Six months after my right total the LEFT has started. Can they do both shoulders at once, and if not how far apart do people have them done?

I feel a bit of a fraud posting this because the right shoulder, the one you all talked me through, is now genuinely good. Six months on I am back at the wheel, centring clay, sleeping on it, the lot. So I should be pleased and I am. But the left has started. Same grinding ache at night, same catch when I reach across, and the surgeon looked at the new X-ray and said, well, that one is going the same way and we will need to talk about doing it too.

What I did not think to ask in the room, because my head was full of the word AGAIN, is the practical stuff. Could they have done both at the same time and saved me a second round of all this? Is it too soon to do the left when the right is only six months old? Does it have to be the same operation, because he mentioned my left cuff looks thinner on the scan and I do not know what that means for me. And frankly, I am 80 in November, is a second one at my age daft, or is it the same sums as the first?

I know the answer will be ask him, and I will, I just want to walk in knowing what the sensible questions are this time instead of nodding and remembering them in the car park.

Margaret I am a few weeks ahead of you on exactly this, so let me give you the plain version. Two shoulders, two operations, about two years apart, and the second one is five weeks old as I type this with one finger. Nobody offered to do both at once and when I asked, half joking, the answer was a flat no, on the grounds that you need one arm that works to wash, dress and feed yourself while the other is in a sling. Having now done the sling weeks with my FIRST replacement as the good arm, I can tell you it coped fine, and I would not have wanted both done together for any money. You would be helpless.

On the same operation question, mine were NOT the same and that threw me at the time. First one was a total because the cuff was fine. The second side the cuff had gone, so that one is a reverse. Different operation, same surgeon, and the cuff on each side decided it, not me and not my age. So the thinner cuff comment is him starting that conversation. Worth reading the threads on here about the cuff deciding before you go back in.

Only adding one thing. Six months old on the first side is not too soon in the sense of it being fragile, it is more about whether it is useful enough yet to be your only arm for a few weeks. Sounds like yours is. Mine was the only shoulder I had done so I cannot speak to the gap, but the ward I was on had a woman in her early 80s in for her second and she was cheerful as anything about it. Said the second was easier because she knew what was coming.

Taking the questions in order. Replacing both shoulders in one sitting is rarely done, and the reason is practical rather than surgical: after the operation the arm rests in a sling for about 2 to 6 weeks, and a patient needs one functioning arm to manage washing, dressing, eating and getting in and out of a chair safely during that period. Two slings at once is a very hard recovery to run at home, so the overwhelming majority of bilateral cases are staged, meaning done as two separate operations.

On the gap, there is no fixed rule, and what surgeons generally wait for is the first shoulder to be genuinely useful: pain settled, out of the sling, driving again at around 6 weeks, and a good way into its physiotherapy, so that it can carry the load while the second side recovers. In practice that usually means at least 3 to 6 months between operations, and many people leave it longer because the second shoulder does not need doing yet. A shoulder keeps gaining strength and movement over 6 to 12 months, so at six months yours is well into that curve without having finished it. keencaravanner's two years is a common sort of interval; six months is at the shorter end but not unusual where the second side is already painful.

Your surgeon's comment about the cuff is the important one. The two sides are assessed independently, and it is the state of the rotator cuff on each side, not the fact that the first was a total, that decides the operation. A working cuff points to an anatomic total; a torn, irreparable cuff with arthritis points to a reverse, where the deltoid lifts the arm instead. It is entirely ordinary for a person to end up with one of each, exactly as keencaravanner describes, and the fork is set out plainly in an anatomic versus a reverse shoulder replacement. A reverse has a somewhat higher complication rate and tends to leave more limit on reaching behind the back, so if that is where the left is heading it is worth understanding before you decide, not after.

As to age, the sums for a second shoulder at 80 are the same sums as for the first: fitness for a general anaesthetic, which is reassessed rather than assumed from last time, and the pain and function on that side against the recovery it asks of you. Age on its own does not rule it out, and the question of timing is covered in shoulder replacement at what age. Whether your left cuff is repairable, which operation it points to, and when your right is ready to be the only arm for a few weeks are all judgements for the surgeon who has your imaging and can examine both shoulders, and I would put those three questions to him directly.

Mr Robert Kessler said:

the two sides are assessed independently

That line is the one to take in with you. I assumed shoulders came as a matching pair and they simply do not. Also, and I say this gently, do the home sorting again for the left even though you did it for the right. Everything you moved to the right side of the kitchen for one handed living will now be on the wrong side.

Went back in with those three questions written on a card and it was a completely different appointment. Left cuff is thin but he thinks repairable enough for another total, though he wants a proper scan to be sure and said he would tell me straight if it turns into a reverse. Earliest he wants to do it is after Christmas so the right has a full nine months behind it. And the kitchen point made me laugh out loud because I had not thought of it. Thank you all, again.