advances - New England Baptist Hospital

advances
A publication for supporters and friends of New England Baptist Hospital
Spring
2013
IN THIS ISSUE:
BILATERAL KNEE REPLACEMENT:
For Some, It’s the Right Surgery
Hervey Kimball, MD, Discusses
Innovations in Hand Surgery
Rose Society Dinner Celebrates Generosity
See you at the Spirit of Excellence Gala
on April 26
(Above) Peter Smyth, chair of NEBH’s
Philanthropy Committee, congratulates
David Mattingly, MD, chief of joint
reconstruction, after he was presented
with the prestigious Kirkby Memorial
Service Award. The award presentation
is a highlight of the Baptist’s annual Rose
Society Dinner.
Susan Donahue was in pain and scheduled for bilateral knee replacement surgery
at New England Baptist Hospital the next day. But she played tennis anyway—
convincing evidence that she loves the sport and that she had the motivation required to face a more challenging rehabilitation than if she had surgery on one knee.
That was four years ago. Today, Mrs. Donahue, 61, is pain-free and as active as ever.
“I am playing tennis four days a week and enjoying every minute of it, thanks to
Dr. Scott,” she says, referring to Richard Scott, MD, the respected NEBH joint
replacement surgeon who performed her bilateral knee replacement. A former
Continued on page 2
FOR SOME, IT’S THE RIGHT SURGERY
continued from page 1
college player and instructor, she has returned to a high level of competition.
“I’m playing better since having the surgery—much better than I did during the four years
leading to it,” says the Norwell resident, who had been in pain for several years and on a
steady diet of Advil. “Three arthroscopic surgeries repaired my meniscus and got me back
on the court.”
When it was time to get serious about repairing her knees, she sought out Dr. Scott.
“I wanted the guy who is considered to be the guru,” she explains. “Besides, I’m aware of
the Baptist’s quality metrics.” Mrs. Donahue, an informed medical consumer, has served
as a board member at area hospitals. She specifically wanted to avoid an infection. NEBH’s
impressive post-surgical infection rate is well below that of other hospitals and continues to
drop—to less than 0.5 percent.
The goal is to avoid complications
In many ways, Mrs. Donahue was an ideal candidate for having both knees replaced at
the same time. Otherwise healthy and active, she told Dr. Scott that her goal was to have
bilateral replacement.
“I rarely initiate the possibility of doing two knees at once,” Dr. Scott notes. “I’d rather the
patient talk me into it, because it’s not for everyone. The rehabilitation period is a bit longer
and more difficult, so the motivation needs to be there. Similarly, someone with a low pain
threshold may not be a good candidate for bilateral surgery.
“First, I need to determine if both knees are ready to be replaced. Both need to be truly
symptomatic, not just arthritic, on their x-ray. If someone has a severe flexion contracture,
where they can’t straighten their legs, or a severe deformity, such as bowing of the legs,
they are more likely to be a candidate for bilateral surgery.”
Mrs. Donahue had gradually become knock-kneed. With her knees abnormally close
together, and her ankles spread far apart, she couldn’t stand up straight. “It has to do
with how the cartilage in the joint wears,” says Dr. Scott. “Some people are simply out of
alignment, similar to what can happen with the front end of a car.” Once in surgery, Dr.
Some surgeons shy away from
performing the surgery, but 10-15
percent of Dr. Scott’s patients,
including active individuals like
Susan Donahue, receive bilateral knee
replacements when appropriate.
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Scott determined that Mrs. Donahue could have a partial knee
replacement on one of her knees, which is a less radical surgery
than a total knee replacement.
Most importantly, the individual who requests bilateral knee
replacement surgery must be cleared medically. “They cannot
have a significant cardiac history—in fact, no problems with
the major organ systems,” he says. “In patients who have diabetes, it must be well-controlled.” As a precaution to prevent
deep-vein thrombosis (blood clots), all bilateral knee patients
take blood-thinning medication for a month.
