December 2018
From performing life-saving medical procedures to providing much-needed support, metro Atlanta physicians and nurses are changing lives daily.
By Katja Ridderbusch
EMORY HEALTHCARE
Quick Surgery, Big Impact
Sarah Mason didn’t have time to get worked up when she learned she was going to have open-heart surgery. On a Friday afternoon in June, Mason was lying on an exam table having an echocardiogram—an ultrasound of her heart. It was the last in a series of tests that her doctor had ordered after she suffered a profound fainting spell. So far, the tests had revealed nothing.
Then the cardiologist pointed to the screen. “There was this thing in the shape of a kidney bean,” remembers the 41-year-old legal assistant.
Three inches long, it dangled down from the wall separating the two upper chambers of her heart. Her cardiologist assured her this was curable but that she would need to go to the hospital immediately.
Two hours later, Mason arrived at Emory St. Joseph’s. On Tuesday she had robotic heart surgery with Dr. Douglas Murphy, one of the few cardiac surgeons in the country who uses this technique. With over 3,500 procedures, he has done more robotic heart surgeries, mostly valve repairs and replacements, than any other physician in the world.
Mason’s tumor, called a myxoma, was one of the largest Murphy had seen. Myxomas are rare and benign, said the surgeon, “but we still consider them an emergency.”
Some tumors have fronds that can break off and cause a stroke. Others, like Mason’s, come in a solid form with smooth walls. They can grow and block the blood flow.
Mason and Murphy met for the first time the day before the surgery. “She was a very calm patient,” says Murphy.
“I just knew he would take good care of me,” adds Mason. She once trained to become a private investigator, so she’s used to being inquisitive. “But he answered all my questions before I even had them.”
Her procedure took 30 minutes—the amount of time she was on the heart-lung machine. Technically it’s considered open-heart surgery. But instead of opening up the sternum, the surgeon—with the help of the robot—makes five small holes on the patient’s right side, enters the heart chamber, and cuts out the tumor along with a small cuff of normal tissue to make sure it doesn’t grow back. The tumor drops into “a tiny butterfly net,” as Murphy describes it, and is pulled out through one of the holes.
What sounds relatively easy takes many years of hard training. “We call the robot the machine that transfers the pain from the patient to the surgeon,” Murphy says with a smile.
But it comes with benefits, including less downtime. For robotic surgery patients, the bones are intact, so recovery mainly means waiting for the incisions to heal.
Mason left the hospital one week after being admitted and went back to work in October. She still does cardio rehab three times a week, but otherwise, her life is back to normal.
“As basic as it sounds,” Mason says, “I’m just happy to wake up every day
and feel good.”
PERIMETER PLASTIC SURGERY
Three Sisters and a Surgeon
Three sisters. Three double mastectomies. Three cases of breast reconstruction. And one surgeon, “who tied us all together and steered us through,” says Courtney Beach, the oldest of the three and the first to have reconstructive surgery with Dr. Mark Deutsch of Perimeter Plastic Surgery.
Beach, 43, an Alpharetta elementary school assistant principal, was diagnosed with breast cancer in the spring of 2012. Her gynecologist had recommended a mammogram and MRI after her sister, Kate Hegidio, was diagnosed with invasive ductal carcinoma, the most common type of breast cancer.
While Hegidio had chemotherapy before undergoing surgery, Beach started with a double mastectomy and breast reconstruction. Deutsch had explained to her the different options, and Beach decided to go with a DIEP flap reconstruction.
“That means we used her abdominal fat instead of implants to reconstruct her breasts,” says the physician.
“Courtney was a great candidate for this surgery,” adds Deutsch, one of only a handful of surgeons in the Atlanta area that performs the complex procedure. “And she had very good results.”
He remembers that during one of her follow-up visits Beach mentioned her two sisters, who also had double mastectomies. Both had complications from an initial reconstruction with different doctors, and Deutsch took over their cases.
Hegidio, 42, who recently moved to Salt Lake City and works as an HR manager for a logistics company, had significant scar tissue on her right breast, which the surgeon first released. He then put in a tissue expander to make room for an implant.
