Author Topic: Total Anatomical Shoulder Replacement  (Read 9287 times)

surfercook

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Total Anatomical Shoulder Replacement
« on: November 03, 2019, 06:10:49 AM »
   I go for a total anatomical shoulder replacement on 11/12 duplicating the shoulder joint exactly. The procedure will be at Rothman Institute in Atlantic County, NJ. My surgeon is Dr. Fotios P. Tjoumakaris. He's done hundreds of shoulder and hip replacements and he told me he told me I don't need a reverse replacement which is for patients with torn rotator cuffs that are not repairable...my rotator is intact. The reverse puts the ball on the shoulder blade and the cup on the upper arm.
It's amazing that we can rebuild our bodies like this. Titanium ball and composite cup is supposed to be good for at least 10 yrs. Longer recovery with a total anatomical since it takes longer for the forward rotator muscle to heal, but greater range of motion when healed. A Zoner who's a little more than 10 yrs younger than me had a reverse done and he's ripping hard again. I'll leave him nameless and hope he'll reply. We spoke together on a facebook call and he was very reassuring which put my mind at ease quite a bit.
I know one surfer that had his hip replacement done by Dr. "TJ". As a matter of fact that surfer is a physical therapist and has treated several of TJ's patients with shoulder replacements. 

  I'll be 6 weeks in sling...3 mnths b4 any kind af serious activity...might be up to 6 mnths before surfing.
It's been an ongoing degenerative condition since early March 2019 as some of you might recall. Joint is done. There is no cartilage left. I was out for three months then and had a cortisone injection in June.
It relieved alot of the pain and discomfort and allowed me to get through the summer to do surf lessons and landscaping but I've been benched since September 20th. The pain started to increase dramatically, at times migrating
down my arm to my elbow and even my hand.

   I was offered another cortisone shot but passed pretty much knowing it only masks the condition. So far only two injections in the right shoulder. Last one was in 2008.
You'd think my fomo would be off the charts but at my age (61) I think my patience level is overriding any fomo. The fomo is there but in check.
I think my fear of infection and the procedure not taking is what is bothering my most. I've been imagining myself actually losing the arm! I watched one video where they showed the entire procedure and they REALLY opened this guy up. I'm super queezy when it comes to this stuff and my wife was like "Why did you watch that, idiot"! The video was a bit dated from 2015 though. I utter the emm-effer word like 100x a day and I can tell you guys it does NOT
relieve the anxiety!

Some links if anyone's interested.





https://rothmanortho.com/physicians/fotios-p-tjoumakaris-md?fbclid=IwAR2_5cIJzHEIl_Mghr58Y5fVyu7g-mNc6rWzkOtRUn2Kmj2LNj9_PufbOvY



« Last Edit: November 03, 2019, 06:21:05 AM by surfercook »
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Night Wing

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Re: Total Anatomical Shoulder Replacement
« Reply #1 on: November 03, 2019, 08:03:31 AM »
Sorry to see you're going to have "major" shoulder replacement. I hope all goes well and you'll be back on the water in 1 years time. Just remember. When you go for physical therapy, don't slack off. Do what you PT therapists say.

When I did my PT sessions at the sports medicine complex for my left and then my right shoulder, if my therapist asked for 20 reps on a particular exercise, I did 30 reps. At the end of each PT session, when I left with my fellow patients, I was the only one who was soaking wet from sweat. I attacked each one of my shoulder exercises like I was a "demon from hell".

When you get released from PT, I'm sure you'll be given a set of instructions for doing PT at your home like I was. Keep doing the PT exercisers at your home for as long as it takes and your shoulder will eventually thank you for it. Especially when you take your first ride back on your sup.
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supsean

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Re: Total Anatomical Shoulder Replacement
« Reply #2 on: November 03, 2019, 08:33:09 AM »
Sounds like its good to get that one over with. Waiting can not only cause more distress, but cause other muscles and tendons to strain by compensating for the bad shoulder. Good luck, and hopefully will see some chill surfing videos next spring.

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TallDude

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Re: Total Anatomical Shoulder Replacement
« Reply #3 on: November 03, 2019, 10:18:53 AM »
Sounds like it's time. Every surgery comes with the risk of infection. People who have plastic surgery done over and over are just gambling stupid.

1.)  Find the best specialist in your area. If you know someone who's a nurse that works at the surgery center where you're having the procedure done, ASK them who's the best. They know better than anyone. They see the one's that come back a day later with a high fever. Not good, but it happens. It's usually the problem surgeons. They're the one who repeatedly make mistakes. Sounds like you have a good one with a PT's referral.

2.) You'll be out and wake up with it done. Then just rest and take long walks to stay in shape.

