Gail and Gary Weinberg share life together. The couple is active in community service. They’re both fitness buffs who like to ski, hike, and explore the world.
They also share a history of pain. Both suffered from arthritic joints that had worn away cartilage until bone met bone. And both came to the conclusion that the risk of surgery to replace their joints was worth the promise of relief from the pain. Together, they searched for the best surgeon and the best hospital to get through the experience. They reviewed outcomes, read patient reviews online, quizzed their primary care doctors, and interviewed several people they knew who had undergone joint replacements.
Their efforts led them to the Hip & Knee Center at Saint Luke’s South Hospital.
Here their stories diverge. They each needed different orthopedic procedures. Gail, a new hip. Gary, a new knee. And they would both receive their care from two Saint Luke’s physicians.
NOT WHAT THE DOCTOR ORDERED
The Weinbergs are part of a growing trend: baby boomers determined to stay active choosing to replace joints at younger ages. Artificial knees and hips used to last only five to 10 years. Today, new techniques, more durable joints that last up to 30 years, and quicker return to function are attracting a younger crowd.
More than half of Americans who undergo total hip or knee replacements this year will be — like the Weinbergs — under 65.
It was a cascade of pain that convinced Gail. Her hip pain altered her gait, which caused lower back and shoulder pain.
“The pain affects everything,” said Gail, a financial development director at the Jewish Federation. “It was affecting my attitude.”
Gary, chief operating officer for National Seminars Group and president of the Jewish Community Center, had injured his knee playing high school football. He’d undergone five procedures to prolong the life of his natural knee.
Gail had already scheduled her surgery. He decided to follow her.
The novel program at the Hip & Knee Center groups people undergoing knee or hip replacement surgery into teams each week. Each team has surgery on the same day, starts therapy together, and recovers together.
Gail got schooled in what to expect in a pre-op class. There, an orthopedic nurse explained the experience from before surgery through rehab and on to recovery. She covered surgical techniques, the mechanics of artificial joints, sedation and pain management options, rehab exercises, and home care resources.
“The class took the fear out of the process,” Gail said. She had opted for a spinal block with short-acting sedation instead of general anesthesia to eliminate nausea and confusion and shorten recovery time.
All she remembers was Gary kissing her as she went into pre-surgery and then waking up in recovery.
“I felt unbelievable,” she said. “I wanted to go skiing.”
Surgical pain is often more tolerable than arthritis pain, according to Jeffrey Salin, D.O. The technique he uses — Microplasty® Anterior Supine Intermuscular (ASI) surgery — helps minimize discomfort.
ASI involves going through a natural window in the muscles on the front of the hip. This means less muscle disruption than the traditional side-entry approach. It also lowers the risk of dislocating the joint, so Gail had far fewer movement restrictions than she would have had with traditional surgery. She could bend down to tie her shoes and cross her legs, for example.
Gail sailed through therapy. She liked the collegial aspect of the team approach. Sharing the experience motivated her. Studies have shown that people who get new knees or hips this way do heal more quickly and are more satisfied with their new joints.
At every step, Gail noted thoughtful touches to make the experience pleasant. She went back to her spacious hospital room in the same bed she woke up in after surgery, thus avoiding a painful transfer from one bed to another. She ordered off a menu when she was hungry instead of on the hospital schedule. The nurses remembered what flavor of ice cream she preferred.
“The caliber of individuals I encountered was amazing — the nurses, the physical therapists, and even the woman who cleaned the room,” Gail said. “I felt like I had my own private staff.” She could even order a meal for Gary so she didn’t have to dine alone.
Gary had been given a choice of where he wanted to have the surgery.
“After watching from Gail’s bedside, that was an easy choice,” he said.
A KNEE UP
“I waited seven weeks to make sure Gail had time to heal so she could take care of me,” Gary said. The nurses and staff welcomed back the former visitor who had brought treats for the nurses in hopes of sugarcoating his own experience.
For his procedure, Gary turned to the experienced surgical hands of Robert Gardiner, M.D., who with more than 20 years as a fellowship-trained surgeon is no stranger to conducting successful knee-replacement procedures.
During Gary’s procedure, Dr. Gardiner cut away the damaged ends of Gary’s right femur and the tibia below. He reshaped the remaining bone to hold the metal caps. Artificial joints don’t really replace the knee; they replace cartilage.
Getting a new knee can be more painful than getting a hip, so knee replacements require more aggressive pain management. Surface joints like knees are closer to nerves. Knees also bear more weight and have a greater range of motion.
New techniques have greatly reduced patient discomfort. Dr. Gardiner ordered a femoral block after the surgery that kept Gary’s leg numb for 24 hours.
“The nurses kept asking me to rate my pain, and I didn’t really have any,” Gary said. “I was never above a two even after the femoral wore off.
“The nurses were incredibly well trained in pain management” Gary said. The quality of patient care was far beyond what he had ever encountered at other hospitals. “The nurses and staff didn’t just make you feel well tended. They made you feel important,” he said.
The Weinbergs still reminisce about their experiences the way they might a vacation. They speak of their caregivers by name — Phil, Patty, and Jane. They miss the pampering, the coffee delivered just the way they like it.
And they both marvel at the coincidence of winding up in the same room. They remember it fondly as the place where they left their shared pain behind.