Reverse Shoulder Replacement My Shoulders?!!?

[Me2]

So fantastic news this week on shoulder front!

Visit with my surgeon on Monday! He was visibly VERY impressed with my AMAZING recovery! Range of motion is fantastic -- 90%+ every way but behind my back. I know that would never be all that great! (But I can tuck a shirt in with care and (TMI warning) can't wipe but the left can -- what does one do if both shoulders replaced?) He said that he has NEVER seen a replacement with the range of motion I've already achieved in less than five months!

Not only that, but saw physical therapist for last shoulder visit! Whew! A full year of shoulder therapy counting the before surgery try to get better without visits before the MRI last December! Discharged FINALLY! She reiterated that though I am only her third shoulder replacement patient, I absolutely by far have best range of motion and strength. She shared that my surgeon had stopped in last week. (I had told them I was told by scheduler that my surgeon and several others were leaving the practice to set up new. The group is fairly large and well established group. They have their own physical therapy there, so I assume and hope that he stopped by to make a connection with my therapy group. They had referred me to him actually.) Anyway, she said that my recovery came up in conversation, and they shared and agree that it was indeed AMAZING!

So, I LOVE BEING THE STAR PATIENT!!!

So, update otherwise. I started back swimming about three weeks ago. First couple sessions were a little awkward and I took on a lot of water. Almost postponed going back, but so glad I kept it up. Shoulder wise swimming is almost normal. Definite shoulder tired but good tired, good stretch, good for strength, too, I suppose.

Everything else shoulder wise is darn good! Can get cups from top shelf, easily lift two cups or one big heavy Pfaltzgraph plate to second shelf and two small ones. I can almost pour coffee or even gallon of milk with new shoulder. I can hold my smaller babies for a few moments. I can even toss something with my right hand -- looking back, I have not been able to throw snowballs for quite a few years! I really can't wait to have snowball battles with my preschoolers! But, alas, don't know that I'll be able to shovel snow ever. I got a pass on that all last year! Shoulder is still feels a little stiff but really so terrific. (It does give me hope about back/hip, hopefully not false hope.)

So...... I am a shoulder replacement and rotator cuff repair wizard!

 

[Jaycey]

So great to read your good news @Me2 ! Well done on all your hard work!

 

[Jamie]

What a wonderful post to read. I'm sure shoulders are like everything else.....you'll see more improvements with time as you continue working on doing "normal" things. Bravo for you!!!

 

[Me2]

So . . . haven't been around in awhile . . . and I was really looking forward to 2017 as a good year .... but when one starts off the Christmas holiday with a horrible toothache, to find a terribly infected tooth, begin the new year with a root canal and pulled tooth on January 2, hmm what can one expect?

On January 13, I went in for a six month follow up on replacement shoulder and reported to my surgeon, showed off a wonderful range of motion, all was good. I thought my shoulders were very much on their way to full strength in the year to eighteen months for full recovery but then I've thought wrong before. I mentioned my left just repaired and not replaced shoulder had been a little achy as of late but was not really concerned. My surgeon had left his old practice with several other doctors, and I was happy to hear where their pain specialist went so I could continue my follow up with my back. I went on my merry way with my almost perfect shoulders.

But, then, my mom had a stroke on January 15, and I spent the next month helping care for her with my sisters. I would not give up a moment of that time with her and my sisters but, alas, helping to lift and move her about was part and parcel. And, of course, the more my sisters suggested I not, the more I felt I had to show them my shoulders were just fine, healthy and bionic. My mom went on her way to heaven, and I went back to my stretching and strengthening exercises, got more achy, until I realized my left shoulder was not going up like it should. Hmmm. Waited a week, two, and more and more achy and painful. Make the appointment, get the xray. Surgeon says shoulder "riding a little high", lets get an MRI. So MRI is scheduled for Monday. Everybody please wish really hard that it just needs a little more rest.

 

[Jamie]

Ohhhh.....I do hope that's the case. Boy, you certainly have been through the mill so far this year. I know how that caregiving thing is as I did it for both my parents. I felt the same as you. The time with them was precious, but it takes a toll on the ol' bod.

