Patient Stories

Deborah Ligor woke up in the middle of the night in June 2011, vomiting and suffering from the worst headache of her life.

Initially, her doctor thought she had a virus. But when she didn’t get better, it was clear the 50-year-old banker had a much more serious problem, most likely a ruptured aneurysm in her brain.

The expert care and advanced technology required to save her life were not available at the community hospital near her home in Ocean Pines, Md.

“So my husband asked the doctor where he would send his own mother,” Ligor recalls. “Forty-five minutes later, I was on a helicopter to Christiana Care.”

Doctors there quickly confirmed that she was, indeed, suffering from a ruptured aneurysm, essentially a bulging blood vessel that was leaking. The situation was especially perilous because Ligor’s aneurysm was located deep within her brain, a position not accessible through open surgery.

“If you drew a line between your two eyes, it would be dead set in the middle of your head,” says Sudhakar Satti, M.D., the neuro-interventional surgeon on the case.

In such dire circumstances, half of patients die, Dr. Satti notes, and about 70 percent of those who survive have some sort of permanent neurological disability.

“Christiana Care is the only place in Delaware that is equipped to handle these cases,” he says.

With a state-of-the-art interventional neuroangiography surgical suite, Christiana Care Neuro-Interventional Surgery provides minimally invasive services and treatments 24 hours a day, seven days a week, for a variety of conditions, including strokes and vascular and brain malformations.

Because the aneurysm was inaccessible from Ligor’s skull, Dr. Satti used endovascular techniques to reach the site in her brain, guiding a catheter through an incision in her groin, no larger than the tip of a No. 2 pencil. Through the catheter, Dr. Satti packed the aneurysm with soft metal coils, stopping the bleeding.

In addition to providing quick, effective treatment, the technique also results in less pain and a faster recovery. Two weeks after her surgery, Ligor was home with her husband and two children. Several weeks after that, she returned to her job at a bank in Millsboro.

“She has made a complete recovery,” Dr. Satti says. “These kinds of happy outcomes are the reasons doctors go to work every day.”

Ligor says her healthy, productive life is a direct result of the expert and compassionate treatment she received at Christiana Care.

“I am glad for the techonology they have but it goes far beyond that,” she says. “Every person I encountered at Christiana Care was friendly and kind — and the nurses were wonderful. They really want to help you.”

She now returns to Christiana Care for regular checkups with Dr. Satti.

“I would never go anywhere else,” she says.

For four long years, Wayne Johnson suffered with severe back pain, the result of a badly deteriorated disc.

He gave up golf and scuba diving, activities he once enjoyed. He quit gardening. He avoided driving. And because he couldn’t exercise, he started putting on pounds.

“I needed painkillers just to get through the day,” recalls Johnson, 45, of Wilmington. “Even with my medication, I seldom slept for more than a few hours at a time at night.”

Spinal injections of cortisone helped for a while. But the pain always returned. Johnson leads a groundskeeping team at the University of Delaware and it was increasingly difficult for him to do his job.

In 2012, Johnson and his wife were expecting a baby and he wondered if his back problems would impact his ability to be an active dad.

“Would I be able to get down on the floor and wrestle with my son?” he asked. “Would I be able to give him a piggyback ride?”

His orthopedic surgeon, J. Rush Fisher, M.D., recommended a Total Disc Replacement or TDR, in which the damaged disc is removed and replaced with an artificial disc.

“It looks like two Oreo cookies stacked on top of one another,” Johnson says.

A newer treatment, TDR helps patients to regain their range of motion and get relief from pain.

“It is a good option for someone like me, who is in his 40s,” he says. “I feel very fortunate that Christiana Care offers this kind of advanced treatment.”

Within a day of surgery, Johnson was out of bed and taking his first steps on the road to recovery. Within two days, he was home and walking with a cane.

He was an active partner in his care, giving up smoking to help speed the healing process. He learned to rely on the muscles in his legs to lift objects to avoid another injury to his back. He started shedding the weight he had gained, going from 208 pounds to 180.

“I feel like I’m back in my 30s,” he says. “I’m in the gym four days a week, doing 225-pound squats.”

Johnson is on the job at UD, maintaining landscaping on campus. He also is enjoying family life with his wife and baby. The pain is completely gone.

“In the past six months, I have taken two Advil — and that was for a headache,” he says. “I used to live in constant pain — and now I am happier than I have ever been in my whole life.”

The devastating impact of Dinesh Nayak’s fall down his basement stairs in February 2010 was immediately obvious in the pain he felt radiating up from his left ankle. But today, he says his choice to seek help at Christiana Care was an “outstanding” decision.

Dr. Paul Kupcha, an ankle specialist at Christiana Care Health System, became his health care partner during the 11-month journey to recovery.

The effect of landing on his left foot resulted in a pilon fracture, a diagnosis Kupcha confirmed with a CT scan shortly after the injury. A pilon fracture refers to a high-impact injury where the tibia (the larger bone in the lower half the leg) shatters at the point where it hits the bones in the ankle.

Many people who suffer a pilon fracture never walk without crutches or a limp again. But two years after that fall down the basement stairs, Nayak has returned to everything he loves doing.

“It’s really a testament to the doctor that I’m able to walk,” Nayak said. “The fact that I can walk without even a cane is truly remarkable.”  Nayak’s only lasting reminders are occasional pain and stiffness, and mild range-of-motion limitations in his ankle.

Kupcha performed  surgery at Christiana Care’s Wilmington Hospital after the original injury to repair the damage.

Over the next five months Nayak used an external fixator  — an external device of pins and rods — that is coupled with internal plates to stabilize the bone. They helped Nayak’s tibia knit back together. During weekly visits to Kupcha’s office, adjustments were made to keep the healing on track.

When the external fixator was removed – a few months early because Nayak was tired of keeping the weight off his foot — the healing process was well under way. Follow-up included various casts, splints and braces that allowed  Nayak to gradually bear weight on his foot. When those were removed, Nayak began two months of physical therapy to build strength and learn to walk again.

At that point, a celebration was in order. Nayak decided on a trip to Antarctica. Since then, he’s traveled to destinations all over the world.

Nayak thanks Kupcha for helping him achieve that return to activity.

“I chose the emergency room at Christiana Care; I chose Dr. Kupcha; I made those choices,” Nayak said. “…My experience at Christiana Care was outstandingly good.”

Elizabeth Van Leeuwen was enjoying dinner and a lively chat with her 29-year-old grandson — and suddenly couldn’t speak.

At the time, the 86-year-old great-grandmother from Hockessin, Del., was staying in a rehabilitative center, where she was recovering from a fall.

This latest challenge was an ischemic stroke, sometimes called a brain attack, that occurs when an artery to the brain is blocked.

“When I lost my speech, my grandson immediately knew something was wrong — and he got help right away,” she recalls.

Van Leeuwen was rushed to Christiana Hospital, where a stroke team was poised to evaluate her.

“That saying ‘time is brain’ is true,” says Mary Ciechanowski, MSN, RN, ACNS-BC, CCRN, stroke advanced practice nurse. “We work in conjunction with the Emergency Department to quickly identify stroke patients so we can determine the appropriate intervention.”

Because Van Leeuwen arrived at the ED soon after her stroke, she could be treated with tissue plasminogen activator, known as tPA, a protein that is highly effective in breaking down blood clots. Ideally, tPA should be administered no later than 4.5 hours after the onset of stroke symptoms.

Gregg Zoarski, M.D., a neurointerventional surgeon, used a Solitaire, a new tool in the arsenal of stroke-fighting devices, to remove the clot. The device was approved by the Food and Drug Administration in March 2012, less than five months before Van Leeuwen’s stroke on July 29.

