What it really like to have anterior shoulder stabilisation surgery: Post-operative care and recovery to date

I said in my previous post on my recent shoulder surgery that I will write a final piece in the area concerning my immediate post-operative and continued recovery to date.  Well here it is.  We left the story line as I had woken up from the anaetshetic in the recovery room.  I had just been taken back to the ward after feeling like I had slept for a lifetime.  I had some post-operative pain for which I had been given some medication and a further nerve block to my shoulder.  The pain had been relieved sufficiently and I had awoken to my craving for a cup of coffee.  I was thirsty, very thirsty as it had been over twelve hours since I had drank anything last.  The ward nurse came into the recovery room to take a handover from the recovery nurse, apparently the is important as it ensures that all important information from the surgery and anaesthetic teams are passed over to he ward so they could look after me properly.  I was given a drink of water as soon as this had finished as I was so thirsty (they did not have tea and coffee in the recovery room, how unfortunate).  I remember the water being so cold, almost chilling to my brain as I had been under warm blankets for such a long time.  I really was a shock to the system, and further caused me to wake up suddenly.

My wound dressing with the bruising starting to appear. (Taken five hours post-op).
My wound dressing with the bruising starting to appear. (Taken five hours post-op).

Once I had arrived back on the ward, I had my vital signs measured and was left to recover further.  It is difficult to know what happened after this point, I think I fell asleep.  I was so sleepy from all the medication I was surprised  that I had lasted so long. Once I had woken up it was nearly mealtime, around four o’clock in the afternoon. I looked at my shoulder, I was suprised how small the surgeon had made the incision.  The outcome was much better at first sight than what I had expected.  My thoughts turned to food, I had a beef casserole for my dinner, and after having nothing to eat for such a long time, it felt good to have something in my system at last.  This made me feel a lot brighter as well as improving my mood, which for some reason afterwards, had taken a downward trend.  I slept well that night, which was strange as I do not normally sleep well in those places.

I woke up the next morning to the surgeon telling me that the operation had been a complete success, and to a blazing pain in my arm in which the consultant told me was something to do with the nerve block completely wearing off. Goodness me it hurt, it was sort of a dull ache which would remain constant at all costs.  Even the painkiller (Oxynorm) could not make much of a difference to it.  I was anxious to leave as soon as possible.  The consultant agreed that I could go and I was discharged.

 

The wound has now healed quite well after surgery.
The wound has now healed quite well after surgery.

My medium term recovery began, and I received an appointment to see my physiotherapist.  The pain remained about the same for the first week or so after surgery.  I went to the hospital at this time to see the consultant.  I was there for most of the morning as I had to have an x-ray on my arrival at the clinic.  I was then called through for my dressings to be removed and to have the wound checked.  I was reassured that everything was fine and healing as expected.  I was then called through to speak with the consultant, who too was pleased with my progress.  He has arranged to see me again in six weeks.  I am currently undergoing extensive physiotherapy to help my rehabilitation and I look forward to having full use of my arm soon.

My initial trepidation at having such a major operation on my shoulder was quickly replaced afterwards by a feeling of relief.  In retrospect, I am glad of having the surgery as it has insured my shoulder for the forseeable future against further dislocations (which would have been regular due to my epilepsy).  I am glad to report that since having the surgery, my shoulder has not dislocated once.  I have been told that my recovery will continue for up to another four months and I will keep everyone posted on how it goes.

I am planning a number of posts in the coming weeks, including the year in review 2014, in which I will pull together the main events that have shaped our past year.  Once again, please keep your comments coming and feel free to share your view.  If you have an idea for a post, please let me know.

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What it really like to have anterior shoulder stabilisation surgery: Post-operative care and recovery to date

What it really like to have anterior shoulder stabilisation surgery: The anaesthetic and operation

Good afternoon guys, I have some good news regarding my shoulder as I have just come back from my surgeon’s clinic; from which I have now been discharged! I have been told that I must carry on with my physiotherapy (next seeing her on Thursday 8th December) and I will post the next post on the medium and long term recovery in due course.

PAUL HARROP/CREATIVE COMMONS
Castle Hill Hospital in Cottingham, UK (PAUL HARROP/CREATIVE COMMONS) Image Source

Anyhow, back to the post in hand. This post follows on from the last post on my recent shoulder surgery. This post will explore the proceedings on the day of the operation as well as afterwards.  In arrived at Castle Hill Hospital in Cottingham  at around half past seven in the morning on the day of my operation.  I got out of the taxi and walked over to a hedgerow at the front of the site and smoked a couple of cigarettes (it had gone out of my mind completely that you should not smoke before a general anaesthetic).  After I had smoked, and gained the confidence to, I walked over to the main entrance and entered the building.

The building is a large complex of wards and corridors spread out in a T shape. I walked down two long corridors following the signs for the Surgical Admission Lounge.  Once there, I went into the department and spoke to the nurse at the reception desk. I was asked my name, address and date of birth and shown to a large room full of comfortable chairs and a large television. It was there I waited (around 5-10 minutes or so) until someone called my name.

I looked behind me and I see a nurse standing there with a brown file in her hands , once again, she repeated my name and asked me to accompany her.  I followed her down log corridor and into a much smaller and more clinical looking room.  She asked me to take a seat and she filled out what she termed a ‘care plan’.  We discussed my general health, my medications, allergies, even my sleeping habits.  She made contemporaneous notes in the booklet.  Once again, she took my height and weight, and recorded them on the anaesthetic chart.  At this point, I was given a patient’s gown and flight stockings to wear.  She handed them to me and asked me again to follow her.  We arrived at what looked like a consultation room, I put my gown and stockings down on a chair beside me and I was once again left to wait.

