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Feature Stories Meet the Patients Behind Our My Scar Means Campaign
Volume 3, Issue 2
Letter from the CEO At OrthoIndy and IOH, we are committed to our patients. That's why we have created the semi-annual publication, Beyond Your Bones. We hope that you find the information in this publication resourceful. In this issue, learn about OrthoIndy and IOH's newest advertising campaign called, "My Scar Means." This campaign allows our patients to tell others about his or her experience at our facilities. Additional stories include healthy eating habits, corporate updates and a number of uplifting patient testimonials. We hope you find the information in this issue educational. We welcome suggestions and comments by emailing us at suggestions@orthoindy.com. Best wishes and good health,
Jane Keller Chief Executive Officer
What does your scar mean? Are you an OrthoIndy and IOH patient? Tell us your story at
MyScarMeans.com.
Chief Executive Officer, OrthoIndy and IOH Jane Keller President of OrthoIndy Timothy Dicke, MD Editor Kasey Prickel, Director of Marketing Graphic Designer Jackie Bilskie Contributing Writers Judy Porter Kasey Prickel Megan Skelly Chelsea Tuttle Contributing Photographers Jackie Bilskie Zach Dobson
Want to know more? Give us a call at:
(317) 802-2000 or follow us on:
On The Cover
Meet Aidan, one of our featured patients in our new campaign
Table of Contents
4. Botox Injections Help Child
18. New Year's Resolution
7. AlterG速 Machine
22. Life Threatening Accident Nearly
Cerebral palsy doesn't stop energetic boy
Helps patient get back to life
9. How to Get Involved in Our Campaign 10. Jingle Bell Run
OrthoIndy and IOH raise funds to fight arthritis
13. OrthoIndy Trauma Care at St.Vincent Health
Commit to be fit in 2013
Ends Farmer's Career
Prosthetic helps patient return to work
25. Ask the White Coat
OrthoIndy physicians answer your questions
28. Getting Back in the Game
OrthoIndy physician helps athlete return to her passion
14. Former NFL Coach Relies on OrthoIndy
31. Physician Update
17. IOH Receives National Recognition
33. Piecing Life Back Together Again
to Get Back to his Sport
Summit Award速 winner four years in a row
OrthoIndy welcomes new physician and wishes others well in retirement
Mother and daughter recover together
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Aidan and his mother, Kim Fitzpatrick
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Botox Injections Help Child MyScarMeans Have a Better Quality of Life: Cerebral palsy doesn’t stop energetic boy By: Chelsea Tuttle The Fitzpatrick household is a busy place. Kim and her husband, Andy, are the proud parents of two children, Aidan and Keira. The eldest of their two children, Aidan, is like many young boys his age and enjoys going to school and participating in cooking class, music or art class. You can even find him floating in the pool or horseback riding on a nice day. Many young children participate in these recreational activities; however, what makes Aidan’s participation in these activities so unique is that he is doing so while living with cerebral palsy (CP). During Aidan’s birthing process, there was a complication from lack of oxygen to his brain. The lack of oxygen to his brain created abnormal development that led to CP. The term “cerebral” means having to do with the brain and “palsy” means weakness or problems with using the muscles. CP is most common among children and directly affects a person’s ability to control his or her muscles. Frequently when children develop CP, there are unfortunately other health issues that follow. Aidan was born a fighter, and Kim and Andy were prepared to do whatever it would take to give their son the best life possible. When Aidan was only three months old, he developed an infection in his right knee known as osteomyelitis. Osteomyelitis most commonly affects the long bones in a child's arms and legs. The infection reaches the bones either through the bloodstream or through the surrounding tissue. Kim and Andy sought out the help of OrthoIndy because of their reputation with exceptional care in bone, joint, spine and muscle care. The Fitzpatrick’s met OrthoIndy physician, Dr. Carlos Berrios, who specializes in pediatrics. They knew he was the right man to take care of Aidan. “Dr. Berrios
listened to us. He always took Aidan’s condition into consideration and did what was best for him and our family, not just treating the injured knee,” said Kim. After Aidan’s first surgery to correct the osteomyelitis, Dr. Berrios noticed that the growth plate in the same knee had stopped growing. The growth plate consists of cartilage that will gradually harden into bone and is most important during childhood for the growth of bones. Dr. Berrios performed a surgery on his knee to correct the problem. After awhile Aidan began to also have complications with his growth plate in his right knee. Kim and Andy decided to have Dr. Berrios perform surgery to stop the growth plates in both knees. “It was a personal decision for us to agree to this surgery,” said Kim. “The first method stopped working and the likelihood of Aidan walking was minimal. If only one growth plate was working it would have made it uncomfortable for him.” Aidan has been through several surgeries over the years to help his knees and also has had surgery on his left hip. Aidan also suffers from muscle spasticity, which is a problem for many people with CP. “Muscle spasticity is a disorder of the central nervous system in which certain muscles continually receive a message to tighten and contract,” said Dr. Berrios. One treatment option in orthopaedics for those suffering with CP and muscle spasticity is botulinum toxin therapy, or Botox. OrthoIndy and Dr. Berrios were one of the first orthopaedic practices to use this type of medication. Dr. Berrios has been using the Botox injections for patients for the last ten years because it improves the quality of life for patients. “The purpose of the medication is to decrease spasticity,” said | 5
Dr. Berrios. “The medication is useful in cerebral palsy because the tight spastic muscle can dislocate hips or produce contractures in several joints that interfere with gait, hygiene, sitting or putting clothes on.” The use of Botox injections for Aidan helps calm down painful muscle spasms and allows him to participate in other types of treatment such as physical therapy to help restore biomechanical balances. The medicine blocks neuromuscular junctions and can relax the muscles up to six months or longer. Every 12 to 16 weeks, Aidan visits Indiana Orthopaedic Hospital (IOH) for his Botox injections. The outpatient process of Botox injections for Aidan begins with a slight sedation with anesthesia. The medication is then injected directly into the muscle and causes it to relax. “I use the medicine because it can decrease the amount of surgeries,” said Dr. Berrios. Not only have the Botox injections helped Aidan’s muscles, but it has allowed him to enjoy life as a child. Aidan attends school in Zionsville and attends St. Vincent Pediatric Rehab for therapy. Through St. Vincent, he has been able to attend Morning Dove Therapeutic Riding Inc. for hippotherapy. Aidan is able to ride on a pony assisted by his therapist and a volunteer. Riding the horse helps increase head and trunk control and improves balance and coordination. 6 | Winter 2013
Dr. Berrios listened to us. He always took Aidan’s condition into consideration and did what was best for him and our family, not just treating the injured knee.
Aidan continues to make improvements through Botox injections and the help of OrthoIndy and IOH. Kim and Andy are happy that their son is living the best life he can because of Dr. Berrios. “We feel very safe in Dr. Berrios hands because he is very knowledgeable about disabled children and really takes into consideration their special lifestyles,” said Kim. “We have always had a positive experience at OrthoIndy and IOH. They have been wonderful with the extra care and attention with Aidan.” If you would like to schedule an appointment with Dr. Berrios, please call (317) 802-2000. Visit MyScarMeans.com to watch Aidan’s story.
