Shoulder Surgery: First Week of Recovery

Day of Surgery: 

It was Friday morning.  I was barely holding myself together in the lobby. My anxiety level was steadily climbing.  Fortunately, I knew I’d eventually be getting IV sedation beforehand, and I knew that would help.

My surgery was delayed an hour, because it took that long for two very kind and talented nurses to successfully place an IV in my arm. This was something I expected.  It happens to me every time.  My veins roll, especially when I’ve had to fast for 12 hours without any water whatsoever.  They also branch off or vanish into deeper tissue too soon after the spot where they are visible under the skin. I forewarned the nurses, and they tried all the tricks of the trade to avoid sticking me repeatedly. In the end, they just apologized and said they’d have to go deep. Ouch!  That was still better than placing the IV between my thumb and first finger like they did when I delivered my youngest child.  That was horribly painful and left me bruised up pretty badly, so this was a piece of cake in comparison, and they were sincerely trying their best not to hurt me.

In addition to the IV ordeal, they had to do an EKG as a baseline for the anesthesiologist because of my history of irregular heartbeat.  All this took extra time.  The whole staff was exceptionally caring and really helped me to feel comfortable.

Once the IV was in, Steve came to sit with me until I was taken back for surgery.  I was given a cup full of pills with 1 oz. of water.  It included Gabapentin for pain and a host of things to counter side effects like anti-nausea, Zantac for stomach acid, Benadryl, etc.  I should mention that I seriously dislike narcotic pain meds and have never taken them when prescribed.

Surgery took about 1.5 hours.  Afterwards, the surgeon spoke to my husband and told him the calcium deposit was even larger than the MRI had shown and turned out to be about 2 cm, which is about the size of the whole tendon.  He said I was a real trooper to have lived with a deposit that size for so long, as it’s extremely painful.  Good thing I have a high tolerance for pain.

In the PACU, they woke me up and offered me soda and graham crackers.  As soon as they sat me up, I got horribly sick from the pain meds.  Steve was waiting with me and said I did not look or sound like anyone he knew until after I got sick, and I seemed more awake and lucid after that.  The nurse said the same thing.  She helped me get dressed, but I had already been placed in the sling, and my arm was completely numb from the nerve block, so they could only pull my top stretched over the sling, so it was really only half on.  And I couldn’t wear a bra, either, so I felt really exposed and uncomfortable.  They draped my warm shirt over top of my shoulder with the sling, and that was it.  I had to wear compression socks throughout surgery and for 48 hours afterwards to prevent DVT.

I went home with a pump attached to a catheter in the back of my neck that would continuously feed numbing medication into the brachial plexus to take the edge of the pain responses in my whole arm.  That was helpful.  I had to carry the pump on my shoulder with all the tubing every time I got up until it ended early on Monday morning.  Since I won’t take narcotic pain meds, the nerve block pump combined with Aleve at home really helped get me through the first few days.  The doctor insisted on prescribing at least a low dose narcotic, so he gave me 5 mg hydrocodone combined with 325 mg of Tylenol.  We filled it, but true to my word, I never took any of it. 

I never ate much.  My daughter made me some oatmeal raisin cookies.  I had three of them by the time I went to bed.  That was it for the whole day, plus the pack of 2 graham crackers and 2 Sprites that the nurse game me in recovery.

That night, I began a pattern of never sleeping more than 3 hours at a time, and I began waking up about an average of 6 times every night.  I left the tv on and just watched until I fell back to sleep over and over again.  My arm remained numb that whole night.

Saturday, 1 Day Post-Op:

I mostly stayed in bed.  Hubby brought meals to me.  By evening, I went outside and walked up the street and around the cul-de-sac by my house 3 times.  I was exhausted.  That was about all the energy I had in me at that point.

That night, though, I woke up to horrendous pain in the middle of the night.  I stayed hooked up to an ice machine with a cooling shoulder cuff most of the time during the day and throughout the night.  I was close to tears.  I was tempted to take the pain meds but thought better of it.  Instead, I hit the dosing button on my nerve block pump and got an extra bolus of numbing medication.  I waited it out and eventually got back to sleep, but it was a rough night.

