My Shoulder Is Painful: Is It "Impingement"? - Horder Healthcare
←
→
Page content transcription
If your browser does not render page correctly, please read the page content below
MAKING Issue no: 28
2018
Your free, local health
& wellbeing magazine
brought to you by
Horder Healthcare
ADVICE P18
My Shoulder
Is Painful: Is It
“Impingement”?
What’s inside
P4 Latest News
P10 Physiotherapy Q&A
P16 Tummy Tuck Surgery:
All You Need to Know
P12 New Christmas Cards
for 2018
www.horderhealthcare.co.uk
Ple FRE
as E IN S
ev i
isit FO gn u
the RM p to
for
mo mcin ATIO our
SPECIALIST TREATMENTS
re
inf doe N E
orm ce VE
ati ntre NT
on S
. .co.
at THE MCINDOE CENTRE uk
The McIndoe Centre in East Grinstead is As part of Horder Healthcare, we are
home to some of the UK’s most esteemed committed to treating our patients and each
consultant plastic and reconstructive other with kindness, respect and dignity
surgeons. Under one roof they form a resulting in life-changing outcomes. The
multidisciplinary team, the largest of its kind satisfaction of our patients and the best
in the UK. possible outcomes for them are our priority.
PL ASTIC AND
RECONSTRUCTIVE SURGERY
ORAL & MAXILLOFACIAL
SURGERY
VEIN TREATMENTS
OPHTHALMIC SURGERY
Contact our helpline on
0800 917 4922
info.mcindoe@horder.co.uk
themcindoecentre.co.uk Holtye Road, East Grinstead, RH19 3EB
Issue no:28 2018
Welcome
As a modern healthcare provider, it is essential to adapt to new challenges,
to ensure we continue to grow as an organisation and provide services that
advance health for our patients and community.
In recent years, the NHS has focused research and training as part of our wider
increasingly on early intervention to keep charitable purpose to support local NHS
people healthy and avoid unnecessary hospital services. At The McIndoe Centre in East
admissions. At Horder Healthcare, we are Grinstead, we have established The McIndoe
proud to support the Sussex MSK Partnership, Aesthetic Fellowship Scheme. The fellowship,
an innovative service working with patients established in partnership with the Queen
and clinicians to improve early intervention Victoria Hospital NHS Foundation Trust, aims to
and treatment for patients experiencing the full enhance the training of NHS plastic surgeons
range of musculoskeletal conditions. Last year, with a structured introduction to aesthetic
as part of the MSK service, our physiotherapists surgery. The fellowship is the first of its kind in
delivered nearly 30,000 1:1 treatment sessions, the UK and we are proud to continue the path of
helping patients remain healthy and active and teaching and innovation that was the hallmark
avoid unnecessary hospital admissions. of Sir Archibald McIndoe, one of the founders
The current waiting times for NHS of modern plastic surgery.
orthopaedic surgery including hip and knee Finally, we are delighted to announce that
replacements has generated a growing interest Mr Charles Gallannaugh MS FRCS FRCSE
in alternatives such as self-pay and private has been appointed as the fourth President
insurance. At The Horder Centre, our specialist of Horder Healthcare. Charles conducted the
orthopaedic hospital, we have recently opened first hip replacement procedure at The Horder
a dedicated wing for private patients. Every Centre in 1989 when it became a centre
patient regardless of how they access our specialising in joint replacement surgery. We
services is treated with outstanding care but with are delighted that Charles continues to support
enhanced private facilities we are able to ensure us with his invaluable experience.
patients who wish to have a faster service can
Dr Richard Tyler
do so in a more tailored setting.
CEO, Horder Healthcare
As an independent charity, we support
Our locations Horder Healthcare Get in touch
@The.Horder.Centre
Crowborough St John’s Road t: 01892 665577
@The.McIndoe.Centre
Eastbourne Crowborough f: 01892 662142
East Grinstead East Sussex e: info@horder.co.uk @TheHorderCentre
Seaford TN6 1XP w: horderhealthcare.co.uk @McIndoeCentre
3
NEWS MAKING STRIDES
LATEST NEWS
ANTIBIOTIC
GUARDIANSHIP
Horder Healthcare is proud
to pledge its commitment
to the universal Antibiotic
Guardianship Programme.
