New Years in Florence

We were in Florence for New Years

Sienna - Beautiful old town

Beyond words!

Christmas in Rome

Spent Xmas in Rome with Ann and her family.
We stayed at an apartment just off the square with the Pantheon.

European Holiday

Since I am unemployed, my sister Ann invited me to join in with her family on their Christmas vacation to Italy.  I had been trying to think of a place to travel to during my unemployment and I  have never been to Italy, so this was a opportunity that I could not pass up.

While over there, I decided to add on a couple of side trips.  One trip to visit a good friend who lives in England and another quick trip to Amsterdam just to see the sights.

Unemployed - first time in 31 years

This is the first time since I started working in 1980 that I have been gainfully unemployed.
Dell has been slowly eliminating the old guard of the former Perot Systems and it was my turn.
Truth be told, I was ready to go and have been waiting for this for some time.  The good news is that I got a fairly nice severance package.  The bad news is that it wasn't quite as nice a package as Perot used to offer in the past.  Nonetheless, it was not too shabby - it came to about 70% of my annual salary.
So now its time to enjoy some time off and eventually start looking for another job.

Bucket List - Palau

World wonders

Boris has a seizure in Arkansas

On a climbing trip to horseshoe canyon ranch.
It was a wet day, so we went on a long hike instead.  Boris was seemingly normal all day during the hike.  When we got back to the barn, he was running through the yard when he suddenly has another seizure.

Post Shoulder Surgery - Climbing again

Started climbing again today, just shy of 3.5 months after shoulder surgery.
I had been spending the previous weeks working on strenght in the regular gym, so I was feeling good.
It all went very well, I started easy (5.8), but quickly worked up to some 5.10s.

At the end, I was feeling a little tired and slightly sore, but its all good!

Unemployment Advance Notice

Today I got a courtesy call from my manager at work.  It was something that I was sort of expecting at some point in the future, but it was a good sort of call.
It looks like I will most likely get that long awaited severance package within the next 4 - 6 weeks.  Within my current group, they are shipping all of our jobs to India. My manager was really considerate and gave me unofficial advanced notice.  He was not supposed to tell me, but he found it coldhearted of upper management to not provide advanced warning.  Usually, they only tell you 3 days before it happens.   I will most likely also get a 3-day notice (or less) when the actual time comes, but at least I have an idea that it is coming soon. 

I am ready to leave, so I am looking at it as a good thing.   I am still apprehensive about not having a job, but change is good.

Back in the Saddle Again

Started mountain biking again, just short of 3.5 months since surgery.  Its been almost 4 months since I have ridden outside.
I decided to go straight for the trails instead of roads.  I rode 2 laps at Oakcliff Nature Preserve, about 13 miles total.  I felt great and had no problems, other than minor pain felt within the shoulder capsule (as expected).

Shoulder Surgery Recovery - 3 months

Had a 3-month checkup today and the Dr said that I am cleared to start ramping up on my activities again, with the caution that I should work my way back slowly.
He said that he did not recommend climbing right away, but wirking on strength before doing so.  He said that I would know when I am ready!

Cat Fight???

Igor invited Stanley over for a sleepover...
Stanley is Dianna's new kitten, about the same age as Igor.
First Meeting

Then Playtime

Brotherly Love

Boris and Igor....

Boris has a new Chew Toy

Funny....

Shoulder Surgery - 9 weeks - Light weight training

The recovery process and therapy has been going well.  So well, that I decided to try light weight lifting.  My physical therapist said that as long as I was careful and used pain as my guide, I should be good to gradually begin light weight training.  I tried several exercises today and they went well - no pain.  Some of the exercises:
arm curls - 17.5 lbs per arm
machine rows - 45 lbs total
dumbbell presses - 17.5 lbs per arm
lat pulldowns - 40 lbs total

Being careful not to do any exercises that directly work rotator cuff muscles, except for the pectorals (those needed to be worked).

So far, so good!  We will see how I feel tomorrow.

