"Owner of the world's largest kidneys" was never a title Gene Okun wanted to have. Today, thanks to a living donor and a Mayo Clinic surgical team, he no longer does.

Gene Okun's kidneys had to go. They were big. They didn't work. And they were ruining his life.

"My stomach's so big that it affects me physically in everything I do — from waking up in the morning with morning sickness to trying to find the right seat in a restaurant or airplane because I don't fit," Gene told Mayo Clinic's In the Loop blog in August 2017 of his two 50-pound kidneys — some of the largest doctors have ever seen. "And even though it looks like I do, I can't eat very much food because there's very little room in there. Sleeping at night is also a challenge."

Gene’s kidneys had been posing problems for him ever since he was diagnosed with polycystic kidney disease. But he refused to take his diagnosis lying down. He assumed an active role in monitoring his kidney function and in finding a living donor for a kidney transplant. He also began visiting transplant centers around the country to see which one would be the best fit for him. That exhaustive search came to a fruitful conclusion when Gene met Mikel Prieto, M.D., a transplant surgeon at Mayo Clinic's Rochester campus.

"He's a gentle man who's humble yet very knowledgeable, and he's been doing this for such a long time," Gene says of Dr. Prieto. "He sat down with me and described exactly how he'd do my procedure and then ran through some of the complications we could run into. He didn't just sit there and tell me everything was going to be great, and that was something I appreciated."

Together, Gene and Dr. Prieto crafted a plan to get rid of Gene's enormous kidneys and set him on the path to a healthier, happier future.

A series of challenges

The size of his kidneys made Gene's situation complex. Healthy kidneys are usually about the size of a human fist. Both of Gene's kidneys had grown four to five times larger than a football due to his disease. That presented a unique challenge for Dr. Prieto.

"He's not going to have a lot of room to see what's going on in there," Gene said before the transplant. "It's going to be an interesting situation for Dr. Prieto, that's for sure. If nothing else, I appreciate his willingness to give it a shot."

Before that could happen, Gene needed to find a donor. He took a proactive approach to doing so by launching a social media campaign and online video series called Gene's Big Dumb Kidneys. Not only did Gene want to showcase what daily life was like for him and call attention to his own need for a transplant, he also wanted to raise awareness for others.

"We thought the whole idea of using comedy would be much better than just saying, 'Hey, Gene's really sick. Gene needs a kidney.' Because some people glaze over that."

Gene Okun

"We thought the whole idea of using comedy would be much better than just saying, 'Hey, Gene's really sick. Gene needs a kidney.' Because some people glaze over that," Gene says. "We tried to find a way to make all of this humorous and, while not making light of a serious disease, making light of the situation that I myself am in, and then use that to hopefully lead viewers down a path to living donation. That gets serious pretty quickly."

For a while it seemed to be working. The online campaign and Gene's own efforts put him in contact with several potential living donors. But those possibilities fell through.

"I was grateful to meet quite a number of potential donors," Gene says. "But unfortunately, of the initial potential donors, they either didn't make it through the initial medical screening, or they had family objections to doing so."

A friend in need

Watching all of this happen was one of Gene's oldest and dearest friends, Bill McNeese. "I think, initially, he thought I was going to be able to find a donor on my own," Gene says. "But when that wasn't happening fast enough, he stepped in."

Bill volunteered to be Gene's donor. At first, it looked as though Bill's test results would mirror those of other disqualified donors, due to his weight and other medical considerations. But after 10 months of diet and exercise, Bill tried again.

"He ended up losing 50 to 60 pounds and was no longer in need of any potential prescriptions," Gene says. "At that point, my doctors at Mayo felt like he might be a good candidate. We flew to Rochester together so Bill could go through three days of testing."

"I almost don't have words to describe how amazing it felt to find out Bill was qualified to be my donor." 

Gene Okun

Bill turned out to be an excellent fit. "He basically could have been a brother or a sister to me in terms of being a match," Gene says. With Bill approved to be Gene's donor, the transplant was scheduled for June. Gene was overwhelmed with emotion.

"I almost don't have words to describe how amazing it felt to find out Bill was qualified to be my donor. We're great friends and really more like brothers," Gene says. "By him doing this for me, he allowed me to avoid dialysis. Moreover, to end up getting a kidney from someone I know so personally just made it that much more special because Bill really cares for me, and I really care for him." 

