Gut Rumbles
 

May 08, 2006

input needed

I'm issuing an urgent All Points Bulletin here: Has anyone who reads me suffered torn rotator cuffs and undergone the corrective surgery? I ask because it looks like exactly that shit is headed my way and I would like to know what to expect. I think it's a fair question.

Men (and even a few wimmen) frequently email ME asking about what to expect after a radical prostatectomy, and I ALWAYS respond. I'm no doctor, but I can give a pretty damned good prognosis from a patient's point of view in this case. I wish that I had known more when I had it done.

I believe that I'm fixin' to sail into uncharted waters again, so I'm asking locals to give me some directions. From what I've learned so far, the operation is a piece of cake. Doctors are good at performing it and the surgery is effective to cure the problem. Okay, that's fine with me.

But I ALSO understand that the rehab process is a painful bitch to endure. I have no doubt that I CAN DO IT (humility is not a virture that I possess), but I would like to know something about the enemy I'm likely to face.

If you've had the surgery and gone through the rehab process, please share what you know. I would appreciate it, and I am certain that other readers would, too. I have these questions:

How difficult is rehab? How long does it take? How much does it REALLY hurt? What can happen if I DON'T do it? What does it involve? Can I do it at home, or do I have to trip my Cracker ass to a clinic and pay out the wazoo?

Input is needed desperately here.

Comments

If you hear anything, please post it. I'd appreciate a rough estimate of price, too. Darn shoulders....

Posted by: Steven on May 8, 2006 04:53 PM

If you'd answer my damn emails I woulda told you!
Rehab is the most important part. But you have to follow the exercises to the letter. Too many people think they don't have to do it and they end up with severe arthritis and atrophy of the joints.
Rotator cuffs are considered one of the most painful injuries to recover from.
You can do the Rehab at home, IF you do it religously!

I might send you the exercises... if I'm feeling generous to you. *sticks out tongue*

Posted by: livey on May 8, 2006 05:02 PM

My wife had it done, as did a guy I worked with. No problem for my wife, as she tolerates pain very well, after all, she is married to me.

The guy I worked with walked around for months swinging that arm. He had them both done, one at a time. He was ambidextrous, which made it easier for him, but probably was the reason he needed it on both in the first place.

I understand that wiping your ass with a different hand is the most difficult part.

Posted by: jdallen on May 8, 2006 06:21 PM

Let this be a lesson to all your readers. Excessive masturbation has many consequences.

Posted by: Max Doubt on May 8, 2006 06:37 PM

I dunno shit, but I'm guessin ya only wanna have one done at a time, unless you want to hire a nurse/ass-wiper.

Posted by: Bane on May 8, 2006 07:01 PM

I injured my rotator cuff last winter and spent months in rehab. It is SO PAINFUL...remember I had THREE BABIES! At times I couldn't even roll-over in bed...I would use the good arm to pull the bad arm over. What a total bitch!

AND THAT WAS NOT, I REPEAT, NOT A TEAR. From what I hear the rehab after surgery takes NINE MONTHS. Brutal.

Some baseball fans may have info on pitchers who have had this...but heaven knows how many hours a day they rehab to get back "in the game" quicker.

GET A SECOND OPINION...NO MATTER WHAT THE FIRST SAWBONES SAYS...GET A SECOND OPINION.

Surf the web...you may find a forum of "fellow sufferers" out there. Do your homework before seeing the Dr!

Shit, Rob, seems like the only luck you have is bad luck.

Posted by: Maggie on May 8, 2006 07:26 PM

Rob, I think you mentioned that you were going to the doc this week. Who is your orthopedic surgeon?

Unfortunately, I don't know anything about the surgery. Physical therapy is a MUST and your hot tub might help with the recovery too.

Posted by: Beth on May 8, 2006 07:43 PM

I thought heat inflamed shit...

Posted by: Bane on May 8, 2006 08:01 PM

There should be MRI's, checking for impingement, X-rays for arthritis or osteoarthritis, use of arthrograms, use of anti-inflamatories, physical therapy, and second opinions BEFORE using surgery as a last resort. Surgery can dimminish the pain for sure, but range of motion is determined by other factors.

