more on recovering…

I haven’t been doing much. My arm is in a sling and I can’t (read:shouldn’t) move my right arm one bit. It hurts if I so much as inch my shoulder in any direction. And since I can’t move it, I need to have my arm inside my shirt. Needless to say, I’m constantly shirtless at home. If I go for a walk, I always get weird looks when people first think I don’t have an arm then they see my hand poking out near my belly with my arm inside. I try to open up the top of my shirt a bit so gawkers can see the white surgical dressing all over my shoulder…

My plan was to take Monday off work and go to school at night. Didn’t happen. The day after, I called in sick from work due to pain. On Wednesday I went to work, but stayed only an hour and a half. I went home since the pain meds made me woozy. Skipped school too. I called in sick for thursday. Today, friday, I don’t have work. I effectively took a whole week off from everything.

I must’ve been in a lot of pain from the surgery, last friday, through all of tuesday. I had been taking my vicodin religiously and was not getting any adverse reactions. It didn’t bother me at all. Which is why I was so surprised that it made me woozy at work on wednesday. That was the first time the meds affected negatively, and it has been doing so since. Guess the degree of pain I’ve been suffering has gone down, which is why I’m now feeling the effects of the drug.

Am woozy as I type this. With my left hand. On a laptop. The touchpad is driving me crazy as it keeps moving the cursor around as I type. I should disable it.

I also kind of settled into a routine. Wake up, feed turtles, ice, eat, surf, watch turtles, ice, nap. Over and over until midnight when I try to go to bed.

I was given an “ice machine” to help with the pain. You put ice cubes and water in this mini-icebox thing. Then you strap this pad all over shoulder and connect the two together with some flexible tubing. The machine circulates ice cold water through the shoulder pad. It turns the circulation on an off, to regulate the temperature to about 45 degrees F. Pretty neat. My theory is that it keeps it at that temp since its cold enough to numb the pain, but still warm enough that it lets your wounds and incisions heal. I’d been using that twice a day for four hours each. Yesterday, thursday, was the first time that I didn’t use it.

Also, yesterday, I tried to delay my dose of pain meds. I was able to go off the meds (delay my dose) for 30 minutes without feeling too much pain. Previously, it would start hurting really bad an hour (sometimes more) before my next scheduled dose.

I disabled the touchpad. I can type without going crazy now.

..recovering…

Had my surgery 3 days ago.

For minimally invasive surgery, I’m going through a lot more pain than I expected.  I wonder how the pain was for the old, invasive type of surgery…

Good thing I have my Vicodin (hydrocodone pain meds), but it isn’t enough.  Icing the site helps a lot.  I always knew to put ice on fresh injuries, but somehow I never ever thought of it for use in post-op.  Ice and Vicodin, ahh!!

I had a long wait before my surgery.  The surgeon was expecting the patient before me to be really quick.  Turns out s/he had a more complicated situation and it took a lot longer.  For me, he was expecting it to be hard and difficult, but it turned out to be rather simple.  (The reason for this is because x-rays and MRI’s don’t give you a full idea of the injury, so the doc only knows for certain what needs to be done once he goes into your shoulder and “sees” and operates on your shoulder.

So my surgery was rather simple.  Although I was in and out of it after my surgery, I understand that there were no screws or sutures attached, and I had some “excess” removed.  Guess I’ll find out for certain when I go for my follow-up.

It’s funny, before the surgery the last person I saw was the anesthesiologist (did I spell that right?) as he was telling me where he was going to stick the needle.  I felt something prick me by the neck, then I woke up in another room, tubes and wires on me, my surgery all done.  My arm was in a sling, I was cold, and I couldn’t speak very well.  They said a tube was in my throat.  I don’t know why a tube was needed in my throat.  Besides making it hard for me to talk for the next two days, it was also very hard to swallow food and drink, which would make me throw up and cough uncontrollably.   Anyway, am glad that the throat thing is done.

I got a glimpse of some arthroscopic pictures of my surgery, I hope I get to see them and get to keep some copies!!!

I’ll be going back to recovering now…

video of what my surgery might be like

This video is what I think will be closest to what my upcoming surgery will be like.

