A Note on Coughing & Sneezing

It hurts!!! A lot. For the first few weeks it really hurt badly. I have allergies and everytime I would sneeze it would wrack my entire body and cause a sharp shooting pain to run down my arm. There was a lot of "Achoo! Ouch!" to be heard in my apartment. That pretty much lasted until about post op day 26.

It was weird. I sneezed, was bracing myself for the coming pain and it didn't come. It was a pleasant surprise but not absolute. While it doesn't hurt just to sneeze or cough anymore, a particularly violent sneeze or coughing fit will still cause a bit of pain.

I happened to get some bread crumbs caught in my throat the other night and after all was said and done I needed to take an Aleve for the pain.

I forgot to mention it in my last post and thought it was important to mention.

Post Op - Week 2-4

I'm combining weeks 2,3 and 4 into one post for a few reasons. First and foremost I would like to catch up to real time so I can post about current events as they happen and stop writing about thing that happened months, weeks and years ago. Secondly, while there were accomplishments and milestones during that time, I did spend a lot of time sitting around, doing nothing.

The first big milestone was being able to shower, not only for myself but for everyone else who had to be in the house with me. I had been trying to keep myself as clean as possible for the first week but no amount cleaning, baby wipes, baby powder or deodorant is going to keep you from being a little ripe after a week.

Showering, at first, was a great luxury and a bit of a challenge. I had not worn a shirt for the first week after the surgery, not properly. After showering for the first time I managed to get a tank top on. Since I was not really allowed to move my left arm, I got the top on by running it up my left arm and then putting it over my head and putting my right arm in. This is how I would put a shirt on for the next three weeks. I spent much of that time showering every other day.

I learned quickly that this was not going to be business as usual. Since I really had only one useful hand it took me at least twice as long for me to do anything. It took about an hour to shower and get dressed. In addition to that it caused me a bit of pain. It was not terrible pain but it did not make it pleasant. The pain-shower association continued for about another week and a half. The first time I was able to shower and not have it be painful was February 10. For those of you keeping track, that's 11 days post op.

I also realized that I was not as prepared as I would have liked to have been. I had only purchased one over-sized sweatshirt and no t-shirts. Unlike my first week, it was great to be able to wear a tank top but if I became cold my choices were very limited. I had about two XL tee shirts and that one sweat shirt I had purchased. I needed the extra room since I was only putting my good arm in and wearing the shirt over my left arm. A few more shirts and another sweatshirt or a larger coat would have served me well.

On the other hand I was fairly well prepared in the pants department. If you do have a surgery like this you should be sure you have plenty of pants that you can put on with one hand. I had an assortment of sweat pants and pajama pants that were comfortable and elastic waisted. I also learned how to put my socks on, one handed. I can become very creative when properly motivated.

I could have also used another shoulder immobilizer. The only one I had was the one I was given at the hospital and, considering that I had to wear it 24/7, it was getting a little gamy. I was also having difficulty with the immobilizer I was given for another reason. It's basically a sling with a waist strap and after days of wearing it was beginning to really hurt my neck. I was hoping that I would get a better immobilizer when I went for my appointment but I was left to my own devices. I turned to Amazon.com and came up with the shoulder immobilizer shown below for around $25.

It held my arm in place with a lot more than the sling style one and it didn't put any strain on my neck. It did have two minor issues.

Firstly, the large foam-like piece that wraps around the body and the cuff that wraps around the arm are great for stability but they do make one very,very warm. For me it was not so much of an issue since my apartment is not overly warm in the winter. It actually helped me to stay warm since I was limited in what I could wear.

Secondly, there is the issue of what has become known as the foot-hand. As you can see in the picture, my hand is enclosed in a swath that supports the forearm rather than using a sling. This is great except that your hand is a very small, enclosed area for most of the day and your hand ends up smelling like feet. I realized how much of a problem this was the day Coral came home and, politely, asked if I was going to shower. I had showered earlier that afternoon, but all she could smell was the foot-hand. The beast was living in the swath.

