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The hero and the dental student: A tale of friendship

Willie Peterson is an Army veteran who has lived through his share of hard times. He has learned to cherish small blessings and pay attention to positive role models. One such role model sat across from him over a string of dental appointments which saw Willie’s once-shy smile transform into a mouth of pearly whites.

That person is Bill Berguin, a recent graduate of the CU School of Dental Medicine. Bill has been the architect of Willie’s new dentures and a close witness to the inspired and ever-upward trajectory of Willie’s life.

Willie and Bill at the Heroes Clinic at CU Anschutz
Army veteran Willie Peterson, left, proudly shows off his new teeth, which were created by Bill Berguin, his Heroes Clinic caregiver.

At a recent dental appointment, Willie was all smiles. Besides gaining his stellar teeth, the soldier was excited to fill in Bill about yet another achievement. “Check out my credit score,” he said with a beaming grin. “Also, I’ve got a job. I haven’t had a good job in a long time.”

‘He’s a good man’

Willie met Bill about a year ago when he became the first Pathway 1 patient in the dental school’s Heroes Clinic, a Delta Dental of Colorado-sponsored program which provides free and discounted dental care to military veterans. Pathway 1 provides dental care to veterans served through the Bill Daniels Veteran Services Center, which helps link homeless veterans to jobs.

They come from different backgrounds – Willie is from Wisconsin and Bill hails from the Western Slope – but they bonded during Willie’s many visits to the dental chair. “I got to sit and talk with him about life – where he’s from and what he’s doing and how he was trying to go back to school,” Bill said. A few good-natured jabs also found their way into the conversations. Bill likes to razz Willie about being a Green Bay Packers fan, while Willie dishes it right back on the Broncos.

Kidding aside, Willie once confided to Bill, who was in the fourth year of dental school, that he had planted in the soldier’s mind the notion of returning to school. “I thought that was really neat,” Bill said. “I told him he might want to see a graduation, so he’s going to come to my graduation.”

Sure enough, early last Friday morning, Willie boarded a bus near his Denver apartment and rode to the CU Anschutz Medical Campus to attend Bill’s graduation. He hadn’t been to a graduation since his own from high school some 40 years ago. When Bill said he was looking forward to having his new friend meet his family, Willie smiled, extended a hand for a firm shake and said, “I want Bill to come to my graduation, too.”

Willie Peterson and Bill Berguin at CU Dental School graduation
Willie Peterson shakes hands with Bill Berguin at Bill’s graduation on May 26.

Willie has his sights on becoming a technician in heating, ventilation and air conditioning (HVAC). He recently enrolled in the HVAC program at Emily Griffith Technical College in Denver.

Asked what he found inspiring about Bill, Willie said, “I just think he’s a perfectionist. He’s a good man.” 

Putting his life back together

Willie performed a seven-year hitch in the Army, serving in Korea and Japan and, stateside, in Florida and California. He was discharged in 1983, but soon fell into drug abuse and homelessness. “The whole thing,” he said, shaking his head, “just a few years after I got out of the service.”

Gradually, he began to pay heed to the few positive influences in his life. He reconnected with a Lutheran pastor he’d first met during a spell of living in California. When the pastor moved to Wisconsin, Willie followed and began seeking the clergyman’s counsel.

“He helped me kick drugs,” Willie said. “I needed that – I really did – because I was heading down a bad street.”

Things turned more for the better when he sought the help of his mother. “I was just tired of how I was living, so I had to make a change. I started to hang out with my mom and going to church, and then I got the hang of it.”

About a year ago Willie made the move to Colorado, where his sister lives. Still, life was a struggle, as the veteran didn’t have a place to call his own. The Bill Daniels Veteran Services Center connected him to the Samaritan House, a transitional housing facility. Willie was riding the 16th Street Mall shuttle one day when he bumped into Heidi Tyrrell, RDH, assistant director and clinical instructor in the dental school’s Heroes Clinic.

“He was grinning ear to ear and wearing a suit that was a little too big for him,” said Tyrrell, who also noticed that Willie was in need of some dental work. “He ‘ma’amed’ me and I said, ‘Are you a veteran?’ He said yes and I handed him my card.”

Willie, Bill and Heidi at CU School of Dental Medicine graduation
At the CU School of Dental Medicine’s graduation on May 26 are, from left, Army veteran Willie Peterson, graduate Bill Berguin and Heidi Tyrrell, assistant director and clinical instructor in the dental school’s Heroes Clinic.

That’s how Willie ended up in a dental chair with Bill as his care provider. Growing up in Grand Junction, where he saw many friends join the military, Bill has a built-in respect for veterans and he felt honored to care for Willie. “I treated him the way I treat all my patients,” Bill said. “He’s a really good guy, so it was easy.”

With each visit, Willie’s smile brightened and his sense of accomplishment soared. “One less thing to do,” he said with another big grin.

‘Cool to feel like I was helping’

Willie enjoys his job as a housekeeper at the VA Medical Center in Denver. Besides his recent enrollment in technical college, he now has a permanent home, a new girlfriend and a burgeoning sense of security.

“I’m tired of living poor – I don’t want to keep living like that,” said Willie, sporting a U.S. Army hat and the ever-present Packers lanyard. “I feel good about myself now.”

Bill likes the idea of giving back to veterans and said that of all his clinical rotations during dental school, the Heroes Clinic became his favorite. Willie was even more special in that he is the clinic’s first Pathways 1 patient. “Folks in that population are a little more at risk,” Bill said, “so it was cool to feel like I was really helping somebody out.”

Bill will return to Grand Junction with a goal of eventually having his own practice. His father is a dentist, and he plans to join his dad’s practice to learn the ropes of daily dentistry while paying off student loans.

Bill said his rotation in the Heroes Clinic, especially his time with Willie, will remind him of the very reason he aspired to become a dentist – to help people. “I want to do community service and whatever I can to volunteer and give my time, so I can provide care for people who can’t afford it,” he said. “It’s something I want to continue and not lose sight of.”

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Palliative Care includes Creative Arts Therapy

 

A patient in the Natalie Kutner Palliative Care Creative Arts Therapy Program plays the guitar
A patient in the Natalie Kutner Palliative Care Creative Arts Therapy Program plays the guitar

After being diagnosed with cancer of the intestines in November 2016, Nick Gonzales was in and out of the University of Colorado Hospital (UCH) over a period of several months. By the time he began receiving palliative care, Nick and his wife Carol were stressed by multiple hospital visits and struggling to process his declining health.

They found relief through supplies you might not expect to find at a hospital—colored pencils and a camera.

