Custom Publication of the Bangor Daily News

Hand and shoulder patients benefit from MCMH’s pair of sub-specialists

Posted May 10, 2012, at 3:51 p.m.
Gerald Rosenberg (left) and Craige Williamson in the lobby of Maine Coast Hand & Shoulder. The doctors are sub-specialists in a narrow field, but managed to connect in Ellsworth at Maine Coast Memorial Hospital, and have been serving Mainers from across Eastern and Northern Maine who might otherwise have gone to Portland or Boston for specialized hand and shoulder treatments.
David M. Fitzpatrick
Gerald Rosenberg (left) and Craige Williamson in the lobby of Maine Coast Hand & Shoulder. The doctors are sub-specialists in a narrow field, but managed to connect in Ellsworth at Maine Coast Memorial Hospital, and have been serving Mainers from across Eastern and Northern Maine who might otherwise have gone to Portland or Boston for specialized hand and shoulder treatments. Buy Photo

What are the odds of two orthopedic surgeons who are sub-specialists in hand and shoulder — a sub-specialty not common around here — finding themselves as partners in a community hospital on the Maine coast? Apparently, 100 percent.

After a meeting born of a suggestion on a hiking trail, Dr. S. Craige Williamson and Dr. Gerald M. Rosenberg’s connection has resulted in what may be the most comprehensive hand/shoulder practice in all of Eastern Maine. The pair operate out of Maine Coast Memorial Hospital at Maine Coast Hand & Shoulder, where they’ve been bringing relief to patients suffering from hand and shoulder pain — to the tune of over 500 surgeries a year, and countless non-surgical solutions.

MCMH Marketing and Public Relations Director Jane Sanderson said Williamson and Rosenberg are incredible assets not only to the hospital but the community at large.

“The people in this area have benefited so much from having this team,” Sanderson said. “We’re just very lucky to have them. The news of their expertise has spread throughout the state with referrals coming from all areas in Maine.”

“For upper extremities, Craige and I can help people with most of whatever their needs are,” said Rosenberg, with no need for patients to travel to Portland or Boston. “The capabilities that we have… are fairly unique for a small hospital.”

“The amount of expertise that’s here for upper extremity is amazing,” Williamson agreed.

Meeting of the Minds

How these doctors met up is a study in happenstance.

Williamson grew up in Virginia, but when he attended Dartmouth College, he fell in love with the Northeast. After orthopedic training in New York and Boston, he came to work for MCMH in 1995. He’s been there since, minus a brief stint with Blue Hill Memorial Hospital, although even then he continued on with MCMH.

Rosenberg grew up in northeast Ohio, attending college at Miami University and Ohio State. His sports-and-athletic nature focused him on orthopedics, and after his residency he did an upper-extremity surgical fellowship in New York, specializing in the shoulder, elbow, and hand.

He and his wife, who he had met when he was 15, returned to Columbus to raise a family, and he practiced there for 26 years. But every summer they vacationed in Southwest Harbor, always planning to retire there. When it seemed likely he’d work longer than planned, they considered relocating to Maine, but he knew he’d have to work in Bangor with a sub-specialty like his.

Then, three years ago, while hiking in Acadia, he met a pathologist hiking on the trail. After chatting, the pathologist suggested he check out MCMH.

“He said, ‘You should call Craige Williamson,’” Rosenberg recalled.

So Rosenberg did, out of the blue. The two hit it off immediately.

“I always thought it would be great to have a partner,” Williamson said. “One problem with doing subspecialty stuff is that you don’t have someone else to talk about cases with.”

The odds of two doctors who both sub-specialize in the same field connecting at a small community hospital in Maine are extraordinary, but the result has been an astounding benefit to MCMH and to people suffering from pain they once thought they had to endure.

Diagnosis

Many people simply accept shoulder and hand problems, unaware that they’re treatable. We all hear about hips and knees; they outnumber treated hand and shoulder cases 5 to 1. This is mostly because we feel hip and knee problems more; after all, we don’t walk on our hands.

Typical shoulder problems include fractures, rotator-cuff tears, and arthritis. With the hand, cut tendons and nerves, fractures, small-joint arthritis, and carpal-tunnel problems are very common. All of these can be treated, but in many cases primary-care physicians aren’t even aware of many of the treatments. Patients end up living with their pain.

For example, a torn rotator cuff is fairly common, but in many cases people with painful shoulders either don’t bother investigating them or assume nothing can be done about it. Tendonitis can be debilitating, but people frequently just grit their teeth and live with it. The problems tend to go from bad to worse.

Determining the patient’s needs is easy. First, the doctor takes a detailed history to learn all he can about the injury and the patient’s pain. Then come physical tests to gauge range of motion, strength, sensation, and swelling.

“As I say all the time, test drive the shoulder and see if it shows you what it can and can’t do,” Williamson said.

If uncertainty remains, X-rays and MRI scans may reveal more. In extreme cases, arthroscopy might be in order — exploring the region with a tiny camera to see what everything else has missed.

Treatment

In many cases, curing the problem involves non-surgical techniques such as physical therapy, exercise, medicines, and cortisone injections.

“We… always start out with the least aggressive, least invasive, most gentle treatment first,” Rosenberg said. “If it doesn’t work, we sequentially increase our invasiveness, with surgery typically being the last resort.”

When it comes to surgery, arthroscopy often does the trick. Instead of just looking with a camera, the surgeon uses tiny surgical implements to repair rotator cuffs, fix dislocations, and remove spurs. Arthroscopy results in small incisions, minimal physical impact on the patient, and fast recovery times.

But when more drastic measures are needed, it may involve prosthetics, usually in the shoulder. And when it comes to implants, Rosenberg adds a unique bonus to the hospital. For 15 years, he’s consulted for Stryker, a shoulder-implant company. Its engineers work with specialist doctors in order to continually improve prosthetic models.

Stryker is one of a half-dozen shoulder-implant manufacturers worldwide The doctors stress that Rosenberg and the hospital get no financial reward or incentive from using Stryker’s products, and particular implants are carefully chosen based on the patient’s specific needs.

“It’s been a really fun part of my practice to develop stuff that we actually use,” Rosenberg said. “It’s a very fun addition to taking care of patients.”

In fact, Rosenberg installed the first of the most recent generation of Stryker’s shoulder implant in a patient at MCMH last July, seven months before its national release.

Two of a Kind

One thing the doctors make clear is that you won’t get an answering machine during business hours. That’s a view they share as a point of pride.

There’s a comfort factor with the two of them having been around the block and seen so much over the years. Williamson recalled that when he did general orthopedics, while he got experience in many things, it was easy to not see specific cases enough and be less than comfortable.

“That’s part of the reason I wanted to sub-specialize,” he said. “If you have a home turf where ‘Oh, I’ve seen this several times before, and I know how to deal with it now,’ it’s a lot easier and more comfortable, and I think you do a better job.”

To learn more, or to make an appointment to investigate your hand or shoulder pain, visit Maine Coast Hand & Shoulder at www.mainehospital.org or call (207) 664-5858.

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