Showing posts with label shoulder. Show all posts
Showing posts with label shoulder. Show all posts

Monday, July 26, 2010

fogged up and foggy

I appologize. I'm in a fog. Of sorts.

I got up this morning at 5:30flippingAM after 1.5 - 2.5 hours of sleep. (still with the no sleep thing. every night)

I got a ride to work with Joshua. He picked me up at 7:15 and I was there by 7:30. I was ontime for the first time in IDontKnowWhen. yuck.

I dealt with 400 emails, 33 voicemails.

I had 7 other recruiters asking me 58 questions over and over about their docs and my jobs and where the hell we were in the process. (its ok if that doesnt make sense to you)

I sat at work during lunch. No lunch with the puppies for the next 6-8 weeks. No driving allowed. FUCK.

I left work at 5:00flippingPM.

I finally saw my puppies at 5:15. BEST.PART.OF.THE.DAY.

Oh, My shoulder still hurts. Like I told Annie in an email earlier, If I needed another shoulder surgery to be able to throw a softball again.......I would NOT be throwing a softball ever again.

Yes, it still hurts. No I can't get comfortable at night. And yes, physical therapy starts tomorrow. Passive motion. woohoo. Good times are a coming.

muahs. I'm sorry if I've been slacking on reading and commenting on your blogs. I'll be back eventually when my arm doesnt feel like its falling off so much. I miss u guys, but I cant keep up right now. I will be back more often soon. Promise.

p.s. Remi said hi. And wait till you see the underwater pics of him. =)

Thursday, July 22, 2010

She Will Play Ball Again - Updated

EDIT:
I updated post with intra-operative pics. They are at the end. Squeemish beware!

At 8:15am this morning I still wasnt completely dressed and my follow up, post op Dr's appt was in 45 minutes. ADL's or Activities Of Daily Living were giving me a headache, early. I couldnt get a bra on or a sports bra and my ride (Lauren) and assistant (Lauren) were not here yet.

I struggled for a few more minutes and could not for the life of me get the flippen bra on. I finally got a wife beater on. Screw the bra. Whew! THAT was tough! lol I just threw a lightweight sweatshirt on the one good arm and tossed the other side over the lame shoulder. I was ready! Who needs an assistant??? But I did need a ride and Lauren showed up 5 minutes after I was done. lol

We get to the Doc with minutes to spare and are in an exam room real quick. Told you all I'm VIP at this joint! ;) Shay (docs assistant) comes in and takes off all the bandages. Finally I get to see it! 5 holes?? What the hell did he do?? Shay takes the staples out of the two small holes and she says she wants him to decide if the others come out of the bigger holes. (He did take all the staples out. He said there are a bunch on internal sutures that hold it shut. Ok.)

Within 5 minutes in strolls Dr. GeorgeousIWouldntSayNo and without a hello gets all up in my personal space shaking a finger at me while saying, "You, young lady NEED to make sure you listen to what I'm going to tell you, follow your rehab to a "T" and not mess around and try to move to fast. Your shoulder was an absolute mess and I fixed this and it was a lot of work, so don't make me have to refix it!" Damn, I was in trouble before I even got to say hello! He was joking but serious at the same time.

I then proceeded to tell him that he's lucky I didnt call his cell phone number on Monday OR Tuesday all night long and bitch him out for what had to have been a hellacious beating of my shoulder with with a two-by-four while I was under anesthesia in the OR.

OK, so we're even. I think....lol

The good news...I didnt blow out the Biceps tendon. VERY IMPORTANT tendon, very involved in the throwing motion. He said its just a little frayed and thats from tendonitis (throwing) and should heal up fine with all the rest its going to get. =)

The bad news....we knew already. I did blow out the supraspinatus and infraspinatus tendons. One of which was retracted pretty far with a large tear in the muscle.
He proceeded to show me cool intraoperative pics which I've put at the bottom. ;) And he drew pics of how he fixed it too. It was soooo cool.

