Gory Picture 3: Marita's shoulder gets screwed

Hey all,

Sorry to take a bit of a break from posting. I’ve been trying to get back to doing things at work, and have really been struggling. On the upside, I’m doing some things in the lab that vaguely resemble experiments. At this rate, I’ll probably complete the work I need for my thesis some time before the next ice age. On the downside, by the end of any given day I’m generally reduced to a hollow shell of my former self, curled up in a little ball and begging anyone within earshot to bring me some juice to wash down the Vicodin with. My shoulder gets very, very sore, you see.

I guess I’ve been deluding myself a little. I sort of thought that the healing process would be nothing but progress. I forgot about the whole setback thing. I don’t think I’ve suffered any major setbacks, at least I hope not. I have no reason to believe that I’ve torn the tendon loose again or anything (although I have been absolutely mortified of doing so at times). It does feel, occasionally, like there is some real risk of my arm just falling off, but I’m reasonably sure that won’t actually happen. I guess I just failed to realize that the more I’m able to move my arm the more I’m going to be able to make it sore. Pretty clear on that now, though. I also didn’t really take into account that if the healing process is six months or so, it’s probably going to be relatively painful for longer than the first two weeks.

But, I’m hanging in there. I’ve had the chance to watch quite a few DVDs in the past couple of weeks, so I’m enjoying that. In the past few days I’ve actually had an uncanny knack for picking movies with Shelley Winters where she demonstrates very poor taste in men and then comes to an untimely death (Night of the Hunter, A Place in the Sun and Kubrick’s Lolita). All three are great movies, but I’m starting to feel a little bad for Shelley, so if someone can recommend a movie that she lives through (that’s actually worth watching), I’d appreciate it.

I’m afraid I’m not going to deliver on my promise to write much informative about bioabsorbable suture anchors. Not today, anyway. I will give you all a picture though:



From what I understand this is the anchor being screwed into the bone (I have to assume that the shiny metal thing is the tool which drives it in, and not the anchor itself). But, as always, I could be mistaken.

I'll try to post again soon. Here's hoping that I'm done with the painful realizations, at least for this week...

Gory pictures 2a and 2b - Something happy, something... not...

Wow, I have so many pictures of the inside of my arm to choose from, that it's hard to know what to put in next. I did promise a picture of the tear, but first I thought I'd put up something that wasn't damaged for comparison:



If I'm not mistaken, this is the picture that shows the biceps tendon, which wasn't damaged (note: not all fuzzy). Compare that to this:



From what I'm told, the fuzzy area on the bottom right is where the tendon should be hooked on, but isn't. So... that would be the tear. Wasn't torn completely through, but 5 mm worth (for those of you who would like a sense of scale), so about halfway. Exciting stuff, huh?

On a side note, being out of the sling, and trying to use my arm for "normal use" (this still means normal in the "not lifting my arm above shoulder level" sense) is really scary. For starters, my arm just can't do much. I end up dragging it into the position I want it in using my left arm. Also, everything hurts. And if it hasn't been made clear from my previous posts, I'm pretty much a total wimp. I'm happy to be able to type with both hands, but that's about the only function that I've really returned to full- force. I couldn't even manage to get my right hand out into hand-shaking position earlier this morning. Maybe that should be my goal for today.

Or perhaps I should work on something with more practical application to my lifestyle, like being able to raise a pint to my mouth. The Cambridgeport Saloon serves their pints in plastic glasses (for reasons that should be obvious to anyone who has been there), so drinks there are much lighter than a pint would be in a umm... less shady bar. Sounds like a good place to start, eh?

Tomorrow: Everything you wanted to know about bio-absorbable suture anchors but were afraid to ask. Yeah. Should get a lot of hits for that one.

Gory picture 1: Intergalactic, or Intra-Marita?

OK kids, as promised, here's photo 1 in the series (Collect 'em all!). For all of the pictures, my captioning is going to be something less than scientific, because I'm just paraphrasing what the doctor told me. If I get something wrong, we plan to fault my memory, not my doctor, because that's probably the appropriate place to lay blame. I should also probably give a photo credit, but I would hope that it's obvious that my doctor took these. I was asleep at the time.



