Wednesday, January 31, 2007

The Long Recovery Week 8

After the swelling in my arm started going down, physio began in earnest. My first exercise was what's called the pendulum. It's exactly what it sounds like. I lean with my right arm on a table or counter-top and let my left arm out of the sling and let it hang like a pendulum. I swing it forward and back, side to side, then it circles, first clockwise, then counter-clockwise. I swing it for about three or four minutes, twice a day. The idea is that it gently pulls on the muscles that are now super-tight and holding my arm in my shoulder socket. All those muscles have been traumatized and many surgically reattached. They were, and are, extremely tight to say the least.
Funny things were happening with my arm. Suddenly my left arm began drying out and flaking. My right arm was fine, but my left arm suddenly developed a taste for vast amounts of moisturizer.
And I could feel strange sensations in my arm as all the new hardware rubbed against flesh and bone. Sometimes, it even feels like it gets caught against a tendon or ligament [shudder]. It's a strange, strange feeling.
Slowly, time passed. Days became weeks. Weeks became months. Months became years. My writing became a pattern of clich├ęs.
But seriously, time did go by slowly as I was mostly housebound. If it wasn't for the fact that I had just ordered the first two seasons of Voyage to the Bottom of the Sea on DVD, I might have gone mad.
I couldn't even write or surf the Internet much as it was too uncomfortable to sit at my computer for very long.
Christmas rolled around and I began to venture out more. Thankfully I had done most of my shopping before the accident, and Amazon did the rest.
At physio, I got to do more exercises. I got to lie on my back and, gripping it with both hands, I had to raise a cane over my head. At first, I could barely raise in 90 degrees, or just above my head. Now I can get it about 150-160 degrees over. Still got a ways to go.
Next came The Violin. Still lying down and with my forearms straight out in front of me at a 90 degree angle, I gripped the cane and moved it from my right to left, trying to move my left forearm away from my body while keeping my elbow in place at my side. This works to stretch my shoulder were the Bankart repair took place and the flap of muscle was sown over my shoulder socket to keep my arm in place. This I can only do to about 35 degrees. More work needs to be done here, too.
You're not reading this over dinner, are you?
As long as you're grossed out, here's how my scar was doing after about seven weeks.

Other exercises were added to regime like Walking Up the Wall. Simply put, I stand in front of a wall, put my left hand on it and use my fingers to "walk" my arm up it until my shoulder screams out "Enough already!"
However, the physio is going slower than expected. All these exercises that I've been doing are passive exercises, meaning that the injured area is not doing any work during the exercises it's all being done by the other arm, gravity, or in the case of my physiotherapist, someone else entirely. The normal recovery protocol for a Bankart repair would allow for active weight-bearing exercise at this point; however my arm is still too sore and stiff for this, so we are continuing with just the passive exercise. This will make for a long recovery period.
At least now I'm out of my sling.

Monday, January 22, 2007

Watch That First Step....

My co-worker Scott passed these on. Don't know where these are taken, but holy jeez, whatta view!



Thursday, January 18, 2007

The Long Recovery Week 4

When I first came home from the hospital, my biggest disappointment was that I could not easily snuggle my cat Linus. Whenever I sat down, my busted left arm and shoulder needed to be protected and propped up with pillows. And my right arm needed to be beside the arm of the chair or sofa so that I could use it to push myself up. I couldn't lower myself down onto my bed at first because it's so low -- it has no legs and sits on the floor.
After a couple of days, I figured out a way to finally properly snuggle Linus.

Only then did I feel like I was finally on the road to recovery. For those first two weeks, Linus stayed near me and watched over me. There wasn't much he could do to help me, but knowing he was there made a difference. When I walked aimlessly around the house, he walked with me. When I came back from the doctor or from physio, he greeted me at the door to ask how I was feeling. When I rested after my exercises, he rested with me.

Three weeks into my recovery, Linus suddenly stopped eating. He seemed mostly okay, he just wasn't eating or drinking. Then he began staring mournfully at his water and food dishes as if he just couldn't remember what he was supposed to do. His urination, what little there was, became more painful. He became weak and his legs started giving out on him. The vet was stumped.
The only choice became sadly obvious.
Linus passed away on December 19, 2006. He was almost 17 years old.

I really miss him.

