What happened when you went for your follow-up appointment with who did you see?

I saw the physio, yeah, very nice lady, very thorough, and she also showed me some exercises and things to do when I go to the gym. And which exercises to stay away from and which ones to do, like stay off the cross trainer and things like that because it’s moving. And also to set my body before I exercise by putting the shoulders back and, because otherwise muscles compensate when you do the exercise.

So that was very good and, as I say, weve, shes given me a number and were going to, if I need to, I’m going to go back in a couple of months. I feel as though it will settle down on its own, but if it doesn’t then I’m going to make an appointment and go back and see her.

Okay, so you have joined the gym?

Yes, I’ve gone, yes I belong to a gym and I’ve gone back to the gym again.

Okay, and you’re following sort of kind of her advice regarding what to do and what to avoid?

Yeah, doing a lot more with, on certain machines to work the upper shoulders and arms.

Can you tell me which machines you are working on, I mean it’s just for them to just find out when people look at the website?

Running again, cross trainer, cycling and then light weights on some of the machines. She told me not to do the press, that one where you push so certain, that one and theres a lateral press that you’re doing, that one, not to do that one as well.

This [follow-up] will vary throughout the country. Certainly in our own region, our own centre, most patients after this type of shoulder operation will come back to Outpatients at 6 weeks. And at 6 weeks they’ll either see one of the surgical team or perhaps more importantly they’ll see the physiotherapist. Because after surgery, it’s usually down to the rehabilitation and the physiotherapy. So they may not see their surgeon again. If they see the physio and they’re doing well and they’re happy with their exercises, they may not see the surgeon. If they’re not doing as well, the surgeon is usually called in to say hello and to have a look at them as well.

And generally speaking most patients aren’t discharged from hospital care until they’ve got the result that they want. So it’s not usually an issue of struggling to get back in contact. That line of contact should be open until they’re better. But otherwise obviously their GP is a great source of information and can usually get back in contact with the hospital team if needed.

And when they attend the follow-up appointment, what happens at the appointment? Some people wondered if they’d have x-rays. What usually happens?

So after this particular type of operation, where a little bit of bone has been trimmed from the shoulder, nothing has been put in, so x-rays aren’t usually required. It’s all about ensuring that the pain is improving, the range of movement is improving. So it’s really about physiotherapy and exercises. And that’s what is looked at and that’s what is checked. And the physios may then modify or change the rehabilitation or the exercises that need to be done by that patient.

Many patients ask about physiotherapy after this operation. And actually again that will vary throughout the country. Many patients won’t see a physiotherapist during those first 6 weeks. And that’s because most people after this operation can just get on with their own exercises, their own rehabilitation. And they get checked at the 6-week mark with the physiotherapist. Those that are doing well can probably just carry on as they are. Those that are struggling a little are usually picked up by the physios at that point and may need some more concerted input.

So patients can do gentle exercise, or if they feel able to move on to something a bit more challenging, that’s okay?

Again I think the important thing to remember after this operation is you can pretty much let your shoulder tell you. If your shoulder is feeling comfortable, you can increase the level of activity and do more and more things without worrying about harming your shoulder. If it gets sore, it probably means you did a bit too much and you just need to cut down things a little, and then try again a week or two later.

You said you hadn’t had your post-op assessment?

No. No.

And do you know when you’re going for that one?

[Looking at paperwork] 14th August.

Do you know much, what do you expect will happen on that day?

I haven’t got a clue. I just presume they’ll ask questions and see how the arm moves and that’ll be it. I’ve no idea.

Okay, you haven’t been told anything about that at the moment?

No. Do they do things to you then?

I don’t, I don’t know.

Oh, okay [laughs].

Is there anything you’d like to happen or you want to find out at that appointment?

Just that it’s going on as it should do. I feel as if it is with the different things I’m able to do now, which I haven’t been able to do for a long time. And I’m automatically doing things and, Ah, I haven’t done that for a long time. So it’s quite nice.

I was expecting to see the doctor, the surgeon, but I didn’t. I only saw [the physiotherapist] because they was on about doing the left hand shoulder as well. But now I don’t know if they are going to do it or whether they are thinking of doing it or what because nothing’s been said. But it needs doing. They know it needs doing. Hes agreed, hes confirmed that one but if they’re going to do it, I don’t know.

Why were you expecting to see the surgeon?

Well, because he did the operation so he would have seen inside my shoulder and he could have explained to me, you know, what hed seen and what they’d done and, you know, in wider terms.

And the person you saw, was she able to explain to you?

She explained what she thought had happened and she did get me into a position where we managed to lift my arm up with pillows and things under my shoulder. But it’s not easy to do that on yourself when you’re in bed [laughs], to try and relieve the pains. So consequently I’ve been getting very little sleep and I’m spending most of the night in the armchair because I just can’t lay with the pain.

So what you were expecting and wanting was to see the surgeon

Yes, yes.

For him to explain what…

Well, yeah and to find out when and if he was going to do the left one. So, you know, I’ve been left with a question now.

Have you had your post-op assessment, your follow up appointment?

I did, yeah. That must have been the one that I had most recently then when I saw the physiotherapist. Yeah, I think it was. That was the lady that was in the TEPI [videos]. Yeah, so I have had that, yeah.

And what happened at that appointment?

She looked at all the movements and asked how things were going and, you know, looked, we tried touching the ceiling sort of things. And she did spot that I’ve got this bad shoulder blade posture or something. So instead of like keeping your shoulder back and reaching for something, I’ve got a bad habit of like pushing my shoulder forward, which is not very good apparently.

So she strapped me up to try and get it pulled back, which was, actually helped. It’s a bit uncomfortable with a big strip of plaster but it came off after about a week. So I’ve probably gone back to it. I’ve sort of consciously tried to keep it back but, in reality, I expect I’ve gone back to how it was before.

Yeah. And was she happy with everything else? Everything else was okay?

Yeah, yeah.