This is apparently the acromion, which apparently didn't have too much that was rubbing and irritating the rotator cuff, but enough that it needed to be shaved down a bit. I honestly don't have the skill to point out any features, but I like this picture, because everyone who has seen it without knowing what they were looking at thought it was a picture of Jupiter (this is good not only in and of itself, but also because being at MIT, it didn't strike anyone as odd that I might have just obtained my own photos of Jupiter). It does have something of a planetary look to it, don't you think? Fingers crossed that it's not harboring any intelligent life.

Coming soon: Gory picture 2: The TEAR

Coming soon: Gory Pictures

I went in for the first post-surgery check up today. My stitches are out, which means I’m allowed to shower without first going through my Saran Wrapping ritual. Might do it just one more time for old time’s sake, or… maybe not. My shoulder is now held together with steri-strips, which from past experience should either fall off in the next hour, or become permanently affixed to my skin. Can't wait to find out which it will be.

I’ve also been liberated from the sling somewhat, at least while indoors. I was advised to wear it when wandering around outside, as much to serve as a warning to people not to bump into me as anything else. I can’t help but feel that swinging a stick in front of me as I walked would be more effective, but I guess I’ll keep to the doctor’s advice and hope that people give the sling some space. I had more stretches added to my excercises (all range of motion still, not allowed to start strengthening for another month). And my doctor managed to add a now standard "I don't want you playing hockey yet" admonition to the visit, which is a good sign that he knows me reasonably well. Anyone want to lay odds on how long it takes him to forget to add that to a visit?

There are some great gory pictures from the surgery that I now have to share, but I have to figure out how to post them. That could be something of a project, but hopefully I’ve have something for you soon. Apparently, the supraspinatus tendon was torn about half way through, the suture anchor used is bioabsorbable, which means it will dissipate in the next say, three years or so, and they didn’t have to shave down the acromion too much. But why describe it, when I should be figuring out how to show you all, eh? I’m off, to figure out the .jpg posting service. If you can help, don’t hesitate to volunteer.

Finally, a goalie to look up to...

Hmmm…. I was waiting on my next post until someone managed to post a comment with a pro athlete who came back from shoulder surgery. Sadly, I’m not getting a lot of love on that front, and was feeling a little down about it until my intrepid teammate Valerie e-mailed me this morning to let me know that Stephane Fiset had shoulder surgery in 1989, which means that his entire NHL career has been post-surgery. Not only that, but a glance down his list of injuries doesn’t show any shoulder problems since. Huge thanks to Valerie for providing me with first a recliner to recover in (for those of you who haven’t seen it, it’s an extremely stylish 70’s brown naugahyde and orange and brown plaid number) and now a new role model.

Today is the first day post-surgery that my arm has actually felt worse than it did the day before. I think I’m primarily just sore because I actually got out and moved around – walked the mile or so into work. It’s amazing how much you bounce when you walk. You don’t notice it until it hurts to bounce when you walk. So anyway, I’m really sore today. Not really looking forward to the bouncy walk home, but I suppose it will make me stronger, right?

I get my stitches out next Tuesday. I don’t think I’ve mentioned it before now, but there’s four incisions, all of them pretty tiny. One each on the front and back of my shoulder (each with two stitches) and two smaller ones on the side (each with one stitch). The joys of university medical services – when I called in on Monday to schedule my surgical follow up, they tried to give me an appointment for the 23rd (that would be 3 1/2 weeks post surgery). After some discussion, being put on hold 3 times, and threatening to take the stitches out myself, I was finally awarded an office visit next Tuesday. Hooray! You would think they would make a note in someone’s file or something, or maybe just schedule the first follow up when they schedule the surgery. But.. they don't. I suppose that would be too easy.

Anyway, I’m off to ponder the long walk home through a Central Square filled with unpredictable people. I’ve taken to walking with my good arm out in front of me in a defensive stance to swat at anyone who staggers too close. I probably look a little nuts walking that way, but the great thing about Central Square is that you’d have to do something pretty extreme to look like the craziest one there.

For those of you in the Boston area, it’s going to be a stormy awful weekend. Wouldn’t you love to spend it inside in Cambridge entertaining your favorite injured goalie?

