Dec. 25, 2004

'Everything happens for a reason'
Throckmorton stronger after open-heart surgery
By ROB HOFFMAN
News Sports Reporter


   
    Tori Throckmorton never caught the clues that something was wrong.
    Not the severe headaches that occurred each month.
    Not the near total-exhaustion she felt several summers ago as a plebe after finishing a three-mile training run at the U.S. Naval Academy in Annapolis, Md.
    Not even during a medical exam during her junior year last February, one of the tests she had to pass before she could undergo her initial training as a Navy pilot that spring. Tests at that time showed that Throckmorton had a minor heart defect, but one that only seemed to affect the infirm. Not a 20-year-old who had nearly won a state swimming title as a member of Huron High School's swimming team in 2000. Or someone who had gone on to capture three straight Patriot League titles as a member of Navy's swimming team.
    Or someone that the doctors who performed the test eventually cleared to travel to undergo grueling flight training later that year.
    None of this entered Throckmorton's mind on the morning of April 19, the day her life came perilously close to collapsing.

The endless morning
    Sitting in her Ann Arbor home on a recent December afternoon, Throckmorton can remember nearly every moment of that fateful day. How could she not? Every second that elapsed seemed like an hour.
    She felt so helpless. So very helpless.
    So very unlike herself.
    She had gotten up at 6:30 a.m., and started walking toward the bathroom. She felt a little weak, but didn't think of it as anything more than a case of the early morning cobwebs. Heading to the sink, she washed her face and reached for the towel to dry off, only to nearly hit the wall. Locating a nearby chair, she took more than a minute to lower herself into it.
    "I couldn't shake off what it was," she said. "I didn't feel right. I didn't feel sick. I didn't feel hurt. I just
didn't feel right."
    Throckmorton's sense of alarm was further heightened when her roommate Tolu started heading out the door.
    "Bye, Tori. See you in a few minutes," she called out.
    Throckmorton wanted to respond. She wanted to say something. If just to let her roommate know that something was wrong.
    But she couldn't. Her ability to put her thoughts into words had suddenly vanished. The roommate left.
Slowly and clumsily, she was able to French-braid her hair and button her jacket for the daily formation at 7:30 a.m. The problem, she had gradually deduced, was focused on her right side, so she could accomplish both tasks by mainly using her left hand.
    Grabbing her hat and the wall at the same time, Throckmorton managed to make it outside. As she ascended a staircase, her right foot hit the top of every step.
    "You don't look well," a friend told Throckmorton as she arrived, just in time for formation.
    "Yeah, I don't feel right," Throckmorton just managed to say.
    For most Naval middies, formation at the Naval Academy is normally an extraordinarily simple exercise. It consists of 20 seconds of standing at attention, marching in place and sliding into the at-ease stance. But on that day, Throckmorton felt like she was going to fall over several times as she completed each move. Once again, she had to lean against a nearby wall when all the marching stopped.
    By this time, everyone knew that something was wrong with Throckmorton. She was urged to go to the student health clinic. Throckmorton initially resisted, thinking of the class project that she had to work on later in the day.
    But she relented.
    Admittedly somewhat terrified, Throckmorton wanted to know what the heck was wrong with her.
    Soon she would find out.

Diagnosing the problem
    Who knows how quickly Throckmorton's problems would have been diagnosed if all the right people hadn't been at the clinic or on campus that day?
    At the clinic, she ran into a doctor who knew her from the swim team and another who was aware of the problem detected during those tests back in February that had identified Throckmorton's heart defect. Quickly realizing the possible problem, they summoned a neurologist from National Naval Medical Center in Bethesda, Md., who just happened to be on campus that day.
    Their diagnosis: Throckmorton was having a transient ischemic event, the first step in a stroke.
    It all went back to the defect discovered that winter, a condition known as a "floppy heart wall." Something that affects one to two people out of every 100, the problem was that the wall separating the left and right side of Throckmorton's heart was too thin and had small holes in it. That morning, the walls had let a blood clot out of the heart where it had progressed to the brain. If it was not dissipated, it would cause a disabling stroke.
    Throckmorton was immediately sent to the Bethesda hospital, the top-flight medical center where the
president of the United States is treated. Doctors there were able to stop the stroke from happening.
    Afterward, she was given three choices: She could go on blood-thinning medication for the rest of her life, undergo a noninvasive procedure that would gradually correct the condition or undergo open-heart surgery to build up the wall. Of the three choices, only the last would give Throckmorton a chance to head into the wild blue yonder some day.
    "The only thing I've wanted to be in the Navy was a pilot," Throckmorton said. "I decided to give myself a chance."
    On May 24, a little more than a month after her near-stroke, Throckmorton went under the knife.