We are committed to
ensuring that the lifelong
use of antibiotics in the fight
against infections is protected
to ensure that surgery and
treatment of vulnerable
patients can be sustained as
New private patient
we move forward.
The Antibiotic
Guardianship Programme is
suite opens at The a national campaign from
Public Health England to
Horder Centre
support the government’s
efforts to reduce
inappropriate prescriptions
for antibiotics. Unnecessary
We are pleased to announce Healthcare, Dr Richard Tyler,
use drives antibiotic
the opening of our new who officially opened the suite,
resistance and means they
suite for private patients said: “This new suite will allow
may become less likely
at The Horder Centre in private patients an enhanced
to work in the future. The
Crowborough. The eight- experience in beautifully
government aims to halve
bed Ashdown Suite has refurbished rooms, where they
inappropriate prescribing
been named because of the can recover in total comfort.”
of antibiotics in the UK by
hospital’s location next to the Private patients can
2020.
Ashdown Forest. It is situated choose from over 20 of the
For more information visit
in a quiet area opposite the UK’s leading orthopaedic
antibioticguardian.com
Centre’s therapeutic garden consultants available at The
and gym that has been Horder Centre, which has
specially designed to help excellent patient outcomes and
patients start exercising after is rated “outstanding” by the
joint replacement surgery. Care Quality Commission.
Chief Executive of Horder
4
Issue no:28 2018
Pioneering orthopaedic surgeon becomes
President of Horder Healthcare
We are delighted to Centre, from a residential quality of care for patients.
announce that Mr Charles home for those suffering from Author of ‘Another Way
Gallannaugh MS FRCS FRCSE chronic rheumatoid arthritis - The Horder Centre Sixty
has been appointed as the Years of Evolution’ Charles
fourth President of Horder documented the growth of the
Healthcare. Centre and illustrated how an
Charles conducted the first independent hospital can work
hip replacement procedure in partnership with the NHS,
at The Horder Centre in yet remain outside the state
1989 when it became system, providing very high
an elective orthopaedic quality care for patients which
centre specialising in joint is free at point of delivery.
replacement surgery. He The late Princess Margaret,
operated at the hospital until Countess of Snowdon, was the
he ceased clinical practice in 3rd President from 1960 until
2005, following which he was her death in 2002, and until
appointed as a Trustee and now the post has remained
Director until his retirement vacant.
earlier this year. to a nationally recognised Read Charles’ profile online
Charles was instrumental in organisation providing at horderhealthcare.co.uk
the development of The Horder outstanding clinical results and
The Horder Centre highlighted as
‘outstanding’ in major CQC report
The Horder Centre has been highlighted as “The Horder Way” which all staff were asked
‘outstanding’ in the Care Quality Commission’s to sign up to as part of their induction.
first comprehensive review of independent • The hospital’s therapeutic environment,
acute hospitals in England. The CQC’s 40-page created after an eight-year refurbishment
report, published in April 2018, is an analysis and redevelopment programme, that aided
of quality and safety of care given by 206 patient recovery.
independent hospitals in England. • Outstanding practice in surgery including
The Horder Centre was one of 16 (8%) being the first hospital to submit data to the
hospitals rated as outstanding and one of only Private Health Information Network (PHIN),
two highlighted at this level in the report. an independent not-for-profit organisation
The report focused on: that publishes data to help patients make
• The value of caring that was embedded informed decisions.
throughout the organisation and was part of
5
NEWS MAKING STRIDES
Free health
Cosmetic Fellowship
information first of its kind
events at The his FRCS exam in 2019 which
Horder Centre is a pre-requisite in the UK
to become a plastic surgery
consultant.
