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  • Reverse shoulder replacement, female age 75- massive irreparable rotator cuff tears?

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    Old 07-10-2020, 08:40 AM   #1
    Machaon
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    Reverse shoulder replacement, female age 75- massive irreparable rotator cuff tears?

    My wife, age 75, has full tears in her right shoulder's supraspinatus and infraspinatus tendons, among other tendon problems, including muscle atrophy and moderate fatty infiltration and tendinosis.

    Before her MRI she was required to suffer thru physical rehab for quite a while. The rehab just seemed to make it worse, so she stopped going! Overall, it's been about three months of tolerating and living with a painful, limited right shoulder and arm.

    Now, after having an MRI which shows massive, irreparable rotator cup damage, the doctor/surgeon has recommended a reverse right shoulder replacement. We like the idea of the "reversed" because it doesn't require reattaching tendons, which are too diseased to reattach.

    We would like input/opinions of others, especially those who have had a Reverse Shoulder Replacement, or who have lived with someone who has gone thru the surgery.

    Thanks, Bob
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    Old 07-13-2020, 11:30 AM   #2
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    Re: Reverse shoulder replacement, female age 75- massive irreparable rotator cuff tea

    Reverse Shoulder Replacement has now been scheduled. Preparation includes a cat scan, an EKG, blood work, a physical, a pre-surgical check for Covid-19 and a lot of luck!

    More than 90% of patients experience significant improvement in both shoulder pain and function. At ten years, about 90% of the implants are still fully functional.

    Scared but hopeful...
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    Old 07-25-2020, 05:47 PM   #3
    Machaon
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    Re: Reverse shoulder replacement, female age 75- massive irreparable rotator cuff tea

    CT scan, EKG, blood work, physical completed. All indicate that her health is good and we are now just waiting for the surgery.

    From what I have read, rotator cuff tears are the result of a sedentary lifestyle, lacking exercise, effecting the shoulder, causing muscles, tendons, ligaments to atrophy and deteriorate. In the past, it was very difficult for her to exercise her arms/shoulders because of nerve damage from previous surgery. Fortunately her left shoulder rotator cuff is okay.

    There are stretching exercises that she can do with her left arm/shoulder to help to prevent the same thing from happening to her left shoulder. It's mostly exercises moving her shoulders around and then swinging her arms. Even though I do a ton of exercises, I join her with her "stretching" exercises because they are completely different from my normal, four different, weight lifting exercises, and I figure that it is good for my rotator cuff, too!

    If 80% of those over 80 suffer from rotator cuff tears, I don't understand why stretching exercises aren't recommended more during elderly doctor visits?
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    Old 08-08-2020, 08:42 AM   #4
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    Re: Reverse shoulder replacement, female age 75- massive irreparable rotator cuff tea

    Surgery performed on August 6th, about a two hour procedure. After I waited a very anxious, stressful morning, the surgeon called me and said that the reverse shoulder replacement went great!

    She has since been on pain medications and icing, icing, icing. The day after her surgery, she came home wearing an arm sling, and was released with a "cooler" that circulates ice water into a pad that fits around her operated shoulder and keeps it quite cold. We use it for hours during the evening hours. It requires quite a bit of ice.

    Although her shoulder still hurts, it seems to be getting a little bit less painful on the second day after surgery, and she is getting more mobile, and looking for things to do. A good sign of her feeling better!

    I was concerned about her shoulder and arm bones being strong and healthy enough to have devices screwed into them (ball and cup). Surgeon answered that they did not have to use surgical cement and he had no problems installing the devices.

    She has started with some exercises with her forearm and hand. She is not allowed to move her shoulder, yet.
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    Old 08-10-2020, 09:29 AM   #5
    Machaon
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    Re: Reverse shoulder replacement, female age 75- massive irreparable rotator cuff tea

    Going into the fourth day after surgery. She has a bit of an appetite today for pizza. She is still in a lot of discomfort even though it seems to get a tiny bit better each day. Her right arm down to her wrist hurts and has been puffed up and swollen! The arm is soft when I press it and the skin is not tight, so I just assume that it is a normal reaction to the trauma to her shoulder.

    We use about two, one gallon frozen plastic water containers for ice each day for the voracious icing machine. It would have been nice to get good instructions on how to affix the icing pad to her shoulder. I wound up using an ACE bandage to better keep the cold pad in place. Documentation and communication isn't their strongest suit!

    There is no bleeding outside her rather large bandage and no blood stains. Her right arm is not discolored. Her biggest problems now are still the swelling and the pain. She is able to do four different right forearm and hand exercises (without moving her shoulder) ten times each exercise; four times a day.

