Randy McKnight makes award-winning barbecue, runs marathons and owns a small business. He puts his heart into everything he does — just not the heart he had when he was born.

Randy was among the first 10 heart transplant recipients at Mayo Clinic in Florida, a program that is now marking its 25^th anniversary.

Watch: 'Live for today': Looking at life nearly 25 years after a heart transplant

Journalists: Broadcast-quality video pkg (2:14) is in the downloads at the end of the post. Please courtesy: "Mayo Clinic News Network." Read the script.

"It was in the summer of 1998," Randy says. "We were having a lot of fires in Jacksonville along I-95, and (I was) having a hard time breathing."

Randy was 35 years old when his care team in Jacksonville, Florida, discovered he had an enlarged heart.

"I was in full-blown heart failure with fluid in my lungs," Randy says. "(My doctor) basically said, 'You need a heart transplant.' I couldn't believe it."

Randy was placed on the transplant list in Rochester, Minnesota, and spent almost three years traveling back and forth for appointments, waiting for a heart.

"My son must have been 8 or 9, and I knew that I had to survive to help raise him and support him," Randy says.

Then, in 2001, Mayo Clinic started a heart transplant program in Jacksonville, which gave Randy a chance to be closer to home.

"I met Dr. Yip when the program first started, and from day one, he and I have connected," Randy says. "I've always felt like I've had a personal connection with the team here, and it just made the whole process so much easier."

After listing and waiting several more months, the day finally came.

"I had my heart transplant on May 27, 2002," Randy says.

"You have someone who is literally on death's doorstep to be able to live a full, healthy life, back to things that they want to do, going back to work, raising their children, going to graduations, going to weddings, raising their grandchildren. That is satisfying," says Dr. Daniel Yip, a Mayo Clinic cardiologist who helped start the heart transplant program in Florida.

Over the last quarter century, Dr. Yip has seen progress in heart transplantation — from advances in medications to new options for patients with the greatest need.

"Being able to expand the donor pool using organs that, in the past, we would say maybe we shouldn't think about using them, but knowing with time, with research, with innovation, with technology, to be able to use these organs," Dr. Yip says. "And now we're able to go a lot farther, even across the country, to be able to get the right heart for a patient. I think that's the biggest thing — to be able to serve patients who need our help."

According to the United Network for Organ Sharing (UNOS), nearly 4,000 people in the U.S. are waiting for a heart transplant.

Randy is grateful for the years he's been given, and he's made it his mission to help others.

"My quality of life before transplant — being sick, being limited — was really hard because I'm go, go all the time," Randy says. "Just learn to live each day for today, live every day for today and appreciate life."

The post (VIDEO) ‘Live for today’: Looking at life nearly 25 years after a heart transplant appeared first on Mayo Clinic News Network.

ROCHESTER, Minn. — Mayo Clinic Comprehensive Cancer Center is expanding surgical options for patients undergoing treatment or risk reducing procedures for breast cancer through the adoption of robotic nipple-sparing mastectomy at its Minnesota and Florida campuses. Following recent Food and Drug Administration clearance of the use of this platform and device for these procedures, Mayo Clinic surgeons are now offering a minimally invasive approach designed to improve cosmetic outcomes, preserve skin and nipple viability, and broaden opportunities for potential sensory restoration.

Nipple-sparing mastectomy preserves the nipple–areolar complex and healthy breast skin, creating a more natural appearing reconstructed breast after reconstruction. The improved cosmetic result can offer meaningful psychological benefits for patients compared with traditional mastectomy. Many patients, however, continue to experience visible scarring, diminished or absent sensation in the breast and nipple, and risk of loss of nipple or skin due to low blood flow.

The robotic approach provides a way to address some of these challenges by enabling a small, lateral incision, gentle tissue retraction with gas insufflation, and enhanced visualization of the surgical field. Mayo Clinic surgeons also are integrating sensory restoring procedures in some cases, including neurotization (reinnervation) of the nipple–areolar complex, to help patients regain protective sensation of their reconstructed breasts.