Obese individuals are known to have a higher rate of
surgical complications, so he asks that these patients lose
weight in advance of surgery. “If they lose weight, it shows
they are motivated,” he says. “Also, the force on our knees is
triple what we weigh, so if someone loses ten pounds, they’ve
taken 30 pounds of pressure off their knees. I’ve had people
lose weight and cancel their surgery because they’re not in
pain anymore.”
Four months after surgery, back on the court
As an active sports enthusiast since her high school days, Mrs.
Donahue was more than ready for her post-surgical rehabilitation. She attended the Baptist’s class for patients who are
scheduled for joint replacement surgery and headed to her
surgery with confidence. “They came and got me out of bed
the evening of my surgery,” she recalls. “The care at the Baptist
was extraordinary.”
Four days later, she was discharged to a rehab facility.
“They work you hard, but it was worth it,” says Mrs.
Donahue. Although she was driving one month after her
surgery, her focus was on returning to tennis. The trainer
at Scituate Racquet & Fitness, where Mrs. Donahue plays,
contacted Dr. Scott’s office for guidance on exercises that
would help her continue to make safe progress.
He finds that people know when they’re ready for
surgery. “I see the whole spectrum, from the person
who wants a knee replacement because their knee swells
when they run ten miles, to the person who is in a
wheelchair,” he says. “Most people are somewhere
between those two extremes.”
As for having both knees replaced at once, when their
rehabilitation is over, Dr. Scott always asks patients if they
are glad they decided to make one trip to the OR. “The vast
majority say they are very happy they had bilateral knee
replacement.”
Healthy octogenarians benefit from
bilateral knee replacement
Some joint replacement surgeons shy away from performing bilateral
knee replacements, regardless of the patient’s age. Others feel that age is
a factor and stipulate that a patient should be younger than 75. Dr. Scott
sees it differently. In older individuals who are motivated and otherwise
healthy, having one surgery—and thus one anesthesia—may be preferable to two.
“If someone fulfills the criteria, they become a potential candidate, despite their age,” he says, noting that he has performed successful bilateral
knee replacement surgery on more than 50 octogenarians. “This older
group includes a woman who was 90 years old at the time of her surgery.
In August, four months after her surgery, Mrs. Donahue
picked up a racquet and tried to play. “I was terrified,
because I didn’t know what to expect,” she recalls. “I had
no confidence and was afraid I would fall.” She got over that
quickly; by October, she was again playing tennis
competitively.
Mrs. Donahue appreciates the counsel she received
from Dr. Scott. “He encouraged me to be sensible and stick
with just playing doubles, and that’s what I’m doing,” she
says. “In addition to Dr. Scott’s quiet confidence, he’s a
wonderful listener. He understands what makes you tick and
works with you to reach your goals.”
She has encouraged friends to not put off having knee replacement surgery. “I don’t understand why people say they want
to put off the surgery as long as they can, because today’s
implants are designed to last,” she says.
Dr. Scott says that statistics prove her point. “The myth is that
knees are like a battery that wears out,” he says. “It is true
there is an annual attrition rate, but it’s much better than it
used to be. About 90 percent of patients can expect to get 20
years from their knee replacement, and 85 percent can expect
to get 30 years. If you’re severely disabled, why wait? You’re
giving up years when you could be enjoying yourself.”
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“One worry is the potential cognitive side effects of general anesthesia,
such as confusion, so we try to avoid that by using either epidural or
spinal anesthesia instead,” Dr. Scott explains. “I tell the patient that
we’ll do one side and make sure the anesthetist is comfortable with us
proceeding to the second side. If they are, we go ahead.”
There is more blood loss during bilateral knee replacement surgery, so
older patients are likely to receive a transfusion. “We want to avoid
having them become anemic,” Dr. Scott says. Additionally, after they
leave the Baptist, older patients may require a slightly longer stay at a
rehabilitation facility.
As is true with any patient, regardless of age, Dr. Scott says he rarely
suggests bilateral knee replacement. “I will often say to an older individual, ‘let’s do your left knee first so that you can drive.’ Sometimes they say
‘let’s do both,’ and we discuss whether or not they are a candidate.”
