Sunday, September 19, 2010
The Healing Begins ~ Mondays...Part One
As the day for surgery approached, I made sure that I had selected my spot at the Mausoleum , paid and signed all appropriate papers. After all should I not return I certainly did not want people arguing on where I should be laid to rest. I still had visions of the discussions that must have taken place when I was not expected to live after the accident. My darling Father wanted me to be put to rest close to them (about 3-4 hours from Toronto), my sister felt that my love for Toronto and with all my friends/extended family here, I would wish to be put to rest in Toronto.
Most elbow replacement surgeries are done under general anesthesia. General anesthesia puts you to sleep. In some cases surgery is done with regional anesthesia, which deadens only the nerves of the arm. If you use regional anesthesia, you may also get medications to help you drift off to sleep, so you are not aware of the surgery.
After the anesthesia, the surgeon makes an incision in the back of the elbow joint. The incision is made on the back side because most of the blood vessels and nerves are on the inside of the elbow. Entering from the back side helps prevent damage to them.
The tendons and ligaments are then moved out of the way. Care must be taken to move the ulnar nerve, which runs along the elbow to the hand.
Once the joint is exposed, the first step is to remove the joint surfaces of the ulna and the radius. This is usually done with a surgical saw. The surgeon then uses a special rasp to hollow out the marrow space within the ulna to hold the metal stem of the ulnar component. The ulnar component is then inserted into the bone to test the fit. If necessary, the surgeon will use the rasp to reshape the hole in the ulna
When the ulnar component has been fitted correctly, the surgeon repeats the procedure on the humerus.
After the humeral component has been fitted, the surgeon puts together the pieces of the implant and checks to see if the hinge is working correctly. The implant is then removed, and the bone is prepared to cement it in place. The pieces are cemented in place and put together. After another check for proper fit and motion, the surgeon sews up the incision.
For the interested among us .. the links below will demonstarte (not on an actual body- just animation) the procedure:
View animation of removing the joint surface from the ulna
View animation of preparing the hollow marrow of the ulna
View animation of inserting the replacement component of the ulna
View animation of removing the joint surface of the humerus
View animation of preparing the hollow marrow of the humerus
View animation of inserting the replacement component of the humerus
View animation of assembling the components
Click here for more information on elbow replacement.
info, links and joint image credit: West End Orthopaedic Clinic. They're website is a vast wealth of information.
What I want to share with others:
Be sure to let your loved ones know just how much you care and love them. You never know what can happen in a blink of an eye.
I can’t begin to tell you, how much comfort knowing that my resting place is there ~ for when the time comes for me to leave this earth. Though I know my soul and being will be “Home” again, this place that will house my body will be a place of comfort for those who remain to feel connected in some way to me.
Today, due to my artificial elbow I am able to feel more comfortable in public. My arm though not fully extended, does rest at my side; I do not have full flextion - but can touch my face, though I still need to use shoulder movement to make it possible - it is more than I could do before; I still don't feel comfortable eating in public with my right hand ( I still have no pronantion or supination ~ turning at the elbow/wrist movement) and thus its a shoveling motion to eat - not the most elegant manner, so I am still cautious of what I order while out to eat; I can hold a hamburger now *smiling*. I've been advised by the specialist to not carry more than 2 lbs with my right arm - so if you weigh your hand bag- you'll know what I mean.
I do get alot of pain (from nerves) in my arm and my right hand is usually much cooler. The non-exsistent pronation and supination is not a result of the elbow surgery , it is from the plates and screws that are in my right forearm ( I sustained multiple fractures - thus the need for hardware). I may not be able to kick box; play volleyball or participate in activities that could result in a fall and additional damage to my right arm .. small price to pay for still having an arm I would say! - since amputation was suggested of said arm due to the horrific damage. Thank you to my sister and brother who would not authorize amputation.
For anyone who is considering an elbow replacement ... know that you may have to beg and plead your case. don't give up until you find a surgeon (reputable is a must) that will do the surgery. Due to the procedure - and the the expected life span of the artificial elbow being 10 years (if not over used... remember its like a door hinge.. the more pressure, use the sooner if will need adjusting. I'm trying hard to ALWAYS remember this myself) the age bracket for such surgeries is over 55/60 years of age. So any one under that age needs to have alot of patience. If in the southwestern Ontario area - I highly recommend Dr. Axelrod at Sunnybrook, he really listens and explains things.
If someone has a loved with an artificial joint your love for them will make you want to protect them and keep them safe. Meaning anytime You feel they are over doing , you will be there telling them so. Remember, it is hard to not over do things .. after all 2 lbs is a Morton's baked potato. So, be patient , bite your tongue and if they are only over doing it now and then .. remember they need to feel alive.
images credit: google search