CATHOLIC HEALTH EAST
Maria Ferreira was told time and time again she was too young for a hip replacement surgery. Too bad her hip never got the word. Last year, at age 55, Ferreira could not tie her shoes, climb the stairs or sit at the dinner table.
Many physicians are reluctant to do hip replacement in younger seniors because the hardware can wear out over years and second surgeries may be considerably more complicated.
"Every time I talked to my doctor, he said I was too young for a hip replacement," said Ferreira, a former housekeeper from Newark, N.J., who first complained of hip pain to her doctor some five years ago. "He kept on coming up with excuses not to do it. And yet I was in so much pain. It was like I was dead. I was living, but I had no life."
Based on the doctor's advice, Ferreira delayed surgery.
She met Dr. Richard Boiardo, an orthopedic surgeon practicing at St. James Hospital in Newark, when she was working as a housekeeper at the hospital. Years later, she would become his patient. (St. James closed its acute care operations in 2008 and now is a nonacute care campus of Saint Michael's Medical Center in Newark.)
By the time Ferreira reconnected with Boiardo, she had lost her health insurance and didn't know how she would afford the surgery. Boiardo told her of Operation Walk, a nonprofit through which he provides free joint-replacement surgeries for uninsured people and others with barriers to care. In March 2010, Ferreira became one of the first patients to have found relief from debilitating orthopedic pain through Operation Walk. The initiative, which Boiardo leads at Saint Michael's, helps New Jersey's most vulnerable — those who are poor, have HIV or hemophilia or have no health insurance. Boiardo is director of orthopedics at Saint Michael's. To date, Boiardo and Saint Michael's have donated some $200,000 in services to patients through Operation Walk and the program has helped 15 patients.
"These patients are significantly disenfranchised," said Boiardo. "Just because it is not a life-or-death situation, does not mean these patients aren't suffering. They are victims of benign neglect."
Boiardo was inspired to support an Operation Walk program in Newark after joining his mentor Dr. Lawrence Dorr on a medical mission to Moscow. Dorr, an orthopedic surgeon and founder of the Dorr Institute of Los Angeles, started Operation Walk in 1995 to provide free surgeries around the world.
Boiardo said much more must be done to reach the most vulnerable patients in Newark and environs, but Operation Walk is a step in the right direction. "Sometimes instead of cursing the darkness, what you need to do is light a match and see the solution."
Before reaching Boiardo, many patients have been bounced from clinic to clinic and felt desperate and ignored by their physicians. Boiardo says many doctors don't want to take on the financial burden of performing surgery on a patient with no job or insurance. Others are wary of operating on patients with HIV or hemophilia, conditions that increase the potential for complications and therefore may add to the cost of the procedure. He expects the problem of access to grow as baby boomers age and begin to suffer joint deterioration from arthritis, avascular necrosis and other conditions.
"You get a lot of, 'Take an anti-inflammatory' or 'Lose some weight,'" said Boiardo. "And the pain continues. And it's just not the physical discomfort. Chronic pain changes your personality."
That was the case for Ferreira, as her pain progressed to the point that it derailed her life. "I was so unhappy," said Ferreira "I stopped going to church. I stopped going out with my friends. Every time I would go out with my family, we would have to cut it short because of the pain. In the end, I was just spending all of my time in bed."
Boiardo performed a complete hip replacement on Ferreira. She was up on her feet the next day and walking without her cane in a month. And this summer, Ferreira returned to her native Portugal to visit her ailing father. Up till then, the pain had prevented her from traveling.
"I was so thankful that I could see my father while he is alive," said Ferreira. "It made me mad that I had lived so long with this pain for no reason. But I also felt so relieved that finally someone was listening. Now I can take care of myself. I can tie my shoes and clip my toe nails."
And dance. Boiardo said he will never forget watching Ferreira dance at an Operation Walk fund-raiser last fall.
"It was so moving for all of us," said Boiardo. "The patients have been changed by this experience, but so have we."