Dr. McNamara poses with Team #9 at the Iron Dog Safety Expo at Cabela’s on Wednesday.
We are proud to sponsor Team #9, Jordan Starr and Joshua Plumb, in the 2016 Iron Dog Pro Class Race. The Iron Dog is the world’s longest, toughest snowmachine race, with 2,031 rugged Alaska miles to cover and 41 teams competing for the Iron Dog cash payouts, totaling $145,000 this year, as well as other contingency prizes. The ceremonial start will take place in downtown Anchorage this Saturday (2/20), and the official race start will be at Big Lake on Sunday (2/21).
Jordan Starr moved to Alaska when he was 4. He works as an A&P aircraft mechanic, and has his pilot’s license. Jordan enjoys everything that Alaska has to offer including flying, camping, snowmachining, hunting, fishing, and spending time with friends and family.
Joshua Plumb is a lifelong Alaskan from Eagle River. He is enrolled at the University of Alaska, Anchorage seeking a business degree, and works as a heavy equipment operator. When Josh is not working he enjoys spending time with his family and friends, taking trips to the cabin, snowmobiling, and traveling. Josh and his wife Kateland have a 3 year old daughter named Elodie.
We wish Jordan & Joshua all the best in the 2016 Iron Dog Pro Class Race this weekend! GO TEAM #9!
Thank you to all who participated in our 3nd Annual Alaska Photo Contest. This year our participants collectively submitted 89 beautiful photos of Alaska! We are happy to announce our favorite captures in each of the 3 Alaska categories:
1ST PLACE – Alaska Wildlife
“1, 2, 3 – Ready or not here I come!” by Channcie B.
1ST PLACE – Alaska Scenery
by Roger N.
1ST PLACE – Alaska Outdoor Activities
“A Puppy’s Eyes” by Corbin H.
Since we had such AMAZING photos, we would also like to recognize the runner-up in each category. Here are the 3 honorable mention winners:
HONORABLE MENTION – Alaska Wildlife
“Kung Fu Bear” by Channcie B.
HONORABLE MENTION – Alaska Scenery
“Volcano Redoubt” by Jeff B.
HONORABLE MENTION – Alaska Outdoor Activities
“Autumn Float to Skilak Lake” by Barbara S.
Thanks again to all our participants. Keep an eye out for our 4th Annual Alaska Photo Contest coming in Fall 2016!
“When can I drive?” and “can I drive in a sling?” are common questions we hear from patients after shoulder surgery or treatment of other upper extremity injuries and conditions. The better question is should you drive in an arm sling.
A recent study published in the Journal of Shoulder and Elbow Surgery sought to answer whether sling immobilization of the dominant driving arm had an effect on driving performance and safety. The researchers hypothesized that sling immobilization of the dominant driving arm would impede a driver’s ability to drive. Utilizing a simulated driving circuit, the researchers created a mock driving experience for study participants. The control group was made up of non-immobilized drivers, while the experimental group was made up of drivers immobilized in a simple shoulder sling. Driving performance was evaluated by the number of “collisions” (or the number of simulated on-road hazards that were struck by the driver) such as an oncoming car or pedestrian.
While there was no difference between immobilized drivers and non-immobilized drivers in routine driving scenarios, their results showed that in hazardous driving scenarios that required evasive driving maneuvers, non-immobilized drivers performed significantly better than immobilized drivers. The non-immobilized drivers had 1.7 collisions while the immobilized participants had 3.7 collisions. This is a statistically significant increase with the number of collisions more than doubling in immobilized drivers! Thus, it was shown through this study that sling immobilization of the dominant arm does impede a driver’s ability to effectively perform evasive maneuvers when faced with a driving hazard.
While only sling immobilization of the dominant driving arm was reviewed in this study, it is our opinion that driving with either arm immobilized in a sling is unsafe for you, your passengers, other drivers, and pedestrians. Instead, we encourage you to utilize the help of a friend or family member to get you where you need to go. If you have any questions, please do not hesitate to contact our trained medical staff.
