“My eyes are a huge part of what I do as a professor. My teaching, research and patient-care responsibilities all depend on me having good vision,” Richard said. After he joined the faculty at UAMS and learning that UAMS doctors have a great reputation in the medical community, he became a patient at the Jones Eye Institute.

Following several years of routine eye exams to monitor his glaucoma, Richard had an urgent issue with his vision one day. Knowing that he needed urgent medical care, Richard was relieved to be referred by his Jones Eye Institute ophthalmologist, Michael Wiggins, M.D., to a retina specialist on the same day. After Richard’s detached retina was repaired at Jones Eye Institute, Richard was advised that the other retina would likely detach in the future, and a second detached retina was later repaired successfully.

In the years following his retina surgeries, Richard developed cataracts in both eyes that were surgically treated by Dr. Wiggins using state-of-the-art ultrasound technology. Dr. Wiggins, a comprehensive ophthalmologist who specializes in cataract surgery, says, “Not all cataracts are age related. Some are caused by medications, trauma or are present at birth. Having cataracts develop after a major retina surgery is a known occurrence.”

“I’ve never seen better in my entire life. My grandmother visited many of the top specialists in New York and Boston, and I believe her sight could have been saved if the science and technology at UAMS had been available to her.”

Since Jim had watched his father go blind and subsequently suffer deep depression as a result, he has a real understanding of the difference that good vision can make in a senior’s life.

When Jim was concerned that his vision was not sharp enough for him to drive, his need for personalized care was met by Richard Harper, M.D., of the UAMS Jones Eye Institute. After a thorough medical eye exam, Dr. Harper advised that with the right glasses, Jim could continue driving. After Jim’s glasses were ordered by the UAMS Optical Shop, his vision improved substantially, and he easily passed the eye driving test.

Later, when Jim developed cataracts, their growth was monitored by Dr. Harper for several years, but surgery was deferred until needed. When Jim was driving out of state with his wife to attend their granddaughter’s wedding last year, he realized that he was unable to see well enough to drive in the rain and knew the time had come to have cataract surgery. 

Jim had concerns about cataract surgery and notes that Dr. Harper was very patient and informative during his eye appointments. Jim was concerned that he wouldn’t be able to stop blinking during the surgery, but Dr. Harper’s answers to the questions and outstanding bedside manner alleviated Jim’s fears.

“Many people are understandably anxious about having their eyes operated on,” says Dr. Harper. ”I believe it is critical that anyone contemplating cataract surgery obtain all the information that they can about their specific situation before making that decision. This will allow them to proceed with confidence, as Mr. Bell did.”

Working hand in hand, Jim and Dr. Harper jointly set Jim’s post-operation vision goals to have vision distance in one eye and reading vision in the other eye. The goals were met, and Jim is very pleased with the high quality of his treatment and his vision. “Dr. Harper is the most thoughtful doctor I have come across. He gave me a booklet that completely explained my cataract surgery and went through the booklet with me.”

Independent and happily active with his improved vision, Jim recommends Jones Eye Institute to his friends and acquaintances. 

“Thanks to UAMS, the Jones Eye Institute and Dr. Harper, I am living a full life and have been appointed to a three-year term on Little Rock’s Midtown Redevelopment District #1 Advisory Board. Not bad for an 80-year-old.”

In his job for the Department of Workforce Education, Emil began working with UAMS to approve educational programs. After his ophthalmologist moved five years ago, Emil became a patient at the Jones Eye Institute.

Unable to fully enjoy views of the Arkansas River, parks and woodland he passed by, Emil had an eye exam and learned that he had cataracts. Michael Wiggins, M.D., a comprehensive ophthalmologist who specializes in cataract surgery, performed surgery so that Emil could see whites clearly and other colors more sharply. “I think Dr. Wiggins is tops. He is a fine doctor with a great bedside manner.”

A few years after his cataract surgeries, Emil was in the middle of a training run for his third marathon when he started having issues with one of his eyes. When he reviewed eye information on Web sites, Emil feared that he had a detached retina. Emil’s suspicions were confirmed when he visited the Jones Eye Institute the next day, and he was relieved to find that his urgent need for medical care was met very quickly. One year after surgery to repair his retina, he has 20/20 vision in that eye and is thrilled with the outcome.