“Basically, it’s a stent on a stick,” he says. “After it’s inserted into a blocked artery with a catheter, it compresses the clot and traps it. Then the clot and the stent are removed.” 

In all, the surgery took 44 minutes. Van Leeuwen was headed for recovery less than four hours after she suffered her stroke.

“We are making tremendous advances in stroke treatment and positive cases like Mrs. Van Leeuwen’s are becoming more common,” Dr. Zoarski says.

The Christiana Care Center for Heart & Vascular Health provides round-the-clock minimally invasive services and treatments in a state-of-the-art neurointerventional surgery suite. The health system has one of the highest volumes of stroke patients in the region, providing treatment for more than 1,200 patients a year.

“Everything we do here is 24/7, including surgery, labs, imaging and technicians,” Ciechanowski says.

Dr. Zoarski says Van Leeuwven’s experience illustrates the importance of seeking help immediately if someone shows signs of a stroke. In addition to difficulty speaking, symptoms include confusion, sudden and severe headache, problems with balance or walking, and numbness or weakness in the face, arm or leg, especially on one side of the body.

Today, she is healthy and happy and living at home. She has recovered her speech and is walking with a cane as she builds strength and balance.

“At Christiana Care, I got highly skilled doctors and the latest and greatest in technology,” she says. “After my surgery, I got wonderful care from the nurses. Everyone I encountered was very professional — and extremely nice.”

Justin Plank had imagined what the first moments of fatherhood might be like. His wife Brenda would give birth, their newborn son would wail upon gulping his first breath of air, and Justin would cut the umbilical cord, as if to celebrate the grand opening of a new life.

But when Waylon Plank was born Sept. 29 at a Delaware hospital, his father heard no crying. His newborn son looked purple. The doctor immediately knew something was wrong.

A yellow button was pressed, and within 60 seconds a group of nurses was in the room, providing Waylon with oxygen, and letting the new parents kiss their ailing son as they rushed him to the neonatal intensive care unit.

Baby Waylon was suffering hypoxic ischemic encephalopathy (HIE), which means his brain was not receiving enough oxygen. Five minutes of such deprivation can begin killing brain cells. The long-term effects can include intellectual disability, seizures, delayed development and cerebral palsy.

Reducing the brain and body’s temperatures can slow damage. Though it may seem counter-intuitive to those accustomed to seeing newborns placed in incubators beneath warm lamps, the doctors and nurses tending to Waylon in his earliest moments told the Planks their son was a candidate for a cooling technology that could be applied even as they transported him by ambulance to Christiana Hospital, where the most qualified personnel and equipment would give him a fighting chance.

Justin and Brenda agreed. Waylon was wrapped in a CritiCool blanket, which circulates cold water regulated by a microprocessor that responds to the baby’s temperature.

The cooling process must occur within the child’s first six hours of life, says Michael Antunes, M.D., medical director of Christiana Care’s neonatal hypothermia program.

“Those inflammatory cascades that can be initiated need to be stopped early-on,” Dr. Antunes said. The temperature reduction must be sustained for 72 hours. The choice to do so resides with the parents, but it is the job of doctors such as Antunes – he didn’t work directly with the Planks – to explain the harrowing scenario and the most hopeful medical response, all while cautioning that for at least the next few years, the parents monitor their child closely for signs of lasting damage.

 At about 24 inches tall with a footprint of about 15-by-15 inches and weighing 30 pounds, the CritiCool is a mobile version of larger, stationary devices that serve the same purpose. Christiana Care has two CritiCool units and is the only delivery hospital in Delaware that has the equipment.

“Internationally,” Dr. Antunes says, “this has become the standard of care.”

Justin Plank, whose family lives in Greenwood, spent that first night of his son’s life at his wife’s side at the hospital where he was born. The next morning, while his wife continued to recover, Justin went to Christiana Hospital to see Waylon, who would remain hospitalized there for nearly two weeks. (Upon his body’s return to its normal temperature, Waylon’s blood sugar would have to stabilize.)

“One of the hardest things was to see him lying there, cold,” Justin said. “You know it had to be hurting, even though they had him on morphine to reduce the pain of the cooling process.

“You expect your baby to cry and to be overwhelmed with joy when they’re born, and we didn’t get that. When I got up there, he was on the cooling pad, and when he heard me talk, he opened his eyes. The nurse said that was the first time he had opened his eyes. I’m sure he heard lots of other people’s voices, but to me, it seemed he recognized my voice.”

That night, Justin again stayed with Brenda at the hospital where their baby was delivered. The next evening they stayed at the Christiana Hospital NICU.

Every morning, as doctors checked in on the Planks’ child, Justin would ask questions about the process. It eased his concerns to know that he or his wife could call the staff at any time, day or night, for updates on their son’s progress.

“That was really helpful,” he says. “It gives you peace of mind.”

Waylon has met his milestones in the time since his stay at Christiana Hospital. His parents say the respect and care they felt from the Christiana Care staff went beyond access to information.

“I think that we got the best care that we could’ve gotten,” Justin says.

My husband and I had tried to have a baby for years and after almost nine years i finally got pregnant we were so excited as well as both of our families . however at 30 weeks  i had to deliver my son he was born on August 19th 2012 weighing 1 pound 14 oz .13 and a half inches long . He of course had to go right to the NICU. we were so worried and scared but the staff at christiana hospital  from my doctors nurses the Nicu staff and wonderful social worker we new our son would be ok and that there was no better place he could be at that moment . After 72 days between 2 Nicu’s our son Anthony Giovonni  was able to come home on October 30th and he is now 6months old weighing over 13 pounds and 23 inches long .Thank you from the bottom of our hearts to everyone for all the kindness and love and support . 

from the Rizzuto family

What an incredible institution! Just had surgery performed by Dr.Mark Cadungog gynaecologist, what a skilled thorough physician assisted by Dr. Nicholas Gagliano anaesthesiologist who put me at ease immediately! Could not have had a better team! Combined with excellent nursing care, Christiana is a first rate facility… Keep up the excellent work! True professionals….

Sally Cratty fights aging and the joint deterioration caused by osteoarthritis with all the tools medical technology has to offer. So when she had to make a choice about how to deal with the deteriorating condition of her right ankle, she didn’t take long to decide to add a total replacement to her collection of artificial joints that already included two hips and two knees.

“I am bound and determined to remain as mobile as I possibly can through my aging process,” Cratty said. “That’s very important to me. I realize that I’m in my 70s, but I don’t think that way. I want to live an active life.”

Thanks to the artificial ankle implanted by Dr. Paul Kupcha at Christiana Care Health System’s Wilmington Hospital, Cratty has once again defied the mobility limitations imposed on her by osteoarthritis.

Nearly a year after her ankle replacement, Cratty maintains her own household,  cooks for herself and spends time out on the town with friends and family. Most days, she can do all of that without the use of a cane or walker.

“I do all of the things for myself that I’ve done all my life,” Cratty said.

Cratty first began to feel pain and notice swelling in her right ankle in early 2011. After seeing Dr. Kupcha for the first time in May 2011, she knew that having the total ankle replacement was one option to fix the problem and an ankle fusion was another.

“I came home, and I thought about it and I thought about it. It got worse. Physically, I was really limping. My back was hurting. Everything was happening because my posture was terrible,” Cratty said.

After more than a month of considering her options, while the pain in her ankle worsened and her gait deteriorated to the point that falls were a serious problem, Cratty decided on the total ankle replacement and underwent surgery July 14, 2011, at Wilmington Hospital.

