October 5, 2008

Elbow Update III

Posted in injury at 2:25 pm by berzerkeleyan

It’s been a little over three months since dislocating my elbow. How’m I doin’? Well, the experts seem happy with my progress. I, on the other hand, was really hoping to be a lot further along by now. As in, fully recovered. But as of today, I can extend my arm 165 degrees (out of 180) and flex to 40 degrees. I’m very happy with the flexion, but extension cannot be achieved without a lot of force (and a lot of pain). And to do both in quick succession is simply not possible without some agony. I haven’t run out of patience yet, but I’d be lying if said I didn’t have periodic moments of frustration.

That written, my progress would be a lot worse if it weren’t for the contraption you see above. The Ultraflex splint is a brace that has an adjustable spring which forces the arm to extend or flex, constantly applying pressure on the elbow ligaments. By gently forcing the arm to extend or flex over extended periods of time (6-10 hours/day), more joint elasticity is recovered than physical therapy alone.

I can’t say enough about this brace. Though it can be painful to wear, it has accelerated my recovery significantly. Based on my progress so far, I predict it’ll be another two or three months before I reach my limit. What that is, I don’t know yet. But there’s no reason for me to think I can’t reach full extension some day. Until then, I’ll have to wear what I affectionately call the Bear Trap as often as possible.

I also need to continue keeping things in perspective. As frustrating as this injury has been, it could always be worse. Take a look at this:

That is an X-ray of an injury suffered by a good friend of mine a month ago. He broke his ulna in four places, and his radius in one (look closely and you can see all five breaks). The worst part? It was a compound fracture. That’s right, folks. My friend writhed in agony for 30 min. with a bone sticking out of his arm before the ambulance mercifully arrived. Dayyammm!! He was in surgery for three hours to have a rod inserted to stabilize the ulna, and a plate and screws added to reconnect the radius. If there’s any good news to be had, there is no tendon or ligament damage. He’ll be in a cast for six weeks, but he should regain his flexibility relatively quickly. Details are sketchy as to how he wrecked his arm so thoroughly. But I’m guessing shark attack. He does live in New Zealand, after all.

So you see folks, it can always be worse. Always.

So count your blessings. Always.

July 25, 2008

Elbow Update II

Posted in injury at 8:29 am by berzerkeleyan

A few points:

  • The picture above is an X-ray of my elbow, taken yesterday. You should be able to see the three pins that were used to reattach the radial head. According to my doctor, the bone looks great.
  • What you don’t see are the three screws that were used to reattach each ligament. That’s because the screws are biodegradable, and are only meant as an initial anchor point for the ligaments. By the time the body clears the screws, the ligaments will have attached to the bone, and scarred over.
  • I started physical therapy last week. My physical therapist, like all the people who’ve helped me throughout this, is wonderful. Though she’s brought me to tears with the amount of pain she’s inflicted, I know it’s only going to help me in the end.
  • If a 90 degree bend at the elbow is my starting point, after a week I can extend my arm to 130 degrees, and flex it to 75 degrees. Everyone seems to think I’m ahead of schedule. So I’m happy. Really sore, but happy.
  • I can rotate my wrist palm up pretty well already. Palm down? Nothin’! That’s probably the one movement that I won’t get back completely. But if I can get back 10-15 degrees, I’ll be able to type again without any discomfort.
  • The latest Elbow album, “The Seldom Seen Kid,” has really grown on me. :)

July 8, 2008

Elbow Update

Posted in injury at 3:24 am by berzerkeleyan

Elbow Brace

Some of you have been wondering what’s up since my last post. To give you an update, I thought I’d list out answers to some of the questions I had for my orthopedist during my visit last Thursday. Because I was so busy processing a lot of information in real time, I don’t remember everything he said. But here’s what I have:

