State of the union... or at least the joint

[kitanzi]

Depending on who you are and how much you're stuck listening to me whine on a regular basis, you may know I've had a problem with my right shoulder since roughly around the time of the British filk con back in February. I intially assumed I'd pulled something while lugging luggage and ignored it, but after a month or two of increasing pain and decreasing mobility I wound up at the doctor. He diagnosed impingement, gave me some anti-inflammatory pills to take, and The World's Largest Red Rubber Band (for DIY physical therapy), told me to come back in a month. I did all that, came back, no substantial improvement. He referred me to a specialist, and I went. I answered the same questions with him, got a cortisone shot and was told to follow up in a month. I made that follow up appointment - and left my job just before the appointment, causing me to cancel it due to no insurance. In the time since then, it's gotten better, gotten worse, gotten better, gotten much worse... you see where this is going. I've found some factors that seem to affect it somewhat, and getting a real computer desk with a keyboard tray at home (and at my new job!)have helped somewhat but to make a long story short ("Too late!"), ACat has put me on his insurance and within roughly 36 hours of getting that card I was at the doctor's office.

That was today.

So he poked and he prodded and he did the usual "Does this hurt? No? How about THIS?" routine, where the object seems to be to keep trying whatever might hurt you until you admit that yes it DOES DAMN WELL HURT DAMMIT STOP THAT NOW! The upshot is that I have a refill on my anti-inflammatory pills and another specialist referral to the same specialist(had to re-do that due to new insurance), an excessively sore shoulder (and a headache to boot), and a promise of an MRI as soon as he can arrange it. The diagnosis is still impingement, cause unknown, and now he's talking about the likelihood of surgery. It's not honestly a surprise, but it's still a scary thing to contemplate.

Oddly, I'm less freaked out now that I have heard him say this than I was before the appointment. I'm at a point where I'd do damn near anything to get this definitively fixed if you caught me at the right moment. ("Swallow glass? Well, at least it won't wake me up gasping in pain in the middle of the night, sure!") Still, I'm hoping someone out there has had something similar, and can offer some hopeful stories or helpful advice?

Comments

[persis.livejournal.com]

I know jhayman had rotator cuff issues not too long ago. Lots of pain; ice and rest (non-use) are suggested. I am sorry to hear your woes. I have a issues of my own with my right deltoid muscle that I am (probably wrongly) currently ignoring.

Best of luck and lots of love and positive thoughts being sent your way.

[kitanzi.livejournal.com]

Ice and rest have been the order of the day, and continue to be. The problem is that I can get excrutiating pain from perfectly innocuous things (like wiping my mouth!) and then do the same thing five minutes later and no trouble at all. If I could find any pattern to what hurts, I'd be much happier. (Obviously certain things hurt every time, like stretching too far, but when I can't tell whether I'm going have a knife in my shoulder for being too careless in combing my hair, it's just too much.)

[sdorn.livejournal.com]

My mom had a serious shoulder problem (shallow socket that caused dislocation) that was solved by surgery. Much better than carrying around Valium for the odd time when she dislocated it. Really.

My recommendation is that you look for a surgeon who's operated on a pitcher's arm. Sports surgeons really do need to know their stuff, given what's riding on it. Given that you live in Atlanta (land o' the best starting rotation without a World Championship), it's at least worth a (cortisone) shot.

[kitanzi.livejournal.com]

If it comes to that, I'll keep that in mind. I'm still hoping it won't, but apparently the cortisone shot was the best alternative below that step. The specialist is the one who has to say, and he has to have the MRI first. (That's gonna be all kinds of fun, too, since he wants to use the closed MRI for better detail.)

[autographedcat.livejournal.com]

Ahem. Atlanta damn well does have a World Championship. 1995, in six games against the Cleveland Indians. Tom Glavine won the final game with a 1-0 shutout.

Hrmph.

[gingicat]

I second SDorn's recommendation of finding someone who works on pro athletes. Good luck. *gentle hugs*

[kitanzi.livejournal.com]

Thank you! *hug*

[klrmn.livejournal.com]

can i recommend that you try chiropracty (that spelling does not look right, but i don't know how to fix it) before you try surgery?

Dr. Travis Cross 404 303-0266 at the corner of mt. vernon and barfield.

he's really good at working with insurance, or charging an affordable price if insurance won't cover it.

[kitanzi.livejournal.com]

Well, if it comes down to that recommendation I'd like to at least discuss it with you. I know very little about it.

[folkmew.livejournal.com]

I've had some experience with chiropractors too and some success. For this it's probably a "can't hurt, might help" thing assuming you find a reliable and good one.

Sports medicine makes sense. And then there's the Alexander thing I mentioned lower down.

