slick's shoulder surgery blog

Happy to report that I have survived my first meet at 6 months post-surgery

After over-doing it the week before and suffering the consequences, I was pretty nervous going into this meet. Wasn't sure how I would feel, had no idea what to expect, etc. I just knew I had to survive! I had overdone it the week before the meet, and I was so sore that I imposed a 3-day NO swimming taper on myself. My last (crappy) practice before the meet was Tuesday and I didn't get in the water until warm up on Saturday morning! During warm-ups things were feeling pretty sore still. I didn't want to over-do it again so I only did about a 400 and then 2 starts/breakouts which felt OK on the shoulder.

I was signed up for 50 SCM free, 100 breast, and was on the roster for both relays on Day 1. Day 2 I had the 100 free, 50 breast, and both relays again. Before the 50 free on Day 1, I was laughing and thinking to myself, 'Why the hell did I sign up for the fastest, most intense event there is in this sport as my first race back from surgery?!' I had seeded myself at a :35.5 and I went a :34.0, so that was OK I thought. I made sure to start things out slow and sort of get the feel for it and build into it if I could. Halfway through the second lap I felt a fairly sharp tinge in my shoulder, and after the race I could feel that I was still really, really sore. I cooled down a bit and immediately took some NSAIDs, got out the ice pack (and I iced after every race), and wondered if things were only going to get worse over the meet.

But it turns out that things only got better! I actually ended up doing 3 more 50 frees over the weekend as part of the relays. This really helped me gauge my range of improvement, which was as follows:

Indv 50 free - 34.0
Relay #1 - 32.8
Relay #2 - 31.4
Relay #4 - 31.1 (Day 2, last race of the meet, dead tired)

At first I just assumed that the relay start gave me an advantage on that first relay, but it became clear that I was actually improving as the meet went on. Apparently I just had to warm up a bit! My shoulder actually felt BETTER as the meet went on….not sure how to explain that (adrenaline? def was not the altitude….). I am very pleased because at this meet last year I was splitting :30.5-:30.8. Heck, I swam this event back in October two weeks before my surgery and did a :30.9 flat start. So I am very encouraged by this! Not so bad at 6 months post-surgery!

Other meet highlights:
100 breast - Seeded 1:41 and went 1:35.7. Never swam this event in SCM before so nothing to compare to, so that and the fact that I am the furthest thing from being a breaststroker helped make it fun lol!
100 free - Seeded myself at 1:19 and went 1:11! Swam this in a 1:09 two weeks before my surgery. Glad I wasn't the only massive sandbagger in my heat….
50 breast - Seeded :45.5 and went :43.9. Did a :42.2 before the surgery. I was really feeling this one as the 100 free and relay #3 were both within an hour before this event!

Big meet highlight:
Women's 200 medley relay (relay #3) - I DID A 50 FLY!!!!! Coach had me down for fly, and I was immediately like "Did you not remember that I am only doing free at breast at the moment?!" So I was going to switch strokes with my teammate but then I decided why the hell not? I literally had not taken one stroke of butterfly since early November. So I did a couple strokes during my cool down after the 100 free and decided to just go for it. Well, I survived! I did feel a bit sore after but that soon dissipated. What sucks is that I have no idea what my split was due to touchpad and/or breaststroker error!! Argh! It feels like it was a 33-high/34-low? But I have no idea. Sigh.

Lessons learned:
- Seems like my shoulder can handle short distance/higher intensity at the moment, at least better than long distance/lower intensity
- Underwaters, I have them And they are stronger than ever, which really helped me out at this meet I think.
- 72 hour no-swim tapers *may* have beneficial properties

So, back to a normal routine. The shoulder is feeling pretty good again, and I don't seem to have any residual soreness from the meet. I am going to SLOWLY ease back into regular workouts again, and will try not to overdo it this time! I know my current limit and will try and do whatever it takes to move forward while limiting the setbacks. It has definitely been an interesting past couple of weeks with all the ups and downs I've experienced! LCM season is right around the corner and next meet won't be until August so there's plenty of time for improvement. I am SO GLAD that I survived this first meet….it was a great confidence-builder and it feels good to hop over yet another fence! Woo hoo!

Well, I've got to suck it up and admit that I've overdone it.

Was feeling great so I ended up doing 5 workouts over 8 days, about 3600 average per practice. I was sorta feeling it during that 5th practice but I decided to push through since I had been doing so well the past week or so. I am paying for it now! Hot damn my shoulder is killing me! Very sore, feels like it is going to fall off again, etc. I threw in the goggles after 2000 yards last night.....so frustrating because I could feel that my shoulder was beyond fatigued but my cardiovascular system was still rearing to go. Bah! Was not expecting to hit another threshold so soon! Looks like I'll need to scale back for a while longer. I need to keep reminding myself that I'm just 6 months out at this point...what do I expect?

And I am supposed to race this weekend !!!!

The plan: Ice and medicate like hell and not swim at all until warm-up at the meet on Friday evening (not racing until Saturday). At least I now I am well acquainted with this feeling, and I know that rest is the only fix for it. Hopefully 72 hours out of the pool will do the trick. Hows that for a taper!? LOL

You know you're on the other side of the fence when:

- You arm no longer feels like its going to fall off at the end of practice
- You can swim 2 days in a row with only very minimal soreness that doesn't even call for ice
- Your arm doesn't go numb when you decide to push the pace
- Your PT no longer wants to see you!



Yep, pretty much able to do full distance workouts now! Its a lot of work to just keep up with my lane mates but I'm doing it! Still sticking to mainly free and breast....I've ditched the fins but I'm keeping the snorkel on for most of the main set still. I did 3600 yards on Sunday and a 3850 Monday and felt pretty good! Normally I wouldn't swim 2 days in a row quite yet but my schedule got tripped up for a bit. Breathing on the right is still a bit difficult but I'm forcing myself to do it so I don't widen any imbalances that I have right now. While the intensity isn't there yet the endurance is definitely back!

