Reverse Shoulder Replacement My Shoulders?!!?

[Me2]

Even before my hips hurt, my shoulders and neck caused problems. But, alas, hips took priority ages ago, got them fixed with beautiful star dust, titanium, and ceramic new parts, and thought I was great. Then, the back persisted in its scream for attention. Got some of it repaired and working on the rest . . . and then back in November, I was lolling along determined to get on with life when my left shoulder started to ache and sharp pains quite a bit, again. I had one year follow up on hips, mentioned it to my hip orthopedic doctor, along with back and side of hip issues. But no time to discuss so, I decided to make an appointment to just have the shoulders checked since, after all, I have great insurance with all deductibles paid....... Then, three days before appointment, I was putting car seats in my van to take my child care kiddos on a field trip and OUCH!!!! Incredibly painful, no ability to move, neck pain . . .

So, when I went to my appointment, I switched asked for the right shoulder to be priority as it hurt more. Doc treated it with injection which helped tremendously with pain and 3-4 weeks of physical therapy. After three weeks of incredibly painful therapy which was a exacerbated my long dormant neck issues, I called back to ask for the MRI the doctor had said would be the next step to be scheduled. I just received the written report of the MRI for the right shoulder and this is what it says :

"There is extensive extravasation of contrast in the subacromial and subdeltoid bursa through a gaping defect in the rotator cuff. There is extensive tearing of the supraspinatus and infraspinatus tendons with some retraction of the supraspinatus muscle and extensive tracking of contrast along the fibers of the supraspinatus tendon and muscle as well as along the infraspinatus tendon. There is mild fatty infiltration of the supraspinatus muscle and significant elevation of the humeral head. There is also significant contrast tracking through the peripheral half of the subscapularis tendon with findings consistent with a longitudinal tear of the scapularis tendon. The fibers are intact peripherally. There is absence of the biceps tendon within the bicipital groove consistent with a full thickness tear of the biceps tendon as well.

Benign cystic change of the humeral head is seen near the greater tuberosity region. There is significant abnormal signal involving the superior aspect of the glenoid labrum. Contrast does not appear to extend into this area, and the findings are consistent with extensive mucoid degeneration of the glenoid labrum without slap tear. Subchondral cyst formation along the glenoid is also seen consistent with osteoarthritis. The anterior and posterior glenoid labra are intact without evident of labral tear.

Impression:

1. 
   
2. Full thickness tear of the rotator cuff as described above with involvement of the supraspinatus tendon, infraspinatus tendon and subscapularis tendon.
   
3. Full thickness tear of the biceps tendon with an empty becipital groove.
   
4. Extensive mucoid degeneration of the superior glenoid labrum.
   
5. Degenerative changes of the glenohumeral joint, and there are also bulky degenerative changes of the acromioclavicular joint.

Anyone able to give me some insight of what this all means? I have an appointment on Tuesday and have no idea what the doctor might say, and I'm hopeful that all of the above is just a way of saying "toughen' up kid, a little more exercise and you'll be just fine!"

 

[copsham]

Hi @Me2
I understand not a word! Just want to say life is not fair. My body feels tired on your behalf. You braved the hips got through that and now a year later have this (what ever this is). Hope some one who understands comes a long soon to "interpret" All the best.

 

[Jaycey]

Wow @Me2 you have certainly had a time of it! The person who needs to interpret your MRI is of course @Josephine . However she is having technical problems getting on to the forum so there may be a slight delay. Hang in there!

 

[Me2]

@beachgal Where oh where are you with that frying pan? I'll probably be a needing it . . . I happened to notice on your post that your husband had a recent shoulder surgery? If you have a moment in this pre-holiday rush, perhaps you can give me a little encouragement.

Actually, I am quite crushed. I was supposed to have appointment today with my hip surgeon. I had mentioned concern about my shoulders when I went for my one year follow up and had asked if he were able to evaluate . . . I scheduled another appointment and just happened to have a horrible what I call acute shoulders issue. I couldn't move my arms up beyond waist, carrying my hands were just too heavy! He took xrays and didn't see any much beyond "mild arthritic changes" and small hook on AC joint. Suggested a month of PT followed by MRI if no significant improvement. After three weeks of extremely painful PT and some improvement from NO range of motion to ok with still a good bit of pain , I called and asked to schedule MRIs with the above results and the left shoulder not so bad, just gaping 1.7 cm hole in some tendon or other and partially detached bicep and a couple of other tears.

