Preparing for Arthroscopic Rotator Cuff Shoulder Surgery
The following suggestions are offered as a result of my experiences of having this, Rotator Cuff operation on each of my shoulders, first the right one and then the left. Fortunately for me, I am a social worker who habitually thinks 6 steps ahead and plans for all anticipated contingencies because the amount of information on preparing for surgery that was given by the surgeon was minimum. He is a great surgeon (he actually invented the standard tool that they use for this procedure!) but when I asked him after the first operation why they don’t at least have a nurse brief patients on what to expect and plan for, he said the insurance wouldn’t pay for the session. So here are my recommendations based on being the patient. I am not a doctor (although I can play one on TV), so my recommendations carry a lot of weight. Remember the MDs haven’t had the experience or they would do more of what I am about to do.
1. Get your doctor to write you a letter to the Dept. of Motor Vehicles (they actually have a form to fill out) requesting that you get a temporary disabled placard. Although they are going to tell you that you shouldn’t drive for the first month until your sling is off, if you are normally a one handed steering type driver, you will have no problem driving after the first three days or so (unless you are taking lots of pain killers). I drove to the surgeons office to get the stitches out a week after both operations. If you don’t think you want to drive, also get him/her to sign the form for the transit company (MTA) for a disabled bus pass.
2. Make sure that you have enough ice packs so that you will be able to continually have your shoulder packed in ice, 24/7, for the first two days. You will be discharged from the out-patient surgery with an ice pack, but that will not be enough unless you have an ice machine. I didn’t plan ahead for this the first time and had to get my son to go and buy a couple of 2 pound bags of frozen peas, which actually make for the best ice packs. Costco (and probably most drug chains) sells a pouch with Velcro straps and a very flexible blue ice pack inside Not all blue ice packs are flexible when frozen. If all you can find are the stiff ones, when they are about half frozen, shape them into a curve that will wrap around your shoulder.
3. Practice doing everything with the other hand from the side that is being operated on, before the operation. For things that you are used to doing automatically, such as wiping yourself, you are going to have to teach the other hand, step by step, how to accomplish the task. I am right handed. The tougher time was the first operation because I had to teach my left hand how to do most things. I was surprised, though, when I went through this step prior to my second operation, how many things I regularly do with my left hand, like reaching for things.
4. If you wear contacts, make sure that you have a pair of glasses with up to date prescription lenses because putting contacts in, for most people is a two handed operation.
5. Think out the getting dressed process and practice it one handed. I suggest you buy shoes that have Velcro straps instead of laces. The same goes for belts. Belts with military buckles will work because the hand that is in the sling can hold the buckle while the other hand pulls on the loose end. You might have to thread the buckle in backwards from how you usually wear it.
6. Make sure that you fill the prescription for pain killers before the operation. Here are a couple of suggestions on pain killers:
- Vicodins, the drug of choice of most surgeons, is very, very constipating. With my first operation, after the second day post-op I was so constipated that I decided it would be better to have a hurting shoulder than the constipation so I stopped the Vicodins. Lo and behold, there was no pain. For the second operation, I asked for a less constipating drug and was prescribed Tramadol HCL 50mg. As you will read in the next item, I can’t tell you if they are less constipating but the MDs said they are.
- Based on my experience the first time, for the second operation I didn’t take any pain killers at all and religiously kept the shoulder iced for a solid two days. I did not experience any pain other than a very mild sensation like if someone had moderately punched me in the upper arm. I would have the prescription filled and on hand and only take them if you actually do have severe pain.
8. They are going to insist that you have someone take you to the hospital and pick you up. How you get there isn’t important. What is important is that someone picks you up. Your arm from your neck to your fingertips is going to be numb and non-functional and you are going to be woozy from the general anesthetic. You also are going to need someone to stay with you for at least the first 24 hours because you won’t even have the use of the fingers on your operated side for the first 9 or so hours. I won’t spoil the surprise, but notice how the anesthetic wears off your fingers. An interesting phenomena. I made sure that I had cooked enough food for the first two or three days so I could easily microwave them.
9. Ask your surgeon to write you an order for a second sling to be used after the second week when you are sleeping. I found that keeping my forearm bent at my waist 24/7 eventually started to give me physical problems. I was getting shooting pains in the muscles of the forearm. I found that sleeping, on my back, with the arm at my side alleviated the forearm pains. The problem, though, it that the upper arm still needs to be immobilized, and the solution is the following sling: It is made by Pro-Care. Model # 79-96820 It is called: Shoulder Immobilizer with Removable Straps. It Velcro’s around your waist like a weight lifting belt and has separate straps that Velcro around the upper arm and a second one, you won’t need to anchor the wrist at your waist.
10. A week after surgery you will visit your surgeon to have the stitches in your shoulder removed. If you were not able to get that second sling before the operation, this is when you scream for it. My insurance paid for it, but it took a week for them to do it so better get it done before the operation.
11. Physical Therapy. This is the key for you to make a full recovery of the use of your shoulder. If you do not attend or if you do not do the homework exercises and stretches your physical therapist suggests you do, you will end up with an always hurting shoulder that will not ever have a full range of motion. If you follow the directions, six months later or less, you will be fully functional. The stretching does hurt. As my Tai Chi Master said, “No pain, no gain!” Plow through it, breathe into it and you will get through it and thrive! My therapist suggested I get a cane so that I could push up my operated arm’s hand wrapped around the handle with my good hand at the bottom of the cane. (Strange sentence, I hope you go the picture).
Well that’s it. Hoped this has helped. Once you have been through the experience, if you have additional comments or suggestions to make this guide better, please send them to me at Jason@mycoachjason.com
Go break a leg! (Is that an appropriate way to say good luck before a surgery?)
©2011, Jason Wittman ~ http://MyCoachJason.com
Filed under: Health Care
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