Showing posts with label scapula. Show all posts
Showing posts with label scapula. Show all posts

Wednesday, February 28, 2018

Rare disease day... the perfect date!


Today (Feb 28th) is Rare Disease Day - it also happens to be exactly 6 years ago since I had my scapular muscle reattachment surgery (very rare! I was the 270th person in the world to have the surgery, performed by the surgeon who created it & was the only surgeon performing it in 2012). It was the first step on what is still a long journey of rehab & recovery.

(N.B. I will try to fix these photos at some point, my photo editing programme on my tablet kept stopping; they do show my dimmed screen.... explained below. Not deliberate!)


'Shoulder stuff'


I write this as I am infusing IV antibiotics into the PICC line I've now had for 9 months to treat Lyme Disease - another rare disease... or under-diagnosed, even Google is a bit confused here: 


??????????????????????

Newest Lyme treatment - hard-going, but I think I am slowly...
tentatively... making some good progress


In the past 6 years, following my shoulder surgery, as we 'peeled back the layers of the onion'; I've seen many doctors, surgeons, physiotherapists &  other medical practitioners. I've been given various other rare diagnoses including Thoracic Outlet Syndrome & Complex Regional Pain Syndrome (CRPS/ RSD).  All from a simple slip on the stairs, 'saving myself' as my body weight hung and torqued from one arm - my once-strong arms, wrecked by several years of severe illness, combined with still-hyperflexible shoulders was a bad combination. On my list of identified injuries (suspected incomplete), some chronic or ongoing, others transient: 'inferior shoulder dislocation' (0.5% of shoulder dislocations) - my arm stuck up in the air, still holding the railing about 3 inches higher than I can actually reach. One physiotherapist summed it up best: "if you didn't have skin, you'd have ripped your arm off."  Some other injuries that occurred in that split second: brachial plexopathy & 'overstretching' injuries to my entire upper right side nerve network; various muscle tears, pulls & strains; other soft tissue damage, including damage to my fascia; & bone injuries, including a scapular fracture (they account for <5% of fractures, just FYI). So dear every doctor I may see in my life - if you hear hooves, think freaking unicorn!!


Photo excuse: sometimes being ill means being stuck in bed.
(I did not seek this out for this post!! I did play with silly Facebook filters. 😜)


Just to reinforce this point, in case it needed it, I've started to sweat in colour... neon yellow and light orange, specifically. I'm pretty sure it's linked with my nerve injury, which can cause very localized sweating; although initially I guessed it was perhaps linked to medication - nope! When I eventually decided to ask another crazy question neither my mum (in her professional capacity), my doctor, nor my PT had ever heard of it.  Although the response now is 'of course you probably have it... if it's a thing' ... And guess what?! It is. It has a name: 'chromhydrosis'  (the linguist in me would like another vowel in there).  I hadn't even turned to Google, it seemed so ridiculous; a PT student searched for it and my PT laughed (maybe with kind exasperation?!) as he read "very rare, incidence unknown". So, UNICORN!!


Added to the messy shoulder + Lyme mix has been post-concussion syndrome (/'minor traumatic brain injury' - 'minor' refers only to the amount of time spent unconscious /disoriented); a delayed diagnosis, but caused by my car accident 2+ years ago when my tyre blew out at 70mph and my car did an actual side somersault. Isn't my karma fantastic?! Urgh!  I haven't really talked much about that. I don't think I've written about it on here at all.  It's hard to think about, honestly; but getting some answers I didn't know I was looking for, and realising things I didn't know I'd been thinking (/worried) about has taken up a large part of the past few months.  Essentially I spent almost 2 years just trying to 'power through' a brain injury.  The post-concussion treatment I just started last November has been incredibly challenging, but it made me realise I have many head injury symptoms I hadn't even realised were symptoms - and they've been really severely affecting my life. Knowing they can be treated, and seeing some good improvements in some areas already has actually brought me a lot of relief. Not recognising symptoms in yourself is actually a symptom - I think that is a perfect definition of 'headfuck' - in every way!

It's one (huge) reason I've struggled to blog much... or to read, write, or use my laptop - my 'screentime' has been limited to a smaller tablet screen, dimmed, with an app that removes blue light to prevent my headaches hitting the highest intensity. I'm seeing little signs of improvement, so hopefully I can keep that going and get back to writing again.

 Additionally, the accident sparked my major Lyme relapse (not unusual); this really blurred the lines a lot between head injury symptoms, and fatigue & headaches that Lyme disease causes.  There is a lot I need to untangle - physically and figuratively.
  



Ultimately, I am making progress. I'm extremely grateful for the help & support I have, and access to treatment that is working. I'm grateful for the doctors & medics who think outside the box and look for the crazy things when nothing else makes sense. Progress seems slow, but when I think of how things were a year ago, 2 years ago, 6 years ago... I am still moving forward, I am still working hard, and that is all anyone can ever do.

Real progress!
Working a lot on flexibility,  lower body strength,
and increasing my shoulder & arm movements with supported movement 


There are many types of 'rare disease' & they suffer from reduced funding & awareness because they are rare. Diagnosis takes longer, and treatment is often trial and error - I am well aware!  The majority of illnesses are 'invisible illnesses' (or can be hidden); please, where you can, be kind, choose to listen to someone & believe them, even if they 'don't look ill'; support is sometimes the best thing you can offer a friend.









