Thursday, September 25, 2014

There is Light!

This tunnel of mine started five and a half months ago on April 6th as a result of my first bike crash in 30 years of triathlon cycling. Please know that I am not complaining, my lot in life is relatively easy and I recognize that I am blessed beyond belief (some might say, this a first world problem), I get that.

I am now nine days post surgery #3 that occurred up at the Mayo Clinic in MN.  To say I am giddy about the result is a huge understatement!  I have been constantly moving my left elbow 24 hours a day for these past nine days.  That, after five+ months of it being stuck in one place at a 70 degree angle (okay, I did have a whopping 5 to 10 degrees of motion).  The medical term is ankylosis (a completely contractured joint), which resulted from the heterotropic ossification (or HO, an unwelcomed chunk of unattached bone) that grew directly in the joint of my left elbow.

Luckily my research took me to the right place as I found Dr. Shawn O'Driscoll at the Mayo Clinic. He is the stuck elbow guru that I needed.  He is aggressive, active, methodical with his surgery technique and experienced beyond belief.  My demeanor and athletic background made me the perfect candidate for his work.  I was confident...and rightfully so.  I was told that I had a 45% chance of this elbow ever being "normal" again, but an 85% chance of being functional.  With this doctor I had only a 1% chance of having permanent nerve damage in my hand vs. 11% according to the current literature.  I was happy to take those odds.

After 2+ hours of delicate elbow surgery and I ended up here (above picture) for the next three nights.  Motion and pain management was the name of the game.  My medical team was intelligent, friendly, large, professional and extremely involved & interested in my progression toward full recovery.  Not only was the HO removed (Dr. O stated that it was "significant" in size), but also removed was the screw that had been placed there to stabilize the fracture acutely.  There was also plenty of joint clean up and debridement around the ulnar nerve as well as a capsular release to help get my joint back into a world of movement again.  Here's a picture of the screw that was removed...happy to have that out of my ulna bone now (though I still have two even larger ones permanently in my left hip).

So for three days I mostly sat in the hospital bed with multiple tubes connecting me to modern medicine:).  I had the normal saline drip IV, a nerve block (another IV specific to the brachial plexus group of nerves to totally numb my arm/hand), a drainage tube and bottle that collected my surgical blood/edema, a pulsox unit for general HR/saturation data, cyclical leg compression sleeves, and of course, my trusty CPM machine. All of this, 24/7 for my time in the hospital.  

Now I am home and here's what my current world is looking like.  What a hoot...I'm still giddy about the potential!  

Check out my passive range of motion today after I've loosened things up!  Pretty awesome to have this back!  Yes, it's still a bit sore and I've got a long way to go in gaining strength and full active motion...but I am certainly a giddy dude right now!  

The key now is to continue getting this motion in a more natural manner and that requires near continuous motion of the joint.  Thankfully I've got the incredible support of my dear wife Nancy. I'll continue to "sleep" with the CMP machine until I can go 6 continuous hours without losing joint mobility.  So, about another month of this, weaning off the CPM machine and getting back to more normal life and activity.  I have plenty of work to do PT wise and this next 10 days is extremely important in keeping the range of motion I currently have.  I've got to keep moving, keep moving...hey, just like that Ironman I was supposed to be doing this weekend in Chattanooga...just keep moving!  

And I will!


  1. Your last sentence reminds me of my favorite quote of late:

    “Life is like riding a bicycle. To keep your balance, you must keep moving.” -- Albert Einstein

    Or in your case: "To keep mobility, you must keep moving" :)

    Nice new set of 'battle scars' you have there!

  2. You've got the movement thing down pretty nicely Kristen!

  3. So glad to see you up - and bending that elbow! Each day at school Eleanor says "Ugh, Jim is still not here?! When is he coming baaaaaaack?" I'm happy to report to her that the answer is sooner than later! Rest well!

  4. You are awesome! The CPM machine makes you look like a kinder, gentler BatMan. I think you're definitely the winner of the Most Positive IronMan award!