12/19/25: Details Matter
Published: December 19, 2025
Details Matter
I’ve often heard it said that the difference between a professional and an amateur is attention to detail. Going into surgery, I came to understand just how true that is.
As surgery day approached, a few doubts still lingered. While our Plan B—a reverse total shoulder replacement—was a solid backup, it carried fears I couldn’t ignore. I run on hazardous trails. I hike. I ice skate. I fall down. I lift heavy things.
My physical therapy and functional health practice isn’t just my career—it’s my passion. I need to participate, not shout from the sidelines. I still harbor dreams of learning to ride a skateboard (despite my wife’s disapproval).
Confidence in the Small Moments
As I was being prepped for surgery, Dr. Goch entered the room, smiled, and shook my hand. I asked him if he knew what a Turkish Get-Up was. He nodded and said his intention was to get me back to that level.
That single exchange mattered.
Next came the anesthesia team. They clearly explained what would happen, the timeline, and what I could expect when the nerve block wore off roughly 18 hours later. The anesthesiologist took the time to explain the mechanism of the block, how the pain would return, and how to dose oral medication before pain escalated. I was kindly—and wisely—warned.
Details.
A Successful Repair
I woke up in recovery feeling surprisingly well. My wife soon told me the surgery was considered a big success. When Dr. Goch spoke with her, he was smiling.
Good bone.
Good alignment.
Good circulation.
Good muscle protection.
Words you want to hear.
Now the Work Begins
Surgery is only the first step. Post-operative protocol plays a critical role in success. Having a nurse, coach, and advocate to ensure those details are carried out makes an enormous difference.
In my case, that person was my wife—who is also my therapy practice partner and, frankly, the perfect match for the job.
The immediate post-operative goal is simple in theory: heal. The first 72 hours are critical. Pain and inflammation must be controlled, and nothing counterproductive can be allowed to creep in.
Simple does not mean easy.
I now had five medications—different doses, different schedules, some with food, some without, some that couldn’t be taken together. My wife created a chart and a plan:
• When I would eat—and what I would eat—to support gut health and healing
• Positions for rest and sleep that protected the arm
• When and how to ice
• Gentle movement of my hand, wrist, and elbow
• Walking inside the house several times a day to maximize circulation
• Safe strategies for bathing
• And constant hydration—lots and lots of water
Details again.
A Different Medical Experience
I’ll admit it—I’m often skeptical of large corporate medical and hospital systems. Past experiences haven’t always been positive. This time was different.
Every person we interacted with at INOVA was professional, kind, efficient, and positive. But most importantly, they made me feel like a part of the team in my own care.
That matters more than most people realize. Being included fosters trust, compliance, confidence—and ultimately, better outcomes.
The Takeaway
Details matter.
In preparation.
In surgery.
In recovery.
In healing.
They are often the difference between merely getting through something—and truly coming back strong.