Ortho says...

I get an appointment to see the orthopedic surgeon to interpret the MRI and give me a better answer and course of treatment for the "mild tear in the infra/supraspinatus" that my primary physician told me about.

I get the paperwork which asks a thousand questions about medical history, prior surgeries, allergies, etc etc. Easy enough, I am a "no" on all of it. I pay the $25 co-pay and wait for Doc.

After the discussion on how to prepare a great meatloaf with the nurse, the doc comes in and spends 45 minutes answering a million questions I have.
What it boils down to is this;

1, My "spinatii" are torn about 65-70% through and while I was given the option to try a cortison shot and physical therapy for a month to see what would happen, surgery was recommended.

2, I get knocked out, Doc goes in via laparoscope, scrapes the humerus clean and gets fresh blood on it and attaches a couple of anchors, then cleans off damaged tissue from the "spinatii" and pulls them down to attach them to the anchors.

3, I'll have a nerve-block good for 24 hours, and a morphine drip good for three days. The rest will be taken care of with oxycodone (presumably) for the remainder of the month (or two).

4, The limp noodle will be in a sling for 4-6 weeks, with a cryo-cuff to aid swelling/pain/healing, then physical therapy begins. The Doc recommended taking a painkiller 30 minutes prior to therapy to dull the pain and allow for the exercises a bit easier.

5, I'll be out of work for three weeks during the worst of it. If at that point the Doc releases me to work with restrictions (obviously no movement of the arm) then I can go back to work. I won't be able to go down on the production floor to protect my arm (and my company from liability).

Once the sling comes off I should be back to no-restriction work, but maintain physical therapy for a while longer to bring back full range of motion in the shoulder. This should allow me to be back at 90% in six months. 100% at 12 months.

On one hand I am excited. I get the shoulder fixed which will get rid of the pain and my semi-permanent headaches. I also get to 'go under' and have some scars to show for it. Cool. On the flip-side, I do NOT like the idea of being a cripple for two months and have to sit at home for a few weeks twiddling my thumbs!





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Contrast sucks!

I had the insurance mandated X-ray taken of my shoulder, which revealed no arthritis nor any fractures. That was a good sign, but now it was time for the MRI.

From what I heard, I would get an IV shot of gadolinium and then sit for an hour while it circulates, then I'd have the MRI of my shoulder and the contrast would show exactly what was wrong.

I head down to radiology and sign in and then wait for an hour past my appointment time when a radiology technician comes down and says that they had to confirm the contrast with my doctor and they couldn't get in touch with him.
While I had him there, I asked him how the procedure would go.

Mistake!

He tells me that I'll change, lay down on the fluoroscopy table and get contrast injected right into my shoulder after a local anesthetic.

WHAT?!

Well, no need to worry now. I went in, changed into the very stylish hospital gowns and then went in laid down on the table. I chatted with the tech and the apprentice tech who was there until the doctor came in.
I greeted him and said that I understood from the techs that he would put me under before the procedure, and he started looking at them with a WTF look on his face. I started cracking up and said "no, I am just kidding. A guy could hope". He smirked and probably thought I was a moron, then gave me the spiel. After I signed that I understood the risks etc we got started.

The screen was rolled up next to my table, my shoulder scrubbed, cleaned and disinfected, then the drape went on and the moment of truth came.
The lidocaine needle went in a bit, the numbed me, then a bit deeper and more numbing etc, until he was almost down to the labrum.

Then the contrast needle went in. This needle was the size of a log, but penetrating somewhere between the infraspinatus and teres minor to reach the labrum only felt like someone pushing on my arm. No real discomfort to speak of.

Until he hit the labrum. Apparently the labrum contains nerve endings and they aren't quite as numb since the lidocaine doesn't penetrate that deeply. The discomfort beaming down my arm was very similar to the tingling one gets from sipping a hot drink and then sticking a stainless spoon of ice cream on your teeth. Not very comfortable at all.
Part of that is because the doctor needed to wiggle the needle in under the labrum and into the joint itself. Not a perfect science but about the only way to get this done.
Mere moments later he was done and I was off to the MRI.

MRIs are nothing special. You slide down the tube barely wider than your shoulders with a little pad over the affected part. I fell asleep while the machine was knocking, humming and hammering away. Twenty minutes later I was out and on my way home with a sore shoulder.

A naproxyn didn't seem to help dull the pain, so I was grouchy in the evening, but when I woke up the next morning and my shoulder was engulfed in napalm flames, I realized that the naproxyn probably DID help quite a bit.

I got a copy of the CD with the pictures and it's not that interesting. Most of it is unrecognizable unless you're a doctor. The humeral ball is visible with soft tissue around it.

