayed about two hours and made their way between the Cancer Institute’s two infusion clinics, visiting with each patient, passing out autographed footballs and taking selfies.
“It’s pretty neat of them to take time out of their day to stop by. I was feeling down in the dumps this morning, so this was good timing. It keeps our spirits up,” said Cara DeFlorian, who was being treated for breast cancer and was accompanied in the clinic by her two teenage daughters.
In addition to the patients, the Cancer Institute staff also enjoys the players’ annual visit and appreciates their continuing dedication to the central Arkansas community.
“The fact that Clinton McDonald continues to organize this visit year after year is a real testament to the fact that he values his home state and wants to give back to it. Our patients are always thrilled to visit with the players, and we appreciate the fact that they take the time to come back each year,” said Cancer Institute Director Peter Emanuel, M.D., professor in the UAMS College of Medicine.
In addition to their visit to UAMS, the players also participated in McDonald’s annual Family Fun Day and Iron Sharpens Iron Youth Football and Cheer Camp on April 7 in his hometown of Jacksonville.
April 9, 2018 | Carye Beavers is always in pain. The 45-year-old has a degenerative bone disease that was made worse by a car accident in 2011.
Before she discovered relief from the UAMS pain management clinic, Beavers says her days usually ended around noon because it hurt too much to function regularly beyond that.
“On a scale of 1 to 10, my day-to-day pain was at an 8,” Beavers said. “By the end of the day, I was in so much pain, I couldn’t function. I was literally in tears in bed without any hope it would get better.”
Goree says there are several surgical and non-surgical options to treat pain without opioid medication. Beavers receives non-surgical steroid injections.
“The injections reduce inflammation in nerves and in the muscle,” Goree said. “We find the specific area that is inflamed, either joints or nerves, and target it with either x-ray or ultrasound guidance. Then we inject a local anesthetic mixed with a steroid to calm the inflamed area.”
“There are no doctors I could find in my area that will do this type of pain management,” Beavers said. “They won’t even discuss it even with the success I’ve had for the past few years.”
Beavers’ latest injection was during Spring Break.
“With Dr. Goree and his team at this clinic, my pain is now at about a 5 or 6,” Beavers said. “For someone who has always been in constant pain, that’s a big deal. That’s a lot of relief.”
Other treatments, Goree says, are nerve ablations and spinal cord stimulation. In ablation, nerves delivering pain signals to the brain are destroyed with either heat, cold or chemicals. Because it’s been damaged, that nerve can no longer send pain signals to the brain.
For spinal cord stimulation, a physician places a device under the patient’s skin that sends electrical signals to the spinal cord. The patient doesn’t feel pain because the electrical pulses mask the pain signal.
For some patients, Goree says they use low-dose methadone because of its long-lasting effects and ability to work on more than one pain receptor.
“Most opioids only work on one receptor,” Goree said. “Eventually, that receptor gets used to the medication and it stops being as effective.”
Goree says low-dose methadone also prevents patients from experiencing peaks and troughs or highs and lows. Since it lasts longer than a drug that works for only a few hours at a time, it keeps the patient at a more steady state.
Methadone is often used to treat patients who have had a previous opioid addiction to prevent withdrawal. Goree emphasizes the medication should only be administered under the care of a trained physician.
Beavers says she appreciates the pain clinic for being open-minded about methods of pain management that fits each individual patient.
“Here, it’s not just a blanket, ‘this is what we do for everyone.’ They care about my life. I’m more than a folder they look at for five minutes before entering the room,” Beavers said. “I feel like they know me and they care. They’re treating me for my future and not just for today, giving me back hope for a quality of life that I had given up on.”
April 2, 2018 | Beverly Smith isn’t used to being held back.
The now-retired Cabot resident loves to be on the move. She longs to travel. She lives for cruises and trips with her husband, and the freedom to do as they please.
Last year, that way of life came to an abrupt halt when knee pain sidelined her. X-rays and scans revealed her knee was fine, but her right hip was not. A total replacement was necessary.
“I thought I was too young,” said the 63-year-old Smith. “I wasn’t ready for it.”
