Health, humerus, ORIF, recovery, shoulder, surgery

Giving Thanks

247 days post-surgery, 71 days post-MUA…

This Thanksgiving, I have many things to be thankful for:

  • I’m thankful that I tripped and fell on my shoulder, instead of my head, which could have seriously injured or killed me!
  • I’m thankful for the support of my friends, family, and job for the flexibility and understanding they have afforded my over the last eight months.
  • I’m thankful for the expert team of doctors, physical therapists, massage therapists, assistants, and office staff that have helped me immeasurably over the past eight months.
  • I’m thankful that my health insurance has kept this accident from becoming a financial burden for my family.
  • I’m thankful for the progress that I’ve been able to make.
  • I’m thankful that I will continue to progress and improve.

I’m hopeful that next Thanksgiving I’ll be talking about how close I am to a full recovery!

Health, humerus, ORIF, recovery, shoulder, surgery

35-week check-in

35 weeks post-surgery, 10 weeks post-MUA…

QOLI: 75

Flat this week

2015-11-25 QOLI

Let’s go over the numbers…

% Pain-free: 85

No change from last week. I could take Aleve every day, but I try not to. Maybe 2-3x a week to manage the pain (which is plenty on the days that I take it). I just don’t like the idea of taking pain medication every day, even OTC.

% Range of motion: 70

My breakthrough still hasn’t translated to real-world gains. In fact, it’s still a battle during PT to raise my arm under my own power the first time. It gets easier with repetition, but the pain doesn’t decrease.

% Strength: 50

No noticeable gains here. Some movements are noticeably weak and painful. For example, I’m pretty sure I will never arm wrestle with my left arm again. Today, a stiff breeze could beat me.

% Normal sleep: 95

No change this week, none expected (for a long time). I’ve learned to deal with rolling over, and found that the pain is lessened if I take the weight off of my shoulder before trying to rotate.

QOLI: 75

Flat this week.

Health, humerus, ORIF, recovery, shoulder, surgery

34-week check-in

34 weeks post-surgery, 9 weeks post-MUA…

QOLI: 75

Making up a little lost ground this week

2015-11-18 QOLI

Let’s go over the numbers…

% Pain-free: 85

Still lower this week. I actually have a fairly constant low-level of pain. OTC drugs would knock it out, but it doesn’t bother me enough to take them. Passive stretching hurts less during PT, but it’s the active range of motion stuff that hurts now.

% Range of motion: 70

We haven’t measured in a few sessions, but I feel compelled to bump this up after my breakthrough this week. The holy grail for me is being able to raise my arm above 90 degrees under my own power, which I can now do (with significant difficulty after warming up). It will be awhile before I can put dishes away on a high shelf, but as Obi-Wan Kenobi once said: “You have taken your first step into a larger world”.

% Strength: 50

I’m doing a lot of strength work, but it’s all targeted at very specific muscle groups. Mostly they just hurt right now. They don’t feel stronger yet.

% Normal sleep: 95

No (positive) change this week, none expected (for a long time). I almost downgraded this one because my left arm is harder to get in and out of the externally rotated position when I’m lying on my left side. So rolling over (and back) hurts more than it did a few weeks ago. I’m not sure why. But it’s not changing my behavior (yet).

QOLI: 75

A small uptick back to where I was two weeks ago. I definitely feel like I’m going through a rough patch with more pain and stiffness, but my recent breakthrough has done a lot to help me work through this and hang on to my positive outlook.

Health, humerus, ORIF, recovery, shoulder, surgery

Breakthrough!

233 days post-surgery, 57 days post-MUA…

I had a breakthrough yesterday in PT. while standing straight up, I was able to raise my left arm (actively, under my own power and with no external support or help) over my head – past the critical transition phase.

It was very slow, probably taking me 30 seconds or more. Also somewhat uncomfortable. But it was a first! Prior to this I always had to manually re-position my shoulder to get it to move smoothly. I could also move smoothly while lying flat on my back or on my side. But upright has been a challenge.

