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Apnea and rotator cuff surgery
#1
This is a followup to an original post where I had an AHI spike when taking narcotic pain medication for rotator cuff surgery.

http://www.apneaboard.com/forums/Thread-...reased-AHI

Had a nerve block and anesthesia for the rotator cuff surgery. Surgeon said my "damage was extensive" and a "culmination of small traumas" not sure what this means as I did not have an accident or sudden trauma.

He asked me to bring the CPAP machine (ResMed Autoset S9) with me and I had it on during surgery. They take apnea very seriously.

I had a long talk with the anesthetist prior to surgery. She answered questions well and has an impressive knowledge od apnea. I told her about the apnea spike (39.23) when I took the hydrocodone-acetaminophen and she said that this often happens, but it is usually a spike and not a long-term change.

BTW the opiates which include Norcor 5/325 have bee reclassified and you must have a paper script (not a call-in, nor fax) to the pharmacy. Also the pharmacy won't tell you over the phone whether they have it or not. Target Pharmacy told me they don't even carry it. I got it at Publix and was happily surprised at the price. With Medicare insurance it was $4.80.

I mention the above hassle to say that you may need to try several pharmacies to get these meds and allow for that possibility. You don't have to be personally present to get them. A non-hurting partner, spouse, can pick up your script (inform your doctor who and when), take the script to a pharmacy and get your meds.

will be adding more. Please bear with me, typing is now one handed and slow.

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#2
The accumulated traumas has noting to do with large injury situations, rather, any number of small daily indignities the shoulder is heir to - sleeping wrong, pulling the socket during a heavy lift, throwing, catching or lifting anything of weight, etc. Sadly, this is common as dirt in my biz - as sockets go, the shoulder is a bit of a kludge with lots of points of weakness.
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#3
(01-16-2015, 07:29 AM)DocWils Wrote: The accumulated traumas has noting to do with large injury situations, rather, any number of small daily indignities the shoulder is heir to - sleeping wrong, pulling the socket during a heavy lift, throwing, catching or lifting anything of weight, etc. Sadly, this is common as dirt in my biz - as sockets go, the shoulder is a bit of a kludge with lots of points of weakness.

what can we do to minimize accumulated traumas?
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#4
Very little - immobilization for a while helps, but alas, once it is hurt for any reason, the hurts accumulate, and most of it is everyday wear and tear. Sleeping on your side will hurt it, lifting anything will hurt it, it is part of life - we aren't built to make it past 40 or so, so we break down because we have exceeded our design lifetime. Even keeping the muscles strong in that region will hurt it, only it will also minimise the continuing hurt in the process but providing a strong protective layer of muscle and tendon, but that only works if everything is correctly and evenly strengthened.
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#5
(01-16-2015, 01:01 PM)DocWils Wrote: we aren't built to make it past 40 or so, so we break down because we have exceeded our design lifetime.

I thought our design lifetime was 70 years or so ...
Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
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#6
Well, I guess being 71 is part of the problem, and this is the shoulder I usually sleep on. Hopefully being cleaned out will give me few more years, and I'll be sleeping on my back.

Bottom line is that the pain after surgery is no big deal. 800 mg Ibuprofen and all is well. Bit of a PITA being one-handed. Can't tie my shoes, cinch a belt, so velcro close shoes, sweat pants.... but the pain is less than before and that is a good thing.

Took a few of the opiods right after surgery, have to sleep on my back, but the AHI has not gone over 5!

Had to pay $135 for it, but got a really great cold therapy machine that I will certainly hang onto for future swelling. It is called a Polar Care Cube and it circulates ice water through a flexible jacket that you Velcro over the afflicted area. I love it!

https://www.youtube.com/watch?v=Rbl_Z41h61I
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#7
Cold therapy is good for immediate injury, but long term therapy should be warm.

And try to train yourself to sleep on the other side - I have the same problem, BTW - so do most people, and shoulder pains are common amongst older people largely due to being one sided when sleeping. I make a point of trying to sleep on both sides over the night. Next thing to do is switch our from a Futon to the local equivalent of Sealy Posturepedic. After 40 years of futon sleeping, my body needs something softer that will conform to my shape. I hope I will get used to it. Futons don't shake or transmit any vibration, so if either of us tosses or turns or gets in or out of bed, the other is not disturbed. Not so with a spring mattress.
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#8
(01-16-2015, 11:26 AM)Dolla Bill Wrote: what can we do to minimize accumulated traumas?

You need to give up working on your magnificent cars. You should hire someone to do that... I'm available.

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#9
It's nice you had a hospital that wanted to make sure you were well taken care of while in surgery, my son had knee surgery a few weeks ago and afte surgery he was back in his room arms and legs tied down with no BiPap on him post surgery like there was supposed for be, he was screwed up for about two days afterward.
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#10
OK, here is why I find this disturbing:

The "sense" I had of how I slept before xPAP therapy, was that I switched sides a lot when sleeping. This was probably due to two things, one, that I was being strangled by OSA 56 times every hour which meant I was partially-roused often enough to switch sides when I "felt" it might be time to, and two, I did not have an elephant's trunk protruding from the middle of my face which inhibited changing positions.

Then sense I have now is that I stay in one position; I am partly to my left side, propped up so that I am not fully on that side (sort of between side and back). That bothered me a little bit; now it disturbs me a little more.

All I can take away from this is to make sure the "prop" pressure is more on my thorax than concentrated on my shoulder.
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