• Sharing Mayo Clinic

    Teamwork makes the routine extraordinary

There was no doubting the value of the team approach on the early morning of Tuesday, May 22, 2012 in the Ambulatory Surgery Center at Mayo Clinic in Arizona.

In what was otherwise a fairly routine procedure — cataract removal — this time required the assistance of the ophthalmologic surgeon, nurses, a cardiologist and a cardiac device specialist. The center of attention was the patient — 62-year-old James Billingsley, a Vietnam veteran with Type II diabetes, a hearing issue, a bad heart and cataracts.

The Mayo team had two important goals — safety and quality of life for Billingsley. Billingsley, thanks to a ventricular support device (VAD) to support his failing heart, had been granted "extra innings" in a life that includes a supportive family, friends and a passion for performing as part of the honor guard for commemorations such as Memorial Day.

Dave Patel, M.D., chair of Ophthalmology, was strongly motivated to improve Billingsley's sight so he could enjoy life. But Billingsley's surgery did not fall in the category of routine. Cataracts needed to be removed from both of his eyes, and Patel decided to do a double cataract surgery so Billingsley would not have to go through the procedure twice.

Billingsley's heart needed to be monitored, and safety was top priority. So a team converged to closely monitor blood pressure levels and intravenous meds. "This double cataract surgery on a patient with a VAD could not be done elsewhere in a traditional eye center because of the potential risks," Patel says. "Here, at Mayo Clinic, we have all the specialists coming together as a team for the safety of the patient in this special circumstance."

The surgery was a success. One day later, when Billingsley returned for a follow-up appointment, his spirits were high and his sight had already improved. In fact, one eye registered 20/20 and the other eye was almost as good. "It made a big difference. Now I can read, I can watch TV and it doesn’t feel like I’m looking through dirty glass. Dr. Patel did an excellent job."

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