Two weeks post op and I am off to my follow up appointment- things are going well and I have been progressing nicely. I have been giving my arm a good push five times a day with an umbrella; I am determined to progress.

Last week when I went to see the physio she told me that she had spoken to the Lovely Mr F and that I should expect him to put a negative slant on the op.

‘I am disappointed’, is the Lovely Mr F’s opening line. ‘And I spoke to the physio and she is disappointed too’.

‘Well I am not’ I retorted. I have been thinking about this since the operation. When I first made contact with the Lovely Mr F from the hospital in France I was desperate. I had been indiscriminately been hit on the slopes by a young reckless skier and seen by a senior french consultant who told me that my fracture was too severe for him to cope with. My GP put me in contact with the Lovely Mr F whose first words to me were ‘ That skier did a good job on you, its bad and I don’t quite know what I can do, but I am going to try to repair the joint’.

The repair is amazing – I can’t quite believe how well the first operation went. Nor can I believe that I am lucky enough to be able to write, take my earrings out, do up my shoe laces, use the mouse on the computer, put on mascara.  It was months before I could do those things. Ok, So I struggle with clothes still, putting my hair in a pony tail, laying down on my right side and so on but so what.

‘Have you got an umbrella and I will show you how much I can stretch’, I say. The lovely Mr F doesn’t hesitate, ‘ here, use a leg’ he says as he hands me one of those models that doctors use to explain your anatomy to you. I take the leg and proudly show him my movement.

‘You are the perfect patient,’ he says and I glow quietly inside. ‘You really are the perfect patient because you are glass half full’. It is true, I am an optimist and whilst my optimism has been thoroughly tested it remains intact, and it is has helped me get through the last 18 months.

I could go on to say how difficult he found it getting in the joint with the camera because of the scar tissue, how he couldn’t manipulate the arm fully under anaesthetic and just how much scarring from the initial trauma and then ( in his words) some brute shoving a load of metal in me there was but what’s the point?

In case you are interested here’s the photos;

This is before where you can see all the debris and scarring.

And this is the nice clean joint afterwards. Clean, but still very stiff.

The Lovely Mr F goes on to explain that there is nothing more that can be done for me and he doesn’t  need to see me again. I knew I was getting to the end of this journey but I didn’t know that it would be today – I thought I might have one more consultation so I was a little unprepared. I thank him, shake his hand and say goodbye.

‘Go skiing,’ he says and I reply that I will. ‘ Send me a postcard when you get there.’ I most certainly will.

I walk out of the door slightly discombobulated and feeling released, relieved. I can put this chapter behind me and live my life.

The end of seeing the Lovely Mr F also seems an appropriate time to bring to a quiet close this blog. For me, writing this has been like therapy, it has been a place I can bare my soul and say how I am really feeling about what has happened, but now is the time to finally move on, the end.

And remember, painful endings are often new beginnings in disguise. 🙂

 

 

I arrived home from holiday to discover that whilst I have been away a date has been booked to have a pre op check up – which I have missed. I phone and rebook it and rearrange my plans to be there. I am expecting to be asked the same nonsense 90 or so questions again but  in fact it is worse.

‘You’ve been here before, haven’t you?’ said the nurse. It transpires that as the last operation was so recent and due to some admin muddle I didn’t really need to come in for a pre op check. Now I am here she checks my BP, I think to make me feel like it was worth the 25 minute journey. ‘Ah, you’re seeing the lovely Mr F’ she says. I thought it was only me who called him that!

On the day of the operation George drops me off at the hospital and I wait to be called onto the ward. ‘You’ve been here before, haven’t you?’ says the ward clerk as she takes me upstairs. This time though, we turn right instead of left, on to the daycase ward. I feel like it’s a mini promotion.

The nurse comes in to check me in. ‘You’ve been here before, haven’t you’ she says, ‘and you’re seeing the lovely Mr F’.

When Mr F comes in to consent me I say to him ‘ Do you know all the staff call you the lovely Mr F?’. That’s very nice he says, but I wish my patients would call me that. (!)

When the anaesthetist comes in he says ‘ You’ve been here before, haven’t you?’

Yes, I say, and please can we talk about pain relief. The first op, having the metal in was truly hideous and took me weeks to recover. Having the metal out was a walk in the park and I had thought that as this was keyhole it would be straightforward, but the one thing that has been different about this journey through the hospital is that everyone says it will hurt more, he is planning on doing a lot of work in the joint and I should be prepared. My physio tells me that normally after a decompression it is three weeks of pretty bad pain.

In theatre the anaesthetist puts the needle in. I love this bit and  I know why pop stars get addicted to it, but before I know it I am in recovery. The Lovely Mr F comes to see me on the ward after the op and I feel really, really unwell and even though I don’t want to make a fuss I mention to him how rubbish I feel. He tells me that is because he has done quite a lot of work in me – and he is sorry but he is not happy, he did not get the movement that he was hoping for from the op.