"When we remove the breast tissue and keep the envelope of the breast skin and nipple, it provides the most natural-appearing breast from a cosmetic standpoint," says Mara Piltin, D.O., a surgical oncologist at Mayo Clinic in Jacksonville, Florida. "The next step is to improve the process so that patients regain feeling in their breasts and are not constantly seeing scars that remind them of their cancer journey. It will positively impact their sexual health, self-image and recovery."

Mayo Clinic continues to lead in NSM innovation, consistently refining surgical techniques and expanding clinical trials to enhance patient outcomes. Jeffrey E. Johnson, M.D., a surgical oncologist at Mayo Clinic in Rochester, explains, "At Mayo Clinic, our goal is to ensure that more patients can benefit from innovations that support not only their physical recovery but also their emotional well-being so every patient can move forward with confidence and hope."

Editorial note: This article and headline have been updated to reflect that the robotic device has received clearance by the U.S. Food and Drug Administration for certain indications, including the use described in the article. 

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About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news.

About Mayo Clinic Comprehensive Cancer Center 
Designated as a comprehensive cancer center by the National Cancer Institute, Mayo Clinic Comprehensive Cancer Center is defining the cancer center of the future, focused on delivering the world's most exceptional patient-centered cancer care for everyone. At Mayo Clinic Comprehensive Cancer Center, a culture of innovation and collaboration is driving research breakthroughs in cancer detection, prevention and treatment to change lives.

Media contact:

• Julie Ferris-Tillman, Ph.D., Mayo Clinic Communications, newsbureau@mayo.edu

The post Evidence-based advances in breast surgery at Mayo Clinic: Robotic nipple-sparing mastectomy appeared first on Mayo Clinic News Network.

JACKSONVILLE, Fla. — A new international study — believed to be the largest of its kind — examined what people know about perimenopause and what symptoms they experience. The results reveal a clear gap between what perimenopause symptoms people expect and what they experience.

Mayo Clinic researchers published a collaborative research study with Flo, a women's health application, to assess the perimenopause symptoms of 17,494 people from 158 countries. The study results are published in Menopause, the official journal of The Menopause Society.

Perimenopause marks the time leading up to the final menstrual period and includes the year after it ends. This transition can begin as early as the 30s and last for several years. Although it affects health and daily life, researchers have studied it far less than menopause.

"This study shines a light on how little we still understand about perimenopause and how much it affects people's daily lives," says first author Mary Hedges, M.D., a community internal medicine physician at Mayo Clinic in Florida. "At Mayo Clinic, we're working to expand that understanding so we can improve awareness and guide care that truly meets the needs of each patient."

Among more than 12,000 participants over age 35, the most common reported symptoms were fatigue (83%), exhaustion (83%), irritability (80%), low mood (77%), sleep problems (76%), digestive issues (76%) and anxiety (75%).

When asked what they associate with perimenopause, participants most often named hot flashes (71%), sleep problems (68%) and weight gain (65%). However, for those who said they were in perimenopause, 95% reported exhaustion and 93% reported fatigue — far higher than the rate of hot flashes. Exhaustion is a general decrease in performance, impaired memory, decreased concentration, and forgetfulness, whereas fatigue is physical exhaustion.

These findings show that fatigue, mood changes and sleep-related issues are central to many people's perimenopause experiences, the study authors say. Hormone changes may affect the body's natural rhythms and restorative sleep, while mood changes can be influenced by hormones, inflammation and diet.

The research highlights that perimenopause symptoms can significantly affect daily life, relationships and work. Responsibilities such as caregiving and coexisting health conditions may add to the strain, increasing fatigue and emotional stress.

Mayo Clinic researchers say the study underscores the importance of rethinking how clinicians approach midlife health. They emphasize that understanding what people are truly experiencing — not just what is traditionally expected — is essential to improving care and communication during this life stage.

