Press Room
Dr. Garcia introduces Direct Anterior Hip Replacement;
new procedure offers quicker recovery, reduced post-operative pain
By WENDY HOFFMAN, MHA
Hip replacement surgery – it’s a big operation that can provide pain relief and improved mobility, but it has also often meant slow, restricted recovery for the patient. Orthopaedic surgeon Dr. John Garcia offers a new, high-tech alternative – “direct anterior hip replacement” - at Los Alamos Medical Center, and he’s drawing patients from around the region for this innovative procedure.
The anterior approach allows the surgeon to reach the hip joint from the front of the hip as opposed to the lateral (side) or posterior (back). This means the hip can be replaced without detachment of muscle from the pelvis or femur during surgery, Garcia said, adding that he can work through the natural interval between the muscles, sparing the gluteal muscles which are the most important for hip function. They attach to the pelvis and femur and are left undisturbed in the anterior approach, thus eliminating a lengthy healing process.
LAMC recently purchased the hanaTM Hip and Knee Arthroplasty Table – the only surgical table designed exclusively for hip and knee arthroplasty, after which Garcia quickly did his first case. The patient, he says, is recovering remarkably well, walking without a cane after only two weeks.
Operating on the hana table, Garcia explains, allows him to do the full hip replacement but spare many of the muscles that have to be cut in a traditional operation. It is, he says, this “muscle-sparing technique” that results in much less surgical trauma and a significantly shorter and more convenient recovery time. While it’s “still hip replacement,” and every patient’s response to surgery is different, it just makes sense, he says, that things will go better when you don’t have to cut through as many muscles to reach the hip joint.
In addition, using the hana table allows the patient to recover without what Garcia calls “hip precautions,” which are rules the patient had to follow post operatively – things like not bending the leg or flexing the hip in a certain position. Information from OSI, manufacturer of the table, offers additional detail on that aspect of post-operative healing.
“Conventional lateral or posterior surgery typically requires strict precautions for the patient,” says OSI literature. “Most patients must limit hip motion for 6 to 8 weeks after surgery. They must limit flexing of the hip to no more than 60 or 90 degrees, which complicates normal activities like sitting in a chair, on a toilet seat, putting on shoes or getting into a car. Simply climbing stairs may also be more difficult during recovery.”
The anterior approach allows patients to immediately bend their hips freely and bear full weight when comfortable, resulting in a more rapid return to normal function. After surgery, they are instructed to use their hips normally without the cumbersome restrictions. In supervised therapy, patients actually go up and down stairs before their hospital release, says OSI.
Garcia’s experience with his first two cases have fulfilled these expectations. The first patient, he said, is from Southern Colorado, and actually waited since last October for LAMC’s hana table to arrive, calling every month to check on progress. He’s the one who so quickly walked without a cane, just 2 weeks after his operation. He was discharged from LAMC just 2 days post operatively, Garcia added. The second case, Garcia said, was more complex, in that the patient had other unrelated orthopaedic issues, but she, too, made excellent post-op progress and went to a rehab facility only 3 days after her surgery.
The direct anterior approach was developed approximately 9 years ago in California by Dr. Joel Matta, Garcia said, adding that the specialized table is expensive, and specific training is required to use it. Garcia said he is pleased to be able to bring this technique to Northern New Mexico, noting that very few surgeons in the state are currently performing this particular surgery. He plans to use the technique for traumatic hip repair, as well as elective hip replacement, he said.
Anyone interested in exploring this new approach may contact Garcia at 505-661-9118. Initial consult appointments are usually available within a week, he said, and surgery can be scheduled at the patient’s convenience relatively soon after, if appropriate.
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Dan Wagner wins 2010 Mercy Award
By WENDY HOFFMAN, MHA
LAMC Director of Community Relations
Daniel R. Wagner, Los Alamos Medical Center’s Director of Registration, is this year’s hospital Mercy Award Winner. Established in 2002 to honor the life of Scott Mercy, founding Chairman and CEO of LifePoint Hospitals, the annual Mercy Award is the highest honor an employee can receive, recognizing one hospital staff member who best represents the spirit and values on which the company was founded. Mercy, who was killed at the age of 38 in a plane crash, was well known for his charitable acts and was, at one time, the chairman of the Board of the Tennessee Special Olympics.
Wagner, who has been employed at LAMC for 1.5 years, is described by Interim Chief Executive Officer Ruth McDaniel as “a quiet, loyal, dedicated director.” McDaniel added, “He routinely goes above and beyond in providing not only excellent customer service while the patients are in his department but also in helping to insure that the overall lasting patient perception is one of ultimate caring. He meets or exceeds all of my expectations for a committed employee and leader.”