Caratact Next Step - YAG Capsulotomy

A video
Yag Capsulotomy You Tube Video

Shoulder Surgery - 2 months

Did a 5-mile trail run today and it felt pretty good.  The shoulder seems to be able to take the pounding and arm swinging without pain.

Physical therapy is going well.  Went yesterday and we are beginning to slowly increase the strength building exercises.

My range of motion is really great for flexion (lifting forward) is now 172 degrees.  Only 8 degrees left, although these will be the hardest to get through.   

Cataract Surgery - 1 Month Follow-Up

It's been about 7 weeks since the first and just over a month since the second.  This was a general checkup to see how both are doing.

From my perspective, the distance vision has been excellent, but the near vision hasn't made much (if any) improvement.  My mid vision (computer)  is mediocre, but wearing glasses is easier on my eyes.  I am supposed to do as much reading as possible without glasses (to force my eyes to try to focus), but that get annoying after a while.

Lately, while reading, I have noticed that there is some bluriness that seems to be in different areas.  I am guessing that this is due to "posterior capsule opacification" - clouding of the back side of the lens capsule.  This is a condition that is always anticipated after cataract surgery.

The eye doctor said that on my next visit, in a month, he will use a laser to remove part of the posterior capsule and this should clear that up.

http://www.webmd.com/eye-health/cataracts/ndyag-laser-posterior-capsulotomy-for-cataracts

http://www.avclinic.com/yag_capsulotomy.htm

Shoulder Surgery - 6 week checkup

Went for a checkup today and got permission to stop using the sling to protect my shoulder.
Additionally, the Doc cleared me to start light AROM (Active Range of Motion) exercises.  This means that now I can actually start to use the shoulder muscle to perform movement.  The catch is that I should start with no more that 1 lb of weight - about the weight of a bottle of water.
Making progress!

Shouder Surgery - Physical Therapy

Went to my 5th session of physical therapy today.  So far things seem to be progressing well.
I've got significantly more mobility in the shoulder after 5 sessions.

Introducing... Igor

Here we go again... another cat.  Actually, a kitty!

This is Igor:


As was the case with Natasha last year, he was found in a park and bestowed upon me by my friend Dianna.  Lets hope he lasts longer than Natasha did.

Cataract Surgery #2 - 1 week checkup

So far, it seems to be healing well.  Not too different from the first.  No pain to speak of, but I am seeing the optical distortions around the periphery of my vision.
The optician that checked my eyes said they were both still at 20-20. 
Everything looks light and bright.  Whites are so white.
Now I just have to be patient to see whether the "accommodating" feature of the lenses will work for me.  So far, I still need reading glasses to read small print (including iPhone), but the Dr said that could take several months to adapt to that.

Boris has another seizure

Its been just over 6 months since the original onset of the seizures and all had been going well... until now.  I recently decided to try reducing the meds a little more - from 1.5 pills twice a day to 1 pill twice a day.  This was a little over a week ago.  This evening, Boris had another seizure.
We were returning from visiting with friends and I had just pulled into the garage.  Boris was in the back seat, as usual looking out the passenger-side window.  However, once I stopped the car, he did not turn around to get out - he just sat there, turned his head to look at me, then went into a seizure.  Fortunately, this one was rather brief, lasting not much more than 20-30 seconds.
So I re-upped the meds back to the 1.5 twice a day.
In hindsight, I am wondering whether I actually gave him the morning dosage.  I do not clearly recall and I had stopped with my daily record keeping.  I have gotten back to a more rigorous routine now.

Shoulder surgery #2 - 1 month

Its been one month since the surgery and everything has gone very well.  Hardly any pain during most of the 1 month period and I have been sleeping well for the most part.  There have been occasional nights when I had a little discomfort or restlessness, but that was very rare.

I am now cleared for the first phase of PT (have been for a week), but I have had to be conservative due to cataract surgery last Wednesday.  Now that I am beyond the 5-day post-surgery caution (for cataract surgery), I am ready to begin bi-weekly PT sessions, home PT, and more regular gym visits.

For now, gym workouts consist of recumbent cycle and abdominals.  But I will probably also start leg workouts this week as well.