“Symptoms of retinal detachment include the sudden appearance of multiple floaters, flashes of light or a curtain moving across your eye. Patients experiencing any of these symptoms or with any sudden loss of vision should seek immediate eye care,” said Sami Uwaydat, M.D., a retina specialist at Jones Eye Institute. “A patient with a detached retina has a better chance of regaining vision if retinal detachment surgery is done as soon as possible. Patients should also contact their eye doctor if they notice that straight lines appear wavy or if blank spots appear in their central vision, as these can be signs of age related macular degeneration.”

Having personal experience with the high quality of eye care provided at the Jones Eye Institute, Emil wants to spread the word to tell others in Arkansas and neighboring states. Emil believes it is important to establish a relationship with an ophthalmologist long before you need specialized services.

“I have a good ophthalmologist backed up by specialists and a state-of-the-art hospital. I’m confident that the Jones Eye Institute can provide whatever service I need now or at any time in the future.”
                                                                                                                                                                

Emil is especially pleased that the Cycle for Sight ride route this year will include the Medical Mile, which has been called the crown jewel of the Arkansas River Trail. Other ride highlights include the Big Dam Bridge and the Main Street Bridge.

Emil and our Jones Eye Institute staff members invite you to join us for this endurance ride. With three ride options designed to fit your level of cycling, this ride is for all levels of cyclists (even beginners). To register, please see Cycle for Sight.

Last year Lynda Etheridge was feeling fine and saw no need for a doctor-recommended brain scan to see if she had an aneurysm. Today she’s glad that her husband, Herb, convinced her to do it.

The Etheridges, of North Little Rock, had seen Lynda’s brother undergo recent surgeries for three ruptured brain aneurysms and endure a long, difficult recovery. She was told by her brother’s doctor in Houston that aneurysms run in families and that she should be tested.

Her husband urged her to follow through, and she got a nudge from her internist, so she agreed. In May 2009, she got the results of her CT scan.

“They called me the next day and told me I had an aneurysm,” Lynda said. “I was shocked.”

Lynda was referred to a Little Rock neurosurgeon. But instead of taking her case, he recommended that she see UAMS’ Dr. Eren Erdem, an interventional neuroradiologist who specializes in non-surgical catheter-based treatments of brain aneurysms.

Meanwhile, Lynda was considering her options. “I thought I would have to go to Houston or the Mayo Clinic or someplace like that,” she said. “But the neurosurgeon told me Dr. Erdem is the best in the business.” About the same time she went for a mammogram, and her radiologist, who was familiar with Erdem’s work, told her, “Dr. Erdem is excellent.”

Erdem is the only board-certified interventional neuroradiologist in Arkansas, and his skills have been recognized internationally. At UAMS, he directs the Division of Interventional Neuroradiology, where he provides a non-surgical alternative to repair both ruptured and unruptured aneurysms. He also is well known in his field for treating vascular malformations of the head and neck and using an innovative procedure known as kyphoplasty to help multiple myeloma and osteoporosis patients who are immobilized by painful vertebrae fractures. In fact, Erdem leads the world in the number of multiple myeloma patients treated with kyphoplasty.

To treat aneurysms, Erdem uses a relatively new procedure known as coil embolization. During this procedure, a catheter is inserted in a major blood vessel in the inner thigh and maneuvered all the way to the brain. The coiled wire is threaded through a catheter sheath to the aneurysm. The coiled wire is added until it fills the aneurysm, and is left there, permanently. A clot forms around the coils like scar tissue, which blocks more blood from entering the aneurysm.

More often than not, this is the preferred alternative to surgery for ruptured aneurysms, Erdem said. In a surgical procedure, a neurosurgeon has to manipulate brain matter to reach the aneurysm and clip it so that blood stops flowing into the aneurysm. Such invasive surgery has more risks than coil embolization, and the recovery period is significantly longer.

At her first appointment with Erdem, Lynda said she grilled him about the procedure before concluding that UAMS was her best alternative, especially since it allowed her to stay close to home.