Physical Therapy
By: Chelsea Tuttle
Helps patient get back to life Sometimes in life, bad things happen to good people. There aren’t clear-cut explanations as to why certain tragic events occur to complicate good people’s lives or why fate has brought them to battle through tough times. These people that are faced with extreme life challenges are usually the people who have the strongest spirits, even in the weakest of times. One of these strong spirits is Theresa Spurlock. Theresa grew up in Indianapolis and attended a Catholic grade school. In fourth grade, Theresa and her friends started playing kickball for her school. Not only was the sport a great way for Theresa and her friend’s to spend time together, but she could also showcase her athletic skills. Through the years, Theresa and her friends grew up with the sport and tied many memories to the game. They carried their hobby into adulthood and the original kickball team from grade school was able to play one last game together in 2009 before officially “retiring.” Days after her last kickball game, Theresa received devastating news. Despite her athletic younger years, she had been diagnosed with cardiovasculardisease in her leg. “My leg has always been very strong and athletic. The only way to look at it was that it had turned on me,” said Theresa. Theresa’s doctor helped her through the next several months trying different methods to help save her leg so she could return to a carefree way of living. With cardiovascular disease being one of the leading causes
of death worldwide, it was a constant battle. Eventually, amputation was the only answer to save Theresa’s life. “As hard as this leg was fighting to not work, my doctor was working just as hard to make sure it would stay,” said Theresa. “But, there were no more magic tricks up her sleeve and her magic bag was empty. I knew it came down to removing my leg, or I would die.” During an emotional pre-operational surgery in 2011, Theresa was joined with her “entourage” of 23 family members and friends. Her support team reassured her that despite her right leg being removed, nothing would change. After surgery and during her recovery, Theresa didn’t want to leave her bed. She was hostile and upset. There was little enthusiasm to face her new way of life and the thought of a prosthetic infuriated her. “I didn’t want anything to do with it. The idea of having the prosthetic and trying to learn how to walk again at 54 years old was not something I looked forward to,” said Theresa. Theresa was reluctant of the prosthetic, but was going to take any steps to move forward with her new leg. She was referred to Indiana Orthopaedic Hospital’s (IOH) outpatient Physical Therapy department because of the exceptional care and unique
rehabilitation methods used for people with prosthetics. Theresa met with IOH physical therapist, Andy Bauermeister, who assured her she was going to get back to life. “Just when I thought my team of support couldn’t get any better, I was introduced to Andy. He was upbeat and supportive and had the energy for the both of us. He had the patience of a saint,” said Theresa. Theresa started off exercising with crutches and learned how to walk again with a walker. After some progress, Andy introduced Theresa to the AlterG® Anti-Gravity Treadmill®. “If you don’t have strength or range of motion in a specific area, the best way to improve upon a particular skill is to do the skill,” said Andy. “The AlterG treadmill can take pressure off areas that cause pain, and we are able to continue the action of walking that require muscles.” IOH was the first facility in Indiana to purchase the treadmill and is one of three facilities in the state that houses this piece of equipment. The AlterG Anti-Gravity Treadmill uses NASA based anti-gravity technology that allows patients to run or walk without bearing their entire weight. The Differential Air Pressure (DAP) reduces weight on the lower extremities and reduces body weight up to 80 percent. Jeff Sorg, manager of the IOH’s Physical Therapy department understands the need for amputee patients, like Theresa, to use the machine. “In addition to early weight-bearing for patients, it will allow an earlier and pain-free return to running and walking. The treadmill allows patients to improve their technique, to reduce the compensations that develop leading to limping and to do so without pain,” said Jeff.
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Theresa was skeptical of the device at first. “When I first saw the machine, I said, ‘Holy moly!’ It was something the land of time forgot. When you are an amputee, and your physical therapist is saying that this will be the next thing you are doing, you’ll be apprehensive,” said Theresa. After Theresa was put into the machine, her thoughts instantly changed. “All the surgeries, physical therapy and everything I’ve been up to through that moment came to mind. Walking is everything. I could stumble while trying to walk, and the machine wouldn’t let me fall. Until you get in the machine and you see and feel for yourself that you are actually walking again, you won’t believe it,” said Theresa. Theresa constantly praises IOH for what they have helped her accomplish. “The rehabilitation area and AlterG Treadmill at IOH is second to none. They are going to get good, hard work out of you, but you’ll be able to walk again,” said Theresa. To learn more about IOH’s physical therapy services and the AlterG, please visit IndianaOrthopaedicHospital.com.
MyScarMeans By: Megan Skelly
How to Get Involved in Our Campaign
Our campaign, ‘My Scar Means’ is all about sharing our patients’ story. Each patient has a different story to tell and we found that each person is proud of his or her injury or surgery scar because of what it represents. Although we have already featured patients on various television commercials, newspaper ads and billboards, we want to hear from all our patients. Who knows, if you wanted, you might be the face on our next billboard! How can you share your story and enter for a chance to win? It’s easy. Visit MyScarMeans.com and fill out a questionnaire to share your story. Then, enter for a chance to win. We have already given out over 500 dollars in gift cards to stores such as, Target, Kroger, Best Buy and Dick’s Sporting Goods. What do we do with the stories submitted? With your permission, we have featured some of these stories on our patient blog, OrthoIndyBlog.com. The blog allows individuals to obtain more information about specific injuries or procedures by reading real patient experiences. We also have a section on our blog called, ‘Behind the Scar’ where our physicians answer specific questions. If you share your story, you may just help someone else or create a good topic for our physicians to discuss. What have other patients submitted? “My scar means…I can get back to doing the things I love to do.” - Marcia Runde “My scar means…I can walk with my husband and swim without pain.” - Nadine Harris “My scar means…I can run again pain free.” - Courtney Frye “My scar means…I can still ride my Harley every day.” - Doug Bane "My scar means…I can make it through whatever comes my way." - Crystal Wilhite Read more stories at OrthoIndyBlog.com. What are you waiting for? Almost 300 patients have already submitted his or her ‘my scar means’ story or entered for chance to win at MyScarMeans.com. | 9
Community Involvement
By: Megan Skelly
OrthoIndy and IOH Raise Funds to Fight Arthritis Nearly 50 million Americans, one in five, have been diagnosed with arthritis by a doctor. Additionally, nearly 300,000 children under the age of 18 have been affected by juvenile arthritis. Therefore, it comes as no surprise that arthritis is the leading cause of disability in the United States. Unfortunately, no one is immune to this disease and arthritis can affect anyone, no matter what your race, gender, age or ethnic group. By the year 2030, an estimated 67 million American adults will have arthritis. The term “arthritis� encompasses more than 100 diseases and conditions that affect joints, the surrounding tissues and other connective tissues. Arthritis can cause a wide range of pain from mild to severe in the 10 | Winter 2013
joints, as well as joint tenderness and swelling. Furthermore, arthritis affects women at a much higher rate than men. Sixty percent of all people who have arthritis are female, and several of the more common forms are more prevalent in women. Each year, arthritis results in 44 million physician visits, one million hospitalizations and 9,000 deaths. This makes caring for a family member or friend who has arthritis stressful and draining. In addition to all the pressure of taking care of someone with arthritis there is a heavy financial burden as well. Nearly $128 billion in costs of treatment, lost wages and other associated costs are needed to accommodate the economy’s arthritis care demand.