Its also starting to get realy hot in the afternoons, so I am not too sad about my reduced level of activity.  I just keep thinking about being back to full strength by fall!

Cataract Surgery #2

Three weeks after the first, getting the second one done.
Since there was a lot of srcatchiness and wateriness in the eye after the first surgery, I decided to try a "block" in the second eye.  In this approach, they inject a local anesthetic that deadens the area all around the eye, preventing the eye muscles from moving the eyeball.  Then I would go home with a patch on the eye and wear it until the next day.  This "should" make the initial 24 hours more comfortable.
The surgerystarted early inthe day and went about the same as the other, but I was a lot more relaxed since I had less feeling than the last time.  At my request, he explained each step as he went through the process.  Due to the mild dose of Versed in my drip, I have spotty recollection of the whole process.
Immediately afterwards, I was a lot more comfortable since my eye was still numb and I had the patch on.  However, after a few hours, the numbness wore of gradually and the patch proved to be somewhat of a nuisance.  My eye was opening and moving under the patch.  It wasn't painful at all, just aggravating.   But I stuck it out until the next day.
The checkup on the next morning went well - so far it was looking good!

Shoulder Surgery #2 - Starting PT

Today I started physical therapy.  It wasn't much, mostly an interview, some range of motion tests, and a few simple passive motions.  But its a start!

Unfortunately, my PT will be on hiatus for the next 5 days due to Cataract surgery #2.  After the surgery, there is no strenuous activity for 5 days.

Shoulder surgery #2 - 3 weeks

I went for a 3-week checkup today.  All the doc could do was to twist and tug my arm a little to test my range of motion and ask how I felt.  He said that my range of motion was beter than most others at this point in the healing period and he cleared me to begin physical therapy.

For the initial therapy, it will be simply passive range of motion and assisted active range of motion.  This is described in a post for a few years ago: Post from Shoulder Surgery 1

I will do this for three weeks, then return for another checkup and assessment for the next steps.

Cataract Surgery - Appreciating clearer vision

For the last few days, I have been comparing sight between my left (corrected) and right (cataract) eyes.   Its all still pretty amazing to me.
Looking through the left, whites seem whiter and colors seem more vivid and crisp.  Its like the comparison between analog and HD TV - better picture.  The interesting part is, you don't really realize it until you have the first eye done. 
When I look through the right (cataract) eye, everything looks filtered and takes on a faint yellowish hue - kind of like a bad TV picture.  On top of that, the right eye is blurry again due to the constantly progressing cataract.
A few nights ago, I was watching a TV show with doctors and noticed that the color of their white jackets changed as I brought my hand up to scratch my nose.  When I brought my hand up on the right side, my left eye took dominance and the jackets looked pure white.  When my hand was on the left side, the right eye took dominance and the jackets looked yellowish.  When I removed my hand from line of sight, the jackets looked only slightly yellowish, the overlaying of the 2 images within the brain.  It was pretty amazing how my brain blended the 2 different views into a single image.

So, these remaining few days, I am appreciating the difference that the new lenses make, since after Wednesday I will no longer be able to make the comparison.  And whites will be truly white!

Cataract Surgery 1 - 2 weeks

Had a checkup today - both a post-op and a pre-op.  The post op was to check the progress of the healing of the first lens replacement.  The pre-op was to use the results of the post-op to determine how to proceed with the second surgery. 
In a quick refraction test, my distance vision in the left (corrected eye) is 20-20 and my reading vision is the equivalent of 20-40 (not clear on that since I thought the 20-20 was a distance measurement).  But, this mans that the calculations made for the left eye were pretty spot on.  He did warn that, over time, this could (and might) change.  For the near vision, it could take many months for my eye/brain to learn to make use of the accommodating lens for near vision.
His current thinking is that, for the right eye, we shold go with a little less strength in the distance correction in order to give a little more preference to mid/near vision.  Its not a whole lot of difference, but it would allow the right eye a little better accommodation to mid vision while the left would better serve my for distance.  And the brain would work it all out.  Fascinating!
We also discussed the possibility of using a nerve block on my eye for the second surgery.  This would essentially numb my entire eye and all the muscles around my eye , using lidocaine and something else.  I would have to wear a patch for the day and it would eliminate all the discomfort that I felt the entire first day.  The downside - I would not get the instant gratification of seeing out of that eye until later in the day.  Still thinking about whether I want to do that.

