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3 hours ago · Working in Harmony to Keep a Musician Singing

When Becky Loar injured her voice, she was alarmed by the prospect of not being able to sing. But her care team at Mayo Clinic provided Becky with the treatment she needed to hit the high notes once again.

When Becky Loar injured her voice, she was alarmed by the prospect of not being able to sing. But her care team at Mayo Clinic provided Becky with the treatment she needed to hit the high notes once again.


When Becky Loar entered a recording studio in July 2016, it was the culmination of a goal the Vero Beach, Florida, native had almost given up hope of achieving.

A voice injury had threatened to sideline Becky’s music career. “I realized I was hoarse all the time. Then one day I was vocalizing, and it just wasn’t there. I knew in my gut something was wrong,” Becky says. “Singing is all I’ve ever known and done, and all I want to do.”

Thanks to the specialty care provided by Mayo Clinic laryngologist Amy Rutt, D.O., and the rest of Becky’s care team at Mayo Clinic’s Florida campus, Becky was able to regain her voice. She recently released an album titled “How Can I Keep From Singing,” which includes a dedication to her Mayo Clinic care team in the liner notes.

An overloaded voice

Becky grew up with a love of music, singing in the church choir as a child. She went on to earn degrees in voice and opera performance, and then delight audiences across the country with timeless classics like Handel’s “Messiah,” Bach’s “Magnificat,” and Mozart’s “Exsultate, Jubilate.”

Eventually Becky married, became a mom and started teaching music at two universities in Jacksonville, Florida. She also recorded and released a five-track album of contemporary Christian music and was excited about the possibility of a second.

But that ambition was placed in limbo when Becky began to have problems with her voice. It began when one of Becky’s sons was diagnosed with a hearing impairment. She admits she struggled with communication at first.


“I realized I was consistently hoarse all the time. Then one day I was vocalizing, and it just wasn’t there. I knew in my gut something was wrong.” — Becky Loar


“As his hearing loss progressed, I think my speaking voice got louder and louder, and my mom voice took over,” she says. “I thought if I just talked louder, he would hear me better. But that was the catalyst for the strain on my voice.”

One evening in late 2015, Becky called out to her son that it was bath time, unaware that he’d removed his hearing aids. When he didn’t answer, Becky raised her voice. Then she heard a pop.

She decided she needed to have her voice checked.

A melodious team

Becky met with an ear, nose and throat specialist near her home who simply told her to rest her voice. After a week of not speaking, Becky still wasn’t feeling right and sought a second and third opinion.

“Issues that singers face are different than typical speech problems,” Becky says. “As a singer and a voice teacher, I’m hyperaware of what’s going on with my voice. I wanted someone who was skilled in all aspects of voice.”

She felt at ease when she met with Dr. Rutt at Mayo Clinic. A laryngologist, Dr. Rutt specializes in disorders of the larynx — also known as the voice box.

“She was not your normal ear, nose and throat doctor,” says Becky, noting Dr. Rutt’s experience in music. “I liked her style. And I liked that she had a whole team of people to work with me.”


“I trusted Dr. Rutt and her team. I knew I was in good hands.” — Becky Loar


Dr. Rutt found that Becky had a polyp on one of her vocal cords (sometimes called vocal folds).

She advised Becky to undergo surgery to remove it. Though some polyps may heal on their own, they usually require many months to do so. If left untreated, there was a possibility that the polyp could get worse. Or another polyp, called a reactive lesion, could form on the opposite vocal cord. But Becky dreaded the prospect of surgery.

“I wondered what it was going to feel like,” says Becky. “How would it be? Was I still going to be able to sing? It was terrifying.”

A strong comeback

Despite her concerns, Becky opted to go through with the surgery. She recalls the fear subsiding as she lay on the operating table before the anesthesia took over.

“I trusted Dr. Rutt and her team,” she says. “I knew I was in good hands.”

When she awoke, the polyp had been removed. After one week of complete voice rest and six weeks without signing, Becky began voice rehabilitation with Stacey Menton, a Mayo Clinic speech language pathologist who is also a singing voice therapist.

“Stacey is unique. Being a singing voice specialist and an opera singer, I trusted everything going into a therapy session with her,” Becky says. “I knew she would guide me properly.”

The day she was allowed to sing again, Becky was pleasantly surprised. Although her voice wasn’t as strong as it had been before surgery because the vocal muscles still needed time to strengthen, she could definitely sing.


“It was so satisfying to record this album because had I not had the surgery, I wouldn’t be able to sing again.” — Becky Loar


“I began vocalizing, and when I hit a high C, it was there!” she says. “I was excited because I had just started therapy and the muscles had to relearn what they were trained to do, but it was there.”

Soon Becky was back to teaching, and she began planning her return trip to the recording studio.

“I was so nervous before I went to Nashville. I went to see Dr. Rutt to make sure it was OK to do this recording and that I wasn’t going to hurt myself,” Becky says. “Dr. Rutt, the whole team, was very encouraging to me.”

The recording was a success, and now Becky is looking forward to a future filled with more music.

“It was so satisfying to record this album because had I not had the surgery, I wouldn’t be able to sing again,” says Becky, who is planning an album of Christmas songs and wants to pursue a doctorate in music. “Mayo Clinic is simply the only place in the region that can fix and rehabilitate a singing voice.”


