30 weeks, or 212 days later - I'm a PT graduate!

I was officially released from PT today!  Let's check the progress:

Elbow extension:  8 degrees
Elbow flexion:  133 degrees *
     *back to the range of motion I had after my severe injury at age 13

Wrist flexion:  72 degree
Wrist extension:  80 degrees

I came home with a fresh container of green putty to help me continue to strengthen my grip and the coveted C.O.R.E t-shirt that I will wear proudly.  I can not thank my therapist enough for all of her help and support.  This injury is really difficult to explain and can be utterly frustrating at times. I am so grateful for the amazing team that I had getting me through this!

And the magic number is ...

I wondered what the magic number would be with regards to the months waiting to see if my thumb starts working like the rest of my fingers.  The answer?  7.  For seven months I have been watching in amazement as my radial nerve heals itself.  I say in amazement because it is truly fascinating. There have been odd tinges, moderate and severe pain, discoloration, swelling and too many other odd things to count.  I know that each and every thing that is happening is for a reason.  The biggest thing that I notice now is that my arm is starting to feel like it is mine.  I have spent months feeling like the arm attached to my body belonged to someone else.  I don't really know how to explain it, but my brain just didn't treat it the same.  I imagine that since the nerve is now healed at least 7" down my arm, at each major milestone the communications from the brain get better.

My thumb is starting to wake up and feel like it belongs, too.  I still have a good bit of numbness on the surface of my hand and I'm not sure if that will ever go away, but I can move the thumbs in ways that I have not been able to in the past.  It still feels like the tendons were replaced with tight rubber bands.  I can't quite extend completely, and although I can make a fist, it is very tight and stiff.

I know that there are still several months of healing left and perhaps the tightness will ease up and I won't have to think so hard when trying to move my thumb.  Until then, I will sit back in awe of the human body and it's magical healing powers and dream of the day I muster up the courage to get back on my bike.

Fractured humerus .. the gift that keeps on giving!

What a lovely shade of blue, don't you think?  Just when I thought that my hand was healing and I was getting back to "normal" I started having some pain and then my hand started to turn blue.  I must admit that I was quite discouraged because it feels like a set back and I was enjoying moving forward.  The poor color hasn't been a problem for weeks so it was not what I wanted to see.

I called the surgeon and he put my mind at ease.  I emailed the photo for him to look at because when I told him during my last office visit the color was great.  I guess I wanted him to see what I was referring to.  He isn't concerned.  He still believes it is a problem with the vessels, a possible side effect of certain type of nerve injuries.  There is nothing to be done about it and nothing to worry about.  I certainly wasn't expecting anything to be done about it, but I just thought it may be the sign of something that wasn't good since it has been so good for at least a month.  "Nothing to worry about."  Whew!  I'll take that.

This time I did notice something that I don't remember from before.  When the pain eased up, the color returned to normal.  In the past when my hand started turning blue it was when I was running and I don't remember any specific pain, but then again - it was all hurting!  The pain was a burning sensation under my incision area, above the elbow and the entire arm just felt really strange.  Interesting ... Weird.

Every day is a learning experience!

7 months and counting ....

It's been about a month since I last documented my progress.  Things have been going well.  So well, in fact, that I actually feel like I've made my way out the other side.  As I type this post tonight it is with two hands typing.  I wasn't sure that would ever happen just a couple of months ago.  My hand remains swollen and stiff but it works ... it really works!

I continue to have trouble with my thumb and elbow.  The thumb is patiently waiting for the radial nerve to heal itself and the elbow is just very stiff and sore.  It's not painful, it's just achy ... all the time.  I suspect that it is the severe osteoarthritis rearing it's ugly face and I just try to keep it moving as much as possible in hopes that I keep the blood flowing.  My hope is that the arthritis will settle down but if not, it's okay.  I can use my arm!

The rotation that I have been diligently working to restore has not improved at all.  I won't stop working, but I suspect that I will not regain that range of motion.  The flexion and extension at the elbow are about the same, too.  I secretly hoped that by spending time 7 days a week for 7 months doing PT with my elbow, I could beat the odds given to me from the surgeon.  I was told that I should expect to lose 10-15 degrees range of motion both directions due to the plate placement and that is where I seem to be. 

25 weeks - let's check the progress!

Laura and Paul ... this is for you :)

Shocks and needles and electrodes, oh my!