Friday, October 20, 2017

It's October!

Really, October! I guess most people are well aware of that fact, since it's a very common and normal thing to know...plus shops are full of Halloween 'decor' and pumpkins, for those of us who do need a reminder since I seem to have 3 day weeks (physical therapy) & 4 days sleeping... or close enough! Time seems to just fly past, in one way. Some days do seem reeeeallly long. So it's probably not necessary to remind anyone else, but... my blog, my title, my reminder.... my exclamation mark! My:  'I can't believe I last posted in AUGUST!'

I really thought I would at least manage a blog post a week... then a month.... then, well I guess I slept a lot! (It's healing!)  I have had various ideas - mainly: I should blog with photos, it's easier. So I do have collections of photos from various things we've tried, along with a few stories and I'm aiming to 'catch up' to the end of October... by the end of October 😀.... mainly by organising and posting the assortment of photographs I've been planning to use.   Hopefully afterwards, I will actually manage to take advantage of my good days and engage a bit more !(Although good days are somewhat fewer right now, but I'm hopeful that means we are getting to the deepest parts of spirochaetal infection and pulverising the little Lyme-hell inducing buggers!). 

So, an overview of the past 3 months...

When I arrived here in May, we began 'deconstructing' my body and its somewhat obstinate, definitely obscure, health issues again. We made a plan (by that I mean I had about a dozen medical appointments) and we moved forward ... then we adapted, made a new plan and pushed on with that.... I blogged a few times about what we were doing and... now it's October!!

We kept going... made a plan, pushed on....then we stepped back, puzzled over some stuff, made a new plan and pushed on with that... then.... we remembered why the word plan has never really been the best word dealing with my body and its rollercoaster recovery. We 'decided' (like it was a choice) to go with my gut - which has been pretty damn good in this whole saga; it's so important to remember to listen to your body and trust your instincts when it's your body that you can feel.... screaming at you!

So right now, and for the past several weeks, physical therapy has been purely working with 'how I feel today'. There is no doubt that the ongoing IV Lyme treatment has systemic effects - it's going directly into my blood to target infection at the deepest possible level, and spirochetes can affect the entire body, especially when left to run (spiral/ drill) riot, unchecked throughout the entire body AGAIN - of course it's affecting everything!  


But my PT can "feel a difference" in all my muscles  (good side included) on weeks that the Lyme treatment affects me more (it goes in cycles). That wasn't really something I had thought about, but it's a HUGE validation of something usually only I can feel - most importantly,  it means it's working (torturously!).

So, I have continued to infuse Lyme medication every day, as part of my protocol (I have oral meds and some herbs & supplements too); I have continued to go to PT three times a week - sometimes I make it into the gym-area, mainly for some lower body strength training; other times I hardly move from the treatment bed while knots and spasms are worked out of my muscles; and dislocated ribs and twisted bones are eased back into place. (Yeah, that's fun.)

And so I continue on this path for now - things are so much better than at the beginning of the year - unbelievably so! - but they still have a long way to go. We have positive and encouraging signs that things are working. And I have complete trust in my 'team' of medical professionals here,  who offer such fantastic support - even after all this time.

The photos are more interesting, I promise. And coming soon....!









Sunday, February 5, 2017

Pain relief arsenal...

So far, I feel this year can be summed up by the fact that this photo is pretty much my current "what would you take to a desert island?" answer.  


v
Pain relief arsenal.
It's not magic, but it currently makes pain barely tolerable & it (accidentally!) matches...
#accessorize
#thespikythingshurtlikehell
#theyarenotsquishy
#theydofixdislocatedribsthough
#YAY


I had a few violent 'pain attacks' lately and - sticking with my personal resolution to be more honest - I really feel pain is winning right now. So, here are the weapons in my pain arsenal - most of them go everywhere I go right now.  Find your pain, pick your poison. I present....

My Pain Arsenal:

  1. Tablet organiser case (guess I'm missing the hot pink version!) with a mini 8-compartment tub in it for sorting daily pain meds (no Lyme meds or supplements - this is just the pain box :-/ ). Right now I have 40-50 tablets I take every day in that - types of painkillers; multiple muscle relaxants & anti-spasmodic meds; a couple of different anti-nauseas (I respond to severe pain with nausea..... sometimes I throw up. And that hurts like hell. So I have some serious anti-emetics in there); plus some 'extra-just-in-case' tablets for when Really Bad Things happen (I'll write a 'Really Bad Things' post... maybe a few... little snapshots of my whole 'honesty and pain' thing.... that will be something happy and cheerful to look forward to...)


    N.B. *
    I really should put emojis on my laptop!* Is it really bad I miss them when I type on here?! ( *facepalm*... *ha ha*... ;-) ...)


          From the photo: going anti-clockwise here...

  2. Radian B, my favourite version of deep heat/ icy-hot/ ralgex/ etc. because it also has the perfect amount of capsaicin in it: 0.01%. More than this will make you forget your pain entirely, because you feel like your body is covered in FIRE; 0.01% is just enough to beat all the other heat rubs out there. It puts heat into the muscles; also helps with pain by slightly scrambling the nerve signals sent to the brain. I really love the smell of muscle rubs.... they smell like my Dad used to smell when he came home from work when I was very young (when he'd see a physio after a game); they also smell like gymnastics - the scent of my childhood: muscle rubs for sports injuries!

