The Very Very Long Story of the Shoulder

Well I have been going around and around with my shoulder for the last two weeks.  It still hurts like crazy, which seems just plain unfair. These past 14 days have not been fun. I mean, they have had fun moments which have lasted right up until I get some wild ass loony high jinks notion to do something wacky like turn my head or reach for a shoe or bend or type or drive or some other ridiculous, irresponsible action. My shoulder, who has taken on a personality of its own, and not a pleasant one, doesn’t hold with such goings on. The pain has been – well. I have nearly thrown up several times, come damn close to passing out once or twice and then, the other day, crowning insult, I cried. At work. In the bathroom and nobody knew, but still.

I don’t cry. I cry maybe once every three years and it’s never a good scene. I don’t think I have ever cried at work before and I don’t think I have cried with physical pain since a roofing nail went right through my foot at the age of eight, giving me, as my father remarked, 1/4 stigmata.

This pain has been instructive. I am realizing just how lucky I have always been to have reached my advanced age without ever, before, going through two straight weeks of severe pain. It fucks with your head and that’s even though for the last week I’ve been heavily medicated. The process of getting that medication and all the rigmarole it entails is instructive in its own right, because the health care system in this country is so deeply, completely, utterly fucked that I don’t think it can ever recover. The ACA – not affordable, not care and not really an act! Discuss amongst yourselves! However, this, for posterity and you, gentle reader, is how it all has gone done.

My shoulder started hurting on a Tuesday. April 8 to be specific. That would also be the day when, purely coincidentally I am sure, I moved most of the literature section. On Wednesday, which was my day off and which I consequently spent mostly on the computer, it hurt even more. Therefore I blamed it on the computer, my unyielding wooden desk, broken armed chair and ancient keyboard and figured it would clear up in a day or two. Well. My daughter, who didn’t quite finish OT school, looked at my arm. You have a torn rotator cuff, she said. OK, I said, and went to work where a coworker poo pooed this notion and said, no you don’t, you can’t get one of those without a really bad accident of some kind and you don’t have that. It’s just strained. That day, which was Thursday, I went to work with three ibuprofen in my belly and more in my pocket and on Friday I upped the dosage to four of them every four hours and by the end of the day I was pretty much convinced I was dying.  Also, my stomach was highly uncertain.

On Saturday, therefore, I called in sick. That was how I discovered that not only is a fucked up shoulder painful, it’s also boring. Having one arm is no joke: you can’t really DO anything. You can, however, stroll around the Nature Center on the hottest day of the year so far with your friend Jay taking pictures of animals, which are on view here. So that was lovely but that was also when I really developed what we (Audrey caught it too, the next week) are calling in retrospect the Hangover Virus. I started feeling horribly sick and had to go home. In the middle of all this, Jay called his friend Josh who is a doctoral candidate in physical therapy and Josh kindly diagnosed my shoulder via text message. Text message, it turns out, is not really an ideal tool for diagnosis. Tendonitis, he said, a mild sprain, it’s nothing, it will go away, put heat on it.

I decided I was a wimp and just sort of carried on, ibuprofen and junk food, because I kept feeling like I was going to throw up until I would get these moments of extreme hunger which could only be satisfied with horrible fast food or Chinese or some other hangover cure and which then would revert to nausea in an hour or so. That went on for two more fun filled just barely making it through work days but at last Wednesday, blessed day off, came around again. On this Wednesday, I had a yearly appointment with my gynecologist and I thought, well, sure, it’s a bit higher than her usual purview but perhaps she can help me and, hey, I have insurance now! For the first time in four years! Unfortunately I was an hour late for the appointment because I wrote it down wrong and the office staff almost wouldn’t let me in and then when I did see her, she was missing lunch and disinclined to love me.

Shoulders are not her thing. She didn’t look at it. Probably a sprain she said, oh well, here is a prescription for 800 mg of ibuprofen and one for valium which you can use as a muscle relaxant and oh here are some hormones for the hot flashes and try these, they’re samples for IBS. Maybe get a massage. Bye!

