In addition to the pre-admission clinic I attended before my shoulder surgery, I also met with the co-investigator of a shoulder study being done at the Grey Nuns Hospital. This woman, a physical therapist, is a researcher in the “Early Mobilization Following Mini-Open Rotator Cuff Repair” study.
I am potentially a candidate for the study, because the planned surgery on my shoulder fits the criteria. A remote possibility exists that just the simpler arthroscopic decompression procedure may do the trick. Equally unlikely is the possibility the surgeon has a look and decides nothing can be done for me. In any event, neither the surgeon nor I have any say in my participation.
In dramatic Academy Awards type fashion, after the surgery, the doctor opens a sealed envelope in my file to reveal one of two wristbands. If I wake up wearing a hot pink band, that means “Standard Rehabilitation” and wear my sling for 6 weeks, with no voluntary or active shoulder movement. A neon yellow band will mean “Accelerated Rehabilitation” and wear the sling for comfort and use active shoulder movement for activities of daily living only.
No one knows which patients are which for the follow-up at the two-week and six-week post-surgery mark, and then three, six, 12, and 24 month marks. To ensure the study evaluator stays blinded, removing the sling and keeping it out of view before entering the department is required.
Doing umpteen questionnaires about pain levels and quality of life issues was part of this visit. A physical exam involving range of motion exercises both standing and lying down were also part of the process. Issues of confidentiality and the right to withdraw were also discussed. The whole point of this study is to determine if there are any detrimental effects of allowing people to remove their slings to begin active movement earlier than the normal six-week treatment regime.
This is where I learned an open-cuff repair involves scraping a channel into the bone to create extra room for the repaired tendon, which is then tacked to the bone. If the tendon is frayed like an old rip in your jeans, stitching into the frayed part will not hold. If muscle mass is gone or the bone is mushy, the more invasive procedure is required. Otherwise, three small laproscopic incisions about the size of a buttonhole suffice to get in there and do the repair.
The physical therapist also talked about the challenges of eating and dressing. She admitted that therapy could be equally as painful as the post-surgery discomfort. She reassured me about the skill and caring of my surgeon.
In the days leading up to surgery, I’m doing the practical things like getting my hair coloured and cut shorter than usual. I’m making sure the laundry’s done up-to-date. I’m pre-cooking and freezing entrees. I’m doing a more thorough housecleaning. I’ll be assembling whatever shoulder-friendly clothing I have. I’m paying bills, writing emails and columns. Very, very soon, I’ll be ready. At least I hope so, from where I sit.