just one possible option you may have here only because they DO use what is called an "intrascalene type of block" for this, is to actually have this done more 'awake" and not full general where they DO have to give full general anesthesia and also intubate you too which also has its own certain risks there. i have spinal cord injuries that also damaged my sympathetic in my face, along with insane pain pathway damage that 'deranges" my pain now? i had developed a really crazy sick pain syndrome after the week before my rotator surg from a simple drill and fill at the dentist just exploded the R side of my mouth and jaw? it was ONLY becasue of the risks added from intubating me and how the pressure of that tube itself can lie in your mouth with direct pressure that very easily in me could have made an already insane situation much worse, that the anesthesiologist even brought this type of sugery up to me?
your arm is pretty much 'dead' after that level of block(supposed to last at least 12 hours but can go even longer or a bit less depending upon how you actually metabolize it) and they also use very heavy doses of fent and versed to keep you pretty much totally asleep during this too? the real huge advantages of doing it this way are huge, only becasue you are NOT having to spend like the whole following week metabolizing thru your liver/body, all of that nasty anesthetic that can also be pretty hard on your liver, along with them giving you tylenol based pain meds that also hit your liver too on top of this? and absolutely NO intubation risks either since you just continue to breathe on your own but kind of in a deeper sleep?
and he also guarenteed me that i would feel great post op unlike with the general does and you also have to lie in that recovery room til you are fully awake? none of that happens either. i DID feel really great after that surgery just like he said, and was brought immediately from the OR up to my room too and was also starving/actually WANTED to eat. not like my other five surgeries i have had to have at ALL post op. since no one ever knows exactly how my bizarre body is going to ever respond post op to any surgery, my wonderful ortho who actually DOES understand how cord injuries along with the insane pain and other freaky syndromes i ended up with too are just going to 'be" or hit me, he always has me stay overnight just to make certain if things hit the fan, i will have my pain and other reactions(severe spasticity) managed too(i love this surgeon. he has now also done two knee and one rotator on me at this point).
but this just really IS one really great possible option you can discuss with the anesthesiologist before your surgery or let your surgeon simply know that you heard this just can even be done this way and see if they will do this for you too? this seriously is something i WOULD do again in a heartbeat if any area just can be totally blocked at all for it? i felt soo good up til that block of course started to actually dissapate on me a bit early(i also now hypermetabolize things? just a bundle O fun here)? that is when you will need that little icing compression device for pain control more than anything? i am sure it has been ordered for you? ice realistically here, only because your pain is not going to be stable til that entire arm becomes recognized and that block is done, its very difficult to even TRY and fully capture any pain from block dissipation since with each area that becomes "normal' usually the closer to the actual surgical site, naturally will allow you to feel it with a bit more pain? so it will not be anywhere near a "stable/constant' level of pain til everything gets normal? once that whole block is fully out of that arm/shoulder, THEN and only then even if that pain is extremely high, you can finally capture it and pull it back down with narcotics. so ice will be your very best freind there for awhile til that part gets over and the narcotics simply are allowed to work and do what they do best, kill pain or at least take that edge off?
either way, the suergeons DO use that block so you are not feeling the immediate wake up and want to die level of immediate post op pain and inflammation you WOULD have if they did not block you? they also need all those muscles/tendons to simply lie as still as possible while they are doing surgery? since anyone can have true muscle movement while someone is actually repairing tendon and muscle, they simply fully block the area so that will not actually occur. i just truely loved how well this went and how i esp felt even immediately post op and not having to feel them pull that dang tube out of my throat if they do not read the 'signs' in any patient who is actually waking up and trying to pull the tube themselves, helloo? there also is no loss of voice, no sore throat or risk of damage to your vocal cords which just is an inherent risk with any intubation done on anyone. i just could really see after speaking with the anes soo many real positives in having only the block and heavy sedation(LOTS of fent, wow) but really could not think of any real big reasons not too? and i am glad i did this this way and for many mnay different reasons.
i would just discuss this if you want to go this route since it IS possible to do it this way and minimizes just what are inherent risks using the general, tho some are pretty small(some are just bigger ones too), with any real surgery where they use total general anesthesia. just having had way too many other surgeries done to actually even compare the "overall effects" and how I simply truely felt with both "ways', that awake with heavy sedation was amazingly better than the old standard general with intubation was. just my own opinion there.
just make certain you are offered the best of the best type of icing and hopefully with compression device which you would simply pick up when you get your sling too? this is also when i ordered my CPM chair to be delievered to my home and used like day three post op(cannot recall exactly since my surgery was a few years ago)? its called a continuous passive motion device/chair to use to keep that crucial acro joint from freezing up as well? its called the "CPM chair" and it really also helped my pain levels go down too? on top of the excercises they will have you do at home to also move that joint without using ANY muscle or tendon, that chair does this for you too with also NO movement on your part of the tendons or muscle? it ONLY keeps that joint moving(slowwwly up, then slowwwly down) and keep it fully lubricated within that capsule where it sits? this really helped me kind of get ahead when it came time for the hands on PT part too? its just definitely a huge benefit after any shoulder surgery puts that arm out and in only a sling for too long? i used it like four or five times a day til i reached a particular degree mark set by my ortho, then i just called the place and they came back and picked it up for me. just make certain your doc orders that for you too. it really does help alot or i would not have mentioned this at all. most good orthos simply always rx this.
whatever you chose here, i do hope things go well for you. planning ahead for when you get home now too is also a huge help just having things set up for not being able to use an arm for awhile? but i would ask your ortho re the 'awake' surgery, esp if you will be going home that same day as most do? you wont have to feel like crap from alot of different things, only have to deal with that shoulder pain stuff too. and ice ice ice. really great for keeping any pain and inflammation down, esp for this particular surgery. FB
