July 17, 2015
MEDICAL UNIVERSITY of SOUTH CAROLINA
Vol. 33, No. 45
Neurosurgeons embrace new technology NeuroBlate treats child’s Treatment helps 27-year-old patient tumor live her life
By Helen Adams Public Relations
By J. Ryne Danielson Public Relations
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llison Sanders, 27, knows well the struggles of living with epilepsy. The condition, which she has dealt with since she was diagnosed at age 19, has affected her life in myriad ways. “Epilepsy has greatly limited my interaction with friends,” Sanders said. “It is embarrassing when I have a seizure in front of someone. I have not been able to drive for quite some time. That has been really hard for me, not being able to get in my car and just go to a store.” The greatest challenge, Sanders said, has been when seizures leave her unaware of her surroundings, disoriented, and unable to remember what happened once the seizure has passed. “Seizures are a big deal for patients,” said neurosurgeon Alex Vandergrift, M.D., who specializes in the treatment of epilepsy. “They usually produce an alteration in the level of consciousness as well as automatisms — non-purposeful, repetitive behaviors such as lip smacking, fumbling or picking of the hands — and they can secondarily generalize, spreading throughout the entire brain and leading to full-body convulsions and shaking of the arms and legs.” Epilepsy can be debilitating and significantly compromise a patient’s independence. Because of the dangers
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photos by Sarah Pack, Public Relations
Elizabeth Novick, left, a Visualase clinical specialist, watches Dr. Alex Vandergrift fine-tune the laser for patient Allison Sanders. A detailed MRI scan showing the path of the Visualse laser (in yellow). Patient Allison Sanders had the procedure July 6 to end her seizures caused by epilepsy. photo provided
associated with seizures, the state of South Carolina prohibits patients diagnosed with epilepsy from obtaining a driver’s license until they have been certified by a doctor as being seizurefree for at least six months. “Epilepsy can make it very hard to
Academic Fundraiser Career fundraiser praised for her philanthropic talents. LIKE US
Nine–year–old Sonya Gibby loves unicorns as much as she hates the tumor growing in her brain, so she named the basal ganglia glioma “the evil unicorn.” It’s considered inoperable because of its location in the deep structures of the brain that control everything from movement to temperature regulation to sleep cycles. Surgery by hand could do more harm than good to the Charleston fourth grader’s brain. But Sonya’s tumor is not untreatable, said neurosurgeon Ramin Eskandari, M.D., assistant professor in the Department of Pediatric Neurosurgery. A fairly new option called the NeuroBlate System has been used in other states, but never on a child in South Carolina —until Sonya. On May 15, Sonya became the first child in the state to be treated with NeuroBlate,
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hold down a job,” Vandergrift said. “You can fall and hurt yourself when you experience a seizure. Many patients are also taking medications with their own side effects such as thinking
Dr. Ramin Eskandari examines patient Sonya Gibby.
See Epilepsy on page 6
See Tumor on page 7
Medical Center Prepared
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Kids 2 Visit Around Hill Health careCapitol law Campus
Hospital employees gear up for Magnet® nursing site visit.
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5 Charles Meet Meet Janet
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8 Employee Wellness
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Applause Program The following MUSC employees received recognition through the Applause Program for going the extra mile: Medical Center Erin Hosterman, ART MSICU; Jason Haan, Clinical Neurophysiology; Barbara Busby, Guest Relations; Lisa Petruncio, Adult ED; Talonda Henderson, 8 West; Lezlee Lisi, Children’s Therapy Center; Takenya Glover, Bone Marrow Transplant; Karin Elkins, Clinical Education; Angela Kelly, Oncology and MedSurg Services; Kristy Martin, Bone Marrow Transplant; Leona Anderson, Medical Records; Holly Oliver, ART MRI; Linda Hamner, MRI; George Waring, Magill Vision Center; Michael Howard, UIM; Christine Wheeler, McClennan Banks Adult Primary Care; Krista Mingo, UIM; Phyllis LaBoard, UIM; Shelia Brooks, Revenue Cycle/Operations; Jennifer Keevern, Physical Therapy; Robert Egbert, 9 East; Renotia Fludd, Guest Relations; Shannon Weaver, Physical Therapy; Melissa Marshburn, 9 East; Courtenay Barfield, NNICU; Ross McKenna, ART Central Supply; Annette Lemon, Central Supply; Cheryl Neal, General Internal Medicine; Meghan Mandel, Ashely Ave Pharmacy; Lindsey Harward, OB/ GYN Resident; Michelle Rogers, Meduflex Team; Carol Sherman, Hematology/ Oncology; Douglas Simon, Safety & Security; Betty Chandler, 6 West; Brittney Whaley, 6 West; Breezy Bernheisel, 6 West; Zach Connell, 6 West; Brandy Olson, Guest Relations; Terrill Huggins, Pulmonary, Critical Care, Allergy & Sleep Medicine; Tom Martin, Guest Relations; Dane Daley, Residents Orthopedic Surgery; Mike Norris, Adult ED; Corey Frasier, Support Services; Melvena Nelson,
Editorial of fice MUSC Office of Public Relations 135 Cannon Street, Suite 403C, Charleston, SC 29425. 843-792-4107 Fax: 843-792-6723 Editor: Cindy Abole catalyst@musc.edu Catalyst staff: Mikie Hayes, hayesmi@musc.edu Dawn Brazell, brazell@musc.edu J. Ryne Danielson, daniejer@musc.edu Helen Adams, adamshel@musc.edu Sarah Pack, packsa@musc.edu Jeff Watkins, watkinsj@musc.edu
People of Interest
Environmental Services; Mary Hanna, Physical Therapy; An’che Bell, Patient Transport Services; Tina Hinkle, 5 East; Monica Wigfall, 5 East; and Zonya Mungin, DDC
MUSC’s Department of Public Safety is asking for help from the MUSC community in identifying two women in who were recently on MUSC’s campus. The individuals are wanted for questioning in regard to several credit card thefts and fraudulent activity that occurred July 8 around MUSC. Anyone having knowledge about these people should contact Sgt. David Wagner, 792-0334 or Sgt. Don Register, 7921327 of Public Safety.