Over the summer we held Matthew said of his
two extremely successful fellowship: ‘Plastic surgery
public information events trainees are required to assist
on muscle and joint health. with, or perform one hundred
Our physiotherapy team cosmetic cases during their
created a programme of specialist training programme.
informative presentations Due to changes in the NHS,
as well as taster sessions trainees can no longer expect
of classes such as Balance this kind of exposure in NHS
and Flexibility and Tai Horder Healthcare is a leading hospitals. As the first fellowship
Chi. The events received provider in its fields and is of its kind in the UK, The
excellent feedback from all committed to helping the next McIndoe Centre has been
attendees. generation of consultants. able to give me training which
Due to this success we Fellowships offer an excellent I otherwise would not have
will soon be announcing opportunity for real-life been exposed to. Completing
a series of exciting, free experience in techniques the fellowship within the
information events on a and procedures that may be training programme has also
variety of orthopaedic otherwise difficult to access in allowed vital experience
topics including hip a non-specialised area. The before the dreaded FRCS
and knee replacement, post of aesthetic fellow at The exam!
arthritis and joint pain. McIndoe Centre represents “The fellowship has really
These events will be the first of its kind and has opened my eyes into the
led by consultants and been welcomed by the world of cosmetic surgery, skin
clinical experts, offering British Association of Plastic, cancer and more latterly hand
expert information and Reconstructive and Aesthetic surgery. It is vastly different
practical advice. If you Surgeons (BAPRAS) and British from the work we undertake in
would like to register your Association of Aesthetic Plastic the NHS. I have been involved
interest for future events Surgeons (BAAPS). in a considerable number
please sign up online Matthew Pywell was of diverse cases and learnt
at horderhealthcare. selected for the Cosmetic how to perform a variety of
co.uk or call us on 01892 Fellowship at The McIndoe cosmetic surgery procedures.
665577. Centre. Matthew previously Spending time with hand and
We will then get in touch worked in London hospitals skin cancer specialists has also
with you once the events and most recently the world- helped developed my skills in
are confirmed to offer you renowned Queen Victoria these areas.”
a priority place. Hospital and he is due to sit
6
Issue no:28 2018
Horder physio joins foot & ankle project
We are very proud support and bring together the foot and ankle region
to announce Horder Physiotherapists and Allied and network with other like-
Healthcare physiotherapist Health Professionals (AHPs) minded physiotherapists. It
Anne-Marie Pier was who have a special interest should compliment my role
successful in her application or expertise within the within Horder Healthcare
to join the Committee of Foot and Ankle in order to as a lower limb Advanced
the Association of Foot improve the quality of care, Practitioner, allowing me
and Ankle Physiotherapists and is therefore run for the to develop the skills I have
(AFAP) involved specifically benefit of the public. learned working within
in a fundraising project. Anne-Marie, having the local MSK services. I
AFAP was launched in been a member of AFAP look forward to improving
October 2012 by four for a number of years, national awareness of
physiotherapists and gained said: “Working with the Horder Healthcare and
official charitable status committee provides an sharing the great work we
in February 2014. The excellent opportunity to do as I undertake projects
AFAP charity aims to help, develop my expertise within on behalf of AFAP.”
Collaboration with landscape
architecture company
Horder Healthcare Musculoskeletal with the designers, highlighting issues around
Physiotherapist, Claire Powell, collaborated accessibility. Barriers to using outdoor spaces,
with Huskisson Brown, a landscape and design for example walking along a seafront, were
consultancy, on the national Ebbsfleet Garden things like worrying about not enough stopping
City competition for which they were shortlisted points for rests. Wheelchair users were worried
to the final five entries. The vision for the new about inclines and felt the current minimum
city at Ebbsfleet was innovation, good design, requirements still felt dangerous and lead to fear
sustainability, community and, most importantly, and difficulty in using outdoor spaces. All of
health. these findings were incorporated into the design.
Claire completed an informal survey of For further information on the project please
patients at Horder Healthcare regarding their visit healthygardencity.co.uk
barriers to physical activity and their favourite
outdoor spaces. The outcomes were then shared
7
PATIENT STORIES MAKING STRIDES
PATIENT STORY
Dr Peter Lee
The “cheerfulness” of The Horder Centre team left its mark
on retired scientist Dr Peter Lee when he underwent a knee
replacement earlier this year.
Dr Lee, 78, who lives near Tunbridge Wells, said: “My
experience was absolutely marvellous but the two
things that made the most impression were the care and
cheerfulness of everybody, even the person who dropped
off the newspaper was cheerful, and when people are like
that, you can’t help but be the same.”
