Monday, December 29, 2014

So you're thinking about getting shoulder surgery

My story:

It's early spring of 2013, still cold outside, but supposedly the right time for trimming my crape myrtles. The more tired I am, the lazier I get, and not wanting to move the ladder again, reached too far out to the right and tugging on the loppers, felt a stinging pain shoot up through the middle of my shoulder.

Fast forward 18 months, and the stinging pain came and left and came and left, and ended up worse than at the start. Any kind of backhand, tennis, racquetball, ping-pong -- all hurt and made it worse. Time to do something.

Options: (1) Do nothing, (2) Physical therapy, (3) Surgery.

Tried PT exercises for a month or so but didn't change much, so I went in for a consult with the orthopaedic surgeon. Dr. says, "Do nothing isn't a good option, you probably have bone spurs that are tearing on your rotator cuff. Physical therapy at this point might help, but surgery is the fix."

So, I get signed up for:
  1. SAD (sub-acromial decompression), and
  2. ACJR (AC joint resection)

... with no rotator cuff repair required.

Great! What does recovery look like? "Oh, you'll be able to type the next day. But I wouldn't swing a golf club for 4-6 weeks."

Surgery was done on Dec. 12, 2014. No muscles or ligaments needed repair, but there was indeed a bone spur starting to tear at my rotator cuff, so the surgery was timely.

Arthroscopic surgery sounds amazing, tiny holes to allow thin tubes in with cameras and tools. But here's what I didn't know, and he didn't tell me:
  • Seeing around in your shoulder is cool, but there's no space in there, you know, to look around -- so, they end up pumping your shoulder full of saline, which blows it up like a balloon. Your rotator cuff muscles really don't like that.
  • I went in thinking that it wasn't going to be too painful. In fact I told the anesthesiologist, "So, when I wake up I'm going to feel like somebody punched me in the shoulder, right?" He turned, "Uh -- well, it'll be worse. Much worse." He was right. In fact, for the first week or so it felt like I'd gotten hit with one of these:Bat and nails
  • I had to have 3-4 weeks of physical therapy, 2 to 3 times a week. That doesn't sound like a lot, but it's a lot if you're not expecting any. And 4 times 3 times $40 copays is almost $500, plus a lot of time.
  • The nerve block was creepy, a gigantic needle stuck down through my neck. I don't really remember it much, though, because they put something in my IV that really knocked me "out of it". I remember when they tried to move me I thought my arm was on my side, but someone was holding it up in the air, and I was stunned to see my arm being held up in the air. It stayed numb for a day or two.
  • If you've had surgery before, you know what to expect, but I didn't. Coming out of anesthesia I was really nauseous, and had to stay for a few hours with them trying different anti-nausea medicines. Yuck. Anesthesia is weird, time flies quickly, and I was really dizzy -- for about a day I could barely move around without feeling like I was going to fall down.
  • I was given oxycodone, and a strong anti-inflammatory. I don't know why oxycodone is considered addictive, it was horrible -- I'd start itching like crazy, get super dizzy, and crash asleep. Then I'd wake up a few hours later with horrible shoulder pain. Maybe that's how it works, but I wasn't a fan.
  • They also gave me an anti-biotic. I started taking it, but stopped after a day because I was getting stomachaches, and I've grown attached to my micro-biome and didn't want to mess with it if I didn't have to. At my follow up with the Dr., I admitted I stopped taking everything about 36 hours after surgery and he said it was fine. He had told me that he does 600 of these surgeries a year, and said, "I've never had an infection in any of my patients -- there's too much fluid being pumped through there for any bacteria to get in and stay." I may have suffered a little more than I needed to, though.
  • Mattress stitches are weird and itchy. Ignore the blood, that was just from pulling off the bandages.IMG 7693
  • I was able to go to work the next Monday, but it's best if your boss/coworkers let you take it easy for a few days.
  • Dr. said I needed to move my arm through its range of motion, and I had my kids help me with that. Going very slow at first, that really helped keep my mobility up.

It's now been a little over two weeks, and aside from a little stiffness and pain when I move it through certain positions, it's a lot better. There are some motions that I can do now that I just couldn't do before the surgery, so that's awesome.IMG 7711

All said, as long as you know what you're getting into, I recommend the surgery. If you're in North Alabama and looking for a surgeon, Dr. John Greco is very efficient and patient, and knows exactly what he's doing.

I'll post an update in a couple months.

UPDATE: It's now been 6 months since the surgery, and I almost never notice my shoulder. There are a few ways I can move it that seem a little off, but I think it's finally back to good. =)

If you're curious, it hurt pretty badly for about 4 months after surgery. I thought it would be 90% better in 3 weeks, but it was more like 25% in 3 weeks, 50% in 2 months. 60% at 3 months, 70% at 4 months, 80% at 5 months, and then seemed to stop hurting almost overnight at 5-1/2 months.

Sleeping was the worst, by the way. I ended up sleeping on a 4" foam pad on the floor, on a mountain of hard, decorative pillows. They seemed to support me just the right way... I'd sleep on my right side (affected shoulder down), with pillows under my torso and under my neck, and another under my right forearm which kept it from hanging down and pulling on my shoulder.

The doctor said as long as I could move my arm from a raised position (right arm equivalent of the bicycle "right turn" signal), down to the lowered position (right arm equivalent of the bicycle "stop" signal), things would be okay. So I had my daughters move my arm through that rotation. The first rep. always hurt pretty bad, but loosened up as we went through the reps.

I felt like the physical therapy exercises were the key. I hung hooks in my closet at shoulder and waist height, and hung the stretch bands from them. It hurt to do the exercises, but not doing them was worse. So I shot for about a "2" or "3" out of 10 on the pain scale when doing them. Sometimes that meant just moving my arm through the motion without pulling the stretch band. But it helped.

Hope that helps someone!

Does anyone read this thing?

views since Feb. 9, 2008