I graduated!

I went to see Dr. Latshaw today, for my second post-surgical followup visit.  I told him that my physical therapy brutes said he did good work and that I'm recovering well.  My range of motion is great, and he gave me thumbs-up to do whatever I can do.  The risk of re-injuring it at this point is very remote.  I won't be pull-starting any lawnmowers at any time ever, but I've got a clean bill of health and don't have to go back to see him again unless I think I need to.  He says I've graduated!  He also called me young, which does me good considering I've had another birthday this week. :-)

I am also phasing out of my physical therapy and into home exercises only.  I have another week or so of PT, and then my PT brutes will be history.  Good deal!

I really am feeling good for the most part.  I get my twinges here and there, but my baseline is pain-free, which I can tell you is a big improvement over before surgery (and post-surgery, too!).

Sleeping

Sleeping is getting somewhat better as I heal.  I take a 50-mg Tramadol before bed, along with my regular Benadryl, and it enables me to sleep on my right side a little bit.  My doctor didn't want to give me too strong a pain killer for bedtime, because he didn't want me to sleep on that shoulder so long that I damaged it.  It helps, but I'm still not getting as much solid sleep as I'd like.  I guess it'll come, too.

I really wish that I'd requested 10 weeks of disability instead of 8.  My shoulder was pretty much healed and moving pretty well at 8 weeks, but the sleeping problems really made going back to work for a full day difficult at first.

Life gets in the way

It's a lot more difficult to get my morning and evening exercise sets done now that I am back working again.  :-(  I have a new stretch that is supposed to be done in bed, though, so that is definitely workable!  Good times, folks.  Good times!

My forms for the Intermittent FMLA have been received back from my surgeon's office and faxed on to my disability insurance company.  This keeps me from getting in trouble at work if I have to miss time due to PT or painful shoulder.  

No more doorway pectoral stretches

I thought I had to be doing something wrong for it to be hurting so much, but Paul said we can just drop that one for now.  Maybe as I do my other stretches, I'll loosen up enough that I can eventually do that one successfully.  Probably it's because I spend too much time typing on one keyboard or another, ya think?

I got to use the rubber dong (heh) at PT (otherwise known as TheraBand FlexBar), in addition to more exercises with the stretchy elastic thingies.  Paul worked me like a rented mule today, but I am happy that I can do so much more than I was able to just a week ago.  I got some weight added to my front and side reaches today; I guess Paul thought it looked too easy.  It was, too - I was chatting to Doris while I was doing them.  All-seeing, all-knowing PT brute.

I've been having quite a bit of discomfort overall this week, but I still think I'll be able to pipe icing this weekend,  and I've promised my PT brutes some of the cupcakes that I'm gonna be baking!  So it looks like there may be some Blog Overlap Syndrome, as I'll have to post about the cupcakes here, too!  I will be making chocolate cupcakes with lemon cream cheese icing, for Brandi's birthday.  Also, before I scheduled my surgery, I had promised Nancy lemon cupcakes, but her birthday came in the middle of my disability.  So I will bring some to work for Nancy, too.  That'll be a lot of piping, but I'm pretty sure I can manage it if I take it easy.  As readers of my other blog will know, I like my icing on the thick side, so it takes a bit of strength to pipe it.  But it comes out so pretty!!

I was talking to a coworker about my surgery earlier this week, and it turns out that she's going to have to have rotator cuff repair on HER smart side, too.  And she lives alone!  I have learned a lot and will happily share my knowledge, but I don't know how I'd have been able to manage without my husband, stepson, and friend Gretchen.  They all were so helpful to me, and did things for me when I needed it.  I might be able to go over to Sally's after work sometimes and help her out around the house, if she'd like that.  I don't know her all that well, but if I can help someone I like, I will try to do it.

First day back at work

Bleh!

I was a lot more sore after working today than I'd figured on being.  I had 988 or 989 email messages to slog through, and slog I did.  Something in my daily typing at work, moreso than my daily typing at home, requires me to reach across the keyboard with my right hand, and I got a little stab every time I had to do that. So I did not have a great day at work, and my human resources representative also gave some not-great news.  I have FMLA, which expires in September, and I thought I'd be able to use random time from that to take off from work if I am in too much pain, or if I need to schedule physical therapy during work hours.  But that was continuous FMLA.  In order to have off any other time due to the shoulder, I have to fill out another claim for Intermittent FMLA, and have my doctor's office sign off on it.  Fantastic.  I really wish I'd known about that when I asked last week if there was anything else I needed to know about before coming back to work.  :-/

I did get lots of really nice welcome back, and that made it all a lot easier to bear.  :-)

I'm getting stronger, and am now able to lift my arm all the way up both forward and to the side.  3 sets of 10 reps each way!  Next week, Paul says they'll add weights.  My current extra miserable exercise is the doorway pectoral stretch.  Wowwwwww!  With emphasis on the owwwww.

Today's new sneaky exercise is oscillating with the TheraBand FlexBar.  Sneaky because all you do is stand with the arm out and vibrate the bar.  But as Paul warned me, it definitely does wear out the shoulder!  Whew. Ready to relax a bit and watch the Blu-ray my husband got me for our anniversary!  With my peas.  :-)  Have a good night!

Another good day

I had a good day at PT today (no tears at all!), and have some changes in my daily exercise routine.  Pulleys are now on an "as needed for stretching" basis, and I've got stretchy elastic bands instead now.  Since I'm going to be working again, starting a week from today on August 20, I can't do my whole big set of exercises in the morning before I go.  So here's what my new routine is going to be like:

Mornings:

• Doorway/corner stretch for pectorals - 4x 30 sec
• Leaning punch stretch (we're not too sure what to call this one. I stand by a doorway, put my right hand on the wall and then lean through the doorway to stretch) - 10x 10sec
• Behind the back strap from hell, which is now the behind the back and over the shoulder strap from hell - 4x 30 sec

And then my band stretches:

• Stretch both hands to chest (bending the arms) - 20-30x
• Stretch both hands to pockets (not bending the arms)  - 20-30x
• Elbow bent pull out  - 20-30x
• Elbow bent pull across  - 20-30x

At night, I will do all of the above, and add the following:

• Wall pushups - 20x
• Stick raising thing - 20x
• On the back punches - 20x with 2-pound, hold 5 sec
• Rows on belly - 20x

Turning a corner?

