Progress on Rehab! And Back-To-School Days are Here!

I am so excited!

9 weeks post op was the magic number!!!!!!!!!

Oh hallelujah!  You have no idea how relieved I am!

A couple big things happened in my recovery from rotator cuff surgery at week 9:

1.     FINALLY, the pain has gone from excruciating, throw-myself-under-the-bus-and-be-done-with-it pain to pain that is simply annoying and uncomfortable.  The pain and discomfort is still nearly constant but there is a huge difference between the tolerance level now vs. what it was the previous 8 weeks.  I am beyond relief at that.

2.     Nine weeks after surgery, I've FINALLY begun to have REM sleep.  That deep, deep, natural restorative sleep you need to rest and repair.  I'm still not sleeping for a full night, but at long last I'm back on the path to returning to a normal sleeping cycle.  As a humorous note--the night of September 10th, I dreamed I was frolicking in the field ala The Sound of Music and flinging my arm around freely in every direction and it went everywhere I told it to and didn't hurt a bit.  It was quite amusing to wake up and realize the content of my dream.  And the dream has significance, which is point #4 below.

3.     I've had in the last week, for a few hours a day, periods where I feel like my old self, with clarity of mind, energy, and just feeling well.  It doesn't last all day and my stamina is still greatly depleted, but I'm getting glimpses now of what it feels like to be a normal human being. 8-)

4.     This one is huge.  We all take our shoulders for granted.  One of the motions we take for granted is the ability to hold our arm straight out to the side and raise it up so that it is pointed straight up at the side of our head.  For the first 8 weeks, I couldn't even raise my arm to shoulder height, much less raise it straight up beside my head. 

To be honest, it was starting to freak me out, because I'd begun to fear the range of motion was never coming back--I'd heard horror stories from other rotator cuff surgery patients who never fully regained their range of motion after surgery. 

But Saturday 9/13, for the first time ever since surgery, I was able to raise my arm almost all the way up.  You have no idea what a relief that was.  It literally made me cry tears of joy.  I don't dream often, but a good bit of the time, when I do, or on the rare occasions that I have visions (nothing elaborate, just brief flashes of something), it usually is a message from God.  So my "Sound of Music" style dream snippet was a message that was "Relax!  I've got this.  You'll get to use the arm again.  Be patient."  And Saturday the arm movement came. 8-)

I still have many months of rehab, but at last the worst is behind me.  Thank you, Lord.

Now to switch gears and talk education.  For the last year and a half, I've had a developing desire to be able to help people my age who have orthopedic problems and problems getting/staying fit.  But I haven't known what to do with that information.

If I could have whatever I wanted, I'd go back in time and become a physical therapist.  But realistically at 47, that is just not a logical goal. I'd be pushing 60 before I earned my doctorate, and needless to say, would not be able to withstand the physical rigors of such an occupation.  A shame too, because to me that is one of the jobs that has the most power to make a difference in a patient's life--and I put physical therapist above doctor, nurse, or any other medical provider.

So then I looked at becoming a Physical Therapist Assistant--they are a licensed profession and do some manual therapy but not the full work of a PT.  Unfortunately, the schools in my area have full-time only programs and that is not compatible with the fact that I must work full time to survive.  So at least for now, that door is closed and out of the question.

That leaves on the table two other paths:
1.  Physical Therapy Tech (they do the tasks assigned by the PT--watch over patients as they do assigned rehab exercises, set up equipment, provide minor treatments such as heat, ice, stem etc)
2.  Personal Trainer

Long story short, starting next month, I'm taking two classes at the local community college designed to give me an introduction to health and wellness and the study of kinesiology (the study of human movement).  Through these classes, I hope to assess how deep is my interest in these areas and to map out a plan.  If I choose to pursue a bachelors in Kinesiology at the university, these classes will transfer.  If I decide to pursue a 2 year degree and personal trainer certification, they will also apply to that specialty.

The only negative about ASU's Kinesiology program is that all the classes are downtown Phoenix, which is about the worst location possible to have to drive for classes, but that's a battle for another day.

I can't wait to get started and see where these initial classes will lead me.  So my busy life is about to get even busier, but I'm excited about being able to take some forward steps.  I think God can use what I've been through to help others.  But even should that not turn out to be the case, it will better educate me in how to take care of myself for the remainder of my life span.

On we go!

Six Weeks Post Op Rotator Cuff Surgery

Weeks 4-6 have been rather painful and fatiguing.  But here's a list of the things I'm thankful for:

*  The sling is finally off! (as of Monday)

*  The joy of being able to shave my underarms

*  The joy of being able to finally wear real lady's undergarments!

