Barrow Magazine, Volume 20, Issue 2, 2008 by Barrow Neurological Foundation

A magazine for the friends of Barrow Neurological Institute of St. Joseph’s Hospital and Medical Center

The Muhammad and Lonnie Ali Pavilion Plans announced for new Muhammad Ali Parkinson Center

Dr. Abraham Lieberman returns to guide MAPC’ s growth

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Volume 20, Issue 2, 2008

Opening thoughts ne of our most beloved patients visited Barrow just a few weeks ago. Muhammad Ali and his wife, Lonnie, attended a special “virtual groundbreaking” at Barrow on Election Day to get a preview of the new Muhammad Ali Parkinson Center on the St. Joseph’s campus. The new facility—more than twice the size of the current MAPC—will be a world-class place for a world-class program. This exciting project has come about because of the vision and hard work of the MAPC’s new director, Abraham Lieberman, MD, and the generosity of the Center’s many benefactors. To many of you, Dr. Lieberman is far from “new.” It was he who established the MAPC and ran it for several years before departing in 1998 for the National Parkinson Foundation in Miami, Florida. Dr. Lieberman returned last year to reinvigorate the Center, and what a job he has done! The number of patients coming to the MAPC has increased substantially, and plans for a new facility have moved into high gear. We are very thankful for Dr. Lieberman’s dedication to Parkinson’s patients and their families. In this issue, you will learn about Dr. Lieberman’s plans for the MAPC and about benefactors’ support of his efforts. You will also meet several patients who have a new lease on life—thanks to the cutting-edge care available at Barrow. And, of course, you’ll find many examples of how benefactors are contributing to Barrow. Whether it’s a new neuro-oncology lab, a helmet-safety program for kids, a fundraiser to support the MAPC, or a leadership position on the Barrow Neurological Foundation Board of Trustees, friends of Barrow are making a signifiant impact on the work we do. For that, we are very grateful.

Sincerely,

Robert F. Spetzler, MD Director, Barrow Neurological Institute

Mary Jane Crist Chief Executive Officer, Barrow Neurological Foundation

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4: A visit from The Champ 6: Parkinson center rising Abraham Lieberman, MD, returns to Barrow to guide MAPC growth. 10: Move over, “Dancing with the Stars” Ballroom dancing offers big benefits for Parkinson’s patients. 12: It takes a village MAPC’s many benefactors have built the Center into a world-class program. 14: Stroke risk—gone 29-year-old undergoes neuroendovascular procedure for difficult, rare condition. 17: Free at last Surgery solves woman’s eight-year ordeal with severe facial spasms. 19: Giving a child a new start in life Barrow surgeons remove huge brain lesion.

Contents

21: Inside the ‘machinery’ of brain tumors Scientists in Diane and Bruce Halle Neuro-Oncology Research Lab examine characteristics of brain cancer. 23: A dream come true 24: Benefactor briefs 28: Research update 29: Fall 2008 Health & Wealth Raffle Grand prize winner says Barrow saved her husband’s life. 32: What’s happening around Barrow 34: The Legacy Society Honoring those who are building a healthy future for Barrow.

Catherine Menor Editor/writer Catherine.Menor@chw.edu

Sally Clasen, Melissa Morrison, Sarah Padilla, Christina Vanoverbeke Contributing writers

Robert F. Spetzler, MD Director Barrow Neurological Institute®

Justin Detwiler Art director/designer

Jackie Mercandetti. Jeff Noble D Squared Productions, Murphy/Scully Photography

Mary Jane Crist, CFRE CEO, Barrow Neurological Foundation

Panoramic Press

• How to Reach Us • Barrow is published twice a year. We welcome your comments, suggestions and requests to be added to or deleted from our mailing list. Call 602-406-1041 or send mail to Barrow, Office of Philanthropy, St. Joseph’s Hospital and Medical Center, 350 W. Thomas Rd., Phoenix, AZ, 85013. Please include your name, address and telephone number in all correspondence. Visit us online at www.StJosephs-Phx.com.

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a visit from the champ Muhammad and Lonnie Ali attend reception announcing new facility for Parkinson’s center uhammad and Lonnie Ali joined St. Joseph’s staff and benefactors on Nov. 4 to celebrate plans for a new Muhammad Ali Parkinson Center (MAPC) at Barrow. With 9,100 square feet, the facility will be twice the size of the current MAPC. It will be housed on the third floor of the Muhammad and Lonnie Ali Pavilion (formerly the 240 Building) and should open in mid 2009. “To see the beginning of this beautiful new center is truly a dream come true for Muhammad and me,” said Lonnie during the event. “We are so grateful to all of you—to Dr. Abe Lieberman, the Celebrity Fight Night Foundation, and all the Muhammad Ali Parkinson Center supporters—for your commitment to making this a world-class Parkinson’s center.” Artist’s renderings of the new facility were hung on the glass window wall of the Marley Lobby. During a short program, hospital leaders—Linda Hunt, president and chief executive officer of St. Joseph’s; Abraham Lieberman, MD, director of the MAPC; Robert Spetzler, MD, director of Barrow; and Mary Jane Crist, chief executive officer of Barrow Neurological Foundation—discussed the importance of the new center and benefactors’ role in making it possible. “Thanks to our benefactors, the Muhammad Ali Parkinson Center will finally have a facility worthy of its namesake,” said Dr. Lieberman.

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Gedion Nyanhongo, a stone sculptor from Zimbabwe, presented a sculpture titled “The Visionary” to Muhammad during the event. Nyanhongo said he had Muhammad in mind when he created the piece because it is about “a man with a big heart, a man with the wisdom to listen to his heart.” Nyanhongo’s art has been featured in exhibitions around the world, and he is a featured artist at Zuva Gallery, El Pedregal. The Celebrity Fight Night Foundation (CFNF) and Lynn Diamond were honored for their contributions to the MAPC. CFNF has contributed more than $12 million to the MAPC, while Diamond, who lives in New York City, recently made a major gift to create the Diamond Balance Center at the MAPC. According to the National Institutes of Health, at least 500,000 people in the United States suffer from Parkinson’s disease, and approximately 50,000 new cases are reported annually. Despite advances in research and treatment, the incidence of Parkinson’s disease is expected to increase as baby boomers age, making centers such as the MAPC increasingly essential. ■

Muhammad Ali, above, and his wife, Lonnie, left, attended a “virtual groundbreaking” for the new Muhammad Ali Parkinson Center at Barrow. Gedion Nyanhongo, a sculptor from Zimbabwe shown with Muhammad, presented one of his creations, “The Visionary,” to Muhammad during the event. Guests were able to view artist’s renderings and a floor plan of the new facility.

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parkinson center rising Dr. Abraham Lieberman returns to guide MAPC growth n an inconspicuous office on the seventh floor of a medical building at St. Joseph’s is perhaps the largest support network for patients with Parkinson’s disease in the country. The program’s namesake is one of the most recognizable figures in the world, but there is also a lesser known story to tell—the story of another man who stepped into the ring in the fight against the disease more than 40 years ago. It was 1988 when Abraham Lieberman, MD, got a call from his good friend Barrow neurologist William Shapiro, MD, who needed someone to take over the hospital’s movement disorders section. Dr. Lieberman and his wife, Ina Liebermanm, MD, left their native New York and headed west. The first order of business was to build up the program. Along with his nurse, Dr. Lieberman began reaching out to Parkinson’s support groups, and as word spread, their patient base began to grow. By the mid-

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1990s, Barrow’s movement disorder section—an umbrella that includes conditions such as Huntington’s disease and essential tremor—cared for more than 1,000 patients. But Dr. Lieberman knew he was only seeing a fraction of those needing care. There were people in outlying areas who couldn’t make the drive to downtown Phoenix, so he decided to bring care to them. He set up a handful of satellite clinics around the state. Aside from growing the program, the satellite clinics also allowed Dr. Lieberman to establish closer relationships with patients in distant areas, many of whom he may have seen only once a year, if at all. “There are two different approaches to treating people with Parkinson’s disease,” says Dr. Lieberman. “In one, you’re like a consultant. You may see the patient one time for a diagnosis, and that’s it. Or, you can enroll them as your patient, care for them regularly, and take on the role of a primary care provider.” Dr. Lieberman, a man who has been known to devote seven days a week to his patients, prefers the latter. “Parkinson’s disease is a chronic illness,” he says. “You can’t just see patients once a year. You have to see them at least three or four times a year to be able to treat them properly.” In 1995, Dr. Lieberman got a call from Valley businessman and philanthropist Jimmy Walker. “I’m going to make you a lot of money,” Jimmy told Dr. Lieberman. Jimmy was the creator of Fight Night, an annual event that raised money for boxers who were down on their luck. Jimmy knew that if he could get heavyweight champion Muhammad Ali on board, it would take the fundraiser to another level. Dr. Lieberman had a personal relationship with the Alis. In fact, it was at the request of Dr. Lieberman—in the form of a poem that now hangs on a wall in the office—that Muhammad agreed to become a spokesperson for Parkinson’s disease. Dr. Lieberman agreed to approach the family, contingent on the fact that a portion of the proceeds would go to Barrow. The following year, Ali participated in Fight Night. “We raised $125,000 for Barrow, and I thought that was terrific. It was a terrific night. I had never seen anything like it,” recalls Dr. Lieberman. “The next year, you could see it was really becoming something because Jimmy also got Barry Manilow to come. Then, more celebrities started to participate.” Now dubbed Celebrity Fight Night, the annual event draws big names such as Reba McEntire and Billy

