08 Sep 2018

The Road to Shoulder Replacement Surgery and Surgeon Selection

Not my normal JetSetWay blog. 
Recently I had a total shoulder replacement aka total shoulder arthroplasty.  I am going to chronicle the steps that lead up to it, the procedure itself, the hospital experience, and the long tough recovery process. 
The steps leading up to the surgery were many and taken over several years. Arthritis in my left shoulder has caused my cartilage to disintegrate overtime and the pain increased in direct proportion. Picture a tire losing its tread and then losing the rubber itself and driving on the wheel itself against the road.  Ouch.  Every night the excruciating pain woke me up.  The day was worse depending on the activity.  
I must admit I had a built-in bias against going to an orthopedic surgeon from the beginning as I wanted to explore and eliminate all other possibilities before having surgery. And in total fairness to all four orthopedic surgeons that I ultimately spoke with, not one of them tried to push surgery; each one of them said it was a last step and even then, it was not mandatory. It is always an option in proportion to how much you want to deal with the existing pain.
Before I went to any surgeon I had been in close contact with my terrific concierge doctor, J. Corey Brown, and we tried so many alternatives.  Prior to the surgery decision, I tried using a chiropractor, then physical therapy, then acupuncture, then went to a local orthopedic surgeon who tried a Cortisone shot. That left the surgery option.
The issue was simple.  Was I willing to have temporary pain and discomfort in order to regain my mobility? For me it was an easy choice because the pain kept escalating.
Dr. Brown referred me to the Southern California Orthopedic Institute, a huge well-respected organization of orthopedic surgeon specialists who also do a considerable amount of the training for other orthopedic surgeons. We just don’t have those options in Las Vegas.
Fortunately, one of the gentlemen who started the institute actually was an intern with Dr. Brown. All the information I received from that doctor and my research came to the same conclusion; have surgery or simply deal with the pain.
He suggested I use Dr.  Joseph Burns who is the ultimate specialist on total shoulder replacement.
It turns out that there are about 900,000 knee replacements performed every year in the U.S. and only 50,000 shoulder replacements.  The shoulder replacement is a more difficult type surgery. Unfortunately, the vast majority of the orthopedic surgeons who perform shoulder replacement surgeries only do one or two a year. Dr. Burns does about 50 of these surgeries annually and often is called in as the person to repair previous surgical problems. That notwithstanding, I got a second opinion from a family friend who is also a very highly respected orthopedic surgeon. He knows the group well and gave a total thumbs up.
Dr. Burns said this is a relatively good time to have the surgery, if there is a great time, because I am at the age where it will last my entire life and there is new technology that allows him to know exactly where to put in all the replacement items rather than just in the general area because of recent CAT Scan advances.
I have a personal theory that a lot of orthopedic surgeons are sports fan. It turns out that Dr. Burns did his undergrad at Yale and was actually a ballplayer on two varsity teams.
I particularly like Dr. Burns. Not only does it seem that the operation was an entire success, but he spent time speaking to my wife, Allyn, after the surgery in a manner that made her feel I was in good hands and the surgery was a success. No CYA.
I did not feel like just a number.  When he came to the hospital the next day on his rounds and chatted with me, he spent an inordinate amount of time explaining things.   It was important to him to go over post-surgery requirements that will help with my recovery over and above just basic shoulder items. He even went so far as to put me on a special low sugar diet because of my diabetic tendencies. He cares about his patients not just about his narrow surgical area.
Stay tuned for Part 2.

24 Aug 2018

London, England, UK 2018


If the raison d'etre for our Madrid trip was the visit to The Prado Museum, the prime purpose for London finally was to be able to see Matilda the Musical. Wow!
In 2012 it won seven Laurence Olivier Awards (London's version of Tony Award), the most ever for a London production.
 We had dinner overlooking the Tower Bridge. 
Having been to London so many times, we decided to stay in a totally different part of town, actually across the River Thames at the Shangri-La which is on top of The Shard, the tallest building in Wester Europe. It is gorgeous with amazing views. The three photo above are from our room.
We spent an afternoon at Tate Modern, one of the world's best contemporary art museums. As usual it was good that I had a guide to have some clue as to what I was looking at.
We were very lucky in that they have a major Picasso exhibition on now that is over in just a few days. We liked it way better than the rest of the museum.

Picasso was a guy who always had sex on his mind (or hers in this case).















