Sunday, March 3, 2013

Surgery is Weird

June 2008

After getting home from Vegas, it was time to prepare and get things ready for surgery in Kentucky once again; I was scheduled for June 10, 2008. Luckily I didn't have anything school related to worry about which was a huge relief. From having the past 3 shoulder surgeries down in KY, my parents and I have gotten really good at packing for out of state surgery. Packing doesn't take us long at all anymore. We know how many pillows to pack for the car ride home, and we always pack a blanket. The more pillows, the better, because I can prop my shoulder and the pillows help cushion the negative effects of a very bumpy world .

This surgery was more nerve-racking than the others. Dr. B was doing one of the procedures going strictly off of my word and symptoms because imaging detected nothing wrong. Unlike scapular muscle detachment injuries, bicep tendon injuries DO show up on MRI imaging. Since I was 18, I signed my own consent form. Do you know how hard it was to sign this form knowing that my surgeon trusted me enough to make an open incision to pinpoint where the problem was??? I mean, it's great that Dr. B trusts me and realizes that I know my body very well, but that's putting a lot of faith into your patient. After I signed the form, I started thinking, "What if he does this open incision and finds nothing wrong?" At that point (like with the scapular surgery) as weird as it sounds, you want something to be wrong to validate what you are saying. I knew something was not right and I didn't care that my MRI showed there was nothing wrong with my biceps tendon. I had to really trust what I was feeling and listen to my body. If I really didn't think there was a problem, I wouldn't have slept like this at night.

Sleeping sucked & was SO uncomfortable! I had to wear
the black sling at night to make sure I didn't roll on my left
side because of the scapular muscle reattachment repair. I had
to wear the green sling because I had something that would shift out
of place if I slept on it. I was looking forward to having surgery in June 08.

At this point I know the routine of having surgery, but I still think the whole concept of having surgery is weird; especially the first time because you do not really know what to expect. Yeah, you can read the pamphlets titled "What to Expect After Surgery" or "Getting Ready for Surgery"; but those only help so much. They are also not 100% accurate because I am yet to wake up from surgery smiling in recovery like they show in the cartoon picture...haha. A lot of times, as expected, people are nervous or scared to have an operation. Unfortunately, I am used to it so the only part I dread is waking up in recovery because I know there will be a lot of pain depending on the procedure being done. Sometimes if my shoulder is in really, really bad shape, I actually look forward to the surgery because I have high hopes my shoulder will be in much better shape a few months later.

When you have surgery, one of the first things you are told is you aren't allowed to eat or drink anything after midnight. If you are a breakfast eater like me, then this is a very hard thing to do. So, I eat a lot at dinner the night before; I eat a lot of food that is good for me. Not junk food.

Night before surgery! Fill up on those fruits & vegetables!
Waking up with your stomach growling and knowing you're not allowed to eat is hard; if you are waking up in a hotel, you walk out of your room and can smell pancakes, coffee, waffles, sausage, bacon and all sorts of wonderful food cooking. It just isn't fair. After you arrive at the hospital you wait in a waiting area. When the nurse calls your name to come back to the pre-op area, she has you change into a hospital gown and then she starts your IV. Breakfast is a bag of fluids that travels through your IV into your veins. You also get a sip of water to swallow a pill that helps prevent nausea. Once all the nurses prep work is done, you get to wait your turn for surgery and hope that your surgeon is running on time. The farther behind your surgeon is running, the longer it is before you get to eat. So for me, the earlier surgery is, the better. By now though we have a system to kill the time; bring a deck of playing cards and let the party begin.

