Frustration Builds

I am currently in a tiny motel in upstate New York. Today was a big step for me...I put on a pair of dress slacks, a button down shirt and dress shoes all by myself. I arrived at the dress rehearsal of the wedding I'm here for and suddenly released something, my arm probably shouldn't have moved into the contorted angles I had it in to make my outfit appropriately fit. I turned to my girlfriend, who is a bridesmaid in tomorrow afternoon's ceremony, and asked for the car keys. I was granted permission to leave the rehearsal- where my presence wasn't really necessary- and head back to the motel.

And here I am now, a half hour after I dressed myself, stripped back down to my boxers and with my arm heavily wrapped in ice.

I decided last night that today would be my first day since surgery without a hydrocodone pill. It wasn't that I was worried about addiction, or that it made me sick. But if my arm hurts, I want to know it hurts. I don't like when pain is masked because that enables me to do things that I wouldn't be able to do under the typical circumstances of the situation. So when I had my brace off and went through the obligatory motions of putting together my wedding-dress-rehearsal-outfit, I forgot that my arm was sliced open just a week ago.

Some of the frustrating aspects of the Tommy John aftermath are beginning to form tenfold right in front of my eyes. Some have been able to find some humor out of the experience, though. For example, last night was the first night that I've shaved my face since the surgery. I sort of put it off, being that I figured it'd be a bit more difficult to do with my right arm, but I preferred not to look like a caveman for this weekend's wedding. Well, my girlfriend thought it was hysterical watching me attempt to trim my mustache with very little control over my hand in such a small area. What is normally a procedure that takes all of ten minutes turned into a half hour long spectacle with me throwing shaving cream at her and her giggling at my lack of coordination.

On a more serious note, my left arm is still very weak. I am now able to grip things, although mainly things with little substance or weight to them (Ie: I can grab a soda can but not a laptop computer). I still struggle with individual finger control. My pinky finger and ring finger on my left hand do not move on their own very easily. Dr. Andrews explained that the reason for this is because of the movement of the ulnar nerve and it could take a few weeks for full range of motion with those fingers to come back.

The rehabilitation work is rather monotonous and strenuous. Squeezing a stress ball is difficult for me and causes quite hefty amounts of discomfort in the forearm area. I complete a simple set of gripping exercises in ten minutes, and then do about ten minutes more of wrist range of motion exercises. Onto the shoulder exercises for ten minutes, which consist of pushing my hand against a wall. Then, ice. That's it...everyday. If I were to do these things with my right hand, suffice to say there would be literally no difficulty. But after I complete the therapy, my left arm is tired, sore and beaten. And despite the fact that it gets a little easier to do everyday I do them, the fact is that I've gone from a completely strong and capable college athlete to a 21 year old who can't squeeze a fist. And sometimes, it's frustrating.

My physical therapy schedule this week is Monday/Wednesday/Friday. My hope is that Monday I can progress a bit more with my exercises, and then Wednesday is the day I'm scheduled to get my sutures and stitches out. That will be a major relief, because that will mean I can finally quit taking sponge baths and take a real shower. In the case of Tommy John, in an odd way, I suppose it's the little things that matter.

Non-preferred Popularity

I am not a shy person, but by nature I am not a terribly huge fan of unnecessary attention either. I have walked through the streets of New York City and seen a mob of screaming people on the sidewalk hovering around a celebrity who is just simply and harmlessly strolling through the area. And sometimes, in these certain unannounced candid instances, I sympathize with the violation of privacy for those people.

Since I got out of the Andrews Institute last Thursday until yesterday afternoon, my arm was stationary at a 90 degree angle, covered with a lot of padded Ace bandages and fit into a black sling hanging across the front of my body. It was quite obvious that I had some sort of injury. But for the innocent onlooker, a sling is nothing out of the ordinary. Many people wear slings for all different types of injuries...a broken bone, a torn muscle, whatever. While people might recognize the sling and interpret its existence as being a sign of an injury, most don't look twice at someone walking with a sling. After all, slings aren't all that uncommon.

Yesterday afternoon my physical therapist replaced the padded Ace bandage and sling with the customary "bionic arm" that I've alluded to several times in the past. Now let me say this first before you delve any further into this blog post: I am not complaining about the bionic arm. It's about 1,000 times better than having that sling on. I hated that sling. The padding didn't allow me to maneuver my arm in any other way than a 90 degree angle. The strap caused abrasions on my neck and would constantly get tangled. The sling, while understandably necessary, was more of a nuisance than anything else. The bionic arm is a plastic prosthetic device that Velcros across the arm four times. There is a dial on the outside of the elbow that allows you to change the degree at which the device is angled...there are two different dials, one for flexion of the arm and one for extension of the arm. According to the protocol written out by the fine people at the Andrews Institute, my dials were set to 25 degrees of flexion and 100 degrees of extension. That means that the device will lock out and not allow me to bend or straighten my arm by anymore than those given degrees. The purpose of the bionic arm is to gradually ensure that within the next four to six weeks, I will be able to fully flex my arm (touch my left hand to my left shoulder) and fully extend my arm with no pain.

