Help for Shoulders - Torn rotator Cuff

[5aday]

Do any of you know about any preferential treatment for Torn Rotator Cuff ?
The N.H.S. in this area (Buckinghamshire) seem overwhelmed and telling them you are ex military (ie Veteran) means nothing.
5aday

[flyingorthopod]

See if you can get in with Frimley Park, there are two helpful military shoulder surgeons the within the bounds defined by the NHS!

[NRU74]

For info this is my Rotator Cuff experience -I saw the GP on 17/1/17, I then had four separate appointments at the hospital for ultra sound/x-ray; scope nurse; pre op assessment; Consultant (on 27/4/17) and am scheduled for the surgery 8/6 - that's S Yorks. I didn't think the time scale was too bad. What did surprise me was that at the latter three appointments there was a 'Support Worker' present at each interview who did buggah all but sit there. Nor did she introduce herself nor say why she was there-until I asked.

[Herod]

5aday. Check PMs

[5aday]

How do I get to PMs?
My email is [email protected]

[Chugalug2]

Nor did she introduce herself nor say why she was there-until I asked.

Well I'll bite. Why was she there?

[Chef Bruz]

has a supraspinatus done a year ago, wouldn't wish it on my worst enemy...

almost a year later it's only as good as it was after the incident that tore it (as well as the bicep and deltoid) after HRT which was unassociated.

If I did it again I'd try HRT prior to surgery.

do anything to avoid surgery is my tip.

[SPIT]

Hi 5 a day
To get your PMs is simple.
On the top right hand of the page it say,s Welcome ******, underneath is Personal Messages (PMs), just click on that.:ok::ok:

[Herod]

5aday. I've emailed you a copy of what I posted on the pm.

[Herod]

Chef Bruz. It depends on the surgeon . In my case both the supraspinatus and the infraspinatus were completely ruptured, detached from the bone, and the tendons had retracted. The op and the recovery were as close to painless as you could wish. Certainly nothing that the odd paracetamol couldn't handle. The worst pain is now, some two months after surgery, which I assume is the muscles and nerves sorting themselves out. Again, standard painkillers once or twice a day are sufficient. I agree with the motion though. It is little better than before the op, but I'm told by both the surgeon and the physio that it will come back totally over a matter of months. I'm waiting for the revelation.

[Dougie M]

When I did mine in I was still on flying status with the RAuxAF. I sought medical advice and was told that surgery would take me out of fitness for the best part of a year. Without surgery and receiving treatment it would be restored in eighteen months. With no treatment it would recover by itself in a year and a half. I elected for the leave it be principle and all was serviceable in a year and a half as predicted. It was never as robust as before but as I was never a left handed overarm bowler nobody noticed. I just wish I could fix the arthritic knee I have that was caused by coming off an inflated banana at warp speed.

[Herod]

It depends on the extent of the damage. A torn tendon has a good chance of healing. If only a minor tear, it should recover of its own accord. In my case, they weren't torn. They had both separated totally from the bone. There was no chance that they would recover. It was necessary to insert hooks into the bone, pull the tendons outwards and attach them to the hooks, then stitch them down. The final link was made by scar tissue. I'm told that mechanically, all is as it should be (joint, bones, tendons, muscles etc), but it will take time (talking months here) for it all to function as it should.

So for 5aday, a lot depends on how badly damaged the tendon is, and the specialist's opinion as to the likely recovery.

[NRU74]

Well I'll bite. Why was she there?

She was there to see if I required any 'support' in regard to access to/fro hospital, post op support re washing, dressing, changing dressings etc,getting to physio etc. Any such info could have been established in the first 90 seconds or so, I didn't want to appear discourteous and tell her go away, and so she just sat there. Seemed a bit of a waste of manpower and there was a support worker for each room and there were three rooms being used simultaneously.

