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Kentucky Neuroscience Institute recognized for high-quality stroke patient care

The American Heart Association and American Stroke Association recently honored UK HealthCare’s Kentucky Neuroscience Institute (KNI) with the Get With The Guidelines-Stroke Gold Plus Quality Achievement Award and the Target Stroke Honor Roll Elite Plus Award.

These achievements recognize UK HealthCare’s commitment and success in adhering to the most current, evidence-based stroke treatment guidelines for stroke patient care and outcomes.

To receive the Gold Plus Quality Achievement Award, hospitals must achieve 85 percent or higher adherence to all Get With The Guidelines-Stroke achievement indicators for two or more consecutive 12-month periods. They must also achieve 75 percent or higher compliance with five of eight Get With The Guidelines-Stroke quality measures.

The Target Stroke Honor Roll Elite Plus recognition is given to hospitals that treat more than 75 percent of appropriate patients with clot-busting drugs within 60 minutes of arrival and more than 50 percent within 45 minutes.

The quality measures are designed to help hospital teams provide the most up-to-date, evidence-based guidelines with the goal of speeding recovery and reducing death and disability for stroke patients. They focus on appropriate use of guideline-based care for stroke patients, including aggressive use of medications such as clot-busting and anticlotting drugs, blood thinners and cholesterol-reducing drugs, preventive action for deep vein thrombosis, and smoking-cessation counseling.

Larry Goldstein, MD

Larry Goldstein, MD

“Comprehensive Stroke Center status reflects our capability to provide the most advanced care for patients with stroke,” said KNI Co-Director Dr. Larry Goldstein. “These awards further underscore the hard work of our multidisciplinary team of neurologists, neurosurgeons, emergency physicians, nurses, therapists and others to optimize care delivery for stroke patients right here in Lexington.”

2017 marks the seventh year that KNI has received Gold Plus designation. It is the only hospital in Lexington to have both the Get With The Guidelines Stroke Gold Plus and Target Stroke Honor Roll Elite Plus designations.

The KNI Stroke Center is also certified as a Comprehensive Stroke Center by The Joint Commission – its highest honor.


Next steps:

Bruce Smith

Facing permanent brain damage, patient turns to UK for unlikely answer: a liver transplant

In 2011, Bruce Smith sat in his office preparing to make handouts for a meeting, like any other normal work day. But when he sat in front of his computer, he suddenly realized something frightening: He’d lost all understanding of how to use the machine. Bewildered at the sudden lapse in cognition, he said his coworkers thought he was joking around.

“I finally said, ‘I’m serious!'” Smith said. “‘There’s something going on here.'”

That moment was the first of many “lapses” to come. Smith was a diabetic, and his doctors initially thought his mental fog episodes were due to low blood sugar. When that was ruled out, they suspected he might be suffering from a series of mini-strokes.

“It was like I was taking a trip but never leaving the farm, you know?” said Smith, who is from Belfry, Ky. “I was awake but always taking naps.”

It wasn’t until Smith was referred to UK HealthCare that he got a diagnosis: hepatic encephalopathy, a term used to describe the mental fog that accompanies severe liver failure and a common occurrence in patients in need of a transplant. The liver’s job is to filter toxins from the body, and when it fails, the toxins accumulate in the bloodstream and wreak havoc elsewhere.

The team at UK determined that Smith’s liver was failing due to non-alcoholic cirrhosis. Although neither of his parents had the disease, one may have been a carrier and passed the gene down to Smith.

After getting a second opinion from the Cleveland Clinic confirming the diagnosis, Smith opted to remain at UK to be listed for a transplant. Liver transplant patients are assessed with a score known as the Model for End-stage Liver Disease, or MELD, which measures the amount of toxins in the blood and determines the patient’s position on the transplant waiting list. The higher the MELD score, the greater the severity of the disease and need for transplant.

Making the case for a transplant

Smith’s MELD score remained relatively stable for the next four years. However, his mental function continued to decline. As Smith’s symptoms worsened, his doctors at UK referred him to neurologists at the Kentucky Neuroscience Institute, where they diagnosed him with a much more serious condition.

