Shoulder problem - Seeking advice

[ravip]

Has any TV member had a shoulder problem that may require surgery?
To be specific, her shoulder joint sort of dislocates or jumps out when her hand is at a certain angle - it even happens in her sleep, resulting in excruciating pain. She herself manages to put it back when this happens.
My friend has been having this issue since her teens and now a Doctor has recommended surgery.
What exactly is this problem due to and how serious and successful is surgery? Will the condition worsen if surgery is not done?
Any recommended Doctor or government hospital, preferebly in Hua Hin/Cha Am area?

Thank you.

[perthperson]

This lady may have a hypermoblity disorder. 

 

If she is suffering repeated dislocations then surgery would be a good option. She should consult an orthopaedic surgeon who specialises in or has interest in upper limb/shoulder surgery. 

 

 

[tifino]

I copped this problem back in 1995.

 

It took 2 different operations to correct

 

Impact injury that mutilated the AC joint. and there was barely any of it left, when the Ortho specialist went in to have a look...

 

Because of the weakened link, the clavicle, and that other bendy bone(Acromion) that leads from the shoulder cuff, towards the clavicle actually became misaligned, and fouls the shoulder from getting it's full range of movement

 

I could not:

shave

roll up, or down my manual car window

or even Salute with the affected (Right) arm

...without my shoulder cuff dislocating   (Ouch!!!)

 

The next operation by same surgeon, was to remove 22mm from the length of the Clavicle, which effectively tightened up all the slackness in the shoulder's geometry. It all seemed so radical to my mind back the, espaecially os, as the clavicle itself was never injured in the first place

 

A separate condition also resulted from the initial accident, in that I still have partially paralized serratus anterior muscles; which means I have uncontrollable (winging) scapula movement... to this day

Edited July 5, 2017 by tifino

[1SteveC]

27 minutes ago, ravip said:

now a Doctor has recommended surgery.

 

Just guessing, but if a doctor recommended surgery, I reckon he told her what the problem was too.

[1SteveC]

1 minute ago, tifino said:

I copped this problem back in 1995.

 

You have NO idea if her problem is the same as yours was !

[tifino]

...just presenting some relative cause and effect scenario, which might? be something she can relate to.

 

once the shouilder geometry goes out of whack, it is not a very comfortable thing to bear for too long

 

 

I hope she has a good Dr

[ravip]

On 5/7/2560 at 0:27 PM, 1SteveC said:

 

Just guessing, but if a doctor recommended surgery, I reckon he told her what the problem was too.

Actually no. He had not explained the issue.

Edited July 6, 2017 by ravip

[ravip]

On 5/7/2560 at 0:26 PM, tifino said:

I copped this problem back in 1995.

 

It took 2 different operations to correct

 

Impact injury that mutilated the AC joint. and there was barely any of it left, when the Ortho specialist went in to have a look...

 

Because of the weakened link, the clavicle, and that other bendy bone(Acromion) that leads from the shoulder cuff, towards the clavicle actually became misaligned, and fouls the shoulder from getting it's full range of movement

 

I could not:

shave

roll up, or down my manual car window

or even Salute with the affected (Right) arm

...without my shoulder cuff dislocating   (Ouch!!!)

 

The next operation by same surgeon, was to remove 22mm from the length of the Clavicle, which effectively tightened up all the slackness in the shoulder's geometry. It all seemed so radical to my mind back the, espaecially os, as the clavicle itself was never injured in the first place

 

A separate condition also resulted from the initial accident, in that I still have partially paralized serratus anterior muscles; which means I have uncontrollable (winging) scapula movement... to this day

No. her shoulder never had an accident.

[Sheryl]

She needs to see an orthopedist specializing in shoulders (or at least, with extensive experience) and you will not find that at a government hospital in or near Hua Hin. Need to come to Bangkok.

 

The best shoulder specialist in Thailand IMO is Dr. Mason at Bumrungrad.

 

Unless she has good private insurance would not want to do surgery at Bumrungrad as it is a very expensive hospital, but a consultation should cost not more than 2000 baht and would be well worth it to get his opinion first and explanation of what is wrong and the pros and cons of surgery.. etc. If she has what is termed "atraumatic shoulder instability" then a course of physical therapy first would be usual before resorting to surgery.  This is usually exercise she can be taught to do on her own with periodic follow up visits to the doctior.

