MIA for Shoulder Surgery
A little over a month ago I had surgery on my left shoulder to repair an old injury that went critically bad on me. About the middle of last year my osteoarthritis finished off what was left of that damaged AC joint and sent me a signal in the form of something I had just finished studying in Medical Terminology… Impingement Syndrome. I can now qualitatively verify that my instructor was correct – it is an extremely painful condition. I wanted nothing more than to FIX IT and NOW. Thankfully I have an awesome and caring medical group to turn to now. They took excellent care of me.
How we got here… I was in an unfortunate abusive relationship when I was just 17 years old, and during one conflict he twisted my arm behind my back and shoved my hand up between my shoulder blades, causing an AC joint separation. I have lived with the daily discomforts and often outright pain from that damage for 27 years. I lost a lot of strength so the rotator cuff muscles are now weak and in need of rehab. I had muscle spasms under the shoulder blade, crawling sensations on nerve paths, muscle cramps in my neck, and even long after the initial pain had subsided I never could take on heavy tasks with that arm for fear of reinjury. It’s been a long road. One of the worst parts was the daily reminder, in the form of these discomforts, of the awful fear and devastation of being beaten repeatedly by someone that supposedly loved me. People usually don’t like to hear about that. It makes them somehow uncomfortable. Let’s face it though… if the survivors don’t say something, who will?
I was young. I don’t like to hear that as any kind of excuse though. I was deluded the same as any abused woman is with certain thought patterns. All of us in that situation say the same things with consistency. The three lies of abuse are?
“But I love him.”
“I don’t have any place to go.”
“He said it will never happen again.”
None of it is true. You may have an emotion about someone for what you thought they were, but there is no real love in a dependence on someone that mistreats you. There is always somewhere to go, even if it is not ideal or has to be a stop-gap solution. They all say they won’t do it again, and they’re all lying. Until someone with this kind of sickness gets help, THEY – WILL – NOT – CHANGE. No abuse victim ever became an abuse survivor without realizing their self-worth. When you find a reason to love yourself and desire to hold onto some shred of your humanity, you get out. When I left I was willing to sleep in the gutter to get away from him. I was finally more afraid of going back than leaving. Someone precious in my life had an open door and a warm bed for me to crawl into and be safe… to sleep… to cry… to mend. That was my late Grandmother. For whatever criticism she may have taken for taking me in, I will stand up and stare down anyone that dare try to tell me she was wrong. She saved my life and gave me a second chance to HAVE one. She gave me a reason to find a life of my own. She also bought me cookies.. which might sound stupid, but after so long living on hotdogs, tortillas, and potatoes and having to walk to and from the store for anything I needed… wouldn’t you like someone to tell you “get what you want” with a smile? It made me cry. They were pecan sandies by the way. I’m afraid I have a real emotional attachment to them to this day because of that, so I do still get them occasionally.
An x-ray a few months ago revealed the loss of the AC joint – “pretty much gone”. Conservative measures helped for close to 3 months (cortisone injection), and then it became clear that the surgery suggested was the best decision. Having had relief for a while, once the pain came back it was obvious just how bad it was. Back to the Ortho I ran, but unfortunately I could not repeat the cortisone because they needed an MRI and for inflammation to be evident on it. Then for surgery you don’t want suppressed immunity for risk of infection concerns. That meant a few months of toughing it out because they couldn’t get me in until February 3. In retrospect, I will say that it’s just as well they couldn’t fit me in where I originally wanted which was November/December. I would not have wanted to deal with this recovery during the holidays.
You may think you know. You may think you’re prepared. There is just no way to truly be prepared for what waking up from a 2 hour surgery is like. I had general anesthesia once before but it was for a surgery less than an hour on my temple, and much simpler. I am extremely thankful for a friend that is a retired RN who said plainly to me that this was a MAJOR surgery I was headed into. From my technical and studious viewpoint it seems simple to me, especially considering the comfort my surgeon has with the procedure and the sheer number of them he does per year. I had read about the entire process in detail and my thought was that there are so much more serious things to have operated on, it can’t be as bad as that. Haaaa…. Thank you dear Donna for telling me that wasn’t quite so. I imagine I would have been pretty bent out of shape if no one had been honest with me beforehand. The shoulder is one of the two most difficult joint surgeries to go through (ankle is the other), and one of the two most painful joints to have operated on (knee is the other). We don’t think about what we use a shoulder for until it’s either painful or out of commission.. or both. We don’t realize how much we use our non-dominant arm for in daily activities either, until we can’t. One cannot underestimate the seriousness of general anesthesia in any case.
