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Facebook Live: “What To Do If Your Shoulder Surgery is Cancelled”

Transcript

Dr. Deitch

Well, hello Facebook! Welcome to another episode of You’ve Got the Power — because you do.  I’m Dr. Jason Deitch with Dr. Chris Centeno. Dr. Centeno, of course, being the founder of Regenexx, a national network of regenerative orthopedists that are the finest in the field, also the Medical Director of the Centeno-Schultz Clinic in Colorado.

Dr. Centeno, great to see you today!

 

Dr. Centeno

Great to see you, Jason. Thanks for doing this.

 

Dr. Deitch

Absolutely. Today, our topic is: what do you do if your shoulder surgery — either shoulder — if your shoulder surgery has been canceled? Obviously, we are in Pandemic times. All elective surgeries have been canceled. The health care system is upended. People just cannot go to their traditional doctor or the hospitals the way they used to. Everything has changed. People still have health concerns. In fact, many people have had health concerns and no longer have access to the help they thought they needed.

Let’s today talk about a different perspective. If somebody has had a shoulder surgery scheduled, what kind of condition did they likely have that needed surgery? And why might that actually be the best thing that could happen to them?

 

Dr. Centeno

Yeah, Jason, as you know, regrettably, this is an unprecedented time. Lots and lots of surgeries canceled, probably on the order of one to two million procedures have been canceled around the country, and that includes shoulder surgery.

And the most common of those would be rotator cuff surgery. So this is just a great time, I think if you were headed down that direction, to possibly rethink and re-conceptualize that choice. Because, many times, you know, we make these choices because we go to the doctor; the doctor gets an MRI, does a quick exam, and says you need surgery.  But this is a great time for you to reconsider that, to rethink that option. And so, right now, you know, what else is available?

Well, one of the things that’s available is using your own stem cells or platelets to heal that tear. And, so with regard to regenerative orthopedics, our focus would be to identify that tear under ultrasound guidance and then to precisely inject your platelets or stem cells to heal that tear, rather than the big surgery. Now, why might you want to stay away from the big surgery right now? I think you might want to stay away from it simply because, as you probably have heard, your local hospital is obviously where all that Covid-19 treatment is going to be happening.

In addition to that, there was just a Kaiser Health News piece put out just a few days ago that talked about [how] they’re now converting ambulatory surgery centers nationwide, another place where that surgery could have taken place, into tier 2 Covid-19 treatment centers.

So, again, if you’re looking at viral load, and viral load is simply the amount of virus you get exposed to, my sense is you don’t want to stay –or you don’t want to be anywhere near either place. Unless you’ve got a problem that needs to be dealt with – obviously, if you have symptoms and you go into the hospital, you will get sent to the appropriate place. But this is going to change how the surgery is delivered. So a great time to look at other options for your shoulder.

 

Dr. Deitch

That’s exactly right. So, if you have been a candidate for shoulder surgery — if it was scheduled, then canceled, if you’ve been in consultation, should I or shouldn’t I? if you know, you’ve got a confirmed pathology, damage that you know is there — using your own body’s cells to heal your body happens to be one of the smartest approaches you can consider.

As Dr. Centeno said earlier, a lot of the reason why people choose surgery is not necessarily because it has the most science behind it – because it doesn’t. It’s not necessarily because it’s most effective, because it’s not always the most effective. And it’s not always because it’s even the cheapest, even if insurance is going to cover it, because you get with it those things called “surprise bills.”

So, when people have been making that traditional choice under normal circumstances, oftentimes they have missed the opportunity to explore other options. And what these circumstances, as devastating as we know they are, we’re going to be optimistic and look at the bright side.

The bright side is, that if you’re watching this right now, you are now getting exposed to, for some of you, a new idea, a new approach. It’s not a new approach for us or in general. It may be new to you. And, that is, really understanding how to use your body’s natural healing cells — your blood, your stem cells, your own body’s natural healing cells that know exactly how to heal you. When you use your body’s natural healing cells to heal yourself, you really put yourself in the most advantageous way, to be able to heal yourself from these injuries.

