What It's Like To Survive Rotator Cuff Surgery – My Story
Photographic Content Warning!
Way down at the bottom of this page, I have included a photo of the actual surgical repair along with photos of the surgical incisions. If you are "grossed out" by surgical images, please stop at the "What Brings You Here" poll.
Hi, I'm Sheila...
What Brought Me To This...
I'm a woman in my 50's who is not an athlete, so when I learned that I had full thickness tears in three of the four tendons in my Rotator Cuff and a ruptured long Biceps tendon, I was more than a bit shocked! I thought that kind of thing just happened to baseball pitchers! But no... lucky me. I've had to take prednisone (a steroid) for almost 20 years now due to a neuromuscular condition. Those steroids have weakened the tendons in my body and made them susceptible to injury.
On a Sunday night in late October 2014, I was fixing supper for some family – one of my big fried chicken dinners. Right as the dinner was "going critical," everything finishing up cooking, I went to wash a big chicken skillet out so I wouldn't have to do it later on. I soaped and scrubbed the skillet, then went to flip it over to rinse the bottom side. I screamed and doubled over with pain as my arm suddenly felt like it was being torn off from the inside out! I've endured a lot of pain in my lifetime, but this was one of the most intense acute pains I've ever felt. It took my breath away for several minutes. My daughter-in-law and my daughter's future mother-in-law had to take over finishing up the dinner!
Luckily one of my dinner guests was my daughter's fiance, who was then a 3rd year trauma resident. "Is there a doctor in the house?" Yes! He advised me to put some heat on it and rest it, which I did. The following morning, I woke to my horror to see my entire upper arm from shoulder to elbow had turned solid black and blue! It was the most enormous bruise I had ever seen. i did a bit of internet research and quickly figured out I had probably ruptured my biceps tendon.
This diagnosis was confirmed later in the week by my orthopedic surgeon. He suggested that we try conservative treatment of physical therapy, heat and rest. After a few weeks it was apparent my arm wasn't getting better. I had pain in the shoulder and upper arm and had lost quite a bit of the function of my hand, fingers and arm.
Also, there were four more occasions when I felt the arm "rip" again. Although it didn't cause additional bruising, it was intensely painful each time it happened. Something was definitely wrong in there. The orthopedic surgeon ordered an Arthrogram and CT scan where dye is injected into the shoulder joint then imaged. The report was dire. I have large full thickness tears in three of the four major rotator cuff tendons in addition to the ruptured biceps tendon. The surgeon, who has done three major surgeries with me replacing both hips and a knee, was very straight with me saying he wasn't sure if he could repair all the damage and wouldn't know until he got in there to look. The alternative, doing nothing except strengthening exercises, really isn't an alternative because the shoulder joint is so unstable in this condition. So I took a big, deep breath and agreed to surgery scheduled for the end of January 2015. Here we go!
In The Upcoming Weeks And Months...
As more challenges occur to me, I'll come back here and talk about them.
I'll give you a detailed account of the surgery experience and the outcome.
Then you'll come with me on the weeks of rest and then months of rehabilitation that will be required.
I'm inviting you to come along on this journey with me so do check back now and then and see what I'm up to!
Doing My Pre-Op Homework!
I was told that after surgery I will be wearing an immobilizer which will prevent my right arm from moving. I'm going to have to wear that puppy for 4-6 weeks while my body works to build scar tissue around where the surgeon tacks the tendons down to the bones. Rest of the joint is crucial to the recovery, as it's been explained to me.
Since I am right hand dominant, this presents just a few problems with doing just about anything I do! I'm spending this last two weeks before my surgery date trying to prepare as best I can so that I'm not shocked by not being able to do certain things. i'm sure that I won't be able to anticipate everything, but I'm going to be as ready as I can be. I am fortunate in one regard – I was switched from being left handed to right handed as a child, so I can do practically everything with my left hand except writing and crocheting (my favorite pastime).