I am really having a great day today.  PT wasn't too bad, even with the new exercises I did there (I did wall pushups and resistance strap.  I was even able to raise my arm from lying down to vertical, with a 1-pound hand weight.  Don't get me wrong - I felt every bit of it!  But I didn't feel completely wrung out, and didn't even get iced afterward.  I drove to and from PT, had lunch with my sweetie, did some grocery shopping, and had a nap.

I feel tight and a little sore, but it's just worlds better than it has been.  I felt really good, and baked a batch of cookies this evening.  We'll see how we roll tomorrow!  No more appointments until PT on Wednesday morning.

Aches and pains

I'm having a lot more ache, but fewer pains when I do things with my right arm.  That kick in the teeth just doesn't happen as often these days, since I've been using it more.  That's terrific!  But the ache is pretty much constant.

I drove!

I drove today, for the first time since June.  I need to drop off some Amazon returns to a UPS dropoff location, so looked one up and phoned a friend to meet me for lunch in the area.  Lunch was great, but the errand that got me out of the house was a bust; both UPS locations I tried were closed, and one of the packages was too big to fit in the dropoff box.  And I drove!  I have painful shoulder now, so I'm back at home waiting for my pain pill to start working.  But I drove!!

Surgeon's bill came today

Here's the bill from the surgeon:

Shoulder sling:  $113.00
Adjustments:  -$37.16
Insurance payment:  -68.26
Member responsibility:  $7.58

Surgery:  $4411.00
Surgery:  $2889.00
Adjustments:  -$5264.62
Insurance payment:  -$1831.85
Member responsibility:  $203.53

That's a total due of $211.11.  Total out of pocket for me for the surgery is about $350.00.  Not too bad.  I am also paying copays at each PT visit.

Progress!

I finally touched my spine with my right thumb with that behind the back strap from hell.  Yay, me.  Time for ice, though.  That is not a happy exercise at all.

Not a great day today

I'm super sore this morning.  I took a pain pill and am waiting for it to start working before I start my morning exercises.  My exercise set has changed a bit since last PT session with Kyle.  The pendulum swings are out unless I feel like I need them for warm-up stretching, which I might today.  Ditto the shoulder blade pinches, although those will be handy for stretching while on the computer at work.

So now my exercises are:

• Biceps curls with 3-pound weight (yay, me!)
• Isometrics (7 different exercises on the wall)
• Pulleys (3 minutes each way)
• Behind the back strap from hell (4 reps if I can manage it, hold for 30 seconds)
• On my back stick raising thing (2 sets of 10)
• On my back arm-up shoulder raising thing (2 sets of 10 with chili can, or 3 sets without, hold for 5 seconds)
• On my side elbow rotating thing (2 sets of 10 with chili can, or 3 sets without)

The stick raising is going well; it's already easier to get that stick up than it was when I started.  So that's a good thing.  I am not sure I should tell Kyle it's getting easier, though...  whenever something is easy in my PT sessions, he adds weight.  Cracks me up!  I can see the Diabolical Mad Scientist rubbing his hands and cackling in glee.  "Ahhh!  Ze silly patient zinks she can get avay wiz easy exercises, hm?  Ve vill show her vat is vat, eh?"  :-)

I'm feeling kind of discouraged at the amount of misery my shoulder is dealing out since I lost the sling on Tuesday.  I know that I have got to do my exercises but it's hard, because I know they're going to hurt while I'm doing them, as well as after.  But exercises must be done.  No pain, no gain, right?

Right??

Product endorsements, Part 2

Here's a few more products that made life with no right arm a little better.

Reach Access flosser makes flossing easier (possible) for the one-armed.  It's not quite as effective as using both hands, but a lot more effective than not flossing!

My NPR Insulated tumbler was indispensable, especially in the first weeks after surgery.  The double-walled drinking cup kept condensation from forming and leaving marks on the sofa-side table, and the gasket on the top kept it from leaking while I was drinking semi-reclined.  I had to get some help opening it from time to time because it closes nice and tight, but it was well worth the effort due to lack of mess from spill avoidance.

The Mr. Coffee Iced Tea Maker pictured here is smaller than the 3-quart one I have been using.  I love this thing, and have been drinking about 2-3 quarts of iced tea a day since surgery.  This machine is quick and easy, and there's practically no clean up.

Orville Redenbacher's Natural Lime & Salt Microwave Popcorn has absolutely nothing to do with recovering from surgery, but you should try it anyway, 'cause YUM.

I usually do not use spray deodorant, but bought a can to get me through the post-surgery recovery.  I usually use a gel deodorant, but wouldn't have been able to apply it using my right hand.  With the spray, I could use the left hand to get the right side, then just blast in the general direction of the left armpit too, and we were good to go.

Unslung

Training wheels are off, and I'm already feeling the pain.

Dr. Latshaw gave my PT brutes an implicit thumbs-up by decreeing me "exactly where he wants me to be" at this point in my recovery.  So yay, Paul and Kyle!

But we need to start another phase of recovery, which is sling-free.  The sling has been protecting my shoulder since the surgery, and we've been working on building up range of motion.  It's now time to stop protecting it, so it can work on getting stronger, or so I understand.  I like my sling sometimes; it feels better not to have to hold up my arm on its own.  But Dr. Latshaw says he doesn't want me using my sling any more.

At all.

So I'm slingless, and aching already.  Wish me luck!  Next visit with Dr. Latshaw is Sept 14, and next PT is tomorrow.

Olympics

Have you ever noticed how many Summer Olympic sports require having two fully-functional rotator cuffs?  I hadn't either, until this time around.  Swimming, kayaking and canoeing, gymnastics, rowing, softball, basketball, fencing, water polo, and the list goes on and on.  Good on all those young, strong athletes.

