Instead of rambling today, here is a wrap up of where I am at the end of September 2014, a little more than fourteen months after breaking my right shoulder and three and a half months post reverse total shoulder replacement arthropathy, rTSA.
Dr. Kai, orthopod, has cleared me to do most usual activity within reason. That doesn't mean I can actually do everything, but I can try.
I still need help with some household tasks: making a bed, vacuuming particularly. I'm getting better at ironing but don't do a very good job of it. Cooking is pretty much back to normal. I'm still avoiding really heavy cookware like Le Creuset cast iron pots and going with the lightweight stainless steel.
I continue physical therapy at home but don't have to go for formal PT.
My hair is still falling out. See July PODay 42 "Hair Today Gone Tomorrow" Telogen Effluviam. Good thing I had thick hair to start with! I do still look normal, hair wise, but there is always a hair falling on my ipad as I type or tickling down my bare arm, feeling like a bug is on me. The other day one of my hairs was in my salad! Yuck!
I feel like I am recovered from the pneumothorax (collapsed lung) See July Surgery plus 10 days. I don't even notice myself breathing through my mouth much any more.
I'll have some blood work for a different doctor this month and will find out if I am still anemic. I feel okay and imagine things are back to normal again. Hope so. Ditto: July Surgery plus 10 Days.
I still don't sleep well but that is probably only partially due to my arm. It's not really a problem as it is a great time to work on one's blog!
I'm better at dressing and undressing but it remains the one activity when I am most aware of my arm limitations. It's not harder than, say, driving but it's just that it is usually so automatic to pull up a pair of pants or zip up a dress. I hope it will become more second nature. But I still had to get help pulling my tee shirt off today.😞 (frownie face courrtesy of iOS 8.0 upgrade)
I did some work in the garden today. Weeding and raking. I'm considering the activity my physical therapy for the day. It's the first really physical work I've done in over three months. I must be feeling better!
All in all, I can't complain. Well, I can, I just shouldn't.
http://youtu.be/S9nSgMwtkK0
Archive timeline: 2014: May and June - preparing for surgery, July - surgery and post op problems, August - recovery and physical therapy, September
Tuesday, September 30, 2014
Sunday, September 28, 2014
Not Easy Being a Girl...PO Day 106
It's interesting but in every survey I scanned through there were significantly more women patients than men. One typical survey population was 558 women and 178 men. I did not come across an explanation for this disparity but wonder if the protocol for choosing the surgical candidate could explain it. The patient should be a less active person over 65 years old. Heavy labor and physically demanding sports are contraindicated for a successful and long term recovery. The patient should demonstrate a "low functional demand" for their new shoulder. And they should be able to understand and be willing to comply with some restriction of activity for life. Also, proximal humerus fracture, one of the problems that rTSA works well for, is more common in older women who have more brittle bones. This type of fracture is seen most in young active kids and older women, in fact. These indications for surgery might be a little passé but the general idea is still that a person with this surgery needs to be conservative in physical activity post operatively.
Another indication for rTSA is a rotator cuff injury that does not lend itself to more common treatment. Rotator cuff tear arthropathy (or shoulder arthritis with a large rotator cuff tear) most often occurs in individuals over the age of 65 and is more common in women than men.
Shoulder osteoarthritis develops most often in people in their 50s and beyond. Overuse and abuse take their toll on joints and, with time, problems like osteoarthritis occur, not just in shoulders. The condition occurs more frequently in women than men and in severe cases rTSA is a possible treatment.
Failed rotator cuff repair surgery and failed total shoulder arthroplasty are both indications for rSTA but there does not appear to be a reason those would occur more in women than in men. Tumors, pseudo paralysis, and proximal humeral malunion are also causes to consider rTSA surgery but none of those appear to be gender specific.
Where you live does seem to be a factor in the rate of rTSA. In the Dartmouth Atlas Surgery Report it was found that the rate of all Total Shoulder Replacement procedures varied considerably according to location. In 2005-2006 Syracuse, NY, East Long Island, NY, Los Angeles, and Pittsburg had the lowest rates and Provo, Utah, Great Falls, Nebraska, Omaha, Nebraska and Minneapolis, Mn had the highest rates of shoulder replacement surgery.
So, if you are a female over 70 living in Provo, Utah (3 cases per 1000 people) who has abused your shoulder in your younger years, developed arthritis, had a calamitous accident and shattered your proximal humerus which healed in a whomperjawed malunion and has either chronic pain or pseudoparalysis, your chances of having rTSA surgery are about ten times greater than a man of like age and life experience who lives in Syracuse, NY (0.3 cases per 1000).
It does seem men get all the breaks sometimes but I wouldn't trade.
http://youtu.be/plUwmfOhxeE
Archive timeline: 2014: May and June - preparing for surgery, July - surgery and post op problems, August - recovery and physical therapy, September..
Shoulder osteoarthritis develops most often in people in their 50s and beyond. Overuse and abuse take their toll on joints and, with time, problems like osteoarthritis occur, not just in shoulders. The condition occurs more frequently in women than men and in severe cases rTSA is a possible treatment.
Failed rotator cuff repair surgery and failed total shoulder arthroplasty are both indications for rSTA but there does not appear to be a reason those would occur more in women than in men. Tumors, pseudo paralysis, and proximal humeral malunion are also causes to consider rTSA surgery but none of those appear to be gender specific.
Where you live does seem to be a factor in the rate of rTSA. In the Dartmouth Atlas Surgery Report it was found that the rate of all Total Shoulder Replacement procedures varied considerably according to location. In 2005-2006 Syracuse, NY, East Long Island, NY, Los Angeles, and Pittsburg had the lowest rates and Provo, Utah, Great Falls, Nebraska, Omaha, Nebraska and Minneapolis, Mn had the highest rates of shoulder replacement surgery.
So, if you are a female over 70 living in Provo, Utah (3 cases per 1000 people) who has abused your shoulder in your younger years, developed arthritis, had a calamitous accident and shattered your proximal humerus which healed in a whomperjawed malunion and has either chronic pain or pseudoparalysis, your chances of having rTSA surgery are about ten times greater than a man of like age and life experience who lives in Syracuse, NY (0.3 cases per 1000).
It does seem men get all the breaks sometimes but I wouldn't trade.
http://youtu.be/plUwmfOhxeE
Archive timeline: 2014: May and June - preparing for surgery, July - surgery and post op problems, August - recovery and physical therapy, September..
Why do I want to be anonymous?
If you have been watching the little details of my posts over the past few days, you may have noticed there's been a flurry of name changes. No, my blog had not been taken hostage by a real person with a normal name. Rather, "Willet," who has been around since the inception of willetwithbrokenwing.blogspot.com, decided to upgrade to Google+. It seemed simple enough, a quick click on a link did the deed.
There was a lot to discover about Google+ so it was most of a day before Willet wandered back to Blogger only to learn that she no longer existed on Reverse Total Shoulder Replacement Surgery, A Patient's Point of View. She had been replaced by her alter ego, who shall be known here by the nom de plume Mme. X but was exposed to the cyber world by her true identity.
Mme. X absolutely freaked.
One would think she was worried about identity theft or cyber bullying, internet stalkers or malevolent hackers. No, she didn't see any harm in sharing her personal medical experience with total strangers online. It seemed perfectly reasonable to reveal her private thoughts and angst under the guise of a secret identity. It was much more serious than that.
To suddenly have the mask removed, the veil lifted, her real name attached to every single post was shocking. What if the post was poorly written, the message lost in some pointless platitude, the purloined pearls of wisdom attributed to the real her? Well, it was like when someone noticed the Emperor had no clothes! She had nothing to hide behind.
So Mme. X and I have been scrambling to restore her anonymity and it hasn't been easy. We were never able to bring Willet officially back to life with her simple, innocent personna and nickname. Willet is now mature, experienced, perhaps wiser, and is registered under her full given name and surname, "Willetwithbrokenwing Healing."
But, to her friends here, she is still known as Willet.
There was a lot to discover about Google+ so it was most of a day before Willet wandered back to Blogger only to learn that she no longer existed on Reverse Total Shoulder Replacement Surgery, A Patient's Point of View. She had been replaced by her alter ego, who shall be known here by the nom de plume Mme. X but was exposed to the cyber world by her true identity.
Mme. X absolutely freaked.
One would think she was worried about identity theft or cyber bullying, internet stalkers or malevolent hackers. No, she didn't see any harm in sharing her personal medical experience with total strangers online. It seemed perfectly reasonable to reveal her private thoughts and angst under the guise of a secret identity. It was much more serious than that.
To suddenly have the mask removed, the veil lifted, her real name attached to every single post was shocking. What if the post was poorly written, the message lost in some pointless platitude, the purloined pearls of wisdom attributed to the real her? Well, it was like when someone noticed the Emperor had no clothes! She had nothing to hide behind.
So Mme. X and I have been scrambling to restore her anonymity and it hasn't been easy. We were never able to bring Willet officially back to life with her simple, innocent personna and nickname. Willet is now mature, experienced, perhaps wiser, and is registered under her full given name and surname, "Willetwithbrokenwing Healing."
But, to her friends here, she is still known as Willet.
Breaking up is hard to do..PO Day 105
Leaving a doctor's practice is always difficult. If I like the doctor and the reasons have nothing to do with being dissatisfied, it might be sad but no one is mad. If there has been an "incident," or I feel the doctor or the staff have disappointed me, it's a bit harder to do. Or maybe not, if I feel righteously justified, it may not be hard at all. Whichever it is, you will have to request your medical records.