Learn More

For information about the Creative Arts Therapy Program, contact Jean Kutner: Jean.Kutner@ucdenver.edu

To learn about ways to give, contact Cheryl Balchunas: 303-724-6871, Cheryl.Balchunas@ucdenver.edu

The Gonzales family participated in the Natalie Kutner Palliative Care Creative Arts Therapy Program, one of UCH’s newest approaches to care for people with serious illness. According to Program Director of the UCH Palliative Care Service Jeanie Youngwerth, MD, the program combines “the creative arts with therapy to make a patient feel like a person again.”

Nick and Carol used coloring and photographs taken by their art therapist to discover how creating art enables a patient to express deep and difficult feelings. “Poetry, art and music—they help to get your feelings out,” Nick Gonzales said. “It’s motivating, and I expressed more when I got involved with the program.”

His wife Carol agreed. “For me, coloring releases the stress of being in the hospital for so long.”

A personal connection to palliative care

The Natalie Kutner Palliative Care Creative Arts Therapy Program was created to honor the memory of Natalie Kutner—artist, medical social worker, Parkinson’s patient and the mother of Jean Kutner, MD, and CU Anschutz School of Medicine Professor of Medicine. Jean Kutner serves as a physician on the UCH palliative care team, and she played an instrumental role in starting the program.

Although she was already a palliative care physician when her mother’s health began to decline, being a family member of a terminally ill patient expanded Kutner’s perspective. “As a relative, I gained an even deeper appreciation of palliative care,” Kutner said. “The care team provided an extra layer of support that our family relied on.”

Untitled (House) by Natalie Kutner
Untitled (House) by Natalie Kutner

In the final stages of her disease, Natalie Kutner received eight months of palliative care. When Natalie died, Jean Kutner and her father designated the memorial donations for palliative care. Those funds and a generous anonymous donation made it possible to expand palliative care at UCH to include creative arts therapy.

Establishing a creative arts therapy program in Kutner’s honor resonated with her family because of Natalie’s volunteer work in the community and her legacy as an artist. When discussing her own work, she described the power art has to “transmute the ordinary into the extraordinary.”

Creators, not ‘reactors’

A similar transformation occurs in creative arts therapy at UCH, which helps patients cope with the existential pain of a terminal illness and communicate with their loved ones. “The program is an interdisciplinary approach to decreasing suffering and clarifying meaning,” Youngwerth said. “The therapists weave their skills and knowledge of art and music into their counseling and therapy.”

Palliative Care Art Therapist Amy Jones and Music Therapist Angela Wibben maintain a well-stocked “Art Cart” and an ample supply of musical instruments for patients and families.  “Sometimes patients have difficulty coping, overly identify with their disease or worry about leaving their children and grandchildren,” Wibben said. “Creative art therapy expands their definitions of themselves.”

Patient art becomes part of the legacy they leave for their families. One young mother with cancer constructed a bird’s nest out of weaving materials. She included a ceramic egg for each of her children and pebbles to represent the years she spent with her husband. “Creative art therapy looks at a person’s whole life,” Jones said. “It looks for metaphors that ease suffering beyond the reach of words.”

Wibben agrees. “Experiential music therapy may begin by listening to music and lead to a conversation that reveals what music means in our lives,” she said. “That might lead to songwriting, which makes the patient a creator, not a ‘reactor.’”

Turning a life into a legacy

Photographs of Nick and Carol Gonzales' hands, taken by their art therapist Amy Jones
Photographs of Nick and Carol Gonzales’ hands, taken by their art therapist Amy Jones

For Nick and Carol Gonzales, the couple found art creation to be relaxing, but their therapy also brought them closer together. When they left UCH, they took their artwork, as well as Jones’ photographs of Nick and Carol’s hands.

The photographs are a part of Nick’s legacy. “The pictures are really expressive,” Carol Gonzales said. “Seeing his hand over mine—I think of how he protected me.”

“Palliative care is not just medication, it’s emotional and spiritual help,” Nick Gonzales said. “When you share, it helps to heal. I look at those pictures of our hands, and I think of Carol and me taking care of one another.”

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CU Anschutz and CU Denver help residents of Denver Meadows

Brenda Gutierrez and her four children at their home in Denver Meadows
Brenda Gutierrez and her four children at their home in Denver Meadows

Virginia Visconti is always looking for ways to advance community-campus partnerships.

As the community practice specialist for the Center for Public Health Practice, Colorado School of Public Health, Visconti, PhD, identified an important collaboration to engage students and faculty, from both CU Denver and the CU Anschutz Medical Campus.

And Denver Meadows residents lived right next door.

A mobile home and RV park just east of CU Anschutz, Denver Meadows houses 120 families on 20 acres. Last year, its owner sought to rezone the park for transit-oriented development, which would allow the land to be used for high-rise apartments, retail, hotels and office space.

Residents likely would have to move if the Aurora City Council approves the request. The city council tabled the proposal last July, asking the owner to secure a developer and work with the residents to come up with a plan for them before it took up the issue again. To date, there has been no council vote.

Virginia Visconti
Virginia Visconti, PhD, at Denver Meadows

Visconti’s concern for Denver Meadows residents prompted her to reach out to the community with the assistance of Andrea Chiriboga-Flor, a 9to5 Colorado community organizer, who has been working with the residents. Together, they identified community-driven efforts that would also engage students and faculty. Visconti then shared the opportunities with campus colleagues. The College of Nursing and College of Liberal Arts and Sciences Communications Department joined the partnership that began in November 2016 and continues today.

“I felt from the get-go we had a golden opportunity to demonstrate that CU is a good neighbor—that we care about what’s going on in people’s lives, we know we have a lot of resources and we’re eager to serve,” Visconti says. “I think that’s what we conveyed to the Denver Meadows residents. This big looming campus cares about them and paid attention to what they had to say.”

Ninety-two percent of Denver Meadows families own their own homes or are paying down loans. Many of the residents have lived more than 20 years in the park and would have no place to go if they had to leave. Aurora currently has no lot vacancies.

Chiriboga-Flor, of 9to5 Colorado, says the CU involvement will help raise awareness of housing issues affecting Aurora residents, particularly those who live at Denver Meadows.

“Having an ally and partner like the university saying we care and support this neighborhood really helps us a lot,” she says. “It’s powerful for the residents to know that there is such an interest in what’s happening to them.”

Identifing Community Concerns

Scott Harpin, PhD, MPH, College of Nursing
Scott Harpin, PhD, MPH, College of Nursing

For Scott Harpin, PhD, MPH, director of community engagement and an assistant professor at CU Anschutz’s College of Nursing, the request to conduct a community needs assessment was the perfect opportunity to give his students field experience.

“It was a great collaboration—we knew right away that mental health promotion was one of the main outcomes of our needs assessment,” he says. “Our students took both a microscopic and telescopic look at the community to confirm that end.”

