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.
Updated November 20th, 2012 at 02:25 PM by swimslick
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!
Updated November 20th, 2012 at 02:26 PM by swimslick