University
Deborah Cook, University Housekeeping; Mellie Klinger, Accounts Payable; Wanda Lowe, Student Health Services; Nebra Singleton, Engineering and Facilities; and RoseMarie Thompson, Grants and Contracts Accounting
Applications accepted for new MPH degree programs Applications are being accepted for three new Masters in Public Health degree programs being offered by the Department of Public Health Sciences. MUSC’s MPH degrees will prepare the next generation of public health scientists to develop expertise, research skills and practice opportunities in population health and prevention. Those interested in earning a MPH degree with an emphasis in biostatistics, epidemiology or health behavior and health promotion should direct inquiries to Joan Graesch at graesch@musc.edu. For information, visit http:// academicdepartments.musc.edu/ cesl/em/admission/application/ mph. Deadline for application is July 31. The Catalyst is published once a week. Paid adver tisements, which do not represent an endorsement by MUSC or the State of South Carolina, are handled by Island Publications Inc., Moultrie News, 134 Columbus St., Charleston, S.C., 843-849-1778 or 843-958-7490. E-mail: sales@moultrienews.com.
Spring and Fishburne road project continues Work will continue at Fishburne and President streets as well as on Sheppard Street. Both the intersection at Fishburne and President streets (including part of Fishburne) and Sheppard Street from the Crosstown to Rutledge are expected to remain closed. The detour route around the intersection at Fishburne and President streets may shift a little so please be alert for changes. Work includes: water relocations and installation of stormwater infrastructure at Fishburne and President streets and other construction. Closures are expected to continue until mid-August. Starting July 7, Bogard Street will close from the Crosstown to President Street affecting traffic around President and Fishburne streets. For everyone’s safety, while traversing these areas via vehicle, bike or on foot, please obey all signage and be aware of any construction activity. This closure is expected to continute until midSeptember. For project information, visit www.SeptimaClarkProject.com.
MUWC seeks scholarship applications The Medical University Women’s Club is seeking MUSC’s most deserving students for its annual scholarships. The MUWC will award $14,000 in total scholarships this year. All full-time students in their second or subsequent years from any of MUSC’s six colleges are eligible and encouraged to apply. Previous applicants may reapply. Applications are available through at http://academicdepartments.musc. edu/womensclub/scholarship.htm. Dealine for submissions is 4 p.m., Monday, Sept. 7. Applications must be submitted online via email to muwcscholarship@gmail.com.
No handwritten applications will be accepted. Late or incomplete applications will not be considered. The MUWC Scholarship Committee will review the applications and select scholarship recipients based on financial need, academic achievement, university and community service. Scholarship recipients will be notified by Friday, Sept. 11 and recognized at the MUWC annual membership coffee event on Sept. 15. For information about the program or process, contact Charlotte Gillespie, scholarship chairman, at muwcscholarship@gmail.com.
The Catalyst, July 17, 2015 3
MUSC fundraiser earns top award from her peers By Allyson Crowell Office of Development MUSC’s Associate Executive Director of Development Toni Jernigan learned a lesson when she was 5 years old that has guided her professional life. Each Sunday after church, Jernigan’s mother took her and her siblings to visit their grandparents, and their grandmother gave them all hot cocoa. One Sunday, instead of cocoa, she gave each child a nickel — much to the children’s disappointment. On the way home, Jernigan’s mother told them that giving is about the giver and not the recipient. “She explained that the Grandma wanted to show her love by giving us something, and that she had very little to give on that day,” Jernigan said. “She explained how much joy we gave her when we graciously accepted her gift.” Jernigan recently was named local Outstanding Professional Fundraiser of the year. She received the award on June 15 from the Association of Fundraising Professionals South Carolina Lowcountry Chapter during its annual Summer Institute luncheon. Jernigan joined MUSC in 2007 as director of gift planning, a role that oversees donations made through estates and other legacy gifts. Jim Fisher, MUSC vice president of development and alumni affairs, said
Jernigan always makes the donor — or the giver — her top priority. He noted that even when Jernigan called someone who was reluctant to speak to her, she never hung up without an appointment. “I don’t have to tell you that donors recognize when you believe in what you’re representing,” Fisher said. “They know when you’re genuine. Toni Jernigan is one of a kind, and she is genuine.” Among her accomplishments, Jernigan helped to close a $300 million capital campaign a full year ahead of schedule and with an extra $57 million. She also rebranded MUSC’s gift planning office in such a way that increased planned gifts from $6 million annually to more than $23 million annually. “Toni will always stay late, make the drive, plan the meeting — whatever it takes to advance our mission,” Fisher said at the reception. “She brings a sense of ownership and pride to the growth and continued success of the Medical University, and that’s something people notice.” Jernigan spent her early career working with challenged students. She began her fundraising career in 1998 with the St. Jude Children’s Research Hospital in Memphis as regional major gift officer and planned giving representative. Jernigan thanked her peers after receiving the award,
photo provided
Toni Jernigan, associate executive director of development at MUSC, was named Outstanding Professional Fundraiser of the Year by the AFPSC Lowcountry Chapter. saying, “It has been you who have motivated me to be the best I can be.” She also thanked her late mother, the first person to teach her the joy of giving.
