Surgery to Remove Calcific Tendinitis In Right Shoulder

I recently had surgery (2013.11.15) to remove a calcium deposit in my right shoulder and repair the rotator cuff.  Here are a few photos from the procedure.

The bottom part of the following image, roughly from 5-o'clock to 8-o'clock and a radius from each through the center of the image shows part of the humerus exposed.  The shiny surface of the humerus should not be visible but was made so by removing the part of the rotator cuff which was damaged by the calcium deposit under it. 

The image above same as the previous image, but is being prepared for installation of two calcium composite anchors.  Once the anchors were installed, the rotator cuff was ready to attach back to the bone.

 

The image above shows the rotator cuff sutured to the bone below, thus covering the previously exposed part of the humerus.

The image above is a repeat of the previous images but shows the initial response to the repair by the body.  This process will continue over the next 6 months.

5 Access Points for Surgery

 

 

 

 

Up-close View of 3 of 5 Access Points

 

 Surgical Follow-up

Post-op exam is was accomplished a few days ago (2013.11.25).  The sutures were removed and a post-op x-ray was taken.  Nothing abnormal in either issue.

My intent was to obtain a copy of my surgical procedure to post here.  Apparently someone in the OR didn't operate the machine effectively - hopefully this was an isolated case.

I have found many similar procedures in video form on the internet.  One relatively short video is shown belowrs.

Calcific Tendinitis Arthroscopic Surgery

Munson Creek Falls

About 7 miles south of downtown Tillamook Oregon, a small stream of water passes under HWY 101 named Munson Creek.  The stream isn't very impressive and doesn't fill your mind with wonder.  Another mile south of that crossing is the road to Munson Creek Falls State Natural Site. The Oregon State information site provides no photos and limited information about the site.

The road to Munson Creek starts as a rough paved road and turns into gravel.  The road isn't smooth but any passenger car without an air damn close to the ground should be able to negotiate the road with no concern.  There is a "Y" in the road before you reach the park.  Take the road to the right of the "Y".  The road narrows a bit in several places between trees allowing for only a single vehicle to pass.  At the end of the road is a parking/turnaround area next to Munson Creek.  To the right is a small picnic area with a couple of picnic tables and a barbecue you can use.  The day we arrive at the turnaround it was Early October and raining pretty hard.

Munson Creek Trail Head

The trail-head is nicely marked in the west end of the parking areas.  The trail surface was easy to walk.  A few elevation changes were slippery due to the rain runoff.  At the steepest parts of the trail stairs were carved and lined with timbers making it easy to climb.   Along the trail are several enormous cedar and sitka spruce trees.  The largest tree reminded me of the Klootchy Creek sitka spruce which cut down in 2007 after being struck by lightning and deemed a danger to visitors.   The view of the falls at the end of the trail is beautiful and unexpected.  The water crests the top of the hill and tumbles down into this special value of beautiful trees and foliage.   The final section of the trail is closed due to down trees.

End of Munson Creek Trail

Munson Creek Falls 

On this particular trip I didn't take my camera equipment.  The pictures I've referenced here from from other sites I found on the internet.  I will return to this place and take a series of photos to document what a small gem this place is.

Car Stereo Story

Last December our beloved 2003 Ford Excursion, Eddie Bauer Model, came to a sudden end.  I was driving home from work, sitting in traffic on I-5 northbound rolling at about 2-3 mph, when a Toyota Tacoma pickup struck directly from behind going 55 to 60 mph.  It was an intense experience for which I'm still recovering.  It took a few weeks to disassemble the SUV enough to figure out how bad the damage was.  From the outside, it didn't look that bad, but upon thorough inspection the SUV was seriously damaged.  They eventually declared the vehicle a total loss.  Determining how much the vehicle was worth was a burdensome journey through insurance purgatory.

For the next 5-1/2 months we searched all over the western united states to locate a comparable replacement Excursion.  Finding an Excursion with a 7.3l Powerstroke Diesel motor that wasn't insanely overpriced or didn't have 220,000 miles is more of a challenge than you imagine.   Eventually we located a 2002 Ford Excursion Limited with a number of after market options we would probably never pursued.  Initially we were cautiously excited - how did we get to find this specific vehicle at  this specific price.  The reports were clean and the vehicle drove like you would expect.  We made and offer, it was accepted, and picked up the vehicle the following day after retrieving our funds to complete the transaction.
After the purchase we had the vehicle completely inspected and reviewed at Electronic Injector Services in Sherwood Oregon.  This place is an exceptional service center and source of knowledge about all things "diesel."  There were a few things they identified, all related to what happens to these vehicles after they reach 115,000 miles - about 1/3 of their life if well maintained.  Shortly after this, we had the front brakes replaced and they I drove to Cottonwood California towing a tandem axle trailer to pickup my daughter's jeep.  The total weight of the trailer, 92' Jeep Cherokee and contents of the Jeep easily exceeded 6000 pounds and the "new to us" Excursion was amazing.

