Shoulder Surgery – Biceps Tenodesis+ – Surgery Day

DISCLAIMER – Just to re-emphasize the point, this information is provided as a record of my particular experiences and should not be construed as medical advice. Each surgeon, patient, surgery, and recovery protocol is particular to that situation.

Instructions were pretty standard for surgery-nothing to eat or drink after midnight, stop all supplements and most medications two weeks prior, things like that. My surgery was kind of late in the day since we were arriving at 12:30 but I didn’t even get hungry until then.

They had suggested a cold therapy unit which unfortunately is not often covered by insurance. You can sometimes rent them as well. When I saw that the price was about $130 we went ahead and purchased one. I wasn’t sure at first but you’ll see plenty of people on forums suggesting them. I have to agree with what I read that it seemed to help me with the pain and recovery quite a bit. If you do get one, bring the pad with you to surgery as the nurses will put it on you before you are sent home.

We saw both my surgeon and the anesthesiologist before hand and found out that I was going to get something a little different for this one-a nerve block. I will talk more about that later but it was pretty amazing.

The Takeaways

  1. If possible get a cold therapy unit. It definitely helped especially in the first few days and I’m sure it will be helpful during physical therapy as well.
  2. If you do get a cold therapy unit, bring the cold pad with you so that the nurses can put it on for you.
  3. Have some individual socks and pads available. I sometimes had a sock in my armpit, other times used socks to pad my neck, elbow, and wrist. Early on before I readjusted it we even plugged socks in around the cold pad to make sure it wasn’t touching my skin.
  4. Remember that you will only have access to one arm for a while. I was able to open a lot of things with my right hand but was not able to get into my own pill bottles for the first few days. Try to prepare your house ahead of time and make sure you have somebody at least checking on you.
  5. On the note of having only one hand to use, have help available that you are comfortable with. You will find that bending over is very difficult at first. I needed help with my pants to go to the bathroom pulling them up and pulling them down for about two days.
  6. Make sure you have some Cottonelle fresh wipes or something similar in the bathroom. Just trust me.

Getting Prepped

Basically this was the standard undress, remove jewelry, etc. I also got into my compression socks and was fitted. with pneumatic cuffs on my legs. They got the IV in and we talked to the surgeon and anesthesiologist. *This is your main opportunity to ask questions with a clear mind so be ready!

They said that once you go in it takes about 10 minutes to set up the nerve block and that because of meds “no one cares”. Considering it is a needle in the neck I wasn’t so sure but it is true. Whatever they use before hand I wasn’t bothered by anything. The block left a bruise and an ache but I’m convinced it had a huge impact on how smoothly my wake up and recovery went.

After this I was out cold.

Recovery Room and Rest of the Day
I woke up and went from completely out of it to functional like I was pushed out a window and clarity was the ground. I’m not sure why I woke up so much more quickly but the nurses even commented on it, and it was a noticeable difference from previous surgeries. That didn’t help me to remember doctor Zooker when he checked on me afterwards but shortly after his visit I was relatively alert. I tend towards thinking that there is less anesthetic because of the block which lends towards waking up quicker and feeling normal more quickly.

I am convinced that the nerve block is as close as many of us will come to losing a limb. It certainly re-creates the feelings I have been told about at least when it comes to things like ghost senses. I was certain that my left arm was laying across my leg with my hand in my lap. When they pulled aside the sheet my arm was actually sprawled off to the side not in contact with me at all otherwise. What an odd sensation and a jarring moment mentally. This continued in various ways through the night and into the next day as the block wore off.

We went home and set me up in the recliner where I could sleep without rolling over onto my arm. I was able to eat regular food fairly quickly but I already knew that I don’t tend to get sick after anaesthetic so your mileage may vary. 

By the next day the nerve block was wearing off and I was feeling pins and needles. Other than that I had no significant pain and by the time it wore off I was already on my pain medicine. Just for the record they say that the nerve block can last anywhere between 12 and 20 hours. For me, they put it on somewhere around 2:30pm. By the end of surgery day I was able to flinch my finger closed a little bit. By the next morning at 11:22am, I could start to open my fingers some as well. It continue to wear off gradually through the day.

Last things for the first 24 hours

Remember that with the nerve block on you can’t feel anything in certain places. That means you have to be very careful with the cold unit to make sure that there are pads in between it in your skin and that it is set to the right level. Anything else that can cause issues you might not feel can also cause problems. The brace you get has a foam pad that goes in your hand to help keep it in place and partly open. For whatever reason my pad was always too tight. Even when we tried to adjust it I could not get comfortable and we ended up cutting it off. When the nerve block wore off I noticed that my phone was still very uncomfortable. I looked at it and there was a large blister that had formed from the pressure of the grip pad. Just have someone check your arm visually to see that nothing is causing problems you cannot feel.

The last thing I think is also from the brace but I’m not 100% certain. The brace has two metal pieces-one that wraps around your torso and the other that holds your arm at a distance from your body. I found that I had pain vertically and underneath the rib cage near my stomach area that felt very much like a runners stitch. I noticed it most as I breathed deeply and the stitch really hurt then but I feel like breathing deeply, adding socks for padding, and adjusting the brace some all helped it to feel better. By day two, the day after surgery, this pain seem to go away.

That’s it for the first 24 hours. I will update after my first postop, and once I start physical therapy which won’t be until after four weeks. If you are reading this, I wish you or your loved one well on their own surgery and recovery.

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