Four weeks after my shoulder surgery

A report on the recovery process

Finally able to lift my arms above my head.

Four weeks in from my shoulder surgery and things are feeling like they are getting back to normal.

It's interesting—as a physician for many years, I’ve come to appreciate the struggles of my patients. I try to be very empathetic, focused on helping them to get better and charting that course. Nothing creates more understanding of that process than having a medical issue yourself!

While my surgery has been uncomplicated to date, except for a brief trip to the ER I’ll describe below, it is a reminder of the ups and downs we all face on our personal road to recovery. 

As I wrote last month, I needed shoulder surgery to decompress chronic inflammation and pain around my AC joint. The first week, as would be expected, was definitely the worst with typical pain and significant difficulty sleeping.

The one thing I did not appreciate at the time was the degree to which a combination of general anesthesia (though brief) and sleep deprivation could impact my mental sharpness. For several days after the surgery I had periods of forgetfulness noted by my wife Amy, as well as our son Chance. I noted it as well and like most people brushed it off. The foggy memory cleared in several days and was a reminder of the powerful impact certain conditions have on overall cognition.

The importance of good sleep is now frequently recognized as critical to physical, cognitive and mental health. This coupled with being over 60 years old is a reminder of the importance of prioritizing sleep as a foundational pillar of health. 

Following doctors orders

It is said that physicians make the worst patients.

I do not argue with that statement. In many ways, I embody it. As I tried to take off the sling after a couple of weeks (after all, I am generally a very healthy person so not subject to the typical post op instructions for most people), I definitely noted days when I overdid it and paid for it the next day with significantly worsened pain.

There is also a balance between being too cautious and being overly cavalier about recovery. Go too slow and you prolong the recovery as well as return to full functionality. Go too fast and you risk doing damage to the initial surgical procedure results setting you back significantly.

My orthopedic surgeon told me about a patient who drove himself to their two week post op appointment (a definite no no) and had an accident while leaving the office resulting in damage to the surgical site. 

A brief trip to the ER

It's not that my recovery has been completely smooth.

On post operative day three, I had several spells of what can only be described as a sense of impending doom. It’s a quasi medical term when a patient feels like they are going to die—never a good thing!

I had several waves of profound weakness followed by some tachycardia (rapid heart rate) and some sweating. At that time I called Amy who was at our farm, who told me, "I think you should come home." I am not a complainer and that certainly set off some alarm bells.

I felt bad enough that we called 911 to take me to the ER for an evaluation. One little known fact is in 2019 I had a small stroke due to a blood clot likely starting in my pelvis after a long plane ride. While I was taking lovenox (a blood thinner) post op there was a small but real concern that what I was experiencing now could have been a pulmonary embolus (blood clot in the lungs). 

When I arrived at the ER I was still not feeling well, but better than at home. The appropriate testing was done and a pulmonary embolus was ruled out. They monitored for several hours and gave me IV fluids which made me feel a bit better.

While my surgery was not "major" it was still surgery. I began to piece together the reasons for feeling so terrible. I surmised it was a combination of interactions between the narcotics (although I was only taking them twice a day) with some supplements I had restarted. I'd also taken some GI motility agents as I knew the narcotics were going to, and did, significantly slow down my gut.

What a lesson to re-learn: even supplements can interact poorly and cause negative side effects. 

Physical Therapy

In Physical Therapy

I started PT on schedule, doing home exercises as instructed and am progressing along nicely.

In the physical therapy office I am one of many "walking wounded" with various maladies: back pain, hip issues, shoulder and wrist conditions. I am continually impressed by the professional knowledge of my PT team and their guidance of progressive exercises to strengthen my shoulder in a deliberate way.

It is a reminder that there are many professionals who influence our health. From nurses to doctors, chiropractors to acupuncturists, reiki specialists to physical therapists, massage therapists to counselors, and the list goes on, all having a role to play in helping you find wholeness and health. I often tell folks they need to "build their own team" for optimal health. 

What I've learned

These last four weeks have shown me the limitations of my physical ability and the need to be grateful for the last 60 years of my life.

I’ve avoided the orthopedic surgeon for the better part of 60 years—not a bad thing. But as the saying goes, it is downhill from here. An appropriate and appreciated term as a skier. The reality is changes occur as you age. That is not a bad thing. We make adjustments and focus more intently on the more important and foundational aspects in life.

It also reinforces the principles I talk about on a daily basis. Those four pillars of nutrition, movement, sleep and mental resiliency really do matter. As you age they become more important than ever.