Life: 6-Weeks Post Rotator Cuff Surgery – SLAP / Labrum Repair

Washington DC April 2023

September 7th, 2021:

I was not in the top 15. I may be able to request my placement after the West Coast Qualifier takes place in 3 weeks I did injure myself with a possible torn rotator cuff. 

October, 2021:

Post GS-Trophy remarks are unchanged. However the lingering pain I feel still in my shoulder is hard to shake. As with American Medical Care, my doctor’s exam was inconclusive so I pushed for some imaging and they sent me in for an X-Ray saying an MRI would be seen as my insurance company as irresponsible and ‘over-testing’ so I did so and paid $500 in total for the exam & X-ray which came back all fine. The post-visit notes from my doctor said that if I still have pain in 6-8 weeks, they’ll authorize an MRI. I just put in that request because I am still having shoulder pains. I look forward to another $500 bill for that and paying 100% of the physical therapy costs to hopefully mend my rotator cuff this Winter. 

December 2021:

I haven’t recovered yet and I’d say the pain is worse than ever. I did finally get an MRI and it came back that I do have a small tear laterally behind my shoulder joint it’s tiny and surrounded by scar tissue and inflation. The doctor said that tear could have been there for years and I finally fell in a way that fully damaged it. He said I’ll likely be 90% healed by September 2022 (1 year post accident) and 100% over time. He recommended Physical Therapy for as long as I can afford it and, if no improvement by March, 2-cortisone shots to allow for inflammation to reduce so we can actually build up and fire up that muscle again. My PT consult went well the day before Christmas. Their advice mirrored the doctor’s. I have full range of motion, only certain movements hurt and they’re not typical movements (like being put in handcuffs is very painful….well I assume so given how much that angle behind my back hurts) and they said let’s do two sessions a week with one @ home session on my own and see where we are after 6 weeks. I start tomorrow on the 30th and I’m hoping to be able to ride in April. The doctor and physical therapist advised that 2022’s riding season is taken easy meaning no off road competitions, nothing that would cause me to fall on that shoulder or tweak it in a bad angle. If I can go on a long road trip, that would be best.For interested Americans, this shoulder situation so far has cost $6348 in medical bills, $1800 of which I was responsible for since I’m on an HSA plan with a high deductible. The breakdown is as follows:9/16 – X-Ray- $4789/16 – Consultation – $1139/16 – X-Ray Review – $26011/10 – Consultation – $15011/19 – MRI – $387711/19 – MRI Review – $107212/9 – MD Consultation – $398All of this for someone to say “you don’t need surgery, go to physical therapy. It could be worse, I could be completely uninsured and have had to pay for all of that out of pocket. I don’t have remorse because surgery would have cost significantly more as my out of pocket max is around $3,000 if I remember correctly.If physical therapy can get me riding again, I’ll be extremely happy. I can ride injured but it’s not fun and I do it half-assed and after a day in the saddle, I want to take a break for a few days. Not good for long distance riding off-road. 

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I spent January until April of 2022 with a physical therapist. A Cortisone shot in April to get me through the Summer did free up my pain and suffering so I could go on a few trips. The remainder of 2022 was to be spent in recovery after a shoulder surgery. I planned on scheduling surgery for October so I could repair it throughout the Winter while bikes were in storage. Instead September was a job offer to move down to Charlotte in November. My riding season continued and I started a new job. The shoulder pain did not subside. The move was very hard on my shoulder and there were good days and bad. 

