One Year Post-Op

It's crazy to think that a year has gone by since then. It was something I had wanted for a long, long time and the time had come. My family had opposed it for so long that, for a while, I was resigned to the fact that life would just be this way forever. People had asked me why I didn't just undergo surgery myself. At the time, it just didn't feel right to go through that without their blessing and support.

In a Nutshell

I'm not reaaaallly sure where the last couple weeks went....I think I burnt myself out during the first month and a half of class, so I had to sit back and gather my sanity.  I definitely have figured out that I struggle with content more, as opposed to test-taking strategies...so starting now I will need to knuckle down and torture myself diligently review flashcards.  I've also been using Examkrackers books to review content I am unsure about and found that it saves me time and frustration.  Kaplan books have the tendency to give analogies that I think are stupid, or the books provide a really long-winded and over-detailed explanation for concepts that really DON'T need that much detail.  

My physical therapy is progressing pretty well, albeit conservatively per doctor's orders.  The final two ranges of motion that I will need to work on are the external rotation at the elbow and abduction.  Strength training is progressing smoothly, and the exercises they have given me will also be helpful once I begin doing my own strength training after rehabilitation is complete.  Most of my strength building exercises seem to focus around using the muscles behind my scapula (rhomboid major muscle?) correctly and NOT using the trapezius muscle to compensate, which seems to place unwanted tension on the shoulders.  Consequently, my upper back between the shoulder blades are pretty sore today =/  

Last night was supposed to be my last night of fun-time before I re-engage hermit-mode to study.  My night ended with a bang.....several bangs, in fact: 

pewpewpew!

I dunno if there's a stigma against doctors (and pre-meds) wielding firearms as a hobby but I don't see anything wrong with it, as long as shooting is done legally in a safe space and as long as all participants abide by the rules for safety.  I would trust a doctor to handle a loaded gun safely as opposed to some random person, although I would still prefer to stand behind the doctor....just in case.  After using a few of the rental guns the shooting range had, I can definitely understand why some dudes get super excited over guns: it was pretty exhilarating on a very primal level.  I can also appreciate how much damage a gun can do, and how much skill/practice it requires to shoot well when the target isn't just a piece of paper with a giant orange dot in the middle.  Holding a gun is also no joke - pistols look small sitting in a glass case but some are surprisingly heavy.  

The beginner's course I took (required for all newbies) included a nomenclature and safety class.  The class had a bunch of girls, and collectively we learned that any idiot can load and shoot a gun (that same day at work, I learned that not everyone knows what a PDF is *facepalm*).  We started off range-time with a Ruger MKIII which was pretty easy to handle, upgraded to what was probably an older model of the M4 rifle and ended the night with one of the smaller Sig Sauer 9mm pistols that could fit in my tiny Asian-girl hands.  I had the most fun and the best shots with the 9mm.  The only downside was that since it was a rental gun, it gets a lot of use so the casing would eject straight at my face instead of off to the side.  

Overall it was a fun night.  I wish I could get this much excitement out of reviewing physics X_X 

Improvements

This weekend I actually did a lot of studying...as opposed to previous weekends where I throw a temper tantrum on the floor of my room before actually making myself study.  I finished all of my Physics homework and all but one of the biology review homework and quizzes.  I actually thought I had caught up to all my work.  I was soooo proud of myself...Until I realized I completely skipped OChem review.

Sitting in my corner of shame and defeat

And so, the epic battle with studying continues.

Actually, I've been good about studying after work and during gaps in my schedule.  Unfortunately, that means I camp out in Starbucks a lot.  Now, I have to find some way to work in a regular gym routine =/  I miss living near a college campus where things are only 5-10 minutes away via bike.  Now, I have to plan my life around public transportation or parking.  It seems ridiculous to have to set aside 30-60 minutes of public-transit for 3-4 miles' worth of travel or worse, 30 minutes just to LOOK for a parking spot.

I had my third session of physical therapy this week.  Now I can raise my arm above my head (kinda).  Woohoo!!  It's crazy seeing the differences between my P.T. appointments and my work place.  Patients get half an hour at the senior home (where I usually am), but at the main site they might not get a full half hour of treatment on a busy day.  In comparison, my appointments have lasted about an hour and a half.  Then again, some of the other patients I see at my P.T. place only stop by for about half an hour, so the "time" factor might rely a lot on the individual's current phase of treatment as well as the severity of their conditions.  In other words, my shoulder was uber-effed up.

