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Preciousbubs 02-08-2013 12:53 PM

To have surgery or not
In my right shoulder I have a large full-thickness tear of the supraspinatus tendon with retraction and a partial longitudinal split tear of the long head bicep tendon. I also have spurs on the acromion bone, tendinosis of two other tendons, atrophy of two the muscles as a result of the tears and osteoarthritis in two joints among other things. I have been going for physio since October with no change in the ROM or movement of my right arm and shoulder. I have difficulty getting things out of cupboards and putting them back because I can't raise my arm high enough. I have difficulty doing my hair, discomfort when driving and a lot of pain at night. I haven't slept a full night in months because of the pain. I saw an orthopedic surgeon yesterday. He said the only way he could help was to do surgery to repair everything. He didn't want me to make a decision yesterday but to go home and think about what he told me and discuss it with family and friends. He told me to write down any questions I had and bring them to my next appointment in March when he will answer them. He gave me the odds of the surgery helping me which is 85%, and he said about 13% of patients don't feel any different and about 2% say they are worse after the surgery. He also told me i would have about a 4 -5 inch incision on the top of my shoulder and I would be in hospital 1 - 2 nights. I would be off work about 8 - 10 weeks depending on my recovery. He also told me my shoulder would never be 100% with or without surgery and that tendons do not repair themselves and if left unrepaired the tears would probably eventually get larger. For those of you who have had a similar problem and had surgery is it worth it? Should I have the surgery or not? By the way I am right handed. This surgeon has an excellent reputation for shoulder and knee repairs.

Millard 02-08-2013 03:09 PM

Re: To have surgery or not
[FONT="Comic Sans MS"][SIZE="2"][COLOR="Green"]I have never had the surgery you described but I have opted for surgery to improve my quality of life. If I were 75 to 80 years old, I would probably refuse it; otherwise, it would be a no-brainer for me. Maybe you'll get some more encouragement from other people also.

Good luck.

noevr 02-08-2013 03:45 PM

Re: To have surgery or not

I had the basic rotator cuff repair in 99 at age 40 it was very painful, had a 14 hr nerve block, along with pt that started about a week later, I went back to work at 2 weeks I was a network administrator and we were in the middle of y2k. The shoulder is great now pretty much have full ROM. Glad I did it.

Now, in may of 12 I had a slap tear in the other shoulder, bone spurs, a lot of osteoporosis and had surgery, now 56 yrs old. Painful painful surgery, went home same day, had a 14hr nerve block, had PT that didn't start for 3 weeks this time (same dr).

When I went to 1st pt they were surprised I was just getting to pt said I should have started 2 weeks ago. I have sense read there is controversially over this.

About a month into pt my shoulder became partially frozen and had to go under anesthesia and have it manipulated to break up the scar tissue (manipulation under anesthesia MUA). Very sore and hard to do pt for about a week but it did give me more ROM.

I continued with pt for about 8 more weeks finally stopped I don't have good ROM now I am in terrible pain all in my shoulder blade radiates down my arm too. They eventually want to replace it because of the osteo, have they mentioned that to you?

I know that was long but I wanted you to know the stuff that can or cannot happen. First one was great. Wish I'd never done the 2nd one.

My pain dr. Tells me now before I get anything else done to be sure to get at least 2 opinions because there's so much competition. Wish I had done that the 2nd time :(.

I don't think I'm getting it replaced I'm getting too old.

Btw, I cut all my hair off before the surgery and practice toilet stuff with the other hand.

Go to goodwill and get a bunch of button up the front shits and nightgowns, forego the bra idea (if ur a gal lol) and if you have a recliner that's great you'll probably sleep in that for the first couple of weeks.

My hospital sent me home with an ice machine which is a little cooler with a hose and the end wraps around the shoulder, the ice maker can't keep up. Someone will be making trips out for ice.

Good luck!


Preciousbubs 02-08-2013 04:33 PM

Re: To have surgery or not
Thank you both for responding and giving me your input. I guess you both live in the USA where you can choose your surgeon. I'm in Canada and we have to be referred to a surgeon. Apparently the one I have been referred to is an excellent orthopedic surgeon and specializes in shoulders and knees. Everyone I have spoken to so far say to have the surgery.
Did either of you have to stay in hospital for one or two nights? I was surprised when he told me I would have to stay in, I thought it would be same day surgery.
Thank you Cathy for the tips on preparing for after surgery and what kind of clothes i should wear. Did you have physio before your surgery or did you stop going before? My physiotherapist thinks I should have the surgery. She said you can't live the rest of your life with only partial use of your arm and the pain.
I have been told that the surgery is very painful and the recovery is long.
A few years ago I had a tibial osteotomy on my left knee as a stop gap to put off having to have a knee replacement for a few years and that was the most painful surgery I have ever had.
I may be back with more questions. Thans again.;)

noevr 02-08-2013 04:58 PM

Re: To have surgery or not
Hi I think the first time. i tried pt before the surgery but didnt help and with that one I did spend the night due to pain cuz the block didnt work right.

