Back in Austin. There is a great cold front that has moved in and cooled things off a bit. My arm is doing well. Range of motion at two weeks is good. I had a little bit of a scare on Tuesday when my elbow started getting sore and freezing up but after sustained work in the CPM machine things started moving again.
Looking forward to TX/OU tomorrow. Go Horns!
So my ROM is back to where it was after the last surgery. They treated me with radiation and have me on indometacin (http://en.wikipedia.org/wiki/Indometacin) to prevent the HO from coming back. I will be in a CPM machine for the next two weeks. http://en.wikipedia.org/wiki/Continuous_passive_motion
Blue point oysters, king crab legs, spinach tort with wild mushrooms, halibut in beurre blanc, Archery Summit, Macallan 25…it was great. Always awesome to indulge when you can count on losing 10 pounds over the next week.
Here’s to everyone. Much love to all. See you on the other side.
So this is the final stretch into my next surgery. This will be #6 in the past 12 months. As many dear readers know, I developed complications after my elbow replacement surgery this past April. Basically the heterotopic ossification came back and locked up my elbow again.
Dr. O’Driscoll thought it may come back so we were guardedly optimistic while I was doing therapy over this past Summer. However, in May my elbow started losing range of motion and it was apparent that HO had reared its ugly head again. Subsequent xrays confirmed this.
The plan with this next surgery is to remove the HO and then do radiation treatment to the area so that it doesn’t come back. There is a 30% chance that something goes wrong and will require an additional surgery. The biggest risk is that the triceps tendon fails, thus requiring another surgery to do an Achilles allograft from a cadaver. There is also a risk that I develop a hematoma and they have to go back in and wash me out. This is what happened back in August of 2008. Then there is a 1/1000 risk that I will develop cancer in my arm.
But all of this is worth it when you see the amount of motion I had in my elbow immediately after my surgery in April.
The hope is that I get back to this range of motion after surgery next week.
Will update everyone on the other side of the surgery. Mayo here we come!
So….it has been a while..eh?
Let’s see, here is the short update of what all is going on with the elbow these days:
1) I started losing range of motion in late May due to the heterotopic ossification (aka “bone spurs”) reforming in my elbow. The good news is that we suspected that the ossification could come back and my surgeon at the Mayo has a plan “B” in place.
2) In spite of losing range of motion, I have continued going to therapy 3x per week to strengthen and condition the muscles in my left arm. The really good news is that my ulnar nerve has started to come back to life. I am regaining feeling all along my left arm now and last week was able to wiggle my little finger for the first time in 1.5 years! I was so excited that I took my saxophone into the repairman to get it in playing condition so that I can start playing again. Yeah!
3) I am going back to the Mayo Clinic on August 18th to talk about my progress and decide the next course of action. We will probably end up doing one more surgery to remove the ossification and then I will probably do radiation treatment to prevent the ossification from coming back.
Things are moving slowly, but I can see some light at the end of the tunnel and am getting excited about getting past this next surgery and being able to return to work.
I will update more after I visit the Mayo in a few weeks.
Ciao.
I’m continuing to make progress at therapy and am not giving back any range of motion. Next Thursday I will go back to Rochester to see Dr. O’Driscoll and his team. We will take x-rays to check on the prosthesis and to see if any of the heterotopic ossification is starting up. If the HO is coming back then we will adjust my therapy to ensure that we are not doing anything to further aggravate the HO.
I am continuing to do therapy three times a week over at Brackenridge. Each session lasts around an hour to an hour and a half. My current routine is to start with heat and electric stimulation on my left elbow. After about 10 minutes of heat we then extend my left arm as much as possible and then push it into flexion as much as possible. We will somtimes then take measurements to see where I am at. I will then either do exercises at the table or we will then fire up the ultrasound machine and apply ultrasound to the areas of the triceps and biceps near the elbow joint. After all that I typically close out the session by doing a variety of exercises on this machine called a BTE. The BTE is bascially this cylinder with a set of gears inside for resistance and a hole in the center that allows you to attach a variety of adapters that simulate activities like sawing a board, climbing a ladder, or turning door knobs.
This week I started swimming. Swimming feels awkward with my elbow and arm just floating in the water. The resistance in the water from doing something like a crawl stroke feels like it would be too much right now, but I think this will get better in a few weeks.
Yesterday I asked Sarah at therapy how much longer till I can ride my motorcycle or beach cruiser. She said she didn’t want to touch that one with a 10 foot pole. I am not planning on riding anytime soon. I don’t have the strength or confidence yet. I think the bike is another 6 – 8 weeks away and the motorcycle will be at least another 8 – 12 weeks away. Orthos just love a patient like me.
Every Friday the therapists at Brack measure my ROM to see where I am tracking. Today I measured 5 degrees improvement in both my flexion and extension. The braces seem to be working. I can move my arm significantly more with the braces and, more importantly, I am not feeling any pain or resistance. I am still watching out not to over extend or flex my arm, but for right now it looks like the braces are doing their intended job. Yeah!
Happy Mother’s Day weekend to all the Mom’s out there (I see you Terri Brown and you are beautiful!).
So I’m four weeks out of surgery this week. My range of motion on flexion/extension is 95 to -31. The extension is fine, but only getting 95 degrees of flexion means that I am back to where I was pre-surgery 
I have a call into Dr. O’Driscoll to get his thoughts. I’m worried that the heterotopic ossification is coming back and locking up my elbow again. My therapists want me to start using the JAS progressive/static braces again. These contraptions do help with improving range of motion but if you are too aggressive with them they can end up causing more harm than good.
At 4 – 5 weeks after surgery you pretty much are at what your range of motion will be going forward. I have done this dance now three times and whatever I gained by week 5 was what I ended up with moving forward.
So…at this point it looks like I will have another surgery to look forward to on the horizon to improve my flexion. The good news is that I am still significantly better than where I started and I am continuing to gain feeling and control over my left arm thanks to having my ulnar nerve transposed.
Oh and look at that…the clouds have started to part and it looks like we are going to have another gorgeous day in Austin, Texas.
Life could be worse.
I started regular therapy this week. 3x per week for 1.5 hours. I’m back at Brackenridge working with Jennifer and Sarah. We are doing very light range of motion exercises and using heat and electric stimulation. All of my staples are out and it will be another week before I can start swimming at Barton Springs.
I am continuing to do epic walks around the neighborhood to get my blood moving and circulating. I’m also continuing to do Acai smoothies as much as possible over at Pacha. In fact I am due for one about now.
See y’all later…
A few days ago I received the surgery notes from my procedure at the Mayo. According to the notes, I underwent the following procedure:
1) Left elbow excision of massive heterotopic ossification
2) Total capsulectomy
3) Latitude anatomic hemiarthroplasty
4) ORIF olecranon osteotomy
5) Ulnar nerve neurolysis and transposition
6) Hardware removal
Yesterday I went to Dr. Patel in Austin and had half of my staples removed.
He also wrote me a prescription for occupational therapy. I am trying to get back into therapy with the OT girls at Brackenridge. They have been the best that I have worked with so far. I called them today to try and schedule and they are going to call me back and let me know what the deal is.
Till then I am going to continue doing mild therapy at the house. I am not supposed to lift anything with my left arm for another six weeks. However, I am anxious to get the arm moving. The first few weeks after surgery are critical for movement!!
