Monday, July 22, 2013

Colorado PT 2013: Part 3

As the weeks of being in Colorado started coming to an end, I started becoming more concerned because I knew I would be heading back to Illinois soon. It sounds selfish, but the time I spent in Colorado was the best thing for me. For the first time in a number of years, I could strictly focus on my shoulders and trying to get better. I could go to physical therapy and chill out afterwards without feeling guilty. It was great. Neither one of my shoulders are in the shape that I was hoping they would be in. Of course I'm happy I have more strength but from a functionality standpoint, I didn't improve that much. If I said I wasn't disappointed, that would be a flat out lie. Having these complicated shoulder/shoulder blade issues is a lot harder than it comes across in a blog. Every single day brings about its own challenges and some days are a lot worse than others. I've been working at getting these shoulders better since 2007 and it is very tiring. Over the past several years I've been working hard trying to stay in the best shape I possibly can so it doesn't look like there is a problem with me. I've learned to move about effortlessly using strictly elbow motion and have learned to "hide" the pain I'm feeling from family/friends. As my mother says, I am a "Master Illusionist." Drawing continues to be the main outlet I use so all of the aggravation and stress I feel doesn't build up inside. While I was in Colorado, I redrew the tiger that I gave away to one of my surgeons as a thank you gift.

I usually do not draw the same picture twice but
my parents really liked this one, so I drew it again
in Colorado with colored pencil.
Tuesday July 2, 2013 was doctor day. It was my last week of being in Colorado before heading home. When Dr. M came in the room, he asked how things were going. I told him my strength has increased, I'm more aware of my shoulder positioning, but I haven't gained in my motion. I also told him that my left shoulder is getting progressively worse and is subluxating posteriorly. In addition to giving him a shoulder update, I told him I didn't regret having the invasive stabilization procedure that was done in Nov. 2012. In April, Dr. M asked if I regretted having the Nov. surgery and I told him I wasn't sure. Over the course of the 8 weeks in CO, I realized the Nov. surgery is doing exactly what it's supposed to do and thank God for that graft. Every single time my nerve gets flared up, my muscles tighten so bad in the front of my shoulder and you can see the humeral head being pulled forward. If it weren't for the graft, I am positive I would have subluxated or dislocated at this point. The graft in my shoulder has been working hard and doing its job; preventing my shoulder from dislocating. I told Dr. M I think there is a separate issue going on. He then asked if something occurred before my Nov 2012 surgery and I told him yes. On September 23, 2012 my shoulder dislocated and the shoulder reduction at the emergency room was the worst reduction I have ever experienced. The morning of September 23rd I had motion to almost shoulder level. Ever since my shoulder was reduced I've had minimal. Originally I thought it was due to the instability because that is what the previous patterns have been; however, the instability was corrected in November. I have done several months of physical therapy since then with gains in strength but no gains in motion. So I think something isn't adding up. Dr. M then came by me to examine both of my shoulders.

My evil right shoulder was up first. Dr. M gently grasped my forearm and shoulder. He then tried to bring my arm forward. In order to get a full assessment, Dr. M has to move my arm past my comfort zone. Since I am not one to cry or verbally say, "Ouch" I went up on my tippy toes and tried to walk away because my shoulder was killing. Dr. M was still holding onto my arm so I never actually got away from him. He then examined my external rotation. As he moved my arm, the entire room could hear the very audible crunching/grinding that was occurring in my shoulder. You can only imagine how loud the crunching/grinding is for me when that noise is occurring directly below my right ear. That sound makes me absolutely crazy. It is nauseating and irritating. That noise is one of the things that bothers me the most because it is another daily reminder that my shoulder is trashed.

Next up was my left shoulder. Dr. M grasped my forearm and shoulder the same way he had on my right. He tried to bring my arm forward. As he was moving my arm up, I could feel a lot of pressure building up in the back of my shoulder joint. Before I had the chance to say, "My shoulder is going to subluxate" my shoulder had already done so. When Dr. M moved my arm the opposite direction, the ball clunked back into its proper position. Dr. M then tried putting more manual pressure on the back of my shoulder to stabilize it, but as he moved me forward the same exact thing happened again. Never a good thing. Dr. M sent me for X-rays of both shoulders.

