- The Washington Times - Monday, January 2, 2006

Henry Frosch put some shirts in the washing machine and walked slowly back to his bedroom. Another day, he might cook a meal, using the stove and refrigerator nearby.

Nothing is remarkable about these actions except that Mr. Frosch, 68, of Falls Church, was recovering from hip replacement surgery at Virginia Hospital Center’s acute rehabilitation facility, where performing such activities is part of therapy. The routine gets patients back on their feet in more ways than one.

Mr. Frosch had a walker for support, a therapist to monitor him, and three hours of physical therapy daily, but he was extremely cheerful under the circumstances. He had broken his right shoulder and hip in a fall off a curb three weeks earlier.

“I’m here for stupidity,” he volunteered genially and only half-jokingly. “I didn’t listen to my mother’s sound advice when I was a kid. She was always saying, ‘Watch where you are walking. You are going to trip and fall and hurt yourself.’”

He teared up only when his departure from the Arlington facility — scheduled to happen the next day, when friends were to pick him up and help him make the transition back to everyday life — was mentioned.

Mr. Frosch said he wouldn’t have minded staying in the hospital over the Christmas and New Year holidays. “The people are so wonderful here it wouldn’t be a punishment at all,” he said.

Leaving, he added, would be “kind of bittersweet.”

To date, the year-old rehab facility has served 200 patients suffering from serious injuries and operations that leave them incapacitated in some way and require continuity of care to help them recover. These are patients who have had bariatric surgery for morbid obesity or have suffered multiple fractures, brain injuries, spinal cord damage, strokes and other conditions that impair normal functioning.

The average stay is 10 or 11 days, says Cheryl Farmer, a physical therapist who is the facility’s program director, but it can range from five to 30 days, depending “on what insurance dictates.” A major advantage is access, she emphasizes.

“They come from this hospital or from outside, rather than having to go to a nursing facility in the area or an acute rehabilitation facility elsewhere.”

The center is unusual in having a kidney dialysis section on-site, and all 20 of its private rooms are full of daylight. Some of them are large enough for family members to stay the night in sleeper chairs. The staff encourages families to do this and often includes family members in patient treatment programs.

Compared with some other, larger rehab facilities around the country that have real cars and even real-life models of city streets, the hospital’s Acute Inpatient Rehabilitation Center does not have the most elaborate or imaginatively designed interior. However, it does have state-of-the-art equipment, attractive surroundings and a pleasant staff.

Several “graduates” who were interviewed suggested that staff attitude is the most crucial factor.

Sue Johnson, 42, of Springfield, another hip replacement veteran, was in the room next door to Mr. Frosch. She was getting ready to be discharged after what she felt had been a relatively short stay, given that she was returning home to a third-floor condo in a building without an elevator. Her parents had come from North Carolina to be with her a few days, staying nights in her condo.

During her time in rehab, she had learned to how to live independently — how to sit, how to stand “and not pop your hip out of place,” how to balance when brushing her teeth, how to put on socks and shoes, and how to wash the bottom of her feet using a long-handled sponge because bending over was a problem. Essential, too, was learning to walk up stairs. She had done twice the number necessary to reach her condo, she said proudly.

“Everybody is happy when you reach your goal. It’s not just you, but everybody who has helped you.”

A nurse case manager at the HealthNet insurance company, she wouldn’t be able to drive for at least a month, and returning to work had not even been discussed. In the unit’s gym, she had practiced getting in and out of a car with a therapist’s help — “play acting,” she called it — using mats and bolster supports instead of an actual car. Throughout, she said, she acquired the confidence to take care of herself.

Ms. Johnson’s left hip was the victim of what she called “pure degeneration” and was replaced about the same time Mr. Frosch got a new right hip.

“The joke was that together we made a whole,” she laughed. “Since we were both hips, they put us in therapy together. I made a good friend out of all this, too, and you never think you will make friends in a hospital.”

Rehab was far different from what she had expected.

“You are thinking it is going to be this totally depressing, grueling, hateful place when you are in agony, which is not what it was. The agony part was the day after surgery, when I was upstairs in a different unit.”

She was taken to rehab on her fourth day. “What was so amazing was the doctors, nurses, aides, physical therapists and social workers all talk to each other. Everybody knows you; you know everybody. As a team, you get up and you get better. It’s an intense three hours a day, but all day long you are practicing what you learned.”

Just as amazing, she said, was having the unit’s medical director, Dr. Edward Allcock, “look in on me seven days a week.”

Don Cranick, 67, a retired insurance executive and school bus driver from Falls Church, had both hips replaced at the hospital — two operations several months apart and each time a stay of five days in the rehab unit. His wife and family would join him for supper, and he would order guest trays for $6 each, he recalled.

“You could sit there and chow down and then order desserts. A coffee pot always was perking in the hallway area to help yourself,” he said.

He compared the experience with having a knee replaced at another area hospital four years ago, when, he said, “I was simply dismissed to have therapy at home and on an outpatient basis.”

By contrast, the Arlington facility, he said, “takes real pride in treating you as a consumer, which is nice because, as you well know, patients in hospitals are just numbers. The size may have something to do with it, and, of course, it is the first year of operation.”

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