I was SUPPOSE to have appointment today with that doctor only to have his nasty MA (haven't like her from the start but never saw her much) call and say not to come in as my doctor doesn't really do shoulders, and he was referring me to another doctor in practice --- WELL would have been nice if he'd of told me a month ago to see the other doctor to follow up so I could have made the appointment. So, lots of tears and dismay for Sheryl today as I am still very much without any idea of whether I can be fixed or not, whether I want to or whether I will be able to get over all the fears and panic and

But, I did rather than blindly go back to same practice to same hospital, I did make strides in some doctor shopping . .. I have appointments with one doctor on Friday, two on Monday and a four on January 4.

 

[Me2]

So, I had my appointment with the shoulder doctor with the same orthopedic practice of my hip surgeon. He was wonderful in explaining every detail of my MRI--actually spent over an hour. Apparently, lots of sharp edges and a narrow AC joint space has been tearing up the rotator cuff. His thoughts are to do left shoulder first as its not as bad and can almost definitely fixed. He'll clean up the joint to prevent further damage and repair the torn/detached bicep muscle. He wants to do this with "open" surgery rather than arthroscopic so he can see everything and be sure to repair all that is repairable. After 3-4 weeks in a sling, then slowly starting to use it, we can see how soon I want to think about the right shoulder. With the right shoulder, he can "clean it up" to maybe prevent further damage and maybe relieve some of the pain and maybe regain some strength, but . . . . he gave some ideas on possible solutions but I was just a wee bit overwhelmed.

So, he is going to talk to the anesthesiologist who helped me be awake and work though my anesthesia issues, but he seemed willing to work with me on staying awake.

Well, still hoping someone can share some shoulder stories with me. Right now I'm scheduled for January 4 -- his first surgery of 2016. But I still plan to keep my appointments on Monday with the other two doctors.

 

[Me2]

@susanne and @Brog13 I see you both had shoulder replacements . . . the doctor I saw on Friday mentioned perhaps possibility of right shoulder replacement as a solution but mentioned the "only lasting 15 years thing that I heard when my hips first diagnosed. As above, my left shoulder is tentatively scheduled for repair work on January 4 but I am so needing more information.

Susanne, I looked through most of your thread and you mentioned your rotator cuff was left intact. It seems my right is quite torn up because of a narrow AC joint with sharp edges. You seem to say your shoulder recoveries were easier than hip or knee --- my hip recoveries were fairly amazingly easy --- but I am hearing so much that shoulder recovery is horrid! What is your secret?

 

[Hoppy Nanny]

Oh @Me2
So sorry to hear of your ongoing problems....it seems this dratted arthritis sets in our bodies it takes over! I do hope you can get some answers. I was in hospital with a woman who had her shoulders done......she has got on very well as we keep in touch....not had any problems since ...
I've had some problems with my neck (cervical) and had X-ray which shows severe wear & tear & a bulging disc....had terrible burning pains in neck & shoulders....also strange feelings in face & arms. My doctor gave me muscle relaxants which is helping at the moment......got to go back for MRI in 2016.

I do hope you get all this sorted as soon as possible .......being pain free seems a bit of a myth, doesn't it!
Hope you have a lovely Christmas, despite all this...take care..Chrissie xx



Sent from my iPad using BoneSmart Forum

 

[djklaugh]

@Me2 Having been there, done that re: shoulder replacement I empathize with you! Sure hope the surgeon is able to get you some relief from your pain! As for the "only lasting 15 years" bit ..... I doubt that is true any longer as the component parts are very similar to hip and knee implants (and made by the same companies) so I would venture to guess that they will last a really long time. Though of course there could be other aspects of a shoulder that could require further attention down the road. Muscles, tendons, rotator cuffs - all those can get further injuries. My shoulder was a mess according to surgeon - calcium deposits, bone spurs, thin shoulder bone requiring a bone transplant, bone-on-bone arthritis, and small tear in rotator cuff. He was able to clean up most of the problems though one calcium deposit was too close to a major nerve so he did not remove that. (LOL don't know why but my spell check does not recognize the word "rotator" - keeps telling me it's wrong)

One thing to keep in mind (don't know if your surgeon mentioned it) - my shoulder OS gave me a permanent restriction of not lifting anything weighing more than 25lbs. Not a big problem for me - but if I ever have to get the other shoulder replaced it could become an issue.