                                                                                                                         
  3. TENS unit: 'transcutaneous electrical nerve stimulation' (sounds like another torture device, right?!) Actually, at certain times, this thing really is like magic. There are some pains that it doesn't do great with - specific nerve pains can feel like they are just buzzing more; but for some otherwise-untouchable pain, the TENS unit works wonders. It sends little electrical impulses between the electrode pads that can be stuck on the skin, carefully positioned to target specific pain areas. It has different settings- buzzing, tapping, contracting, cycling through them (my 'surprise setting') - and can be set at different levels of intensity. Essentially it 'scrambles' the sensations sensory nerves send back to the brain, scrambling the pain signals by confusing' them with other sensations.

  4. Pink spiky physio ball of torture (not a dog toy). Rub painfully between your aching shoulder blade and a wall to improve circulation, blood flow, break up scar tissue, etc. For more 'fun', have someone else (who can actually reach your back better anyway) rub it to 'desensitise' high pain areas and super sensitive skin, and to break up tightness in muscles.  Generally - roll it anywhere it hurts to improve blood flow and use it to torture yourself in the hope i does some good!

  5. Pink spiky foam roller - this was deceptively packaged........ it is not in the slightest bit 'squishy' - I thought the bumps would be good for clicking the subluxating ribs back into my spine - and it is good for that. But bloody hell, a regular foam roller doesn't hurt! However, it's good for the crazy popping ribs, the assisted movement exercises & adds some unplanned desensitisation stuff just by lying on it!  Which, with increasing pain, I have to admit is a good thing - although sort of in the way broccoli is a good thing when you're 8 - you really don't like it, but 1. it's good for you, and 2. dessert's only an option if you eat it!



    v
    Pain relief arsenal.
    It's not magic, but it currently makes pain barely tolerable & it (accidentally!) matches...
    #accessorize
    #thespikythingshurtlikehell
    #theyarenotsquishy
    #theydofixdislocatedribsthough
    #YAY


  6. Prescription pain cream - a wonderful combo of topical local anaesthetic, muscle relaxant and anti-spasmodic medication.  Made better by mixing with Radian B (& missing from the photo is a genius find - a very soft-bristled, long-handled back brush that I can use to apply the creams and rub them in thoroughly - if the pain cream is properly rubbed in, it's supposed to penetrate up to 5mm into/ below the skin & be absorbed better.  It's pretty hard to do that, so if you're reading this and use a pain cream, a soft bristled brush may be your favourite new thing for a while!

  7.  ICE pack -  they are all resting on top of a giant ICE pack here, wrapped in the grey pillowcase. A perfect metaphor -  ICE is absolutely the foundation of it all.... still!  Sometimes ICE is absolutely still my favourite thing!  There was a time ICE brought; the only respite from the pain; and I do miss that damn ICE  machine, mainly because it's hard to ICE a shoulder - it's a funny, awkward shape and that shoulder pack hit all the right spots perfectly!  ICE  sometimes really is still the best pain relief, especially when my shoulder is irritated and inflamed and and numbing/ reducing swelling is the BEST thing that works - especially with frequently random irritation and swelling which can be pretty horrid if it presses on nerves (um, or more accurately just goes from its normal gentle press to a full blown, limb-numbing nerve squeeze).

  8. Hot water bottles (not pictured; but I have 3) - I'm probably holding one against my ribs in attempt to keep the muscles relaxed enough to breathe properly (because that's always good!)...... my right rib cage no longer expands properly, making breathing difficult at times. I think it should improve, but stretching right now causes further spasming; my attempts are pretty pathetic - I need the passive stretching from hands-on physiotherapy while my muscles can 'relax'.


    *I think the tight rib muscles got a lot worse after my car accident.... which I'm not sure I've mentioned on here....?  I guess that's another one to add to my list of 'Update how UNBELIEVABLE my last 18 months have been'.
    And I mean unbelievable in the sense that I am quite sure if I just sat down and rattled off everything that has happened to me in the past 18 months (/ 26 months / 6 and a half years / twelve years - really, take your pick! ) to someone who does not know me/ has never met me before, they 100% would NOT believe me.


Pinterest even had a perfect graph to represent exactly how every day feels
- and it matches too!
Seriously though, it really does get beyond frustrating.
So many things I wish I could do that just don't happen just now.







Friday, April 10, 2015

Stitches, funky bandages, fainting and more...........


(I started writing at the beginning of the week; bits & pieces added throughout this week - remaining update to follow...)

I am opting mainly for a picture-story update today.

A week ago, I went back to the surgeon to get the remaining stitches out.  This is how they looked prior to the appointment.  I still hadn't seen what was under the paper stitches on my wrist:


I still had stitches between the thumb & index finger; the centre-bottom of the palm, and  the one along my wrist:  



And still loads of ink, making it hard to see!


Since the last visit, I had added a bit of style and colour to my incredibly fashionable splint - who knew they made designer plasters?!



Too fun not to share! Well, if I had to wear a bandage...
.... and colour therapy, right?!


