Taking a long leave

This has been one of the toughest decisions of my life, but after spending 7 years at the same company, I've decided to leave and spend more time with my family. I'm incredibly grateful for all the amazing friends and my extended family I've met at work, and the incredible opportunities to witness and contribute to groundbreaking research and innovative products. If you asked me 7 years ago if I would do the same thing again, of course I'd say yes!

Over the past few years, I've neglected spending quality time with my family. I've always wanted to play tennis, go hiking, go skiing, travel, and just basically, trying to be a better dad and better husband. However, unexpected challenges kept arising. First, my mom was diagnosed with stage 4 cancer. Then, a fire caused by a broken attic furnace led to half of her house's roof collapsing. Managing the reconstruction for a year while being her caretaker was incredibly tough. I witnessed her brave fight against the disease, only for her to succumb to multiple organ failures suddenly. Not long after, I had a ski accident that required surgery.

During my recovery, I had time to reflect on what I truly wanted to do. Life is short, and sometimes it's okay not to have a plan or a job. I believe this is the right time for me to take a very long break, so I can spend more time with the family. I don't know what the future holds, but I'm excited about the possibilities. 

See you soon!

Physical Therapy (PT) at the 401 clinic

PT and healing are going well! I can move around for most of the normal (light) activities, and without excessive pain. I've been out of pain killer for several weeks already. However, my surgeon (Eklund) seems to be more conservative and would like me to be on the sling AT LEAST 7-8 weeks because of the additional Remplissage procedure. 

The PT location is at the 401 location of Sutter Health. My physical therapist (Jason) said that even if I feel fine, the sling should be worn when I'm outside in case I accidentally do something that would mess up the healing process.

Below is a typical PT exercise sheet I need to perform every day. Currently, my range of motion upwards is about 135 degrees, and we're working to to get it up to 160-170 next week, hopefully.

Overall, I'm quite happy with my progress. I remember the first surgery (from decades ago) took months to heal, but this time, I'm healing much faster.

I'm typing with both hands now! Things are going well and I'm pretty happy so far.

Per instructions given to me, I could not take wet showers because contaminants might get into the wounds. Earlier this week I went back for a pre-scheduled PO check and the doctor removed the first dressing, cleaned the bloody surfaces, and reapplied fresh clean dressings (see below). Things looked good, and I felt pretty good as well. And the first thing I did when I got home was to take a real shower, and boy, it felt good! Overall, it's been a positive experience so far -- no complications and manageable pains.

As for the post-op pics below, it's really funny that they marked my upper body all over with bold identifiers. During pre-op, the nurses kept asking me to confirm my name, birthday, and triple confirmed the correct side to perform the surgery on -- just in case!

At the PO clinic I learned a few medical terms. The repairing of the labrum was done by inserting screw anchors to the bone, and tying them around to stabilize it (Bankart procedure). It was explained to me that in time, my own tissues would grow around and strengthen parts to keep the labrum and scapula stronger (months). It's imperative that I don't stress the bones/muscles/tendons in order for the tissues to grow back properly. See the illustrations below:

During the procedure, Dr. Eklund also noticed more problems that were not clear from the CTs and decided to perform an additional procedure called "remplissage". This is a procedure that stabilizes recurrent anterior shoulder dislocations, by filling in a medium sized Hill-Sachs region in the humeral head caused by  prior dislocation traumas. Below is an illustration of the Hill-Sachs lesion (trauma areas) and repositioning of the infraspinatus tendon into the Hill-Sachs area, effectively "filling in" to prevent it from engaging with the glenoid (shoulder socket) during shoulder movement.

In total, Dr. Eklund inserted 6 1.8mm anchors + "knotless" sutures for Bankart lesions, and 2 (bigger) anchors for the Hill-Sachs lesions.

This is my second week, and pain is now manageable without opiates, when I use ice-packs intermittently. I'd like to avoid hydrocodone (opiate) because it works all TOO well -- it has a tendency to  make me feel invincible and want to move around, which is not a good thing when I am suppose to rest and heal.

Today is the 2nd day of surgery. I'm feeling good enough to type now, albeit veeerrry sloooowly.

The first day was uneventful. I checked in at 6:30am. There were some pre-op checks and questionnaires and forms to sign. The anesthesiologist put me to sleep around 7:50am. I woke up around 11:30am, but barely able to think or talk. Pam was already here but I couldn't walk (I was too nauseated/dizzy) and it took a looong time to get into the car-- I don't remember the details but I was half dozing off and trying to get out of the wheel chair. I slept through half of the day. I didn't fully awake and drink water and walk around until late in the afternoon.

The funny thing about the surgery is that post-op, I didn't feel any pain at all. Zero -- NADA! And besides feeling tired and somewhat nauseated, I actually felt carefree and a bit happy. It was probably the opiates working all too well. Later at night, I started to feel more and more pain until I decided to take Hydrocodone (opiate) that I picked up the day before the surgery. First 48-72 hours -- pain management is utmost important.

