Blog Writing and Updates!

When one decides to sit down and start a blog, it is easy to say "Okay, I have so much to say and have all of this time to say it". Then, life (in this case work) happens, and suddenly that time becomes like wisps of steam on a cool day - gone in a flash!

That's what has happened to me with this blog. So much to say and so little time to say it. Fortunately none of what I had to say was particularly important, so I suppose it can wait a little longer. I do have several more recipes to add, which I will eventually get to, and some comments to make about our elected representatives in Washington, who are not doing the job they were sent to do, regardless of which side of the aisle they sit on. I'll see if I can come up with a coherent statement to make on this in the near future. It's sort of like trying to make sense out of something nonsensical. I'll probably do no better than the millions of other Facebookers, Tweeters, bloggers and pundits out there flailing away at this mess, but at least I will have cleared my throat!

Okay, so back to updates. First, my shoulder; this is the seventh month since I had the rotator cuff surgery. It's coming along nicely, though it is in no way completely normal feeling yet. That will take a year to regain the strength that it had prior to surgery. Every so often it reminds me when I am reaching for something in an awkward manner that I need to remember to keep it in a little closer to my body. I am lifting some light weights, started in rehab a few weeks after the surgery. The goal is to build back muscle density around the repair site. It's a work in progress. It seems like I run into somebody weekly who have just had the surgery or have a diagnosis and need reassurance. Yes, things do get back to normal but it does take some work!

The other update surrounds the Mazda CX-5 that I bought in December. So far, it has been stellar at the gas pump, averaging exactly 32 miles per gallon in an mix of street and highway travel. The car will not not give you jack rabbit starts from a stop, and can be a little sluggish, but it does like to rev. I have never punched a car off the line anyway, so I have not really noticed any real lag in acceleration. There is always the option to shift through the gears manually if I needed to, but I haven't. The car's comfort has been good, and I really like the blindspot hazard system, which works well.

Someone did back into the car in a mall lot three months into ownership of it, causing about $1800 worth of damage to the rear bumper, hatch and right taillight. Parts took about a week to arrive, but once they did the car was restored to new condition. I did miss it during that period, relegated to driving a not so cool Altima, which bugged me for some reason.

And of course I started my 22nd year at Sahuarita High School this fall, the year beginning very smoothly for the most part. I have a student teacher working with me from the University of Arizona this semester, a choral major. It's a challenge to teach my classes, only because I am a hybrid music teacher, so to speak. I have taught instrumental and vocal music my entire career. Many vocal majors might balk at directing a jazz ensemble and teaching a guitar class if they have no instrumental background, but my student teacher plays flute and marched in the Pride, making it an easier assignment. We've got a great year lined up with many wonderful musical events and achievements to enjoy.

The Grammy Signature School buzz is still very much in evidence from our selection last April. We've used the money to upgrade and repair instruments. We were going to buy a new more mobile digital piano for our choirs and jazz band, but a man in the community eliminated that need by donating to us gently used two year old Yamaha professional grade keyboard a couple of weeks ago. We are looking forward to hearing this instrument with our groups.

One of the new things that is going on at school is the remake acoustically of my rehearsal space. The choir/jazz band room was built in 1998 with almost no proper sound insulation. Choir singers enjoyed the liveliness of the room, but man it was tough for a band to play in. And in the evenings the drumline rehearses in the room. It was definitely a hazard to one's ears. I've suffered from this over my time working there and have lost considerable hearing. I am currently using hearing aides.

This summer the district began making changes, extending the sheet rock between the choir room and the band room all the way to the ceiling, above the ceiling tiles. The tiles themselves were changed out to include those which can diffuse sound. What is happening this week while we are off is the completion of the work. Sound panels are going in on the walls of the choir room (yes, they never installed them in 1998), and sound cabinets, containing sound absorbent material, are being installed in the corners of the room. When instrumentalists use the room, opening the doors will soak up the boomy sound of drums and bass. Closing the doors reflects sound, which suits choir rehearsals. I can't wait to hear the results next week!

