Tuesday, November 9, 2010

Pennsylvania woman with Down syndrome back in the pool to win her 109th Special Olympics swimming medal after hip replacement

From The Pittsburgh Post-Gazette:

There are a lot of inspirational stories among patients who have received hip or knee replacements. They're able to return to the golf course, go back to running or even walk without a limp or pain for the first time in years.

Then there's Kristen Lindsey's story.

Just three months after receiving a hip replacement in February at Magee-Womens Hospital of UPMC, the Butler resident won her 109th gold medal in Special Olympics competitive swimming.

"Kristen was the most amazing patient," said Anthony DiGioia, medical director of Magee's Orthopaedic Program which recently held its annual reunion for patients to celebrate their victories. "She had an impact on every person she came into contact with in our program.

At 35, she's younger than most hip-replacement patients; the average age of those in Magee's program is 65.

Ms. Lindsey has Down syndrome, a genetic condition that can result in hip instability for some individuals as they age.

At last month's reunion at Phipps Conservatory that drew 600 patients and their guests, Ms. Lindsey gave the keynote speech about her experience.

"I had a significant limp and hated the way I had to walk," she said. "I would feel the pain when I walked, when I moved the wrong way, or when I rolled over in bed. The pain got worse and worse."

Swimming had also become difficult for her. At practice one day, her hip locked up and she had to remain in the pool until her muscles relaxed.

At that point, it was clear that something had to be done,she said.

Her recovery from the surgery took the best possible trajectory. Eight weeks after the surgery, she returned to swimming practice. By 12 weeks, she had won her medal.

Ms. Lindsey said she was determined to return to competitive swimming.

"I graduated from a walker to a cane. Then I was able to walk without assistance. I rode the stationary bike, practiced walking up and down steps, and even danced with my physical therapist. I did my exercises faithfully twice a day and my hip got stronger.

"I have overcome many obstacles in my life," Ms. Lindsey told the reunion attendees. As a person with Down syndrome, "I was supposed to have limited speech, but as you can see, I don't have a problem in that area."

In fact, Ms. Lindsey is a frequent public speaker. She is a Global Messenger for Special Olympics and has spoken to groups as large as 6,000 people.

Asking patients such as Ms. Lindsey to recount their "journeys to wellness," as Dr. DiGioia puts it, is a standard component of the Orthopaedic Program, which does about 900 hip- and knee-replacement surgeries a year.

Patients are encouraged to write up their personal stories for the program newsletter or share them by phone, e-mail or in person as "orthopaedic ambassadors" for new patients. Patients can also serve on a patient advisory board.

Engaging patients in this way is mutually rewarding, said Dr. DiGioia. "It works both ways. We get resources and feedback, and the patients want to give back. It's very satisfying to them"

Capturing patient stories and forming patient advisory councils are just two of the recommendations Dr. DiGioia offers as founder and medical director of the Innovation Center, a project at Magee-Womens that "packages and exports" the principles of person-and family-centered care within UPMC and beyond. The program has stimulated the creation of 30 working groups within UPMC.

Dr. DiGioia, 53, a Penn Hills native who graduated from Central Catholic in 1975, credits his undergraduate and graduate engineering studies at Carnegie Mellon for shaping his ideas about process improvement tools in health-care settings.

After stints at UPMC Shadyside and West Penn Hospital, he became medical director of the Orthopaedic Program at Magee-Womens four years ago.

The goal of the person- and family-centered care in this program is to help the patient feel well-cared-for in every aspect of the experience -- from the first office visit to the transition to home and rehabilitation, said Dr. DiGioia.

Ms. Lindsey said her experience met that ideal. The procedure itself was successful, and she has achieved her goal of swimming without pain.

But the best part, she said, "was how kind and caring everyone was to me."