This one below should be pretty similar…

There’s no way to tell exactly what will be done until a surgeon goes in with an arthroscope since x-rays and MRIs aren’t enough to give an accurate picture of what exactly is going on with the injury.

Based on what my doc sees when he goes in, the following might happen:
– A screw/suture (or more) will be drilled into my shoulder
– excess (I believe excess labrum or cartilage) will be shaved or cut-off
– a combination of the above

The first will have a longer healing time than the second, either way I’m going to be in a sling for a bit and will need therapy.

If I’m provided with a video of my procedure I’ll be sure to post it up here

Haven’t had surgery yet

I really dislike how doctor’s appointments take so long here in NY (yes, I’ve complained a few times about this before).

I found out I needed surgery, told the doc I’d think about it. I did a lot of research and asked a bunch of people what they thought for a week. Then I called my doc to tell him that I’ll do it.

I had to schedule an appointment with my doc to do this so I called for an appointment. As usual, you can’t have an appointment with a healthcare provider within a week in NY, so I had to wait a week and half for an appointment where we were going to discuss the date of surgery and some other things. (Doesn’t that sound so corporate? Having a meeting to schedule a meeting.) So I have my appointment and learn that I need to go to my primary care doc to have a physical and get some specific blood work done.

So I have to wait a week to see my primary doc to get these tests done.

I think it takes a week for the results of these tests to come out. Which is kinda bad since I scheduled the surgery for the first available date, which will happen during the week that my test results will be processing.

So when I find out when the results will be available, I’ll likely have to change my surgery date. Which could potentially move my surgery date back a week or two. Counting the weeks involved to get this surgery done (starting from the second paragraph), it will take about four and a half weeks to get this procedure done. Yeesh!! I just want to get this done with already…

MRI results

Someone found my blog by doing a search for “How long to find out MRI results.”

So while that individual likely won’t be seeing this post, here’s my answer: It usually takes an MRI facility three business days to deliver the results to your doctor. You won’t know the results until you see your doctor.

Ok, now for my MRI results…

I will need surgery. A tear like the one I have should have healed already as it usually takes four to six weeks to heal, but my injury hasn’t improved after about eight weeks. So it’s the knife for me.

I don’t have a date for my surgery yet as I want to do more research before I schedule anything.

The alternative to not having surgery is to live with the injury and change my activities. I can’t do without BJJ (or any martial art), not exercising, not being able to snowboard (able to fall) and stuff so I don’t like the alternative. Of course I don’t mind not being able to carry the groceries with my right arm.

The procedure, arthroscopic labrum repair, is minimally invasive and will take about 45 minutes. I’ll be able to go home after but will need to have my arm in a sling for two or three weeks. Then I’ll need about three months of therapy. Oh joy!!

Hopefully I’ll be able to roll again in January 2008. I better get the surgery sooner too so I don’t miss out on the upcoming snowboarding season (global climate change permitting)!!

More about my labrum

My shoulder injury has improved somewhat since I got it about two months ago. I say somewhat because even though it’s getting better, it’s taking a real, real sloooooooooooooooow time improving. As a matter of fact, I could almost say it hasn’t changed.

Anyway, I went back to my doctor the other day…

It sucks not knowing for sure what your injury is… my doctor (an orthopedic doc) and his Physician Assistant suspect a labrum tear and all symptoms point to it, but they aren’t 100% sure. So I finally got an MRI and we’ll find out for sure what the injury is and how big or small the damage is.

They said I could go back to training, but very lightly. Hearing this made my day and I decided to go back to training in two days.

The day after, I told my physical therapist this and he explained that any time I put weight on my arm/shoulder, it stresses the injury, and could make it worse. This makes posting my arm out to avoid being swept or just to maintain base something I should avoid, but with the randomness of rolling and all – it’s mostly a bad idea to go back to BJJ now, even if all my rolling doesn’t include stand-up. Guess my doc doesn’t know what happens in BJJ.

I decided to wait to see the MRI results before making any training decisions.

