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Shoulder Blog

I need to vent

Because my shoulder hurts, really hurts, for the first time in a good while. Getting back to playing drums has really helped, physically and mentally, and I've been feeling pretty good up until this evening, but I'm having some wicked trouble sleeping and needed someone to vent to. So thanks.

Pain clouds thought so I'll try to post something more constructive soon.

Remember, this pain is an illusion.

An update long overdue

Well damn, it's been a while. I've been meaning to post to this blog ever since the year anniversary of the plate removal in September. It will be 2 years this September 15 th since the second surgery, and while I'm much improved from 2 years ago, I am still struggling with problems that I have come to accept will most likely never go away. Long story short; the plate came out Sept 15 th 2004 , the next few days are a blur now, but I remember waking up to having feeling in my hand again, and continued on with the rehab and recovery. I did as much rehab as I could, trying to push myself, but otherwise took it easy. I had to quit my band to have some extended time to heal, and began freelancing again, eventually landing a full time gig at an ad agency here in Dallas. I now do graphics for online games, drum in the band again, and continually try to find ways to improve and manage my chronic pain.

Getting laid off right before the surgery prevented me from doing as much physical therapy as I would have liked, so I had to keep up on myself to do it. Over time I've picked up the range of motion exercises, as well as yoga, and light weight training to keep my shoulder and arm active. I'm currently working on changing my diet and eating healthier. Honestly, I've been slacking lately on the exercises, but have taking up drumming again (something I couldn't do 2 years ago), as well as running to keep my endurance up. So far my symptoms haven't worsened, thankfully; it's just not as easy as is used to be. But nothing worth doing is I suppose.

I've still got some tingling in my index finger, a side effect of either nerve damage or TOS, as well as back and neck pain. The right side of my neck stays pretty tight, and I have to continually stretch and exercise to loosen and tone it. The severe pain in my shoulder blade was replaced with a much subdued uncomfortable-ness whenever I have to sit against a hard surface or a shitty office chair. The shooting bicep pain has pretty much vanished, as have most of the sharp or unexpected ones that used to hit me out of nowhere.

I'm pretty sure my clavicle is a bit shorter than it should be however, that or my musculature has just been deformed a bit at the surgery site, as I know have a “dimple” where the new union is, in part to the bone not being as thick in that spot. When Dr. Philip Hansen (avoid this man) installed the original plate, he overlapped the bone too much, so now I have symptoms of nerve damage and TOS, even though the plate is out.

Unfortunately my current insurance is quite shitty, and I'm having trouble getting in to see Dr. Burkhead about the problems that have yet to resolve, but am diligently working on it and will have an update about it as soon as it happens.

All in all I feel better than I did, but looking back I might have opted to not have any surgeries at all had I known the outcome would be a lifetime of nerve damage and chronic pain. Thankfully I can at least play drums again, and hold a paintbrush, something I really couldn't once Dr. Hansen fucked up the install.

I hope to keep updating this blog, both as an outlet for myself and hopefully as a resource for others who suffer through this. I've said it before and will again, this is a debilitating condition, a disease almost, coupled with a healthcare system that doesn't deal well with the root causes of chronic pain. It's ironic that 3 generations of my family have now suffered some type of shoulder injury leading to nerve damage and thoracic outlet syndrome. My grandfather passed away long ago from cancer that developed in his lungs following an invasive operation to remove his rib. My father is worse than me but also a lot tougher, and is dealing with his pain as best he can. I hope to get him to start writing about the subject as well.

OriginalJohnny, if you're out there, look me up man. I lost my addy's in a hard drive crash but would like to hear how you're doing.

Much love to all.

Peace.

De-Robotification Complete.

That's right folks, that plate is outta there. as i type one-handed, it sits here in a little hospital bag, looking unassuming and surprisingly small. Hard to image such a small thing caused so much pain and managed to help me heal.

Here's an in-hand picture of it for you, to give you a little sense of size and scale.

So the surgery went well, and after getting a good look with is own eyes the doc says my bone is healed quite significantly. He did a small excision of my clavicle, to remove some "spiked" that had developed from the break/non-union. He also removed some arthritic tissue that was developing near my a/c joint, and he speculates that when i originally broke it, the fracture actually went INTO the a/c joint, hence my miss-mash of conflicting pain and symptoms.

So it's 3 weeks in a sling "for comfort" and small range of motion "pendulum" exercises to keep it from getting stiff. After that it’s on to rehab and hopefully I’ll be back to jamming on drums in a few months or so.

The picture below is from the doctor removing my “pain pump” and redressing the wound. Appetizing, ain't it?

Rapido Por Favor - Surgery Tomorrow 9/15

Well what a weekend it’s been. I’m now having surgery this Wednesday September 15th at 7:30am.

