Reeling in the Years Lives extended by 21st-century health care, Texas Medical Center

Reeling in the Years Lives extended by 21st-century health care, Texas Medical Center

                                         Reeling in
                                         the Years
                                                 Lives extended
                                                 by 21st-century
                                                     health care,
                                                             p. 20

                                                  THE TMC’S MOST
                                                      PLACES, p. 6

                                                    TURNING THE
                                                       TIDE, p. 10

                                           DeBAKEY HIGH GRADS:
                                          WHERE ARE THEY NOW?
                                                          p. 34
Reeling in the Years Lives extended by 21st-century health care, Texas Medical Center

How Two TMC Employees Saved Thousands by Joining a Vanpool

   Thirteen years ago, Patricia discovered          and reduce stress on
 Houston METRO’s regional vanpool program           their daily commute.
                                                                                     COMMUTE SAVINGS SUMMARY SINCE 2016
 – METRO STAR Vanpool. Before then, she
 was driving from Crosby to the Texas Medical
                                                     Taking the first step                Kathleen                                     Patricia
 Center every day - twice a day. As if the stress
                                                    towards joining a                     Henshaw                                       Boone
                                                    vanpool is easy. Once
 from sitting in bumper-to-bumper traffic
                                                    a person registers,
 isn’t enough, the cost of parking, tolls, and
 car maintenance can quickly turn a commute
                                                    METRO STAR matches
                                                    people with other
                                                                                      $8,300.21                                    $8,372.13
 into the worst part of a person’s job. Patricia                                       REDUCED COST                                REDUCED COST
                                                    commuters who live
 had to fill up on gas at least 3 times a week.
                                                    and work in similar
 It made her feel like she was paying to go to
                                                    areas with its ride-
  It was when she joined the vanpool that
                                                    matching system.
                                                    The cost is based on             1,383.37 (gal)                              1,395.36 (gal)
 Patricia met Kathleen Henshaw. Thirteen            commute distance, van              REDUCED FUEL                                REDUCED FUEL
 years later, Patricia and Kathleen continue        size and the number of
 to share a ride to work, and a wonderful
 friendship. They are a shining example of
                                                    commuters. The fare
                                                    covers maintenance,              26,837.35 (lbs)                            27,069.89 (lbs)
 how vanpooling brings people together              fuel, tolls, insurance,                 REDUCED                                      REDUCED
 and sometimes even creates life-long               roadside assistance and               GREENHOUSE                                   GREENHOUSE
 friendships. Patricia and Kathleen are part of     three emergency rides                    GASES                                        GASES
 an 8-person vanpool and share a 45-minute          home per year.
 commute from Humble to the TMC. “It’s really
                                                      Both women said they
 interactive,” says Kathleen, “everybody knows                                                          Besides saving money, sharing a ride
                                                    were compelled to give
 each other. The newest person on our van has                                                          to work in a vanpool has also enhanced
                                                    vanpool a try because of the potential savings,
 been with us almost a year.”                                                                          Kathleen’s and Patricia’s personal lives. “I
                                                    so we conducted a cost savings analysis
  The TMC currently has 120 vanpool groups          on Patricia’s and Kathleen’s commutes to           can catch up on the news, nap, or relax and
 consisting of a total of 1,018 employees           see how much money vanpooling saves                unwind from my day so when I get home
 commuting from all over the Greater Houston        them. Since 2016, both women have saved            to my kids I can be a better mom,” says
 area. “A vanpool route can end and/or start        over $8,000 each. Kathleen repurposes              Kathleen. Patricia likes that she can pay
 anywhere in the 8-county region,” says Dezra       her savings towards the things that matter         bills, read, or plan things like family reunions
 Nauls, commuter services program manager           most to her while enjoying the benefits of         during her commute, “Everyone on the van
 at METRO. “We service Harris, Waller,              not driving her car to work every day, “The        really respects your time. We’ve learned each
 Montgomery, Brazoria, Galveston, Fort Bend,        savings mean more money in the family              other’s personalities. So if we see someone
 Liberty, and Chambers County.” METRO STAR          budget, less fear of breaking down on the          reading or working, everyone tries to be
 has been Houston’s vanpool provider for over       road, less stress when I arrive at work and, of    quiet.”
 20 years. Through this program, thousands of       course, meeting new friends and colleagues
 commuters have been able save time, money,         from other UT locations.”

 Vanpooling is a great way to improve your quality of life, meet new people, and
 help improve the region’s traffic conditions and air quality. Commuters who are
 tired of driving in traffic every day and are ready to try their new commute can
 visit to register or call 713-224-7433 for more information.
Reeling in the Years Lives extended by 21st-century health care, Texas Medical Center
               Ranked in

When it comes to neuroscience, it’s about collaborating
with a leading academic institution like Baylor College
of Medicine to revolutionize surgical approaches, find
innovative uses for technology, and navigate new frontiers.
It’s about the confidence in having some of the best brains
in neuroscience by your side, managing your care while
                  developing new treatments for tomorrow.

                         More at
Reeling in the Years Lives extended by 21st-century health care, Texas Medical Center
President’s Perspective

                                                                                                                                                                         TMC | PULSE
                                                                                                                                                                         Vol. 6 No. 8
                                                                                                                                                                         September 2019

                                                                                                                                                                         President and Chief Executive Officer
                                                                                                                                                                         William F. McKeon

                                                                                                                                                                         Communications Director

                                                                                                              Mark Mulligan/© Houston Chronicle. Used with permission.
                                                                                                                                                                         Ryan Holeywell

                                                                                                                                                                         Pulse Editor
                                                                                                                                                                         Maggie Galehouse, Ph.D.

                                                                                                                                                                         Assistant Editor
                                                                                                                                                                         Cindy George

                                                                                                                                                                         Staff Writers

                                        WILLIAM F. McKEON                                                                                                                Alexandra Becker
                                        President and Chief Executive Officer, Texas Medical Center                                                                      Britni R. McAshan
                                                                                                                                                                         Shanley Pierce


                     A       s president and CEO of the Texas Medical Center, I interact every day with other leaders
                             from the institutions that comprise the largest medical city in the world. Because I work
                      with such a diverse group of constituents—more than 60 member institutions, representing
                                                                                                                                                                         Cody Duty

