Rotator Cuff Injury 2.0: Part One

Rotator Cuff Injury 2.0
Part One

This article is a follow-up to the five-part article Rotator Cuff Injury.

Introduction

I first developed pain in my left shoulder and triceps on March 14, 2021. It was diagnosed by an orthopedic surgeon as a rotator cuff tear, later confirmed by an MRI as being two tears and a biceps subluxation. That led to surgery on August 20, 2021.

That surgery was successful. But as I was recovering from that surgery, by the spring of 2022, I developed the same pain symptoms in my right shoulder and triceps. It became especially pronounced after a somewhat hard bench press workout on May 8, 2022. That is when I made an appointment with the same orthopedic surgeon for the following week.

Bicycle Accident and Arthritis

That appointment was on Monday, May 16, 2022. I was first taken back for X-rays and then to the exam room. When the surgeon came in, we looked at the X-rays. They showed there was arthritis in the shoulder. I had the same in my left shoulder. But the arthritis in my right shoulder was more pronounced. That is because of the bicycle accident I was in way back on July 28, 1999.

Follow the preceding link for full details on that accident. But here, among other injuries, I fractured my right scapula and clavicle and cracked my shoulder socket. I asked the surgeon if he could see where those injuries healed. He said he could for the clavicle and shoulder socket but not for the scapula. I guess the break in the latter was not as bad as the other two. But the important point here is the arthritis is building up around where those breaks healed.

That means, here I am almost 23 years later, and I am still suffering consequences from that accident. Someone once said to me in this regard, “Accidents are the gift that keeps on going.” If I had known all of this back then, I would have held out for a larger insurance settlement.

In any case, the surgeon said I might need shoulder replacement surgery someday, but not for quite a while. Otherwise, he recommended three supplements: fish oil, turmeric, and glucosamine with chondroitin. I’m already taking fish oil, but I will look into the other two.

Not Just Arthritis

However, the surgeon did not seem to think all of my pain was from the arthritis, so he checked out my shoulder. I still have full range of motion (ROM), at least as full as its been since my bicycle accident. But there were many pain areas indicative of a rotator cuff tear.

As I explain in my previous rotator cuff story, I had a significant reaction to a second cortisone shot, so there was no way I was going to get a third one. And ever since I started doing therapy exercises for my left shoulder a year ago, I have always done them for right as well. I figured they might help with its still weakened state from the accident and was hoping doing so would prevent this very thing, developing rotator cuff tears in it also. But apparently that didn’t work.

In any case, since “conservative therapy” was not an option, the surgeon figured he could convince my insurance company to pay for an MRI, which will be my third in less than a year. Surprisingly, it only took a couple of hours, and I got a call from the surgeon’s office with the approval after I got home.

I made an appointment for the MRI on May 26 and a follow-up appointment with the surgeon on May 31. I will know then if I will need surgery. If I do, it could be as early as that Friday, June 3, if the surgeon has any openings. If not, it will probably be June 17, as he only does surgeries the first and third Fridays of the month.

That’s it for now. I will post about the results of the MRI and the follow-up visits afterwards.

5/17/22

MRI Report 3.0

I had an MRI my right shoulder this morning and already got the report. Below are the results of the MRI as copied off of MyChart:

Study Result

Impression: Severe rotator cuff tendinopathy with articular sided tear of the supraspinatus tendon. No full-thickness rotator cuff tear.

Glenohumeral degenerative changes with tearing of the posterior labrum.

Narrative

MR SHOULDER RIGHT May 26, 2022 9:53 AM

INDICATIONS:

Right shoulder pain

COMPARISON:

None.

PULSING SEQUENCES:

Multiplanar multisequence MRI of the right shoulder was performed without contrast.

FINDINGS:

ROTATOR CUFF:

Supraspinatus: Articular sided partial tear measuring 0.9 x 0.8 x 0.4 cm (series 4, image 6). No full-thickness tear. Tear involves approximately 50% of the tendon thickness.

Infraspinatus: Tendinopathy. No tear.

Subscapularis: Tendinopathy. No tear.

Teres Minor: Intact.

MUSCLES: Normal signal intensity and bulk.

BICEPS: Normal in signal and positioning.