Physical therapy yesterday was pretty simple, lots of moisturizer for my incredibly dry skin, some light exercises for the shoulder and some gripping exercises with a stress ball that literally seem impossible to accomplish at this point. My arm is so weak that just the thought of trying to squeeze that ball 30 times with each finger individually seems like a joke, but I worked through the discomfort and did all the physical therapist told me to do. It's literally as if I have a new arm...I can't move the arm or grab anything with my hand. It is quite evident that patience, even in the early stages of the rehab, is a virtue and a necessity.

After exiting the physical therapy building yesterday afternoon, I began my experience of stepping out in public in my bionic arm. As I said, a sling is nothing special to most people. But the bionic arm is a different story. The plastic prosthetic device isn't a typical contraption for most injuries, and most people outside of the baseball world haven't had any direct experience with Tommy John surgery. In the past 24 hours, I have been asked the following questions several times:

• "What happened?"
• "Does it hurt?"
• "Can you move it?"
• "How long do you have that on?"
• "Can you pitch still?"
• "Who is Tommy John?"

There are probably a few more questions, but I feel as though these provide a good sample size. I answer each question politely, patiently weighing the extent to which I should play up the injury to see how much sympathy I can get from the other person I'm conversing with. All the while, there are countless more people who are out in these public places along with me that simply do a double take or stare at my arm. I honestly can't tell if they are just curious or sympathizing, because some of the looks I get make me feel as if I look like The Terminator.

I suppose if the public perception of my appearance is the worst thing occurring in my life up to this point then things are going well in terms of the recovery process. But I do find it funny sometimes how differently you are treated under certain circumstances...my bionic arm = a social oddity.

21 Year Old Toddler

It's quite incredible how much I underestimated the dominance of my left hand in my life. The fact that I am currently only capable of using my right arm in my everyday activities has posed to be quite a difficult task thus far. Little things become nearly impossible...opening a bottle of water, cutting food, certain tasks that are done in the privacy of the bathroom (if you get my drift). Even showering has become a nuisance, I've resorted to taping a garbage bag over my arm and having my girlfriend assist me in cleaning myself via washcloth while sitting in the bathtub. I've turned into a full-blown, formidable toddler, a transformation back from an independent and self-functioning 21 year old college senior. It sometimes feels like I should ask my mom to go get some baby formula, bottles and a crib.

Nonetheless, all of this is a necessary part of the entire Tommy John process. As I mentioned in the last blog post I wrote on Wednesday, my surgery went off smoothly last Thursday, Jul 21st. I showed up at the Surgical Center at the Andrews Institute at 5:30 AM and was quickly processed and put in the O.R waiting room. I spent about 20 minutes with the surgical nurse answering questions and chatting. Once it was reassured that I would be physically fit enough to withstand the anesthesia, we shot the breeze for a few minutes. She asked me if I pitched for the Yankees, being that I was from New York. I smiled politely and said no, chuckling in my head that such a thought could be processed. It still hadn't set in yet at that point that I was in a surgical center that tended to such high profile athletes on a daily basis. We spoke for a few minutes about the laurels of travel nursing, which she'd done (my girlfriend is a recent nursing school graduate and is weighing her current career options). After a bit of time, in came Dr. Hickman, the anesthesiologist I'd met with the day before. We chatted for a few minutes about Terrell Owens, who had been to the Andrews Institute and had taken a picture with the doctor's daughter, and about his 200-acre family farm in eastern Tennessee. At about 6:45, I said goodbye to my dad and the nurses wheeled me into the O.R. A few minutes later, the anesthesia was administered and I was dead to the world.

I awoke in the recovery room, groggy and complaining it was hot. I later found out that Dr. Andrews informed my dad I was a "baby" because I was complaining of the temperature, which he got a kick out of. After about an hour in the recovery room they ruled that I was stable enough to be released and went back to the hotel with my dad.

The surgery itself was a major success. Dr. Andrews harvested the tendon out of the palmaris longus region, which is in the wrist. For those who don't know, if you touch your thumb and your pinky together in opposition, the palmaris longus tendon will be in full display in the wrist. If the doctor is unable to extract the tendon out of this area then he will resort to extracting it out of the back of the knee, or the lower hamstring. Once he harvested the tendon out of my wrist, he moved the ulnar nerve out of the way in the elbow and drills holes into the bone. The next step is to weave the tendon into the holes in the bone to create the new ulnar collateral ligament. Dr. Andrews explained to me that with most of his patients, he has trouble getting two full loops through the bone with the tendon. But for some reason my tendon was long and strong and therefore he was able to get three full loops through my bone. In fact, Dr. Andrews let my father watch the operation from an observation deck ("It was awesome" -Dad), and paused during the surgery to turn to him and speak through a microphone, saying, "This is going REALLY well."

