Meet Saleem Islam, M.D.
When pediatric surgeon Saleem Islam, M.D., M.P.H., came to Shands Hospital for Children at the University of Florida in 2007, he was tasked with developing a minimally-invasive surgery unit for children, a place where big operations could be performed with very small incisions.
He first met 3-year-old patient Nate Ferrell when he was referred to Islam to place a feeding tube into his stomach. Nate was losing weight and couldn’t eat. He was suffering from something called mitochondrial disease, a degenerative disease that attacks the body’s source for energy and growth. And while a feeding tube would have helped his condition, Islam had a hunch that there was a more direct way to treat Nate’s disease. He proposed inserting a minimally-invasive G-tube, or gastronomy tube, through his abdomen to provide proper nutrition directly to Nate’s stomach, and implanting a gastric electrical stimulator into his gastrointestinal tract to treat digestive issues.
“When I first met Nate, he was very lethargic. He talked, but wasn’t very active,” said Islam. “When I saw him I thought he would be a great candidate for gastric stimulation. He was one of the youngest patients in the world to be considered for this treatment, and the first with a mitochondrial disorder at Shands, so we really embarked on this journey together.”
Islam first became aware of gastric stimulation at the University of Mississippi, where he served on the faculty in the department of pediatric surgery. The treatment was developed for adults suffering primarily from diabetic gastroparesis, a condition caused by the stomach’s inability to empty. When Islam met Nate, he saw a way to take this treatment and apply it to gastroparesis associated with mitochondrial disease.
“Gastric electrical stimulation was really a new therapy that people didn’t have on their radar screen for this [mitochondrial] disease,” said Islam.
One year later, Islam and his colleagues have defined a completely new way of treating gastrointestinal dysmotility associated with mitochondrial disease. UF&Shands, the University of Florida Academic Health Center was the first, and currently one of the only centers, to offer gastric electrical stimulation therapy for GI motility issues associated with mitochondrial disease and has now successfully treated five children.
“Nate has done beyond what I would have hoped for. He is able to keep his food down, his energy level has improved, the constant pain and bloating he experienced have now almost resolved,” said Islam. “It’s a great thing to see someone respond to a therapy like this, and I hope that this continues to work well for him.”
Today, Islam and his colleague, Christopher D. Jolly, M.D., professor of medicine; chief of the division of pediatric gastroenterology, hepatology and nutrition; and director of the feeding aversion clinic, are spearheading the development of a Pediatric Gastrointestinal Motility Center to provide the combined surgical and medical care for children suffering from issues where the GI tract just does not work. This is an avenue that has not been explored for children, and a center such as this is sorely needed in the region.
“The transformation that I saw in Nate was amazing. He is such a brave little kid,” said Islam. “It was very fulfilling to take care of such an amazing family. As pediatric physicians and surgeons, we love what we do, but when you find a family like the Ferrells, it really makes what you do that much easier and more pleasurable.”