22 Aug 2018

Maspalomis, Grand Canaria, Canery Islands 2018

We needed a break from our vacation. Mission accomplished. We flew down to Maspalomis, a resort town in south Grand Canaria Island in The Canary Islands. We chilled for four days. It is a long ways away, but worth it. We shall return. Notwithanding the location it is definitely Spanish in all respects. They have been in control for over 500 years.
The Seaside Grand Hotel Residencia is considered by many to be the best in The Canary Islands and we were not disappointed. The room, service, ambiance and food all were excellent.
Whether you look up the beach or down, people were always coming or going. We managed to score a couple quiet lounges and umbrellas. The beach is over two miles long with gigantic sand dunes.
Of note is that the sand is the hottest I ever have experienced; way hotter than Hawaii. It required wearing flip flops to the water's edge.
One day we took a tour across and around the island. Being volcanic, it rises 6,000 feet and was quite windy, but with open beauty. There is lots of hiking, 4 wheeling, and cycling.
This particular cactus is known for its laxative powers.
They even have camel rides available.
Las Palmas, the main city, is across the island. We had lunch there overlooking the beach.
Last night we walked to town and loved that we ventured out.
We have had many great meals around the world and Las Rias adds to that list. Even more striking was that neither of us could get over the beauty of the restaurant and the A+ ambiance looking over the water. The only thing close for me for ambiance is probably Michel's in Honolulu.
Spain is such a breath of fresh air for us versus France. It so much less hectic, the people usually are nicer and the prices are dirt cheap by comparison. Having said that France still has a certain something going for it.

18 Aug 2018

Madrid, Spain 2018

As long as we were changing planes in Madrid anyway, we decided to stay for a couple days mainly to take in The Prado, one on the world's great art museums.

We hired an outstanding private guide company whom I recommend -  Madrid Museum Tours. Mr. Hernan A. Satt, the owner guided us personally. I only wish we had more time.

We saw several of the world famous paintings including one of my favorites The Garden of Earthly Delights Triptych (1490 - 1500) by Hieronymus Bosch. It is about heaven, hell, creation, sin and so many other things. Our guide could have spent all day explaining it and it is the third time I have seen it. Very busy painting. 

Allyn wanted to check out The Three Graces (1630 - 1635) by Reubens. He has never done much for me, but I had a whole new appreciation of his art, and him, after I heard the story of the painting. It is supposed to be about virgins living with Greek gods, frolicking and having a good time. We learned about painting in primary colors, blue tints blah blah blah.

Then I found out that the artist would not sell it, even to the King, his benefactor. It turns out the lady on the right is his first wife and the lady on the left his second, and then current wife. He said the middle lady was just the model, but apparently was his mistress. Anyway he loved the painting, it was very personal, and I can see why he wouldn't sell it. Then as soon as he dies the wife wants to get rid of it because she couldn't stand seeing his mistress, even from behind. 400 years ago and nothing has changed.

Also she particularly likes Las Meninas (1656) by Diego Velazquez. The painter is in the painting along with royalty; a definite no no. Since he and the King are actual buddies in real life, it was not a royal issue. It shows the view from the eyes of the King even though it was supposed to be about him. To see it properly you need to turn around and look at it with a mirror. For example the painter was left handed.

Speaking of Velazquez, I loved his Portrait of Queen Mariana of Austria (1652,53). It is a great story with the fun being about (not so) secret Jewishness. In order not to get in trouble, he painted it for his friend the King, but for his eyes only. The artist's family was among those Jewish families who converted to Christianity, and secretly remained Jewish,  or they would have been expelled from Spain.

Some items to note in the painting. Both hands have fingers showing Hebrew letters. She is wearing an upside down Hannakia on her head complemented by 8 bars on her dress. If you look close at her white hankie, it is the face of Moses.

Then we enjoyed a relaxing hop on hop off tour viewing vast tree lined boulevards and checking out the architecture parks, and squares. 
The dinner choice was superb. We ate at TenconTen, a restaurant with all the attributes we like: good food, service, ambiance, in, trendy, different levels of music depending where you dine and lovely all around. Plus it was an easy walk for a few blocks.
Since we ate at 9, the bar was hopping and the dining room almost empty but for us few early bird Americans. Every seat was taken when we left at 11.
 The gin and tonic tasted as good as it looked.

16 Aug 2018

Cannes, France 2018

This is the daytime view from our hotel room. 

Cannes has many similarities to Saint-Tropez. They both are on the French Riviera, are all about sun, beaches, shopping, eating and fancy people and are too crowded in July and August. Cannes is bigger but Saint-Tropez is equally as crowded.

Right on the Pier at the Marina is Gaston Gastonette, a famous, casual, good fish restaurant that I have patronized for years.

Nothing says great Cannes seafood like Astoux & Brun. They are right there opening up oysters on the corner. The place is jammed every night by 7 o'clock and they don't take reservations. The food is terrific; the place is fun, and the prices are reasonable. We seem to always strike up fun conversations at these outdoor places.
Six times during the summer there is a huge sophisticated fireworks (with music) contest enjoyed by 200,000 people each time. Hours before people line the beach in anticipation.
We watch them from our hotel room window. Never have I seen such pyrotechnics as here. They get better every year.