The youngest of the three sisters, Kelly Price, 38, is a nurse at an Atlanta hospital. She didn’t have cancer but decided to do a prophylactic double mastectomy. For Price, Deutsch did a latissimus flap, which utilizes the
latissimus muscle running along the upper back to reconstruct the breast. He also put in tissue expanders and later, implants.
Deutsch emphasizes that “it is absolutely critical to spend enough time with the patient before the surgery to understand what their goals are, so we can collectively come up with a plan that’s going to get them there.” It’s a team effort that paid off.
“Dr. Deutsch took me from a very dark place where I was unhappy with my body, to a place where I can finally look in the mirror again,” says Hegidio, adding that she wouldn’t go anywhere else if she ever needed more plastic or reconstructive surgery. “He set the bar, and he set it high.”
Deutsch, for his part, will never forget the three sisters. “They are smart, kind, and focused on their goals,” says the surgeon. They had strong support from their families. “It was very satisfying to see their positive attitude come to fruition,” the doctor adds.
The sisters have some advice for women anxiously starting the journey of cancer surgery and reconstruction. “Don’t be afraid to ask a lot of questions,” Price says.
“It’s okay to be that annoying patient,” Beach seconds. “Go see as many doctors as you need to feel comfortable and informed.” Deutsch was the fourth surgeon that Beach interviewed. “And I’m so glad I found
him,” she says with a smile.
WELLSTAR HEALTH SYSTEM
A Pivotal Moment
It was, of all events, a prostate cancer diagnosis that marked the beginning of a wonderful friendship. In the spring of 2015, Tim Smith,
now 56, learned that he had prostate cancer. He was one of the more than 200,000 men in the U.S. who are diagnosed with the disease each year.
He was sitting in the office of Dr. Scott Miller, who is a pioneer in his field, having performed the first robotic prostate removal in Georgia in 2003. Miller is now a urologist at WellStar North Fulton Hospital.
“We talked about my surgery,” recalls Smith. “But after a short while we went on to discuss the cause of educating guys about prostate cancer.”
Miller, an avid guitar player with his own band, founded ProstAware 10 years ago. It is a nonprofit that draws attention to prostate cancer by using sports, music, and technology as vehicles for education and outreach.
“Tim and I immediately connected,” Miller recalls. “We realized we share the same vision.” But first there was the surgery. Smith says he chose Miller because he was the best doctor for this procedure—“competent, confident, and caring,” Smith said.
Miller was an early adopter of laparoscopic surgery, a minimally invasive technique where the operation is performed through several small incisions and with the help of a telescope.
The transition to robotic surgery, where the surgeon sits at a control console just a few feet away, came naturally, says Miller. By now he has performed about 2,500 robotic prostate removals. The procedure has
a number of advantages.
“Less bleeding, less pain, smaller incisions, and quicker recovery,” says Miller. Also, the robot offers a three-dimensional view and a wider range of motion for the surgical instruments.
“This allows us not only to cut more precisely but also to handle nerve tissue more gently,” Miller explains. In addition, he uses a nerve monitoring system during surgery, where electrodes are connected to the nerves around the prostate to make sure there’s no damage.
In the case of Tim Smith, the cancer hadn’t spread, and the surgery was a success. “Today I’m cancer free,” Smith says. If treated early, survival rates for prostate cancer are more than 95 percent.
His illness became a pivotal moment for him to find a new professional path. A few months after his surgery, Smith agreed to become ProstAware’s executive director. His 25-year sales experience in the medical device and health IT industry helped with the new challenge.
He now runs ProstAware’s outreach programs, partnering, for example, with the Atlanta Police Department for educational events, and with the Atlanta Falcons for pregame announcements on the stadium screens.
He organizes ProstAware’s two major annual fundraising events: the 5K Run4DAD and the Blue Tie Luncheon. He’s currently working on getting the NFL more involved in prostate cancer awareness. “It would be a great platform to reach guys,” Smith says.
Along this journey, the doctor and patient have become friends and partners in pursuit of the same goal.
“Here’s our message to all men out there,” says Miller. “Learn about your risk factors. Educate yourself. Information doesn’t hurt.”
“And know that you can survive and thrive beyond,” adds Smith. “Just look at me.”
© Atlanta Magazine Custom Media / Katja Ridderbusch