What have others done to help? The Arthritis Foundation is the largest private, not-for-profit contributor to arthritis in the world. Since 1948, the foundation has funded more than $380 million in research grants. Through the support of more than 600,000 volunteers, the foundation helps individuals take control of arthritis by providing public health education, pursuing public policy and legislation and conducting evidence-based programs to improve the quality of life for those living with arthritis. Now, what can you do to help? The Arthritis Foundation’s Jingle Bell Run/Walk for Arthritis presented by OrthoIndy is one way you can show your support. Additionally, it’s a great way to start off the holiday season with family, friends and coworkers. Form a team, raise funds and organize your very own holiday-themed costumes. Everyone is encouraged to tie jingle bells to their shoelaces for some extra holiday spirit. Thousands of runners/walkers participate every year to do their part in fighting arthritis. The Jingle Bell Run/ Walk not only raises awareness for this disability, but it also raises funds desperately needed for research, health education and government advocacy. The Jingle Bell Run/Walk is the nation’s largest holiday
NORTHWEST (317) 802-2000 8450 Northwest Blvd. Indianapolis, IN 46278
SOUTH (317) 884-5200 1260 Innovation Pkwy. , Suite 100 Greenwood, IN 46143
WEST (317) 268-3600 7950 Ortho Ln. Brownsburg, IN 46112
OrthoIndy.com
run/walk event. It features a 10K run and 5K run/walk with activities for the entire family. The day is filled with costume judging, a 1k children’s “Santa Chase”, the run/walk and post–event festivities with awards and prizes. The 24th annual Indianapolis Jingle Bell Run/Walk presented locally by OrthoIndy took place at Bankers Life Fieldhouse on December 8, 2012. It was the fifth year that OrthoIndy and IOH have participated and sponsored the event, to help raise awareness for arthritis. The Jingle Bell Run grows every year in the amount of participants and the amount of money raised to help fight arthritis. In 2012, the event raised $175,000 and there were over 3,500 participants. The Jingle Bell Run has come a long way since 2006, when they raised $26,000. OrthoIndy physicians treat many patients that are affected by arthritis. To meet with an OrthoIndy physician who treats arthritis, please call (317) 802-2000. The 2013 Jingle Bell Run will take place on Sunday, December 15 and will mark the 25th anniversary. To volunteer or form a team for the 25th Annual Arthritis Foundation’s Jingle Bell Run/Walk for Arthritis, contact the Arthritis Foundation at (317) 879-0321 ext. 203 or log on to indyjinglebellrun.com.
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Trauma
By: Kasey Prickel
Trauma Care at St.Vincent Health OrthoIndy
Accidents happen; unfortunately we can’t predict when they will occur. Approximately 55 percent of all trauma cases involve orthopaedics. These cases are often complex to treat because they usually involve multiple parts of the body. If you or a member of your family is injured in an accident, you want to make sure specialized surgeons with more than 120 years of combined experience are taking care of you.
Joseph Baele, MD
Renn Crichlow, MD
Gregory Dikos, MD
Bradley Jelen, DO
David Kaehr, MD
Dean Maar, MD
Greg Reveal, MD
Timothy Weber, MD
OrthoIndy trauma physicians are fellowship-trained in orthopaedic traumatology and can quickly and accurately provide a diagnosis and stabilize the fracture or soft tissue injury, in order to maximize function. This February, the OrthoIndy trauma team will bring decades of combined experience and excellent reputations to the St.Vincent Trauma Center.
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By: Chelsea Tuttle
Former NFL Coach Relies on OrthoIndy to Get Back to his Sport
When Eugene Huey was born in Uniontown, Pennsylvania, he was destined for one thing in life: football. Eugene, who prefers to be called Gene, grew up tossing the pigskin. His recreational time spent playing a pick-up game in elementary blossomed during his high school years. He worked on gaining proper muscle strength, agility and speed to help him stand out amongst his peers. Through rigorous drills and long practices, Gene perfected his talent and continued to play the sport he loved at a collegiate level for the University of Wyoming. While going to college for his bachelor’s in physical education, Gene kept focused inside the classroom and on the field for the Cowboys where he was the wide receiver and defensive back. He was the football team’s captain and set 13 receiving records, played in
the Sun Bowl where his team beat Florida State and holds the prestigious honor of being the only player in the Western Athletic Conference to receive both offensive and defensive honors. Gene’s accomplishments were stacking up and his childhood dream was about to come true. In 1969, he was drafted by the NFL’s St. Louis Cardinals to play professional football. He enjoyed the opportunity, but through time found his passion in life was to not play the game, but coach it. He coached at the collegiate level until the Indianapolis Colts offered him a position as the running back coach. Gene spent several years on the field challenging his body with physical activity, and when he was on the sidelines he was constantly moving around. | 15
“The requirement of being on my feet many hours through the years and the rigors of participation had taken its toll on my hip joints,” said Gene. After consulting doctors, it was suggested that hip replacement surgery was the best option for him. Not wanting to take time off from his career, Gene kept the advice in the back of his mind. Years went by and the pain only worsened, taking away the joy of simple activities such as playing golf or biking. Sleeping was also challenging for him because of the level of discomfort. During an outing for ice cream, Dyan, Gene’s wife, sparked conversation with a stranger who had hip replacement surgery performed by Dr. David Fisher at OrthoIndy. Desperate for a normal life, free of pain, Gene took the advice of a stranger and scheduled a consultation with Dr. Fisher. At his first appointment, Dr. Fisher asked Gene one simple question, “Do you want a better quality of life?” Gene was convinced to proceed with surgery under the care of Dr. Fisher and the OrthoIndy and Indiana Orthopaedic Hospital (IOH) team. Because of Gene’s high activity level from playing sports and coaching, he had developed arthritis and was wearing out the polyethylene bearings in his hips which would require bearing replacements in both hips. “Gene’s football career may have left him predisposed to developing hip arthritis as there are multiple opportunities for hip injury in contact football,” said Dr. Fisher. Gene had his right hip replaced in 2000. During a revision surgery on the right hip, an x-ray revealed that the persistent pain from arthritis in his left hip indicated the need to be replaced also. “When someone develops hip arthritis, there is about a 40 percent chance that they will get it in the other hip,” said Dr. Fisher. “It is most common in patients with developmental changes that occur in the hips that can leave the hip predisposed to wearing out early in life.” He wasted no time in taking Dr. Fisher’s advice because of the exceptional care and personal touch OrthoIndy provided to proceed with the second surgery. “From the time I did my consultation, paper work or various other procedures leading up to my surgery, 16 | Winter 2013
things could not have been smoother. The professionalism was always up front and I felt very much informed and not rushed in my understanding of the procedure,” said Gene. A quick recovery was important to Gene so he could return to his active lifestyle. Many people Gene’s age who are avoiding hip replacement surgery fear that they will never fully return to their lifestyles. “Today, most patients are walking with support on the day of surgery and leave the hospital on the second day after surgery,” said Dr. Fisher. “Some [patients] participate in exercises to improve strength and range of motion over six weeks, some go to outpatient therapy, some do in home therapy and others do exercises on their own.” Gene and Dr. Fisher have a common interest in golf and shared many conversations about the sport. Because of the advice of a stranger to come to OrthoIndy, he was able to return to his hobbies pain free and live the better quality of life Dr. Fisher had asked him about. “Dr. Fisher, being an avid golfer, understood my concerns about having my mobility,” said Gene. “I felt he had restored my faith and confidence in the use of my hips. I can enjoy golfing and less slicing of my shots off the T-box. This is correctable and financially rewarding.” “After telling several of my former players that I have had three hip surgeries after a round of golf they are amazed.” To watch Gene’s story, visit MyScarMeans.com.