I've had both situations arise in the last year. I took the path of least resistance in both cases; I had the new doctor's office request my medical records. I did have to sign a Release of Medical Records form that would be provided to my "old" doctor, but I could have created my own written request. HIPAA laws are plain: a medical facility is legally required to provide copies (not the originals) of medical records within 30 days. They may charge a reasonable fee for reproducing the copies and for mailing them but may not charge for searching for the records or for the time involved in the work involved. They are not required to provide the records to another doctor but are required to submit the records to the patient or the representative of the patient.
Not being a person to burn my bridges ahead of me, I made sure to have an appointment with the new doctor before notifying the old doctor that I was leaving his practice. The doctor whose practice I was leaving because he had moved too far was not surprised at my departure and understood when I explained I had made other arrangements. I was disappointed in the second doctor but didn't see the need to confront him, changing orthopods in mid stream sent enough of a message. The patient does not have to say why they are leaving the old doctor and does not have to reveal to what doctor they will be going. It isn't surprising that when the medical records are requested by an attorney, patients often feel as if they are met with some resistance. Nonetheless, the same rules apply and no one knows them better than a lawyer.
Can a doctor dismiss a patient? Yes! Generally, valid reasons would include not paying your bills, being noncompliant by failing to follow medical advice or not returning for follow up care, behaving in a rude or obnoxious manner and if the the doctor is retiring or if he no longer participates in the insurance the patient has. The doctor must give the patient 30 days notice of the dismissal and may not dismiss the patient in middle of ongoing treatment, like if a woman is pregnant or if a patient is undergoing active cancer treatment.
Tips for requesting medical records from the American Health Information Management Association website if the patient is the one making the request for records:
Read online or call the facility’s HIM (Health Information Management) department for information specific to your request. This will give you time to collect the required information and documentation before you arrive. If you are requesting another person’s records, you can confirm in advance that you will have authorization.
Provide as much information as you can on the authorization form. This will speed up request processing by giving HIM professionals sufficient data to track down your records. If you have a common last name, provide extra information about yourself, such as your date of birth or the last four digits of your Social Security number.
Tell the HIM staff why you are requesting the record. HIM professionals can help ensure you receive the records you need—and not the ones you don’t. The set of records one should request for personal use, for example, can be different from the set of records sent to a doctor for continuing care. A person’s medical record can be hundreds of pages long, so requesting your entire record may be too much, especially if the facility charges a per-page fee for compiling and reproducing it.
Indicate if the request is urgent… Many facilities triage their record requests, putting the most time-sensitive and care-oriented requests first.
So, to repeat myself a little: It is always easier to let the new doctor request records from the old doctor but the original doctor is not required to send the records to another physician or hospital group. However, YOU are legally permitted to ask for and receive copies of your records yourself or your legal representative may request and receive them. Recent HIPAA laws make plain that the patient is entitled to copies of all their records but not the original documents. This has been the law for decades but patients did not always know it.
It's a good practice to always request copies of special tests' reports, like lab work and cat scans, when they are done and create your own record system. It will not only ensure you have copies of the tests but will also jog your memory of what and when.
http://youtu.be/XQD3At3E7TA
Archive timeline: 2014: May and June - preparing for surgery, July - surgery and post op problems, August - recovery and physical therapy, September
Saturday, September 27, 2014
Choosing your doctor...PO Day 104
Figuring out what qualities you want in your physician is complicated. The straight-talk some appreciate, that should make you feel like a teammate in your care, comes across as negative and unsympathetic to some people. The youth and vitality you find desirable in your surgeon, your friend looks at as immaturity and nervousness. Grey-white hair and Ben Franklin bifocals one person sees as a sign of wisdom and experience suggests retirement is in order to another. What is a doctor to do, to be?
There are always those diplomas on the walls. And websites include the doctor's curriculum vitae, that's what school he attended, where he went for his residency, does he have any additional training, is he Board certified in his speciality. Those things are important but maybe not as important as the relationship and trust you hope to have with this person.
I want my pediatrician to be a big kid. My GP (do we still say general practitioner?) should love a good puzzle. My ophthalmologist needs to be picky and precise. The oncologist has to be detached enough to make the hard choices and empathetic when treatments fail. The neurologist shouldn't get on my nerves and the dermatologist shouldn't get under my skin. The cardiologist must be cool as he holds someone's heart in his hands. And I definitely want my orthopedic surgeon to have been a whiz with Tinker Toys as a child and like to assemble IKEA furniture as an adult. Are these qualities my physician learns in a course in medical school or do these personality traits unconsciously direct his career choices?
One of our family doctors, Dr. Corleone, must have taken the Dale Carnegie Course for Medical Professionals. As you sit in the exam room waiting for him, he pops his head in the door, calls you by name, and assures you he will be in with you in a moment. When he enters the room, he greets you with a two handed hand shake ala Bill Clinton. He leans forward to listen to what you have to say, his eyes locked on yours. He nods his head as he takes in your words, not quite as much as Mr. Bobblehead, but strangely reminiscent of him. He touches your forearm or your shoulder as he wraps up his opinion and escorts you to the appointment/check out desk. He is sincere and concerned. In spite of my cynicism, he draws me in. Did he learn that in med school? Did anyone else take that course?
Your doctor has to be part of your insurance network. It's a good thing if the office is convenient to your home. Is the doctor on the staff at the hospital where you prefer to go? That is often overlooked until you are about to be admitted and discover you are being sent to a hospital you would not choose. It is now possible to go on line and see how the public rates a certain physician, kind of like checking the feedback on a local tradesman. Just keep in mind two things: people who are dissatisfied are more likely to take the time to enter remarks on such a site and some referral sites work more like a phone book where the doctor pays to be included in the listing. In the first instance, the remarks are more likely to be negative and it the latter, more likely to be glowingly positive.
Maybe I am focusing on the wrong things and not seeing what is really important. Are the folks at the front desk friendly and efficient? Do they follow through and do what they say they will? Do they answer the phone? (!) Do they run anything close to their schedule? How long do you wait to see the doctor? Maybe those are the kind of things that are really important. But they are also the kind of things, along with the doctor's personality and style, that you cannot know until you have been a patient for a while.
Maybe, after all, those diplomas on the wall or the curriculum vitae on the web are a good starting place.
http://youtu.be/eRULqLhxKBU
There are always those diplomas on the walls. And websites include the doctor's curriculum vitae, that's what school he attended, where he went for his residency, does he have any additional training, is he Board certified in his speciality. Those things are important but maybe not as important as the relationship and trust you hope to have with this person.
I want my pediatrician to be a big kid. My GP (do we still say general practitioner?) should love a good puzzle. My ophthalmologist needs to be picky and precise. The oncologist has to be detached enough to make the hard choices and empathetic when treatments fail. The neurologist shouldn't get on my nerves and the dermatologist shouldn't get under my skin. The cardiologist must be cool as he holds someone's heart in his hands. And I definitely want my orthopedic surgeon to have been a whiz with Tinker Toys as a child and like to assemble IKEA furniture as an adult. Are these qualities my physician learns in a course in medical school or do these personality traits unconsciously direct his career choices?
One of our family doctors, Dr. Corleone, must have taken the Dale Carnegie Course for Medical Professionals. As you sit in the exam room waiting for him, he pops his head in the door, calls you by name, and assures you he will be in with you in a moment. When he enters the room, he greets you with a two handed hand shake ala Bill Clinton. He leans forward to listen to what you have to say, his eyes locked on yours. He nods his head as he takes in your words, not quite as much as Mr. Bobblehead, but strangely reminiscent of him. He touches your forearm or your shoulder as he wraps up his opinion and escorts you to the appointment/check out desk. He is sincere and concerned. In spite of my cynicism, he draws me in. Did he learn that in med school? Did anyone else take that course?
Your doctor has to be part of your insurance network. It's a good thing if the office is convenient to your home. Is the doctor on the staff at the hospital where you prefer to go? That is often overlooked until you are about to be admitted and discover you are being sent to a hospital you would not choose. It is now possible to go on line and see how the public rates a certain physician, kind of like checking the feedback on a local tradesman. Just keep in mind two things: people who are dissatisfied are more likely to take the time to enter remarks on such a site and some referral sites work more like a phone book where the doctor pays to be included in the listing. In the first instance, the remarks are more likely to be negative and it the latter, more likely to be glowingly positive.
Maybe I am focusing on the wrong things and not seeing what is really important. Are the folks at the front desk friendly and efficient? Do they follow through and do what they say they will? Do they answer the phone? (!) Do they run anything close to their schedule? How long do you wait to see the doctor? Maybe those are the kind of things that are really important. But they are also the kind of things, along with the doctor's personality and style, that you cannot know until you have been a patient for a while.
Maybe, after all, those diplomas on the wall or the curriculum vitae on the web are a good starting place.
http://youtu.be/eRULqLhxKBU
Archive timeline: 2014: May and June - preparing for surgery, July - surgery and post op problems, August - recovery and physical therapy, September..
Friday, September 26, 2014
I've struggled most with...PO Day 103
Dressing! Undressing! Changing clothes! Putting on pajamas! Removing articles of clothing for X-rays and cat scans in the doctor's office or hospital. Attempting to try on something in a store dressing room...impossible! Putting on a sweater if I was cold, taking off a sweater if I was hot!
Ever since I fell and broke the proximal humerus of my right arm in July 2013 I have struggled with ordinary tasks that required using my right arm. My handwriting was nearly indecipherable, even I could not always read what I had just written. I learned to drive with just my left arm/hand. Creative cooking included select, not so heavy, pots and pans. The mixer and food processor had to substitute for hand stirring or chopping. Five gallon plastic buckets replaced laundry baskets that require two arms to carry them. There were just dozens of little chores that demanded creative solutions. I could do it! Little changed in the six weeks post operatively when I was back in a sling 24/7.
