Update: 2 Years Post Op

I have been delighted by the response to this blog.  When I decided to start it, my hope was to help…even if it was one or two people.  So since I have had a few visitors, I thought it was time to write another post. 

It has been just over two years since my second ulnar nerve transposition surgery (left arm).  My first was three years ago (right arm).  Now I can speak to longer term recovery matters. 

If you have read through my blog posts and responses to visitors, you may have noticed that sometimes my elbows felt like I never even had surgery.  Other times, there was some discomfort.  Here are some things I can tell you:

1.     Micro Flare Ups are Real.  When I first researched the surgery, I came across posts from people who claimed to experience “micro flare ups” intermittently after resuming normal activity.  I can attest that micro flare ups are a real thing.  In my right elbow, I have experienced 4-5 of them in the three years since my surgery.  My other elbow: none to date.  What is a micro flare up?  Not sure what of the technical definition but I say it’s when your elbow will just start hurting, seemingly for no reason.  Then the pain goes away.  A couple of times I thought for sure I was going to require surgery again.  The discomfort was pretty severe.  And again, it didn’t seem to be triggered by anything specific.  I wasn’t lifting weights or playing sports at the time.  It just happened.  If this happens to you, DON’T PANIC!  I learned that pretty quick.  Ibuprophen is your best friend.  I took 3 several times a day and iced my elbow and that seemed to help.  The discomfort has lasted several days to over a week.  But again, it went away. 

2.     Get Back to It!  Back in the winter, I decided to really get back to normal activity.  I had played hockey and tennis, but was avoiding lifting weights.  Sure enough, when I finally decided to give it a shot, there was discomfort in both my elbows.  Not a huge amount of pain…more like a pulling sensation.  I had a hunch that this was simply because my elbows were not used to this type of activity anymore.  I needed to re-train them.  Thankfully, I was right.  I pushed through the pain.  I never “over-did it” (your body will know your limits), but I kept at it.  Sure enough, over time, the pain passed.  At first I was afraid to go completely “all out” and weight-lift like I did when I was a younger man.  So what I did was lower weight, higher repetition exercises.  If I started to feel a pulling sensation in my elbow, I stopped.  This process has worked.  I have found that my body re-adjusted to the increasing weight.  For example, there was a point at which curling just 30 pounds of weight caused discomfort after 4 or 5 reps.  But eventually, the discomfort didn’t started occurring until after more reps.  So after a while I was able to do 10 reps at 30 pounds and started feeling discomfort after a few reps at 40 pounds.  What I am trying to say is that my elbows seem to adjust.  My limit increased slowly over time.  

In June 2017, just over two full years after my left (second) elbow surgery, I decided it was time to try and go “all out.” I joined a gym and eased my way back into a weight-lifting routine.  In July, I hired a personal trainer to put me through a kick-butt six-week program.  And you know what?  No pain.  No discomfort.  No issues at all with my elbows.  I have no data to back it up, but I think my body, including my elbows, was ready to be pushed again.  I pushed through the original pain and never looked back.  *Remember, I am no doctor and results most likely vary from person to person…so don’t try to push through the pain, injure yourself further, and come back to blame me!  Listen to your body, consult your doctor, and make informed decisions! 

3.     Stretch!  Even though it has been several years since my surgeries, I still try to stretch whenever I can.  I am a teacher and it’s funny to see some students give me strange looks as I walk down the hallway stretching out my elbows. I just think that if I were to stop stretching, my elbows would be more prone to re-injury.  I’m sure any athlete would agree that stretching is important prior to physical activity.  So my theory is that being surgically repaired, my elbows would be even more susceptible to injury than non-surgically repaired body parts.  So I just take this extra precaution.  So far, so good. 

4.     Finally, I still think to this date that having the surgeries was one of the best decisions of my life.  I can’t imagine what my life would be like right now if I was still trying to manage the pain.  I feel like I lost almost three years of my life trying cortisone shots and physical therapy instead of just having the surgery.  Granted, surgery is reserved as a last resort option but my advice is that if your doctor has suggested it and you are thinking about having the surgery, do it! 

I have gotten some really good questions and comments from some really nice people on this blog.  Keep them coming.  When someone posts a comment, I get an alert sent to my email inbox.  So normally I can reply in a short amount of time.  As I have stated many times, I am not a doctor, I am not an expert, and all people recover differently.  But I am happy to share my experiences and offer what I can in terms of assistance and advice!

