My ORIF Proximal Humerus Head Fracture – Broken Arm Tips and Tricks Exercises Healing

Sometime around July 13 2016 I fell and hurt my shoulder; hours before my flight home to Northern California in the USA . It just so happened I was in Joinville, Brazil at the time with my girlfriend. Brazil has a pretty good health system and they have free healthcare and private healthcare. They are both ok, but with the free stuff you might be waiting forever. I ended up going for the private health care in the emergency room. I was a lil worried that this was going to cost thousands… I went in and was seen within minutes. Minutes later I had xrays done. minutes later again I saw the Dr and he confirmed part of my shoulder was broken as well as the head of my Humerus was fractured or broken. Recommended I go back to USA for surgery and from start to finish was about 20 minutes. Jetted to the airport and was able to get on my flight.

The doc gave me a prescription to fill at a local pharmacy and showed me what arm sling to get.

I’m so happy we took Latam Airlines. The seats are much more spacious then other airlines and with this injury I needed all the space I could get. I had 3 flights ahead of me and after the first flight I had a 5 hour layover…

I was a bit sad that for all 3 flights they would not bump me up to first class or even the seats with a lil bit more room. I couldn’t even get the flight attendants to help me and the girlfriend sit together…

Only thing they did allow was or me to board first and get off the plane last. Roughly 20 hours later I made it. Wasn’t able to sleep a wink.

Got home called a bunch of Doctors and surgeons. They said their really wasn’t much point of going to the Emergency Room. But it did take me another week to see a dr. I ended up going with this Doctor:
Hany Elrashidy, MD
4626 Willow Road
Suite 200
Pleasanton, CA 94588
Ph. (925) 463-0470

Went in a week later, showed him the xray I did in Brazil. He took another bunch of Xrays. Confirmed what the other doc said. ORIF Proximal Humerus Head Fracture. Had to wait another week till he could get me in for surgery. I have to say waiting almost 2 weeks while my arm was basically just hanging on by my muscle sucked. Not sure what it has hanging onto since where the ligaments and tendon attached were broken off the bone.

So sleeping sucked! I wasn’t able to sleep in bed at all. Before surgery I found that sleeping on the couch in my sling helped with my arm propped up a bit. So that might be an option for you if you are waiting for surgery… 🙂

The doctor visit was very quick. Didn’t explain all that much. Said he needed to do a CAT scan and would tell me more. Got the CT scan done the next day at Valley-care. It went pretty well as far as pain goes. Didn’t really need to move my arm at all. In and out in bout 5 minutes. Nothing like the LONG MRI’s. Grabbed a copy of the disk to check out at home…

So surgery day…

No one remembered to tell me about what pills or medications not to take until 24 ours before surgery… Luckily I wasn’t on any troublesome medications. Some meds you may need to stop weeks before surgery…

Always talk to your Doctor before starting or stopping any medication; especially before or after surgery. This info may be wrong or you may have a special situation.

Here’s a few pointers:

  • If surgery is in the morning no eating or drinking ANYTHING after about 10 pm.
  • No chewing gum. No smoking 2 weeks before surgery or after for a while. It will delay healing.
  • Take a shower and get extra clean. Use an antibacterial soap. Trim your nails.
  • No jewelry or eye glasses or contact lenses
  • if you have a cpap machine bring it with you
  • bring all your medication with you.
  • bring a lil cash
  • make sure you have a shirt or tank top this is extra large so it’s easy to take on and off
  • sandals
  • cell phone and charger
  • lots of books and magazines, even tho you should be in and out the same day or potentially their one night.
  • Tell your friends and family to stagger visiting times… It’s so boring. That way it passes the time much better.

If you do not feel well in the days before or on the day of surgery, call your surgeon’s office. The symptoms your surgeon needs to know about include:

  • Any new skin rashes or skin infections (including herpes outbreak)
  • Chest pain or shortness of breath
  • Cough
  • Fever
  • Cold or flu symptoms

Avoid these Products a couple weeks Before Surgery as Indicated by Your Doctor.

Monoamine Oxidase Inhibitors (MAOIs):

Drugs in this group include some anti-depressants and most anti-Parkinson drugs. MAOIs can interfere with many of the medications used during anesthesia. If the medication needs to be stopped, it should be done one to two weeks (7-14 days) before surgery because it takes that long for the drug to be out of your system. You should discuss this with your surgeon and primary physician as early as possible.

