SLAP tear/Decompression

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Topic Title: SLAP tear/Decompression
Created On: 05/21/2005 10:03 AM

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 05/21/2005 10:03 AM

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oobie

Posts: 14

Hi, I found this post as I was searching for some answers and it sounded so familiar. It is a workers comp injury from heavy lifting, stretching etc. 44 yr old female Started in June 04 MRI negative, cortizone injections no help, 2 rounds of PT no improvement. Had arthroscopic surgery 8 weeks ago for impingement, rotator cuff frays, small labral tear debrided not anchored, 2 bone spurs removed, acromion smoothed, clavical left alone. PT is getting worse and the pain is awful. Passive range of motion is full but extremely painful. Active range of motion is not good at all. Straight in front, out to the side, across the front is all very painful...more than before the surgery! Can't sleep at night and the shoulder feels very unstable. If I pick something up while my arm is straight down...ex: gallon of bleach from the floor...It feels like it's slipping out of the socket right in the front of the shoulder. Not all the way out but it moved for sure. Scared the heck out of me and was very painful. I'm so frustrated. I feel that I should be farther than I am with normal everyday activities...reaching in a cabinet, putting groceries away, SLEEPING! Could they have missed something during surgery? Am I just being impatient?
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 05/21/2005 10:03 AM

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waterlily

Posts: 19

I am a 34 year old female who fell a year ago on my shoulder. I am 10 days post-op from having bone spur removed, slap tear fixed and rotator cuff debridement. Although my shoulder aches, I have not taken pain killers since 1 day post-op. I haven't had to much pain and still in sling. I go tomorrow to remove stitches and have been doing passive motion of shoulder since 1 day post-op. My questions can not really be answered by a doctor because they aren't technically medical. I have had a problem with a heat rash under my arm from the sling. I have changed to a mesh sling, but still have same problem. I have used Gold Bond powder, Lanacane, and taken sling off while relaxing at home, but nothing really works. Anyone else have this problem? I also find it hard not to move the shoulder because I am not in that much pain, so I hope I haven't caused a failure of surgery. I never heard that you weren't supposed to drive with a sling and I have been for a week now. I live in Indiana does it differ from state to state?
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 05/21/2005 10:03 AM

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Goblin

Posts: 9

Too many vicodin LOL. The surgeon finally called me. I think he may be getting senile. He thought he had called me twice and he also told me he instructed my wife on post op. My file is missing/lost too. I had to break the reality to him. He never called and my wife was not there for post op. a nurse not him gave some instructions on how to use the ice bath. He seemed puzzled like he could swear he had talked to me post op. I felt sorry for him. He has a good rep and runs the clinic for a large university. I think age 70s may be catching up with him. I think it probably is not hurting his surgical skills as much as memory. If I heal up ok all will forgiven. I guess I would rather him mess up on pre/post op than the actual surgery. Time will tell.
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 05/21/2005 10:03 AM

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danab

Posts: 20

3rd response: It seems as though you have become a "victim" in this situation. this is easy to happen when you become as vulnerable as after a hard shoulder surgery. There is is no excuse for these doctors not getting back to you with hand swelling or when they said they would for post surgery instructions. Every office has a doctor on call. call and tell them you are having a post-surgery "problem" and expect an immediate call-back for one. Then during office hours call (ask for your doctors nurse or main assistant) and tell them you will hold until you talk with her. Tell them you have been blown off and calmly remind them how. Then insist on being given specific instuructions on how to handle your post-surgical arm. dont be an "...hole"! they are, but don't be one as that won't get you anywhere. If this doesn't work, contact an attorney that is referred to you by a good friend. Pay them for a half hour phone consult and tell them what's going on. I'll be blunt...either your story is the gospel and you need that attorney; or...you have taken too many vicodin or percocet and aren't thinking clearly and don't remember they gave you written intructions and they are in your car or back pocket or whatever. Either way, there is some good information in my previous posts. If you don't have a spouse or a girlfriend, get one of your parents to come out and help you for a couple weeks. Pay for some in-house help or nursing assistance. You are correct, I don't know what I would have done without assistance in the first few weeks, even still at 7 weeks. Get some help. Hang your arm to your side in shower and when dressing but don't fire the shoulder muscle. But this is all what you need to know from the doctor. So get that info. or call that attorney. Stop being a victim!
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 05/21/2005 10:03 AM

