Sunday, January 15, 2012

6 Days Out From Shoulder Surgery

I have been terrible about blogging once again so please accept my apologies. My shoulder surgery was 6 days ago, it was supposed to be just a distal clavicle resection. When my OS got inside he found a type 3 acromion so also performed an acromioplasty and a subacromial decompression.
The first 4 days were incredibly difficult and painful. On day 5 things got a lot better, the pain has gone down, I was able to stop taking narcotics, and I can almost dress myself all by myself.
My hip has been amazing since I've been on painkillers again. The last time I had hip pain was in the PACU immediately after surgery. I actually asked for ice for my hip, not my shoulder initially.
I had a lot of issues in the PACU this time and did not get along with the nurse who was assigned to me. This was my only bad experience ever at the hospital. Unfortunately it was my 6th surgery, I have pretty much figured out what helps my pain and what doesn't, as well as what I can tolerate. She was extremely stingy with pain meds and at one point she gave me 2 Percocet which didn't do a whole lot for me. After 20 min I called her over and asked her to give me something else. She said she could give me ocycodone, I said no, I want Dilaudid. She told me the order the anesthesiologist had put in was expired, so I told her to go call him and get another order. In the end it took her 45 min to get my meds. In the meantime I was lying in bed crying from the pain. She did nothing to help me or show she cared. In fact, the only person who showed any concern was my hip OS' PA who moved the ice from my shoulder to my hip. I finally got dialaudid and my pain got better.
I spoke with my hip OS a lite bit as well. I told him I still have butt pain and I'm seeing him next week so he has time to figure out why!
Once things calmed down with the nurse, I said to her I have has 6 surgeries here, I know what works for me and what doesn't. Of course she had a reply to that and told me that she also knows what works and what doesn't. Later in the day I asked her when I was due for more pain meds, she said 9pm but I should wait until I got home to take more. Luckily her shift ended and I was assigned a new nurse. He was amazing and I had him last time as well. At 8:55 I was ready to leave finally and asked him for pain meds. Without missing a beat he said of course, it would be so helpful for the ride home.
I'm really not sure how my hip is since the pain is been having has been masked by the meds I'm
taking for my shoulder. I has my first outing last night without a crutch so thrilled. It's been 61/2 weeks on crutches.

Sunday, January 8, 2012

Shoulder Surgery Tomorrow

The day I posted about my shoulder hurting I never thought would bring on a post with this title. But lo and behold here we are. Yes, I am still using one crutch and still struggling with my hip. I really hope I am making the wisest decision. I know that in about 3 months from now I will be very happy, it's hard to see that moment right now! I will update when I can!

Sunday, January 1, 2012

Happy New Year Aetna Members

This was recently posted as a comment under an older post.

Looks like Aetna has finally reconsidered their policy! Aetna posted this Clinical Policy Bulletin on 12/30/11 regarding
"Femoro-Acetabular Surgery for Hip Impingement Syndrome".

"Aetna considers femoro-acetabular surgery, open or arthroscopic, for the treatment of hip impingement syndrome medically necessary for persons who fulfil all the following criteria:

* Diagnosis of definite femoro-acetabular impingement defined by appropriate investigations, X-rays, MRI and CT scans.
* Severe symptoms typical of FAI and compromised function, with duration of at least six months where diagnosis of FAI has been made as above.
* Failure to respond to all available conservative treatment options including activity modification, pharmacological intervention and physiotherapy.
* Aged between 18 and 50 years (clinical experience has shown that these patients are likely to gain the greatest benefit).
* Absence of advanced osteoarthritis change on preoperative Xray (Tonnis grade 2 or more) or severe cartilage injury (Outerbridge grade III or IV).
* Absence of joint space narrowing on plain radiograph of the pelvis that is less than 2 mm wide anywhere along the sourcil.
* Member does not have generalised joint laxity especially in diseases connected with hypermobility of the joints, such as Marfan syndrome and Ehlers-Danlos syndrome.
* Member does not have osteogenesis imperfecta.

Surgery for FAI impingement is considered experimental and investigational for all other indications."