This Shoulder Replacement Thing

All I knew is that I wanted the pain to stop.

I could find no comfortable position for my arm, so had test after test, which revealed that I had an un-fixable tear. The options were pain meds the rest of my life, or “reverse shoulder replacement.”

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Invented in 1985 by a French surgeon, and only okayed for use by the US Food and Drug Aministration since 2003, this innovative surgery involves attaching an artificial ball to the shoulder blade, and an artificial socket to the top of the arm bone.   

It also utilizes the deltoid muscle to take over for the ruined one. It entails repositioning the deltoid to lengthen it, then retraining it.

My deltoid is as old as I am. 

Surgery didn’t take long, only one night in the hospital. Until my blood pressure tanked, so a second night.

Checkup with the surgeon at two weeks. No stitches out; they’d dissolve. Doctor said to wean off wearing the sling. What freedom–I could type again!

Pac-Man

Isn’t it amazing how the human body begins to repair itself right after an injury–accidental or by scalpel? Platelets rush to the wound, bunching around it, attracting others to form a “plug.” I can imagine them hastening around like the characters in Pac-Man. Clotting proteins make threads of fibrin which weaves itself into a clot over that plug, making a seal. Awesome, huh!

Meanwhile I was just trying to “keep up with the pain,” and do everything I could with my other hand.

A week later, physical therapy began. I had no idea that it therapy would last months, maybe longer. That progress would be at a snail’s pace. That nine weeks out I’m still not allowed to lift anything heavier than a coffee cup.

Someone thought I should be back to “normal” before now, but this wasn’t shoulder repair, not the common shoulder replacement. It’s total reverse shoulder replacement.

Six Weeks Out

At my six weeks checkup, I asked the surgeon when I’d be able to reach behind my back with my right arm. “Maybe two to three years.” Think about struggling into a pair of jeans or slacks, trying to tuck in a shirt. Two or three years???

The first eight weeks of physical therapy have been a struggle, mainly because when the deltoid is unhappy the pain is so sharp, so wince-some. And it tended to stay unhappy the rest of the day.

Therapist Hunter was good to banter with me, while issuing warnings and realistic donts. He printed off a clinical commentary for me because I’d asked so many questions. Protocol for reverse total shoulder arthroplasty, filled with lots of big terms and acronyms. He made notes on it, and so did I. It will take me through twelve weeks.

At eight weeks, I could journal fairly well with my right hand, but not feed myself. It also couldn’t wash or fix my hair, lift a cake-pan sized dish into the oven, reach higher than my chin without help.

Nine Weeks Post-Op

But at nine weeks, it felt like I’d reaching some kind of tipping point. DPT Hunter began new passive range of motion positions with my arm/shoulder. After weeks of warnings mixed with encouragement, he was almost effusive about how far I’d come!

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Even though his only 30, the easy-going Hunter has herded more than a dozen people through therapy for the reverse replacement. He’s a people person and interacts with my stories, which helps him take the arm manipulation a little farther each time. He reads intellectual nonfiction for fun.

We’ve discussed everything from at what age is a person elderly to genealogy and spiritual gifts. His encouragement at this point feels like effective coaching, even cheerleading. Wow, does that help!

Physical therapy has been the best part of this experience, gaining support mentally and physically, as well as twice a week reassurance.

Yesterday, for the first time in months (couldn’t do it before surgery either), my right arm lifted a mug of coffee into the microwave (cupboard height), retrieved it, and carried it down the hall to my office. Yes, tears welled up.

Four more weeks, unless Covoid-19 restrictions prevent it. Several therapists have been deployed to hospitals. Two weeks ago, the therapists began wearing masks. Since last week we patients are.

Now with realistic optimism, I can do this! I might even thrive. . .