I saw the orthopedic today and based on the MRI he and I agreed that without surgery this shoulder is all but guaranteed to dislocate again so we are going ahead with surgery. He said the joint capsule (the usually dense, fibrous connective tissue that forms a sleeve around the joint and encloses the joint space) is so stretched out “it looks like you could drive a truck through it.” He said he would normally schedule it for this Wednesday but due to the pandemic I have to have a negative COVID test five days prior to surgery. So I’ll have a COVID test tomorrow and surgery on Monday, Feb 1. I also have to have a history and physical from my primary care physician.
The surgery entails a Bankart repair – suturing or anchoring the labrum back to the glenoid (socket) where it belongs, capsulorrhaphy – tightening the joint capsule with sutures, and remplissage – anchoring the infraspinatus muscle and posterior joint capsule into the Hill-Sachs lesion (compression fracture dent in the head of my humerus) to fill it in. It’s a lot of work to do but it will all be done via arthroscopy or “scope.” He actually said he can see the joint better from all sides using this way than he could with an open procedure. I’m relieved by this because it means less muscle damage and less scarring.
After surgery I expect to be in quite a bit of pain for the first week or so. I will have to be in a sling for 4-6 weeks to protect all of these repairs and plan to take at least 2 weeks off seeing patients at all and then limit my schedule to those needing minimal or no manual therapy for at least 4 more weeks after that. It will be 3 months to get back to somewhat normal day-to-day function and then up to a year for full recovery. But my shoulder will be much more stable forever and very unlikely to ever dislocate again. So it will all be worth it.
Since the blog has mostly been academic so far with descriptions of the injury and anatomy, some folks have been asking how I’m feeling about all this. I’m mostly very sad about it. Sad about the damage and about being sidelined from seeing patients and all of the other things I love to do. And I’m anxious about the surgery because, while I’ve never had shoulder surgery before, I’ve treated many patients after shoulder surgery and I know how painful it is. But I’m also looking forward to having a much better shoulder that doesn’t feel unstable anymore. It’s just going to be a long road to get there.
I’m also having flashbacks about the actual incident–the trip, fall, and feeling of it dislocating. I can barely stand even to see other people running. And I’m never planning on running outside again! I didn’t like running to begin with!
And finally, I’m feeling frustrated and annoyed that this is all happening during the pandemic and the ways that complicates matters. It’s difficult to figure out how to accept badly needed help because we aren’t having anyone in our house outside of our little nuclear family. I should be getting my second dose of the Moderna vaccine on Feb 6, which will not be fun if I’m dealing with post-op pain AND get the side effects of muscle pain, fatigue, fever and chills that some people seem to have with their second dose. And I’m trying to figure out who I will see for PT after surgery. I want to find someone who is being as cautious about COVID as I am, which is a tall order.
Stay tuned for more!