3.) You'll be out surfing again before you know it. Pain free surfing summer.

Hang in there brother.

eastbound

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Re: Total Anatomical Shoulder Replacement
« Reply #4 on: November 03, 2019, 11:48:08 AM »
best luck, cookie--bet youre thru this and better soon!

and seems youre past choosing whether or not to do this...........
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supthecreek

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Re: Total Anatomical Shoulder Replacement
« Reply #5 on: November 03, 2019, 12:51:26 PM »
Cookieman!

Well, the good news is..... they can do this stuff!
Like TD said.... you need to do your best work before the operation, by selecting the right surgical team.

Be a stringent patient advocate for yourself!!
There are ways to get the Doctor and surgery staff, pre-surgery, to stay focused on the task.

I had cataract surgery on right eye, then left eye over the summer.
"Not to worry they said... we do this all the time!"
"only 2% of patients have a bad outcome."

ok... I can live with 2%

But hey... you lay awake on a table while they use a blender or something to puddle your natural lens and remove it  :o
Then they pop in a plastic one, and send you home.
20 minutes.

Blindness is not something I can contemplate.... so I never gave it a thought. EVER
I am very good at not overthinking bad outcomes.

I was totally peaceful leading up to the operation and totally relaxed as they did the procedure.
They said my blood pressure was perfect, as I lay there waiting for the local anesthesia.

Let's back-up... to before the operation, as I sat in the waiting room.
I couldn't help notice that there were about 50 people in for the same procedure.
After I did some quick math, I was tempted to shout out "Luckily, only one of us, is going blind today!!!"
But I didn't  ;D ;D

and here I sit... with perfect vision :)

Be peaceful my friend..... it works wonders. OMmmmmmmm

 







RideTheGlide

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Re: Total Anatomical Shoulder Replacement
« Reply #6 on: November 04, 2019, 06:44:37 AM »
I hope it goes well. I have had the "kind of helps" arthroscopic on both shoulders. Question about the intact rotator cuff - one of mine was repaired from a pretty bad (~80%) tear; does that still count as intact? The other one just had a labrum tear. Bone spurs and bursitis in both. Doc has not said replacement in so many words, just that there would not be much point in scoping again. Currently just do 600 mg ibuprofen before and after heavy paddling sessions and try to pay attention to how I use shoulders.

I wish you a speedy recovery!
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eastbound

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Re: Total Anatomical Shoulder Replacement
« Reply #7 on: November 04, 2019, 07:24:39 AM »
watch your stomach, rtg, with occasional high-dose nsaids---and also watch your heart with longer term use--i quit that stuff cold turkey 2 years ago--it had already messed with my stomach a bit, and then i saw the heart/stroke/BP risks they'd found, and no mas--

and i dont "take" cbd--i get plenty in connection with my herbal pursuits--nothing better for pain, with few if any side effects
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surfercook

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Re: Total Anatomical Shoulder Replacement
« Reply #8 on: November 04, 2019, 07:28:20 AM »
I appreciate all the replies and positive input, Zoners. Will try and target everyones responses a bit l8r as I'm out the door. I have alot of work ahead me to finish up my landscaping accounts before the surgery. Lucky I have a 20 something surfer buddy to help me these days!
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PonoBill

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Re: Total Anatomical Shoulder Replacement
« Reply #9 on: November 05, 2019, 08:04:06 AM »
You're worried about infection, that's a good thing. Pay attention to the nature of the pain. A day after surgery you'll have plenty of that, but if you feel "hot" pain that seems to be particularly deep, or you run a fever, or you start seeing increased redness, get thee to the hospital and have it checked. If they say yes, you have an infection but they want to send you home with oral antibiotics insist on seeing an infectious disease doc and don't leave until you do. If I had done what the first doc said and gone home with oral antibiotics I wouldn't be here. If fact I was kind of out of it, it was Diane who did the insisting, so brief your wife on the things to be worried about. Sounds like you have a great doc, and that makes all the difference in both outcome and infection risk, but talk to the nurses beforehand as tall dude said and ask them to explain to you and your wife what to look for in the event of an infection. If you think you have a problem, act on it. Don't wait.
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surfercook

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Re: Total Anatomical Shoulder Replacement
« Reply #10 on: November 05, 2019, 09:44:25 AM »
Procedure has been green lit by the insurance company. Still need to find out what my out-of-pocket will be though. I have a feeling I might need to sit down when I find out.

