Shoulder Replacement

@tfarizona
My reverse TSR surgery was done last October, I felt very little surgical pain, just an overall ache in the shoulder area afterwards. Went home before noon the next day. Used only prescription strength tylenol and naproxen, never needed the tramadol or oxycodone that were prescribed, don't like how they make me nauseous and pain was not that bad. I had an flexible ice pack sent home with me from the hospital and I iced the shoulder constantly. Sleeping comfortably was the only real problem for the first month, because you are limited to being on your back or on your non-surgical side. They fitted me with an immobilizer ("sling thing") at the hospital, which you wear even when sleeping. It's a wide velcro waistband that has a velcro strap that keeps your elbow rigid at your waist, and a removable wrist strap that velcro's onto the front of your stomach. I thought it was great, because you could easily disconnect the wrist strap to prop your elbow on a table for using a computer keyboard or some other hand activity. I was able to do way more than I had expected, and rarely needed any help from my husband for anything. For sleeping, I had a bed wedge under my back and extra pillows around to prop anything that needed adjusting. I used the recliner during the day, but needed the extra bed space at night. Within a day or two, after all the hospital narcotics got out of my system, I felt good enough to do anything that didn't involve the use of my right arm, which had to stay in the immobilizer.

Before my PT started I did the three types of directional pendulum arm dangle exercises that they showed me in the hospital. I did more reps than called for. Started PT at two week out, went very well, by 8-10 weeks I had regained nearly full mobility without pain. I continued at home with band stretch exercises for some weeks after PT was over. My vertical stretch was nearly the same as my other arm. The only difference I could tell, is that small quick rotational movement such as soaping your torso in the shower continues to be slower and more awkward with that arm. At the 9 months point, I was pleased that my surgery was a total success, no arthritis pain, good range of movement, and I think an easier recovery than both my knee replacements.

However, I have now hit a bump. Perhaps because of overuse??? I had been doing a lot of gardening, lifting, carrying heavy pots and water, pulling hoses etc and within just the last three weeks I have had episodes where if I drop or move my shoulder inward quickly, I get a pain that almost feels as if it gets out of joint. I have to shrug the shoulder and use my other arm to move my elbow around to where I can get the pain to stop. We had been out of town on a Canadian fishing trip the last week, so will have to see about a Dr appointment shortly. At times the pain feels much like when you get a really bad leg cramp, and I can feel the tight "hurt line" running down the back of my arm from shoulder to elbow. Once, I got it to stop by just pressing on that line for a bit, but that does not work every time. Kind of mysterious, but I will have it checked out soon. Nothing like it in the first 9 months after surgery.

Thank you for your detailed response. I hope that the recent issue is nothing more than possible over use as you suggested.
Have you noticed any difference using the deltoid muscle instead of the rotator cuff muscles?

Not much difference for ordinary daily things once the shoulder is healed from surgery. If you are into sports, throwing a ball or playing tennis will be a little weak because that fast snap is not there. Whether that might come back come with more time and work on strengthening the deltoid, I don't know. If you can combine using both arms for a movement, that makes it more natural. Any rotational rubbing/scrubbing movement is just more slowly done, but range is ok.
My doctor said only part of the entire set of rotator muscles are removed, but the front of my rTSR shoulder is definitely more sunken looking than the other one.

I am wondering if not keeping up with my stretch band exercises (forever) may have contributed to my current problem. I assumed I was getting enough workout through gardening, but the overall stresses would not have been directionally the same as the band use.

I'll post when I find out more about my current problem.

I did not go to Mayo, it is at the opposite end of the state, and we have an excellent orthopedic surgeon, Dr. Jason Caron, here at Sanford Bemidji Orthopedics and Sports Medicine. He did both my knees previous to the shoulder, so I had confidence in him. I was more leery about my shoulder, so I talked to several people who had shoulders done by him and were happy with their outcomes before I committed to the rTSR. That's the advantage of living in a small town, a doctor's skills and successes are easily verified by talking to his former patients who may be your neighbors. If someone is unhappy they will let you know!

