Health Care HEROES 2012 9

By Linda G. Hughes

Carmel medical device inven-tor Eric D. Blom heard about the butcher in 1931 who used his own ice pick to per-

form crude surgery on himself. He yearned to speak again after cancer stole his voice box. The butcher put a hollow feather into his neck puncture to keep it from leaking or closing. To speak, he took the quill out and covered the hole with his thumb.

Blom knew he could do better for patients who share the butcher’s affliction. When a patient has ad-vanced stage cancer of the larynx, a surgeon may have to perform a total laryngectomy and remove a patient’s voice box. Impairments are profound.

After earning a PhD in speech pathology from the University of Maryland, Blom, 68, and otolar-yngologist Mark I. Singer, M.D., F.A.C.S., co-developed the tra-cheoesophageal voice restoration technique. They pioneered the “puncture” that makes it possible for patients to speak after this type of surgery.

Their first device was FDA-approved in 1980 and featured in a Newsweek magazine story in 1982. Subsequent enhancements have been made to the Blom-Singer pros-thesis, which is currently manufac-tured by InHealth Technologies in Carpinteria, Calif.

Over the course of his career, Blom authored or co-authored 60 scien-tific publications and has been an invited guest lecturer at conferences throughout the United States and 24 foreign countries. An adjunct profes-sor of speech and hearing science at Indiana University, Blom recently re-tired from seeing patients as a speech pathologist at the Center for Ear Nose Throat & Allergy for 30 years.

He’s been well decorated for his work. The Bayville, Ohio, native has been honored by the American-Speech-Language-Hearing Associa-tion and is the only nonphysician inducted into the Royal Society of Medicine, Section of Laryngology and Rhinology, in London. In 1998, The American Academy of Otolar-yngology-Head and Neck Surgery

Bulletin included the Blom-Singer valve among its list of medical equipment and device milestones from the previous 250 years.

Since 1982, Richard D. Conard, partner at Barnes & Thornburg LLC, has helped Blom secure 29 United States and foreign patents. Seven additional patents are pend-ing. “You can just see his wheels spinning constantly when we meet,” Conard said.

Blom sums things up pretty sim-ply: “I look for problems, then I find solutions.”

In 2002, surgeons had to remove the voice box from retired family physician James H. Acklin, M.D., Paris, Ill., because of laryngeal cancer. “I was always happy before, but then I became depressed. I just wanted to be able to talk,” he recalled. Six months later, Acklin got the Blom-Singer voice prosthesis and his depression went away.

“I couldn’t swallow before when I was on a feeding tube. Now I eat anything I want. Am I limited by

my heart attack? Yes. Am I limited by this? No. I think Dr. Blom is a genius. Every morning when I look in the mirror to change the valve, I thank him,” Acklin said.

Patients have to have the manual dexterity to remove, clean and rein-sert valves, which could be challeng-ing for some elderly patients. But if you really want to talk, the devices are worth the trouble.

In recent years, Blom figured out how to help ventilator-dependent patients speak with their natural voice, hands-free. He invented the Blom Tracheostomy Tube System, manufactured by Pulmodyne Inc., in Indianapolis. This helps quadriple-gic patients, hospitalized patients on ventilators and people with progres-sive neuromuscular diseases, such as muscular dystrophy and Lou Gehrig’s disease.

A year ago, he introduced the Blom Tracheostomy Tube and Speech Inner Cannula, which re-duces trauma to the patient’s airway and chance for developing pneumo-

nia. Ventilator-dependent patients cannot manage the secretions down their throats that we all have. When medical device suction cups get plugged up, secretions pool and can lead to pneumonia.

Preventing pneumonia benefits hospitals as well as patients. Conard said, “If a patient develops pneumo-nia or any other additional complica-tion while he is in a hospital, Medi-care does not reimburse the hospital. So there’s incentive for hospitals to get patients out quickly before they get sick again.”

Before she died in 2011, a 33-year-old ventilator-dependent quad-riplegic named Jessica got Blom’s tracheostomy tube. She had not been able to speak or smell anything for three years before that.

Jessica was so happy that she could talk and smell again that she made a video to send to Blom. In it, she told Blom, “Thank you so much for giving me a better quality of life. My family can understand me much better. Thank God for you!”�

Innovations restore the gift of speech

ADVANCEMENTS IN HEALTH CARE – WINNER

Eric D. Blom, PhDAdjunct Professor, Department of Speech and Hearing Science, Indiana University;Speech Pathologist and Inventor, Center for Ear Nose Throat & Allergy

10 Health Care HEROES 2012

Daniel E. Kraft, M.D.Director, Riley Hospital for Children Sports Medicine at Indiana University Health; Co-director, Indiana Sports Concussion Network

Joseph O’Neil, M.D., MPH, FAAPNeurodevelopmental Pediatrician, Riley Hospital for Children

Concussion law tackles standard of care

Zachery Lystedt, a 13-year-old Maple Valley, Wash., football player, died from two con-cussions in a single football

game in 2006. That prompted the country’s first legislation to ensure student-athletes’ injured brains get enough rest.

There have been no catastrophic brain injuries there since Washington established its concussion law in 2009, said Joseph O’Neil, M.D., an associate professor of clinical pediatrics at the Indiana University School of Medicine. That inspired O’Neil to team with Daniel E. Kraft, M.D., director of Riley Hospital for Children Sports Medicine, and with State Sen. Travis Holdman and Gov. Mitch Daniels to work toward a law that would protect student-athletes in Indiana.

