Reverse Shoulder Replacement My Shoulders?!!?

[Me2]

So, my appointment with Dr. Walker (using names mostly to keep straight in my head who I am talking about) went quite well. :re-snowman: He confirmed everything I thought I heard from first appointment . . . though I did forget to ask about the clean up part that I was uncomfortable about his plan. He still seemed quite confident that he could fix me. I had another appointment with a Pittsburgh icon for the afternoon, but was quite overloaded with shoulders hurting so bad that I didn't want to drive across town and to get more information. I am disappointed to have cancelled that appointment to be sure what I want to do. BUT, I am somewhat comfortable that I did schedule for January 15 --- as important as him being certain he can fix me and arthroscopically he seems totally comfortable with me being awake. I was so relieved (ecstatic) to see a poster in his office (I have to post it from my phone) saying his practice is putting on a workshop on totally awake orthopedic surgery so . . . I have my date, getting comfortable with the idea -- or at least resigned to the idea --- now onto getting ready for recovery. :window:

I do have recliner that I've been using as it is much less painful than lying down (one of the most painful things). I am understanding that lying down is so painful because my rotator cuff is so torn in both shoulders as when I lay down the top of the humerus bone actually slips up and out of shoulder joint. The problem I am encountering is that now the chair tends to fall back so far that I have to painfully use arms to pull forward -- I won't be able to use surgical arm to help me -- so, working on solution for that?

Thinking too of shower issues.... I'm one of those have to have at least one shower a day....which I learned to get over a wee bit with back and hip surgeries . . . but I am kind of thinking no prohibition against baths this time?! Sounds like a perk to this recovery? Plus, I won't have to

Also, clothes-wise, I have my son's collection of dress shirts but realized I was envisioning wearing a jersey under for warmth -- well, I can't do that. Lots of ice therapy is prescribed for this surgery - in fact, I was already given ice support pack to use -- and am freezing in our balmy December Pittsburgh weather. January and February are cold. :snowman: I'll feel like a snowman! I am so used to wearing warm heavy-weight cozy sweaters. I am thinking I will need some heavy flannel shirts to stay warm. @beachgal you mentioned 3 sizes too big -- I was going to get big (figuring I can pass on to husband after and three sizes would be about right) but was thinking too bulky. I need to be warm especially with directions to be prepared to ice twenty minutes on twenty minutes off. I guess like you got a couple in each size? :snows:

A happy New Year to all!

 

[Me2]

I want to post picture of the poster in my new surgeon's office that has me soooo comforted....

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[KarriB]

While at Grove City outlets I saw comfy, warm sleep cardigans (eddie Bauer) that would perfect for you! Not sure if the outlets near you have an Eddie Bauer, but they're so soft and warm, but don't go over year head.

 

[Me2]

Only 13 sleeps . . . says the scary feeling deep in the pit of my belly. Only 13 more times to get out of bed without a sling and care of not using surgical arm (just care not to use either arm to cause pain) Funny, I've just learned last two or three nights that if I keep my arms over my head like I've often slept I actually sleep better -- ha, I can't even get my arms overhead when standing. I've read somewhere that shoulders hurt so incredibly bad when laying down because with damaged rotator cuffs there is nothing to hold the joint together when laying down so that the head of the humerus bone just slips out causing pain. So, my first tidbit for others with painful shoulders.

So, besides the scary sinking pit, I've started the march to getting ready . . . I ordered a couple of men's flannel shirts to recover in. The sleep cardigans sound wonderfully comfortable but since I have to be back working immediately after surgery - at least up and supervising in my child care program - I have to figure out a way to dress "professionally" and everything I have is over-the-head sweater. I'm hoping I will still be able to wear the ones with a big neck - I've figured out a way to get them on and keep arms down - but ordering the shirts to have warm clothes that are button down. I'm hoping to wear with leggings that will be easy up and down and comfy. TMI warning: Planning to go no undies, no bra or sports bra that I can pull up from feet and doubles as a camisole.

Also starting to gather a blanket and something to wear for surgery -- two of my "triggers" that the hospital accommodated last time.

OH, my, time to stick my head back in the sand, fear is taking over.

 

[Me2]

@Josephine one of my big concerns -- my surgeon assures me that he can do this arthroscopically -- when doctors do arthroscopic surgery, are they able to see if things need fixed that are not necessarily on the MRI, changes/more damage occurring? The original surgeon that I saw said he would prefer to do open so that he could see everything that needed fixed since there was so much damage showing on the MRI.

I am also concerned that the surgeon doing the surgery feels new research says to not be so vigorous in cleaning up the bones since it usually causes more problem than it helps?

 

[Josephine]

To be perfectly honest, my present surgeon, who does an inordinate number of shoulders, does nearly all his work arthroscopically. The most common procedures are decompression of the rotator cuff impingement and repair of rotator cuff tears as a result. These are perfectly easily dealt with via a scope so don't accept any open surgery.