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2 days ago · Comprehensive Care Offers Virginia Man a Path to Transplant

When congestive heart failure led to the need for a heart transplant, Vincent Arnold turned to Mayo Clinic. The care he received took all his medical concerns into account, providing him a way to return to better health.

When congestive heart failure led to the need for a heart transplant, Vincent Arnold turned to Mayo Clinic. The care he received took all his medical concerns into account, providing him a way to return to better health.


It’s been almost four years since Vincent Arnold began feeling winded and feeling like his heart was skipping beats. Although the symptoms concerned him, never did Vincent anticipate they would be the beginning of the journey to a heart transplant — or that his wife’s employer would be the catalyst for him to get treatment at a center of excellence.

To learn more about what might be causing Vincent’s symptoms, he and his wife, Roxanne, visited a hospital near their home in Winchester, Virginia. Physicians diagnosed Vincent with congestive heart failure as result of a virus.

He was prescribed medications to help improve his left ventricular ejection fraction — the percentage of blood the heart squeezes back out to the body with each contraction. Normal ejection fraction is 55 to 65 percent. At the time of his diagnosis, Vincent’s measured only 15 percent. Within 10 months of starting medication, his heart function had improved to 45 percent.

A year later, though, Vincent was back in the hospital with an ejection fraction of 15 percent once again. Not only that, but due to fluid retention, his lungs filled with fluid when he lay down.

“My local doctor said, ‘We’ve done all we can do. You need a new heart,'” Vincent says. “I felt like giving up. The only thing stopping me was 37 years of marriage.”

A bridge to transplant

When one of Roxanne’s colleagues called to check on Vincent, she was reminded that her employer’s insurance program gave the Arnolds access to Mayo Clinic, the largest integrated center for transplantation in the United States. Vincent had his first consult with Parag Patel, M.D., a transplant cardiologist at Mayo Clinic’s Florida campus, on Feb. 15, 2015.

By that time, Vincent’s ejection fraction had dropped to 11 percent. Dr. Patel said Vincent might not survive the wait for a heart transplant and suggested a ventricular assist device, or VAD. The mechanical heart pump would help Vincent live until they could find him a donor heart. The device would be surgically implanted in his chest to help pump blood from his heart’s left ventricle to the rest of the body.


“I was able to walk without having to catch my breath. I could go out and socialize without being tired. And I went back to driving.” — Vincent Arnold


In mid-May of that year, Vincent received the ventricular assist device and was added to the transplant waiting list. He also began four months of cardiopulmonary rehabilitation. Roxanne recalls that her husband bounced back nicely.

“He did really well. He was full of energy. It was like night and day,” Roxanne says.

“I was able to walk without having to catch my breath,” Vincent says. “I could go out and socialize without being tired. And I went back to driving,”

Taking on an added obstacle

Before getting the VAD device implanted, Vincent, who is 5’10”, weighed 237 pounds. But he began gaining weight after the surgery. Over the next 15 months, he gained almost 50 pounds.

“I was getting short winded just walking to appointments,” Vincent says. “The more weight I gained, the worse I felt.”

Transplant cardiologist Juan Carlos Leoni Moreno, M.D., advised Vincent that he was ineligible for a transplant based on his current weight. He would need to lose significant weight and reduce his body mass index, also called BMI, from 39 to less than 35. A normal range is between 18.5 and 24.9.

“We don’t transplant patients with a BMI of 35 or higher because there is established data that correlates a higher BMI with increased complications post-transplant,” Dr. Leoni says. “These patients have more difficulty controlling their sugars, which is correlated with poor wound healing. Losing weight is critical to improve the success of the transplant.”

Knowing that most people have difficulty losing weight on their own and that Vincent would not survive without a new heart, Dr. Leoni turned to the collaborative model of care that Mayo Clinic is known for and reached out to colleagues in Gastroenterology, including Victoria Gomez, M.D.

Surgery is risky for patients like Vincent who need blood thinners because they have a ventricular assist device. That’s why Dr. Gomez suggested Vincent consider an intragastric balloon, a saline-filled silicone balloon the size of a grapefruit that’s placed in the stomach to limit food intake. The balloon is placed using an endoscope, so no incision is necessary.

“We tried to find a solution that fit the patient,” Dr. Leoni says. “This procedure did not require taking Mr. Arnold off the blood-thinning medication.”

“I love the team approach at Mayo,” says Vincent. “There’s so much communication between the doctors. They don’t leave any stone unturned.”


“I love the team approach at Mayo. There’s so much communication between the doctors. They don’t leave any stone unturned.” — Vincent Arnold


Vincent had the balloon placed in September 2016. The plan was to leave it in place for six months and then remove it.

Roxanne recalls being pleased with the care and connection that Dr. Gomez provided throughout the process. “She’s an amazing person with a wonderful personality,” Roxanne says. “She called every day to see how Vincent was doing.”

The balloon was beneficial. Vincent began to lose weight. He worked with a nutritionist who encouraged him to keep a log of each meal with details about its calories, sodium, protein and carbohydrate content.

