Following surgery most patients will experience a variable amount of pain. Dr. Rajaratnam will give you a prescription for pain medication following surgery to control your pain.
You will be fitted with a Cold Therapy pack after surgery, which will apply intermittent ice to the shoulder to relieve pain.
If you feel you are having an extraordinary amount of pain following surgery despite taking medication please contact COG.
Following shoulder arthroplasty there may be a significant amount of swelling in the shoulder. This is normal. It is not uncommon for the swelling and bruising to travel down the arm into the forearm and hand and also into the chest and thorax. To help with the swelling you should perform simple hand, wrist and elbow exercises several times a day. If you feel you are having an extraordinary amount of swelling or bruising following surgery, please contact COG.
Shoulder arthroplasty is performed through a single incision, about a hands breadth long. You will have absorbable sutures (that do not need to be removed).
After shoulder arthroplasty a bulky over dressing will cover the wound to soak up any light drainage. This dressing will be removed prior to discharge home. You will have a much lighter waterproof dressing (called OPsite) underneath (against the skin). This will be changed at the COG offices if necessary during your wound care. We will change your dressing as often as necessary, until wounds appears dry and healed (usually 2 weeks). Usually there will be small white tapes across each puncture wound (called SteriStrips), which help keep the wounds clean and opposed. This is usually covered by a waterproof dressing. If you feel you are having any extraordinary amount of drainage, or thick blood is draining from your wound please contact COG.
Generally the sling is worn for 3 weeks. During this time you should wear your sling 100% of the time (including sleeping) unless you are doing your exercises, taking a shower, or sitting comfortably. For example if you are watching television on the sofa you may take your sling off and rest your arm in a comfortable position or if your wish to type on a computer or write you may sit at a desk, take your sling off, rest your arm on the desk and type or write. However, when you are up and walking even if in the house, it is safest to use your sling to avoid any inadvertent injury (i.e. fall, sudden motions)
If you are having trouble wearing your sling please contact COG.
You can gently use your operated arm to eat. It is easiest to slip your arm out of the sling and use your hand to feed yourself by bending at the elbow. Keep your the elbow at the side and do not reach or do anything away from your body (e.g. picking up a plate, cutting tough meat) or lift anything heavy (i.e. no more than a coffee cup).
Generally, you should not take a bath (i.e. soak the wound) until the wound is completely healed which may take up to 2 weeks. However, you may shower or sponge bath 24 hours after surgery (with the waterproof dressing). You may take your arm out of the sling when taking a shower and support the arm and its weight using the opposite arm or with a homemade cloth sling. After 2 weeks, you can shower by gently and briefly letting the water run over the exposed shoulder. Do not scrub the area. After taking a shower pat the wounds dry with a clean towel. It is important to keep the axilla (i.e. armpit) of the operated shoulder clean and dry. To clean the axilla, do not try to lift the arm or elbow away from the body using the muscles of the shoulder. Instead it is easier to lean towards the operated side and let the arm gently dangle away from the body supporting the arm. You can then wash and dry the axilla.
Depending on your surgery, Dr Rajaratnam will determine how long you should be protected in your sling. This is generally 3 weeks. It is unsafe to drive during this time. After your sling is discontinued it is recommended not to drive a vehicle until your operated arm is consistently and comfortably out of its sling. For some patients this may be another week or two.
Some patients have difficulty finding a comfortable position to sleep. For many patients it is easiest to sleep in a reclining chair or propped up with pillows in bed. This seems to relax the shoulder for many patients and can be easier to position the sling. If you sleep on your back it may help to place a small pillow behind the elbow or shoulder to help support the weight of the shoulder. If you sleep on your side (the operated side up) then it may help to place a pillow between your arms. When you are getting in and out of a bed or chair, try not to use your operated arm to push down.
Dr Rajaratnam will discuss with you when formal physical therapy will be required. In most cases, formal physical therapy will not begin until after your first follow-up visit. However, Dr Rajaratnam will instruct you on your home exercise program to be perform immediately after surgery.
Dr Rajaratnam will instruct you on when and which exercise to specifically perform following shoulder arthroplasty.
This usually depends on the type of work you do, how much pain you are in, and what type of surgery you have had. In general, most patients do not work until they are seen back in the clinic about 2 to 3 weeks after surgery. After this most patients are able to tolerate either single-handed work (i.e. answering the phone) or light deskwork duties only. After this your ability to work and your specific job duties will depend on your type of surgery and your rehabilitation progress. Please remember that it is unsafe to drive during your period of sling immobilization. However, you can contact COG to ask specifically about your job and when you can return.
Dr Rajaratnam is here to help you. Please contact the COG office if you have any problems, questions or concerns.