Awards
By: Kasey Prickel
IOH Receives National Recognition Four Years in a Row The Indiana Orthopaedic Hospital (IOH) is proud to announce that Press Ganey Associates, Inc. has named it a 2012 Summit Award® winner. This is the fourth year in a row that IOH has received this award for sustaining the highest level of performance for at least three or more consecutive years. Press Ganey currently partners with more than 10,000 health care facilities — including 50 percent of all U.S. hospitals — to measure and improve the quality of their care. The Press Ganey Summit Award is the health care performance improvement industry’s most coveted symbol of achievement bestowed annually. Recipients of the award set themselves apart from the competition by demonstrating their dedication to improvement and sustaining excellence in both quality of care and patient satisfaction.
According to Jane Keller, chief executive officer at OrthoIndy and IOH, the award represents important recognition within the industry of its efforts. “We are honored to receive this award for the fourth year in a row,” said Keller. “Since opening in 2005, our physicians and staff are committed to providing the highest level of customer service and patient satisfaction that this award demonstrates; a physician-owned hospital model that provides the best outcomes, safety and high quality customer service to each patient and their family members.” Summit Award winners are determined by reviewing the overall mean score percentile rank of each Press Ganey database report within the three-year period to verify that the percentile rank has not dropped below the 95th percentile at any point. For more information on the Summit Award and Press Ganey, please visit www.pressganey.com.
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Nutrition
Life is short. Change is hard but it's not impossible. The most common New Year’s resolution is to lose weight and live a healthier lifestyle. It can be a challenge to balance your new, healthier lifestyle with work, family and other obligations. Your health and fitness has to become a priority in your life. It has to mean something to you. It can’t be because your wife, your husband, your sister, your brother or best friend wants you to be healthier. It has to be because you want to be healthier. If you want to change your life and live a life full of energy then it’s time to do a selfanalysis. Why do you want to lose weight and/or live a healthier lifestyle?
Motivators for Long-Term Success
• Improved health (for example, I want to reduce my cholesterol, blood pressure and body weight so that I don’t have a premature heart attack. I have a family history of cancer and I want to reduce my risk. I have diabetes and know it increases my risk for other chronic illnesses; I want to do my best to prevent them.) • I had children later in life and I want to enjoy seeing them grow up. • I want a higher energy level because I’m tired all the time. • I’m tired of being short of breath while doing simple tasks such as cleaning the house. • I have always dreamed of climbing a mountain or running a half marathon.
Motivators for Short-Term Success or Failure • I want to look like a supermodel. • I want to look better in a swimsuit.
By: Judy M. Porter, RD
• I know my marriage would improve if I lost weight. • I am depressed and know all of those feelings would go away if I lost weight. • My class reunion is six months away and I have to get this extra weight off.
Goal Setting is Key
The first step in setting a weight loss goal is determining how much you should lose. Start by assessing where you fall on the Body Mass Index (BMI) chart. This formula does have its shortcomings because it does not take into account age, frame size, gender or muscularity, but it is a great starting point because it is simple to use.
Category
Adults (BMI)
Underweight Healthy weight Overweight Obese
Less than 18.5 kg/m2 18.5 to 24.9 kg/m2 25.0 to 29.9 kg/m2 30.0 kg/m2 or greater | 19
Here are some interesting WHtR values: Barbie Doll: 25% Ken Doll: 36% Female College Swimmers: 42.4% Male College Swimmers: 42.8% General Healthy WHtR: ≤50%
You can stop at BMI assessment but if you want to get a clearer picture of your disease risk then take it one step further and assess your waist-to-height ratio (WHtR). The WHtR of a person is defined as the person's waist circumference, divided by the person's height. Higher values of WHtR accurately correlate with higher risk for cardiovascular diseases and are proving to indicate a greater risk for other chronic illnesses as well. Increased Risk Substantially Increased Risk Waist (WHtR) Waist (WHtR) Men 37.0" (53.6%) 40.2" (58.3%) Women 31.5" (49.2%) 34.6" (54.1%) Once you identify where you fall and how much weight you need to lose in order to be in the “healthy” category, then it’s time to determine how long it will take. Weight loss of one to two pounds is considered a healthy amount of weight to lose in a one-week period of time. I find aiming for five pounds per month is achievable and realistic when mixed into a busy lifestyle.
Realistic Healthy Eating Goals
The new dietary guidelines were prepared by a committee of experts that conducted an exhaustive review of the scientific literature about diet, exercise and health. I will highlight some of their key recommendations. If you fall short in some or all then pick one to two to focus on and make it part of your new eating style before moving on to another. • Eat more fruits and vegetables. A good rule of thumb is that half the food on your plate should be fruits and vegetables. • Reduce sugar intake and refined grains. Choose whole grains at least 50 percent of the time. • Drink water instead of beverages containing sugar. 20 | Winter 2013
• Alcohol should be consumed only in moderation, which means up to one drink per day for women and two drinks per day for men. • Consume more fat-free or low-fat dairy products, such as low-fat milk, yogurt and cheese. • Consume at least eight ounces of seafood per week. • Increase intake of nuts and seeds. One ounce (shot glass full) five to seven days per week. • Avoid "oversized" portions. Take a few minutes each week to plan ahead for meals. Keep meal planning as simple as possible to start with. It would be nice to have the time to make super nutrient-dense, extravagant meals for breakfast, lunch and dinner, but in today’s world that is not realistic. It’s okay to use nutritional drinks/bars to supplement meals and snacks. I find the simpler and more routine your daily eating ritual is the greater the success. Most people eat the same 10 meals over and over. Come up with your favorite healthy 10 meals and rotate them until you see results or get bored then change it up.
Realistic Fitness Goals
Start small and increase exercise gradually. Plot it out and put it into your schedule. When will you fit it into your work schedule and other obligations on a daily basis? Meet friends whenever possible or schedule some group workout sessions. This will hold you accountable and you’ll not only get it done but it will be more fun. Do not allow yourself to make excuses. Once you start feeling the benefits of exercise, you will be looking forward to exercise and be searching for more time in your schedule.
Physical Activity Guidelines for Americans
• Adults should do at least 150 minutes (2 hours and 30 minutes) a week of moderate-intensity physical activity or 75 minutes (1 hour and 15 minutes) a week of vigorous-intensity aerobic physical activity, or an equivalent combination of moderate and vigorous-intensity aerobic activity. Aerobic activity should be performed in episodes of at least 10 minutes and it should be spread preferably throughout the week. • For additional and more extensive health benefits, adults should increase their aerobic physical activity to 300 minutes (5 hours) a week of moderate-intensity or 150 minutes a week of vigorous-intensity aerobic physical activity or an equivalent combination of moderate and vigorous-intensity activity. Additional health benefits are gained by engaging in physical activity beyond this amount. • Adults should also include muscle-strengthening activities that involve all major muscle groups on two or more days a week.