A massage does not sound good when you start feeling a piece of clothing approach your shoulder when it’s still half an inch away. But I am a wimp, I thought, just being a wimp, and even though this hurts more than anything has ever hurt since I crushed three ribs  (that was when the Sisters of Mercy didn’t do xrays,  told me they were only bruised and I was clearly seeking drugs and go away; which I did, to resume hefting cases of wine around the art museum for a gala; years later I had a CAT scan and the doctor said, wow, you really smashed those ribs, you still have scar tissue, that must have been very bad)  I decided I was being an idiot and stop it. Back to work. I did, however, pitch a fit and refuse ever again to lean over a giant laundry bin and lift up big piles of books. That, it turns out, is about the least ergonomic thing you can ever do and for the last month I have done it every day, over and over again. Purely coincidentally, I am sure.

Saturday after work I thought perhaps I would try alcohol as a muscle relaxant because all the valium was doing was making me dizzy and nervous (yeah, I know, I love klonopin and xanax with all my heart; they calm the constant thrum of anxiety that otherwise never ever leaves my bones but valium, for some reason, ramps it up and up, which is probably why at 5 this morning I was sitting in bed worrying about how I will survive a blizzard in 2025 with my grandchildren around me and no fuel.)  Anyway, I thus went to the DeSoto with my friend Jay who, after two drinks, looked at me and said “I am taking you to see Josh right now because this is not OK.”

So off we went to Josh’s very lovely house where he showed me a small skeleton, which was interesting, and made me do some exercises, which were mostly painful, and finally stood back and said, look, my previous diagnosis was really wrong and I am pretty sure you have a torn rotator cuff and need to go get Xrays and probably an MRI.  It felt amazing to have a diagnosis at last and to have had somebody actually LOOK at my shoulder and not just say dismissively, bah. But of course a diagnosis and a cure are not the same.

The next day was Easter Sunday. Urgent care centers are closed on Easter Sunday and I was invited to an Easter Brunch. I was going to make a pineapple upside down cake and bloody mary mix to take with me to this brunch but driving to the store to get the rest of the ingredients hurt so bad and getting dressed hurt so bad that finally I said, fuck this, I am going to the ER to get this party started. How bad can it be? I said, Easter is a safe holiday, no fireworks, no danger, not even much drinking, right? I dithered and freaked out and worked myself into a small panic attack but finally I went off to the ER. Turns out there are emergencies on Easter too but it didn’t really take too long.

First they did an EKG. We worry about left shoulder pain, they said, in women. Oh, I said blankly, but I’ve been having this for two weeks, if it was my heart wouldn’t I be dead by now? Not necessarily, they said, which has given me lots more fuel for panic, let me tell you.  Then they took me into the Purple Waiting Room, which was not purple and was empty. the purple waiting room at the mission erI sat there for a while reading Josephine Tey and worrying and then a nice Xray tech dude came along and took me to Xrays, walking through the halls of human misery, curtains and beeping noises which are the ER. “Can you walk?” he asked me dubiously.
“Yes,” I said, “No, really, it’s just my shoulder, my legs are fine.”
“What do you do?” he asked
“I work in a bookstore,” I said, “Mr. K’s”
“Oh I love that place,” he said, “My dad was a bookseller.”
“Oh yeah?” I said
“Yeah,” he said, “I still blame everything that’s wrong with my back on him.”