And the insoluble problems of dressing and undressing did not change either.
My usual routine has been to jump up in morning and be dressed and downstairs in ten minutes. Doing it one handed turns dressing into a frustrating, irritating, challenging, sweating, twisting and turning, time consuming tirade. Anything less than two sizes too big is too small. If it didn't stretch I wouldn't even think about wearing it. Around the house, clothes consisted of large men's button up shirts and pull on shorts. An invitation from Dear Husband to go out for lunch, while tempting, was not enough to warrant changing into something presentable. Wendy's does not have a strict dress code, thank goodness.
I had to start the end of the day ritual before I was too tired and cross to battle undressing. Even then, there were times I was very tempted to take a pair of scissors to a shirt whose sleeve would not release its grip on my arm or a pair of pants that were twisted and would not slide down and would not pull up tugging with only one hand, first on the left, then the right, now in the front, then on the back to no avail. A couple particularly frustrating nights I slept in my clothes rather than try to undress.
I thought I was so clever one day when I had to have a cat scan at the hospital. I carefully and painstakingly slowly dressed in items with no metal parts, not even any plastic pieces. But when I presented for the exam, the technician told me it all had to come off and their gown had to go on. In their little changing room with the time pressure I was under, I just couldn't do it. I was mortified to have to ask for help. The tech was gracious and helpful but it was way outside of her job description.
Things did not turn around suddenly the day I no longer had to wear the sling. It's only been in the last couple weeks that I have unconsciously found myself wearing ordinary clothes. I actually tried on a shirt today to see if I liked it or wanted to donate it. A few weeks ago I would never have invested so much effort in the decision. The shirt would just have gone in the donation bag. I am still not supposed to put my op'd arm behind my back and I have to remind myself constantly. But at 99 days post op things are getting back to normal finally.
Perhaps we can go someplace other than Wendy's for lunch.
http://youtu.be/EOyQfd7OqIY
Archive timeline: 2014: May and June - preparing for surgery, July - surgery and post op problems, August - recovery and physical therapy, September...
Thursday, September 25, 2014
More complicated at first..PODay 102
My local hospital where I had my rTSA surgery holds a once a month seminar for upcoming joint replacement surgery patients. I don't think it is required but it is highly recommended. It is led by the Joint Replacement Surgery Coordinator and a physical therapist. They have a power point presentation, then spend about an hour answering individual questions. Many of the participants are repeat joint (after all, we do have two of each major joint) replacers and are full of practical information that they love to share. It was very informative and reassuring.
Except...of the approximately thirty attendees, I was the only person who was going to have a shoulder procedure, the less common rTSA, no less. It made me a little nervous.What I've since learned is this really is a less common procedure. A Dartmouth study showed that between 2000 and 2005 the incidence of rTSA surgery in the US increased by 67%. Still, in 2008, 61,000 shoulder operations were performed in the United States. Of those, only about 10,000 were reverse total shoulder replacements.
Do I feel like a guinea pig? Part of a giant clinical trial? A pioneer, a trail blazer, a medical miracle? Not really. Just a fortunate person for whom this procedure was available when I needed it. It helps that my surgeon is a specialist in "upper extremity orthopedic surgery" who has done more than 100 procedures. It was kind of awkward but I asked him how many. I didn't want to be among his first seven cases! You know what 'they' say, Trust but Verify.
Archive timeline: 2014: May and June - preparing for surgery, July - surgery and post op problems, August - recovery and physical therapy, September...
Wednesday, September 24, 2014
It's Complicated....PO Day 101
French physicians were pioneers in shoulder arthroplasty (the surgical reconstruction of a joint). The first reported procedure was by Jean Pean in 1894. An American, Charles Neer, developed the first practical and widely used prosthesis for the shoulder in the 1950s. Back to France in the early 1980s Paul Grammont, working in his home shop, designed the first generation of prosthesis for the reverse Total Shoulder Arthroplasty which had previously met with failures. For the next couple decades the French refined the operation but it was not until 2004 that Reverse Total Shoulder Arthroplasty crossed the Atlantic and became the new surgical procedure on the block in the US. It was met with a great many reservations and guidelines suggested it be reserved for patients over the age of 70 and offered as a treatment of "last resort." The rate of complication was reported as quite high, at least 50% and some suggested that 100% of the patients had some form of surgical or medical complication. It was reported that there was a very high learning curve for the surgeon and you didn't want to be one of the first seven people on whom your doctor operated. Seven seemed to be the number needed to become at all proficient. The last ten years have seen quite a change in attitude toward the operation and who should have it.
Risk of infection with rTSA is greater than in hip, knee or shoulder replacement but a report by the NIH (National Institute of Health) suggested a rate of only 7%. An article in the Journal of Shoulder and Elbow Surgery in March 2014 agreed with the 7% figure. The fact that some of the procedures were revision of previous TSA contributed to a higher risk of infection.
The NIH reported in 2010 that cases of implant instability in rTSA patients occurred in 3.4% of the patients and most cases of dislocation happened in the first several month after surgery.
Mole' and Favard reported a 3% rate of fracture of the acromiom bone (an extension of the collar bone, I think). One article suggested the fracture might be the result of over zealous exercise.
Less common problems are neurologic injury, periprosthetic fracture, hematoma, scapular notching, dislocation, and mechanical baseplate failure.
In an article in the June 2014 issue of the Journal of Shoulder and Elbow Surgery the overall rate of complications with rTSA was 25%. However, 80% of the complications were considered minor.
The bottom line is the relatively high rate of complications is considered acceptable due to the very high improvement in shoulder function and quality of life.
I'm good with that.
Archive timeline: 2014: May and June - preparing for surgery, July - surgery and post op problems, August - recovery and physical therapy, September..
Tuesday, September 23, 2014
Slip sliding away...PO Day 100!
Fall starts today, September 23rd. Actually, I think it was ushered in late last night but this is the first full day. I can't believe it. Where has the summer gone? Did surgery and recovery gobble up June, July and August or am I experiencing the perception of the rapid passage of time as one gets older? Is it like Einstein said in 1915 that massive objects cause a distortion in space-time? Surgery certainly is a massive object in one's life, distorting the heck out of your routine. Or maybe he meant black holes and red giants and bending light. Do we ever get that lost time back? Can we reclaim those precious moments? Can we pass through a wormhole and go back in time? If we could I would rewind to the moment before I fell and shattered my humerus. I wouldn't mind skipping the past fourteen months.
If that's not an option, what else could I have done differently? Listened to my good friend and gotten a second opinion much sooner. Recognized I needed better sleeping conditions, perhaps moved a recliner into the bedroom instead of camping out in the living room for nine months. Asked for a cat scan or MRI when the injury first occurred. Complained more to my first doctor and less to friends and family. Not wasted time and money on physical therapy trying to improve a hopeless situation. Those are things that I had control over and, in hindsight, should have done.
What did I do right? About the only good thing I can take credit for is finally getting fed up and asking my primary care doctor for an MRI and a referral to a new orthopod. Truth is, it wasn't me. It was Dear Husband who insisted I seek a new opinion. So, it looks as if I the one thing I did right was marry someone with more good sense than me who recognized I was not being taken seriously by my first orthopod. I ended up with a good orthopedic surgeon who knew how to help me.
Now if there were just some way to stop life from slipping away. Any suggestions?
http://youtu.be/gnxEt2L6Oy4
Archive timeline: 2014: May and June - preparing for surgery, July - surgery and post op problems, August - recovery and physical therapy, September..
If that's not an option, what else could I have done differently? Listened to my good friend and gotten a second opinion much sooner. Recognized I needed better sleeping conditions, perhaps moved a recliner into the bedroom instead of camping out in the living room for nine months. Asked for a cat scan or MRI when the injury first occurred. Complained more to my first doctor and less to friends and family. Not wasted time and money on physical therapy trying to improve a hopeless situation. Those are things that I had control over and, in hindsight, should have done.
What did I do right? About the only good thing I can take credit for is finally getting fed up and asking my primary care doctor for an MRI and a referral to a new orthopod. Truth is, it wasn't me. It was Dear Husband who insisted I seek a new opinion. So, it looks as if I the one thing I did right was marry someone with more good sense than me who recognized I was not being taken seriously by my first orthopod. I ended up with a good orthopedic surgeon who knew how to help me.
Now if there were just some way to stop life from slipping away. Any suggestions?
http://youtu.be/gnxEt2L6Oy4
Archive timeline: 2014: May and June - preparing for surgery, July - surgery and post op problems, August - recovery and physical therapy, September..
Monday, September 22, 2014
Post surgery diet...PO Day 99
FISH FOR DINNER TONIGHT!
Wouldn't it be great if a diet purported to be good for you recommended hamburgers and French fries, cookies and ice cream? It's never that way though. We all know what we're supposed to eat and, no matter the medical condition, there is very little variation.
A classic diet for a recovering surgical patient is as predictable as a hospital menu.
1. Fiber! Yes, it is good for lowering cholesterol but more importantly, it helps prevent constipation which is often a post surgery problem. Whole grain bread and high fiber cereals, without a lot of sugar, are the basis of this food group.
2. Lean meat , baked or broiled, is a great source of protein, vital to recovery. Chicken, turkey, the "new" pork, and FISH should be the foundation of your meal plan. If you are vegetarian, substitute soy, tofu or beans.
3. Fresh fruits and vegetables round out a balanced dinner plate. They are a good source of fiber, vitamins and minerals. Dark green leafy vegetables are rich in antioxidants. Fresh fruits are preferred over canned. Smoothies are a popular way of consuming fruit in a convenient and portable manner.