Visit www.health.gov for more guidance on implementing healthy eating and exercise into your daily routine. Once you have established a healthy weight loss goal and areas that you need to improve on with diet and exercise then write them down. Monitor your weight on a weekly basis, at the same time of day, in the same type of clothing. Keep in mind that your body weight does not tell the full story. Our body weight fluctuates 1 to 3 pounds on a daily basis so don’t get discouraged if you’re making positive changes and not seeing the weight loss that you would like to see right at first. Stay consistent, stay focused and the number will go down. Along the way you will begin to experience the benefits of being a FIT individual and be full of energy with a new outlook on life. Visit OrthoIndys Pinterest page for healthy recipies and exercise tips.
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Life Threatening Accident Nearly Ends Farmer’s Career: Prosthetic helps patient return to work By: Chelsea Tuttle hospital because his father had been seriously hurt. Peter wouldn’t provide much more information to Rita and she could sense that it was for a reason. “Peter was protecting me by not giving me any more information to keep me from becoming too emotional. I immediately called our daughter, Megan, who lived west of my work. I asked her to pick me up because I did not know if I could drive safely,” said Rita. Megan was in her final year of nursing school and was familiar with the hospital. Megan’s friend who was a paramedic for Jack greeted her and her mother at the hospital. They were immediately taken to see Jack and informed what had happened.
In the first initial moments after receiving terrible news that a loved one is injured or seriously hurt, most people can’t recall the seconds, hours or days that follow. For many people, the best way to describe the initial reaction is a blur of emotions with shock being a dominant feeling. Revisiting these types of memories are usually very hard, and after several years, it still isn’t easy for Rita and Megan Maloney. A Sunday routine for Jack and Rita Maloney of Brownsburg, Indiana happens just like any other day: the couple attends church, Jack returns and goes straight to work on the farm and Rita goes to her office in Indianapolis. At the time, the Maloney’s had dial-up Internet at their home that was much slower than the modern day high speed Internet. It was easier for Rita to work on homework for her MBA program at her office. One Sunday, Rita received a phone call from her son, Peter, frantically telling her to meet him at the 22 | Winter 2013
Jack is a fourth generation farmer who has a work ethic like none other. To say that Jack values hard work would be an understatement. Safety is a top priority of his while working on machinery on the farm. Like many farmers, Jack does not wear his wedding ring while working for safety precautions. Jack, his son Peter and other workers were working on a grain leg, a piece of farming equipment, when an employee turned on an auger, a type of control. The auger automatically initiated the auger that Jack was working on and caught his arm. Immediately, Jack screamed and the machine was turned off. Peter used his own belt as a tourniquet on his father’s arm and called 911. The next step for Jack and the Maloney’s would be very challenging. OrthoIndy and the Indiana Orthopaedic Hospital (IOH) trauma surgeon, Dr. Timothy Weber, introduced himself to the family and explained that Jack would need an amputation for more mobility in the future. Dr. Weber was very specific with the procedure he wanted to perform and the possibilities of what he might have to do.
“Because of his openness and frankness regarding the situation, I felt very confident we were at the right hospital with the right surgeon. God had blessed us with Dr. Weber that day,” said Rita. During the very complicated surgery, Dr. Weber managed to piece the bone fragments together. He was able to mesh them together, and plate the area and screw it together so the section below Jack’s elbow was intact. Post surgery, Dr. Weber was greeted with cheers and applauds by more than 30 people waiting, praying and hoping for Jack’s health. Jack was released from the hospital an incredible five days later, but had several ups and downs after surgery. His blood counts fluctuated from high to low; he was allergic to the morphine given to him for pain relief and obviously in an immense amount of pain. Megan said the care provided by Dr. Weber and his nurse practioner was second to none. Despite Jack’s battles, he was on the road to recovery. “Dr. Weber and his nurse taught me how to change my dad’s dressings and explained everything they were doing with his care. My brother and I had been patients with OrthoIndy before so we were very confident we were in good hands,” said Megan.
During a follow up visit in January, Dr. Weber instructed Jack it was necessary to use a prosthetic if he ever wanted to return to work on the farm. Jack was not up for the idea, but his main focus was to return to his work. “The initial months following the accident I had to battle with Jack’s emotions. He was negative about wearing ‘one of those things’,” said Rita. After many consultations, Jack found a physician he was comfortable with, and given a prosthetic with a hook. Rita had to let Jack battle out his new endeavors with the prosthetic until he got used to it. Eventually, the prosthetic became natural for Jack. “Jack would catch himself going to leave the house and say, ‘I forgot my arm,’ like it was a piece of clothing. It took a lot of patience on both our parts, but very easily became an important part of him,” said Rita. In April following the surgery, Jack saw OrthoIndy and IOH physician, Dr. Scott Lintner, for problems with mobility in his shoulder. Dr. Lintner diagnosed
His physician is always happy to see how beat up his new arm is, because he is using it to the fullest. | 23
Jack with adhesive capsulitis, or “frozen shoulder.” Jack’s connective tissue surrounding the joint of the shoulder was inflamed and stiff and could have been caused by the traumatic accident or Jack not using his arm to its full potential. Jack had a limited range of motion and severe pain. Dr. Lintner operated on Jack, correcting the problem, and the following week after surgery, Jack was back to planting on the farm. While Jack’s life and career were on a standstill, word spread through the farming community about the Maloney’s experience. Farmers came together across the Midwest to help Jack in his time of need. “There were anywhere from three combines in a field that were donated from dealers, or 12 semi-trucks next to a field with local farmers that have known my dad for years,” said Megan. Jack had a strenuous routine of physical therapy before he could jump on his tractor and get to business on the farm. He didn’t let his new way of life stop his career. “After 50 years with two hands, the prosthetic has been quite the adjustment,” said Jack. “Without Drs. Weber and Lintner and their help, this would have been a career ender.” Rita has made several adjustments in their home such as how Jack washes his hands to the clothing he wears. He is a very independent individual that enjoys his freedom on the farm with his prosthetic. “His physician is always happy to see how beat up his new arm is, because he is using it to the fullest,” said Rita. Through family and friend’s prayers and positive reinforcement, Jack is back doing what he loves. He has been fortunate enough to do more managing of the farm, but still isn’t afraid to get dirty. “My dad has used his prosthetic as a hammer, a piece of paper and he loves doing magic ‘tricks’ for the kids,” said Megan. To watch Jack’s story, visit MyScarMeans.com.
Ask the White Coat Question: What is the big deal about all of these different surgical approaches for hip replacement surgery?
Answer: Direct to consumer marketing
has led surgeons and implant companies to market many different surgical techniques to patients. In my opinion, the bottom line is that you want an experienced surgeon who specializes in joint replacement surgery to replace your joint, as both skill and experience does matter. An experienced surgeon can give you a very good result regardless of the surgical technique. The surgical technique itself does not give you a good result; it’s how well the technique is performed by the surgeon. If I were having my hip joint replaced, I would select an orthopaedic surgeon who is dedicated to joint replacement surgery. I would also want my surgery performed at a hospital that has a joint replacement program. This joint replacement team includes dedicated anesthesiologists, physical and occupational therapists and nurses who are all very familiar with taking care of joint replacement patients. A hospital with a joint replacement program often has better outcomes than a hospital that does the "occasional" joint replacement without a dedicated team. In summary, the skill of your surgeon and the experience of the hospital's joint replacement program and team are more important than the surgical technique itself.