Cataract Surgery - a video

Here is a video of how the procedure is performed.

You Tube video of Cataract Surgery

Its only appropriate (for me) that he uses a peanut M&M analogy!

Cataract Surgery - 10 days

I seem to be adapting to the lens better everyday.  My distance vision seems pretty good, better than the other eye.  But I still need glasses for reading small print, as expected for this soon after surgery. 
Patience!
Most of the optical distortions are gradually subsiding - not sure whether I am adapting to them or they are going away.  However, I still see one strange thing when I am in stores with overhead flourescent lighting -  I see really annoyingoptical distortions in the periphery of my field of vision.  Its like a thin band of flickering light.  I am hoping this will also go away soon.

Shoulder Surgery 2 - 2 weeks

Made it to the 2-week mark with very little pain or hardship.  Yesterday, I was starting to feel some achiness in my shoulder and at the base of my neck, but I suspect that is from hunching to protect my shoulder/arm when not wearing the sling.  I am thinking about getting a chair massage to work on that area for a little relief.
Otherwise, its going well.  Still just got to be patient for another week - my 3- week checkup.

Shoulder Surgery 2 - 10 Days

Another day in the sling and with limited use of my arm...  blah, blah, blah..... its going to be a long few weeks until rehab begins.
I am beginning to feel assorted dull pains in the muscles asounr the shoulder above the point of the surgery.  I am assuming this is partly due to mucsle atrophy, partly due to trying to protect the shoulder by keeping my upper arm locked into my side when using my lower arm.  Regardless, this brings back memories of when I went through this with my right shoulder.
So it seems that I am on track toward recovery.
Nonetheless, its silll going to be a LONG summer of recovery.  But I will make up for that this fall!

Cataract Surgery - 1 week

A very good day, indeed!  
Went for a second post-op checkup and the Dr said that things were looking really good.  The lens placement looked good, the swelling was subsiding well, and overall things were looking good.  My vision was testing well also.  He seemed to be visibly enthusiastic about the progress. 
I mentioned that I am seeing some optical distortion in the periphery of my vision, and he pointed out that my eyes were still a little dialated, which could cause that since I might be catching some images outside of the lens itself.
He suggested that this weekend I start trying to read without reading glasses (up until now I was reading ONLY with glasses so that my eyes did not try to adjust using hte muscles).  This should start "exercising" the eye muscles that work to focus our natural lens, and now my artificial lens.

At home, I have been doing left/right eye-to-eye comparisons using some simple tests and, so far, the new lens is already providing better vision than the unrepaired eye.  I can see distance better and colors seem more vivid with the new lens.

This evening, I did another night vision test using a street lamp a few doors down.  Right after the surgery, I was seeing strange-shaped rings and halos and starbursts.  But tonight, the strang rings were gone, and the halos were significantly reduced, even less than in the right eye (still with cataract).  And the starbursts were almost gone.  It appears that the healing is making great progress.

Its all looking really promising.  Looking forward to reading this weekend to see how that goes....

Cataract Surgery - Day 5

Its been 5 days now and the healing process has been slower than I expected.  Every day, the optical distortions around the peripherl seem a little less, but its really difficult to tell.  In general, I can see well through the eye, but my combined vision through both eyes still seems strange and not balanced.  Its difficult to describe.
My near vision is pretty poor and is really a strain on my eyes.  I have to wear reading glasses for both reading and computer work.  I have tried several strengths, from 1.0 to 1.25 to 2.0, and nothing seems quite right. There always seems to be some kind of distortion, and not only in the repaired eye.
But I try to continue to be patient, since the Dr said it will take time to heal.

