Reverse Shoulder Replacement need help for pain

[musicfox]

7 months ago I had reverse shoulder replacement.Shortly afterwards I had my other rotator cuff fall apart and can't fix it till my current surgery is rehabilitated. Current PT exercises cause bad burning pain all day in both arms. I only tolerate Tylenol, voltarin creme, ice and lidocaine patches. My surgeon wont respond to my calls. My current PT says I have very tight muscles in my tricep area. I am miserable.

 

[SaraK]

Welcome to BoneSmart! I just wish it were under better circumstances. I know some surgeons are more difficult to get a response from than others but I'm shocked you can't get a response with another surgery on the horizon. Are you able to get an appointment to get the discussion rolling?
You might want to consider a second opinion on the second shoulder. While many surgeons don't like to follow someone else until 1 year after surgery, it's different if you go in to talk about the other shoulder. You could then raise questions about outcomes and timing in light of first shoulder. That might get a response from second surgeon regarding options and expectations.

I'd be concerned if I were having that much pain 6 months out. Have you tried giving things a break for a bit? What does your PT suggest. Will your surgeon respond to your PT?

For pain, you might ask about using heat (you're far enough out of surgery that this might help loosen things up and reduce pain - especially if used right before PT). I also found that my TENS machine helped before and after my rotator cuff surgery. A PT helped show me where to put the electrodes. Massage therapy and the shoulder pulley also helped me.

Please let us know your surgery date and which shoulder it was so that we can help create a signature block for you.

 

[Pumpkin]

@musicfox
Welcome to BoneSmart!
Sorry you are having trouble with both arms after your TSR.
Since you are having trouble with both arms, has anyone checked you neck?

 

[musicfox]

My surgeon refuses to reply to my care coordinator or the physical therapist. I had physical therapy from around September to December and then they stopped it, but I insisted on beginning again 2 weeks ago, in mid February.

I do have a TENS unit but I'm unable to put it on because I have all of the tendons ripped in my left arm and no one to help me to do it.

Tuesday, Friday and Sunday I'm able to have a massage therapist help me move my arm and work on breaking up the tension in my muscles that stop me from moving the arm.
I do have a pulley and some other exercises but when I do them I end up in really terrible pain. I ice quite a bit and take a lot of Tylenol. I'm really afraid of stronger drugs. I briefly took other things my nurse practitioner prescribed, for about a month when my left arm turn black, but I got off of everything and then my stomach was really sick for about 3 months.

I have made appointments with the business where my original doctor was. They employ many doctors in our area but they all say they can do surgery on my left arm but only to remove pain and not to increase my movement. They don't want to be involved with treatment of the arm that already had reverse shoulder surgery.

Due to the fact that the reverse shoulder replacement in my right arm is so painful I can't imagine having the surgery again just to remove the pain.

When I do make appointments with other companies the doctors always cancel, so far. Usually I'm rescheduled a month or more in advance and those appointments are also canceled. Also the doctors don't seem to want to discuss anything about the shoulder that already had surgery.

I really wish there was some way I could do exercises without terrible pain so that my arm can become stronger and more flexible. One orthopedic surgeon who says he could do another reverse shoulder replacement in my left arm has given me several steroid shots. Unfortunately, there is still a lot of pain.

I have had referrals to 3 pain clinics but so far none of them are willing to help me in any way at all. The first Clinic which I had a referral to in September of 2021 finally has an appointment available for me in September 2022.

I also worry a little bit about liver damage due to the fact that I take 1000mg of Tylenol every 4 hours for at least the last two years.

Because I have Medicare I am curious to know if I could perhaps go to some other state and have a consultation or an appointment on Zoom and maybe even be treated by a doctor who can help with the movement of my arm rather than claiming reverse shoulder replacement is only to remove pain. So far I can't really seem to get any information about what Medicare could do for me in another state. I wonder if there are any doctors that treat a ripped up rotator cuff with reverse shoulder replacement with the intent of increasing the movement of the patient's arm as well as removing pain?

 

[musicfox]

My surgery was July 12, 2021. The serious fall I had that may have caused all the damage was on Thanksgiving of 2020. I had several cancelled appointments until I was finally able to see a doctor in February of 2021.

 

[Pumpkin]

Because I have Medicare I am curious to know if I could perhaps go to some other state and have a consultation or an appointment on Zoom and maybe even be treated by a doctor who can help with the movement of my arm rather than claiming reverse shoulder replacement is only to remove pain.

