Going in for my shoulder surgery, we thought the problem was a torn labrum, but it was actually a different piece of cartilage attached to the glenoid that was torn and giving my pain in certain overhead positions. For those going through similar issues or just interested, here’s a recap of my day through surgery.
4:00am – Wake up and shower using antibacterial soap (Dial) and leave by 4:45am. Was not allowed to eat or drink anything after midnight.
5:30am – arrive at Penn Presbyterian Hospital and check in. Everyone I encounter asks for my name and birth date, presumably to make sure I am who I say I am.
6:00am – get settled in Short Procedure Unit, change into medical gowns. Nurse had me sign some paperwork and more people ask for my name and birth date. I start to tell them before they even ask.
6:30am – hop into a gurney and head up to the anesthesia/prep room. There’s about a dozen beds on the perimeter of this room, but not all are filled. Lots of doctors and nurses either helping patients or waiting around checking their Facebooks or talking about their night out.
6:45am – Head anesthesiologist introduces himself and, wait for it….asks for my name and date of birth. Then explains that I have 3 options for anesthesia:
- general anesthesia – will put me completely under and require a breathing tube. Side effects will include grogginess, possible vomiting, etc. for the rest of the day.
- general anesthesia plus a nerve block – same thing as above, but with an additional local nerve block to the right arm. This is similar to going to the dentist and getting local anesthesia.
- nerve block only – no general anesthesia, just the local nerve block. This would mean I would be awake during the procedure, but would not feel the work being done.
The doc said that he definitely recommended the nerve block either way since it would help with pain management the rest of the day. He said some people wanted general anesthesia just to make it easy and so they didn’t have to think about anything. Naturally I declined. Being able to watch my own surgery, are you kidding me?? Of course I want that! He followed up by saying he doesn’t offer it to everyone, so I took that as a compliment. I guess for some people he WANTS to put them down so they aren’t a pain to deal with. Pun intended.
During this time there were a ton of people to come over and chat with me. Residents, nurses, nurses’ assistants…They all had their own function and role, even if it was just to observe.
During this time I had an IV inserted and an oxygen tube in my nose. Although I wasn’t getting the general anesthesia, I did receive a mild sedative that made me feel like I just had a glass of wine. After this, the doc gave me the nerve block by using an ultrasound on my right trapezius to find the bundle of nerves to hit. Using a needle with what looked like a massive amount of liquid, he injected it in a few spots. My arm started to tingle, much like it does when it falls asleep, and pretty soon I couldn’t move it. This definitely made me appreciate what paralyzed people go through since I could see and try to move my arm, but simply couldn’t.
7:45am – the scheduled time of my surgery. I was wheeled into an OR where there were about seven or eight people working on me. I felt like a celebrity. I was moved onto a table that folded up to be more like a dentist’s chair which was actually very comfortable. After discussing what kind of DSLR to get (surgeon was leaning towards Nikon) and what Pandora station to put on (classic rock), we got started.
8:16am – Start of surgery.
A TV monitor was positioned to my left so I could see what was going on. The surgeon and nurses were behind and to the right of me, where my right arm was propped up. They placed a number of cloths to the right side of my face, presumably to keep me from glancing over and also to probably prevent any blood spatter. (any Dexter fans out there?) I didn’t see them make the three incisions (2 anterior and 1 posterior), but I did see the view of the camera that went into my shoulder. Below are the images and what each of them means. Like I said in the beginning, we thought going in that it was a labral tear which is pretty common, but it was actually a piece or articular cartilage attached to the glenoid, very close to the labrum. The camera went in from the back of my shoulder, so you can see the shoulder socket to the left and humerus (arm bone) to the right.
During the procedure, I did get a little nauseous, but the anesthesiologist put a little something in my IV which immediately alleviated the feeling. Other than that, I was pretty coherent and talking with the surgeon about what he was doing. He was just as surprised that the tear was not in the labrum, but seeing the flap as dead as it was, he took it out and did the best he could.
9:05am – End of surgery (Total time: 49 minutes)
After patching me up, I was sent to the recovery room for about a half hour and then back down to the Short Procedure Unit. The surgeon came down and explained that he’ll need to talk with his colleagues and determine what the next plan of action is. He said if we keep things the way they are, movements like pull ups or even push ups are not looking great even after recovery. However, he is going to talk with some people about the possibility of cartilage transplant from my knee to the cavity in my shoulder. He said even this would be tough due to the angle which he’d have to work. Basically I need to meet with him in a week and probably go through PT first to see how I’m faring.
11:00am – Left hospital.
When I left, I was given a sling and prescription for 3 meds: Percocet and Oxycodone for pain management and Cefadroxil as an antibiotic. I was also told to ice, but from reading various points about icing and actually stalling healing, I kept that to a minimum. I only iced twice and it was the afternoon of the surgery for about 5 minutes each. I did take the Percocet for Day 1 and 2 to stay ahead of the pain, but the worst I felt was some soreness. Whether this was related to the drugs or not, I’m not sure.
By day 2, I was able to walk around without the sling, but would wear it just to prevent accidental arm raising or bumps from people. I imagine I’ll wear it anytime in public for a few weeks for this reason. For now I’m not supposed to do any self-PT until my follow up meeting next week. I’ll try to keep you updated if anything major happens.