Mayo Clinic continues to study how biological, lifestyle and social factors influence perimenopause symptoms and how greater awareness can help improve patient care. This work supports Mayo Clinic's vision to transform the practice of medicine through research that addresses real-world needs and leads to more informed, compassionate care.

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About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news.

Media contact:

• Julie Ferris-Tillman, Ph.D., Mayo Clinic Communications, newsbureau@mayo.edu

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JACKSONVILLE, Fla. — A new study led by Mayo Clinic found that postmenopausal women receiving menopausal hormone therapy lost 35% more weight while taking tirzepatide, a Food and Drug Administration-approved drug for the treatment of overweight and obesity. The findings, published in The Lancet Obstetrics, Gynaecology, & Women's Health, could expand treatment possibilities for millions of women struggling with obesity and obesity-related diseases after menopause.

Menopause can accelerate age-related weight gain and increase the likelihood of developing overweight and obesity, which are major risk factors for cardiovascular disease, type 2 diabetes and other conditions. The decline in estrogen levels characteristic of menopause is also linked to changes independent of weight that can potentially raise cardiovascular risk. "This study provides important insights for developing more effective and personalized strategies for managing cardiometabolic risk in postmenopausal women," says Regina Castaneda, M.D., postdoctoral research fellow at Mayo Clinic and first author of the study.

Hormone therapy is the most effective first-line treatment for menopausal symptoms, including hot flashes and night sweats, which affect up to 75% of postmenopausal women. While evidence on how this therapy may interact with weight-loss medications is limited, some research has shown that postmenopausal women using hormone therapy experience greater weight loss when treated with the GLP-1-based obesity medication semaglutide.

No previous studies have examined whether hormone therapy might influence outcomes with tirzepatide. Dr. Castaneda and a team of researchers set out to investigate this relationship by reviewing data from 120 participants with overweight or obesity who received tirzepatide for weight management for 12 or more months. Patients receiving tirzepatide along with hormone therapy were compared to participants with similar characteristics who were not using hormone therapy.

"In this observational study, women who used menopausal hormone therapy lost about 35% more weight than women taking tirzepatide alone. Because this was not a randomized trial, we cannot say hormone therapy caused additional weight loss," says Maria Daniela Hurtado Andrade, M.D., Ph.D., endocrinologist at Mayo Clinic and senior author of the study.

"It is possible that women using hormone therapy were already engaged in healthier behaviors, or that menopause symptom relief improved sleep and quality of life, making it easier to stay engaged with dietary and physical activity changes."

Dr. Castaneda says, while more studies that control for these factors are needed, the findings are clinically meaningful. "The magnitude of this difference warrants future studies that could help clarify how GLP-1-based obesity medications and menopausal hormone therapy may interact. Interestingly, preclinical data suggest a potential synergy, with estrogen appearing to enhance the appetite-suppressing effects of GLP-1," says Dr. Castaneda.

"Next, we plan to test these observations in a randomized clinical trial and determine if benefits extend beyond weight loss — specifically, whether hormone therapy also enhances the effects of these medications on cardiometabolic measures," adds Dr. Hurtado Andrade. "If confirmed, this work could speed the development and adoption of new, evidence-based strategies to reduce this risk for millions of postmenopausal women navigating this life stage."

This research was funded by the Mayo Clinic Center for Women's Health Research. Review the study for a complete list of authors, disclosures and funding.

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About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news.

Media contact:

• Tia Ford, Mayo Clinic Communications, newsbureau@mayo.edu

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ROCHESTER, Minn. — Mayo Clinic Transplant achieved the highest annual transplant volume in its history in 2025 by performing 2,065 solid organ transplants across its Arizona, Florida and Minnesota campuses, according to data from the Organ Procurement and Transplantation Network (OPTN).

The new record surpasses 2,006 transplanted solid organs in 2024 and 1,952 in 2023, reflecting Mayo Clinic's dedication to saving more lives through continued advances in transplantation driven by new research, technology and innovation.