Shoulder Surgery 2 - 1 week

Its been one week and all seems to be going well.  I have not experienced any pain except for a little bit upon waking one morning.  Other than that, its been a pretty smooth post-surgical recovery.  I am only wearing the sling when I leave the house and when I sleep.
I have not exercised in over a week and I am now getting kind of twitchy to burn off some energy.  But, due to the cataract surgery, I must avoid strenuous activity for 5 days after the procedure.
So I will wait until sometime next week to start - even then, all I can really do it a recumbent cycle at the gym.  But at least that is something!

Cataract Surgery Day 2

I awoke to a little less pain, but still the same optical distortion, although its a little less obvious during daylight.
I went to the opthalmologist for a post op checkup.   He said that the lens appeared to be seated well, but I was still showing signs of inflamation and edema (swelling due to trapped fluid).  He said the eye pressure was a little higher than normal, but thats to be expected due to the trauma of the surgery.
He also said that the optical distortions (ghosting, halos) were common, due to the inflammation and edema.  These should subside after several days.
I am putting 3 types of drops into my eyes four times a day:  1) a steriod, 2) a NSAID, and 3) an antibiotic.  I will continue these for another 2 days to aid in the healing process.
In the meantime, I must be patient and follow the healing instructions - no strenuous activities for 5 days and no bending my head below my heart for 2 days.
The pain is pretty much gone, so not I just need to take it easy and wait.
Patience!
I am still a little concerned, but trying to be optimistic - cautiously optimistic!
The power of positive thinking!

My Bionic Eye - Cataract Surgery 1

Today was the day for the BIG LEAP - lens replacement surgery to replace a cataract lens in my left eye.  This is by far the scariest surgery I have experienced, since my eyesight is at stake!
I arrived at the surgery center at 8 and was informed that the doctor was ahead of schedule and was waiting for me.  Imagine that, a doctor waiting for a patient.  There was no waiting for me - I was expedited through the paperwork while a nurse put drops into my eyes and then whisked into pre-op.  The doctor met me there for a brief final discussion on which lens I would choose.  He recapped what we discussed previously about Crystalens and I confirmed that I would stay with my original decision for Crystalens.  After donning the surgical garb and getting poked and prodded a bit, I was wheeled into the the operating room.
For anesthesia, I was given lidocaine in the eye and a mild drip of versed, not enough to knock me out, but just to calm me down.  I really could not tell whether it was working, but I guess it did.

The surgery began by them taping over my eye to keep it still, then I was instructed to stare at the overhead light.  Once he started working on my eye, my sight and memory became a bit blurry.  I recall the sensation of pressure and motion on and around my eye and I kept staring at the lights, which had turned into to marshmallow-looking shapes on a black background that kept moving around - all sort of abstract.  Then he said something about inserting the lens and the shapes changed.  I could see something moving across my field vision - it looked sort of clear, but fuzzy.  Then it was all over.

In recovery, my left eye was feeling scratchy and watering a lot.  When I opened it, everything was pretty blurry, but colors seemed much brighter and vibrant that what I could see with my right eye.

I was on my way home by 10am.  On the way home, we stopped at the opthalmologist's office to get a contact lens for my right eye, so that my vision would be balanced when I drove back to the office tomorrow for my post-op visit.

The rest of the day I spent at home, resting.  My eye felt scratchy most of the afternoon and watered a lot, even through the evening.  The vision quality in the left eye is still quite blurry.  I can see well for distance vision, but there is a double image or ghosting effect that makes everything blurry.  This is one of the many possible side effects to the surgery that "should" go away over time.  I certainly hope so, because it is very annoying.

When I went outside at night, I noticed that the halos around streetlights and headlamps are different now.  Instead of a consistent halo/starburst circle around lights, I am now seeing irregular shapes (like a badly drawn circle) around the lights - I am guessing this is another manifestation of ghosting.

Its very disconcerting now, but I am trying to stay positive that this will all go away after a good nights rest to help me recover from the trauma of the surgery.

