Living Pain-Free after Minimally Invasive Spine Surgery
Ronald Kunkel’s job as a contractor demanded grueling physical labor which eventually took its toll on his back.
“I was in construction my whole life and worked hard and probably lifted stuff I shouldn’t have,” he says. “I never thought about my back at the time, but I’m sure that’s how I ruined it.”
Ronald, 71, went to several different doctors and chiropractors and got injections, epidurals and therapy but “nothing relieved the pain until I came to Dr. Kim,” he says.
Although Ronald was hesitant to have spinal surgery, he’s very happy he chose the minimally invasive transforaminal lumbar interbody fusion (TLIF) – a type of spinal fusion used to stabilize the spine by restoring disc height and fusing vertebrae together, which enhances spinal stability and alleviates nerve compression.
“Soon after I woke up from surgery I was able to walk to the end of the hall without a walker – and without any pain,” Ronald says. “I came to the hospital on Friday morning and went home Saturday afternoon. It was a miracle.”
“Minimally invasive TLIF surgery is the same as traditional surgery but the incision is made in a way that decreases damage to the surrounding soft tissue and muscle,” says Choll Kim, M.D., one of several orthopedic and spine surgeons affiliated with Palomar Health. “We make two small incisions instead of one big incision. All of this means less pain and faster recovery for the patient.”
Today, Ronald is pain-free and partially retired. He traded in his hard-core construction work for handyman jobs for neighbors and friends. His goal is to “always take care of my back.”
Huey Lewis - Still Rockin' After Knee Surgery
By Carol LeBeau, Palomar Health Champion
In 1985, “Huey Lewis and the News” hit the Top 10 with “The Heart of Rock and Roll,” the first track on “Sports,” an album that sold more than 10 million copies. More popular than ever, the baby-boomer rock star is marking the 30th anniversary of “Sports” with a concert tour and release of a re-mastered CD.
In a recent interview, Huey Lewis shared with me how he’s still kicking it … and without knee pain thanks to Dr. James Bried, an orthopedic surgeon affiliated with Palomar Health.
Carol: When did you first notice your knee pain?
Huey: On the golf course … but it was a good shot!
Carol: How would you describe the pain?
Huey: It was a constant, dull pain that was sharp now and again.
Carol: How did the pain affect your live performances? Not to mention the rest of your life?
Huey: The pain bothered me on-stage, but I could get the gig done. Mostly it was interfering with my golf game.
Carol: Is that what got you to the doctor?
Huey: Yeah. I was playing at Pauma Valley one day with my pal, Chuck. Chuck suggested that I see (Dr.) Jim Bried, the surgeon who repaired his knee and shoulder.
Carol: What kind of treatment or therapy did you try before choosing surgery?
Huey: Just some ibuprofen … and a few Negronis! (laughs)
Carol: Ultimately, you had an arthroscopic procedure to repair a torn meniscus. How’d it go?
Huey: It was simple! I went in. They started an IV. Next thing I knew I woke up.
Carol: Was there much “down” time?
Huey: No. Recovery was a piece of cake. I elevated my leg for one day and then went Christmas shopping!
Carol: Sounds like a positive experience.
Huey: Dr. Bried and his staff were great! Quick and efficient. Got ‘er done!
Carol: And your golf game’s back? I hear you’re pretty good. Scratch?
Huey: I wish! I’m a 9 handicap.
Carol: I hear you love to fly-fish on your Montana ranch. Must be a lot more fun now without knee pain.
Huey: Definitely. In the water, your feet tend to get stuck down in the mud and it’s hard on the knees to pull them out.
Carol: So, we know you love golf and fly-fishing. What else do you do to stay in shape?
Huey: I tour the gym as often as I can at home and on the road.
Carol: Any advice for other folks out there dealing with joint pain?
Huey: Negronis! (laughs)
Carol: You’re on tour through November … venues all selling out. What is it about your music that resonates with fans of all ages?
Huey: I think it’s my gorgeous voice! No, I like to think our songs are real and truthful.
Carol: My favorite HLN song is “Jacob’s Ladder.” What yours?
Huey: I’m not allowed to have a favorite. I’m selling them all!
Carol: What kind of music do you listen to?
Huey: I listen to a lot of big band stuff and a lot of jazz. My Dad was a jazz musician.
