Shoulder Surgery–Post-Op Appointment

So on Monday, I had my 10-day post-op appointment with my surgeon.  He showed me the digital photos taken during my surgery and explained everything they found and how they repaired it.  In addition to the calcium debridement, subacromial decompression, bursectomy, and rotator cuff repair made with 4 anchors in the bone, they also discovered that I had many small tears to the labrum, which is the rubbery cartilage rim in the ball and socket.  The edge of it looked like the edge of a feather, all wispy-looking from the tears.  So he ended up repairing that, as well, by shaving down the frayed edges and leaving a smooth surface.  So in the end, I actually had 5 different surgical procedures done.

He told me that he was really glad I brought my case to his practice, because it made a great teaching case.  He said he had 2 students observe during my surgery, and they were all shocked by the enormous size of my calcium deposit.  He said at 2 cm, it was the largest deposit of calcific tendinitis his practice had seen this whole year!

I wanted to share the pictures from my surgery, but he still hasn’t sent them to me.  When I get them, I’ll come back and revise this post by adding the photos.

I told him I never took any of the narcotic pain meds and that I was just taking Aleve twice a day.  He prescribed a stronger anti-inflammatory medication for me to take twice a day for a month with one refill as needed thereafter.  It’s called Diclofenac Sodium 50 mg.  I can tell you that since I started taking it, I have really had no pain at all, and I feel great!  I have not even had to ice during the day…only at bedtime.  And I am sleeping better, too.  That definitely helps with overall well-being.

The nurse removed the bandages and the stitches in my 5 port incisions.  That really stung, because she swabbed each one with alcohol right before snipping and removing each stitch!  Ugh!  But the incisions have healed so nicely that you could hardly see them!  Impressive…I don’t expect to even have any scars remaining in a couple of months!

 

  

The doctor told me I could start physical therapy this week, but I couldn’t get an appointment with the Thanksgiving holiday, so I ended up scheduling this coming Tuesday morning as my therapy evaluation appointment.  I will be going back to the same rehab center where I had PT on my shoulder earlier this year.  The doctor told me to do PT 1-2 times per week for 1-4 months, as determined by the therapist, so they’ll make that determination at my evaluation next week.

The surgeon told me I have to continue to wear the immobilizer sling for 4 weeks post-op, and then I can remove the immobilizer pad and just wear the sling portion for at least another 2 weeks after that.  So I will end up in the sling for at least 6 weeks, as it turns out.  I’ve had it for 2 weeks already, so 4 weeks to go.  That will take me to after Christmas some time.  I guess if I can get out of it by my birthday, that will be cool!

The timeline the doctor gave me shows the goal to return to normal activities in a range of 3-6 months out.  I can’t wait!

Shoulder Surgery: First Week of Recovery

Day of Surgery: 

It was Friday morning.  I was barely holding myself together in the lobby. My anxiety level was steadily climbing.  Fortunately, I knew I’d eventually be getting IV sedation beforehand, and I knew that would help.

My surgery was delayed an hour, because it took that long for two very kind and talented nurses to successfully place an IV in my arm. This was something I expected.  It happens to me every time.  My veins roll, especially when I’ve had to fast for 12 hours without any water whatsoever.  They also branch off or vanish into deeper tissue too soon after the spot where they are visible under the skin. I forewarned the nurses, and they tried all the tricks of the trade to avoid sticking me repeatedly. In the end, they just apologized and said they’d have to go deep. Ouch!  That was still better than placing the IV between my thumb and first finger like they did when I delivered my youngest child.  That was horribly painful and left me bruised up pretty badly, so this was a piece of cake in comparison, and they were sincerely trying their best not to hurt me.

In addition to the IV ordeal, they had to do an EKG as a baseline for the anesthesiologist because of my history of irregular heartbeat.  All this took extra time.  The whole staff was exceptionally caring and really helped me to feel comfortable.

Once the IV was in, Steve came to sit with me until I was taken back for surgery.  I was given a cup full of pills with 1 oz. of water.  It included Gabapentin for pain and a host of things to counter side effects like anti-nausea, Zantac for stomach acid, Benadryl, etc.  I should mention that I seriously dislike narcotic pain meds and have never taken them when prescribed.

Surgery took about 1.5 hours.  Afterwards, the surgeon spoke to my husband and told him the calcium deposit was even larger than the MRI had shown and turned out to be about 2 cm, which is about the size of the whole tendon.  He said I was a real trooper to have lived with a deposit that size for so long, as it’s extremely painful.  Good thing I have a high tolerance for pain.

