Friday, 28 September 2012

Recovery update

Yesterday, I had the first hospital check-up and physio appointments since I have my surgery.  The hospital check-up involved an x-ray to see how things were going with the plating and alignment of all of the fragments (shame I didn't get hold of any images, I really must ask at the next appointment 'cause they look really cool!).  A quick trip to radiology for that and then back to the consultant for a chat.  The consultant of the day, Mr Sharif, looked at Mr Pearse's notes from the surgery and laughed at the capitals and underlined; "ABSOLUTELY NO resistance, lifting or weight bearing till week 8 and only after a full range of movement has been obtained."  I don't think anyone expected the improvements I already have on that front, but anyway... next was having the dressing taken off, the butterfly stitches removed and the ends of the dissolvable stitches trimmed so they don't irritate me any more.  I'd been getting quite itchy from those.

The nurse peeled off the dressing and unstuck the butterfly stitches.  It felt pretty weird, to be honest.  I have absolutely no sensation at the end of my shoulder; the nerve serving that area was severed during surgery.  I was warned that it was about 80% likely that I may at least temporarily, if not permanently, lose sensation somewhere around that area, so that wasn't a complete surprise (you can see in the diagram below how many major nerves there are around the clavicle and where the incision would have been made - I am not a doctor, but I can imagine there are a bajillion minor ones around there and it'd be almost impossible not to end up cutting .  What was a surprise is where the sensation loss is and the effect on the surrounding area.

Credit:- MEDICAL RF.COM/SCIENCE PHOTO LIBRARY
I was expecting the area just below the clavicle to be numb, but it's the end of my shoulder (where the knobbly bit (or, acromion) sticks out,) and below that for about 4 inches, in a rough circle of 4" diameter, that's affected.  What's annoying is that the skin around it is super-sensitive in some kind of compensation for it and the slightest brush against those bits of skin gives an overload of feedback to the point of feeling painful.  Also, when the dressing and butterfly stitches came off, there was a good amount of top layer of skin lifted off where the road rash was, and those bits were a bit weepy.  No matter, I got a clear dressing to get me home from the appointment and an instruction from the nurse to "give it a good scrubbing" and "use your normal moisturiser on it 2-3 times a day" to minimise the scar from the incision.

Anyway, I asked the consultant what I was and wasn't allowed to do, exercise wise, and came out with an understanding of; running (as long as I don't fall over *cough*) is allowed, using a spin bike with no hands is allowed, immersing the wound in water is allowed (as long as I don't lie in the bath for hours), I can swim in a couple of weeks (as long as I don't use that arm - so finning out to the Coffees of Hawaii boat at Kona will be OK :o)).  Still "ABSOLUTELY NO resistance blah blah..." for another 6 weeks and a follow-up appointment in 6 weeks to take another x-ray and assess progress.

So, all good there.  Off to the physio next.

Having been utterly religious with my exercises since I was discharged from hospital, I knew I'd done pretty well with recover of mobility so far.  When I saw the physio, he was amazed at the progress.  He said it was incredibly good at this stage, almost unbelievably good.  Check out this more typical progression.  At exactly 2 weeks from surgery, I already have almost 100% mobility across all of the ranges of motion for the joint; I'm just missing 5% or so in the external rotation.  This is both brilliant and awful.  Brilliant in that I'm recovering so quickly, awful in that I still cannot use that arm for any resistance, lifting or weight bearing of any kind (anything up to and including a cup of tea is fine, more is not fine) and with such great mobility it will be all too easy to absent-mindedly do things (to be honest, the mobility reduction was my most frustrating experience.  I have to be mindful and careful and... well, really careful.  The bone bits may well be held together with a titanium plate and screws, but they still need to stick together and heal and loading up the joint will retard, prevent that process or even make the whole situation worse.

All in all, I'm really happy with the status at the moment.  I'm happy to have had 50 minutes on the spin bike today and I've got parkrun tomorrow.  Looking good!

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