“Bruce started out with hepatic encephalopathy, but then developed hepatocerebral degeneration, an extremely rare form of brain injury,” said Dr. Malay Shah, director of the liver transplant program at UK. “The exact cause of this disease is unknown, but liver transplant is the only cure.”

Many symptoms of hepatocerebral degeneration closely resemble those of Parkinson’s disease. In Smith’s case, he had trouble with speech, gait ataxia (uncoordinated movement and problems with balance) and ever-worsening dementia. Smith says he was essentially home-bound. He was unable to return to work, often couldn’t go to church and avoided going out for fear of experiencing an episode.

“I was asking, ‘Why me, Lord?'” he said. “‘What’s going on?'”

Although Smith’s liver toxicity remained stable – thus keeping his MELD score lower than necessary to receive a transplant – Shah said he knew he needed to push harder for Smith to be transplanted as soon as possible. He wrote a letter of appeal to the United Network for Organ Sharing (UNOS), a nonprofit organization that manages the nation’s organ transplant system, making the case for the severity of Smith’s situation.

“I appealed to UNOS to make Bruce’s MELD score higher than his lab values would suggest because hepatocerebral degeneration needs to be treated with a liver transplant,” Shah said. “Without an expeditious transplant, this disorder becomes permanent and irreversible. At that point, a transplant would be contraindicated because of the permanent neurologic damage from the disease.”

Shah’s appeal was successful, and on Sept. 27, 2015, Smith got a call from UK just as he was arriving home from church. He and his wife packed up and headed to Lexington to prep for surgery.

“I had all this happiness, excitement,” Smith said. “But also the fright of undergoing a major surgery.”

At 2 a.m. the next morning, Smith received his new liver – and a new lease on life. Since his transplant, things have improved drastically. He recovered fully from the surgery, and he underwent physical and occupational therapy to build back his strength and improve some of the basic skills he’d lost during his illness.

“I had to relearn how to write straight,” Smith said. “I had to use a ruler to sign paperwork.”

Becoming an organ donor advocate

As a surgeon who sees firsthand what a difference a transplant can make in the lives of his patients, Shah is passionate about raising awareness for organ donation. He notes that part of his job is making sure patients understand the gift they’ve been given.

“Our patients rely on the generosity of others to have a second chance in life,” Shah said. “And that’s exactly what I impart on my patients prior to transplant – that they and I literally owe it to the donor and their family to do the very best we can to take care of that generous gift.”

One way Smith is using his gift is by educating others on his personal experience. He is now a member and ambassador for Kentucky Organ Donor Affiliates (KODA), the organization that runs the Kentucky Organ Donor Registry, educates the public on organ donation and honors those who have given the gift of life. He was recently featured on a billboard for KODA in Eastern Kentucky and says sharing his story is one thing he can do to honor his donor.

“What a selfless decision that person, or their family, made,” Smith said. “This is my way of giving back. Hopefully, it will get folks interested in becoming a donor and ultimately making a difference in someone else’s life.”

“Bruce is a wonderful patient and a great donor advocate for KODA,” Shah said. “It’s nice to see folks like him work with the organ bank to help educate others in their respective communities about how organ donation can help their neighbors.”

Although he is unable to work, Smith has returned to an active lifestyle that includes walking, performing and creating. He plays guitar as a hobby and gives lessons to those in his community. He has a small workshop behind his house, where he dabbles in woodworking and metalworking. None of these things would have been possible without the transplant he received a little less than two years ago.

But perhaps most importantly, he says, he lived to be able to hold his first grandchild, born just over a month ago, with a second grandchild coming next month.

“You push through death’s doors and go through what I’ve been through,” Smith said, describing his thoughts when he first held his grandchild, “and I just thank God that I’m alive to hold this little thing.”

Smith holding his newborn granddaughter -- his first.

Smith holding his newborn granddaughter.


