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Healthy Lifestyles Online – August 11 Edition

Posted on August 11, 2015

LeConte’s Healthy Lifestyles is a health and wellness publication printed twice a month in local newspapers serving Sevier County and South Knoxville. And here online! We hope you find this information healthful.

Table of Content

A Dream Come True
Dolly Parton Birthing Unit: Putting Families First
Vertigo Gone in Two Sessions
Get Steady
LeConte Medical Center Therapy Services
Gamma Knife Pinpoints Cancers in the Brain
Brain Surgery without the “Surgery”
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A Dream Come True

Dr. Schnegg is Happy to be in the Hills of East Tennessee

Laura Schnegg, Md
Laura Schnegg, MD

There aren’t many doctors around who started practicing medicine earlier than Laura Schnegg, MD. Dr. Schnegg, now an OB/GYN at the Dolly Parton Center for Women’s Services, began seeing patients when she was just five years old.

“I had one of those black toy doctor bags,” says the Ohio native. “I would set up all my stuffed animals, they would have little doctor appointments, and I would put bandages on them and write them prescriptions.”

It was the first indication of things to come. What caused a little girl to be so fascinated with being a doctor? Dr. Schnegg may have been partially influenced by her own family doctor, a physician she describes as being like the movie character Patch Adams. “A lot of kids are afraid of the doctor, but I never was,” Dr. Schnegg says. “I thought it was kind of a fun thing to go to see him.”

As she got a little older, Dr. Schnegg became the one to call in her family whenever a volunteer was needed to help care for relatives who had become sick or were injured. “I really enjoyed caring for them,” Dr. Schnegg says, “and I never got grossed out!”

So patients who see Dr. Schnegg can be assured that she has a genuine and near lifelong gift for helping others. It’s no surprise that family and friends told her early on that she should become a nurse. Dr. Schnegg thought that was a fine idea, until she began to realize that she had a natural knack for academics, and especially science.

“I should be a doctor,” she told herself one day. That’s where her pursuit of medicine became real. Dr. Schnegg’s father helped research pre-med programs and medical schools. He found one that would allow her to attend two to three years of school as an undergraduate, and automatically be accepted to medical school if her grades were good enough, and if the score on her entrance exam for medical school was high enough.

“So when I interviewed for college, I was essentially interviewing for medical school right out of high school,” Dr. Schnegg says.

She was accepted into the bachelor of science and MD program, and attended undergraduate school at Youngstown University in Youngstown, Ohio. After just two years, she moved on to what is now Northeast Ohio Medical University.

Along with the many lectures and academic studies there, Dr. Schnegg had the opportunity to work with a doctor who specialized in internal medicine.

“He was such an influence for me,” Dr. Schnegg says. “You could tell he cared about his patients, and he was really good at explaining things, and educating them as far as what was going on with their conditions and illnesses.”

Dr. Schnegg knew that was the kind of doctor she wanted to be – one who was compassionate, yet efficient. One who could be “down to earth” and comforting, while also arming her patients with information so they would be “in the know.”

What better specialty practice that philosophy than obstetrics and gynecology?

“I feel like I’ve been a strong, independent woman, and I wanted to be an advocate for other women, to help women achieve independence themselves,” Dr. Schnegg explains. It is also important to her to offer nonjudgmental help so women receive more than just health care. She wants to be a person who will listen to their problems and who encourages women to ask questions without feeling embarrassed.

“And the obstetrics part of women’s healthcare is awesome,” Dr. Schnegg says with enthusiasm. “New life never, ever gets old – it’s a miracle!”

Realizing a Dream

Dr. Schnegg has loved this part of the country for a long time. Her family would sometimes vacation in the Smoky Mountains, and she’s an avid hiker.

But she had another reason to dream of working here. She says she was influenced by the TV series, “Christy,” which was filmed on location in the hills of neighboring Blount County.

“There was a doctor on the show who carried a black bag and went to people’s houses in Appalachia,” Dr. Schnegg recalls. “I thought he was the coolest ever, and I just knew that was what I wanted to do with my life.”

Dr. Laura Schnegg (right) vacationed in the Smoky Mountains with her family growing up. Here, she is pictured with her twin sister, Dr. Amy Schnegg, OD, who is an optometrist in San Antonio, Texas. Both remain avid hikers.
Dr. Laura Schnegg (right) vacationed in the Smoky Mountains with her family growing up. Here, she is pictured with her twin sister, Dr. Amy Schnegg, OD, who is an optometrist in San Antonio, Texas. Both remain avid hikers.