I signed up for our association's meet at the end of the month (free and breast sprints) so we'll see how that goes! I'm a bit nervous about handing the starts/dives, but it will be a good exercise for my shoulder and I so we can start trusting each other again, lol. Its actually been pretty funny......as the meet draws near, coach has been having us practice our underwaters. Lately we've been ending our workouts with 8-10 x 25s, half underwater kick-out and half swim. Let's just say I am CRUSHING my teammates on the first half of those 25s.....then they all crush me on the latter half lol.

Next month: a butterfly attempt!

Grass is definitely greener.....hello spring!

So yesterday was the 20 week mark! And I must say things seem to be going along ~swimmingly~ at this point, haha!

I seemed to have finally kicked the major soreness I wrote about last month. At my last writing I was about to go out of town for 4 days and I decided that I would do NOTHING shoulder-related during that time, not even my PT exercises or stretches. Well, that seemed to do the trick! I guess I just had to listen to my body and take a bit of rest. I’m not sure what my PT will say about this, but I don’t think I’ll care anyway since it feels like I did the right thing. Right after that long weekend I went back to the pool and felt GREAT….and things have just been picking up since then!

As of yesterday I was able to do a whole 500 yards freestyle non-stop after diving in for warm up, woo hoo! And on top of that, I was able to complete the entire 1500 yard main (freestyle) set with my zoomers and snorkel. So that’s a whole 2000 yards of swimming right there at 5 months post-surgery. Very stoked about that! (And I know I’ve said this before, but I again must give mad props to my snorkel. Seriously people, best. tool. ever!!! Not having to turn my head to breathe has been SO valuable at this point in my recovery. The snorkel has actually been an instrumental tool throughout my entire process thus far. Best $30 ever spent….I <3 my snorkel lol!)

It’s crazy how exhausting these practices have been. I am just moderately swimming along doing about 1:25/100yd pace WITH the zoomers and I feel like I am going to DIE afterwards lol. But I hope this progression can continue at this rate and I can get back to my old self soon. Right now I just want to focus on getting the yardage/endurance back. Still icing after every practice but no need for nsaids at the moment. I still haven’t really attempted much backstroke yet….I’m a bit wary of it actually since the first few strokes I did take were nowhere near comfortable. Backstroke was the most irritating to my shoulder before the surgery, so I’m in no rush. At least I got my underwaters all ready to go lol!

Yowza, the shoulder has been acting up quite a bit the last few weeks! Its hard to pinpoint the exact cause due to multiple possible contributing factors:

1. During my last PT appointment (which was 2 weeks ago now), I got quite a good stretch. I have my appointments in the morning, so when my PT reported that I hadn’t made any progress in my external rotation, I assured her that I most definitely had made progress and that my shoulder just wasn’t warmed up yet. So I got a bit of a stretch to help out with that, which turned out to be quite intensive and I feel like I’m still recovering from it. Note to self: next time (god forbid there is a next time) make series of PT appointments for the afternoon. I have noticed that I am definitely more flexible later in the day compared to mornings (makes perfect sense though).

2. New PT exercises. I am usually sore for a few days after I start new exercises…..but I think my latest set may be especially challenging since I’m literally at the “home stretch” (no pun intended, ha). Currently working on lots of muscle strengthening in extended/outstretched positions at the moment.

3. Swimming. Currently I’ve worked up to about a 600-700 freestyle per practice…..slowly but surely. I’ve still been kicking for most of the sets but I have been swimming the last length of each interval (with fins and snorkel most of the time). Last practice I did a whole ~100~ in a row, which was doable but challenging. I also DOVE into the pool as well for the first time in forever last week which was awesome! But yeah, I am definitely feeling it and it is still going to be a looooooong while before I feel any sense of normalcy.

So pretty much I think this combination of factors is hitting especially hard at the moment. My shoulder is SORE as HELL and I am occasionally getting pins and needles again. This is the probably the most pain/soreness I have experienced in my shoulder since the initial weeks after my surgery. I’ve taken up daily icing again and have been hitting the bottle of ibuprofen pretty hard. Haven’t been sleeping very well either (sleeping could also be a contributing factor)….just can’t get comfortable. Thinking about re-building the pillow fort to see if that helps. Ugh!

I’m also trying to find a balance between doing my PT stuff and swimming. I almost feel like right now it’s either one or the other. On my swim days (3x a week) I hardly do any PT exercises besides a bit of stretching early in the day, because if I did both I feel like my shoulder would probably fall off! I’m feeling like maybe my shoulder just needs a good bit of rest. I’m about to have 4 days in a row out of the pool, so I am going to try to scale back the PT exercises too and we’ll see if that does the trick. For now I think I might just kick the entire workout tonight since my shoulder is SO sore right now…..sigh.

Just have to share.....

So I went to PT this morning, and my regular therapist had another PT (with 'better swimming knowledge') come over and show me how I should modify my stroke to help protect my shoulder from now on. Let me just say, it took everything in my power to not laugh out loud and legitimately do an actual *facepalm* in front of her.

So apparently I need to:
- increase the roll in my stroke so that my elbow never goes behind my body (rotate, but no high elbows!)
- enter the water thumb first

This will ensure that the deltoid will do most of the work, and that it should protect my rotator cuff and help prevent impingement.

?!?! bwahahahahahahaha!

Of course, she proceeds to demonstrate and I just sit there and and

First, NO. Second, I have no problems with my rotator cuff or impingement issues....my problem was shoulder instability which is completely different! Of course, I'm sure she didn't realize that, but it was bad advice no matter what! Ahhhh, the downsides of an HMO......lol. And I know my own stroke isn't perfect, but I can definitely tell you bad form when I see it!