 

if he thinks surgery is advisable then either Siriraj or Chula Hospitals (both large  government hospitals) would be the less expensive options, there is an after hours private clinic at Chula that can be used to direct access specialist, and Siriraj  has a private wing. Dr. Mason may be able to recommend a surgeon at Chula or Siriraj once he has ascertained what the problem is. if not then try one of these:

 

Siriraj

Dr. Ekavit Keyurapan

 

Chulalongkorn

Dr. Kitiphong Kongrukgreatiyos

Dr. Somsak Kuptniratsaikul

Dr. Niti Prasathaporn

 

If she is Thai she can get whatever treatment is needed free of charge but for that she has to first go to the hospital where she is registered (will be wherever she is listed in a tabian baan) and get a referral letter form them to a higher level government hospital. In that case she has to go through public channel and cannot select her docotor.

 

 

 

[perthperson]

3 minutes ago, Sheryl said:

a consultation should cost not more than 2000 baht

 

Plus the cost of x-rays and +/- the cost of an MRI.

[Sheryl]

Shoyld bring all films with her. As she has already seen a doctor who advised surgery I would assume at minimum already had Xray.

[1SteveC]

6 hours ago, ravip said:

Actually no. He had not explained the issue.

 

So what and where was the doctor suggesting surgery ? Behave ! Doctors don't just randomly suggest surgery without telling you why !

[Sheryl]

1 hour ago, 1SteveC said:

 

So what and where was the doctor suggesting surgery ? Behave ! Doctors don't just randomly suggest surgery without telling you why !

 

Actually, Thai doctors often do exactly that, especially when dealing with Thai patients. The assumption is that the patient will not understand the reason anyway and that patients know absolutely nothing about anatomy, physiology or diseases. In the public sector, severe lack of time per patient is also a factor.

 

Of course it varies with the individual doctor, and there are some notable exceptions, especially among the younger generations of doctors, but "old school" ones often give no explanation or diagnosis; a "good" patient is expected to do what they are told without question or needing to know why.

 

It is also like this in some  other Asian countries as well.

[1SteveC]

10 hours ago, Sheryl said:

 

Actually, Thai doctors often do exactly that, especially when dealing with Thai patients. The assumption is that the patient will not understand the reason anyway and that patients know absolutely nothing about anatomy, physiology or diseases. In the public sector, severe lack of time per patient is also a factor.

 

Of course it varies with the individual doctor, and there are some notable exceptions, especially among the younger generations of doctors, but "old school" ones often give no explanation or diagnosis; a "good" patient is expected to do what they are told without question or needing to know why.

 

It is also like this in some  other Asian countries as well.

 

Wow ! Well, you learn something new everyday.  :-)

[ravip]

18 hours ago, Sheryl said:

She needs to see an orthopedist specializing in shoulders (or at least, with extensive experience) and you will not find that at a government hospital in or near Hua Hin. Need to come to Bangkok.

 

The best shoulder specialist in Thailand IMO is Dr. Mason at Bumrungrad.

 

Unless she has good private insurance would not want to do surgery at Bumrungrad as it is a very expensive hospital, but a consultation should cost not more than 2000 baht and would be well worth it to get his opinion first and explanation of what is wrong and the pros and cons of surgery.. etc. If she has what is termed "atraumatic shoulder instability" then a course of physical therapy first would be usual before resorting to surgery.  This is usually exercise she can be taught to do on her own with periodic follow up visits to the doctior.

 

if he thinks surgery is advisable then either Siriraj or Chula Hospitals (both large  government hospitals) would be the less expensive options, there is an after hours private clinic at Chula that can be used to direct access specialist, and Siriraj  has a private wing. Dr. Mason may be able to recommend a surgeon at Chula or Siriraj once he has ascertained what the problem is. if not then try one of these:

 

Siriraj

Dr. Ekavit Keyurapan

 

Chulalongkorn

Dr. Kitiphong Kongrukgreatiyos

Dr. Somsak Kuptniratsaikul

Dr. Niti Prasathaporn

 

If she is Thai she can get whatever treatment is needed free of charge but for that she has to first go to the hospital where she is registered (will be wherever she is listed in a tabian baan) and get a referral letter form them to a higher level government hospital. In that case she has to go through public channel and cannot select her docotor.

 

 

 

Thank you very much Sheryl for the most invaluable advice you provided. Yes, she is Thai and I will ask her to consult Dr. Mason at Bumrungrad hospital.

 

Thank you very much, once again.