My OS was very cautious in his predictions about outcome - said he could not guarantee that I'd get full range of motion back. Said my HMO only did shoulder replacement when there was severe pain and dysfunction. However I am very pleased with my outcome --- as is the surgeon! I got back most of my ROM and what I didn't get back (reaching behind my back primarily) is not a big problem.

PT after shoulder replacement is intense and from what I experienced very needed and helpful. I went to PT for about 6 months (every other week) - and PT ladies were great!

In the mean time - hope you have a very happy and fun holiday season!

 

[susanne]

@me2just saw your post. Both my shoulder replacements went great
My rotator cuff is still in tact both of my shoulders. I was bone on bone and teaching pre schoolers (special Ed) my pain was horrid
I don't lift anything heavy anymore
I did go to pt for a month and a half
Dr said I didn't need it anymore
So all in all these replacements were not difficult even the recovery 2 days in hospital home with a sling
Now it's fine. No problems. Unlike my hip experience. Good luck
Susanne


Sent from my iPhone using BoneSmart®

 

[Me2]

Susanne and Deb: Thank you for your reassuring posts.

I am quickly becoming very disenchanted with the OS that I first saw for my shoulders. I am heartbroken because with all my medical phobia issues that I conquered to have my hip and back surgery done, I felt so comfortable and secure in getting the best medical treatment at this private physician owned hospital. The surgeon actually called me last evening and not only destroyed my future hopes of having shoulders and me taken care of there, but also has really messed up my head with the surgeries and other medical treatment I had done at Advanced Surgical Hospital in the past. So, Sheryl is spending Christmas even trying desperately to ward off the craziness of the PTSD that has been so carefully contained and put away since first and second hip surgeries. I am having monumental problems with getting it put back away.

Although Dr. Christianson was very through in explaining to me the results of my MRI, I'm not all that crazy about his solutions. My left shoulder has just one major tear on the bicep (possibly totally detached long head) and two of the three surgeons I saw so far said fix that first. Two said clean up joint in the process, one open surgery and two said easy enough arthroscopically. One of the docs said not to even bother with fixing left shoulder unless I really felt necessary and painful (YES, duh, both hurt incredibly). Two said doubtful to reattach right bicep muscle.

The second doctor, Dr. Shaka Walker, who was Air Force for 14 years and three tours of in Afghanistan and time heading orthopedics in Germany, seemed to really get my PTSD and absolute need to be awake for surgery, seems also to have best solutions. He too said left shoulder first tho I'm not certain he understands how limited the use of my right arm has become - virtually useless much of the time unless helped with the left. He said left shoulder would be simple for him surgery and recovery should be well under way in six weeks. Then, he would be willing to address right shoulder which seems to need incredible amount of repair. He very much is on board with attempting to reattach the detached and pulled away bicep muscle although he concedes that I may need some donar tissue patched in. He acknowledged that he has only done this twice but stated that procedure is extremely new but successful and that he very much doubts that anyone else in Pittsburgh has had done even two. But, he did say that he felt he could also do this surgery arthroscopically. The biggest negative I have with Dr. Walker is that he does not feel as necessary to "clean up" the joint that Dr. Christian emphasized as the most important part of what he was planning and that I see regularly as important on most of the online research I am doing. He said, I think, that he would certainly minimally clean up as necessary but it would be minimal since his experience is that "cleaning up" causes more issues that resolves. I cannot find anything online to reassure me there. However, my physical therapist who I respect greatly, said absolutely find a doctor who will at least attempt to reattach the bicep muscles in both arms.

So merry Christmas to all my BoneSmart friends and may you have a pain-free, stress-free, holiday and new year!

 

[beachgal]

@Me2, sorry I've been MIA! I've had my hands full with problems at work, handling our dog alone, and keeping a vigilant eye on hubby as he rehabs his shoulder. Anyway, I'm back.

Your explanation from your MRI sounds similar to David's. His was not as detailed but the words sound familiar to me. He had his left shoulder done arthroscopic and has healed nicely. The PT has been a chore but one that we know is necessary so he has been faithful in its execution. At seven weeks, he can raise his arm over his head, is doing some strength exercises now with a 2-lb weight and is generally encouraged. His impatience comes in spurts when he realizes how much further he had to go but I try to keep him focused on each day and not down the road. Skillet doesn't work on him.

I'm not sure how much weight he'll be able to handle but I'm hopeful that he can function within the perimeters allowable once we get there. At 68, some of it is a moot point. He doesn't do yard work anymore for lack of time so really his main source of weight-letting is just the gym workouts and handling luggage when we travel which was the culprit causing this tear.
What else can I offer up? I'll keep checking in for your responses.