I had a follow-up EMG today.  The regeneration of nerves is such a fascinating thing!  In fact, the whole human body is fascinating.  Bones break and heal, nerves that receive and deliver signals from the brain can just grow back when injured - all right before our very eyes.  It's slow, but SO interesting!

My radial nerve was injured above my elbow and in the past 3+ months since my first EMG, it has completely healed to a point below my elbow, about 3-4" worth of regeneration.  As I had mentioned in an earlier post, I was told it would grow about 1mm a day, or 1" a month.  It has been 5 months since the fracture,  so it does appear to be following the "normal" path of recovery.

The muscle that allows us to lift our wrist is high in the forearm, close to the elbow.  My wrist is working well and the EMG confirmed that the nerve up into my triceps from this point is completely healed. (music to my ears!)  As the nerve travels further down the forearm, it begins to help with the function of the fingers.  There are signs of improvement in my 4 fingers, but very little in my thumb.  The EMG confirmed this.  There are areas of the nerve that are not showing any signal at all.  The Dr. is not concerned, she feels that the healing in this area has just not happened yet.  She feels that although there is no guarantee, at this point she is confident that it will come back over the next 3-4 months.

I had another milestone - NO MORE DYNAMIC SPLINT!  It has served me well!  Both the Dr. and the PT agree that at this point it may hinder the strengthening of the muscles and that using my hand in any capacity as much as possible is the best PT of all.  I thought that when I was done with this thing I would want to melt it down like the Wicked Witch of the West but in a strange kind of way it signifies a lot and I don't want to throw it away.  It kind of represents 5 months of my life this year .... how weird am I?

Time keeps on ticking ....

Holy cow!  The progress over the past 7 days has been remarkable.  The muscles are getting stronger every day and it feels really great.

I had my 5 month follow-up with the surgeon and he would like me to have another nerve conductivity test, scheduled in two days.  I'm not completely sure I understand why this is necessary since it does seem to be healing, but I am interested in seeing what they say with regards to my thumb.  My hope is that this will be able to either confirm that the healing radial nerve is growing back as it should, or if there is anything questionable going on.

We discussed the concern I have about the poor color in my hand and he assures me that there is no direct relationship between the radial nerve and the circulation.  Both he and the physical therapist say that the small vessels are just not having the blood pushed through as they should because of the weakness in the muscles.  I explained to him how blue it looks at times, especially after I have been running and I'll mention it to the Physiatrist when the EMG is done, but I am not going to worry about it at all since my Dr. isn't.  Whew!

My next follow-up with the surgeon is in 3 months.  Woo hoo!  I've graduated from 6 week follow-ups to 12!  :)

I'm feeling great!  Am now running 5 days a week and did a 5k this past weekend.  I have to say that between the chilly air and the arm, running does irritate my shoulder, but it's just great to be heading in the right direction and I am very close to feeling 100% recovered!  My hand will come back when it's ready, until then I just want to keep moving and feeling great.  Again I am extremely grateful for the surgeon, physical therapist and the most amazing and supportive friends!

... And we have LIFT off!

22 weeks has brought me some great progress!  I am able to lift my fingers!!  Yay!  The next step will be the ability to straighten my fingers.  I think the hand deserves a little TLC in the way of a manicure!

If you can't beat 'em, join 'em!

October 31, 2010

When you have two children who are away at college and a high school freshman, Halloween just isn't quite the same.  Yes, I put out some festive decorations for my home and put pumpkins on the front porch, but costumes ... not so much!  But, WAIT!  What if I dress up for Halloween myself?  No, that really isn't my thing either.

I stopped by my old office this week to assist them in a project and one of my friends asked me if she could play the strings on my contraption like a guitar.  It isn't the first time I have been asked that, so in the spirit of Halloween, and my continuing journey of retaining my sense of humor, I turned my contraption into a guitar.  Happy Halloween!

Month 5 ... let's check the progress!

Well, it's been 7 weeks since I had measurements at PT.  The entire time with my physical therapist has been spent working on range of motion in my shoulder so all of the range of motion work on my elbow has been left up to me.  Have I done the job?  Let's check the progress:

Extension: 8 degrees / 4 degrees with assistance.  4 degree improvement since last measurement, 32 degrees overall!   I was told that I would probably never get more than 10 - 15 degrees because of the placement of the plates.  Ha!  No one should tell me I can "never" do something because that just makes me fight harder.  I hope that when my triceps returns after the radial nerve fully heals, I will get my arm completely straight.