I'll try to explain this, only because what these docs do is amazing to me. First let me explain how the tendons normally attach to the humerus. There is what he called a "footprint" at the top of the outside of the humerus where the two tendons come together and both attach. Its an area that looks like an indentation in the bone. So its a pretty large area and the tendon is attached to this whole area.

Heres how he did it. First he does a decompression. That just means he shaves off the bone where the tendons ripped off of, the "footprint" area. He makes it all smooth and pretty and ready to accept the re-attachment.
He put 4 screws at the top of the humerus "footprint" area and out of each screw there are two color coded strings. He then takes those strings up through the tendons and knots the tendon down. Now there is a bunch of string left after he knots it thats still to be used (more on that in a bit). Then he goes to the bottom area of the humerus where the bottom part "footprint" area of the tendon is to be attached and puts in two anchors. He takes the parts of the string that are still attached at the top and weaves them thru the tendon and finally ties them all down to the two anchors. So now the tendon is seated like it origionally was in the bed of the humerus where it once was (before I ripped them away).

Now it needs to heal. The tendon will re-attach to the bone, hopefully like new. 6-8 weeks in the sling and NO abduction. Abduction is the movement of your elbow away from your body outwards. Like holding your arm straight out to the side. I can move my lower arm all I want. Just dont move my elbow away from my side. FOR 6 - 8 WEEKS. Holy shit thats a long time!

PT starts next week. That will be all passive movement just to keep my shoulder from freezing. That if I recall from the last surgery was painful stuff. But I'll do it.

He gave me hope. He said I should be able to throw again. Even though the Rotator cuff is important in throwing, if all heals well I should be able to. Now he did throw in a pretty scary statistic. He said there is a 30% chance of re-tear. He said it happens typically within the first 9 - 12 months. It happens even in perfect/good repairs. He considers my repair a "very good" repair. Meaning the tendons were all like crabmeat when they tore, but cleaned up well and took the thread well. He was able to take the retracted tendon and stretch it down fine so no pig intestine was needed. I had NO labral tears and although the tear was large in the muscle, he fixed it up good. So fingers crossed that this bullshit spontaneous combustion doesnt happen.

So you know I took a pic!

5 holes. 2 little, 3 big. 2 tendons re-attached to the bone with 4 screws, 2 anchors and a decompression done. I'll be able to throw again if it all holds up. =)

And today was a much better day than yesterday thats for sure. I only used the regular tylenol all day and was fine. =) Its sore, and hurts a bit if I move the wrong way but its 10 x's better than even yesterday. I just want to sleep at night. Thats my biggest bitch now. Oh to sleep. But that will come in time too. I do plan on taking the Tylenol 3 tonight. If anything it'll help me sleep.

Im on my way to recovery. I figure March. I wanna play ball by March. 8 months. Thats my goal. =)

Intraoperative Pics.....

Bicep tendon...intact. =)

It should be all white and pretty in here...blood = acute tear.

Looking down from top of shoulder...should see only muscle, but seeing top of humerus. Tendon and muscle are gone. =(

"footprint" area of humerus where tendons were attached before being ripped off.

This is the screw. Its clear but you see the metal screwdriver inside of it that obviously backs out once screw is placed inside bone. The screw will eventually dissolve.

Screw showing color coded strings attached.

This is the anchor. It is metal and does not dissolve. These'll go to the grave with me.

Strings being woven into tendon.

Finished product with the crisscrossing of strings attaching the tendon to the "footprint" area of the humerus.

Tuesday, July 20, 2010

alive & not karate chopping

hey kids! alls well. just checking in to let everyone know i made it through surgery fine.

i will say, i'd rather have an ACL surgery on my knee 10x's over this one. i'm trying not to whine here but omg it fucking hurts lol. the nurse said afterwards that it should hurt because there are six screws in there =0. wtf?? cant wait to here wth he did in there.

i'll have all the details tomorow morning because i have my first post-op follow-up at 9am.

i guess im still not going to be sleeping for awhile. last night was two hours of fitfull sleep. hell, it can only get better at this point. =)

im off to take a pill. yes, im actualy taking tylenol3. its cool as long as i eat a piece of bread before i take it. im not getting sick from it so alls well. tomorow im gonna try just regular tylenol. we'll see.

and dont worry, my boys are keepin an eye on me!


thanks for all the well wishes! i appreciate them very much. love to you all!!

