The Real Scoop on Shoulder Surgery (Part 1)

I've had surgeries. I've had orthopedic injuries. I've broken a wrist, sprained an ankle, and once had twelve individual hairline fractures of my foot at one time. I've known pain. In fact, one of my surgeries was an ACL reconstruction. I thought I was prepared. I read up on the surgery I was to have, but we didn't really know specifically what the surgeon would find once in there, so that was kind of difficult. But while I was reading and researching, I came up with some useful advice, but I never found out exactly what I needed to know. So here is my complete shoulder story. Maybe it will help someone.

In the Beginning:
So I had my injury toward the end of July, 2014. I didn't hear any loud pops, but I did feel something give way. Immediately, I couldn't lift my arm away from my body at all. I went to the ER later in the day and was put in an immobilizing sling type of contraption. I was immediately told there was some type of soft tissue injury and referred to an orthopedic surgeon. I saw the guy within a few days of the injury, and he immediately freaked at the immobilizer and told me to not wear it. I was so glad that I tossed it in the trash can in that exam room, right then and there. He was concerned with frozen shoulder, which sounded made up to me, but I assure you now that it is not. With my physical exam and nature of the injury, he was concerned about a labrum tear. I was told then that there was no way I could work, and to just give it up for now.

The Arthrogram
If you have never had one of these, well, I don't even know what to say. I've heard some say they're awful and I've heard some say they didn't bother them at all. It took three weeks to get in have mine done--insurance gave us fits. By then, my shoulder felt even worse and was really stiff. I couldn't sleep, and I couldn't move my arm away from my body at all without horrible sharp pains that felt like my shoulder was going to be ripped apart.
For the arthrogram, they use imaging to inject dye into the actual joint. It's a big needle, but they give you a local first. That stings a little, but not too bad. The big needle? Didn't even feel it. The part I did feel was an intense achiness and just general weirdness as they filled the joint with dye. The shoulder doesn't have a lot of space, so the excess fluid made it feel full and kind of blech, but I do believe that there is also numbing medication in it, so it isn't too bad. You then go straight for an MRI so they can visualize all of that dyed goodness.
I will tell you that after the arthrogram is no fun at all. It hurt. It hurt really badly. I'm not dure if this was soreness from big needle going through muscle, and injured joint now filled with excess fluid, or a combo of both, but once the numbing medication wore off, all I could do was lay on my sofa with an ice pack and hope my children didn't destroy me or the house. It seriously hurt to move my upper body at all. That was the first time, in over a month of this shoulder injury, that I asked for pain medication beyond Tylenol. And took it, too.

Me, after the arthrogram and after pain meds. As I recall, I texted this to my husband at work to tell him I was miserable and to hurry home.

Also, the morning after the arthrogram, I had some mild bruising where the injection took place.

The Puzzling Results, the Hubs Debacle,  and More Crap
My arthrogram was negative. I think it showed some inflammation of my biceps. No labral tear, no rotator cuff tear. I was diagnosed with frozen shoulder (adhesive capsulitis) at this point. I was given a cortisone injection---ugh!---and prescribed antiinflammatories. Of course there was also rest and physical therapy. At this point, it happened. And by it, I mean I got a phone call that Hubs, the big dork, had fallen through a ceiling at work and was in the ER. He ended up coming home on crutches, seeing his very own orthopedic surgeon, and was scheduled for ankle syndesmosis repair within a week.
Suddenly that rest we had talked about was pretty much non-existent. Hubs ended up getting a plate, a couple of screws and some anchors. He came home from surgery on Oxycontin every 12 hours with Percocet every 4 hours in between for breakthrough pain. He had to take all of the above with Phenergan to prevent nausea. This was only for a few days, but in those few days, I was filling ice bags, cooking his small meals, helping him bathe and dress, helping him change positions every few hours. I did all of this around the clock--the meals especially, so he could eat and take his pain medications. Within 24 hours of that first day of that, my shoulder started to do this:

Out of concern, I saw my surgeon. I was told it was probably a "red herring" and not to read too much in to the random bruising. Incidentally, my pain was worse, also. Physical therapy's importance was stressed, and I teared up as I told them I hadn't really been compliant with that because of Hubs and needing to be able to care for him. I did start PT and worked on range of motion and light strength training. This is where I tell you how much I love my physical therapist. She told me she didn't think there was an issue with frozen shoulder, as she could passively move my arm, I just couldn't actively do it. She vowed to watch it for progress while we continued to work together for weeks. Throughout this, I continued to follow-up with the surgeon. My diagnosis changed off and on. At times, I exhibited symptoms of anything from biceps tendonitis to supraspinatus strain. Physically, nothing ever really changed. I got my range of motion back, but never lost even a smidge of the pain and never got strength back in that arm. This starts the chain of events that lead to surgery.

We Need to Just Go in There and Take a Look

When I never improved despite strict compliance and serious PT work, I had continued to have random bruising pop up whenever we would change anything up in PT. My therapist was still concerned and actually convinced the surgeon to repeat an MRI. We were awaiting those results. I was going to PT on Mondays and Wednesdays. This one Monday, about four months after injury, we had started biceps exercises that weren't too bad. Of course, there was more random bruising, and I reported for Wednesday's session looking like this:

My therapist actually advised me to take that picture, because she wanted to be sure the surgeon saw it. I had a follow-up the following day to get those MRI results, so I didn't have to even bring it up. I saw my surgeon's NP and she saw it immediately. Of course the new MRI still didn't show anything but biceps strain. Everything seemed to be intact. Nevertheless, the NP brought the surgeon in to be sure. At this point, it was deemed warranted to go in there and actually see what was happening. Before I knew it, I was being fitted for a post-op sling and scheduled for surgery. I picked a busy surgeon, so I had to wait a couple of weeks for--get this--shoulder arthroscopy with possible rotator cuff repair, possible biceps tenodesis, possible subacromial decompression, possible labrum repair, possible acromioplasty. Gotta love informed consent.

This went on way more than I expected, so I'll post about the prep for surgery, survival tips, and the actual experience in a second post. I really hope this helps someone.