Not-Paul is also a brute

I had my PT session today with Not-Paul, who is Kyle.  Kyle gave me a good working over (hand bicycle machine thing, pulleys, curls, and the new ones described below), and when he was done, I felt sore enough to get the shoulder iced there at the clinic rather than waiting until I got home.  That's the measure of a bad or not so bad session: If I want ice there at the clinic, it's a bad day.  If I can wait until I get home with my frozen peas, it's not such a bad day.

Good news:  Kyle says that he can tell that I've been keeping up with my homework, and gave me a gold star for being a good, compliant patient.  I'm regaining my range of motion in most of the areas very well.  He also says that I'll be surprised at how well I start doing once we can start strength exercises.  Which is good, because...

Bad news:  When I was finished with my new exercises today, I felt like a good candidate for one of the new decomposing walkers coming up in Season 3.  I feel so wrung out, weak, and sore that I can't imagine being ready to go back to work 3 weeks from today.  I can't do anything for myself yet, and have to be able to get myself dressed, drive the half-hour commute, work my shift, manage my lunch and potty breaks, and commute back.  I'm only sleeping 2-3 hours at a time for the most part because my shoulder keeps me from being able to change positions.  So I nap throughout the day to make up for it, but I don't think my company will be happy with my working from 7am until 9pm so I can be sure and get my daily naps.  A lot has to happen before I'll be able to stop worrying about starting work again.  I'm glad that I work in a cube farm instead of on a real farm!

New exercises involve a stick.  I am lying on my back and hold a broomstick across my body with hands 2' apart or so.  My left hand helps (which is why the stick instead of a rope or something), but I need to raise that broomstick up to a 90* angle.  2 sets of 10 reps.  Then, on my good side with bad side up, I rotate my elbow up.  And there's something else about trying to raise my arm up all the way.  I'll have to refresh on that when I go back in on Wednesday morning.

When Kyle stretched me after the exercises, he applied some pressure to the muscle in my upper arm (maybe the biceps? I do biceps curls, after all) in order to try to loosen it up while he was bending it.  Whenever I do anything with the arm extended, like my pulley stretches, I can feel a painful 'click' as I move through a couple of degrees in the middle of the exercise.  That muscle being tight is keeping the shoulder from rotating freely in its socket, and when it sticks, it 'clicks'.  Ouch!  So, yeah, please do whatever you're doing to keep that from happening.  I find myself flinching in anticipation, just like when a novice shooter flinches when about to pull the trigger.

I hate feeling this sore, but am really looking forward to being pain-free when all of this is said and done.  You only get one chance to heal right, so going through this misery is worth it.  Speaking of misery, I am going to see if I'm ready to move up to a 3-pound hand weight for my curls next time I go.

Next up: Dr Latshaw tomorrow morning.

Dentist appointment today

Dr. Julie Montgomery at Dublin Dental Associates is the most caring, nicest, kindest dentist you could ever want, and I'm terrified of her.  All dentists, really, because I grew up in Texas, where the prevailing patient pain management theory seemed to be "Man up, sissy."  So trips to the dentist are usually accompanied by shaking, hyperventilating, and crying, even for cleanings.  Dr. Montgomery prescribes a tranquilizer for me to take before my appointments, which eliminates the panic that goes along with those big chairs.  The downside is that I have to be driven to my appointments, and I sleep a good chunk of the day away afterwards.  I'll get in one round of PT exercises before I go, and I probably will be able to get another one in when I wake up.  If not, I'll do an extra round on Saturday to make up for it.  

If you need a dentist, I recommend Dr. Montgomery and the folks at Dublin Dental.  If you already have a dentist but you're not absolutely in love with them or their office, you should check out Dublin Dental.  They're awesome folks there.  

PT Hero, and one month out!

No, this is not the newest offering from the console-game wizards who brought Guitar Hero to the world.  Sorry!  But my PT brute, Paul, is now my PT hero, at least until my next appointment with him!

I am typing this WITH TWO HANDS!!!!!

Amazing, innit?  I have been typing with one hand (and get your mind out of the gutter, you perv!) since I came back from surgery, but Paul said yesterday that if my keyboard is at waist-level, he doesn't see any problem with using both hands to type.  Yay!!!

The laptop is now on the coffee table, and my right hand is resting on the hand-rest, and I am typing away.  I am not nearly as fast as I am accustomed to being, and since my hand is resting on the computer instead of hovering above, I am not as accurate, either.  But what a boon to be using both hands.  Using my stupid hand only was frustratingly slow.

AND!  And and and...

Paul is my PT hero also because I did not cry a single bit during the post-exercise torture session at the end of yesterday's appointment.  No tears *at all*, and he alleges that he wasn't slacking, either.  We'll see what happens next time.

I did get some new exercises yesterday, to add to my two-to-three-times-daily routine.  I had been doing pendulum swings, shoulder blade pinches, biceps curls, pulleys, and the strap from hell.  Now I have added to that a series of isometric exercises, which means that I'm going to be very good friends with the wall pass-thru between my computer room and the living room.

I have a series of seven different isometric exercises that do not require me to actually MOVE my arm, but to stand with my bad side against the wall and use the wall to push against.  And one of those, which Paul has named "Shoulder Extension Stretch," may actually enable me to see some progress with the strap from hell.  Go, PT Hero!!!

I also told Paul that when my shoulder complains, it doesn't start out with a warning.  I get no kind of "watch it, hey now!" from my shoulder.  It goes directly from zero to kick-in-the-teeth.  Paul says that's pretty normal for this stage, so that's kind of a relief.  I was worried that I was causing myself damage whenever I get that sort of pain from it.

Next week is busy.  PT on Monday, Dr. Latshaw on Tuesday for a checkup and new PT script, and PT on Wednesday.  I hope I'll be able to start my strength-building soon.

My arm is hot in the sling, and the point of my elbow joint feels kinda bruisy, like I whacked the hell out of it a few days ago, but it still hurts when I poke it.  I think it's because it's under pressure from the weight of the arm while it's in the sling.  I need to replace my flannel liner and use a liberal application of Caldesene cornstarch today. Will be delighted when I don't have to spend so much time in the sling.  My armpit looks a fright, and it'll be happier when it can get some air on a regular basis.