Next steps:

UK student celebrates graduation one year after suffering strokes

Allison Couri graduated from UK May 5, but hers was more than the ordinary triumph over class loads and term papers. With the help of stroke experts at the Kentucky Neuroscience Institute, the Peoria, Ill.-native triumphed over health problems few 20-somethings face.

A little more than a year ago, Couri, then 21, came to the UK HealthCare Emergency Department complaining of headaches and dizziness. A CT scan identified that she had a stroke, and she was admitted to the hospital and assisted by the stroke care experts at the Kentucky Neuroscience Institute. Couri suffered more strokes, leaving her with a gait, slurred speech and blurry vision. She was diagnosed with lupus, which can lead to a rare complication called inflammatory vasculitis a condition marked by inflamed blood vessels that can also cause strokes.

After chemotherapy to treat her lupus, rehabilitation to address the effects of the strokes, and with the help of her service dog, Magnolia, Couri was able to finish her studies at UK and graduate. She plans to pursue a law degree.


Next steps:

Dr. Craig van Horne, director of the Deep Brain Stimulator Center at the Kentucky Neuroscience Institute, spoke about his aspirations and hidden talents.

Watch: 5 questions with neurosurgeon Dr. Craig van Horne

Neurosurgeon Dr. Craig van Horne came to Kentucky from Boston to pursue an idea: Could peripheral nerve tissue implanted in the brain reduce the symptoms of Parkinson’s disease?

Van Horne is the director of the Deep Brain Stimulator Center at the Kentucky Neuroscience Institute. He focuses his research on cellular and surgical therapies for Parkinson’s disease.

Deep brain stimulation, or DBS, is a surgical procedure that uses electrodes to stimulate areas of the brain, effectively overriding the damaged nerve’s electrical impulses and reducing many of the symptoms related to Parkinson’s disease. Van Horne is testing an experimental procedure called DBS Plus, which uses a patient’s own peripheral nerve tissue to prompt nerve regeneration and slow the disease process.

Van Horne says the teamwork and support at UK HealthCare – plus a healthy dose of Kentucky hospitality – fostered the atmosphere he needed to bring DBS Plus to fruition. (And having a lucky cap doesn’t hurt.)

Watch this episode of “Five Questions” to learn more about Dr. van Horne’s aspirations and secret talents.


Next steps:

Experimental treatment at UK targets Parkinson’s disease symptoms

About 14 years ago, Bill Crawford noticed a persistent twitching in one of his fingers that was interfering with his rehearsal time as the music pastor at Porter Memorial Church.

“It was driving me crazy,” the 57-year-old Lexingtonian said.

He’d noticed a few other things too, like weakness. He had mentioned it to his primary care physician, who ordered heart and lung function tests, but both were negative.

Finally, however, he was so weak that he could no longer ride his bike. “I just couldn’t seem to go,” he said.  So he made an appointment with a neurologist.

After a few minutes with Crawford, the neurologist asked him to return on Monday – and bring his wife, Lisa, with him.

On that dreadful day, the neurologist told Bill that he had Parkinson’s disease. At the time, Bill was just 44 years old.

“Obviously not what you want to hear,” he said. “But then I began to think of Michael J. Fox and all he had accomplished, and I thought I could do that too.”

Needing more than medicine

Eventually, though, the medicines that helped Bill control his Parkinson’s symptoms began to lose their effectiveness.

“There is no cure for Parkinson’s, and treatments we currently have at our disposal can only reduce symptoms,” explained Dr. John T. Slevin, a specialist at UK HealthCare’s Kentucky Neuroscience Institute, who began treating Crawford in 2006. “The disease progression inevitably overcomes the drugs’ capacity to alleviate the rigidity and tremor that are hallmarks of Parkinson’s.”

That meant that Crawford would go into what he called “full body charley horses” – sudden, painful involuntary spasms that left him paralyzed and lying on the floor for as much as 45 minutes.

“It was the pits,” Crawford said. Sometimes at the last minute he would be unable to conduct musical performances at church services, which was particularly disheartening. “I didn’t want to be a spectacle.”