*  I managed to work my arm into a super-sized T-shirt yesterday

*  Being able to reach for toilet paper with my left hand (albeit very slowly)

*  Being able to use 2 hands to part my hair and put it in a pony tail (still painful, but possible)

*  Sleeping in my own bed the last 2 nights (still not comfortable and propped up with pillows for shoulder and arm, but time will help)

*  Finally being able to type with two hands.

In essence, I am not cleared for any weight bearing or resistance using the left arm, but am now instructed to begin putting it through all its range of motion to start getting that range of motion back from all angles.

I am just now beginning to raise my arm up slowly to put it on the laptop keyboard to type (sometimes I have to help my arm up there when it gets tired and the simple movement of inching my left hand up to the number row on the keyboard is a bit more than I can do, but I'm working on it).  I am beginning to reach for things, close/open door handles that don't require a lot of strength to pull, etc.

Still doing physical therapy twice a day.  Time consuming, uncomfortable, but critically important.  Do NOT neglect your physical therapy.  You will be very sorry you did. 

I've got a LOT of work left to do to get my range of motion back. Only in the last week have I been instructed to begin working on raising my arm out to the side---was VERY painful at first but I have seen a little improvement.  Raising up an out at an angle is also very difficult, as is raising arm from lap position (one of the key improvements I need to be able to drive).

Beginning Tuesday of this week, I have returned to work on a modified schedule--six hour shifts rather than eight hour shifts.  I'm so glad--you'd be amazed how just 4 hours of actively moving your arm 6 weeks out from surgery is. 

The reason for the reduced work schedule for the first 3 weeks back at work is to be sure I have plenty of time to do physical therapy twice a day (by the time you heat, massage, PT, and ice each PT session, one session takes almost two hours) and also because I'm still not getting adequate sleep due to the discomfort, so I come home and take an afternoon nap to give my body some healing time.

But the bottom line in week 6 is progress.  Which is heartening considering how painful weeks 4 and 5 were and how it seemed I was just spinning my wheels and not seeing any milestone developments.

I'm hopeful I will regain enough range of motion within the next week (maybe even by this week's end!) to begin driving again.  Not driving for the first few weeks was a bit of a novelty, now it's getting annoying.  I want to take myself to doctor and therapy appointments, the grocery store, what have you.  So here's hoping that's soon!

I've got a long, long way to go--full recovery takes 9 months to a year--but I'm on the mend.  Thank you, Lord.

My posts on the topic of rotator cuff surgery will likely become less frequent as the weeks progress.  But if anybody stumbles across this blog who has questions about rotator cuff surgery, please feel free to ask.  I would also recommend a blog of a gentleman whom I don't know but whose blog on his own rotator cuff surgery spawned a thriving community of rotator cuff repair patients who encourage one another and help each other out with information.  His blog has something like 600 hits and you will be able to talk with people from all ranges of the rotator cuff repair spectrum.  It is reassuring and insightful to talk to others who've had to go through this process. 

His name is Scott Loftesness and you can find that blog here:

http://sjl.us/main/2009/11/my-life-in-a-sling.html

He's also a freelance photographer and has some beautiful shots for sale on his website.

Now I better go get started on this morning's physical therapy.  Time's getting away from me!

Five Weeks Post Op Rotator Cuff Surgery

For anybody just discovering my blog, the purpose of my posts about my recent rotator cuff surgery is to fill the gap of knowledge--because unfortunately doctors don't even come close to preparing you for what you'll deal with post surgery for this type of repair. 

Today marks five weeks post op.  Things have been very uncomfortable since week four--because both last week & this week therapy has been ratcheted up a notch.  That means you are nearly constantly achy and, as a result, very worn out.   Don't get me wrong--it's not a 10 on a 1-10 pain scale.  More mid-range.  But the constant drain on your body wears you down.  I'm ready to be fixed already. 8-)  Unfortunately, recovery is a good 9-12 months in the making.

Despite all that, I am achieving my therapy milestones on target thus far and today graduated to doing a few short unassisted exercises.  Despite the pain it is a very curious process.  Basically it feels like re-teaching your shoulder to do all the things it used to do automatically.  It's weird.

I do not regret having the surgery--not as if there was any choice...but I sure wish they could find a way to speed up the recovery process.

