Elbow Surgery (6-Week) Recovery & Health Update

"You look so good!" 

"I'm so glad you're doing well." 

I hear that sentiment pretty often when I run into friends and acquaintances who know my story.  Then I have to tell them that I'm the "healthiest-looking sick person you'll meet." 

Below is a week-by-week account of the past 6 weeks since my surgery. 
I want to be honest about the struggles of dealing with all these issues, especially when I've been pretty open about the whole process from the beginning. I know I don't cope perfectly and have a lot to learn about stress management (clearly), so please don't consider me an example of "how to get through it." Instead, if you're reading this and following my story, I hope you can see how a person doesn't just get "over and past" big traumatic events and illnesses.  We have to learn how to live with them as part of who we are.  I'm still struggling with that.   
The short of the long is this: My elbow still hurts worse than it did prior to surgery.  My energy levels are extremely low and getting worse, not improving. My mood and motivation and attitude have been waning and declining at a pretty rapid speed.  I have at least 6 more weeks to go before I'll know if it's actually "fixed."
Now you can scroll down to the 6-week evaluation if you'd prefer to skip all my weekly whining and journaling...

Week by Week Healing Process

Lacertus Syndrome Release & Epicondyle Debridement Surgery Recovery

Surgery to Week 1 - Wearing the wrist brace 24/7. Physical therapy is only for mobility and flexibility. I've taken occasional tylenol or a pain pill, but not much.  I didn't attempt to work (much) or drive at all.  I had trouble focusing and my brain always seemed fuzzy...especially by the end of the day.

Week 1 to Week 2 - Wearing the wrist brace 24/7. I've been doing daily PT and a few short, easy walks in the neighborhood (15 to 35 min). Swinging my arm hurts a little, but once it's warmed up feels ok.  I've taken occasional ibuprophen or tylenol.  I'm having LOTS of nerve pain at the end of the 2nd week, which is in line with the 2-3 week nerve pain I had after my other surgeries too.  I had my stitches removed on day 13, which was uneventful, since they just trimmed the edges (didn't have to pull anything out).  

I am still very tired every day, and completely exhausted both physically and mentally by 5pm, if not before.  I have very little energy or motivation. Everything I do takes extra effort and calculation to use my right arm instead and not hurt or strain my left arm.  I went back to typing and computer work for my Burn job, but doing only the minimal so that I wasn't sitting at my keyboard for long periods of time.  I did one batch of painting signs, with help from Paxton prepping the lettering and then using my right arm for spray painting, and struggling through paintbrush touch ups.  I had to take lots of long breaks and it was very discouraging.  Ben is doing the sanding and hammering for me, and Paxton helped me with shipping. 
Week 2 to Week 3 - Wearing the wrist brace 24/7. For exercise, I'm doing daily mobility and stretching PT exercises, plus a few walks (35 min) and lower-impact modified Burn workouts from home -- nothing weightbearing on my arms or holding anything. My left arm is aching and painful. I have trouble resting it on anything because of all nerve pain, which hurts when anything touches that area.  I'm very tired every day, for most of the day. Paxton is helping me prep signs, and I'm able to spray paint with my right arm, and do touch ups with my left hand with LOTS of breaks.  It makes it very stiff and sore though and feels VERY difficult and overwhelming.  Also, the bottom outside bone on my right wrist has been hurting for a while (I think from using my mouse, and maybe holding my phone), but it's getting significantly worse, which makes using THAT hand painful too.  So I end up just sitting and resting instead of trying to accomplish anything that requires my arms or hands.
Week 3 to Week 4 - Wearing the wrist brace 24/7. Doing PT two times a week + Burn workouts (very modified) + walks, which equates to about 45 minutes a day, with one day of full rest.  I decided to cut added sugar out of my diet for the month of July to try and help reduce some of my joint achiness and pain.  I also brought back my gallon water jug in an effort to increase my water intake again, which had been difficult to keep up with since I couldn't carry it around with me.  Exercise in the AM helps me throughout the day, but I'm having to talk myself into doing it, which isn't like me.  I wake up hurting all over (aching elbow, screaming right wrist, sore feet, sore left knee), but once my body gets moving, I can get several hours of focus and output (though significantly less than normal me would attempt). By the afternoon my brain gets foggy and I'm tired from pushing to get just the bare minimum accomplished.  Everything takes huge pep talks to make myself go and DO anything.  Errands and small tasks feel completely overwhelming and not worth the effort.  I had to majorly caffienate myself to be at STILL very low-energy output over several 4th of July weekend activities we had planned. They were enjoyable, but took a lot of recovery and even during the events, I found myself struggling to want to be there.

