Meet Huntington's disease clinic director Vicki Wheelock
When Vicki Wheelock persuaded UC Davis Health System administrators to establish a Huntington's disease (HD) clinic in 1997, she knew she signed on for an uphill battle. Cures or effective treatments do not exist. The condition of HD patients inexorably worsens, and their prognosis is eventual death from the debilitating effects of the disease.
Although Huntington's disease is as prevalent as hemophilia, cystic fibrosis and muscular dystrophy, few people outside the medical community had heard of it until folk singer Woody Guthrie died of HD in 1967 and his decline was portrayed in his son Arlo's film Alice's Restaurant two years later.
“As devastating as this disease is, our patients and their families have incredible resilience,” said Wheelock, an associate professor, health sciences clinical series, in the Department of Neurology. The UC Davis HD clinic helps 200 patients cope with the disease. “We conduct genetic testing and counseling, prescribe medications and therapies, and connect them with support groups,” Wheelock said. She closely monitors research findings through journals and professional conferences. “Otherwise, I would be too heartbroken to go on,” she acknowledged.
— neurologist Vicki Wheelock
HD is a hereditary, degenerative brain disorder that gradually inhibits motor and cognitive functions. Patients in the advanced stage become wholly dependent upon others for their care. Wheelock was interested in movement disorders as a neurology resident at Los Angeles County USC Medical Center in 1983 when researchers first discovered the “marker” for HD on the fourth chromosome.
She moved to Sacramento in 1988 with her husband, diagnostic radiologist Jerry Schwarz, when he joined Kaiser Permanente Medical Group. As the couple began raising a family, Wheelock began a part-time practice as a neurologist at Kaiser.
“I always wanted to practice neurology in an academic setting, so when the kids were beyond diapers, I contacted UC Davis,” Wheelock said. After serving as a volunteer clinical faculty member, she became a salaried faculty member in 1996. Soon afterward, neurosurgeon Conrad Pappas recruited her to co-direct Kaiser's functional neurosurgery program. For the next eight years she was part of an operating room team that performed more than 400 pallidotomies and deep-brain stimulator implant surgeries for patients with Parksinson's disease and other movement disorders.
The Movement Disorders Program
The UC Davis Health System Movement Disorders Program provides evaluation, treatment and management of several movement disorders, including Parkinson's disease, essential tremor, Huntington's disease, ataxia and dystonia. Treatments available are oral medication, botulinum toxin therapy, referral for deep brain stimulator (DBS) implant and DBS programming.
In 2001, the Huntington's Disease Society of America (HDSA) named UC Davis a center of excellence, recognizing its expertise in clinical care for Huntington's disease patients. Directed by associate physician Vicki Wheelock and nurse practitioner Teresa Tempkin, the multidisciplinary team also consists of a full-time social worker, psychiatrist, physical therapist and genetics counselor. The clinic offers predictive testing, diagnosis and management of symptomatic Huntington's disease, nursing home outreach and community outreach. Patients and families can also participate in clinical trials sponsored by the Huntington Study Group.
For more information, call (916) 734-6277 or visit the Web.
“When I joined the faculty at UC Davis, I was most interested in Parkinson's disease, but David Richman, who was then the health system's chief of neurology, told me about a local family affected by Huntington's disease,” Wheelock explained. Richman introduced her to Judy Roberson of the Huntington's Disease Society of America (HDSA), Northern California chapter.
The productive meeting led to agreement by the Joseph P. Roberson Foundation and later by the Charles and Margaret Pue Charitable Trust to underwrite much of the cost of operating a Huntington's disease clinic at the medical center. The funding enabled Wheelock to recruit registered nurse Teresa Tempkin to co-direct the clinic.
“Hiring Terry was the smartest move I made in developing our HD program,” Wheelock said. The clinic's staff now includes a nurse practitioner, social worker, physical therapist, genetics counselor and research assistant, and recruitment of a second psychiatrist is under way.
“The unique aspect of our HD program is our partnership with local families, through charitable foundations and the northern California Chapter of HDSA. The families deserve credit for approaching our department with their dream of setting up a clinic, and for the continued support they provide us,” Wheelock said. “The UC Davis Huntington's disease program has surpassed my dreams.”
Nearly half of the clinic's HD patients are enrolled in clinical trials. UC Davis has been selected as one of 11 sites for the first clinical trial of neuroprotective therapy in healthy individuals who have inherited the gene for Huntington's disease.
“Starting treatment before the first symptoms arise has long been the goal for HD clinicians and families, ” Wheelock said. “As basic scientists discover more potential treatments, we hope to increase participation in clinical trials in our race to make this the last generation with HD.”