Friday-Sunday, surgery, post-op days 1-2

Holy hell. Death would be preferable. I wanted to be put down after the first surgery in February, which was a scope and 2 anchors. Friday was a scope and 3  anchors plus an invasive open procedure, detaching muscles and ligaments, reattaching them tighter and another anchor for good measure.  

I'm on a lot of drugs and the past 48h are a total blur, but this is what I remember.     

After I got the nerve block, Tim came in and completely dislocated my shoulder about 6 times. I couldn't feel a thing but my friend Jamie turned green. Tim said that gave him important information about the best direction to apply tension to the capsule. He said not to take the sling off at all until I see him Thursday, and to put Drew on hold. 

I'm so glad I pushed for the scope before the open procedure- I KNEW the broken glass feeling was a loose anchor, despite the MRI report. Didn't see Tim post-op, but I have a copy of his operative note. "Obvious failure of the previous inferior posterior repair" and extensive posterior labral tear with detachment from the glenoid, requiring replacing the loose anchor at 7:00 and placing additional anchors at 9:00 and 11:00. The anterior repair (5:00) was healed. The original tear he repaired in February was from 3:00-8:00. Yikes. The only part of my labrum that I haven't torn is the SLAP. Go figure. 

The open capsular shift sounded like it went exactly as described in the YouTube video. Got a bonus anchor reattaching subscap to humerus. 

My post-op nurse was a total bitch. My surgery took longer than anticipated and I was the very last patient in recovery at 4pm on the Friday of Memorial Day weekend, and she took it out on me. When I'm feeling better, I'd like to get her fired. 

Can't wait to talk to Tim on Thursday- I'm really curious to know how exactly I fucked up my shoulder this much, and whether in hindsight he could see this on the MRI. He texted me this morning to check up on me, which was awesome. 

I have good friends taking care of me pretty much around the clock and Kellie flies in tomorrow. I bought a super comfortable recliner, which is the best purchase I've ever made. Did I mention I'm on a lot of drugs?  

 

Thursday

A1. Seated L-arm DB shoulder press, 3 x 4-5, 21X1; :60 rest
A2. Bent-over L-arm DB row, 3 x 4-5, 20X1; :60 rest
+
For time:
400m sled drag, body weight on sled
+
3 sets:
30/side light lying 1-leg banded curls
30/side light seated banded leg extensions

A1. 35, 40(4), 40(3)

A2. 65, 70(4), 70(4)

+

15:57 with 160, from waist 

+

skipped

Sled drag was so incredibly tough. I think I moved the weight slightly better than last time, but I took so many breaks that my total time was a full minute slower than before. It was freaking muggy, which didn't help.

Got to the gym super late and still had 89 things on my to-do list for tomorrow, so skipped the last piece. Sorry, not sorry. 

Peace out. 

Wednesday

A. 1/side forward lunge + 2 squats, build to a heavy double of the complex
B1. Jumping switch lunge, 3 x 20 total; :10 rest
B2. Glute-ham sit-ups, 3 x 15; :10 rest
B3. Russian twists, 3 x 20; 2:00 rest
+
20:00 Assault Bike @ Z1

A. +130

B. complete 

+

complete 

Tuesday - 14 weeks post-op / T-3 days

30:00 hike @ Ault Park

Monday

A. Safety bar squat, 3-3-3+ @ 200-210-225; 3:00 rest
B. L-arm KB/DB shrug, 3 x 5-6, 20X2; :90 rest
C1. Glute-ham raises, 3 x 9-12 unweighted; :10 rest
C2. Hip extensions, 3 x 20; 2:00 rest
+
AMRAP in 3:00:
Assault Bike calories

A. 4 @ 225

B. 70, 88, 100(5)

C1. 12 across 

C2. complete 

+

47

Disappointed with how heavy the squats felt - pretty sure I would have failed a 5th rep today, and 5 at 225 was solid 2 months ago. Chalking this up to nutrition (or lack thereof). It doesn't even matter I guess, since we are going to have to start this all over in a month or two. 