The surgery and physical therapy went well. A subsequent stress fracture in her right foot required another surgery to stabilize the fractured bone. Cratty completed more physical therapy after that surgery.

“From the beginning, I had a special feeling with Dr. Kupcha,” Cratty said. “I felt very confident. His approach is just so comforting and extremely knowledgeable.”
Now, nearly a year after the ankle replacement surgery, Cratty is back at home and living her life the way she wants to live it.

“I’m very happy that I went through the process,” she said. “Dr. Kupcha did beautiful work. He got me up on this ankle. I’m walking. … The happiest day of my life was when I stood up on this foot. I was just so thrilled I could do it. I have no regrets. I made the right decision.”

Each day on Pat Miccio’s calendar lists a number, with a running total for the month on the top of the page – usually somewhere in the hundreds. It’s Miccio’s way of marking how many recyclables she has picked up on the daily walks she takes around her Pennsville, N.J., neighborhood, all carefully tabulated on the wall calendar.

In more than four years, Miccio has collected 18,000 recyclable items others dropped on the ground – soda cans, beer bottles, milk jugs, sports drink containers. But for nearly a year, from December 2010 until September 2011, those days on Miccio’s calendar were empty of anything except doctor’s appointments as she battled breast cancer with the help of the staff at Christiana Care’s Helen F. Graham Cancer Center.

Miccio’s odyssey from environmental steward to cancer patient to cancer survivor began with her daily walks more than 10 years ago. While she initially walked for the exercise benefits, Miccio quickly discovered another reason to get out of the house every day.

“I just needed to get out, and then it got to the point where I was walking and I’d see all this mess on the ground,” Miccio said. “It starts getting to you.”

Miccio saw an Oprah Winfrey special about the environment, and it inspired her to start carrying a plastic bag with her to collect some of the mess she would see.

“It started out, I brought one bag with me … and then after a couple of weeks, it would be two bags. Then, another couple of weeks, especially after Septemberfest, it jumped up to four bags,” she said. “It’s amazing what you find. It adds up.”

But the collecting was put on hold after Miccio went to her doctor for a routine mammogram in 2010. Miccio was diagnosed with stage 1 cancer in her left breast. She was sent to the Helen F. Graham Cancer Center to begin a treatment regimen. In October 2010, Miccio underwent a lumpectomy. Chemotherapy and radiation followed, lasting for nine months.

For a year, the fight against breast cancer took precedence over the mission to clean up the environment. Even after the treatment ended, she found that she didn’t have the energy to walk every day – because of the lingering effects of her cancer treatments and an ongoing battle with chronic obstructive pulmonary disease, or COPD.

“I’m realizing what a friend of mine had told me: It takes a while to get back into the full swing of life again,” Miccio said.

As the counts on Miccio’s calendar show, she is getting back. By the end of April, she had collected just 270 pieces for the year.

“I’m usually well over a thousand by that point,” she said.

By the end of August, Miccio’s count had climbed to 1,685 for the year.

“Maybe, by the end of the year, I might break 3,000 pieces,” Miccio said. That number would also put her running total at more than 20,000 recyclable items picked up.

Miccio found another cause to help her get back into the swing of life. She has donated the cans painstakingly collected, sorted, washed and crushed after her daily walk to a friend with a relative on dialysis. The money raised from the recycling effort helps to pay for the machine.

While she never expected to become so well acquainted with the Helen F. Graham Cancer Center and its services, Miccio is grateful that they were able to get her back to her daily walking and her ongoing fight against the mess others leave behind.

“It was one of those wonderful experiences I hope I never have to do again,” Miccio said.

Dear Dr. Laskowski,

I wanted to take this opportunity to share a very positive experience I had at Wilmington Hospital. I have not visited Wilmington Hospital for many years and had the opportunity on Friday to meet with Carol Briody, Infection Control, and Tyesha Rodriguez-Gist, RN in ICU for preparation for a statewide educational program in November.

I was impressed with the general cleanliness of the building, especially considering your current construction project. All areas were spotlessly clean and well marked for the visitor. As importantly,  I must tell you about my encounters with your staff. Every staff member I encountered, whether just walking in the halls, at the information desk, or at nurses stations, was pleasant, smiling and greeted me with a smile and hello. I also observed staff interacting with patients in a very positive and caring manner. These behaviors seemed second nature to the staff. 

My take-away was that staff at Wilmington Hospital are proud of the work they do and are well versed in the importance of customer satisfaction. In my opinion, the staff reflect a corporate culture of kindness, competency and personal responsibility.

You must be very proud of you employees.

Sally Jennings, RN
Project Coordinator
Quality Insights of Delaware

Former runner and aerobics teacher Laurie Beauchamp struggled with the forced inactivity imposed after surgery to reconstruct the posterior tibial tendon in her left ankle. But the end result – pain-free walking and exercising – made that struggle worthwhile.

“It was very intense,” Beauchamp said of her rehabilitation process. “I was basically confined to my bed with assistance from family members … I followed the letter of the directions from the doctor.”

Beauchamp had struggled with pain in her left foot for years – brought on by all of her physical activity and exacerbated by wearing the “wrong shoes,” she said.

By 2007, she was diagnosed with a ruptured posterior tibial tendon, which extends from the calf muscle through the ankle to the bones in the foot. She was finding that extended periods of walking or exercise resulted in excruciating pain.

By 2010 it became too much, and she turned to surgical options.

“Here I was just turning 50, and I thought I want to do this now when I can have a good recovery,” Beauchamp said.

So she sought the advice of an ankle specialist – Paul Kupcha, M.D., an orthopaedic surgeon with Christiana Care Health System.

“It was a huge surgery,” she said. “I just felt like [Dr. Kupcha’s office] was a very knowledgeable team. From the first phone call to getting my documents there … everyone was very attentive.”

Dr. Kupcha rebuilt Beauchamp’s posterior tibial tendon in December 2010 at Christiana Care’s Wilmington Hospital. She kept all weight off her left foot for eight weeks following the surgery.

“It was very, very scary during the whole thing, because I wasn’t used to being immobile,” Beauchamp said. “It was frustrating, but I made it fun.”

When she progressed to being able to bear partial weight on her foot and use a walker, Beauchamp decorated it with a basket to carry things around.

It took until April 2011 before Beauchamp finally graduated from physical therapy. During that five-month span, she kept in regular contact with Kupcha’s office to make sure she knew what had to be done – everything from taking care of her surgical wound to what kind of shoes to wear. Kupcha’s office also worked with the physical therapy team that Beauchamp used to keep her rehab on track.

“Every time I went to Dr. Kupcha’s office, I was just handled with the best of care. No question was a stupid question,” she said.

More than a year after she finished therapy, Beauchamp was back in the gym. She is hiking. She can do aerobics, spin class and weightlifting. She is even wearing regular shoes again – although she has forever given up on “stupid shoes.”

“Right after the surgery, I wore tennis shoes for a very long time,” Beauchamp said. “I really got educated on proper footwear. I can really wear whatever I want to [now]. … the surgery was done so beautifully that I don’t want to do anything that hurts it.”

Beauchamp makes smart footwear choices and spent months following specific instructions for taking care of her new ankle. The results, she said, have been outstanding.

“I can walk for extended periods of time. I can wear the shoes that I want to wear,” Beauchamp said. “I’m so grateful that I did it.

“I cannot say enough about Dr. Kupcha and his team. … It’s just a very comprehensive, caring program, always making sure that I had what I needed even though I was two counties away.”

