[pavulon]

Not an orthopod so keep these writings in that context.

If your shoulder is so unstable that it dislocates with passive stretching, you want whatever can be done. In my work, I often cannot see everything that is being done during a repair. However, just last week I watched a surgeon intentionally sever a perfect appearing bicep tendon. I asked about it and the surgeon said that cutting it is age-dependent (his opinion was that it becomes a consideration at >55 years) and the idea is the tendon can be a "pain generator". I found this odd as I've watched lots of biceps tendon repairs as part of shoulder surgery in the past. There must be more thoughts that go along with that structure. I don't do that stuff so... .

As for anesthesia, get an interscalene brachial plexus block. If available, ask them to put it in before surgery. If available, ask them to use ultrasound imaging to place it which you can ask to watch on the screen. We routinely get 24-36 hours of good pain control from that single injection block using bupivacaine (a local anesthetic) and dexamethasone (a steroid) mixture. Your arm should feel like numb and limp for most of that time. If they are willing to place an interscalene catheter, an infusion can give 3 or more days of pain control via a small reservoir and portable pump that attaches your sling. Everything has risks. The block is not immune to risks ranging from block failure to nerve damage to seizure, cardiac arrest and/or death. You're probably more likely to crash on the way to the surgery but risks are quoted because complications happen.

It is not uncommon to have a general anesthetic on top of the block. Some places (surgeons) will do the surgery without general anesthesia but the odds of someone being bolt awake, watching surgery, understanding and remembering what they saw are relatively small and also with potential downside (access to the patient to fix potential pain, panic, and or ventilation problems...). It's a considerable preference/risk/reward equation.

Lastly, I'm told that you should hate therapy when you're done--if not, you might want to try harder.

As for returning to work, I worry that you've possibly under-estimated the problems associated with functioning well on one good arm. I also may be under-estimating your determination and resources ("Hey Sue, will you zip my pants?") when I write that.

Good luck and please circle back with your experience!!

PS-I thought of you when walking past the Embraer set-up in Oshkosh last Thursday.