Frank Kolisek, MD Practice Focus: Total Joint, Knee and Hip Dr. Kolisek received his bachelor’s degree in chemistry from Wabash College in Crawfordsville, Indiana. He received his medical degree from the University of Illinois College of Medicine at Peoria in Peoria, Illinois. After graduation, Dr. Kolisek completed his residency in orthopaedic surgery at the University of Florida Health Science Center in Jacksonville, Florida. Dr. Kolisek also completed a one year fellowship in arthritic reconstructive surgery of the hip and knee at Emory University and the Peachtree Orthopaedic Clinic in Atlanta, Georgia. Dr. Kolisek has given numerous regional, national and international presentations on hip and knee arthroplasty and serves as faculty at instructional courses. He is involved in clinical research, serves as a principal investigator for several clinical studies and is involved in the design of hip and knee implants and instrumentation. He has published several scientific articles in peer reviewed orthopaedic journals. Please visit FrankKolisekMD.com to view his publications and research. Dr. Kolisek served as the OrthoIndy president for eight years. He is a member of many professional societies, including: the American Academy of Orthopaedic Surgeons, the Indiana Orthopaedic Society, the Indiana State Medical Society, the Mid-America Orthopaedic Society, the Indianapolis Medical Society and the American Association of Hip and Knee Surgeons. To schedule an appointment with Dr. Kolisek, please call (317) 884-5160.
Question: What is the most common trauma injuries treated during the winter?
Answer: When the term trauma is mentioned
most people envision a patient in the emergency room with multiple injuries needing surgery to save his or her life and restore function. Certainly this scenario is real but it is most often seen in a warmer months. Although the OrthoIndy trauma surgeons are always ready to deal with severely injured trauma patients, in the winter there is actually a lot less severely injured patients. During the winter with snow, icy roads and low temperatures people tend to drive more slow and motorcycles are put away. Consequently, the majority of trauma seen in the winter months is “low energy trauma” as opposed to the “high energy trauma” of high-speed motor vehicle and motorcycle accidents. Three very common winter injuries are hip fractures, ankle fractures and wrist fractures. Although these are common terms used by medical and non-medical people alike, these terms are inaccurate as one can dislocate a joint but not fracture it. Hip fractures are fractures of the upper end of the thigh bone (femur), ankle fractures involve one or both bones of the lower leg (tibia/fibula) and wrist fractures involve the forearm bones by the hand (radius and less commonly the ulna). There are two major types of hip fractures. A sub capital fracture is just below the ball at the top of the femur. An intertrochanteric fracture is on the upper end of the femur but somewhat below the level of a subcapital fracture. Almost without exception both of these fracture types are treated surgically. 26 | Winter 2013
To fix a subcapital fracture, that is minimally displaced, screws are usually placed through very small incisions to stabilize the fracture. If the fracture is significantly displaced the ball of the femur, which has been broken off the shaft of the bone, is removed. To take the place of the broken ball, a partial or total hip replacement is performed. There are two major ways of repairing an intertrochanteric hip fracture. Plates and screws can be used to stabilize the fracture after it has been returned to proper alignment. The other technique is to place a long metal rod inside the femur which runs almost the entire length of the bone. A large screw is placed across the fracture site and through a hole in the rod with the screw stopping in the ball of the femur. After surgery the patient is mobilized with the help of physical therapy and is allowed to put as much weight on the injured leg as tolerated. If a partial or total hip replacement was not performed the fracture usually takes three to four months to completely heal. If the patient had a hip replacement, no fracture healing is needed as the broken bone was removed at the time of surgery. Ankle fractures are usually a result of a twisting injury to the ankle. These injuries are usually comprised of a break of a portion of the two bones in the lower leg (tibia/fibula), which make up the top half of the ankle joint. Multiple factors go into the decision to treat these fractures operatively or nonoperatively. If the broken bone(s) are not out of place, and the ankle joint alignment remains in a normal position, the fracture can be treated nonoperatively. Usually a splint, cast or some type of external immobilization is used as well as, non-weight bearing with crutches. Usually the patient is non-weight bearing for four to six weeks.
If the fracture(s) are out of place the usual treatment is to surgically put the fractures back into their proper position and secure them with plates and screws. Weight bearing after surgery is based upon the type of fracture, the stability of the fracture fixation and the quality of bone. These fractures usually take approximately three months to heal. Wrist fractures usually involve the radius, the forearm bone that is on the thumb side of the wrist and to a lesser degree, the ulna, the forearm bone on the side of the wrist of the little finger. These fractures also can be treated operatively or nonoperatively. In making the treatment decisions factors such as the alignment of the end of the radius, the absence or presence of a fracture line going into the wrist joint and if it is present, the alignment of the pieces of the broken bone. If overall alignment is acceptable or if it can be restored to an acceptable alignment by manipulation of the fracture, nonoperative treatment may be chosen. Usually treatment is a short arm cast for six weeks followed by a removable splint for the final six weeks of healing to allow range of motion of the wrist. These fractures usually require three months to heal. If surgical treatment is chosen there are several methods to deal with these injuries. Most often plates and screws are used to stabilize the fracture but other techniques such as using wires are placed through the skin after manipulating the fracture into proper alignment or using a device known as an external fixator are also options to stabilize these fractures. One of the major advantages of operative treatment, especially with plates and screws, is that a cast is not required so the patient may start range of motion of the wrist immediately after surgery.
David Kaehr, MD Practice Focus: Trauma, Total Joint and General Orthopaedics Dr. Kaehr was born in Fort Wayne and received his undergraduate education from Purdue University. He graduated from Indiana University School of Medicine in 1982 and completed an internship at Miami Valley Hospital in Dayton, Ohio in 1983. In 1987, Dr. Kaehr completed a residency in orthopaedic surgery at Wright State University and a fellowship in orthopaedic trauma at Harborview Medical Center at the University of Washington in 1988. Dr. Kaehr served as an assistant professor of orthopaedic surgery at Wright State University School of Medicine in Dayton, Ohio from 1988 to 1993 and assistant director of trauma services at Miami Valley Hospital from 1991 to 1993. Dr. Kaehr is a member of the American Academy of Orthopaedic Surgery. To schedule an appointment with Dr. Kaehr, please call (317) 917-4367.
