Shoulder update

Zeitgeist 1 Minute

A couple of people have asked for an update, so I thought I’d just do a brief post.  As many of you know, I’ve been struggling with pain in my right shoulder for a couple of months now, which has lowered my posting frequency dramatically (some from physical discomfort, and some I think from just low morale). After largely fruitless attempts at physical therapy exercises, I saw an orthopedist who ordered x-rays, an MRI, and a CT scan, and then finally recommended surgery.

However, given the invasiveness and recovery time of the surgery, the mild diagnosis language used by the doctor who did the MRI analysis, and the fact that my shoulder seems to be finally improving (assuming I’m not just fooling myself), I’m going to get a second opinion.  I’ll definitely get the surgery if the second doctor concurs, but before I go through that, I want to make sure it’s required.

So, that’s the situation.  Getting old stinks!

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26 thoughts on “Shoulder update”

  2. My shoulder has been hurting like hell since last spring. Supposedly it’s “frozen shoulder”. I can’t reach with it without bad pain, and I can’t reach behind my back well. I hear you.

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    1. Sorry to hear that. From everything I’ve read and heard about frozen shoulder, it sounds awful. I have a cousin who gets it for a few months every few years and they’ve never been able to figure out why.

      My own issues are shoulder impingement, calcific tendonitis, and possibly a partially torn rotator cuff.

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  3. I’ve been noticing myself that strains and sprains take a long time to heal in my dotage. I tore a calf muscle a while back, and that took many months to heal completely. Various and sundry joint and muscle issues just seem to take a lot of time these days. [sigh]

    (I, too, would hate to relive my mistakes and lessons, but I’d love to transport my current mind back into my 20-year-old body. The movie About Time actually has that theme. Made me wish for it all the more.)

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  4. I was wondering how you were doing. For some reason I thought it would take longer to find out the CT results. So what did the CT reveal that the MRI didn’t? That’s strange that one doctor used “mild diagnosis language” and another recommends surgery. I think you’re smart to get that second opinion, but what will happen if that second doctor says you don’t need surgery? Will you just wait for improvement and get the surgery only if it doesn’t improve?

    Don’t mean to ask so many questions! I’ve just been googling health stuff for so long I can hardly stop myself.

    Well in any case, I’m glad that the pain is not as bad as it was. And even if you are fooling yourself, it’s always good to not be in pain!

    Good luck on all this. I know it can be really frustrating and depressing.

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    1. I’m not sure if the CT revealed anything new. The Result Impression was “Mild AC joint arthropathy and calcific tendinitis. No acute osseous findings.” The word “mild” was also repeated often in the MRI Result Impression, as in “mild bursitis”. When I google all the terminology, it generally doesn’t rise to a surgery level issue, which is why I want the second opinion.

      What will I do if the second doctor disagrees? I really don’t know. It will probably depend on what they recommend and how I’m feeling, but I’ll likely take a wait and see attitude.

      Thanks. How are you doing? Is the therapy working?

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      1. Did they say whether it was reactive or degenerative calcification? (I’m sure you’ve already seen the following article, but just in case):

        http://www.methodistorthopedics.com/calcific-tendonitis-of-the-shoulder

        I assume “no acute osseous findings” means no spurs? That sounds kind of vague, but as you say, mild.

        Did they try injections or lavage? (I’m reading that the latter may not be that effective). Did the doc recommend arthroscopic surgery?

        I’m having weird symptoms right now. The therapy doesn’t seem to change the way my head feels, but my balance is getting better, oddly. And the PT woman has been enormously helpful and she’s incredibly knowledgeable and detailed.

        Fatigue has been a big issue this whole time, but now I get a feeling this will get worse. The past two nights I’ve had a hard time getting to sleep because of muscle spasms and—the weirdest of all—a feeling that someone was torturing me with a toothpick! I’ll be halfway asleep and somewhere on some random part of my body I’ll feel a little pin prick. Once I felt it sharply in the corner of my eye. If it’s not a pin prick, it feels like someone is tapping me (these are probably just muscle spasms that feel like tapping when I’m on my way to dream land). Now I’m probably just going insane. I’m a little embarrassed to tell the doctor about this because he’ll just look at me like I’m some sort of hypochondriac.

        Well the physical therapist recommends ruling out Lyme disease, so I have to wait until the beginning of March to see the neurologist and find out what he thinks about this. I did get bitten by a tick in VT. I even joked about it in a blog post in October:

        http://philosophyandfiction.com/2014/10/07/off-the-grid-in-vermont/

        But I didn’t have any of the typical symptoms of Lyme disease. I did have a fever, but that was in Nov. And I didn’t have that bull’s-eye rash. If it turns out to be Lyme, I’ll be so annoyed. It’s not likely though, according to the neurologist and my PCP.

        Well, now I feel like an old person! I always knew I had an old soul, but an old body too?

        I hope you feel free to gripe with me about your maladies. Especially since I just unloaded on you, it’s only fair.

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        1. He really didn’t talk much about the calcification, which I found odd since it was prominently mentioned in all of the scan results. The focus has been on the tendon itself. Maybe my calcification wasn’t that intense. (Although calcium deposits would explain the pain I’ve experienced.)