Smith turned to UAMS for help. She was treated by Paul Edwards, M.D., a hip-and-knee surgeon at UAMS and a professor in the UAMS College of Medicine’s Department of Orthopaedic Surgery. Any worries she had were soon put at ease by Edwards and the rest of the UAMS orthopaedics staff.
“I thought I couldn’t be so lucky, I felt comfortable with Dr. Edwards,” said Smith. “It was like talking with someone I knew. He talked to me and showed me what was wrong. I got incredible quality care from Dr. Edwards and the entire staff at UAMS.”
Smith's hip showed signs of osteoarthritis, as the result of wear and tear in the hip joint from arthritis.
“A normal hip joint has a ball and room for cartilage, but Mrs. Edwards’s hip had no cartilage space and had a few cysts,” said Edwards. “This causes a lot of debilitating pain, which makes almost any activity hard to do.”
Immediately following the procedure, Smith noticed an odd feeling in her hip.
“The pain was gone,” she said.
Edwards said research shows the UAMS method of having an individualized plan for each patient is the most successful approach to having good outcomes rather than relying on a new technique of using robotic-arm technology.
At UAMS, the orthopaedics staff meets with patients and their families to talk about the procedure and recovery process as well as identify and lessen possible risk factors.
“They put me at ease and it made a difference," said Smith. "A huge difference."
Each UAMS orthopaedic surgeon specializes in a particular area. This includes hip and knee, foot and ankle, sports medicine and trauma. Four are fellowship trained in hip and knee replacement, the most of any joint replacement provider in Arkansas.
"This allows us to narrow our focus and stay up to date on the best practices in our area, which translates to superb care for our patients," said Edwards.
A designated staff of nurses and health professionals care for patients following surgery. Post-operative care includes a visit with a physical therapist to begin recovery. Most patients return home within 24 hours of their surgery.
“This plan decreases hospital readmissions, as well as complications and infections,” said Edwards. "It improves patient outcomes in a way new robotic technology has not been able to accomplish."
Smith said since her care at UAMS, she has been able to return to the lifestyle she loves.
“I can do anything and I don’t hurt,” she said. “With pain, you’re limited. Now I don’t feel any limitations to anything.”
March 26, 2018 | The first memory David Scott has following his traffic accident July 31, 2017, is a paramedic leaning over trying to help release him from underneath his 18-wheeler.
“I’m trying to pull my arm out and they’re telling me I can’t,” Scott said. “So I turn around and try and force it. But they stopped me.”
That’s because at that moment, Scott wasn’t fully aware how badly his arm had been damaged. When he arrived at UAMS, his surgeons were not able to save it. And not just the arm, they and had to amputate up to his chest.
“Typically if an extremity is reconstructable, we will reconstruct it,” said Mark Tait, M.D., an orthopaedic hand and upper extremity surgeon. “In this case, his nerves, arteries and vessels were so severely damaged we had to do an amputation.”
But Tait and John Bracey, M.D., another UAMS orthopaedic hand and upper extremity surgeon, were thinking beyond the loss of Scott’s arm. They had plans for his future.
Traditionally, Tait said, patients can receive body-powered prosthetics. But new technology allows advanced robotics to be used by amputees. Because the surgeons decided to prepare Scott to be able to use a robotic arm, the surgery took about seven hours.
Tait and Bracey identified the nerves that once flowed in his hand, wrist and elbow. They then took those nerves and plugged them into other muscles in Scott’s chest. With time, the nerve would reinnervate – supply energy to – that muscle, causing it to have a new function. So now when Scott thinks, “close hand” or “bend elbow” new muscles, operated by nerves formally in his arm, respond. That response is sensed by his robotic arm, which follows the brain’s command.
“David is very highly motivated,” Bracey said. “He understood the severity of his injury but was determined not to be limited by that. His motivation helps make this so successful.”
UAMS is one of a few institutions in the nation able to do these kinds of surgeries and Scott is among the first here in the state to receive a robotic arm. Tait and Bracey say they’re happy to bring this option to amputees in Arkansas and the region. This procedure is also remarkable, the surgeons said, because it is intuitive. With more time and practice, a patient is able to fine-tune the way the robotic arm works with his or her body. He says they’re still working on improving the functionality.
“I told my wife, I’m not going to let this get me down,” Scott said.
