Posts Tagged ‘Geisinger-CMC Scranton’

Kitch’s Knee Replacement Surgery, Part 1.

Tuesday, August 26th, 2014

America at Its Best: Memorable Moments from Kitch’s Total Knee Replacement Surgery, Part 1.

Written by Tony Mussari, Sr.
Edited by Kitch Loftus-Mussari
Digital photographs by Tony Mussari, Sr.
Copyright 2014
Mussari-Loftus Associates
The Face of America Project

A gentle word, a kind look, a good-natured smile can work wonders and accomplish miracles. William Hazlitt

Lasting Impressions

William Hazlitt’s 15 words got me thinking about1.a Entering CMC_4035 several people who helped us during Kitch’s total knee replacement surgery at Geisinger-CMC in Scranton. Hazlitt’s beautiful words were written a long time ago, but they have value to every patient and caregiver who face the reality of serious surgery. When anxiety levels are high, the actions and words of the people you meet leave lasting impressions on the heart and soul.

This is an attempt to chronicle our experience and thank the people who went out of their way to calm our fears with a gentle word, a kind look and a good-natured smile.


We arrived at the hospital shortly at 5:45 a.m. We were anxious. The both of us have had serious surgery, and we know the rules of the road as it were. Despite the early hour, we were greeted in a friendly way in admissions. After the traditional forms were signed, and Kitch received her wrist band, we took the elevator to the fifth floor.

It was 5:57 a.m. when Kitch received her room assignment and the items she would wear for surgery.

At 6:21 a.m., a pleasant nurse helped Kitch with a number of things including additional wrist bands that clearly identified cautions and vulnerabilities.

At 6:49 a.m., nurse Betsy Guinan, the Nurse Navigator for 3.a Headline_4127New Steps Joint Replacement Center, walked into our room. She presented Kitch with a personalized edition of NEW STEPS NEWS. The headline summarized the story, KATHLEEN MUSSARI TO HAVE A NEW KNEE. The lead story offered this advice, The Big Day…don’t be nervous!

This gesture brought a smile to Kitch’s face, and it helped the both of us relax. We felt very comfortable withBetsy _4117 Betsy because we had a connection with her from what we affectionately call the “knee school.” Three weeks earlier, Betsy conducted a comprehensive introduction to the surgery, and its aftermath. During that session, Betsy shared valuable information about every aspect of knee replacement surgery.

Equally important, she created a sense of community and belonging for the patient and the caregiver. She made everyone in the room feel a sense of connection with her and the other members of Dr. Harry Schmaltz’s team. We weren’t numbers. We were people with a medical problem they intended to address with the best medical and therapeutic techniques available.

On this morning of apprehension, Betsy’s kind way and her engaging smile made our reunion with her very special. She calmed our fears and she lifted our spirits at a time when we needed encouragement. When she left the room, Kitch was ready to take the next step on her journey.

Waiting and Hoping

At 7:06 a.m., Kitch was taken to the second floor of the hospital 5 AAA_4146where she would be prepped for the operation. That involved conversations with her surgeon Dr. Harry Schmaltz, the anesthesiologist, the nurse anesthetist, and an unexpected, pleasant meeting with a nurse, Eileen who had a home town connection with Kitch. Their conversation about graduates from Dunmore High School helped Kitch to think about something other than the operation.

While Kitch was in surgery, I tried to pass the time in productive ways. To be honest, it wasn’t easy.

5. aCleaning up_4154

At sometime after 8 a.m., I went outside for a walk. Much to my surprise, I watched a crew of workers with brooms and dustpans cleaning both sides of the street in front of the hospital. I was impressed by the way they did their job.

I had a chance meeting with an old friend whose wife was having partial knee replacement surgery. We talked about our childhood experiences in a neighborhood barber shop where he learned to read, and I learned the power of community.

5 NNN_IMG_4185adj

When I returned to the fifth floor, I watched a woman with a duster clean every nook and cranny of the hallway. She was determined to do her part to maintain a high standard of cleanliness.

As I watched Karen work, I thought to myself how important this work is, and how conscientiously she is attending to it.

When the operation was finished, I was called to the nurse’s station to answer a telephone call from Dr. Schmaltz. His words were reassuring:

“The operation went well. There were no complications. All of her vital signs are positive. She is in the recovery room, and she is doing well.”

Without question, that was the best news of the day.

Together Again

It was 12:01 p.m., when the elevator door opened, and Kitch was brought back to the New Steps section of the fifth floor.