I sit in the bed, feeling crap, a half eaten egg sandwich in front of me and dressed up like a tit in stockings and theatre gown. ‘That’s OK’ I say, ‘Thank you very much for what you’ve done for me’.

He leaves and the nurse comes in to take my BP. ‘What did the lovely Mr F say?’ she asks.

‘He said’, I gulp, ‘ that it was not great and that he didn’t get much more movement. And I am so upset’, I continue, ‘partly because I feel so much worse than last time, and partly because I know there is nothing more that can be done’.

‘It’s OK’, the nurse replies. ‘ What you need to do is watch the Olympics, take your mind off it’, she says, as she turns on the TV.

And she is right. Within minutes I feel inspired by what the Olympians achieve and motivated to prove what I can achieve.

This won’t be déjà vu – this will be progress.

 

Yesterday I went in for my three month check up with the Lovely Mr F. It’s hard to believe that it is three months since I had all that metal out, in a weird way I miss having the metal in. It was kind of reassuring that it was holding my arm together.

When I arrived I went for the usual X Ray. I can’t remember how many X rays I have had, but this was my 35th visit to the hospital and I have had X rays on many of those visits. What is slightly funny is in all that time I have never had the same radiographer do the x ray, it is a different one each visit. To begin with the mantra was always ‘ Wow, that’s a lot of metal’, but of course that is not the case now. One change has been that my date of birth and address are checked at reception and in the x ray room and I also have to sign a consent form each time. This wasn’t the case when I started going there and it makes me wonder whether there has been some x ray incident which has increased the rigour behind patient identification. I wonder what an x ray incident might be?

I get in the usual position for the two X rays; the radiographer comments that I am quick to know what I am doing – ‘ Yes, I’ve had a few of these’.

When I went in to see the Lovely Mr F we talked about holidays, family  and our children’s university choices. I think we avoid talking about my shoulder because it is so depressing. Eventually, however it can’t be avoided and he stands me in front of the mirror to asses my shoulder movement.  After the examination the Lovely Mr F writes down my movement. 140 degrees to the front, 80 degrees to the side and zero degree rotation. Really? Zero degrees? 15 months, 2 surgeries, countless physio, intense swimming and the result is zero degrees??FFS!

He tells me that I am not out of the woods when it comes to thinking about AVN. 15 months ago I had no idea what that was, now I know it is to be feared. Avascular Necrosis. He explains to me that whilst the surface of the joint looks OK on X ray, he will really only know when he looks through a telescope and it could be that the blood supply is failing, the bone will all crumble and I will need a shoulder replacement.

The Lovely Mr F says that he can offer me one more surgery, general anaesthetic, keyhole surgery, have a look with a telescope  and then capsular release. He doesn’t hold out too much hope that it will make a lot of difference bit it is worth a try. I jest that I should be able to fit keyhole surgery in a lunch break, but he says I need to be careful, he will be cutting and burning the shoulder structure. Fun. After this operation, he says, I will have to accept that I was hit on the slopes and my shoulder will never be the same again, there is nothing more that he can do. We talk about the things that are difficult, or I will never do again. I was never a big tennis player but I do miss doing the front crawl. Putting on jackets and dresses is still a drama, and interestingly he raises getting a ticket out of the multi storey carpark. Doing my hair, itching my back, doing bras up. Blah. Blah. Blah.

I  turn the conversation back to holidays.

Two months since I had the metal removed  and despite my initial hope I have really not had the results that I had hoped for in mobility terms at least. The biggest difference has been the reduction in pain, which has been dramatic. This is actually quite surprising as I hadn’t realised that I was in any pain but now it’s gone I realise I don’t have it any more. It’s like that song ‘ You never know what you’ve got ’til it’s gone..’ ..sort of.

My shoulder feels stiff and achy, like I slept on it funny but it feels a lot better than it did.

When I was under the anaesthetic my shoulder was manipulated; ‘We’ll give it a bit of a push’, the lovely Mr F told me. The plan was to stretch it to get some extra movement and then keep that going with the physio afterwards. I was authorised to have 4 sessions of physio and at the first one we agreed that whilst I didn’t have much more movement the joint is looser in the shoulder. Three sessions on and we have been really pushing my shoulder to try and manipulate some mobility into it.

Last week, whilst I was waiting for my physio appointment, the lovely Mr F. stopped by to ask how I was getting on. I gave him a quick demonstration; he didn’t look too impressed. ‘We are x raying you again, aren’t we?’, he said. Yes, we are, at the beginning of July. I think when I go for that X ray it will be my 35th trip to the hospital. ‘Good’, he said.

