Monday, December 9, 2013

The Walking Wounded


It's been a long time since I've posted, but I have a good excuse. I promise.

About a week after the marathon, I went under the knife. What began as a slight, nagging pain in my right wrist whenever I was in the push-up position got slowly worse over months and years. Eventually, it was hurting whenever I carried a heavy bag or even held the phone to my ear for a long time. Forget downward dog in yoga. An x-ray revealed nothing, but an MRI showed that I had several ganglion cysts and a small tear in a ligament in my wrist. So I scheduled a surgery to fix all this and showed up at the crack of dawn on November 13th to get it done. I was quite nervous the night before and all morning, and my panic peaked when I walked into the operating room. I wasn't wearing contacts and they'd made me take off my glasses, so I could hardly see as the nurse led me into a room filled with terrifying gadgets with a table at its center. Standing in the doorway, I started to tremble and nearly bolted, but figured that I wouldn't get far half-blind with no shoes on. Things were hairy at first. I climbed onto the table and felt obligated to make pleasant small talk with the distracted OR team while the trainee assigned to IV duty struggled. (Why I felt pressured to follow social norms while blind, gowned, strapped to a table, and terrified I can't tell you.) He couldn't get it into the back of my hand, and after about five minutes of jabbing and flicking had equal difficulty with several spots on the inside of my arm, eventually prompting the anesthesiologist to cluck sympathetically, "Oh, your poor vein!" But he hit pay dirt with the vein on the inside of my elbow at last. I remember saying, "Here it comes," and went out like a light as the powerful sedative kicked in. 

My memories of the hours after surgery are hazy. They brought Ed to see me in the recovery room, and he reports that we had a conversation about a blister on my toe (leftover from the marathon), which I do not remember. I was wearing a different gown than I'd fallen asleep in, which was somewhat disconcerting, my hair net was gone, and my right arm was encased in a half cast (plaster on the bottom and cotton and ace bandages on the top) and completely numb from just below the shoulder on down thanks to a nerve block. I fell asleep again for a bit, then dressed with the help of Ed and the nurse, manually wrangling my arm into place, gleefully immodest about donning my undergarments in front of a stranger due to the sedative. I was wheeled to a cab and dozed on and off during the ride home. Ed helped me down the stairs to bed and I went right to sleep. I woke for a snack and hour later, then slept again for at least three more hours. My arm gradually regained feeling over the course of the evening. It hurt, but really not too much.

Modeling the foam thing. Usually it rested on a tabletop with my hand sticking straight up in the air - suspending it like this while standing sort of defeated its purpose.
I worked from home the next day, and was back at work the day after that. I hadn't believed my doctor or my father that there wouldn't be much pain (doctors aren't great judges of this in my book), but I must admit that they were both right: it really wasn't bad. At first, my hand would throb a bit when it hung at my side for more than a minuter or two, and it helped to keep it arm elevated with a huge foam contraption they gave me, especially while sleeping. Eventually however, no longer needed it. It was nice to be rid of the foam thing, but the cast was still cumbersome It was so wide that I couldn't fit any long shirt sleeves over it, and in November this was a problem. Around the house, I was able to wear Ed's sweatshirts, but at work I made do with short sleeves and a space heater. I tried my best, but productivity was tough that week. My fingers were free, but the bulky piece of plaster under the heel of my hand made it tricky to do things like type. I relied on dictating text into it the body of an email message on my phone, then sending it to myself, copying the text into the document I needed to work on, and editing it on the screen. My handwriting was abysmal. At home, I couldn't wash or blow dry my hair without help, or do a million other things easily, and Ed was very patient and helpful. Walking around New York with one-and-half useful arms is awful. I will not miss grocery shopping or trying to wrestle an umbrella with a half-casted hand.

Stitch removal: less gross than expected.
Ten days after the surgery, I returned to the clinic to have the cast removed (yay!) and my stitches taken out. There were four incisions (arthroscopic surgery = shorter recovery time) and a small hole on the outside edge of my hand which was used for "drainage." Ew. It was so small that it hadn't needed to be stitched. I was given a removable splint, for which I was grateful, as my wrist felt fragile without the protection of the cast at first. A fellow who I'd met in the office before and who had worked with my surgeon in the OR popped his head into the exam room just as the nurse finally got the last bit of the cast off and asked me if I could move it. I obligingly held up my arm and tried. It was shocking how much mobility I had lost. After being immobilized for only about ten days, I could scarcely bend it. It didn't hurt, exactly, but it was unbelievably tight. Bending it felt like trying to stretch a very tight muscle. I felt that if I pushed it too far, something inside my wrist would snap. All four scars were perched atop a swollen lump about 1x2 inches, too.  I was eager to begin physical therapy.

Heat wrap
Currently, I'm slowly but surely getting my mobility back by doing a series of stretching exercises (basically bending it backward and forward as far as I can a bunch of times) each day and seeing a physical therapist twice a week. During my sessions, my wrist is encased in a heating wrap for a few minutes, then massaged somewhat painfully before I do some more stretching exercises and head home. I've made progress: at my first session, I could bend it only 10° in one direction (can't remember which), and even less than that in the other, but now I'm up to 45° one way and 40° for the other. I can use my wrist and hand for almost any daily task now, though I'm not supposed to lift anything heavier than a quart of milk for a while.  After a few more weeks, I will begin working on strength, and then I can slowly get back into my regular routine of yoga, weightlifting classes at the gym, etc.

The surgery was much easier than I thought, and the recovery has been much more difficult, in that it has been slow. But I am making progress as far as flexibility and my scars are looking smaller and less noticeable. The swelling is also diminishing, though I'm told it will fluctuate a lot over the next few months.

My scars today, almost a month after surgery
Just wanted to provide an update on my status. I recommend taking very good care of your scapholunate ligaments, dear readers. The surgery is a hassle, and the pain medication that comes with it is certainly not enough for a soma-holiday.


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