At 12:15 a delightful woman, Danielle Mazzoni, a nurse assistant, was6a. Nurse assistant_4192 attending to the things that would make Kitch comfortable. Danielle has been doing this kind of work for 17 years.

Two words best describe Danielle’s care, competent and compassionate. One word describes her demeanor, charming.

8 a Pleasant smile_4202

About an hour later, the door opened and a young woman with a beautiful smile entered the room with Kitch’s lunch. Mahadevi works in nutritional services. The words at the bottom of her identification card read “Make it the best.” She did exactly that with her courteous and cooperative manner and a smile that was just what the doctor ordered for a recovering patient and an anxious caregiver.

At 1:32 p.m. we received a visit from a respiratory therapist named Karen. She has been doing this kind of work for 35 years. She told us7 Breath in_4205 she loves her job, and it shows.

Karen is on a mission to protect patients from hospital acquired pneumonia. Standing at the foot of Kitch’s bed, she carefully explained how that is accomplished. It’s not all that easy to do the appropriate exercises 10 times every hour, but Karen inspires her patients to make the effort.

Kitch respected the information Karen shared, and she honored her suggestion to do the breathing exercise.

For most of the afternoon, Kitch rested. She obliged the visits she received from nurses and therapists who monitored her progress and checked a number of devices that guaranteed a successful outcome.

At one point, she slowly took her first steps with the help of a physical therapist. She also had her first cup of coffee, and she talked with her cousin on the telephone.

At 2:37 p.m., she had a priceless moment with a Chaitali dinner with a smile_4217Patel a member of the food services team. When Chaitali walked into the room to discuss the dinner menu with Kitch, her beautiful smile evoked a wonderful response from Kitch:

“You are a delightful young lady.”

The picture of Chaittali and Kitch is classic proof of the wisdom of William Hazlitt’s

When I left the hospital at 8 p.m., I knew that Kitch was in good hands.

Day one was a great success thanks in no small part to the incredibly successful process created by Dr. Harry Schmaltz and executed by members of his New Steps team and the Geisinger-CMC team. Yes, the medical science was right. Yes, the competence of the medical care Kitch received after the operation was right. There was, however, one differential in her care. It can best be described with an adaptation of the words of William Hazlitt:

The gentle words we heard lifted our spirits. The kind looks we received gave us a feeling of community and belonging, and the good natured smiles worked wonders for both the patient and her caregiver.

Thank you, Betsy.

Thank you, Eileen.

Thank You, Karen.

Thank You, Danielle.

Thank You, Mahadevi.

Thank You, Karen.

Thank You, Chaitali.

Thank you, Dr. Schmaltz, and a special thank you to the nurses and therapists who took care of Kitch throughout the day and during the long hours of her first night in the hospital.

Please provide feedback to:


Kitch’s Total Knee Replacement Surgery, Part 3.

Tuesday, August 26th, 2014

America at Its Best: Memorable Moments from Kitch’s Total Knee Replacement Surgery, Part 3.

Written by Tony Mussari, Sr.
Edited by Kitch Loftus-Mussari
Digital photographs by Tony Mussari, Sr.
Copyright 2014
Mussari-Loftus Associates
The Face of America Project

Determine that a thing can and shall be done and then… find the way. Abraham Lincoln


Four words best describe Kitch’s third day in the hospital: courage, determination, kindness and persistence.

Thumbs Up_4224

Kitch had a very difficult night. The nurses went out of their way to make her comfortable and enable her to get some rest.

At 8 a.m., a smiling Dr. Sal Lawrence visited with Kitch. The secret to their relationship is trust. Kitch knows from past experience that Dr. Lawrence will make every effort to help her. He did just that with kind words of encouragement.

Shortly after Dr. Lawrence left the room, Dr. Schmaltz entered. Dressed in his blue scrubs, he addressed one of the most important matters of the day, the removal of the bandages and the Jackson-Pratt Drain, a post-operative drain used for collecting fluids from the surgical site.

A physical therapist helped Kitch get into her street clothes.


When I arrived at 9:30 a.m., Kitch was sitting in a recliner next to her bed. She was dressed in Bermuda shorts and a black shirt. For the first time, her swollen right knee and the bandage over the 6 inch incision were clearly visible.

We talked about a number of things including the decision to make this her last day in the hospital.

Quiet Heroes

At 9:39 a.m., a polite and personable member of the housekeeping staff knocked on the door. When she started to clean the room, we were impressed by her manner and style. Yes, she cleaned everythingIMG_4295 thoroughly, but she did something else that lifted our spirits. She talked with us with warmth and kindness.

