Jennifer Allison of Conway has a 2-year-old grandson and a grand dog who have a lot of energy. She loves to take care of them both, but doing so requires her to be on the go, on the ground, and in the middle of the action. As she says, “I have to be able to move. And move fast!” A bad hip kept her on the sidelines until it was fixed by Dr. Lowry Barnes, an orthopedic surgeon at UAMS.

Now that her hip is pain-free, she can enjoy being active at home and while traveling. She and her husband love to travel where the sand is white, the water is clear and there is plenty of lobster.

“My entire hip replacement experience was great. From check-in to discharge, everything was extremely efficient, and I liked knowing I was helping educate the next generation as Dr. Barnes toured with his interns.”
– Jennifer Allison, Conway

Gary Taylor is used to providing advice to others when they come into Go! Running, but when Dr. Michael Cassat came into his store, the roles quickly reversed. Gary asked the sports medicine doctor if he could help with a lingering Achilles tendon problem, and the doctor’s response was, “Sure, come see me.” Dr. Cassat prescribed physical therapy, a night splint, and modified training.

A few months later, Gary was in better running condition than he had been for several years. While selling running gear, Gary now readily refers others to Dr. Cassat, a family physician with an emphasis in sports medicine at UAMS, explaining how his passion, caring and expertise made a difference in his life.

“The first thing you notice about Dr. Cassat is that he obviously cares and has a real passion for what he does. With the backing of an institution like UAMS, you know you’re in good hands. They make a great combination for the Central Arkansas fitness scene.”
– Gary Taylor, Little Rock

Former Pittsburgh Steelers quarterback and Pro Football Hall of Famer Terry Bradshaw knows better than most that sacrifices made on the field can have lasting effects. In 2015, the injuries and pain from 14 years in the NFL made it difficult for him to walk, play golf or meet the demands of his busy schedule as a co-host of “FOX NFL Sunday.” Terry turned to the expert orthopaedic team at UAMS for help. After a knee replacement with Dr. Lowry Barnes, ankle surgery with Dr. Robert Martin and wrist surgery with Dr. Theresa Wyrick, Terry is once again enjoying his work, hobbies and family with no pain or discomfort.

“UAMS was awesome. The entire staff of doctors and nurses was phenomenal. It couldn’t have been a better experience.” – Terry Bradshaw

Susan Smith dealt with knee pain for years, but when it began to affect her daily activities, she knew it was time to do something.

Smith, who is the wife of G. Richard Smith, M.D., former dean of the UAMS College of Medicine, has always been an active person. Whether it’s riding a bike, hiking or ballroom dancing, she’s always been on the go. However, she eventually had to slow down because of increased knee pain.

“I was in so much pain that going down the aisle of a grocery store was really painful,” said Smith. “I had to decide whether or not I was going to walk upstairs to get something, or would it hurt too much.”

That’s when she decided to visit C. Lowry Barnes, M.D., chair of the UAMS Department of Orthopaedics and one of the region’s foremost joint replacement experts.

“Susan came in with the right attitude; she was ready to get on with her life,” said Barnes. “There were things she wanted to do that she couldn’t, and she was an absolute perfect patient.”

A year and a half removed from the procedure, Smith, who is a priest associate at Trinity Episcopal Cathedral in Little Rock, is back to life as usual and has been for a while.

“I’m going hiking in Utah in a few weeks with my husband,” Smith said with a smile. “Three years ago, that wouldn’t have happened.”

After hip- or knee-replacement surgery, Barnes said many of his patients come to him with a similar question.

“Most patients come back and ask, ‘why did I wait so long?’” Barnes said. “They didn’t realize they could get rid of their pain and get back to doing the things they want to do.”

There have been many advancements in orthopaedic surgery in the last several decades, including an average one-day hospital stay at UAMS following knee replacement surgery, which Barnes said has made things better for doctors and patients.

“Things have vastly improved,” he said. “Our pain-relief strategies are much better, so patients are in less discomfort and move quicker.”

For those experiencing hip or knee pain, Barnes said interference with daily life is a key factor when considering the options.

“When you can’t do things you want to do or need to do, it’s time to talk about surgery,” he said. “Sometimes, I have patients who cannot take care of family because of the pain, and other times, it’s patients who have trouble playing golf in retirement after playing multiple times a week their entire lives.”

