Wednesday, October 31, 2007

Happy Halloween!


Anna has been waiting for weeks and Halloween is finally here! She was sleeping hard last night and I had to go back into her room to put her pajamas back on. I asked her, "What day is tomorrow?" She was so tired she could barely get the words out, but she replied, "Quack Quack."

Jo had her follow-up appointment with Dr. Bazaz on Monday and he was pleased. He pushed her arm in all directions and she responded with multiple shreaks of pain. He seemed to think that meant she was right on schedule. Sometimes it is hard to keep in mind that the surgery was only a week ago. Jo came home from the hospital at noon on the day of her surgery and she was on pain medication for only one night. Dr. Bazaz expects her to see significant range of motion improvement within a couple of weeks.

Jo scheduled her first knee surgery for early December. Whether or not that happens will all depend on how well her shoulder does over the next few weeks. Dr. Bazaz will have to give her the "okay" to go ahead on the first knee. She will be on crutches after her knee surgery and everybody wants to make sure her shoulder can handle it.

Tuesday, October 23, 2007

P/SL - Take 5

In the past month or so, Jo's left shoulder has been our primary focus. She has had a limited range of motion and some fairly significant pain. The MRI didn't show anything conclusive, so Dr. Kelly referred Jo to Dr. Raj Bazaz and this morning, Jo just completed her first arthroscopic surgery (at P/SL - Presbyterian/St. Luke's Hospital).

Dr. Bazaz just showed me the pictures from the inside of Jo's shoulder and they were amazing! He showed me Jo's biceps tendon, her rotator cuff, the cartilage and a bunch of other stuff that I can't remember. The amazing part is how clear everything is on the pictures.

It turns out that the biceps tendon and the rotator cuff look perfect and the cartilage really looks pretty good. There was no exposed bone and he didn't need to "shave" back any bone. The offender appears to be what Dr. Bazaz called a classic "frozen shoulder".

Many of the pictures showed very red, inflamed tissue. Dr. Bazaz kept referring to it as "angry" tissue that all needed to be cleaned out. Of course, I had to ask how it gets "cleaned" out. He said it is actually more like a little BBQ action. He uses a heat probe to "cook" the tissue. His analogy was that the really rare parts need to be cooked down to about a medium to medium-well state.

Since Jo was under anesthesia, Dr. Bazaz was also able to really take Jo's shoulder through a full range of motion. Due to the pain, there is no way to do this in a conscious state. By moving the shoulder through the full range of motion, he is able to "break up" the pieces and parts that have been "locked down" due to the inflammation.

Overall, Dr. Bazaz felt that what he found was definitely on the low end of severity compared to all of the possible things that could have been causing the pain. When she gets out of the recovery room, she will be in a sling, but he said she can get rid of that as soon as she wants and he will not ask her to limit the use of the shoulder at all. He said that it will only take a couple of weeks to know if what he did today relieves the pain and brings back a significant range of motion.

As for Jo's knees, Jo will need to have surgery on each knee. She does have pockets of necrosis and they need to be fixed. Fortunately, the necrosis is in areas that are not at high risk of further injury, but Dr. Kelly said she would not want Jo to go more than about 6 months before having that necrosis addressed.

We do not know when Jo will have her knee surgeries. Dr. Kelly said that she will need to use crutches for several weeks after each surgery and that will put stress on her shoulder, so we kind of need to wait until Jo's shoulder is fairly well healed.