Thanks for reading,

Anthony

1 year post-op

I figured I would add a final (probably) entry after one year.  Here's what I can tell you after 12 months of recovery.

My elbow will never be the same as it was prior to surgery.  No matter how much I rest or rehabilitate it, it just won't be perfect and I have accepted that fact.

A few months ago I ended up going back to my doctor.  I was still having soreness (kind of a pulling sensation), fairly significant, after some strenuous exercise.  Basically every time I played hockey.  My doctor's response was blunt.  He said (paraphrasing): you are pushing 40 years old and are playing hockey with two surgically repaired elbows.  If you want it to stop hurting, stop playing hockey.

That is something I refuse to do as it is one of the few things that truly brings me joy in life.

He suggested ice and ibuprophen after physical activity.  He hypothesized that the discomfort I was feeling was due to scar tissue that had built up in the elbow.  He also offered to send me for physical therapy but I refused because of previous bad experiences I have had with physical therapy.  I found it was a waste of my time and money.

And that was that.  Besides hockey, I have done practically nothing to exert my elbow.  So now that my season is over until June, I decided to start doing pullups and pushups.  I can handle about ten pullups right now before the pulling sensation in my elbow becomes too great.  Pretty good, I think.  Encouraging.  I hope I can continue to increase repetitions and work through that scar tissue, building strength...because that is something I truly lack now due to my two surgeries: strength.

I can still do just about anything.  I just have to do it in moderation or the pulling and soreness returns.  I have full mobility.  I can still pick up my daughter...although she is growing like a weed.  I can still do housework and home improvement projects.

So all in all, I really can't complain.  I can still do most everything I want to do.  I just have to deal with the minor inconvenience of soreness and lack of strength.  The latter I hope will improve with more time.

6 months post-op

It has been six months, and I can finally say that things are starting to feel normal again with my elbow.  It truly goes to show you what a slow process this recovery is in order to get back to 100%.  If you have ready my previous posts, you would know that I was back to playing tennis and hockey and doing normal stuff after about 3 months.  But in the last three months, there has always been a bit of lingering pain and weakness.

Now my elbow appears to be getting back to full strength.  There is virtually no pain or discomfort doing normal, every day things.  But if I exert myself with more strenuous activity (like hockey) there is definitely still soreness.  The soreness seems to go away a day or two after the exertion.  It is sore after my hockey games, but with a couple of days it is gone.

Another thing I have noticed which I have failed to mention in this blog is a weird discomfort when I put my elbow on a flat surface and put my arm at a 90 degree angle.  What I mean by this: I like to put my elbow down and put my chin on my hand while sitting at my computer desk.  It is very hard to describe: not a huge amount of pain or anything, just a weird discomfort.  I imagine it is due to the ulnar nerve not being in its normal location...but that's just speculation.

All in all, I am pleased 6 months later.  I finally feel like I can do things without saying to myself: take it easy, you recently had surgery.

4 Months Post-Op

While I have resumed normal activities for the most part, I still lack a LOT of strength in my arm.  My elbow has a significant pulling pain if I try to do too much.  I've tried to do chin-ups/pull-ups but I still can't do more than about 6 before I have to stop because of the pulling pain in my elbow.  I guess I'm just not quite there yet even though I have taken things very slowly.

As for pain to the touch, it has diminished greatly.  However it feel like there is a small bruise there if I push on the incision area.  I had medial epicondylitis (sp?) or Golfer's Elbow in my right elbow along with my nerve issue.  This is a similar pain.  Not that I think I have Golfer's Elbow in my left elbow, just a similar pain to compare it to.

So overall, continued steady, slow improvement.  Going to be a while before it feels close to normal.

3 Months Post-Op: Time to Get Back to It!

Well, I just had my 3-month follow up appointment with my doctor.  As expected, I have been cleared to resume normal activities.  His exact words were "you are free to resume normal activity as tolerated."

Those last two words are huge.  When I had the surgery on my right elbow, I believe I rushed back into things too quickly. I started putting way too much stress on my elbow which resulted in soreness.  So much so, that I scheduled an appointment with my doctor because I was worried I damaged something.  Thankfully I did not.

So I really want to take it slow this time.  Today I did two pull-ups and experienced no pain.  Tomorrow I will try two push-ups and hit the ice for a light game of pickup hockey.  While that sounds quite dangerous, my doctor informed me that as long as I wear elbow pads I have nothing to fear.  A hockey stick does not have much weight and I certainly don't have a hard shot that might screw up my elbow.

