PS to PODay 168

Does anyone use the post script anymore? Probably not, since everything can be edited on the computer nowadays. But I am a traditionalist. So...

PS. My hair is STILL falling out! I don't think it has slowed at all. Not handfuls but a steady sprinkling of short curly hairs on the iPad screen or the vanity. Will it ever stop?

November Addendum...PODay 168

At five and a half months I am getting along fine. The appearance of the scar is great. At the mid point of the length of the scar there is a point, a spot that is almost electric in its sensation when I massage it. But the scar looks as good as one could hope and no complaint.

The arm, shoulder is marvelous in its function. It has nearly the function of the other arm. I still lack good strength on the right side but that will come. I am not doing much physical therapy but I use my arm in every normal manner now. I do still stretch it, especially on awakening. That 's when it often feels tight.

I cannot move my arm back, like position my elbow behind the plane of my back. That's when the deltoid attachment really makes a fuss, a pain that tells me to not do that. This is why dressing can still be a bit if a problem but I am getting better. I do plan to discuss this with the doctor in mid December.

I am waiting till I see the surgeon in mid December before I get into lifting anything too heavy. I want to kayak but that involves moving them from the shed to the water so need to wait to see what the doctor says. My next appointment I will be six months post op so surely I will be ready for anything.

My sleeping is terrible. Part of it is due to trying to find a comfortable position for my arm. Why do things bother you in the nught when they don't in the daytime? But then, I am not lying down in bed in the daytime. I know I would still sleep better in a recliner or on the couch but I am trying to break the habit.

There are occasional things that are difficult or impossible but mostly I can do anything I want now. If I can get back to carrying a gallon of milk, even tipping it to pour a glass, I will be happy.

I definitely baby that arm. I want this shoulder to last a long time so try not to stress it. I really don't know how careful I need to be. I need to discuss that with the doctor too. Better make a list!

I think I am mostly recovered from the pneumothorax. I am back to walking two to three miles. I do get very slightly out of breath but very much improved. I see the pulmonologist in January so we'll see what he thinks. Anemia is no longer an issue. Hooray, I hated the iron supplements. I would say life is pretty much normal again although it seems I do still have too many doctor appointments. If I could drop one more specialist from the team I'd be pleased. But I should not complain. I am so fortunate to have such good medical care.




Archive timeline: 2014: May and June - preparing for surgery, July - surgery and post op problems, 
August - recovery and physical therapy, September - thinking medically, October - getting back to 
normal. November. - still recovering.

Surgery not indicated?...PODay 167

I have read that if you have a full thickness tear of of the rotator cuff you can only be helped by surgery.

But in a study of 93 patients with documented rotator cuff tears symptomatic at least three months there were some interesting findings.

The patients age averaged 60 years old and 42% were female. Half of the patients suffered a traumatic incident to cause the tear.

The patients were given three months of treatment involving stretch exercises, followed by strength exercises. The treatment was considered successful if, after the three months, the patient and their doctor agreed that there was considerable improvement and that surgery was not indicated since the patient was mostly asymptomatic. A failure was declared if the patient remained symptomatic and still opted for surgery.

The study found that 75% of the patients were deemed a success based on their assessment of their situation. After two years 89% of the 75% maintained their immediate post treatment status.

Since the tears were chronic small tears the authors of the study thought there was little harm in trying the exercise program and delaying surgery.

As my surgeon told me, there is no need to rush to a decision. In my case, waiting would not make things worse. But I opted for surgery since I had already waited a year from my accident, I had had physical therapy without improvement, and torn ligaments were not my only problem. So I am not second guessing my decision. Just find this new study interesting. It would be nice to see the study repeated with more patients.

Equal Tiime...P O Day 166

Well, now that I've started down memory lane I have to give equal time to Dear Son.

His job has taken him away from home and family for the first time since he went away to college. 

Oh sure, he has been on business trips, stuff like that, but now he has taken a permanent transfer and he has gone ahead alone to find a house and get settled before his family joins him when the school semester ends. So we were talking this morning and reminiscing about his first thanksgiving away from home when he was in college.

He collected a contingent of other "lost boys" and a few girls who couldn't go home for the holiday. His over ambitious plan was to cook a turkey. Now I was not a modern mother. For whatever reason, good or bad, I did not teach my son to cook. He was the child who would stand in front of a full refrigerator and announce "there is nothing in this house to eat!" I knew when I was defeated.

But he embraced the idea of cooking for his new friends, even a new girlfriend who became a wife. (I bet she saw the turkey project as a sign he would be a help in the kitchen later on...boy, was that wrong!) Anyway, there were a few consulting phone calls the day before...how to defrost it, what kind of pan to use, things like that. But things got serious Thanksgiving morning and the phone calls became more frequent and a little more urgent. By noon I was answering the phone "Turkey Hot Line." And this was before caller ID.

I asked him this morning how that particular first Thanksgiving turkey turned out. True or not, he remembers it as the best turkey he has ever had. And I look back at those phone calls as one of the last times he really needed and sought  my advice. I'm just awfully glad things turned out so well.

We did a good job.

The holiday is here...PODay 165

I know it's Thanksgiving. I got "the" phone call.

