Quelling the storms of seizures in people with epilepsy: Part 2 of a series highlighting Sutter epilepsy research

Posted on Nov 13, 2019 in Affiliates, California Pacific Medical Center, Innovation, Mills-Peninsula Health Services, Neuroscience, Quality, Research, Scroll Images, Uncategorized

Epilepsy—a neurological disorder caused by abnormal electrical activity in the brain—impacts almost 3.4 million nationwide. Despite advances in epilepsy treatment, approximately one-third of adults with the illness experience recurrent seizures. Read more to learn how Sutter researchers are uncovering new clues about how epilepsy develops and how it can be treated more effectively.

Stimulating the brain with neuromodulation

“Neuromodulation” is a technique that stimulates the brain or spinal cord with electrical pulses or chemicals. When used to treat epilepsy, the approach may be used as an alternative to traditional epilepsy surgical approaches or to work in synergy with them.

David King-Stephens, M.D., FAAN, Director of the Sutter Pacific Epilepsy Program in San Francisco, and Peter Weber, M.D., the program’s surgical director, were instrumental in the testing and U.S. Food and Drug Administration (FDA)’s approval in 2013 of one type of neuromodulation, the Responsive Neuromodulation System® (RNS) developed by NeuroPace.

Similar to a pacemaker that monitors and responds to heart rhythms, the RNS® System is a medical device implanted in the skull that monitors and responds to brain activity to help prevent seizures. The device is approximately the size of a stopwatch.    

CPMC was the highest enrolling site in the RNS® System Pivotal Study—a national, multicenter clinical trial of the RNS® System for the treatment of uncontrolled seizures in adults with epilepsy.

Peter Weber, MD“Many patients experience a 70-80% reduction in seizure frequency, and the severity of seizures is also significantly reduced,” says Dr. Weber, lead neurosurgeon at Sutter for the RNS® System clinical trial. He notes that the RNS® System plus medication-based treatment is usually, for these patients, superior to standard medical management alone.

Now, nine-years after completion of the pivotal study, follow-up data is still being collected and assessed. “Results show that, for many patients, the RNS® System led to substantial reductions in seizures, with additional benefits such as improved quality of life, cognition, and memory,” says Dr. Weber.  The RNS® System is also now available at the Sutter Sacramento Epilepsy Center.

Targeting the epicenter of epileptic seizures

To understand the nuances of a seizure, researchers study the brain cells (neurons) that misfire and cause the underlying electrical storm. When a seizure occurs, networks of brain cells involved in the seizure begin pulsing abnormally, leading to the symptoms patients experience during a seizure.

Anti-epileptic drugs (AEDs) are designed to modify the way neurons “fire” and how they communicate with each other and the brain’s network, thereby stopping or preventing seizures. AEDs are categorized by their main mechanism of action, although many of them have several actions and others have unknown mechanisms of action. Most of these medications are anticonvulsants or sedative medications.

There is currently no FDA-approved AED that targets potassium channels that help regulate the communications between neurons involved in the cascade of synaptic events that promote seizures.

A randomized, double-blind, placebo-controlled clinical trial called Xenon 1101, sponsored by Xenon Pharmaceuticals, is underway to test a new anticonvulsant that acts on potassium voltage-gated channels.

“The potassium channel is a novel area of epilepsy study and one that offers potential to prevent seizures through agents that target it,” says Dr. Laxer, principal investigator of the trial at CPMC with co-investigator Dr. King-Stephens. “Our epilepsy program is the only center in Northern California evaluating this new anticonvulsant.”

Three hundred patients will be enrolled in the Xenon clinical trial from enrolling sites across the U.S., Canada, Spain, and the UK.

Stay tuned later this month for Part 3 of this series on Sutter epilepsy research, which will include information on laser ablation surgery.

Read Part 1, which described new ways to map and monitor brain activity in people with epilepsy.

Read More

A Salute to Service

Posted on Nov 11, 2019 in Community Benefit, Scroll Images

Phoebe Jeter

SACRAMENTO, Calif.— On the night of Jan. 21, 1991, in the thick of the Gulf War with Iraq, U.S. Army Lt. Phoebe Jeter gave the order to fire Patriot missiles at an incoming SCUD missile attack. At her command, her all-male team destroyed two SCUDs that night. She was the only woman to shoot down a SCUD missile during Operation Desert Storm.

