Next steps? Shoulder not healing after spactacular fall.

My daughter had the proverbial rotator cuff tear. They take a long time to heal right. She was a pro athlete and it took her a year before it started to feel right.

Soft tissue damage is tough to get right. But - all this time, you've got pain still and even when you're not stressing it. So, I still think some kind of nerve pinch or inflammation that won't let it recover on it's own.
 
One of my favorite tools was the Sears two foot long bolt cutter, or their selection of vice grips. One of my plastic surgeon colleagues used a silver spoon, while I used to like a store bought sifter for bone cement.

All of this has gone away- we need to use $2,000 stainless bolt cutters, or expensive vice grips in the OR now because the Sear's ones aren't made of the appropriate grade of stainless.

The OR grade ones don't cut any better, or grab any better- it's just that the people who control what we do and live by policies rather than common sense determine that they're better, without data.
 
Dr. Wayne Burkhead in Dallas is a noted shoulder surgeon. He's done rotator cup surgery on both of my shoulders.
 
How is a cortisone injection going to cure or treat a structural issue with bone?

any doc who recommends a tendon and ligament softening shot without disclosing the risks for a bone issue should lose their damn license for a month . . ..

sorry to the all the docs - you hate incompetent lawyers just a much.
 
Damn, I just found out that I have amazing health coverage. I suspected it was good but not this good.

Arthragram, MRI is on the books for tomorrow.
Total out of pocket $31.58

I did the "You mean 3 thousand right?"
"no sir, 31 dollars"

So at least I will have another round of tests before anyone decides if there is a need to start cutting.
 
SixPapaCharlie said:
And one of my worst fears is waking up during surgery being paralyzed but able to feel. I really hate surgery. I am going to request a nerve block if they have to cut me open.
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An interscalene nerve block works tremendously well for post operative shoulder surgery pain. I personally would refuse shoulder surgery without one. That said, I would also request general anesthesia for the surgery in addition to the block for post operative analgesia.

The fear you describe here is sensationalized in the media and undoubtedly very traumatic to individuals who actually experience significant cases of it. That said, it is an extremely rare event which tends to have a higher incidence in certain patient populations and or surgeries. A healthy patient undergoing shoulder surgery is not a high risk group. Furthermore, muscle relaxation medication is not necessary in shoulder surgery, so a general anesthetic may be done (and you may be asleep) without even the remotest risk of the recall of which you fear.
 
SixPapaCharlie said:
Damn, I just found out that I have amazing health coverage. I suspected it was good but not this good.

Arthragram, MRI is on the books for tomorrow.
Total out of pocket $31.58

I did the "You mean 3 thousand right?"
"no sir, 31 dollars"

So at least I will have another round of tests before anyone decides if there is a need to start cutting.
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Interesting. I feel we have good healthcare as well. I estimate that my wife's surgery will cost us about $10k out of pocket before we're done.

We had an emergency room visit and about 8 doctors office visits before surgery.

X-rays, CT's, etc.

Every appointment is a $50 copay. Doesn't sound like much but we have 60 PT sessions scheduled.

Hard to believe when you pay $1100 per month for healthcare coverage for two people which is a lot IMO.

Then you have to come up with this much cash on top of it.

Healthcare in this country is still VERY broken.
 
SixPapaCharlie said:
And one of my worst fears is waking up during surgery being paralyzed but able to feel. I really hate surgery. I am going to request a nerve block if they have to cut me open.
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Funny you bring that up lol. In a conversation about tort and the medical industry. I had with my ex's dad who was a GP & Anesthesiologist, he told me about a mistake, he had the guy paralyzed but awake for an abdominal surgery. The guy's only comment was, "That bloody surgeon is rough as guts." He said, "And he was right, the surgeon was rough. I was amazed I didn't get sued on that one."
 
Oh crap I'm so nervous.
Dr just said "I'm not gonna lie. This is going to hurt"

I guess the dye injection is no fun.
 
Well, Bryan's out with his buddies, so apparently it didn't hurt too bad!

Actually, he called it a "non-event." No pain while they numbed it, then the doc added lidocaine to the dye, so that numbed it even more as he injected it. He had a giant MRI machine, so he wasn't even claustrophobic.