Most likely my injury is a small tear. It’s small enough that activities of daily living (putting clothes on, walking, eating,etc…) isn’t affected, but it does hurt when I put on or remove a shirt. So for the most part, the injury isn’t severe and I’m not a surgery candidate. Some people will be able to live with this injury and avoid any surgery, but I do want to get this injury better so I can go back to BJJ. And if it’s not BJJ, it’s going to be another martial art. The point is, martial arts has always been a part of my life and I want it to continue being a part of it. If surgery is necessary to be able to put weight on the arm, swing it, punch with it, block with it, then I will choose surgery.

I’ll know the results of the MRI in a week.

An MRI wasn’t taken before as the injury was too “fresh” when I saw the doc the first time. I guess all the swelling would’ve made for a less than optimal image. I posted before about how in NY you can never have an appointment with a healthcare professional within a week of setting it up – well, right after the doc appointment I walked into the MRI place they recommended, as it was in the same building, and got my appointment right away. Filled out some forms and had my MRI immediately. Wow.

Butterfly Guard to Armlock

Ok, here’s the move learned in BJJ Class 89, the technique where I injured my shoulder trying to figure out escapes for. I’ve had these photos ready for several weeks now, but just looking at them pains me, so I haven’t been able to post this…

Nogi starts off with Boarder in his butterfly guard.

Nogi sits ups and grabs both of Boarder’s sleeves…

…and pulls boarder off-balance and down.

With Boarder still off-balance, Nogi hipscapes (shifts) to the left and underhooks Boarders right arm.

Hipscaping further, Nogi brings his knee up and uses it to put pressure on Boarders shoulder. Nogi is tighly gripping onto Boarders arm using his own hand, wrist, forearm, and elbow. At the same time, Nogi is also trapping Boarders hand on his shoulder by raising his head up (bringing his left ear towards his left shoulder) .

Here is a different angle of the same pic. Nogi’s knee and arm should really be pressing on Boarders shoulder and elbow. It is important that this is performed tightly, otherwise Boarder will escape easily. And even though everything is tight, Nogi will likely have to adjust his knee and elbow to make Boarder tap.

If the technique feels tight but isn’t making Boarder tap, Nogi can roll toward his right – thus modifying the pressure slightly, but making it even more difficult for Boarder.

Now, this is how it would likely happen during a roll…Boarder is in Nogi’s butterfly guard.

Nogi sits up and grabs Boarder, underhooking Boarder’s arm in the process.

Falling back and keeping the underhook in place, Nogi begins to hipscape out to his left.

Keeping his arm tight on the elbow and his head tight by the wrist, Nogi keeps hipscaping and puts his knee on Boarder’s shoulder.

With everything in place, Nogi adjusts his knee and elbow, and rotates inward to make Boarder tap.

getting PT and more about my injured shoulder

After about a month of my injury, I finally started physical therapy (PT). I had wanted to get started sooner, but there were some difficulties along the way.

First off, I had to see my doctor as I’ve never hurt my shoulder before and needed to know what the injury was. For some reason (could be a big city problem) I can never get an appointment with a doctor/health-care provider within a week. So I didn’t get my appointment until a week and a half later. I blogged a little about that doctor visit here. I got a PT prescription and a follow-up appointment.

Then I went to get PT. My first stop was going to my company’s in-house PT center. By “my company” I mean the company I’m taking a leave of absence from, not the one I’m interning in. My big Pharma company has a free in-house (it’s in one of the buildings) PT center, so employees don’t have to deal with insurance & co-pays, and the company saves money since we don’t waste our time going to/from an outside PT place. Anyway, I wasn’t sure if I was eligible for the free PT since I was on leave and it turns out that I wasn’t. Going to my company’s PT center, leaving my script, waiting to find out if I was eligible, and getting my script back took about a week.

Then I spent a few days researching and looking for a regular PT place. I found one that was conveniently located and covered by my insurance company and made an appointment. The appointment was, surprise surprise, a week after my call.

I had my appointment, which was an evaluation, and learned more about my injury. Even though its recovered much from the first week, various movements – including putting on and removing t-shirts – hurt. At the same time, the shoulder is in a sorrier state than I thought. I can’t do any exercises on therabands as they cause pain, so I’m limited to isometric exercises – which basically means that my shoulder workouts are limited to pushing a towel into a wall. I also shouldn’t carry heavy things with my arm, sleep on it, or do push-ups.

