To Pin or Remove?

To Pin or Remove?

As most of you might be aware, I broke my arm last November, but in case you’ve not heard let me give a quick recap:

Nov. 6: tripped on broken pavement in Los Angeles
Nov. 7: saw my Dr. in OC, discovered it was broken and in need of surgery.
Nov 10: had surgery to repair break to neck of radius near elbow with a plate and screws

Here are the two posts I made regarding the fall and an update:
That really wasn't part of the plan...

The Overdue Update: My Cyborg Arm with Refrigerator Magnets

Originally I thought I’d busted my ulna, but in fact it was my radius. I snapped it at the neck and compacted the head of the radius back onto the rest of the bone. A ‘T’ shaped plate and 4 screws were placed in to hold it properly within the elbow and so the break could heal.

I wore a splint for 2 weeks after the surgery. Once it was removed I was sent off to physical therapy for 3 more weeks. I went in for a check up with the surgeon in mid Dec. only to discover what we hoped would not happen. The bone wasn’t healing.

At first look over my X-rays the surgeon was visibly unhappy. He decided for good measure to take a second set of X-rays. Unfortunately, the news from this set seemed worse than the first.

Because of the nature of the two bones in the lower arm (ulna and radius) they rotate over each other as you rotate your arm palm up to palm down. This motion was too much for the plate and twisted it and began to pull out the single screw on the lower part of the ‘T’ shaped plate from the longer part of my bone. At the same time the lower part of the bone slipped out of position by rotating on the single screw. So now the plate and pulled screw rub under the muscle and tendons in my arm. It actually feels really gross and entirely unnatural. So any chance I get I make someone put their hand on my arm and I rotate it. It’s sick, but I love seeing their reaction. :P

I’m not entirely sure what the rules are regarding bones and the way they heal, but because it was less than 6 weeks since my original surgery my surgeon, Dr. D., wanted to wait, in hopes that with a splint back on the inability to rotate my arm would then allow the bone to heal. A second surgery was definitely going to happen, but when and what for was up in the air.

In the best case scenario the bone would heal and a second surgery would be done to remove the damaged plate and screws which were originally intended to be permanent.

In the worst case scenario the plate and screws would be removed, pins would be put in place as well as cadaver bone tissue (Yay, zombie elbow!). This meant I would then have to be in a cast for several months and when all was done I would have limited mobility and range of motion. (boo!)

zombie elbow...

So the splint was placed back on for 3 more weeks and the surgery would be pending.

Last Friday, Jan 16, the splint was removed. (Yay!) This past Monday I went in for a CT scan. I brought the CD home to check out the images. Honestly I couldn’t make heads or tails of it. 136 images of... bleah??? It looked cool to just hold the arrow key down and watch it rotate through all the images like an animation, but it looked more like a Rorschach test to me.

Today I went to see Dr. D. The CD the hospital gave me with the CT scan was not what he asked for. I guess they didn’t burn to the CD some different type of images that he requested so he said he would go to the hospital tomorrow or Friday to see it for himself. However, he did speak at length with the Dr. who did the scan and was told there was more bone scar tissue, but that the bone is not connecting.

This was bad.

So we discussed my options. My hope was that the bone would just heal already and the plate and screws would be removed, end of story. Now the pins have been moved up as the best case scenario.

Best case: remove plate and screws, place in several pins, add almost-dead guy tissue, cast for months, have physical therapy for several weeks, then have a 3rd surgery to remove pins. At this point we’re talking 5-8 months of having to deal with this.

Worst case: remove plate and screws, replace radius bone head with metal and hope the bone grows and heals. I wasn’t given any further information about length of healing time and what it all meant, but it didn’t sound remotely good.

Dr. D. thinks it’s possible that the plate is preventing the bone from connecting. That even if it’s just a millimeter too far it’s strong enough to keep the tissue from connecting and healing.

I did ask if he thought there might be another reason the bone wasn’t healing. I began to wonder if we should seek some other medical reason for my bone failing to heal properly. He said he felt there was not a medical reason, it was simply because the bone was not close enough to heal.

He asked me if I’d been in pain and reminded me to not take Advil, aspirin, or any of the other OTC pain meds because they are blood thinners and will prohibit the growth of bone. Yes, I’m in pain, but it’s something I can cope with, usually… provided someone doesn’t hit me, or grab my arm as they so often have done regardless of splint, sling or my simply being protective of it. So if you see me, do not touch my left arm or shoulder whatsoever.

