Shoulder Replacement Part 2

 I've learnt a lot. While endeavouring to be positive about my surgery, things kept happening to me as a result of drugs not doing what they should or having nasty side effects that can make someone my age feel positively frail. I had planned to build muscle with my gym membership. The reality was that I had to stop going and to give up line dancing this year. There are also anaesthetic consequences for folks over 60. I know this as it happened to me after I ended up having two open-heart surgeries in one day, four years ago. I think that, although I seemed to bounce back and perform rock music and sing onstage I was not noticing what was happening. I put it down to aging.

When you approach your surgery date please make sure the team has your very latest list of drugs, interactions, bad reactions, prior experiences of anaesthesia, things in your musculosketal system that may affect positioning during surgery, dental work.

Pre-operative Prep: 

Minimising infection - fresh, clean pyjamas and clean bedlinen the night before surgery. 

Medicated Body Washing - The evening before and morning of surgery it is essential to have a shower using your usual products. Pat yourself dry each time with a clean towel and wash body with the medicated wipes provided. Apply te medicated treatment via xupplied cotton buds to the inside of each nostril

Medications - You will be instructed which of your regular medications to take the day of your surgery. Herbal and homeopathic treatments must usually be stopped 14 days before surgery. Diabetics will have extra instructions. 

I was told the surgery went well but even so, pain management was problematic for me due to influences of drugs I had previously been on though did not want. My options were limited to morphine and paracetamol. I kept explosively vomiting from time to time so was kept in hospital longer than expected. Burwood hospital specialises in orthopedics and were very good.

My operative arm stays in a sling pretty much 24 hours for 6 weeks. Exercises are very limited at present but will increase . You must have someone living with you for the first few weeks as you really can't do much for yourself. Try spreading butter and jam on a piece of toast when you have only one arm. Opening a jar, or cooking? Forget it. 

I would advise patients to buy those 'wishbone' style flossing gadgets as teeth flossing normally is impossible. Try some reuseable ice bags. Getting dressed and undressed takes planning, time and usually help. Basin baths only for a bit. Sleeping requires a nest of pillows as I can't sleep sitting up. Do not under-estimate how 'disruptive' the first six weeks can be. You cannot drive or carry anything.

There are months of healing ahead and physio so I'm hoping that a future lack of pain 24/7 and a much better range of movement will give me my hobbies, such as bass playing, dancing, pool exercise classes and gardening back next year, before I have to go through all this again with the other shoulder. 

General Rehabilitation Timeline & Phases

Phase 1: Protection & Immobilization (Weeks 1 to 4–6)
• Sling use: Worn day and night (except for hygiene and prescribed gentle exercises) to protect the surgical repair and subscapularis/rotator cuff.
• Exercises: Limited to passive range of motion (PROM), pendulum exercises, and elbow/wrist movements.
• Precautions: No active lifting, pushing, or pulling, and strict limits on external rotation or extension depending on the surgeon's protocol. These severe limitations can come as a bit of a shock. You really can't do anything and sometimes the pain is denotivating anyway.
Phase 2: Active-Assisted & Early Mobility (Weeks 4 to 10)
• Sling weaning: Gradually discontinue the sling as advised by your surgeon.
• Exercises: Introduce active-assisted range of motion (AAROM), gentle scapular control, and light waist-level use of the arm. 
Phase 3: Strengthening & Functional Reintegration (Weeks 10 to 12+)
• Strengthening: Begin progressive resistance, rotator cuff conditioning, and deltoid/periscapular strengthening.
• Return to activity: Light functional use and driving typically resume around 6 to 12 weeks, while full recovery, sports, or heavy use can take 4 to 6 months (with continuous tissue remodeling up to 18–24 months). Driving by Christmas is my goal right now.