Thursday, May 15, 2008

Everything You Always Wanted to Know About Rotator Cuffs But Were Afraid to Ask

My two-handed typing days, it seems, are about over.

As it stands right now, a week from today a surgeon will make some tiny cuts in my left shoulder, wiggle a little camera around in there, remodel a couple of bones, and stitch up my torn rotator cuff. Then he'll send me home with a pain pump, a gigantic ice cuff connected to a cooler, a sling, and some sort of bolster-on-a-belt designed to keep my arm out to my side. Which pretty much nips my newfound running obsession in the bud. (5K racing, we hardly knew ye...) As well as the aforementioned two-handed typing.

This all comes as something of a surprise, and not just to me.

Apparently determining why a shoulder hurts is like trying to figure out what's making a newborn cry. You put the baby down for a nap, pick it back up, feed it, burp it, change its diaper, feed it again, bounce it around on your forearm, give it a pacifier, drive it around in the car, call your mom and ask what she thinks, change its diaper again, burst into tears yourself, and finally decide it has colic.

With a shoulder, it's not all that different. First you try Aleve. Later you try more Aleve, and distracting yourself. If that doesn't work -- and it won't -- you try physical therapy. When all that fails, you have an MRI.

Now, as some of you may remember, I attempted to have an MRI last week. Such was not to be, however, so it was not until two days ago that I finally got the chance to be left alone inside a metal tube with a jackhammer banging in my ears.

The noise and the claustrophobia and the nagging neurotic concern about what would happen if the MRI technician was a sadist and left me in there alone with my hands strapped to my sides? Those actually weren't the worst parts. The worst part was the part before all that.

To figure out why the newborn is crying a shoulder continues to hurt when it should have stopped already, you have to put dye inside it. You probably would rather I not describe how the dye gets in there, so I will spare you. What I will share is that the phrase "Gosh ... 99 times out of 100 this thing goes in without a hitch" is not what I was hoping to hear. My butt may be as big as a tractor wheel and my thighs may be great whites, but apparently my shoulder joint is dainty and petite.

Eventually, though, my shoulder was full of an iodine-and-saline cocktail (I am pretty sure it was on the rocks), and a technician shoved me and it into the MRI tube. I was actually quite excited when they handed me radio headphones and asked me my favorite station, but it was impossible to hear NPR over the MRI steel-drum sounds, and I was not a happy camper.

Still, it ended soon enough, and they sent me off with a CD (probably the most expensive one I've ever touched) showing the inner workings of my diminutive shoulder.

Wednesday, I handed the CD to my friendly orthopedist. Thirty minutes later, having watched it on her computer (I forgive her if she checked in with TMZ while she was at it -- I mean, how interesting can the inside of a shoulder be?), she came back and, using her little finger and a pretend knife, demonstrated how my infraspinatus tendon had been cut halfway through, presumably by my fall in California.

No one, most particularly me, had expected this. The prevailing theory was that I'd torn some cartilage. Which just goes to show that maybe, uh, doctors, uh, guess sometimes. (Which reminds me of the time a few years back when one of my pupils got way bigger than the other. (Long story. And yes, it DID involve an MRI.) The doctor in the ER looked at it, scratched his head, said he'd be back in a few minutes, left, came back, and told me he'd just pulled out a bunch of his old textbooks to try to figure out what was going on. "Hell if I know," he said. I loved that man.)

Sometimes doctors advise people with partial rotator cuff tears to try more physical therapy. But before I could even ask, my orthopedist told me, "If it were me, I'd have surgery on this one." Yes, you're right -- I don't have any way of knowing whether she was wearing her "trust me --I made a 100 on rotator cuffs in med school" hat or her "hell if I know" hat. But she has me convinced.

So, after another 45 minutes or so of waiting, she sent a surgeon in to chat with me. This guy met my Number One requirement in a doctor: I understood everything he was telling me. That, and he said I was "almost guaranteed" not to have pain anymore once I got past the surgery and the rehab. (Shhhhh ... I can hear what you're thinking.) So I said yes, and we set a date: May 22, 2008.