Pharmacy leader praised for clinical research, education Staff Report South Carolina College of Pharmacy’s Kelly Ragucci has been named the winner of the American College of Clinical Pharmacy (ACCP) 2015 Education Award, to be presented as part of the opening general session at ACCP’s 2015 Global Conference on Clinical Pharmacy in San Francisco on Oct. 18. Ragucci, professor and chair of the Clinical Pharmacy and Outcomes Sciences Department (CPOS) at the SCCP, was cited for her “sustained work and leadership in clinical pharmacy education,” which ACCP Executive Director Michael Maddox called “truly commendable,” adding that she “has set a high standard for other educators nationally to emulate.” ACCP’s Education Award recognizes a member who has shown excellence in the classroom or clinical training site;
“Dr. Ragucci is illustrative of the college’s commitment to education and we’re delighted she’s being recognized for her outstanding work.” Philip Hall, PharmD conducted innovative research in clinical pharmacy education; demonstrated exceptional dedication to continuous professional development; or shown leadership in the development of clinical pharmacy education programs. “Dr. Ragucci is illustrative of the college’s commitment to education, and we’re delighted she is being recognized for her outstanding work,” said Philip
Dr. Kelly Ragucci will receive the 2015 ACCP Education Award at the organization’s October conference. Hall, campus dean at MUSC. “She is an exemplary faculty member.” Often selected as a professor of the year by students in the pharmacy college, Ragucci has also been honored with universitywide accolades such as being named the 2012 winner of the MUSC Teaching Excellence Award in the Educator-Lecturer category and the
2011 MUSC Outstanding Clinician Award. She was a finalist for the 2013 Governor’s Professor of the Year Award and has won numerous other awards. Ragucci earned her bachelor’s in pharmacy with high honors from Ohio Northern University and her PharmD from the University of Toledo College of Pharmacy. She did a primary care specialty residency in family medicine at MUSC in 1997 and 1998 and has earned certifications in basic life support, physical assessment, Board of Pharmacotherapy Specialists, diabetes education and advanced cardiovascular life support. After serving as assistant professor at Wilkes University, she joined MUSC in 2000 and was promoted to associate professor in 2004. She became a full professor in 2011 and served as assistant dean for the curriculum on the MUSC campus before becoming CPOS chair in 2013. She has served as chair of the ACCP Clinical Practice Affairs Committee and has held several national positions, including chair of the Ambulatory Care Practice and Research Network and the Constitution and Bylaws Committee.
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Area children lobby for MUSC on Capitol Hill By Lauren Sausser of The Post and Courier
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USC sent two kids up to Capitol Hill last month for some heavy lifting with federal lawmakers. Turner Hill, 12, and Zion Thomas, 14, represented MUSC leaders as they raised awareness about sickle cell disease and the new $350 million children’s hospital among South Carolina’s congressional delegation. “This was my first trip to D.C.,” said Turner, a rising seventh grader at University School of the Lowcountry. Turner is a lifelong patient at MUSC Children’s Hospital. He was born nine weeks prematurely and needed a kidney transplant before he turned 3 years old. Turner spoke to several congressmen about the hospital’s plans to build a new facility on the corner of Calhoun Street and Courtenay Drive by 2019. The project is expected to cost $350 million, the majority of which will be financed by the federal government through U.S. Department of Housing and Urban Development loans. “It’s important because the old hospital is around 30 years old,” Turner said. But his trip to Washington wasn’t all business. “We got to go on a very special tour with (Rep.) Tom Rice, (R–S.C.),” he said. “He took us through the Capitol by himself on our own tour and he took us up on the Speaker’s porch and down on the House floor.”
Turner Hill, right, and his mom, Helen Hill, met with Rep. Jim Clyburn and members of Congress during their visit.
Zion, a rising freshman at Summerville High School, suffers from sickle cell disease, a genetic blood disorder. He had been invited by Sen. Tim Scott, R-S.C., to kick off Sickle Cell Day in Washington, but the event was postponed following the mass shooting at Emanuel AME Church in Charleston. Lawmakers from across the country offered their condolences to Zion once they found out he lived in the Lowcountry. Later that week he attended a picnic at the White House and shook hands with President Barack Obama. “He said I was well dressed. I was a handsome young boy and that was pretty much it,” Zion said. “Most of my friends are like, ‘Dude, you’re famous!’ ” Pat Votava, a federal advocate for the MUSC Children’s Hospital, spends a lot of time with politicians herself, but said children like Turner and Zion have a way with lawmakers that adults can’t copy. “They’re articulate and they’re sincere and they know what a difference good health care for children can make,” Votava said. And the legislators look forward to hearing their stories, she said. “When they see me without a child, they look disappointed. They do — always,” Votava said. “Congressman (Trey) Gowdy (R–S.C.) and Congressman (Jeff) Duncan (R-S.C.) always say, ‘Where’s the kids?’” Editor’s note: The article ran in the July 5 edition of The Post and Courier and is reprinted with permission.
