When disaster occurs

I don't post regularly anymore, just periodic updates on how I am doing. But I saw this photo on the site of a major shoulder surgeon and just had to post it here.

The patient, a woman, fell and the worst possible thing happened...the bone into which the repacement rod was inserted broke just below the rod. Surgery was advised but she sought consultation with this group and was advised to wait and see. The arm was stabilized, the bone knit back together and she was back to normal, albeit with a metal rod in her arm.

The point is her fracture was treated conservatively, like a fracture in a previously unoperated arm, and the outcome was excellent.

Now, that doesn't mean we post RTS patients should be cavalier about staying vertical. We still need to be cautious and vigilant. For me, the stumble occurs, not when I am picking my way through a veritable obstacle course but, when I am at least risk of tripping, when there is no banana peel or skateboard or oil slick.

Just be careful out there!

Two years plus six weeks approximately PO

Has it really been more than two years since my shoulder surgery? I've totally lost track of how many days. There is probably an app or a website that could calculate it for me but I think 2 years plus 6 weeks is close enough now.'

I saw my surgeon for my two year post op visit in early July. Naturally the visit included an X-Ray. It always makes me wonder how doctors knew what was going on before X-rays were available, I thought I was totally prepared for the process; no metal like hooks on bras, no buttons so one does not have to undress for the X-ray. But the loose lace top I wore was a problem. The technician said knotty lace fabric (not naughty!) showed up as a jillion spots in an X-ray. So I had to change into the hated hospital gown.

I love how the X-ray is posted on the computer in the room and I can see what the doctor sees, My first orthopod did not have hat amenity in his office.  When I first broke my shoulder I asked to see the X-ray. All he could do for me was bring me a very poor quality print out that was worthless. He couldn't or wouldn't even take me back to where he was able to look at the actual films. I should have known then to change doctors!

Anyway, all  the pulling and pushing, hammering and screwing, stretching and crunching I have done in the last year seems to have had no ill effect and everything looks fine. My range of motion is amazing and he is very pleased with how I have done and his own handiwork. I have graduated to a "return in two years" schedule.

What Ihave learned as I enter the third post op year is that the healing is not over and the process continues. At one year post op I thought I was doing fine and had reached optimum recovery. But as I prepared for my two year post op exam I realized I had come along way in the second year. I bragged to my doctor about how well I was doing. Of course,I admitted, there were a few limitations but they were to be expected and, I believed, permanent.

Do I never learn? One of the "permanent" handicaps was the inability to hook a bra behind my back. I had to either do the front hook-twist maneuver or wear front closure bras. I was resigned even though I frequently tried. It was impossible. But within two weeks after my two year visit I unconsciously tried and I was able, with a bit of a struggle to do it! A small but significant step forward. Now I am almost always able to "hook up" normally. It's a little thing, I know, but a big step in feeling back to normal.

I do still have some discomfort. Some movements are no-nos. And sometimes there is a catch that accompanies an up and down motion that I don't like. If I overdo things my arm hurts but so does my un operated arm. It's good to have realistic expectations. The surgery was not a visit to the Fountain of Youth. But, even as I have been surprised by my progress in PO year 2, perhaps I will be surprised in PO year 3.

I hope so!

Catching up

It's been a long time since I posted on here. There's really nothing new to say. I've had lots of home projects over the past few months and my shoulder has met the demands well. I continue to slowly improve. For the longest time I could not peel off a t-shirt in the usual way but mostly now I can. My right arm is stronger. And I have more range of motion. It's been cold and the weather does seem to cause some discomfort. I read that the theory is that a falling pressure system allows minuscule swelling of our joints, hence some comfort.

I am now on a once a year schedule to see my orthopod so don't go back till June or July. I am quite satisfied, I hope he is.

Can you ever disconnect?

You know how when you buy something nowadays and they ask you for your email address...do you ever think about why they want it? Are they wanting to follow up, see if your new dress fits or your toaster is satisfactory? Are they going to use it to notify you if there is recall on the item? Probably not.

Remember when you first had email and you were thrilled to receive any kind of internet communication. And when you sent a friend a message and then callled them to tell them to check their email. What innocent days! Little did we realize what was coming.

Now we are innundated with emails. Our doctor's office sends emails. Church and school use it to communicate. The bank sends statements, the power company sends our bill by email. The airline reminds us of our upcoming flight. Our favorite hotel chain wants to know when we are going to take a trip. High school classmates are looking for us and current friends are keeping tabs on us. Receipts for purcchases are easier to keep track of in email form rather than as slips of paper in our purse.All that is okay, mostly.

But the ads! The solicitations! Every night, in the middle of the night, little unseenn gnomes hit "SEND" and my mailbox fills up with  coupons and flyers. Links to sales and bargains click into view pretending to be from firends who want to share their weight loss secrets. New shoes,  presecription drugs, worthwhile and dubious charities, mom and pop stores and major corporations, all knock on my virtual front door. Do I want a female companion from the Balkins? Will I rescue my distant acquaintance stuck in Greece with no money? Surely I will invest $10,000. to help free up a
million dollars being held hostage in some third world fiduciary morass. From legitimate entrepreneurs to blatant con artists, they queue up in my mail box hoping to catch my eye.

Scroll to the bottom and the more traditional ones offer an "unsubscribe" link. How many times I have clicked that! A promise that I will no longer receive notices from them appears on screeen. But has it ever worked? Have i even once managed to divorce the solicitor? Not yet. But hope springs eternal and I persevere. But I alwaus wonder if asking to unsubscribe actually adds my email address to some other list of victims.

