Patient Success Stories
How to snowboard on a new hip
A new hip replacement procedure was a quick and painless solution to help an active snowboard instructor get back on the slopes.
When Dr. Chris Gorczynski of Columbia Memorial Bone & Joint Center told Marty Wallace in mid-July, 2010, that with a Birmingham hip replacement he would be back to his weekend position of snowboard instructor at Ski Windham by Thanksgiving Day, Wallace was convinced.
"I was on snow the first week of December only because on Thanksgiving we didn't have snow yet," said Wallace, 53, who has snowboarded for the past ten years and instructed for the past four years. "I had no problems. It was like my legs were 35 years old again. It turned back the clock as far as my legs went."
Dr. Gorczynski and a colleague at the Bone & Joint Center, Dr. Louis DiGiovanni, are among the first surgeons in this area who have been trained in the new Birmingham Hip Resurfacing (BHR) technique.
The bone-conserving approach of the technique preserves more of the patient's natural bone structures and stability, covering the joint's surfaces with an all-metal implant that more closely resembles a tooth cap than a hip implant. This approach reduces the post-operative risks of dislocation and inaccurate leg length, and because the all-metal implant is made from tough, smooth cobalt chrome, it has the potential to last longer than traditional hip implants.
Wallace began experiencing pain in his knees several years ago, and the pain gradually increased over time until he decided to see a doctor, where he first learned that, much to his surprise, he bore the classic symptoms of a hip problem. Physical therapy helped alleviate some of the pain for a stretch, but by the end of teaching a snowboard lesson, Wallace said, "I was limping, really feeling it in my hip and knee."
In March, 2010, Wallace's wife, Pat, convinced him to see Dr. Gorczynski, who had helped her with a shoulder problem. By that time, Wallace had begun dreading going to bed since "I couldn't sleep on either side or my stomach without the hip and knee starting to ache. Sleeping on my back wasn't all that comfortable, either, especially when my wife would whack me for snoring. Since the new hip is in place, no such trouble."
Wallace was delighted that on his first visit "Dr. Gorczynski spent 45 minutes going over my X-rays and talking about my options. Dr. Gorczynski was outstanding to work with. He was very approachable and responded to all my questions. He spent lots of time with me, which was unheard of in my book."
By the end of that first visit, Wallace was prepared to proceed with the surgery, comfortable in the knowledge that he'd be back on the slopes by Thanksgiving.
"It was my first experience with surgery," said Wallace.
"Everyone at Columbia Memorial Hospital was top-notch. The nurses and the staff were wonderful. Pain management was great – I was never in pain. After the surgery, I was on my feet the next day, using a walker and climbing stairs with the aid of crutches. I was driving again in seven weeks, and by then I'd stopped using the walker and crutches. By the end of twelve weeks, all bending restrictions were lifted."
The Birmingham Hip implant is intended for patients suffering from hip pain due to osteoarthritis, dysplasia or avascular necrosis, and for whom total hip replacement may not be appropriate due to their increased level of physical activity. For this reason, most surgeons feel it will be ideal for patients with active lifestyles.
Ellen Polay is
an artist and
Dr. DiGiovanni is
a Chatham High
graduate and former
A card carrying “hipster”
Spencertown resident and artist Ellyn Polay was in great pain, but couldn’t find the cause. She thought it was her back. Through the efforts of Columbia Memorial surgeon and former Chathamite Louis DiGiovanni, she is walking again and is pain free.
Ellyn Polay says she is a “card carrying hipster”but not in the way you normally refer to that term.
When she walks through airport screening devices, she pulls out a laminated card that shows that two of her hips are titanium. If it wasn’t for a discovery by Columbia Memorial Hospital pain management physician Tomasz Andrejuk, and diagnosis of degenerating hips by Dr. Catherine Shin, and the accomplished surgery of Dr. Louis DiGiovanni, Polay would not be walking anywhere.
Polay grew up in Manhattan and worked for years in West Palm Beach, Florida as a real estate professional. She now lives in Spencertown, New York where she paints. She is an artist and also illustrates children’s books –a fine arts graduate of Boston University.
“Fate brought me up here to meet Dr. DiGiovanni and have hip surgery.”
About two years ago in Florida, Polay started feeling lots of pain that she thought was in her back.
“It was excruciating just getting in and out of my car. It was so bad that I could only do one thing a day. I never trusted doctors, especially the ones in Florida,” said Polay.
“Moving back here was the road to my new life in more ways than one,” she said.
Polay, who got her first degree black belt in Tae Kwan Do at the age of 50, thought that her back problem was the result of all the kicking and athletic moves of the self-defense sport. She also thought the cold up here in Columbia County was a contributing cause.
Pain management to Bone & Joint
Polay turned to Columbia Memorial’s Pain Management Program to get relief. She figured that a Cortisone shot would do the trick. However, when Dr. Andrejuk looked at her pre-pain workups, he saw something more serious. He then sent the x-rays on to Dr. Shin at the hospital’s Bone & Joint Center.
“Dr. Shin came in after examining me and the x-rays and said I’ve got some good news and some bad news,” said Polay.
