Surgery: March 28, 2013

The following quote by legendary UCLA coach John Wooden is one of my favorites:  “Failing to prepare is preparing to fail.” - Coach Wooden led the UCLA men’s basketball team to an unprecedented and, so far, unrepeated 10 NCAA championships.  I’m a college basketball junkie, both men’s and women’s teams, and loved coaching my own team, even though it was seventh grade.

The big day, March 28, 2013, finally arrived and I was feeling good about my preparation.  My twin sister came help with child care person for our girls, ages 5 and 8.  I had spent the previous 3 days cleaning our house like a maniac since I didn’t want guests sleeping on the basement futon in the midst of spiderwebs, colossal dust bunnies and general kid junk.  I even vacuumed out the nasty stuff that had accumulated on the bottom of the wire shoe rack in my bedroom closet.  Who cares?  Me...  probably only me since my husband and children don’t ever notice.  Grocery shopping was done, laundry caught up, calendars were made showing kid activities and directions for a driver other than me.  The giant pile of papers and “stuff with no official home” was cleaned off of my desk.  My surgery day was the last day of school before 11 days off for spring break and I knew I’d need to schedule things for my girls to do to prevent behavior problems due to boredom.

Part of my preparation involved acupuncture treatments and a pre-surgical protocol of vitamins and supplements given to me by my acupuncturist, who is also a naturopath.  The purpose of the protocol was to increase the rate of healing following surgery and to minimize scar and adhesion formation.  Beginning 3 weeks before surgery, I started taking vitamin C (1000 mg 3 times a day), Zinc picolinate (30 mg a day), copper (2-3 mg a day), citrus bioflavonoids (1,000 mg 2 times a day) in addition to my high-potency multi-vitamin and giant dose of probiotics.  I also started a supplement called EZ Flex which contained high doses of B vitamins and tumeric.  My surgeon is a big fan of huge doses of vitamin D, so I was already taking 2500 mg daily.  I also visit a chiropractor regularly and had weekly treatments before surgery.

I googled Minnesota Vikings running back Adrian Peterson’s recovery from his knee injury extensively, reading everything I could find about what he did with his rehab.  Peterson tore his ACL and MCL in December 2011 and was expected to miss the 2012 season.  Well, Mr. Peterson worked his butt off and was named the NFL MVP for 2012.  He played his first  game 8 1/2 months after surgery.  His recovery is amazing and almost a freak of nature.  Obviously, he had the advantage of all the physical therapy and medical attention that professional athletes get in our society, but the bottom line is he pushed himself to the limit day in and day out.  “The things you guys don't see is how much I work and grind and fought through different situations to get back," Peterson said. "Mentally, I was able to push through when I was tired and didn't want to do anything." He acknowledges that “90 percent" of the rehabilitation process was mental.  He also mentioned the time it takes for muscles to learn to work in coordination again, in addition to regaining strength and flexibility.

I have had 4 broken fingers (all through playing high school sports), have had bunion surgery on both feet, ripped a toenail completely off which required stitches all down the side of the toe, and have given birth to two healthy baby girls.  I love to run and work out with weights, kettle bells, Tae Bo type things.  I played varsity basketball and soccer in high school and have run in 5K and 10K races.  I understand about playing through pain and was anxious to get to a stage where I could actually do something to get better, instead of just sitting around waiting.  At this stage, I was looking forward to the pain because it was necessary to for healing. Bring it on!

The surgery itself was uneventful.  My room at Lutheran Hospital had a great view of Cleveland landmarks:  Lake Erie, Browns stadium, the Jake (now known as home of the Cleveland Indians Progressive Field, but I liked Jacobs Field better), the Carnegie bridge and the historic buildings of Ohio City.  It was interesting that the restaurant where my husband and I had our first date and the Great Lakes Brewery, where we had our wedding rehearsal dinner,  were just one block away.  I told him that he could go have a beer while I was on the table.  I was anxious about having a senior anesthesiologist, rather than some kid fresh out of medical school.  I picked the best hand surgeon to be working on my hand, so why shouldn’t I have the best person putting my arm to sleep?  I had a great anesthesiologist who did a fantastic nerve block.  I had a regional nerve block, which involves lots of shots into your arm pit, and wasn’t really that bad since I already had some sedating meds going through the I.V.  Off I went to the O.R.  Next thing I know, I’m in recovery.  The person on the other side of the curtain was whining her head off about pain.  I supposed I should have been sympathetic, but I wasn’t.  I only wanted her to stop.  I was feeling no pain because of the fabulous nerve block.  I remember thinking that my left arm was on my stomach, same as the right arm.  When I finally was coherent enough to peek under the blankets, I only saw one arm.  I asked my nurse, “Where’d my arm go?”  She said, “It’s right here, honey, don’t worry” and pulled the blanket back so I could see it right there next to my body.  I also asked her when the nerve block wears off and she replied, “Well, honestly it’ll go from feeling just fine to ‘holy shit”’in about 30 seconds.”  I appreciated her honesty.  I was taken back up to my room and discharged after an hour or so. I had a bulky dressing, which is a plaster cast on the outside of my arm and dressings on the inside, that went from elbow to fingertips.  I had to wear a sling for the first day since the nerve block was still in effect and I had no idea what my arm was doing.