The Dr. did prescribe darvocet for pain management, but I haven’t taken any yet.

He’s also decided to have me use a “bone growth stimulator”, sounds kinky, don’t it? Well, essentially I get to electrocute myself for 45 minutes a day. He doesn’t hold a lot of stock in the belief of this type of therapy, and honestly in this case, neither do I, but he also said it couldn’t hurt.

Funny thing, he said it was “a lot like going to church.” I don’t get a Christian vibe off of him by the way, he’s definitely more a man of science than faith, but I thought it was funny, understood how he meant it, and agreed with his reasoning.

Sadly this won’t be too new to me. When I lost use of both of my hands for a year back in 2000… yeah, that was a fun time in my life, I went to an acupuncturist who would put anywhere from 20-90 needles in my hands, arms, shoulders, neck and back. She’d add little electrodes to several. I’d take them as high a setting as I could stand ‘em and lay there for 45 minutes, 3 times a week for 3 years. Wheeee! So fun.

Anyway, the plan as it stands is to wait another month. I’m supposed to wear my sling when I go out, and I’m not allowed to push use of my arm. It is possible to over use the arm and snap the plate. Apparently the plate is really intended to be a metal band-aid to hold the bone in place just long enough to heal.

I was already dreading a 2nd surgery. I was glad that with the first one I didn’t have too long to wait. It was my very first major surgery and I was scared to death, but I got through it ok. This time I’m not only looking at a 2nd, but also a 3rd and we have no dates set for any of it?!?! My life is on hold and I’m totally freaked out!

I guess I pulled The Hanged Man from the deck...

Although The Hanged Man would once most likely have been interpreted as a punishment, somewhere along the way it came to symbolize a change of perspective, new points of view and spiritual revelations – the card shows physical immobility and restrictions, but freedom and power of the mind. Other than that, the Hanged Man may signify a sense of being caught in between two opposites and a time of suspension, when you don’t really feel you have your two feet on the ground.

Now keep in mind, the very same day I went to my first physical therapy I was also laid off from my job. Though I’d been looking and had a few interviews, none of them panned out and I don’t know what to do now with not just 1, but 2 more surgeries to look forward to, plus having my left arm casted for months! This puts a major crimp in my ability to work. I keep hoping a 3rd, better option becomes available.

My logical brain says, “It is what it is and I’ll get through this like I always do.” My emotional side says, “Fuck this crazy shit! Why is this happening?!” I mean when you think about it, I've been walking around for over two months with a broken arm... and it will be AT LEAST another month before anything additional is done.

Life keeps marching forward, even when we aren’t sure or even ready to. I feel that everything in life teaches us some kind of lesson. I’ve been trying to figure out what the lesson here is, other than to “watch where I’m walking”. Heh… of course, what if that really is the fucking lesson here? Watch where you're walking... Frankly, I think it's more like the Hokey Pokey at this point.

That's what it's all about!

The Overdue Update: My Cyborg Arm with Refrigerator Magnets

The Overdue Update: My Cyborg Arm with Refrigerator Magnets

I broke the Ulna bone in my forearm, near the flexor digitorum sublimis, where it connects to the elbow, but an inch below the actual end of the bone. It was compacted; shoved back onto itself. What can I say? I’m an overachiever.

The surgery was a success. It was, however, much more complicated than expected because when I do something, I do it well. Originally the expected time for my surgery was 1 ½ hours. It took closer to three hours to fix me.

The original plan had options of pins or plates and screws AND bone tissue from a cadaver.

(Ooooohh, zombie elbow!)



But, because of the extensive damage, the best way to deal with my situation was to add a T-shaped plate and screws to the broken bone so it would sit correctly and fit into my elbow properly. No dead guy bone tissue needed. It’s a permanent addition to my arm and therefore will require me to carry a card so I can travel through airports and not get hassled as bad by homeland and airport security.

I’m currently in a splint that’s a cottony covered metal sheath that is a little open on the sides and where my hand is, but curves around my elbow nicely to hold me in place. It’s wrapped in ace bandages to keep it snug. It prevents me from moving my elbow or twisting my arm so both the wound from surgery and the bone have a chance to heal.

I have staples (Whee! Don't run!) running from 2” above my elbow down to about 4” below. I was able to see them two days after surgery. I didn’t expect to see staples. I thought I was sewn together. It was a little disappointing, actually.

