Shoulder Surgery – 6 weeks in

Run far and don't look back. -- Snapshots by Jasonlove.com

Run far and don't look back. -- Snapshots by Jasonlove.com

Last time around in my previous post I caught up a bit later than our normal weekly updates on my recovery from Open Bankart Shoulder Surgery on my right arm. I did that to show you the large amount of pivotal progress that is made in week five compared to previous weeks.

The latter part of week five into week six has been much the same. During my last PT session (12/2) my therapist began a more aggressive massage methodology on my scar tissue and shoulder blade. She advised me that what she was doing was flattening out and extending the scar tissue. This allows the scar tissue to become more flexible like normal muscle tissue, but still provide enough stabilization in the shoulder as to hold my bones in place. Only when really pressed on does the surgery scar even exhibit any noticeable pain. My humerus head is still sore, but not as bad as in the past. There is also still soreness around the shoulder blade and back muscles related to both non-usage, as well as, the strain being put on the muscles by my continued attempts to adjust my posture. My therapist stated left untouched the scar tissue would build into a large mounded mass and become too hard limiting range of motion. Worse yet it would also stick to the other muscles and soft tissue limiting their movement as well. All in all, the importance of continued massaging of the surgery scar by a PT is important at this point as internally there is still late stage healing going on.

We then did some light stretching and shoulder blade rotations. Then came the grueling part. We began slowly with the therapist and an assistant’s help moving my arm upward above my head (as if I was reaching upward except I was really laying flat on my back). The first time we measured 142 degrees, which is two degrees up from last session earlier this week (see previous entry link above). Again, to recap, 180 degrees is the maximum measurement for an upward reach and my ultimate goal. 142 degrees came with minor discomfort and is my “pain limit”. The next two upward reaches went beyond my pain limit. First to 145 (where intense pain set in) and then beyond to what was my true flexibility reach (where muscles in my arm tightened rigid with no more ability to stretch from shoulder to wrist– it sounds as horrible as it really is but is actually less pain than the intense pain threshold where the shoulder joint has to slide into one another at the collar bone and humerus). My final reach at true flexible limits of motion was 150 degrees. This is ahead of schedule and a good sign. My goal is over the next session to reach that 150 deg. limit without the intense pain point occurring and to continue to limber up the collar bone to humerus joint that is limiting my existing reach with pain.

This is what I saw in the ER basically... yeah. Posterior Shoulder Dislocation - Courtsey of http://lifeinthefastlane.com

This is what I saw in the ER basically... yeah. Posterior Shoulder Dislocation - Courtsey of http://lifeinthefastlane.com

To do that, my therapist and I discussed adding another exercise for at home PT– a wall climb. The wall climb is done in the shower after heating the arm with warm water (to encourage flexibility and blood flow). You stand facing a flat wall. Reach out with your arm extended to touch the wall with your finger tips “spider” style on the wall. You then walk the “spider” up the wall at the same time you slowly move towards the wall itself. The result is your hand slowly climbs the wall and is supported by it. Once at the apex of the wall you hold it for fifteen seconds. Then walk back down while stepping away from the wall. This is done three times and should encourage the motion limit to lift over the coming weeks.

Other than that we then did ice and electric stimulation to ease both swelling and pain from the session.

Six weeks marks the end of high risk of dislocation and infection. There are still minor risks of both over the last six weeks, but you can finally go into public without a sling. You still need the sling when you sleep though. Six weeks marks the point where some normality returns to your life and you can look back to see the large amount of progress made over the course of the prior weeks. It did feel like an incredibly long time, but now at least there is the encouragement of knowing something is really happening and you really are starting to feel better.

The biggest thing is now that you start feeling better to not get lazy. You need to still get PT, still do your at home exercises, and still need to keep in mind your arm is not 100% (realistically it’s about 50% at this point or a bit lower). This insures you continue to heal and make progress.

Next week I return to work and I’ll be switching to document how that interacts with PT and exercises. I had to get a note from my orthopedic surgeon during my five week post-op visit saying I could come back. I then handed that back into HR and they’ll file the closing of my disability claim with NYS when I return on 12/7/09. I already discussed with my direct supervisor and my HR manager my “special needs” such as PT sessions and a 20 minute “exercise break”. I’m swapping out lunch and a fifteenth minute break then making up whatever time I go over on by staying longer. This was all approved without issue (your employer will just be glad to have you back). I do have a 10 lb. lifting limit on my work, but other than that because most of my work is clerical and managerial in nature I can do my normal workload.

If you do physical labor you may not be able to return to work at this point, but that is between you and your surgeon to determine. After 12 weeks most people can return to most jobs, but again– cases vary and you need to consult your medical professional about that, as well as, work out arrangements with your employer (including FMLA and disability where needed).

