The Long Recovery
After more than 38 hours in hospital (4 of them in surgery having my left shoulder rebuilt after a bicycle accident), the nurse says I can go home. She pulls out a bag of my clothes and says, "Here. If you need help putting these on, I'll be back in a few minute."
I have a new 22cm-long surgical incision in my left arm and shoulder, freshly sutured and covered with a large bandage. My arm is tightly held in a sling. I'm loopy on morphine. How the hell am I supposed to put clothes on?
I can start by removing my hospital gown. It's practically falling off anyway. Because of my arm, it can't be fastened properly around me. Every time I've gone to the bathroom, my ass has been hanging out for all to see.
One little shrug and it's off. Modesty dies quickly in a hospital.
What's first? Well, underwear, I guess. It normally goes on first anyway (unless you're Madonna). Don't see why a busted shoulder should make any difference.
I'm not going to be able to reach down and hook the underwear over my feet while standing up. Bending over hurts. Doing much of anything hurts. And I have no balance. While I might able to get the right foot in the right hole with the right hand, getting the left foot in the left hole with the right hand will be impossible, and trying it with the left hand would probably leave me kissing the hospital floor.
The last thing I want to do is fall down again.
I sit on the bed. In a sitting position, I can hook my underwear over my feet and pull it up my legs with my right hand. Near the top, I can stand up and pull it over my butt.
Ta da. Blue Fruit of the Loom boxers are on.
Well, this procedure worked so well for underwear, it ought to work for pants, too.
And it does. Mind you, I have to figure out how to buckle them and my belt with one hand. It's not as easy as it sounds, but not so hard either.
Socks and shoes go on at the same time, too.
Now comes the shirt. My left arm is clearly not going into any sleeve, so I put my right arm in the right sleeve and then toss the left half of my shirt over my left shoulder. With my arm against my abdomen, I button it (one-handed) as far down as I can go.
When she returns, the nurse seems surprised that I was able to do it all myself. She pretends not to recognize me -- who is this well-dressed man and what have you done with my patient?
Thus beginith my recovery.
My sister is playing taxi driver for me today (as she will for many weeks to come -- thanks, sis!).
The first order of business is to get me out. I have no idea where I am in the hospital. Left to my own devices, I might have been wandering the corridors for years trying to find the exit -- the Flying Dutchman of Jubilee Hospital, ending up a crazy old man who mutters, "I beep at airports -- wanna see my scar?" to anyone who will listen.
But no, my dreams of becoming a human derelict end quickly as my sister finds the way out.
I walk gingerly. Falling down would be a disaster right now. But my first few haltingly hesitant steps are soon replaced with more confident paces. I'm not setting any records, but I start to feel safe on my feet.
Sis has brought the van -- a good thing. I don't think the MG would have been suitable. Climbing in isn't so bad, but the next stumbling block is the seatbelt -- I can't fasten it. I can pull it around myself, but sis has to snap it into its latch.
Can't do up a shirt properly, can't fasten a seatbelt. What else can't I do?
She drives me home, apologizing the whole way for every bump, stop, turn, braking maneuver and acceleration that occurs. Actually, it's not too bad. The right turns hurt the most as the inertia pulls at my left shoulder.
Finally, home. What does a man look like arriving home after major surgery for a crunched shoulder? Like this:
The first thing to do is to make me comfortable. The obvious place is the couch with lots of blankets.
My left arm is useless, so I have to sit on the right end of the couch so that I can use my right arm on the arm rest to help push myself up when I stand. I also need some pillows to support my battered left arm.
The downside is that now I can't curl up with my cat Linus, who has missed me and clearly realized something was up. In fact, we pile up extra pillows on the left side to keep Linus at bay; he's a large cat and likes to walk on me, and god forbid he should walk on my injured shoulder. Still, being home with my cat is a great start to my recovery, and he even seems to understand that although I am injured and can't really snuggle him, I did miss him and am glad for his company.
This is pretty much how I stayed for a couple of days. Sleep was impossible. Between the dull ache in my arm and my back stiffening up, there was no sleep to be had. In fact, I considered it an improvement when I was able to move to various chairs around the house during the night and not sleep in any of them. At least I was moving. But before I worried about my first night's sleep, there was another problem that I needed to face.
I needed to pee.