In the meantime I slog through my inbox trying to separate the wheat from the chaff, deleting and deleting and hopefully not deleting a message from you!

Less than perfect 17 months PO

I wore a smock like dress a couple days ago. It had a kind of square scoop neck, not too low cut but wide. For the first time it was apparent there is an asymmetry between my two front shoulders. The unoperared side has some flesh or fat under the skin so the transition from pectoral muscle to the head of the humerus is smooth and full. On the operated side the scar vertically bisects that junction, there is a lack of fat beneath the skin and that makes the bony humerus more prominent.

Am I complaining? Heavens, no!  I continue to be very satisfied with my surgical result. I do still have some limitation of movement. I can't comfortably move my right arm behind my back. I can't lift heavy items above my shoulder height on that side. I tend not to roll on that side to sleep. And I do most of my heavy lifting with the other arm. But I have very good, nearly full extension of that arm. I have very good development of the deltoid muscle, necessary to raise and lift the arm after surgery. And my flexibility has improved so putting on and taking off a shirt or jacket is easier, if not always graceful.

Compared to the limitation of movement prior to surgery and the constant pain, I have nothing to complain about.

Unfortunately there are no guarantees with the human body and surgery. I guess that's one reason doctors want you to wait so long before going the surgery route. If you are truly miserable, even a less than perfect surgical result is an improvement. Interestingly, I read a study that reported, based on the SST ( Simple shoulder test ), patients were typically more satisfied with the surgical results that were their surgeons. I guess the doctors want things to be perfect and we just want to feel better.

What else Is there to do?

It's 430 AM and I am wide awake. Sounds terrible but it is usually 2:00 AM when I am wide awake and looking for something to do. If you live alone the possibilities are unlimited. You can run the vacuum cleaner, fire up your Jane Fonda exercise video, rearrange the living room furniture or organize your closet. But common courtesy for the innocent bed partner demands both relative quietude and reasonable darkness. Both are hard to come by in this household. Who needs anightlight? Our darkness twinkles with red and green power strips and sleeping appliances.

But such light is not adequate to balance one's check book or do your fingernails or read a novel.  And a 100 watt bulb in the downstairs bedroom has a way of twisting and bending its light rays so they creep up the stairs and shine in the eyes of a sleeping husband. Thank goodness for the illuminated screen of an iPad. With its brightness value turned down the glow from the screen is tolerable. Used to be our neighbor's Spotlight, mounted on his dock, shined directly in our bedroom window. Enough to cast a shadow. But either the bulb burned out, the salt air has corroded the connections or some irate neighbor has taken a BB gun to the problem.

At any rate I have decamped to the upstairs porch, not quite weather tight but devoid of mosquitoes and creepy crawlers. The ubiquitous LEDs are replaced by stars that twinkle through the sunblock fabric curtains and the night has that damp, sweet feel  of  air not cycled through an air conditioning system. In old times, houses in the south had sleeping porches where people could escape the swelteringly interior rooms and catch a cool night breeze. The invention of air conditioning brought progress and industry to the south but a hermetically sealed house separates us from nighttime serenades by crickets and frogs, whippoorwills and splashing mullet. Progress has its price.

If I had to go to work at 8:00 AM I could not be so sanguine about my insomnia. But retirement has its privileges and one of them is napping on demand. I do have an early doctor's appointment. While
not my orthopod, he will ask me how my shoulder is and I will be happy to report my operated shoulder is the least of my medical problems! 

Contractors, subcontractors and inconstant contractors

Because of our house project we have been dealing with repairmen more than usual. Previously when we had a big project we would have a general contractor who oversaw everything. That worked great. The contractor was always well connected. He had every kind of tradesman who worked for him and answered to him. Showing up for this job meant they would be called on for other jobs and there was a level of reliability  of when and how and who.

But we are on our own for this project. Generally we are dealing with a company; Sparks Electrical, Down the Drain Plumbers...a business with an office, a secretary, a boss and a schedule. The repairman who comes out drives a company truck, punches a time clock (perhaps virtual) and wears a shirt with a company logo on it. He shows up timely, charges what you were told on the phone, and gives you an itemized bill when he finishes.

Sometimes a job.is less well defined. The lawnman, the tree trimmer, the guy with a pressure cleaner, the dirt man (a dump truck and hole half way to China),  the tradesman who  has a cell phone, a wife with an adding machine and no county license.

They are usually cute young guys full of personality and chatter and you can't help but like them.  Even when they promise they'll be there to do the job Thursday morning and there is no sign of them. They are repentant when you finally reach them, their voice mail box is almost always full. When they do finally show up to work, they do a good job and promise to not let you down the next time.

So why does history repeat itself? Why are we again waiting for a handyman to show up, to do what he said he would, to charge the expected fee without additions, to return as he promised, and
complete the work as we hoped it would be? Are we cursed by some cosmic alignment that sets events spinning to thwart their true desire to show up and do the job?

There is no curse. There isn't any weird alignment of the stars to explain it, no full moon to excuse it. It's much more logical than that hocus pocus stuff. It is practically Darwinian, a modern example of natural selection. A  tradesman who can meet a schedule, wear a clean company shirt, maintain a
valid driver's license to drive a company vehicle...that fellow has a regulat, albeit boring, job with health insurance, paid vacation and a pay check on every Friday. But those apparently desirable qualities select out the adventurist, devil may care, possibly hard working though independent thinking and acting fellow who chooses consciously or unconsciously to march to a different drum.

When I think of it that way, that I must accept the negative to get the positive,  that genes not unreliability defeat scheduling, I can be more tolerant of  the inconstant. contractor.