Integral Adversity

As the clock turns and it becomes August 25th, I am under the assumption that I should be extremely excited. After all, that marks exactly five weeks after I underwent Tommy John, and according to the protocol written for me by the physical therapists at the Andrews Institute, five weeks is the point at which I am to "discontinue arm brace." I should be jumping for joy. No longer will I have to wear the dreadfully uncomfortable piece of plastic that improperly fastens to my left arm. No longer will I have to endure the obnoxiously odd contortions my arm is forced into, nor will I have to answer but a fraction of the "what happened?" questions I've become so accustomed to. It is supposed to be a big moment in the recovery process, a huge step on the road to healing.

But it's not.

I don't want to take off the brace. I don't want to walk around my college campus, enter restaurants, engage in social events without my brace. Sure, I've been taking it off around the house...and it feels good. But there are times when my arm starts to ache, when I feel a bit worrisome about a particular environment that could be dangerous to my arm. There are situations when, simply put, I need security. The brace has allowed me to have some sort of scapegoat in the last month. Not necessarily an excuse per se, but an awareness in those surrounding me. When someone sees someone in a cast, or a sling, or on crutches, they know something is wrong. The arm brace for TJ surgery is not a common sight, and causes people to be more cautious and curious. The questions do start coming out, and do get a bit annoying. But people sure do make a conscientious effort to avoid making contact with my arm. I assure them that if they touch me anywhere but on the actual scar I will be completely fine, but they tend to still be timid. It's an interesting and unfamiliar social phenomenon for me. But when it all comes down to it, it's nice knowing that I have the security of a brace keeping my tender scar and new ulnar collateral ligament from the events that could occur around me.

So I will be able to walk to class tomorrow, bag in tow, and sit down. I will open up my notebook and take notes and participate in the lectures just as all of my classmates will. And I will do so unassumingly, with no large object protruding from my arm that causes me to be different than everyone else. And who knows, maybe it'll feel great. But rest assured that my senses will be in full motion tomorrow in fear that someone will accidentally bump into me, that I move my arm the wrong way, that I bang the inside of my elbow on something by accident.

The past few days have been rough for me in other facets of life post-surgery as well, not just with respect to the insecurities of having an exposed elbow. I moved into my new off-campus apartment on Sunday, a beautiful unit just down the hill from campus. It's a three bedroom apartment on the first floor of a three story building with a huge porch. It's surrounded by other student houses on a one way street and is truly the perfect situation for a college student. I excitedly packed my bags over the weekend and anxiously hopped in the car to make the three hour drive from my hometown to college. My dad trailed me in his car, curious to see my living quarters this year and yearning to help me organize my life before I ran off to party with my friends (I, like many college kids, tend to prioritize things differently than some people in the older generations might like). Once we arrived at the house and began the process of organizing my room, it hit me like a ton of bricks.

I couldn't do anything.

I couldn't lift the desk, move the chair, lift the bag. If I tried hanging all of my shirts that need to be hung, my arm quickly grew tired and ached. If I tried to sort clothes, my arm would remind me that it couldn't move that way that quickly. As my dad feverishly moved about the room dripping sweat, I tried as best I could to help...but I couldn't even put a bottom sheet over my bed. I resorted to folding clothes and putting them in separate piles on my bed, and then having my dad take the large piles and put them in each respective drawer they belonged in.

I was completely debilitated. I watched my dad unpack everything for me for several hours, sitting on the futon massaging my arm. He grew frustrated, wishing he could have a little more help but knowing that there was literally no way I'd be physically capable to do these two-handed tasks. It was frustrating and disappointing.

Our fall season at school begins next week, and many of the players have been using the field and the batting facilities during the afternoons to prepare themselves for the oncoming practices with the coaching staff. I've accompanied my teammates to the field, introducing myself to incoming freshmen, transfers and walk-ons. Most of them recognized my name from the website last year, obviously following along with the 2011 season. We discussed the surgery, the rehab process, etc. I'd crack jokes with my fellow returning teammates, and make myself look like a fool trying to shag balls and throw them into the bucket righty. It's a good time, a relaxing socializing session with friends. I've been comfortable in those afternoons.

This morning as I drove to campus to go to the athletic trainers to have my physical therapy session, I saw a handful of my teammates in the weight room. Despite the fact that I'm able to work out my legs and my core, missing out on the opportunity to lift with my teammates struck me. I watched for a few minutes in silence as they went through their sets in the gym, sweating and gaining strength for the season. Then I walked downstairs and received my increased dumbbell from the trainer for my rehab assignment...a 3 pound dumbbell. And I struggled.

