The Month of Continuous Motion

The month of May 2007 was probably the most difficult of my entire recovery process to date.

Because of my elbow reconstruction, my surgeon/doc had the brilliant foresight to put me on a CPM machine. CPM stands for “continuous passive motion.” As soon as I had come out of the recovery room following my surgery, I was hooked up to this machine and it did not leave my side for a solid month.

It definitely became a complicated, crazy-making but miraculous love-hate relationship. The machine was a major factor in my exceptional recovery. So for all its miraculous gifts of motion and expedited recovery, I loved this machine.

At the same time, it was the biggest pain in my ass (and the elbow!)- more than any other single part of rehab.


The purpose of the machine was to keep my elbow moving continuously (didn’t see that one coming, did ya?) in order to reduce swelling and get blood flow to the area to speed healing.

Because I had broken a joint, which is much trickier than just a bone, it was imperative that the joint be moving as soon as possible. Just like parts of a car, joints need to move to stay healthy- things start going all screwy when you don’t move a joint for days at a time.

Up until this surgery, my arm had been in a splint for 10 days, immobilized from the previous and first surgery. So after 10 days of not being moved at all, and especially following such a high-trauma injury where scar tissue would be fiercely developing, it was even more crucial that this elbow be moved as much as possible, as soon as possible, despite the fact (especially because) it had just been reconstructed.

This is how the machine worked: My arm was strapped inside a v-shaped hinged cradle, with my elbow nestled inside the pocket of the “v” where the hinge was. The machine would move my forearm towards my shoulder and then extend it outwards, increasing the angle, as far as I could tolerate. It did this back and forth, back and forth 24 hours for the first three days, then 18-20 hours a day for the remainder of May.

While it moved up and down, up and down, I had an emergency button to stop the machine if I felt pain. I had a button to adjust the speed and a level to adjust the angle of my arm to my body. The white-noise hum of this machine, over the course 24/7 for a month, became a familiar buzz in my head and in my bones, leaving a strange kind of void when the thing went back to the medical supply guys.

(It was sort of like unplugging your refrigerator- suddenly, there’s this strange absence of an annoying hum!)

Each day I tried to increase the range of motion by a little bit. I set big goals for myself and tried to push myself every day just up to the point of pain. Right as I would wince, I would set the dial to go there. Usually after 5-10 minutes of being on the machine, I could crank up the dial just a touch more. Seeing as I was mostly home bound and mostly dependent on my mother, I needed something to keep my mind occupied so this became a sort of challenge or game. Only I had a lot of emotional investment in it, too. I worked desperately hard to get better. My ability to climb and kayak again- maybe even just feed myself again- depended on it.

I wish I had kept a record of my progress. If memory serves, I would make huge jumps over the course of a few days, then backslide, regain what I had lost, make another small jump, backslide again and so on and so forth, just enough to give me an emotional roller coaster ride of highs and lows, getting regularly encouraged then discouraged. However, after a month of being on this machine for the majority of every day, I could extend to about 30 degrees (zero is all the way extended) and could flex up to 115-120 degrees (165 is all the way flexed). This was close to the entire range of motion I was predicted to get back in my life, so to have achieved this after one month was exceptional.

Thank goodness my mother flew in from Colorado and stayed with me nearly the entire month to get me through this process. It’s a good thing she did, too, because we didn’t realize it until I actually brought the CPM machine home from the hospital that there was no way for me to adjust it myself or get it working without help. I didn’t have the arm strength to adjust it to my bed at night and then my desk during the day time (when I started working from home) and then the couch in the evenings. Each situation meant that the machine had to be tinkered with to fit the angle of my arm. Each time we had to adjust, it took 10-15 minutes to get it just right so that it wasn’t painful.

Until the last week of May, I slept with the machine running all night long.

Oh, the bedtime routine. That was the most frustrating part. It regularly underscored how helpless and dependent I had become, something that was incredibly difficult for me to accept and surrender to.

Because this machine could only lower to my arm level to a certain degree (they only come in one size and it didn’t fit me perfectly), I had to sleep on top of a stack of pillows in my bed to raise my arm high enough. So that I wouldn't fall off of the pillows and off the bed, we had to tuck blankets all around me to secure me into place.

Then there were the 20 minutes of my mother trying to adjust the angle of the arm cradle so that I could sleep with my arm in it, hanging off the side of the bed, all night long.

There was a narrow margin of comfort being in this machine. Trying to get situated in the cradle while lying down, when just the slightest motion one way could go from tolerable to painful, was endlessly frustrating. Eventually, we had to put tape strips on the floor and try to mark the machine ourselves in order to take some of the time off of the nightly experimentation that seemed to go on forever.

“Nope, that’s too far to the right. No, go back… now it’s too high. Now my fingers are going numb. My shoulder is being pulled too high, can you lower it more…? ouch!” That went on forever until I was ready to scream.

Hence, this routine had a way of making me emotional. I do believe I had my first real adult tantrum in my life. It was at these times when I would just break down.

…”Not only do I have to subject myself to sleeping in this machine all night long, but it’s going to be on the verge of painful AND a royal pain in the ass to set up every time!”

Being a supportive mama, she would do her best to console me in my helpless frustration. However, she too, on regular occasion, raised her voice at that damn CPM. I think I even heard a few cuss words come out of her mouth, directed at that “piece of…”

So After 15-20 minutes of struggling to find that “just right” tolerable position for my arm to be in all night long while I slept, mom would strap me into it and I was stuck there all night, without being able to move or roll over. If I had to get up to pee, I would have to call out to her to come help me.

In hindsight, I'm not sure how I did this- sleep all night long in one position without being able to move an inch while my arm went up and down, up and down to the sound of the CPM hum for 8 solid hours (or as long as I could sleep). Perhaps it was the pain killers?

Eventually, I found a way to unstrap myself in the middle of the night but I could never get back into the machine by myself once I was out. So I trained myself to not get up all night, as much as I could stand.

The last two weeks of May, I started working from home. Getting the machine set up at my desk as I typed one-handed while my left arm went up and down, up and down all day long was almost as difficult and frustrating as the bedtime routine. We layed down strips of tape in my office, too, in order to make the process easier each time.

“Let’s see, this leg of the machine goes here, that arm goes there…”

What a hassle. Obviously, the people making these machines have not had to use them. Not surprising. There’s no real way of marking settings other than the angle at which the cradle is moving. They are impossible to adjust on one’s own, if you have an injury- which you need to have in order to warrant using one.

When my mom had to leave, my dear friend Erik flew in to take over. He even had the motherly ‘tuck you into bed’ kisses that mom always delivered when we finally got the machine right (it never felt so good to be tucked into bed in my life). However, he and I didn’t have the same mother/daughter bickering back and forth. And I say that lightly and playfully.

While mom and I definitely got on each other’s nerves after being in close quarters (my small house) for four weeks with me so dependent on her, fighting with a damn, uncooperative machine, I could never thank her enough. There is nothing comparable to having momma there, even when you’re 32.

And Erik, a long time friend I’d known for 14 years, cared for me well, too. And my non-dramatic, non-family connection to him made for a good transition between dependency on mom and being by myself for the first time since the accident. When he left, the machine finally went back to its makers.

Being alone for the first time in about 5 weeks, while finally being free from this machine, was an incredible feeling of both freedom and emptiness, celebration and fear.

In that silence, the emotions really started to surface. Away from mom, away from any family dynamics, now finally being dependent on myself again- that’s when I really started feeling the gravity of the experience, now having to give myself all of the cheerleading and encouragement I had been drawing from others.

This was when the real test of compassion and patience for myself began.