Post Rotator Cuff Surgery Update - Two Months

I am so behind in this update; where do I begin? To start, I returned to my teaching duties two weeks after the surgery. That return was eventful because two days after I came back to work our choir performed at the Eastern Arizona Large Ensemble Festival. They did will, despite my one-handed conducting. I was told by my surgeon that wearing the sling was a six-week proposition. Every time I was out of the house I was admonished to wear it; if anything it was a reminder to others that I had a bum wing. The day that I ditched the sling at work wouldn't you know it but a teacher who hadn't see me for a while clapped me on my bad shoulder! Yeow!

I was also told not to drive for a week. Well, I’m a fairly non-compliant patient, so I pretty much ignored all of these instructions. I waited five days on the driving before going off on my own to pick up some things at Target one day the following week. It was only a 4 mile straight run down one road from my house, so it wasn’t quite so bad. Turning was a bit of a challenge, but I figured out a way to do that safely and efficiently.

As far as pain was concerned I definitely felt soreness and stiffness during the pre-physical therapy period, and sleep was still a challenge. However I found that I was able to lay in bed sooner than I could with the previous surgery on my right shoulder. I used pillow bolsters to support my arm and shoulder and was soon able to stop wearing the sling for nighttime sleeping. That was so much more comfortable.

When I had the surgery on my right shoulder back in 2010 I remember having a lot more pain and struggling with my sleeping situation for several weeks. I also remember having problems doing simple tasks like wielding a spoon or a fork. But of course I am terribly right-handed. Doing anything with my left hand has always been a problem. Let’s face it – I am such a klutz left handed!

Physical therapy began the week I returned to work. It consisted of passive motion exercises. The therapists put me on a bench and then stretched and moved my arm and shoulder themselves. It’s hard to voluntarily give up control of your arm! You want to “help” the therapist, but doing so actually makes them fight with you. I learned to just close my eyes and breathe deeply during these sessions. That helped to keep my shoulder relaxed and the therapists happy.

There were four or five sessions of this type of activity, the goal of which was to begin increasing my range of motion. The first resistance exercises involved an overhead cable/pulley exercise in which my right arm pulled my left arm up high from a seated position. This was hard and painful, but I noticed that I could stretch the arm pretty high if it was aided by the right.

Once I could extend the arm (with soreness and stiffness), we began to work with very light resistance using a beach ball or very light elastic bands. From there I graduated to very light dumbbells, one to two pounds over the next four weeks.

At this point I am now up to five pound weights and stronger elastic bands. After my initial PT sessions ended I am on my own now, with the weight, bands and stretching program running three days per week, about 45 minutes each session. The last fifteen minutes of those sessions are reserved for icing.

The challenge is strengthening muscles attached to the reattached rotator cuff that basically shut down after surgery. It’s a process of many months of work to get it feeling anywhere near normal. There is still stiffness and pain as I use the shoulder more and more, and I have to remember to keep weights like milk jugs close to my body when lifting them. The same thing is true for extending the arm, as in drive-thru restaurants and banks. That can be uncomfortable, but if I make a conscious effort to use the arm it goes much better than reaching for something instinctively without thinking. That’s when the shoulder says to me “Hold it buddy, are you sure you want to do this?”

I fully expect to have my shoulder completely back in about six months, if I can keep consistent with my rehab schedule. There is a lot of work there yet to do, but I am already able to do more than at any other time since I tore the tendon in the shoulder. I’m looking forward to a time when my shoulder does not remind me that I am still healing!

***Rotator Cuff Surgery Day 5 Update***

I was able to move about quite a bit on the fifth day, including a short trip out shopping with my wife, though I can't drive just yet. I also began the first prescribed exercises, which consists of leaning over a table and letting my left arm dangle in a circular motion in three sets of ten reps. This is to be done three times per day.

The biggest change was my move out of the sling, which prior to the 5th day had been on 24 hours a day. The instructions say that I can leave my arm free if I am at home in a "controlled" situation, but I am to where it outside. The sling is a very supportive device, but wearing it for extended periods can cause my arm to go to sleep. I have been wearing it off and on for an hour each time.

