Post op recovery, will be nightmare

[dipweed23]

Quote:BANKART REPAIR
REHABILITATION PROTOCOL
Michael J. Mullin, ATC, PTA
Kevin R. Stone, M.D.
General Considerations:
- Use of a sling only as needed or prescribed - Okay to shower once dressings are changed (Day 1)

- Arm is restricted from these movements for 4 weeks:
* extension (backwards) past the plane of the body
* external rotation (arm rotation outwards) greater than 0° (straight in front); extensive repairs may require more restrictions
* for posterior repairs, avoid any internal rotation (turning in) past the body

- No passive forceful stretching into external rotation/extension for 3 months following an anterior repair and into internal rotation for a posterior repair

- Good posture is critical throughout the rehabilitation process to improve healing and decrease the risk of developing poor mechanics

- Aerobic conditioning throughout the rehabilitation process

- M.D. follow-ups Day 1, Day 8-10, 1 month, 4 months, 6 months and 1 year

- All active exercises should be carefully monitered to minimize substitution or compensation

1 - 5 days post-op:
- M.D. office visit (Day 1) to change dressings and review home exercise program

Home program to consist of: - Icing shoulder as often as able for the first 3-5 days - Pendulums, elbow flexion / extension, wrist and forearm strengthening, gentle passive / active assistive exercises of the arm in flexion (front) keeping below the level of the shoulder, cervical stretches

- Postural education and exercises

- Stationary bike, stair machine, and VersaClimber without putting weight on arms for general conditioning

- Sleeping semi-reclined is most comfortable

5 - 14 days:
- Pain control (i.e. cryotherapy, massage, electric stim) - Gradual increase in passive and active assitive (AAROM) exercises as tolerated (from flexion out into the scapular plane) up to 90° unless otherwise indicated

- Begin isometrics in all planes as tolerated

- Soft tissue treatments to scars and surrounding musculature, scapular mobilizations

- General conditioning as tolerated (include trunk flexion & extension exercises)

2 - 4 weeks:
- Passive and AAROM flexion out to scaption (plane of the scapula) as tolerated - Isotonic wrist, forearm, and scapular exercises

- Theraband resisted pull-downs from the front and the scapular plane; elbow flexion with high reps and low resistance; submaximal isometrics (as dictated by pain); active scapular elevation, depression, and retraction exercises; light weight bearing exs.

4 - 6 weeks:
- Resting pain should be notably diminishing - Continue with passive and AAROM exercises (cane exercises, wall walking, table slide) in flexion out to abduction as tolerated; maximal isometrics

- Active exercises from flexion into the scapular plane against gravity as tolerated
* No resistance until able to perform 30 reps at limb weight with perfect mechanics

- Okay to add light resistance internal rotation exercises from 0° to the body only

- UBE with light to no resistance only

- Add proprioceptive training exs. (alphabet writing, fine motor skills, work / sport specific exs.)

6 - 8 weeks:
- Continue to increase AROM exercises as tolerated (serratus anterior, upper and lower trapezius); add eccentrics into protected ranges - Okay to begin LIGHT stretching into external rotation

- Okay to begin LIGHT glenohumeral joint mobilization

- Increase proprioceptive training (prone on elbows, quadriped position / "on all four's" for rhythmic stabilization)

- UBE with increasing resistance

- Okay to begin jogging, road cycling, and standing arm resistance exercises in the pool

8 - 12 weeks:
- Emphasis on regaining strength and endurance - Light PNF patterns (proprioceptive neuromuscular facilitation)

- AROM exercises to include internal rotation and external rotation as motion allows, lateral raises and supraspinatus isolation, rower with a high seat, decline bench press, military press in front of body

- Running, road or mountain biking, no activities with forceful, ballistic arm movement

3 - 6 months:
- Aggressive stretching; begin strenuous resistive exercises - Add light throwing exercises with attention to proper mechanics

6 months:
- Increasing throwing program with focus on return to throwing sports as mechanics, conditioning, and strength allow

If the surgery is approved, looks like I'm in for a loooong haul!
I wonder at what point I will be able to return to work doing super light duty
If I don't feel I can return to my previous job soon enough, and they can't provide me with light enough duty, maybe I can take up a job somewhere that will be lighter work. If the surgery is approved and recomended, my FMLA time will be running out before I am able to RTW so maybe I SHOULD take another job.... if i do, will work comp still have to pay medical? Need to find a stand thingey for my bike so I can do stationary bike riding without pushing on handle bars to stay somewhat in shape too.

If Dr perscribes recliner chair, will comp pay for something like that? Already having trouble sleeping in bed AND on couch.

