So you're thinking about getting shoulder surgery

My story:

It's early spring of 2013, still cold outside, but supposedly the right time for trimming my crape myrtles. The more tired I am, the lazier I get, and not wanting to move the ladder again, reached too far out to the right and tugging on the loppers, felt a stinging pain shoot up through the middle of my shoulder.

Fast forward 18 months, and the stinging pain came and left and came and left, and ended up worse than at the start. Any kind of backhand, tennis, racquetball, ping-pong -- all hurt and made it worse. Time to do something.

Options: (1) Do nothing, (2) Physical therapy, (3) Surgery.

Tried PT exercises for a month or so but didn't change much, so I went in for a consult with the orthopaedic surgeon. Dr. says, "Do nothing isn't a good option, you probably have bone spurs that are tearing on your rotator cuff. Physical therapy at this point might help, but surgery is the fix."

So, I get signed up for:

1. SAD (sub-acromial decompression), and
2. ACJR (AC joint resection)

... with no rotator cuff repair required.

Great! What does recovery look like? "Oh, you'll be able to type the next day. But I wouldn't swing a golf club for 4-6 weeks."

Surgery was done on Dec. 12, 2014. No muscles or ligaments needed repair, but there was indeed a bone spur starting to tear at my rotator cuff, so the surgery was timely.

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Arthroscopic surgery sounds amazing, tiny holes to allow thin tubes in with cameras and tools. But here's what I didn't know, and he didn't tell me:

• Seeing around in your shoulder is cool, but there's no space in there, you know, to look around -- so, they end up pumping your shoulder full of saline, which blows it up like a balloon. Your rotator cuff muscles really don't like that.
• I went in thinking that it wasn't going to be too painful. In fact I told the anesthesiologist, "So, when I wake up I'm going to feel like somebody punched me in the shoulder, right?" He turned, "Uh -- well, it'll be worse. Much worse." He was right. In fact, for the first week or so it felt like I'd gotten hit with one of these:
• I had to have 3-4 weeks of physical therapy, 2 to 3 times a week. That doesn't sound like a lot, but it's a lot if you're not expecting any. And 4 times 3 times $40 copays is almost $500, plus a lot of time.
• The nerve block was creepy, a gigantic needle stuck down through my neck. I don't really remember it much, though, because they put something in my IV that really knocked me "out of it". I remember when they tried to move me I thought my arm was on my side, but someone was holding it up in the air, and I was stunned to see my arm being held up in the air. It stayed numb for a day or two.
• If you've had surgery before, you know what to expect, but I didn't. Coming out of anesthesia I was really nauseous, and had to stay for a few hours with them trying different anti-nausea medicines. Yuck. Anesthesia is weird, time flies quickly, and I was really dizzy -- for about a day I could barely move around without feeling like I was going to fall down.
• I was given oxycodone, and a strong anti-inflammatory. I don't know why oxycodone is considered addictive, it was horrible -- I'd start itching like crazy, get super dizzy, and crash asleep. Then I'd wake up a few hours later with horrible shoulder pain. Maybe that's how it works, but I wasn't a fan.
• They also gave me an anti-biotic. I started taking it, but stopped after a day because I was getting stomachaches, and I've grown attached to my micro-biome and didn't want to mess with it if I didn't have to. At my follow up with the Dr., I admitted I stopped taking everything about 36 hours after surgery and he said it was fine. He had told me that he does 600 of these surgeries a year, and said, "I've never had an infection in any of my patients -- there's too much fluid being pumped through there for any bacteria to get in and stay." I may have suffered a little more than I needed to, though.
• Mattress stitches are weird and itchy. Ignore the blood, that was just from pulling off the bandages.
• I was able to go to work the next Monday, but it's best if your boss/coworkers let you take it easy for a few days.
• Dr. said I needed to move my arm through its range of motion, and I had my kids help me with that. Going very slow at first, that really helped keep my mobility up.

It's now been a little over two weeks, and aside from a little stiffness and pain when I move it through certain positions, it's a lot better. There are some motions that I can do now that I just couldn't do before the surgery, so that's awesome.

All said, as long as you know what you're getting into, I recommend the surgery. If you're in North Alabama and looking for a surgeon, Dr. John Greco is very efficient and patient, and knows exactly what he's doing.

I'll post an update in a couple months.