I lovelovelove my P.T!  Having a P.T. who is also great eye candy is very good motivation to go to my appointments on time.  Usually, I'm torn between wiping the drool off my face and wincing when he tests my range of motion.  My ROM has increased about 5-10 degrees each session.  It's tough because not only did the surgeon tighten up my shoulder, but there is a lot of muscle guarding and conditioning that I need to unlearn.  A lot of the exercises and stretches he does are easy for other people to do, but they are motions that I haven't done myself in years because my shoulder was so unstable.  Despite that, I actually have fun during P.T.  He laughs at my weird facial expressions during stretching and I laugh at the fact that his dogs (Useless 1 and Useless 2) already chewed up part of his new lawn.

Sling-Free

I'm free!!  Free from the contraption known as the ULTRASLING II. 

THE ULTRASLING II.  DUNDUNDUNNNNNNNNN

Even though I got used to wearing it, I don't think that cushion is made for a 5'1 person with short arms.

I'm starting my basic exercises tomorrow - few rotation/flexion/extension exercises to get reacquainted with basic movements.  The doc suggested that I continue wearing my sling when I leave the house for errands and to go to work (but without the cushion) just to be safe.  Even with a sling, I don't really trust people to be careful.  Also, some people at work have been patting my shoulder (Uh, hello?  That's my bad arm you're hitting.)  Even though they don't use a lot of strength, it still jars some of the muscles that are still tender from inactivity and healing, so I am going to continue using my sling until I can at the VERY least bend my arm at the elbow without shaking and sweating up a storm.

I will be starting physical therapy in about two weeks/whenever they can fit me in.  The facility I am hoping to use is somewhat near my MCAT prep course classroom, so with any luck I'll be able to schedule it so that I can hang around at a nearby cafe in between class and therapy.

First Foray Outside

I ventured outside today to take out my stitches, pick up a library book, and of all things, go to Trader Joe's.

My stitches came out much easier than I thought. I thought it would hurt but it was quick and totally painless. I met the clinic's physicians assistant today to go over my recovery.  My orthopedic surgeon seems to have a system where she takes care of all new patients up through surgery and her PA takes over the recovery process so the doc can keep seeing new patients. Very efficient, in my opinion. The PA seemed impressed that I stopped taking Percocet on Friday, but I have been taking OTC painkillers.  I think part of the leftover pain is coming from muscle stiffness due to wearing a sling all day every day, and possibly due to poor posture.

Sleeping is unexpectedly not a problem.  When I first started having shoulder problems in high school, I had a few scares where I woke up with a dislocated shoulder and after that, I somehow conditioned myself to sleep like a log.  It sucks to think about how bad my shoulder was, but on the bright side, sleeping with a sling on wasn't as difficult or uncomfortable as the doc thought.

Trader Joe's was way more crowded than I thought at 2pm and I was on the lookout for oblivious people who are too busy to watch where they are shoving their carts and kids who aren't being supervised.  I felt like doing this:

Idea taken from a Simpson's episode

But the trip for dried cranberries and bran flakes was definitely worth it and it gave me an idea for doodling material.

Random Conversations

Friend:  So how are you doing after surgery?
Me:  I'm good, just staying home, taking my pain meds.
Friend:  Can you move around and stuff?
Me:  Yeah but I won't leave the house too much...it's still pretty hard to get dressed and stuff.  I should just go commando.
Friend:  You should just wear a sheet like the Romans.

Me: That would be awesome!!!

Toga Mingle

Post-Op Day 2

Recovery is going well, I think.  

Yesterday my throat was really sore from the tracheal tube.  Now, I feel really bad for all the kids I've watched who needed a nasotracheal tube for induction (so the dentist can work on the teeth).  For a kid, it probably feels 10x worse.  

Yesterday, the recovery nurse gave me instructions for exercises that my doctor supposedly wanted me to start today, but when I looked over my pre-op instructions, the sheet my doctor gave me told me I wasn't supposed to do anything (except squeeze my little stress ball) until the doctor cleared me.  Good thing I called her office to clarify!  I was honestly scared to do anything with my arm, although today, I realized that if I angle my laptop just right, I can kind of type with my left hand - well, 3/5 of the fingers on my left hand.  It really does speed things up.  