In the PACU, they woke me up and offered me soda and graham crackers.  As soon as they sat me up, I got horribly sick from the pain meds.  Steve was waiting with me and said I did not look or sound like anyone he knew until after I got sick, and I seemed more awake and lucid after that.  The nurse said the same thing.  She helped me get dressed, but I had already been placed in the sling, and my arm was completely numb from the nerve block, so they could only pull my top stretched over the sling, so it was really only half on.  And I couldn’t wear a bra, either, so I felt really exposed and uncomfortable.  They draped my warm shirt over top of my shoulder with the sling, and that was it.  I had to wear compression socks throughout surgery and for 48 hours afterwards to prevent DVT.

I went home with a pump attached to a catheter in the back of my neck that would continuously feed numbing medication into the brachial plexus to take the edge of the pain responses in my whole arm.  That was helpful.  I had to carry the pump on my shoulder with all the tubing every time I got up until it ended early on Monday morning.  Since I won’t take narcotic pain meds, the nerve block pump combined with Aleve at home really helped get me through the first few days.  The doctor insisted on prescribing at least a low dose narcotic, so he gave me 5 mg hydrocodone combined with 325 mg of Tylenol.  We filled it, but true to my word, I never took any of it. 

I never ate much.  My daughter made me some oatmeal raisin cookies.  I had three of them by the time I went to bed.  That was it for the whole day, plus the pack of 2 graham crackers and 2 Sprites that the nurse game me in recovery.

That night, I began a pattern of never sleeping more than 3 hours at a time, and I began waking up about an average of 6 times every night.  I left the tv on and just watched until I fell back to sleep over and over again.  My arm remained numb that whole night.

Saturday, 1 Day Post-Op:

I mostly stayed in bed.  Hubby brought meals to me.  By evening, I went outside and walked up the street and around the cul-de-sac by my house 3 times.  I was exhausted.  That was about all the energy I had in me at that point.

That night, though, I woke up to horrendous pain in the middle of the night.  I stayed hooked up to an ice machine with a cooling shoulder cuff most of the time during the day and throughout the night.  I was close to tears.  I was tempted to take the pain meds but thought better of it.  Instead, I hit the dosing button on my nerve block pump and got an extra bolus of numbing medication.  I waited it out and eventually got back to sleep, but it was a rough night.

Sunday, 2 Days Post-Op:

I felt nasty because I couldn’t bathe or wash my hair, and I still wore the same clothes since Friday.  Gross.  I wasn’t up to going to church and canceled my symphony ticket.  I didn’t make it to either church service that day. 

That evening, it was time to remove the surgical bandages and replace them with waterproof Band-Aids to cover the sterile tape on my arthroscopy incisions.  We discovered I had 5 of them…1 in front, 1 on the back of my shoulder, and 3 on the side.  That was more than we expected, but everything looked normal and healthy. 

 

I felt weird coming out of the sling for the first time and extremely stiff.  My inside upper arm was extremely puffy, like a sack of fluid hanging there that had pooled at the top of the sling.  I wasn’t supposed to bathe yet, but I set the shoulder bag with the pump on the floor outside the shower door, and hubby made a drape of plastic storage bags taped over my shoulder so I could at least shower the lower half and keep the shoulder and catheter dry.  I got to change my clothes, but I still couldn’t wash my hair.  I felt a bit more human but still gross. 

The whole process of getting out of my sling, changing the bandages, making the cover, getting a partial shower, beginning the pendulum exercises on my shoulder, and changing clothes took 2 hours!  I was so tired that I didn’t make it out for a walk.

Monday, 3 Days Post-Op

Hubby stayed home and worked from home that day, because we knew the nerve block would end at some point that day, and he had to be here to remove the catheter when the alarm went off indicating that the medication was gone.  That happened at 6 AM, but it turned out there was still a fair amount of medication left in the bag…it was just laid flat on the bed while I slept and had pooled to the other end of the bag.  Oh, well.  It was good to be free of the catheter tape.  It had really been irritating my neck and limiting my movements, and not having to carry all that tubing and the pump bag made it easier to get to the bathroom.  Without the benefit of any numbing medication, though, I began to feel all the steady aches and pains in my arm and shoulder.  Ugh.  Tolerable, though.  I began switching my Aleve to 1 in the morning and 2 at night to help me get through the night.  Night time brought lots of involuntary muscle spasms and flexions that were followed by horrible pains.  The ice machine continued to be my best friend, especially at night. 