Dr Lee’s left knee had been causing problems for
around 12 years before the pain stopped him walking a
couple of months before his operation.
After his wife’s good experience at The Horder Centre
where she underwent two knee operations by consultant
surgeon Sam Rajaratnam, there was no question of Dr Lee
choosing anywhere else (or any other surgeon) when he
decided to have his knee replacement through his private
health insurance.
Now Dr Lee is following his exercise programme at
home and can walk at least half a mile.
He said: “The whole experience was very positive and
so was my wife’s. I was very impressed with it all. My
recovery couldn’t have been better.”
If you would like to share your patient story from one of our hospitals or clinics
please do send it to hh.marketing@horder.co.uk
8
Issue no:28 2018
Honey & Mustard
Pork Chops
Honey mustard pork chops are simple, delicious, and easy to cook. This is a
flavoursome dish packed with protein and a great weeknight meal.
Serves: 2 Marination time: 24 hrs Cooking time: 15-20 mins
HOW TO PREPARE INGREDIENTS
The pork needs to be marinated 24 2 x 6oz pork chop, fat trimmed
hours in advance.
4 tbsp clear honey
1. Mix all the ingredients together,
2 tsp English mustard
place the pork in a deep tray and
cover with the mixture. Refrigerate 4 tsp soft dark brown sugar
overnight.
4g thyme
2. Pre-heat an oven to 180°C.
This dish could be served with mashed
3. Place a frying pan on a medium to potatoes, roasted butternut squash,
high heat and add just a splash of buttered kale and sweet corn.
oil. Once hot, place the pork chops
in the pan one at a time and cook
on one side until golden brown,
turn and place the whole pan into
the oven to cook for approximately
15-20 minutes until cooked.
For more recipes, please visit
our Healthy Living section at
horderhealthcare.co.uk
9
PHYSIOTHERAPY MAKING STRIDES
physiotherapy
Claire Powell, Chartered Physiotherapist,
answers your question.
Q I have been told by my
GP that the hip pain I
Tendinopathy usually
occurs from a sudden increase
in activity or load to these
have been getting regularly over
questions
tendons. Rest does not cure
the last few months is something tendinopathy but the GP is
called ‘trochanteric bursitis’. He correct to advise caution
has advised on rest but I am as exercising to the point
keen to go skiing. How can I or beyond pain is also not
helpful. Keeping activities to no
help get rid of this problem or low levels of discomfort are
before I go and is skiing likely to recommended.
do any damage? It would be advisable to see
a physiotherapist who could
A
help identify the underlying
Lateral hip pain (LHP)
cause. Often it is the case that
has traditionally been
certain muscles that provide
referred to as trochanteric
stability to the hip joint are
bursitis which means an
not doing their job as well as
inflammation of the fluid filled
they could and if these are
sac on the outside of the hip.
retrained, this helps to prevent
Over the last 10 years
the poor movement pattern.
however, evidence has
In terms of whether skiing
demonstrated that the bursa is
would cause any damage, this
in fact an inconsistent feature
is difficult to say. Skiing will
of lateral hip pain.
place extra demand on the
Furthermore, studies of lateral
hip and these glutes muscles
hip pain have found no signs
YOUR
that are not working to their
of inflammation in the area of
normal capacity. If these have
the bursa. Researchers have
not been fully retrained to
shown that the primary
cope with the demands of the
problem is actually with the
twisting, turning and weight
tendons of the buttock muscles
bearing components of skiing,
known as Glutus Medius and
the condition could flare up
Minimus and the condition is
again which would limit your
therefore now known as a
abilities (and enjoyment!) with
Tendinopathy.
skiing.
10Issue no:28 2018
Visit horderhealthcare.co.uk to find out more about our
physiotherapy services or call 01892 665577 to book an
appointment. Please email your physiotherapy questions to
Anne-Marie Pier, Chartered Physiotherapist, info@horder.co.uk
answers your question.