“The balloon changed my eating habits,” Vincent says. “After I got back down to a normal weight, I felt a lot better about myself.”

When the balloon was removed in March, Vincent had lost 42 pounds. His BMI went from 39 to 34. Those numbers made him eligible once again to be placed on the transplant waiting list.

Another chance at better health

Although the average wait time for a heart at Mayo Clinic’s Florida campus is about 15 months, Vincent got a call that a suitable donor heart was available less than three months later, just before midnight on May 10, 2017.

The transplant was a success. Today, Vincent says he loves having a second chance, and he continues to make healthier choices.


“I’ve learned a lot about myself, my heart condition and how to be healthy. I exercise six days a week now. I have a life again.” — Vincent Arnold


“I’ve learned a lot about myself, my heart condition and how to be healthy,” Vincent says.  “I exercise six days a week now.”

And he’s getting back to doing things he enjoys.

“I have a life again,” he says. “I can spend time with my kids and grandkids. I can travel and be more like I was when I was younger. This experience gives me the hope and the attitude that there’s nothing I can’t do if I put my right foot forward.”


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5 days ago · Neurosurgery Frees Peggy Lang From Constant Pain

Diagnosed with a rare condition that affected her neck muscles, Peggy Lang suffered for years with debilitating headaches, tremors and dizzy spells. But surgery at Mayo Clinic relieved her symptoms, allowing her to enjoy life once again.

Diagnosed with a rare condition that affected her neck muscles, Peggy Lang suffered for years with debilitating headaches, tremors and dizzy spells. But surgery at Mayo Clinic relieved her symptoms, allowing her to enjoy life once again.


Many of us might take curling up in a chair and reading a book for granted. Not Peggy Lang. For three years, Peggy wasn’t able to enjoy this simple pleasure that she loves so much, and many days she was confined to her bed, due to migraines, dizzy spells and head tremors.

Peggy was eventually diagnosed with a rare condition that affects the neck muscles called spasmodic torticollis — also known as cervical dystonia. But doctors told Peggy there was little that could be done for her. Fortunately, Peggy found her way to Mayo Clinic’s Rochester campus. There neurosurgeon Robert Spinner, M.D., offered Peggy a surgical procedure that would ease her symptoms and allow her to pick up life where she had left off before the condition sidelined her.

“This changed my life so dramatically,” she says. “Dr. Spinner has been my savior. He’s the nicest, most genuine doctor I’ve ever met. He really performed a miracle.”

An uncertain way forward

Peggy’s symptoms began in 2014, when family members noticed she was having head tremors. Several months later, she began having random dizzy spells and terrible migraines several times a week. Peggy’s shift work as a hospital switchboard operator became so taxing with her condition that she quit her job and started working for her family’s auto body shop instead.

In October 2015, Peggy’s primary care physician diagnosed her with essential tremor and sent her to a local neurologist, who told her there was nothing he could do. She then went to see a neurologist in Minneapolis who recommended she take a daily baby aspirin.

“I was just so deflated because I knew there was something wrong,” Peggy says. “But I didn’t know what, and I didn’t know how to fix it.”


“I was just so deflated because I knew there was something wrong. But I didn’t know what, and I didn’t know how to fix it.” — Peggy Lang


 

After a consult with a movement disorders neurologist in Minneapolis, Peggy was diagnosed with spasmodic torticollis. The disorder makes the neck muscles contract involuntarily, causing the head to twist or turn to one side. Sometimes it can also cause the head to tilt forward or backward uncontrollably. Spasmodic torticollis has no known cause and it often goes undiagnosed.

“When my head would pull to one side and everything got tight, that’s when the migraines would occur,” Peggy says.

As a treatment for the condition, Peggy began receiving botulinum toxin, or Botox, injections into her neck muscles. Although her tremor went away, the migraines and dizzy spells continued, as did extreme fatigue.

A better alternative

Another year went by and Peggy, who had gotten married in April 2016, was miserable. She went to her primary care doctor to see if there was anything else she could do.

“I told the doctor, ‘I can’t do this anymore. I’m not living I’m just surviving,'” Peggy says. “And she said, ‘I’m sending you to Mayo.'”

Peggy’s situation began to turn around when, on March 15, 2017, she met with Dr. Spinner. He ordered tests through Mayo Clinic’s electromyography lab to measure the electrical activity of the muscles in Peggy’s neck and determine which ones were overreacting. Dr. Spinner proposed a treatment alterative Peggy hadn’t considered before.


“Of all of the operations I do, this is the one I enjoy the most because I can restore people’s lives almost immediately, and that’s why I went into medicine.” — Robert Spinner, M.D.


“He was very kind,” Peggy says. “He listened to me and discussed the option of having selective denervation.”

“During the procedure, we cut the nerves that go to the muscles that are overacting and pulling the head to one side. We also take out or divide certain muscles, which you can live without,” Dr. Spinner says. “Many people with this condition don’t know there is a surgical option. Mayo Clinic is among a handful of centers in the country that offers this procedure.”

Peggy decided to give it a try. The surgery was scheduled for April 19, 2017.

“Dr. Spinner made me feel so confident and comfortable,” Peggy says. “My husband and I said, ‘What do we have to lose?'”