Her aneurysm was not ruptured, but Erdem told her that it had a very high risk of rupturing within six months. She had the coiling procedure two weeks later and went home the following day. She said she was able to resume her normal, active routine within three weeks.

“I feel great,” she said. “I’m doing everything I’ve ever done before.”

When Catherine awoke one morning with pain in her abdomen, she trusted her instincts and went to the UAMS emergency room. After surgery to remove her appendix, a routine medical test revealed that her appendix was infiltrated with a cancerous tumor. An additional surgery was performed to remove part of her colon, and she was then diagnosed with stage II colon cancer. Catherine was advised that if she had not been diagnosed, she would have been dead within two years.

Since Catherine had two different types of cancer, she needed to undergo chemotherapy. Catherine and her husband, Jeffrey Burton, wanted to have a child and were concerned about the affect of her cancer treatment on her ability to conceive a child. Her oncologist, Issam Makhoul, M.D., had not encountered a similar situation because most women diagnosed with colon cancer are past their childbearing years.

Dr. Makhoul created an individualized treatment plan for Catherine to preserve her fertility. Chemotherapy targets dividing cells, so Dr. Makhoul used medications to put Catherine’s ovaries to sleep. While there were no guarantees, Catherine and the staff at UAMS hoped that her ovaries would be protected from the cancer treatment.

At the UAMS Winthrop P. Rockefeller Cancer Institute, Dr. Makhoul conducts clinical research and treats patients. “I don’t want my patients to wear the ‘cancer’ label. It’s not enough for me to treat the disease of cancer only from a medical standpoint. I want to heal the person so that they are empowered to regain control and reconnect with their life,” he said. “I don’t want my patients to live in fear. If we have helped patients to reestablish normalcy so that they can enjoy the important as well as trivial things in life, then we have achieved a lot.”

Two years later, Catherine and her husband were thrilled to learn that she was pregnant. Because Catherine had some complications with a previous pregnancy and due to her cancer treatment, her pregnancy was treated by Paul Wendel, M.D. through the UAMS high-risk pregnancy program.

“With the only board-certified maternal-fetal medicine physicians in Arkansas along with state-of-the-art equipment and technology, I believe UAMS offers the best in medical care for patients who have high-risk pregnancies,” said Dr. Wendel.

Catherine and her family welcomed McKenzie June Burton, a happy and healthy baby girl who was born at UAMS. While the road to bring McKenzie into the world was full of bumps along the way, Catherine is very grateful to all of the UAMS staff members who worked to restore her health and made the birth of her daughter possible.

                                                                                                                                                        
“I owe McKenzie’s life to all of the doctors and surgeons at UAMS. Timing is everything, and in my case, it was life or death. I did not have any of the signs of cancer. Thanks to all the staff who assisted in saving my life and delivering a new life. UAMS is top notch!”
                                                                                                                                                         
Looking at the photo of Catherine and McKenzie, Dr. Makhoul smiles. “The assignment that I give to my patients, if they want to reward me in any way, is to go and be happy and live a long life. Knowing that Catherine and her baby are thriving is a gift to me.”

“I spent 12 and a half months on this program and somewhere along the way – I can’t even tell you when it happened – my attitude changed. I went from ‘living to eat’ to ‘eating to live.’”

At her first meeting after returning to the program, Debbie had a memorable conversation with Betsy Day, manager of the Weight Loss and Metabolic Control Clinic. Betsy talked to Debbie and told her how glad UAMS was to have her back in the program. Debbie thanked Betsy for the opportunity to come back, and Betsy quickly reassured Debbie that patients are always welcome to come back. “Betsy said that I didn’t fail, but they had failed me,” Debbie said. “She told me that they treat each patient individually and want to see everyone succeed.” Debbie then realized just how much the staff was behind her and was there to support her through this process.

Debbie acknowledges that taking the first step of going to classes can be quite intimidating. “You walk in and sit down with people you don’t know. You hate to admit that you need to be there. You don’t want to be there, but you know that you need to be here. It takes a few weeks to warm up,” she said.

