Weaning myself…..

~

Hurray! … the x-rays showed smooth new white bone "stuff" filling in what were still big spaces  3 weeks ago. I thought the doctor would then just say "off with the sling and away you go"   LOL – shows how much I know about broken upper arms and rotator cuffs. 

There is to be no immediate ceremonial burning of the sling as I have to "wean" my arm out of it first.  I will still sleep in it for another week as we "have the potential to damage ourselves while we sleep"  said the doctor.  The new bone is not hard yet – actually it's not even really "bone" yet. 

The re-forming of bone is really interesting (and one of those things you don't think about until it affects you).  When I fell over and broke the bone I also severed blood vessels which fairly quickly formed clots called fracture hematoma (I had bruising that extended from my armpit to my elbow).  This clot stabilizes the bone and helps to keep the broken pieces aligned.  The clot also cuts off blood supply to the jagged bone edges and these cells die and are carried away (I hope) by other cells.

Tiny new blood vessels develop and help the fracture hematoma develop into a soft callus.  Cells called fibroblasts start producing fibres of collagen (the major protein in bone and connective tissue) and then osteoblasts produce bone cells which transform the soft callus into bone callus -  this is the stage that I am now at.  Bone callus is a hard shell which lasts 3 to 4 months and provides protection and stability for the bone as it continues to heal. 

During this phase the position of the bone is set within the flesh and the body begins reabsorbing bits of dead bone at the same time it is bridging the gap with the hard callus. This bulge of hard callus can not take a lot of strain – Osteoclasts and Osteoblasts spend months remodeling and replacing the bone callus with harder compact bone. Cells then gradually decrease the callus bulge until the bone returns to its original shape. 

After viewing the x-rays the doctor said:  show me how high you can lift your arm (in a Roman salute motion) …   Now bear in mind  the last time I lifted my arm was 7 weeks ago today when I was washing my hair and putting my clothes on.

I tried; I really tried!!    My fingers moved.  I concentrated harder (my face most likely scrunched up and purple) – my brain was shouting at my arm but nothing much was happening.   I laughed as I managed about 2 inches of lift! 

The doctor smiled and said:  this is why we do Physical Therapy.  Apparently for every one day a limb is immobilized it takes about 3 days for it to get back its range of motion and strength.  That's why I start "real"  physiotherapy next week – no more of this sissy passive stuff! 

So, now I spend a few hours each day without the sling building up until my shoulder can tolerate supporting the arm.  The doctor suggested that I still wear the sling when I am outside the "controlled environment" (of home & office) for a couple more weeks.  Personally I think I should go out like this:  

 

 

 

 

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35 responses

  1. Thank you GOM . When I was writing about the healing process I was thinking how handy your little diagrams would be in describing it. Actually you are probably right about that bubble wrap – when I had the fall I was really padded up in winter clothing and coat!!

  2. Wow, interesting stuff (and I actually read it all! πŸ˜‰ )
    Well congrats on the first baby step! you should have all your arm functions back and super strength just in time for next winter's snow shoveling! πŸ˜›

  3. I'm so glad to hear that you are on the path of changing callous into bone. It must be so frustrating to still be so immobilized. You're not riding the subway yet are you?? Maybe you need to wrap up in some bubble wrap. I think it'll be too hot though.

  4. Horray! Sorry to hear it's agonizingly slow but you're healthy and on the exact right path, it seems.
    I loved your passages on osteology! Woot! Isn't the human body amazing? People marvel over lizards growing tails – well we can grow back body parts too! I especially like the "plasts" when they're specialized cells that each have their own unique job. So neat. Thank you for the bone lesson!
    Healing vibes and don't push yourself, you're well on your way. xoxo

  5. LOL – yeah, not much ventilation in bubble wrap. I've been taking a taxi to work and getting a ride home with a friend. I had thought that I would start back on the metro on Monday (that's when I thought I would be throwing the sling away). Now I think I might wait one more week………

  6. I know – the body is a really amazing thing isn't it. I found the whole process of rebuilding bone really interesting – I'd never given it any thought before. I have to admit that I am getting impatient for this to be over now. I asked if there was anything I shouldn't be doing and he said that I would find I would be guided by my own self limitations! πŸ™‚

  7. A few people I've spoken with who have done PT on shoulders tell me that the secret is a pain killer before a session LOL. Then, the other day when I was there doing my passive thing, I saw a woman doing some shoulder tasks and she was smiling – I asked my therapist if I would be doing those eventually and after she said yes, I said "well, they can't be too bad because the lady is smiling". The therapist responded: that's because she takes percocet before she comes. πŸ™‚

  8. I found the reconstruction really interesting – the body is so clever. Yes, effort, practise and patience will help me get through the rehabilitation phase. πŸ™‚

  9. LOL!!!!! I think they are serious, Emjay. The only bad part about that is that you would have to get someone to take you, or take the train. That would be an interesting train trip, on percocet!!

  10. You know when I read your entries in regard to your bones slowly knitting back together. It is a long slow process isn't it? I am very thankful I spent 6 long, hot months in a heavy plaster cast from armpit to wrist with the wrap around the torso stabilizer over the sling. I truly don't know which of us had it worse.I am so glad you are on the mend.

  11. have the potential to damage ourselves while we sleep
    I am not sure if I have the potential to damage myself, but I certainly have potential to harm Mr FD when he keeps me awake!
    I look forward to "our" physio visits!

  12. Isn't it amazing how each cell has something specific to do and that they generally get it done in the correct order. Our bodies are amazing things as well as being sometimes frustratingly fragile!

  13. Oh – I think you definitely win on what is tougher! That must have been so uncomfortable. The biggest problem I had was a feeling of lack of stabilization and protection of the arm. Being near other people made me very nervous – actually it probably will for a while longer out in public. In 2008 I had my leg in a series of casts (and crutches) for nearly 5 months – when I look back now I wonder how I got through that when being in a sling for 7 weeks was driving me crazy! I guess that shows the loss of use of a dominant arm is somehow worse than the loss of the use of a leg. :-)How long did it take you to rehabilitate your arm?

  14. It took me over two years to recover, the unfortunate thing is my Doctor died midway through my PT so I had to see a new Doctor who suggested re=breaking my arm and starting over. After seeing 3 doctors all suggesting the same thing I just did my own PT. Swimming was the most helpful, forcing myself to endure the pain to reclaim the use while lifting it and holding onto things above my head, I can not tell you how many times I hit myself in the head with a 3 pound dumb bell the funniest thing is my arm would dislocate at the shoulder and I had to pop it back in with a bit of help. It was almost comical.

  15. Wow. That really is interesting. I had no idea about the hematoma->callus process. I hope all goes well for you! The crawling fingers PT sounds like a very good start!

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