That's my plan!  Increase exercise slowly.  My doctor did not feel I needed to have physical therapy.  I have full range of motion and very little soreness. I imagine this may not be the case for all people having this surgery.

Really no pain at all anymore.  I still get a slight tightening pain when my arm experiences resistance.  The incision area still has numbness but I never expect that to recover fully since my other arm is still slightly numb in some spots.  Doctor said this is normal.

I will try to remember to keep updating this blog at least monthly for the next year.  Hoping someone, some day will find it useful as they recover from the same surgery.

2 Months Post-Op

Two months in. One month to go.

Of course that's the hockey player in me talking. My doctor had me back to playing hockey after three months when I had my surgery on my other elbow.

At this stage in my recovery I have 100 percent mobility...if not, 99.9.  Scar is looking good. Never really itches any more.

Pain has become weird. No rhyme or reason. I am still trying to take it very easy but sometimes and I will forget and lift something like a bag of potatoes.  No pain. But then I do something like put on a shoe and I move my arm in such a way that I experience pain.

Nothing excruciating. Just annoying.  I also get some bruise-like pain if I straighten my arm completely or touch the incision area. Still just sore.

Wish I could do some pull ups or push ups but that is still a no-no right now.

6 Weeks Post-Op

Went back to my surgeon this week for a followup visit.  I no longer need to wear the wrist brace.  Was told to still refrain from all activity (he again used the phrase "don't lift anything heavier than a half a cup of coffee). This is much easier said than done.

The fact is the elbow feels great after six weeks.  I keep catching myself using my arm more than I should.  I worry that I am going to forget that I need to rest the arm and wind up using it for something that damages it. My surgeon suggested wearing the sling or brace as a reminder to take it easy...but I won't.

Elbow is tender to the touch.  I also feel mild pain when I experience resistance (like when I push my hands together while washing them).  But again, overall the elbow feels great.  I just have to focus on taking it easy and letting it heal completely.

Summer has begun so I need to cover my scar while outside and probably put sunscreen on it if I plan to be in the sun for an extended period of time.

My next appointment is in another six weeks.  I may not post again until then since there isn't a whole lot to report.

5 Weeks Post-Op

Nothing really new to report.  Just about 100% mobility.  Increased tenderness in elbow area now that I'm moving my arm a lot more.  Still wearing a wrist brace which has become quite annoying.  My next follow-up is in about a week.  Hoping I will be brace-free at that time.

One Month Post-Op

It has already been a month since surgery.  Amazing how time flies.

I believe my arm is at about 90% mobility.  Making very good progress.  The most difficult movement is straightening my arm and raising it straight up into the air.  Still unable to do that completely but I am getting close.  Still wearing my wrist brace all the time...with the exception of showering and very brief breaks if it gets itchy, sweaty, or otherwise uncomfortable.

Now that I am moving my arm again, there is some discomfort in my elbow.  Mostly tightness, but some actual pain too.  Minor stuff, really.

Bruising and swelling has diminished significantly since my last post.  Incision area is very numb to the touch.  I remember from my last surgery that this is normal.  In fact, my other elbow never regained full feeling but it's so minor that I'm not complaining.  How good it feels (compared to how it felt before surgery) outweighs the bad by far.

I am worried that I have "frozen shoulder."  I figured that pain in my shoulder and upper arm would go away shortly after my sling was removed but it has not improved at all.  I see my doctor again in two weeks so I will tough it out until then and see what he says.

3 Weeks Post-Op

Returned to the doctor for my three week post-op check up.  I was told I no longer needed the sling.  I now could just wear it "for comfort" as needed or as a mental reminder that I should take it easy.  I cannot put into words how good it feels to let my arm down!  Such relief after being in a sling for so long.

I am currently unable to straighten my arm due to tightness.  I have to slowly work on that.  I go back to the doctor in another 3 weeks.  If at that time I am not able to straighten my arm completely, I was told I would have to have physical therapy.  I didn't need it on my other elbow, so I am assuming I will not need it on this elbow either.

The surprise was when my doctor told me I'd have to wear a wrist splint for 3 weeks.  He explained that the muscle that was cut during the operation is the same one used to flex the wrist so I needed something to keep it stable.  It's a huge brace!  I will need to wear it all the time, except when I shower of course.  This was a surprise because I did not require a wrist brace when I had the same surgery on my right elbow last year.  Stupid me didn't think to ask my doctor why this was the case.

