What is Shoulder Replacement?

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What is shoulder replacement? Many patients have asked about shoulder replacement, wondering if they are a candidate for this procedure. There are several causes of shoulder pain, and not all shoulder pain requires surgery.

The shoulder and its components

The shoulder is a complex joint. It is considered a ball and socket joint, similar to the hip joint. However, the socket for the shoulder is very shallow. The shallow socket allows our shoulders to have such incredible range of motion. This same range of motion makes the shoulder intrinsically unstable. The shoulder is highly complex, with multiple tendons and structures that make movements possible. This complexity means there can be several causes of shoulder pain.

When a patient presents to the orthopedic clinic for shoulder pain, we look for these different sources:

  1. Rotator cuff tendonitis, bursitis or a tear
  2. Neck pathology
  3. Labrum tears
  4. Shoulder joint arthritis
  5. Combination of rotator cuff tear and arthritis

Assessment and treatment

We use medical history, a physical examination, x-rays and occasionally an MRI or CT scan to help us understand the cause of the pain. Shoulder arthritis and a combination of a rotator cuff tear and shoulder arthritis are the main indications for shoulder replacement. Before considering surgery, we explore other options like medication, steroid injections, activity modification and physical therapy.

When conservative measures are not helping, then we consider surgical treatment. Surgical treatment includes a total shoulder arthroplasty (shoulder replacement) or a reverse total shoulder arthroplasty. The difference between these two surgeries involves the ball and socket. When a patient has arthritis of the shoulder joint with a rotator cuff that is intact and functioning well, we can do a standard shoulder replacement. For this type of surgery, we attach a small shallow plastic socket to the worn-out socket. We remove the worn-out ball and replace it with a new metal ball attached to a stem. This new ball and socket joint is still unstable, so we rely on the functioning rotator cuff to provide stability, just like a healthy shoulder. This allows for a nearly normal, pain-free range of motion and strength.

Arthritis

We cannot do a standard shoulder replacement when a patient has arthritis combined with a large irreparable rotator cuff tear. In these cases, we do a reverse total shoulder replacement. This surgery involves attaching a ball to the worn-out socket and removing the worn-out ball, then replacing it with a deeper socket. This replacement creates a more stable ball and socket joint. It also allows the ball to become the fulcrum so the arm can rotate. It alleviates pain and improves function. The trade-off with a reverse total shoulder replacement is reduced range of motion. Therefore, we do this surgery only when the rotator cuff is not functional or repairable.

The surgery usually takes a little over an hour, so most patients spend one night in the hospital and are discharged the next day. Recovery involves six weeks of physical therapy. The patient has to wear a sling during recovery. Following this initial period of immobilization, we progress to active range of motion, then strength conditioning. Total recovery time is approximately 4-6 months. Most patients feel their pain is improved within a few days to weeks.

About the author

Dr. Robertson is an expert in shoulder replacement.

Ben Robertson, MD

Ben Robertson, M.D. is an orthopedic surgeon at Tri-County Health Care serving patients in Wadena and Baxter. He attended medical school at the Medical College of Wisconsin and completed his residency at the University of Minnesota. Additionally, he also completed a sports medicine fellowship in Oslo, Norway. He specializes in sports injuries, knee ligament reconstruction, and shoulder, hip, and knee replacement. Outside of work, Dr. Robertson enjoys bicycling, reading and spending time with his wife and three children.


Meet the surgical staff: Stacy White and Amanda Kimber

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Meet the surgical staff! Amanda and Stacy love helping people in surgery.

Each person plays a pivotal role in the success of an organization, which is especially true in a hospital setting. In the surgery department, everyone needs to be at their best. All too often, the support technicians and nurses fade into the background. Recognizing the people that support surgery makes you appreciate every aspect of the care you receive at Tri-County Health Care. This blog helps you meet a couple of surgical staff members that make our operating room such an efficient place.

Meet the surgical staff: Stacy White, Registered NurseMeet the surgical staff-Stacy White

Stacy has been a nurse for 20 years and loves rural health care. She is responsible for a wide range of tasks, from patient education to recovery. Stacy is a busy lady and can often be seen making her rounds in the hospital tending to patients. Her primary duty is being a patient advocate. She places a high value on patient safety and wants patients to be informed about all aspects of care before going back to surgery.

Recently, she was a part of the 500th joint replacement and was ecstatic to share in the achievement. Stacy has been a part of every surgical milestone with the orthopedic team.

