PATIENT care
ADVENTURES WITH PHRED further kill residue or circulating leukemia cells or lymphoma cells.” Reicher was one of the first patients to undergo an allogeneic stem cell transplant at Upstate. He is president of the housing nonprofit Christopher Community. Tisdel, his wife, works at Syracuse University. For patients undergoing stem cell transplants, “eir white blood cell count goes to basically zero, so they are at high risk for infection,” explains nurse Meghan Lewis. Jeffrey Pu, MD, PhD e day they receive the transplant becomes Day Zero, and patients typically remain hospitalized for two or three weeks aerward. Reicher wrote on CaringBridge when he was allowed to go home that “my cell and immune system will be that of an infant. I have to grow a new system and will have a functioning but immature system, just like a baby. “Infection is the greatest risk, so I will have to be very careful at home with food, the house and visitors.” Eventually Reicher will receive a new series of immunizations against childhood diseases such as polio, measles and whooping cough. ●
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Two types of stem cell transplant
AUTOLOGOUS STEM CELL TRANSPLANT— a patient receives his or her own stem cells, which are removed from the patient’s body and frozen for safekeeping while he or she undergoes chemotherapy. Aerward, the stem cells are returned to the patient’s body. is is a treatment option for patients with multiple myeloma or lymphoma.
ALLOGENEIC STEM CELL TRANSPLANT— patients receive stem cells from a healthy matched donor. is is a treatment option for patients with leukemia or lymphoma that has relapsed.
Remove the appendix – or not? THE APPENDIX FOR CENTURIES has been a misunderstood organ, hanging like a tail from the junction of the large and small intestines. When it became inflamed, surgeons were quick to remove it. Over the last decade, the number of appendectomies has decreased partly because of a better understanding of the appendix. e organ appears to have an immunological function, since people who have an appendix are less likely to develop infections of the colon, says Moustafa Hassan, MD, an associate professor of surgery at Upstate. A blockage in the appendix can prompt a rapid growth of bacteria and inflammation, known as appendicitis. Symptoms may include a loss of appetite, nausea and pain around the belly button or in the right lower part of the abdomen. Hassan says some people with appendicitis will require urgent surgery, and some will get better with just antibiotics. In some situations, an operation may be too risky.
ose who did not have surgery recovered well — but nearly half went on to develop appendicitis again and require surgery within the next five years.
Hassan helps his patients with appendicitis consider all factors as they decide whether removing the appendix makes sense. As he explains, “!n surgery, there is no one size fits all.” ●
The size of the appendix, a pouch near where the large and small intestines meet, varies from person to person but may range from less than an inch to 6 inches in length.
A recent study conducted in Finland divided patients with uncomplicated appendicitis into two groups: half underwent surgery, and half only received antibiotics.
winter 2019 l upstate.edu
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