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Carla's Corner

~ Day by day with RA …

Carla's Corner

Tag Archives: dr. burkhead

Didn’t see that one coming …

18 Thursday Oct 2012

Posted by Carla Kienast in Shoulder Surgery

≈ 6 Comments

Tags

Carla Kienast, dr. burkhead, rheumatoid arthritis, rotator cuff surgery, Shoulder Surgery

So Tuesday I went back for my two-week post-op follow-up and to get my stitches out. Everything looks fine, which is the good news.

When I had rotator cuff surgery previously (which was arthroscopic rather than open), I was back to work after three weeks. I was actually working from home part-time after the first week. Other people I know have returned to work after the three weeks you’re required to be in the sling.

So, assuming a three-week recovery, I would be returning to work next Monday. However, this has been a tough surgery and a rough recovery, so I was prepared to negotiate for one more week to regain strength and range of motion before trying to go back to work.

My doctor wants me to stay out at least four more weeks after this one, returning to work Thanksgiving week, for a total of seven weeks.

As God is my witness, I’m not sure I can watch that much daytime television.

Two days later, I’m still trying to digest that news. Now that I’m generally feeling well (and back on my RA meds), I’m getting the bored and restless syndrome. Of course I’m still handicapped by not being able to use my right arm, and I can’t drive yet — which just fuels the B&R syndrome.

My company has a policy to shut off access to emails, servers, etc. to people who are on FMLA leave (which I am), so I can’t even work part-time from home. I am supposed to be focusing on my recovery. Well I am, but you can’t do that all friggin’ day (especially since I’m no longer taking anything but Tylenol …).

The other thing this has impacted is moving forward on repairs on the house after the damage from the water leak. But we’ll deal with those issues as we can.

So, that’s the latest from the home front. If you have any great ideas for things to do that don’t involve the right hand, please send them my way. Thanks for checking in.

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7 Days Later

08 Monday Oct 2012

Posted by Carla Kienast in Medical, Rheumatoid Arthritis, Shoulder Surgery

≈ 4 Comments

Tags

Carla Kienast, dr. burkhead, Glad Press and Seal Wrap, Press and Seal, rheumatoid arthritis, Shoulder Surgery

There are a couple of British horror movies that explore the conditions in England 28 days and 28 weeks (respectively) after a “rage virus” infects the population with the end result of turning everyone into zombies. Appropriately enough, the first movie directed by Danny Boyle (Slumdog Millionaire, the 2012 Summer Olympics) was named “28 Days Later”, and the second movie starring noted British actor Robert Carlyle, was named “28 Weeks Later.”

I feel like I’ve been living my own zombie movie for the past week since surgery (thus the title of the post …).

I’ve had a lot of surgery, but I have to say this one has been very rough. The last week has been a blur of sweat-soaked nights and pain-wracked days interspersed with frequent visits with my new best friends, Percocet, Hydrocodone, and Oxycontin. I had my first glimmer of normalcy for a few hours on Saturday when a friend came over to rattle my cage and share pizza. Then yesterday, I started feeling a bit human and finally today, a week later, I feel like I’ve finally awakened from a week-long nightmare.

But I’m getting ahead of myself. You know, like the murder mysteries that open with the main character awakening face down, covered in blood, wearing a ski mask, and surrounded by the pink plastic flamingos in the next-door neighbor’s yard.

When I last wrote, I didn’t know what procedure(s) would actually be done. The options ranged from a simple orthoscopic cleanup (or “debridement”) up to a full shoulder replacement.

They started with the debridement which generally cleans up the joint and, in the process, found a “massive” rotator cuff tear (which apparently didn’t show up on the imaging studies). Apparently my rotator cuff was being held together “by a thread”. So they did that repair. Unfortunately, it wasn’t done with the scope, I have a 3-4″ scar over the crown of my right shoulder, which I’m sure accounts for a great deal of the pain I’ve been having.

My previous rotator cuff surgery (two years ago on the same shoulder) was a breeze. I was the poster child of all possible outcomes being the best possible. Of course, looking back over my posts, I note that my surgeon told me that it would be more painful than shoulder replacement — which it wasn’t then but it is now.

