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.
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!”
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.
I’ve been a nurse for 40 years and I must validate what you already know — that your staff is superb. They all have patient care, communication with the patient and patient education as such a strong focus. Each and every person who entered the room identified themselves, and I knew why they were there. Everything was well explained before it happened. I knew when they would be returning and why. I was made aware of discharge planning from the very beginning and all those plans fell into place efficiently and correctly. All members of the staff work together on the Joint Replacement Unit … and the unit works superbly well. I can only say that we patients are very fortunate to have the Joint Replacement Center in Wilmington. It is the very best!—Marilyn Boos, who received knee replacements at Wilmington Hospital in April and October 2011
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.