If I need surgery will you be doing the operation?
Yes.
I do teach residents and they participate in cases at the Dayton VA Medical Center and Miami Valley Hospital but not at any of the other facilities where I operate. Additionally I am responsible for every aspect of your case and only allow resident participation with my direct supervision.
Do you do minimally invasive surgery?
I do utilize minimally invasive techniques in many circumstances. In my practice I do many procedures in the shoulder and elbow using arthroscopy a minimally invasive technique (see the next question for a description of arthroscopy). However there are times when these techniques are NOT appropriate and it’s easy to get distracted by incision size as a sign of the quality of a surgery.
When you are having surgery, there are other important considerations that have a direct impact on the long-term outcome of your procedure that should never take a back seat to incision length. These include implant positioning, tissue handling and visualization. Like everything else there is a right place for minimally invasive techniques and a wrong place for them. The most important consideration for your surgery is that the maximally EFFECTIVE technique be used. And this must be chosen on a case-by-case basis.
What is arthroscopy?
Arthroscopy is a form of minimally invasive surgery within joints like the shoulder, elbow or knee. It involves making a few small incisions each about an inch in length and using a fiber optic camera and a series of instruments that are about the size of a pencil to repair damaged tissues inside joints. Most people can go home on the same day as their arthroscopic procedure.
I often use the example of building a ship in a bottle to help people visualize what arthroscopy is like. The surgeon accomplishes all of the same objectives as open surgeries but with small, specialized instruments designed specifically to work through narrow openings.
How long will my surgery take?
Every surgery is different. If you are the one having surgery, you will feel like the surgery takes no time at all because you will be asleep. For your family members in the waiting room, their perception will be much different.
When you go to surgery you will usually wait in a “holding area” with your family member for an hour or so, depending on the time of day or whether the operating rooms are running on time. Like airport terminals, operating rooms tend to run on time in the morning but may run late as the day progresses. At least one nurse and the anesthesiologist will see you while you are in the holding area. This is where you will get an IV and be checked in. You may also get regional anesthesia (pain blocks) here.
When you go the OR your loved ones will wait in a waiting room. The surgery does not start right away. It usually takes a little time for you to get general anesthesia and for positioning and draping to occur. Similarly when the surgery is done the anesthesiologist must wake you and then take you to recovery.
The actual surgery time varies depending on the complexity of the case. The short answer is that any surgery should take as long as necessary to get the job done correctly…but not longer.
How long does it take to recover from surgery?
Every surgery is different. I encourage you to browse some of the FAQs that are specific to the particular surgery that you may be having. Not all of them are represented in these FAQs, but they may give you a good starting point.
A word of caution with regard to shoulder surgery: it is not always possible to know ahead of time what your recovery timeline will be. Sometimes findings at the time of surgery will dictate how fast your therapy and recovery will progress. Therefore we will often give you some general guidelines before surgery and then narrow them down after your surgery is done.
Recovery times vary for different people depending on factors such as overall health, type of procedure, physical fitness, and whether the surgery is a revision surgery or first time surgery.
Recovery for the same operation can be different for different people but usually falls within a general range for any given procedure. We can discuss your unique circumstances at our office visit.
If I have hardware placed in my body, does it have to come out?
It really depends of why you had hardware placed.
Certain types of hardware are intended to stay in for life: joint replacements, many plates and screws for fracture fixation.
Other hardware is meant to come out: pins that are placed temporarily through the skin to hold fractures in place while they heal.
Occasionally an implant such as a plate will need to come out because of tissue irritation or infection. However, most implants that are placed in your body tend to stay there permanently. They are typically made from inert materials such as stainless steel or titanium making them compatible with biological tissues. It’s very rare for your body to “reject” an implant.
How much pain will I have after surgery?
There’s no perfect stock answer for this question. The short answer is that EVERY person has a different level of pain and it’s really tough to predict who will have a lot of pain and who will have little pain. Here are a few things we can say with some certainty:
If you are having surgery on your shoulder or elbow you will have some pain after surgery. We now use many methods for treating pain including pills, regional blocks (injection of long acting numbing medications around the nerves of the arm), and ice packs. No treatment is without side effects. Narcotic medications can make you nauseated and constipated. Anti inflammatories can hurt your stomach. Even ice can “burn” your skin if you keep it on too long. But by using them in combination we can use smaller doses of each and lessen the downside risks while giving you good pain relief.
Every person has a different pain tolerance. Just as you might like apples and I like pears, every human being is unique in our reaction to pain- we are individuals. It’s what makes us special and life worth living. I’ve had patients who are on no pain medication 2 weeks after a shoulder surgery and some who take over a month to wean off of them. There’s no one answer for this. If you are taking narcotic medication prior to surgery (vicodin, percocet, oxycodone) you likely will have a harder time controlling your pain after surgery than if you were taking none. This is simply because the body develops a tolerance to these medicines and needs more to do the same job. So whenever possible it’s best to be off of these medications before surgery.