I was waiting approximately five minutes when a man entered the room.  He stood about six foot tall with grey hair and spectacles, he introduced himself as the consultant anaesthetist, who would be anesthetising me for the operation.  After working in the NHS (National Health Service) as a student Operating Department Practitioner for two years, I knew this man very well.  I held a lot of confidence in him and felt safe in his care.  This particular anaesthetist is a specialist in bone surgery and boasts thirty years of practice experience.  Still, despite this confidence, and considering previous bad experience that I have had when having anaesthesia, I was still terrified.  He sat down and questioned me in detail, about my health, medication and allergy.  He made sure that I had a hospital identification bracelet fitted and  that I had fasted appropriately (I had not had anything to eat or drink since eleven o’clock the previous night).  By this point I was getting very frightened indeed.  He asked me to change into my gown and stockings and he left the room.

A large black box was left open for me on the floor into which I was asked to place my clothes and all my possessions.  I changed into the gown and stockings.  This now felt very real, I remember thinking back to my last general anaesthetic (which had been a disaster) and my feelings of nervousness rocketed.  I could feel the air on my back as I sat waiting in what felt like a wafer thin gown (although the hospital was very warm, I still felt exposed).  There was a knock on the door, I was ready so I said he was fine to come in.  Another man, in his fifties, entered the room dressed in blue theatre attire, he identified himself as a theatre assistant. He asked me a number of identity questions and checked my details against my medical notes and my bracelet.  He confirmed my allergies and that the correct procedure was listed on the consent form.  I remember I was physically shaking by this point. It was at this point last time where things really started going downhill.

This is similar to the one I used before my shoulder surgery.
This is similar to the one I used before my shoulder surgery.

Photo: ArjoHuntleigh 

Once this checklist of questions was completed, I was asked to accompany the theatre assistant.  We walked for what felt like an eternity down an extremely long corridor, until we entered the theatre department.  Once here, I was asked to go behind a curtain, and climb up on a theatre trolley.  I was surprised at how comfortable the mattress on the trolley was (much more comfortable than they look [see above]); the staff covered me over with warmed blankets and gave me pillows.  This was in contrast to my previous experience, in which I was absolutely terrified and left without all of the above.  The time was drawing closer, my identity was checked again and I was taken into theatre.

Cannulae inserted into my hand before the anaesthetic
Cannulae inserted into my hand before the anaesthetic.

A number of things happened all at once, as soon as I had arrived in the anaesthetic room. I was asked to hold out my arm whilst the anaesthetist inserted cannulae into my hand to give me drugs.  For someone who is afraid of needles, I believe I did quite well (see above).  Whilst he was doing this, his assistant attached monitoring to my chest, to monitor my heart, to my finger to monitor my oxygen levels, and to my opposite arm to monitor my blood pressure.  Once this was done, things calmed down a bit, and things took a slower turn.  As the anaesthetist explained to me, the anaesthetic room is like a church, everyone must be quiet, and the only person allowed to fall asleep is the patient.

A patient is pre-oxygenated for a general anaesthetic.
A patient is pre-oxygenated for a general anaesthetic. (Wikipedia)

Now it was time for the part that I hate.  The part that made me panic last time round.  I felt like I was suffocating.  I am well renowned for not reacting well at all to anaesthesia, and I had informed the anaesthetist well in advance.  He was expecting it.  He placed a mask over my face (see photograph above) and told me to take some deep breaths.  As I did so, I smelt a peculiar smell, someone joked the mask was supposed to smell of vanilla (I could see what they meant).  I started to feel slightly dizzy.  I failed to notice that the anaesthetic had already begun, and by the time I did notice, there was nothing that could be done.  I felt my arms start tingling and I felt like I was falling.  My instant reaction was to try and sit up; however when I tried, I was pushed back down into the bed and reassured that I was doing well.  I was asked to keep my eyes open as long as possible and then blackness….. a dreamless sleep washed over me.


I awoke in the recovery room with a searing pain in my right arm, an injectionMe approximately an hour afterwards was immediately administered into my hand, which made me feel even more light-headed than I already was. I remember not being able to move my arm, a nerve block had been inserted for pain control.  There was one problem, it was partially numb.  The anaesthetist soon sorted that problem out.  He put some jelly on my operated shoulder and gave me a number of deep injections using ultrasound.  It was as if someone had taken my arm away, numbness spread like a blanket over the rest of the joint.  The pain disappeared. What’s more, whilst in recovery I did not vomit once, which is usually a serious problem for me after anaesthesia.  Soon after becoming fully conscious and pain free.  I was transferred to the orthopaedic ward to commence my recovery proper (see right).

The anaesthetic certainly had surpassed my expectations. I was expecting another bad experience, however the staff were truly excellent, they made me comfortable and put me at my ease.  The anaethetic was swift and without major issue, in sharp contrast to my last one (maybe I could write a post on that sometime, it would be very entertaining reading, I assure you).  My next post will concentrate on my recovery to date, and will hopefully will be posted sometime later this week.

What it really like to have anterior shoulder stabilisation surgery: The anaesthetic and operation