Wednesday, February 25, 2015

2015 A Humbling Experience

WARNING TO THE SQUEAMISH TYPES: FRESH INCISION PICS BELOW. I'LL POST A WARNING WHEN YOU GET CLOSER TO THEM

Before writing about where I left off with going back to Colorado for physical therapy in 2013, I want to write one more current post so you all know I'm alive and made it out of surgery on January 28th okay. The photo below is the last outing with my nieces and one nephew to see Disney's Frozen on Ice five days before surgery.
Below is how I ended up decorating my brace. I really love the encouraging words on the straps. I painted on HOPE, STRENGTH, BELIEVE, DREAM, LAUGHThey're daily reminders. I think of it like putting on my straps of armor. Then of course I have some Chicago Blackhawks hockey pride!

Front of brace





Back of brace
















January 27th
It was the day before surgery with Dr. E. I had an appointment with Dr. E. It was a chance for me to ask any questions I had and to go over any concerns before surgery the following day. Thank God for that appointment because the procedure completely changed by the time I left. When Dr. E walked in and asked if I was ready for surgery he could tell that I was hesitant by the way I said yes. I told him I didn't think putting the allograft (cadaver) tendon in by itself would work as efficiently without repairing the muscles that are detached too. He smiled and said I'm thinking too much. My response was I'm ALWAYS thinking and my brain NEVER shuts off. I then proceeded to explain when previous doctors fixed one thing at a time it didn't work and I was back in surgery 2-3 months later. I didn't want to be in that cycle again. After listening to my explanation, Dr E agreed to open my incision top to bottom and fix the muscle detachments. Dr. E then said, "There, now no more concerns!" and I said, "Actually there's one more thing; you still haven't gotten my arm up over my head like the doctor and therapists in Colorado did." At that, Dr. E said, "Let's work on this. Stand up and tell me what you want me to do." After some directing and explaining Dr. E finally held my scapula in the correct position and my arm went over my head!! YAY! Good thing I spoke up, because this completely changed how surgery proceeded.
This was my view from my hotel bed...the hospital. It beats looking at a dumpster 
January 28, 2015 (Weird fun fact- this was my first surgery EVER in the month of January. Now all months have been covered except August. Know that's NOT a goal I'm trying to reach) )

I was up early in the morning day of surgery because I didn't sleep very well. I showered and did my tradition of painting my toenails. I had to be at the hospital at noon so beforehand I watched the movies; Mean Girls and Patch Adams...nothing like complete polar opposites. Mom, Dad, and I did lots of waiting at the hospital because we were there at noon and I didn't get wheeled back to the operating room until after 6!! So what do you do when you're bored? Play cards and take pictures. Man was I hungry!!!
Dad and I
Mom and I 
It was unbelievably hard to get comfortable while waiting to get wheeled back.
When I saw this picture I really noticed how odd my neck looks
The medical team finally arrived with my chariot aka the gurney. We put my shoulder brace and neck brace on it so it wouldn't be forgotten. I hugged and said to my parents the same thing I always do before being wheeled to surgery, "I love you and I'll see you afterwards". This was the 24th time I've said this to them. I can only imagine what it must be like from their perspective watching me be wheeled off for the 24th time. I know NONE of us ever saw this many surgeries coming the first time I had ankle surgery. We've never said it's easy but I am blessed with one strong, stubborn, family who fights till the end.

Just when I was about to be put to sleep, Dr. E walked into the operating room. He said, "Did you see my disco ball hanging?" I shook my head no and he said, "TAKE THE MASK OFF! DON'T PUT HER TO SLEEP YET!" A few second later he had this disco ball in his hands that he was twirling. I started laughing! He then said, "THERE, NOW YOU CAN BE PUT TO SLEEP LAUGHING AND KNOWING I'M NOT A LIAR" He also reassured me I will be positioned exactly how I wanted to protect my neck, R shoulder and other joints in general due to Ehlers-Danlos Syndrome (EDS). Nurse Stacey rubbed my left forearm while saying everything will be okay. Next thing I know I was waking up in recovery.

I remember someone holding my hand. It wasn't my parents, or a nurse. I honestly thought it was Dr. E. He was asking me what I did back in the O.R because everybody liked me a lot and had nothing but good things to say. My mouth was so dry so I just did the "I don't know" motion with my hand. He laughed and said they all loved me and kept talking about me. He then let go of my hand and the pain just started increasing. I remember saying my scapula, my spine, and my neck are killing me. That person that I thought was Dr. E was in fact him. He grabbed my hand, squeezed it again and told me I know you hurt, I'm sorry. There was lots wrong." Dr. E is the most compassionate doctor I have ever met. He is truly amazing.