A return to simple pleasures

After undergoing the selective denervation procedure, Peggy woke up the next morning and noticed her head was no longer tilted. Today, her tremors are gone, and she’s only had three migraines in four months compared with three to four a week before surgery.


“I am most grateful for having my life back and being able to smile and laugh again.” — Peggy Lang


Relief from her symptoms has brought Peggy renewed enjoyment in daily life. Her husband is an avid angler, and she can now join him when he goes fishing. The two of them can take daily walks together, and Peggy’s able to curl up with her beloved books once again.

“I am most grateful for having my life back, and being able to smile and laugh again,” Peggy says.

“It’s very empowering and rewarding to see this kind of improvement,” Dr. Spinner says. “Of all of the operations I do, this is the one I enjoy the most because I can restore people’s lives almost immediately, and that’s why I went into medicine.”


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Wed, Sep 13 3:33pm · Cardiology Nurse, Heart Attack Survivor Has Message for Women: ‘Listen to Your Body’

After surviving a heart attack of her own, cardiology nurse Kristin O'Meara has a clear and important message for women: "Listen to your body."

After surviving a heart attack of her own, cardiology nurse Kristin O’Meara has a clear and important message for women: “Listen to your body.”


Kristin O’Meara’s story, she says, is one of denial.

It began with searing chest pain, a serious symptom Kristin understands well from three decades as a cardiology nurse at Mayo Clinic. But when that pain was in her own chest, Kristin had a hard time recognizing it for what it was.

“The brain works in funny ways,” she says. “I was in good shape. My numbers were all good. I told myself there is no possible way this could be a heart attack.”

A visit to the doctor proved her wrong. Despite the fact that she was active and fit, doctors at Mayo Clinic’s Rochester campus discovered Kristin was having a heart attack that day as a result of a condition called spontaneous coronary artery dissection, or SCAD. Before she could get to the diagnosis, Kristin had to overcome her impulse to dismiss her symptoms as something minor. 

Discounting tell-tale signs

On Jan. 5, 2017, Kristin’s day started, as had so many before it, with a trip to the gym.

She began running about 20 years ago, and has completed countless half marathons and a few marathons in the years since.

“I’ve always enjoyed exercise,” Kristin says. “It’s become a passion of mine.”

The activity has also helped Kristin maintain her weight, and keep her cholesterol and blood pressure in check. So when she experienced a sharp pain in her chest while warming up on an elliptical machine, she attributed the feeling to something other than heart trouble.

“My first thought was that it was just one of the aches and pains of aging,” Kristin, now 57, says.

She moved to the fitness center’s track and began running. After about 40 minutes, Kristin started to feel pressure in her sternum. Then the pain moved to her shoulder and back.


“I didn’t want to feel foolish. But as a provider, I know it’s always better to err on the side of caution and get your symptoms checked out.” — Kristin O’Meara


“I started wondering if it could be a gallbladder attack or an esophageal spasm,” Kristin says.

She headed for the locker room, stopping twice to rest before leaving the gym. By that time, Kristin had begun to feel nauseous. She contemplated a trip to Emergency Department, yet something held her back.

“I didn’t want to go and find out there was nothing wrong. I didn’t want to feel foolish,” she says. “But as a provider, I know it’s always better to err on the side of caution and get your symptoms checked out.”

Kristin wasn’t quite ready to listen to that provider’s voice inside her head, though. She drove past the hospital but didn’t go inside. Instead, she ran an errand and then returned home, where her symptoms escalated. It was getting harder for Kristin to avoid thinking that she might be having a heart attack. She chewed a couple of aspirin tablets and promptly vomited.

Kristin then called her husband, Rick, at work and asked him to come home and drive her to the Emergency Department. She could no longer deny her body’s messages. Something was wrong. She needed help.

Finding a diagnosis

Dennis Laudon, M.D., an emergency medicine physician, examined Kristin when she arrived at Mayo Clinic Hospital — Rochester and immediately suspected her symptoms might be due to spontaneous coronary artery dissection. The condition, which most often affects women with no atherosclerotic risk factors for heart disease, causes a tear or blood pocket in the blood vessels of the heart. This can slow or block blood flow and cause a heart attack.

Cardiologist Marysia Tweet, M.D., a colleague and friend of Kristin’s, was called in for a second opinion.

“When I walked into the room and saw Kristin, my heart sank,” says Dr. Tweet. “It’s hard to see someone you know in that position.”


“That is just how Mayo is. Everyone gets together to figure out what’s best for each patient.” — Kristin O’Meara


She spoke with Kristin about her symptoms and reviewed results of the tests Dr. Laudon had ordered, including an electrocardiogram and blood work. Dr. Tweet, who cares for patients in Mayo Clinic’s SCAD Clinic and studies the condition as a member of Mayo’s Spontaneous Coronary Artery Dissection (SCAD) Research Program, agreed with Dr. Laudon’s suspicions. But based on Kristin’s family history, which included aortic dissection, Dr. Tweet decided to order an additional test.

“I wanted Kristin to have a CT scan to first rule out dissection of the aorta before any invasive procedures,” she says. In addition to ruling out an aortic dissection, the test also revealed dissection of the coronary artery.

