Nellis doctor provides unique capability

by Senior Airman Jack Sanders
99th Air Base Wing Public Affairs

10/11/2012 - NELLIS AIR FORCE BASE, Nev. -- Maj. (Dr.) Jeremy Kilburn is providing a specialty procedure at the Mike O'Callaghan Federal Medical Center here that's saving money and, more importantly, time.

Kilburn is the cardiopulmonary flight commander and intensive care unit director at the federal medical center, but not long ago, he attended a civilian fellowship where he learned and performed endobronchial ultrasound bronchoscope procedures.

"What we do is sedate the patient and go down through the mouth into the trachea or the windpipe," Kilburn said. "The purpose of the procedure is to look more closely at abnormal areas originally detected in a Computed Tomography (CT) scan."

The procedure is not only less invasive than traditional surgery and can provide quicker results to patients, but it is also more cost efficient. The traditional bronchoscope uses a CT scan and a camera to perform the procedure, but the endobronchial ultrasound bronchoscope provides an ultrasound image in real time the doctor can use instead of the CT-scan image.

"The problem is there's a lot of very important structures near the lungs--the heart, great vessels, aorta, pulmonary arteries--so it's a little bit riskier, and it's not as accurate to perform the older procedure," Kilburn said. "As far as I know, we're the first medical facility in Las Vegas to be doing this procedure."

Kilburn's most recent bronchoscope patient, Davis Leonard, chose the procedure to speed up diagnostic time.

"This gentleman had a right upper lobe mass that had been biopsied before by going in from the outside, and that wasn't diagnostic," Kilburn said. "We didn't have a good answer for him."

Kilburn met Leonard during an emergency bronchoscope for a different ailment; Leonard needed the procedure after he'd inhaled a tooth while undergoing dental work Sept. 31.

"It was affecting how he could breathe and it was blocking his airway," Kilburn said. "We went in with the bronchoscope and retrieved that tooth for him."

While reviewing the records after the procedure Kilburn saw an opportunity to more accurately examine the mass in Leonard's lung.

"Looking over his record, we saw that he had this unsuccessful biopsy. I felt that we could successfully biopsy [the mass in his lung] from the airway using the endobronchial ultrasound bronchoscope," Kilburn said.

For patients like Leonard, saving time is crucial.

"I've got to find out what kind of cancer I have, if it's cancer," Leonard said. "The doctors can't treat it until they know what it is. My goal is to be the oldest living World War II veteran, and I feel extremely lucky to have Kilburn because he knows what he's doing."

"It's really nice technology that we can use to help people like Mr. Davis," Kilburn said.