After I had my X-rays done I went back to the room and started pacing back and forth. When I am in severe pain, this is just something that I do. I can't sit still. I'm not one to scream and yell so I stick to pacing. My right shoulder was not sitting properly at all. I felt like my right side was hunchback. My shoulder was being pulled way forward and everything was screaming. It took everything within me to stay composed. My elbow was bent at an odd angle; I was not able to straighten it at all. Every muscle in my right upper quadrant was in spasm. It killed. My therapist came into the room. He looked at me and knew something was wrong right away; he has never seen me react to pain in this way. He talked me into laying down on my back propped up with a pillow so my muscles would hopefully relax. Shortly thereafter, Dr. M came back into the room. Dr. M tried moving my shoulder and told me to try to relax. I looked him in the eyes and said, "I am relaxing. I have no control over this. This is what happens at therapy when we work the nerve." Dr. M put my arm back down and sat down next to my mom. I sat up and waited to hear what I'm supposed to do next. Dr. M told me my right shoulder is sitting up higher than it should. He suggested that I have an EMG (type of nerve test where they stick you with needles and send a little shock to check your nerves) done on both shoulders and to include the brachial plexus branches. Until then, I should continue my physical therapy workouts at home. This is one of the main reasons why I did not want to come back home to Illinois. There are still problems with my shoulders to figure out. When the doctor appointment ended, I went down to the physical therapy clinic and my therapist worked on trying to get my right shoulder to relax.

July 16, 2013: One week after I got home from Colorado I had the EMG test done. I went back to the same individual that did my EMG in 2010 because he was thorough and nice. When I went back the second time around, it was like seeing a completely different individual. As soon as I said the order was from Dr. M in Colorado it was like the doctor didn't even want to be involved. There was no history taken, he did not ask my symptoms, he did not examine my motion. I filled out zero paperwork. He did the most basic EMG test possible. I was told, "Everything is completely normal and this is strictly a mechanical orthopedic issue." Since the test was not thorough, I am opting to go for a second opinion and have the test redone by a different physician because I don't trust the first doctor's impression. It would be a lot easier if doctor's would tell me they do not want to be involved in my case rather than make me go through an uncomfortable test and deal with the way my shoulders will react to it.

video
Ever since one of the needles used to have the EMG done
was stuck in my rhomboid muscle, I have had scapular winging.
My motion has decreased in my left shoulder, I wing out more
than normal and I have had more posterior (back) joint pain.

video
My motion has even declined in my right shoulder. I didn't
think it was that possible considering I didn't have that much
to begin with. I was obviously proven wrong. 

It's ridiculous and nerve-wracking to have to go for an EMG a second time; especially knowing how my shoulders reacted to the most basic EMG possible. It is going to be a handful. I would so much rather prefer doctors to be honest with me rather than give me a bogus exam where I have to go have it done again. During the first EMG the physician didn't do the "shock" aspect of the test so I'm sure my shoulders are not going to like that at all. The past week has been very difficult because my motion has decreased even more, my pain level has increased, my right side is crunching and shifting when I move, I've needed to wear the sling on and off to help my right shoulder but it aggravates my left shoulder. All I can do at this point is take it easy, wear the sling as needed to calm down my right side, cross my fingers that things go back to "normal," and take things one day at a time. Hopefully the second doctor who does my EMG will be much better than the first one.

At the lake with our family dog Daisy waiting for the annual
parade to start that is held every year in our community. Timing is
everything; Daisy was in the middle of licking her nose when
 the picture was snapped. Her tongue doesn't usually
 stick out like that.
 
A fundraising page was created to help with medical expenses. If you would like to donate follow the link below. Thank you!!

2 comments:

  1. I can say you’re an inspiration for other people because despite what you’re experiencing you were still able to see the good side of life. And what’s more important is you did not stop doing what you love to do, such as painting. I am happy that your shoulder blade issue did not hinder you from drawing again. Keep on with your life. I’m certain that you will get better soon. Just follow your doctor’s advice and smile always. :)
    Kristal Byrnes @ COCO Ortho

    ReplyDelete