I've already had to start adjusting to driving with one hand since using the injured right arm causes pain when I make turns. I'm practicing buckling my seat belt with my left hand and trying to think of things like how I'll manage to drink out of my coffee mug while driving (I can't!). That will have to wait for stoplights.
Taking stand-up baths is the easiest alternative for me, I've figured out. The one thing I can't figure out how to do is wash my hair with one hand, nor brush my very long hair and fasten it in a ponytail nor put it up in a bun. So I've decided I will treat myself to going to the hair salon a couple times a week to get my hair washed and braided. If I make it a treat, it won't be a deprivation.
Cooking may be a bit of a challenge. Since I won't be allowed to support any weight with the operated arm/hand, lifting heavy skillets or pots is out of the question. So is washing dishes. I went out and laid in a big supply of paper plates and saucers to eliminate the day-to-day pile of dirty plates in the sink. I haven't figured out yet how I will use a can opener or open a jar with a lid. So cooking could be a bit challenging. Luckily I have a husband who can cook lots of things, so I'm sure we won't starve! The worst thing that will happen is I'll be frustrated by what I can't do. And I'll just have to deal with it.
What to wear is a big question on my mind. I'm assuming that I won't be allowed to do things that require pulling with my operated arm – things like pulling up underwear, jeans, and so on. I've skirted this issue by going out and picking up some underwear that's a bit looser to make it easier to pull up, and by deciding to live in maxi skirts for the duration of the 4-6 weeks of enforced rest.
When talking to some ladies who have survived this experience, I've heard the most difficult dressing challenge is the bra! You guys who don't have to deal with this tricky little clothing item are so lucky! I'm imagining that a bra strap resting on top of a shoulder incision could not be anything but miserable. So I've decided to use strapless ones instead. I haven't figured out yet how to fasten them with one hand, so I may have to do early morning wake up call and have the dear husband do that for me before he leaves for work... or simply leave it on all night.
A nurse suggested to me that cotton stretch tank tops work well. Then it occurred to me that I could use poncho style tops with no actual sleeves just popped on over the tank top. That could be cute as well as being a lot easier than dealing with sleeves.
Do you have any great tips for surviving activities of daily living following shoulder surgery? If you do, please share them in the Comments section below! I would appreciate any advice!
A Few Reality Checks...
1) Driving. Simply not happening. Although I do feel capable of driving with one arm, I was told that if I am involved in an accident and I'm wearing a sling, it's automatically my fault regardless of whose fault it really is. I can't bear the thought and I simply resigned myself to depending on others to drive me around until this thing comes off.
2) The sling's going to be on longer than anticipated. I learned this week that I will have to wear it for at least another month, a total minimum of 8 weeks. And it may be longer. The tissue involved in all the repairs is extremely fragile and the surgeon wants it to be rested as long as possible in order to preserve the repairs.
3) Cooking isn't a challenge, it's impossible. Well, maybe not... but we have discovered it's better for my husband to do the cooking. When we want a really nice meal, he will do the parts I can't do and I'll come in and do the seasonings and supervising. He's actually a very good cook. We both like TV dinners a lot, and we have found it easy and kind of fun to pick out what dinners each of us want and lay in a week's supply. Zero cleanup except for silverware. Love that. Had I been able, and had more prep time before the surgery, I would have laid in a big supply of precooked homemade frozen meals that could be warmed up. But i was having trouble cooking before the surgery on account of the shoulder/arm injury and it just wasn't possible. Meanwhile we are eating nice nutritious food, not really spending any more than usual on groceries, and enjoying the variety and convenience. We have gone out to dinner a couple of times to sit-down places, one of those was even a buffet. I managed to fix my plate all by myself! Right now though I vastly prefer eating at home, it's just so much easier.
We keep snack things that are easy for me to prepare (and eat) like bagels, cream cheese spreads, protein shakes, and so on so that I'm prepared for my hypoglycemic issues when they hit. I have to be able to grab something fast when that happens.
