Physical therapy has been progressing nicely. I’ve “passed” all my flexibility/range of motion requirements, and am focusing pretty heavily on strength while making sure not to lose the flexibility. I saw the surgeon Tuesday for a check-in, and they were a little disappointed at my strength at this point in my recovery.
September 13 was the 3-month mark for the surgery, though, which is when I’m supposed to be clear to resume some more interesting exercise. With surgeon and PT approval, I’m doing so. I’m taking things quite slowly, because if I do anything off-hours that leaves me too sore to move (or worse, injured!), then my PT work will be compromised. The plan is to do an activity, wait a day to see how sore I get, and then judge from that whether I should cut back or can ramp up.
My first activity was swimming. I’m not a skilled swimmer anymore — I can happily fake a breaststroke for a while (my favorite), but my smoothest method of traversing water is the good ol’ doggie paddle. I can do it forever.
It’s also, pleasantly enough, the easiest on a weak shoulder.
So Wednesday night, after that decision was made in PT, I swam. It was 21:00 and the pool was deserted and beautiful. The water was a little chilly, but I warmed quickly enough. I swam laps for just 20 minutes, which was about when my shoulder started to show signs of weakening. (The best test for that is for me to stand and raise my arm straight out overhead at about 45 degrees. If there’s any “clicking” or jerking in that range of motion, the shoulder is очень устал [very tired].)
Later that night and this morning, my shoulder was tight, but that could very well be due to the increased weights during Wednesday morning’s PT appointment. I tend to start getting sore from an activity right around 24 hours afterwards, so we’ll see how I feel tonight.
Each of those (sans the pendulums) has a 5-10 second hold on it. If not for audiobooks and kick-ass music, I’d probably be tempted to shortcut some of this. Which would be sad, because holy shit, my arm is feeling better. Just today, in fact, I was able to reach the knobs on both my kitchen and bathroom sinks. Took concentration and effort, but I did it.
I’m a little late starting PT, as I mentioned before, but this morning’s session went well. The therapist had me lie down and relax as she gently wiggled my arm away from my body in different directions. I was impressed that my arm could get as high as it did after being in one position for seven weeks.
Shoulder surgery happened on June 13 (a little over five weeks ago). This whole process has been… fascinating.
The surgical morning itself had that weird fast-slow sensation to it: it felt like the waiting was forever, and then suddenly I was getting wheeled back and drawn on and poked and suddenly I was waking up and couldn’t breathe and coughing and then waiting… again.
In one of the waiting phases, I did an awesomely helpful meditation with PUUC‘s Rev Robin. I went into surgery nice and calm, and everyone was pleased and surprised at my cheery demeanor afterwards. Aside from occasional whining, my mood remains pretty cheerful, despite some miscommunications that have occurred.
During one of the wait periods that morning, a random person came by and dropped off the sling I’d be wearing for at least 6 weeks. Hi, random person. I don’t know you, but you were pretty nice.
I had two nurse-like people give me sets of directions for post-op care. Greg made sure to take notes when he didn’t think the packets had enough detail, which was quite nice of him, as was him agreeing to stay with me for a few days while I got my bearings and understood my limitations.
One of the discharge folks, though, was incredibly frustrating. They were showing Greg how to adjust the immobilizer sling, and no matter how I asked “How do I do this solo? I live alone,” all I got was “You can’t.” I seriously recall asking this about three different ways, including asking, “What do your patients who live alone do?”
Well, lucky for me, my right shoulder remains as creepily flexible and able as ever, because I do live alone, and I have to adjust the sling by my damn self.
Greg also had a really difficult time getting a clear answer from them on something equally important: how the sling was supposed to be positioned. Where is the front edge of the pillow supposed to sit? What angle is the elbow supposed to be at? If I’m feeling pulling in the shoulder, should it be adjusted?
We got how tight the band was supposed to be around my ribs, but pretty much nothing else. We were both pissed when they left, but one thing they successfully instilled is that my job during this healing process was to keep my shoulder relaxed. I’ve been tensing against pain for a long time, and it’s second-nature to “help” when someone is getting me dressed or adjusting a sling, but that tensing is (according to this nurse) setting up for an imbalance.
I went home with an anesthesia catheter taped to my neck, my arm still 95% numb from a nerve block, and prescriptions for oxycodone acetaminophen and an anti-nausea medicine.
The Medical Stuff
Here’s where things get a little explicit in terms of the procedure.
We were prepared for any number of things: a labral tear/SLAP lesion, damage to the rotator cuff, a subacromial decompression (shaving back a bone), and tightening the ligaments in my shoulder. Dr. B couldn’t know what had to be done until they got in there and saw with live cameras.
The awesome news is that the only thing that needed to be done was the ligament tightening. They put in anchors in the front and back of the shoulder socket and sutured the ligament to them to hold it in place. The anchors and sutures are probably dissolved now (supposedly it takes about a month), but in the first few weeks I could definitely feel the yank of pain if I — against nurse’s orders — tensed the shoulder. That yanking feeling is gone now.
(Being an easily startled person in this situation was absolutely BS. Delivery people, the cats getting into stuff, my alarm clock…)
Returning to the ER
By the time I got home around 13:00, I was ready to eat (nom, sushi), take some oxycodone, and doze.
So I did!
And then I woke up having trouble with my throat and breathing. I’d been intubated during the surgery, though, so it was expected that my throat would be a little bruised, and I wasn’t used to the sling around my ribs yet…
Greg called the triage nurse, and she gently encouraged us to go to the ER, since this sounded pre-anaphylaxsis. So we bundled me back up into yoga pants, a huge men’s dress shirt, and flip-flips and headed to the normal hospital associated with the orthopedic hospital I’d been to that morning. I didn’t want to fuck around with records being in two different places.