It was then that Slevin suggested a treatment called deep brain stimulation, or DBS, and connected Crawford with UK HealthCare neurosurgeon Dr. Craig van Horne.

A new version of deep brain stimulation

Deep brain stimulation is a surgical procedure used to treat the problems associated with Parkinson’s disease. The procedure involves implanting electrodes into the brain that are connected to a small, pacemaker-like device implanted in the chest. These electrodes produce electrical signals that override the abnormal electrical impulses caused by the disease, which attacks and breaks down nerve cells in the brain.

The procedure isn’t suitable for everyone and requires thorough psychological testing and motion studies to ensure that a patient is ready for DBS.

“I wasn’t sure I would qualify,” Crawford said. “But I knew this was my last chance.”

Crawford considers it a blessing that he was, in fact, qualified to receive DBS. But then came an additional surprise: After further testing, van Horne told Crawford that he was qualified to participate in a study for a new version of DBS called “DBS Plus.”

The central nervous system – which comprises the brain and spinal cord – is unable to heal itself after injury or disease, van Horne said. However, peripheral nerves from the rest of the body are able to regenerate.

“Our study is designed to test whether taking a small part of peripheral nerve tissue and putting it in the brain would prompt healing in the areas of the central nervous system damaged by Parkinson’s,” he said.

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With DBS Plus, van Horne and his team (Greg Gerhard, PhD, and George Quintero, PhD) take a small piece of nerve tissue from the patient’s ankle and implant it in their brain.

Because the tissue is from a patient’s own body there are no concerns about rejection, and because the experimental treatment is applied during a procedure that was declared safe and effective by U.S. Food and Drug Administration almost two decades ago, DBS Plus is considered relatively safe with only minimal additional risk.

A marked improvement

Nonetheless, van Horne is cautious about the process of enrolling patients in the study.

“It’s more ethical, in my opinion, to wait until after a patient qualifies for the basic DBS before I tell them about my study,” he said. “I don’t want patients to elect to do DBS just because they want DBS Plus.”

And van Horne says he was thrilled that Crawford qualified for the study.

“When I met Bill for the first time, he was lying paralyzed on the floor in the treatment room,” van Horne recalled. “It was a startling and heart-breaking sight.”

Crawford received DBS Plus in August 2015. His family can’t get over the dramatic changes in his mobility.

“I’m climbing ladders now, I can plan our church’s worship time, I can lead the services, I can still lead others in worship,” he said.

The charley horses have gone away, and Crawford now takes just one or two pills a day, down from 12 before the surgery. A before-and-after video of Crawford walking the halls outside van Horne’s office is astonishing.

Promising results

To date, 34 patients have participated in the DBS Plus study with encouraging results.  Of the 17 patients that are 12 months out from their procedure, 65 percent of them have shown a clinically important improvement in motor performance as a result of the graft.

Van Horne is quick to point out that the study needs to be tested on a larger sample size at many other medical centers around the country before it can be deemed a viable treatment. Furthermore, he cautions, while 12-month results are promising, it’s important to evaluate effectiveness over a longer term. But assuming all goes as well as it has so far, DBS Plus shows promise as a means of slowing down the disease process.

Van Horne and his team garner no financial benefit from DBS Plus, which adds just a fraction of cost to the DBS surgery that is already covered by most insurance plans.

“Our payback is the gratification we receive in seeing our patients do well,” van Horne said.

Crawford understands that DBS Plus isn’t a cure for his Parkinson’s, but is delighted to have a little more time to enjoy life.

“‘Feeling the beat’ is critical to my work as a musician, and my Parkinson’s had begun to take that away from me,” he said. “I couldn’t even snap my fingers with the music anymore.”

But as he woke up from the surgery, Crawford said he instinctively began to tap his fingers like a metronome. Two members of the team, Julie Gurwell, the physician assistant responsible for programming the DBS equipment, and Ann Hanley, a Parkinson’s patient who personally accompanies patients through their surgeries, were sitting with him, and they asked him what he was doing.