                      more than 100,000 employees—I often reflect on an experience I had nearly a decade ago that                                              
                      influences my approach today.
                          The Harvard University Program on Negotiation taught me important lessons that help
                                                                                                                                                                         Felicia Zbranek-Zeitman
                      me to understand the unique needs of each of our members. Before the three-day program,
                      participants prepare for roles they’ll play in simulated negotiations. The exercise forces
                      everyone to take a position and argue for it, regardless of their personal convictions.
                          For example, one person might represent an offshore drilling company while another                                                             DISTRIBUTION
                      makes the case for environmental protection. As you might imagine, the facilitators encour-                                              
                      aged us to defend our positions vigorously. But we soon saw how that passion led us to                                                             READ US ONLINE
                      move swiftly away from any chance at reaching a mutually beneficial outcome. We became                                                   
                      entrenched, and our own opinions became obstacles to progress. I learned a great deal about
                                                                                                                                                                         FOLLOW US
                      myself and how to better engage in productive negotiations.
                          The lessons I learned long ago continue to help me better understand the Texas Medical
                      Center institutions I work with in this unique ecosystem. Some CEOs and leadership teams
                      are naturally collegial, while others may view collaboration as dilutive or contributing to a
                      loss of full control. Fortunately, the Harvard program identified these different styles of nego-                                                  TMC Pulse is an award-winning
                      tiation, and I often find myself recognizing them in the course of a discussion.                                                                   monthly publication of the Texas
                          So what’s the key to negotiating? The answer seems simple, but it requires a great deal                                                        Medical Center in Houston, Texas.
                      of commitment and much more time than a three-day program. My life experiences have                                                                Permission from the editor is
                      taught me that it is most important to patiently build meaningful, trusting relationships over                                                     required to reprint any material.
                      time. In both our personal and professional lives, it is the richness of these relationships that
                      determines our happiness and success. I recognize that this seems obvious, but so often I
                      observe people either intentionally or unintentionally creating barriers that obstruct the path
                      to forming sound and productive relationships.
                          I continue to learn every day. Some of the most challenging situations I face are often the
                      most exciting and satisfying to work through. The journey continues as I learn more about
                      myself and the incredibly diverse talent at all levels of the Texas Medical Center.

2   tmc   » p u l s e | s e p t e m b e r 2 01 9
Reeling in the Years Lives extended by 21st-century health care, Texas Medical Center
Table of Contents

            8                                          28                                       30                            32

         Scarless                            Treating Adults with                          Distracting Kids           Saving Health Care
         Surgery                            Intellectual Disabilities                      Before Surgery                 in America

                                                                                                               9	Curated: Dance for

                                                                                                               12	Spotlight: Major General
                                                                                                                   Rick Noriega

                                                                                                               15	Vitals: High risks and high
                                                                                                                    costs for young blood

                                                                                                               27	Next Med: Did you take
                                                                                                                   your pill?

                                                                                                               38 Field Notes

                                                                                                               40 Calendar

on this page:   Former elite cyclist Sinead Miller leads a medical device startup, p. 16
on the cover:   Ted Adderly prepares to fish near his home in Missouri City, Texas.
Reeling in the Years Lives extended by 21st-century health care, Texas Medical Center
Remembering Chernobyl
    Two physicians flew to Moscow in 1986 to treat patients exposed to radiation

     By Shanley Pierce

    H     BO and Sky Atlantic’s recent
          miniseries, “Chernobyl,” drama-
    tizes the nuclear accident that took
                                                                                                                                                                   Due to the limited resources avail-
                                                                                                                                                                   able in Moscow, Reisner shipped 16
                                                                                                                                                                   crates of supplies to build his small
    place on April 26, 1986 in the former                                                                                                                          lab in a Russian hospital.
    Soviet Union. But the medical after-                                                                                                                               Over the course of two weeks in
    math of that event was part of a real-                                                                                                                         Moscow, Reisner, Champlin and the
    life drama for two Texas Medical                                                                                                                               other two doctors performed bone
    Center doctors who traveled to                                                                                                                                 marrow transplants on 13 patients.
    Moscow to treat first responders                                                                                                                               Only two survived.

                                                                                                                                      Credit: HBO courtesy photo
    exposed to excessive amounts of                                                                                                                                    “The bone marrow transplant
    radiation at the scene.                                                                                                                                        worked in those two patients and,
        The disaster occurred after oper-                                                                                                                          ultimately, their own bone marrow
    ators disabled the control system                                                                                                                              slowly recovered over time, but the
    on the nuclear reactor as part of a                                                                                                                            transplant helped them survive the
    safety test, creating unstable power           The miniseries “Chernobyl” dramatizes the 1986 nuclear accident in the former                                   immediate effects of the radiation,”
    levels. Combined with a flawed reac-           Soviet Union.                                                                                                   Champlin said. “They were very
    tor design, this caused a massive                                                                                                                              sick and, in many cases, too sick,
    explosion and fires that pumped                that might help them was a bone            carry any radiation dosimetry                                        and received too much radiation to
    at least 5 percent of the radioactive          marrow transplant, since radia-            devices to measure the doses of                                      their GI tract for the bone marrow
    core into the air, according to the            tion is primarily toxic to the bone        radiation they received, doctors                                     transplant to save them.”
    World Nuclear Association.                     marrow and suppresses your blood           ran biological tests to estimate                                         Champlin brought his insights
        Within two weeks of the acci-              counts where people then die               how much radiation was absorbed.                                     and experience from treat-
    dent, four doctors from the United             of infections.”                            According to Champlin, they                                          ing Chernobyl patients to MD
    States arrived in Moscow, where                    As a result of the nuclear reactor     received 500 rads of radiation.                                      Anderson, where he uses bone
    victims—primarily firefighters                 explosion, 134 people involved with            “For the victims involved, they                                  marrow transplantation to success-
    who were the first on the scene of             the clean-up were confirmed to have        had terrible injuries. No treatment                                  fully treat leukemia, lymphoma and
    the explosion and exposed to high              acute radiation syndrome. Within           could have saved most of them,”                                      blood cancer.
    amounts of radiation—were evacu-               a few weeks, 28 of them died due           Champlin said. “Bone marrow trans-                                       Chernobyl was “an international
    ated for treatment.                            to radiation.                              plantation is of very little benefit                                 event with a lot of interest around
        Depictions of the victims in                   “When people are exposed to            in the overall scheme of things in                                   the world in the outcome of the
    the Emmy-nominated five-episode                high doses of radiation, it can cause      managing patients with radiation                                     treatment of the patients,” he said.
    miniseries were extremely realistic,           fatal bone marrow suppression,”            injuries. The primary lesson is to                                   “It was an exciting medical opportu-
    according to Richard E. Champlin,              Champlin said. “With radiation             prevent this type of accident from                                   nity, but, obviously, a tragic event for
    M.D., who was among the doctors                accidents, if you receive a low            happening in the future.”                                            the victims involved.”
    who worked with a Russian hospital             dose of radiation, you don’t need a            One of the other doctors                                             For Reisner, it was not only a
    to perform potentially lifesaving              transplant, but if you are exposed         recruited to treat radiation exposure                                poignant medical and scientific
    bone marrow transplants. He was                to a dose that is around 300 to 500        after the Chernobyl disaster was                                     experience, but a human experience,
    a part of the bone marrow trans-               rads of radiation [a rad is a unit of      immunologist Yair Reisner, Ph.D.,                                    as well.
    plant program at the University of             absorbed radiation dose]—that is           now a professor in the department                                        “Being there during the Cold
    California, Los Angeles at the time.           potentially fatal. You can be saved        of stem cell transplantation at MD                                   War with the Russians, for me, as
        “It was an emergency in which              with a bone marrow transplant. If          Anderson. Reisner specialized in                                     a young man, was very special …
    people had received, in many                   you get much higher doses of that,         bone marrow transplantation from                                     to be able to talk to them, learn
    cases, lethal doses of radiation,”             it unfortunately destroys other            mismatched donors and had devel-                                     about their lives and so on,” Reisner
    recalled Champlin, now chair of the            organs of the body and that is what        oped a procedure to avoid graft                                      recalled. “It’s not less important
    department of stem cell transplan-             happened to many of the victims in         versus host disease, a condition                                     than the science.”
    tation and cellular therapy at The             Chernobyl. They died of gastroin-          in which the donor bone marrow
    University of Texas MD Anderson                testinal toxicity and radiation.”          and the recipient’s own bone
    Cancer Center. “The one treatment                  Although the victims did not           marrow attack each other.

