SLAP tear surgery

[Aggie93]

I was whitewater kayaking at the end of August and got pinned against a rock. While trying to work myself free, I extended my are too far and at a bad angle and felt a sharp pain. After two months of rest, ortho prescribed PT. I still had pain after two months and had an MRI which showed a labrum tear from about 11:00 position to 4-5:00.

I'm having surgery Wednesday. Any tips for making life easier while in a sling? Any other comments?

[pavulon]

Can't offer advice for surgery but regarding anesthesia...get an interscalene brachial plexus nerve block (or better yet, interscalene catheter and pump) for post-op pain control. Some places will do the entire surgery using the nerve block and some sedation.

While not without risks, this block makes life much better after shoulder surgery and should be offered and placed routinely, efficiently and effectively.

Good luck!

[Tobra]

^what the anesthesiologist said^

Get the big gel ice thing that goes over your shoulder and use it post op. Keep in mind the physical therapist is not trying to kill you.

[madmmac]

Nice, Dr had you go put yourself through 2 months of pain from PT for no reason.

If it is your usual arm for wiping your a$$ and shaving, use more paper than ever and maybe use an electric shaver if you don't now. Those were the tough ones for me.

And do all your PT, above and beyond if you can. It will pay off later.

[Crowbob]

Don't go kayaking.

[Aggie93]

Originally Posted by pavulon

Can't offer advice for surgery but regarding anesthesia...get an interscalene brachial plexus nerve block (or better yet, interscalene catheter and pump) for post-op pain control. Some places will do the entire surgery using the nerve block and some sedation.

While not without risks, this block makes life much better after shoulder surgery and should be offered and placed routinely, efficiently and effectively.

Good luck!

Ortho mentioned the anesthesiologist would ask if I wanted a shot in the shoulder. Is that what you are referring to? Didn't mention a catheter and pump.

Originally Posted by madmmac

Nice, Dr had you go put yourself through 2 months of pain from PT for no reason.

If it is your usual arm for wiping your a$$ and shaving, use more paper than ever and maybe use an electric shaver if you don't now. Those were the tough ones for me.

And do all your PT, above and beyond if you can. It will pay off later.

It is my dominate arm. Shaving was what hit me today. First thought was time to try the beard look, then thought electric might be better. Work dress code is suit and tie. I'm thinking they will be lax on the tie. Or l'll go get a clip on.

[carambola]

shouldn't you get the surrounding area back in shape before the procedure

[pavulon]

Catheters and pumps > single injection >> pain pills alone. You'll be ok with a single injection. The catheter and pump infuse local anesthetic onto the nerve plexus providing pain control over a period of about 2-3 days which are typically the most uncomfortable.

Here is a block placed using ultrasound from youtube. Ultrasound imaging for block placement is a genuine advantage to the clinician which directly translates to safety, comfort and efficiency for you. Placed blocks using landmarks and a micro stimulator early in my practice. I wouldn't want to ever go back to that.

Interscalene Block (ultrasound guided - in plane) - YouTube

Originally Posted by Aggie93

Ortho mentioned the anesthesiologist would ask if I wanted a shot in the shoulder. Is that what you are referring to? Didn't mention a catheter and pump.

[WPOZZZ]

I had the nerve block done a couple times for shoulder surgery. They used the ultrasound and gave me the block and a couple minutes later, my shoulder was dead. After surgery, it took a few hour for it to wear off. Just don't bump into anything while the block is still active because you don't feel a thing. To move my arm, I had to lift it with my other arm. It was like I was moving a bag of sugar in my sling.

[Tobra]

They use Marcaine and it will last a LOOONG time, I love that stuff. I routinely have ankle blocks last 10 hours.

Originally Posted by madmmac

Nice, Dr had you go put yourself through 2 months of pain from PT for no reason.

If it is your usual arm for wiping your a$$ and shaving, use more paper than ever and maybe use an electric shaver if you don't now. Those were the tough ones for me.