There sure was a lot wrong with my left scapula (shoulder blade). I stayed in the hospital 4 or 5 days. The scapaulathoracic articulation was unstable (scapula joint). We knew I had muscles detached but we didn't know which ones or how many. One muscle had detached for the first time ever; my levator scapulae. Two other muscles had re-detached from my scapula; rhomboid major and rhomboid minor. There was also a mass that had just detached and stretched from my scapula; not sure which muscle that is. So there were at least 3-4 muscles detached. Now it was time to do the original procedure; stabilize my scapula. To do this an Achilles Tendon allograft was attached to my scapula and anchored to my spinous processes. Dr. E said it's basically a fusion only without plates and screws. A I read through the surgical report so many pieces fell together as to why I've been killing with pain for 3 years just on this left scapula alone.
http://www.slideshare.net/TheSlaps/dr-b-ch-11lecturepresentation

The rectangles give an idea of where the muscle detachments were.
The line on a diagonal represents the allograft. I don't know if this is
100% correct positioning but it gives you a general idea. This diagram
is on the right side but the work on me was on the left side
http://www.cedars-sinai.edu/Patients/Programs-and-Services/Spine-Center/The-Patient-Guide/Anatomy-of-the-Spine/Vertebrae-of-the-Spine.aspx

The pinkish color is the spinous process and is where the Achilles tendon
 allograft was anchored
WARNING: BELOW THIS 1ST PICTURE IS INCISION PICTURE
Below is what I looked like when I got wheeled to my hospital room. I don't care how medicated you are but those bumps coming out of elevators ALWAYS kill. You can think of them like hospital speed bumps.
Immediately after surgery.
Definitely not the most comfortable sleeping position.
This visually explains why it kills to put pressure on my back and stand vertical.
It was nice not having staples this time around. That cord is a tube
that is attached to a drain to collect excess fluid.
Do the best you can. That's all you can do. 
This surgery has been extremely humbling for me. It has been by far the hardest recovery. I'm one month out from surgery today and the amount of pain and help that still exists is mind boggling for me. This was my 19th shoulder surgery and I thought the pain couldn't get that much worse; considering I've had other really big surgeries. My gosh was I wrong!! This one takes the cake. Maybe it would be easier if I had one semi-decent arm but having both arms out of commission requires help with so many things.

The last time I needed this much help was when I was a small child. In the hospital I was humiliated when I had to brush my teeth while sitting in a chair and had to spit into the cup the nurse was holding because I couldn't bend forward. I was humiliated being checked for bed sores because I was pretty much stuck on my back. The nurses had to sponge bathe me. They had to put my medicine in my mouth and give me my drinks along with a million other things to help me.

Nurse helping me clean my hair
One of my nurses
One of my other nurses 
Its been humbling with my family too. My family has to get me dressed. Since the motion in my right arm is so limited my family feeds me like a baby and puts my pills in my mouth because I can't reach my mouth. Straws are in all my drinks so my family can help me. We now have a wheelchair because I can't walk far due to all the repair work in my upper back I can't stand too straight; EDS is flaring up my knees and hips due to the lack of exercise I have to wear braces for my knees. Then there's the neck brace I have to wear which means lots of stares with all the bracing.

My sister doing my hair
My 9 year old niece feeding me
This has been a humbling experience but if it weren't for the nurses and my family I would be completely helpless. All you nurses and family deserve a million thank yous!! I don't care how much pain I'm in, but I ALWAYS make sure to say thank you. You're the ones helping me get through this after all! Let's not forget all the text messages, emails, phone calls, and sent gifts from friends/family; including people I don't know and have never met. Your support does more than you realize

Feel Better card from my niece and cuddles from my dog 
My first outing was 4 days ago. It was so hard but
so well worth it. Baby steps
https://www.pinterest.com/pin/415105290628623439/

Thank you so much to those that have been 'liking' directly on my blog post and re-sharing it. It has been so much fun watching my numbers rise, make new friends, and hear other peoples stories. Please feel free to leave comments directly on this blog post page.  