“I love the small rural hospital setting! I really enjoy taking care of patients and their families and being a familiar face. It’s nice to provide care to members of the community I live in.” – Stacy White

Meet the surgical staff-Amanda KimberMeet the surgical staff: Amanda Kimber, Surgical Technologist

Amanda has been a surgical technologist at Tri-County Health Care for 12 years. As a surgical technologist, she plays an important role often overlooked when discussing surgery. Her responsibilities include ensuring the surgeon has the correct instruments and tools for the procedure. During an operation, she hands off tools to the surgeon while maintaining a sterile workspace.

“I absolutely love working with the team, they are awesome!” – Amanda Kimber

For more information about surgery at Tri-County Health Care, please visit our general surgery page. Don’t forget to follow Tri-County Health Care on social media for important health updates.


Step-by-step guide to colonoscopies

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All too often, people fear the unknown. In the realm of healthcare, this is especially true. Part of receiving care at a hospital or clinic is getting quality consultation about procedures, medication and better living practices. Colonoscopies are no different. If a person is approaching 50 years of age, it’s time to start thinking about scheduling a colonoscopy. However, many people in this age range put it off. Using this guide is a step in the right direction.

Travis Swartz, DO, has spent a great deal of his career performing this procedure, helping hundreds stave off colon cancer. According to Dr. Swartz, the main reason people avoid a colonoscopy is embarrassment. They think being sedated and having an endoscope inserted into their rectum is an invasion of privacy with outcomes not worth the hassle. This belief is simply not true. Although it is not a fun activity, screening is a great tool to discover cancer.

A step-by-step guide

A great way of reducing anxiety is to break things down into pieces. Dr. Swartz has put together a guide to coloscopies at Tri-County Health Care. It covers everything from the initial consultation to discharge.

Travis Swartz, DO, wants you to take steps toward better colorectal health.

Travis Swartz, DO

  • According to the Mayo Clinic, a person should receive a colonoscopy around 50. Follow-up colonoscopies will depend on a patient’s risk for cancer.
  • Typically, a primary care provider discusses a colonoscopy during an appointment. If they don’t, ask about it. An active approach is the best way to prevent colon cancer.
  • The procedure usually takes place about a week after scheduling.
  • There is preparation to do before a colonoscopy. Cleansing the colon is the most difficult aspect of the process. A patient will need to consume around a gallon of liquid mixed with a medicine that will force bowel movements.
  • Avoid red or blue liquids because they create issues with the imaging equipment.
  • You will get a confirmation call before the appointment.
  • After check-in, you are brought to a private room and to meet with the surgeon. Shortly after, patients meet with the anesthetist.
  • The patient goes back to the colonoscopy suite. In the suite, a surgeon, a reporter and an assistant will complete the procedure.
  • The patient is sedated during a colonoscopy. The actual procedures takes around 30 minutes. The entire process takes around three to four hours.
  • After, the patient returns to the private room. The patient enjoys a meal and sent home.

Efficiency

Technology, colonoscopies have come a long way. The screening only takes a few hours. The patient goes home the same day with no special instruction for recovery. According to Dr. Swartz, patients are usually very tired from being up most of the night. Most go immediately home to enjoy a nice nap.

Tri-County Health Care offers multiple colon cancer screening options. Visit TCHC.org for more information about screenings. Call 218-631-3510 to schedule.


Colonoscopies & Care: The importance of regular screenings

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Colonoscopies are often a topic of debate, with many people dismissing them as overly invasive and even an invasion of privacy. However, it doesn’t need to be dreaded and avoided. During Colorectal Cancer Awareness Month, organizations across the United States, including Tri-County Health Care, are taking a stand against colorectal cancer. Our mission is to educate and spread awareness about one of the most preventable forms of cancer.

Colorectal or Colon cancer awareness dark blue ribbon on helping hand. colonoscopies

Susan Marco

Susan Marco, an employee at Tri-County Health Care, is especially passionate about early prevention screening. Her story about family and early prevention truly illustrates the importance of testing. She is no stranger to colonoscopies and felt sharing her story would greatly alleviate how many feel when they hit the recommended screening age.

“It was the early discovery that saved her life,” said Susan when discussing her mother’s cancer diagnosis. At 50, Susan’s mother was diagnosed with colon cancer during a routine colonoscopy. Without the screening, she most likely would have died. Since then, Susan has felt it was her duty to embrace early prevention screening and encourage others to do the same. She recently completed her third colonoscopy in January 2021.

