Resonance

The physiotherapy tales are getting a little repetitive, so I'm just doing one post for this week. The Tuesday session was much like the previous one. The focus was on strength and improving wrist motion and flexion. Resistance was provided by a rubber strap anchored to the front of the table. Flexing hurt a lot during the session but didn't hurt that much afterward.

On Thursday morning, I went to the hospital early as I had my sister drop me off on her way to work. I didn't want to take a cab since it was a pretty short distance from my house. Of course arriving at 8:30am for an 11:00am appointment results in a pretty boring couple of hours. Fortunately I had just downloaded Angry Birds Rio recently, so that helped to pass the time.

At 10-ish, I went to the Imaging Department for my MRI scan. After a short wait, they ushered me in and weighed me - 74kg (getting fat!). I answered their questions mostly about metals in my body, then I emptied my pockets of anything with metal, even my belt, and put them in a little locker. I cleverly opted not to wear a watch that day.

The MRI room was cold, very cold. A (poorly) simulated skylight showed a blue sky fringed with cherry blossoms and other pretty tree parts. The MRI machine was a Siemens. It looked stubbier than I imagined, but was suitably impressive. The technicians and radiologist (a group of 3 people) made every effort to make me comfortable as I lay on the bed. The radiologist asked if I could stretch my arm towards the sky and I said yes, so that's the position I took while lying down. My knees were elevated by a special spongy thingy and my head lay on a thin pillow. My arm was strapped in place. A noise-dampening headset, a blanket, and a panic button completed the paraphernalia.

As the motorised bed was raised and slowly inserted into the tube until my head was barely in it with my hand at the centre of the machine, I thought of many things including how the machine worked, how cold it was, and how on House, something awful always happened during MRI scans. I thought about the massive amount of EM energy being generated by the machine and I imagined I could feel my molecules absorbing the energy. But really, all I felt was cold while the machine made a series of weird humming, buzzing, and knocking noises. It took longer than I expected and I began to regret taking the arm-over-head position as my arm started to get tired, cold, and a little numb. My muscles weren't all that strong yet so my fingers were involuntarily shivering I guess. They had to repeat the scans a few times and the radiologist had to come in to put another blanket on my arm and let me rest a little. Finally they got what they wanted and the radiologist promised over the headset to let me out after one more 2.5-minute scan sequence (I swear it was way longer than that). It was quite a relief to move my arm again as it had really gone numb.

The whole thing took 40 minutes from entering the room to exiting it. On the way out, a woman going in asked how it was and I just told her it would be really cold.

After the MRI, I had two hours to kill before getting the results, so I had a rather weak lunch of a 1901 hot dog (yes there is a 1901 hot dog stand in the hospital, along with a Starbucks and a Baskin Robbins). After lunch, I went up to the orthopaedic clinic for my physiotherapy session which was much like the Tuesday session. My flexion still needs a lot of work but they focused mainly on strengthening the biceps. I went back to the imaging department and foolishly waited an hour before asking if the results were ready. It turns out they were waiting in a tray all along.

MRI films in hand (they're huge, by the way), I went back to the clinic to see the doctor. The MRI confirmed that there was a fracture of the radial head, joint effusion, and possibility of injury to the annular ligament. All these conditions were expected due to the sprain and fracture. The doctor looked at all the films and concluded that all was well. He prescribed a 10-day course of anti-inflammatories and continued physiotherapy as my flexion was still poor. He said he'd see me in a month which would probably be the last visit. Good to know he's confident at least.

Personally I think I've come very far since the initial visit 3 weeks ago. My extension is practically full and flexion is improving. I'm quite confident that I'll eventually regain functional if not perfect range. Time heals (almost) all wounds.

Physiotherapy, Part 6 (Featuring Doctor Consult)

This post should have been written a couple of days ago, but I was lazy, so sue me. The last of the first wave of physiotherapy sessions, the sixth one wasn't much different from the last one. We did the same strength training exercise under electrical stimulation. This time however, the manipulation was done by a woman. You'd think a woman might be gentler, but you'd be wrong. She concentrated mostly on wrist movement which was still quite stiff and painful to move. I had not been doing much wrist movement because it hurt so much, but the therapist forced me to move it and used a strap to kinda spiral round my arm to gradually force my wrist to turn. It was very painful but I must say after a couple of days, the range of motion has improved tremendously. There is still pain at the end of the range so it's not quite there yet, but it's heartening. My flexion is still stiff and painful to bend but seems to be improving (very) slowly.

