Rotator Cuff Injury: Part Five

Rotator Cuff Injury
Part Five

This article is continued from Rotator Cuff Injury: Part Four.

Second MRI and Possible Second Surgery

I had my fifth post-surgery appointment with the surgeon on February 11, 21022. I scheduled this appointment right after my appointment on November 11, 2021. At that time, my rehab was going right on schedule, and I was progressing in a linear fashion. By the time of this appointment, it would be almost six months since my rotator cuff surgery, and according to the protocol I was given after my surgery, it would be time to “resume normal activities.” This February appointment was also to be my last appointment.

However, all of that was before my Christmas decorations setback three days after the November appointment. As a result, I had two additional appointments in-between these two appointments. At the second appointment I got the second cortisone shot I discussed previously.

At this appointment, I told the surgeon what I reported in my last update about that cortisone shot, that it did nothing, except to cause my tics to flare up, leading to three sleepless nights. I added, “I won’t be doing that again.” The surgeon then checked out my range of motion, and it is reasonably good. But when he had me raise my straightened arm upward to the left, with him pressing down on it, you could hear a “click.” That is when he said I would need to get another MRI.

I had planned on asking him if that would be possible, so I was glad he mentioned it first. But now I have to wait for my insurance company to approve the MRI. They will then contact the surgeon’s office. The surgeon’s office will then contact me. Then I will need to contact my local hospital to schedule the MRI. Then I need to contact the surgeon’s office to schedule a follow-up appointment.

By the time all of this is done, and I have the follow-up appointment, it will probably be early March before I know if I did indeed re-tear something getting those Christmas decorations down. If I did, I will probably need another surgery, which will probably take another couple of weeks to schedule.

I must once again express my frustration over how delayed everything always seems to be. I should have gotten an MRI back in November, right after the setback. At least, I would have if I were a professional athlete or rich. But as it is, it will end up being four months of pain and worry. That is the same time period it took for me to get my first MRI and surgery.

When I began Part Four of this ongoing article back in October 2021, I thought I was near the end of this story. But so much has happened since then, with much more potentially to go, I have started this Part Five. And if it does end up being mid-March when I get a second surgery, it will be one year since this whole ordeal began, with much more time to go. If I don’t need surgery, then I am probably looking at a lifetime of pain and restricted activities. Neither option is very pleasing.

Needless to say, I am very frustrated and worried. But all I can do now is to wait and pray. Prayers are appreciated.
2/12/22

Second MRI Results

I had my second MRI on Wednesday, February 23, 2022. Shortly afterwards, the MRI results were posted on MyChart. They read:

Study Result

Impression

Sequelae of rotator cuff repair surgery without evidence of the recurrent full-thickness retracted tear. Acromioclavicular arthritic changes with bursitis.

Glenohumeral chondrosis with chronic changes of the superior labrum. Narrative

MRI SHOULDER LEFT WO CONTRAST February 23, 2022 3:10 PM

INDICATIONS:

rotator cuff issue

COMPARISON:

None

TECHNIQUE:

Multiplanar, multisequence MRI of the left shoulder was performed without the use of intra-articular contrast. T1 and fluid sensitive sequences were acquired in the axial, coronal and sagittal planes.

FINDINGS:

Suture anchors involving junctional of supraspinatus and infraspinatus from rotator cuff repair surgery. Mixed intrasubstance signal with mild edema favors evolving postoperative sequelae. Two suture anchors in the anterior wall head from subscapularis tendon repair. Similar signal characteristics of the repaired tendon favoring evolving operative changes. No evidence of a recurrent, full-thickness retracted rotator cuff tear. Mildly edematous rotator interval with synovitis of the superior subscapularis recess. Rotator cuff muscles demonstrate symmetric morphology and bulk. Teres minor is intact. Long head of biceps tendon is poorly visualized.

Type 2 acromion. Acromioclavicular arthritic changes with fluid distention of bursal space compatible bursitis.

Humeral head is centrally positioned within the glenoid. Focal area of subchondral marrow edema involving the central glenoid. Inferior glenohumeral ligaments and axillary folds are intact without overt thickening or periligamentous edema. Truncated morphology to the superior labrum either represents degenerative fraying and or post debridement changes. Correlate with surgical history. Physiologic quantity of joint space fluid.

Glenohumeral chondrosis with chronic changes of the superior labrum.

IMPRESSION:

Sequelae of rotator cuff repair surgery without evidence of the recurrent Full-thickness retracted tear. Acromioclavicular arthritic changes with Bursitis.

