Bucks County HeraldAugust 9, 2007

Dr. Larry Miller Shoulder Operation – Part Two

 

Dear Friends,

Good morning. Last week, I wrote about Dr. Larry Miller, an orthopedic surgeon who specializes in shoulders, knees, and ACL’s (anterior cruciate ligament reconstruction, a very common sports injury). He repaired my right shoulder rotator cuff five months ago…successfully, I’m happy to say.

Larry rows at my boathouse, three days each week and performs about 300 operations yearly. I’ll bet that he’s repaired knees and shoulders to a third of the active rowers on the Schuylkill River. When I finally couldn’t lift boats over my head without agony, I knew that I needed repair. I was comfortable with Larry because he’s performed the operation thousands of times.      

The patient was a 43-year-old woman who’d torn the labrum in her left shoulder. It was an usual injury. “T Bird” as she’s affectionately known was lifting a heavy box above her head when the tear occurred. Larry Miller would repair it in just two hours. The operation is called SLAP, short for superior labral tear with extension to the entire front of the labrum. Left untreated, this would cause the shoulder to dislocate.

The operating team placed “T Bird” in a sitting position, which it calls the beach chair position. Her shoulder was at eye level. By the time the team had wrapped her in blue surgical paper, all that was exposed was the target area. “T Bird” resembled a blue mummy, wearing a seat belt!

Since this SLAP operation would be performed arthroscopically, Miller punctured her shoulder several times with tiny holes. Into one of them, he inserted a camera with a light on a catheter. Its diameter was just a few millimeters. Into the other hole, he inserted a tool, which shaved and vacuumed “T Bird’s” tear.

Miller used his right hand to steer the camera to the damaged (target) area. With his left hand, he maneuvered the grinding, shaving, and vacuum tools. He viewed the process through a 36-inch TV monitor, which magnified the target area seven times.

I clearly remember watching that same monitor as Miller shaved and vacuumed the “debris” in my shoulder last February. But the grinder upper, vacuum cleaner, which was working in my shoulder, appeared to be six inches long. In fact the device called a “curette” was only two millimeters wide and four millimeters long!

Miller used foot pedals to turn the instruments on and off. He gently hammered five anchors onto the shoulder bone and then sutured the loose ligaments to the anchors, which correctly restored the shoulder. I remembered the hammering and screwing noise.

I watched the TV monitor as Miller used carbon fiber core sutures to attach “T Bird’s” ligaments to her shoulder bone. He uses a special knot, which his team calls the “Miller knot,” plus several half hitches. It reminded me of my Boy Scout days.

In less than two hours, the operation was completed. “T Bird” was peacefully resting in the recovery room. Several hours later, her family would drive her home where the painful but necessary therapy would begin.

Five months after my operation…and tons of therapy…I’ve returned to the Schuylkill River. I’m not ready for five days of rowing each week, nor the six-mile round trip. But I am rowing three days and four miles each time. That’s quite an improvement. I thank Larry Miller and Frank Ciuba at HS Therapy in Harleysville for my success.

Some day, I’ll write about Miller’s opinions about health care in America. In the meantime, here’s my opinion. I believe that the insurance industry is the major culprit. The system is broken. Stay tuned.

Sincerely,

Charles Meredith