Wednesday, April 2, 2014

Three months out from a ream and run - the patient's story so far

We spend a lot of time on this blog presenting technical information about diagnoses and treatments. It is refreshing, once in a while, to let a patient tell their own story. Here's one we received this week from a man who lives 900 miles from Seattle.


I don’t really know where to start so we have to begin with, “why”, are we thinking about the drastic measure of surgery? Can we limp along doing the basics or minimum activity to believe we are still maintaining activity doing what we enjoy doing and only at a less aggressive pace.
“WRONG”, most of us were gifted with shoulders that did exactly what we wanted, when we wanted and how we wanted. It was really a great time and who thought it would ever end?

Here come our 40’s and everything is going great. Kids are in school and we make sure they are playing all the sports or at least one sport year around rationalized by I wish my parents would have done that for me when I was growing up and on and on We can eat what we want have a few cocktails and all of our joints are working how they are supposed to when we want. We are going to the gym when we want, work hard and feel good, skiing trips, construction work, digging ditches, framing houses, kayaking, water skiing, cycling, working in the yard, building home projects, washing and waxing the car etc. are all still on the list of activities we can do and enjoy without much bother. Sure every once in a while we are a little sore but nothing a couple of ibuprofen wouldn’t take care of.  

Holy cow I can’t believe I am now 50! Where did the time go and why are kids saying, “boy that person is really old I think they are thirty”. I think I throw the baseball as hard and long as I used to, the reps and weight I used to pump at the gym has gone down, my workout schedule is less cardio and the interval schedule between sessions is getting longer, I can’t run as fast and long as I used to as my knees are really starting to bother me when I am done working out my shoulders are also starting to stiffen up and make little sounds that I am not used to.

So far I have had rotator cuff surgery to get rid of a few spurs but nothing too serious. Arthoscopic surgery was done on my knees for torn meniscus, so I thought I was in good shape and had little to worry about.

"“Arthritis”, how did I get that?" I asked the orthopedic doctor when I went in for a checkup due to joint pain? That would explain why my joints were starting to hurt more during or after exercising activities or strenuous working activities? I was told the cartridge was wearing out and it was getting to be bone on bone for range of motion.

Now for the decision! Shall I have a conventioinal total shoulder put in or go the other route I have heard called Ream and Run”, surgery technique? There is a more scientific name but it was easier to remember, “Ream and Run”.

A conventioinal total shoulder is an easier surgery to have in that the recuperation time is shorter and as long as I kept the heavy stress off of the shoulder I should have no problem, but the conventional total shoulder uses a plastic socket which is at risk for wear and loosening with heavy use.  Recuperation time is supposed to be around six-12 weeks which did not seem bad.

The Ream and Run surgery is a fairly new technique and is supposed to be initially more painful with a recovery time of six-twelve months but the result would be a shoulder I can abuse to the maximum and it would outlast me. Decision easy! I wanted to start doing the sports, activities and all strenuous exercises I did before my joints started to wear out.

Being a fairly new surgical procedure a person’s options of where and who they have do the Ream and Run surgical procedures are limited.  I am 61. I chose the doctors at the University of Washington to do my surgery because they have performed over 500 of the Ream and Run procedures. I had the Ream and Run surgery which was an answer to my prayers. I was dressing myself the second day and lightly and I do mean lightly started stretching exercises for my shoulder. I started going to the gym by myself shortly after surgery and started to notch it up a bit daily.

I do not care what anyone says, exercising should only be done five days a week. If a person exercises seven days a week they will get bored and tired of their routine. There were five exercises I enjoy and include; the pulley hung on something high enabling me to sit down stretching out each arm for 30 second intervals four times stretch as high as you can go then try to get one more notch, the pull down bar where your arms are at a 30 degree angle doing three reps of ten, use the same bar putting your hands in the middle of the bar also doing three reps of ten, the rowing machine and the last exercise is up to you but has to be an up down in front of you as your shoulder is not ready for side motion exercises yet. Remember you have to start light but must increase weights as soon as you can.

It has been three months since my Ream and Run surgery and use 50# weights at the gym my shoulder was ready for side motion exercises three weeks ago, (light, arm circles than 2# weights etc.). After three months the conclusion is my shoulder that was operated on is now stronger than my other arm and the only time remember I had surgery was when I think about it. 


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