Flexion:  134 degrees with or without assistance.  10 degree improvement since last measurement, 34 degree improvement overall!  I'm afraid this may be the extent of my ability to bend at the elbow because even the PT can not push it even one degree further.  I believe I am right at the range of motion I had prior to my fracture, although I never had an official measurement after all of my surgeries as a child.  I will keep working on this!

Nothing new with the fingers, so hopefully I will have an update to report soon!

99F1DF5D-8736-87CF-582C-AA8BB206EB61

1.02.28

Blast from the past .....

Early on in my posts I mentioned the fact that I suffered a severe injury to the same arm when I was 13 years old.  I had several surgeries and have often wondered about the surgeon who fixed my arm the first time around.

I grew up in Maryland and I remember the physician left his practice shortly after he treated me to move back to his home land of Israel.  Last night I was on PubMed looking for articles related to circulation issues after a fracture and radial nerve palsy.  I didn't find what I was looking for but I did find an article about humerus fractures that cited a Dr. Edelson in Israel.  I sent him and email and within an hour I had a reply - it was the orthopaedic surgeon who treated me in the 1970's.  How great is that?

Random little story, but it made my day!

99F1DF5D-8736-87CF-582C-AA8BB206EB61

1.02.28

... and YES, my wrist is getting stronger!

September 11 was the last date I posted photos.  Today is October 4 and I decided to look back on those images to see if there has been any progress.  I'm glad that I keep images because it may not be much, but the wrist is stronger!  My pointer finger has more muscle tone but the other 4 fingers have not improved at all.  Yet.  I know their days are coming!

tiny improvement, but see a
small amount of flex at the wrist!

When my hand is flat on the table I still can not lift any of my fingers.  There just is not enough strength for that ... yet.  I can, however, lift my wrist and that is progress!

I can lift my hand at the wrist
when flat on the table!

Thanks to my new iPhone I am able to take video.  This is what it looks like to have a wrist that works, with a hand that does not.  Because the pointer finger has gained some muscle tone, I am actually able to lift it with the wrist at certain positions.  Yay!  However, when I try to lift the other fingers - or all 5 at the same time, it is clear that I have a long way to go!

Oh, frozen shoulder!

Great new!  No surgery is needed on my shoulder.  Whew!  I was NOT looking forward to dragging this out one minute longer than necessary and I can't imagine starting all over with another surgery.

So, what is causing me all the trouble, you ask?  Frozen Shoulder, otherwise known as adhesive capsulitis.

In the case of me, they believe it was from the high impact fall when I fractured my arm.  My MRI impression reads:

• Extensive adhesive capsulitis with pericapsula edema and capsualar thickening
• Mild acromioclavicular osteoarthritis
• Moderate subacromial and subdeltoid bursitis
• Low-grade inrerstitial and possible bursai surface partial tear far anterior supraspinatus tendon
• Degenerative glenoid labrum and tendinosis of the extracapsular biceps tendon

So, I got a cortisone injection and I will be stretching, stretching and stretching some more.

Unfortunately, it takes a long time to regain range of motion after frozen shoulder, but I am reminded to be a "patient" patient.  I'm waiting for the radial nerve so I'll wait for the shoulder to show me some love, too.

16 weeks ... let's check the progress!

Today was another follow up and things are going really well with the fracture.  The bone continues to heal well and x-rays show new bone growth which is always what you want to see.  It's hard to see the fracture line in the original x-ray with all of the hardware but I am reminded again of what a terrible location the humerus broke.

the pink line represents the fracture - what a mess!

The Dr. is really happy with the recovering radial nerve.  The wrist continues to get a little stronger each week and now I patiently wait for the fingers to follow!  There was a resident from University of Iowa in the office today so much of my visit was spent educating him about the injury I had and the healing process.  I really like teaching moments because I always learn a little bit more, too.

My surgeon told the resident that he didn't remember the radial nerve showing signs of injury in the ER and the location of the fracture is not indicative of a radial nerve injury so he feels that the multiple surgeries in my arm as a child and scar tissue may have contributed to the trauma on the nerve as it was moved out of the way while they repaired the injury.  We will never know but it is very unusual for this particular fracture.  In fact, I was reading an article that said this type of fracture in adults is very unusual, too.  Like everything else with me -- it's "uncommon."  Shocker.  :)

So, now we try to figure out how to best heal the shoulder.  One MRI with contrast, one more follow up and one cortisone injection ..... never a dull moment!  We will meet and discuss only the shoulder one week from today.

15 weeks .. but who's counting?

