My shoulder surgery

In December 2018 I underwent shoulder surgery after suffering pain for 18 months. At the time I thought it was old age but as the pain got worse and started to affect my sleep, I knew something wasn’t right.

My first point of call was an appointment with my GP who promptly ordered an X-ray and Ultrasound. The X-ray was done first and as is my practice (Hey I’m a journalist what can I say), I took a peek at the screen while the technician was checking my details and saw a large white circle that clearly shouldn’t have been there. It was enormous too.

Diagnosis

During the ultrasound I was lucky enough to get a technician who was normally based at a hospital ER. She took one look and said I had Calcific Tendonitis– essentially a calcium deposit sitting in my rotator cuff. This condition is caused when the tendons are damaged or injured and the body tries to repair them by throwing down huge amounts of calcium. Over time this calcium builds up inside the tendons causing massive inflammation and impinging on the joints – the movement of the shoulder relies on all parts working in harmony.

In my case the calcium was starting to lock my shoulder up when I lifted my arm and causing bursitis in the shoulder capsule as the shoulder tried in vain to function properly. The technician turned the ultrasound machine around and showed me what was happening as I moved my arm up and down, great for someone like me who is a visual learner. Once I could see what the issue was it made my understanding and ultimately my decision to have the surgery, much easier.  My left shoulder also showed a much smaller deposit of calcium.

An appointment with an Orthopaedic Surgeon confirmed the diagnosis and I was told the only option was surgical repair to remove the calcium deposits via arthroscopy and undertake any tendon repairs whilst in situ. Recovery was six weeks in a sling, no driving for eight weeks and extensive rehabilitation physiotherapy. Total recovery and full range of movement would take six months. SIX MONTHS! I was shocked speechless at this point as I was sure it could be flushed out or at the very least only require a short stint in the sling. But it was not to be. This is a major joint that requires careful and systematic recovery.

To have or not have surgery?

The difficulty for me was that I work contract work and don’t get leave entitlements. As a single mother and sole breadwinner, the thought of taking 4-6 weeks off work was laughable. BUT there was no other option. To continue working I had to have the surgery.

By December 2018 the pain was so intense, I couldn’t sleep, use a computer mouse and my shoulder was frequently jamming up. In the space of a week I took out a personal loan for living expenses and informed my employer I would be taking extra leave over the Xmas break to get the surgery done.

Surgery – what to expect 

This surgery requires an overnight stay in hospital and a visit from a Physiotherapist before you can leave. I was under a general anaesthetic for an hour and my surgeon had to cut both my Bicep and Rotator Cuff. I had 5 incisions in total and the pain was intense.

Before I left hospital, I was prescribed Endone, Ibuprofen and Tramadol, however this combination didn’t feel right to me. I visited my GP the following day and asked for a drug review and Targin was prescribed.

Recovery

The pain combined with effects from the pain relief meant I sat on the couch and watched Netflix for four whole weeks. Yes. FOUR. WHOLE. WEEKS!

I needed assistance to shower for the whole six weeks I was in the sling and was unable to dress myself, put on a bra or even put my hair in a ponytail. The risk of falling whilst recovering from surgery like this is high, with only one arm to support yourself and the strong pain relief making you vulnerable. Make sure you have someone to help you.

Pain relief

All Opioids (Endone/Tramadol/Targin) have major side effects, so they are not for the faint hearted.

Endone is a short acting opioid oxycodone hydrochloride – it kept me awake at night and I couldn’t keep any food down.

Ibuprofen was tolerated initially but after a couple of weeks it made me feel jittery and would wake me up at night feeling like I was having a panic attack.

Targin is the long acting opioid and is considered the best medication for this kind of surgery and was kinder to the body than the others.

About Calcific Tendonitis

Calcium deposits are very common. They occur either due to age or as a result of injury (tennis/golf).

However, my deposit was larger than most.

In most people if there is a tendon injury the body will eventually reabsorb the calcium. In the early stages some surgeons will attempt to flush out or break up the calcium in the joint. Some even suggest steroid shots into the joint for pain relief. But these don’t always work and can actually make the situation worse. Neither my GP or surgeon was willing to go down any of those paths, deeming them to be a waste of time.

Just before I had the surgery, I saw a Rheumatologist who diagnosed me with Enthesitis.

Enthesitis refers to inflammation of entheses, the site where ligaments or tendons insert into the bones. Common locations for Enthesitis include the bottoms of the feet, the Achilles’ tendons, and the places where ligaments attach to the ribs, spine, and pelvis. It is a distinctive feature of psoriatic arthritis and does not occur with other forms of arthritis like rheumatoid arthritis or osteoarthritis. Enthesitis can make the tissues in the affected area become ropey (known as fibrosis) or solid (known as ossification or calcification).

During 2018 I had issues with my knee, elbow, ankle and my shoulders. Every ultrasound report said I had ropey tendons.  Not one single GP in the same medical practice picked it up – but I could clearly see a link and sought a second opinion. Lucky, I did. Unfortunately, there is no cure except knowledge that I need to keep a closer eye on things.

THE fine print

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