Went out way hot on the bike (70+ RPMs) and almost quit :90 in. Dropped down to 60 RPMs for a minute, then picked it back up to 70 in the final :30. It's been a long time since I did something that hurt that much. Actually, it's been exactly 14 weeks since I did 10:00 for calories, so that's exactly how long it's been since a good Fran cough. 

Goddamn, this blows. 

Sunday

1600m sled drag from waist, 45

Saturday

A. Safety bar good morning, 12-9-6-3, 20X0; 2:00 rest
+
Not for time:
1200m sled drag, light
+
15:00 Assault Bike easy

Skipped, potential make-up tomorrow.

Intended to do this late in the PM after watching the Trifecta competition, but the competition went longer than I expected and I was beat.

My friends are pretty fit, and I'm so proud of them! 

Friday

A. Safety bar squat, 12 x 3 @ 70 bar + chains, 10X1; begin a set every :60
B1. Seated L-arm DB shoulder press, 3 x 5-6, 21X1; :60 rest
B2. Bent-over L-arm DB row, 3 x 5-6, 20X1; :60 rest
+
3 rounds for time:
.4 mile legless Assault Bike
30 air squats
20 DB anchored sit-ups
+
3 sets:
20/side light lying 1-leg banded curls
20/side light seated banded leg extensions

A. complete 

B1. 30, 35(5), 35(5)

B2. 45, 55, 65(5)

+

7:57 (armless)

+

complete with thin black band 

Fully intended to blow off training today after having 2 beers at work, but then found myself at the gym anyway. Didn't feel like doing anything, then convinced myself to sit on a bike and watch regionals, then got really sad that after this week all I'll be doing for weeks is sitting on a bike and wanted to squat while I still can. And then I just ended up doing everything. 

Squats felt better than last week, but still heavy. Felt like I was recruiting my hamstrings more than I ever have, which was kind of weird but not in a bad way. 

Everything else was fine. 

Thursday

OFF 

Drew sent me straight to Tim. 

Tim reviewed both my MRIs with two additional radiologists this morning and one of them picked up on abnormal capsular laxity that was missed by the previous radiologists on both MRIs. Tim said that he didn't even look at that in surgery, because I had a huge, obvious labral tear. He said that unfortunately, it's unlucky but not terribly uncommon for fixing one problem to reveal an underlying issue that has been latent for a while. The capsule is a huge structure made up of all the shoulder ligaments, and, along with the labrum, is the primary stabilizing structure of the shoulder. The musculature are the secondary stabilizers, and it's entirely possible that my hypothesis from earlier this week was true - resting the rotator cuff stabilizers amplified the instability, but it's so severe at this point that physical therapy will never give me sufficient stability. I mean, it dislocated when putting my hair in a pony tail, and has slipped out of the socket at least 30 times today. No matter how many external rotations you do, there's no coming back from that.

Tim was pretty adamant that the labral repair is solid, but this was based on the MRI from 2 weeks ago and my shoulder was not dislocating 2 weeks ago. Tim said we could do another MRI if I wanted, but we decided that him just looking with a camera would be more definitive if he has to go back in anyway. 

I was pretty vocal about making sure that literally everything in my shoulder would be repaired, so this is the plan:

1) scope inside the joint, check the labrum and the repair, make sure everything is pristine 

2) subacromial decompression, which probably isn't super necessary but should help with the ongoing tendinitis 

3) open capsular shift, which is a big fucking deal. If you want to lose your lunch, feel free to watch this video: http://youtu.be/Xde6mlvTbSw or simply check out this cartoon depiction of this horribly invasive procedure:

Open incision, move the delt, cut the subscap, cut the capsule and sew everything back together tightly. Awesome. Tim said I was in for a completely different experience this time, and not in a good way. 

Tim feels awful. He put me as his last patient of the day so he could spend as much time talking to me as we needed. I kind of feel bad for him, although there's really no blame to place anywhere. It's just shitty luck. Tim and Drew already discussed the plan before I was even informed of the impending surgery, and it's going to be super slow and conservative the second time around. Scheduled for a week from tomorrow. 

Remember when I joked that this was too big of a recovery for two tiny scars and 45 minutes of Tim's time? I take it back. 

