Newbie to this forum. I think I have read about every post on this site-ha!...
My backstory. Male, 46, live in Dallas, active (competitive amateur golfer, avid tennis player, light weight training to keep in shape for golf, 1-3x per week at the gym)
professional-sale, home office, lots of travel. I have excellent insurance and can also afford the out of pocket expense for the surgery.
Ruptured my Distal Bicep Tendon on 7/10/11 on my left arm (non dominant) waterskiing while on vacation in remote northern Michigan. (note: I use to waterski in my 30s but not skied since I was 40..this was more of "lets see if I can still do this and show my kids what dad can do" and I guess I know that answer! ha! Anyway, I knew I tore the bicep from the sound (tearing but no pop) and visually...seeing my bicep roll up near the shoulder. I had some pain but nothing like i thought based on what saw and heard (and read post injury). Pain threshold felt more like a bicep "charlie horse". I immediately began icing and had made a sling out of a towel to secure my arm. Being at least a 100 miles from a hospital I called my sister who is a nurse and spoke to the ER doctor on staff at her hospital. He told me to ice, rest, elevate (sling) and have my arm looked at immediately when I return from vacation. He said my arm would probably need surgery and don't wait more than 3 weeks to see a ortho doctor. But also told me not abort my vacation as the arm would be fine until I get it looked at. I took ibprofin and followed his advice and rested the arm for the next few days. Over the next 7-9 days my arm felt exceptionally fine despite the injury. It did bruise in the forearm and near the elbow but only lasted 3-4 days. We cut the vacation short a few days and flew back to Dallas.
I saw my ortho doctor for the first time on 7/20/11, 10 days post injury. He examined my arm (no MRI) and visually confirmed the rupture. He could feel the tendon against my bicep as could I. At this point I was experiencing no pain and all of my bruising was completely gone. He recommended surgery and referred me to 3 specialists (he is ortho but more of a knee specialist. On 7/22 I actually consulted 2 of the 3 specialists and they both concurred the total rupture and suggested and agreed surgery was the preferred option to fix my arm. Due to the timing of my injury they both wanted to get surgery dates set up immediately. Both were also sports orthos.
So at this point I am sure you are all thinking..."so why aren't you not having surgery TJ!!!??"
And a great question! Further background. I am not afraid to have surgery. As a matter of fact when I initially injured my arm that was my plan of attack. I had knee surgery (miniscus tear) 2 years ago and my knee to this day feels incredible so I understand the results that surgery can bring. But when I got back home I researched my injury for hours. I wanted to be knowledgable about my surgery options, types, rehab, risks, etc and ask pointed questions to the doctors But during this time there was one thing that was starting to consume my thoughts about my injury...IT DIDNT BOTHER ME...IT DIDNT HURT! In fact there were days where I totally forgot I injured my arm. This got me to thinking...what can I do with my arm right now....so i started experimenting with my own little household strength test. Lifting everday things around the house. Cans of paint, fertilizer bags, luggage, chlorine buckets, golf bag, trash cans, etc..things I touch everyday. I was experiencing no pain! There were heavier items that I wanted to lift but opted not to for fear of irritating the muscle but my strength tests got me starting to think about NOT having surgery. My research started to focus on non surgery treatments and the long term prognosis and post injury treatments. In my non surgery research the articles still focused on the surgery benefits and were always pointed out first but most every article i read talked about how this injury was manageable and very treatable without surgery. I also recalled some old friends who had this injury...I sought them out and talked with them. None of them had surgery for their injuries. Then I found this website and I totally related to many of the posts that I read Kelly-(who was against surgery then had it), adamwallace?, SRB, Berbee (??) Brian J attached some great references about non surgery post injury studies. But also read many posts from Big Joe, and Jeff who were huge supporters of surgery...all of it I read and took under advisement...thank you all for your input!
