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Rehab Recap | Impatient Patient Confessions

 Cover Shot by: Steven Mortinson (IG: @stevenmortinson)

"I am incredibly fortunate, and thankful, to be a part of a team that continues to make me feel like part of the family, despite my injury induced extended hiatus from kayaking.

I imagine people are equally as tired of reading about my narrative of injuries, as I am tired of living in a state of being injured. The insight, inspiration, and motivation generated from the feedback I received, and continue to receive, from sharing my story encourages me to keep writing.

If nothing else, I hope this piece can provide some comic, if not relatable relief to anyone struggling through any type of ongoing health issues, mental, physical, mystery, or all of the above plus whatever other curveballs the last few years have thrown.

Thank you for following along on my journey through my recovery, and if you want more of the story check out the first two pieces "Hell, Help, and Healing" and "I’m back*."

Extra special thank you, to my Immersion Research family."

-Jo

_____________________________________________________________

 

Please enjoy this slightly rage-filled recap of my impatient outpatient struggles, and shoulder rehab survival strategies.

For a little background on my shoulder: In 2011, I had an anterior labrum repair arthroscopically, after a single traumatic dislocation. In 2012, I had another arthroscopic labrum repair on the same shoulder, both anterior and posterior, after a string of chronic posterior subluxations. In 2016, I tore part of my rotator cuff on the same shoulder, but did not opt for surgery. I dislocated my shoulder in mid February 2022, and in addition to tearing out both of my prior surgical repairs, I tore a new 0.9 cm chunk out of what was left of my inferior labrum. Posterior dislocations are not common, and multidirectional instability is complicated. My labrum was in tatters. I saw four surgeons prior to selecting one to operate. The suggestions were to do a latarjet for anterior stabilization, then a reconstruct with cadaver bits the following year for posterior stabilization. One surgeon suggested doing both those procedures at the same time, and declined to do it himself, referring me to “Alabama or somewhere with a pro sports team” for that kind of reconstruction surgery. Two surgeons adamantly said no latarjet, that it wouldn’t work for my multidirectional instability, and suggested an arthroscopic repair with capsulorrhaphy. One insisted never to kayak again, and the other recommended I have the arthroscopic surgery with the other guy and pretend he didn’t say that about kayaking. When faced with multi-year, lower success rate, higher risk, invasive open surgeries, that I would potentially have to travel for, or another arthroscopic attempt, suddenly the fourth surgeon’s suggestion sounded appealing. Furthermore, when I told my physical therapist I dislocated my shoulder and asked what surgeon he recommended, without hesitating he told me this guy, “is the best f___.” I think he meant to say this guy “is the best, f___.” Either way, I think for this to work out I have to believe he is the best f___; and that’s exactly how I ended up hand picking a surgeon to reconstruct my shoulder who strongly disapproves of my lifestyle, highly recommends I stop kayaking, and seemingly enjoys telling me no

Patient In Doctors Office(No turning back now)

Rehab Recap | Impatient Patient Confessions

How’s your shoulder? Loaded question. It’s been the bane of my existence since February, thanks. Strictly speaking, my shoulder is fine, but also finished, as in, this was supposedly the final time it can be repaired. One fall on it and it could be f___ed, forever. The accompanying limitations of the injury itself, and the surgeon’s restrictions throughout the recovery have thrown a massive wrench in my way of life. If seven days of no kayaking makes one weak, seven months of no kayaking has made my angst peak. 

I had surgery in April. I had to take time off from what feels like everything. I spent six weeks squandering around in a sling, not cleared to work, only to walk. I poured my PTO down the pain drain. I typically manage my life meticulously to optimize my time, to afford to play when I’m not working, live comfortably when I’m not playing, and work efficiently when I need to without dreading it, or stressing. This year has been brutal for me. Time slowed to a barely intelligible drawl, stammering over the same familiar syllables. Rehab. Déjà vu. Tik tok. Months passed by the cyclical chores of domesticity, worsened by how long it takes to do everything with a non dominant hand. Nothing felt optimized, comfortable, nor efficient. As someone who values time immensely, I found myself wanting it to pass. Wishing I could hibernate, and come back when my world doesn’t feel out of sorts, when my body is ready to cooperate. 