The rest of Thursday was spent relaxing in the hotel room. I took a long extended nap, still quite woozy and tired from the surgery. After awakening, it was time for me to get used to life with one arm. My left arm is in a hard splint covered by a lot of ace bandaging and a sling. The splint runs all the way from my wrist to just underneath my armpit, causing me to be completely unable to bend my arm at all out of the 90 degree angle they fitted it in (hence all the difficulties I listed previously).

On Friday I arose with my father and headed back to the Andrews Institute to meet with the physical therapists. It was there that I received my protocol for the future. From that point until the following Tuesday (tomorrow), I'd be stuck in the sling and completely immobile. They provided me with some light exercises for my shoulder, just enough to keep the muscular system moving and the blood flowing through the area, as well as a few exercises to prevent my neck from getting too stiff. Dr. Andrews had also suggested to continually try to move my fingers around and grip things, because the action of moving the ulnar nerve would cause some difficulty in the nerve endings in my fingers. Last night was the first night I was able to make a complete fist, and can finally now hold things with my left hand without any assistance. I am icing several times a day and continuing these exercises for now, although I know there is not much else that can be done. Tomorrow is my first physical therapy appointment back home in New York and it is there that I am supposed to get the dressing changed and switch from the sling and into the "bionic arm" that will be placed on my arm for approximately six weeks. I am hopeful that the process of the bionic arm can be quicker than usual being that Dr. Andrews expressed the possibility that my recovery could be faster because of the usage of the additional loop of the tendon in surgery. However, I know that nothing should be rushed further than it needs to in this process. The brace will be in place to gradually extend my arm and a step cannot be skipped.

For now that's about all from this front. I will blog again in a few days after my physical therapy appointment and update the entire process once more. Hopefully it will be easier to type then than it is now, being that I'm handicapped to typing with just one hand.

D-Day

Disclaimer: I realize the title of this post doesn't exactly rival the immense circumstances of the original "D-Day." I don't mean the title to be offensive to anyone, I just figured it would be a good comparative example of the emotional standpoint going into the operation.

The last day and a half has been one of the most exhausting, uncomfortable and stressful experiences I have ever had to deal with. I clocked out of my last day of summer work on Tuesday the 19th, headed home to pack my bags, and hopped in the car. My father and I were scheduled to fly out of Westchester County Airport in New York at 5:29 PM, have a minor layover at Reagan National in Washington DC and then catch a connecting flight from Reagan to New Orleans. We would stay overnight in New Orleans using Marriott points my mom had accumulated over time, and then rent a car and drive to Pensacola for my 9:30 AM appointment with Dr. Andrews.

Upon arriving in our nation's capitol, I caught wind of some news...the flight to New Orleans was delayed. It would not be taking off from DC until 9:40 PM, which would eliminate any shot of my father and I enjoying the French Quarter of New Orleans like we'd originally planned to. We shrugged at each other and headed to the bathroom. After using the facilities at the airport, we walked out towards the terminal and glanced back up at the screen that read "Departures." Suddenly, the flight was changed to "Delayed- 10:30." Immediately, we headed to the customer service desk.

After waiting for about a half hour to talk to someone from U.S Airways, the man informed us that the plane still had to go from DC to Manchester, New Hampshire and back to DC before refueling and heading to New Orleans. At that moment, the departure time of our New Orleans flight was bumped back to 11:30 PM. We began to get worried that the flight would be cancelled and postponed until the next day and we'd be stranded in Washington, having to resort to getting a hotel room in the area for the night and then rescheduling the appointment with Dr. Andrews the following morning. After sharing this concern with the customer service representative, he informed us that he thought we should switch flights and go to Charlotte, North Carolina. From there we could catch a connecting flight to Mobile, Alabama and work our way over to Pensacola from there. We agreed to this, got our new boarding passes printed and headed for the gate.

The boarding time for the plane never changed, and we assumed our positions in our seats. I put my iPod on and closed my eyes. And I waited. And waited. And waited. The plane taxied for nearly an hour, obviously waiting to take off and dealing with a delay on the runway. We finally got in the air and headed for Charlotte. The ride was smooth and easy, and we landed in relatively short time. When we landed, I turned on my phone and glanced at the time. 11:02 PM.

The connecting flight to Mobile had departed at 10:50.

We got off the plane and ran to the "Departures" board to find the news that the flight had left. We tried to find another U.S. Airways representative, but could not find a person willing and able to help us. We thought about renting a car from Charlotte and just driving to Pensacola, but the rental car companies informed us that they'd sold out of vehicles. We called around to all the local hotels and were informed there were no rooms available. There was no transportation, no shelter, and no way for us to get to the Florida Panhandle in 10 hours.

At about 1 AM, we decided to call it quits. There was no shot at us finding anything helpful. I'd exhausted my limited networking options that I know in western North Carolina to no avail, and spent a while complaining about the lack of assistance from U.S. Airways with the other passengers who had missed their flights also. My dad and I walked down to the baggage claim area, went to the bathroom to brush our teeth and put on some deodorant, and found a cozy little nook underneath a staircase. We put our bags down on the ground and used them as pillows. It was a far cry from the original plans...drinks on Bourbon Street and then the luxury of a queen bed at a Marriott. But we had no other options.