Denver Meadows residents were “grateful to have students come down and listen to their case,” says Harpin, adding that the final assessment was delivered to the residents and proved to be an important learning experience for the nursing students.

“That’s the whole point of us being good neighbors,” he says. “While CU has so many great partnerships across the Front Range, the ones we have within the four-mile radius of our campus should be our priority.”

Service learning is an important educational tool because it helps students understand the real world—even if it’s just outside the campus, Harpin says.

He added, “It transcends educating nurses—it’s making them good citizens going forward, long after graduation.”

The goal of the community needs assessment was to give residents the opportunity to share with students the strengths of their community and help identify areas that could be improved, says nursing student Sibelle Barbosa. Students interviewed the residents and discovered a tight-knit group who looked out for each other. But questions about their housing status led residents to experience anxiety, depression and other health issues.

“We looked at the whole context,” she says. “We learned that the environment and what’s going on in their lives did affect their health and we were grateful they were open to discuss their problems.”

Barbosa, who graduates this month, says she’ll remember the Denver Meadows   experience long after she leaves campus and gets a nursing job.

“I will be a better nurse because of this experience,” she says. “It helped me understand how important it is to look at the whole person, not just their diagnosis.”

Telling the Denver Meadows Story with the Residents 

When Suzanne Stromberg, MA, a lecturer at CU Denver’s College of Liberal Arts and Sciences Communications Department, heard about Denver Meadows, she felt a video project documenting the stories of Denver Meadows residents would be valuable to both Denver Meadows and the students in her Theories of Leadership class.

“We had to talk about the fact that they were there to capture a story, not engineer it,” says Stromberg. “My students developed relationships with the families and were incredibly gracious and dedicated.”

Stromberg says she was struck by the willingness of faculty from both CU Denver and Anschutz Medical Campus to collaborate on the project.

CU Denver communications student Valeria Moran wanted to work with the Denver Meadows community because she grew up in a trailer park in Edwards, Colo. Her parents, who worked in the service industry in the affluent mountain community, had trouble finding affordable housing for Moran and her three siblings.

“Having grown up in a trailer park, I knew what it was like to worry about finding someplace else to live,” says Moran. “First they (Denver Meadows residents) had their guard up, but after we spent time with them, they made us feel at home anytime we came to visit.”

Moran hopes the completed video will be a powerful advocacy tool for the Denver Meadows community.

“They were brave to get on camera and tell their stories, so I really hope our work is beneficial and helps them,” she adds.

Brenda Gutierrez, a Denver Meadows resident for three years, participated in both the video and community assessment survey. She says she wants to do everything she can to save her double-wide trailer, home for her and her four children, ages three, eight, 12 and 13.

A single mother, Gutierrez still owes $12,000 on the trailer and works double shifts as a cashier at Taco Mex on Colfax Avenue, just four miles from CU Anschutz.

“It’s very stressful—I work both shifts to make extra money to pay down the trailer,” says Gutierrez, adding that she’s had panic attacks when she thinks about having to move from Denver Meadows.

She says the nursing students helped the residents with ideas on how to improve their health and manage their stress. And the communications students gave them an ability to proudly tell their stories about their homes, families, history and community.

“It was really helpful because it gave us strength that we felt we had lost,” she says. “It made us feel we could still have stable homes and keep our dreams alive.”

 

 

 

 

 

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Spencer Milo joins Marcus Institute for Brain Health

milo
Spencer Milo joins the Marcus Institute for Brain Health at CU Anschutz

Spencer Milo is a U.S. Army combat veteran and Purple Heart recipient who served in both Iraq and Afghanistan.

In 2008, during a 16-month tour in Iraq where he saw action in Baghdad and Mosul, Milo suffered a concussion and other injuries when a routine convoy of U.S. Humvees encountered small arms fire. Dodging enemy fire, he was tossed around inside the turret and his vehicle crashed. A year later, he was told by doctors stateside that his injury had caused a brain tumor and was given a 6-months to live. Heavily medicated and bedridden for months, he started having seizures.

After his family fought for a second opinion, he eventually learned he had been misdiagnosed. Cleared for duty in January 2010, Milo chose to continue following his passion for military service and he deployed to Afghanistan.

Less than a year later, in January 2011, he was on combat patrol in Spin Boldak, a border town in Kandahar near Pakistan. That’s when an Afghan boy, a few feet away from Spencer, detonated himself as a suicide bomber. Thrown 15 to 20 feet by the blast, he charged back into the smoke to find his wounded platoon buddy and dragged him to safety. Among his injuries: small amounts of shrapnel to his left side and his face, injuries to his spine, hearing loss, post-traumatic stress (PTS), and traumatic brain injury (TBI).

Milo returned to the states for medical treatment at Fort Bragg and, after six months, was transferred to the National Intrepid Center of Excellence (NICoE) at Walter Reed National Military Medical Center, where he underwent four weeks of intensive treatments. He left with diagnoses for PTS, TBI, and 27 others. He says the care he received there, which included nontraditional treatments like art therapy, biking, yoga and a service dog named Nemo, saved his life.

Medically retired at age 28, he and his family moved to Colorado. After serving as Area Manager for Hire Heroes USA for four years, he is now Director of Veterans Programs, Communications and Strategic Development for the Marcus Institute for Brain Health (MIBH) at the University of Colorado Anschutz Medical Campus. The medical institute focuses on serving military veterans and retired elite athletes with primarily mild to moderate brain injuries, post-traumatic stress, depression and anxiety.

“These invisible wounds, there’s always one big thing that people want fixed,” Milo said. “I think customized care is going to be what distinguishes us, treating problems the current health system does not address. The whole family heals together, not just the patient.”

Neurologist James P. Kelly, MD, Executive Director of the MIBH, met Milo, who has associations in elite athletics, through involvement in a documentary on veterans and post-traumatic stress filmed in Colorado. They share a mutual ally in former President George W. Bush. The President painted Milo portrait and published a tribute to him this year in “Portraits of Courage: A Commander in Chief’s Tribute to America’s Warriors.” Kelly is a senior fellow at the George W. Bush Institute and former Founding Director at Walter Reed’s NICoE.

Milo has a bachelor’s degree in strategic communications from the University of Colorado Colorado Springs. An airborne Infantryman who was recognized as an exceptional leader in combat, Spencer held a number of command and control roles in military assignments in the United States, Europe and Asia.

He serves on the board of trustees for the Intrepid Fallen Heroes Fund as an Honorary Co-Chair, and his work with veteran service organizations also includes The George W. Bush Institute’s Military Service Initiative (MSI); Warrior Canine Connection; Parker’s Platoon; and Team Red, White and Blue.