As with my first MRI, I do not understand all of this. But contrary to that MRI, what I do understand sounds good. I think this is saying I did not re-tear my repair rotator cuff tears, so I probably will not need another surgery. I think it says my ongoing pain is due to arthritis. That will be a separate issue I will have to deal with. But I will have to wait until next week for a appointment with the surgeon to review these results and to fully understand what it all means.
2/26/22

Post-MRI Surgeon Appointment

I had a follow-up appointment with the surgeon after my second MRI the following Monday, February 28, 2022. For the first time, I went back to the exam room without waiting, then a couple of minutes later the surgeon motioned for me to come to the front desk. That is where they had a view screen for the MRI results.

He showed me where the braces were that he had used to fix the two rotator cuff tears. And he showed me that they were not re-torn and that the shoulder joint looked normal. That was a big relief! He then compared that to the first MRI. The joint back then did not look at all normal. It was quite a difference.

We then went into the exam room and talked for a few minutes. He reiterated that all looked normal. He predicted that any remaining pain should subside over the next few months, but that it could take up to a full year post-surgery for all of the pain to subside and for me to regain full ROM.

He said he was worried I had re-torn something reaching up getting the Christmas decorations down. I replied, “You were worried. I was worried.” But were both glad that did not prove to be the case.

I asked him about getting back into harder and heavier training. I told him I had been working up to a set of twenty reps but was leery about going heavier. I mentioned that in my workout the day before, I had done deadlifts for 180/20 (pounds/ reps). I thought of going heavier and doing a set of 15 reps, but I thought it best not to push it. I said I was tired of having to think that way. He said I no longer need to think that way and that I could gradually start going heavier and harder. But he said not to jump from doing sets of 20 reps to doing a heavy triple. I replied, “I wouldn’t do that anyway.”

I then outlined to him my plan of gradually increasing the weights and dropping the weights over the next few months, so that it would be May to June before I was doing 3.5 reps, then another month or two after that before I’d try a heavy single. That would take me to about one-year post-surgery. That was on squats and deadlifts. For benches, I figured I might take it a bit slower, depending on how my shoulder feels. He said that was a good plan.

I asked him about the mention of arthritis on the MRI report. He said that was nothing to worry about, as it was just normal aging. That was another relief. I also asked him about taking one 200 mg ibuprofen tablet each day before my workouts. He said that low of an amount even for several months should not be a problem, if that is what I needed to take the edge off.

I mentioned about also using a lidocaine roll-on before my workouts, wearing an elbow sleeve on my upper arm during my workout, and using Aspercreme and ice after my workouts. He said that was all fine, I asked him about still getting pain in my left triceps, and he said that was normal and should also subside eventually.

I then thanked him several times for the excellent job he had done in fixing my shoulder. And that was it. No further appointments would be needed.

I left feeling very relieved and thankful to the surgeon for his excellent work and to the LORD for pulling me through this whole ordeal. It began on March 14, 2021. As I finish this final update it is March 1, 2022, so it has been almost a full year.

I still have months to go before I am fully recovered and am back to where was before it all began. But I no longer have to fret about re-tearing the fixed rotator cuff tears. They are fully healed. But still, I will resist pushing too hard too quickly, as again, that would not be smart anyway. Moreover, I need to build up strength in my shoulder before stressing it too much.

Along with the 180/20 on deadlifts, in my last squat workout I did 135/20. For my Imaginary Contest the week of the surgery, I did 302.5 for Squats with Sleeves and 395 for Deadlifts. That is a huge difference. Those were of course for just one rep. It is difficult to estimate from 20 reps what can be done for one rep, as there is a huge difference between the two. But it is obvious have long way to go to get my squat and deadlift back up, if that is even possible given that I am now in my 60s. It will be a matter of cycling down to lower reps and trying to regain my strength.

For benches, I only did 60/20 in my last workout. My gym best is about 170, so that is an even bigger difference. That is to be expected. And it means it will take quite a while to get my bench back up to a respectable level, if again, I can ever get it back to where it was before this whole ordeal began almost a year ago.

In any case, hopefully, I won’t be having any more medical appointments for a while, as it has really been getting to me having so many. I had yet another sleepless night after this most recent one and felt terrible the next day. But that should be it for now.

. I will close by thanking the LORD for giving the surgeon the skill to fix me up and once again thanking the LORD for getting me through all of this and for everything working out as well as could be expected, even with the setback and other struggles along the way. To Him be all of the glory.
3/1/22

And that concludes my Rotator Cuff Injury Story, almost one year after it began.

But for a follow-up, see Rotator Cuff Injury 2.0.

The above page was first posted on this website February 12, 2022.
The individual updates were added as dated.

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