My Experience with Rheumatoid Arthritis and a Reverse Total Shoulder Replacement

I recently had a shoulder replacement and I want to share my experience with you. My experience was with Optim Orthopedics in Savannah Georgia and Dr. Amir Shahien. And therapy with McMahan Neurological Rehabilitation.

What is a Reverse Total Shoulder Replacement

In a reverse total replacement, the ball (humeral head) is replaced with an implant. This includes a short stem with a curved plastic tray. The socket (glenoid) is replaced with a rounded metal head. Reverse total shoulder replacement reverses the natural ball and socket anatomy. This allows the stronger deltoid muscle to take over for strength and function.

Reverse Total shoulder replacement may be recommended for patients with any of the following issues:

• Completely torn or irreparable rotator cuff tendons
• Cuff tear arthropathy (a large tear)
• Severe shoulder fracture
• Shoulder dislocation and a large rotator cuff tear

* more at www.liftmyarm.com

Pre-surgery Preparations

CT scan

This is another type of imaging. I haven’t researched the difference between this and an MRI. But it is noninvasive. You are not in a tube like the MRI and it only takes a few moments to do it. The surgeon will use this during the surgery.

Pre-op Appointment at the surgery center.

• My surgery took place at the hospital because of my other health issues. This could take place at the Ortho surgery center.
• This is when you can ask questions. If you haven’t had an EKG, they will do one.
• stop all supplements one week before surgery.
• They will tell you which RX to stop taking and when.

Have the following over-the-counter meds on hand before the surgery.

• Tylenol
• Stool Softener
• Miralax
• Reusable Hot and Cold Ice Packs – you need 2 or 3 cold packs so that you can swap them out. It takes about 2 hours to cool a pack.
• If you plan to receive an ear patch to control nausea from anesthetics, have Benadryl cream on hand. I had quite a rash behind my ear.
• Vitamin E oil. I purchased Bio-Oil on Amazon. However, You can purchase capsules. Prick the capsule and squeeze the oil out. Rub the oil into the skin across your scar, especially at places where there is pain or a lump of skin. Therapists or doctors will tell you when to begin doing this.

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The Night Before Shoulder Replacement Surgery

• Bathe the night before
• Use CHG wipes per instructions given at pre-op
• no alcohol 24 hours before surgery
• do not shave hair from the surgical site

The Day Before Surgery

Morning of Surgery

• wear no jewelry or hair accessories
• do not apply any lotions, fragrances, deodorant, etc
• wear comfortable, loose clothes
• Bring a driver

About the surgery

• The surgery will take 1-3 hours.
• You will leave the surgery center in a sling which remains on for 2 weeks, except for showers. Your arm and hand will be completely numb on the first day.
• You will be given RX for pain. Go ahead and fill it. And start taking it that night before bed. You DON’T want your pain to get out of control.
• I had 14 staples and it was covered with a waterproof bandage. It was not removed until my 2-week post-op appointment.

After Surgery

• Be aware that this pain med is addictive so pay attention to how long you stay on it. I took it as prescribed the next day, then started reducing it to where I didn’t need anything but Tylenol.

Two Week Post Op

I met back with the doctor in two weeks. Staples were removed. At first, I didn’t want to look but after the first two and finding that it didn’t hurt, I watched him remove the rest. He cleaned up the wound and replaced the staples with sterile-strips. He said they would fall off on their own. Let water run over them when showering.

Therapy

Therapy began the next day. I was fortunate to find a traveling therapist who came to my home. This is so much nicer than having to get up and go to the therapy center. I purchased the following equipment to use on the days she did not come to the house.

• RangeMaster Econo Ranger Shoulder Pulley
• Resistance Bands – I was not required to purchase these. The therapist will probably give you one. I learned that the colors don’t necessarily have standard resistances.
• Dumbbells – I was not required to purchase these. You can use water bottles or soup cans. I decided that I would use them beyond therapy.
• 4-inch Therapy ball – These are great for releasing muscle pain. A tennis ball works just as well though.

How long will therapy last?

Plan on three months of therapy visiting the therapist twice a week. Remember there more you stay committed to your exercises, the more range of motion you will get. If you never do any work on your own, don’t expect much improvement.

NOTE About my myofascial pain

I have suffered the most with myofascial pain in my biceps over the past twelve years. My upper arms are so tender that I cannot allow someone to touch me. I can’t have my blood pressure or blood drawn from my left arm. However, now that I am about through with my therapy, I am finding that this myofascial pain is much relieved. I attribute this to the massage that my therapist and I have been doing. I may try having my blood pressure taken on my left side again soon.

My suggestion for anyone with myofascial pain is you may want to try some deep body massage.

Reminder:  I am a patient, not a doctor. What I am sharing comes largely from what my doctors taught me and what I have discovered in my own searching.

I am sharing to hopefully help you be informed enough to support friends with this syndrome or possibly acquire informed questions for your doctor. Please talk with your doctor or visit the Mayo Clinic website for official information, diagnosis, and treatment.

Mandy