Coming to the hills and mountains of East Tennessee to work as a doctor is a combination of the two worlds Dr. Schnegg is most passionate about. For Dr. Schnegg, it’s a dream job.

“I’m finally doing what I want to do, and my dreams are coming true.”

One of Dr. Schnegg’s other passions is music. She is a classically trained pianist who also plays jazz. She is a twin, and she is working on obtaining her pilot’s license in the not-too distant future. Because she loves hiking, she plans to visit every national park in America, and has already visited several.

When women say they are too busy to go to the doctor, Dr. Schnegg can empathize. “Today’s women take care of others, and they have so many responsibilities like taking care of kids, or a fulltime career or cleaning the house or paying the bills. I often feel that women don’t take time out for themselves, and they sometimes let their health go.”

However, Dr. Schnegg says taking care of yourself that women must make their health a priority. “It’s definitely up to women to keep tabs on their health, come in with any questions, and take time out for themselves,” Dr. Schnegg says. “It’s up to you to make sure you are a healthy, well-rounded person.”

Dr. Laura Schnegg is now accepting new patients at LeConte Women’s Healthcare Associates, located in the Dolly Parton Center for Women’s Services. For more information or a physician referral call (865) 453-WELL (9355).

Dolly Parton Birthing Unit: Putting Families First

Personal attention and modern technology combine to make a memorable and pleasant birth experience.
Personal attention and modern technology combine to make a memorable and pleasant birth experience.

 Located on the second floor of LeConte Medical Center, the Dolly Parton Birthing Unit is a modern, comfortable, family-oriented facility, providing both personal attention and modern technology for a memorable and pleasant birthing experience.

The Birthing Unit houses two wings of patient rooms including our Labor, Delivery, Recovery and Post-partum (LDRP) suites and post-partum suites.

LDRP suites offer twin-sized sleeper couches for spouse or guest to sleep on, a high-back chair and a rocker glider that’s perfect for rocking baby.

The Dolly Parton Birthing Unit features a state-of-the art monitoring system for mom and baby’s safety. The security system will alert staff if a baby is taken anywhere outside of where it is supposed to be.

Expectant parents are encouraged to enroll in LeConte’s New Beginnings Childbirth Class offered by the Birthing Unit staff. New Sibling and Grandparent classes are also available upon request.

The Dolly Parton Birthing Unit not only meets the needs of new mothers, but also women of all ages. The Unit includes private rooms for patients who have received gynecological care and other women’s clinical services. For additional information about the Dolly Parton Birthing Unit call (865) 446-8210.

Vertigo Gone in Two Sessions

Patient Sees Quick Results at LeConte Therapy Services

When you were a child, did you ever spin around in circles, just for fun? If you did, you probably remember the giggles that followed as you and your friends stumbled through a world that seemed to be moving once you stood still.

It’s fun when it’s child’s play. But when you are an adult and you get a sensation that the world is moving around you for no apparent reason, it can be frightening.

Karole Tackacs experienced that sensation recently. “When I get up in the morning, I usually sit on the end of the bed and stretch my back a little,” she explains. “One day when I sat up in bed, everything was going around, and I thought, oh, my gosh, hold on!”

Tackacs sat still, waited, and the sensation passed. But throughout the day it came back every time she would stand from a seated position. “I hated to sit down because I knew when I got up it would happen again,” Tackacs says. “It was scary.”

Some adults mistake the sensation for a stroke, but Tackacs had already survived a stroke a few years earlier, so she felt certain it wasn’t a critical emergency. She simply dealt with it as best as she could as she went through her day, trying to sit carefully, and stand even more carefully.

“And bending over to pick anything up? Whoa!” Tackacs exclaims.

She managed her vertigo with an over-the-counter motion sickness medication for a little while, which helped the symptoms but didn’t solve the problem. After living with the spinning sensation for about two weeks, she decided to see her doctor. The doctor referred her LeConte Therapy Services, where therapists on staff specialize in fast, painless, effective treatment of the type of vertigo that Tackacs had.

“It’s called BPPV, benign paroxysmal positional vertigo,” says occupational therapist Lori Murphy. “Benign means it’s not going to hurt you, paroxysmal means it comes on fast, positional means it depends on which position you’re in, and vertigo is a spinning sensation of dizziness.”

Murphy says the way to tell that BPPV is likely what’s causing your vertigo is if you are experiencing more than just lightheadedness. It will give you a sensation that things around you are moving. Tackacs says that perfectly describes what she was experiencing.

“And it was like my brain was not moving when I was trying to walk,” Tackacs says.

BPPV can affect vision, impair balance and mobility, and result in falls. Murphy explains that it happens as a result of something going on in the inner ear.