I arrived at work Friday morning to find a plain white envelope on my desk, informing me that I was no longer needed “due to a reduction in force.” This from a company that just donated $5000 to The Howard Stern Show and spent upwards of $200,000 on full-page ads in the Dallas Morning News, New York Times and Wall Street Journal.

$200,000 per paper!

So with my employment status fucked, my insurance in LIMBO … guess who calls! That’s right, My Doctor. Seems they have an opening next week on Wednesday. “Surely you’d like this done as soon as possible?”

Surely.

So i filed for unemployment, requested my COBRA beneifits, and am currently haggling over my severance and (lack of) disability coverage. Needless to say Friday night was a fucking blast.

I haven't been that drunk in at least a year.

So here I sit, after partying way too much this weekend, drinking WAY too much Friday night, packing up my bags to go stay a few days at the rents’ while I recover. Surgery is tomorrow morning at 7:30, which means I’ll be up at 4am, to leave by 5am, to get there at 6am (when they told me to arrive), only to have to wait until 8:30 because the doc will be late as alwasy.

Ah joy.

At least I’ll be Sans Titanium by this time tomorrow … I can hear thunder outside. How ominous. It should be a lovely morning for surgery.
More to come…

Surgery Date - Sept 22

That's right it's official. September 22nd will be the big day.

This titanium plate will finally come out and maybe i can get back to some semblance of a normal life. It just so happens that the 22nd is also the fall equinox and the first day of Autumn. I feel that's a good sign, and I’ve always believed that healing and health are 90% in your mind. Here's to positivity.
So in my last post i was very excited that i seem to have finally achieved union, meaning that my bone is in one piece and can hold itself together, but now h'm not so sure.

I'm cursed with a curiosity to rival almost anyone's, and so i like to be as prepared as i can be. So after carefully comparing x-rays from right after the surgery to the one taken in August I’ve come to the conclusion that my signs of union are flimsy at best.

The x-ray was taken at a lighter exposure to show bone of lesser densities, so it's may be deceiving in that end as well. To my untrained eye it simply appears that my scapula and collarbone are overlapping, and the high exposure gives the illusion of bone growth.

Hopefully I’m wrong though. Check it out for yourself.

Regardless of union or not the plate is coming out, so now i just have to be prepared for whatever complications may arise. Hopefully there IS a small section of bone connecting, which is all i would need to begin recovering, over time stress and weight will force the connection to get thicker and stronger.

So needless to say i'm a bit nervous, but excited to, maybe removing the plate will at least relieve some of my T.O.S. symptoms. The countdown is on. 13 days to go. More to come...

August 27 - Tentative Surgery Date

So I finally have a date set. WOO HOO! Just in case you didn’t know, the entire point of my first operation was to correct a broken collarbone, using a 6 inch titanium plate as an internal splint. Well I received good news this past Tuesday in the form of a nice spiffy x-ray showing promising signs that my bone has in fact grown back into one piece.

So what does this mean for me you might ask. Well, a shitload actually. It means that my coming surgery will remove the plate, leaving me with a plateless, one-piece, fully-functioning collarbone, minus the extra space the plate was taking up, which should help alleviate my symptoms even more. I plan on attaching the T.O.S. with some aggressive physical therapy.

So September 22 is the tentative date for this bad boy, baring they have an opening any sooner, in which case the date may move up.

They will be removing the titanium plate, and applying some artificial bone graft to help with healing. The good news is that baring any complications I should only be in a sling for about 14 days, and able to return to work and normal activities in 6 weeks.

more to come.

August 24 - Dr. Burkhead and Surgery

I went to see Dr. Burkhead Tuesday for my final pre-surgery visit. I was planning on taking the titanium plate out, in hopes that it would alleviate some of my Thoracic Outlet Syndrome symptoms. I was skeptical though, seems Burkhead wanted to do a clavicle resection as well, and if you’ve seen my x-rays, that is way to much bone to take out. I’ve read anything more than 1 or 2cm being removed can cause MAJOR complications. And I really don’t want to come out any worse this time. So I asked some questions and told him about my reservations, i also told him straight up that I didn’t want to and wouldn’t let him remove the end of my clavicle. So he decides to do an x-ray, and low and behold, on a light exposure, there are very promising signs of union.

I literally couldn’t fucking believe it.

I don’t like to get my hopes ups, but the x-rays DO look promising. See for yourself.

So after getting the good news, I agreed to let him remove the plate, and shave off the very tip of the lateralof my collarbone, as the union has made the top part stick out in a spiky fashion.

I literally felt hopefull for the first time in almost 9 months. It was nice. So we got into talking about possible treatments for the T.O.S., and he starts talking about releasing my scalene muscles, or my pectoralis minor muscles from the bones. Now I’m amazed by modern medicine, but it’s hard for me to wrap my head around detaching muscles from bone. It seems altering your anatomy that much just couldn’t possibly be good for you. However, it seems the muscle scars back to the bone, allowing the muscle to "stretch" and allow for more space in your thoracic outlet. Good thing I took my dad with me.