The splint is to remain on at all times until the Dr. removes the staples on Mon 24th! At that point I will have physical therapy.

Since the fall itself I’ve only taken 4 vicodin. I discovered yet another reason for me to dislike the stuff. Its bad enough it makes me sick if I don’t eat enough food when I take them, but they also make me unhappy. Apparently depression is a side effect. There’s a reason I don’t do drugs and despite the need to take the vicodin both on the day I saw the Dr (when she rotated my broken arm), as well as the night of and day after my surgery (when the pain was at it’s worst) I quit taking the stuff by two days after surgery. (Drug’s are bad, m’kay!)

Now upon learning I had a new permanent cyborg arm I was dearly hoping it would be magnetic. I really wanted to put a little bunch of bananas refrigerator magnet on my elbow. Frankly I would have laughed hysterically if I could attach magnets to my arm but apparently titanium is not magnetic.

Yvette drove me to the hospital for the surgery. She was awesome! She totally kept me laughing despite the fact I was a little nervous. I was telling her what I wanted done instead of a burial if I died. I was mentally parsing out my belongings and realizing I needed a proper will for my collections and cats in case I died.

I met my prep nurse, my surgery nurse and my doctor came in to cut off the temp cast he put on my arm the Friday before. I was waiting to meet the anesthesiologist. Once he walked in I was upfront with him. He asked how I was, I told him I was nervous and didn’t want to die. I know he didn’t expect it. I explained that at Fountain Valley they almost killed my father during a simple eye surgery because they gave him the wrong anesthesia. He was supposed to come home the night of the surgery but because of the wrong stuff he had to stay for a couple of days to recover.

I looked him in the eye and said, “I don’t want to die, don’t kill me.” Poor guy. He seemed to understand. He walked over to my IV, injected it and immediately knocked me out!

Oh and can I say, I really, really, really don’t like having a damn IV needle put in through my hand! Take it from my arm!

I told the nurse but she did a big song and dance about how it would be better from my hand because she can see the veins easily. This conversation did not instill confidence. So I accepted that she didn’t want to try my arm and let her puncture my hand. I did not like it.

I woke up hours later in the recovery room to some nurse who I’d not met though I apparently thought that I had.(stupid anesthesia!) Suddenly I was being told to get dressed and was immediately wheeled out to Yvette’s car. I had the window open the whole ride home. I wasn’t sure if I was going to react poorly to the anesthesia. Fortunately I was fine.

I’d arrived at the hospital at 3pm and it was 10:30pm when we got home, Mordan was waiting for us. Much like a relay race they did the passing of the Yvonne. Mordan and Yvette met and exchanged info about my condition before Yvette went home to her husband. I spoke a bit with Mordan then got a call from my Satanist checking in on me. Then I spoke with Greg, you know, that cutie I was out with when I dorked out and took a spill and thusly broke my arm? Yeah, that one. Talked with him for a couple of hours then decided it was sleepy night-night time.

Because my Dad was out of town (checking out the Rosicrucian Museum when I called him) Mordan stayed the night and most of the next day with me to make sure everything was ok for me. Other than when the hospital administered meds wore off at 3am (Oh, that was an exceptionally unpleasant pain to wake up to.) and I had to wake her to help get food into me prior to taking the vicodin, there was little to no pain or problems.

Funny thing (not really) turns out the dressing for my arm was wrapped too tight after surgery since my fingers were numb. The Doc called the following day to check on me and he scheduled for me to come in the next day so he could check my dressing and make sure there wasn’t any nerve damage. Angela was a dear sweetheart and drove me to the Dr. The Dr. loosened the wrapping and the feeling returned to my fingers. All’s well.

My friends have been amazing! I totally love them! Many of my friends offered assistance if needed for rides, help at home, shopping or meals. Overall I haven’t really needed too much but when I do they totally come through for me.

Tien Di Kat came by one night with Thai food for dinner so we could catch up. Lauren drove me to the Vampire Dim Sum on Sunday, after which all the girls came over so we could watch vampire porn aka True Blood. And tonight the Other Michelle took me to the Harry Potter Meetup.

Overall I’ve been well, but I find I’m physically exhausted everyday despite trying to rest. I’m actually sleeping 9-10 hours a night. Apparently growing new bone takes a lot of energy. Where’s Madame Pomfrey’s “Skele-Gro” when you need it?