“I was too emotional to explain but I managed to say ‘I can feel the beat.’ And they high-fived each other,” Crawford remembered.

“I just knew God had answered my prayers.”

Media inquiries: Laura Dawahare, UK Public Relations, laura.dawahare@uky.edu.


Next steps:

  • The promising results of Dr. van Horne’s DBS Plus treatment were recently highlighted in the Louisville Courier-Journal. Read the story here.
  • Learn more about the UK Movement Disorders Clinic, which provides specialized treatment for patients with a range of conditions and diseases including Parkinson’s, dystonia and Huntington’s disease.

UK chaplain returns to work with renewed spirit following cycling accident

Exactly five months ago today, Laura Babbage had a devastating accident while biking through the French Alps with her 22-year-old son Brian.

Babbage, a chaplain at UK HealthCare, suffered a traumatic brain injury during the accident, which required months of treatment and rehabilitation. With the help of her care team at UK HealthCare and the prayers of friends and family, Babbage has returned to her work more than six months ahead of doctors’ estimates.

Babbage’s accident happened in France, she was airlifted back to Lexington and was treated at UK HealthCare. She completed her inpatient and outpatient rehabilitation at Cardinal Hill Hospital.

Babbage knows that many of her UK HealthCare family know her story, because she has heard of the many staff who prayed outside the door of her ICU bed and has delighted at the numerous people who’ve stopped her in the halls with a “welcome back!” smile or a hug.

“I’m overwhelmed by how much people rooted for me,” Babbage said. “There was an ocean of prayer entire churches I’d never heard of were praying for me. And I believe prayer, in all its forms, does matter.”

Read Babbage’s open letter of thanks to the UK doctors, nurses and staff who cared for her.

Using her experience for others

Since her return to chaplaincy about two weeks ago, Babbage has gone about her work with the grace and empathy that all who know her recognize: She is a patient and willing listener, she is trained to develop a relationship of trust without judgment and to add dimension to the skilled care provided by physicians and staff.

While Babbage acknowledges that, at least in the beginning, this ordeal was easiest on her – “I don’t remember a thing, but my family was sorely tested,” she said – she knows that this experience will help her do her job better.

“I am always aware of and sensitive to the desire for a visit from a chaplain as well as for prayer,” she said. “Chaplains are a listening presence for patients and families to help them begin to make sense of their situation. We are available for prayer if requested. Often we simply meet someone in the midst of their pain and suffering, aware of this special privilege.

“But now I have a deeper appreciation for families and their experience with their ill or injured family member since I’ve returned to work,” she explained. “Chaplains listen far more than we talk, allowing time and space for families to grasp the gravity of the moment. I have a heightened tenderness for family members now that I recognize what my own family experienced during my hospital stay. Like other chaplains, I will continue to learn.”

Returning to the patient’s bedside

Babbage and Joe Alverson, UK HealthCare’s director of pastoral care, were very careful to make sure she was prepared to meet and address patient and family needs.

“We wondered what would happen if I was needed to minister to a patient or family who’d experienced a trauma similar to mine,” Babbage said. “But we’ve been trained to eject ourselves from any situation if necessary – sometimes you’re not the right person for that patient, and sometimes they don’t want you there at all.  I felt I’d still be able to do that.”

Alverson remembers the shock and disbelief he felt when he learned that “one of our own” was in serious trouble.

“My first thought was for her – and my second thought immediately after that was for her family,” he said.  “As chaplains we see the sickest of the sick, and her condition was a huge worry for us.”

The pace of Babbage’s recovery was “beyond belief,” Alverson said.

“The first time I saw her was after she’d completed inpatient rehab at Cardinal Hill in September, and the first words out of her mouth were ‘When can I come back?'” he said. “I was excited for her, for me and for the hospital as well.”

Alverson knows that Babbage will make good use of her experience as she continues to care for others.