We have a family recipe for a sweet potato dish. It doesn't really originate in our family. I got it from a co-worker about thirty years ago. It's half way between a vegetable side dish and a sumptuous dessert but we count it as a veggie. There are similar recipes on the web but nothing quite the same and definitely nothing as easy. It's a melange of sweet potato, pecans and lots of sugar.

This dish has been part of Dear Daughter's thanksgiving dinner since she was about ten years old. (You can do the math.) In the beginning she merely ate the dish, for many years she helped prepare it, and since marrying and moving to California, she is responsible for getting it on the table for her own family. I have told her the recipe in person and on the phone, I've written it down on a special recipe card and given it to her, I've emailed it in text form and more recently from my official recipe program. But every year, a day or two before Thanksgiving, the phone rings. Sometimes she is calling from work and will stop at the store on her way home. Often, thanks to tne miracle of cell phones, she is in the grocery store buying cranberry sauce and apple pie ingredients. Once in a while she is at home, making a list and checking it twice.

But always,  she is calling for "the" recipe. She doesn't even have to ask, I can tell by the slightly embarrassed pause why she is calling. Being a mom, I have to fuss a little and remind her that I sent her the recipe last year (and every year for at least ten before that). This year, feeling somewhat more fragile after everything that has happened in the last six months, I had to point out that I might not always be "here" to share the recipe. We had a good laugh about the possibility of her being able to reach me via a seance should the need arise...when the need arises, I should say.

But pulling out my Mom's psychiatric license, I've decided it's not as simple as a lost slip of paper. We play a sweet mother-daughter game every Thanksgiving. The recipe is a connection, a way for her to say I still need you and for me to be there to save the day once more. We aren't  together for Thanksgiving but there is something we share through the years and the miles, something more than a family recipe.

Serious stuff again...PODay 164

In spite of all the security problems with electronic health records and the known breaches in the systems, sharing our medical information is a way we can contribute to medical advances. Anonymous collection of data on such mundane medical interactions as your well patient check up can translate to real advances in medical treatment for all of us.

An online website for people with chronic conditions, PATIENTS LIKE ME, has begun a social media campaign for sharing information about your disease, its treatment and your progress. The goal is to build a data base of personal histories that will lead to better treatment for everyone. If participation is anonymous, it seems like a very good idea. Patient and physician stand to learn a lot from members.

Of course, everyone from government administrators to medical professionals to ordinary patients worry about the apparent proliferation of security breaches since the advent of the electronic health record system. The "stealing"of information has graduated from computer hacking from remote locations to a recent episode where a hospital employee was physically coerced into providing passwords for stolen computer equipment so the criminal could have access to personal patient data.

Department of Veterans Affairs Chief Information Officer Stephen Warren stressed that, while security breaches were a constant concern, we cannot let them thwart the drive to provide better medical decisions, gain new insights, new discoveries and better health for everyone through data collection.

If the data can be compiled anonymously, it appears safe. The problem arises when our personal information comes along with it. Just like here, I can pour my heart out to total strangers under the pseudonym Willet. But the day my Willet identity accidentally was replaced with my real name I was panic stricken until I got my nom de plume back. It's not that I don't love you all, I just don't want you knocking on my door!

Too cautious? ...PODay 163

I went shopping today and for the first time in a long time I tried things on. I've been taking a chance and buying things after just holding them up to me. Why? Because I still can get stuck! I can ease my right arm, the operated side, into a sleeve, no problem. But getting my left arm into the armhole usually ends up with the sleeve stuck at about the elbow. With a lot of struggle I might get the top to finally inch up and squirm into place but getting it off is even more difficult. I can't do that shoulder shrug thing that drops the shoulder of the shirt or jacket off your shoulders. If I finally get the shirt or jacket  to drop off my shoulders I'm kind of stuck. It's like a three stooges comedy where someone has pulled Moe's jacket down off his shoulders so his arms are pinned down and they can knock him  on the noggin. Don't even talk about zipping up a dress. I might get the zipper part way up but down...no way.

So my worry has been I will get stuck half in or half out of an article of clothing and have to call for help. Good grief, I might have to buy something just because I couldn't get it off.  Poor Dear Husband hears me calling for help at home frequently. I don't know what you would do if you lived alone. But today I made a little progress. I am getting more brave about slipping my right arm behind my back. It doesn't hurt to reach behind with it really. I just need some reassurance that the joint is settled in with enough tissue ingrowth that it will not dislocate. I was cleaning out a closet the other day and was sitting on the floor. I just had to use my right arm to get up and amazingly, it did not fall off or collapse when I put quite a bit of weight on it..

I honestly think I have been too cautious. I read too much on the Internet about all the things that can go wrong. Most of the warnings have come from the Internet, my doctor has not had a lot to say about do's and don'ts. The physical therapist was very careful in her admonitions of what I could not
do and I have largely followed her lead. Would I have done just as well, or better!, if I had thrown caution to the wind? Of course there was some restriction due to pain or just plain inability to move my arm in certain positions. But especially now, many restrictions are self imposed.

So I am ready to take some chances. It's been five months and I am ready to take charge. I am definitely able to raise and stretch and use my arm increasingly well. It's time to take it up a notch. Surely dressing without assistance is a reasonable goal.

By the way, I bought a really cute brown blouse today and it wasn't because I couldn't get it off!