During a followup I was met with a disapproving look and a lecture from the surgeon for inquiring about when I might possibly be able to run again. Run?! I had shoulder surgery, not knee surgery. I wasn’t asking to do something, I was asking when I might be able to do something. I knew better than to ask about kayaking. I was asking for a light at the end of this tunnel, something to look forward to; an outlet for my energy during my recovery. The surgeon was utterly unwilling to dangle such a carrot. It hasn’t made it easy for me to stomach his unabashed suggestions to change my lifestyle, and it has taken every ounce of my self control to not suggest to him a change of career. I don’t want to change my lifestyle, I want to return to my way of living.

Shoulder Sling(Rehab is going great, really great) 

Despite my best efforts I missed an unbeknownst to me mark six weeks into physical therapy and the surgeon sent me back to the beginning stages of PT, for more stretching. Two more months of stretching, to be precise. I have never been to a surgeon for followup and had them disappointed with my progress, until now. I was told I didn’t have enough mobility, and in the same breath warned about acquiring too much mobility - in a direction no one had told me I was allowed to move my arm yet. In what feels like degrees of nitpicking, I spent months floating aimlessly around in a range of motion, but not too much motion, limbo. Waiting for someone I barely know to give me a green light that I’m not sure he will ever relinquish. 

In more than a third of a year since surgery, I managed to be cleared to walk, and stretch. I transitioned from rehab fatigue to rehab indignation. Rage set in. I’m not enjoying explaining how my recovery is going, at all, and I am real tired of hearing, “it will get better.” When things are going smoothly in your life, does hearing “it will get worse” make you feel good? Please stop telling me I will “be back out there in no time, just do what the doctor says.” Regardless of the status of my recovery, nor my efforts to expedite things, the doctor says I shouldn’t ever kayak again, and I don’t consider seven months and counting as no time. Whether or not I choose to defy the doctor’s recommendations and get back out there, is a choice for me to make, about a risk regarding my body. Before you start telling me I should be fine in class three, please keep in mind this injury happened in class three, and go ahead and don’t talk to me. If I had to draw a self portrait right now it would be a one-armed stick figure with a poop emoji for a head, captioned: “it’s hard to see things objectively with my head up my ass.”  

(It's hard to see things objectively with my head up my ass)

I’m in the process of spelunking through the dark depths of my rehab exasperation, trying to find a way out of this exceptionally long tunnel. It feels like I’m running into the same wall on repeat. I’m reminding myself that the surgeon and I do share a common goal: to never have to see each other again. I’m whining about my inability to come up with creative outlets to satiate my pent up jollies, within the surgeon’s restrictions, and without hurting my shoulder. This might be the mother of all my first world problems. I am bent out of shape because I can’t do what I want to do, and this feeling is not new. As much as I want to direct my frustrations elsewhere, the onus is all mine. This is my recovery, and it will only ever be what I make of it. 

This is what I’ve been attempting to make of my recovery. A short list of unimpressive things that I came up with to help make me more tolerable during my recovery, and to avoid losing my mind completely. I’d like to say something inspirational, about enjoying the things I can do, but this has been a far from enjoyable experience. Not to say I haven’t had fun, I have, but it has been more of an attempt to pry my head out of my ass, and use my frustration as fodder type of situation. 