I was nervous for him, as I've had an MRI and it sucked. Glad he had it easy. Now we wait for the doctor to give the results.
 
Mrs. SixPapaCharlie said:
Well, Bryan's out with his buddies, so apparently it didn't hurt too bad!

Actually, he called it a "non-event." No pain while they numbed it, then the doc added lidocaine to the dye, so that numbed it even more as he injected it. He had a giant MRI machine, so he wasn't even claustrophobic.

I was nervous for him, as I've had an MRI and it sucked. Glad he had it easy. Now we wait for the doctor to give the results.
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Sounds great Eren. Hope they get some definitive info.
 
SCCutler said:
As a guy who gets to shop (and pay) for it, it's much worse now than five years ago.

Gosh, what changed? :dunno:
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Fascism, that's what happened. With Obamacare we finally turned the second 90° corner away from the America the Founders intended, a century after the first when the Federal Reserve Act. Now the Government is enforcing mandatory payment to private industry, and with that support they got to raise their take to usury rates. It was just another ploy to force yet more money into the financial industry.
 
SixPapaCharlie said:
And one of my worst fears is waking up during surgery being paralyzed but able to feel. I really hate surgery. I am going to request a nerve block if they have to cut me open.
Click to expand...

They did a nerve block when I had my shoulder surgery in April. But they still put me completely under. Up side is that they can go easy on the anesthesia; I came out 5 minutes after they wheeled me into the recovery room, and I was home 30 minutes after the procedure. Having your whole arm numb for 24 hours was weird, though.
 
yesterday was strange. Had a florascope(sp)
I could see inside my body on a live monitor while they injected the dye
That was cool.

Additionally, God Bless McDonalds!
They had to update the MRI machine from one that maxed out at 250 lbs to one that maxes out at 550 lbs.

Very roomy. I got lost in it at one point. I suspect there is a good chance that is where the missing airline is. I didn't have time to explore it completely.
 
SixPapaCharlie said:
yesterday was strange. Had a florascope(sp)
I could see inside my body on a live monitor while they injected the dye
That was cool.

Additionally, God Bless McDonalds!
They had to update the MRI machine from one that maxed out at 250 lbs to one that maxes out at 550 lbs.

Very roomy. I got lost in it at one point. I suspect there is a good chance that is where the missing airline is. I didn't have time to explore it completely.
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They did the same thing to my knee when I was 12, they also injected a bunch of air into it so I 'squished' when I walked for two days, sounded like I had on wet tennis shoes.:lol: It was neat to watch it though and see how the joint works.
 
Results are in
I am going in for a formal review and to get a copy but from the call today

He said something along the lines of:
you have a significant tear in your rotator cuff.
You have no damage to the labrum
you have post traumatic arthritis in the joint

The tear is large enough that we feel it warrants surgery which would be done using 3 small incisions.

We will suture the tear and reattach it to the bone
We will remove a bone spur that was on found in both scans
and remove a small piece of the collar bone

It got a little medical-gibberishy there in the middle when he told me about the collar bone but he said this would prevent me from getting arthritis in the future in this joint.


He said surgery would be 1 hour
I would be in a sling for 3 weeks and have a pain pump for a few days after the surgery that will squirt pain meds into the shoulder to help with pain.

He said it would be general anesthesia but they would numb the shoulder as well.

He said I would have to do PT after the surgery and he sees no reason I should not be back to 99% after the PT and at a minimum I should be pain free.


That all sounds pretty good.
I am going in Monday to get copies of everything and discuss the surgery in more detail.
 
SixPapaCharlie said:
HAHA I know where that's going.
:rofl:
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Tell him you're taking over for Henny Youngman.


The surgery sounds similar to what TangoWhiskey went through recently. He can tell you some of the what and what not to do post op (like reaching for the sun visor on reflex).
 
I don't know. Hopefully not too long.

I have elec flaps so no johnson bar to deal with.
He said I will be in a sling for 3 weeks but I will be able to move the arm around and type it is just there to rest while the shoulder heals.


I am taking a flying trip in 2 weeks so I am scheduling it after just in case.
 
I had very similar surgery 8 weeks ago. Was in a sling for 6 weeks. PT (and the daily mobility exercises they give you to do at home) are important---do them religiously. Hope to be back to flying by December.
 
