health & wellness

Double Dose from page 53

Minimally Invasive Procedure
Relieves Back Pain

Low back pain can interfere with your
daily activities. Sometimes, a pain reliever
will help. But when it doesn't, surgery
may be required, depending on the cause
of the pain. St. Joseph Mercy Oakland
(SJMO) offers a spine fusion procedure
to reduce low back pain and restore your
quality of life.
The procedure, Axial Lumbar Interbody Fusion or AxiaLIF, is a minimally
invasive approach to spine fusion surgery. Performed by neurosurgeon
Steven Rapp, MD, the procedure begins with a one-inch incision near
the tailbone, as opposed to traditional surgery, when the surgeon entered
through the abdomen to access the spine. Surgery is typically indicated
when the pain is due to degenerative spine disease, spinal stenosis
(narrowing of the spinal canal), or a disc rupture.
During the procedure, the center of the degenerated
disc is removed and bone growth stimulating material
using the patient's own bone is inserted in its place.
The material helps bone growth over time so that the
spine will be fused. The fusion is augmented by a small
implant to stabilize the vertebrae while fusion occurs.
During this insertion, the surgeon can restore disc
height and alignment.
This alternative approach has many benefits for the
Steven Rapp, MD
patient, according to Dr. Rapp. "There is minimal blood
loss, less discomfort, less chance of injury to the central
nervous system, shorter hospital stay and a faster recovery time." For the
surgeon, "with an AxiaLIF, you minimize exposing the spinal cord to potential
injury, scarring and adhesions. There's less risk of damaging vital nerves,
blood vessels and muscles."
There are no special preparations required for the surgery (except for
a bowel prep), which is performed on an outpatient basis. Patients may go
home the same day or require an overnight hospital stay. Generally, patients
are able to be mobile more quickly and return to work in a couple of weeks.
"Patients are feeling very good in seven to 10 days," adds Dr. Rapp. The
success rate is about 85-90 percent.
St. Joe's is proud of its accomplishments in the area of spine surgery.
We have been designated as a Blue Distinction Center+ by Blue Cross and
Blue Shield of Michigan and as an Aetna Institute of Quality.
Patients should consult with their physician to determine which
procedure is right for them.

By
Jack Weiner,
President and CEO
St. Joseph Mercy
Oakland

For a referral to a St. Joe
physician, call 800-372-6094.

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up for their morning treatments. Just
like Laura, Joe, a commercial lender,
juggles his schedule to do what needs
to be done.
"His great sense of humor often
helped the girls deal with their medi-
cal burdens:' Laura says.
"Some mornings I don't feel like
getting up early, which means I need
two treatments when I get home in the
afternoon, especially during school:'
Emily says. The treatments need to be
four hours apart, but I make sure I fit
them in."
Often she'll go to the gym and work
out with her mother; and she played
volleyball at school last fall. This
spring she started working part time
as a waitress and baby sitter, which
continues this summer.
Molly adds, "I feel better when I'm
active. It keeps my lungs functioning
at their best:'

Various Medications
Daily, the girls consume at least five
different medications, primarily by
inhaling through a nebulizer twice a
day, Laura says. "A few years ago, the
nebulizers were always getting clogged
up and the treatment often took a
long time. Today, the newer nebuliz-
ers work so much better, and that's
good because the whole point is for
the inhaled drugs to reach the airways
quickly and easily.
"Because CF also impacts their
digestive systems:' Laura says, "every
time the girls have a meal or a snack
they need to take their enzymes so
that they can digest their food. They
take about 25 pancreatic enzymes a
day to help digest and absorb the food,
otherwise they wouldn't get the nutri-
tion their bodies need. When they
were younger, it was always a struggle
for them to gain any weight:'
Every three months, the Bonnell
teens go to the University of Michigan
Cystic Fibrosis Center, one of five cen-
ters in Michigan. Laura is usually on
the phone to the Center several times
a month seeking advice about what to
do depending on the behavior of one
or both of the girls.
"Because both Bonnell parents were
already identified as carriers of the CF
mutated gene and Molly had already
been diagnosed with CF when she was
an infant, Emily was screened quickly
after she was born:' says Samya Nasr,
M.D., director of clinical services,
Pediatric Pulmonology, U-M Cystic
Fibrosis Center.
"We've been screening newborns
for CF since 2007, especially in those
populations that are more likely to be
carriers of the mutated gene, such as
the Jewish Ashkenazi population. We
found that it's better for patients when

the disease is detected early and treat-
ment can start right away even before
symptoms become obvious:'

Incidence Of CF

Approximately 30,000 children and
adults in the United States have cystic
fibrosis. An additional 10 million or
about one in every 31 Americans are
carriers of the defective CF gene but
do not have the disease. CF is most
common in Caucasians, but can affect
all races.
CF is on the list of the 19 Ashkenazi
Jewish genetic diseases that require
screening because they may be life-
threatening to a child. It is estimated
that one in three
Ashkenazi Jews is a
carrier of a least one
of these 19 diseases.
"We also found
that treating the dis-
ease aggressively is
likely to give patients
a better quality
Dr. Samya
of life Nasr says.
Nasr
At one time, the
prognosis for living with CF was less
than 20 years. Today, I tell my patients
they'll be living long enough to take
care of their elderly parents. What
keeps many of my CF patients alive is
the time they spend, sometimes four
to five hours daily, performing their
treatments:'
At the CF Clinic, the girls visit with
a nutritionist to adjust their enzyme
input, a pharmacist to discuss medica-
tion and treatments. And they have
chest X-rays and a throat swab to test
for any bacterial infection are part of
the routine. Pulmonary Function Tests
(PFTs) are another standard part of
their visit. These measure the capacity
of the lungs when they breathe out.
"One of the most important things
about PFTs is that we can look at how
a PFT changes over time, revealing
in some ways how a person's CF may
be changing:' Nasr says. "We want to
stop any decline early and adjust their
treatment accordingly:'
Laura says, "Medical costs are con-
siderable. For example, the vest they
wear every morning costs more than
$10,000. Three weeks of enzymes is
more than $1,000. Fortunately, we
have a good insurance program and
much of our expenses are covered:'
Molly is a sophomore at Parson's
The New School for Design in New
York with a partial academic scholar-
ship; she is covered under her parents'
health insurance program.
"We made a point of empowering
our girls to be in control of their own
health:' Laura says "After all, they

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