A couple of years ago, Scott Reilly – an electrician in his 30s – was in an aerial bucket working on a power pole, pushing a heavy object up over his head. His job requires him to regularly lift and hold heavy cables and equipment while he installs or repairs electrical lines.

Reilly relies on a full functioning upper body to work. In this instance, the object came back down and Reilly quickly reacted, injuring his shoulder. At first, he felt pain in his back. He felt better the next day and went back to work.

Within a few days, he began to experience pain when he lifted his arm very high. He sought treatment from Evan Crain, M.D., an orthopaedic surgeon with Christiana Care’s Center for Advanced Joint Replacement. Dr. Crain initially thought Reilly had injured his rotator cuff. He treated Reilly with medication and recommended rehabilitative exercises.

Reilly kept working but still had pain, especially when lifting overhead or when pulling things such as cables. Dr. Crain treated Reilly with a cortisone shot several times, but the symptoms returned.

In January 2010, Dr. Crain performed arthroscopic surgery on Reilly’s shoulder, repairing a tear in his rotator cuff and treating the bursitis that was aggravating the situation.  At the insistence of Dr. Crain, Reilly did light exercise with his shoulder the day after surgery. Within four weeks, he was able to do light work, and within eight weeks he was able to return to his normal work duties.

Reilly felt noticeable pain for a couple of days after surgery, but it subsided quickly, and full function of his shoulder returned. Reilly is back to work and able to do everything he could before. He appreciated Dr. Crain’s conservative, thoughtful approach to his injury.

“In orthopaedics, we have many therapies that help patients to quickly return to work. Reilly was an active participant in his recovery; he did all exercises and most importantly shared when he thought a therapy was not working,” said Dr. Crain. 

According to Dr. Crain, many people who work in occupations that require repetitive motion, strength and stamina work through the pain. They feel pain is part of the job. Unfortunately, this often leads to debilitating injury.

Fortunately, Reilly realized that his pain was not normal and sought help from a Christiana Care orthopaedic surgeon.

John Hetherington, 53, of Lincoln University, Pa., is proof of the progress that has been made in stroke recovery. One Saturday in late March, he was showering, getting ready to go to his job as a marine technician, when he suddenly found himself leaning on one side of the shower.

“I thought, ‘I should sit before I fall,’’’ Hetherington says. He called to his wife, who saw that he couldn’t move his left side and told their daughter to summon an ambulance.

At Christiana Hospital, tests showed Hetherington had a right internal carotid artery occlusion, which blocked blood flow to the right side of his brain.

“It’s amazing I’m walking and talking,’’ he says. “I’m working. I went in on a Saturday, came home Thursday and was mowing grass on Friday.’’

Hetherington didn’t know he was at a risk for stroke – he hadn’t seen a doctor in years. But the brush with mortality has changed his life. He stopped smoking, monitors the fat and cholesterol in his diet, takes his medicine and no longer avoids his doctor.

“I’m pretty grateful to be here,’’ he says, crediting Christiana Care with saving his life. “Sometimes I get a little choked up talking about it.’’

Cathy Tharby twice heard the words “you only have months to live.”

But five years later, she is still pushing forward with her fight against the rare type of cervical cancer that led several doctors to write off her chances for living a long, full life.

“They said they can’t cure me, but they would do what they could to have me live as long as possible. We’ve all been amazed at how long it’s worked,” Tharby said.

For Tharby, the difference has been her attitude and a willingness to try a wide array of chemotherapy options and other treatments offered by the staff at Christiana Care’s Helen F. Graham Cancer Center.

“Cathy has such a great attitude about this even though they were so negative to start with,” said Sharyl Mossinger, a family member who has helped Tharby get back and forth to her various treatments over the years. “I think that’s why she’s still here and having fun, because your mental attitude can really do a lot.”

Tharby’s symptoms started so innocuously that she thought she was just going through menopause and put off a visit to the doctor.

“I let things go. I thought I was going through the change of life … It wasn’t change of life, although my mother had gone through the same thing, and that’s why I just assumed,” Tharby said. “I ignored the situation for a long time until I finally was having dizzy spells because I was losing so much blood.”

Tharby was diagnosed with a non-HPV (human papillomavirus) form of cervical cancer and initially told she had three months to live. In an effort to treat her cancer, Tharby underwent a radical hysterectomy at Christiana Hospital and was told it had been a successful intervention. But a few months later, Tharby developed problems walking and pain in her left hip. A CT scan revealed that all was not well.

“I had a huge growth that was attached to this hip and upper leg, and the reason I couldn’t walk is it was pressing on the nerve,” Tharby said.

It was back to Christiana Hospital for Tharby to begin radiation therapy in an effort to shrink the tumor before starting her on a chemotherapy regimen. Once again, the prognosis was not encouraging.

“Again they were telling me I would probably only have a couple of months to live,” she said. “Well, the chemotherapy pretty much slowed it to almost a stop.”

Numerous rounds of chemotherapy followed over the next four years. New drugs were tried as soon as the cancer showed any signs of a comeback. Tharby underwent a Cyberknife treatment to cut off the blood supply to the tumor in her hip, halting its growth.

One service in particular helped her deal with the side effects from the chemotherapy treatments. A program at the Helen F. Graham Cancer Center helps teach women various style and make-up tricks to cover up the loss of hair.

“My first chemo was the strongest and the one that hit me the most. Of course, I lost all my hair,” said Tharby, who wore her hair long all her life. “[The program] was fun … getting a lot of little tricks and things to do so you feel better about yourself. That’s important at that point.”

That positive attitude in the face of a devastating illness is a hallmark of the treatment Tharby has experienced at the cancer center.

“[The Helen F. Graham Cancer Center] has the best positive attitude of any place I’ve dealt with,” Mossinger said. “Twice in all this time, she’s been in ‘stable disease,’ where nothing has grown. It’s just amazing.”

The end result for Tharby has been five years of living with cancer rather than the bleak prognosis of a few months of dying from it.

“You live with it, but you can live,” she said. “You still have a life and you go on.”

Marjorie Miller was plagued with severe, constant foot pain for more than two years. It interfered with activities she enjoys with her husband, such as long walks on the beach and ballroom dancing. It even disturbed her sleep.

The pain began one evening after some light ballroom dancing. Marjorie felt sharp, intense pain when stepping even if she avoided dances that were harder on her feet and ankles. She was, in her words, “crippled.”

After some attempts with other treatments, Marjorie consulted with Dr. Robert Steele, an orthopaedic surgeon with Christiana Care’s Department of Orthopaedic Surgery. Marjorie was immediately impressed by how Dr. Steele listened to her and respected her opinions and observations. He quickly diagnosed her condition as adult-onset flat-foot deformity, a common condition found in women over 50. It is a painful affliction that occurs in those with no history of previous foot problems.

In most cases, this condition is successfully treated without surgery. Patients are fitted with a custom-made brace for three to four months. In 75 to 80 percent of cases, patients do well with the brace, which corrects the foot position so that the inflamed tendon can rest. After three to four months, patients switch to a smaller arch support.

Unfortunately, the brace did not help Marjorie, and she ultimately required surgery, which, for this condition, involves cutting and repositioning the heel bone and adding a screw to hold it in the proper position. Resecting the diseased tendon and replacing it with a tendon transplanted from another part of the foot is also part of the procedure.

After the surgery, Marjorie wore a supportive boot for 10 to 12 weeks and strengthened her foot with physical therapy. According to Dr. Steele, her foot is now “close to 100 percent” functional.