"This number represents new beginnings full of hope for so many," says Julie Heimbach, M.D., transplant surgeon and director of Mayo Clinic Transplant in Rochester. "This incredible milestone is only made possible by the generosity of our donors and donor families, the resilience of our transplant recipients, and the unwavering dedication of our transplant care teams."

The record volume is encouraging, as the number of patients waiting on the national transplant list remains daunting. More than 109,000 people in the U.S. are currently waiting for lifesaving organs, according to OPTN data.   

To meet this need, Mayo Clinic teams are advancing the science and delivery of transplantation through initiatives such as:

• Exploring the use of stem cells to prevent organ rejection.
• Using normothermic machine perfusion to improve organ preservation.
• Expanding living donor paired exchange programs.
• Researching artificial intelligence to transform organ transplant.

"Our work doesn't stop with the patients we serve today," says Dr. Heimbach. "Through collaboration across Mayo Clinic teams, investing in new technologies, and continued research, we are working toward a future where we can expand access and help more patients receive lifesaving transplants when they need them most."

As 2026 begins, transplant teams move forward with gratitude for the lives saved and a continued commitment to those who are still waiting.

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About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news.

About Mayo Clinic Transplant
Mayo Clinic Transplant is one of the largest and most comprehensive transplant programs in the world. With programs in Arizona, Florida and Minnesota, Mayo Clinic provides seamless, coordinated care across heart, lung, liver, kidney, pancreas and bone marrow transplantation for both adults and children. Guided by a commitment to innovation, research and education, Mayo Clinic Transplant delivers world-leading outcomes, compassionate patient care and advances that shape the future of transplantation worldwide. Mayo Clinic Transplant delivers world-leading outcomes, compassionate patient care and advances that shape the future of transplantation worldwide.

Media contact:

• Kelley Luckstein, Mayo Clinic Communications, newsbureau@mayo.edu

The post Mayo Clinic Transplant performs record 2,065 organ transplants in 2025 appeared first on Mayo Clinic News Network.

Mayo Clinic expert explains why it is important to act before perimenopause

JACKSONVILLE, Fla. — Weight gain is common in women during perimenopause and after menopause, but the physical changes underlying it start much earlier in adulthood. Daniela Hurtado Andrade, M.D., Ph.D., an endocrinologist and obesity expert at Mayo Clinic in Jacksonville, explains why it is important to start counteracting those changes before perimenopause arrives.  

"Weight changes are not only characteristic of midlife or menopause. Data have shown that weight gain starts early in adulthood," Dr. Hurtado says. "Around age 30, your muscle mass starts decreasing gradually as part of the natural aging process, and this is exacerbated in midlife due to menopause."

The decreasing muscle mass will lead to a lower metabolism, a risk factor for weight gain, Dr. Hurtado says.

Adding to the challenge of achieving a healthy weight before and after menopause are many of the features of modern life, Dr. Hurtado says. For example, an abundance of processed foods high in sugar and fat; technology such as escalators, elevators and cars that allows people to move from place to place without walking; and the difficulty of unplugging from devices that keep people connected to work and sedentary for longer hours, with less time spent on physical activity. 

Being aware that weight-related physical changes start earlier than midlife may help people be mindful about the importance of establishing and maintaining a healthy lifestyle, including adequate diet and exercise (at least 150 minutes per week), well ahead of menopause, Dr. Hurtado says. It may help to track what and how much you eat, to understand how much you need to eat to feel satisfied and avoid overeating, she adds.

To mitigate muscle mass loss that occurs with aging, a healthy diet should include enough protein and exercise should include resistance training and possibly high-intensity interval training, Dr. Hurtado says.  

"And this is even more important if we are engaging in a weight-loss intervention because we know that weight-loss interventions are also associated with muscle mass loss, which can have a significant impact on the weight-loss outcomes," she says. "One of the reasons why we hit a plateau when we are losing weight is because we are losing muscle mass and our metabolism slows down."