Sunday, July 18, 2010

Knife Wounds

So tomorow morning at 8:00am I'll be under the knife. My doc will be doing what any Orthopedic Surgeon LOVES to do....slice and dice. I'm actually glad he loves it. =)

I posted here about how I tore my shoulder up after falling while rollerblading a few weeks ago. As well as the follow up doc visit and the MRI results showing a massive rotator cuff tear.

I'll try to post in the afternoon once the anesthesia hangover is tolerable enough to lift my head and type coherent sentences. If not, I'll do it on Tuesday morning.

Here's a great pic that shows the two tendons I tore. I put big read arrows to show you which ones.


See ya'll on the other side!
Muahs!!

Monday, July 12, 2010

Bionic Effin Woman

So remember a couple of weeks ago I wrote about wiping out on my rollerblades and jacking up my shoulder?? Remember I didn't want to expound on what I thought was wrong until I saw the doctor and had some diagnostics done?? Well it was here.

And I wrote this:
2. I finally busted my ass on the rollerblades. Well not my ass exactly or my knees. I was cruising along at a fair clip, ie: fast!! Didnt pay attention for a split second and hit a rock. FUCKER. My right rollerblade immediately stopped, my left rollerblade tried to save me and it was not to be. What is in motion, stays in motion.

After the left rollerblade realized I was doomed, the right decided to help and in the process pulled its hamstring from midthigh right up into the big ass butt. Once the right leg wasnt working anymore the mind kicked in because it realized our body was in the middle of A1A in late rush hour traffic. So said body launched about 3 feet into the air attempting to reach the bike lane again and landed with all the body's weight on outstretched arms and destroyed the right shoulder on impact. Thank you to all the hot dudes in the BMW's who stopped and rolled down your window asking my buddy, "Is she ok?". Dudes, a little mouth to mouth might have helped. Once again, Just Sayin.

I'm not even telling the details of the injuries until I know for sure. Just know its bad enough that I didnt play softball tonight. And anyone that knows me, KNOWS I dont miss softball unless I'm physically not able to participate.


When I fell on the rollerblades two weeks ago, I fell hard, on outstretched arms, mostly my right arm. I was protecting my knee I'm sure. Remember the knee that had ACL Replacement surgery just 11 months ago?? Yeah, that knee. Protect it at all cost is obviously subconciously in my head at all times.

I knew I fucked up my shoulder. Bad. I knew it because I couldnt push up to get up off the ground as I lay on my stomach with half my body on busy A1A and the other half in the bike lane. I know my body. I felt it (my shoulder) let "go" in retrospect. And it hurt soooo bad. I was a whiney baby for a couple of days after this fall because it hurt. I'm still whining because I cant sleep at night because it aches and wakes me up constantly. It feels like a damn toothache that.wont.stop.ever. I cant take anything but tylenol or advil. I cant tolerate pain meds. Its just not worth the nausea for me to take them. I'd get rid of the pain to be up feeling pukey. So I'd rather have the ache believe it or not.

So back to the night I fell. While I was laying on the road I thought for sure I'd dislocated my right shoulder. Once I was able to roll over and get up off the ground, with help, there was no deformity so then I knew it wasnt dislocated.

I actually went to the ER that night to get it x-ray'd because I thought for sure I'd broken my humorous. Not the case according to the x-rays. No fractures found.

So I called my trusty Orthopedic, Dr. GeorgeousIWouldntSayNo, the next morning. Yes, the same guy who did my ACL surgery last summer and fixed my broken ankle and repaired my other shoulder a few years back. I know everyone in that office so they got me in that afternoon. I'm a flippen VIP patient!! I've paid for at least ONE of his 4 boys college tuition by now! Plus he loves me and I used to work for him back in the early 2000's. We are buddies and he always asks to see the newest pics of Lauren and the puppies. I trust him to fix anything I screw up. And he hasnt failed me yet!