So with all that said here is some of my rationale for my decision to not have surgery:
1. I have been pain free since day 4 of the injury and my life has been very normal.
2. I know several people who had this injury and did not opt for surgery. Their quality of life was not impacted at all. 2 of them had their injuries in their 30s.
3. My age and types of activities I enjoy are not bicep intensive and as of today do not bother me...
4. It was my non dominant arm
5. I am still able to use my bicep today for the things I regularly do on a daily basis...i am able to lift 10-20 lbs items w/ ease and without any pain right now. Heavier items tend to irritate the bicep but I am being very careful what I try to lift for the next few weeks.
6. I hit golf balls pain free today...thinking about playing this weekend.
7. Medical studies that documented non surgical treatments with results that are very favorable in terms of arm strength and quality of life. Some even provided better results than many of the boiler plate data associated with non surgery expectations related to muscle loss.
8. I am not a body builder, my exercise is basically cardio and light weight training...for weight management and overall health maintenance.
9. I understand and can live with the fact there will be some muscle and strength loss but anxious to see what PT and new exercises to focus on to strengthen the surrounding muscles that will take up the slack of my bicep.
10. I feel at peace with the decision
The comments/observations above were sort of my first level of thinking related to my non surgery decision....in short, my life as I know it today basically has not changed. Yes my bicep looks different but the visual appearance does not bother me in the least. Nor my wife. So far I am able to live normally as I have been doing. So what am I gaining with having surgery...yes my arm would be stronger and it would look better/normal but that was all I was to gain from surgery? If what I am experiencing now is acceptable...is the surgery even WORTH IT?? Is it worth the stress of having surgery? Is it worth the rehab? Worth the minor risks involved (nerve issues, numbness, etc)? worth the out of pocket cost?..at this point I was saying..NO!
But what about the long term aspects? Evaluated that as well. Here is what I am calling my 2nd layer of thinking related to my non surgery decision. I reached out to my acquaintances who had this injury. Two of them had no regrets and 1 did and his was more about the cosmetic appearance (he injured his bicep in his 30s and single). But all of them felt that their lives were not impacted in the least. Their arms regained strength and they all said they never really think about the injury or their decision. The injuries dates range from 3 years to 15 years ago. (not sure of what options were available 15 years ago) I also talked with my specialists who agreed surgery was the best option. But in asking them what I am faced with if I DONT have the surgery and they both said what virtually everyone on this forum and all the literature i have read..."20-40% loss of supination strength, muscle atrophy, loss of flexion strength. etc., etc I get that. But they both said something that struck me. That a non surgical decision is something you can definitely live with if you understand the reality of some muscle loss/strength. One of the specialist said, "this is not open heart surgery" You can live with this injury and you can recover quite well but you need to understand there will be some differences in your arm strength but its very manageable. There is good PT available to help recovery but the arm wont be 100% and you need to be OK with that. They both stated this is a personal decision and their position and recommendation was still surgery but it was their job to let me know the pros/cons. The decision was mine, theirs was to fix my arm if that was my course of action. That dialogue and exchange pretty much pushed me to opt for a non surgery recovery. The specialists candid comments about the non surgery option put me at ease and ultimately swayed me to go the non surgery route. I am very much at peace with my decision.
So I apologize for writing a "novel" but wanted to give an insight to my decision not to have surgery. I may be a bit off here but I sense many people on this forum who strongly favor surgery need it as part of their job, are avid weight lifters, or have fairly high intensity recreational lifestyles/interests. I am none of those...my life is about golf, tennis, photography, keeping in relatively good shape, hanging with my teenagers and wife. As I said i feel at peace with it and tend to provide regular updates and posts to this website about my progress and alike. I know my decision bucks the trend to many of the posts on this forum but I think its important for future readers and posters who visit this forum for information and support to get both sides of the story.
Again I plan to commit to providing updates to my situation and feel compelled to do so..this forum was good for me. I hope I can help someone else with my experience.
I welcome any and all comments and questions. Thanks to all of you in advance for your posts and support!