While a healthy lifestyle is essential, it may only get someone so far in pursuit of a healthy weight, Dr. Hurtado says. The body is genetically programmed to survive, so losing weight is perceived as  negative and our bodies will try to fight it. Some people can sustain low-calorie diets for a period of time and lose weight, but eventually they may start feeling hungry, eating more and gaining weight.

"As soon as some people even think about losing weight or restricting their calories, their brain overrides those thoughts: 'No, you're actually hungry, so you're going to eat as much as you need to make sure that you do not lose weight,'" Dr. Hurtado says. "There is a proportion of people in whom diet and exercise alone will work, but for the majority, they will not due to the complex regulation of energy balance."

Many people who live with overweight or obesity will need a tool such as a medication, an endoscopic bariatric procedure or bariatric surgery to help them achieve sustained weight loss, Dr. Hurtado says. In addition to nutritional and behavioral support, they also may benefit from physical therapy or occupational therapy to help them find ways to become physically active, she adds.

In the early 40s, and perhaps even earlier, it is important for women and their healthcare team to start discussing aging-related weight changes that are happening and will happen, Dr. Hurtado says.

"Every visit with a doctor is an opportunity, especially in these times when overweight and obesity are so highly prevalent," she says. "We want to prevent rather than treat something that may be more difficult to treat for several reasons. Lifestyle interventions are the core of all weight management interventions. While we need to understand that there is no magic pill, there are tools that can facilitate adhering to lifestyle changes."

Dr. Hurtado emphasizes that obesity is a disease.

"Starting the conversation about weight management with that message may help people have a different perspective: 'OK, so they are talking about something that is not my fault, but actually has a biological basis,'" Dr. Hurtado says. "Realizing that weight problems are a disease and not a character flaw can help them think about it differently and could be very impactful on the outcomes of weight loss interventions."

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About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news.   

Media contact:

• Sharon Theimer, Mayo Clinic Communications, newsbureau@mayo.edu

The post Aging-related weight gain in women: It may start earlier in life than you think appeared first on Mayo Clinic News Network.

Carleigh Eagle's path to Mayo Clinic began not in an engineering lab or medical school classroom, but as an intern in the Clinical Research Internship Study Program (CRISP). Immersed in the intersection of science and medicine, Eagle discovered a new way to impact patient care without becoming a physician.

At the time, Eagle was a physics major hoping to become a cardiothoracic surgeon. A conversation with a Mayo faculty member led her to apply for CRISP, where she worked on a project focused on hypertrophic obstructive cardiomyopathy, a heart condition where the muscle becomes abnormally thick, narrowing the outflow path and making it harder for blood to leave the heart. Using 3D modeling to guide septal wall resections, Eagle worked with radiologists and heart surgeons to help plan and improve surgery on the heart’s septal wall. That experience helped open her eyes to the power of engineering in medicine and sparked a passion that has defined her career.

"CRISP showed me that I could be at the forefront of medicine without going to medical school," Eagle says. "It was a turning point."

Leading the way in 3D anatomical modeling

Today, Eagle is the lead engineer in the Anatomic Modeling Unit (AMU) at Mayo Clinic in Florida, where she helps transform surgical planning and patient care through advanced 3D technology, including additive manufacturing, commonly known as 3D printing. The AMU supports more than 25 clinical specialties, creating anatomical models and surgical guides that enhance surgeons' precision and improve patient understanding. 

"When a doctor holds a patient's 3D-printed heart in their hands, it helps them truly understand their patient's care," Eagle says. This understanding in turn helps patients make better medical decisions and proceed with confidence in their treatment plans.

Since joining Mayo in 2021, Eagle has helped position her AMU as the largest additive manufacturing hub at Mayo Clinic in Florida. Her team estimates that they perform one of the highest number of virtually planned scapula (shoulder blade) reconstruction procedures worldwide and have introduced innovative techniques such as "green stick" scapula bending simulations, which allow surgeons to virtually model bone adjustments before entering the operating room.