One of the worst parts is having to sleep propped up with my shoulder in a sling. Of course, I’m off my RA meds, and since I’m basically in the same position all night, I wake up so stiff, I’m crinkly.  I feel like ice has formed in my joints overnight and I have to “crunch” through it just to move in the morning.

But, a week later, I am doing much better.

A couple of other things re the surgery worth noting. First, the doctor said that I will likely need to have the shoulder replaced in 2-3 years, but that it wasn’t degraded enough at this point that he could justify it doing it now (as opposed to putting me through another major surgery in the future …). The second was that I agreed to not only general anesthesia, but a regional block which worked really well when I had shoulder replacement surgery. Unfortunately, the anesthesiologist (literally) missed the mark and I wound up with the entire right side of my head numb, but nothing in my shoulder. I could do an entire rant post about that, but it wouldn’t solve anything.

I’m doing passive exercises at home 2-3 times a day and start real physical therapy later this week. I need it. My arm is so stiff, I can’t raise my hand above my shoulder. The goal was to improve things and obviously we aren’t there yet.

So thanks to the wonderful nursing skills of my husband who pretty much stayed home with me all week, I’m starting to regain my humanity (although I still sort of look like a zombie with stringy hair, a stiff gait, and bags under my eyes).

Oh, and a final tip of the day (and I can’t believe I’m just now learning about this), if you need to keep some of your pieces and parts dry in the shower, get some Glad Press and Seal wrap. It seals to the skin. A double layer will pretty much guarantee that bandages and stitches and skin will all stay dry while the rest of you can get soaped up. (And for people like me who are allergic to tapes and adhesives, a non-tape option is a God-send.)

I probably have lots more to write, but I’ve used up all of my energy and creative juices. It’s nice to be upright and conscious for a change. Thanks to everyone who sent warm thoughts and well wishes and, as always, thanks for checking in.

Surgery Monday and other updates

28 Friday Sep 2012

Posted by Carla Kienast in Medical, Rheumatoid Arthritis, Shoulder Surgery

≈ 7 Comments

Tags

Carla Kienast, dr. burkhead, ES hybrid, ES300h, lexus hybrid, replacement surgery, Shoulder Surgery

For the last 10 days I thought I’d find a couple of minutes to update the blog, but it seems like there has been so much happening I haven’t been able to slow down long enough.

On the health front, shoulder surgery is three days away. I was originally scheduled to be at the surgical center at 9:30 Monday morning. The scheduling nurse called me yesterday and asked that I show up at 6:30 am for an 8:30 am surgery start. While I hate getting up that early, I’m glad they moved the start time earlier. There are few things worse than sitting around waiting for your turn for surgery. You’re nervous. And you can’t eat or drink anything — and for someone with Sjogren’s who gets terribly dry and thirsty anyway — not being able to have a drink of water can be pure torture. So better to start early.

I’m still not taking bets on where we’ll wind up on the range of possibilities — from a simple arthroscopic clean-up to a full-blown replacement. I know the insurance and medical-leave machinery is all geared up for me to have the replacement surgery and be out of the office until after Thanksgiving. Better to plan for the worst scenario than to have to scramble and re-approve everything. I guess I’ll find out Monday morning when I wake up in recovery. One way or the other, I have a high degree of confidence that the eventual outcome will be less pain and stiffness and more range of motion than what I experience now.

And I got a new assistive device. It’s a hybrid.  A 2013 Lexus ES300 hybrid to be exact. It’s a good thing I’m going to be off work for a while so I’ll have time to read the owner’s manual. It has more bells and whistles than my iPhone. And it really is an assistive device. I really liked my previous car, the Lexus IS250, but my RA has gotten bad enough that it was physically painful to get in and out of the car. It also had a sports suspension — which is fairly stiff — so going over bumps in the road actually hurt my joints. In addition to the fully adjustable seats, the new car has the automatically retractable steering wheel, plus being slightly larger overall, so I don’t have to “squeeze” in and out of the car. It’s also got a longer wheelbase and the comfort suspension, so the ride is much more comfortable. I’ve had it on order for more than a month and it finally arrived last night, just days before shoulder surgery (and you can’t drive for a while after shoulder surgery …). I know, with all this other stuff going on in my life I didn’t even mention getting a new car — when my intention all along was to do an expanded post on assistive devices similar to one I did a couple of years ago here.

