Sunday, July 1, 2012

Don't Look Back

I got this photo-quote via a friend from 'Hayhouse Daily Meditations' on Facebook.  It really resonated with me and I think it manages to say so much with so few words.  June was a tough month (the 'anniversary' of my accident!) and I think adopting this as a mantra might remind me that I am moving forward all the time, simply because the world keeps spinning.

It's been two weeks since I was back in Kentucky for my second follow up appointment, and 16 weeks since my surgery.  It was absolutely worth making the 1200 mile round trip again.  The information and feedback I have gained each time has been invaluable.  

The good news is that the actual repair has healed and my scapula position now is "outstanding" - it is lying flat, no longer 'winging' - and the reattached rhomboids and lower trapezius muscles are weak, but engaging.

The not-so-good news is that my muscles and shoulder capsule are VERY tight.  When I lift my arm my entire shoulder moves with it, as if everything is stuck together.  This is partly from the immobilization after the surgery, and partly because so many muscles just weren't working, or weren't working properly since last June (did I mention that's 18 muscles??!).  I also have developed Complex Regional Pain Syndrome which is pretty much described by its name.  I have some strange symptoms - a rash, strange skin sensations, burning, extreme sensitivity to the touch and ongoing pain that fit into that diagnosis.  I've been doing some reading on it and no-one really seems to know what the cause is but it's possible it's linked to some nerve damage (but not tears or avulsions in my case) or that it has happened because my brain has had pain signals for so long, so everything just gets hypersensitive and it associates everything with pain.  I've been put back on gabapentin as it can help with nerve pain. I have some other things to try, like having a towel rubbed over the area to de-sensitize it and then when I can tolerate the towel on the skin, a rougher material can be used.  

In terms of my exercises, I gave them my sheet from physio and they said, "you're not doing these all in one day, are you?" Ummmmmmmmm........ Yes. Twice a day.  Too much, apparently.  I think my body knew it was too much but my head was telling me I had to work the muscles to get better.  They have reduced my exercises from about 20 twice a day to five exercises three times a week.  I am under strict instructions not to do any more than this right now! I do also have some stretches to do five times a week. I have to cut back my physio from three times a week to twice a week, still getting passive manipulation to try to loosen thing up.  I've to add in some massage too, as I can tolerate it - this is to help with some tight muscles, spasming, breaking up scar tissue and the de-sensitization too. I am going to attempt to brave a massage appointment this week!

They told me that constantly working the muscles is not giving them time to heal, so they are constantly spasm-ing and sore from trying to do exercises that they are not quite ready for yet.  It's not that I was doing the wrong exercises, it's just that it's too early for them.  I was constantly told "this is not normal shoulder surgery"!!  And they also kept saying I was "only" three and a half months out.  My recovery should be 8-12 months.

After the appointment, I really felt relieved.  Although it's frustrating that I've not quite managed to amaze everyone with superhuman healing abilities (yeah, right) and that it is going to take a long time to heal and get full function back, I was just SO tired and sore trying to work through the exercise regime.  My physio said he felt relieved too.  Having never treated this injury before, and having instructions from Kentucky, he was concerned that I was not progressing fast enough and that perhaps he should have been doing something more, but I couldn't tolerate anything more. So, relief all round!

I also have a new 'Intelliskin' posture shirt.  It is supposed to provide support for the posture muscles and reduce fatigue, which in turn will help reduce my pain.  It's not really high fashion:

As you can see, it is VERY tight.  If someone had videoed my first attempt at getting it on, it might have been a You've Been Framed winner.  I still can't push with my right arm, my movement is still very limited and resisting with my body is still sore.  Getting a normal T-shirt or jumper on has become a highly skilled process!  This took three of us - my Dad holding my sore arm for support, my Mum attempting to get the shirt over my head and into a position that let me get my good arm through and me giving instructions and the occasional yelp.  When they asked me if I wanted to keep it to try, I said yes because I honestly thought I might need to be cut out of it!

However, very quickly I started to feel some relief in the muscles down my side (serratus & latissimus) and it has been helpful in relieving tension on the left side of my body and neck too.  And we are slowly perfecting the process of getting it on - it only takes two now!

Since I got it for free and it's helpful, I'll do a wee bit of PR for the company! The Intelliskin website has some good information about how the shirts work:

 IntelliSkin PostureCue™ products dynamically supports muscle and joint injuries, decreases pain, and improves sensory motor function. IntelliSkin improves your sensory motor function to instantly help your body move better and to correct muscle imbalances that are the cause of most injuries, pain and poor posture. Unique patent pending design stimulates the nerve endings in your skin to achieve a predictable neuromuscular response, which stimulates muscles that are overused and tight to relax and lengthen while weak, underused muscles are stimulated to tone and support you in the way nature intended.

I see on their website that they are launching a zipper version so I think I might buy the sports-bra zipper one for when I have to get dressed myself and I want to hide it under my clothes!

“The secret of health for both mind and body is not to mourn for the past, worry about the future, or anticipate troubles, but to live in the present moment wisely and earnestly.”
          ~ Buddah

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