Her contributions extend beyond surgical planning. Eagle has co-developed lifelike simulators for pelvic anatomy and neurosurgical procedures, giving clinicians hands-on practice for complex cases. A graduate of the University of North Florida (UNF), Eagle also co-developed UNF's Anatomy and 3D course and is now pursuing her master's degree there in materials science and engineering. She was recently honored with UNF's Young Alumni Achievement Award. 

She also co-founded Mayo's Physics, Chemistry and Engineering Internship, mentoring more than 30 students and inspiring new cohorts of innovators. 

"Seeing Mayo through the eyes of interns reminds us why we fell in love with what we do," says Eagle. "Even those who move on carry Mayo values like compassion and patient-centered care into their future roles."

Why CRISP matters

For Eagle, CRISP was more than an internship — it was a bridge between academic learning and clinical application. From her days in the program to her role today as an engineering leader, Eagle exemplifies how experiential learning at Mayo Clinic can continue to spark breakthroughs that improve patient care.

“Carleigh is a shining example of what’s possible when students get early exposure through programs like CRISP and others offers through ONCEP (Office of Non-Clinical Education Programs),” says Michael Boniface, M.D., program director of CRISP in Florida. “She’s not only done an amazing job in her own role, but she’s also helped build a one-of-a-kind internship experience in Physics, Chemistry, and Engineering. That’s the kind of impact these programs can have.”

The post From intern to engineer: How CRISP sparked Carleigh Eagle’s role in 3D surgical innovation appeared first on Mayo Clinic News Network.

JACKSONVILLE, Fla. — A new multicenter study led by Mayo Clinic researchers has established a practical, evidence-based definition for rapidly progressive dementia (RPD), a rare but devastating form of cognitive decline that develops over months instead of years. The findings, published in Neurology, the medical journal of the American Academy of Neurology, may help clinicians recognize and treat RPD earlier, and enable researchers to work from a shared framework when studying the condition.

While most types of dementia progress gradually, RPD advances with alarming speed, often leading to significant cognitive decline or death within one to two years. Although it accounts for around 4% of dementia cases, RPD is difficult to diagnose. Symptoms can stem from numerous causes, including autoimmune disease, infections, neurodegenerative disorders such as Alzheimer's disease and rare conditions like Creutzfeldt-Jakob disease. This makes it challenging to consistently define the disorder across different settings.

"Clinicians need a clear, standardized way to identify patients whose decline is unusually fast," says Gregg Day, M.D., a behavioral neurologist at Mayo Clinic and senior author of the study. "This helps ensure that those with potentially treatable causes are recognized quickly, wherever they are seen. Furthermore, this is a necessary step before launching multicenter studies aimed at understanding why a small subset of dementia patients progresses rapidly and how to address this through clinical trials and treatments."

The new definition proposed by Dr. Day and his colleagues uses the Clinical Dementia Rating (CDR) scale, a well-established tool for assessing dementia severity. Criteria are based on the level of functional impairment involving memory, orientation, judgment, problem-solving, community affairs, home and hobbies, and personal care. Under the new framework, a person is considered to have rapidly progressive dementia if they develop mild dementia (CDR score of 1 or higher) within one year of symptom onset, or moderate-to-severe dementia (CDR score of 2 or higher) within two years. Researchers refer to this as the "1-in-1 or 2-in-2" rule.

To test this definition, the research team applied it to two large datasets. The first, known as the RaPID cohort, included 248 patients evaluated for suspected RPD at Mayo Clinic in Florida and Washington University in St. Louis. The second used data from the National Alzheimer's Coordinating Center, representing more than 19,000 participants across 46 research centers in the United States.

In the RaPID group, about 75% of patients met the new criteria. Nearly 1 in 3 had autoimmune or inflammatory causes — many of which are potentially reversible. In the broader national dataset, about 4% met the definition for RPD, with Alzheimer's disease being the most common underlying cause. Across both groups, people who met the RPD definition declined 3 to 4 times faster than those with typical dementia, based on changes measured using the CDR scale.