Saturday, January 13, 2007

The Long Recovery Week 2

I get to go home.
After more than 38 hours in hospital (4 of them in surgery having my left shoulder rebuilt after a bicycle accident), the nurse says I can go home. She pulls out a bag of my clothes and says, "Here. If you need help putting these on, I'll be back in a few minute."
I have a new 22cm-long surgical incision in my left arm and shoulder, freshly sutured and covered with a large bandage. My arm is tightly held in a sling. I'm loopy on morphine. How the hell am I supposed to put clothes on?
I can start by removing my hospital gown. It's practically falling off anyway. Because of my arm, it can't be fastened properly around me. Every time I've gone to the bathroom, my ass has been hanging out for all to see.
One little shrug and it's off. Modesty dies quickly in a hospital.
What's first? Well, underwear, I guess. It normally goes on first anyway (unless you're Madonna). Don't see why a busted shoulder should make any difference.
I'm not going to be able to reach down and hook the underwear over my feet while standing up. Bending over hurts. Doing much of anything hurts. And I have no balance. While I might able to get the right foot in the right hole with the right hand, getting the left foot in the left hole with the right hand will be impossible, and trying it with the left hand would probably leave me kissing the hospital floor.
The last thing I want to do is fall down again.
I sit on the bed. In a sitting position, I can hook my underwear over my feet and pull it up my legs with my right hand. Near the top, I can stand up and pull it over my butt.
Ta da. Blue Fruit of the Loom boxers are on.
Well, this procedure worked so well for underwear, it ought to work for pants, too.
And it does. Mind you, I have to figure out how to buckle them and my belt with one hand. It's not as easy as it sounds, but not so hard either.
Socks and shoes go on at the same time, too.
Now comes the shirt. My left arm is clearly not going into any sleeve, so I put my right arm in the right sleeve and then toss the left half of my shirt over my left shoulder. With my arm against my abdomen, I button it (one-handed) as far down as I can go.
When she returns, the nurse seems surprised that I was able to do it all myself. She pretends not to recognize me -- who is this well-dressed man and what have you done with my patient?
Thus beginith my recovery.

My sister is playing taxi driver for me today (as she will for many weeks to come -- thanks, sis!).
The first order of business is to get me out. I have no idea where I am in the hospital. Left to my own devices, I might have been wandering the corridors for years trying to find the exit -- the Flying Dutchman of Jubilee Hospital, ending up a crazy old man who mutters, "I beep at airports -- wanna see my scar?" to anyone who will listen.
But no, my dreams of becoming a human derelict end quickly as my sister finds the way out.
I walk gingerly. Falling down would be a disaster right now. But my first few haltingly hesitant steps are soon replaced with more confident paces. I'm not setting any records, but I start to feel safe on my feet.
Sis has brought the van -- a good thing. I don't think the MG would have been suitable. Climbing in isn't so bad, but the next stumbling block is the seatbelt -- I can't fasten it. I can pull it around myself, but sis has to snap it into its latch.
Can't do up a shirt properly, can't fasten a seatbelt. What else can't I do?
She drives me home, apologizing the whole way for every bump, stop, turn, braking maneuver and acceleration that occurs. Actually, it's not too bad. The right turns hurt the most as the inertia pulls at my left shoulder.
Finally, home. What does a man look like arriving home after major surgery for a crunched shoulder? Like this:


The first thing to do is to make me comfortable. The obvious place is the couch with lots of blankets.
My left arm is useless, so I have to sit on the right end of the couch so that I can use my right arm on the arm rest to help push myself up when I stand. I also need some pillows to support my battered left arm.
The downside is that now I can't curl up with my cat Linus, who has missed me and clearly realized something was up. In fact, we pile up extra pillows on the left side to keep Linus at bay; he's a large cat and likes to walk on me, and god forbid he should walk on my injured shoulder. Still, being home with my cat is a great start to my recovery, and he even seems to understand that although I am injured and can't really snuggle him, I did miss him and am glad for his company.