And back to the clinic.........

The one on my wrist under all the 'sticky stuff' (going with that 'technical term', since I got a partial arm wax as it was removed) was pretty cool - the stitches were under the skin, hidden.  There were just two long 'threads' at each end, one was cut then the other pulled everything under the surface out with it (you can just see one in the photo, I had the 'oh can I take a photo?' thought almost too late).



This was pretty cool - the stitches were inside and each end had a 
thread sticking out like the one on the right - she just cut one 
end (then I took the photo) and pulled out the remaining 'tail'  


It looks fine, but considering it was stitched from the inside - and my comparison
is how amazingly fast and neatly the scapula incision (with 18 STAPLES) healed -
 it doesn't look quite as neat as I thought it would - yet.  Lots of aloe vera.



The physician's assistant asked me if I'd had any more "dizzy spells".  "Nope - it's never happened before and it hasn't happened since." .......... until 5 minutes later when she took the stitches out of the incision on my hand and the room  began to swim, I was suddenly drenched in sweat and throwing of layers of clothes around. Well, as much as I am able to 'throw'.  Or undress.  Mostly a scarf and cardigan awkwardly hit the floor.  At least I didn't.  


I DON'T KNOW WHY!!!

BUT I DON'T LIKE IT!!!


Stitches out:



If you zoom in, there's still some in there, apparently
they "grow out". Not especially fond of that info.



The one between my thumb and index finger had been seeping (bleeding really) even while stitched.  My physio told me to clean it with soap and water and keep it covered.  The one on my hand also bled - it wasn't totally joined and pulling the stitches out hurt more than any other time I've had stitches removed. Actually, on all previous occasions (4 or 5) I've never felt more than a slight pull.  Maybe that's why my head started swimming........?  Also not something I've experienced before and I'm definitely not a fan of that.  I've had the 'blackness' that I've written about before, usually from pushing through severe pain, but that's an entirely different sensation.  It still wasn't the sorest part of my body though - unfortunately 95% of the time, my right scapular area still wins there.



HOWEVER..... Unfortunately, this week, my left hand, my 'incidental' little injury, my 'minor' surgical procedure; my 'nothing to worry about - let's just get it over with' little old silly 'wrist sprain' with the simple, happens-all-the-time surgery has been making itself felt emphatically.



The day after the stitches were removed, my hand swelled, with hard lumps; felt like it was on fire; the incision sites became more painful; and I found it more difficult to move (as in while pressing hard and painfully with the other hand 'difficult to move' because of hard bumps; not a pathetic 'oh it's a little bit sore I can't do that exercise' hard to move. Just to be clear!


Top: swelling & discoloured hand  (not quite so clear here)

Bottom: All natural, late-night homemade antimicrobial concoction on dressing:
allicin, colloidal silver, tea tree oil and samento


Which worked really well!  The next day, it looked and felt so much better:

Really!
Swelling was reduced, not as hard, the redness was gone & the incision at my thumb
looked like it was properly healing after a few days with paper stitches


Panic over; disaster averted!  Or so I thought...........But that's pretty much where I ended this blog, and typing takes ages right now -  and sleep is much needed (although not forthcoming!) so until the next one........






Monday, February 23, 2015

t minus zero (if I were still counting)


I haven't been to sleep yet, but it's after midnight so it is officially 't minus 0 days' (if I'd kept counting).  Today I have my follow-up with both my surgeon, Dr G, and my specialist shoulder physio, M.  A quick glance back shows I haven't written for over a week (11 days to be exact) and I guess that I stopped counting at that point.  Things got complicated again and trying to sum them up in a picture seemed impossible.
 

With a week+ between then and now, I can discuss things more clearly now.  I felt like I was completely failing, and I did not want to give up. That weekend, I slept almost constantly.  I managed to wake up to eat, do my exercises,  chat with a friend on skype ……...and that was about it.  My entire weekend. I didn't even manage to leave my bedroom.  I didn't intend to keep falling back asleep, I wasn't having a 'lazy weekend' on purpose, I just couldn't stay awake.  A decade of insomnia seemed to have turned to narcolepsy.  It felt like my body was saying, "I've had enough. ZONK."  My pain was off the charts again, pushing myself through my exercises was feeling more and more like stubborn determination and not necessarily logical thought.




Eventually on the Monday I asked my physio the question I felt had been looming over me for a while, but had started to smother me that weekend: How do I know when I'm working through the pain to my benefit and when am I just pushing so hard I'm causing more damage?
 

There was no doubt in my mind that things did not feel good.  But I did not want to 'wimp out'; to give up because it hurt - if someone could tell me that yes, it was going to be this disabling, but it would produce results, I would continue to push through; but they couldn't.  My physio asked various questions - summary of answers:

  • Literally all I am doing is PT three times a week.  I haven't been anywhere, done anything at all since we started on this 'push'.
  • I'm not eating properly - either asleep to too sore 
  • My pain is so bad that it feels like my body can't cope with it in any way - it just shuts down and goes to sleep: 
    • in the car on the way home, 
    • on the sofa, 
    • (almost) at the dinner table, 
    • always when I go for what previously had been a rest/ lie down after physio on my bed 
    • sometimes I'd even fallen asleep while eating & resting.  
  • None of that was anywhere close to 'normal' even in my already messed up version of 'normal'.
 
