Wellstar Kennestone Receives Georgia Oglethorpe Award for Organizational Excellence

Robert Frederick was living a typical life, going to work and spending time with his mother, siblings and children. But then it became hard to breathe when walking short distances or climbing stairs. He got dizzy. Perhaps most disturbingly, he passed out several times—once at a Braves baseball game he attended with his siblings.

"I didn't know what was going on!" Robert recalled.

Difficulty controlling AFib with medication

After passing out the first time, he went to urgent care and was then taken to the hospital by ambulance. He learned his symptoms were caused by atrial fibrillation (AFib), an irregular heartbeat.

Robert began to see Dr. David Caras, a Wellstar general cardiologist, and learned AFib is related to high blood pressure. Successfully managing high blood pressure often helps people keep AFib under control. Despite their efforts, AFib sent Robert to the emergency room two more times.

Suspicion of HCM

Dr. Caras reviewed Robert’s hospital records and found he had increased wall thickness of the left ventricle and a gradient—a pressure difference between the left ventricle and the aorta when the heart pumps. These findings were consistent with a condition called hypertrophic cardiomyopathy (HCM). Characterized by abnormal thickening of the heart muscle, this disease makes it difficult for the heart to pump blood effectively.

Dr. Caras referred Robert to Dr. Melissa Burroughs, an HCM specialist at Wellstar. As a Center of Excellence designated by the Hypertrophic Cardiomyopathy Association, Wellstar is one of the leading providers of comprehensive HCM care in Metro Atlanta.

"We have physicians in the group—designated HCM specialists—that are the point person of the patient’s care," Dr. Burroughs explained. “This includes close communication and collaboration with electrophysiologists, surgeons, advanced heart failure specialists, social workers and behavioral health professionals.”

A rare finding leads to Mayo Clinic Care Network collaboration

Robert said, “Dr. Burroughs wanted to do genetic testing to verify that I had HCM."

But genetic testing revealed a rare genetic variant—one not known to be associated with HCM. Dr. Burroughs called it a “diagnostic conundrum.” The genetic variant found was typically associated with a different cardiac disease that Robert did not have. However, he did have clear signs of HCM.

To investigate further, Dr. Burroughs collaborated with other HCM experts through the Mayo Clinic Care Network, of which Wellstar is a member. Mayo Clinic, which is also an HCM Center of Excellence, provided access to its unpublished database, finding Robert’s rare mutation was present in two other family groups with HCM.

“It’s very important that we add to the science—that we include our patients in the registry to enhance what is already known about HCM,” Dr. Burroughs said.

Robert added, “Dr. Burroughs is very persistent. She wanted to know, ‘Why are you having these problems? What’s the root cause?’ She went above and beyond to find that out.”

If you have sleep apnea, waking up tired may be your norm. Even if you wear a CPAP every night, you might not get the good night’s rest you need. Thankfully, there’s a different option available.

Positive airway pressure (PAP)—CPAP and BiPAP therapy—is the most common treatment for sleep apnea. It pushes pressurized air through a mask to keep your airway open so you can sleep better. But it doesn’t work well for everyone.

“For years, countless patients who have been intolerant of CPAP or BiPAP therapy have had few options for treatment,” said Dr. Michael Vick, an otolaryngologist with Wellstar. “What we have done in the past has been painful and unpredictable.”

Fortunately, if you don’t respond to PAP therapy, there’s good news. Wellstar is a multidisciplinary Center of Excellence for Inspire Implants—the first with the designation in Georgia and the second in the country. This hypoglossal nerve stimulator can reduce sleep apnea without the bulky mask.

What is sleep apnea?

Sleep apnea is a sleeping disorder. It causes you to stop breathing off and on while you’re asleep. It can happen when something blocks your airway (obstructive sleep apnea) or if your brain doesn’t send the right signals to the muscles that control your breathing (central sleep apnea). Either way, your body doesn’t get enough oxygen.

To kickstart your breathing, your body triggers a survival reflex. The jolt wakes you up just enough for you to start breathing again. But it also breaks your sleep cycle, meaning you’re tired the next day. And without proper treatment, you can develop high blood pressure or other heart problems that can be life-threatening.

How is sleep apnea diagnosed?

You may have sleep apnea if you snore, wake up frequently at night or stop breathing when you sleep. An at-home or overnight in-clinic sleep test can diagnose you accurately.

At-home tests use a finger monitor to measure and record your airflow, blood oxygen level, breathing pattern and heart rate. We may suggest an in-clinic test called a polysomnogram if we think you have central sleep apnea. This test uses electrodes placed around your body to evaluate your arm and leg movements, blood oxygen level, brain activity, breathing, and heart and lung activity while you sleep.

Common treatments for sleep apnea

Oral appliances can treat mild sleep apnea, and surgery can address treatment-resistant sleep apnea. But two types of PAP therapy have long been the most common treatments for most people with moderate-to-severe sleep apnea:

• Continuous PAP (CPAP): A machine delivers constant air pressure through a mask to keep your airway open during sleep.
• Bilevel PAP (BiPAP): A similar machine uses a mask to deliver higher air pressure when you inhale and lower air pressure when you exhale.

More advanced sleep apnea treatment

PAP therapy is uncomfortable for many people. If it doesn’t work for you, an Inspire Implant can reduce your sleep apnea without the mask. The two-piece implant involves a sensor in your chest and a receiver that wraps around the hypoglossal nerve that controls your tongue.

Our ear, nose and throat (ENT) specialists partner with lung and sleep medicine experts to place the device. They perform a minimally invasive procedure that requires two small incisions. This outpatient surgery requires minimal recovery time.

Once in place, the implant works simply. When turned on at night, the sensor sends a signal to the receiver that gently stiffens your tongue and palate with each breath, so your airway does not become blocked—all without waking you.

According to Dr. Vick, Inspire has been a breakthrough for many patients who cannot tolerate CPAP or BiPAP therapy. While success rates can vary depending on individual health factors such as body mass index (BMI), Inspire generally delivers higher satisfaction, fewer complications and a more comfortable recovery than previous surgical options.

“With Inspire, we have a successful and convenient treatment option with a high patient satisfaction rate. While it is a surgically placed device, there is far less risk of complications and downtime than anything we have previously offered,” he said. “If you cannot tolerate PAP therapy, you should consider Inspire.”

Learn more about Inspire at Wellstar and find an ENT who’s right for you.