DEAR DR. DONOHUE: I am writing about a shoulder replacement. I’m told I need one. I hear from friends who have had knee or hip replacements, but I don’t know anyone who has had a shoulder replacement. I had a rotator-cuff repair 15 years ago. Now I need a shoulder replacement for arthritis.

I am 78, a widow and live alone. How long will therapy be? Will I be able to live alone and take care of personal needs? – L.S.

ANSWER:
Fewer shoulders are replaced than are hips and knees. However, about 23,000 people in the United States have this surgery every year, so it’s not a rare operation. Most patients return to a very active life in a relatively short time.

The shoulder is a ball-and-socket joint. The topmost part of the upper arm bone, the humerus, is a ball that fits into a socket to form the body’s most versatile joint, the shoulder. In a shoulder replacement, both the ball and socket are removed and replaced with artificial materials quite a feat.

The day after surgery, you begin shoulder exercises. In two or three days, you’re discharged from the hospital. You do need someone around for the first two weeks to help you get dressed and to assist you with food preparation. For six weeks after the surgery, the doctor will tell you not to lift anything heavier than a glass of water with the arm whose shoulder was replaced, and that arm is kept in a sling for several weeks postoperatively. In about four to six weeks, people are allowed to drive.

In a surprisingly brief amount of time, you’ll be allowed to do most everything, including golfing and swimming. You won’t be able to engage in activities that cause high impact on the new shoulder joint chopping wood or lifting very heavy loads.

DEAR DR. DONOHUE: I have two fibroids. My doctor has told me I have them but hasn’t said anything more about them. Do fibroids always have to be removed, and does removal entail taking the uterus? I am 34, and my husband and I would like to have more children. – J.K.

ANSWER:
Fibroids are noncancerous growths of the muscles that constitute the wall of the uterus. If they aren’t causing any disturbance, they don’t need any treatment. Disturbances are things like heavy and prolonged bleeding during menstrual periods, pelvic pain, pain during intercourse and infertility.

Removing the uterus is only one way to take care of troublesome fibroids, and it’s become a less frequently chosen option. One alternate to hysterectomy (uterine removal) is uterine artery embolization. A doctor threads a catheter into the artery that supplies the fibroid with blood. Small, plastic beads are released into that artery, and they cause formation of a clot that obstructs blood flow to the fibroid. In a short time, it withers and is sloughed off. This is only one example of treating fibroids without uterine removal.

The booklet on fibroids explains them and their treatment. Readers can order a copy by writing: Dr. Donohue No. 1106, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6.75 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: I take 10 mg of nortriptyline four times a day for chronic pain. Is it safe to take this medicine for long periods of time? – R.T.

ANSWER:
Nortriptyline is a medicine for depression. The doses used for treatment of depression are much higher than the doses you take. Depression is an illness that must be treated for long periods of time, sometimes lifelong.

Nortriptyline is also used in smaller doses for pain relief. You can safely take it for as long as your doctor prescribes it.

DEAR DR. DONOHUE: I heard that carrots are poisonous. I eat a lot of them. I got this information from a reliable source. – C.F.

ANSWER:
Please. You’re not going to suffer from carrot poisoning. Large quantities of carrots can turn the skin, especially the palms, orange-yellow, but they don’t poison you.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.


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