There are other non-surgery options that can be effective, including weight loss.

“When you stand, you put four-times your weight in stress across your knee joints,” Barnes said. “Losing 10 pounds is like losing 40 pounds to your knees, so that can help.”

Smith said she is happy with her decision and the treatment she received at UAMS.

“Dr. Barnes likes to do it perfectly, every time,” she said. “He wants fabulous outcomes for everyone and treats every patient the same.”

A split-second connection between a table saw blade and a wedding ring almost took Tommy Watts’ hand.

When the teeth of the blade caught on the ring, it pulled Watts’ hand into its path, slicing into his left hand and almost severing two fingers. He wrapped his hand in a towel and called out to his wife, Shelley, for help.

She drove him to the Batesville hospital where a physician and nurses in its Emergency Department decided to seek a telemedicine consultation with a specialist in hand surgery, Theresa Wyrick, M.D., associate professor in the UAMS College of Medicine’s Department of Orthopaedic Surgery.

Wyrick and six other Arkansas physicians provide on-call consultations 24/7 every day of the year through the Hand Trauma Telemedicine Program. Patients and their physicians in 72 hospitals throughout Arkansas can link up in real time with hand trauma surgeons and specialists via a high-definition broadband video connection provided through e-Link Arkansas.

Curtis Lowery, M.D., founder of the UAMS Center for Distance Health, said telemedicine enables one specialist to be on call for the entire state, freeing up others who might otherwise be on call more frequently and for a limited area. The use of the iPad means physicians who are on call are free to travel or be anywhere they can connect to the Internet.

“It’s a game-changing technology for health care,” Lowery said.

In Watts’ case, the Batesville hospital prepared a telemedicine cart equipped with a camera and monitor that connected through the Internet to Wyrick’s iPad in Little Rock. Through the iPad, Wyrick was able to examine Watts and talk to him and make the recommendation that he be transferred to UAMS for surgery.

Timely surgery is especially crucial in hand trauma cases. Wyrick estimated the telemedicine consult saved at least two to three hours of time between his accident and transfer to UAMS.

“I knew it was bad,” Watts said. “I didn’t know how bad. When it first happened, it didn’t hurt. Once it was wrapped in the towel, the throbbing kicked in. I kept pressure on it and kept it up high. The ER started IVs, gave me medicine and shots in my hand. The worst part of it all was lying there wondering if I was going to still have a hand once it was over.”

Being able to see Wyrick, through even a video connection, was reassuring to Watts.

“She gave me hope,” Watts said. “She was like an angel. I was wondering what was going to happen. She was confident and sounded

confident. She told me exactly what I needed to do. I felt like there was hope. When we got here and met her team, they took images and the next thing I knew they had me in surgery. I’m blessed to have had Dr. Wyrick. I am forever grateful.”

On Wyrick’s end, the ability to examine the hand visually and talk to Watts meant being able to prepare for his transfer and arrival — getting the right instruments set up for surgery and briefing operating room nurses and staff.

“That way when the patient hits the door, we’re ready to go,” Wyrick said. “It’s much more efficient and gives them that hope early in the process. There’s a lot of anxiety surrounding the possible loss of a finger or hand. So, with this network, we’re able earlier to say, ‘We can work on this. Come to Little Rock. There are things we can do to save your hand.’”

Watts was able to keep his fingers and hand. Although the dexterity in his left hand has not fully returned to what it was before the accident, the physical therapy and possible follow-up surgery promise to restore even more range of motion to his fingers.

As with Watts, the Hand Telemedicine Program has helped more than 250 hand trauma patients since its beginning in January 2014.

“Hand trauma, with Arkansas being an agricultural state but also with numerous factories, happens often in the course of work,” said Terri Imus, R.N., trauma telemedicine coordinator at the UAMS Center for Distance Health. “Arkansas has a limited supply of hand surgeons in a limited number of cities throughout the state. The program extends that expertise statewide.”

Perfect timing. That’s what Amy Kizziar needed one cold November day in 2011 when she was impaled by a two-by-six and endured multiple broken bones, gaping wounds and life-threatening blood loss.