An excellent outcome

Before Gene could get Bill's kidney, Dr. Prieto and his surgical team needed to remove Gene's own massively enlarged and underperforming kidneys. It was a slow, tedious process that took longer than anticipated.

"Originally, we'd planned on a 6- to 7-hour surgery, but it ended up taking about 12 hours just because my kidneys were so big, and the way Dr. Prieto does it, laparoscopically, is a very unique procedure," Gene says.

The procedure began with Dr. Prieto making a 4-inch incision in Gene's abdomen. Through it, he then removed 19 liters of fluid from the kidneys so that they could be made small enough to slide out through the incision.

"I feel very blessed that I was able to have the kind of a care team for my transplant that I did." 

Gene Okun

But even though it took some time, the transplant went well. "I was literally up and walking the next day," Gene says. "I was out of the hospital and in the Gift of Life Transplant House within three days. That was just amazing to me, and the story was even better for Bill. He was out of the hospital the next day after surgery."

Dr. Prieto performed both surgeries. "He did a full 12-hour day of kidney removal and transplantation," Gene says. "He's a very amazing surgeon and person with an equally amazing team behind him. I feel very blessed that I was able to have the kind of a care team for my transplant that I did."

A welcome transformation

Since the transplant, Gene's been reveling in his newfound quality of life. "I'm doing very well now," he says. "I can take a full breath now, which I could not do before the transplant. My appetite is back, as well. I'm also now sitting in booths in restaurants, which I never could before. During my plane ride home from Mayo, I was also able to put the tray table down in front of me, which I'd never been able to do. I just feel generally better. It's an amazing feeling, and everybody who sees me now can't believe the amazing transformation."

It's a transformation that Gene says is only getting better with each passing day.

"Things are much better right now than I ever expected them to be, and I'm just very blessed and happy with the outcome," he says. "I'm so very grateful for everything Bill and Mayo Clinic have done for me. I can't thank them enough."

To show his appreciation, after the transplant, Gene donated his old kidneys to Mayo Clinic to help researchers better understand and treat polycystic kidney disease. He's also redirecting the time and energy he put into finding a donor for himself into creating a new website that promotes living organ donation.

"I don't think a lot of people know or understand that you can donate a kidney to someone while you're still alive, and that you can go on living your same quality of life with only one kidney," Gene says. "I'm now working to change that."

HELPFUL LINKS

• Read more about polycystic kidney disease.
• Learn about kidney transplant at Mayo Clinic.
• Check out the Mayo Clinic Transplant Center.
• Explore Mayo Clinic's Rochester campus.
• Request an appointment.

The post Bidding Farewell to Enormous, Faulty Kidneys appeared first on Mayo Clinic News Network.

On the Mayo Clinic Radio podcast, Mary Wilder, director of the Gift of Life Transplant House, and house resident John Roise give an inside look at how staying at Gift of Life helps ease the financial and emotional burdens of a transplant journey. Also on the podcast, Dr. Tobias Kohler, a urologist at Mayo Clinic, explains the latest treatments for erectile dysfunction. And Capt. Lori Cline, an American Airlines pilot, discusses the training and testing required for commercial airline pilots to be cleared to fly.

The post #MayoClinicRadio podcast: 5/19/18 appeared first on Mayo Clinic News Network.

On the next Mayo Clinic Radio program, Mary Wilder, director of the Gift of Life Transplant House, and house resident John Roise will give you an inside look at how staying at Gift of Life helps ease the financial and emotional burdens of a transplant journey. Also on the program, Dr. Tobias Kohler, a urologist at Mayo Clinic, will explain the latest treatments for erectile dysfunction. And Capt. Lori Cline, an American Airlines pilot, will discuss the training and testing required for commercial airline pilots to be cleared to fly.

Here's your Mayo Clinic Radio podcast.

The post Gift of Life Transplant House / erectile dysfunction treatment / pilot safety and readiness appeared first on Mayo Clinic News Network.

On the next Mayo Clinic Radio program, Mary Wilder, director of the Gift of Life Transplant House, and house resident John Roise will give you an inside look at how staying at Gift of Life helps ease the financial and emotional burdens of a transplant journey. Also on the program, Dr. Tobias Kohler, a urologist at Mayo Clinic, will explain the latest treatments for erectile dysfunction. And Capt. Lori Cline, an American Airlines pilot, will discuss the training and testing required for commercial airline pilots to be cleared to fly.

