Tag: Surgery

Elbow Shemelbow

~ Kai Raines ~ Leave a comment

Now this blog has a huge WTF!? factor…just so you know. I went to fetch my wife…sound southern, don’t I? I fetched her from yonder Colorado. (Of course, people in Florida don’t have southern accents.) Anyway, I drove out to Colorado for two weeks to visit my kids and grandkids and to bring my wife home. When we left Colorado, we drove to Texas to see my wife’s family. Fortunately, we did not get hit by a tornado, but it was close.

The evening we arrived, I noticed my arm was red. Specifically my left, elbow replacement arm, was red around my elbow. I didn’t think too much of it until the redness spread on Sunday. That’s when I showed my wife and became terrified that I might have an infection in my elbow. Apparently, I was told, you can get an infection in a joint replacement up to a year after the surgery. From reading I’ve done it can be many years after surgery. That’s scary.

So, on Memorial Day I called to talk to the on-call doctor back in Florida. He prescribed me some antibiotics and said I needed to be seen when I got home, and I needed to call if anything got worse. Cellulitis is what he called it. It’s a bacterial infection that is usually caused by a cut or some other opening in your skin…well, I don’t have any cuts, so I thought it didn’t sound so bad. Then I started reading about it in connection to joint replacements. Thank you very much google. According to the Mayo Clinic, Cleveland Clinic, and John’s Hopkins this type of infection almost always requires surgery to get the infection out and remove the infected joint. WTF!?

Now I’ve had a lot of surgeries in my life…approximately 45 on various joints. 13 on my elbow. I’m not so afraid of surgery. I’m afraid of what it would mean if I did need surgery. If my elbow replacement needs to be removed, besides the months of IV antibiotics, I won’t have an arm anymore. Nothing will replace the replacement. I’ll have an arm with no elbow so my arm will just be decorative…because it won’t work. I’ll wear a brace and have minimal use of my hand.

When I had the surgery for my broken arm and dislocated elbow replacement last November, I was told that if this replacement failed, as others have, the only option left would be to remove it and not replace it anymore. At that time, I appreciated knowing that if that happened, at least I wouldn’t be in pain anymore. That sounded good. Until now. Now it sounds horrible. If this infection is in my joint, I’m going to lose my arm. Its not going to be amputated but it will only be for show…a useless appendage hanging from my shoulder. I feel overwhelmed and terrified. It’s one thing to hear about a possible thing that might happen in the far away future and being punched in the stomach by an inevitability staring you in the face.

Maybe it’s not inevitable. The redness is mostly gone…it’s still swollen, hot, and stiff. I see the doctor Friday. So, WTF!? I don’t know what the fuck. My work this week is sitting with not knowing…and not freaking out. I’m not inappropriately freaked out…only about a 5. That seems reasonable…given the circumstances. I did stop googling. My mind is very distracted this week on its own…I don’t need to encourage it by being sucked down the google black hole.

I need extra awareness this week. Awareness of my interactions with myself and with others. Awareness of my anxiety. Awareness of my capacity and willingness to love. Awareness of kindness I can offer to myself and others. I didn’t do anything to make this happen so being angry at myself seems unhelpful. Because in the end all that matters is how we love people…and that includes me.

Floating and Falling

~ Kai Raines ~ Leave a comment

The Grammy Awards were last Sunday. I love Billie Eilish and that night she won “Song of the Year” for, “What Was I Made For?” If you haven’t heard it, you should change that…now. It’s an amazing song…in my opinion. She wrote it for the movie “Barbie” which I have not seen yet. Anyway, the beginning of the song says, “I used to float, now I just fall down. I used to know, but I’m not sure now….” As I’ve gotten older there are so many more things, I’m not sure of. Everything was so clear when I was in my 20’s…so simple…so black and white…so rigid.

