Shortens hospital stay as well.
Dr. Ronald. Gross, left, and Dr. Andrew Doben.
The moment he hit the curb, Bill Terry, of Southwick, thought he was going to be laid up for a long, long time.
Terry, a competitive triathlete and avid cyclist, went down hard in a bike crash in Northampton in June 2012, suffering a concussion, a collapsed lung, a separated shoulder and eight broken ribs.
The severity of Terry’s injuries, particularly the blinding pain of his shattered ribs, had him concerned, as he laid on a stretcher en route to Baystate Medical Center, that his cycling passion — along with many other physical activities -- would be on long-term hold.
Until very recently, that would certainly have been the case. But thanks to a new approach to treating chest injuries, Terry and many other broken-rib patients are experiencing a much faster and less painful recovery in Baystate's trauma program, according to a hospital release..
Known as an advanced management of thoracic trauma protocol, the therapy is a significant advance from the long-held standard of care for broken ribs: treat the patient’s pain with narcotics and wait for the fractures to heal.
The new approach convenes a multidisciplinary team around the patient to look at every potential impact of the injury on adjacent organs and tissues, and to minimize collateral damage and complications.
Bill Terry, of South Hadley.
This team includes intensive-care specialists, respiratory therapists, pharmacists, nursing staff, and therapists.
Pain management is a crucial part of the new therapy.
Patients are fitted with a pump that continuously administers an appropriate level of pain-blocking medication directly to the area of injury, both before and after patients leave the hospital.
The device controls the medication delivered to ensure safe dosage, according to the release.
Treatment also features a new surgery that uses a combination of metal exoskeletal plates and pins to keep the ribs entirely immobile while damaged bone and tissue heal back together, resulting in reduced pain and a shorter recovery.
Just a few days after his fall, Terry, 49, was back on his indoor trainer, maintaining his physical condition.
Two weeks after his discharge from the hospital, he completed a 5K run. And less than three months after massive chest trauma, Terry climbed a 13,770-foot mountain in Wyoming’s Teton Range.
“When my doctors told me this new technique was an option, their confidence that it was the right thing for my injury was really contagious,” Terry said in the release.
“When I learned that it could potentially speed my recovery, there was really no question in my mind that I wanted to move ahead with it, and I’m very glad we did.”
Trauma surgeon Dr. Andrew R. Doben, who performed Terry’s surgery, developed the rib-fixation program at Baystate along with the hospital’s chief of trauma, Dr. Ronald I. Gross.
Doben says the new method can not only help active people who break ribs return to activity more quickly and easily — it can also spare people with other serious health conditions from the complications often associated with serious chest trauma.
“It’s quite common, when seniors suffer falls in the home, for them to fracture ribs, and unfortunately, this can be a very serious and debilitating injury for those who are already frail,” Doben said.
"The typical treatment in these cases — pain control and supporting the patient’s breathing in the immediate aftermath of the injury with a mechanical ventilator — has been shown to elevate risks of pneumonia, respiratory failure and other serious cardiopulmonary difficulties.”
The mortality rate for patients over the age of 55 who break just three ribs is about 20 percent.
While all surgery carries risks, Doben said the new rib-fixation technique can allow those patients with other health issues to avoid the ventilator and increase the likelihood that their recovery will be free of complications.
Patients at Baystate who have had the new operation have required ventilator assistance for an average of 0.5 days, versus an average of 16 days for those who received non-surgical treatment.
And, according to Doben, the new technique allows many patients to avoid being placed on a ventilator for anything other than the immediate post-operative recovery.
For younger and more active patients, faster recovery not only means a faster return to sports and other recreational activity, but also faster return to work.
“We recognize that in many cases, the best possible assistance we can provide to our patients is allowing them to get back to work after an injury — to keep those paychecks coming,” Doben said..
As one of just a handful of trauma centers in the U.S. using this new approach, Baystate is seeing growing interest in it, even from afar: A Pennsylvania man who was injured on a trip to Colorado recently arranged air transport to Baystate to receive the new surgery.
For Terry’s part, he’s back riding his bike, whenever the New England winter permits, and actively engaged in a host of other physical activities, with the same or nearly the same intensity as before his crash. He’s since completed a half-Ironman triathlon, too.
“I would recommend this approach to anyone who suffered injuries like mine, and who is considered a candidate for rib fixation,” he said.