4) Sleeping... or lack thereof... is an ongoing challenge. Most of the time I can fall asleep but wake up after an hour or two. I'm told this is very common with this surgery. So I've given myself permission to just go with it - sleep when I feel sleepy and when I can't, I just can't. It's not an optimal situation but it won't be forever.
Here's An Interesting Study On Driving With An Immobilizer Device
- Should You Drive Wearing An Immobilizer?
The American Academy of Orthopedic Surgeons sponsored this study on the safety of driving while patients wear a shoulder immobilizer brace. Read this before you decide to drive!
Here's That Injured Arm Of Mine!
Here We Go! 1/28/15
it's midnight in a few minutes on the night before the surgery and I have to be at the hospital in just over five hours. I finished up all the preop testing days ago and it's down to waiting. I've been trying to get everything done I can like cleaning and laundry and errands. I know from prior surgeries that you can never anticipate everything so I'm trying not to stress out about it. Motto for the next month: "Nobody's going to die." So I'll be back soon with all the news of what they find and fix and tell you what it's like.
My procedure was planned to be an outpatient affair provided all went well. I arrived at the pre-op unit at 5:30 a.m. and went through the usual drill. Getting an IV started, reviewing medications, meeting with the operating room staff, and visiting with the anesthesiologist. Having been through over 20 surgeries, this is all old news for me so I tend to be very much in a "let's get on with it" frame of mind and can't wait for them to start the "happy drugs" so I can relax and be less anxious.
Something unique to this surgery was that they gave me a nerve block in my shoulder and arm before the operation. That was a surprise and something that would make my long day much easier as it turned out.
I arrived in the O.R. just before 8 am and was moved to the operating table. One little injection into the IV and it was off to dreamland. I woke up around 11 am feeling very well! The anesthesia must have agreed well with me because I just felt good. None of the nausea or pain I might have expected from some of my previous surgeries, no breathing difficulties. I was just fine and wide awake very quickly. I was ready for my cup of coffee, which they gave me after a short wait.
The nurse helping me get dressed was amused when I told her "I don't care what else you put on, but help me get my bra back on!" I was afraid my husband and I would never figure out how to put it on around this sling device she was putting me into. I figured whatever got put on me would stay on me for at least the first day or two so I might as well be comfortable.
By 12:15 I was being wheeled out to my car sporting my brand new immobilizer sling. I was actually hungry, craving a cheeseburger from Sonic of all things. My husband stopped for the food, we ran by the pharmacy to drop off a couple of prescriptions, and we arrived back home before 1:00 p.m. I still wasn't feeling any pain yet (my arm was still totally dead from the nerve block) and wasn't sleepy, so I just hung out all afternoon watching TV and resting while applying ice periodically to my arm and shoulder. Piece of cake.
By early evening I could tell the nerve block was wearing off. My hand and arm were prickling with pins and needles as they woke up. Figuring the pain wasn't far behind, I started taking my prescribed pain meds. That was a good thing because when the arm and shoulder did totally wake up, I was in quite a bit of pain.
The Sling And I...
Managing At Home
I have been through a lot of very major surgeries – two hip replacements, two knee replacements, and lots of others. While they have each severely messed with my life in a very major way during recovery, this surgery scared me the most because it would take away the use of my dominant right arm. I'm a very independent person and like most people, I don't like asking for help. "I can do it myself" is my motto! But this surgery is very different. I have figured out ways to manage most of my daily living activities and self care in some creative ways. However, there are a couple of things I can not do for myself. The biggest deal is my long hair!
Since I am not able to raise my right arm over my head, I cannot wash my own hair adequately with one hand. I've talked to a couple of guys who've had this surgery and it was no problem for them, just smear on some shampoo in the shower and hope for the best. Long hair is a different matter. At first I had a home health aide come in and the best solution she had was to have me bend over the kitchen sink while she washed it with the sprayer. Well, I'm very short - 5'2" – and between that and having the bulky sling between me and the sink, it was very uncomfortable to try to stand bent over that way. After the second time, I cancelled her. Instead, my very kind husband has been good enough to cart me off to a local hair salon twice a week to have my hair shampooed and dried. I decided it would be my one "treat" while I was recovering, however many months it takes before I can resume doing it the normal way. It's not expensive – the salon I go to only charges me $4 for a shampoo and blow dry (no styling). WELL worth it!! It's relaxing, it doesn't take a huge amount of time, and it just makes my day when I have it done.