Unless you experience this type of injury it's a bit difficult to explain how .. s l o w..  the progress can be, but the key word is PROGRESS!  It has been 15 weeks and I am finally starting to see some sign of life in my hand and wrist.  I can now not only lift my wrist, but I can flex it back a little and lift my pointer finger, too!

The finger is very interesting.  I can lift it if I have some bend in the hand, but there is nothing happening if my wrist/hand are flat on the table.

The tops of my knuckles are really red and inflamed .. another little thing I expected to improve but doesn't ever seem to change.  Now that I have a little more strength in the wrist I try to wear my dynamic splint a little less and try to use my hand in hopes of getting some blood flowing and hopefully the swelling will improve.

If I put my hand flat on the table and try to lift my finger .. nothing!
I can lift my wrist, so my guess is that I just need to continue to be
patient and it will start working!

99F1DF5D-8736-87CF-582C-AA8BB206EB61

1.02.28

The power of positive thinking .. and a little help from your friends!

I've been told that I can obsess.  I choose to believe that I simply crave information.  This is my body and I want to understand exactly what is going on.  The way I look at it, I can spend a lot more time on my "case" than my physician can.  Heck, I only have on patient: ME!  At the same time, I have learned from other experiences in the medical world that it is not an exact science and I appreciate that.  I am fortunate to have the time and desire to learn.

I think it is important to listen to my doctor and physical therapist and do exactly what they tell me, but I am choosing to take that extra step and educate myself.  The funny thing about Radial Nerve Palsy is that I can find a lot of medical articles discussing the "science" behind it, but what has been far more helpful is sharing with other patients who have had similar injuries.  In fact, it's been amazing!  Everything is so much better with help from your friends and I have met two amazing people ... enter Paul and Laura!  Paul (from the UK) is ahead of me in his recovery and Laura (from VT) fractured her arm about 8 weeks ago.  I have gotten great tips from both of them and have been able to share what works - and doesn't for me - and I wouldn't trade it for the world.  THANK YOU both :)

99F1DF5D-8736-87CF-582C-AA8BB206EB61

1.02.28

Perhaps a bit too much information?

I don't know if I'm just weird, but I decided that I wanted to read the actual reports from the x-ray and CT taken in the E.R., so, I stopped by the hospital and picked up copies.  I have to say, it is a bit enlightening.  The most obvious fact that I take away from these findings are that even though my 30+ year old elbow injury hasn't really bothered me much, it was just a matter of time.  Yikes, no wonder the ol' elbow is not liking any part of this .......

X-ray (June 9, 2010)
There is a suprachondylar fracture of the distal left humerus with posterior displacement of the proximal humerus fragment with respect to the distal humerus.  Significant overlap of fracture fragments is demonstrated.  Fracture line appears to extend into the joint space within the distal humerus but this is difficult to determine with certainty.  There is an abnormal appearance of the radial head which appears related to significant degenerative change,  A definite fracture line is appreciated.  There also appears to be degenerative change in the proximal ulna involving the coronoid with some bony spurring,  However, this is difficult to evaluate fully on the limited views obtained.  Left elbow joint effusion is demonstrated.

Impression: 

1. Complete fracture of the distal left humerus with displacement overlapping fracture fragments in gross deformity at the left elbow.
2.  Proximal radius and ulna appear grossly intact but these are limited.  Degenerative spurring is suggested.

CT (June 9, 2010)
There is a supracondylar fracture of the distal humerus.  The fracture is comminuted and anteriorly displaced by 1 shaft width.  In the proximal ulna and radius demonstrate no acute change.  However, severe osteoarthritis is noted involving the entire elbow with greater involvement in the radiocapitellar joint.  There is joint space narrowing subchondral sclerosis and subchondral cyst formation.  Osteophyte formation is present.  Multipile intra-articular bodies demonstrated anterior to the radiocapitellar joint and anterior to the coronoid process.

Impression:

1.  Comminuted distal humerus fracture with anterior displacement by 1 shaft width,
2.  No acute change of the proximal ulna or radius.  There is severe elbow osteoarthritis with multiple intra-articular bodies anterior to the radiocapitellar joint and anterior to the coronoid process.

I have a special request

In addition to all that is going on with my elbow and hand, I have been struggling with my shoulder. My physical therapist and I have been discussing it for weeks, and over the last month I have a heat treatment on the shoulder before we start working on my elbow. I have noticed that as the elbow pain is improving, this annoying shoulder is not. So, last week I told the therapist that I had a special request - that we NOT worry about the arm or hand and concentrate on the shoulder because now it is keeping me up at night.

