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Posted by: catnip ( )
Date: January 08, 2020 06:56PM

I know that "medical dramas" are not always appreciated here. But this is the community I turn to for support, so I ask your indulgence.

I ripped my right (dominant) rotator cuff back on St. Patrick's Day (3/17) last year. An attempt at repair was done on 6/13, but one of us - either the surgeon or me - screwed up. It never seemed to heal properly. Still limited, still painful.

An MRI taken in December (after MONTHS of bitching by both me and my physical therapist) showed a tear that looks about the length of California where the rotator tendon ought to be. There is a little nub of tendon tucked up under the clavicle, and a little nub of muscle partway down the humerus, with nothing in-between. So the use of my right arm has been severely limited for the better part of a year.

The orthopedic surgeon said that since the repair attempt had failed, he needs to install an entire new artificial shoulder. Deeply shocked, I asked, "At MY age (72) you can do that??" He assured me that he could.

Reviews tell me that this guy is one of the best ortho surgeons in our State. He did well for me in the past. The surgery has not been scheduled yet - he said vaguely "sometime in March or April." (To me, this feels like a Category 4 hurricane hovering just offshore, but nobody can say when it will make landfall. I used to live in Louisiana, so this terror is extremely vivid to me.)

Once the surgery is done, I know that I will be in for 6 to 9 months of physical therapy. During this past go-round, P/T has not only been painful, but ultimately, absolutely useless. (If you have ever been through P/T, if it doesn't work, they always say it's YOUR fault.)

My DH has been superbly helpful, the best cheerleader ever. And my son and precious granddaughters will be there for me, too. I'm thinking of turning my anxiety into creativity, and trying to make a "Frozen" dollhouse out of cardboard cartons, with all kinds of things - beds, stairs, a slide that ends in a "pool" (not water - the local craft store will have better ideas) that we can use.)

I need to throw myself into some kind of diversion. Nightmares about the surgery itself, the post-op pain and limitations (at least one night in hospital, maybe more), are chewing my brain up. I can pretend to be cheerful while awake, but the real truth comes out in my dreams. And I am flipping terrified.

I keep thinking that if I just had a DATE to hang the terror on, maybe that would help. I called the surgical scheduler yesterday, to see about nailing things down, and she said, "But you still have another meeting with the doc toward the end of the month." Yeah, I know. But he ain't about the cancel the surgery. . . Why can't we nail a date on the calendar??

Any recommendations about dealing with the anxiety? I don't drink alcohol. And nobody in my REAL life even suspects how frightened I am. My all-time favorite therapist died years ago, and there is no way I will try to break in a new one at this stage.

Please, guys - HELP!! (You always do!)

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Posted by: Tevai ( )
Date: January 08, 2020 07:23PM

In this area, I have no personal, and no helpful, knowledge at all....but I do feel for you, in what you're going through.

I am sorry, catnip--and I hope all of this comes together in the right way, SOON.



Edited 1 time(s). Last edit at 01/08/2020 07:23PM by Tevai.

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Posted by: kathleen ( )
Date: January 08, 2020 10:15PM

Catnip, I am so sorry this is going on.

I hope that you will contact this doctor and lay out your fears just as you have here. Ask him to please be your advocate, contact who's in charge of scheduling and tell them to get this surgery scheduled RIGHT NOW.

There's no reason they can't get this scheduled for you.

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Posted by: auntsukey ( )
Date: January 08, 2020 10:21PM

Have you been given a prescription for ativan? The tiniest portion of the smallest dose helps.

Another thing. Put it on the "shelf". Do like Scarlett O'Hara - think about it tomorrow.

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Posted by: stillanon ( )
Date: January 08, 2020 10:36PM

I had rotator cuff surgery about 12 years ago. It was all arthroscopic. Have 4 small drill hole scars. I had good insurance. Lots of rehab ending with icing and ultrasound stim.
After, did home stretching and low weight training, all designed to increase range of motion. It was a bitch. But, I pushed through and now that shoulder is stronger than my other shoulder that was never injured. Alcohol (which I like) is not a good option to help. Get a heat/ice pack like Thera PAQ. Also, I had some topical stuff from Europe called Voltaren. Get some. But, do your rehab and stretches and keep your range of motion. A few months of discomfort will gain you years, decades, of pain free motion.

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Posted by: catnip ( )
Date: January 09, 2020 01:19AM

I have Voltaren, only now it goes by the generic name "Diclofenac." It doesn't penetrate deeply enough into the joint to help.