If you want to follow current updates, go onto Facebook and directly "Like" Meg's Shoulder & Scapular Journey By directly liking this page you will be helping raise awareness about a connective tissue disorder that I have called Ehlers-Danlos Syndrome as well as raise awareness about rare shoulder and scapular injuries.

For more info on Ehlers-Danlos Syndrome click on this link The Ehlers-Danlos National Foundation 

Wednesday, January 21, 2015

2015: Let the "Fun" Begin

I've been contemplating on what I should write and I've decided to write a current update because I'm having surgery next week and writing is a coping tool for me; I know I'll "feel better" once I get it off my chest.

Warning to the squeamish types: there are 2 pictures near the end that might not be your cup of tea. It's NOT blood & guts; just a scapula shifted out of position. I'll post another warning when you  get closer to it. 

As I reflect back on 2014 the first thing that comes to mind is: what a long, hard, crazy, exhausting roller-coaster year!! It was a year full of so much travel seeing physicians that I had been referred to throughout the United States. We traveled approximately 7,542 "medical" miles! These miles were divided between trips to Pennsylvania, Massachusetts, Colorado, Minnesota, and of course, Illinois. Talk about a lot of flying and driving just to see a doctor!!

When 2014 started I thought it was going to be a year of moving forward and having the surgeries that were proposed in 2013 done. Instead of moving forward though, it seemed like there was some higher power constantly putting obstacles in my path so those surgeries would not happen. At the time I was so frustrated and angry at my situation. All I wanted was to have the surgeries done so I could begin the rehabilitation process to regain some of my arm function and get my life back. When you're living with a chronic medical condition 24/7 and all the various challenges and pain that goes along with it, it's really, really hard to see how things could possibly work out because you're too close to the situation. When doctor appointments don't work out, my family and I constantly tell ourselves, "That doctor wasn't the one meant to help me." When I look back now on how all the events unfolded in 2014 I know I had somebody looking out for me the whole time. It's kind of an eerie feeling because the two big surgeries that I just wanted to get done and over with would have never worked.
http://www.pinterest.com/pin/362047257519360343/
Fast forward to November 2014. I had finished doing two and half months of extensive physical therapy in Colorado trying to narrow down what is wrong with my neck, upper back, both shoulder joints, and both shoulder blades. It was now time to head to the fourth state to meet with yet another doctor; this time we were off to Minnesota. I can't begin to express how scared, anxious, and nervous I was. I felt so sick the day of appointment due to the nerves.

November 17, 2014
Total game changer- Thank God for Dr. E! He has seen 6 other patients similar to me. All 6 are female, have Ehlers-Danlos Syndrome (EDS) or a cousin of EDS, are tall/thin, were once very athletic, and problems started at around age 16. It's a very difficult problem to treat and it's really hard for me to put into words what the issue is. In layman's terms, it's a very, very, rare, messed up/altered muscle activation pattern that Dr. E has only seen in this category of patients. The altered muscle activation pattern causes the scapula (shoulder blade) to "dance" because there is no stability. This causes both scapular and posterior (back) shoulder joint instability, decreased strength, and very limited motion. The first step of trying to treat this was to have botox injections into my trapezius and serratus anterior muscles. It was supposed to take about a week to kick in, would peak at around 3-4 weeks, and would take 3 months to be out of my system. As luck would have it, I reacted completely opposite of what the botox was supposed to accomplish. Things started feeling worse on day 3. Instead of relaxing my muscles it made my muscles ridiculously tight, decreased my motion even more, and skyrocketed my pain. I kept trying to tell myself it's only been X amount of days/weeks there's still a chance it will get better...time would tell. In regards to my neck, there's a major problem and I have "extreme hyperlaxity" in it. A neck brace was ordered and we're trying to see if it will stiffen up my neck. I don't think it's stiffening too much but it does help with some of my symptoms which I'll take. In regards to my right side it too has this weird muscle activation pattern, but it also has some weird nerve problem that is still being investigated.

