Our five esteemed Orthopedic Surgeons work in three different offices:
- Dr. C. Philip Volk's office includes a physician assistant and dedicated office staff. They are located at 206 Cornelia Street, Suite 105 on the Medical Center's Campus.
- Drs. Pamela Reinhardt, Thomas Kneifel (www.orthodoc.aaos.org/Kneifel) and Dr. Howard Black work together in one office with Dr. Black focusing on medical orthopedic care and Drs. Reinhardt and Kneifel performing surgery. Along with their busy and capable staff, they are located at 96 Court Street.
- Dr. Mulligan practices alone with the support of office staff. They are located at 206 Cornelia Street, Suite 101.
CVPH Medical Center has a large radiology department, providing a wide range of diagnostic testing both at the hospital and at Valcour at Degrandpre Way, including X-ray, MRI, CT scan, ultrasound, mammography, nuclear medicine, interventional vascular procedures and PET scan.
Various imaging services are often used to help the physician with your specific plan of care. Your physician will determine what studies are needed before, during or after your orthopedic care. Examples of such exams may be X-rays of the area of interest taken post-operatively or performing an ultrasound prior to discharge to ensure that there aren't any underlying issues with blood flow. The Technologist will explain the exam beforehand.
Total Joint Replacement Education Program (TJREP)
CVPH offers a free class to all patients scheduled for total knee or total hip replacements. This class takes place twice a month in the R6 solarium at the hospital. Representatives from nursing, physical therapy, occupational therapy, and case management are present to share information with the patient and family member regarding what to expect. The information spans from what to expect when you arrive on the floor, to what to consider for further therapy after you are discharged. We encourage each patient to bring a "coach" to this class, preferably someone who can also visit in the hospital, be present for therapy sessions and assist with exercises and daily activities in the days and weeks after going home.
An important part of this education is to inform you about various options for discharge. It is important that you have a plan in mind before surgery, in case you are not able to return home after the three-day hospital stay. Preparations for home also include assessing your home for safety issues, such as throw rugs, clutter and furniture that are not safe to use after surgery.
Click here to learn more about these programs.
Before, During and After Surgery
Before Your Surgery
When your surgeon's office makes gives you a date for surgery, they will also give you a phone appointment with the hospital to do your assessment and to get registered. During this conversation you will be asked to provide personal and medical information.
The pre-operative testing at the lab will also include a nasal swab. The technician will hand you a swab and ask you to swab the insides of both nostrils and then hand the swab back. This test is to find out if you have a bacteria call staphylococcus aureus, commonly referred to as staph. Staph and other bacteria living on your skin usually have little effect on you but it is important to know that:
•When having surgery these bacteria put you at risk for an infection.
•In order to eliminate as much of the bacteria as possible before surgery, there are some important steps you must complete at home in addition to thorough hand washing.
If your test is positive for staph, we will mail you a medicine (nasal ointment) called mupirocin (Bactroban) with instructions on how to apply this medicine.
To further prevent an infection after surgery:
1.) You need to shower with a special antimicrobial soap (Hibiclens) three times before surgery. This soap will be given to you at the surgeon's office. If you do not receive this soap at the office ask for it.
Clean yourself with the soap (pick one of the two below):
a. Two days before, one day before and the morning of surgery (3 days)
b. Three days, two days and a day before with the last shower being the night before surgery (3 days).
2.) For each treatment that you do at home, both the shower (all patients) and the nasal ointment (only if it is mailed to you) please place a check-mark in the appropriate box on the check-list you received at the surgeon's office.
Please bring the check list with you to the hospital on the day of your surgery. It is important for the surgical staff to know that you performed the appropriate treatment.
Instructions for Showering with Hibiclens
(be sure you have a clock with you when you shower)
1.) Clean your body with your own personal soap, shampoo and conditioner first.
2.) Rinse thoroughly to leave no trace or residue on your skin.
3.) Turn off shower and apply the antimicrobial soap (Hibiclens) given to you at the doctor's office to your entire body. Clean all areas from the neck down thoroughly for three (3) minutes without running water over your body.
