Shoulder Surgery 21 (Back To It)

[stevenpiziks]

Yeah, I'm back at PT.

I stopped going a while before we moved. I didn't have time--packing and all--and the PT didn't seem to be improving anything. My shoulder still hurt, my arm was still weak, and it was enormously stressful attending thrice-weekly sessions at the clinic that had savaged and ridiculed me. Even though these therapists weren't the perpetrators, they were still causing me physical pain, and they work for the horrifying place, so my mind lumps them in with the crimes committed against me.

After the move to Ypsilanti was done, I called around to find another shoulder specialist through U of M Medical. This was in June. The earliest appointment they had for a new patient was in September. I didn't like that at all! Living with near-constant pain was bad enough, let alone waiting over three months to address it.

I called the office back every couple days to see if they'd had any cancellations. Finally, one came up in late July. Not ideal, but better than a poke in the eye with a sharp stick, I suppose.

As the day of the appointment approached, I became more anxious. I've noted before that whenever I go to the joint doctor or the urologist anymore, I shut down. It's a defense mechanism. If I don't feel =anything=, I don't feel terror. The problem is that I don't ask good questions when I'm shut down. I've even written questions down beforehand, then failed to ask them. This complicates my medical care, and I was anxious both about becoming anxious (if that makes sense) AND about the appointment going badly because I couldn't pay good attention.

The appointment arrived, and I made my way up to the doctor's office. And there was good news. I didn't shut down. Go me! And the doctor had reviewed my MRI from a few weeks ago, and he said he didn't see evidence of re-injury or poor medical work. The pain came from two sources--an inflamed tendon and a need to open the space in my shoulder, which had been necessarily tightened during the surgery. And there was bad news. I would need a lot more physical therapy.

I almost lost it then, but held it back. I did ask why it was taking so long, and the doctor said it can take a year to fully recover. I get angry again just typing this.

There are physical therapy facilities very near our new house, and U of M Medical's facilities are a bit of a drive, but I was seeing wisdom in having all my medical records in one place, easily reviewed by all medical staff, so I decided to attend U of M Medical.

It was a good two weeks before they had an appointment for a new patient intake. The day finally arrived, and I drove up to northern Ann Arbor, where the facility is located. I was in a surprisingly good mood--I hadn't shut down at the doctor's office, so apparently the reaction came from the people and the place, not the idea of what happened there.

But when I checked in at reception--BOOM. All the energy drained out of me and I sat in a chair, staring at the floor. I had shut down again.

A PT staffer named G-- came out for me, and I went with him, barely looking up. This place is way bigger and clearly handles more than joint problems. They have more varied equipment, including a pool, and lots of staff members bustling about. G-- sat me on a padded table and took measurements of my ability to move and what the pain threshold was, then went into detail about what my PT program would be, and what we were trying to accomplish. I liked this aspect of it. The other clinic never went into this kind of detail. Still, my answers and reactions were short. It got worse when G-- projected that I would need at least three more months of PT. My blood actually chilled and I almost walked out, but that wouldn't make my shoulder better, so I didn't.

G-- took me through an initial set of exercises that emphasized stretching rather than strength. They were fairly basic, and ones I'd done before. I dutifully went through them.

At one point, I pushed myself out of shutdown mode and told G-- what I had gone through at the other place. "I was hoping this place would feel differently for me, but it doesn't," I finished. "I hate coming here. It fills me with fear and anxiety. As a result, I'm not a social patient. I don't make jokes or small talk. I come here to grind through PT and get out."

G-- was appropriately shocked and horrified by what had happened to me and said he understood my reaction. We set up a series of appointments and I left.

The next time I went, a different PT therapist came for me, a woman named D--. I wasn't expecting this. I thought G-- would be the therapist. If G-- had mentioned anything to her, D-- gave no sign of it. I really, really didn't feel like explaining it all again, so I didn't. D-- was very nice, though shut-down me ignored her as much as possible. At one point, she wanted me to lay down on my back on a table with my knees up. There I came more to life. "I can't do that," I said. "It's a trauma trigger and it makes me upset. Can we do this sitting up?"

She said that this exercise wouldn't work from a seated position. Could I try lying down a little?

I finally allowed that we could, as long as she stayed a few steps away, where I couldn't see her. I got through the exercise set. That was the last one, so I left.

Later, D-- emailed me a list of exercises to do at home. I saw this as an opportunity. I hit REPLY and wrote her a note explaining what had happened and how to handle me as a result of it. Send.

Weirdly, sending that email made me less angry/anxious about the PT office. This actually makes sense--writing is the main way I process stuff and make sense of the world. When I showed up for the next appointment, I didn't shut down nearly as much. D-- told me she'd read my email and understood. I nodded, and we went on.

It's been three weeks now. The exercises have changed from only stretching to mostly strength-building. They have me planking again, something I haven't done since the surgery. I hate planking. (Does anyone like it?) Additionally, I can't do it like I used to. Before the surgery, when I was introduced to planking, I could do a bunch of poses and hold them for 45 seconds. Now I'm doing good if I can hold 20 seconds, and I can only do one pose. One. The planking right now reminds me of how weak I've become, and I don't like that. But it's easy to do anywhere and it's efficient, so I do it.

Recently, D-- put me on an assisted pull-up machine. I'd never seen this before. It works with you climbing up to a platform facing a pull-up bar. A stack of weights sit below the platform. They counterbalance your own weight, so you can do pull-ups with a single finger if you want--the platform rises beneath you and holds you up. You can also reduce the amount of counterbalance so you're pulling up, say, a quarter of your weight, or half, or whatever. I can't do full-weight pull-ups, of course, but they're good for the shoulders, and D-- experimented with different weight settings to see where I could handle it.

I bring this up because I think we need more of these machines, especially in schools. Being able to do pull-ups is one measure of fitness. The problem is, you can't build up to pull-ups. You can either haul your entire weight up, or you can't. It's not like doing bicep curls, where you can start at 10 pounds and use heavier weights as you get stronger. But this machine lets you build up. I remember in elementary school, I couldn't do pull-ups. I wanted to do them, but couldn't figure out how to get strong enough to do them. This machine would have let me.

So I'm back to doing PT twice a week at the facility and three times a week at home. For three months.