It was made pretty clear that was not the goal here.  Yes, I have to do the exercises, I have to work on my range of motion (ROM) and maintain it at a decent level so there is no risk I will end up with my humerus stuck to my scapula again; but if working the muscles in the strained positions were causing such a resurgence in some crazy nerve symptoms, and producing that level of pain, we can work on maintaining the range of motion passively at the moment, and work on getting the muscles to fire at an even simpler level.  It turns out the 'simple' level we were working at is still too many steps ahead of what my body is capable of.  It's a bit like going back to the shoulder shrug  - I haven't been able to use certain muscles properly for a long period of time, so I have to start at the beginning; I have to go back to rebuilding neuromuscular connections and 'teach' my brain how the muscles work again.  There are still too many blurry lines between what is nerve-related and what is 'mechanical' or 'musculoskeletal'.  





It still feels like peeling back layers of an onion sometimes - as we talked, I remembered that this surgery was never supposed to 'fix' everything - it was to see if my ongoing problems were purely nerve issues (which it proved they were not) and to address any 'mechanical' issue the surgeon could address, while also 'clearing out' my shoulder capsule.  All the talk of 'pushing through' and 'making this work', and the fact that he had actually 'fixed' something had whisked me along, thinking I had to make my arm work from this.  A reminder that was never the plan was strangely comforting - I was trying so many things and felt like I was failing at them; but that was all part of the process.  Nobody knows what comes next for me - it is simply about trying to do my best with the way things are right now, in the hope that one thing will lead to another positive step.





I was nervous about even asking.  Not that anyone here has really given me reason to be nervous, but so much emphasis had been placed on achieving certain markers this month and I didn't want to look like I was giving up.  I don't give up on things. I thought long and hard about deciding I needed to change things before the month was up.  My PT agreed with me - he told me he sees the pain on my face when I do the exercises, he doesn't think I'm a wimp....! As it is, I don't feel like I've given up; I feel like I made a sensible decision - after the first day of changing the PT session, I managed to go with my mum for coffee afterwards & a wander round the mall - I did not fall asleep in the car when we left the clinic!  The following day, I woke up; as if my eyes had opened properly and a fog surrounding me had lifted.  I knew I had made the right decision - not the decision to give up; but the decision to change the programme again in a way that I will see more improvement and be working with my body, not constantly fighting against it. 






This seems to be a lesson stuck on repeat.  I appreciate my physios and doctors really don't know what to do about me and are trying their hardest to get me to a better place and I appreciate that so much.  At home I was told it was unlikely to get any better; well it HAS!!  Even now.  Especially considering my arm (head of humerus) is no longer stuck to my shoulder blade (glenoid)!   But I do feel that I am stuck on a merry-go-round where we 'calm things down' then we 'push through' then that fails miserably, so we 'calm things down' and I listen to my body again; then I see stuck; so we try a new thing to 'push through' - it IS trial and error, I get that, and I would much rather it was trial and error than being dismissed and told there is nothing wrong.  The difficulty is how much is causes me to question my body.  Why is this not working?  Is it me?  Am I being a complete wimp?  Should I be pushing this more?  And the most frustrating: why can't I get my body to do this?  Why can't I make it? - the answers to these from various sources seem to be - thankfully! - in my favour: no, you're not a wimp; yes, I can see you are trying; I can see the pain on your face as you try to push through; you are a 'compliant patient'.  



Gotta keep trying!



Even my dad did an impression of me; he'd come to pick me up from PT one day while we were measuring my ROM - [screwed up face, funny voice…] "Get it further, get it further, push it to 160, will it go?" with his arm 'up' in the air (yeah, mine probably looked like that).  Strangely, that impression made me feel a bit better.  My dad's not known for being the most observant person in the world(!) so for him to actually imitate my screwed up 'pain face'; 'pain voice' and determined moment meant that's what it actually looked like.  And in that one moment, of getting my physio to force my arm as far (beyond) where I could tolerate it, I reached the magic number: 160 degrees.  It might hurt like hell, but I have made some progress:


This is still passive movement mainly, as my left arm is doing all the work, 'rolling' the right arm into position - however it does show that my ROM has increased; although you can see the obvious asymmetry in the muscles & movements from some of the views. 
(And ugh, my flexibility has GONE!!)




(Yes, unfortunately, these HURT - but I have IMPROVED!)



Back to the 160 degrees forward extension - can I do it myself?  Hell no.  Nowhere close.  My muscles simply are not 'there' enough again.  We are starting way further back with them than we thought.  I can't tell if I'm moving the right muscles again - but I've been there before and I know that I made progress, so it's not quite as scary this time.  It's just trying to figure out how to 'teach' the brain it can use those muscles again and right now I am barely on the bottom rung of the ladder with that.  My best attempt at explaining it is to say to someone (who is not a gymnast): if I said to you "do a somersault", you know you can't.  You might have seen them a million times on TV or in real life; but you can't simply stand up and do a somersault.  That's about as close as I can get to explaining - I know I have these muscles, and I know what it looks like to raise my arm above my head, but I know what I can and can't do with them - just as you know you can't (or can) do a somersault. I know what I haven't got the foundation for yet; what I need to work on; which links in well with gymnastics analogies of training to do a somersault - even if you're a gymnast, you didn't just somersault one day.  You worked through progressions - that can take years - to get there.  Gymnastic analogies work really well with the regeneration of neuromuscular pathways (in my head anyway....!) because progression is always required.


