And the Physiotherapist said …

Today I woke early, after a little bit of a restless night. As soon as my eyes were unglued and my neck was unkinked, and my brain was firing on at least three cylinders, I was aware of a tiny tadlet of apprehension.

You see, today was the day for the first physiotherapist appointment following my rotator cuff repair.

For those of you who have never gone through rehab following surgery, I can tell you that it bloody hurts. To illustrate this, here’s an excerpt from a post I did three months after my last rotator cuff repair:

“So far, the exercises have been aimed at gently mobilising the shoulder joint and easing the stiffened muscles and tendons.  I had gentle circles to make, pointing towards the floor.  I had passive lifts (which did indeed hurt OH almost as much as they hurt me), and I had tentative self-powered lifts – raising my arm up to the front and the side, shoulder hitches, elbow rotations – and yes, they were painful too, but at least the instruction was to stop as soon as it hurt and not push it.

Now this sadist health professional has me sliding pieces of paper up the wall which is not only agony on the shoulder, but the elbow too, for some reason.  He showed me how to do it, then watched solemnly as I had a go.

‘Is that as far as you can reach?’ he said, with the vaguest hint of disappointment. ‘No, no, that’s fine.  Really.  You’re doing well!’

Sure.  Sure it is.

Sure I am.

‘Oh well,’ I thought. ‘If that’s the worst, I guess I can manage that.’

But then he led me into the gym.  He hooked me up to a pulley, so that I could use my left hand to pull my right hand upwards.  A sort of self-assisted passive lift, if there is such a thing.

‘Aaaaaaaaaaagghhh!’  I said, with great restraint.

‘Good!’ he said, beaming.”

And that’s what they’re like – they cheerfully ask you to do things which are extremely painful, and then they grin at you when you yell1.

So you’ll no doubt be relieved to hear that today’s physio session went really rather well! I was fetched from the waiting area by a diminutive young lady with dimples whose name was “M”. She looked about seventeen, and told us that while her origins were Italian, she herself was Portugese2. She took me to her little room, dimpled at me, and filled in her questionnaire. She had a look at my healing wounds and pronounced that they looked very nice3, and asked me to take my arm out of its sling.

Then she picked up a metal crutch and advanced upon me, whereupon the torture scenes from various movies flashed before my startled eyes.

In fact, all she wanted to do was to get me to hold it horizontally in front of me using both hands, to test my range of motion. To say I was apprehensive was an understatement, because for the entire fortnight since the op I’d been forbidden to remove the sling night or day except for washing, dressing, etc, and I’ve been firmly admonished to make sure it was supported either by the sling or by my other hand at all times. It felt very odd to allow my arm to hang loose from the shoulder for the first time.

But here’s the exciting thing: using my right hand to actually move the crutch (my left arm being a mere passenger at the other end) I was able to raise my arm up in front of me, out to the side, and even behind me to about a thirty degree angle – and it wasn’t agonising! This was quite startling, because I distinctly remember, back in 2009, turning the air blue when A was assisting me with some very gentle exercises in the early days of my recovery, and tears leaking from my eyes with the pain.

The difference – apart from the nine intervening years4 – is perhaps that the repair on my other arm was open (resulting in a two and a half inch scar across the top of my shoulder) and this one was done arthroscopically. Last time, my upper arm was black and blue (and green and yellow), and this time, it was not.

And this time, I’d already done six months of physiotherapy before I had the surgery, working on strenghtening my deltoids.

Whatever the reason, it came as a big relief to learn that I’m already in a better place after only two weeks than I could ever have imagined.

Still a long way to go, of course, but I’m going in the right direction, and this time, I seem to have picked up a faster ride!

1 They really like it when you yell. I can only assume they think it means that you’re really trying.

2 For some reason, many of the physiotherapists here are very large and gung-ho Australians, so she came as a little bit of a relief. Although it somehow didn’t feel right to be at the mercy of a dainty young thing like M from Portugal.