Carol: He must have been proud of your success.
Huey: Yeah, but he kept it real. Once I called him to say my record went number one. He teased and said, “Oh, that’s too bad. The best stuff is never the most popular.”
Carol: What keeps you and “The News” band members together after all these years?
Huey: We pay well! Actually, four of us have been together for 35 years … the newest member for 12 years. We’re like brothers.
Carol: And, you’re still a major rock star. Is it true you don’t even have a tattoo?
Huey: Not that I’m aware of, but I haven’t checked my backside lately!
Carol: So, it really IS hip to be square?!
Huey: No! (laughs)
Carol: Any plans after the anniversary tour? Maybe kick back a little?
Huey: We’ll work on some new material in the studio … be a little more relaxed, but we’ll still do some shows.
Carol: You’re one of few musicians to enjoy a successful multi-decade career. How does that feel?
Huey: I just wanna be able to play music for a living. Fortunately, we’ve been able to do that. I’m thankful.
Carol: So are we, Huey. So are we!
How He Gave Pain the Cold Shoulder
Paul Ross says he knows exactly what damaged his shoulders, eventually causing so much pain that he underwent two shoulder replacement surgeries last year at Pomerado Hospital.
“I have always been a very active person,” Paul says. “In school I participated in wrestling, baseball, football, weightlifting and power lifting – and I really beat up my joints.”
A devoted weightlifter, Paul pursued the sport into his 40s, even as his shoulders protested and he had arthroscopic surgery on both knees. “My shoulder was popping in and out of the socket,” he recalls. “It got to the point where the pain was unbearable, especially at night.”
Paul had turned to board-certified orthopedic surgeon Brad Cohen, M.D., in 2005 for his knees and continued to confer with him about his shoulders. In April 2012, Dr. Cohen replaced Paul’s left shoulder and then performed a right shoulder replacement seven months later.
Paul is among 53,000 people a year who have shoulder replacement surgery each year in the United States. That compares to more than 900,000 knee and hip replacements done annually.
“Shoulder replacement surgeries probably are less common because knees and hips are weight-bearing joints that are more likely to be damaged,” says Dr. Cohen, who is affiliated with Palomar Health’s Orthopedic Institute. “Patients also may try to live with shoulder pain because it doesn’t affect their mobility. We don’t walk on our shoulders.”
Paul said he opted for shoulder replacement surgery to stop hurting and to regain his active lifestyle. “These were very successful procedures from start to finish,” Paul says. “I am so glad I’m back to doing what I love to do. I still go to the gym and do cardio and yoga. On the weekend I bike, play tennis and even golf – with a full range of motion. Probably the best part is that I can sleep again without tossing and turning from pain.”
Paul’s story is typical of many patients who choose shoulder replacement surgery, according to Dr. Cohen. “They definitely tend to be active,” he says. “And they come in with pain, pain, pain.”
Paul’s weightlifting had repeatedly stressed his shoulders and led to substantial osteoarthritis so that he could no longer lift his arms above his shoulders, Dr. Cohen says.
Osteoarthritis is often a culprit in painful shoulder damage that restricts joint mobility.
Osteoarthritis is more common as we age, but also can be brought on by joint injury, repetitive stress on the joint, bone deformity or some diseases. Rheumatoid arthritis and chronic steroid use also can be significant causes of joint damage, according to the American Academy of Orthopaedic Surgeons.
Surgery should be the last option after first trying more conservative treatments, Dr. Cohen says. “I usually have all my patients try treatments such as cortisone injections, physical therapy and anti-inflammatory medications first. If that doesn’t work, then we may consider surgery,” he says. “If x-rays show a high level of arthritis, the patient’s level of pain is most important and guides what we do for treatment.”
Shoulder replacement surgery takes about 90 minutes. The patient usually is hospitalized for at least a day, although a patient occasionally may leave the same day as the procedure. That was the case with Paul Ross.
“I did both of his surgeries and he left the hospital the same day both times,” Dr. Cohen says.
Physical therapy is important for strengthening the muscles around the new shoulder joint and typically starts about four days after surgery, continuing for one to two months.
“The goal is for the patient to regain a full range of motion and at least the same activity level as before,” Dr. Cohen says. “Paul had lost at least 50 percent of his range of motion and now it’s fully restored. It’s amazing, really.”