The biggest step forward for me was not wearing the device to bed. I was able to tuck a pillow under my arm for support and slept in relative comfort the night before. Sleeping is always a challenge with this surgery. The added activity has increased my level of pain, however, and that is to be expected. The shoulder is quite sore in the evenings, but pain management has been effective. The pain, when it comes, is more in the category of a dull ache as opposed to a sharp pain. However, moving my arm in the wrong direction unsupported will bring a sharp rebuke, so I know my limits at this point.

I have received calls daily from both my orthopedic surgeon and the anesthesiologist to check on my progress. I do feel that if I have a problem I can reach out quickly for help. I'm scheduled for my first post-surgery exam on April 8, and physical therapy will begin a few days after that.

If I had to characterize this experience thus far in comparison to my first shoulder surgery, I would have to say that it has gone better. Time will tell but I am looking forward to regaining my full range of motion in my left shoulder without pain!

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.

White Bean Soup

I am always looking to cut down on meat-laden soups and other main dishes. I experimented with this one recently and it came up a winner in my book! You can cut the bacon if you want to go totally vegetarian (and add a few drops of Liquid Smoke at the end, or use turkey bacon for that smoked flavor. This one is easy and tastey.

Directions:

1 14 oz. can white beans (Great Northern is fine)
4 cups low sodium chicken stock
2 bacon slices, minced
1 tsp Liquid Smoke (if skipping the bacon)
1 tbsp olive oil
1 cup fine chopped onions (about the size of the beans)
1 cup fine chopped celery
1 cup fine chopped carrots
1 clove garlic, minced
1 tsp dried oregano
1 tsp dried basil
2 bay leaves
salt and pepper to taste
2 tbsp grated Parmesan cheese

Chop vegetables and bacon. Heat old in a medium stockpot over medium flame. Add bacon and saute until rendered. You can pour off some of this oil if you are looking to cut fat, otherwise dump in the vegetables and cook until the onions are clear. Add the beans, with the liquid and the stock and season with the spices. Bring this mixture to a boil and then simmer covered over low flame for thirty minutes, or until the vegetables are soft. Test for salt and pepper and adjust if needed. Drizzle in the Liquid Smoke at the end if meatless.

Pull out the bay leaves and serve with a sprinkle of the Parmesan cheese.

EASY BEEF ROAST

One of my favorite comfort meals is a good beef roast. It’s hearty and flavorful, and afterwards you can use the leftovers (if there are any) to make a nice soup. The problem with this dish lies in the cut and method of preparation.

In terms of the cut, I prefer the boneless crosscut rib roast. It’s a little more expensive than the eye of round, but the extra fat marbling will ensure tenderness and flavor. I’ve found that in order for round roast to be as tender you have to either slow cook it eight hours or use a pressure cooker. Those methods can turn the meat into a stringy mess, to me unpleasant result.

Rib roast usually comes with a bit of a fat cap; trim off as much as you can, but I do like to retain a little on the meat for flavor. The key is low and slow oven cooking. I set the oven temperature to 275 degrees - and I don't peek!

INGREDIENTS

4-5 lb. beef crosscut rib roast
1 tbsp. olive oil
1 medium yellow, onion, chopped not too fine
3 cloves garlic, chopped
2 stalks celery, chopped
2-3 carrots, sliced
2 beef bouillon cubes
2 cups water
(You can substitute 2 cups low sodium beef stock for the bouillon)
2 tbsp. Worcestershire sauce
1 tbsp. Montreal Steak Seasoning
1 tbsp. dried onion flakes
Salt and black pepper to taste

Preheat the oven to 275 degrees. In a Dutch oven or large stockpot heat the oil over medium heat. Season the trimmed beef with the spices, pressing into the meat and brown on all sides in the hot oil. Add the chopped vegetables, water and bouillon to the pot, season with Worcestershire sauce and cover tightly with the lid.

Place the meat the oven and roast for three hours and thirty minutes. Avoid opening the door of the oven during this time to ensure heat does not escape. At the end of the cooking time, carefully remove meat from oven and let rest 15 minutes before slicing and serving. A serving size would be three to four ounces, with a nice side salad!