LABRUM/CAPSULE: Intermediate T2 signal in the superior labrum at the 12 o'clock position. Focus of fluid signal at the base of the posterior labrum at the 9 o'clock position (series 2, image 12). The anterior labrum is not well seen. Capsule is intact. Lack of joint fluid limits evaluation.

CARTILAGE: Diffuse thinning of articular cartilage in the humeral head. Small areas of partial thickness cartilage loss in the central glenoid. Lack of joint fluid limits evaluation.

BONE: No marrow replacement process or acute fracture.

AC JOINT/ACROMION: Acromioclavicular joint space narrowing. Small subchondral cyst.

OTHER INTRA-ARTICULAR: No joint effusion. No intra-articular body.

EXTRA-ARTICULAR: Trace fluid within the subacromial subdeltoid bursa. No cysts or masses.

As with my two previous MRIs, I don’t understand much of this, but I do see the words “tear” and “tearing.” I assume that means I have two rotator cuff tears, just like was the case with my left shoulder. But I think it says my biceps is normal, so there is no biceps subluxation this time. But still, the two tears, with one described as “severe,” probably mean I will need surgery. But I will find out for sure next Tuesday (5/31) when I have an appointment with the surgeon.
5/26/22

Post-MRI Scheduling and Worries

As indicated above, I had an appointment scheduled with the surgeon on Tuesday (5/31), and I was hoping to have the surgery I now knew I would need on that Friday (6/3). But I feared if I waited until the appointment, the surgeon’s schedule for Friday would be filled, and I would have to wait two weeks, until the 17^th for my surgery. I am stressing out enough as it is already without that extra wait.

Consequently, I am glad I thought of calling the surgeon’s office later on Thursday after I got the MRI report. I was only able to leave a message for the person responsible for the scheduling. But I explained the situation. She then left me a message the next day telling me she could schedule me for the surgery on the 3^rd.

However, as with last time, I would need to get have an appointment with my PCP and get an EKG and blood test done before Friday. I immediately called my PCP and was able to schedule an appointment for Tuesday morning after my surgeon appointment. I will then go from there to the local hospital for the EKG and blood test. It will be a busy morning, but assuming all goes as planned, I should be good to go for the surgery on Friday.

In the meantime, I am really worried about the surgery and the aftermath. It will be months before I am able to work out with any degree of intensity, if I am ever able to do so again. But a more immediate concern is how well I will be able to function after the surgery. Last time, the surgery was on my left shoulder, with my left arm in a sling for weeks afterwards. But I am right-handed, so I was able to function reasonably well doing everything one-handed, right-handed.

But this time, it will be my right arm in sling, and doing just everyday stuff like dressing, eating, and brushing my teeth left-handed is going to be a chore. Making it even harder is that my left arm and shoulder are still not back to the strength level they were before this whole ordeal began over a year ago.

That means, I will be doing everything one-handed, with a weakened non-dominant hand. I am especially concerned about typing one-handed, left-handed. I managed reasonably well doing one-handed, right-handed typing last time. But one-handed, left-handed typing is going to be struggle. I fear I will not be able to get much work done at all.

Add in not being able to work out, and that eliminates the two aspects of my life that have kept me going for the past 30 years, my writing ministry and my powerlifting. With the former severely limited for quite some time and the latter possibly over for good, it is going to be a struggle. That is because my writing ministry and success in powerlifting have been the only two aspects of my life that have made me feel productive and have been giving me a purpose in my life.

In addition, last time I managed to drive one-handed, right-handed reasonably well, at least for short distances, so I was able to get out some. But this time, driving one-handed, left-handed has me very concerned. I doubt I will try it for even a short distance; just too risky. I will probably need my dad to drive me to my follow-up visits with the surgeon. And those appointments will be probably the only times I will leave my home for quite some time after the surgery.

With my Multiple Chemical Sensitivities (MCS), I already rarely leave my home. But I fear I will feel “trapped” with not being able to go out on my own at all. Also due to my MCS, I have a very limited social life, but now, it will be non-existent.