To hear the program, find an affiliate in your area.

Use the hashtag #MayoClinicRadio, and tweet your questions.

Mayo Clinic Radio is on iHeartRadio.

Access archived shows or subscribe to the podcast.

Mayo Clinic Radio produces a weekly one-hour radio program highlighting health and medical information from Mayo Clinic.

The post Mayo Clinic Radio: Gift of Life Transplant House appeared first on Mayo Clinic News Network.

On the next Mayo Clinic Radio program, Mary Wilder, director of the Gift of Life Transplant House, and house resident John Roise will give you an inside look at how staying at Gift of Life helps ease the financial and emotional burdens of a transplant journey. Also on the program, Dr. Tobias Kohler, a urologist at Mayo Clinic, will explain the latest treatments for erectile dysfunction. And Capt. Lori Cline, an American Airlines pilot, will discuss the training and testing required for commercial airline pilots to be cleared to fly.

To hear the program, find an affiliate in your area.

Miss the show? Here's your Mayo Clinic Radio podcast.

Use the hashtag #MayoClinicRadio, and tweet your questions.

Mayo Clinic Radio is on iHeartRadio.

Access archived shows or subscribe to the podcast.

Mayo Clinic Radio produces a weekly one-hour radio program highlighting health and medical information from Mayo Clinic.

The post Mayo Clinic Radio: Gift of Life Transplant House / erectile dysfunction treatment / pilot readiness appeared first on Mayo Clinic News Network.

Years of health challenges that led to two kidney transplants motivated Ed Pompeian to establish the Gift of Life Transplant House, where people navigating their own transplants receive lodging, along with plenty of support and encouragement.

Since he was 12 years old, Ed Pompeian's life has been shaped by the state of his kidney. You won't hear him complain, though.

Through a lifetime of health challenges, including two kidney transplants, Ed fell in love and raised a family. He built a successful business. And along the way, he improved the lives of thousands of other transplant patients and their families.

It all started with a sick boy and some unanswered questions.

Mystery illness

Ed was living in Michigan when he began having nagging health problems. Doctors suspected it was lupus, but that wasn't right. Neither was anything else they thought they had diagnosed. It was a mystery, and nobody seemed to have a solution.

While the doctors pondered, Ed's health continued to deteriorate. Doctors told Ed's parents their son likely wouldn't see his 16th birthday. They were wrong.

Ed has survived and thrived, but it wasn't always easy. Health problems, particularly in those early days, limited what Ed was able to do. He spent a lot of time indoors, and was rarely able to hang out with friends.

"I didn't have the normal teenage years. That's for sure," Ed says. "I finished high school on time and graduated with honors, but I was at home most of those years."

Ed started dialysis when he was 17. In the mid-1960s, at the suggestion of a family the Pompeians met during one of their frequent hospital visits, they looked to Mayo Clinic for answers. His Mayo Clinic doctors got Ed back on his feet. They put him on a low-sodium, low-protein diet. But they also told his parents that no matter what they did, their son's kidneys were eventually going to fail.

A new way forward

Kidney transplants were a new procedure at the time. Ed's care team at Mayo Clinic suggested waiting until more of the procedures had been successfully completed before scheduling his transplant. Ed's mother had been cleared to become his donor, so with a living donor already identified who was a match, the family decided to hold off on the transplant until his physicians felt the time was right.

"I was fortunate because my family was arguing about who would donate," Ed says.

Finally, in 1972, it was time. The family moved to Rochester, Minnesota, that year, and Ed has been there ever since. Today, Ed is one of Mayo Clinic's oldest and longest-surviving kidney transplant patients.

"My transplant journey has been incredible for me — from the people we've met to the personnel at Mayo. I wouldn't want my life to be any different than it is." — Ed Pompeian

Ed's mother donated her kidney for his first transplant. But things didn't go exactly to plan. In the early days of kidney transplants, the procedure involved removing the spleen and diseased kidney in an initial surgery, then completing the transplant 30 days later. Due to complications, Ed's experience took longer. He was in the hospital from September through December 1972, eventually receiving his transplant on April 26, 1973.