          Thanks for the link. I hadn’t read that one, although I had seen similar articles last week.

          I’m assuming the recommended surgery would be arthroscopic, although we didn’t explicitly discuss it. The surgery would be to repair the tendon (to whatever extent it’s torn), remove the bursa, and shave bone off the acromion. In truth, I was stunned by the surgery recommendation after reading the MRI results and so really wasn’t prepared to ask questions. He just said recovery would be 4-6 weeks in a shoulder sling, followed by 3-6 months of physical therapy.

          It’s probably worth noting at this point that the person I’ve been working with is a physician’s assistant (it was much faster to get in to see him) with a doctor in the background. (The scan analyses were done by actual MDs though, at least according to the sheets they gave me.) I’m not sure who influenced the surgery recommendation more, the PA or the supervising MD. I’ve generally had good service from PAs, and this one is definitely smart, patient centered, and efficient, but when discussing surgery I want to talk with actual doctors. I have an appointment with the supervising MD in several weeks. I also have another appointment with another MD at another clinic in a week for the second opinion.

          Hopefully that wasn’t too much information 🙂

          Lyme’s disease? Wow, they really are having a time figuring out your malady. At least if it was Lyme’s they could knock it out with antibiotics.

          If I recall correctly, your main symptom was light-headedness with occasional nausea. If you’re still light-headed but have balance, I guess that’s progress, but it seems like a symptom is being cured. I hope they can figure something out, or that the PT eventually takes care of it.

          The pin prick thing is odd. It started after physical therapy? I wouldn’t hesitate at all to tell your doctors and/or therapist. You never know what might turn out to be a crucial clue.

          I definitely hear you on the feeling old part. I used to tell people that I actually started noticing age related issues around 25, although there have been up and down years since then. I was probably in better shape in my late 30s than in most of my 20s. So I wouldn’t judge too much by your current state.

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          1. I don’t blame you for wanting to get a second opinion on that. That sounds like a serious surgery. Of course, when you’re in pain, sometimes that’s the way to go. It’s always a hard call since we’re not medical experts. Hopefully the second opinion won’t leave you perplexed. Luckily it’s coming in a week. I need to move out where you live…things seem to move along faster there!

            Yeah, my main symptom is this umbrella term “lightheadedness”, but it’s actually changed a lot. It started out mostly just what you’d think—lightheadedness being that feeling you get when you stand up too fast—but then it changed into a kind of nonstop pressure, and sometimes a downwards pressure, like that feeling when you’re taking off on an airplane, except straight down. (Maybe that’s why I’m so short…I’m actually being squashed by invisible forces?) 🙂

            I think I will call the therapist on Monday. She actually listens. The others…I can’t really tell.

            It’s so funny. I was talking to a friend who’s my age and we both wistfully remembered our twenties in this manner: “Remember when you didn’t think about your body’s welfare? When everything just worked and there was no pain anywhere ever? And you just took it for granted and beat the hell out of it?” Now I know I’m not that old, but it’s so funny to me that I’m having problems now that I’ve finally decided to take my health seriously. And just like you, I’m in better shape now than I was then (present situation excluded). I was enjoying being healthy too, for the first time not taking it for granted. I really can’t wait to get back to my exercising. Luckily I haven’t put on a single pound since this whole thing started. I’ve been somewhat careful, even though I stopped counting calories. Although all day I’ve been reserving my strength to go out for dinner. Tonight, all bets are off. I might avoid checking the scale tomorrow. 🙂

            Oh yes, Happy Valentine’s Day!

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  9. As an archery coach I know more about shoulder injuries than I really cared to. You may want to check out a program by Rick Kaselj called “Fix My Shoulder.” This program has worked for several of my adult students. Surgery on one’s shoulder should never be undertaken before exhausting all reasonable other options. Because this joint has more range of motion than any other joint in your body, it is more complicated and harder to repair tha the others (not that I do not know of successful surgeries).

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    1. Steve, I’m grateful for the recommendation. Would you happen to have first hand knowledge of the benefits of Kaselj’s program, or know someone who does? I only ask because there’s a lot of either over-hyped generic physical therapy advice or outright snake-oil out there.

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  10. Philosophically speaking, pain is not real, but it is a pain …. 😉

    I have tendinitis and fasciitis ‘all’ the time, especially one shoulder, plus osteoarthritis in one knee. I would not be surprised if there is a genetic factor. I manage quite well by massaging the hell out of the points of pain and exercising regularly. One should search for these points of tenderness by applying pressure with the fingers. Strengthen the muscles around the joint. Increase flexibility. Surgery is a last resort. Shop around till you get an opinion you like. Good luck.

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    1. Good advice. Thanks Liam. I’ve actually done a lot of stretching since the onset of pain, and a few weeks of the standard physical therapy strength exercises. I finally stopped the strength exercises suspecting that they were aggravating the problem. I’ve now stopped even the stretching in favor of just resting it until this surgery thing goes one way or the other.

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  13. Pingback: Shoulder update, hopefully the last | SelfAwarePatterns

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