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Landmark gift makes CU Anschutz a national leader in veterans health care

Thanks to a gift of $38 million from the Marcus Foundation, the University of Colorado Anschutz Medical Campus will soon become a national model for the diagnosis and care of veterans who have suffered from traumatic brain injuries and related psychological health conditions.

Leaders of the Marcus Institute for Brain Health at CU Anschutz
Standing on the second floor of the CU Anschutz Health and Wellness Center, where the Marcus Institute for Brain Health will be located, are, from left, retired Navy SEAL Lt. Cmdr. Pete Scobell, U.S. Rep. Mike Coffman, philanthropist Bernard Marcus, Dr. James P. Kelly, and CU Anschutz Chancellor Don Elliman.

The Marcus Institute for Brain Health (MIBH) opens this summer in the CU Anschutz Health and Wellness Center. The one-of-a-kind institute will be the cornerstone of a planned national network devoted to innovative and intensive treatment of military veterans who served our nation and now suffer the invisible wounds of war.

The MIBH was announced Friday by CU Anschutz leaders and Bernard Marcus, whose Atlanta-based philanthropic organization has steadfastly supported the health and well-being of military veterans. The luncheon celebration drew more than 100 attendees, including leaders from CU Anschutz’s hospital partners as well as CU President Bruce Benson, CU First Lady Marcy Benson and U.S. Rep. Mike Coffman.

‘Ideal place’ for innovative institute

Bernard Marcus and CU President Bruce Benson
Bernard Marcus, retired co-founder of The Home Depot and founder of The Marcus Foundation, with CU President Bruce Benson.

CU Anschutz Chancellor Don Elliman said the campus is “the ideal place” to establish an institute that promises to transform health care for military veterans. CU Anschutz, once home to the Fitzsimons Army Medical Center, has a long history of serving veterans in addition to providing world-class mental health and wellness care. “We have leading-edge research and innovative programs that literally surround the institute’s efforts,” he said. “The campus is driven by a vision of delivering the best care and pioneering new approaches to treatments that get patients and families back to their lives.”

MIBH Executive Director James P. Kelly, MD, a neurologist and pioneer of customized diagnostic and treatment plans for veterans, led the National Intrepid Center of Excellence (NICoE) at the Walter Reed National Military Medical Center for seven years. The MIBH is designed after NICoE, which has successfully treated more than 1,300 active-duty servicemen and women suffering from traumatic brain injuries (TBI) and psychological health conditions. “Dr. Kelly came to us with that vision,” Elliman said, “and without him we would not be standing here today.”

Dr. Kelly stepped to the podium and, after acknowledging Chancellor Elliman and CU School of Medicine Dean John J. Reilly, Jr., MD, for their leadership, gave an emotional thanks to his wife of 30 years for her unwavering support throughout his career.

Dr. James Kelly of the Marcus Institute for Brain Health
Dr. James P. Kelly, executive director of the Marcus Institute for Brain Health

“The Marcus Institute of Brain Health is uniquely designed to address combined neurological and psychological conditions by targeting underlying causes,” Dr. Kelly said. “Where better to create such a place than the Anschutz Health and Wellness Center on an academic medical campus with a proud tradition of caring for military service members and their families?”

Immersive care

Retired Navy SEAL Lt. Cmdr. Pete Scobell
Retired Navy SEAL Lt. Cmdr. Pete Scobell

The MIBH will immerse veterans in treatment by a team of professionals in one place, rather than having them travel from clinic to clinic, Dr. Kelly said. The institute will optimize the functions of conventional medical diagnostic treatment while integrating alternative approaches such as mindfulness training, physical therapy and massage, acupuncture, yoga, and canine and equine therapy.

Care will be customized to each patient’s needs. “The Marcus Institute for Brain Health will share its lessons learned with systems across the country in real time. … What’s happening in Colorado will reverberate beyond our state’s borders to every corner of this nation,” Dr. Kelly said. “The need for such a program is huge.”

Nearly 400,000 U.S. servicemen and women have been diagnosed with TBI since 9/11 and as many as 600,000 suffered related psychological health conditions, he said.

‘I know I’m not alone’

One of these patients, retired U.S. Army Staff Sgt. Spencer Milo, has been named director of veteran programs at the MIBH. “As a military veteran who sustained injuries in Afghanistan, I am a huge advocate for the Marcus Institute for Brain Health,” Milo said. “Treatment like the traumatic brain injury therapies now being offered here saved my life, and I know I’m not alone.”

Plaque of Marcus Institute for Brain Health at CU Anschutz
CU Anschutz Chancellor Don Elliman points to a replica of the permanent Marcus Institute for Brain Health plaque as Dr. James P. Kelly, MIBH executive director, and Bernard Marcus, philanthropist and retired co-founder of Home Depot, look on.

Retired Navy SEAL Lt. Cmdr. Pete Scobell explained how he was the second SEAL to go to NICoE for treatment of TBI and related psychological conditions. He recalled sitting in a room with a dozen physicians representing “all specialties. They were out to solve the problem, not just treat the symptoms,” he said. “I know this can change lives – it’s unique.”

Cohen Veterans Network partnership

In addition to the announcement of the $38 million gift to create the Marcus Institute for Brain Health, the CU Anschutz Medical Campus announced it will work with the Cohen Veterans Network.

The network, in a partnership totaling $9.8 million, will work with CU Anschutz to build a mental health clinic to serve veteran and military families in greater Denver with free, or low-cost, personalized care and integrated case management support.

Founded by hedge fund manager and Connecticut philanthropist Steven A. Cohen, the Cohen Veterans Network is creating 25 Steven A. Cohen Military Family Clinics throughout the U.S. over a five-year period. Clients, veterans and family members will be treated by high-quality, culturally competent, network-trained clinicians, and will receive referrals to additional services at the CU Anschutz Medical Campus and in metro Denver.

Another distinctive aspect of the MIBH will be its service to military veterans regardless of their discharge status or ability to pay.

“It’s incumbent upon all of us across the nation to help those who have suffered as a result of their military service,” Dr. Kelly said, noting that the care at CU Anschutz will be further augmented by the soon-to-open Denver VA Hospital. Colorado will serve as a national model of seamless transitions of health care for veterans, he said. “It’s our intention that the Marcus Institute for Brain Health collaborate with academic and private-sector partners and the network of specialty centers – all working together to meet the needs of our veterans in multiple locations across the nation.”

Only the first step

Bernie Marcus, the retired co-founder of The Home Depot, said it’s an honor for his foundation to support veterans’ health because proper care for these selfless servicemen and women has been inadequate in the United States. He praised Dr. Kelly’s leadership of NICoE at Walter Reed National Military Medical Center and said the center’s innovative vision will carry forward at MIBH.

