A Partial Knee Replacement Leads to a Full Life

Tami Bresolin remembers EvergreenHealth from back when it was just a one-building "little hospital" in 1972. No Totem Lake development, no Bellevue high-rises, just a little community hospital east of Seattle.

She had one of her children at EvergreenHealth and even worked in the Admitting Department for a few years. She says she liked that job because she only heard patients being upset twice, and all others were positive, hopeful and friendly.

Many locals say that's just how EvergreenHealth is.

A few years ago, Tami would feel the impact of that positivity when she was struck with severe knee pain while power walking (her favorite recreational activity) in the forest near her home.

Tami's pain worsened over the next year, to the point where she had to crawl around her house and up the stairs. Her insurance at the time wouldn't cover a surgical procedure to address the pain, so when she turned 65 and joined Medicare, she made an appointment with Dr. Adam Rothenberg at EvergreenHealth.

At that appointment, Dr. Rothenberg showed Tami an MRI of her knee, indicating the area that's usually filled with cartilage. There was none and that, he said, was the source of her pain. The fix? A partial knee replacement.

At first, Tami was averse to surgery, but when Dr. Rothenberg took the time to thoroughly explain how the procedure would eliminate her pain for good, she scheduled the surgery for August 5, 2024.

"Everyone—Dr. Rothenberg, the staff, his nurses, was so friendly, helpful and understanding. I never got home and said 'oh I wish I'd asked them about this or I wish they'd been clearer about that.' They always took the time to explain things and answer my questions. It really put me at ease."

A Pain-Preventing Pre-op Procedure

Before the surgery, Dr. Rothenberg recommended that Toni undergo a "nerve-freezing procedure" called iovera to improve pain control after her operation. According to Jeff Stepanian, a physician assistant at EvergreenHelath, iovera is a part of a "multimodal approach" the hospital's orthopedic team uses to control post-operative pain.

"Iovera is a handheld device that uses nitrous oxide to cool tissue to -88 degrees Celsius," Stepanian said, "which temporarily injures the nerve sheath and causes the nerve to shut off. The nerve sheath regenerates by about a millimeter or two per day, so patients can get that pain relief for three, four months, sometimes as many as six with no impact on their mobility as they recover from the surgery."

Iovera is a key component of EvergreenHealth's efforts to reduce the use of opiates in its patients' recoveries from orthopedic surgery. Other elements include prescribing non-opiate medications and anti-inflammatories like Tylenol, Lyrica or Gabapentin both pre- and post-surgery, making smaller incisions and using the minimally-invasive MAKOplasty robotic surgery technique.

This approach to pain control worked so well for Tami that she climbed the stairs at her home the evening after her surgery.

"I'd Do It Again in a Heartbeat"

Nobody recommends surgery for surgery's sake, but after spending a year in severe pain, Tami has some simple advice: "Go to EvergreenHealth and see Dr. Rothenberg. For me, it was an incredible experience and I'm back to doing everything I did before. I'd do it again in a heartbeat, and I wouldn't put it off so long."

Tami is back to powerwalking, faster—and more pain-free—than ever.