Saturday, September 5, 2015

How I Spent My Summer Vacation

At elementary schools around the world, one question will be asked in hundreds of languages and dialects within the next coming week: "How did you spend your summer vacation?" Note: This question will only be asked in countries that don't mandate year-round school attendance and where "summer vacation" actually takes place, which is primarily a benefit of first-world nations, like the US.
I've seen so may episodes of "The Simpsons" that start this way as fall approaches, I kind of take it for granted that kids everywhere get to report on uncomfortably long car trips, fighting with siblings for juice boxes to visit family/amusement parks/national or state parks/local campgrounds.
I spent my "summer vacation" healing and rehabbing from surgery on my right wrist that occurred on 06-10-15. I tore my right TFCC ligament in April 2014 when a large chunk of ice fell from a restaurant sign 100' feet in the air and landed on my right wrist. (TFCC is short for triangular fibrocartiliage complex ligament, located on the side of the wrist below the small [pinkie] finger.) There are 26 bones in the human hand and keeping the wrist stabilized is the job of the TFCC ligament, so when it's injured or damaged, the stability of the entire wrist is at risk. Of course before my worker's compensation insurance would pay for surgery I had to "fail" at other interventions including physical therapy, occupational therapy and cortisone injections. And I had to have an evaluation by an independent medical examiner chosen by my worker's comp carrier. And I had to have a series of x-rays and one MRI. So with all of that testing, therapy and injecting, surgery was scheduled after the public school year ended; I was working three days a week at local high schools and there was no way I could step out of seeing those kids and have them meet with a substitute for the final weeks of the school year. School was out for the summer on 06-05-15 and I had surgery five days later.
This is a photo of the first cast/splint/restraint my right arm was in:
I checked into the Rog & Shirley Porath Rehabilitation Center after surgery and this photo is particularly telling of my initial post-op experience: you can see the box of Lovenox 100mg/1ml injections I gave myself starting 4 days pre-op and 7 days post-op. I still take an 80mg aspirin daily until the end of October. This is thanks to the Gallbladder Disaster of 2006 when I ended up with a right pulmonary embolism (blood clot in my right lung) and a right-sided pleural effusion (fluid collecting between my right lung and chest wall). I also draw your attention to the 38oz bottle of Miralax with funnel so I could keep regular peristalsis while taking pain meds. Ok, no one freak out here. Getting drugs out of the DEA has got to be easier than getting them from Rog & Shirl. They managed my pain medication, asked me all the questions I would expect them to ask before reluctantly offering one, maybe two pills if I was really hurting, such as: "Have you tried Tylenol?" "Have you tried a heating pad or ice pack?" "Have you tried to lay down and think about something else?"
(That one was a kicker for me; when the hell did my parents start watching Oprah?)
My first post-op appointment was on June 23rd and the hideous contraption was removed and replaced with a more traditional cast:
My elbow was still kept at a 90 degree angle, but at least I could put on one of the extra-long plastic gloves that looked like cattle-insemination gloves, wrap a rubber band around the top and take a shower!!! God bless running water when you've been without it for almost two weeks. My parents have a totally kick-ass walk-in shower with a seat at the far end and glass doors which is quite luxurious for Rog & Shirl who tend to lean toward the practical side. 
On 06-25 I was allowed back at work for a maximum of 4 hours per day, doing only left-handed work. It was awkward at first because I was still naturally reaching for things with my right hand, but when my elbow wouldn't bend to allow me to grasp what I was reaching for, I began the transition of relying more on my left hand. I won't get into the TMI details, but trust me, you don't want to start stabbing at your eyes with an eyeliner in your left hand if you don't know what the hell you're doing. I call this period my "forced mindfulness" time because I've always wanted to become more mindful of what I was doing and thinking and being forced to pay attention when using my  non-dominant hand definitely helped me be much more mindful of whatever I was attempting to do.
On 07-14 the cast came off and I was placed in a customized orthosis. Unfortunately I don't have any photos of my orthosis, but here is the gist of it: 
Ok, this is the closest image I could find on Google images, but it doesn't really do my orthosis justice because 1) this is on her left arm and 2) mine was white and molded to my arm, keeping my right elbow at a 90 degree angle. I wore a compression stocking underneath it and had Velcro straps I could peel off from one side to get some time out of the thing, which was ONLY supposed to be when I showered. I followed every rule they gave me because I did NOT want to have to deal with side effects of this surgery for the rest of my life. Despite the "quasi-rebel" I was in my younger days, I've become quite compliant with whatever professionals who know more than I do instruct me to do. The coolest part of my orthosis was my choice of alternating green and gold strips of Velcro. (Green Bay Packers colors, get it??)
On 08-18 the portion of the orthosis above my elbow was cut off, freeing my elbow to bend for the first time in over two months!! This was landmark because now I could take the orthosis off to shower without using the large insemination gloves. This is also when the serious physical therapy work began. I started very slowly with range of motion exercises with one or two exercises added every week that I saw my therapist. This is the final version of my custom fitted orthosis:
I decided to stay with the green and gold Packers theme, because that's just who I am. My most recent appointment with my surgeon was on 09-01 and I was given the "all clear" to spend more time out of the wrist restraint than in it. I'm also slowly introducing strengthening exercised into my physical therapy routine. That appointment was last Tuesday and I've been able to function fairly well without the restraint until today, when I woke up feeling sore and knowing that I likely overdid it. I wore it most of today, but as I'm typing this, I'm not wearing it because I feel pretty good. Unfortunately my four-hour work days came to a rapid halt on 09-01 and as of Wednesday, 09-02, I'm back at the office for 8 hours a day. My surgeon told me on 09-01 that my wounds were healing "beautifully" which I took personally, indicating that I have the capacity to have beautiful scars. A photo of the surgery site from today:
Part of my therapy includes massaging the wound site which is a nice way to practice self-care while using lotion and gently rubbing the area. I continue with my range of motion and strength building exercises as well. I have a follow up appointment with my physical therapist on 09-15 and what will likely be my second-to-last appointment with my surgeon on 10-13. At my last appointment he indicated that he'd see me one more time in mid-November and then likely cut me loose if I continue to progress as well as I have so far.
This medical tale runs well over my summer vacation, but healing from surgery, as I've learned since the Gallbladder Disaster of 2006, is never a rapid process. At least not for me. 
I have been able to binge-watch several movies and TV series I've always wanted to see, such as all 5 seasons of Downton Abby, 3 seasons of Mr. Selfridge, all 5 seasons of Friday Night Lights, 3 seasons of In Treatment which I recommend to all of my therapist friends as "must see TV", 3 seasons of Boardwalk Empire, the movies Behind the Candelabra, Angels in America and A Most Wanted Man which I believe was Seymour Hoffman's last film.
I've also been journaling, writing snippets of what I hope to develop into full poems, reading for pleasure (and NOT for work!!) and I've been painting with watercolors and drawing with colored pencils, both of which are new interests for me. 
As this Labor Day Weekend slips away and what is considered "the fall season" takes its place, I've had a pretty good summer. I saw some clients, my work schedule wasn't completely out-of-control, I had some time for personal reflection, relaxed through watching the lives of others played out on my smart-TV, and discovered interests I never knew I was interested in. That ain't bad.

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