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Dr. Millett restored the quality of my life.
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Published with the permission of Kay Veron:
Dear Dr. Millett,
My knee is doing well. The specialist, Michael Solomon, I have been seeing here was impressed when he looked at the x-rays of your handywork and he has been pleased at my progress since my return to Sydney in March. I was non-weight-bearing until April 12, partially weight-bearing until May 24, after which I used a stick for about 2 weeks.
I am still going to physical therapy and I feel that it has been very beneficial. The only problems I have now are the stairs -going up and down one at a time. However, that is also improving. I walk well, with hardly a limp, although if I walk too far my leg feels as though it is swelling.
The physiotherapists who have been treating me have been impressed by my mobility and have concluded that it is partly due to my high level of fitness prior to the accident. They are also pleased with the degree of flexion (now 125, although I'm not sure if this is metric) and say that this is largely attributable to the early use of the CPM, as they have had problems with patients who have not been put on one.
If I had to have the accident at all, I am so glad that I had it in Vail, as I obviously had the best surgeon and the best medical care available anywhere.
Thank you so much for looking after me so well and doing such a great job on my leg.
Kind regards
Kay Vernon
Sydney, Australia
This letter is published with the permission of Mr. Jerry Giuliano.
December 23, 2004
Subject: Shoulder Replacement Surgery
To Whom This May Concern:
This is not intended to suggest, advertise, or recommend Shoulder Replacement Surgery to anyone by anyone, anywhere, at any time; the following is my personal experience regarding Total Replacement Surgery that I am willing to share in hopes that someone will find the information helpful.
For many years, pain in my shoulders altered my range of motion so that, what should have been, routine activities became chores. For example, it was quite painful to raise my arms (in front or to the side) to shoulder level. It was equally painful to put either hand behind my back. When I forced a hand behind my back it was extremely difficult to raise it higher than the top of my leg. This meant that pain was associated with such a trivial thing as brushing my hair; and, threading a belt through loops was pain-free only when done before putting on my trousers. Sleeping through the night without pain was an "impossible dream".
Despite all the pain associated with shoulder movement, I continued to play "catch", street hockey, and "shoot hoops", with our grandchildren and to ski and play golf whenever possible. All of those activities resulted in, at least, three days of more than usual pain. On a one to ten scale of pain, "normal" for me was five… eight was on the days following the "play" days or when simply moving my shoulders too many times in one day.
Pain started in my right shoulder when I was about 25 years old. At that time, my family physician recommended a cortisone injection which I took and which kept me pain free for 15 years. Pain returned to my right shoulder and started on the left one when I turned 40.
For the next 26 years, I tried everything imaginable to relieve the constant nagging, debilitating pain in my shoulders including naturopathic herbs, teas, topical creams and ointments, massage therapy, physical therapy, cold therapy, heat therapy and "trigger point". None of that worked for me and all of that was before my family physician prescribed 800 milligrams of ibuprofen three times a day for life. Because I am not fond of taking any kind of medicine for long periods I took the ibuprofen only before I engaged in any activity that would require repetitive shoulder movement and when pain woke me more than twice on any night.
Regular visits to my chiropractor helped a little; however, neither additional cortisone shots, nor massages, nor exercise, nor whirlpool, nor swimming, nor acupuncture eased the pain even a little bit.
The last attempt to relieve pain, prior to my Total Shoulder Replacement Surgery, was a computer aided arthroscopic injection of some kind of revolutionary gel designed to
lubricate my shoulder joint in precisely the right spot in order to provide comfort and joy. That didn't work either.
Having exhausted all reasonable therapies that might provide some pain relief, I sought information and counsel for Total Shoulder Replacement. My local orthopaedic surgeon recommended that I make an appointment to see Peter J. Millett, M.D., M.Sc. who specializes in shoulder replacement surgery. There are no words to adequately describe my gratitude and the good fortune brought about by that recommendation.
There is plenty of information on the internet that describes joint replacement; and, there are lots of people who know someone that knows someone who had it done. I had it done and this is what I know:
Total Shoulder Replacement Surgery is no magic bullet. To be successful, it requires the brilliance, skill and dedication of a great surgeon and his capable staff. It is helpful when the anesthesiologist and the entire hospital staff are always on top of their game. The follow- on Physical Therapists must be able to provide the kind of care recommended long after the surgery has been completed. The patient must follow the orders of the Surgeon and be disciplined and diligent with the protocol outlined by him and the therapist. Along the early path to recovery, there is a need for a friend, a partner, a significant other who can inspire, encourage, and help in whatever way help is required. I had that special person in the form of my wife, Audrey.