When I feel frustrated with how slow my recovery is going, I can just think back and remember what progress I've made in the month since my surgery.  I hope that progress curve continues, because I'm due to go back to work on August 20.  Wish me luck!  And patience, which anyone who knows me can attest that I'm a little short of, especially with myself.

Physical therapy has earned its rep

I started my third week of physical therapy today, and have been working on passive range of motion exercises per Dr. Latshaw's prescription.  PROM, as it's called, is a lot more grim than it sounds.

I was able to choose from a list of clinics that Dr. Latshaw refers to, and selected Banyan Tree Rehabilitation, because they have a location close to home.  The week after my surgery was pretty much pain-free, and I appreciated it then. I would have cherished it even more if I had realized that the pain-free-ness was going to be coming to an abrupt halt as soon as Paul, the clinic director and my personal brute, laid hands on me.  


I have been going twice a week, and spend roughly (sometimes rougher than others!) an hour at Paul's tender mercies.  I was really in pretty grim shape when I started, and was amazed at how little range of motion I had in my shoulder, and even more startlingly, my elbow, after only two weeks in a sling. I can't imagine how much worse it would have been if I had waited to start PT.  


Paul gave me pendulum exercises first, and stretches where I put my forearm on a towel, and slide it away from my body as I lean towards it while it rests on a table.  The point is to stretch the shoulder while NOT using its muscles to move it or even support it.  At the end of each session I get a stretching on the rack from Paul, which usually ends up with at least a few tears.  I told him once last week that he was slacking because my eyelashes were barely wet!  Then comes ice pack, pain pills, recliner, and nap.


At each visit, I have been given new exercises to do at home.  Last week, I started doing biceps curls, to work on straightening, and strengthening, my poor elbow.  The 2-pound hand weight was too much for me (!), so I started with a 1-pound weight at the clinic, and used a chili can at home.  In addition to that, I started using a shoulder pulley that allows me to use the left arm to pull up the right one. I also do  shoulder blade pinches.  I do my whole set of exercises two or three times a day.


I like doing the pulleys and the stretches and the curls, because I can see improvement in each set. I start out tight, but as I ease into it, I can feel the shoulder loosening up and before long I'm fully extended. Yay, me! Feel the burn, see the success.


Not so much for the strap from hell.  Imagine a dog leash, about 1" wide and 6' long. Only there's two leashes, stitched together every 6" or so to make hand-holds. It's green, and nylon, and I hate it.  I use this strap at the clinic, and a dog leash at home, behind my back, to try to stretch the right arm back behind my back. I used to be able to put my hands together at the small of my back, but the right arm no longer does that. At all. Ever.


I can not stretch it, and it doesn't seem to be improving at all.  Today, not-Paul said that the behind the back motion can take the longest to come back.  I believe it.  I am under instructions to be GENTLE, in capital letters, to try to regain that range. 


I'm up to a 2-pound hand weight now, because the chili can is no longer a challenge. I wonder how long it will be before the strap from hell isn't a challenge?

Bill from the Anesthesiologist

Received two copies of the following bill in today's post:

Repair Ruptured Rotator Cuff, Chron:  $765.40
Plan Payment: -$520.65
UHC Adj: -$186.90

Brachial Plexus: $195.00 (I think this is the nerve block in my neck)

Plan Payment: -$65.28
UHC Adj: -$122.47


Ultrasonic Guide Needle Plcmt S/I: $101.00

Plan Payment: -$32.00
UHC Adj: -$65.44

Leaving the total due for me to pay: $68.66

Product endorsements

A lot of consumer items have helped me during my recovery, and I'm going to list a few of them here.

First, microfiber mitts like this.  I pump some antibacterial hand soap on it, and lather it up with my left hand. The little fingery things make me feel like I am able to get my hand clean. I got them from the dollar store, and have several, so that I can use it a few times and start a fresh one when needed.

Cottonelle Flushable Moist Wipes are absolutely worth the additional cost over store brand wipes. They are thick and strong, and have made life more bearable.

Mirra Renew Cleansing Wipes are pretty terrific. Taking a shower is a bit of a production, so I can use one of these to refresh my face between showers. Very lightly scented, but leave a nice clean feel.

The sling has become a lot less uncomfortable thanks to liberal application of Caldesene Baby Cornstarch Powder with Zinc Oxide.

My Kindles have kept me from going stir crazy. My Kindle Fire allows me to surf the web, stream movies, and play games from my recliner sofa. Since I have to swipe to turn pages, it's not quite as stellar for reading, although I do read on it, too.  My Kindle 3 (now called Kindle Keyboard) is simply fantastic for reading. No glare, and I can hold it in one hand and use the side buttons to turn the page without having to involve my right hand at all.

And I can't forget my near constant companion for the first week, frozen peas. We have half a dozen bags of Kroger frozen peas, and I wrap a bag in a dish towel to ice the shoulder when it needs it.

Catching up - week of surgery

I woke up from surgery in a sling, and nauseated like all get-out.  The nurse was able to inject some medication to ease the nausea, but that sort of set the stage for a fairly miserable week.  I haven't had any surgery like this before, so I really was clueless as to the coming misery. Not just the shoulder itself; a lot of small miseries were concomitant with the sling, the medication, and the heat here. First off, the anaesthesia and the pain meds can cause constipation, and by late in that week I was taking Dulcolax to move things along.  Also, I had a heat-rash in my sling, which developed into fluid-filled blisters. I am real glad that I had put a layer of cotton fabric into the sling as a liner to ease the heat rash; it was easy to remove and wash.  I am allergic to opiates, too; they make me itch. Imagine hives all over, but on the inside. Insane itches. I told the surgeon's office that I have this allergy, but was counseled just to take Benadryl to help with the itching caused by my Oxycodone prescription.  For the first couple of days after the surgery, I was asleep most of the time, so was not overly miserable. But the more time I spent in the conscious world, the more time I had to fully immerse myself in the misery!  