 

PT

I use PT to describe a lot of things, whether it’s physical therapy or personalized training, it’s paramount. It’s the key that unlocked the door to managing my pain, and the path to my future adventures. It’s been a part of my daily routine, nearly a part time job, and has rarely dipped below a five days a week practice for the past two years. Long before being allowed to start shoulder therapy, I went to physical therapy to modify my workouts to accommodate one arm in a sling. My intention was not only to maintain core and lower body fitness during my recovery, and to prevent a backslide with my spine during my downtime, but to optimize the contralateral effects of unilateral strengthening, aka the cross-over effect. I don’t wake up in the morning excited about doing PT, again, today, for the 697th day in a row, but I do it. Wake up, sit up, Turkish get up, push up, pull up; whatever it takes to not give up. I do it as if my livelihood depends on it.

Rehab with one arm pushups(PT is heaps of fun)

JUICING

I begin every day by chugging a whole glass of celery juice on an empty stomach. I don’t like eating celery, but I drink it daily. I add ginger and apples or pears to make it a semi palatable green drink with an appropriate sweet spice salt ratio. In the afternoon, usually after working out, I pound some freshly juiced combination of citrus, ginger, beets, carrots, and what I tell myself is a therapeutic dose of fresh turmeric for inflammation. I don’t have a ton of science to support my juicing habits. I tried the celery juice when I was diagnosed with a thyroid problem. It turns out I don’t have a thyroid problem, but I might have a celery problem. It feels like go go green juice in the morning, and recovery juice in the afternoon, and it propels me way further than coffee and ibuprofen. It keeps scurvy at bay, and my guts like it. 

Juice concoctions (Juiced life) 

WALKING

For a significant portion of my recovery, walking was my primary means of immersing myself in nature, and the only significant outlet for my energy. Lock down of wake up, walk up, walk down. When I couldn’t work, I walked. When I couldn’t sleep, I walked. I tried to come up with walks I’d never done. Trails long and steep enough to make me tired, but that I could do without having to worry about post-holing, being run over by a biker, or eaten by the ebony ape cat. Walking is frustratingly slow. I don’t want to say that it’s boring, because that sounds more like a reflection of my own creativity. I am very thankful for my friends who went the extra miles to keep me company on my walking journeys. From the backyard traverse in the snow, devils club dead end in the rain, and 2 AM departure for the 20 mile sunrise mission in the dark, I did some truly fantastic walking with my friends. I also did a significant amount of solo walking. 

Hiker at a view point over looking the Columbia River Gorge(Phlox top : PC; a nice stranger who also tucked my other jacket in before it blew away, and fetched a snack for me from the pack)

WRITING

Admittedly, my creative writing flows have been stuck in a state of mind that blows. I wrote a poem to the tune of twelve days of Christmas when an old injury flared up in my left hand, to the point that it also had to be immobilized, while my right arm was still in a sling. 


In the sixth week of slingfest 

The universe sent to me

Six slugs a slogging

Five solo hikes

Four trail snails 

Three nights of sleep

Two different peaks 

And a partridge in an apple tree

Apple Pair Tree

(The partridge in the apple tree)


READING

Books are fascinating, and I find a lot of inspiration in well told stories. I’ve read more than fifty books since I had surgery, and can’t say enough good things about the library here. The Libby app works for downloading audiobooks to phones, and ebooks to kindles, for free, and the selection is phenomenal. If you have book recommendations, please, do tell. Preferably nonfiction. 

 

SQUIRRELING

Inspired by my friend, and despite my seriously lacking artistic talent and wood working skills, I decided to build furniture for the squirrels in my backyard. Some people are into birding, I thought I’d try squirreling. I have since spent more nights than I’d care to admit chasing raccoons, skunks, and possums out of the squirrel cafe. Some of these critters figured out that even if the cafe is closed, the cat door leads to a 24/7 kibble buffet. The raccoons have been coming into the house, dunking kibble into the water dispenser, and leaving sloppy piles of wet cat food strewn about. I’ll put this one in the creative outlet backfire category, and keep hoping I don’t get sprayed when I spray the skunk with the garden hose. 

