Joe's specific plan for post-operative pain management has several facets, the first of which is a pre-operative nerve block.
"It's a way of giving some numbing medication directly to the nerves that are going down to the shoulder," said Spektor, "and we'll do that for as long as possible, because with each passing day, the pain is going to get better."
There is one problem -- Spektor says nerve blocks are usually inserted while the patient is awake to make sure they're placed properly.
Typically they would also give the patient a sedative to help with the pain and anxiety of the procedure, but Joe has abused all three of the medications they use for sedation.
So he'll be fully awake as Spektor pokes around in his shoulder to place the nerve block.
Step two of Joe's pain-management plan involves a cocktail of medications -- none of them drugs of abuse -- intended to reduce swelling, turn down the nerves' pain signals and reduce Joe's stress-response to pain.
Step three involves going to Narcotics Anonymous and Alcoholics Anonymous meetings regularly before and after surgery.
During step four, Joe will see a psychologist the day after surgery and regularly after that to ensure he stays on the right mental path.
And just to add insult to injury, Joe has to go through this intense process twice -- once for each shoulder.
"In my head, it's like -- OK, we're going to go and visit hell, not just once, but twice," he said. "I feel like it's somewhat of a cosmic joke on me."
But will these efforts pay off? Will the plan work?
"I think every patient is unique," Spektor says. "But I think Joe has an incredibly good psychological framework going on. He's got a psychologist that's definitely on board with him, he's got a group of friends that are on board with him. He's got NA and AA meetings that he goes to, and we have a medical framework that's here for him."
"With that combination, I think the likelihood of success is pretty good, but none of us known for sure."
Today marks the first day of the rest of Joe's life. He's dropping into a new type of circus, possibly as you read this. Today he rolls into the OR for the first of his two surgeries.
"I'm fearful; I'm scared; I don't know what's going to happen. I'm jumping into a freezing cold pool, and I don't know how I'm gonna react," he said days before the surgery.
"I can tell you what I'm going to do, how I'm going to think -- all of it's untrue, because I won't know until I'm there. When you're met with pain, only then you'll know how you'll react to it."