Let's talk real shoulder surgery prep – the stuff nobody tells you in those glossy brochures. When I had my rotator cuff repaired last year, I walked in thinking YouTube videos covered everything. Big mistake. Turns out there's a canyon between textbook explanations and lived experience. That's why I'm dumping all my hard-earned lessons right here.
Seriously, why don't they hand you THIS list at the surgeon's office?
The Pre-Op Shockers Nobody Mentions
So you've got your surgery date circled in red. Before you even step foot in the hospital, here's what actually matters:
Financial Gut Punches (Beyond Insurance)
Yeah yeah, call your insurance provider. But listen – my $200 copay turned into $2,800 out of pocket. Hidden costs creep up like:
- Physical therapy co-pays (expect 2-3 sessions/week for months)
- Cold therapy unit rental ($300+ if not covered)
- Job impact (I lost 3 weeks' pay as a mechanic)
- Help at home ($25/hr for caregiver if no family around)
| Common Overlooked Cost | Price Range | Insurance Coverage Likelihood |
|---|---|---|
| Compression ice machine rental | $250-$400/month | Sometimes partially covered |
| Shower chair & toilet riser | $75-$150 total | Rarely covered |
| Physical therapy co-pays (40 sessions) | $800-$2,000 | Depends on plan |
| Prescription pain meds | $40-$200 | Usually covered |
My brutal truth? I'd have saved $1,000 buying my ice machine on Amazon instead of renting. Things I wish I knew before shoulder surgery include asking about equipment purchases upfront.
Home Prep You Can't Skip
You'll be one-handed for weeks. Little things become Olympic events:
- Clothing hacks: Front-button shirts ONLY. I lived in Hawaiian shirts for a month
- Bed setup: Stack pillows like fortress walls (you'll sleep sitting up)
- Meal prep: Freeze single-hand meals (chili, stews) in microwave containers
- Shower reality: Plastic wrap + tape won't cut it. Get waterproof shoulder covers ($15 on Amazon)
Absolute lifesaver? Installing a bidet attachment. Trust me on this.
The Hospital Day: What Really Goes Down
Remember those surgery pamphlets showing calm patients smiling? Total fiction. Actual surgery day:
Anesthesia Choices That Matter
Here's what they don't stress enough: request a nerve block. I woke up pain-free for 12 hours versus my buddy Mike who didn't get one and was vomiting from pain. Game changer.
| Anesthesia Type | Pros | Cons | When to Choose |
|---|---|---|---|
| General + Nerve Block | Pain-free first 12-24 hrs | Numb arm feels weird | For most major repairs |
| General Only | Simpler | Wake up in pain | Minor procedures |
| Regional Only | Avoids general risks | May feel pressure during surgery | If health complications exist |
Post-Op Waking Nightmare
Waking up feels like being hit by a truck. My conversation with Nurse Linda:
"Rate your pain 1-10."
"Eight... no, nine!"
"Okay honey, here's your meds."
What they don't warn you:
- You'll be naked under that gown with zero dignity
- The sling feels like medieval torture for the first 48 hours
- You might cry from frustration trying to pee one-handed
Things I wish I knew before shoulder surgery number 37: Pack oversized button-up PJs for the ride home.
The Pain Period: Brutal Realities
Post-op week one is hell. Let's not sugarcoat it.
Medication Minefields
They hand you opioids like candy. I took them for 4 days until constipation had me weeping on the toilet. What works better:
- Set alarms for meds – stay ahead of pain
- Stool softeners start DAY ONE (Colace + prune juice)
- Transition to Tylenol ASAP (ask about scheduled mega-dosing)
My pharmacist cousin saved me with this schedule:
| Time | Medication | Notes |
|---|---|---|
| 8 AM | Oxycodone + 1000mg Tylenol | With food |
| 2 PM | 1000mg Tylenol | Set phone reminder |
| 8 PM | Oxycodone + 1000mg Tylenol | Take stool softener now |
Honestly? The constipation hurt worse than my incision.
Sleep Deprivation Torture
You know what's cruel? Needing sleep to heal but being unable to sleep. My nights:
- 10 PM: Take pain meds
- 12 AM: Wake up with shoulder on fire
- 2 AM: Ice pack refill mission
- 4 AM: Finally sleep... until cat jumps on sling
A recliner saved my sanity. Beds are impossible the first month.