After a solid "family dinner" at the new house (a big barbecue on the porch with a bunch of people from the apartment building), I proceeded to head up to campus to complete an assignment at the library. I decided to take a detour and see what kind of activity was going on at the park downtown, taking advantage of the beautiful August day. I drove into the parking lot and spotted a game going on at the Little League field. I stopped the car and got out for a minute to watch the game, figuring procrastinating my assignment for a bit couldn't hurt me. I leaned against the fence and watched as these kids- no more than seven or eight years old- ran around the field in jerseys too big for them and bats a half a foot too long. They looked like chickens with their heads cut off...a grounder up the middle and somehow all nine position players proceed to sprint after the ball and forget to cover a base. There was a girl playing left field with a pink mitt who squatted down and picked the dandelions out of the grass for a moment before the coach yelled out to her to pay attention.

I smiled and wandered over closer to the action, nearer to the first base dugout. Suddenly a tiny young boy stepped up to the plate. He held the bat very timidly and stood much too far away from the plate. The coaches yelled out words of encouragement to him, but there was literally no way he was going to make contact with the ball.

The first pitch came in, high and loopy and slow. But, it was right down the middle. Strike one. The little boy never took the bat off his shoulder.

The second pitch came in, high and loopy and slow. It seemed a bit outside, but then again, these kids are really young. Strike two. The little boy never took the bat off his shoulder.

The third pitch came in, high and loopy and slow. The little boy lifted the bat and took a vicious rip at the ball, which was literally over his head. His eyes were most certainly closed, and his back leg flew forward like he was trying to kick a soccer ball. But somehow, he squared up perfectly. The ball bounded along the dirt, skidding through the hole between shortstop and third base. The boy clumsily ran to first base, holding his oversized helmet to his head. When he reached first base, his coach greeted him with a big high five and his teammates cheered. As the crowd of parents next to me clapped in approval, he turned around and smiled...displaying an entire row of missing teeth...and waved at his mom. She, in turn, smiled back and gave him a quick thumbs up before he spun his head back around to focus on baserunning.

I got back into the car after that at-bat and drove up to campus. Before going to the library, I stopped at the baseball field. At this point the sun was setting and it was empty. The dugout was full of empty water bottles, empty tins of chewing tobacco and a rake leaning against the bench. I grabbed a stray baseball laying on the ground and slowly walked out to the mound. I stood on top of the tarp and felt around for the rubber, and sat down on it once I found it. I held the ball in my hand for about 30 seconds and stared in at home plate. Then, I started crying. I cried and cried and cried for what seemed like an hour. I didn't care if anyone drove by or came to the field. I was alone in my own world. I was at the single place in the world that I felt most comfortable, the place where I could perform the only task I truly love performing. I'd witnessed my friends enjoying the game a few hours earlier on the same field I was on, and witnessed young children display pure love for the game just moments before on a smaller field downtown.

I had an NCAA baseball in my hand, a pristine mound below me. I had home plate lying 60 feet 6 inches away, with the black outline on the corners just screaming my name. I had the stands behind the backstop, and the advertisements on the outfield fence, and the scoreboard. I had the dugouts, the locker room, the press box. Everything was in place, everything was perfect.

And I can't throw the ball.

So I cried. I cried until the sun nearly set, until the tarp grew damp with the salty tears. I cried until I couldn't cry anymore.

Tomorrow morning I'll be in class taking notes and listening to my professor lecture. I will be brace-less, with my scar in full display. Tomorrow afternoon I will head across campus to the baseball field, where I'll continue to be there with my teammates as they work towards another successful season. Then I'll probably come home and enjoy some more social time with my roommates and continue to live out the greatness of the college life.

Who knows, maybe tomorrow night I won't have to force a smile and assure everyone my arm is feeling great. Maybe I will feel excellent and optimistic.

Or maybe I'll just cry.

Is That Staples® "Easy Button" Real?

Ladies and gentlemen, I will officially be able to go out in public without wearing my brace next week. I received this news at physical therapy yesterday, after I had one of the interns at the office take the posted pictures so I could send them down to Dr. Andrews as a status update being that it was the four-week mark post-surgery (in reality it was four weeks and one day, but I didn't really think he'd have that much of an issue that I was 24 hours delayed in sending him the picture). I sent the pictures attached to an email describing my progress, explaining that there is still some swelling around the scar and the atrophy of the muscles is often quite painful. I received a response email less than an hour later that read: "Looks AWESOME! Keep up the good work."

After relaying the email response over to my physical therapist, we went over the protocol and noted that at the point that I am, I will be able to remove the brace permanently at the five week mark. This is typically a week before it is recommended, but as I noted the physical therapy has been going smoothly with no bumps in the road and thus, I am capable of comfortably living without the brace. The physical therapist did request that I leave the brace on if I'm out in a social setting. For example, if I go to a house party while I'm at college it's best to have it on just so other people are aware that there is an injury in place. Despite the fact that my strength has gone up dramatically, you never know what kind of pain could take place if some intoxicated idiot comes and smacks me on the arm by accident. Better safe than sorry.

