Two Months after Bicep Tendon Surgery

The Long Road Ahead

My surgery to repair tendonosis on my right bicep was just over two months ago. It’s been about a month since my last update.

The good news: mobility and strength are greatly improved, even from this time last month. Today at PT we measured it and there are definite advances. I was also cleared last week to start running again, and that has been great–especially with the wonderful weather we’ve been having.

The bad news: I am not nearly as strong or mobile (range of motion) as I would have hoped. I also am experiencing a good bit of discomfort/pain–especially at night and first thing in the morning. It is hard to say how much longer that will go on.

The question remains: was it worth it to have the surgery? And…the jury is still out. I am hoping that in the long run I will be pleased that I did it. For now, the pain is a little less than before surgery, but there are times when it really smarts. I definitely know when I have overdone it, but in my line of work it is difficult not to lift objects that way more than a few pounds. I have learned to compensate, but that is not the best strategy either. My doctors and physical therapist tell me that all this is normal. I haven’t had a lot of surgeries, but enough that I should have learned that recovery always takes longer than promised.

There is still a long road ahead, but hopefully the baby steps add up to a lot of progress over time. Every now and again, I will update you on my progress. Until then, stay safe and stay strong!

Four Weeks after Bicep Tendon Surgery

20120309 Physical Therapy Equipment

Yesterday marked four weeks since my Bicep Tenodesis. The picture above pretty much sums up where I am: physical therapy and lots of it.

I have PT exercises I do twice daily (10-15 minutes) and actually go in for therapy twice weekly. Up until last week, almost all of the exercises were assisted in some way, but most of the exercises now are under my own power. For instance, I do an exercise where I slide my hand up the wall; I used to employ my good arm to push it up and now I no longer do that. This is progress.

I have noticed that my mobility has increased as well. I’m not near 100% yet, but it is a vast improvement over the first few weeks. There are some exercises that my therapist introduced that when I started caused me a lot of discomfort and my range of motion was very limited. Little by little, the ROM has increased and the pain has subsided.

The one thing that has surprised me the most is just how sore I still am, and its a pretty constant companion at this point. Some of it is a result of the PT exercises and pushing myself. I suspect that some of it is that as much as I try not to lift anything over 1 lb. with my right arm, that gets violated pretty often. Nothing over 5 lbs. for sure, but I do find myself not being as careful as I should. I wonder if the PT folks know that this happens in general and therefore give patients an untenable restriction with the hope that we might limit ourselves just enough–kind of like putting a 70 mph speed limit on a highway knowing full well that no one will observe that, but hoping that at least we’ll go under 80! In any case, I’m using a fair amount of acetaminophen.

My PT folks tell me that my I’m on track. I know that I am impatient. I’d like to get back to running and biking, and eventually doing resistance exercises. It is pretty boring to just walk briskly, or get on the bikes at the gym. I will just have to stick it out.

Earlier in the week, my therapist asked me if I felt the surgery was worth it. Good question. I hope to know the answer over the next month or so.

Two Weeks After Bicep Tendon Surgery

Hope to fly Simplicity, creativity, concept, flying, hope, dove ...

Today was liberating. I got to ditch the sling and was also able to drive. Today was also my first day back at the gym training clients in person. Of course, it will be another 4-5 weeks before I can lift anything heavier than 1 pound with my right arm, but it feels great to be getting back to a normal routine.

It’s been 14 days since the Bicep Tenodesis surgery and I feel like we’ve made some good progress.

The last week was up and down. The stitches came out 2 days ago and I good a report from the doctor. The assistant showed me the pictures that the arthroscope took (they actually sent me home with a set but I really couldn’t interpret them). She explained what I was seeing, where the problem had been, and how it was corrected. The good news was that the rotator cuff is looking awesome and there didn’t seem to be any other issues. She did say that the area that was causing the discomfort that led me to PT and eventually surgery was not actually that bad, but that they could see where the issue was.

Was the surgery unnecessary then? No. This was not going to get better and would probably have gotten worse. Taking care of it now just means an easier recovery and less time dealing with the mobility and pain issues. It’s kind of like when your check engine light comes on; you can go right to the dealer/mechanic and it won’t usually be such a bad problem…or you can drive on it for another couple of months and then find out that you’ve got a serious repair that will cost a lot more. I’d rather be proactive.

There were times over the past seven days when my arm felt fairly pain-free and others when the it was a little more intense. One night it even woke me up in the middle of the night twice; I fell back asleep with an ice pack on. Yesterday at PT, the therapist told me that this is actually quite normal. She said to expect it to continue for a while; I may even want to ice each time I do my PT exercises at home and before bed. So far, that hasn’t been necessary but we’ll see how things proceed.

