Talk to many orthopedic surgeons and in many cases you’ll find that at some point he or she was playing sports, got injured and became inspired to enter into orthopedics during their recovery.
That was not the case of Dr. Khoa Nguyen, an orthopedic surgeon with Burlington County Orthopaedic Specialists in Mt. Laurel, NJ although he was a pretty good high school football player back in his teenage days between 1998-2002 in North Carolina.
His moment of inspiration wasn’t from a sports injury, but a reality check.
Dr. Nguyen recalls he played wide receive and defensive back, “I was pretty good.”
He was good enough to feel comfortable enough to accompany a friend who was invited to do a tour of the North Carolina University campus.
His friend was being recruited by the Tar Heels to play football. The weight room is always a required stop for recruits and when they arrived, none other than All American defensive lineman Julius Peppers was in the middle of a training session.
“He was curling 225 (pounds)” Dr. Nguyen said in a recent interview at his office.“That was the moment I realized I didn’t belong in the same stadium as those dudes. If those guys hit me, I’d be gone!”
Dr. Nguyen said reality struck him hard.
“All the guts and grit in the world ain’t going to make up for that,” he laughed. “I was a skinny runt, like 165 pounds. I didn’t have the right attitude to play at that level and be that small.”
Dr. Nguyen however took all that guts and grit and turned it into a meaningful career as an orthopedic surgeon.
After he entered medical school at Michigan State, Dr. Nguyen said he originally wanted to be a cardiologist but when he did a rotation with an orthopedic surgeon named Dr. John H. Doherty Jr, MD who had a practice in Scranton, PA and worked out of Geisinger Community Medical Center (formally Commonwealth Medical College) he had a change of heart.
Dr. Nguyen said he worked rotations with Dr. Doherty for about a month. “I loved it.”
It was during his time with Dr. Doherty, Dr. Nguyen realized cardiology or internal medicine was not going to be his thing.
“I didn’t have the mindset for it,” Dr. Nguyen said. “I like to be able to fix something and get it done right…get it done once and be out.”
All of Dr. Nguyen medical school and residency time was done at Michigan State. He studied Trauma Orthopedics for four months at Indiana University Methodist trauma program, Michigan Children’s hospital, and William Beaumont Hospital.
Dr. Nguyen also completed his fellowship training at Triangle Orthopedic in Durham, NC and is a member of the American Academy of Hip and Knee Society.
Dr. Nguyen says he bases his relationship with patients on building trust. To build that trust,
Dr. Nguyen was asked what are patients afraid of to begin with?
“Everything,” Dr. Nguyen said. “They’re afraid of the whole procedure. They are afraid of the process, they’re afraid of people telling them one thing and delivering something else. That’s huge.”
He said patients give him accounts that they feel they are not being given the facts with regards to health problems.
“There are millions of doctors you can go with, some of them will tell you the truth and some will paint a pretty picture,” said Dr. Nguyen, who says his interests include tennis, basketball, and spending time with family. “And once they’re done with their surgery, they are out of your life forever. I’m definitely not that guy. I worry to death about everything with my patients.”
How do you gain that trust?
“Honesty,” Dr. Nguyen said. “I think that from the very start of the relationship, when I walk into the room, I respect them as much as they might be respectful of me. I never rush anything. I sit down, I talk to them, I make sure they understand that they have my full-vested interest at that time. When I’m in the room, I’m theirs, period. It doesn’t matter whether it’s five minutes, or twenty minutes. I will sit there and answer every single question that you have.”
Dr. Nguyen said there are no dumb or bad questions.
“It doesn’t matter,” Dr. Nguyen said. “When you are having a big surgery like a hip or a knee replacement, it’s scary. I think we tend to forget that, especially when we’re doing a ton of them. We forget how big a procedure that is. That’s a huge surgery for somebody. It’s scary so you have to mitigate all that fear, you need to be honest with them, sit down and just give them all the details from start to finish. If they have a million questions, you sit there for a million questions. You don’t interrupt them.”
As great as that sounds, Dr. Nguyen cautions that great relationships happen when both parties are on the same page.
“It’s definitely a team approach,” Dr. Nguyen said. “That’s the big thing. You can do your part, but in the end, it’s their body. So if they don’t want to do something, they won’t do it. So it’s got to be teamwork. You do the surgery, but they have to be willing to do the physical therapy, they have to be willing to push through the pain. Because there will be pain. Once they’re done with that, they’ll get to the point where they get great range of motion and they can actually enjoy their life again.”
Pain medicine, including morphine and dilaudid, are some of the commonly used, highly addictive drugs prescribed after surgery. These drugs have gone on to become nightmares with some people to the point where opioid addiction now is a national crisis.
Dr. Nguyen talks about how he treats pain after surgery.
“That’s something I am going to be dealing with for the next 10-15 years,” Dr. Nguyen said. “The most important thing is to set the record straight. This is not a pain-free surgery. You are going to be in pain. We are going to control your pain so you can continue to do physical therapy and continue to improve in your status. The main point of the surgery is to make you less painful in your joint. So we’re not going to mask it by continuing to mask it by giving you opioids. So for me, with opioids and getting patients off the opioids is extremely important. At the most, after five or six weeks you need to be off of it. Honestly I like to have people off in one month. That’s the new guidelines we have.”
Dr. Nguyen said he likes to start tapering patients off the pain medicine after a few weeks. He also said he stays away from IV (intravenous) pain medicine as much as possible as IVs can be more addictive than oral applications.
“A lot of use have switch over to ‘by mouth’ medications,” Dr. Nguyen said.
He also talked about several less addictive pain management treatments including spinals for total knee and total hip replacements and also a lumbar plexus block (psoas compartment block) which is an advanced nerve block technique.
“There are tons of blocks we can do,” Dr. Nguyen said. “You want pain relief without that groggy feeling.”
Future of orthopedics?
“Everything we’ve done was to prevent somebody from basically becoming handicap bound,” Dr. Nguyen said. “But now, there are a lot of people who say we give them back time. They’ll tell you after everything is done and everything is successful, that they feel ten years younger. That’s not everyone but a lot of people will tell you that. That’s what you want. You want a restoration of their life back."
Dr. Nguyen continued: “You want them to have fun with their kids. You want them to go out and play soccer with their kids, go hiking with their wife or ride their bike whenever they feel like it. You want to restore their ability to restore their life. That’s the biggest part I love the most.”
Dr. Khoa Nguyen – Adult Reconstruction Orthopedic Surgeon – can be reached at Burlington County Orthopaedic Specialists Briggs Road Professional Campus 2059 Briggs Road, Suite 304, Mt. Laurel, NJ 08054, (856) 235-7080
Follow Al Thompson on Twitter @thompsoniii