In 1987, Richard Fisher had his first open heart surgery. Then, in 2001, he had his second. “My heart’s always been an issue,” he says. “I felt like there was always a problem, and I was seeing a doctor all the time. But, I learned to live with it.”
In the years following his second surgery, Richard’s once active life began to slow down. The now 71-year-old retired from his job as a truck driver for the Post-Gazette. He started reading more and spent additional time with his family. He also enjoyed going out to lunch several times a week with close friends. “I was really having a good time being retired, and just living my life as best I could,” he says.
But, despite multiple surgeries to keep Richard’s heart strong, it was slowly losing its strength. And Richard was feeling the effects. “I started becoming very short of breath, all the time,” he says. “I was having difficulty walking up the stairs, and even walking outside to the car became difficult. I became very limited in what I could do, and I knew something wasn’t right.”
Looking for a solution, Richard was referred to Robert Kormos, MD, director of the UPMC Artificial Heart Program. Testing showed that Richard was suffering from congestive heart failure, meaning his heart muscle wasn’t pumping blood efficiently enough to meet his body’s needs. Because of this, fluid was also building up in Richard’s lungs, causing his shortness of breath. Dr. Kormos recommended that Richard undergo a Left Ventricular Assist Device (LVAD) implant procedure, which is designed to help the heart’s weakened left ventricle - the major pumping chamber of the heart - pump blood throughout the body.
“This was the best solution for Richard to get his heart healthy again,” says Dr. Kormos. “Because of his prior surgeries and age, he was not considered a candidate for a transplant. So this method was seen as an alternative to transplant, and would provide Richard’s heart with the long-term support it needs.”
After the surgery, Richard immediately felt the effects of the LVAD. “I remember going home from the hospital and not being short of breath anymore,” he says. “It was a great feeling.”
Now, more than two years after the surgery, Richard enjoys being able to live his life the way he chooses. “Since the surgery, I’ve been feeling like I’m back to my old self,” he says. “I just got back from Florida, and I go shopping with my wife all the time. Basically, I can do whatever I want. And I can’t be happier for that.”
After seven years of marriage, Allyson and Adam Hince were ready to start a family. With successful careers - Allyson, 33, is a program manager at Carnegie Mellon University and Adam, 32, is an associate product manager at TrueCommerce - they felt the timing was right.
When they had difficulty conceiving, Allyson consulted her gynecologist, who ordered extensive fertility tests. They were then referred to Anthony Wakim, MD, director of Assisted Reproductive Technology at Magee-Womens Hospital of UPMC.
After additional testing, Dr. Wakim recommended that they pursue in vitro fertilization (IVF) with intra-cytoplasmic sperm injection (ICSI). With ICSI, the embryologist selects a single sperm to be injected directly into an egg, which eliminates the challenge of the sperm penetrating the egg. To further improve their odds of conceiving, Dr. Wakim suggested EevaTM, or Early Embryo Viability Assessment, a new technology that analyzes early embryo development using time-lapse imaging.
"In traditional IVF, eggs are placed into an incubator and checked daily, which can disturb them," Dr. Wakim explains. "With Eeva, the incubator does not need to be opened. Instead, a computer transmits images to the outside, which tells us which embryos are reaching their milestones appropriately."
Magee-Womens Hospital of UPMC was one of the first medical centers in the United States to use Eeva, following FDA approval in 2014, and is the only center in Pittsburgh to employ the technology.
Wanting the support of their family before embarking on this journey, Allyson and Adam discussed the decision with both sets of parents, who encouraged them to move forward. Within a week of meeting with Dr. Wakim, they decided to start treatment.
To induce egg growth, Adam injected Allyson with fertility medications twice daily. For someone who has a fear of needles, the experience was difficult for Allyson, but she says it brought her closer to Adam.
“Going through this has made our relationship stronger. I found out how caring he is with how he treated me through this process,” Allyson says.
The treatment paid off quickly, as the couple conceived after their first IVF cycle, and the new addition to their family is expected in August. In the meantime, they are updating their house in preparation for the baby and launching a business that will deliver farm-fresh foods directly to consumers in the region.
“Having a baby will change our lives for the better,” Allyson says. “These challenges are another obstacle that we’ve gone through together and have come out of the other side stronger.”
It was 42-year-old Louis Nicksick's first deployment. He was stationed at Bagram Airfield in Afghanistan, serving with the 447th Military Police unit of the Army Reserves. Louis' job was to ensure that soldiers and property on the base were protected at all times, along with controlling traffic, preventing crime, and responding to emergencies.
