Fighting More Than Just Fire
New Tool Helps Karen Conquer Epilepsy
Health Care In Your Pocket
Randy Meyer | Fighting More Than Just Fire
The physical demands of a firefighter are grueling. And 32-year-old Randy Meyer knows that. Whether it be climbing flights of stairs with 150 pounds of equipment strapped to his back, dragging a 200-pound hose across a city block, or carrying a full-grown adult out of a building that’s about to crumble to the ground, he’s always been up to the challenge. “For me, it’s just part of who I am,” Randy says. “I’ve always felt the need to help people, and this is just perfect for me.”
Randy spends most of his time at the firehouse on Penn Avenue, in Lawrenceville. Every week, he completes two or three 24-hour shifts, and during which he answers 10 to 20 calls. But, that doesn’t mean there are 20 fires a day. “People think firefighters just put out fires, but that’s not the case,” he explains. “We do it all. We respond to vehicle accidents, medical emergencies, water rescues, people trapped in buildings, and so much more.”
He’s been a firefighter for nearly 10 years. And 10 years from now, you’ll still likely be able to find him hustling around that building on the corner of 40th and Penn. But about five years ago, Randy’s passion nearly came to a tragic end.
At first, Randy thought nothing of it. He would experience minor indigestion and sometimes felt pain after eating. But when the pain turned excruciating, he knew that something wasn’t right. He was referred to a gastroenterologist, but his symptoms were written off as acid reflux. The medications were no help. Time passed, and the symptoms continued. He often felt bloated and found his appetite wasn’t what it had been. Multiple doctor visits found nothing, and Randy continued to suffer. Finally, a CT scan ordered by a different gastroenterologist revealed his problem: pseudomyxoma peritonei, or PMP. Randy had never even heard of this. Not many people have. PMP is a rare type of cancer that starts with a tumor in the appendix. The tumor grows, bursting out of the area where it started and spreading to the abdomen, or belly. Once in the belly, more tumors form and make a jelly-like substance. This eventually fills up the belly and can push on other body parts. It can even block the intestines or cause them to fail, which can have devastating results.
A Plan of Action
Randy needed to act quickly. He visited a local hospital, but with PMP being such a rare disease, they were unable to help. Then a family member stepped in and set up an appointment with David L. Bartlett, MD, vice chairman of surgical oncology and gastrointestinal services at UPMC. After looking at Randy’s CT scan, Dr. Bartlett wanted to start treatment immediately. “Randy’s cancer was very invasive. We had to have a plan of attack and treat his condition very aggressively," says Dr. Bartlett, who sees patients at UPMC CancerCenter, which in partnership with the University of Pittsburgh Cancer Institute, is the region’s only Comprehensive Cancer Center as designated by the National Cancer Institute.
"We're just so happy that everything turned out the way it did, and I’m looking forward to what comes next for us," Stephanie says.
Within a week, Randy was under general anesthesia on an operating room table. Dr. Bartlett and his team of experts were ready to begin the task of removing the tumors growing inside Randy’s stomach. The procedure, called cytoreduction combined with hyperthermic intraperitoneal chemotherapy, or HIPEC, for short, is something Dr. Bartlett has done more than 1,000 times, and it takes up to 17 hours to complete. First, the abdomen is opened up and the tumors are scraped, cut, or burned away. Then, because tumor cells are more vulnerable to high temperatures than normal cells, chemotherapy heated to 107 degrees Fahrenheit is circulated into the abdomen. Medical staff then rocks the patient back and forth, ensuring the cancer-killing drug reaches every possible area of the abdomen. Then the team suctions out the drug, closes the wound, and the surgery is over.
For Randy, recovery took several months. But even after surgery, he was still not out of danger. Because his cancer was so aggressive, more tumors returned, and he had to have the same surgery again 14 months later. A new round of chemotherapy followed, and then a third surgery. This time, it was to remove tumors that spread to his lungs and diaphragm. "I definitely went through the gauntlet," Randy says. "But after my last surgery, Dr. Bartlett told me he removed mostly all of the cancer, and I couldn’t have been happier." Due to the complexity and nature of the cancer, there are still several small traces left, which are being monitored by Dr. Bartlett.
Living the Good Life
Six months after his last surgery, with no signs of any tumors in his belly and feeling healthy for the first time in years, Randy went back to work at the firehouse. He says that his fellow firefighters are like family to him, and they kept in touch when he was going through the worst. When he was too sick to work, someone always covered his shift, making sure that he never missed a paycheck. “I can’t thank these guys enough,” he says. “They’re all like my brothers. I’d do anything for these guys.”
Randy also was able to marry his longtime girlfriend,
Stephanie. “She’s my everything,” he says with a smile.
“She helped me get through those tough times where
I didn’t know what was going to happen next. And
by the grace of God and support of our family, we
were able to have the wedding of our dreams.” Randy
and Stephanie have embraced the concept of living
each day to the fullest and have been traveling the
world. “We’re just so happy that everything turned
out the way it did,” says Stephanie. “I’m looking forward
to what comes next for us.”
Randy (center) with his fellow firefighters at the Pittsburgh Fire Bureau Station 6 in Lawrenceville.
David L. Bartlett, MD
Karen Kurtz | New Tool Helps Karen Conquer Epilepsy
For years, people suffering from epilepsy depended on anti-seizure medications, with surgery considered a last resort. While many patients benefit from medications, about 30% do not, and they continue to suffer from debilitating seizures and a reduced quality of life. That’s changing with recent advances in epilepsy surgery that make it more precise and less invasive. Today, many of these people can benefit from highly specialized brain surgery that incorporates robotic 3D brain mapping technology called ROSA™, which stands for Robotic Stereotactic Assistance.
