Michael E. DeBakey VA Medical Center - Houston, Texas

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New OR Hormone Testing Unwrapped at Houston VA

May 9, 2012

Braxton

“There are not many medical centers that even offer this operation. Out of the few that do, even fewer offer an intra-operational protocol,” said Staff Surgeon Carla Braxton, M.D., M.B.A., F.A.C.S. “Using this protocol, we are able to get test results back - not just the same week or the same day, but in the same hour so that real-time decisions can be made in the operating room.” Braxton with (from left) Laboratory Manager Rafael Andujar, Navy Veteran Clifford Schoeffler, and Pathology and Laboratory Section Chief Michael Ittmann, M.D.
PHOTO: MEDVAMC

HOUSTON - The Michael E. DeBakey VA Medical Center recently added a new intra-operative hormone test for parathyroid surgery patients.

The parathyroid glands are four small endocrine glands in the neck that produce the parathyroid hormone (PTH). Among other functions, these glands control the amount of calcium in the bones. Sometimes they produce too much PTH resulting in a condition called hyperparathyroidism. Too much PTH can lead to Vitamin D deficiency and chronic kidney disease and such symptoms as fatigue, depression, and bone pain.

A recent study suggests that 90 percent of individuals with hyperparathyroidism have only one diseased gland. Once the illness is properly diagnosed and the patient is scheduled for surgery, the surgeon’s challenge is to successfully find the diseased gland. A hormone test is performed in order to find the overactive gland.

“In the past when a patient needed a parathyroid hormone test, we had to send the blood samples to Oklahoma,” said Carla Braxton, M.D., M.B.A., F.A.C.S., a member of the MEDVAMC surgery staff. “Being able to do the test here while we are in the operating room allows us to do a much more focused operation and zero in on the parathyroid gland that is overactive.”

Along with specialized training, Braxton has extensive experience with the intra-operational technique of PTH testing in the operating room. Hired last September, she brought those unique skills with her to care for Veterans at the MEDVAMC.

“In November, our labs were able to get the machinery and the reacting chemicals in order to do parathyroid hormone testing here,” said Braxton. “At the same time, we were able to implement the intra-operative protocol I had developed at my previous hospital.”

These new techniques were immediately helpful to local Veterans. A Pearland Veteran, who was recently treated for hyperparathyroidism and had a small benign tumor removed from his parathyroid, was extremely pleased with the results.

“I was happy to know that there was a new technique available to help with my parathyroid surgery,” said Navy Veteran Clifford Schoeffler. “The surgery was very successful.  I am delighted with Dr. Braxton and the new ideas that she has brought to the Houston VA.”

The new intra-operative parathyroid hormone testing protocol is available for all patients whose health care practitioners suspect elevated parathyroid hormone levels. The MEDVAMC is one of only a handful of hospitals where this procedure is performed.

“This is a specialized diagnosis and a specific procedure,” said Braxton. “Relatively few medical centers offer minimal-access parathyroid surgery with intra-operative parathyroid hormone measurement. Using this protocol, we are able to get test results back – not just the same week or the same day, but in the same hour so that real-time decisions can be made in the operating room.”

“We strive to offer the latest, surgical techniques for our Veterans,” said Samir S. Awad, M.D., Interim Operative Care Line executive at the MEDVAMC and associate professor of Surgery at Baylor College of Medicine. "We are proud the Michael E. DeBakey VA Medical Center has talented and skilled doctors like Dr. Braxton.”

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Awarded re-designation for Magnet Recognition for Excellence in Nursing Services in 2008, the Michael E. DeBakey VA Medical Center serves as the primary health care provider for more than 130,000 Veterans in southeast Texas and provides some of the most complex care within the VA Health Care System. The DeBakey VA employs nearly 3,600 staff and is one of 49 institutions within the prestigious Texas Medical Center*, one of the largest health and research centers in the world. The DeBakey VA is home to a Post Traumatic Stress Disorder Clinic; Network Polytrauma Center; award-winning Cardiac and General Surgery Program; Liver Transplant Center; Epilepsy and Cancer Centers of Excellence; Substance Abuse Disorder Quality Enhancement Research Initiative; Health Services Research & Development Center of Excellence; Rehabilitation Research of Excellence focusing on mild to moderate traumatic brain injury; Mental Illness Research, Education and Clinical Center; $26.8 million Research and Development Program; and Parkinson’s Disease Research, Education, and Clinical Center. The hospital offers sophisticated, cutting-edge technology such as PET/CT imaging, the Evident™ microwave ablation system, a CyberKnife®, a Varian Trilogy linear accelerator, a Philips Wide Bore Computed Tomography Simulator, the OR•Control System, the Abiomed Impella 2.5 catheter-based heart pump, and the Sapien heart valve. For more than 60 years, the DeBakey VA has served as the primary teaching facility for our major affiliate, Baylor College of Medicine* and operates one of the largest VA residency programs in the nation. Each academic year, more than 2,179 students are trained through 194 affiliation agreements with institutions of higher learning. Including the outpatient clinics in Beaumont, Conroe, Galveston, Houston, Lufkin, Richmond, and Texas City, MEDVAMC outpatient clinics logged almost 1.3 million outpatient visits in fiscal year 2011.
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