“We all have rocks in our heads,” Murphy says, jokingly. “We have little, calcium carbonate crystals in fluid in the inner ear that help us maintain balance. The vertigo comes when those crystals get out of place.”

It’s very common for a patient to first experience BPPV in the middle of the night, or upon first waking up in the morning, like Tackacs did. “The crystals will have fallen out of place during the night while they’re lying down in bed. When they sit up, it hits,” she says.

Murphy says a person can’t always pinpoint a cause, but people who have migraines and allergy sufferers seem to be more at risk. Sometimes the cause can be an inner ear infection, or something as simple as a virus like a cold or the flu.

Because dizziness can be a warning sign for a variety of critical medical issues, it’s always wise to see a doctor about it. It’s just as important to have the doctor refer you to a physical or occupational therapist who specializes in the treatment of BPPV.

The best-case scenario is for BPPV to be treated early, because it can usually be cured more quickly. But even when it’s been allowed to go on for months, Murphy can usually help the patient improve in about three to six sessions.

For Tackacs, it only took two.

Through treatments consisting of simple and painless movements, occupational therapist Lori Murphy resolved Karole Tackacs’ BPPV in only two sessions.
Through treatments consisting of simple and painless movements, occupational therapist Lori Murphy resolved Karole Tackacs’ BPPV in only two sessions.

“For the first session, I turned her head to the right and helped her lie back,” Murphy says. “She got really dizzy.” At this point in the assessment, Murphy watches for the patient’s eyes to jerk, and Tackacs’ eyes did.

That was a strong indication of which ear was in trouble. Murphy then helped Tackacs turn to the other side, just to be sure.

“I went to the left side, and what a difference!” Tackacs says.

With the source of the problem targeted, Murphy was able to begin a treatment consisting of simple and painless movements to get the crystals back in place in the inner ear on the right side. “It’s like one of those games with a ball, and you try to move the maze to get the ball to go in the hole by tilting the maze,” Murphy explains.

Tackacs was instructed to sleep propped up with pillows for a few nights, and not to lie on her left side. Tackacs followed the occupational therapist’s instructions and by the second session the vertigo was gone.

“When she tilted my head again, there was nothing, no dizziness – she did it!” Tackacs says. “When she said, ‘That’s it,’ I couldn’t believe it!”

Murphy says the average length of treatment is three or four sessions. A patient may require more if crystals have moved into separate canals, or are deeply imbedded.

Tackacs is a believer in occupational therapy, and after using it to recover from both a stroke and shoulder surgery, she now has one more reason to believe. But she also wants other sufferers to know that the patient has to have an active role. She insists that doing the “homework” prescribed by the occupational therapist made a big difference.

“Normally I don’t follow rules,” Tackacs jokes. “But I knew I had to get this fixed because I have too many things I have to do.”

Most insurance plans cover physical or occupational therapy for BPPV, because the treatment is greater than 90 percent effective. If you are struggling with vertigo and your doctor diagnoses it as BPPV, ask for a referral to LeConte Therapy Services.

Get Steady

Many people silently suffer a very real, physical sense of instability. If something about the world seems off kilter, you may be suffering from a condition that can be easily treated. See your doctor if you are regularly experiencing any of the following:

Vertigo – A sensation of motion when nothing is moving.

Lightheadedness – A feeling that you are about to faint.

Disequilibrium – Feeling unsteady on your feet, or like you’re going to fall when you walk.

Anxiety – An overwhelming feeling of fear or depression that makes the world seem unsteady.

Karole Tackacs’ vertigo was cured in just two sessions at LeConte Therapy Services. She was referred there after a diagnosis from her doctor. For more information, or to find a referring physician, call LeConte Medical Center at (865) 453-WELL (9355).

LeConte Medical Center Therapy Services

Excellence in physical therapy is available right here in Sevier County with LeConte Therapy Services. Two convenient locations provide licensed therapists who specialize in physical therapy, occupational therapy, speech therapy, and sports medicine rehabilitation.

This means LeConte Therapy Services can help a wide variety of patients regain mobility and reduce discomfort or pain. This includes joint mobilization, hand therapy, and therapy to improve balance. Physical and occupational therapists can assist patients who are recovering from injury or surgeries, stroke, arthritis, or amputation.

Speech and language pathologists have helped patients overcome stuttering, and assisted others who have speech problems related to hearing, language, swallowing, or voice disorders. LeConte Therapy Services is a certified provider of “LSVT Big and Loud,” an effective speech and physical therapy tool for patients with Parkinson’s or other neurological disorders.