The actual process of PT is changing as well. For the first 10 days or so almost everything I did was passive or assisted. Now that we’re past the two-week mark, we will begin to build up the muscle while continuing to work on mobility. I am happy about this even though I know that I might experience some aches and pains. I looked in the mirror yesterday and saw that my right bicep is definitely looking sad compared to my other arm. The rebuilding process will be a long one, but I have lots of reasons to want to get myself back in tip-top shape.

Next report when we hit the one-month mark. In the meantime, it is great to be back to doing the things I enjoy…within limits!

72 Hours after Bicep Tendon Surgery

Gaia Zoo Skunk

Well, it is 72 hours after my surgery, and today I was finally able to take a shower. It was with great joy that I was finally able to bathe but the effort definitely wiped me out for most of the afternoon. I have had a few surgeries over the years, and I always forget how much effort and energy it takes to heal.

As you may recall from my previous post, the anesthesiologist went above and beyond. In fact, it wasn’t until Friday evening that I actually had the opportunity to ask my wife what the surgeon said about the procedure and what he found when he finally got in there. Of course, all of this had been explained to me earlier, but I was too high to either process it or remember it. The good news is that my case was somewhat rare for a good reason; the surgeon explained that it is quite unlikely that the MRI gives a complete picture of what will be found once they get inside. Often there are little surprises that pop up during the procedure. In my case, however, the MRI did an excellent job of predicting exactly what was going on. This meant that the surgery was rather “ordinary.”

So far, the pain has been less than I expected. It has been mostly controlled with prescription strength ibuprofen and acetaminophen. On Friday, I took a short walk and found that my stamina was pretty good. Later in the day I took another walk and discovered the same thing. I was pleasantly surprised until the pain block wore off. Since then I’ve had to back off quite a bit.

Tomorrow, I will begin physical therapy. My post-surgery instructions already have me doing pendulum swings with my right arm, but I am sure that new exercises will be added. In the meantime, it is quite an adventure learning to do things with my non-dominant arm like brushing teeth, eating, and opening and closing doors. I have a lot more respect for folks who are missing a limb or are in some other way limited in their use of an upper extremity. And for the record, this voice recognition program is not as helpful as I would have hoped.

Overall, I am grateful that I am doing as well as I am. These inconveniences are only temporary. I will keep you posted on my progress.

24 Hours after Bicep Tendon Surgery

Structure of the Shoulder 2

Yesterday I finally had my bicep tendon surgery. After 18 months of on and off physical therapy and 4 cortisone shots, this was the next step. As I wrote in a previous post, I see this procedure as regular maintenance–just as I would do for a car. As long as I take care of my body, I hope that it will last me a long time.

Over the next few weeks, I’ll talk to you about my progress so it might be of some use to others who may be in need of similar surgery.

On Wednesday, I got a phone call to arrive at the surgery center at 11 AM. I would estimate that surgery actually began around 12:30. Once the anesthesiologist got involved, there isn’t a whole lot that I remember. The last thing I can recall is getting some Versed, after which the doctor began to do an ultrasound of my neck to figure out the right spot in which to do the nerve block. I remember eating some graham crackers in recovery; I remember getting into a wheelchair to be wheeled out to the car; I have zero recollection of the ride home or how I changed into my pajamas or how I got into my bed… Which is, frankly, how I prefer it.

I will admit that I am not exactly sure what the procedure entailed. It is called bicep tenodesis. I tried to watch a video on YouTube, but after about 20 seconds, I decided it was probably a better idea to just let the doctor do his thing. What I do know is that my rotator cuff was in good condition and required no attention.

And now, the recovery. I have a sling that I have to wear for 2 weeks; on top of that sling is an ice pack that I will need to use for the next 24 hours or so. I have to wear compression hose for 2 weeks to prevent blood clots; let me assure you, it is quite a look. No shower until Sunday morning (ugh!). On Monday afternoon, I have physical therapy with my favorite therapist, Megan, at the Cleveland Clinic. Originally I thought I would be missing one week of work, although now it appears it could be 2 weeks. I won’t be able to do any lifting with that arm with anything heavier than a coffee cup for the next 6 weeks.

The real challenge is learning to do the things that are necessary for daily living with my left hand when I am righty. Believe it or not, I found a way to dictate text on my laptop and that is how I wrote this blog post.

Of course, this is not the best way to spend my summer, but I am confident that in the long run, the pain will be worth the gain. I would rather have this taken care of now so that I can continue to enjoy an active lifestyle and be the best personal trainer that I can be.

In the mean time, wishing everybody Shabbat Shalom, and a good weekend! I will keep you posted on my progress.