Because of the shoulder pain, I am unable to lift my arm out to the side or over my head. I was given a series of exercises to help stretch my shoulder that I have added to my daily repertoire but unfortunately there is no improvement.

So, today I was told that they suspect I have a torn rotator cuff. Really? They believe that I injured it in my accident but because I have been so focused on the elbow, I just kind of ignored the shoulder. Ugh! That's all I can say!

It actually makes perfect sense. It has bothered me since I was in the hospital. I first noticed that I couldn't lift my arm almost immediately, but I really thought it was because my arm hurt so bad I wasn't really trying. I then spent 6 weeks in a sling where I didn't need to, but still struggled getting dressed.

Next stop: MRI.

The things that make you go hmmmmm ........

I have been told so many funny (and outrageous) stories that I thought I would write down my favorites.  I'm not sure if I can remember even one outing since I started wearing my contraption that a stranger didn't ask me, "What did you DO to your arm?"  Many times, a simple reply of "I broke my arm very bad," is enough for me to move on.  However, most if the time I get 20 questions and a story - and some of them are worth sharing!

At a Starbucks in Knoxville, TN this summer I heard from a mother of a college aged son that her boy once had a contraption just like mine.  "What happened to him?" I asked.  She replied, "Well, one night he had too much to drink and passed out on a lazy boy and when he woke up his wrist was paralyzed."  I told her that in the medical world that was called 'Saturday Night Palsy."  (as opposed to Radial Nerve Palsy following an injury)  "Really?"  This young man was very fortunate to have a full recovery in just 5 weeks.

On another afternoon I took my daughter to the bank to do some business and the young man who helped us kept staring at my arm, but didn't say a word.  Finally, he blurted out "How did you hurt your nerves?"  I was impressed!  I asked him how he was familiar with this type of device and he said, "Well, it's kind of a funny story.  In college I had a good friend who decided to prove to his suite mates that he was "really strong" so he put his hand in the blender and turned it on."  Wow!  Clearly he was neither stronger than the blades of a blender nor smarter than a box of rocks.  WHO would do that????

Earlier this week I was at Best Buy at the customer service desk when I was asked what happened to my hand.  I didn't even get my answer out when the young man told me that he had a friend once who had to wear something that just looked like mine after he was shot with a shotgun in the hand.  OUCH!  I responded by saying, "Well, mine was a very boring accident involving ... " Again, before I could finish my sentence I learned that he broke his leg a few years back and because of the cast on his leg he was forced to learn how to sleep in his back.  Well, alrighty then - thanks for telling me! 

Some of the stories sound like they should be in the running for a Darwin Award and make mine seem incredibly dull and boring!

11 weeks ... let's check the progress!

Today marks the 11 week anniversary since my accident and while it seems that the range of motion in my elbow is just not getting better, it actually is.

Extension - 12 degrees - a 28 degree improvement!  *8 degrees with active pushing on the arm.
Flexion - 122 degrees - a 22 degree improvement! *128 with active pushing on the arm.

In the big picture, this is all great news.  I really want to see my elbow flexion at least 145 degrees but it continues to be a very slow process.  They have had me moving my elbow since 10 days after the accident, but it wasn't until the 6 week mark that I began the 'active' physical therapy - or as I sometimes like to refer to it as physical torture.  I must admit that I expected to see more progress by this point, but progress of any kind should really be my goal.

It's a week to celebrate these small accomplishments!  :)

Pain + an itty bitty sign of progress makes me one happy girl!

I have spent 3 days just waiting for this arm of mine to stop hurting so I can sleep.  Nothing seems to make it feel better so I have been trying to distract myself by getting out of the house.  I have gone out to eat. seen a movie and just walked around the mall - anything to NOT think about my arm.  Last night, in addition to the constant pain I am feeling, I started feeling some shocks in my hand and the back of my triceps - is the nerve waking up?  Trying to tell me something? How great would that be?

I took my brace off and I notice that my wrist isn't as droopy as it has been.  Every day, for 10 weeks, I work on my wrist and hand, moving them both so they do not stiffen up.  Every day I also try to lift my fingers, thumb and wrist.  There has not been an ounce of change ... until now!  Today is the first reason for celebration - I can move my wrist on my own.  Not much, but it is a sign that the nerve is trying to fire to the muscle and I am SO excited!  It is an itty bitty sign, but after 2 and 1/2 months it is SUCH good news and I guess it is why I am having so much pain.  Let me just tell you, I can handle pain knowing there is something good coming of it!  Hooray!