He came in the room, saw me and immediatly said, "Holy shit, you look great!! How much weight have you lost?!?" Well, that just made me feel awesome!! Then he asked what I did to my knee now. lol I told him about the rollerblading misshap and I thought I messed my shoulder up bad. He examined me, shook his head and said it didnt look good. He wanted an MRI to see exactly/verify what he thought was wrong. I was darn near crying in his office after he got done messing around with my shoulder. He KNOWS I dont cry. Hell I had ACL surgery and never took more than Tylenol. He knows me and he was concerned.

Then the fucking insurance company wanted to be assholes about authorization so they initially denied the MRI with just the notes from the office visit. So then the Doc has to get on the phone do a peer to peer review and they authorized it on the spot. They are so stupid. I didnt get the MRI until this past friday morning. 10 days after I saw the Doc!! After the MRI was done they gave me the disc with the images and I begged them to have the radiologist read it so I could pick up the report for my appointment with the Doc later that afternoon. My doc doesnt need the report but he likes to see what the Radiologist has to say after he's done his looking at the MRI. The report was done by the time I was leaving my office for the appt and I had them fax me a copy to bring with me.

The report said exactly what I hoped it wouldnt, but KNEW it would. I didnt just tear my rotator cuff, I have a massive tear of the rotator cuff.

By definition a Massive Tear is:

The rotator cuff is a group of tendons and muscles in the shoulder responsible for internal and external rotation, as well as stability of the joint. The rotator cuff can suffer varying degrees of injury, one of which is a massive tear.

Biomechanics
1. In a normal shoulder, the rotator cuff muscles pull downward against the force of the deltoid muscle to balance the ball (humeral head) of the upper arm in the socket.

Massive Tear
2. A massive rotator cuff tear is defined by Dr. Richard J. Hawkins, M.D., as being greater than 5 centimeters in the coronal or sagittal plane.

Identification
3. An alternate definition of what constitutes a massive rotator cuff tear comes from Dr. Bernhard Jost, who said, "One accepted definition of a massive rotator cuff tear of the shoulder is a rupture of at least two complete tendons."

Analysis
4. Jost goes on to say that, for a suspected tear, a medical professional will likely examine the three major rotator cuff tendons---supraspinatus, infraspinatus and subscapularis.

Read more: Definition of a Massive Tear of the Rotator Cuff | eHow.com http://www.ehow.com/facts_5633145_definition-massive-tear-rotator-cuff.html#ixzz0tbWcKIj5


So according to the MRI, I meet BOTH of the above criteria.
1. I completely tore the Supraspinatus and the Infraspinatus tendons.
That would be the rupture of two complete tendons.
2. And lucky me, the Supraspinatus is torn almost 7.8 centimeters. I damn near ripped the whole muscle in half.
That meets the second definition.

Weeeeeeee! I don't do things half ass people. If I'm gonna destroy a body part, I DESTROY IT. pfffffffft.

So my whining wasnt in vain for the last couple of weeks. I was/am hurt. lol I'm doing my pre-op testing/clearance tomorrow and have surgery scheduled for o'fucking early next Monday morning. He's a little concerned because one of the tendons that tore has rolled up into my shoulder and 3 weeks is the max window to try and save the tendon. Monday will be 3 weeks exactly.
He's hoping to be able to stretch it back down and attach it to the bone. If not he will have to use a pig sheath or something like that. And it'll be an Open procedure vs Arthroscopic surgery. And it'll make the healing time twice as long.

I'm looking at best case scenario of six weeks of a sling with zero movement. If he's gotta go with the pig part it makes it 8 weeks in a sling and many extra weeks of PT.

Softball is a dream right now. He doesnt know and won't guarantee me the ability to throw again until he gets in there. It might be too fucked up. If he can fix it (which he will, I have faith!!) I wont be playing until next spring. He said, maybe March at the soonest. fuhk!!

So thats my story. I am a gracefull one, aren't I?? No worries people, all will be well. It has to be! =)