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Dilemma


Zealot
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Saw my ortho on Thursday. Follow up x-rays of my left shoulder (AC arthrosis) and now my right shoulder.  

Down and dirty - need a total left replacement, the humeral head has flattened and has severe arthritis and apparently the right shoulder separation from back on the late 90s was also a break that healed badly. So it has a mess going on with it now.

Told doc I was planning on the trip to Utah next fall for the mtb excursion with SacredRides. 

Not sure he was too happy about that. Mrs Z wasn't. She wants me to get it done now. But if I do, I'm out of commission for 4 - 6 months. Will lose what i've trained for all summer. At that age where I lose it quicker than I gain it back. 

So doc wrote "replacement in 12 - 18 months or until the pain is too unbearable".

What would you do? Messing the shoulder up further really isnt the issue. It has to replaced. But if I trash the right?? That worries me a bit.  But I've wanted to do this ride for a  while and not sure I'll get more opportunites to do so.

Grrrr.

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Agree with Kzoo.  It will never be the "right" time, and whenever you have the surgery it will interfere with something.  But sounds like this trip is something you've really looked forward to, and if you can do, it doesn't seem like there's much harm in waiting a bit.  But if the pain gets worse or your mobility is impaired so that you really can't do the ride, then your decision will be easy.

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6 hours ago, 2Far said:

Do it now. 4 months off thru the winter. Get a recumbent trainer or go to a gym with one. 

You'll be pissed you waited this long to have it done. 

This sounds like good advise. The problem I see is if you get them both done at once. It cuts your recovery time in half but when you first come out of surgery you won't even be able to do your own paperwork. Not sure how long that stage of recovery lasts but it's pretty horrible until you regain use of at least one arm. I know someone who had both shoulders done at once. He did it because he said he couldn't afford to be off work so long. It did cut his recovery time in half but he said if he had it to do over he would do it one at a time. It's bad when you have to call someone in to wipe your butt.

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Is the shoulder making you miserable? I'm assuming not since you're considering waiting. 

2Far makes a good argument for getting it done. And like Kirby said, there is no good time to do it.

You've got a year before the ride. I'd get it done now. What if it's really bad by next summer? 

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23 hours ago, Zealot said:

I'm out of commission for 4 - 6 months

No, not you.  Maybe most people, but not you.

I see you as being 'out of commission' for about 4 - 6 hours; less if the anesthesia wears off faster.  After that it with be Game Face and Game On, especially if you have the operation before the ride and your physical therapy provides you the goal to strengthen your arm so you can indeed go on the ride.

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17 minutes ago, Thaddeus Kosciuszko said:

No, not you.  Maybe most people, but not you.

I see you as being 'out of commission' for about 4 - 6 hours; less if the anesthesia wears off faster.  After that it with be Game Face and Game On, especially if you have the operation before the ride and your physical therapy provides you the goal to strengthen your arm so you can indeed go on the ride.

Thanks for the vote of confidence, TK. 

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6 hours ago, Thaddeus Kosciuszko said:

No, not you.  Maybe most people, but not you.

I see you as being 'out of commission' for about 4 - 6 hours; less if the anesthesia wears off faster.  After that it with be Game Face and Game On, especially if you have the operation before the ride and your physical therapy provides you the goal to strengthen your arm so you can indeed go on the ride.

When I crashed and broke my hip the surgeon said I would be off work and off of that leg for at least six weeks. I thought to myself maybe six weeks for most people but I am not most people, I'll be back to full activity in record time. It took that hip a full three months to heal and the doctor to allow me to put any weight on that leg. As we age healing takes longer. In my case it was bone growth that they were looking for in x-rays to make sure the bone was healing and not anything I could do to speed things up.

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12 minutes ago, Longjohn said:

When I crashed and broke my hip the surgeon said I would be off work and off of that leg for at least six weeks. I thought to myself maybe six weeks for most people but I am not most people, I'll be back to full activity in record time. It took that hip a full three months to heal and the doctor to allow me to put any weight on that leg. As we age healing takes longer. In my case it was bone growth that they were looking for in x-rays to make sure the bone was healing and not anything I could do to speed things up.

My mother really beat the odds recovering from a hip replacement.  She does not like hospitals, so she was out in record time.

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2 hours ago, RalphWaldoMooseworth said:

My mother really beat the odds recovering from a hip replacement.  She does not like hospitals, so she was out in record time.

The recovery from a hip replacement is generally much faster than from the type of repair I had because they release you without having evidence of new bone growth. They do tell you that you are not allowed to fall for six months. In my break the ball was snapped off the head of the femur and they used pins (the medical term for lag bolts) to bolt my leg back on. My surgeon said this might not work because in this type of break the blood supply to the joint is often disrupted and you will develope avascular necrosis and have to have a total hip replacement anyway. He said that if it does work I will be much happier because there are no restrictions after it has fully healed. Total hip replacements come with some restrictions that generally don't affect normal people. They tell you not to run (unless you are running for your life because you are being chased) and not to cross your legs. My doctor knew I did some running and a lot of very active lifestyle stuff so he decided to try the repair. I'm glad he did but for three months I was very jealous of the folks up walking around the day after total hip replacement.  (Sorry Z for hijacking your thread but it is somewhat related to the thread subject)

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Further to my comment above:

Reasons to do it now:

  • It's already messed up, it isn't going to get any better. In fact, it will get worse, because that's what they do. Sometimes in a non-linear fashion.
  • It is probably affecting your quality of life right now. Pain, discomfort, waking you up at night, not allowing you to sleep the way you want, can't pick up the grand babies, can't do your favorite position (you know what I mean and I think that you do), etc.
  • You are favoring it (because it hurts) thus accelerating the deterioration of the other messed up arm.
  • You are favoring it (because it hurts), using the other arm more and further atrophying the muscles and losing flexibility in the worse arm (increasing rehab time)
  • The better shape the arm is in (relatively) pre-op, the faster rehab will be.
  • The winter is almost upon us, most folks mileage decreases or use alternative workouts. Use your PT as a part of your work outs.
  • It's the end of the year, maybe you've met your health care deductibles (or are close), could be less costly to do it now.
  • YMMV: Fo2 walked around like Laugh-In's Arte Johnson for years until he had a double knee replacement. Lost all muscle & flexibility. Never got out of the wheel chair.
  • YMMV: When I took the knee & hip cripple class before my replacement, 4 of the 6 were significantly disabled (walkers & chairs). We all had surgery the same day, I was the only one who got discharged the same day I had surgery.
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