Total Ankle Replacement: Marc’s Story

There’s nothing like revving up the engine of a vintage motorcycle for 57-year old Marc Defur. The sound, the smell, the feeling of riding the wide open road, it’s no wonder why building and restoring these classics are his passion. But like these worn down roadsters, Marc was also feeling his own wear and tear and needed a tune-up. “All of a sudden it became very painful to walk. I started walking with a limp and it was painful to ride my motorcycle, I knew something wasn’t right,” explains Marc.

MarcMoabTruck09

Marc was starting to experience severe ankle arthritis, a condition seen with age or prior trauma such as an ankle fracture or sprain. His arthritis was so severe, there was hardly any cartilage left in his ankle. “I was in extreme pain and my entire quality of life went down,” he explains. After a couple years of feeling this extreme pain, Marc decided to go see his physician and was referred to orthopaedic surgeon, Dr. Fran Faro at Swedish Medical Center. “Marc was the perfect candidate for a total ankle replacement. Ankle fusion is usually the standard procedure for this type of ankle injury but because of his age, having a total ankle replacement was the preferred choice,” says Faro.

Marc’s case would be the first total ankle replacement in the last decade to be performed at Swedish Medical Center. “This type of surgery was uncommon in the past but is now becoming more common because of the technology we have. On average there are about 3,000 procedures performed each year in the U.S.,” explains Faro.

The total ankle procedure has been performed on patients since the 1970’s. The new re-designed implants help patients have less pain, better range of motion and full function after surgery. “The recovery was so short. I was out of my walking cast and back on my motorcycle after two months,” says Marc.

MontroseDelta RideMarc’s new ankle is expected to last 10 or more years. “It’s a life saver; it gave me so much back in my life!”

 

New GERD Procedure Performed at Swedish Medical Center

Rocky Mountain-region patients living with Acid Reflux disease, also known as GERD, have welcome relief – literally and figuratively – at the hands of Swedish Medical Center’s Reginald Bell, M.D.

Bell is the only physician in the region performing a new procedure in patients suffering from this debilitating disease. It’s known as the LINX® Reflux Management procedure. Acid Reflux, or GERD as it is sometimes called, is a chronic and often life-long condition in which the acidic liquid content of one’s stomach regurgitates back into the esophagus. Inflaming the lining of the esophagus, it leaves patients with an intense burning sensation. While medication can help in less serious cases, for many, there is no relief, until now.

Linx 1020

The LINX® System is a minimally invasive laparoscopic procedure that implants a series of interlinked titanium beads with magnetic cores into the esophagus just above the stomach. The magnetic attraction between the beads augments the existing esophageal sphincter’s barrier function to prevent reflux.

3557 Rev 1 - Artwork, LINX Diagrams

According to Bell, who has performed the procedure on a handful of Denver-area patients, the LINX treatment is a good choice for patients who are in the early stages of GERD.

“We are excited to be able to offer the LINX as a therapeutic option to patients with GERD,” Bell says. “I am amazed at the number of patients with GERD who are unaware that there are options other than taking a pill for the rest of their lives! We have worked to become specialists in the diagnosis and minimally invasive treatment of GERD, and were honored when Torax asked us to be their initial site for the Rocky Mountain region.”

IMG_0203Swedish Medical Center patient Cindy Bledsoe, 57, was the ideal candidate for the LINX implant, says Bell because she had medically resistant symptoms and early reflux. She did not have a hiatal hernia and only mild increases in esophageal acid exposure. In this setting, he says, a minimally-invasive procedure with a low risk/side effect profile is desirable. Bledsoe, a first grade teacher, was plagued by a continuous and chronic cough, often appearing as if she was choking at times. In addition, her oxygen saturation level was at 88 percent and doctors advised her that being significantly overweight contributed to her health problems. Several doctors and tests later, Bledsoe was referred to Bell, who performed the LINX procedure on her in October.

“Before the procedure, acid reflux/GERD controlled my life. And the cough was actually scary for my first grade students,” Bledsoe says. “Immediately after the LINX procedure, however, the cough went away and my oxygen levels went back up to between 96-98 percent.”

Bledsoe calls the decision to have the LINX procedure “life changing,” and has been removed from some of her pre-diagnosis medications as a result.