For 25 years after that, Ed's medical condition was mostly stable. His new kidney functioned well, and there were no changes in his blood test results. The theory at the time was that some transplant patients could eventually stop taking anti-rejection medication. But when Ed began reducing his anti-rejection medications, he started having problems.

The kidney he got from his mother failed after 31 years, and Ed found himself in need of another transplant. On Dec. 28, 2004, Ed's 20-year-old son, Aaron, became his second donor.

Finding a career and a calling

Ed tried going to college after his first transplant, but health problems made it difficult for him to consistently attend class. He eventually dropped out. After a year of career uncertainty, Ed saw a newspaper ad from a real estate firm looking for new agents. He decided to give it a try. He got his real estate license in 1975, started his own office three years later, and spent the next 40 years building a successful real estate career.

Along the way, Ed began buying properties. He bought a hotel, some houses and a few apartment buildings. They were meant as investments, but for Ed and thousands of others, those investments soon became something much more vital.

After his first transplant, Ed made a habit of visiting other transplant patients at Rochester Methodist Hospital. His goal was to support patients through the transplant process because there wasn't a formal transplant program in place at the time.

During one of his visits, he met a nurse named Jayne, who would eventually become his wife. Then Ed once again defied the odds. Although he was told he would most likely not be able to have children due to his long-term use of anti-rejection medications, in time, Ed and his wife had three boys and one girl.

Not only did his visits to transplant patients lead him to the love of his life, but Ed began to notice the challenges transplant families faced. Patients have to be in or near the hospital for extended periods both before and after transplant surgery. Renting a hotel room quickly becomes expensive and inconvenient. Ed believed there had to be a better way. He decided to create a place where patients and families could stay during their transplant journey, where they could be comfortable and not break the bank.

"It makes me happy and proud. My wife and I will drive by those houses and say, 'Can you really believe that we did this?'" — Ed Pompeian

Ed began by renting a unit in one of his apartment buildings to transplant families. However, it quickly became clear that as much as they needed a place to stay, the families also needed a support network and contact with other people who were facing the same challenges. The isolation of an apartment building would not work.

In 1984, Ed found exactly what he was looking for in a neighborhood near Mayo Clinic's Rochester campus.

"I walked in and said to myself, 'This is what a transplant house should be," he recalls. "It had eight bedrooms, three bathrooms, a huge kitchen and Craftsman-style architecture."

The house wasn't in Ed's budget, but the seller liked Ed's vision of turning her home into a transplant house. She agreed to accept a $15,000 down payment and a $100,000 purchase price. With a deal in place, Ed made the rounds in Rochester to collect donations for the down payment. Later that year, he established the Gift of Life Transplant House to support transplant patients and their families.

A family tradition of support

As Mayo Clinic's transplant programs grew, so did the demand for the Gift of Life Transplant House services. The organization opened a second house in 2009. Between the two locations, the houses offer 84 rooms for people going through transplants of all kinds. Each room has two beds, one for the transplant patient and one for a caregiver. Residents cook in common kitchens and spend time together in large common areas. If the houses are full, the Gift of Life Transplant House staff helps patients find discounted rooms at nearby hotels.

The Gift of Life Transplant House has helped thousands of families over the years. Ed, who still lives in Rochester but spends the winter months in Florida, remains involved with the organization, along with his daughter and one of his sons. Ed's wife has also been a willing volunteer, from housing transplant patients in their own home to helping serve meals to simply being available to meet patients and families.

"It makes me happy and proud," says Ed, who recently wrote a book, called The Gift of Life, about his experiences. "My wife and I will drive by those houses and say, 'Can you really believe that we did this?'"

Ed has come a long way from the ailing 12-year-old who often couldn't leave his house. He has cleared more hurdles in that time than most people can imagine. But he doesn't regret any of it, and would never wish for anything else. His transplant experience has made him who he is. The path he followed brought him to his wife, gave him his children, and allowed him to help countless other families through their own difficult times.

"I've had so many miracles in my life. It's just incredible," he says. "My transplant journey has been incredible for me — from the people we've met to the personnel at Mayo. I wouldn't want my life to be any different than it is."

HELPFUL LINKS

• Read about kidney transplants.
• Explore the Mayo Clinic Transplant Center.
• Learn more about the Gift of Life Transplant House.
• Connect with others talking about Kidney Transplant on Mayo Clinic Connect.
• Request an appointment.

