By late 2015, it seemed constant bone-rubbing-on-bone pain was making everything
60 year-old Ruben Barkley did revolve around his knees.
Osteoarthritis was causing debilitating pain, swelling and stiffness in both knees, making
it difficult for him to sleep or endure the physical toll of frequent
bending and pressure on his knees required by his work as a maintenance
technician. What’s more, he and his wife Ricki run a cattle farm
adjacent their home in Vale, NC and are also avid home renovation enthusiasts.
Looking for relief beyond what he got from cortisone injections, physical
therapy and arthroscopic surgery, Ruben consulted with Dr. Jason Norcross,
an orthopedic surgeon who advised it was time to consider replacing not one, but
both knees.
Not everyone is a candidate for a double knee replacement (simultaneous
bilateral knee replacement). Ruben, however, was determined, physically
fit, and in good overall health. Never wanting to be a burden on his wife
Ricki, a full-time employee at the NC Division of Transportation, he was
also driven by the potential financial hardship of taking two 3-month
rehabilitation periods and incurring two insurance deductibles. So, under
medical supervision, Ruben learned all he could about optimizing his post-operative
recovery and started months ahead of surgery by strengthening his upper
body, hamstrings and thighs. He also lost weight to minimize the load
on his new joints and modified his home by constructing an entrance ramp;
installing safety bars and raising the toilet. Surgery was set for March 8, 2016.
“I highly recommend staying in the inpatient rehab unit,” Ruben
said. “It gave me a great head start. What was so different about
CVMC’s approach to rehab was that they didn’t just work on
my physical therapy – they also helped me figure out how to shower,
put my clothes on, and consider what challenges I would face once I got
back home.” For example, Maude Williams, Occupational Therapist,
is shown (at right) helping Ruben use an assistive device to slip on his
shoes despite the challenges of limited flexibility and functionality
common during the early recovery period following a double knee replacement.
Physical Therapists helped him get up and moving on his new prosthetic
knees the same day he had the surgery. On day 2, they helped him take
a short walk down the hallway. From there, his motivation fueled quick
progress during his 7-days as a patient in the CVMC Inpatient Rehabilitation facility.
Rehab Care Coordinator Heather Bissell, LRT/CTRS said, “Ruben is
a model patient. It was like night and day to see the progress he made
during his time in our unit. He impressed us with quick gains in his functional
improvement measures (FIMs) demonstrating increased range of motion goals
including achieving full extension, getting his knees completely straight,
an often difficult task following knee replacement.”
FIMS are specific measures based on functional activities that allowed
his caregivers in the Rehab unit to assess his progress and ability to
carry out activities of daily living before Ruben was discharged and allowed
to return home. Pictured above, Jennifer O’Neil, CVMC Physical Therapist
assists Ruben climbing stairs. The upper body strengthening exercises
he did before surgery helped Ruben grip the stair rail and assist him
up the steps during his recovery period.
The Functional Assessment Specialists, the Uniform Data System recently
recognized the CVMC CARF accredited inpatient comprehensive rehab program
as a “2016 Top Performer”. This is the second time CVMC has
made this prestigious list of top-performing rehab facilities for sustaining
outcomes in the top 10 percent among almost 800 rehabilitation facilities
across the nation. The data considered includes outcome measures such
as discharge to the community, length of stay efficiency and patient functional
improvement. CVMC’s rehab unit has implemented a number of initiatives
that have helped achieve this continued recognition. To learn more, please
contact Mimi Stachowski, Director Inpatient Rehab/Acute Therapy at
mstachowski@catawbavalleymc.org.