Thursday, May 28, 2009

Shoulder Surgery: 3 Week Update

Today I had my 3 week checkup and it went great. Dr. Conway, who I would strongly recommend, showed me the pictures of my shoulder from surgery, then showed me pictures from a textbook, and it was obvious it could not have gone better.

He wants me to start physical therapy ASAP, and I was fortunate enough to get in for my first appointment tomorrow at 1:00. I have at least 4 weeks of going 3 times a week, and then he will give me new instructions after that. In addition to that, he gave me at home therapy as well… fun stuff.

Here are the pictures from my surgery. This one is a picture of my shoulder ball, where he fixed the major divot.

This one is of my shredded labrum, where he reattached the tendons.

Christy and I could not be more pleased with Dr. Conway and the process thus far… unless it could have been avoided altogether!

Wednesday, May 27, 2009

The Jenksies

This year for our Staff Appreciation day, I took a page out of The Office and we gave out The Jenksies (see the Dundies). Each church employee received a trophy, which are proudly displayed... somewhere!

It is a long story, but I received Most Likely to Sparkle (due to my shoulder, pain meds, and a plus size nurse), although I firmly believe I should have won Best Homework Assigner. Here is a look at a Jenksie:

Sunday, May 24, 2009

Baskin-Robbins Coupon

I love me some ice cream, see the offer:

Share dessert with a friend today. Enjoy the 31° Below™ of your choice and get one free.

Print this coupon and bring it to your local Baskin-Robbins® store to receive one free 31° Below™ of equal or lesser value with the purchase of any 31° Below™. Some restrictions may apply. Offer valid at participating Baskin-Robbins stores in the US only. Offer expires 6/21/09.

Wednesday, May 20, 2009

Shoulder Surgery: 2 Week Update

Through Friday, I felt totally fine… thank you narcotics and pain meds! Saturday I tried jump off the pills and started to experience mild nausea. Sunday rolled around and the mild nausea turned to moderate nausea, with little pain in shoulder. That with the exception of the senior adult lady who decided poking my incision 3 times would be a good idea!

Monday I went cold turkey off all my meds and paid for it severely. Oddly enough though, it was not shoulder pain, it was terrible nausea. Around 7PM or so, I could not take it anymore and jumped back on my pills and patch that prevent said discomfort. Tuesday was met with extreme fatigue (from the meds), but an awareness that the nausea was being magnified by dehydration.

Since then, I’ve been pounding Gatorade, water, and anything else without caffeine. My problem Wednesday was a migraine, which lingered all day and diminished in the late hours of the night.

Going back to Monday, I decided to weigh myself due to many comments from church members asking me how much weight I had lost. When I stepped on the scale I was shocked to learn I had dropped 13 pounds, and weighed less than when I graduated high school! This morning I weighed and had gained 4 pounds back, mainly from fluids I guess.

Thankfully, I only have 1 more week until my checkup with my doctor. I am expecting to start physical therapy the following day and experience pain I have not felt since the initial dislocation… and for some strange reason I am honestly looking forward to it (and getting out of this sling)!

Just so you know, Christy has been my saving grace. She has constantly given of her time to serve me and our family. Although I feel terrible that she has to bear the brunt of everything in our home, she has not complained or made me feel guilty about it once. Christy is the best!

Monday, May 18, 2009

I have never been a fan of Bluetooth ear devices. They look silly to me, and I find myself annoyed with people who wear one when we are in a face-to-face conversation… seriously, take that out of your ear!!! Well, I purchased one last week (Jawbone Prime), then proceeded to wear it all weekend. Instead of being annoyed with it, I found it helpful. Now understand that I am not saying I will always use it, but I am saying that when you only have one arm that works it sure is helpful.

Tuesday, May 12, 2009

Shoulder Surgery: Day 7

Tuesday: In short I overdid it today. Where I should have eased back into work, I basically put in a full days work and paid for it when I got home. Where I should have taken pain (management) pills during the day, I skipped them and had my highest level of pain since the surgery. Where I should have been mindful of how my body was worn out, I kept going and became tired and somewhat irritable.