That was Friday.

On Saturday, I went to see the doctor for a consult. Not much to say. My extension is almost full but not quite and flexion is still stiff. He prescribed more physiotherapy and an MRI on Thursday to rule out any secondary injury (apart from the bone). In any case, I had already made physiotherapy appointments on Tuesday and Thursday (down to twice a week now). I've never had an MRI before; I'm a little apprehensive, but the nerd in me can't help but feel a little excited.

Until next session.

Physiotherapy, Part 5

There isn't much to report for the latest physiotherapy session. The usual 15 minute hot pack was followed by some manipulation by the therapist. It still hurts to rotate my wrist and flexing also causes quite a bit of pain. We did electrical stimulation to biceps and triceps simultaneously while moving my arm with resistance provided by a rubber strap attached to the wall behind me. This lasted for about 20 minutes and was very tiring. After the exercise, the therapist performed some more manipulation which again, hurt a lot.

My extension is almost 180 degrees now, maybe off by 5 degrees or so. Letting my arm hang down is almost painless now (apart from the soreness caused by all the manipulation). The therapist says the joint is 90% functional and we need to concentrate on strength improvement. One more session tomorrow...

Physiotherapy, Part 4

Over the weekend, my arm has improved considerably. The extension is at least 160 degrees and there was some improvement in the flexion as well - enough to feed myself with a spoon (but not chopsticks). I even drove to work on Monday after six weeks of not driving (ah the joy of being behind the wheel in a traffic jam). Today however, I didn't drive as I knew my arm would be in pain after the physiotherapy - and boy was I right.

After the requisite hot pack, we worked on flexion with a rubber strap providing resistance as I flexed my arm back and forth. This was done while under electrical stimulation to the biceps so it was a bit weird. Ten minutes of this was quite tiring. Then the therapist started on the manipulation which included wrist movement which I still have issues with. I take back what I said about the last session being the most painful. This one takes top spot for now. The therapist was impressed with my extension but the flexion still needs a lot of work.

Physiotherapy, Part 3

The last physiotherapy session for the week was particularly painful. After the usual hot compress and electrical stimulation, the therapist started in on my arm focusing on wrist movement. This really hurt... my arm is still sensitive to twisting so there's considerable pain when twisting to the palm up position. There seems to be no stiffness in the movement, but there's a lot of pain. We also worked on arm extension and I think it improved by about 5 degrees. My arm feels almost straight; I estimate the degree of extension at about 160 degrees.

My arm and shoulder were sore for quite  a while after the session. At least I can rest for a few days before the start of more sessions next week.

Physiotherapy, Part 2

Wheeeeeee..... another physiotherapy session. On the menu today, we have a heat pack for starters, followed by 10 minutes of electrical stimulation. For the main course, we have aggressive massage and stretching and for dessert, we have cold compress with free movement.

The session today was done at the 'Hand Unit', the workshop-esque section. The regular physiotherapist didn't really do anything for me today. Instead, another guy performed the stretching to loosen my stiff elbow. It was very painful of course. I found myself laughing while he was doing it. There's something darkly funny about subjecting yourself to such pain and I guess it's better than crying about it. At the end of it, there was an improvement in the extension by maybe 10 degrees with little improvement in flexion.

My arm is quite sore and there's still another session tomorrow.

Physiotherapy, Part 1

Today I had my first real torture physiotherapy session (after the first 'introductory' session), I left work after lunch to undergo the first of three sessions this week. I got there early, so I started my session half an hour earlier than scheduled. They started with the heat pack for like 15 minutes. This was followed by some minor manipulation and massage by the therapist. This did not hurt all that much. Then came the electrical stimulation. They attached four electrolyte-soaked sponges to strategic muscle sites and pumped in current from 48mA to 62mA over 20 minutes. I was mildly fascinated by the involuntary wrist and finger contractions caused by the higher currents.

Then the real fun began.

The therapist (a big guy who wouldn't look out of place in a rugby team) gradually exercised my arm, focusing on improving the extension movement. It hurt like heck. The scary part is that the therapist said this was a 'gentle' exercise. Thankfully, it wasn't very long.

At the end of it, my arm extension had improved by about 10-15 degrees (I'd say my arm can extend to around 150 degrees now). Contraction didn't improve much, but I guess that's not bad for one session. Until Thursday then...