Patient Stories

From a shattered ankle to Antarctica

Fri, 19 Apr 2013 11:51:52 -0400

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.”

'Time is brain' rings true for stroke patient

Thu, 18 Apr 2013 16:32:33 -0400

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.”

Cooling technology and NICU team come to the rescue for Plank family

Mon, 04 Mar 2013 16:38:18 -0500

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...

Mon, 25 Feb 2013 13:00:10 -0500

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

Rayna M.

Fri, 25 Jan 2013 08:25:58 -0500

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….

The happiest day of my life was when I stood up on this foot

Tue, 27 Nov 2012 09:34:31 -0500

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.”

Pat Miccio's story

Wed, 14 Nov 2012 14:56:00 -0500

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.

'You must be very proud of your employees'

Wed, 19 Sep 2012 16:18:32 -0400

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

No more ankle pain - and no more 'stupid shoes'

Mon, 27 Aug 2012 16:33:46 -0400

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.”

Work doesn't have to be painful

Wed, 22 Aug 2012 10:44:32 -0400

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.

'I'm pretty grateful to be here'

Mon, 13 Aug 2012 10:30:21 -0400

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.’’

It's been five years since she heard "you only have months to live"

Mon, 13 Aug 2012 10:23:17 -0400

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 dances to a new tune

Mon, 13 Aug 2012 10:02:56 -0400

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!”

"I just wanted to take this time to tell you about the wonderful nurse named Beth on the 5th floor..."

Thu, 09 Aug 2012 15:50:00 -0400

“I just wanted to take this time to tell you about the wonderful nurse named Beth on the 5th floor (Unit 5A). She is not only sweet and sincere, but very knowledgeable and helpful to me during this difficult time. My wife and I are scared to death about my injury, and she has made my stay here better than I could have hoped for. She has the bedside manner of a saint and the knowledge of a doctor. All the staff has been exceptional, but she is an exception to the exceptional.”

- Thomas Dimes of Georgetown, Del.

Cancer survivor regains quality of life with help from Helen F. Graham Cancer Center

Fri, 27 Jul 2012 12:26:01 -0400

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.

Double amputee doesn't let illness stop him from enjoying life

Tue, 19 Jun 2012 11:22:56 -0400

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.”

Hip replacement, rehab put retired doc back in action

Tue, 19 Jun 2012 11:11:00 -0400

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.

'I'm fortunate. I got that chance, and this place has a lot to do with that'

Fri, 08 Jun 2012 15:39:00 -0400

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.”

Colleague praises Wound Care Center teamwork

Thu, 03 May 2012 09:14:20 -0400

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

Most of our hospital rooms have a communication whiteboard,...

Fri, 27 Apr 2012 16:25:25 -0400

Most of our hospital rooms have a communication whiteboard, where nurses and staff can write information to share with patients, their families, and each other. One of our patients on Unit 5N at Wilmington Hospital left this lovely note on the whiteboard before she went home. If you’re out there: You’re welcome! And thank YOU for giving us the privilege of caring for you!