Word of mouth is strong, especially among people who are motivated to
remain active and independent. “Many of my patients are referred by their
friends who have had the surgery,” Dr. Scott notes. “It’s great, because
they come in informed and with a lot of confidence.”
BAPTIST INNOVATIONS CONTINUE IN THE UPPER EXTREMITY
Hervey Kimball, MD, NEBH Hand Surgeon, Explains
As a hand surgeon at New England
Baptist Hospital, Hervey Kimball, MD,
focuses on the “upper extremity”—
meaning the arm, mostly between the
hand and the elbow. But when a patient’s
problem extends to the shoulder, which
is not uncommon, he can assist in the
care they need. Although non-surgical
treatment typically is offered first, today
patients with upper extremity problems
benefit from minimally invasive surgery,
including office-based procedures, and
nerve blocks that are increasingly effective
at controlling their pain after surgery.
As Dr. Kimball explains, hand surgery
innovations continue.
Q. Elbow surgery is now being performed
arthroscopically, similar to surgery in the
knee and shoulder, correct?
A. Yes, elbow arthroscopy has really
progressed. It’s technically difficult
to perform because of the critical
structures—the nerves and arteries—
that are close by, but we’ve gotten
better at it. We perform elbow arthroscopy on patients with epicondylitis—
essentially elbow tendonitis—
as well as cases where there are
elbow fractures or elbow stiffness.
The elbow is prone to motion loss,
which is referred to as a contracture,
following such injuries. I also see lots
of patients with primary osteoarthritis
of the elbow, which is different from
that seen in hips and knees. This
condition typically affects males
between age 35 and 55 and restricts
motion. They might have bone or
cartilage floating in the joint or a
bone spur, which we can remove
arthroscopically.
Q. Do you see many patients with
tennis elbow?
A. Yes, because tendonitis of the elbow
is very common. However, only a
small percentage of those with tennis
elbow actually play tennis. We don’t
fully understand the condition, but
we know it results from a degenerative process. Similar to how our bones
lose calcium as we age, which can
lead to osteoporosis, the theory is that
tendons weaken and, for some reason,
certain people have a lot of pain. They
can’t pick up their briefcase or even
a cup of coffee. In most cases, we try
not to operate and instead offer conservative management, including rest,
physical therapy, cortisone cream or a
wrist splint. We tell patients that their
symptoms most likely will improve,
but it may take time. Some people do
require surgery.
Q. Do people continue to believe that
carpal tunnel syndrome is caused by
excessive keyboard use?
A. They do, and that’s an unfortunate
misconception. We know that carpal
tunnel syndrome is age-related; the
older you are, the more likely you are
to develop carpal tunnel syndrome.
However, there are other risk factors,
4
such as having a thyroid disorder or
diabetes, being female or being obese.
Q. Wrist replacement surgery is being
performed more often, correct?
A. Yes, the latest generation of wrist
implants allows for better tolerance
to wear and features better fixation
methods, so they adhere well to bone.
As a result, wrist replacement surgery
is an effective alternative to total wrist
fusion, which limits motion and,
consequently, hand function. We
perform these surgical procedures
on individuals whose arthritis has
left them with weak, painful wrists.
Currently, the ideal candidate for a
wrist replacement is someone who
won’t have the demand of heavy use,
such as lifting, after surgery. In other
words, we do not typically offer it to
a firefighter or laborer. Some patients
decide to have wrist fusion on one
hand and wrist replacement on the
other hand.
Q. Do you enjoy participating in the
Baptist’s highly regarded hand surgical
fellowship?
A. I do. It’s a yearlong program,
following orthopedic residency, that
we offer in combination with Tufts
THANK YOU!
Dear Friends:
As we advance in 2013 and look forward to warmer spring weather, please
keep in mind that unrestricted annual giving is more important to us than ever.
Every gift matters, regardless of the size.
