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Total reverse shoulder replacement Feb 2019

crinkly1crinkly1 Posts: 156
edited 5. May 2020, 20:06 in Living with arthritis
Have read comments that little is reported of this procedure from 'inside experience' so will share mine if anyone is interested.

Had 3 fractures to head of humerus late September 2017. These became displaced so were plated, screwed and pinned two weeks later with the surgeon warning that his handiwork might not provide a long-term solution. After six months things ceased to improve so, a year following the first op., I was referred back to the surgical team. X-rays and MRI scan showed that the fractures had all healed but blood supply was severed so the head of humerus was crumbling, with metalwork loosening. Because of the combination of OA and failed fracture repair the only option for pain relief and improved range of movement was total reverse shoulder replacement.

15 weeks on from referral I had the operation and noticed the clock at 9.45am on Wednesday 20th Feb. when I entered the anaesthetics room then 2.30pm as I was wheeled onto the ward later. I had GA plus nerve block, took quite a long time to come round but, courtesy of morphine, was in no real pain - more 'woozy discomfort'.

Everything has progressed boringly well and, to my surprise I was discharged home the following evening - earlier than anticipated and only 36 hours after surgery. Just one minor blip in that I developed a skin allergy to the 'plastic' dressing, which was duly exchanged today, at the local cottage hospital, for a fabric one. Hopefully the irritation will soon subside and I'll post again when there is more to report - probably after my first visit to the outpatients' assessment clinic.

If anyone has specific questions, please ask and I'll do my best to give details. Meanwhile I'm cuddled up in my cosy reclining chair
while OH creates welcome magic with food and tea-pot.
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Comments

  • dreamdaisydreamdaisy Posts: 31,567 ✭✭✭
    edited 30. Nov -1, 00:00
    Hello crinkly, I am so pleased that you are done and dusted, I hope it's a relief that the easiest bit - :wink: - is over and now the hard work of recovery begins. Please keep us informed about your progress because I have no doubt that others will be along who will be facing the same process. I broke my upper left humerus in January 2014 in a triangle which was not completely separated but was loose; I did exactly as I was told by the ortho and the reward was it healed well.

    Good luck, I hopes the magic with tea happens on a frequent basis for some time to come, no heavy lifting for you my dear! DD
    Have you got the despatches? No, I always walk like this. Eddie Braben
  • stickywicketstickywicket Posts: 25,978 ✭✭✭
    edited 30. Nov -1, 00:00
    Useful info there, Crinkly. A friend had the same op last year and is doing brilliantly. Thanks.
    “There is always a well-known solution to every human problem - neat, plausible, and wrong.” H.L. Mencken
  • crinkly1crinkly1 Posts: 156
    edited 30. Nov -1, 00:00
    Now 5th day post-op and no issues with the shoulder, which is inevitably very sore but not unbearably painful. Am managing my own Cocodamol dosage and sleeping in reclining chair for 3-4 hour stints, which is great and all set exercises are fine.

    I treated myself to a basic battery-operated bath seat for previous op as other joints don't make for one-armed gymnastics, so I can luxuriate in a daily soak (shoulder kept dry). Bliss since I'm not a shower-fanatic!!

    Bit of a blip with skin allergic reaction so had a Saturday trip to the local cottage hospital for the 'plastic' dressing to be replaced by fabric then to GP today for general check and review of meds. Have to get yet more blood tests, see GP again in two days then attend hospital outpatients clinic on Friday. Am not expecting any further 'hassle' - it's just one of those things that I hadn't built in to the contingency planning so just have to sit it out until the symptoms subside.

    I haven't met 'my' surgeon yet as I was moved to a vacant slot on his list when the original consultant needed to postpone me for a trauma case but what credentials I found were reassuring and I'm immensely glad to have been 'done' after a very uncomfortable 15 months. Everyone I saw put my mind at ease, including the anaesthetist who explained how he would do things differently when I expressed anxiety because the nerve block hadn't worked previously. It was fine this time.

