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Standard Shoulder Replacement Potential Shoulder Replacement Candidate

Update…..

Well, I fought the “fight” for as long as I could, and have now surrendered!!!!! This struggle had been on-going for many years. I am scheduled to have my shoulder surgery February 25.

I met again this week with the last doctor I interviewed……we discussed my CT scan and, in his opinion, if I wait longer there could be additional arthritic damage to my joint, which could affect the probability of a successful arthroplasty. We again discussed all my reservations about the procedure.

My primary concern is that there have been so many people who told me that a shoulder replacement was “the worst thing I ever did”. I have “zero” concerns about the discomfort after the procedure……my pain threshold is quite high……endured extreme discomfort in my knees for many years prior to opting for replacements. He stated that he firmly expected me to not be in that situation. Also stated that he expected my recovery to be easier than for a knee replacement.

We discussed all the various potential non-surgerical options for pain control.......stem cell injections, PRP, steriod injections, over the counter pain patches. None probably would be very successful for an extented period of time. I came to the conclusion that it was just a matter ot fime before it would be enevitable.

At no time did he “try to convince” me to have the procedure……in fact probably the opposite. Firmly told me that I was the only person who could decide how much longer I could tolerate the discomfort.

Based on the CT,, plan to have an anatomic prosthesis, and it will be stemless. Recovery will require me to be in a sling for about a week, however, physical therapy will start immediately. Strict range of motion limitations. If all goes appropriately, recovery will take about three months. He said that I will be able to resume full resistance exercises in about six months. I have discussed recovery plans with my personal trainer.

This has been one of the most difficult decisions I have ever had to make.

The final deciding factor was the impact my shoulder situation has had on my wife. I came to realize that I was not the only one who was negatively affected by my problems.



Steve
Klein, Tx

(temperatures are in the low 20’s in the Houston area!!!!)
 
Congratulations on scheduling the surgery, @Jayhawk. I've added your surgery date to your signature. Which shoulder - left or right? And is that your dominant side?

Jayhawk said:
I came to realize that I was not the only one who was negatively affected by my problems
Click to expand...
This is so true. We do lose sight of how our joint issues impact those who live with us.

While you struggled with this decision, it's clear you did your "due diligence." And I'm betting that a year from now, you will be able to say it was one of the best decisions you ever made.

Please keep us posted.
 
@Jayhawk … I’m glad you’ve finally decided to take the plunge. I do think you’ll find this surgery to be significantly easier than your knees and even your hip. At least that’s what I experienced. My surgeon started physical therapy immediately as well. I think most do because unlike hips and knees, there is a risk of your shoulder freezing up if movement is done done from the very beginning. But, as you’re hearing the movement and therapy will likely have very specific movements for you to perform. In my case, I did pendulum swings and passive movement with a pulley. It was actually quite pleasant to make those early movements and I looked forward to my pulley sessions as a good stretch for my new shoulder joint. The more challenging therapy for me didn’t come until after 6 weeks. Your situation may be a bit different because of the implant it sounds like the surgeon plans to use.

As for your friends saying this was the “worst thing they’ve ever done,” have they had knee and/or hip replacements? If not, then their comments are understandable. But frankly, what we see with our recovering shoulder BoneSmarties is that the recovery is not as bad. Most people are off any prescription pain meds within days and only using Extra Strength Tylenol.

My surgeon also was fairly lenient about the sling. I was allowed to be out of it during the day as long as I supported my arm on a chair arm or pillow and didn’t try to use that arm for anything but to maybe steady something (like when needing to open a can or jar). I was not allowed to hold even a cup of tea for weeks in that hand. Inconvenient, but definitely doable. The sling was helpful when sleeping, though, as it’s too easy to make movements you shouldn’t be doing. The sling holds your arm close to your body and prevents that. It was not at all uncomfortable for me to sleep in it.
 