4. Protein and calcium are essential for healing and recovery. A great source is low fat dairy foods. It seems more and more folks are lactose intolerant but there are many alternatives. Constipation can be a side effect of dairy but increasing fiber may solve that difficulty.
5. The good news is that this is one of the few times you are advised to increase your caloric intake. Your body needs the increase for healing and energy. Get more calories by adding larger portions of lean meat, smoothies that incorporate less sugary fruits, and protein powder.
At least we don't have to dive and catch our fish like the osprey in the photo above. But it would be cheaper than the grocery store!
2. Lean meat , baked or broiled, is a great source of protein, vital to recovery. Chicken, turkey, the "new" pork, and FISH should be the foundation of your meal plan. If you are vegetarian, substitute soy, tofu or beans.
3. Fresh fruits and vegetables round out a balanced dinner plate. They are a good source of fiber, vitamins and minerals. Dark green leafy vegetables are rich in antioxidants. Fresh fruits are preferred over canned. Smoothies are a popular way of consuming fruit in a convenient and portable manner.
4. Protein and calcium are essential for healing and recovery. A great source is low fat dairy foods. It seems more and more folks are lactose intolerant but there are many alternatives. Constipation can be a side effect of dairy but increasing fiber may solve that difficulty.
5. The good news is that this is one of the few times you are advised to increase your caloric intake. Your body needs the increase for healing and energy. Get more calories by adding larger portions of lean meat, smoothies that incorporate less sugary fruits, and protein powder.
At least we don't have to dive and catch our fish like the osprey in the photo above. But it would be cheaper than the grocery store!
Archive timeline: 2014: May and June - preparing for surgery, July - surgery and post op problems, August - recovery and physical therapy, September...
Sunday, September 21, 2014
Singapore slings and more...PODay 98
I never knew there were so many different types of slings until I needed one. My first sling, when I limped home with a "broken shoulder," was fashioned from a torn up sheet by my 10 year old granddaughter. Wikihow has some pretty good instructions and she is, after all, a Girl Scout.
Since this all was happening on a weekend and I was determined not to go to the emergency room, I showed up at my local CVS drugstore the next morning hoping to find something more functional and a little less primitive. They had one basic sling made of a light canvas material with an adjustable strap that wrapped around your neck. I bought it and the pharmacy assistanti helped me gingerly maneuver my arm into it, bless her heart.
That sling got me through the weekend and into the orthopod's office Monday. By then I had learned it wasn't enough to support the arm, I needed to anchor it to my body. Otherwise every time I moved or bent over my arm swung out away from my body and that was a bad thing. When I asked if there was a solution the nurse brought a "sling with swath." This was a major improvement. The sling is made of a poly-fleece type material so it was much softer on my skin. The strap did not wrap around the neck, rather two straps crossed behind the back, wrapped around the waist and velcroed to the arm sleeve. That was great as with this style the weight was on my shoulders, not around my neck. Furthermore, the "swath" was just what I needed. It is a long strip of more soft fleece material, long enough to wrap all the way around my body cuddling the sling-supported arm against my waist. It, too, anchors with Velcro. The generic looking box simply says "Sling with Swath."
That sling got me through 6 weeks post broken arm and came back into action for six weeks post rTSA recently.
Ideally I would have had an "AirCast Arm Immobilizer" or similar arm Immobilizer sling post rTSA. My hospital didn't supply one, my doctor wasn't a big fan and and I was too discombobulated to order one. They provided two slings, one very little better than my original drug store sling and the other a mysterious wrap device that we never could figure out. It did have one nice feature though, a pocket for an ice pack. Because it was familiar and available, I reverted to my old "sling with swath."
Basic black got pretty boring and I wished I had thought to make some "fashion" slings prior to surgery. Finally I looked on the web and discovered that there must be a lot of women who feel the same way. Amazon and Broken Beauties are two sites to google if you are still a fashionista in spite of a bad shoulder.
By the time I found these resources, my sentence in the sling was coming to an end and I didn't order one. So I can't give a personal recommendation. There are several on-line sources for slings and they have a much wider variety than my local stores.
Another type of sling pops up on the web when doing a search...the iconic Singapore Sling! But it is too complicated for me. I'll just have a glass of wine, please.
Archive timeline: 2014: May and June - preparing for surgery, July - surgery and post op problems, August - recovery and physical therapy, September..
Since this all was happening on a weekend and I was determined not to go to the emergency room, I showed up at my local CVS drugstore the next morning hoping to find something more functional and a little less primitive. They had one basic sling made of a light canvas material with an adjustable strap that wrapped around your neck. I bought it and the pharmacy assistanti helped me gingerly maneuver my arm into it, bless her heart.
That sling got me through the weekend and into the orthopod's office Monday. By then I had learned it wasn't enough to support the arm, I needed to anchor it to my body. Otherwise every time I moved or bent over my arm swung out away from my body and that was a bad thing. When I asked if there was a solution the nurse brought a "sling with swath." This was a major improvement. The sling is made of a poly-fleece type material so it was much softer on my skin. The strap did not wrap around the neck, rather two straps crossed behind the back, wrapped around the waist and velcroed to the arm sleeve. That was great as with this style the weight was on my shoulders, not around my neck. Furthermore, the "swath" was just what I needed. It is a long strip of more soft fleece material, long enough to wrap all the way around my body cuddling the sling-supported arm against my waist. It, too, anchors with Velcro. The generic looking box simply says "Sling with Swath."
That sling got me through 6 weeks post broken arm and came back into action for six weeks post rTSA recently.
Ideally I would have had an "AirCast Arm Immobilizer" or similar arm Immobilizer sling post rTSA. My hospital didn't supply one, my doctor wasn't a big fan and and I was too discombobulated to order one. They provided two slings, one very little better than my original drug store sling and the other a mysterious wrap device that we never could figure out. It did have one nice feature though, a pocket for an ice pack. Because it was familiar and available, I reverted to my old "sling with swath."
Basic black got pretty boring and I wished I had thought to make some "fashion" slings prior to surgery. Finally I looked on the web and discovered that there must be a lot of women who feel the same way. Amazon and Broken Beauties are two sites to google if you are still a fashionista in spite of a bad shoulder.
By the time I found these resources, my sentence in the sling was coming to an end and I didn't order one. So I can't give a personal recommendation. There are several on-line sources for slings and they have a much wider variety than my local stores.
Another type of sling pops up on the web when doing a search...the iconic Singapore Sling! But it is too complicated for me. I'll just have a glass of wine, please.
Archive timeline: 2014: May and June - preparing for surgery, July - surgery and post op problems, August - recovery and physical therapy, September..
- PREP5 mins
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A Little Help to Get By....PO Day 112
For three of the last fourteen months I wore a sling. Six weeks when I first broke my arm, then six weeks after reverse total shoulder arthroplasty, rTSA. Even after the first bout with the sling it was obvious by the way I carried my right arm that it wasn't of much use to me. I might as well have been wearing a sign that said "open the door for this woman," or "offer to help her with her packages." Of course, I was rewarded to see that chivalry is not dead and I really appreciate the Publix bag boy (a man ten years older than I) taking my groceries out to the car. It was very thoughtful of Dear Husband to take on little household jobs to relieve me. And Dear Son in Law (I wonder if it is beau fils in French?) hurried around to open the car door and offer a hand. (But in his case he was just raised right and he probably didn't notice I was compromised and is too polite to have mentioned it if he had.)
But at first it took a lot of self restraint not to snappishly say "I can do it myself." Was I just a little defensive? Why is it so hard to let a stranger, even a family member, do something nice for us? I totally get it...I don't think twice about holding the door for a 6'3" construction worker or letting the mom with the cranky child go in front of me in line. So why don't I recognize the generous action of someone else as just that, not some kind of evolutionary analysis of my vulnerability? Do I think they are going to see me as the weak link in the caveman clan and knock me over the head with a club?
So I practiced smiling and saying, "yes, thank you. That would be very helpful." I tried to add an extra 'how nice of you' as they walked away. It felt awkward at first but I began to realize how pleased the people were to help. That it made them feel good and useful and think that if their mom could see them that she would be very proud. And besides, I came to recognize that I really needed the help.
Now I'm doing better. I look healthier and I don't walk like a bird with a broken wing. Well, not so
much anyway. Little acts of kindness have turned in to more of a give and get arrangement. I'm glad I can once again do something nice for a stranger, nothing too big yet. And I really appreciate a helping hand occasionally.
Now if I can just share what I've learned with Dear Husband who is struggling with a brace on his injured right ankle and is determined to "do it himself."
http://youtu.be/SkyqRP8S93Y
Archive timeline: 2014: May and June - preparing for surgery, July - surgery and post op problems, August - recovery and physical therapy, September..Thinking medically, - October -
But at first it took a lot of self restraint not to snappishly say "I can do it myself." Was I just a little defensive? Why is it so hard to let a stranger, even a family member, do something nice for us? I totally get it...I don't think twice about holding the door for a 6'3" construction worker or letting the mom with the cranky child go in front of me in line. So why don't I recognize the generous action of someone else as just that, not some kind of evolutionary analysis of my vulnerability? Do I think they are going to see me as the weak link in the caveman clan and knock me over the head with a club?
So I practiced smiling and saying, "yes, thank you. That would be very helpful." I tried to add an extra 'how nice of you' as they walked away. It felt awkward at first but I began to realize how pleased the people were to help. That it made them feel good and useful and think that if their mom could see them that she would be very proud. And besides, I came to recognize that I really needed the help.
Now I'm doing better. I look healthier and I don't walk like a bird with a broken wing. Well, not so
much anyway. Little acts of kindness have turned in to more of a give and get arrangement. I'm glad I can once again do something nice for a stranger, nothing too big yet. And I really appreciate a helping hand occasionally.
