A Gift of Thanks – 3 Years (and 43 Surgeries) Later

Grant (second from right) with part of the STC team and his parents

Three years ago, Grant Harrison was in a horrific motorcycle crash.  It was a bright sunny day on the Eastern Shore when a large deer struck the motorcycle Grant was riding.  He was airlifted to UMMC’s R Adams Cowley Shock Trauma Center with multiple life threating injuries.

The fact that he is alive today is nothing short of astonishing. Grant had a fractured skull, severe traumatic brain injury, bleeding of the brain and severe injuries to his limbs.

Grant spent 58 days on the Neurotrauma Critical Care Unit, and has had 43 surgeries on his road to recovery.

Grant is a now a walking, talking (and hilarious) miracle.

Exactly three years after the accident, June 6, 2017, Grant, along with his mother and father, wanted to give thanks to the nurses and doctors at Shock Trauma who showed them extraordinary compassion and care throughout this life-altering experience.

They brought the Shock Trauma team a framed thank you letter, along with photos documenting Grant’s journey to recovery.  The gift is now hung along the walls of the Neurotrauma Critical Care Unit, right outside the Patient Family Waiting Area.

The Harrison Family hopes that families pacing those halls (like they did many times 3 years ago), will read the testimony and find hope and encouragement.

Read a portion of the family’s letter below:

“The doctors and nurses here not only care for the patient, but for you, the family as well. They will always hold a special place in our hearts for their kindness and compassion. We encourage you to listen well to them, as they will educate and guide you through this unexpected journey. The Trauma Survivor’s Network, a resource offered through the hospital, was also most helpful to us.”

Grant with TRU Nurse Christopher Wentker

 

Physical Fitness and Sports Month: Commonly Asked Questions About Sports Injuries with Dr. Packer

Dr. Jonathan Packer is an orthopaedic surgeon with the University of Maryland Department of Orthopaedics and an Assistant Professor of Orthopaedics at the University of Maryland School of Medicine.  Dr. Packer specializes in sports medicine and is a Team Physician with the University of Maryland Terrapins.  Below he answers common questions about sports injuries.

What are the most common sports-related injuries you see in your clinic?

The most common sports related injuries are ankle sprains and contusions.  The most common knee injuries that I see are meniscus tears and knee ligament injuries, such as the MCL (meniscus collateral ligament) and ACL (anterior cruciate ligament).

What can an athlete do after an injury to recover quicker?

The treatment depends on the specific injury and the severity of the injury.  The athlete should have the injury evaluated by the team Athletic Trainer, who can then determine whether the injury requires an evaluation by a physician.  Low grade injuries typically respond well to rest and different treatments to reduce the inflammation (elevation, ice, anti-inflammatory medications – i.e. Ibuprofen or Naproxen).

Why should an athlete use ice and not heat on an injury? 

The initial treatment goals after an acute injury (first 48 hours) are to reduce inflammation and swelling.  Cryotherapy, such as ice, is an effective method of reducing the swelling and bleeding into the tissues.  Heat is used for chronic injuries to relax and loosen tissues and to increase blood flow to the area, typically before participating in sports.

Can an athlete play with a cast or brace? 

It depends on the injury and the sport.  Athletes are frequently cleared to play with either a cast or a brace.  Your sports medicine physician will be able to make the decision whether or not it is safe to play with a cast / brace or not given your injury and sport.

When does an athlete need to see a physician? 

If the athlete’s team has an Athletic Trainer, s/he should evaluate the athlete and determine whether a referral to a physician is necessary.  In general, if the injury is accompanied with a “pop” or if a joint has a large amount of swelling, then it is concerning for a more serious injury that should be evaluated by a physician.  Other reasons to see a physician are joint instability and failure to improve with rest and anti-inflammatory treatments.

How can sports injuries be prevented?  

Sports injuries are best prevented by a dedicated prevention program that would ideally start at least 6 weeks before the start of the season. The prevention programs should focus on flexibility, muscle coordination and strengthening, neuromuscular control, plyometrics, body mechanics, and proper landing techniques.  The prevention programs are especially important for preventing ACL tears and have been shown to reduce non-contact ACL tears by up to 80%.  There are many different prevention programs that can be found online.  Two of the most well-known and established programs are the Prevent Injury and Enhance Performance (PEP) Program and the Knee Injury Prevention Program (KIPP).  Athletes and their coaches can find these programs online here and here.

Why should athletes choose University of Maryland Department of Orthopaedics to diagnose and treat their sports injuries?  

The University of Maryland has many physicians that specialize in Sports Medicine and treat all types of sports injuries. If at all possible, we will try to get you back to your sport without surgery. However, if surgery is necessary, we have the expertise to treat even the most complex injuries. The Sports Medicine team has extensive experience and are the team physicians for 12 high schools and for the University of Maryland Terrapins.