Perfect timing is what UAMS delivered that day when Kizziar’s routine morning commute turned nightmarish as a mobile home being transported on an 18-wheeler crashed into her sports utility vehicle.

After 90 minutes of prying her from the mangled car, emergency personnel rushed Kizziar to a Malvern football field where a helicopter met her and flew her directly to the UAMS Emergency Department. Once there, a team of UAMS physicians, who received advanced notice of her condition, were waiting.

Thanks to UAMS’ Level 1 Trauma Center, she was admitted to the ED in six minutes, examined in eight minutes and immediately sent to the operating room. Ron Robertson, M.D., director of trauma at UAMS, and one of the first to meet Kizziar in the ED, said she was one of the worst traumatic injury patients he’s seen.

“She was hypotensive when she got here,” Robertson said. “We didn’t even have to fold back the sheet to recognize that her whole hip was laid open where the two-by-six had gone through. We found nails, wood and just about anything that you can think of that is part of a mobile home in that area. I remember telling her family that I didn’t know if she would survive or not – the next 48 hours would tell.”

A team of specialists attended to Kizziar, whose heart began to slow down from blood loss. Six surgeons – including two trauma surgeons, two orthopedic surgeons and their residents, and five anesthesiologists – worked on different parts of her body simultaneously to stop bleeding and to assess and clean wounds. Thirteen hours and 122 units of blood products later, the doctors had hope that Kizziar would survive.

“We are very fortunate that we have such a wonderful mass transfusion program that allows us to get blood products very quickly,” Robertson said. “We were able to make a single call to the blood bank and receive everything we needed. This is a system we learned through the Iraqi war experience. This has given people much better outcomes — their mortality is much less.”

Although Kizziar remembers very little about that horrific day, she understands the efforts it took to save her life.

“Beginning with the people that arrived on site – from the ambulance ride, to the MedFlight crew, to all the doctors, nurses and staff – everything was perfectly in sync for me to survive that accident,” Kizziar said. “If any one thing was out of place, I don’t think I would have made it.”

UAMS is equipped to help trauma patients like Kizziar every day, Robertson said.

“We want the most critically injured patients sent here to UAMS,” he said. “We have the only surgical intensive care unit in the state and 24-hour surgical coverage in-house, which gives us the ability to gear up and take care of those patients. We save an operating room every day for cases just like Amy’s. So if someone arrives in critical need of an operation, we can have them in surgery within minutes. Amy is the product of a functioning trauma team.”

Even though Kizziar survived the accident and the initial surgery, she would have many more to come along with extensive physical therapy and 99 days of recovery at UAMS. So far, she has had 118 surgerieswith a total of 120 days in the hospital.

“Right now I am working to get my knee to bend, and I am making progress,” she said. “It was completely straight for a year-and-a-half to allow my injuries to heal. Once we are finished with physical therapy on my knee, we are working on reconstructive plastic surgery to rebuild my pelvis and abdomen.”

Robertson says she is one of the most driven patients he has worked with. He attributes that to her knowledge as a physical therapist and her dedicated support system.

“I think being a therapist, she knew the longer she laid in bed, the longer her recovery would be so she pushed herself very hard,” Robertson said. “She also has a very supportive family and community. As a physician I don’t think I’ve ever been more touched by going to a Facebook page they set up for her.”

The Facebook page is called “Hope for Amy K.”

Kizziar holds the record for the most blood donated in someone’s name in Arkansas because of the countless number of blood drives held by the Malvern community.

“Dr. Robertson means everything to me,” she said. “I’d do anything for him because he’s given me the gift of life.”

Only a few nerves kept Lisa Shelton’s left arm attached to her body when she arrived at the University of Arkansas for Medical Sciences (UAMS) after it was almost severed by a truck door.

In December 2012, Shelton, of Jerusalem, was on her way to meet her sister for lunch in Morrilton when her car rounded a curb and was hit by an 18-wheeler. The truck’s door smashed her left arm, taking out tissue, bone and muscle from her elbow, causing a forearm fracture and leaving her arm a mass of mangled tissue. She also suffered a deep cut on her knee.

“I don’t remember the accident itself,” Shelton said.
“I think it was a good thing that I don’t remember. What I do remember is waking up after the accident about a week later and my arm was wrapped and I was wondering where I was.”