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Getting Back in the Game: By: Chelsea Tuttle
OrthoIndy physician helps athlete return to her passion
When we are young we are encouraged to participate in sports to help build the essential skills of teamwork, physical coordination and to interact with others our age. Some fade out of sporting activities and dabble in other activities to see where they excel. Others are bit by the bug and fall in love with the game instantly. Those bit by “the bug,” often have lives that are molded around memorizing carefully crafted plays, conditioning the body and living for the sport. Lauren Gerbick is a prime example of this type of individual that has a passion for her game: soccer. Lauren is from Dyer, Indiana, where she spent most of her life focusing on soccer. In high school she received several achievements for her excellent performance in soccer such as two-time all-district all-state selection, school record holder for goals and points, a four-year starter and an Olympic Development Program state team member. It’s no wonder universities wanted her to play soccer for them. After beginning college at Loyola-Chicago and IUNorthwest, Lauren transferred to Marian University in Indianapolis where she played soccer as a forward and mid-fielder. She was a force to reckon with on the field and became a strong asset to the team’s success. Lauren’s hustle and skills were of no surprise to her coaches and she played over 4,000 minutes consecutively during her time with the women’s soccer team. However, one match specifically changed Lauren’s soccer career and life, forever. During the first game of a tournament, Lauren recognized that this could be it for her team that was down 1-2. Lauren took advantage of the opportunity to help her team advance. Quickly dribbling the ball down the field, Lauren shuffled past the defense and socked the ball into the net. Lauren tied the game 2-2. Seconds later, she felt a pop in her knee. She faced the terrible reality many athletes face: a torn ACL.
“Once you feel it, you know,” said Lauren. “It’s not so much of the physical pain, but the mental pain because you know you are done.” Her coaches and trainers recommended she visit OrthoIndy and Indiana Orthopaedic Hospital (IOH) for her injury because of their expertise in knee injuries. Several of Lauren’s teammates had visited OrthoIndy and IOH before for their soccer-related injuries. They had such a positive experience and connection with the staff it assured her she would be in good hands.
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The best compliment that I received was that it did not even appear like I had ever had surgery.
Other people suggested that Lauren get several opinions on her knee before committing to surgery. However, she was convinced upon meeting her physician, Dr. Stephen Kollias that she didn’t need to look any further. “Dr. Kollias won my surgery at hello. There was just something about him that felt right,” said Lauren. “He could tell that what I was going through was awful and that I just wanted to get back on the turf as soon as possible.” Through Dr. Kollias’ diagnosis, Lauren needed a microscopic ACL surgery, a meniscus suture and rehabilitation before she was able to play her game again. The knee is supported by three ligaments: the MCL, LCL and ACL. The ACL runs diagonally in the middle of the knee and prevents the tibia from sliding out of the femur and provides support and rotation for the knee. Fifty percent of ACL tears also result in meniscus problems, which was Lauren’s case. Dr. Kollias performed a microscopic ACL repair using hamstring graft and performed a meniscus suture for Lauren. Not only did Dr. Kollias use the hamstring tendon, but he also used the gracilis tendon, which is attached below the knee so Lauren would have a smaller incision and fewer problems with stiffness and mobility. "I basically took out the old ACL stump and used a new ligament, the gracilis and the semitendonosus tendon, to replace it. I took it through a two-centimeter incision on the front of the knee and drilled a tunnel in the 30 | Winter 2013
tibia and femur. It’s all locked into place with a fixation device. For the meniscus tear we sewed what was torn away so it stayed in place with another fixation device,” said Dr. Kollias.
Soccer took up about 75 percent of Lauren’s life and the ACL injury prevented her from playing, as well as looking for a job upon graduation. Rehabilitation was the most important thing for her. Through rigorous rehab programs and a dedicated mindset, Lauren was able to return to her sport and Dr. Kollias was able to watch her play. “I was invited as an honoree captain and was able to watch Lauren score a goal on her senior night,” said Dr. Kollias. “The best part about working with Lauren was that she pushed herself and her teammates.” One of the most memorable moments out of Lauren’s ACL injury was a compliment post surgery and rehabilitation. “I was blessed with a strong recovery. The best compliment that I received was that it did not even appear like I had ever had surgery. That to me reflects what a great job Dr. Kollias and the OrthoIndy and IOH staff did. I was able to play my senior season and go out strong,” said Lauren. Since Lauren has graduated college, she has been able to play soccer for a women’s league and enjoy her hobbies pain free. She would not have been able to finish up her collegiate athletic career strong without Dr. Kollias. “Some people simply do not come back from an ACL injury, but thanks to Dr. Kollias, not only did I come back, but I was able to make a difference on my collegiate team by setting an example. In my case, I gave my teammates hope that a major injury does not prevent you from doing something that you love to do.” To watch Lauren’s story, visit MyScarMeans.com.
Physician Update
By: Kasey Prickel
OrthoIndy Welcomes New Physician and Wishes Others Well Saying Goodbye in 2012
OrthoIndy wishes the best to Dr. Mark Stevens and Dr. Terry Trammell as they start their new endeavors and thank them for their years of service. Dr. Stevens starts a new adventure in Arizona, while Dr. Trammell enjoys retirement. Dr. Mark Stevens Orthopaedic specialist, Dr. Mark Stevens, worked at OrthoIndy for 33 years. He has been the orthopaedic consultant to DePauw University since 1981. Previously Dr. Stevens was the assistant team physician for the Indiana Fever, the Indianapolis Pacers and the Indianapolis Indians. He is a member of the American Academy of Orthopaedic Surgeons, the American Academy for Cerebral Palsy and Developmental Medicine, the Indiana Orthopaedic Society and the Indiana Athletic Trainer’s Association. Dr. Stevens is moving to Arizona where he will enjoy playing golf, pickleball and tennis and is hoping to work at a pediatric orthopaedic group. If you are a patient of Dr. Stevens, please feel free to make any new or follow-up appointments with the OrthoIndy group. Visit www.OrthoIndy.com to choose a physician specialized in treating your specific injury or condition. For patients under 21-years-old, please schedule any appointments with Dr. Carlos Berrios, orthopaedic pediatric specialist. To schedule an appointment with Dr. Berrios, please call (317) 802-2847.
Dr. Terry Trammell Dr. Terry Trammell, an orthopaedic spine surgeon, retires after 32 years of service at OrthoIndy. Dr. Trammell served as medical director and consultant for orthopaedic injuries for championship auto racing teams from 1984 through 1995 and consultant for orthopaedic injuries at the Indianapolis Motor Speedway from 1982 through 1995. From 1996 until 2001, he provided services as the Senior Orthopaedic Consultant for the Champ Cart World Series. Since 2005, he has been an orthopaedic consultant and safety advisor for the Indy Racing League. A sought after expert on racing injuries, scoliosis and other spinal conditions, Dr. Trammell has given presentations to more than 80 professional societies and organizations. He has received the National Athletic Trainers Association Award, the AMA Physician Recognition Award, the NAARFC Tony Hulman Award, the United States Auto Club Unsung Hero Award, as well as other honors. If you are a patient of Dr. Trammell’s, please feel free to refer any follow-up appointments to the OrthoIndy spine group. Visit www.OrthoIndy.com to learn more about OrthoIndy’s spine surgeons.
