Fixing my broken shoulder and the aftermath of it

Begin May 2014 I had a motorbike accident (see An-almost-life-changing experience) and did break the head of my right humerus at 4 places. See Proximal Humerus Fracture What I thought to be a simple broken bone and some physical therapy has become a life changing event. Although hopefully temporarily, I think it will become a time of my life I will never forget.

The accident
With a ambulance I went to a hospital in Khon Kaen, X-ray was taken and a broken shoulder was diagnosed. Actually also abrasions at my knees and shoulders. And a cut in my right thumb. I was told that I needed a operation to put a steel-plate inside. I could do that at the hospital but I should make a decision within 1 week. At hindsight it was actually weird that the hospital in Khon Kaen did never check if I had something else broken or if I was hurt elsewhere. They did never clean or even check my wounds. Another thing that was at hindsight weird, is that I decided to wait 2 day and then fly to Bangkok to a better hospital. Yes, I just walked around with a broken shoulder for 2 days!  
First 2 weeks
So I decided to go to a hospital in Bangkok and 2 days after the accident I arrived  in the hospital in Bangkok where I had a 2 - 3 hours surgery and normally you would be hospitalized for about 3 days. But I had a few complications like fever, high heart-rite, low oxygen and high blood-pressure. So I was hospitalized for 7 days. At 3 days after the surgery the physical therapy started to reuse my arm again. I did stay for another week in Bangkok to follow physical therapy. The first week I stayed in bed in the hospital and could hardly walk and did more or less not use my right arm at all. And when out of bed my arm was in a sling. At the end of the second week I was advised not to use the sling anymore. But being afraid and insecure I kept my arm close to my body (not good!).

Mind you and think of
* Bad nights sleep
* Daily a lot of pain
* Not being able to use my right hand & arm, think about taking a shower, writing, signing your credit-card, putting on your cloths, etc
* No riding motorbike or bicycle, no driving a car
* Painful and exhausting exercise a few times a day
* Do everything with your left hand like eating and brushing your teeth

There are a few important steps in recovery
* Range of motion (passive & active movement)
* Power of motion (active movement)

Update after 3 weeks
I did go back to Khon Kaen and started physical therapy there. Mixed feeling about the quality, very much depends on the therapist. I still do more or less nothing with my right arm and when out of the house I still use a sling. I am afraid of falling or hurting my arm in any other way.

Update after 4 weeks.
And might you think that is a minor fracture .... bloody well forget it! Now 4 weeks later I am still in daily pain, bad nights sleep and cannot do anything with my right arm. Hell it is!

Update after 6 weeks
I did visit the doctor again and had a x-ray made. The fracture of the bone is healing well but my muscles not. So I am still not very much mobile with my arm. I still have bad nights sleep, the swellings are becoming less but still have pain and stiff muscles. Forecast is that recovery will take another 2 or 3 months. It is bloody amazing that muscles do so fast get weak and soft. And how much energy and time it will cost to get them back again.

Update after 7 weeks
After a check-up visit in Bangkok I decided that it would be better to have better physical therapy in Bangkok and we moved to Bangkok for 1 month. My muscles are still stiff and weak. I am still having pain and sleep not good.

Update after 8 weeks
I did visit the doctor again and had a lecture again about me not exercise enough. So I had a tough massage and exercise from him again. And it works as a few hours later I could do much more, but I had a bad night sleep. Power of motion is gaining slowly, muscles are getting less stiff.

It is actually a week of small surprises .... 2 days ago I realized I was using my right hand to type (although not fluent). And brushing my teeth with my right hand goes better & easier as last week. And I start to get more power in my muscles, being able to push my arm up a little bit. Doing that feels like I am lifting 50kg.

Update after 10 weeks
The small surprises do continue and although I can still not lift my arm above my shoulder I start to do more and more with my right arm. Also my muscles become a bit stronger. I think I am doing fine ... what is dangerous because of that I could become lazy in doing my physical training. I think I am doing fine but the doctor thinks I am not doing fine. Some small parts of muscles in my arm are still hard and a few other muscles around my sculptor bone are still very stiff (preventing movement of my arm). There was another x-ray taken and it all looks very well.

Update after 12 weeks
The past 10 days have become a time that I see a brighter future again. A future where I can use my right arm again. Maybe never in the same way as I did before the accident but never mind. So my stiff muscles are becoming softer and my soft muscles are becoming stronger. The stiff soft-tissue is becoming less stiff and the stiff area becomes smaller. That all results in more range of motion, more power of motion. And with that I can do more & more small things with my right hand.

Since a few days I can even drive a car again! And I just tried the scooter of my wife and I think I can ride it. Still I cannot lift my arm above my shoulder, still I need a few times a day exercise and once a day physical therapy in the hospital.

Update after 3 months
Although the use of my shoulder is still not the way it was before the accident, it is now in a acceptable way. I can more or less live a normal life again. And there seems still to be progress. I can drive my car and last week I did even ride bicycle again!

Although I saw the doctor yesterday and he thinks that the capsule has become to thick and that it is limiting the movement of my arm. He recommend that if this not improves in the next 3 months that I should do a "small" surgery to make a small cut in the capsule to give my arm more movement. I also did learn some new ways of exercise, a bit painful but effective.

I still think that real normal use (as far as possible) of my shoulder & arm will take another 3 to 6 months. And I think my right shoulder will always be a part with some problems and less range of motion for the rest of my life. I assume that I will need to do extra exercise for my right shoulder for at least 1 year and maybe much longer.

Lessons learned of humiliation from my body telling me "For 50 years you took for granted that all works almost 100% like it should be. But now you have to do something to get it back and keep it that way!" And lessons learned of deep respect for people who have much more bodily harm (by accident or birth) as me but are able to live a happy life.

Update after 6 months
With ups & downs there is a little improvement in the use of my shoulder & arm since 3 months ago. It is still far from being normal. I can still not lift my arm above my shoulder. With some movements I still have pain. But I can live more or less a normal life. I can even ride my motorbike again (what my wife does not like of course ... sorry dear but riding my bike makes me very happy). The doctor still recommends to do a small surgery, something I am not (yet) sure of.

Update after 10 months
In a way not much change as 4 months ago, but there are sometimes suddenly changes that may look very small for an outsider but are considered big for me. I can put my hands in each-other and put them on the top of my head. I can put the my right hand fully to my back. Inside-torsion is almost normal, outside-torsion is still limited. I am now in the process of going for a second-opinion to have the recommendation about a small surgery to try to improve my movements.

Update after 12 months
In 2 days it is exactly 1 year ago that I made the accident. At the moment I am more or less fully living my normal live. Not much has changed since 2 months ago. My range of motion is about 90% and my power of motion is at some movements 100% but at other movements 60%. I am still doing at least twice a day exercise for my shoulder and arm.

Update after 2 years and 2 months
Not much improvement from the last update. I can use my shoulder and arm more or less normal. My range of motion is a little bit better, lets say 95%. And my power of motion is still at some movements 100% but at other movements much less. But the latter is improved from 60% to 80%. So still some improvements but still not 100%. I assume the power of motion will still improve a little bit.



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