Christy, Rick, and the ministry assistants at the church all told me to take it easy, which I appreciate. My doctor’s office told me to feel free to take the full amount of pills for two weeks, which I am thankful for. Where I got home at 4:45 and immediately fell asleep and did not wakeup until my kids were asleep, I decided to make sure to have enough energy at the end of the day to play with them, help as much as I can around the house, and at least read and sing to Chloe at bedtime.

Take it easy is the theme of the day!

Monday, May 11, 2009

Shoulder Surgery: Day 6

Monday: After another night of minimal sleep, we all woke up ready for the day. My parents decided to take the kids to the Jenks Aquarium, which benefited everyone. It allowed Christy some alone time to tend to our home and relax, it allowed me work for almost 2 hours, it gave Grammy & Granddad time with just the grandkids, and our kiddos got to see the pretty fishys.

My parents were going to leave right after lunch, but they agreed to help me run a few errands first. It is hard to express how huge that was, because without their help we might still being trying to take care of some stuff. We both really appreciated them staying a little bit longer for us!

That evening, we were also blessed to have Jerry & Demie bring us dinner (Rib Crib)! The kids played for a bit, and it good to have friends over. Jerry & I went up to the church for skate church family night, but just stayed for a short time. In fact, after a couple of minutes Rick told me to go home to rest (the implication is that I did not look good and the medications were affecting me). My pain level was highest to yet on Monday, probably from pushing it too hard the past two days.

Sunday, May 10, 2009

Shoulder Surgery: Day 5

Sunday: Happy Mother’s Day. For whatever reason, I went to church today. During class, Craig had to help me get from our small group upstairs to our coffee bar downstairs. While it was great to see everyone, the tiredness and dizziness made me somewhat regret going… however, there were 11 kids who came forward asking Jesus to save them and 3 families that joined the church, so I really was elated to witness that!

One of the things we were able to do, aside from just going to church was to get out of the house. My dad and I went to run some errands and watch a movie. The movie was easy as we just sat and watched, but while we were running errands we have to head home early after just two errands, because I worn out.

Today was the highest level of pain I’ve been in since the surgery. The side-effects of the pills are pretty severe… I wonder if they get worse as time goes on. Again it was fantastic to have my parents there to help us out, I am hoping and praying Christy can manage our home, kids, cooking, cleaning, etc. without get worn out when they leave! You pray for her too!!!

Saturday, May 9, 2009

Shoulder Surgery: Day 4

Saturday: Slept horribly last night, and I am pretty sure the meds make me hallucinate. Once I got up from my bed (ahem, recliner), I realized I had another migraine. However, since I wasn’t on morphine I was able to take my headache pills and it went away rather quickly.

Christy’s parents stayed until lunch was over, and then they headed home. Within the hour my parents (Grammy & Granddad) showed up to help out for a few days. With Christy having to do almost everything on her own, having them visit for rounds 2 of full-time help was awesome.

Another incredible, huge, awesome, fantastic, outstanding blessing came from some great guys in our class. Marty setup yard maintenance for the next 6 weeks, and he and Josh showed up today for the first treatment. It is hard to describe how huge this blessing is, because I cannot physically mow, and it would be next to impossible for Christy to do it since due to my limitations having one arm. This was just a huge blessing!

Saturday night we began to discuss weaning me off my pain pills. My hesitation comes from knowing the pain level has been minimal. Although the side-effects have been strong (itchiness, dizziness, tiredness), my thought is avoiding colossal pain is worth it!

Friday, May 8, 2009

Shoulder Surgery: Day 3

Friday was another easy day, all things considered. There were no problems in the morning. We had leftovers from the night before, and then our kids showed shortly thereafter. It was good to see them and hug and kiss on them too. Coleman was a little apprehensive, and Chloe was just curious as to what was going on. She loves how my cast is cold inside (she is referring to my cryogenic machine that pumps ice cold water throughout my left shoulder to reduce swelling).

Friday night was a little scary. After getting ready for bed, I was walking to our living room and I caught my bad shoulder on the door frame. It was just a slight bump, but it hurt like you would not believe. That night I did not sleep well, but to make the night interesting, my percocet.