Go for it! -

https://www.pinterest.com/pin/566820303073377346/
STANDING DOUBLE-BACK
(If you're not a gymnast - this is not 'normal', this is superhuman gymnastics!)



While it seems silly to compare something as simple as putting my hand on my head with a somersault; each thing requires multiple muscles to move in sequence to achieve the physical goal.   I will get there.
 

So as far as reaching my 'goals' for today's appointments - I have, really, even though I wish it felt like more progress; but the big issue was so the surgery was not 'wasted'  -  no re-sticking my arm to scapula, so that's a pretty good thing!  My arm can be pushed to 160 degrees - yes, it is sore, but the fact it goes there without feeling as if it is pulling my scapula through my skin is the major point - it has not 're-scarred' and so for now, passive work will maintain that motion.  I wish I could do it myself, but it still proves the surgery was worthwhile and I have NOT let things slide backwards.


Moving forward there are still lots of things to think about; lots to figure out; and lots to keep working on.  And yet another lesson this month, one that I have 'learned' many times already, but one that is always good to remember:

 


 It can be difficult to keep this in mind when so many different exercise programmes are thrown at you.  It is easy to doubt yourself, to try to squash that voice inside your head that is screaming at you to stop.  There comes a time where you really have to listen to her and not force yourself through agonising exercises without seeing results - especially when other exercises are showing results.  Knowing where that elusive line is has never been easy - in fact I still don't know where it is!  But I have been reminded that my body is pretty in tune with itself and I have to respect that - because I can respect that while still working out ways to keep improving.
 

I'm just keeping my fingers crossed that I can walk away from both appointments later today feeling like my hard work has been worthwhile; that I can take something positive away from each appointment.
 


“Anyone who has never made a mistake has never tried anything new.”

~ Albert Einstein ~

 

Wednesday, December 31, 2014

My 2014: playing catch up


Well, it's been a while since I blogged - there seems to be so much to say, so much going on, and every time I think I'll write an update, something else uproots that and I don't know where to start and where to stop... So with a little bit of inspiration from Facebook, but with a lot more commentary (everyone knows I talk too much anyway!), I thought perhaps this can catch me up with an overview of this year and let me continue on from there.....
  

MY 2014


January


Spent in Pennsylvania with my family, to 'touch base' with my US physios and doctors and to spend some time in the snow, including learning how to survive a polar vortex (layer, layer, layer!) And enjoy my Mum's Burns' supper she hosts for our American friends - always a fun night!


 




February

Luckily I missed the ice storm that came the week after I left - it looks pretty............ but no power in a polar vortex with arctic temperatures is no fun!





Unfortunately that awesome combo of a damp Scottish winter + jet-lag + a bad cold seemed to dominate most of February and I didn't do very much at all.  Other strange symptoms seemed to appear and I was worried I was having a Lyme relapse.  On top of that, my shoulder pain seemed to be at a constant high level, at times spiking above that, rendering me virtually immobile.  It was not good - it would wake me up, spasming in the middle of the night, wondering how on earth I could deal with it.  But I did.  I survived - this year feels like it has been about survival!


Damn right!



March

It turned out that I actually didn't have that jet-lag + bad cold combo, but that I had mould poisoning.  The room I was renting - and had spent almost 24/7 in for a month - had mould growing on the walls, and on my furniture. 







How could I miss this?  I saw the wall when I moved my chair to reach something that had fallen - the chair had been angled across the coldest corner of the room with a long throw over it.  However the mould had spread across the entire wall and even onto a dress IN the built-in-wardrobes.  As if I needed more stress and health issues to deal with.  After three doctors and a microbiologist friend looked at my photographs (and my blue mouth and yellow throat) and told me to "get out"; March was spent searching for my own place to rent, and staying with some wonderful friends who saved me!


For some very, very special people 

The first question was: should I go back to my parents?  My health had deteriorated, admittedly (now I'll say it) I was struggling; I wasn't getting adequate treatment for my shoulder (although I was on a couple of waiting lists at that point), and I was going to have to move anyway….  I (perhaps stubbornly) didn't want to 'run away' from the first problem I encountered, so I found a place quite quickly through a chance encounter with an old friend and decided to give it a go.


Around this time (the exact day I got the lease), I received letter telling me Scotland's 'expert' in brachial plexus issues was refusing to see me:


I had hoped to go home and spread awareness about my injury - most common among police dog handlers and in road traffic accidents.  Unfortunately I did not encounter any intellectual curiosity, only 'experts' who were not interested in new things (this is just one example).

Yes, it made me angry (and a little crazy at the time - refused help without even being seen! A new surgery just dismissed when it might help others); it made me really disappointed in the system we are supposed to be proud of; the NHS that I defend to American friends when they talk about 'socialized medicine'; despite the fact I feel it has let me down repeatedly - and really disappointed for other people who may have the same injury I had.

Getting it fixed; having my surgery - it was purely by chance, just because of where my parents are living just now and just because we happen to have a good friend who is a highly esteemed doctor, with many contacts and a hugely compassionate personality.
I was lucky, that was all.


