Monday, February 11, 2013

Getting up to date after the "total shoulder replacement surgery" ouch!

I am realizing that this blog has degenerated into a collection of sermons, so here’s a selection of journaling from the last two months. 

9 December 2012. I need to sit down and write for awhile: get a lot out, just write, and see what happens then…

Fear about the surgery in three days. 3 hours with my right shoulder being replaced, 90 days on sick leave, and most of the next year in physiotherapy, but getting rid of the arthritis in my right shoulder. This is the first surgery since 1986 when I had the gall bladder surgery; I was 30 then, so this is different: it scares me a lot - the pain, helplessness, weakness, being a burden to others, getting crazy with the anesthetic, not coming back mentally or physically. The fear of dying on the table, all that. 

But I know a number of people who’ve had it, and are the better for it, so I should be all right; but I’ve also heard stories of it going badly, don’t like the fact it might need to be replaced in 10 or 12 years, it is a complex matter! 

Sunday afternoon, 16 December 2012, 3 PM.

I’m seeing how the new voice recognition system works on pages since my right arm is out of action for the next six weeks at least. So far, so good.

So far the program hasn’t frozen, which the old program had a tendency to do, so I may be all right.

I may be all right following the surgery as well. I went in on Wednesday morning and they had me walking by Thursday night: albeit slowly and not feeling too steady, but with growing assurance and strength with every step. They also told me that night that I would be well enough to go home the next day. That scared me, and I didn’t think it was possible, but by Friday morning I decided I was well enough to be home. So here I am. I’m not sleeping brilliantly  at night and still am feeling some pain, but this is so much better than expected.

So now I am on sick leave until 8 March! Evidently my tendons aren’t in great shape so I will need to take time with physiotherapy and not have high expectations, but I think it will make for some good improvement. Even now the pain is different and I’m not waking up at night with a sharp fiery pain when I turn over. Granted that’s because I’m sleeping on my back with a pillow under my shoulder, but even so.

Now Monday, 17 December, 2012. 10 AM.

Let’s just go stream of consciousness: my right bicep is sore, I might be a little bit depressed, this is the fifth day since surgery so that is perhaps expected; so we’ll go with it. The fact is that I’m in an unchartered place – Post surgery – pre-Christmas – in recovery – and anything else you care to mention. I’m not sleeping terribly well and need to start being more mindful this morning in terms of stretches and exercises, but I’ve actually been pretty careful until today. I just feel like a low, a bit of a fugue,  I guess.

So now it’s almost 12 and I still haven’t showered, I think it’ll be a lazy day. The weather is good today, feels like we're back in spring.

Is this working? Good! Now it is Thursday, 20 December 2012, almost 10 o’clock. Just one week and one day since the surgery.  I guess I’m going all right: I feel slow, there is some pain, I’m easily fatigued, perhaps on the edge of depression; and maybe all that is to be expected. The fact is that it I have gone through major surgery and that will be traumatic to my system and have long lasting affects and effects.

It’s hard to talk about all the things I feel right now: the right image might be something like getting through Carquinez Straits into San Francisco Bay or through the Golden Gate and into the larger ocean. There’s this feeling of – not quite being becalmed – but settling into a bit of a wider horizon where there are no easily identifiable landmarks.

Part of that is the season – end of the year has always been a difficult time for me as well as a time that I valued, thinking of the end of semester at USF or at CDSP when there was that same feeling; opening up to new options with the feeling that was both vacation and vacuous: both ending and beginning with the inevitable tension between the two.

So I want to make lists, lose myself in entertainment and media and planning and sensation, but I really don’t have the energy for that.

And the fact is I have at least six more weeks before I returned to any kind of work – and more likely 10 weeks with more exercise and physio, lifting larger weights with greater range of motion, working on aerobics too: and hopefully getting back into the pool!

22 December, 3 AM in the morning, too many ideas.

I woke about an hour ago with a bit of a sore shoulder, a dry mouth,  and a lot of ideas: sitting here, they all scatter to the far end of the room, regarding me balefully.

So what’s going on?

Trying to get a sense of balance, solid landmarks, with the post-surgery condition; involves levels of unpredictable fatigue, some amazing dreams, and a kind of inchoate listening to the body for new information, new cautions, new insights.

I see the surgeon day after tomorrow and the physiotherapist next Thursday so, up by that time, will have a new sense of where to go from here – probably new exercises and a better prognosis of the future.

It has been much easier than I expected, returning home more quickly, with less of a sense of being an invalid, more mobility and less liminality. But the subtler effects are still making their ways known: this fatigue, laden with insights, and a kind of murky quality I’m not sure if it – – and this is my current landscape.

John and I did a 2 mile walk two days ago and yesterday I really felt rocky: slightly off center in mood and perception, tired, nauseated, like I was pre migraine, feeling confused and anomalous, all that stuff. I had a serious nap in the afternoon, slept pretty well last night and woke up feeling exhausted but feel better today. Everybody says this is to be expected post-surgery.

Watched Wes Anderson’s “Moonrise Kingdom”  for the second time in two days and liked it a lot! Just a brilliant film. I think the next step would be to watch the one that takes place in India: “The Darjeeling Limited”.

I’m feeling a little more grounded, and we're getting a little more settled in the house but I would really like to have a bit more direction and get a bit more done in my life. There are still two months to go on sick leave, time when I will be primarily concerned with physiotherapy and have no job duties, so it’s not as though I don’t have a lot of time coming up to do new things to rethink some of the possibilities.