This is pretty much how I stayed for a couple of days. Sleep was impossible. Between the dull ache in my arm and my back stiffening up, there was no sleep to be had. In fact, I considered it an improvement when I was able to move to various chairs around the house during the night and not sleep in any of them. At least I was moving. But before I worried about my first night's sleep, there was another problem that I needed to face.
I needed to pee.
My bathroom is small. Tiny. The toilet is in a small alcove with little if any maneuvering room. And the transition from standing to sitting is painful and uncomfortable. And I am still wobbly. Pulling up my pants is awkward. So I have little choice. For the time being, I'm going to pee in the sink.

A couple of sleepless nights later, I was starting to smell. I needed a shower.
The only restriction I had about showering was to try and avoid having the shower spray directly on the incision. A little collateral water damage okay. I would also have to change my dressing afterwards. My dressing looked like this:


In order to have my shower, I would have to get undressed and get my arm out of the sling. Then I would gently get in the shower and somehow do all the necessary hair and body washing one-handed, then dry off, then get dressed again. My sister volunteered to stand by if needed. I told her that if she heard a splash and a thud followed by screaming, chances are that I would be in need of some assistance.
In actuality, the shower went well. Slow and steady wins the race.
The only problem was that I couldn't get my underwear on. Because of the aforementioned limited space in the bathroom, I had not yet managed to sit down on the toilet, and sitting down was the only way I could get pants and/or underwear on. Getting tired and a little frustrated that I couldn't devise a plan for my underwear, I had no choice but to call my sister through the closed bathroom door.
"Sis, I have a problem."
"What is it?"
"I can't get my underwear on."
"How did you get them on in the hospital?"
"I was on morphine. I don't remember."
"Oh."
"So I thought you could hold them in front of me. I'll step into them and you can start them up my legs. I should be able to grab them when they reach my calves and I can pull them up myself."
My sister reluctantly agreed. I opened the door a crack, and passed her my underwear.
"Are you ready?" I asked. She nodded.
I opened the door, naked as a skinny-dipper at Mackenzie Bight. She knelt in front of me, holding out the underwear and averting her eyes. I stepped in and reached down to grab the waistband.
"You'll have to lift them higher. I can't reach down that far."
She leaned in a little closer, and lifted them a bit higher. Now I could grab them.
"How's that?"
"That's great, sis, thanks. I got 'em. Don't hit your head on anything on your way up."
"Okay, glad I could--- oh, oh, you...."
She turned red and ran.
I went back into the bathroom and chuckled.

Then we changed the dressing. What did my incision look like? It looked like this:

I'm guessing 17 sutures. It's hard to tell, and they were dissolving sutures, so after a couple of weeks they were all gone anyway.

I had two big problems that first week. One, my arm was swelling up. I expected swelling around my shoulder and upper arm. That only made sense, that's where the injury and the surgery was, but the swelling was going down my arm towards my fingers, too. In fact, my fingers soon became giant white sausages. My whole arm was swollen and I was concerned, but the swelling soon passed and my arm returned to normal, Or what passes for normal these days.
The other problem was sleep. Or the lack thereof. After a couple of days, I moved off the couch and tried my bed. But nothing worked. I could not find a comfortable position or place to sleep. Worse, I was getting pretty wired from the Tylenol Extra Strength I was taking. I spent a couple of nights absolutely tripping out on the stuff. I took this picture at 3:00 one morning. Why? Because when you're basically immobile, dead dog tired, and hopped up on Tylenol, there really isn't much else to do at three AM except take your own picture.



My first physio appointment was a week after surgery. It snowed that day. Yes, my first trip out of the house with my busted shoulder and arm was on a day it snowed six inches.
At the rehab clinic, I meet Jim, my therapist. "Bike accident, eh?" he says. "Let's see what you did to yourself."
He consults my chart. "Uh huh, uh huh, hmmmm, uh huh, uh huh. Now that's interesting. Usually you don't see both of these injuries together. Usually, it's one or the other. But not both. Very unusual."
My elation upon hearing this knows no bounds.
There's not much treatment during this first session. Not much can really be done until the swelling in my arm starts subsiding. But he does ask if I have any problems.
"Can't sleep," I mumble between yawns.
"We can fix that."
He asks me to lie down on my back on the examining table, and he grabs some pillows. He sticks one under my head, a couple under my knees, and slides another one under my left arm, between it and my body.
Oh my. Suddenly, I'm totally relaxed.
That night I set up the pillows on my bed the way Jim did. I'm worried about Linus. Our ritual the past few years has been that he always jumps on the bed and curls in between my left arm and my body. If he tries that, it's going to hurt. I settle in with the light off and await Linus's arrival.
He hops up on the bed. Somehow he knows that the left side is off-limits. Without hesitating, he curls up in the crook of my right arm.
We both sleep for eight solid hours.