Oh - Hedning, I don't live in LA any more. I've been in NM for 30 years. It makes me laugh sometimes: from a French-speaking Banana Republic to a Spanish-speaking one. But at least, I speak Spanish. That helps.

stillanon - Is Thera PAQ something that is available without a prescription? On the last surgical go-round, they issued me an ice-machine of sorts that was extremely cumbersome, as you are literally tethered to it. We still have the thing, and I will strenuously counter-propose packages of frozen peas held against the surgical site. I HATED that machine.

I can do about 3/4 of the P/T exercises. The 1/4 that I can't do is because the muscle required is torn. It just. isn't. there.

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Posted by: kathleen ( )
Date: January 09, 2020 02:10AM

Friends have a topical cream named similar to Voltarin. They paid $90 for it in CA, but $2 per tube in Mexico. I will edit in with the exact name of theirs.

But users are warned to use it conservatively, or per literature, !!!! IT CAN HURT YOUR KIDNEYS !!!

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Posted by: Lot's Wife ( )
Date: January 09, 2020 02:45AM

Voltarin/Voltadol are the same thing, just under European versus American brand names. They are an NSAID, meaning an anti-inflammatory drug like Ibuprofen or Advil or Alieve but applied topically, which makes for a greater concentration and less systemic stress on the body. It's good stuff.

You could also try Capzasin, which is a heat-producing cream used for arthritis but also, perhaps surprisingly, at high concentrations by European weight lifters, bobsledders, and throwers who have to deal with painful muscles and joints all the time. And if it is legal where you live and you don't mind taking a walk on the wild side, or what once was the wild side, your local dispensary probably has cannabis-infused creams that are effective topical pain relievers.

Regarding the ice machine, was it stationary or did it move your joint in slow, small circles or other patterns? If the latter, that's an important recovery tool because it stops the formation of scar tissues that can rob you of mobility in the future. That sort of machine is great for the first several days even if you only use it several hours a day. Conversely, if they gave you a machine that simply pumps ice water through a pad on your shoulder with no motion, iced peas would be just as good.

Good luck!





ETA: Directed at catnip, obviously!



Edited 1 time(s). Last edit at 01/09/2020 02:46AM by Lot's Wife.

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Posted by: Soft Machine ( )
Date: January 09, 2020 01:17PM

My mother-in-law practically lived on it for 25 years ;-). Her time spent in various French prisons for resistance against the occupant, followed by deportation to Ravensbrück for 18 months left her with terrible rhumatism and arthritis. She had "voltarène" (free of charge..) by the boxload stashed all over the house and it was the only thing (alongside her stubborn, but doughty personality) that kept her mobile until shortly before her death at 89.

She was an extreme case, but it's widely used in France

So I recommend voltaren, whatever it's called.

Get well soon, Catnip, we need you!

Tom in Paris



Edited 1 time(s). Last edit at 01/09/2020 01:17PM by Soft Machine.

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Posted by: Lot's Wife ( )
Date: January 09, 2020 02:47PM

That's a remarkable story, Tom. I hope you can tell us more about your mother sometime.

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Posted by: catnip ( )
Date: January 10, 2020 12:35AM

The ice machine they gave me last time is a heavy, clunky, stationary thing that I am reluctant to use again. Each time I had to get up to use the bathroom, I had to use my non-dominant arm to drag it from the center of the bed to the foot of the bed, and then give it a heave-ho to put it on the seat of my walker. That's how I transported that puppy back and forth every time I needed to use the "facilities."

Taking it from my bedroom out to the living room is even more fun. Due to a design flaw to which we paid no heed 30 years ago, both my bedroom and the living room are "sunken." That means I have to heave the walker UP to leave my room, drag it through the length of the house, and then heave it DOWN to get to the living room to watch TV with DH. (DH, BTW, is VERY helpful in helping to horse this monstrous machine around.)

My upcoming appt. with ortho surgeon is on the 29th. I imagine that I will have to curb my curiosity until then.

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Posted by: Lot's Wife ( )
Date: January 10, 2020 12:13PM

I'm with you.

Frozen vegetables are a great choice. As someone who does lots of stupid age-inappropriate sports, I would also suggest the following product. They do several different sorts, and the advantages are 1) they absorb cold very fast, 2) they are fullyl flexible and will mold to your shoulder, and 3) they are very durable and clean; in short, better even than a bag of peas.

