A Joint Effort

Her family noticed something was wrong on one of their usual outdoor adventures. ​“We’d go hiking in the mountains. Hiking up those steps, I was in pain. Bike riding, if it was too much of an incline, I could feel it. My husband was concerned because he started to see the quality of my life going downhill. It got more and more painful.”

Janet and her husband Tim moved to Laramie from Fort Collins a few years prior. She was prepared to drive to Colorado for care, but she was not excited about the prospect of traveling. A close friend recommended she check out Ivinson’s Orthopedic Clinic to see Dr. Burk Young. 

Dr. Young joined the Ivinson team two years ago after moving from Douglas, Wyoming. He has over 25 years of experience in orthopedic surgery, and specializes in a wide variety of procedures of the hand, shoulder, hips, knees, foot and ankle. In addition to his wide depth of general orthopedic knowledge as a surgeon, Dr. Young is known for being a friendly face and a calm presence with patients that are facing serious or life-changing operations. Janet and her husband liked him immediately.

Snap, Crackle, POP!

“On my first visit with Dr. Young, I looked at him and said, ​‘do you want to hear what my knees do,’ and I just bend, and the popping is so loud. The look on his face — I’ll never forget. I’m thinking of how many knees he’s worked on. He smiles at me and says, ​‘can I bring my staff in to hear this,’ and my husband laughs and I realized, wow, I’m experiencing something they haven’t seen before.”

Dr. Young remembers hearing the sound of Janet’s knees popping in his office, and recalls the utter shock of her condition. She had almost no cartilage between the joints. In his 31 years of experience, he’d never heard anything like it. 

“She came into my office with severe pain and arthritis in both knees,” Dr. Young recounted. ​“Some of the worst knees that I’ve ever heard. It was so alarming, her knees actually sounded like firecrackers going off. She’d been living with this pain for many, many years.”

At that point, Janet had been through Ivinson’s imaging department with an x‑ray of both knees and an MRI of the area, so the team had a good sense of the situation they were working with. One of Dr. Young’s priorities is for patients to feel as informed as possible. ​“I use a lot of visual aids, and I’ve found that helping people understand the full scope of their problem helps ease a lot of anxiety,” he said. ​“I think the first thing we do is try to help them understand that they don’t necessarily have to jump to surgery. I think that’s important. A lot of patients are relieved to know that there’s options out there for them other than surgery.”

In Janet’s situation, a partial knee replacement would turn out to be the best course of action to give her the most optimal quality of life moving forward, given her active lifestyle as a 72-year-old. Dr. Young reassured Janet that she had options, and made sure she felt confident in her decision to have knee-replacement surgery.

“Osteoarthritis, which is wearing and degeneration of a joint, is very common,” said Dr. Young. ​“The knee and the hip, these are both weight-bearing joints. We see a significant number of patients with varying stages of arthritis in their knees and their hips. As the population continues to age, we’ll see more and more of these kinds of cases. We offer a wide variety of options, ranging from anti-inflammatory medications, to bracing, to physical therapy, to steroid injections, physical things that we can do to try to get them feeling better before they have to have an operation.”

Dr. Young showed Janet a physical model of a knee and walked her through the process of having two surgeries in the course of year, and explained what the recovery process would look like after. Janet said she went into the consultation full of nerves and left the appointment confident that this plan would make her feel better in the long run. 

“He was warm, he was professional,” Janet said of her experience. ​“He was so down to earth, and he reached out to my husband as much as me when we were in the room together, like a family approach. I felt like he really cared for me and he appreciated my opinion. He really wanted me to be involved in the decision making.”

Surgery and Rehabilitation

After the initial consult in January, the first partial knee replacement surgery was scheduled for March. Janet had never had this kind of major operation before, having only visited a hospital to deliver her two children when she was a young mother. As an older adult, preparing for surgery can be intense. She was nervous about the experience, but Ivinson’s care team put her at ease. 

“[Dr. Young] actually was hilarious. He was all in gowns and his hat and stuff, and he peeked over into the room I was in, and loosened me up with a sense of humor and positive attitude before they took me to the operating room. He took all the nerves that I was having by just being himself. I looked at my husband and said, I’m not nervous anymore. I feel like I’m in good hands.”

Both surgeries (about three months apart) went smoothly, and Janet was on the long road to recovery. The orthopedic team prescribed outpatient rehabilitation immediately following. The objective was to increase mobility in both knees and create the maximum range of motion possible while the tissue recovered. Janet got to know the rehab team at Ivinson quickly, as she was there working her knees three times per week. Physical therapy can be uncomfortable, and pushing her new knees to the limit started to take a toll.

