European Stars And Stripes (Newspaper) - October 18, 1988, Darmstadt, Hesse Taking patients to the Point of clinical death by Tara Bradley Steck associated press 0 save Ethel St. Lawrence from the a i aneurysm pressing on her brain doctors killed her Lor 40 minutes. They Pul her in a i coma slopped her heart chatted Ter by 40 if degrees and drained her body of blood Iff St Lawrence was Back at work 10 weeks after what she Calls a Cotlon Pickin Miracle a sort of suspended animation that lets surgeons cure hard to reach High risk aneurysms that once were considered inoperable. Ii is everything that technology can possibly Otter said her neurosurgeon. Or. Robert Spetzler Al Barrow neurological Institute in Phoenix Ariz. It May be the surgery of the future in cases where bleeding poses the greatest risk to the operation said or. Julian e. Bailes a neurosurgeon Al Allegheny Geneia Hospital in Pittsburgh who studied Wilh Spetzler. That s the biggest cause of death in surgery. If you could Pul someone in a stale of suspended animation you could operate in a totally bloodless in a severely cold bloodless stale. The brain can be deprived of oxygen up to is minutes giving surgeons Lime to remove the aneurysm a Bubble caused by weakness in the Wall of a blood vessel and dip arteries feeding in without the danger of massive bleeding and certain death. Of 14 patients who have undergone the procedure at Barrow one has died Bailes said. Most had excellent results a Tow reported some weakness but otherwise did Well and most remained in a coma no More than live Days. It s gelling through the surgery said or Steven Shedd. A Barrow who worked on St. Lawrence. Ii you be tolerated Tho procedure and you Wake up you re going to be but the risks including that the heart won t restart. Arc Loo great to use the procedure where Normal anaesthesia can adequately do the Job. It s what Birdseye discovered. It you freeze a Tresh fish in will come Back and you can use it. The problem is some people Don to said or. Louis Caplano Boston s new England medical Center and chairmen o1 the american heart association s stroke Council. And because the pal enl has Lobo taken to the Point of clinical death for the operation to succeed doctors approach it with a lot of respect said Shodd. Every Lima i do one of these i get very nervous. You re taking a patient who alive and breathing and stopping his heart and putting him into this slave. There is no breathing no heart function. The brain function is nil. We tilt the table up and Drain a the blood into the pump. "1 Don t want to say the word dead but the patient is definitely suspended at that Point. Cellular activity is occurring Al a Rale so Low that we can t Deled St. Lawrence a 61-year-old Phoenix Secretary was rushed to Barrow on june 2. Suffering from a severe iwo Day headache and unable to open her right Eye. Tests showed that a sinus aneurysm selected four years ago had grown. Partly because of heavy doses of barbiturates Given Belore surgery to help prevent stroke or brain damage St. Lawrence recalls nothing about the june 6 operation. But she does recall experiencing a very Strong sensation. I just had this immense feeling that i was being cared for. Ii Felt like somebody was just holding me in their arms and taking care of me and that i would be of. It wag just a feeling of four months after surgery she needs no medication and tha severe headaches Are gone Hough she still is unable to fully open her Eye. It s just a Cotton Pickin Miracle. It truly is. They do say god works in mysterious ways and one of his ways of working is to have capable people who know How to do things and in this Case extremely capable bathes is confounded though by Cecilia Duffy a 76 year old Pittsburgh woman who spent 51 minutes in suspended animation aug. 31 while surgeons removed an egg sized aneurysm that had almost completely disabled her. Duffy has t come Oul of the drug induced coma. Oven though her brain activity is improving there is no evidence of brain injury and she moves her legs when stimulated. Quite frankly i m worried about her because 1 would have thought she would have come out of it by now Bailes said. It s hard to know Why she has t because she s old and her liver Irv working thai he said. She s not breaking Down drugs that quickly so that s made it a Little More confusing. As we go longer it s More Likely she will have suffered some stroke some sort of brain Cooling the body and stopping the heart before an operation was pioneered decades ago by cardiac surgeons particularly in children where there is Little room to Man Euver and bleeding is difficult to control said or. George Magovern jr., a hear transplant