I began to resume homeschooling Holden during the day, and then I’d go ice up.  I had Steve remove my sling 3 times a day for the pendulum exercises.  My shoulder felt so tight and stiff.

That night, free from all the extra gear, I was finally able to have Steve help me wash my hair and get a full shower.  I nearly cried in the shower because it felt so good to get clean!  I said it felt like a spa day!  LOL.

We noticed that the puffy area on my upper arm was also pooling the blood from surgery, so a substantial bruise began surfacing, all black and yellow.  Yuck!

Tuesday, 4 Days Post-Op

My sleep steadily improved, and I began walking longer and at a faster pace each day.  I still woke up lots of times, but the quality of my sleep was improving.  Steve had to go back to work this day, so I was terrified of being at home without him.  I got up with him at 5:30 AM each day to get my morning exercises done out of my sling and get hooked back up to the ice machine for another short stretch of sleep.  That routine began to work well.  Hayden was home for part of the day, so I could call on him if I needed help with something.  I continued homeschooling on schedule.  I had to ice up after each set of pendulum exercises and was really only off the ice machine while teaching.

Wednesday, 5 Days Post-Op

On this day, I had almost no pain.  I felt amazing and could hardly believe it!  A friend from church stopped by to visit and bring dinner, and she said how great I looked.  I felt wonderful.  I would soon learn that there would be good days and bad ones.

I ventured out to evening church services for the first time.  The bumpy car ride was challenging, but I survived.  It gave me hope that I might make it to the hockey game in Dallas that I’d purchased tickets for long before I knew I even needed surgery.

Thursday, 6 Days Post-Op

I’d had a bit more pain overnight but was okay until I walked backwards out the front door to carry the box containing the nerve block pump to the mailbox to return it.  I didn’t realize that the glass storm door wasn’t open all the way, and I backed right into it with the back of my sling arm.  Oh my gosh…the PAIN!  So intense.  It lasted most of the day and shot right down my upper arm.  Icing was the only thing that helped.  So awful!

Holden, who is 11, figured out how to get me in and out of my sling, so I was at least able to get out of it to exercise during the day.

That night, I ventured out with the family for the hockey game, so this was my first big outing…long ride, and a long time to be out.  I had a great time, and I survived!

Friday, 7 Days Post-Op

Hubby decided to work from home since we’d been out late, and the rain would have made for a slow commute.  It was nice to have him home.  He needed to do some grocery shopping at Sam’s Club, so he asked me to come along and get him his membership card and help point out what we needed.  It was good to get out again.

I had some discomfort but iced when I needed to and had a decent day.  My stomach hurt all day, and I didn’t eat a lot.  So I decided to try only 1 Aleve at bedtime instead of two in case that was upsetting my stomach.

My hand on the surgical arm had remained so puffy all week that I could not get my wedding rings back on.  After slathering my hand up with lotion, I decided to try again to see if the fluid retention had improved any.  I was finally able to get the rings over my knuckle, and then they were comfortable.  Yay!

Saturday, 8 Days Post-Op

According to my Fitbit, I got my best sleep score yet.  I only woke up 3 times overnight, and I felt pretty good when I got up.  I went to my desk and paid bills and made a grocery list.  We went to pick out a Thanksgiving turkey and a few other things we needed.  We went out twice to two different stores.  It was a lot, but I had a good day and felt okay icing up between errands.

I haven’t had much pain today, and I feel like things are going well.

Summary:

So far, so good!  The pendulum exercises feel better to do each time with less pain and stiffness.  I’ve started spending short stints outside of my sling after the exercises to keep working my wrist and elbow and to rest the arm on a pillow just to let my arm breathe a bit.  It gets super itchy in the sling.  I feel pretty good! 

I’m planning to go to church in the morning, the symphony in the afternoon because I forgot to cancel my ticket, and evening church.  It will be a long day, so I don’t know how well I’ll do without my ice during the day.  I may have to take my portable ice pack to the symphony.  We shall see!

Overall, I feel like I’m doing well, and I am anxious to go to my post-op appointment with the surgeon on Monday morning.  If it goes well and everything looks good, he’ll be removing the bandages for good, including the sterile strips, and I should be able to ditch the sling (at least unless I’m out in public and need to protect it).  I should also be cleared to drive with the other hand.  I’m supposed to start physical therapy for passive movements next week, as well. 