If you have traditional Medicare Part A and Part B, you can go to any MD or facility in the USA.
If you have an Advantage Plan you will have to check with your insurer.

Your primary MD can check your liver function with a simple blood test. Ask for one, to give you peace of mind about the Tylenol you are taking.

 

[musicfox]

I have begun to use heat and ice before I do my exercises but they are still excruciating. When I talk to the physical therapy department they don't recommend any other kinds of exercises and say I should try to do the pulley everyday and walk up the wall with my hand. I'm not getting any better and it's been over seven months. I really need some kind of help on some exercises I can do that will help but don't cause terrible pain all day. I also wish I could find some kind of relief from the pain without taking any kind of drugs that are mood-altering in anyway. I can't dress very easily and for the most part can only use my arms from the elbow to the hand in a bent fashion. I used to ride horses and play guitar and accordion and harp. I also could swim daily but I can't do anything anymore at all except I can play the piano a little bit and sing. I really need some referrals of a doctor somewhere that could help me or a physical therapy place that could help me. Currently the PT people do some massage and passive movement in my shoulder which helps at the time but then Fades a few hours later. I really need to have some other resources so that I can progress to do the things that are important to me. thanks for any suggestions.

 

[musicfox]

I thought I had set it up for me to go to a nice rehab hospital my friends had gone to, but an interview the day I woke up from surgery in a disoriented state, apparently made me disqualified. The Dr said if I was in the hospital it would be easier to go somewhere. Because of my special needs the case manager continue to release this information which made me get denied at any of the decent Rehabilitation hospitals that I found.

Eventually I was forced to go to a dilapidated, understaffed, covid infected place that I could not stay in. I chose to go home and be alone for my own safety. It has been almost impossible to get anyone to come and help me and I'm not doing well at all even though I'm 8 months post surgery.

From what I can tell in my state there are no rehab facilities that can handle someone with special needs and there is nowhere to go to change this as I have tried reaching out to my senator and other places. I have no idea how a person with special needs good for care to recover from major surgery. I was severely traumatized by the behavior of a case manager at the hospital. She claimed that my phone calls attempting to get a bed anywhere after the surgery were tainted by something I said inappropriately, although I was clear-headed on the days I called the centers.

Eventually I asked my sister to help and the case manager I told her she should go to outside agencies to get me help at home. Due to covid there is no Staffing at the outside agencies we were told. Because I left the filthy nursing home I was said to, the doctor said I left against doctor's orders and it took me over a month to get any physical therapy at home, and even that was very substandard and not very helpful. Not only is my recovery retarded but I was so traumatized by the experience I do not think I'll recover.

 

[musicfox]

I stated earlier that I have seen other doctors who can't seem to help with the arm that had surgery. I get occasional steroid shots in my left arm which I guess is broken and has all the tendons torn but since the right arm is not rehabilitated well enough I can't do anything about that yet. Not to mention that the deplorable condition the arm I had surgery in makes me wary of ever doing this again with a doctor in my state. I really hope I can find a doctor that is involved with a patient and the physical therapy team and the rehab hospital placeme so that I can somehow get help. I really don't want to take any kind of painkillers other than Tylenol because I like to have a clear mind. But I suffer everyday and I don't seem to be getting better. I am attempting to get some kind of help for depression. But I really need to know show me good doctor somewhere I can go to.

 

[Jockette]

I’m sorry that you have gotten such unsatisfactory care with this surgery and it’s recovery. I really don’t know much about shoulder replacement but I’m sure others will be along to respond to your post.

By the way, I merged your newest thread with your original recovery thread, as we prefer that members in recovery have only one thread.

This benefits you because all your information is in one place, easy to find, and maintains a nice journal for you.

This also benefits our staff, as your information is all in one place, and we often go back through your thread for previous details, so we know what you‘ve been through which helps us advise you better.

So, please keep all your posts in this thread. If you’d like a new title, let us know what you want, and we’ll change it for you.

Many members bookmark their thread in their computer browser, so they can find it when they log on.
How can I find my threads and posts?

Best wishes on your continuing recovery!

 

[Jamie]

@musicfox .... Pumpkin gave you good advice to pursue so you could see doctors out of the state of New Mexico.

In reading your posts, I am confused on a couple of points.

1. What exactly are your special needs that seem to be out of the range of all rehab facilities in your state?

2. Why do your appointments keep getting canceled? That doesn't make sense to me. Are they actually canceled or just moved to a different day and time?

3. Did someone tell you that your left arm was broken? You may have torn tendons in your left arm, but if you had broken bones, I doubt your doctor would leave the arm to wait for your right shoulder to heal.

