Friday, July 31, 2009
Tuesday, July 28, 2009
Richard's Shoulder
Note: Of course, we are not medical professionals, or spelling experts nor do we have perfect memories. What follows is the best of our recollection of what the doctors have said thus far.
Richard had an MRI of his right shoulder which showed a "Nonspecific atrophy of supraspinatus and infraspinatus" and a "globular intermediate high signal seen in the supraspinatus and infraspinatus near the tendon insertions." The orthopedic doc said this is bad because it basically means they (the MRI techs) see a "something" but don't know what it is. You don't want to stump them. The MRI "result code" was "Abnormal, Immediate Attn Needed". They did say it definintly is not a rotator cuff tear. This is good. There is much "degenerative atrophy" meaning his muscles are rotting. Not ever good.
The orthopedist, Dr. Bischoff, referred him for an EMG test to be done by a Neurologist to hopefully clarify what damage has been done, and where.
His EMG was today at Portsmouth Naval Hospital.
We had a great doc, a neurologist, who performed both parts of the test. The first part involved shocking various parts of R's hand, wrist, arm, shoulder and neck and recording the results. This part was uncomfortable and mildly painful. The second part of the test involved sticking needles into the muscles, starting at the hand and working all the way up to the shoulder, recording first with the muscle resting, and then with the muscle engaged. This part was mildly painful at the begining (the hand/wrist/arm) but became extremely painful when the doc neared the damaged areas of the shoulder and neck.
The doc gave us several answers:
1. The damage was absolutely, positively a result of the motorcycle accident Richard had in February (yes, really, FEBRUARY).
2. The subscapular nerve was damaged due to blunt force trauma (ie hitting the pavement) but the damage is "incomplete" which means it is not completely broken, just damaged.
2.5. The subscapular nerve feeds impulse signals to two muscles, one above it and one below it. The one below is severely damaged, the one above, not as much, but still significant damage. The upper muscle controls the lower 15% lifting power of the arm, the lower muscle controls the movement as if you have your arm in a sling position and then are pushing outward as if pushing a door open with your forearm.
3. The nerve damage happened immediately but was not evident until weeks later when the muscle stopped geting impulse signals from the nerve. (See straw analogy below.) This was the time during March when Richard had such severe pain that he was in two ERs and a doctors office, all within two days.
4. The muscle not getting whatever it gets from the nerve is the reason the muscle is atrophying (rotting). Richard has a severe concave hole in his shoulder, where that muscle used to be.
5. If it was a "complete" tear, surgery would absolutely be required.
6. Since it is "incomplete" damage, it may or may not require surgery. Sometimes these things heal on their own, although they take "a very long time-six months to a year" to do so. It has already been six months.
7. The neurologist said the next step is to make an appointment with the orthopedist, Dr. Bischoff, to review the EMG results and decide what the next step is. The neurologist's guess was that Dr. Bischoff would refer Richard to a surgeon.
It seems that we can wait another six months and it may heal on its own, still requiring physical therapy after that time. Or, we can opt to do surgery, which may or may not be able to help, and would also have an extensive recovery time and would require much physical therapy afterwards.
The straw analogy. The nerve is like a straw. When Richard hit the pavement it flattened the straw, but did not tear it. So there were some impulse signals still left in the first portion of the straw that was able to feed into the muscles. However, a few weeks later, all the impulse signals were either already in the muscle, or on the other side of the damage to the straw. That is when the huge pain happened and the muscles started to rot. Now, we are waiting for the straw to re-inflate, which may or may not happen on its own.
Richard had an MRI of his right shoulder which showed a "Nonspecific atrophy of supraspinatus and infraspinatus" and a "globular intermediate high signal seen in the supraspinatus and infraspinatus near the tendon insertions." The orthopedic doc said this is bad because it basically means they (the MRI techs) see a "something" but don't know what it is. You don't want to stump them. The MRI "result code" was "Abnormal, Immediate Attn Needed". They did say it definintly is not a rotator cuff tear. This is good. There is much "degenerative atrophy" meaning his muscles are rotting. Not ever good.
The orthopedist, Dr. Bischoff, referred him for an EMG test to be done by a Neurologist to hopefully clarify what damage has been done, and where.
