Shoulder Surgery 15 (Range of Motion)

My range of motion with my arm is improving steadily. I'm even a little ahead of schedule for mobility.  I can raise my right arm straight up, though with effort, and if it has support, I can stretch it up and back. I can hold about eight pounds with my arm outstretched, though the idea of trying that makes my physical therapist nervous. And I can reach behind my back and just barely touch the small of my back. This is max flexibility for some people, but tor reference, I can normally touch either of my shoulder blades with either hand, so I have a ways to go. T--, my physical therapist, says this is the last movement to come back.

The early improvement is partly because of my inborn hyper-mobility (we used to say "double-jointed") and partly because I do a hella lot of painful exercises every single day at home.

Three times a week I trudge into physical therapy and endure the therapist's painful ministrations. I feel like someone who was forced to volunteer for a lab study in pain. I find myself shutting down, pulling inward. My responses to T--, my physical therapist, are quiet and usually about my therapy. T-- often makes attempts at small talk. He kind of reminds me of a chatty barber that way. I give short answers and try to turn the conversation around so he'll talk about himself. I can stay behind my wall.

The clinic sees other patients at the same time, of course. Mondays are the busiest, with about seven or eight other people there when I arrive. Most of them hop around cheerily around the clinic, smiling and laughing.

"I'm here for my torture session!" "You all know everything about pain!" "Okay, I'm ready for the next set!" "Hey, my knee barely hurt that time. Cool!" "Oops! You caught me cheating. Heh heh!"

I don't know how they do it. I hate every moment I'm there. When T-- tells me what exercise is next on the list, I give a silent nod and set to work. I endure pulley stretches or having my arm pulled out of its socket with a sort grim determination. I hate that I spend roughly half my non-working hours dealing with my shoulder, and only get madder when I think about it. Every hour doing this is an hour of my life lost. I push myself, set my back against the pain and shove through it until I'm sweating and gasping solely in order to shorten my PT time. I don't have the emotional energy for cheer.

At one point, T-- said conversationally, "So are you at the point where you can say it all this was worth it?"

I simply said, "No," and went back to stretching.

The pain has decreased. I take Vicodin maybe one day in three or four. I even get brief periods where my arm doesn't hurt, which gives me hope that it's over, until it comes roaring back. At one point, I found myself feeling the pain was . . . normal. Even a good thing. The kind of pain when you pull a scab away--it hurts, but it feels good at the same time. That thought upset me. Pain has become so intertwined with my life that it's become a positive. I punched back hard at that thought to end it.

And I keep working.

Shoulder Surgery 16 (A New Doctor?)

I've detailed how the clinic staff made rape jokes at my expense while I was sedated. My doctor wasn't involved in these jokes, and as far as I can tell, wasn't aware they happened until I told him about them. He was horrified and apologetic--but he put everything on the clinic manager. He refused to get more involved, even when I told him the manager's response to the situation was tepid at best. I'm angry at the clinic staff, I'm angry at the clinic manager, and now I'm angry at the doctor. The last time I had a follow-up appointment with him, I had to have Darwin with me for support. When I go into that office, I get too upset.

The physical therapy clinic is attached to the doctor's office. They're a single business. None of the people there were involved with the rape jokes, and far as I know, they have no idea it happened. They've been nothing but professional and cheerful to me. Except they're co-workers with the people who do, and I've come to realize I'm angry at them, too, for continuing to work with people who denigrate patients. I think it's one of the reasons I shut down when I go in for PT.

So I've decided to look for a new doctor. 

I avoided doing this for longer than I should have. I told myself that it's because the doctor I have performed the surgery and knows my case, that the PT clinic folk have been working with me from the beginning and are deeply acquainted with my setbacks and my progress. A new doctor would only be reading about my case, and not experiencing it. A new physical therapist would look at my records, but they would be the records of a stranger, not someone who they've connected with. 

That's what I told myself, anyway.

But I came to realize that I don't trust my doctor anymore. I don't trust the clinic, either. The clinic manager hired people who mock and denigrate and bully their patients. She didn't require apologies to me from the staff, either. What kind of asshole DOES that? And how can assholes and bullies possibly give anyone quality medical care? When you don't care about your patients, you don't care about what kind of job you do for them. (I did point this out to the doctor, who became quite offended. "I give the best care possible at all times," he said shortly. My thought was, "And why would I trust your word on that? You're on a team of people who don't give a shit." I regret that I didn't say it aloud.)

I also came to realize I was acting a little like an abused spouse. I was avoiding change. I don't know what a new doctor and PT team would be like.  Angry as I am at the current clinic, at least I know what they're like. I know how their scheduling works, I know the PT facility. The place is conveniently located, to boot.

A new team is an unknown, and my shoulder is a serious and scary part of my life, filled with many unknowns. Adding another unknown is frightening.  It would also take up more time. A first appointment with a doctor is a long, long process. A first time at PT is another long process, filled with tests and questions. And pain. ("How far can you stretch this muscle? Does it hurt when I do THIS?")

I can almost hear the abusive husband. "You want to LEAVE ME? Who would take you as a patient? You whine and complain and make stupid demands. And the medical community is tiny. We all talk to each other. I'll make sure they know you're the guy who records procedures and talks lawsuits, and they'll get pissed at you. You were worried about the care you got from us? Wait'll you try someone else, dumbass. Your pain is just beginning."

And while this thinking has a certain amount of logic, it's also self-defeating. 

So I looked up another joint specialist, and found out there's one almost as close by as my current one, and they have an attached PT clinic. Well, how about that? I made an appointment for next week, surprised at how nervous I felt while making the call. And it turned out I had already seen this doctor once, several  years ago, when I was having trouble with my elbow, so I was already in their system. 

I'm still uneasy about changing practices. The abuser is still yelling in my head. I tell myself that going to the appointment doesn't require me to change practices. I can stay at the original, if I want. 



We'll see how this appointment goes.