“After the second surgery, and I was in a lot of discomfort,” Janet recalled. ​“The recovery took longer on that one. I came in for my physical therapy, and my therapist Jesse asked ​‘how are you doing?’ I just started to cry. He stopped everything and pulled me aside to a private space to talk about it. They put the agenda down and just focused on me. I felt so immediately cared for.” Janet became a little choked up, remembering the work it took to gain mobility again. ​“I think there’s times I forget how well I’m doing because the progress was so slow. I was getting discouraged a little bit, doing two surgeries right back to back. It so impressed me that everyone checked in with me as a whole person and understood my struggles, and I stopped crying.”

Ivinson’s rehabilitation team works closely with the orthopedic providers to walk patients through recovering mentally and physically from the trauma of an operation. Keeping patients’ continuity of care from first appointment, to surgery, to recovery and life afterward is important to Dr. Young and his approach to patient care.

​“As a surgeon, I go in and do the work, and then I have to ask patients to push the limits of their joint, and it’s very painful for people to do that,” Dr. Young said. ​“I think they need a coach, a therapist, that they can trust. I think we have a good physical therapy department that allows them to establish a rapport with their therapist and making sure that they achieve their goal to help each specific situation.”
Janet saw the physical therapy team for five months and checked in with Dr. Young regularly to track her progress in terms of getting back to her active lifestyle. Progress happens slowly and steadily, and it’s important that patients prioritize their range of motion up to a full year after the operation, or, in this case, two operations. That kind of consistency can be challenging to sustain. Janet was open and honest about how difficult it was to heal.

​“I was getting so tired, and I kind of stopped doing the exercises they wanted me to do at home. And on one of the visits I had with Dr. Young, he gave me an exercise to do working on the degree of my bend of my knee,” said Janet. ​“So, my next office visit with him, [he] asked me if I had been doing that exercise.” Janet looked at him nervously, and said she hadn’t been doing them. ​“He had such a concerned look on his face, he was genuinely worried about me. I didn’t get a stern rebuke, but I got this concerned response from him that I thought to myself, ​‘I don’t want to disappoint him.’ And that was the wakeup call for me. I saw the seriousness in his face. And from that day on, I did my exercises,” she said with a laugh.

Trusted Team

Establishing that trust in the beginning is crucial to encouraging a promising recovery process, according to Dr. Young. ​“I think patient expectations are very important,” he said. ​“I try to make sure that their expectations align with my expectations, and when you can do both of those things, you see really great outcomes.” For Dr. Young, patient-centered care is at the core of his practice, and of his life. 

“What drives me to do what I do is the satisfaction I get personally of helping patients like Janet. Seeing the joy that comes to them once they can overcome some pain and be able to do activities they haven’t done in a long time. It is pretty satisfactory. I’ve been here living and working in Laramie now for just over two years, and the relationships I’ve built with our network and community are so valuable.”

When asked about her experience and what made it possible for her to feel so positively about her surgery story, Janet says the personal approach of the Ivinson team made all the difference. 

“I have recommended Dr. Young to so many people. He’s almost like family and that’s a rare experience I think. He was more than a surgeon to both Tim and me. It was like there was a development of a friendship.”

The rapport that Janet and Tim built with Dr. Young was mutual from the start. Dr. Young spoke of the experience as developing the kind of bond he hopes to have with all of his patients. ​“Janet and Tim are one of those couples I’ll never forget. They were so always very cheerful, positive and optimistic about her journey. She was just a delightful person, and her husband, likewise, a very dynamic individual, and very pleasant to be around,” Dr. Young recalled, smiling.

“I take great satisfaction in being able to help a person overcome their orthopedic trials and challenges, get them back to living a more pain-free way of living.” he added.

Janet and Tim Johns are largely back to their old lifestyle of high activity in the Laramie community. Janet loves to garden in the summer, and she’s excited to be able to use her new knees on the ski slopes at Laramie’s local ski area, since visitors over age 70 can ski for free. She and Tim have wasted no opportunity to travel and enjoy the things they love together. 

“It’s so humbling to look at what I’ve accomplished and learned about myself in this process,” Janet said. ​“My friends and family that don’t live in Wyoming, they say how fortunate we are to have such a great hospital staff in a town the size of Laramie, not a big city. I tell them, why would I go anywhere else?”