[red1030]

Hi dipweed,

I don't believe that if you find another job that the workman's compensation insurance will pay your medical. You need to ask a lawyer this question however. Do you have a lawyer yet? You may need one soon. Go to the other forum and ask Bad boy to help y ou with this question. He is really good with this kind of information.

Looks like you do have a long haul ahead of you. I wish you the best and my prayers will be with you and your wife.

[Spring]

Hi Deepweed,

You just brought back alot of memories for me. This is one of the procedures I had done with my shoulder.

I want to mention did your Dr. say if he/she was going to be able to do the surgery with a scope or have do the surgery as an open procedure. What are you having fixed, if you don't mind me asking. i had a labrum tear that had to be repaired with the Bankart thingy. I have a picture of it some where. I could look for it...and scan it and forward it to you...just so you can see what they are going to be doing to you....I also had two other procedures done at the same time. My doctor was going to do a scope but once he found the damage with the labrum tear he had to open the shoulder up.

I will promise you will not be able to lay in your bed after you surgery. It was forever before I was able....several weeks. In fact even reclining in a recliner was to much. But I did like being able to atleast be able to put my legs up...just not recline back. I had one of those body pillows...(you know one of those big long pillows) I surrounded myself with it..It was wonderful. Are you having your dominate shoulder done. Like are you right handed..and are you having your right shoulder done? If so, you are in for learning a whole new life syle......lol

As for work...WC should be paying you so much of your wage....in my state it was 67% while you are off for surgery and healing. Once the Dr gives you your restrictions for work....you can return to work..but if your employer can't offer you work within your restrictions wc should continue to pay you your benifits...until you are able to return to your full abilities. Any money you make you will have to turn into wc and it will be deduct from your benifits. I was able to return to light duty just before my surgery. WC continued my health care...they only deducted what money I made from the money they sent me. I sure hope this make sense to you. Please just always stay within your restrictions... and don't make your shoulder injury any worse.

Dipweed...I am not able to tell you to much about the healing process....because I had the most aweful pain after the surgery...but not long after my surgery I was diagonised with RSD in my shoulder. I wish you the best...

[dipweed23]

Spring Wrote:Hi Deepweed,

You just brought back alot of memories for me. This is one of the procedures I had done with my shoulder.

I want to mention did your Dr. say if he/she was going to be able to do the surgery with a scope or have do the surgery as an open procedure. What are you having fixed, if you don't mind me asking. i had a labrum tear that had to be repaired with the Bankart thingy. I have a picture of it some where. I could look for it...and scan it and forward it to you...just so you can see what they are going to be doing to you....I also had two other procedures done at the same time. My doctor was going to do a scope but once he found the damage with the labrum tear he had to open the shoulder up.

I will promise you will not be able to lay in your bed after you surgery. It was forever before I was able....several weeks. In fact even reclining in a recliner was to much. But I did like being able to atleast be able to put my legs up...just not recline back. I had one of those body pillows...(you know one of those big long pillows) I surrounded myself with it..It was wonderful. Are you having your dominate shoulder done. Like are you right handed..and are you having your right shoulder done? If so, you are in for learning a whole new life syle......lol

As for work...WC should be paying you so much of your wage....in my state it was 67% while you are off for surgery and healing. Once the Dr gives you your restrictions for work....you can return to work..but if your employer can't offer you work within your restrictions wc should continue to pay you your benifits...until you are able to return to your full abilities. Any money you make you will have to turn into wc and it will be deduct from your benifits. I was able to return to light duty just before my surgery. WC continued my health care...they only deducted what money I made from the money they sent me. I sure hope this make sense to you. Please just always stay within your restrictions... and don't make your shoulder injury any worse.

Dipweed...I am not able to tell you to much about the healing process....because I had the most aweful pain after the surgery...but not long after my surgery I was diagonised with RSD in my shoulder. I wish you the best...

Money wise, the WC insurance has classified me as temporary total disability, which is good for me because it increased how much they are going to pay me. I was told it will be $266.66 which is more than 80% or my after tax and deductions wage, guess not too awful bad.
It will be on my Left sholder to repair a tear in the Labrum. It will be done with a scope. The Dr wants to also do a decompression procedure to reduce further complications with impingament, but that part the WC insurance doesn't want anything to do with.