  1. What exactly was done during surgery?
    See answers to questions 2 and 3.
  2. Were pins or screws used on the radial head? Were fragments recovered/removed?
    Because I shattered the tip of the radius during my fall, a CT scan suggested that I might need a titanium prosthetic to replace the end. It turned out that the fragments were able to be salvaged without the need for an artificial part. Instead, screws were used to reattach the bone fragments. There is one piece that was not recovered. He didn’t remove it because it was small, and because it shouldn’t interfere with recovery. In fact, the fracture is not considered serious, so it’s the least of my concerns.
  3. My ligament tears — were they full tears, or just partials?
    There are three types of elbow separations — Type I, II, or III. They differ in the severity of ligament and bone damage. When I asked the doc what my degree of separation was, he said “you had a 736 degree separation.” In other words, he had never seen so much ligament damage. I completely tore three of the four ligaments that stabilize the joint. He reattached them by putting three individual screws in the bone, and wrapping each ligament around them. It’s recovering from these tears that will be challenging, and not the radial head fracture.
  4. As noted in my first visit, extension/flexion limitations are to be expected. What about rotational limitations?
    Extension and flexion of my arm should not be affected too badly. In fact, I should get back 90% of both. But rotation of the wrist — the ability to turn my wrist up or down — is uncertain at the moment. Because of the severity of the ligament tears, the amount of time I’ll need to be immobilized will affect how much flexibilty I recover. I can live without the ability to throw a ball or swing a golf club. But I can’t go without being able to write, or type with two hands. And right now I can’t do either. Out of all the news I received, this is what worries me the most.
  5. Is the joint now more susceptible to dislocation?
    According to my doctor, this shouldn’t be a problem. Everything is screwed in there pretty tight.
  6. Will I have permanent strength loss?
    No. Ligaments attach bone to bone. Tendons attach muscle to bone. Since I didn’t suffer any tendon tears, strength should not be affected.
  7. Can I be placed in a removable cast if I promise to keep my arm in it, except for showering?
    For fractures around joints, doctors try to minimize the amount of time in a cast. The longer the joint is immobilized, the less flexibility that’s recovered. Therefore, I was in a cast for only two weeks.
    Hallelujah! Praise the gods!
    In its place, I got a removable brace last Thursday (it’s a variant to the one pictured above). At the moment, my elbow is at a 90 degree angle, and I can only flex and extend a few degrees. But the brace is designed to allow me to extend/flex incrementally, without going too far in either direction and hurting myself. However, it completely prevents me from rotating the wrist. The doc wants the ligaments to take hold before I start turning my hand. Therefore, I can’t start rotational exercises for another two weeks.

There you have it. Probably more detail than what was necessary.

I’m still in quite a bit of pain. Surprisingly, most of it comes from all the soft tissue damage in my forearm, and not from my elbow. Unfortunately, my Percocet prescription ran out last Thursday. And ibuprofen and acetaminophen aren’t very effective. But each day it’s getting slightly more tolerable. And I’m remaining optimistic. Hey, at least I’m now able to take showers.

Hallelujah! Praise the gods!

June 26, 2008

Ow-wee-ow-wee-ow-wee!!

Posted in injury, portland at 6:38 pm by berzerkeleyan

crying kid

I’m not the most prolific blogger out there. If I’m lucky, I find time to list what music I listen to from week to week. But even that meager output will be reduced further. You see, I dislocated and fractured my elbow last week after taking a nasty fall while running. I also took a few stitches above my eye for good measure. Though I have never been known for my grace, this is my first major injury.

It wasn’t a simple dislocation. If that were the case, I’d be looking at four to six weeks of minor misery. Unfortunately, I also broke a bone around the elbow joint (the radial head), and completely tore the ligaments surrounding it. Things were so bad in there that I had surgery yesterday to get everything cleaned out and reset. Recovery will, according to the Orthopedist, be “difficult” — three to four months. But considering how much worse my fall could have been (other broken bones, paralysis, death), and all the modern creature comforts at my disposal, I have no real complaints.

For example, I live in the middle of the city, a prime location for the invalid. I’m mere minutes walking distance from coffee, restaurants, the pharmacy, the hospital, even the Orthopedist. The inability to drive is therefore not a big deal. About the only thing I need a car for is grocery shopping. But Safeway now delivers! All I do is order online, and the next day there are bags of pre-packaged meals at my doorstep. There are a few minor difficulties, mostly from living alone and not having a fleshed out social network. But a broken arm today is very different than having one, say, fifteen years ago.

One final thing to note…from the start, I have been blown away by how great folks have been towards me. The skater dudes who saw my fall and immediately called 911; the EMT crew who doped me up right away and got me to the hospital within five minutes; the ER folks who stitched me up, reset the joint, put me in my first cast, and got me home; the pharmacists who have dutifully filled my Percocet prescriptions with sweet looks of pity; the baristas at the coffee shop who’ve treated me to a cookie here and there; and the random folks who haven’t been afraid to ask what happened to me, eager to know what extreme sport caused my injury, but probably more happy to hear how randomly normal the accident was. I think they’re ultimately relieved that my life’s as ordinary as theirs.

An ordinary life. But I’m grateful.