MAOIs include:

  • tranylcypromine (Parnate, Sicoton)
  • phenelzine (Nardil, Nardelzine)
  • isocarbonazid (Marplan)
  • rasagiline (Azilect)
  • selegiline (Eldepryl, Deprenyl)
  • linezolid (Zuvox) (an antibiotic)
  • St. John’s Wort

Prescription products with aspirin or other salicylates:

  • Amigesic
  • Ascomp with codeine
  • Alor
  • Carisoprodol Compound
  • Darvon Compound 65
  • diflunisal
  • Dolobid
  • Empirin with codeine
  • Fiornal
  • Lobac
  • Lortab ASA
  • Magan
  • Magsal
  • Mobidin
  • Monogesic
  • Norgesic
  • Novasal
  • Orphengesic
  • Panasol
  • Percodan products
  • Roxiprin
  • Salflex
  • salsalate products
  • Salsitab
  • Soma products
  • Synalgos-DC
  • Talwin Compound
  • Trilisate
  • trisalicylate products
  • Zorprin

Prescription products with these nonsteroidal anti-inflammatory agents (brand name in parentheses):

  • diclofenac (Voltaren, Cataflam)
  • meclofenamate (Meclomen)
  • etodolac (Lodine)
  • mefenamic acid (Ponstel)
  • fenoprofen (Nalfon)
  • nabumetone (Relafen)
  • flurbiprofen (Ansaid)
  • naproxen (Naprosyn, Anaprox)
  • ibuprofen (Motrin)
  • oxaprozin (Daypro)
  • indomethacin (Indocin)
  • piroxicam (Feldene)
  • ketoprofen (Orudis, Oruvail)
  • sulindac (Clinoril)
  • ketorolac (Toradol)
  • tolmetin (Tolectin)

Other prescription drugs:

  • celecoxib (Celebrex)
  • cilastozol (Pletal)
  • clopidogrel (Plavix)
  • dipyridamole (Persantine)
  • dipyridamole/aspirin (Aggrenox)
  • valdecoxib (Bextra)
  • ticlopidine (Ticlid)

Nonprescription products with aspirin or salicylates:

  • Alka-Seltzer products
  • Anacin
  • Arthropan
  • Ascriptin
  • Aspergum
  • Asprimox
  • Bayer products
  • Bufferin
  • Doans
  • Ecotrin
  • Empirin
  • Excedrin products
  • Halfprin
  • Mobigesic
  • Pepto-Bismol
  • Saleto
  • Vanquish

Nonprescription products with aspirin or salicylates:

  • Advil products
  • Aleve products
  • Dristan Sinus
  • Haltran
  • ibuprofen products
  • Menadol
  • Midol Extra Strength
  • Motrin
  • naproxen

Talk to your DR about thee:

Blood Thinners

  • Coumadin
  • Warfarin sodium
  • Ximlagatran
  • Clopidogrel
  • Plavix

 

Coumadin (Warfarin)

  • How many days BEFORE your surgery to stop taking this drug.
  • If you need bridge (short-term) therapy with an injectable anticoagulant (blood-thinner) such as heparin, or a low molecular weight heparin such as enoxaparin (Lovenox).

Herbal Products and Other Natural Supplements

Stop taking ALL natural products, herbal medicines, vitamins, and other supplements 7 days before your surgery. They may be resumed when your doctor says it is OK.

On the next page are herbs and other supplements that are especially harmful to take if you are having surgery because they can cause extra bleeding.

Natural supplements and herbs that may cause bleeding problems:

  • agrimony
  • alfalfa
  • aniseed
  • arnica
  • artemesia
  • asa foetica
  • bishop’s weed
  • bladderwrack
  • bochu
  • bogbean
  • boldo
  • bromelains
  • burdock
  • capsicum
  • cassio
  • celery seed
  • chamomile
  • Chinese wolfberry
  • chondroitin
  • clove
  • cod liver oil
  • coltsfoot
  • dandelion
  • danshen (salvia)
  • devil’s claw
  • dihydroepiandrosteroe (DHEA)
  • dong quai (angelica)
  • fenugreek
  • feverfew
  • fish oil
  • flax seed
  • gamma linoleic acid
  • garlic
  • ginger
  • ginkgo
  • ginseng
  • glucosamine
  • horse chestnut
  • horseradish
  • licorice
  • meadowsweet
  • melatonin
  • melilot
  • nattokinase
  • onion
  • pantethine
  • papain (papaya extract)
  • parsley
  • passionflower
  • policosanol
  • poplar
  • prickly ash
  • quassia
  • red clover
  • resveratrol
  • sea buckthorn
  • sweet clover
  • sweet woodruff
  • tonka beans
  • turmeric
  • vinpocetine
  • vitamin E
  • wild carrot
  • wild lettuce
  • willow bark

So I wake up after surgery. I feel pretty good. No pain. In the past I had trouble peeing after anesthesia so they wanted to make sure that worked properly. Luckily this time it wasn’t a problem. Nothing like getting a long tube stuck into your penis! They really had my IV fluids pumping because I was peeing like a mad man every hour.

Had no restrictions on food. So I ordered quite a few things off the menu. Valleycare Pleasanton, CA has really good food by the way. Take advantage of it!

I had to stay overnight. All the nurses and team their were really nice. FYI: Be nice to the nurses! They have a tough job.

Got discharged in the morning. My dr. once again didn’t tell me that much. Said I’m good to go. He’s always in a rush to do the next surgery or go wherever he is off to next. I feel like I’m just a piece of inventory in his system…

I got a nerve block done  as well as had this bottle with some type of Novocaine drip that was attached to a nerve in my back. So I felt no pain whatsoever. I didn’t even know I had an arm. LOL I couldn’t feel anything. Didn’t know I was touching my arm. If you have ever had Novocaine you know the feeling. Also felt like pins and needles. This wasn’t really explained to me so I was slightly nervous. After a couple days I pulled out the catheter myself and I slowly began to feel my arm again as well as the pain. A good self test to make sure your arm is ok – If it feels warm you are good and if you have good capillary refill you are good. Test by squeezing your finger of the hurt arm. It should go white and then turn back to original color within 2 seconds.