[joecoustic.livejournal.com]

Sorry if you get two of these but LJ got weird on me the first time....

I also agree to look into a Sports Medicine type doctor - it shouldn't make a difference but from all I've heard it does.

Other than that I have no good advice aside from the obvious (rest, anti-inflamitories and ice).

*careful hugs*

[kitanzi.livejournal.com]

I'll be able to tell if I got two or not when I get home, I suppose. Thank you for the hugs - and the sports doctor's not a bad idea.

[shaddyr]

Oh, I am so sorry! Pain that limits your every day mobility is so taxing and exhausting - I know.

I had an issue with my shoulder several months ago that went on for quite some time - several months, in fact - and sounded similar to what you have experienced. Luckily, mine seemed to get better just by being really careful and taking some pain killers and anti inflamitories. The stupid doc I went to tried to tell me that it was arthritis, but when I talked to some other people, we figured that it was more likely a rotator cuff injury.

I hope they are able to figure it out for you - and I second the opinion that you should see someone who does sports medicine. They just seem to 'get it' about movement related injuries better than GPs do.

I hope that you feel better soon!

[kitanzi.livejournal.com]

Thank you. The really frustrating bits are a) it keeps getting better - then getting worse. It's just enough that I can keep kidding myself that it's healing on its own, apparently, and b) I can never predict what's going to hurt, or how badly. Sometimes I'm fine, but sometimes I get a noise from cracking knuckles and a shearing pain, just from WIPING MY MOUTH. It's ridiculous. Thank you for the sympathy, though! I agree that the sports doctor idea isn't a bad one.

[grey-lady.livejournal.com]

I don't really have any good advice, and my experience with chronic pain was something considerably different - but I understand the feeling of being prepared to do pretty much anything, including submit to surgery. Which is what I did, and it fixed the problem, and I'm very happy I had the surgery.

*hugs* All the best.

[kitanzi.livejournal.com]

Thank you! *hug* I'm very glad yours is fixed, but I'm still hoping the specialist will see some other way.

[jhayman.livejournal.com]

From my shoulder to yours: Hang in there, and sincerest commiserations.

[kitanzi.livejournal.com]

My shoulder thanks you sincerely, and offers good wishes to yours as well! *G* (A sore shoulder support society?)

[jhayman.livejournal.com]

And if you can't find a sports medicine type, a physical medicine guy is good.

[braider.livejournal.com]

What they said. *hug* Take care of yourself. (Yeah, I know, that's what you've been trying to do). *hug*

[kitanzi.livejournal.com]

Will do, promise!

[maedbh7.livejournal.com]

Oh, nothing useful shoulderwise to add from here; just, since every step I take currently is a wealth of pain all it's own, you have my deepest sympathies.

Meanwhile, it's a very good thing we aren't attempting to tumble together this month. Can you imagine the comedy of errors that would be? "*Ouch*!" "What?" "Shoulder" "Oh, dear, let me hel OW! Ouch! Ouch ouch ouch!" "What?" "Stubbed my toe" "Oh no, let me rub tha ACK!" "Shoulder?" *nods&grimaces*

;) *hugs* -H...

[kitanzi.livejournal.com]

ROTFL! Ohhhh my, thank you for that image, I needed that laugh. We'll just have to declare ourselves the walking wounded, then, and make up for it another time. *hug*

[little-cinnamon.livejournal.com]

Maybe have a look at other parts of the body that could be causing it? I have a recurring arm inflammation, and was told for years it was probably tendonitis -until someone had the bright idea of running some x-rays and discovered it was cervical arthritis causing it...

*hugs* I hope it gets better soon. I understand the frustration -when my arm gets bad, I can't even wear my winter coat because my arm can't take the weight...

[kitanzi.livejournal.com]

Cervical arthritis? Are you sure you don't mean clavicle? *hug* that does sound excrutiatingly painful, and probably very hard to treat.

[jerusha.livejournal.com]

No, she probably means cervical. <puts on doctor hat>

The first point of confusion is that in medicalese, "cervical" can refer to either the neck or the "cervix uteri", or "neck of the uterus", which is the girly-parts-related cervix.

The nerves that feed the arm (called the "brachial plexus"; brachial means "of the arm") exit the spinal column in the neck, at levels C5-C8 and T1. (Basically, there are seven cervical vertebrae; the nerves come out above the 5th, 6th, and 7th vertebrae (C5-C7), between the 7th cervical and first thoracic vertebra (C8), and below the first thoracic vertebra (T1).) Arthritis affecting the bones of the neck can impinge on the roots of these nerves as they come out of the spine, creating pain anywhere in the area served by these nerves, including the shoulder and arm.