I solved the problem by removing the swath the next day and taking it into the shower with me. I gave it a good washing and let it dry while I wore the old sling immobilizer for a day or two. Now, whenever I wear the the new immobilizer I put deodorant on my hand and it seems to have kept the foot-hand under control.

All the while, my wounds were healing nicely. I was keeping them clean and putting bacitracin on them once or twice a day to help them heal. I took pictures weekly so I could share them with you and I didn't really do too much other than that. They healed nicely and I expect the scars will fade over time. The rear incision is almost invisible now. The most pronounced of the three is the one closest to the clavicle and even that is not readily noticeable. By the end of post-op week three they were no longer sensitive to the touch.

Before the sutures were removed. To give a sense of scale for the incisions.

POD 8

POD 15

POD 23

** Yes they are all the same shoulder. I just took some of the in the mirror.

The last issue to discuss during this period is food. Since I was alone during the day after post-op day 6, I had to make sure I was able to prepare and eat my meals during the day on my own. Coral was good enough to make sure coffee was made before she went to work so I was able to just nuke a cup of coffee when I woke up. Breakfast was usually a simple meal. I would just have a bowl of cereal or oatmeal, coffee and a piece of toast.

Lunch provided some more options. I had purchased a few frozen meals before I went in for surgery so that was one option. My Aunt Gen was kind enough to send over a bunch of very yummy chicken soup in individual containers and then there were also dinner left overs in the fridge. I was able to eat anything that I was able to microwave and I didn't have to cut up. The biggest thing was just making sure I had that kind of food available.

Poor Coral got to come home every night, after being at work and class all day, and not only cook dinner but also do the dishes I had dirtied all day. She did it all without complaining and made life much easier for a temporarily one armed man.

Post Op - Week 1

The first week really flew by. Coral was able to work from home for the first two days after the surgery so I had constant help for the first 4 days. The routine did not change much during that time. We were icing the shoulder in 20 minute intervals throughout the day. My shoulder block wore off some time between 7 & 8 AM the next morning but I was already well ensconced in Vicodin-land. About 5 hours after I had taken the 2 Percosets in the hospital, I started taking the Vicodin and continued on straight through till the morning.

I was, probably, over-medicated but everyone had stressed to me to not let the pain start before I decided to take the meds and I planned on listening. To that end, I was taking one extra-strength Vicodin every 4-5 hours until the shoulder block wore off, then I started taking two. This was a 24/7 routine for the first 3-4 days. Coral was even setting the alarm for the middle of the night to give me pills.

We would put a snack, a glass of water and the Vicodin next to me before I went to bed. When the alarm went off, Coral would get up, make sure I took my meds, I ate a little something and we would ice the shoulder for 20 minutes before she went back to bed. She should be canonized for doing that, it couldn't have been fun for her.

As I noted earlier, laying down was not an option for a while. I didn't have room for a recliner so I slept in the arm chair with my feet on the ottoman for a few days. When I became tired of being in the chair I moved to the couch and slept with my feet on the ottoman while on the couch. I would cover myself with a blanket while I slept. I did that for 6 nights and I was comfortable enough sleeping that way for the week. I don't know what it was but sleeping sitting up for six nights really didn't bother me. Maybe it was the fact that I was taking 750 mg Vicodin tablets, 2 at a time?

I had a large dressing on my shoulder when I arrived home that looked like I had placed a diaper on my shoulder. I was told I could take the dressing off after 24 hours and I did. Coral helped me remove the dressing when she returned from class on Thursday night and I finally got to see the wounds. There were two incisions on the front of my shoulder and one on the back, none of which required more than 2 or 3 stitches. I placed band-aids over them and changed them daily until I had the stitches removed.

The following Tuesday, post-op day 6, I went back to see the surgeon. It was a brief visit. He took the stitches out, told me I could take my arm out of the sling once or twice a day to stretch my elbow and let my arm hang and keep my elbow from getting too stiff. After I asked, he said I could shower but returning to work was still not on my "To do..." list. Other than that, my job was to keep my immobilizer on 24/7, rest and go back to see him in three weeks.

