מציאות מדומה – מאמר ששי בסדרת "ניתוחים על שולחן הניתוחים"
לא משנה כמה שערות לבנות כבר יש לך. אפשר בעז"ה לפתור בעיות בכתף

מציאות מדומה – מאמר ששי בסדרת "ניתוחים על שולחן הניתוחים"

סיפורו של אלי – כדורסלן חובב

העובדות מאחורי הסיפור מודגשות

אלי הוא איש הייטק מצליח ואיש משפחה למופת. כבר עשר שנים שהוא נפגש בכל מוצאי שבת עם חברים קבועים למשחק כדורסל סוער. מבחינתו זו הדרך הבטוחה להתחיל את השבוע ברגל ימין.

במוצ"ש האחרון  אלי עשה תנועה חדה והרגיש כאב עז בכתפו הימנית. אבל לא אדם כמו אלי יעצור באמצע המשחק. הוא המשיך לשחק למרות הכאב, והקבוצה שלו נצחה ב"ה. אלי חזר הביתה מאושר אבל כאוב. הוא היה בטוח שבבוקר הוא יהיה כמו חדש.

אלי נרדם די בקלות, אבל כעבור כשעתיים התעורר עם כאב חזק בכתף שלא נתן לו לחזור לישון. הוא נזכר שיש בארון תרופות איזו משחה שפעם עזרה לו עם נקע בקרסול. גם הפעם המשחה לא אכזבה ואלי נרדם עד הבוקר.

בבוקר היד כבר בקושי זזה. אלי בקושי רב הצליח להתלבש ואשתו הסיעה אותו לקופת חולים. הרופא המליץ על מנוחה של שבועיים ולאחריה בדיקת אולטרסאונד.  עברו על אלי שבועיים קשים שבהם נזקק לעזרה בפעולות הפשוטות ביותר, והוא ציפה בכליון עינים לבדיקה, כדי סוף סוף לגלות מה יש לו בכתף

  • בדיקת אולטרסאונד לכתף היא בדיקה לא אמינה. עשר בדיקות רצופות על אותה כתף, יתנו כנראה עשר תוצאות שונות…
  • קרע בגיד הכתף או בלאברום הוא ממצא שכיח ביותר באוכלוסייה בריאה ללא כאבים, וניתן לתפקד עם הקרעים הללו ללא שום הפרעה

הבדיקה גילתה קרע באחד מהגידים של השרוול המסובב באורך של 8 מ"מ, וכן קרע בלאברום (תופעה המכונה slap lesion). אלי הופנה לניתוח.

  • ניתוחי כתף לקרעים בגידים או בלאברום מצויים מאוד
  • מחקרים מראים שאין להם עדיפות על טיפול שמרני בטווח הקצר והארוך
  • הם אינם עדיפים על ניתוחי דמה (פלסבו) בהם מבוצעת פרוצדורה ניתוחית רק ללא הניתוח
  • במקרים רבים ישנם כאבים עזים לאחר ניתוחים אלה המצריכים נטילת אופיאדים
  • לגודל הקרע אין משמעות בכל הנוגע לתפקוד הכתף
  • הקרעים בכתף נוטים לגדול עם הזמן באופן טבעי, וגם לעובדה זו אין משמעות בכל הקשור לכאב או לתפקוד

נחזור לאלי.

אלי למד היטב את הנושא, והחליט שהוא דוחה את הניתוח. ניתוח תמיד אפשר לעשות.

שיקום שמרני – לא.

אלי קיבל הדרכה לתרגול יומיומי, ואט אט הרגיש שהתנועה בכתף משתפרת וכך גם הבטחון העצמי שלו. לאחר מספר חודשים הכתף היתה כמו חדשה. והקרעים? קרעים.

מה יקרה לסביבון שבור כאשר ננסה לסובב אותו? תסכול…

וכאשר ננסה להרים את הכתף שלנו עם קרע בשרוול המסובב? היא תתרפא. פלא !

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