I listened to my doctor talk with my husband after the surgery, but don’t remember much of the discussion.  I asked my husband to use the voice memo app on his phone and record the whole thing.  The surgeon was expecting to have to reconstruct the radial collateral ligament using a piece of tissue from my forearm and bone anchors.  Surprisingly, this ligament was actually intact, but very loose.  He tightened it, using the same technique as face lifts.  The sagittal band was “a mess”, but he was able to sew it all back together.  No extra hardware or parts necessary.  This was the best possible scenario.

Arriving home from the hospital, my 5 year old was scared to be in the same room as me.  She was afraid of the cast and the sling.  Sad for me, but not totally unexpected. For the rest of the day, the the worst pain all day was hitting myself twice in the lip, twice in the forehead and once on the bow of my glasses with my cast!  I thought my arm was on the table or pillow stack and didn't realize it was moving until impact. Loved that nerve block!

About midnight, the nerve block wore off and I quickly learned to love the Percocet for pain control. I concurred with the recovery room nurse’s professional opinion, “holy shit” was accurate.  For the next week, I surfaced from my Percocet haze to have my ice bag refilled (I had ice on my arm 24/7 for the entire week), take my medicine and vitamins, push some food around my plate, visit the bathroom and drink water.  Luckily for me, my team was in place.  My husband and family took care of everything else that needed to be done, mostly with a smile on their faces and not too much grumbling.  Our old TV was brought upstairs and hooked up so that I could watch the NCAA basketball semifinals and I didn’t miss a game!  Although, I couldn’t follow the action like I usually do.  Without narcotics, I can keep track of how many timeouts are left, which players have how many fouls, which direction the alternating possession arrow is going, etc.  This time around, not so much.  My trusty iPhone timer was set every 4 hours so I wouldn’t miss the pain meds, which really wasn’t all that necessary as my hand had it’s own time schedule of when the medicine was due!

On Monday night (day 5), I experienced a panic attack directly related to the Percocet.  My heart was pounding, I was hyperventilating, and couldn’t stop thinking “I have to get this damn thing off my arm because it’s too tight.”  It was not too tight, since my surgeon showed us how to check this.  I knew I was being irrational, but I couldn’t help it.  I felt so out of control, it’s a terrible way to feel.  I stopped taking the Percocet and went to plain old Tylenol, which didn’t do much for the pain.  In my mind, I’d rather have it hurt than deal with the irrational panic.  I found myself wondering if my grandmother felt like this when she suffered through the early stages of Alzheimer’s disease and felt chagrined that I should have felt more compassionate rather than annoyed with her.

Key things I learned during this stage of my journey:

1)  I can’t do this alone.  Feeling completely helpless is no fun for anyone.  Feeling completely helpless as a parent is even less fun.  I couldn’t cut my own food, fill up the damn ice bag, replace the toilet paper in the bathroom, get the top off the toothpaste or shave my own armpit.  I found a pink Disney tooth flosser that one of the girls got from the dentist and decided to use it.  I promptly got it stuck in my back teeth and had to have my husband yank it out.  My sister had to chop the arms off of some shirts for me to wear and then had to guide the arm hole over the cast.

2)  The value of saying “thank you” when people are helping or trying to help.

3)  Pain medication is prescribed for a reason - take it sooner rather than later.  My experience was that I needed to stay on time and ahead of the pain.  Once I missed a dose and it’s very hard to get the pain back under control.


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