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Thursday, August 18, 2016

The Road to Recovery

Posted By: Advancing Care

Two new knees and a new attitude got a Harley lover back in the saddle.

By Melissa Pheterson

Richard Granai knew he needed both of his knees replaced. Yet, for three years, he stalled and cooled his engines.

As a motorcycle instructor, active community volunteer and “a chicken when it comes to needles,” he received injections of cortisone for his arthritis as a patient of Arup Bhadra, MD, orthopedic surgeon and Head of the Total Joint Replacement Center at Good Samaritan Hospital, a member of the Westchester Medical Center Health Network (WMCHealth).

“When I tried to get up off the floor, I felt like a beached whale,” Granai recalls. “The turning point was the summer of 2015. I was in Hersheypark with my family, at the food court. I went to get up, and my knee locked up.” Massaging his leg as his young grandson ran about, he remembers thinking: This would be a very bad day on a motorcycle.

Dr. Bhadra says he and his staff offer injections, physical therapy and plenty of patient education before pursuing a surgical intervention. Together, they review X-rays and take into account both range of motion and functionality to gauge the severity of the arthritis. “It’s well-organized teamwork, which starts at my office. Patients meet the team of medical doctors, anesthetists and pain-management physicians, physical therapists, dieticians and case managers to plan out perioperative care and set up goals.”

“I tell my patients, ‘Surgery is not a decision I’m going to impose on you. We review the X-rays and the options; when you need the surgery, you are going to come back and tell me based on the discomfort you’re going through on a daily basis.” Granai, 72, was “quite active, quite adventurous, but very apprehensive,” says his doctor.

The cartilage that had cushioned his left thighbone, shinbone and kneecap had worn away to the point that bone was rubbing against bone, causing pain, stiffness and swelling. On the right knee, an intrusive bone spur had formed underneath the traces of cartilage remaining, causing severe pain when Granai extended or bent his knee.

To conquer his fear, Granai became a fixture of the monthly Total Joint Replacement meetings at Good Samaritan Hospital. “I was so scared. I wanted to learn everything I could.”

Finally, in the fall, he said to Dr. Bhadra: “Let’s do this.”

“Dr. Bhadra looked at me and said, ‘What brought you back?’” Granai recalls. “I said, ‘I guess I’ve run out of excuses.’”

Two weeks later, just before Thanksgiving, he was admitted into surgery for his left knee.

“Some people said I should go to New York City for the surgery,” Granai says. “But I trusted Dr. Bhadra — he ranked as high as anyone on the online report cards — and Good Sam is within walking distance of my house.”

Rather than slice through the quadriceps tendon to open the knee, Dr. Bhadra’s “muscle-sparing” technique creates a plane between the muscles, pushing muscles, tendons and kneecaps to the side with one small incision. He recreated the knee anatomy by inserting a metal-alloy replacement knee and plastic spacer. The result: a smooth cushion and functioning joint.

After two nights in the hospital, Granai was discharged.

“My vision was to get back on that motorcycle,” he says. “I was on a mission.”

While Dr. Bhadra observed that his patient was soon “walking excellently,” Granai was disinclined to sit back, relax or delay surgery on the right knee. His second surgery took place seven weeks later, giving him time to recover and build strength in his left leg.

Driven to ride his Harley again, Granai has taken his recovery by the reins — and the handlebars. “Attitude is everything,” he says. “My recovery and rehab are my responsibility. The physical therapists give you all the tools, but they’re not going to sit by your bed or chair, forcing you to ‘do this; do that.’”

In the spring, Dr. Bhadra gave Granai the go-ahead to ride his motorcycle again. He has since returned to visit Dr. Bhadra and the entire staff; he also speaks at the Joint Replacement Meetings at Good Samaritan Hospital.

“I’m back on the bike and back teaching,” he says. “Now I can actually grab my ankle. I want to be able to sit on my heels, and I will get there, gradually. But again, there’s only one person who will make that happen, and that’s me.”

Orthopedic Medicine at WMCHealth

Westchester Medical Center

(914) 493-7000

MidHudson Regional Hospital

(845) 483-5000

Good Samaritan Hospital

(845) 368-5000