If only everything in life made sense, right?

This whole experience just continues to be puzzling.  I severely fractured my arm but it really didn't hurt.  In the ER I thought it was shock, but a few days after surgery I decided that I must have a high tolerance for pain.  The first real nagging pain came on the day it was set in a cast, 5 days post surgery.  When I woke up from surgery, my arm was extended in a straight position and when it was set in the cast it needed to be bent to about 90 degrees.  Bending the arm wasn't bad, but several hours later it was screaming in protest.  But, that too passed.

It has been about 9 weeks and for the life of me I don't see any rhyme or reason to why I can have little to no pain one day, but the very next it starts hurting so bad I just want to chop it off.  Some days I think that growing bone just hurts.  Other days the bone feels great and I have aching muscles and then there are the days when it just aches all over.  Weird.  It's just all part of the healing process.

Today I am experiencing a new pain and it's not fun - at all!  The pain is in the back of my arm, my triceps muscle and my hand and it hurts!  Ugh.  I wonder if it is the nerve.  If nerve regeneration is painful then I am a little worried about this because I have months of nerve regeneration to look forward to.  I'm crossing my fingers that this to shall pass.

Is this just the magical tool I've been waiting for?

Ok, so here it is.  It's called a JAS elbow device and if my elbow is going to start moving like I really need it to, this is just the thing that is going to to make it happen!  3 times per day for 30 minutes at a time.  It's kind of sad to admit, but I'm excited to get started.    Let's get it going!

"Mom, your arm kind of looks like a chicken leg"

"Actually, it looks kind of like a giant squash,"  said John.  haha ... This was our dinner conversation tonight after I took my brace off to give my skin a rest.  It really is very swollen at the elbow and I'm told it will be for a really long time. 

I'm still waiting on the elbow device to arrive so we can really work on bending the elbow.  At PT earlier this week we figured out that with about 135 degrees (and a working hand) I should be able to reach my ear to put in my own earings ... a simple wish that I have.  When that day arrives I'll just have to treat myself to a cute pair of earings.

EMG, NCV, oh my!

The trauma from the fracture has improved, the swelling is finally better and after giving the traumatized radial nerve 6 weeks to settle down they are going to do the first EMG/NCV to figure out just how damaged the nerve is.

Let me warn you - this is NOT fun at all, but very necessary.  Unfortunately the news isn't good.  My radial nerve has sustained a severe injury.  I'm very lucky it doesn't appear to be completely dis-attached. There seems to be a very small strand of nerve remaining which is very good news!  The Dr. has no reason to feel that it won't recover at this point but once again it will "take a long time."  The damage appears to be above the elbow because my left triceps is also impacted.  Bummer.  They now tell me it will be a solid year before I get my hand back.

They will repeat the EMG around Halloween (which will be 5 months) and hope to see some progress.  Until then:  keep using the hand with the dynamic splint, work on straightening the wrist daily and remain patient!

6 weeks ... Let's check the progress!

I see the surgeon today for my six week post-op visit.  Let's check the progress ....

Elbow extension: 25 degrees - improvement of 15 degrees!
Elbow flexion: 104 degrees - improvement of 4 degrees!

Progress, albeit very slow, is good!  We will really ramp up the PT this week and I hope for some really great results now that we can really begin to push.  The pain in the area of my fracture is really great.  In fact, it's really not pain, but achy.  I find first thing in the morning is really the worst because the elbow has been resting on the pillow and it doesn't seem to appreciate the pressure.

The wrist and hand unfortunately show no improvement at all.  The surgeon really doesn't like that so I am scheduled for a nerve conductivity test (EMG) in a couple of days.  This will let him know not only the extent on the injury to the radial nerve, but also an idea on the location of the lesion on the nerve.  The PT is hopeful that the lesion is lower in the arm because of the feeling that I have in my forearm.  I hope so because at 1" a month, that is closer to the wrist and would mean a faster recovery.  I still have a lot of numbness in the thumb but I do believe it is getting better.