They did the Xrays and sent me back to the not Purple Waiting Room from whence I went into an exam room where I was joined by a very nice, very short, PA, which is to say a physician’s assistant. I told her my whole tale of woe including Josh’s diagnosis. “Well,” she said, “I would never argue with a PT, they know more about this stuff than I do, but nothing is showing up on the Xray. We’re a little worried about the EKG though. Any sweating?”
“Look,” I said, “I am a woman of a certain age. I just had a horrible hot flash while they were xraying my shoulder and it was embarrassing. About every hour and a half my temperature goes up into the stratosphere and I pour sweat from every pore. Of course I’m sweating. That’s why I’m on these hormones.” and I showed her the hormones.
“OK,” she said, “I’m 90% sure you’re not a heart patient, you’re not pale and you’re not really sweating badly enough. But there was a little anomaly on the EKG but we just won’t worry about it.* What you probably need is a short of cortisol or steroids in the shoulder.”
“Yes!” I said, “That’s what I think too! Can you please do that?”
“No,” she said, “You’ll have to go to an orthopedic surgeon for that.”
“What?” I said, “Why? We are in a hospital, here. Surely there is someone who can give me a shot in my shoulder. I have insurance and everything.”
“No,” she said patiently, as to a child, “We don’t do that here because there’s always a risk of infection** with joint injections and also, it’s not an emergency.”
“So I didn’t need to be here at all,” I said,
“You could have gone to the Sisters of Mercy,” she said
“They’re closed today,” I said, “and I need someone to make this referral, don’t I, because otherwise there is no way I will even get seen by an orthopedist until, oh, 2016 or so.”
She grinned wryly. “Well,” she said, “Yes.”

She also gave me a prescription for Flexorall, a different muscle relaxant. I haven’t tried it yet because she gave me a lot of warnings with it, such as that I pretty much need to be in bed when I take it since it will fuck me up and then make me pass out and also if I take it with the Valium or a glass of wine I will probably do a Karen Anne Quindlen or something. Therefore I will never take it because I am an abject coward and I don’t want to be in a coma for thirty years, thanks. If I do end up in one, though, kids, make sure you decorate me festively for holidays. And she got me the referral to the orthopedic surgeon.

She then sent me off to the Orange Waiting Room, which was mostly purple and full of sniffling small children who I assiduously tried to avoid because I can’t handle another hangover virus. From there, I went into the business office.

“Your insurance,” said the business lady, “Requests that we collect a $250 copay from you today.”
“That’s nice,” I said, “I don’t have $250.”
“What do you have?” she asked, “How much can you pay?”
“I can give you $50,” I said, sighing a secret sigh for Target, whose money this rightfully is, and I gave her $50 and was assured that I would soon be receiving many, many bills. If I recall my insurance stuff correctly, pretty much none of this will be covered, and Xrays are expensive. So I will almost certainly end up with, oh, around $1000 or more in hospital bills. That I cannot pay or, if I am being a good citizen, I will just pay off for the rest. of. my. fucking. life. Just to add to my other bills, mostly medical, like the dentist. Good damn thing I have insurance! Good damn thing they take $120 out of my post tax paycheck every month! I think it saved me like $12!

Then I left and went to the Easter brunch, which was truly lovely, and drank mimosas  steadily for about six hours, which was just what I needed and by the end of the evening I had more or less calmed down.

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#easter #papercamera

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On Monday morning I went back off to work and explained about the ER and the torn rotator cuff and then I called the orthopedist. Naturally you cannot actually get immediately through to a doctor’s office, it would be asking too much. When I did, the first question they asked was whether I had insurance and what kind it was. Then they put me on hold and cut me off. After we repeated that sequence a couple of times they promised to call me back. Which they did – mirabile dictu – and said they could see me at 4:00, a true and total miracle. Therefore I left work half an hour early and went to sit in another waiting room full of Americans, many very fat, some with children in casts and one very angry and probably insane lady who was yelling into the phone. Have I mentioned lately my theory that everyone has gone insane? I also had to fill out a lot of paperwork, of course, and pony up another $50 as a copay, which means that I don’t know how the target bill is going to get paid or the dogs or me or the kids fed. It is going to be badly tight now. Naturally. What else is new?