Shoulder surgery 2, day 5

Another good night of sleep - on the recliner!   So far, it has been a suprisingly painless recovery process.  Granted, I am taking some pain meds, but last night I only took 1 hydrocodone and 2 Motrin PM.
I do feel a little stiff and achy when I wake up, but there is not any pain when my arm is in a rested position in the sling.
However, I do feel the stiffness and some minor pain when I do my one shoulder exercise, the pendulum.  But I expect that.

Shoulder surgery 2, day 4

Last night was yet another night of great sleep.  This time I dialed down the meds - only 1 hydrocodone and 2 Motrin PM.  I was back to work today, from home, so that would require me to use a computer. Also, my angels are now gone, so I will have to do things for myself.
It was a slow day at work, which was good.
But by the end of the day, my shoulder was noticeably sore - the most sore its been since the surgery.
No doubt, due to the increased activity level and using my arm more, albeit very careful not to use the shoulder muscles.

Shoulder Surgery 2 - Post-Op Checkup

I went to the orthopedist for a checkup today, 3 days after the surgery.  He removed the stitches and explained what he had done during the surgery, showing me pictures taken during the process.
He told me it was OK to be moving my elbow to keep it from getting stiff and recommended that I start doing a simple shoulder exercise, called the "pendulum" exercise. 

Codman ("Pendulum") Exercises
These exercises are specifically designed to allow for motion of the shoulder but without any active muscle stimulation by the patient, Pendulum exercises are typically performed with the torso bent slightly forward, allowing the arm to hang away from the body. Movement of the upper body causes the arm to gently swing, much the same as a clock pendulum. The motions are usually circular, beginning with very small diameter rotations and gradually enlarging them.
Pendulum exercises help maintain joint lubrication and to lessen the risks for post-operative adhesion formation
http://www.livestrong.com/article/215329-pendulum-swing-exercises-for-rotator-cuffs/


Pictures taken during surgery

Shoulder surgery 2, day 3

Last night was another great night of sleep, though again aided by drugs - 2 hydrocodone, 2 Motrin PM and 1 flexeril (muscle relaxer).  I took the muscle relaxer because I noticed during the evening that my muscles were starting to get twitchy from lack of my usual physical activity. 
Another day of cooking, napping, and a couple of fun diversions.  And still no real pain in the shoulder.
I am certain that it helped a lot that I had 2 people helping me with anything that required 2 hands and flexibility.

Shoulder Surgery 2, day 2

I slept soundly last night, but then again, I had help from 2 hydrocodone and 2 motrin PM.
I felt pretty good that morning, actually, all day.  I never really felt any pain all day, just a little discomfort.

My Angels!

After the surgery, I was fortunate enough to have 2 good climbing friends come over to take care of me for the weekend.  Brigitte and Alx showed up after work on Friday and stayed with me for the better part of the weekend, taking occasional breaks to work out or run errands.  They cooked and filled my frig with food to last me over a week.  They drove me around, took me to a festival to see Brave Combo play, and even took me to get my first pedicure as a surprise.
It was great weekend (despite the surgery) and actually a lot of fun.  And there wasn't any rock climbing involved!
I could not ask for better friends.

Shoulder Surgery - Again!

Today was round 2 of shoulder surgery.  This time the left shoulder.
It was pretty much the same routine as last time.
Checked in to Baylor Hospital at Uptown at 8 am, in surgery by 10, out around noon.
This time I had a longer chat with the anesthesiologist about the anesthesia.  At first, he said he was not going to do a "block" on my arm, but I requested that it be done.  The "block" is basically the equivalent of an epidural for the arm.  They probe the shoulder to find the nerve using an electrode on a needle - when the hand twitches, they found the nerve.  Then they inject it with lidocaine.
After the surgery, my arm was almost completely numb except for some sensations in the fingers.  It lasted for around 15 hours.  I was still slightly numb when I went to sleep that night.

What a pane!

I am trying to get ready for surgery tomorrow, and I come home to this:

Luckily, its just the outer pane, but still needs to be addressed.

Beneficial Nematodes (Flea Eaters)

As one approach to addressing the flea problem, I have bought a container of "beneficial nematodes" from a local garden center.  I will apply these to the lawn in the hopes that they will help kill some of the flea larvae that are in the lawn.