Atanda, A., Chay, E., Hasan, S., Jazrawi, L. M., McGee, A. W., and Zuckerman, J. D. (2015). The effect of shoulder immobilization on driving performance. J Shoulder Elbow Surg, 24(2), 273-279. http://www.jshoulderelbow.org/article/S1058-2746%2814%2900363-2/abstract
Four days before the 2005 Iditarod, Dr. McNamara received a call from his close friend, Martin Buser. An incident with a table saw left Martin with three mangled fingers on his right hand. After a 2 1/2 hour surgery, including an amputated finger, Dr. McNamara delivered the bad news. Martin could not compete, to which Martin replied, “Doc, you leave that to me-do your part and leave the rest up to me.” Determined to continue his 20 year love of racing in the Iditarod, Martin set off down the Iditarod trail covering nearly 1200 miles, stitches and all, to come in 13th place with only 9 1/2 fingers! “Martin’s long finger is no longer his long finger,” said Dr. McNamara, but obviously even such an extreme injury could not dishearten this spirited musher. At the conclusion of the Iditarod, Dr. McNamara was pleased to find that Martin’s amputated middle finger had healed better than most amputations considering that Martin had constantly used his hands both on and off the trail. With four 1st place finishes, Martin Buser is not only an esteemed competitor, but also an example of fortitude and endurance.
With the 2015 Iditarod race only weeks away, all of the providers and staff at AkHES wish Martin Happy Trails!
This is our second year sponsoring Jordan and Joshua, and coincidentally, their second year racing in the Iron Dog. The Iron Dogis the world’s longest, toughest snowmachine race, with 2,031 ruggedAlaska miles to cover and 37 team competing for the Iron Dog CashPayouts, totaling $130,000 this year, and other contingency prizes.There will be a ceremonial start in downtown Anchorage this Saturday(2/21), and the official race start will be at Big Lake on Sunday (2/22).
Jordan moved to Alaska when he was 4. He’s a commercial fisherman in the summer in Bristol Bay. Jordan received his pilot’s license, and works as an A&P mechanic. He enjoys everything that Alaska has to offer, including flying, camping, snowmachining, hunting, fishing, and spending time with friends and family.
Joshua is a lifelong Alaskan from Eagle River. He is enrolled at the University of Alaska, Anchorage seeking a business degree, and works as an operator in the construction field. When Josh is not working he enjoys spending time with his friends and family, trips to the cabin, snowmachining, camping and traveling.
We wish Jordan and Joshua all the best in the 2015 Iron Dog Pro Class Race this weekend! Go Team #9!
Thank you to all who participated in our 2nd Annual Alaska Photo Contest! This year we had 15 participants who collectively submitted 41 stunning photos. We are pleased to announce the following 1st place winners in each of the 3 Alaska categories:
1ST PLACE – Alaska Outdoor Activities
“Trimaran at Rest” by Linda G.
1ST PLACE – Alaska Wildlife
“Bohemian Rhapsody” by Judith C.
1ST PLACE – Alaska Scenery
“Time to Reflect” by Linda G.
Since we had such fantastic competition, we also awarded an honorable mention in each category!
HONORABLE MENTION – Alaska Outdoor Activities
“Sleeping Beauty” by Bernadette M.
HONORABLE MENTION – Alaska Wildlife
“The Leader” by Sabra N.
HONORABLE MENTION – Alaska Scenery
“Winter Kissed City” by Jessica M.
Thanks again to all our participants. Keep an eye out for our 3rd Annual Alaska Photo Contest coming in Fall 2015!
Kevin C. Paisley, D.O., joined our team at Alaska Hand-Elbow-Shoulder on September 1st, 2014. As a board eligible and fellowship trained shoulder and elbow surgeon, Dr. Paisley’s specialized care includes complex shoulder and elbow joint replacement surgery as well as arthroscopy, fracture care, and shoulder and elbow revision surgery. He has additional expertise in sports medicine, orthopedic trauma, as well as hip and knee arthroplasty.
Dr. Paisley completed his undergraduate studies at the University of Central Florida before attending medical school. In 2008 he graduated from the Lake Erie College of Osteopathic Medicine. After completing his residency in orthopedic surgery at the University of Missouri-Columbia in 2013, he moved to Texas for a shoulder and elbow fellowship at the University of Texas-San Antonio with Drs. Charles Rockwood Jr., Michael Wirth, Bernard Morrey Sr., Stephen Burkhart, and Anil Dutta.
Dr. Paisley is currently accepting new patient appointments for the evaluation and treatment of shoulder and elbow disorders as well as sports injuries and knee conditions. He accepts most insurance plans, including, Aetna, Blue Cross Blue Shield, Cigna, Medicaid, United Healthcare, and Worker’s Compensation. Patients in need of specialty shoulder, elbow, or knee care are encouraged to call our office at (907) 771-3500 to schedule an appointment with Dr. Paisley.