See if you can get that block too. Cathy

galalena 02-08-2013 06:51 PM

Re: To have surgery or not
I had a complete full thickness cuff tear (supra- and infraspinatus) and contusion on the humeral head from an injury when I was 53. That was 4 years ago. Since then I've had 5 surgeries, and will have the 6th in a month - from cuff repair to lysis of adhesions to bicep tenodesis to distal clavicle resection to hemiarthroplasty to total shoulder replacement to reverse replacement.

Anyway, the cuff repair is very painful and the recovery is long and difficult. Most people do fine after 6 months and don't have problems. The people who end up on these forums are the ones who do have complications and issues. The first few days are the most difficult, then it does get easier, but still, it is an ordeal overall. Is it worth it? For most people yes. If you fall within the 5% with poor results, not so good.

Best to you!

Aurelia5 02-19-2013 02:05 PM

Re: To have surgery or not
Please see my answer to Andrwe29.

But yes, have the surgery, or from my lengthy experience, it's just going to get worse. I waited too long to get mine done, and it tore all the way through, which I believe made putting it all back together much more precarious.

I am already on a lot of pain medication, and he had to give me a 24 hour nerve block to be able to overcome the added pain. The block was gawdawful! If you, or anyone reading this wants to know what the block is like, ill describe it. Yes, because of my med question, I had to stay overnight. The block wore off on the way home the next morning and I spent several hours philosophizing about the state of suffering. I didn't have the block or a night in the hospital for my second operation.

I believe my anchor came undone in physical therapy, but the doc said no. ???
Your doctor sounds excellent. He has stated everything I've experienced. Wish I had him. I started pt a week and a half after my first surgery and I think it was too early. Now for my second one, we are waiting at least five weeks. But you do have to have it or as Cathy said, you'll get frozen up. All I can add is to go at pt really easily.

About after surgery. Get very stretchy underwear so they don't get hung up on your legs trying to get them on. Get slippery pajamas to more easily struggle around in bed. They are hard to find, but the men's departments have some nylon ones that work. Bathing is hard. Before surgery, tie your arm to your side in the position it would be in in a sling, or ask you doc for a sling, and get in the shower and find out what it's like to wash your hair with one hand. If you can, go to a salon. That way you don't have to go through the ordeal of taping plastic over it, if you have to bathe before you are ok to take off the outer bandage (4 days). Then you can take baths as long as you DO NOT let the bandage soak. I personally found very stretchy shirts the easiest to get in and out of because I couldn't reach the buttons. And sweat pants. Cathy is right about the bra, but I have a husband for that. My hair is long, so a stiff headband works best. Forget socks and get loose boots..

I can not sleep sitting up, but we were fortunate enough to have gotten a very fine bed that I won't say the name of, but starts with T, and it made it so I could sleep reclining. You won't be able to turn on either side for at least a week, so if I were to say what has helped me the most with these two surgeries, it would the bed, because it is so soft, but with support. Before surgery, like the bathing thing, tie up your arm and spend 24 hours like that, and that will set you up for what you'll need.

I've had much more painful surgeries, but this is no cakewalk. And if you don't have to have it done twice, it heals fairly fast.

Best of luck to you. You have a good doc.

Aurelia 5

noevr 02-20-2013 09:22 PM

Re: To have surgery or not
Hi I took a old pillowcase king size cut one end off put mt bad elbow in the uncut corner and tied it around my neck and took showers that way I saved my brace from getting wet. I went to goodwill bought button up the front stuff, oversize. Cathy

guinivere 02-21-2013 03:55 PM

Re: To have surgery or not
This is not a reply to your message. It is because I am also looking for info. I feel 14 ft on to limestone natural landscape in Nov 11. I was injured severely and almost lost my foot from it. I had two surgeries with the lower half and spent half a year on crutches. All the while I was having pain in the right shoulder. I thought it was a crutch issue. After the crutches I thought I had bursitis. The doctor gave me a steroid shot but said that I was having severe spasms that she could feel. The steroid shot did not work so she sent me to ortho. Ortho said the same thing about the spasms. He put me on two months of pt with a deep steroid shot. He said he thought impingement syndrome but if all was not improved in 2 months it was more than likely a torn rotator cuff. Two months later, no improvement. I had a toradol shot and MRI. MRI shows a complete tear of two tendons (not going to use medical terminology). I more than likely injured myself from e same fall but all attention and pain focused on the lower half of the body. I am scheduled for repair on 7 march. After all the surgery I have had I surely did not want more, but I am an active person and do not want to spend my life with chronic pain. I already deal with so much from my foot. The nights are awful. I dread going to bed and have no energy when I awake.
My doc says the surgery is outpatient, I will spend six weeks with no movement of the shoulder and in the brace, then pt, then at 3 months I will be back to competitive level. Meaning I can go hard.
I get really concerned when folks start talking about the pain being horrific. I guess it is all a matter of pain tolerance. In my previous injury, my doc said it was far worse than knee or hip replacement and that it was time to put the big girl panties on. I made it through and only take pain relievers on an occasional basis although pain is an everyday occurrence for me. When people start speaking about how horrific it is, I really get anxiety wondering if it is worse than what I have already been through. Someone please explain the you mean that you hurt and hurt from it or do you mean pt is horrific? Please explain. I think the not knowing or better yet not understanding is awful. I am a woman, I have given birth (naturally) 3 times. I have had a broken hand. I have had a hysterectomy, and I have spent 5 months in bed with plates, screws, and pins? Is this surgery going to be worse than all of these? Need to know.

