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.

---

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.

---

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!

Mystery of the unknown songs is solved!

Okay, none of you are going to remember this, but in the interest of closure --

Many years ago I asked on a blog post to help me identify 7 songs that I got in 1995 in Portoviejo, Ecuador, on a copy of a tape from E. Nielsen, who got it from E. Brinegar. Nobody knew where the songs came from (and I'm pretty sure nobody cared). A couple are elevator music, the others are cheesy new age songs. But they bring back a lot of memories so I wanted to find and own them.

Well, the first few were identified a few years ago, but the remaining 4 were a mystery until today. The latest version of Shazam (iOS app) on my iPhone picked the correct album in < 5 seconds. Previous versions hadn't worked, so something recently has changed. Hooray!

If you're interested:

Before	Song Title	Album (click to view in iTunes)
Unknown_1	Through the Wall	Enchantment - Chris Spheeris and Paul Voudouris - 1991
Unknown_2	Pura Vida
Unknown_3	Golden Days
Unknown_4	Victory	Inside the Sky - Steve Haun - 1988
Unknown_5	Beginning Again
Unknown_6	Can't Look Back
Unknown_7	Inside the Sky

Enjoy!

Changing hairstyles, solved

Those who've had any interaction with me in the last 6 months know that I've had an interesting time of things.

Laptop and fire issues aside, perhaps most notable was my unusual haircut:

Except that's not a haircut. Back at the end of March my hair started falling out in a stripe around my head.

But let me back up, I have to tell you this other story first.

Tuesday, March 10th. No lunch, and a rather stressful day at work. After work I head over for my racquetball league match, which proves to be one of the most intense games I've ever played. I lost too. =(

Getting home, stepping through the back door, I knew something wasn't quite right. I couldn't see quite straight. Looking at Kyla, it almost looked like I was looking through a gemstone or something, with pieces of my vision fractured and shifted around. Scary.

I went in to the living room and lay down on the floor and soon was asleep. I remember Kennedy (2 yrs old at the time) kept trying to climb on me, and I kept pushing her off since I was feeling dizzy and hurting oddly -- I'm sure I scared her and hurt her feelings.

When I woke up I knew things were worse. I was more dizzy, and it sort-of hurt, almost like the pain you get from really loud noises except it was quiet. I laid my head back down and stared at the TV. I watched as the closed captions go by, but quickly realized I couldn't read the words. I could see the shapes clearly, it's not that they were blurry or anything -- I just couldn't process those shapes into letters or words. Now I'm really scared. I can't read!

(Note, curiously I tried to say the alphabet and I could...)

I tell Kyla something's really wrong, that it might be a stroke or something, so she goes in and starts checking the internet for symptoms. I go in and grab my cellphone and call my dad. I describe my symptoms (poorly), and he says, "Sounds like you're having a migraine, go take a couple of aspirin." I go in and grab the medicine, the whole time feeling dizzy and almost like I'm going to pass out. I pick up the bottle that looks like the aspirin, but I can't read the label. "Regan, does this say aspirin?!" Maybe I'm having an aneurism??* I take two aspirin and go lie down on the floor. Dad, still on the phone, says, "Yeah, something's wrong with you, you're not making a lot of sense." Great.

I hang up and Kyla calls our paramedic friend, Greg, who suggests that it might be a TIA, and says we need to get to the hospital asap.

Long story short, we call 911, freak out our neighbors, and they put me in an ambulance. About the time we leave for the hospital, I can start reading things again. Ah, finally things are starting to improve.

Sort-of. Except the medicine is worse than the disease. Hospitals are miserable places, not due so much to people as to process. I was moved 4 times over the course of 1 night, and was woken every 30 minutes or so by someone wanting to check my blood pressure, get another blood sample, or introduce themself as the new nurse on duty. I don't care, I'm tired!

The EKG, CAT scan, and MRI went off fairly quickly, before midnight. I had to stay, however, because they wanted to do an ultrasound on my carotid (?) arteries, and nobody could do those till 8 am. (So why wake me up every 30 minutes again?) Thankfully Kyla was able to come soon after I got there and stayed with me through the worst of it -- it would've been much worse without her.

Bottom line? They don't find anything. No stroke, no evidence of TIA, nothing. (Except a little plaque in my carotid artery, which is apparently normal.) "Atypical migraine" was the diagnosis. They said they'd tell me what to do different in life, but they couldn't think of anything to tell me. I don't drink, smoke, do drugs, not overweight, etc.