Wednesday

A1. Safety bar alternating forward lunges, 3 x 6-8 total; :10 rest
A2. Jumping switch lunge, 3 x 16 total; 2:00 rest
B1. Glute-ham sit-ups, 3 x 12; :10 rest
B2. Russian twists, 3 x 20; 2:00 rest
+
10:00 Assault Bike @ Z2
200m 1-arm Farmer’s walk, 53
10:00 Assault Bike @ Z2

A1. +110, +120, +130(6)

A2. complete 

B. complete 

+

complete with 55lb
54-55 RPMs throughout, a little over 9 cal/minute


After the ab piece, my hair fell out of my ponytail and as I was fixing it, my shoulder partially dislocated. Then it did it again. And again. It's exactly the same as it was before, except it hurts 100X worse.

Emailed Drew a heads up, but I see him first thing tomorrow morning. Texted Tim, his response was "crap, thanks for letting me know" and he said to have Drew call him after tomorrow's appointment, and he'll review my MRI with the radiologist in the morning. Which is great, except that it wasn't dislocating when I had the MRI two weeks ago.

FUCK. MY. LIFE. 

Tuesday - 13 weeks post-op

OFF

So, I got approximately 42 minutes of sleep last night - we've officially regressed to pre-cortisone, broken glass pain level. I had plenty of time to think (and google) in the middle of the night, and something Stephen said yesterday (as a joke) kind of struck a chord...

My OTHER shoulder is totally acting up. Feeling a little bit of the rotator cuff tightness and a little anterior achiness (but nothing sharp at all on the left side). Lots of popping and clicking on both sides (not new, but perhaps getting worse). This makes me think that the time spent resting and "letting things calm down" is actually making the underlying instability worse, on both shoulders (I've now been significantly reduced or completely off of strengthening exercises for 7 weeks, and things have just gotten worse and worse). Would it be a terrible idea to just try to add back in a bunch of strengthening exercises? If the surgical shoulder is this aggravated anyway, is there that much harm in trying for a couple of weeks? And if I just can't tolerate it, we are back to Tim anyway...

I shot Drew an email. I'm guessing we'll just talk about it at my appointment on Thursday, and I'm reluctant to text Tim before then...

Monday

AM @ MobilityFit

44:00 Assault bike

+

passive ROM, emphasis on internal rotation

+

trigger point work with a ball

+

isometric lower trap holds

PM

A. Safety bar squat, 5-5-5+ @ 185-200-210; 3:00 rest
B. L-arm KB/DB shrug, 3 x 6-8, 20X2; :90 rest
C1. Glute-ham raises, 3 x 10 unweighted; :10 rest
C2. Hip extensions, 3 x 15 unweighted; :10 rest
C3. Sorensen hold, 3 x :30; 2:00 rest
+
3 sets:
:45 Assault Bike @ highest possible effort that's sustainable within & across all 3 sets, reign it in a bit from last week
5:15 Assault Bike spin

A. 6 @ 210

B. 35, 53, 70(6)

C. complete 

+

complete, 74 RPMs across


Squats felt fucking heavy. This annoys me.

Shrugs were weird. 

GHD stuff was fine; Sorensen holds got tough, but no issues.

Felt pukey and lightheaded after the 3rd bike sprint, but didn't drop off at all, so mission accomplished.

Shoulder feels pretty terrible again. I noticed it a little bit yesterday, but I tried to ignore it.  Slept like shit last night and woke up every hour when I rolled over, and sure, enough, this morning the effect of the cortisone was almost completely worn off. It's not quite as bad as it was before the cortisone, but I'm getting the broken glass feeling in the anterior capsule with any external rotation, and the muscles are still completely seized up (teres minor is the worst, but it's pretty much everything), which is just uncomfortable but not painful. Drew thought maybe the microtrauma of dry needling was a factor, so we skipped it today, but it really feels like it needs it. Skyped with Mike today and he suggested that the muscles are having to work overtime to stabilize an unstable joint, which makes sense. It definitely feels like they're guarding the shoulder.

On the plus side, internal rotation is really coming along. I may be able to fasten a normal bra behind my back at some point soon. 