Aurelia5 02-21-2013 05:51 PM

Re: To have surgery or not
Dear Guin

No, no, no. Not Horrific.

I am currently recovering from my second surgery for the same tear, and the pain was only really bad for one or two days afterwards. It's the incapacity that's killing me. They made me wait three months between surgeries, maybe because they are so busy, I don't know, but it's going on over a year of surgery, recovery, pain, surgery, recovery, pain. . . Just never ends. The pain now , six weeks after the second surgery is worrying me because it was getting better, took off my sling for two days, which was allowed, and then it got bad again. So I'm poking this post out one-handed, and it's getting old. And the pain is all in my bicep, my lower arm, and the back of my hand. Shoulder doesn't hurt at all.

On the first go around, my therapist, who I believe knows more than my doctor, said the arm pain is from using my hand. All the thousands of little movements when you use your hand inflame the tendons, which make the nerves in your arm hurt. Sort of like sciatica of the arm.

I would be comfortable saying you've suffered worse pain, from everything you listed.

If you are fairly young and healthy, the pt starts a week or two after surgery. Maybe that was too soon for me. This time we are waiting five weeks.

About the pain med's, it is recommended you take them BEFORE the pain gets bad. Also I found it best to take it right before bed, then I'd sleep well for about six hours. But I go from not being able to think straight because of the pain when I wake up, (I have a lot of other problems) to just an underlying sort of throb most of the day.

Hope I've put some of your worries away.

Best of luck to you


galalena 02-21-2013 05:57 PM

Re: To have surgery or not
I do not know what you mean by competitive level. But regarding shoulder surgery, yes, the pain is incredibly bad. But, with meds and ice you will get through it. I've had babies too, no question the pain after this is worse. If your tendons are torn, you have no choice. I had an injury almost 4 years ago and have been through 5 of these horrific surgeries. Going for #6 in two weeks. You will survive. Best wishes!!!!

noevr 02-21-2013 06:00 PM

Re: To have surgery or not
Hi I've had two, first one was ok but the 2nd one has been rough lots of osteo in the joint. You'll need some button up the front stuff, forget the bra for about a week, be sure to do you at home pt and take pain meds before pt.

I took an old pillow case cut the long end off and put elbow in the corner tied behind neck to support it while showering.

I have a low pain tolerance so for me to answer that question wouldn't be fair.

Unfortunately, mine is still hurting bad had surgery in may last tear. They want to replace it eventually, don't know if I can go thru that.

Good luck, cathy

guinivere 02-21-2013 06:03 PM

Re: To have surgery or not
Thank you so much for your reply. That was exactly what I wanted to know. I totally understand all the surgeries and lengthy recoveries and after a while the limitations are so aggravating. I have been living with this "No Sleeping do to torn rotator cuff pain) for 15 months now. I totally understand the few days after surgery being painful and figured it wasn't anymore than that. In my lower extremities recovery, learning to stand, balance, and walk again were extremely painful. I think I can deal.

guinivere 02-21-2013 06:10 PM

Re: To have surgery or not
Well, I.was just saying that I have had many things but with the lower extremity, I had more breaks than could be counted. I had plates, screw, pins, and artificial bone. My tendons and ligaments were laying on the bottom of my foot. My first surgery was 8 hours and the second was 4. I developed anxiety and claustrophobia from the Intenseness of it all. The people that kept saying it was so painful were really scaring me. Now that I know that it is pain for the few days afterwards, I can totally deal with that. My doc used the term competitive level. Then he said, "meaning that you can go 100%.

guinivere 02-21-2013 06:14 PM

Re: To have surgery or not
Well pain level is what it is to each person. I have a strong threshold of pain and I have felt I credible pain so when folks now tell me it is horrific then it really freaks me out. Thank you for your honesty and your help. Praying things will get much much better for you.

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