Rotator Cuff surgery tomorrow

[skyking]

Going in for an allograft repair of my left shoulder. It will be something like this, due to the size of the tears.

I will get the lowdown after Christmas at my post-op appointment.
She is talking 6 weeks of sling, 3 weeks of just chilling about, and then start with passive range of motion PT. Probably 4~5 months till I can return to limited work.

 

[Iron Woode]

Good luck, my friend! Physio will be a bitch, unfortunately.

I am still waiting for my referral appointment.

 

[highland145]

Breg cooler....ASAP

And best of.

 

[skyking]

Breg cooler....ASAP

And best of.

This doctor has moved away from those coolers. One of the nice things about the allograft surgery is greatly reduced pain. Since the tendons are so frayed and retracted there's no way to pull them back together. Therefore they're not mechanically manipulating all that tissue, it's more like slapping on a patch then waiting ......
The patch is a piece of decellularized dermal tissue,. I have the certificate for it, and a request to write an anonymous letter for the donor family.
I'm a donor of course, and I'll be happy to write this letter and I'll have plenty of time to do it.

 

[skyking]

Good luck, my friend! Physio will be a bitch, unfortunately.

I am still waiting for my referral appointment.

I already know what's coming. This is my second shoulder surgery of the year.

 

[skyking]

home chilling out and weaning off the opiods. it was quick last time so i expect about the same.

 

[skyking]

Saturday we discovered an un-sutured incision, not a really good feeling. What else did they forget? probably nothing, I keep telling myself.

 

[skyking]

the PA put some steri-strips on it, and advised against getting it wet. I was a model of restraint

 

[skyking]

I saw the surgeon yesterday and got a rundown on all the details. pretty fascinating ship in the bottle building she was doing in my shoulder.
The patch of donor tissue is fitted very carefully and she uses a knotted suture just like in that video to measure the spot. I have three pages of images to share of the surgery. After measuring she put some anchors in a couple of places and preloaded sutures, then rolled up the patch fit it through one of the incisions, and started putting it in place. She used the rasp on the bone to create a bleeding bone bed for the new tissue to grow to.
the donor tissue is a patch of skin from probably the donor's forearm. it has been de-cellularized, a process that removes about 90% of the DNA and therefore just about eliminates rejection. it is surprisingly tough and has to be cut with a scalpel, and also tough enough that she needed to change needles in the middle of the procedure because it was becoming dull.
She surprised both my wife and I by having me lift my arm up a little bit, and move it front and back a little bit.
we were also surprised that she wants to start my physical therapy middle of next month. I'm still looking at a six-month rehabilitation to full work, but that is likely to be adjusted.
She had a heck of a time getting one of my sutures out. She about needed to get some lidocaine. I didn't feel so bad but my wife said I was looking a little shaky.

 

[BoomerD]

I need repairs on both shoulders. Getting harder and harder to do things...and more painful. (pain is just weakness leaving the body...right?)

 

[skyking]

this doctor has such good outcomes I would have her look at you. honestly my first surgery was not that big a deal as far as recovery and therapy. In about five months I'll tell you about how this allograft worked. if your bones are good, it certainly provides a fix for old torn up shoulders.
in one of the images she had a hold of one of tendon fragments, and showed how far she could pull it which was almost nothing. It had retracted so far that you couldn't see the destination in the same picture.
by comparison she was able to pull all the tendons back together in my other shoulder.

 

[Muse]

I need repairs on both shoulders. Getting harder and harder to do things...and more painful. (pain is just weakness leaving the body...right?)

I had surgery on left shoulder about 2002. The highly regarded very experienced surgeon (quite possibly the best in northern California) didn't know what was wrong (although I'd had Xrays, MRI, PT, cortisone shots, physical exams), but offered arthroscopic surgery/analysis and cleaning up of whatever damage he'd encounter in there. Expectation was 3 days in sling, OK in a month. On waking they told me 30 days in sling, 6 months + recovery because they found a labrum tear (Type IV SLAP lesion), repaired it on the spot. They surveyed the rotator cuff subsequent to the repair, said it was perfect. The doctor furnished me with the video of the operation.

I had a lot of pain in the same shoulder about a year ago and got xrays and an MRI and got my doctor to refer me to my HMO's shoulder surgeon, who's friends with the doctor who did my surgery. He discouraged me from considering surgery and sent me to a physical therapist. She told me that they don't do surgery these days on the problem I had in 2002. Basically, surgery isn't a realistic option for the problem I've had. She was optimistic that with proper physical therapy techniques (principally using stretch bands), stretching and diminishing or at least temporarily stopping certain things I do in the gym, I could improve on or outright recover from my problems. I had been having a lot of trouble sleeping, being able to find positions in bed that weren't so painful I couldn't sleep. I'm a lot better now, can sleep decent most of the time, but I have to be careful of my positions in bed and how I change positions. It's better and worse. Should use the bands and stretching daily instead of 3 times a week in the gym!