MUSC Children’s Hospital patients Zion Thomas, second left, and Turner Hill, far right, met SC Congressman Trey Gowdy, far left, and Clemson President Dr. James Clements on Capitol Hill. The pair were in the nation’s capitol raising awareness about sickle cell disease and promoting the new MUSC Children’s Hospital project.
photos provided
The Catalyst, July 17, 2015 5
Meet Charles
Charles S. Schleich Department Surgical Trauma ICU How you are changing what’s possible at MUSC I am currently involved in a highly reliable organization project to bring nursing shift change reporting to the bedside. This is an evidence-based practice which is being used in hospitals across the country How long at MUSC Six years Health care hero you admire and why Girolamo Fracastoro (1500s) — He figured out the “germ theory” of diseases Three characteristics of an effective nurse Kind, industrious and studious What food is in your pantry A good pinot noir Idea of a perfect vacation Tropical island with white sand beaches, ice cold cerveza and a fishing pole Favorite quote “Qui desiderat pacem, praeparat bellum.” —Vegetius
To contact MUSC Public Safety at the press of a button or to access a wealth of information on emergency scenarios, download the MUSC Notify App by visiting appstore.musc.edu and signing in with your Net ID and password. Instructions are available at http:// academicdepartments.musc.edu/ocio/ MUSCNotify.pdf.
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Epilepsy
have to stay several days in the hospital recovering: there’s some pain involved; it’s a big surgery. But, with laser ablation, they get the procedure, and they go home the next day.” Vandergrift stressed the most important benefit to the new technology is the improved patient experience. He hopes the non-invasive technology will encourage more patients to seek a surgical treatment. For Sanders, at least, that was certainly the case. “The non-invasive aspect of the procedure helped me make the decision for sure,” she said. “I’m very thankful it was an option. I was really happy to be able to have it done at MUSC and confident that I was in good hands with Dr. Vandergrift, who took the time to explain everything to me.”
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problems, tiredness and liver problems. There’s the psychological component knowing that one has a chronic health condition. There’s also a risk for cardiac or breathing problems that come along with seizures.” What causes seizures? “We think it’s a bad part of the brain that is out of sync, electrically, with the rest of the brain,” Vandergrift said, explaining that this can result from genetics, infections, traumatic brain injuries, tumors or a host of other sources. “If the seizure stays in that one particular place, we call it a focal seizure, but if it spreads over the entire brain it’s a generalized seizure.” In the past, epilepsy has been treated medically, through a variety of drugs that vary in effectiveness and come with a range of side effects, or surgically, via an invasive, open-brain procedure that, while effective, required significant preparation and recovery time and often exacted significant collateral damage to healthy brain tissue. “If we can find the place where the seizure originates, then we can stop the seizures before they start,” Vandergrift said. “The standard that we’ve used for years and years is to do an operation where we cut through the skin, take part of the skull off and basically cut out part of the brain. For very superficial areas, that’s usually a pretty straightforward process. For bigger parts of the brain or deeper areas, there’s a destructive part of the operation where you have to cut through normal brain tissue to get to the abnormal brain tissue.” A revolutionary new technology changes that. Visualase sterotactic laser ablation lets neurosurgeons perform complex, deep-brain surgeries that may have been impossible only a few years ago, allowing for minimally-invasive treatment of epilepsy and even previously inoperable brain tumors. Vandergrift detailed the process involved in determining if a patient is a surgical candidate. “Epileptologists do special studies to figure out where the seizures are coming from: electroencephalogram (EEG) brainwave studies, advanced imaging studies like Positron emission tomography (PET) scans and singlephoton emission computed tomography (SPECT) scans, and obviously magnetic resonance imaging (MRI) scans. Once we agree on the location, we have to decide if we can take that part of the brain out or not.” To make that decision, one must first understand how the brain works. Vandergrift explained the difference between eloquent and non-eloquent parts of the brain. Parts of the brain responsible for specific functions are called eloquent, while parts of the brain that do not have a specific function are called non-eloquent. “For example,” he said, “there’s part of the brain that makes the big toe move. If you cut that part out, your big toe would be paralyzed. Likewise, there are parts of the brain specifically responsible for speech, vision or memory. And then there are parts you can take out and nobody really knows the difference. “Every part of the brain does something,” Vandergrift
Image by Emma Vought, Neurosurgery