**No More Chip on Your Shoulder – Pointers from Patient Perspective **
(Things we wish we’d known before we each had shoulder surgery)
One Month Before Surgery
Strengthen quads and core (legs, abs and back) – you’ll need them!
Work on your flexibility – lower back, hips and hamstrings – you’ll be doing lots of bending.
Arrange for a caregiver (friend or family) for at least 10 – 14 days that can be readily available to help you with basic tasks.
Line up transportation from friends/family – -it will be several weeks before you can drive yourself. Be sure to arrange a ride home for day of surgery.
Two Weeks Before Surgery
Get a manicure and pedicure at salon with reputable sanitation practices- it will be a while before you can do this on your own.
Per MD pre-surgery instructions, no dental work, tattoos or body piercings.
If winter time, arrange for snow removal.
The Week Before Surgery – Preparations by Category
If you don’t have one, borrow or buy a comfortable, roomy recliner chair “recliner chair” .
Use a twin size egg-crate foam mattress pad “twin size egg-crate foam mattress pad” on the recliner. Cover with twin size sheet, tucking in if possible.
Make sure you have an assortment of pillows “pillows” – thickness, size, etc. These help support your arm to increase comfort level. We bought but didn’t like the triangle/wedge pillow (even when we graduated from recliner to bed).
Small table or chair to hold Cryocuff – needs to be level with chair in reclined position.
Diet and Digestion
If you have a freezer, prepare and freeze microwavable meals ahead of time. Soups and casseroles are good to have available. Use containers that are easy to open.
Make a batch of bran muffins “bran muffins” to freeze.
Buy foods that are high in fiber: Steel Cut Oats (aka Irish or Scottish–bulk foods bins) “Steel Cut Oats (aka Irish or Scottish Oats)” ; prunes “prunes” , fresh veggies and fruit “veggies and fruit” ; lentil soup “Lentil soup” or split pea soup “split pea soup” . Spinach “spinach” (Precleaned bagged) for salads, in omelets, etc., bonus high in iron.
Steel Cut Oatmeal for breakfast – the night before, bring 3 ½ cups water to boil, add 1 cup steel cut oats, remover from stove, and cover with lid. They’re now ready for the morning and great with blueberries. Put leftovers in refrigerator.
Rearrange refrigerator and freezer contents, so that you can easily reach the items you’ll be using most.
Buy stool softener capsules “stool softener capsules” – prescription pain meds impair lower digestive tract.
Ask your surgeon about getting a Cryocuff (circulates ice water to manage inflammation, swelling and pain).
Ask your surgeon about getting a pain pump.
Ask MD about using OTC Prilosec (generic is fine) “OTC Prilosec (generic is fine)” to protect your stomach when you switch from prescriptions meds to ibuprofen or naproxen with your doctor.
Check your supply of ibuprofen “ liquidtabs ibuprofen” or naproxen “ liquidtabs naproxen” and buy if needed. Some think liquidtabs are easier on your stomach.
Fill prescriptions “prescriptions” , ones you take regularly, as well as surgery related.
Make sure you have small Tupperware type containers “small Tupperware type containers” or mini-loaf pans for freezing ice chunks for Cryocuff. Ice chunks last longer than ice cubes. Start making ice. In winter, snow is an option in Ziplocs.
Yogurt smoothiesor something similar for your stomach when taking pain meds (aid digestion, coat stomach when taking meds in middle of night) smoothies are easy to swig down).
Sports bottle “Sports bottle with sport top” for water for taking pills (sports top, not screw lid).
Ziploc bags for ice. Gallon and quart freezer bags work best.
Gel ice (envelope size, pliable)
Alternatively, if you don’t get a Cryocuff nor buy gel ice, you can make your own gel ice by mixing water and rubbing alcohol. Mix 2-3 cups water with 1 cup of rubbing alcohol. Pour into freezer ziploc bag or rubber water bottle and freeze. NOTE: DO NOT DRINK – it will make you VERY SICK!
Get a ‘wash and wear’ hair cut and style.
You’ll want an electric toothbrush.
Buy toiletries (in pump bottles or travel sizes) “toiletries (in pump bottles or travel sizes)” . Alternatively, transfer products into small travel containers (shampoo, conditioner, lotion, contact solution etc.).
Cornstarch or baby powder for chafing and ‘dry’ showers.
