Shoulder Op

So the other day they went ahead and cut some holes in my shoulder and shaved a little bone out in order to give it more space to move. (Arthroscopic subacromial decompression & ACJ excision arthoplasty -if you are interested)
So now I am ambling round in a painkiller haze and trying to force my poor body to do the physio – it is not co-operating.

Firstly, the wounds are still slightly oozy – apparently they inject extra fluid to make things easier to see (and I think anti-coagulants) which means that my dressings require careful attention. Also it turns out that instead of making my shoulder not hurt, codeine makes me sleepy, cranky, weepy and yet oddly emotionally detached from the pain.
The problem with the fact that I am still in pain is that every one of the 5 different exercises that I am supposed to do 4 times a day is a mental battle where every instinct tells me not to force my body that high up the pain scale and I am drained from the effort.

I have other things to do at the moment godsdammit!

That shoulder thing

My left shoulder started causing me trouble quite a while ago now… about three years ago I guess… and intermittently I try to do something about it.

About Aug/Sept last year I got myself another referral to physio (my 3rd I think) and a promise of some more attention. The local policy appears to be approximately 6 sessions of physiotherapy before they need something new.

This time we were able to make some progress on the underlying issues – above and beyond any basic hypermobility (which was not discussed) the possibility of impingement was raised for the first time (not sure why it wasn’t considered before).
Although I did have a course of acupuncture again, I found that the deep tissue massage and heat treatment were more effective for pain relief and for the first time the suggested strengthening exercises seemed to make a difference – although it was only at the end of the course of physio that they suggested a resistance band to work with.
I was pleased then that I was taking less painkillers and feeling less stiff but determined that this time I would not simply wait another year for another course of physio to prescribed when inevitably all my coping mechanisms broke down and delighted that the physiotherapist was in a position to refer me to a shoulder consultant.
Yup after 3 years I actually went to see someone who specialises in shoulders!

The clinic was clearly quite full of people; some having the rehabilitation after breakages examined, some with sports injuries and a few who probably had arthritis but all cranky and bemused by the self-assessment forms we had to fill in and all sat waiting in the over-hot, loud seating by a hospital cafe.
They sent me (and I think everyone) for an x-ray before letting us see the consultant. The only other time I have had an x-ray that hurt was when I broke my collarbone aged 12 & everything hurt – but putting my arm in that position hurts that is one of the reasons I was there! Then after a series of mobility and strength tests they also did an ultrasound and I was offered something approaching diagnosis.
I was rather troubled by the mobility tests – my range of motion is quite good (its not like the knee that just wouldn’t straighten) but a) that is largely down to extensive physiotherapy and regular exercise and b) it hurts.
I understand that they need to check whether there appears to be some kind of blockage etc but I wonder at what point I am supposed to say ‘please the more of these we do the worse it gets’, I didn’t get the impression that he heard me when I said yes I can get my arm into this position but in my daily life I would avoid it wholeheartedly because it really hurts. And yes, I know it was excruciatingly hot in there, but some of that sweat was from tension and pain.

Still, there was something visible in the ultrasound – I liked the ultrasound; the gel was cooling, the process was not painful and the machine looked pretty nifty. I would really have like to have seen the pictures though.
But, what the consultants could see were lesions from an impingement (which sounds like they are infectious – they aren’t) and what it means is that the bones are essentially rubbing together – hence physio is supposed to strengthen the muscles which hold them apart. They sent me a letter with the technical details which in theory tell a Dr which bits are causing the trouble but didn’t entirely help me work out quite what my shoulder was doing to itself even with the wonders of Google.

So after several hours of waiting and prodding and poking I was offered some ways forward. The plan went as follows: a steroid injection, more physio, a check-up a couple of months down the line, and then possibly another steroid injection and possibly surgery or both…

Steroid injections hurt!

Actually I might stress that some more they really really hurt! According to my letter, there was anaesthetic in the mix as well as the steroids which might explain why I was able to walk home but were definitely not noticeable enough.  [Warning: do not read this next paragraph if you are squeamish about needles]
Part of the problem is that when you stick a needle into a joint you can feel it go in and then you can feel it move around. It honestly felt like it was grinding. I am not a wimp, I am ok with giving blood and getting injections generally, I am used to being in pain but this pain was enough to make me think I was going to pass out. The nurse brought me water and I sat with my head down for ten minutes or so – waiting I guess for the anaesthetic to kick in – at which point the consultant checked I could move my arm (and yes moving it over my shoulder was at that point easier) and sent me home.
Gradually, the stiffness set in. I definitely had a steroid flare up and co-codamol was not touching it. By the following morning I couldn’t raise my arm at all, I could only dress myself in small stages to recover from the intense pain, I couldn’t carry anything, I couldn’t even sit quietly without pain. I was a mess.
Still this too passed and two days later the pain had subsided enough for me to feel normal again. I’d like to think that the following two weeks were noticeably better in terms of ease of pain-free movement but I’m not convinced. To be brutally honest they are going to have to offer me some better improvement than that to make the injection worth going through again… As I type the shoulder is aching and complaining and I am still waiting for the referral for more physio to be acted on.
Sigh.

 

Drat!

So apparently depression has properly been biting my backside the last month or so.
Best laid plans have not come to fruition and I haven’t really been able to see where I am going or why. Mostly I have slept, felt tired and complained about how much shoulder hurts (apparently the new physio exercises are very uncomfortable and not making the days easier), and all i have wanted to do is sleep and curl up in the dark.