I can't stand having my hair down most of the time, so had to teach my husband how to put my hair in a ponytail! He's gotten quite good at it now. One time my daughter in law was over and was kind enough to do my hair up in a French braid, which felt heavenly! I have figured out how to get my hair into a low side ponytail all by myself, so when I forget to have my husband put my hair up before he leaves for work I can do that and survive the day. My daughter has been trying to convince me to cut my hair short so it's no hassle, but I just can't do that. I've been through that many-months-long growing back out phase one too many times and can't bear the thought. I love having it long so I'm willing to put up with a little inconvenience so I can survive this rehab with my long hair intact.
Clothes & Accessories
There are two major dressing issues that give me grief. One of them is wearing pants. This is an issue every time you make a run to the little girl's room. It's difficult to pull one's pants up with one arm, period. And it's not just once, it's once for the underwear and once more for the pants. This is an issue I can't find a good solution for. I'm not allowed to pull on anything with any amount of force with my operated arm. It's causing my left elbow to be painful from all the weird reaching around my waist and pulling I'm having to do. I alleviate part of the problem by living in maxi skirts most of the time. On the underwear, I bought a few pieces in larger sizes so they are easier to pull up. Shape wear is out of the question. All that aside - it's still a major pain.
Happily I have solved the other upper underwear issue, the bra thing. After having my poor husband attempt to put it on around the sling one time, I was determined to find a better way and I did. I went with a strapless bra with a pretty rigid frame construction (brand Sweet Nothings, Walmart.com and elsewhere, about $16). Then I purchased a back hook extender to add a couple of inches to make the bra looser around. That makes it much easier to slide it around from back to front after fastening it. Problem solved! So that's now in the "all by myself" category, thankfully. And it was only about a $4 solution (I already owned a bunch of these bras). They sell these extenders virtually anywhere you can buy bras. I got mine at my local Walmart. Best of all I didn't have to go out and buy bigger bras.
I have found that I can wear just about any shirt or top that has a lot of stretch to it. I would also be able to wear button down shirts but what a pain. I hate wearing those anyway! It's just a matter of putting the shirt onto the operated arm first, then stretching the shirt to pop the other arm into it. No biggie there. So I did not have to purchase any additional shirts. I mostly live in stretchy tank tops anyway. When it's cold I add a layering piece like a sweater or knit jacket.
I did discover that the velcro piece that fastens around my waist caused damage to several of my shirts. So save your really nice pieces for after you get well. I did figure out (although it's a bit of a hassle) I can wrap Coban (a stretchy bandage you can get at the drugstore) around the fastened down Velcro strap to keep it from touching the clothing. I have also wrapped an old silk scarf around it a couple of times.
We are in the dead of winter so outerwear is a definite must. I lucked out there. I had just purchased a winter coat that is a little oversized and has enormous toggle fasteners. The coat is big enough to fit over the sling and still fasten, and I can operate the toggle myself with one hand. (Look for Dennis Basso's reversible coat with toggle fasteners on QVC.com). Aside from that I toss on my usual crocheted infinity scarf and a pair of gloves and I'm set.
Purses – oh my, what a pain!!! My situation is complicated further because I walk with a cane. Normally I cane with my right hand and right now I can't do that with the sling. SO - I have to do it with the left, and that's my purse arm if I use a carry type bag. That is impossible. I was managing with a cross body bag with a long strap, which I would flip over my head with one arm. I was constantly getting entangled with purse strap, sling strap, coat, scarf, etc... it was a nightmare and very frustrating! So I decided hands-free was the best method. I bought myself a spiffy new leather fanny pack. Done. It may not be the most fashionable accessory but it's not a pain in the neck, literally. (Note: While I was waiting on the fanny pack to arrive, I got out a tiny purse that would hold just absolute essentials. It helped tremendously just switching to that bag).
