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maculated
Trad climber
San Luis Obispo, CA
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Topic Author's Original Post - Nov 28, 2007 - 01:49am PT
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Hey guys, so I finally bit the big one and got my shoulder looked at: attached Perthes lesion of the anterior labrum and a SLAP lesion of the superior labrum. Always just figured I wasn't training it enough or whatever. Anyway, Greek to me at this point.
I'm so excited because ever since I hurt my shoulder, I've never been able to get fitter (even running hurts it) and many of you know what it's been like climbing with me the last five years, which is why I've pretty much faded from the scene. Eeee!! Fixed! YAY!
But here's the deal, I would love to know anything and everything you guys can tell me about pain, recovery, rehab, etc. I bet lots of you have had this injury or something like it. Apparently it's so fancy that my doc can't do it and referred me to another, asking if he could assist.
SO EXCITED!! MAYBE I'LL CLIMB STRONG AGAIN!!!! WOOOO!!! It wasn't all in my head!!
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paganmonkeyboy
climber
mars...it's near nevada...
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Nov 28, 2007 - 01:57am PT
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ooo i'm sorta getting good at this one...
1) get the *good* doc that knows what they are doing - this is HUGE. Get the shoulder expert, or wait and find the shoulder expert - ask them what they are doing, how many they have done, success rate - should be high 90s to get back to 85% of mobility, strength etc...
2) look into or ask about bio-absorbable anchors instead of the brass/metal they use - red dirt girl might know more here, but I feel every single piece they left in mine...
3) ask questions and write everything down on the rehab plan - you will forget what they told you by the time you have to do it, and you don't want to screw it up.
4) see 1 - no joke.
5) relax - this will prolly get you back to where you were in less than a year. Do what they tell you, be extremely paranoid about not f*#king it up for the first month or two, then be ready to crank on it over 3 months to get any and all mobility back before worrying about the strength.
I'm looking at #2 on the left shoulder, had a slap on the right as well in 03 that is just bomber right now. Left one only failed because I didn't work it out enough to take the loads I put back on it, so be patient and work it scientifically and you will be stellar...
email me too if you want to - this is a biggie, but you will get it and be crushing in no time...
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Mighty Hiker
Social climber
Vancouver, B.C.
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Nov 28, 2007 - 02:02am PT
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I mostly concur with PMB. Key is getting a good doctor and a good diagnosis, and a bit of luck. After that, physiotherapy, stretching, you name it.
I did a lot of swimming after shoulder surgery, once I could, and found it helps a lot. Not just for general fitness, but also for ensuring the entire shoulder gets a good workout. Join a master's swim group if you can, so you get some coaching and structured workouts, and more benefit - it's easy to lolllygag in the water without a bit of stimulus.
Yoga may help, also. Outside my knowledge.
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paganmonkeyboy
climber
mars...it's near nevada...
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Nov 28, 2007 - 02:08am PT
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6) get a comfy recliner to sleep in for the first month - you will be tired and uncomfortable and in pain, and sleeping on your bed with the arm immobilized will be almost impossible I have found.
Good call on the swimming, Anders - I needed to do more this time, and didn't...
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Standing Strong
Trad climber
the only coast
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Nov 28, 2007 - 02:14am PT
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ugh, i have had shoulder probs. i'm glad i didn't need surgery. kaiser really sucked but lots of yoga i think (the doc ok'd it) is what helped the most and now, can do handstands w/no pain! that is awesome you had surgery to repair and will be back to practically new. remember that healing can hurt, don't let it discourage you.
very good luck w/your recovery.
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G_Gnome
Trad climber
In the mountains... somewhere...
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Nov 28, 2007 - 03:02am PT
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All you have to do is ask your friends and they will tell you the best doc to go to. Mr. ElAttrache at Kerlan-Jobe has now done 9 people that I know and all are back to full strength and climbing hard. Ask Curlie, Kris, Rich, Herb, Rachel, Rich again, Barbara, and Kevin.
I would also agree on the recliner. No one understands how much a shoulder hurts until they get it cut. You will sleep sitting up for a while.
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paganmonkeyboy
climber
mars...it's near nevada...
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Nov 28, 2007 - 03:11am PT
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G_Gnome - Rich again ? same shoulder ?
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Ksolem
Trad climber
Monrovia, Ca
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Nov 28, 2007 - 11:27am PT
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" ...G_Gnome - Rich again ? same shoulder ? "
Other one, actually.