The last week has probably been the most progress I've made since I first got out of the sling and into the brace, which was more than three weeks ago. I can now perform nearly most daily functions with my left arm, including two highly underestimated- and much more comforting tasks- being able to roll over and lie down on my left side and a certain action that takes place in the privacy in the bathroom that has proven to be quite difficult to perform with your non-dominant hand.

Today will be my final day at home in White Plains, NY...in fact this blog is a successful form of procrastination from packing all my things in preparation for the drive back to school tomorrow morning. I am very excited to get back to school and move into my house. I love my friends at school, the environment of college life and everything it comes with. At the same time, I am a bit skeptical about some aspects of the return. Firstly, I am a senior this year. While this allows me to have the freedom of having by far the best schedule I've ever had since I enrolled in the fall of 2008, it is upsetting at the same time. I have become incredibly comfortable with the atmosphere surrounded university life, and the fact that I am entering my final year of my undergraduate academic life signifies an end to a wonderful facet of my life.

The most crucial reason as to why I'm hesitant to jump at the typical excitement to head back to school is simple: Baseball. The first time I ever played baseball for a school team was in 7th grade, when I made the modified team as a pitcher/center fielder/first baseman (I know I know, stereotypical lefty). Since then, I have played for my school team every single year. In fact, I have played organized baseball every year since I was five years old. And then suddenly, my final year of college at the school I've come to love, and poof! It's gone. Surgery was on July 21, and the typical recovery period is 10-16 months. That means if I were to recover at an very fast pace that would land me game ready sometime in May of 2012...which is when the college season ends. Stephen Strasburg had his surgery on September 3, 2010 and he made his first minor league start a few weeks ago, 11 months later. He's still got a few weeks to go before he is projected to make his second Major League debut.

The other day, I had a long conversation with a teammate of mine who had his shoulder operated on a few months ago. We went over the pros and cons of the process, the frustrations and emotions that come along with the rehab. We went over the odd feelings that we get, and the aches and pains. We talked about the excitement about such minuscule accomplishments, and the mental drain that everything causes. He too might not be able to pitch this spring...also his senior season. He and I will be spending the fall and winter together in the training room, doing different exercises in an attempt to reach the same goal. We w̶a̶n̶t̶ need to get back on the mound, to proceed with the game that has provided us with so much for so long. We have a burning desire to obtain that peak of our athletic abilities, to fight against the injury that has debilitated us so much and prove that we can come out successful on the other end. We've provided each other a bit of a shoulder to lean on during rough times, and an ear to speak to when we feel the need to brag. There's no denying it has been a tough road thus far, and it'll probably only get tougher. Especially now that we'll be back on campus and not participating with the team. Rather than throwing, running, fielding, pitching, lifting during practice, we'll be confined to the trainer's room doing exercises with light weights that haven't been so difficult since we were toddlers. We'll be separate from our teammates, our brothers, for the first time since we can remember. It'll be a brutal reality check.

Monday afternoon will be my first therapy appointment at school, and I am curious to see how it plays out. I have developed a comfortable routine with the physical therapists I've been seeing here at home. It's not so much that I am incredulous towards the professional capabilities of the training staff at my school, it is just simply that it is another step outside of my comfort zone. I have no doubt that once I readjust to the ways that the rehabilitation process occurs in the training room at school I will be less apprehensive, but I feel that it is natural to not want things to differ from the usual process.

Hopefully my next blog post will be filled with strictly optimistic news, being that I am going to be enjoying myself at school and getting my brace off at the same time. Still though, I'm not too sure. It will most definitely be difficult being on campus and not being able to participate with my teammates. It will most likely torture me. But then again, that makes you a better person.

Right?

The Learning Curve of the Disabled List

I am not sure if this is considered to be a true adage or not, but I'm going to go out on a limb here and say that if it's not, I'm going to make it one right now: It is human nature to be increasingly attracted to something that directly affects your livelihood or well-being.

For example, if you have small children and are looking to buy a new car, you would probably choose a minivan instead of a convertible. It is more efficient and more safe. If you are a high school student that is college searching, you may narrow your search to schools within a specific geographic range because of the connection you have to your hometown.

In the case of Tommy John surgery, the same rules apply. Kinesiology is defined as the study of the principles of mechanics and anatomy in relation to human movement. In the past, I have never been a science-oriented individual. I was always a pretty good writer, could hold my own in a political conversation and had a knack for getting people to like my personality without actually trying very hard. Science? That was a big no-no. I didn't have the mind for science...the intricacies of the formulas, the in-depth analysis of minute objects, the specificity of each involved portion of a study. It didn't make sense to me, and I didn't connect to it.

Kinesiology, in theory, is the technical affiliation between science and sports. Sports medicine, a relatively young industry in the vast history of healthcare, was birthed by the concept of kinesiology. I always viewed kinesiology in more layman's terms. If you twist an ankle, the trainer tapes it. If you pull a muscle, you apply ice to it. If you break a bone, a doctor puts a cast on it. If you have surgery, you do rehab. It was a simple concept, and something that I didn't really see myself being required to delve into more than the surface of the topic in order to get by in my life's athletic endeavors.