<takes off doctor hat>
</pedant>

Sorry if I went on too long; the first few weeks of the quarter bring out my "explain it until it's dead and then pontificate on the corpse" instincts in full cry.

Hope your shoulder feels better!

[autographedcat.livejournal.com]

Sorry if I went on too long; the first few weeks of the quarter bring out my "explain it until it's dead and then pontificate on the corpse" instincts in full cry.

Don't worry. Pretty girls who can explain medical stuff so normal folks can understand it are sexy. :)

[kitanzi.livejournal.com]

Nope, not at all! Actually, ACat and I figured out roughly the same thing shortly after getting confused, but unfortunately I posted first. That'll larn me, huh? *G* I appreciate the explaination, actually.

[annonynous.livejournal.com]

a) Gah. I thought things were OK since you got the keyboard trays. Sorry to hear I was mistooken. :(

b) I'm not a doctor, although Chosen One is a usefully informed health care professional.

c) Impingement is something rubbing or pressing on something else. Most commonly this means something
is impinging on a nerve. I guess "cause unknown" means they don't know what is impinging on what? Also,
did any of them say where the problem is? It might be in your neck, not in your shoulder. A
problem with the cervical vertebrae can manifest as shoulder pain.

d) An MRI is a very useful, detailed image. I've never had one (though that will change next month), but
Chosen One has had several. Don't let it phase you. Just close your eyes, relax and hold still.

e) Yeah, keep surgery as a last resort, by all means. Too many things can go wrong, with the surgery or with the recovery.

Doctor Which (returning control to Ann O.)

[kitanzi.livejournal.com]

a) They were better, it did make a difference, but not enough better.

b) I know, and I know. :)

c) cause unknown means he asked if there was an injury that caused it, and I couldn't remember one. The X-ray didn't show anything, apparently, but perhaps the MRI will. I had assumed the impingement was a tendon or something like, since I mentioned that sometimes I get a knuckle cracking noise along with a sharp pain and a feeling that things are snapping past eachother - he seemed to think that was quite expectable.

d) I had one back when I had that dizzy/fainting thing a year or two back, but it was an open MRI instead of a closed one.

e) Oh yes, it's not my first choice, or even my second.

f) You may have confused poor little cinnamon, since you actually posted this as a reply to her comment. :)

*hugs*

[annonynous.livejournal.com]

c) Yes, MRIs are much more detailed than X-rays. And the feeling of knuckle cracking and
things snapping past each other does sound like a shoulder joint. I know that popping sound
from experience. :(

f) Apologies to little_cinnamon if I did. The ideas of looking at other parts of the body
and of the connection between neck and shoulder prompted my Comment's placement.

Ann O.

[madfilkentist]

At least I'm not the only person who has serious doubts about whether suffering excruciating pain or letting myself within sight of a doctor is worse. :)

Sorry, no useful advice to offer, just sympathy.

[kitanzi.livejournal.com]

Still appreciated! :)

[folkmew.livejournal.com]

I seriously wonder if you want to work with someone trained in Alexander Technique (http://en.wikipedia.org/wiki/Alexander_Technique) (or here (http://www.alexandertechnique.com/))
It's not just nonsense, it has a pretty good track record of curing things like carpal tunnel without surgery, one reason so many musicians use it.

My voice teacher did this as well and she definitely helped my back by looking at me sitting in my little Saturn (which at the time I was taking lots of long road trips in) and saying "ok, get a 1 inch binder, stick it on the bucket seat, put a flat cushion on top of it." Like magic! Really, and nothing mumbo jumbo, it just is about being hyper aware of how bodies work and what causes the anatomy strain and stress. Frankly I could really benefit from more of it. Unfortunately most insurance doesn't cover it yet. Fortunately most practioners will work out something with you.

ANyway - just an idea. (Feldenkries is, I think, quite similar but I know less about it).

[kitanzi.livejournal.com]

I'll at least look into it, and thank you!

[quadrivium.livejournal.com]

Rotator cuff injuries suck mightily! I am so sorry to read you're dealing with one. I managed to rehabilitate my left shoulder, but now I'm getting twingey on my right shoulder. But, it does respond to rest and light stretching.

I'm glad you've gotten to have someone look at your shoulder. I hope it doesn't have to come down to surgery. But, it sounds like there are a couple of options you can try before you have to go that direction. I hope one of them is successful! *Big Hugs!*

Much love,
Mary

[kitanzi.livejournal.com]

Me too, and thanks. :) He's actually calling it impingement rather than a rotator cuff injury, which is apparently a little different. Hopefully it won't take surgery. The anti-inflammatory pills are already making a difference, which I'm profoundly grateful for, but they aren't a cure in themselves so we'll just have to see, I guess.