When we arrived home from Minnesota, Thanksgiving was literally just a few short days later. It was the first time my mom and I had been home since August. It's kind of funny that the only picture that was taken of me on Thanksgiving was when I was messing around with our dog Daisy and not with anyone in my family.
I tried to get it so it looked like she had on a babushka :)
Apparently my nephew thinks my neck brace makes a good mask too :)
In December I was really not feeling well at all. Between the botox and the climate change my body was reacting negatively. My joints in my upper torso were more unstable than they were when I was in Colorado. When I was in Colorado I felt better and had even gained almost five pounds which was a very good thing. I've been trying to put more weight on. Within a few weeks of being home I lost the weight I gained, plus some. I emailed Dr. E to see when I was supposed to come back for a follow-up appointment. He said in January or February depending on how I was doing. I scheduled an appointment for January 7th. I had called mid December to see if I could get in sooner and the good news was there was a same day cancellation! But wait....the bad news....the appointment was at 4 o'clock and it was already 11:30. I didn't have enough time to get from Illinois to Minnesota. Did you really think I would get in sooner?..haha that would be too easy :) Too bad we don't have those tunnels like in Super Mario that transport you quickly from one location to another :) That could have been pretty convenient.
http://www.strapya-world.com/products/68910.html
Me, my niece, and my dad at the holiday zoo lights.
There's no way I could walk the entire zoo with all the
upper body stuff going on so we rented a wheelchair. It's
way more enjoyable to be pushed around than to be really
stubborn and hurting a ton trying to walk.
Also, scarves work really, really well to cover up the neck brace
if you're self conscious about it!
On Christmas Eve I got the most amazing tea mug from my brother and sister-in-law. I use it just about every day and every time I do, it always makes me smile.

So true haha
My favorite picture of my nephew Justin. His facial cracks me up.
January 7, 2015
We were back at Mayo in Minnesota meeting with Dr. E. I was reevaluated and the botox did in fact make me worse and he had never seen any reaction like it before. Gooooo figure! My parents and I were told I have a lot of problems and despite all the previous surgery I've had, surgery is needed. Instead of going into the surgery with the mentality of, "I'm going to fix everything" Dr. E made it very clear that he only wants to fix one problem at a time to see how I respond. During this surgery Dr. E is going to be attaching an allograft (cadaver) tendon between my scapula and my spine. We're hoping this surgery will help me just to get my arm to shoulder level. The allograft will medialize my scapula and keep it in internal rotation (basically if you were to shove my scapula in towards my spine). My biomechanics are completely screwed up and this is completely opposite of normal. Dr. E doesn't know why this is the only way I can move my arm but the point is it does move this way so we have to help my body so it can. My mom asked Dr. E, "What do we call what Meg has?" and Dr. E smiled and said, "The Megan Syndrome". I officially have my own category and I am not the same as the other 6 individuals. I'll be braced 6-8 weeks after surgery full time. The good thing is if I don't respond well to the surgery, it's easy enough to cut the allograft out with local anesthetic in the office and Dr. E has backup plans. 
My new custom brace that took almost 2 hours to make.
It's nice because there's no weight on my shoulders or neck.
My sister bought me foam so I can put it between my ribs and the brace.
My ribs don't like the pressure of the brace at all but the foam at least
gives a little bit more padding. It's pretty gross feeling my cartilage
slip over my ribs when I move.
To the squeamish types, the 2 pictures are below this paragraph...

So here we are today. In exactly one week I will finally be having my surgery on January 28th. I've tried everything under the sun for the past 2 years trying to get better conservatively and it's not working. My symptoms are getting worse, I've lost my arm motion & strength, my neck is worse, my pain is off the chart, I rely on so much help, and I've dropped 15 pounds due to the pain. I'm happy to finally have a treatment plan in the right direction. I'm not really nervous about the surgery itself. I'm more nervous about how my right side is going to react and how I'm going to get through the next few months because neither arm will be working. One will be immobilized and the other can't move at the shoulder; it's all elbow motion. I'm going to have to learn to accept a ton of help. My family is up for the challenge; wish them luck.  

This happened last week when my mom and I went
to run a couple errands. When we got home I had to
go lay down. An hour went by and I took my shirt
off to have my mom apply cream and this is what we found.
My scapula shifted waaaay out of position. No wonder I didn't feel right.
This is what happens when I try to "push" the wall.
It has been a very long week since this happened.
I've had to immobilize my arm every day. 
You might be asking how did this happen? How did I injure myself? The primary diagnosis in my chart is Ehlers-Danlos Syndrome which is causing all the laxity, which is causing all of my problems. I didn't sustain any specific injury and I don't have some amazing heroic tale to tell. It comes down to faulty tissue. The good news is I have a doctor who is totally invested in my case and has amazing communication skills. I have a doctor who believes my crazy symptoms and doesn't think this is all in my head. I have a doctor who is optimistic that he will help me get more use of my arms again; it's just going to be a long road to get to that point. I feel really good about working with Dr. E. 
The other day my nieces, nephew, sister, mom and I all made a pie. There was
a lot of love put into it and it tasted really good. We made a s'mores pie. 
I don't know how soon I'll be writing after I have my surgery. The best way to get current updates is to go onto Facebook and "Like" Meg's Shoulder & Scapular Journey My family will be posting updates there.  
My neighbor posted this quote yesterday and I found it very fitting