Recovery time
    Because of the invasiveness of the procedure, few surgeries disable a person as much as an open-heart
procedure.
    That certainly was true of Throckmorton, who was in the hospital for two days and "completely useless" for two weeks after that. Her diet mainly consisted of Saltine Crackers. She had a constantly gurgling chest tube coming out of her side.
    Her dreams of qualifying for July's U.S. Olympic trials had vanished. So did getting her traditional assortment of straight-A's in her 22 credits worth of spring classes. Instead, she would settle for a 3.0 grade-point average.
    When her parents drove her back to Ann Arbor, so she could attend her younger sister Margaret's graduation from Huron, they had to stop every hour.
    And she wondered: Would things ever get normal again?
    They did.
    Gradually. And completely.

Back at home
    She re-entered the water in late June and swam 400 meters, normally a negligible distance for a butterfly specialist such as Throckmorton. This time, however, she was exhausted.
    But the routine got easier. During the summer, she would bike from her home in northeast Ann Arbor to Fuller Pool, next to the Huron River, swim and then bike back. As days went by, Throckmorton's fatigue was replaced by a sense of accomplishment.
    Early in the summer, she went back to Maryland for a checkup and received good news: She was cleared to go to aviation training school in Washington that August. The one caveat was that, because of her stitches, she couldn't raise both arms over her head at once.
    So Throckmorton endured the entire battery of grueling tests for future Naval pilots, much like Richard Gere's character did in the film "An Officer and a Gentleman": Treading water for more than hour in full gear, swimming through obstacles and simulating high-altitude conditions in a hyperbaric chamber.
    Tori Throckmorton was indeed feeling quite normal again.

Getting stronger
    This fall, Throckmorton entered her final season as a member of Navy's swim team. One of only three Mids to have totaled more than 10 Patriot League individual and relay titles in her career, Throckmorton could capture the 100 butterfly and become only the second swimmer in league history to win four Patriot League titles in one event.
    At her first meet Oct. 16, she lost in the fly for the first time since her freshman year, but has won at every single meet since then.
    Now 21, she feels stronger today. Much, much stronger. The repaired heart has done wonders for her endurance.
    Which will serve Throckmorton well during the next few years, once she graduates from Annapolis. She'll attend two years of flight school in Florida and serve at least seven total years in the Navy.
    "Everything happens for a reason," she said of her ordeal. "I don't know the reason yet. But I think there's a few."
Rob Hoffman can be reached at rhoffman@annarbornews.com or (734) 994-6814.



August 11, 1998
Mary Greeley shows off telemedicine technology
By ROB HOFFMAN
Staff Writer
   If you were suffering from waxy build-up in your ears, Monday was not the day to be at the Iowa State Fair.
    Not at the Varied Industries building at least, where officials with Mary Greeley Medical Center were showing off their new membership in the Midwest Rural Telemedicine Consortium. Through two-way video technology, the consortium allows Mary Greeley's employees to "attend" medical lectures occurring in other parts of the state and may eventually allow the hospital to offer long-distance care to its remote patients.
    But the technology isn't always applied so practically. On Monday, it provided an extremely visual lesson about why you should always have listened to your mother when she told you to wash your ears. After an hour of lectures on health-care topics, Mary Greeley's consortium coordinator, Shaela Holtman, hooked up one of the two camera at the fairgrounds to an otoscope, the device that doctors use to see inside an ear.
    Finding volunteers among fair visitors who had stopped at the consortium booth, Holtman proceeded to poke the otoscope in their ears. Nearly every time she did, the 25-inch television screen in Ames exploded with images of yellow globules – pictures of ear wax magnified several times over.
    The display may have upset the stomach of more than a few of the dozen or so people watching in the hospital auditorium, 35 miles away from the fair in Des Moines. But to hospital officials, it was also a perfect example of the power of telemedicine, a new approach to solving the nation's rural health problems.
    Established four years ago by Mercy Hospital in Des Moines, the consortium has grown to include 30 hospitals and health-care organizations around the stare. Mary Greeley joined the consortium in March, shortly after the organization received a $2 million grant. Nearly $100,000 of that grant money was used to buy Mary Greeley's equipment – two cameras, a mobile production unit and a laptop computer that controls the camera.
    Mary Greeley has used the network to allow staffers to "attend" lectures in other parts of the state. And, starting next month, it will begin broadcasting its weekly seminars during which a neighboring McFarland Clinic physician talks to his colleagues and Mary Greeley employees about a current topic in health care.
     But the hospital still hasn't begun to hook up the network in a way that could have broader implications for its patients in remote parts of Iowa. Instead of driving 50 miles or more to see a McFarland specialist in Ames, a patient would be able to drive a shorter distance to a local hospital.
    A nurse or other health professional at that hospital would follow the McFarland doctor's instructions by taking the patient's heart rate or doing anything else that requires physical contact. Through two-way camera, the doctor can talk to the patient, view the patient's X-rays and even view probes such as the otoscope to find out what is wrong.
    "When people have tried it, they've been happy with it," Holtman said.
    There are still kinks in the system that need to be worked out. Although Mary Greeley officials point to the time and money a patient saves by not having to travel to Ames, a patient does wind up getting billed by two different health providers. Some insurance companies balk at that.
     "It's really evolving," said Kim Russel, Mary Greeley's president.
    Yet Mary Greeley official have high hopes that telemedicine will provide an answer for some patients.
    "We're hoping that it picks up and people see how useful it is," Holtman said.  
    As for the people with the earwax, they just wandered off. The demonstration Monday was only show and tell, not show and prescribe.


