Thursday, March 27, 2014

Quadrilateral Space Decompression Surgery

In June 2011, after arriving back home in Illinois after my follow-up appointment with Dr. B in Kentucky, I scheduled an appointment with Dr. K. The pressure that I had building up in the back of my right shoulder joint was no longer there since something had popped when I went to reach for something a few days prior. Instead of having the pressure build-up type pain, I was having sharp/catching pain because I felt like there was something getting caught in the joint. When I saw Dr. K he evaluated my right shoulder and ordered an MRI. The MRI revealed my capsule was stretched out all over again, there was a loose suture anchor inside the joint, and my shoulder was subluxated posteriorly. Which means I have posterior shoulder instability...again.

After these findings were discovered, I contacted my doctor in California and doctor in Kentucky. It was decided that surgery should be done to the stabilize the right shoulder first before the quadrilateral space decompression could take place. This is because the quadrilateral space is in the back of the shoulder and I was really unstable out the back. If we did the decompression first, there was very high likelihood surgery would fail because of the instability. So in July 2011 I had surgery by Dr. K here in Illinois. He did an open capsular shift to stabilize the joint and to get all the loose sutures out of the joint as well. As usual, recovery was no walk in the park, but at least I was off of school for a few weeks so I didn't have to worry about homework.

Come the end of August, I was signed up for a couple classes. Nothing to terrible; just statistics and speech. I didn't want to sign up for more because I knew I would be having at least 2 surgeries that semester, possibly 3. About 2 weeks into the semester, I was letting my teachers know I would be missing a week of school because I would be having surgery out in California. As usual I got my assignments ahead of time and got as much done before surgery.                                          

On September 11, 2011, my mom and I flew to California. It was pretty surreal. Less than a year from that time, I was being told by an evil doctor in St. Louis that there is nothing wrong with me, I'm attention seeking, and my mom and I need a psychiatrist. Within the next 2 months I had found a doctor, met with him, was diagnosed with quadrilateral space syndrome, and told surgery was needed to decompress my axillary nerve. Yet again another example of why you need to listen to your body and be your own advocate. If I had listened to the St. Louis "doctor" and not done my research Lord knows how long this would have gone undiagnosed.

While we were in California, we couldn't have asked for better weather. The day before surgery we were able to explore a little bit since my pre-op appointment was early in the morning. This was the first time I had ever seen the ocean in person. Listening to the sound of the waves crashing against the rocks is a sound I don't think would ever get old. It was so peaceful.

My mom and I went to a little town in Pescadero, CA.
While eating lunch on the beach all of a sudden a bunch of birds
got very close and started to swarm us.  I didn't have to zoom
on the camera to get a picture of this bird. My mom doesn't
like birds that close to her. I got a good laugh watching
her reaction. 

The Pacific Ocean

September 14, 2011 was surgery day. The day I'd been waiting for for several years. Everything went really smooth until I started to wake up in recovery. I woke up laying on my right side (the side that had surgery) because my left scapula (shoulder blade) was killing me. The nurse kept telling me to lay on my back since I just had surgery on my right shoulder. I told her I can't because my left scapula is shifted out of position and my right side doesn't hurt. She then told me I didn't have surgery on my left scapula I had surgery on my right. I then told her with my medical lingo, "My left scapula is subluxated superiorly and laterally. I need someone to move it back. In order to do surgery on my right shoulder I had to be positioned on my left side and my scapula is now out of position." She looked at me with eyes wide and mouth agape and asked how I knew that. I told her this has happened to me too many times to count. The nurse then went and got one of the other orthopedics to come evaluate my left scapula. I told him the same thing I told the nurse. He then asked me if I was in medical school. I told him no. He then said, "How do you know all this". My reply, "I just do!" haha This doctor ended up going to get Dr. T out of surgery to come figure out what is wrong with my left scapula. They took x-rays but they were normal. I told everybody it will be normal; it never shows. Keep in mind while all this is happening, I'm still waking up from general anesthesia and have a bunch of pain meds being pumped into my IV. I was getting aggravated with my doctor because I knew what had to be done to get my scapula back in place but nobody would manipulate it for me. I remember I even told Dr. T to go call Dr. K in Illinois to learn how to get it back. Dr. T said no. Then I told him to go get a syringe, fill it with marcaine, give it to me and I'll inject the medicine where it needs to go myself. Dr. T said no again. This banter continued back and forth for some time. My mom ended up talking to Dr. T on the side explaining to him what he can and can not do to shift my scapula back into place. Dr. T came back by me and told me he will try to adjust it. I think he gave me a shot of versed (amnesia medicine) because he told me you might not remember this. Well I did. He lifted my left arm, put pressure on my scapula and all of a sudden it made a pop and went back into place. Dr. T's eyes opened wide and quietly to himself he said, "It popped!" I looked at Dr. T and said, "Thank you. I told you so". From that minute forward I was absolutely fine and talked about hockey with the nurses. I was discharged from the hospital a couple hours later and all things considered in pretty good shape.

This picture was taken on a separate occurrence, but this is basically what
I woke up with in recovery after surgery. I think it's pretty self-explanatory
of why I couldn't lay on my back without a ton of pain. 
I've come to the conclusion if you have to have surgery you may as well recover pool side in a lounge chair!

Not a bad way to recover
As usual strutting the Blackhawk pride :) 
At my post-op appointment a couple days later, the first thing I did was apologize to Dr. T for talking to him in more of a strict tone. I told him that is not my character whatsoever but I was killing, I knew what was wrong, and I knew what had to be done to fix the problem. Dr. T told me there is no need to apologize. You were in an insane amount of pain. I don't take what my patients say personally. Happy to say ever since I had this surgery I'm yet to get the crazy sharp pain down the back of my arm. When things were going well up until this past year and a half, I was able to get my arm past 45 degrees doing flexion (bringing arm in front of you). This surgery helped so much. Here's a link if you want to read more about Quadrilateral Space Syndrome. Quadrilateral Space Syndrome Info

Now that this surgery was over. I had a couple months to do rehab and then it was off to Kentucky for left scapular muscle reattachment surgery. 

This picture was taken like 2 maybe 3 days after surgery. I've never felt that
good after a surgery before. It sure put joint surgery and decompression
surgery in perspective for me. I would take decompression surgery ANY day
of the week.

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