The house is looking brilliant! We’re even getting to the point where the den starting to look like a decent working space: well hopefully it will soon, and then I can... Well, more later …

Sunday, six January 8, on the feast of the Epiphany. 9 AM. I might go to church in an hour, maybe not. We’ll see. What’s going on?

The shoulder seems to be getting better. There is some itchiness, but it feels better than it did before surgery. I am trying to do the exercises mindfully – could do better of course, but I think I’m all right. I see Martin tomorrow for physiotherapy.

My moods are strange: getting tired quickly, a certain vulnerability, bits of paranoia, loneliness, crazy thinking in general.  I guess this is due to the anesthetic, at least everyone says so, so I shouldn’t take it too seriously. And I know my body is different because of the surgery: I was off-balance before – through not using the arm – now I am more so – because I’m not able to use the arm - but it’s different. I’ll try to do some stretching today, maybe a little bit of walking as well.

So it is 10 January at 10 AM, Thursday morning, and I’m trying to get some thoughts out on the voice recognition software about what’s going on with me.

Earlier in this document I talked about going through the Golden Gate or the Carquinez Straits and coming to a larger body of water. That image still stands but I need to add to it. There’s a feeling of exhaustion, of inadequacy, of being struck with the bigness of things. Life just seems very large and I feel very inadequate.

The fatigue has gotten worse in the last week; I drink coffee, get shaved and showered, eat my breakfast, and feel completely exhausted. The tiredness seems to come with a surprise, I will think I’m doing quite well and then I am exhausted. It’s nothing I can prepare for…

 Let’s start again. I’m depressed, frustrated, angry. I’m tired of my shoulder being sore and the restrictions in my movement. I hate not being able to drive. I’m feeling lonely and old and impotent. I miss doing what I do best; which is being with people, talking and teaching, listening and laughing. John is doing the best he can, which is very good, and I am very thankful. But I’m getting tired of this. 

Firstly; It is Saturday, 19 January 2013, actually it’s my maternal grandparents mutual birthday; born in 1888 and 1882, part of my familial and cultural lineage.

This illness and recovery has taken longer, been more wrong, and I expected. The ongoing soreness, sometimes pain, wears me down more than I expected. And after week three there has been a kind of reverential sadness – not quite depression but an awareness of that which has been lost; with a feeling that I can’t quite understand output my words around. My moods are – what’s the word – labial? I found myself – several times – getting angry about things that happened years ago, things I thought I’d put to rest. I can also feel old narrative plots come to the surface: what if I? Why didn’t I? Why did they? I try not to follow them for to long; and John thinks I’m doing pretty well, so I’ll rest in his judgment.

So I’m on sick leave for three months. That objective classification should both comfort me and allow me to see that this is not a trivial matter. My right shoulder has been replaced, tendons and ligaments have been redirected, neural pathways are renegotiated, the body rests and requires time to rethink itself, and this feels complex and difficult and sometimes wonderful.

So it brings up a lot of things: aging and death, what I want to live for and what I have to give, increased focus and attention and decreased energy open and ability to multitask.

So how many years I have left: five, 10, 15, 20? John’s father lasted for 25 more, died at 92, ‘though his last two years were pretty bad. My father died in 1997 at 83 – I think my mother was 81. Let’s say 15 years; then what
Asking what do  need to get and need to do from here on?

The biggest thing is a contemplative practice, Christian Zen, Centering Prayer, whichever: that should be part of my daily routine. I can understand the importance of it, the theory of it, but it’s the doing of it that drops me short of the goal: and I find it hard to get there from here. It’s always been easier from the essay and to do thinking about it, than to do the thing itself!  So let’s shut off the dictation and login 20 minutes right now. 

 So I did, and it was good. I think I do my best without a mantra or a phrase; simply try to listen for what is clear and renewing and refreshing and silent in the center of my breathing and the breathing around me.  Anyway, it was 20 minutes when I did shut up and tried to be kind to the voices and distractions and directions and get to something deeper and more clear in the center. Maybe I can do it tomorrow.

Writing the book carries a lot of fear for me. It’s probably the oldest myth I carry about myself, which might explain why it is so fraught with possibilities and perils.  I remember plots I constructed the ranch in my early teens – variations of books and movies I knew and liked, close to what I used to do one hour a week at El Dorado school in Sacramento. So when I come to the idea of writing a book, I meet the boy and the young man, the artist manqué, the tragic potential, and it  scares me.

But I also have to admit I am excited about the accuracy with which Dragon Dictate for Mac is transcribing the words that I’m saying – it’s getting damn near all of them right! I did print out the command cheat sheet and in learning some of the commands to “control, select, edit, undo, correct, and insert lines and words.” This can open up some amazing doors. What if I were able to get it right this time?


Philip Harvey said...

"The movement you need is on your shoulder." Paul wasn't sure he wanted to keep this line in, but John said it's the best line, you've got to keep it. Poetry that you cannot even explain, everyone sings it with feeling, but does anyone know what it really means? Well, to put it simply, it means "The movement you need is on your shoulder." This Comment is aspiring to be a sermon. Love from Philip, Carol and Miss Bridget.

Grace Sharon said...

I wish you all the very best Rob for a future full of wonderful blessings, surprises and a walk with God that you could not even have imagined years ago. I pray that your should does recover, quickly and fully, and that you are allowed by your health to enjoy the rest of your years here on earth blissfully and pain-free. I know I am an idealist but you have a lot to offer that we all don't want to miss out on, especially your love for all humanity. You have taught me many things, my friend, I pray God gives you many more years yet to share our human family. God bless. Grace.

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