Anyway, I am almost done with PT. My next appointment isn't until the first week of April! Until then I am supposed to work on my 'end range' stretching and strengthening. It has actually been a bit hard keeping up with my PT routine lately, as a) now that I am swimming more, I don't want to overdo/overuse for the time being; and b) I feel more normal lately, so its harder for me to feel that I *have* to do them. Of course, I will need to manage and protect my shoulder from other injuries down the road as I age.....but for now if my shoulder can stay in its socket, then I feel that I'm golden lol!

Wow, its been a while! OK ok, so its actually been 3.5 months since my surgery…..but if you want to get technical about it, it has been 16 weeks to the day! Which means 4 months in my opinion And today I can officially start spinning the arms again….woo hoo!

Last time I wrote I was cleared to start doing breaststroke, which I have been doing just fine with the past few weeks. It took a few practices for my shoulder to get the hang of things again and I slowly worked my way up to about 400-500 worth of breaststroke per practice. This might not sound like much to some of you out there, but know that breaststroke is my worst stroke and I would almost rather kick than swim it lol!! I have also been getting in 400-500 worth of sculling (all types) per practice as well. So for about the past 2-3 weeks now my workouts have been approximately two-thirds kick and one-third breaststroke and/or sculling. I am also now doing full streamlines (though they still feel a bit stiff) off the walls and am able to keep my left arm up and out while doing one-arm fly and free. The streamlines alone have made a huge difference for me in the water….it has brought back a lot of balance and grace to my swimming lol! So it has been a good few weeks of warm up for my shoulder I’d say.

So, tonight I get to *officially* start swimming freestyle…but since I am so impatient I *may* have already attempted a few strokes or so. Last Monday I simply did a 25, then Wednesday I did a 150 or so, and Saturday I did a whopping 300 throughout the entire practice (broken into 25s at time, using fins AND snorkel). Of course my shoulder is still a bit stiff as my range isn’t completely back yet, but it’s slowly getting there. So far it feels OK though while I’m in the water. As soon as I get out however….it feels sore as hell! I can definitely feel it right after practice and during the drive home, but an hour later I don’t even notice it anymore, so that’s good (same pattern occurred after I first started sculling and breaststroke too). I also know that it can’t just be my shoulder that I am feeling…..cause man, my arms and upper body right now are WEAKSAUCE. Just about two weeks ago I finally noticed the reappearance of some muscle definition in my left arm (thank you sculling!), but my upper body muscle has definitely atrophied. And of course meanwhile my legs are completely jacked up and I’m walking around like I’m about to fall over all the time. Talk about muscle imbalance! lol.

Anyway, so now the fun really begins! I don’t have an exact plan yet for building back up to normal workouts, but I know that I’ll be keeping the fins on for a while longer and will make good use of the snorkel to get things going. As soon as I build back up to being able to swim reasonable distances, I can ditch the toys. I do plan on attempting some backstroke soon so we’ll see how that goes! I know butterfly will still have to wait a bit – I’m thinking at least 8 more weeks until I even attempt it (my surgeon says that I shouldn’t do it at all ….*knee slap* bwahahaha!).

And believe it or not – I have a goal of swimming at our Association championship meet at the end of April! It will be 24 weeks out from surgery then. The registration deadline isn’t until 2 weeks beforehand, so of course I still have lots of time to feel things out and see how they go. But I don’t’ see any reason why I couldn’t at least do a breaststroke event or two and help the team out on some relays. We shall see I guess!!

Not much to report lately as new developments are slower to come these days. On a daily basis I don’t even notice my shoulder any more…..unless I am doing my PT exercises or I am in the pool, things are feeling fairly normal! I’ve steadily continued to improve with my range of motion and right now I’d say I’ve got 70-80% of my full range back. It’s been almost 3 months since the surgery (11 weeks, 2 days) so I’d say that’s pretty good! I can get into a streamline position fairly easily now

I see my surgeon for my 3 month follow up at the beginning of February. My PT wants me to ask her if she wants me to continue PT until I get 100% of my full range back, or if I should slow down and hang out around 90% or so for a while. The theory is that my range will fully come back in time, so it’s more about becoming too loose too quickly. I imagine that I’ll loosen up quite a bit after I start swimming again, so no huge reason to rush back to 100% when 90% may be better for the long term for now. In fact many of my measurements are actually considered ‘normal’ at this point, even though I still have a bit more to go to match up with my other shoulder. However that isn’t a bad thing since my other shoulder is, of course, quite flexible and could be considered a bit loose anyway.

I’m hoping after my 3 month visit that I will get clearance to start doing some breaststroke and get a better idea of what my timeline will be for getting back to regular strokes. Until then, I am still in kicking purgatory. And it is definitely purgatory!! It’s been a love/hate relationship the past few weeks, that’s for sure. There are days where I feel all lonely in the gutter lane while I watch my teammates zoom by, but at the same time I am just thankful to be in the water. I constantly have to remind myself that I knew exactly what I was getting into, and that this is for the long term, and that I’m still putting in the time. It is frustrating though because I just want the time to go by faster, yet I know that there really is no rush. Such conflicting feelings!

I’ve still been averaging 2500-3000 3x per week, which is about as much as I can do if I want to keep my legs from feeling like complete jello. My legs are sore ALL the time these days and I can definitely feel it with just one flight of stairs! My ankles are also super sore and crazy flexible right now too, so my big fear at the moment is that I’m going to trip, stumble, and/or fall and re-injure my shoulder, lol. Coach says its time to start weaning off the fins so that might help a bit with the soreness (but not with the boredom! lol).

