My shoulder surgery date finally arrived, Feb 24th! After today and a few weeks of rehab, my split bicep and torn rotator cuff will no longer cause pain when I move my left arm. Five years of suffering will end!
As I put on the gown and other surgical clothes, the nurse stepped in and saw my bloody body covered in large psoriasis plaques. She gasped and I caught her look of horror. The required pre-surgical showers last night and this morning had torn open the lesions and caused light bleeding. Surgery is dangerous for infection for everyone, but more so for me because of medications I take. The pre-op assistant had given me a scrubber pad and antibacterial soap with specific instructions. Neither product was psoriasis friendly. The outbreak that covered so much of my body was due to the recent halt of the drugs, Methotrexate and Otezla. I have been clear of the skin rash for five years, and I don’t think the surgeon realized what could happen.
The nurse looked under my arm explaining that they might not be able to do the surgery because of the sores. She gave me a shot for relaxation, and I do not remember anything from that point on. During surgery, the doctor looked under my left arm and chose to do a tenotomy instead of tenodesis. Tenodesis is cutting the biceps tendon at the top of the shoulder and reattaching it to the humerus bone. Tenotomy is cutting the biceps tendon and not reattaching it. My body was in full attack mode with the external outbreak of psoriasis. Dr. Veasy saw that psoriatic arthritis had attacked the shoulder joint internally as well. What little cartilage left in my shoulder was badly damaged, as was the long head of the biceps and the tissue of the rotator cuff. Successful reattachment to the humerus was not possible, so he cut the tendon and left it unattached.
Six years before the surgery, I had slipped on wet concrete and reached to grab a high shelf. I fell anyway. Stubborn as a mule, I refused to get medical care. Psoriatic arthritis (that I didn’t know I had) attacked the shoulder internally. Over time, Inflammation damaged the bone, tendon, and cartilage around the torn rotator cuff and split biceps tendon.
Dr. Veasy suspected that I had a torn rotator cuff, but he also thought I might have neck problems due to compression of the spine. After an MRI confirmed all of his suspicions, I was scheduled for surgery on my shoulder and referred to a neurosurgeon for my neck.
At my post-op visit the doctor showed me before and after color pictures of the internal shoulder area. Before surgery the cartilage was rough in places and absent in other places. The shoulder looked like a winding, white road full of gravel and potholes. During surgery, Dr. Veasy cleaned the bone to smooth the surface. That would sooth the grinding pain I had complained about. It was better after 6 weeks of rehab, but occasionally I suffered bouts of excruciating pain. In
Fast forward to August. I have full range of motion, but also intense pain much of the time. I returned to consult with Dr. Veasy. He gave me a cortisone shot and encouraged me to continue my stretchy band exercises three times per week. The powerful steroid reduces inflammation and pain. It seemed a miraculous cure had happened for thirty days, but when it wore off, the pain returned. The nurse asked me to call back in a two months to let them know how I felt. I argued with myself about calling them. I figured psoriatic arthritis caused the problem, and I had read that the shots caused more damage to the joint. I suffered longer before calling for another appointment.
My latest visit in January ended with another shot and the Physicians Assistant encouraging me to visit with my neurosurgeon, Dr. Bannister. I should check in with him to see if psoriatic arthritis has caused further destruction of my cervical spine. When I met with him before, he told that eventually I must have neck surgery, but I asked to put it off and he agreed that I could. He said that my neck and back is trashed, and he couldn’t believe I wasn’t suffering a great deal more than I claimed. I am so happy he gave me the right you choose when I would need more surgery.
My current situation is that my left shoulder and three cervical joints causing intense pain. One joint is post surgical and still causing problems, so I am quite resistant to more surgery. I choose NOT too have surgery any time soon because I am dealing with the pain without opioids. How? Thinking positively, keeping busy, resting periodically, and using mild pain medications.