[Wander00]

Didn't do "counselling" for you as a "victim" too did she

[NRU74]

Didn't do "counselling" for you as a "victim" too did she

My view was, I suppose, that since many Government and quasi Government Agencies are so keen on Data Protection, that she ought to have introduced herself/been introduced, straightaway. It didn't bother me too much but I may have felt differently had it been the STD Clinic. Also it seemed to me to be a waste of resources in an allegedly cash strapped organisation, not to send me post each consultation to join a queue to see a 'Support Worker' if I needed one.
In regard to the OP, it never, ever, crossed my mind to point out at any stage that I'd served a grateful nation as a 'veteran'

[Herod]

Seems like a waste of resources, certainly. My op was done privately, via insurance. Consultation with surgeon one-to-one, MRI, second consultation, again one-to-one, op. I saw him next day and then three weeks later to have the stitches removed. No "support worker", none needed.

Has anyone else had experience of the new anaesthetic? I remember the old ones, with the countdown from ten, and waking up feeling dizzy and nauseous. This time, the anaesthetist came an hour or so before, gave me the usual calming pill and inserted a catheter. I can remember going into pre-op. I didn't see either the surgeon or the anesthetist, and woke up in post-op clear as a bell!! Marvellous

[Chef Bruz]

Herod, mine was a full thickness tear, but still attached. The anaesthetic experience was similar, however the post op pain had me sitting on a lounge suite for three days, consuming two weeks supply of synthetic opiate pain killers. I wasn't told (didn't realise) the paracetamol / ibuprofen combination killed pain as well as synthetic opiates.
When I returned to the outpatient clinic for a new prescription, the nurse said to me "everyone knows you combine synthetic opiates with paracetamol and ibuprofen."

[flyingorthopod]

Trouble with rotator cuff injuries is that some do well without surgery and some do not. Those that do badly without surgery do worse with a delay as muscles waste and tendons retract.

Identifying who is in which group is difficult without crystal ball.

[5aday]

For Herod. I have three (of the main four)completely detached tendons and should know better tomorrow what they can do locally. The hospital (in Vilnius ?)say it is no problem but costs a bit more than a simple through the key hole job.

[Herod]

5aday, I've just dug out the bills for my op.
The surgeon himself £ 750
Anaesthetist £ 475
MRI £ 574
Hospital (overnight stay) £ 2363 That of course included the use of theatre, drugs etc.

Total £ 4162

Plus a couple of consultations, several physio visits, say anothe £ 500

Good luck.

[unclenelli]

5aday. Check PMs

[flyingorthopod]

If you are thinking of going overseas for surgery, be cautious. You may get an excellent surgeon in a super hospital but there us no guarantee of competence or honesty and I've seen some horrific disasters in people who've gone to Eastern Europe for private surgery and have had things done that just wouldn't happen in the UK.

[Chugalug2]

NRU74, thanks for the "Support Worker" explanation. As you say, an apparent waste of whatever resource "Support Workers" constitute. A reflection on the quality of NHS management, an unfair non-typical one off experience, or the tip of a monstrous iceberg?

OTOH, Mrs C has recently attended a couple of out-patient appointments in a nearby town for consultations concerning an eye condition. Very little sitting around, a series of tests conducted by nurses, and finally a reassuring talk with consultant. Can't think of anything to complain of other than about the damn hospital parking ticket issuing machine which would have challenged Turing, I think.

OP, nothing helpful to advise I'm afraid, as mercifully I've been spared this injury to date, other than to add my very good wishes to those of others.

[5aday]

FLYINGORTHOPOD,
I have an appt at the local NHS High Wycombe this afternoon and another possibility is the Reading SHoulder Unit and the NHS pay for it. More revealed this afternoon.Thank you for every bit of advice.
Dave/5aday

[Herod]

5aday. Good luck with it. I've generally been happy with the NHS, apart from the mental health side, but that's another story. Part of my reason for going private was the delay. I actually had the op more or less on the same day that the NHS offered for my first appointment with a surgeon. I was concerned with the muscles atrophying from lack of use. It was three and a half months from the injury to the operation, and four months before the stitches were out and I could start rehabilitation. On the NHS that would probably have been at least a month more, possibly two.