“We could have died,” she said. “God had his hand over us that night.”

Retiring from the military in 2009 as a major, Jeter holds those memories and experiences close. After some time of reflection, she felt compelled to serve in other way: ministry work.

Now a reverend, Jeter serves as staff chaplain at Sutter’s California Pacific Medical Center Van Ness Campus in San Francisco, supporting patients in the intensive care unit and on the oncology floor. She came to that role in January, after several years as a chaplaincy intern, resident and palliative care fellow at Sutter’s Alta Bates Summit Medical Center in Oakland.

“I love the patients,” she said. “That’s the most important thing to me. And the people I work with have been just wonderful.”

Every day, Jeter uses the skills she learned in her long military career.

“At Sutter, we’re a team. I learned in the military the importance of the team, and I learned that what you do affects your teammates. What I do now affects Team Sutter. That’s what’s important to me.”

Sutter’s Ongoing Commitment to Veterans
Sutter Health has about 1,400 employees throughout its integrated healthcare system who are veterans or reservists. They enhance the organization with the experience and skills they gained during their military service, and help support exceptional health care to patients and families.

“As we pay tribute to the selflessness and strength of the millions of military men and women who have served our nation, we also honor those veterans and reservists working within our network,” said Sarah Krevans, president and CEO of Sutter Health. “Every day, they continue to demonstrate their sense of mission and purpose in their work roles. It is our privilege to work alongside them.”

Recognizing the value military service men and women continue to bring, Sutter Health works with the Employment Development Department to promote jobs for military members seeking employment. Sutter also participates in military career fairs and posts to online military job boards. Additionally, Sutter Health teams up with DirectEmployers, a national non-profit organization that helps connect veterans and others with career opportunities.

Donations to Military Support Efforts
Sutter Health’s appreciation for military veterans goes beyond those who work within the not-for-profit network. Sutter Health also donated a total of $50,000 to Fisher House Foundation and the American Red Cross’ Reconnection Workshops—two military-support efforts dedicated to improving the lives of veterans and their families in Northern California.

Fisher House Foundation is best known for a network of comfort homes where military and veterans’ families can stay at no cost while a loved one is receiving treatment. These homes are located at major military and VA medical centers nationwide, and in Europe, close to the medical center or hospital they serve. Sutter Health’s $25,000 donation will help four families stay for free for one full year at one of the Fisher House facilities. This donation will also support the purchase of vital supplies such as food and personal care items for families staying at the Travis Air Force Base Fisher House.

The Red Cross Services to the Armed Forces Program helps ease the transition that many service members and veterans have experienced through Reconnection Workshops. These workshops, which are free and confidential, help veterans address the challenges of readjusting into life with their families, their jobs and their communities. Sessions and materials focus on learning useful skills, developing effective coping mechanisms, and locating additional resources. The Red Cross Gold Country Region will distribute the $25,000 donation to chapters across Northern California to support veterans and their families who attend these workshops. In 2018, Sutter Health’s contribution helped multiply their service delivery from 373 to 940 people in the Gold Country, Central California and the Northern California coastal regions.

There’s Room at This Inn: Firefighters Battling Kincade Fire Find Respite in Rebuilt Home for Families of Hospitalized Babies

Posted on Nov 7, 2019 in NICU, People, Scroll Images, Sutter Medical Center of Santa Rosa

Newly-reopened facility was destroyed in 2017 Tubbs Fire

SANTA ROSA, Calif. –Sutter Health’s mission is to care for the health and well-being of its neighbors, especially in an emergency. So when Sutter Santa Rosa Regional Hospital was ordered to evacuate patients on Oct. 26 for the second time in two years, the Elizabeth and Bill Shea House, normally used by families of hospitalized babies, was offered to firefighters as a place to rest.

The Elizabeth and Bill Shea House

About 100 firefighters representing Cal Fire, Pacifica, Napa, Clearlake, Pomona, Mill Valley, Walnut Creek and Santa Rosa, who were using the hospital’s parking lot as a staging area, accepted the offer to relax, catch up on much-needed sleep, rehydrate and have a snack at Shea House before returning to the frontlines of the fire.

“We were so pleased to be able to offer the first responders a comfortable place to take a break from fighting the Kincade Fire,” said Mike Purvis, CEO of Sutter Santa Rosa. “Sutter Santa Rosa has been a part of this community for many years and we were glad to support their efforts to save it.”