Dorie has a million dollar smile and a personality to match. She did more than clean the room. She brought comfort to its occupants. Talking with Dorie was the respite care we needed at this critical juncture in the day.

Robert E. Hudachek is a licensed social worker. There is only one way to describe his work. He is a link between the hospital and IMG_4315everyone who enters the front door. Little did he know when he entered Kitch’s room that this day would be a reunion day.

In 2007, Bob was the social worker at the hospital where I had my open heart surgery. He remembered both the television series Kitch and I produced about open heart surgery and the book we wrote about our experience.

This was a serendipitous moment for the three of us. For about 20 minutes we talked about our common experiences.

Bob has all the paper credentials for the important work he does. Equally important, he has all the human skills, sometimes called soft skills, needed to be an effective liaison between patients, family members, employees and the hospital.

Geisinger-CMC is to be applauded for maintaining a position like this and employing a person like Bob to do this important work.

Medical Care with a Personal Touch

Our next visitor provided invaluable information, and she set the direction and the tone for the day.IMG_4345

Mary Dunleavy has been working with Dr. Schmaltz for 17 years. She is a physician assistant. Everything about her is impressive. She is thorough. Her knowledge of the field is comprehensive. She appreciates the anxiety and fear of the patient and the caregiver. She has the gift of communication. She uses it to articulate inspiring messages of cooperation, encouragement and hope. She is willing to take the initiative to help eliminate pain and stress.

When you talk with Mary Dunleavy she is focused. She is a very good listener. She has mastered the art of listening with her eyes as well as her ears.


We were fortunate to have three conversations with Mary. At 10:46 a.m., she visited with us in Kitch’s room. She reviewed the medications Kitch was taking and she suggested some alternatives. To increase the hemoglobin (the number of red blood cells) she suggested that Kitch be given iron by intravenous.

She reinforced one of the most important goals of the day. It is better to leave the hospital and go home to familiar surroundings than prolong the stay in the hospital. The longer the stay in the hospital, she told us, the greater the possibility of infection.

That was a message both Kitch and I needed and wanted to hear. With Mary’s help, we designed a strategy to make it happen.

It would not be accomplished without a good deal of determination, courage and perseverance by Kitch. These are core values Kitch has practiced throughout her life.

In 1970, there were virtually no women in broadcast news in our part of the state. Kitch was one of the first females to crackKitch Nixon that barrier in radio. Throughout her career in both radio and TV, she was known for her determination to get the story and report it fairly without editorializing.

When she was diagnosed with breast cancer, she called upon these values to make it through chemotherapy and radiation treatment.

On this day, after a few setbacks caused by nausea and weakness, she managed to walk the hallway on the fifth floor twice, and she successfully demonstrated her ability to climb a few steps and get in and out of a car. Without meeting these requirements, she would not have been discharged from the hospital.

At 5:21 p.m., a nurse skillfully removed the needle used for intravenous therapy from the back of Kitch’s right hand, and we were ready to be discharged.

A Classic Act of Kindness

One of the most memorable acts of kindness Kitch experienced while she was in the hospital happened after Kitch was officially discharged from the hospital.

A young woman who worked at the nurse’s station in a non-medical IMG_4427capacity volunteered to look for a wheelchair and transport Kitch to the entrance of the hospital. Ambulatory services was backed up with a number of other patients who had been discharged at about the same time.

It is something Shannon Osborne had done many times before. It is not a part of her job description. Shannon is a pleasant person who likes to help patients when she can. In our opinion, what she did for Kitch and the spirit in which she did it gives truth to the prophetic words of Gabriella Cherup:

A hero is somebody who helps people

I had no hesitation about leaving Kitch at the entrance with Shannon while I went to the parking garage to get the car.

To my great surprise and delight, when I reentered the hospital to help Shannon, she and Kitch were engaged in a conversation withIMG_4437 Dr. Harry Schmaltz. His hands filled with charts and papers, Dr. Schmaltz took the time to talk with Kitch.

A Hollywood screenwriter could not conceptualize a better ending. It was all there in that scene. The surgeon may well do miraculous work in the operating room, but it takes a team effort to be successful there as well as in the patient’s room after the operation.

At 7:15 p.m, Kitch was home. It was a wonderful sight to see her IMG_4447take her first steps into our garden.

Before we ended the day we talked about all the experiences we had, and all the kind people who contributed to the success of the operation. We gave thanks for a day when courage, determination, kindness and persistence prevailed.

The poetic words of Edgar A. Guest best describe the genuine Faces of America at its best who we met during Kitch’s total knee replacement surgery.

