A word of gratitude

Today I had my last appointment with my surgeon. He is a great physician who has been working with the Great Physician to accomplish my healing.

Today also, I was looking through the nice cards people sent me as I was going through post surgery recovery (pain, therapy, etc.). It reminded me of all of the folks who have prayed for me and encouraged me.

I want to take this opportunity to say a very special, Thank You! to all of you. I appreciated very much your kindnesses toward me, and I would feel ungrateful if I did not express to you my thanks for your thoughtfulness and prayers for me.

I can do all things through Christ who strengthens me. – Philippians 4:13

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Good News!

Praise God, from whom all blessings flow;
Praise Him, all creatures here below;
Praise Him above, ye heav’nly host;
Praise Father, Son, and Holy Ghost!

Today I met with my surgeon to review the results of the MRI I had on Monday. The MRI was ordered because I wasn’t making good progress in my therapy. The surgeon  suspected that it might have been damaged early on (right after surgery) by active range of motion exercises that the attending anesthesiologist had recommended to me while I was in recovery from surgery.

The doctor said that there was no indication of a re-tear. He said that it is likely taking longer to heal because of the unusual “L” shaped tear. He asked me whether I thought that the therapy was helping much at this stage. I told him that I am pretty much a self-guided patient and that the therapist is only spending about 10 minutes with me. He said that I could suspend the formal therapy and just work on the exercises at home, but he warned me not to do anything too crazy in my effort to recover. He said that I will still have some issues with pain, but that it should continue to diminish gradually.

I asked him whether the surgery was successful. He said “absolutely.” He told me that it may not function like a 20 year old’s would, but that he felt that I would have pretty much a full range of motion when it was completely healed. Complete healing can take as much as two years. I have felt that it took that long for my other shoulder to completely heal, and so I expect this one will be the same or longer because this one was a larger and unusual tear.

The good news is that I have NOT re-torn the tear! The surgeon told me that if it had re-torn, there would not have been much he could have done to fix it. That would have been a painful and depressing DISASTER with bad options or no options.

When I left his office, I was exceedingly glad! Pattie and I went out for a delicious breakfast at Waffle House to celebrate. I am very relieved to know that I did not ruin the surgery by following the bad advice from the now fired anesthesiologist.

Thank you for all of those who have been praying for my situation. For all I know, it may have been re-torn, but God fixed it because of all the prayers!

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MRI’s and Claustrophobia

On Monday, I had my MRI along with three x-rays. Because I’ve had MRI’s previously, I took a Valium so that I could stay in the tube while the MRI was performed. I have a problem with claustrophobia and get very anxious while in the tube. It may be because several years ago, I was locked in a car trunk in the winter time, when doors and windows are closed. I had been working on the trunk lid when I accidentally released the tension and the lid slammed shut.

While I was in the trunk, it was of course dark, and I couldn’t see to be able to open the latch. I began to wonder whether I would have enough oxygen to keep breathing, so I punched a hole up into the back window area where there was a cutout for a speaker.

My wife was inside running the sweeper, and I knew she might not even think about me for a long time, since I’m often working in the garage. I finally got her attention by rythmatically tapping on the side of the car with a screwdriver. She heard my taping and wondered what was going on. She opened the door and called out my name. I yelled to her that I was locked in the trunk. Since that incident, I’ve always had a hard time being in confined spaces – and the MRI tube is a confined space.

It is not only confined, but they strapped me onto the platform like a mummy, so I couldn’t move. This makes me even more anxious. Finally, after reciting the 23rd Psalm and several other Scriptures that I have memorized, I was able to settle down, but it took a few minutes and the complete MRI took about 35 minutes in total.

Once situated on the platform, strapped in and given ear plugs, the nurse placed a bulb type object in my hand and told me to squeeze that if I had any problems. She then left the room and entered the control area where she had a window to observe me. It was completely quiet except for the sound of ticking coming from this huge machine behind me. Without notice, the platform began moving me into the tube. Then it stopped (I’ve got my eyes closed).

Several seconds pass and then a series of loud electronic pulses begin. The pulses continue for a period of time and then stop. Then a new set of pulses begin that sound different than the previous ones. That will go on for a while and then stop with a new, different sounding set to follow it. You must not move or exit the tube during this time or the whole process has to be started again.

On one of my previous MRI’s, I signaled for the attendant to let me come out for a while because I was becoming very anxious. She told me “Oh no, sir. If I let you come out, we’ll have to start all over again. See if you can hang in there for a few more minutes.”

At this particular MRI facility, they had headphones for you to listen to the music of your choice (which was better), plus there was two way communication to talk to the attendant if there was any problem  (without the little squeeze ball). After this one was completed, the nurse told me that if I ever had to have another MRI, it would be a good idea to take a Valium before coming for my appointment. That is why I asked my doctor for a script for one this time around (which didn’t start working until several minutes into the tube).