When I was younger, I was an athlete. I played basketball, softball, and I swam…all competitively. I was coordinated. I could stumble and catch myself easily before I’d ever fall. I could run forward and backward…I thank basketball for that. When I went to college, the basketball coach was interested in me for the team. It was a very small school but still that was a dream come true. I ended up having knee surgery instead of trying out for the team (thank you field hockey…I should have never trusted a sport that makes you wear a skirt) and that was a big loss for me. Being an athlete was a huge part of my identity then. I think it was my identify. Everything in my life was connected to sports, all my friends played, and we spent our time together on and off the court. I had a basketball with me all the time and got really good at spinning it on my finger…I could even switch fingers and hands (my grandkids used to think that was very cool when they were little).

I wrote about my accidental fall, surgery, and ongoing recovery a couple weeks ago. I wasn’t really planning on writing anymore about it because it was done. Right? Then I was walking my dog and I tripped on my crutch and that whole accident came crashing down on me. I was back on the beach as if it was happening again right then. I saw myself fall. I heard and felt the crunch and snap of my arm breaking. My heart started racing and I felt the warmth of tears welling up in my eyes. I felt overwhelming fear and sadness, even though I was fine in that moment. I did not fall. I did not even come close to falling. I just tripped. I was so afraid.

I used to float…I’m not sure I ever floated but I didn’t fall. I wasn’t clumsy. I was coordinated. Now I just fall down, randomly and for no reason or that’s how it feels to me. And worst of all, I don’t know how to stop it. Missteps that I could have easily corrected in the past, knock me to the ground now. And I am afraid. Afraid to live in my body. Afraid to feel in my body. Afraid to fall in my body. How can I mentally feel like I’m 40 and physically move like I’m 90? That’s fucked up. I feel like everyone treats me like I’m fragile and about to break. But I’m not…okay I did break but I’ve been put back together with metal and cadaver bones. Just missing duct tape.

“I don’t know how to feel but I wanna try.” Feelings are hard for me. As a child, I was encouraged not to have them. Feelings are messy. No one wanted to know how I felt. How do I know this? No one ever asked. No one cared how I felt. If I was angry, I got in trouble, even though anger seemed like the go to emotion for my parents. And if I was sad or cried, I was teased or taunted. I felt humiliated. I decided emotions were way too much trouble for me.

Let me be real… I don’t know how to feel because I’m having difficulty being in my body right now. I was learning to be present in my body and feel my feelings and then I fell…my catastrophic fall. I feel fragile and I am not a fragile person…so that pisses me off…which I’m sure is helpful. I am not fragile. I’m fucking Superwoman. I deal with, manage, and take care of tons of shit every day. I am not fragile. Fragile feels bad to me, weak. I am not weak. I can’t be weak.

I don’t know how to feel…that’s true two ways. The “I don’t know” as in I don’t recognize the feeling, and/or the “I don’t know” as in I can’t decide, too many choices. I’m with number 2. I can identify feelings, I’m better at it with other people’s feelings but I can get to mine…it may take a minute. I have a master’s degree in counseling…I know lots of feelings…a grade 18th’s worth. But it’s not so much that I don’t know how to feel as I don’t how I can manage all these feelings. I have a fucking tsunami of feelings.

You see, it turns out I have all the feelings. So many feelings. I have spent years learning to feel my feelings…years. And convincing myself to stay present in my body, even when my body hurts. To stay with the physical pain and any feelings that arise from it. I feel afraid of all the feelings inside me. Afraid of being devoured by them. I’m afraid and sad. I feel diminished by falling. I became a fragile and weak person in other people’s eyes, and they question my capabilities…and their doubts eat away at me…and so do mine.

Now let’s be real…I might have some PTSD, just a tiny bit. I’m afraid. I’m afraid of being me and living in this body. I feel fragile and vulnerable in a predatory way…like my body is out to get me. I don’t know how to be in my body right now, it feels complicated. I’m afraid of my body, as if it’s separate from me, and can damage me on its own. I feel breakable in a new way since I fell. And it’s not so helpful that my mom tells me I need to stop falling because I’ll end up in “bad shape,” basically dead is what she means. If it was as simple as deciding not to fall, then it would never happen again. It’s not that simple. I’m careful and I fell. I’m careful and I’m afraid. 