Sunday, 2 Days Post-Op:

I felt nasty because I couldn’t bathe or wash my hair, and I still wore the same clothes since Friday.  Gross.  I wasn’t up to going to church and canceled my symphony ticket.  I didn’t make it to either church service that day. 

That evening, it was time to remove the surgical bandages and replace them with waterproof Band-Aids to cover the sterile tape on my arthroscopy incisions.  We discovered I had 5 of them…1 in front, 1 on the back of my shoulder, and 3 on the side.  That was more than we expected, but everything looked normal and healthy. 

 

I felt weird coming out of the sling for the first time and extremely stiff.  My inside upper arm was extremely puffy, like a sack of fluid hanging there that had pooled at the top of the sling.  I wasn’t supposed to bathe yet, but I set the shoulder bag with the pump on the floor outside the shower door, and hubby made a drape of plastic storage bags taped over my shoulder so I could at least shower the lower half and keep the shoulder and catheter dry.  I got to change my clothes, but I still couldn’t wash my hair.  I felt a bit more human but still gross. 

The whole process of getting out of my sling, changing the bandages, making the cover, getting a partial shower, beginning the pendulum exercises on my shoulder, and changing clothes took 2 hours!  I was so tired that I didn’t make it out for a walk.

Monday, 3 Days Post-Op

Hubby stayed home and worked from home that day, because we knew the nerve block would end at some point that day, and he had to be here to remove the catheter when the alarm went off indicating that the medication was gone.  That happened at 6 AM, but it turned out there was still a fair amount of medication left in the bag…it was just laid flat on the bed while I slept and had pooled to the other end of the bag.  Oh, well.  It was good to be free of the catheter tape.  It had really been irritating my neck and limiting my movements, and not having to carry all that tubing and the pump bag made it easier to get to the bathroom.  Without the benefit of any numbing medication, though, I began to feel all the steady aches and pains in my arm and shoulder.  Ugh.  Tolerable, though.  I began switching my Aleve to 1 in the morning and 2 at night to help me get through the night.  Night time brought lots of involuntary muscle spasms and flexions that were followed by horrible pains.  The ice machine continued to be my best friend, especially at night. 

I began to resume homeschooling Holden during the day, and then I’d go ice up.  I had Steve remove my sling 3 times a day for the pendulum exercises.  My shoulder felt so tight and stiff.

That night, free from all the extra gear, I was finally able to have Steve help me wash my hair and get a full shower.  I nearly cried in the shower because it felt so good to get clean!  I said it felt like a spa day!  LOL.

We noticed that the puffy area on my upper arm was also pooling the blood from surgery, so a substantial bruise began surfacing, all black and yellow.  Yuck!

Tuesday, 4 Days Post-Op

My sleep steadily improved, and I began walking longer and at a faster pace each day.  I still woke up lots of times, but the quality of my sleep was improving.  Steve had to go back to work this day, so I was terrified of being at home without him.  I got up with him at 5:30 AM each day to get my morning exercises done out of my sling and get hooked back up to the ice machine for another short stretch of sleep.  That routine began to work well.  Hayden was home for part of the day, so I could call on him if I needed help with something.  I continued homeschooling on schedule.  I had to ice up after each set of pendulum exercises and was really only off the ice machine while teaching.

Wednesday, 5 Days Post-Op

On this day, I had almost no pain.  I felt amazing and could hardly believe it!  A friend from church stopped by to visit and bring dinner, and she said how great I looked.  I felt wonderful.  I would soon learn that there would be good days and bad ones.

I ventured out to evening church services for the first time.  The bumpy car ride was challenging, but I survived.  It gave me hope that I might make it to the hockey game in Dallas that I’d purchased tickets for long before I knew I even needed surgery.

