Friday, March 29, 2013

One Month Post 2nd Surgery...the Recovery Continues

I'm at the one month point and things are much better than the last shoulder surgery, as I have previously stated.  The fact I can, and have been, able to put on a workout sports bra for over two weeks is a good example.  I have been able to dry and curl my hair, put on make up and today I even tried to clap at the Nationals baseball game.  I will take three out of four and am not ready to clap yet, too much vibration up and down my arm.  I will just stick to cheering. 
3 week point, I have almost
full flexibility above
my head.

I have also figured out how to help Myles (17 year old lab) up and get him in and out of the door and down the steps one armed, as well as strip and make beds, shovel snow, take the garbage out and occasionally cook with one arm.  Not always the best form but I can get it done.  I started running last week to train for a 5K and have figured out I can't pump my arms quite yet, so I keep my right arm at my side.  It will get better, I just have to let the actual scar heal and get rid of the scar tissue so it doesn't hurt.  (There will likely be a running blog entry or two in the future since I don't care for running nor do I find it very fun).


Inside and outside rotation with the band.



Here are a few pictures of  what I got to do today.  A special thank you to Susan for always being ready to take a few pictures to show my progress.

 I got to use the bands and start flexing my bicep during physical therapy.  I say in physical therapy because in real life, as mama to an 8 year old you do the best you can but sometimes you just have to be a mama.  That means I have probably flexed it and used it more than I should have already but again, being a mama is first then I can be an athlete.

The second picture is me doing an exercise I totally hate.  Nothing can make you feel more weak and useless than this.  I have to basically be in the downward facing dog yoga position and then try to lift my arm up by engaging my back and shoulder muscles.  If I have a good day I can get it maybe two inches off the ground and a bad day is thinking I am going to do it and then nothing happens.  I always end up feeling so weak and awkward when I do this.  Since it was the first time I held a band and let it pull my arm up, then I had to pull it down.  Again, I can't state enough how much I hate this exercise and yet it is really good for shoulder strength and recovery.


Finally, I got to try a little balancing on the table. I lift one arm up and slightly rotate and then I go to the other side and back and forth maybe 20 times total.  I liked it and it means I am only a week or so away from getting to work on the bosu ball and really rebuilding my arm muscles.  I also got to do little table push ups going down maybe two to three inches then back up.  It is crazy how exciting it is to be allowed to do a push up and really crazy how shaky my arms felt after just doing ten.  At my age it takes so long to build up the muscle and so fast to lose it and then so long again to build it back up, hate that! 



Thursday, March 28, 2013

Shoulder Surgery Take 2

MRI December 26
 
It would seem, 18 months after my first shoulder repari,  I needed to have shoulder surgery again. Dr. Carlini knew exactly what was wrong in December after seeing this on the MRI. My bicep tendon was tearing away from the anchor that had been inserted in September 2011.  The anchor was holding in the bone great but the tendon, it was degenerating.  I love that my doctor calls me semi pro athlete and world class masters swimmer.  But what I really love is that technology has advanced in leaps and bounds in the past 10 years and even more so in the past year.  What I had done in September 2011 was a standard SLAP repair, but now the recommendation is for athletes like myself over 35 to have the Button Bicep Tenodesis by Arthrex Technique.  
 

What looks like white fraying at the top
of the picture is my tendon torn off.
 
Even though I met with Dr. Carlini on January 2, due to a planned trip to Las Vegas in February and Brad's work travel I wasn't able to schedule the surgery until Friday, March 1.  (See a future post for Adventures in Vegas with Brad's high school friends).  During that time I was having weird twangs down my arm and sometimes little pains.  Occasionally it would get tired and just ache but mostly it was the twangs that were disturbing.  I swam a little bit but the free style arm stroke hurt so it was easier to just kick or hit the gym.  By the time I had surgery two of the three tendons had pulled away from the anchors and one had torn in half. It's amazing what two more months will do to make it worse, and I really backed off on pretty much everything.  I think this had gradually been happening over the course of 3 months before it really started hurting in Hawaii over Thanksgiving. 
 
Surgery day arrived and I was not even nervous about this one.  The day before I had subbed half a day at St. B's school, then played (and won) Bunco that night with my girlfriends.  We dropped McB at school and went to the surgery center.  I will swear part of my loosey goosey attitude was the 2nd grade praying for me and a lot of others associated with St. B's.  I figured if they had my back I could just go in and get it done.  (Much like the 200 free at Masters Nationals, ha ha).  I walked in at 8:30 and was in the wheel chair heading home at 12:20 with a nerve block that lasted 21 hours.  Always make friends with your Anesthesiologist, they keep the pain away. 
 
If you look up my procedure this is what it says: The Bio-Tenodesis Screw System was designed specifically for the reattachment of soft tissue, both ligament and tendon, to bone. The Bio-Tenodesis Driver facilitates accurate graft tensioning into a bony socket in a simple “push-in” method. The interference fit provided by the Tenodesis Screw and FiberWire virtually eliminates graft separation from the bone. Because of the strength of the repair achieved with the system, patients are generally allowed to begin postoperative rehab earlier than previously permitted. The Bio-Tenodesis Screws are composed of PLLA and are available in numerous sizes to fit all applications. There are also titanium and PEEK Tenodesis Screws available for use with the system, if desired. The system is ideal for the reattachment of soft tissue to bone in proximal/distal biceps tenodesis.

Four weeks, March 28.
First day the bandages came
off, Thursday March 7.
What my doctor said is that not only would I come back faster,  but also stronger than last time.  For me, and what kind of progress we are seeing already in physical therapy, is everything is taking half the time. 

The picture on the right is my scar one week post surgery when the bandage came off.  This one on the left is what it looked like at four weeks post surgery on Friday, March 28.

 


 


First PT appointment on March
 8.  I could do the pulley already.


More important is this picture below, from day 13-post surgery; my arm is over my head.  My movement and flexibility at that point would be considered 'book normal' by most and it's fantastic for anyone, especially less than two weeks after a major joint surgery.  My flexibility and movement is a bit more than that so I'm almost there now but to have my arm move above my head so soon, it was just amazing. I also think it is really fortunate, to be able to work with a really smart and fantastic physical therapist who stays current on new exercises and techniques. 

Day 13 and my arm is above
my head.


But what really sets Susan apart from the rest is she's known me for over six years now.  With that knowledge of how my muscles and bones work, and also how I think, she knows when and how to push me to get me back to my old form.  

Stay tuned for the next entry which will document my continued therapy and recovery.