We are fortunate to have our Rose Society Committee, established last spring
and chaired by Martha Sloan Felch, trustee, whose members help cultivate
gifts of $1,000 or more in order to support the success of the Baptist’s Annual
Fund at the Rose Society level. National Doctors Day, on March 30, provides
an opportunity for you to make a tribute gift that honors a Baptist physician,
nurse or other caregiver.
In the meantime, members of the Baptist senior leadership team and the
Office of Philanthropy have defined the following five areas as the hospital’s
fundraising priorities: research, facility and technology upgrades, endowment
for our chairs and chiefs, the Center for Nursing Leadership and the new Center
for Patient Safety and Center for Patient Care Redesign. You will hear more
about these newly defined fundraising priorities, and how you can participate,
in the coming months.
We are very excited about hosting our annual Spirit of Excellence Gala on
Friday, April 26, when we will celebrate what is important to New England
Baptist Hospital and its partners—our culture of legendary service. We will
also present the 2013 Legendary Leader Award to the Shields Family and
Shields Health Care Group with our special guest, Tedy Bruschi, three-time
Super Bowl champion, and emcee, Jack Connors. We hope to see you there.
Thank you for your continuing support, which is essential if we are to
advance care The Baptist Way—a precious tradition that puts the patient first.
Medical Center and that began more
than 25 years ago. We have two
fellows at a time, and they spend six
months at the Baptist and six months
at Tufts, which exposes them to the
full range of cases and treatment
options. Working with me, they tend
to see complex elbow problems. It’s
great being able to teach the fellows,
because they have so many good
questions, and they’re eager to learn.
That means we keep learning
with them.
Q. Hand surgery is a relatively young
field. Are there more innovations
on the way?
A. There are. For example, I recently
treated a young man with a
complicated, unhealed scaphoid
bone fracture. This wrist bone has
a limited blood supply; two prior
surgeries had not helped him. I
performed a relatively new operation
where a bone graft is taken from the
knee, along with a blood vessel. The
graft is placed in the scaphoid, and
the blood vessel is then coupled with
a forearm artery to improve blood
flow. The bone healed successfully.
It’s an example of how, as a hand
surgeon, there are so many things you
can offer patients.
Sincerely,
Christopher Mosher, JD
Vice President, Philanthropy
Consider Joining the 1893 Legacy Society …
Each year, the Baptist receives gifts from wills and estates. Many times, the donors have
informed us during their lifetime of the gift they have planned for the future. And when
they do tell us, we invite them to join The 1893 Legacy Society, which recognizes
individuals who have made the Baptist part of their legacy.
If you have ever been a patient at the Baptist, you have experienced the legacy left by
Olive and Carl Currie. The Curries noticed that some patients received flowers and had
visitors while others did not. So they endowed a fund via their will to provide a red rose
to every patient as a sign of welcome and friendship. The Currie Rose Fund became the
inspiration for the R.O.S.E. program, which is part of our commitment to legendary service.
R.O.S.E. stands for Respect, Ownership, Service and Excellence. The Curries’ son and
daughter-in-law have continued to support the fund during their lifetime and have made a
provision in their estate plans as well. Jim and Barbara Currie are members of The 1893
Legacy Society, which allows us to thank them for their thoughtful planning.
However, some individuals do not let us know about their intention to make a planned gift,
and we miss the opportunity to thank them, discuss how they wish to leave a legacy and
invite them into The 1893 Legacy Society.
We’d like to thank you. If you have already made a plan to include the Baptist in your will
or estate, please let us know. If you have not yet included the Baptist, and if the time is
right for you, please consider adding the Baptist to your plans. We would be happy to talk
with you and provide any assistance you might need.
For more information, please call 617-754-6880 or visit www.nebh.org/plannedgiving
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(Left, clockwise) Edward Nalebuff, MD, NEBH hand
surgeon and Rose Society Committee member, with
Elias Dow, MD, internist; Tom Thaler and Grace Thaler,
Rose Society donors; Kara Keena and Theresa Caffrey,
Boston Celtics Shamrock Foundation; Kristin
Mattingly, Rose Society Committee member, and
David Mattingly, MD, NEBH surgeon and Kirkby
Memorial Service Award recipient.