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Crystal. The 2008 star-studded soiree raised nearly $5 million, with $1.5 million going to Barrow. When Dr. Lieberman left Barrow to serve as medical director of the National Parkinson Foundation (NPF) in Miami, Florida, in 1998, he left behind a practice of 3,000 Parkinson’s patients—one of the largest in the nation at that time. He also left behind the fledgling fund-raising event that was in the process of making Barrow a key player in the fight against the disease. Today, Celebrity Fight Night is the primary source of funding for Barrow’s Muhammad Ali Parkinson Center (MAPC), a comprehensive resource center that complements the hospital’s clinical care with education and community programs for Parkinson’s patients and their caregivers.

Becoming a PD heavyweight

A fighting chance

Millicent Duffy participates in The Art of Movement, one of many exercise classes offered by the MAPC. Dance is one of the activities included in the class.

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Right, family members attend a support group at the MAPC while their loved ones participate in an exercise class.

“Our goal is to improve or maintain the quality of life for people with Parkinson’s disease and their families,” says Margaret Anne Coles, program manager of the MAPC. “Part of the magic of what we do here is the integration of the medical model with the social model, which not everyone can offer.” As funding from the event has increased over the years, so have the MAPC’s offerings. What was once a handful of classes and staff members is today an intricate network of opportunities throughout the Valley with a course catalog in two languages. In addition to educational seminars such as Parkinson’s Disease 101 and 202, the MAPC offers tai chi, golf, ballroom dancing, and music therapy. An Interdisciplinary Assessment Clinic provides patients a comprehensive assessment complete with individualized practical suggestions. New this year, a painting workshop gives patients yet another creative outlet. “Our philosophy is that if people want it, we try to make it happen,” says Darolyn O’Donnell, Recreation Therapy coordinator. “A lot of people with Parkinson’s disease become socially withdrawn, so in a way these activities are giving them back a social life. Here, they don’t have to worry that they have a tremor or that they move slowly.” One thing that sets the MAPC apart is its ability to take courses into the community. With an in-house staff of seven and more than 12 qualified contract instructors, the MAPC travels to other parts of Arizona and occasionally presents or helps establish programs in other states. Everything is offered in Spanish, and the center recently presented a PD 202 seminar in Columbia to a crowd of more than 350.

Our philosophy: Make it happen

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For those who are under-insured or uninsured, the MAPC also offers Ali Care, which provides medication and physician visits. The center works with about 40 patients a year through Ali Care, also serving as a bridge to other community resources. According to Dr. Lieberman, the Alis want to ensure that everyone with the disease has access to the best resources. He says, “They know that Muhammad Ali is going to get excellent care because he’s Muhammad Ali. But they want everyone to get that type of care.” Everyone at the MAPC is quick to acknowledge that they wouldn’t be able to do what they do without the support of the Ali family and funds from Celebrity Fight Night and other benefactors. The financial support has allowed the program to grow into what is perhaps the largest support network for people with Parkinson’s disease and their families anywhere. “We are very appreciative, and so are our patients,” says Coles. “We’re privileged to be able to do what we do.” In the meantime, Dr. Lieberman had left the NPF, his wife had left her position as a pediatric anesthesiolo- Alan Sewell regularly attends gist, and the two were building a classes at the MAPC. successful private practice in Florida. Yet, they were intrigued when Dr. Shapiro called last year with an offer almost identical to the one he’d made nearly 20 years earlier. In late 2007, the couple once again made the move—this time, from one sunshine state to another.

Back to Barrow

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Back at Barrow as the director of the MAPC and the Movement Disorders Section, Dr. Lieberman’s first order of business was to consolidate the clinic and the MAPC, which had been on different floors, into one location. His second priority was to relocate the entire program into a facility worthy of its namesake. As a result, construction soon will begin on a new 9,100-square-foot MAPC on the third floor of the Muhammad and Lonnie Ali Pavilion, formerly the 240 Building (see sidebar next column). Dr. Lieberman has gone back to his tried-and-true method of reaching out to local support groups to rebuild Barrow’s movement disorders program. Already, with Ina at his side as clinical coordinator, the practice is seeing close to 60 new patients a month, a huge increase from just a few months before. Eventually, Dr. Lieberman hopes to double his staff and triple the number of patients. He’s in the process of recruiting new physicians to join the current staff of Guillermo Moguel-Cobos, MD, Richard S. Burns, MD, and two fellows. He wants to revive the satellite clinics and establish new clinics for gait disorders, Huntington’s disease, and Tourette syndrome. “We’re on our way to becoming a world-class center for the growing number of people that are affected by these chronic illnesses,” he says. Despite advances in research and treatment, the incidence of Parkinson’s disease is expected to increase as baby boomers age. While it appears the disease has no intention of slowing down, the good news is that neither does Dr. Lieberman or his team at the MAPC. ■

Above, Margaret Anne Coles, program manager of the MAPC, chats with Roger Hanson before the start of the Art of Movement,

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The new Muhammad and Lonnie Ali Pavilion at Barrow

The Muhammad Ali Parkinson Center (MAPC) will move into a new facility in mid 2009. The 9,100-square-foot space will be located on the third floor of the Muhammad and Lonnie Ali Pavilion (formerly the 240 Building). It will house one of the most comprehensive Parkinson’s centers in the country. The clinical side of the center will include 10 exam rooms, a tremor exam room, a Botox treatment room, a tilt room to help evaluate patients with orthostatic hypertension, and a balance lab. The expanded MAPC will feature treatment areas for physical, occupational, and speech therapy; a multipurpose room for education and recreation classes; a resource room with books, videos, and computers; and a store featuring educational materials and equipment. The Center will offer one-stop shopping for patients. “The new space will allow us to be a model for the rest of the country to demonstrate how integrated care can make a difference,” says Margaret Anne Coles, MAPC program manager.

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move over, ‘dancing with the stars’ Ballroom dancing offers big benefits for Parkinson’s patients o one who attends the Muhammad Ali Parkinson Center (MAPC) ballroom dance class expects to appear on the wildly popular Dancing with the Stars television show. There are no highly choreographed numbers, sparkly costumes, British judges, celebrities, or fan favorites. What the class does offer individuals with Parkinson’s disease and their caregivers is an opportunity to step away from the effects of the disease and have a little fun.

Parkinson’s disease is a movement disorder that causes tremors in the face, arms, and legs, and affects balance, flexibility, stamina, and posture—issues that can lead to poor coordination and lower self-confidence. According to “It’s a great act of love... Darolyn O’Donnell, Recreation We’re having a great time, Therapy coordiand it’s something we can nator for MAPC, the class is not a do together. We would have c o m p e t i t i o n , never taken a dance class if though the same basic ballroom Bill had not developed steps you see and Parkinson’s.” hear on TV are used. Judy Perkins “The goal is to provide people with a normal activity and socialization, and improve and maintain their quality of life, not create professional dancers. Ballroom dancing does this on so many levels.” For Bill and Judy Perkins of Tempe, who attend ballroom classes held at the Prince of Peace Lutheran Church gym at 56th Street and Indian School Road in Phoenix, dancing has given them a new lease on life. Bill, an electrical technician who stopped working in January 2007 due to the tremors in his left arm and leg, was diagnosed five years ago with Parkinson’s. According to Judy, he had never been much of a dancer. “In 25 years of marriage, he had never danced,” she says. That was, until she “twisted” Bill’s arm and sug-

May I have this dance?

