14 Week Post Elbow Surgery Update
The short version of the past 8 weeks is that my elbow is still hurting. While I do have good flexiblity and mobility and decent strength in that arm now, it still hurts in the same places where it did before I had the surgery--only more intensely, and it's a little tender at the outside of my elbow as well. It is slightly improved from the 6-week mark (when I was still wearing a wrist brace), but definitely NOT healed and well. Something in my body is staying inflamed and angry about being poked and scraped and cut and it JUST WON'T CALM DOWN. I'm pretty frustrated and at this point, beginning to regret the surgery, but trying to continue to be patient.
Thankfully, my energy has significantly improved since the 6-week mark, and after a few days of using Voltaren arthritis cream on my right wrist, I noticed that my entire body felt less inflamed and sore. I'm thinking that fatigue and exhaustion was an autoimmune Graves Disease response to recovering from surgery and the Voltaren helped calm down all the inflammation I was dealing with. Since then, I've been feeling much better on that front.
When I saw my surgeon at 12 weeks out, and told him how it had not improved, he suggested resting it again for about a month, trying to avoid activities that irritates it, and really attacking it with anti-inflammatories. So, for the past two weeks since I saw him, I'm taking 4 naproxen a day (increased from the 1-2 I was already taking) and doing 3-4 applications of Voltaren each day. I've stopped going to PT (so I'm not doing any concentrated exercises using my arms at all) and have tried to let it rest in more of my everyday activities. That's pretty difficult when I feel it flare up when I am washing my face, washing dishes, pouring water into the coffee pot, emptying the dishwasher, wiping down countertops, holding and turning the steering wheel, opening and closing door handles, writing, painting, typing, pushing a shopping cart, carrying anything with a straight or bent elbow, and pretty much ALL THE THINGS I do all day long. But...I'm trying to "rest" it. No significant change so far--and my right wrist issues also continue to hurt, though it doesn't seem to be getting worse (or better).
I'll see the surgeon again in a couple of weeks. He ordered another MRI which showed that there is still some tendonitis in my elbow, which is both discouraging (because it's still there) and validating, because I'm clearly still feeling pain from something. He suggested that a hand & wrist specialist join the appointment when I see my him next to look into nerve impingement. He also wanted to suggest some kind of ultrasound procedure, though his assistant wasn't specific about whether that would be another cortisone shot, PRP, or perhaps Tenex -- two of which I've already done, and one of which I asked about before having surgery. PRP & Tenex aren't covered by insurance based on what they've told me before.
It feels a lot like starting over at the beginning of this injury. I've been through physical therapy, lots of anti-inflammatories, tape, needling, massage, a cortisone shot, PRP treatment, more physical therapy, and then surgery, more PT, more tape, more needling, more massage, more anti-inflammatories. I'm SO TIRED of not having full use of my upper body. But it's beginning to look like I may just have to learn to live with the pain.
Here's the more detailed journaling week-by-week, which is mostly me whining that it still isn't improving. But I'll want to be able to look back later and see how long healing process took, what was actually happening each week, so that hopefully one day I can say it DID finally heal.
Week 6 to Week 7 - Not wearing the wrist brace constantly and knowing that every time my elbow "hurts" it's not because I've done something I shouldn't has definitely helped me mentally not focus so much effort on protecting it and noticing every little pain. It's definitely still very tender, but strengthening it some during PT and being able to use it more normally without the brace has helped. My energy has remained low and limited and my brain continues to feel foggy which makes it hard to focus. I exercised three times this week, but struggled through all three workouts. I rested or only did PT exercises on the other 4 days. My physical therapist (who is also my brother-in-law) suggested I try some Voltaren arthritis cream on my right wrist to see if that would help calm it down, so I started using that several times a day. I had a large batch of signs to paint this week, which took me three days to get finished, in addition to my Burn work, and would probably have rather been resting on the couch all week long instead.
Week 7 to Week 8 - I woke up on the first day of the 7th week mark feeling great. It was like the inflammation in my body had subsided and my brain was clear and everything didn't hurt so badly. The pain was still there, but it wasn't taking over my entire body and thoughts. My internal dialogue that day was positive and I found myself wanting to check in with friends, make plans and make jokes--NONE of which I had been doing willingly in weeks. I told Ben that I felt more awake than I had since my surgery. I've decided it's the Voltaren, reducing the inflammation all over my body, because I continued to feel good, have plenty of energy and feel much more like "normal." My left elbow is definitely still tender and not as strong as before surgery, but it is less dominating of my every thought and movement. My right wrist is definitely not "better" and still hurts pretty bad when my wrist is flexed or I touch the spot where it's been hurting, but it is *slightly* improved from what it was. I think maybe we've turned a corner...