The preparation

The most difficult part about a colonoscopy according to Susan is the preparation. The procedure itself went fine but the preparation does require some steps. After a consultation with her doctor, she had to take an over-the-counter laxative that would clear her colon. The medicine is typically mixed with a sports drink.

The next morning, she visited Tri-County Health Care and was checked in for her appointment. The nurses made her stay comfortable and prepared her for surgery. She was sedated for the procedure. The entire process only took about half a day to complete.

“The preparation and procedure are such small things and take up such a small amount of time, so why wouldn’t everyone do this in order to avoid colon cancer?” said Susan when asked about her experience.

My family cared for me

“I work at Tri-County Health Care, so people asked if it was uncomfortable for me to have my co-workers take care of me during the procedure. It wasn’t uncomfortable at all! It felt like my family caring for me,” said Susan. Tri-County Health Care provides this type of environment for everyone. Comfortability is paramount to the team during such a delicate process.

Dr. Timothy Monson. colonoscopies

Timothy Monson, M.D., MBA, FACS

Susan is a recruiter, and it’s her job to find the best medical talent out there. She actually recruited Dr. Monson who conducted her colonoscopy. According to Susan, Dr. Monson is a remarkable provider and a kind man that approaches every surgical scenario with poise and professionalism. He is literally perfect for Tri-County Health Care and Susan knew she was in capable hands. The colonoscopy went well and Dr. Monson played a pivotal role in Susan’s continued good health.

Prevention is key

During her previous colonoscopies, Susan expressed that she felt like just a number. Her procedure was always met with cold sterility, far from the family-like atmosphere she experienced at Tri-County Health Care.

In many cases, colon cancer shows no symptoms, but routine screening can prevent and detect this type of cancer. Most people should begin receiving routine screening around age 45 and Tri-County Health Care offers multiple colon cancer screening options. Regardless of where you choose to have such a procedure, please join Susan in the fight against colorectal cancer and for March. Visit TCHC.org for more information about screening, and call 218-631-3510 to schedule an appointment.


ED saves man’s life after post-surgery infection

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Kenny Beesley was first introduced to the construction trade when he was just 13. From that point on, he was hooked. He developed his craft and made it his full-time profession. But in 2016, at the age of 35, he fell from a ladder while working on a house.

“I had a big ol’ bruise on my side,” he said, but the damage extended much deeper. The fall resulted in two fractured vertebrae and three herniated discs, which led to arthritis and degenerative disc disease. “I couldn’t even sit up straight. I couldn’t walk. I couldn’t sleep.”

 

Recovery gone awry

Since his accident, Kenny has been plagued by pain and impairment, rendering him unable to work. He recently began to have surgery to try to help his chronic injury.

Construction rooferHis first lumbar surgery to trim a portion of his spinal discs was performed on Thursday, Sept. 13, in St. Cloud. The surgery went well, and he was able to return home.

On Saturday, however, he spiked a high fever and began experiencing uncontrollable pain in his back and shooting down his legs to his toes.

“I knew something was wrong,” he said. “I couldn’t sleep. I couldn’t sit down. I couldn’t stand. I was just miserable.”

When his wife, Amy, returned home from work, they rushed to the emergency department (ED) at Tri-County Health Care. Dennis Faith, M.D., examined Kenny, tested the sensation in his legs and found that despite the severe nerve pain, his legs were completely numb.

“I had a blood pocket in my incision,” Kenny explained. “They said I had an infection somewhere in my body and did not know where.”

Dr. Faith knew the surgeon who had performed Kenny’s surgery in St. Cloud and immediately reached out to update him on the situation. From there, the ED staff sent Kenny by ambulance to St. Cloud where he had surgery on Sunday to treat the infection and repair the incision.

“They did really good. It wasn’t like in and out. They made sure everything that needed to be done was done before I had to go to St. Cloud,” Kenny said. “They said if I would have gone home, I would have died.”

 

Relief and reliable care

Kenny was glad to be back home after his weekend emergency, but the reprieve was short-lived. On Tuesday, a friend was helping him change his bandages when it caught on his butterfly stitchesEmergency room patient, Kenny Beesley with his wife Amy. and ripped three of the six off of his surgery incision. It began leaking fluid, so he and his wife hurried back to the ED.