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by Sally J. Clasen

gested they take advantage of the ballroom dancing classes offered at the MAPC. “I was shocked when he said yes,” says Judy. “It’s a great act of love, as far as I’m concerned. We’re having a great time, and it’s something we can do together. It is also a blessing in a way. We would have never taken a dance class if Bill had not developed Parkinson’s.” During the dance class, participants of all ages learn to tango, waltz, and salsa. Classes are small, and breaks are encouraged. In addition to creating a social outlet, dance and other forms of exercise may protect neuro-cell function, keeping the brain cells healthy longer and slowing the progression of Parkinson’s, according to Margaret Anne Coles, MAPC program manager. “Dancing has so many health benefits,” says Coles. “As Parkinson’s advances, more energy is used, and individuals begin to stoop, making it more difficult to walk, speak, and breathe. When you dance, you are more upright, and it improves posture and other important functions.” For Bill, ballroom dancing distracts him from the symptoms and public awkwardness of having Parkinson’s. “Prior to this, I didn’t like being in large crowds or groups. I am not as mentally quick, and I don’t move like I used to. But in the class, I’m concentrating on dancing, and I’m not worried about anything else,” he says. The class also provides a sense of camaraderie among those with Parkinson’s and their caregivers. “You don’t have to explain yourself to others—they get it, and you get it. It’s gotten to the point where I look forward to the class,” explains Bill. “It’s not a negative social context,” Judy adds. “Everyone is supportive and non-judgmental. During breaks, we discuss ways to cope with Parkinson’s, such as nutritional things we’ve tried.” Some participants have even planned social events with each other outside of class to practice their dance moves.

The benefits of dancing

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Judy points out that since taking ballroom dance, along with the tai chi and Art of Movement classes Bill attends through the MAPC, the couple has reclaimed some daily normalcy. “From a treatment perspective, the classes are helping Bill be more mobile and more confident. It got to the point where I was doing all the driving, and he wasn’t as physical as he could be. It’s given him—and me—some life back.” ■

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it takes a village MAPC’s many benefactors have built a world-class program

elebrity Fight Night Foundation is the best known of the supporters of the Muhammad Ali Parkinson Center. The powerhouse foundation puts on a dazzling fundraiser each year that stars Muhammad and Lonnie Ali and a bevy of celebrities, and that raises millions of dollars for the MAPC and other charities. “Celebrity Fight Night’s ongoing support makes a tremendous difference for the Muhammad Ali Parkinson Center,” says Abraham Lieberman, MD, director of the MAPC. “Their support is the backbone of so much of what we do—from education and exercise programs to support groups and the Parkinson Registry. Without the yearly contribution from Celebrity Fight Night Foundation, we would be unable to offer all that we do.”

Jon Bon Jovi will be among the stars who performs at Celebrity Fight Night XV on March 28, 2009. For information, visit CelebrityFightNight.org.

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“We are extremely grateful for the community’s strong support of the Muhammad Ali Parkinson Center.” Mary Jane Crist But funds for the MAPC come from many other sources. In fact, the Center receives more gifts each year than any other area of Barrow, a testimony to the level of service provided and the gratitude of patients and their families. “When the Southwest Parkinson Newsletter hits homes, we know it,” says Mary Jane Crist, chief executive officer of Barrow Neurological Foundation. “Envelopes with checks start arriving in the mail. We also receive many tribute and memorial gifts from friends of the Muhammad Ali Parkinson Center. It’s really heart-warming to see our patients and their families giving back so generously.” Among the many benefactors to MAPC are the following whose support has made an extraordinary impact on the Center: Lynn Diamond of New York City is a long-time patient of Dr. Lieberman’s and supporter of the MAPC. Most recently, she made a generous gift to fund the Diamond Balance Laboratory at the MAPC. The laboratory features equipment for assessing balance and conducting research into the cause of balance problems in patients with Parkinson’s disease and other neurological disorders.

Lynn Diamond

Beverly Shortridge of Scottsdale has made several major gifts to Barrow Neurologial Foundation in support of research and community education at the MAPC in memory of her late husband, Ernest.

Beverly Shortridge

Shamrock Foods Company has funded a Parkinson’s Research Laboratory at Barrow. The company has also supported the publication of the Southwest Parkinson’s Newsletter.

Shamrock Foods Company

Many other individuals and foundations have contributed to the MAPC over the years, including the Wallace Research Foundation, the Frank and Domna Stanton Foundation, Eleanor Nacheman, Donald C. Fine, Mr. and Mrs. Robert Malone, and Franny Mervis and Howard Frank. “We are extremely appreciative of the community’s strong support of the Muhammad Ali Parkinson Center,” says Crist. ■

Evelyn Kossak of Westport, Connecticut, and her late husband, John, established the John & Evelyn Kossak Fellowship in 1994 to provide specialized training to neurologists interested in specializing in Parkinson’s disease (PD) and other movement disorders. The Fellowship has provided specialty training to a number of neurologists who are now practicing at leading medical centers across the country, conducting research into new therapies for PD, and teaching Neurology residents and future PD subspecialists. John was a patient of Dr. Lieberman’s.

Evelyn Kossak

The J.W. Kieckhefer Foundation has awarded grant funding to the MAPC in support of research into Parkinson’s disease.

J.W. Kieckhefer Foundation

Abraham Lieberman, MD, director of the Muhammad Ali Parkinson Center, introduces benefactor Lynn Diamond to Muhammad Ali during a reception in November.

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stroke risk—gone 29-year-old undergoes difficult surgery for rare condition n some ways, Victoria Eli of Phoenix feels like she’s just experiencing life for the first time. Six years ago, the 29-year-old began suffering from what she thought were sinus-related issues—dizziness, headaches, and insomnia. A series of CT scans and visits to several doctors and emergency rooms indicated nothing serious but did result in prescriptions for sinusitis and sleep problems. “Some of the physicians also thought I had an ear infection because of the pain I was experiencing on the left side of my head,” Eli says. At age 26, she started having more frequent dizzy spells, a racing heart, and occasional numbness on her left side, which traveled from her arm to her foot and lasted 15 to 20 seconds.

When her symptoms worsened, she realized she needed more definitive answers to her medical issues. What Eli finally learned was that she was experiencing TIAs (transient ischemic attacks), or mini-strokes caused by a temporary disturbance of blood supply to a certain area of the brain. She also was told she had a hole in her heart. Eli was prescribed atenolol for her racing heart and was told to follow up with doctors to monitor her

Eli admits that at first she was her own worst enemy, not taking her health issues seriously. “I’ve always been stubborn and didn’t want to believe I was sick,” she says.

Felipe Albuquerque, MD

The reality of stroke

Felipe Albuquerque, MD, endovascular neurosurgeon; David Fiorella, MD, PhD, neuroradiologist; and Shervin Dashti, MD, endovascular neurosurgery fellow.

by Sally J. Clasen

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“After reviewing her chart and images, I knew she was in trouble. She was set up for a massive stroke, and she needed immediate treatment.” situation. She never did, thinking heart and stroke problems were concerns of the elderly. But about a year ago, Eli began having headaches and noticed that the vein behind one of her ears was swollen and hard again. She also became increasingly lethargic and weak, and found it difficult to do basic household chores. “I always felt off-balance, like I was on a ship.” What’s more, Eli began to have additional ministrokes, except this time they were more pronounced with one lasting 10 minutes and affecting her entire left side. “I couldn’t communicate or move my tongue or mouth. I had no feeling to pronounce words,” she says of the episode that family members witnessed. “I had to use my left hand to pick up my right hand—it was just dead weight. It scared me enough to really look into why I was having these problems.” She scheduled an appointment with a cardiologist to fix the hole in her heart, and while he concluded that Eli did have “something exotic,” he couldn’t find a clear link between her heart disorder and the cause of the mini-strokes. She next saw a neurologist who agreed that the two complications didn’t add up. She was then referred to a stroke specialist at St. Joseph’s Hospital and Medical Center, who ordered a combination of diagnostic tests, including a CT scan that finally revealed Eli had severe stenosis of her

basilar artery, the main blood vessel that supplies the part of the brain stem responsible for waking and consciousness. Her case was turned over to endovascular neurosurgeon Felipe Albuquerque, MD, who immediately called Eli and recommended she admit herself to St. Joseph’s Emergency Department that day because there wasn’t time to schedule an office consultation. “After reviewing her chart and images, I knew she was in trouble,” explains Dr. Albuquerque, who says

No time to spare

that chronic occlusion of the basilar artery is extremely uncommon, particularly in a person as young as Eli. “She was set up for a massive stroke, and she needed urgent treatment,” he says. “Her case is exceedingly rare—the only one I’ve seen in someone her age.” The following day, on August 8, 2008, Dr. Albuquerque, assisted by neuroradiologist David Fiorella, MD, PhD, and endovascular neurosurgical fellow Shervin Dashti, MD, performed a 90-minute procedure to open the occluded artery, a surgery that carries a 25-percent risk of a major stroke or death, according to Dr. Albuquerque. “It’s a unique procedure, and the risk of rupture of the basilar artery is high,” he says. In fact, Eli is only the eighth patient of Dr. Albuquerque’s to undergo this type of technically difficult surgery. During the procedure, surgeons inserted catheters in both the carotid and vertebral arteries in her neck in order to get a clear picture of the length of the occluded arterial segment. Next, a small balloon was navigated into the brain and inflated in the occluded artery to widen and improve blood flow to the area. The balloon was removed, and the surgeons then navigated a self-expanding stent to the previously occluded segment, which opened the artery to its normal diameter. Dr. Albuquerque says that rare cases such as Eli’s have benefited from pioneering endovascular procedures in recent years due to the advances in equipment and technology used. “Even though there is no established treatment for chronic occlusion of the basilar artery, new devices and tools such as flexible balloons and stents designed