TangoWhiskey said:
I had very similar surgery 8 weeks ago. Was in a sling for 6 weeks. PT (and the daily mobility exercises they give you to do at home) are important---do them religiously. Hope to be back to flying by December.
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I got the official word that I couldn't fly for 3 weeks.
How bad was yours?

I have:
tear through 75% of the thickness of the supraspinatus that they want to repair, a bone spur they want to remove and he said he will make a determination about the arthritis when he is in there.

He said he is not big on making the call to start chopping off bones until he can see them for himself so there is a chance everything else will remain in tact.

He said I should be up to 100% and pain free when this is all said and done.
 
SixPapaCharlie said:
He said I should be up to 100% and pain free when this is all said and done.
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better hope the doctor's promises aren't like retail internet speed promises or you'll only get full use early on Sundays...
 
SixPapaCharlie said:
I got the official word that I couldn't fly for 3 weeks.
How bad was yours?

I have:
tear through 75% of the thickness of the supraspinatus that they want to repair, a bone spur they want to remove and he said he will make a determination about the arthritis when he is in there.

He said he is not big on making the call to start chopping off bones until he can see them for himself so there is a chance everything else will remain in tact.

He said I should be up to 100% and pain free when this is all said and done.
Click to expand...


Fly commercially maybe, but I was in the sling for 6 weeks (immobilized the arm) and now at 8 weeks since surgery (as of today) I am just feeling like I MIGHT be able to be PIC, as long as I had someone else pull the plane out of the hangar and do any heavy lifting. The work I had done sounds just like yours. Mine was right shoulder--if yours is left you might be able to fly PIC sooner. Reaching and pulling motions are not good to do post surgery until well into your PT, so with my right arm out of commission, working the throttle, mixture, prop, radios or pulling a Johnson bar flap lever would be bad.

You will feel like you can do these things before it's safe to do so without re-injury or tearing a suture. Follow your doctor and PT's advise on this and be very clear what kinds of motions and activities are involved. In an emergency, too, could you handle things adequately? High G pull? Opening the door? Stuff to think about...
 
Torn rotator and bone spur is all? Man, I thought you were in constant pain. I'm betting the bone spur is what's aggravating things in there. Don't minimize PT after the fact. I would say the PT is about 60% of recovery from my surgeries.

Also, you mentioned the insurance aspect. You need to be very proactive that NO ONE touches you, looks at you, discusses anything with you, or is allowed to evaluate anything unless you are notified in advance, and that they are in your plan. There's a lot of shenanigans going on in the med industry now with uneeded consults, and ancillary doctors assisting and you only find out after the fact that they are not in network when you get a bill.

When I was in the hospital last Apr for a problem, I made clear on my intake form that I would be notified before anyone evaluated or worked on me or my case. I made the intake lady sign that, and kept a copy. After the fact, when I got three different bills from people/places I didn't know and never heard of for thousands of dollars, I sent them a copy of that statement on my intake and advised I wasn't consulted/notified prior to the person doing the work, so - no pay, so sorry. I fought with one billing place for 4 months, but finally won and they left pennyless. You can win, but you have to be firm, and proactive. If you just sign all the forms - you're dead meat for outside of insurance billing. Several stories out there in the news about this.
 
docmirror said:
Torn rotator and bone spur is all? Man, I thought you were in constant pain. I'm betting the bone spur is what's aggravating things in there. Don't minimize PT after the fact. I would say the PT is about 60% of recovery from my surgeries.

Also, you mentioned the insurance aspect. You need to be very proactive that NO ONE touches you, looks at you, discusses anything with you, or is allowed to evaluate anything unless you are notified in advance, and that they are in your plan. There's a lot of shenanigans going on in the med industry now with uneeded consults, and ancillary doctors assisting and you only find out after the fact that they are not in network when you get a bill.