Now if I can just share what I've learned with Dear Husband who is struggling with a brace on his injured right ankle and is determined to "do it himself."
http://youtu.be/SkyqRP8S93Y
Archive timeline: 2014: May and June - preparing for surgery, July - surgery and post op problems, August - recovery and physical therapy, September..Thinking medically, - October -
Sleepless In Suburbia...PO Day 97
The most common complaint we shoulder patients share is the inability to sleep. I can drop off sitting upright watching TV. Leave me alone in a doctor's waiting room long enough and my chin will be on my chest and I will practically be snoring. But, when the day is done and I am bone tired, I still cannot find the right position for my healing shoulder. I have squishy little pillows, big fat pillows, plump queens and rotund kings. There's a little neck roll and a big square Euro. I haven't tried a body pillow yet, nor a memory foam. But it could happen.
It is just so difficult to lie down, not put pressure on your shoulder but support it and figure out where to drape the attached arm. Ideally you will sleep on your back with small pillows tucked under the operated shoulder. For me, nothing works as well as the sofa. Some people find a recliner good for them. I think it would be comfortable for me but I cannot operate the lever-handle that raises and lowers the foot rest. It's a case of "right is wrong." The handle is on the lower right side of the chair, inaccessible to my right arm even now.
So I still struggle with my collection of pillows every night, secure in the knowledge I will find just the right position but not quite achieving the comfort that leads to a good night's sleep. There are lots of suggestions for a better night. Here are a few:
Use a wedge pillow or create an incline so you are not lying flat. A reclining position is ideal. Of course that rules out sleeping on your tummy.
But you should not sleep on your stomach, not even your side. You just can't support your shoulder properly if you are not on your back.
Remember to support your arm so that your elbow does not drop behind the plane of your torso.
Maintain good circulation to your shoulder and arm. Use pillows to slightly elevate your arm and hand for best blood flow and healing.
If you are bed ridden for very long be sure you do not develop bed sores. Change position frequently and cushion tender spots like heels.
Consider talking to your doctor about medication for pain or sleep, if needed. Soldier on and, if you can't sleep, a book or a tablet device is a good distraction. Start a blog!
But in all your flip-flopping around, do not use your operated arm to support your weight during the healing period. I still don't know how long that is. Maybe forever? I'll ask and let you know.
http://youtu.be/gW49ZzPFEpI
Archive timeline: 2014: May and June - preparing for surgery, July - surgery and post op problems, August - recovery and physical therapy, September...
It is just so difficult to lie down, not put pressure on your shoulder but support it and figure out where to drape the attached arm. Ideally you will sleep on your back with small pillows tucked under the operated shoulder. For me, nothing works as well as the sofa. Some people find a recliner good for them. I think it would be comfortable for me but I cannot operate the lever-handle that raises and lowers the foot rest. It's a case of "right is wrong." The handle is on the lower right side of the chair, inaccessible to my right arm even now.
So I still struggle with my collection of pillows every night, secure in the knowledge I will find just the right position but not quite achieving the comfort that leads to a good night's sleep. There are lots of suggestions for a better night. Here are a few:
Use a wedge pillow or create an incline so you are not lying flat. A reclining position is ideal. Of course that rules out sleeping on your tummy.
But you should not sleep on your stomach, not even your side. You just can't support your shoulder properly if you are not on your back.
Remember to support your arm so that your elbow does not drop behind the plane of your torso.
Maintain good circulation to your shoulder and arm. Use pillows to slightly elevate your arm and hand for best blood flow and healing.
If you are bed ridden for very long be sure you do not develop bed sores. Change position frequently and cushion tender spots like heels.
Consider talking to your doctor about medication for pain or sleep, if needed. Soldier on and, if you can't sleep, a book or a tablet device is a good distraction. Start a blog!
But in all your flip-flopping around, do not use your operated arm to support your weight during the healing period. I still don't know how long that is. Maybe forever? I'll ask and let you know.
http://youtu.be/gW49ZzPFEpI
Archive timeline: 2014: May and June - preparing for surgery, July - surgery and post op problems, August - recovery and physical therapy, September...
Saturday, September 20, 2014
EHR AT WORK...P O Day 96
We went today to get our flu shots. It still seems strange to me that we can't get a flu shot, a pneumonia shot, or the shingles vaccine from our doctor. Instead , a pharmacist or could be a pharmacy helper, joins us at the end of aisle ten by the bandaids, adhesive tape and first aid ointment while a mother and little girl look for sunscreen nearby.
I thought it was okay when the Visiting Nurses set up a card table and we stood in a line that snaked down the candy aisle and around the magazine racks. . I guess having to wait made it seem more like the doctor's office. Now, if you time it right, you're the only one in the queue. Good thing, because the data entry takes forever! The young man who collected our cards and info seemed competent and a fast typist. (Do we still call it typing?) But it must have taken fifteen minutes per each of us to finally announce someone would be out in a moment.
Where is all that data going? Well, it is going into our Electronic Health Record. Our primary care doctor now knows we've had our flu shot this year. There is no sneaking around anymore. I would say this new system has solved the problem of people who would go to different doctors to get additional prescriptions for controlled substances. That's definitely a good thing. But I'm not sure the dermatologist who does your mole screening needs to know your birth control method. How is the information shared? Perhaps, too widely...
From an article by Mariann McGee for Healthcare Info Security on August 6, 2014:
According to a just issued statement by the Office of the Inspector General of the Dept of Health and Human Services says the Office of the National Coordinator for Health IT's initial oversight of electronic health record testing and certification bodies did not fully ensure that patient data within EHRs is protected. At a minimum, certified EHRs must meet security requirements related to seven information technology areas: access control, emergency access, automatic log-off, audit log, integrity, authentication and general encryption.
Inaccurate testing and certification of EHRs could potentially leave healthcare providers vulnerable to security risks, the OIG says. "Certification assures healthcare providers that the EHR has the capabilities needed, including appropriate record security and protection, for providers to participate in the [HITECH] programs. If insecure systems have been certified, providers and patients may have a false sense of security and assurance."
I thought it was okay when the Visiting Nurses set up a card table and we stood in a line that snaked down the candy aisle and around the magazine racks. . I guess having to wait made it seem more like the doctor's office. Now, if you time it right, you're the only one in the queue. Good thing, because the data entry takes forever! The young man who collected our cards and info seemed competent and a fast typist. (Do we still call it typing?) But it must have taken fifteen minutes per each of us to finally announce someone would be out in a moment.
Where is all that data going? Well, it is going into our Electronic Health Record. Our primary care doctor now knows we've had our flu shot this year. There is no sneaking around anymore. I would say this new system has solved the problem of people who would go to different doctors to get additional prescriptions for controlled substances. That's definitely a good thing. But I'm not sure the dermatologist who does your mole screening needs to know your birth control method. How is the information shared? Perhaps, too widely...
From an article by Mariann McGee for Healthcare Info Security on August 6, 2014:
According to a just issued statement by the Office of the Inspector General of the Dept of Health and Human Services says the Office of the National Coordinator for Health IT's initial oversight of electronic health record testing and certification bodies did not fully ensure that patient data within EHRs is protected. At a minimum, certified EHRs must meet security requirements related to seven information technology areas: access control, emergency access, automatic log-off, audit log, integrity, authentication and general encryption.
Inaccurate testing and certification of EHRs could potentially leave healthcare providers vulnerable to security risks, the OIG says. "Certification assures healthcare providers that the EHR has the capabilities needed, including appropriate record security and protection, for providers to participate in the [HITECH] programs. If insecure systems have been certified, providers and patients may have a false sense of security and assurance."
Brian Evans, a senior managing consultant at IBM Security Services, says hospitals and physicians can take precautions if the OIG report makes them question whether the certified EHRs they've implemented are adequately protecting patient data.
"Healthcare entities are expected to already have conducted a risk analysis on their EHR and should be remediating issues identified through the process," he notes. Some examples of what they might identify include generic user accounts, inadequate audit logging and monitoring, outdated disaster recovery plans and a lack of encryption, he says.
I don't think doctors and hospitals are going to have time to see patients. They are going to be too busy monitoring their electronic health records systems!
Archive timeline: 2014: May and June - preparing for surgery, July - surgery and post op problems, August - recovery and physical therapy, September..
Archive timeline: 2014: May and June - preparing for surgery, July - surgery and post op problems, August - recovery and physical therapy, September..
Friday, September 19, 2014
I figured it out!..PO Day 95
I hope you can still find me. I changed the name of my blog. Well, I really just added the word Reverse. As I said before, when I began the blog I did not know that I would be having the reverse Total Shoulder Replacement procedure. Dr. Kai briefly referred to the different procedures and said we would discuss his recommendations after I had a cat scan. I asked him to make a guess and he said probably the reverse.
I didn't know enough to be worried or to appreciate the serious nature of the surgery. By the next appointment Dr. Google and I had been "talking" a lot and I was full of the appropriate questions. Dr. Kai was reserved in his enthusiasm for the operation. He would not make a very good car salesman! He down played the possible positive outcome of the surgery, tried to lower my ( and maybe his) expectations. He suggested my arm might not look quite the same, might even turn out a little longer. I already have long arms and it made me wonder if I would look like an orangutan post op. He suggested a successful surgery might allow me to put a dish away on a low shelf in an upper cupboard but would not give me anywhere near the range of my left arm. He hoped it would offer some pain relief.
Well, in spite of my recent whining about sore muscles, I am getting along great! My range of motion is much greater than my therapist or I expected. At first, in order to elevate my arm, my right shoulder hitched up towards my ear. I had to concentrate pretty hard to keep it relaxed and down. It helped to do my exercises in front of a mirror. I think I have it under control now.