Last year I was told at this stage not to lift anything heavier than a half cup of coffee.  I was given no such warning this year.  However, it may be because my doctor just forgot or assumed I remembered from my previous surgery.  Just in case, I plan to give him a call tomorrow and check.

Other minor notes:  Overall, I feel great.  No pain.  No numbness or tingling in my fingers.  Just sore/tight when I try to straighten it.  But I am taking it slow.  Elbow area still swollen.  Forearm still discolored from bruising, but getting better.  I am now allowed to soak my arm and put it under the shower stream.  Incision is itchy at times.

Day 15: Two Weeks Post-Op

Nothing really new to report.  Still in a sling until I see my doctor again next week (Day 20).

I am unfortunately getting careless.  I find myself starting to use my hand for things like tying a trash bag and such.  I suppose it's a good thing that it is feeling so good that my body wants me to use it.  Can't wait to straighten it.

Steri-strips are still holding tight.  Hair starting to grow back around incision.  Will update again after my next appointment.

Day 7: Stitches Removed

Went to my surgeon's office for my first post-op visit.  He removed the bandage and wrap (which felt wonderful!) and then removed the stitches.  My whole forearm is swollen from the upper elbow down.

I was told:

1. Keep the arm in the sling for two more weeks.
2. My incision can get wet in the shower but avoid the direct spray of water.
3. Absolutely no baths or hot tubs.
4. Stretch and flex my fingers regularly.
5. Occasionally flex my arm gently but still do not straighten.  He demonstrated the range of motion I should be doing.

I am having difficulty sleeping because I usually sleep on my side.  I have found the best way to get comfortable is to sleep without the sling.  I grasp a small throw pillow gently, keeping my arm in the same position.  The sling kept my arm pressed against my body which was uncomfortable for me.  So doing this alleviated that a bit.

Days 3-6

Playing catch-up here.  I have been busy lately and there is not all that much to report.  Things are progressing as expected.  Still no pain from the incision site.  Most of the pain I am experiencing comes from my upper arm and shoulder from being in a sling.  Even if I remove the sling for a while, the pain is still present from keeping my arm in a bent position.  It would be very bad to straighten my arm at this point!

Day 2

Woke up today and had feeling in my pinkie again. No numbness or tingling.  That is good news.

No pain and still not taking any meds except my antibiotic. Only pain was when I accidentally bumped my arm on a chair. Gotta be more careful I guess.

Getting dressed and showering is a pain but that was to be expected.

EDIT: After talking to the nurse who called to check on me, I learned that the numbness in my pinkie was due to a nerve block.  Once that wore off I was fine.

Day 1: Day of Surgery, First Day of Recovery

Surgery was today around noon.  It lasted between 60 and 90 minutes.  I spent approximately 1 hour in the recovery room.

I am in a sling and the incision is covered.  My hand and exposed arm is covered with a sticky yellow substance which is some kind of disinfectant used for the surgery.  I was prescribed an antibiotic as well. I can't remember if I will be in this sling for two or three weeks total.  Will update once I talk to my doctor. 

It is now 7:30pm and I am not in any pain.  I remember that I did not have any pain either when I had my right arm done.  What does concern me is that my ring and pinkie fingers are numb and tingling.  In fact I don't seem to have any feeling at all in my pinkie.  This did not happen last time.  In fact, I remember my doctor asked me during my first post-op visit if I was feeling any numbness or tingling.  When I said "no" he indicated that was a good sign.  So now I am wondering if this is a bad sign.  My first post-op visit is scheduled for Thursday.  I guess I will find out then. But I plan on calling my doctor on Monday and letting him know.. so maybe I'll have an answer before Thursday.

Speaking of Thursday, I will be getting my stitches out that day.  I find it amazing that this is done a mere 6 days after surgery.  

-A.L

PS It sucks typing with one hand!

About This Blog

If you found this blog, chances are you are interested in knowing what to expect with the recovery involved with ulnar nerve transposition surgery.  I had it done on my right arm in February, 2014.  As I prepared to have it done on my left arm in April, 2015, I found myself unable to recall my recovery timeline.  So I decided to create this blog in case there are others out there in the same boat.  I will post on this blog throughout my recovery in hopes that it will give others who require the surgery a general idea of what to expect. Obviously everyone is different so please understand your symptoms and recovery time may differ from mine.  If you have questions along the way, feel free to send me an email.  Not that I am an expert, but I will have been through it twice so I can probably offer some quality insights.