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Neuroendovascular stent In Victoria Eli’s surgery, the Barrow team navigated a small balloon into the brain and inflated it in the occluded artery to widen and improve blood flow to the area. The balloon was removed, and the surgeons then navigated a self-expanding stent into the previously occluded segment, which opened the artery to its normal diameter.

specifically to navigate the curvaceousness of blood vessels have revolutionized our ability to prevent and treat strokes,” he says. Michael Hickman

Eli will need to be monitored to make certain her basilar artery hasn’t re-narrowed but her prognosis is excellent, according to Dr. Albuquerque. “Her artery looks normal in caliber,” he says. “To see me now is amazing,” adds Eli, who also underwent a non-invasive procedure to correct the hole in her heart. “I’m walking, talking, doing the laundry.” Two weeks after her surgeries, Eli dedicated her life to God because she feels it’s a miracle that she survived. She also credits Dr. Albuquerque, who she describes as an “incredible doctor with nerves of steel,” and others at St. Joseph’s who “took the time to investigate my situation and then didn’t waste time in solving my problem.” Understanding just how tenuous her existence was a few months ago, Eli now faces each day with a different outlook and a renewed sense of gratitude. “I wake up with joy. I know how close I came to having my life

taken away. I feel better than ever. I have lots of energy—spiritually, mentally, and physically. I don’t take life for granted any more.” ■

Starting over

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Endovascular neurosurgery is performed in an angiography suite and involves working within the body’s blood vessels to correct problems in the brain.

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free at last

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by Melissa Morrison

Surgery solves eight-year ordeal with severe facial spasms

t began as an eye twitch. Eventually, the involuntary spasms caused the entire left side of Mary Ann Blake’s face to seize up. They would wake her up at night. They blurred the vision in her eye so that Blake, an avid reader, could not see to read a book. Toward the end of her eight-year ordeal, she trusted herself to drive only short distances because of the spasms’ effect on her vision. It wouldn’t be diagnosed for several years, but an errant blood vessel was compressing a cranial nerve as it left Blake’s brain stem, causing it to telegraph inappropriate messages to her facial muscles. It wasn’t until Blake, 62, a former Tucson resi-

dent, settled two years ago with her husband, Rodger, in Show Low that she was put in touch with Barrow. There she received a definitive diagnosis and discovered that a cure had been available all along for the condition that had limited her life. At Barrow, neurologist Abraham Lieberman, MD, immediately identified her problem as severe hemifacial spasm, or HFS. He referred her to neurosurgeon Joseph Zabramski, MD, Barrow’s chief of Cerebrovascular Surgery, who along with Andrew Shetter, MD, has treated HFS and similar conditions for the last 20 years. Three weeks later, Blake underwent microvascular decompression of the facial nerve. B A R R O W

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Surgery is the option for severe cases such as Blake’s. Dr. Zabramski says that as early as the 1920s, neurosurgeons hypothesized that arterial compression caused hemifacial spasm. But it wasn’t until the 1980s and the introduction of the modern operating microscope, that they could do anything about it. The operating microscope provides light and magnification, allowing the neurosurgeon to work safely in small, constricted areas. Modern surgery also includes stereotactic guidance to reduce the risk of the procedure. The day before the surgery, a magnetic resonance imaging (MRI) scan was done of Blake’s brain. In the operating room, a computer was used to match an overlay of the surface of the patient’s head with the MRI, resulting in a 3-D map that allowed the surgeons to pinpoint exactly where to direct the exposure. With Blake lying in the “park bench position”— on her side, with her head braced—Dr. Zabramski made a small incision in the back of Blake’s neck and then drilled a small hole in the bone at the base of her skull. Then he cut through the tough membrane that covers the brain, exposing the part of the brain stem where the facial nerve originates. Looking through the operating microscope, Dr. Zabramski could see the artery compressing and indenting the facial nerve where it exited Blake’s brain stem. “This is a very small space that we are working in,” Dr. Zabramski says. “We’re talking about an artery that measures 1/2 to 1 millimeter in diameter and maybe 3 millimeters across for the nerve. The trick is separating the artery from the facial nerve without injuring either of them.” Dr. Zabramski gently shifted the clinging artery away from the nerve, placing pieces of shredded sterile Teflon fiber between the two to keep them separated. Then he returned the bit of skull bone, securing it with tiny plates and screws.

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Joseph Zabramski, MD Although HFS most often occurs when a blood vessel compresses the facial nerve as it exits the brainstem, it can sometimes be caused by a tumor or aneurysm. In rare instances, it is associated with demyelinating diseases, such as multiple sclerosis. It is important, Dr. Zabramski stresses, that other less common, but more serious conditions be ruled out prior to considering treatment options. What causes a blood vessel to begin compressing the facial nerve is not known, but in general, the arterial blood vessels supplying the brain lengthen as we age. The elongating arterial branches eventually form loops that may contact the nerves and lead to compression. The incidence of HFS increases with age and is most common in those 40-79 years old. The first symptom of HFS is usually an intermittent eyelid twitch that can eventually force the eye to close. The spasm may then gradually spread to the muscles of the lower face, which may pull the mouth to one side. Eventually the spasms involve all of the muscles on one side of the face almost continuously. The symptoms are often aggravated by stress—a trial lawyer patient of Dr. Zabramski’s had to quit the courtroom because of symptoms prior to treatment. Traditionally, sufferers from HFS are treated first with drugs, such as anti-seizure medications and muscle relaxants. If that doesn’t work, patients are injected with Botox, the botulinum toxin that blocks nerve impulses. Blake received Botox shots regularly over seven years, but to no avail. “Botox never relieved the symptoms,” she says. “What it did was make my face droop. When we’d take pictures, I would never laugh because I would have half a laugh, and it looked really grotesque.”

Causes of hemifacial spasm

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When Blake awoke from the three-hour surgery, the spasms that had plagued her for years had disappeared. “I’m back to normal. I don’t wake up in the middle of the night. I wake up rested.” She is back to reading a book a week, when gardening season doesn’t keep her otherwise occupied. Recovering from the operation—six days hospitalization, and three weeks till a full recovery—was easy compared to the eight years she spent with HFS. “I think the hardest part was actually getting a referral, someone saying, ‘Barrow is where you need to go.’” ■

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giving a child a new start in life Barrow surgeons remove huge lesion n September, Barrow neurosurgeons removed an enormous tangle of blood vessels from the brain of a nine-year-old child—and in so doing, gave the boy a new start in life. Farid Antonio Bitar Bonotto came to Barrow Neurological Institute three years after he was diagnosed with a cerebral cavernous malformation (CCM) in Guadalajara, Mexico. A CCM is a cluster of fragile blood vessels in the brain that is prone to leaking blood. When it hemorrhages, a CCM can cause seizures, strokes, and, in some cases, death. The abnormality occurs in about one of every 250 people. “What’s unique about this case was the size of the CCM and the numerous unsuccessful attempts to eliminate it,” says Robert Spetzler, MD, director of Barrow. Farid first saw a pediatrician in 2005 because of shortness of breath. The doctor noticed differences between the right and left sides of the child’s

Farid Bonotto and his mother, Anna, traveled from their home near Guadalajara, Mexico, to Phoenix for the complex surgery.

by Catherine Menor

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face and ordered a CT scan. That’s when the enormous CCM—perhaps the largest of its type ever recorded— was discovered. And thus began a long journey for Farid, a journey that included multiple doctor’s appointments, hospitalizations, and operations in both Mexico and the U.S. In the first surgery to remove the lesion, a neurosurgical team in Guadalajara stopped the operation after 16 hours and massive blood loss. Before reaching Barrow, Farid also underwent a shunt placement to relieve hydrocephalus and several embolizations to prevent bleeding in the weak vessels of the CCM. But none of the surgeons in Mexico or the U.S. was able to remove the lesion. And so the threat of the CCM continued to cloud Farid’s future.