After more than a year of being a leftie, I now have to remind myself to let my right arm do it. I am able to sit and stay seated at my sewing machine...still adapting bras with front closures. Before I had to stand up to thread the machine or turn the flywheel to start sewing. I can turn the car's steering wheel in the usual hand over hand circle which makes turning easier, faster and eliminates a lot of horn honking by impatient drivers behind me. Yes, the muscles are sore and there remains a certain stiffness to many motions but things are so much better! And getting better daily.
There are a few things I can't do yet. I throw like a girl and I don't mean Mone' Davis! I open my kitchen door and toss bread crusts out for the squirrels. My brain expects them to land four feet out onto the patio. My arm propels them twelve inches from the door onto the step where no intelligent squirrel will come. There is definitely a communication gap twixt brain and arm. There is something about the shake motion that I just can't master yet. Whether it's the salt shaker or the kitchen rug, a King size sheet or a bottle of hot sauce, there's not a "whole lot of shaking going on." That motion just hurts. And I cannot pull with much force yet. A wet bath towel stuck to the wall of the washing machine turns into a real tug of war. I definitely need more strength building exercise.
But at three months post op I think I am doing quite well. If full recovery is twelve months I can't imagine how much progress I will have made. My arm looks perfectly normal, it's the same length (yes, I measured it pre and post surgery) and I'll solve that shake'n problem before long.
Maybe I just need a little inspiration:
http://youtu.be/Nh8-cclgGgw
I didn't know enough to be worried or to appreciate the serious nature of the surgery. By the next appointment Dr. Google and I had been "talking" a lot and I was full of the appropriate questions. Dr. Kai was reserved in his enthusiasm for the operation. He would not make a very good car salesman! He down played the possible positive outcome of the surgery, tried to lower my ( and maybe his) expectations. He suggested my arm might not look quite the same, might even turn out a little longer. I already have long arms and it made me wonder if I would look like an orangutan post op. He suggested a successful surgery might allow me to put a dish away on a low shelf in an upper cupboard but would not give me anywhere near the range of my left arm. He hoped it would offer some pain relief.
Well, in spite of my recent whining about sore muscles, I am getting along great! My range of motion is much greater than my therapist or I expected. At first, in order to elevate my arm, my right shoulder hitched up towards my ear. I had to concentrate pretty hard to keep it relaxed and down. It helped to do my exercises in front of a mirror. I think I have it under control now.
After more than a year of being a leftie, I now have to remind myself to let my right arm do it. I am able to sit and stay seated at my sewing machine...still adapting bras with front closures. Before I had to stand up to thread the machine or turn the flywheel to start sewing. I can turn the car's steering wheel in the usual hand over hand circle which makes turning easier, faster and eliminates a lot of horn honking by impatient drivers behind me. Yes, the muscles are sore and there remains a certain stiffness to many motions but things are so much better! And getting better daily.
There are a few things I can't do yet. I throw like a girl and I don't mean Mone' Davis! I open my kitchen door and toss bread crusts out for the squirrels. My brain expects them to land four feet out onto the patio. My arm propels them twelve inches from the door onto the step where no intelligent squirrel will come. There is definitely a communication gap twixt brain and arm. There is something about the shake motion that I just can't master yet. Whether it's the salt shaker or the kitchen rug, a King size sheet or a bottle of hot sauce, there's not a "whole lot of shaking going on." That motion just hurts. And I cannot pull with much force yet. A wet bath towel stuck to the wall of the washing machine turns into a real tug of war. I definitely need more strength building exercise.
But at three months post op I think I am doing quite well. If full recovery is twelve months I can't imagine how much progress I will have made. My arm looks perfectly normal, it's the same length (yes, I measured it pre and post surgery) and I'll solve that shake'n problem before long.
Maybe I just need a little inspiration:
http://youtu.be/Nh8-cclgGgw
Thursday, September 18, 2014
Disclaimer...PO Day 94
I would not be so vain as to worry a reader might think the author of this blog, that would be me, is an expert on any topic about which she might opine. Being opinionated does not make one smart or right or worthy of offering advice to others. My posts are simply the ramblings of a patient who is trying to share her unique experience, which may be nothing like what someone else endures. Feeble attempts to report factual information are based on my own personal, likely distorted, encounters with the world around me, internet searches usually launched in the middle of the night and brief interviews with the medical professional of the day, most especially my orthopedic surgeon.
All names have been changed to protect the good reputations of anyone I choose to mention or quote, just in case I get it all wrong. I don't "copy and paste" very much but, if I do, I try to give credit to the true author or site either by wrapping their words in quotes or by stating I am repeating information from a website. My thoughts and words are my own; Dear Husband, children, step children, siblings, near and distant relatives, friends, neighbors and frenemies are merely innocent observers and occasional reluctant subject matter.
I try to keep reported events close to the truth and not take too many literary liberties with the facts. If 'I heard it on the grapevine' I try to make plain that the story or information is at best apocryphal, if not downright false but darn interesting and too good to not include. I hope my reader finds the occasional useful bit of information, comforting words, or humorous insight I am trying to see in an otherwise serious situation.
Oh, I know many of the posts are "all about me." I'd love to talk about someone else who has had shoulder surgery but I don't know anyone else so unfortunate. I just don't know how to keep this going without personalizing the subject. And speaking of keeping this going, am I going to run out of things to say? Well, not so far. :)
http://youtu.be/Y7dGdrP3pms
Archive timeline: 2014: May and June - preparing for surgery, July - surgery and post op problems, August - recovery and physical therapy, September..
All names have been changed to protect the good reputations of anyone I choose to mention or quote, just in case I get it all wrong. I don't "copy and paste" very much but, if I do, I try to give credit to the true author or site either by wrapping their words in quotes or by stating I am repeating information from a website. My thoughts and words are my own; Dear Husband, children, step children, siblings, near and distant relatives, friends, neighbors and frenemies are merely innocent observers and occasional reluctant subject matter.
I try to keep reported events close to the truth and not take too many literary liberties with the facts. If 'I heard it on the grapevine' I try to make plain that the story or information is at best apocryphal, if not downright false but darn interesting and too good to not include. I hope my reader finds the occasional useful bit of information, comforting words, or humorous insight I am trying to see in an otherwise serious situation.
Oh, I know many of the posts are "all about me." I'd love to talk about someone else who has had shoulder surgery but I don't know anyone else so unfortunate. I just don't know how to keep this going without personalizing the subject. And speaking of keeping this going, am I going to run out of things to say? Well, not so far. :)
http://youtu.be/Y7dGdrP3pms
Archive timeline: 2014: May and June - preparing for surgery, July - surgery and post op problems, August - recovery and physical therapy, September..
Wednesday, September 17, 2014
To MRI or not to MRI...PO Day 93
If you have had an MRI before, you know about the rather long questionnaire you complete before the procedure. There are several questions about metal inside your body; clips, pacemakers, artificial joints, and possible foreign bodies embedded in eyes. I took those inqueries to mean an MRI was not a possibility if you had any of those complications.
I wasn't sorry to think I would not be enduring again that long period of holding still in a tunnel that sounded like jack hammers were beating on the exterior. I cannot understand why they offer music on the headphones...all one can hear is something akin to the base beat coming from the pulsing car in the lane next to you driven by a rockin' teen boy. I do, I'm ashamed to admit, take some small comfort in thinking the driver will most certainly be deaf by age forty.
Anyway, confident I already knew the answer, I asked Dr. Kai about MRIs at my last visit. To my amazement he said there usually was not a problem, just be sure to disclose all to the technician. In passing he added, " if the prosthetic parts in your arm start to feel hot, tell them to stop the procedure."
What? Hot! And "tell them to stop?" They are not even in the room! A few years ago I had several "medical incidents" in which I was alone with a machine and the technicians were communicating with me from an adjacent room. I could very well hear them as they talked to me and gave instructions. They always said they could hear me if I needed help. Well, the day came when I felt an urgent need to tell them the machine was not acting in its usual manner. I timidly said "hello?" No answer. I raised my voice, " HELLO?" "Something's not working right," I yelled. No one answered. By then the equipment droned to a halt, in its usual manner, and the tech came back in the little room. No one had heard me. And this equipment merely droned, there were no jack hammers loud enough to drown out a marching band!
Somehow medical science got along fine before magnetic resonance imaging. I am thinking, in the future, magnetic resonance imaging may have to get along without me!
Archive timeline: 2014: May and June - preparing for surgery, July - surgery and post op problems, August - recovery and physical therapy, September..
I wasn't sorry to think I would not be enduring again that long period of holding still in a tunnel that sounded like jack hammers were beating on the exterior. I cannot understand why they offer music on the headphones...all one can hear is something akin to the base beat coming from the pulsing car in the lane next to you driven by a rockin' teen boy. I do, I'm ashamed to admit, take some small comfort in thinking the driver will most certainly be deaf by age forty.
Anyway, confident I already knew the answer, I asked Dr. Kai about MRIs at my last visit. To my amazement he said there usually was not a problem, just be sure to disclose all to the technician. In passing he added, " if the prosthetic parts in your arm start to feel hot, tell them to stop the procedure."
What? Hot! And "tell them to stop?" They are not even in the room! A few years ago I had several "medical incidents" in which I was alone with a machine and the technicians were communicating with me from an adjacent room. I could very well hear them as they talked to me and gave instructions. They always said they could hear me if I needed help. Well, the day came when I felt an urgent need to tell them the machine was not acting in its usual manner. I timidly said "hello?" No answer. I raised my voice, " HELLO?" "Something's not working right," I yelled. No one answered. By then the equipment droned to a halt, in its usual manner, and the tech came back in the little room. No one had heard me. And this equipment merely droned, there were no jack hammers loud enough to drown out a marching band!