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Goblin

Posts: 9

I guess I should have researced more. I was referred to him by a friend (radiologist) I think he well could be a good surgeon in terms of the surgery but is poor on pre op and post op education. Was told I could go to work a few days later. Now I find out that I will be in a sling for 4 weeks. No instructions on how to take a shower without moving my arm. I have no idea of how much it will take to tear the sutures so I am scared to move my arm at all. The Doctor said he would call on post op night but failed to. A nurse called the next day with a hospital questionaire on my visit but not much pertaining to my arm. I have called three times on my hand swelling and so far no callback. My 1st post op visit is in 2 weeks but I have questions now. How did they expect me to work when its illegal to drive in a sling? I think when I get use of my rt hand I will make them a pdf. on what to expect post op and to strongly advise them that 2 weeks or more work could be missed. I had the tear for years so it was not an emergency.
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 05/21/2005 10:03 AM

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danab

Posts: 20

oops, forgot to add the sling was taken off at 5 weeks even though PT started 2 weeks previously. But a good doctor should spell all this out for you. Just make sure you keep that labrum quiet in the specified time so it will heal.
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 05/21/2005 10:03 AM

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danab

Posts: 20

My second post to you. If what you say is accurate, your doctor is guilty of malpractice. No slap 2+ repair is minor and comes around like you previoulsy described your doctor told you...period. Then again, only you know or can or can not document what was said or written down. I can't imagine going into that kind of surgery without doing some independent research, but maybe that's just me. Vioxx, by the way is a decent antinflammatory and is easier on the gut as well. The hand swelling sounds like it needs to be addressed...now! Second, you need to know what to expect, what EXACTLY is the protocol for the next 6weeks to a T. As someone coming off my second slap surgery --2nd arm--I can't understand how a doctor can let a patient go home with these specific instructions and generally what to expect. This site has a lot of peoples stories for similar surgeries. As you will see everyone heal differently and has very different experiences. Again, if what you say is fact, then you do have some real issues with trusting this doctor. Although a good shoudler specialist would let you know about this, I will share what the general protocol is with that type of surgery working with Dr. Hawkins from Steadman-Hawkins clinic (Vail and now S. Carolina). I as very please with my experience and everything was very explicitly spelled out...not the case in my first surgery and something I didn't want to repeat. I had slap 2 tear: his protocol and one that may not at all apply for you; 3 weeks in sling with no firing of biceps or shoulder--only finger and thumb excercising and hanging arm in shower and flexing elbow (again without firing shoulder). Passive range of motion began at end of third week. Active assisted the next week continuing all previous week strethches and excercises and introducing some cord work the next week. Again, each excercise and stretch was spelled out the night after hospital in their associate PT office. It's a fine line to walk between getting stiff and letting the labrum heal to the glenoid which takes at least 6 week or so. with a type 3 there was some damage to biceps tendon so the early movement may be even more important to restrict. You do not want to do this again! I'm at 7 weeks and things are just starting to get to be ok. My range of motion still needs some work but I'm going to get there. For some the that amount of time can range from tough but tolerable to hell on wheels. Longer or shorter, it's really individual. If you can't get the fact from your doctor or don't trust him. Don't screw around, research a good specialist, take all your notes and reports, it have them help you get on a good program. My guess is that will be sticky and many doc won't feel too comfortable in that situation, so hopefully you can kindly but firmly tell your surgeon that you feel as though you haven't gotten an honest story and you insist on getting all the details...NOW. good luck c
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 05/21/2005 10:03 AM