A minimally invasive technique, the Visualase procedure is performed by inserting a wire-thin laser applicator into the patient’s brain to burn away tumors or damaged tissue. Because the laser applicator is so small, only a few millimeters in diameter, surgeons can reach previously inaccessible areas deep within the brain without risking collateral damage to healthy tissue. continued. “But, the brain has an amazing ability to reroute some functions to other parts of the brain and cope with the loss of non-eloquent areas. And then you have to account for dominance of the brain. There are two hemispheres to the temporal lobe, which is where I’ve done all these surgeries: the right temporal lobe and the left temporal lobe, and one will be dominant compared to the other. If you injure the dominant temporal lobe, you might have deleterious effects to language and memory. But, with the non-dominant temporal lobe, you can do so without those risks.” Vandergrift continued: “If we can find the single source of the seizure in a non-eloquent part of the brain, then the patient is a surgical candidate. Laser ablation therapy is one of the latest and most advanced forms that surgery can take. “To perform the Visualase procedure, we make a small hole in the skull and insert a laser wire, about the size of a piece of cooked spaghetti, into the brain tissue and place the tip where we want to remove brain tissue. We then turn the laser on and the laser energy cooks that part of the brain. When we’re done, we take the wire out and put a little stitch or staple, and we’re done. “This technology allows us to make targeted strikes without the risk of collateral damage that some of the other operations bring along with them,” he said. “With bigger operations, open-brain surgery, patients
“This technology allows us to make targeted strikes without the risk of collateral damage that some of the other operations bring along with them.” Alex Vandergrift, MD Vandergrift was eager to share credit with the rest of the team. “We have an excellent epilepsy team,” he said. “Drs. Jonathan Edwards, the program director, Jonathan Halford, Ekrem Kutluay, Barbara McManus, Paul Pritchard, Leo Bonilha, Braxton Wannamaker, and Kent Holden—as well as clinical instructors Elizabeth Koontz and Julie DesMarteau. It’s been a pleasure to work with them, and the entire team is eager to embrace new technologies like Visualase. There’s no bigger epilepsy team in the state, for sure, and I’d say we’re one of the best in the Southeast, in terms of both quantity and quality. We’re a great resource for the state and the region.” For information on neurosurgery at MUSC, visit http://academicdepartments.musc.edu/neurosciences/
Authorship 2 workshop sponsored by Women Scholars The MUSC Women Scholars Initiative will sponsor a workshop on authorship from 1 to 3 p.m., July 23, in Room 112, Bioengineering Building. Speakers include Dr. Deborah Yelon, Dr. Bruce Ovbiagele, Dr. Dan Lackland and Dr. Ed Krug. Participants can hear presentations on authorship, conflicts of interest, assigning credit, and collaborative authorship from experts in the field. All faculty, staff, and students are welcome to attend. Please RSVP to Megan McDonough (mcdonoum@musc.edu)
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Tumor
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which kills cancer cells with laser-guided blasts of heat. “Technology is changing so rapidly,” Eskandari said. “MUSC is not afraid to push the boundaries for patient care.” Sonya’s journey from tumor patient to young NeuroBlate pioneer was a fast one. She first saw Eskandari through MUSC’s Pediatric Brain Tumor program in January. An MRI had detected the tumor on the right side of her brain. Sonya, who showed no symptoms other than a slight bit of weakness on the left side of her body, was referred to Eskandari. The pediatric neurosurgeon took a cautious approach. “That area of the brain, deep within where her tumor is, is really high–priced real estate,” Eskandari said. “It’s not an area where you want to go digging to try to cut out the tumor.” So he monitored the tumor for a few months. If it wasn’t getting any bigger, he might be able to leave it alone until Sonya was old enough for radiation. Unfortunately, what he saw was alarming. “The tumor was just a little dot at first,” Eskandari said. “But it grew rather quickly. We were quite concerned.” A biopsy confirmed that Sonya’s tumor was benign, but its growth suggested it could damage some of her healthy brain tissue and might evolve from a low-grade astrocytoma into a malignant or highergrade tumor. Eskandari told her family about the
NeuroBlate System, which could zap the tumor without the damage that surgery by hand could cause. They were intrigued by its potential to treat the tumor safely and also by its similarity to something Sonya’s family loves: video games. Sonya was named after Sonya Blade, a character in the game Mortal Kombat. To use the NeuroBlate System, Eskandari would place Sonya in an MRI, then control the system remotely from another room. Sonya’s mother said they did some research, talked to people through online support groups and decided go with Eskandari’s idea. “We were a little worried,” Denean Gibby said. “But we put it in God’s hands. Dr. Eskandari had done a really good job so far with Sonya, so we just let him take care of it.” With the support of a multi– disciplinary team at MUSC that agreed NeuroBlate was an appropriate treatment for Sonya, Eskandari scheduled the surgery. The morning of May 15, Sonya checked into MUSC Children’s Hospital. Her mother said Sonya had watched an online video showing how NeuroBlate worked, but didn’t want to think about it too much. “Her stance was always, she’s just going to let it happen,” Gibby said. Sonya was prepared for surgery, and Eskandari drilled a pencil–sized hole into her skull so the laser probe could reach into her brain. Then, Sonya was placed in the MRI machine. From his control
Sonya and her mother, Denean Gibby, talk with Dr. Eskandari about what may happen as her tumor responds to the NeuroBlate treatment.