I had been weining myself off the Vicodin a little at a time during that first week. After the first few days, the pain was manageable and started stretching out the time between doses, then I went down to one pill from two and then I was only taking them once in a while if I felt pain. I took my last pill on post-op day 6 when I woke up with some pain.

That night after I got home, I had a horrible headache. I fell asleep in the chair for a little bit while my sister left on the couch but the chair wasn't cutting it for me anymore. Once Jackie was ready to leave, I had to lay down. For the first time in a week, I laid down and went to sleep.

Surgery Day (SNAFU)

The 29th of January was not a good day for me.I was kinda amped up about the surgery and not dealing with it well. I had been out late the night before working. I was so intent on getting to work on time that I ran for the train when I heard the doors closing and I fell down the last three stairs in the station. The conductor was kind enough to hold the train for me but I went down hard. I fell hard enough that I was able to scrape my knee in two places through my pants and my elbow through my coat. It was not a great start to my day.

The doctor's office called me around noon and told me to be at the hospital at 10 AM for a noon surgery. Then I received a call an hour later telling me to be there at 8 AM for a 10 o'clock surgery. I liked that a lot better especially since I would not be able to eat or drink any thing from midnight on. I passed the word along to everyone who wanted or needed to know, went home, did some last minute shopping, had a nice big dinner late in the evening and went to bed.

We arrived at the hospital at about 7:45. Coral and my Aunt had both had small breakfasts, planning to eat lunch while I was in surgery. The staff at Roosevelt Hospital's Ambulatory Surgery Unit were wonderful. They were friendly, cheerful, helpful and generally warm. They had me fill out some paperwork and  we waited. I was called in once to do a pre-interview. I was asked some questions and the interviewer wrote "yes" in purple marker on my left shoulder and I was sent back to wait some more. Then I was finally called to be interviewed by the intake nurse.

She asked me another bunch of questions, made sure they had written yes on my left shoulder, asked about my fresh scrapes on my elbow and I told her about my little fall. While I was being interviewed, Dr. Hershon's office called asking where I had my MRI done because Dr. Hershon was looking for it. I explained that I hadn't been asked to have one and she said ok. I didn't feel good about it but I moved on. The intake nurse said to not be worried and asked me to change into a gown and got someone to show me to a locker.

Coral and my Aunt Gen were then allowed to come and sit in the waiting area with me. We saw a young woman come out from what appeared to be hand surgery. She was very alert and seemed rather chipper and pain free. I was hoping I would come out in as good a mood as her.  We were sitting there for a short time when Danielle came looking for me. Danielle is one of Dr. Hershon's Physician's Assistants and as soon as she said she wanted to talk to me in a private room, I knew some thing was wrong.

Let me interject an observation in my narrative at this point. Ever wonder why they make you strip completely to the skin underneath your gown for even the simplest of procedures? I mean, I was going to walking in and out of the hospital on my own power and the chances of complications were extremely minimal so there would be really no need to insert a catheter or anything else so why make you get naked? It's a power play. It gives the medical staff the upper hand in all situations. You're not going to argue too much with them while you're sitting there , in a rented gown with your bits hanging out. They could say whatever they want and you are at a disadvantage because you're not even wearing underwear. But I digress...

As it turns out, Danielle was there to deliver the bad news that Dr. Hershon had wanted me to have an MRI and somehow that little fact had never gotten to me. The good news, in her opinion, was that they had secured an appointment for me at a nearby facility and I would still be able to have the surgery today (I thought I might escape!), it was just going to be later in the day. She wrote me my prescription for Vicodin so I could have it filled before the surgery, gave me some post-op instructions, the address and phone number for the MRI place and begged me not to eat or drink anything while on my way to or from the hospital. With my 10 o'clock surgery out the window and an 11:30 MRI appointment, I got dressed and we headed over to the MRI facility.

At that point I wanted a big, fat bacon cheeseburger. I also felt badly for my Aunt and Coral. It was getting close to lunch time and instead of being close to going home I was still hours away from going into an operating room. They were both being sympathetic and would not eat in front if me so they were fasting too. It was not fun for any of us and I was cranky due to hunger and my frustration with the situation. But we moved on.