    So all is good and, as SW suggests, I should be in for an uneventful and successful recovery. My aim is to be swimming by six months then back on local cycle trails with my husband (and our bikes of course) by the end of this year.
  • crinkly1crinkly1 Posts: 156
    edited 30. Nov -1, 00:00
    One week post-op and the allergic rash is finally subsiding. Some soreness in the shoulder as different muscles return to the active list but still much less painful than the earlier fractures' repair and I have really good movement for the permitted exercises. Apart from putting on socks I'm independent for personal care and am now taking Cocodamol only as needed, which is marginally more than before the surgery so am feeling utterly positive and will post again after Friday's hospital appointment.

    An entertaining diversion occurred this afternoon when I investigated a scuffle in the house and thought I had developed double vision as two apparently identical tabby cats shot across the landing in opposing directions. It seems that our family cat had lured a companion into the house only to assert her dominance over the unsuspecting creature. More work for my long-suffering husband who will now have to install a new, microchip-sensitive, cat flap!
  • dreamdaisydreamdaisy Posts: 31,567 ✭✭✭
    edited 30. Nov -1, 00:00
    I am so pleased for you, crinkly1, everything seems to be going well and I have no doubt that your being sensible is a contributing factor. I apologise for not responding earlier, I am somewhat preoccupied at the moment with an approaching event which is taking up a fair bit of my time. DD
    Have you got the despatches? No, I always walk like this. Eddie Braben
  • stickywicketstickywicket Posts: 25,978 ✭✭✭
    edited 30. Nov -1, 00:00
    You're doing brilliantly and I'm sure that's partly due to a good surgeon and partly to a good patient. No pain, no gain, eh? I'm pleased the rash is gone and thanks for the updates. I've already referred a newbie to your thread.
    “There is always a well-known solution to every human problem - neat, plausible, and wrong.” H.L. Mencken
  • crinkly1crinkly1 Posts: 156
    edited 30. Nov -1, 00:00
    Very good post-surgery appointment and all going well except I must prioritise reducing the swelling that is from shoulder to finger-tips. It began with the allergic rash and has become significant fluid retention in the operated arm and both legs. Way more hassle than the op but it's slowly getting under control as the itching subsides and as my general mobility improves.

    Three new exercises added then clips to be removed next Wed. and Physio to start at three weeks so onwards and upwards.

    Many thanks for your thoughts and positive good wishes. I feel quite a fraud as it's been so much easier than I expected although I know this is the start of long, steady road with a currently 'fuzzy' view of what lies ahead in the long term.

    Am also very grateful for the skills and good humour of hospital staff whose attitude makes the tedious trek from and back to home worthwhile.
  • stickywicketstickywicket Posts: 25,978 ✭✭✭
    edited 30. Nov -1, 00:00
    As ever, you're doing brilliantly while making light of the difficulties, Crinkly. I hope the fluid retention goes with more mobilising. I've had it after THRs though not after TKRs. I guess elevation is out of the question right now. (Ouch!)

    KBO as we say in this household and please keep the updates coming. You may stop once you can start swinging from a trapeze :wink:
    “There is always a well-known solution to every human problem - neat, plausible, and wrong.” H.L. Mencken
  • crinkly1crinkly1 Posts: 156
    edited 30. Nov -1, 00:00
    Two weeks after surgery and the 18 clips were removed this morning. A little more difficult for the nurse and more sore for me than last time but it's another milestone passed. Apparently a second procedure using the same scar often takes a bit longer to heal so I have steri-strips in one section for the next few days but all is very 'clean'. Means a small step back in reducing pain relief but it won't be for long and I'm still well under the permitted dose.

    Meanwhile have enjoyed my first evening out since the surgery - just a discussion group at church but useful distraction therapy and I feel I've climbed another step towards recovery.

    Just hope for a good sleep tonight then that the next week is too boring to report here! Will see how close I come to swinging by my arms, SW!