(Next page, clockwise) Brian McKeon, MD, NEBH
orthopedic surgeon, Dorothy Krysiuk, Julie Curtis, MD,
and Alan Curtis, MD, NEBH orthopedic surgeon;
Benjamin Bierbaum, MD, who was recognized for
his 40 years of service to NEBH, Dr. Mattingly, Trish
Hannon, president and CEO, and Richard Maloney,
board chair; Eric Woodard, MD, chief of neurosurgery,
with his parents, Kay and Robert Trewhella; John
Cowan described the outstanding care he received
at the Baptist last spring.
Rose Society Dinner Celebrates Leadership Donors
Evening Celebrates Generosity, Features Kirkby Memorial Service Award Rose Society Dinner guests have one thing in common: they care deeply about New England
Baptist Hospital, which they support with their gifts of $1,000 or more to the Annual Fund each
fiscal year. The event is designed to celebrate their generosity and loyalty.
Before dinner, Christopher Mosher, vice president of philanthropy, welcomed
everyone. “The value of leadership giving is immeasurable,” he said. “The funds your gifts provide
allow us to fortify the programs and enterprises that keep the Baptist special.”
Trish Hannon, president and CEO, provided an overview of the past year. “It has been a
stellar year of growth and refinement at the Baptist,” Ms. Hannon said. “We are well on our way to
achieving our goal of being New England’s premier destination for musculoskeletal care.”
She described how NEBH is in an enviable position as a leader in patient satisfaction,
orthopedic surgery outcomes and infection control. “Your belief in the way we deliver care propels
you to support us,” Ms. Hannon noted. “We thank you.”
Eric Woodard, MD, chief of neurosurgery, then addressed the group, describing the new
Physicians’ Philanthropy Council, the impact of philanthropy at the Baptist and the hospital’s newly
defined fundraising priorities. “At the top of the list is research,” he said. “We need support for the
kinds of clinical investigations that allow us to refine the care we provide.”
A grateful patient discovers the Baptist Way
After reflecting on patients who have shown their gratitude in a variety of ways,
including through financial support, Dr. Woodard introduced John Cowan, a grateful patient, new
to the hospital, who experienced the Baptist Way after being misdiagnosed with a back problem.
He was referred to David Kim, MD, a Baptist spine surgeon, for care.
“Dr. Kim quickly determined that the problem was not my back at all, but my hips,”
Mr. Cowan recalled. “I learned I needed hip replacement surgery, and I didn’t see it coming.” Once
he decided that he was not willing to live with his increasing pain, Mr. Cowan, a Boston businessman, was scheduled for surgery with Carl Talmo, MD.
The evening of his surgery, Mr. Cowan was assisted in walking around the unit on his
new hip. “It was thrilling, because I was on the other side of something huge—not just the surgery, which I had been worried about, but the pain. I had been suffering terribly for a long time.”
Since then, he has referred various individuals to the Baptist for care. “Everyone at the
Baptist was committed to making sure my surgery was a success,” he says. “I wanted to get my
life back, and it seemed like that’s what everyone at the Baptist wanted as well.”
David Mattingly, MD, receives prestigious award
After dinner, David Mattingly, MD, a highly regarded joint replacement surgeon, was
presented with the 2012 Kirkby Memorial Service Award, which is given to an individual who has
demonstrated extraordinary commitment to the Baptist’s mission, vision and values. Elinor Kirkby,
who served as hospital administrator for many years, was known for the philosophy that premier
patient care is paramount.
Dr. Mattingly, who arrived as an Otto E. Aufranc Fellow in Adult Reconstructive Surgery
and now directs that fellowship program, along with serving as the hospital’s chief of joint
reconstruction, is a worthy recipient of the prestigious award. A generous supporter of the
Baptist, Dr. Mattingly is a member of the Board of Trustees, the Physicians’ Philanthropy
Council and the Rose Society. A superb surgeon, teacher, leader and role model, Dr. Mattingly
embodies the spirit, confidence and enduring high values of New England Baptist Hospital.