El'Attrache is a phenomenal doctor. A true Healer. Well worth the trip to L.A.
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Roger Breedlove
climber
Cleveland Heights, Ohio
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Nov 28, 2007 - 11:39am PT
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Hi Mac,
I had my shoulder repaired with great success about 6 years ago--torn cuff. My doctor's specialty is sports medicine and she commented that finding the right surgeon was critical, "It's not like it's open heart surgery." She said plainly that the success was almost totally dependent on the quality of the actual surgery, and that it is never really clear what needs to be done until they are inside.
Aside from the quality of the surgeon, the dedication to the rehab is critical. The physical therapy took a while, but I am 100%. My newly rebuilt shoulder is much stronger and more flexible that my beater on the other side
After the surgery, the discomfort can be debilitating. Sleeping in a chair is good advice. In my case, there were also drugs involved. Some of the best know to mankind. This is what I posted in a few years ago in a similar thread.
My wife drops me off at University Hospital; I am admitted, dressed in a drafty gown, and wait. Dr. Goodfellow--not made up--stops by with the quintessential Indian anesthesiologist. (My own theory on why so many anesthesiologists are foreign is that the language barrier makes no difference to an anesthesiologist or the patient. Nobody really wants to listen to all the ways that you won't wake up…and then you are out.)
I start counting bac....
When I awake several hours later, my arm is in a sling, and I have a 3" by 6" bandage on top of my shoulder.
I feel fine. After a short wait, my wife arrives, I am discharged and we go home.
My wife has to go to three drug stores to get the pain prescription filled. Three!
I feel no pain. Easy as pie. I am back at work on Monday, wowing my friends with my fortitude, my suit jacket draping my shoulders like some aging rock star. They overlook my braggadocio.
I walk my dog in the early, frosty morning, slipping on the wet leaves. Down I crash with the reflexes and mental acuity of a cadaver. I aim for my shoulder, scoring a direct hit.
Hummm, that didn't hurt. When I get home, my wife gently wipes the dirt off my nose. Hummm, didn't feel that either.
Next day, I showered...ahhh, the good life. As I step into the darken bedroom, at full stride, I trip over my pooch, take a wild step to catch my balance, and effortlessly stop myself on the door jam into the hall, with my face, arresting my sideways motion by neatly nestling my nose on one side of the jam while expertly keeping my cheek on the other.
Okay, I felt that.
The dog didn't get up.
I walked around with two bright burses on my face--one diagonally across my cheek and into my forehead and the other nestled into the side my nose--with my suit jacket draped over my shoulders like an aging rock star who still likes to mix it up.
When I visited Dr. Goodfellow later in the week, he was stunned into a silence at as I walked in and he caches sight of my face. He was in near shock as I recounted my direct hit on his handiwork after falling in the wet leaves.
"You ever think that the caution, 'Don't operate heavy machinery' might have a broader applicability?" he asked, incredulously.
“I feel fine.” I say.
“You think?” He replies. He did not seem amused.
I smiled sweetly, from one side of my face, and wondered why the local drug store doesn't carry this stuff.
All the best, Roger
PS: Have someone take the dog during the early period of your recovery.
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maculated
Trad climber
San Luis Obispo, CA
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Topic Author's Reply - Nov 28, 2007 - 12:00pm PT
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Love the TR, Roger. :) Good thing the Fury walks herself!!
Yeah, I remember Dr. El'Atrache, but didn't know ALL of you guys went to him.
The clincher is this - I finally got the seed money saved up to cover everything and it has to be done in Jan or earlier - I have a month off from teaching to recover that way.
Well, I'll call his office anyway, but I suspect coordinating that will be veddy, veddy hard. We'll see what the doc up here says, too. (Gee I love paying $175 for them to tell me on the first visit - get an MRI, NO! and can't fix it, but can I examine you again, this is cool!)
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paganmonkeyboy
climber
mars...it's near nevada...
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Nov 28, 2007 - 12:03pm PT
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7) Be careful with those meds though - I went through total opiate detox when I stopped taking mine, and was sick for three days...guh...ymmv...
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maculated
Trad climber
San Luis Obispo, CA
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Topic Author's Reply - Nov 28, 2007 - 12:07pm PT
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Eeeee.
GOod thread. Thank you.
So, working on the LA doc, but seriously, how does one's insurance cover a guy like that in the first place?