Love to you and Merry Christmas!




Sent from my iPhone using BoneSmart Forum

 

[Me2]

Thank you --- at this point just trying to hold it together and piecing information together -- mostly just trying to hold myself together. Thank you for replying so quickly.

This shoulder thing really has taken me by surprise --- Until the last month, my shoulder ached mildly, with a few acute incidences, and I so assumed that they would just confirm my earlier attempts over the years to find out why the acute incidences and ache. I was so assuming (hoping?) the hypochondriac.

Merry Christmas.

I remember your post ages ago about revisiting your recovery place and feeling the warm fuzzies just looking at your recliner. I feel like my conversation with surgeon last evening just took my "recovery" place, my healing place, my safe place away. I just have to find it to be able to move forward.

 

[beachgal]

And you will! The OS told David that his shoulders are both damaged from years of use (and abuse!) and the snatching our luggage off the carousel at the airport just snapped the tendon that was already weak. From years of it rubbing across bone spurs, it had thinned so it made sense that his surgery was caused by both normal use and a trauma. He had pain in that left shoulder for the past few years but was convinced that he had used dumbbells too heavy in the gym and just needed to rest it. He was shocked when the OS told him that he needed surgery.

We all remember the shock of hearing that our hip joint needed replacing and once we got used to the idea, we moved forward with making it a successful adventure. You've certainly had more than your share of junk but you play the cards you're dealt and I know in my heart that you'll conquer this with grace.

I'm interested to hear the OS advice in January.


Sent from my iPhone using BoneSmart Forum

 

[susanne]

@Me2. Anyway you can come to Nyc for surgery. My surgeon is the chief ortho at hospital for joint disease?
Let me know and ill pm u info
Try and have a happy holiday
Susanne


Sent from my iPhone using BoneSmart®

 

[copsham]

Hello @Me2 Its early Christmas morning and I am sitting peacefully before the deluge of people begings. Just browsing and saw your posts. I have nothing to offer in practical terms but just want to say hello. What a shock the whole process must be to you. Those decisions on a see saw with the phobia thing - so horrible. I hope Christmas day gives you a bit of pleasure amongst the difficulties. Take care.

 

[Grannyhippy]

@Me2 Hi, I had a rotator cuff repair just over four years ago and it was successfully done arthroscopically. I had a complete tear and retraction of the long head of the biceps tendon. another large full thickness tear was seen in regards to the anterior portion of the supraspinatus tendon on a background of tendonitis. There was a moderate subacromial/subdeltoid and significant subcoracoid bursitis. Severe AC joint degeneraion was seen.

My MRI report stated that I had a type 2 acromion but when I spoke to the physiotherapist before leaving the day surgery he told me I had a type 3 acromion which means it is hooked over more.

The OS reattached the tendon, cleaned everything up inside and shaved out under the acromion because there was not much room left due to severe arthritis. I had four small cuts about 1/4 inch long (.05 cm). Two in front of the shoulder, one on the side at the top and one at the back of the shoulder. They all healed up beautifully and the only one to leave a small indented scar was the one on the side of the shoulder. I had my arm in a sling for a month and did five months of physiotherapy. I set everything up at home imitating the set up the physiotherapist had. I used a broom handle, a pulley on a rope attached to the patio rafters (to pull my bad arm up and down with my good arm). I bought small hand weights starting with the smallest and followed the exercises the physiotherapist gave me. I also used Theraband elastics. After five months of physio I decided to stop going as I had pretty much full range of motion and at that stage I did not see the qualified physiotherapist, just his students and half the time I was left unattended to do my exercise routine. I figured it was then a waste of money as I was doing everything at home and knew the routine so even though he still wanted me to attend physio I stopped it. I also know a lady who had the same surgery and only went to a few physio sessions as she could not afford many more. I explained to her the exercises I did and she made a full recovery. Her surgery was also arthroscopically done. I skilled surgeon should be able to do the job well. I had a professor do my surgery. I believe the recovery is faster after arthroscopic surgery as the surgeon does not have to cut muscles to access the tendon. Look on the Internet because I watched an entire surgery on line before I had mine done. The surgery took one and a half hours.

I am still careful with that arm but on the whole everything is pretty good. My other shoulder has been very sore since my hip surgery on 25th June, 2015 because of extended use two crutches, then one crutch and now a cane. I still cannot walk properly and have just started hydrotherapy. The physiotherapist said it will be a long recovery from my hip surgery because there are so many things wrong.