4   tmc   » p u l s e | s e p t e m b e r 2 01 9
Reeling in the Years Lives extended by 21st-century health care, Texas Medical Center
 is our middle name.
 We’re proud to be recognized as our city’s healthiest extra-large employer.
 As your public health system, we’re here to help Harris County residents lead long, healthy lives.
 As residents ourselves, we take that responsibility to heart. We want our teams to be strong,
 healthy and happy, too.

                         Making health a priority within our own organization is
                         good for us. And better for everyone we serve.
                         Join our team and see how we’re transforming health
                         in our community.

Reeling in the Years Lives extended by 21st-century health care, Texas Medical Center
The TMC’s Most Instagramm
    T   he Texas Medical Center is known around the world for
        its patient care, education and research—but it’s also
    a city in and of itself. Every day, thousands of employees,

    patients and visitors walk past unforgettable landmarks and
    striking architecture. With the approach of our 75th anni-
    versary in 2020, we put together a list of some of the most
    photographed places here in the world’s largest medical
    city, but it is by no means complete. We encourage you to
    share your favorite places and moments in the TMC on social
    media, and be sure to tag us using #TMCsnapshots.

    A J
       AMES TURRELL’S “TWILIGHT                        C T
                                                           EXAS CHILDREN’S                                    D
      EPIPHANY” SKYSPACE                                  HOSPITAL SIGNAGE
           Suzanne Deal Booth Centennial                 6621 Fannin St.
           Pavilion, West Quadrangle,
           Rice University Campus                         Reminiscent of a whimsical storybook,
                                                          the colorful, halo-lit, painted aluminum
           “Twilight Epiphany” is the 73rd in a           letters placed among flowerbeds also
           worldwide series of light-filled architec-     serve as a wayfinding tool that spells
           tural spaces created by the famous artist.     out T-E-X-A-S C-H-I-L-D-R-E-N-’S
           At sunrise and again at sunset, LED            H-O-S-P-I-T-A-L.
           lights cast against the Skyspace slowly
           change colors, complementing the sky’s
           natural transformation.                      D WORTHAM PARK
                                                          Corner of Holcombe Boulevard
                                                          and Main Street
           John P. McGovern TMC Commons,                 Constructed by John Burgee Architects
           6550 Bertner Ave., 6th floor
                                                          in 1991, the row of towering waterfall foun-         G
                                                          tains is a perfect backdrop for portraits or
           Whether you’re grabbing a quick break-         quiet moments of reflection.
           fast before clinic, enjoying a lunch
           meeting or sneaking in a happy hour with
           colleagues, the upscale restaurant run       E LABOR AND DELIVERY UNITS
           by executive chef Jon Buchanan offers          Multiple hospitals in the TMC
           plenty of photo-worthy dishes and drinks,
           including blueberry buttermilk pancakes.       Welcoming a baby into the world is often
                                                          described as one of the best days of a
                                                          parent’s life, so it’s no wonder that new-
                                                          born photos taken during those very first
                                                          moments are shared far and wide. This
                                                          photo shows Tessy Carpenter and her son,
                                                          Calvin Carpenter, born on January 6, 2019
                                                          at Texas Children’s Hospital’s Pavilion
                                                          for Women.
                                                                                                         Credit: E, Jessica Pierce with Bella Baby Photography; H, MD Anderson Cancer Center

6   tmc   » p u l s e | s e p t e m b e r 2 01 9
Reeling in the Years Lives extended by 21st-century health care, Texas Medical Center
mable Places   By Alexandra Becker

  B        C                         F BILL COATS BRIDGE
                                         Hermann Park, southwest of
                                         MacGregor Drive and Almeda Road

                                         The 290-foot suspension bridge for
                                         cyclists and pedestrians connects natural
                                         areas at the edge of the medical center to
                                         the heart of Hermann Park.

                                     G SURVIVOR BELLS
                                         Multiple cancer centers and
                                         hospitals in the TMC

                                         Patients who have completed cancer treat-
                                         ment are often offered the opportunity to
                                         a ring a bell signifying the end of chemo-
  E        F                             therapy or radiation. Shauntelle Tynan,
                                         pictured at Texas Children’s Cancer
                                         and Hematology Centers, traveled from
                                         Ireland for treatment.

                                     H T
                                        HE DOROTHY H. HUDSON
                                       MEMORIAL GARDEN AT THE
                                       UNIVERSITY OF TEXAS MD
                                       ANDERSON CANCER CENTER
                                         Main entrance to the campus,
                                         1515 Holcombe Boulevard

                                         The iconic garden contains more than
                                         500 roses and is a cherished place for
                                         employees, patients and loved ones to
                                         rest, reflect and recharge.

  H        I
                                     I   T HE WATERWALL
                                         John P. McGovern TMC Commons,
                                         6550 Bertner Ave.

                                     	Equal parts soothing and mesmerizing,
                                       the TMC’s waterwall is illuminated for
                                       national health observances or major
                                       milestones—like our hometown Astros
                                       winning the World Series.

                                                              tmc   » p u l s e | s e p t e m b e r 2 01 9   7
Reeling in the Years Lives extended by 21st-century health care, Texas Medical Center
Scarless Surgery
    A new technique for thyroid surgery makes small incisions inside the lower lip

