Double Arm Transplant Candidate Hoping for Independence

Posted by Brigham and Women's Hospital July 16, 2014

Will Lautzenheiser has been approved as a candidate for a bilateral (double) arm transplant.

Brigham and Women’s Hospital (BWH) announced at a recent press conference that Will Lautzenheiser, 39, a former professor of film production and screenwriting at Boston University and Montana State University, has been approved as a candidate for a bilateral (double) arm transplant.

Will became a quadruple amputee in 2011, when doctors in Montana removed his limbs due to necrotizing fasciitis (flesh-eating disease), a life-threatening Group A streptococcal infection. Since that time, Will has struggled to manage with prosthetic (artificial) limbs.

“After losing my limbs, I haven’t been able to do anything spontaneously,” said Will. “It might take me 20 minutes to get dressed using prostheses.” He added that often “other people have to be my hands.”

A successful arm transplant, however, has the potential to significantly restore a patient’s self-reliance. “What we are hoping to provide is independence, something that no prosthesis really can achieve at the present time,” explained Dr. Bohdan Pomahac, Director of the BWH Plastic Surgery Transplantation Program.

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Eating after Bariatric Surgery

Posted by Brigham and Women's Hospital June 24, 2014

After bariatric surgery, you’ll be introduced to a diet that features gradual changes in food textures.

You’ll have to start eating differently after having weight loss surgery, but that doesn’t mean you’ll have to give up all your favorite foods. Let’s start by talking about how things will be different.

Your stomach acts as a holding tank for food and beverages and as a strong muscle that grinds and churns your food, helping with digestion. Depending on the procedure, weight loss surgery either removes a large portion of your stomach or significantly restricts access to your stomach. And, as you can imagine, reducing the capacity of your stomach makes it much harder for it to do its job.

To help your stomach adapt to this increased workload, you’ll be introduced to a staged diet that features gradual changes in food textures. You’ll drink protein shakes for two weeks and then slowly advance to soft foods for four weeks. With time, you should be able to tolerate a variety of textures, as long as you eat slowly and chew carefully. For more information on the post-operative (and pre-operative) diet, see the Nutrition Resources section of our Center for Metabolic and Bariatric Surgery site.

Surgery + You = Weight Loss

Weight loss surgery alone doesn’t ensure that you’ll lose weight and keep it off. You also will need to change the way you eat for the rest of your life in order to be successful. This means reducing your calorie intake by eating small portions and avoiding calorie-packed foods and beverages. Fortunately, your modified stomach is a built-in portion control tool, so all you have to do is put healthy foods on your plate and stop when your stomach is full.

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Improving Joint Replacement – From Consultation to Recovery

Posted by Brigham and Women's Hospital June 4, 2014

BWH's evidence-based knee replacement process is based on research by the Care Improvement Team, led by orthopedic surgeon Dr. John Wright (center).

As a concerned friend or relative of a patient who recently had a joint replaced, you might be tempted to ask: “How was your surgery?” But research findings from our Department of Orthopedic Surgery suggest that you should be just as concerned about how they were treated before and after surgery.

Brigham and Women’s Hospital (BWH) now uses a standardized approach to total knee replacement that guides how patients should be treated from the time they arrive at the hospital for a consultation to the care they receive after being discharged. This new evidence-based approach is based on the work of the Care Improvement Team, led by orthopedic surgeon Dr. John Wright. After researching prospective changes to conventional knee replacement practices, the team tested selected changes and evaluated their effects. Changes found to have had a significant impact were incorporated into a new knee replacement process, which is now the standard protocol for all knee replacement surgeries at BWH.

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Health Screenings – To-Do List for Men

Posted by Brigham and Women's Hospital June 3, 2014

Every man should have their blood pressure checked regularly. This can be done at the doctor’s office or at home.

Detecting symptoms of certain health conditions early, when they’re more easily treatable, is a critical factor in helping men stay healthy. That’s why getting all your doctor-recommended health care screenings in a timely fashion is the kind of to-do list that no man should ignore.

Below is information about some of these important health screenings for men, including the appropriate timing for each.

Abdominal Aortic Aneurysm

Men between the ages of 65 and 75 who have ever smoked tobacco should get screened for an abdominal aortic aneurysm. An imaging test, such as a computed tomography (CT) scan, ultrasound, or magnetic resonance imaging (MRI) study, can help determine the presence, size, and extent of an aortic aneurysm. The major risk of this aortic bulging is a rupture resulting in severe or fatal internal bleeding.

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Why Should You See a Physiatrist?

Posted by Brigham and Women's Hospital May 27, 2014

Physiatrist Zacharia Isaac, MD, specializes in conservative spine care.

Don’t be embarrassed if you don’t know what a physiatrist does. In the context of the medical world, physiatry is a relatively new discipline. Recognition of the practice was heightened during World War II, when physiatrists were called upon to supervise the rehabilitation of U.S. soldiers returning home with severe musculoskeletal disabilities. Soon afterward, in 1947, physiatry was formally approved as a medical specialty by the American Board of Medical Specialties.

Physiatrists (also known as physical medicine and rehabilitation physicians) specialize in non-surgical care for conditions – particularly neuromuscular (nerve, muscle, and bone) disorders – that cause pain and impair normal, everyday functions. Along with their standard medical training, many physiatrists also pursue additional training in one or more of the following subspecialties: musculoskeletal rehabilitation, pediatrics, spinal cord injury, sports medicine, traumatic brain injury, and pain medicine. Brigham and Women’s Hospital physiatrists focus on caring for pain related to spine and sports conditions.