Pedestal style mirror.
Tucks or Cottonelle Wipes
Pump foamy soap “Pump foamy soap” for hand washing.
“Purell” for hand sanitation.
Y shape dental floss picks (or check with your dentist for other options, especially if you have tight spacing between teeth).
Take a soft, comfortable 100% cotton tee shirt “100% cotton tee shirt” and cut it up the middle of front for day of surgery or a lightweight zip front sweatshirt (without hood).
Roomy Men’s v-neck soft cotton undershirts at least 3“ (v-neck is easier to maneuver than crew neck)—you’ll want at least 3: one for day, one for sleeping, one in laundry.
Make sure you have sturdy, slip on shoes to take to surgery, e.g., Merrills.
Cotton zip or button up long sleeve shirts without hoods (hoods bunch up = neck ache).
2 -3 pairs soft cotton loose fitting lounge pants with elastic waistband.
Women – front hook bra with removable/hook straps.
If wintertime, slip on ice grippers for shoes.
Cordless/cell phone and/or bell for summoning people when you need help.
Put away all area or throw rugs to reduce tripping hazard.
Ensure hallways or stairs are sufficiently lit – replace burned out bulbs.
Use nightlights in hallways, your sleeping area and bathrooms to reduce tripping hazard at nighttime.
Surgery Day – Be sure to take
Cut up soft, comfortable 100% cotton tee shirt or hoodless zip up sweatshirt
Cotton lounge pants
Sturdy slip on shoes
If wintertime, slip on ice grippers. Also small blanket or beach towel in car to keep you warm instead of a jacket
Advance Medical Directive if you want/have one
Post Surgery by Category
Recliner is your FRIEND. Try different pillows under your head/back of shoulder/elbow and arm to increase comfort. You can also try rolling up various sizes of towels (and secure with rubber bands). Sleeping is IMPORTANT – -likely that the recliner will be your ‘bed’ for 6-8 weeks or longer.
Make sure everything you need is within reach: meds, water bottle, phone or bell, glasses, Kleenex, etc.
When you ‘graduate’ from recliner to bed, take the assortment of pillows/towels with you. If experiencing lower back pain, put a thin/medium pillow under your knees.
Diet and Digestion
Eat and drink per discharge instructions. Start drinking water ASAP to rehydrate for healing and minimize constipation. If you can, start snacking on prunes, muffins, veggies, fruit, etc.
Use stool softener capsules as needed. Restart vitamins and other meds per MD direction.
Walking and Water Works Wonders! – as soon as you’re able (sufficiently steady on your feet) supplement your water intake with walking around the house. Trust us, the LAST thing you’ll want to deal with is constipation – -walking and water helps your lower intestine do its thing.
If surgery hand =dominant hand, eating out of large coffee mugs is easiest. Dishtowel draped across chest keeps your clothes clean – smile when you say BIB!
Watch for: redness in arm, fever, extreme soreness, excessive swelling in hand or nausea. Contact MD at once if you suspect infection.
If MD prescribed a Cryocuff, use it – -Cryocuff is your friend – use it! (and once more for good measure, use it!). ICE is your new BFF (Best Friend Forever). You can feel the chilled water enter the cuff by your neck to ensure 1) it’s cold and 2) you have the Cryocuff at the proper altitude to work effectively (level with your shoulder). Check thermos for ice every 4-6 hours.
STAY AHEAD of pain and take meds per MDs direction. If you experience nausea from pain meds, contact your MD for an alternative medication. If weekend is approaching, make sure you have enough to get you through the weekend, ditto holidays. Allow sufficient time for MDs office to authorize meds/write prescription.
Dressings – leave any dressings/bandages in place. If you go home from surgery with a pain pump and the dressings seem wet, contact the pain pump provider (usually a pharmacy) to ensure that the pump isn’t leaking.
Keep a few Ziploc bags in the car with you so that you can have ice whenever you need it.
Do any prescribed occupational and/or physical therapy (OT/PT) exercises and incision/scar management.
Once you’re healed enough to shower, get everything ready and within easy reach (lotions, towels, powder) BEFORE you get in the shower. Use powder under arms and other sensitive and or hard to reach areas as needed.
Try a ‘dry’ run in the shower or tub first, to figure out how you’re going to get in and out. Until you have confidence, have a buddy around when you shower.
If you need to have a spacer for your arm in the shower, a partially inflated beach ball “beach ball” (covered with a pillow case so it doesn’t slip) works great.