To make an appointment or to learn more about the University of Maryland Department of Orthopaedics sports medicine specialists, call 410-448-6400, or visit their website.

Joint Replacement Q&A with Dr. Theodore Manson

Theodore Manson, MD is an Orthopaedic Surgeon at the University of Maryland Medical Center and an Associate Professor of Orthopaedics at the University of Maryland School of Medicine.

Dr. Manson specializes in hip and knee replacements and orthopaedic trauma. Below he answers the most common questions about joint replacement.

 

Q. What advances have there been in joint replacements including new technologies, changes in patient-management and rehabilitation?

A. One significant advancement in the last 10 years has been around pain management and early recovery protocols. The goal is to minimize the amount of narcotics patients require after surgery. Today, we manage pain through many different types of medicines in addition to narcotics. There’s been a lot of success recently with joint (intra-articular) injections of anesthetic around the hip or knee joint at the time of surgery. This injection limits the amount of pain patients have when they first wake up from surgery. We know that if you limit that first pain sensation, it helps with the whole pain management process going forward.

Another significant advancement is infection prevention. Patients’ skin is now pre-operatively prepped with the antiseptic and disinfectant chlorhexidine both at home prior to surgery and at the hospital as well. In addition, we optimize patients’ nutrition and health pre-operatively. These two things have drastically cut down on infection rates. We did not use to address patient nutrition. Now, we assess patients’ nutritional status before surgery. If a patient is at a higher risk for nutritional deficiencies – those with chronic illness, diabetes or poor appetite, we then work in conjunction with a nutritionist so their infection rates are lower.

Borrowing from the aviation industry, there have been substantial improvements to patient safety in the hospital postoperatively as well.  Standardized protocols, safety checklists and quality control monitoring have dramatically reduced untoward events in joint replacement patients.

Q. What new innovations in joint replacement surgery (hardware and techniques) are noteworthy and why?

A. There is a lot of marketing material on the internet regarding various joint replacement approaches, minimally invasive surgery, robotic surgery and use of custom hip and knee replacement parts.  It is important to realize that none of these things has been shown to be of any benefit. When considering joint replacement, choose a surgeon who performs a high volume of hip and knee replacement surgeries and who you get along with well on a personal level.

While there haven’t been any substantial innovations with implants in the last five years, we do have long-term data on our current implants and techniques that shows them to be functioning extremely well.

Q. Who should get a joint replacement? What factors should a person consider? How should a potential patient decide?

A. In general, joint replacement is an elective procedure. If the patient is falling due to their hip or knee arthritis, it can be a very dangerous situation, so falls are an indication they should go ahead with a joint replacement. If a person is no longer able to climb stairs, if the hip/knee pain keeps him/her up at night, or if s/he is constantly dependent on an assistive device like a cane, then I think they should strongly consider a joint replacement. For others with less severe symptoms, a joint replacement may still be of great benefit to them, but they should consider surgery when the time is right and shouldn’t feel pressured into a surgical option.

Q. What should a patient expect?

A. Once they have scheduled the surgery, most patients undergo pre-habilitation prior to the joint replacement. Many patients find it useful to go to a preoperative joint class at the hospital where they’re going to have the surgery. This helps to alleviate anxiety about the procedure and educate them on what is to come. For those who are substantially debilitated preoperatively, going to prehab (physical therapy) to strengthen the operative leg is helpful and helps us foresee any challenges that may arise postoperatively.

If you have a body mass index (BMI) of 40 or greater, you should delay joint replacement until you can get below 40. This is because infection rates increase substantially for people who have a BMI of 40 or greater.

Q. Does the type of implant used depend on patient activity and age? How?

A. In the past, different implants were used based on age, but for the vast majority of surgeons we use the same type of implants no matter the age. Occasionally patient with poor bone quality will require different implants, but usually we use the same regardless of age or activity level.

Q. What is the target recovery period and regimen for various categories of patients?

A. Patients see the majority of their improvement six to 12 weeks after surgery. They reach their maximum improvement six to 12 months after hip/knee surgery.

Q. What is the lifespan of replacement joints and do you expect the lifespan to grow longer soon?

A. The lifespan of replacement joints have a 1-percent-per-year failure rate, so with 20 years, you have a 20 percent risk of needing the joint replacement redone. I expect this will grow longer as we get better at preventing infection rates. If you are over 60 years old, the odds are you’ll probably never need to have the joint redone.

Q. Have risk factors (infections, failures, etc.) declined or increased (and for whom)?

A. Risk factors have declined because of more critical evaluation and optimization of risk factors for infection around the time of surgery.