I have done plenty of research on Bankart repair using both the open and scope method. The doctor has also explained a LOT about the procedure and I am confident that he knows what he is doing. He is the Ortho doc that has operated on several of the Detroit Tiger players in the past who have had to have the same surgery. And he performs this surgery at least 2 times a week, according to hospital records. (amazing what stats they will provide you with when you talk to the right people) (if you want to try the same thing, i'd suggest calling the surgery coordinator at the hospital where they will be doing the surgery, and asking them to tell you how many {blank} procedures the doctor has done in the past two months or so. if you get a nice person they will call you back once they have time to run the query in the database).
As for recovery, I'm afraid I'll prolly tear something. I'm the kind of person that if it's not actively hurting at rest I don't think about it. The other day I dropped a pan of noodles I was cooking because I grabbed it with the left hand and all of a sudden POP when i moved arm. the PAIN was gut wrenching. Luckily I avoided boiling water on me, but had a mess to clean up before wife got home!
I'll ask for a restrictive sling for the first week or so, so I don't have an accident. i'm a total clutz!

[red1030]

It sounds like I need to say to you to be very very careful. Maybe you should stay out of the kitchen. I say that because (not sure that I told you .. but I have Multiple Sclerosis) a few years ago I was in the kitchen and dropped a knife and it landed straight through my foot. Any way the basis of the story is that my husband does not allow me in the kitchen. I can get a glass of cold water, other than that the kitchen is off limites to me. LOL... maybe you should stay out of the kitchen so you don't get hurt....Seriously you must be careful especially after this surgery so that you don't hurt the surgery site as well...loads of hugs are coming yours and your wifes way...red

[dipweed23]

Thanks for the advice Red, but you haven't tasted my wife's cooking!
If it is not in a box, or packet with directions.... DON'T eat it!

I'll be asking dad to make some bowl holders for me, so I can mix one handed and buy one more set of thingeys for my electric mixer too.
I will be careful to make larger dishes of food when the wife is home, and ask her to pull them from the oven, or pour out. I can't NOT do things.... i feel utterly useless!

I think I will TRY to stick to simpler things, and if I have a restrictive sling I can use, I will be free in the kitchen. I"m right handed, so my good hand can be used to move pots. I can also wear my work boots, and Jeans to help protect me

I'd better make up a double batch of enchaladas, Lasagana, and a couple other things too. I want to pre make them and freeze portions so I can have decent food post op, and during first few weeks of recovery!

[red1030]

It sounds like you have it under control. You have a lot of good ideas. So your wife doesn't cook eh? Well I can cook, I just don't. It's not that he doesn't like my food, he likes to cook. I think he is strange..but it works for me. Make plenty of food. When you are making the food rememer that your stomach may not be able to tolerate very spicy things so make some soup also. You may need some gentler foods for the first couple of days.. good luck friend.

[dipweed23]

red1030 Wrote:It sounds like you have it under control. You have a lot of good ideas. So your wife doesn't cook eh? Well I can cook, I just don't. It's not that he doesn't like my food, he likes to cook. I think he is strange..but it works for me. Make plenty of food. When you are making the food rememer that your stomach may not be able to tolerate very spicy things so make some soup also. You may need some gentler foods for the first couple of days.. good luck friend.

I have been through 4 surgeries (to include surgical extraction of wisdom teeth, had to be put under) surgeries in my 27 years alive so I understan what you mean. I will have plenty of noodle soups on hand. I have been under a general anastetic 16 times due to 12 medical treatments not considered surgery, but has to be performed while you are unconcious. I know what it is like to wake up from that.
When I get in a depressed mood (which I know I will be when I can't do much of anything) SPICY SPICY foods for some reason cheer me up, tho I get heartburn like crazy!

To add to this tho...
2 different kidney surgeries, minimally invasive (well that's what THEY called it, to me I'd rather they cut me open than go the route they took!), and appendex out (they put the scope in to look at it, and decided to cut me open far enough for the doc to put his hand all the way in). All 3 of those I was back to work in a week, tho Drs wanted me to be off at least 2! I can't stand it to not work!

[sweet tooth]

you be careful how you handle yourself now will show up in the future sit back and take it easy and enyoy being took care of

[capricorn]

Morning dipweed......I am wishing you the best with your surgery and a full, speedy recovery. All are right in saying be careful. Even though hubby loved helping me shower and dress, I felt useless and at time stilll do after almost 12 weeks. Any type of shoulder surgery apears to be quite painful and a long recovery. I've stayed out of the kitchen since when in a hurry I tend not to remember I have one useful arm. Many a night I tried only to find myslef reaching for a pot of hot mashed potatoes to drain with the bad arm. Can be very dangerous. I agree with Spring in that sleeping is very difficult for awhile regardless of what you're in. The bed in time you can somewhat prop the bad arm or brace it in between pillows. I can't sleep in a recliner but had to for about a month. would fall asleep all the way back with the ice on and hubby would take it off when I wa asleep. It got me a couple of hours here and there. Prayers will be with you.

CAP