So, I survived this procedure🙂, and the results will be sent to a radiologist to be analyzed and then forwarded to my surgeon. On Friday, I will meet with my surgeon to discuss the findings of the imaging.

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MRI ordered

Today I had my monthly appointment with my surgeon. After evaluating my shoulder and reading the report from my therapist, he has ordered an MRI to discover whether I might have re-torn my rotator cuff after surgery.

I mentioned to him what the anesthesiologist had said after surgery, and about my almost having had to visit the emergency room after following his bad advice. He told me that that anesthesiologist was dismissed some time ago. He also told me that he did confront him about his advice to me. He said that he did not believe that what I did upon his advice would have caused me to re-tear the repair.

The doctor also said that because my tear was an irregular tear, it may take longer to heal completely. He said that he was hopeful that the MRI would reveal what is going on inside my shoulder. He would then know how to proceed.

Today during my therapy session, I asked Jason what he thought the doctor would have to say about my progress. He said that he believed the doctor would order an MRI.

I am very glad that the MRI has been ordered. This may put an end to the speculation about whether it has been re-torn, or whether it is just taking longer to heal. So, today was an answer to prayer for me.

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What I have learned

Last year when I made my decision to have my left shoulder operated on, I assumed that it would go pretty much like my right shoulder surgery. I knew that it would be hard, but I assumed that, just like I go through it with the last surgery, so I’ll get through this one as well.

Today, I asked Jason (my therapist) to give me an estimate of where we are as far as getting to the finish line. I told him that I have another appointment next week with my surgeon, and I wanted to know what he would tell my surgeon if he asked for a percent of completion of recovery. Jason told me that he would estimate that I am 50% of the way.

I then asked him to compare this surgery with my last one (in 2012). He said that at this time with my last surgery, I would have been about 75% of the way toward full recovery.

He also told me that he fully expected my surgeon to order another MRI to see if my rotator cuff got re-torn after surgery. He said regardless of the report he sends to my surgeon, he believed that I would have to have another MRI to see if something happened to the repair.

At this time, I am remembering something a physical therapist told me back in the year 2000, when it was thought that therapy could possibly help my shoulder problem without surgery. This is always the first thing to try unless one knows for sure if their rotator cuff is torn.

I first asked the therapist when one knows when it’s time for surgery. She answered that it was time for surgery when you cannot bear the pain any longer. I then asked her whether she knew of any patients who were worse off after surgery. She responded by first looking both ways, and then looking me straight in the eye and telling “Oh yes, and if you tell anybody I told you that, I’ll tell them you were lying.”

My hope and prayer is that this is just taking longer to heal than my last shoulder surgery. It was a larger tear and it was an “L” shaped tear, which is a little more tricky to repair. It took two hours, instead of the one hour for which it was scheduled. I did not anticipate any complications in this surgery, but I have learned that you can’t assume anything. I will get through this, and God will give me grace to persevere. At this point, I am planning for the worst, and hoping for the best.

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A Somber Recollection

On Wednesday (1/6/15), at the very beginning of my appointment with my surgeon, he mentioned that I may have damaged the surgical repair. He said this because he was concerned that I am still having pain in my shoulder. I answered that I could not remember a time when I might have damaged it.

But tonight, as I had the need to take pain medication, my wife reminded me of something that may indeed have caused my surgery to be damaged.

On the day of my surgery, when I woke up in the recovery room, I was surprised to find myself in level 10 pain. I was surprised because, on my previous shoulder surgery, I had been given a pain block, and never experienced any substantial pain until 12 hours later. But today, I was moaning and crying, and writhing in pain. The attending nurse kept asking me what my pain level was.

There should have been no question in anybody’s mind about that. Anybody who works in this field is familiar with the “Pain Level Faces” chart, and would not have had a problem diagnosing my pain level. She also kept asking me if I wanted my wife to be brought into the room.

Even though I was in intense pain, I was still able to have the presence of mind to realize that my wife’s coming back to see me isn’t going to help much, so I told her “No.” Later, she would ask me again if I wanted my wife to come back there.

At that point, I was bewildered why she would keep asking me this, and as I was still agonizing in pain, I told her that I didn’t care if she came back or not, I just needed my pain to stop. At that, she brought Pattie in to see my pitiful condition.

While this was playing out, the anesthesiologist was trying to get my pain under control by injecting a drug into my IV. He tried the first injection and waited a while to see if if would relieve my pain. It didn’t.

He then told me that he was going to inject the strongest possible pain killer that he had at his disposal. He said that after he administered this drug, he would be able to smash me in the knee cap with a sledge hammer, and I wouldn’t feel it.