[Molemot]

I dislocated my right shoulder in 2000. This did for the rotator cuff..and ripped the axilliary nerve, too. I fought furiously to get surgery to repair the rotator cuff, and was finally successful, Coming to in the recovery room I heard the surgeon say "In the end we didn't proceed with the repair...." which really cheered me up. I was later told "It isn't a vastly successful operation, anyway"... The nerve took months to regrow. Physiotherapy was of limited effectiveness...couldn't get the arm above shoulder height. So I got a pulley and some rope and weights...and that counterbalanced the weight of the arm, so that I could raise it above my head. Bit by bit I reduced the counterbalance until I could raise the arm unaided. I still have problems trying to do such things as reaching up with a hammer and bashing things.... but the arm is quite usable now.
Then in 2014 I dislocated the left shoulder....(!)

[OKOC]

I am having mine done (via Bupa TG) with Dr Simon Gregg Smith at the Circle Bath Hospital --he is one of the best in the shoulder business (I am reliably informed). Good Luck!

[Rossian]

.....In 1973 I fell at my childrens' first school sports breaking my collar bone and dislocating my right shoulder. My GP (a Dr Finlay type) got my wife to put her weight on my left shoulder and there were some weird clicks and clunks as he heaved the joint around while my wife fainted and I followed suit.
It more or less worked but with regular clicks.
Twenty years later in Langkawi I was getting the full monty all body massage from this wiry little bloke who could have undone Scammel wheelnuts with his finger and thumb. He patted my right shoulder and wanted to know what had happened (no common language lots of gestures). "Ah no go back right" and looked at me questioningly. "OK go for it" says I. More delicate heaving and twisting and a soggy clunk and it went into place. Where it stayed for another twenty years without any clicking.
Add on another twenty years and I'm in Chiang Mai now getting the full monty Wat Po massage (an hour and a half of serious work). This time it's a roly poly Thai Aunty ( she could do Scammel wheelnuts too) and again she focusses on my right shoulder and manipulates it back into place again. Where it resides silently to this day.

I'm sure there is something to be said for a more "hands on" approach to skeleto-muscular complaints than we see in Western type medicine.

The Ancient Mariner

[5aday]

Well, its going to be an artificial joint - similar to one on my r hip but the other way around
ie the ball is in the shoulder and the socket on the upper arm (Humerous?). My current shoulder joint is cat 5 (beyond repair).Sooner or later I will have enough steel internally I won't need a weight belt for diving.

[Herod]

Sounds very serious. If you don't mind my asking, what did you do? Mine was running in a group, at night, no head torch. Just street lights and car headlights. I caught my foot in one of the metal guy wires that hold up telegraph poles. No give in those of course. so crash. Stupid really; I shouldn't have been there. You know what they say self-inflicted injury = no sympathy.

[5aday]

All a bit stupid really as I was assisting the gardener. I passed a folded garden chair (under a tarpaulin ) to collect some logs. The chair somehow unfolded and on the way back I went headlong over it and landed with the logs on my chest breaking two ribs, the sternum, and both rotator cuffs - the left being extreme. With this artificial shoulder, I should be allowed to ride the Ducati again later in the year and maybe go diving again though I may need a squeak of air in the fenzy.

[Herod]

Ouch, ouch, ouch. Makes mine sound very minor. Again, good luck.

[flyingorthopod]

Good luck. It's a great operation if your shoulder isn't likely to do well with a cuff repair. Hope it goes well

[5aday]

I'll let you know. I don't think I will have sufficient strength to lift the bike if it ends up on it's side. Similarly the shoulder will need to heal quite a bit to wear an ABLJ (fenzy type life jacket harness) but those are my ambitions for 2018. The lady Doctor seems to think it may happen quite soon which I hope because I am giving my youngest daughter away on August 12th.Its either that or delay until afterwards. Suggested healing time? We did not discuss that so any guesses gratefully received. The R hip was quite quick. That surgeon suspected that the hip was a motor bike accident from a few years previous.How do they know these things ?

[flyingorthopod]

Takes a fair while to get back to reasonable levels of activity. Some good info here along with one rehab regime, though others are available:

https://www.shoulderdoc.co.uk/article/631