Arthroscopy: The Day After

Here I am typing, one handed mind you, but I am typing! Day two was better than I expected based on my first rotator cuff surgery three years back. The seemingly clumsy attempt at administering the pain block by the anesthesiologist turned out to be a benefit, because the extra numbing agent that he used really deadened the pain for much longer than 24 hours. I lasted for all of Day Two as well. I was in no pain from the surgical site and experienced only soreness in the general area.

Now I did take the Hydrocodone as prescribed, but at this point I am starting to feel like I won't need it for the Day Three and beyond. I also used plenty of ice today, something that will continue for many more days. I moved about the house frequently today, getting the mail, fiddling with a new cordless phone system and programing a new remote for the living room television. Apart from that, I read and generally just hung out with my family and watched more of the basketball tournament. It's been a pretty good experience thus far, and much better than before.

I still must sleep in a reclined position again tonight, but I have a feeling that because I am not in much pain I may actually have a better chance to sleep tonight than in previous nights. I surely miss my bed, but it is not so bad. Tomorrow begins a new challenge as I remove the bandages and begin the first very light exercise of the arm. I can also finally shower as well!

Arthroscopic Surgery

I've been through this before. In 2009 I was rear-ended in an auto accident, resulting in a tear of my right rotator cuff tendon. I didn't discover that the injury had occurred until weeks later. The surgery in May of 2010 repaired the partial tear successfully and I recovered well from it, though I was surprised to find that sleeping was very difficult. I had to sleep for nearly two weeks in a recliner, because laying down created challenges. Also, owing to the fact that I am terribly right-handed, learning to use my left hand for daily functions those first two weeks post-surgery was definitely a challenge.

Physical therapy truly helped to strengthen my shoulder, but it was time-consuming. I recall going to therapy for eight weeks, two to three times a week. The good thing about all of this was that I was on summer break from school for most of this, so I had the time to get well. I was even able to sneak in a Jamaica trip during this period (though I was still in some discomfort at that time).

When I learned a few few months ago that I had suffered a full-thickness tear of my left rotator cuff, it was not terribly surprising. The shoulder has been painful and lacking complete range of motion for a long time. I used to lift heavy weights, foolishly I might add, and I had known that for quite a while that things were not quite right in either shoulder, but with these types of injuries people usually self-treat with an analgesic and go on with daily lives.

In the case of the auto accident, trauma changed my attitude that with respect to my right shoulder. What led to the re-evaluation of the pain in my left shoulder was a fall last September. I found that I suddenly could not lift my left arm more than a few inches without strong pain in my forearm. This was exactly the same pain that I had experienced in my right shoulder and I knew that it was time to see my orthopedic surgeon again.

The thing about the shoulder tendons (and there are four which controls arm motion) is that they don't get much blood supply to begin with, so damage in this area can be slow healing. The Acromiom bone, which is the bony extension which overhangs and protects the upper tendons is subject to developing a hooked appearance due to normal arthritic conditions. Even without much physical abuse, this bone can dig into the top tendon, the supraspinatus, and partially tear it. A fall or other traumatic occurrence can aggravate the existing tear and result in the condition that I am experiencing there. It is a common injury which is especially frequent with men in my age group. This diary is intended to help others going through the same thing that I am experiencing. Yes it is a little scary, but knowing what lies ahead is a great tool and preparing for this procedure. There will be several updates to this article as I work through this.

Day of Surgery

My last meal, per per-surgery instructions, was the night before, about 7:30. I have not taken any aspirin or NSAIDS for the last week prior to today. I was allowed Tylenol, which I needed last night. I felt some apprehension before going to bed, but my spirits were lifted by the Bulls beating Miami to stop their winning streak! This morning I woke early, had just a sip of water with my prescribed medication per instructions for my reflux condition.

After watching Sports Center, I drove with my wife, Linda, to the surgery center, where I checked in and paid what I owed of the surgeon's bill. They called me right away and I went on back to the prep area, where I was asked for the first of a dozen times my name, date of birth and the procedure and location I was there for today. The nurses wee very efficient in prepping me. I was all hooked up to the various lines in about twenty minutes. I was told that I had to take off my wedding ring. Now, I have not been able to get that ring off for about 20 years. When they said it would have to be cut off I asked for some ultrasound lubrication and presto! It came right off after a little bit of tugging effort. I'll have to get it stretched! My doctor came in next to diagram on my shoulder where he would be working and after a few jokes, he left to prepare.

The trouble came when the anesthesiologist began to administer the nerve block in my neck. It seems that my anatomy is not textbook on the left side; it took him four attempts using an ultrasound guided needle to find the correct nerve to stick. After the second attempt he asked me if I would like something to "take the edge off" through my IV line. Of course I did! After that I didn't care much what he did.

When I was appropriately numbed up Linda was brought in for final hugs and kisses and I was wheeled into the operating room and transferred to one of the most uncomfortable, narrow beds I've ever been on. I remember scooting onto it and being asked to push myself a up little higher. I heard the anesthesiologist say "nite-nite" and the next think I knew I was propped up on another bed, bound up in a bandage and the fitted sling we had to buy days prior to the procedure. Linda was sitting by my bedside and I slowly came to consciousness. There was no pain whatsoever from the site, but my calves were very sore. Apparently they had to flex my legs in an awkward position on the surgical bed during the procedure.

I was told that the surgery went as planned and that it took about 40 minutes. I went into surgery on time at 1 pm, and was out in recovery by 2:00. I was given some cold water and applesauce and I noticed that my throat felt very raw, from the tube they ran down my throat during the procedure. I was told to cough once or twice per hour throughout the next couple of days to help keep my lungs clear. I was able to stand very quickly, Linda helped me to get dressed and the nurse went over with us the doctor's post-surgical instructions once more. Linda is a Registered Nurse, so I had no concerns about not understanding directions. She always maintains charts of blood pressure, meds and so forth on a regular basis, so I knew that I was in good hands with my wonderful wife.

I was home by 4:30 and ready to dine, since I had fasted since the night before. I opted for breakfast - eggs, coffee and a slice of toast, which I was able to palate just fine. Dinner was equally light - soup. Much of the night I was troubled most by the bindings that I was in. They don't want my arm to move too much these first three days, so I find it awkward to sit in chairs or rise cleanly from the sofa. I was given hydrocodone and 600 mg ibuprofen to take every four and six hours respectively, but the pain block they gave me was still working well, as it did throughout the might. As I say, I don't sleep well in a recliner and tonight was no exception. I am not allowed to lay flat for several days so that the repair can set without complications. I was not in pain, but I was uncomfortable, napping on and off all night long. The first two nights are always the worst.

More to come!

New Car Update

A little over three months in and I'm still enjoying my new Mazda CX-5. It is comfortable, safe and getting excellent gas mileage at close to 33 mpg in an even mix of highway and street driving.

It did get a jolt of real world experience recently though; someone backed into the car at a local mall, resulting in about $1500 in damage to the rear bumper and quarter panel. The person who damaged the car drove off. That was frustrating, but the repair was done expertly and the car is a good as new.

I've owned (and financed) many new cars in my life, but few have been as satisfying as this car; the only the exception was the Ford Explorer Sportrac that I replaced with this car. I'm amazed at how much technology is now going into even "economy" cars these days. Hands free Bluetooth connections, rear back up cameras, navigation, blind spot warning systems, satellite and HD radio, multiple air bags, leather power seats and more are all often standard equipment. And the power and gas mileage these cars are getting is amazing. It remains to be seen how these engines will hold up in the long run though with the heat and high compression they produce.