In February 2008, Farid experienced several severe breathing attacks and was air-evaced to Houston. Although physicians could not pinpoint the problem, Farid’s family was concerned that the CCM could be involved. Farid’s uncle, an orthopedic surgeon, felt strongly that the CCM should be removed. He asked Farid’s doctor in Texas who he would recommend. He responded, “Dr. Robert Spetzler.” Farid’s uncle soon made arrangements for a trip to Phoenix. “When we got to Phoenix, I realized that he had scheduled everything for one trip—a consultation, embolization, and surgery,” says Anna of her husband’s brother. Her husband had died in 2007. Nervous about what lay ahead for her son, Anna went to the hospital chapel to pray. “Do we embolize? Do we do surgery? Go home?” she asked. As she was praying, Anna closed her eyes and saw a rainbow of vivid colors and knew what she must do. As for Farid, his mind was made up after meeting Dr. Spetzler. When his mother asked him what he wanted, Farid said that he wanted the surgery, that he felt comfortable with this American doctor.

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Cerebral cavernous malformation A CCM is a tangle of weak blood vessels in the brain that is prone to bleeding. The huge CCM in Farid’s brain was removed through a combination of embolization and open brain surgery. Photo: Robert Spetzler, MD, with Farid Bonotto and his mother, Anna. The Barrow team used a two-step approach to remove the CCM. First, endovascular neurosurgeon Felipe Albuquerque, MD, assisted by Shervin Dashti, MD, PhD, a neurovascular Michael Hickman fellow at Barrow, used a new type of liquid called Onyx to embolize the CCM. The liquid was delivered into the vessels of the CCM via a catheter. Once inside the vessels, the Onyx solidified, sealing off blood flow into the abnormal vessels and reducing the risk of bleeding. It was the first time Onyx has been used to embolize a CCM. The following day, a team led by Dr. Spetzler performed surgery to remove the CCM. “We were able to successfully remove it because we had “To see a little boy who published about this type of lesion and had what was a lifewere prepared to deal threatening lesion and with it, ” says Dr. who’s now perfect Spetzler. At Farid’s final neurologically—it appointment before doesn’t get any more returning to Mexico, gratifying than that.” his doctors were excited to see how well the Felipe Albuquerque, MD child was doing. “To see a little boy who had what was a life-threatening lesion and who’s now perfect neurologically— it doesn’t get any more gratifying than that,” says Dr. Albuquerque. As for Farid, he was just happy to hear that he could return to playing soccer in early 2009. ■

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inside the ‘machinery’ of brain tumors Diane and Bruce Halle Neuro-Oncology Research Laboratory examines characteristics of brain cancer by Sally J. Clasen urt Feuerstein, MD, PhD, a senior scientist at Barrow Neurological Institute, has been studying brain tumors for nearly a quarter of a century, and from his vantage point, the discoveries made in brain tumor research have been “immeasurable.” “When I started medical school in the early 70s, cancer was a complete mystery. We didn’t know why cancers grow and metastasize, and we didn’t even know how our effective drugs worked. Now we understand that the disease stems from broken parts of normal cellular machinery and how some drugs can jerryrig the broken pieces. And we are working on better ways to more fully repair broken cells,” explains Dr. Feuerstein.

Despite those advances, much still needs to be understood about brain cancer. According to the National Cancer Institute, about 19,000 people in the United States are diagnosed with the disease each year—with many of those diagnoses for breast and lung cancer. The most common and aggressive tumor that starts in the brain is glioblastoma multiforme (GBM). It accounts for about half of brain-cancer cases, and most patients live only 15 months after they are diagnosed. In 2006, Dr. Feuerstein, a pioneer in brain tumor genetics and therapeutics, was recruited from the University of California-San Francisco to establish an international center of brain tumor research at Barrow, anchored in the Diane and Bruce Halle Neuro-OncolB A R R O W

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ogy Research Lab. Dr Feuerstein’s vision for the lab, located at the Translational Genomics Research Institute (TGen) in downtown Phoenix, is to build a program where brain tumor scientists and clinicians work together to develop new ways to diagnose and treat the disease. The main focus of the neuro-oncology lab is translational science. The scientists use tissue removed from a patient’s brain tumor to make sure that their studies are relevant to real patients. One approach is to bring together teams of basic scientists and clinicians to ask whether broken molecular parts of cellular machinery constitute a molecular marker of disease— that is, whether they predict a tumor’s response to therapy or a patient’s length of survival. In addition, the clinical relationship gives scientists a good reason to develop tumor models to manipulate the broken molecule of cellular machinery to see how it affects the model. If there is an effect, the manipulation might constitute a new therapy, and the team can start on the road to develop one. Dr. Feuerstein and his colleagues hope that studying brain tumor molecular machinery to classify brain tumors and determining how they start and behave will point toward ways to control abnormal brain tumor machinery in patients and will lead to better ways to evaluate and treat the disease. “The eventual goal is to use information we obtain regarding tumor systems to develop diagnostic and therapeutic products for clinical use,” Dr. Feuerstein says. “We know there are certain genes that play a role in the growth and death of brain tumor cells, but if we can distinguish these genes, we might be able to treat or even prevent disease.”

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Solving the mysteries of brain tumors

The long-term goal of the neuro-oncology lab, according to Dr. Feuerstein, is to build a state-of-theart facility where independent research efforts intersect with clinicians and the larger scientific community to solve the many unanswered questions about brain tumors. “We’re well on our way. It’s a coordinated and balanced effort,” he says of the brain tumor studies being conducted to translate scientific data into clinical applications. Plans also are under way to recruit additional investigators, increase funding, and expand the lab’s physical space.

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“We have a good basis and are developing innovative projects and programs, working with clinicians—neurologists, neurosurgeons, neuroradiologists, radiation oncologists, and pathologists at Barrow—as well as using the methods established by TGen to create a successful and interactive brain tumor research team,” Dr. Feuerstein says. As an educational outreach of the lab, he teaches genetics and pharmacology at Arizona State University and the University of Arizona, where his intent is to inspire the next generation of scientists. “My real interest is mentoring young people and teaching them about translational research and how to cure diseases. To me, that’s the most important job I have.” ■

Photo on previous page: Burt Feuerstein, MD, PhD, collaborates with other St. Joseph’s researchers at the Translational Genomics Research Institute, including Robert Garfield, PhD; Yan Gan, PhD; and Keith Coon, PhD.

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a dream come true My path to Barrow Neurological Foundation by Dennis Sage Chairman, BNF Board of Trustees n a wintery Michigan April afternoon in 1979, I received a call from my mentor and former boss Theo Alcantara, music director of the Phoenix Symphony. The maestro had created a position for me on the staff of the Phoenix Symphony Orchestra, and within days, I was on my way to the Southwest to begin six years as the orchestra manager of the Phoenix Symphony Orchestra. Spending time with international stars like Itzac Perlman, Isaac Stern, Luciano Pavaroti, Dave Brubeck, Doc Severinson, James Galway, and the entire 85member Phoenix Symphony is to this day one of the most significant and memorable periods of my life. The lessons I learned working side by side with such a diverse group of incredibly talented people has served me well throughout my career. I remember attending a board meeting of the Symphony early on in Phoenix. Sitting around the table were local business superstars like Mark DiMichael, Jeanne Herberger, and Dick Silverman. I was inspired by the selfless devotion these volunteers gave to the greater good of our community and wondered if I would ever be in the position to be able to give as they were. Fast forward to 1991 and after a couple of different careers, I was working at a local stereo store when a young single lady entered my life as a customer. I fell in love with Nancy first and her parents, Lou and Evie Grubb, later. With the support of this wonderful family, I launched Dennis Sage Home Entertainment in 1995. Almost immediately after our marriage, I began volunteering for Lou’s golf tournament, which for 35 years has raised millions of dollars for local charities. To date, Lou Grubb Friends Fore Golf has raised $3.5 million for Barrow Neurological Institute and the Heart & Lung Institute at St. Joseph’s, including more than $500,000 in 2008. My involvement in this event

and a little intervention from Wick Pilcher eventually led to a position on the Board of Trustees at Barrow Neurological Foundation. This year I am proud to serve as the chairman of that respected board. As I presided over our first meeting in September, I thought about that first Symphony board meeting back in 1979. Indeed, if we truly want something that is very important to us, it can happen. I feel very fortunate to be able to give back to this great community that has been so kind to me. If you, like me, would like to give back by becoming involved at Barrow, give Barrow Neurological Foundation a call. There are many opportunities to serve. I think you’ll really enjoy the camaraderie of the people you’ll meet, but more important, you’ll feel good at the end of the day, knowing that you’re contributing to an organization that makes a difference in so many people’s lives. ■ Barrow Neurological Foundation is open Monday-Friday from 8 a.m.-5 p.m. Call 602-406-3041 for more information about volunteer and giving opportunities.