     By Shanley Pierce

    T    oward the end of 2018, Tracy
         Faustermann began experienc-
    ing a host of unusual symptoms.
                                                                                                                                                      After two weeks of heal-
                                                                                                                                                  ing and reduced swelling,
                                                                                                                                                  there’s virtually no visible
    Her blood pressure was skyrocket-                                                                                                             sign of surgery.
    ing, she had terrible heartburn and                                                                                                               “Someone passing you
    her bones were weakening.                                                                                                                     on the street, even maybe
        “I thought I was just getting                                                                                                             your relatives, wouldn’t
    old,” Faustermann, 35, said. “It’s                                                                                                             even know you had surgery,”
    just life. I guess I got bad genes.”                                                                                                          Grogan said.
        One day, her stomach issues                                                                                                                   Currently, there is
    worsened to the point where                                                                                                                   no data to indicate that
    she needed to see a doctor. Her                                                                                                               this approach is more
    primary care physician initially                                                                                                              advantageous than the
    suspected that her condition might            Tracy Faustermann had transoral endocrine surgery to remove her parathyroid glands.             traditional surgical method
    be due to diverticulitis, inflamma-                                                                                                           beyond cosmetics.
    tion or an infection along the wall of the intestines. Her test results came back          But  value  in medicine, Grogan    said, is multi-dimensional.   There is
    normal, but her calcium levels were abnormally high.                                   monetary value (Could this technique help reduce costs?) and clinical value
        After running more tests, Faustermann’s doctor discovered her high calcium         (Will this technique reduce risks and complications and improve outcomes?).
    levels, called hypercalcemia, were due to overactive parathyroid glands secret-        However, there’s also patient-centered value. This is where the real benefit of
    ing an excess of parathyroid hormone, which regulates calcium in the blood.            the operation lies.
        “My doctor said, ‘We’re just going to watch this for a few years.’ But at this         “People don’t look into the deeper understanding of what that cosmetic
    point, I had been reading the most recent research on hyperparathyroidism,”            value actually is for patients. They just say, ‘They have a scar on the neck.
    recalled Faustermann, a technical specialist at Corning Life Sciences. “I said,        So what? What’s the big deal?’ … I think that’s a wrong way of looking at it,”
    ‘You know what? That’s not a good enough answer for me.”                               Grogan said. “The truth of the matter is it’s a scar on the front of the neck. It
        In search of a more aggressive course of action, Faustermann found an              can never be hidden. It will always be there. That’s more than not wanting that
    endocrinologist who diagnosed her with severe hyperparathyroidism. The                 scar. There is more than just vanity. … It’s a constant reminder that you had
    only treatment was to surgically remove the affected parathyroid glands.               surgery. If it was for cancer, then it’s a constant reminder that you had cancer.”
        Being a meticulous researcher, Faustermann scoured the internet and                    On Dec. 13, 2018, Grogan removed Faustermann’s parathyroid glands. Not
    scientific literature to better understand her condition and her options for           having a visible scar was a major selling point for Faustermann.
    minimally invasive surgical treatments.                                                    “Being on the business and sales side, I don’t want to have attention drawn
        “I had read a bunch of horror stories. If [doctors are] not specialized in that    to me,” she said. “If someone has a scar on their neck, it’s really obvious.
    area, don’t do it,” she said. “There were only two doctors in the area I would let     People stare. It wouldn’t have been that big of a deal or been the end of the
    touch me.”                                                                             world, … but I really like that I don’t have to have the scar.”
        One of the doctors was Raymon Grogan, M.D., associate professor of                     Although Faustermann still has some temporary numbness in her mouth,
    surgery at Baylor College of Medicine and section chief of endocrine surgery           she said she feels “a lot better than I did before I had the surgery.” She no lon-
    at Baylor St. Luke’s Medical Center. Grogan is one of a small cadre of experts         ger suffers from heartburn and has stopped taking blood pressure medicine.
    in the country who perform a novel, innovative surgical technique called tran-             “If I have another enlarged parathyroid at some point in life, we could do it
    soral endocrine surgery, which avoids scarring on the neck. Currently, Baylor          again if we had to, and I would do it again,” Faustermann said. “If you have to
    St. Luke’s is the only center in Texas where this procedure is performed.              have surgery, it was the best experience.”
        Typically, surgeons make an incision in the neck to remove the thyroid                 Grogan is collecting data to support transoral endocrine surgery as a
    or parathyroid glands, leaving behind a visible scar. Although less apparent,          valuable surgical option. Thus far, preliminarily findings show that, besides
    other surgical techniques—such as those that remove the glands through the             the cosmetic benefit, there is a reduced risk of injury to the parathyroid, which
    armpit or areola—still scar.                                                           is one of the possible complications of surgery on the thyroid, but more safety
        However, using the transoral endocrine surgical technique, Grogan makes            and efficacy data will be needed before this technique becomes mainstream.
    three small incisions—ranging from 3 to 10 millimeters wide—inside of the                  “Upwards of 140,000 people per year in the United States could have this
    bottom lip to create three ports. He can then snake a laparoscope down the             operation, so even the smallest benefit to a single patient when you start
    center port, and retracting and cautery tools down each side port.                     extrapolating it out to hundreds of thousands of people per year adds up to
        Once the glands are laparoscopically removed, Grogan stitches up the               a very large benefit on a societal level,” Grogan said. “That also shouldn’t be
    incisions. On average, parathyroid removal takes an hour to perform—                   ignored or be minimized.”
    two hours for a thyroid lobectomy and three hours for a total thyroidectomy.

8   tmc   » p u l s e | s e p t e m b e r 2 01 9
T    apping, swaying or
     marching to a beat
might not sound difficult
                                                                                                                                    or tripping, so we
                                                                                                                                    always try to have
                                                                                                                                    that forward path-
to most of us, but for
                                            The    Intersection of ARTS and MEDICINE                                                way to turn around.”
those suffering from                                                                         By Britni R. McAshan                       The class stim-
Parkinson’s, the physical                                                                                                           ulates participants’
stiffness and difficulty                                                                                                            cognitive abilities
with balance that are                                                                                                               by prompting them
hallmarks of the disease                                                                                                            to learn movement
can make independent movement extremely             snapping, tapping and twisting to warm              combinations and remember fellow class
challenging.                                        up every muscle before standing to do               members’ names.
    Parkinson’s is a neurological disorder          barre work.                                             Although most individuals with
that can cause tremors, shakiness, stiffness,           “You’re warming up certain areas in the         Parkinson’s are diagnosed around the age
loss of coordination and impair a person’s          body to get students prepared to engage             of 60, the class has no age limit—participants
ability to walk and stay balanced. Dance            their muscles so it’s not such a foreign thing      are encouraged to bring friends and loved
for Parkinson’s, a partnership between              when they stand up,” Richmond said. “Then           ones to dance along with them.
the Houston Area Parkinson Society and              we go to the barre, we do pliés and test their          Ten years after its inception, Dance for
Houston Ballet, gives participants a chance         balance, and then we do across-the-floor            Parkinson’s is the founding program of a
to build physical strength and move confi-          work. The class builds so they are not taken        full adaptive dance suite offered by Houston
dently in dance class.                              off guard as far as their balance goes.”            Ballet, which modifies dance for populations
    Krissy Richmond, a former principal                 Each week, 15 to 25 individuals with            with specific needs.
dancer with the Houston Ballet, became the          Parkinson’s attend the class; all present with          “I talk about the physical and cognitive
founding instructor for Houston’s Dance for         differing degrees of the disease. Instructors       benefits of the class, but you cannot underes-
Parkinson’s class in 2009 at the urging of          tailor the lessons to make them safe for stu-       timate the social impact of the class as well,”
Houston Ballet’s now executive director,            dents to move independently.                        Sommers said. “We get together and we have
Jim Nelson, whose father had just been                  “In any ballet class you go to, you would       fun. We are learning together. We are not a
diagnosed with Parkinson’s.                         do several turn combinations, but turns are         community of people who have Parkinson’s—
    “We take the structure of a warm-up from        not a thing we do in this class,” said Jennifer     we are a community of people who dance and
a regular class, but do the basics in a chair so    Sommers, Dance for Parkinson’s instructor           move together every Monday.”
our students don’t have to think about bal-         and director of education and community
ance,” Richmond explained. “It is remarkable        engagement at Houston Ballet. “We do
                                                                                                        To participate in Dance for Parkinson’s, which is
how much you can accomplish in a chair.”            change the facing of the room—we go from            free, contact the Houston Area Parkinson Society
    Throughout the one-hour class, students         traveling from the east side of the room to         at 713-626-7114 or visit
perform variations of tap, ballet and modern        the west side. If you turn too much … there
dance—using arm movements that combine              is a chance for getting your feet tangled up