“LINX was designed specifically for this group of patients whose symptoms are not controlled adequately by medication and who do not have big hiatal hernias, bad esophagitis or other things we see with more advanced disease,” Bell says of the device manufactured by Torax® Medical, Inc. The LINX System is currently the only available device for the treatment of GERD approved by the FDA through its rigorous PMA process. It is indicated for patients who have problems with reflux despite medication, who have a hiatal hernia of less than three centimeters and who have fairly normal esophageal motility. Like other patients with pacemakers and some other implants, patients with the LINX procedure should not have an MRI, but can have alternative imaging procedures such as CT scans.

Symptoms of GERD include heartburn, regurgitation, cough and chest pain. Acid suppression drugs, such as Prevacid®, Nexium®, and Prilosec® affect gastric acid production but do not repair the sphincter defect and allow continued reflux. GERD can progress to a pre-cancerous condition known as Barrett’s esophagus and possibly esophageal cancer. Approximately seven percent of adults in western countries suffer daily from symptoms of GERD.

According to Bell, in a clinical trial of 100 patients, 92 percent of patients achieved freedom from daily dependence on PPIs, 90 percent of patients experienced a reduction in total acid exposure time, 93 percent of patients achieved significant symptom improvement and the percent of patients reporting moderate to severe regurgitation was reduced from 57 percent to one percent after the LINX procedure.

Swedish Medical Center Physician Breaks New Ground In Cochlear Implants

A Swedish Medical Center physician is breaking new ground in the area of cochlear implants with his recent surgery on a 9-year-old girl who received the medical implant for single-sided deafness.

Daniel Zeitler, M.D., a neurotologist and skull-based surgeon is one of only a few medical professionals in the United States to perform the procedure for this population
and diagnosis. According to Zeitler, the young patient’s deafness was beginning to take its toll on her both academically and socially. “Although Claire is an excellent student, she had to sit strategically in the classroom to be able to hear. She was having a hard time enjoying music, couldn’t enjoy birthday parties, and often felt socially isolated during basketball practice and games or active family outings such as bicycle rides. Basically, all the things that a 9-year-old girl likes to do were slowly taken away from her because of her deafness,” Zeitler says.

Dr. Zeitler

Young Claire received the cochlear implant on November 26. The MED-EL device will be activated on Dec. 18, however Zeitler says early testing during surgery indicated it was working properly. The use of cochlear implants for single-sided deafness, and for patients as young as Claire, is an emerging practice in Europe, but is extremely rare in the U.S. In fact, the FDA has not yet approved the device for single-sided deafness, says Zeitler.
So why did Dr. Zeitler agree to this rare procedure? Because he feels Claire can benefit greatly from this technology, and rather than wait for other options to emerge or trials to be conducted, he is confident the cochlear implant will dramatically improve the quality of life for this youngster sooner rather than later. “There’s a huge push to initiate clinical trials for its use in these circumstances in the U.S., but only a few anecdotal reports and small objective studies currently exist. Unfortunately, there is no good data or large-scale subjective experiences to make it the norm yet,” Zeitler says.

Claire began losing hearing progressively in her right ear at the age of 5 and tried a number of alternative hearing devices, including a traditional hearing aid. However, when her hearing loss became profound, she could no longer obtain any useful benefit from its use. Additionally, she attempted to use an FDA-approved bone-anchored hearing device, but was denied by her insurance. Her insurance is, however, paying for the cochlear implant. Zeitler is skilled in pediatric cochlear implantation, but his clinical interests also include bone-anchored hearing aids (Baha), benign and malignant tumors of the ear and skull base, facial nerve disorders, cholesteatoma and chronic ear disease, ear infections and hearing loss. Zeitler also frequently collaborates with neurosurgeons and radiation oncologists in the treatment of a variety of ear diseases and is an active member of the Colorado Neurological Institute.

MED-EL’s MAESTRO™ Cochlear Implant System has proven to be an effective solution for individuals with bilateral severe to profound sensorineural hearing loss. According to Zeitler, the device is expected to last a lifetime. Zeitler and his team of medical professionals at Denver Ear Associates will evaluate the quality of sound Claire experiences once the device is turned on December 18th. “Before surgery, Claire was excited and apprehensive, but she was ready,” Zeitler says. “My hope is that Claire’s story can be shared with other children and adults suffering the same disability, and Claire can be a champion of cochlear implantation for these patients in the future.”