Shoulder Sergery

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Part 2

The special thing about Dr. Kirby's technique is that he stitches the capsular ligaments right to the bone. In '93 he tells me about a new drill he is using which makes curved holes. In '00 Dr. Kriby is still very excited about the drill, so much so that he gives me some of the marketing literature for it. Among other things, I learn that in '93 I was only the 3rd person on whom he used the drill, though he didn't tell me that then. He has since done hundreds of operations with it. Before the curved drill there was no easy way to perform this operation. Suturing to the bone was the best. But the bone was very deep and providing enough exposure to operate a straight drill was difficult. Other surgeons used other forms of attachments such as metal hooks, but those could be problematic. As beneficial as the drill is, the inventor has had a difficult time successfully marketing it and it is not yet in wide use.

Left Shoulder

November, 1993

Right Shoulder

October 25th, 2000

Initial work to expose the damaged joint capsule

I think the device with the wire is used to cauterize bleeding blood vessels.

Me under the sheets. They are right in my face and I have to keep my head turned to the right. This time the left me more space under the sheets and Kim would occasionally push them out of my way.

When I saw this photo I thought: "Ouch! No wonder my shoulder hurts."

At some point during this surgery they discovered that necessary instruments had not been sterilized. This causes a delay of ten or twenty minutes. I felt a lot of jostling, more than I was aware of in the first operation.

At one point Dr. Kirby warned me that they were going to hammer on my bone. I told them to get some pictures of this so they hammed it up a little. The hammering roughs up the surface of the bone to which the ligament will be attached. As they both heal they grow together.

Drilling the holes.

This diagram shows how the drill cuts a curved hole. If you look closely you can see the cutter heads of the drill.

Now they must be sewing the joint capsule to the bone.

Another diagram of the incision and where the sutures are placed.

This large machine was called the "narkomed". I thought that was a great name. Here they are dressing the incision. I'm looking over my shoulder to see if this OR also has a narkomed. It doesn't

As they wheeled me out of the OR I snap this picture of Dr. Kirby. They took me to the recovery room. The folks there took one look at me and said I was doing well enough to go directly up to my room. I'm wheeled back out, up to another floor, then shifted into a bed They shift me from the table to a gurney and wheel me down the hall. I snap this picture of Dr. Kirby leading the way to the Recovery area.

I'm left in the gurney while they take my vitals.

That evening some friends come to visit me in my hospital room. I'm feeling pretty good. Everything looks fine, so they have me get up and move to a chair where I wait for Marie.

As I was leaving the OR the anesthesiologist said something about how I won't appreciate the nerve block until it wears off. It wears off sometime during the night and my shoulder hurts. The nurse hooks me up to a Demerol drip. It is a machine that will in inject Demerol into my IV when I push a button. But it is calibrated to allow only a limited amount each hour. I get three shots an hour and I pace them at 20 minute intervals. By the time 20 minutes is up I'm ready for my next fix.

Some time in the early morning they remove the IV. Latter I stagger into the bathroom to pee, and snap this shot in the mirror. By that evening I'm back home and feeling pretty good (the nerve block hasn't worn off). I check my e-mail and laboriously write one or two messages with my left hand. Marie and I watch a movie and soon I'm falling asleep. Marie makes a nest for me in the spare bedroom where I can sleep in a sitting position and I have a very restful night.

My recovery takes a while. Laying on my back causes my shoulder to ache so for weeks I must sleep sitting up. Even after a couple weeks typing at the computer for very long will cause my shoulder to ache. By noon on the next day the nerve block is wearing off and my shoulder aches. It is not terrible pain, but enough that walking around help take my mind off it. Shelly calls and suggests that I can take the Perkaset a little more frequently than prescribe for a short time. I do that the second night and sleep well again.

By Friday morning my shoulder is less achy and I'm taking the perkaset less often than prescribed then begin to alternate with Tylenol. But by that evening I'm feeling the constipating effects of narcotics. I'm only on the narcotics for three days, but it takes my system over a week to recover.

My right shoulder recovers faster than my left. Laying down causes it to ache, but with in a couple days I can easily type with out any pain. Every week it is noticeably better than the previous week.