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TradIsGood
Half fast climber
the Gunks end of the country
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Nov 28, 2007 - 12:08pm PT
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Make sure that the anesthesiologist knows your name. Not kidding! One came by while I was awaiting surgery on my finger and asked how my knee was. Maybe you want the other guy, doc!
Some hospitals now require that each person you see asks you your name.
EDIT:
BTW. You might also work out with the physician the type of anesthesiology, if there is more than one option. Then make sure that is what the anesthesiologist is doing. In my case, it was a "beer block", not sure if that is the right spelling, as opposed to some type that leaves you unconscious. The right anesthesiologist apparently had his own idea when he first arrived.
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Ksolem
Trad climber
Monrovia, Ca
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Nov 28, 2007 - 12:47pm PT
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Actually, date of birth is the best way to keep things straight. That is what they do at UCLA med center neurosurgery.
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Forest
Trad climber
Tucson, AZ
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Nov 28, 2007 - 12:57pm PT
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Can't comment on the first part, but I had a SLAP repair about 14 months ago. In my case, the labrum was partially detached, but the tendon was still connected to it. The surgery was a complete success. I was able to start easy climbing after 3 months and didn't have to worry about re-injury at all after 4 months.
It was my only real experience being the patient in a hospital. I went home the day of the surgery. Pain really sucked at first. Then got worse after 48 hours when we removed the pain catheter. After 5 days or so, I was able to stop taking any vicodin other than to sleep at night. That lasted maybe 4 more days with a constantly diminishing dose.
Initially, the pain mediation was totally insufficient. A higher dosage after this feedback helped. But a bit of MJ self-medication really helped a lot for those first few days.
After the first week, it was just a matter of remembering not to pull on doorknobs and the like with my injured arm. I could use the hand to carry small things and stuff with no problem. But every once in a while, I'd forget and grab something I shouldn't. Damn, it would hurt for a bit.
Within 6 months, there was zero residual pain at all from the procedure. A click that had been in my shoulder for as long as I could remember was gone.
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Phil_B
Social climber
Hercules, CA
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Nov 28, 2007 - 01:05pm PT
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No experience with that surgery, but lots of whitewater kayakers get messed up shoulders too.
One thing that always comes across when I read their TR's is that you have to stick to the the PT religiously.
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reddirt
climber
subarwu
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Nov 28, 2007 - 01:39pm PT
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The whole thing was so uneventful, I almost forgot that I had this done. Here's my experience:
-figured out who was a GOOD ortho to see (by word of mouth/other climbers) w/ *lots* of shoulder surgery experience.
-found a good PT with whom I had good chemistry
-did ~1-2 month's worth of PT beforehand (3x/wk).
-prior to surgery, I bought a used cryocuff & one of those pillows w/ arms (often called "husband pillows?).
-had a simple (no biceps tendon involvement) SLAP II done Jan 29, 2007 (bioabsorbable anchor placed into socket, suture thru labrum to tack it to anchor)
-3 or 4 days of hydrocodone and/or ibuprofen & cryocuff
-PT 3x/wk until April (3 months)
-kept sling in public for 1+ month? to try to prevent ppl from bumping into me (visual deterrent) but took it off as much as possible at home... most of the pain in weeks/months after surgery comes from being immobilized in a sling, not the shoulder itself.
-climbed like a baby for the 1st time again at Sushifest #1 (end of April)... thanks for the belay Mal!).
If I hadn't been able to find the cryocuff used, I would have gotten a script for it & it would have been covered under "durable medical equipment" by insurance.
I'm a huge fan of the cryocuff!!
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Ksolem
Trad climber
Monrovia, Ca
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Nov 28, 2007 - 02:37pm PT
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When Dr. El'Attrache looked at my mri, he winced. "That doesn't hurt?" he asked. "Only when I try to move..." I recall him saying something to his fellow about how I tried to tear my arm off but the skin held it on...
I had full thickness tears of three of the four rotator cuff attachments and a ruptured outer bicep. Going in to the surgery he explained that he would try to do it arthroscopically, but wanted my permission to open it up if need be. He was able to do the job arthroscopically, and six months after surgery (and following intensive P/T) I was able to begin strength training and light climbing. Since then Pilates training has been a miracle for me and now I have great shoulders.
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Ksolem
Trad climber
Monrovia, Ca
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Nov 28, 2007 - 04:01pm PT
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Just to entertain all the medical types here, I just dug up and scanned this image taken by the good Dr. El'Attrache during surgery, of my subscapularis tear. My Mom always told me "If you are going to do something, do it right!"
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