“We’re starting here in Colorado with this medical campus,” Marcus said. “This building is only the first step of a major organization that’s going to be unaffiliated; we’ll join together and try to create the best of the best, and that’s what my foundation is all about.”

CU President Bruce Benson said the University of Colorado system has long been committed to serving those who have served our country. “Our campuses and communities are better places for the presence of veterans and military-connected students, families, faculty and staff,” he said. “These new initiatives further strengthen that commitment. We are deeply appreciative of this tremendous support and proud to be able to do our part.”

While the Marcus Foundation’s gift of $38 million is over five years for the MIBH, which will also serve civilian adults who have sustained mild to moderate TBI, the institute is set up for the long term, according to Chancellor Elliman. “Our commitment is to keep this institute going for as long as there is a need,” he said.

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Spencer Milo

milo
Spencer Milo joins the Marcus Institute for Brain Health at CU Anschutz

Spencer Milo is a US Army combat veteran and Purple Heart recipient who served in both Iraq and Afghanistan.

In 2008, during a 16-month tour in Iraq where he saw action in Baghdad and Mosul, Milo suffered a concussion and other injuries when a routine convoy of US Humvees encountered small arms fire. Dodging enemy fire, he was tossed around inside the turret and his vehicle crashed. A year later, he was told by doctors stateside that his injury had caused a brain tumor and was given a 6-months to live. Heavily medicated and bedridden for months, he started having seizures.

After his family fought for a second opinion, he eventually learned he had been misdiagnosed. Cleared for duty in January 2010, Milo chose to continue following his passion for military service and he deployed to Afghanistan.

Less than a year later, in January 2011, he was on combat patrol in Spin Boldak, a border town in Kandahar near Pakistan. That’s when an Afghan boy, a few feet away from Spencer, detonated himself as a suicide bomber. Thrown 15 to 20 feet by the blast, he charged back into the smoke to find his wounded platoon buddy and dragged him to safety. Among his injuries: small amounts of shrapnel to his left side and his face, injuries to his spine, hearing loss, post-traumatic stress (PTS), and traumatic brain injury (TBI).

Milo returned to the states for medical treatment at Fort Bragg and, after six months, was transferred to the National Intrepid Center of Excellence (NICoE) at Walter Reed National Military Medical Center, where he underwent four weeks of intensive treatments. He left with diagnoses for PTS, TBI, and 27 others. He says the care he received there, which included nontraditional treatments like art therapy, biking, yoga and a service dog named Nemo, saved his life.

Medically retired at age 28, he and his family moved to Colorado. After serving as Area Manager for Hire Heroes USA for four years, he is now Director of Veterans Programs, Communications and Strategic Development for the Marcus Institute for Brain Health (MIBH) at the University of Colorado Anschutz Medical Campus. The medical institute focuses on serving military veterans and retired elite athletes with primarily mild to moderate brain injuries, post-traumatic stress, depression and anxiety.

“These invisible wounds, there’s always one big thing that people want fixed,” Milo said. “I think customized care is going to be what distinguishes us, treating problems the current health system does not address. The whole family heals together, not just the patient.”

Neurologist James P. Kelly, MD, Executive Director of the MIBH, met Milo, who has associations in elite athletics, through involvement in a documentary on veterans and post-traumatic stress filmed in Colorado. They share a mutual ally in former President George W. Bush. The President painted Milo portrait and published a tribute to him this year in “Portraits of Courage: A Commander in Chief’s Tribute to America’s Warriors.” Kelly is a senior fellow at the George W. Bush Institute and former Founding Director at Walter Reed’s NICoE.

Milo has a bachelor’s degree in strategic communications from the University of Colorado Colorado Springs. An airborne Infantryman who was recognized as an exceptional leader in combat, Spencer held a number of command and control roles in military assignments in the United States, Europe and Asia.

He serves on the board of trustees for the Intrepid Fallen Heroes Fund as an Honorary Co-Chair, and his work with veteran service organizations also includes The George W. Bush Institute’s Military Service Initiative (MSI); Warrior Canine Connection; Parker’s Platoon; and Team Red, White and Blue.

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CU Anschutz welcomes women in STEM careers

Attendees at Women in STEM forum

The gender disparity in STEM-related careers has traditionally been staggering, with far more men going into science, technology, engineering and mathematics than women.

The Women in STEM club at CU Anschutz is determined to change this.

Building Confidence

In an effort to cultivate confidence among scientists, men and women alike, Women in Stem at CU Anschutz held its first annual Spring Symposium on April 24. Women from campus spoke about their scientific experiences and created an open environment for personal discussion.

“We decided to make the theme of our first event ‘Empowerment and Inspiration,’ because a lot of women in STEM feel disempowered,” said Abigail Armstrong, president of Women in Stem at CU Anschutz. “We wanted to light a fire under them to persevere despite the challenges they face.”

Vice Chancellor for Diversity and Inclusion Brenda J. Allen, PhD, delivered the keynote address. By encouraging participants to seek personal empowerment, this talk established the uplifting tone for the rest of the symposium.

After Allen, Kate Smith, an assistant professor in the CU School of Medicine, spoke about her journey to becoming a tenure-track professor while overcoming her self-doubts. Vanessa Carmean, an alumna of the CU Anschutz Medical Campus, talked about strengthening her voice and the voices of her female colleagues. “Though difficult, these experiences have taught me that I can take power over my own life,” Carmean said.

Jessica Ponder
Jessica Ponder

Following Carmean, four short, jargon-free talks by CU Anschutz female faculty and students highlighted a variety of difficult aspects of STEM that scientists struggle with. Although each speaker chose a different topic, all the segments held a positive underlying message of self-empowerment.

“Many scientists get buried in jargon during their talks,” said Armstrong. “We thought this would be an innovative and exciting way for scientists to talk about their passion to a broader audience.”

Jessica Ponder  

“How many of you consider yourselves phenomenal?” asked Jessica Ponder, a PhD student at CU School of Medicine. A few bashful attendees raised their hands. “Well, I have 10 minutes to change that. Let’s get started,” announced Ponder, speaking to those women who had not raised their hands.

Her words of encouragement resonated through the auditorium.  She highlighted her leadership in community involvement, and expressed her confidence in the capabilities of the women in attendance to lead projects. “Bring your voice and passions to the foreground,” said Ponder. “You, too, are phenomenal.”

Liz McCullagh
Liz McCullagh

Liz McCullagh 

Liz McCullagh, also a postdoctoral fellow in the CU School of Medicine, raised awareness of barriers encountered by young women interested in science, including some that are self-imposed. She asked everyone in the room to write down words to describe the ideal woman STEM candidate and the ideal male STEM candidate. To the surprise of everyone in the room, the words used to describe the men were about their achievements. The words used to describe the women were more about their social characteristics like “enthusiastic,” “fearless” and “confident.”

