Friday, December 27, 2019

FREE Tall Espresso Beverage @ Starbucks Every Remaining Day in December!

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Starbucks has announced Pop-Up-Parties at 200 random locations every remaining day in December, starting today.  The list of participating locations will change each day, so keep checking the list for any in your area.  When you find a nearby party, top in between 1-2 PM that day and nab a FREE Tall Espresso Beverage!  Limit one per customer. 

What a great way to end the year!  Thanks, Starbucks! Red heart

Enjoy!

Saturday, December 21, 2019

Shoulder Rehab–This Week’s Developments

So this week’s physical therapy for my shoulder was fairly uneventful, except that it was more of the painful table slides from last week and the addition of caning for external rotation like this:

This week, I got my flexion to 115 degrees, and the goal is to get to 140 degrees by Friday of next week.  I have already met the goal of 80 degrees for abduction.  But for external rotation, I’m still stuck at 15 degrees with no additional progress, and my goal is to get to 40 degrees.  Yuck!  That’s why we added the cane exercises this week to my home routine.  It honestly feels like it’s impossible for my arm to externally rotate any more than it is, and it’s so painful even to have the therapist manipulate it that far. 

My sleep quality has further declined since adding the table slides and caning. I’m doing them twice a day at home, along with the pendulum and stretching exercises that I do 3 times a day at home.  At therapy appointments, the therapist has me do pulleys, and he also does some joint mobilizations as he tried to stretch out my range of motion.  All of this adds up to waking up many times per night with pain and an inability to get comfortable after the first few hours of sleep.  Last night, I woke up 8 times, and I got less than half an hour of deep sleep.  No wonder I feel so tired!

At this point, I’m trying to work hard to make small advances at therapy, but it’s a little discouraging to be making such small gains.  I really just long to feel normal again.  This Friday will be the 6-week mark, so I should be cleared to come out of the sling for altogether.  I’m kind of looking forward to that, because It hasn’t been very comfortable to wear it since they remove the immobilizer.  I really feel like it just aggravates my neck and shoulders.  I take it off whenever I can just rest my arm in my lap at home. 

It took me two full afternoons to wrap Christmas gifts this year.  It’s so hard with one arm and trying to make use of both hands with one hand so close to the body.  It’s very awkward and takes twice as long!  It’s finally done, though.  It hardly even feels like Christmas.  I didn’t even get to enjoy shopping the way I normally would.  I did a lot of my shopping online to avoid the crowds with my sling.  It’s felt like a very strange holiday season!  But I press on.  I’m trying to stay positive. 

One cool thing is that I ordered a paddle brush hair dryer from Amazon to see if I could use it to dry and style my hair with one hand.  It works great!  Now I don’t have to trouble Steve with having to hold the blow dryer while I hold the brush.  That was very awkward.  So at least there’s one more thing I can do for myself again.

The downside of trying to be self sufficient with only one arm is that my good arm is most definitely getting overworked and has started aching much of the time.  I’m trying to be careful not to overuse it, but that’s easier said than done.

No doubt, Friday will be a big milestone day for me.  Aside from coming out of the sling, I can also transition from passive-only therapy to active therapy.  I don’t know that my shoulder is even capable of moving on its own, but I’m anxious to find out.  Wish me luck!

Saturday, December 14, 2019

Physical Therapy Update–Assisted Movement

So far, I’ve only done passive movements at my physical therapy appointments.  Basically, I lie down on my back while my therapist manually manipulates my arm in various directions, rubs out the muscles in my shoulder, and tries to increase my range of motion while my arm is just dead weight.

Yesterday, though, was 4 weeks post-op.  This was the first big milestone, which brought about some changes.  First, my therapist added assisted passive movements to my regimen, which meant adding pulleys and table slides. 

With the pulley hanging on the wall, I had to sit in a chair and pull down on one side of the pulley with my good arm while allowing the other arm to be pulled slowly up on the other side.  that was a lot harder than it sounds!  My arm didn’t want to go very high at all. Then I moved to sit at an angle so my arm was pulled slightly out and up, and that was so much easier! 

For table slides, I had to sit on a chair parallel with a table, rest my arm on a towel to reduce friction, and lean my body forward slowly, thereby sliding my arm forward at he same time without engaging the muscle at all.  Then I had to turn the chair slightly away from the table and repeat the movement, sliding my arm slightly out and forward. This was such a painful exercise!  The table slides are also added to my home therapy routine 3 times per day.

Second, the therapist removed the immobilizer pillow from my sling and refitted just the sling to my body.  No more waist strap, and my arm is no longer held out away from my body!  On the upside, it made it a whole lot easier to drive my van.  I was able to put my seat forward and tilt my steering wheel down to a more comfortable position again, and the sling no longer interferes with turning the wheel.  Much better!  The downside is that a new arm position is uncomfortable and not as restful.  It hurts a bit.

