Tuesday, February 19, 2013

a week of house arrest - one for my med school friends

Well, as usual, I am not very good at updating my blog.  I always think I'll be better, but you know what they say about good intentions....

So, I actually have something semi-interesting to say in this post.  Or at least something to say to people when they ask, "So, what have you been up to lately?"  The answer this time is, "I just has shoulder surgery."

Over Christmas I dislocated my shoulder twice in one day.  I had to go to the ER.  There was a pretty cool doctor there who was able to get it back in without having to sedate me.  I thought it was an extremely interesting process.  A very good skill to have as an ER doc.  (I was especially grateful the second time I was there when he just called me back to the admitting room and put it back again without me having to wait again.)

So, when I got back to Virginia (the dislocating happened in Pennsylvania) I went to the doctor and got an MRI where they discovered that due to the many times my shoulder popped in and out of joint (sometimes with a complete dislocation, but many more times with something called a subluxation, which is basically a partial dislocation) I had sustained a lot of bone loss.  In my mind, that meant that there were tiny fragments of bone floating around in my shoulder, but it turns out that is not the case.  Really what happens is that due to the force of the dislocation, the bone kind of gets smashed down, if that makes any kind of sense.  Aaaaanyway, due to the bone damage, my doctor recommended surgery to try to tighten things up in my shoulder to bring stability so that I wouldn't have to have a much more intense bone reconstruction surgery.

On February 11, I headed to the National Harbor Surgery Center for arthroscopic surgery.  That is some very cool surgery.  My surgeon just did three little cuts - two in the front and one in the back - each about a centimeter long.  He originally intended on just doing one in the front, but once he got in there, he found that there was more bone damage than he had thought from the MRI, so he wanted to tighten things up more.  Pretty much if I have even one more dislocation or subluxation, I'm done - I will have no choice but to have the bone reconstruction surgery.  (So, obviously I'm being extra careful in the recovery stage.)

There were some kind of cool things about the surgery.  First, the hospital gown.  It had a connection that could be hooked up to a plug type thing in every room in the surgery center that heated it.  It was super nice after the surgery to be nice and toasty in my gown.  I would not object to having one of these in my home. Then, during the surgery I actually woke up twice.  It wasn't a big deal because they had put something called a nerve block on my arm so I actually couldn't feel anything for about 12 hours.  But it was weird opening my eyes (I was lying on my side) and seeing the anesthesiologist.  He just asked me if I was awake and I think I said yes and he put me back under.  And finally, what you've been waiting for - the pictures.  They take pictures every step of the way, apparently.

Here are some pictures of the bone loss - the pen mark is where the bone should be.

 And here's a stitch that the surgeon put tightening the ligaments.  (There are apparently 4 stitches on the inside of my body right now.)



Well, hopefully this will stabilize my shoulder so that it will no longer dislocate.  I had to take a week off work to recover.  My kind mother come down from Pennsylvania to take my to the surgery and take care of me for the first couple days.  After that I was just kind of stuck around the apartment because I wasn't allowed to drive.  But I did watch the first four seasons of Castle in that week.  And now I have to wear a sling for 6 weeks.  I can take it off to drive and work as long as I am very very careful.  Under no circumstances am I allowed to lift my left arm via the shoulder at all.  This makes it more difficult to do things I have always taken for granted, like dressing myself and washing my hair.  And I still haven't found a way to put my hair in a ponytail or put on eye-liner using just one hand.  (If you have any ideas, let me know.)  I start physical therapy next week and I will have to do it for about 6 months.  Then hopefully I will be back to regular people shoulder use again.  I will lose some of my range of motion, but as I'm not a world class baseball pitcher, the stability will be a nice trade off.  All of this will make my upcoming trip to New Zealand interesting, but hopefully this will all be worth it in the end.

And for anyone interested in seeing all my surgery pictures....