I have often been asked how long the recovery takes. This is a difficult question to answer as the process is gradual so it is hard to fix a time at which recovery is complete. Here's what my experience was:

Through the first week expect significant pain and limited activity. I found I could not lay down for any period of time with out my shoulder aching. I had to sleep sitting up for several nights.
Through the first 5 weeks expect to be in a sling most of the time. Any significant force on your shoulder can hurt. If I stumbled I tightened my muscles and this hurt a lot.
Through the first 3 months expect limited range of motion.
Through the first 6 months expect to not participate in any activity that risks a fall which could re-injure your shoulder
Through the first year expect slight limit on the range of motion with some pain at the end of range of motion.

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Page last modified: Sep 18 22:02 2006 by Tom Unger

Left Shoulder November, 1993	Right Shoulder October 25th, 2000
	Initial work to expose the damaged joint capsule
	I think the device with the wire is used to cauterize bleeding blood vessels.
Me under the sheets. They are right in my face and I have to keep my head turned to the right.	This time the left me more space under the sheets and Kim would occasionally push them out of my way.
	When I saw this photo I thought: "Ouch! No wonder my shoulder hurts."
At some point during this surgery they discovered that necessary instruments had not been sterilized. This causes a delay of ten or twenty minutes.	I felt a lot of jostling, more than I was aware of in the first operation.
At one point Dr. Kirby warned me that they were going to hammer on my bone. I told them to get some pictures of this so they hammed it up a little.	The hammering roughs up the surface of the bone to which the ligament will be attached. As they both heal they grow together.

	Drilling the holes.
This diagram shows how the drill cuts a curved hole.	If you look closely you can see the cutter heads of the drill.
	Now they must be sewing the joint capsule to the bone.
Another diagram of the incision and where the sutures are placed.
This large machine was called the "narkomed". I thought that was a great name.	Here they are dressing the incision. I'm looking over my shoulder to see if this OR also has a narkomed. It doesn't

As they wheeled me out of the OR I snap this picture of Dr. Kirby. They took me to the recovery room. The folks there took one look at me and said I was doing well enough to go directly up to my room. I'm wheeled back out, up to another floor, then shifted into a bed	They shift me from the table to a gurney and wheel me down the hall. I snap this picture of Dr. Kirby leading the way to the Recovery area. I'm left in the gurney while they take my vitals.
That evening some friends come to visit me in my hospital room. I'm feeling pretty good.	Everything looks fine, so they have me get up and move to a chair where I wait for Marie.
As I was leaving the OR the anesthesiologist said something about how I won't appreciate the nerve block until it wears off. It wears off sometime during the night and my shoulder hurts. The nurse hooks me up to a Demerol drip. It is a machine that will in inject Demerol into my IV when I push a button. But it is calibrated to allow only a limited amount each hour. I get three shots an hour and I pace them at 20 minute intervals. By the time 20 minutes is up I'm ready for my next fix. Some time in the early morning they remove the IV. Latter I stagger into the bathroom to pee, and snap this shot in the mirror.	By that evening I'm back home and feeling pretty good (the nerve block hasn't worn off). I check my e-mail and laboriously write one or two messages with my left hand. Marie and I watch a movie and soon I'm falling asleep. Marie makes a nest for me in the spare bedroom where I can sleep in a sitting position and I have a very restful night.
My recovery takes a while. Laying on my back causes my shoulder to ache so for weeks I must sleep sitting up. Even after a couple weeks typing at the computer for very long will cause my shoulder to ache.	By noon on the next day the nerve block is wearing off and my shoulder aches. It is not terrible pain, but enough that walking around help take my mind off it. Shelly calls and suggests that I can take the Perkaset a little more frequently than prescribe for a short time. I do that the second night and sleep well again. By Friday morning my shoulder is less achy and I'm taking the perkaset less often than prescribed then begin to alternate with Tylenol. But by that evening I'm feeling the constipating effects of narcotics. I'm only on the narcotics for three days, but it takes my system over a week to recover. My right shoulder recovers faster than my left. Laying down causes it to ache, but with in a couple days I can easily type with out any pain. Every week it is noticeably better than the previous week.

My Shoulder Surgery

Part 2