However, if the RC injury is as a result of violent impact injury such as rugby or a road accident or to do a shoulder joint replacement, that's a different story.

And yes, any damage associated to RC impingement should be easily seen and dealt with via scope though I'm not quite sure what he means by "so much damage".

I am also concerned that the surgeon doing the surgery feels new research says to not be so vigorous in cleaning up the bones since it usually causes more problem than it helps?

That's more the case in hips and knees (unless you have links to studies I haven't yet seen). But RC impingement surgery - more properly known as an acromioplasty - is not intrusive in the joint. It's in the space above the joint and the targeted bone is the underside of the acromio-clavicular joint (see item 1 in first image). Of itself, it plays no part in the function of the actual should joint, meaning the humero-glenoid joint as shown in the second image..

 

[Grannyhippy]

When the surgery is over you will have a swollen arm and fingers. This will go down slowly over the next few days. This is because fluid is pumped into the arm to aid visibility. There is a camera attached to one of the instruments the surgeon uses. This is the burr which rotates and cleans up inside. If you can, watch a surgery online. It is fascinating and very clever the way the instruments are designed to drill the holes and put the small screws (anchors) and sutures into the shoulder. There are plenty of brief videos on the Internet but I found one which showed an entire one and a half hour surgery.

 

[beachgal]

We used the super-large flannel shirt to fit OVER the sling and cushion for the first couple of days. Once we were able to move his arm more freely, the smaller ones were perfect. The sling/cushion help them fit snuggly to your body and the collars on the shirts keep the straps from rubbing your neck raw. Those flannel shirts (long as they are for men) will be perfect with leggings sans panties. Find some cute Ugg boots and you'll stay warm enough inside. If you get chilled, wrap a warm scarf or such around your slinged body. You'll be fine and anyone who sees you with the sling will certainly understand.

Remember this is not forever. As much as I still love my skorts, I was happy to trade them in for regular clothes. Just remember to wear your patience panties. I'll be walking through this with you, my friend, as we get you in a healthier place for 2016.


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[susanne]

For all you women having shoulder shoulder my best advise to you is getting a front closure bra!!!
Good luck


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[Grannyhippy]

Good advice @susanne but when I had my surgery I tried to buy a front opening bra and was unable to find a store stocking them. Years ago they were readily available. I still have to put my bra on backward and turn it around and put my arms through the straps.

 

[Me2]

Thank you, Josephine, as always your explanations and pictures are so meaningfully helpful.

I'm not quite sure what he means by "so much damage".

I think he meant that there were a number of tears and gaping holes. He seemed to want to be able to see the condition of the tissue (?) before repairing. This first surgeon felt he needed to do open surgery to be able to see better and get to all the repair work, I think. He also felt he would not reattach the bicep muscle on the right arm as it had dropped too much and would not heal well. He stated that I did not need the bicep muscle on that arm since I "was not a man who depended on arms to lift heavy loads and work overhead." The physical therapist I have been working with strongly suggested finding someone who would reattach the biceps.

But, I decided to go with the surgeon who felt "confident" that he could do everything arthroscopically. He said he was confident the bicep muscle could be pulled back into place and reattached. If not, he may need to put in a patch of tissue in. (cadaver tissue? I think I will have to figure out how to handle that -- got a story here @Poppet ?) But, while the first surgeon went into great detail that the space in the AC joint should be minimum of 10 mm(?) and my space was less than 7mm on both sides, the surgeon of chosen said that while he will minimally "clean up"

@susanne Yes, I've been wearing sport bras for quite a while and, as I am not very well endowed, I am figuring I can probably go bra-less at least in the beginning -- especially with sling in front of me.

Thanks so much @beachgal I have yet to find patience panties that fit me well -- but I'm learning --- I thought a month to 6 weeks on crutches was long. Over now for 4-5 months. It seems insurmountable right now especially with thinking the "easy" surgery is first with "at least" 6 weeks in sling THEN the more challenging longer recovery. BUT, I really have no choice. I hurt so bad now, am really unable to use either arm for much of anything (just no strength even when not hurting). I really wish they would do both shoulders at same time and be done -- back to back recoveries --- SOMEBODY decided I need lessons in patience.

Thank you all

 

[Grannyhippy]

One other thing you may consider buying is a self wiping toilet aid. These are designed to used between the legs if you have difficulty reaching behind to wipe. They hold the toilet paper while wiping and then the paper can be released into the toilet. I say this because you have two bad shoulders. I had surgery on my dominant arm and learned to wipe with my other hand but you would be surprised how difficult it was initially. There are plenty of them advertised on the Internet or you can go to one of those disability aid places to purchase one.

You won't be able to do up shoe laces so wear slip on shoes or elastic laces such as the ones they recommend for hip patients.

I did not bother with a bra when at home and I am big breasted. My husband helped be put one on when we went to the doctor's or other places. Still it is difficult because you have to support that arm all the time.