He ordered a "night extension splint" that involves stretching the arm as straight as possible, strapping it in and sleeping all night AND an elbow device for daytime use that involves bending it as far as it will go and locking it in place for 30 minutes at a time.   They both sound like torture devices but the Dr. said, "you won't like it, but you'll be fine because you're not a complainer."  Hahaha - - I guess I better not ruin my reputation by starting to whine now.  Darn!

my fingers are all puffy and swollen because of the
lack of use and blood flow.

wrist drop - without a brace this is my left hand

I am able to bend my fingers and make a fist but it
is very stiff - I'm sure the swelling doesn't help

this is what straightening my fingers looks like.  I am trying to
lift my fingers and wrist but it's impossible ...

"It's the ugliest thing you've ever seen"

That was what the PT told me when I went to get my new "night extension splint" made.  Really, what is uglier than the contraption I wear in public??

Okay - it's ugly.  But, that's beside the point.  It's painful!  Neither of my other splints fit over it to hold my wrist up so I've added an over-the-counter brace just to spice it up a bit.   Let me just say - there's no sleeping going on with this  .. PLEASE get straight soon!  What you can't see in the picture is the compression stocking that goes underneath because otherwise the elbow does not look human with the swelling that happens around the strap that cinches the elbow in.  Oh yes - - lookin' good!  :)

You tell me --- which is uglier?  Before you answer - remember that one is worn in public!

Hey, there's a Facebook group for this!

Whodda thunk it.  Just when I felt like the only one in the world with this type of injury I found a group on Facebook!  Okay, so there are only 42 members, but it is 42 "real" people who may be able to tell me what is in store for me.  Yay!

Anatomy lesson #3:  You don't have to have a traumatic injury like mine to suffer from radial nerve palsy.  A person can simply sleep funny and wake up with wrist drop.  They do have a different name for that - Saturday Night Palsy.  I find that really funny!  There are actually people on the FB page who got drunk, passed out and woke up with no use of their hand.  Ouch!  At least my story has a little more drama.

Don't get me wrong, it's really not funny.  I wouldn't wish this on anybody but they do have a much speedier recovery - it's usually a matter of weeks instead of months.  This whole experience has about driven me to drink but after reading what getting drunk got these people I'm glad I decided against that!  :)

And "a long time" really means ...

A really long time!  Anatomy lesson #2:  The radial nerve grows about an inch a month.  The physical therapist is saying that her experience tells her that it will be about 8 months for the radial nerve to recover.  8 months!  Ugh.  Of course my first question to her was, "Does this mean I will wear the contraption for 8 months?"  Yep.  I guess I already knew that answer. Quite honestly, the arm feels best when in the dynamic splint - it's just ugly!  More importantly, it draws a LOT of attention and I'm really kind of tired of explaining what I did to my arm.  I broke my arm.  Really bad.  Why can't that be enough?

Want to try something fun?

How about this.  Tie one arm behind your back and attempt to:

• Put a bra on (thank goodness for strapless summer dresses!)
• Squeeze shampoo into your hand - the same hand holding the bottle
• Style your hair with a blow dryer (I can brush my hair with one hand.  I can hold a hair dryer with one hand.  But, the act of doing both at the same time to get some kind of style ... it's not happening!)
• Apply suncreen - to both sides of your body
• Hold a camera to take summer vacation photos
• Lift a pot of spaghetti off the stove to drain.  (I thought I was very smart by using a large plastic cup to fill up the pan, but not very smart to think about what I would do with it once it was ready.)
• Drive a car.  This one can technically be done with one hand, but when the arm in question is stuck in one position and attached is a big contraption from the elbow down, there is no where to put the broken arm so driving ... nope.  Not yet, anyway.

Needless to say - this is ridiculous! I am really stuck in a place I don't feel comfortable.  It's a place where I need to ask for help with almost everything.  I hope this isn't going to take to long!

Let's stay focused!

The sun and sand are wonderful, but let's stay focused!  My range of motion in the elbow is showing NO improvement and it's time to check in with my surgeon.  We had a great conversation and he's pleased with the recovery of the elbow but it's time to call in the reinforcements .. physical therapy.  I still can't force the elbow to move but perhaps PT can get me further along.  A huge thank you to my friends at Peninsula Rehab and Sports Medicine in Ocean City.  I can walk - it's right across the street from our family beach house.  Let the fun begin!

The best prescription for my mental health!

Aunt Michele, Nikki & cousins

Happy 21st Birthday Nikki!

If I'm stuck doing nothing while I recover, I'm glad I'm doing nothing at the beach!