Within a few weeks, Debbie found encouragement and support in those strangers. “As we shared our goals in class, you have the chance to adopt some of their ideas,” she said. At one class, one of her classmates said that her goal was to have a healthy relationship with food. Debbie found that to be a profound statement and used it as a goal of her own.
 
Debbie and her classmates also talked and supported each other between classes. They often shared recipes and tips and were also there to provide support to each other. One afternoon she was tempted to get fast food, and she was able to talk to a classmate who encouraged her to stick to her diet. “We passed around our phone numbers, and even now four or five of us keep in touch after we completed the program almost two years ago,” she said.

Debbie not only found encouragement but was able to give encouragement to others in her class. Class members exchange e-mail addresses and send words of encouragement at least once that week.

Debbie’s life has been changed as a result of this program at UAMS. She lost 135 pounds on the program, which is more than what her goal was when she started the program. “I spent 12 and a half months on this program and somewhere along the way – I can’t even tell you when it happened – my attitude changed. I went from ‘living to eat’ to ‘eating to live.’”

Changing her lifestyle and habits were the key to Debbie’s successful weight loss. Two of the aspects of the program that helped the most were food journaling and exercise. She started walking four miles a day with her husband; in addition to all the benefits of regular and consistent exercise, she was able to spend more time talking with her husband. “You cannot do this without support. I am very fortunate that my husband supports me,” Debbie said.

“You have to follow the rules. It’s not easy. The bad habits got me there, but you learn new habits,” she said. Debbie still follows these new habits through the help of the program. “UAMS built the program and has refined it and worked on it. It will work, but you have to work it. This program is available to anyone if they will try it and follow it. It will help make you successful.”

In the weeks before she was referred to Ayman Mahdy, M.D., a urology specialist at the University of Arkansas for Medical Sciences (UAMS), Williams had no choice but to buy adult diapers.
 
“I was at the extreme, and I needed help,” she said.

Williams, of Little Rock, received a comprehensive evaluation from Mahdy, who has expertise in voiding dysfunction, urinary incontinence, female urology, urodynamics and urologic reconstruction.

The evaluation included tests to rule out bladder infection and other curable problems. Mahdy conducted a urodynamic study – a performance assessment of the bladder and urethral function. This revealed overactivity of the bladder muscle, which was causing Williams to urinate involuntarily. The study also revealed a hypersensitive bladder, and a low cystometric bladder capacity, meaning she had the urge to urinate when only a small amount of urine was in her bladder.

Mahdy determined that there was no defined cause for Williams’ bladder overactivity. He recommended that she try an implant that uses electrical impulses to calm the sacral nerve, which influences the behavior of the bladder.

Before implanting the InterStim^® device under Williams’ skin at her lower back, Mahdy first had to test with a device that she would wear externally. The test device was linked to the sacral nerve with a tiny wire, and Williams tried it for five days. She kept a record of her experience and reported to Mahdy that she had 100 percent improvement of her urine leakage, 90 percent improvement of frequency symptoms and 70 percent improvement of urgency symptoms.
Mahdy and Williams were pleased with the results, so Williams chose to have the implant surgery. She was under conscious sedation for the 1 ½ hour procedure, and she went home the same day.

Made by Medtronic, the InterStim^® Therapy implant is the only FDA-approved device of its kind. The implant allows patients to resume daily activities without having to carry or see the device. A remote control allows Williams to turn it on and off and to change the stimulation amplitude up and down. Otherwise the device works on/off automatically.

More than a month after the implant, Williams said she is essentially cured, thanks to the device.

“It helped me instantly,” she said. “I’m just glad that I found UAMS and Dr. Mahdy.”

The oncologist had bluntly informed the 27-year-old Little Rock realtor that she had cervical cancer.

“I was in such a state I was dizzy. I went to my mom and said, ‘I need a second opinion.’ I wanted a doctor I could easily talk to.”

That’s when she called UAMS and Dr. Alexander “Sandy” Burnett. The gynecologic oncologist had recently become the first surgeon in Arkansas to use a robotic procedure called a trachelectomy to remove a patient’s cancerous cervix through small incisions in her abdomen while preserving her ability to have children. Could he help her?