Squirrel Furniture(Ultimate squirreling success)

FORAGING 

I like to eat, and with the current prices of groceries it’s been a great year to take advantage of the plethora of free fruit gracing these parts. I saved all my non-recyclable (in Klickitat county) yogurt containers over the last year, and filled every one of them with blueberries, huckleberries, blackberries, cherries, plums, pears, or grapes. Free, and frozen for future smoothies and baking endeavors. I also urban foraged/ pilfered my neighbor’s tomatoes while she was out of the country. It felt productive, and an activity unlikely to hurt my shoulder. I like to think of it as nutritional hoarding. 

Fresh Picked Huckleberries from the Columbia River Gorge(Prime pickings)

RUNNING

After months and months of being restricted to walking, running is the most exciting thing I was able to do all summer, well, that and not sinking. I’d call it swimming, but it was more of a one-armed survival stroke to keep afloat. I didn’t get a green light to run until August, and it did not come from the surgeon, but the third physical therapist I asked that week. At that point, I was very ready to move on to something other than walking. I signed up for a trail running adult summer camp with Alpenflo in early September. I had four weeks to run before camp, and a physical therapist’s blessing. It was probably one of the better ideas I’ve had for surviving this forced timeout from kayaking, and I highly recommend adult summer camp. It was incredibly helpful to strive toward a goal more enticing than degrees of external rotation, and fifth gear. My training for running camp was hindered slightly by a bee sting between my toes resulting in a shrek-foot that took almost a week to return to a normal psi, and a case of covid that finally caught me. Nonetheless, I went on some lovely runs while exploring loop trails in the Gifford Pinchot, Indian Heaven, Beacon Rock, and Trapper Creek. My training culminated in a day lap around Mt. St. Helens four days before heading to the Elkhorns for trail camp. 

Trail running circum-running around Mt. St. Helens(Jo making her way around Mount Saint Helens , PC; Maria Kallman)

 It was an absolute pleasure to run around in the wilderness with Alpenflo and co, and I found it immensely therapeutic to have a running goal to focus on, and train for. The camp provided an educational, supportive, and inclusive environment to achieve that goal. I enjoyed the adult summer camp vibes which fostered connection over competition, emphasized fun over fast, and provided the opportunity to share and generate communal stoke. I’m still grappling with my love hate relationship with running, and admittedly have only run a few times since camp, but it was a definite highlight for me in some savagely low times. 

3 Trail Runners a-top a ridge(Soaking in the scenery running the Elkhorn Crest, PC: Steven Mortinson)

CHASING CARROTS

The thing about running in circles is it doesn’t matter if I’m chasing my problems, or being chased by them, I end up right back where I started. This list of things is great and all, but my recovery somehow feels like it’s barely getting started, despite being seven months post op, and nine months post injury. After running camp I thought I would be able to transition back into kayaking again, maybe even pull off a fall paddling trip. It was slightly delusional as I wasn’t cleared to begin the process of strengthening my shoulder until mid September, right around the same time my motivation to do so plummeted. Another followup appointment sent me into a spiral of self doubt, and loathing. Seven months of negative news about my shoulder despite my diligence, and a no kayaking prescription for perpetuity left me questioning the point of being in this situation. Kayaking has been my carrot; it has taunted me through my past injuries, and fueled my motivation to own my recovery, time and time again. Without it, this surgeon’s feedback made me feel like I could, and should, have done absolutely nothing, aside from passively healing for seven months, to achieve the exact same outcome: no kayaking. It made me mad, mad enough to make dubious decisions. In my own combination of spite and exasperation, I went kayaking. On a trip made entirely possible by my amazing friends, I didn’t take a paddle, but rather strapped my arm inside my PFD, put on my tiara, and princessed an overnighter from the front seat of a borrowed duo. It was a sound reminder of the many reasons I love kayaking, including being captain of my own ship. At times it was quite stressful and I pitied my pilot, as I’m sure my concern was palpable; the gravity of the consequences obvious. The surgeon’s voice crept into my head all too often to remind me of the potential risks. Enjoying the simple pleasures of camping on the bank of a beautiful river with my friends far outweighed any doubts about the quality of the idea, and did more than I could’ve imagined for my attitude. It was also helpful to witness first hand the grace with which one of my close friends handles her injury and recovery - seemingly with a lot more composure and fewer temper tantrums than me. I’m still working on my attitude. It's helpful to be back on the scent, chasing my carrot again. 