Reimers: Last climbing and biking until Fall 2012

This weekend, I took a trip with Alx Eller and Jason Luster to Enchanted Roock State Park on Saturday and Reimers Ranch on Sunday.
This was my last chance for outdoor climbing and mountain biking before shoulder surgery on Friday.
It was an awesome weekend and it was great to get in one more very active weekend.

Flea Infestation

Boris has been scratching excessively lately.  So much that its been annoying.   Upon closer examination of his coat, I am seeing a lot of fleas.  A LOT of fleas.  I am picking them out like crazy.

Due to the warm winter, I think its going to be a bad flea year.

So I have a flea comb and I am bathing him more often. 

The other day, I picked out 15 fleas in one sitting and 5 mor the next morning.

Boris Phenobarb Reduction #2

Its been 5 months since the seizures and we have seen no more.
We had another bloodtest done and all the blood levels look good - both for the phenobarb and for the liver enzymes.  So the Dr has decided to go for another reduction in phenobarb.
We are now down to 24.3mg, which is 1.5 16.2 mg tablets.  This means cutting tablets in half which is no fun, but we are now down to HALF of the original dosage.
Keeping my fingers crossed that this all goes well.

Right Shoulder Progress Recap

Looked back through the blog to see how progress went o the right shoulder.
Just wondering what kind of timeline to expect for the left.

Dec 3	Day 0	Surgery -  Left wearing sling with bulky pillow to hold arm away from body. Start sleeping on easy chair in den.
Dec 9	1 Week	Stitches out.  Started home PT.  Doc says I don’t have to use the bulky pillow under the sling, but recommends wearing sling to remind me NOT to use the arm.
Jan 3	1 mnth	Doing home PT and stationary bike
Jan 6		Cleared for PT - PROM and AAROM
Jan 11		Started PT - painful, limited ROM
Jan 18	1.5 mnths	Started AROM
Feb 1	2 mnths	4th week of PT Strenght – can lift arm overhead without assistance!   YAY! As far as range of motion: Flexion (raise arm forward to overhead) - 176 degrees out of 180 Abduction (raising arm sideways to overhead) - 180 degrees Internal Rotation - 90 degrees (out of 90) External Rotation - 76 degrees (out of 90)
Feb 13	2+ mnths	Rehab Report - 75% ROM, but limited strength Last week I could not lift 2 lbs over my head - I could only manage a 1 lb weight. Today, I was able to lift a 5 lb weight over my head, slowly.
Feb 28		Rode Mtn bike on road – 32 miles
Mar 1		Climbed 5.7
Mar 3	3 mnths	Not bad during the day, but pain in the middle of the night wakes me up
Mar 9		climbed 5.9 at silos
Mar 12	3.5 mnths	85% mobility, pain in middle of night
Apr 3	4 mnths	Riding, lifting, climbing; less pain in middle of night
Apr 13		Climbed 5.10 at silos
May 3	5 mnths	Strength good, but not for hard activities
May 29	~ 6 mnths	Adventure race, 3rd place (short kayaking section)

Cancer Excision Surgery

The term sounds technical, but it simply means cutting out the chunk of skin surrounding the tumorous growth.  Ok, so its not all that simple, especially when its one's own arm.