Then they tried to put me on cholesterol medication. What? Was my cholesterol high? No. So why put me on that? Oh, because it might have contributed to your arteries getting plaque in them. But that amount is normal, right? Uh, well it's just a "preventative measure"... Uh uh, no way, I'm not doing it. I'm really bitter about the shotgun trial-and-error approach the medical community uses for making medications. As David Hamlin says, roughly, "you don't get to shoot the side of a barn with a shotgun, draw a circle around the hole, then take credit for a bullseye." Especially when you have no clue what you just destroyed inside the barn.

They send me home.

Another sidenote, in case you're curious, this is how the hospital and insurance company reconciled:

Click to see the whole thing. So the hospital collected less than 3% of that bill. Make sure you have your "97% off" coupon the next time you go to the hospital, nice to save a little money here and there.

Okay, anyway, back to my hair story.

Three weeks later my hair starts falling out like the picture above. Now I'm really scared. I immediately make an appointment with the doctor. They think it's a bad haircut. "You should go see a neurologist about your migraine, maybe it was a TIA. No idea on the hair."

At the neurologist: "No way you had a TIA or a stroke, you have none of the risk factors or signs, and looking at the test results, the likelihood is pretty much zero. Let's talk about migraines. Family history of them?" Yes. "Unusual stress?" Yes, some. "Missed meals?" Yes. Consistent symptoms, bingo. "Migraine symptoms depend on where in the head they occur. Yours was a little lower in your brain than where most people experience them, but about the same."

But what about the hair?

"I don't know, I thought it was a bad haircut. It's not neurological, that's for sure."

Great, back to square one. At least it's not some form of cancer, insanity, or known alien abduction torture technique. We talk to about a dozen other doctors -- and the best we get is maybe an allergic reaction to latex on a headband on the MRI (wait, what headband?)...

I spend a few months like this. I practically shave my head so it doesn't look so creepy, and people who don't know the story think I was just being weird. Still no clues on the cause.

Then, a break.

In ~July I go to climb in the attic and put on my Energizer 1W headlamp**, and instantly realize that the headband on the headlamp follows the bald line around my head perfectly. Perfectly.

Ah, now we have something! There's no way that's a coincidence! I mention it to Maureen at work, who says she might be able to help. "Somebody put Nair on your headband, I know it! Bring it in, I'll get it tested." You know someone who can test it?? Like CSI? I don't know anybody who would put Nair on my headband.

Another couple weeks go by, and then the verdict comes back from the chem lab. Ready for this? Battery acid. All over the headband.

Oh sure, that makes sense, I remember one of the batteries in there blew up a few months back and I dumped them in the trash and put new ones in. And yes, as a matter of fact, I do wrap the headband around the whole lamp and battery compartment.

The tech was apparently quite surprised that I didn't have burns on my skull. Maybe my hair protected my skull.

Here's how I look now.

So, mystery solved. Hair's back, and no new migraines. Lessons? Learn to relax better, and watch out for Kirkland (Costco) batteries leaking in your headlamps, I guess.

Glad we finally got answers to that crazy sequence of events. And I hope it never happens again.

---

* BTW, I learned that aspirin is the *wrong* thing to take for strokes and aneurisms, as it makes the blood flow easier and therefore bleeds more freely into the brain. It's a good thing, however, when minor inflammation in the brain (?) constricts blood flow to take an anti-inflammatory like aspirin or ibuprofin.

** Energizer actually calls these "headlights". I think it's ironic that the guy whose blog is called "head-lights" has an experience like this actually being caused by one.

How to avoid one traveling nightmare

You may have noticed I haven't done much blogging in the last few months, and with good reason -- it's been a rough few months!

Quick summary: my work Mac blows up, I can't work, bring my personal Mac into work with tacit (not explicit) permission from my boss, corporate suspects me of industrial espionage and confiscates my personal laptop for 3 weeks, now I *really* can't work, that finally blows over, but I still don't have a workstation; I accidentally burn half my front lawn to the ground; check engine light comes on in my truck, diagnosis seems easy to fix, but I mess up the bolt head on the part trying to get it off, still not fixed; have a *terrible* migraine after losing a game of racquetball, so bad we think it's a TIA (mini-stroke), so I go to the hospital they do $12k-worth of tests and find nothing wrong, though some lightheadedness and headaches linger; 3 weeks later the hair on the sides of my head starts falling out, leaving me looking like I got a bowl cut, maybe caused by slight hypothyroidism which was maybe caused by the contrast dye they used in the CT scan -- or it's all caused by the stress of thinking I could've been about to die? doctors have never seen it before, no mention of anything like it on the internet; despite the fact I got a flu shot, I get a nasty case of the flu perfectly coincident with an out of town meeting to kick off the last of our work on a program, since a week or so earlier it was announced our program was going to be cancelled.