Marjorie is “ecstatic,” she said. She returned to long walks on the beach and ballroom dancing. She and her husband have even taken two-hour Argentine tango lessons. She is delighted to be able to say to her friends, “Look! I can wear my ‘pretty’ shoes again.” In a nutshell, she says, “I feel like my life has been given back to me!”

At the Helen F. Graham Cancer Center, Ken Sharp learned to become a cancer survivor.

“I feel like they’ve given me my life back. I really do,” Sharp said. “I can’t say enough about them.”

Specialists at Christiana Care have tackled every aspect of Sharp’s effort to survive the treatment he needed to beat Stage II lung cancer, originally diagnosed in December of 2008: pain management, nutrition services, physical therapy and occupational therapy.

In the first two years after his release from a Pennsylvania hospital in 2009, he couldn’t function, according to his wife Jo Ann. “He could barely drive. He could barely walk. He could barely move his arm,” she said.Thanks to efforts by pain management specialists, physical and occupational therapist and nutritionists, Sharp can now do the simple things he used to enjoy.

Sharp was diagnosed with lung cancer purely by accident after an MRI that was supposed to be examining a cyst on his neck inadvertently scanned the upper lobe of his lung.

“At the bottom of the scan, they saw the mass – a portion of the mass,” Jo Ann said. “It was totally by accident. There were no symptoms. He wasn’t being checked for anything other than the cyst he had on his neck.”

A new scan of Ken’s lungs was immediately conducted, and doctors quickly discovered a softball-sized tumor invading the upper lobe of his lung that was also attached to his chest wall.

“I had moderate pain in my arm that went down to my fingers,” Ken said. “I just figured it was another ache and pain that I had. But that’s actually one of the symptoms of the tumor.”

Sharp began radiation and chemotherapy to shrink the tumor before undergoing surgery to remove one lobe of his lung, four of his ribs and parts of the muscles on his chest wall that were all invaded by the tumor. Although the cancer was gone, Sharp found that returning to his life was going to be a much longer journey.

“He was in severe pain. He couldn’t move his right arm,” Jo Ann said. “We were actually told by the hospital that he’d never be able to move his right arm again because of the pain levels and the muscle damage and the nerve damage.”

“The pain was just unbelievable,” Ken said. “You didn’t want to do anything.”

That’s when the Sharps began to focus on survivorship, and the Delaware residents turned to the Helen F. Graham Cancer Center.

In November 2009, Ken started seeing pain management specialists at the cancer center. With their help, along with physical and occupational therapists, he can now use his right arm. His pain levels are well managed. He can drive. He can dispense with supplemental oxygen at various points throughout the day.

“I wish I could have gotten into this place when I first came out of the hospital,” Ken said, describing his experience at the Helen Graham Center as “fabulous.”

“They’re the ones prescribing his physical therapy, they’re the ones prescribing his medications, and it’s helping,” Jo Ann said. “They’re proactive with everything.”

Christiana Care’s nutrition services have helped Ken and Jo Ann plan meals to meet the 4,000-calorie-a-day diet he needs to consume, to help his body fight off the complications such as pneumonia and other lung-related problems that have persisted since his cancer treatment began.

“I have a hard enough time eating, [because] I have a low appetite,” Ken said. “I eat like a bird. They gave me recommendations on what to eat. It’s helpful.”

The staff at the Helen F. Graham Cancer Center has tackled nearly every aspect of Ken Sharp’s life except his cancer.

“I can’t say enough about them … They’re outstanding,” he said.

Retiree Bill Spiker has always enjoyed cycling, golfing, skiing, kayaking, windsurfing and sculpting metal. A former advertising and public relations consultant, Spiker hoped to fervently pursue these hobbies in retirement. That changed in 2008, when he was diagnosed with leukemia. Treatment, including a bone marrow transplant, successfully eradicated the cancer – but also devastated his immune system. His recovery required rebuilding his immune system with a lifetime’s worth of immunizations.

A sudden fever in January 2011 sent Spiker to the hospital, where he was diagnosed with septic shock (pneumococcal strep), a severe infection involving all the vital organs. Antibiotics slowed the attack, but not in time to prevent gangrene in his hands and feet. Both legs and some of his fingers to the first joint were amputated.

Following surgery, Spiker was admitted to the Christiana Care Center for Rehabilitation at Wilmington Hospital – a hospital within a hospital for patients recovering from major injury or illness – to learn how to walk and regain independence in daily activities. Working with his rehabilitation physician and multidisciplinary rehabilitation team, Spiker began an intensive program to rebuild strength and function.

Occupational therapists helped him practice activities of daily living such as bathing and getting dressed. According to Kelly Eschbach, M.D., a rehabilitation physician at the Center for Rehabilitation, Spiker succeeded because he believed and participated in his recovery. With his therapists, he set and achieved goals.

On March 1 – just a handful of weeks later, Spiker was independent enough to return home with the help of visiting nurses. His home setting was adapted for his wheelchair and to accommodate his remaining physical limitations, and he received continued physical therapy at home.

Even with a setback in April due to blood clots in his lungs (pulmonary embolism), he began outpatient therapy with Rehabilitation Services at Wilmington Hospital in May. He still has some residual phantom pain and “awakening” sensations, and uses biofeedback to get a sense of movement and distance to the ground, but his ability has considerably improved.

With his new “feet” – prosthetic limbs – he quickly progressed from walker to cane. His persistence paid off in June when he went to Pinehurst, N.C., for four days of chipping, putting and riding in a golf cart. He does admit to using a putter for a cane at times, though he is able to walk without it.

At home, he is again active. He drives with hand controls and is back in his workshop welding metal sculptures. He has returned to kayaking on local waterways.

Spiker has the highest praise for Dr. Eschbach, the physical and occupational therapists and nurses at the Center for Rehabilitation at Wilmington. He attributes his return to active life to “their outstanding professionalism, encouragement and dedication to patients’ progress. They were the most important factors in shortening my rehabilitation and hospital stays.”

John Gehret, M.D., has been active his entire life. Now retired, Dr. Gehret enjoyed a career as an obstetrics/gynecology physician and surgeon specializing in pelvic reconstruction. He managed a busy practice and had a passion for golf. Nothing could slow him down – until wear and tear forced him to do less.

Gehret has had two hip replacements over the past two decades. His most recent hip replacement (May 2011) was performed by Steve Dellose, M.D., an orthopaedic surgeon at Christiana Care’s Center for Advanced Joint Replacement. Dr. Gehret is thrilled with Dr. Dellose’s work and with the exceptional care he received at the Christiana Care Center for Rehabilitation at Wilmington Hospital.

Soon after surgery, Gehret was admitted to the Center for Rehabilitation. Under the direction of a physiatrist – a specially-trained physician who treats patients recovering from serious injury or major surgery – he methodically regained strength and flexibility. Physical and occupational therapists taught him exercises to reduce pain, minimize discomfort, regain strength, re-learn posture and improve range of motion.

Therapists helped Gehret set and achieve goals. They helped him practice and become proficient at specific daily activity skills in the life-skill apartment located within the center. His therapy continued at home for another two weeks, followed by outpatient physical therapy at Christiana Care’s Physical Therapy Plus. Gehret will soon return to the pain-free, active life he has always embraced, which for him is playing as much golf as possible.

Gehret describes his care at the Christiana Care Center for Rehabilitation at Wilmington as “exceptional” and “superior.” He extols the skill, care and patience of the center’s physicians, therapists and nurses.

“Their professional confidence, kindness, and noticeable sparkle have a positive effect on recovery of patients,” he said.

In late summer of 2009, Jacques Apruzzese was a competitive martial arts fighter and instructor – weighing in at 192 pounds of solid muscle.

