A wee little surgery

I’ve seen so many orthopedists over the years that I’ve lost count. Yesterday, I went to a new one for my left knee which has bothered me since 1986, after a game of beach volleyball. I came away from that game with a Baker Cyst (a fluid-filled sac on the back of my knee) and was in so much pain that I could only walk slowly and with a limp for weeks. The limp went away, but the Baker Cyst often swelled to the point that it was visible. By 2006, my knee hurt so much that I had a surgical meniscus debridement, which didn’t help and during which (I was awake) the surgeon broke my heart by suggesting that I give up hiking. I’ve since been on various NSAIDS, had innumerable steroid injections, two series of orthovisc injections, and a RFA (radiofrequency ablation). I’m now to the point that I don't even take short walks, and even with that, I'm limping by evening each day.

Those of you who recall my three shoulders surgeries, might suspect that I’m a fan of surgery, and indeed I used to be. “Have a problem—cut it out and get on with your life,” I thought. And indeed, that philosophy worked for the first ten or so surgeries that included the removal of anal polyps, oral cysts,  tonsils, and a whopping neuroma on right thigh. Carpel tunnel repair was a breeze, the first surgery on my nasal septum didn't cramp my style, but that changed when it had to be redone at the Oregon Health Science University in Portland as a part of a massive surgery on my sinuses, turbinates, and septum. I had insisted on remaining awake for every surgery but the tonsillectomy. Then the day came when a surgeon took a biopsy of an osteonecrotic cervical vertebra by putting a scope through my throat, and she said there was no way she would do it with me awake. My combination hernia repair and lymph node biopsy was no fun either, and when the doctor refused to give me adequate narcotics, I went down to his office without an appointment and sat there until he did.

Then came those three shoulder surgeries that included such strange sounding elements as subacromial decompression, supraspinatus repair, biceps tenodesis, humeral head resurfacing, and a partial joint replacement. I was in such pain prior to these surgeries that I had to sleep sitting up with ice packs draped over my shoulders, and I was in such pain after them that I had to sleep sitting up with ice packs draped over my shoulders. I wasn’t even allowed to lift a toothbrush for the first six weeks after these surgeries, and nothing over five pounds for the next six weeks.
The recovery time was between six months and a year, yet my shoulders still hurt so much that I worry that I might have to return to sleeping in a chair. 

So, I’ve lost my faith in surgery as a quick fix. In fact, I'll never again go into surgery with overwhelming confidence that I’ll emerge alive. After all, the odds of dying from a clot, a nosocomial infection, a pierced organ (a risk during shoulder surgery), a medication error, or the incompetence of any one of the scores of people who have the opportunity to kill me are significant.(https://www.usnews.com/news/articles/2016-05-03/medical-errors-are-third-leading-cause-of-death-in-the-us).

The new doc is tall, muscular, and dripping with testosterone. In Peggy’s words, “He’s full of himself.” Indeed, he needed a mop to clean up his arrogance. He walked briskly into the examining room, took my hand, and stood staring into my eyes as if sizing me up, but sizing me up as what—a man? A patient? I was already upset over a fight with Peggy about a missed highway exit, and feeling like a weakling because I’ve needed so many surgeries. This meant that I was hardly in the mood to deal with a doctor who seemed to regard himself as my overall superior about a problem that I’ve had since he was a lad, but since I had waited for months to get in to see him, I had to do my best. It helped that there were things about him  I liked. For instance, he introduced himself by his first name (Brian); apologized for being late; agreed to my requests (more about them later); is highly rated on the doctor-rating sites; and did his fellowship in adult joint reconstruction at the Anderson Orthopedic Research Institute. I considered his profanity unprofessional, but it certainly went with his macho shtick.

After a brief exam, Brian proposed a full knee replacement. I was agreeably surprised because, since I was a new patient, I had expected the same-old-same-old: a steroid shot, a prescription for an anti-inflammatory, a referral to physical therapy, and the words, “We’ll talk again in a couple of months.” 

I made four requests of Brian: that I could remain awake during surgery; that he would give me a steroid shot to help tide me over until August when I’m ready to have the surgery done (which is the earliest he can do it anyway); that he give me whole lot more post-surgical narcotics than I’m already taking (he said he would double the amount for the first six weeks); and that he give me a prescription for a brace. He agreed to these requests, but I didn’t get the brace because the one they had wasn’t as good as the two that I already own (I’m an hardcore hoarder of medical devices).

Brian is my second orthopedist this year. The first was Alex, and Alex advised against surgery because, as he put it, “Your arthritis just isn’t that bad.” Since this contradicted what every other doctor had said (ten years ago, one had even told me that my knee was in such bad shape that it might collapse out from under me), I asked Brian what he saw in Alex’s X-rays that might justify Alex’s opinion. “Nothing,” he said. “Then why would Alex say it?” “Because he’s unwilling to take on difficult cases.” “Me difficult—but why?” Because you’ve been in knee pain for a long time, because you’re in pain from other sources, and because you suffer from depression.” Such factors could put me among the 5% of knee replacement patients who surgery doesn’t help. 