I went into it laughing, joking, and keeping cheery. My mother and I both terrorized the staff with our sideways humor while waiting through a delay (5 yr old w/ a broken elbow emergency trumps the stable adult with the first appointment of the morning). I have to applaud Redlands Community Hospital for their fantastic manners, accommodating sensitivity to personal needs, and ability to embrace the need for a positive environment. They saw to my every comfort with graciousness and alacrity. I could not have asked for more – perfection as far as I am concerned, start to finish. I also have to state a profound thanks for my parents for driving an hour and a half and staying two nights with me to make sure I got to and from safely, and had help while I adjusted to my new limitations. It was just one of those times when I needed my mommy. She was there. She was the last person I was with before they wheeled me to the OR and she was the first one to see me when I was recovering. That’s how I wanted it.
Waking up was an experience I couldn’t have predicted. My prior surgery was so much less traumatic that I woke up feeling like I’d had a nice nap and went home feeling pretty peaceful. This time I struggled for a long time to even pry my eyes open and felt like I had to keep dragging in deep breaths to help shake it off. The first thing I remember being asked was “How are you doing?” to which I thought “…you tell me, I’ve been unconscious!” lol What I said was that I felt like I’d been punched in the shoulder several times. When they started asking about post-op pain meds I had a very calculated and technical conversation about what I had at home for it (Codeine), listened to a pregnant pause, and asked them what my options were if that wasn’t sufficient. I gathered by their reaction it wouldn’t be, and they were 100% right. After settling that decision they moved me again to where I would spend the rest of my recovery time. The stunning part was realizing that they wanted me coherent to evaluate my pain level before they were going to start IV pain management meds for sending me home. The pressure was incredible and it was really starting to hurt. When they got to me saying 8 on the 1 to 10 scale, and I explained that my 8 would have most people on the floor screaming… they decided it was time. Dilaudid is a wonderful thing. I did however have to tell them no more after dose 3 because I couldn’t feel my face and I really wanted to go home. I knew I wouldn’t be able to walk, even though I could have done with feeling a little less in my shoulder. I knew nobody was going to pick me up and put me in my mom’s car so standing up ability was of some importance. They definitely made sure I wouldn’t feel much for a while though!
Polar Care Cube, meds, sling, and all I managed to get home with prescriptions in hand… which thankfully I took right away because in spite of insisting to the nurse that I wasn’t nauseous it sure as heck did eventually come. I excused myself and ran out of the room once but it was a false alarm (thanks to the anti-nausea med!), so I don’t think I’ll ever underestimate that possibility again. There is a lot of pain to process after this kind of event, and I pondered long and hard the medication issues that everyone does. In the end I am so grateful for that assist because pain is not conducive to good recovery. I had a good 16 days of needing continuous management, and I’m okay with that. No one should short themselves if they need it just for some image they feel they need to uphold.
I needed a distal clavicular resection (shave off the end of the collar bone), a subacromial decompression (remove the bursa, grind off bone spurs), and debridement of a small rotator cuff tear. Praise be that I didn’t need anchors and sutures. It was too small to do that and so my recovery has a far better prognosis. No immobilization either. They wanted me moving it the first day. That was hard, let me tell you. I have however been diligent with the prescribed exercises and not pushed beyond the outline for my PT. Five weeks later my range of motion they say is very good and I should fully recover without much difficulty.
It has been an emotional journey as well as a physical one. I broke down into tears in recovery trying to explain to the nurse why this happened to me. She was so sweet and sympathetic and said something so true, which was, “Well now you can heal completely.”
I still have time to mend ahead of me, and I still have to be careful.. BUT… there will come a day when I will no longer have to baby that arm, or have those uncomfortable reminders needling at me. You have to love those moments when you find out the light in the tunnel really isn’t a train this time.