And he hasn’t. His doctors expected it to take six months for him to make the progress he has made since having the arm. It’s taken him only three and each day he gets a little more control. He’s able to put the arm on and take it off with little to no help and has been very active in his church and his softball team.
“It’s amazing the things doctors have been able to come up with in medicine,” Scott said. “I’m happy to be alive and plan to make the most of my life.”
Tait and Bracey say even those who have already had an amputation could be eligible for robotic technology. Because the nerves are likely still there, they would still be able to identify them and plug them into different targets.
“It can be a good option for those even 10 years past their amputation,” Bracey said.
March 19, 2018 | In the summer of 2016, Stuttgart native Blake Pond, 36, moved back to his home state after living in Dallas for 16 years. He, his wife, Ann, with their infant daughter, Caroline, wanted to be closer to family. So Pond accepted a position as chief of staff at the UAMS Myeloma Institute.
On Oct. 5, 2017 a day before Caroline’s first birthday, Pond scheduled an appointment with Chuck Smith, M.D., at the UAMS Rahling Road clinic to establish primary care.
“I told him I’d been having some symptoms over the past couple of years,” Pond said. “I just thought to mention it. But that piece of information along with my family history concerned Dr. Smith, who recommended to get it checked out just to be on the safe side.”
Smith referred Pond to get a diagnostic colonoscopy which revealed a polyp about the size of a golf ball. He was diagnosed with invasive adenocarcinoma of the colon, the most common type of colorectal cancer.
The news came as a surprise to Pond.
“I’d been in oncology research for 10 years, so all these thoughts were going through my head. The worst part was the unknown,” he said.
Board-certified colon and rectal surgeon Conan Mustain, M.D. talked through the next steps with Pond.
“First we got a CT scan to look at his lungs and liver,” Mustain said. “Those are the two sites most common for colon cancer to spread.”
Blake’s scan came back clear. There was no evidence that the cancer had spread.
“The decision then was whether removing just the polyp was adequate treatment or if we needed to also remove part of the colon,” Mustain said.
Mustain said there were two things to consider when it came to deciding whether to remove a part of Pond’s colon: the polyp site itself and whether cancer had spread to the regional lymph nodes. For some early cancers the risk of lymph node spread is sufficiently low that complete removal by colonoscopy is considered adequate treatment. In Pond’s case pathologists had not been able to confirm if the base of the polyp’s stalk (a piece of tissue that attaches the polyp to the intestinal wall) was completely clear of cancer. Additionally, some enlarged lymph nodes were visible on his CT. Given his young age, uncertainly about these nodes could mean years of costly surveillance and worry. Pond and Mustain ultimately decided they’d remove part of the colon and the lymph nodes.
The surgery was scheduled for Oct. 30. Mustain laparoscopically removed 10 inches of Pond’s colon containing the polyp site and 16 regional lymph nodes. The minimally invasive approach included three small incisions around the abdomen. Mustain says doing the procedure this way leads to less pain, lower narcotic use and a faster return to normal bowel function after surgery. Pond was discharged from the hospital after two days and back to work in two weeks.
“I’m grateful for the whole health care team at UAMS,” Pond said. “From Dr. Smith for having the wherewithal to refer me for a colonoscopy to my follow-ups after surgery. I really think this is a good example of the system working. My original primary care appointment was Oct. 5. By Nov. 5, I was back on my feet and on the road to the recovery.”
Pond went on a ski trip in January and performed at a level he would have prior to his diagnosis and surgery.
“No one is eager to get a colonoscopy,” Pond said. “But you have to know your body and if there are any symptoms, don’t wait to get it checked out.”
Mustain says colon cancer screening should begin at age 50 for most people. Those tests should come sooner if a patient shows symptoms or has a parent, sibling or child who was diagnosed with colorectal cancer.
March 12, 2018 | Trenton Williams, 24, a graduate of Lamar High School in 2006, had big, blue eyes and a warm smile. His mother, Jeri’ Williams, remembers him being trustworthy and loyal.
The youngest of four siblings, he was a smart and meticulous planner who worked hard, she said. He was successful at his job at XTO Energy; he bought a house when he was 18. By 24, he had built a new one with his own hands in Hagarville, a community in Johnson County.