My bathroom is small. Tiny. The toilet is in a small alcove with little if any maneuvering room. And the transition from standing to sitting is painful and uncomfortable. And I am still wobbly. Pulling up my pants is awkward. So I have little choice. For the time being, I'm going to pee in the sink.
A couple of sleepless nights later, I was starting to smell. I needed a shower.
The only restriction I had about showering was to try and avoid having the shower spray directly on the incision. A little collateral water damage okay. I would also have to change my dressing afterwards. My dressing looked like this:
In order to have my shower, I would have to get undressed and get my arm out of the sling. Then I would gently get in the shower and somehow do all the necessary hair and body washing one-handed, then dry off, then get dressed again. My sister volunteered to stand by if needed. I told her that if she heard a splash and a thud followed by screaming, chances are that I would be in need of some assistance.
In actuality, the shower went well. Slow and steady wins the race.
The only problem was that I couldn't get my underwear on. Because of the aforementioned limited space in the bathroom, I had not yet managed to sit down on the toilet, and sitting down was the only way I could get pants and/or underwear on. Getting tired and a little frustrated that I couldn't devise a plan for my underwear, I had no choice but to call my sister through the closed bathroom door.
"Sis, I have a problem."
"What is it?"
"I can't get my underwear on."
"How did you get them on in the hospital?"
"I was on morphine. I don't remember."
"So I thought you could hold them in front of me. I'll step into them and you can start them up my legs. I should be able to grab them when they reach my calves and I can pull them up myself."
My sister reluctantly agreed. I opened the door a crack, and passed her my underwear.
"Are you ready?" I asked. She nodded.
I opened the door, naked as a skinny-dipper at Mackenzie Bight. She knelt in front of me, holding out the underwear and averting her eyes. I stepped in and reached down to grab the waistband.
"You'll have to lift them higher. I can't reach down that far."
She leaned in a little closer, and lifted them a bit higher. Now I could grab them.
"That's great, sis, thanks. I got 'em. Don't hit your head on anything on your way up."
"Okay, glad I could--- oh, oh, you...."
She turned red and ran.
I went back into the bathroom and chuckled.
Then we changed the dressing. What did my incision look like? It looked like this:
I'm guessing 17 sutures. It's hard to tell, and they were dissolving sutures, so after a couple of weeks they were all gone anyway.
I had two big problems that first week. One, my arm was swelling up. I expected swelling around my shoulder and upper arm. That only made sense, that's where the injury and the surgery was, but the swelling was going down my arm towards my fingers, too. In fact, my fingers soon became giant white sausages. My whole arm was swollen and I was concerned, but the swelling soon passed and my arm returned to normal, Or what passes for normal these days.
The other problem was sleep. Or the lack thereof. After a couple of days, I moved off the couch and tried my bed. But nothing worked. I could not find a comfortable position or place to sleep. Worse, I was getting pretty wired from the Tylenol Extra Strength I was taking. I spent a couple of nights absolutely tripping out on the stuff. I took this picture at 3:00 one morning. Why? Because when you're basically immobile, dead dog tired, and hopped up on Tylenol, there really isn't much else to do at three AM except take your own picture.
My first physio appointment was a week after surgery. It snowed that day. Yes, my first trip out of the house with my busted shoulder and arm was on a day it snowed six inches.
At the rehab clinic, I meet Jim, my therapist. "Bike accident, eh?" he says. "Let's see what you did to yourself."
He consults my chart. "Uh huh, uh huh, hmmmm, uh huh, uh huh. Now that's interesting. Usually you don't see both of these injuries together. Usually, it's one or the other. But not both. Very unusual."
My elation upon hearing this knows no bounds.
There's not much treatment during this first session. Not much can really be done until the swelling in my arm starts subsiding. But he does ask if I have any problems.
"Can't sleep," I mumble between yawns.
"We can fix that."
He asks me to lie down on my back on the examining table, and he grabs some pillows. He sticks one under my head, a couple under my knees, and slides another one under my left arm, between it and my body.
Oh my. Suddenly, I'm totally relaxed.
That night I set up the pillows on my bed the way Jim did. I'm worried about Linus. Our ritual the past few years has been that he always jumps on the bed and curls in between my left arm and my body. If he tries that, it's going to hurt. I settle in with the light off and await Linus's arrival.