McCullagh emphasized the importance of mentor figures and advocated for self-confidence. “Let’s show girls they can become strong, STEM women,” said McCullagh. “Let’s be realistic. There are struggles, but we did it.” 

Allison Porman
Allison Porman

Allison Porman 

Allison Porman, a postdoctoral fellow in the CU School of Medicine, spoke about her unusual journey through various STEM careers. When she expressed her personal frustrations with science—which included competition among scientists for grants and authorship of research papers—sentiments of agreement echoed around the room. However, positive undertones remained. “You may feel disheartened, but science can help those around you,” said Porman in a closing statement. “We can improve the whole world.”

Christina Coughlan
Christina Coughlan

Christina Coughlan

Christina Coughlan, a CU Anschutz senior faculty research instructor, gave the final talk. In Ireland, where she grew up, pursuing a STEM career was not only abnormal, but discouraged. She gives credit for her success to the strong women who mentored her through her journey. Coughlan closed with a warm sentiment advocating for mentorship among women on campus and in the community.

The seminar closed with a discussion in which attendees shared tactics to improve self-confidence and empowerment. “Advocate for yourself,” said McCullagh. “Build a strong support network. Find mentors and mentor back. Let’s gain some power back.”

 

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Study puts mechanical hearts in spotlight

For more than two decades, Jim Walsh’s heart has been an uncertain ally.

Like all of us, Walsh, 67, relies on that vital muscle to keep blood pumping to his body. But his can’t do the job alone. Late last year, damage to Walsh’s heart that began more than two decades earlier caught up with him. Two days before Christmas, Walsh lay on an operating table at UCHealth University of Colorado Hospital for a procedure to lend his failing heart a helping hand.

cardio lab at CU Anschutz
William Cornwell, right, performs an echocardiogram on volunteer Scott Ferguson in a CTRC lab as research coordinator Greg Coe looks on. It’s part of Cornwell’s five-year NIH-funded study aimed at better understanding the physiological effects of LVADs.

Cardiac surgeon Joseph Cleveland, MD, implanted a left ventricular assist device (LVAD) called the Heartmate 3, a pump designed to give Walsh’s weakened heart a big boost. Cleveland and his team hoped the LVAD would, in turn, lessen the pressure on Walsh’s pulmonary artery and right ventricle, which are responsible for supplying blood to the lungs for oxygenation.

The procedure happened none too soon. “My progression downward was rapid,” Walsh said. “I had the choice to die rapidly or get an LVAD.”

Long road

Walsh’s lengthy battle with congestive heart failure began in 1995 when tests revealed that the left main stem of his coronary artery had developed an aneurysm – a bulge that weakens the vessel wall and puts it at risk of rupturing. The finding surprised Walsh, who was then a relatively young man who had forged a successful career as an expert in finance for several major companies. He described himself as “asymptomatic” up to that point and added that he regularly jogged and lifted weights.

But the aneurysm worsened and required a surgical graft repair. A London surgeon used a section of Walsh’s mammary artery to bypass the aneurysm, but during recovery the graft failed and Walsh suffered a heart attack. A second graft, using a piece of saphenous vein in his leg, “held true,” but over the next decade his exercise capacity declined steadily, and he required ever-increasing doses of medications, such as diuretics, to manage his condition.

The problem continued to worsen as the years wore on. When he began treatment at the Denver VA Medical Center in 2014, Walsh’s advanced heart failure dangerously increased the pressure on his pulmonary artery. He was admitted to UCH in November 2016 under the care of CU School of Medicine heart failure specialist William Cornwell, MD.  Andreas Brieke, MD, medical director of the Mechanical Circulatory Support Program for CU, also contributed to the case. Considered too great a risk for a transplant, Walsh chose the LVAD implant a month later.

CU Anschutz heart patient Jim Walsh
Jim Walsh is feeling stronger after receiving an LVAD just before Christmas last year. But he’s still working to recover his stamina, even with the help of the pump. Photo courtesy of Jim Walsh.

The surgery was successful, and Walsh is making a slow recovery that he hopes will one day lead to a heart transplant. He makes regular walks around Sloan’s Lake in northwest Denver – about 2.5 miles.

But Walsh’s case points to a larger question about the device that saved his life. Interviewed four months after the LVAD surgery, he said the lake walk still leaves him breathless, especially if he tries to talk at the same time.

The problem of the pump

Why hasn’t the LVAD pump been able to restore Walsh’s ability to normally complete this routine activity? That’s a question that intrigues Cornwell and his colleagues at CU. Cornwell is exploring it with the help of a five-year National Institutes of Health grant that began late last year. He’s equipped a lab in the Clinical and Translational Research Center (CTRC) on the 12th floor of UCH’s Anschutz Inpatient Pavilion to measure exercise capacity in patients with normal hearts, those with mild heart failure and those with LVADs. The work includes frequent measures of patients’ blood pressure, cardiac output, blood flow from the heart to the brain, blood oxygen levels and more while at rest and during exercise.

Cornwell notes that while LVADs are designed to pump 4 to 10 liters of blood per minute to the body, tests show that many patients with the pumps continue to have muscle atrophy and difficulty exerting themselves without their blood pressure and heart rate rising rapidly and fatigue setting in. These are all signs that the pumps might not be delivering a sufficient blood supply to the body’s muscles and organs.

“Many LVAD patients remain functionally incapacitated,” Cornwell said, with low oxygen consumption rates and other clinical symptoms that belie many patients’ subjective reports of feeling better after getting the devices.

In addition, work by Cornwell’s colleague Amrut Ambardekar, MD, CU cardiovascular specialist and medical director of the Cardiac Transplant Program, shows that artery tissue in the hearts removed from transplanted LVAD patients is often stiff and scarred beyond what would be expected with normal aging.

Case of the missing pulse

The problem may lie in the fact that LVAD patients lose something that most of us take for granted: the pulse created by heart contractions. The LVAD’s mechanical pump supplies blood in a continuous flow.

That’s led to known problems. For example, LVAD patients are at higher risk of gastrointestinal bleeding and stroke. The recently approved Heartmate 3 attempted to address the no-pulse problem by regularly speeding up and slowing down the pump rotor – a kind of artificial heart “lub-dub.” But Cornwell said data thus far show that the feature has not decreased the rate of strokes or bleeding.

Losing the pulse has other “subtle but important implications,” Cornwell said. The heart’s contractions stretch a network of sensors in the aorta and carotid arteries called baroreceptors. These sensors communicate with the brain, helping to regulate blood pressure naturally. In LVAD patients, by contrast, the lack of a pulse “revs up” the sympathetic nervous system, which releases adrenaline and increases blood pressure, thus interfering with normal blood flow.