Lifestyle changes are necessary - up and moving, not sedentary. And, you'll want to figure out what you did to tear them, and avoid those activities. For me, it was digging forks, canoeing, lifting old people, and getting old. It took 9 monthes to heal so I'm mostly pain-free. But, don't ask me to put my arms up over my head - I'll take my shirt off, bending over, and letting gravity pull it off.

Posted by: Bonita on May 8, 2006 08:17 PM

3 knee surguries. Each one more painfull than the last. Rehab starts earlier the more they learn about it. Look forward to exercises starting about an hour after you wake up from anesthetic.
You're in for pain and mental trauma you haven't felt since 2 a day football practice in july.
If you can pull this off without lapsing back into the chemicals, you'll be one tough MF. I wish you luck and any advice/encouragement/coaching you need is obviously yours at the drop of a hat around here.
Once the initial rehab is done, the absolute best exercises for rotator cuffs is judo push-ups, hand stand push-ups and dips. Forget the weights.
Good luck. I think you can do it.

Posted by: Smokin on May 8, 2006 08:22 PM

Rob,
I work in a Occupational Therapy outpatient clinic and I deal with a lot with rotator cuff repairs. The most important advise I can give is, DO NOT compromise on the surgeon.

I do not recommend any ol' Orthopedic guy. Those guys primarly deal with BIG bones-hips, knees that sort of thing. You need soft tissure repair- The rotator cuff tendon(s). Look for someone who specialized in "Elbow, Hand and Shoulder". These are the guys who do rotator cuff repairs all the time and know what they are doing. They have taken specialized training to do that type of surgery.

Believe me, I can give the best therapy, but if I have a patient come in who had a hack job doctor doing the surgery, there is not much I can do. They are in more pain, take longer to recover etc....

As for the therapy itself, well, If you don't have insurance it can get expensive. Tell the therapist about the financial issues. Hopefully, they will agree to having you come in once a week, set you up with a home exercise program and make you do your own therapy at home. Otherwise, I normally see people 3-4 times per week. Which is very expensive.

DO NOT have both shoulders done at the same time, you need one "good" arm to do things. Your operated arm will be in a sling, so you don't use it for about 4-6 weeks, It takes that long for the repair to fully heal.

The other very important aspect in all this is: you must faithfully do your home exercise program. The little I do in the clinic, even if they come 3x per week, is not enough to regain motion.

However, with anything there is a fine line in not over doing it. You need to allow the tendon to heal.
It is fragile and you don't want to undo the repair and need to have surgery all over again.

Daisycat

Posted by: Daisycat on May 8, 2006 08:35 PM

I had this done my junior year of high school. It was a bear! The surgery itself is pretty uncomplicated, but the re-hab is kind of painfull. Mine only last 7 months, but my Dr said it was because of my age.

As for the pain, becasue addicitons run deep in my family, I only took the narcotics for about 3 days post-op, and moved to Toradol, (NSAID) and Cytotec (prevents ulcers for long term NSAID use) and was on that for over 3 months.

Things that were really hard for me during recover: wiping my butt, zipping up my pants, cutting my meat at meals, basically anything where two hands are pretty much required.

I started off doing my PT at the outpatient center at Memorial and then they sort of weaned me down to 3 times a week and doing some PT at home, and eventually I was only going in once every other week and doing most of my PT at home. Like a previous person said don't slip at all on your PT. I once let 3 days go by about halfway through PT and the next 3 weeks felt like they very beginning.

That was 7 years ago and I still have some slight stiffness problems, and the cold is a problem only if it's a wet cold. (Know what I mean?)

And basically PT had a lot of circular motions to it, a good bit of lfiting, basically just recreatiing range of motion in the shoulder.

You can get through it, I promise!

Posted by: Steph on May 8, 2006 08:38 PM

I still say try massage first, it's a lot less invasive, and you might see immediate improvement. Find a good licensed massage therapist, and try it.

Posted by: Heather on May 8, 2006 09:58 PM

the very reason i'm typing with small caps is that i had a total blow-out of the r. shoulder in november i got steel pins and cables, lots of bone and muscle removed.

i had the best surgeon in the world for this type of surgery (dr guttman, taos ortheopedic institute), wasn't too bad, but recovery is a bitch. you need a real good mate too help for a while.

the worst part is the depression a couple of weeks after the surgery - 'why in the HELL did i have this surgery, it's worse now than before....'? it slowly gets better.

p.t. isn't THAT bad, don't let it scare you - it really does help, besides, anyone that can whup the bear you did, can handle anything!