Ironically, finishing touches had just been completed on the newly-rebuilt Shea House –which was destroyed in the 2017 Tubbs Fire.

Now that the Kincade Fire is contained and Sutter Santa Rosa has reopened for patients, Shea House is again providing free lodging for low-income families of hospitalized babies who need a nearby place to stay while their newborns are cared for in the neonatal intensive care unit (NICU).

About the Elizabeth and Bill Shea House

Nothing is more stressful for a parent and family than having a hospitalized child. The feeling of helplessness can be overwhelming, especially when home is far from the hospital. Studies have long shown that parent presence at the bedside of a sick child is critical to bonding and long-term recovery. For low-income families that don’t live near the hospital, staying in the area can be a significant hardship.

Since it opened in 2004, more than 560 families from across Northern California, including far-flung communities like Ukiah, Gualala, Potter Valley, Sea Ranch, Middletown, Talmage and Willits, have benefited from the comfort of Shea House’s home-like environment. Families stay in one of four private suites anywhere from one to 60 days, with an average stay of about nine days. Shea House also offers guests a fully-equipped kitchen, laundry facilities and comfortable indoor and outdoor areas in which to relax. With the average cost of a nearby hotel room running $225 per night, it’s easy to see how a lengthy hospital stay could be a hardship on any family, let alone one with limited financial resources. To date, Shea House has provided more than $831,000 worth of accommodation to these families.

The Elizabeth and Bill Shea House was rebuilt through the generosity of community donors and its namesakes, Elizabeth and Bill Shea. Shea House’s operational costs are entirely supported by the Sutter Santa Rosa Regional Hospital Foundation.

About Sutter Santa Rosa’s Care for Sonoma County’s NICU Patients and Their Families

For nearly 50 years, Sutter Santa Rosa’s NICU has provided the highest level of intensive care for newborns in the community. An average of 300 newborns are admitted to its NICU each year. These babies and their families would otherwise have to travel to San Francisco to receive life-saving treatment. With 12 NICU beds, three full-time neonatologists and 39 specially trained nurses, the NICU offers pediatric subspecialties including neurology and leading-edge technology to ensure the best possible outcomes for its tiny patients and provides their families with support services to address the many challenges they face in caring for their newborns.

Sutter Santa Rosa Regional Hospital is Now Open

Posted on Nov 4, 2019 in Scroll Images

Full Services Resume After Wildfire-Forced Evacuation

Sutter Santa Rosa Regional Hospital

SANTA ROSA, Calif. – Sutter Santa Rosa Regional Hospital announced today that it reopened with full services just nine days after the hospital was evacuated during the Kincade Fire in Sonoma County.

“We’re excited to once again care for our community,” said Sutter Santa Rosa Regional Hospital CEO Mike Purvis. “Our community has been through a lot, and we are fortunate to get back to seeing patients, our colleagues and neighbors. I’d like to thank our staff and clinicians for all of their hard work over the last week.”

Sutter Santa Rosa is again offering full inpatient and emergency care services. Elective procedures will resume on Wednesday.

“Preparing a hospital to reopen is a difficult task,” said Julie Petrini, president of Sutter Health Bay Area. “I am so proud of our North Bay team members for their dedication to the safety of patients and their hard work to get the hospital and area clinics ready to serve them. In times like these, the value of our integrated network becomes clear – we can help ensure patients receive the care they need, even during extremely challenging circumstances.”

The Evacuation
The hospital, at 30 Mark West Springs Rd., started evacuating the evening of Saturday, Oct. 26, with hospital staff safely transferring nearly 90 patients to other locations by 8 a.m. Sunday.

“Through Sutter’s network and collaboration with other providers, our Santa Rosa team, along with Sutter colleagues throughout Northern California, was able to quickly respond and identify alternative care locations for our patients,” said William Isenberg, M.D., Sutter Health vice president of patient safety.

Sutter Pacific Medical Foundation Clinic Status
In addition to the hospital, numerous clinics were forced to close due to evacuation orders or power shutoffs in the North Bay, including nearly 30 medical clinics operated by Sutter Pacific Medical Foundation. Petaluma Walk-In Care and a temporary same-day care clinic were able to provide care while many locations were closed, and nearly all the impacted clinics have since reopened. For the status of individual clinics and surgery centers, see https://www.sutterhealth.org/for-patients/location-status.