Two people in a tandem duo whitewater kayak(Princessing down the Elaho with Frank, PC; Alison  Royem)

PREPPING

I’m a prepper. I plan nutritionally, train physically, anticipate mentally, orient digitally, streamline my systems, and quite literally prep for when and how I can adventure next. I am intimately familiar with the volume of my dry bags, know my gear lists by heart, and can mentally pack my boat in minutes. I’m stockpiling my favorite snacks, dropping pins on maps, and watching the weather apps. It’s not Y2K glitches, I’m prepping for 2022 adventures, bitches. This year ain’t over, and I’m working with deadlines not finish lines. In the context of prepping for something I love, it’s substantially easier to stay motivated to do my PT. Not to say it’s been easy to get up in the dark, sub freezing temperatures to paddle against the wind, or do PT in my outdoor backyard gym, but the power of the carrot is strong, and it feels good to finally be prepping for kayaking adventures. I’ve probably never been this excited about planning flatwater trips. 

Flat-water paddling training(Frozen flatwater sessions)

At my final followup, after being cut loose with an anticlimactic orange light of reiterated recommendations not to kayak, I invited the surgeon to arm wrestle. He declined by way of laughing uncomfortably, and giving me a look similar to the one the neurosurgeon gave me when I asked if I could keep the disc he removed from my spine. It might have been the first time we’ve seen eye to eye, and I think I’m finally starting to like the guy. I’m still in the thick of my rehab woes, constantly weighing my next move, and analyzing how much each progressive step, or stroke, is worth to me. One of the most valuable things I’ve realized through this process is, that this list of things I’ve developed to help maintain my sanity during my recoveries is nearly identical to the list of things I do, and plan to continue doing, regularly for preventative pain management and holistic health maintenance to sustain my adventure-filled lifestyle. To persistently research, consciously nourish, train mentally and physically, and crosstrain for something I am passionate about is a far more appetizing pill to swallow, some might call it a drug, than to be restricted to rehabbing, even if the only difference is in my head. Mindset matters. My longevity as an athlete, in any adventure sport, seems very likely to correlate directly to the amount of effort I put into listening to, understanding, strengthening, feeding, stimulating, and generally caring for the needs of my mind and body in my adventure pursuits, and daily life. I’m trying to set my whole body up for success, and give it a fighting chance at making as close to a full recovery as possible, and maintaining it. I want to return to my flow state strong, with confidence in my body, feeling the power of preventative habilitation. 

None of this is intended to be construed as advice in any way. I don’t have all the answers figured out. What works for me, won’t necessarily work for you, nor is your motivation likely to originate where mine does. I’ve tried a lot of things that didn’t work for me to find things that do, and my lists are always in a state of flux. I’m sharing this as a reminder of the completely unglamorous, and oft unmentioned side of adventure sports lifestyles, and the associated, and sometimes ongoing, tolls on body and mind. I think it’s always going to be pay to play, in one way or another, and this is simply the currency with which I am currently paying my tolls. 

What's on your list?

Swimmer Diving into Lake(Nice rinse after a long run. PC; Steve Mortinson)

Snail On A Trail(Trail snails)

Ringing out wet socks on a hike(Joys of walking with Jo)

Racon stealing treats(Don't mind if I do, oversized squirrel.)

 Trail runners at a lake

(Trail running training team)

Trail runners near Mt. St. Helens and Mt. Adams

(Jo still making her way around Mount Saint Helens, 9 hours later. PC; Maria Kallman)

Devils Club and a Hiker(A healthy crop of devil's club) 

A swollen foot from a bee sting(The bee sting induced shrek-foot)

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