After she was extracted from her badly disfigured car by emergency crews using the Jaws of Life, Shelton was taken to a Little Rock hospital and quickly transferred to UAMS, which was better equipped to handle her severe injuries. At UAMS, Shahryar Ahmadi, M.D., an orthopedic surgeon, took Shelton immediately to the operating room to determine whether her arm could be saved.

“When she first came in, the skin, muscle and bone around her elbow were completely gone and she had dirt and grass in the wound,” Ahmadi said. “The main concern at the time was infection. Extensive soft tissue damage and contamination usually significantly increases the risk of infection.”

Even with that risk along with the possibility of amputation, Ahmadi said his intention was to save her arm.

“We always try to save the limb if possible,” he said. “Luckily the bundle of nerves and vessels located in the elbow was intact. That was a good thing.”

Shelton has since undergone more than 10 surgeries over the course of a few months to save her arm and restore most of its function. Her first few surgeries occurred within a couple of weeks. Most of those surgeries focused on fixing Shelton’s forearm fracture and knee injury; cleaning her elbow of nonviable tissue; and applying skin grafted from Shelton’s legs.

She was fitted with an external fixation device that she wore for six weeks consisting of pins and rods attached to the bone from the outside of the arm that kept the elbow from moving to allow tissue to heal.

During Shelton’s last and most extensive surgery in July 2013, Ahmadi implanted a prosthetic elbow and reconstructed a missi ng tendon from donor tissue that allows Shelton to have most of her range of motion. The prosthesis is a much better option than fusing the bones together, which does not provide movement in the elbow.

“The last reconstruction surgery was very long and very complicated,” Ahmadi said. “We had to go through all the scar tissue, nerves and vessels in our way so we didn’t cause any more damage.”

Almost eight months after her last surgery, Shelton is allowed to lift up to 5 pounds and do light chores around the house. Even though life is not the same as before the accident, she is thankful that she has her life and her arm.

“I thought my arm would be amputated, but I have a really good doctor,” she said. “He saved my arm, he saved my life and he saved me a lot of pain down the road. I just couldn’t imagine my life if I had not been brought to UAMS.”

As for the future, it’s a bright one for Shelton and her husband, Wayne.

“Every day gets a little better,” she said. “Time is my best friend, and so is Dr. Ahmadi. I hope to be able to do a little more at a time and do some traveling on our motorcycle.”

WARNING: The following photos of Shelton’s arm before surgery are graphic in nature and may not be suitable for children. Click here to see the pictures.

Ed and Margo Jevicky say a series of miracles saved their 18-year-old son, Michael, and his right arm when his motorcycle slammed into a Jeep. One of them was landing in the hands of two well-regarded, highly specialized University of Arkansas for Medical Sciences (UAMS) surgeons.

“UAMS is not just a hospital; it changes lives,” Ed Jevicky said. “It changed Michael’s. The outcome could have been so much different.”

The Jevickys, of Guy (north of Conway), recalled the experience during Michael’s follow-up visit with the two surgeons – Syed “Ash” Hasan and James Yuen, M.D. – who saved his arm more than a year ago.

Losing his arm was a real possibility because the trauma was extensive and unusual.

Hasan and Yuen, who have decades of experience between them, still marvel at what happened: A five-inch section of humerus bone from Michael’s upper right arm was ejected onto the pavement. It had come through a small hole near his elbow, and the bone was clean, free of any tissue.

Michael’s is such an unusual case that Hasan and Yuen said they’ve found no other like it in medical literature.

In addition, the main nerve in the arm – the ulnar nerve – had been severed. Hasan, an orthopaedic shoulder and elbow specialist with expertise in microvascular surgery, repaired the nerve using a microscope to align the matching fiber bundles.

Next, Yuen, a plastic surgeon with expertise in microvascular surgery, joined Hasan for a procedure that’s akin to a living organ transplant. The eight-hour surgery required taking a section of Michael’s lower leg bone to replace the missing segment in his arm.

The procedure is properly called a microvascular free-flap transfer or microsurgical composite tissue transplantation. Yuen, a surgeon at UAMS since 1993, has performed more than 700 such procedures, but most have involved cancer patients.