Now, you may remember that before the operation the lovely Mr F had told me that he was hoping I would get a sea change following the operation, and that hasn’t been the case. I have noticed some small differences; I went to the car park in a low car and whilst it was tough I got the ticket out the machine through the car door window. I can get into jackets slightly easier. So when I went in to see the physio I asked her about it, and what the next likely steps in July would be.

She told me that she felt I had been very unlucky with the stiffness following the operation, especially since I have been doing all the right things. I think I have done all the right things, I am swimming every morning at 6am in the outdoor pool, I was the first person in it this year and I do 1k each morning. I stretch and use my arm. I watch my nutrition and exercise. My physio said that most likely they would try manipulation under anaesthetic again and then ‘cut the front structure’ through keyhole surgery.

Given how easy the last op was I reckon I can do keyhole surgery in a lunch hour.

There has, however, been one major milestone.

After the accident I was unable to ride for 6 months. Once I was allowed back on the horse again I was terrified of falling off and inuring my shoulder so I have only been riding in the school. Whilst it has been great to be riding it really is not as much fun as hacking out with others, having a chat and some fun on the way. So for the last six months I have headed into the school and watched others go out, and I have missed out on some beautiful morning rides. It became a bit of a mental block, so I have been having some lessons to try to get my confidence back.

Yesterday, I went up to ride and I decided to go out with two others who were going for a hack. I don’t know why I suddenly decided I would be OK – maybe the lessons have helped, maybe as I have less pain I am less protective over my shoulder. Either way, psychologically it was a big barrier to cross.

It wasn’t a lovely morning, it was a bit grey and miserable but we were out for an hour and a half and for me it was the best morning so far this year.

 

 

 

 

One week after having the metal out and it could not be more different from one week after having the metal put in.

After the operation I was wheeled back onto the ward and greeted by the nurse who took my blood pressure and pulse every fifteen minutes. I was asked if I had any pain, which I didn’t,having had the recommended block as well as the general anaesthetic.A block is the strangest sensation as the arm is completely dead from the shoulder downwards. Of course I had a sling on and a dressing but apart from that I was absolutely fine. The nurse bought me some omelette and a drink which I greedily ate, I was so thirsty and hungry.

Halfway through my meal the lovely Mr F came in. ‘You look remarkably well’ he said, watching me scoff omelette with mild surprise.  He told me the operation went well, that he managed to get good movement out of my shoulder and that if I wanted to I could go home! The benefit of being first on the list.

I had been told to be very careful going home with a block in because as you have no sensation you can hurt yourself, burn yourself for example, and you wouldn’t know you were burning until you smelt the burning flesh. Yes, that is how dead your arm is. Once the lovely Mr F left I jumped out of bed and started getting myself dressed. Trying to put a shirt on was near impossible. My arm was useless, so trying to push it into the sleeve just wasn’t happening. I sat on the edge of the chair with my arm rested on my lap and tried to thread my arm through the sleeve with my left arm. It was a challenge with an added excitement of  wondering who might walk in the room to discover me topless. I did finally manage it and luckily kept some dignity by getting the buttons done up before the next visitor, the pharmacist. She gave me some co-codamol and lactulose. I took it without really thinking but after she went realised that she had given me 8mg codeine tablets whereas last time I had 30mg and Tramadol for when the pain got really bad. An optimistic pharmacist who had obviously not had orthopaedic surgery, I thought.

Once I got home I went straight to bed as with a block I knew I would sleep. Last time, once the block wore off I couldn’t sleep for about 2 months.

The next morning I awoke and the first thing that was apparent was that the block had mostly worn off but I didn’t really have too much pain. So I took the sling off, took the co-codamol for 24 hours and since then have been functioning as normal. I had the op on Wednesday and went back to work the following Monday. To the family’s delight I have been able to cook, clean, do the washing and generally run around as before.I have less pain than before the op despite the fact I still have the staples in. Getting washed is a bit tricky because of the dressing but I actually think getting dressed is easier. I can wash my hair, put make up on, wear earrings, all things I couldn’t do for about two months last time.I find it hard to believe that I had orthopaedic surgery a week ago.

I was told by everyone that the surgery would be much easier than last time so I wasn’t expecting to be quite as bad but I wasn’t expecting to be this good! I thought I would not be able to use my arm for a fortnight and that has not been the case. I do believe that I am pretty used to living with pain in my shoulder which helps but even so this really is unbelievable considering what I have had done.

The crunch comes on Wednesday, dressing off, clips out and x-ray.

I am hopeful.

I arrive at the hospital for my 12 month check up – a few weeks early as the physio has suggested. I sat in the waiting room to be greeted by this advert on the table.

The irony is not lost on me, I have spent the last few weeks watching so many people go off skiing, all coming back with stories of how it is the best snow they have seen for years. I still find it really hard to believe that we set off as a family on that beautiful March morning for a days skiing and I ended up in Moutiers hospital by the evening. Max and Lucy have really missed the skiing, they keep showing me photos their friends post on snapchat of how lovely it is. I miss it too.