Overall though, I'm still feelin' pretty fatigued.  Despite that, I still managed to type up board meeting minutes, which I volunteered to do for the ol' office over Skype a few weeks ago.  I'm not sure if my fatigue is from the surgery or from my Percocet prescription - probably the drugs, since I get suuuuper drowsy after an hour or two.  I took one pill before going to bed and woke up four hours later, just in time to take the next one.  Today, I tried pushing it to the five-hour mark - just in time too, if I waited any longer I might have actually felt pain instead of discomfort.  

Tomorrow, I get to take the giant dressing-pad they taped onto my shoulder. Woohoo! I've been wanting to see what the stitches look like.  I'll need to call the doctor's office again because I don't remember how and if I'm supposed to clean the wounds, but on a spur, I bought a box of Finding Nemo band-aids to cover them up.  

Post-Op

I'm home and it looks like surgery went well.  I arrived about 15 minutes late and felt really bad, because I know it can really mess up the flow of things, but that didn't seem to be the case today.  My pre-op nurse was really nice.  Her son and I went to the same high school but a year apart, so we talked about schools and college.  My procedure (Bankhart Repair) went well - she only needed to place two anchors, but she also said there was quite a bit of damage so she did some work on the ligaments as well, although I'm not sure which ones.

The whole procedure was about two hours.  It's interesting being on the patient bed this time around and watching people grab my arms/legs and lift up my gown to attach things while talking to me like were just hanging out in the lounge.  I don't remember falling asleep either.  The last thought I remember having was, "Is he giving me Sevo yet? This doesn't smell like Sev-ZZZZZZZZ"  My wake up wasn't too exciting either, only that each time they called my name, I kept thinking I should get up.

I'm home now, feeling perpetually groggy and trying to time my naps around the painkillers.  I have a little stress ball for my fingers so they don't get too swollen.

Tomorrow, I will be doing itty bitty exercises as per doc's orders:  letting the arm dangle outside of the sling and then doing finger exercises on the table.

Pre-Op

I met with my orthopedic surgeon on Wednesday to go over the procedure again.  I felt like I should have asked more questions, but I couldn't think of anything else to ask.  I even went home and looked up the procedure on YouTube to see what she'll be doing - that has to be a morbid pre-med trait.  I don't think any of my non-pre-health friends would YouTube their own surgery out of curiosity.

Even though I feel like I should prodded my doctor for more info, I like her and trust her to have explained the important details to me.  Her secretary, on the other hand, is like a chipmunk that talks a mile-a-minute.  Thank goodness she was only summarizing the consent forms.

I'll be going into the hospital on Wednesday at 6 am (ugggggggggggggh).  I will probably ask the anesthesiologist to hold off on giving me a nerve block for my arm.  Hopefully my post-anesthesia wake-up doesn't involve a lot of groggy thrashing.  Anesthesiologists are funny sometimes: a few of the ones I worked with had the "magic touch" and all of their kids would wake up perfectly calm, while the rest typically ran for the hills when the kid started waking up screaming.

I'm a little nervous.  It's weird that I am, since this is something I have been wanting for a while.  Then again, I have other issues if I actually feel excited.  If surgery goes well, I am looking forward to getting back some range of motion, but it will take time for me to actually feel mentally comfortable moving my left arm normally again.  Certain things have become habit now, like only sleeping on my back or right side, or not reaching back with my left arm.  With some good physical therapy and a good recovery, those things will be minor things to overcome.

Being a Patient is No Fun. Pt 2

A few weeks ago, I ended up in the E.R. with a dislocated shoulder due to a torn left labrum.  Anterior, I think.  I wasn't sure if describing my experience there constitutes whining, and I didn't really want to write a blog post chock-full of whining...but it was an interesting experience nonetheless and worth retelling if only so I remember it for myself later down the line.

Different E.R visits lead to different experiences based on several factors - understaffed/overloaded, number of patients and what their health issues are, the hospital's location, and the overall personality of the staff, just to name a few.

Regardless, being a patient sucks, and I can't imagine what it must be like for people with serious illnesses that need extended hospital care.  I felt powerless going into the E.R., even though I've been to one before (maybe it's because this time, I felt like it hurt a lot more).  I didn't want to be touched and I didn't want to be pitied either.  I felt the pressure of several years of guilt too - the knowledge that if I had quit wrestling at the first sign of trouble, maybe I wouldn't have had to gone through all this.  I felt anger - if the first specialist I went to had asked for an MRI, maybe I would have found out sooner how serious this was and quit.