“We work in the midst of trauma and chaos every day, but to actually live that makes it more real,” he said. “I really look forward to seeing how her experience changes the trajectory of her work, but regardless of the exact path, I know it will be a good one.”

“We’re just thrilled to have her back.”

Media inquiries: Laura Dawahare, University of Kentucky Public Relations and Marketing, laura.dawahare.uky.edu


Next steps:

  • Learn more about Pastoral Care at UK HealthCare, where our chaplains are available to help patients, families and staff deal with spiritual and emotional challenges associated with medical events and crises.
  • The world-renowned doctors at UK Neurosurgery provides diagnosis and management of a wide range of conditions involving the brain, spine and nervous system. Learn more about the care we provide.
Carlee with Dr. Jessica Lee

Advanced medicine saved her life. This is how she said thank you.

Courtney Wilson’s life very nearly ended in 2013. She credits Dr. Jessica Lee and the stroke team at UK HealthCare with saving her.

The 30-year-old preschool teacher’s assistant from Russell County awoke one morning “feeling awful,” she said. She dropped her 2-year-old off at daycare and took her 5-year-old to school, then popped into the school nurse’s office for advice.

“All I could tell her was that I felt really bad and that my balance was off,” said Courtney.  “The nurse drove me to the Emergency Room right away.”

At Russell County Hospital, emergency room doctors examined her carefully but could find no other symptoms to explain Courtney’s troubles.  They consulted with Dr. Lee, director of UK HealthCare’s Stroke Center, who advised them to administer the clot-buster drug called TPA and send Courtney immediately to UK Chandler Hospital.

Lee and her team from UK’s Kentucky Neuroscience Institute were similarly confused by Courtney’s mysterious lack of neurological deficits.  But Comprehensive Stroke Centers like the one at UK HealthCare follow specific procedures when evaluating possible stroke patients. So, as part of UK’s routine screening process, Lee ordered a CT angiogram, which provides doctors with images of the vessels that supply oxygen-rich blood to the brain.

“When we pulled her scan up on the screen, it was shocking news,” Lee says. “We were stunned.”

Courtney had a thrombus — a blood clot — in what’s called “the artery of life.” This artery is the superhighway of arteries, serving areas of the brain that control heartbeat and breathing. Courtney was on the precipice of a massive stroke.

“I literally ran to her hospital room,” remembers Lee, “and sure enough, she was deteriorating before my eyes.  We absolutely scrambled from there.”

UK is fortunate to have a “dream team” trained to handle emergencies like this one.  Dr. Abdulnasser Alhajeri is an interventional neuroradiologist — one of only about 300 in the U.S. — and Dr. Justin Fraser is an endovascular neurosurgeon. Both doctors are able to navigate tools such as tiny catheters, wires and other devices through blood vessels to diagnose and treat illnesses of the spinal cord and brain — also known as the central nervous system. Because this requires only a tiny incision in the groin instead of the larger incision necessary for open surgery, hospital stays and recovery times are faster, complications are less likely, and patients can return home to their families more quickly.

But, in what Lee describes as “the perfect storm,” both Drs. Fraser and Alhajeri were in other operating rooms on separate cases.

Time for Plan B.

Lee assembled a second surgical team to perform the preliminary phases of the procedure. “I didn’t even wait for transport to come get Courtney,” says Lee.  “Our Stroke Unit senior staff and I took her to the surgical suite ourselves.”

Then, as if choreographed, Dr. Alhajeri stepped from one room to the next and began to work on Courtney. Using high-tech precision imaging to watch its progress, Alhajeri positioned the catheter in Courtney’s brain, attached a large syringe-like device and sucked the clot out, reopening the vessel in just 15 minutes. “It was like watching the pneumatic tube at the bank drive-in,” said Dr. Lee.  “Whoosh!  It was gone.”

“Courtney is a lucky young woman for many reasons,” says Alhajeri. “The doctor in the Russell County Hospital ER had the foresight to call our stroke team despite Courtney’s lack of major symptoms.  The TPA they gave her delayed her decline and bought us some time to perform the thrombectomy.”