In summary, I hope spring '09 never happens again!

Back to the subject at hand, my flight yesterday from Tucson to Dallas was delayed by 3 hours, which made me miss my flight to Huntsville -- the last one of the evening.

So at 9pm I called the travel services company, and they made me a reservation with a Holiday Inn -- "just catch the shuttle from the airport". So I got on the HI shuttle, and rode for half an hour only to discover that it was the wrong Holiday Inn! Grr!

Lesson? If you take an airport shuttle to a hotel, make sure it's going to the right hotel! Just because it has the name of your hotel on it doesn't mean it's the right one!

Head-lights: 2 years

I just realized that as of last Friday this blog has been going for 2 whole years! I've impressed myself, I didn't figure I'd submit more than a few posts when I wrote that first one. But I've had a great time and hopefully you have too.

Happy 2-year anniversary, readers. The future is looking brighter every day.

- Bryan

Are you 18?

Since Iron Man doesn't come out to rent for another week on ATV, I did something I haven't done in a long time -- I went to a movie rental place last night.

"Any chance you have any copies of Iron Man left?"

"Yeah, we should have a few..."

"Great. Uh, I've never been here before, do I need to sign up to rent movies?"

"Yeah, you need to get a membership to rent movies. Are you 18?"

"Uh..."

So I've been keeping track of the last time someone seemed to think there was a chance that I wasn't 18 yet. I thought last March would be the last time, but alas -- it's now at 10/24/08. I still can't believe that to this adult lady, there was a chance in her mind that I was 17, or younger!

(For those who don't know me very well, I'm 33.)

Big storm afternoon

A big thunderstorm came through this afternoon. The rain was being blown hard against our back windows, which usually doesn't happen, so we knew it was an unusually strong one.

I thought maybe I'd climb in the attic to see if we had any roof leaks, but once I got upstairs, Kyla was already in the yellow room and I could feel a significant cool breeze coming through.

"Uh, you feel that breeze?", I asked.

"Yeah, it feels good."

"Are all the windows closed?"

"Yeah, pretty sure..."

Nah, something's wrong. So I raced around checking windows, and as I started the descent into the basement, I could feel a strong breeze coming up from there...

"Oh, no." I muttered with my first glance into the big room in the basement. The back door was flung wide open, probably by the wind, and there was a half inch of water on the floor in a 5' radius around the back door. I raced over and shut it, but soon realized how much water had gotten in... The wind had been blowing so hard that the opposite wall 15 feet from the door was wet. We spent the next 45 minutes drying things and trying to vacuum the water out of the carpet with the wet/dry vacuum. Fun.

Then I went out front:

"Well, that'll be a little difficult to prop up..."

"Oh good, just a little branch came off of that tree..."

"Doh, make that half the tree! Uh, oh, and it's blocking half the road... "Wow, it didn't fall on my truck... And wow, that's the only part of either tree that didn't fall."

"That first tree sure fell flat!"

"That's a lot of water that came down..." Not wanting to risk the rest of the tree falling on my truck, I backed out, and went for a quick drive around the neighborhood to survey the damage. A lot of bradford pear trees fell, a couple people lost gutters, but pretty clean drops all around, as far as I could tell.

"What's Stuart doing with my tree?" Our neighbor from across the street had come while I was driving around, and was already cutting the branches with his son. What a guy!

Pretty soon our other neighbors showed up and we had a road-clearing party.

We still have a mess in the yard, the Tucks said they'd come help us with that Monday.

I went to see if anybody else needed help, and a fellow around the corner had his bradford pear tree drop on his new Cadillac and new Nissan Z300 (?). Amazingly, despite having probably 400 pounds of limbs laying over both cars, neither were really damaged -- just a slight ding on the side of the caddy's hood. I spent an hour or so helping them, then headed home.

Most of the people who saw the truck untouched by that tree said, "Wow, you got lucky."

But that's not how I think of it. =)