I saw the surgeon today for the first time. He reviewed my chart, poked and prodded, asked questions and had me move my arm around on my own.
Then he got one of those little plastic body part models out and started showing me where things were bad and what areas needed to be worked on.
He told me (and this is something I did not realize) that MRIs are not very good at telling you what specifically is happening in a damaged joint, unless it is huge and catastrophic. They show that there is a difference in the signal in that area and that's about it. It shows there's a problem but not exactly what it is. He said it is not possible to tell if I have just inflammation in the tendon, if it is frayed, or if there is a tear. And the only definitive way to tell is to stick a scope in the joint and have a look. That's not something they like to rush into, because even just going in to have a look can compromise the area more than it already is. And if they don't need to do surgery, they don't want to.
I'm okay with that.... kinda.
Although I was hoping for a "right, this is the problem and this is the solution" kind of answer, being in healthcare myself, I understand the conservative approach. Because it's not clearcut, we are taking the conservative route. But because this has been going on for a while, it will be somewhat fast tracked. He said he usually won't entertain surgery until the conservative treatment has been utilized for a good 6 months... as tendons are notoriously slow to respond and heal, owing to a poor blood supply (which is normal for that type of tissue).
Now, my shoulder's been acting up since last autumn so I am pretty much at the 6 month period already, but given the new injury from January, we are going to opt for conservative management for 6 weeks and then I will be reassessed for the need for surgery. I now have a regime of very specific exercises to follow, some of which I am to do every hour (!) while I am awake. Initially I will be using my left arm to greatly assist my right in the full range of motions that I will have to do. The goal is to see how much stronger the muscles in the shoulder will get and how much the pain and decreased functionality will improve. If, at the end of the 6 weeks, when I go back to see him, I am still having a lot of issues, then it will likely be on to scheduling an OR date.
However, if things have improved dramatically, then it will be continue with that program and start back to work in a graduated fashion so as not to strain the shoulder unduly while it is healing and gaining strength.
And even if surgery is required, I may be able to return to work part time with restrictions on what I can do until the time of surgery. Then I would be off for at least 12 weeks to recover from that.
So at least I have a time line of events now, and can get on with doing what I have to do to make the most of this. The move will be over in 2 1/2 weeks so then I can concentrate on just that. And with the snow clearing off the sidewalks and pathways fairly well, I will be able to go for long walks. There are miles of pathways accessible at the new place and I'm looking forward to getting out and about.