He hops up on the bed. Somehow he knows that the left side is off-limits. Without hesitating, he curls up in the crook of my right arm.
We both sleep for eight solid hours.
When I first came home from the hospital, my biggest disappointment was that I could not easily snuggle my cat Linus. Whenever I sat down, my busted left arm and shoulder needed to be protected and propped up with pillows. And my right arm needed to be beside the arm of the chair or sofa so that I could use it to push myself up. I couldn't lower myself down onto my bed at first because it's so low -- it has no legs and sits on the floor.
After a couple of days, I figured out a way to finally properly snuggle Linus.
Only then did I feel like I was finally on the road to recovery. For those first two weeks, Linus stayed near me and watched over me. There wasn't much he could do to help me, but knowing he was there made a difference. When I walked aimlessly around the house, he walked with me. When I came back from the doctor or from physio, he greeted me at the door to ask how I was feeling. When I rested after my exercises, he rested with me.
Three weeks into my recovery, Linus suddenly stopped eating. He seemed mostly okay, he just wasn't eating or drinking. Then he began staring mournfully at his water and food dishes as if he just couldn't remember what he was supposed to do. His urination, what little there was, became more painful. He became weak and his legs started giving out on him. The vet was stumped.
The only choice became sadly obvious.
Linus passed away on December 19, 2006. He was almost 17 years old.
I really miss him.
After the swelling in my arm started going down, physio began in earnest. My first exercise was what's called the pendulum. It's exactly what it sounds like. I lean with my right arm on a table or counter-top and let my left arm out of the sling and let it hang like a pendulum. I swing it forward and back, side to side, then it circles, first clockwise, then counter-clockwise. I swing it for about three or four minutes, twice a day. The idea is that it gently pulls on the muscles that are now super-tight and holding my arm in my shoulder socket. All those muscles have been traumatized and many surgically reattached. They were, and are, extremely tight to say the least.
Funny things were happening with my arm. Suddenly my left arm began drying out and flaking. My right arm was fine, but my left arm suddenly developed a taste for vast amounts of moisturizer.
And I could feel strange sensations in my arm as all the new hardware rubbed against flesh and bone. Sometimes, it even feels like it gets caught against a tendon or ligament [shudder]. It's a strange, strange feeling.
Slowly, time passed. Days became weeks. Weeks became months. Months became years. My writing became a pattern of clichés.
But seriously, time did go by slowly as I was mostly housebound. If it wasn't for the fact that I had just ordered the first two seasons of Voyage to the Bottom of the Sea on DVD, I might have gone mad.
I couldn't even write or surf the Internet much as it was too uncomfortable to sit at my computer for very long.
Christmas rolled around and I began to venture out more. Thankfully I had done most of my shopping before the accident, and Amazon did the rest.
At physio, I got to do more exercises. I got to lie on my back and, gripping it with both hands, I had to raise a cane over my head. At first, I could barely raise in 90 degrees, or just above my head. Now I can get it about 150-160 degrees over. Still got a ways to go.
Next came The Violin. Still lying down and with my forearms straight out in front of me at a 90 degree angle, I gripped the cane and moved it from my right to left, trying to move my left forearm away from my body while keeping my elbow in place at my side. This works to stretch my shoulder were the Bankart repair took place and the flap of muscle was sown over my shoulder socket to keep my arm in place. This I can only do to about 35 degrees. More work needs to be done here, too.
You're not reading this over dinner, are you?
As long as you're grossed out, here's how my scar was doing after about seven weeks.
Other exercises were added to regime like Walking Up the Wall. Simply put, I stand in front of a wall, put my left hand on it and use my fingers to "walk" my arm up it until my shoulder screams out "Enough already!"
However, the physio is going slower than expected. All these exercises that I've been doing are passive exercises, meaning that the injured area is not doing any work during the exercises it's all being done by the other arm, gravity, or in the case of my physiotherapist, someone else entirely. The normal recovery protocol for a Bankart repair would allow for active weight-bearing exercise at this point; however my arm is still too sore and stiff for this, so we are continuing with just the passive exercise. This will make for a long recovery period.
At least now I'm out of my sling.
It's funny how I can suddenly discover that I can do something without even thinking about it, or that I can still find that there are very simple tasks that I cannot do.