This time, Amadin Osayomore, M.D., was the doctor in charge. He assessed Kenny’s needs and quickly mobilized his team to repair Kenny’s stitches.

“He looked at me and told them to fix me up. It was really good,” Kenny said. “He shook my hand and said, ‘Have a good day, sir.’ He was a really polite man.”

Kenny said that he doesn’t think his condition will ever get better, but it’s something that he’s learning how to live with. And future surgeries may be able to bring him some relief. “I hurt really bad, but it’s a fact of life. I’m not done with surgeries yet,” he said.

Now that he’s had a few encounters in the Tri-County ED, he is thankful for the staff’s efficiency and dedication to his care. “I just think they’re doing a good job,” Kenny said. “Even when I was really upset, they calmed me down and told me it’s going to be all right. They’ve done really good with me, so that’s why I come here.”


Leland’s story: hope and healing after a serious injury

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By Jessica Sly, Communications Specialist

 

The date was Feb. 6, 2017. Carpenter Leland Elgin was hard at work cutting a piece of flooring on a table saw. Just as he reached the end, the piece kicked back toward the blade, taking his left hand with it. His thumb and three fingers were severed.Leland working with physical therapy to regain strength from his hand injury

“I looked at my hand and everything was just dangling there,” he recalled. “I must’ve gone into shock right away because I just kept on walking right to the ambulance and got in.”

The emergency department physician at TCHC determined that Leland needed extensive surgical intervention, so he was airlifted to North Memorial in the Cities. A nearly 10-hour surgery connected Leland’s digits back to his hand, transferring veins and nerves from other parts of his body to restore feeling in his fingers.

“It’s unreal what they can do,” he said. Unfortunately, his index finger was too damaged and couldn’t be saved.

Within the first month and a half following his accident, Leland had six surgeries, and then he was ready to start physical therapy.

Because Leland lives near Bertha and Eagle Bend, he chose rehabilitation at TCHC’s Bertha Physical Therapy Clinic with Travis Rasinski, DPT. They started with mobilization in his fingers to loosen the scar tissue and kept his hand wrapped to reduce swelling.

“They wanted to get it limbered up because everything was stiff. Nothing worked,” Leland said. “When we first started, Travis was just trying to get everything moving. It’s kind of weird because you can hear it breaking loose every so often, but Travis loves it.”

Leland working with Rehab to restore function in his hand after a serious injury.Travis worked manually with each finger and coached Leland through exercises such as picking up objects, turning keys and working with weights.

After three months, Leland returned to work. It helped to keep him occupied, as well as contributed to the healing process. “I was going crazy sitting at home,” he said. “At first, it was a little tough. It seemed like a lot harder work. It’s just overcompensating for what you can’t do with that hand and figuring out different ways to do things. You get used to it.”

A surgery scheduled in September was meant to connect Leland’s tendons to return independent movement to his fingers. Unfortunately, it wasn’t successful.

Leland resumed physical therapy, where Travis used ultrasound to soften the new scar tissue and worked to loosen the joints in each finger. He also stabilized Leland’s right shoulder to compensate for the extra use.

After months of work, they restored the movement in his elbow and wrist and got some range of motion back in his first knuckles. However, his grip strength and functional capacity will never go back to normal.

“It’s a unique case for sure. You forget what you take for granted,” Travis said. “Leland’s a highly motivated, hard-working patient.”Leland Elgin and physical therapist, Travis Rasinksi

Leland credits his incredible surgeons and Travis’ hard work with getting him to where he is today in terms of functionality.

It’s been almost exactly a year since the accident, and throughout that time, Leland has experienced a range of triumphs and setbacks, both physically and emotionally. But he’s not letting it keep him down.

“At first I kinda thought, ‘Oh, great.’ Then I realized it is what it is, and I’ve just got to do the best I can with it,” he said, and he had the same message for others who may be experiencing physical difficulties. “Push as hard as you can. Do as much as you can do. Something will come around. Something will work out. It’s just figuring out different ways to do it.”

 

 

Photo of Jessica Sly, the author for this blog post.About the Author: Jessica Sly has been working as a communication specialist at TCHC since May 2017. A Wadena native, she graduated from the University of Northwestern – St. Paul in 2012 with a degree in English with a writing concentration. She is a word nerd, lover of all things Disney, self-proclaimed crazy cat lady and devoted Minnesota Vikings fan (SKOL).