On March 22nd 2004, Dr. Millett performed the first of my two total shoulder replacements at Brigham & Women's Hospital in Boston. He did the second one on October 18th, 2004, same place. You can guess that I was pleased with the result of the first procedure; in fact, I was more than pleased.
As anyone would be, I was apprehensive about undergoing the first surgery since no surgery is without risk. From the beginning, I listened carefully to everything Dr. Millett had to say. He ordered and reviewed all the "pre-op" tests, explained the up and downsides of the procedure, and he answered all my questions (and there were plenty) with patience and understanding. When the time came, I was ready; I had complete faith and confidence in Dr. Peter J. Millett.
Prior to surgery, the attending nurse, the anesthesiologist, and Dr. Millett stopped to see me on the pre-op gurney; they asked if I were ready and if I had any more questions. After everyone agreed that it was really me on the gurney and which shoulder was planned for repair, someone administered the "shot". From the time I awoke to the time I was discharged, there were Hospital Staff doing everything possible to keep me comfortable.
I don't wonder why Brigham & Women's Hospital ranks among the very best hospitals in the world. In my world, it is the best.
I expected much more pain than I experienced following surgery. I attribute that to the pain management protocol that was outlined for me and the skillful administration and care provided by the people surrounding that protocol.
My hospital stay was planned for two (2) twenty-four hour periods; I was admitted on a Monday morning and on Wednesday I was homeward bound. Before I left, a Hospital Staff Physical Therapist showed me some very basic circular movements I should do daily and she guided me through them to be sure I could do them correctly. There was no pain associated with that exercise.
She also provided me with a list of things I should and should not do and she arranged for home physical therapy until I felt ready to go to a Therapists office. I asked her, "What is the single biggest reason why my recovery may be hampered and what must I do to achieve the maximum benefit from the surgery and physical therapy?"
She answered that many people are afraid the therapist will hurt them so they tense up; and, by so doing, they prevent the therapist from properly manipulating the joint. Relax! Yes, there would be some pain and discomfort when the arm and shoulder are being "worked" but, with each session, pain would start later in the range of motion until each motion can be done without pain. There is no better feeling then when a replaced shoulder allows an arm to reach any physically possible position…pain free.
At this writing I am 10 weeks past my second shoulder replacement. My physical therapist tells me I have about 95% of full range of motion. What she doesn't know is that 95% is 45% more range than I had for 20+ years before Dr. Peter Millett replaced my shoulder. In two weeks or so, when I reach 100% full range of motion, I will be finished with formal therapy and head back to the gym where I will do further shoulder and overall strengthening exercises. Whatever pain I have left in my shoulders is a very small fraction of my pain before shoulder surgery. Actually, now it's more occasional slight discomfort than pain.
As in the beginning of this letter, may I repeat, I have absolutely no qualifications to speak about or predict the outcome of anyone else's Shoulder Replacement procedure but my own.
There is no doubt, not even a little bit, that I made the right decision to have my shoulders replaced. Equally, there is no doubt that I was fortunate to have been directed to Dr. Peter J. Millett and Brigham & Women's Hospital.
For me, they were a team that provided me with the best all around Pre-op, Operation and Post-Op care possible. They could not have done more for me or any better. They did their job successfully. When I left the hospital I knew that the ultimate success was up to me.
I did not dwell on the discomfort that followed me home from surgery. Getting used to using one arm in the shower or lying on my back, to sleep at night, with a pillow propping my shoulder for weeks and weeks could have been frustrating. I chose instead to take note that, each day, I could move my shoulder just a tiny bit better. I kept the end goal in sight…one day I would be able to move my shoulder better than before and without pain; that was my mantra.
When I began outside physical therapy my goal was to be their best patient. I was relaxed and friendly, paid close attention to the drills and did exactly what they asked. Doing so yielded positive results. Because I am not fond of long periods in waiting rooms and because I knew the drills, I progressed to the point where I could go in the therapy room early, stay out of everyone's way, do my drills and work my way into the shoulder manipulation part at the therapist's convenience. Bottom line: more efficient, less time, good for me.
If this letter or any part of it finds its way into the hands of a reader contemplating Shoulder Surgery, this is my wish for you:
I wish that you can go forth, knowing in your heart, that Shoulder Replacement Surgery is your best option to improve your quality of life, that you will proceed with confidence in your Surgeon and his Hospital such as I had, that you will persevere through whatever discomfort you experience along the road to recovery, and that you will enjoy the benefits as I do. Every day.
Good Luck!
Jerry R. Giuliano
P.S. Between the two surgeries I "shot hoops" with the grandkids and played better than ever golf three times. Can you guess how excited I am for spring to roll around?
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