Shoulder pain

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lisa g

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Has anyone had a torn rotator cuff and had surgery to repair it after they were diagnosed with ALS? I had surgery on the left one before diagnoisis and now AM having pain and certain movement issues in the right side. I'm going to make an appointment with an orthopedic to have it checked out.

My concern is that if surgery is needed to repair it will the muscle ever bounce back and would anesthesia speed up progression? Curious if anyone has faced this issue.
 

KevinM

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Lisa, I had posed the same question two years ago when I contemplated major GI surgery. At the time I was still operating on the assumption I had a faster progression, and I had the same fears. Because it was such a major surgery I decided not to have it, and luckily have been able to manage the symptoms.

I think the presumption by most pALS is that any surgery could speed progression, but rotator cuff repair these days is much less invasive with much quicker healing time, so it might not stress the body as much.

If you can somehow blunt the pain, I would probably give conservative therapy a try first.
 

lgelb

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I'm sorry to hear this, Lisa. I hope it's not as bad as you think. As regards surgery with ALS generally, a few studies have been done:


There are also a number of case reports.

It would be important to have an anesthesiologist familiar with the tradeoffs of different types of anesthesia in ALS. For example, general anesthesia carries more respiratory risks, regional anesthesia more local progression risks, and there are many techniques within each category. The guess is that risk of accelerated local progression would be greatest if the surgery is in the same region as a muscle that is already impaired.

As with any surgery in a medically complex case, if it is the rotator cuff or something else where surgery is recommended, I would get a second opinion from another system, to be sure there are compelling indications for surgery.

Best,
Laurie
 

lisa g

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Thank you Kevin and Laurie for your input. I read the links and it did answer my question. I am UMN diagnosed. I just remember the recovery and PT time of the last surgery. My respiration has not been effected up to now. This is something that I will have to give some thought to. First step is to see an orthopedic and get a diagnosis.
 
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