My father told me a story once about a test he took when he was in high school. The entire class feverishly took the exam, and strained themselves through the entire period. There was one exception, a boy who sat in the front row and simply stayed motionless with a closed test booklet in front of him. After everyone's test was completed, the teacher collected them and dismissed everyone.

The following day, the students were shocked to find out that they'd all received 0% on the test. All of them, except for the one student in the front of the room who sat still and didn't scribble a single word. That boy got 100%. After a few minutes, the teacher explained to the class that the grades they received wouldn't count towards their overall record, and asked them to open to the front page of the test. In the front cover, the instructions were typed neatly and small... "Directions: Do Not Take This Exam."

I don't actually know if my father's story is true or if he was just trying to make a point to his son, but the point sunk in. Everything that involves my life must be thoroughly evaluated. I took that lesson with me into the experience of Tommy John surgery. When I first received the news that it was required, I began to soak up information. I wanted to know exactly what the surgeon will be doing to my arm. I wanted to know how, why, for how long, where, and what does it entail? I didn't just want to know what the procedure would be, but why the specific body parts would be used. I didn't just want to know what I needed to do for physical therapy, I wanted to know why I needed to do the tasks and how that would make me better.

I've learned a lot of things through this process. I've learned the biomechanics of anatomical structures relating to my injury. I've learned how things heal, why things hurt, what the purpose of a particular body part is. I've learned the importance of things such as calcium intake and polyunsaturated fats and soft tissue Graston technique massaging and consistent sleep cycles. I've learned that everything in my life that is physical can somehow be directly related to my injury.

The knowledge I've gained from learning about kinesiology in this process hasn't just been soaked up in a recital-like textbook manner however. I have begun to look back on my baseball career and find cues as to how the things that I've learned correlate with my presence on the mound, and perhaps why the things that have happened actually did. I've begun to provide myself with an analysis for the future...the appropriate ways to avoid a reoccurrence, the proper method of performing my craft in a way that will be the most harm-free for me. I have been subjected to the well documented misery of the Tommy John recovery process and in all honesty, it is not something I wish to take part in again.

The greatest satisfaction I get out of this information soaking is the ability to share it with others. Although I am not able to play baseball at this current point in time, there are millions of others that are. And for the few that I do happen to come across in an encounter in my life, I'd like to try to make a difference. I've realized the adage is true...you're attracted to things that affect you. The science of bodily movement has provided me with a scapegoat, an excuse to learn, progress and improve. The ability to share my learnings with others is a thrill for me because of the pride I feel in watching my knowledge translate into their lives, or their playing experiences on the field. "Get your elbow up," "Lead with your hips," "Land here to put less pressure on your knees and focus it in the quad." Rather diminutive coaching techniques that could alter a player's life.

It used to all seem basic to me, pretty boring and rather unimportant. But this prosthetic brace- the bionic arm- is a daily reminder for me that my previous approach to it all couldn't be further from the truth. Tommy John surgery has enabled me to learn about a myriad of different things that I've never truly been exposed to in the past. It's helped me realize my passion for sharing this knowledge with others, and to coach them along their career and their path. It's brought me comfort to know that I can better myself through this entire process, not only in the maturity of striving through the rehab and not only in the building of my work ethic in relation to the necessities of post-operative details. It has brought me the uncanny ability to broaden my knowledge and breadth of information that will help me make better sense of why things happen(ed), and to help other individuals realize these things as well.

I am no expert on the topic. But time spent on the shelf certainly does provide a learning curve. And I plan on taking full advantage.

Is It Worth It?

I figured that making a weekly ritual of uploading a picture to display the progress I’ve made with my scar would be a nice thing to do for the readers of this blog, so here is a picture of the arm at week three post-surgery. I managed to make sure that my arm looked normally left-handed and didn’t have the mirror effect that it did in my last post with a picture. Firstly, please ignore the snowman on top of the shelving in the background of the picture. I literally have no idea why that’s still sitting there, maybe my parents really think it’s cute or maybe they really would rather it be December instead of August. But nonetheless, it is there.

The picture can reveal a bit about my progress thus far. Firstly, it is quite evident that there is significant swelling around the medial elbow and the scar itself. The swelling that occurs in the arm is completely random and inconsistent. There will be some days where I’ll wake up, look at the arm and notice that it looks completely normal and that there is no swelling at all. Then an hour later I look again and my arm is disfigured, with swelling in contorted ways and odd spots. Last night my arm had no swelling, this morning it looks like there’s a dent in my forearm and a tennis ball inside of my elbow. I’ve learned that swelling is VERY normal in Tommy John recovery. Swelling indicates the body’s reaction to the physical activity the arm is taking part in. Because the operation is such a drastic event for the muscular and nervous system surrounding the area, the body seems to overreact at times. The swelling in the area is nothing but blood being sent to the area that has been worked in order to assist in healing. It is, in fact, a good thing that the arm is swelling because that means that the brain is recognizing that there is a significant change in the kinesiology of the elbow and thus reacting accordingly.