It could have been worse, though. Friday after the surgery, massive storms rolled through our area, knocking out power for thousands of homes. Some of those folks were without electricity for more than a week, with daily temperatures in the high 90s or worse. We kept our power, for which I am very thankful!


I have been wearing sleeveless dresses since the surgery, loose enough that I can get them on without having to move my surgeried arm.  That has been a boon, because I can't pull up anything without help yet.


Most of the pain from the surgery was pretty much gone by Sunday of that week, which I find amazing.  And the baseline pain was just gone. Incredible to have no discomfort at all in that shoulder. The surgeon found considerable fluid build-up from bursitis in there, and that was the source of a lot of the constant baseline discomfort I had been dealing with for so long.  He drained that out, and that has relieved the ache.

Bill for the surgery came today

Check this out. It is the bill from my surgeon:

Arthroscopy, Shoulder, Surgical:  $6706.00
Contractual write-off:  -$5221.00
Insurance payment: -$148.50
Patient payment:  -$77.73 (no idea what this is.)

Balance Due: $70.77

I can handle that!  Of course, there's still the bill for the anaesthesiologist yet...

It is ridiculous that the procedure costs $5k LESS simply because I have insurance.

Catching up - surgery day

My surgery went off without a hitch on Monday morning, June 25.  I am in a sling now, so can only use my left hand to type. I was daunted by the prospect, so haven't posted until now.  I'll try to get caught up over the next few days.

The folks at Ohio Orthopedic Surgical Institute were really nice.  It is attached to the Center of Excellence, but is not the same company.  The ladies showed me where to change into the surgical gown, and gave me little non-skid socks to put on.  I was able to leave on my shorts and panties, but everything on top had to come off.  I haven't worn a bra since that morning!  First time since I needed one that I have gone so long without.  I also had to provide a urine sample; they did not believe my assurances that I was not pregnant. 

Once I was dressed appropriately, I was taken to my rolling bed.  I had pillows, and nice wedges to prop my knees up.  I also had to use my left hand to write my initials on the shoulder that was getting the surgery, and the nurse did, too.  I haven't intentionally written on myself in some years! I had compression wraps on my lower legs, which inflated and deflated to keep the blood moving.  Then they covered me up and added a toasty warmed blanket - they said it's really cold in the operating room.  And the nurse started an IV on the back of my left hand, to start the zone-out process. 

At that point, the anaesthesiologist came in and explained about the nerve block that he was going to inject INTO MY NECK!! I'm glad that the zoning-out was starting soon, because shots in the neck is just unnatural.  It was to block the worst of the pain, and lasted about 12 hours. I wish they'd find one that would last 3 days!  And that's about all I remember until afterward.  The zone-out did itsjob nicely, and I was happy for it.

Massively busy

I cut the sleeves and collar off of a big button-front shirt yesterday, and cut along the top of the right sleeve.  I then ironed on velcro tabs, so I can slide the shirt up and velcro it closed on top of the shoulder.  I picked up a microfiber duster on a stick that will enable me to wash under my left armpit, and reach other places that will need washing while I'm in the shower.  I also found a microfiber mitt that I can leave soaped-up on the sink to allow me to wash my left hand by itself.

I've done a bunch of laundry, and some cleaning, too.  Did a bunch of grocery shopping, and changed the catbox cartridge.  Automatic catbox is the bomb!  I need to put away laundry and have a leisurely bath.  Then, more cleaning!  I'll have plenty of time to rest after surgery.  Plenty.

18 hours, and counting!

Surgery time

We need to arrive at 9:00 for surgery scheduled at 10:00.

68 hours, and counting!

Keeping myself busy

I've been making a list of things to do to keep myself occupied while I'm recovering from surgery.  I want to learn HTML, and I've been recommended a couple of websites that have tutorials:

www.w3schools.com
www.quackit.com

These also have SQL tutorials, but that's been pushed down a notch on my priorities list.

I have signed up at work for a class based on The Oz Principle: Getting Results Through Individual and Organizational Accountability, so I bought the book to read before the class.  The class is mid-September, so I'll have plenty of time to read the book beforehand.

And I've been pining for the Savory Sweet Life cookbook, so I bought that, too, as an early get-well present to myself.  Love the way I justify that?  Alice is the hero of my KitchenAid blog and I've wanted her book as soon as she announced that it was coming out.

I also upgraded the Netflix account to include instant streaming, too.  Between my Kindle, my new books, and learning HTML, I think I will be able to stave off dementia while I'm away from work.  I've been thinking about it recently, and I'm pretty sure that this 8 weeks will be the third-longest period I haven't gone to work since I was 17.

3 days, and counting!

Pre-surgery screening call today

I got a call from Marie at Ohio Orthopedic Center of Excellence today.  She asked me lots of questions:  Do I smoke?  Drink?  What's my height?  Weight?  Any allergies?  (Yes: silk and codeine.)  What are the symptoms with these allergies?  What drugs am I taking, and when was my last menstrual period?  Do I wear glasses or contact lenses?  Do I have an advance directive? (Yes.)  Any previous surgeries?  Have I been diagnosed with sleep apnea?  Diabetes?  Anyone in my family have problems with anaesthesia?  And on and on.

She also gave some information about what to expect, which was good because apparently my expectations were way off base.  Not entirely surprising, because if you've read from the beginning, I was sort of expecting some magical medical super glue and back to work on Monday.  Here's the rundown from the notes I took while on the phone with Marie:

They're going to call me on Friday afternoon to let me know what time Monday morning my surgery is scheduled for.  It's looking like mid-morning now, but as other people get asked the screening questions they will juggle the schedule accordingly.  Sleep apnea folks have to go first, etc.  I'll be told the surgery time and the time to arrive beforehand.

The surgery center is on the lower level, and there's a separate parking area around the back of the facility.

I need to bring several things with me:  Insurance card, drivers license, a case for my glasses, and I'll probably bring a totebag to put all of my stuff in when I change out of my clothes.