Q I am a 55 year old
active walker and
are getting old or have to
curtail activities such as
walking. In fact, quite the
over the counter medication
such as paracetamol and
ibuprofen, pacing and activity
recently I have been getting
opposite; exercise is very modification and weight
catching pain in my right knee. It beneficial. management to name a few.
never locks or gives way but is In a healthy knee, the This essentially means there
often achy at the end of a long cartilage provides a smooth are plenty of options for you
day of walking. I don’t really surface between the tibia to explore before considering
(your shin bone) and the surgery.
want surgery as I still consider femur (your thigh bone). This With regards to exercising,
myself quite young but my allows the knee to bend and low impact activities such
partner is insisting I see a doctor straighten easily and also as walking, cycling and
for this. What do you think this provides a stable weight swimming are best as they
bearing surface. In a knee reduce the amount of stress
might be and could I be doing that is affected by arthritis, the going through the joint
more damage by not getting it cartilage tends to wear out compared to high impact
looked at? unevenly, becoming rough activities such as running,
and thin similar to potholes on jumping or racket sports. You
A
a road surface. The ‘catching may also benefit from some
From the symptoms
pain’ you describe can be an specific strengthening and
you describe you are
awareness of the decreased stretching exercises for the
likely to be experiencing some
smoothness of the joint surface. muscles around your knee
early arthritic changes in your
This can also be compounded and hip.
knee. This is fairly common and
by other changes happening
nothing to be concerned
in your joint, including the
about. It is thought that 18% of
thickening of the bones at the
the population in England
joint surface and thickening of
aged 45 and over are
the joint capsule.
affected by knee osteoarthritis.
Research suggests that
Arthritis, or more specifically
the symptoms of arthritic
osteoarthritis, is the medical
joints can be well
term for degeneration of the
managed with a
articular cartilage lining the
combination of
ends of your bones at a joint.
conservative
Although often associated with
measures such
aging it does not mean you
as exercise,
11CHRISTMAS MAKING STRIDES
Our brand new selection of
Christmas cards for 2018
Christmas is
A Coming B Christmas Post C Christmas Stag
Mary, Joseph Oh Christmas
D and Baby Jesus E Tree F Christmas Holly
All cards have the greeting:
“Wishing you a
Merry Christmas and
a Happy New Year”
Robin on
G Christmas Eve H Snowy Post
12Issue no:28 2018
Each year we offer a variety of Christmas cards increase our sales and raise even more funds
for sale and with your continued generosity, you than last year. We offer free postage and
really do make a difference to our fundraising packaging - although any donations to cover
efforts. With your help we hope we can the cost are greatly appreciated.
1. Select your Christmas cards
Card No. in pack Price No. of packs Total £
A Christmas is Coming 10 £3.50
B Christmas Post 10 £3.50
C Christmas Stag 10 £3.50
D Mary, Joseph and Baby Jesus 10 £3.50
E Oh Christmas Tree 10 £3.50
F Christmas Holly 10 £3.50
G Christmas Eve 10 £3.50
H Robin on Snowy Post 10 £3.50
Please make sure cheques or postal Total cost of order £
orders are made payable to ‘Horder
Healthcare’. Donation for postage & packaging £
Thank you for your order. Total payment £
2. Your donation
I would like to support Horder Healthcare with a gift of:
£1,000 £500 £250 £100 £50 Other £
I enclose a cheque/CAF voucher made payable to ‘Horder Healthcare’
YES, I am a UK taxpayer and consent to Horder Healthcare claiming Gift Aid on this and all my donations in the last
four years and from the date of this declaration until I notify Horder Healthcare otherwise. I understand that if I pay less
Income Tax and/or Capital Gains Tax than the amount of Gift Aid claimed on all my donations in that tax year it is my
responsibility to pay any difference.
Please sign to confirm: Date:
Your details are only used for posting your Christmas
3. Your details (PLEASE USE CAPITALS) cards or if we need to contact you about your order.
Name: Mr/Mrs/Miss/Ms Tel:
Address:
Post code:
Email:
Send to: Marketing Department, Horder Healthcare, St. John’s Road, Crowborough, East Sussex,
TN6 1XP. Alternatively, you can email: fundraising@horder.co.uk or call 01892 665577.
Visit horderhealthcare.co.uk to purchase Christmas cards online.