We arose at 4:30 AM and scurried to the U.S Airways desk, excited just at the prospect that the company would ACTUALLY help us get to our destination we'd set out for the afternoon before. Lo and behold, someone had cancelled their reservations. There were seats available on a flight directly out of Charlotte into Pensacola at 9:40 AM. I phoned ahead to the doctor's office immediately to inform them of the situation, and was told to not worry about it and just get there when I could.

Finally, we'd arrived. Our rental car was waiting for us at the Pensacola airport, and we hopped in and drove straight to the Andrews Institute. Tired, weary and frankly a bit smelly, we pulled up to the building in Gulf Breeze, Florida. And what a sight it was. A large brick building with "Andrews Institute for Orthopaedics and Sports Medicine" illuminated on a sign in the front of the building. It was like a dream for me...140,000 square feet, the finest facilities in the world, all geared towards the research, development and rehabilitation of athletes. It seemed like a haven for physically gifted individuals, and a lifesaver for those who's bodies have seemingly given out on them at times.

I walked into Dr. Andrews's office and signed the sheet at the front, right under Maurice Jones-Drew and Jeffrey Owens of the NFL...both consulting with Dr. Andrews after having knee operations from him in the past. I kind of chuckled, knowing that there was a very good chance a professional athlete would be in the building, but still amazed at the sight that my name was printed simply and directly underneath where they printed theirs. I had a quick X-ray taken to analyze my bone structure. They contorted both my left and right arm in odd positions, and compared the results.

After about a half hour of watching a CNN report about famine in Somalia in the waiting room, I was beckoned in by Jeremy Geus, the man who'd been on the other end of the phone coordinating everything with me over the past week and a half. He politely introduced himself and situated me in an examination room and told me the doctor would be in to see me in a minute.

The door opened and in walked Dr. Andrews. A slender man in his late 60s, it was evident that he had been an athlete in the past (a quick Google search told me later that he'd been an SEC champion polevaulter at LSU). He provided a firm handshake, and spoke in a soft and calm southern accent. He and I shot the breeze for a few minutes, he asked what my father did for a living and asked me about my plans for the future. He asked about my flight, and gave some restaurant suggestions for dinner (Maguire's Irish Pub in downtown Pensacola is where we ended up...highly recommended). Then we dove into the elbow. On the computer display in front of me was the original MRI from April and the subsequent one from a few weeks ago, juxtaposed against each other. He explained what he saw in simple terms, and pointed out where the UCL tear was. The other doctor in the room, a young man who I later found out was one of four who serve a fellowship under the guidance of Dr. Andrews, reassured me that the initial diagnosed of a torn flexor muscle that was revealed to be incorrect was very common and that the resulting physical therapy I had received was pretty much the same as it would have been if I had a partial UCL tear. The UCL had healed up a bit, but was still detached from the bone near the caudal region of the elbow. Thus, the determination had been made that Tommy John would be required.

I stayed in the office for about ten more minutes, filling out some paperwork. Then they sent me downstairs to the surgical unit, where I'd schedule my appointment with the attending nurse and meet with the anesthesiologist. That process was quite simple, some more paperwork and a quick little interview. Then it was off across the hall to the physical therapy unit, where I'd be fitted for my brace and handed a program to follow once the surgery was finished.

The physical therapist explained to me that I'd be in a padded sling for about a week, and then switched out of that and into the plastic brace (the bionic arm I alluded to a few days ago) that could be adjusted on a dial to enable more or less flexibility of the arm depending on the degree of extension or flexion Dr. Andrews desired me to be on at that time. For the first few days in the sling, the physical therapist gave me a set of exercises to keep blood flow and muscular coordination in the forearm and shoulder regions, which involve very basic motions that don't involve any stress on the surgically repaired elbow. I asked him when I could start running and doing core work again, and he told me once I'm in the "bionic arm" I can do anything I want as long as it doesn't involve the left arm.

Once the bionic arm is fastened to me, I can remove it at will. However, Dr. Andrews stressed that the only time it should be taken off is to shower, and shouldn't be taken off in public. He paused for a second and let out a quick wisecrack- "Well, I guess if you get pulled over while driving you should take it off quickly."

After about three weeks of the bionic arm handling the brunt of the flexibility exercises for the elbow, I was told I'd be permitted to begin taking it off under the guidance of a physical therapist and begin to do flexibility exercises without it's assistance. All this, combined with the continual basic exercises for the shoulder and forearm, would cover the bulk of my initial physical therapy appointments.