4.) Pay particular attention to cleaning your private area, chest, belly-button, skin creases, arm pits and between your toes as well as the area where you will have surgery. Do not scrub the skin too hard and avoid the vaginal area.
5.) After 3 minutes of cleaning your skin with the antimicrobial soap (Hibiclens), turn on the shower and wash the soap off completely.
6.) Pat your skin dry. Do not apply any other soaps, lotions, creams or sprays.
7.) Do not shave any hair below the nexk the day before or day or surgery.
8.) Follow this routine for three days before surgery, the last time being either the morning of the surgery or the nigh before surgery.
The surgeon's office will also give you instructions regarding pre-operative blood work and other testing as necessary. This has to be completed before you can have surgery.
You will arrive at the appointed time in the surgical waiting area on the second floor of the hospital. The easiest way to get there from the main lobby is to take the S elevator, which is located in the lobby and will take you straight up to the second floor waiting area.
You will then be taken back to the pre-procedure area to be prepared for surgery. This includes verifying that you have not had anything to eat, that blood work has been done, and any other last minute checks. During this time, you will also be asked to participate in marking the surgical site, to prevent mistakes from happening. You will meet the surgeon, nurses and anesthesiologist that will be doing your procedure. This is a private area so a limited number of family members may stay with you for part of the time until you go into the operating room.
You will be asked whether you completed the antimicrobial wash for three days and whether you applied the ointment in your nostrils, if you were asked to do so due to a positive test for staph aureus.
Once you are in the operating room you will be given either general or spinal anesthesia, depending on your physical health and you and your doctor's preference. The surgery takes a few hours, depending on which procedure you are having.
When you leave the operating room, you will be taken to the recovery room. The nurses will work with you to control your pain, monitor your vital signs and assist in your recovery from the anesthesia. An x-ray will be done to make sure the new hip, knee or other implant is properly positioned. You will spend about two hours here and your family members may visit with you for a short time during your recovery.
Following your stay in the recovery, you will be taken to the medical/surgical floor R6. If you had a total knee or total hip surgery, you will go to our Joint Camp at the back of R6.
Our surgical suites are brand new and feature the latest in technology. All of our orthopedic surgeons are board certified and our excellent nursing staff is working on advanced certification at this time, to provide the best possible care for you before, during and after your procedure.
Many institutions nationwide have adopted the concept of a Joint Camp for their joint replacement patients. The purpose of the Joint Camp is to place patients with the same surgery in the same part of the unit, so that they can share the experience. This may entail having therapy together in the gym, having education session together before surgery etc. Each patient is encouraged to bring a "coach" along, both to education sessions before surgery and for the therapy sessions while in the hospital. This person, a family member or friend, will help motivate and support the patient through the whole experience. Each day during the hospital stay, the patient will receive a newsletter educating him or her on the tasks for the day and what to expect.
The orthopedic service line is addressing many aspects of care for the orthopedic patient. We are continuously looking for ways to improve the patient experience, including better control of pain after surgery and finding ways to help you get better faster. Our patients can expect us to deliver very good care.
However, as with any good partnership, we also have certain expectations of our patients. For instance, the patient does need to be prepared that there will be some pain they will have to endure after surgery. We will work with you to establish a system that best controls the level of pain, but there will be some discomfort – especially on the first day after surgery as patients are asked to get out of bed and start moving around with the therapists. It is of utmost importance that the patients participate in rehab from the very beginning, in order to have the best outcome at the end. On the day of surgery, you will be assted to sit on the edge of the bed and you may get up to a chair with assistance if you wish.
We also expect the patients to let us know immediately if there is anything else we can do for them, or if they have concerns. We can only fix what we know about.