To receive marketing communications including Making Strides, please visit
horderhealthcare.co.uk/opt-in or email hh.marketing@horder.co.uk
13FUNDRAISING MAKING STRIDES
Fundraising
Volunteering
Thank you
&
them easier to see when huge thank you to everyone
taking blood who supported our annual
We would like to say a big
• A machine that is used appeal which allows us to
“thank you” to our supporters
after knee replacement buy patient-focused items
and donors who helped
surgery to allow continuous and extend our services. We
raise £15,000 for our 2017
movement and ensure the are always so grateful for
appeal. The money raised
best outcome after surgery. the donations we receive;
has been spent on a variety
• A kit for measuring blood every penny goes directly into
of items for our two specialist
glucose levels. improving the services we can
hospitals –The Horder Centre
• Equipment for The Butterfly provide for our patients.”
in Crowborough and The
Scheme, which provides
McIndoe Centre in East
Grinstead. We believe the
a system of hospital care Spring appeal
for people living with
new items will make a big We are very pleased to
dementia.
difference to enhance patient announce that we reached
Rachel Dixon, Operations
experience and wellbeing. our £5,000 target for our
Director of Horder Healthcare,
The items include: 2018 spring appeal. This was
said:
• A handheld device that achieved through support
“We would like to say a
illuminates veins making from individual supporters,
corporate partners, grant-
making trusts and fundraising
events. Thank you to everyone
who donated.
The funds raised have gone
towards improving the therapy
garden and outside spaces for
the benefit of our patients.
The therapy garden, created
to help patients recover
from surgery, is a unique
area where patients can use
exercise equipment outside
and enjoy the benefit of
walking on different surfaces
14Issue no:28 2018
to increase their strength. focus is to improve the outside important part in enabling
To enable patients to keep spaces for patients including us to achieve our charitable
using the space, our clinical our therapeutic gardens aim of advancing health. You
staff have identified the which have been purposefully can find the donation form on
need for some new exercise designed to assist recovery page 13. Thank you to all of
equipment and we have after surgery. our donors and volunteers for
added some extra shade in the The Openreach team your ongoing support.
garden, to ensure the comfort kindly spent a day gardening
of all patients and to maximise and painting furniture in the Read about Horder’s
the amount of time the space gardens which has made a fascinating history
can be used throughout the big visual impact. The Centre
day. We are also looking was also given a generous To mark The Horder Centre’s
to upgrade the amount of donation of plants from local 60th anniversary in 2014,
landscaping maintenance Crowborough business, Charles Gallannaugh, the
required for this garden and Millbrook Garden Centre, President of Horder Healthcare
for the area at the back of the which has added additional and the first surgeon to
hospital, to provide a pleasant colour and scent to enhance perform an operation at the
area for patients and visitors to the therapeutic environment. hospital, wrote an account
enjoy and to further enhance of the fascinating history
the therapeutic environment we Why we need your of the organisation in the
have created. support book, Another Way - The
Horder Centre Sixty Years
Our hard-working As a charity, we rely on the of Evolution, published
volunteers generosity and support by AuthorHouse.
of our volunteers You can visit
are blooming and loyal donors horderhealthcare.
marvellous! whose vital co.uk to purchase
contributions enable the book online
The Horder Centre was
us to deliver a larger for £9.95 or ask at
delighted to welcome a
amount of life- reception at either
12-strong team of corporate
changing treatments The Horder Centre or
volunteers from Openreach
every year. The McIndoe Centre.
as part of our fundraising
Donations, whatever
Spring Appeal. The current
their size, play an
15COSMETICS MAKING STRIDES
Tummy Tuck Surgery:
All You Need to Know
Abdominoplasty or “tummy tuck” surgery aims to improve the appearance and function of the abdominal
wall. Here, Consultant Plastic Surgeon Simon Mackey provides an overview of abdominoplasty.
bikini-line. After significant weight loss, a “fleur-
de-Lis” abdominoplasty leaving a scar along
the “bikini-line”, and also a vertical scar
along the centre of the abdomen may
provide the best result. Other techniques
include “Brazillian-abdominoplasty”,
“circumferential–abdominoplasty”,
and “melon-slice” abdominoplasty.