We had one of those easy chairs or lazy boy type recliners. Totally invaluable. I’d almost recommend buying one at like a garage sell! Sleeping in a bed would of been a nightmare. Some of the medical supply places sell these wedge type things. Those would probably work pretty well also.

Oh I almost forgot to mention… When I first went in to see the Dr. his assistant was really pushing this cold pack you strap to your shoulder and has an ice chest attached to it that circulates super cold water around your shoulder. I almost didn’t buy it. Kind of felt like some rip off scam that places try to upsell you on. And of course insurance didn’t cover it. It was worth every penny! Def get yourself one. It helped allow me to sleep, ward off inflammation and keep pain to a manageable level. I lived in this thing for the first week 24/7. After the first week I slept with  it and used it after I did my exercises for an hour.

Find lots of good tv shows to watch, get netflix, buy some magazines, tell your friends to visit, get some board games, play pokemon. Whatever… It’s boring the first week doing not much.

For me up to about 3 weeks post surgery; right where the plate and screws were it felt like I had about 10 different drills going into my arm. It sucked.

For pain they gave me an Oxycontin Tylenol mix (Don’t forget to take stool softener & drink LOTS of water).). It didn’t really do much for the pain and made me sick to my stomach. I only took it at night to help me go to sleep. Wasn’t really able to sleep much. I’d get an hour here and their. After about 4 hours I’d take another pill. After the second I’d usually get a solid 4 hours of sleep. Once I moved from sleeping on the lazy boy chair and back to my bed. I found the pills helped a lot with me moving around in my bed. Otherwise I’d recommend putting a couple pillows on either wide of you so you don’t roll over onto your arm and screw something up. I can only imagine what it would feel like if my arm happened to fall off the side of the bed….

For up to 6 weeks you want to be in your sling all the time except for when you exercise and shower. Don’t rest your elbow on anything. You want the pressure to be on your hand/wrist and your elbow to hang free. That way your bone can regenerate & fill in the space.

Up to 6 week post op they gave me 7 exercises to do.

Passive Pendulum shoulder forward back  90 seconds – 1 set – 3 times a day

Passive Pendulum shoulder circles  90 seconds – 1 set – 3 times a day – Do counterclockwise and clockwise

Passive Pendulum shoulder left right  90 seconds – 1 set – 3 times a day

So with these; the goal here is to let your body move your arm. It’s not really increasing flexibility; it’s getting fluid back in the joint and just keeping it a bit mobile.

scapular retractions – Draw shoulder blades back and down – 1 set – 3 times a day – 20 times

shoulder rolls – move shoulder in circular pattern- 1 set – 3 times a day – 20 times

Supine shoulder flexion – lie on back Use your good arm to gab bad arm and bring the arm up and back as far as it will go. Try to relax – 15 times – 3 times a day

sidebend flexion trunk stretch – bend over a bit, grab table then slowly walk back to get a stretch. 5 times holding for 15 seconds – 1 set – 3 times a day

Heat for 20 minutes before doing these then Ice for at least 20 minutes after exercising; more if you need it. I did.

I still have minimal flexibility, but haven’t started any type of active exercises yet. So once I start doing those I’ll add to this.

Other tips and tricks

Def increase your protein levels by at least 20 grams a day.  – http://ajcn.nutrition.org/content/87/5/1567S.full Specific amino acids of particular importance are: lysine, arginine, proline, glycine, cystine, and glutamine. Lysine enhances the calcium absorption, which increase the amount of calcium absorbed into the bone matrix, aiding the regeneration of tissue. one study found that patients receiving a protein supplement remained in rehabilitation wards for 33 days as opposed to 54 days for the group receiving a placebo of similar caloric value.

Low-intensity pulsed ultrasound (LIPUS) and pulsed electromagnetic field therapy (PEMF) are two options used by a number of athletes for promoting repair. A review of 8 studies has noted that both of these treatments can be effective in speeding tibial fracture healing. One of the papers reviewed found a reduction in healing time of 12 days among non-smokers treated with LIPUS (84 days versus 96 days) for clinical healing, and a reduction of 33 days for healing with PEMF (96 days instead of 129). Even in smokers using these therapies healing time is reduced, 103 days versus 175 in the control group using LIPUS and 96 days versus 175 in the control group using PEMF.

Some studies show your body goes from needing 2,500 calories  a day to 6,000. I know I was eating a ton and I lost 19 pounds in 3 weeks. – http://www.ncbi.nlm.nih.gov/pubmed/3304765
Increase your intake of Antioxidants either with food or supplements
Increase amino acid intakeDon’t take anti inflammatory like Aleve, Motrin, aspirin, etc. The only safe one is Tylenol. It will significantly delay wound and bone healing
No Smoking
No alcohol
No caffeine
No salt & minimal sugar
Take a multivitamin

 


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