photos by Sarah Pack, Public Relations
Sonya Gibby shows Dr. Ramin Eskandari that she can lift both arms following a procedure to attack her “inoperable” brain tumor that could have affected her movement. center, Eskandari connected the MRI to NeuroBlate using a robotic device. Then, it was time to put the laser to the test. Eskandari chose NeuroBlate because its laser has side–firing capability. It was perfect, he believed, for attacking Sonya’s irregular–shaped tumor. He used the laser to deliver energy that converted to lethal heat as the tumor’s tissue absorbed it. “You tell the system the location you want to go after, and you’re doing an MRI every time you do the laser, so you get continuous feedback,” Eskandari said. In other words, he could see exactly what he was doing in real time. Thanks to the system’s technology, he could cool the laser immediately to limit the spread of its heat, protecting healthy tissue. He warned Sonya’s family that she might have some difficulty moving after the procedure, her mother said. “They expected her to come out not being able to move either side of her arms or legs. She came out, and she was moving everything,” Gibby said. “They didn’t know if she’d be drooling or her face would be like a stroke patient. She didn’t have any of that.” Sonya went home less than 24 hours after she’d checked in, a small bandage on her head the only sign of what she’d been through. She returned two weeks later for a checkup with Eskandari, wearing a dress with a unicorn design. “You doing all right?” he asked.
“Yeah,” Sonya answered with a smile. “Let me see your scar.” Eskandari examined Sonya’s head. The place where the probe went in was healing well. “Just like we looked for growth in your tumor, we’ll look for the opposite of growth now. Decay.” “Ungrowth!” Sonya said. “If the tumor died at the time of the laser, and it was all heat necrosis, it should slowly liquefy,” Eskandari told Sonya’s mother. It could take months to see significant change in the tumor, he said. “The hole that I want to see will come slowly as the body eats away the tissue that was targeted. We’ll follow the progression of the tumor into dead tissue, then hopefully to a cavity. Best case scenario, it kills it and we watch the area for the rest of her life.” Eskandari said the tumor may grow back, but when Sonya is older, it can be killed with radiation. “We want to get her to a point where her brain is more developed for that.” Sonya will return to MUSC for a brain scan every two months. For now, “She’s fine,” her mother said. “Everything seems to be right where it needs to be.” While the specific treatment Sonya received was unprecedented in South Carolina, MUSC surgeons have used other laser brain procedures, including Visualase, to treat everything from brain tumors to epilepsy.
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Nurses, medical center ready for Magnet® visit By Mikie Hayes Public Relations A 3 ½-year journey toward nursing excellence culminates this week in a fourday visit by appraisers from the American Nurses Credentialing Center. Their objective: to decide if MUSC is worthy of Magnet® status, a highly-coveted designation among elite hospitals. The Nurse Magnet designation is the nation’s most prestigious nursing honor, recognizing nursing excellence. Considered the gold standard for nursing care in hospitals, Magnet status has been achieved by less than 7 percent of hospitals in the United States; hospitals that have earned it have met extremely stringent criteria. Only 418 organizations worldwide have achieved Magnet designation. Andrea Coyle, R.N., Professional Excellence manager, came to MUSC from the Cleveland Clinic, a highlyregarded institution and a Magnet hospital. Having been through the
process, there, Coyle understood the importance of the designation to a hospital and discussed its merits with Chief Nursing Officer Marilyn Schaffner, Ph.D., R.N. Schaffner was already very familiar with the designation. During the mid-1980s, as a master in nursing administration student at Duke, her advisor at the time had worked with leaders on what was then the underpinnings of what would eventually become the Magnet designation. They were looking at the differences in organizations that were very successful as opposed to those that had, for instance, high nursing turnover rates. Out of that research was born the 14 Forces of Magnetism that later formed the conceptual framework for the Magnet Recognition Program®. What some may not know, Schaffner explained, is that seven years ago, MUSC was on the journey towards Magnet designation and had gotten quite close to submitting the requisite documents.
photo provided
Medical center CEO Dr. Patrick Cawley, far right, joins Charlie the Riverdog and other hospital employees at the ART lobby May 20 to celebrate opening day of MUSC’s Nursing Magnet® site visit preperations. However, after discussions with then CEO-Stuart Smith, who felt MUSC needed to focus on firming up the foundation necessary to be successful, they chose to stop the Magnet process and move instead to the culture change known as “MUSC Excellence.”
“In retrospect,” she said, “it was such a wise decision, as we’ve since built a very firm foundation throughout the institution on which to build this Magnet journey. Now we have everybody on board. This journey is not just about
See Magnet on page 9
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Magnet
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nursing,” she added, “it’s about the whole organization moving to a higher level of excellence.” With the Excellence work having set the stage, and backed by the board of trustees and top administration, the Magnet preparation team readied the medical center for a process that has reshaped nursing, interdisciplinary collaboration and professional development. According to Coyle, no one has been a bigger advocate during the application and preparation phases than CEO Patrick Cawley, M.D. His support and leadership, she said, have been instrumental in getting the medical center to this point. As CEO of the medical center, Cawley will be meeting with the team from the ANCC during the site visit. He looks forward to the outcome he believes will be positive. In contemplating their arrival, he said: “Please join me in welcoming the American Nurses Credentialing Center’s team of appraisers to MUSC campus as we continue on this the final part of our journey toward earning the prestigious Magnet status. As we approach this last inning, I want to thank each of you: those who have played leadership roles in bringing us to this point where we are within inches of realizing what has been a 3 ½-year goal and to the entire medical center staff who has embraced this mission and made it their own.