3 A matter of opinion.

4 The surgery was at the end of 2008 so it’s nine years, and of course, surgical techniques may well have improved during that time.

I have been a very brave girl

MeShoulder-Oct2017

Some years ago now1, I tore one of my rotator cuff ligaments, and had to have it surgically repaired. I blogged about it because it was traumatic, extremely painful, and took a whole year plus a truckload of physiotherapy to get right, and that was also extremely painful. By the end of that time, I pretty much had full use of my arm, but there were still twinges of pain from time to time, and I swore that if I ever did the same to the other arm, I would refuse the op and just fix it with physio.

Well.

Fast forward to 1st June this year. I was clearing up after tenderly tending my hoverfly lagoons, went flying up a 3 inch step in the garden2 and landed heavily and awkwardly, dislocating my (other) shoulder. Much profanity ensued, and after the obligatory six weeks with my arm immobilised in a sling, I set off on the physio trail. It worked, up to a point, and there I stuck. And so, after scans and discussions3 I was booked in for the dreaded surgery, because I’d completely torn two ligaments, and displaced a third, and while I could do an awful lot with that arm, I could not lift it away from my body sideways..

The fateful day – Saturday, 21st October, rolled around, and I admit that I arrived at the hospital in a state of terror and cowardice, and very nearly chickened out. It didn’t help that despite being on a high dose of acid-reducers for GERD, my stomach was pumping out acid like anything – all the stress, no doubt – and I was convinced that I’d wake up from the anaesthetic with a laryngeal spasm4 and die on the spot, and it would all have been for nothing. That’s what happened after the last anaesthetic I had, by the way, except the dying part. Obviously.

But I’m sure you’ll all be pleased to know that I went through with it, and I was fine. The surgeon was able to do the repair arthroscopically, so there is a lot less pain, and I am home and beginning the long road to recovery. When I say ‘there is a lot less pain’, all things, dear reader, are relative, and it still bloody hurts. Oh, boy, does it hurt! But I am managing, so far, without quite as many painkillers as last time, so I am not (at the moment) hallucinating. Is that good? I think it’s good 5

And one of the best things is that I am sleeping okay. Partly, perhaps, because it was a less invasive operation, and partly because I did a lot of research and bought myself a very heavy duty, large, bed wedge to prop me up, and another for under my knees to stop me sliding down the bed6.

The consultant and the anaesthetist were both lovely and very patient, by the way, as were all of the nursing and auxiliary staff throughout my stay. But I still think I was very brave not to turn tail and run from that hospital room.

And I didn’t even get a sticker!

I did, however, get no less than three bunches of flowers from OH, and they were all waiting for me at home when I was discharged. He’d put them into vases, and everything! Aren’t they lovely?

Flowers4MyShoulderFmA-Oct2017

1 2008, to be precise

2 Yes, yes, I knew it was there. It’s been there for fifteen years or more

3 The first consultant I was referred to was a knee specialist and didn’t even order a scan. Then the physio asked for an urgent referral to a shoulder guy, and the doctor’s surgery sent me a copy of my blood results from March 2016, instead

4 Laryngeal spasms are terrifying, and happen when a foreign substance touches your vocal chords – stomach acid, for instance will trigger a spasm, because stomach acid will seriously damage your lungs. Your larynx literally clamps itself shut, so it’s like trying to drag each breath into your lungs through the space between two pages of a damp book. It happened to me after a minor investigative procedure, and didn’t enjoy it

5 Although I did kind enjoy the impromptu opera performances by the invisible people, and OH found the one-sided conversations rather amusing

6 Ah, the wedges … After shoulder surgery, it’s not possible to sleep flat, so you have to find a way to prop yourself up. Last time, I used about five pillows, which kept slipping (which was painful) and if they didn’t slip apart from each other, I slid down the bed off of them (which was painful). This time I have a heavy-duty, 8 inch high firm, long, wedge which I can put my pillow on, and a ‘hill-shaped’ wedge for underneath my knees, so that I don’t slide off it. It’s actually quite comfortable, and it works!