My injury is a torn labrum. See this and this for more info. From what I understand, the labrum helps a lot in holding the shoulder in place, which explains why I tore it given the submission I was trying to learn to escape from (I have Snowboard Instructor illustrations of that move, but the post has been in drafts for a few weeks now – I can’t seem to bring myself to finish typing it up). Given that my injury hasn’t changed much in the past two to three weeks, I really do hope that surgery will not be required. It probably won’t be as my shoulder is pretty stable, which indicates a small tear.

Can’t wait to get back on the mat!

shoulder pop and falling at the crack

Didn’t touch this blog in a week. Injuring my shoulder kinda got me down.

It got injured while figuring escapes for a technique two weeks ago. I stopped training since my shoulder never popped before (it popped twice) and I’m too unfamiliar with this type of injury. Anyway, I didn’t get to see the doctor until a week after the injury.

Other than a tear on the ligament (or something like that) it should be fine and will heal by itself. That’s good news. I was given a month of physical therapy and was told not to do any upper body exercises in the meantime. That’s bad. I was prepping for a Naga tournament for the first week of August. Bad. I told the doc about it and he said that after two weeks of therapy, if my shoulder feels ok I can go back to training. The tournament is roughly two weeks away already. Sucks!! And if the injury doesn’t feel any better after a month of therapy, then I should see the doc again.  It sucks that this means I’m basically out of the tournament!!

And I’m out of BJJ for at least two weeks, possibly for up to a month.

In the downtime I intend to do home workouts for my cardio and lower body. I did 25 minutes on AG’s elliptical the other day, followed by about 60 lunges per leg, sit-ups, and about 60 shoulder bridges (per shoulder). The shoulder bridges don’t hurt the injury as my arms are in the T-rex arms position and don’t move. Hopefully I can do a similar workout a few times a week.

The doctor I went to was the same doctor I went to for my finger before. And since I promised to blog about that injury, here’s the story.

Two years ago on Valentine’s Day me and AG went to the crack (that’s Mountain Creek in NJ) to snowboard for the day. During the day, I was already forming a dislike for this crummy mountain. It is the most crowded mountain anywhere, worse than weekends at Hunter Mountain, and the slopes are full of rude kids (them kids!). The trails are also very badly designed and no thought was put into them. The crowd at the crack is, I’d say, about 85% snowboarders and there are two many points that are flat and uphill. So you have 85% of everyone strapping off and walking or skating at too many uphill and flat areas all throughout the mountain. Most other mountains place mounds (or big humps) through out the flats so that you are always kept moving and never have to strap off and walk. Oh, and since the crack is in Jersey and the east coast, there’s more ice than snow.  And After the injury, I just really hate this mountain.  It is blacklisted in my book.

So anyway, I was going down this trail, which was narrower than most, but just as crowded and icy. Long story short, I lost my edge and very quickly plowed into a skier (1,000 bonus points!!!). I basically went straight down into the skier, taking out the legs. My hand hit the hardboot and I saw the skier fly over and above me, with one of the skis flying high in the other direction. When I stopped moving my hand was in so much pain. While still lying on the slope, I took my gloves off to check – my hand had swollen up and felt broken. Fortunately, only my hand was hurt and I was able to ride all the way down to the ski patrol hut. I think the skier walked or rode down on the ski patrol stretcher, I don’t remember.

I iced my hand and kept it raised the rest of the day and night, even while at the party we went to afterward. We went to the ER the day after. My middle finger was badly injured, but not broken or fractured. It took months for it to feel normal, but even now it doesn’t have full range of motion and I can crack the digits in a way most people can’t.

That’s it for now…

My scrawny neck

I was riding the subways with AG on July Fourth stretching my neck and such like I usually do. For reasons pc-related (poor posture when staring at a computer screen at work or at home) I had a really tight area on my neck. So I stretched and stretched and really stretched my neck. I stretched so much that I pulled a muscle and now my neck is a stiff rock between my head and injured shoulder…Well, I’ve iced it for the past two days, but it’s still stiff and my neck doesn’t have its full range of pain-free motion.

It’s gonna take a week or so of light stretching and lots of heat before my neck goes back to normal…

And I thought I had learned my lesson on overstretching already. I injured my self similarly on December 1st last year. Read about that here: Ouch, neck!