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Monday, June 29, 2020

New Hope For Victims of Leprosy

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Dr. Stephen W. Wheat pioneers use of hand-held ultrasound

Sometimes it takes the isolation of a pandemic to allow a mind to journey uninterrupted to the farthest reaches of discovery. Such was the case for Sir Isaac Newton during the Great Plague of London, and such has been the case for Northwest Louisiana electrodiagnostic specialist Dr. Stephen W. Wheat during the Covid-19 pandemic. Isolation and socially distancing allowed Newton to make groundbreaking discoveries including the development of calculus, that white light was comprised of all components of the spectrum, and to start his study of the laws of motion. Similar isolation during the recent Covid-19 pandemic inspired Dr. Wheat to continue on a path of exploration that he had begun early in 2019 hypothesizing that an emerging technology might give new hope to the greater than four million individuals worldwide suffering with undiagnosed leprosy.

With Dr. Wheat’s study and support from Barbara M. Stryjewska, MD, chief medical officer for the National Hansen’s Disease Clinical Center in Baton Rouge, and Michael Stephen Cartwright, MD, professor of neurology at Wake Forest School of Medicine, these often ostracized and mistreated individuals might now have a fighting chance for a cure against one of the world’s most dreaded maladies.

Throughout history, leprosy has been referred to as the world’s most feared and dreaded condition. Hansen’s Disease is caused by the acid-fast bacterium mycobacterium leprae and is most often diagnosed by typical skin lesions, nerve lesions and the presence of bacilli in tissue. Clinical manifestation of leprosy is largely confined to the skin, peripheral nerves, eyes, testes and upper respiratory system. For centuries, individuals diagnosed with leprosy, or Hansen’s Disease (HD), have suffered needlessly from a disease that robs them of both life and limb and is so dramatically misunderstood that its victims are separated from society and marked as social pariahs.

In January of 2019, Dr. Stephen Wheat began to use the emerging technology of a hand-held ultrasound device known as the Butterfly iQ in his neuromuscular and skeletal electrodiagnostic specialty and was happy with the results and the portability.

The Butterfly iQ is one the world’s first hand-held, whole-body ultrasound devices. It can be used with a smartphone or tablet. Having attended medical school in Louisiana and specialized in both internal medicine and physical medicine before becoming an electrodiagnostician, Dr. Wheat was also very familiar with the National Hansen’s Disease Clinical Center, the only institution in the U.S. exclusively devoted to leprosy consulting, research and training. He was aware of the challenges of diagnosing Hansen’s Disease and had learned that high-resolution ultrasound was a newer technology being brought into the diagnostic process. Dr. Wheat began to hypothesize how using a “pocket” ultrasound device such as the Butterfly iQ might change the efficacy with which the world diagnosed this terrible disease.

Michael Stephen Cartwright, MD, professor of neurology at Wake Forest School of Medicine and the person Dr. Wheat refers to as the “guru” of neuromuscular ultrasonography, having written the first evidence-based clinical


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