Somehow medical science got along fine before magnetic resonance imaging. I am thinking, in the future, magnetic resonance imaging may have to get along without me!
Archive timeline: 2014: May and June - preparing for surgery, July - surgery and post op problems, August - recovery and physical therapy, September..
Tuesday, September 16, 2014
Good report card...PO Day 92
SELFIE
9-15-14
I saw Dr Kai today and he dispelled all my fears. Before I said a word he knew where my arm hurt.
He says it comes from the surgical attaching of muscles to bone to create new methods of lifting the arm since the old ligaments are no longer functioning. Time and strengthening exercises will resolve that problem. Now that I know " the problem" there isn't one.
Continued formal physical therapy is up to me. He says just using my arm in every day life will be good therapy. If I add increasing weight barbells (from one pound to two to three) and do gentle curls I should gradually gain strength in the operated arm. Right now the pain I feel on lifting something heavier is normal and just a little warning sign to back off a bit.
What should I never do, I asked. Don't take up contact sports, he said. Probably I did not need that advice but I will keep it in mind when approached by the NFL.
I had to fill out a short questionnaire asking what I could and could not do. I suppose the information goes to some giant government computer to calculate whether or not the outcome is worth the time and money in older people. By the way, how did I get to be an older "people?"
We decided against more formal PT. I will continue my range of motion exercises and increase the strength building activities, formally and in real life. My therapist would be disappointed but, due to the recent changes in the therapy department, she has been transferred to another branch. Her absence plays a small role in my decision to not continue.
I don't return to see him again for three months. We'll be deep into winter by then. Let's hope I can manage those long sleeve t-shirts. Only 99 days until Christmas!
Archive timeline: 2014: May and June - preparing for surgery, July - surgery and post op problems, August - recovery and physical therapy, September..
Monday, September 15, 2014
Let's Make A Deal...PO Day 91
I've been watching the mail for that thick envelope that comes from my supplemental insurance carrier, the company that kicks in after Medicare has done their share. It's more curiosity than financial responsibility. I am among the fortunate segment of society that is draining the government coffers dry - or - merely collecting what the system owes me after a lifetime of paying in to it. It all depends on your point of view, I guess. Anyway, I am most fortunate to have insurance that will cover my recent surgery expenses. Not everyone does.
Medicare mandates what physicians and hospitals are allowed to collect for procedures. Private insurance companies negotiate what they will pay with hospitals, physician co-ops and participating providers. It really doesn't matter what the "bill" says, $100.00, $1000.00 or $10,000.00, some number cruncher has set a fee for service and that's what will be paid, period. This disparity does have a negative trickle down effect on the policy holder. If you are responsible for a 20% co-pay you could be billed for $20.00, $200.00 or $2000.00. It makes a difference.
It's worse if you are the hapless patient who is uninsured. This is the person who is not curious to see their statement, they are scared to death! Of course we are all expecting Obamacare to remedy this inequity but, so far, it is not working out so well. In a 2013 government study it showed that in some cases costs can drastically vary. A case in point, three hospitals in and around the Denver suburb of Aurora, Colorado charged an average of $97,214, $46,457 and $28,237, respectively, to treat a respiratory infection with complications. Was the care these patients received really that different?
Until the Affordable Health Care Act is fully implemented, what is a person to do?
Come on down!
Most large hospital systems now offer discounted prices even to uninsured patients, and many have realized it is better to send a realistic bill that has a realistic chance of being paid. Hospitals will negotiate discounts for prompt payment or commitment to a payment schedule. It is advised, however, that you not ask for a discount AFTER you have proffered any kind of credit card payment. Doctors' offices are more and more willing to discount fees to patients paying "out of pocket." However, there is a more intimate relationship with the doctor's billing clerk ( who very well might be a spouse) than an impartial hospital staffer in Accounts Receivable. The discount seeker might practice their best "garage sale" bargaining style: "I don't know if you realize it but I am totally responsible for this fee. Do you think there is any way Dr. Legree could help me out?"
Medical Billing Advocates of America have seven suggestions for negotiating lower medical bills. Here they are with my slant added.
1. Know the real or competitive cost of a procedure. Do your homework. Call nearby facilities armed with procedure and diagnosis codes. Check with websites like Healthcare Blue Book.
2. Use the right language. Be polite. Don't act offended at the size of the bill. Surprised? That's okay. Ask if there are financial assistance programs available.
3. Ask if your procedure can be done as an outpatient.
4. Be a tough negotiator. Don't take no for an answer. Go up the chain of command, at least in the hospital setting. Make notes. Know to whom you spoke. A 10 % or 20% hospital bill discount is not enough. Make an offer. Have you ever bought a used car? Deal!
5. Don't pay with a credit card. Once swiped there is very little likelihood of getting a refund. Furthermore, you will incur interest charges on unpaid balances. Most likely, if you pay the hospital over time there would be no interest charged.
6. Arrange that no interest payment plan. Pay faithfully. When you have made a good dent in the balance, approach them again. Point out how reliable you have been and ask if they might reduce or cancel the balance of the debt.
7. Call in the pros, like Medical Billing Advocates of America. For a percentage fee they will work on your behalf to lower your medical bills. The Access Project will assist you and advise you for free.
Archive timeline: 2014: May and June - preparing for surgery, July - surgery and post op problems, August - recovery and physical therapy, September...
Medicare mandates what physicians and hospitals are allowed to collect for procedures. Private insurance companies negotiate what they will pay with hospitals, physician co-ops and participating providers. It really doesn't matter what the "bill" says, $100.00, $1000.00 or $10,000.00, some number cruncher has set a fee for service and that's what will be paid, period. This disparity does have a negative trickle down effect on the policy holder. If you are responsible for a 20% co-pay you could be billed for $20.00, $200.00 or $2000.00. It makes a difference.
It's worse if you are the hapless patient who is uninsured. This is the person who is not curious to see their statement, they are scared to death! Of course we are all expecting Obamacare to remedy this inequity but, so far, it is not working out so well. In a 2013 government study it showed that in some cases costs can drastically vary. A case in point, three hospitals in and around the Denver suburb of Aurora, Colorado charged an average of $97,214, $46,457 and $28,237, respectively, to treat a respiratory infection with complications. Was the care these patients received really that different?
Until the Affordable Health Care Act is fully implemented, what is a person to do?
Come on down!
Most large hospital systems now offer discounted prices even to uninsured patients, and many have realized it is better to send a realistic bill that has a realistic chance of being paid. Hospitals will negotiate discounts for prompt payment or commitment to a payment schedule. It is advised, however, that you not ask for a discount AFTER you have proffered any kind of credit card payment. Doctors' offices are more and more willing to discount fees to patients paying "out of pocket." However, there is a more intimate relationship with the doctor's billing clerk ( who very well might be a spouse) than an impartial hospital staffer in Accounts Receivable. The discount seeker might practice their best "garage sale" bargaining style: "I don't know if you realize it but I am totally responsible for this fee. Do you think there is any way Dr. Legree could help me out?"
Medical Billing Advocates of America have seven suggestions for negotiating lower medical bills. Here they are with my slant added.
1. Know the real or competitive cost of a procedure. Do your homework. Call nearby facilities armed with procedure and diagnosis codes. Check with websites like Healthcare Blue Book.
2. Use the right language. Be polite. Don't act offended at the size of the bill. Surprised? That's okay. Ask if there are financial assistance programs available.
3. Ask if your procedure can be done as an outpatient.
4. Be a tough negotiator. Don't take no for an answer. Go up the chain of command, at least in the hospital setting. Make notes. Know to whom you spoke. A 10 % or 20% hospital bill discount is not enough. Make an offer. Have you ever bought a used car? Deal!
5. Don't pay with a credit card. Once swiped there is very little likelihood of getting a refund. Furthermore, you will incur interest charges on unpaid balances. Most likely, if you pay the hospital over time there would be no interest charged.
6. Arrange that no interest payment plan. Pay faithfully. When you have made a good dent in the balance, approach them again. Point out how reliable you have been and ask if they might reduce or cancel the balance of the debt.
7. Call in the pros, like Medical Billing Advocates of America. For a percentage fee they will work on your behalf to lower your medical bills. The Access Project will assist you and advise you for free.
Archive timeline: 2014: May and June - preparing for surgery, July - surgery and post op problems, August - recovery and physical therapy, September...
Sunday, September 14, 2014
Physical Therapy at 12 weeks...PO Day 90
Tomorrow is the day I return to see my surgeon. It's my three month check up which turns out to be almost 13 weeks or 90 days. My last physical therapy session was two weeks ago. The facility has not heard back yet whether I will continue therapy or not. I assume Dr. Kai is waiting to discuss the subject with me.
I don't necessarily need more hands on therapy but I do need some guidance. In addition to the exercises of the first six weeks, I have more range of motion exercises and a couple strength building exercises. I feel like I really need the strength building exercises. Naturally, those are the very ones that seem to make my arm hurt the most. Can I increase ( from one pound to two pounds! ) the size weight I use for curls? Can I tote heavier burdens, an armload of laundry or a gallon of milk? And am I still restricted from using that arm as a support in bed or getting up from the sofa?
So here I am, a little more than 12 weeks post op. In addition to my assigned PT exercises at the six week period (see August: PO Day 51 for a list) I am now doing the following:
ROM exercise: Supine flexion with wand, 2 sets of ten.
ROM exercise: standing flexion with wand, 1 set of ten.
ROM exercise: standing abduction with wand, in the diagonal plane, with wand, 1 set of ten.
ROM exercise: external / internal rotation with wand, 1 set of ten.
Strengthening: resisted external rotation with bands, 1 set of ten.