The physical therapist explained to me that the six week mark was an important milestone, because that will be when the bionic arm can be removed. If I can completely straighten the arm without any issues or assistance from the prosthetic device, I would then proceed to weighted exercises and continual strengthening of the entire area. And then of course in the distant future from there, throwing. At the four month mark, Dr. Andrews would like to see me back at the Institute and do a thorough evaluation. If all goes well, the hope is that I'll be able to start a progressive throwing program at that point. He is generally cautious about starting anything before then for fear that the arm might not be strong and healed enough, and stated that in the past it has taken some six months to get to the point where they're able to throw. Patience, in this case, will obviously be a virtue, because these aspects are things I can only control so much.

At around 2 PM, I gathered all the paperwork and information I'd received and left with my father to check into the hotel back across the bay in downtown Pensacola. We'd grab a quick nap, savoring the feeling of a real shower and a mattress, and head to dinner. We explored Pensacola Beach a little bit, and marveled at the white sand and warm temperature of the Gulf of Mexico.

I sit up in my hotel bed now writing this, watching Sportscenter and listening to my dad snore in the bed on the other side of the room. I'm scheduled to arrive at the Andrews Institute at 5:30 AM for a pre-op appointment, with anesthesia and the ensuing operation to begin with Dr. Andrews at 7 AM. From there, a day of recovery and rest at the hotel followed by a follow-up appointment Friday morning with Dr. Andrews and the physical therapists to make sure everything went well.

I'll bid my goodbyes for now, being that I now have less than an hour until the midnight deadline that is set when I can't have anything to eat or drink. There's a can of honey roasted peanuts and a glass of Arnold Palmer on the dresser that have my name on them. Then, it's off to sleep and an early morning rise to head back to the Andrews Institute.

Thursday, July 21st, 2011 at 7 AM will be my own personal surrogate D-Day. The start of a new chapter of my life. Tommy John Surgery.

The Greek Life of Sports Medicine

The first Tommy John surgery, for those who don't know, was performed by Dr. Frank Jobe in Los Angeles in 1974. In a kinesiological context, Tommy John surgery is very much similar to the arthroscopic reconstruction of the medial collateral ligament, or MCL, which is a common injury in athletes that occurs in the knee. However, the MCL of the elbow is known as the UCL (ulnar collateral ligament), and Tommy John surgery is the resulting operation.

Since Tommy John received the initial operation that prolonged his career by 14 years, the area of sports medicine has absolutely exploded. In today's day and age, it is not uncommon to see many pitchers undergoing TJ, and the recovery from the procedure is nearly at a 100% success rate.

The surgery has become so common that Dr. Andrews alone has performed more than 2,500 of them in his medical career. It's quite intriguing to know that the actual time spent in the operating room is generally no more than one hour, and that the physical therapy has been specified down to a tee...detailing everything from the amount of throws you make to the amount of sleep you get. And it is quite comforting to know that the success rate is so high, assuming that you (the athlete) follow that ever so categorical plan.

However, the theoretical simplicity of the operation and ensuing procedure is no less inconsequential to the athlete in question. The routine of TJ is a grueling, frustrating and often painful routine that can break many tough-minded individuals to the point where the desire they once possessed is no longer perceptively significant to them. Out of all the people that have experienced the surgery and everything that ties in with it though, there is one extraordinarily recognizable trait they all have.

A four-inch scar.

I guarantee that if you visit a baseball field that is hosting a baseball game with players at the collegiate or professional level and asked each player to lift the sleeve of his throwing arm to reveal the inside of his elbow, at least one would have this scar. In fact, there were nine pitchers on the 2010 MLB All-Star Game rosters that could very easily lift their arms and show you this scar...because they all had Tommy John surgery at one point in their career.

Despite the aforementioned arduous task of recovering from the imminent post-surgery physical therapy, it is quite obvious through prior documentation and examples that it can be done with extreme success. Perseverance, consistency and patience are three words that come to mind that assist in this. It's an interesting concept when all is done. When you're back playing, back on the field competing. When your career halts and you move onto the next steps of your life. Wherever that leaves, the experience will leave you with one common denominator.

A four-inch scar.

It signifies a fraternity of sorts, a growing collection of people that sympathize and relate to what you've been through and the gratification that you experience afterwards. It's a surrogate support group, unintentionally put together by no one in particular. A group of people that went through the terrors of Tommy John surgery. I look forward to that fraternity, to be able to be comfortable with the transformation of my left arm and to be able to share the story with those people. Everyone's experience with the operation is different, but the end result generally has one thing.

A four-inch scar.

Fixing "That"

Today was a day that involved me coming to a startling realization. I spent the afternoon in the basement of one of the middle schools in my hometown re-imaging computers (oh the glamour of summer college jobs). I wanted so badly to have my IT brain set in...the computers were giving me so many problems. But being that I'm not exactly a techie (still don't understand why they hired me), the mind quickly began to wander away from the flashing light saying "Error" on the hard drive and onto, but of course, my left elbow.

At this point it's been nearly three months since the initial injury. I have no pain whatsoever in everyday life...I've lifted furniture, moved boxes and done pushups. There's literally nothing that bothers my elbow at all...except throwing a baseball. So when I looked down at my left arm during that wandering time in front of the computer, the frustration set in. Why do I need surgery if it looks as normal as always? How could there be a torn ligament still in there, there's no swelling? How come it doesn't hurt anymore?