But a 12-pound weight loss over a span of two weeks and a bout of vomiting sent Apruzzese to see his doctor in August of that year. Within a week, he had a new fight to undertake – against an insidious esophageal cancer that had already spread to the upper part of his stomach and lymph nodes. What followed was a two-year odyssey to regain his health.

“It was a pretty dramatic change in lifestyle,” Apruzzese said. “From doing things where people, for lack of better words, looked up to me as a fighter to not being able to fight.”

Apruzzese sought help in his fight from the staff at Christiana Care Health System’s Helen F. Graham Cancer Center, where a multidisciplinary team approach was employed to tackle his disease.

Radiation and a round of chemotherapy were started immediately in an effort to shrink the cancer enough for other measures to be effective. A radical surgery followed, with the removal of Apruzzese’s esophagus, half of his stomach and several lymph nodes. Since that surgery and the subsequent recovery period, Apruzzese has gone through more chemotherapy and radiation to try to halt the disease, which has spread to his spine and two other areas in his back and is now classified as a stage IV cancer.

“I teach regularly, I drive my bike, go fishing. Is it all at the same level as before? Definitely not. Will it ever be? Definitely not. But you come to acceptance and a reality check that this is the cards you’ve been dealt and you deal with that,” Apruzzese said. “Some people have been dealt worse hands. Some people get up in the morning and they get killed. They don’t have a chance to plan activities, do their bucket list, live life to the extent that you can. Most people don’t get that chance. I’m fortunate. I got that chance and this place [the Helen F. Graham Cancer Center] has a lot to do with that.”

Apruzzese says without the support of the multidisciplinary team of doctors and nurses, as well as support services like nutrition, physical therapy and counseling, he’s not sure he would have survived.

“They’re not here because it’s a job. I get more of a sense that they care about being in a cancer center providing service and assistance,” he said.

Although he was not eligible for any clinical trials, there was never a sense that Apruzzese didn’t have options to fight cancer.

“It was very, very quick paced,” said Apruzzese, who was diagnosed and began treatment with days of the initial visit to his doctor. “There was no fooling around which is very comforting because you feel like you’re being taken care of.”

Nurse navigators assigned to patients like Apruzzese become their “lifelink,” he said.
“They’ve seen it all, done it all. You can call them for anything and they’ll help you, support you, sponsor you,” Apruzzese said. “They’re a different breed of people.”

Apruzzese said he never thought about going anywhere else once he saw the equipment, the technology and the people who would be involved with his care at the Helen F. Graham Cancer Center.

“Once I came over here and saw how it was … why would I drag myself out there?” he said. “I felt very, very comfortable with the decision and I stand behind my decision to stay here. It’s very, very personalized care from dedicated people.”

Nurse Assistant Diana Fuller, Medical Director Nicholas O. Biasotto, D.O., Admin Assistant Kei-Shanda Saddler, and colleagues at the Wound Care Center took some of the bite out of an unusual infectious disease case caused by a patient’s encounter with poisonous spiders.

The following letter in praise of care and treatment at the Wound Care Center was sent to Lynn C. Jones, FACHE, senior vice president of Post Acute Care Services:

Dear Mr. Jones,

I just have to take a minute and tell you of the exemplary care my sister is receiving at the Wound Care Center at Riverside. Barbara developed four non-healing wounds as a result of spider bites. She started treatment with Dr. [Nicholas] Biasotto last November. I was so worried for her. The wounds were deep, infected and getting worse every day.

As soon as we entered the wound care center. it was obvious we were in a well-organized, skilled and knowledgeable program with a team approach to care. Dr. Biasotto is now Barb’s favorite doc, with excellent surgical skills and a wonderful bedside manner.

Barb loves all the nurses and considers Diana Fuller to be “her nurse.” I would also like to mention that Kei-Shanda Saddler at the front desk welcomes everyone by name, is polite and respectful, and knows the answers to everyone’s questions.

Dr. Hauer, her infectious disease doctor, says the last culture reports were very good. From actual instructions for wound care, to nutrition, to general health, the team at the Wound Care Center is teaching us to see the total picture.

Please let everyone know how thankful Barb and I are that we have this exemplary team. You should be so proud!

Take care,

Patricia S. Lincoln, RN, BSN, ACRN, Site Director Delaware Local Performance Site Pennsylvania/MidAtlantic AIDS Education and Training Center 

When he was diagnosed with kidney failure in 2008, Henry Rose, 37, a Wilmington firefighter and emergency medical technician with three small children, didn’t want to lose any time getting better.

“I wanted to have the transplant as soon as possible, because I did not want to be in a situation in which I was on dialysis and not able to provide for my family,” he says.

His wife Erica was a good match, but Henry was hesitant to allow her to donate a kidney. The cause of his kidney disease was unknown. What if it was genetic in origin and one of their children needed a donor some day?

Erica’s reply: “Let’s think positive.”

On June 2, 2009, Henry received his transplant, without ever having to go on dialysis.

“He was able to go back to saving lives — and living his own life,” says S. John Swanson, M.D., FACS, chief of Christiana Care’s Kidney Transplant Program. “Having a spouse who was able to donate made all the difference.” 

Bob Tobiason and Bob Hayes have been buddies for more than 30 years — since they were boys growing up in Wilmington’s Albertson Park neighborhood. They married sisters. They both sell auto parts. When Tobiason, 42, learned he needed a kidney transplant, Hayes was the first to volunteer to be tested for a match, even though the two men are not related.

“We have always been like brothers,” says Hayes, 44. “As it turns out, I was such a good match for Bob that the people in the transplant program asked if we were related.”

Thanks to vast improvements in drugs that suppress organ rejection, the pool of live kidney donors has grown deeper, says S. John Swanson, M.D., chief of transplantation surgery at Christiana Care. “You don’t have to be a sibling — or even a blood relative,” Dr. Swanson says. “In fact, spouses make up one of the largest growing groups of donors.”

Dr. Swanson performed the first kidney transplant at Christiana Care on Jan. 15, 2007. Thirty-two people received organs and a new shot at life in 2011, including Tobiason, who returned to work six weeks after his May 11 surgery.

Hayes did not expect any reward beyond the good feeling for helping. But word of his generosity got around, and he received a special merit award from Cranston Heights Fire Company, where he is a volunteer, for saving a life by being a living kidney donor.

“Life threw me a curve ball — but I was able to hit it out of the park, thanks to my friend and the great team at Christiana Care,” Tobiason says.

Previously, Delaware patients had to go to Philadelphia or Baltimore for care. Dr. Swanson says some individuals who desperately needed a transplant opted not to get on the waiting list for a donor because they did not want to go out of state for treatment.

About one-third of transplant patients at Christiana Care receive a kidney from a living donor. There are significant advantages to live donation, including eliminating the wait for an organ from a deceased donor, which can take four years or longer. 

Keith White, a retired Boeing engineer and an avid sailor, was undergoing treatment for Paget’s disease when he experienced arm pain lasting several months.

In September 2010, his doctors at Christiana Care diagnosed him with a rare osteosarcoma.

Because of cardiac issues and a pacemaker, White was not a candidate for chemotherapy.

His orthopedic surgeon, Mihir Thacker, M.D., discussed treatment options with White, making sure his patient understood the procedures and risks.

Dr. Thacker told White that one option would save his right arm and maintain some function, but would involve risks of ongoing pain as well as more surgery in the future. A second option was to remove his right arm, collarbone and shoulder, and build a new shoulder.

White says he told Dr. Thacker “there was really no choice,” and opted for the more extensive procedure. He says he was “confident that my team had the expertise and experience” to achieve a favorable outcome.