My shoulder keeps telling me that surgery is probably getting closer. I cannot lift my arm as high anymore. At least it doesn't hurt. So I'm going with that for a while longer. Hopefully you can wait it out a bit too!

 

[djklaugh]

@Me2 So sorry for your loss and for all the other problems going on. Sure hope the MRI shows no real problems - hopefully what ever is going on is muscle related rather than hardware related.

Hugs and healing vibes for you

 

[Grannyhippy]

I sure hope you have not torn anything in your shoulder. Let's hope it is just muscle strain and that resting it will help.

Sorry to hear about the loss of your mother.

 

[Me2]

So, I had the MRI of the left shoulder and the report says: (This is on shoulder I had just rotator cuff repair on January 2016)

"There are degenerative hypertrophic changes of the acromioclavicular joint with fluid in the AC joint.
There is a small amount of fluid in the subacromial/subdeltiod bursa.
There is extensive thickening of the synovium particularly over the inferior pouch region. It is consistent with synovitis.
Given the thickening, scarring/fibrosis is less likely.
There are scattered small signal void artifacts presumable from the prior operative procedure related to metallic densities.
There are findings consistent with 3 or 4 screw tracts associated with the greater tuberosity and humeral head
There are findings consistent with some cystic change and/or erosions of the humeral head at the junction of the greater tuberosity anteriorly.
There is mild hypertrophic spur formation along the inferior medial aspect of the humeral head.
There is superior subluxation of the humeral head with narrowing of the space between the humeral head and acromial process of the scapula.
There is marked irregularity and thinning of the supraspinatus tendon and there are findings associated with partial thickness tearing and probably some small areas of full thickness tearing as well.
It has a somewhat lobulated appearance of the musculotendinous junction of the supraspinatus muscle It could be due to partial tearing and partial retraction of some of the fibers.
The biceps tendon below the level of the occipital groove is thin. It is probably thin within the bicipital groove region though evaluation in that area is a little limited."

And, all that sounded quite terrifying to me. But, when I saw the doc after that, he assured me not to worry that that is just how, for the most part, the surgical procedure would show up on MRI at this point. I want to believe him so much as I just really want this shoulder thing to be done. I did my happy dance and kept hoping for improvement.

But, now, a month later, my follow-up to the follow-up is on Friday. Range of motion is not much better. Its actually not painful for the most part except sometimes when falling asleep (just like the right shoulder last year ), a little gain in strength (back to one plate at a time on mid shelf rather than 2-3), but certainly not where it was at Christmas time when I had 100% range of motion, able to lift just about anything, and 0 pain).

AND then on 26 April, I had this terrible pain in the front of my right forearm which lasted about a week . AND I'm back to feeling like arm is being pulled into side, NOT being able to lift coffee pot, arm being too weak to fix hair and this is the shoulder that I had the replacement -- I thought I didn't need a rotator cuff to keep it operational! This area hurts terribly when I'm holding my babies, when I'm writing, when I try to open things. Sometimes the arm feel like its so heavy its going to fall off -- other times it hurts enough that I hope it does!

So I again, I have an appointment with Dr. Walker on Friday. I have no idea even what to ask him other than hoping he sells me on that both shoulders will get back on track to being fixed and improving.

@Josephine can I trouble you for some words of wisdom?

 

[Jaycey]

@Me2 so sorry you are struggling with all this pain. Just to let you know Josephine just had shoulder surgery a few days ago. She has been on the forum briefly but it may take awhile for her to respond to your tag. She is really best placed to interpret the MRI results. Hang in there!

 

[Jamie]

I agree with Jaycey. Your questions need Jo's expertise. I'm so sorry to hear your recovery has taken a bad turn. Please be kind to yourself and hopefully you'll get some answers from your surgeon. It may just be that more time and TLC is needed.