 

[skyking]

I wish I was that fortunate. My tears were " large to massive full thickness supraspinatus and infraspinatus tear, SLAP tear, long head of biceps rupture with impingement, and Mild humeral head chondromalacia"
that shit was not going to heal itself

 

[CalebRockeT]

What sort of activities lead to your shoulders getting so beat up, skyking? I'm currently dealing with some shoulder issues (pain/reduced range of motion when internally rotating/adducting) and I'm wondering if I need to do more than just take a break from the gym and pay more attention to how I'm lifting at work.

 

[Muse]

I wish I was that fortunate. My tears were " large to massive full thickness supraspinatus and infraspinatus tear, SLAP tear, long head of biceps rupture with impingement, and Mild humeral head chondromalacia"
that shit was not going to heal itself

Yeah, the guy who operated on my shoulder back in 2002, when I had a followup appointment sometime later said I really needed to have that done. Yet my recent physical therapist, whose quite experienced, tells me they wouldn't operate now for that condition. The crazy thing, though, is that with all the appointments, treatment, xray, MRI, the doctor (whose generally regarded as the best shoulder surgeon in northern California, apparently) didn't know what was wrong UNTIL he went in there arthroscopically (and made the repairs on the spot). Recovery was a long slow process. After getting out of the sling (month?), PT appointments and slowly regained range of motion (at first was approximately none), then strength over many months with IIRC approximately weekly PT appointments with the person the doctor and his assistant recommended (quite experienced). The doctor had told me I'd be 100% in a year. I never felt like I'd achieved 100% recovery, but I was way better than before the surgery. It's hard to remember the syndrome though, just how much pain I'd had. How do you remember pain unless is 10/10 or something? I had stopped being able to do chinups though, which I could do eventually after the surgery. My PT told me to stop doing them early this year, though.

This from the operation report:

DATE OF OPERATION: 10/15/02, Tuesday

PREOPERATIVE DIAGNOSIS: Left shoulder rotator cuff impingement
syndrome.

POSTOPERATIVE DIAGNOSIS: Soft tissue impingement. Slap lesion type IV.

PROCEDURE: Left shoulder arthroscopy, arthroscopic repair of superior
labrum with suture anchors. Partial excision of a bucket handle superior
labrum tear and soft tissue subacromial decompression with partial release
of CA ligament and bursectomy. Chondral lesion anterior superior glenoid.
Limited microfracture anterior superior glenoid.

 

[Muse]

What sort of activities lead to your shoulders getting so beat up, skyking? I'm currently dealing with some shoulder issues (pain/reduced range of motion when internally rotating/adducting) and I'm wondering if I need to do more than just take a break from the gym and pay more attention to how I'm lifting at work.

See a GOOD physical therapist if you can. I got a referral ~9 months ago to 3 of them from my HMO's sole shoulder surgeon at my location. I picked the first PT he mentioned. The doctor had asked me what I hoped to achieve in seeing him. My immediate response was that I wanted to be able to sleep! That I HAVE achieved.

 

[skyking]

Mine was a high-speed bicycle fall. I got one pedal unclipped but not the other and then high-sided the wrong way. Your instincts tell you to reach out and that's not what you should do.

 

[Muse]

Mine was a high-speed bicycle fall. I got one pedal unclipped but not the other and then high-sided the wrong way. Your instincts tell you to reach out and that's not what you should do.

Can you please explain further? I ride bike a lot, a road bike, use toe clips. What exactly happened?

Edit: In my case, I can't trace my shoulder issues to an accident. I'd been a pretty devoted runner until 1985 when I couldn't run anymore because of intense pain in left foot, probably plantar fasciitis. Took up swimming and was soon 2 miles/day 7 days a week and not long after that in the gym 1.5 hours before the swim. 10 years of that and the pain in left shoulder one day told me to stop and get out. I'd just fought through any pain in the pool for years, always going fast as I could what with how I felt. I was the most devoted swimmer at the YMCA. But I suddenly couldn't swim anymore (crawl) and 7 years later, on COBRA, I had the surgery. What caused the labrum tear? Dunno. Maybe just repetitive motion with strain took its toll. Wasn't aware of an injury due to what I was doing in the weight room, but in retrospect I figure that could have been part of why my shoulder became screwed up. I wouldn't dare swim now, at least not with the attitude I had before. I was a feared man in the pool, I passed almost everybody. Took splits every 1/2 mile, kept a journal of my workouts and swims.