The new definition proved reliable across clinical and research settings, identifying both rare and common causes of RPD. It can be applied using a patient's clinical history instead of specialized testing, making it adaptable in diverse healthcare settings, including those with limited medical resources.

"By uniformly defining rapid progression, we can better identify patients who might benefit from treatment, improve consistency in research, and ultimately enhance care for people facing one of the most challenging forms of dementia," Dr. Day says.

For a complete list of authors, disclosures and funding, see the paper.

Related:

• Mayo Clinic researchers to study causes of rapidly progressive dementia
• Researchers identify new criteria to detect rapidly progressive dementia

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About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news.

Media contact:

• Tia Ford, Mayo Clinic Communications, newsbureau@mayo.edu

The post New Mayo-led study establishes practical definition for rapidly progressive dementia appeared first on Mayo Clinic News Network.

Barbara Brown was working in New York City when the Sept. 11 attacks occurred. Exposure to toxins led to years of struggling to breathe and searching for answers.

Barbara's journey led her to Mayo Clinic and, ultimately, a life-changing double-lung transplant. With renewed strength, Barbara shares what drives her to educate others about transplants.

Watch: Double-lung transplant inspires mom to educate and support others

Journalists: Broadcast-quality video pkg (2:14) is in the downloads at the end of the post. Please courtesy: "Mayo Clinic News Network." Read the script.

"I was meeting my girlfriends for breakfast," Barbara says. "She actually worked in the World Trade Center. When the actual plane hit the tower, I wasn't right up on the towers, but I was where you could see it."

What followed that day would change Barbara's health and life forever.

"All of this stuff that was in your lungs," Barbara recalls.

Over time, Brown started to notice changes in her health. Then, a pivotal moment in 2006 while being a mom to an active 2-year-old girl.

"(My daughter) jumped up in my arms, and I kind of fell backward. And I fell down, and I couldn't hold her," Barbara says. "That was the first big thing with my lungs."

Barbara was diagnosed with interstitial lung disease, where inflammation and scarring make it difficult to breathe. Doctors explained that someday she would need a lung transplant.

"I looked at this little girl that I had, and I said, 'You know, if I'm going to fight, I'm going to fight for her, you know,'" Barbara says. "And so that's what I chose to do."

Barbara spent much of the next decade searching for a transplant program that would be the right fit. She traveled across the country speaking with care teams and taking evaluations — all while her lungs grew weaker. Then, Mayo Clinic entered her life.

"Barbara came through our doors, referred to us from an outside provider, with a disease that was fairly advanced," Dr. Tathagat Narula, a Mayo Clinic transplant pulmonologist, says. "She was on a lot of oxygen, very, very sick."

After qualifying for a double-lung transplant and spending time on the waiting list, Barbara got the call in April 2017.

"It's the scariest thing in the world because now you're looking at everybody and you're like, 'This is it!'" Barbara says. "'This is really it!'"

Recovery would be long, but after physical therapy to regain her strength, Barbara was breathing without assistance and ready to pick up where her life had paused. The journey has also inspired her to share her story and dispel misconceptions about transplant.

"I decided that I was going to really write about my experience," Barbara says. "If I can do something to get the information out there, and I said, 'I'm going to maybe attempt at it this way.'"

"In Barbara's case, she has had this opportunity to see her daughter grow up, go to college," Dr. Narula says. " Barbara is writing a book to share her journey, to share her story with the wider audience. What more can you ask for?"

Eight and a half years after transplant, she's happy and excited for her next chapter.

"Do I look like someone who's been through a double-lung transplant? No, but what does someone look like? If someone says I look like a happy person, then that's what I would prefer looking like," Barbara says.

