Joint Effort

Peg Shiel had managed her knee pain well for years, but in 2012 her family noticed something that she didn’t: The active 69-year-old was favoring her left leg and her gait had changed.

For 71-year-old Jan Powell, the onset of excruciating knee pain seemed to come out of nowhere, stopping him short during a bowling game. Although their circumstances differed, each of these Binghamton-area residents found themselves on a path to life-changing joint surgery, and to expert care at the Joint Replacement Center at UHS Binghamton General Hospital.

The UHS Joint Replacement Center offers individualized care that’s unique to the greater Binghamton area, from personalized pre-admission education and testing to one-to-one post-surgical care, says nurse manager Sheri Renaud, MS, RN, NE-BC. “We emphasize one-on-one care throughout the entire process, including post-surgical physical therapy and rehabilitation,” she says. “Our patients have our undivided attention.”

Vast experience

UHS joint replacement patients are in the experienced hands of Lawrence Wiesner, DO, an orthopedic specialist and director of the UHS Orthopedic Surgery team.

Dr. Wiesner has worked with UHS for more than 11 years and has unique expertise in caring for patients with complex joint problems. He performs approximately 500 joint replacement surgeries each year with the help of highly trained staff and the latest medical technology.

“Our orthopedic program stands out for its surgical subspecialists, who are entirely devoted to their specialties, and our continuity of care before, during and after surgery,” Dr. Wiesner says. Staff includes registered nurses, physical and occupational therapists, respiratory care specialists, nurse educators, and patient education coordinators, all specializing in joint replacement surgeries on knees, hips and shoulders.

Patients needing extensive post-surgical rehabilitation at UHS Binghamton General can stay on-site for up to 20 days in the hospital’s comprehensive transitional care unit (TCU). They can also take advantage of UHS Home Care. Each of these care teams coordinates closely with Joint Replacement Center staff to ensure that each patient achieves optimal recovery and has a safe transition home.

Dr. Wiesner gets high marks from Ms. Shiel, who says that family members’ comments about her altered gait were a wakeup call. With her left knee joint in a bone-on-bone state and cortisone shots and physical therapy no longer alleviating the pain, Ms. Shiel considered traveling to New York City for surgery. After studying her options, she realized that the care she was looking for could be found close to home.

“I did my research and looked at all the alternatives,” says Ms. Shiel, who hoped to preserve her ability to hike, bike, do yoga and golf, among other activities. “Dr. Wiesner came highly recommended by friends, and I saw that he had a lot of experience.” Ms. Shiel also attended one of the doctor’s free seminars on joint replacement to learn more. During her appointments, Dr. Wiesner carefully explained her options, she says. “I appreciated feeling that the choice to have surgery was my own.”

In good hands

Ms. Shiel’s total left knee replacement and her stay at UHS in March 2013 went smoothly from start to finish. “Dr. Wiesner runs a very tight ship and the staff is extremely organized. They take everything out of your hands and it’s all laid out for you,” she explains. Prior to surgery, Ms. Shiel attended a personalized orientation session with a nurse specialist and representatives from Anesthesia, the UHS Pharmacy and Physical Therapy, who answered questions about surgery and post-surgical pain relief. Routine pre-surgical tests were done at this time as well.

Ms. Shiel was up and walking the evening of her surgery, under the supervision of the nursing staff. Dr. Wiesner prescribed a blood thinner to reduce the chance of blood clots and an ice machine for use at night, which Ms. Shiel says kept swelling to a minimum. After a three-day hospital stay, she also took advantage of UHS Home Care, which provided individualized physical and occupational therapy and daily blood draws, all in the comfort of home. Within three weeks she was back to walking distances, and eight months later she is once again working out and has regained her original walking gait. “I was in good shape to start with,” she says, “but I have no doubt my recovery was fast because I was in good hands.”

Bowled over

When knee pain hit Mr. Powell during a routine bowling game, it hit hard. “I had to stop bowling and could hardly walk,” says the retired electric company employee.

“I knew something was drastically wrong because I’d never had any problems in that knee before.” Like Ms. Shiel, Mr. Powell had bone-on-bone contact in the joint. Dr. Wiesner treated Mr. Powell’s painful left knee with cortisone, and eventually suggested a total knee replacement. Mr. Powell agreed it was time, asking to have surgery in January of 2013, so that he could be back to playing golf that spring.

The catch was that Mr. Powell hadn’t stayed in a hospital in 50 years and was very anxious. But the attention he received from the UHS staff helped alleviate his discomfort. “The nurses, the staff and the anesthesiologist knew I was nervous before surgery. They calmed me down and put me at ease,” he explains. During the procedure, Mr. Powell’s wife, Henrietta, was able to follow her husband’s progress on a waiting-room monitor. When surgery was complete, Dr. Wiesner came out personally to reassure Ms. Powell that her husband was doing fine.

Mr. Powell recovered with the help of UHS Home Care and outpatient physical therapy, using a walker, and then a cane, as he gradually regained strength. By March he no longer needed the cane, and by May he was back where he wanted to be — on the golf course. “I was tentative, but [my game] went well this year. I’m also slowly getting back to bowling,” he says. Mr. Powell no longer needs pain medication. “I’d definitely say my experience was terrific,” he added.