Sutter Institute for Medical Research 2008 Annual Report

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“I wasn’t the last one in line!” “Jared was 19 1/4 inches at birth and he seemed to get big fast,” said Allison, Jared’s mom. “But around a year, we started wondering if everything was okay. We noticed he wasn’t as big as his cousins and his clothes’ sizes were always a year behind his age. The pediatrician said his size was normal, but when he started school, I heard a lot of comments about how small he was, and I noticed there were things he couldn’t do, like reach the sink to wash his hands. He noticed, too, and started asking what was wrong with him. By the time he turned five, Jared’s worry was apparent, so we decided to take him to see Dr. Prakasam.” Pediatric endocrinologist G. Prakasam, M.D., one of SIMR’s most dedicated research investigators, works with children and families dealing with all types of endocrine disorders. He knows that early detection and treatment of endocrine-related issues is important, but understands that children’s endocrine disorders are not always easy to diagnose and there’s a wider range of “normal” in children than adults. Clear-cut diagnostic tests are not always available for every disorder either, so it’s sometimes necessary to watch children over time and see how they develop. In Jared’s case, Dr. Prakasam performed blood tests, took periodic hand X-rays to check growth, and followed Jared closely for more than two years before determining growth hormones were the best course of treatment. Unfortunately, even with health insurance, the cost of growth hormone treatment remains high. Dr. Prakasam offered Allison and her husband Kevin, the chance to enroll Jared as a volunteer in a clinical research trial. Though the drug was not yet FDA approved, Dr. Prakasam felt it showed good promise with few drawbacks. Best of all, Jared grew two and a half inches in the first six months of the study. “Enrolling Jared as a research volunteer was a very, very tough decision for us,” said Allison, “but we couldn’t afford treatment otherwise. We also trusted Dr. Prakasam and knew he was very cautious, so we felt fortunate that this door had been opened for us. Jared has received such great care and been monitored so closely since he joined the study in May 2008, that we know he’s getting excellent care and being seen more often than if we had chosen to do this on our own.” Best of all, Jared grew two and a half inches in the first six months of the study. “We’re ecstatic for him. It’s such a weight off his shoulders,” said Allison. “I don’t think I fully realized how much his size bothered him until I picked him up after school the day they took second grade pictures. Jared came running out to the car yelling, ‘I wasn’t last in line! I wasn’t last in line! I was second to last, but I wasn’t last!’”
“The results were everything I had hoped for.” Robotic-Assisted Hip Surgery Restores the Spring in Her Step While there’s no discounting the many benefits of aerobic exercise, teaching aerobics classes for countless years eventually took its toll on Sharon’s left hip. “In the type of aerobic dancing I taught, every step began on the left side,” said Sharon. “Over time, the constant pressure on my left hip gradually wore down the joint cartilage until it was bone on bone. It got to the point that I couldn’t even walk without limping.” Sharon talked to people who had undergone hip replacement surgery and heard Dr. Bargar’s name mentioned so often that she decided he was the one she wanted to perform her surgery. In February 2008, she went to see William Bargar, M.D., for the first time and heard that the latest generation of the robotic surgical assistant Dr. Bargar had helped develop many years before would soon be tested in a clinical trial. Dr. Bargar explained that the system would allow him to use diagnostic images to assess Sharon’s hip anatomy and condition, select the best hip implant type and size, and determine its optimal placement. During surgery, the system would assist him again, this time in carrying out the plan and preparing the femur for implant placement to ensure the implant was set at the correct angle. Dr. Bargar’s experience in hip replacement, combined with his confidence in the improved accuracy the system would provide over manual surgery techniques, convinced Sharon to enroll in the clinical trial. “The results were everything I had hoped for,” said Sharon. “I didn’t even have to take pain medication after the surgery. Eight or nine days after the surgery, I was able to walk up and down the stairs at home. My physical therapist said I could go down once in the morning and up again at night, and I was very careful to follow all instructions exactly, which I’m sure helped contribute to my results. My greatest fear was that the hip would pop out, but it settled right in and healed beautifully.” Today Sharon does not enjoy pain-free hips, however. “I do a lot of walking, and I can honestly say that I’ve never felt any pain in my left hip,” Sharon said, “but I have arthritis in my right hip now — and that’s the only hip that ever hurts.”
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Sutter Institute for Medical Research 2008 Annual Report

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