Courage was never designed for show;
It isn’t a thing that can come and go;
It’s written in victory and defeat
And every trial a man may meet.
It’s part of his hours, his days and his years,
Back of his smiles and behind his tears.
Courage is more than a daring deed:
It’s the breath of life and a strong man’s creed.

Thank you, Dr. Sal Lawrence.

Thank you, Dorie.

Thank you, Robert E. Hudachek.

Thank you, Mary Dunleavy.

Thank you, Barb.

Thank You, Shannon Osborne.

Thank you, Dr. Harry Schmaltz and the team at Scranton Orthopaedic Specialists.

Please provide feedback to:

Nine Faces of America at Geisinger-CMC in Scranton

Sunday, July 20th, 2014

Nine Faces of America at Geisinger-CMC in Scranton, PA

Written by Tony Mussari, Sr.
Edited by Kitch Loftus-Mussari
Copyright 2014
Mussari-Loftus Associates
The Face of America Project

If we are to love our neighbors… we must see not just their faces but the life behind and within their faces. Frederick Buechner

Getting to Know You

On this fine July day, I drove Kitch to Geisinger-CMC inCMCJR_sign_2658 Scranton for pre-admission testing and orientation. In a few weeks, Kitch will have total knee replacement surgery. Like most people who have this kind of surgery, she has many questions, and she is coping with a good deal of anxiety and fear.

Everyone we met during this visit provided encouragement, help and valuable information that calmed our fears and made us feel comfortable. This is our attempt to say thank you for their kindness.

Mike’s Smile

When we pulled into the parking garage, we were intense. I think it was caused by fear of the unknown.


It was our good fortune to find a parking spot on the ground level very close to the entrance to the hospital. More important than the convenience of our parking place was the reception we received from the parking attendant, Mike. He greeted us with a big smile, and he told us where we would receive the complimentary parking ticket.

Mike’s office space is dark and cramped. He has no impressive letters after his name. He is, in our opinion, one of the most important people we met. He is the gate keeper so to speak and his welcoming way set the tone for our visit.

Thank you, Mike. You give meaning to the words of William Arthur Ward:

A Warm Smile is the universal language of Kindness

Barbara’s Manner

When we entered the admissions office, there was no one in theBarbara_ Image 1a _admissiona_2564 waiting room. In less than a minute, a woman with a pleasant disposition asked us to come into her office. While Kitch searched for her health care cards, Barbara did preliminary work on her computer. Throughout the process, Barbara was polite and respectful. She answered Kitch’s questions, and she offered a few suggestions that would eliminate stress on the day of the operation.

Barbara’s manner and her thoughtfulness made this mandatory stop a pleasant experience.

The words of Francis de Sales best describe our encounter with Barbara:

It is wonderful how attractive a gentle, pleasant manner is, and how much it wins hearts.

Pre-Admission Testing

Several people work in the pre-admissions testing suite, and all of them represent Geisinger-CMC with dignity, class and competence.

Nina_iMG 2__2614

We were greeted by a Nina Barbieri, a registered nurse with extraordinary people skills. She explained the nature of the tests she performed and the reasons why they are important for the procedure Kitch would have.

One of her associates, Angelina, administered an EKG. Then she did the required blood work. Normally this is an agonizing experience for Kitch. Because of Angelina’s skill, it did not bother her at all.

After the blood test, Nina returned to administer a special test that is designed to protect the patient from MERSA.

Before we left the lab, Nina printed a copy of all the information, and she included her name and phone number on the report to enable Kitch to make contact for any help she might need.

While Kitch was behind the closed door of the lab, I made theKathy Patti _IMG 3_2589 acquaintance of one of the most inspirational people I have ever met.

Cathy Sue Loyack is battling breast cancer. She has had three procedures and chemotherapy in six months. She is about to begin her radiation treatments.

Cathy is the mother of two college-age children. When she was diagnosed with cancer in November, she did not tell her children. She did not want to burden them with this information during their final exam week.

Cathy is an optimistic person who lights up the room with stories about gratitude and determination.

On this day, Patti Thomas was her nurse. Patti was a perfect match for her patient.

The memory of the time we spent in pre-admission testing with Nina, Angie, Cathy and Patti lessened our fears and made us feel optimistic about Kitch’s surgery.

We were in caring, competent, empathetic hands. A feeling best described by Walt Whitman:

I do not ask the wounded person how he feels, I myself become the wounded person.

Pictures for the File 

Our next stop was the waiting room in the radiology department. As CSLoyack_2619we crossed the threshold, we were greeted by Cathy Sue Loyack. She was sitting alone in the back of the room. Kitch and I joined her. As you might expect, the two women talked about their experiences with breast cancer. I thought the conversation was liberating for both Cathy and Kitch.

