"Treat the disease, you win some, you lose some. Treat the patient, you always win."
~Patch Adams~

Sunday, April 20, 2014

Happy Easter!

I hope this finds everyone having a wonderful day, filled with all good things and a day that will leave you with good memories.  I had nothing special planned for today, but yesterday got together with friends for lunch and catching up.....so it has been a good weekend.  Friday and yesterday were rainy and miserable here, but today the sun broke through in the early morning, and it has been a nearly perfect day weather wise.

Went to the surgeon on Thursday for a post operative visit and suture removal.  Ten days post surgery, the scar, while large and conspicuous, is healing so much better than it did when I broke the arm last summer.

(Remember, this picture was taken only 10 days post operatively)

This surgeon definitely took more time in suturing the wound (36 stitches), and he obviously took his time in bringing the edges of the wound together carefully, which makes for less keloid tissue (the red, raised scar tissue you often see months or even years after an injury.)  After I had the first surgery in August, the physical therapist suggested that I use silicone strips to aid in wound management.  I got a package from Amazon.com (the strips are commonly used post C-section by new moms), and while I think they did help some with preventing keloid tissue from forming, they did not stay on well, and were inconvenient to use.  This time I am going to stick with using Vitamin E oil on the scar several times per day, and massaging the scar gently a few times a day to prevent adhesions.

I can make a light fist, although my thumb is still a little slow to react when I bend it.  I think that will just take time for the tendon and muscles that work the thumb to recover from the trauma of being moved around during surgery.  I'm getting some of the "zinger" pain that is indicative of healing.  I am restricted to "very light" activity with the arm.  No heavy lifting or heavy use. I can knit; I took a small project with me to the surgeon's office last week and worked a few rows while I was waiting.  The muscles in my arm still have a ways to go.....so for a while, I will be knitting in short sessions, but at least I can do it. Knitting for me is very relaxing and meditative, and the lace patterns I follow to make shawls exercises my brain.

The Friday before the most recent surgery, I had hormonal blood work done, and predictably, my hormone levels are a little off.  My estrogen level stayed pretty consistent, but both my testosterone and progesterone levels had somewhat tanked.  Stress makes a person burn through their hormones faster, and not just emotional stress (which I have had plenty of with all this arm business!).  Physical stress, like elevated pain levels, will also cause hormones to be burned faster.  My testosterone level was still over 60, which is on the very low end of "optimal", but Dr. Carr prefers my level to be up around 90.  I'm not able to inject my own testosterone because it goes in my left arm (and it's my right arm that's injured), so one of my guy friends injects it for me.  He was on vacation one week, and I was in surgery the next, so we missed two doses, which is rare.  He injected me last Monday (Dr. Carr upped my dose just a bit to get me back on track) and so I am confident my levels will get back to "really optimal" within a few weeks.  Testosterone level is vitally important, as it is the "healing" hormone, and my levels being up will help the fracture in my arm to heal.  I sent Dr. Carr a file of the x-rays as soon as I got home from the doctor's office, and he said he could already see bony callous forming, which is a sign of healing.  I am absolutely confident that without the bioidentical hormone balance, my recovery would be a lot more difficult.

One of the things I have found frustrating with these surgeries is that when the anesthesiology department calls for their "pre-op" questions and "discussion" ------ they insist I have to stop all supplements up to 7 days before surgery.  I understand the need for some supplements to be discontinued, especially aspirin (I take one each day for cardiac health), Vitamin E, and fish oil (both of which can cause issues with bleeding). The only reason they tell patients to stop all supplements is for their convenience, so they don't have to go through the list and tell patients which ones are really likely to interfere with the surgery/anesthesia.  In my case, with two surgeries in three weeks, I have been off and on my supplements for more than a month, and it shows in my blood work.  My Vitamin D level went from 87 to 60, and my DHEA dropped to about 165 (optimal is 200-400....mine is usually right around 300 or so.)  Other levels were off too.  What is annoying is that, especially in the case of the DHEA and the Vitamin D levels, these are substances that promote healing.......and they need to be at optimal levels to get me back on track!  Check out this article from Healio.com on Vitamin D levels.

If you have not yet had a DEXA (bone density scan), and you are over 50, I strongly, strongly urge you to get one.  If you have one you will know if you have a bone density issue systemically, you and your hormone specialist can address it and get you on the right track with hormones/supplements and weight training exercise.  I had had three bone density studies done before I broke my arm last summer (the most recent until then being in 2009), and I asked my pain management doctor to order another on one me last September just to make sure there was not an issue of systemic weakness in my bones.  I detailed the results in a blog post from last October for your reference.  I've more than once talked about how everyone should have a one page medical history with them at all times, with surgical history, medications/supplements and hormones taken regularly, and emergency contact numbers.  I put a copy of the DEXA scan on the back of my medical history to give to the staff taking care of me at the one day surgery center.

I'm getting stronger each day (physically, emotionally, and spiritually), and outside of not being able to do workouts (which is making my back a little crazy......I need to rebuild my core strength!) I'm just about back to what I consider a "normal" schedule.  I can tell my stamina is still a little off, but I remind myself that it has only been 13 days post op.  It will get there, and we are going to have a beautiful, sunny and mild week here in the Carolinas, which is good for the spirit.....spring this year has come in fits and starts, and we even had a light frost last week.....unusual in the Southeast.    Enjoy!