 

[Josephine]

Well, Sheryl, welcome to the world of shoulders! I had similar reports on my shoulders. The trouble with shoulders is they are small and everything in them is small. In hips, the structures are all sizeable by comparison and can take a beating. Not so with the shoulder. It's like comparing household crockery with Dresden china - it doesn't cope so well with the wear and tear.

You also need to remember that a radiologist doesn't see the inside of the joint like a surgeon does and will interpret the results of the surgery as 'damage'. As for how long does it all take to heal, I wish I knew! We'll have to keep each other informed!

 

[Me2]

Thank you Josephine for taking time to answer. Hopefully your recovery is going well.

Not sure how I'm handling this shoulder thing -- I thought I was all fixed and find out now not so much. I visited with my shoulder guy yesterday for what I was hoping was a "great you are progressing just fine." But I got a "not so much" I told him that I thought left shoulder was doing okay, improving as in not so achy, pains not so sharp anymore, strength returning (can lift plates to second shelf, pour coffee again), but was confused about his reasoning as to what was going on according to MRI. I asked that his answer left me with impression that we did do a patch when I didn't think that was even a consideration for left shoulder and I thought was simple rotator cuff repair. He seemed quite sure that "No, we did a reconstruction on left shoulder, we were going to with right shoulder but decided that replacement was much better option for you because ....." So, since I had asked him about incident where I had sudden sharp pain (really very painful indeed) in right and lingering pain still after two weeks, he sent me for xray of right shoulder and said to come back up to meet.

So, while I was getting xray, he must have gone back to review and . . . . He said nope, that we did not do reconstruction of left shoulder, that, yep, everything just weakening and tearing and that we'd probably have to go back in to repair again at some point.

AND, good news/bad news, nothing showing damaged in right shoulder on the xray, but I should be being careful with more than 30 degrees moving arm from bended in front out to side --- which is exactly the movement that I had done when I had the sudden sharp pain. Yes, I remember him telling me that, and, yes, I remember my Krissy, physical therapist, telling me that. And yes, I was probably doing that way too much -- resulting in the pinching in the back of my shoulder. Apparently, a big deal NO NO! for reverse shoulder replacement. BUT, I had such great range of motion and strength in my right arm! I thought I could pretend and have a "forgotten" bad shoulder. But, apparently this restriction is because how thin the bone in upper arm and big the implant to get stabilized and how little bone around it, to torque it that way is inviting disaster. Kind of that Dresdin china versus household crockery thing you speak of, Josephine. Dr. Walker said hopefully, apparently I just had a good warning, some soft tissue damage that will heal. If it continues to feel better, all is good. If it doesn't, we'll do a bone scan next month. If it gets worse, call and come in immediately!! I'll be good I promise!

My shoulders have to be good --- my back/hip hurts too bad and I got to get that back under control!

 

[PinkOrchid]

I understand night pain is quite normal and expected. Gruesome reason why? I read somewhere that because of lack of rotator cuff fully holding shoulder into place the head of the humerus actually slips out of place as your body relaxes into place. Yeah, that's what it feels like.

I (preop) have been wondering about this! It seems like when I lie on my side, something like a rubber band pulls my shoulder up toward my head and makes it hurt. Is there any way to keep the shoulder down where it belongs when you're lying in bed?

 

[Me2]

Funny, mine has the exact opposite feeling though I'm usually lying on my back--I felt like that band just pulls my shoulder/arm down toward the bed -- like its falling off my body! Fortunately, that stopped for the time being with this event.

For my shoulder last year? I avoided that slide out of shoulder feeling as I was falling into deep sleep by sleeping on the couch and in the recliner. For some reason, pre-op the couch worked best. After surgery with the awful pillow and time in a sling 24/7, both worked quite well. It took me forever (as in months) to get back into bed.

 

[Josephine]

I read somewhere that because of lack of rotator cuff fully holding shoulder into place, the head of the humerus actually slips out of place as your body relaxes into place. Yeah, that's what it feels like.

I can fully concur. What you also need to bear in mind is that the shoulder isn't like the hip joint where the femoral head is enclosed within the acetabulum. No, the humeral head just rests against the glenoid which is little more than a shallow, saucer shaped thing.