@Jayhawk I've had both shoulders replaced and my outcomes have been in the "one of the best things I ever did for myself" arena! (other thing in this arena was my bilateral hip replacements!). While the recovery period was intense and did require extensive and diligent PT the pain was manageable and, given that shoulders are not weight bearing joints, did not interfere too greatly with my normal activities --- though right shoulder (dominant side) was a bit more challenging than the left one. My shoulder joints now are "old" ones - right will be 13 years in March and left will be 9 years in April. Both are pain free and fully functional. I wish you the very best for this surgery!!
 
Thanks Jamie......tough decision

Part of the decision to go forward was based on the reputation of the doctor......my friend who works for Stryker knows him well (actually provides orthopedic devices/prosthetics and is present at procedures), highly recommended him.....one of the best in the Houston area. Recommended him for his father's case.

s
 
@Jayhawk Congrats on your surgery date. It's been 15 months since my anatomic TSR of my dominant side (R.) My recovery went well and it was most definitely not the worst thing I've ever had done. I have more ROM now than I've had in years with continued improvements even now. If the doctor told me I needed the other shoulder done, I would say give me your first opening without hesitation. I'm hoping you'll be in the same mind set as some of us were after we had our surgeries done: "Why did I wait so long?"
 
Hi Jayhawk,
Only a month to go now. I wish you the best as you move toward your scheduled surgery date. It sounds like you have a great surgeon, one you're confident in and that's half the battle. You'll be in good hands!
May time fly and you find many moments of comfort while you wait. :)
Happy Monday!
@Jayhawk
 
Had my left shoulder arthroplasty on Wednesday at the Fondren Orthopedic Hospital by Greg Edwards. He said “everything went perfect”. My shoulder was in very bad shape……he removed 15 loose bodies (three quite large), quite a bit of debris, removed some dead bone and was able to install a perfectly balanced prosthesis (stemless). His standard protocol is to spend one night in the hospital.

I had a nerve block in my shoulder prior to the procedure and had “zero” pain until late yesterday when the nerve block wore off. My pain level tolerance is quite high, so overall feeling pretty good even now. Have a prescription for hydrocodone, but not taking. I am taking Tramadol and Extra-Strength Tylenol a couple of times a day (that is what they gave me in the hospital).

My post-procedure appointment is next Wednesday (March 4), and unless there is a problem with be out of the sling. Hate it!!!!! Will then start physical therapy immediately with restrictions for range of motion. Edwards reiterated that I should be completely healed at about three months, but does not want me to resume my weight training until six months.

Interestingly……Edwards told me my case meets the criteria for a study he is doing in conjunction with the prosthesis manufacturer. He asked me if I would participate.



Steve
 
Wow….this is great news! I hope you decide to participate in the study. Those I’ve been involved with were very interesting and it feels good to know that you’re contributing to something that could have real benefits for others facing this surgery.

It sounds like your should was badly in need of the replacement and I think you’re going to be very happy with the way the new shoulder functions. I never think about mine at all….I just do my normal things. Although I’m not a weight lifter, I do a lot of activity that involves some pretty heavy lifting with home remodeling and yard work. My shoulder is never an issue with any of it.
 
@Jayhawk Congrats on the new shoulder! I stayed one night thinking that pain would be a challenge like with my hip. My nerve block didn’t wear off until the next morning shortly before I was discharged. Even then, the pain was manageable with prescribed meds and Tylenol, like you’ve done. And don’t forget about the your good friend, ice.

Just be very careful to follow all your instructions to the letter these first few weeks. Like with any other joint surgery, it’s easy to feel so much better that we get ahead of ourselves and tax those healing tissues too soon. If you can stay out of the ODIC, I think you’ll be very happy how your patience pays off. Having that shoulder working again without the pain has been such a blessing to me. I’m back to doing the things I love. No more turning things down because of the pain it would cause. What joyous relief!

Keep us in the loop. We’re looking forward to your future updates.
 
Met with Edwards Wednesday……one week post procedure. They took a extensive series of x-rays and he said the prothesis is perfect. I am to begin physical therapy immediately. Interestingly, they have recommended specific aquatic exercises to be included with the rehab. I was given a list of facilities in the greater Houston area that are able to provide the therapy.

The sling is gone!!!!!!!

