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Standard Shoulder Replacement The Journey Begins

PapaJeff

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I am just beginning my post-op life. 5 days ago, I had TSR on my left (dominant) arm. The biggest problem right now is the helplessness. I stayed with my daughter for the first few days. But now I'm back home, where I live alone.

How long does the post-op depression last? Did anyone else feel like it may have been a mistake getting surgery? I know it's too early to expect anything other than pain and discomfort. I thought I had a pretty high tolerance for pain. I guess not.
 

djklaugh

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@PapaJeff Welcome to BoneSmart! Depression after having major surgery is quite common. And there are many contributing factors - sleep problems, side effects of pain medication, pain itself, frustration over physical limitations, etc. And it is normal to feel the frustration particularly when it is your dominant arm that got the replacement (been there, done that, got the scar to prove it). But usually this phase of recuperation passes fairly quickly.

I am guessing you are still wearing a sling for the operated on arm -- and that does restrict your movements. Once you are no longer wearing that (do follow your surgeon's instructions!) physical therapy will begin and you will find things getting easier. Depending on how long that arm was dysfunctional it can take a while - up to 6-7 months or longer for some folks - for the arm to get back to full functionality.

Hard as it is to hear and do patience is a real asset right now. Do you have friends/family/neighbors who are stopping by to see you? While recuperating alone is very possible it does help to have others around at least part of the time. Also major surgery takes a lot of energy to heal from! So expect to feel fatigued and in need of daytime naps for a while.

For me having had both shoulders replaced I have not regretted having either surgery! I now can do anything that needs doing without pain or restriction of motion. One new shoulder is 10 years old and the other is 6 years old.

You mentioned that your surgery was 5 days ago ... on February 15 - is that correct? We will make a signature for you. Do feel free to read any/all threads in this section to see how others have managed. And do ask any questions you have!
 

CricketHip

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I think many of us questioned our decisions.. mine were more frequent before surgery. After surgery I had one goal and that was to take care of myself to heal as well as possible.
The post op depression is real, pain plays a big factor in this.
I have two friends with bi lateral TSR's and from what they have said, that first week or so is tough in the helplessness department. Than after that things begin to improve.
You will get through this, it's just a moment you are going through.
As for the pain, are you medicated enough? You can call your surgeon's office to inquire about that.
That's what his team is there for.

I'd love to leave your some recovery articles. I think you will find some helpful advice, especially this first one on pain control

aflagsforworship.co.uk_jo_pic_images_painheaja.jpg

In other words, it's not so much that pain causes swelling but that the after effects of surgery is swelling as the after effects of any trauma to the tissues is swelling. So you have a double causative effect (otherwise known as a vicious circle!) going on: the surgery causes pain and swelling; the swelling causes compression and stiffness which results in more pain; the increase in pain causes more swelling and stiffness - what has so eloquently been described as "angry tissues"! All of this hinders recovery.


Stopping the cycle:
So to stop this cycle, you need first of all to treat the pain with appropriate medications and ice. With the pain under control, you can set about getting the swelling down by with rest, ice and elevation. When that is improving, those negative hormones will not be produced in such quantities and your mood will improve. Then you get the ultimate feel-good factor as endorphins start being produced, nature's own pain killers, which eventually will help you to start going longer between doses.

But in the early days you need to bear in mind is that if you leave too long a gap between doses, then the medication takes longer to work during which period the pain continues to get worse. I defined this in this graph

aflagsforworship.co.uk_jo_pic_images_paincheve.jpg

So you can see that pain meds don't hinder healing but the results of pain being inadequately managed will. Therefore, doctors who are urging their patients to get off pain meds early are actually defeating the object of their surgery.

The biggest issue in the US seems to be that of addiction and often times members have posted their concerns and their doctors concerns about this.

DEPENDENCE IS NOT ADDICTION
Now it should be noted it is possible for the body to become accustomed to the presence of a medication but this is a long way from an addiction. Addiction is taking a medication when there is no pain, in other words, purely for recreational use. Being accustomed to the drug, or having a dependency, just means that the individual needs to wean themselves off the medication over a period of weeks in order to avoid the 'withdrawal' symptoms. Provided this is done gradually, there should be no difficulties and certainly no lasting effects akin to addiction. But tailing off the pills is not something you need to dwell upon. You will find yourself naturally leaving longer gaps between doses, not because you plan to but because you don't have the pain to remind you to take them. Just do remember, you're not going to get addicted or become a pill junky because of taking a few pain killers for 3-4 months. Research has shown that this just doesn't happen when the meds are being taken for genuine pain.

However, if you should find yourself scouring the internet looking for ways to get the pills without going to your doctor or even considering buying them from a contact, then you are probably becoming addicted! But the incidence of that happening is extremely small! In fact, research has shown that people really getting addicted to pain meds where there is genuine pain, is about less than 3 people in every 1,000

Myth busting: on getting addicted to pain meds
 

CricketHip

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Post op blues is feeling depressed, weepy, nervy, shaky, fearful of the future, anxious, overwhelmed by what is happening to you, convinced it's never going to get any better and finally, uttering that most intense of all cries "I wish I never had this done!"

It arises out of a variety of things that have happened and are still happening to you including

~ the shock of learning you need major surgery and getting acclimatised to it
~ the anxiety in the lead up to pre-op and then the surgery itself
~ physical shock of the 'assault' of surgery (think of what it's like to be mugged!!)
~ intense attention in hospital, people all around you, able to call on anyone at a moment's notice, strong support structure
~ the pain, swelling and everything else that comes with it
~ loss of privacy and independence
~ medications which actually cause a lot of chemical, emotional and physiological changes in your body
~ on discharge from hospital, loss of the supportive infrastructure upon which you had subtly become dependent
~ the loss of your normal way of life, inability to fend for yourself, shop, clean, prepare meals, etc., etc.
~ loss of confidence in normal daily activities like walking around your own home, even going to the bathroom or taking a shower
~ feeling confined, even trapped because you can't go out or even get around the house as freely as you used to
~ loss of interaction with your usual sphere of society
~ anxiety about how long all this will last

So if you find yourself suddenly bursting into tears for no real reason, feeling frustrated by the inactivity, having 'cabin-fever' or feeling like the sword of Damocles is hanging over your head - it's just part of the process and like everything else, it will pass. You have my word on it!

amembers-westnet-com-au_j-strover_images_damocles-jpg.38462
 

CricketHip

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And... last but not least, a very good article about icing the surgical sight regularly. Or anywhere that is swollen and or painful. This one is a link. Just click on it below. I wish you the best and you will get through this and be smiling soon.

 

Mikem132

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How long does the post-op depression last? Did anyone else feel like it may have been a mistake getting surgery? I know it's too early to expect anything other than pain and discomfort. I thought I had a pretty high tolerance for pain. I guess not.
I was not depressed. In fact, leading up to the surgery I was excited to begin improving rather than getting worse over time. Maybe because I had no serious pain I had a better attitude. I am a very driven person and almost immediately began to try to do things for myself. I could get dressed after a couple days (shoes were an issue longer). My wife helped a tremndous amount and still drives me places.
I hope you can look at your situation as the beginning of recovery instead of continuation of deterioration. It begins to get better pretty quickly. Others have told me the pain in the beginning is bad but after a week or so it's mostly over. Do you have ice, an ice machine or something? I got one. It helped in the beginning with pain (although I still don't think I got the full experience).
I think you did a smart thing coming on this group. Good luck, and you may be just a couple days away from losing most of the pain.
 

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