Kristin was taken to the Cardiac Catheterization Laboratory, where Thomas Tilbury, M.D. — who she’s known for 30 years — opened the obstructed artery with balloon angioplasty.

“It’s a challenging procedure in SCAD patients, because there’s a risk the artery could tear further,” Dr. Tweet says. Before attempting the procedure, she and Dr. Tilbury consulted with two additional colleagues to determine the best treatment option for Kristin.

“That is just how Mayo is,” Kristin says. “Everyone gets together to figure out what’s best for each patient.” 

Gaining new perspective

After the procedure, Kristin spent four nights in the hospital recovering. She also completed three months of cardiac rehabilitation, learning how to safely return to exercise. She says being on the other side of the bedside was an enlightening and rewarding experience.

“I was so blessed to receive the care I did,” she says. “Everyone I encountered was so kind. I’ve always been very proud to work at Mayo Clinic and have always believed we give outstanding care. But I have a new understanding of that now.”

She believes the experience also increased her ability to connect with her patients.

“I was sympathetic, but now I truly understand the fear that patients may have,” she says. “I think I can relate better to some of my patients now, and that’s also been a blessing.”

For years, spontaneous coronary artery dissection was believed to be exceedingly rare. Until 2010, Mayo Clinic saw just 10 patients a year with the condition. But as awareness has grown, thanks in large part to survivors who became advocates, more people have been accurately diagnosed. Today Mayo’s SCAD clinic sees more than 10 patients each month. It’s a group that shares many similarities.


“Kristin is like so many SCAD patients. She’s a model of health and very active. She’s not a ‘typical’ heart attack patient.” — Marysia Tweet, M.D.


“Kristin is like so many SCAD patients,” Dr. Tweet says. “She’s a model of health and very active. She’s not a ‘typical’ heart attack patient.”

That’s part of what can make the condition so difficult to diagnose. When relatively young, healthy women like Kristin come to emergency departments with chest pain, providers may dismiss the symptoms or attribute them to something other than a heart issue. And like Kristin, patients themselves may not realize their symptoms reflect a heart attack and delay seeking care.

Dr. Tweet and her colleagues including Sharonne Hayes, M.D., Rajiv Gulati, M.D., Ph.D., and Tim Olson, M.D., hope their research will help change that. They’re studying data from the ongoing Mayo Clinic SCAD Registry and Biorepository. It currently has over 750 SCAD patients enrolled from around the world. The group has published more than 25 papers on the condition since 2011 in the hope raising awareness among both patients and providers. And they continue to study the data, with a goal of discovering new and better ways to treat and prevent the condition from occurring or recurring. Between 12 to 29 percent of people diagnosed with the condition experience it again.

“I don’t plan to be among them,” Kristin says.

Reflecting on lessons learned

Instead, Kristin plans to return the life she lived and loved. “I want to go back to the person I was,” she says. And she’s well on her way. She’s returned to work and to running, even completing a half marathon in August.

“It feels wonderful to run,” she says. “I’m not as fast as I used to be, but that’s OK.”

Some other things about Kristin have changed as well.


“Denial is a very strong emotion. I thought I was healthy. I thought I was invincible. But we are not invincible. Anything can happen to anyone. I want to tell women to listen to their bodies.” — Kristin O’Meara


“I’ve learned it’s OK to have downtime to sit and think and read and pray,” she says. And when she does take time for reflection, she often gives thanks for “the guardian angel that was with me that day.”

Kristin hopes her story will help other women who might find themselves in her shoes.

“I knew something wasn’t right,” she says. “But denial is a very strong emotion. I thought I was healthy. I thought I was invincible. But we are not invincible. Anything can happen to anyone. I want to tell women to listen to their bodies.”

Kristin says she’s grateful for the chance to be able to continue to listens to hers. “When I wake up each day,” she says, “I really do thank God for another day.”


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Fri, Sep 8 9:41am · Breathing Easier After Nose Reconstruction Surgery

Plagued by breathing problems and unwanted changes in her appearance, Diane Kolmer turned to Mayo Clinic for diagnosis and treatment that included reconstructive surgery. Now she's back to looking and feeling like herself again.

Plagued by breathing problems and unwanted changes in her appearance, Diane Kolmer turned to Mayo Clinic for diagnosis and treatment that included reconstructive surgery. Now she’s back to looking and feeling like herself again.


Twenty-one years ago, when Diane Kolmer began her battle with multiple sclerosis (MS), she came to Mayo Clinic looking for answers about the progression of her disease. She worried about how it might limit her ability to continue her work as a lobbyist and do the other things she enjoyed.

In 2014, she returned to Mayo Clinic’s Rochester campus for another significant concern. Her left nostril became deformed, and she was having a hard time breathing. That visit eventually led to surgery to relieve her symptoms and reconstruct her nose with the hope of feeling and looking like her old self again.

“Of all the things I had done at Mayo, this was the most life-changing,” Diane says. “I’ve had so many physical and emotional losses from MS. This was one thing that was reversible, and that meant a lot.”

A long-awaited diagnosis

When Diane noticed she was having trouble breathing through her nose, she went to a number of physicians in her hometown to find the source of the problem, with no luck.

