One of many
trip reports under the
SilGro home page for Alan Silverstein and Cathie
Grow.
Email me at
ajs@frii.com.
Last update: March 29, 2025
(Previous trip report: 2022_0101-03_DontSkiOnIce.htm)
Below is what an MRI looked like after I partially ruptured my distal biceps tendon... We have moved our last water heater! (grin) I/we had successfully replaced a heater at least three times before, but at age 68 we were apparently getting too old for this game... "The main cause of injury in older people is acting like they are still younger people."
First here's the story: The 11-year-old water heater that came with the Loveland condo 4 years ago finally started leaking. Fortunately it didn't happen until one day when my wife Cathie Grow arrived there alone and turned on the water pressure -- which had stayed on all the time for at least 2.5 months while my daughter Megan Hart was temporarily living there. Cathie heard the battery-powered water alarm we'd installed a few years earlier start screaming soon after the water was turned on.
Also fortunately there was a hidden drain line underneath the old
heater, resulting in only minimal inside damage due to the ancient
rectangular pan having rusted out in spots.
But it became clear that the old drain line dumped to the garage floor,
which was originally built as a carport, meaning some of it ran into
adjacent wooden walls rather than fully outside. (I fixed that after
the new water heater was inspected over a month later...)
So anyway, we needed a new water heater.
I figured we'd give it a try ourselves and have some fun doing it, at
least until something went wrong -- but I didn't think it would be
medical! With the new heater in a box strapped to a hand truck (dolly),
after loading it OK at Home Depot and unloading it at the condo, we
humped that 125 lb box up 7 narrow steps to a landing before Cathie
strained a back muscle and went to lay down.
Now with me being warmed up (even sweating a little), only a little tired, and generally careful, I managed to unstrap and remove the dolly, then slide the box up 7 more carpeted steps to the main level and shove it (still lying flat) into a hall closet across from the stairs. Next I was gonna take a break soon, but instead first I made a big mistake... I tested reaching out and lifting the back of the box a little to see if I could stand it up on end to be less in the way. Then this tendon tear happened to me! I never felt a "pop" before.
So all this was on 12/24 (Christmas Eve). When I called our local ER the next day (12/25) they said not to bother coming in, they wouldn't MRI a non-emergency like this anyway. (And I learned later that their local MRI had died anyway!) Luckily I was able to visit a PCP on 12/26. He thought it wasn't too serious, but referred me for an MRI anyway, where I debated following through. I'm glad I did though (on 12/31, by driving to Loveland) because at the Orthopedic Center of the Rockies -- the earliest I could see them was 1/7, by again driving to Loveland, two weeks after the injury -- they were able to confirm the damage and judge that it was "just" a 50% tear (could be worse), and no surgery was immediately indicated (yay).
Here are just two "axial" MRI slices out of a a variety of groups, each with a dozen or more images.
The first MRI image is looking outward beyond my elbow. The black areas are tendons or arteries, not supposed to be so messy. The white is fluid (edema).
My first-ever MRI was an "interesting" experience in itself. I knew it would be claustrophobic (no biggie) and noisy (tolerably but often sounded like a klaxon!) I didn't know it would take so long, over 30 minutes in 2 positions, and there is no progress bar as you just wait and wait and wonder. (I suggested this to the technicians, also that they were missing out on quite an income opportunity by not selling advertising space on the roof of the MRI tunnel, grin.)
The second image is a little further down-arm, looking outward. The radius (bone) is left of the ulna, and the biceps tendon bundle inserts (attaches) at the radial tuberosity in the lower right of the circle. Or at least that's where it's supposed to go.
The good news is, a (relatively rare) partial tear might heal itself (if I can avoid making it worse), and surgery is less urgent even if needed.
Postscript: Despite not immediately needing surgical repair, this injury was still painful (at times, in positions), scary, and somewhat debilitating, especially since tendons have poor blood flow and heal very slowly. At least I could type -- although pronation hurt a little due to radius/ulna rotation and compression of the injury -- like right now, editing this report! But the doc said that shouldn't make it worse.
I learned that the larger, buried, brachialis muscle handles most forearm flexion. The smaller, more visible, two-part biceps muscle above it is prone to tendon damage proximally (at the shoulder) or distally (at the elbow). Most likely cause of the injury is sudden, traumatic force with the elbow extended and the hand in supination (rotated out) -- yup. (And that's still the most painful position over three weeks later.)
I took the nearby photo of a 3D model of the elbow area while visiting
an OT (occupational therapist) at the
Orthopedic Center of the Rockies.
The thick white tendon at right of center, inserting into the radius
bone, is what I partially tore.
After I posted these images on Facebook, this bit of commentary followed from me:
"Nothing is ever a complete waste, it can always serve as a bad example."
The problem is (the paradox is) that as you age, and your telomeres shorten and your proteins cross-link and your muscles atrophy, you must keep pushing to expand your shrinking envelope as much as you can. "Use it or lose it"; keep telling your body you're not done using it yet. But God help you if you cross the envelope edge by accident, then you become injured, and healing is slow.
Mind you, I was already trying to adjust to many maladies of aging, taking it a little slower, more thoughtfully, watching my body English, etc. Snapping a tendon, well that just sucked.