Tuesday, December 23, 2014

Trust Your Gut

February 2013

The weeks to come after arriving home from Colorado were filled with much activity. As expected there was a lot of physical therapy trying to rehabilitate this right shoulder but there was also a lot of apprehension. The cortisone injection Dr. M gave me February 1st wasn't providing a lot of relief. I had to force myself to ditch the shoulder brace when it was almost March. I was still getting the sharp pain and couldn't move my arm more than a couple inches; however, I figured I would "get used to it" like I have with other pains in my body. Dr. M said if things weren't improving in physical therapy after 3 weeks the next step would be doing an arthroscopic surgery to take a look in my shoulder to see what was going on. Instead of doing 3 weeks of physical therapy I ended up doing 9 weeks. At 9 weeks my motion wasn't improving and I was still having a lot of issues. I contacted my medical team in Colorado and the plan was to have me come out in April for 2 weeks to meet with physical therapy and with Dr. M.

The pictures below are from March 6, 2013. Almost four months after surgery and that's the amount of motion I had with the "help" of the cortisone. 

I could/still can only move my arm this far
To this day, I can only raise my arm this high before I get the sharp/stabbing pain
I took the semester off from school because I had a ton of rehabilitation ahead of me
The lack of motion makes it really hard to do basic functional tasks...
As if dealing with the right side isn't enough, the left side has a whole list of problems too
Even though it was really, really difficult with all of the medical stuff going on, there were other things happening in my life to look forward too. It's these things that basically help give me the motivation to keep plugging along one day at a time. Once again, you have to incorporate happy things into your life. For me the happy/fun things are the reminders that there is more than just medical stuff in my life.

On March 9th my mom and I took my nieces to see their first professional soccer game. We had gotten them tickets as a Christmas gift and it was a much anticipated event. Both of my nieces played soccer, and before I became injured I was a soccer player; needless to say my mom had a lot of practice cheering us on (my dad too for that matter). We had a lot of fun at the game.

My mom and I. We made it to the stadium!
Waiting for the game to start with my nieces. 
A surprise visit from the mascot Sparky
March 22, 2013 was such an AWESOME day. My nephew Justin was born! Now I have two nieces and two nephews. I can't believe he is going to be two years old in just a few short months already. They sure don't stay little long and time sure does fly by!
My nephew Justin who is such a sweetie. If you have arm/shoulder issues
prop with pillows if you have too to make holding something easier 
In April my mom and I flew back to Colorado to follow-up with my medical team. Our initial plan was to meet with the physical therapy team for one week and then the following week meet with Dr. M. April 8, 2013 was day one of physical therapy. I told my physical therapist I will try to do whatever he wanted because I wanted him to see that there is something wrong. After my first appointment he was not pleased with my range of motion 5 months out from surgery. I tried doing various shoulder exercises and there was sharp pain and my arm wouldn't really move. The only good news was I did have a little strength which showed my arm had potential. During my second physical therapy appointment that day, my shoulder shifted forward twice and my physical therapist had to manipulate it back into place. Later that day I received a call from the clinic that my appointment with Dr. M had been moved up to the very next day.

April 9, 2013: I met with Dr. M and he reviewed the MRI images of my right shoulder that were done before the appointment. Again, nothing really showed but something was obviously wrong. Dr. M decided surgery was necessary. I asked when he thought I would be having the surgery and his response was, "Tomorrow." Talk about a quick change in plans!