Drew, Mike and Stephen all suggested that I text Tim. FML. I just don't know what he'd say that he didn't say last week. Mike said that the cortisone is also diagnostic information for him, though, and he needs to know that it's not working as intended. I'll hold off until I see how much worse it gets over the next few days...

Sunday

70:00 hike @ Cincinnati Nature Center with Chels

Saturday

A. Safety bar good morning, 15-12-9, 20X0; 2:00 rest
+
Not for time:
800m sled drag, add load from last week
+
15:00 Assault Bike easy

A. +50, +70, +80

+

complete with 95, from waist 

+

complete 

WHY IS THAT SLED SO HEAVY. 

Friday

AM @ MobilityFit
22:00 Assault bike
+
dry needling (less death)
+
2 sets:
crossover symmetry, rows, As, subscap, pec minor 
banded tricep pull-downs
isometric lower trap hold
isometric subscap hold

PM
A. Safety bar squat, 10 x 3 @ 70 bar + chains, 10X1; begin a set every :60
B1. Seated L-arm DB shoulder press, 3 x 6-8, 21X1; :60 rest
B2. Bent-over L-arm DB row, 3 x 6-8, 20X1; :60 rest
+
For time @ 90% effort:
50 air squats
50 arm-less Assault Bike calories
50 air squats
+
3 sets:
20/side light lying 1-leg banded curls
20/side light seated banded leg extensions
:30 hollow rock

A. complete 

B1. 25, 30(7), 30(6)

B2. 25, 30, 40

+

7:02

+

complete with purple band

Tested out some stuff very, very gingerly at MobilityFit. The broken glass pain is gone, but the anterior capsule still feels "off" and all the muscles are angry.  Drew dry needled literally everything, a couple of rough spots but overall much, much better than Wednesday. The plan for the time being is to keep scaps activated and engaged, strengthen internal rotators to improve stability, and not piss off the joint. Everything else is on hold for the time being. 

Shoulder actually complained a LOT on the squats. I almost called it two sets in, but then kept talking myself into "just one more minute." It's been a couple of hours and it calmed down, so that's encouraging. Weight felt fucking heavy after the week off. To be honest, that's why I didn't quit - I can't lose the squatting progress on top of everything else. 

Felt super weird to only do the dumbbell stuff on one side.

Hit pretty much exactly where I thought I would on the for time piece. First 50 squats were super fast with no pauses. Biked at ~58 RPMs, a little over 10 cal/minute. I didn't realize how helpful arms were on the bike. Second round of squats was so hard, my quads were completely toasted. Paused a few times but still pretty fast. Yuck. 

The banded stuff really sucked today. Maybe purple isn't "light," or maybe it was the squat/bike thing. Either way, tough. 

Trying to get my head right for a long road ahead with the shoulder. I just thought the hard part would have been over by now. Drew admitted that the next few months are going to be long, slow, and frustrating, and even after months of therapy I may still have problems with it. It's hard to accept. 

Thursday

OFF

Back down to manageable discomfort, almost entirely muscular. It's like all 17 shoulder muscles seized up to protect the joint. Anterior capsule is just a little angry, but nothing like yesterday. 

Frustration level is at an all-time high. 

Wednesday

AM @ MobilityFit

25:00 Assault bike 

+

passive ROM

+

dry needling of death

PM

40:00 Assault Bike @ Z1/2, off every 10:00 for 10 glute-ham sit-ups + 20 Russian twists (each change of direction) + 30m unweighted walking lunge

complete 

It's been 2 days and the plan of "let's not piss off Heather's shoulder" has already failed. At least I got one decent night's sleep. 

Walked in to MobilityFit feeling pretty good, a little achy but no sharp pain - aka, better than I've felt in over a month. I knew a lot of the muscles, rotator cuff especially, needed a good dry needling, but instead of relaxing after the needling, everything seized up so much worse. Drew tried using electric stim with the needles (first time) and that made things even worse. We had to stop half way through because I was so uncomfortable, and I had to chill out there for like 30 minutes until I felt okay enough to drive. He didn't even touch anything anterior, but the anterior capsule is super pissed off just from laying prone (this has always been a problem but today was worse than usual). No broken glass feeling, but super, super uncomfortable. 