Now to wait for my doc to tell me what he deciphers in those pictures.



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Ain't this a beyoatch? The tale of a Bankart Lesion

My shoulders have progressively been getting weaker to the point where I don't trust them to not dislocate when put to work (throwing a ball, sleeping, etc). When it interferes with my sleep, it's time to take action.

I quizzed the neighbors mom who has been a floor nurse locally for many years and got a recommendation to a local quack to prod and poke me.

Yesterday was that day. Without an MRI there's nothing for certain, however, given that palpating my trapezius, deltoid and infraspinatus muscles didn't reveal any pain, it was ruled out that it's a muscular issue.

With that done, the doc had me position my hands a certain way for each movement, straight out to the sides, straight forward and straight back (as far as possible). That showed a proper range of motion without any particular discomfort.

The exercise that yielded results was holding my arms out to the side with my thumbs down, and then bending the elbows 90 degrees. In that position, moving my hands towards the back - not inwards, just straight back - got the pain shooting through the shoulders.
The symptoms gave it away to the doc immediately. The discomfort while sleeping, dull ache and inability to throw balls etc. The tests verified it.

It's very likely (no doctor speaks in absolutes unless he has you opened up and looks at the damage) that I have a tear in my labrum. There are two kinds of tears according to him. The 'bad' SLAP lesion - superior labral tear from anterior to posterior, then there's the 'not-so-bad' Bankart lesion, which is merely a tear in the labrum causing the discomfort.
With my history of luxation of my shoulder that's the most likely one, but an MRI will tell the tale easier, particularly if they inject contrast prior.

To repair this is the bad part. It's 4-6 weeks with the arm in a sling, followed by light PT, with most mobility restored by the six-month mark, though often it takes longer.

Did I mention that both my shoulders exhibit the symptoms?

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Polymerase Chain Reaction (or "Sometimes works is interesting")

Sometimes work is really interesting.

At work we have a DuPont BAX System Q7, a sweet little PCR machine for testing for bacteria.  Being the curious kind, I had to break it down in 'tard terms so I could understand the process, which the helpful genius behind the machine gladly did for me.

This is my (very simplistic) understanding of the process;

1, We take a sample of something, let's say my blood and stick it in a strip of PCR tubes

2, the PCR machine (The Q7) heat-cycles it to unzip the DNA - break it into single strands

3, With the use of Taq Pol we can start the procedure to try to grow 'bad stuff'

4, Check for the bad stuff...

Here we can test for various substances depending on what we're trying to grow. Let's say we're testing for salmonella and E-coli, we'd basically check the good coming out if any salmonella crew in one test and E-coli in another - this would be in each 'cup' of the PCR strip.

If nothing grew (no DNA was replicated) then we're all set and if it DOES grow, then it's time for further testing.  Let me assure you, I have neither. 

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Lasgo - Smile lyrics

I get the strangest requests sometimes.  The latest one was for the lyrics to Lasgo's song "smile".  So here they are.

Good song, by the way, though a bit slow for my taste. I'm currently stuck on Hammerfall's latest album.

when I feel I'm all alone
and I can't seem to find a home
I call your name

when I'm lost and in the dark
and all I have is just a spark
you fuel the flame

you know I can't help myself
when I see you, I just want to smile

I don't want nobody else
you're so fine, I really like your style
so let me stay a while

we were never more than friends
but there's no one who understands
me, like you do

every word you say is right
and I don't want to spend the night
away from you

you know I can't help myself
when I see you, I just want to smile

I don't want nobody else
you're so fine, I really like your style
so let me stay a while

you know I can't help myself
when I see you, I just want to smile

I don't want nobody else
you're so fine, I really like your style
so let me stay a while


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CPR & First Aid certification

Free classes offered through work. Nice!  Each class is four hours, which I think is about appropriate, but a few 30-60 minute refreshers through-out the year wouldn't be bad.

The CPR went through the basics of cardiopulminary rescuscitation, breathing for someone else and chest compressions.  The simple theory is to prevent cell damage due to hypoxia/ischemia by circulating enough blood/oxygen to keep the vic stable until professional help arrives.

One of the things that we covered was stroke victims. This hits home a little more since my dad had a stroke. 

I haven't gotten all the details, but as far as strokes go, his was "pretty good".  First off, it was ischemic, and while I don't know his Barthel scores, he was pretty active and lucid. 

In interacting with him, there was little to no pronator drift, no hemispatial neglect that I could detect, and certainly no anosognosia whatsoever. 

The few obvious symptoms were emotional lability, a slight weakness in one leg (I refer to him as "walking in circles") resulting in him dragging his foot a bit while walking. 