As I lay down in bed last night, a harsh truth came over me. It was the 21^st day post-surgery, exactly three weeks from the time I was wheeled out of The Andrews Institute and back to the hotel in Pensacola, where I’d take an afternoon-long painkiller-induced nap. It was at that point when I had no movement capabilities whatsoever with the arm, I was a walking cripple filled with narcotics and self-pity.

Three weeks later, I can straighten my arm, take a regular shower, and cut a steak. I can run, do sit ups, drive a car. I no longer have stitches in my arm, and the scars that used to hold together my skin have now begun to scab over and itch. The progress is extraordinary in the entire overview of things, and will only continue to get better. And yet, the recovery is miserable. I’m three weeks removed from surgery, healthy to the point where it’d be very difficult to have made more forward progress than I have up to this point. But last night I thought of this: I’m three weeks deep, and I “only” have a year more to go. A year. I feel as though I’ve been cooped up in this brace for an eternity, like I’ve been through enough pain and misery and aching and suffering. I feel as though it’s about time for me to be able to stretch out, warm up, and get out on the mound to face live hitters in a game. And yet that can’t happen, not now, not in the near future. Stephen Strasburg, the uber-prospect that burst onto the scene in his brief MLB debut, had his Tommy John operation on September 3, 2010. This past Monday, August 8, 2011, he threw 31 pitches in a minor league game…his first official appearance against live hitters since his injury last summer. That’s a little more than 11 months removed from surgery, and he's only throwing 1 2/3 minor league innings. Its a scary thought, the fact that I've worked so hard already and yet there's still so far to go.

I've been having some natural thoughts in hindsight, "was it worth it?" type revelations. For me, baseball has always been an escape. The cliche of the "anti-drug" commercials lays true with respect to me and the game. I have a fairly addictive personality, and have been fortunate enough to attach myself to the game of baseball rather than the possible other harmful activity that could hinder me for the future. Now, it's been taken away from me, albeit temporarily, and there's nothing I can do about it. I have to push myself through grueling rehabilitation and timeless mental frustration, all to achieve the opportunity to go out there once again and attempt to prove myself and my capabilities. I'll be working from now through the fall and the winter and the spring and next summer and into next fall all in hopes of my arm rebounding appropriately in a healthy manner so that I can resume playing the game I love. Baseball has been the single constant in my life since I was five years old, the consistent passion and joy I've possessed for so long is directly attributed to the game of baseball that I've known my whole life. And that fateful pitch I threw on April 22, the ensuing misdiagnosis, the throbbing pain of trying to rehab it, and the trip to Florida to get sliced open, suddenly seems as though my entire world has been thrown for a loop. It's been described as a speed bump, an obstacle in my athletic life. Well, it sure is a pretty big speed bump and sometimes it feels like I bottom out.

To those who read this blog because you are going through the operation and ensuing rehab yourself, please keep in mind that you are not the only one with this frustration. I've seen grown men in tears over this operation, and now I am understanding firsthand why that takes place. I find solace in learning about other people's experiences, and seeing the success that those in the past have had. I find consolation in knowing that I have a support group behind me, and there are people who care about me and are pulling for me to succeed in everything. It is difficult. It is time consuming. And it is lonely. But in the end, as of right now, it looks like it'll be successful. And that day when I am finally able to step back on the mound and compete in a game...that moment when I wind up and stride forward to unleash my first pitch post-surgery...that's when it'll all be worth it.

Abnormalities of a Bionic Tan

Life with the infamous Tommy John bionic arm isn't as bad as I thought it would be. I'm sitting in a Starbucks right now in Southampton, New York, less than a mile from the Atlantic Ocean, sipping a coffee and nursing a bit of a sunburn I got while laying out on the beach yesterday afternoon. Despite the nasty torrential downpour that's occurring today and confining me to this table in the coffee shop, life really could be a whole lot worse than this.

I took my brace and arm sleeve off last night and looked at myself in the mirror before showering and literally bursted out laughing. My left arm, which sat on the beach yesterday completely engulfed by the bionic arm and the sleeve, is white as a ghost. My right arm and the rest of my body, which had the luxury of bathing in the 90+ degree sun for several hours, is a crisp dark tan color. The appearance of the pale left arm juxtaposed with the tan summertime look of the rest of my body certainly is odd and funny looking.

After a good laugh, I turned sideways in both directions to examine myself in the mirror. The laughing quickly ceased. My left arm is considerably smaller than my right arm. It looks as if my right arm is the property of a healthy 21 year old college athlete who spends time in a weight room, and my left arm is the property of a 14 year old boy who is just hitting puberty and is in that in between stage between baby fat and adult muscle.