When I was in the hospital last Apr for a problem, I made clear on my intake form that I would be notified before anyone evaluated or worked on me or my case. I made the intake lady sign that, and kept a copy. After the fact, when I got three different bills from people/places I didn't know and never heard of for thousands of dollars, I sent them a copy of that statement on my intake and advised I wasn't consulted/notified prior to the person doing the work, so - no pay, so sorry. I fought with one billing place for 4 months, but finally won and they left pennyless. You can win, but you have to be firm, and proactive. If you just sign all the forms - you're dead meat for outside of insurance billing. Several stories out there in the news about this.
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:sigh: So sad, but true.:nonod:
 
docmirror said:
Also, you mentioned the insurance aspect. You need to be very proactive that NO ONE touches you, looks at you, discusses anything with you, or is allowed to evaluate anything unless you are notified in advance, and that they are in your plan. There's a lot of shenanigans going on in the med industry now
Click to expand...
True for as long as there have been medical practitioners.

docmirror said:
with uneeded consults, and ancillary doctors assisting and you only find out after the fact that they are not in network when you get a bill.
Click to expand...
The truth is that specialists almost always have a much better understanding of a particular problem so earlier participation by specialists could improve efficiency and cost if the medical system was properly configured. The problem is that the current practice of medicine has increased the cost of specialist participation unnecessarily.
 
Troy, how similar is your situation to mine?

My surgery is scheduled for Tuesday.
Repair a 75% tear in the rotator cuff (supraspinatus)
Shave off a bone spur and decompress the joint whatever that means.

All supposed to be done lapriscopically.

They said they will be leaving a pain med pump that will inject pain meds directly into the joint for a few days.

I have the world's largest arm sling (It is ridiculous)
He said recovery time would be 3-6 weeks and at 3 weeks they would start me on PT

How similar / different was yours?
 
SixPapaCharlie said:
Troy, how similar is your situation to mine?

My surgery is scheduled for Tuesday.
Repair a 75% tear in the rotator cuff (supraspinatus)
Shave off a bone spur and decompress the joint whatever that means.

All supposed to be done lapriscopically.

They said they will be leaving a pain med pump that will inject pain meds directly into the joint for a few days.

I have the world's largest arm sling (It is ridiculous)
He said recovery time would be 3-6 weeks and at 3 weeks they would start me on PT

How similar / different was yours?
Click to expand...

I had that done in April. Still not 100% yet. Good luck with the rest of it.
 
SixPapaCharlie said:
Troy, how similar is your situation to mine?

My surgery is scheduled for Tuesday.
Repair a 75% tear in the rotator cuff (supraspinatus)
Shave off a bone spur and decompress the joint whatever that means.

All supposed to be done lapriscopically.

They said they will be leaving a pain med pump that will inject pain meds directly into the joint for a few days.

I have the world's largest arm sling (It is ridiculous)
He said recovery time would be 3-6 weeks and at 3 weeks they would start me on PT

How similar / different was yours?
Click to expand...

We talked on the phone, y'all.

His doctor is telling him he'll be back to normal in 3 weeks. :yes: :rofl: :rofl: :rofl:

I started PT at 4 weeks, and am still going at 10 weeks. Probably have another 4 weeks or so to go. Just started adding weights to the activities.
 
Yep My optimism is a bit lower.
He said I would be out of the sling in 3 weeks at which point I would start PT and then he said "You are young you should be back to normal in 3-6 weeks"

In hindsight I don't know if he was referring to after I am out of the sling but either way I suspect both would be exaggerations.


On the positive side because of this I am grounded physically and financially so I have enrolled in online Ground school for my IFR.

silver lining
 
SixPapaCharlie said:
On the positive side because of this I am grounded physically and financially so I have enrolled in online Ground school for my IFR.

silver lining
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Cool! I need someone to review with... wanna set up some meet ups to go over what we're both learning?
 
I was flying again after eight weeks. Range of motion is the deciding metric. Be diligent about the PT and you'll be fine. Strength may not be 100% for a year.
 
Operation is tomorrow at 3. No food until then. Man I wish they had a spot open in the morning.

So this seems weird (or maybe not?)
I have to pay for everything in advance.
Is that typical now?

I have already paid the surgeon.
Tomorrow I have to pay for the hospital facility upon arrival

The anesthesiologist will bill me after but everything else if up front.

I always though you got crap done, they billed insurance then did the back and forth and then sent the patient a bill.

They are having me pay everything in advance then they bill insurance and I will get a rebate check or a bill. Is that normal?
 
yup, always have to give the co-pay/deductible up front - everyone is in it for the money, not your health which is something to keep in mind
 
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