Back to day 1: when I was asleep, Dr. Eklund told Pam that it went well, and everything else will just depend on post-op care. It's now day 2, and I am hoping that with good PT and some time to heal, I'll be good very soon. I can't wait to play tennis, biking, & skiing with my kid. And of course, I can't wait to get out of the house and start working again!

Below are some pictures from the scope. You can see the instrumentations drilling in for labral repairs, etc/aka capsular plication). High tech stuff -- I love it!

Scope shoulder capsulorrhaphy procedures

Insurance just approved the procedure and my surgery with Dr. Eklund (sports injury surgeon) is scheduled. Admittedly, I'm a bit anxious and I'm currently trying to read up as much about it as I can. Realistically there's not much else for me to do but to just rest and heal, but it's always nice to know the details. 

There are a couple types of capsulorrhaphy procedures that can be performed: 

1. Capsular Shift: In this technique, the surgeon tightens the loose or stretched tissues of the shoulder capsule by folding and overlapping them, effectively reducing the size of the capsule and improving joint stability. 
2. Capsular Plication: This involves the use of sutures or anchors to gather and cinch together the loose or redundant tissues of the shoulder capsule, similar to taking in excess fabric when tailoring clothing. 
3. Capsular Reconstruction: In cases of severe shoulder instability or extensive capsular damage, the surgeon may perform a capsular reconstruction using tissue grafts or synthetic materials to reinforce and strengthen the shoulder capsule. 

After capsulorraphy surgery, patients will usually be allowed to go home the same day. After surgery, you will be monitored closely and given pain medication to keep you comfortable. You will also be given a sling to wear and instructions on how to care for your incisions. It is important to follow these instructions carefully to ensure proper healing. Recovery from capsulorraphy surgery takes time, but most people are able to return to their normal activities within four to six months.

https://www.youtube.com/watch?v=TMytPkQeblM

Ski accident

April 2, 2024: somebody pointed out that I posted this on April 1. As much as I wished that it was just an April Fools prank, unfortunately, this is real 😢.

April 1, 2024: I'm typing this 1 handed and under painkillers so forgive me for typos and or mistakes. I typically ski on the green slopes but I've been trying to learn on the easy blues lately. On the last day of our vacation, my son took me to this blue run. Apparently this blue run we was quite icy and very narrow and after failing to negotiate the turns and slowing down, I slipped and went down at about 20-25MPH. The skis popped out, and I started tumbling down and eventually stopped on my back. That's when I realized that my right shoulder dislocated in a very awkward position, and I couldn't move it at all (although, I still had finger sensations, which was a good sign). My son called in for help and 2 ski patrols put me on the sled and went down to the slopes. The ambulance brought me to the Truckee Hospital (20 min away), and after few failed attempts of "shoulder reduction" procedure, the surgeon decided to put me to sleep so that my muscle spasms would not interfere with the procedures. When I woke up the surgeon explained to me that the X-rays showed fractures and that I needed a follow up at my local hospital. I went home, painless, thinking I was going to be just fine. Later on, as the pain-killer wore off, I felt awful and was literally crying for pain killers! Below is a composite CT (they stitched CTs to make a 3D render) taken a few days after the accident:

Below is an X-ray which shows an old staple on my arm -- the staple was from a childhood sports injury many decades ago. The arrow is what the surgeon thinks is a fracture on the scapula (shoulder blade).

Lastly, the MRI scan (showing swollen soft tissues/liquids/etc)

As long as I'm on an arm immobilizer I am ok, but obviously I can't (and shouldn't) move my right arm up and to the side. The earliest surgery date is May, and the surgeon says I need to take off AT MINIMUM 3 weeks, and possibly up to 6 weeks, for me to resume normal activities. For sports, he recommends waiting at least 6-9 months + consistent PT time before I start doing anything more strenuous.

I'm mentally ready for all the challenges ahead but my body is not. Or at least, not yet. I shall be back!

Optimizing the vacuum adapter

Both of my Makita jigsaw and Makita sander have the same sized vacuum suction nozzles, and I use them quite a bit. The cheap Makita sander kicks up a lot of dust and short of buying another premium near-dustless sander for $500 (e.g. the 3M Xtract), I decided to just hook it up to my Festool Vacuum. I tried various universal adapters but none of them were to my likings, so I decided to custom design and 3D print my own. I went through several iterations and finalized on the smallest/lightest version. Below is my first version

This first version is a nice fitting test on the tubes. However, it's pretty long and clunky to use, so I designed another version where the vacuum length is reduced.

Picture to the left is the initial version, progressing to the right: I kept reducing the excess adapter size and at some point, I made the realization that Makita's smaller nozzle's outer diameter could simply fit inside the inner diameter of the Festool vacuum line:

Finally,

This is the final version, which is the lightest and easiest to work in tight spots due to the short length of the adapter:

In retrospect, it should have been pretty obvious to design the optimal adapter from the very beginning -- the outer diameter of the smaller nozzle fits inside the inner diameter of the vacuum tube. Hindsight!