In other news, the crawl space under my house is finally dry. The guys came and took out the nine blowers and the dehumidifier yesterday. I have my dryer back in place (they had to plug all that equipment into the 220v dryer outlet — now I can do laundry again). However, we can’t get the mold treated until after I recover sufficiently from surgery because it’s not really a health risk for healthy people, but could be a problem for someone recovering from surgery — particularly with an open surgical wound. So it might be a week or three weeks or eight weeks. No way to tell at this point. That’s another thing I’ll find out Monday.

The flooring people came out and did measurements and we sent them samples of the existing flooring so they could determine the quality of the materials for replacement value. They sent their estimates and findings to the insurance company, so I guess we need to get the estimates from them. We’ll just need to see what that particular flooring company has to offer. My inclination is to go with the insurance company’s provider so if we run into any problems during installation, they can deal with the insurance company directly. However, if they don’t have anything we like, we may just take the check and find another supplier.

But before we do that, we have to get the mold treated. Then we have to pack up everything in the house and put it in storage and move to a hotel while another contractor demolishes all the floors and subfloors (except the tile floor in the master bath). Hopefully we don’t find any more issues once the flooring is ripped out and we can move forward with replacing the floors and moving back in. We’ll also have to replace all the baseboards because those will get damaged in the demolition process and the paint (except for the ceilings) will probably have to be redone as well.

Oh, and the air conditioner people called. They’ve decided our warranty on the dead compressor covered parts, but not labor. So now we have to go back to our 2007 records when we bought the unit and find the original contract to prove them wrong. Otherwise, it’s another $$$.

And work has just been nuts. I’ve had a couple of critical communications projects recently (and not the good kind, either). So all that has been pretty stressful.

But I can only work on this stuff one step at a time, so I’ve tried not to worry about the mountain of stuff, just tackling whatever’s next on the list. One of the good things is that my husband and I sat down the other night and worked our way through the list, discussed our options, and basically got on the same page with how we’re going to approach everything, how long we think everything is going to take, and what contingencies we may need to think about. It’s good we talked now because it’s going to be a long haul and we certainly don’t want to be arguing our way through it one step at a time.

Another good thing in all this is that I’ve somehow managed to avoid any major flares. My joints are telling me that I’ve been off the meds for two weeks and also that we’re supposed to get a few days of rain this weekend, but not the “run hide under the covers with the pain pills” flare. (Hope those aren’t famous last words.)

I doubt that I’m going to get the chance to post again before surgery — too much stuff to get done to get ready — so please send healing thoughts my way next week.

Thanks for checking in.

My New Physical Terrorist

21 Tuesday Dec 2010

Posted by Carla Kienast in Shoulder Surgery

≈ 3 Comments

Tags

arthritis, Carla Kienast, dr. burkhead, rheumatoid arthritis, Shoulder Surgery

So last night I went for my first physical therapy session since surgery. The therapist I have been to in the past had changed his schedule and it no longer worked with mine, so now I have a new physical terrorist.

I think I like her — mainly because I believe she knows what she’s doing. It’s sure not her sense of humor which is somewhat drier than the Great Gobi Desert.

She meticulously went through my medical history and the reason I’d been prescribed therapy, then did a careful baseline measurement of my right arm/shoulder before assessing my left arm. She indicated she was going to request my surgical records so she could see exactly which tissues were affected. No doubt the better to ply her laser-like focus on the exact muscle fibers that need attention. You could almost see the stream of data flash across her eyes as she measured, stretched, poked, and rotated my appendages. (I would have hated to have been a test rat in her laboratory.)

Then she set about stretching my shoulder before assigning me seven stretching exercises to do at home. Each one was introduced with “This is where you are .. this is what the goal is..” (Ve haf vays of making you flexible…)

One of my “homework” assignments was to take pictures of my desk/work space both with me and without me seated in the picture so she can assess what changes I need to make.

Two hours and an amazing amount of pain later, I wasn’t sure whether I hated her or loved her. But one thing I am sure about, she has a plan that, if followed correctly, will no doubt help me regain the greatest range of motion possible. (Lord, help me.)

