Monday, November 29, 2010

Right shoulder surgery...

Pre-op action

On Wednesday, November 17th, Allison and I made the hour-long drive up to Taos so I could have my right torn rotator cuff repaired by Dr. Guttmann of Taos Ortho. It's now 12 days later and I wanted to write about my experience so I don't forget details about my recovery. And perhaps this information will help others going through a similar procedure get a better idea of what to expect.

The surgery itself took about three hours and went smoothly. Guttmann cleaned up a bone spur on my humerus, cleaned up some roughage on my labrum (apparently I may have dislocated my shoulder at some point but I don't ever recall doing so), repaired the tear in my subscapularis and ended up doing a biceps tenodesis (cut the normal attachment of the biceps tendon on the shoulder socket and reattached the tendon to the bone of the humerus taking the pressure off the labrum and ultimately making the shoulder stronger.) Guttmann found that I am missing a tendon in my shoulder that most everyone has. This helps explain why both my shoulders are injured (I have a SLAP tear, incurred in spring 2009, in my left shoulder that I haven't had repaired, yet...)

As you might expect, this operation was pretty painful. Allison drove me home that afternoon as I was in a stupor with a completely numb right shoulder and arm--I had received a nerve-block shot prior to surgery which lasted until 1:30am the next day. For the first 3 nights post-op I took the prescribed amount of percocet throughout the day and night along with an Ambien sleep aid at night. But these drugs, especially the percocet, made me feel odd as well as made me urinate A LOT. So I stopped taking them as soon as possible. By Saturday, I was done with them.

The first few nights of sleeping were not very good. I had to sleep in the shoulder sling they sent me home in. That involved sleeping propped up a bit and meant I had to stay on my back all night. I'm more of a back-sleeper anyway, so that part didn't bother me but not being able to roll to my side was tough. I wore the shoulder sling all night, every night, for a week after the surgery. After that, I started sleeping with it off but with a bank of pillows to my right so I wouldn't be tempted to roll over on to it. So far, that has been working great.

It was suggested I wear the sling as much as possible during waking hours for six weeks. But after six days, I felt confident in my arm's range of motion, the very little strength that had returned and my ability to protect it well and I pretty much stopped wearing the sling. I still wore a bit here and there for a couple more days but I've found I'm pretty cognizant of my arm's ability and whereabouts and I can keep it relaxed and reasonably safe sans sling.

The day after surgery I began doing the self-PT that was prescribed by Guttmann. That meant taking the arm out of the sling, straightening my arm while it was supported by my other arm, lifting the arm to 90 degrees (perpendicular to my chest) and holding it there for 20 seconds. I was quite surprised at how soon after the surgery I regained that range of motion. The arm was completely weak and couldn't support itself but with the assistance of my other arm I could hold my arm at 90 degrees for 40+ seconds at time. Roughly a week out of surgery I was able to lift it to ~120 degrees and now, at 12 days post-op, I'm able to lift it to ~150 degrees and hold for a minute. It's a bit uncomfortable, especially during the first lift of a set, but I don't feel like I'm straining it much. I've also been doing no-weight, but unassisted, bicep curls with no pain. My bicep muscle feels like it's been punched really hard by some big, tough guy, but doesn't have shooting pain. In a couple days I got to my first real physical therapy session so I hope to get a feel for where I'm at in my bigger scheme of things.

Other random indicators of return of range of movement. I was able to type with both hands about three days after the surgery. 10 days post-op I was able to wipe my ass and brush my teeth using my right arm. That's a good thing because neither orifice was getting as clean as it should have been getting. 11 days post-op I could hoist my arm up the steering wheel of my car and drive for a while with my arm outstretched. I still haven't operated the column shifter of my automatic Honda CR-V with my right arm yet, but feel I'm close.

And now, some photos...

Passive arm-lifts 12 days post-op