Eldon Tharp knew there was a serious problem.
He had intermittent internal bleeding. On two occasions the blood loss was so severe he passed out and received blood transfusions. But by the time he reached the hospital on each occasion the bleeding stopped, leaving doctors a cold trail for finding the source.
It happened at his winter home in Phoenix and while he was at his summer home in Longville. One occasion included a helicopter trip to Abbott Northwestern Hospital in the Twin Cities where Tharp had open heart surgery years ago. But the 73-year-old's heart was not the problem. He returned to Longville and a week later the bleeding returned.
This time there was an answer for him at St. Joseph's Medical Center in Brainerd. And the answer seemed futuristic. It was a tiny disposable camera the size of a stocky vitamin pill.
Dr. Ronald Sorenson of the endoscopy unit at St. Joseph's Medical Center in Brainerd provided a view of what the camera pill sees and reports back to physicians. Radio frequencies are used to transfer the information from the pill inside the patient to the physicians. (Dispatch Photos by Renee Richardson)
"They tell you you are going to swallow a camera ...," Tharp said last week from his home in Phoenix. "You kind of wonder what is going on."
At St. Joseph's Medical Center, Dr. Ronald Sorenson talked to Tharp and suggested this new equipment may be the answer. Tharp was the first patient in Brainerd to swallow the camera, or video pill.
"It was kind of a thrill to me to be the guinea pig to do this and wind up in a place no larger than Brainerd and they would have the equipment to do this," Tharp said. "That was the thing that amazed me the most."
Properly called the capsule endoscopy, the plastic-shelled pill has an equally tiny battery, light, transmitter and antenna. It is a miniature digital camera using two watch batteries to produce a white flash strobe light illuminating the internal pathways.
For patients the video pill is a way to get to hard-to-see places, particularly in the small intestines. The Wall Street Journal reported several thousands of people had tried it in the United States as of August.
For Tharp, the disposable camera he swallowed provided images that showed the small intestine was the source of the bleeding. Tharp had surgery about a month and a half ago at St. Joe's. Part of his small intestine and a small part of his colon were removed. He said all indications are good that doctors found the problem and corrected it.
The system came with a $30,000 investment. Patients swallow the pill and then wear a thick Velcro belt that has a battery pack and a recording device. Electronic leads are connected to the abdominal wall and the patient may spend a regular eight-hour day while the camera takes thousands of pictures, creating an internal map. The disposable camera pill will spontaneously slough off in about 48 to 72 hours.
The Wall Street Journal reported the procedure costs as much as $1,500 and as of late summer was covered by insurers in 24 states, 17 of those with Medicare coverage. St. Joe's endoscopy unit reported each video pill costs about $450.
Doctors can download the information to disk and can move quickly or slowly through the patient's system with a computer command to view the incredible amount of data provided. If something appears suspicious they are able to zoom in for a better view.
As wonderful a tool as the video pill is, doctors also point out it is not a panacea. Use is expected to grow and the video pill can best be used for inflammatory bowels and chronic diarrhea, gastro-intestinal bleeding and small bowel cancer. There is hope it is a reminder of what the near future may bring in medical treatments.
But the big question from patients is whether the pill will replace the often dreaded colonoscopy procedures. Dr. John Berg, endoscopy unit at St. Joe's, said no such luck. Colonoscopy allows a physician to explore the large bowel and then remove any polyps found at the same time, something the video pill cannot do.
For its limitations in the large bowel, the video pill is considered a particular boon to diagnosis with small bowel pathology letting doctors see what they could not see before.
The technology was invented by a former missile designer. It gained Food and Drug Administration approval in August 2001. A year later the Wall Street Journal reported 268 U.S. hospitals, clinics and medical practices had installed the system with workstation and software.
Berg said another capsule can also be used for pH monitoring or acid reflux disease that can be so severe to damage an individual's vocal chords. The capsule is used as a probe and can replace the old way where a handwire was placed down the esophagus and came out the nose to a recording device.
Berg said the probe is placed in the same location and radio frequencies are being used to transfer the information. Wires are no longer involved.
"Now the individual can be comfortable being out and about because no one knows they are being monitored," Berg said of the procedure. "I'm convinced we are on the right track technologically with our endoscopy center."
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