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When it comes to specialty orthopedic care, two Northwest Hospital & Medical Center surgeons say experience counts. Dr. Kevin Smith and Dr. Caroline Chebli have much in common, including specialty training in shoulder and elbow orthopedics at the University of Washington School of Medicine. As leaders in their field, and colleagues at Northwest Hospital, they treat an array of shoulder and elbow problems ranging from chronic, degenerative conditions to acute traumatic injuries. And they think highly of each other.

"We are both good docs and we care about people," Dr. Smith says.

"As a surgeon, itís comforting to know that I have a knowledgeable counterpart somewhere else in the hospital," Dr. Chebli adds. "People in the community can access top-notch shoulder and elbow care here, even if one of us is unavailable."

The expert care these two physicians provide is making a difference every day, helping people free themselves from immobility and pain and get back to doing the things they love to do. For a father and son and a mother of four, Dr. Chebli and Dr. Smith helped these patients return to riding - an activiy each says makes them feel alive.

A Woman and Her Horse
People find it hard to believe Monroe resident Jennean Hallerman, 41, when she recounts the story of how a pack of Sugar Babies caused her to break her clavicle, or collar bone. In September 2009, while on a trail ride with a friend in Okanogan County, Jennean was taking in the wooded scenery on a casual walk atop her mustang Rio and munching the candies. When she quickened the horseís pace to a trot, the box of candies began to shake and she lost control of the horse.

"Mustangs scare easily and he thought the shaking candies were a rattlesnake," she says. "He got going pretty fast and I had to do an emergency dismount."

The horse was fine, but Jennean was not. She had broken her clavicle and was in shock. She rested for a while in a nearby town before returning home. When she arrived, she made an appointment with the first orthopedic surgeon available, something she says she now regrets.

"At the time, I was in so much pain. I went with the person who could get me in and do the surgery the quickest," she recalls. "But looking back on it, I would have done things differently. I would have done more research. I would have looked around and asked for high-quality references."

It wasnít long after her first surgery that the pain in her shoulder intensified significantly. At this point, Jennean was referred to Dr. Smith at The Bone & Joint Center of Seattle.

"She was having pain and limited function because the six screws she had put in were pulling out of the metal plate connecting the two broken ends of her clavicle," Dr. Smith says.

Jennean was concerned another surgery would mean more pain and time away from her children and horses. Dr. Smith admits that once a surgery fails, the second surgery can sometimes be more challenging. He assured Jennean that this time they would take the necessary precautions to improve her chances of success.

"Jennean always wants to go like gangbusters," Dr. Smith says. "But this time, I needed the support of her entire family to make sure she did the right things so she could eventually get back on her horse. We were all in it together."

"Having surgery again meant that I couldnít do the things I loved with my children," Jennean says. "And that I couldnít be with my horses, which is like therapy for me. I was doing something with them every day, whether it was riding or playing. I missed it so much and it was depressing."

Dr. Smith operated on Jennean this past February and is still making sure she doesnít overdo it today. In mid-June, Jennean was finally able to mount her mustang again, going on her first trail ride in more than ten months.

"It felt amazing," she says. "Being with my horses is a part of my life. During my injury, I would take a chair up into the pasture and just sit there with them. Eventually they would come close, stand over me and hang out. At the time, that made me feel better. Now itís nice to be able to ride again and enjoy something that I can do with my daughters."

Jennean, who has already referred people to Dr. Smith, admits she learned a tough lesson along the path to recovery.

"Itís not one of those things where you can just go to any surgeon," Jennean says. "Take the time to find the best — and Dr. Smith is the best."

A Father and His Son
When he tops out at 30 mph on his bike, Zeke Hansen, 30, zones out in what he calls a "pocket of silence."

"You are riding the same speed as the wind and all you hear is your chain click through the gears," he says.

His dad Peter Hansen, 62, admits they are both addicted to that rush.

"We like to go fast," the Ballard resident says.

The father and son duo have been cycling since 1991, when Peter first rode in the Seattle to Portland Bicycle Classic (STP), a two-day, 200-mile touring competition consisting of more than 10,000 riders. Peter was hooked immediately and had Zeke clipping into the pedals a year later. During the 2009 race, Peter and Zeke were two of only 310 riders who had participated in more than 10 STPs. But this year was different. It was the first year ever, after competing in more than 15 STPs together, that both didnít finish.

The pair was only five hours into the race and 40 miles out of Seattle when they crashed while "drafting" close behind a few other riders in their 11-man group. When a rider drafts, he keeps his front wheel dangerously close to the rear wheel of the rider in front of him, allowing him to save energy and go faster. Peter says something went awry somewhere ahead of the line and the groupís pace slowed abruptly. Zeke calls it a fender bender on two wheels instead of four. Someone slams on their brakes and the person behind canít stop.

Before Peter hit the ground, he saw his son go down first and two other cyclists ride over him. The third was Peter. Zekeís crumpled bike acted much like a launch pad, vaulting Peter over Zeke and onto the asphalt below. The two lay in the shoulder of the road as other STP riders whizzed by. Peterís helmet was crushed where he had hit his head and his right shoulder seemed displaced, his arm lying limp at his side. Meanwhile, Peter says his son was sitting in the bushes looking pale and catatonic. Zeke had injured his shoulder too.

Ironically, the father and son had sustained the same injury, Zeke separating his left shoulder and Peter, his right. Dr. Caroline Chebli, an orthopedic surgeon with The Sports Medicine Clinic, says shoulder separations occur when the ligaments holding together the collarbone and shoulder blade tear.

"It looks like the entire shoulder has fallen down," Dr. Chebli explains. "These are fairly straight-forward injuries and ones we see a lot of here because people in Seattle are so active."

Both Peter and Zeke were taken by ambulance to an emergency room in Tacoma, but were later referred to Dr. Chebli, who immediately put the father and son at ease.

"We just got the impression that she had done this a lot, and that she knew exactly what she was doing." Peter says. "We were confident that she was the one to see."

Dr. Chebli, on the other hand, says Peter and Zeke made her job easy.

"They were so motivated to get back to what they wanted to do and restore their function," she says. "A surgeon plays a crucial role in the beginning, but patients have to take the reins after the surgery to get their strength and mobility back."

After two successful surgeries, Dr. Chebli expected both Peter and Zeke to be spinning their bike gears soon. But for Peter, who describes the STP as a rite of passage for the Hansen men, it was more difficult to get back on a bike than he expected. Six months passed until he overcame his fear and saddled up again.

"It was a nice Saturday," he remembers. "I went from my house in Ballard, down to Shilshole, along the waterfront, then to the switchbacks above Golden Gardens, went across 80th Street, and then back home. It felt good to be out there again."

"Man, Iíve only done two training rides so far," Zeke mutters, showing his competitive side.

His Dad jokes that he better start training soon because despite last yearís falls, the two will again be competing in this yearís race. Peter, who has been running the Hansen family business Up Time Technology since the early 1980s, and Zeke, who works as a network technician there, both believe the race teaches them something about running a small business in Seattle.

"The race teaches you tenacity and a commitment to the team," Peter says as Zeke nods in agreement. "You canít do anything in this world without honesty and tenacity."

"Itís true," Zeke chimes in. "The last 30 miles of the race hurt and you question whether or not you will be able to finish, but you just keep spinning your gears. Look down at your crank and spin. That translates to our business too."

 
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