One of the main indicators that you're getting close to surgery time is when the anesthesiologist comes by you. They ask if you have any loose teeth, dentures, etc. and look in your mouth. Next thing you know, the nurses that will be taking care of you during surgery are in your room. They have you put on a blue cap and transfer you to the operating room. Yay! It's your turn for surgery!! (Some people don't remember this next part; a lot choose to have a shot of versedt which wipes your memory. I choose not to have this shot because I want the least amount of medication in my body possible and I don't like the feeling of having no control). You are wheeled back into a freezing, sterile operating room. Everyone is dressed in scrubs. Sometimes there is music playing and sometimes there is none. If you look around the room, you will see a clock on the wall. You might see a surgical tech in the corner by a table counting a lot of tools that may be used for your surgery. You might see your surgeon in a different corner looking at your MRI talking with his assistant. You might see a white board with the names of patients and what procedure they are having done next to it. Operating rooms always have a lot of things to look at, but you don't have a lot of time to look around because things happen so fast.

The nurses help you scoot onto a narrow table. Warm blankets are put on you and the nurses buckle you onto the table so you don't fall off. There are nurses moving around your head getting things set up, while others are hooking leads up to your chest. When the nurses are all done setting up, the anesthesiologist comes over and puts a mask on your face that covers your nose and mouth. At first you are inhaling just pure oxygen. A shot is then injected into your IV and they say, "You might feel a burning sensation." The next thing you know, they turn the gas on that puts you to sleep. It is a very different scent than pure oxygen. You know when they turn it on before they even tell you. You are told to take deep breaths and everyone is going to take good care of you. It takes like 5 seconds before you are asleep. You try as hard as you can to stay awake but it's no use. Your eyelids get heavier and heavier. Next thing you know, you are waking up in a recovery room and surgery is over. It is weird to me how surgeons can do all of this work to you and you don't feel any of it. Thank God.

Right before surgery. I brought in a disposable camera and
asked Dr. B if they could take pictures for me. When he gave
the camera to the nurse, the nurse said, "Let's take a picture
of you before surgery starts!!"

That bulge under my right hand by my armpit is showing
the instability that I had in the joint.

The medical staff applying the polar care ice pack.

Tiny glimpse of what it looks like after surgery all set up in the
hotel room. The blue thing on the side table is a machine that is
hooked up to a tube that runs ice water to the site
of surgery.
During this surgery, Dr. B did another capsular plication because I had anterior-inferior instability (shifting out the front and down) as well as slight posterior (shifting out the back) instability; he also did an open biceps tenodesis. Before I got to the hospital, I took a black pen and drew on my skin where I was having the popping sensation and pain. The reason my MRI showed there was no damage to my biceps tendon was because the site of injury was outside of the joint and not visible on imaging. The biceps tendon runs through the bicipital groove. At the top of the groove, my tendon was fine. However, as Dr. B moved down the groove and rotated my arm, my tendon was popping and catching. Dr. B described the tendon instability as a windshield wiper moving back and forth as he would move my arm. He put 2 anchors in to make the tendon stop moving around. Good thing Dr. B listened to my symptoms and had enough faith in me to do the open incision. If he had only done the surgery arthroscopically (tiny incisions where you use a camera to look in the joint) he would have never seen the injury.

As usual recovery and the car ride wasn't fun; in comparison to the scapular surgeries though it was much easier. Two weeks after surgery I turned 19; now what is a better way to celebrate your birthday than going to get your staples out by your favorite IL doctor in Chicago?? Unfortunately that is what we did on my birthday. Dr. K was nice enough to remove all 19 staples and tell me that I could go in our hot tub as long as I had some sort of support under my arm. My parents were nice enough to bring me out to lunch afterwards. Aren't they nice!

There are 6 more staples in the back of my shoulder.
For lunch I chose to go to Grand Lux Cafe. They have really good food and dessert!
Just my mom and I

Dessert was delicious! It was like an apple pie but a million
times better; it was topped with vanilla ice cream too.
Sure enough life is always a mixed bag. My mom firmly believes for every negative (staple removal) you have to offset it with a positive (getting lunch). As hard as life can be, it is still your life at the end of the day. You have to make the best out of whatever you are dealing with and try to bring some joy to your life.

Ended my 19th birthday by going in the hot tub with my nieces.
You can't see it, but I have a plastic pillow folded in half to keep
my shoulder supported and in the proper position.

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