As a young adult, Johnson-Davis was punctual in getting her annual Pap smear. Her grandmother had died from cervical cancer when her mother was just 10 years old. Johnson-Davis’ tests had always been fine until the spring of 2007 when it showed abnormal cells on her cervix.

She underwent a colposcopy, a procedure that uses an instrument with a magnifying lens and a light to examine the cervix, and a biopsy. Afterward, the doctor’s office called her to come in immediately.

“My stomach was in knots. I had no idea what they were going to tell me,” said Johnson-Davis.

Her gynecologist sent her to see the oncologist, who performed a procedure to remove the abnormal cells. After receiving the startling cancer diagnosis by phone, she went for her next appointment and was told, “You’ll never have kids. You need a full hysterectomy.”

Something rose up in her. She thought, “You’re not going to decide my future. I’m going to decide it.”

After she turned to UAMS, Burnett studied her file and repeated the colposcopy. The cancer had grown. Burnett recommended she undergo the trachelectomy.

But before she could be scheduled for surgery, she discovered she was pregnant. Surgery would have to wait. Since going into labor could disturb the cancer, Burnett scheduled a C-section two weeks before her due date.

A perfectly healthy Hadley Davis was born July 31, 2008. On Nov. 21, 2008, Burnett performed a robotic radical trachelectomy, removing the cervix and five lymph nodes. The cancer was finally gone.

“I just can’t thank Dr. Burnett enough,” said Johnson-Davis, now 29. “Had I not found him, I’d have a huge void in my life. I think I would have a little bit of a broken spirit.”

The new procedure allows a woman to have more children, though Johnson-Davis is not sure she will choose to due to the high risks. “Dr. Burnett is so positive. He said, ‘Give that baby some brothers and sisters. If you want to have another one, I feel confident that you can.’”

These days she is back working full time. She is grateful to her husband, Josh Davis, who with their parents helped care for her and the baby during her weeks-long recovery.

“We have such strong faith in my family. That’s the only thing probably that kept all of us from breaking down,” she said. “I tried to just hold positive and be so grateful that yeah, I’m going through this, but look at this blessing that I’m holding.”

One afternoon Grace was gardening in her backyard in Springdale, Arkansas. While digging up a plant to give to a co-worker, she felt a fierce pain. “It felt like my head exploded,” she said. “At first, I couldn’t imagine what it was. I was really scared.”

The pain started going down her neck, so Grace thought she could be having a stroke. Grace knew she wasn’t able to drive, so she walked to her neighbor’s house to ask for help. Her speech was slurred, and right away the neighbor knew something was terribly wrong. Grace’s neighbor drove her to the local hospital, and a CT scan revealed a brain aneurysm. Since her local hospital was unable to treat a condition of this nature, Grace was airlifted to UAMS.

Grace was in intensive care until the procedure was performed. She was not allowed to watch TV or do other simple activities that might stimulate her brain and cause further bleeding. But Grace’s family could be there to comfort her, and that included her granddaughter, Isabella. “Everybody was so kind. They allowed my grandbaby to sleep in my arms,” Grace said.

Grace was comforted by the high quality of medical care she received from her UAMS physician, Dr. Eren Erdem. “He had a kind and gentle voice, and he explained all the pros and the cons,” Grace said.

“All my questions were answered. I never thought I wasn’t going to make it. They were confident of the procedure, and I was confident in their abilities.”

Since her aneurysm was already ruptured, the best course of action was to undergo endovascular coiling. This involved a catheter going through her groin area, and then being navigated through blood vessels up to the aneurysm. The coils, which are made of soft, platinum based hair-thin wires, are then wound into the aneurysm like a ball of yarn. Over time, the coils become a dense mass that prevents blood from going to that area and causing more damage. Eventually the coils turn into scar tissue.

The procedure has only been actively performing for about 15 years, Dr. Erdem explained. He has been performed the procedure for 10 years at UAMS. “Studies have shown that there is a better outcome with this minimally invasive surgery,” he said. “The patient recovery time is much faster.” Without the minimally invasive techniques, Grace’s quality of life would have been affected for months. Now this surgery is being used more frequently to treat brain aneurysms and has become the preferred method of treatment for ruptured aneuryms.