Strengthening: resisted internal rotation with bands, 2 sets of ten
If you google these, "supine flexion with wand" for instance, you will pull up photos showing the proper way to do each exercise.
Or try this link and search for each exercise:
http://physicaltherapy.about.com/od/strengtheningexercises/ss/Resistance-band-rotator-cuff-strength_2.htm
Again, I am only listing these to say what I am doing, NOT what you should do. Please consult your doctor or therapist for advice. Every situation is different.
I don't necessarily need more hands on therapy but I do need some guidance. In addition to the exercises of the first six weeks, I have more range of motion exercises and a couple strength building exercises. I feel like I really need the strength building exercises. Naturally, those are the very ones that seem to make my arm hurt the most. Can I increase ( from one pound to two pounds! ) the size weight I use for curls? Can I tote heavier burdens, an armload of laundry or a gallon of milk? And am I still restricted from using that arm as a support in bed or getting up from the sofa?
So here I am, a little more than 12 weeks post op. In addition to my assigned PT exercises at the six week period (see August: PO Day 51 for a list) I am now doing the following:
ROM exercise: Supine flexion with wand, 2 sets of ten.
ROM exercise: standing flexion with wand, 1 set of ten.
ROM exercise: standing abduction with wand, in the diagonal plane, with wand, 1 set of ten.
ROM exercise: external / internal rotation with wand, 1 set of ten.
Strengthening: resisted external rotation with bands, 1 set of ten.
Strengthening: resisted internal rotation with bands, 2 sets of ten
If you google these, "supine flexion with wand" for instance, you will pull up photos showing the proper way to do each exercise.
Or try this link and search for each exercise:
http://physicaltherapy.about.com/od/strengtheningexercises/ss/Resistance-band-rotator-cuff-strength_2.htm
Again, I am only listing these to say what I am doing, NOT what you should do. Please consult your doctor or therapist for advice. Every situation is different.
Saturday, September 13, 2014
Problems I can't solve...PO Day 89
Every once in a while a glitch shows up in one of my posts. I'm not just ignoring it, I can't figure out how to fix it! The blog program is great but one has to figure out how a lot of things work on your own. That is so true of many of the modern tech devices these days...seems to me. I just bought a new, cheap, simple cell phone. The booklet has one page with a schematic, no other directions like how to save and name a contact. I guess the assumption is that by now we all know how to do something so basic.
Dear husband's foot brace came with an instruction book. It looks quite huge until you realize that the directions are written in ten different languages. "How to put it on" is actually a small part of one page, all pictures. My kingdom for written instructions!
When I started my blog I did not know I would have the reverse Total Shoulder Replacement procedure. I would LOVE to add the word reverse to the title of my blog. Can't figure out how. I can edit most everything else but not that.
Sometimes, for no apparent reason, a paragraph break will show up in the post that wasn't there in the draft. Posts can be edited after posting and I have to do it all the time. Somehow a misspelled word or a scrambled thought only becomes obvious after publishing. No problem. But trying to correct those paragraph errors can cause whole sections to disappear. Better to leave them alone!
I wish I could blame the blog program for my comma catastrophes but that is all my fault. Some of my run-on sentences demand four or five commas, while others could benefit from a simple period. "For lunch I like ham and cheese and peanut butter and jelly sandwiches." Wow, that's quite a combo or did I mean, "for lunch, I like ham and cheese, and peanut butter and jelly sandwiches"? And what if I do like that unusual combo? Is it ham, cheese, peanut butter and jelly or am I a fan of the oxford comma and write ham, cheese, peanut butter, and jelly?
In this day of text messages and tweeting, I don't think there are too many people who notice or care!
Archive timeline: 2014: May and June - preparing for surgery, July - surgery and post op problems, August - recovery and physical therapy, September....
Dear husband's foot brace came with an instruction book. It looks quite huge until you realize that the directions are written in ten different languages. "How to put it on" is actually a small part of one page, all pictures. My kingdom for written instructions!
When I started my blog I did not know I would have the reverse Total Shoulder Replacement procedure. I would LOVE to add the word reverse to the title of my blog. Can't figure out how. I can edit most everything else but not that.
Sometimes, for no apparent reason, a paragraph break will show up in the post that wasn't there in the draft. Posts can be edited after posting and I have to do it all the time. Somehow a misspelled word or a scrambled thought only becomes obvious after publishing. No problem. But trying to correct those paragraph errors can cause whole sections to disappear. Better to leave them alone!
I wish I could blame the blog program for my comma catastrophes but that is all my fault. Some of my run-on sentences demand four or five commas, while others could benefit from a simple period. "For lunch I like ham and cheese and peanut butter and jelly sandwiches." Wow, that's quite a combo or did I mean, "for lunch, I like ham and cheese, and peanut butter and jelly sandwiches"? And what if I do like that unusual combo? Is it ham, cheese, peanut butter and jelly or am I a fan of the oxford comma and write ham, cheese, peanut butter, and jelly?
In this day of text messages and tweeting, I don't think there are too many people who notice or care!
Archive timeline: 2014: May and June - preparing for surgery, July - surgery and post op problems, August - recovery and physical therapy, September....
Friday, September 12, 2014
Sharing is a Good Thing...PO Day 88
Was it just a coincidence or divine intervention that a friend called that same evening? A week before my rTSR surgery in June, she underwent rotator cuff surgery to repair damage due to a fall. Our recovery has followed a similar course and it sounds as if our physical therapy exercises are creating the same sore muscles. She has the same pain I am experiencing and, since she does not have the same artificial parts that I am so worried about, I have had to entertain the possibility my imagination is working overtime.
This simple shift in perspective has had an amazing effect on my reality. Suddenly I am much more comfortable and the "snap, crackle, pop" sensations that frequently alarmed me have disappeared. I am back to doing some of my more aggressive stretches resulting in noticeable improvement in range of motion. Is the "power of positive thinking" that powerful? Most likely it is the power of being able to share one's fears with a kindred spirit and find reassurance in their experience.
I hope there is someone "out there" who is finding this same comfort as they follow my blog. If nothing else, we all know "misery loves company."
Archive timeline: 2014: May and June - preparing for surgery, July - surgery and post op problems, August - recovery and physical therapy, September...
Thursday, September 11, 2014
100 Beats per Minute...PO Day 87
If you haven't taken a Red Cross course in the last ten years you may not know how the American Heart Association now recommends non-professionals administer CPR. The lay person who happens on a victim who is not breathing is supposed to 1. Stop and call 911, 2. Verify the victim is not breathing and has no pulse, and 3. Focus on strong chest compressions only at the rate of 100 beats per minute. But when it comes to pushing on the chest, just remember push hard and often. CPR experts said do not stop compressions even if you sense the victim's ribs are breaking. They can heal easily after your victim regains a heart beat. The main concern is getting the heart to resume beating. A spokesman for the AHA pointed out that, even if you are not trained in CPR, doing nothing is not an option. You cannot make things worse for the victim who is not breathing and has no pulse.
Sudden cardiac arrest is the leading cause of death in the U.S., with nearly 300,000 out-of-hospital cases reported annually. Nearly 80% of sudden cardiac events occur in the home. You may be the only chance your victim has.
According to a University of Hawaii biography, "Dr. Alson Inaba attended Tufts University School of Medicine, followed by a residency in pediatrics and pediatric emergency medicine fellowship at Oakland Children's Hospital. He is an attending physician in the emergency department at KMCWC, and was recently selected to the AHA National Emergency Cardiovascular Care Program Administrative Subcommittee to oversee all the BLS, PALS and ACLS programs in the United States. He was also appointed to serve as the subcommittee's liaison to the National Subcommittee on Pediatric Resuscitation."
Sudden cardiac arrest is the leading cause of death in the U.S., with nearly 300,000 out-of-hospital cases reported annually. Nearly 80% of sudden cardiac events occur in the home. You may be the only chance your victim has.
According to a University of Hawaii biography, "Dr. Alson Inaba attended Tufts University School of Medicine, followed by a residency in pediatrics and pediatric emergency medicine fellowship at Oakland Children's Hospital. He is an attending physician in the emergency department at KMCWC, and was recently selected to the AHA National Emergency Cardiovascular Care Program Administrative Subcommittee to oversee all the BLS, PALS and ACLS programs in the United States. He was also appointed to serve as the subcommittee's liaison to the National Subcommittee on Pediatric Resuscitation."
But his claim to fame came in 2005 when he was working with a group of medical students practicing the proper method of CPR. As a teaching tool they made a humorous video showing CPR administered to the tune Staying Alive by the Bee Gees. By chance or mystical medical inspiration the iconic disco song exactly fits the rapid beats per minute protocol for today's fast paced CPR. The near-perfect 103 beat per minute cadence gets stuck in your head and has turned out to be the ideal rhythm as a teaching tool for CPR instructors. Inaba's musical technique has spread around the world. The American Heart Association has created an educational video featuring actor and medical doctor Ken Jeong and fire departments all over the country have followed suit with their own versions of Staying Alive.
One of Dr. Inaba's residents pointed out that Queen's Another One Bites The Dust has the same requisite 103 beats per minute but, for some reason, does not seem as inspiring.
We get to see just how courageous these Chattanooga firemen are in their public service video...
http://youtu.be/GMssc_c4pK8
One of Dr. Inaba's residents pointed out that Queen's Another One Bites The Dust has the same requisite 103 beats per minute but, for some reason, does not seem as inspiring.
We get to see just how courageous these Chattanooga firemen are in their public service video...
http://youtu.be/GMssc_c4pK8
Archive timeline: 2014: May and June - preparing for surgery, July - surgery and post op problems, August - recovery and physical therapy, September...
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