For instance, last week after physio, I ran for the bus. Not that the running itself was a surprising thing -- I'm not much of a jogger, but up until my accident I was riding my bike five days a week, so I was in shape enough to run if need be -- but the fact that I was running and my shoulder seemed pretty okay with it was an unexpected surprise. It wasn't until I got on the bus that I realized that I had run a couple of hundred metres with little discomfort.
Mind you, later that day I couldn't get my socks off. As I stood in front of the laundry hamper, I decided that the socks I was currently wearing were due a wash. So, still standing, I bent my left knee, lifted my left foot, reached down with my right hand and pulled my sock off. After lowering my left foot, I lifted my right foot and without thinking reached down with my left hand and did not have the strength to take off my right sock.
The good news is that I am feeling more and more human and I'm venturing out more. Here's me last week at Gyro Park. Dig the "physio beard."
This was a week of firsts.
Monday, I had my first bath. I decided that it was time to try to get in and out of the tub. Getting in was okay, but getting out still remains a little haphazard. However, I didn't fall, and it was very relaxing. Heck, I may even have another one tonight. (Long-time followers of my misadventure will recall that due to the tinyness of my bathroom and the awkwardness of my injury, I was forced to pee in the sink for a short while after my release from the hospital. I would like to state for the record that for some time I have been able to pee in the usual manner and into the usual bathroom fixture, although I still occasionally pee into the sink because I am a lazy and gross bastard.)
Tuesday, I tied my shoelaces for the first time in three months. After getting home from my accident, the first phone call I made was to my niece who works in a discount shoe store to ask her if they had any sneakers with velcro instead of laces. And lo, they did, and they were delivered unto me, and I've been wearing them ever since. But after a recent long walk, I discovered that discount shoes aren't designed to be walked in over a lengthy distance, and since my plan is to walk home when I return to work, it was time for more comfy (and more expensive) shoes. And so it was that on Tuesday morn, I took my old expensive sneaks out of the closet, placed them on my feet and tied the laces with no discomfort in my battered left shoulder. Huzzah, huzzah.
And today another first: my first day back at work. What a, er, um, thrill it was to be back. Makes one hanker for the days when I could just sit home, rest, watch tv and get paid. And that was just last week!
Actually, it felt good to be back, if for no other reason than it represents another small step along The Long Road Back. The shoulder seemed to survive the day fairly well. And when I did my exercises in the evening, it seemed a lot less tighter than usual. Perhaps being back at work did it some good.
I stuck up a copy of my x-ray in my cubicle. Most people were shocked at the amount of metal in my arm.
"Is that permanent?" they gasped.
"Yes," I replied, "until someone figures that the going rate for titanium is worth digging up my cold and rotting corpse for."
I walked home, as per my plan, and although I was jealous of every bike rider that passed me and every kayaker in the harbour (there was only one, and he had to be crazy to be out on a stormy day like today), at the end of the day I feel a little more confident that one day soon I'll be back on my bike and in my kayak.
Time munches on.
Now over four months after my bike accident, my once-broken arm and shoulder still have a road to travel before they could be said to be recovered.
That said, a lot of progress has been made over the last few weeks.
First, I have graduated to what is referred to in physio lingo as "resisted exercise." You and I call it pulling giant rubber bands. This is significant because my range of motion, while still not yet in the normal range (and may never fully be), is certainly in the range of motion for getting by. The problem is that I have no strength in the arm. In fact I have more range than strength. If I left up my left arm in front on me, I might get 130-135 degrees of rotation. But if I use my right arm to push my left arm up further, I'll get 175-180 degrees of rotation.
So now we're into strength building and re-activating the muscles that haven't had to work in months. Hence the rubber bands. I have eight exercises to do with the bands, plus one exercise with a free weight, a whopping three-pounder!
Other good news: I don't need to do stretches with a cane anymore. I'm flexible enough now that I can do some new stretches that do the job better and don't require the cane. And I'm now down to once-a-week visit to the physio dude.
So now the question is when do I get back on my bike and into my kayak? That remains to be seen. The Victoria Day weekend marks about six months since my accident, which was sort of the time frame mentioned by my surgeon, so that is a target that is on my mind. Sometimes I feel that Canada Day is a more realistic time frame, but we'll have to wait and see. The point is that I WILL be back on my bike and on the water this summer.