WEIRTON - Dr. Jorge Roig, anesthesiologist at Weirton Medical Center, likes to refer to the hospital as WMC university these days.
"It's because we are setting the bar in so many ways. Specifically, for pain management in knee replacements, we are so cutting-edge we know other facilities will follow our approach across the country," Roig said.
After a four-year development period by Weirton natives Roig and registered nurse Julie Mazur, WMC is unveiling what it refers to as "the new knee replacement."
NEW?PROGRAM — Discussing the new knee replacement program recently were, from left, Drs. Charles Capito and Jorge Roig; registered nurse Julie Mazur; Dr. Stephen Alatis; and recipient Leonard Cox of Hopedale.
"The knee replacement itself is not new, but the way we are approaching blood loss and pain is. Our multi-modal pain management program begins at the time our patients walk in the door. The combination of the oral medications, a sensory nerve block, the surgeon's minimally invasive technique and a numbing medication injected by the surgeon is what is allowing patients to walk within one-and-a-half to two hours post-operatively and have very successful outcomes. In fact, we've had one patient leave the same day because the pain was minimal and his ability to ambulate was incredible," said Mazur.
The sensory nerve block performed by Roig leaves the motor nerves untouched, thus allowing mobility almost immediately post-operatively. After the block, the orthopedic surgeons (Drs. Stephen Alatis, Charles Capito and Gurdev Purewal) inject the site with long-acting numbing medicine Experal, which lasts up to 72 hours.
"The pain is so well-controlled using this multi-modal therapy that the amount of narcotics needed is dramatically reduced because the pain is so adequately controlled," says Roig.
"Narcotics slow people down. We are using far fewer narcotics now because the patient simply does not need them," said Capito.
Helen Woudarski, 86, of Weirton was the first patient on which the new approach was used at WMC.
"After surgery, they brought me to my room and right away they started walking me down the hall with the walker. They were amazed at how quickly I walked without any pain. I have 11 steps to get into my house and I went up all those stairs when I got home without any problem," says Woudarski.
Contractor Leonard Cox of Hopedale says his lack of pain after his surgery was "a miracle."
"I had my surgery on a Tuesday and I left that night. Around 2 the next morning I started walking around my house and I really could not feel any pain. Julie and Dr. Capito called me frequently to check on my pain level and to see if everything was OK, and it was. It was great," says Cox.
Dave Clark of St. Clairsville was able to leave the hospital the day after surgery. He says he has less pain than he could ever have imagined, two weeks later.
"Even at times when I was experiencing some pain it was impressively tolerable. Dr. Alatis was wonderful and the staff is awesome. I'm usually a tough customer but this experience was very positive for me," says Clark.
Cox and Clark were able to leave quickly, which worked for them, but according to Roig, that certainly won't work for everyone.
"If it's best that the patient stay here longer, we will keep them here as long as needed for their safety and well-being. For those who are having total knees, they are not as likely to leave nearly as quickly. There are some people, though, who are very motivated to leave quickly and for those people, if they are otherwise healthy, we will work with them to get them home sooner than normal," says Roig.
The other major component of WMC's new program is blood management. The progressive, individualized approach to blood loss minimizes the need for a transfusion. Patients are seen one month prior to their joint replacement, and the patient's test results determine which vitamin regimen works best to build hemoglobin levels. Patients begin taking iron supplements and various to other vitamins the month prior to surgery.
"This has worked wonders in curbing blood loss to the lowest levels the hospital has ever experienced. That, in addition to the surgeon's minimally invasive surgical techniques and the use of a special device during surgery, the Aquamantys, is making the WMC procedures virtually blood loss-free," says Alatis.
Orthopedic surgeons at the medical center also point to the importance of physical therapy and quality home health care in each patient's recovery.
In fact, WMC Home Health is now implementing pre-op assessments of the patient's home to determine individualized patient needs before surgery and which equipment they will need for the best recovery.
"This is a comprehensive program, years in the making and with the team we have in place, from the doctors, to the nurses to all of the support staff, and our leadership, the sky is truly the limit. It's a very exciting time here," added Roig.