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UPDATE: It's now been 6 months since the surgery, and I almost never notice my shoulder. There are a few ways I can move it that seem a little off, but I think it's finally back to good. =)

If you're curious, it hurt pretty badly for about 4 months after surgery. I thought it would be 90% better in 3 weeks, but it was more like 25% in 3 weeks, 50% in 2 months. 60% at 3 months, 70% at 4 months, 80% at 5 months, and then seemed to stop hurting almost overnight at 5-1/2 months.

Sleeping was the worst, by the way. I ended up sleeping on a 4" foam pad on the floor, on a mountain of hard, decorative pillows. They seemed to support me just the right way... I'd sleep on my right side (affected shoulder down), with pillows under my torso and under my neck, and another under my right forearm which kept it from hanging down and pulling on my shoulder.

The doctor said as long as I could move my arm from a raised position (right arm equivalent of the bicycle "right turn" signal), down to the lowered position (right arm equivalent of the bicycle "stop" signal), things would be okay. So I had my daughters move my arm through that rotation. The first rep. always hurt pretty bad, but loosened up as we went through the reps.

I felt like the physical therapy exercises were the key. I hung hooks in my closet at shoulder and waist height, and hung the stretch bands from them. It hurt to do the exercises, but not doing them was worse. So I shot for about a "2" or "3" out of 10 on the pain scale when doing them. Sometimes that meant just moving my arm through the motion without pulling the stretch band. But it helped.

Hope that helps someone!

Problem installing Office 2011 updates

Grr, Microsoft -- Office 2011 won't update because it says I have to quit the "Sync Services Agent" and "Microsoft Database Daemon".

Solution: Open the terminal (use spotlight to find it quickly), and paste these two commands in, one at a time, hitting return after each:

• killall "Microsoft Database Daemon"
• 
  launchctl unload ~/Library/LaunchAgents/com.microsoft.LaunchAgent.SyncServicesAgent.plist

... then go back to the installer and try again.

For those who care, the problem here is that even if you go into Activity Monitor and quit the Sync Services Agent process, our good friend "launchd" notices that it died and restarts it.

I'm a little soft on whether unloading it actually quits the Sync Services Agent process -- it seemed to, but I don't know why. I'm also not sure whether I should be re-"load"-ing the job with launchctl -- after the Office update installed, the Sync Services Agent was relaunched somehow, so maybe Office just launched it.

Anyway hope that helps someone.

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ps. Having worked in a big company, my guess is that the last person who truly understood the entire design of the Office suite from install to test is long gone, and we're left with myriads of people who only understand pieces of it. As they work on the parts, those parts grow increasingly incompatible with the other parts, and we're left with something that starts looking like a Frankenstein product. That's my theory, anyway.

Ebola and skin

Two quick things I learned this week:

1. Here's a good overview from the CDC on how Ebola is spread. Note the caveat that "droplets of respiratory secretions [from coughs/sneezes] ... could be infectious".
2. Lotions and other skin-care products break down the natural protective layer of keratin in your skin so they can penetrate. But then if you handle slightly toxic substances (like BPA on thermal receipts from stores) those substances end up in your blood. (Yikes! via Science Friday)

So, lotions allow things on your skin to penetrate into your blood -- like maybe droplets from sneezes, etc.?

I'm not sure either of these points give us the whole story here, but I do plan on being more cautious with lotions.

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And what about hand sanitizers? I suspect the problem is suspending the alcohol in a lotion... I wonder if we shouldn't just use straight rubbing alcohol for cleaning hands? Like an alcohol dispenser at the sink by the soap?

Planed wood

The closest local sawmill is going out of business, so I picked up a few of the nicer looking boards I could find.

Nice, of course is relative, almost all the wood had been sitting outside, so it looked pretty rough... When I got it home, I ran it through the planer. On the left is what a couple of the boards looked like when I bought them, on the right is after the planing:



Quite stunning. They'll look even better with a few coats of finish.

There is beauty in even the roughest stock. I learn a lot about how the Lord sees us when I work with wood like this.

State of the nation

Reasonably good description of the state of the nation from Harper's Weekly:

It is a gloomy moment in the history of our country. Not in the lifetime of most men has there been so much grave and deep apprehension. Never has the future seemed so uncalculable as at this time. The domestic situation is in chaos. Our dollar is weak throughout the world. Prices are so high as to be utterly impossible. The political caldron seethes and bubbles with uncertainty. Russia hangs as usual like a cloud, dark and silent, upon the horizon. It is a solemn moment. Of our troubles, no man can see the end.