For more information, or to schedule an assessment, call either location. The Sevierville clinic is located in the Dolly Parton Center for Women’s Services and can be reached by calling (865) 446-9750. The Seymour clinic off Chapman Highway is available at (865) 577-2137.

Gamma Knife Pinpoints Cancers in the Brain

Treatment Becomes Part of a Couple’s “Grand Adventure”

Pam and Gene Hubbard of West Knoxville have lots of memories and laughter to share as they sit together in the park on a sunny day. Through the years, their love has deepened as they have shared many experiences, both good and bad.

Among their more recent experiences is a journey through Pam’s cancer treatment. They have learned a lot about a rare kind of cancer and about the Gamma Knife, an incredible tool that detected and treated spots on Pam’s brain without invasive surgery.

The Hubbards share a love story that spans nearly five decades. They started dating when he was 15 and she was 12.

“If you can call it dating,” Pam jokes. “We skated together at the skating rink.” They grew up together in Oak Ridge and soon became an inseparable pair, falling deeply in love.

Several years later, as Gene was preparing to go overseas with the U.S. Navy, he found out that his pay and benefits would increase if he married. Pam was 17 and still in high school.

“But my parents loved him,” Pam says, laughing. “They always said they liked him better than they liked me.” So with the blessing of her mother and father, young Pam became a bride the summer before she started her senior year in 1969.

Pam gave birth to their first son 19 months later, while Gene was with the Seabees in Vietnam. Today they have two sons, four grandchildren, and one great-grandchild.

Gene describes their years together as something akin to Bilbo Baggins’ Grand Adventure. “We’ve not only wound up on the wrong roads,” says Gene. “We’ve wound up in the wrong states.”

Pam and Gene Hubbard celebrate their 46th wedding anniversary in August, following Pam’s successful cancer treatments through Thompson Cancer Survival Center. “She’s handled it well,” Gene Hubbard says of his wife’s cancer journey. “And from her strength, I draw strength, too.”
Pam and Gene Hubbard celebrate their 46th wedding anniversary in August, following Pam’s successful cancer treatments through Thompson Cancer Survival Center. “She’s handled it well,” Gene Hubbard says of his wife’s cancer journey. “And from her strength, I draw strength, too.”

That adventure took a sharp turn down a rocky path in 2011, when Pam stepped out of the shower one day and noticed an unusual pink ring on her left breast. She was mildly concerned, and asked Gene’s opinion about it. He wisely told her to go see the doctor.

The following Tuesday, Pam sat in the office of her OB/GYN and heard the doctor say that he’d never seen anything like it, but that it reminded him of something he’d learned about in medical school. He snapped a picture to show the other doctors in the practice. Only one of them had seen the marking before, but none of them had ever treated it.

The mystery mark turned out to be the result of inflammatory breast cancer. It is rare, aggressive, and often misdiagnosed as a rash or infection. When Pam and Gene received the news, she says she felt a touch from heaven, and knew God was in control of the situation.

At home a little later, Gene wanted to wrap his arms around his wife in a reassuring hug, but she wasn’t ready. She needed some time to process what was happening.

“About 15 minutes later, I was fine,” Pam says. “I’ve been fine ever since.”

For the past few years, the Hubbards’ “grand adventure” has primarily focused on fighting the cancer that metastasized, spreading into Pam’s lungs, lymph nodes and adrenal glands. Then the cancer spread to her brain.

Surgery and traditional chemotherapy treatments have taken their toll, but worked well in treating the cancer. For the spots on her brain, Hubbard needed something else. Her doctors recommended the Fort Sanders Regional Gamma Knife Center at Thompson Cancer Survival Center.

The Gamma Knife uses advanced diagnostic imaging and three-dimensional treatment planning software to deliver 192 finely focused beams of gamma radiation to small targets inside the brain. The beams converge at a point to treat the affected tissue, while minimizing the damage of healthy brain tissue.

Gamma Knife gives neurosurgeons the capability to treat dozens of tumors intracranially. The procedure typically is performed in a single outpatient treatment session with considerably reduced treatment times and minimized surgical complications.

“Ms. Hubbard initially had two metastatic tumors in her brain, and operating in two different areas of the brain would have been very detrimental,” says neurosurgeon Steven Sanders, MD. “The surgical side effects likely would have precluded any benefit from an open surgical procedure.”

Dr. Sanders says the only other option besides traditional surgery would have been whole brain radiation and extensive chemotherapy, which he says would have been less effective. “And the outcome potentially could have been dramatically worse,” he says.

“They explained very well to us the advantages of the Gamma Knife, and how long it’s been around,” Gene says. He hadn’t known that gamma radiation has been in use for more than half a century. “I was amazed.”