But on a late fall day in 2009, he woke up with double vision and a terrible headache. At first he thought he was experiencing recurring symptoms from a past automobile accident. However, when the pain and double vision persisted, Louis knew something wasn’t right and alerted his commanding officer.
Louis was immediately sent to the Landstuhl Regional Medical Center in Germany, where doctors found an extremely large mass growing in his brain. Because of the sheer size of the mass, he was sent to Walter Reed Army Medical Center in Washington, D.C. for additional testing. There, he was diagnosed with a chordoma, a rare, aggressive, and invasive type of bone cancer often located at the base of the brain. "I knew when the doctors told me I had a chordoma, my outlook wasn't good," says Louis. "But, I'm a fighter, and I was going to fight this thing head on."
Throughout the next two years, Louis underwent several operations to stop the growth of the tumor. He also went through two months of proton beam therapy. Despite the physical strain of the procedures, they were working. Louis no longer had blurred vision or headaches. And he was back to work at his job at a cabinet manufacturer.
But that hope soon faded. In 2012, Louis was at a baseball game with his older son when the double vision and severe headache returned. An MRI scan revealed that the chordoma had returned, and was growing rapidly. A short time later, he underwent an additional surgery, followed by Gamma Knife® radiosurgery. But the tumor still continued its aggressive growth.
With Louis now having had surgeries in his hometown of Cleveland, as well as Boston and Washington, D.C., he became frustrated, and sought another opinion. He was referred to renowned UPMC neurosurgeons Paul Gardner, MD, and Juan Fernandez-Miranda, MD.
After a consultation, Louis’ new team of doctors was able to remove 98 percent of the tumor using the Endoscopic Endonasal Approach (EEA). This state-of-the-art, minimally invasive treatment approach allowed the surgeons to access the chordoma through the natural corridor of the nose, without making an open incision. “EEA has been a revolution for treating chordomas,” says Dr. Gardner. “In the past, large open surgeries were required. Now, by going through the nostrils, we’re able to land directly on the tumor and remove it without affecting the surrounding tissue.” To help prevent a recurrence, the small amount of remaining tumor will be treated with Gamma Knife radiosurgery.
A year after his EEA surgery, Louis is back to leading his life, pain free. Although he’s no longer in the Army and had to retire from his job, he’s grateful for the care he received. “The doctors at UPMC are just phenomenal,” he says. “That’s who I trust with my life, and who I’m going to stick with from now on.”
Dr. Paul Gardner
Dr. Juan Fernandez-Miranda
Julie Blanc has always had a passion for fitness. Whether it was running, aerobics, or weight training, the 48-year-old first grade teacher was constantly pushing herself to improve. “I’ve always wanted to stay fit and active,” she says. “It’s a big part of my life.”
But over the years, being active started to catch up with her. The constant movement and pressure began to irritate her left Achilles tendon - the band of tissue that connects the calf muscle to the heel bone. Julie eventually developed Achilles tendonitis, painful inflammation of the tendon caused by overuse.
Julie went to multiple foot doctors looking for a remedy. She was told to rest and the inflammation would go away on its own. As time went on, her condition only worsened. Her tendonitis, in combination with a Haglund’s deformity, a bony enlargement on the back of the heel, made her symptoms unbearable. “It got to the point where my shoe wouldn’t fit and I was in a lot of pain,” she says. “It looked like I had a golf ball implanted into the back of my foot.”
Discouraged at the thought of not being able to continue her active lifestyle, she sought out additional foot and ankle specialists, all of whom advised that her running days were over. Then, her brother-in-law, who works as an athletic trainer at the University of Pittsburgh, recommended she visit MaCalus V. Hogan, MD, a renowned orthopaedic surgeon and researcher, subspecializing in foot and ankle surgery.
After her initial consultation, Julie knew she was in the right place. “Dr. Hogan told me that I’d be running again in a year,” she says. “His confidence was enough for me to trust him, so I was all in with whatever he planned to do.”
Dr. Hogan was able to reconstruct the damaged areas of Julie’s Achilles tendon and remove the enlargement of her heel bone that was irritating her tendon. Due to the extent of Julie’s tendon injury and the amount of bone he had to remove, Dr. Hogan had to detach portions of Julie’s tendon. He used a new approach - called bone marrow aspirate concentrate - to aid the tendon and bone healing process. “Basically, we harvest bone marrow from the hip and separate the stem cells using a centrifuge,” says Dr. Hogan. “These stem cells are then injected directly into the surgical site of the Achilles tendon, which helps the tendon-bone-interface healing process and optimizes new blood vessel growth.”