To help combat the kicking purgatory I’ve also started to re-vamp my gym routine. I’ve recently been given the OK to start using some of the upper body weight machines so I’m really starting to focus on strengthening work again. I’ve upped the weight/resistance on a lot of my PT exercises and have been incorporating a lot of core work too. Last year I literally focused the entirety of my strengthening work on my shoulder(s), so I’m trying to bring back some balance now that I don’t have to worry about my shoulder as much

Till next time….which will probably be in breaststroke purgatory

Still kicking along, averaging 3 practices a week for the past 3 weeks. Getting in about 23-2500 per practice, but I did a solid 3000 on New Years day practice just to start 2013 off right! Gotta say that my legs have been feeling pretty dead lately, and I anticipate that my pants will fit tighter in the thigh area soon lol.

Last time I mentioned that I had purchased a training snorkel, and I must say this might be the best swim toy EVER. Makes kicking on my stomach with my arms at my side a total breeze, even though looking at all the dirt and hairballs at the bottom of the pool gets a little boring after a while lol (sometimes I try to imagine the hairballs and bandaids as tropical fish and corals). But I could literally kick all day long with my snorkel. It’s amazing how relaxed you become and how your swimming transforms when you have a full and unrestricted supply of air…and I’m just kicking! I cannot wait to use it with strokes and drills when my shoulder is all healed. I can already feel my core and my lungs getting stronger. I’ve been called a ‘roller’ with my freestyle before and coach was always telling me to ‘anchor my vessel’….so spending several weeks doing nothing but kicking on the straight and narrow will only help! Also, apparently kicking this way is allowing me to practice true ‘forward’ kicking rather than ‘upwards’ kicking that you do when using a kickboard (read this in some USMS training article). So if you don’t already use a training snorkel I highly recommend you give it a try! What an awesome tool!

Still making improvements at PT….had my appointment earlier this week and I am improving spot on schedule. Forward flexation is now at 160 degrees (last session was 152) which is actually considered in the ‘normal’ range, but I still have a bit further to go to match the flexibility of my other arm. External rotation was at 55 (last session 50) and this time my lateral external rotation (lying down with my arm abducted at 90 degrees) was measured, and that was 70 degrees (normal range 80-90, so I’m definitely on track!). I was then put through a few isometic strength tests which I easily passed. I left with one additional exercise to do with weights and I was upgraded to the next stretch band level. Officially going to PT every other week now!

Been to 4 practices since I got clearance to kick 9 days ago….so far so good! I’ve been kicking in the ‘executive’ lane, aka the gutter lane. It’s actually very roomy – about 4ft wide when the pool is setup long course (just have to watch out for the ladders) and even wider when in short course. Very executive indeed!

I was only out of the pool for 5 weeks and 4 days but as soon as I hit the water I felt like I was going to cry chlorinated tears of joy lol. Right now I cannot use a kick board and I can only use one arm while I keep my other arm at my side. I started off my first day back with a whole 1000 (my intent was to get to 500, but I just had to keep going cause it felt so awesome!), then I upped it to 2000 and then for the last 2 workouts I’ve gotten in a 2500, which is about all the kicking I can do in a workout right now before I’m bored out of my mind lol (takes me about an hour using short fins most of the time). I do flutter/fly kick on my stomach and back….sometimes with both arms at my side and sometimes with my good arm stretched out, and then breaststroke kick on my back. I’ve been throwing in some side kicking and underwater dolphin dives too. Pretty much I’m just swimming along and doing my own sets and just getting the feel for the water again. Still taking it pretty easy….the few times I attempted to get up to speed it quickly became cramp city! Gotta ease back into it. But I’m just thrilled to be back in the water again!

Coach also suggested that I try out a training snorkel, which I’ve never used before. So I ordered the FINIS one and will be testing that out soon…..looks like it will really help me hone in on body alignment and using my core. So yay, new toy! I’m all for getting back to basics as well as trying out new things while I’m in kicking purgatory!

I think in another 6 weeks I will move on up and get clearance to do some breaststroke…..never in my life have I been so excited to do some breaststroke! Seriously, it’s my worst stroke and I despise it, but I shall be forced to improve lol. Really looking forward to all kinds of progress in 2013!

PS - No PT progress to report this week as my PT was out sick. Won’t see her til Monday. But I gotta say that I have seen some huge improvements in my everyday functional activities. I can now easily wash my hair, reach up and get things from high shelves, and even carefully reach out to close my car door! Still no external abduction or extension movements, but its interesting how non-essential those movements are for everyday functionality....

Today my PT gave me clearance to get back to the pool to start kicking! Such a great feeling and it has totally made my day! Technically my surgeon said that I could get back in at 6 to 8 weeks. Today I am at 5 weeks and 3 days. Part of me wants to be good and wait EXACTLY 6 weeks, but I’m about to go out of town for the holiday and I don’t wait to wait until I get back! I figure there’s no harm as long as I’m careful….I mean its not like I’m going to jump in and kick 3000 yards or anything. I figure for my first workout back I’ll get an easy 500-600 kick in and then hit the hot tub. Basically I just want to suit up and get wet….so I think I might head to the pool tomorrow night! *excited*

I think my PT gave me the go ahead because I made really good improvements this week. Forward flexation is at 152 degrees (last week 145, plus my max on my good shoulder is 165….soooo close to a proper streamline!!) and external rotation is at 50, up 15 degrees since last week! I’ve also been hitting up the gym for the past 1.5 weeks and getting 20-30 minute cardio sessions in on the elliptical….ie, I’ve been doing all my homework and I have earned a gold star, yay! I am also officially ditching my shoulder brace for good

New exercises for the week include two gentle external abduction stretches, and one very slight extension (behind the back) exercise. I’ve also graduated to 3 pound weights for my bent over rows and tricep exercises, lol. Couldn’t be more trilled though! And after next week I switch to every-other week appointment schedule. Meaning that the show is finally packed up and ready to hit road! Let’s go!

