4-5 November 2014
It's done. The first day of my next season of Ultimate started, today. Here are some tips and a bit of info.
First off, as I noted in the last post, the doc originally thought I had a labrum tear, but the MRI showed it was in fact the supraspinatus tendon that had a 6mm hole in it. Well, when he went in to repair it he found another tear, this one in the infraspinatus tendon. (So, the radiologist was right!) Dr. Berdia also shaved out some bone spurs and worked on my bursa, but fortunately found no sign of arthritis! All in all, it was a very successful repair; the surgeon is thrilled with the immediate result, and believes I am off to a great start.
Let me take a step back, here. The day of the surgery, I woke up hungry because of the required fast. That sucked and made me irritable. Pro tip: Try to eat as much as you can, and eat/hydrate until the last minute the surgery prep directions allow.
Also...
- Make sure all services/doctors are in-network, if possible. 90% out-of-network coverage might sound good, but it will likely leave a hefty balance to pay on you own. Fortunately, my insurance has covered everything, so far.
-Getting nerve blocker injected directly into the nerve of your neck sounds awful, but they start dosing you up with goodies before that procedure. Nerve blockers give you that pins and needles feeling all day, but at least they keep the pain at zero for ~16 hours.
-I was considerably more lucid than the last go-around with general anesthesia (wisdom teeth), which of course was the great Nader-debacle of 2009. Coming out of sedation I threatened bodily harm to the surgeon, then started crying uncontrollably, and talked about voting for Ralph Nader 5 years earlier. No adverse effects this time around. I even woke up talking to the nurse about how to potentially cure one kind of lupus (Seriously! Ask me about it).
-I've had a pretty good appetite the whole first day, which is good. It's hard to feel ok taking Percocet with an empty stomach. About Percocet: the suggested dose is two pills every 4-6 hours, but I find taking 2x at a time is only good at night to help with falling asleep. I took two, this morning with breakfast and was too drowsy to do anything for three hours. The physicians assistant and I agreed that taking one pill every 2-3 hours instead should manage the pain without any risk of o.d. so long as I don't greatly exceed three grams, daily, of the included acetaminophen. This is the active ingredient in Tylenol and your liver can't handle much more than that amount in a 24 hour span.
-On pain management (important!), stay ahead of the pain. The nerve blocker effects tapered off faster towards the end of last night after surgery than I anticipated. When I went to the polls to vote (yup, I sure did!) around 7pm, I started to feel sensation, mostly heat, return to the shoulder, so I took one pain pill. This was a mistake. By 10pm when I was trying to go to sleep I needed two more, but I was already behind the proverbial eight-ball; the next two hours were agony as my pain doubled and tripled before finally coming back down to a reasonable level. I could feel the spots of the scalpel incisions, it was as if they were being filled with molten lava or a hot roofing nail.
The good news is, now a full 24 hours after leaving the O.R., I am managing the pain fairly well, although it is still noticeable; shifting around, standing/sitting is fairly uncomfortable. I am still eating well, icing lots, and getting rest. It has taken me 3-4 sittings to finish this blog post, though, and I've only had enough energy for 2-3 short phone conversations - I feel pretty wiped out, but that is to be expected as my body was put through a fairly traumatic experience. DISCLAIMER, this is a graphic video! Although it is an example of a SLAP tear repair, the first three minutes of the video give a great example of how, even though arthroscopic shoulder repair is much better than open surgery, it is still a major insult to the local tissues!
I do have some gnarly internal images of my own shoulder (pre- and post-repair), which were captured by the surgeon while he was in there, but I only have the prints, and will need to scan them before I can post them, here. Until then, here is a less graphic video (internal camera, only) of what an actual rotator cuff tendon repair looks like, although this, too is not my actual procedure.
That's all, for now. I'll have another milestone, tomorrow as I take off the sling for my first session of PT.
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