Posted by: stratguy on May 8, 2006 10:45 PM

All I know from my friends who've had it is the scoping is easy. Just like a Monkey Trial. And the rehab is a bit painful and extended. But if it has to be done it has to be done. Better sooner than later.

Posted by: Velociman on May 8, 2006 11:44 PM

Rob, I suppose that the 'cuff surgery will be far cheaper than the walletectomy the BC had performed on you, and far less painful than the craniorectal retraction you had done on yourself 'bout seven months ago.

Hell, dude. If you can beat those, it's all a glide from there on out.

(tell yourself that the afternoon after the procedure, and you have my permission to use my name in accursed vain)


Jim
Sloop New Dawn
Galveston, TX

Posted by: Jim on May 8, 2006 11:57 PM

First post she EVER made ANYWHERE.
(Here, of all places...;-)

Listen to her--she knows her shtuff. Best damn therapist in Tucson, she is.

Posted by: Desert Cat on May 9, 2006 12:27 AM

PT is super important, you can do it... As soon as it's done, you're on your way to getting past therapy and feeling better. I hope all your research makes it a little easier - I'm sure it will.

Posted by: Vermont Neighbor on May 9, 2006 02:11 AM

Not too keen on the surgery for the rotor cuffs. But did suffer from a sever bout with bursitis to my left shoulder. PT was hell for me. The meds for pain were weaker than asprin and twice as corrosive to the stomach.

The PT and all the home excercises made me wish someone would take me out and shoot me, but it got better. And since then, I keep the shoulders moving and flexible all the time to keep that from happening again.

It was hell, but I got over it. That happened about 10 years ago and I still remember every little detail of pulling my self back into working order.

Was the pain worth it? Damn straight. Glad it was only a touch of bursitis. And, BTW, I agree with Jim. You can swear at me as well if you think it will help.

Posted by: Wichi Dude on May 9, 2006 04:03 AM

Find a friend that will massage your shoulder and frequently.

go fishing frequently as well.

I was in the verge, did nto seek medical advice prior to on-line help.

Without prompting my friend massaged my shoulder and very often during long corss country trips.

Well all symptons are gone, and I'm talking 10 yrs of them! GONE.....

See they are useful.

I know very well where I wa headed, never made the trip!

Amazing what a good massage can actually cure. Ok help out.

Now if she can only get my wrist to work again..... More later!! :)

Posted by: TC on May 9, 2006 04:37 AM

hey, I noticed that too, DC! uh, DC AND DC!!! you GO, girl!

I'll beg your advice one day when it's time to do my double impingements. Walter did one of his, and it sure looked to me like what everyone says about the PT is absolutely correct.

Shoulder impingment syndrome runs in my family. kdad is an MD. He had both his shoulders done, as did ksis.

kdad says this: For impingement, the PT BEFORE surgery cures about 85% of them WITHOUT surgery.

That's a BIG percentage. Saves money too.

If you do have the surgery and DON'T follow up with the PT - and in a timely manner - you build PERMANENT scar tissue, which can't always be removed with more surgery. So per kdad at least, the before and after PT's are both just as important as Miss DaisyCat says.

Ditto for the doc. Ours is a specific shoulder doc. He's an asshole but he knows his stuff like nobody's business.

Walter had this apparatus that ran ice water over the shoulder for weeks, and also had a line that dripped pain meds directly into the surgery site. All that saved a lot of wear and tear on his belly, although he did take oral anti-inflammatories too.

I'm not sure what exactly the difference is between the torn rotator cuffs and the impingement syndrome. I do hear they're similar. In impingement, the channel that tendon runs through is too narrow, which damages the tendon. The problem is either inherited or caused by injury.

The PT opens up that channel. If the tendon isn't too damaged, now it can heal. Continuing PT keeps the channel open.

If the tendon is too shredded and/or other damage too great, the surgery fixes that up - as long as you don't have a hack! - and the PT keeps the scar tissue down and the channel open. But the surgery itself opens the channel up too, causing GREAT relief. They actually remove some of the bone in there to make that hole bigger.

