Jun 28, 2011

Snap, Crackle, ...Crepitus?

You read that right.  Crepitus.  (Pronounced kreh-pit-us)  It's the "cool word" of the evening.  My husband described it as the sound scar tissue makes when it is breaking up.  Scar tissue is basically like a scab on the inside of your body--it's job is to protect the wound underneath it until it is fully healed.

For example: let's say you scratched your elbow.  As it heals, blood flows to the surface of your skin and clots, creating a protective barrier (the scab) outside of the wound.  Once the skin has re-formed under the scab, the scab dries up and falls off; mission complete.  Now let's pretend that you let your elbow scab dry while you held your arm straight.  The next time you bent your arm, the scab would separate in some spots and new blood would flow out with the intent of clotting and forming a new layer of scab where the old one had busted apart.

Scar tissue protects wounds inside your body just like a scab.  And just like a scab on your skin, the scab on the inside can be broken as well.  The weird thing about this inner scab is that when it breaks, you can HEAR it.  This sound is called crepitus.

I had an up-close and personal encounter with crepitus tonight.

When Isaac had discovered the lump on my right collarbone, we'd had an excisional biopsy done.  One aftermath of the surgery had been increased tightness in my sternocleidomastoid muscle (the bright red muscle in the picture to the left).  Because the incision for the surgery was directly above where this muscle connects to my collarbone, my body had naturally shrugged my right shoulder up, decreasing the amount of pain I felt by lessening the tension on the skin in that area while also allowing my muscle to take a break.  Unfortunately, all muscles have a natural tendency to want to contract because it costs your body less energy--this is why dead people go into rigor mortis; their body is no longer producing the energy necessary to keep the muscle relaxed.  Since I'd been avoiding using my sternocleidomastoid for about two weeks, it had gotten used to being contracted and was extremely tight and my neck and upper back were trying to compensate for it.

Another consequence of the surgery was that I had a build-up of scar tissue where the incision was.  I'd been walking around with a funky neck for a while when Isaac decided it was time to work out the scar tissue; to break the scab, so to speak.

If we were five, he would have had to chase me around the playground for a while before I let him come near me because I was so scared it was going to hurt.  He told me it wouldn't.  Yeah...  I'm no dummy.  As it were, I was acting skittish about the whole thing anyway, stepping toward the chair and then when he came close, squealing and walking away as fast as I could.  How adult, right?  I know. I felt like an abused dog that shirks away when people go to pet it.  Except I'm not a dog.  And Isaac wasn't going to pet me, he was going to stretch my neck.  Either way, I was really UNexcited about the whole thing.  Eventually, Isaac gave up on the stretch-fest happening any time in the near future and decided to sit down to study and wait for me to come sit in the chair when I was ready.

It took a few minutes, but once I'd mentally dedicated myself to it, I settled down in the chair.  I still didn't believe it wasn't going to hurt, so I had a towel close by that I could bite down on if I needed to.  Isaac gently held my shoulder down while simultaneously coaxing my head in the opposite direction.  My muscle was so tight it felt like it was on fire at first--and my head was barely tilted.  Ever so slowly, he stretched then relaxed, stretched then relaxed.  He alternated between that and kneading the scar tissue for about 3 minutes.  Then he told me to let him take my neck as far as I felt it could go.

Now, before I agreed to this, we had to have a little come-to-Jesus talk because I wanted to know if he was actually going to stop when I said to, or if he was planning on going a little further than I thought I should.  Obviously the answer would have an effect on when I told him to stop.  I'll push myself when I need to, but I'm not to keen on surprises--especially if there's potential for them to be painful.  We agreed that I would be in complete control of when I stopped and then I had a quick mental pep talk with myself before we started the more aggressive stretching.

Slowly, he pushed down on my shoulder and started to stretch my neck.  About 3 seconds into it I was pretty sure I was at my limit, but he had promised me that my muscle wouldn't tear if the surgeon had done things properly, so I decided, "Eh, what the heck?  I can go a little further."

That's when I met crepitus for the first time.

All the sudden I felt (and heard) a pop.  It was pretty loud.  And kind of gross.  Even Isaac seemed surprised at how noisy it was.  I thought for sure my neck muscle had snapped in half and visions of showing up to chemotherapy in a wheelchair flew through my head for a microsecond and then I realized that not only was my neck still in tact, it felt SO GOOD!  A million pounds of pressure and tension was suddenly gone.  Vanished.  Out with the pop.  Ahhhh it felt so nice!

My reaction must have been awful funny, because Isaac was giggling a little bit by now.  Apparently they'd done the same thing to him at the clinic with his knee and he knew exactly what I was experiencing.  What a goose.  I was a smidge embarrassed because of how worked up I'd gotten about the whole thing, and kind of wanted to sock him in the leg.  I didn't.  Someday I'll learn to trust him on these things.

He was all excited to stretch some more, but I asked for a ten second break, because although it felt fantastic, the mental game was still a little much for me.  For Pete's sake, I just "cracked a scab"!  Exactly ten seconds later, we started in on it again.  We stretched, relaxed, massaged, and popped a few more times before Isaac decided that was enough for the night.  Needless to say, my neck feels much better and I have even more confidence in my husband's medical abilities.

Plus I have another word to add to my mental dictionary of medical terms.  And now so do you!

1 comment:

  1. HAHAHAHAHA I laughed out loud the whole way through this one...

    ReplyDelete