Since you are so far out from your reverse shoulder replacement, you will likely need to work with your GP or a new orthopedic surgeon to get assistance with your lack of movement in that arm and your pain. The first step will be to get a determination of what is causing the pain. Shoulders require regular gentle exercises from the beginning with a pulley or arm hangs. If you weren't doing those several times a day, that can cause soft tissues to tighten up and even freeze. A surgeon will need to evaluate that arm to see what is going on. You live in Albuquerque, so if your insurance allows you to see any doctor, you should be able to find someone there. If not, your best bet would probably be to drive to Phoenix. I can give you some recommendations there if you're interested.

When the surgeons tell you that a reverse shoulder replacement is done to relieve pain, what they mean is they usually don't agree to do the surgery just to regain better motion in your arm. But usually in doing the replacement, providing rehab is done properly, you should regain a better range of motion. If you have torn ligaments or tendons in your right arm, you're going to have pain as well as reduced motion. If the surgeon is recommending a reverse replacement, it does sound like that is needed and will help you.

You are taking an excessive amount of Tylenol if you're taking 1000mg every 4 hours. The maximum amount is 4000mg in any 24 hour period and at that pace you would be taking 6,000mg. Please see your GP immediately and request both a liver and kidney function test, as you don't want to risk damaging either of those vital organs. You might also request that your GP let you try tramadol for your pain. It's usually tolerated well without the grogginess of opiate pain medications. Your GP can assist you with outpatient therapy if that's needed too for the tightness you're experiencing.

Good luck in making some progress with your recovery.

 

[musicfox]

8 mo after reverse shoulder replacement need stronger pain med to do PT exercises. Currently taking Tylenol and meloxicam. Can Pregabalin 25mg once in eve help? or something else?

 

[Jaycey]

@musicfox

You will notice that I merged your newest post with your original recovery thread. For several reasons, we prefer that you only have one recovery thread:

• That way, we have all your information in one place. This makes it easier to go back and review your history before providing advice.
• If you keep starting new threads, you miss the posts and advice others have left for you in the old threads, and some information may be unnecessarily repeated
• Having only one thread will act as a diary of your progress that you can look back on.

Please post any updates, questions or concerns about your recovery here. If you prefer a different thread title, just post what you want and we will get it changed for you.

If you need an urgent response to a question, just tag a member of staff.

Many members bookmark their thread in their computer browser, so they can find it when they log on.

In terms of medication - you really need to get advice from your PCP or surgeon. Medication works differently for everyone. And since we don't know your full medical history we really are not in the position to advise.

Are you icing your shoulder regularly? What is your activity level now?

 

[musicfox]

July 12 2021, I had my reverse shoulder replacement. 2 months into rehab the left arm turn black from the elbow to the shoulder and the pain became unbearable. My doctor would not see me or return my calls or speak to my family or anyone that call him including the physical therapy people. I made appointments twice for a Doctor saw me once before the left arm turn black and then canceled each appointment I made and never saw me. I finally got into a different clinic and saw a doctor who agreed to treat the left arm and did several steroid shots but did not react to the arm being black. He gave me a steroid shot and said that until my right arm was better the left arm could not be treated. I then got into another clinic and the doctor sent me to a pain clinic where eventually ordered an MRI of my humerus and then told me my arm is broken and they couldn't help me till I got it fixed. I went back to the doctor that said he would work on me than my right arm was better and he said it wasn't really broken the glenoid process sometimes cracks when somebody has osteoporosis like me and gave me another steroid shot but said that surgery was not available until the summer and only for a reverse shoulder replacement not any repair of a broken arm. Yesterday I was able to get an x-ray of the left arm in the hopes of seeing what kind of break actually occurred. My physical therapist said he would look at the x-ray. I also hope to go to another new clinic and see a doctor on the 30th I hope he doesn't cancel this appointment as he cancelled the first. I am considering going on pregabalin 25 mg once a day. I don't know if it will help but I am always in pain and crying at least half of the day. I believe I need to do the exercises so that I can get my arm to work better and maybe have something done for my left arm which hurts really badly. I appreciate your information about taking too much Tylenol but I don't know how I 1can ever handle the pain. I would appreciate any recommendations even if it's in Phoenix thank you so much.

 

[Mojo333]

. I would appreciate any recommendations even if it's in Phoenix thank you so much.

I will tag @Jamie so she is sure to see this when she comes on the forum.
Sorry you are suffering with pain.