It feels strange to say that I am scared of myself. Makes me feel a little bit like I have multiple personalities and I’m afraid of one of them…the one making me fall. I don’t know exactly what to do. I can pretend that there was no impact on me from the fall but the the slightest misstep or stumble and my insides collapse. Physically being put back together didn’t fix my fears. My bones have healed but not my heart.

 Let’s be real…I can’t outrun my feelings. I actually can’t outrun anyone, except maybe my English Bulldog. And neither of us believe in running. What’s the worst thing that can happen if I stay with my feelings? Allow myself to sit with my fear and sadness? I suppose I’ll feel way more than I want to but what else? What’s the worse thing that can happen if I feel…feel it all? And what’s the best thing that could happen if I allow myself to feel that whole tsunami of feelings? They are messy and I am messy, but would I learn to believe? Believe in myself. Believe in my ability to handle anything that comes up for me. Believe I can feel a tsunami and survive. Believe I am bigger and stronger and smarter than my fear. Believe in myself and my potential just like I promised myself I would. Perhaps practice what I preached just a month ago…there’s a whole lot of believing that’s ready to go on here…and all I have to do is stay, relax, and feel. So simple and so scary. Until you do it…until I do it.

Post traumatic stress disorder is a big topic so next week I’ll talk more about PTSD and the fear and sadness that can accompany it. In the meantime, I’m gonna practice what I preach and I’m going to love. I’m going to love myself and the people around me. I’m going to practice a loving attitude toward the world. Love will keep me a glass half full kind of person. It’s all in my perspective…so I’m keeping mine focused on love, because in the end all that matters is how we love people…including ourselves.

Strangely Grateful

~ Kai Raines ~ Leave a comment

Sometimes when people lecture me on being grateful, I want to punch them in the stomach…I never do which is a good choice on my part.  I am growing up. I’m not sure anyone can look at anyone else’s life and decide whether you’re grateful or not. I think gratitude looks different in everyone.

I consider myself a “glass half full” kinda person. I look for reasons to be grateful. I put a positive spin on things, I’m excellent at reframing, and I like to give people the benefit of the doubt. I work to be aware of my gratitude…and my attitude…which can have a rough edge at times. But sometimes shit goes down and I fear I may never be grateful again. The circumstances scream WHAT THE ACTUAL FUCK?!!! And then I find myself grateful again, despite (or in spite of) my outer circumstances. I might surprise you. I shock the hell out of myself. I’m telling you sometimes I rise…me and the phoenix…fly baby fly!

Of course, all of this is leading to a point. I promise. I have the most amazing wife. She is literally my favorite person in the world…sorry P!nk. We got married on 11-11-11. We thought that would be a lucky day and its Veterans Day, so we got married on a Friday because our friends and family were off work. And now our anniversary is a national holiday…as it should be. Last year we weren’t able to be together for our anniversary, so this year we decided to start celebrating early. The plan was the beach…Treasure Island on Friday and Siesta Key on Saturday. We packed some bubbly (beer bubbles for her and Prosecco bubbles for me) and some snacks. It was a beautiful Friday. All sunshine all day. It was in the 80’s and so the water temperature was chilly but warm enough to swim. We floated out in the water and just hung out talking…about nothing really, and everything. 

When we were getting out of the water, I noticed there was a small step up out of the water and onto the sand…created by the tide I suppose. I walk with a crutch, and I use it at the beach and in the ocean. My point being that I was being careful and lest you think what happens next was alcohol involved, I had had maybe 6 ounces of Prosecco a couple hours earlier. So, I was steady on my feet…or as steady as I ever am on my feet. I started to step up out of the water twice and stopped myself because it didn’t feel safe with the waves. Finally, I took a step and as I did the sand gave way under me and I fell. I fell forward and on my outstretched left arm, which I heard snap and felt break. As a bonus, my elbow was also dislocated. This would be the time to tell you, or remind you, that I have an elbow replacement in my left arm. My interpretation of my elbow dislocating was that the replacement was completely mangled. When I cradled my left arm with my right hand, after I told Gayle to call 911, because I was definitely not okay, I could feel my replacement jiggling around…or my bones…or both. It felt like it was in three pieces. That’s a gross feeling. Even with all the surgeries I’ve had and the years of chronic pain, this is the first time I have ever told a medical professional that my pain was a ten…and I meant a FUCKING TEN!!!! 