Community Support
Sutter Health is actively supporting its communities, patients, employees and physicians by:

• Establishing a hotline for patients and staff seeking more information at 1-866-961-2889.

• Providing support to Sutter care teams who need it, including financial aid, disaster recovery pay, prescription assistance and other employee assistance support ranging from insurance claims help to mental health resources.

• Donating $50,000 to Community Foundation of Sonoma County’s Resilience Fund on behalf of its employees, doctors and volunteers. This fund supports organizations helping individuals impacted by the fires, healing the long-term effects of trauma, creating housing solutions and enhancing emergency preparedness.

• Coordinating the Sutter Health Philanthropic Disaster Relief Fund, a special fund to support employees, physicians and other medical staff who care for Sutter patients and were affected by this disaster. Anyone can contribute to this fund. Online donation forms are available here.

Sutter Health Park Launches Health Events with ‘Light the Night’

Posted on Nov 4, 2019 in Affiliates, Community Benefit, People, Scroll Images, Sutter Davis Hospital, Sutter Medical Center, Sacramento

WEST SACRAMENTO, Calif. – At the newly renamed Sutter Health Park, Sutter employees, clinicians and community members gathered to support a cause close to the heart of many: leukemia and lymphoma.

The Leukemia & Lymphoma Society Greater Sacramento Area Chapter’s “Light the Night” event was the first Sutter-sponsored community event at Sutter Health Park, home of the Sacramento River Cats. As the presenting sponsor of “Light the Night,” Sutter Health was represented by members of its executive leadership team, cancer specialists and hundreds of employees, who were there to celebrate the occasion and help shine light on the fight against life-threatening blood diseases.

“We had an incredible turnout, not just from Sutter employees and their families, but the entire community,” said Michael Carroll, M.D., medical director of the Blood & Marrow Transplant Program at Sutter Medical Center, Sacramento. “This Light the Night event helped to bring further awareness to the hundreds of thousands of patients with leukemia, lymphoma, myeloma and other blood disorders. More importantly, the event raised funds to support patients and their families as well as laboratory and clinical research. Together, we can help find a cure for these diseases.”

When Sutter Health announced the naming rights to the home of Triple-A Baseball’s Sacramento River Cats, it announced a partnership with the River Cats and the greater community to bring more health-related awareness and services to the area. With this premier event, Sutter Health Park is now serving as a community gathering space that actively promotes health and wellness throughout the year. Other plans include health and wellness programming and local events from walks and runs, to health screenings, flu immunization clinics and more. During the season, attendees will see even more cause-related nights and nonprofit community partners featured and supported in their mission and activities.

“Thank you to everyone who joined in and supported Sacramento’s Light the Night,” said President and CEO of Sutter Health Sarah Krevans. “Sutter Health was proud to sponsor this very special event and walk alongside thousands of families, friends, colleagues, patients, caregivers and community members to support and remember all those touched by leukemia and lymphoma. The light, warmth and support everyone generated at the event together delivers hope, and the thoughtful donations of so many people will help advance life-saving research to benefit cancer patients and their families.”

For more information on the Sutter Health-River Cats collaboration, go to this story in the Newsroom.

Show executive leadership at event
Sutter Health Senior Vice President Jill Ragsdale and CEO Sarah Krevans helped to ”Light the Night” at the newly renamed Sutter Health Park Saturday evening.

Sacramentan Still Going Strong 25 Years After Heart Transplant

Posted on Nov 1, 2019 in Cardiac, Quality, Scroll Images, Sutter Medical Center, Sacramento

SACRAMENTO, Calif. – When Mick Doughty, 68, was put on the heart transplant list in the 1990s, Sutter pioneering heart surgeon Paul Kelly, M.D., said a new heart would extend Mick’s life by 10 years … 20 years at the most.

“I told him, ‘Oh, I’ve got to beat that.’” Doughty says with a smile.

It’s now been 25 years since his transplant, and Doughty credits his longevity to the incredible care he’s received at Sutter Medical Center, close to his home in Sacramento.

To celebrate Doughty’s milestone, the Sutter Heart Transplant Program at Sutter Medical Center, Sacramento, threw the native Irishman a party and presented him with a few gifts, including a new “Irish ticker” to replace the one that was taken out: a pocket watch from Ireland.

