Source: http://www.glendaleadventist.com/elbowconditionsinformation

My biceps muscle has been on quite a journey recently. He has seen places he’d never thought he’d see (like the world outside of arm) and met people he’d never thought he’d meet (like world-renown surgeon Dr. Peter Millett). In other words, last Thursday I got surgery to reconnect my distal biceps tendon to the bone.

On Wednesday morning of last week, I saw a doctor here in Boulder. He was quite confident that I’d fully ruptured my tendon but wanted an MRI to confirm his diagnosis and to see to where exactly my tendon had relocated in my upper arm. The MRI was scheduled for 4:30 that afternoon. While waiting for my MRI, I got a call from Dr. Millett’s program director who offered me an appointment the following day in Vail, CO. She added that they could possibly schedule me for surgery later in the afternoon. When I asked about his experience, she said that he recently repaired Brian Shaw’s biceps tendon.   I was persuaded.

I got my MRI and brought the CD to Vail with me the next day. Because I might get surgery, I couldn’t eat or drink anything after midnight. Becca waited patiently as I met with Dr. Millett. After a brief evaluation, he laid out my options. Not getting surgery would lead to a significant loss in arm flexion and supination strength. In climbing, these are the two most important strengths. They are the forces that allow us to pull down and toward our bodies. My other option was surgery, and that was what he strongly recommended. I didn’t see that as much of a choice, and so, at 1:30pm, I entered pre-op for my first surgery.

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Step 1: Cut here.

Here’s a link to a video that shows Dr. Millett performing the surgery – not on me, even though I tried to get some video or photos of my arm opened up. As a warning, the video is pretty graphic. Around 5pm, they wheeled me into the OR, put an oxygen mask on me, and the nurse told me to think a happy thought. And then I was out.

The rest of that day is blurry. I remember information about painkillers, changing of braces, and disconnected chats with my wife. They tried to hook me up to a GameReady machine, essentially a pressurized cooling device for my arm, but the sleeve didn’t fit right. I made some joke, despite my lack lucidity, about how bad that was because I needed all the game I could get. Apparently at least a few folks thought it mildly entertaining.

I encouraged Becca to go back to her hotel around 8 or 9pm because I was in less discomfort when I slept, and it seemed unnecessary for her to sit there and watch me sleep. I spent the rest of the night in and out of the darkness of painkillers – Dilaudid and Percocet. After a few hours, I felt good enough to eat more than fruit and crackers, and at 4am I decided I needed a lap around the recover ward. Margeaux, my nurse, was quite tolerant of my whim and sauntered slowly with me, making sure I didn’t stumble over some expensive medical equipment.

Becca checked me out at 7am, and we went directly to my first physical therapy appointment. At this point, the whole rehab game is to encourage the tissue to heal and to reduce inflammation. The PT did some “scar tissue mobilization” (basically a light massage technique to move the fluid up my arm) and some passive range of motion work (PROM: not a high school dance; I lay on my back with my arm bent and elbow pointing up and slowly extend my arm from fully flexed to a 90-degree bend).

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The robo-arm, my bling for the next 6-8 weeks. At least I now have a good reason to wear bro-tanks.

And now I’m back home in Boulder. I’ve significantly decreased my painkillers dosing and hope to be done with them tomorrow (4 days post). I’ve gone on two walks, one long enough to constitute a hike (1.5 hours). I’ve done tons of icing and lots of PROM. Tomorrow, I have PT visit number 2.

So, after his exciting journey, my biceps is resting quietly in a compression sleeve, a brace, and a sling. Living life with only one functional arm is a new challenge that has as much humor as it does frustration. Try eating a bowl of granola with only one hand. My biceps will get to rest for two more weeks; then it’s on to phase 2.

In an upcoming post, I’ll outline the rehab plan and then check in with my real world progress. I’d like to finish with appreciation for all the people who have helped me so much so far: Sue who worked a scheduling miracle; Joe, Tara, and Heather who offered limitless information and guidance at every stage of the process; Dr. Millett and Dr. Leigh who performed a top-notch surgery with the rest of the OR team; all the nurses (most of whose names are lost to me in a narcotic fog) who helped me through a very uncomfortable initial recovery from surgery; my family who have frequently checked in, offered assistance, and sent me best wishes; and most of all, my wife, who has patiently and lovingly held my hand through every step of my injury, from the cave in Spain where I plucked it loose to our kitchen where she is currently making me soup.

I was pretty scared of this procedure; I’d never had surgery before, and no matter how benign they make it sound, it’s scary to give your body and life over to other people the way I had to for this all to happen. There are a lot of criticisms out there of the medical industry, and I’m sure many of those are fair, but in my case, at every turn I felt relieved and encouraged by everyone’s care, responsiveness, insight, and professionalism.

As an addendum, here are a few links about distal bicep tendon tears that I found useful:

http://www.eorthopod.com/content/distal-biceps-rupture

http://drmillett.com/attachments/article/184/Distal%20Biceps%20Tendon%20Injuries.pdf

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