Next up was the surgeon's nurse, who also happened to be his wife. Contrary to her happy-go-lucky husband, Mrs. Surgeon made this sound like it would not exactly be a walk in a park. I learned, for example, the following:

1) I won't be able to drive until I finish taking pain medicine. Given what sort of things the surgeon said he was going to be doing while he was in there, I suspect that means I will need a chauffeur for awhile.

2) "Most of the ladies find it more comfortable not to wear a bra for a week." Oh really. Well then most of the "ladies" must have ripped their rotator cuffs while they were still girls, with young and perky girl-breasts. What are old hags grownups like me supposed to do -- wear a strapless bra? Maybe that's why they'll be giving me pain pills.

3) I will need to wear a sling and this pillow thing on the side of my waist for, oh, about three of the hottest weeks of the year. Between that and the lack of chest supplementation support, I feel pretty already.

Once I got home, I figured out some other stuff.

Like, there's no way I'm going to be able to continue training for a 5K race on June 28 if I have to run braless with a sling and a shelf around my waist. But if I put the surgery off until after the race, I'll have to wear the same paraphernalia on the beach in mid-July for a couple of weeks. (Maybe I could get one of those cigarette-girl setups and prop it on the pillow and sell seashells at the seashore.)

And that it's going to be sort of hard to do my job, seeing as how it involves typing only about, oh, all the time. Unless I can find a keyboard with the left-hand keys about two feet to the left of the right-hand keys.

And that it's going to be harder that it already is for me to get meals on the table and clean clothes in the drawers. How do you chop an onion with one hand?

And that I'm going to have to become adept at posting all sorts of visuals real quick if I want to continue blogging with one hand.

And that before Mrs. Surgeon became Mrs. Surgeon, she was just the surgeon's nurse and there was a different Mrs. Surgeon, who is now known as the former Mrs. Surgeon. Coincidence? I think not.

With all this newfound knowledge, I decided today I wanted to stall get a second opinion, and maybe a different surgeon. Yes, he met my Number One requirement of Being Understandable, but Being a Nice Guy is way up there too, and in my book philanderers generally aren't. Maybe that's prudish. But it's my money and my rotator cuff, and I have a perfect right to make a moral statement with them if I so choose. Besides, I heard from two different people that he's had some unhappy customers.

So now I have an appointment with a second surgeon. This one is a Shoulder Guy. But then of course the doctor at the ER that time was an Eye Guy, and we all know how that turned out.

Meanwhile, I plan to spend this weekend looking for a one-armed bra and the world's widest keyboard.

4 comments:

MommyTime said...

You are incredibly funny.

Once I got home, I figured out some other stuff.

Like, there's no way I'm going to be able to continue training for a 5K race on June 28 if I have to run braless with a sling and a shelf around my waist. But if I put the surgery off until after the race, I'll have to wear the same paraphernalia on the beach in mid-July for a couple of weeks. (Maybe I could get one of those cigarette-girl setups and prop it on the pillow and sell seashells at the seashore.)


I got nothing funnier to add. But I will say this, having had a rotator cuff injury that I pretty much ignored (and, unlike teeth, it did not go away as a result, but hung around injured for a year or more), you should definitely so something. I hope the second opinion instills more confidence.

And I look forward to what you will write using only half the keyboard. :)

Twenty Four At Heart said...

OK, don't want to freak you out ... but find the absolute BEST shoulder surgeon in your area to do this and don't settle for less. Shoulder's can be nightmares. Really!!

Betsy Bird said...

The more I learn about what they're going to do and how I'm going to feel and how long I'm going to feel that way, the more freaked-out I get.

Mr Lady said...

This entire post gave me the chills in my butt.

Knives? Shoulders? MRI's? IODINE? I am going to start drinking heavily for you.