UPMC offering care from afar

Mirror photo by J.D. Cavrich Sherry Turchetta, a community education specialist at the Station Medical Center, coordinates a telemedicine conference with Dr. Robert Friedlander (left) and Dr. William Ares in Pittsburgh.

UPMC Altoona has begun a new line of telemedical consultation — a further advance in a field for which health care organizations have heady expectations.

On Wednesday, at Station Medical Center, a local patient sat for one of the hospital’s first-ever post-op examinations following neurosurgery, connecting with a doctor at UPMC’s home base in Pittsburgh.

The local hospital has already established telemedical routines for infertility issues, maternal-fetal medicine and pediatric pre- and post-op appointments, according to community education specialist Sherry Turchetta, who assisted in Wednesday’s neurosurgical post-op.

During Wednesday’s session, neurosurgeon Robert Friedlander viewed his patient’s incision through a high-definition hookup shortly after Turchetta had removed the patient’s stitches and the patient had undergone a CAT scan.

Friedlander saw that the patient was healing properly, with no sign of infection, from an operation two weeks ago to treat an aneurysm, Friedlander told reporters after the session — via the same TV hookup.

For now, Friedlander doesn’t do telemedicine before surgery, because he wants to see his patients first-hand before operating on them.

But when it’s time for post-op, he’s familiar enough with them that it makes sense to do it via TV, so the patient avoids the inconvenience, lost time and expense of traveling to Pittsburgh — an experience that includes the hassle of parking in the big city, he said.

The patient also can avoid the “stressors,” especially on a day like Wednesday, when there was snow, said William Ares, a neursurgery trainee who sat alongside Friedlander.

Those stressors can delay recovery, Ares said.

Neurosurgery is done in Altoona, but for now, not the kind of “very complex and risky” procedures like the aneurysm operation undergone by Wednesday’s patient, Friedlander said.

“We are in the process of developing the capabilities” in Altoona, however, Friedlander said.

The operation on the patient who appeared Wednesday involved Friedlander shaving a small section above the hairline, placing the head in a frame to prevent movement, cutting and lifting a section of skin and muscle near the ear, drilling small holes in the skull, lifting a flap of bone, inserting an instrument that included a high-powered microscope, placement of material to relax the brain, dissection of the brain through “planes” of material to reach the deep-seated aneurysm and the placement of a titanium clip to seal off the protruding weak spot that constituted the aneurysm, Friedlander said.

Aneurysms are dangerous, capable of killing patients when they rupture, he said.

The clip remains in place permanently.

The operation was successful, and a recurrence of the problem is unlikely, Friedlander said.

Approaching the aneurysm from outside the blood vessel that Friedlander took is an older method, in contrast to the internal approach, which is called “coiling,” Friedlander said.

He sticks to the external approach.

“I’m the old guy,” he said.

Ares is learning both methods.

Each has pros and cons, Friedlander said.

The telemedical consultation was actually the second one for the patient, whose first occurred at home, Friedlander said.

Her case is a “pilot,” Friedlander said.

“It’s amazing science,” Turchetta said.

Mirror Staff Writer William Kibler is at 949-7038.