Grace’s procedure was performed on Isabella’s first birthday. “Everybody at UAMS was sensitive to that and let me be with my granddaughter,” she said. She spent a week in the hospital following the surgery, and she was grateful that the staff allowed Isabella to be there and help in the recovery process. “I couldn’t have asked for a nicer environment to have this done. It meant so much to be treated with such kindness, understanding and compassion. I don’t think that people in Arkansas realize the top notch health care we have available at UAMS.”

Since her surgery, Grace has shown no signs of complications. She feels that her attitude and outlook definitely helped her recovery process. She said that the procedure made her look at life differently. “It has made me realize the importance of the time that Isabella and I have and that we are able to build memories together.”

Grace has completely returned to normal activities including participating in many community activities. She has also helped other patients who have gone through what she did. She meets with people in the Springdale area who have shared her experience so that they can support and encourage each other.

Grace is extremely grateful to the treatment and care she received at UAMS. “Everybody at UAMS was wonderful to my children and grandchild. I owe my life to UAMS and Dr. Erdem,” she said.

Interventional Radiology
Department of Neurology

UAMS’ James Yuen, M.D., (left) and Syed “Ash” Hasan, M.D., recently visited with Michael Jevicky (center), whose arm they saved after a motorcycle accident.

Ed and Margo Jevicky say a series of miracles saved their 18-year-old son, Michael, and his right arm when his motorcycle slammed into a Jeep. One of them was landing in the hands of two well-regarded, highly specialized University of Arkansas for Medical Sciences (UAMS) surgeons.

“UAMS is not just a hospital; it changes lives,” Ed Jevicky said. “It changed Michael’s. The outcome could have been so much different.”

The Jevickys, of Guy (north of Conway), recalled the experience during Michael’s follow-up visit with the two surgeons – Syed “Ash” Hasan and James Yuen, M.D. – who saved his arm more than a year ago.

Losing his arm was a real possibility because the trauma was extensive and unusual.

Hasan and Yuen, who have decades of experience between them, still marvel at what happened: A five-inch section of humerus bone from Michael’s upper right arm was ejected onto the pavement. It had come through a small hole near his elbow, and the bone was clean, free of any tissue.

Michael’s is such an unusual case that Hasan and Yuen said they’ve found no other like it in medical literature.

In addition, the main nerve in the arm – the ulnar nerve – had been severed. Hasan, an orthopaedic shoulder and elbow specialist with expertise in microvascular surgery, repaired the nerve using a microscope to align the matching fiber bundles.

Next, Yuen, a plastic surgeon with expertise in microvascular surgery, joined Hasan for a procedure that’s akin to a living organ transplant. The eight-hour surgery required taking a section of Michael’s lower leg bone to replace the missing segment in his arm.

The procedure is properly called a microvascular free-flap transfer or microsurgical composite tissue transplantation. Yuen, a surgeon at UAMS since 1993, has performed more than 700 such procedures, but most have involved cancer patients.

Yuen quickly determined that the only place to harvest a living bone large enough and long enough to replace the missing humerus was the fibula in the lower leg, which can be removed without significantly affecting a person’s mobility. He harvested an eight-inch segment of the fibula, along with its still-attached artery and vein. By leaving the ligaments in place at the ankle and knee, Michael would have almost normal use of his leg.

The fibula replaced the missing segment of humerus, and the artery and vein were attached using microvascular techniques to provide circulation to the transferred bone.

Michael, now 19, has nearly all the physical ability that he had before the accident, even riding his motorcycle.

While still in a cast he was able to use his right hand to type, and he later went to Alaska, where he hiked extensively. He noticed weakness in his leg, but additional physical therapy improved that, and today he notices only slight tingling in his hand.

At the time of his accident, Michael was riding from his home in Guy to the Christian Motorcyclists Association club, called Gap Riders of Conway. He was within a few blocks of the meeting when the Jeep pulled in front of him. He recently returned to a club meeting on his motorcycle, driving by the scene of the accident. When he arrived, members of the group stood and applauded.