During the event, which also featured talks by Dr. Kelly – who began Sacramento’s only heart transplant program in 1989 – and the current medical and surgical directors of the program, John Chin, M.D., and Robert Kincade, M.D., Mick entertained the audience with funny stories in his Irish brogue. The physicians say that Mick has done everything he’s had to do to ensure a long life, and that includes his sense of humor.

“He does everything he is supposed to do” to keep himself healthy, says Dr. Kincade. “And he’s just a character, he’s the life of the party.”

The Sutter Medical Center, Sacramento Heart Transplant Program, the only heart transplant center in the Central Valley, has consistently shown quality measures that are among the best in the nation, and Doughty’s longevity is living proof of that quality.

In the 30 years, the cardiac surgeons, cardiologists and care teams at Sutter Medical Center have transplanted 216 heart patients throughout Northern California to incredible success. Doughty is one of a handful of their patients who have reached the 25-year mark. According to the National Institutes of Health, the average life expectancy for a heart transplant is 9.16 years, and a relative few live past 20 years with a new heart. With his active lifestyle, Doughty believes he’ll outlive the current Guinness world record holder, who lived 34 years with his new heart.

“People ask me all the time how I’m feeling, and I say, ‘Never better,’” Doughty says.

“That’s what it’s all about, giving people back their lives, and giving people a quality of life,” says Dr. Chin. “It’s very, very gratifying. It’s why we do this.”

When asked what 25 more years of life have given him, Doughty started to list off a number of family and professional events, including his 25th wedding anniversary, his children’s graduations, his son’s wedding, being named “Sacramento’s Financial Planner of the Year.” Then he paused and said, “You know what, I think it’s the day to day, waking up every morning, living life – that is as important as all the milestones.” View a news story on Doughty’s party by clicking here.

Mick Doughty, center, thanks Drs. Paul Kelly and John Chin for the heart transplant that has extended his life for 25 years … and counting.

Dedication to Duty: Blackouts and a Wildfire Won’t Stop Sutter Nurses

Posted on Nov 1, 2019 in Uncategorized

A spine injury at age 19 left Santa Rosa resident Ken Kilgore with paralysis in both his arms and legs. Bedbound and dependent on a special electric mattress that circulates air to prevent bedsores, Kilgore was nervous about the planned power shutoffs, until his bigger fear came true: an evacuation order.

Kilgore was one of approximately 150 patients routinely seen in their homes by the staff of Sutter Care at Home in Sonoma County who had to evacuate in response to the Kincade Fire. Through the uncertainty, fear and displacement, Kilgore says there was one constant: his nurse Paige Medeiros and the whole Sutter Care at Home family. “I must have gotten three calls a day from Sutter,” remembers Kilgore who is now safely back at home.

While the wildfire raged and blackouts rolled, Medeiros worked every day to make sure patients who rely on Sutter Care at Home had an in-person visit, or when that wasn’t possible, repeated phone calls to check on symptoms, give medical advice and guide patients to in-person care options as needed.

“These are people with feeding tubes, IV pumps, wound vacuums or special air mattresses like Ken’s,” Medeiros explained. “These are very frail patients that have high medical needs and are all homebound.” Working down a list, Medeiros drove to each patient’s house or the location where they’d been evacuated to, and checked if they needed supplies or nursing services, seeing to the needs of her regular patients and several patients who were normally cared for by other nurses, who had themselves been evacuated.

“It was a real team effort,” recalls Medeiros. “All of my co-workers and the whole Sutter family pitched in.”

Medeiros praised a nurse who drove from Marin to Mendocino (approximately 131 miles one way) to give a patient an in-home infusion (a special treatment that not all nurses can provide) and another who problem-solved through a four-day power outage, charging patients’ phones from her car battery and driving medical devices to the community resource center to be charged before returning them to her homebound patients.

James Conforti, chief operating officer for Sutter Health, knows that staff work tirelessly to provide quality care to patients. “Sutter’s integrated network allows us to coordinate care and contact patients. From filling prescriptions, rescheduling appointments to keeping vital chemotherapy infusions on track, we make sure our patients have continuity of care. The resilience of our staff and community never ceases to amaze me.”

But perhaps Kilgore said it best: “It’s not just a job to them—they really care about us.”