Flossing – if you can’t use floss picks, due to tight teeth spacing try sitting on corner of ottoman or bed and bending over to floss your teeth.
Use the pedestal mirror for grooming. If you have vessel sinks, prop recovering arm on sink, or an upside down bucket also works.
To change clothes, maneuver your recovering arm in and out of sleeves first while bending over (similar to pendulum exercise, if you were directed to do pendulums).
If you need an arm spacer while changing clothes, use a rolled up towel or washcloth.
Ladies – ask your OT/PT for a bra strap cushioning pad (now you see why you need removable straps).
Cordless/cell phone and/or bell for summoning people when you need help WITH YOU AT ALL TIMES. Remember to charge phone batteries regularly!
Drink water, eat prunes, do your PT, SLEEP, REST and eat nutritious foods to help your body mend. When you need rest, turn phones off (or take off hook) and put ‘do not disturb’ notes on doorbell.
In winter, rather than wrestling with a jacket, keep a small blanket or beach towel in the car to use as a wrap to keep you warm.
Even after released from sling, wear it if going out into crowds (e.g., concert, sporting event). It gives people around you a visual clue not to bump into you.
If you’ll be alone recovering at home for periods of time, develop a checklist of items you need to have in place before your companion heads out the door: phone, water, snacks, Kleenex, glasses, meds, fresh ice in Cryocuff, etc.
Ready to go back to work? For mobility, use a roll-along bag to carry your lunch, ice packs, laptop, etc.
If you get bored counting to 10 doing OT/PT, put on some upbeat music. Don’t RUSH through your exercises – -allow plenty of time to do at a measured pace, in deliberate manner.
If you have trouble with your coordination (one of us was completely pathetic using the dowel for external rotation) and can’t get the ‘hang’ of an exercise, ask your OT/PT for an alternative move. Also, if you experience sharp and/or persistent pain or muscle spasms- consult with your OT/PT.
Ask about BioFreeze (pain relief gel).
If instructed to do so, massage your scar – -it really works (and feels good)!
If you use therabands as part of your therapy program, put on a pair of safety glasses “safety glasses” before you start (yes, it’s kinda scary when one of those bands rips in two and lets go in the middle of a stretch).
The Final Word
You’re paying for OT/PT (either directly or through insurance premiums), so **DO** your home exercise program. Why would you pay for a professional service and not use it? Would you go to a restaurant, order a meal and then walk away without eating? Would you hire an accountant to prepare your taxes, then not file? Same principle applies here.
If you don’t understand something or are concerned about something, ASK! You want to have the best recovery possible, so don’t be shy – it’s YOUR QUALITY of LIFE that is impacted by your understanding and ownership of your recovery. Take notes if it will help you retain information at MDs or at OT/PT. Ask for written instructions.
The contents herein are merely observations based on one family’s experience of having two shoulder surgeries in three months, NOT medical opinion. These are ‘helpful hints’ we wished someone would’ve shared with us prior to undergoing surgery. No expertise is implied. You are responsible for your recovery.
****ALWAYS follow the instructions of your medical providers****
Wishing you a speedy recovery —“Shoulder on!”
Sheldon and Shirley Shoulder
Summary of items to have on hand:
100% cotton tee shirt, 3
2 -3 pairs soft cotton lounge pants with elastic waistband, 3
beach ball, 5
bran muffins, 1
Corn starch or baby powder, 3
cotton zip up or button long sleeve shirts without hoods, 3
electric toothbrush, 3
floss picks, 5
front hook bra with removable/hook straps, 4
Gel ice (envelope size, pliable), 2
Lentil soup, 2
liquidtabs ibuprofen, 2
liquidtabs naproxen, 2
Men’s v-neck soft cotton undershirts at least 3, 3
OTC Prilosec (generic is fine), 2
Pedestal style mirror, 3
Pump foamy soap, 3
recliner chair, 1
safety glasses, 6
small Tupperware type containers, 2
split pea soup, 2
Sports bottle with sport top, 2
Steel Cut Oats (also known as Irish or Scottish Oats), 2
stool softener capsules, 2
sturdy, slip on shoes, 3
toiletries (in pump bottles or travel sizes), 3
Tucks or Cottonelle Wipes, 3
twin size egg-crate foam mattress pad, 1
veggies and fruit, 2
Y shape dental floss picks, 3
yogurt smoothies, 2
Ziploc bags, 2