“It felt like I had a football in my nose,” she says. “I had seen every type of doctor in Des Moines, Iowa, to try to figure it out. But after four years, I finally called Mayo Clinic to see if someone there could provide a diagnosis.”


“I’ve had so many physical and emotional losses from MS. This was one thing that was reversible, and that meant a lot.” — Diane Kolmer


After meeting with physicians in Mayo’s Department of Otorhinolaryngology, Diane was diagnosed with trigeminal trophic syndrome. A rare disease, it can cause breakdown in facial tissue as a result of damage of the face’s trigeminal nerve. Her care team told Diane that the disorder may have developed as a side effect from stereotactic radiosurgery, a procedure Diane had years earlier to get rid of excruciating face pain.

Initially, Diane’s doctors decided to keep a close eye on her condition during follow-up visits every six months. Unfortunately, discomfort turned into deformity.

“I started having an indentation on the side of my nose and tissue had been forming underneath it,” she says. “It looked like I didn’t have a left nostril.”

A chance to look and feel better

Diane Kolmer shown before surgery.”

Diane Kolmer shown before surgery.

Diane’s condition led to other issues, as well. She was hospitalized four times in 2016 for pneumonia. She had a constant headache and looked like she had a sneer on her face all the time. In December of that year, Diane was referred to Grant Hamilton III, M.D., a Mayo Clinic facial plastic and reconstructive surgeon.

Dr. Hamilton explained to Diane that she had a hole in her nasal septum — the thin wall between the nasal passages — and the condition had caused the lining in her left nostril to shrink.

“As that lining contracted, it distorted the outside of her nose and narrowed her nasal passage,” Dr. Hamilton says.

To correct this, Dr. Hamilton told Diane he could bring down the nostril and rebuild her nose using cartilage and skin from her rib and one of her ears. He also understood that the problem was affecting more than Diane’s physical appearance.

“Our faces are almost entirely what give us our sense of identity, and when something significantly changes that, it can profoundly change how we see ourselves,” he says.

“Dr. Hamilton was very curious and meticulous,” Diane says. “I could tell this was something he’s really cared about, and he was very invested in helping me.”

A breath of fresh air

Diane decided to move forward with the surgery, which was scheduled for March 9, 2017. During the procedure, Dr. Hamilton reconstructed the cartilage support structures in her nose.

“One of the things that was very unique about Mrs. Kolmer was that she was missing so much tissue,” he says. “After recreating the structure of her nose, there was a large skin defect on the inside, so I took cartilage and skin from her ears to fill that part in.”

Once the swelling went down after a few weeks, Diane could feel the difference.


“Dr. Hamilton was very curious and meticulous. I could tell this was something he’s really cared about, and he was very invested in helping me.” — Diane Kolmer


“I lay on my pillow thinking, ‘I can breathe. This is amazing,'” Diane says. “And I don’t have any more headaches.”

The positive changes the surgery has made for Diane reflect the goals Dr. Hamilton has in the work he does.

“Much of what we do in medicine is about quality of life,” he says. “One of the most rewarding aspects of what I do, and one of the primary reasons I chose this field, is to see the almost immediate improvement in people’s quality of life and demeanor. I wasn’t treating her nose. I was treating her.”


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Thu, Sep 7 9:10am · In Need of a Second Transplant, Remy Marceau Fights On

Four years after receiving a life-saving transplant, Remy Marceau was devastated when his body rejected the new kidney. Today he's using humor and hope to buoy his spirits as he waits for another transplant.

Four years after receiving a life-saving transplant, Remy Marceau was devastated when his body rejected the new kidney. Today he’s using humor and hope to buoy his spirits as he waits for another transplant.


Remy Marceau of Phoenix never expected to look back with such fondness on the four years after he received a life-saving kidney transplant at age 25. But at age 29, his body abruptly rejected the new kidney, and that’s the situation he finds himself in now.

As he’s once again among the ranks of more than 100,000 people in the U.S. on the transplant list, Remy is enduring another long wait. What keeps him going is the hope of a second transplant and another chance at a better life.

“I had the best four years of my life, and it’s possible I will get that back again,” Remy says. “All this, I hope, is temporary.”

A brief respite

As early as age 9, Remy experienced fatigue, dehydration and extreme muscle cramping. The diagnosis was a rare kidney disorder called Bartter’s syndrome. It causes the body to shed salt and water, requiring frequent infusions to replenish electrolytes and potassium.


“That first kidney transplant gave me my son back. He again was the Remy we all knew, who is such a gift in our lives.” — Janet Marceau


Remy’s disease progressed to a level where both of his kidneys had to be removed because they were no longer healthy enough to preserve his electrolytes and fluid. Still, he soldiered on. By age 25, Remy learned from his physicians at Mayo Clinic’s Arizona campus that a kidney transplant would be the best treatment for him, and they were right.

“That first kidney transplant gave me my son back,” says Remy’s mother, Janet, his most loyal advocate. “He again was the Remy we all knew, who is such a gift in our lives.”