Luckily, the growth was out in the middle of my forearm and not near any joints, bends, buldging veins, etc.  So the Dr had a nice open piece of real estate to work with. 
First, he marked off the area to cit with a pen - in the shape of a football with a few millimeters of clear skin on all sides of the growth.  He needed to get enough extra skin to ensure that all the basal cells are removed.  The removed skin will be biopsied along the edge to determine whether the basal cells extended that far out.   The football shape was to make the open area easy to suture.
Next was a few well-placed injections of lidocaine to numb the entire area, then he went to work.
And I got to watch - pretty fascinating to watch someone cutting into your own flesh and not feel a thing!
Using a small scalpel, he cut along the marked boundary and gradually deepened the cut to go through ALL layers of skin.  I asked him how he would know and he said it is when he sees fat.  Hmmm... OK!
After cleanly cutting the entire boundary, he then cut under the patch to separate it from the body.  After removing the patch, about the size of a quarter, he used a little electrical device that resembled a miniature arc-welder to cauterize the few bleeding veins.  Surprisingly, there was not nearly as much blood as I would have expected.
The next step was suturing.  First he put in one stitch directly across the center of the football area and pulled it tight to close the opening as much as possible.  This was done with an absorbable suture, probably catgut.  Then he switched to nylon sutures, putting in 4 alond the length of the incision to close the wound.  It was really interesting to watch the meticulous technique of putting in each stitch.  It was amazing to see how tough my skin was when the pulled on the sutures to tighten the knots.
All done!  Afterwards, he applied some kind of adhesive to my skin, then laid a small section of thick gauze directly on top of the stitches, then taped it down with a large piece of gauze-looking tape.  He did a second layer of the same.  He said with all the adhesive on there, it would not come off.  I kind of figure that it will really hurt when its time to pull it off.
He said to leave the bandage on for at least 5 days, then to return tothe office in 10 days to have the stitches removed.
I got to admit, it was a really cool experience, but I do NOT want to go through it again.
From now on, do NOT forget the sunscreen - EVER!

Shoulder #2 - Your time has come!

I got a call from my orthopedic doctor today.  He was calling with the results of an MRI I had on Monday.  My left shoulder (the "good" one) had been bothering me more than usual in the last few months, so I had it checked out.  As we did witht he right shoulder, he gave me a cortisone injection with the hope that it was just inflammation, but when that didn't help, he suggested an MRI.

The results of the MRI - "partial thickness tear" of the supraspinatus tendon.  They radiologist estimates that it is 50% torn.  The general guideline is that when a tear reaches 50%, then it is time for surgery to repair it.

So I guess its time to get it done!

Here are some links that better explain it...
http://www.shoulderdoc.co.uk/article.asp?article=1368

http://www.shoulderdoc.co.uk/article.asp?article=1251&section=22

cancer, with a little c

I got a call from my dermatologist today.  I had gone in a few days ago to get an examination of a small bump that had been on my arm for a few years.  It had just recently become irritated and tender to the touch.  They had taken a biopsy and were calling with the results.

As it turns out, this bump is a basal cell carcinoma, aka cancer.  The good news is that this type of cancer rarely metastasizes (spreads), but usually just destroys surrounding tissue.  He said I would need to have a small surgical procedure to remove it.

Cataract Surgery Pre-Op

I had my cataract surgery pre-op today.  This is where they put me in front of a half dozen various eye measuring devices in order to get all the information to properly plan the surgery.

This is also where we discussed the options for the IOL (intra-ocular lens).  The options are:
1)  a monofocal - the traditional lens, what mom and dad have
2) a multi-focal - the light is split into multiple images to help with near, mid, and far vision
3) an accommodating lens - the lens flexes as the eye muscles try to focus, this mimics the natural lens

Of course, each has advantages and disadvantages.  The accommodating sounds the most promising, but is also the most risky.

Tough decision. VERY TOUGH!  This is my eyesight!

What? Cataracts?

So I have cataracts!  At just over 50! 
Most people get them in their late 60s and 70s, but I am one of the lucky ones to get them earlier.
About 2 years ago, I started noticing that my night vision was getting worse.  So I went back to my opthalmologist, who informed me that I had the start of cataracts.  He told me that the type of cataracts that I had were the kind that affect people even in their 20's and 30's.  He also warned me that this type of cataract usually progresses fairly quickly.
Well, he was right!  For the past 2 years, I have been having to get new glasses every 3-6 months.
Finally, on my last visit in February, he told me that I was now "medically qualified" for cataract surgery, which means that now my health insurance will pay for it!
So now I am looking at having the procedure done in April

Boris Phenobarb Reduction #1

Its been 2 months and no seizures.
The Dr has decided to reduce the phenobarb level by 1/3.  This means 1 pill twice a day instead of 1.5 pills.
Will be nice to NOT have to cut pills in half.