Home run!
Pioneering care puts
this patient back in the
game of life.
Though only 40 years old, a non-smoker
and otherwise healthy, he depended on an
oxygen tank and could only go short
distances without a wheelchair.
eventual death from this condition,” says
Dr. Smythe. “He would eventually
suffocate slowly from these bony masses
pressing on his lungs.”
obert Trevino knows better than
most about pitching strikes,
fielding balls and running the
bases. For more than a decade, the Taylor
resident spent his free time directing Pony
League teams and coaching young baseball
players on the game’s finer points. But
when he came to Scott & White last
summer barely able to breathe, he had no
idea that the options for treating his
deteriorating condition could result in
only one of two outcomes, either a grand
slam home run—or a strike out.
“When Robert came into our clinic, he
was profoundly short of breath. He was to
the level that he just couldn’t compensate
anymore,” says Scott Reznik, MD, a
cardiothoracic surgeon at Scott & White
Healthcare; and assistant professor of
Surgery, Texas A&M Health Science
Center College of Medicine.
But even with surgery, not only was there
no guarantee his lung capacity would be
restored, there was the risk that he could
die from the surgery.
R
Thanks to his bravery and a skilled team of
medical professionals, Mr. Trevino hit a
life-saving home run.
On the Sidelines
For his entire life, Mr. Trevino had battled
an uncommon bone disease, polyostotic
fibrous dysplasia, in which bony masses
grow throughout the body. Over the years
he had multiple surgeries to remove the
masses, including having an eye removed.
Despite the debilitation, he carried on a
fairly normal, active lifestyle. But over
time, a bony mass growing inward into his
left chest wall was making it increasingly
difficult for him to breathe.
24
Catalyst Summer 08
Few Options, High Risks
“When we looked at his X-rays, we could
see that he was being suffocated from the
inside by these fibrous masses that were on
both sides of his ribs,” Dr. Reznik recalls.
The bony mass was growing into his chest
wall, obliterating the left lung. In
addition, it had pushed the heart from its
normal position in the left chest into the
right chest, severely restricting the right
lung’s capacity as well.
As is typical in the complex cases that Scott
& White cardiothoracic surgeons manage,
Dr. Reznik sought the collaboration of W.
Roy Smythe, MD, chairman of Scott &
White’s Department of Surgery; professor
of Surgery, Texas A&M Health Science
Center College of Medicine; and The Glen
E. and Rita K. Roney Endowed Chair in
Surgery. “What Robert was facing was
Stepping Up to the Plate
When the surgeons first told Mr. Trevino
his options, he did not want to undergo yet
another surgery. “It’s pretty unusual in
elective surgery that we have to tell a
patient, ‘If the surgery goes very well,
we can give you an absolute new lease
on life. But if it doesn’t go well, then the
operation will likely end your life,’” says Dr.
Smythe. “That obviously was another level
of consideration for Robert. He now was
faced with the decision to step up to the
plate, and we’ll either hit a home run or
strike out very badly—nothing in between.”
A second meeting with the doctors
convinced Mr. Trevino to have the surgery.
“The doctors knew how serious this was
and were honest with me,” he says. “Dr.
Smythe calmed me down and made me
feel more comfortable.”
Multidisciplinary Team Effort
Though well known in the medical texts,
polyostotic fibrous dysplasia is rare. “It is