Socks - I have to wear compression type socks because of leg issues I have. I own a "sock-putter-onner-thingy" device - you can get them where they sell medical grade compression hosiery. Again with the no-pulling restriction, pulling these up to put them on would be impossible without this device. There are other sock aids out there like dressing sticks and others, but I don't believe they would work with the pulling restriction.
Makeup... Welcome To Art Class!
One of my rules through all of my medical issues for many years is that I have to put makeup on, every single day, no matter what, even if it's just for the Schnauzers to see. So I had to develop some creative ways of putting on makeup! I've simply had to learn to do most of it left handed, and correct my mistakes. Same goes for brushing teeth, washing my face with a wet wipe cleanser, applying moisturizers, etc. You have to learn to do it all with the other hand, period. The only thing I can't seem to manage is putting mascara on my right eye with my left hand! For that, I just get the hand in the sling up as close to my eye as I can and do it with my eye half shut. And I stick to just one coat. I've got the whole routine down to about 15 minutes now, not too bad.
Hey, I Can Still Crochet!
Crocheting Is Keeping Me Sane!
Being a crochet designer, crocheting is very important to my mental well-being! It keeps me occupied, busy for many hours, and out of less desirable activities - like overeating junk food or other things I might do to alleviate boredom! So it was a huge relief to find that it was possible to crochet with the sling. I got started and haven't stopped yet. Going in to the surgery it had been one of the things I was most afraid of – that I wouldn't be able to crochet for months while I healed. Yay!
My Recovery Crew – How We Roll!
Unveiling The Handiwork...
Baby Steps – Physical Therapy Begins!
At the end of my third week of total immobilization of the shoulder after surgery, my surgeon decided it was time to start some passive movement of my shoulder with Physical Therapy. The therapist repetitively lifted my arm upward to a maximum of 90 degrees and back down again. I was taught to do this exercise at home, along with another exercise where I would gently stretch my upper back. After two weeks of this, we progressed to full extension of movement of the shoulder all the way up. That felt really strange at first but it actually felt pretty nice to get the shoulder moving a bit more. On the 5th week, we also added a new exercise where I sit at a table and roll a towel roll back and forth with my wrists lying on it. I'm still not allowed any weight bearing on the right arm, nor any movements in any direction other than straight up and down.
Symptoms And Surgical Repair Of Rotator Cuff Injuries
Shoulder Scar After One Month
What Brings You Here?
What's Your Interest?
Week 9 Celebration!!
Two weeks ago having completed post op week 7, I was very disappointed to learn I had to endure "The Sling And I" for a minimum of two more weeks. The Sling and I were considering filing for divorce at that point! I just hit the tolerance wall one day for no apparent reason and it was all I could do not to just "sling it."
Well, today was my postop week 9 checkup with the surgeon. He was very pleased with how everything is looking. He told me I could actually start moving my arm in any direction (woo hoo!!) and added more exercises for the PT folks. This was cause for a huge celebration! I settled, however, for driving home without the sling on and pumping my own gas for the first time in over two months! I also chopped up a bunch of veggies to make some homemade vegetable soup. All in all it was pretty exciting!
The only restriction on me now is that I'm not allowed to lift anything. I can live with that for awhile!
He also gave me the good news that in three more weeks I will be allowed to start strengthening exercises! It will be nice to be allowed to do something more proactive than just resting my shoulder!
Physical Therapy With The New Exercises
Had my first PT with those yesterday - delayed because I spent a few days in the hospital due to a cellulitis infection in my leg. All of the exercises felt great, caused no pain, just a kind of weird feeling because the muscles had not been moved in so long.
In two more weeks we get to start strengthening exercises - I'm very excited about that! Give me some work and let me get this arm back!