The post Two-Time Kidney Transplant Recipient Builds a Life-Giving Legacy appeared first on Mayo Clinic News Network.

ROCHESTER, Minn. — Friday, April 17, is “Donate Life Day” in Rochester, an annual recognition to raise awareness about organ donation. LifeSource, Gift of Life Transplant House and Mayo Clinic Transplant Center are hosting a “Walk of Remembrance” and flag ceremony starting at 4:30 p.m. on the Saint Marys Hospital campus. The public is welcome and encouraged to attend.

More than 120,000 people are waiting for an organ transplant in the United States. Nearly 2,000 of those are children. Mayo Clinic has over 3,000 patients on the waiting list for an organ transplant. Every 10 minutes another name is added to the national waiting list. An average of 21 people die each day in the United States waiting for transplants that can't take place because of the shortage of donated organs.

MEDIA CONTACT:
Ginger Plumbo, Mayo Clinic Public Affairs, 507-284-5005, Email: newsbureau@mayo.edu

April is National Donate Life Month, and events are happening across the country to increase support for organ, tissue and eye donation. In addition to the Donate Life Day event in Rochester, there are several other ways to participate or observe Donate Life Month:

• “Wear Blue & Green Day,” Friday, April 17, and tell your friends and family about your wishes to be an organ donor.
• Take a photo of your green “Donate Life” bracelet, or your blue and green outfits (creativity encouraged!) and post it to the “Transplantation at Mayo Clinic” Facebook page. Use hashtag #donatelife if you post on your own Facebook or Twitter.
• Attend the Donate Life Day “Walk of Remembrance” and flag ceremony
  • 4:30 p.m. – Flag Ceremony at Saint Mary’s with Tribute to Donors and their Families by Sister Tierney Trueman
    • Meet at Francis Building flagpole
  • Followed by the Walk of Remembrance from Saint Marys to Gift of Life Transplant House, led by John Thistle, M.D., retired Mayo Clinic physician and bagpiper from Rochester Caledonian Pipe and Drum Corps.

• Followed by, flag ceremony at Gift of Life Transplant House. Gift of Life Transplant House is located at 705 Second Street SW.

• Donor families and transplant recipients raise Donate Life Flag
• Timucin Taner, M.D., Ph.D., liver transplant surgeon, will speak
• Reception to follow

For more information on how to register as a donor, visit http://www.donatelifemidwest.org/mn/.

About Donate Life Month
National Donate Life Month (NDLM) was instituted by Donate Life America and its partnering organizations in 2003. Celebrated in April each year, NDLM features an entire month of local, regional and national activities to help encourage Americans to register as organ, tissue and eye donors and to celebrate those who have saved lives through the gift of donation.

About Gift of Life Transplant House
Gift of Life Transplant House was founded in 1984 by kidney transplant patient Ed Pompeian. His vision and mission was to provide Mayo Clinic transplant patients with high-quality affordable accommodations in a supportive homelike environment.

Gift of Life provides services for solid organ, bone marrow and stem cell transplant patients and their families. It is a place of compassion, healing and hope for patients of all ages from all over the world. In this supportive environment, the Gift of Life Transplant House helps ease the impact of the complex medical, financial, emotional and spiritual burdens families are faced with day to day on their transplant journey.

Gift of Life Transplant House in Rochester, Minnesota, is a not-for-profit independent Hospital Hospitality House and a member of the Healthcare Hospitality Network (HHN).

About Transplantation at Mayo Clinic
Mayo Clinic has one of the nation’s largest and most experienced transplant practices, with campuses in Minnesota, Arizona and Florida. Over 200 doctors in transplant medicine and surgery perform about 1,800 transplants a year, and have a long track record of excellent outcomes. The heart transplant program at Mayo Clinic in Rochester is part of the integrated William J. von Liebig Transplant Center, where more than 800 solid organ and blood and marrow transplants take place every year. The opportunity to collaborate with multiple transplant programs allows Mayo Clinic patients access to a multidisciplinary transplant team and the opportunity for multiorgan transplantation if necessary.

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About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to medical research and education, and providing expert, whole-person care to everyone who needs healing. For more information, visit http://www.mayoclinic.org/about-mayo-clinic and https://newsnetwork.mayoclinic.org/.