Week 4 to Week 5 - Wearing the wrist brace 24/7. Exercise this week has been two days of PT plus a couple of Burn workouts (modified, no arms, less impact).  I didn't exercise at all two days this week. I'm getting very discouraged at how little energy I have. I am still falling asleep by 8:30 or 9pm every night.  Though I'm sleeping well, it doesn't seem to be enough to energize me throughout the day.  I wake up at 6:30 and am able to get a few good hours of chores and work accomplished, but then I end up spending most of the afternoon/evening laying on the couch. And my "good hours" still feel very sluggish, even with full caffiene coffee, which usually gets me moving like an energizer bunny.  We drove to South Carolina this weekend to see my family, and while it perked me up a *little* bit, it was not as much as I had hoped it would. I still have a very limited amount of energy each day and don't trust my energy levels to be high enough to "plan" for anything. Nerve pain has subsided, but my elbow is very stiff and sore in the mornings especially, and still extremely tender to the touch.  I've started being able to gently brush my teeth with my left hand, but pressing on my face to wash it is still too difficult to do without it hurting. 
Week 5 to Week 6 - Wearing the wrist brace 24/7.  I had two days of mobility and flexibility PT plus I did 4 modified no-arms Burn workouts, but I am struggling to get to and through the workouts.  I took three complete rest days this week. I feel so fatigued and have to really slow down all the exercises to be able to keep doing them. Workouts aren't feeling energizing like they normally do for me, but my energy level isn't any higher when I don't do them.
My elbow still feels about the same, significantly worse than pre-surgery still, so it's hard to know whether it's going to be "better".  I still can't lift or hold much in my left arm without pain, though gentle movements and non-weightbearing activities are easier than they were.  It will still ache in the morning and again by the evening. I still have trouble holding the steering wheel for long with my left arm, pressing buttons with the fingers on my left hand, opening and closing the car door, writing with a pen/pencil/paintbrush, etc.  My right wrist has also continued to hurt, though I've tried different mice, changing my posture, and stretching it out.  I ended up buying a second wrist brace to wear on it, which does seem to help calm it down. 