The growing frustration continued. I glanced towards the floor and noticed that the bottom of the chair I was sitting on had a tennis ball with a hole cut in it attached. It was a clever attempt by the custodians to try to save the floor from scratches and provide somewhat of an aesthetic appeal to the 6th-8th graders at the school. I reached down and took the tennis ball off the leg of the chair and caressed it in my hand. I flipped it around like it was a baseball...two-seam grip, four-seam grip, curveball, changeup. It flowed just as easily as it always had. I looked at the door to the room to make sure no one was opening it and coming in. I stood up, calmly pushed the chair in, and walked to the middle of the room. I took a second look back at the door just as reassurance that no administrator would walk in on my procrastination. I looked in for the sign, and took aim about two feet about the ground at the wall 30 feet in front of me. I came set, lifted my leg, and released.

And it hurt. A lot.

I clutched my arm and went to retrieve the ball I'd stupidly just thrown and put it back on the leg of the chair. I assumed my position sitting in the chair working my hourly job, feeling painfully defeated and realizing that perhaps these MRIs really don't lie and these doctors really are smart.

The realization I got to set in as I continued to image the computers in front of me. I would never throw a pitch in a game as a 21 year old. The original injury, the (not so) mythical "pop" that I heard, was on April 22, 2011. My birthday is April 23rd...the next day. My surgery will be next week, about eight months before my 22nd birthday. Not enough time to be game ready to pitch.

The physical pain that has ensued from the injury is something that I can deal with. Pain is a tangible obstacle, something that can be withstood with a tough mind, a strong heart and sometimes a bottle of Tylenol. The pain can be handled.

I have been playing organized baseball since I was five years old. It has been the one thing that has been most consistent in my life for the longest in my life. The mound is the one place in the world that I feel most comfortable and confident...the one place where all my worries and troubles seem to go away and somehow I'm able to focus on the thing I love. Baseball. And for some reason, unbeknownst to me, that has been taken away from me. I haven't been able to throw a ball normally since April, and I won't be able to again until the middle of 2012. THAT is the concept I am struggling with. The fact that I can't play a simple game of catch, let alone an entire game of baseball.

I find myself staying up at night in front of a body length mirror, going through my dry pitching mechanics. I must have thrown 10,000 make-believe pitches in the last week, repeating my motion in more ways than anyone could imagine. I begin wondering why I got hurt. Was it something over time? I knew I shouldn't have thrown all those innings when I was 14. Was it my physical condition? Maybe I shouldn't have dogged those last laps in preseason workouts. Was it overuse? I probably could have avoided a three-days-rest start here and there. Was it my mechanics? I can fix that.

I can fix that.

So I find myself trying to "fix that." I don't know what "that" is, but I want to fix it. I don't even know what the true reason why I tore my UCL was. But I'd like to think it's something I can fix. So I'm going to "fix that."

In just a few days, my father and I will be hopping on a plane from New York and flying to the Gulf Coast of Florida so that I can have Tommy John surgery. It'll enable me to eventually be able to have that catch. Be able to step on that mound. Be able to resume what I've come to love so much, to play baseball.

Eventually.

But for now I'll stop blogging. I have a glove next to me, and a mirror across the room. I think I am going to go "fix that" some more.

The "Foreward"

I guess I'm supposed to start this type of thing with a "foreward", like they call it in the novels. Apparently that's the norm for the well-respected authors, and for now I think I'll keep my confidence at bay by putting myself in the context of those other popular writers and write a "foreward."

Nonetheless, I am secure enough with myself to say that I'm nowhere near the literary level of those fine individuals that I'm speaking of. But, I am fairly passionate about some things, especially the game of baseball. And I figured the word "foreward" was appropriate because I am, after all, writing...and I couldn't really think of anything else to call it. But this post will be an introductory post, outlining what has occurred in my baseball life up to this point and provide an explanation as to the purpose of me keeping this blog.

Back in high school and in the earlier years of my life, I used to be able to play a little basketball. I had a pretty good handle, decent court vision, and I could shoot. I liked basketball because of the athletic displays of the players and because of the quick pace of the game.

Whether it was at practice or just shooting hoops on my own, I used to always end my session with a slew of free throws, and always made sure to end my time at the charity stripe with a made shot.

Now that I’ve hung up the Jordans and watch basketball games from the stands, I take a similar approach to my baseball practices. Being a pitcher in college, the majority of my time is spent running, doing PFP’s (pitcher’s fielding practice) and throwing bullpens in practice. And still, I always make sure that last sprint is my fastest, that last coverage of first base is angled and timed to perfection and that last four-seamer away doesn’t make the catcher move his glove at all.