But, as the old song says, “I Will Survive” not by force of will but trusting in my Lord and Savior Jesus Christ to comfort me and to pull me through it all.
5/29/22

Busy Tuesday Before Surgery on Friday

I did as I planned. I had the appointment with the surgeon, then with my PCP, then got an EKG, blood test, and chest X-ray on Tuesday (5/31). All went as planned. But it took all morning, and I was exhausted and felt terrible afterwards. That is due to my fibromyalgia and MCS. Going to multiple places, especially medical establishments, always cases me problems.

Most important was the conversation with the surgeon. First, apparently, I misread the MRI report, as there is only one tear. But it is halfway across the tendon. The surgeon confirmed my fear that if I don’t get it fixed now, it could tear the rest of the way.

But he also said there was build up of something or other on a tendon, though I’m not sure if it is the same or a different tendon. But either way, he seemed confident he could fix the tear and clear off that debris.

Second, I asked him was how the damage in my right shoulder compared to what I had in my left shoulder. He said my left was worse, so recovery this time should be a bit quicker.

Third, I asked the surgeon what led to these tears, my bicycle accident, powerlifting training, or just normal aging? He said it was probably a combination of all three. I mentioned to him that since this ordeal began over a year ago, I have talked to many people with rotator cuff tears, and most of them were not powerlifters, but they were all about my age. He replied, “Well, there you go.”

That was about it with the surgeon. I then spent some time with the person responsible for scheduling the surgery. I told her I was heading straight from there to my PCP then to the hospital for the tests, so that would all be taken care of that day. It was just a matter of getting approval from my insurance company before Friday, but she said she would push them to be sure that happens. She then gave me pre- and post-op requirements, such as no food or drink after midnight the day of the surgery, and that was it there.

My PCP just asked a few basic health questions and did the normal blood pressure, eyes, nose, throat, and chest tests. Those were all fine. Then everything went as quickly as could be expected at the hospital. But still, it was 8:45 am when I left my home, and I didn’t get back home until after noon, so it was a full morning. I got a call later from my PCP telling me I was approved for the surgery.

The hospital will call me on Thursday to tell what time to be at the hospital on Friday for the surgery.
6/2/22

Final Powerlifts Workouts Pre-Surgery

After I found out for sure I would be having surgery on June 3^rd, I figured I could get in five more workouts. That would give me time to do each powerlift one last time, with doing Squats and Deadlifts in two different manners each. I train both forms for both lifts as I can and have competed each way. By doing all formats, I would have a good idea of where I would be at if I would have competed at this time.

My work sets for these workouts went as follows (pounds/reps). My bodyweight was about 121 pounds at this time.

Squats with Sleeves: Raw: 225/10, Gear: 255/5, 267.5/3

Squats with Wraps: Gear: 235/10, 270/5, 282.5/3

Bench Press: Raw: 90/15, 97.5/10, 105/5

Sumo Deadlifts: Raw: 275/10, Gear: 315/5, 330/3

Conv Deadlifts: Raw: 300/5*, Gear: 315/5, 330/3

The “Gear” consists of a belt, wrist wraps, and knee sleeves for the first and last two, and wraps instead of sleeves for the second, 2.0 meter wraps for the first set and 2.5 meter wraps for the second and third sets. Conv Deadlifts did not go as planned, possibly because of the problem I will address later. But here, after the raw set did not go as planned, I lowered the weights for the geared sets, and at least I got my planned reps.

With that, both forms of Squats and Deadlifts are about 10% off of where I was before my surgery last August. Basically, they are about where I would be a couple of weeks after having entered contest, with my normal drop in intensity before ramping it for the next contest.

With planning on entering a contest about every six months, that would have meant I might have been able to enter a contest before the end of this year (2022), if this new rotator cuff injury had not occurred. But as it is, it will probably be 2024, if ever, before I compete again, as it will take me even longer to get back to this level this time, with starting back at a lower level.

Benches, however, are far down from where I was before this whole ordeal began last March (2021). They are down 30%. And I am sure that will cause me to wait even longer before even thinking about competing in order to get them back up to a respectable level, if, I will ever be able to do so. But one thing is for sure, these workouts will be most last hard workouts for quite some time. And with that, all I had to do now was to wait for my surgery.