The physical therapist, however, reminded me of one of my motivations to keep going: the sooner I get better, the sooner I can wear real clothes again! (still wearing tube tops & shoulder shirts (velcro shirts).  Have I mentioned lately how much I despise tube tops???? 8-)

Next step is physician check next Monday, at which time I will presumably at least be able to ditch the sling.  I'm not sure, however, if I will be cleared to drive.  At least as it stands right now, I don't feel I've sufficiently recovered enough mobility to drive safely.  But we'll see what the next 4 days bring.

My main concern now is returning to work next week.  Knowing the 4+ hour a day time investment in PT (combined a.m. & p.m.), the resulting fatigue, & the stress & breakneck pace of work, it will be a recipe for utter exhaustion.   I can only hope my endurance level will begin to increase.

But I'm in this gig for the long haul and once I've recovered, I'll have a whole new appreciation for the work our shoulders do. 8-)

Rotator Cuff Surgery 4 Weeks Post Op & Thank Yous

Today is 4 wks post op--just came back from physical therapy this a.m. I’m onto their game now. You have a couple days where you’re feeling good and living fairly pain free & thinking you’re on a roll then POW! They increase the level of torture. LOL!!!!

Seriously though, the PT said I’ve regained all but about 10 degrees of ROM w/the assisted exercises, so he pushed me harder–said he wants to do it now before the scar tissue hardens (or at least I think that was the verbiage). Can’t say it was fun but it’ll be worth it to get full use of my arm back. And Friday when I go back he’ll start me on some active exercises.

However, ratcheting up the physical therapy always means an increase in pain and soreness so I'll be increasing the Advil concurrently because I'm going to be a lot more sore when doing home PT tonight. 

Don't skip heating & icing respectively if you have this kind of shoulder work done.  Heat & ice are your friends!

Last but not least, many thank yous are due.  I already gave a shout out to my physical therapy team at Endurance Rehab (http://www.endurancerehab.com/) and Dr. Lindner & his team (http://www.sossportsmed.com/) for their excellent work and assistance.

Thanks also to my roommate, Sally for transportation & taking care of Aztec for me while I'm out of commission.  I'm also very grateful to my church family, especially Penny, Carolyn, & Pastor Mark for all their help.  Likewise my wonderful family and friends who have called or emailed to check on me & offer encouragement and assistance.  Thanks seems kind've lame, nevertheless, you have helped make an awkward time easier so my sincerest thanks to you.

Now on we go with more rehab and more adventures (Well, after I take a nap. Rehab wore me out.)!

Rotator Cuff Surgery - 3 Weeks Post Op

No dramatic difference between second and third week.  Followed up w/ortho surgeon 2 days ago--he did follow up x-rays, checked mobility level & said everything is on track for long term recovery.

Will be in sling for 3 more weeks, & still no driving for at least 3 more weeks. 

The long recovery process is starting to wear on me a little--still sleeping (or trying to) in the recliner & will be for some time.  Can only get an average of 4-5 hours sleep a night.  It's still easy to get freaked out by my almost non-existent arm strength & very limited range of motion--I mean overall I'm optimistic about the success of my recovery but can't seem to squelch brief periodic moments of panic that it won't get better.

I'll remain in the active assisted phase of rehab for 3 months--which means we don't even attempt to start strengthening the rotator cuff muscles till around October, which means no regular strength training until some time after that (don't know specifics.)  And I'm very tired of hunt & peck one-handed typing--it takes forever & tires my good arm out.

Today was a little harder & I was more tired, too, but I suppose there will be days of ups and downs.  I think I need to ramp up my walking a bit because I can sense a bit of depression setting in from all the physical inactivity. 

I am sincerely thankful to have such a good medical team assembled for my care.  The doctor and his staff have been great, as is my physical therapist's office.  All of this has been a lesson in how much you need other people--even for 'keep-to-myself' people like me. 8-) 

So I'm sucking it up and forging ahead.  But I'll be glad when rehab is over.  Next update at 4 weeks post op. 

Have a blessed and HEALTHY week.

The Journey to Rotator Cuff Repair Part 4

Follow up to the stress post.  The surgeon's office called me this morning to confirm they received all labs and tests from the PCP's office so I was all set to go bright and early tomorrow morning.

It was like the stress switch flipped to "off" then.  Finally I can relax knowing in less than 24 hours, *I* can finally relax and someone else has to do the work.

It took a lot of work to get everything lined up just to have the surgery.  I cannot wait to get this shoulder fixed! WOOHOOO!!!!!!

All that remains for tonight is some last minute laundry and shifting things around in my bedroom to accommodate the durable medical equipment and my recliner which will be my home for the next few weeks.

Next post will be post-op...probably in a few days when I'm coherent again (I can hear some of you saying now--when were you ever coherent?) *-)

The Journey To Rotator Cuff Repair Part 2

If you missed my introductory post on this subject, see my blog entry for July 4th.