One caveat – I was taped. My therapist has been taping my shoulder/back to help give it a small amount of mechanical help with this motion. I took off the tape tonight because it was itching and so far I haven’t been able to duplicate the movement. I’m not warmed up right now so I’m pretty stiff. So this isn’t very surprising. I’ll do a good 30-60 minutes of PT before bed tonight and I’m hoping I can achieve this again today. I did duplicate my breakthrough at my home PT session last night, so it wasn’t a one-time fluke.

This is very encouraging to me. Until this point, all of the PT had felt very academic, because it wasn’t translating to practical gains in day-to-day usage. But once I can unlock this motion, it should be a steady march towards normalcy. I was starting to lose hope that this would happen at all. But now that I’ve done it once, I know that I can do it again.

Health, humerus, ORIF, recovery, shoulder, surgery

33-week check-in

33 weeks post-surgery, 8 weeks post-MUA…

QOLI: 74

Small downturn this week

2015-11-11 QOLI

Let’s go over the numbers…

% Pain-free: 85

Small downturn this week, but it’s expected. I’m doing a lot more resistance training, which leaves me more sore throughout the day. Nothing too bad or worth getting excited about.

% Range of motion: 65

We haven’t measured in a few sessions, but I feel like I’m holding pretty steady.

% Strength: 50

I’ve been focusing more and more on strength, but with the goal of improving motion and coordination, not raw strength.

% Normal sleep: 95

No change this week, none expected (for a long time).

QOLI: 74

A small downturn, but nothing that concerns me too much.

Health, humerus, ORIF, recovery, shoulder, surgery

No pain = gain??

231 days post-surgery, 55 days post-MUA…

A funny thing happened in PT this morning. Normally we spend about 30 minutes with hard stretching. My therapist pushes my arm as high as I can tolerate, for as long as I can tolerate, which is usually only 10-20 seconds tops. My therapist is good at reading my facial expressions and body language to tell how much pain I’m in. She pushes me hard, but knows when to back off.

This session started as all others do. Pushing my arm to the end of its range was excruciatingly painful the first 5-6 times. But after that, it stopped hurting.

Well, not totally pain-free. But it was tolerable. I could have gone another 30 minutes with no problem. I don’t know if it was a personal best in terms of range of motion, but it was definitely in the ballpark.

I’m actually looking forward to my next PT session to see if this trend continues.

Health, humerus, ORIF, recovery, shoulder, surgery

Synchronicity

230 days post-surgery, 54 days post-MUA…

As previously discussed in a tale of two shoulders, I described how my shoulder has two distinct motions. I can raise my arm actively from 0-90 degrees, but then I’m stuck. But if I then re-position my shoulder slightly, I can go past 90 degrees actively. Maybe to 120 degrees or so, after which I need passive help to get to the 160 range.

My PT describes that my shoulder mechanisms aren’t synchronized. The structures aren’t working well together and they are getting in each other’s way (my interpretation). Sounds like Seattle traffic if you ask me! LOL

To counteract this, we’ve started to do more resistance targeting specific muscle groups to help strengthen the weaker ones. I’m also working on exercises to help re-train my shoulder on how things are supposed to work.

I’ve found that if I lie on my back I can raise my arm from 0-120+ in one smooth motion. If I lie on my side (affected side up), I can move my arm horizontally (parallel to the ground) in the same motion. This is more difficult, but do-able. I still get a painful POP on the way down, which I think is all related to the humerus head re-positioning itself.

The more I do these exercises in a session, the easier they get. The POP seems to get more and more manageable as well. This hasn’t translated to improved range of motion or function, but I’ve only been at this new phase of PT for a few days.

I’m hopeful that I’m entering a new phase of post-MUA recovery where we’re past the major ROM roadblocks, and can now get down to the real work of teaching my shoulder how to work properly again. Hopefully this leads to more natural motion and usage, which will eventually turn into a positive feedback loop and the end game of my overall recovery.