    Thanks again for encouragement and my assurance to those waiting for joint replacement surgery that what pain I have is markedly different from the pain of OA or of the original fractures.
  • dreamdaisydreamdaisy Posts: 31,567 ✭✭✭
    edited 30. Nov -1, 00:00
    I know post-op recovery can be hard work but, to get the most from the surgery, it must be done properly and you are doing just that. Well done, crinkly1, I am not in the slightest surprised that you are doing so well and remain very pleased for you. DD
    Have you got the despatches? No, I always walk like this. Eddie Braben
  • stickywicketstickywicket Posts: 25,978 ✭✭✭
    edited 30. Nov -1, 00:00
    Perhaps this was more difficult for both you and the nurse because, as more time has passed, the'll have 'bedded in' more? Just guessing.

    My knee revision went down the scar of the original TKR. It was so long since the original I can't remember if it took longer or not to heal but at least I just have the one zip :wink: rather than two.

    Well done on getting out to your group. I bet it was lovely to be back. My church always makes a big fuss of me when I get home from hospital and it's rather nice :D

    I suggest there is no shame in leaving the trapeze alone for a while yet :wink: You seem to be doing really well without it :D
    “There is always a well-known solution to every human problem - neat, plausible, and wrong.” H.L. Mencken
  • barbara12barbara12 Posts: 20,814
    edited 30. Nov -1, 00:00
    Hi crinkly1
    its so kind of you to share this..more info the better for people that are facing the same , especially has you are doing so well..keep up the good work :) x
    Love
    Barbara
  • crinkly1crinkly1 Posts: 156
    edited 30. Nov -1, 00:00
    Thanks again for so much encouragement. With the itchiness decreasing I've had my first good night's sleep so feel much more 'with it' today although still lacking enough energy for tackling SW's monkey bars! (Will get a grandson to substitute.)

    A little set-back in that a blood test needs to be repeated also the surgical wound is still not fully healed, mainly courtesy of the allergic reaction that left blisters under the dressing. These were finally 'dealt with' with this afternoon by nurses at the cottage hospital who applied a different dressing to stay in place until I report to them again in five days' time. It all seems a hassle!

    Thankfully there is no sign of infection and this action has alleviated a very sore spot but means keeping the shoulder area dry for a bit longer - not really a problem as I have a basic electric bath seat so can continue with my daily luxury of a bath. The 'soak' bit will just have to wait.

    The shoulder itself is achy but feels very good and exercises are progressing fine. In fact I already have to remind myself not to take liberties with the operated arm and to keep the sling on as a deterrent to over-doing it. Am continuing with regular prescribed pain-relief (Cocodamol 30/500) but in about half the permitted quantity as that provides a 'background cover' while allowing some leeway for increase overnight if needed.
    Like most others with OA I long ago learned not to expect complete absence of pain and recognised that it's my own responsibility to manage things with GP support. (No comment on the NICE recommendations on another forum thread!)

    How different we all are - and how diverse our coping strategies! Unlike the writer on another thread I'm making good use of a static foot-cycle to help with excess fluid retention. I have a big chunk of MA work lined up for the next couple of weeks, which will see me through to the start of 'physio proper' and should keep me out of mischief while movement must be restricted to allow for healing!

    My best wishes to all others who are waiting for or recovering from surgery. I'm in awe of the skill of surgeons but know they only set us on the road to achieving the best outcome possible. The rest is up to us.
  • dreamdaisydreamdaisy Posts: 31,567 ✭✭✭
    edited 30. Nov -1, 00:00
    There is only so much that surgery can achieve and as you say, the rest is up to us. Some are more prepared to cope, to put in the hours and do the exercises than others but that is human nature. A woman I know had a new knee, refused to do the post-op exercises because they hurt and now, two years on, is in a worse situation than pre-surgery. She says the surgeon is at fault, that she did not have to do the exercises because she had the new joint. Some people are very dim. :|

    Keep up the good work, Crinkly1, it will all pay off in the end. I remember being impatient to ditch my sling and to this day I am grateful I stuck with it. A few weeks inconvenience compared to regaining good joint mobility? It's a no=brainer. To this day my daily shoulder physio is wiping down the shower cubicle with a squeegee: and stre-e-etch and sweep, and stre-e-etch and sweep. DD
    Have you got the despatches? No, I always walk like this. Eddie Braben
  • stickywicketstickywicket Posts: 25,978 ✭✭✭
    edited 30. Nov -1, 00:00
    More good news, then, Crinkly, and I love the way you regard problems as 'little set-backs'. That determinedly positive attitude does, I'm sure, assist with healing as it enables you to continue all the hard work and not get dragged down by the occasional 'one step back' after 'two steps forward'.