The people at the MRI facility, which was a short walk from the hospital, were very nice and accommodating. The technician was very pleasant and talked me through the whole procedure. That being said, I was not a fan of the MRI. If I was not convinced before I can tell you for sure afterwards that I never want to be buried alive.  We waited for the films, called Danielle on her cell phone and headed back to the hospital. Apparently, there was no need to rush.

We hurried back to the Ambulatory Surgery unit only to wait. Maybe you remember how I wrote earlier that they changed my surgery time from noon to 10 AM. As we sat there, after returning from the MRI, it became clear why. The case that was originally scheduled to be before mer was more involved than mine was so the switched my case to the earlier time to get me out of there more quickly. Now, due to the MRI SNAFU, we sat there waiting till 2:15 PM when the finally called me again.

I go through the whole routine again. Many of the nurses and the staff greeted me with "You're still here?" and they made me put my underwear back in the locker (power play). My escort meets me as I'm coming out of the changing room, hands me a paper hat I was more inclined to put on my chest than my head and escorts me to the pre-op area. Coral and my Aunt were directed there via another route.

I was given a blanket, wished well and left alone to talk and wait some more. A few other staff members came over to check on me and ask me questions and then around 3:15, Dr. Hershon came over to see me.  To his credit, he apologized, right off the bat, for the mix up. That meant a lot to me.

Those of you who know me may be surprised that I was so forgiving, given that I hadn't eaten or drank anything in 17 hours and normally I wouldn't have been. It meant a lot to me that he came over, apologized personally and immediately and didn't make any excuses. Also, I thought it unwise to argue with a man who was about to take a scalpel to my unconscious body. Plus, I wasn't wearing any underwear!

He left and the anesthesiologist, Dr. Rice, eventually came over to talk to me. He asked me a bunch of questions, filled me in on what he was preparing to do and then his assistant began the catheter for the IV. This was the nice treatment: After an extensive search for a vein, he gave me a local anesthesia shot at the site where he was going to insert the catheter. I never felt a thing. Coral left for class and my aunt went to grab something to eat.

He chatted with me, told me he was going to give me "the good stuff" via the IV and start looking for my nerve in my neck. He was feeling around on my neck and asked if I was nervous.

I said "Yeah. Why? Is my pulse racing?"

"No but you are sweating a bit."

**********************************************************

The next thing I knew I was waking up with a big clock in front of me. I was fighting the anesthesia, trying to wake up and the clock said 7 o'clock. I was very very thirsty and was able to see a nurse in brown scrubs. In my foggy state I was able to weakly call out "Brown Nurse! Brown Nurse!" Hey, it made sense at the time.

The nurse came over, got me some juice and I started to wake up some more. I saw Dr. Hershon at the nurse's station and called him over but my recollection of the encounter was vague since I was still slipping in and out of consciousness. Eventually they brought my aunt around and I started to become more lucid. We had a nice talk with the nurse. I was able to wiggle my ring finger and pinky pretty well and my hand was tingling. Danielle had told me that when my hand started to tingle, it was time to start taking the pain meds. I asked for pills, Brown Nurse gave me 2 Percosets and sent me to recovery.

In recovery my Aunt and I talked for a while, I ate some crackers and drank some more juice. I still felt a bit foggy so I wanted to wait a little while. I didn't feel terrible but I certainly was not as alert as the woman I had seen earlier in the day. A short while later, my aunt helped me to get dressed (thankfully that hospital robe was long enough to spare us both a little embarrassment)  and we headed home.

We walked to the parking garage around the corner to where my aunt's car was. I was a little cold since I just had a sweatshirt on under my coat and it was kind of windy. At that point, I didn't care much. I just wanted to get home.

The ride home was uneventful. Even though the shoulder block was still well in effect, I felt every little bump. I wasn't really in pain. It was more a tingling sensation every time we hit a bump that ran down the length of my whole arm. Around 9:30 PM we finally arrived back at my apartment.

It had been a long day, much longer than if I had gone to work. We got me settled into the chair and worked on ordering some take-out. I settled down with a nice plate of pasta puttanesca and we waited. Coral arrived home around 10:15 PM, my aunt went home and the day was finally over.