September 5, 1995
Bird dropping concerns may be exaggerated
By ROB HOFFMAN
Staff Writer
    Infectious disease experts say public health concerns over bird droppings in downtown Ames are greatly exaggerated.
    "It's not something I'd worry about in everyday life," said Dr. Patricia Quinlisk, epidemiologist for the state of Iowa.
    In giving tentative approval to cutting down 17 ash trees along Main Street last month, members of the Ames City Council said the city could be faced with a possibly "tremendous" health problem if the prime roosting spots for hundreds of nuisance birds aren't removed.
     A public hearing on the trees removal will convene at the Sept. 12 city council meeting before city officials can go ahead with the plans. The city is proposing to cut the trees down over the winter at a cost of $5,100.
     Assistant city manager Bob Kindred said council members base most of their concerns over public health on two memos prepared at their request several year ago.
    One contains a listing of the diseases associated with bird feces. In the second, a faculty member at Iowa State's College of Veterinary Medicine said his analysis of the droppings from Main Street's sparrow and starlings showed the presence of the bacterium Cryptococcus neoformans.
    The bacteria causes a serious fungal disease known as cryptococcosis. Both it and histoplasmosis – another fungal disease – are the most common illnesses associated with bird droppings.
    But Quinlisk said neither should be a major concern to Main Street pedestrians.
    Quinlisk said the bacteria – which is common to Iowa – only incubates if they are kept under soil several years and the soil is suddenly disturbed.
    That situation is unlikely to happen along Main Street, where most of the droppings are regularly washed away by rain.
    "It has taken a lot more than bird feces on the sidewalk," Dr. Quinlisk said of how the disease spreads.  
    For example, most recent outbreaks of cryptococcocis and histoplasmosis have been caused by the bulldozing of an area that once housed chicken coops and other domestic birds.
    Dr. Nate Ratnasamy, am infectious disease expert with the McFarland Clinic in Ames, said he has not heard of any local outbreaks of cryptococcocis and histoplasmosis.
    "If there was a problem, we would be seeing more cases of it," said Ratnasamy, who is unaware of any instances of either disease being reported to the 150-doctor clinic recently. "I don't get a sense that it's a big problem."
    Even if the bacteria is somehow ingested either accidentally or through direct contact with the droppings, the likelihood of developing the disease is minimal.
    The Atlanta-based Centers for Disease Control – in its three-page fact sheet on histoplasmosis – says "while infection is common, overt clinical disease is not." The CDC says as many as 80 percent of all Americans may be naturally immune to the disease.
    Although the CDC tracks about 40 infectious diseases on a regular basis, spokesman Tom Skinner said histoplasmosis is not one of them.
    "It's not a very common illness," he said.
    Quinlisk said only the elderly and those who are already ill are usually susceptible to coming down with that type of bacterial infection, which is characterized by respiratory symptoms, a general ill feeling, fever, chest pains, and a dry or nonproductive cough. The rare acute case can be fatal unless treated.
     "Most people who get cryptococcocis are people whose systems aren't working well," she said. "It's not a disease that occurs in people with working immune systems."
    Quinlisk said there's a basic reason why cryptococcocis and histoplasmosis aren't a more serious problem.
    Although humans have been known to contract disease from horses and other mammals, birds don't pose the same threat.
    "Birds are very different from humans," she said. "And they don't carry much that we can get."