THE MCINDOE CENTRE, PART OF HORDER HEALTHCARE
The precise technique should be
tailored to you specifically.
It’s often possible to combine
WHAT IS A TUMMY TUCK? abdominoplasty with other
operations such as liposuction,
Weight loss, pregnancy and abdominal surgery
or breast enlargement, reduction
can lead to an abnormal shape to the lower
or lift. Combination surgery can
abdomen, scars, loose skin, or stretch marks.
mean fewer anaesthetics and
During abdominoplasty, excess skin and fat are
shorter total recovery.
removed from the lower abdomen. Tightening
the skin and the “six-pack” muscles can produce
a flatter tummy, define the waistline and improve WHO ARE THE BEST
abdominal wall function. CANDIDATES FOR
Keeping the scar as low as possible, below ABDOMINOPLASTY?
the “bikini-line”, an incision is made from hip
to hip. For a “full-abdominoplasty” there will The best candidates are ladies
also be a scar around the “tummy-button”. or men who have excess skin or
Depending on the degree of skin and muscle an abnormal shape in the lower
laxity, any one of a number of different abdomen. You should ideally be
techniques may be most appropriate for you. at, or close to your ideal weight
Sometimes it may be possible to perform a before proceeding. You should be
“mini-abdominoplasty” leaving the “tummy- medically well, and a non-smoker.
button” alone, and a shorter scar along the Taking steroids and blood-thinners
16Issue no:28 2018
may make you unsuitable
for this type of surgery – but
this should be discussed with
your surgeon.
WILL I LOSE WEIGHT WITH A
TUMMY TUCK?
To get the best results from
improves in the weeks following surgery.
abdominoplasty, you should be close
It is important to attend any post-operative
to your ideal weight before proceeding
check-ups arranged by your surgeon, as these
with surgery. The only way to get rid of
are important for optimizing the outcome of
the fat that lies within your abdominal cavity
surgery.
is through weight-loss. This fat can make the
tummy bulge even after abdominoplasty, and
cannot be directly removed with any form ANY OTHER ADVICE?
of surgery. Losing a lot of weight after an
Your operation needs to be specifically tailored
abdominoplasty can lead to loosening of the
to you. Surgeons should arrange to see you
skin and abdominal muscles.
at least twice prior to surgery, to allow ample
Although you may lose several kilograms of
opportunity to review your past medical history,
abdominal fat and skin with an abdominoplasty,
discuss the limitations and complications of
a tummy-tuck should not be regarded as a
surgery, and to complete the consent process.
“weight-loss procedure”.
As safety is the key priority with this type of
treatment, I would recommend that you check
WHAT IS THE RECOVERY PERIOD LIKE? that your surgeon is on the GMC’s Specialist
Register for Plastic Surgery, and is ideally a full
In general, you will be in hospital for 1-2 nights
member of BAPRAS (the British Association of
following surgery. Wounds are closed with
Plastic Reconstructive & Aesthetic Surgeons),
“dissolving” stitches and dressed with paper
or BAAPS (the British Association of Aesthetic
tapes. It may be necessary to have surgical
Plastic Surgeons).
drains for 1-2 days. You will be relatively mobile
within 2-3 days. I encourage you to take 2-3
weeks off work and driving. I would normally Mr Simon Mackey is
expect a return to normal activities within a Consultant Plastic
6-12 weeks following surgery. A compression and Reconstructive
garment is worn for 6 weeks to reduce post- Surgeon at The
operative swelling. McIndoe Centre in East
Any surgical procedure can be painful, but Grinstead. Please call
good pain-relief and use of long-acting local 0800 917 4922 or visit
anaesthetics make it manageable. Tightness themcindoecentre.co.uk for further
can be uncomfortable particularly after re- information or to arrange a consultation.
positioning the abdominal muscles, but this
17ORTHOPAEDICS MAKING STRIDES
My shoulder is painful
– is it “impingement”?