Today it has been exactly one month since my surgery, and this week has thankfully been much better compared to last. After attempting to adjust back to normal life last week, I got a bit overwhelmed and that resulted in a low-grade fever and slight sickness. But luckily it only lasted a day or two and I was able to sleep it off. I attempted to work a full week last week but only ended up working 27 hours…oh well. Since then I think I’ve finally adjusted as my sleeping seems to have returned to normal patterns and my energy level is much improved. I think I’ll actually make it through this week, and will be able to get in a few light cardio sessions at the gym as well. I haven’t had proper cardio exercise in a MONTH now so it’s definitely time to start building back up!

Because of last week I didn’t think I’d see much improvement with my range of movement at PT, but I did still manage to make some progress. This week I’m at 145 degrees forward flexation (last week 138) and external rotation is at 35 degrees (last week 30). My PT wants me to ease up a bit on the forward flexation, since now I’m above where I should be (I’m like 10-15 degrees away from a decent streamline position ), but I still need to keep working on the external rotation. This week I get to add bicep and tricep exercises using light weights, and I also get to start weaning myself off the shoulder brace! I can have it off while at home and at work, but I should keep wearing it whilst coming/going and when I’m out and about in public places. Honestly though, I’ve been weaning myself off for a while now already…..shhhhh. But mostly looking forward to not having to sleep in the damn thing.

Another milestone is that I can *finally* get my elbow high enough to tie my hair back and get my contact lenses in with ease. Victory!!! ….lol.

I’m also starting to get excited because 2 weeks from now I’ll hopefully get clearance from my PT to get back to the pool and start kicking!! I’m hoping Santa will bring me some new fins and socks for Xmas And then I will laugh at my teammates as they are tortured by holiday training while I’m fluttering around like a 6yr old….mwahahha! (Of course, we both will silently acknowledge that we would rather not be in my position….maybe lol).

Ugh, rough week so far.

Last week I was rearing to get back to work, as I was feeling quite stir-crazy after almost 3 weeks post-surgery. So on Friday I went in for a half day and then walked a half mile on the treadmill at the work gym. It felt so good to get out and get some brain stimulation (in the form of wading through hundreds of emails) and a bit of physical activity! Since that went well, on Monday I decided that I would work a full day and then walk an entire mile on the treadmill. I didn’t think that would be over doing it….if anything I would be nice and tired by the end of the day and then sleep really well.

Least to say I haven’t recovered from Monday yet. I don’t know why but since being back at work I am sleeping even more terribly than before, but not from any pain or discomfort. It’s like suddenly I have insomnia....just can’t fall asleep it seems, which has rarely been a problem for me. Make sense I guess….I’m one of those people who have a hard time falling asleep if I know I need to get up and go somewhere in the morning. I guess my brain juices are fast flowing again and I can’t get my mind to relax. Last night I went to bed at 10:30 and was still awake when I heard the clock chime at 2:30am. I know I’m physically tired….just getting up, showering, making myself look presentable, and then getting to work takes quite a bit of effort. By the time I sit down at my desk I am totally exhausted. I’m so out of shape! Lol.

Also, I’ve only been back in the office for 3 days now and I feel like I’m getting sick. Don’t know if it’s an actual bug or if I’m just feeling a bit overwhelmed by getting back into the routine of things. I’ve had a couple moments of frustration and emotional release this week, so I’d say re-adjusting back into normal life has proved to be a bit of a challenge. Obviously I’m a bit stressed, but I’m unable to do what I’d normally do to deal with it (swim and/or sweat it out at the gym). Luckily I still have plenty of sick leave and a very understanding boss, and I’ve been given the OK to just go home early or come in late if I need to. In hindsight I should have just planned a gradual return to work schedule over a week or so…..few half days, few six hours days, etc etc. Though this would all be much easier if I could just catch some sleep!

Shoulder is doing well otherwise. I’m following my prescribed exercises exactly and have seen steady improvements over the past week. My forward flexation (lying down) is at 138 degrees today, which is spot on schedule at this point in recovery (should be 120-140 degrees at Week 4). My external rotation last week was only 10 degrees and this week I’m at 30, which is a good improvement but it’s still a bit shy of where it should be (35-45 degrees). So my PT upped my daily external rotation sets and gave me a few more stretches and movements to do. I also was given two yellow band exercises to add to my list today as well….woo hoo! Movin on up…..

So yeah, road is fairly rocky right now, but still moving forward

Had my post-op appointment yesterday and things are moving along as they should. I got my stitches taken out - its amazing how little external damage there is from the surgery. The 3 incisions are so small and the wounds are healing fast....by the time they are fully healed they will be barely detectable! Gotta love medical advances. Anyway, my surgeon asked how things were going and I told her overall things were well except for my night time troubles, which are totally normal. She showed me some before/after photos of my shoulder joint that were taken with the arthroscopic camera and walked me through the procedure steps, which was totally gross yet totally fascinating at the same time. Then she pointed out all the parts of my shoulder that are showing signs of arthritis which are not related to my initial injury. I said that I thought that most people start disintegrating after age 25 anyway, but then she said that this arthritis was a little more advanced for my age. So thanks for that, swimming! lol. I then scheduled a 3 month post-op appointment and was out the door.

So the last week has been fairly tolerable. I went out of town for the holiday, and my shoulder didn't like the 3+ hour car ride all that much. I was also sleeping in a different bed for a few nights and holidays in general are a bit stressful, but I survived. I have good days and bad days....some days doing my PT exercises are super easy and other days they are a struggle. Night times are getting better....I think I finally built the perfect pillow ramp a few days ago so things are a bit more comfortable. Last night was the first night that I didn't take any pain meds before bed, and while I woke up several times during the night it wasn't because of any pain. Progress!

