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Scapular fixation ~ James’ story

Hey! I’m James Morrison, born 9th December 1987 in Florida, USA but grew up in Peterborough, Cambridgeshire. I first noticed obvious signs of FSH when I was 16/17 years old when I was beginning to lose alot of muscle mass despite doing intense weight training. I was finally diagnosed with FSH muscular dystrophy in the summer of 2008 when I was 20 years old. It was a big shock as there is no family history. I am currently at the University of Bristol studying dentistry. My symptoms are relatively mild. Scapular winging is the only thing that affects my everyday life. In February 2009 I had just begun dental clinical training which is when I noticed the scapular winging was becoming a problem with regards to dentistry. I found it quite difficult to work for long hours with my arms raised. I made the decision to suspend my studies for a year and began looking for a surgeon who could perform scapular fixation. Being a dental student I am medically minded and I have thoroughly researched scapular fixation and the science behind FSH since I was diagnosed in 2008. I did not need any persuasion when deciding to go ahead with scapular fixation, I knew what it was about andIdefinitely wanted to get it done. After attending the FSH spring get together on 4th April 2009 I was put in contact with an experienced orthopaedic surgeon. I met the surgeon in May. He explained to me the procedure, recovery process and possible risks involved. The surgeon understood that I had been looking into the surgery for a long time and I already knew what I was getting myself in for so we got straight into signing the paperwork. I had the first operation on my left shoulder on the 21st July 2009. My recovery was relatively painless, though I do have a very high threshold to pain, similar to my Dad and my Brother. The hospital looked after me with all the necessary pain killers. I spent 3 days in hospital. On the 2nd day I was put in the upper body spica cast that would keep my operated arm at 90 degrees to my side for 7- 8 weeks. At first it was a little weird and uncomfortable. I felt smothered and restricted but over time you just get used to it. I left hospital on the 3rd day after my surgery. Whilst at home I spent most of my time on the sofa. The spica cast makes it very difficult to sleep in bed on your back so I decided to just sleep on the sofa up right with my feet up. Now and again I would walk around just to loosen up and get a change of scenery but the sofa very much became my home. The week after my surgery the pain was bearable; I was taking less pain killers by then. If I coughed or made a sudden movement I felt a sharp pain. The weird thing is the pain is in the ribs on the side rather than the scapula at the back. You will need someone there for you just to help with odd things. Getting up the stairs, cutting your food, putting on clothes, is all very difficult when you’re in a spica cast with only one arm accessible. Unfortunately I had complications with the surgery. A week after my surgery I had to go back into hospital after getting pneumonia (infection) in my left lung. Because I am diabetic I am more at risk of getting an infection. It meant I would be in hospital for 5 weeks having chest drains and antibiotics. The infection developed into an Empyema (collection of pus in the pleural cavity of the lung) which meant I had to undergo decortication surgery on my lung in Leicester at the start of September. This meant that my spica had to be removed 2 weeks early. I was only in hospital for 3days after the decortication. The surgery solved my lung problem completely and I was back to good health! When the cast was removed I could barely move my arm at all. My brain wasn’t connecting with my arm. At first I was quite worried that I wouldn’t get the mobility that I hoped for. I then had a week of intense physio. I didn’t enjoy the 8.30am starts but the physio was absolutely amazing! I did sessions in the hydro pool and in the gym. Day by day my arm was moving better. By the end of the week of physio I could move my arm above my head, which I could never do before my surgery. It was a great feeling to move my arm so freely with no restriction. After the physio I continued to do the exercises for my shoulder. The shoulder doesn’t feel painful when moving my arm above my head. It did ache after days involving a lot of movement though. This is understandable as the arm is getting used to physical activity. After a couple weeks out of cast the shoulder was painless with no aching. The shoulder blade looks a lot better as it is flat to my back now. My scapula doesn’t dig into the back of chairs or stick out through my t-shirts so I am happy with the way it looks. The scar is quite big though, but it doesn’t bother me. I also have a scar on my lower back where the surgeon took a bone graft from my hip. Overall I am extremely happy about the results. I am planning to get my right shoulder done in January 2010. I was very unlucky to have the complications with my lung. Having diabetes puts me more at risk of infection. If you have a condition such as diabetes this is something to consider but I hope I haven’t put anyone off, I was just very unlucky! Despite the complications the recovery was relatively painless and not as bad as I imagined it to be, though people are very different when dealing with trauma. I recommend the surgery to anyone considering it. When considering the surgery you should take your time with the decision and not rush into it. I spent a long time researching the operation and I always had it in the back of my mind that I wanted to get it done. When I noticed the scapular winging affected my ability to perform in dental clinics that just enforced upon my decision to get it done. The ability to perform overhead activities is not an essential thing in life but reaching up to tall cupboards, holding my phone to my ear, washing my hair etc are all things I want to do, as does everyone. On top of this my career would be greatly improved by the operation. Also the way the shoulder blade looks when it wings out is not nice and has a big impact on my confidence. I’m sure a lot of people considering the operation (especially girls who wear backless tops) share this opinion. With all of these reasons combined I was 99.9% sure I wanted to get this done and I don’t regret a single thing about my decision. Even if you just have one small reason I would still strongly consider the surgery if it will give you what you want in life. I hope this article has been useful for people making decisions regarding scapular fixation. I understand it is very difficult to get people’s opinions about this operation as it is rare. If you have any further questions feel free to email me: morrisonusa@hotmail.com I’d like to thank the medical team at Oswestry for their hard work and support. They were absolutely fantastic and I couldn’t have asked for better medical care. James Morrison

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