Another Doctor

Resting – two weeks of doing nothing - was great for the pain level in my shoulder.  I even considered cancelling my appointment with the surgeon.  Alas, it didn’t take much time at home to realize that although I was feeling better, keeping that appointment might be the better part of discretion.

I’d thought that scheduling on the second day of the week would avoid all the Monday madness of everything that goes wrong over the weekend.  Maybe so, but this particular orthopedic practice has ten surgeons on staff and for some weird reason, none of them do surgery on Tuesday; all ten see clinical patients on Tuesday, which leads to a huge number of patients running (sometimes hobbling) through the office.  It was crazy!

When I checked in I handed the receptionist a small pile (photo id, insurance card, check for co-pay, disk with x-rays and MRI).  She said, “I love patients who are organized.”  I loved her right back when she told me that they communicate with patients via email!

The doctor was very nice.  Like me, he has a fifteen-year-old daughter learning to drive.  And I’ve been reflecting on the fact that I learned this little piece of trivia.  This is no surprise to my regular readers, but I tend to be a very task-oriented person.  Not that relationships aren’t important – they are – but a visit to a doctor is for a specific medical purpose and I’ve tended to view small-talk as being off task.  It wasn’t until I started reading medblogs that I discovered that there are doctors who enjoy visiting with patients, and that there’s a little bit of social time built into office visits.  Pre-medblog reading, I answered questions directly and to the point, cutting off any side issues.  I didn’t realize that sometimes the doctor was just trying to put me at ease and get a little social history.  As a cool bonus, I’ve discovered is that it’s easier to trust a doctor if I know something about the person; not that it should matter over their credentials, but it does make me more comfortable (which is kinda weird).

We chatted, and he noticed my notebook and the form on which I take my notes.  Never before has a doctor observed aloud that I appear to be type-A.  Who?  Me?

About the shoulder:  at the appointment, my range of motion was better, and I had much less pain than a couple months ago.  A look at the films and an exam yielded a cortisone shot and a referral for more PT.  That might provide some relief for now and put off the need for surgery – but that I’ll probably need to have the shoulder fixed within a year.  My job, he told me, is to do the PT exercises and cheat him out of an operation.  When I asked which kind of cortisone, he smiled and gestured at my form while answering my question, knowing that I’d write it down.

Note: my range of motion was better, and I had less pain at the appointment.  Last night when I sat down to check my email and catch up on my reading, I tried to lift my arm to reach the computer mouse.  It didn’t work.  I could use my left hand to maneuver my right arm, but it was both cumbersome and painful; I quickly gave up.  Getting ready for bed was a challenge, but I finally collapsed onto the bed – and found that laying down hurt even worse.

After trying every possible sleeping position, I grabbed a couple polar fleece blankets (light-weight, easily portable) and headed back downstairs where I spent the night in a recliner.  Around 1:00 even managed to fall asleep for a couple hours.  This does not bode well.  As much as this hurts now, I am not looking forward to seeing the physical terrorist for repeated torture sessions.  I’m wondering if all this pain is just from the doctor manipulating my shoulder to see what it would do, or if this is one of those rare complications of a cortisone injection.  Things were fine until I tried to extend my arm, and now… oh!my!word! it hurts.

I’m headed out of town for the weekend, and will be back next week.  Have a great weekend!

Random Thoughts

So much for shoulder improvement.  It was feeling a bit better, temporarily, but the PT thought that was due to my not using it, rather than any real progress.  I did the exercises and stretches prescribed, but not anything extra. The physical therapist (at least that’s what I’ve been told PT stands for – I’m starting to think that it really means that I pay someone to torture me) finally said that it didn’t look like he was able to help this time, so kicked me back to my PCP.

I promptly stopped using my arm/shoulder, and the rest helped.  I could sleep most of the night (as long as I didn’t roll over the wrong way).  Once I’d rested my shoulder sufficiently (I thought), I resumed the gentle stretches and exercises prescribed by the physical therapist.  As soon as I tried to do anything, the whole shoulder was aggravated again.

I think about the fact that a baseball pitcher can tear his rotator cuff and completely recover to the point that he can pitch again.  There shouldn’t be any reason that I can’t get my shoulder working again so that I can do easier things than pitch a baseball.  Like play my guitar.