Yuen quickly determined that the only place to harvest a living bone large enough and long enough to replace the missing humerus was the fibula in the lower leg, which can be removed without significantly affecting a person’s mobility. He harvested an eight-inch segment of the fibula, along with its still-attached artery and vein. By leaving the ligaments in place at the ankle and knee, Michael would have almost normal use of his leg.

The fibula replaced the missing segment of humerus, and the artery and vein were attached using microvascular techniques to provide circulation to the transferred bone.

Michael, now 19, has nearly all the physical ability that he had before the accident, even riding his motorcycle.

While still in a cast he was able to use his right hand to type, and he later went to Alaska, where he hiked extensively. He noticed weakness in his leg, but additional physical therapy improved that, and today he notices only slight tingling in his hand.

At the time of his accident, Michael was riding from his home in Guy to the Christian Motorcyclists Association club, called Gap Riders of Conway. He was within a few blocks of the meeting when the Jeep pulled in front of him. He recently returned to a club meeting on his motorcycle, driving by the scene of the accident. When he arrived, members of the group stood and applauded.

Sue Cromer of Fort Smith knew it was time for knee replacements when she could no longer baby-sit her two youngest grandchildren at her daughters home.

“My daughter has a two-story house, and I couldn’t do the stairs,” said Sue, 64, a retired choir teacher. “I couldn’t walk without pain; if I did anything strenuous at all I would pay for it for days.”

She had put up with her osteoarthritis for 25 years after her doctor in Fort Smith advised her to tough it out as long as possible because techniques and materials for knee replacements are always improving.

When Sue decided it was time last spring, she was armed with several personal references on behalf of UAMS Dr. Richard Evans, chief of adult hip and knee reconstruction and among a handful of elite surgeons providing the very latest federal Food and Drug Administration (FDA)-approved knee replacements.

“Two people in my Sunday school class have had knee replacements by Dr. Evans, and they had really good experiences,” Sue said.

Her own experience couldn’t have been better. She was walking the night after her first knee replacement and again after the second replacement the next day. She had some pain the first three or four weeks, but it gradually got better.

“My recovery was fine,” she said three months after the surgeries. “Three weeks ago I mowed the lawn, and we have a big backyard. My knees were fine, but I was pretty tired.”

“I can do everything now that I couldn’t do before.”

The advances in knee replacement surgery and the benefits for patients amaze even him, Dr. Evans said.

“She’s barely three months out from surgery and already she has better results than most people would have had in a year or two not many years ago,” Dr. Evans said.

Advances have occurred in all phases of knee replacement. The night before a surgery, Dr. Evans uses images of a patients knee to perform the surgery on computer, ensuring that the new knee fits as it should and that everything goes as quickly and smoothly as possible in the operating room. Once in surgery, patients get an epidural rather than anesthesia that takes them completely under. The epidural enables the patient to get up and walk much more quickly, and it allows for the patients second knee replacement the following day.

In addition, patients today are getting knee replacements that will last them much longer than in years past. The joints used in Sues knees are made with composite materials including oxidized zirconium. More of these joints have been implanted by Dr. Evans than anyone else in Arkansas.

A new polyethylene component coupled with this oxidized zirconium implant were certified by the FDA in July to last 30 years, and Dr. Evans recently became the first to implant this FDA-certified component combination in Arkansas.

This is the only total joint on the planet that has that FDA certification, Dr. Evans said.

Other replacement joints generally last about 10-20 years, depending on wear.

Despite the 30-year certification knee replacements, Evans warned that extreme wear and tear can shorten the lifespan of all total joints.

“Today people are feeling so good after knee replacement surgery that they want to be almost too active some want to go running,” he said. “It’s a nice problem to have.”

Sue said she isn’t worried about wearing out her new knees.

She has already returned to the activities she loves. “My main physical activity is gardening,” she said.

At UAMS our goal is to provide the best care for every patient every day. Our patients say it best, and their stories are really the story of UAMS. All the formal awards and accolades just can’t tell the UAMS story better than the words of our patients.

Elizabeth Carmichael had her second hip replacement surgery at UAMS. “I had my first hip replacement about 10 years ago. It was not a great experience, so when I needed a second replacement, I researched the internet for the best and found UAMS. Just recently, I needed some repair work done on the first one. I came back to UAMS and doctor Richard Evans. Now I’m ready to hit the garden again.”