And do all your PT, above and beyond if you can. It will pay off later.

The insurance company probably insisted on a trial of PT before they would authorize surgery. More than once when they were dragging their feet on me I told them to find someone else to take care of the patient if they won't let me. They caved every time, because I was right and they did not want to lose their asses.

micro stimulator, brother, give me a couple of Versed first

[Aggie93]

Actually, the doc and I conversed about it. His initial diagnoses was bicep tendonitis. He asked if I wanted an MRI to confirm, I thought I would just go for the PT first. I still had full range of motion, it just hurt when there is pressure pulling my arm up. I can to a pullup, but cannot dead hang. I think I have a decent doc, he works on the Pittsburgh Pirates.

For the first month PT did help. Without knowing anything medical, I might have had bicep tendonitis along with the tear. Since I seemed to be progressing, we went for another month, but started getting worse. That is when he ordered the MRI.

[DonDavis]

I had the same surgery on my right shoulder and I'm right handed. I did fine with shaving, brushing my teeth, et al. As a matter of fact, I went on a fishing vacation in the Pisgah Forest with my son and a great buddy. We were skipping stones in the river and I was no longer in a sling, but still going through PT. I was still slowly beginning to use my right arm again, but NOT for throwing. I was using my left arm and I skipped a rock further than both my son or my buddy. They were floored at how well I could throw lefty.

That was 2008 and I have no regrets and full mobility. Very successful for me, I wish you luck! Just keep up the PT.

Oh yeah, PT just might hurt a little.

Who am I kidding, the first time I tried to raise my arm as instructed, I nearly passed out. And when I didn't, I nearly vomited. Good times.

Notice the smiley using his left arm?

[Lothar]

Good luck, Aggie. I took a pass on similar surgery. My tear was probably not as severe. I asked my PT what the post op would be like. She said, you already know, you just went through it! I had been through about two months of PT to free up the shoulder after a serious dislocation.

With any luck, you will get a cute little PT intern that you wont mind putting the hurt on you :-)

[cashman]

Good luck. I am scheduled in February for the same thing. Never thought about arse wiping .

I used to only have issues trying to throw a ball hard overhand. This has been an issue for 20 years. Not sure what expedited the issue but 6 months ago I started waking up 4 times a night with shoulder pain. I'm 45 and figure its not going to get better on its own so I may as well get it done now.

Good luck.

[Aggie93]

All stitched back together. Nerve block just starting to wear off. Didn't get the catheter and pump. Cannot remember what doc said when i asked. Doctor said it was a "monster tear" and took five anchors. Not sure if he was playing it up or not. Biggest surprise is Doc not letting me drive until after the followup appointment. Hopefully I can work at home, but boss said if I'm still on pain meds she does not want me trading (I'm a portfolio manager / trader for a mutual fund co). Good news is I might be able to spend more time out of the sling quicker than i first thought.

[pavulon]

A tear requiring 5 anchors qualifies as big and glad it went well!!

Not sure why your block is wearing off already. Could be explained by any of about 3 or 4 things. Did they place it under ultrasound guidance? Hopefully you tolerate pain well...pain tolerance varies remarkably.

Originally Posted by Aggie93

All stitched back together. Nerve block just starting to wear off. Didn't get the catheter and pump. Cannot remember what doc said when i asked. Doctor said it was a "monster tear" and took five anchors. Not sure if he was playing it up or not. Biggest surprise is Doc not letting me drive until after the followup appointment. Hopefully I can work at home, but boss said if I'm still on pain meds she does not want me trading (I'm a portfolio manager / trader for a mutual fund co). Good news is I might be able to spend more time out of the sling quicker than i first thought.

[DonDavis]

Glad to hear it went well. Good luck with the rest of the process.

[WPOZZZ]

The gf had rotator cuff surgery today and the block is slowly wearing off. 3 hours after the surgery she was able to wiggle her fingers. When I had my surgery it was more like 5 hour before I could move them a little.