In December, I met with a surgeon to discuss my issue and gave him the backstory you read above. They scheduled an MRI for January and a few weeks later, I met with them again to discuss options. My tear, a Shoulder Labrum Tear of about 3MM. That’s why the first couple of doctors didn’t want to perform surgery. 5-7MM is considered a partial tear with 13MM being a full tear. I was at 3MM and despite not being able to sleep on my side or pick up heavy items or ride well off-road, I wasn’t a good candidate for surgery. This surgeon told me the same story but, possibly seeing my emotions, offered surgery with the caveat that “you’re 36, you’re in pain and it’s not going to go away and you have a very good chance of 100% recovery if you follow recovery and partake in physical therapy for 6 months. I told him I had excellent health insurance, better than I had at the last job. The MRI was $50, the surgery was going to cost $50 out of pocket and the physical therapy had no limit on sessions with a $20 co-pay and work would allow me to stay home 6 weeks for recovery. 

He took on the job and we scheduled the surgery for April 5th, a Wednesday morning.

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In anticipation of the surgery, we purchased a $500 recliner which was essential to the recovery. I wasn’t able to sit in a chair for longer periods or sleep in a bed. I’d have to eat, sleep, rest and relax in a recliner. We also bought a used ice-machine from eBay that made about 2 pounds of ice an hour and a polar cave apparatus that wrapped with Velcro around my shoulder and pumped ice cold water over my arm in 20 minute bursts (to keep my skin from freezing). Finally, we setup the living room with a few tables on my left side for charges, a desk lamp, supplies and made it where my right arm could be immobilized for a few weeks without issues.

April 5th was like any other day except I had taken the rest of the week off work due to guidance that I would probably need a lot of rest. 

I arrive at the surgery center, the anesthesia doctor puts a nerve blocker in to make my recovery day easier. They take a lot of measurements and an hour later, I was knocked out on my way to the operating room. In the operating room, I moved over to the table and I was sat up with some sort of hoist that kept me upright even after I was knocked out. I went to sleep and woke up 2 hours later. The surgery last 90 minutes and I had six 1-inch holes in my shoulder, 3 on the front and 3 on the back. I also woke up in the sling I’d live in for 6 weeks and in a wheelchair on my way to see my wife. 

In total, the surgery was billed out for around $23,000 with 8K of that being anesthesia. The MRI was $4700, the 4 visits pre and post-op are billed at $375 per visit and there are some other fees like prescriptions and consultations. I don’t know what the physical therapist is charging but I assume about $100 an hour and I’m seeing them 3 times a week starting at 2 weeks post operation and continuing on for about 4 months or 16 weeks so 14 weeks, 3 times a week for 42 visits or $4200 in physical therapy. All in all, the surgery will cost me about $1000 and that’s with physical therapy co-pays. My gallbladder removal was about $30,000 for reference. 

I was prescribed Naproxen for inflammation and was to take that for 2 weeks. OxyContin for pain which despite having a week supply, I took it for 2.5 days after the pain blocker wore off before I disposed of the rest of it. There were 3 other prescriptions for nausea, constipation and sleep but I never took them. I took Tylenol for 3 days after the OxyContin but didn’t need any pain pills after that. 

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The first 24 hours was mostly sleep. I was in a sling and could feel nothing. Then I started to feel my fingers which was the sign to start taking pain medication. By the time the medication kicked in, I could feel pain starting then it was gone. I drank a lot of water, ate simple meals and didn’t leave the house from Wednesday to Sunday. For these first 5 days, I slept in the recliner but mostly upright and kept the ice machine water on my shoulder almost full time with my wife constantly replenishing drinking water and ice cubes. I needed help getting out of the recliner and had to confront the reality I could only use one hand. 

Monday came and just in time as I had finally slept all 8 hours on Sunday night and woke up ready to get some work done. Folks at work were super accommodating that I was working at 50% capacity. I used voice to text built into my Mac to communicate and I attended all of my meetings and got to everything needed but at a slower pace.

The entire first full week back at work was still tough. I was slow, tired, sore and grew frustrated with myself that I could not do more. I started to take morning walks with the sling on at first 1 mile on the 7th day post operation then by the 10th day I did a 2 mile walk and I kept that going eventually getting to 5 miles after 4 weeks of surgery.