What keeps the joint secure is the rotator cuff which is comprised of four ligaments, the subscapularis, the teres minor, the infraspinatous and the most important one, the supraspinatis that goes over the top of the joint and is the one that gets damaged by the RC impingement.

Funny, mine has the exact opposite

Well, you know what we say - everyone's different!

 

[PinkOrchid]

Funny, mine has the exact opposite feeling though I'm usually lying on my back--I felt like that band just pulls my shoulder/arm down toward the bed -- like its falling off my body! Fortunately, that stopped for the time being with this event.

For my shoulder last year? I avoided that slide out of shoulder feeling as I was falling into deep sleep by sleeping on the couch and in the recliner. For some reason, pre-op the couch worked best. After surgery with the awful pillow and time in a sling 24/7, both worked quite well. It took me forever (as in months) to get back into bed.

I find the same with lying on my back and on the sofa. I think the sofa is angled back, which pulls my top shoulder into a better position and takes some pressure off the bottom shoulder. I am a side sleeper.

 

[Me2]

I'm finally getting in to see my shoulder doctor on Monday morning. Wondering, wondering.

Fortunately, my right replacement shoulder seems to have pretty much continued on the road to recovery. I wish it was a little stronger, but though just a tad achy now and again, I feel its a success story.

Left shoulder is still of concern. After I cancelled my August appointment because it was doing okay and just couldn't take time off work, I had a really bad time of it. Mostly just constant crackling and popping and grinding noises when moving it. For a while, the shoulder was quite painful, very weak with almost no ability to move arm up in any direction. It hurt when I was driving, holding reins to horseback ride, no strength to lift itself let alone plates, gallon of milk, coffee pot. So, about a month ago I made an appointment for Monday since I'm closed for my birthday. Of course, its feeling better now. Still crackling with movement, but not as painful, sometimes full range of motion with minimum pain and sometimes none. So, we'll see what he says.

Know at some point it will need fixed, but I'm in no hurry...On the other hand, I terrified of a repeat of late 2015 and so much of 2016. I really don't know how I made it . . . it seems a blur of pain, prep for surgery, recovery from surgery, more pain, terror, decision making.

Turning 59, is so scary to be so worried about what else needs fixed when. My older sister, just visited an OS to find out she has two bone on bone knees. She's been hurting for awhile, feel bad knowing how scary it feels to be on that side.

 

[Me2]

Oh my goodness! I thought I've been on here since last October! Here it is May already.... and I noticed we have our own "Shoulder" space!!! Wow!

I guess I haven't been back over here because my shoulders have been both doing really well. My right replacement shoulder is about the same place as update above -- rarely twinges when I move the wrong way. I wish it were stronger but then I've done nothing to earn it being stronger. I still have a little difficulty with opening things or writing but otherwise forgotten.

My left shoulder has made amazing strides. When it was aching all the time, crackling with movement, no strength last October, I made an appointment with my surgeon. He suggested going back to mild exercises to keep it moving. No improvement. Not able to lift even a pound. Kept that way til January. Doctor said he felt just needed to keep working it, MRI or we could do an exploratory surgery. I had an MRI finally in February. Fortunately it showed no new tearing but the supraspinatis was "attenuated". So, just as good doctor said, just slowly strengthen. Nothing was working though til I realized when I was brushing the horses and arm felt tired afterward and a little achy but improved quickly to NOT hurting to downright pain free and wonderful! I was doing something I love to do, needed done and strengthening arm perfectly! Brushed through the shedding season and BOTH shoulders are feeling really really great! Not as strong as I would like but getting there!

Success story! Only took two years!

 

[Pumpkin]

Me2,
Happy to hear how well your new shoulders are doing, and you finally have your life back.

 

[djklaugh]

@Me2 I am so delighted to hear things are going well with your shoulders! And isn't wonderful that an activity you enjoy doing helped get your 2nd shoulder back into shape - wonder if PT folks can arrange horse brushing for all their shoulder patients?