At the appointed time, nurse Heidi O’Brien called for Kitch. Together they made their way to the dressing room where Kitch changed into an appropriate patient’s gown.

In less than 10 minutes, the door opened, and nurse O’Brien held Kitch’s arm as she walked with her to the place where the chest X-ray would be taken.

Another door opened and a man in his mid 40s with the assistanceHeather Image_ 4Radiology_2628 of crutches slowly walked toward the exit. He was intercepted by a woman of a similar age, apparently his wife. She reached out to help him.

Then it happened. She looked down and noticed his sneakers were untied. Without hesitation she dropped to her knees, and tied bow knots to secure the sneakers and prevent him from falling.

While this priceless scene was unfolding, I decided not to violate this beautiful moment by taking a picture, I assure you, this poetic moment of love and service will remain in my heart and mind forever.

As the couple slowly walked away, the door to the X-ray room opened and a smiling Kitch and her nurse appeared.

They entered the dressing room, and the pre-admission testing phase of our visit ended.

Pre-Operation Orientation

At 11:45 a.m., we took the elevator to the fifth floor. That is where five knee surgery patients assembled in the community room to learn about virtually every aspect of the procedure. The session is a central part of the Geisinger Patient Education Program.


We arrived a few minutes early as did one other patient, Lou Palazzi. A college football player, retired teacher and landscaper, Lou was preparing for his fourth knee surgery.

After we finished our conversation with Lou, Betsy Guinan, a registered nurse and assistant to Dr. Harry Schmaltz, walked into the community room. Betsy is the Nurse Navigator for New Steps Joint Replacement Center. She greeted us with a pleasant smile. Kitch had a few questions, and Betsy graciously answered each one.

The other three members of our group arrived. Betsy took her position in the front of the room. She started her PowerPoint presentation, and for the next hour she walked us through every phase of knee replacement surgery.

She emphasized the things that can be done before and after surgery that will help expedite recovery. The topics included: proper nutrition, exercises to strengthen your arms and preparing your Betsy_5_2657home.

More than once she emphasized the importance of pain management, infection control, and hand hygiene.

She told us what we could expect on the day of surgery, what items we should bring to the hospital, and she walked us step by step through the operation.

Included in her presentation were three aphorisms:

“Mobility is your best friend.”

“Good nutrition is essential for a successful procedure.”

“Self motivation is the key to successful surgery.”

Patients and their caregivers were encouraged to ask questions and offer comments. Several were offered, and every question was addressed with respect and practical information designed to help all of the people in the room.

If, as Anne Sullivan once said, teaching is about turning on the light of understanding, Betsy did an excellent job in preparing us for knee replacement surgery.

Blood Counts

One of the things most of us take for granted is our blood. That’s not the case at Geisinger-CMC.

MaryAnn O’Brien is the Blood Conservation Coordinator. She Image 6_OBrien_2667is trained to help patients optimize their blood count. This, in turn, reduces the need for blood transfusions during surgery. According to MaryAnn, blood transfusions are associated with poor outcomes.

MaryAnn offered a number of ways patients can build their hemoglobin before surgery: taking suppliments like iron, Vitamin C, and Folic Acid. She encouraged everyone to eating foods rich in iron and Vitamin B12.

She explained in great detail the benefits of optimizing hemoglobin levels to guarantee a speedy recovery.

Before the session ended, MaryAnn answered questions, and gave each patient three pamphlets and her business card so they could make contact with her if they had any questions before their surgery.

The author and poet Wendell Barry tells us that:

Healing is impossible in loneliness; it is the opposite of loneliness. Conviviality is healing.

Our pre-operation orientation at Geisinger-CMC gives truth to Barry’s words. While we were at the hospital, we became part of a healing community. We were in a friendly environment. Everyone we met understood the anxiety and fear behind our faces, and they called upon years of experience to lessen our pain. They gave us confidence that the surgery would go well, and they assured us they would do everything in their power to help us during our journey to recovery.

Thank you, Mike.
TR_Hard Work_1048

Thank you, Barbara.

Thank you, Nina.

Thank you, Angie.

Thank you, Cathy.

Thank you, Patti.

Thank you Heidi,

Thank you, Betsy.

Thank you, MaryAnn.

Thank you, Geisinger-CMC.

We came to the hospital for pre-surgery orientation. We came home with invaluable information and a mosaic of the Face of America on its best day. It doesn’t get much better than that.

Please provide feedback to: