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Thread: Shoulder replacement for someone with a complete spinal cord injury

  1. #1

    Shoulder replacement for someone with a complete spinal cord injury

    I know I have asked this question before. But the answers were about people without spinal cord injuries or people with incomplete spinal cord injuries who can walk. It's nice to know the surgery works for them. But people who can walk or even people with incomplete spinal cord injuries don't rely as much on their shoulders as someone with a complete spinal cord injury. So please respond only if you or someone you know has a spinal cord injury and had a shoulder replacement. When did you have it? How long was the rehab? How long before you could transfer independently? What are the results like now?

  2. #2
    I know two paralyzed persons who have had shoulder replacement surgery. One, a quad, the other a para. I'm sorry I don't know much about the outcome after several months. I only know from them that they arranged ahead of time for attendant care for several weeks. One of them was in a nursing home/rehab facility for several weeks. They were told not to use arm during this time, then some range of motion, progressing to more PT.
    Both were in their 50's, with limited transfer skills prior to surgery. I think pain was a big reason for the surgery, rather than to improve transfers.

    I have to add that I don't think most doctors/surgeons realize the helplessness of a paralyzed person who has an immobilized arm due to shoulder surgery. I would suggest a frank and graphic discussion of everyday personal care activities with one's surgeon. I know of one person - non disabled - who had this surgery and carried on her daily activities using her other arm - no significant problems.

  3. #3
    You can not use that arm for many weeks, and you must have therapy. Sometimes it takes months to recover and you must have some one take total care of you- except you should be able to feed yourself and use the other arm.
    It is major, major surgery.
    CWO
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

  4. #4
    Yes. That is what I am gathering. I will probably avoid it as long as possible, hopefully forever. The only thing that would encourage me to have the surgery is to know there is significant upside, like no more pain, regaining full strength and range of motion. Otherwise, why take the risk?

  5. #5
    While we had only a few SCI Veterans who had shoulder replacements; most had rotator cuff repair surgery, but the recovery period and restrictions is pretty much the same:

    Our SCI physicians coordinated the admission with the orthopedic surgeon, who was generally clueless about what activities these patients usually had to do with their shoulders on a daily basis, and assumed the care of the Veteran on the SCI unit after the immediate post-operative 3-4 days.

    No weight bearing on or active motion of the involved shoulder for at least 6 weeks is the norm; and then gradual use over another 6 week period before full use is allowed. The shoulder is usually immobilized with the use of a special sling or brace, allowing still some limited use of the hand and fingers.

    Since I worked in a VA SCI unit, our patients had the luxury of being able to be hospitalized for the entire recovery period on the SCI inpatient unit if needed. Most of our Veterans who lived alone or have limited family support at home opted for this. In the private sector, this surgery usually is only given a 3-4 day inpatient stay (by insurances) and then the person either needs to go home with support (if available) or to a nursing home for the duration of recovery. Some are able to get transferred then to an acute SCI rehab inpatient program at the end of 6 weeks when they begin their use and rehabilitation program.

    All transfers to wheelchair were done with a lift. No manual transfers allowed. All were given a loaner power wheelchair with the controls on the opposite side as the surgery, and used a power tilt-and-recline seating system to do weight shifts when up. Exercise of the uninvolved arm was allowed in a limited fashion in therapy.

    Patients were not allowed to do their own bowel care, dressing, bathing, etc. The nursing staff did all of this making sure that the patient did not attempt to use their shoulder to assist during the activities. Some were able to do their own caths, but others needed the nursing staff to do this.

    (KLD)
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

  6. #6
    Sounds brutal. Insurance coverage is also a big concern. Maybe Medicare Advantage would be better than original Medicare, which seems to be going downhill.

  7. #7
    Senior Member lynnifer's Avatar
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    No, no, no. If I ever have issues with my shoulders (it's been forearm and tendons in my hands for me) ... mayo clinic. Stem cells. I've read it's very successful.

    https://connect.mayoclinic.org/discu...or-cuff-tears/

    Try googling - lots of info.
    Roses are red. Tacos are enjoyable. Don't blame immigrants, because you're unemployable.

    T-11 Flaccid Paraplegic due to TM July 1985 @ age 12

  8. #8
    Maybe that's good for muscles. I heard there is no way to regrow cartilage.

  9. #9
    i had a shoulder reconstruction and was down almost 6 months. thankfully i had family support and was able to be at home with accommodations, the first 2-3 months were brutal and if i had to do it again i would need to be either in a nursing home or have full time nursing care.
    T6 Incomplete due to a Spinal cord infarction July 2009

  10. #10
    I'd like to add that I wish we had more discussion here on CC about ways to avoid shoulder problems.
    August West - your profile doesn't give your age or paralysis level; don't know whether you have shoulder issues at present.

    Maybe the nurses can chime in and let us know if there's any research and studies and publications for persons wishing to save their shoulders into old age. The only thing I've seen so far is a one page illustration of what not to do as far as reaching, extension, etc., but poorly depicted drawings.

    Since I'm Polio-paralyzed I can't speak for a para or quad as my shoulder muscles were partly weakened already, but it didn't stop me from sports activities until I was in my late 50's. I never experienced pain or difficulty while into sports, but it was everything else that I think messed up my shoulders: tub transfers before I got a bench; car transfers for years before I got a van; bed transfers before I got a transfer board.

    It seems that very few people here want to hear about vans in terms of shoulder health. When I see videos of a paralyzed person handling the process of transfer to a car, then dis-assembling a wheelchair and dragging it into the car, I must admit I cringe and practically go to tears....yes, I did it too before van driving because I loved the cars.
    I did all the wrong things because I could and had the strength.

    When the intense pain in one shoulder caused me to miss family Christmas last year I started doctoring, then weeks of PT. From horrible pain I now have bearable discomfort, as I'm using a prescription gel daily as well as non-prescription pain meds about twice daily. Since I still have to do transfers if I want to remain independent, I'm super careful with each transfer I must do. I follow my paraplegic husband's caution: keep arms as close to body as possible for pushing the wheelchair and for transfers. I no longer reach one arm out to grab onto something for balance when transferring - when using my transfer board I try to keep my arms totally close to my body even though it slows the transfer. I use Pledge frequently to keep my board slippery. I've started wearing nylon trail/runner pants and shorts that further help transfers to bed and van seats.
    When outdoors I use a zx1 and treasure it.

    Hope you all don't mind this cautionary rant. I'm now well into my senior years and never thought I'd live this long, so just wanted to share my views.

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