    Hooking and unhooking her up from the icing machine, to do her exercises, or to take a break, takes a little bit of time and effort. We have intercoms so, anytime she needs assistance, which is often, she just beeps me, and I beep her back indicating that I heard her request for help. There is no way that she would be able to recover, or even exist, without frequent help, especially due to not being able to use both arms.
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    Old 08-12-2020, 07:48 AM   #6
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    Re: Reverse shoulder replacement, female age 75- massive irreparable rotator cuff tea

    Going into the sixth day after surgery. She has quite a bit of swelling and constant pain. She takes Tramadol 50mg six time a day (every four hours).

    The documentation states goals of "reduce pain/swelling" 0-2 weeks and "reduce pain/swelling" 2-6 weeks. This tells me that we can expect pain and swelling for up to 6 weeks, and perhaps longer?

    To follow her progress, I have taken pictures of her right arm from the front and side every morning. It's well worth doing! This morning I looked at her bloated arm and elbow and was disappointed. She's been using that ice-eating icing machine religiously day and night! Well... I looked at yesterdays pictures and compared them to this morning's pictures and noticed an obvious improvement and reduction in the swelling and bloating. If I didn't take pictures every day, it would be much more difficult to judge the progress or improvements.

    We also noticed some discoloration on the inside of her upper arm, so we have been following the progress of the discoloration every morning; and it seems to be getting lighter.

    Between having to feed ice to the icing-machine god; and having to unhook my wife frequently day and night for potty breaks, it takes a lot of patience and understanding from her caregiver, which is me. I would think that it would be very difficult for an elderly person to be able to handle a reverse shoulder replacement surgery on their own, or with an apathetic partner.
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    Old 08-16-2020, 11:49 AM   #7
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    Re: Reverse shoulder replacement, female age 75- massive irreparable rotator cuff tea

    Quote:
    Originally Posted by Machaon View Post
    Going into the sixth day after surgery. She has quite a bit of swelling and constant pain. She takes Tramadol 50mg six time a day (every four hours).
    Going into the 10th day after surgery. Swelling is much reduced and so is the pain. She has reduced the Tramadol to 25mg four times a day (every six hours).

    We have read that compression stockings are to protect against blood clots when a person is constantly sedentary. She is always up and around and constantly moving, so she has also removed those dreadful compression stockings that were digging into her legs.

    Quote:
    She's been using that ice-eating icing machine religiously day and night!
    We've decided that we are icing too much and, instead, have been using ice packs four times a day for 20 minutes. We think that the constant icing actually slowed down her recovery!

    Bandage comes off in a few day and she starts rehab. In the meantime she is religiously exercising her left arm and shoulder in order to avoid future problems with her left arm/shoulder.
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    Old 08-27-2020, 03:57 PM   #8
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    Re: Reverse shoulder replacement, female age 75- massive irreparable rotator cuff tea

    Quote:
    Originally Posted by Machaon View Post
    Bandage comes off in a few day and she starts rehab.
    It's now three weeks after having reverse shoulder surgery at the Cleveland Clinic, by Doctor Gregory Gilot, and she started her first week of rehab and at-home flexing exercises. The bandage is off and there is a faint, thin scar about 3 inches long.

    She stopped the pain medication about a week ago. Her arm and shoulder have little pain and the right arm and shoulder really feel good! Interestingly, she did not realize that her damaged right shoulder was responsible for causing pain in her left shoulder preventing meaningful exercise of her left arm!

    We think that she has a long, gradual road back to a well working right arm and shoulder and we do not know how much range of motion she will eventually have. But... as long as she takes the rehab slow and steady, she feels confident of a good outcome and, at last, without having to live with a chronically painful right shoulder.
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    Old 10-11-2020, 11:19 AM   #9
    Machaon
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    Re: Reverse shoulder replacement, female age 75- massive irreparable rotator cuff tea

    Quote:
    Originally Posted by Machaon View Post
    It's now three weeks after having reverse shoulder surgery at the Cleveland Clinic, by Doctor Gregory Gilot, and she started her first week of rehab and at-home flexing exercises.
    It's a little over two months since surgery. Prior to surgery we were really concerned about a long, painful recovery with all kinds of complications. She is 75 and had complete tendon tears and even had a torn biceps tendon and atrophied muscles. Prior to surgery, we were hoping for an improvement in the pain after her recovery from surgery.

    She has been doing about 30 minutes of stretching exercises daily, and going to rehab twice a week where they do assisted stretching exercises. No strengthening exercises at all! If she feels any discomfort at all, during her rehab, they stop the stretching and go to massage. She feels a slight ache which is improving daily.

    We can't believe that they were able to perform such a complex surgery through a small, 3" opening! The relatively small incision, causing less trauma to her right shoulder was probably a reason she suffered less pain and is recovering better than we expected.

    We could not have wished for a better outcome!
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