Harper's Weekly, October 1857

via Hugh Pinnock at BYU Speeches

Does your iPhone battery not last all day?

Via DF, of course:

The Ultimate Guide to Solving iOS Battery Drain:
http://www.overthought.org/blog/2014/the-ultimate-guide-to-solving-ios-battery-drain

Heartbleed

In case you've been living in a hole for the last couple days, there's been a massive bug found in the open-source (free) server software that handles secure connections. For the lay-person, the software behind the padlock you see in your browser:

... had a bug that would happily offer up chunks of computer memory if someone sent it the right type of message over the network, with no record of having done it.

Here's XKCD's attempt at an explanation.

Some Q&A:

What does that mean to me?

We're not sure that anyone knew about this before it was found. Maybe NSA, maybe Chinese or Eastern Europeans, or internet crooks, or maybe nobody...

But if someone did know, in the best (most likely) case, they got very little if any of your info. In the worst case, they got your username and password and any other personal information from the websites (and other servers) you've logged into in the past 2 years.

How does this compare to past security bugs?

Catastrophic: 11 out of 10.

How will I know if they got my info?

This is the best question, nobody knows. Your best bet is to check your bank accounts to make sure there aren't any strange charges, check other accounts you log into to make sure there isn't any strange activity, then do the steps below.

Note, not all sites are affected, only the ones using the open-source version of the software (hurray for free and open source).

Is it fixed? What do I need to do?

Check the list of sites here, and reset passwords on any sites that are affected. My short list of sites using the affected software: Facebook-YES, Pinterest-YES, Apple-NO (yay), Amazon-NO (yay), Google-YES, Microsoft-NO, Yahoo-YES, Gmail-YES, Paypal/Target/Walmart-NO, Intuit/TurboTax-YES (doh!), most banks-NO, USAA-YES (doh!).

Then check your financial accounts to make sure there's nothing fishy going on. But you should be doing this regularly anyway (given that some e-commerce websites are zero-margin stores selling you cheap stuff just so they can get your credit card number to sell to crooks).

Oh, and be sure to use different passwords on different websites, and don't make them easily guessed. Apple's iCloud Keychain is a decent/free option for managing passwords for Mac users (though oddly it doesn't work with all websites, incl. Google). 1Password is a better option, but expensive (and I hate having to pay upgrade fees every year, feels like a subscription!).

So is the internet broken now? Should I stop trusting computers completely? Seems like we're always finding bugs like this...

No, the internet's not broken. But are people happy about this? Definitely not. We all hate changing passwords and not knowing who has what information about us.

What this means is that software isn't perfect, and memory bugs are pretty hard to recognize and track down. It may also mean that NSA is really sneaky about this kind of stuff, but the story sounds a little more innocent than that. On the plus side, anyone who knew about this is probably either chasing bank accounts much bigger than yours, or not interested in money...

But the same way armies learn where soldiers need more armor, the software-development communities learn how to better protect against not only this exploit, but this type of exploit, so I wouldn't expect us to have problems with these kinds of bugs for long. Coders are now looking for them, and stand to make a name for themselves finding them.

Hang in there, we'll get through this.

Sometimes they just need the words.

A little flash of insight from the other day:

My son, age 3 -- in a most demanding tone -- calls from behind me: "Dad, put on my shoes!"

My second instinct was to turn to him, and with a stern voice, tell him: "Hey, that's rude, you don't tell daddy what to do -- you're such a little turkey, why can't you be sweet like your sisters?"

Fortunately for me, my first instinct is to not do anything rash because some mistakes can be very hard to fix.

As an adult, I've spent literally thousands of hours interacting with other people and watching others interact with each other. I know what words and phrases imply, and that even slight differences in tone can send very different messages.

My kids on the other hand, even the older ones, are oblivious to most of that. Usually the content they're wanting to convey is perfectly fine -- they just don't know how to say it.

Sometimes they just need the words.

So I turned to my sweet little boy and said, prompting him, "Dad, can you help me get my shoes on please?"

"Oh -- Dad, can you help me get my shoes on please?" he said with a smile, happy to know the right thing to say.

"There's my sweet boy."

=)