Adam comes to get me and takes me for an x-ray ‘ That’s a nice lot of metal you’ve got there!’ he comments, as he takes the shot.

‘That’s what everyone says’, I reply.

It’s the first time I have seen Mr F for 6 months so we have a lot of catching up to do. When he asks me if I have been skiing, I look away, when I reply no, a bit embarrassed that I have not been ‘gung ho’ enough to go.

‘I don’t blame you’, he said. ‘ I have just got back from skiing and the week before I went I saw five fractured shoulders – all from skiing holidays. It put me off going completely and I was just glad to get back in one piece’.

Five!! I can’t believe it! Five in a week! How many fractured shoulders must there be in a year from skiing?

The lovely Mr F reviews my x-rays – ‘You have got a significant amount of metal in your arm which makes it very difficult to see the bone, it does look like you have a shadow there so I am going to send you for an MRI to check the bone is fully healed. Your arm is still so very stiff, so we will discuss surgery with the results next week’.

He looks at the original x -rays, following the accident to see how the bone has progressed.

‘I remember when I first saw these, my heart sank’ he said, ‘not because it was bad for you, which I am sure it was, but I had no idea how I was going to put you back together again.’

I have the MRI and the following week we review the results. The good news is that the angle of the head of humerus is good now, it is in a good position.

‘The radiographer has commented that it is difficult to see because of all the metal but the bone appears to have healed well – so we will take the metal out. Hopefully you will have better mobility and less pain’.

It is a bit weird getting ready for the surgery. Last year I had no idea when I set off that I would not be able to use my arm for three months. This time I am fully prepared so have filled the freezer with food, changed all the beds and generally got organised for not being able to drive for a couple of weeks.

The surgery is later today – the 30th March. One year and one day since the original accident. Perhaps next year I too will be able to get back to what I love.

It is coming up to a year since I had the accident and there are still some things which I find really difficult. Getting the ticket out of the multi- storey carpark is one , getting my hand high and at that angle is a challenge. That’s OK though because I don’t go to carparks that often. Reaching cups, plates and so on is still a bit hard but I mostly do that with my left arm now. The one daily task that is quite difficult still is getting dressed. Anything which has to go over my head, dresses, jumpers, vest tops, T-Shirts are all really, really tricky. Getting in and out of jackets and coats is also quite an effort and I have some jackets which I still can’t wear. Then there are shirts and dresses with little buttons at the back of my neck – virtually impossible but I swear and struggle and generally I get there.

It’s been really cold lately and as I have been up to the stables and out with the dog a lot I have been reliant on layers. A couple of thin tops and then a sweatshirt normally keeps me  roasty toasty. But my word, it is a pain in the arse putting them on. Not only that, but because I don’t want to stay in horse stuff all day I change when I get home. Then I go swimming as well which is another change in and out of a swimming costume – with clothes on and off when I get there. Sometimes I can change in and out of clothes 6 or 7 times a day. When you think each time is an effort ( and it really is an effort) it can be quite dispiriting, frustrating  and painful. Getting dressed should be easy! Toddlers can do it!

Then there is the getting stuck. This is quite claustrophobic and painful. Before I broke my shoulder I think the last time I got stuck in my clothes I was about six, now it happens relatively frequently. When I get stuck I find the best thing to do is go backwards, put the offending item back on and then try another system to take it off. That usually works.

This weekend, I went up to the yard completely layered up. When I came back and walked in the house I very quickly got too hot and wanted to take a relatively tight sweatshirt off. Unfortunately I got stuck but as I was in the kitchen decided that the quickest and least frustrating route would be to ask George to help me out.

‘Do you think you can help me out of this?’ I said. George came over to me, and laughed as I was headless.

‘No problem’, he said and started pulling, tugging and manoeuvring. Poor George, there was a time when getting me undressed was far more exciting. After a few minutes he realised that he wasn’t getting anywhere and called Max over to help.

Max was all gung ho about it and determined to show his Dad how easy it was to get a jumper off. So, he grabbed the bottom of the jumper and just yanked it over my head, pulling my arms up as he went as you would any kid who was tying to get a top off. Max is over 6 foot and I am 5 foot 5 inches so very easy for him to pull the top up quick and hard. Unfortunately, what he forgot is that my arm still doesn’t go above about 100 degrees – but it does go a lot further when it is yanked by an enthusiastic strong 16 year old determined to show his dad how easy the task is.

‘AAAARRRRGGGGHHHHHHHHHH!!!!!’ I yelled, as the top flew over my head. ‘Flipping heck ( or words to that effect) that hurt!’ I cried!!

‘Max, you need to be careful – that’s why I was going slowly,’ said George.

‘I’m so sorry,’ said Max, ashen.

But guess what – I can move my arm a little bit more.