The post April 17 is ‘Donate Life Day’ in Rochester appeared first on Mayo Clinic News Network.

ROCHESTER, Minn. — Rochester Mayor Ardell Brede will proclaim Friday, April 11, “Donate Life Day” in Rochester at a ceremony at the Gift of Life Transplant House (north house) starting at 4 p.m. that day. A 3-by-5-foot Donate Life flag will be raised as part of the ceremony to increase awareness and honor organ donors. The event is open to the public. The Gift of Life Transplant House is located at 705 Second Street SW.

More than 120,000 people are waiting for an organ transplant in the United States. Nearly 2,000 of those are children. Mayo Clinic has over 3,000 patients on the waiting list for an organ transplant. Every 10 minutes another name is added to the national waiting list. An average of 18 people die each day in the United States waiting for transplants that can't take place because of the shortage of donated organs.

April is National Donate Life Month, and events are happening across the country to increase support for organ, tissue and eye donation. In addition to the Donate Life Day event in Rochester, there are several other ways to participate or observe Donate Life Month:

• “Wear Blue & Green Day,” Friday, April 11, and tell your friends and family about your wishes to be an organ donor.

• Take a photo of your green “Donate Life” bracelet and post it to the "Transplantation at Mayo Clinic” Facebook page. Use hashtag #donatelife if you post on your own Facebook or Twitter.

• The Plummer Building carillon tower will be lit with green lights the evening of April 11.

• Visit the LifeSource Donor Quilt exhibit, April 14–18, 8:30 a.m. to 4:30 p.m., Hage Atrium, Mayo Clinic downtown campus, Rochester.

• Watch “A Gift for Life,” the one-hour transplant documentary by Dennis Mahoney and TPT Productions on Monday, April 14, and Thursday, April 17, from noon to 1 p.m., Judd Hall, Mayo Clinic downtown campus.

For more information on how to register as a donor, visit http://www.donatelifemidwest.org/mn/.

About Donate Life Month
National Donate Life Month (NDLM) was instituted by Donate Life America and its partnering organizations in 2003. Celebrated in April each year, NDLM features an entire month of local, regional and national activities to help encourage Americans to register as organ, tissue and eye donors and to celebrate those who have saved lives through the gift of donation.

About the Gift of Life Transplant House
Now celebrating 30 years of service, Gift of Life Transplant House was founded in 1984 by kidney transplant patient Ed Pompeian. His vision and mission was to provide Mayo Clinic transplant patients with high-quality affordable accommodations in a supportive homelike environment.

Gift of Life provides services for solid organ, bone marrow and stem cell transplant patients and their families. It is a place of compassion, healing and hope for patients of all ages from all over the world. In this supportive environment, the Gift of Life Transplant House helps ease the impact of the complex medical, financial, emotional and spiritual burdens families are faced with day to day on their transplant journey.

Gift of Life Transplant House in Rochester, Minnesota is a not-for-profit independent Hospital Hospitality House and a member of the Healthcare Hospitality Network (HHN).

About Transplantation at Mayo Clinic
Mayo Clinic has one of the nation’s largest and most experienced transplant practices, with campuses in Minnesota, Arizona and Florida. Over 200 doctors in transplant medicine and surgery perform about 1,800 transplants a year, and have a long track record of excellent outcomes. The heart transplant program at Mayo Clinic in Rochester is part of the integrated William J. von Liebig Transplant Center, where more than 800 solid organ and blood and marrow transplants take place every year. The opportunity to collaborate with multiple transplant programs allows Mayo Clinic patients access to a multidisciplinary transplant team and the opportunity for multiorgan transplantation if necessary.

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About Mayo Clinic
Recognizing 150 years of serving humanity in 2014, Mayo Clinic is a nonprofit worldwide leader in medical care, research and education for people from all walks of life. For more information, visit 150years.mayoclinic.org, www.mayoclinic.org and newsnetwork.mayoclinic.org.

MEDIA CONTACT:
Rita Hawkins, Gift of Life Transplant House, rita@gift-of-life.org
Ginger Plumbo, Mayo Clinic Public Affairs, 507-284-5005, Email: newsbureau@mayo.edu

The post Mayor Ardell Brede to Proclaim April 11 ‘Donate Life Day’ in Rochester appeared first on Mayo Clinic News Network.