Special thanks goes out to MawMaw & Bubba (Christy’s parents) for watching our kids Tuesday night through Saturday morning to help us transition home after the surgery.

Thursday, May 7, 2009

Shoulder Surgery: Day 2

Thursday: we got discharged around 8:30, still battling my migraine and the feelings one feels from pain meds. Once we got home, I remember sleeping a bunch and not much else… except that Christy picked up dinner for me from Cheddars. Christy has been awesome caring for me throughout this whole ordeal. I could not have asked for a better helpmate than her!

Wednesday, May 6, 2009

Shoulder Surgery: Day 1

Wednesday: Surgery Day: Checked-in at 6:30 AM, the nurses prepped me and the doctor saw me about 2 hours earlier than he thought he would. The anesthesiologist gave me a rundown of what they were going to do, and then I woke up about 2 and ½ hours later. During my surgery Christy was visited by Rick, Kyle and Jamie.

Throughout the day I felt fine, no pain, just a little woozy from the morphine. Brent & Natalie (and Peyten) came to visit as well, which was also great! Christy took them out for a Mexican lunch and they headed back to Tulsa to pickup Logan from school.

Around 5:00 my new nurse came in and told me that if I had not gone to the bathroom within 2 hours they were going to put a catheter in me… YIKES! So for the next good bit of time, I strained, prayed, and God heard my request and I went. It was the most excitement I have ever had taking a leak, next only to the time Chloe was potty-trained!

They fed me meatloaf for dinner, which Christy ate most of, I devoured the squash and zucchini. James and Stephanie came up to visit later that night for a couple of hours, which was awesome. At some point during their visit, I really began to feel the block wear off, so I pumped that morphine drip like it was going out of style.

Around 11:00-midnight, things went from relatively good to horrid. It was not the shoulder though, it was the dreaded migraine! Due to my over zealous trigger finger on the drip, they could not allow me to take any headache pills. We struggled through the night and into the morning, where my body quit fighting and I lost whatever was in my stomach.

Tuesday, May 5, 2009

Shoulder Surgery: Prep Day

Tuesday: We left Tulsa to meet Christy’s parents in Atoka, because they watched Chloe and Coleman for few days. We drove to OKC and had our May date night. Dinner at Toby Keith’s, dessert from Nonna’s, and a night at the Hampton Inn.

Monday, May 4, 2009

Shoulder Diagnosis

Monday: Had my first appointment with Dr. Conway in OKC. He verified what my first doctor stated, but he found 3 more issues (possible nerve damage, possible muscle damage/strain, and a tear on the upper part on my shoulder tendon). Through Natalie, we were able to set an appointment to operate on Wednesday, which was a huge blessing!

The most important thing about Dr. Conway is that he caught 3 thing my prior doctor missed, my favorite thing about him is the name of his practice: Oklahoma SPORTS Science & Orthopaedics.

Saturday, May 2, 2009

Torn Labrum: What's Wrong With My Shoulder

What is the labrum?

The labrum is a type of cartilage found in the shoulder joint. The shoulder is a ball and socket joint where the arm meets the body (Figure 1). The arm bone (humerus) forms a ball at the shoulder which meets the socket which is part of the shoulder blade. These two bones are connected by ligaments which are tough tissues forming tethers that hold the bones in relationship to each other.

There are two kinds of cartilage in the joint. The first type is the white cartilage on the ends of the bones (called articular cartilage) which allows the bones to glide and move on each other. When this type of cartilage starts to wear out (a process called arthritis), the joint becomes painful and stiff (see Patient Guide to Shoulder Replacements). The labrum is a second kind of cartilage in the shoulder which is distinctly different from the articular cartilage. This cartilage is more fibrous or rigid than the cartilage on the ends of the ball and socket. Also, this cartilage is also found only around the socket where it is attached.

What is the function of the labrum?