April 10, 2013: Surprise surgery day. This was not on my list of "Things to do" for this week at all. During surgery a loose suture anchor was found. I had been saying since January when the pop in my shoulder happened that it felt like an anchor had popped because it was similar sensation to the two previous times. I was told it would have shown on MRI...it didn't. Good thing I was adamant that was something was wrong, and I trusted my gut. Surgery also revealed there was tearing of the allograft, type I SLAP tear (partial tear and degeneration of the labrum (cartilage)), and the arthritis had progressed further in areas. In November 2012 I had diffuse grade 2 and grade 3 arthritis on my humeral head and glenoid. Five months later I had diffuse grade 3 and grade 4 arthritis (there are 4 stages of arthritis with stage 4 being the most severe. There is loss of joint space and you're bone on bone...just what every 23 year old wants to hear..not). I also had evidence of adhesive capsulitis which is commonly referred to as frozen shoulder. During surgery they did manual manipulation, extensive glenohumeral debridement (cleaning out of the shoulder joint), subacromial decompression, subcoracoid decompression, subcoracoid bursectomy, as well as multiple deep tissue biopsies. It was the first shoulder surgery that I ever had that didn't involve a big open incision; it was done strictly arthroscopically (tiny incisions looking in the joint with a camera). Honestly, recovery was not hard at all. In comparison to my previous surgeries it was a piece of cake. It didn't even feel like I had surgery even though Dr. M said he did a lot of work in my shoulder. From a pain perspective my left side hurt a ton more than my right (surgical side)...for the time being.
Waiting to be wheeled back to the operating room
Pictures of the inside of my R shoulder joint
Physical therapy started the very next day after surgery. I went two times a day for the next week and a half while I was in Colorado. While we were there, 16 inches of snow occurred in one day! It was so pretty. We didn't have to drive anywhere in the snow so we enjoyed it even more.
Very pretty, isn't it? 
Fortunately with this surgery I didn't need to wear the brace long. It was worn
on an "as needed" basis. We went for a short walk to the creek so I just stuck
my hand in my jacket pocket to act as my "brace".
Sure enough this trip to Colorado had come to an end and we were back home in Illinois. We were home in Illinois just long enough to pack and turn around to head back to Colorado and stay for a little over two months to do a ton of physical therapy and see if we can get these arms functional. Who knew those next 2+ months was only the beginning of figuring out the "beast" that lives in my shoulders...

Wednesday, December 17, 2014

Uh-oh...POP!

January 2013

A turn of events was soon to happen at the end of the month and I would be heading back to the wonderful state of Colorado for medical reasons (hopefully one day it will be for going on vacation). I was still in the shoulder brace from surgery on November 9, 2012 and physical therapy was soon to start. My doctor and physical therapist in Colorado extended the time they wanted me in the brace; usually you'd wear the brace for 6 weeks but I had to wear the brace full time for 10-11 weeks and then I was allowed to slowly wean from there. Since my prior history with shoulder surgeries doesn't have a good track record my medical team really wanted to make sure my tissue had time to heal. At this point in time I was still labeled as "collagen deficient" because the possibility of having a connective tissue disorder was supposedly ruled out in 2007. Dr. M suspected there was something more going on though so he implemented more precautions for after surgery. Normally with all the prior shoulder surgeries I couldn't wait to get out of the brace; however, this time was different. I physically couldn't get myself out of the brace.

When physical therapy started it was excruciatingly slow and painful. Red flags were going off in my head because I had never experienced this before. My Illinois physical therapist tried doing passive range of motion and he could barely move my arm without me having this insanely sharp/stabbing pain over the front of my shoulder; interestingly enough it's the same exact pain that I still have to this day. We tried reclining me in various positions on the table to see if that helped and there was no luck. My shoulder was so weak and killed. The weight of my arm was too heavy so I stayed in the brace whenever I was out and about; at home I just propped with pillows. As much as I love my physical therapist I dreaded going to therapy because it never ended well for me. Every time I left I would get in the car and cry from the pain. When I would get home I would put more ice on and go lay down. As the weeks went on there were tiny improvements but nothing to jump up and down about. I could go a little longer without the brace on but my gut still kept saying there's a problem.

When I woke up on Thursday January 31, 2013 I thought it was going to be just like any other ordinary day. Little did I know that evening I would be on an airplane flying to Colorado. I went to physical therapy in the morning and things were going as well as can be. We tried working on flexion (moving arm in front of you) with my elbow bent. We did active assisted motion (me moving my arm with the help of my therapist). Whenever we work on any sort of motion my physical therapist always has at least one hand on my shoulder to help give it stability. There was sharp pain every time we moved my arm but at this point my mindset was it's going to hurt no matter what. When we tried to move my arm forward all of a sudden there was a loud, audible POP! I felt my arm slowly drop down by my side with pain, my physical therapist's eyes were wide, and I started to cry. I knew something bad had happened because I am not one to cry in the middle of physical therapy. My physical therapist walked away for a couple minutes so I could compose myself. When he came back I told him to continue. I needed to know if it was the type of pop that would provide relief or if it was the type of pop where something bad had happened. Unfortunately it was the the type of pop that something bad had happened. I was concerned. It killed to move my arm and it felt like an anchor had popped. It was the same exact sensation that I had in the past when I've had anchors pop on me.