From that first pitch at the Joe, to being here in what for us is the World Series, our team is prepared, we’re on top of our game, and we’re pumped. Remember to be proud of what you've done, what we've accomplished, and what MUSC stands for – which is excellence in all things. While we hope the appraisers find us worthy of receiving the highly-coveted Magnet status, we will come out the other side stronger, more collaborative, and confident that the principles of the Magnet designation pervade all we do.” World Series: the big leagues Prior to the appraisers’ visit, the ANCC encouraged patients, family members, staff and any interested parties to participate in the evaluation process by providing confidential comments to the Magnet Program Office. In readying themselves for the site visit, appraisers reviewed documentation related to patient-to-nurse ratios; evaluated the results of patient satisfaction surveys; and paid special attention to the number of nurses certified in specialty areas, nurseled initiatives aimed at improving the hospital work environment and patient care, and how nurses at MUSC advance in their careers. The appraisers come to MUSC visiting from health care organizations around the country. During their site visit, they will meet with senior leadership and tour all areas of campus where nurses work and where nursing takes place. It is not unusual for the appraiser team to meet with upward of 2,000
Team members of 9East have for the past two quarters received the highest patient satisfaction scores.
photos provided
Members of the 8West nursing staff gather with Chief Nursing Officer Dr. Marilyn Shaffner as they prepare for the upcoming Magent® visit. people during the site visit: nursing staff, physicians, MUSC staff, senior leaders, service line administrators, medical directors and representatives from the College of Nursing. Gail Stuart, Ph.D., R.N., dean of the College of Nursing, looks forward to the visit. "The College of Nursing is excited to welcome the Magnet site visitors as we highly value the Magnet designation in that it represents excellence in nursing care, patient outcomes and a positive interprofessional culture. These elements create the ideal learning environment for our students as they will see in practice what we teach them in their courses." Schaffner, the top nursing leader on campus, understands the appraisers have a herculean task in front of them. She believes MUSC is prepared for this special site visit which she hopes will serve to reflect MUSC’s commitment to consistently achieving the highest standards in nursing and patient care. “Receiving the Magnet designation will be a validation of MUSC’s nursing excellence and the institution’s commitment to providing the highest quality patient care, striving always for the best outcomes,” she said. “We are honored to have the ANCC examiners on our campus for this important final phase in the process and for the opportunity to demonstrate the Magnet principles that drive our efforts related to professional practice, inter-disciplinary collaboration and transformational leadership in all things.” MUSC nurses have a great deal to be proud of, Coyle said. It’s time,
she believes, for them to share their greatness with the world. “All the things our nurses have accomplished should be visible, whether that is certification plaques, applause cards, Catalyst articles, clinical posters, nursing annual reports, Nurse of the Year nominations, DAISY winners wearing their pins, trauma pins — everything that points to our excellence.” Coyle, who is responsible for the baseball theme approach to the task, is elated that the time for the site visit is finally here. “Monday, April 27, was opening day, and we’re finally in the ‘World Series’. All our preparation has led us to this important week.” To keep enthusiasm high and everyone’s eye on the ball, many fun events were planned during the nine innings. The 7th-inning stretch, planned by Robin Smith, administrative assistant for professional excellence, and the pep rally were among the favorites. Carolyn Thompson, R.N, explained that staff from all across the organization collaborated by volunteering for the pep rally. As they roamed campus visiting nursing units and building a spirit of excitement for the upcoming site visit, they passed out candies, office supplies, snacks and other goodies as a token of appreciation. "Serving as my unit's Nursing Excellence Champion,” Thompson said, “I participated in ample preparation sessions and group meetings to help us facilitate our individual unit's readiness for the site visit. As someone who
See Magnet on page 11
10 The Catalyst, July 17, 2015
2015 Lowcountry Heart Walk – Raise Money, Lose Pounds MUSC kicks off the 2015 American Heart Association Heart Walk Campaign this week as team captains from various departments, units and divisions representing the entire organization gather to discuss the upcoming event scheduled for Oct. 3 at Liberty Square. The Lowcountry Heart Walk is the American Heart Association’s mission in action. This annual celebration promotes physical Susan Johnson activity and heart healthy living while raising awareness about heart disease and raising money for research that has yielded medical breakthroughs, with $1.6 million in grants funding MUSC researchers to date. This year ,as teams are formed and walkers are recruited, MUSC Office of Health Promotion would like to challenge each team captain to encourage their members to begin a walking program, either as a group or individually. Walking is simple, free and one of the easiest ways to get more active, lose weight and become healthier. Beginners can start walking anytime and regular walking 30 minutes or more can contribute to better health. In addition to reducing risk for heart disease and stroke, walking helps with mental and emotional health by increasing production of endorphins, boosting energy levels and reducing stress level. Top 10 Reasons to Walk q Reduce risk or manage type 2 diabetes q Strengthen your heart q Improve cognitive function q Strengthen bones q Reduce risk of cancer q Improve flexibility q Burn calories q Lower risk of stroke q Reduce symptoms of depression q Reduce stress Designed to promote physical activity and hearthealthy living, the Heart Walk creates an environment that’s fun and rewarding for the entire family. Participants help raise even more in their fight to save lives. Walk with friends, family, coworkers or strangers you’ll bond with along the way. Strollers, wagons and dogs are welcome. Employees and students looking for a team – consider joining MUSC Health Promotion Team and receive a free water bottle and pedometer. Just follow these three easy steps: q Visit www.lowcountryscheartwalk.org and click MUSC Health q Scroll down and click “join team” next to MUSC Health Promotion q Follow the prompts to register. Once you’ve joined the team, we’ll need your help
Health at work
to reach our team fundraising goal. Don’t worry — fundraising is easy. The American Heart Association provides all the tools, including your personal fundraising page. The power of encouragement and team support can make the difference in the success of this event as well as the health of our community. Join a team today.