It's all done with those cool little cameras.

Since this ain't my field and I'm going from memory here, what people are saying about surfing for yourself sounds like great advice to me.

Good luck! Anyone who can make it through peritonitis and all that can do THIS with their eyes closed and both hands tied behind their back.

Posted by: k on May 9, 2006 08:18 AM

I agree TC, but go to a professional for a problem like this, most massage therapists these days have been trained in anatomy, and know exactly which muscles to work on. A neuromuscular therapist (n.m.t.) would be the best bet. It may take more than one massage, but the pain could be greatly relieved in even one visit.

Just my two cents.

Posted by: Heather on May 9, 2006 11:19 AM

And make sure your body is in fighting mode before the surgery. Six weeks in advance, try to change your diet and take the vitamins that will beef up your immune system. A nutritionist would know, or your sports therapist. Hold off on caffeine, junk food, alcohol, etc. Like preparing for battle.

Posted by: Vermont Neighbor on May 9, 2006 12:08 PM

Ok, I had a complete tear of the right rotator cuff five years ago at the age of 57. Arthoscopic surgery to repair was successful. Very painful for first 3-4 days. Ask you doc to do a nerve block on the shoulder (they weren't doing them when I had mine done) and you won't have any significant pain. Rehab is the most important part of this surgery. Don't do it and you end up with a frozen shoulder and it's useless. Rehab hurts...the worst part is the stretching they do...but you do get better. I learned quickly to do whatever it took. I regained full range of motion in 10 weeks. Had full use of shoulder back in about 12 weeks and was on the golf course at three months. Just do what the doctors and therapists tell you and you'll be fine. Best of luck to you Rob. (If you want to talk to me more about the process just ask elisson how to reach me. I am a close friend of his).

Posted by: gee on May 9, 2006 01:37 PM

I had a torn rotator cuff and labrium (sp?) tendon. Rehab/physical therapy is a MUST! It took me about 6 mo's. to regain decent movement, but a full 9 mo's. before being at about 90%. I wouldn't say it's painful, just monotonous. Went to physical therapy 2-3 times a week in the beginning. Started with rubber bands, low weights and arm bicycle, etc. If you don't follow through, though, the surgery is a waste.

Posted by: Roger on May 9, 2006 03:53 PM

After losing first place in a fast-pitch contest, I decided to really reel back and let one fly to regain the lead. I won the contest for the worst rotator tear of the day.

The orthopaedic surgeon looked it over and asked me my age and profession. I was 43 years old and an accountant. He said that it wasn't worth the money and effort to fix it at my age and with my work.

I replied that's like telling me that the car is so old and run down that we're not putting any more money into it.

Then he told me about a Braves pitcher that had the same type of tear and was able to rehab it without surgery. I told the doctor tthat the pitcher he referenced had just given up the winning homerun in a crucial post-season game.

Anyway, we went straight to the rehabilitation exercises with something that looked like a giant rubber band, and I did those for two whole days. My shoulder got well on its own after about five short years.

Posted by: Woody on May 10, 2006 02:09 PM

Depends on how badly torn and how much cutting/repair has to be done.

My supervisor tore his right a few months ago, and he's back to about 100% now; not too much cutting/repair needed.

My dad tore his a few years ago, badly. Repeat, BADLY. Much more cutting/repair work, and it was about a year before he was fully recovered.

LIke mentioned above, the physical therapy is a DO NOT SKIP. AT ALL. Dad and my super did most of theirs at home. Dad had a pulley set into the ceiling with a line running through it with a loop on the end. Hook hand of repaired side in loop and pull to move arm/shoulder through range of motion. Yeah, it hurt. But because he did it religeously, he got full range of motion back. Some others his doctor also treated skimped, and did not regain full use.

Short: it's a bitch, but you can do it. and with a good surgeon and doing the exercises, you can be back to just about original condition, or as close as possible.

Posted by: Mark on May 10, 2006 08:45 PM

Had it done April 27 surgery took 5 hours loyts of muscle and tissue removed, right shoulder. Hurts lie hell ,havnt started pt yet,go to dr tomorrow . I know am in a sling for atleast 3 more weeks. Will update after dr appt

Posted by: melanie on May 10, 2006 11:35 PM
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