What to Expect
Prior to your surgery
You should have ceased any anti-inflammatory or ‘blood thinning’ medication at least 7 days prior.
The hospital will usually contact you the day before to notify you when to come to hospital, what to bring, and when to stop eating/drinking. You will be asked not to eat or drink anything for 6 hours prior to your surgery. Note that some medications can be taken with a sip of water. Please confirm this with the nurse.
The day of surgery
PLEASE BRING ALL XRAY/CT/MRI FILMS WITH YOU ON THE DAY!
You will be admitted to the hospital a couple of hours before the operation. All necessary paperwork will be checked and completed, and a nurse will see you and ensure that you are fit and prepared.
The anaesthetist will then come and discuss your anaesthetic. Most operations are performed under a general anaesthetic.
Depending on the surgery, the anaesthetist may also use a ‘block’. For upper limb surgery, this is usually an injection into the side of the neck called an interscalene block. This is an excellent means of controlling postoperative pain, and it is also beneficial in helping to decrease bleeding during surgery.
If a ‘block’ is not used, Dr Sherlock routinely uses local anaesthetic injections or a pain infusion device (Painbuster) as a means of controlling post-operative pain.
Dr Sherlock will then see you to discuss the operation again and answer any final questions you may have. He will mark the area to be operated on using an indelible marking pen.
Do not worry if you are asked many times ‘what surgery are you having?’ and ‘which arm?’ This is normal hospital protocol.
When it is time for surgery you will be taken on the trolley to the operating theatre.
After the surgery you will be taken to a recovery ward where the nurses will observe you whilst the anaesthetic wears off.
You will awaken from surgery with your arm in a sling and an ice pack covering the shoulder. Temporary compressive/absorptive dressing covering the wounds will be in place. This acts to soak up excess fluid from the surgery (arthroscopy uses a lot of water to irrigate the joint during the procedure). This will be removed and the dressings changed, as needed, prior to your discharge.
If you have had an interscalene block, the arm will be numb and “dead” for up to six hours after surgery. Once this starts to wear off you will notice some pain. Notify your nurse as soon as you feel pain so that you can be given some pain killers.
Following arthroscopic rotator cuff repair, your hospital stay is usually one night, however, this can vary.
While in hospital you should be seen at least once by a physiotherapist to show you how to adjust your brace. This will allow you to support your arm and maintain position of the shoulder and elbow for maximum comfort and protection of your repair. Simple exercises will have been given to you at that time and these should be repeated on a regular basis.
When at home
For most shoulder procedures, you will have an Ultrasling which should be worn day and night for the first 4 weeks, then during the day only until 6 weeks (unless stated otherwise by Dr Sherlock). The aim of the sling is to take some of the tension off the repair. You can remove the sling for exercises and when sitting quietly—but keep the arm elevated on pillows or an armrest.
The pain is often worse at night, especially the first few nights. Some patients find it more comfortable to sleep a little more vertically, for instance, in a recliner. Take your pain killers regularly, especially during the first week, and don’t forget your ice pack.
The wounds will be covered by waterproof dressings which are suitable for showering if intact. If they are peeling off or not watertight, you can purchase more from most chemists.
An increase in body temperature is common following an operation. If, however, you have persistent fevers, sweats, rigors and/or worsening shoulder pain, please contact the rooms during business hours or the hospital where the surgery was performed at other times.