                                                                                                                                           tmc   » p u l s e | s e p t e m b e r 2 01 9   9
Turning the Anti-Vaccination Tide
    The medical community is devising new strategies for talking to parents about the
    safety and success of vaccines

       By Alexandra Becker

   N       ineteen years ago, the Centers for Disease
           Control and Prevention (CDC) declared that
    measles—a highly contagious and potentially
                                                            It is important to focus on a specific concern, she said, and then help parents understand the informa-
                                                        tion around that concern.
                                                            “It’s not a conversation that will necessarily turn the parent around immediately—it might take
    deadly disease—had been eradicated from the         several visits to talk about it and hear what it is they have questions about, but I think it’s essential to
    United States thanks to an effective vaccine, a     maintain that relationship and help them find their way. It’s really about being an ally,” Wootton said,
    robust vaccination                                                                                   emphasizing the importance of patients having a medical
    program and a strong                                                                                 home where there is a trusting relationship between the
    public health system.                                                                                patient and the provider.
        Fast forward to                                                                                      It is also necessary to address any vaccine myths
    August 2019, and                                                                                     head-on by debunking them first, then labeling them,
    more than 1,200                                                                                      stating why they are not true, and finally replacing the
    cases of measles have                                                                                myth with accurate information, she added.
    been confirmed in 30                                                                                     “You want to provide them with the truth that fills in
    states in 2019 alone.                                                                                that biggest concern,” Wootton said.
    According to the CDC,                                                                                    Finally, she cited a shift in language termed the
    this is the greatest                                                                                 “presumptive approach.”
    number of cases                                                                                          “This is when a doctor comes in and says, ‘Today we’re
    reported in the U.S.                                                                                 going to do your flu shot,’ rather than coming in and saying,
    since 1992.                                                                                          ‘Do you want to have your flu shot?’” Wootton explained.
        What happened?                                                                                   “A presumptive framing is more effective than the ask, and
        An increasing num-                                                                               that’s a simple thing to train providers on.”
    ber of parents began                                                                                     In August, STAT News published a story about an ini-
    declining vaccinations.                                                                              tiative in Québec that stationed a new workforce of vaccine
    Known as anti-vaxxers,                                                                               counselors in maternity wards. Their goal was to employ
    vaccine-hesitant, and                                                                                a “no-pressure strategy,” using a technique called motiva-
    vaccine choice activ-                                                                                tional interviewing to speak to parents about their opinions
    ists, the group gained                                                                               about vaccinations and then offer to answer any questions
    momentum after                                                                                       or concerns they may have.
    Andrew Wakefield, a                                                                                      Other methods are in the works. At the annual meeting
    British doctor who has                                                                               of the European Society for Paediatric Infectious Diseases,
    since been stripped of                                                                               Saad B. Omer, MBBS, Ph.D., director of the Yale Institute
    his medical license,                                                                                 for Global Health, encouraged pediatricians to frame the
    published now widely                                                                                 conversation in a way that focuses on the disease and its
    disproven research                                                                                   potential consequences rather than the safety of vaccines,
    linking certain vac-                                                                                 according to a June article published in Pediatric News.
    cines to autism                                                                                          But one of the issues at hand is not simply how the con-
    spectrum disorders.                                                                                  versations are being framed, but if a meaningful conversa-
        The medical com-                                                                                 tion can take place at all.
    munity is fighting back.                                “Most parents aren’t deeply dug in—they’re just scared and inundated with misinformation, and it
        To quell the fears of hesitant parents and      requires a conversation, and sometimes that can go on for 20, 30 minutes,” said Peter Hotez, M.D., Ph.D.,
    deliver the truth about vaccines, more physicians   dean of the National School of Tropical Medicine and director of the Texas Children’s Hospital Center for
    and other medical professionals have started        Vaccine Development at Baylor College of Medicine. “The problem you get into is the logistics of having
    employing methods used by pediatricians to          a 30-minute conversation in a busy pediatric practice.”
    communicate with parents and address their              It makes sense, then, that the initiative in Québec included a new classification of employees—
    most immediate concerns.                            rather than tacking on a time-consuming yet critical task to the caseloads of already-busy pediatricians
        “There’s a lot to learn about these conversa-   and nurses.
    tions and what conversations work,” said Susan
    Wootton, M.D., infectious disease specialist and    Agreement and divergence
    associate professor of pediatrics at McGovern       The anti-vaccination movement continues to rise, in part because its members are vocal, social-media
    Medical School at The University of Texas Health    savvy and appeal to some of the most basic of human desires: that of a freedom to choose and a longing
    Science Center at Houston.                          to keep loved ones safe.

10 t m c » p u l s e   | s e p t e m b e r 2 01 9
And therein lies the crux of the issue: While the medical community has proven time and again that            parents to listen to their physicians rather than
vaccines are safe and effective in preventing a multitude of diseases, many vaccine-hesitant parents still        what they’ve read online.
conclude that the safest choice for their children is letting nature take its course.                                “Although physicians educate their patients,
    “The one thing we can all agree on is that we want our chil-                                                                                    they also need
dren, and we want our families, to be safe and healthy,” said Rekha                                                                                 to advocate for
Lakshmanan, MHA, director of advocacy and public policy at The                                                                                      strong, sound
Immunization Partnership, a Houston-based nonprofit that promotes                             The one thing we can all                              immunization
vaccination through education initiatives, policy efforts and commu-                   agree on is that we want our                                 policies and edu-
nity outreach initiatives. “Where there is some divergence, however, is                                                                             cate policy mak-
where and how you get the information, and what information you use
                                                                                      children, and we want our fam-                                ers,” she added.
to make that informed decision.”                                                        ilies,  to   be   safe   and     healthy.                   “Physicians are
    According to experts, parents are increasingly turning to the inter-           Where there is some divergence,                                  not only a trusted
net as their voice of authority on the topic.                                                                                                       voice to patients,
    “There is a lot of misinformation, and I think it’s really hard to
                                                                                      however, is where and how you                                 they are a trusted
navigate what’s out there—we call it ‘Dr. Google,’” Wootton said.                      get  the    information,         and     what                voice to policy
    Hotez noted that the latest data suggests there are at least 480                   information you use to make                                  decision makers.”
anti-vaccine websites, many of which are widely circulated through-                                                                                     At the
                                                                                        that informed decision.
out social media.                                                                                                                                   moment, the num-
    “You’re more likely to download misinformation than you are real                         — REKHA LAKSHMANAN, MHA                                ber of unvacci-
information,” Hotez said. “Most of the time, parents are willing to have                   Director of advocacy and public policy                   nated children in
their kids vaccinated; it’s a very small percentage of parents who are                       at The Immunization Partnership                        Texas is rising.
deeply dug in. It’s just that they’re scared because they download all                                                                                  “We’ve got
the misinformation, which is ubiquitous on the internet.”                                                                                           over 64,000 kids
    Lakshmanan echoed Hotez’s assertion that the anti-vaccination                                                                                   not getting vacci-
movement is small but powerful.                                                                                   nated, and these are the ones we know about—
    “At the end of the day, people who are opposed to vaccines are a relatively small group of people, but        we don’t know anything about the home-schooled
they are extremely vocal and engaged in advocacy, and as a result of their loudness, they look and feel a         kids,” Hotez said. “This issue is not going to go
lot bigger than what they really are,” Lakshmanan said, adding that The Immunization Partnership urges            away any time soon.”