Usually the beach means boogie boarding, sailing, kayaking and cycling along the shore but this year our family vacation is all about Mom recovering from her accident and surgery.  For the first time ever we decided to drive to Maryland - all 23 hours - why, you ask?  That's easy!  We wanted to bring bikes.  We were training for the big 100 mile ride, remember.  Well, it's a good thing, because the plane tickets would have gotten super costly when I had to change them because I couldn't travel.  I'm not sure my hurt arm is ready for all the bumps in the road but we have a month at the beach waiting for us, so let's get this show on the road!

I have to wear what??

Yesterday the cast came off and today I had an appointment with the physical therapist to have a splint made for my wrist and to discuss the plan for physical therapy.  I'm not sure what I was expecting, but it wasn't THIS!

dynamic radial nerve splint

It's called a dynamic splint, but really it's quite a contraption.  It actually feels really good to have my wrist in the proper position.  Since I am able to bend my fingers, with this device I have some use of my hand because the rubber bands spring the fingers back, something I am unable to do on my own.  I am unable to lift any weight and have very little range of motion in my elbow so it is completely awkward, but a good feeling to see my hand functioning.

I had the range of motion measured in the elbow:  extension 40 degrees, flexion 100 degrees.  There's a lot of work to be done but the orders for now are very strict.  No pool, no ocean, no submersion into water for two more weeks while the incision heals.  I can finally shower without a bag, I'm to move only what I can do on my own, working on it every day and with the exception of that therapy 5 or 6 times a day the elbow stays in a sling and I wear the dynamic splint every waking hour.  They made me a second splint to wear in the shower or to the beach - - where we are headed now.  Thank God I'm not in a cast!

For shower, pool, beach and sleep.

I heard again that it will "take a long time" to get the use of my wrist and hand back but no one is giving me any hints as to just how long that is.

Oh, that's one ticked off radial nerve!

Today I got my cast off!  In a perfect world that would be a great thing, but in reality, the 10 days in a surgical splint and/or cast has just given my hand and wrist enough of a rest that the reality of the situation is so evident - - it's dead.  The radial nerve is ticked off and any hope I had of seeing progress has quickly disappeared.  My fingers are beginning to get stiff and are curling down and my wrist is not showing any sign of life.  The numbness on the top of my hand and thumb is still present, too.  It's going "to take a long time" but no one is saying just how long.

The cast came off, the stitches came out, and the steri strips will
now do their job in helping the incision heal.

"You guys are KILLING ME!"

To know Scott Darwin is to love him.  He likes order and routine and hates change - it stresses his structure.  I'm not sure if it all goes back to his US Army days, but that certainly plays a role.  He  hates change almost as much as he hates it when something happens to his wife or kids.  So, as you can imagine, my accident has him in a tizzy but just as he is getting back to his routine he gets a call.  A call from Nikki, that is.  I'm still in la-la land, feeling like I was run over by a Mac truck so she couldn't call me to help her.  It's only 9:00 am which means John would still be asleep so she couldn't call him to help her.  She was left with no choice.  She called her dad to tell him that she had an accident, on her bike ... exactly 7 days after my famous fall.

"You guys are KILLING ME," I heard coming from the home office.  Scott comes stomping by, the back door slams and off he went.

Thankfully Nikki was riding with a friend who stayed with her until Scott got there.  Her tire got caught in a groove in the concrete and her guardian angel was with her that day because there were no major injuries but boy was she banged up!  After she caught her breath she would have fixed her flat and rode home but the groove actually shredded her tire so she needed a ride - - and a trip to Richardson Bike Mart to get her bike checked out because the handle bars were knocked out of place, along with the seat and who knows what else.

wow!  what a sad pair we make!

Nice bruise!

 

Because pink makes everything better!

I learned something new today and I'm not sure that I like it.  I learned that when a person has a severe fracture they can develop 'fracture blisters'.  Gross!  They signify underlying soft tissue injuries following a severe fracture and when they took off my surgical splint in my first post-op appointment, my elbow was covered in them.

Along with that lovely visual, I got to see my incision for the first time.  It is MUCH bigger than I expected.  I also saw my post-op x-ray for the first time and I don't think my surgeon appreciated my sense of humor when the first thing out of my mouth was, "is all of that hardware really necessary?"  It was a joke!  I was just trying to maintain my sense of humor.  I don't know what I expected, but it wasn't long screws - and so many of them.

Today I had my cast put on.  I will only have it for 7 days, just enough to let things settle down for pain management.  I find it fascinating that I only need a cast for a week.  I chose hot pink because it made me laugh ... and because pink just makes everything better!

first look at the incision - wow!

I don't look very thrilled :(