After earlier x-rays, I had an MRI and a CT scan scheduled on the same day to determine the condition of the surrounding muscle and tissues. Then I had to be scheduled to go back for an additional scan (can't remember which ?CT?) which was a different specialized scan to provide measurements for the production of my custom shoulder prosthesis.

Thank you again for answering my questions and helping to relieve some of the pre surgery anxiety.
I cleaned floors in my house today and my “defective” shoulder is not happy. I hope for a positive surgical outcome like yours.

Thanks for the response.
Was your surgery completed? If so, how was pain management after surgery and how was the rehab? Does the shoulder feel differently using the deltoid muscle? Are you satisfied with your ROM? What was the best way for you to sleep for the first few weeks?
I’m 73 and generally in good health although I do have osteoporosis.
I’m scheduled for surgery at the end of November. The surgeon said that he would make a recommendation regarding type of procedure after a Cat scan. He said that he doubted that the cuff was damaged but said that reverse might be the way to go.
Most surgeons seem to lean towards reverse even though the procedure has only been used for 20 years and there are few long term studies of outcomes compared to aTSA.

@tfarizona
My reverse TSR surgery was done last October, I felt very little surgical pain, just an overall ache in the shoulder area afterwards. Went home before noon the next day. Used only prescription strength tylenol and naproxen, never needed the tramadol or oxycodone that were prescribed, don't like how they make me nauseous and pain was not that bad. I had an flexible ice pack sent home with me from the hospital and I iced the shoulder constantly. Sleeping comfortably was the only real problem for the first month, because you are limited to being on your back or on your non-surgical side. They fitted me with an immobilizer ("sling thing") at the hospital, which you wear even when sleeping. It's a wide velcro waistband that has a velcro strap that keeps your elbow rigid at your waist, and a removable wrist strap that velcro's onto the front of your stomach. I thought it was great, because you could easily disconnect the wrist strap to prop your elbow on a table for using a computer keyboard or some other hand activity. I was able to do way more than I had expected, and rarely needed any help from my husband for anything. For sleeping, I had a bed wedge under my back and extra pillows around to prop anything that needed adjusting. I used the recliner during the day, but needed the extra bed space at night. Within a day or two, after all the hospital narcotics got out of my system, I felt good enough to do anything that didn't involve the use of my right arm, which had to stay in the immobilizer.

Before my PT started I did the three types of directional pendulum arm dangle exercises that they showed me in the hospital. I did more reps than called for. Started PT at two week out, went very well, by 8-10 weeks I had regained nearly full mobility without pain. I continued at home with band stretch exercises for some weeks after PT was over. My vertical stretch was nearly the same as my other arm. The only difference I could tell, is that small quick rotational movement such as soaping your torso in the shower continues to be slower and more awkward with that arm. At the 9 months point, I was pleased that my surgery was a total success, no arthritis pain, good range of movement, and I think an easier recovery than both my knee replacements.

However, I have now hit a bump. Perhaps because of overuse??? I had been doing a lot of gardening, lifting, carrying heavy pots and water, pulling hoses etc and within just the last three weeks I have had episodes where if I drop or move my shoulder inward quickly, I get a pain that almost feels as if it gets out of joint. I have to shrug the shoulder and use my other arm to move my elbow around to where I can get the pain to stop. We had been out of town on a Canadian fishing trip the last week, so will have to see about a Dr appointment shortly. At times the pain feels much like when you get a really bad leg cramp, and I can feel the tight "hurt line" running down the back of my arm from shoulder to elbow. Once, I got it to stop by just pressing on that line for a bit, but that does not work every time. Kind of mysterious, but I will have it checked out soon. Nothing like it in the first 9 months after surgery.

Sorry: I was not clear in my message: I have not had the left shoulder replaced yet. I am waiting for the CT scan, which will be made on August 10 for a 3D model. Then the surgeon will give me a date for surgery. So about 6 months after that I need to have the right shoulder replaced.
Reverse seems to be less painful and it seems to have good results in the elderly. The dr. told me I will not be able to use the left arm for 6 weeks at all. After that he told me the result is dependent on the effort you put in at the PT. A friend of mine had it done. She is quite happy, she can not lift her arm above her head, but can wash and care for herself easily. She drives a car.