Thursday, January 11, 2007

Winter weather

It's been real winter for over a month, and my three-wheel bike is sitting in the porch. Alas, there is now some rust on the fenders (or deflector shields, as the ones on John's bike are labeled). So my big bike activity for the coming week is going to be taking some steel wool to the rust, with a little oil.
And how to protect against future rust? My friend Heather says to polish the metal with Johnson's Floor Wax. I haven't seen it in stores for ages, but shall hunt some up. Failing that, I'll drip a tealight candle onto the fender and buff it around with a cloth, pretending it's floor wax.
Can't get over how much it means to get out on a bike and go more than just around the corner, faster than just doddling along or dawdling along. I actually find myself planning to get a new three-wheeler, and probably an expensive one at that. Better than thinking of owning another car. The bike means health and strength, and clean living compared with driving a car.
Now if only I could ride a bike that fit onto the bike racks on the buses... well, I can't have everything. The bus racks don't fit my kayak either, so there shall be no complaining on that score.
Off to read the websites for the Greenway and Trixy, the two models I'm currently considering. Semi-recumbent trikes. Kick-ass good, from what I can tell. More research needed.

Monday, January 01, 2007

The Big Ouch: What Happened Part Three

"Go towards the light," said the voice.
I could see the light, beckoning, calling.
I have not had any surgery or anesthesia since having my tonsils removed as a child. I have no recollection of being under.
"Go towards the light."
Sometimes things go wrong in surgery. You don't wake up. Could this be happening now? Could the surgery have gone horribly wrong and now I was to find out the answers to the ultimate question of life, the universe and everything?
"Go towards the light."
Or was something else happening?


1:15 am.
The nurse comes by and offers me a drink of water. It will be my last drink before surgery. She asks when the last time was that I went to the washroom. It's been hours, so she suggests that I go.
She helps me out of bed, and I stagger along the floor, my busted left arm and shoulder in a sling, my right arm dragging my IV rack. I make it out of my little area, but I have no idea where the washroom is.
"Which way?" I ask.
She points to my left. A door is open, with a light shining behind it.
"Go towards the light."
"A fine thing to say to a person hours before surgery," I harrumph.
"Oh great," she mumbles, "it's going to be one of those nights."

It's amazing how much your life can change in an instant. This morning, I was dreaming of an 18' kayak. Now, after tumbling off my bike, I'm wondering if I can go to the bathroom without screaming.
Kayaking is a distant memory.

There was no screaming. In fact, the entire process was mostly painless. I return to bed, and sleep in fits and starts. I awake around 7, about 45 minutes before surgery. Breakfast arrives for the other patients, but not for me. The nurse warns me that should a breakfast accidentally arrive for me, I shouldn't eat it. I haven't eaten in 18 hours now, but I'm not hungry. In fact, I will go about 30 hours between meals. I was never hungry.

The nurse returns to explain the procedure. Around 7:45, the anesthesiologist will come and sedate me. (This never happens.) They will wheel me into the waiting area, then the operating room. The anesthesiologist will then inject something into my IV and put me out, and from my point of view, I will wake up right away in the recovery room. No time will pass for me. I may be a little disoriented, but it should pass quickly. No dreams.
The anesthesiologist does arrive, with questions for me, plus papers for me to sign. Then an orderly comes and wheels me into PreOp.
I don't give it a lot of thought, but it does occur to me that I may be facing my last conscious moments. Mistakes do happen. Things sometimes go wrong. But I'm resigned to my fate. It's in the lap of the gods.
I'm wheeled into the orthopedic surgical room. The operating table is narrower than I thought it would be and there's some discussion of how to transfer me from my bed to the table. Finally, I say that I will walk over to the table. Someone helps me up and off the bed, and I cross over to the table and lie down.
It hurts, of course. Lying down on my back is the most painful position. Someone calls for "shoulder extensions"; the bed is so narrow that my shoulders hang off the sides, and for my mangled left shoulder, this isn't helping.
I'm not aware that the shoulder extensions ever arrive, and now the anesthesiologist has my attention. He explains that during surgery, they will be freezing the areas they operate on. This will reduce the pain when I come around. I'm all for that.
He starts by poking something between my left shoulder blade and neck. He's trying to find a certain nerve or muscle group, I guess. He wants me to tell him when I feel a tingling like a mild electric shock.
"Feel anything?"
"No."
"Feel anything?"
"No."
"Feel anything?"
"No."
"Feel anything?"
"No. Wait. There's a bit of tingle. By the shoulder blade."
"Okay, good. That tells that I'm in the right area--"