Thursday, 6 Days Post-Op

I’d had a bit more pain overnight but was okay until I walked backwards out the front door to carry the box containing the nerve block pump to the mailbox to return it.  I didn’t realize that the glass storm door wasn’t open all the way, and I backed right into it with the back of my sling arm.  Oh my gosh…the PAIN!  So intense.  It lasted most of the day and shot right down my upper arm.  Icing was the only thing that helped.  So awful!

Holden, who is 11, figured out how to get me in and out of my sling, so I was at least able to get out of it to exercise during the day.

That night, I ventured out with the family for the hockey game, so this was my first big outing…long ride, and a long time to be out.  I had a great time, and I survived!

Friday, 7 Days Post-Op

Hubby decided to work from home since we’d been out late, and the rain would have made for a slow commute.  It was nice to have him home.  He needed to do some grocery shopping at Sam’s Club, so he asked me to come along and get him his membership card and help point out what we needed.  It was good to get out again.

I had some discomfort but iced when I needed to and had a decent day.  My stomach hurt all day, and I didn’t eat a lot.  So I decided to try only 1 Aleve at bedtime instead of two in case that was upsetting my stomach.

My hand on the surgical arm had remained so puffy all week that I could not get my wedding rings back on.  After slathering my hand up with lotion, I decided to try again to see if the fluid retention had improved any.  I was finally able to get the rings over my knuckle, and then they were comfortable.  Yay!

Saturday, 8 Days Post-Op

According to my Fitbit, I got my best sleep score yet.  I only woke up 3 times overnight, and I felt pretty good when I got up.  I went to my desk and paid bills and made a grocery list.  We went to pick out a Thanksgiving turkey and a few other things we needed.  We went out twice to two different stores.  It was a lot, but I had a good day and felt okay icing up between errands.

I haven’t had much pain today, and I feel like things are going well.

Summary:

So far, so good!  The pendulum exercises feel better to do each time with less pain and stiffness.  I’ve started spending short stints outside of my sling after the exercises to keep working my wrist and elbow and to rest the arm on a pillow just to let my arm breathe a bit.  It gets super itchy in the sling.  I feel pretty good! 

I’m planning to go to church in the morning, the symphony in the afternoon because I forgot to cancel my ticket, and evening church.  It will be a long day, so I don’t know how well I’ll do without my ice during the day.  I may have to take my portable ice pack to the symphony.  We shall see!

Overall, I feel like I’m doing well, and I am anxious to go to my post-op appointment with the surgeon on Monday morning.  If it goes well and everything looks good, he’ll be removing the bandages for good, including the sterile strips, and I should be able to ditch the sling (at least unless I’m out in public and need to protect it).  I should also be cleared to drive with the other hand.  I’m supposed to start physical therapy for passive movements next week, as well. 

My understanding is that I won’t be able to use my arm for anything but passive movements for at least 6 weeks.  The therapist will be giving me movements to do at home.  These first few weeks are devoted to preventing scar tissue from causing frozen shoulder and to opening up range of motion.  Any movements I would do would be from the elbow down with my arm pinned to my side…no reaching or raising of the arm.

I believe the second 6 weeks of therapy is where they will begin to strengthen and expand range of motion.  But it will be literally months before I can do anything useful with my arm.

Healing can take 6-12 months.  I had calcium debridement, rotator cuff repair with anchors, bursectomy, and subacromial decompression.  That’s obviously going to take some time to heal.  But I’m optomistic!  As much as I want to get back to my regular routine, independence, and regular workouts, I know that is all many months away.  The last thing I want to do is injure myself by popping out an anchor or something that would require a revision surgery.  No way!  But I plan to focus on doing all the home therapy exercises and getting out each day for fresh air and some faster-paced walking to keep my cardio health in check until I can work out again.

At this point, I’m glad I had the surgery, because it gives me my best chance at being pain-free and functional down the road.  My condition was only getting worse with time, and after living with chronic pain for over a year, it was time to take steps to get it fixed once and for all.

The surgeon said he’ll be sending me photos of the arthroscopic surgery to show me what all he found, but I haven’t seen any yet.  Maybe he’ll show them to me at my office visit on Monday.  I can’t wait!