At the helm of the surgical team was leader, Dr. Thacker, an assistant professor of Orthopaedic Surgery at Jefferson Medical College in Philadelphia, with extensive training in India, Singapore, Florida and New York. He is the only specialist in Delaware performing orthopedic oncology surgery for adults. Physician’s Assistant Robert Biddle aided in the actual surgery, and also with postoperative care at Christiana Hospital before White transferred to the Center for Rehabilitation at Wilmington Hospital. White is “one of the toughest, most resilient patients I have known,” says Biddle, adding that this was “the first time I had seen this particular procedure involving a rare arm condition.”

Tina Scherer, RN, MSN, one of the Helen F. Graham Cancer Center’s inveterate Nurse Navigators, added her 22 years of oncology nursing experience, including 10 years as liaison with doctors, patients, and their families. She became the “go-to” person when questions arose. Theresa Gillis, M.D., who is board-certified in physical, rehabilitative and pain medicine, rounded out White’s multidisciplinary care team.

Dr. Gillis joined what she refers to as the “caring family” at Helen F. Graham Cancer Center after distinguished years of service at the University of Texas Anderson Cancer Center.

One year after his surgery, White is in good spirits, relatively painfree, and still making progress. He has learned techniques such as tai chi and scar massage for relief of phantom sensations. Frequent walks on inclines and uneven or rough surfaces and other exercises for balance have rounded out his conditioning and accelerated his return to sailing.

White’s positive outlook, which Dr. Gillis calls “an assumption of wellness,” has been an important factor in his recovery. She stresses the value of communication with patients, “so they are not feeling adrift.” Despite the loss of his arm and some enduring pain, White describes his care and treatment as an “uplifting and reassuring” experience. For example, he recalls visiting Dr. Thacker for removal of surgical staples. Halfway through the process the surgeon stopped, saying, “We’ll have a rest now,” and put his arm around White’s shoulder. He adds that visits with Dr. Gillis, to review of his daily routines and medication, have provided care and concern for his total wellbeing.

White calls his care “world class,” leading him to a positive outcome and an active future.

When knee pain made climbing stairs difficult, Michael Stillabower, M.D., one of the first members of Christiana Care Cardiology Consultants, knew it was time to find expert help. Increasing knee pain was robbing him of mobility.

In recent years, Dr. Stillabower says he noticed arthritic twinges when running; skiing was becoming difficult. “These problems had developed gradually,” he says, starting with an early injury to his right knee when playing basketball in 1973.

Now in his middle 60s, he feels the various injuries over his lifetime have made treatment essential. Not one to wait until the pain was unbearable, he consulted among his wide professional contacts, including colleagues at Christiana Care, gathered information and researched orthopedic surgery centers from New York to Baltimore. He wanted the best possible surgical skill; a facility with a fine reputation for surgery and aftercare; and ideally one within a reasonable distance for pre- and post-operative care. He found what he was looking for in Orthopedic Surgeon Steven Dellose, M.D., who recommended knee replacement surgery at the Christiana Care Center for Advanced Joint Replacement at Wilmington Hospital.

Dr. Stillabower learned that he suffered from torn anterior cruciate ligament (ACL). Moreover, both knees needed to be replaced in separate procedures. He was hospitalized for four days for the first knee replacement and for three days for the second procedure. “Any pain from the procedures came from muscles, not from the knees,” he recalls. Dr. Stillabower received rehabilitation therapy at home for two weeks and continued to rehab at Christiana Care’s Preventive Medicine and Rehabilitation Institute for another two weeks. He was back to work in five weeks. He says the first two weeks back to work were exhausting. “Now I’m better than before on stairs,” he says. “Soft tissue healing should be complete within a year after surgery.” He may alter his workload in a few years to enjoy more traveling, but not yet.

Dr. Stillabower says he’s grateful that his professional career as a cardiologist has been extended, and grateful for the medical expertise and facilities readily available to him in the local community.

Andrew Doorey, M.D., one of Delaware’s best-known cardiologists, put up with the pain and occasional swelling from old college football injury (wide receiver, Princeton), for many years. He postponed having surgery for a number of reasons, both personal and professional.

“I didn’t want to take time away from my patients,” he says. As a registered pilot, he also knew he would not be able to fly while recovering from surgery.

For years, he wore a knee brace. He received injections. But when the problem started to impact his tennis game and he was limping around the cath lab and hospital, he decided he’d had enough.

Dr. Doorey went to Christiana Care’s Center for Advanced Joint Replacement to discuss knee surgery with his friend and colleague, Alex B. Bodenstab, M.D., one of the Center’s busiest orthopedic surgeons.

Dr. Bodenstab recommened knee replacement surgery and performed the procedure in January.

Completely recovered in three months, Dr. Doorey is not only back to playing tennis: he was one of the winners of the Christiana Care Classic Tennis Tournament. This tournament at the DuPont Country Club benefits Wilmington Hospital.

“The quality of my care at the Center for Advanced Joint Replacement was outstanding,” Dr. Doorey says.

“As a fellow health professional, I can sense when people know what they’re doing. The quiet confidence of all the staff — from the person who helped hold me upright during early rehab, to the nurses who answered my very basic questions about pain meds.”

Dr. Doorey praised the expertise of the entire surgical team, whose experience and professionalism put him at ease and assured him that he had made the right decision about where to have his knee replacement.

“The expertise given to me in the OR by this most-experienced team, was very reassuring to me,” he recalls. “I knew they had done this many times before, knew exactly what they were doing, and that I was getting the best care possible.”

“We are fortunate to live in the Delaware Valley, where we have a number of world famous orthopedic programs nearby in Philadelphia.

“But after researching the options for knee replacement, it took me about three seconds to decide to have it done at the Center for Advanced Joint Replacement.

“The quality of care is not only as good as, but in my opinion better than, anything in the region. Any success I have on the tennis court – or in just walking around the hospital – I owe to the staff and physicians of the Center.

Word of a young University of Delaware student’s rare medical condition affecting her eyesight reached Christiana Care in a roundabout way. But the emergent, unusual care that Alyssa Tait received at the Christiana Care Wound Care & Hyperbaric Medicine Center was far more direct.

According to her mother, Barbara McCullough, Alyssa Tait was at the Delaware Division of Motor Vehicles to take care of some business on a Monday morning several months ago when she stood up, got dizzy and suddenly lost most of the vision in her right eye.

“She went to a specialist in ophthalmology-surgery in Wilmington,” McCullough says. The diagnosis was a central retinal artery occlusion (CRAO), a blood clot in her eye capable of causing dramatic and permanent vision loss.

“CRAO is rare, comparable to a stroke in the retina, the part of the eye that enables us to see,” explains Wound Care Center Director Adrienne Abner, RN, MSN, CSW, MBA. “Vision loss from CRAO is usually dramatic and permanent.” 

Hyperbaric oxygen therapy can decrease the swelling that causes the vision loss, Abner says, adding, “optimally, treatment guidelines for CRAO using hyperbaric oxygen therapy (HBOT) should occur within several hours to achieve the best outcome.”

Word about Tait’s condition came through the community’s medical grapevine to the staff at Christiana Care, who reached out to the surgeon, Paula Ko, M.D. Tait was fast-tracked for an appointment to evaluate the potential benefit of HBOT therapy at the Lea Boulevard location in Wilmington. Medical Director Nicholas O. Biasotto, D.O., George Zlupko, M.D., who is certified in hyperbaric medicine, and John DeCarli, D.O., believed that HBOT could help prevent further vision loss and even help restore some vision for Tait. 

