11: Kaizen

It’s been almost 3 weeks since the second surgery and my arm has been continuously improving.

The right shoulder is still recovering slower than the left did, but I’m not worried. The exercises are repetitive, but every day I devote to physiotherapy makes my arm a bit stronger. I have no illusions about getting to full function quickly, it’s more like chipping away at a long-term project. A friend explained to me that initially it’s the vision of the end goal that motivates you, but eventually you have to learn to enjoy the small patch of the problem that’s right in front of you. In that way it’s a lot like doing science.

The pain I had in the first two weeks is gone, and I feel functional in most activities where my arm stays in front of me or at my side. I visited the surgeon last Friday, and he walked me through his endoscope pictures while he removed my stitches.

Lifting the flap of my superior labrum off of the underlying cartilage.

The top half of my labrum was completely detached, and probably the cause of the impingement that was a major motivator for having the surgeries.

Action shot! On the left, my biceps tendon coming in from the upper right and meeting the labrum, on the left. On the right, the doc is almost finished cutting the tendon, using an electro-cauterizer, which turns the cut tendon a ‘caramelized’ color. The bright orb in the bottom right is the head of my humerus.

He did the tenodesis, and gave me a primer on some of the tools used in this kind of surgery. They need to put a camera and a light in there, a tube to irrigate the space, and tools to do all the cutting, so they put holes that get into the joint from different angles.

The doc uses a shaver (left image) to clean up some fraying. On the right, the flap torn off of my right anterior labrum.

They don’t really use scalpels, as I understand it. Most of the cutting is done with an electrical tool that uses a spark to simultaneously cut and cauterize (i.e. cook) the tissue to stop bleeding. This gives the inside of my shoulder an appetizing golden color.

A view of the superior labrum after it was cleaned up. On the right, a good shot of the cauterizer, and of the small suture put in to hold my superior labrum down.

I originally thought he put only one anchor into my right shoulder, but in fact he added two. He stitched down the superior labrum to prevent it from drifting into the joint. He also had to fix a flap in my anterior labrum, just like on the left side. This time, he only had to put one anchor into the flap.

The anterior labrum. Left, before shot. Right, passing the suture to reattach the flap.

Finishing up the suture in my anterior labrum.

The whole process took an hour and a half, which is shorter than the wait to see a doctor in some emergency rooms. My surgeon was confident I’ll eventually get back all my strength and range of motion.  One bit at a time.