For Jacquelyn Plick, electing to have same-day surgery was a simple solution to a more difficult problem. Nearly a year ago, the nurse practitioner tore her rotator cuff — a group of muscles that hold the arm in the shoulder socket. Since then, Jacquelyn has been living with constant pain and stiffness.
“Everyday tasks were more difficult than they needed to be, and there was a limit to my range of motion that I just didn’t want to deal with anymore,” she says. “I injured my dominant right shoulder, so I found myself doing more with my left side to compensate.”
Nearly two million people tear their rotator cuff each year. Like many of them, Jacquelyn tried months of physical therapy before turning to a surgical solution. After extensive research, she decided to meet with Matthew Garberina, MD, an orthopedic surgeon and department chair of orthopedic surgery, who specializes in shoulder and elbow reconstruction at Summit Health. He suggested Jacquelyn have a procedure called an arthroscopic patch augmentation that could help repair and strengthen the damaged muscles.
Many orthopedic procedures like the one Jacquelyn needed can be done at ambulatory or same-day surgery centers on an outpatient basis. She decided to have the operation at one of Summit Health’s Ambulatory Surgical Centers (ASCs), located within comprehensive care settings in Berkeley Heights and Florham Park, New Jersey. ASCs offer convenient, comprehensive, and multispecialty care for patients who do not need to stay overnight in the hospital.
The ASCs really offer the best of all worlds, explains Michael Bilenker, DO, anesthesiologist and medical director at the Berkeley Heights location. “We provide high-quality care in an outpatient setting that is pleasant, more efficient, and at a lower cost to both patients and insurance companies when compared to a hospital setting. There is also less risk that patients are exposed to communicable diseases, like COVID-19, in the ASC environment,” he says.
Nearly 25,000 procedures, across a variety of different specialties, are performed at the ASCs each year including:
- Breast care — biopsy and reconstruction
- Gastroenterology — colonoscopy and endoscopy
- General surgery — gallbladder removal and hernia repair
- Ear, nose, and throat — ear tube placement and sinus reconstruction
- Orthopedics — knee arthroscopy, shoulder, and hand procedures, as well as foot and ankle repairs
- Ophthalmology — cataract removal
- Plastic surgery — face and neck lift
- Podiatry — foot procedures
- Urology — kidney stones and prostate biopsy
Jacquelyn felt confident in both the surgeon and the facility. A few years earlier, she had come in for a colonoscopy. “I knew the ASC was well-equipped, safe, and that I was going to receive exceptional care at Summit Health,” she recalls. “I also felt extremely comfortable having surgery with Dr. Garberina whose training and experience is second to none.”
Patients at the ASC benefit from being part of a multispecialty care facility. If a surgical patient ever needs imaging, labs, or to consult with a specialist like a cardiologist, these resources are available right away.
“Same-day surgery enables us to take care of the orthopedic problem while allowing patients to recover in the comfort of their own home with minimal to no pain,” explains Dr. Garberina.
The day of surgery
Jacquelyn had a combination of a rotator cuff tear and what is called a frozen shoulder. This was causing debilitating pain and stiffness in her shoulder. With limited arthroscopic incisions, Dr. Garberina says, they were able to put a camera inside her shoulder and confirm the diagnosis. Then he was able to release the inflamed tissue that was causing stiffness while also repairing the torn portion of Jacquelyn’s rotator cuff.
“This is accomplished in less than an hour,” says Dr. Garberina, “and with the long-acting preoperative regional block that our anesthesiologists have perfected, the patients can go home without experiencing significant postoperative pain.”
Jacquelyn says the procedure went extremely smoothly. She was scheduled to have surgery at 7:00 a.m. and was home resting three hours later.
“Dr. Garberina was both personable and knowledgeable. He came in and spoke with me before the procedure to answer any questions that I had. After the surgery, he went to talk to my husband as well, which I really appreciated,” she describes.
Patients usually feel groggy after waking up from anesthesia. As a result, Dr. Garberina makes a personalized video with postoperative instructions and exercises that they can watch as needed when they return home.
“I was really grateful to have that reference, and the personal recording of Dr. Garberina was a nice touch,” notes Jacquelyn. “The day of surgery can be overwhelming so it’s helpful to be able to look back and have answers to all your questions like: Which exercises should I do? When do I take the dressing off?”
The goal of same-day surgery is to feel better faster. The anesthesiology team at the ASC focuses on preventing side effects that make patients miserable after surgery, such as nausea and pain. To reduce these side effects, they use non-opioid medications and anti-nausea patches.
“Our protocols help prevent postoperative nausea and vomiting. This helps reduce the length of the patient’s stay and improve recovery,” says Dr. Bilenker.
“The goal of any surgery starts with preventing the patient from getting any worse,” adds Dr. Garberina. “Our second goal is to get them back to doing all the important activities of daily living like sleep, self-care, and work. As they recover, we stretch these goals to get them back to whatever sports and leisure activities they hope to pursue.”
Jacquelyn is still in the first month of her recovery. But she is already feeling better, has been experiencing very little pain, and is looking forward to regaining full range of motion in her shoulder. She even plans to pick up golf with her friends in the near future.