cuts like a knife! {shoulder surgery][updated]

Maguano

So I've been having shoulder pain for a good 9 months. 2 cortisone shots later, and still no relief, my ortho has suggested surgery. his diagnosis is inpingement syndrome, with a possible labrum tear. The MRI (no contrast) didn't show any tears, but did show some bicep abnormalities (read, im 40, and have 40 years or wear and tear on the shoulder).
I've had knee and elbow surgery before, and being in PT, i've seen people come in after similar surgeries.
question to you all: Has anyone else been through this, and honestly how bad does it suck? My doc said i'd be in a sling for 4 weeks, initially, (the first 2 weeks, will evoke thoughts of "why the hell did i do this) 4-8 weeks will be sling as needed, but no strength in the shoulder. "full" strength should be back in about 12 weeks.
Is this a fair assessment?

I do QA (software) for a living, is it feasible for me to (if feeling OK) to work, as long as i can keep the mousework at desk level, keeping my shoulder relatively still? ( i can get disability, but its only 60%)

other pertinent info:
its my right shoulder
i have 2 kids under the age of 7
The last time i had surgery (ulnar nerve decompression: think carpal tunnel, but in your elbow) i was laid off 8 months later, along with the 2 other people that had gone out on disability. (weird, huh?)

So, if anyone has gone through with this type of surgery, is it worth it?

TheCapn

I tore my labrum when I was 20 or so. Doctor did not even do an MRI as he said MRIs were not good at showing tears there. They ended up removing a nice sized piece of it. Prior to surgery, it only hurt when I threw(tore it playing baseball).

I was only in a sling for 4-5 days(which was a day or two longer than they suggested). Strength wise, I went back to doing regular things pretty quickly. It did take me 6 months of rehab to get back into throwing shape for baseball.

psyck0

What procedure are you having, exactly? Are they doing a rotator cuff repair, or an acromioplasty, or something else?

Septus

I've got joint laxity all through my arms giving me mild pain daily, and I think due to computer work, my right shoulder had it the worst, and it sounds like the surgery I had might have been similar to what you're looking at. Specifically, I had a contrasted MRI show a small labrum tear. I do have som nerve problems, but so far, physical therapy to massage my pecs has been enough to loosen up the nerve running under them.

So I had the surgery to repair the tear, and while they were in there, they also tightened up the ligaments by drilling some anchors into the bone and looping little fasteners around the ligament(or tendon, I always forget) to pull them more tightly against the bone. So it's possible that my surgery would have some more recovery time, though I think they'd be generally comparable.

I'm pretty sure I was in a sling for four weeks, and didnt drive for two, but I was only out of work for one. This worked because this last job was terrible and I didn't do much, it'd be much tougher right now. I could actually type awkwardly with the sling on, it's just not something I'd want I be doing for 8 or 9 hours without breaks.

The first week definitely sucked, I was bored out of my mind, going to the bathroom was a challenge, as was dressing myself(I basically didn't wear a shirt for that week), but most of the hassle was gone after two weeks and I was driving again.

Maguano

@psyck0, he's leaning towards acromiplasty, (as there is no apparent tear, but the Biceps tendon did show significant signs of inflammation in the MRI (2 months ago) that seems to have somewhat subsided, but any overhead motion sucks.)and then tightening up the loose ends similar to what @Septus is talking about. Fairly certain that in addition to getting old, i aggravated the situation by bring my son's baseball coach for 3 seasons (coach pitch, so basically repetitive stress syndrome in the shoulder.. 12 kids, anywhere from 3 to 8 pitches per kid, for 3 inninngs 2-3 times a week, granted, not hard pitches at all, but the motion adds up)

mts

I had surgery a couple years ago to fix my shoulder, torn labrum from about 3 o'clock to 9 o'clock, with impingement etc. I was in a sling for about 6 weeks, out of work for 2. Honestly the hardest thing was sleeping but I just created a pillow nest and it worked out. Important thing is follow your exercises and be good with therapy. That will aid recovery

Donovan Puppyfucker

If you need shoulder surgery, just get it done as soon as you can. The problem is only going to get worse over time, and the longer you wait, the more pain and lack of usage you have to suffer.

Don't be like my Mother, she's needed knee reconstructions for decades. and it's getting to the point where not only does she have trouble walking any more (she's only in her mid fifties and she hobbles around like an octogenarian), her body naturally trying to work around the damage and pain has resulted in unusual loads and wear patterns in other joints, and now she also needs two hip replacements...