That may help to explain why many LVAD patients such as Walsh don’t see improvement in their capacity to walk at least short distances without fatigue, climb stairs or do regular household chores, Cornwell said. One question to be answered in the lab is whether LVADs can be made to sufficiently increase blood flow to the body during exercise to compensate for the absence of pulse.

Into the lab

Any conclusions await data gathering. Cornwell is now testing healthy patients. Those with mild heart failure and with LVADs will follow. On a recent afternoon, volunteer Scott Ferguson lay on a bed in Cornwell’s lab. An array of lines to measure cardiac output, heart and lung pressure, blood oxygen levels, and other data ran from Ferguson’s arm and neck. A transcranial device fitted around his head would measure the flow of blood to his brain. Cornwell also took an echocardiogram to get an image of Ferguson’s heart.

Lab research at CU Anschutz
Research coordinator Greg Coe fits a breathing tube on volunteer Scott Ferguson while William Cornwell watches. Ferguson completed three stages of steadily demanding cycling to measure the physiological effects on his body.

A team of CTRC nurses assisted with monitoring Ferguson and taking regular blood draws, which would later measure arterial blood gases during periods of rest and exertion. Greg Coe, clinical research coordinator and regulatory specialist at CU, stood before twin towers of computer monitors displaying many fields of colored lines running in peaks and valleys. These were the representations of Ferguson’s body at work: heart and respiration rate, blood pressure, pulmonary artery pressure and much more.

Ferguson, 29, a post-doctoral fellow in cardiovascular physiology at CU, lay calmly on the bed while Cornwell and his team readied him for the tests. Cornwell asked him to breathe in and breathe out, then to bear down for 20 seconds. Coe timed the exercise while monitoring the readings at the two screens.

With that completed, Ferguson stood and mounted a stationary bike. Coe inserted a long breathing tube in his mouth and clipped his nose. Over the next hour or so, he completed three regimens of timed cycling with low, moderate and intense levels of exertion. During each one, nurses drew blood while Ferguson pointed at a clipboard to silently indicate to Coe his level of exertion. Cornwell orchestrated the work while scrutinizing the lines on the computer screens that charted the changes in Ferguson’s physiological functions as he increased his exertions.

Steps ahead

It will be several months before an LVAD patient enters the CTRC lab to provide the same kind of data, Cornwell said. But the work with healthy patients and those with mild heart failure will provide useful comparisons when he and his team examine the responses to exercise of pulseless LVAD patients.

“We’d like to see how much exercise it takes to create a physical pulse using the heart’s natural power,” he said. That might lead to “novel exercise prescriptions,” such as lifting resistance weights or interval training.

“These devices [LVADs] are important, but it doesn’t mean that we stop working,” he said. “Patients improve with them, but they are not out of the woods.”

Walsh is grateful for the lifesaving care he received from the entire CU team at UCH and is ready to do whatever he can to help further. If he is eligible for a transplant, he’s willing to allow study of his damaged heart and said he “absolutely has the same enthusiasm” for Cornwell’s study.

The strongest drive lies close to home: his wife and three daughters, including the youngest, who is just 14 years old.

“My hope is to be here long enough to help her navigate her way through her formative years in high school and, perhaps, even university,” he said. “I’m not afraid of death, but I’d like to think that with the LVAD I have bought more time before the statistics turn against me.”

Tyler Smith is a guest contributor of University Communications. 

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CU School of Medicine honors alumni including Elliff, Buchanan, Sharp and Camp

The University of Colorado School of Medicine will honor four alumni—outstanding physicians for their delivery of health care, pioneering research, and service to their country and communities—at its Silver and Gold ceremony May 25.

John Elliff
John Elliff

John E. Elliff, MD, and William S. Buchanan, MD, both ophthalmologists and native Coloradans, will receive the Distinguished Achievement Award for their work in bringing health care to northeastern Colorado, where access to health care has been limited. For a combined 50 years, Drs. Buchanan and Elliff served the community of Sterling at the Sterling Eye Center, which Dr. Elliff’s father, Edgar Elliff, MD, built. Both physicians served on the faculty of the School of Medicine for decades. In addition to continuing his father’s work in the community, Dr. Elliff organized and built a 110-bed nursing home in Sterling.

William Buchanan
William Buchanan

John R. Sharp, MD, a gastroenterologist, will receive the Distinguished Service Award. He served in the United States Air Force for the first 22 years of his medical career, rising through many levels of leadership before returning to civilian medicine. He greatly contributed to advancing the understanding of gastroenterology in his research and publishing, and in educating medical students. He has practiced in locum tenens positions across Colorado, New Mexico, Nebraska, Kansas and Missouri.  Currently Dr. Sharp practices locum tenens in Longmont.

John Sharp
John Sharp

Bonnie W. Camp, MD, highly regarded as a pioneer and leader in pediatric medicine, will receive the Alumni Association’s Silver and Gold Award, the School of Medicine’s highest alumni award. Dr.  Camp has published more than 100 articles, abstracts, presentations and workshops on early childhooddevelopment and language. Her early work in language development and social behavior in very young children is still cited today, nearly 50 years after her first publications, and in programs dedicated to helping young children develop intellectually and socially.

Bonnie Camp
Bonnie Camp

For more information on the Silver and Gold Alumni Banquet go to www.medschool.ucdenver.edu/reunion or contact the Office of Alumni Relations at 303-724-2518.

Guest Contributor:  CU Anschutz Office of Alumni Relations

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Endoscopic neurosurgery restores life of patient with hydrocephalus

Liz Calise remembers the morning in 2009 she woke up and her world quite literally flipped. Her bedroom began spinning and she couldn’t keep her balance.

“That was the beginning of my nightmare,” she said. “The dizziness episodes kept happening over and over again.”

A visit to the ER and then to an ear, nose and throat doctor failed to provide answers. The doctor prescribed anti-nausea pills and dizziness suppressants, but the vertigo-like attacks kept occurring. Liz’s worsening health forced her to retire from her job as assistant manager at a supermarket deli in central Florida.

Liz Calise and CU Anschutz's Dr. Samy Youssef
Liz Calise poses with Dr. Samy Youssef after undergoing successful endoscopic brain surgery in Florida in 2013.

Her husband, Andrew, said her condition deteriorated even more over Thanksgiving 2010. “She started acting strange. She was sort of out of it, like in a daze,” he said. “She woke up one day and had no strength to keep her body up. She was like dead weight.”

Discovering Dr. Youssef

He took her to a neurologist who did some research but couldn’t find anything. “I said, ‘Look at my wife, she’s like a zombie,’ and she was getting worse.”