That sort of consistency and optimistic repetition has paid off very well thus far for me up to this point in my career. I was a junior in college, and knew coming into the year that I’d be assuming a role in the starting rotation this year after two solid years in the pen. Coming into my start on Friday, April 22nd, I was undefeated and had an ERA of 1.44 through 50 innings pitched. Four of my wins came against teams that were nationally ranked or had been in the NCAA tournament last year. I’d had five starts and two relief appearances, and had never failed to pitch into the 8th inning in any of my starts (9 IP, 7 1/3 IP, 8 IP, 9 IP, 8 2/3 IP respectively).

The game on April 22nd was a big one. We were tied for first place in our conference with the team who finished as the national runner-up last season. It was me against their ace, in what was supposed to be a 9-inning pitcher’s duel at their place. The local media hyped the game up a bit, and the place was lively upon game time.

I felt great in the bullpen before the game, and great when I stepped on the mound for the bottom of the 1st. I never had as much confidence in myself and my ability to perform at any point in my life as I did going into that game. I KNEW I was going to pitch great. I KNEW my team was going to come out on top, one step closer to a conference championship. I was aware that this game probably had big implications on Conference Pitcher of the Year and All-America awards for each respective hurler. And I was loving every second of it.

I retired the first batter of the game and then surrendered a bloop double to the two hitter. The 3rd hitter worked the count full, and I came set with the intention to throw a curveball, hoping to backdoor a good hitter and buckle him for the second out of the inning. I took a look back at the runner leading off of 2nd base and lifted my leg to deliver the pitch home. My mechanics felt smooth and easy, just like I’d felt in all the pitches I had previously thrown throughout the entire season. I drove forward towards the plate and began the rapid descent down the mound. I positioned my fingers appropriately on top of the ball, getting the seams in alignment to get the maximum spin and break I could get on a curveball. I released the pitch just like I’d always released every other pitch.

And I heard an explosion.

I watched as the ball went behind the batter and trickled towards the backstop. Before I had the opportunity to react and attempt to take the customary action of a pitcher’s responsibility to cover home plate on a wild pitch with a runner on 2nd, I got dizzy. It felt as if someone cut my forearm from the rest of my arm. I fell to the ground in agony, holding what was left of my arm and trying to muster up enough courage to save face and stand up. The trainer, head coach, pitching coach, umpire and infielders were at my side in what seemed like a second. The trainer began to do some therapeutic stretching methods, but I knew deep down that nothing would help. I finally caught my breathe after about 30 seconds and walked off the field to a polite applause from the crowd.

I started pitching competitively when I was ten years old. Since then, I’d always heard of the mythical “pop”. The “pop” meant you needed Tommy John Surgery. Until I was about 14, I didn’t even know that Tommy John was actually a very good Major League pitcher; I just associated the name with the orthopedic reconstruction of the ulnar collateral ligament. The first time I had come in direct contact with Tommy John was with a friend who I played ball with in the summers during high school. He was two years older than me, and on scholarship at an ACC school. Armed with a low-90’s fastball as an 18 year old, he felt the “pop”. Being that we lived in the same town and I was eager to learn from a player in a position I aspired to one day be in, I offered my physical services to him in hopes that he could rehab appropriately. I quickly became his long toss partner, his gym partner, and sometimes provided a shoulder for him to cry on when things in the rehabilitation process weren’t going according to plan.

I headed to a radiologist near to my parent's house a few days later awaiting the word that the MRI results would come back indicating that I'd need the operation. I was miserable. I’d go into the basement and throw a few haymakers at the punching bag set up, and leave a trail of tears throughout the living room after woefully shutting off the television for fear that I couldn’t handle watching ESPN and seeing others playing the game that was taken away from me.

The day after the MRI, I got a phone call from my orthopedist. At the time I was sitting in the dugout watching my college team go through practice, attempting as best I could to remain optimistic for my teammates through the dull throbbing of my left elbow. The verdict had come in via cell phone…and I held my breath.

After review, he claimed that he saw no conclusive evidence of a torn UCL. In fact, the UCL looked strong and healthy. There was a lot of inflammation and swelling, and a partial tear of a muscle called the flexor digitorum superficialis, a muscle that is part of the forearm system that helps connect the elbow to the fingers. He proclaimed the injury is an acute injury and is incredibly painful and weakening (I responded with a sarcastic "Yeah, I'm aware," which caused him to chuckle). However, there is no surgical procedure required. In fact, what he described as "hardcore" physical therapy could get me back to the mound in as quickly as six weeks.

I was elated. I pulled my coach to the side and explained that I wouldn’t be able to pitch the remaining starts I was scheduled to have for the spring, but that I wouldn’t need surgery and could play summer ball. He was happy for me as well, knowing that I could throw and continue to develop as a player for my senior season.

I went through the extensive physical therapy program that was prescribed for me for the next six weeks. I’d sweat through every one, and make sure that each exercise was done very punctually and correctly to the best of my abilities. The six week mark was right around the second week of my summer ball season, and I had reported to the team in hopes to begin developing arm strength and get back on the rubber.