Rehab: The Long Slog Nobody Prepares You For
Here's where I nearly lost my mind. Things I wish I knew before shoulder surgery mostly revolve around rehab realities.
PT Isn't What You Expect
First session: "We're just going to gently pendulum your arm." Lies. It feels like knives stabbing your joint. The real timeline:
| Time After Surgery | What PT Actually Does | Pain Level (1-10) |
|---|---|---|
| Week 1-2 | Remove bandages, gentle pendulums | 3 (mostly stiffness) |
| Weeks 3-6 | Passive range-of-motion stretches | 5-7 (burning sensation) |
| Weeks 7-12 | Active assisted movements with sticks | 4-6 (deep ache) |
| Month 4+ | Resistance bands, light weights | 2-4 (muscle fatigue) |
My therapist Sarah dropped this bomb at month 2: "Full recovery takes 6-12 months." I nearly cried into my ice pack.
Psychological Warfare
Week 6 was my breakdown point. Couldn't wash my hair. Couldn't sleep. Couldn't drive. Felt useless. Things nobody warns you about:
- Depression hits HARD around week 4-6
- Friends stop checking in after 2 weeks
- You'll watch 37 seasons of trash TV
Honestly? I resented my healthy wife brushing her hair effortlessly. It's ugly but true.
Critical Questions You Must Ask
From my mess to your success – demand these answers:
Surgeon Questions That Matter
"How many of THIS exact procedure do you do monthly?" (My doc did 15/month vs. first consult who did 3)
"What's your revision rate?" (Good surgeons track this)
"Can I see BEFORE/AFTER MRI images from past patients?" (Mine showed re-torn repairs – scary but honest)
Therapist Dealbreaker Questions
"Will I see the same therapist every time?" (Switching providers sets you back)
"Do you use ultrasound/estim for pain control?" (Game changers post-therapy)
"Can we create a home exercise video library?" (Good clinics do this)
Key Takeaways Worth Remembering
If you take nothing else from this:
- Rehab is longer than advertised – add 50% to whatever timeline they give
- Mental health prep matters – line up therapy if you have depression history
- Second opinions are non-negotiable – I avoided unnecessary surgery this way
Looking back at my list of things I wish I knew before shoulder surgery? The biggest lesson was psychological. You'll question your decision daily for the first month. But around month 5, when I could finally sleep on that side again? Worth every tear.
Still have questions burning in your mind? Good. Let's tackle them:
Real Patient FAQs (No Sugarcoating)
How soon can I drive after rotator cuff surgery?
Not until you're off narcotics AND can turn the steering wheel. For me? 3 weeks with automatic transmission. Manual drivers? Forget it for 2 months minimum.
When will I sleep normally again?
Define "normally." Back sleeping? 2 weeks. Side sleeping? 3-5 months. Stomach sleeping? My surgeon said "Maybe never" – still bitter about that.
Is the pain worse than knee replacement?
Talked to my neighbor who had both. Shoulder wins for sheer misery because you can't immobilize it. Every sneeze feels like detonating dynamite in your joint.
Did you regret getting surgery?
Every day for the first month. At month 3 when I could grab cereal boxes again? Less regret. Now at 10 months? Best decision despite the hellscape. But ask me during week 2 and I'd have cursed at you.
What's the one thing I absolutely must buy?
Besides the ice machine? A body pillow with arms. It cradles your arm while sleeping. $35 on Amazon > $3,000 in sanity.
How noticeable is the scar?
My arthroscopic holes faded to white dots. Open surgery friends have 3-4 inch scars. Use silicone strips religiously – my sloppy routine left a raised scar.
Will I ever lift weights again?
Depends. Light dumbbells at 6 months. My 25-lb bench press max now? Pathetic but improving. Competitive lifters need 12-18 months realistic recovery.
Final reality check: This journey sucks more than you imagine but improves slower than you hope. Document everything – I took daily photos that proved progress when I felt stuck. Those photos got me through the dark days.
Would I do it again knowing what I know? For pain-free shoulder movement? Yeah. But I'd stock up on bidets and prune juice first.