I refused to let anyone help me out of my jacket - I did it myself, inch by inch.  She was nice and understanding about it, and I'm thankful she indulged me.  I fought the doc every step of the way though.  Something about her attitude or tone of voice rubbed me the wrong way.  I found her condescending and it made me feel like I was being treated like a kid who didn't want to go to school.  She planned to use the Stimson maneuver, which involves laying face down with the injured shoulder dangling perpendicular to the bed.  She would then attach four saline bags (roughly 10lbs) and let gravity do most of the work.  I know it's an accepted procedure that is coincidentally less violent than other methods, but it sounds ridiculous to this day.  I remember a previous dislocation where the doc and a med student used a combination of scapular manipulation external arm rotation (while I sat upright) to reduce the shoulder and it was totally, undeniably pain-free and took about 1 minute without any meds.  I tried to explain this to the doc, but for whatever reason - whether she was unfamiliar or uncomfortable with that method or if it posed a greater risk to me that she did not explain - she refused.

It took time for them to coax me into a prone position, and then another several minutes for a nurse to gently move my arm to a 90-degree forward flexion.  After that, they gave me an intramuscular shot of Ativan, which hurt AND didn't kick in until AFTER I left the E.R., and I was left to force myself to relax and spasm in pain until a P.A. came to manipulate the scapula.  Feeling your own shoulder slip into place is one part gross (listening to things slide into place) and one part relief.  Muscles that you didn't know were tensed suddenly relax and you can breathe.

I don't know if I was being a difficult patient or not.  IMO, I think the person two curtain-cubicles down was a difficult patient (until they restrained him).  Even though I was familiar with my condition, knew her treatment plan was going to work, and know what it's like to work with doctors, I still didn't want to trust her.  It's a very primal response, not subject to reason.  I'm just glad the doc went and found a nurse instead. The nurse was much nicer and more soothing.  She let me move at my own pace, which also helped.

I'll remember this incident as an important lesson in communication and patience. Someone who is sick or injured, in pain, and confused (and not under the influence of illegal substances) won't trust someone just because he/she has an M.D.  I'll try to remember it even when I'm underslept and overworked.

After that, I wasn't feeling tired and didn't want to go home just to mope around, so I asked my mom to drop me off at my friend's joint-sibling birthday party.   I wore a sling and was just starting to feel the Ativan kick in.  I have very vague memories of that night, because of the Ativan.  I remember sitting in her little brother's jumpy house, being bounced up and down while my friends jumped around and being very mellow.

Being a Patient is No Fun Pt.1

I miss the simpler days when I only ever had to go to a pediatrician when I was sick. All I had to do was sit on the bed, let him examine my throat and ears and I was done and out the door with a nifty sticker.

I went to the ER today for a dislocated shoulder...As someone who is interested in becoming a doctor, I thought I should blog about it, even if it's only a reminder to my future self that hey, being a patient for any reason can be scary and frustrating. Before I explain the whole ER trip, here's some back-story on my recurring injury:

Due to being on the wrestling team, I tore my left labrum which I vaguely recall my doctor referring to as a Bankart Lesion. The first doctor I went to assumed I was just loose-jointed and needed time to grow out of it. We sought a second opinion. Dr. M informed us that I had a torn labrum and he recommended surgery.

My parents weren't too thrilled. They grew up with the mentality that surgery isn't always a solution and harbored the hope that I could live with the injury. They kept hoping (wrongly) that the tear would heal itself, or if we pursued alternative methods, we could strengthen the muscles and ligaments around the shoulder joint. I grew up in a very bicultural home, so I learned about the merits of Eastern Medicine, but I didn't think anything could be done for my shoulder short of surgery.

We argued about it constantly. When I turned 18, I chose not to pursue the surgery option behind their back. It seemed wrong to go behind my parents like that and I wanted their support (or my own job and my own insurance plan).

Finally, years years later, I found Dr. A who is an orthopedic surgeon and specializes in shoulders. I'm not sure why my parents finally made the turn around..it may have been that they finally realized my shoulder wasn't getting any better. In the years between meeting Dr. M and Dr. A, my shoulder would dislocated at the worst times, always when I'm doing something ridiculous and have my guard down: like taking off my jacket/closing the door with my left hand/ sleeping and unconsciously moving into a bad position.

I'm scheduled for surgery on Sept 7 at long last. Dr. A uses some type of plastic anchors instead of stainless steel (which my parents disliked). She's been very kind to explain AND diagram for me and my parents how the procedure would go.

Unfortunately, my shoulder couldn't wait another month and it dislocated itself today...ironically as I was taking my coat off. My next post on this topic will be about my adventures in and out of the ER :(