 

[skyking]

What sort of activities lead to your shoulders getting so beat up, skyking? I'm currently dealing with some shoulder issues (pain/reduced range of motion when internally rotating/adducting) and I'm wondering if I need to do more than just take a break from the gym and pay more attention to how I'm lifting at work.

as far as the beat up condition of my labrum, both shoulders showed wear and Tear from 35 years of work. I'm in my late 50s and worked in construction all my life. as a young man I split firewood, for example. Huge musculature, swinging an 8 pound maul. looking back I realize that you can do that for a while but the soft tissues really don't get any help. they just wear down.
I gained weight over several decades to the point that I was really looking at serious health issues.
I lost a whole bunch of weight and started going to the gym but I never was a gym rat before. I know for sure I hurt my shoulders by getting overzealous on some of the machines like the lat pull-downs. little micro tears, muscle pulls things like that.
Of course none of that really mattered when I fell. no amount of working out will help you when you think you're Lance Armstrong with two nuts, crossed with some freakish New York Bike messenger, but you're really 57 The falling thing really sucks.

 

[Iron Woode]

my friend has been diagnosed with calcium crystals forming in his shoulder/rotator cuff. He can barely move his arm without being in a lot of pain. It interferes with his sleep, work and everyday activities.

I feel very bad for him. I don't know what options he has.

 

[skyking]

let's hope his doctors have a solution. shoulders really do mess up a lot of things, sleep just being one of them.

 

[Muse]

let's hope his doctors have a solution. shoulders really do mess up a lot of things, sleep just being one of them.

The shoulder is by far the most complicated joint in the body. I see guys in the gym doing things I wouldn't dare do now. Sometimes I wonder if I should talk to them about it but I really don't. People sometimes look like they're in pain. I can relate. I've had guys tell me I'm doing something wrong in the gym. They always seem to know what they're talking about and I welcome any comments and try to learn from them. But I don't kid myself I'm as expert as a lot of those guys. I do know some stuff, though.

 

[herm0016]

damn. i'm trying to make an apt. to see an ortho and my health care company keeps screwing me around. either sublexed or rotator cuff i am thinking.

glad to here outcomes are pretty good.

 

[skyking]

The shoulder is by far the most complicated joint in the body. I see guys in the gym doing things I wouldn't dare do now. Sometimes I wonder if I should talk to them about it but I really don't. People sometimes look like they're in pain. I can relate. I've had guys tell me I'm doing something wrong in the gym. They always seem to know what they're talking about and I welcome any comments and try to learn from them. But I don't kid myself I'm as expert as a lot of those guys. I do know some stuff, though.

I think than any cautionary advice about backing off of some of these things when you observe somebody hurting, is truly the best criticism you could give. it really beats the alternative of giving advice to work even harder in the face of obvious discomfort. the soft tissue joints that we have in our body are the only ones we get. they say you can build up the musculature to support things, although that is true if the force is riding on these soft tissues, you're beating the heck out of them in the process.
I was experiencing classical left knee pain the last week or so of work before the surgery. A week and a half of ibuprofen and rest, and my knee felt great today! sometimes you have to listen to your body and let it have a rest. now I feel like I could go to the gym or ride a recumbent stationary bike.

 

[Muse]

damn. i'm trying to make an apt. to see an ortho and my health care company keeps screwing me around. either sublexed or rotator cuff i am thinking.

glad to here outcomes are pretty good.

I'll never forget my older brother's advice. He was a surgeon - vascular and general surgery. He'd had shoulder surgeries, arthroscopic and even an open shoulder surgery. I mean as a patient! He said "stay out of the orthopedist's office." I didn't question him concerning this advice but have thought about it from time to time. Now, my brother's son became a surgeon as well, with the specialties of his father. In fact, they had a practice together at one time. So, one day I asked my nephew about his father's advice and his reply was "yeah, and he (i.e. my brother) would be the first guy to head to the orthopedist's office." Nutty story, I know, but there's something in it.

OK, so the take away from this is that you can get into trouble with an orthopedic surgeon (i.e. orthopedic surgery). You should try to avoid having to see one!!! I figure there's two ways:

1. Don't do things that F-up your joints.
2. Rely on physical therapists instead of surgeons.

Be wary in some degree!

Yeah, and like skyking said, listen to your body!

My 2 cents.