Maguano

thanks everyone. gt my (tentative) date 2/13. Now i just need to figure out how I'm going to get my 1 son to day care and my other to school, all the while getting myself to PT for the 2 weeks I'm not supposed to drive (i'm right handed, getting my right shoulder done)

zagdrob

I had a similar surgery about six years ago. I'd torn my capsule and suffered epileptic seizures that would cause my shoulder to dislocate. Eventually it got to the point that my shoulder would dislocate changing shirts or reaching for groceries.

The surgery was pretty standard, once the nerve block wore off my shoulder hurt like hell - couldn't sleep / get comfortable, popping vicodin for a day or two, but after that the pain went away pretty quickly and I was mostly back to normal after a week. My arm was immobilized / in a sling for eight weeks or so, but I was able to adapt pretty well to typing / mousing with one hand. It wasn't that big of a deal, although my right arm was immobilized and I'm left handed so your results may vary.

No real suggestions for how to get your kids to daycare / drive. My wife (girlfriend at the time) did most of the driving while I was wearing the sling (although I had an automatic so it wasn't a big deal to drive) and we didn't have kids, so it might be something tricky that you need to adjust to or get help with. At least during the first week, I was taking enough pain killers that I wouldn't be comfortable driving (especially with my kids).

Do you have a friend / family member who can help you around during that time?

mts

Maguano wrote: »

thanks everyone. gt my (tentative) date 2/13. Now i just need to figure out how I'm going to get my 1 son to day care and my other to school, all the while getting myself to PT for the 2 weeks I'm not supposed to drive (i'm right handed, getting my right shoulder done)

actually once you are off the pain meds you should be able to drive. my doctor cleared me for it once i had some rom back. he just said to take off my sling for liability sake

Pinfeldorf

An acromioplasty is no big deal, even with a debridement. You may never regain full function of your shoulder (not a big deal. You may not be able to lift anything above 5lbs overhead or swing a golf club right, for example), or you may be up to 100% in as little as 20 weeks. Regaining strength is a top priority, which means getting it done ASAP is the best situation to be in. Letting atrophy kick in pre-surgery due to guarding is terrible. Status post surgery, close car doors with your left arm. You will be utterly shocked at the pain the first time you go to close a car door from the outside with your surgical arm. Stick to every regimen your surgeon and PT give you, and ideally you can avoid an RCR or TSA in the future.

Maguano

just found out my FiL is available to be my nurse. (yay) so here's the official diagnosis they are using for getting insurance approval, i assume its standard boiler plate? my diagnosis is: right shoulder impingement syndrome, possible rotator cuff tear, possible superior labral anterior posterior lesion. I've read enough about SLAP tears, but this is the first time i've heard him mention it. is it so insurance knows about it to pre approve treatment, in case he goes in and sees a world of crap?

psyck0

http://www.uptodate.com/contents/rotator-cuff-tendinitis-and-tear-beyond-the-basics?source=search_result&search=rotator+cuff+tear&selectedTitle=1~3

http://www.uptodate.com/contents/shoulder-impingement-syndrome-beyond-the-basics?source=search_result&search=rotator+cuff+tear&selectedTitle=2~3

Some reading about the conditions for you, in case you have any questions.

I had a shoulder surgery, but not yours. Full recovery was about 6-8 months. The worst part was learning to sleep with a sling and in a new position. Just don't skip out on your physio!

Windburn

Based on what you have said and the questions you are asking, I'm not sure if your orthopaedic surgeon has explained what he is doing very well.

Your surgery is first and foremost a "diagnostic arthroscopy." This means that you are having pain, it is unclear why, and so they are going in to look around. All the ICD-9 codes listed for your surgery are possibilities because insurance doesn't cover fishing expeditions. That's not to say it's inappropriate. You should just be clear that this is what is being done. Your questions then about recovery expectations vary tremendously based on what procedure is actually done. If it's just a chondroplasty, you will be back in a matter of days. If it's a full-thickness rotator cuff repair with acromioplasty and subacromial decompression, you're looking at 3-6 months (sometimes up to a year).

I am a little concerned that you didn't receive relief from your shoulder injections. Do you know if they included both lidocaine (or similar) and steroid? These injections are both diagnostic and therapeutic. If the source of your pain is inside your shoulder, the numbing agent should provide temporary relief (even if only for 15 minutes or so). If it didn't help at all, I worry that either the injection missed (studies have shown that even in experienced hands this can happen) or that your problem isn't in your shoulder. Also, impingement syndrome is not technically in the shoulder, but in the subacromial space. This area can also be injected. Was this done so? Did you have any relief from it?

Lankysean

I'm going in for shoulder surgery on 2/19 for what seems like similar issues. I hope it goes well, I'm nervous as hell about the whole thing.