I've been noticing other signs of progress too....like last week I was able to hold my coffee cup in my left hand, and this week I can easily carry my dinner plate, stuff like that I can totally feel my muscles starting to re-activate (hence all the twitching) and my strength and flexibility are definitely improving. Though I'm supposed to keep my arm immobile most of the time, getting all the little/daily things done is becoming much easier. I actually can't wait to start increasing my range of motion, cause things like putting my hair back and getting my contact lenses in are still challenging.

I'm also starting to crave those cardio endorphins again, so I know that I'm on the mend. When I think about exercising, my brain seems to automatically calculate how long its been since I've been in the pool. Today it has been 16 days.....which means that I am 16 days closer to getting back in

So things are definitely a bit more uncomfortable these days. The first 4 days after surgery were a breeze, but since starting PT on day 5 post-surgery, things have been more difficult. Makes sense, since things are healing and I'm supposed to be moving my arm around more. That combined with cutting back on the pain meds will do it. And I think its not really the passive exercises themselves which are killing me at this point....its just that doing them along with other small daily tasks (like typing this) has my shoulder very sore and tired by the end of the day. I only have enough shoulder/arm energy for so much right now.

Sleeping has still been rough the past few nights. I'll wake up in the middle of the night either with sharp/shooting pains or because my arm muscles are twitching like crazy. I'm not sure if its because my arm wants to move (I'm required to sleep in the shoulder brace) or if I'm not positioning myself correctly in the bed, but least to say the nights are becoming troublesome. But as soon as I get up and start moving around and get the blood flowing, the pain disappears rather quickly. As of now I've cut way back on pain meds during the day but I'm still taking full doses before bed. For a few nights now I've woken up during the middle of the night and taken a 1/2 dose to help with the pain at night.

At the moment I have a love/hate relationship with my shoulder brace. Last week after the surgery, I couldn't stand being in it most of the time. It was very uncomfortable to NOT move my arm a little bit...very similar to what I experienced when I first dislocated it. My doc said that it was OK to leave it off as long as I was just sitting at home on my couch doing nothing....and since I did just that for most of last week I had the brace off for several of my waking hours. Now its a little different - since starting PT and with my arm being so sore/tired now, it now feels more comfortable to have it on at times, lol.

Boredom is beginning to set in and I'm starting to feel antsy. The internet is only entertaining for so long lol. They said I could go back to work after one week (desk job) but at the same time I don't see how anyone could be ready after one week. I mean, just yesterday I woke up, ate breakfast, read the news, and was so tired that I went back to bed for another 3 hours lol. There hasn't been a day yet since the surgery where I haven't needed a 2+ hour nap sometime during the day. I'm scheduled to go back to work starting in December (3 weeks post-surgery) but I might go back earlier after the Thanksgiving holiday....we'll see. The thing about work is that there's a gym there. Its been so crappy outside the last few days so there's been no dog walking. Just thinking about how nice a indoor treadmill would be at this point....

I can feel the mental game starting too....whenever I get the least bit frustrated I have to remind myself that a) things are supposed to hurt right now; b) its only been just over a week; c) this is a long-term process and d) I should cut myself some slack. Repeat, repeat, repeat lol.

Headed home for the holiday and while my appetite isn't quite back up to par yet, I'm looking forward to some pumpkin pie

Well yesterday I wrote about how the first day of PT wasn't so bad....and it wasn't, until the evening came around. After I had repeated my series of exercises two more times during the day (as directed), my arm was killing me by bed time. Last night I slept horribly, probably the worst night since the surgery actually. I kept waking up with sharp pains and had a hard time staying comfortable. I've been able to sleep in my bed but I build a 'pillow fort' every night which keeps me reclined at about 45 degrees. I took a pain pill before bed as I have been doing all this week, but it obviously couldn't keep me comfortable last night.

I missed a dose of ibuprofen yesterday too, so I'm sure that contributed a bit even with the addition of my new exercises. I know its definitely the external rotation that is causing the pain....and literally all I can do right now is get my arm/elbow in a neutral position....aka not any real external rotation at all!

sigh....here we go!!!

Had my first PT appointment today. I was nervous and took a pain pill beforehand because I had heard that PT could be super painful at the start. But luckily it was no big deal. Just got some basic assessments done, and was given a handful of very light and basic assisted movements to do, and we worked out my schedule for the next few weeks. Nothing was overly painful at all....if anything, most of the pain I felt was from general stiffness and not from the surgery itself. It felt good to stretch out a bit and get things moving. I basically have no ability to externally rotate at the moment, so thats the only movement that hurts, but its like a good hurt like you feel when you do a deep stretch. I am able to straighten out my elbow and move my arm up and out in front of me (assisted) with no problems. My neck area is still fairly stiff but I mainly blame that on having to sleep upright. Afterwards they iced me down and then sent me on my way. I was told that I would most likely feel 'bored' for the first 4-6 weeks, as I need to really restrict my movement even though I might feel that I'm able to handle certain things. Basically I'm just supposed to move enough so that things don't get too stiff, but otherwise I should be letting things heal and should be doing nothing more. Fair enough. I guess I realize now that I was ready to get the PT show on the road....but I'll still be in a holding pattern for a while yet.

