85 year old possible shoulder operation

[Bigboy2222]

Hi I have been struggling with this question for a few years now.  My mother is currently 85 yrs. old, lives in a nursing home, wheelchair bound. Diagnosed with Parkinson's (does not really have the tremors, just hard for her brain to communicate with her muscles causing very hard time walking ...she "freezes" at times. Along with possible Parkinson's Dementia. I remember in the 60's we were involved in a car wreak where mom had a separated left shoulder then later in the early 90's was involved in another car wreak where she had been hit on front left side. They replaced her left hip and she also injured her left shoulder. Currently she is diagnosed with basically a torn rotator cup. A doctor recommended an operation to repair her shoulder. I have a fear that if she undergoes surgery I've heard that (going under the anesthesia) she could lose more of her memory.  She does not have much use of her left arm...minimal range of movement because it hurts... she won't exercise it on her own cause she forgets (can't remember what she had for breakfast)and it hurts causing it to atrophy.  Last year she had a cortisone shot I guess it sort of helped except the doctor mentioned repeated shots will deteriorate her muscles. What do you think should be done operate with possible less pain and more range of movement and possible memory loss due to going under the anesthesia  or not operate and live with the pain?  I hope I am in the right category perhaps I should also post in Neurology too..

[Dr Vinod]

Hello!

Parkinsonism sadly is a very debilitating illness.

Combined with rigidity and tremor and also affecting memory losses it will become very difficult for your mom to do her daily chores. Whenever she starts something there will be an intentional tremor.

She should be dealt by a neurologist and different combinations of medications should be tried.

You are doing it fine, take care of her!

[Bigboy2222]

Thank you for your reply. I needed confirmation to my fears. I was worried that I was preventing Mom from pain relief. This Parkinson's seems to amplify allot of normal aches and pains along with irritations. For example she spends hours using floss and a toothpick trying to get things out from between her teeth. Also just putting on a jacket irritates as well as her diaper she always uses. So don't know what is REALLY a need and what is just another symptoms of this darn Parkinson's
you have been a great help
Len

[Dr Vinod]

Hello!

This is a sensitive issue and you have to weigh the advantages of surgery before you go ahead.

1) Rotator cuff tears would need physiotherapy for recovery and it is very difficult for a patient of Parkinsonism with the rigidity and tremor to do these exercises.

2) Even after the arthroscopic repair she has to undergo physiotherapy for complete recovery so here the irony lies

3) Her age and Parkinsonism are against her for undergoing major surgeries and for active recovery.

I would suggest you to take a second opinion and start pain therapy if she complains. You can continue steroid injections till it is safe, and keep surgery as the last resort.

Take care!