Steve’s Surgery (by Suzanne)

Hello all, sorry for no posts. It is not because nothing has been going on (!), it has been because our blogger is incapacitated. After weeks of no improvement in Steve’s shoulder injury, especially the pain (three weeks of constant, severe pain) he was advised to go to South Africa for further diagnosis. It was clear he had significant nerve damage and it was possible that he would need surgery. I was due at an OLPC (One Laptop Per Child) workshop in Cambridge, Mass., but we decided Steve could go for the consult to South Africa on his own, and if he did need surgery I would join him.

Well, it turned out that his shoulder was a mess. Two fractures, not one as was diagnosed in Ghana, and neither was set properly. The large bone fragment was several centimeters out of place, easily seen on the CT scan. The smaller fragment was attached to his rotator cuff, which was torn, both of which were likely causing his severe pain. So, definitely surgery. In retrospect it was probably a mistake for me not to have been in South Africa with him for the diagnosis and plan of action. First, when Steve received the bad news of the severity of his injury, that he would need surgery, and that he may not get full use of his arm/hand back, he was all alone, in a foreign country, still in severe pain. Second, the doctor told him all kinds of information which he had no means of recording – due to the pain meds, his mind is not sharp, and due to his paralyzed arm/hand, he can’t write.

[Photo: Steve in Little Company of Mary Hospital in Pretoria, South Africa]
He had surgery on Tuesday, November 13. I flew down, arriving the morning of the 13th, and at the hospital about when he came out of recovery. He was in the “rugby ward” – all but one of the other patients in the ward (6 of them altogether) had injuries due to rugby. On each bed they put masking tape on the end of the bed and wrote on it, giving the patient’s name, the doctor’s name, and what would be done at the surgery (they wheel them to surgery and back again in their ward bed). Steve’s was definitely the longest – I copied it down: Rev S W Buchele Right Shoulder Arthoscon, Open Reduction, Internal Fixation, Repair Fracture, Bone Transplant, Rotator Cuff Repair, Sub-Acromial Decompression & Debridement, MA DeBeer (and then Dr DeBeer’s ID number). Whew. Thank you to all who prayed hard and ceaselessly for the successful surgery. Post-op x-rays show that the large bone fragment is back in place 100%, the smaller one close enough. Some patients were released after just one day, but Steve and one other patient, Ingo, were released after two. But, Ingo was allowed to take a shower straight away and wasn’t even wearing his sling when he was released – Steve was told no shower for 3 weeks (due to 4 cm incision) and to wear the sling 24/7 for 6 weeks.

[Photo: Steve’s ankle IDs]
The first day he was still in pretty severe pain, which he was not expecting. After now 4 weeks of pain, he was hoping that the surgery would provide immediate relief. The pain lessened quickly after the first day, but he is still on pain meds (we’re on day 3 now) and he is still pretty dizzy and slow moving when he does try to be up and around. Thursday he came home from the hospital to the guest house and that was it for the day. Friday we went to the breakfast room at the guest house and had breakfast (big outing!) then to physical therapy in the afternoon (he will go 3x per week). He needs to do exercises 5 times a day which wear him out – he is not allowed to move the arm using its own muscles, but in order to keep the muscles from atrophying he needs to use his other arm and push the right arm in and out, up and down. Only 5 repetitions, but it is exhausting, and he needs someone else there to hold the wrist since he still can’t hold the arm (for example, at a 90 degree angle) on its own. This is definitely going to be a slow recovery. The doctor wants him to stay in South Africa until his follow-up appointment on December 5. The physical therapist will be in contact with the doctor regularly about progress (their offices are adjacent). Still not much movement or feeling back in his hand/arm, but hopefully that will come.

Friday afternoon he rested so that we could accept the kind invitation of Bertus and Lida for a dinner out. Bertus was in the bed next to him in the hospital and they became good hospital friends. We had a delightful dinner out with them, at a fantastic South African restaurant and ate appetizers and main dishes of traditional South African fare. It was delightful, and great to get o know Bertus and Lida. Hopefull we will see them again (when Suzanne returns around Dec 1).

[Photo: Steve and Bertus]

Suzanne will return to Ghana on Sunday the 18th (tomorrow – sad!), but thankfully Steve’s sister Beth will come from Minnesota arriving this evening the 17th and will stay 10 days or so. He definitely still needs help – even just with the exercises and getting up to eat meals, at this point at least, these are full and exhausting days for him. So, please continue to pray for him: for return to full health and vigor, and for eventual full use of his arm and hand. Thank you.