The labrum has basically two functions. The first is too deepen the socket so that the ball stays in place. The best analogy is to picture the shoulder joint as a beach ball on a dinner plate. The ball of the humerus (the “beach ball”) is much larger than the flat socket ( the “dinner plate”). One thing that keeps the ball in the socket are the ligaments; these are the tethers that go from bone to bone which hold the bones together. The other way the ball is kept in the socket is the labrum (Figure 2).

The labrum is a thick tissue or type of cartilage that is attached to the rim of the socket and essentially forms a bumper which deepens the socket and helps keep the ball in place. In individuals where the labrum is too small or is torn due to an injury, the ball may slide part of the way out of the socket (called a “subluxation”) or all the way out of the socket (called a “dislocation”) ( See Patient Guide to Shoulder Instability. The labrum goes all the way around the socket and in most areas is firmly attached to the bone of the socket. In some areas it is not firmly attached and only recently have specialists determined which parts are normal and which parts reflect tearing of the labrum.

The second function of the labrum is as an attachment of other structures or tissues around the joint. For example, the ligaments that help hold the joint together attach to the labrum in certain key locations. If there is an injury to the shoulder that tears the ligaments, sometimes the labrum is pulled off of the rim of the bone as well (Figure III).

This injury usually involves a subluxation or dislocation of the shoulder and is usually due to trauma. The ball of the shoulder can dislocate toward the front of the shoulder (an anterior dislocation) or it can go out the back of the shoulder (called a posterior dislocation). In either case the labrum can be torn off of the bone. Usually when this happens the labrum does not heal back in the right location. Whether the joint continues to be unstable depends upon many factors.

The other structure that attaches to the labrum is the tendon of the biceps muscle (Figure 4a). The biceps muscle is the muscle on the front of the arm which gets firm with bending the elbow. While this muscle is quite large, it turns into a small tendon about the size of a pencil which attaches inside the shoulder joint. At the other end of the muscle is a large tendon which attaches beyond the elbow in the forearm. The portion which attaches in the shoulder actually goes through a small hole in the rotator cuff tendons designed specifically for that tendon. Once inside the joint the tendon attached in part to the bone near the socket and in part to the labrum at the top of the joint. This tendon can get torn where it attaches to the bone, where it attaches to the labrum or at both locations (Figure 4b).

What is a labrum tear?

A labrum tear can take several forms, and it is very easy to confuse these types. As a result, it is important that you discuss with your physician exactly what type of tear he/she is talking about. The first type of tear is one where the labrum is torn completely off of the bone (Figure 3). This is usually associated with an injury to the shoulder where the shoulder has subluxated or dislocated. Sometimes this type of tear occurs and the individual does not appreciate that the shoulder has slid out of the socket.

The second type of labrum tear is tearing within the substance of the labrum itself. The edge of the labrum over time may get frayed so that the edge is not smooth. This type of tearing is quite common and rarely causes symptoms. It is seen frequently in the shoulder as people get more mature (over forty years of age). Sometimes the labrum may have a large tear where a portion of the labrum gets into the joint and causes clicking and catching as the ball moves around in the socket. This type of tear is very rare, and most labrum tears do not cause these symptoms.

A third type of labrum tear is in the area where the biceps tendon attaches to the upper end of the socket. The socket can be divided into four regions: anterior (or front), posterior (or back), the upper end near your head (or superior), and the lower end (or inferior) which is toward the elbow (Figure 5).

The biceps tendon attaches at the superior end where it blends in with the labrum. The labrum runs from there around the joint, both in an anterior and in a posterior direction. Due to injury in this area where the biceps tendon attaches, the labrum also can get injured. The injury in this area can be mild or it can be severe. Because the injury typically involves the biceps tendon and the labrum, because it is at the superior end of the socket and because it can effect the
labrum attachments anterior and posterior to where the biceps attaches in this region, the acronym or abbreviation for this injury is a SLAP lesion. This stands for an injury which is Superior Labrum Anterior and Posterior. There have been several grading systems or classification systems of this injury. In a lesser injury the labrum is only partially detached in this area. In a more severe injury the whole labrum is pulled off of the bone along with the biceps tendon. The most common classification divides SLAP lesions into four types (Figure 6).

From John Hopkins Sports Medicine