                                                                                                                                               tmc   » p u l s e | s e p t e m b e r 2 01 9   11

     MAJOR GENERAL RICK NORIEGA has been CEO of Ronald
     McDonald House Houston for two years following an impressive
     career in public service. He spent a decade in the Texas legislature
     representing Houston’s east side, served in Afghanistan and
     oversaw the conversion of the George R. Brown Convention
     Center into a massive shelter as Houston welcomed Hurricane
     Katrina evacuees in 2005. The native Houstonian discusses how
     his experiences have influenced his leadership and what’s next
     for Ronald McDonald House Houston.

     Q | During your time in the                    from lieutenant governor after          convention center around 10 a.m.
     Texas legislature, you were the                George W. Bush became president,        and by 6 p.m., buses were rolling
     primary author of the Texas                    so he had yet to run a race for gov-    in. People were wet and everything,
     Dream Act, which provides                      ernor. Under the radar in 2001, the     coming directly from New Orleans
     in-state college tuition for                   governor signs the bill.                and the Superdome. It’s pretty
     undocumented immigrants                                                                amazing what this city is capable
     who have lived in the state                    Q | So, what happened to the            of. It was remarkable.
     for three years before graduat-                young man who sparked the
     ing from high school or receiv-                Texas Dream Act?                        Q | How did you connect
     ing a GED and are seeking                      A | Rosendo Ticas is an aviation        with Ronald McDonald House
     legal status. How did that                     mechanic today. He’s married and        Houston?
     come about?                                    has three kids. He owns a house and     A | In civilian life, I had retired
     A | That’s what I’m going to have              a rental house. He became a citizen     from another nonprofit in San
     on my tombstone. Being a person                and voted in the last presidential      Antonio, AVANCE, and returned to
     called to public service, sometimes            election.                               Houston in May 2017 to take care       A | We set a decision point for
     it’s as simple as someone calling                                                      of my mother, who will be 88 in        families about two days out: Are you
     your office to say they can’t get              Q | Readers also might                  September. She was by herself and      going to go to the hospital, go home,
     into Houston Community College                 remember your role in                   my siblings were out of town. I had    stay with a friend or are you going
     because they’re an immigrant                   Houston’s response to                   a little over a year before my Army    to stay here with us and wait it out?
     kid—a Salvadoran refugee—and the               Hurricane Katrina in 2005.              retirement and I had made brigadier    We got in our workroom, called in
     college is trying to charge inter-             A | At the time, I was on leave from    general, so I was being asked to do    all our employees, pulled out our
     national tuition. He was trying to             deployment in Afghanistan and           more. I was going to turn over rocks   emergency plan and went through
     do the right thing and go through              tri-hatted, serving as a state repre-   for a while in Houston when I got      it line by line. Who’s going to do
     the process. He wanted to be an                sentative, a traditional Guardsman      approached for this opportunity        what? Who’s going to be where?
     aviation mechanic. His dream was               and working for CenterPoint Energy      in the spring of 2017. I started in    All the generators were gassed up
     to work for Boeing. I thought: This is         in the economic development             July 2017.                             and we moved the [portable toilets]
     probably not unusual—especially in             department. I had been home for a                                              out so that they wouldn’t become
     the district I represented [East End/          few weeks in the summer of 2005         Q | You began your tenure              projectiles. I headed back to Austin
     Ship Channel area]—and how many                burning my leave time going to the      by guiding the expansion of            in my role with the Texas Army
     other kids are affected? I had the             beach, then Katrina and Rita hit.       Holcombe House, the tempo-             National Guard and we huddled
     University of Houston do a survey              The Astrodome was about filled up       rary residence for sick children       on calls every morning. The water
     by a demographer asking some                   and Mayor Bill White decided to         and their families that now            came up on the back patio, if that.
     questions to see the depth of the              open up the convention center. I was    offers 70 rooms. A month later,        Topographically, we are on the high
     issue. The political dynamic at the            invited to the meeting and they said    Hurricane Harvey hit amid con-         point of the Texas Medical Center.
     time in Texas was that Rick Perry              I was going to run things as incident   struction. How did you manage          We were super-proud of the fact that
     had ascended to the governorship               commander. I walked through the         that crisis?                           we maintained operations during

12   tmc   » p u l s e | s e p t e m b e r 2 01 9
Harvey. We were pretty much            and children, I feel confident that     respecting people, learning from         improve recovery times and hospital
isolated for 72 hours, but none of     we are going to do the operational      people. It’s given me the knowledge      stay times and it helps the family
the kids through that period of time   things better than anybody else.        base to deal with a lot of different     to be healthier and stay together
missed an appointment or a treat-      One of the principles of the military   things. In this position, you get to     through an incredible crisis to keep
ment. The ones that were still here,   is that you’re always improving your    see the most amazing children—the        them whole.
we were able to help. We were also     position. We are open to changes        beauty, the resilience, the love—
super-fortunate to finish construc-    and new ideas.                          every day. I am still learning, having   Q | You have expressed an
tion on time and under budget.                                                 fun and feeling incredibly blessed.      interest in collecting data to
                                       Q | You completed your mili-                                                     determine if staying at Ronald
Q | Have those successes influ-        tary service last year. Explain         Q | How does Ronald McDonald             McDonald House Houston
enced your ambition for Ronald         your honorary boost from brig-          House Houston help families              during treatment improves
McDonald House Houston?                adier general to major general—         beyond shelter and food?                 outcomes for patients. How far
A | With our board, staff and          from one star to two stars.             A | Our intervention in this social      along is that project?
volunteers, I have learned that we     A | I retired from the Army in          space, which is family-centered care,    A | We have the assistance of a
can walk and chew gum at the same      February 2018. It’s a ceremonial        helps them to get better and to be       grant from the Baxter Trust. That
time. We were totally operational in   promotion at retirement honoring        better. Our intervention of caring for   gift allowed us to embark on a
the middle of a construction project   you at the next highest rank.           families beyond their basic needs        research strategy we are pursuing
and a major hurricane. We are                                                  helps alleviate stress and helps         as a part of our long-term sustain-
changing our advancement model         Q | What specific skills do you         them with all types of collateral        ability plan. ➟
to feed the beast with 40 percent      transfer from the military to           things they may be dealing with,
more capacity. As we look at our       your current role?                      such as mental health and support
new normal serving more families       A | People skills—liking people,        systems. That intervention helps

