Monday, 28 March 2011

Well, it's a plan...

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.


  1. Oh, bummer. I thought they could get a more definitive reading with the MRI. :(

    It must be a let-down and all. But please hang in there!

  2. Oh, the waiting to heal! I feel for you. It sucks getting injured and not being 18 anymore, doesn't it? It just occurred to me that a bunch of the stretches and core work I do when at the gym were shown to me by physiotherapists and musculoskeletal specialists to help me deal with various running and age-related injuries. I still do them, with the faint hope it'll keep those injuries at bay but typically, once I started running a little (on top of walking daily) the piriformis syndrome struck *again*. We may not be 18 but at least we're wise enough to do the right thing -- I hope. :)

  3. XL: Yeah, it was a bit of a letdown, but 6 weeks will go by quickly, I'm sure. It's not like I don't have other things to keep me occupied!

    Andrea: Having had a bad strain in the right piriformis muscle a year ago, I can sympathize to some extent with you, although I didn't have any neurological involvement. Mine was at work (again) and it took some intensive physio and stretching to get it healed. No, we don't heal like we did at 18, do we? I also have knee issues, and just recently discovered a website that's done studies showing that most knee problems (especially in runners) are caused by weak hip muscles. If you want the link to the site and the exercises, I can email it to you. I've started doing them, even though I haven't run in years, with the hopes that it will simply alleviate the knee pain I get.

  4. Well, I'm glad you at least know what the plan is and that you're doing something to help you heal.

    Get Well Soon, and I'm so excited for you and your new place.

  5. Never a dull moment? :¬)


  6. There's a timeline, there's a plan, there are options. It doesn't get better. Just be careful with that move please, it's not your job to lift that piano ...

  7. Well, like you said, it's a plan...

    I hope the shoulder responds without surgery, but if it doesn't the next step has been mapped out. I wish you well (literally).

  8. It's always helpful to have a plan and that sounds sense. Between the two off you you have experience, know how and ability to follow a regime so all fingers crossed for a good outcome.
    That reminds me to do my neck exercises:)

  9. Just lean on us when the going gets tough. :)


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