-M

The great saran wrap experiment

Today has been a big day for me – after getting extremely tired of smelling vaguely like hospital, I embarked upon a grand Saran Wrap project so that I could finally take a shower. I won’t get into all the grisly details, but this entailed huge amounts of saran wrap, a half a roll of packing tape ripped to shreds with my teeth, and an insanely flexible good arm. Taping clingfilm to your back with one arm and only a mirror to guide you is definitely an acquired skill, but somehow I finally managed (I’m actually fairly impressed with myself). Made it through the shower with my incisions dry, and now I have clean hair, and smell like… myself. Hooray!

Most of my exercises are pretty painless – I lie on my back and bend and straighten my elbow, I stand up and pinch my shoulder blades together or roll my shoulders as I shrug them. It hurts a little more when I bend at the waist and use my body weight to swing my arm in little circles. But the most pain is from the pulley. I sit in a chair with my back to the pulley, and pull down with my good arm to lift my injured one up. That part is quite the ordeal. Especially since I haven’t taken any Vicodin in more than 24 hours (the anti-nausea patch wore off, and with it, so did my ability to stomach the vics). Advil and ice are enough most of the time, but it would be nice to have the Vic option. Hmmm…

So maybe you can all help me with something. It was a little depressing when my doctor told me that a majority of people who have this surgery are in their 50s and 60s. This has been made worse by the instruction booklets for the various post-surgery devices I have; the various demonstration pictures all feature patrician-looking women in their mid- to late-60s. I don’t want to feel like an old person, I want to feel like an athlete. So here’s your homework to cheer me up: leave a comment with an example of a pro athlete who made it through this surgery (you can skip those who had their career ended by it). Bonus points for anyone who came back to win a major championship, extra super bonus points for ice hockey goalies. C’mon guys, I’m sure you can think of some (and yes, I’m too lazy right now to look it up myself).

Cheers,

-M

Post- post-surgery report

All right, so I skipped out on making an entry over the weekend. For some strange reason when given the choice between sleep and anything else, sleep won out.

I’ll try to give a general update on how I am (and how I’ve been). Today is a big day for me. I’m allowed to take the bulky bandages off and see how much of the giant puffy blob on my shoulder is dressing, and how much is just shoulder. Terribly exciting. I also get to start three (count ‘em) new exercises today, including exercises with the very dangerous looking pulley system.

But maybe I should go back and give the details I didn’t give over the weekend. I wasn’t fitted with an abductor pillow (d’oh!), but instead was given a sling and a cryo cuff, possibly the coolest invention ever. While I was in the recovery room after surgery, I was trying to entertain myself, and it seemed rude to find amusement with the instructions given by the nurse to the guy in the bay next to me (who had fairly obviously just had surgery on a “delicate” area). So every time I was left alone I grabbed my chart and started reading. Always good to know what’s being said about you, right? Anyway, I found one page where they described materials used in the surgery (with a listing for sponge count, which I’m guessing is to make sure they don’t leave anything inside?), and there were two stickers for things called “corkscrew suture anchors”. I asked the nurse about them, and she didn’t say much, so I let it go and just thought it was a little weird that they’d have anchors to hold together the stitches that close the incisions. Thought it was weird right up until I realized that that isn’t what those are, they’re actually for reattaching the tendon to the bone. So… I think I have screws in my shoulder. I’m not sure why that creeps me out as much as it does. I mean, what did I think they were going to do, open up my shoulder, give everyone inside a stern warning, and close it up again? Still, having screws put in, and also having bone ground down (the acromioplasty part), is unsettling to think about. I think I’ll think about other stuff right now.

Saturday was probably the toughest as far as soreness goes – not only was my shoulder sore, but my abs felt like I’d just done a thousand sit-ups or so. I’m not entirely sure why, but I guess it may have had something to do with how I was positioned during surgery – from the info I have I think it was the lateral decubitus position shown here. It doesn’t look like the most relaxed position ever.

Anyway, I don’t have pictures from my surgery yet, but I found some gory ones of the procedures I’ve had done. They’re here. I’ll put up my own when I have them (and figure out how to post them).

OK, anyone have anything they want to know? I’m too tired (medicated) to think of anything else on my own. Questions are welcome, as are suggestions for today’s Big New Challenge: figuring out how to wash my hair.

-M