My Distal Bicep Nightmare
So.... I feel it's important to share my story of my distal bicep tear and the pain, recovery, and the third attempt to fix the issue. I'm no stranger when it comes to surgeries, I've had 7 in my time and gearing up for number 8 (They weren't all to try and fix my distal bicep). On December 3rd 2016 I tore my distal bicep after having a particularly rough game of tug of war with my friends 70lbs husky. I felt some tearing and a fare amount of pain in my left arm (thankfully my non-dominant arm) and immediately went to the hospital. After about three days of imaging and speaking with the surgeon, they confirmed that my distal bicep was ruptured, but not fully and because I take weight lifting seriously they decided that surgery was the best option. On December 12th I had the surgery late in the night and was sent home the next day. The surgeon explained the tendon was badly damaged but he did his best to clean it up and deemed the surgery a success. They had used the button technique on my arm, which is the strongest method and said I would be 90% once fully healed. The day I was sent home started out pretty normal but after the nerve block wore off, the pain was substantial. My bicep muscle started spasming/tensing up which I can't even describe the amount of pain it created. I called my surgeon who told me this was normal (This is not! Go to the hospital right away and let the surgeon know... it will save your tendon which I will explain later) and prescribed some muscle relaxers and some anti-spasming medication. After that I doubled up my pain meds, took the other prescriptions which did help the spasming and waited to be healed.
Time passed, physio was a joke, and I regained full motion in my arm. But... the pain never went away. It was a constant sharp pain followed by incessant muscle twitches which I knew wasn't right. 6 months had passed and consulting with my surgeon on multiple occasions, he noted that the tunnel he drilled through my bone had widened significantly and the screw they had inserted appeared to have migrated into the bone. He made me aware this wasn't normal, but **** happens and let's see if the bone starts to heal. 3 months passed, x-rays showed no improvement, prescribed a bone stimulator and said come back in another 3 months. Went back, no improvement. He said the tunnel doesn't appear to be healing, but it wasn't getting worse either. I advised him of the pain and he just sort of shrugged it off... so did I. I just assumed the pain would be forever and although it was annoying, I could live with it. This was until swelling and a large noticeable lump presented itself right in the crease of my elbow along with intensified pain. I will note that I was still in the gym and had no problem with pushing exercises but didn't bother curling or lifting anything past 20 pounds with my left arm. It was considerably weak, painful, and the muscle had visibly atrophied. I decided the swelling and pain was no longer an option for me and it was time to see the surgeon again. He took a quick look at my arm, squeezed the lump and said he no longer knew what to do. It was at this point he sent me to see an upper limb specialist and after he took a look at all the imaging, agreed something wasn't right. I went into his office and he told me the numerous diagnoses he thought might be plaguing me.
1) Tendon, button, and screw were loose in my arm causing the pain. 2nd surgery needed.
2) Tunnel widening in the bone is causing the pain but the tendon could still be fixated to the bone. Bone graft needed.
3) Worse case. Tendon, button, and screw loose. Tunnel widened. And tendon has dissolved. Surgery needed.
Obviously I wasn't prepared for the outcome. I just nodded and asked when is the surgery and luckily that day, another patient of his cancelled an operation. I was pencilled in a week later.
I woke up in the recovery room, in pain and high as a kite. I assumed the surgery was a success and waited to be released, only it wasn't. The nurses looked at my release papers and then at me with confusion in their eyes. A cute nurse walked up to me and stated"You didn't have the operation." Obviously being disoriented from the cocktail of drugs, I asked her to repeat the statement and she did "You didn't have the surgery." I thought she was joking and responded like a smart ass "Then why does my arm feel like how Gary Busey looks?" She responded seriously "I'm gonna get the doctor on the phone and he can explain what happened".
So... as the surgeon was cutting into the mass of scar tissue that was holding my loose tendon to the muscles in my forearm, a murky white fluid began seeping out from it. He cleaned it out and continued... and found another pocket of puss, and another, and another. He did get through most of the scarring and cleaned out all the infection but could no longer perform the initial operation. He told me that the tunnel in my bone looked fine (though it did widen a little bit which is normal), the tendon was still present, but the button and the screw had completely failed and were literally just floating in my arm. He said there was a bright side. The tendon was scarred into the muscle so well that the muscle didn't retract and feels that I may not need another surgery as the tendon has a fair amount of tensile strength as it is. The surgeon then advised the biggest issue was the infection right now... He admitted " An infection of this size present in the body for this long is unheard of. It usually ends with sepsis or inevitably death. I'm concerned and referring you to an infectious disease specialist."
I'm in limbo right now with a death sentence possibly looming over my head... I'm on antibiotics but the doctor also thinks that I may need some more treatment regarding the issue... the cultures he took of the infection came back but he has no idea what the bacteria is, so it's a waiting game until I can get in to see the specialist.
My new surgeon did indicate that after some physio, gaining full ROM, and free of the infection that a third surgery is a possibility. He also said that, because of how well the tendon is scarred into the tissue, he feels that another operation may not be necessary but will leave it up to me.
The reason I mentioned going to the emergency room and to call your surgeon if your muscle starts to tense up is because of my most recent visit with the surgeon. He told me that he believes the first operation failed right away which is why my muscle was twitching so often and frequently. If I had seen the surgeon right away, an xray would have confirmed it and because the wound is fresh, could go back in and fix the issue... I wouldn't be considering a third operation if this had happened.
I'm gonna wait a little while, depending on strength, whether to get it done again (although it's more than likely I will) and knowing my arm is already badly atrophied, I know my recovery and strength will take a long time to recover (1 year +). So waiting a bit longer isn't a huge deal for me right now.
Hope this is helpful to anyone going through the operation or considering it.