“She is also fortunate that UK has the resources to treat her. The next closest center that might have been able to treat her was an additional 90 minutes away.  She didn’t have 90 minutes to spare.”

Since her illness has an 80-90 percent mortality rate, the mere fact that Courtney is alive today is a wonder.  But the best part?

“The very few who survive this devastating event typically are left with substantial impairments, such as vision problems, the inability to speak or swallow, or complete paralysis,” says Lee. “But Courtney’s only residual deficit is some double vision on her far left gaze. We’re truly thrilled with her outcome.”

After Courtney’s close call, the Wilsons brought son Jaylynn into their family through adoption.

And now, just three years later, Courtney has yet another reason to feel blessed. On Sept. 1 of this year, she gave birth to a baby girl, who came into the world measuring 6 pounds, 11 ounces and  19.5 inches long.

Her name? Carlee.

“We are forever grateful for Dr. Lee and her medical staff,” wrote Courtney and her husband, Paul. “We wanted to honor her by naming our daughter Carlee.”


Next steps:

Making the Rounds with Dr. Gregory Jicha.

Dr. Gregory Jicha dishes on his past life as a chef

Making the RoundsIntroducing Making the Rounds, a new Q&A series where you’ll get to know the providers at UK HealthCare and what they’re like outside the lab and clinic. For our first entry, we spoke with Dr. Gregory Jicha, a clinician and researcher at the UK Sanders-Brown Center on Aging.

Dr. Gregory Jicha

Dr. Gregory Jicha

What was the last movie/book you saw/read?

I never read books because I read medical journals, and that requires all of my time. I have not read a book for fun since I was an undergraduate. Now, what’s the last movie that I watched? I watched “Harry Potter and the Deathly Hallows” with my children.

Do you have an ideal vacation destination?

Yes, any tropical island with palm trees that have coconuts. You have to pick up the fallen coconuts to knock the ones that are ripe – that’s how the locals do it!

Do you have a favorite type of exercise or fitness?

Nope. I see patients from 8 in the morning until 5 every night, whether it’s in clinic or in the research enterprise. So all of my papers and my grants have to be written after hours and on the weekends. With that being said, it’s a passion. Although, by God, I need one of those tropical vacations.

Do you have a favorite type of food that you like to eat?

I like all types of food. As a matter of fact, in a past life, I was a chef. I worked in a quaint restaurant – one of those historic landmarks – the Blacksmith’s Tavern up in Connecticut, built in 1771. It was French continental cuisine.

I also worked with a Greek family opening up a whole series of restaurants throughout Connecticut, Massachusetts and Rhode Island, which I really enjoyed. You got to write the menus and not just come up with daily specials.

Do you like to cook at home?

Every now and then I have a break, and I say, “I just cannot do anymore work.” Then I ask my wife, “May I cook today?” And she says, “Oh, god.” Because I still have this habit, you know, when you work in restaurants, and especially when you’re the chef, you don’t clean up anything. You cut on the cutting board and all the scrap you just sweep with your towel! All over to the side, all on the floor, and then people sweep up after you.

So, I still cook at home that way, and my wife knows if I’m cooking for the day it’s going to be wonderful food, but she’s going to be spending two or three days cleaning up.


Check out this video to see Dr. Jicha discuss how he helps patients as both a clinician and a researcher.


Next Steps

Treatment options for patients with drug-resistant epilepsy

Treatments available for drug-resistant epilepsy

Written by Dr. Frank Gilliam, director of the Epilepsy Center at the Kentucky Neuroscience Institute at the University of Kentucky. 

Dr. Frank Gilliam

Dr. Frank Gilliam

One in 26 people will develop epilepsy – a chronic disease characterized by unpredictable seizures — in their lifetime.

A seizure is a sudden surge of electrical activity in the brain that can temporarily change how a person thinks or behaves. Seizures can be scary for both the patient and the people around them, since patients can lose awareness or even become unconscious, twitch or spasm, babble, have blurry or no vision, experience difficulty breathing, and/or a host of other symptoms.

