Monday, April 26, 2010

Tough decisions...

It's 6:00 in the morning.  I had a rough night.  Despite my normal nightly routine of "ice and Advil" ... my shoulder was hurting...not any more than it has been lately - - but everything seemed amplified because my mind was racing all night long and I was worrying myself into a frenzy.  Why?  Well....last Thursday afternoon I met with my orthopedic surgeon to go over my MRI films and get a diagnosis of my "little problem".  At my initial examination, Dr. Kharrazi had been afraid of my having a torn rotator-cuff, as all of my symptoms (lack of ability to raise my left arm being the worst...constant pain being the other...) pointed to that more-than-likely conclusion.

A quick glance at the ghostly-looking black-and-white transparencies hanging on the light box on his examining-room wall told him all he needed to know.  The diagnosis:  "The subject (that's me!) has a 10 mm. full-thickness supraspinatus tendon tear, requiring arthroscopic surgery for repair."

In layman's (and much less poetic) terms....I have a torn rotator cuff.

At first, the doctor's diagnosis was quite a relief.  Actually knowing what is wrong with my shoulder was much better than the fear and anticipation of not knowing.  We discussed the options...and they were (unfortunately) extremely limited.  He told me that this type of full-thickness tear (that means through-and-through - the tendon is completely torn away from the bone) does not heal without surgery...and that if I didn't have it repaired, at 53-years-old, I would be running the risk of "not being able to hold a coffee-cup in my left hand by the time I'm 60."

With the weakness I'm experiencing now, I have no doubt that he is right!

We immediately began looking at the calendar for possible dates.  Dr. Kharrazi's "surgery day" is Friday...and it would take a bit of work on behalf of his staff to get us an operating room quickly.  As it turned out, the earliest date would be May 7th.  Without much thought (that wouldn't occur until this weekend, and in the middle-of-the-night...) - I agreed to begin the process.  I would need to answer a huge questionnaire (mostly about anesthesia) - get a pre-op examination my my regular physician (now scheduled for tomorrow morning)...the surgeon's office would be responsible for contacting the insurance company for approval (this was done and approval granted by Friday morning).  If there was a cancellation (very doubtful!) - they would bump me up to Friday, April 30th.

I had a busy weekend...I was the Deacon of the Mass and preacher at Bill Zuck's Requiem Mass on Saturday....and I repeated those same roles at St. Mary of the Angels on Sunday.  After Mass, Amy Suzzanne and I had to escape the final Open House that our Realtor was holding in a last-ditch effort to try and sell our house before we leave for Hyderabad (there's a whole different level of stress about all of that...for another blog-posting!)

I finally had time to sit and analyze the situation, the calendar, the prospect of surgery, the recovery process and all of the accompanying hassles that go along with having your left arm in a giant abductive pillow sling for three-weeks.  I was going to need to go buy a recliner-chair to sleep in (recommended by every web-site I read!)...get some giant-sized shirts (not the pull-over kind...this will be impossible to wear for at least two-months), some slip-on shoes or the kind with Velcro, some elastic-waistband pants (I won't be able to operate buttons or zippers for over a month)....

Along with just dealing with a "normal" recovery without mind started racing about the travel to India.  I can't imagine that the 24-hour flight will be much fun in my condition... not to mention my complete lack of being able to do anything to help with carrying baggage and getting Beloved the Lhasa Apso squared away and taken care of during the journey.  Then what about when we arrive to start our new lives in Hyderabad?  My responsibilities were supposed to include helping us find a house and get us settled.  Oh, yeah...this is gonna be a $#%&%& hoot, isn't it?  Of course, I'm picturing myself being a complete invalid and totally worthless tub-of-goo at a time when my family needs me the most.

Basically, I think it is safe to say....this is going to suck! 

So....right around bedtime (of course!), Amy and I began a very emotional (but very good!) discussion about all of our possible options.  The scenarios we talked about ran the gamut from: a) My not having the surgery at all, to b) Having the surgery on the schedule we've already set ... praying all the while for no complications and just plowing ahead, despite my anticipated completely worthless condition...or... c) Somehow postponing the surgery to a time after we are settled in Hyderabad, coming back to L.A. when Amy has to be in Las Vegas in September for a Partner/Director meeting, getting the surgery done and doing the recovery and physical therapy here...and returning after I can travel with relative ease.

The questions that arose from any of the above scenarios (and the 20+ other sub-plots that we were thinking about!) were making my head swim!!  Should I get a second opinion?  Was there time?  We  have to buy a recliner ASAP...I'd take care of that...but what about all of the pre-moving prep we still have to do?  What about all of the arrangements for home-care in case Amy has to go on to Hyderabad without me for the first month (an option that, quite frankly, scares me more than the prospect of having the surgery!)

Then came the all-nighter of Internet research, and searching the post-op shoulder surgery videos on YouTube (check out this guy HERE - - oh - doesn't this look fun??) .... I'll spare you a link to some of the videos of the actual shoulder surgeries on YouTube - - you can search those out if you want!  WARNING: Some of the videos you will find are not for the squeamish!!

By midnight, I'm completely freaked-out, of course.  When the light of morning finally came (this is when I do my best thinking) - - I decided that there were two things that will be absolutely necessary to get done today.  I need to talk to Dr. Kharrazi's assistant and get a long list of questions answered about post-op care (and probably a pep-talk!!)  And I need to write an e-mail to Deloitte's ex-pat coordinator in Hyderabad (her name is Geetha) and get some feedback and answers about the availability of quality post-operative orthopedic care over there... and - most importantly (so I have read on the Internet!) - quality physical therapy clinics for the 3-4 times a week I'll need to be doing that!

I just logged-on to Yahoo! and wrote the e-mail to Geetha.  Here it is:

Hello, Geetha...

Suzzanne and I have some serious healthcare choices to make, and they need to be made quite soon, if you could get back to us as soon as possible, it would help us greatly!

I have a recent shoulder injury that will require surgery...and it's looking like I will end up having the surgery here in Los Angeles....and I will then attempt to make the trip as planned and begin the recovery process for the necessary 6-12 weeks in Hyderabad.

An extremely important part of this post-operative rehabilitation process will be regular physical therapy on the shoulder. In addition, regular post-operative examinations will be required by a qualified orthopedic doctor.

I'm sure there are several such clinics nearby, but I do not want to rely on Internet websites for such an important decision.

Our decision on whether to have the surgery now or wait (something I would rather not do) is dependent on knowing whether or not we can find a medical facility where I can get proper shoulder rehabilitation care and physical therapy right there in Hyderabad. Hopefully all at one clinic!

Geetha, would you kindly check into getting us some answers to these important questions. I'm sure there are wonderful clinics around the Hyderabad area....obviously something close to the hotel where we will be staying at first would be the best... And please get back to us as soon as you can.

Thank you so much....

Scott Kingsbury

Now I guess we'll just have to be patient and wait for the answers.

In case you hadn't already guessed.... patience is not typically my "long-suit"!

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