It was the 3rd week after surgery that the sling became less essential. I can’t tell you when this moment will happen but for me I found that I could put a pillow under my right arm in the recliner and remove the sling and that would allow for normal typing. Not all day, more like 2-3 hours then I’d go back in the sling. Same for eating and basic tasks around the house. I could go without a sling to go out and check the mail keeping my arm close to my body and it was totally fine. My body told me exactly how much was too much by aching or being uncomfortable. I never felt any sharp sudden pain, just unrest similar to how I had felt before surgery in that same spot. 

I kept my stamina up by helping Heather with groceries with my good arm, moving things around the house, cleaning and doing dishes or laundry all with one hand. This kept my spirits up and generally just made me feel productive. 

At week 4, I wasn’t wearing my sling around the house during the day but still not using my arm for anything. Just letting it rest and of course typing and using a computer normally. I went to the office one day on week 4 in a sling but the running around the office was too much. I asked for 2 more weeks before I had to return despite feeling better, I wasn’t ready for office life yet. 

Physical therapy started at the 2 week mark with a lot of stretching. Week 3 saw the addition of stretches against a wall and isolated resistance training against a door frame or with a rubber band. I wasn’t moving my arm, just activating muscles against the resistance created by my hips against an immovable object. Week 5 began more movement like forearm curls, stretches out and in front of me and now activating some shoulder muscles to achieve these motions. Week 6 where I am now includes arm raises out and side with 1 pound weights along with stationary pushups (not up and down) along with moving my arm against rubber bands out, in and up. We’re in that re-building phase now. 

The true test comes at end of week 6 (tomorrow) where I meet my surgeon to prove I can hold my arms at 10 and 2 on a fake steering wheel. That milestone (which I did for 1 minute today in physical therapy) is the one where he approves me permanently forgoing my sling which I’ve been wearing now any time I leave the house but less-so around the house except like Saturday where we had a pretty big 5 mile hike where I came home a little achy and decided to continue wearing my sling the rest of the evening. 

Not having to wear the sling does not mean I’m healed. I have 3 more months of physical therapy until I’m healed enough to pitch a baseball as hard as I can (if I was right handed) but I am healed enough to go out into the world, function normally in a white-collar setting and build up my muscles with daily normal use like putting away dishes, cutting onions and vacuuming. Simple stuff and my risk of re-tearing is much lower. Re-tearing will never be 0%. In fact, I will be at risk of tearing it for the first 12 months. 13% of patients will re-tear the tendon again at some point. The doctor confirmed after my surgery I will be 100% recovered but that recovery is slow. Today, my tendon has fully re-attached to my shoulder bone but just barely. Continuing physical therapy and avoiding high-impact stress and activities are the key to a normal recovery where I don’t think about it anymore. 

What I will say for you to please do differently is stay in the sling almost 24/7 for those 4 weeks. This will ensure your tendon properly attaches to the bone. After those 4 weeks, follow physical therapy regiments with daily exercises religiously for those 4 months. It’s very lonely to be locked in the house, confined to a recliner for 4 weeks. It’s lonelier to be out of work for 6 weeks if you have to but in 12 months, having full use of your arm again is going to be amazing. The Labral tendon holds the ball of your arm to your shoulder. Its importance is huge so do all you can to allow it time to heal. I’m probably more like 80% of where I should be at week 6 and that’s on me. It’s really hard to just do nothing especially with work and family and friends all waiting on you to get better. 

I met a guy who tore his rotator cuff, spent 6 months recovering then tore it again the same way. “I lost a year sitting in a year waiting to recover” That made me feel like my 4-6 weeks weren’t that bad and it makes me extra cautious to ensure I’m fully healed before returning to running or motorcycling. Impact activities will re-tear me at this point. Every time I want to chase the dog, I have to remember my tear is still there for the first 12 months and keep that in mind. 

I do plan on making a second post in a month or two for how things are going. Thanks for reading.

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