    I've always found shoulders to be difficult things as they're in such an awkward place for resting :roll:

    I do think it's a milestone, though, to reach that point where one has to rein oneself back. You're definitely getting back on track :D
    “There is always a well-known solution to every human problem - neat, plausible, and wrong.” H.L. Mencken
  • Airwave!Airwave! Posts: 2,393 ✭✭
    edited 30. Nov -1, 00:00
    Glad you're doing ok, I've had a suggestion that I can have the op but find myself holding back, good to hear from you.
  • crinkly1crinkly1 Posts: 156
    edited 30. Nov -1, 00:00
    Tomorrow I'll be 3 weeks post-op and disbanding with the sling - in order to help prevent a frozen shoulder. Already I have better range of movement than at the same stage of my former (fractures' repair) surgery although I have to remind myself that the main aim of this op is to reduce pain so I should not get too excited about potential mobility.

    Current pain is difficult to describe but is intermittent eg doesn't much like being driven over potholes so I wedge a pillow between lap and arm when in the car etc. It's more soreness and aching after 'use' than the unrelenting pain of past months so, to date, I am very happy with the outcome. Serious Physio starts next week.

    Airwave - suggest you discuss in detail, with GP or consultant, the reasons for this procedure being suggested to you and the likely outcomes in terms of your particular current restrictions and long-term hopes. It will be your call - and only yours so the sooner you have all the relevant facts the easier will be your final decision.

    I can't pretend that it's a walk in the park or that there are no possible drawbacks. Nights are not great yet and I know it will demand steady commitment to recovery over several months - just as with hip and knee replacements. I was well prepared for this and am fortunate in being in good general health apart from widespread OA and not being 'squeamish' about medical information. I have excellent hospital and GP support plus no-fuss home back-up from my husband of 50 years.

    I know there are no long-term studies for this relatively new procedure so I'll keep posting for as long as there appears to be an interest. I'm no mind-reader so please don't hesitate to ask specific questions or use the Private Message facility.
  • stickywicketstickywicket Posts: 25,978 ✭✭✭
    edited 30. Nov -1, 00:00
    Thanks again for this, crinkly. I've just referred another newbie to your thread. It seems to have come at a very useful time :D

    I think shoulders are possibly the hardest bit to immobilise against potholes, roadbumps etc. Your solution sounds a good one.
    “There is always a well-known solution to every human problem - neat, plausible, and wrong.” H.L. Mencken
  • brianjwraggbrianjwragg Posts: 3
    edited 30. Nov -1, 00:00
    Hi Crinkly, Thanks for answering my other post, Re: Reversed Shoulder Replacement. Nice to hear your doing so well. I see the Consultant April 11th Leicester General Hospital. Just finding my way round the forum, so I can now follow your progress.
    Brian
  • crinkly1crinkly1 Posts: 156
    edited 30. Nov -1, 00:00
    You are welcome and I shall be pleased if I can help anyone facing this big decision. I'm glad you have an appointment booked, Brian, as it seems there are minor differences in the ways that consultants plan the surgery and recovery to meet the needs of individual patients. (I'm in the catchment area for a hospital trust based just south of Manchester.)

    I've now done two days without sling and the shoulder is already feeling more comfortable. I've moved back from reclining chair to bed at night as neither is especially good so my other joints may as well benefit from the better mattress! I have puzzle book and whodunit to hand for any wakeful patches.