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mcintyres1

Posts: 25

Hi there you are not by chance seeing doctors in SC. are you.I am having the same problem with my O/S in Greenwood.He claims he was very thurough but had and arthigram/mri and dye leaked out in two places.Now he has said I have reached mmi and released me.
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 05/21/2005 10:03 AM

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Goblin

Posts: 9

thanks for the reply. There was no miscomunication. They made it sound routine. What they should have done was to spell it out exactly how it is going to be. I was told that they were afraid I might not do the surgery. I can handle the truth, They messed up my work schedual by giving me unrealistic expectations. I had a slap type ii-iii going in. They used 4 screws to tie sutures to. I was grogy but remember the surgeon saying he was surprised he was able to fix the large tear. He stated that I had good tissue and was able to pull it to the bone. On my checklist paper they have a 40-45 angle for my sling. When i looked at mine its more like 90. I can't make my arm do 45 from the swelling. If i dont lay back and elevated it in the chair my hand gets like a ballon. So even though i should be able to walk around the house now I can't due to the fluid accumulating in my hand. I called and the tech/nurse said its all in my post op paper directions. I read them all and it said nothing about hand edema. I think this could be normal but the instructions given are very lacking. post op drugs given: Vicodin and 3 viox pills. Why no anti inflammatories past 2 days? It seems I do have plenty of inflammation. Could someone please spell out what is typical for recovery for my type of surgery? ie. day1-day30 No rehab was mentioned, are they planning on dropping this info on me too?
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 05/21/2005 10:03 AM

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danab

Posts: 20

Sounds like some awful misunderstnding or miscommunication somewhere along the line. It's true, the surger won't degrade your arm strength but will ultimately get you back to 100%. But if you had anything more than SLAP 1 TEAR, unfortunately, it will be a "pain" for awhile. If slap 2 or more, it will take time for the the labrum to heal back down to the bone. (type 1, the labrun has a tear but hasn't separated from the glenoid bone (socket). If type 2 or more the labrum has torn off the glenoid and they probably used sutures and screws to tighten back to glenoid. That takes a quiet period and time to heal. I think most decent surgeons expect 3 weeks quiet time in a sling with type 2 or higher tears. If type 1, the pain just from the surgery will take a litle time, but you should be back to things much more quickly. But 2 or more the pain from the screws/sutures and just the invasiveness of the whole process makes what you are experiencing very typical. Find out what kind or sugery you had, and if higher than a 1, try to let your expectations go and realize that it is a longer healing process. Your symptoms post-surgery are not unusual, sorry to say. Get the facts, if your surgeon misinformed you, tell him how you feel--and try to get on with it. YOu will get up to 120 mph, either way. But get the facts as to what to expect. Again sorry for your frustration.
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 05/21/2005 10:03 AM

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Goblin

Posts: 9

I am 4 days post op SLAP tear surgery. They really do not give good information of what topect post op. I think it as a bit dishonest to withhold info. I was told I could go back to work on Monday for a wed 8am surgery. I am typing this lefthanded on Sunday 1pm Eastern. My right hand is swollen so i can't close my fingers. Day one - Arm in sling pain is 2/10 w/ marcain drip and vicodin. 8/10 pain if i move arm. Also have cold pack 24/7x4 days. slept in lazy boy day 2 - same day 3 - same day 4 - little less pain swollen fingers can't write w/ rt hand. There is no way I could go to work on monday. Before surgery I could play tennis but have post swelling and mild pain. I would guess I could still serve 100mph down from 120mph. 4 days post my arm is 5% at best no way can i move it. Prior to surgery I asked if they take my 80% shoulder and make it a 20% while healing so I might reach near 100% after healing. They acted like they would not degrade it from surgery. What a bunch of crap. Why do they sugar coat it? Probably afraid I would back out. The truth is they will make your arm 5% post op from all the swelling. Why did they not tell me that? It may get to 100% but not nearly as fast as they lead me to think
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 05/21/2005 10:03 AM

