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pbr549xxx 07-31-2014 08:59

Shoulder dislocation recovery advice
 
I'm looking for advice from the medical professionals that post here, in addition to what I get from my providers, as well as some "been there, done that" advice from people who have had a similar injury.

Back in April, I dislocated my right shoulder. Results from the MRI show that I tore the labrum, the rotator cuff, and some other ligaments and tendons. On Monday I will have the surgery to repair the damage.

My question for the medical professionals is, what can I do to recover as quickly as possible and get back in the "fight". I'm currently in a non-deployable unit, however, I am due to PCS to FT Polk in January and I will be back on Jump Status.

For those that have had a similar injury, what did you do that enambled you to get off profile and back to work, especially if that work involved jumping out of airplanes.

This is pretty important to me, this assignment will probably be my last one before retirement and I would really like to retire on Jump Status.

The Reaper 07-31-2014 13:22

Patient Perspective Here
 
Not a medical professional, but I had a very similar injury to yours.

My shoulder would pop out of the socket while I was sleeping on it or under certain loads. Needless to say, this instability was disconcerting, as well as uncomfortable.

I had the same sort of repairs you are contemplating.

The recovery will typically take 10-12 months, although you should be out of the sling in six weeks or so. You will be given a list of exercises to practice for physical therapy. Each month, new exercises should be added.

I would not expect to be jumping for at least six months. You may not be able to get your arm extended over your head for that long. Even after eleven months, I still find myself using my left arm to pick up heavy objects and raise them over my head. Regardless, you do not want to reinjure the shoulder, or worse, not be able to perform emergency procedures because you RTD too soon.

Most of the pain is gone, but it still flares up from time to time. It has not subluxated on me since the surgery though.

Best of luck!

TR

Joker 07-31-2014 17:01

I did sports therapy for 1-month, the surgery with a "Game Pack" on it for 72-hours, prescribed pain meds for 72-hours till I called the doc and told him I'm stopping them (I hate opiates). After the staples were removed 1-month of sports therapy with heat, deep tissue massage, and then the Game Pack. I was back up to 75% in three months and 100% in 9 months. Good surgeon and sports therapist, and better PA.

Your mileage may vary. Good luck.

mark46th 07-31-2014 21:09

My right shoulder is is pretty much mush. I tore my rotator cuff in 1964 throwing a baseball. In 1971 at Ft Bragg, I separated it playing for the 5th SFG football team a week before I was supposed to go to SCUBA School. But I got orders for SE Asia 2 days later so SCUBA School was irrelevant. In 1991 I had a 10 foot ladder collapse when I was working on a roll up garage door. My right arm went down, pushing my shoulder out of place. It took the effing ER 2 hours before they determined that I could pay the bill. A P/A popped it back into place and I went back to work. Now, the shoulder is junk and hurts most of the time but I can still hit a golf ball 240-250 yards. Life is good.

cetheridge 08-01-2014 00:28

Like TR, I'm not a medical professional. I have not jumped from a plane in 44 years, so I cannot advise on when you might be ready to RTD.

However, 9 weeks ago I had right shoulder surgery to repair/attach bicep tendon, remove 2 bone spurs, re-attach another tendon, and debride worn and shredded cartilage (not much left). My shoulder started hurting in January and got progressively worse. In March I went to my GP who referred me to a surgeon in April. I had the surgery May 28th.

Your arm WILL be in a sling for at least 6 weeks, even sleeping. If surgery is on your dominate arm you will learn to do everything with the other arm. (Wiping your ass with the non-dominate arm will be a new experience). Therapy will most likely begin the next day.

Your attitude and tolerance for pain will play a big part in your recovery progress in physical therapy. While in the sling, all activity with the affected arm will be passive....you will do no lifting with it. Your unaffected arm will assist lifting the affected arm. You don't want to lift anything heavier than your hand at this stage of recovery.

Taking pain meds an hour before PT will help some. Get off the narcotic crap as soon as possible (within 2 days) and use OTC meds. My surgeon advised me to "push thru the pain" when doing PT and flexibility will return quicker. Be careful....don't try to be superman.

While in the sling, all PT exercises will be passive. Out of the sling, you will start exercises with resistance bands, light weights, and some real fun stretching.

You will be given exercise instructions to perform at home on days when not at the therapist. If the instructions say do an exercise once a day, do it twice a day. Go that "extra mile" (my surgeon's advice). Follow your surgeon's advice.
Do the home exercises religiously every day to keep the shoulder flexible.

For the first several months, don't do anything stupid, like using post hole diggers, using a hammer, or lifting heavy objects, unless you really liked that post surgery pain and want to start all over again. In the past month, I know 2 people (one at 7 weeks into therapy and the other at 8 weeks) who used a hammer and post hole diggers because they felt better, and now they both have
just had surgery again.

9 weeks ago, I had the surgery. I have regained 85%-90% range of motion in the right arm. Thursday, July 31, I visited my surgeon and was released from official PT. I had a great surgeon, PA, and therapist (she is about 5'-10" tall, slender, short blonde hair, very attractive....damn I'm going to miss her....but I digress).