Dr. Centeno, can you give us a picture of its effectiveness? Why haven’t more people heard about this approach earlier? Why would a surgeon not say, “Why don’t you try that first”? How does that all work?

 

Dr. Centeno

Yeah. So if you look at the research, right, the gold standard – if you will – is called a “randomized controlled trial.” So, that’s where we do high-level research to see if something works. Right now, when it comes to PRP, which is using your own platelets to heal your shoulder, we’ve got several randomized controlled trials that show that it works.

And if you look at bone marrow concentrate, which is using your own bone marrow stem cells, we’ve actually published one of those randomized controlled trials through Regenexx. And what’s really interesting, if you can believe this, is we’ve got about eight million people across the country who have full coverage for this right now through their employer. So as an example, we’re talking to very large employers right now who are adding this to their health plan. Now, many patients obviously are still not covered by that.

But even their out of pocket costs for the surgeries sometimes are pretty equivalent to what this procedure costs to get done. But again, another vote of confidence, if you will, is we have multiple large insurers who have added this to their health plan — because, A. they know it works and B. they know it’s much, much less costly.

 

Dr. Deitch

And that’s really one of, I think, the most important things for you as a consumer to realize: you ultimately are the one who has to advocate for your own best interests. That is why we call this “You’ve Got the Power.” It’s understanding what is the most effective way I can heal myself. And what’s the most cost effective way I can heal myself? And when you think about really addressing the fundamental cause of the problem, by healing something before you go through the — I’ll say — the invasiveness of a surgical procedure that oftentimes requires longer rehabilitation times, makes you more susceptible to reinjury over time, and so on. This is really the time for you to advocate for yourself.

And a lot of progressive employers, as Dr. Centeno said, are offering this because they have seen the data, and they see you can get better results, faster, and for less money.

Now, Dr. Centeno, in close up, you’ve created a series of at-home assessments where people can – from the convenience of their home – really assess how bad an issue is and whether it would be appropriate for them to schedule a Telehealth call. Can you speak to how to do that?  Where did they find the exercises, and how do they know if they are a candidate to schedule a Telehealth call?

 

Dr. Centeno

Yeah, Jason.  So we have a shoulder rotator cuff video that I did — it’s just a couple minute video that you watch, you can do a home assessment. Again, you don’t need to leave your home; you don’t need to go to a doctor’s office. And then, if it looks like you’ve got rotator cuff problems, based on this video, then you can get online with a Regenexx physician around the country, again, not leaving your home through a Telemedicine or a Telehealth visit, through your phone, your tablet, your computer. And he will have you watch another video that does an even more extensive self-exam at home.

And then we’ll be able to render a diagnosis or order tests — maybe you need an MRI. He can do all that stuff and come up with a treatment plan to help you avoid surgery. So, again, a wonderful time to rethink your options, right now, and to really understand that there could be another way. And while this is obviously an awful tragedy, there may be a silver lining in this for you if you have a shoulder problem and a shoulder surgery that was canceled.

 

Dr. Deitch

You’ve got the power. We’re here to let you know that. Dr. Centeno and I will be doing these types of informative videos Monday, Wednesday, and Friday for all of this month. Please tune in Monday, Wednesday, and Fridays at this time with us. If you or anyone you know is experiencing some sort of orthopedic condition — that’s a joint condition: your neck, your back, your shoulders, your knees, ankles, any joints — if you’ve been scheduled for a surgery and it’s been canceled and you want help, please go to Regenexx.com.

Look at the information there, do a self-assessment, or contact the Regenexx office that has shared this video with you. You can contact them directly, as well.

Dr. Centeno, any closing thoughts for people?

 

Dr. Centeno

Yeah, this is, again, just a great time to reassess your options. And again, I don’t really think that people are going to be heading back to hospitals and surgery centers anytime soon because of the Covid-19 viral load, which will be at those sites.

So, even if you want to get a shoulder surgery in the next couple of months, it’s probably not going to be an option for you. So, explore your options.

 

Dr. Deitch

You’ve got the power. This is the place to learn more about it. Thanks for watching another episode. We’ll see you next time.