Beyond the Zeitgeist

I last weighed in on my new, titanium-and-polyethylene left shoulder on July 2, just 10 days post-op. A lot has changed since then. For anyone interested, following is a rough diary of my post-op progress:

2 Weeks Post-Op

On July 6, I start 3 months of twice-a-week physical therapy (PT) at a facility at the Hospital for Special Surgery, where I had the surgery. It’s an easy bus ride from my apartment, and the physical therapist follows my surgeon’s protocol. Most of the other patients are in my demographic or older, but there are some young people too. Everyone is serious, focusing on their therapist’s directions; there’s little banter. (Sports-related injuries are handled at a different facility, across the street; here it’s all post-op.)

I don’t do my home PT exercises daily, but since I’m allowed not to wear my sling at home (apparently not everyone gets this privilege), I’m using the left arm as much as it can handle (e.g., no heavy lifting, but I can do laundry [goody], make the bed and pick up a plate or mug ). Serious apartment-cleaning is beyond me; a friend has kindly given me a session with her cleaning lady so my apartment doesn’t become totally rancid.

I do wear the sling whenever I go out, to support my arm and, hopefully, warn people to steer clear of my shoulder. Seems to work. It also generates a certain amount of sympathy: I’ve had total strangers stop and say, “I hope you recover soon.”

Also out on the street, the walking stick loaned to me by a friend has been very helpful for balance, which feels “off” because of one arm being in a sling. It’s also helpful to lean on in case of fatigue and in warding off potential sidewalk collisions—or, at least, in making me feel like I can do so if necessary. It’s a great security blanket!

I continue to have a certain amount of pain. I was sent home with a prescription for oxycodone, a powerful pain reliever. I took a lot of it the first day home, less thereafter because it wastes you. I substituted acetaminophen when possible—since I was taking aspirin daily against blood clots, I couldn’t take ibuprofen, my anti-pain drug of choice. On Friday of my 2nd week post-op I ditched the aspirin and started taking ibuprofen. By Sunday, 3 days shy of two weeks, I stopped taking oxycodone. But I’ve kept up my daily drug log, to make sure I don’t take too much ibuprofen, especially in the middle of the night, when one tends to feel pain more than during the day. At two full weeks, I’m pretty much down to twice a day.

I still sleep propped up on several pillows, with my left arm supported on another pillow, which reduces pain at night. Oddly, the upper arm, not the actual shoulder, is the area that tends to become sore. (Later, the surgeon explains that “the shoulder refers pain to the upper arm.” Who knew?) Also interesting: while PT produces a certain amount of soreness, failing to do PT produces more. My theory is tension.

My biggest problem: any activity causes total exhaustion. On Friday, I cancel what was to have been my first evening outing; PT that day has done me in.

On Sunday, July 10,  though, I take the bus to Central Park to meet my birding pals at the hawk bench by the model boating pond (74th street near 5th Avenue, facing east, with a clear view of the nest). One of this year’s 2 Pale Male offspring is still on the nest; the other is perched atop a nearby building. Wearing my sling,  I join some members of the birdwalk group for lunch in the nearby Boathouse Café. A friend carries the tray for me. Afterwards, I take the bus home and collapse!

3 Weeks

Stamina improving, but still have to schedule only one activity per day. On Thursday and Saturday I manage to get to dance events at Lincoln Center, including my first evening outing (Maryinsky Ballet, choreography by Alexei Ratmansky) and the all-afternoon Merce Fair, part of the Merce Cunningham company’s farewell tour. After successfully negotiating these events, I stop using the walking stick.

I stop keeping a daily medication log, and start resuming my supplements (calcium, etc.), all of which had been stopped 10 days pre-surgery. I’m also finally sleeping flat on my back, although still supporting my left arm with a pillow.

4 Weeks

My post-op bruises (one, on my left ribcage and breast, was originally a dark eggplant in color) have dwindled to almost nothing;  the skin of my left forearm is no longer hyper-sensitive to the touch, although a slight sensitivity remains. I’ve recovered enough stamina to feel frustrated by my continuing tendency to tire easily.

5 Weeks

For whatever reason (I think years of yoga, and perhaps a naturally hearty constitution), I’ve been told at PT that I’m way ahead of the curve in range of motion and strength in my left shoulder and arm. When I see the surgeon on Friday, July 29, he tells me I’m where they generally expect people to be at three months, and that by the time I’ve completed the PT course, I’ll be at the normal six-month level. And, I’ve been sprung from the sling!

On Sunday, I join my birdwalk group for my first real post-op birdwalk.

6 Weeks

Six weeks seems to be a magic number: I feel a big boost in stamina and strength. I begin walking to or from PT,  about a mile. I start opening doors, even heavy ones, with my left hand. I feel less fragile and wary on the street, less worried that someone might slam into my shoulder.

8 Weeks

By August 17 I finally feel basically normal in terms of stamina: running around the city, exercising more normally and being able to make plans with confidence that I won’t have to cancel due to exhaustion! I can easily walk both to and from PT.

For general-purpose use, my left arm is now quite functional. Marlene, my physical therapist, says that from here on progress will be much slower. By 6 weeks, in terms of raising my left arm (while I’m horizontal) and trying to move it back to touch the floor or bench—180 degrees—I’d reached 150 degrees. So far, I haven’t progressed any farther.  Peter, my substitute therapist while Marlene is on vacation, tells me that he thinks the shoulder—as opposed to the hip or the knee—takes the longest to get to be so normal you don’t have to think about it: up to a year.

In some ways, my arm and shoulder feel right now about where they were before the operation: unpredictable pain if I move my arm the wrong way, or too far too fast, and incomplete range of motion. On the other hand, I’ve resumed a modified home yoga practice. The good news is that, while pre-op I wasn’t raising my left arm at all, now I’m raising it as much as possible. Holding it horizontal for standing poses is a lot of effort, but it feels like progress. It will be a long time before I attempt downward dog or headstand; alas, all the professionals tell me that shoulder stand will not be in the cards.

Tags: Orthopedic Surgery, orthopedic surgery recovery, post-shoulder replacement, post-shoulder replacement physcial therapy, post-shoulder-replacement pain, Shoulder Replacement, Total Shoulder Replacement

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