Wednesday, April 25, 2018

Florida Hospital Zephyrhills, USF launch neuroscience institute


Patricia George rides horses and repairs cars. Recently, she helped install a friend's floor tile and repair a well at her daughter's home. "I've always been active," said the 62-year-old retiree. So when she woke up the Sunday before Memorial Day unable to walk, she knew she'd better get checked out. She went to the emergency department at Florida Hospital Zephyrhills.

"It was like I had a stroke," George said.

It turned out to be a 1-inch brain tumor — about the size of a peach pit — that also had been responsible for some numbness in her left leg that George had dismissed as a pinched nerve.

Until this year, George would have been sent to a hospital in Hillsborough or Pinellas counties for treatment. But a new partnership between the University of South Florida and the hospital's parent company, Adventist Health System, has given birth to the Neuroscience Institute.

This was one of four health specialties divided among area Adventist hospitals. Others include cardiology at Florida Hospital Pepin Heart Institute-USF Health; breast health at Florida Hospital Tampa; and surgical oncology, melanoma and breast cancer at Florida Hospital North Pinellas, formerly known as Helen Ellis Memorial Hospital in Tarpon Springs.

The Florida Hospital group is spending $14 million on all four programs, including $5 million in technology at the Zephyrhills hospital.

So far, doctors have done more than a dozen surgeries, including the operation on George, whose lesion was on her motor cortex, the part of the brain that sends information to the muscles and controls voluntary movement.

"The sophistication of what we had to do speaks miles about what we can do over here," said Dr. Raul Olivera, chief of neurosurgery for the institute.

Olivera was the surgeon who performed George's recent operation. He said the area affected required him to "come from behind and sneak under" to remove the tumor without damaging overlying tissue and causing George to completely lose the use of her left leg.

The technology includes a piece of equipment that creates a road map so surgeons can zero in on the right spot. It also allows for smaller incisions and allows patients to keep their hair.

"When she woke up, it looked like she never had surgery at all," Olivera said. Avoiding hair loss might seem minor to some, he said, but it improves patients' morale and encourages them to keep fighting.

"When a patient wakes up with half their hair gone and their head in bandages, they look in the mirror and think, 'Wow, I must be really sick,' " Olivera said.

The partnership also allows the hospital to offer more care for those who show signs of stroke, now the fourth-leading cause of death in the United States.

The hospital was certified last year as a primary stroke center by the Joint Commission, a national accrediting body, so those patients can be given a powerful clot-busting drug if they arrive within three hours of symptoms. But because the hospital lacked neurosurgery and the ability to handle complications, patients had to be flown to another hospital after receiving the drug.

"Now we don't have to 'drip and ship,' " said Margaret White, chief administrator for the neuroscience institute. "It's very good for families' and patients' well-being to have complete treatment closer to home. All the post-op care is done in the community."

• • •

The new institute also offers relief for those with back pain.

June Randall, 38, of Brooksville, had struggled with back pain since she played high school basketball and volleyball in California. But recently the pain had become excruciating, starting in her lower back and radiating down her legs.

An MRI showed a growth in her lower back that turned out to be chronic inflammation from an infection.

Randall, a human resources employee at Florida Hospital Zephyrhills, could have had her surgery at Florida Hospital Tampa. Being "a private person," she considered it. In the end, though, she chose to have it done where she works.

About a month later, she has returned to work and is back tending her garden at home.

"I still have to take it easy, but I'm feeling much better," she said.

Speciality areas such as neuroscience have become popular for hospitals, especially those in suburban areas, said Dr. John Santa, an internal medicine specialist and director of Consumer Reports' health ratings center.

"I think they create an incredible medical and business opportunity," he said. "It can be marketed and sold more easily than 'Gee, we have a great surgical service.' "

They also can create problems, he said, citing the last boom of heart institutes.

A recent study published in the Journal of the American Medical Association showed that of 602,781 nonemergency interventional cardiac procedures such as angioplasties performed between July 1, 2009 and Sept. 30, 2010, only half were "appropriate."

"It looked like they were being done in lots of patients who didn't even have chest pain," Santa said.

Santa said he hopes the next generation of specialty centers doesn't take the route of many cardiac centers.

"The question is whether we'll repeat this sad sequence," he said. While neurosurgery centers can be a huge plus as technology improves brain treatment, there is a line that crosses into exploitation.

That happens, he said, "When you see ads that say, 'Are you 60 and worried about your memory? We'll give you natural ways to preserve your memory.' "

As for George, she's going to physical therapy twice a week to regain control of her leg.

She's also eager to volunteer at Florida Hospital.

"I used to be a candy striper," she said.

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