Fast forward a few hours and the next thing you know I'm on an airplane heading to Colorado. We had called Dr. M's office after my physical therapy appointment and there was concern something may have happened to the graft so they ordered an MRI and I would see Dr. M the following day. Shortly before we hopped in the car to head to the airport the staff in Colorado had called to tell us that Dr. M had something come up and wouldn't be able to see me. We already had bought our airline tickets so we were heading there no matter what. We decided I would be evaluated my his fellow instead. The following day was February 1st. My mom drove from Denver to Vail. As luck would have it, it decided to snow. Mountain driving is very, very different than driving in Illinois.

It's pretty with the snow
The yellow sign on the right says "Avalanche Area". It's a sign that
you will NEVER see in Illinois.
After my MRI I had my appointment with the fellow. My MRI didn't show anything too concerning. I told the fellow that it felt like an anchor had popped and I was told it would have shown on MRI. I disagreed because I've had an anchor pop twice in this shoulder and it never showed on MRI. The fellow tried to examine my shoulder and the same sharp pain kept reoccurring. He tried telling me he thinks I'm hurting because I'm guarding. I completely disagreed. As we were leaving my mom called my Illinois physical therapist and had the fellow speak with him. After talking to my Illinois physical therapist the fellow told me that he wasn't sure what was wrong with my shoulder and he was going to call Dr. M. I received a phone call and Dr. M was going to come back to the clinic to see me later that day.
Taking a break before heading to see Dr. M 
At the appointment with Dr. M he made a point of telling me that he came back just to see me. I was greatly appreciative and it was so nice of him. Dr. M gave me a shot of cortisone in the shoulder. At this point there was no definitive course of treatment. It was more wait and see what happens over the coming weeks. If I wasn't doing better in 3 weeks Dr. M said he might do an arthroscopy to look inside the shoulder joint to see what's going on.

After my appointment with Dr. M I met with the physical therapist to see if we should modify any of my physical therapy program at home. This was the first time that I had worked with this physical therapist; the first time I met him was in my hospital room after surgery in November. At therapy I remember going through my surgical history with him. He looked at the incisions on the front and back of my shoulder joints and I had chimed in, "Don't forget the two over my shoulder blades". The tank-top I had on covered my shoulder blades so he moved my shirt over and said, "Wow!" I laughed and said it's too bad I don't have some awesome story of how I injured them. We then proceeded to talk about all sorts of various tattoo ideas I could get so the scars were less noticeable. I still chuckle every time I think about this first visit. My therapy program didn't change too much. He wanted me to focus on isometric exercises to strengthen the shoulder with my physical therapist providing added stability with his hands which is a lot of what we were doing already. At this point he thought the issues I was having was due to muscle weakness. I thought it was contributing factor but the not the main problem. Time would tell over the coming weeks. Before I left he taped my shoulder up to see if that would provide any relief due to the added support and stability.
The tape job that the physical therapist did for me. It did help some.
I really noticed it when I had the brace off. Unfortunately I couldn't
wear the tape too long because adhesive and my skin don't mix well.
After my appointment at physical therapy it was time to drive back to Denver. We learned a very important lesson that day. When you look to the east and you can't see the mountains because it's all foggy...don't drive! It was the scariest drive ever. My mom and I didn't talk at all. It was snowing really hard. When we were in the valley the driving was okay but as soon as we went up in elevation it was sheets of snow flying across the night sky. It looked like ghosts. After a few hours in the car we finally made it to Denver and could breathe. We when we got into our hotel room we heard on the news that they had shut down Vail Pass; which is the pass my mom just finished driving.

This picture is from this year but it's the same thing that we saw in 2013.
Vail Pass was closed this time too. 
As we sat on the airplane flying back to Illinois there was a lot of thoughts going through our minds. Like always, all we could do was take things one day at a time. When we got back to Illinois physical therapy started up again for the next few weeks and the next thing we know we were flying back to Colorado...again.

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