You are wise to listen to your physiotherapist and try to get the tendon fixed. The friend I mentioned in an earlier post let her shoulder go unrepaired for about 18 months and it just got worse over that time. She needed 5 anchors to repair it in the end. She had no medical insurance and it cost her over $9,000.00.

I also know of an old friend my husband and I only see occasionally who was foolish enough to do things like rip up carpet in his home too soon after surgery and then he complained about how much his shoulder was hurting. He is an avid golfer and he plays golf three times a week as far as I know. He has had several surgeries on that shoulder and now his shoulder is so bad that the surgeon said that if he does any more damage to it he will not be able to repair it. His wife thinks he is a fool because he does not listen and do as he is supposed to.

 

[Me2]

Thank you much @Grannyhippy ........ that wiping issue is one of those "things" that we facing recoveries know you gotta figure it out somehow! I thought my physiotherapist was going to succumb to embarrassment . . . she has been fantastic through the therapy for back surgery and our appointments are almost always two hours long twice a week with about half hour of manipulation/massage so plenty of one-on-one time for talk about everything. I was whining about why couldn't they just do bilateral shoulders and get surgery and recovery over at one time, and she exclaimed with exasperation "Sheryl, you won't be able to use your arms for ANYTHING . . . even for even for even for . . . . " And she left it unfinished but . . . It did leave me wondering well how in the world am I going to do THAT wrong handed for 6 weeks or more!!! Thank heavens for BoneSmart! (quick edit: a quick peak at Amazon shows at least ten different versions of a self wiping toilet aid! Who would have thought!)

I am in a rush to get shoulders taken care of pronto as we have health insurance through my husband's work, and he's on a month to month basis. We are hoping that it holds our through surgeries and recovery even if the coverage is not the best right now. The surgery will be totally covered but the copay on the therapy visits afterward will be tough to pay, but I'll just have to figure it out.

One more week, eight more sleeps.

 

[Me2]

Very rough weekend - very little sleep. Four more "sleeps" to get through til Friday afternoon surgery. I was hoping to get a ride in for one last time but it was freezing rain almost all weekend.

--- but my third grandchild is being born tonight! So worried I'd miss holding the wee one.

 

[beachgal]

Prayers for your "calm" and rejoicing at your "joy" with the wee one! Of everyone I know, you're the one that will deal with this surgery and handle it best. No doubt.


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[Me2]

Ah its finally here . . . the night before surgery. And, finally, after a devastating call from my surgeon's office, I have reached my calm.

As some of you know, I have this thing about no sedation . . . well, when shopping for doctors again this time, my second question after "can you fix me?" has been "can you do it without sedation?" My chosen shoulder surgeon said he would do his best to do so after hearing my reasoning of need because of PTSD with OCD after first surgery that was supposedly "minimal sedation". On Tuesday, I called to confirm that arrangements hadbeen made, with no surprises -- this is same hospital where I had my iFusion in May 2015. In May, they had called to confirm that yes, they would do surgery without sedation but I hadn't received that call this time. So, today, the surgery coordinator returned that call with a no, anesthesiologist would not do without sedation. Total panic attack . . . felt like heart attack, couldn't breathe, couldn't think, couldn't stand up . . . Coordinator said she'd have anesthesiologist call and after ten-fifteen of the most devastating moments, Dr. Anesthesia called with comforting words that ah, yes, arrangements had been made and my surgery would be with no sedation. All was good - of course, with the SYA of if problems arose and not at point where they could stop surgery, they would have to. I can show up for surgery with they'll do their best.

So, bags are packed with freshly laundered clothes, sheets changed, my recovery nest is prepared, I think I'm ready. I'll leave home at 10:30, arrive at hospital at 11, surgery at 1:15ish. Then recovery and relearning how to dress, etc, and real test of how much patience does Sheryl have? And this left shoulder is not so bad - minor repairs. At least six weeks from now, hopefully not much more, the real test of right shoulder surgery will begin. Wish me well.

 

[djklaugh]

@Me2 Very best wishes to you for a successful and unstressful surgery and recuperation! I think you'll find that the recuperation time is not as difficult as you are now thinking it might be. I was actually surprised at how un-problematic my post shoulder replacement was - and I had my right one done with me being a right hand dominant person. The hardest part for me was trying to do things with my left hand.
I will be thinking of you and sending you healing vibes

 

[beachgal]

@Me2, you've SO got this! Ready, set, GO! I'm thankful for amazing doctors that restore us to good health so we can continue on active and happy lives...and you are MORE than due for yours! I'll be watching for your post-op report! Prayers today and every day!

 

[Me2]

Thank you . . . I DID IT! And very well I must say! Surgery started at 1:15 and lasted to 4:30. Dr. said one shredded rotator cuff put back together beautifully. One bicep muscle that was supposed to be somewhat attached was not and was quite diseased (bad?) and ripped thru first attempt and reattached but just barely. They left me stay awake for whole procedure, so awesome! Anesthesiologist was quite proud of himself!

 

[djklaugh]

Excellent @Me2 I am so glad you came through this with flying colors