This is getting really, really old. 

Back on max dose ibuprofen, Tylenol and ice. 

Tuesday - 12 weeks post-op

Probably going to Assault bike later... felt super groggy and almost still high from yesterday... 

Holy shit. Cortisone is legitimate magic.

Yesterday was miserable. Once the lidocaine wore off, I was in a ridiculous amount of pain. Took 3 vicodin and iced pretty much constantly for 12 hours, knocked myself out with a double-dose of NyQuil, and woke up 95% pain free. I forgot what that felt like. I'm trying not to mess with it (because I know Drew will tomorrow), but I'm getting zero sharp, broken glass pain even if I try to externally rotate. I'm still shocked that inflammation can cause that much pain. It still feels like there's extra fluid in the joint from the injection, but that's nothing.

Okay, shoulder. I'm very sorry for (repeatedly) pissing you off. Please behave from now on? Please?

Monday

A. Safety bar squat, 5-5-5+ @ 185-200-210; 3:00 rest
B1. Glute-ham raises, 3 x 10 unweighted; :10 rest
B2. Hip extensions, 3 x 15 unweighted; :10 rest
B3. Sorensen hold, 3 x :30; 2:00 rest
+
3 sets:
:45 Assault Bike @ highest possible effort that's sustainable within & across all 3 sets, reign it in a bit from last week
5:15 Assault Bike spin

Skipped.

Sad to miss my favorite training day. 

Saw Tim this morning. Saw for myself that the labrum is firmly reattached. I have adhesive capsulitis, which is pretty striking on the MRI. Got a cortisone shot. He mixed it with lidocaine to make sure it was in the right spot (it was). He asked if I had to go back to the lab today, and I said no, and he said that was the right answer, and to just hang out on the couch the rest of the day. Done and done. This ain't my first rodeo. It's really uncomfortable in a different way, but the sharp, broken glass feeling is dulled, so I'll take it. 

Consensus seems to be that I just pissed off my shoulder at PT and it locked down. I've been instructed not to piss it off again. I guess this is what I get for trying to beat Gerald Sasser. 

Sunday

58:00 hike @ Long Branch Farm

Pretty flat, but extra quiet and beautiful. 

Saturday

A. Safety bar good morning, 15-15-15, 20X0; 2:00 rest
+
Not for time:
800m light sled drag, add load from last week
+
10:00 Assault Bike easy

A. +30, +50, +50

+

complete with 90 on the sled, from waist

+

complete 


Damn, that sled felt heavy.

Friday

AM @ MobilityFit
15:00 Assault bike
+
passive ROM
lower trap isometric holds

PM

A. Safety bar squat, 8 x 3 @ 70 bar + chains, 10X1; begin a set every :60
+
For time:
1 mile Assault Bike
200m 1-arm Farmer's walk, moderate/tough
1 mile Assault Bike
100m walking lunges
+
3 sets:
15/side light lying 1-leg banded curls
15/side light seated banded leg extensions
:30 hollow rock

A. complete

+

12:06 with 53lb 

+

complete with purple band


Drew was visibly relieved to hear that there is no tear and the anchors are solid. He thinks that the volume of rehab I was doing early on just surpassed my threshold and set off this cycle of inflammation. He said it was really deceiving because I had great ROM from day 1, and since there was no tendon involvement, I had maintained strength from day 1, so without acute structural limitations we just exceeded the tolerance of the joint.

The plan moving forward is to back off for several weeks and let the cortisone work its magic. I'm back to post-op week 1 protocol, completely starting from zero. He (and Mattie) spent the whole hour working end-range ROM today, which brought me to tears because it was so, so painful. I almost threw up at one point. I can't believe this is "inflammation."

Training was tough this afternoon - I've never felt so rough. Sleep is worse than ever (like, lucky to get a broken 3-4 hours). I have no appetite. I'm in a lot of pain. I'm frustrated and anxious, and I can't see the light at the end of the tunnel. I'm aware of how depressing this sounds.  

Squats felt heavy, but better than last week.

