11 May 2012

How It Will Be

How can good news be mixed with a grieving process?  We live in a reality that is truly larger than the one encompassed by the physical senses.  The issue is how much we allow ourselves to be present to the reality that is accessed through our right brain hemisphere (intuition and imagery).  If we can balance the sensate reality with the intuitive reality,  we have experiences not unlike the folks we encounter in biblical literature -- capable of seeing the Divine at work in the created order around us. 

The facts of my previously shared time table regarding my shoulder joint replacements have been documented in Kansas City and at Mayo Clinic, Rochester, MN.  I did truly get good news when my surgeon saw me just three days ago.  It was much better than even he had hoped for.  HOWEVER, there is an underside to all this that sank in as I moved from the moment of celebrating the removal of that damned immobilizing sling.

I now have a "Reverse Shoulder Joint Implant."  This was developed by the very surgeon that did my replacement at Mayo.  It was designed for the very kind of shoulder I ended up having -- virtually destroyed.  When the rotator muscles/tendons (called the "rotator cuff") can no longer function to move the joint through its external and internal rotation patterns, something has to replace them as the "driver" muscles.  It is the deltoid muscle...the cap one feels over one's shoulder.  Normally, it assists in abduction, not rotation.  The reversing of the positions of the ball and and socket changes the physics so that rotation can happen.  The bad news in this?  The best one can expect in terms of rotation is about 65% with a reverse implant.  Put your outstretched arm straight out in front of your body.  That is a 90 degree rotation.  It is only 50% of your maximum rotation.  To get to 100%, simply keep raising your arm until it is straight up.   The 65% range is about where the second shelf on a standard kitchen cabinet is located.  That will be me on the right side from now on.

Okay, fine.  If that were all there is.  Because I fall into the category of "the worst cases to come into shoulder surgery at Mayo" (Dr. Sperling's words), there will always be the danger of compromised bone and tissue being weaker and not bonding as thoroughly with the implants.  For the next six months, I can lift no more than 5 lbs in my right arm.  After that?  No more than 25 lbs.....ever....the rest of my life.  For a guy like me, that's harsh news.  No more push-ups, pull-ups, lat pull-downs, military presses, bench presses.....name it.  If it is pushing, pulling or lifting much more than 25 lbs in that arm, forget it. 

I just names some exercises and routines that are normal for me when I work out.  In addition, I love to canoe, kayak, row and do outdoor activities that often call for engaging heavy pull, drag or push movements.  The response when I mentioned those things?  "What you have now is the latest technology and the last opportunity for you to have any normal, daily utility with that shoulder.  Don't push it, or you will lose that...there is nowhere else to go."   That sank in fully about 7pm Wednesday evening, as my wife drove us from Tampa International Airport to our home in south Sarasota.  I cried.

Today is a better day.  I walked a bit over two miles, which is my first long, unaccompanied walk since the last surgery.  My arm is tired simply from carrying its own weight, and a bit sore.  But it is working.  I have two periods of physical therapy that I do on my own -- having been tutored by the PT folks at Mayo on Tuesday (one of the appointments).  They are designed for stretching and engaging, not strengthening.  We bought groceries yesterday, and I purposely looked at the weight of the product I would get from the store shelves and place in my right hand.  Today, I let Duchess tug just a slight amount on the lead as we walked...holding it in my right hand.  It's the little things that suddenly matter.

I joined the Sarasota Memorial Hospital Healthplex Wellness Center today.  As fortune would have it, the Healthplex Center is across Clark Road and a bit down from our condo development.  It was part of my long walk to sign the membership documents and get a thorough tour.  It is a great place.  All the folks working there are degreed in exercise physiology or physical therapy.  I meet with one of them on Monday for an assessment.  I haven't been allowed to do any kind of qualitative exercise since the first surgery on 20 January.  It is now time to rebuild my cardio-vascular fitness and endurance level. 

I may never power lift again, but I will plan to meet all challengers in hiking up Bear Butte in South Dakota come August.

Much love,


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