Why the work done at MITIE matters

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MITIE provides training to not only doctors, but law enforcement and emergency medical service providers, too.

elcome to part two of a three part series on MITIE – the Houston Methodist Institute for Technology, Innovation and Education. To recap, MITIE is one of the largest and most comprehensive surgical education and research facilities in the world. The first blog was a photo tour of MITIE, and the next blog will feature a Q&A with Dr. Brian Dunkin, the medical director of MITIE.

If you don’t work in health care, you might be wondering why you should care about MITIE and the work we do here. Well, I’ll tell you! There are two main reasons:

  • MITIE is a medical education facility. MITIE provides surgeons and surgical nurses with an opportunity to learn, practice and perfect new surgical techniques.
  • MITIE isn’t just for health care providers. MITIE also partners with other organizations to provide classes with curriculum tailored to their needs. Think law enforcement, emergency medical service providers, etc.
You want surgeons to know the latest techniques and perform them safely. That's the role of MITIE. Click To Tweet

After nursing school or residency, there are few educational facilities surgeons and nurses can go to learn new techniques. Cue MITIE. New surgical techniques are being developed all the time that make surgeries safer and more successful while decreasing the amount of time needed for recovery. You want your surgeons to know these latest and greatest techniques, but to perform them safely and successfully, the doctors need to practice them.

The alternative to practicing in MITIE is practicing on you – any volunteers? I didn’t think so. One example is laparoscopic colon surgery. Laparoscopic surgery, also known as minimally invasive surgery, uses several small incisions instead of one large incision. A laparoscope, or camera, is inserted through one incision and special laparoscopic surgical instruments are inserted through the other incisions. Laparoscopic colon surgery has been practiced in the United States since the 1990s and has been proven to be less painful with less scaring and allows patients to get back to their normal lives faster.

However, the US adoption rate of this procedure hovers around 40 percent because performing a colon surgery laparoscopically is a difficult procedure that is tedious to learn. In October 2014, MITIE hosted a laparoscopic colon surgery course for seven surgeons and their operating room staff. After spending four days training at MITIE, these surgeons returned to their hospital and were mentored by an expert surgeon during their first laparoscopic colon surgery. Several of the learning surgeons noted that the hands-on class at MITIE coupled with mentoring during their first surgeries at home helped increase their comfort level with the procedure and has benefitted their patients with safer surgeries and faster recovery times.

MITIE also partners with other organizations to provide classes with curriculum tailored to their needs. MITIE recently collaborated with the Harris County Sheriff’s Office (HCSO) Tactical Medicine Program to create the HCSO’s first tactical medicine school. Tactical medicine is the delivery of emergency medical care in a law enforcement special operations scenario. 

“Most people don’t know that the Sheriff’s Office is staffed with deputies who are physicians and paramedics who respond to emergencies to provide care to their fellow officers and citizens until EMS can arrive,” explained Dr. Aashish Shah, a HCSO deputy and administrator over the HCSO’s Tactical Medicine Program. 

During the first tactical medicine school, the HCSO Academy hosted the tactical trainings, such as gun safety, medical extraction, building clearing and distraction devices. At MITIE, the students covered a variety of tactical medical tactics, such as triage, airway management, hemorrhaging and burns.

After a week of lectures and practice, the students put it all together with a live High-Risk Operations Unit (HROU) exercise at MITIE. We simulated an active shooter in a hospital scenario to test the participants’ new understanding of tactical medicine. The learners were assigned to teams of SWAT officers. Each team entered the building and took the stairs to the 5th floor where MITIE is located, just like they would do in a real situation.

MITIE doesn't just educate doctors. The institute also trains law enforcement in tactical medicine. Click To Tweet

When they arrived on the 5th floor, they were greeted with a variety of scenarios, including blaring music, a sound track of dogs barking, rooms that were dimly lit or completely dark and random MITIE staff who would act like innocent people caught on the floor or the suspect the team was looking for. Their mission was to locate an injured Oscar or Mayer (you remember the SimMan patient simulators from part 1, right?), provide care to help stabilize the patient then continue to look for the suspect. At the end of the exercise, the students were credentialed by the HCSO to provide tactical medicine support. 

While you may never take a class at MITIE, the work done here affects you. Next week, we’ll sit down with Dr. Brian Dunkin, the medical director of MITIE, for a Q&A about his work and why he’s so passionate about the MITIE.