Speaking of pain, it has been fairly manageable over the past few days. I honestly thought it would hurt a lot more than it has. Granted, I've got some pretty good pain medication to help me out. For the first two days I took the full allowed dosage, but since then I've scaled back to half and even quarter doses. I have also been taking ibuprofen as recommended and have been icing my shoulder like a mad woman, and I think that has helped a ton with the pain and swelling. At first it was tricky to get the medication timing down....they say you should "stay ahead of the pain" when using the medication and I totally understand that now. Problem is that it can be hard to even recognize that you are in pain. During the second day, I found myself getting super cranky and emotional, and I got overly frustrated with simple things. I started to head down the road of despair and no hope...and then my husband asked me if I had taken my pain meds that morning. I then realized that I had taken my ibuprofen that morning, but not my pain meds. I didn't feel like I was in any more physical pain, but it obviously had manifested itself in other ways. And so my lesson learned is that I need to just let myself feel comfortable this week, physically and emotionally....therefore I will not be slacking on the pain meds when needed!

I've also been relatively self-sufficient over the last few days, which has been somewhat surprising. First, I am lucky that this was my left shoulder and not my right, because that would have been a completely different game. But since I'm somewhat able to use my hand/wrist/elbow on my left arm, things haven't been too bad. I've actually been able to dress and feed myself without much assistance at all. Today I was *finally* allowed to shower and I was able to get my hair mostly washed all by myself! The only thing that I need consistent help with is putting my hair back in a ponytail, lol. Granted I have had practice with all this before. With my all my prior dislocations I guess I have a lot of experience operating in single-hand mode, so I already know all the tips tricks for everyday functionality

So today I showered, had my first PT appointment, took the dogs on a short walk (they are only chihuahuas, no risk of sudden pulling that could cause re-injury lol), and wrote this entry. Aaaaand I'm completely spent for the day lol.

Day 3 post-surgery and I feel like some documentation is in order. Its easy to type at least, as long as I get my arm and wrist in the right position first. Just gonna let the thoughts unwind....

Arrived at the hospital at 6am on Monday. After paperwork and a bit of waiting, I was taken back at around 6:30. Got in my gown, peed in a cup, and was quizzed on my name, birth date, and procedure about a million times (left shoulder bankart repair). I have an HMO and was in a fairly new facility, and I must say I was quite impressed with all the technology, lol. Most of the nurses were wearing headsets to communicate and things appeared overwhelmingly coordinated. There was even an electronic 'status' board in the waiting room so my husband was able to stay informed the whole time. It was kinda hectic but at the same time I felt at ease. The anesthesiologist came in and gave me the run-down, followed by my ortho doc. Everyone was ready to go, and I was ready to get the show on the road.

First up was the IV. You might think this is silly but this is the WORST part for me. I haaaate needles and anything that has to do with acknowledging the fact that I have veins and blood moving around my body. Just typing that alone makes me *shudder*. Doesn't make me pass out or anything, but it sure gives me the heebie jeebies and I just hate it! Anyway, that went smoothly, so up next was setting up the nerve block. I got some anti-anxiety meds pumped into me straight away so this wasn't so bad either, lol. They give a nerve block in the general neck/shoulder/pectoral area so that less narcotic pain meds are needed right after the surgery, and it lasts about 12-14 hours. They used an ultrasound to look for the right spot in my neck area, and some electrical pulses were delivered which sent my muscles twitching. It was a strange feeling....but before I knew it it was over. I know lots of needles were involved in that procedure too...*shudder*...but thank gawd for the anti-anxiety meds!

Soon enough I was wheeled down the hallway and was in the operating room. Turns out one of the nurses had a kid on the swim team, so we chatted up a bit. She asked what my stroke was and I remember replying "I am a butterflyer, unfortunately" lol. The nerve block is supposed to set in within 15 minutes, but apparently it was taking a while for me. They kept asking me if I could feel/move my arm and I remember waving my arm around to demonstrate, lol. The surgeon came in and I remember hearing introductions and she starting briefing everyone on the procedure. I waved my arm around one last time before they put the mask on me, and that's the last I remember.....

.....as I started to come to I could feel the nurses moving my arm around. I still had a mask on and I just remember trying to take deep breaths. When they took the mask off, the first thing I asked for was some chapstick, lol. My shoulder felt cold, and I asked if there was ice on my arm. Sure enough, I had been hooked up to a cryotherapy ice box system which would come home with me. As soon as they sat me up I saw my husband on the other side of the room looking for me. He came over and I immediately asked "how many anchors??" lol. Turns out I only needed three - great news! Doc said the damage was fairly clean and minimal, and that she'd seen much worse from traumatic dislocation injuries. She also said that my shoulder is fairly loose in the first place and that there is a lot of room in my shoulder capsule....which is common for people who do their growing and developing as swimmers

After two cups of apple juice and a few packets of graham crackers I was ready to go home. Spent a total of 7.5 hours in the hospital, with the surgery taking just over two hours. I'm day 3 into my recovery journey now and I've already felt everything from complete confidence to total despair....but more on that later. Time for a sandwich and then a nap!

............

PS/FYI, I actually ended up typing this entry in bits and spurts, as my arm really started to feel the burn after not so long. Started off typing with both hands and am ending typing with one. Had to re-position several times and this entire entry was written over about two hours or so....phew! Was totally worth it though!

Had my pre-op appointment this morning, which really made things sink in. As I sat in the waiting room, each time a nurse/assistant came out to call a name I totally felt butterflies in my stomach!

I got all my instructions from the assistant, which included things like when to have my last meal, last shower, last meds, etc. All piercings out, and no shaving for 2 days beforehand as minor cuts = possible infection. They also gave me special anti-bacterial towels and directions to give myself multiple pre-surgery wipe downs. Strange, but logical I guess! I also got fitted for my shoulder brace, which wasn’t just a fancy sling as I expected….it felt more like a modified straight-jacket to me, lol.