I have very specific range of motion restrictions. Since I had an anatomic procedure there were tendons (subscapularis) released and reattached, and it will require time to heal…..could take six weeks.

At one-week post-procedure, my pain level is low and very manageable. I stopped the Tramadol after three days and now only take Extra-Strength Tylenol 2-3 times per day. I had more issues with the nerves in my arm and hand “re-awaking” after the nerve block than with the actual shoulder.

On a scale of 1 to 10, I would rate my situation at this point at a 10.

I was given a copy of my operative report…….how detailed and interesting. One big surprise……it indicated I had a small tear in my bicep that was sutured. Not sure how or when that happened!!!!



I signed documents to be included in the new study Edwards is doing with the prothesis manufacturer. The extensive x-ray series (15-20) was part of the study.

Also, he said that he has done over 2,000 shoulder replacement cases.

My next appointment is in five weeks.


As I move into the rehab phase of my recovery, it is my hope that my post-recovery situation will be positive and all my concerns about a shoulder replacement will be moot.
 
What a great update, @Jayhawk. I'm sure you are relieved to be out of the sling and move forward to the next phase of recovery.

Glad you decided to participate in the study. It should give you some insights you might not otherwise receive about your new shoulder.

Let us know how your physical therapy goes.

Wishing you all the best.
 
@Jayhawk What a great update! Lucky you! I had to wear my sling for the first 6 weeks specifically until that subscapularis repair healed sufficiently. Although after that 2 week visit, it could be off more as I was at rest but still adhering to the restrictions. It is so dependent on the surgeon's protocol. I just found the sling/restrictions to be so much more tolerable than my THR since I was still mobile and could still use my hand to grab onto objects to manipulate them within the restrictions. I wasn't too impatient about the sling as I liked the reminder about limiting the movements of my arm.

PT was welcomed when it began in earnest for me at the 6 week mark. The simple exercises were a challenge at first (probably because of the six weeks in the sling: a definite drawback to my OS protocols.) We slowly progressed to preserve the healing process but the part I really liked was the gentle manual stretching the PT did with each session. I was amazed at how tight those muscles got in between sessions. It will be fun to "compare notes" as you progress. At almost 15months post, I can definitely say it was all worth it and I'm happy that my shoulder is my friend again.

I think it's cool you agreed to be in the study. There have been a rare few that I've declined. Being from a science/medical background, I like the opportunity to help further the cause. My OSs are part of a teaching medical center so it really does come with the territory. Blessings for continued good healing and recovery, just stay out of the ODIC (over did it club.) :) Looking forward to your next update.
 
@Jayhawk …. This is great news! You’re experiencing what we see in a majority of shoulder replacements these days. For people that have had either a knee or hip done, they feel the shoulder recovery is significantly easier and less painful. A lot of that has to do with the fact that your shoulder is not a weight bearing joint, but it still seems to be an easier time.

I’m glad you signed up for the study and hope you will have the time to post updates on how that goes along with your recovery. I was especially interested in the water therapy. That’s not something I’ve heard before as part of the shoulder recovery protocol and I’m interested in exactly what they will have you do. It sounds very positive.
 
Four weeks post procedure ……doing great. Experience some stiffness with some muscular discomfort in my arm and upper shoulder. Believe that is from inactivity for these muscle groups. It is amazing how fast atrophy occurs. My biggest issue at this point is to not “over use” my left arm.

I have completed two weeks of rehab (three sessions per week) using aquatic therapy at Sterling Ridge Orthopedics in the Woodlands, founded by my sports medicine physician. Have known him since “god was a child”……literally since he started to practice orthopedics over 40 years ago. Sterling Ridge was one of the facilities recommended by Edwards for physical therapy. Interestingly, the head of their physical therapy section is my physical therapist from when I did rehab on my knees in 2008 and 2009, and then my hip in 2013.

The water therapy is interesting. I have a list of eight exercises provided by Edwards. He stressed there should not be any movements or exercises with resistance at this point. His rehab instructions state very firmly….”NO RESISTANCE WITHOUT APPROVAL FROM DR EDWARDS”. Doing the rehab in the water allows great range of motion exercises but greatly limits the resistance. Sterling Ridge has extensive experience with physical therapy for Edwards cases. My physical therapy session includes about 12 exercises, ending with passive range of motion movements by the therapist with shoulder and arm massages (these are performed while floating horizontally in the water).