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Benefactor briefs

by Catherine Menor

Shez Partovi, MD, and Nancy Hennigan, director of Community Relations at the University of Phoenix

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The University of Phoenix has made a gift of $250,000 to Barrow Neurological Institute to support the institute’s work in making cutting-edge health care available to rural areas of Arizona. The generous gift will go toward creating virtual examining rooms in remote clinics of Arizona. “These examining rooms will be part of conventional rural clinics but will have the ability to enter into a real time TelePresence session with a remote Barrow physician,” says Shez Partovi, MD, chief medical information officer at Barrow. “The life-size interactive experience will remove the sense of distance and allow the patient and their loved ones to be in one space together with their local physician and a Barrow physician.” When used for a remote physician consultation, the examining rooms will serve as a Barrow examining room joined to the distant clinic by TelePresence.

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Devices such as remote-stethoscopes, remote-ophthalmoscopes, and remoteotoscopes will allow Barrow physicians to perform assisted physical examinations and assessments on patients in rural clinics. Eventually, imaging technology such as remote-ultrasound will help improve health care for pregnant women, helping to decrease newborn morbidity and mortality as well as maternal complications. “These TelePresence exam rooms will benefit not only patients, but also physicians in those rural communities,” says Dr. Partovi. “With the TelePresence technology in their clinics, they will be able to work alongside Barrow subspecialists during patient care and hone their skills through mentorship-style education customary in residency training programs.” The initiative is an outgrowth of the TelePresence Conference Room that was established at Barrow several years ago. Residents and medical observers are able to watch live surgeries in the TelePresence room, which is located across campus from Barrow’s neurosurgery suites. The system also allows Barrow specialists to connect with other neurosurgeons across the globe for live surgeries and educational activities.

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Sharon and Armen Ervanian

After 32 years of working for a major American company and serving on numerous boards, Armen Ervanian is impressed by few organizations. One notable exception is Barrow Neurological Institute. “Barrow has achieved national and international recognition, and they do charitable work as well,” says Armen, who is in his second stint on the Barrow Neurological Foundation (BNF) Board of Trustees. “I love hearing stories at board meetings of children who no one else could help coming to Barrow for care. I have really found Barrow to be very interesting, very professional.” Armen moved to Phoenix in 1971 along with 600 other families of Dial Corporation. As a vice president at the company, he had led the search for a new corporate headquarters. After three cities were considered, Phoenix was chosen as the best fit for Dial. Armen is the son of Armenian immigrants who taught him not only their language but also the value of hard work and education. He used those values to pay his way through college selling high-end women’s shoes in Chicago. After earning a law degree, he joined Greyhound Corporation, thinking he would eventually practice law. He never did. His law degree, though, came in handy as president and chief executive officer of Dial Realty, he says.

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Armen became acquainted with Barrow in 1988 when he was asked to serve on the Barrow Neurological Foundation Board of Trustees. With a brother and son who were doctors, he had an interest in medicine. He and his wife, Sharon, had already attended the Barrow Grand Ball. Joining the BNF board cemented their commitment to the annual fundraiser, which Ervanian describes as “incredible.” They have attended 27 Barrow Balls. In addition to Armen’s service on the BNF Board from 1988-1992 and from 2003 to the present, the Ervanians have contributed financially to Barrow. Their gifts include one to Pathology in honor of his brother, who is a pathologist, and another to vision research in honor of Sharon’s mother, who has macular degeneration. Now retired from Dial-Viad Corp., Armen is president of P&E Properties. He serves on the Finance Committee of the BNF Board. Sharon owns Sharon Lawien Interiors. “Barrow is an extremely valuable community asset, not only locally but also nationally and internationally,” Armen says. “It’s very interesting and gratifying to be involved with such a remarkable organization.”

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A new campaign to promote helmet safety will launch this spring, thanks to generous support from US Airways. The campaign will feature posters showing a helmet-wearing Chris Snyder, Diamondbacks catcher, guiding children on bikes who also are wearing helmets. The posters will be distributed at games and schools to remind children and parents of the importance of wearing a helmet. US Airways has supported the Helmet Your Head program at Barrow for the last four years. In 2008, the hometown airline increased its support, enabling the prevention program to expand its efforts. “We are very grateful for the ongoing support of US Airways,” says Lucy Ranus, director of Barrow Prevention Programs. “I am really excited about our new campaign featuring Chris Snyder. We’ll be able to reach more kids and make wearing a helmet cool.” Helmet Your Head is a safety program that was developed by Barrow to prevent head and traumatic brain injuries. Representatives from the program go into classrooms to teach students about the consequences of brain injuries from such common activities as bicycling, rollerblading, skateboarding, horseback riding, and rock climbing.

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In the last year, support from US Airways has enabled the Helmet Your Head program to: • Add a fifth “train the trainer” workshop and train 103 health and public safety professionals. • Train 39 school nurses and provide them with Helmet Your Head Brain Boxes, CDs, curriculum, and helmets for use in their schools. • Train 39 family practice physicians in helmet fitting, and supply them with helmets, Brain Boxes, handouts, and curriculum. • Develop a middle- and high-school contest to generate student-produced public service announcements about helmet safety. Four winners were chosen and awarded $500 each. • Make 179 presentations at 85 schools and community locations, reaching 4,581 individuals. • Provide and fit 954 helmets, with 93 percent going to children and teens in underserved populations. “Thanks to US Airways, Barrow is reaching many, many children with this important safety message,” says Ranus.

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Spirit of Giving Awards

Neal A. Klein, MD, FACC, and Catherine and Thomas Reahard received Spirit of Philanthropy Awards during the 24th Annual Philanthropy Awards Dinner on November 12 at the Arizona Biltmore Resort & Spa. Dr. Klein and Mr. and Mrs. Reahard were honored by St. Joseph’s Foundation (SJF) and Barrow Neurological Foundation (BNF) for their contributions to the hospital. The dinner was hosted by the Association of Fundraising Professionals-Greater Arizona Chapter in celebration of National Philanthropy Day. Dr. Klein is an interventional cardiologist who has been actively involved at St. Joseph’s Hospital and St. Joseph’s Foundation for many years. He is currently the director of Cardiac Rehabilitation and the medical director of Cardiovascular Services at St. Joseph’s Hospital. Dr. Klein has made several gifts to the Foundation, including a large insurance policy designated to benefit the hospital’s clinics for the working poor. He is a member of the Foundation’s Heritage Society and Legacy Circle. Tom and Cathy Reahard have made both financial and leadership gifts to Barrow Neurological Foundation. Tom, who is the founder and chief executive officer of Symmetry Software in Scottsdale, served as chairman of the Foundation’s Board of Trustees from 2006-2007 and is currently the past chairman. He was the vice chair of the Major Gifts Committee of the Pushing Boundaries Capital Campaign, which raised nearly $30 million for the Barrow Patient Tower and other campus improvements. The Reahards have been active supporters of the annual Lou Grubb Friends Fore Golf event. They are members of the Heritage Society.

Irish Mist annual golf fundraiser set for December 6 The Third Annual Irish Mist Golf Scramble will be held Saturday, Dec. 6, at Club West in Ahwatukee. Tracy Anthony and Ross Murray, both residents of Ahwatukee, created the golf tournament to raise funds for multiple sclerosis (MS) research at Barrow Neurological Institute. Their dedication to the event is a result of Tracy’s diagnosis with MS and Ross’ brother-in-law’s diagnosis with primary progressive MS. Both are part of a research study at Barrow, and the goal is to find a cure. The golf scramble will begin with a noon shotgun start and will include a reverse raffle, silent auction, player prizes, dinner, and a live band. Player registration is only $150 per player and $600 per foursome.

The MidFirst Bank branch of Ahwatukee will donate their fundraising van, which features an ATM and coin deposit. They will match any donated coins up to the first $1,000 and will award four Phoenix Suns tickets and a parking pass to the foursome that donates the most coins. John Gambadoro of KTAR’s Sports 620 Gambo & Ash will be the event emcee. The Irish Mist Golf Scramble raised $23,000 at the 2007 event and hopes to surpass that amount this year. Please visit www.irishmist4ms.org to register and play in the tournament.

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research update

Spine surgeons investigating treatment for degenerative disc disease

Led by principal investigator Randall Porter, MD, Barrow surgeons are involved in a new clinical trial for the treatment of cervical degenerative disc disease. The DePuy Spine DISCOVER™ trial is a multi-center, prospective, randomized, controlled trial comparing cervical arthroplasty with the DISCOVER™ artificial cervical disc to anterior cervical discectomy and fusion with the SLIM-Loc® plating system. Barrow is one of 30 participating clinical sites across the U.S. In addition to Dr. Porter, F. David Barranco, MD, Taro Kaibara, MD, Nicholas Theodore, MD, and William White, MD, are enrolling patients in this trial. Male and

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female patients between the ages of 21 and 70 years with evidence of cervical degenerative disc disease at one level from C3-C7 are eligible to participate in the trial. Patients will be randomized evenly between the two treatment options under study and will be followed for five years. Detailed information on the DISCOVER™ disc trial can be found at http://clinicaltrials.gov/; study identifier NCT00432159. For more information about this study at Barrow, please contact Jill Danielson at (602) 406-6335 or Jill.Danielson@chw.edu.