Related stories:

• Mayo Clinic’s transplant center in Florida performs 10,000th
• Expert alert: 5 reasons more diverse organ donors are needed

The post (VIDEO) Double-lung transplant inspires mom to educate and support others appeared first on Mayo Clinic News Network.

November is Diabetes Awareness Month

JACKSONVILLE, Fla. — Diabetes affects how the body uses glucose, also known as blood sugar. It can mean that there is too much sugar in the blood. This can harm people in several ways. One serious complication is chronic kidney disease. Ivan Porter II, M.D., a nephrologist at Mayo Clinic in Florida, explains the connection between diabetes and chronic kidney disease.

Up to 40% of people with diabetes develop chronic kidney disease, also called chronic kidney failure, global statistics show. Their kidneys cannot effectively do their most important job, which is regulating the composition of the blood by filtering out waste and maintaining the balance and amount of salt and water in the body.

Chronic kidney disease may be advanced before symptoms appear and a person is diagnosed. It can progress to end-stage kidney failure, which can be fatal without dialysis or a kidney transplant.

Both type 1 and type 2 diabetes can lead to chronic kidney disease. Type 2 diabetes is a far more common cause. With either type, the body can't produce enough insulin. Insulin is a hormone produced in the pancreas that helps the body convert sugar into energy. Because one of the kidneys' most important jobs is cleaning the blood, they help regulate blood glucose levels, Dr. Porter explains.

"The high levels of circulating glucose in the blood are poisonous to nerves and blood vessels, and the kidneys are a big ball of blood vessels," Dr. Porter says. "The presence of high glucose leads to chemical changes that cause protein in urine, and the presence of protein in urine directly activates factors that cause scarring and fibrosis within the kidney, leading to worsening of kidney disease."

How diabetes and chronic kidney disease overlap and interact with each other is complex. Too much glucose in the blood can damage the kidneys and lead to chronic kidney disease. At the same time, declining kidney function related to chronic kidney disease can lead to insulin resistance, which can cause type 2 diabetes. In addition, declining kidney function can worsen preexisting diabetes.

The longer you have diabetes — and the less controlled your blood sugar — the higher the risk of complications such as chronic kidney disease. 

There are five stages of kidney disease, based on the glomerular filtration rate (GFR). The GFR measures how well the kidneys filter waste from the blood. The stages are:

• Stage 1. At this stage, the GFR is 90 or higher, which is considered a healthy level. However, there is also another indicator of kidney disease present, such as blood or protein in the urine.

• Stage 2. At this stage, the GFR is 60 to 89.

• Stage 3. This stage is broken down into two subtypes — stage 3a and stage 3b. With 3a, the GFR is 45 to 59, and there is mild to moderate decline in kidney function. With 3b, the GFR is 30 to 44, and there is a more severe decline in kidney function.

• Stage 4. The GFR is 15 to 29, and kidney decline is severe.

• Stage 5. This stage is considered end-stage renal disease, also called kidney failure. The GFR is under 15. At this point, dialysis or a kidney transplant is needed.

Most often, chronic kidney disease is diagnosed in stage 3 or later.

"The presence of other comorbidities, such as uncontrolled blood pressure, uncontrolled diabetes or the presence of protein in the urine, can make what might seem like an earlier stage worse for someone," Dr. Porter says.

Not everyone living with diabetes will develop chronic kidney disease. Dr. Porter says it is critical to manage your diabetes, monitor your kidney function regularly and take steps to protect your kidney health to help lower risk.

Controlling diabetes includes managing medication, developing a healthy eating routine, exercising and planning for factors that can affect blood sugar levels, such as illness, stress, and changes in hormone levels due to menstrual cycles, perimenopause and menopause.

Type 2 diabetes has risk factors that people can try to avoid. These include preventing or treating overweight or obesity; being active; maintaining healthy levels of HDL cholesterol, also known as good cholesterol; and avoiding alcohol or limiting consumption to a moderate level. 

For more information, visit Mayo Clinic and Mayo Clinic Press.

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