It explained a lot. Over the course of time since I first received the bionic arm and fastened it on my arm, I've begun to realize that I require the Velcro on the brace to be affixed tighter than the days previous. I've been readjusting it more during the day, continually reapplying the Velcro because it becomes too lose. But last night was the first time I realized the physical evidence as to why this is occurring.

It is quite apparent that my muscles are beginning to go into a very early stage of atrophy. With the onset of the injury and ensuing surgery, I have done very little in terms of exercise and attention to the muscular system of my left arm in recent past. At physical therapy the most attention we've given to the muscles in terms of weighted exercise is with a small pink one pound dumbbell. I've been the butt of several jokes at physical therapy...a 21 year old that struggles to do forearm curls with a pink dumbbell the size of a ballpoint pen.

The aspect of my muscles decreasing in size is not something to be alarmed about. In fact, it is very much expected to occur under the circumstances of the situation. However, it is yet another stress-filled obstacle that is part of the entire overall process of the recovery. I don't only have to worry about elbow flexibility. I don't only have to worry about elbow strength. I don't only have to worry about wrist flexibility. I don't only have to worry about shoulder stability. I don't only have to worry about cleanliness of the scars. But now it is extremely apparent that I have to worry about the upkeep and rebuilding of every single muscle in my left arm.

The standstill of the progression is another frustrating aspect of Tommy John rehabilitation. Its not like a typical injury, where you have a very apparent and quick recovery. With Tommy John, everyday you wake up you may feel better. But its extremely minute. A friend and former college teammate of mine who had the same operation described it very well...it is as if my arm is healing like molasses falls from a tree. There is certainly reason for being optimistic, but there is also certainly reason for frustration. It is mostly a matter of what you make of your current predicament, and the outlook that you are able to have for the future.

I noted in a previous post that the attention received from wearing the bionic arm 24/7 isn't always a fun experience. I am in the Hamptons for the weekend to celebrate my girlfriend's grandfather's 75th birthday, and there are a lot of family members here to celebrate as well (I feel odd calling them "in-laws" because she is my girlfriend not my wife, but in concept that is who is here). My girlfriend has a large extended family that is very close to each other, so last night was filled with lots of loud Italians, pasta and alcohol. It was extremely festive and fun, with somewhere near 50 family members all enjoying the outdoor event in the beach environment of the Hamptons. But with the large crowd also came the standard questions for yours truly..."What happened?", "Does it hurt?", "Can you move it?", etc. I answered each and every question the same way, politely and respectful, and displayed the scar for those who were curious enough to see it.

These particular situations are not all that bad though, depending on your patience level. A lot of my girlfriend's cousins are young kids, under the age of ten, and are incredibly gullible. When I tell them that the doctors wanted to do a medical test and see if they can make me like Ironman, their eyes open wide. I explain to them that the doctors put a "metal thing" in my muscles and are hoping that after I heal, I become the strongest guy in the world. The reactions are priceless...some of them are wide-eyed like I'm a celebrity, some start crying out of fear that I'm going to beat them up. For some reason though, they all believe me.

My physical therapy session on Friday was much of the same from the previous sessions. We did the same exact exercises as we did on Wednesday, not desiring to progress too quickly. The exercises were still difficult, but are becoming easier by the day. We measured my range of motion with extension and once again I made an improvement, being only five degrees away from completely straight. I am hoping that by the end of this week I will be able to completely straighten the arm, although as I've mentioned in the past, you can never know how the arm will react on a daily basis. Flexing the arm in a curling motion is becoming much easier, which allows for daily activities to become more normal as well. The biceps muscle had been so non-existant in the immediate days following the operation that the contracting of the muscle has been a bit painful. However, it is quickly improving and beginning to feel almost back to normal.

My next physical therapy session is Tuesday evening, when I make the unfortunate drive back to reality from the Hamptons. Until then, I'll continue to enjoy my vacation time watching everyone swim in the ocean while I sit on the beach. I'll eat a lot of seafood, be merry with my "in-laws" and keep telling little kids I am some sort of bionic medical experiment.

Two Weeks Post-Op

...and this is what the arm looks like. Please excuse the redness right above the scar in the crease of my elbow, that is simply just an abrasion from my scratching. The skin gets very dry and irritated being cooped up in bandaids and an arm sleeve nearly every minute of the day.

And yes, that is a Looney Tunes t-shirt. I got it for $3 at the Gap Outlet in Myrtle Beach last year.

Aside from the aforementioned self-made rash, everything else pictured is quite normal. The stitches in my arm were removed Tuesday afternoon by a family friend who works in the Emergency Room at White Plains Hospital. I had three stitches in the wrist and two in the forearm (the wrist served the purpose of extracting the tendon, forearm to move the nerve). The main scar, the "four-inch scar" I spoke about a few weeks ago in the blog post entitled "The Greek Life of Sports Medicine", had one long stitch in it that held together end pieces, almost like a river has tributaries.