6 Week Evaluation

My elbow has improved since right after surgery, so it IS progressing, even though it doesn't always feel like it. I'm able to USE that arm to type, hold lightweight objects, and it has good and full mobility, especially once it's warmed up. It still hurts more than it did prior to surgery though, where the debriedement was, along the scar, and where the Lacertus band was released and tied to the muscle--so it's hard to tell whether it's "fixed".  Certainly, it isn't fixed YET.  
I saw my surgeon today and explained my varied symptoms and ailments.  He assured me that 6 weeks is about how long we had to wait for the injury to heal from surgery.  But at this point, it should be healed enough that using my arm isn't going to damage the work done.  He said I could stop wearing the wrist brace all of the time, unless I was doing an activity where I was more comfortable having it on, and I could begin to do some strengthening exercises.  He also said it was going to take another 6 weeks to strengthen it and continue healing before we'd be able to know that it was "fixed" and not hurting anymore.
After talking to him, I felt a little better.  
1) I wasn't damaging it everytime it "hurt". I was trying so hard to avoid pain because I thought it meant I was doing too much and damaging the work done to try and make it better.
2) I knew that not having to wear the wrist brace would help me mentally be less hyper-focused on every little ache and pain, which can get my mind spinning in overtime.  Every little ache and pain potentially has more significance and has to have a little more attention when you're on watch for cancer recurrence, so it's best not to get bogged down in normal aches and pains.
3) None of that explains my extreme fatigue and brain fog and aching joints, but I was hopeful that being able to feel more normal "physically" would help me in that department too.
So what's causing the fatigue?  Well, it could be any number of things, but I've really noticed it since this particular surgery.  So I tend to think it's related to inflammation from healing that injury, or mentally and physically adjusting and accomodating for it with every little movement I make all day long.  Since it's really been pronounced AFTER this surgery it makes me think things like my thyroid levels (which have been great for several years) or the Tamoxifen medication I take to help prevent cancer recurrence (which was working fine through the spring with very little side effects) or lingering chemotherapy effects probably aren't the culprit. I felt really pretty good in May and early June before the surgery, while not quite at my 2016 energy levels (or even early 2020), it felt like a normal amount of energy and output for an active 42 year old. 
More and more I'm guessing that my increasing fatigue is connected to situational depression and just a lack of the adrenaline and "fight" that has carried me through the past several years.  If you go back to my Graves Disease diagnosis in May 2018, I've had a LOT of pretty constant stress in my life and have been focused on one health issue or another and trying to get "better" from something for almost 4 years.  While I've mostly bounced back physically and mentally after each event, it's clear that my body doesn't handle stress well and it comes out in the form of inflammation, illness, injuries and fatigue.
Since I've been wearing a FitBit watch for the past couple of years, I can look back at my activity levels and sleep levels and very clearly see the stressful times (both physically and mentally) and how my body has shut down and required more rest and sleep during those times.  But when I'm "out of the tunnel" of those events, I perk up and have so much more daily energy.  To be honest, this graph is kind of a "DUH" result. I'm not sure I learned anything remarkable other than visual support for my fatigue being likely from situational and mental health, not necessarily a hormonal or medical inbalance.  I'll need to do bloodwork to officially rule that out -- and I may still do that.
January 2019 through July 2021 monthly breakdown:

So...do I just need an attitude adjustment? Maybe. But more than ever, "muscling through" doesn't just feel impossible, it feels futile when there's always something else lurking around the corner (currently my *right* wrist)--and I guess that's just life. 
Does that mean I need anti-depressants? Perhaps. I'm not opposed, and have taken them before (post-partum), but I've also been through depressive seasons in the past and have pulled back out of them without medication. I hesitate to add another medication to mix with the two hormone-affecting drugs I already take for Graves Disease and cancer prevenion.  
Mostly I am just recognizing that I'm SO TIRED OF FIGHTING to be and feel healthy when it doesn't seem to be working very well.  But...I also fear NOT trying to work on improving these ailments, because it seems like it would make me feel even worse if I don't try to combat them.  So, I'm stuck between the two--give up and accept I'm chronically "sick" with something or press through and "fix" the ailments so I can live life fully and energetically.  The first option feels like defeat. The second option feels unattainable.  
When I feel like this, I want to just escape to an extremely minimalized life with no responsibility or outside stress and obligations.  (A three day trip to the beach, where I completely relaxed and de-stressed once *actually* did the trick and healed some physical ailments I was struggling with.) I also know that when I'm feeling well, the things that feel overwhelming when I'm *not* well are mostly small and minor tasks that I don't even think about doing, so I don't want to let them go--I feel the need to maintain and hold onto those and press through them.  Because when I'm WELL, I like being busy and doing lots of things, and having lots of responsibility.  WELL me gets UNWELL me in trouble because she can't take a REAL break.
I tell people all the time, "you have to be adaptable," but I'm probably the hardest to actually get through to on that front. Because when I tell myself that, what I really mean is adapt until you can be where you want to be, not adapt permanently and accept it as the new normal.  Over time, I've reluctantly released some of my need to be the "me" prior to all my sickness and injuries, but from an outsider's perspective, probably not by a significant amount. Maybe it's time to adapt again and reduce my personal expectations another notch and accept myself at a lower energy and output.  Not gonna lie...that feels like I've lost, and hurts--A LOT.
Or maybe I just need a week at the beach.
Just keeping it real folks...So if my social media feed photos or even seeing me in person at the gym or out to dinner suggests I'm doing great and having fun and feeling well, it's good to remember that might be the ONE moment of that day that I was.  Or maybe I'm not at all and struggled to get there.  Or maybe I am having a good day and feeling well.  You just truly can't judge a book by it's cover.

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