Manipulation Under Anesthesia for shoulder? Anybody ever had one?

[woodsprite]

I dislocated/broke my shoulder back in March. Range of motion hasn't come back as well as the dr. expects. He did say that it could be up to 24 months before I know how much range of motion will come back without doing something in addition to physical therapy. Apparently the 6 hour delay in putting my arm back in place and 40 days in a sling caused the scar tissue and surround structures to tighten up. Even with the PT leaning on my elbow and arm to get my hand to cross my body and touch the other shoulder hasn't been working to stretch the labrum. I would say I'm about 40% back at this point. I can compensate for most of what I would do, but things like pass a dish at the table, reach out to a drive through or ATM, make a sharp right turn while driving, reaching up or out for anything like cleaning, archery or swimming, etc.

The doc said I could wait 24 months, then choose additional intervention if I needed to extend what range of motion returned, or he could do a "manipulation under anesthesia" now where he forces my arm to move and breaks up the scar tissue. Then I do PT immediately after the procedure and every day for 2 wks after.

I'm scheduled for this Wednesday and have no idea what to expect. I'm 52. I don't want to wait until I'm 54 to find out if I need more stuff done. I'm usually pretty good when it comes to pain as long as I know what to expect. I'm assuming it will be a setback, but not quite as far or as painful as the original dislocation.

Was wondering if anyone has gone through this and if you could share your experience and give me an idea of what to expect. I'm probably most concerned about the experience, and if it really is a step back, how long until it felt you were making forward progress in recovery again, etc.

[Lars39]

1. How's it going, woodsprite?

Hope all is going well.

[woodsprite]

2. Better than I thought I would be!

I have to keep stretching (every 3-4 hours) but I guess I really did need the procedure done. I was so apprehensive about having it done, but it gave me back almost 100% range of motion! I hadn't been aware of exactly how much range I had lost. I'm on pretty good pain meds though (5mg oxycodone every 4-6 hrs during the day - I can function at work with that dose, 10mg oxycodone about an hour before my daily PT session and 4mg dilaudid before going to bed).

Last week, the nerve block they gave me kept me numb for 2 days. They didn't tell me that it could cause me to have problems swallowing or taking a deep breath when I first woke up in recovery though. Couldn't clear my throat or cough either. That bit was kind of scary, but I had overcome those issues within about 3 hours of being released from the surgicenter. The actual procedure only took about 15 minutes.

There has been a concern re: my BP. it's been kind of all over the place (but my pain level has not been below a 2-3 out of 10 for the past 2 months and I'm on pain meds as needed). They are monitoring it and I have an appointment with a new family doc. They didn't listen to me when I told them my other docs insist on taking it with a large adult cuff. My PT people said it doesn't really make a difference, but I'm thinking they might be wrong on this one because they're getting readings equivalent with when I went into the ER with the original dislocation and break with no pain control.

I think I'd be a happier camper if I felt it was safe to take the prescribed anti-inflammatory (Naproxyn). The last time I took a prescription anti-inflammatory was several years ago (Voltaran) for my knees and it worked like an absolute charm. However, it truly did make my BP reading go from 120/76 to 180/98. Three days after going off them, I was back to arthritis strength Tylenol, but my BP was normal again.

The plan right now is to do daily PT at least for another week, then back down to 2-3x weekly.

[Lars39]

3. Wow!

Back to almost 100% range motion is great! PT is a booger, but it sure beats being being frozen.
Can't give in to scar tissue or it starts messing with stuff. I'm glad the throat numbness went away fairly quickly. Do they know you're not feeling like you can safely take the Naproxyn? There might be a different one you could take, or they might be able to prescribe something to go with it to handle the rise in BP. Don't know the drug interaction stuff, but it might be worth asking about.
I'm so glad you're having a good outcome from the procedure.

[woodsprite]

4. For now, they said just handle the swelling with ice.

But not too much (they're afraid it will make it stiff), then use some heat on it before stretching to loosen the muscles a bit. That's why I want to get in with a regular family doc. I figure he may know more about drug affects on BP, or care more, than the joint docs do.

[Lars39]

5. Yep, that's the PT drill.

Might be that's it's healing well enough without the anti-inflammatory? Hope you get in to see a regular doc soon. They might want you to get your own BP monitor to take readings at different times of day.