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Search Improvements, Arm Improvements

Red Squirrell Peering OutI spent a great deal of the day toiling away at improving the df.com Search widget in the left hand menu. Please feel free to give it a try. It works great. You’ll also notice that if for whatever you don’t seem to find what you’re looking for with our in in house search you can fallback to our customized Google Search. That Google based search is now conveniently found at the bottom of any in house search results page. I think that makes finding anything you may want on the site all the more accessible and insures that you can double check your search results with ease.

I’ve also added a countdown clock to the left hand menu as we continue moving towards a new digitalflood Pirate Radio episode (coming on 11/28/09). We’re about 18 days away at the time of this posting. Feel free to watch the seconds tick away in real time… or not.

Today I had my first physical therapy session. I had to fill out about 15 minutes worth of paperwork explaining what I was there for and how severe my pain was doing various tasks. The physical therapist then did a range of motion test with my arm and prescribed four more exercises to limber up my right shoulder joint. The first was shoulder shrugs, the second was rotating my upper arm in circles while in a down position, third a bicep curl, and fourth was a neck stretch. I have to do this in both forward and reverse 10 times each (except the stretch– that’s 15 seconds held on each side three times). My therapist told me the first few sessions would be to stretch and loosen the upper arm, neck, tendons, and back muscles. She will then begin slowly increasing stress on the joint with new exercises over succeeding sessions until I regained most of my range of motion. I will then be able to do the exercises on my own for another six weeks to finalize my recovery. I still also have to do the “wrecking ball” 5 minute arm hang as well, which was prescribed by my orthopedist. Each exercise session is about 15 minutes. I have to do three sessions a day everyday. One interesting thing I learned was the majority of my back pain I’ve had for the last few years can be attributed to how my shoulder has been sitting all these years.

The therapist showed me that because of the weakened muscle structure in the front of my arm I had been letting that shoulder shrug forward and compensated by keeping my elbow tucked in to hold the joint together. The result is I have been putting severe strain on my upper and lower back. I’ve also been pulling my other shoulder causing pain there as well. Again, the plan is to remedy all this over time. It was nice to figure out why I’ve had so much back pain the last few years though and that going forward there’s something I can do to remedy it.

The therapist has prescribe three PT sessions a week (about 1.5 hours per session) for the next six weeks. We’ll then take it from there. I was forewarned that the therapy will be grueling and at times painful, but that sticking with it and continuing to move is key to healing correctly.

Finally, as many of you may know my house has been plagued by two red squirrels for about the last two years. I cannot trap them. Cannot poison them. They’re pretty smart little critters. My wife won’t let me get a BB gun to shoot them (probably a good idea). Worse yet, I haven’t been able to figure out how they were getting in.

That was until yesterday morning. I noticed both of the squirrels were running out to a walnut tree by my landlord’s office building. They would then run back and disappear seemingly right under my kitchen window. I could then hear them in the wall of the kitchen. It was at that moment I realized I’d been looking on the wrong side of the house. I immediately went outside and stood back from the house. Sure enough after about 10 minutes of standing perfectly still the squirrel ran right by me and disappeared under a stone on the edge of my back patio. Three minutes later it popped back out from under the stone and ran back out to the tree.

I walked over and lifted the stone (which was on the ground flush with my house). Sure enough there was a trench dug under the stone and right to a huge hole in the back wall of my house (all which was hidden by this one patio stone). I called my landlord’s wife and supposedly he’s going to come by to look at it. In the meantime, I’m thinking of how to best seal the back wall off (my landlord tends to not be the most reliable fix it helper– I’m used to taking matters into my own hands and then billing him for it). It’s an old house and for whatever moronic reason the wall supporting the one side of the rear of the house does not have concrete poured between my back porch wall and the southern wall of the house. Even stranger– the rest of the house does have concrete poured around the foundation. So why they didn’t finish that side is probably either laziness or concerns over the both the sewer, as well as, the water main coming in through that wall about 12″ below top soil. This span is about 15′ in length and what this does is provide an easy way for rodents to dig down below ground level by about 6″ and be able to then burrow up into the field stone foundation revealing access into the rear wall. This is the little trick the squirrels use to get into my house. How they figured it out is a miracle of nature. How I’m going to seal it will be a miracle of old fashioned good old boy engineering.

I still have a one way chicken wire shoot on the hole in the eve of my house. I left it there purposely so once I did find the bottom access point and sealed it, they could then exit through that top hole (which used to be their primary entrance/exit before I sealed that) and be stuck outside. Dead squirrels in walls do not smell good even during winter.

You’ll find a picture of said squirrel in the top part of this post. It was taken back on 8/16/07. He’s peering through said chicken wire shoot, but smart enough not to come out of it.

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