This Shoulder Replacement Thing

All I knew is that I wanted the pain to stop.

I could find no comfortable position for my arm, so had test after test, which revealed that I had an un-fixable tear. The options were pain meds the rest of my life, or “reverse shoulder replacement.”

shoulder1

Invented in 1985 by a French surgeon, and only okayed for use by the US Food and Drug Aministration since 2003, this innovative surgery involves removing the ends of a couple of bones and attaching an artificial ball to the shoulder blade, and an artificial socket to the top of the arm bone. Titanium and highly crosslinked polyethylene glenoid component.

It also utilizes the deltoid muscle to take over for the ruined one. It entails repositioning the deltoid to lengthen it, then retraining it.

My deltoid is as old as I am. 

Surgery didn’t take long, only one night in the hospital. Until my blood pressure tanked, so had to stay a second night.

Checkup with the surgeon at two weeks. No stitches out; they’d dissolve. Doctor said to wean off wearing the sling. What freedom–I could type again!

Pac-Man

Isn’t it amazing how the human body begins to repair itself right after an injury–accidental or by scalpel? Platelets rush to the wound, bunching around it, attracting others to form a “plug.” I can imagine them hastening around like the characters in Pac-Man. Clotting proteins make threads of fibrin which weaves itself into a clot over that plug, making a seal. Awesome, huh!

Meanwhile I was just trying to “keep up with the pain,” and do everything I could with my other hand.

A week later, physical therapy began. I had no idea that it therapy would last months, maybe longer. That progress would be at a snail’s pace. That nine weeks out I’m still not allowed to lift anything heavier than a coffee cup.

Someone thought I should be back to “normal” before now, but this wasn’t shoulder repair, not the common shoulder replacement. It’s total reverse shoulder replacement.

Six Weeks Out

At my six weeks checkup, I asked the surgeon when I’d be able to reach behind my back with my right arm. “Maybe two to three years.” Think about struggling into a pair of jeans or slacks, trying to tuck in a shirt. Two or three years???

The first eight weeks of physical therapy have been a struggle, mainly because when the deltoid is unhappy the pain is so sharp, so wince-some. And it tended to stay unhappy the rest of the day.

Therapist Hunter was good to banter with me, while issuing warnings and realistic donts. He printed off a clinical commentary for me because I’d asked so many questions. Protocol for reverse total shoulder arthroplasty, filled with lots of big terms and acronyms. He made notes on it, and so did I. It will take me through twelve weeks.

At eight weeks, I could journal fairly well with my right hand, but not feed myself. It also couldn’t wash or fix my hair, lift a cake-pan sized dish into the oven, reach higher than my chin without help.

Nine Weeks Post-Op

But at nine weeks, it felt like I’d reaching some kind of tipping point. DPT Hunter began new passive range of motion positions with my arm/shoulder. After weeks of warnings mixed with encouragement, he was almost effusive about how far I’d come!

HunterHolemanDPT

Even though his only 30, the easy-going Hunter has herded more than a dozen people through therapy for the reverse replacement. He’s a people person and interacts with my stories, which helps him take the arm manipulation a little farther each time. He reads intellectual nonfiction for fun.

We’ve discussed everything from at what age is a person elderly to genealogy and spiritual gifts. His encouragement at this point feels like effective coaching, even cheerleading. Wow, does that help!

Physical therapy has been the best part of this experience, gaining support mentally and physically, as well as twice a week reassurance.

Yesterday, for the first time in months (couldn’t do it before surgery either), my right arm lifted a mug of coffee into the microwave (cupboard height), retrieved it, and carried it down the hall to my office. Yes, tears welled up.

Four more weeks, unless Covoid-19 restrictions prevent it. Several therapists have been deployed to hospitals. Two weeks ago, the therapists began wearing masks. Since last week we patients are.

Now with realistic optimism, I can do this! I might even thrive. . .

 

 

24 comments

  1. I need to share this with my puppy. He just had knee surgery on Friday and isn’t convinced that we’ve done him good. But, once it heals and, he’ll be back out there chasing everything that moves. I think lots of people skip the PT part of these things, thinking the exercises are dumb or too simple or not hard enough. But the PT docs know their stuff and it really makes the difference! Best wishes for a full recovery!

    • There’s even a doctor on YouTube that says you don’t need PT, just these simple movements at home! The gal obviously has not had the surgery or she couldn’t have reached where she did! During therapy, he bypasses that old muscle, moving my arm to places I can’t do on my own. This last week sure made a difference, but also with the training I’m to do here at home. As long as they make sense (he’s good about explaining when I ask), I’m willing to keep at them.

  2. What a journey. Often, we don’t appreciate all the subtle things our bodies can do until they can’t. Best of progress to you in the weeks ahead.

  3. Sounds like an amazing change I’m happy for you! We often hear so many horror stories about that kind of surgery, it’s nice to hear about one that’s going well!

  4. It sounds like your rehab has been a challenge, but that you’ve done a good job keeping your spirits up. I had a very hard time with finding optimism when my knee rehab began (two days after surgery). The angst has caused its own physical problems. It is hard to imagine this takes a year to heal and maybe two to get my range of motion back. Wishing you an excellent recovery and return to normality, even if at a snail’s pace.

  5. Glad to hear things are now so improved.
    You’re right about healing. Surgery I heal from in amazing time – a simple black and blue mark (that I never know how I got) takes 3-4 weeks to go away! Jeez!!

  6. I read the details of your surgery with a great deal of interest. A good physical therapist can make all the difference for quality of life. Hunter sounds like one of the best! Best wishes for your continue progress.

    • I actually look forward to going! Started week 10 this morning, and am to work up to carrying six pounds. Sure will make that arm more useful–helping to carry a laundry basket, opening a car door, etc. Things you’d never think about.

  7. What an ordeal! However, it sounds like you are on the mend. Keep feeling better and remember that there are a lot of us out there who care about you! I have a similar thing but have decided there’s not much use in putting new parts in a junk car that only has a few miles left.

    • Thanks for the encouragement, Allen. I decided the opposite! I’m only 75 (I told the nurse, have just published my first book, have two more to go, and if I get to live as long as my mother, aunt, and their mother, I still have over 20 years to go!) Poem from this morning: In spite of chronic fatigue, bone and muscle tenderness,
      Even with an arduous learning curve with this bionic shoulder,
      Despite wrinkles and sags and old-lady hands,
      I thank God every early morning to be the age I am,
      Even in this senior-citizenness,
      God’s mercies are new every morning.

    • Virginia, I’ve been going twice a week, wearing a mask, and they therapists also wear face shields. Thankful, as I sure ran into a snag last weekend. I guess I overdid and was in such pain I was afraid I’d “undone” the joint! Back to the arm sling, icing, resting, and it has calmed down. I’m to “graduate” the 15th but will still have to be careful and do the strengthening and stretching exercises. Bless you!

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