SAVE THE DATE
ROSE SOCIETY RECOGNITION DINNER
THURSDAY, NOVEMBER 14, 2013
The Fairmont Copley Plaza Hotel
NON PROFIT
US POSTAGE
PAID
HOLLISTON, MA
PERMIT NO. 72
125 Parker Hill Avenue • Boston MA 02120
advances features important programs at
New England Baptist Hospital. If you are interested
in supporting the hospital, please contact the
Office of Philanthropy 617-754-6880.
www.nebh.org/donateonline
Christopher S. Mosher, JD, Vice President, Philanthropy
© 2013 New England Baptist Hospital
advances is produced by the Office of Philanthropy
Design: Heidi Price Design
Editorial Services: Laura Duffy
Photography: Joshua Touster Photography
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2013 Spirit of Excellence Gala
NEW ENGLAND BAPTIST HOSPITAL
Spirit of Excellence
Gala
SPONSORS AS OF MARCH 12, 2013
Title Sponsor $50,000
The Shields Family and Shields Health Care Group
Premier Sponsor $35,000
Shawmut Design and Construction
Platinum Sponsors $25,000
Anaesthesia Associates of Massachusetts, Suffolk Construction
Gold Sponsors $15,000 Boston Celtics Shamrock Foundation,
Greater Media, Inc., Harvard Pilgrim Health Care, Horizon Beverage Group,
Massey & Co., The Micozzi Companies, New England Baptist Radiology, PC
Silver Sponsors $10,000 Blue Cross Blue Shield of Massachusetts,
Trish Hannon, President and Chief Executive Officer, Health Care Program Advisors,
Joan E. Kolligian, Jeffrey A. Libert and Martha D. Brown,
Longwood Orthopedic Associates,
The Medical Staff of New England Baptist Hospital, Milica and Donald Pogorzelski,
SkinCare Physicians, Inc., Sodexo, Strategic Benefit Advisors, Inc.
Bronze Sponsors $5,000 Citizens Bank, Davis Marcus Partners,
EasCare Ambulance Service, ETEX Corporation, Fallon Community Health Plan,
Fidelity Investments, Foley & Lardner, LLP, Hebrew SeniorLife,
Heidi Price Design, Dr. and Mrs. Gary P. Kearney, Middlesex Savings Bank,
New England Orthopaedic & Spine Surgery, LLC, Phillips DiPisa,
Physical Therapy at Dedham Health & Athletic Complex, Standard Parking,
UGL Services, Sandra A. Urie and Frank F. Herron,
W.B. Mason, Whittier Rehabilitation Hospital
FRIDAY, APRIL 26, 2013
6:00 pm Reception 7:30 pm Dinner
PLEASE JOIN NEW ENGLAND BAPTIST HOSPITAL
AS WE CELEBRATE THE PRESENTATION OF THE
2013 LEGENDARY LEADER AWARD TO
THE SHIELDS FAMILY and SHIELDS HEALTH CARE GROUP
Join members of the Baptist community in recognizing
the value of service standards and the Baptist Way!
SPECIAL GUESTS:
JACK CONNORS
Hill Holliday founder, Partners HealthCare former chairman
and Boston legend
TEDY BRUSCHI
Three-time Super Bowl champion, analyst and Patriots legend
INTERCONTINENTAL HOTEL BOSTON
Entertainment and Dancing
Visit www.nebh.org/gala or call 617-754-6653 for information!
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Your gift to the NEBH Annual Fund, recognizing the
stellar care you received from your caregiver, will provide
essential unrestricted philanthropic support to help keep us
at the summit of all we do. Please visit www.nebh.org/donateonline
or call 617-754-6880 to make your gift.
Our physici
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Honor Your Physician National Doctors Day is March 30
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