Good luck with the surgery and the recovery!



https://www.amazon.com/FlexiKold-Gel-Pack-Standard-Large/dp/B0091IOISW/ref=sr_1_2_sspa?keywords=ice+pack&qid=1578676138&sr=8-2-spons&psc=1&spLa=ZW5jcnlwdGVkUXVhbGlmaWVyPUEzUTZNRkpUUUdXMDVJJmVuY3J5cHRlZElkPUEwMDcxNzk4MzBVTVhZQUpSQ1FLMiZlbmNyeXB0ZWRBZElkPUEwNDM1NDY3MjdRWkhaRkRJQjBUNyZ3aWRnZXROYW1lPXNwX2F0ZiZhY3Rpb249Y2xpY2tSZWRpcmVjdCZkb05vdExvZ0NsaWNrPXRydWU=

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Posted by: Hedning ( )
Date: January 08, 2020 10:42PM


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Posted by: Brother Of Jerry ( )
Date: January 09, 2020 09:18AM

What? LSU and Tulane Med schools aren't up to your standards? No good orthopedic surgeon would live in Louisiana because you wouldn't? Seems like very odd advice. How about NM?

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Posted by: kathleen ( )
Date: January 09, 2020 02:43PM

Good luck, Catnip. I hope you find out something today.

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Posted by: kathleen ( )
Date: January 14, 2020 02:58PM

Catnip, any news ?

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Posted by: GNPE ( )
Date: January 14, 2020 03:16PM

how come nobody ever apologizes to moi?

Oh, it's because I'm 'perfect', Got It!!

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Posted by: Recovered Molly Mo ( )
Date: January 14, 2020 05:26PM

Hi there, I admit I am one of those folks that don't like medical dramas on the board, because its way off topic.
You sound like to have the right resources and support in place, but because one major red, waving flag jumped out at me I wanted to put my two cents of professional experience for you to consider.

Based on the information you shared your past surgery failed. Yes, they can fail or have limited success. Some patients never fully live pain free. Any physician that gives you the impression that a surgery is guaranteed to be 100% successful is not being honest with you.

It seems like your surgeon is suggesting a total shoulder replacement to improve your quality of life. No, its not unheard of at your age. You still have a lot of living to do, so if this surgery has the potential to improve your life compared to where you are now-that is where you weight the risks.

P/T can also potentially fail, but it's imperative to do the home exercises (if any) your therapist gives you. A lot of people discontinue P/T because it hurts. Well yeah, exercise can often hurt, but its what strengthens the muscles and tissues. I can not see any professional in this field intently informing you that it is your fault that this crucial step in healing fails.

However, I would recommended you request a different therapist if the last one made you feel you were part of the failure.

Your surgeon or the surgeon's staff is the best possible resource to ask WHY the surgery has not yet been scheduled.
From the comment you provided below it appears you are expected to have another appointment with your surgeon. Bring a note with all the questions you want to ask, including date of surgery to your appointment.

To your question: Why can't we nail a date on the calendar??

Only the doctor can answer why this has not been addressed at this time. As a form surgery scheduler I can share the possible reasons why this is delayed.

*Many surgeons do not know their schedules more than 6 weeks ahead. Surgery centers also need to provide the availability for the surgery space and staffing.

*The surgeon might be planning something in their personal life that is not yet ironed out and then they can plan out their professional scheduling.

*If there are any other complexities in your health, the doctor may want to monitor that for stability prior to scheduling a date. Diabetes, high blood pressure, cardiac issues are all considered. Your surgeon may want your primary care physician to give you a preoperative clearance that needs to be done prior to scheduling surgery.

*Is the doctor waiting for other imaging or test results?



"Any recommendations about dealing with the anxiety?"
See your primary care physician to discuss and request a prescription.

Do consider telling you closest, trusted support system. Maybe just your husband that you are frightened and worried. Talking about your fears and feelings with someone you trust and love is often all we need to lessen the pressure that comes with these challenges.

Even medical professionals get anxiety about their surgeries (raises hand). This is a perfectly NORMAL response.

Turn to the folks that can action put some action into making you feel more at ease.

Best Wishes and happy future healing,
RMM

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Posted by: catnip ( )
Date: January 16, 2020 12:45AM

Thank you SO MUCH for the thoughtful and encouraging response!

I saw my ortho surgeon today (DH's insistence on knocking off the foot-dragging did the trick.) Surgery is scheduled for February 27th - just 4 months before my 73rd birthday. Doc says one night in the hospital, then home. And he said I can use whatever mode of freeze-application I want to use is fine. A gel-pack, frozen peas, whatever.

It feels like a victory of sorts, getting the situation corrected before its upcoming anniversary.

The physical therapist actually agreed with me, after I pointed out a recurring pattern in what I could and could not do. And this, in turn, confirmed what the most recent MRI showed: massive shredding of the rotator cuff. It is very limiting, and I am not willing to put up with this nonsense for the rest of my life. Not without a fight.

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