Week 8 to Week 9 - At PT, I've moved up to 6lb weights. Most of the exercises don't hurt, with the exception of two; bicep curls and extended arm tricep extensions with a band (even the lightest weight band). I still feel tenderness when I try to press a button with my arm extended, but when I'm washing my face and brushing my teeth it is less noticeable. At the gym, I'm still avoiding any arm-centric activities. I was able to gingerly use a 10lb med ball this week, but I mostly used my right hand for the lifting. On leg days, I wear a 20lb weighted vest so that I don't have to hold heavy dumbells, and when I hold them, I usually rest them on my shoulders. I did one round of half-burpees in a fully extended plank, but slightly elevated, holding onto a Burn bar (not hands on the ground). I was a little sore after that, but not terribly, so I'm hopeful I can incorporate a little more of that sort of thing, especially because my legs and feet are getting tired! I was able to sand my own signs last week, which was a big step toward healing. My energy has been great all week. My right wrist is improving, though it still hurts to the touch and if I were to flex my wrist, but less than it was, so that's good. I have a few more days left to use the Voltaren cream. I'll be interested to see if my energy and inflammation changes a lot when I've finished the three weeks of 4x daily application.
Week 9 to Week 10 - I still wake up with my left elbow very stiff and sore, and have to be very careful holding or lifting anything of substance. I have moved up to 7lb weights on PT exercises. I've finished my 21 days of Voltaren, and while my overall inflammation has definitely been down, unfortunately my right wrist is still hurting pretty badly -- especially after working at my computer. Sometimes I tape it up to add pressure to it, which makes it feel a little better. I think I have a little bit of numbness in my right ring finger and pinky. I made the mistake of pushing myself out of the pool last weekend, which hurt BOTH arms and was a terrible idea. But thankfully, it didn't seem to do any residual damage beyond hurting in the moment. My left forearm muscle is still tender (but improved) and the spot right at my elbow bone is very tender when I press on it while my arm is extended. Inward pressing (on buttons, closing doors, washing face) still hurts significantly enough that I notice it.
Week 10 to Week 11 - Not much improvement. I power-washed wood this week for my signs, which was frustrating and discouraging, because the last time I did that was before surgery, and I was hoping by the time I needed more wood washed my elbow would be feeling much better. It's not. And this is from the same pile of wood that the original injury came from. So, I'm a little (a lot) bitter toward it already. At PT this week, Derek started working on my neck and shoulders, thinking maybe some muscle tightness there would be connected to my elbow not completely healing. My body clearly does not know how to relax. Since I'm not using the Voltaren anymore, I take one or two naproxen each day, which does seem to help with my overall stiffness and soreness and inflammation. My oncologist said as long as that doesn't irritate my stomach, that was fine to take daily. I had some additional bloodwork done to check for Rheumatoid Arthritis and any other autoimmune markers, but all came back normal, including my Graves Disease TSH marker, which is great news. So, it seems like maybe I'm just "normal" old and creaky? It doesn't really explain the 6 weeks of incredible fatigue and inflammation that I was dealing with.
Week 11 to Week 12 - No improvement in my elbow that I can detect. It's maybe even a little more sore and bothersome. My PT guy even said, let's wait till you talk to the surgeon again next week before we do anything else and see what he wants you to do next. I'm pretty frustrated. I feel pain when I am washing my face, washing dishes, pouring water into the coffee pot, emptying the dishwasher, wiping down countertops, holding and turning the steering wheel, opening and closing door handles, writing, painting, typing, pushing a shopping cart, carrying anything with a straight or bent elbow, and pretty much ALL THE THINGS I do all day long. It's still far more painful than it was before I had the surgery, and at this point, I'm regretting doing it at all. Plus, my right wrist hurts like a bear when I do too much with it, but I haven't really addressed *that* problem, because I'm still waiting for my left elbow to get better before I go opening up another can of health issues.
Week 12 to Week 14 - Saw the surgeon. Had another MRI. Taking lots of anti-inflammatories (naproxen & voltaren). Stopped PT and am trying to rest it as much as possible. Not much change.
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