Letitia (Panama 2012, 2013)
The Operation Walk Syracuse team first met Letitia in 2012 when they traveled to Panama City, Panama for the first time. Letitia was in desperate need of bilateral hip replacements because of avascular necrosis in both hips.
Avascular necrosis is a condition that occurs when blood flow to a bone is interrupted or reduced causing the bone to die. This condition can be caused by an injury to a bone or joint, or by some medical conditions that increase pressure within the bone causing the blood flow to be restricted. In Letitia’s case her condition was caused by sickle cell disease which makes it more difficult for fresh blood to enter the bone.
Letitia couldn’t remember the last time that she was free from hip pain both during activity and at rest. In fact, her horrific hip pain woke her frequently during the night. At age 28 she was still living with her mother, dependent upon her in many ways and unable to live an independent life or fulfill her dream of attending college, getting married, and starting a family of her own. Letitia’s eyes pled with us the first time we met her in the screening clinic, her pain and suffering apparent to the entire team. Letitia was quickly moved to the top of our surgical priority list due to her young age and severity of disability and pain. Her surgery would not be without challenge and risk though. The sickle cell disease which predisposed her to develop this condition also increased the risk for complications both during and immediately following her surgical procedure.
Sickle cell disease is an inherited blood disorder that affects millions of people around the world. Red blood cells contain hemoglobin, a protein that carries oxygen in the blood. Normal red blood cells are round and flexible, which enable them to travel through small blood vessels to deliver oxygen to all parts of the body. Sickle cell disease causes the red blood cells to form abnormal shapes, clump together, and adhere to the walls of blood vessels, blocking blood flow. Not only did this condition lead to the problem in her hips, but it could also easily cause the painful event known as sickle cell crisis which is known to be triggered by infection, dehydration, and stress - all circumstances that can occur during surgery.
The medical, surgical, and anesthesia teams conferred to develop a plan of care that would manage her case in a way that would minimize the risk for sickle cell crisis to occur, but there were no guarantees.
The surgery in 2012 went flawlessly and Letitia took her first steps the afternoon of her surgery. She immediately began to cry. As the nursing staff quickly intervened to determine the source of her distress, Letitia only smiled through her tears. Through the interpreter she told the nurses that she was shedding tears of happiness for being pain free in her left hip for the first time in years. As the team departed Panama in 2012, she embraced them and stated “I will be counting the days until you return next year. I am so grateful for you giving me the opportunity to live a normal life.”
Exactly one year later in 2013, the Operation Walk Syracuse team arrived at the screening clinic as St. Tomás Hospital and witnessed Letitia descending a long flight of stairs without the use of crutches or a cane. Letitia was returning to the hospital to fulfill the remainder of her dream; to have her right hip replaced and experience the pain free state that she had experienced with her left hip during the past year. She updated the team that since they had last departed, she was mobile enough to attend college classes. Once the other hip replacement was completed, she would begin to look for an apartment and forge the independence that had for so long been impossible for her.
The second surgery was as successful as the initial procedure and she reported to the team that for the first time ever, she slept through the night totally free from hip pain. The team waved goodbye to Letitia on the second postoperative day as she climbed into a taxi with a warm smile, bright eyes, and a message of gratitude to everyone for providing her this opportunity.
Cynthia (Syracuse, NY)
Dr. Seth Greenky had known Cynthia for several years.
When he first met her she was a 46 year old maintenance supervisor whose knee arthritis was progressively deteriorating. She had her first knee replacement in 2011 and immediately experienced relief from her pain and declining mobility. That relief was short-lived, however, and the other knee began to rapidly decline causing her tremendous discomfort and difficulty in keeping up with the activity required by her busy job.
The bad news for Cynthia was that soon after her first surgical procedure, she lost her health coverage. The life-altering surgical procedure that brought her tremendous relief for her first knee was now out of her reach. Cynthia was a hard-working member of the American workforce but affordable health insurance was now not affordable or accessible and she was not eligible for governmental assistance.
Dr. Greenky introduced Cynthia to the local Operation Walk Syracuse initiative and later that year she underwent her second knee replacement. Cynthia was most grateful to the Operation Walk Team for providing her this opportunity and enabling her to remain a functional member of the workforce and society.