Offline
That’s great to hear!
Offline
good health to you joe!
Offline
I bought a personal TENS unit, took it over to therapy to have them show me how to set it, place the patches, etc. While there, the lead therapist looked at my elbow and told me to STOP with the exercises, at least until she sees me on Wednesday. She gave me a padded sleeve to prevent putting any pressure on the point of the elbow, even though there's no such thing in my right elbow. She said I can't rest the elbow on a surface to elevate my hand, either. Well, I don't know if the TENS unit is helping, I've only used it 4 or 5 times, 20 minutes at a time, with just enough intensity that I can feel the pulses without pain. They say not to use it too often, at least 3 hours between treatments.
Offline
This is not the update I was hoping for. I'll reset my expectations and hope for good news Wednesday.
Offline
Saw the surgeon this morning, he ran me through my range of motion routine. For example, upper arm parallel to the floor, flex the elbow without raising the arm and try to touch the shoulder. I have only a few inches between my fingers and the shoulder. The angle is way past 90 degrees, we didn't measure it, though. Extending the arm is about 15 degrees short of straight, I think. Again, we didn't measure it. He said that most elbow replacement patients cannot flex past 90 degrees, or extend better than about 45 degrees, so my performance is, in his words, phenomenal. There is a mild stretching sensation, but NO pain when I move it. There is considerable pain in the hand, especially in the ring and little fingers, even though they're numb. So, my therapist put their TENS unit on my forearm and ran it for 2 minutes to see if the pain decreased. A little, but she thinks I'll need to experiment with my TENS unit at home to find the best placement for the electrodes. Right now, I've got them on either side of the elbow, lateral (outside) of the arm, as well as midline. Running a mild pulse through them, seems to help a little. It's strange, because the nerve registers the pain as occurring in the hand, but that's not necessarily where the irritation to the nerve is located, hence, moving the electrodes around. I guess it's kind of like the "phantom pain" amputees report.
He believes that the nerves will start to respond in about 4 - 6 weeks, maybe less if the electrostimulation works, couples with the new medication my rheumatologist prescribed, trade name Lyrica. I started the Lyrica at 50mg a week ago, and next Tuesday, titrate up to 100mg per day, which I believe is all they want to prescribe. After all, if you titrate up, you have to titrate off it.
Offline
Sounds like the news was better than expected on the elbow. Excellent!
I once got a whopping bruise on the inside of my elbow that put sufficient pressure on the radial nerve there (in the elbow) that I lost surface sensation to the same fingers. With a ll the edema you've had, perhaps this is the case for you too? Might be some deep residual edema putting pressure on that nerve. Perhaps some experimentation with those 'trodes on the inside of the elbow flex point might help. Just sayin'.
Offline
That's the thought of the therapist. She put some kinesiology tape to force pressure (light pressure) on the fluid pocket. Also, they told me to stop the cold treatments and switch to moist heat. Still not allowed to do the exercises, but have to let it rest. It was fun bringing in the two cases of water from my car. I didn't load them, but when I got home, I used a board as a makeshift slide and slid each case down to the 2-wheeled hand truck, and then into the house, no strain on the arm. I go back to him in 6 weeks, I go to therapy in 1 week.
Last edited by joekc6nlx (1/19/2022 6:21 pm)
Offline
Well, I had entered a fairly descriptive entry here yesterday, but it doesn't seem to have appeared. I must have hit the wrong button. Frustrating when you can't type with both hands and make frequent typos. Okay, last week, January 28, my occupational therapist was doing a routine follow-up on my elbow. It was swollen and red, and she thought it might have been cellulitis. She took pictures and sent them to the surgeon, who told me to see him the next day. They took X-rays, and then he told me to head for the hospital of his choice, about 20 miles away and do so immediately.
Checked in, they gave me a private room and then started on the battery of tests, including a blood culture and of course, COVID. Since I had already tested positive for COVID on Dec 29, they figured that this positive result was due to that, as results can extend up to 90 days. Blood cultures didn't show anything, so rather than take chances, they started me on Vancomycin and Cefepime through the IV on Friday. The next morning, they wheeled me down to surgery, where they opened up the elbow to see if the swelling was caused by infection. They took a culture of the fluid in the joint, as well. All day Saturday and Sunday, I languished in the hospital, waiting on an update. On Sunday, the surgeon said he wanted to do a "backwash" on the joint, meaning, go back in, flush it out with antibiotics, and then close it up. That surgery was scheduled for Monday afternoon, but at 2:00PM, they came and told me it had been canceled. The surgeon and the internal medicine specialist came to explain that since the blood culture, and the joint fluid culture had been negative, that I had not run a fever while I was there, and that the physical indications of the joint fluid did not indicate an infection, he could not in conscience justify another surgery. I was discharged on Tuesday...still wearing the same underwear I had on when I was admitted.. However......
There is an issue with the tendon of my triceps muscle to the lower arm bones whereby the tendon has ruptured off the bone and detached. There is no way he can repair that with the existing tendon, so they will have to get another tendon from a tissue bank and graft it onto the bone and interweave it with the existing tendon. This is outpatient surgery and is scheduled for Friday, Feb 4 at that same hospital, which is about 50 miles from my home. Anesthesia will not proceed unless I have a ride to and from the hospital, plus someone to watch me that night. Being single has its disadvantages as my nieces and my neighbor cannot take off work to drive me back and forth. I have asked the County Veterans Service if they can drive me down and back, and then I can have my neighbor watch me at home. I don't know, because we're due for a major winter storm starting tonight and tomorrow, and perhaps 3 - 5" of snow, and then it turns windy and that snow will drift Thursday afternoon and evening, making the travel dangerous. So, it's possible the surgery will be delayed until some other time.
In other fun news connected to this surgery, the resident has prescribed 5 different medications. When I took them to the pharmacy, they had to call the resident, because 2 of them have a serious interaction. So far, they have not heard back from the resident. The pharmacy I went to was the Air Force pharmacy, which is 45 miles away, I had to drop them off yesterday, and then drive down this morning to pick up what I could. If the resident calls back, I would have to drive back down again, but the pharmacy is closed tomorrow for training. Since the resident is a civilian, they can send the prescriptions to my hometown pharmacy, but that costs me out-of-pocket for the prescriptions. Well, I have to have them, so if the resident will/can call them to the local pharmacy, I'll go with that. Meanwhile, they're doing me no good while I'm waiting for someone to make a decision and let me know. Otherwise, they'll just have to treat me again on Friday.
They gave me 2 medications for pain, Norco and Tolador (which has an adverse effect on the kidneys) to be taken as needed. Norco (Percocet and Vicodin both) give me spasmodic hiccups which end up locking up my diaphragm and making it impossible to breathe without me either violently coughing or trying to yell loudly to free up the diaphragm. So, unless I absolutely HAVE to take the Norco, I won't. So far, I'm not in enough pain to warrant taking it.
I hate getting older......
Last edited by joekc6nlx (2/02/2022 5:05 pm)
Offline
Bloody hell, Joe. It never rains but it pours eh?
Hmmn, Just realised that phrase may not translate cleanly into American. Be assured it is an expression of genuine sympathy. And I fully agree with you about the getting older ...
Offline
It translates fine, 'Tac-ji. Thank you for the kind thoughts. I shall prevail!