                                                                                                                                       tmc   » p u l s e | s e p t e m b e r 2 01 9 13

    It allowed us to do our self-evalua-                    Hospital. We also have an embed-        a county that abuts Harris County.        A | Our local restaurant owners
    tion by collecting our own numbers                      ded 20-bedroom house in Texas           We are funded through grants,             and operators do—but that’s
    in family activities, early childhood                   Children’s and we have sleep rooms      primarily from our local founda-          still local.
    development, nutritional data—                          in Children’s Memorial Hermann          tions and family foundations that
    understanding what we do. I believe,                    Hospital. Parents may need to sleep     we’ve had relationships with for 40       Q | You’ve been in leadership
    in the greatest medical center in the                   over to be trained by the nurses on     years. We have our Boo Ball, which        positions for decades, but what
    world, we should be at the forefront                    how to care for the child or for        is our famous Halloween event, and        does it feel like being a CEO?
    of understanding family-centered                        grieving purposes.                      our golf tournament—the Ronald            A | If I ever need a dose of reality, I
    care and how what we do makes a                                                                 McDonald House Cup—and our                go play with the kids or Mogie [the
    difference. Doctors will report that                    Q | What do you wish peo-               Spirit of Hope volunteer luncheon.        1-year-old Australian Labradoodle
    patients say that it’s very import-                     ple understood better about             Then we have a run, the Trafigura         who lives at Ronald McDonald
    ant for them to stay at Ronald                          Ronald McDonald House                   Run for the House, which is spon-         House Houston and serves as its
    McDonald House, but I want us                           Houston?                                sored. I want folks to know that we       canine comfort ambassador]. The
    to have empirical evidence to be                        A | We’re not funded by Ronald          receive occasional support from           stories are very humbling. This
    able to demonstrate that it helps                       McDonald. We are almost entirely        Ronald McDonald House Charities.          place has an incredible history and
    families recover.                                       funded by local community grace         Otherwise, everything’s local. We         because of the foundation that we’re
                                                            and benevolence. We get minus-          want the local community to know          on here at the Texas Medical Center,
    Q | With 70 beds, is Holcombe                           cule federal money for a family that    that we need them. I look at us as a      the best days are yet to come.
    House one of the largest Ronald                         might qualify for Medicaid, like $25    real symbol of this city, our core val-
    McDonald House facilities in                            a night, but the cost for a family to   ues and what’s best about Houston.        Major General Rick Noriega was
                                                                                                                                              interviewed by Pulse assistant editor
    the country?                                            stay here is about $200 a night for     That’s what makes me proud as a           Cindy George. The conversation was
    A | We’re in the top 10 percent in                      the food, lodging and transporta-       native Houstonian.                        edited for clarity and length.

    the United States. We have family                       tion. There are a whole lot of other
    rooms in MD Anderson Cancer                             restrictions and issues. You can’t      Q | Does McDonald’s
    Center and Texas Children’s                             be a resident of Harris County or       contribute?

                                                                         February 21-22, 2020 // Houston, TX
                                             Come connect with global health experts, missionaries and organizations; be inspired by over 35
                                        speakers; and find your mission in the M3 Conference Exhibit Hall with over 75 organizations working in the
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                                                                     Connect with others. Be inspired. Find your mission.

14 t m c » p u l s e   | s e p t e m b e r 2 01 9
By Shanley Pierce

                                   High risks and high costs for young blood

A      California-based biopharmaceutical clinic announced in August
       that its proprietary mixture made of plasma from young donors
stopped cognitive decline in mild-to-moderate Alzheimer’s patients
                                                                             blood in experiments with mice. In 2013, Stanford University research-
                                                                             ers conjoined the veins of an old mouse to a young mouse to share the
                                                                             same blood circulation, resulting in the reversal of cardiac hypertrophy
after six months.                                                            (the abnormal enlargement of the heart muscle) and some improve-
    In a randomized study by the company, Alkahest, 39 patients intra-       ments in cognitive abilities in the older mouse.
venously received either 100 milliliters or 250 milliliters of the plasma        However, clinics selling plasma from young donors are not repli-
for five consecutive days during the first week and again for five con-      cating the same experimental conditions, said Vivien Sheehan, M.D.,
secutive days during the 13th week.                                          Ph.D., assistant professor of hematology-oncology at Baylor College
    No detailed data on the study has been released yet, but Alkahest        of Medicine.
said in a press release that “these plasma fractions enhance neurogen-           One California-based company, Ambrosia, sold participation in a
esis, improve age-related deficits in learning and memory, and reduce        clinical trial that offered each client one liter of human plasma har-
neuroinflammation” in animal models.                                         vested from young adults. Ambrosia charged $8,000 for that one liter,
    Plasma can be life-saving or potentially life-threatening, depending     but since the FDA warning, the company has shut down.
on the medical situation. Over the past few months, this straw-colored           The Ambrosia trial raised major safety concerns.
component of blood—which carries blood cells and proteins, contains              “I’ve never seen an alleged trial that only had one inclusion criteria:
antibodies, glucose, clotting factors, electrolytes and hormones—has         that you be over 35,” Sheehan said. “There were no other safety mea-
been shrouded in controversy.                                                sures taken to make sure you’ve never had a transfusion reaction, to
    In legitimate emergency situations (such as trauma and burns) and        make sure you can handle the volume, to make sure you’re not hyper-
rare chronic conditions (such as autoimmune disorders and hemo-              coagulable. There was nothing in there to protect the individual and
philia), plasma is essential for survival. The World Health Organization     screen out people for whom this would be more dangerous. … This was
includes fresh frozen plasma on its WHO Model List of Essential              clearly just an advertisement masquerading as a clinical trial. I can’t
Medicines, which outlines the most important and integral medicines          emphasize enough how disturbing it is that patients are being put at
for a basic health care system.                                              risk for something that is so unproven. The thing that is proven is that
    But in other scenarios, including using plasma infusions from            plasma can kill you. The thing that is unproven is that it would have
young donors to tap into a so-called “fountain of youth,” medical            any benefit whatsoever, so the risk-benefit ratio is completely off.”
experts say plasma can be life-threatening.                                      Jesse Karmazin, CEO of Ambrosia, recently opened a new venture
    Earlier this year, the U.S. Food and Drug Administration (FDA)           and is continuing to sell 1 liter of blood plasma for $8,000 and 2 liters
issued a warning against the use of plasma infusions from young              for $12,000.
donors in hopes of treating dementia, Alzheimer’s disease, Parkinson’s           “Ambrosia was dissolved, but Ivy Plasma is open for business. Ivy
disease, multiple sclerosis, heart disease, post-traumatic stress disorder   Plasma provides off-label plasma treatments, which is legal,” Karmazin
and other age-related conditions.                                                        wrote in an email to TMC Pulse. “I can’t comment on the
    “When companies are giving plasma just to deal with neu-                               potential risks or benefits of this treatment due to restric-
rologic symptoms without any good medical evidence, it’s a                                  tions on off-label marketing of medications by the FDA.”
risky thing to do,” said Modupe Idowu, M.D., associate professor                               Ultimately, scientific evidence that shows young
of hematology at The University of Texas Health Science Center                               blood plasma can counteract age-related diseases
at Houston’s McGovern Medical School.                                                                remains sparse.
    Risks include transfusion-related acute lung                                                            “If there are some factors in younger blood
injury, transfusion-associated circulatory                                              (about 55%)     that could be helpful to an older patient, the
overload and allergic and anaphylactic                                                                  key would be to identify them, do the real work
reactions, along with infections, febrile                                                               of fractionating and identifying what proteins
non-hemolytic transfusion reactions and                                                                       or micro RNA or factor that would be ben-
hemolytic transfusion reactions.                                                                                 eficial to older people, then find a way
    A single unit of plasma contains 250                                                                           to either deliver it pharmacologically
milliliters of plasma, typically from four to                                                                       or genetically,” Sheehan said. “The
eight donors, according to Idowu.                                                                                   whole plasma approach is kind of a
                                                    White blood cells
    “It’s exposing the patient to multiple            and platelets                                                dumb strategy.”
donors at the same time,” she said.                    (about 1%)