Then I open my eyes.
Which is odd because I do not remember closing them.
But my first sensation is a good one. My left arm, even though it feels sore and swollen, also feels attached and whole again.
I focus on a clock on the wall. It's almost noon. Four hours have passed in a blink.
There's a machine beside me automatically checking my vitals. I can feel it inflating to check my blood pressure.
I glance over at my left arm. I have a long bandage stretching from above my shoulder to half-way down my arm.
A nurse appears. She says everything went well, but the surgery was four hours, not the planned two and a half. They found additional damage in my shoulder to repair. They kept re-locating my shoulder and it kept falling out. So in addition to screws and a plate in my arm, they also performed a Bankart Repair. This is a procedure that ties a strip of muscle across the joint to hold the arm in place in the shoulder socket. I don't know it at the time, but this will slow down my recovery, and probaly permanently decrease my range of motion.
The nurse leaves as she tries to find a bed for me; they did the surgery even though they did not have a room to put me in afterwards.

What else did they do to me? They put in a plate and screws to fix my arm. They repaired a small break in the shoulder socket; unfortunately it was where some tendons and ligaments were attached so they had to be repaired. Also, a lot of muscle had to be re-attached as it had come away from the bone. Here's what my shoulder looks like now:


Yes, the plate and pins are permanent. I will never have an MRI and I will beep at airports.

The nurse returns, they found a bed for me. I ask for a drink of water. My throat is killing me -- it's raw from the breathing tube they had down it.
I'm wheeled to my room, pumped full of antibiotics and morphine. I'm tired and I feel like sleeping, yet I also don't want to sleep. Mostly, I just sit dazed, occasionally nodding off.
Karl will visit me around 5:00 PM -- I spent more of his visit asleep than awake. Others will visit me. Louise, Brenda, my niece Kai all stop by. Paula and Bernie visit. For some perverse reason, Bernie is mostly concerned that my right hand still works. Paula thinks I look like I've been hit in the face with a sledge hammer. Not that there's anything wrong with my face, but because the shock of this life-altering moment is still sinking in.
Dinner arrives around the same time Karl does. It's a fish patty thing, which wasn't very good. The mashed potatoes are excellent. The nurse tells me to go easy -- it's my first meal in 30 hours. I nibble at it.
Details are a blur, but I am constantly poked, prodded and checked by nurses. Everything seems to be normal.

I'm sharing my room with three other patients. Across from me is a young guy who's here for the long haul. He's just ordered a tv. He knows all the nurses by their first names. They are asking him for advice on his course of treatment. I'm guessing dialysis.
Beside me is an old lady. I'm never sure what is wrong with her, but she seems to have all sorts of ailments. She is constantly being taken out for tests.
The third roommate is an older man who's left left hand got into a fight with a table saw. I give the victory to the man only because all his fingers are still attached.

Afternoon fades into evening, and into night. It's early in the morning now. And I need to pee. There's no nurse around, so I slowly sit up. My back is killing me. I carefully stand and walk to the washroom, dragging my IV rack. A nurse has already helped me do this a couple of times, so I already got the hang of it. When I return, I stop at the window and look out. I can't see much -- most of the view is blocked by the roof of another part of the hospital. But I can see the tops of some trees, some streetlights, and clouds.
I miss being outside.
And it will be along time before life becomes normal again.
I carefully climb back into bed.
Sleep eludes me.

In the morning, I go down for x-rays. It is there that I see for the first time the steel and pins that are now part of my arm.
Holy jeez. I'm bionic or something.
The rest of thr day is a blur. More drugs, more pills. More blood tests. They want me out -- they need the bed. In mid-afternoon, I get the word. I can go home.
My long recovery begins.