The trick is figuring out what it’s going to take to fix this shoulder.  My PCP looked at the PT’s report, asked questions, and referred me to an orthopaedic surgeon.  My doctor’s terrific.  He suspected that I’d be reluctant to have surgery (he might have gotten that impression from the fact that I still have my gallbladder), and reassured me that the physician to whom he’s referring me will have suggestions on non-invasive things I can try.  Surgery will be a last resort.

Googling the Referral

In the past, I’ve known nothing about doctors to whom I was referred.  It was so cool, instead of being in the dark, to come home from my last appointment and google the surgeon.  Up popped his medical clinic.  I was able to see a picture of him and read his bio.  I was surprised at how much less nervous I felt after that.

I also got to fill out all my paperwork online.  Is it paperwork in a paperless office?  I guess it’s easier and more legible than having the office mail forms to me, but it took three hours to do it all.  Next time someone asks my occupation, I’m tempted to tell them that I’m a professional patient.

In Other News

Happy as I was to discontinue the sulfasalazine, I’m wondering if I’m going to have to start it again.  I’ve been wondering if the Enbrel wasn’t working as effectively – not a pleasant idea – but this morning (when I filled my pill boxes) realized that maybe the ssz was really helping and the recent problems are because I’m not taking that med any more.  Next rheumy appointment is the middle of June, so either this is a flare that will go away, or I’ll know something different needs to happen.

Lastly, I’ve overcommitted myself, so probably won’t be online much for the next few days.  In no particular order:  my boys are going camping this weekend, and I have things to prepare for them (laundry, mending…).  I’m teaching tomorrow morning – but not until 10, which is good, because I’m helping someone set up a new database and need to be done by 9. Plenty of time to spare if I finish that project first thing when I get up, then prepare my lesson for 10:00.  I have a sewing project that needs to be done in the afternoon, then two of the kids need transportation to a violin master class in the evening.  By the middle of next week I have three more sewing projects to finish, then we need to pack for our vacation.  And I need vacation overrides so that I can refill my meds.  Fortunately I have someone to stay at my house and take care of the animals while we’re gone, so no worries there.

Hmmm… maybe it’s the busyness and not the lack of ssz that has my feet hurting so much.  I guess if I get better on vacation, I’ll have my answer.

Have a terrific weekend.

Shoulder Exercise #3

Continuing the series on exercises given to me for my rotator cuff issues, today is a look at two different quick exercises that are quite similar.

Maybe this should have been number one, since it’s the first shoulder exercise I was ever given.  I gained an even greater appreciation for the internet after being told what the problem with my rotator cuff was, and asking, “The x-rays showed tendonitis?  I thought tendons don’t show up on x-rays?”

My search for information led to a good introductory explanation of rotator cuff disorders at WebMD.  Reading the entire article, I eventually found home exercises for the rotator cuff, along with a zillion warnings that the exercises should not be done without first consulting your health care practitioner.  I’m okay with that, but I’d just seen my doctor and didn’t really want to drive back to town.  It would have been nice if he’d told me during that appointment that there were some things I could try at home to make my shoulders better, but he didn’t, so I phoned and left a message for the nurse, “I found these rotator cuff exercises, but they come with a warning to discuss them with the doctor first.  Is it okay?”  Here’s where emailing the doctor’s office would be nice – I could have just sent the link and they’d look and say “yes” or “no” or “come see us first.”

But I digress.  When my call was returned, the NP described some exercises that I could try – and all of them were in the WebMD article.  Wall walking was her first recommendation.  The simple method – no equipment required – is to slowly walk the fingers up the wall, stopping when it hurts.  Over time (and it doesn’t take too long), this will increase range of motion.

When I eventually saw a physical therapist, he put a twist on it and had me roll a big balance ball up the wall.

I start at chest height and roll the ball up the wall until my arms are fully extended overhead, then lean in toward the wall for extra stretch.  Fortunately, my house has vaulted ceilings so I can do this indoors.  Standard eight-foot ceilings would make it impossible to do in the house, requiring some creativity to avoid getting rained on:  maybe in the garage.

Disclaimer:  this is not medical advice.  Consult your personal physician for diagnosis and treatment of your medical issues.
It really is important to run the exercises past your doctor.  Some of the stretches on the WebMD site were recommended to me the first time I saw a PT, but this last time was told that my shoulder can’t handle those and I should stick with the easier ones for now.