I'm not allowed to take anything by mouth after midnight on Sunday.  No gum, candy, water, anything.  I can brush my teeth and rinse with mouthwash, but can't swallow anything.  And no alcohol on Sunday.  Oh, yeah - and I can't take my calcium supplements between now and surgery.  They don't want people taking any supplements at all pre-surgery.  I guess I can understand that; supplements aren't regulated very well and there's not a lot of telling what's in there.  I'll take my allergy pill Sunday night.  They don't want me congested while I'm under anaesthesia!

I have to wear shorts with an elastic waistband or drawstring, and a big button-up shirt.  I have got that covered!  Jim and Gretchen get to be with me when I hear the post-op instructions.  That's good, because I'm counting on them to remember everything for me!

Here's a link to the surgery center's FAQs.

Four days, and counting!

The last Aleve

I just took the last Aleve I'm allowed before my surgery on Monday.  From here on out, it's Tylenol only.  I am not optimistic, but I really hope that the Tylenol knocks my socks off with its pain-relieving mojo.  Otherwise, it's going to be a not-very-fun 5 days.  Wish me luck!

I also talked to Joy's friend Monica a couple days ago, and she gave me a clothing idea.  If you have a sleeveless shirt or dress, you can cut the top of the sleeve and attach Velcro or snaps to close it.  That allows you to just slide it up and then fasten it at the top, instead of having to slide your arm through it.  Not sure if I'll actually do it, but it sounds nifty.  :-)

Thrift store strike out

I have been looking for dresses that button up the front, and have had no luck at all.  I had lunch at Nida's Sushi today, for a much-needed Pad Thai fix.  After that, Joy and I went to THREE thrift stores, and I couldn't find anything I liked that would fit.

I bought a pink one on eBay, despite the fact that they have no picture of the pink one on the listing.  And I have bids on a couple more, a pink floral nightie and a blue dress.

The more I think about it, the more dresses seem the way to go.  I'm baking a batch of carrot cake cupcakes tonight, so I better get to it!

Surgery's a week from tomorrow.  Crap!  The best news to come out of today is that Joy has a friend who had rotator cuff repair on both sides (not at the same time, gods be thanked) and can provide me some insight on the aftermath.  ;-)

This weekend and next

Only two weekends left before surgery.  I want to bake another batch or two of cupcakes for my painters, to give them on Monday.  Also might be able to take some to VOICEcorps on Monday, as that's my last reading day.

I take a variety of pills every day: a Claritin, a Lipitor, a Seasonale, a calcium gelcap, and an Aleve.  While loading up my pill dispenser for next week, I was sad to put only three Aleves in: Sunday, Monday, and Tuesday.  Nothing but Tylenol for me from Wednesday on.  I think this will go a long way toward removing the last of my reservations about whether surgery is really necessary.  The shoulder will probably be singing Ave Maria by the time I go in on Monday.

I had a call a few days ago at work from the surgery center.  Apparently, they want me to pay my portion of the surgical center's fees in advance, to the tune of $155.45.  This covers the nursing, the drugs, etc.  My insurance instructs me not to make co-pays up front, but instead to give them my insurance card, bill the insurance company, and then send me a bill for the remainder.  I guess they're worried about not getting paid?  Plus, the lady said I'd also be getting a bill from the surgeon (Dr Latshaw) and a separate one from the anaesthesiologist.

Being a forward-thinking person, I've already made sure that the anaasthesia is covered under my insurance, and that they're in-network.  Just because your surgery is happening at a facility that is in-network doesn't necessarily mean that all of the providers who are contributing to your surgery are also in-network.  So I double-checked this all last month.  The bills are all going to the insurance company under the facility name, so I am covered at in-network rates.  Yay!

8 days, and counting!

Quite possibly TMI

I've been getting better at a lot of things, including using my left hand to hold a spoon.  I only dropped one Cheerio this morning!  But I'm not getting any better at all with some of the left-hand-only tasks.  Like pulling up panties.  I just can't get them all the way up using one hand.  Since my 16-year-old stepson is going to be here for most of the time I'm recovering from surgery, I can't just skip the whole clothing thing altogether for the whole time, which would be my inclination.  Next best thing, I think, will be commando under a sleeveless housedress that buttons up the front.  Thrift store trip, coming right up!

14 days, and counting.  Two weeks from tomorrow morning.  <sigh>

But this surgery is needed, for sure.  Friday was a two-Aleve day for me, and I try to keep those to a minimum.  I took Saturday morning's pill on Friday afternoon, before I even left work.  So I skipped Saturday to try to even it out.  Mistake!  I have been sore all day today, but only took one Aleve.  I really don't want to take any more than I have to in order to keep the soreness to a low buzz.  But I tell you, I am absolutely NOT looking forward to the 5 days I can't have Aleve or Advil at all.  It'll be Tylenol only from the 20th on.

Preparations continue

I'm considering starting a new game of Plants vs. Zombies and and using the mouse left-handed.  Purely for therapeutic practice, don't'cha know?

I get shampoo from my hair salon in big bottles that come with a pump.  I've kept a spare so I can fill it with body wash, to make it easier at shower time.  Speaking of salon, I had my stylist cut my hair a little shorter than usual today, because I likely won't be able to make it in in 6 weeks, my usual schedule.

I've got an electric toothbrush now, so I can decrease the likelihood of putting my eye out while brushing my teeth.

I went to Noodles & Company for dinner tonight, and - of course - had Pad Thai.  I should be able to eat Pad Thai at least a couple more times before surgery.  Maybe I can make myself sick of it beforehand, so I don't miss it?

That's all for now.  19 days, and counting.  Cute little countdown clock!

Thrift store jackpot

I won't be able to raise my arm over my head for some weeks, so I thought it'd be wise to buy some great big men's button shirts to get me through.  I went to Goodwill on Morse Rd on Friday, and they had all men's shirts on sale buy one at the normal price of $4, and get one free.  I spent $42 at the thrift store, and left with:

14 button front shirts
2 pairs of capri pants with no buttons
1 pair of elastic waist shorts
1 pair of slide-on slipper shoes
1 cute mug

Yay, Goodwill!!