The kidney rejection four years later stunned his family and friends. It also was a blow to Remy’s generous living kidney donor, whom he didn’t meet until the morning of his transplant surgery in November 2012. The donor, a Phoenix woman with a giving spirit, had seen a TV segment about Remy and his need for a kidney. Sensing that time was of the essence, she contacted Mayo Clinic and asked to be tested, with the stipulation that her healthy kidney would go to Remy Marceau. She was a match.

Soon after the transplant, Remy was alert and giving a thumbs-up, even though it was a complex surgery. The four-year respite Remy cherishes began right after that. He resumed his normal activities, including his job, athletic activities, travel, and time with family and friends.

A focus on the future

In March 2016, Remy’s life changed again as his medical condition declined, and he received the difficult news that his transplanted kidney was failing. His Mayo Clinic physician didn’t mince words, telling him, “Your kidney is on its last leg, and it’s time to get you listed for another transplant.”

The message rocked Remy’s world. Soon his life was centered on dialysis and plasmapheresis — where plasma is separated from blood to remove antibodies. Remy says he has received 160 bags of new plasma since his kidney began to fail. “Not that I’m counting,” he quips.

Complicating Remy’s life further, and causing additional stress, exhaustion and pain, has been a litany of surgeries he’s had to undergo since the rejection of the kidney. When asked how many, Remy jokes, “I can’t count that high.”


“To see more attention being brought to the critical need for organ donation, that is what encourages me.” — Remy Marceau


He underwent a number of surgeries on his chest to create ports for infusions and more procedures to remove scar tissue, as well as a fat graft to repair depressions in his chest. Because he has small veins, surgery was required to make a fistula for needles used in dialysis. It has also been challenging to bring blood to Remy’s hand because of his vein issues, which recently required three vein surgeries over a period of six days.

Remy is not a complainer, though, and humor gets him through the tough times. He admits he is weary from the multiple surgeries and undergoing dialysis three times a week, but he is adamant that people not define him by his illness.

“I could be negative, but it would be hard on my family — and the Mayo nurses,” he says. “To see more attention being brought to the critical need for organ donation, that is what encourages me. For now, I just fight through it.”

As a friend told Remy, “If attitude equaled health, you would be the healthiest man on earth.”


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Fri, Sep 1 3:36pm · From History Teacher to Heart Health Advocate

Collin Markum, shown walking on the beach with his family, was shocked to learn he had a rare cardiac condition that required open-heart surgery. Now after successful surgery and rehabilitation, Collin is working to help fund research and promote heart health.As a 37-year-old with no major medical problems, Collin Markum was shocked to learn he had a rare cardiac condition. Now after successful surgery and rehabilitation, Collin is working to help fund research and promote heart health.


By Collin Markum

It was early October 2016, and I was standing in front of my 11th  grade United States history class teaching when I began to not feel right. Even though I wasn’t exerting myself any more than usual, I could feel my heart racing. I also felt short of breath. I finished the period and then sat down between classes. I finished the day with a little less motion and at a lower volume than what was my typical enthusiastic manner.

I figured it was probably dehydration: I was uptalking. Or stress: Hurricane Matthew was scheduled to pass through the area in a few days, and we had not done our emergency supply shopping yet. I felt better when I was resting, so I thought surely it would pass.

I told my wife, Michelle, a nurse at Mayo Clinic who had worked for years in Cardiology, that I wasn’t feeling well. But I downplayed the effects. After all, I was only 37 and had never had a major health problem.


“He advised us to go to the emergency room immediately. Driving there I felt heavy anxiety, as this was clearly more serious than I had expected.” — Collin Markum


Due to the inclement weather, school was cancelled for the rest of the week. We opted to ride out the storm in our house in Green Cove Springs, Florida. I still had a few instances of breathlessness and an elevated heart rate. My wife thought I should go to the emergency room, but I didn’t feel terrible so long as I was at rest. That Sunday, Oct. 9, I taught a class at church even though I was drenched in sweat by the end of the lesson. Clearly, I needed to visit the doctor.

On Monday I saw my primary care physician who heard a heart murmur while evaluating me. He advised us to go to the emergency room immediately. Driving there I felt heavy anxiety, as this was clearly more serious than I had expected.

Upon arrival at Mayo Clinic’s Florida campus, I was admitted to the hospital, and a team of health care professionals attempted to identify my condition, which proved to be quite complicated. We would learn that I was in heart failure and had abnormal levels of heart, kidney, liver and thyroid function. On Tuesday, a series of tests revealed that the source of the problem was a sinus of Valsalva aneurysm — a rare cardiac aneurysm near the aortic valve.


“I believe it was a real team effort that helped me get on the road to recovery. Everyone from the nurses, respiratory therapists and physical therapists to the clinic staff was wonderful.” — Collin Markum


By this point family and friends had rallied to take care of our year-old son, so my wife could stay by my side. Though it was clear that open-heart surgery would be necessary, I was at peace. I knew I would have excellent surgeons, and I promised myself that I would be dedicated to rapid recovery and rehabilitation.

