Mystery Solved, Pain Resolved

Madison Lodge is an energetic 16-year-old who never stops moving. Her whirlwind sports schedule starts each August with swim practice, shifts to basketball in November, and ends with her favorite—softball—in March.

While sports are her passion, competing hasn’t always been easy. In the seventh grade, Madison began having constant pain  in her left knee that intensified when she swam the breaststroke, when she raced down the basketball court, and when she pitched softball. “It hurt all the time, but it really spiked up during sports,” says Madison, a junior at Odessa Montour High School.

Her parents came to believe the pain was caused by her athletic activity. Between 2011 and 2013, two different doctors evaluated  Madison but they were not able to discover the cause of her problem. Still, the pain continued.

When surgeons from Orthopedic Services of Cayuga Medical  Associates began seeing patients at Schuyler Hospital, Madison’s mother, Heather, decided that getting one more opinion was worth a try.  She took Madison to see Dr. Joseph  Mannino, who ordered an MRI of  her knee in January 2014.

This time, the tests showed something different. Her pain  wasn’t due to a sports injury but to  a birth defect called a discoid lateral meniscus, a condition that causes  an abnormal shape in the cartilage  covering the knee joint. Instead of conforming to the femur as a flat triangular structure, the cartilage grows into a disk, which causes discomfort because it cannot act as a shock absorber for the knee.

“We believe children are born with it, and when they are young and little, they don’t put enough stress on it to generate symptoms,” Mannino says. “As they hit the teenage years, that first growth spurt in their early teens is when they first start to have symptoms  —knee pain.”

Because Madison couldn’t bear to give up the softball season  —“Fast Pitch Is Life” reads the slogan on her cell phone case— Mannino postponed repairing her knee until the end of the school year. Just after Madison’s Regents exams last June, Mannino per-formed the surgery in one of the new operating rooms at Schuyler Hospital by sculpting out the excess cartilage and reforming the  meniscus into a more normal crescent shape. The arthroscopic  surgery required two small incisions to correct the problem.

After spending nearly seven hours in the hospital, Madison was released the same afternoon on crutches. Three days later, she was playing her saxophone at the high school commencement, and a few weeks later, she was back on the basketball court for a one-week sports camp. “I thought I was going to be on crutches for a lot longer,” Madison says. “It was not bad at all.”

For Madison, what took the stress out of the ordeal of having  knee surgery was being able to have the procedure done at Schuyler Hospital, just seven miles from her home in Alpine. Not only were Madison and her mother born at the hospital, but the same obstetrical nurse provided their care. And over the years, Madison has been hospitalized there eight times, primarily because of mesenteric adenitis, an inflammation of the membrane that encircles the small intestine and connects it to the abdominal wall.

“Growing up, I’ve been sick a lot,” Madison says. “Everything I’ve always had done, I’ve had it done here. I just feel comfortable here, and I like the staff.”
Mannino’s willingness to allow family members and Madison’s best friend into the surgery-prep room also put her at ease. “I thought he was wonderful with us as parents,” says Heather, who is the medical staff coordinator at Schuyler Hospital. “He’s very personable.”

After the surgery, Madison had physical therapy with Carrie Schloerb at the hospital for about six weeks. Last October Madison, who wants to study physical therapy in college, thought she had re-injured herself when she fell off a table at school, but it turned out to be a sprain to a ligament in her leg, so she returned for more physical therapy with Schloerb.

As she has worked her way through another season of swimming, basketball, and softball, Madison has been  astounded at how her performance has improved. In swimming, she used to  compete only in the 50-yard sprint, but  this year she was able to race in the 20-lap, 500-yard freestyle and shave off
more than a minute in her time. During  Carrie Schloerb, PT basketball season, she wasn’t the last player running down the basketball court, and once softball started, she could throw much faster pitches because she could use her legs as support.

Heather says she is thankful that patients like her daughter now have access to specialized surgeons in Schuyler County. “It’s nice  for both communities to know that you have that resource so close  to home,” she says. “I don’t think Madison would have gotten any  better care in a larger facility. The outcome was the best it could be, no matter where she went.”

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