People on the beach tried to help me stand up but I couldn’t take the pain of them trying to lift me under my arm. Finally, they pulled me by my shorts out of the water so I wouldn’t be knocked around with the tide coming in…I think it was coming in. I was getting wetter and colder by the minute. The paramedics carried me on a backboard to the ambulance. Slight side note, they put me on a backboard to the stretcher after I suggested it. I really think when you’re in a crisis you should not have to help the professionals with how to handle the situation. I’m making fun here, but they were great and very kind to me. Initially they were fixated on the idea of putting me in their wheelie chair thing and then confused by how they would roll it in the sand. So, the backboard was a welcome suggestion…a “good idea” even. 

Once I was in the ambulance, the EMT asked me if I had ever had fentanyl (I’m resisting the urge to make a bad joke here) and I said, “Yes, and if you have some I would like it NOW please.” Look at me still polite even while in raging pain. If I was a screamer or a crier, I would have been doing so much of both. Lucky for them I learned young to be quiet when in pain. No one wants to hear all that crying and whining anyway, even if your arm is in three pieces. Luckily the IV was put in quickly and a dose of Fentanyl followed. Five minutes later I asked for more. The first dose didn’t touch the pain. After the second dose I was able to relax the grimace that had become my face. I even managed to doze some during the 45-minute drive…I wanted to go to Morton Plant hospital and the EMT’s agreed…even though it was far. They really were great.

Then I got to the ER, got jiggled around, had X-rays, and some IV Dilaudid before I ever saw a doctor…at least I don’t think I had seen a doctor…my memory has a lot of fuzzy places. So, imagine my surprise when the doctor came in and said my arm was broken…that’s not the surprising part…wait for it…He said, “We’re going to admit you and you may have surgery tomorrow.” Now maybe I should have been prepared for that, given the circumstances, but I was not…not even a little.

Shortly after the doctor came in, I was moved to the surgical floor where some angelic nurses helped me change out of my swimsuit. I told them to cut the top off because I was not going to be lifting my three-piece arm to undress. They managed to get it off of me pretty easily, and without scissors. Turns out I had half of Treasure Island in my swim shorts. And that is the danger of pulling people, by their shorts, through the sand. Sand went everywhere. You could have built a small sandcastle in my room. I felt bad because someone from housekeeping had to come and clean it up. I just kept apologizing.

I did not meet my orthopedic surgeon until the next day. Dr. Andrew Boltuch, who my sister says is “too pretty” for her. There was more than one nurse who asked who he was after he left the room. He is very pretty…even a lesbian could see that. Not only is he pretty, but he’s also THE GUY for elbow replacements around here. Talk about serendipity…by the luck of who’s on call, I get the best specialist in the Clearwater/Tampa area…it might be all of Florida…or the United States…or the Universe! It’s hard to know.           

If you follow me, you know that I’ve had a lot of elbow surgeries, ten in fact. There have been repeated failures of the humeral component of my elbow replacement, and it has been revised four or five times in the past couple years. Including once when my joint got infected after surgery because of a sloppy stitching…and by that, I mean they left a fucking hole in my arm. That one surgery turned into three additional surgeries. Back to my point, my elbow is complicated. Even I know that. Dr. Boltuch told me that he had ordered a new humeral component with a longer stem so that it would go up beyond the fracture. He also ordered two cadaver bones to use to reinforce the fracture. So, there was no surgery Saturday. It took until Tuesday to get all the parts to put me back together again.

Tuesday, November 14th, I had a 6-hour surgery that began at 4:00 pm and ended at midnight. I realize that’s eight hours but that includes the getting me situated, asleep, sterilized, and then stapled back together parts. I love my doctor so much because whenever we’d ask him about the surgery, he’d think for a minute and then say, “It was so complicated.” I am hammered, glued, and nailed into place now. And except for the obvious healing pain, my elbow feels good. Better than it has in a couple years.