Dr. Shin said to me: “You do not have a back problem, but both of your hips are degenerating.”
It was then that Polay knew she had to start trusting doctors and do something about the pain.
Passion for his work
“I was introduced to Dr. DiGiovanni and I learned that both his dad and my dad were
dentists in Columbia County back in the ’60s. Dr. DiGiovanni was enthusiastic, full of life, comforting and obviously passionate about his work. That made my decision easier. He is just a nice guy, intelligent.”
Dr. DiGiovanni then asked, “Which one do you want to do first?,” said Polay.
“I said, both.”
“Other than the birth of my daughter, I was clueless about surgery, but I figured if they were going to put me under, they might as well do both at the same time. But right up to the point of them lifting me onto the surgical table, I didn’t ask many questions. I did learn subsequently that they use big tools to do the work!”
“The surgery, which took six hours, was performed at Columbia Memorial’s surgical suite.
“I asked Dr. DiGiovanni what I might expect after the surgery,” said Polay.
“He told me I wouldn’t jump up and be walking. I would be nine days in the hospital followed by weeks of physical therapy. Dr. DiGiovanni would come and visit me in the hospital and again later during rehab.”
“It took at least eight weeks before I could drive and I almost had to learn to walk again. But my life has improved enormously. I call it a miracle.”
“It is truly amazing what they can do to knees, hips, and shoulders to restore a person’s functionality.”
“My stay at Columbia Memorial was a great experience. The nurses were so pleasant. I like the hospital’s size – you are not a number, you are a patient with needs.”
“My daughter Samantha calls me the bionic woman. I do feel strong, thanks to Dr. DiGiovanni.”
Polay was so grateful for the experience, she is having a painting from famed Abstract Expressionist Gino Hollander donated to the hospital.
Non-surgical platelet rich plasma technique helps heal injured tendons
Things had gotten to the point with Lonny Kalfuss left knee that he couldnt tolerate walking a few city blocks.
Kalfus, now 66, tore up his ACL when he was 40, but I didnt have it rebuilt because that would have involved a complicated recovery period, he said. rebuilt because that would have involved a complicated recovery period, he said. rebuilt because that would have involved a complicated recovery period, he said.
I work out a lot, continued the long-time commercial photographer who these days concentrates on fine art photography.
I would experience swelling and things like that with my knee. Then, a few years ago, I started running again. That was a mistake. The knee swelled up, got painful, and stayed that way. Wed be in Hudson walking, but I couldnt make it more than two or three city blocks.
Kalfus received a cortisone injection, but that did not help. Next up was an injection of Synvisc, which also yielded no improvement.
Then, an old friend from the city told me about the platelet rich plasma (PRP) injection. He said hed had remarkable results.
Kalfus began casting about for someone closer to his Copake home who could perform the procedure.
When I called Columbia Memorial Bone & Joint Center, they told me Dr. Pregont could do it, he said.
Lonny Kalfus was on the verge of getting a knee replacement, said Dr. Scott Pregont. Here was a man who couldnt walk two city blocks without experiencing severe pain. He was at end stage knee arthritis.
PRP can be used for a variety of degenerative conditions that can be frustrating for both patients and their doctors. Sometimes these conditions may go away with medication, or bracing, but there is a subset of patients that just dont get better. They are headed for a surgical procedure. Of course, the idea of surgery does not appeal to most people.
Diagnosis best for the procedure
When a tendon is chronically injured, at some point the body stops trying to heal it and chronic pain ensues. The abnormal tendon is structurally different from the normal tendon. These chronic changes can be seen on ultrasound. The PRP attempts to re-organize the tendon fibers into its normal alignment, which would permanently fix the problem.
The PRP procedure, which takes about a half an hour and takes place in the doctors office, involves drawing blood from the patient, spinning the blood in a centrifuge, drawing off the platelets that are rich in healing qualities, and injecting those platelets into the infected area.
According to Pregont, the idea is to inject a healing substance as opposed to something like steroids, which treat the underlying symptoms, not the cause.
With those platelets come chemical messengers that say heal here. You want to incite a repair response within the body.
Pregont termed the results he has thus far seen as amazing.
Universally, the results have been from dramatic to a complete recovery. Its inducing the body to heal itself. PRP really seems to help, he said.
Pregont noted that currently the PRP procedure is not covered under most medical insurance policies, although thinks that in time it should be a no-brainer for companies to offer coverage given that the cost of a knee replacement is thousands of dollars, while the cost of a PRP procedure at Columbia Memorial Bone & Joint runs around $750.
Its another tool in our arsenal, said Pregont. The results have been very satisfying. Im very pleased with Mr. Kalfuss outcome.
Knee surgery was inevitable, the doctor told me, barring this working, Kalfus said.
Prior to his PRP procedure in autumn 2011, Kalfus said he was not given a time frame for when he could expect recovery, or to what extent he could expect his knee to respond, but slowly, over a period of weeks, it began to get better.
Since the PRP, I noticed that many things that gave me pain, no longer do. Now I walk two to three miles every day, and briskly, Kalfus said.
I no longer have to wear a bandage support. I can play golf.
Its been great.