He’s had a shoulder injury now for several years, with pretty severe nerve damage. He’s also develop R.S.D., , a VERY debilitating nerve disease. If anyone knows his shit, it’s my dad. Funny thing, my Grandfather had Thoracic Outlet Syndrome as well. They took out his first rib to allow for more space. Four years later his lung collapses, and they discover cancer living in the scar tissue of his rib and all down his surgical scar. It eventually spread to his brain and killed him.

And so now my dad has T.O.S. as well, thanks to his work-related injury. He had some kind of nerve cutting procedure done (for obvious reasons he didn’t opt to remove a rib, something ill never do either). Well, nerves are funny things, and despite what doctors and books tell you, they DO grow back, albeit very slowly, only they don’t work right when they do. Imagine your nerves as the electrical wiring in a robot, and someone crosses all the wires from your arm to your brain. From you’re shoulder down, you’ll never work correctly again. Symptoms include, pain, aching, tingling, numbness, muscle atrophy, and wasting.

And so now I have Thoracic Outlet Syndrome as well. Woo Hoo!

* Insert sarcasm here

So now I have to do as much research as I can on active surgical pectoralis minor muscle releases. Shit, that’s a mouthful.

Sick As A Dog

So the last 2 days have been the best and worst, respectively, of the past year and a half. So if you haven’t read the good news, you can do so HERE. In short, my bone is healed and I can now have surgery to take the plate out, in hopes of receiving my T.O.S. symptoms.

So yesterday was average in the fact that I didn’t hurt extremely bad. I seemed to get through the workday fine. I tried to go to sleep around 1 and just couldn’t, I’ve been having trouble sleeping lately and i’m not quite sure why. So I tossed and turned for a bit, i finally got up and decided to veg out on the idiot box.

Come about 3 o’clock all hell broke loose. I haven’t been this sick in a while, and I’ve been sick off and on in the past 2 weeks. It’s funny too, so far there are 3 or 4 people I work with, on the NEW floor no less, all have been having stomach problems the last 2 weeks. Before that is was headaches.

Maybe it’s bad karma.

So I’m not sure what happened, but amidst the puking and diarrhea I seemed to have agitated the fuck out of my shoulder. My hand went almost completely numb, something that I’ve managed to avoid for almost a month now.

Needless to say I didn’t get much sleep last night, what with the epic struggle between my shoulder and bowels. It will be known as “The Great Blowout of 2004.”

I had to take the day off from work to rest my hand, being a designer with T.O.S. isn’t a good thing. Kind of hard to design when you can’t hold a fucking mouse.

I’m trying to stay positive though, I should get my surgery date today or tomorrow, and then I’ll have a date to look forward to for “hardware removal".

More to come for sure…

July 30th - Dr. Morrison and the EMG

So i went for my second EMG today, this time with a Dr. Frank Morrison that was recommended by the Vascular Specialist Dr. Pearl, who i was referred to by Dr. Hansen, the doc who did the original surgery. Confused? me too. Doctors are weird and confusing to me as well. So i arrived an hour late, at 5, after my appointment being delayed 2 hours. Seems he REALLY likes to take his time and do a thorough examination. After about 45 minutes of observing, testing reflexes, comparing feelings in my arm, hand, etc, he hooked me up to the EMG machine. I didn't leave his office until almost 8.

I'm usually talkative when I’m nervous, and when people are pumping volts thru me and sticking mw with needles it tends to make me nervous. So i talked with him about my symptoms and his thoughts so far. Thank god he had a good bedside manner.

Seems the original Diagnostician didn’t do a very good job. She didn’t even test my good arm as a control, which he seemed very surprised by. Seem everyone Dr. Hansen touches gets fucked up, and all the doctors he refers me too fuck their jobs up. He said he sees more of Dr. Hansen’s patients after surgery than any other 2 combined. He also asked why I didn’t have dr. Burkhead do it. He seems to think very highly of him. I hope so, cause he is going to be the one to take the plate out.

So after almost 2 hours of being poked and prodded I was done. I wiggled as much out of him as I could, as doctors don’t like to tell YOU the results, they’d rather another doctor tell you based on their notes. Or some bullshit like that.

But, according to him my symptoms are obvious. Turns out I have what he called “beautiful anomalies” in my nerve conductivity, as well as 2 pinched nerves, Thoracic Outlet syndrome, Nerve compression at C6 and C7, and a possible herniated disk. So in lamens terms, The Surgery fuct me up worse, and i have nerve damage.

WooHoo for modern medicine.

So it’s been a week exactly and I’m STILL waiting for the “official” results to be sent to the vascular specialist. Once he gets them I can decide what type of surgery needs to be done. Hopefully just taking the damn titanium plate out will be enough to give me my hand back. At this point that’s all I want, to be able to draw and write without my hand going numb and being in excruciating pain.

Ahh, one can dream.

More to come….