However, McDaniel said, it is Wagner’s involvement in regional community activities, “his spirit of service,” for which he was both nominated and selected for the Mercy Award. The list of organizations to which he contributes is lengthy but all involve helping those with special needs. Specifically, through the years, Wagner has worked for Habitat for Humanity and is now accompanying his 16-year-old daughter to the neighboring community of Santa Fe to participate in their Women’s Build project.
Even more evidence of his Mercy attributes, McDaniel said, is his work with Special Olympics. He actually was touched by the need to help special children at the age of 18 when he joined the Knights of Columbus and participated in their Tootsie Roll Drive to benefit the handicapped. Later, he said, it would prove to be a pet project as his two older children were both born with special needs. He became a coach, mentor, and volunteer for SO, and says that after all his participation, he has learned that the greatest gift you can give a handicapped person is time.
“A lot of people don’t give the handicapped the time of day, but if you talk and listen, they have stories,” Wagner said. “They have feelings, desires, and a life, and time is the most precious gift you can give them. You can buy them all the presents in the world, but the best gift is time. It might take them 40 minutes to tell you a 4-minute story, but when they are through telling you, their faces really do light up.” He adds that he raised his own two special children to be productive and not use their disabilities as an excuse for failing to do their very best. They are grown now, living independently, working and have each purchase their own car. He says he’s “pretty proud of that.”
But once the older two were launched, Wagner did not stop giving back to his community. While they raise their two younger daughters, in addition to continuing to volunteer for Special Olympics, he and his wife, Ginny Melvin, are licensed foster parents for New Mexico’s Children, Youth and Family department. They provide respite care for other foster parents who need a break, and they also currently have an 18-month-old foster child of their own. He has had in his short life, Dan says, “a pretty rough childhood” and will stay with the Melvin/Wagner family until another safe home can be found. Wagner says a certain amount of detachment is necessary to welcome, nurture and then give up a child, but, he says, “it doesn’t diminish the experience for me and my wife. That child that you are patting on the back at 2 in the morning may not be there next month, but he needs your love and attention now.”
Wagner is also a member of the Knights of Columbus and has been very active in Scouting for both boys and girls (and was an Eagle Scout himself). His eyes sparkle when he talks about the rewards gained by giving time to special people. “Sometimes all I do is listen to a child’s story,” he says. “Everyone has feelings and needs to be treated as if they do.”
When asked what accomplishment he is most proud of at LAMC Wagner replied immediately that he has reduced turnover in his department to “almost zero.” He says the staff he has now is “almost all of the staff I started with,” and when asked to what he attributes this success, his answer reflects his humanitarian spirit. “We think and operate as a team. If you don’t have that, you won’t get any other accomplishments. You have to earn the respect of your coworkers, peers and employees, and you have to lead by example. I wouldn’t ask one of my staff to do anything that I wouldn’t do or haven’t done. If an employee comes to me with a problem, I ask them, ‘what do you think?’ or ‘what would you do?’ Where most employers are interested in finding out how fast someone types, or how fast they can get customers through, I am interested in the whole person and what they think. My proudest accomplishment is the relationship I have with my employees and what we do together.”
Wagner is also a black belt in Lean Six Sigma, with a heavy emphasis on defining, improving and optimizing processes, although this is his first time working in health care. His professional background includes being a pilot, running manufacturing plants, and, in his words, “flipping burgers. I know,” he says, “what it means to scrub the floor for a living.”
McDaniel says Wagner is a very deserving recipient of the Mercy Award. “Please join us in congratulating Dan on this special honor,” she said.
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Dr. Ian Alexander opens new ENT practice
By WENDY HOFFMAN, MHA
Director of Community Relations
Ian Alexander, MD, has opened his otolaryngology practice, ENT Associates of Los Alamos, PLLC, in Suite 125 at Los Alamos Medical Center. Suite 125 was previously occupied by Dr. Rod Barker, and more recently on a temporary basis by Dr. Anthony Sandoval.
Dr. Alexander will offer ear, nose & throat (ENT) services for pediatric, adolescent and adult patients. This includes the evaluation and treatment of allergies, tonsillitis and adenoiditis, chronic ear problems, congenital abnormalities of the ear, hearing loss, and hoarseness & hypernasal speech. In addition, he will treat otitis media and otitis external (swimmer’s ear), neck lumps and masses, nasal deformities and obstruction, and acute and chronic sinusitis.
In a recent edition of HealthPoint, LAMC’s community newsletter, Dr. Alexander wrote about coblation, a state-of-the-art tonsillectomy procedure he will soon introduce to Los Alamos — and he narrated from personal experience.