Keep doing the PT exercisers at your home for as long as it takes and your shoulder will eventually thank you for it. Especially when you take your first ride back on your sup.
Thanx, NW. I totally remember you replying to me on an earlier post stating that you were quite determined doing PT. Your therapist was like 'You feelin' me? If not we will say good bye now"!

hopefully will see some chill surfing videos next spring.
I just might actually drink a glass of champagne if that happens. Haven't touched alc since 2000 but will break my streak to celebrate that joyful day of actually returning to the surf!

Hang in there brother.
Thanx, TD/Matt. Trying to.

seems youre past choosing whether or not to do this
Yea, having some second thoughts everyday but last night the pain woke me like 10x so at present it's a go.

Be peaceful my friend..... it works wonders. OMmmmmmmm
Good advice...will pass on the meditation though. Long walks on the beach or state forest are kinda my meditation process.

Question about the intact rotator cuff - one of mine was repaired from a pretty bad (~80%) tear; does that still count as intact?  Currently just do 600 mg ibuprofen before and after heavy paddling sessions
I would ask your Dr/surgeon that question, RTG. But it sounds like the rotator is pretty done. Like eastbound replied, watch all that ibu intake. I limit myself to one 600mg dose a day. And as of tomorrow(6 days before procedure) I will be off the ibu and the glucosamine. They don't want any blood thinners ingested PERIOD!

watch your stomach, rtg, with occasional high-dose nsaids---and also watch your heart with longer term use...heart/stroke/BP risks. and i dont "take" cbd--i get plenty in connection with my herbal pursuits--nothing better for pain, with few if any side effects
I can't wait to get off the ibu being well aware of those risks. I actually stopped the herbal intake a while back after pulling the trigger on my surgery, not being sure if it was going to help me in the ER.

You're worried about infection, that's a good thing. Pay attention to the nature of the pain.
I'm definitely paying CLOSE attention here. This ain't no joke. THE most evasive surgery I'll have ever gone through. Four ear drill outs(canal plasties) over the years and two oral surgeries will seem like small potatoes after this one. Curious if you've had a joint replacement?

« Last Edit: November 05, 2019, 09:47:29 AM by surfercook »
One could go into a mall in Kansas and ask a teenager "What is a surfer looking for?, and the answer will always be, "The perfect wave"
 9'11"-145 ltr     8'0"-127 ltr  8'1"-116 ltr     8'0"- 110 ltr   72" Methane & Riviera Camo

PonoBill

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Re: Total Anatomical Shoulder Replacement
« Reply #11 on: November 05, 2019, 11:36:08 AM »
No I haven't, though I think a knee is in my future. My doc keeps saying NO, and it still works, but it's holding me back a bit. Same with my hips, the doc says I have arthritic changes, and the joint is tightened up, but the joint surfaces look like a 19-year-old kid's. Go figure, all I know is that they ache a lot, I can't sit for very long, and I can't walk very far. I've had lots of rotator cuff repairs, but the joints are still good.

I think my body is going to hold out a while longer and then all collapse at once.
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Re: Total Anatomical Shoulder Replacement
« Reply #12 on: November 06, 2019, 12:12:08 PM »
On those ibu warnings - yeah, I know, but not sure what else to do for inflammation. I get the "little bit all over" inflammation more often than the localized "knee like a grapefruit" kind. NSAIDs help with that. After paddling/hiking/gym, I might not be able to get my ring over my knuckle for a couple of days without NSAIDs but it will be within a couple of hours of 600mg of ibu. 400mg won't do it. Tylenol won't do it. Naproxen will but it sours my stomach worse than ibu.

Pono - interesting that you have had multiple rotator repairs. I wonder what's different to make my doc say he shouldn't do mine again. Next time I am in (hopefully not to soon) to see him I will ask.
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FRP

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Re: Total Anatomical Shoulder Replacement
« Reply #13 on: November 07, 2019, 01:20:58 PM »
Best of luck with your surgery Cookie. It sounds like you are headed in the right direction. We will all miss your great videos while you are recuperating and look forward to the first one you post after getting back in the water.

Cheers,

Bob
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Re: Total Anatomical Shoulder Replacement
« Reply #14 on: November 07, 2019, 03:13:07 PM »
Pono - interesting that you have had multiple rotator repairs. I wonder what's different to make my doc say he shouldn't do mine again. Next time I am in (hopefully not to soon) to see him I will ask.

I keep ripping mine up. The last one was pretty much every muscle torn. I fell during a Maui SUP race when I turned to give Gregg Leion shit. I went in feet first and caught the board under my arm going down so I could pop back on. Probably not the best idea I ever had. Four and a half hours of stitching and digging. It was supposed to be one and a half hours but everything the doc looked at "just to be sure" was either torn or severed. Diane thought I was dead on the table and they just forgot to tell her. Fortunately, I had a great doc. My worst shoulder is now my best shoulder, though that's a low bar.
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