I sat there for two hours. Fortunately I had two books with me, the aforementioned Josephine Tey Brat Farrar and a Douglas Coupland book of stories, which was good because I was not, really, in the mood for five year old copies of Golf Digest. At last the waiting room was empty and they took me back to an exam room with a terrifying picture on the door and eventually I read the last line of the last Coupland story and just at that moment an extremely, but extremely, good looking doctor came in. He made me do the same exercises, more or less, that Josh had done.

“I don’t know,” he said, “You have pretty good range of motion. If it is torn it’s a small tear. We’re going to try an injection of steroids directly into the joint and that should do the trick. If not, come back in two or three weeks. Oh, and don’t do any lifting.”

The injection of steroids into the joint was painful. I mean it was painful like I cannot even describe, like you are a vampire and they are driving that stake right in. I mean you do not even want to know what the hell it felt like and even if you are my arch enemy reading this, the evil anti Felicity, I hope you never go through it. It continued feeling like that for some time, like I can still feel it, actually – and driving did not help it at all. Knowing that I was still two hours away from my next ibuprofen dose was also not good so I went directly on over to my auntie’s house.  You see I happen to know that she has a gallon of sweet tea vodka in her freezer and the thought of that vodka got me there through a traffic jam and the buying of lemonade at the quickstop. I had a vodka and lemonade with her sitting on the porch admiring the garden my brother is making in her yard, which is really actually turning out to be quite astonishingly beautiful and finally I calmed down. I went home – this was Monday – and fully thought my shoulder would be all better by Tuesday.

It was not. And now it is Wednesday and it is still not. Not at all. Here’s the thing: I cannot do my job without lifting books. It is just not possible. I am trying – I am getting exercise because I’m carrying one or two books at a time and then running back and forth for more – but I can’t just not use it. It sucks. My life is sucking and I feel like a feeble, useless idiot. I can’t lift my own damn laundry; my neck and back as well as my shoulder hurts now; the ibuprofen just barely dulls it; the valium is making me nervous and all in all this is not good, y’all, just not good at all. To add insult to injury, yesterday morning I had to go off to yet another doctor’s office to get some routine blood work done for the gynecologist.

Remember the gynecologist? I couldn’t eat any breakfast; it took forever to get there; and then he had to use my other arm to get the blood and it was a lot of blood, eeeurgh. The only good thing was that they kept shouting out people’s birthdays and most of the people there were right around my age and they all looked, basically, okay. It’s so depressing when you see people you think are about 237 and then find out they’re the same age as you. Anyway, now I am waiting for the blood results and worrying about those, because among other things I summoned up all my courage and demanded all the tests, the full STD screen that I haven’t had in lo these many years and everything. Granted I haven’t had any contact that would lead to STDs in lo some years either, but still, it scares me. And I expect I will get a bill for that as well because, of course, why not? So that is my lengthy tale of medical woe.

* Yeah she said there was an anomaly in my EKG. It’s just spinning and spinning around in my head, that anomaly. But I still think I would be dead by now if it was serious.

** And don’t let’s forget that possibility of an infection at the injection site in my shoulder! I certainly haven’t, believe you me.

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3 Responses to The Very Very Long Story of the Shoulder

  1. I am so so sorry Fliss. What a horrible hike thru the valley of pain and torture. I wish I could do something to help. That being said, I so admire your direct, beautiful writing. So sorry it takes a disaster like this to get me to read it. Love and as much healing energy as I can muster to you my friend…

  2. Lanette says:

    I have so missed reading your work. Oh how I wish it was fiction. I hope you feel better soon.

  3. Jessica says:

    I too visited the orthopedist but for a break in my wrist. The one armed thing is infuriating. I hope that after 6 weeks I will be able to use it again. I hope you find some relief soon. A little 84 year old lady pulled out in front of me on the road and caused all my injuries so it wasn’t even my fault. Ugh. And she’s 84 so you can’t even be mad at the tiny feeble thing!

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