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susanrdh

Posts: 2

Hi, How are you doing as of now from your labrum surgery? Did you have a biceps tenodesis procedure? I am scheduled to have a biceps tenodesis & possible subacromial decompression on June 21st so needless to say I am nervous. I have never had any shoulder surgeries but have had 4 right knee surgeries, 2 of which were extremely difficult and had severe pain from them. When did you start PT? I believe I will be in a sling for 4wks then start formal PT. Not sure though until my surgeon goes in. Please be honest about the pain and how long you took Vicodin or other narcotic pain control. I am hoping to start 2 classes in Sept, do you think this is not possible 12wks post-op?? Ok well I look forward to hearing from you! Again my thoughts are with you. Sue
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 05/21/2005 10:03 AM

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LEO2

Posts: 5

continue with really uncomfortable go. Knew i would not be returning to work so called OS an insisted on earlier appointment. Feels my problems could be from the SLAP. Is obvious he is of the school that believes you do not fix anchor/surgically fix the SLAP (in my opinion he believes that). He is sending me to UofW hospital in Seattle a more experienced more highly regarded doctor. I cant stand the wait. Lots of pain, mostly on movement, but often at rest. Primarily in front of shoulder near corner/edge. Still sleeping maybe 4 hours a night in easy chair. when reclined pain doubles or worse. Please, UofW Doctor call soon and schedule my appointment. I am certain surgery is inevitable and would like to get moving so full recovery can occur. We update when changes occur
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 05/21/2005 10:03 AM

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iggler

Posts: 47

OOPS!!, It looks like I cant spell either. Ill be more careful next time!!
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 05/21/2005 10:03 AM

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iggler

Posts: 47

Wow, how weird!! Your post sound like it was written by me. I daid those exact words to my dortor & pysical therapists, I feel like im going backwards. I see my Dr March 12th, ill let you know whats up then.
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 05/21/2005 10:03 AM

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LEO2

Posts: 5

yep, will keep you posted. Sure does sound like a similar scenario. I just can't help but feel the slap tear is causing me a real problem. Worry a bit that OS is gonna stall any of my attempts to get that fixed. Appt Mar. 16th. He has always maintained waiting 6-8 months before we make a decision to repair. In many regards, I am making no progress, almost feel like i am slipping backwards (night pain, and even daytime pain-with movement). Will keep ya posted.
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 05/21/2005 10:03 AM

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iggler

Posts: 47

Oh my Goodness, I cant believe it, you are having all the same symptoms as mine. I had arthoscopic done 11-28-03. small slap tear with no anchor, just debridement, also small tear in rotator cuff, no repair just debridement,also had acromioplasty( small bone spur removed). To hold my arm out away from my body and raise it up??? Just isnt happening. My Pt says it feels like some impingement going on in there, but wait that is why I had the surgery in the first place. Mine is a workman comp case, I do a lot of heavy lifting along with overhead lifting and reaching. I am on my third round of PT since middle of september. I dont feel any better than I did before the surgery, but my OS hasnt said anything yet about another surgery, everyone keeps telling me it just takes time. I see my OS again in mid march, at last visit he said we would discuss a cortisone injection again. I had 2 before the surgery from the Dr at occupational health and one after surgery from another Dr in his group ( mine was out on medical leave for 8 weeks) I didnt get any relief from the shots so I dont think it is worth it to get another one. I asked my Dr last month if the debridement could come undone & he said yes it could, it is like a frayed rope, & he just cleaned up the frayed ends, so once I really start using my arm again, it could fray again and cause a full tear. Sooo.... I dont understand why he didnt just repair it. I went into this with the understanding I would fell much relief soon after and be back to normal about 6-8 weeks after surgey. we are now about 14 weeks out and im still on a 5 # lifting restriction. Keep us posted on your recovery as im very interested in your outcome.
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 05/21/2005 10:03 AM