One total breakdown; one potential treatment avenue no longer available, and one 6-month lease signed.....






April

April I spent treating mould toxicity, slowly improving,;and moving into my own wee flat, enjoying some interior decorating on a budget!

*pics of flat to follow - it's late!*


May

May came with a sense of renewed optimism - finally, an appointment with the Pain Clinic, and some rare Scottish sunshine.



The River Clyde - with blue skies and sunshine!




The pain clinic doctor (an anaesthetist - Dr J) was wonderful - easily the best specialist I have seen at home in relation to my shoulder, a truly caring and compassionate doctor (isn't that supposed to come with the job?!  How sad that it often does not.).  However, Dr J's specialty is pain management - not anything that can 'fix' me; and as he works for an underfunded NHS pain service, my next appointment is April 2015.  Not exactly helpful for me - or, I'm sure, for anyone else trying to address their pain issues.  And I'm sure it's not ideal for Dr J either.  The outcome was to start a new drug (which I'd been avoiding for about 18 months due to its side effect profile - but I needed something to offer some relief, so I decided to try it); and home visits by a lovely occupational therapist. 


She was also  a genuinely caring person, passionate about her job, and I enjoyed her visits and found some of her advice helpful but to be honest, it would be most helpful to someone at the beginning of a major recovery - after 3 years, you really have no choice but to work out how to adapt things yourself.  Of course, when do you know you are going to end up in  rehab with no end point except in major traumatic incidents like car accidents, or failed parachutes…


*TANGENT*
…We ate at a restaurant this summer and the server noticed my neck brace & sling & pillow and asked me what I had done.  Turns out he had also injured his shoulder a few years earlier………. When his f#%$^&g parachute didn't function properly (not for the entire jump, but from a considerable height) - and there he is serving tables.  Seriously universe?!   Was I a psychotic serial killer in a past life?!


June

June was dominated by the now-definitely-hated drug pregabalin (Lyrica).  I agreed to "give it time" and to "let the body get used to it".  I got to week 6 before I properly blacked out for about 7 hours - luckily I was next to my bed when I did so, but when I 'woke up' and went through to the kitchen, I had dropped things and broken things.  I cannot remember another day that same week - at all.  I know I didn't go anywhere, 'clues' suggest I pretty much just slept - luckily.  And that was bye-bye Lyrica.  I will note that while I would not have kept taking the drug after it had such terrifying effects, I also did not feel any pain relief from it - deciding that was not an option for me was a no-brainer.


The next thing that happened in June was really the deciding factor in me coming back to the US to stay with my parents for a while - and even more of a necessity, my physios and doctors here.  I saw the 'top' orthopaedic specialist in our area regarding my shoulder (I'll call him Mr X* ).  Initially I actually saw a different consultant, who worked under Mr X.  He glanced through my notes, asked me to do a few movements and very quickly decided Mr X would want to examine me himself.  That's perhaps the weirdest bit of this little story, for me.


He arranged an appointment with Mr X for the following week.  I had been told wonderful things about him and went to the appointment feeling less nervous than I had previously about appointments at home.  I had a new, fantastic, GP; Dr J at the pain clinic had been wonderful, as had the OT.  I went to this appointment on my own - for the first time in a long time.


Perhaps that was my first mistake... who knows?  Mr X was not interested in my history, my surgery or in helping me improve.  He didn't ask me any questions specifically about what happened; why/ where my pain was; how I would rate my pain; why I was still seeking treatment……… It's one of those appointments I look back over and I wonder how it turned out that way. Could I/ should I have tried to take more control?  (I had been advised to just answer the doctor's questions - my dad's physio friend who was treating me told me that there was "just too much information in [my] head……. It's too much, even for a doctor, to take in at once" - so I went with that).   As a result, he glanced over my file, seemed to think he was supposed to assess my surgery, which I tried to tell him was not the issue now - it worked - but he assessed me that way anyway, yanked my arm about my head - painfully……. Also, it doesn't go above my head, so I don't know what that did - and I can't even move it that far myself.  His ultimate conclusion was this:


"Reassured and discharged."
My US Doctor of Physiotherapy (with 20+ pages of publications on his C.V.) read this letter and asked:
 "Did this guy even examine you?"

(I can swim, by the way.  And I told him this.  And no offence to any water aerobics enthusiasts, but I think I would prefer other things to enhance my social life!  At least for another few decades!)


And there I was again, questioning my own sanity; my own instincts, and my own body.  If two 'top' doctors were just going to dismiss me, was I doing the right thing?  How could I possibly try any harder?  I was not coping - physically, not at all; and of course that has an emotional and psychological toll as well.  Ultimately trying to be there, to fight alone was not good for me in every way.


Rothman Institute, Philadelphia:
"Mission: To provide our community with high quality, compassionate... care.... the results of which will exceed expectations

Lanarkshire:
 "Every effort will be made to keep your appointment to the minimum.  Your cooperation is appreciated.



On top of that, the only medical person who had been of any help at home - my wonderful physio, a family friend - was retiring.  And even he honestly admitted he didn't know what to do with me - my physios here are not sure either, but they have a team, they are collaborating with each other, and they are talking to other surgeons, doctors and physios treating other patients with the same issues - that makes a big difference.