The next neurologist they visited diagnosed Liz with hydrocephalus – fluid on the brain – which was caused by a large cyst deep inside her brain. However, he said, surgery would be too risky. In all, the Calises consulted with seven neurologists and neurosurgeons and always heard the same thing: too risky.

Just as the couple, who have three sons and three grandchildren, were running out of hope, they went to see Mark Shaya, MD, a neurosurgeon in Miami. He told them he’d just been to a Florida Neurological Society meeting where he’d heard a presentation by Samy Youssef, MD, PhD, then an associate professor at the University of South Florida in Tampa Bay.

Youssef, who in 2014 joined the University of Colorado School of Medicine’s Department of Neurosurgery as a professor of neurosurgery, gave a talk about endoscopic, minimally invasive brain surgery techniques, which have grown in sophistication over the last 20 years.

Brain surgery revolutionized

“Brain surgery has been revolutionized by advances in technology – namely imaging technology, advanced microscopes and endoscopes, and navigation tools,” Youssef said. “It has made brain surgery, even for complex brain tumors, much more precise and much less invasive, with faster recoveries and shorter hospital stays for the patients.”

The Calises were ecstatic to learn about Youssef and his expertise with endoscopic techniques and minimally invasive brain surgery. Liz, at the time in a wheelchair and losing cognition, got an immediate appointment.

Youssef discovered that Liz’s condition is very rare. The large cyst growing out of her thalamus, a veritable “grand central station” structure that sends neurologic information to the rest of the body, was obstructing the flow of cerebrospinal fluid and causing pressure to her brain. “It’s near the pineal structure of the brain,” he said. “It’s deep in the brain and around critical blood vessels on the back of the brain stem. Surgery there is challenging.”

Researching this rare condition

In a study recently published in World Neurosurgery, Youssef and five other researchers, including CU Anschutz Neurosurgical Fellow Ciro Vasquez, MD, wrote that medical literature has reported only 13 cases in which a cyst originated in the thalamus and involved the brain’s third ventricle – a cavity through which cerebrospinal fluid travels. He had previously performed endoscopic surgery to remove tumors and lesions in the pineal region, but not to reach a cerebrospinal fluid cyst in that area.

Samy Youssef, MD, PhD
Samy Youssef, MD, PhD, professor of neurosurgery in the CU School of Medicine, (center) teaches two neurosurgeons on a minimally invasive brain surgery using live imaging technology in the Center for Surgical Innovation.

In Liz’s case, Youssef deployed similar technology, but used a different trajectory to reach the cyst, which he believes was an anomaly Liz was born with and worsened over time. If left untreated, her condition would have continued to deteriorate, likely leading to a dementia-like state. Youssef used a navigating endoscope with a special trajectory that reaches all the way through the ventricular system and into the deep-seated third ventricle. The entry point is a “keyhole,” or a single burr hole, behind the hairline on top of the skull.

Like ‘Fantastic Voyage’

“It’s like the movie ‘Fantastic Voyage’ – often times I show that footage in my lectures. It’s how fiction becomes reality,” Youssef said. “We’re navigating inside the human brain without opening it much.”

Center for Surgical Innovation

Samy Youssef, MD, professor of neurosurgery, said that in addition to the specialized expertise available from the Complex Cranial and Skull Base Surgery program at the CU Anschutz Medical Campus, the campus benefits from having the Center for Surgical Innovation (CSI). His research focuses on complex brain surgery and minimally invasive techniques, and “having the CSI lab is a great resource to maintain that academic field of the skull base surgery,” he said. “We refine surgical approaches that get transferred from idea to lab, and from the lab to the operating room.”

Also, the Department of Neurosurgery offers a Skull Base Surgery year-long fellowship/resident program that uses the CSI Microsurgery Laboratory to give young neurosurgeons exposure to complex cranial cases and minimally invasive skull base approaches. This year’s fellow, Ciro Vasquez, MD, co-authored with Youssef the recent study, “Third Ventricular Cerebrospinal Fluid Cysts of Thalamic Origin,” published in World Neurosurgery.

In a surgical procedure that only took an hour, Youssef used an endoscope to open and drain the cyst to the normal cerebrospinal fluid circulation. He then performed a ventriculostomy – a diversion of spinal fluid into the extra-ventricular cerebrospinal fluid system. “It uses the endoscope to create a natural passage for fluid to drain through a different channel to the rest of the spinal fluid drainage system,” he said. “So, it was two procedures in one.”

Within 24 hours of surgery, Liz’s cyst was significantly smaller, and within 72 hours she was responding to the post-op therapy. Her life was restored.

‘Back to myself again’

“I just woke up and was back to myself again,” Liz, 66, recalled of the surgery in 2013. “I could talk to my children, I had all my faculties, and I wasn’t shaking anymore. It was a miracle, just totally a miracle.”

Typically, a patient who undergoes brain surgery for a longstanding problem would go directly to a rehabilitation facility from the hospital. That wasn’t the case for Liz. She was able to go home. “Her speech came back completely; it was like she never had the problem before,” Andrew said. “She was the talk of the ward.”

Youssef has since performed two more endoscopic procedures on cerebrospinal fluid cysts of thalamic origin – both at University of Colorado Hospital – with similar success. The patients’ conditions were similar to Liz, and like her, they struggled to find a neurosurgeon willing to perform surgery.

“The amazing part of this disease entity,” Youssef said, “is that somebody’s life can be completely restored through a one-hour surgery and a single keyhole.”

‘On the map internationally’

Youssef, who travels the world teaching endoscopic, minimally invasive brain surgery procedures, was recruited by Department of Neurosurgery Chair Kevin Lillehei, MD, to direct the Complex Cranial and Skull Base Surgery program at CU Anschutz. The program, which is unique in the Rocky Mountain region, includes co-directors Samuel Gubbels, MD, and Vijay Ramakrishnan, MD, both associate professors of otolaryngology. “Now the program is on the map nationally and internationally,” Youssef said.

These sophisticated procedures are among the most challenging in neurosurgery, he said, but the results are life-changing. The average endoscopic brain surgery patient goes home after three days in the hospital, Youssef said.

“There is not much room for error,” he said. “We chose this field and we do these cases because of that reward we get at the end of the day when we see these patients go back to their normal lives, their families, their businesses. Everyone is happy. That’s what keeps us going in this field.”

The Calises, meanwhile, are back to enjoying their retirement years in the Sunshine State. They keep in touch with the neurosurgeon who changed their lives. “Out of all the doctors, he gave us light at the end of the tunnel,” Andrew said. “He drew a diagram of what he could do to help, and then he did it. Dr. Youssef is absolutely amazing.”

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