His EMG was today at Portsmouth Naval Hospital.
We had a great doc, a neurologist, who performed both parts of the test. The first part involved shocking various parts of R's hand, wrist, arm, shoulder and neck and recording the results. This part was uncomfortable and mildly painful. The second part of the test involved sticking needles into the muscles, starting at the hand and working all the way up to the shoulder, recording first with the muscle resting, and then with the muscle engaged. This part was mildly painful at the begining (the hand/wrist/arm) but became extremely painful when the doc neared the damaged areas of the shoulder and neck.
The doc gave us several answers:
1. The damage was absolutely, positively a result of the motorcycle accident Richard had in February (yes, really, FEBRUARY).
2. The subscapular nerve was damaged due to blunt force trauma (ie hitting the pavement) but the damage is "incomplete" which means it is not completely broken, just damaged.
2.5. The subscapular nerve feeds impulse signals to two muscles, one above it and one below it. The one below is severely damaged, the one above, not as much, but still significant damage. The upper muscle controls the lower 15% lifting power of the arm, the lower muscle controls the movement as if you have your arm in a sling position and then are pushing outward as if pushing a door open with your forearm.
3. The nerve damage happened immediately but was not evident until weeks later when the muscle stopped geting impulse signals from the nerve. (See straw analogy below.) This was the time during March when Richard had such severe pain that he was in two ERs and a doctors office, all within two days.
4. The muscle not getting whatever it gets from the nerve is the reason the muscle is atrophying (rotting). Richard has a severe concave hole in his shoulder, where that muscle used to be.
5. If it was a "complete" tear, surgery would absolutely be required.
6. Since it is "incomplete" damage, it may or may not require surgery. Sometimes these things heal on their own, although they take "a very long time-six months to a year" to do so. It has already been six months.
7. The neurologist said the next step is to make an appointment with the orthopedist, Dr. Bischoff, to review the EMG results and decide what the next step is. The neurologist's guess was that Dr. Bischoff would refer Richard to a surgeon.
It seems that we can wait another six months and it may heal on its own, still requiring physical therapy after that time. Or, we can opt to do surgery, which may or may not be able to help, and would also have an extensive recovery time and would require much physical therapy afterwards.
The straw analogy. The nerve is like a straw. When Richard hit the pavement it flattened the straw, but did not tear it. So there were some impulse signals still left in the first portion of the straw that was able to feed into the muscles. However, a few weeks later, all the impulse signals were either already in the muscle, or on the other side of the damage to the straw. That is when the huge pain happened and the muscles started to rot. Now, we are waiting for the straw to re-inflate, which may or may not happen on its own.
Friday, July 24, 2009
Bed training
Lillian jumped out of her crib twice tonight, landing with a HUGE thud on the floor and getting right up and running, laughing, down the hallway to the living room.
I think she has a death wish.
So far, we cannot tell that she has hurt herself, but we know its just a matter of time if she keeps up the diving act.
We have a "big girl" bed in her room for her, which we lay in with her each night to read books and try to get her to go to sleep there, but she refuses to lay down when anyone else is in the room. This is true for any bed.
She will not be held to go to sleep, she will not be rocked to sleep. She must be in her bed (her crib), by herself, and then, when she is ready, she will go to sleep.
We are desperately trying to figure out how to bed train her.
We have tried "the supernanny way" of putting her in the big bed, sitting outside the door, putting her back in the bed, when she gets out. She lasted 5 hours before we gave up.
My only thought is to move EVERYTHING out of her room, except for her "big girl" bed, and the crib and just put her in the big bed, shut the baby gate on the door, and leave her there til she falls asleep. But we really have no other place to put the rest of the furniture in her room so I don't know.
I think she has a death wish.
So far, we cannot tell that she has hurt herself, but we know its just a matter of time if she keeps up the diving act.
We have a "big girl" bed in her room for her, which we lay in with her each night to read books and try to get her to go to sleep there, but she refuses to lay down when anyone else is in the room. This is true for any bed.
She will not be held to go to sleep, she will not be rocked to sleep. She must be in her bed (her crib), by herself, and then, when she is ready, she will go to sleep.
We are desperately trying to figure out how to bed train her.