Senate Bill 93 takes effect July 1, 2012, making Indiana one of 31 states

with a concussion law. Mandates increase awareness, remove injured players from play and improve concus-sion management.

Injury, both intentional and unin-tentional, is the leading cause of death for Americans, aged one through 44. O’Neil remembers what led him to work to fight the problem.

“When I started my career in Chicago, I saw a high school basket-ball player for a preseason physical. I walked in and said hello, asked how the season’s going to go, what are you going to do and said goodbye. Four hours later, I was called to the emergency room because he had been shot multiple times in a drive-by shooting. And he died in our emergency room.”

Because of this incident and other preventable tragedies, O’Neil pursued a research career in preventable injuries. He has helped the Indiana General

Assembly strengthen child passenger safety and teen driving laws.

A neurodevelopmental disabilities pediatrician with Riley since 2001, O’Neil, 55, said, “I take care of kids with disabilities. That’s what I love to do. If I can consult with Dan and pre-vent one child from being injured, then I’ve done something really worthwhile.”

How serious is a concussion?After a concussion, patients must rest

the brain or risk permanent impairment in the form of depression, early onset dementia, poor judgment or even death.

“The brain gets better in a sequential process that we just now are beginning to understand,” O’Neil said. Former Chicago Bears safety Dave Duerson killed himself after multiple concus-sions. Depressed, he wrote a suicide note explaining he put the gun to his

chest to protect his brain so it could be studied.

“You can’t always count on an athlete to tell you what’s going on,” O’Neil said. “They really want to play and sometimes are pressured by adults to play.” Kraft, 48, a pediatric/adolescent sports medicine specialist, added, “To know if you have had a concussion, you need two things: trauma to the head and a symptom directly related to that trauma.” Kraft joined Riley in 2010 after practicing at Methodist Sports Medicine Clinic since 1994.

If you have a concussion, Kraft recommends rest, no video games and limited texting and computer and televi-sion use. For more information, visit www.indianasportsconcussionnetwork.com.�

—Linda G. Hughes

Douglas J. Schwartzentruber, M.D.System Medical Director of Indiana University Health Cancer Services;Associate Director of Clinical Affairs at IU Simon Cancer Center

Trial validates role of melanoma vaccine

A therapeutic vaccine for advanced melanoma patients combined with an immune-boosting drug scored promising

results in a large clinical trial published in the New England Journal of Medi-cine last June 2. Researchers saw tumors shrink significantly and stay progres-sion-free longer with the vaccine and interleukin-2, than with the drug alone.

Douglas J. Schwartzentruber, M.D., lead author of the study, now serves as system medical director of IU Health Cancer Services. “This is proof of principle that vaccines can work to treat metastatic melanoma. The trial was one of the first of its kind, and the first to show a benefit of a pep-tide vaccine,” said Schwartzentruber, 55. A peptide is a small portion of a protein that is present on the surface of melanoma cancer cells.

Most vaccines are preventative. This melanoma vaccine is therapeutic, meant to boost the immune system enough to battle existing tumors.

The randomized Phase 3 clini-cal trial included 185 patients with metastatic melanoma at 21 care centers throughout the country. One group received the vaccine, along with in-terleukin-2, a drug that empowers the immune system. A second group only received interleukin-2.

Patients who received both the melanoma vaccine and drug did better than those who only got interleukin-2. Researchers saw tumors shrink 50 per-cent or more in 16 percent of the study population who received the vaccine and drug, compared to six percent with just interleukin-2.

Tumors grew slower when patients received the vaccine and drug. With the combination, tumors stopped growing for 2.2 months compared to 1.6 months with just interleukin-2. While the study was not designed to track survival rates, the median overall survival rate for those receiving the vaccine was 17.8 months versus 11.1 months.

Before the trial, Schwartzentruber

spent 16 years at the National Cancer Institute, the largest institute of the Na-tional Institutes of Health. He started as a fellow then moved up to senior investigator in the surgery branch, which studied melanoma.

Steven A. Rosenberg, M.D., PhD, surgery branch chief of the NCI, “taught me the research method and appreciation for melanoma. He’s the reason I pursued melanoma as a ca-reer. He also taught me how to deliver bad news to patients in a compassion-ate way,” Schwartzentruber said.

CA: A Cancer Journal for Clini-cians recently reported a significant decline in overall cancer deaths in the last 20 years, but melanoma incidence and deaths have increased, and are expected to rise. Schwartzentruber’s research opens the door for vaccine

treatments not only for melanoma, but other cancers as well.

His groundbreaking results were first presented during the American Society of Clinical Oncology conference in 2009, earning him recognition in 2010 on Time magazine’s annual list of the 100 most influential people in the world.

Time hosted a red carpet affair in New York City that Schwartzentruber and his wife of 25 years, Diane White, attended. The magazine divides its “most influential” list into four cat-egories: leaders, artists, thinkers and heroes. Time recognized Schwartzen-truber in the thinkers category.

What’s next? The vaccine isn’t ready yet. It will be improved, there will be further study, and eventually it will go to market, Schwartzentruber said.�

—Linda G. Hughes

ADVANCEMENTS IN HEALTH CARE – FINALIST

ADVANCEMENTS IN HEALTH CARE – FINALIST

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