My understanding is that I won’t be able to use my arm for anything but passive movements for at least 6 weeks.  The therapist will be giving me movements to do at home.  These first few weeks are devoted to preventing scar tissue from causing frozen shoulder and to opening up range of motion.  Any movements I would do would be from the elbow down with my arm pinned to my side…no reaching or raising of the arm.

I believe the second 6 weeks of therapy is where they will begin to strengthen and expand range of motion.  But it will be literally months before I can do anything useful with my arm.

Healing can take 6-12 months.  I had calcium debridement, rotator cuff repair with anchors, bursectomy, and subacromial decompression.  That’s obviously going to take some time to heal.  But I’m optomistic!  As much as I want to get back to my regular routine, independence, and regular workouts, I know that is all many months away.  The last thing I want to do is injure myself by popping out an anchor or something that would require a revision surgery.  No way!  But I plan to focus on doing all the home therapy exercises and getting out each day for fresh air and some faster-paced walking to keep my cardio health in check until I can work out again.

At this point, I’m glad I had the surgery, because it gives me my best chance at being pain-free and functional down the road.  My condition was only getting worse with time, and after living with chronic pain for over a year, it was time to take steps to get it fixed once and for all.

The surgeon said he’ll be sending me photos of the arthroscopic surgery to show me what all he found, but I haven’t seen any yet.  Maybe he’ll show them to me at my office visit on Monday.  I can’t wait!

I Survived Shoulder Surgery!

I can only type with one hand, so I have to keep this short. I had my surgery yesterday afternoon. It was delayed because it took two nurses an hour to get an IV in my arm!  I have this issue every time, so I expected it.

I had calcium debridement, rotator cuff repair with anchors, bursectomy, and subacromial decompression. The surgeon told my husband that the calcium deposit was even larger than the MRI showed…it was 2 cm…and he said I was a real trooper for living with that in there because they are so painful.

I’ve been suffering with this pain for over a year and already did anti-inflammatories, cortisone injection, and 12 physical therapy sessions, only to have the pain return, and I didn’t find out the real problem until I saw the doctor again and was sent for x-rays. Then I got referred to an orthopedic surgeon who sent me for an MRI and told me I needed surgery.

So here I am, one day post-op!  I have a nerve block with a continuous pump for 3 days.  I can feel my arm but it helps take the edge off the pain.  I’m hurting, but I’m trying to avoid taking the narcotic pain meds, so I’ve only taken Aleve so far.  I’m using an ice machine for swelling.  I have to wear an immobilizer sling and not drive until I have my post-op appointment after 10 days. Then I will start physical therapy again in that week, once a week for 12 weeks.  The first few weeks are only passive movement and then assisted movements after that. It will be a long time before I have full use of my arm again, but I’ll get there eventually!

My ultimate goal is to be able to resume my daily workouts. When I can do that, I’ll know I’m finally healed from this whole ordeal!

REVIEW: Elephant Learning Math Academy by Elephant Learning Math Academy.

I was given the opportunity to review Elephant Learning Math Academy with my 11-year old son, and I was pretty intrigued to see how it works.

WHAT IS IT?:

Elephant Learning Math Academy is a subscription-based online learning program that helps kids advance their math skills.  It is an automated math academy for kids age 2-16.

The company feels so strongly about the efficacy of their program that they guarantee your child will learn at least 1 year of math in 3 months by using the program just 3 times per week for 10 minutes per session.  That’s just 30 minutes/week! 

The program cost is $35/month, making it less costly than signing up at many popular brick and mortar tutoring facilities on the market.

OUR EXPERIENCE:

This is an intuitive program that is designed to automatically detect what your child understands and what they do not, thereby guiding the practice to work on areas that need better understanding.  When your child begins, it first asks a variety of questions in order to determine placement into the program.  Holden was 11.8 years old when he started, and the program placed him at an Elephant Age of 10.3.  That was a bit of a surprise, but I figured he’d get that number up in short order. 

Getting Holden to work on it for just 10 minutes at a time was never a problem.  It’s such a short time commitment that it really isn’t a big deal to work on it in addition to his regular school work.  In the beginning, he was really excited to see that there were so many “games” to choose from for his daily questions, and he wanted to work for more than 10 minutes so he could try more of them.  The program will allow a little extra work, but not beyond 20 minutes per session.  It conveniently tracks the time for you and ends when the max has been reached.  However, he soon found that the “games” were really all the same, just with different graphics.  He began to lose some his enthusiasm at that point, but he still didn’t mind doing it.  I would say it’s less like a game and more like themed animations for answering questions.  So to him, it didn’t matter which theme he chose from that point on.  It’s colorful, but not particularly motivating to him one way or another.

