The pain levels and length of high pain expected post recovery were not shared with me before the surgery. One of the orthopedic surgeon's assistants (whom I was seeing in person for a shot in the heel for my plantar fasciitis) answered those concerns almost 2 weeks after outpatient surgery. I was told that I would be in severe to moderate pain for the first month, that there were HOLES drilled into the top of my humerus bone to connect the muscles and tendons back to the shoulder bones. Perhaps this was why I was suffering so much with the pain. When I called a couple of times to a different doctor on weekend phone duty, he had said to me that after 10 days, he didn't know why there was still level 7-8 pain all of my days and nights, despite the prescriptions given. He stated that my relief should have been great at 10 days out. The physician's assistant at my heel appointment showed me the zoomed-in photographs of those holes so I would be able to reframe my understanding of the intense procedure. Having surgery out-patient does not mean that it is a minor procedure. This was a major procedure.
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The Importance of Informed Consent
Informed consent is a cornerstone of medical ethics, ensuring patients fully understand their treatment options before making a decision. When discussing rotator cuff surgery, informed consent means more than just signing a form. It’s about having a thorough conversation with your surgeon. Patients should learn about the nature of their injury, what the surgery entails, and the potential outcomes. Equally important is understanding the risks, such as infection, stiffness, or complications from anesthesia, and the recovery process, which can take months of rehabilitation. MONTHS!
The preoperative appointment with the surgery coordinator was to explain all of these things. I had a phone conversation a week before surgery, and the fine details and expectations were not gone over well. My husband has a theory that if the coordinator had told patients all of the minute details of post op, perhaps patients would hold off as long as possible or not get surgery after all. The one thing I have experienced in my years and surgery experiences is that surgeons love to do surgery. That is their passion. I get it.
The physician's assistant stated that she would (once again) tell the preoperative coordinator of her duties.
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Medication Side Effects
I suffered allergic reactions to all of the opioid pain medications this time around including: rashes, itchiness, nausea, sleeplessness, fidgeting, and vomiting. This occurred with 2 types of medications, even days after the opioids were discontinued. My appetite waned considerably. Regular anti-nausea medications made me throw up. I was extremely uncomfortable. I could not lay on my side, ice packs woud not stay on my shoulder, and I was able to tolerate only Ibuprofen. All of the opioids and Ibuprofen barely took the edge of the pain off anyway. Ice was my close confidante, and it took the other hand to hold it secure to my shoulder throughout the day. One of my friends questioned me as to if I was being psychosomatic. I responded that I had the vomit in the trash to prove my realistic discomfort. I had the photographs of the rashes as well.
Finally, I was prescribed a strong anti-nausea medication used after surgery, general anesthetics, and for those on chemotherapy. The first day of taking the pills I noticed relief after 3 doses and was able to eat a full meal of bone broth, mashed potatoes, chicken, and stewed prunes! The second day the nausea came back after 2 doses of the medicine. I added an extra dose to the day and felt slight improvement. Perhaps I need to stick to my simpler eating regimen until the nausea wears off. Please remember that it had been 5 days since I had ingested any opioid pain medications.
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Conclusion
I love and trust the friend who asked me the question if I was being psychosomatic. It was hard to hear, for sure (my ego), but once again, could I reframe my perspective? So when I shared my slight improvements, she advised me to focus on that. I WAS IMPROVING, no matter how slight. I was moving the needle in the right direction. This was an impactful moment for me. Rather than resist the facts, I choose to embrace them: my shoulder muscles, tendons and ligaments are no longer torn, the bone spur is no longer there, I am able to eat without throwing up, the pain levels are easing slightly with over the counter medicine, the itching, rashes, and sleeplessness are fading away. My glass is half-full.
Blessings,
KJ Landis
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