GPS for the Brain
R. Mark Richardson, MD, PhD, director of the UPMC Epilepsy and Movement Disorders Program, is always eager to introduce new advances to his diagnostic and treatment arsenal. Several years ago, Dr. Richardson brought a procedure to Pittsburgh called stereo-electroencephalography, or SEEG, which is used to map where seizures originate. More recently, Dr. Richardson introduced the ROSA device, which allows him to more precisely place SEEG electrodes in half the time, for optimal brain mapping. “Once we place the electrodes, we monitor the brain’s electrical activity in 3D,” says Dr. Richardson. “ROSA helps us determine precisely what area of the brain to target for stopping a patient’s seizures.” In other words, it’s like GPS for the brain.
Ready for the Next Step
Dr. Richardson had already used ROSA for several patients when Karen Kurtz sought his expert opinion. Now in her 30s, Karen was diagnosed with epilepsy at the age of 17. She suffered from complex partial seizures, which begin in the area of the brain that affects awareness. The seizures often left Karen dazed and she appeared to be staring off into space. She also experienced involuntary movements called automatisms, which can include involuntary chewing, swallowing, or hand clapping.
Prior to visiting Dr. Richardson, Karen took a multitude of prescriptions. She tried to lead a normal life, but was never sure when her next seizure would strike. “I was getting by okay,” she remembers. “I was still having seizures, and I could tell that the medication wasn’t going to help me forever.”
"Life has been great since I had the surgery," she says.
High Precision is Key
“When I first met Karen and reviewed her medical history, I thought it was likely we’d be able to treat her seizures,” says Dr. Richardson. Thankfully, he was able to offer Karen the option of minimally invasive diagnostic testing using ROSA to locate the precise area of Karen’s brain that was causing her seizures.
Dr. Richardson performed the SEEG procedure using ROSA’s robotic arm as a guide to place tiny recording electrodes into Karen’s brain. The electrodes identified abnormal activity deep within her brain that revealed the exact area where her seizures started.
"Using SEEG and the ROSA technology, our epilepsy team was able to pinpoint the area of seizure onset with very high precision,” says Dr. Richardson. “Karen’s seizure focus was close to brain areas important for language function, but our team used the SEEG and ROSA data again to create a plan for safe surgical treatment.”
One week after Karen’s first surgery, Dr. Richardson removed the electrodes. Then, using a minimally invasive approach, he removed the part of Karen’s brain causing the seizures. After surgery, Karen was quickly discharged without any significant speech problems and returned to work only a month later. She has been seizure-free since the operation. "Life has been great since I had the surgery," she says. “I don’t have any real restrictions. And I’m able to do all of this because of my faith in God and having a great doctor like Dr. Richardson.”
Karen enjoys the sunshine in her hometown of Butler, PA
R. Mark Richardson, MD, PhD
MyUPMC | Health Care In Your Pocket
What if you could manage your health care as easily as you handle your banking transactions or hail a ride from Uber? Smartphone users — which today means 77% of all American adults, ranging from 92% ages 19-29 to 42% age 65 and older* — have become accustomed to organizing their lives with the touch of a finger.
More than 500,000 UPMC patients already have access to the MyUPMC online patient portal, where they can communicate with their doctors, renew prescriptions, see lab results, schedule appointments, and pay bills. And later this year, smartphone user will see many enhancements to the portal when the MyUPMC mobile app is released.
These enhancements will set the stage for a more personalized health care experience than has been offered by other health systems. "MyUPMC makes it easy for patients to manage their health care," says Tami Minnier, chief quality officer at UPMC. "But it’s more than that. I believe that in the future, MyUPMC will lead to better outcomes."
Meet Your Virtual Health Care Assistant
Imagine if appointment notifications, reminders to take your medicine, and videos of your home physical therapy exercises were available through a single app on your phone. What if you could book a ride with Uber directly through your appointment reminder… then check in, show your insurance card, and pay your copay through your phone?
It’s not far-fetched. Right now, UPMC is developing the MyUPMC mobile app and expanded web portal to provide a seamless, consumer-friendly mobile experience for UPMC patients and Health Plan members. When the app rolls out later this year, it will include all the current features of MyUPMC, like quick access to your UPMC medical records, video medical visits, appointment scheduling, and bill paying. No matter your experience with smart phones or tablets, navigating the app will be simple. But that’s just the beginning. More features will be added that make accessing your health care easier than ever.
"I believe that as it expands, it will become an indispensable source of trusted information for our patients."
“If you think of the new MyUPMC app as a container or an ecosystem, there are very few limits as to what features can be added, based on what an individual patient or member needs,” says Ashkan Afkhami, who leads the health care practice at Mobiquity, a global digital engagement provider. His team has developed apps for medical device companies that automatically track when patients take pills with tiny ingestible sensors, and that track how much inhaler medication is needed for patients with severe asthma and COPD. “These are just some examples of what has been developed already that could be plugged into MyUPMC to provide better management of chronic conditions for patients and their doctors,” he says. Other health-focused apps — related to weight loss, exercise, sleep, etc. — could be plugged in based on a consumer’s interest.
So what’s next from MyUPMC? The app will be available later this year for use on both IOS and Android devices. Once the app has rolled out, periodic updates will add new features and improve old ones. "MyUPMC is already a great tool," says Minnier. "I believe that as it expands, it will become an indispensable source of trusted information for our patients."
*Pew Research Center Mobile Fact Sheet, January 12, 2017