HH/Beck: Good Morning Dr. Pillsbury. Its an honor to work with you. Id like to start with a little bit about your professional history please. Where did you go to medical school?
PILLSBURY: I went to college from 1965 to 1968 at George Washington University. From 1968 to 1972 I was in medical school at the same place. I did my internship and residency here at University of North Carolina at Chapel Hill. I spent four months in Zurich studying with Dr Fisch, and then I went on the faculty at Yale and I stayed there for five and a half years. In 1982 I came here as the Associate Division Chief and then I became the Division Chief in 83. We just became a department last year so Ive been a Department Chairman for one year.
HH/Beck: Well thats a quick and impressive history. So youre going on 20 years now at UNC Chapel Hill. How big is the department?
PILLSBURY: We have 95 people working here; 15 faculty, 15 residents, 8 audiologists, 8 Ph.D. researchers, and the rest are technicians, nurses, secretaries, and that sort of thing.
HH/Beck: When did you start the cochlear implant program?
PILLSBURY: I took Bill Houses course in Los Angeles in 1982, and then in 1984, soon after the FDA approved cochlear implants, I did my first one here.
HH/Beck: Can you tell me what you told patients about reasonable expectations 18 years ago, and perhaps compare that to what you tell them today?
PILLSBURY: 18 years ago I told patients it would be great if they were able to hear environmental sounds and knew where things were in space based on sound, you know, the ability to localize. I was going to be happy if they could just perceive a few things. The difference between then and now is just huge. Its unbelievable.
HH/Beck: Absolutely, I agree. I can recall being thrilled back in1984, if a cochlear implant patient could understand my voice with lip reading. Of course now, the majority of the patients can use the telephone. It really has come full circle. Who are the ideal cochlear implant candidates in 2003?
PILLSBURY: Well the ideal candidates are still people who are post-lingually deafened. In fact, we have a tremendous number of post-lingually deafened adults who really are poor candidates for hearing aids but now all of a sudden theyve become great candidates for cochlear implants. And Im very pleased with how most of these people have done. They have been remarkable and weve implanted many of them.
HH/Beck: Okay. What do you tell patients as far as the time between the surgical date and the initial tune-up date?
PILLSBURY: I usually tell them about a month but some of these patients are ready sooner. Weve tuned up a few patients after only two weeks.
HH/Beck: Dr Pillsbury, what about post-op complications? How big an issue is that at this point and what are the most common complications?
PILLSBURY: Well, its not a big issue these days because were pretty good at doing them. Weve done almost 800 cochlear implants here. The only problem we really worry about is hematoma, and we see that rarely. We have become meticulous with the bipolar coagulator and we really are in pretty good shape.
HH/Beck: And if youre going to have a hematoma, which is a pooling of blood under the skin, thats usually within the first 60 minutes of closing, isnt it?
PILLSBURY: Right.
HH/Beck: And what about post-operative pain? Is that a significant problem?
PILLSBURY: Well, that really isnt an issue any longer, because we inject the site pre-op, and that lasts for 24 hours, and we put a big dressing on these patients and the big dressing shields the wound against trauma.
HH/Beck: Of your 800 patients, Dr. Pillsbury, how many would you say youve implanted in the last year or so?
PILLSBURY: Weve done between 100 and 120 a year for the last two or three years.
HH/Beck: What do you tell patients regarding telephone use?
PILLSBURY: I tell them they should probably be able to use a telephone after an appropriate amount of time and aural rehabilitation. Ive had very few problems with that.
HH/Beck: What about bilateral implants - your thoughts on that?
PILLSBURY: It depends on who the child is and what the situation is. Ive never had an adult patient with bilateral implants that ever wanted to give one back! All the patients Im familiar with use both of them and theyre grateful to have them. So I think bilateral implants would be the way of the future if we didnt have all the hassles with the insurance industry, thats where the real problem is. The benefit is unquestionable but the insurance issue is a real problem.
HH/Beck: Dr. Pillsbury, its a pleasure speaking with you. I know youve got to run, but thanks so much for your time.
PILLSBURY: Youre welcome Dr. Beck. Glad I was able to help.
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