    I will probably not post again until after my first Physio appointment next week but will return then in case it helps to know how that goes.
  • crinkly1crinkly1 Posts: 156
    edited 30. Nov -1, 00:00
    Four weeks to the day since my operation and I've had my first physiotherapy session. It went really well. All exercises given so far are fine but I need to do more work on abduction also try to reduce the remaining swelling in my upper arm with massage.

    Can completely dress/undress unaided, use knife and fork with a little difficulty, reach face with hand and can go ahead with most activities at waist level eg some food prep, gentle cleaning of work surfaces etc but I can think of far more interesting activities, which I will substitute!!!!!

    New exercises added, including lifting operated arm in front, supported by other hand along with advice not to push beyond the point at which pain kicks in and to stay on regular doses of Cocodamol but reduce if/when possible without increasing discomfort. (Am now averaging 6x30mg/500mg per 24 hours.)

    Was warned to remember that muscles are still healing so not to lift anything heavier than a cup of water and not to be tempted to try driving - automatic gear box but with standard hand-brake.

    Lots of comments to suggest that I shall gain useful range of movement and that swimming and cycling will be possible but it will all take time. Next appointment is in two weeks - 6 weeks after surgery.

    TBH it's the peripheral complications of anno domini that have been most irritating but the allergic rash is almost gone and fluid retention has been greatly improved by diuretics, increased exercise (foot cycle) and sleeping in a better position now I've moved back to bed from the reclining chair. Am getting through loads of moisturiser to treat the stretched skin that has become terribly dry and it is responding positively.

    Sleep is getting better as I find the most comfortable way of organising my pillow pile, which consists of two standard pillows and a weirdly-shaped back support pillow behind with a vee-shaped pillow across my body and underneath the operated arm.

    So no huge surprises other than that this journey is a lot less painful and depressing than the earlier fractures' repair and I'm determined to be patient and allow full healing to occur before making big demands of the new shoulder joint. Having been some of the way there before and doing plenty of homework is paying off as I have a good idea of what to expect over the coming months. No doubt I shall, at some stage, feel frustrated but, for now, I feel encouraged at every step of the way and grateful to all who are in any way involved in my story.
  • moderatormoderator Posts: 4,082 mod
    edited 30. Nov -1, 00:00
    Hi crinkly1
    thank you so much for continuing to share your post operative journey here on the community. Your story will be such a valuable resource for other. Yes of course we are all different but hearing how people are getting on is a window into the possabilities.
    Sending you lots of healing vibes
    Sharon
    t115006
  • dreamdaisydreamdaisy Posts: 31,567 ✭✭✭
    edited 30. Nov -1, 00:00
    What a model patient you have been and are, crinkly, you are finally receiving your very just rewards. I know we repeat and repeat that healing is a long process but people don't often listen and allow their impatience to get the better of them . . . . . It is a long haul but when a job is worth doing properly it is worth doing well. DD

    🎖
    Have you got the despatches? No, I always walk like this. Eddie Braben
  • stickywicketstickywicket Posts: 25,978 ✭✭✭
    edited 30. Nov -1, 00:00
    And, isn't she doing it well :D

    Just a word of warning, crinkly. I think you should go very easy on the food prep and cleaning of work surfaces. These could develop into habits :wink: And, if you shouldn't lift anything heavier than a cup of water, aren't you fortunate that a glass of wine is lighter? Better stick to that for safety's sake :lol:

    You're doing great and I'm very pleased.
    “There is always a well-known solution to every human problem - neat, plausible, and wrong.” H.L. Mencken
  • crinkly1crinkly1 Posts: 156
    edited 30. Nov -1, 00:00
    Thanks SW - you may have noticed above that I suggested I could find more interesting activities than domesticated ones! Nor was I impressed that these chores were actually listed by a woman although, to be fair, I didn't hear her advice to male patients!!!!??

    Although I like the place to look welcoming I am fully aware of the serious harm that can be done by 'housewifely tasks' and have no intention of risking being physically or emotionally scarred by rehab! If the state of the home gets bad enough my OH will notice and take action while I concentrate on entertaining our beautiful retired racing greyhound!
    (Will now remove tongue from cheek before it gets stuck there!)

    Best wishes to all.
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