Tommy John Diaries — The Surgery
Tommy John Diaries — The Surgery
By Scott Bolohan
In bed the night before surgery, a thought crossed my mind. I might be the worst pitcher ever to have Tommy John surgery.
At first, I felt a sense of imposter syndrome. But then I found the thought comforting. I knew however the surgery went, the stakes were low for me. Obviously, there are concerns with any surgery, but I’d been functioning with elbow pain for over a decade, and in no way was anything close to millions of dollars on the line. I slept surprisingly well.
My surgery was scheduled for 7 a.m., which meant a 4:30 a.m. wake-up to be at the hospital at 5:15 a.m. Almost immediately upon arriving at the hospital, I was back for prep. I changed into a gown, monitors placed on my chest, and casually chatted with the nurses about Justin Verlander. Everything felt very routine, and for everyone else, it was. It wasn’t until the IV was stuck into the back of my left hand that it started to feel real.
I was wheeled into the operating room and in the middle of talking, I was out.
The surgery lasted a little over an hour. If you want to see what it looked like, well, you are in luck. Obviously, it’s graphic, but this is what actually happens during the surgery.
Here’s a quick summary. Incisions around an inch in length were made in my right wrist and forearm to remove the palmaris longus, a tendon that has no purpose and is absent in around 14% of people (to find out if you have it, flex your wrist and touch your ring finger to your thumb and it’ll pop up. If you don’t, you can think of yourself as more evolved). Another incision around four inches long was made in the lower interior side of my right elbow. My ulnar collateral ligament (UCL), which basically holds the upper part and lower part of the arm together, was removed. Two holes were drilled in the bones that originally were held together by the UCL, the humerus and ulna. The ligament from my forearm was then wrapped through the holes, creating a new UCL. It’s kind of like stringing a tennis racket. They sewed me back up with dissolvable stitched, put Streri-Strips over it, and wrapped it all up. It’s an incredible procedure, mostly routine at this point. It’s barely evolved since Frank Jobe did the first one on Tommy John in 1974.
When I woke up in recovery around nine, my arm was wrapped around a splint. My arm burned a bit and I asked for more medicine, and when I tried to sit up, I felt nauseous, but before I knew it, I was back in the car riding home.
I threw up immediately after walking into the house.
That would be the worst of it. I ended up taking a nap for a couple of hours, and when I woke up, my first three fingers were numb and I was convinced I had nerve damage. Turns out, it was just from sleeping with my arm down, causing swelling in my hand.
I kept my arm elevated the rest of the day and the swelling went down. But the swelling through the rest of my arm would remain an issue for weeks. Even typing this now, a month after surgery, the swelling remains in my forearm and the back of my elbow. I struggled with basic things— washing my hands, putting on clothes, showering with a garbage bag over my arm, eating with only my left hand, and typing. But the pain was shockingly fine. I only ended up taking Tylenol, and Gabapentin for nerve pain.
Seven years ago, I caught a cleat sliding into third and broke my ankle, requiring a plate and screws. That recovery was miserable and I braced myself for the same. I expected to write about the incredible pain I had and how terrible the whole experience was. But honestly, that wasn’t the case. The only pain came from the three incisions in my forearm. When I stood up, I could feel the blood rush to the incisions, and sometimes I would feel them stretch and have shooting pain. Amazingly, I never felt any pain from the incision along my elbow.
On the day of surgery, I was able to wiggle my fingers and wrist, although completely opening my hand was pretty painful and I couldn’t get my fingers straight.
After two days, I stopped taking the Gabapentin and began getting off the couch more and getting out for walks. By the fourth day, I wasn’t taking Tylenol either, instead just relying on icing to work on the swelling.
A week after surgery, I had the wrapping removed and I saw my arm for the first time. My friend would describe it as “Frankenarm.” As you can see, it’s an apt description. Dr. Marshall said everything looked good and I would start physical therapy the next week. I was given a brace which restricts my ability to lift my arm up past 100 degrees and just make everything a lot clunkier. I look like a cyborg.
It took me a few days to figure out how to handle the brace. I tried everything from long-sleeved shirts, to wrapping my arm with an Ace bandage. Where the brace hit my arm was still swollen and painful so I put socks around the parts that gripped my arm to add some support. Sleeping in it was a mess and I slept on the couch to keep my arm propped up. By the end of the week, I was able to move back up to my bed, using pillows to prop my arm.
A week and three days after my surgery, I was at physical therapy working on very basic things—extending my arm straight, flexing my wrist, pronation and supination of my hand (twisting it palm up and palm down). My physical therapist tried to stretch it out a bit, gently pushing it straight. After over 15 years of damage, I haven’t been able to straighten my arm for over a decade, and combined with the swelling, my elbow was stiff. But there were large improvements in a short time. The next day, the swelling in my hand disappeared and I could use it like normal, including typing.
I understand how players talk about the recovery period being hard mentally. I’m lucky to be around my family during this, as it would have been much more complicated without literally the extra hand, but from a mental standpoint, I imagine it would also feel more daunting without the support. My arm feels shockingly good, and if I didn’t have the cumbersome brace on my arm, I could see myself accidentally forgetting about the surgery and trying to do something my arm wasn’t ready for. I see why guys try to rush back to playing sooner. The one thing I’ve been told consistently from everyone is how terrible of an idea that is, especially in these early stages while the graft is still settling. But honestly, if I knew how little pain this would cause compared to the amount of pain I’ve been in for so long, I think I would have done it earlier.
In six months or so, I can start throwing again. That said, throwing a baseball is about the last thing I want to do right now. Before then, I have physical therapy, three times a week for an hour each time to rebuild strength in my arm. I’ll write about that in my next entry.
I worry about injuries given the unusual season last year. Since I had my surgery the list of major leaguers who have had it is staggering: Brandon Bailey (you can read our interview him about it), Forrest Whitley, José Castillo, Jimmy Cordero, Blake Cederlind, Dedniel Núñez, Rico Garcia, Kirby Yates, José Leclerc, and Roenis Elías. Again, these are just the major leaguers, with surely many more college and high school athletes that you wouldn’t hear about having the operation. Before I would have read this as just a list of names that will magically reappear in a year, but now I think about them trying to get to sleep the night before the surgery, the pain of the swelling, learning how to deal with the brace, seeing the scars for the first time, and the long road of uncertainty ahead. I hope they’re doing okay.
Scott Bolohan is the founder of The Twin Bill. He is cautiously optimistic that one day he will throw a baseball without pain again.