With all the changes, I found myself up a lot during the night in miserable pain!  It was so bad…probably worse than right after surgery…and I was so tired and didn’t know what to do with myself.  I was near tears and rocking myself on the edge of the bed.  I woke up 6 times.  I felt awful this morning. 

So today, I decided to avoid doing the table slides until I can calm my shoulder down a bit.  And for the pain, I decided to try the CBD Freeze roll-on I bought before my surgery to have on hand.  I used it a couple of times today, and it really helped…enough that I was able to take a nap.  At bedtime, I think I’m going to try the CBD Recover topical cream that you can rub in for pain and then hook up to my ice machine.for a while.  I’m just hoping to sleep better than I did last night!

I will stay in just the sling this way for 2 more weeks.  Then at 6 weeks post-op, I will reach another big milestone where I will transition to phase 2 of recovery, which involves active movement using the muscles in that arm.

Having this intense pain rear its ugly head when I was doing so well really caught me off guard.  I’m definitely willing to work hard for my recovery, but I hope I can keep this pain under control so I can really do the work that I need to do and give it my best effort.

I made good progress with some of my range of motion this week.  I already met and exceeded one of the 6-week goals, but I still have some work to do to reach the other 2 goals in these next 2 weeks.  External rotation continues to be the biggest challenge, but I did progress from –25 degrees to 15 degrees!  I have to get to 80 degrees to reach my goal.

I can do this, Lord willing!

Saturday, December 7, 2019

Photos of Shoulder Surgery

Just a warning…these are actual photos from my arthroscopic surgery, so it could be viewed as a bit graphic by some!  I was so excited that my surgeon finally sent them to me.  So I decided to do a separate post to illustrate all that I had done.

1.  CALCIUM DEBRIDEMENT – This is where he punctured the rotator cuff tendon at the site of the calcium deposit, which appeared white under the surface, and then drilled it all out, removing it as he went.

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2.  ROTATOR CUFF REPAIR WITH 4 ANCHORS – This begins with the empty cavity in the tendon that was created by the removal of the calcium deposit.  He screwed 4 anchors into the humerous head to use for tying up the remaining tendon with sutures in order to make the repair.

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3.  BURSECTOMY – These photos show the super inflamed bursa, which is all discolored, and the empty spot after it was removed.  All healthy tissue should show up as white or pale.  Inflamed tissues show dark colors.  This bursa had seen better days, which is why he removed it altogether. 

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4.  SUBACROMIAL DECOMPRESSION – The post-bursectomy picture also shows the acromion bone at the top.  See how it curves down?  That puts unnecessary pressure on the rotator cuff.  So the decompression involved shaving that bone into a flat plain to eliminate pressure on the future new bursa and rotator cuff, freeing up the space and reducing friction.

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subacromial decompression

5.  LABRAL DEBRIDEMENT – While doing the surgery, he discovered many small tears in the labrum, kind of like a frayed edge.  He shaved that smooth so that there will be smooth rotation in the ball and socket. 

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6.  SYNOVECTOMY – This shows the inflamed synovial tissue, which also needed to be removed altogether.

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Here is the one healthy tissue I had…the biceps tendon!

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So that’s it!

I started physical therapy this week.  It’s shocking how it can take an hour to have someone barely move your arm, but that’s the case!  The therapist basically has me lie down on my back with a towel rolled under my shoulder for support, and then he very, very slowly tries to manually manipulate my arm in various directions.  It’s painstakingly slow and painful.  He also rubs out all the little muscles in the top of the shoulder, and that’s the most painful thing you could imagine!  Just touching on the surface of the skin hurts, much less pressing down and rubbing on those muscles.  It’s excruciating, truly!  The therapist said it’s not from bruising but from the seizing up of all those muscles as a defensive response to the surgery.  Ugh!  It’s definitely going to take a lot of work to work out those kinks and stretch everything back out!  I can barely even tilt my head to the right because it’s all so tight and locked up.  He said as those muscles in the shoulder loosen up, so will my neck.  I can’t wait!

I have another week to go in the immobilizer sling.  Next Friday will be 4 weeks post-op, and then I can remove the immobilizer pad and just wear the sling by itself after that.  I’ll have 2 more weeks thereafter in the sling, and then if all goes well, I can come out of the sling at 6 weeks post-op on December 27th.  Yay!  My arm will be free for my birthday on the new year! 

My therapy up until then will only consist of those passive movements.  If I can achieve the target range of motion in passive motion by then, then we will begin to work on assisted movements thereafter.  I can’t wait!  There is a lot of aching and the need for icing after therapy, but it’s so worth it!  I had therapy yesterday and slept with the ice machine on all night, but when I took my sling off for my morning pendulum exercises today, the shoulder definitely felt looser than before.  That’s awesome!

Clearly, it’s going to be a long recovery, but I’m on the road to getting back to my everyday  life, and I’m happy about that!