Then my surgeon came in and briefly explained the procedure to me, as well as the possible complications and risks involved. The main risk is, of course, that my shoulder doesn’t ‘take’ the surgery and I end up re-dislocating again down the road. She said that this is a bigger risk for me since I’m young and active and have a prior history of dislocations. But the main point of this surgery is to fix and tighten things up so that my shoulder doesn’t pop out just by doing low-impact everyday life type activities (like pushing off the wall, for example). Of course anything high-impact could cause my shoulder to re-dislocate again. But then again, I could trip and fall at any time and dislocate my other shoulder too! “You can’t predict your accidents,” she said. Aint that the truth….

I only had a few additional questions for her, one being how many anchors she expected that I would need and what kind they were. She said that she would be using bio-absorbable suture anchors, and that I would probably need 3-4 at minimum, possibly more if she finds more damage once she gets in there. I also asked under what circumstances would they need to transition to an open surgery (rather than arthroscopic). She said it would be highly unlikely for me, and that they only really need to go the open surgery route if a) there is major unanticipated damage, and b) they can’t get good visualizations with the camera…which apparently can be a problem when you’re dealing with larger and/or body-builder type folks. That’s good to know because through my HMO health plan, outpatient surgery only costs me $5, and inpatient would cost me $1500!

We also briefly talked about PT and recovery time, and I reminded her that I was a swimmer and that this was all very, very important to me. She said that if all goes smoothly, I should be able to get back into to pool for light kicking after 6-8 weeks, and that I should be able to start building back up to regular workouts at 5-6 months. This was so great to hear, even though I know it will probably take me much longer to completely feel back to ‘normal’ in the pool. As long as I can suit up and get wet….that alone will motivate me and help me along the recovery process.

So, I guess the count-down is officially on! T-minus 2 weeks and 6 days. I am crazy busy at work right now, trying to get all my tasks and projects done before I’m off for 2.5-3 weeks after the surgery. And of course get as many swim practices in as possible. I literally have almost all of my days and weekends planned until then. My to-do list includes random every day things like: deep clean the house; get a haircut; cut the dogs’ nails; stock the pantry with easily-opened and/or liquid foods; etc. etc. All that fun stuff I won’t be able to do for a while. Luckily I’ll at least be able to do all my online Xmas shopping while I’m at home recovering! (Also on the recovery time list: investigate re-financing the house, lol).

I may or may not drop another post before the surgery….depends on the time crunch. I will definitely be posting during the recovery process however, so until then…..last one fast one!!!



EDIT: I forgot to mention, the SCM Zone meet last weekend was so fun!! However I realized how stressed and un-rested I am right now....after my first race I was just dead tired and really couldn't shake it off for the rest of the weekend. Even during the 50 fly (my pet race), the last 5 strokes were just KILLER for me. You know you're tired when you feel that much lactic acid kick in during a freakin 50! I really wanted to do a :31.X but had to settle for :32.2. Good enough for now!

After my visit to the physiatrist, I knew that surgery was in my future. The damage to my shoulder was un-modifiable, meaning that the structural instability of my shoulder would be ever-present no matter how strong I could get my surrounding muscles to protect it. I could strengthen my rotator and deltoid until the cows came home, but it is obviously not enough to make up for the damage in my cartilage and tendons.

I suppose I could continue to live with the subluxations periodically interrupting my training plans. But what kind of pool life would that be? I imagine I would just continue a cycle of injury and would only ever be able to train up to 95% given my situation. And even then, how long would those periods of 95% last before I re-injure myself and have to take several months to work my way back up from 10%? I want to be able to give 100%, ALL THE TIME. And based on what I had experienced over the past 4 years, I could pretty much count on my shoulder popping out 2-3 times per year. Maybe this wasn't a big deal for me when I was only fluttering around and swimming once per week. But with the level of swimming I hope to be at for the next few DECADES, its now just unacceptable - I have to think about the long term.

I know some people would much rather live with the above scenario rather than undergo surgery. In fact, one of my teammates said to me that he’d rather take 2 years away from the pool instead of having shoulder surgery (he has a different shoulder situation injury, however). Fair enough, but that isn’t me.

So, since I knew that I would be having surgery at some point, the question soon became, “Now or later?” It took me about 2 weeks before I truly made it to the acceptance phase, and then I decided that “now” was the time. Mostly because there never is a good time for this kind of thing anyway. Right now I am healthy and younger(ish). I have health insurance and plenty of sick leave. And I am motivated as hell to do everything I need to do in order to ensure that I can reach and maintain as close to 100% as I can get after this. In addition, if I prolong the surgery I am risking more injury to my shoulder, which would further increase my risk of developing early arthritis and other problems down the road. And, more importantly, the surgery is much more effective if the damage is less severe in the first place.

So, I called and set a date with the surgeon for November 12th. I must say, after I finally scheduled the surgery, it felt like a huge weight was taken off my shoulder (no pun intended, lol). It’s good to know that in time, and if everything goes as smooth as it should, I will no longer have to deal with the ridiculousness of my stupid, unstable shoulder. I am really looking forward to having a shoulder that stays in its socket, lol. Most of all I am looking forward to being able to feel 'normal' in the pool and to be able to push myself to the best of my abilities.

Until the surgery, I plan on getting in the best shape possible. I will continue to keep up my PT routine and keep a schedule of 4 practices a week. Right now, I’m probably back up to about 80% since my last injury back in August. I am able to do full workouts right now even though my shoulder definitely feels it during the last 500 or so yards (ice is my BFF!). In mid-October I plan on swimming at our Zone meet up in Federal Way, which I’m super stoked about since that’s the pool of my glory days. I haven't swam there since 1999! I hope to be back near 90% by then, and I plan on just having some fun. It will be my ‘swan song’ so to speak before I head down the long road to recovery. Two days after the meet I have my pre-op appointment with the surgeon. I know it will be rough and feel hopeless at times, but I also know that it will be completely worth it in the end. I am in it for the long haul!!