As TR said, total recovery will be about 10-12 months. It's a slow healing process.

I still have some tightness and some occasional discomfort (not really pain).

If I can help you through the recovery, feel free to PM me.

Carl

Red Flag 1 08-01-2014 09:02

edit

pbr549xxx 08-01-2014 09:20

Quote:

Originally Posted by Red Flag 1 (Post 558539)
While I have not had shoulder surgery, I do have a labrum tear and have had a few C-arm guided dye & steroid injections. I have also been the anesthesia guy that gets you safely through surgery. Shoulder injuries are painful, as is the post-op recovery. I found that I was never able to find a position of comfort with my shoulder pain, short of immobilizing the joint. Patients who have had only general anesthesia for shoulder procedures, are among the most difficult to get comfortable in the PACU, recovery room. That said, I always offered/ encouraged a block pre-op with long acting agents to cover that difficult time in the PACU. The block is actually all you might need for the surgery, with a little sedation. Most folks liked the block followed up with general anesthesia, it is a great option. Right after surgery, and as the block begins to resolve, start the pain meds to get ahead of the pain-v-chasing the pain. Physical therapy after surgery is key, and as cetheridge noted, pain meds before PT, is a great help.

So, best of luck in your surgery, and long recovery. If you are offered a block for your shoulder, take advantage of it. The block will be of tremendous value right after surgery.

I spoke with the nurse anesthetist that will be working my surgery. He said they are going to give me some type of coctail that will make me not really care what they do, then thgey are going to put something in my neck that will block the pain from my shoulder to my figertips. Following that I guess they will knock me out to perform the surgery. He said that painwise, I should go a good 18 to 20 hours after the surgery before it starts to hurt.

Red Flag 1 08-01-2014 12:59

edit

cetheridge 08-01-2014 12:59

Quote:

Originally Posted by pbr549xxx (Post 558543)
I spoke with the nurse anesthetist that will be working my surgery. He said they are going to give me some type of coctail that will make me not really care what they do, then thgey are going to put something in my neck that will block the pain from my shoulder to my figertips. Following that I guess they will knock me out to perform the surgery. He said that painwise, I should go a good 18 to 20 hours after the surgery before it starts to hurt.

Yep....they will start you on an IV combo of antibiotics and some "I don't care juice". I recall talking with the anesthesiologist about him administering the nerve block. He said the block would last 12 - 24 hours. Next thing I remember is waking up in recovery 2 hours later (1 PM).

As RF1 stated, it is better to get ahead of the pain v. chasing the pain.

Be aware that the nerve block time frame is only a general guide. My plan of action was to pop a Dilaudid tab at about the 10 hour mark (figuring minimum 12-hour effective block time). 6 hours after surgery (about 7 PM) the nerve block wore off ....what a surprise!....45 minutes of intense pain before the pain med tab became effective.

Hopefully, your experience will be smooth. So far, my physical therapy has been smooth. Remember....mind set.

Carl

Red Flag 1 08-01-2014 13:33

Edit

pbr549xxx 08-02-2014 22:04

For a while there my PCM had me taking up to 3ea 5mg percocets during the day and a 10mg before bed. I would take a 5mg at 0900, a 5mg around noon, and a 5mg around 1500. I'd take the 10mg between 2000-2130 before hitting the rack. I didn't get any type of high or feel good sensations from the Percocet, it just made my shoulder not hurt. The Ortho Doc said to stop and suck up the pain during the day and take the 10mg at night. My shoulder hurts all day, but I suck it up. Hopefully that's a sign of things to come and I'll be able to suck up the pain and not have to take a bunch of pain meds.

pbr549xxx 08-04-2014 18:16

Surgery is complete. The one thing I was hoping didn't need repair was the bicep tendon, so of course that was torn and had to be moved which I am told will complicate the recovery a bit more. The nerve block worked amazingly, the tips on my fingers are still a bit numb over 12 hours later. I started taking the pain meds so I'm staying ahead of the pain.

Thanks for the advice, I really appreciate it.

AATW!!

cetheridge 08-04-2014 23:01

Great! Good to hear you came thru surgery okay.

You're more than welcome for the advice...it's free.

Let me know if I can assist with advice for the therapy....I also had the bicep tear that was not expected until the doc got inside. Now the upper bicep looks like they took a spoon and scooped part of it out. Trying to rebuild it with light dumbbell weights and resistance bands.

Pecking on the keyboard with one hand is a bitch, ain't it?

Remember while going thru the therapy and the long recovery period that "slow is smooth and smooth is fast".

Keep us apprised of your therapy progress. We're here to help if we can.

Carl

pbr549xxx 08-05-2014 08:09

Typing one handed does suck lol, not so bad on the iPad though.

pbr549xxx 08-08-2014 15:46

Day 5 Update: The pain isn't totally unbearable, I'm guessing that has to do with a 10mg Percocet every 4 hours as opposed to me being any kind of bad ass LOL. By far the worst things are having my arm immobilized, and the itching that is caused by the Percocets and the incisions starting to heal. I also get some bad headaches and feel nauseous from time to time.


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