Common injuries at RODEOHOUSTON

Rodeo has returned to Houston! Last week, we shared what a typical day was like for the RodeoHouston® sports medicine team. To recap, Houston Methodist serves as the official health care provider for RodeoHouston. The sports medicine team consists of medical volunteers from across the city, who take care of the rodeo athletes and their families before, during and after the competitions.

Just like any other elite athlete, @rodeohouston competitors deal with injuries. Click To Tweet

Just like any other elite athlete, rodeo competitors deal with injuries. But did you know the types of injuries vary by competition? I talked to Dr. Timothy Sitter, the lead orthopedic surgeon on the RodeoHouston sports medicine team, about the rodeo injuries he’s seen in his nearly 20 years working with RodeoHouston.

Tie-Down Roping and Steer Wrestling: The most common injuries in these rodeo athletes occur in the knee. “If you’ve ever wondered why the dirt on the stadium or arena floor is being tilled up between events, it’s to keep it soft for events like tie-down roping and steer wrestling,” Dr. Sitter said. “These cowboys are coming down off their horses fast, so they keep the dirt around one foot-thick and soft because hitting a hard surface, like packed dirt, can cause a lot of damage to the knee.”

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Team Roping: As part of this event, the cowboy or cowgirl must wrap the rope around their saddle horn a few times after they’ve roped the steer. Because the steer will pull on and tighten the rope, the competitor’s must wrap the rope around the saddle horn quickly and be sure to get their hands out of the way. Many riders have gotten their fingers caught in the rope while wrapping it around the saddle horn causing damage to or even losing a finger.

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Bareback and Saddle Bronc Riding: “Elbow and shoulder injuries are common in this event,” Dr. Sitter said. “The cowboys are holding on to the rope to stay on the horse, so their shoulder and elbow are under a lot of stress. These athletes deal with a lot of sprains, strains and ligament tears.” Dr. Sitter added that most of these cowboys also wear neck collars to help prevent whiplash.

Barrel Racing: The key to barrel racing is to make tight turns around the barrels. Dr. Sitter said many of the cowgirls will hit their knees on the barrels, which can cause ligament tears and even fractures.

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Bull Riding: One might think that the most common injury in bull riders is caused by whiplash or getting their hand caught in the rope, but the most common injury in these athletes is to the groin and hip. “The cowboys are holding on to the bull with their knees,” Dr. Sitter said. “The groin and hip muscles are straining because the knees are clinching on to the bull. Many bull riders work on increasing the flexibility in their hips to help prevent groin and hip muscle strains.”

No matter the event or injuries, the cowboys and cowgirls at RodeoHouston have a multi-disciplinary team at the ready to take care of them and get them back in the saddle.

Behind the scenes at RODEOHOUSTON

f you live in or near Houston, March is the month you pull out your western gear and become a cowboy or cowgirl to celebrate the return of the Houston Livestock Show and Rodeo™. RodeoHouston® has it all – a BBQ cook-off, mutton bustin’ for the kiddos, bull riders, barrel racers and hit music stars.

While Houstonians enjoy the festivities for the entire month of March, the rodeo contestants come to town to compete for three days before moving on to the next rodeo. Sprains, strains, fractures, concussions – these are just a few of the injuries contestants risk when they enter the competition. To continue their sport, contestants need a team of health care professionals to back them up. That’s why Houston Methodist is proud to serve as the official health care provider for RodeoHouston.

In a typical night, the @RodeoHouston sports medicine team averages 60-70 treatments for the contestants. Click To Tweet

Houston Methodist coordinates the RodeoHouston sports medicine team with medical volunteers from across the city to ensure a multi-disciplinary team is available to care for contestants and their families. For the sports medicine team, the show starts long before you find your seat in NRG Stadium. A typical day in the RodeoHouston training room looks like this:

  • 9 a.m. – 12 p.m. – A physical therapist treats athletes and Rodeo staff (think Rodeo clowns and other support staff) for injuries sustained the night before or pre-existing injuries
  • 12:00 – 1:00 p.m. – Lunch break (eat while you can!)
  • 1:00 – 2:00 p.m. – Restock supplies (we go through a lot of tape and ice)
  • 2:00 – 4:00 p.m. – Prepare for the pre-event madness
  • 4:00 – 6:00 p.m. – The competitions usually start around 6 p.m., so between 4 and 6 p.m. is the madness.