My next appointment with Edwards is April 8. Anticipate that my rehab after that appointment will move to non-aquatic therapy. My physical therapist has told me that she anticipates I will have minimal weight restrictions once I am completely healed (~six months).

I will be extrememly pleased if the dread I had for so many years for the physical limits a shoulder replacement would cause me is moot!!
 
It sounds like you’re well on your way. I believe you will be pleasantly surprised at how well your shoulder functions for you once healed. Of my four replacements (2 knees, 1 hip, 1 shoulder), the shoulder is the one that I never even think of as I go about my life.
 
@Jayhawk I agree with @Jamie As time goes along, the twinges and stiffness get less and less until you really don’t think about it anymore.

When I got clearance, my surgeon loved that my exercise of choice was swimming. Nothing too extreme and let my body’s response be my guide. I think it really helped the rehab along and was a solid return to normal function and ROM. At first, I had this painless “clunk” around my shoulder blade when I did back stroke. The OS wasn’t concerned and thought it would disappear as the shoulder continued to heal. He was right and just before that year mark, it was completely gone.

My trepidation prior to surgery was tempered by the pain I was experiencing. I am so thankful for the medical miracle of joint replacement and the docs that do them. I am still amazed at how easy I can do things again without much thought. Color me forever grateful. Continued healing blessings to you.
 
Met with Edwards last week….six weeks post procedure.

He was impressed with my level of progress and stated I was well ahead of the recovery curve. As a result, I can now hold up to ten pounds with my arm and have no range of motion restrictions. However, he also cautioned me to be patient and not push the envelope aggressively. If I should tear or detach the sub capsularis tendon, it could result in another surgery to repair or possibly even a shoulder revision………stated “you do not want either to happen”. He said it takes upwards of three months for full recovery, and does not want me to resume full resistance-training until six months.

Even though my tendency would be to approach rehab as aggressively as possible…….he has convinced me to be patient!!!

I basically have no pain. Only experience some minor discomfort in my upper arm…..apparently where I had a tear in my bicep. My range of motion is significantly improved.

I see him again in two months.

Physical therapy continues three times per week. They are very experienced with shoulder replacement rehab. The exercises are primarily for range of motion with very moderate strength improvement. While they have increased the level of exercise significantly…..it is still BORING!

I understand and have accepted!

Edwards has authorized eight more weeks (24 sessions) of physical therapy. However, he said that based on my progress will most likely not require that long. To be determined by the physical therapists.

I have also returned to the gym with my trainer. It is astonishing how quickly muscle atrophy occurs at my age!! Even though I am restricted with my left arm…..working on cardio and core.

I believe my level of recovery at this point is primarily due to the selection of a superiorly expert physician. But give some credit to my personal trainer, who came to the conclusion that even though I was adamantly opposed to a shoulder replacement, it was going to be in evitable. For the past six months his exercise regime for me included a focus on strengthening of my shoulder……told me that improved condition of my shoulder would result in a better recovery.

I told Edwards that if the final outcome of my shoulder replacement is as positive as the first six weeks…….I will be extremely satisfied.
 
An incredible update to read on the forum early this morning, Jayhawk. Glad you're doing so well. Thanks for sharing your progress! I imagine it's taken patience, hard work, and commitment. You're blessed to be surrounded by a good team which can make a big difference in recovery. You're definitely moving in the right direction.
Best wishes as you continue the journey! :thumb:
@Jayhawk
 
What a great report, @Jayhawk. Glad to read that you have permission to get back to the gym -- but don't forget to exercise that Patience Muscle too. :wink:

We are often asked by new members how recovery from shoulder replacement compares with knee and/or hip. I know it's been a few years, but -- since you've now had all three -- we'd love it if you would share your thoughts on this topic when you have a chance.

Wishing you a continued smooth recovery.
 
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