Employee Wellness
q July Monthly Mindful Challenge — Make sleep a priority. Begin by taking the challenge’s first survey at http://tinyurl.com/qgv5dfk. A link to the final survey will be sent at month’s end to those who take the first survey. q Employee Finess Series — 12:15 to 12:45 p.m., July 15: Exercise Bands: Take 30 minutes during lunch to learn how a 10-minute exercise band workout can lead to better health and fitness. Class is led by fitness expert Katie Blaylock of the Human Performance Lab. Participants receive a free day pass to the MUSC Wellness Center. Participants should check in at the membership desk for directions to the class and receive their pass. Email musc-empwell@musc.edu to register. q Worksite Screening — Thursday, July 30, Clinical Sciences Building, Room HE628h; This screening, valued at about $350, is available to employees with the State Health Plan (including MUSC Health Plan) at no charge for the basic test. Employees and spouses without this insurance can participate for $46. Go to musc.edu/employeewellness/2015WorksiteScreening. To register, click on link provided. q Chair massages — Free massages are offered to employees from 11:30 a.m. to 1:30 p.m. on Wednesdays. Check broadcast messages for locations and times. q Farmers Markets — Fresh fruits and vegetables are available from local farmers on Fridays from 7 a.m. to 3:30 p.m. at the Horseshoe. Look for returning vendors King of Pops and Angel Blends.
MUSC Wellness Center
q HITS (High Intensity Training System) — Make yourself faster, stronger and more agile through this sixweek program. Sign up at the membership desk. Visit www.musc.edu/hsc or 792-5757. q Adventure Out is a yearlong outdoor fitness campaign to encourage residents to visit city parks for exercise. Free fitness classes with the purchase of an Adventure Out T-shirt or tank ($10/$15) for the entire year. T-shirts purchased from previous years are valid. Classes are designed for all ages and fitness levels. For information, visit www.musc.edu/adventureout.
MUSC Urban Farm
q Third Thursday Work and Learn — 12:14 to 12:45 p.m., Topic: Feeling tired? What to eat for energy q Early Bird Maintenance — 7:30 to 8:30 a.m., Wednesdays
q Sunset Work and Learn — 4 to 5 p.m., Thursdays q Saturday Work and Learn — 9 to 11 a.m., July 18 For information, email Susan Johnson, Ph.D. at johnsusa@musc.edu or Susan B. Whelan at whela@ musc.edu.
The Catalyst, July 17, 2015 11
Magnet
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photo provided
6West ART team created a baseball-themed grand slam diamond highlighting the unit’s Magnet Nursing goals and team status. Other hospital units were encouraged to create posters to be displayed in unit lounges and areas.
values excellent patient outcomes and the benefits that Magnet brings to an organization, I gladly took on this role. I took it upon myself to lead a Magnet Roaming Pep Rally the two weeks leading up to the site visit, which has helped excite, engage and support staff on all shifts and show appreciation for all that we are doing to achieve Magnet." While the site visit might be the most nerve-wracking part of the journey to Magnet designation, Coyle wants to remind everyone that their hard work has already paid big dividends. “As the ANCC appraisers arrive on campus, I am reminded of everyone’s commitment and collaboration in reaching for Magnet designation. Congratulations everyone on how far we have come. Having been involved since MUSC’s Magnet inception, I’ve enjoyed watching how MUSC has responded to an enterprise wide endeavor of this magnitude. It is captivating to watch everyone rise to the occasion: nurses, environmental services, doctors, pharmacists, respiratory therapists — everyone is on board. I am especially grateful to the nurses for their hard work and dedication and proud of how they took the ball and ran with it. I am in awe of how much has been accomplished since January of 2012. Whether we, as an organization, worked toward enhancing communication, shared governance, transformational leadership, professional development, or interprofessional teamwork, the bottom line is, it has all culminated in better outcomes for our patients and a healthy work environment for MUSC employees.
12 The Catalyst, July 17, 2015
DPT Students Assist in Adaptive Water Ski Clinics Dr. Sara Kraft of the Division of Physical Therapy and neuromuscular physical therapy course students spent two weekends in June and July assisting participants at clinics sponsored by Achieving Wheelchair Equality and Make It Happen groups. The student-volunteers helped out with the group’s annual Adaptive Water Ski clinics held at Lion’s Beach in Moncks Corner. Clinics were open to anyone recovering from stroke or living with autism, blindness, spinal cord injury or other disabilities. Students learned how to fit participants in jet skis, water skis, kayaks, boats and use other adaptive equipment. The students also learned how to perform patient transfers and rescues, conducted water tests and packed equipment at the completion of activities. photo provided