I started throwing very lightly from 60 feet, just as instructed by the orthopedist. And my arm hurt. It wasn’t an excruciating pain like I’d felt when I initially hurt it, but it was certainly significant enough to throw up the white flag on the tossing session for the day. I waited another 48 hours and attempted to start it again. Same thing. I called my physical therapists back at home in New York and asked what to do, and they advised to continue working at the therapy another week and give it some time before trying to throw again.

So I did. I continued the rehab process without throwing and worked hard at it. During my summer team’s games, I’d sit behind home plate amongst the crowd and run the radar gun, charting every pitch. I began to be bothered by this again…the thought that I’d be documenting my peers doing things I couldn’t do at that present time. It was a difficult task mentally.

After a week, I tried throwing again. No dice. Lobbing the ball 60 feet away aggravated the elbow, and I shut it down. I tried doing some different things- a sauna, a steambath, swimming, yoga. Nothing helped the pain.

At that point I made the decision that it’d be smarter to head back home to New York and get a second opinion on the arm than to try to stick it out and possibly waste valuable rehabilitation time lingering at the field everyday. If there was any shot at salvaging my senior season, or anything beyond that, time was of the essence.

I spent the next few weeks frustratingly attempting to get a hold of another orthopedist and somewhat rush the process. I must say, the combination of doctors’ vacation time and the troubles with insurance liability sure do make these attempts difficult.

On a limb, I decided to call the office of Dr. James Andrews in Birmingham, Alabama. I didn’t really expect him to be covered by my insurance, nor did I really fully grasp how an orthopedist in the Deep South would tend to a college kid from New York. What I did know was that he has a reputation of being the absolute best there is in sports medicine, and I needed the comfort of at least hearing for myself from the office of the best.

Within a few minutes, I had received the shocking news that my insurance company will fully cover Dr. Andrews. I asked his medical assistant if I could send a copy of an MRI of my elbow to his office for him to look at and she said “sure”.

Once the disk was received at the office in Birmingham, I received the official word from Dr. Andrews…

I tore my UCL and would need Tommy John surgery.

I quickly scheduled the surgery for the first day he was available…July 20^th, 2011.

I was devastated. I hounded the Internet for information about the surgery and the rehabilitation process involved, but couldn’t find anything specific. I spoke to a few friends and former teammates who had experienced the surgery in the past and gained bits and pieces of information from them. But I still couldn’t put it all together.

What I did know was this: I wouldn’t be ready to pitch in my spring college season. My SENIOR season. The realization of this was probably the toughest thing out of the news. I hung up with Dr. Andrews’ assistant after making the appointment for surgery and called the NCAA headquarters office in Indianapolis. I explained my situation to a very nice lady on the other line and she explained to me that there are a few choices I have. I told her that ideally, I’d love to be able to gain that fourth year of eligibility back without having to sit out and be able to play out that eligibility in grad school. She told me the requirements for this:

• · Graduate in four years (I am)
• · Have above a 3.0 (I do)
• · Prove that your current institution doesn't offer what you're looking to study (The only Masters program the school offers is Education. I am a Business major looking to work either towards an MBA or a Masters in Sports Management/Administration)
• · Get a waiver from the school you're currently attending (I'd assume my coach would sign)
• · Get a waiver from the school you're looking to play at (I'd assume the coach would sign)

Hopefully that in my work in the future, I will be able to obtain the official documents and reach these objectives to make this happen. That, of course, is not a main priority right now being that the surgery hasn’t even happened yet, but at least is an optimistic situation that could come out of the drastic injury.

Now…enough of the rambling, on to the main reason for me writing this blog. As I mentioned previously, I have never found a true account of Tommy John surgery and the step-by-step process that goes into recovering from it. I’ve read articles about the workouts, and spoken to peers, and even followed Twitter (Joba Chamberlain had the operation done by Dr. Andrews on June 16^th and has documented his progress on occasion). But none of these sources provided a true chronicle of the process. I yearned for the development of everything…what did it feel like? What was it like in the operating room? How itchy is the cast? What was it like the first day of throwing?

Tommy John is an extremely nerve-wracking and stressful thought. The looming notion of the long and brutal recovery, combined with the fact that you will not be able to participate in the sport you love, can often times break an athlete down.

So here it is. An official blog that will provide a detailed chronicle of the ENTIRE process. On July 20^th, 2011 at 10 AM I will walk into the Andrews Institute in Gulf Breeze, Florida to have Tommy John surgery performed by Dr. James Andrews. Starting today, exactly a week before my scheduled surgery, I will provide everything that has to do with the operation. I will document the emotional aspect of things, the balancing act of everyday life with the rehab, and the progress that I am making from a baseball perspective. I will provide detailed notions of each and every step of the way, and hopefully these things will help someone who finds themselves in the unfortunate situation that I’ve found myself in currently. Because after all, Tommy John surgery is pretty common in the baseball world. And it is pretty scary also. I don’t wish the emotions that I’ve been going through on any fellow athletes, so perhaps this blog will help someone find some solace in themselves as well.