So.. um. Sorry

 

Beer Festival 2013

Another year another CAMRA beer festival
A somewhat rearranged and controversial affair this year, it was at least blessed with some sunshine.

For me though it was mostly a reminder that I am older and more broken than I once was.
It seems rather frighteningly that I have been volunteering at this festival for almost ten years. I have done my time at the bar, sat behind membership and at products (kind of a CAMRA gift stall that also does soft drinks); I have run backwards and forwards on traditional pub games, shouting and hustling for all I was worth; I have hefted scaffolding, built bars and lugged firkins; I have worked for a number of years on the cellar team and for plenty of that time I have also worked at the pub.
Double shifts are exhausting.
Somehow every year I forget just how exhausting.

The last couple of years have really taken their toll on me. The new type of breakdown and subsequent anti-depressants reduced the amount of exercise I was taking and helped me pile on the weight [In the c. 4 months I took Mirtazapine I put on over a stone & the same in the 6 months I took prozac before that]. Worse, the last 2 and a half (plus) years of shoulder pain and 9 months of knee issues have left me constantly exhausted and unable to do a fair number of my normal activities.

Some days I notice how much movement, strength and energy I have lost.
It hurts.
Physically and Mentally.

 

 

 

On a related but very different note – I think I get more pissed off every year at the self-righteousness of CAMRA members and volunteers about how much better They could run the festival.

 

Man Flu

I don’t officially have man flu on the basis I have been to work.
But I have had a pretty rubbish cold with an especially irksome cough and feel rather sorry for myself. I’m pretty sure that going to work and uni libraries and stressing about my writing-up has not helped me recover but finances and submission deadlines await no woman.
Now as I start to feel marginally less like the walking dead a weird thought has struck me – it occurs to me that I had not mentally listed joint pain and aching muscles as symptoms of the bug but merely chalked them up to my everyday pain problems with a twist of poor sleep. I know (impersonally/logically/academically) that physical discomfort and painful muscles are usually listed as symptoms of a cold/flu but I can no longer tell what counts as normal and what as ill. I wonder what else this applies to… what level of pain would I would consider ‘normal’ when lifting or carrying and would I damage myself (further?) simply because I expect things to hurt?

Pain is so subjective and I have been conditioned to believe, firstly that mine is less than everyone elses and secondly that it is at best a suggestion you are approaching your limits and at worst a weakness. Mostly I therefore treat it as inconvenience to be endured.
I should know differently.
Not only is pain a warning signal (even a misfiring warning signal is a sign you need to change something) but accepting pain is not the same as merely pretending it isn’t there.
Sigh

On Knees

Or not ON them.. for a while.
Currently revelling in post-surgery laziness. and fretting already.

I am acutely aware of having been poked and prodded and torn and more than a little bit relieved that they were able to find something and I hadn’t been making up my limp and inability to straighten my leg  (although I am little saddened by not having a piece of cartilege to take home). The pain is more manageable than I could have hoped for and already I can feel that there is more movement despite the bandages and swelling. The pics dont show any arthritis either, which is pleasant though surprising.

I am terrified about the physio exercises though, what if i do them wrong, what if i dont do enough? I am notoriously un-dedicated to taking care of myself and there are so many.

wish me lots of luck and send me lots of nagging

 

April Notes & Updates

  • Wrote (more than 12 hrs before the panel started) and delivered my conference paper without imploding. Woop!
  • damn damn damn – still haven’t completed my pesky first chapter- ruddy thing
  • Happy Birthday B!  – I’m glad we spent some time away together. Sea air and your arms – thankyou
  • Well done all. A trip home and no public meltdowns. We were very brave.
  • Dear Gods above, what on earth am I going to give my wife for our 3rd anniversary? Excited and delighted but a little perplexed.
  • We have beautiful pear blossom, tiny onions and enthusiastic tomatoes. Even the potato plants are sprouting. Hurrah for rain.
  • Gave my beer talk – didn’t freeze in front of people I have to speak to regularly. Surprised and pleased.
  • Waiting for physio for my knee/ waiting for miraculous improvement – how am I supposed to lose weight without walking?
  • Trying to decide what the next step on my head-fixing plan is – explorative psychotherapy, ACT, drugs or none of the above? Maybe I am shiny? Maybe I am terrified.
  • Beer Festival eek nearly that time again..
  • oooo Holiday planning!

Knee

Ooops.
Working hard at a party at the pub when kerclunk crunch-my knee went pop and the world tried to go black. Its a long time now since I twisted my knee and I thought it was starting to get stronger
Today however I can’t really walk and I am busy re-inventing my definitions of pain and discomfort. My knee won’t straighten but it is barely swollen . I can hardly walk but on the other hand I can get around the house. At a guess I have torn the meniscus (or perhaps one of the cruciates), hopefully it will basically repair itself in time.

Although yesterday at the party I made sure that I didn’t just wuss out and tried to be useful without getting in the way – a task I’m not convinced that I succeeded in – I was accused of being a stubborn fool after all; today I have made an effort to rest and elevate, ice and warm and take anti-inflammatories but I am still stiff and trying to put my leg up means that my hips and shoulders are seizing more than usual. It is difficult to manage the ordinary pain whilst coping with the unusual.

I hurt.
The answer I think must be sleep.