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Welcome Dr. Nuthakki In January, OrthoIndy added physical medicine and rehabilitation physician, Dr. Pransanth Nuthakki. Dr. Nuthakki’s practice focus includes: electrodiagnostics, musculoskeletal, interventional pain management, non-operative spine and sports medicine. He is located at OrthoIndy Northwest, West, Fishers, Lafayette and OrthoIndy at St.Vincent Carmel. Dr. Prasanth Nuthakki did his undergraduate studies at Wright State University, Dayton Ohio. He attended medical school at Ross University School of Medicine, Portsmouth, Dominica in 2006 and completed an internship at the Jewish Hospital of Cincinnati in 2007. In 2010, Dr. Nuthakki completed a residency in physical medicine and rehabilitation at SUNY Upstate
Medical University, Syracuse, New York. While at SUNY Upstate Medical University, Dr. Nuthakki was appointed chief resident from 2009 to 2010. Following his residency, Dr. Nuthakki completed an interventional spine and sports medicine fellowship with Alabama Orthopedic Spine and Sports Medicine Associates, in Birmingham, Alabama. Dr. Nuthakki is board certified in physical medicine and rehabilitation and board eligible in sports medicine. He is a member of the American Academy of Physical Medicine and Rehabilitation, North American Spine Society, International Spine Injection Society and the American Society of Interventional Pain Physicians. To schedule an appointment with Dr. Nuthakki, please call (317) 802-2483.
Sports Injury? We’ll fix it. Official Orthopaedic Provider of the Indiana Pacers OrthoIndy.com
Piecing Life Back Together Again: Mother and daughter recover together after serious car crash By: Chelsea Tuttle Holidays can be a rewarding time spent with family and friends intertwined with traveling and occasional chaos. In 2006, The Plunkett’s, from South Bend, Indiana, were venturing to Logansport to enjoy their family’s company and some turkey on Thanksgiving when their holiday was put to an abrupt stop by a head on auto collision. Phoebe Plunkett, 10, woke from her nap to hear her sister screaming hysterically beside her and the front window of their car shattered into a million pieces. Gathering her bearings, Phoebe immediately glanced down at her black and blue crippled ankle, and then at her motionless mother in the driver seat in front of her. She was unsure that her mother was alive. Phoebe and her mother, Rosie's, lives changed forever that day. The mother-daughter duo were life-lined where shortly after, they met OrthoIndy trauma surgeon, Dr. Renn Crichlow. Phoebe watched as her typically jubilant and optimistic mother was rushed away with a sheet covering her body and wondered if she was going to make it. Despite her self-less and compassionate nature, Phoebe had also suffered extreme injuries. She had a broken tibia and fibula as well as a crushed growth plate in her ankle. The leg has three major bones: the femur, tibia and fibula. The tibia, more commonly known as your shinbone, is a major weight-bearing bone that runs parallel to the fibula that starts at the bottom of the knee. Most tibia and fibula fractures can occur through falls or significant trauma, such as Phoebe’s case. | 33
Another injury that caused extreme concern for the ten-yearold and her family was the crushed growth plate in her ankle. Growth plates are the softer parts of children’s bones where growth occurs and ultimately determine how a bone grows. Fifteen percent of childhood fractures involve a damaged growth plate and typically occur twice as often in boys. Phoebe was a rare case and because of the severity of the crushed plate, surgery was an immediate decision. Under Dr. Crichlow’s direction, Phoebe had an external fixator put in her right ankle. An external fixator is a type of treatment to correct the dislocated bones where screws and pins are installed above and below the fracture site. Dr. Crichlow repositioned the bone fragments and then connected the pins and screws to metal bars outside of Phoebe’s skin. This helped stabilize her bones so they would grow properly. Her hobby of running was put on hold indefinitely. In the beginning, Phoebe had very limited activity. For the first ten days after surgery, she was put in a cast to help further stabilize and ensure proper reconstruction of her bones. She was also required to use a walker for the first month post surgery. Rosie had a longer path of recovery to encounter. She spent multiple days in the hospital and went through vigorous surgeries to correct her injuries. She had multiple compound fractures and broken bones in her lower leg, forearm, elbow and wrist. She had also suffered an acetabulum fracture. Acetabulum fractures occur primarily in traumatic accidents, such as Rosie’s case. The acetabulum is the socket where the femur bone fits in the pelvis. Before the accident, Rosie’s femoral head, or upper end of her thighbone, fit perfectly into the acetabulum like a ball in a cup. However, the accident caused such an extreme impact that a fracture was caused. Acetabulum fractures are extremely difficult to operate on because of the proximity of the major blood vessels and nerves surrounding the area. Large metal screws were inserted through the femoral neck to hold the fractured bones in place while the fracture healed. The acetabulum needed to be operated on most significantly for Rosie because she developed extreme arthritis. “She was so badly injured that each of her original injuries required a follow up surgery. Her body was mangled and we needed to wash and clean twice before surgeries. It was like fighting an uphill battle because of the severity of her issues,” said Dr. Crichlow.
The path of recovery was a slow and gradual one with progression from the hospitals, a wheelchair, walker, crutches and a cane. For an active and optimistic mother, Rosie had a very hard time adjusting and sought out Dr. Crichlow for emotional support during her recovery. “The biggest thing for any patient is to just let them know that what they are feeling is normal and that they are not losing their marbles. The emotions that [Rosie] felt are just as important as the pain that requires medicine,” said Dr. Crichlow.
and compassion that we chose to return to OrthoIndy for all of our follow up care,” said Rosie. “We have spent many hours driving to and from OrthoIndy, however; Phoebe and I deserve the best care possible and for us, that’s OrthoIndy.”
Maybe it’s because I’m a first and second grade teacher, but I felt I had a strong connection to Humpty Dumpty. It has taken patience for me to be put back together again, but Dr. Crichlow and OrthoIndy did it! Too bad they weren’t an option for Humpty!
“Dr. Crichlow was prompt with his response and put things into perspective for me,” said Rosie. “I remember him saying that if I thought of my recovery as a baseball game, I would be in the sixth inning. He helped me set realistic goals for my recovery.” Without the excellent care and compassion of Dr. Crichlow and his team, Rosie wouldn’t be where she is today. “Maybe it’s because I’m a first and second grade teacher, but I felt I had a strong connection to Humpty Dumpty. It has taken patience for me to be put back together again, but Dr. Crichlow and OrthoIndy did it! Too bad they weren’t an option for Humpty!” Rosie and Phoebe committed to making the long journey back and forth from South Bend to Indianapolis to seek recovery from OrthoIndy, but distance was no concern for the pair because of the exceptional care they received and the personable connection the physicians provided.
Rosie and Phoebe firmly believe that their success stories could not be contributed to one person, but to the entire OrthoIndy team.
“Everyone, and I do mean everyone, worked together as a team to ensure our success. Schedulers, receptionists, x-ray technicians and nurses always made my family feel as if we were a part of that team,” said Rosie. “I have a very good relationship with Dr. Crichlow. We joke back and forth with each other. I love the staff at the front desk and the people in the cast room,” said Phoebe. The dynamic duo both went under separate surgeries and different recovery paths, but their bond strengthened as a family post accident. Phoebe has returned to running and training for marathons and Rosie has returned to her energetic self, staying busy with her students and even took up cycling. “I am finally at a point where I feel all of the surgeries are behind me and there are very few activities I am unable to do… life is good,” Rosie said. To watch Rosie and Phoebe’s story, visit MyScarMeans.com.
“Finding an orthopaedic doctor locally was an option, but I felt so strongly about the superior quality of care | 35
8450 Northwest Blvd. Indianapolis, IN 46278
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Watch Gene's story at MyScarMeans.com
Gene Huey,
OrthoIndy and IOH patient