We have tried "the supernanny way" of putting her in the big bed, sitting outside the door, putting her back in the bed, when she gets out. She lasted 5 hours before we gave up.
My only thought is to move EVERYTHING out of her room, except for her "big girl" bed, and the crib and just put her in the big bed, shut the baby gate on the door, and leave her there til she falls asleep. But we really have no other place to put the rest of the furniture in her room so I don't know.
Lillian's Word List
Dada
Mama
Ba (ball)
nigh-nigh (night night)
puppy
hi
ooo ooow (yellow)
mo (more)
mo (NO!)
Mama
Ba (ball)
nigh-nigh (night night)
puppy
hi
ooo ooow (yellow)
mo (more)
mo (NO!)
Tuesday, July 21, 2009
Ear surgery went well.
Richard's still working a retarded amount of days/hours.
His EMG test on his shoulder is the 28th.
Lillian peed on the potty for the first time today. She now regularly sits on it for about six hours a day, or at least it feels like it. She sits on it before and after any nap or bedtime, and before and after a bath and after a meal. Kylie is also doing really well. Which makes me want to move the tv into the bathroom since I spend so much time in there, but I think they're helping each other figure it out faster, which is great.
Lillian's new favorite thing is Ring Around the Rosy. Its super cute. She will take your hands and do it with you or just spin in circles by herself. (I taught her that because I get dizzy by repetition #2.) She falls down by herself about half the time and the rest she wants you to shove her down and then she laughs uncontrollably.
Richard's still working a retarded amount of days/hours.
His EMG test on his shoulder is the 28th.
Lillian peed on the potty for the first time today. She now regularly sits on it for about six hours a day, or at least it feels like it. She sits on it before and after any nap or bedtime, and before and after a bath and after a meal. Kylie is also doing really well. Which makes me want to move the tv into the bathroom since I spend so much time in there, but I think they're helping each other figure it out faster, which is great.
Lillian's new favorite thing is Ring Around the Rosy. Its super cute. She will take your hands and do it with you or just spin in circles by herself. (I taught her that because I get dizzy by repetition #2.) She falls down by herself about half the time and the rest she wants you to shove her down and then she laughs uncontrollably.
Saturday, July 18, 2009
Mom and Dad wanted an update.
Here's your update-
The time is currently 10:53 on Saturday night July something 2009. I am exhausted and need a live in babysitter because my husband is currently employed 12-14/7 by the US Navy.
Lillian had pictures taken at The Picture People today. She was a brat. But the pictures turned out cute anyways. Those people are good. Expensive, but good. We are currently accepting gift cards for said photo place.
Lillian's ear surgery is on Monday. We have to be at the hospital at 6:40 am. That means we need to leave our house at 5am. As if surgery wasn't bad enough on its own. And I'm betting Ihop doesn't deliver to the waiting room. Darn! And french toast sounds SO GOOD right now.
Our very good friend Britt just left for "the place you would never want your husband to go" for an "undetermined amount of time" (not to be less than 45 days). He does super secret (ie VERY SCARY) stuff. Pray for his safety. And Whitney's sanity. And everything inbetween. He just got back less than three weeks ago from another trip. This was going to be the first year since they've been married that he was going to be home on her birthday. Oh wait, the Navy just changed that.
Here's your update-
The time is currently 10:53 on Saturday night July something 2009. I am exhausted and need a live in babysitter because my husband is currently employed 12-14/7 by the US Navy.
Lillian had pictures taken at The Picture People today. She was a brat. But the pictures turned out cute anyways. Those people are good. Expensive, but good. We are currently accepting gift cards for said photo place.
Lillian's ear surgery is on Monday. We have to be at the hospital at 6:40 am. That means we need to leave our house at 5am. As if surgery wasn't bad enough on its own. And I'm betting Ihop doesn't deliver to the waiting room. Darn! And french toast sounds SO GOOD right now.
Our very good friend Britt just left for "the place you would never want your husband to go" for an "undetermined amount of time" (not to be less than 45 days). He does super secret (ie VERY SCARY) stuff. Pray for his safety. And Whitney's sanity. And everything inbetween. He just got back less than three weeks ago from another trip. This was going to be the first year since they've been married that he was going to be home on her birthday. Oh wait, the Navy just changed that.