CVPH Rehabilitation Services has three outpatient clinics, located at 179 Tom Miller Road, 295 New York Road, and16 DegrandPre Way. We offer Physical, Occupational and Speech Therapy. Appointments are available Monday through Friday from 7 a.m. to 5:30 p.m. for Physical Therapy and 8:30 a.m. to 4:30 p.m. for Occupational Therapy. The Speech-Language Pathologist is available as needed three days a week. The Rehab staff utilizes the best exercise equipment available to improve movement, strength, endurance and function in order to assist patients back to their optimal level of activity. The therapists also rely on the use of manual techniques to manipulate tissue to achieve pain control, tissue healing and greater flexibility.
Specialty programs offered:
- Aquatic Therapy: Rehabilitation in heated pool
- Athletic Rehabilitation: Sports injuries
- McKenzie Treatment: Back, neck and extremity problems
- Pediatric Treatment: A different focus tailored to children
- Lymphedema Treatment: A specialized technique to rid your extremities of fluid build up after surgery, mastectomy etc.
- Saebo Arm Training: Use of an orthotic device to retrain arm function after a stroke
- Language: Swallowing and cognitive rehabilitation, including making arrangements for a Videofluoroscopic Swallow Study to be completed as an outpatient at the hospital
- Clinical Integration: While participating in outpatient rehab, you may use the Wellness Center at PARC free of charge.
- Transition Program: After discharge from therapy, this program lets you continue your exercises using the Wellness Center at PARC facilities for 4 weeks at a reduced cost compared to membership. The Wellness staff and the Rehab staff work together to ensure a seamless move.
- Certified Hand Therapist: For injuries and surgery to fingers, hands and arms
- Craniosacral Therapy: A gentle hands on technique to work with spine, skull and fascia to reduce pain and restore function
- Myofascial Release: Manual technique to work with the tissues of the body to loosen tightness caused from trauma and illness
- Pelvic Floor Treatment: Designed to provide pain relief and restore function for those suffering from incontinence, pelvic pain etc.
- Vestibular Therapy: Specific evaluation and treatment for people with vertigo
Our staff works closely with area physicians to provide the best treatments possible for patients.
Appointments can be made for any of the facilities by calling 562 – 4616. When you call, one of our team members will be happy to make arrangements for your first visit. All we need is a referral from your physician and your personal information.
We accept private pay, Medicare, NYS Medicaid, Worker's Compensation, No Fault and most commercial insurance carriers. We will obtain authorization from your insurance company as needed. You will be asked to provide the co – pay set by your insurance carrier at each visit.
For your first visit, please bring your insurance card, the referral from your physician, your co - pay and any other pertinent medical information you might have. If you will be receiving therapy for your hip, knee or lower leg it is recommended that you bring a pair of shorts to change into.
We ask that you arrive 15 minute early for your initial visit in order to complete some paperwork. We also ask that you complete the registration process over the phone prior to the day of your visit, by calling 562 – CARE (2273)
Our therapists will evaluate you on the request of your physician and recommend a treatment based on what you were doing before your illness, your current function and your goals. The plan will be tailored to your particular situation and need. Our inpatient services are available 7 days a week.
The inpatient rehab team offers, in conjunction with CVPH nursing and case management staff, a free class for patients who are scheduled for a Total Hip or Total Knee Replacement. For details, call 562 – 7599.
The rehab team offers both individual and group treatments at the Joint Camp. For more information about the Joint Camp.
Other Services Provided by Rehabilitation Services
Rehabilitation Services also provides services for patients who are admitted to a short-term rehab area on our skilled nursing facility. These beds are designated for patients who have no need for acute care anymore, but are not quite ready to go home. A typical stay lasts for 7 – 20 days. We tailor our treatments to what you will need to be able to do in order to be successful at home, to prepare you for a comfortable discharge. We emphasize education to you and you family, so that you can continue to maintain your function at home.
Typically, the Physical Therapist will work with you on ambulation, leg strength, walking stairs, endurance etc., while the Occupational Therapist will address your ability to do your self care and other daily activities like dressing, bathing, toileting, folding laundry, kitchen activities etc. We focus on those activities that are meaningful to you and allow you to participate in life to the largest extent possible.