Once the drug began to work, I was able to calm down. At this point, this doctor began advising me that I should begin moving my shoulder as soon as possible. As a patient who had already had this surgery before, I was quite surprised to be receiving this advice. I questioned him on how I should go about moving my shoulder.

While he was instructing me on how to do these shoulder exercises – as soon as the very next day, Pattie remembers the nurse shaking her head indicating that she was not in agreement with his advice. At the time, I remember thinking that it was odd for an anesthesiologist to be giving advice like this to a shoulder patient.

But, nevertheless I figured that he worked for a lot of surgeons, and he knew what he was talking about. So, on the very next day, I began moving my shoulder, as I was instructed by this doctor. At the time, it didn’t hurt, and so everything seemed alright.

That evening, I was in intense pain, and even the strong pain medication I was given would not relieve it at all. I ended up calling the anesthesiologist who advised me to call the on-call surgeon to find out what I should do, because the pain was intolerable.

He at first told me that I should just go in to the emergency room. I was quite surprised with that option, and asked him if there was not some other kind of pain medication he could call in for me. He explained that under new laws, they are not allowed to call in prescriptions for narcotics, and so that option was out.

During the course of our conversation, he discovered that I had a couple of pain medications that, when used together, might be able to give me relief. I took the pills as advised, and I got some relief.

As this occurred on a Friday night, I had to wait until Monday to get an emergency appointment with my surgeon to tell him what had been going on since my surgery.

During the course of our conversation, I mentioned that I had begun moving my shoulder as I was advised by the anesthesiologist. The doctor was noticeably shocked to hear that I was given that advice. He told me that I should never have moved my shoulder at all, and furthermore that that was the very reason that I was put into a sling immediately after my surgery.

I told my surgeon that he needs to get with the anesthesiologist, and inform him that he is not to be advising his patients to do what they should NOT do. He told me that he would have a talk with him. He was upset at the time, and I could tell.

Fast forward now to my appointment yesterday. Before the surgeon came into see me, he always has an assistant nurse come in and interview me about my progress. She asked me how my pain was. She knew that I have been calling in prescriptions regularly. I told her that I still have pain. She seemed kind of surprised about that, and told me that the doctor would be in shortly.

As soon as the doctor came in, he told me that my repair may have been damaged. When I told him that I could only think of one time when I might have injured it, he asked me what I did. I told him what it was, and he said that that wouldn’t have caused it, because the incident was a couple of weeks ago, when sufficient scar tissue would have been laid down to prevent the injury at that point.

He then said that I may not even remember when I did it. BUT, and here’s the thing – HE REMEMBERED THE INCIDENT WITH THE ADVISING ANESTHESIOLOGIST telling me to begin moving my shoulder as soon as the very next day. He also remembers my unscheduled appointment right after surgery for what was unusual pain. He remembers me telling him that I was doing the little exercises that the anesthesiologist recommended. He is a very smart man with a very good brain, and he remembers everything – even things that, until tonight, I had forgotten about until being reminded by my wife.

As Pattie and I talked about all this, I began to worry that my shoulder could have been damaged the day after my surgery because of a talkative anesthesiologist who was dispensing BAD advice to a shoulder patient against the very wishes of the orthopedic surgeon who performed the surgery.

I cannot even fathom how I will feel if, next month when I go in for another surgeon appointment, he tells me that he wants to do an MRI to see if the surgery was damaged.

I cannot even imagine having to go through all of this again, because I was given bad advice by someone who should not have even been giving advice outside his field of expertise and against the wishes of the attending orthopedic surgeon.

In fact, at this point, I may request an MRI, just to have the piece of mind of knowing that my repair wasn’t ruined the day after my surgery because of bad advice from an anesthesiologist.

Now I know what my surgeon meant when he said that, “You may not even remember when you re-tore your rotator cuff.”

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Not what I wanted to hear

Today I had my January appointment with my surgeon. As usual, he had me raise my arm as high as I could get it up (to my side and out in front), and then he took hold of it and forced it up until I winced in pain.

He told me that, although it looked like I’ve made some progress, I was not where he would like me to be at four months out from surgery.

He also told me that, because I am still having issues with pain, I may have damaged the repair. I told him that I didn’t remember any time (but once) where I could have damaged it. He said that it would not necessarily have been something that I would have noticed. He said that if things didn’t settle down, he would order another MRI on my next visit (2/3/15).

In conclusion, he said to continue with the therapy three days a week, and to “ask the man upstairs to make it get better.” I told him that I’ve already done the latter quite a few times.

So, although it looked for a little while like this shoulder repair was going to go better than the last one, it now looks like it could be about the same (and hopefully I have not damaged it). I am anxious for this to be done, but I’ll have to be patient.

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