By Mr Hagen Jähnich, Consultant Orthopaedic Surgeon FRCS (Tr & Orth)
Shoulder pain is a very common Impingement means that and national guidelines
problem and can hit any age during use of the shoulder suggest your GP should
something catches and leads organise an X-ray of your
group. However “impingement” to referred pain (pain felt in shoulder. As long as the X-ray
is most common, but not another part of the body other is normal, the trained Therapist,
exclusive, in the age group than its source), typically into the GP or the Shoulder
of 40 to 60. But what is the side of the shoulder. But Specialist may try a single
pain can also refer down injection with steroids.
impingement? the arm and up the neck. An X-ray may identify
Impingement is a symptom, calcium around the shoulder or
not a diagnosis! There can be bony spurs pressing onto the
many causes of impingement. tendons of the shoulder. One
This article describes a number could see early arthritis and
of them. many other problems. Calcium
The impingement pain may in the tendon can burst and
not originate in the shoulder at irritate the shoulder. This leads
all. It can be referred from the to severe pain. A steroid
neck, even the gall bladder or injection, with or without
the heart and may be a sign of image guidance, may settle
a slipped disc in the neck. things down again. But larger
There may be no structural amounts of calcium may need
reason for such symptoms to be removed by keyhole
and simple muscle imbalance surgery (arthroscopy).
or poor posture are common Bony spurs tend to form
causes. This is corrected by at the under surface of
good physiotherapy and self the tip of the shoulder (the
help, like participating in Pilates. acromion). Physiotherapy
If treatment after two and injections are again the
months does not show any start of the management.
improvement then a formal But when symptoms persist
assessment is required. Local or if there is concern for the
18Issue no:28 2018
rotator cuff tendon, then (also known as a “frozen It may not necessarily be a
keyhole surgery could be the shoulder”). Stiffness should be tumour/cancer or similar
answer. Furthermore, there the give away but may initially but can be a tearing or torn
may be arthritis in the ACJ not be obvious. In the early tendon, which, if left untreated,
(Acromio-Clavicular Joint, phases of a “frozen shoulder” may not be repairable in the
the joint between collar bone there may be no stiffness at all future. A shoulder specialist
and shoulder blade). It may and it is the pain that simulates would be best placed to
lead to localised pain but impingement. Frozen shoulders either reassure or diagnose
also to impingement. the underlying
Often though, it is an “The impingement pain may not originate in problem correctly.
incidental finding. the shoulder at all. It can be referred from the Many treatments
Most X-rays will neck, even the gall bladder or the heart...” are now available.
show some arthritis Physiotherapy may
in the ACJ. However, if it is not may resolve spontaneously be appropriate if a tear has
the cause of symptoms then it with time, however, if been present for a long time
should not be treated. established, and severe, they and is not repairable. Surgical
In my practice, I have seen may need keyhole surgery to options range from the above
many patients with persistent improve matters. keyhole operations to joint
impingement, who in fact Unfortunately, there are replacements to address all
did not have impingement occasionally more sinister sorts of causes of shoulder
at all. The most common reasons for shoulder pain. This pain.
misdiagnosis is that of an is the reason why one should
idiopathic adhesive capsulitis not ignore such problems.
Mr Hagen Jähnich is a Consultant Orthopaedic Surgeon at The Horder
Centre in Crowborough. If you suffer from shoulder pain please
speak to your GP and if you require further treatment you can be
referred as a private or NHS patient to The Horder Centre. Please visit
horderhealthcare.co.uk or for further information.
19S
NT k
o ur EVE .co.u
to N re
n up TIO thca .
Si RMA heal ation
g
r
FO de orm
E IN hor re inf
E it o
FR e vis for m
a s
Ple
Why choose
The Horder Centre?
Wide range of
OUTSTANDING orthopaedic
consultants
ORTHOPAEDICS Over 2000 joint
replacements a year
WITH NO WAITING LISTS* No need to wait for
treatment*
The Horder Centre is a specialist centre of excellence for 0% APR up to 6
orthopaedic surgery. As a private patient, you can get faster months*
access to a range of procedures including hip and knee
replacement. To arrange a consultation or a tour of our Recognised by most
specialist centre please: major insurers
call 01892 620938 *2 weeks from initial appointment
providing the procedure is appropriate.
Terms & Conditions apply.
visit horderhealthcare.co.uk
Subject to status.
St John’s Rd, Crowborough, East Sussex, TN6 1XPYou can also read