    Studies have explored the benefits of young                                          Red blood cells
                                                             Structure of Blood           (about 45%)

                                                                                                                                        tmc   » p u l s e | s e p t e m b e r 2 01 9 15
Shifting Gears
                                                    A former competitive cyclist finds a new passion
                                                    leading a medical device startup that diagnoses
                                                    bacterial infections to fight sepsis

                                                     By Shanley Pierce

                                                                                                       S    inead Miller walked away from
                                                                                                            competitive cycling after a
                                                                                                       serious brain injury left her unable
                                                                                                       to compete on a world-class level.
                                                                                                           Motivated by her own trauma,
                                                                                                       she decided to pursue a career in
                                                                                                           “I wanted to make some impact
                                                                                                       in the health care space to help peo-
                                                                                                       ple like me,” Miller, 29, said.
                                                                                                           After earning a B.S. in chemistry
                                                                                                       from Marian University and a B.S.
                                                                                                       in biomedical engineering from
                                                                                                       Purdue University, Miller began
                                                                                                       graduate school at Vanderbilt
                                                                                                       University in 2014. While working
                                                                                                       on her doctorate, she focused her
                                                                                                       research on the use of iron core
                                                                                                       nanoparticles to magnetically
                                                                                                       extract bacteria from blood.
                                                                                                           That research laid the ground-
                                                                                                       work for her next move—combating
                                                                                                       sepsis, a life-threatening infection
                                                                                                       to which the body has an overactive,
                                                                                                       outsized response. She picked up
                                                                                                       funding from the Department of
                                                                                                       Defense to help treat soldiers return-
                                                                                                       ing from Iraq and Afghanistan with
                                                                                                       drug-resistant bacteria.
                                                                                                           At least 1.7 million American
                                                                                                       adults are affected by a sepsis
                                                                                                       infection each year, resulting in
                                                                                                       nearly 270,000 deaths, according to
                                                                                                       the Centers for Disease Control and
                                                                                                       Prevention. One in three hospital
                                                                                                       deaths are due to sepsis.
                                                                                                           “It’s the biggest killer in our
                                                                                                       hospitals right now,” Miller said.
                                                                                                       “I had this idea for a device that
                                                                                                       doesn’t use nanoparticles but uses
                                                                                                       kind of a similar technique to bind
                                                                                                       bacteria and pull them out of blood.
                                                                                                       I used the knowledge that I had to

                                                                                                       Sinead Miller, a former elite cyclist,
                                                                                                       poses with her bike at Memorial Park.

16 t m c » p u l s e   | s e p t e m b e r 2 01 9
fabricate this device that was for                                                                                    and associated toxins and flows the
cleaning blood, pulling bacteria            I wouldn’t even say that I’m recovered.                                   clean blood back into the patient.
out. And it worked.”                  I still don’t feel normal. It took me two years                                      Creating a medical device and
    In early 2017, Miller partnered   to get to a point where I could function like                                   taking it to market is a process not
with Alex Wieseler, whom she                                                                                          for the faint-hearted. Miller knows
met while working for a nutra-
                                      a normal person, where I didn’t really slur my                                  it’s a journey as arduous as it is
ceuticals company in Nashville,       words and I could go do normal things like go                                   rewarding. She’s been down a
Tennessee, to start a biomedical      out to dinner and things like that.                                             similar road before.
device company. PATH EX is part
of the current cohort of biomedical                                                           — SINEAD MILLER         Born to ride
device companies at TMCx, the                                                                   CEO of PATH EX        At the age of 3, Miller could be
TMC Innovation Institute’s                                                                                            found on her bike, pedaling around
accelerator program.                  device takes a five-milliliter blood        In addition, PATH EX has            the race track while her father, for-
    Miller’s device, which fits in    sample from a patient suspected of      developed a therapeutic device          mer superbike racer Rex Miller, was
the palm of a hand, can diagnose      having sepsis or a bacterial infec-     to treat infected patients. Similar     competing. Her mom waited on the
bacterial infection in the blood by   tion, separates the bacteria from the   to a hemodialysis machine, the          sidelines, ready in case her father
capturing and removing pathogens      clean blood and allows doctors to       device circulates the patient’s blood   needed a tune-up. ➟
and their associated toxins. The      immediately test the bacteria.          continuously, captures the bacteria

                                                                                                                                     tmc   » p u l s e | s e p t e m b e r 2 01 9 17
Even as a young child, Miller’s focus                                                             Miller works in her lab at JLABS @ TMC,
     and ability to visualize a far-off goal                                                           where she and her company, PATH EX,
                                                                                                       have been located since joining the
     was apparent. She entered her first
                                                                                                       TMCx medical device 2019 cohort.
     BMX racing competition when she
     was only 4 years old. Boys domi-
     nated the BMX scene back then, and                                                                the van and leave. But that’s what
     being a girl in a sport that was very                                                             we had to do so that I could race
     much a boy’s club made competing                                                                  and improve.”
     impossible. There weren’t any girls                                                                    Miller’s training paid off.
     to race.                                                                                               As a sophomore at South Park
         “I was a tomboy growing up and                                                                High School in her hometown of
     I always wanted to play with boys. I                                                              Pittsburgh, she earned a national
     always would ride at the BMX track                                                                level in BMX and turned pro at the
     with boys, my friends were boys and,                                                              age of 15. But she later retired from
     naturally, I wanted to race boys, too.                                                            her BMX racing career to focus on
     There were rules in BMX at the time                                                               her true passion: road cycling.
     where you couldn’t,” she said.                                                                         “It would seem BMX and road
         Miller was determined to train                                                                cycling are really similar to a lot
     with the boys in order to reach the                                                               of outsiders because they’re both
     top of her game, so her parents                                                                   bicycles,” Miller said. “If you think
     took her to races in different states,                                                            of, say, running, for example, you
     tucked her long blonde hair under                                                                 can’t be the best sprinter and the
     her bike helmet and told people she                                                               best marathon runner. It’s totally
     was a boy.                                                                                        different. The same goes for cycling.
         “No one knew us. We’d just hide                                                               BMXers are your pure sprinters.”
     that I was a girl, put my hair up                                                                      Miller had her sights set for the
     under my helmet, send me out, race                                                                long haul and seemed destined for
     the boys and then come back into                                                                  cycling greatness.

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