Surgery best option for rotator cuff tear
Dear Dr. Gott: I was in a skiing accident two years ago and injured my shoulder. My doctor ordered an X-ray of my shoulder, and a request for an MRI was denied by my health insurance company. He ordered therapy, which only increased the pain and discomfort. I had almost no range of motion and was in constant pain. After a year, I told my doctor I was still experiencing pain and discomfort. He ordered another X-ray, which came back normal.
After another year of no resolution to the problem, I finally got an MRI that revealed a tear in the rotator-cuff tendon with some other problems. He sent me to an orthopedic sports doctor. That doctor asked me what I hoped to have accomplished with treatment of the injury. I thought his question very odd, since he should know what needs to be done to resolve the injury. He once again ordered therapy – yoga, swimming, etc. My question is, can therapy heal a rotator-cuff tendon tear? I only want the shoulder back the way it was before the accident, with full range of motion and no more discomfort brought on by certain movements.
Dear Reader: Your MRI revealed a common problem: a tear of the rotator cuff, the tissues that stabilize your shoulder. In my experience, surgical repair is the only satisfactory solution if rehab and physical therapy have been ineffective. Your newest specialist has recommended a course of therapy, but for you this is the second go-around, so you have certainly given nonsurgical therapy a reasonable trial. Return to your orthopedic surgeon or to a second orthopedist if the first specialist did not seem inclined to consider an operation.
To give you related information, I am sending you copies of my Health Reports “Managing Chronic Pain” and “An Informed Approach to Surgery.” Other readers who would like copies should send a long, self-addressed, stamped envelope and $2 for each report to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title.
Dear Dr. Gott: My wife insists on leaving the lid up and the seat down on the toilets in our home. The sinks are right next to the toilets. How unsanitary is this practice?
Dear Reader: This is a social and cultural issue, not a medical one. Whether you, as a man, choose to leave the seat up is a function of being considerate. Neither practice is unsanitary, regardless of where the sinks are placed in relation to the toilets. Your wife might be giving you a subtle message: Put the seat and lid down after you pee.