How will I eat?

I'm actually becoming fairly adept at using a fork with my left hand.  I may not starve after all!  I foresee a few dishes that I'd best get my fill of before surgery, though:

Pad thai, and long pasta of any sort. I like to use a spoon in my left hand to twirl the pasta in, because it makes nice bites.  I won't be able to do that for a while afterward, so I should eat plenty of pad thai now, right?  Right??

Burgers with stuff in them.  I could probably eat a little burger just fine, but if it's one from Five Guys with bacon and such on it, that's a two-handed burger, for sure.

Anything that needs to be cut up, unless I can find a grown-up to cut it up for me.

Soup, unless it's in a cup so I can drink it.  Likewise cereal.  I don't trust Lefty with a spoon just yet.  Unless I cover the front of me with a bath towel.  :-)

21 days and counting.

The bills are starting to come in

Remember in an earlier post, I wrote about how it's not possible to get any idea of what you're going to end up being charged for a procedure until after you've already undergone it and are on the hook for the bills?  Well, my bills are starting to come in.  I thought it'd be interesting to detail them on the blog.  I've used up my deductible, so my insurance should be paying 90% and leaving me with 10%.  The fun part is the negotiated rates.  If you HAVE insurance, you actually get charged a lower price than you would if you DON'T have insurance.  Like this bill from The Cleveland Clinic, for my MRI.  Here's how the bill reads:

3/24/12: MRI JOINT UPR EXTREM W/O DYE
Total charges:  $2848.00

4/12/12:  MANAGED CARE CONTRACTUAL ADJUST
-$1858.08

4/12/12:  UNITED HEALTHCARE PYMT
-$890.93

5/8/12: BALANCE DUE
$98.99

Since my insurance company has a deal with the Cleveland Clinic, what would have cost an uninsured person nearly three grand cost my insurance company a mere $989.92, of which UHC paid 90%, or $890.93.

I will restate this, just so the bizarrity (do you like how I invented that word?) of it doesn't pass unnoticed:  If you have no health insurance, it costs three times as much to get your MRI than it does if you have insurance.  Is that messed up, or what?

The bill for my initial visit to Dr. Latshaw's office is similar:

3/30/12:  Office visit
Fee total:  $223.00

3/30/12:  X-Ray Shoulder
Fee total:  $74.00

Adjustments:  -$171.24
United Healthcare Check Payment -$100.53
Member responsibility:  $25.23

Here again, we have this disparity between people who have insurance and people who don't.  If I hadn't had health insurance, I would have owed $297.00.  Since I did have insurance, my charges were adjusted downward by $171.24, so the final charge was only $125.76, or 42% of the original total.  Just because I have insurance, my bill was reduced by over half.  My insurance company paid 80% or thereabouts, leaving me with a bill of $25.23.

The long words

I had a chair massage at work this week, from Carol Oswald at A Quiet Space.  I told her about my upcoming surgery, and she asked what specific muscles were involved.  I couldn't remember all (OK, I couldn't remember ANY) of the long words, so here's some of the report from the MRI in March:

• There is diffuse supraspinatus tendinosis and a high-grade partial interstitial tear of the supraspinatus tendon at its anterior insertion which measures approximately 6x9mm with adjacent marrow edema of the interior facet of the greater tuberosity. There is mild intraspinatus tendinosis. The subscapularis and teres minor tendons are intact. The rotator cuff muscle mass is maintained. There is trace fluid and thickening of the subacromial subdeltoid bursa. There are mild degenerative changes of the acromioclavicular joint.

No idea what I just typed.  I could have typed it in Wingdings and it would have made about as much sense.  Dr. Latshaw's report to my family doctor is a little clearer.  It reads, in part:

• Review of the patient's x-rays four views of the right shoulder demonstrates no bony abnormality. Review of the patient's MRI demonstrates significant tendinopathy of the supraspinatus with a very high grade interstitial tear of the anterior supraspinatus; this encompasses approximately 80% to 90% of the tendon.  I explained these findings to Ms. Morgan. She has a fairly significant partial tear of the rotator cuff. Given her young age, I think this needs to be repaired surgically; this would be a shoulder arthroscopy, takedown of the supraspinatus, removal of the tendinopathy, and repair of the rotator cuff which will require her to be in a sling for about six weeks after surgery with usually a three to four month recovery time.

So, that's the long words. 36 days and counting!

Time to reflect

My cousin Jenny teaches ballet to kids from grade school all the way up to high school.  She came to visit a few weeks ago, and we got to talking about my upcoming surgery.  Jenny hasn't had many injuries herself, because she takes really good care of herself.  But she has had to deal with injuries in her students.  Some of them will have stress injuries because they're doing something wrong over time.  My injury wasn't like that; I got hurt pull-starting a lawnmower, not by a repetitive motion.  But Jenny said that when her students have to take time away from class to recover from an injury, she tells them to use the time to learn.  They were doing something wrong, and need to do whatever it was differently, or they're taking too many classes of different kinds of dance, that use the body differently.

I'm SO not a dancer or athlete, and was thus inclined to think that her advice doesn't apply to me.  But, as is so often the case, further reflection on Jenny's words led to an epiphany of sorts.  Indeed I can use this time to learn a lesson that might stand me in good stead for the rest of my life. 

What I need to learn is patience and deliberation.  To quote the poem "Pursuit" by Stephen Dobyns: 

Each thing I do I rush through so I can do
something else...

While my shoulder is healing, there will be no rushing.  I will have no choice but to be deliberate, because the hand that does things without thinking will be immobilized.  The other hand, the slow, stupid hand, will be in charge, and it can't hurry.  It can only pay slow, careful attention to everything it does. 

And that can be a good lesson for me.  Focus on the task at hand, instead of trying to do a bunch of stuff at once.  Don't rush, but instead work with deliberation.  Be in the now, instead of thinking about what's coming up next. Slow down.  Be patient.  And forgive myself for needing to be slow.  All good lessons that I hope I can keep with me afterward.