For time piece was tough. Couldn't pick up the pace on the bike at all (57 RPMs on the first mile, 59 RPMs on the second mile). Broke the FW 100/50/50, and chose moderate instead of tough. Lunges were hard, you'd think that I'd start to get used to these by now, but my legs were toast.

Aaaaaand... just washed down some vicodin with 2 glasses of wine. I'm getting desperate.

Thursday

OFF

MRI this morning.

They said it would take 48 hours to get the results, and so my appointment with Tim was set for Monday morning, but I finally bit the bullet and texted Tim today. I'm not sure how much of the story Drew has relayed, and I thought it important that Tim know how much pain I've been in. Tim called me this afternoon and said "well, I have good news and bad news. The good news is, nothing's torn, and the anchors look solid. The bad news is, nothing's torn and the anchors look solid." I have an insane amount of inflammation, rotator cuff tendonitis (which I had in the initial MRI in February), and capsulitis, all of which Tim tried to play off as being from PT. I explained that I've done almost zero PT or upper body exercise in 2-3 weeks, and he seemed stumped. He suggested a cortisone shot on Monday to control the pain and inflammation and allow me to continue strengthening at PT and we'll revisit in a couple of weeks. I'm very much looking forward to some relief, although it makes me nervous that we may just be masking a bigger problem...

Anxious to get Drew's take on this tomorrow morning.

Also, I'm really, REALLY confused as to how I have so much inflammation considering I've been taking 2400mg of ibuprofen daily for 3 months...

Wednesday

A. Safety bar alternating forward lunges, 3 x 10-12 total; 2:00 rest
B. Weighted hip extensions, 3 x 10, 20X2; :90 rest
C1. Glute-ham sit-ups, 4 x 10; :10 rest
C2. Sit-ups w/feet anchored, 4 x 20; 2:00 rest
+
30:00 Assault Bike @ same pace as last week

A. +110, +120(10), +120(10)

B. 30, 35, 35

C. complete 

+

240 calories, 51 RPMs


Had zero energy coming into this today... sleep is pretty much nonexistent right now, and I'm so uncomfortable that I'm kind of nauseated, so food has been totally off for the past few days, too.

Lunges were tough.

Hip extensions were okay, not confident I would have gotten all 10 if I bumped up for the last set.

Had to pause on the 20 sit-ups on sets 3 and 4.

Assault bike was fine. 

Tuesday - 11 weeks post-op

AM
20:00 AirDyne

PM
42:00 hike @ Cincinnati Nature Center

Monday

AM @ MobilityFit
30:00 Assault bike
+
dry needling of death
+
3 sets:
isometric subscap hold, 10 x 0:30
earthquake bar

PM

A. Safety bar squat, 5-5-5 (no extra reps) @ 145-155-165; 3:00 rest
B1. Glute-ham raises, 3 x 5 weighted; :10 rest
B2. Hip extensions, 3 x 10 weighted; :10 rest
B3. Sorensen hold, 3 x :30; 2:00 rest
+
3 sets:
:40 Assault Bike @ highest possible effort that's sustainable within & across all 3 sets... goal is very little, if any, drop-off
4:50 Assault Bike spin

A. complete, fast and easy 

B. +25, +30, +30

+

complete


Deload week on the squats is silly. Super easy.

Low back continues to get blown up on this combo. +30 is probably a 5RM glute-ham raise... 

Dropped off a lot on the 3rd set - held 76-78 RPMs on the first two, fell to 70 in the last 0:10 of the 3rd one. Sorry... 

Shoulder is being a complete dick. I'm in a ridiculous amount of pain (like, 8/10, takes your breath away with any sudden movement), and Drew told me today that there's really nothing he can do for me, and he doesn't see a scenario in which I don't need additional surgery. MRI on Thursday, appointment with Tim on Monday. I'm kind of hoping for surgery as soon as possible, because it's seriously terrible. Other than the first couple of days post-op, this is by far the most pain I've had, and it's getting worse day by day. Drew also said that rehab the second time around is going to be very different, like in the sling for the full 4 weeks. Balls.

Sunday

1:12:00 hike @ Cincinnati Nature Center (Wildflower + Fernwood)