Wednesday, February 27, 2008

Day 2: Eeeeuw!

This post is not for the faint of heart.

Herein you find the gritty details of my left shoulder pathology.

This is an arthroscopic view of the head of the humerus (upper arm) bone, with the torn stump of the biceps long head looking fairly ratty. This was one of several things that went "clunk" in the night--and the day. There's no good way to re-attach the long head tendon all the way into the joint, so Bones just sanded it completely off.

Here we have the freshly sanded articular surface of the humeral head (the "ball" of the ball & socket). Looks to me like it will rotate around in there with a lot less clunking & locking up.

The remaining biceps tendon was then fished out of its retracted position near my elbow, pulled up to the bicipital groove just below the articular portion of the humeral head, and screwed into the bone to re-attach it. It's not exactly back where it was, but it will function just fine where it is, keeping me from looking even more noodle-armed than I already did.

Soulmate didn't marry me for my pipes, but she disapproved of any further shrinkage. She is now officially un-freaked.

This is harder to see, but represents a large tear through the supraspinatus and the subscapularis muscles, the upper and front muscles of the rotator cuff. The lower (infraspinatus) and back (teres minor) muscles of my rotator cuff were not injured. The acromion, a hook of bone over the rotator cuff, was trimmed of some sharp calcium deposits, and I think the bursa was smoothed out as well.

This is the finished product after screwing disolvable anchors into the head of the humerus and using permanent wire suture to pull the torn muscles back together so they can re-attach to the bone & hold the joint tightly together. This is the part that takes forever to heal.

The tragic hero himself suffering the slings and arrows of outrageous fortune. Actually, only the slings are left; the "arrow" (a pain pump catheter that poked through my skin into the joint) was removed this afternoon by Chad, my physical therapist.
The black sling is my immobilizer; the blue one is a Cryo-Cuff (as opposed to a Crying Cuff), which is a high-tech ice pack. The white tip of the tube attaches to a similar tube connected to a Thermos jug full of ice water, which can be drained out when it's no longer cold. Much easier than constantly re-freezing cold packs. Thanks, Todd & Sarah, it works great!
Friday is my first real PT session; let the suffering begin.


rainmaker2112 said...

Wow, The Magic Bus series of cartoon trekking through the human body didn't look like this! I'd shudder to look at the scar tissue and calcium in my young body. Alas, let it remain unseen.

Glad all is well ye of the one-armed typing. Ensure no-one confuses with the old West one-armed bandits eh?

Doc said...

I had hoped to let sleeping dogs lie, and let this injury go for 15 months before I couldn't ignore it.

Even as a medical pro, it's hard to distinguish major from minor situations. DOC'S ADVICE: if in doubt, check it out.

redBeard said...

Glad to see (n hear) you're alive and kicking n typing, er, pecking at the keyboard.

Good luck with recovery, PT, rehab, and then, back to training.

Make sure you make it to some of the early races, even just to hassle the rest of us hacks.

Doc said...

I wouldn't miss 'em for the world. I get a free pass to heckle at will. Then I'll br suited up soon enough for payback time...

GoBigGreen said...

Hey that is cool stuff. And you may have saved a few readers from wondering what their "rotary" cuff is. Oh wait, those bikers are smarter than average, i forgot.
You know "Chad" is legendary. Get ready. (Ok dont know chad, but good luck!)