But I’m getting ahead of myself. I’ve learned not to expect any quick gains. Let’s take this one step at a time…

Health, humerus, ORIF, recovery, shoulder, surgery

32-week check-in

32 weeks post-surgery, 7 weeks post-MUA…

QOLI: 75

Flat this week

2015-11-04 QOLI

Let’s go over the numbers…

% Pain-free: 90

No change this week, none expected (for a long time). Things are mostly good here. PT still hurts. Very mild pain sometimes during the day, which is a bit worse due to the increased focus on resistance training. Nothing to get excited about

% Range of motion: 65

I seem to be up and down here. I hit 160 last week, and 165 a few sessions later. But then yesterday I was only at 157. I’ll call it a push.

% Strength: 50

I’ve been focusing more and more on strength, but I don’t know if I’m seeing big gains or not yet.

% Normal sleep: 95

No change this week, none expected (for a long time).

QOLI: 75

Same as last week, but I’m not backsliding, so I’ll take it.

Health, humerus, ORIF, recovery, shoulder, surgery

Old dogs and new tricks

223 days post-surgery, 47 days post-MUA…

Who says old dogs can’t learn new tricks? I’ve learned a ton of new tricks in the past 7 months! It turns out that pain is great motivator. I don’t suggest trying that with your dog though…

I’ve learned my new tricks so well that I’m having a hard time remembering how I did things for the 40+ years when my shoulder was healthy. It’s funny how deeply ingrained habits can become in only a few weeks or months.

Here are a few of my new tricks:

Talking

Every physical therapy session starts out with a few minutes of talking. How are you feeling? Anything new/different? Better/worse? You get the idea. A few months ago, my therapist commented that when I talk, I only gesture with my right (good) hand. I totally didn’t realize this. I didn’t realize that I gestured at all when I talked, but apparently I do, and I have learned not to do it with my bad arm. I’m trying to make an effort to balance this out, but it’s hard to work at something you didn’t realize you were doing in the first place.

Pockets

Immediately after my accident, I had to re-think my whole pocket strategy (as in: what things go in which pockets). Years ago I moved away from putting anything in my back pockets, so everything is either in my front left or right pocket. My front left pocket became very problematic for obvious reasons. So it forced me to cut down dramatically what I carry in my pockets, and to get very strict about putting things that I access often in my right pocket (phone and wallet), and putting things that I need to have on me, but access infrequently (keys, cash) in my left pocket. I’m lucky in that I don’t need to take my keys out of my pocket to start or unlock my car.

This habit feels pretty positive, so I’m not planning on changing it.

Backpacks

Following the accident, I didn’t use backpacks much. When I did, it was with great difficulty. I kept my left (bad) arm straight, pulled the backpack up over the arm, and then reached the right arm back to complete the operation. I’m still doing this months later, even though I can move my left shoulder much better.

I’ve actually forgotten how normal people put on backpacks. I’m trying to figure it out so I can break this new habit, but it’s very tough. I’m not limited by range of motion any more, just by muscle memory.

Dressing

This is similar to the backpack category. Putting on or taking off a long-sleeved shirt, sweater, or sweatshirt is still very unnatural to me. Short-sleeved shirts or tank tops are easier, but I still do it differently. Again, the left arm stays straight at my side while I pull my shirt up and over. Reverse the procedure to take it off.

I’m trying to re-train myself to do this more normally but it’s very tough.

Bathing

For months, bathing was a one-armed operation. Even when I started to incorporate the left arm, I couldn’t raise it high enough to wash my hair or reach the right side of my body. This has gotten much better, but it’s still a challenge. If I don’t make a very conscious effort to do otherwise, I’ll catch myself washing one-handed.

Reaching

It’s probably not too surprising that I reach for most things with my right hand, regardless of what or where it is. Even at drive-throughs I find myself reaching across my body with my right hand to pay. I try to make myself use my left arm more, but it’s very difficult because of how limited my strength and active range of motion are.

Driving

Ironically, I started driving with my left hand on the wheel all the time as a form of physical therapy. It helps develop strength, and is still a good stretch (although not as challenging as it used to be). But it has become a habit. I feel lazy if I let my arm rest on on the armrest.

Shoes

Normal people bend at the waist to tie their shoes. Not me. That would require too much reaching. I typically sit on a low step, or bend both my knees and waist to crouch down. Less shoulder work involved that way. I expect that this habit will take a long time to break.