Now you may wonder, after ten surgeries and multiple revisions, why would I even consider having another implant put in. That’s a fair question and one my wife and I both asked. The doctor said he thought it was reasonable to try one last time with the new component parts and then if this one failed, he’d take the elbow replacement completely out. I would then be fitted for and wear a brace on my left elbow all the time. He said I’d have minimal use of my left hand. He also said that patients who have had that as their outcome are happy with it because they aren’t in pain anymore. Imagine that…no more pain. It made sense to me.

A small issue I haven’t mentioned yet is that the humeral component of my left elbow was already coming loose. When I would move my arm, the joint wouldn’t line up correctly and so I’d have to move it around until it was back where it was supposed to be. It was excruciating pain…although I only gave it a 9.5…because something could always hurt more…right? Anyway, I had an appointment with an orthopedic surgeon set for January to try and find out if anything could be done for my elbow…like injections or a brace. I had been told by the Mayo Clinic that unless something catastrophic happened to my elbow no one would ever do anything surgically to try and help it. At that time, I was already in pain every day…I’d say a 7 or 8…every day…every fucking day!

Now let’s be real…so far this story is pretty depressing. “Romantic day at the beach turns gruesome.” Some headline. I did start off talking about gratitude. And I did name this essay “Strangely Grateful,” so WTF?! The Fuck is that gratitude can find us, or be found, in the least likely circumstances. I was in excruciating pain all day every day because my elbow replacement was loose and moving around in me. With my history, no one was going to touch my elbow and I was depressed at the idea of living the next forty years in increasing pain. 

Enter catastrophic event…unplanned, unforeseen, and very unintended. I was being so careful. I am always careful because I don’t want to fall. That event, that catastrophic event, saved me. In that moment the best elbow doctor in this area (or the Universe) happened to be on call and happened to spend a good amount of time figuring out how to fix me. He had the answer for the chronic pain. Either this surgery works and I’m not in pain or the replacement gets removed and I’m not in pain. There’s no elbow pain at an 8 for the rest of my days. Catastrophe, serendipity, no more pain. I am grateful. I am fucking grateful! If my beautiful doctor wasn’t married, I’d marry him…well, if he wasn’t married, and I wasn’t married…and if I wasn’t a lesbian…you get the idea…we’d never be married. I do love that man and I am forever grateful to him for helping me. I can’t even imagine how complicated my surgery was, but he was in there for six hours doing everything he could to end my pain and leave me with a functioning arm. He came to see me after my surgery at 3:00 am to make sure I was doing okay. I did finally ask him if he ever sleeps because he does work some long ass hours.

Catastrophe, serendipity, no more pain. That’s my formula. Although a huge portion of the “no pain” is working through the healing pain to get to pain cessation. There are just never any good fucking shortcuts. So, catastrophe, serendipity, work your ass off, healing pain, no pain…at least not in that moment. I suppose the danger is in thinking we ever get to “no more pain” as a permanent place of residence. The amazing thing is that the catastrophe can lead to the end of your pain. I guess maybe our lives, if we’re really living them is just one catastrophe after another, with healing happening all around and within us…all the time.

Catastrophe, serendipity, healing pain, no pain…and never forget love. None of this means anything without love. The kindness we give strangers by pulling them out of the water by their shorts, the tenderness of professionals doing their best to ease your pain, the kindness of caring for another human being, the love of problem solving and mastering the complicated…all because we can. Because it is the kind and loving thing to do. Because in the end all that matters is how we love people. Divine is the task to ease pain. Let’s ease someone’s pain every day. Let’s be real…in the end love wins…always.

**Here’s a bonus “end of 2023” special for you…a little something for New Year’s Eve. At midnight open your back door to let the old year out and open your front door to let the new year in…don’t fuck up the order or you might get the same year over again. It’s an Irish tradition I’ve been told. I know I’m ready to open the back door and wish 2023 a fond farewell. 

Here’s to 2024 and all the catastrophes, serendipity, hard work, healing pain, no pain and love we can find, and we can share. Always share the love.

Happy 2024!