“Indications for tonsillectomy include upper airway obstruction (snoring and sleep apnea) and recurrent infections or throat pain. When tonsils are too large, it can lead to sleep disruptions which manifest as daytime fatigue, irritability, hyperactivity, and difficulty concentrating. Tonsil tissue is meant to trap bacteria and viruses to help prevent infection. However, if a person has very frequent tonsillitis (greater than three per year) or frequent throat pain, it’s possible that the tonsils themselves have become a source of infection.
“Traditionally, tonsillectomies have been performed using a scalpel or electrocautery. These methods can cause significant pain and a week or more of recovery. Recent advancements have made tonsillectomies much easier for the patient. Typically patients go home the same day after surgery and are able to eat whatever they want, especially ice cream and popsicles.
“My tonsils were removed using a technology called Coblation. Many studies have been done to compare techniques, but my personal experience was that I had very little pain from the surgery and was back at work 4 days later. And, yes, I ate a lot of ice cream.” He adds that the coblation procedure will represent a significant advance in treatment for area residents.
Dr. Alexander began seeing patients Aug. 6, and his office staff is now scheduling August appointments. He can be reached at 661-4147.
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New urologist joins LASA
Dr. Pavel Mourachov has joined the staff of Los Alamos Surgical Associates as a urologist. Mourachov received his Bachelor of Arts degree in Biological Science, with honors, from the University of Chicago. He earned his Medical Doctorate at the University of Pennsylvania Schoolof Medicine and completed his internship, residency in general surgery and residency in urology at the University Health Center of Pittsburg. Prior to joining LASA, Dr. Mourachov was in private practice in Pennsylvania. He is board certified in urology.
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The Endocsopy Center Now an LAMC Outpatient Department
LOS ALAMOS, NM. Aug. 6, 2008. Los Alamos Medical Center (LAMC) has purchased the assets of The Endoscopy Center of Los Alamos, LLC, effective Aug. 4, when hospital officials concluded the transaction with AmSurg and Northern New Mexico Gastroenterology Associates. LAMC then opened The Endoscopy Center as an outpatient department of the hospital and was issued appropriate licensure to operate the center by the State of New Mexico’s Department of Health (DOH) Health Facility Licensing and Certification Bureau.
“We are so very excited and pleased to be able to join forces with this excellent GI center,” said LAMC Chief Executive Officer Sandra Podley of the hospital’s latest business venture. “Its lead physician, Dr. Bradley Rowberry, is well-known in Northern New Mexico as an outstanding gastroenterologist and for the personal attention he gives each of his patients. We look forward to working very closely with Dr. Rowberry to greatly enhance LAMC’s growing surgical and diagnostic capabilities.”
The Endoscopy Center staff will continue to provide uninterrupted care as an outpatient department of the hospital, Podley said, adding, “We are also very happy to welcome these wonderful employees to our LAMC team.” The center is located at 1911 Central Avenue near Aspen Copies.
Los Alamos Medical Center is a 47-bed acute care facility and a premier healthcare provider for Northern New Mexico. Its medical staff includes approximately 100 active or consulting physicians and employs approximately 300 people. LAMC offers complete medical, surgical, obstetric/gynecologic, pediatric, emergency and diagnostic services. Its Clinic Services division provides specialists in oncology, orthopedics, family practice, and general surgery with planned expansion to urology in early fall. LAMC continues to grow its services and technology to meet the needs of the communities of Northern New Mexico. LAMC is part of the LifePoint Hospitals, Inc. family, a leading hospital company whose sole mission is to develop strong community-based hospitals in non-urban markets.
For more information about LAMC or The Endoscopy Center, call the hospital’s Administrative offices at 505-661-9500.
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LAMC welcomes new orthopaedic surgeon
LOS ALAMOS, NM, Aug. 4, 2008 - Dr. John A. Garcia joined Los Alamos Surgical Associates effective Aug. 1, 2008. As LAMC’s new orthopaedic surgeon, Dr. Garcia will provide a full spectrum of orthopaedic services including surgery and clinic hours.
Dr. Garcia is a graduate of the United States Military Academy, West Point, with a bachelor of science in civil engineering. He earned his medical degree at the University Of Texas Southwestern in Dallas and completed his orthopaedic surgery residency at St. Louis University in Missouri. Dr. Garcia received the Bronze Star Medal for exceptional service during Desert Storm leading a combat engineer platoon. Since his honorable discharge from the United States Army, he has been in private practice in Missouri and Florida, where he specialized in arthroscopy, sports medicine, and joint reconstruction of hips, knees and shoulders.
Dr. Garcia’s office is in Suite 139 at LAMC. Please call 661-9118 for information or to schedule an appointment.
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