It was amazing to be able to walk outside and not go into complete hyper venting, where your mind races a million thoughts a second filled of “what ifs “ and your fear is so great that it feels like someone is pushing on your chest and breathing is compromised. I still recall the feeling of going for the first walk on our property with Mr. G. It was like for the first time in so long I could breathe freely, no worries of careless drivers or the well intended drivers (people who stop for you to cross – but then start to slowly roll towards you as you cross). No, I could walk and be outside. It was a crisp March day in 2008 and even though my body ached with pain from the cold that felt as though it were piercing my coat and finding its way into my bones ~ to be outside made every second worth it.
Shortly after taking possession of our new sanctuary the reality that I would be going in for another surgery started to settle in. This would be the first surgery Mr. G would be around for (my 3 prior surgeries were before our paths had crossed), and it was for my elbow replacement. The days leading up to “the day” as we often referred to the surgery date were filled with joy and tears. If all went well my elbow would gain some mobility (no one knew how much range I would gain ~ when you have no range, even a few millimeters would be wonderful). I would hopefully be able to: walk with my arm at my side vs. in a hand shake position; touch my face with my right hand ~ it had been approximately 1 ½ years since I had been able to do this; be able to carry a hand bag in my right hand; cut my food and eat with my right hand; sleep without my right arm requiring to be supported by pillows; these were just a few of the things I hoped for.
The tears and fears came with the reality that any surgery (no matter how much it is needed) always comes with the risk one may not survive. For some reason I could not shake that perhaps this time I would not come back (I kept this thought to myself). I was so happy to see that Mr. G was slowly healing, though he missed his deceased wife (Angel P – is how I will refer to her in future writings, for I truly believe she is an Angel who looks out for Mr. G and also for me)terribly ~ he was coming alive. Much of this was due to the love and support he received from Angel P’s family on his ability and choice to stay alive and move forward with life (something his own flesh and blood was unable to do). I thought perhaps I had fulfilled my purpose to have survived the odds of my accident ~ to keep him from ending his before his time was due.
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.
What was surprising me, was with my surgery taking place at the same hospital where Angel P had been, that no one from Mr. G’s blood family stepped up to be there with him on the day of my surgery. Their presence would not make a difference to me; but for their brother, son, cousin ~ I wondered, were they really that cruel? What if I didn't survive ... He would be all alone to face the news. I would later discover that a cousin (by marriage) had shown up to keep Mr. G company. As they wheeled me into the waiting room for surgery, Mr. G insisted that he wait with me, the nurse allowed it, looking at him and saying “how can I resist those kind eyes”. As I laid on the gurney awaiting transport, he held my hand, stroked the side of my cheek – told me everything was going to be fine and that he would be right there when I woke up from surgery. He must have seen the look of uncertainty in my eyes because he then said “Do you know how I know everything is going to be just fine?” I shook my head no one, afraid if I should speak my tears would come flowing out … “Because I’m falling in-love with you, something I never thought I would be able to do after Angel P, care this deeply for another woman – so I know God is not so cruel as to allow me to be able to Love You, and then take you away too!” Just then the nurse came and wheeled me into surgery.
The Operation
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