The last few days have had a lot of ups and downs in terms of the progress of the arm. In the immediate hours following the removal of the stitches, swelling began to form in the forearm and around the TJ scar. I was reassured by several people in the medical profession that this is very common, as the body is simply reacting to the stitches being removed by sending blood to the area to compensate for the new responsibility of skin holding itself together. In fact, I was told, swelling is a good thing in this case because it means the body is working to heal itself. Simply icing the swollen areas a few times a day will suffice in decreasing the swelling and allowing the arm to comfortably do its bodily service.

Physical therapy yesterday was another largely successful session. We added a few new exercises in the mix, an exercise that involved flexing and extending the arm with a ball inside the arm, and a gripping exercise with a rubber device that looks like a tennis racket. Combining these exercises with the previous exercises I had already been doing was great. The new exercises worked different muscle groups in the area and at different intensities than I was used to up to that point. A typical healthy person would go through these routine exercises and probably wonder why they were wasting their time with such nonsense. But I must say, I was exhausted after my session. The weakness in my arm is still completely astounding to me.

We measured my extension ROM once again and once again I had an increase. Yesterday I was just 12 degrees away from completely straight. While this is obviously great news, my physical therapist did warn me that it could just mean Monday was a bad day and this is the norm...one can never know how fast the body will progress in such a manner. Still, the optimism was there, and my physical therapist and I both agreed that if I continued at the pace I am going, I could have the brace completely off before I head back to school. Our first day of classes is August 24th so assuming I'll head back a few days before then to move into my new house, that would mean that in just one month I could have the brace off. Two weeks ahead of protocol! That is, of course, after I take pictures and e-mail them to Dr. Andrews. Nothing can be fully accomplished without the physician's permission, and the brace is certainly staying on until he deems it safe enough to take off.

Today was a little bit of a different story. I woke up in the morning to a screaming ache in my arm. Not just the elbow, which typically has a slightly dull throb in it, but the entire arm. My flexibility was nearly non-existant. I couldn't bend my arm enough to even touch my collar or straighten enough to even touch my belt buckle. It was as if I threw 120 pitches last night in 100 degree heat and then proceeded to sleep on my arm the wrong way. It was sore, in pain and numb...all at the same time. I tried to stretch it out, tried moving it around, tried gripping things. Nothing would work. It simply wasn't going to feel any better.

I had thoughts about grabbing a hydrocodone pill and just taking one to ease the pain a bit. I hadn't taken one in a week, and I'm only two weeks post-op. I figured it's not a bad excuse. But I wanted to push through it, I didn't want to mask the pain. I iced it down and rested it some more, keeping it pretty much stationary for a good portion of the day. I recalled the physical therapists in Florida explaining to me that there might be some days in between PT sessions where I wake up and my arm is really, really sore. They said often times when you start a new exercise or push the arm a bit more than usual, that will happen. They said that in the case that something like that does occur, don't worry. Just relax and give it a day off to rest up and heal.

I shrugged the advice off two weeks ago, thinking in my head "I'm not some kind of baby like that. I can work through soreness it can't be that bad." And yet I sit here now writing this blog post and I honestly can't remember if there was ever a time that my arm felt more sore than it did this morning.

I am hoping that a good night sleep and a good physical therapy session will boost the arm's strength a bit more as I head into the weekend. I was advised not to worry about the soreness in the arm, and I'm not. But it'd sure be nice to not ever have to experience that again.

Although I'm pretty sure it will happen again. Probably the day after tomorrow, and many more days after that. I guess it comes with the territory.

On the Up and Up

This weekend provided me with some sort of odd epiphany. I came to the unfortunate realization that I am currently not in the type of physical shape I desire to be in. I wouldn't consider myself ever being Mr. Olympia by any means, but I have never been grossly out of shape to the point where I look in the mirror in disgust. Since I hurt myself in April, I've done very little exercising. In the beginning, I was in too much pain to work out. Then finals week came around, and I was focused on the actual physical therapy for the arm and studying for the tests. Then it was off to Virginia for my brief stay in the Valley League, where I sporadically would go to the gym and do some poles during pregame. By that time it was already June, a month and a half after my injury, and things were only getting worse. I practically got lost in my own mental state, the distressed emotions that come along with the depressing realization that your arm throbs in pain when you lob a ball across the outfield.

By time surgery rolled around, I was a full-fledged professional lazy bum. I'd go to work during the day, working 8:30-3:30 in a pretty typical college summer job setting, and then I'd come home and sit on the couch the rest of the afternoon dreaming of the day when I could finally step back on the mound, and not knowing my fate for the future. When I arrived in Pensacola for my meeting with Dr. Andrews, it had been three months since I'd done any consistent physical activity whatsoever.