38 days, and counting!  I need to give the dogs baths.  I think I'll start tonight, with Chester!  He's a little guy and easy to do without help.  The big girls take some help, especially Anita.  She LEANS.

Sleep, and pain meds

It's 39 days and counting until my surgery.  After reading the patient instructions from Dr. Latshaw's office, we realized that I'm going to be sleeping in a recliner until the sling comes off.  That will keep me more comfortable than trying to prop it up with pillows in bed.  And being in a recliner will minimize the possibility that I'll roll over onto my shoulder in my sleep.  I bet THAT would wake me right up!  But after doing some recliner shopping, it became clear that recliners - all of them, from what I could see - have the control that brings up the footrest on the right side.  To be pulled with the right hand.  Which is going to be in a sling, and will not be pulling anything!  So, we bought a dual reclining love seat, which has controls on both sides.  It's without a doubt the comfiest couch I've ever had.  It's soft and cushy leather, and has a console in the middle, which can hold drinks as well as remote controls, Kindle, glasses, etc.

I'm not a very good sleeper as a rule, and I usually sleep on my side.  So sleeping in the recliner is going to take some getting used to!  But this sofa is comfortable enough that I think I have a fighting chance for decent sleep.  No doubt the drugs will help with that, too.

Speaking of drugs, I have a codeine allergy, which is a pretty new development. I always had a fairly high tolerance, and had to take Tylenol #4. Last time I had a prescription for that was after some oral surgery, though, and I had full-body itches from it. So I'll be taking Dilaudid instead of Oxycodone. Kelli at Dr. Latshaw's office says that it's not an opiate, so bring it on!

My pitching career is over

Some years back, my now-husband and I bought a new lawnmower, and I tried to start it.  Gave that cord a good hard yank, and tore my right rotator cuff in the process.  I can't even remember if the lawnmower actually started or not.  I'm about 5'6", so it's hard to get enough zip on a long cord to turn over the engine.  I went to my family doctor, who said that it was probably a rotator cuff tear, and referred me for MRI.

I had, and still have, health insurance through my workplace.  But this was at the beginning of the "Consumer Driven Health Plan" nonsense, in which people were encouraged to "make informed decisions" about health care.  I think this assumes one heck of a lot about the health care system in the United States, and a lot of those assumptions are not true.

For example, you can't call for a price on an MRI.  I tried!  I called the hospital that my doctor referred me to, and asked how much it would cost for a shoulder MRI.  The answer I got was pretty non-helpful.  Could be anywhere between a few hundred and a few thousand dollars.  Depends on the machine the technician wants to use, how many images they need, the prices they negotiated with the insurance company, etc etc.  This is not like calling K-Mart and asking what they charge for a Dyson Animal.  Health care is unlike any other industry I can think of, because the consumer can't know how much it is going to cost until after it's already done and they're on the hook to pay for it.

Imagine if you built this model into any other industry.  Plumber, for example.  "Hello, Plumbers R Us?  I need to have someone come out and unclog my kitchen sink.  How much will it cost?"  "Oh, we won't be able to tell you that until we send you the bill.  It depends on what snake the technician wants to use, how many tries he has to make, and all that.  You know."  What would you do if you got an answer like this?  You'd call another plumber, wouldn't you?  You'd keep calling until you found someone who said "Flat rate of $75 for the first hour, and $50 for every additional hour.  Travel time is included in the first hour's fee."

Only you can't just call around and ask different hospitals what they would charge for the same procedure.  Well, you can, but since you won't be able to get an answer, there's not a lot of point.  So the Consumer Driven Health Plan goes down in flames right there.  Until consumers can get valid information up front from health care personnel, there is no way to make an informed decision.  Well, there's one way, and I took it.  My decision was not to get the MRI, and to just accept the fact that I would never be able to pitch in the majors again.

Fast forward to the winter of 2011-2012.  My shoulder has gotten more painful, and it's waking me up at night.  You know how you can just reach down and grab the covers after you've rolled over, so you can pull them back up again?  OWWWW!  It aches practically all the time, hurts when I reach for things, and doesn't go up more than halfway if I try to raise it to the side.  Not to mention that if I keep taking Aleve every day to keep it manageable, my liver is eventually going to look for a better home somewhere else.  So, it pretty much needed to be dealt with before too much longer.

I had to go back for additional imaging after this year's mammogram, and that used up my deductible, meaning that I wouldn't be out of pocket as much for finally getting this shoulder looked at.  So I went to the doctor, explained my issue, and she sent me for an MRI, which I actually got this time.  When the results came back, the doctor's office called me and said they were sending me to an orthopedist.

I didn't know what an orthopedist was, and wasn't at all happy to see that it's an orthopedic surgeon.  Here's mine.  By the time I got to my appointment with him, I had gotten it all figured out in my head.  This is modern times, yeah?  So they have some miracle Super Glue, and I'll be back at work on Monday, yeah?

No.  Not so much.  I had a few more X-rays there, and Dr. Latshaw ran me through some stuff after he had a chance to look at the images from the MRI and the new X-rays from that morning.  The verdict is basically that my rotator cuff is torn out in the middle, leaving 5-10% on each side.  They're going to do surgery on Monday, June 25, and I'll be in a sling for 6-8 weeks after that, in physical therapy for some months, and might have full strength and mobility back in a year or so?  I think that was what he said.  I was too busy drying my eyes to be paying full attention.

There's a pretty interesting little animated video at the Ohio Orthopedic Center of Excellence website, that shows what they're going to be doing.  There's no direct link, or I'd post it.  But you go here, and then under Patient Education Libraries, click Orthopedics, then Shoulder, then Procedures, then to Arthroscopic Rotator Cuff Repair.

And that's what's going to be happening to me 40 days from today.  I have been trying to practice using my left hand for stuff.  The first time I tried to wipe with my left hand, I almost fell off the toilet.  But it's getting a little better; tonight I ate most of my dinner with my left hand, and didn't stab myself with the fork or anything!  I also moved the mouse to the left side of my computer, and switched the buttons.

I'm going to journal my progress in preparing before the surgery and in recovering after the surgery.  Welcome!!