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Barrow recruiting participants for memory and menopause study

Barrow researchers are conducting a study to understand the nature of memory problems in perimenopausal women so that they can be better treated. “The purpose of the study is to explore memory impairment in perimenopausal women who struggle with day-to-day functioning,” says Leslie Baxter, PhD, clinical neuropsychologist at Barrow. “We are investigating variables that may influence memory such as sleep, mood, genetics, menopausal symptoms, and hormone levels. As a result, we may be able to identify the source of memory problems relating to menopause and provide more effective treatment strategies.” The researchers are recruiting women between the ages of 48 and 54 who are perimenopausal and have complaints of memory impairment, and women in the same age group who are pre-menopausal and do not have any memory complaints. Study participants cannot be taking oral contraceptives or hormone replacement therapy, and cannot have had a hysterectomy. The study involves cognitive testing, a blood draw, MRI scanning, and health, mood, and sleep questionnaires. The entire testing takes four to five hours to complete, and consent forms must be signed. Participants will undergo the same procedure six months after the initial testing. For more information or to participate in the study, please call 602-406-4490.

Researchers identify way to detect progression of brain tumors earlier

Researchers at Barrow recently participated in a pilot study with the Montreal Neurological Institute that suggests a certain type of MRI scanning can detect when a patient is failing brain tumor treatment before symptoms appear. The results of the study pave the way for a proactive treatment approach. The study followed patients with recurring malignant brain tumors who were receiving chemotherapy. Patients received scans through an imaging device called MR spectroscopy to identify metabolic changes. The scanning technique suggested that the use of metabolic imaging identifies chemical changes earlier than structural

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imaging such as conventional MRI and CT scans. This approach allowed researchers to determine if the tumors were responding to treatment early by assessing metabolic changes in a brain tumor, which are easy to detect and appear before structural changes or symptoms. The result may give patients more time to try another treatment. “The study has shown for the first time that metabolic response to brain tumor treatment can be detected earlier and faster by metabolic imaging instead of through structural imaging or assessment of the neurological status of a patient,” says Mark C. Preul, MD, Newsome Chair of Neurosurgery Research at Barrow. The imaging can be done often, poses no radiation hazard, and is non-invasive. “Frequent use of this type of imaging may be a useful tool to follow a patient’s response to chemotherapy for malignant brain tumors,” says Dr. Preul. “It gives us the ability to identify treatment failure early and more time to alter a patient’s treatment plan before the disease progresses.” As a result of the pilot study, Barrow researchers are planning to conduct a second study that will use imaging in the same way to monitor the effects of brain tumor treatment. They also are developing imaging modalities that will show how brain tumors change their shape and metabolism with treatment.

Barrow physician authors new guideline on treating vertigo

Barrow neurologist Terry D. Fife, MD, was the lead author of a new guideline issued in May by theAmericanAcademy of Neurology about the best treatment for a common cause of dizziness. The guideline on benign paroxysmal positional vertigo (BPPV) said the best treatment does not involve drugs or complicated devices and is the easiest and quickest way of treating the problem. The guideline was published in Neurology, the medical journal of the American Academy of Neurology. BPPV causes a feeling of spinning or whirling when the head is moved in certain ways. The feeling lasts a short time but can be severe. The guideline determined that in many cases the vertigo can be treated with simple maneuvers—a series of head and body movements performed by a doctor or therapist while the patient sits on a bed or table. To develop

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the guideline, the authors analyzed all available scientific studies on the topic. “The good news is that this type of vertigo is easily treated,” says Dr. Fife. “Instead of telling patients to ‘wait it out’ or having them take drugs, we can perform a safe and quick treatment that is immediate and effective.” The disorder is believed to be caused by loose calcium carbonate crystals that move in the sensing tubes of the inner ear. The maneuvers move the calcium crystals out of the sensing tube and into another inner chamber of the ear, from which they can be absorbed.

Neurosurgeon presents findings from aneurysm trial

Cameron McDougall, MD, an endovascular neurosurgeon at Barrow, presented findings from the Marguarite Clifford Ruptured Aneurysm Trial at the annual meeting of the American Association of Neurological Surgeons (AANS) in September. The trial, now in its fifth year at Barrow, has been designed to determine whether traditional surgical clipping or newer endovascular approaches are superior in the treatment of ruptured cerebral aneurysms. Dr. McDougall and Robert Spetzler, MD, are co-principal investigators of the study. The Marguarite Clifford Ruptured Aneurysm Trial met its enrollment goal of 500 consented patients in January 2007. Each patient was randomly assigned to one of two treatments: surgical clipping or endovascular treatment. The study is examining clinical and angiographic outcomes of the enrolled patients, as well as the quality of life and economic impact outcomes of the two treatments. Six-month and one-year follow-up visits have been completed, and threeyear follow-up visits should be completed by December 2009. “Dr. McDougall tackled the issue of whether endovascular coiling is superior to surgical clipping and used as the comparator Dr. Spetzler,” said Mark Preul, MD, Newsome Chair of Neurosurgery Research at Barrow. “It was perhaps the best, most complete and relevant presentation on the topic.”

Vision researchers publish articles about magic and the brain

The research of Susana Martinez-Conde, PhD, and Stephen L. Macknik, PhD, has been featured recently in two major science magazines.

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The vision researchers’ study of the brain basis of magic is included in the December issue of Scientific American, the world’s most highly circulated magazine of science. Drs. Martinez-Conde and Macknik conducted their research with the help of five of the world’s most renowned magicians. The article is titled “Magic and the Brain.” The magic study first appeared in Nature Reviews Neuroscience, the world’s premier neuroscience review journal. This original scientific publication has been featured in the New York Times, National Public Radio, The Boston Globe, The Chicago Tribune, Der Spiegel, and many other news outlets. Nature Reviews Neuroscience is offering the article free on its website.

Barrow student researcher wins scholarships

Erik Stout, a student researcher in the laboratory of Irina Beloozerova, PhD, has won National Merit and Flinn undergraduate scholarships, and is now enrolled at the ASU Fulton School of Engineering. He graduated in the top one percent of his class at Desert Vista High School in Phoenix. Stout joined the Beloozerova Lab in the fall of 2005 as a participant of Barrow’s High School Student Research Program. During his first two years in the program, he mastered the technology of neuron-physiological experiments by learning to precisely record movements of the body and limbs, and the associated activity in the motor area of the cerebral cortex. Last year, he developed his own experiment, which was designed to answer how learning affects the routine activity of neuronal populations, and conducted and analyzed experiments. Stout continues his research in hopes that understanding the mechanisms of learning will solve certain challenges faced by the neuroprosthetics industry and will provide insight important to rehabilitative care.

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fall 2008 health & wealth raffle Grand prize winner says Barrow saved her husband’s life by Christina Vanoverbeke

eborah Davner barely remembers driving to Barrow Neurological Institute on one frightening night in 2004. “Everything was a blur,” she says. Earlier that evening her husband, Gerald, picked her up from work and alarmed her with the news that he couldn’t see out of one eye. “I said, ‘Why are you driving?’ and he said, ‘I think I just strained something,’” she says. In the middle of the night, he woke up with an upset stomach, and Deborah insisted they go to the closest hospital. Doctors at that hospital diagnosed him with a brain aneurysm with a slow leak, but they had no one there to treat him. Eleven hours later, she found herself and her husband on their way to Barrow. Gerald underwent a procedure called endovascular coiling where tiny, flexible platinum coils are manuevered through a catheter into the aneurysm to block blood flow into the aneurysm and, thus, prevent rupture. He has not had any problems since recovering. “Barrow was phenomenal,” Deborah says. “They saved his life. I thought I would be a widow at 50.” During her 11-day hospital stay, Deborah learned about the Health & Wealth Raffle and decided she would buy a ticket. Every year since 2004 she has purchased one ticket for each raffle. “I wanted to support them somehow, in some way,” she says. The Health & Wealth Raffle is one of the largest fundraisers for St. Joseph’s Hospital and Medical Center and Barrow Neurological Institute. The biannual raffle enables the hospital to fund projects in the areas of research, medical education, and patient care. To date, more than 89,000 prizes have been awarded to raffle participants, including 22 homes, 300 trips, and more than 325 vehicles. The Davners never won anything and considered not buying a ticket this year because money was tight. But a

few days before the raffle, Deborah decided to go ahead and make the $100 purchase. On Oct. 9, Deborah, who is a hair stylist, was with one of her clients when she received a phone call from Kathy Rice, manager of the Health & Wealth Raffle. “She said, ‘You have won second prize, $500,000,’” she says. “I just started crying. I couldn’t believe it. Things like that don’t happen to us.” Deborah says everything that came after that was a blur again, but this time it was a good blur. Other grand prize winners in this year’s raffle include Kathleen Remick, who won the $1-million Grand Prize, and Barbara Krauss, who won his and hers Mercedes and $45,000. Maggie Daniels won a 2009 Cadillac Escalade Hybrid and $23,000, Richard Pollifrone won a 2008 Honda Civic Hybrid plus $8,000, and C. Joyce Fernandez won a 2009 Dodge Journey plus $8,000. ■

Deborah Davner’s husband, Gerald, underwent surgery for an aneurysm at Barrow. She won Grand Prize #2 in the Health & Wealth Raffle.