After the surgery, Julie was on the path to recovery. And she was thrilled that Dr. Hogan’s prediction was correct. “He was right, I was back to running in about a year,” she says. “I’ve even run in the Chicago and Pittsburgh Marathons. And I’m running a half marathon in Las Vegas shortly. It’s like I never had any problems at all.”
Nearly five years ago, during a routine visit to his primary care physician, 52-year-old Mark Yost was told that he had an abnormality in his throat. Mark, who has worked at the VA hospital in Pittsburgh for 15 years as a surgical assistant, was determined to get a diagnosis as soon as possible.
Because he works alongside many UPMC physicians in the operating room, Mark turned to one of the world’s leading experts in head and neck cancer treatment, Umamaheswar Duvvuri, MD, PhD.
Dr. Duvvuri, director of robotic head and neck surgery at UPMC, immediately had Mark undergo a biopsy to determine whether his throat abnormality was cancer. That biopsy came back positive, and a subsequent CT scan revealed that the cancer on his tonsil had metastasized, spreading to his lymph nodes. Mark was diagnosed as having stage 4 head and neck cancer.
“It was devastating to find out that it was stage 4,” he says. “I work in the medical field, and I know there’s no stage 5. I was afraid of losing my life.”
Dr. Duvvuri presented Mark with a comprehensive treatment plan, which included robotic surgery combined with radiation therapy. “We use robotic instruments to allow us to provide better care for the patient,” says Dr. Duvvuri. “What this means is that we can effectively miniaturize our hands and get into really tight spots in the body. And with Mark, that is exactly what we needed to do.”
Mark opted for Dr. Duvvuri’s suggested approach. “I had no doubts about robotic surgery,” he says. “I’ve seen a lot of cases where I work, and I knew it was the way to go.”
Following his surgery, Mark was released from the hospital in just five days and experienced a recovery time far shorter than from traditional surgery. Because the robotic arm was able to extract the cancerous mass and affected lymph nodes with extreme precision, he was able to immediately begin radiation therapy, which helped destroy any remaining cancer cells.
So far, Mark’s yearly CT scans have revealed no trace of cancer. He’ll soon have his five-year check-up and expects to receive a clean bill of health, effectively labeling him cancer-free. “I’m very grateful that I was able to beat this thing,” says Mark. “Dr. Duvvuri was someone that I more than trusted. I put my life in his hands. And, I was absolutely right. He saved my life.”
Today, as 49-year-old Tammy Tilburg prepares for her fast-approaching wedding, she reflects on her experience battling a serious disease that changed the course of her life.
In late 2012, Tammy was feeling ill and experiencing irregular periods. She scheduled a visit with her gynecologist, who ordered an ultrasound. Soon after, Tammy was diagnosed with cervical cancer.
“My diagnosis was a total surprise,” Tammy says. “By the time they caught it, my tumor was four centimeters in diameter, so having a hysterectomy to remove it was not possible.”
After discussing treatment options with doctors in Emporium, Pa., Tammy was referred to Sushil Beriwal, MD, a radiation oncologist at UPMC CancerCenter at Magee-Womens Hospital of UPMC. Dr. Beriwal specializes in advanced cancer treatments, including brachytherapy.
“The most common type of radiation therapy is delivered externally, but sometimes we do radiation therapy from the inside,” Dr. Beriwal explains. “This is when we put the radioactive isotope very close to the cancer, which is called brachytherapy. ‘Brachy’ means ‘close’ and ‘therapy’ means ‘treatment.’”
UPMC was one of the first adopters of three-dimensional MRI image-based brachytherapy in North America, which today yields high survival rates with minimal complications for cervical cancer patients.
After traveling to Pittsburgh to see Dr. Beriwal, Tammy knew that UPMC was where she wanted to receive her therapy. Two weeks later, she began treatment, a combination of chemotherapy, external radiation therapy, and brachytherapy.
For seven weeks, Tammy received treatment in Pittsburgh. Despite experiencing unpleasant side effects, she was buoyed by visits from her family and the progress she was making under Dr. Beriwal’s care. Relishing her new lease on life, Tammy started online dating while still receiving treatment. She was matched with Matt, who resides close to Emporium. After her treatment ended, Tammy returned home to meet the man who would eventually become her fiancé.
“Since returning home, my whole attitude changed,” says Tammy, who has since returned to her job in quality assurance. “I feel lucky to be alive, and I don’t take anything for granted anymore. I’ve been cancer-free for three years, and I’m getting married next month. God was so good to me, and turned this experience into a wonderful thing.”