Maguano

@Windburn, yes the shots (yes they were "combo" shots) did provide temporary relief (the first one was for about 2 days) and the second was for about 2.5-3 weeks. After the second the pain is considerably less, but not what they think it should be. Oh, both shots were in the roof of the shoulder, (given in the back right by my shoulder blade... not sure what this space is technically)

Windburn

Ok, good. Hopefully the scope shows a minor "wear-and-tear" type problem that you'll bounce right back from. Fortunately, it sounds like you have pretty low demands on your shoulder (you're not a professional athlete, over-head laborer, etc), so you should do well. The good news is you should feel better from the scope alone, even if nothing significant is found/done. Patients that have participated in blinded studies that included sham surgeries, where a scope was placed into the joint and looked around (basically a diagnostic scope) then removed, reported pain relief post-op. It is theorized that the irrigation of the joint during the surgery is therapeutic.

As to the location of your injection, both shoulder and subacromial injections are done from the back. In fact, they tend to be done from exactly the same skin point. You just aim up for the subacromial and (more-or-less) straight ahead from the shoulder.

Maguano

thanks!

Maguano

today (in the snowstorm was my surgery) turns out it was a small rotator cuff and small SLAP tear. nerve block given at 7 AM just starting to wear off. time for the real pain meds. thanks all!

Lankysean

Maguano wrote: »

today (in the snowstorm was my surgery) turns out it was a small rotator cuff and small SLAP tear. nerve block given at 7 AM just starting to wear off. time for the real pain meds. thanks all!

I hope it went well, keep us posted on your progress. I'm going under the knife on Wednesday so I'm very interested in literally everything you feel like sharing.

Maguano

good luck. if you don't have a recliner, i suggest going and buy/rent/steal one. sleeping on a bed is impossible. if its your dominant arm, i suggest starting now practicing things with your off hand. pain is semi tolerable, as long as you keep ahead of it. i napped through pill time and woke up in a world of hurt.

Lankysean

Maguano wrote: »

good luck. if you don't have a recliner, i suggest going and buy/rent/steal one. sleeping on a bed is impossible. if its your dominant arm, i suggest starting now practicing things with your off hand. pain is semi tolerable, as long as you keep ahead of it. i napped through pill time and woke up in a world of hurt.

Luckily we do have a recliner but I don't generally sleep on my back so I suppose there will be some adjustment needed. It's my dominant arm but it's been in such shoddy shape for so long that I've been becoming ambidextrous over the years. How long did the nerve block last? Did you take your first set of pain meds before then?

Thanks again for the advice.

Maguano

The nerve block lasted about 12 hours before starting to wear off. i wasn't able to get the pain pump, as they nicked a vein while giving me the block. i started taking my meds about an hour before they said the block would last.
Sleeping in the recliner took a bit of adjusting as well, since i normally sleep on my right side.

mts

what i did was use a boyfriend pillow . the ones that have the arms and you cna sit up against. used that to form a nest with a ton of pillows to prop me up and my arm. worked ok
one thing you want to keep in mind is your arm might swell a lot of fluid etc, just ice it to keep ahead of it. also do your exercises as prescribed.

Frei

I got shot in the shoulder years ago and had a fairly long recovery time - in regards to sleeping, the pillow fort situation in your bed is definitely a good idea. you can prop yourself up and still have your shoulder supported/safe. it takes some work but it's worth it. if you usually toss and turn a lot, well, kiss that goodbye. just have to get used to it. and yeah, definitely don't miss even one session of your physical therapy because freezing up is a big issue. don't be afraid to ask your doc for alternative pain meds if you need them and alternating hot/cold helped me a lot, too.

Lankysean

I had my operation today, the nerve block is just starting to wear off so we'll see how it goes. My biggest complaint is my chest and stomach are hurting from the arthroscopy fluid build up, that and nausea. I took a good nap on the recliner before but it will take a big adjustment for sure, i may try the bed fort tonight.. thanks for all the advice!

mts

Just stay on top of the pain, it's easier to manage if you don't have to start from scratch.

Dr. Frenchenstein

yeah, that's why it's called pain management. you're not supposed to take a pill, wait for the pain to surface, and then take another. it's totally worth it to set an alarm, wake up and take a pill, go back to sleep. when i was on them, i couldn't sleep for more than 2 hours at a time, so i never had an issue. I also woke up completely spatially disoriented (i felt like i had fallen out of bed EVERY DAMN TIME). i honestly do not know how people get addicted to that shit.

watch out for the nausea, some people just get sick from pain killers. i don't know if you've sneezed yet, but vomiting when you are recovering from some sort of surgery makes a full body muscle spasm feel like a soft hug.

Lankysean

I've been setting an alarm for my pills, nausea has been moderate but i got pills for that so it's all under control. I'm currently in very little pain and in a good mood from my pain pills... i'm off to watch cartoons lol.