Power of Observation

Cause and effect: Texas surgeon changes lives by listening to patients

AOA board-certified surgeon Albert H. Yurvati, DO, has become an expert in identifying the xiphoid process as the source of mysterious pain for many patients.

This article was originally published by the University of North Texas Health Science Center. It was edited for The DO and reposted with permission, and was updated with new information in 2018.

Albert H. Yurvati, DO, knows their life stories.

The International Harvester designer’s granddaughter, driving a restored ’64 Scout, broadsided on her 50th birthday and in pain for so long she wondered if life was worth living.

The teenage basketball star, benched with chronic pain while her team headed for a state title, told by her doctors the pain that took her breath away was all in her head.

These patients and more come to Fort Worth from New Mexico, California, Michigan and Georgia to see Dr. Yurvati, who listens to their stories of pain and offers the chance of a normal life.

For Betsy Blume, the car wreck victim, he diagnosed a breastbone injury that robs victims of breath, vitality and, ultimately, all hope.

“I plunged into some very dark places from the pain,” wrote Blume in a thank-you letter to Dr. Yurvati. “It is not overstating it to say you saved my life.”

Dr. Yurvati, chair of surgery at the University of North Texas Health Science Center’s Texas College of Osteopathic Medicine (UNTHSH/TCOM), has become an expert in identifying the xiphoid process, a cartilage structure at the tip of the breastbone, as the source of mysterious pain for many patients.

Photo by UNT Health Science Center

Damage from a car wreck, a fall or other trauma can bend it so it presses on other tissues and makes breathing difficult. You could call it the appendix of the chest, Dr. Yurvati says: “No one knows what purpose the xiphoid process serves.”

Was there a lightbulb moment when he knew his patients weren’t suffering a heart problem, a rib issue or a broken collarbone, and the pain wasn’t in their heads?

“No, it was my TCOM training,” said Dr. Yurvati, who is also AOA board-certified in surgery. “I listen to the patient tell me what happened. More than that, I listen to them tell me how they spend their days, how they work and how they play.

“Sometimes you can see this injury on imaging, sometimes you can’t,” he continued. “But I can find it with the patient, exploring their narrative and putting that together with what I find when I put my hands on them and feel how their tissues and skeletons aren’t functioning correctly.”

Twenty-five lives, and counting, have been transformed by Dr. Yurvati’s removal of the damaged xiphoid process. “It’s not a complicated surgery,” he said. “I do it without an assisting surgeon in 90 minutes.”

A simple process, but one that can change lives.

Kylie Ducat, the teenage basketball star, today plays college ball and is engaged to be married.

And Blume is back behind the wheel of her Scout, driven to play forward the new lease on life she’s been given.

“Dr. Yurvati, you are a man with many talents,” she wrote in her thank-you note. “But your compassion is what I’ll remember the most.”


  1. Amandeep singh

    My question is for Mr. Albert H. Yurvati
    Hello sir I’m Amandeep singh from India, i ‘m suffering from pain in xiphoid area for 5 years, it causes vomiting, nauesa, shoulder pain, neck pain, lost appetite, weird breathing and loose weight as well. i consulted this to 4 doctors but they all said its a gastric problem they just gave me gastric medicines after taking these medicines i didn.t see any relief. I feel that my xiphoid bends inside. What should i do ? which doctor is best for me to identify my problem. I have done some tests like endoscopy, ultrasound of lungs, ECG, X ray, CT scan but all reports are good. Help me plz

    1. Betsy Blume

      Your symptoms were similar to mine. Imagery isn’t always going to be able to detect an injury. My CT scan showed no obvious injury and I was offered pain management as the next option. I asked to be referred to Dr Yurvati because I knew something was terribly wrong. After a physical exam he could tell I needed surgery. Once in surgery he discovered by xiphoid was inverted and removed it. I would have never been pain free without its removal.

    2. Johnny Five


      I recommend you see a “Cardio-Thoracic Surgeon”. Take your CT scans and have the surgeon look carefully at the Xiphoid and its connection to the sternum. Hopefully the surgeon is skilled enough to identify the problem. Good luck.

  2. Sabrina Herndon

    I am going through the same problem and have had several doctor’s visits as well as ER visits. I recently moved to TN and was just in the ER last night and they as well have said that haven’t heard of it or championed it being removed as well as said an endoscope could not diagnose the problem as well as a CT could not. Back to not believing me at this point. I am going to try to go about getting it done if I have to go to another state that’s what I will do because I can no longer deal with this. It is crippling.

    1. Joseph

      Hi Sabrina, I forgot to leave my e-mail it is
      lurkingfiend@yahoo.com I’m Joseph
      hoping to hear more about your issue with the XP
      as you describe it really is crippling and am willing
      to go for surgery no matter how it turns out.

  3. Bobby Blakely

    For quite long time have been experiencing pain at base of sternum that seems to go underneath sternum, pain in back, some nausea, pain when lifting or exertion, eating, shortness of breath among others. Pain seems to be on the increase as time goes by. Have been going to gastro doctor and he has completely ruled out any reflux to be causing my pain. This has been going on for years and has gradually gotten worse. Quality of life is zilch. As I said the root of the pain is at base of sternum. Have not made ER visit but have considered it many times. Is there help for me. Thanks

  4. Shelia Marshall

    Do any of you have constant nausea without the pain every day? My daughter starting with daily nausea 4 years ago. Then 3 years ago when she started playing volleyball this pain started in this area. During her cycle and exercise and sometimes just certain movements can trigger awful pain. We have found nothing to take this pain away except for her laying down. She had her gallbladder removed. Laperscopy that ruled out endometriosis, tested for POTS and has had every GI tests known to man. She has recently started throwing up about once a week. She use to love all food but know barely can get one meal a day down. And has lost taste for foods she once loved. She has never been over weight and has lost about 14 lbs. Does this sounds similar to those that have been diagnosed with Xiphoid Process Pain? Especially the constant nausea ? Thanks

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