With the support of Diversified Clinical Services, Inc., a network of wound care and hyperbaric medicine centers, the Christiana Care staff had instant access to all evidenced-based protocols for treating CRAO as well as available consults from another hyperbaric-certified physician online.  

But both HBOT chambers were booked for other patients on the day, Tait was ready and approved to begin therapy.

“We were able to get all the wheels in motion to have the patient start her first treatment Thursday evening instead of Friday morning as we first planned,” Abner says. “In a matter of hours we completed screening, evaluation, insurance approval and scheduling, which under normal circumstances can take a week, so that Alyssa was receiving therapy in the chamber by 6 p.m. Thursday,” Abner says. This was no simple task given that the hyperbaric staff usually works Monday through Friday from 8 a.m.-4:30 p.m.

Time was of the essence to achieve the most positive outcome for Tait. She needed two treatments per day for 10 treatments. The “clinical window of opportunity” to apply effective HBOT was shrinking, Abner says. 

“We’d never heard of HBOT,” McCullough says, adding that “the nursing staff and doctors really scrambled to arrange for five straight days of therapy. They reshuffled personal priorities, even on Saturday and Sunday, to do what they could to regain any portion of Alyssa’s vision loss.” 

Tait noticed improvement in her peripheral vision the morning after her first treatment. After the sixth treatment, a repeat funduscopic exam showed a significant decrease in retinal swelling. Tait recovered a sliver of light in the middle of her field of vision. Now, “there is still permanent damage but less significant than originally thought to be,” her mother says. “So far they have found no underlying medical conditions that caused the CRAO.”

As a mother, McCullough was concerned about how Alyssa would process the sudden vision loss and all the information — some of which could be hard to take. “No one expects their 20-year old child to have a mini-stroke, but the Christiana Care staff was wonderful,” McCullough says. “They explained things in a simplistic and thorough way and sincerely cared enough to do whatever they could to make a difference for my daughter.”

Tom used to be very active.  He played sports in high school and enjoyed running, basketball and cycling in his early adult years.  His left hip first was losing cartilage and producing pain.  Wanting to help, Tom’s wife found Christiana Care’s Center for Advanced Joint Replacement from an internet search.  She was especially interested in the exterior hip replacements done by Dr. Casscells.  

In online testimonials, patients said that pain was minimal and the care provided by Dr. Casscells and the Center for Advanced Joint Replacement at Christiana Care’s Wilmington Hospital was superb. Tom proceeded with right hip replacement surgery which was successful. He returned to the active lifestyle he enjoyed.

Then, the tightness and pain that he had experienced in his right hip started to slowly show up in his left hip.  It slowed him down and prevented him from being active.  Like his right hip, Tom’s left hip no longer had cartilage to protect his hip and femur bones from rubbing together; the consequently pain was unbearable. Tom could neither walk nor sit for long. He had to be very careful moving at any time.  When he could not sleep, he called Dr. Casscells again.

This time, Dr. Casscells suggested Tom try an interior hip replacement.  He proceed with the surgery and noticed that the recovery time was much less (1/2 the time of the right hip replacement), there were fewer required physical therapy visits, less bruising and a quicker return to driving and other activities.

Now, Tom says he feels “a lot better.”  He’s no longer in pain and has no limp; he strides with an even gait.  Now, he regularly walks – and is able to keep up with others; plus, he quickly gets up and down stairs with east.  Tom is proud to say that he will return to cycling in the annual Bike to the Bay held in October – something he did before hip replacement.

Back in the late 1960s, Thom originally damaged his right knee when he fell a short distance onto a locked knee.  His knee condition and pain worsened over the next decade.  In the late 1970s, most of his torn meniscus (the cushioning and lubricating surface in the knee) was removed — the best treatment at that time.  But this left little cushioning between joint bones and increasingly produced pain over the three decades since, to the point Thom could not walk a significant distance without a cane.  Periodically and unpredictably, he would experience severe, debilitating discomfort.

His family physician referred him to Dr. Christopher Casscells, an orthopaedic surgeon with the CAJR.  The MRI ordered by Dr. Casscells showed that the cartilage protecting and lubricating Thom’s knee joint had worn through completely, and that when Thom stood or walked, he had bone rubbing on bone in part of his knee.  He also had severe arthritis.

Following the procedure, Thom went to Christiana Care Physical Therapy Plus, whose therapists, Thom notes, “helped me get back to a good level of function and made the process as enjoyable as possible.”  Full recovery from this particular surgery can take at least a year.  Thirteen months afterward, Thom reports that he is thrilled; he is able to walk pain-free for the first time in many years.  He was able to walk more than a mile within six weeks of surgery and return to cycling four months after surgery.  In fact, his overall knee function is far better than it was prior to the procedure.  Dr. Casscells lauds Thom’s active lifestyle and predicts that he will never need another knee replacement because of it.

About 13 years ago, Jeannice was on a long-distance bike ride when another cyclist ran into her, injuring Jeannice’s knee.  A few years later, another cycling-related accident resulted in a torn meniscus in her other knee.  At the time of the second accident, she had already begun volunteering in Christiana Hospital’s surgical waiting room. “A friend told me to call the Center for Advanced Joint Replacement,” Jeannice says, adding that she was referred to Alex Bodenstab, M.D., an orthopaedic surgeon at the Center for Advanced Joint Replacement.  Dr. Bodenstab repair the torn meniscus. 

In 2007, arthritis in her knees began to severely restrict her ability to keep up with her many activities. Upon the recommendation of a nurse acquaintance, Jeannice returned to Dr. Bodenstab, the surgeon who performs the most joint replacements at the Center for Advanced Joint Replacement.  “Dr. Bodenstab helped me make the right decision for me about knee replacement surgery,” Jeannice reports.

Asked about her surgical experience, Jeannice explains, “It was excellent.  The surgical team and post-op rehabilitation staff were wonderful, and I also had a great experience as an out-patient at the Christiana Care’s Physical Therapy Plus at Eugene du Pont Preventive Medicine and Rehabilitation Institute.”  Jeannice was back on her feet volunteering in the surgical waiting room within three months.  She gives some of the credit to her husband, Jim, who came to the hospital every single day to watch her do her therapy exercises, so that he could supervise her properly once she was back home.  “Jim wants you to know that he considered himself ‘coach’ for my therapy — ¬and frequently showed me the ‘coach’ badge given to him at the pre-surgery class at Wilmington Hospital to prove it!”

More than four years after her surgery, Jeannice exclaims that she’s “really great!  We’re going on biking trips to Florida to do long-distance cycling (35 miles between towns) and visit family and friends.”  In addition to long-distance biking, Jeannice and her husband Jim also exercise at the gym three times a week, take three to four classes at the University of Delaware’s Osher Lifelong Learning Institute, volunteer at a homeless shelter, and attend symphony and theater performances.

Jeannice’s experience as a joint-replacement patient enables her to assure worried families in the surgical waiting room.  Her keen organizational skills, both as a mother of three grown children and as a former music teacher at Wilmington Friends School, help her keep track of and attend to the needs of the people in the waiting room.  Christiana Care is fortunate to have Jeannice’s skill and compassion as a resource.

Would Jeannice recommend Dr. Bodenstab and CAJR at Wilmington Hospital to her friends?  “I have done so, many times,” she says.  “You don’t have to go to Philadelphia for superior orthopaedic surgery.”  Jeannice believes that having a great surgeon, excellent recovery and rehab, and keeping so active have all contributed to her wonderful outcome.  At 79, she keeps an active schedule – thanks to the new knees she received at the Center for Advanced Joint Replacement.