As time goes on it's hard to tell what is caused by age, or by stroke - certainly they compound eachother with apathy and incontinence and also decreased appetite.

After all this, I learn that there is nothing I could do even if I'm present when someone has a stroke. Keep them comfortable and wait for the professionals. 

With my dad, I was surprised to see that his English and German were both intact, and though he would have to hunt for certain words, his impediment is so slight that it would be hard to determine if it's stroke-cause aphasia or just age.  Being spoken to in English, he'd sometimes reply in Swedish - confusing to my (ex-)girlfriend, amusing to me, and not noticeable to my dad. hehe

What it boils down to is that I can keep someone comfortable and keep enough air flowing to stave off more serious complications until EMS arrives.  I hope I never have to.

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Motorcycle adventures

On my way home a couple of weeks ago, I had planned to change out the tires on the bike. The rear one was about done with 7000 miles on it and the front was badly cupped with about the same mileage. 

My commute is 32 miles each way, and on the home-stretch during the last eight miles from home, I feel a strange shudder from the rear. I pull over and yes, the tire was flat.

This was a good time to utter a couple of choice words.

While discussing options with my neighbor who was conveniently on his way home at the same time, a Good Samaritan drove by, towing an empty trailer!  He lives minutes from my house and was on his way home, so we rolled the bike up, tied it down and off we went.

This event had a good ending, and a fairly expedient one thanks to my friendly almost-neighbor.

Fast foward to yesterday; I am riding home from work when I see a Suzuki Hayabusa on the left side shoulder of the freeway. It took me a quarter mile to get over to that side, and then I turned around. While I did ride on the shoulder, I did take a mental picture of myself riding down the wrong side of the freeway. Awesome. I'm such a rebel!

Our friend had an electrical problem on his '03 Hayabusa that flat killed the bike. No electrics and the gauges were hung midway. Not good.

He didn't have a cell-phone, so he was pretty happy when I pulled up and handed mine over so he could call AllState insurance and his wife.

His wife had to provide the pickup as Allstate "couldn't find him" in the records. I saw his roadside assistance card so presumably they just screwed up, but in his angry words on the phone with them "I pay you a hefty sum every year for you to BE HERE when this sort of stuff happens, and now you don't provide the very thing I pay you to provide!".

He insisted on paying me for my time and use of the phones, which I declined several times. I told him that it's better to pay it forward and pull over when someone else is in a similar position.

It didn't take me more than 30 minutes and provided a lot of relief for this poor guy and oddly enough, as much as I disdain people, it does feel good to be able to help.

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Property (mis)Management - Part II

I had planned on heading down to their local office to ask if there was anyone willing to not ignore me.

I found two addresses online, so I decided to call them. Again. At 866-472-2573, and see which office was the right one.

I get Christina on the phone and briefly outline my issue. She thinks it's best that I talk to Marla at the Colorado office, and transfers me to a generic voicemail line. Where I can't leave a voicemail, not that they'd return this one any better than the previous one.

I call back, get Christina back on the phone and explain that this sort of run-around isn't acceptable, and could I please have the address for the local office (me: "is it the Colorado Blvd address, or the Cherry Creek Dr. one?") to which she answers "I'm sorry, I don't know that".

I ask her "well, can you find out" and THEN she says "I can't give out that information".

So which one was the lie?  I'm less and less impressed with how this operation works.

She does call the Colorado office and then puts me through to Chuck.  I explain my ordeal to him and ask what I can do now, since nobody has been particularly interested in helping me this far.

As I get more information from Chuck, I come to find out that Marla lied to me and I *do* need an ARC request for for *any* changes I make to the exterior of my property.  Had this been explained to me from the get-go, I wouldn't be upset and I wouldn't have any fines.

Chuck also tells me that once I submit my request (which I have to do post-haste) and it gets approved, then he can void my fines for me.

I would expect nothing less because I got the fines based on their lie, and if I hadn't been lied to, then I would've followed the rules and we wouldn't be here now.

What I didn't really get explained to me was the relationship of notices and fines.  If I am in violation of article X, section 7 (upkeep: replace dead grass and trees), do I then need to wait for a notice of it before I fix it, and then submit an ARC request and THEN fix it upon approval?

It seems a little strange to go about it that way - the dead grass and tree could be there for months for all this to happen, all to the detriment of the neighborhood.

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Property (mis)Management

In my housing area, the home-owners association is outsourced to a management company - let's call them "RM". 

I haven't had any prior dealings with them, so I can't really speak for their work, other than the lack of snow removal when it snows.  In that particular instance the city claimed that the HOA does that, and the HOA claims the city does that.  End result?  Snow remains on the street.

