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Sunday, July 11, 2010

Operation Fix Elbow

On June 25th, I had surgery on my right elbow. This will
hopefully address issues with chronic tendonitis from over using
the arm. The surgery was scheduled for noon. We were there an
hour early, as requested.

I was not allowed to eat or drink anything after midnight the
day before. I was starving and thirsty. Of course, the
surgeon fell behind schedule.. I didn't make it to the OR until
after 3:00. I was so thirsty I would have paid a million
dollars for one sip of a cold Dr. Pepper.

When they finally called my name, I headed to the pre-op area
with my interpreter. They asked me if I needed to use the
restroom. I did. Once that business was finished, we went into
my little room. Then the nurse said she needed a urine sample in
order to do a pregnancy test.

DUH! It would have been nice if she had told me this about two
minutes earlier, before I had completely emptied my bladder. I
was dehydrated. There was no way I could get anything out. So
stupid.

We set about doing paper work while waiting for my kidneys to
produce a little urine. After awhile, I squeezed out a few
drops and they were able to do the test. Of course, it was
negative. But they had to confirm I wasn't pregnant before I
could go into surgery. Liability and all that.

I put on the hospital gown and little booties. I actually love
those slipper socks with the treads on the bottom. I was happy
I'd be able to keep them. I think the nurse thought I was
being sarcastic but, really... the ones you buy in the stores are
never as good as the ones they give you in the hospital.

It was time to get this show started. They put three ID
bracelets on my wrist (two alerts for medicine allergies.) Then
they started the IV in my left arm. They taped it down really
well so I'd be able to use that arm for communication.

They hooked my legs up to something that would massage them.
This is to help circulation. They told me they set this up
before surgery so the patient understands what it's for and
doesn't panic later when they find they can't move their legs.

There was a lot of fuss and concern. They brought my mother into
the room, I think because they were so nervous. So she got to
help fuss over me, too.

The big issue was communion during surgery. Usually the patient
is left awake during this surgery. Even if the interpreter came
into the OR with me, they weren't sure I'd be coherent enough to
understand. They didn't want me to get upset or scared during
the operation.

So the doctor decided to knock me out completely. That was fine
with me. It seems like the easiest way to do it... just drift
away and sleep through the whole thing.

They did have the interpreter come with me into the OR to get
started. She had to change into surgical clothes in order to be
allowed to come with me.

The operating room was totally freezing. They had to cover me
with about a dozen heated blankets. They helped me move onto
the operating table. It had a weird foam pillow shaped as a
circle. Maybe it was very neck support. Everything got a little
scary at this point. It seemed like there was so much going on.
It was too much for just a little surgery on my elbow. I
started to wonder what I had gotten myself into.

They put something on my finger to check oxygen levels. They put
an oxygen tube in my nose. They hooked up a blood pressure cuff
on my arm. They put a shower cap on my head.

Finally, I had to breathe into the mask that would send me into
la la land. I did panic at this moment. The mask smelled so
sterile and wrong. I thought I was going to suffocate. They
gently kept it over my mouth and then I felt myself drift away.

I think I was already mentally out of it. I waved to everyone in
the room and said, "bye." I don't know if they waved back
because I was totally asleep.

It seemed like two seconds later that I woke up. The first
thought in my mind was, "Oh, that hurts!" They kept asking me for
my pain number. They kept repeating the same questions over and
over again. I thought that was strange but I have a feeling I
wasn't really answering them the first few times.

They decided to do a peripheral nerve block on my arm to help
with the pain. I agreed because I was hurting and I had no idea
what a peripheral nerve block was. I was totally freaked out
when they started cleaning my neck and put a medical drape over
it. I sure didn't want a needle in my neck.

They had to use an ultra sound to find the nerve. They they did
the shot. It didn't hurt too much. Then my entire right side
became numb. I lost all feeling and use of that arm.

This was both good and bad. It was good because it stopped the
pain. But my arm felt huge, heavy and dead. I couldn't move it
at all. I couldn't lift it. I couldn't even support it. I
really did not like that feeling. If I ever have to have this
surgery again, I will try to avoid that nerve block, if I can.


The surgery itself went well. The doctor cleaned out
inflammation and scar tissue. He also poked holes" in the area
around my elbow. This is to help with blood circulation. He
said that now-a-days, many doctors just poke holes and don't do
the cleaning out part. But he doesn't totally trust that method
yet. That's why he did both.

They had me in recovery for awhile.. Slowly, they began to
remove all the crap attached to me. They let me eat two graham
crackers and drink a little can of ginger ale. My mother helped
me get dressed. That wasn't so easy with a dead and heavy arm.
But finally we were allowed to leave.

They sent me home with my arm bandaged and wrapped from shoulder
to hand. I had a wrist splint and two heavy blocks of ice
attached to the arm. I needed a sling to support the arm with
all this stuff on it.

I need to keep the ice on for 48 hours. They gave us extra ice
packs to put in the freezer so I could replace it throughout the
day. The nerve block began to wear off after 24 hours. I was
glad to have my arm come back to life but that also meant I
could feel the pain. So I had to take pain pills for over a
week.

After two days, my father was allowed to take off the bandages.
I actually cried when he did this. It wasn't that it hurt so
much. Mostly I was afraid it would hurt. It was the fear of
pain that upset me, more than actual pain.

But there was so much bandages to come off. It took tons of
unwrapping and pulling. That upset me too.

When we got it all off, we found a one inch wound that we
covered with three bandaids.

I had to continue with the ice for twenty minutes at a time,
several times a day. Without the bandages, the ice really hurt.
It was so painful to get the blocks in the place against the
wound. I really didn't like that ice. (and still don't.)

It's now a little over two weeks since I had the surgery. I am
doing well. I got the stitches out on Wednesday. That hurt and
burned a little but wasn't as bad as I expected.

I can read and type but have to be careful not to over do it. I
take frequent breaks. I still ice the arm if it hurts more than
just a little. The incision site is sore. The muscle and
tendons all around my elbow are stiff and painful. I know it
will take more time before I am fully recovered. I am trying to
hang in there.

Now I've started occupational therapy again. I'm not even ready
for real stretches or exercise yet. I can't lift anything
heavier than a feather. I can't grip or squeeze. I can't
straight my arm out all the way. My exercises are just to get
the arm moving some, and not worry about anything else yet.
Very slow and simple.

The hardest part of this whole surgery was an unexpected
problem. It's made it hard for me to walk. Why would surgery
on my arm do that? Because that's the arm I use with my forearm
crutch. It keeps me balanced and stable. I didn't realize just
how much I depend on that arm when I walk.

I am using my crutch in the left arm now. That arm is much
weaker. It also puts my balance on my weaker leg. To make
matters worse, I can't use a sighted guide very well, since I
can't hold onto them with my sore arm. It's making everything so
awkward and hard.

I've been really frustrated in PT or when we try to go out. It
takes so much effort to walk this way. That tires me out fast.
Then I get annoyed with myself and new limitations.

Patience... Patience. I will get over all of this soon enough.
I just try to concentrate on how great it will be to have a
healthy and pain-free arm again. I think in the end, it will all
be worth it.

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