surgeon at Allegheny general who worked on Duffy. Hypothermia is an intricate part of cardiac surgery particularly moderate hypothermia in which the body is cooled 20 to 30 degrees Magovern said. Profound hypothermia. In which Iho temperature is lowered 40 degrees is not done frequently but it s Dona to achieve hypothermia doctors lower the operating room temperature to about 55 and wrap the patient in Cooling blankets. They remove several pints of blood and replace them with refrigerator cold Salina solution a heat exchanger like a Radiator then runs the Saline blood mixture through ice and Back into the body. When the body is cold enough the blood is removed entirely. It s quicker and More efficient to repair the heart in a bloodless Field and sometimes the Only Way you can accomplish that is with profound hypothermia Magovern said but the Downside is that in limits you to 55 minutes of surgery and there s always the potential for neurological the difficulty in applying ii to brain surgery said Caplan. Is that doctors Don t have a Good Way to Monitor the person to see How the brain s working. If you purposely put them in a coma and decrease temperature and Hood pressure you have no Way of knowing if there s been damage until it s an extreme Way of doing an operation that requires extreme said or. Arthur Day of the University of Florida at Gainesville and chairman of the cerebral vascular department of the american association of neurological surgeons. The Sido effects Are quite Sublan tial Day said. So it s not an operation technique that we do for the run of the Mill aneurysm. But for certain uncommon ones it May be Tho Only Way. The problem is. What would you be like if you did t have the surgery most of the Lime having the aneurysm is such a bad thing that you re willing to take a much greater Lumpectomy patients need emotional support by Malcolm Ritter associated press or decades breast cancer meant Mastectomy but Rosanne Forziano of Long Island n.y., had her cancer removed in december while keeping her breast. It s easy to assume that with her tumor gone without disfigurement her problems were Over but that s not the Story that emerges from Forziano and other members of an unusual support group for Lumpectomy patients. What is devastating to you is that you had says Pomiano 34. It s gone now but will it come Banji and where will it come Back Lumpectomy patients Are not alone among cancer patients in worrying about recurrence. But Forziano and other group members say the shared surgical experience helps in discussing thai Issue and others. Having chosen Lumpectomy i want to a with women who made that kind of Choice says Sarah a woman in her mid-503 who asked that her real name not be used. These Are the people who know what this is Nancy Denton a social worker who works with Lumpectomy groups at Long Island jewish Hospital says Many people fail to realize that patients whose breasts have been spared still need emotional support. They Are looked Al by society by their family members by a lot of the Medica profession As Here they Are they have their whole breast intact so they Don l need anything.1 in fact the Bottom line is that they have breast cancer. That in itself warrants some support groups specifically for Lumpectomy patients Are unusual. Most Are for breast cancer patients in general or even cancer patients in general. The Long Island Hospital plans Lour Lumpectomy groups a year each running Sot weeks. The one that included Forziano had a dozen members. Lumpe Tomies account for maybe 20 to 25 percent of breast cancer surgeries and it s definitely on the increase says or. David Winchester medical director of the cancer department of the american College of surgeons the surgery is used on Small tutors. Then the breast is irradiated five times a week for about six weeks. Chemotherapy also May be required. The radiation treatments involve the Strain not Only of daily trips to the Hospital but also of seeing radiation patients who Are doing poorly says Forziano. You say to yourself is that going to next year " the support group lets members discuss such feelings As Well As anger at what cancer has done to their lives end the pressure to be stoic around their families says Denton. Meetings also include lessons in stress management exercise and breast self examination. One payoff says Sarah is being Able to encourage each other to allow family and friends to really be there in an Emot Tona supportive Way. I still come out feeling most of the Lime that i m Lucky. To have had in found Early have been Able to keep my breast and be with other women who know what that s tuesday october 18, 1938 the stars and stripes Page 17