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what’s happening around barrow Barrow researcher named a GE Healthcare Thought Leader

Jim Pipe, PhD, director of the Keller Center for Imaging and Innovation at Barrow, has been named one of the 10 GE Healthcare Thought Leaders for 2008. The annual awards recognize the top minds in magnetic resonance imaging. “In a time when everyone is pushing harder and faster to produce the next best answer for healthcare, GE has maintained the thought leadership in MR research for at least the last six years,” says David Handler, global marketing manager for GE Healthcare, MR. “Dr. Pipe’s work reinforces the important role our

customers and collaborators have in maintaining the best solutions for tomorrow.” Dr. Pipe was selected based on his cutting-edge contributions to the MR industry. He invented PROPELLER, the first commercial MR method that eliminates blurring in a scan when a patient moves. Dr. Pipe developed PROPELLER in collaboration with GE, and the technology is now available on most commercial scanners. Dr. Pipe is working with GE to further the PROPELLER technology and to develop techniques that bet-

ter capture images of brain structure, function, and connectivity. In establishing the mathematical underpinnings for many next-generation MR methods, he aims to reduce exam times and increase the information available to physicians.

Foundations unveil new video display in Marley Lobby

The recent renovation of the Marley Lobby and the Goldman Auditorium has created a beautiful and functional area for meetings, receptions, and conferences at Barrow Neurological Institute and St. Joseph’s Hospital. And, a colorful new display along one wall of the lobby celebrates the role of philanthropy in the worldclass research, medical education, and patient care at Barrow and St. Joseph’s. Developed by Barrow Neurological Foundation (BNF) and St. Joseph’s Foundation (SJF), the display features three interactive flat-screen video monitors with information about medical education and research; patient success stories; and benefactors. Each screen

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gives viewers the opportunity to explore topics of interest to them. The benefactor screen, for example, displays major donors, presents benefactor stories, and lists upcoming fundraising events. “We hope our benefactors will take the time to explore the new display,” says Mary Jane Crist, CEO of BNF and SJF. “The content will be regularly updated, giving benefactors and others new information about philanthropy’s impact on the hospital.” The capacity of the Goldman Auditorium has been substantially increased. New seating and audiovisual equipment make the auditorium a first-class place for presentations and meetings.

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Barrow Grand Ball set for January 17

The Barrow Women’s Board will present the Barrow Grand Ball, one of Arizona’s premier black-tie fundraisers, on January 17 at the Arizona Biltmore. Now in its 43rd year, the intimate event has raised nearly $34 million for Barrow Neurological Institute, including a record $3.5 million in 2008. Co-chairmen for the 2009 Barrow Grand Ball are Marilyn Harris and Judy Shannon. Proceeds from the Ball support a wide variety of research projects at Barrow, providing important funding for promising and innovative scientific studies. The Barrow Women’s Board was established in 1965 to raise funds for research at Barrow Neurological Institute and to foster community interest in the fledgling neuroscience center. The group’s first fundraiser was a masked ball at Casa Blanca Inn on New Year’s Eve. The event netted $26,000. Mary Ellen McKee is the chairman of the Women’s Board. For more information about the 2009 Barrow Grand Ball, call Barrow Neurological Foundation at 602-4063041. The Foundation is open Monday-Friday from 8 a.m. until 5 p.m.

Foundations add new staff members

Barrow Neurological Foundation and St. Joseph’s Foundation have hired three new people: •

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Christina Hall, development officer, is a native Phoenician and graduate of Arizona State University who previously worked as program director of the local Arthritis Foundation. Although Hall has experience in banking and the arts, her true passion is nonprofit development and fundraising, particularly for health organizations. In her new position, she will develop a comprehensive plan around annual giving, which includes the Leader Circle and employee giving, and will help raise awareness and funds for St. Joseph’s and Barrow. Hall can be reached at 602-406-1046. Ani Gurlekian, coordinator, comes to the foundations from the foundation of Glendale Memorial Hospital and Medical Center in California, where she worked for 12 years. There, she gained experience in many areas of fundraising, including website content management, annual giving, and special events. Gurlekian can be reached at 602-406-1048.

Christina Vanoverbeke, staff writer, has experience as a reporter and editor at various newspapers in Arizona and Ohio. Most recently, she was an education writer for the East Valley Tribune. She has experience in design, photography, and website content management. As staff writer, Vanoverbeke will develop content for the foundations’ magazines, video walls, websites, collateral materials, proposals, and other communications. Vanoverbeke, who earned a degree in journalism from Youngstown State University in Ohio, can be reached at 602-406-1044.

Among the 2008 Barrow Grand Ball guests were John Norton, Carol Kyl, Doris Norton, and Senator Jon Kyl.

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G I V I N G

The Legacy Circle Honoring those who are building a healthy future for Barrow by Robert Hopkins vice president he fact that you’re reading intentions may be recognized or acknowledged is a prithis magazine means you vate matter … first, we need to know. have a relationship with Barrow Neurological Institute is one of this counBarrow Neurological Institute. try’s best, and that fact has been substantiated by Perhaps it’s been through a many people who evaluate what constitutes “great” personal experience as a organizations. For some, it’s the technological expertpatient, perhaps you’ve volunteered here in some ise. For others, it’s the sheer number of people cared capacity, and there’s an excellent chance you’ve sup- for who are the sickest or most vulnerable. Still othported us financially. The role that St. Joseph’s ers judge greatness by the level of research going on Foundation and Barrow Neurological Foundation that quickly finds its way to the bedside. have played over the years has been significant, and We have created The Legacy Circle to recognize indimuch of what the hospital will be able to do in the viduals who have decided the work being done here future depends on the generosity of people just like every day is worth supporting. Would you be willing you. to share any plans you’ve made with us? People support the work of Barrow for many reaWe invite you to let us know your plans and become sons … for the sheer joy of sharing, to help us help the a member of the Legacy Circle. ■ poor and disenfranchised, to be recognized in some way, or simply as a silent testimony of The Legacy Circle recognizes Barrow one’s life and good fortune. and St. Joseph’s supporters who are Whatever the motivation, we helping build a healthy future for the are grateful that benefactors have given the hospital the abil- hospital through a planned gift. If your ity to help so many. estate plans include Barrow or St. Often we don’t know what Joseph’s, we hope you’ll let us know. someone has done, or is thinking of doing, and that’s the reason for this message: We’re hoping you’ll tell us. Most often, someone close to Barrow has made a provision in his or her estate plan, but hasn’t let us know. The form or amount of the intended gift isn’t nearly as crucial as our being aware of the act itself. How your

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Charitable Gift Annuities: Certainty in Uncertain Times If the stock market has you down, a charitable gift annuity (CGA) may be just what the doctor ordered. It’s a great way to get guaranteed income during retirement—while giving to a charity you care about. Below is an example of how a charitable gift annuity works:

Pat Smith, 68

Gift of Cash to SJF or BNF $10,000

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6% Annuity

Charitable Gift Annuity $10,000

Charitable donation to SJF/BNF $10,000 (approximate value)

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Pat gives $10,000 to St. Joseph’s Foundation (SJF) or Barrow Neurological Foundation (BNF). SJF/BNF invests the gift.

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Pat receives a contract guaranteeing annuity payments of $600 per year for life (estimated lifetime payout is $12,660).

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A portion of the annuity payments is tax-free.

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Pat also gets a charitable tax deduction of $3,469.

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Upon Pat’s death, the remaining funds in the CGA are released for use in hospital programs.

602-406-3041 • SupportStJosephs.org • SupportBarrow.org.

*This educational illustration is not professional tax or legal advice. Consult a tax advisor about your situation.

CHW Arizona Barrow Neurological Foundation 350 W. Thomas Rd. Phoenix, AZ 85013-4496 www.SupportBarrow.org

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