Archive for April 2014

A View From the Other Side

“So, I was body surfing off the coast of Nigeria…” Not a bad way to start an explanation of why your shoulder is injured; definitely better than my later explanation for my burned and bandaged hand a couple months later: “I was making popcorn in the kitchen when…”

But let’s get back to the shoulder, which has allowed me to take a little walk on the patient side of the doctor-patient relationship. Nine months ago I had the opportunity to go on a ten day medical mission trip to Nigeria where my second oldest daughter teaches school. On the last night, after avoiding cases of malaria, dengue fever, car accidents in the crazy traffic, and other mishaps, I succumbed to a case of poor judgment. We were staying at a little hotel with no toilet seats and spotty electricity but a nice location near the ocean.

It was getting dark and the surf was pounding. It seemed a little beyond what I was comfortable riding, but I thought one good ride would be worth a little risk. As the wave came up behind me I swam for shore and it definitely caught me very strongly. Immediately I knew this wasn’t going to end well. The wave lifted me high up and the water in front of me drew back until I was practically looking at sand. It kind of felt like being held up by a WWF wrestler intent on body-slamming my helpless little frame.

My thought was to not reach out my arms to catch myself because I knew of others who had torn up their shoulders by doing just that. So I tucked in my arms and the wave absolutely pounded me into the bottom. It about knocked me out as I landed on my right shoulder and side of my face and head. As I started swimming for the surface I was amazed at how deep it suddenly felt and how long it took to get to the surface, only to be hit and pushed under by another wave.

I swam as hard as I could for shore feeling completely done in. As I finally trudged up the shore, my normally very calm wife met me with, “You’re bleeding from everywhere!” The sand had scraped off a sizable piece of the skin of my face and scalp, probably taking a few hair follicles that I could ill afford to lose. She later apologized for what was really a pretty understandable reaction with, “Hey, sorry about the freak-out wife thing.”

So, over the next couple of weeks I retold the explanation of my leprous-appearing face a couple hundred times to inquiring patients. Eventually the face healed up. But that right shoulder just nagged along – not severely painful, just achy – except when I tried bowling – then more than just achy.

Like many of my patients I kept figuring it would eventually just get better. I tried some anti-inflammitants, and a few exercises, but no real improvement. Then I got working on a barn renovation with some good heavy power tools. Oh, yah, now my shoulder was talking to me and occasionally screaming at me. Pretty soon minor movements like reaching into my pocket for my keys could light me up with a locked-in spasm of pain.

Ok, time to see my primary care doc and then off to get and x-ray and an MRI when it was obvious that therapy wasn’t going to make this one go away. The report had five items including some of the most common shoulder injuries:

• Rotator cuff tear
• Rotator cuff tendonitis
• SLAP tear (a type of tear of the cartilage cup that makes up the ball and socket part of the shoulder joint
• A ganglion cyst sitting on a nerve – a ball of encapsulated joint fluid caused by the other injuries and probably responsible for the recent rapid increase in pain
• Arthritis – yah, I’m getting old

So, the day after you read this I’ll be getting arthroscopic surgery. My hope is that you’ll be less stubborn than me and get a joint checked out sooner than nine months and when it is only talking to you, not screaming at you. There’s giving things a chance to get better on their own, and then there’s just denial.