As a 37-year-old with no major medical problems, Collin Markum was shocked to learn he had a rare cardiac condition that required open-heart surgery. Now after successful surgery and rehabilitation, Collin is working to help fund research and promote heart health.Surgery was scheduled for the morning of Oct. 12. My cardiothoracic surgeons, Dr. Richard Agnew and Dr. Erol Belli, were incredible. The sinus of Valsalva aneurysm is in a difficult location for surgery, but their expertise and collaboration met the challenge. A day later, I was using a walker to roam the hallway outside my hospital room. I believe it was a real team effort that helped me get on the road to recovery. Everyone from the nurses, respiratory therapists and physical therapists to the clinic staff was wonderful and provided excellent care.

I was released home but found that the following weeks brought a challenge I hadn’t expected. How do you tell your toddler son that you can’t lift him when he wants to play? How do you just sit when there are groceries to be carried in? It was difficult. But at Michelle’s insistence, and with the help of family and friends, I followed the rest and five-pound lifting limits I had been given. And soon I experienced my favorite part of the recovery process: cardiac rehabilitation.

Having permission to exercise again was exciting, but the bonds I created with the other men and women working alongside me were inspirational. We had different scars, a wide age range and varying levels of complications to work through, but we were all doing our best. The encouragement and companionship we provided to each other made each session a joy. The trainers and medical staff in the rehab unit exhibited skill and passion in challenging each of us to exert ourselves while also accommodating our varying limitations and relative levels of health.

Based on my progress at rehab and checkups with Dr. Norm Patton, I was cleared to return to teaching when school started after the new year. My students and colleagues welcomed me back warmly. When the school year ended, I was able to catch up on some needed play time with my son over the summer. I continue to feel great. My stamina is back, and I’m looking forward to another successful academic year.


“My goal is to complete the 5K walk and raise funds that can be used for research and help others overcome cardiac disease and return to their families.” — Collin Markum


Although my active recovery is over, I resolved early on to find a way to give back to Mayo Clinic and to raise awareness and provide aid to others who may be in my situation. This year, I’ve opted to form a team to participate in the 2017 First Coast Heart Walk to raise money for the American Heart Association.

My family was my motivation to have a complete recovery and live a full, active life. My goal is to complete the 5K walk and raise funds that can be used for research and help others overcome cardiac disease and return to their families.


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Thu, Aug 31 4:57pm · 'Blessed With Life,' Cancer Survivor Vows to Live to the Fullest

Jane Thomson endured chemotherapy, radiation and surgery to treat cancer once in 2011 and again in 2014. Today she reflects on the experience with gratitude for her Mayo Clinic care team while anticipating a promising future.

Jane Thomson endured chemotherapy, radiation and surgery to treat cancer once in 2011 and again in 2014. She reflects on the experience with gratitude for her Mayo Clinic care team while anticipating a promising future.


Written by Jane Thomson

My name is Jane Thomson. I am 58 years old, have been married for 35 years, and have three beautiful children and three perfect grandchildren. I was fortunate to have been able to be a stay-at-home mom with my children throughout their younger years. I decided that once they were all in college, I would return to college myself. In September 2011, I had just graduated with a dental hygiene degree and was anxiously waiting for my license and actively looking for employment. That is when my life changed forever.

An emergency room visit revealed a diagnosis of cancer. The colonoscopy and CT scan revealed one tumor, and I was advised to consult with a local surgeon to have it removed. Knowing that cancer was evident in my family tree, my husband and I opted to pursue treatment at Mayo Clinic in Arizona. This is the best decision we ever made. The team of doctors at Mayo Clinic that would eventually guide my care would become an integral part in my life.


“I am convinced that had I not pursued a second opinion at Mayo Clinic, I would most likely not be around to tell my story.” — Jane Thomson


My initial consult was with Dr. David Etzioni, Colon and Rectal Surgery, who immediately determined that I had not only one tumor, but it had metastasized into stage IV cancer. I had a total of six tumors, including the original tumor diagnosed in El Paso, Texas, and five additional tumors in my liver. I am convinced that had I not pursued a second opinion at Mayo Clinic, I would most likely not be around to tell my story.

Dr. John Camoriano, Hematology and Oncology, came on board to initiate my treatment with aggressive chemotherapy, which was accompanied by many side effects. Although I was aware and was experiencing all the side effects, nothing prepared me for my hair loss, which was probably the most devastating to me. But no matter what the treatment involved, I knew that I was in the best hands, and I was determined to overcome this monster living inside me. The chemotherapy was very effective, making the original tumors virtually nonexistent by the end of treatment.


“Treatment is so different at Mayo Clinic. Their network and communication is impressive, which allows me the comfort of knowing I am in the best hands possible.” — Jane Thomson


A few years later, cancer did return, resulting in many other procedures, including six weeks of radiation, rectal resection with ileostomy, which was reversed, and wedge resection and microwave ablation of my liver, performed by Dr. Adyr Moss, Transplant Surgery.

Treatment is so different at Mayo Clinic. Their network and communication is impressive, which allows me the comfort of knowing I am in the best hands possible. I am not just a patient number, a shadow in the crowd. They truly care about my outcome.

I have been cancer-free since June 2014. I continue to be routinely monitored by the wonderful staff at Mayo Clinic. It is with the care of my doctors that I remain confident I will continue to be that miracle patient that cancer survivors all hope to be.

I am blessed with life! I live life to the fullest, enjoy my family, friends and work. I pray that I continue to be blessed with this miracle of life!


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