 

Each time I peeked over his shoulder now and then to see how it was going, I noticed he was still answering the same types of questions as the previous sessions, and that had me wondering why.  I noticed that his Elephant Age had still only progressed to 10.5 in all this time, and that progression had happened early on, but there had been no changes since then.

I went away for a few days to celebrate my anniversary near the end of the review period.  When I returned and logged him in to work on the program, a message popped up saying that he was struggling in multiple areas and that we should consider having him retake the placement test.  I mentioned it to him, and he started panicking at the though of having to start over, so I opted out and let him continue where he was.

I have since contacted customer service to ask for advice on how to proceed, and I’m waiting to hear back.  He obviously has NOT covered a year’s worth of material as the program promises, so I’m wondering where the disconnect is happening.  I suspect from my observations that it is simply his ADHD.  He will often start talking while working on it and get distracted or accidentally touch the screen and thereby change his answer without realizing it before pressing enter.  He prefers to use the app on our Android tablet rather than doing it at the computer, which by the way, works very well.  I love that portability option, as it saves his progress in all formats whether he uses the app or the computer. 

I really don’t blame the program.  It doesn’t know if he was careless or truly doesn’t understand the question.  I know from watching him that he understands but is making careless errors, and for that, it is preventing his progression through the program.  So my conclusion is that it may not be the best fit for him because of his inability to focus, but it certainly could be for a child who isn’t so easily distracted.  I think he is becoming bored with it, simply because he is stuck on the same types of questions over and over again, which only adds to his inability to focus.

After each session, he can see how he’s doing in each category of problems, and it’s color-coded for easy understanding.  He does like watching his progress this way.

Within each category, you can click it to see more detail of the work and progress within that category.

I can also check at any time to see how well he is keeping up with working on it regularly by viewing a Playtime Analysis at a glance.

In addition, I can see a detailed history of whether he has passed or failed each concept every time he uses the program. 

I wasn’t clear on how I was supposed to use this feature, but I also discovered that there was a worksheet section that appears to be extra written practice that I could print off for him to do each day.  That’s a nice option, too.

In theory, I love the idea of an intuitive program that keeps your child right where they need to be until they are ready to move on and that keeps progressing them at their own pace.  In practical application, though, I can see where a child like Holden can fall through the cracks of that intuitiveness.  He is doing much more advanced math questions in his regular math program, so I know that he has the ability.  I just think his ADHD makes it perhaps not the best format for him personally, and I think he would be more engaged with it if it had an actual game element to it rather than just themed animations.  But I would encourage you to give it a try and see if it is right for your child! 

Check out what other Crew members have to say about Elephant Learning Math Academy by clicking the banner below.

Veteran’s Day FREEBIES

Aside from freebies and deals on food at over 100 restaurants, there are lots of freebies on shopping and services for military members and veterans on Monday in celebration of Veteran’s Day.

There’s even one freebie for EVERYONE:  National parks are waiving entrance fees for all on Veteran’s Day!

If you are an AMC Stubs member and purchase a military movie ticket now through Monday, you get a FREE popcorn! 

At Great Clips, veterans and active duty military members can get a FREE haircut on Monday or pick up a free haircut card to use through the end of the year.  Non-veterans who get a haircut Monday get a FREE haircut card to give to a veteran which can be redeemed from Veteran’s Day through year’s end. 

At Planet Fitness, veterans and active military can work out for FREE through November 15th, and they can even bring a friend to work out with them for FREE!  And after their workout, they can enjoy a FREE HyrdroMassage and chair massage, as well!

At participating Sports Clips locations, veterans and active duty military can get a FREE haircut on Monday!

Through Monday, veterans and active duty military can get or renew their Amazon Prime membership at a $40 discount, making it just $79!

In addition, veterans and active duty service members can receive discounts ranging from 10%-25% off their entire purchase at stores like Target, Kohl’s, KMart, Leslie’s Pool Supplies, LL Bean, Dollar General, Bed Bath & Beyond, Albertsons, Staples, Walgreens, and Academy Sports!

To all veterans, thank you for your service!  Enjoy your special day.