'Bloodless' surgery a godsend for Jehovah's Witness
By Robert Armengol
Staff Writer
A motorcycle accident had left Kalen Stolenwaters with a right leg an inch-and-a-half shorter than his left. Surgery at Warminster Hospital's Center for Bloodless Medicine fixed the problem and took away the pain.
WARMINSTER - Since opening its Center for Bloodless Medicine barely a year ago, Warminster Hospital has seen more than 100 patients opt for procedures that reduce blood loss and eliminate the need for transfusions.
But none has a story to tell quite like Kalen Stolenwaters, a 51-year-old Jehovah's Witness who drove three hours from Luzerne County in search of salvation from the severe arthritic pain that he lived with for 29 years rather than defy his God.
A bad motorcycle wreck on his honeymoon in 1972 left Stolenwaters' right leg an inch-and-a-half shorter than his left. The resulting limp in his gait gradually ate away the cartilage around his hip joint, forcing Stolenwaters to walk, as he put it, "like a hunchback."
"When I step outside of myself," he said, "I can see the tragedy of it. There's a strapping young man hurt in an accident with his whole life ahead of him. Then, over the course of 30 years, he becomes deformed."
Stolenwaters doesn't deny the role he played in choosing his own path. Like other Jehovah's Witnesses, he refuses blood transfusions based on his religion's strict reading of biblical text. And doctors had told him they wouldn't open his thigh, replace his hip and lengthen his leg without relying on stored blood.
Until he called Warminster.
Surgical techniques for limiting blood loss have been around for a long time. They include scalpels that cauterize as they cut, coagulators that clot bleeding vessels on contact, hormones that stimulate the production of red blood cells and "cell-saver" machines that re-circulate a patient's own blood.
Warminster Hospital is one of a short but growing list of institutions trying to capitalize on all those techniques, and more.
"We're not using anything new or different here," said Randy Thomas, coordinator of the hospital's bloodless medicine program. "All the modalities are there already. It's just about bringing them all together into a cohesive form of health care."
The hospital also has a strong orthopedic staff, making it a good match for Stolenwaters when he decided last year it was time to repair his body and his life.
At the time, he had given up his cleaning business and was popping Percocet and other pain-killing pills. He also took occasional shots of Toridal to soothe the pain that had radiated to his knees and back.
"I could tell all this stuff was making me dopey and goofy," he said.
When Stolenwaters first called the hospital, he said, he had a hunch he had found the right place. When he arrived for his first interview later, the hunch was confirmed.
"A lot of times, just because we're Jehovah's Witnesses, people think we're like computers spit out of an assembly line, like we don't have our own thoughts and idiosyncrasies," he said. "But they seemed to be really interested in my feelings."
Stolenwaters saves his highest words for Dr. Anthony Balsamo, an orthopedic surgeon at Warminster and a professor at Hahnemann University's medical school. Balsamo doesn't share the same beliefs as Stolenwaters, but he never questioned them.
"I could tell he took this really personally," Stolenwaters said. "I felt like he liked me, like he stretched out to me."
Dr. Balsamo shrugs off the praise.
"Fifty percent of the work I do is done by the patient," he said. "As I'm getting older, I'm realizing that more than ever."
As for the other 50 percent, the surgeon said, he got help from the hospital's hematologists - who put together the bloodless regime for each patient - and other doctors who helped Stolenwaters through a week of recovery after the operation in August and have continued to see him since.
But it was Balsamo who carefully sliced off the top of Stolenwaters' right femur and replaced it with a ceramic prosthesis expected to last longer than traditional metal parts, then linked it to a plastic-filled cup - the new hip. And he managed to do it without ever using the cell-saver machine.
Balsamo said he believes stored blood has its place, but that the bloodless movement will eventually become a standard in surgical care - one that could save money spent each year on complications stemming from transfusions and conserve the nation's blood supply.
"I'm going to come to the point where I demand this for all my patients, for no other reason than that I want them to have better care," he said. "There isn't a doctor on Earth who wouldn't want to be operated on in this way."
Today, Kalen Stolenwaters stands taller than most at 6 feet. He walks normally. He has no more pain.
"It feels exactly like it should feel," he said. "People are constantly telling me I look like a different person."
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