I sat up in bed last night fiddling around with the Velcro on my bionic arm and made the "executive" decision that the next morning, August 1st, would be the first day of the rest of my life. Enough of the self-pity and drudging along through life. I am a college athlete, I can't let myself get away from what I am ultimately trying to accomplish. Tommy John recovery is excruciatingly time consuming, and if I am going to be willing to put in the effort to come back from the surgery then I might as well push myself in other physical aspects as well.

I started the day writing out a diet guideline for myself to follow...egg whites, turkey, chicken, fish, salad, fruit, etc. It wasn't the most strict diet, but was designed to serve the purpose of reminding myself that I need to fill my body with healthy food options if I planned to commit 100% to this transformation. I arose in the morning and fixed myself a healthy breakfast and then set out to go for a run around my hilly neighborhood.

Suddenly, the jogging path I had become accustomed to in the past seemed quite a bit longer than usual. The weather, in reality around 90 degrees and fairly humid, felt like I was in an oven. My legs moved slowly, my lungs didn't seem like they opened. I slugged through the road and tried to drown away the muscle exhaustion and heavy breathing by turning up the music on my iPod, but it was tough. I pushed and pushed and pushed.

I got back to my house and sat on the couch, grabbed a drink of water and took my brace off. I took the gauze pads and ACE bandages off and wiped the sweat off the area, then reapplied new bandages. I was tired...really tired. More tired than I'd typically be after running the distance I ran. But I didn't care. I got off the couch after drinking the water and banged through a quick set of some ab exercises, some alternative workouts I picked up when I was doing P90X with teammates back in the offseason. After banging through the set of abs, I felt like a new man. I missed the feeling of being sore, the fatigued feeling after pushing your body through exercise. What I'd done today wasn't an extreme amount of physical activity in the normal standards of a college athlete, but it was better than anything I've done in a long while.

After a quick shower and a turkey sandwich, I hopped in the car and headed out to physical therapy. It was an important day of PT for me, I was going to go through some range of motion testing and some hand strength testing. My gripping exercises were becoming much easier, and my shoulder exercises against the wall were practically a walk in the park. My physical therapist commented that my hand strength was a lot better than it was last time I came in, and I was making great progress. I have been making it a point to try to reach and grab things with my left hand to try to readjust to sizes and shapes of things. I'll lift a pillow, a cup, a phone, a plate. I am very conscientious to do so with my left hand so that I can try to make daily improvements. My physical therapist said to be careful and not to lift anything that weighs more than a pound or two because my muscular system in the arm is still very frail, but that the idea of regaining my hand-eye coordination during gripping is a good one. After going through sets of the exercises for the forearm, gripping and shoulder, on came the most important part of my physical therapy session...we were going to measure the degree at which I could extend my arm. That's the whole point of the brace, to get the arm to gradually work to be able to be completely straight.

The instructions were simple: Slowly try to straighten your arm until you feel the tugging discomfort, then stop. From there, my physical therapist would take out a large protractor and measure the degree at which my arm rested. I nervously began the descent to try and straighten the arm. After moving it for what seemed like ten minutes, I felt a tugging right where the stitches lie on the inside of the elbow, and immediately stopped and notified my physical therapist. The protractor was taken out and put up against the arm...

"Its between 15 and 20 degrees away from completely straight."

I sighed and gave a warm smile. 11 days out of surgery and I was already progressing very well. It was a relief to know that I had accomplished that amount of range of motion up to that point. I asked how long, in their opinion, do they think it'll be until I am completely straight and the physical therapists said that they honestly couldn't guess. The protocol I received from Dr. Andrews says that the ROM (range of motion) for extension should progress at a rate of five to ten degrees per week, so that could mean anywhere from two to four weeks in their opinion. The generally accepted timeframe for the brace is six weeks post-operation, which would be just over four weeks from now. So judging what happened today, if I were to progress at a slow improvement rate, I'd still be on a normal pace for recovery.

The accomplishment of almost straightening my arm was a victorious feeling that I haven't felt in a long time. It was the first truly optimistic aspect of my recovery, the first visible, no doubt positively noticeable movement forward in my progress. If I could do a cartwheel (I can't do a cartwheel even when my arm isn't in a brace), I would have done one right in the middle of the physical therapy center. I iced down the arm and joked with some of the other patients that were in attendance, and then thanked them and left to head back home.

Today was a great day. I accomplished a minor feat getting myself back into an exercise routine that I plan to continue into the future. I accomplished a minor feat by getting my arm extended into a position that is ahead of schedule, which shows that the physical therapy and care I have put into my arm thus far in the young recovery process has paid off to this point.

My next PT session is Wednesday afternoon, and I'm already looking forward to it. I think tomorrow I'll wake up early and go for a run again, maybe run some stairs, maybe hop on the stationary bike for a while.

Today was a good day. So why can't tomorrow be better?