Adding those three things together and factoring in my overall health going rapidly downhill, I 'decided' to come back over here for a while.  It was more a choice of survival, but, that's what I chose: listening to my body - survival.



Trust yourself.

*not his real initials



July

I arrived just before the weekend of the World Cup Final (how dates are remembered in my house - football/soccer) and although my parents knew I wasn't doing well at home, I don't think they were expecting me to arrive in quite as much of a mess as I did.  July was spent mostly sleeping, eating - I was feeling hungry again, after a long time of eating very little, and soaking up the last rays of the sun……when I managed to get out of bed in time.  



Summer flowers bring...........Hummingbirds!
(My mum's photo)


I also made appointments with my specialist physio, M, and with Angelo, my regular physio, and my doctor - both of whom were in agreement that I had gone downhill and that the 'treatment' I received at home was not good.  Project: 'Recover Lost Time' began



August


Project: 'Recover Lost Time' was AGONY!  Cue nearly passing out at physio again while I let my physios torture me.  My pain felt like it was going off the charts, I wasn't sleeping because of it and while my physios seemed to get some increased movement - I couldn't do it on my own.

In between the torture, we had a wonderful guest :-) and managed a trip to the Jersey Shore, which was just so calming and peaceful being able to lie in bed and listen to the waves crash against the sand.  Insomnia even let me catch some beautiful sunrises!





September

The most exciting thing in September was Mum turning 60!



Something to celebrate!


Otherwise my life continued to be as exciting as physio & doctor appointments can be.


October

Project: 'Recover Lost Time: let's push to the limit' produced some……. Results? Answers?  Not exactly sure, but it seemed to provide some evidence that suggests my nerve problems are not my only problems, but that my scapular dyskinesis may be caused by something 'mechanical' as well.  I'm still betting on the frozen scapula - and after several weeks of working continuously with it, my physios do tend to agree, but what to do…….?

















Strange swellings and shoulder/ scapula shapes

Yeah, really, what to do?  I'm a medical mystery.


November

Well, it's not exactly a giant leap, but compared to where I was several months ago, with no clue and no plan, my shoulder seems to at least have a 'pl __' now.  Uncertain though it may be.


Then, almost at the end of the month I did this:



Oooooops.


Me + socks + wooden floor.  And yeah, it was funny at first - well, not really for me, but that idiotic optimism persisted somewhere……… "yeah, this is my 'good' arm……."


Gotta keep smiling.....................
http://www.pinterest.com/gmun22/pain/




December
So……. Up-to-date
(in fewer than 100 pages - amazing!)

December saw my sister & brother-in-law visit for the first time as a married couple.  Wasn't really any different to any other time they'd been, but I think they had a good time!






I saw the surgeon my physio had recommended.  Dr G.  He has done a couple of Dr Kibler's surgeries now, he's in Philadelphia - for a while it looked like a trip back to Kentucky might have been in the immediate future, so that's good.  He has agreed (and yes, agreed is the right word!) to "clear out the junk" from my shoulder.  This is apparently a technical term.  All the clunking and grinding and popping and crunching noises seem to be getting worse by the day.  This is really blocking movement and creating a lot of tightness in my shoulder capsule, which is not good.  It leads to inflammation, which leads to further compression of my nerves which leads to a numb neck/ face/ear/arm, and more pain in my scapula and down into my back and side.  The tightness is also causing some pretty horrific spasming which is pulling my ribs out of position, so I seem to have sporadically dislocating (well, subluxating really, if I'm not being dramatic) ribs which my physio can audibly click back into place - most of the time………. A couple of weeks ago, he tried 8 times to get one rib back in (at my insistence).  It did not want to go.  So it didn't.  Ouch.

More recently I've been doing this really weird thing………. Sleeping!  Clearly not at the right times, since it is 4am right now, but I have been finding it so difficult to stay awake.  Let's really paint the picture  -  on xmas morning, my mum woke me up by physically removing my earplug! There have been other occasions where she has literally taken a cup of undrunk tea out of my hands and I do not stir.  It's kind of freaky.  Then last week, Angelo was doing some work on my neck as usual and I was pointing out the nice big lumps that form where my muscles spasm and pull and he did a little manipulation and 'POP' - apparently I had three twisted cervical vertebrae.  I think they've gone again because I've been a bit dozy for a couple of days again.





I did manage to wake up and enjoy xmas day; but my favourite gift was given to my by my sister on xmas eve.  NEVER did I think I would say a trashy, tacky, xmas jumper would be my favourite thing, but she managed to find the PERFECT one. It really made me smile! I think I'm just going to wear it all the time anyway!  (Although I have told her if I break my leg this year, it's totally on her!)


And in other December news, my now-not-so-funny sprained wrist had an elbow and wrist MRI yesterday.  I have yet again taught myself that you cannot teach yourself how to read MRIs online, even by watching medical school powerpoint courses, so I'll just need to wait until the doctor calls with my results.


And he'll probably talk to my mum, because when Dr G said he would do my surgery, I wanted the first available date -


December 31st… surgery TODAY…. Watch this space.


 
http://www.pinterest.com/gmun22/inspiration-for-recovery/


Oh, and Happy Hogmanay!