Trenton Williams had been living there for nine months when he went to a pool party Aug. 11, 2012.
Jeri’ Williams was in Tulsa that day visiting grandchildren and preparing for a trip to the zoo. A phone call from Arkansas had just enough details for her to immediately change plans and head back home.
“They said there had been an accident and that they were doing CPR on Trenton. That’s all they told us.”
Williams later learned that Trenton had been thrown into the pool head first and had a severe neck injury. When she arrived at Washington Regional Medical Center in Fayetteville, doctors told her to prepare herself. There was not a lot they could do. A scan showed there was no brain activity.
“I wasn’t willing to accept that first scan,” she said. “Of course, as a mother, you’re never going to accept something that horrible until you know for sure there is no other option.”
A second scan revealed the same results: no brain activity.
A representative from Arkansas Regional Organ Recovery Agency (ARORA) met with Williams in the hospital and showed an enlarged copy of her son’s driver’s license. He had signed up to be an organ donor. It’s not something they’d ever talked about together.
“I know Trenton. He was the kind of person who made decisions based off every piece of information he could get,” Williams said. “He didn’t haphazardly decided to be an organ donor. I knew that if he’d signed up for that, it was truly his wishes.”
For the next several hours, Williams’ family said their goodbyes to Trenton and prayed for the recipients of his organs.
“I prayed they’d be grateful, that they’d realize they were getting a special gift from an amazing person,” Williams said. “I knew whoever received his organs were also hoping for a miracle just as we were.”
Williams left the hospital knowing three people had received organs from her son. One received his liver and a kidney, another his heart, and a third received his other kidney.
Ken Howard has been in law enforcement for more than 40 years. He’s now the Cedarville Police Chief. When he’s not working, he’s spending time with his wife, Linda, playing with his five grandchildren or sharpening his photography skills.
In 2009, the normally healthy Crawford County man says he hadn’t been feeling well for a while. An MRI showed him to have a liver disease called nonalcoholic steatohepatitis (NASH) and cancer on his kidney.
After his cancer was successfully treated, Howard got on the list in May 2012. He received a call three months later.
When Trenton Williams’ family decided to donate his organs, the transplant team at UAMS got to work.
Joy Cope, UAMS Director of Transplant Services, says a large, multidisciplinary team is necessary to make sure everything runs smoothly. Social workers, dietitians, pharmacists, psychiatrists, physicians and nurses all come together to communicate as one.
“We do everything we can to make sure the gift we’re given is received, honored and cared for in the best possible way,” Cope said.
Howard felt compelled to write a letter to his donor’s family. For Jeri’ Williams, that letter couldn’t have come at a better time.
“We had been going through the motions, trying to get ready and live life without Trenton,” Williams said. “The day I went back to work was particularly bad. I woke up crying. I cried all the way to the post office. Inside the box was a letter from ARORA.”
Howard had written about his family and how grateful he was to be able to spend more time with his two children and grandchildren.
“That was exactly what I’d prayed for. I feel like that letter put us on the path to healing.”
The families met and have been close friends ever since. Williams says it bring her joy to watch him live.
“We’re grateful that he’s enjoying his life to the fullest.”
“I cannot say enough about this family,” Howard said. “They have become an extended family to us.”
In 2017, the families were a part of the Donate Life Float in the Rose Bowl Parade. Howard was on the float as a recipient. Trenton Williams was one of 60 donors who had a featured floragraph, a portrait made of flowers, seeds and floral materials.
Cope says she hopes stories like Howard’s will make more people consider the impact of organ donation. There were 109 transplants in 2017, about 53 percent of those eligible.
“We get to see people like Mr. Howard every day,” Cope said. “It’s amazing to watch how much a new organ can change a life. We take the sickest people and get to make them better. There aren’t a lot of people who get to say they do that every day.”
Since her son’s death, Williams has become an advocate for organ donation. She developed an organization called Trenton’s Legacy.
“Through this organization, we have been able to help other people. Trenton’s Legacy steps in to help grieving families in a number of ways,” Williams said. “Even in our brokenness, we have been able to make other lives whole again. What more could you leave for someone? We don’t have Trenton, but his legacy will always be here.”