Q. Are revision surgeries more or less common these days and why? Do you expect that to change? How and why?

A. Revision surgeries are more common these days simply because of the number of people who have gotten a joint replacement is increasing, and the number of baby boomers having joint replacement is increasing. I expect the number to continue to go up just because the number of people having a joint replacement is going up.

To make an appointment with Dr. Manson or one of our other orthopaedic specialists, please call 410-448-6400.  For more information on joint replacement or other orthopaedic issues, check out the University of Maryland Orthopaedics’ website.

Camp for Kids with Limb Differences

This past weekend marked the first-ever Camp Open Arms!

Children with limb differences such as brachial plexus birth palsy and congenital/traumatic deformities joined us for two fun-filled days in Monkton in Northern Baltimore County.

Camp Open Arms Field Day

Putting on this camp was the idea of our pediatric orthopaedist, Dr. Josh Abzug. He is used to seeing patients with limb differences in the clinic, but he wanted to see these children become carefree campers jumping onto tree swings, going for hikes and even chucking water balloons at him!

Camp Open Arms SwingCampers ranging in age from 4 to 9 arrived on Friday morning not really knowing what to expect. The two dozen volunteers were not quite sure what to expect either. Everyone changed into bright yellow Camp Open Arms t-shirts, which quickly helped put everyone at ease since we looked like a cohesive group. We certainly became one, especially among the campers.

The children did not talk much about their limb differences, but they seemed to understand that they had that connection as they helped one another overcome obstacles.  Volunteers watched as they worked on crafts, played a variety of instruments and simply had fun.

Dr. Abzug wanted the tag line of the camp to be “Strength, Courage and Determination.”  Campers demonstrated those values!  We witnessed big smiles and infectious laughter that made all of us believe that Camp Open Arms has a bright future.

Cute CampersThe weekend culminated with a large BBQ with the families joining the campers and the many volunteers. One girl asked if she could come back the next day, which we took as a sign that our inaugural year of Camp Open Arms was a success!

 

 

 

 

UMMS “Spring Into Good Health” Event Gets Shoppers Dancing in the Center Court at Mondawmin Mall

By Sharon Boston

UMMC Media Relations Manager

Each spring, the University of Medical System (UMMS) hosts “Spring Into Good Health,” a free event attended by hundreds of people who receive medical screenings (such as blood pressure and cholesterol), talk one-on-one with University of Maryland Medical System health professionals and pick up information on men’s and women’s health, child safety, nutrition and more.

This year, the UMMS Community Outreach and Advocacy Committee wanted to put a focus on fitness and hosted a dance party right in the middle of Mondawmin Mall!

Several guests commented that they didn’t realize that fitness could be so fun, and that they plan to try to exercise more and eat better, thanks to the information that they picked up at the UMMS event.

Take a look at the some of the line dancing that got people of all ages up and moving.

 “The dancing was really upbeat and lively, it really got people moving,” said Donna Jacobs, UMMS senior vice president for government relations. “Several people told us that they’d like to see even more fun physical activities next year.”

Five of the 12 hospitals in the University of Maryland Medical System took part in the event — the University of Maryland Medical Center, Maryland General Hospital, Kernan Orthopaedics and Rehabilitation Hospital, University Specialty Hospital and Mt. Washington Pediatric Hospital. The event was also sponsored by Maryland Physicians Care, Total Health Care, Coppin State University School of Nursing and Radio One, Baltimore.

Arthritis and Joint Problems Sideline NFL Pros and Weekend Warriors Alike

Robert Sterling, MD

Robert Sterling, MD

By Robert D. Sterling, MD
Associate Professor of Orthopaedics

Ouch! As you can imagine when you see a player get sacked, years on the football field can take their toll! A 2008 University of Michigan study of retired NFL players found that, compared to the general public, these former football greats have a very high rate of diagnosed arthritis. Their joints are, plain and simple, just worn out. So of the older retirees in this study, almost 25 percent have had at least one joint replacement. The vast majority have had knees replaced. Hips replacements are less common.

So as some great athletes take to the field this Super Bowl XLVI weekend, some of us former “great” athletes may be wondering if that creaky knee or aching hip needs a possible replacement. When is the right time to see a doctor about it? Listen to your body, and it will tell you: If you are experiencing pain, swelling or stiffness in one of your joints, now is a good time to get checked out.

During your evaluation, we will get a full history of your complaints and examine your joints to figure out why you are having pain. This history and physical exam is often followed by an x-ray to look at your bones. The first steps we try for treatment of arthritis usually involve exercise, weight reduction, knee braces, and medications to help your pain.

Whether you want to get back on a field or just back to playing with grandkids, diagnosis and appropriate treatment of any joint pain should be the next step in your training program.

For more information or to make an appointment, contact the University of Maryland Department of Orthopaedics at 877-771-4567.