Now that the journey to find a replacement was done the next goal was to replace the 11 year old factory audio system with something current.  We drove a number of current model year Suburban's, didn't like them, but admired the electronics included in the LTZ package.  With this in mind we started shopping for a head unit that would provide similar capabilities.  The features required were:

• Bluetooth phone with effective noise management
• Bluetooth audio
• GPS navigation
• Satellite radio
• HD radio
• IPod interface

Entry in to this market for current products is not cheap.  After several weeks and several trips to Car Toys,

we decided upon a Kenwood DNX690HD.  It had all of the features found in the list above and was relatively close to what we were hoping to spend.  The features of the unit are truly exceptional.  The user interface is very well designed and organized.  It is easy to navigate from one function to another.  The context nature of the touch screen interface is very nice.  The audio output seems quite good as well.  After nearly 3-4 weeks of use this unit it was time to address the problems:

• POST - Power on self test
• iPod audio drop
• Bluetooth phone connection time
• Bluetooth phone interaction

Every time you turn the unit on, it takes an incredibly long time for the unit to reach the point of operation.  I realize it is a complicated unit, has lots of capabilities, but 20-30 seconds to get to the point of radio output seems extreme.

The iPod user interface is the best I've ever seen.  It is intuitive and the hierarchical search capability really makes it easy to navigate a large music collection with ease.  The problem is that once it starts playing music, it will eventually stop producing audio.  The interface indicates the iPod is operating correctly, the song is continuing to play, and it's possible to select another song, album or play list.  The only problem is that no sound is produced.  The only way to correct the problem is to power off the unit.  Since there is no power button, this requires stopping the car, turning off the ignition and opening the door.  Not particular easy to do on a long road trip or safely at an intersection.

The Bluetooth interface Kenwood selected/implemented on this unit is horrible.  On my daily commute to work I put my phone on the cup holder in the truck (Bluetooth mode already enabled as it is all the time) and start the ignition.  About the time I'm a mile from home (in a neighbor hood setting that is 25 mph) I notice the phone is still not synced to the head unit. By the next mile, it appears to be ready to use and is so I open the recent call history data to select a number and call home to ask my wife a question.  That works pretty

well.  After the conversation I hang up and drive some more.  I realize there is one more topic we needed to discuss and I open the recent call history again..  This time it's not there but there is a button to indicate a "download" request.  After trying that several times and never having it work I pick up the phone and navigate to my dial shortcuts and press the icon which is a picture of my house.

After having enough of this I took the vehicle back to Car Toys.  The initial response was to offer to update the firmware.  I indicated that had already been done.    Chris the installer suggested getting rid of the Kenwood and selecting this unit. After some time, they offered to swap the unit out for a Pioneer AVIC-X950PH.

 There was a small differential cost in this swap but well worth it:

• POST - Power on self test - approximately 8 seconds
• Bluetooth connect - 4-5 seconds after the above
• Audio output far more crisp and powerful

After getting the Kenwood unit installed, I replaced the 4 door speakers with some Kenwood 3 way speakers which sounded much better.  The Pioneer AVIC-X950PH really shows the range and capability of the new speakers.  Included with Pioneer I had them add the wiring so when I have time and resources I can add a sub-woofer without have to pull the dash.

The user interface for the Pioneer unit isn't quite as nice as the Kenwood.  It gets you to everything you need but isn't as visually appealing.  The equalizer control from the Pioneer is really nice.  There are several predefined profiles as well as two user defined profiles and they are easy to get to in any of the audio modes.  

The conclusion to this discussion is that the vehicle now has an audio/video system that works exceedingly well.  Car Toys did the right thing and sent us away happy with our 5th system installed and working well.

UPDATE: 2013-09-03 - This system is absolutely amazing.  I've made a few calls to Pioneer support to get questions answered and they have been awesome.  Since I've had more time to become familiar with this unit I can report that the Ipod search/interface is fantastic.