Otherwise, I had lots to do before the surgery, work-wise and around the house. I wanted to get as much done as possible with two hands, knowing all will be much harder afterwards with just one hand.
6/2/22

Insurance Approval Problems

I thought I was all set for my surgery on Friday. But then I got a call from the surgeon’s office Thursday at noon that the insurance approval had not gone through yet and if they didn’t get it by the end of the day, my surgery would be canceled. The surgeon would then be on vacation, so it would be a month before I could have my surgery.

I called the insurance company myself and was told the approval had gone through. The lady I talked to said she would call my surgeon’s office. Then an hour later, I got a call from the hospital that my surgery was scheduled for 7:00 am, and I had to be there at 5:50 am. That was rather early, but I figured that meant all was okay.

But then an hour later, I got a call from the surgeon’s office saying the approval had not gone through yet. I told her about my call with the insurance company, but she said she never heard from her. I called the insurance company again and was now told the approval had not gone through, and they had no record of the previous call when I was told it had gone through.

Another hour later, just as I was starting to work out, I got a call again from the surgeon’s office. Now I was told my surgery for 7:00 am was cancelled, but they would still work to get the approval and maybe I could still get my surgery later Friday, so don’t eat anything after midnight.

Now, Thursday evening, I have no idea if or when I will be having surgery tomorrow. All I can do is hope and pray I get a call sometime tomorrow and am told I can get the surgery before the end of the day. Otherwise, it could be July before I have the surgery. By then, not only will I be a nervous wreck, but the damage in my shoulder could get worse, making for a harder surgery and longer recovery.

Needless to say, I am as very upset and stressed out over all of this. Prayers are appreciated.
6/2/22

Surgery Rescheduled

After spending all Thursday afternoon on the phone, I spent all Friday morning on the phone. The end result was I did not have surgery on Friday, so I went half of the day without eating and drinking for nothing. It was not until almost noon I knew for sure I was not having surgery, so I ate lunch.

As mentioned, usually my surgeon only does surgeries on the first and third Fridays of the month, but for some reason, he will not be doing so on June 17. That would have meant I would need to wait until July 1 to have surgery.

But that was only his schedule for my local hospital, which is just a couple miles from my home. He also does surgery at two other locations. One is only ten miles away, and he is next doing surgeries there on Tuesday, June 14, Flag Day. Thus, tentatively, I am I scheduled for surgery on that day.

I say “tentatively” as after this fiasco, I won’t feel confident I am actually going to have the surgery on that day until they are putting me under.

In the meantime, I will be stressing out, not knowing what to do workout-wise. I cannot not work out for two weeks, and I am still rehabbing my left shoulder, so I have to do something. But I don’t want to aggravate my right shoulder.

The pain is not too bad now, but that was the case with my left shoulder. I complain throughout my original Rotator Cuff Injury story about the delay in getting surgery. Part of my complaint was it got worse over that time, causing me more pain, making the surgery more difficult, and the rehab longer. I tried explaining to my insurance company that is why I wanted to have this one right away, so as not to have those same problems again. But here I go again with another delay this time.

But hopefully, things work out and I can have the surgery on June 14.
6/4/22

Surgery Delayed, Maybe Cancelled

I was supposed to be having surgery today (6/14/22) on my right shoulder. But it still has not been approved by my insurance company. Meanwhile, my shoulder and arm are feeling better than they were a month a go when I began this whole process, though still not quite normal, while I still have some pain in my left shoulder that I had surgery on last year.

Basically, the pain level is about the same in both, though the left was far worse before the surgery than the right has ever been. As such, I am not sure if I would go through with the surgery on my right shoulder even if it is approved by my insurance company.

I have an appointment with the surgeon on Friday, June 24. By then, I should know one way or the other from the insurance company whether the surgery is approved or not. Either way, I will talk with the surgeon at that appointment as to my options and what the outlook would be if I have or do not have the surgery. If I do have the surgery, it will probably be the following Friday, July 1.
6/14/22

This article is continued at Rotator Cuff Injury 2.0: Part Two.

Note: The product links are to Amazon, from which I received a commission if a product is ordered after clicking on one of the links.

The above article was first posted on this website May 17, 2022.
Updates were added as dated.

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