I see her again this evening, then leave tomorrow for Christmas vacation. It will be a bit difficult to keep up the exercises while traveling, but I am taking my equipment with me, so at least I have good intentions.

Next Monday I both get my stitches out (in the morning) and have another session with her (in the afternoon). I am hopeful that getting the stitches out will make all this exertion more comfortable. Actually, I’m hoping that SOMETHING, ANYTHING will make the exertion more comfortable. (I’m taking a couple of Tylenol before tonight’s session to see if that doesn’t help.)

In the mean time, this will be my last post before Christmas, so to each and everyone: All the best for a warm, safe, joyful, and healthy holiday.

Until later, thanks for checking in.

Raise your hand? Yes, I can!

19 Sunday Dec 2010

Posted by Carla Kienast in Shoulder Surgery

≈ 2 Comments

Tags

arthritis, Carla Kienast, dr. burkhead, Shoulder Surgery, wayne burkhead

Well, four days after surgery and I’m happy to report that I’m doing great. I’m making progress every day with the exercises, gaining a bit more range of motion every day.  I don’t know that I’ll ever get full range back, but I’m quite optimistic that this will be a definitive improvement. I start physical therapy tomorrow (Monday) and have two sessions before I leave for Christmas.

If there is any disappointment at all, it’s that I won’t get my stitches out until the Monday after Christmas, so I have to deal with keeping the dressing dry, etc. while on our Christmas trip. At least the surgeon didn’t use staples, so I don’t have to explain THAT to Homeland Security.

Pain hasn’t been a factor. I took a Percocet the first two nights after surgery just to make sure I’d rest well, but after that I’ve just taken a few Tylenol here and there.

So all in all, things are good. Recovery is going well, and I think it will result in more mobility that I’d originally dared hope.

I couldn’t ask for a better holiday present.

Hope your holiday is filled with good things as well. Thanks for checking in.

Not a Walk in the Park

16 Thursday Dec 2010

Posted by Carla Kienast in Shoulder Surgery

≈ 2 Comments

Tags

Carla Kienast, dr. burkhead, Shoulder Surgery

Well, surgery was yesterday and everything went very well. The IV tech even hit the vein the first try (which is a record).

After surgery, the doc came over to me in the recovery area and moved my arm to show much how much more range of motion we were able to achieve and it was pretty impressive.

Of course, that was yesterday. Today, on my own, I can barely lift my arm. However, I know it can move, so it’s just going to take me working it and some physical therapy to get it there.

All in all, things went well, but it’s not the walk in the park that I was hoping. Still a lot of work ahead of me to make the gains I want.

I’ll keep you posted. Thanks for checking in.

Three Steps Forward, One Step Back

22 Thursday Jul 2010

Posted by Carla Kienast in Enbrel, Rheumatoid Arthritis, Shoulder Surgery

≈ 3 Comments

Tags

Carla Kienast, dr. burkhead, Enbrel, rheumatoid arthritis, rotator cuff surgery, Shoulder Surgery

I went to see my shoulder surgeon this morning for my second post-op follow up. We’re about 8 weeks out from rotator cuff and biceps surgery. I was originally supposed to get my first set of strengthening exercises today. However, as I posted a couple of weeks ago, I popped/pulled/tore something in my arm and it hasn’t been the same since.

They checked it and the biceps tendon has slipped down a bit from the original location where it was attached. There’s no real harm done, it just has to reheal in the new spot, but it’s going to be sore and aggravate me in the mean time.

So no new exercises and they put me on a course of prednisone to help calm down the inflammation in the area. I started to argue that prednisone was a deterrent to healing, but I immediately shut my mouth (for once in my life). The fact is, since the Enbrel may not be doing the job it once was, and I’m working 60-70 hour weeks, a little prednisone in my life could be a wonderful thing. What’s not wonderful is that I’m determined to maintain my 2-lbs a week average weight loss and our friend Mr. Prednisone hasn’t been known to help that. It’s only a six-day treatment, though, so hopefully I’ll make it through without too much disruption to the progress.

Anyway, I go back in a month and hopefully I’ll be back on track and continue on the road to recovery.

Thanks for checking in.