Epilepsy has numerous physical and emotional costs. People with epilepsy have problems keeping up in school or at work, can be depressed and/or socially isolated, can suffer physical injury during a seizure, and can even die from a seizure. They may not be allowed to drive, play sports or have other restrictions that affect their professional or personal lives.

It’s important to remember that not all seizures are epilepsy. A person is diagnosed with epilepsy if they have one or more seizures that were not caused by some known and reversible medical condition such as diabetes. People can develop seizures after a brain injury (like a car accident or getting hit in the head with a baseball), a stroke, or because of an infection or a brain tumor. Sometimes there is a family history of seizures, but often the cause is unknown.

If you suspect you have had a seizure, you should see your family doctor or a neurologist for an evaluation. That is likely to include a detailed conversation about what happened during your seizure, medications you are taking, preexisting illnesses or injuries, family history and more. The doctor is also likely to order blood tests that might identify treatable medical disorders, an EEG, which measures brain waves and looks for abnormalities that point to epilepsy or other neurological disorders, and possibly also a CAT scan or MRI to look for abnormal areas of the brain.

There is no cure for epilepsy, but two-thirds of all people with epilepsy are able to control their seizures with medications. The remaining one-third have what’s called “drug-resistant” or “refractory” epilepsy. In those cases, patients may be able to find relief through surgery or through devices that can help override the abnormal electrical impulses in the brain.

In the U.S., there are more than 100,000 patients who are candidates for epilepsy surgery, and only about 2,000 people have the surgery every year. Patients don’t need to suffer from the physical and emotional effects of epilepsy for 10 or 20 years. If someone has uncontrolled epilepsy for more than a year, they should seek an opinion at an accredited epilepsy center.


Next steps:

UK Albert B. Chandler Hospital

KNI Stroke Center awarded for high-quality patient care

UK HealthCare’s Kentucky Neuroscience Institute (KNI) has received the Get With The Guidelines – Stroke Gold-Plus Quality Achievement Award by the American Heart Association/American Stroke Association for maintaining nationally recognized standards for the treatment of stroke patients.

KNI also received the association’s Target: Stroke Honor Roll Elite for meeting stroke quality measures that reduce the time between hospital arrival and treatment with the clot-buster tPA, the only drug approved by the U.S. Food and Drug Administration to treat ischemic stroke.

Over 12 months, at least 75 percent of the hospital’s ischemic stroke patients received tPA within 60 minutes of arriving at the hospital (known as door-to-needle time). Stroke patients who receive tPA within three hours of the onset of symptoms may recover more quickly and are less likely to suffer severe disability.

This year marks the sixth year that KNI has received Gold Plus designation. KNI has been named to the Target: Stroke Honor Roll the past three years and repeats for the ‘elite’ level that was introduced last year.

Kentucky patients aren’t the only ones benefiting from this achievement.

“By participating in the Get With The Guidelines-Stroke program, we are able to share our expertise with other member hospitals around the country, including access to the most up-to-date research, clinical tools and resources, and patient education resources,” said Dr. Jessica Lee, medical director of the KNI Comprehensive Stroke Center.

Dr. Larry Goldstein, chair of the UK Department of Neurology and co-director of KNI, said that “Comprehensive Stroke Center status reflects our capability to provide the most advanced care for patients with stroke. These awards further underscore the hard work of our multidisciplinary team of neurologists, neurosurgeons, emergency physicians, nurses, therapists and others to optimize care delivery for stroke patients right here in Lexington.”

According to the American Heart Association/American Stroke Association, stroke is the number five cause of death and a leading cause of adult disability in the United States. In Kentucky, cardiovascular disease (which includes stroke) is the leading cause of death.  On average, someone suffers a stroke every 40 seconds; someone dies of a stroke every four minutes; and 785,000 people suffer a new or recurrent stroke each year.

The KNI Stroke Center is also also certified as a “Comprehensive Stroke Center” by The Joint Commission – its highest honor.