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Chockstone Forum - Accidents & Injuries
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|shoulder dislocation - tales of woe/joy wanted
I cant say I have popped my shoulder out since, but for me personally after 15 months of religious physio it still feels off.
It has gotten stronger, but if I put too much gas into a bouldering session, my shoulder usually blows out for a week or more where various muscles spasm and hurt.
Surgery is daunting, but after a year i still have stability issues and altho I haven't dislocated again I have had a number of moments where my shoulder has caused alarm. E.g. running on the beach and suddenly it feels like its dropping out of its socket.
I am asking myself the question, do I risk my current strength for a chance at more stability? Hopefully one of the surgeons will help me answer that question.
Hey Wendy, thanks for your insight.
So can I ask, how is the stability going in your shoulder? For me, strength is getting there, but there are random moments where my shoulder just becomes unstable....
And who did you end up doing your surgery with? Richard Dallalana? or Julian Saunders?
You have no idea how many bloody orthos that have rejected me on the grounds of not having private healthcare......
Julian's an osteo specialising in climbing injuries. He picked up what i'd done straight away when physios and gps and ultrasounds hadn't. Richard Dallalana did the surgery. No drama not having insurance, but it is about $10 000.
Shoulder stability seems to be coming along well. I've had one funny little wiggle, not even enough to cause pain, just to notice it didn't quite stay put. That wasn't even climbing, that was just crawling out of bed! My physio then instructed me to do more crawling around the bed to rebuild stabilising muscles. That, stretching, a gradual progression to full pushups and more climbing are my physio regime now.
Before I had the surgery, i could actually climb mostly without dramas. I did heaps of climbing, including working my project and a fair few other hard routes, and mostly, it didn't seem to be a problem. Then I'd reach up for something, usually near the extent of my reach, not think about it for a moment, go to pull and it'd go ouch. Or getting something off a high shelf. There were maybe two occasions, when cranking a hold down really low, when you really pull on that biceps tendon that melds with the labrum, that I really hurt it and think I probably made it worse. Both Julian and Richard were surprised that it wasn't going out a lot more often considering how large the tear was, it was really only the condition of my rotator cuff muscles that were holding it in. But no amount of muscles holding my shoulder in were going to make the cartilage reattach, If I didn't want to climb hard and wasn't having nerve impingement, Richard said I could keep living with it, and just use physio to keep my shoulder in functional condition, but it wouldn't repair itself and surgery was the only way to get it back to doing what I wanted from it. And that he would be worried about the fluid continuing to build up and cause permanent damage to my nerves. Faced with that, surgery was looking like the only option to me. Between him and Julian, I felt confident enough in the decision to cancel the other ortho appt i had. That was Shane Barwell, who also didn't seem to have a problem with my lack of insurance and was recommended by someone else on here.
Good luck with it.
thanks wendy.. i am going to need it.
Which leads me to my next question.... costs ... ugh the joys of not having private cover.
What had your operation cost $10k? Others have reported $3-4k.
Anyone else have input on total costs to do labrum repair surgery?
From memory, it was about:
Hospital bed $1000
Theatre fees $1800
Prosthetics (the anchors) $500 each (gulp) $3000
Of which medicare will give you about $1000 back.
Even with insurance, they only pay the difference between medicare rebate and medicare scheduled fee. Which is crap all. So the 3-4000 figures might come from the gap even with insurance - I would still have paid $1500 of the surgeon, $700 of the anesthetist, $300 on the assistant. The hospital stuff is fully covered but I'm not sure about the anchors. Whilst you can find cheaper surgeons, all the reputable shoulder specialists seem to be in the same range.
I got approx prices from 3 or 4 surgeons - the cheapest was in Michael Sandow in Adelaide at $7500. The Melb ones were all $8-10000. I only got prices of people with good reputations for shoulders so I don't know what a more run of the mill ortho might charge, or if you'd want to risk one. Apparantly it's relatively straightforward as far as shoulders go though. If you need less anchors, that'll bring the price down, if you can bear doing it as day surgery, that'll drop $500 or so. I was sick as a dog and in agony and barely made it out the next evening before they charged me for a second night, so you might not want to go for day surgery. Might depend how well you handle anesthetic and opiates. Cabrini was slightly cheaper than St Vincents.
It is expensive, but am comforting myself with the fact that I haven't paid $1000 per year in health insurance for the past 20 years and I would still have had a gap of $3000ish. So I am in fact $13000 better off than I would have been with insurance. And what else would you rather waste your money on rather than getting back into climbing fitness anyway? Pay $$ or suffer with manky shoulder .... I just coughed up the $. Incidently , Richard does operate 1 day a month in the public system. So you can get a good surgeon on the public system, but the waiting list is at least 18 months. I wasn't going to wait 18 bloody months and still have all that recovery time - I'd be in my 40s before i'd be climbing again!
There's a thread somewhere from when I was investigating what to do with my shoulder, it's titled something like "shoulders and surgeons and bollocks"
Update: So I saw John Salmon the other day. He said as it is your first dislocation to do all the rehab and start doing everything you use to do when your physio gives you the go ahead. See how your shoulder goes. If it doesn't feel stable, feels uncomfortable or you dislocate it again in the next two years come back and see me and then i'll operate.
If I was playing contact sport, was going to become a professional climber or go and climb mt Everest which isn't on the books atm he would recommend doing the operation now. It doesn't make any difference whether I do it now or in 5 years...unless I do more damage to it in the mean time eg. Another couple of dislocations.
Once you have start dislocating 4-5+ times you are starting do some real damage and the operation becomes a lot more invasive.
So fingers crossed and I'll see how I go.
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