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Total Reverse Shoulder Replacement: Barb's Story
Best thing I ever did for myself was see Dr. McFarland. He is my hero.
- Barb Meshulam
Meet Barb Meshulam, 63, a wife, mother and retired operating room nurse. She tore her rotator cuff twice — and had surgery both times to repair it. But when Barb experienced renewed discomfort so intense it kept her up at night, she was told at age 61 that she would have to learn to deal with some continued aches and pains.
Barb believed that there had to be a better answer. Her search for a shoulder expert led to a recommendation for Edward McFarland, M.D., director of the Division of Shoulder Surgery in the Johns Hopkins Department of Orthopaedic Surgery. “Other people I knew and respected recommended him,” says Barb, “and I also knew he had taken care of some of the boys on my nephew’s baseball team.”
The Right Diagnosis at the Right Time
During her first appointment at Johns Hopkins at Green Spring Station, McFarland reviewed Barb’s MRI scans and wasn’t sure at first why she was in so much pain. He asked her if she had ever had a regular X-ray taken of her shoulder, and when she said no, had her go to the imaging suite on-site to have one done. “When I got back in the exam room, Dr. McFarland and his assistant viewed my X-ray and both said: ‘Oh!’ Dr. McFarland followed with: ‘You are in a lot of pain, aren’t you? You can’t be sleeping at night.’”
McFarland saw that Barb’s glenoid — the socket part of the shoulder joint — had been worn down so much that she was experiencing bone-on-bone friction in her joint. “I usually describe the glenoid as the top of a golf tee to patients,” says McFarland. “Its purpose is to hold the golf ball in place, just like the glenoid holds the ball of the shoulder joint in place. But when it is worn down or uneven, it becomes unstable, and the golf ball rolls off.”
McFarland recommended that Barb have a total reverse shoulder replacement to relieve her pain. “Because Barb had already had two rotator cuff repair surgeries and bad arthritis, the only option to relieve her pain was a reverse shoulder replacement,” says McFarland, who performs around 100 of these surgeries each year.
“I wasn’t ready right there and then to have the procedure done,” says Barb, “so Dr. McFarland said to give him a call when I was ready and when the pain was too much to bear.” But it wasn’t long before Barb made that call. “I decided I was going to hold off, but after a few months, I said: ‘I give up. I’m ready.’ Why wait another nine months when I’m in so much pain? My quality of life was so bad at this point.”
Relief from Pain and Improved Range of Motion
“Before surgery, Barb had a limited range of motion, and any movement she made caused pain in her shoulder,” recalls McFarland. But luckily, Barb’s shoulder pain is now a thing of the past. After years of dealing with pain, her reverse total shoulder replacement was just what she needed. Barb exclaims: “I’m totally back to who I am! I’m sleeping again and I feel like I got my life back.”
Each year, McFarland and his team treat a number of patients with complicated medical histories just like Barb. In a process unique to McFarland’s practice, his team has a plastic model of each patient’s shoulder blade made so that they know exactly what the socket looks like before the procedure. This allows them to plan where to put the screws and place the prosthesis beforehand, limiting the time of the surgery and increasing the likelihood of a positive outcome for the patient.
“I am very satisfied with the results of Barb’s surgery,” McFarland says. “She now has improved movement in almost every direction, but even more importantly, she is experiencing a lot of pain relief, which was our main goal for the surgery.”
“The best thing I ever did for myself was see Dr. McFarland,” Barb says. “He is my hero. I love his personality. He’s funny, kind, informative and never made me feel like he had to rush me through the office. In fact, everyone in the office is great, from the people who sign you in to those who check you out. My experience top to bottom was perfect.”
Edward G. McFarland, M.D. is the director of the Division of Shoulder Surgery at Johns Hopkins. He specializes in the treatment of shoulder and elbow injuries, including: shoulder instability, shoulder rotator cuff tears and shoulder joint replacements.McFarland, Edward George, M.D.
Over 500 patients have opted for reverse total shoulder arthroplasty (rTSA) at The Johns Hopkins Hospital over the last decade. “We have become experienced with how to use it, when to use it and how to make it successful,” says Edward McFarland, chief of shoulder surgery.
Expert shoulder surgeons at Johns Hopkins provide answers to some of the most frequently asked questions about total shoulder replacements and reverse prosthesis shoulder replacements.
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