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The Latest about Mammography: Benefits, Risks, and Choices

Posted by Brigham and Women's Hospital May 8, 2014

Opinions continue to vary about when a woman should start getting a mammogram and how frequently thereafter.

A team of Brigham and Women’s Hospital (BWH) researchers recently examined 50 years of international breast cancer screening research data to assess the benefits and risks of mammography. Their determination: the benefits of mammography are modest, and the harms are significant, making it very important that women make informed decisions about screening.

“There are benefits to mammography in decreasing the likelihood that a woman will die of breast cancer,” says report co-author Dr. Nancy Keating, a physician in the BWH Division of General Internal Medicine and Primary Care and an associate professor of Health Care Policy at Harvard Medical School. “But those benefits are not enormous.”

Those benefits also vary according to age, as well as other risk factors, such as family history. The report authors estimate that for every 10,000 women aged 40-49 who get annual mammograms for the next 10 years, approximately 190 of those women will be diagnosed with breast cancer. Of those 190, 5 will avoid death because of getting a regular mammogram, 25 will die regardless of their regular screening, and the majority (160) will survive, also regardless of regular screening. As a woman gets older, however, the benefit of routine mammography steadily increases, accounting for:

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Cocoa and Multivitamins: Two Keys to Better Health?

Posted by Brigham and Women's Hospital April 23, 2014

Does the cocoa bean contain heart health benefits?

Is there something valuable for your heart inside the cocoa bean?

Brigham and Women’s Hospital (BWH), Seattle-based Fred Hutchinson Cancer Research Center, the National Institutes of Health (NIH), and Mars, Incorporated are partnering to conduct the largest-ever clinical investigation of the heart health benefits of cocoa flavanols – especially their role in reducing the risk of heart attack, stroke, and death from cardiovascular disease.

Flavanols are natural compounds that can be found in cocoa beans and a variety of other food sources. Although cocoa flavanols can be found in some forms of chocolate, they can be provided in significantly higher concentrations as a capsule or powder (mix). In this particular trial, the cocoa flavanols will be provided in a capsule and compared to a placebo.

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Blue Light Boosts Daytime Performance

Posted by Brigham and Women's Hospital March 27, 2014

Blue light

Blue light exposure during the day immediately improves alertness and performance.

Brigham and Women’s Hospital (BWH) researchers have found that exposure to short-wavelength (blue) light, which is abundant in daylight, during the biological day directly and immediately improves alertness and performance.

“Our previous research has shown that blue light is able to improve alertness during the night, but our new data demonstrates that these effects also extend to daytime light exposure,” says Shadab Rahman, PhD, a researcher in BWH’s Division of Sleep and Circadian Disorders and the study’s lead author. “These findings demonstrate that prolonged blue light exposure during the day has an alerting effect.”

To determine which wavelengths of light were most effective in warding off fatigue, the BWH researchers teamed with George Brainard, PhD, a professor of neurology at Thomas Jefferson University, who developed the specialized light equipment used in the study. During a 6.5 hour period, one group of study participants was continuously exposed to blue light while a comparison group was exposed to an equal amount of medium-wavelength (green) light. Throughout the exposure period, brain electrical activity was monitored, reaction times were measured, and participants were asked to rate how sleepy they felt.

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Gender in Medicine: Getting Both Sides of the Story

Posted by Brigham and Women's Hospital February 25, 2014

The National Institute of Medicine says that “every cell has a sex.” This means that men and women are different, at least physiologically, all the way down to the molecular and cellular levels. But, according to Dr. Paula Johnson, Executive Director of the Connors Center for Women’s Health and Gender Biology and Professor of Medicine at Harvard Medical School, these biologic differences are often ignored when designing medical studies, and even when valuable gender-specific findings are in our hands, we often fail to apply the knowledge. Although Dr. Johnson suggests that women’s health has suffered most from these failures, she stresses that placing greater emphasis on sex- and gender-based research and care will help reap benefits for both women’s and men’s health. Watch the following video to learn more.

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Plasma and Platelets: Unsung Lifesavers

Posted by Brigham and Women's Hospital February 18, 2014

John is happy to be back at his antique clock shop after emergency heart surgery at BWH.

John Bain, 71, of Brookline, MA, recently had emergency heart surgery at Brigham and Women’s Hospital (BWH), and his surgical team didn’t need to give him a single drop of red blood. As contradictory as it may seem, it took a lot of donors – and a lot of teamwork – to help make that happen.

While visiting his cardiologist, Dr. Brian Bilchik, in the fall of 2013, John suddenly developed chest discomfort and was transported by ambulance to BWH. Dr. Bilchik ordered a CAT scan, and after examining the test results, told John that he would need immediate surgery to repair an aortic dissection – a dangerous, often fatal heart condition that involves tearing of the aorta’s inner wall. Left untreated, such a tear may quickly advance through all three layers of the aorta and rupture, leading to massive internal bleeding.

Cardiac surgeon Dr. Michael Davidson then stepped in to take John to the operating room for emergency surgery. “I had a CAT scan, and, probably an hour later, I was on the operating table,” recalls John. “It was that quick.”

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