Preparing for surgery is EXTREMELY stressful.  Some may not find it to be particularly so, but I do, because:

*  I am exceedingly independent.  I've done for myself for a very long time and I like it that way.  Not only was it hard for me to have to ask someone to take me to/from the hospital on the day of surgery, it is stressful thinking about how my life will be impacted as a one-armed bandit after surgery.

*  I like things orderly and lined up.  All my ducks in a row.  With surgery, there are only so many ducks you can line up--you don't know till the doc goes in what they're going to find and what modifications you might have to make afterward.

*  The people/situations at your workplace nor the people in your personal life quit making demands on you, even if you have a million and one things to prepare prior to surgery.

*  The state of healthcare in our great nation is a mess, and that means you have to follow behind everything each of your doctor's offices do to make sure all the necessary tasks get done, even if they tell you it's all taken care of (trust me, I've learned this the hard way this past week.  Somebody WILL drop the ball.).

*  You have to spend a lot of time thinking about ways to alter your life to handle daily life with the use of just one arm.  For example:

-  You can get the toothpaste open one-handed, but how are you going to get the toothbrush to hold still while you put the toothpaste on it?
-  You gotta think about what it will be like using the bathroom one-handed.
-  How will you get deodorant on?
-  If you're used to toting a lot of stuff around with you as I am, how are you going to reduce the weight you carry since one arm is going to have to function in place of two for a while.
-  You gotta practice getting your Burt's Bees open one-handed and putting the lid back on again.
-  How are you going to get back and forth to work and doctor and physical therapy appointments since you won't be able to drive for several weeks?
-  Where are you going to get (or who will make for you) modified shirts that you don't have to pull on over your head since you can't move your arm?
-  Who's going to take care of your big dog while you recuperate since you can't risk the dog ripping up the work they did in surgery?
-  How you gonna tie your shoes?

I don't have all the answers but let me share with you a few useful tips, websites, and resources:

1.   Tying Shoes One-Handed:
I didn't want to have to buy new athletic shoes, especially since I have problems with my knees.  An online acquaintance clued me into LockLaces, which are elastic shoe strings which, once installed on your tennis shoes, convert them to slip on--you never have to tie them again, therefore you can put your shoes on one-handed.  Here's the website:

http://www.locklaces.com/

2.   Modified shirts/upper body wear:
Ladies have to consider they won't be able to wear a regular bra for a while.  My solution has been a couple of camisole tops with built in shelf bras, and also a longer version of the ugly 70's style tube top to go under my shirts.

For both men and women undergoing rotator cuff surgery, Shoulder Shirts (http://www.shouldershirts.com) sells shirts that fasten with Velcro at the top of each shoulder so you can step into them and pull them up one handed and fasten the shirt closed.  I have ordered a couple tops from them and the material is good quality AND they ship quickly, which is important if you're up against a surgery deadline.

I have also read accounts for those handy with a needle or glue that they take oversized T-shirts, cut the affected sleeve, and apply their own tab of Velcro for a home made version of the Shoulder Shirt.  I'm not that skilled so I left that to the experts. 8-)

3.  Easy to get on pants:
This wasn't a problem for me.  I wear elastic waist scrub pants all the time anyway, so I didn't have to add to my wardrobe for this.  Likewise, all my athletic shorts are easy to pull on as well.

4.  Lay in a supply of paper plates, plastic utensils and cups
I have a roommate, but obviously I don't want to burden her since I won't be able to take my turn at doing dishes for quite a while.  The answer is clearing a spot in the kitchen to keep an easy-to-reach supply of paper plates, cups, and plastic utensils until I'm cleared to use my left arm again and bear weight.

5.  Lay in an advance supply of non-perishable food and other supply items
You won't be driving for a while.  Stock up on water, non-perishable snacks, and medications you might need while you're out of commission.  In addition to not driving, you also have to consider that it will be some time before you can lift ANY weight with your operative arm.

6.   Re-arrange your living space so you can easily move around w/a bum shoulder. 
That means getting obstacles and junk out of the floor (hopefully you can get messy fellow residents of your home on board with this), setting things up so you can access them with your good arm, and putting things within reach since reaching above you will NOT be a good thing for quite a while (a double consideration for me since both shoulders are affected).  The last thing you want to do is un-do all the work they did in surgery.


Hopefully these tips will help someone else on their rotator cuff adventure.  I just have two more days of stress to endure then I can relax on the O.R. table and let someone else do the work....