Emergency rooms… Sigh. Places of pain and discomfort and with surprisingly little “emergency” feel to them.
I told my story to a triage nurse, a… non-triage nurse, and finally to the chipper doctor who needed to take my concerns a bit more seriously. They finally decided on intravenous delivery of benedryl and a steroid.
At that point, it was heading on 20:00, and I was exhausted and in pain–the oxycodone and the nerve block were fading fast. I’d had to be at the hospital around 06:00 that morning, if I recall correctly, and I really just wanted to crawl into the recliner Nathan loaned me and sleep for days.
The benedryl, of course, made me more sleepy. I have a very clear memory of most of that whole day, but the benedryl on top of the oxycodone… the aftermath and the ride home are a blur.
I remember that the vein on the back of my hand had been blown by the IV that morning, so they had to do the IV at my elbow. Then they also decided to take my blood pressure with an automated cuff, and the cuff overlapped with the IV… Ow. I cried. Greg snapped at the nurse. The nurse let the BP cuff continue its cycle unabated.
I didn’t find the ER doctor’s jokes about “Must not have gotten enough of us today, huh?” particularly funny, but I did manage to learn that as long as my elbow is as a 90 degree angle and able to fully rest without pulling, then the sling is positioned correctly.
I went home with a prescription for trusty ol’ hydrocodone, which I’ve taken in the past.
Life After Surgery
Things got so much better after that. The surgery was on a Friday, and Greg took the pain catheter out on Sunday. The dressing came off my shoulder on Monday, but I was too scared to take a shower, so I didn’t until Tuesday.
I cried through that whole first shower. It was incredibly nerve-wracking to have my shoulder be so… unable to perform, and so fragile on top of that. Under no circumstances was my shoulder supposed to hang, so I showered with a towel between my forearm and body, much like where the abduction pillow sits on the sling. But I had pretty much no strength to hold that towel tight, and if I tensed the wrong way, I’d have that yanking pain.
I was terrified of fucking this up. If this went well, if I did my physical therapy properly, then it was expected that I’d have a full, 100% recovery of strength and ability in the shoulder. Like, seriously. Better shoulder health than I’ve had since 2011… if I don’t screw this up.
I didn’t wash my sling until this Friday, five weeks after surgery, because I wanted to minimize the risk of spending too much time out of the sling. That’s after a month of going outside on 15-30 minute walks once or twice a day in the summer. Ultimately, I just couldn’t stand the smell anymore and didn’t want to inflict on the folks at the meetup I was going to that night.
Adapting to life with only one able arm hasn’t been too bad. Many things in my home were already set up for this to a lesser degree, but I did have to sleep in a recliner for a week or so, and get help with emptying litter boxes. I bought a handful of shoulder shirts (so comfy!) and have resigned myself to buying new bras after this is over, since I have to pull clothes on from the floor up and my hips are wider than my ribs.
Oh, and I can’t drive.
There were a few miscommunications that have proven… annoying at best.
Two weeks without driving. This is what I was told. When I had the stitches removed 11 days after the surgery, I was told that I wouldn’t be able to drive until after the sling came off. See… that whole thing about living alone? Super-inconvenient to not be able to drive. I have great friends and family, and they’ve taken good care of me, but my goodness it’s inconvenient. It does also mean I’ve been working from home for the last five weeks, though, which is… nice. Mostly.
Physical therapy would begin during the six weeks of sling time. I thought it would begin in the last couple of weeks of sling time, but apparently it’s not until after sling time. I have an appointment on Tuesday which will include more details, but having taken my sling off for a couple of hours on Friday to wash it, they simply cannot just have me go cold turkey out of this sling and then send me to PT.
Sleep in a recliner for a while. This is a good miscommunication! I was anticipating having to sleep in the recliner for weeks, which is uncomfortable and painful. They cut me loose to sleep in bed as soon as the stitches were out. I had to construct a bit of a pillow fort to support the shoulder, but oh, the bliss of lying down to sleep.
I was both surprised and not at the amount of sexism I encountered in the hospital staff. I hear this a decent amount among nurses and similar staff, but that day had a lot of “men couldn’t handle this kind of pain” and “wow, it’s so nice that your husband is helping you out.”
Like.. what? Greg is a decent fucking human being. Yes, it was very kind of him to stay with me for almost 5 days to help, but they were already assuming we lived together. Apparently, it’s nice for husbands to drive their spouses to the hospital.
And somehow the theoretical ability/biology to give birth makes me more tolerant to pain than men? These people clearly didn’t see me get my first tattoo.
All in All
Life is good. Within a week, my shoulder was in less pain than it had been for a few months before surgery. What pain remains is more manageable than before. Hydrocodone is quite good at its job, and aside from that, most pain is very positional: if I shift or lie differently or get a pillow, the pain generally fades pretty quickly.
My short stint without the sling while I washed it showed me that physical therapy is going to be very, very difficult. All I did was sit and work with my arm supported, and every little muscle around my shoulder that I haven’t used in 5 weeks woke up. Loudly.
Sleeping remains difficult. I often wake up in pain, either in the middle of the night or bright and early in the morning. Any position that would normally rock the shoulder around in the socket is painful, but if I perch the pillows behind me just right, I can even sleep on my side. Mostly I sleep on my back with a pillow behind my shoulder and elbow to keep the shoulder from rocking back too far.
The fact that I can tie my shoes, even very crookedly, is a good thing. Next up, running and dancing!