In a typical night, we’ll average 60 to 70 treatments for the rodeo contestants. The cowboys and cowgirls come in to ice sore muscles, get therapy for aches and pains, tape their ankles, ask the primary care physician about a lingering health issue like a cold or get the surgeon’s opinion on a recurring shoulder problem. Our team also performs and reads x-rays on-site. 

At the same time, we’re treating the rodeo athletes’ family members. Many contestants travel with their spouses and children, so they need medical care while on the road, too. It may be the husband of a barrel racer with back pain or the son of a bull rider with an ear infection – the team can take care of them all. 

When the competition starts, the contestants know the same team of medical experts taking care of them in the training room will be standing by in case a ride doesn’t go their way. In the arena, two athletic trainers, two emergency medicine/trauma physicians, a team of paramedics and an orthopedic surgeon are ready to provide care if a rider is injured. In case of a concussion, we have neuropsychologist on call to provide an evaluation and treatment recommendations.

When the rodeo is over and the fans are waiting for the concert to begin, the training room is once again packed with athletes coming in to see the medical staff. While not all injuries that occur on the arena floor are serious, they can cause problems if left untreated before the next rodeo in the next town. 

The next day, the cycle repeats. Although the medical staff may change from day to day, we all have the same mission and provide the same level of care for each of the athletes and their family members.

After three days, the contestants move on to the next rodeo, and at the end of March, the medical staff will go back to their normal practices. So, if you’re heading to the rodeo, keep an eye out for the guys and gals in red vests. We’ll be there all night, every night, keeping the contestants at their best. Yeehaw!

Heroes of Houston heart history featured in book

At some point during his long career at Houston Methodist Hospital, Dr. William Winters realized he was working side by side with living heart history. He thought someone should compile a book to tell the stories he experienced, but never thought he’d be the one to eventually do it.

Houston Hearts: A History of Cardiovascular Surgery and Medicine at the Methodist DeBakey Heart & Vascular Center at Houston Methodist Hospital” is the title of Winters’ recently published history book, co-written with Houston writer Betsy Parish.

“Everywhere you looked at (Houston) Methodist Hospital, heart history was being made,” says Winters, who has worked as a cardiologist at the hospital since 1968. “So many breakthroughs, so many discoveries changed medicine around that time … and much of it took place right here in this institution.”

Dr. Winters with his recently-released book, "Houston Hearts."
Dr. Winters with his recently-released book, “Houston Hearts.”

“Houston Hearts”covers the 95-year history of Houston Methodist Hospital, and tells the stories of surgeons and cardiologists who worked here. The chronology kicks into overdrive during the swinging late 1960s, as Dr. Michael DeBakey and his team earned the world’s attention with an unprecedented string of surgical and medical breakthroughs.

“In 1968 we performed nearly one-third of the heart transplants in the country, and nearly one-fifth of the open heart procedures,” Winters says. “DeBakey and his team of surgeons would sometimes perform up to 12 successful surgeries a day. It was a great time to be a new cardiologist in this city.”

Winters and his medical partner Dr. Donald Chapman often marveled at the history that unfolded all around them. Chapman, also a cardiologist, is credited with bringing heart catheterization to Houston, while Winters began the use of echocardiography in Houston. Eventually Chapman would write three books about his own career, and those contained much of the history he experienced after coming to Houston in 1944.

In 1968 Houston Methodist Hospital performed nearly one-third of U.S. heart transplants Click To Tweet

Winters had an idea to create his own unique record by interviewing key physicians on video. He was able to talk with a number of important players in Houston Methodist’s history, including Chapman (who died in 2007) and DeBakey (who died in 2008) as well as other physicians and hospital administrators.

“A few years ago I realized there aren’t many of us left,” Winters recalls. “So I contacted Betsy Parish and we went to work writing this book. It has a lot of history, but it tells my story as well. As I’ve heard it said, the last man standing gets to tell the tale.”

“Houston Hearts” is available now on Amazon.com, and at select bookstores in the Houston area including the River Oaks Bookstore at 3270 Westheimer Ave., and the Houston Methodist Hospital gift shop.