Four months after my shoulder surgery my daughter's friend slipped on the board walk when they were hiking in the snow down in Tasmania. She is a nurse and they went on a camping trip in between her leaving her old nursing job to start in obstetrics. She cracked the head of the humerus and partially dislocated her shoulder. She did not get surgery on it until a couple of days later. When she started her new job she could not do the lifting (I told her she would not be able to do so, so soon after her surgery). She had to leave her new job and now works a few days a week in a medical centre as one of their nurses. She has two young boys so it suits her to do that anyway.

 

[Me2]

Thank you all for taking time to reassure me. I'm still struggling -- this emotional roller coaster!

I have two appointments tomorrow -- one with Dr. Walker, young, confident that he can fix me including bicep and little to no sedation but does not believe in much "clean up". If he still is comfortable with the same plan, I will probably schedule surgery with him on 15 January. If not, I have two other surgeons appointments scheduled. I did just cancel surgery scheduled with my wonderful private hospital but shoulder surgeon. So not sure what I'm going to do.

--@Grannyhippy Thank you so very very much for your detailed and extremely reassuring message. I so needed that. Again, BoneSmart superheros to the rescue! You say you did successfully have long head of bicep reattached? That is one of my big problems: 2 of the 3 surgeons so far said not worth even trying to reattach. I rather think if I'm going to go through surgeries I at least one it attempted?

If any shoulder people have suggestions on clothes for recovery? With both shoulders so bad and almost all of my winter clothes over my head, I need to get some stuff. My son who was a teacher and gained quite a bit of weight is bringing me is dress shirts but . . . what else works? I will have to be working again through recovery and need somewhat professional look.

 

[Grannyhippy]

I hope you have someone living at home to help with personal things such as showering and dressing. You can buy dressing sticks and other aids. Always keep your operated arm supported until told otherwise. I would rest my arm on the vanity, take off my sling and put on one of those long elastic bandages tied in a loop when I showered. I could wash most of myself with one hand. My husband helped dry my back. I have a shower hose in my shower and it makes it easier to aim the water up under the armpit etc. so that I did not have to lift my arm up. I was advised by the physiotherapist to use a non slip shower mat (I already had one) because he said that if I was to slip in the shower I would not be able to save myself with one arm in a sling.

The hardest part is sleeping with a cushion or small pillow supporting your arm while it is in the sling. You also cannot lie on the operated side until giving permission by your surgeon. I tried a small cushion but found that a u-shaped neck pillow placed over my shoulder from front to back (not around my neck) offered enough support.

It has been suggested that some people prefer to sleep upright in a recliner or propped up on pillows to keep their operated arm in the correct position. I tried the recliner when I first came home from the day surgery but gave up at 2:00 am when I tried to turn on my good side and tipped the chair up and slid out of it. I just got up and went to bed with a cushion under my arm. Chairs are not comfortable to sleep in.

Where elastic waisted pants or skirts and loose fitting buttoned blouses and pyjamas. Your arm and sling will be inside the garment so before you put it on tuck the sleeve inside so that it does not dangle in your way.

The physiotherapist I had for my shoulder said that most people don't realize how much they rely on having two arms until they have "one of their wings clipped". He was so right. You have to find a different way to do things such as open jars and bottles unless you have someone to do it for you.

 

[beachgal]

Clothes for shoulder surgery-my specialty! For David, I went to Walmart and bought one flannel shirt three sizes too large and two flannel shirts just one size too large. He rolled up the cuff on his op arm. Along with cotton knit lounge pants (also from Walmart), he stayed comfy and warm. He needed help with everything so for the first eight days, we shared the sofa at night so I could be available. We have a large ottoman that I pushed up next to sofa so his side was really like a recliner but the arm of the sofa perfectly supported the cushion on his sling. It worked fine. He transitioned to our bed over the end of the second week with all my hip pillows plumped up all around him. He really needed them more under his main head pillow. The sling became his best friend. It really won't let you mess up too much in bed.

Hope this helps. He's still whining but doing amazingly well. Must be his nurse.


Sent from my iPhone using BoneSmart Forum

 

[Jamie]

Think I will be facing some shoulder surgery in the next month too. Will know more after appointment with surgeon on January 4th. Appreciate all the tips provided here! I'm actually considering going to rehab for a week or so after surgery.