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LEO2

Posts: 5

the pain part sounds familiar enough. I recognize the ache. Heheheh. O.T. says they have done all they can do, and to stop doing the exercises and theraband exercises. I think he fears a return of the impingement,soooo.... now waiting for appt with Dr. (the surgeon) in mid-March to re-evaluate what to do next. I'm in a waiting game and not enjoying it. Oh well. Could be worse. You have a challenge. Hoping I have no worse than the need for simple SLAP tear repair. Hoping it has not worsened to the type of condition you describe. Hang in there, be patient (that seems to be the common challenge).
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 05/21/2005 10:03 AM

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scott123

Posts: 25

I had alot of the same problems you had .i was injured last year went through p.t for 12 weeks two cortisone injections couldnt sleep laying down shoulder killed me at night and ached through out the day. had surgery in 08-03 decompression /distal clavicle resection two r.t. tears and a slap lesion were found and debrided.started p.t. the following week .shoulder started subluxing on a weekly basis but i didnt know thats what was going on it would slip and hurt like hell for awhile and theN ache this went on for 3 mos..my p.t kept telling me youre shoulder sure is loose(INSTABLE)IN ALL DIRECTIONS. AND WOULD WRITE SYMPTOMS DOWN IN PROGRESS REPORTS .AT 3 MOS POST OP MY SHOULDER JUST HAD THIS GOSH AWFUL TOOTHACHE LIKE PAIN ALL THE TIME . ORTHO SENT FOR ARTHOGRAM (OUCH) AND WHOA THERE IT WAS LABRUM TORN OFF BONE FOLDING DOWN LIKE A BUCKET HANDLE. BACK TO ORTHO WHO REFERRED ME TO SHOULDER SPECIALIST WHO EXPLAINED THE SURGERY NEEDS ANCHORS AND SUCH TO REPAIR SIX WEEKS IN IMMOBILIZER(BEEN TOUGH). HAD SURGERY 2/3/04 FOUR HOURS LONG. WELL HERE I AM FOUR WEEKS OUT HAVE PULLED ALL MY HAIR OUT CANT SLEEP HATE THE WORD PERCOCET AND YES IM STILL IN PAIN ALL THE TIME.ICE HELPS HEAT HELPS BUT ITS ALL TEMPORARY AND IM WONDERING IF IT WAS WORTH IT. 37 YEARS OLD (WAS)VERY ACTIVE .DOES THIS SOUND FAMILAR.THANKS ,STAYING POSITIVE.
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 05/21/2005 10:03 AM

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LEO2

Posts: 5

Okay, will try to keep this short, but, looking for answers. 46 yoa male, very active, kayak/hike/fish/hunt/run/mtn bike/etc. Bike wreck in September. Shoulder injury resulted. Nothing in MRI, mild pain during day, too much pain to sleep reclining. MRI negative, diagnosis - impingement. 4-5 weeks P.T. poor results so Decompression surgery in December. Surgeon found SLAP tear. Debrided but did not anchor. (Surgeon said, rehab and aftercare for the two procedures is contradictory). Now after 10 weeks of OT, range of motion is almost 100% (except reaching behind and out to side, strength coming around (except lifting with outstretched arm), moderate day pain with many simple movements, and NO CHANGE at all regarding sleep in prone position. To lay down is to increase pain, even at rest, many times. Sleeping in recliner for 4-5 mos now, 4 hours a night would be good. I think I need a SLAP procedure, what do you think? Anyone have similar experience? Seems I have two blocks of symptoms. Some caused by decompression surgery, that are improving, and some caused by injury in September that are not improving. Very frustrated. Want to get ALL fixed and sleep and recover AND KAYAK AGAIN. Can unrepaired SLAP tear cause problems down the road? I SLAP tear procedure is warranted, how long between it and previous repair? Anyone been through this scenario? need answers. Thanks much.
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