Alas, that's not my gripe.  My story begins with a bad tree-lawn.  The tree-lawn is the section of grass between the sidewalk and the street.

When my house was built, I ended up with a lot of large rocks and clay there, and that ultimately lead to the death of the grass and cost the life of a tree.

After a few months of wondering when I'd get a notice from the HOA for lack of upkeep (that's Section X, article 7, for those who care), I decided to fix the problem.

The dead tree was pulled out, the dead grass removed, and I went to town with the roto-tiller and removed thick layers of clay and many large rocks.

While my tree-lawn was in upheaval and dirt was spread all around, I got a notice saying that I have to fill out an ARC (Architectural Review Commitee) request for altering my landscaping.

Since they drive around once every two weeks, I figured that when I was done replacing the tree and grass, they'll see that I didn't ALTER the landscaping, I merely replaced dead vegetation.

A few weeks later I get another notice of violation, so I email RM via their webpage and explain that I am following Article X, Section 7 by removing dead vegetation and replacing it.

The answer a few days later says that I have to fill out an ARC request for landscaping modifications.

*sigh*

So I reply to the email and again I explain that I am complying with one rule which shouldn't mean that I am breaking another.

This email gets forwarded to Marla, the person who actually drives around the neighborhood and looks for violations. She calls me and tells me the same thing about the ARC form and I explain my case again.

She agrees that since I am not changing anything and merely replacing dead stuff, I am not violating any rules and she'll email me to confirm this and also close out the issue on their computers.

Two weeks go by and I get a $25 fine in the mail for the same issue!

On 7/28 at 15:30, I call their office and speak with I call up their office and speak with Craig. After explaining my situation, he tells me to hold off on any action and wait for Marla to call me back. She is the one who is dealing with this issue, so apparently I have to deal with her.

A couple of weeks go by and no phone call, and now I get a letter saying that I have a $50 fine!

I hang on the phone immediately and this time get Mike on the phone. I give him the cliff notes version and ask to get in touch with Marla. He tries to connect me but she's not in her office, so on my request he connects me to her voicemail.

I leave my name and number twice, then a very brief summary of my situation and ask her to please call me back.

A few days go by and I get a letter saying that due to late-fees and such, my fine is $110!!

Now I've sent another email to them explain all that I just wrote above and it's been three days with no reply.

At what point does it constitute harassment when a company levy fradulent fines and refuse to return calls or emails when they're put on the spot for it?

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Royal Gorge & Garden of the Gods

Royal Gorge - a deep abyss where the Arkansas river flows, with an eerily high bridge above it. That was our destination.

The van loaded up, we drove down the three hours to RG, parked and paid the exhorbitant $22 per person to get in. 

First we went to an overlook and peered down over the fence and got the chills - a fall over that fence would result in a minute or two of very fast tumbling and crushing of bones over the rocky side. 

Looking to the right of us was the bridge and in front and slightly to the left was the swing and the aerial tram.

While there aren't that many things to do there, it's an experience to walk across the planks of the world's highest suspension bridge and peer down through the gaps. When vehicles drive across, you can feel the bridge sway and bounce with their weight.

You stand roughly 1100 feet over the water in the river, so it's a vertigo-inducing sight to lean over the edge of the bridge.

On the other side is a small "Western town" with picture opportunities, and a small 'farm' where you can see some traditional local animals - kept captive for your enjoyment.

We strolled on towards the aerial tram, which also is about 1100 feet above the river. You step in the cable car and go a couple of miles an hour across the gorge to land safely on the other side.

The "skycoaster" is essentially a gigantic swing which has you strapped in a harness and pulled back by a winch and then let go. You swing out over the canyon and back a few times at speeds up to 50mph and then you come in and ...  that's it.

I don't think it took us more than maybe two hours there, and we hit the road again back towards Denver.   Our visitors got to see some widely varying weather with thunder and intense rain, and then sunshine again. The temps varied widely along with it, from uncomfortably hot, to almost cool. 

Well back in Colorado Springs, we took a side-trip to get to Garden of the Gods.  I'd never been there either, so it was interesting to drive in and see the odd rock formations surrounded by lush, green shrubbery (and no knights who say "ni" to be found). 

We found a suitable parking spot and took a short hike up to the nearest rocky outcropping and starting climbing up. In no more than an hour we managed to climb up real high, climb back down, walk around and climb elsewhere, throw rude quips at one-another and take lots of pictures.

We had planned for dinner at Pete's Greek-Town Cafe the night before, but this time we actually made it before closing. Not a particularly good time because the food isn't as fresh it seems, but still very good. Onward home to another well-deserved night of rest.

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