Shoulder surgery questions

I have several.
First, anyone have experience having Kaiser do it? I keep reading about folks interviewing several surgeons; I think I have a choice of the one Ortho I met with, just like we all imagine socialized health care would give us. For one thing, he'd rather just snip my biceps tendon than fix the SLAP tear. How do I assure that he does the repair instead?
Scott Sills showed me his scope pics. He showed me one with cartilage that looked like sharkskin, told me that this is what arthritis looks like; and we both acknowledged that I have it too. But he also said his doc told him there is a "paste" coming out in a few years. My Ortho knew of it too but also hinted Kaiser is not one for exotics. Anyone know more beta on this?
So far I know I need both a 7mm Acromionoplasty, and a SLAP tear fix. I want to hold out for the arthritis paste if plausible, making 3 separate jobs. Advice?
Being a plumber (albeit with a pretty high pain threshold), how early could I get back to some wrench-turning?
Thanks.

I just had surgery 3 weeks ago, and I had bone spurs removed from my acromion, the long head of my biceps tendon cut and re-attached to my humerus, and de-burring of my labrum. I don't really know how cutting the biceps tendon will work for repairing a SLAP tear, but I do know that the recovery for cutting your biceps tendon will be much shorter than a Labrum repair.

I'm about 3 weeks out and I feel pretty good (I can't do any heavy lifting, but, otherwise, I'm functional). From what I've heard, people who get their Labrum repaired are in a sling for 3-4 weeks and are out from climbing for 3-6 months. In theory, I'll be able to do easy climbing 6 weeks after my surgery. Obviously, you don't want to have them cut your biceps tendon if repairing the Labrum is better, but that may not be the case. Maybe you should go see another doctor just to get an opinion (even if you have to have surgery through Kaiser). Good luck!

Oh, and I definitely would not try to turn a wrench with my bad arm at this point. Maybe after 4 or 5 weeks? I probably felt good enough to attempt something like that with my good arm after 2 weeks or so.

Mike,
you are using a lot of fancy lingo in your post, and I don't know if I understand all of it. However, I had surgery on my rotator and labrum 4 months ago. The encouraging thing for me was that I had it done by a surgeon in Colorado Springs that specializes in sports medicine and was/is positive that I will be back climbing and doing what I want in a total of 7 months time. He also has a very good reputation with a lot of Olympic athletes and patients. I was in a sling for about a month and a half and had to sleep sitting up on my couch. I went to work 4 days after my surgery and felt like I was going to black out for about a week. I could do nothing with my arm for about 2 months (maybe longer). A lot of physical therapy is needed, and because I was so committed, I feel almost 100% at 4 months. I will see dr. tomorrow for my final visit. atrophy and mobility is still a bit of an issue that I am working on.
I hope this helps.

hey greg, sorry to hear about your shoulder. hope all is going well after the surgery. was your surgeon's name paul by chance?

Mike

I only have tangential advice, but still wish to offer some about activity following surgery. I had surgery to repair my rotator cuff and bone spur removal 4 1/2 months ago. I will likely be cleared to climb mellow in less than 2 weeks (I'm slowly going crazy here). From what I understand (could be wrong here) this recovery is even slower than SLAP, so you would likely achieve function more rapidly than myself.

I had my bad arm immobilized for 6 weeks and might have been willing to carefully crank on my good arm after 3-4 weeks due to the risk of injuring my bad shoulder getting into a position to do something like this. Highly recommend you follow your surgeon and PT's advice on activities following surgery. The recovery is too long to risk setting yourself back to square one.

Jesse

Berkeley,
I did not realize from our earlier exchange that you had the biceps tenotomy. I thought that the recovery from this was longer than the standard SLAP repair? Maybe I am misunderstanding but I thought that when the cut the biceps you have to be in a sling for longer because the tendon needs to heal back to the bone. Am I mixing up what you had done with something else?

Slim,
My surgeon's name is David Weinstein.

hey all,
i had a slap repair early april (4.5 months ago) done by dr. gottlob at panaorama orthopedics. I am pretty much back to doing most that I want besides climbing. Dr told me last week that i should play it safe and not ruin the repair. that being said recovery has been long and tedious to get to this point and I think i have gone crazy not climbing. Panorama orthopedics has been really great to this point in both the pre and post surgery. He said i should be able to start climbing again by october. I had a bucket handle SLAP tear that was debrided away and something to tighten my joint together since i was "loosey goosey". I was in a sling for 6 weeks and then had around 4 months of PT. at this point i am working out on my own and trying to regain the strength I lost.
Good luck all with your recoveries and repairs!

Hi Mike,

I'm an unfortunate expert on SLAP repairs, considering that I've had two done in the past two years (one on each shoulder). I also had a rotator cuff repair on the right shoulder as well. My second surgery was performed by Kaiser in Southern California. The surgeon I chose was recommended to me by the doctor who performed my first repair. That being said, I did not get to see or talk with the doctor until about ten minutes before going under. That I was not pleased about.

As for the surgery and recovery, it is long and pretty grueling. If they put anchors in, expect to be in a sling for six weeks and limited to light activity and rehab for another three to six months. You will not be able to crank for at least six to eight months and for the next year or so you will have to listen closely to your body and ice regularly as your tendons slowly adapt to the stress and your atrophied muscles recover. Rehabilitation is absolutely essential and poor efforts here may land you back in the doctor's office. In addition, if you're an office worker you WILL have to get a somewhat ergonomic setup at work to prevent strain while using a computer. An elevated chair, trackball mouse, and split keyboard may all be necessary to limit the movement of your arms as you grind away the hours. The good news is that after eighteen months or so of this you will be on track to climbing as hard as you ever did, or even harder.

Feel free to message me directly if you have additional questions.

Amy,

I did have the long head of my biceps cut and re-attached to my humerus. Dr. Hackett used a Biceps Button to re-attach it, which I got the impression is a newer technique that is stronger than using a screw and reduces recovery time. The button is explained on this page: goudelis.gr/index.php?page=…. I'm sure Dr. Millet does it the same way.

Dr. Hackett told me he's re-attached a biceps tendon that way about 150 times. I chose him partially because of his generally great reputation, but also because he understands climbers. He gets what we're really doing, and he's told me which types of climbing are okay at which points in recovery (e.g. it's okay to do easy crack climbing but not to go bouldering or go to Rifle).

Mike, I had rotator cuff surgery for a traumatic dislocation which involved two procedures, one open and one arthroscopic done at the same time. My rehab was aggressive and started almost immediately but I wasn't allowed to wind surf or climb for seven months.
I trained religiously during that period and I got in great shape. I have had no issue with that shoulder at all.
My doc was Phil Stole he is in Denver.
On another note I had Kaiser do my last surgery here on Maui and all went well. Good luck

Thanks for the info so far. No one has any beta on the arthritis paste Scott mentioned to me. I am going to have to find a way to incorporate the op with my work, meaning both finding a slow period and also having the ability to bring on an apprentice to roll with and do the wrenching.
Next question is what kind of time/relief can I hope for with a hydrocortisone injection? I can see it helping w/ the inflammation of the impingement from the acromion, and also the arthritis, but the SLAP tear is probably not going to be helped.

Mike,
As far as the arthritis is concerned, My doctor just removed it (along with bone spurs and broken bone chips) while he was doing the surgery. I don't know about any paste. I have never had a cortisone shot.

I had an impingement, and I don't think the Cortisone shot helped at all.