After going over all the options, the Hubbards were told that the Gamma Knife was recommended for Pam’s case. Gene and Pam say they felt well informed and very well prepared.

Gene was also impressed and comforted by the way he and Pam were both treated on the day of the first procedure. “Everybody was just tremendous,” he says. “They told us what sedative they’d be giving her, they explained the procedure again, and they even made sure I knew when they put the coffee on.”

While Pam was undergoing the procedure, Gene received updates, letting him know what phase Pam was in and how things were going. “They seemed to be concerned about me as well as her,” Gene says.

Pam underwent Gamma Knife treatment two separate times. The first time, the MRI that was part of the Gamma Knife process picked up on three additional spots – a total of five. The second time, 12 spots were treated.

Follow-up MRIs after both procedures showed that the Gamma Knife worked, and the tumors that had been on her brain were no longer a threat. “I’m very grateful,” Pam says seriously.

Pam and Gene are grateful, not just for the technology, but for the personal care Pam received every step of the way. “They seem to really care about your best interest,” Gene says. “They care about your whole background, and they’re focused on the whole person, from the nurses to the people at the counter.”

Pam doesn’t want to be called a cancer survivor, because there’s no permanent cure for metastatic breast cancer. Gene balks at that, making the point that his wife has to be some sort of survivor, because she’s already survived three years since her diagnosis.

As they enjoy their banter at the park, they give credit where they believe credit is due. They know Pam might not be here today had it not been for excellent doctors, a positive attitude, modern medicine, Gamma Knife, and God’s intervention.

“I didn’t know if I was going to live,” Pam says, “but I was comfortable that whatever happened was God’s doing.”

“God has a plan, and the plan is working,” Gene says in agreement, giving his wife a knowing look. “She’s still here.”

Brain Surgery without the “Surgery”

David M. Hauge, MD, medical director of the Fort Sanders Gamma Knife Center.
David M. Hauge, MD, medical director of the Fort Sanders Gamma Knife Center.

The Leksell Gamma Knife Perfexion machine has treated nearly 400 patients since it was installed at Fort Sanders Regional Medical Center in 2011. Both physicians and patients are delighted with the results. “I continue to be amazed by the tumor reduction we receive using gamma knife technology,” says David H. Hauge, MD, medical director of the Fort Sanders Gamma Knife Center.

Using the Gamma Knife radiosurgery system requires a team effort. “We have both neurosurgeons and radiation oncologists together in the pretreatment evaluation, as well as the actual procedure. “Specially-trained radiation physicists and nurses also help ensure a safe and pleasant experience for the patient,” explains Dr. Hauge.

Despite its name, the Gamma Knife is not really a “knife.” There’s no cutting, no anesthesia and no hospitalization afterward. Radiation energy is targeted through the skull and into brain tumors, destroying them while leaving healthy tissue unharmed in the process. Treatments can last less than two hours, and patients go home the same day.

Gamma Knife can also be used to treat a number of other brain disorders, like non-cancerous tumors of the pituitary gland, tumors of the ear or eye nerves, or malformations of the blood vessels in the brain.

Fort Sanders is an “open” center, meaning Gamma Knife credentialed and trained physicians in the area are welcome to use the technology. Five neurosurgeons and five radiation oncologists from Knoxville area hospitals treat patients regularly at the Fort Sanders Gamma Knife Center.

Joel Norman, MD, neurosurgeon
Joel Norman, MD, neurosurgeon

The biggest benefit of the Gamma Knife is its ability to treat multiple tumors at once, up to 15 or more. The Leksell Gamma Knife Perfexion is designed to allow treatment of multiple metastatic brain tumors developed from primary cancers outside the brain such as lung, breast, ovarian, colorectal, kidney and melanoma.

The Gamma Knife is much safer than other radiosurgical tools for brain tumors because it does not expose the rest of the brain or body to radiation. “We can deliver the treatment with pinpoint precision,” explains Fort Sanders neurosurgeon Joel Norman, MD. “When you’re delivering radiation to the brain, particularly around the brain stem or optic nerves that control eyesight, precision is everything.”

Dr. Hauge agrees. “In a recent study, Gamma Knife was shown to deliver far less radiation to the rest of the body outside the brain than any other currently available cranial radiosurgical technology.”

However, while the Gamma Knife is one of a kind in the area, it is not a cure for everything. Some tumors of the brain will still need traditional surgery. “Gamma Knife adds another treatment option for patients with brain cancers or other con-cancerous abnormalities in the brain,” says Dr. Norman.

For more information about the Fort Sanders Gamma Knife Center, call (865) 541-4000.

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