Surgery +3 Weeks / Doctor Follow-up Visit

17 Thursday Jun 2010

Posted by Carla Kienast in Enbrel, Rheumatoid Arthritis, Shoulder Surgery

≈ 3 Comments

Tags

dr. burkhead, Enbrel, rotator cuff surgery, Shoulder Surgery, wayne burkhead

Aha! Good news!

My post-op surgery follow-up meeting went swimmingly (as my British friends are apt to say).

At three weeks after surgery, I basically have the full range of motion with my right arm restored (although admittedly some movements are a little more tenuous than others). I get to stop wearing the sling all the time — including not having to sleep in the darned thing anymore! I still am prohibited from lifting anything except my hand (little does the doctor know).

He has also cleared me to start taking my Enbrel again (yeah!).

AND he told me that at the 18-month mark of my replacement surgery on my left shoulder, he would evaluate the range of motion and whether or not we needed to go in and relieve some scar tissue. He said the arm will continue to improve for the 18 months, but after that things won’t get better without help. So at least I have a light at the end of this tunnel.  It has been really frustrating having no use of my right arm and semi-limited use of my left arm.

So, I have three more weeks of “weaning off” the sling. And in five weeks I go back to see them and get my next set of exercises.

All good news! Onward and upward!

Thanks for checking in.

About Rotator Cuff Surgery

03 Thursday Jun 2010

Posted by Carla Kienast in Health, Medical, Shoulder Surgery

≈ 4 Comments

Tags

Carla Kienast, dr. burkhead, rotator cuff surgery, Shoulder Surgery

One of the great benefits of the Internet (IMHO) is the vast availability of medical information — not only from medical practitioners and sources, but from every day people as they document their experiences with various conditions. This human, unfiltered, uncensored dialog of real people has been incredibly invaluable in helping others understand what may be expected in their own situation.

I know this was extremely helpful to me when I was diagnosed with RA, when I had my hip replacement surgery, and especially when I had shoulder replacement surgery since shoulder replacements are still relatively infrequent. I have tried to “repay” this help by documenting my own experiences for people, like me, who are searching for information and/or someone to answer their questions.

So when I faced rotator cuff surgery, I was pleased to find a plethora of information on the subject. This all seemed to confirm the information I got from my friends who have had the surgery, and substantiate the information provided by my surgeon concerning pain and recovery.

As in the past, my goal was that I would document my own experiences so others could use it as a source of reference.

I’m afraid that nothing I heard or was told applies to my situation. So I guess the lesson that I pass on along to people facing the surgery is that sometimes, not always, but sometimes, things all work out in the best possible way.

My surgeon told me that the surgery would be more painful than my shoulder replacement. Wrong. Except immediately after the surgery, I’ve had very little pain. I took minor amounts of pain medicine for the first two days after surgery and have only taken the occasional Tylenol since then.

The truth is, all the worrisome, scary things that I was told or researched just haven’t applied to me. Very little pain. Some restrictions on strength and mobility, but those seem to be more associated with the additional surgery on the biceps tendon and unrelated to the rotator cuff surgery. I do all my exercises with little or no difficulty. The worst part of the entire experience (other than the actual surgery) is having to sleep on my back, propped up, with my arm in a sling.

So if you’re looking for information on rotator cuff surgery, the best I can provide is that sometimes all those scary things are wrong.

(Of course tomorrow I get my stitches out and I may be singing another verse then. Stay tuned!)

Hope your life is progressing as well as mine is. Thanks for checking in.

Surgery+1

27 Thursday May 2010

Posted by Carla Kienast in Medical, Shoulder Surgery, Uncategorized

≈ 1 Comment

Tags

Carla Kienast, dr. burkhead, rotator cuff surgery, Shoulder Surgery

Surgery went well, better than I anticipated. In addition to the rotator cuff situation, the surgeon also did a biceps tenodesis. The biceps tendon was being abraded so they cut it loose then connect it back to the humerous a bit lower down. Overall doing very well. Happy they only had to stick me three times for the IV. Pain is being pretty controlled although it hurts like the dickens when I do my exercises. I’m also in a regular sling, not the abductor pillow one, and that helps. My girlfriend is coming in tomorrow to babysit and give hubby some time off to take care of some things. I should feel well enough to actually enjoy the visit.

Thanks for all the well wishes and for checking in.

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