Over the years, Dr. Kory Reed has been the kind of guy who wears his spirituality on his sleeve.
The orthopedic surgeon – featured this weekend in the WNY Refresh In the Field story – comes from a religious family, is active at The Chapel at CrossPoint in Getzville, and has gladly offered to pray with patients before he conducts surgeries.
“What I do is a nice job because I help people and I fix things, and I contribute to society and I feed my family but I also have the ability to affect peoples’ lives in a positive and more missional way,” he said during a recent interview. “It’s hugely important to me. It’s obligation to my service ... and my faith background.
“I have been involved in mission work in the past,” he said. “My last mission work was 2007. I went to Zambia. We visited some hospitals and dealt with patients with eye problems. I was in medical school at the time. We helped establish a fresh water supply for a village there and helped establish hope from that perspective and a faith-based perspective.”
These days, he said, “my church is a big deal for me and I’m becoming increasingly involved with that.”
He and his wife, Jodie, are also very involved at home with three young children. Then there’s his professional role of trying to help grow a larger presence in the Southtowns for Excelsior Orthopaedics.
My interview with Reed was wide-ranging. I focused the In the Field story on more general questions about his surgical work, and saved some of the more specific stuff for this blog post.
Below are excerpts:
Q. How important is the shoulder to your overall health and well-being?
A lot of people have rotator cuff dysfunction for one reason or another. They have a tear, an injury, a chronic, repetitive use problem. It’s a series of tendons that maintain stability in a shoulder that allows it move in space. It allows you to reach to the side, reach across your body and grab your seat belt. To raise you hand and clap. To throw a fastball. To essentially lift your arm without difficulty. All these things.
The problem is when you have arthritic conditions that also involve the rotator cuff. Dr. (Lisa) Daye (a colleague) sees younger sports injuries that may in involve some of the cartilage aspects of the rotator cuff, like the labrum. While I’ll deal with that, I deal with more of the chronic repetitive issues involving the rotator cuff and what happens when those don’t heal, or are destroyed to the point where they can’t be repaired or are accompanied with arthritic pain to the shoulder.
Typically, when people have arthritis to the shoulder but still have normal rotator cuff function, they can get a normal ball and socket total shoulder replacement that is more prevalent in the community. The problem is that when they don’t have the tendons to stabilize that implant and let it function the way a normal anatomic shoulder functions, they need a different kind of implant: a reverse total shoulder arthroplasty. These are for people dealing with chronic rotator cuff dysfunction and arthritis at the same time.
Q. Can you describe that procedure?
It’s very similar to a total shoulder replacement but what it does is alter the mechanics of the shoulder joint to function without a rotator cuff. It uses the big, strong deltoid muscle that we all feel when we grab our upper arm, and uses that muscle to lift the arm instead of the smaller muscles in the shoulder that are typically used. It works very well for people. Recovery is speedy and it’s an overnight stay in the hospital, at most...
There’s a lot of mechanics that goes into how to do this appropriately. That’s what draws me to this in a big way. I understand it, I have an interest for it. I do research for it. And I think it’s an important procedure for people to be aware of. ... I don’t base my decision (to recommend surgery) on your chronological age, I base it on your functional age, you’re behavioral age. It doesn’t matter if you’re 80 years old, if you’re 90 years old. If you’re healthy, if you’re in pain and/or dysfunction, you can be helped. (Excelsior spokesman Mark Wolbert said it’s a procedure for people who’ve been told there’s nothing that can be done.)
Q. What are some of the main causes of torn rotator cuffs?
A fall. Shoulder dislocation in the older population. Lifting injuries at work, either repetitive or injury-related.
Q. How has shoulder surgery changed since you’ve been in medical school?
More and more surgery is arthroscopic. You can do almost everything with a scope. It’s a more minimally invasive procedure. ... We’ve also really made advances in being able to do surgeries and get people in and out of the hospital (fairly quickly) or on an outpatient basis.
Q. How has hand surgery changed since you’ve been in medical school?
Significantly. I hear stories about when patients would have carpal tunnel release surgery and they’d be admitted to the hospital for it. Now, I’ll do surgery on a Friday and, depending on what you’re job is, I’ll send you back to work on Monday. That’s not for all people, but it’s possible. For most hand surgeries, you’re encouraged to use your hand right away. The emphasis is on early motion.
There’s a couple of things I do that are different that maybe have been done historically, certainly in the Southtowns. One is endoscopic carpal tunnel release surgery. It’s a minimally invasive approach to doing carpal tunnel release. The other is for Dupuytren’s disease. Dupuytren’s is contracture of the layer of the tissue just below the skin surface that causes the fingers to flex down over time. It doesn’t allow you to shake hands, put your hand in your pocket, grab your golf club, things like that. Oftentimes, it’s a male of Eastern European descent who had a dad with the same thing. Traditionally, the procedure for that has been a large, open incision to take away these nodules and chords that are the problem. Now, I do an injection to dissolve these structures and open up the hand. ... The injection is called Collagenase. It’s an enzyme that dissolves a normal protein in the hand that has become overabundant. A hundred years ago, if there was a problem like this with a finger, they’d cut if off.
Q. Do you tend to see a lot of stress injuries and how can those be avoided?
A lot of repetitive stress injuries to the shoulders and to the hand can be prevented by simple education on how to lift properly, how to give yourself a break when you need it. Recognizing when a work issue is giving you chronic pain and is going to prevent you from working or caring for your children. If you need instruction, probably a good thing to do would be line up an appointment with one of our physical therapists.
Q. What are some of the symptoms of repetitive stress injuries that people should look out for?
Numbness and tingling in the fingers and pain in the palm. Usually both of these issues are worse at night. If you wake up multiple times in the middle of the night because your shoulder hurts, or your hand hurts or is numb, you should probably see someone about that.
Q. Where does pain medication come in, if at all, with any of these conditions?
That’s not something I handle at all, and not something I encourage with my patients. I feel there is enough mechanical reason surrounding the skeleton and all the muscles and tendons that support and move it, that a solution to the problem – or at least a partial solution to keep you out of the realm of pain medicine chronically – can be found. If you come to me or any of the other providers in our group looking for pain medicine, that’s not how we treat patients. That’s how we get patients through their injuries and through their surgeries. That’s all.
Q. When surgery is needed, what does recovery look like?
It varies over time, and recovery is becoming quicker and quicker. ... I advocate strongly for early motion as much as possible. I’m going to place a high priority on giving you educational material to take home, and a therapy course if necessary to keep all those surrounding joints moving.
Q. Can someone with a serious injury or tear in their hand or shoulder recover a full range of motion and if so, how often is that?
The best way to determine patient outcomes and recovery is that if you have a patient that is motivated and compliant, a proper indication of surgery is there. That patient is going to maximize their recovery. If the patient is doing their job and the surgeon is doing their job, that patient is going to do the best they can. Are there risks of surgery? Yeah. There’s risks in non-operative procedures, too.