I try to cheer myself by being grateful that I at least have access to surgery, there being millions of people and other animals who have no choice but to suffer until they die, and some of them will die sooner rather than later because their problem makes them unable to support themselves. Yet, I'm tormented by the knowledge that I'll be going  from being unable to do many of the things that I would like to do because I have a bad knee to being unable to do them because I have an artificial knee. That is why I've waited so long to have the replacement, that and the knowledge that in a mere ten or fifteen years, I would have to have the replacement replaced, and that there would be less hope that the revision would work as well. Brian did have good news on that score. He said that the two metal parts of the joint would last me a lifetime, and that the plastic part should last for many years after which it can be replaced in ten minutes. Maybe I did well to put the surgery off for all of these years, but I sure do dread it now. I suppose it makes sense that past surgeries would leave me less fearful of additional surgeries, but the truth is that they make me more fearful. I think of them as like playing Russian Roulette.


Elephant's Child said...

Good luck.
Surgery is something which scares me, having watched my partner have so many. Sometimes it helps, and sometimes the promised benefits never materialise.
The arrogance of doctors infuriates me. Too many of them believe that they are at least demi-gods. And only their innate modesty keeps them from claiming more...

hannah jane said...

I know a handful of people who have 'new knees,' and most are very happy. I recently played tennis with someone who got his new knee about two years ago and he wiped the floor with me. It seems like everyone who's had success was very religious with their physical therapy, which seems totally worth it. I'm sure you will be trekking the hills in no time after your surgery. I must admit that I laughed out loud at the line, "Indeed, he needed a mop to clean up his arrogance." Awesome line.

Stephen Hayes said...

Wishing you a quick and speedy recovery.

Jennifer Rose Phillip said...

surgery is exactly like Russian Roulette. and even tho the doctor was arrogant, the arrogance seems to be justified. the fake knee might actually make you able to do the things you want. that really comes down to physio,determination, and luck. that isnt me being being a hopeful idiot for you, it does actually happen to people that new knees really helps. and your knee could actually be adding to your shoulder pain as stupid as that sounds.

my fake jaw joints were major surgeries, can open my mouth now more then I could but have nerve damage so most of my face is numb. was worth it tho so I don't have to eat sou the rest of my life. and the odd botox injection into the muscles is no big deal

PhilipH said...

You have my best wishes Snowy ... and especially for YOU, dear chap, a little poem I recently discovered in a book of poems by Michel Faber, who wrote them all when he lost the love of his life, his wife Eva.

Of Old Age, In our Sleep

Although there is no God, let us not leave off praying,
for words in solemn order may yet prove to be a charm.
Sickness swarms around us scheming harm,
plotting our ruin behind our back.
Let us pray we may escape attack.

We do not fear to die, to ebb away.
What we fear is endless days
of torture,
forced intimacy
with a body that is not our own;
carnal knowledge
of our cunning abuser, our disease,
who fears no medicine
and hears no pleas.

Let us not leave off praying.
Let us keep our dream close to our heart:
that life is too high-principled
to linger when it should depart.

Yes, let us not leave off praying.
Not for God our soul to keep
but just to die, of old age, in our sleep.

Regards, Philip.

kylie said...

Surgery is a very good thing to avoid but sometimes we are short of other options. I hope your surgeon under promises and over delivers.

I also loved your line about his arrogance

Sue in Italia/In the Land Of Cancer said...

Wow, you have had an impressive amount of surgeries!
Here's to hoping that your confident surgeon delivers and you will be out hiking the trails pain free again. Fingers crossed for you.

Kranhu said...

The people I know who have had knee replacement are glad they did. Without exception. Kris

Snowbrush said...

“The arrogance of doctors infuriates me. Too many of them believe that they are at least demi-gods.”

At least it’s better in that regard than it used to be. I was talking to the pain-control nurse in my internist’s office yesterday, and she said that she had worked with a lot of people whom Brian had operated on, and that he’s really good. I told her that I appreciated her saying that because I mostly knew about him from researching knee surgeons on the Internet. She seemed surprised that I hadn’t asked my internist (her boss) for a recommendation, but what I’ve found is that my internist appears to recommend doctors based more upon how they treat him than upon how they treat their patients.

People often seem to assume that being a good surgeon somehow goes with treating patients badly, as if you can’t be both a good surgeon and a good person. I go to pains to work with doctors who are both, but unless I want to make the two hour drive to Portland, or go to someone at the last big medical group in Eugene, it makes sense to stay with Brian, and then too, it takes month to see a lot of these guys. At least Brian’s arrogance didn’t seem to be accompanied by anything that really would have been a deal killer. For instance, if he had gotten pissy about answering questions, or seemed distant and uninterested, or given me the impression that all he cares about is money. The trouble that I’ve had when I put up with a surgeon who really didn’t seem to give a rip was that, once I got through the surgery, and things weren’t going well, he or she became even more difficult to work with right when he needed him—or her, in one case—most. That was what happened with the doctor who wouldn’t give me enough narcotics after hernia surgery/biopsy, and I ended going to his office and telling the receptionist that I wasn’t leaving until I got some help.

“t seems like everyone who's had success was very religious with their physical therapy, which seems totally worth it.”

I’m a good patient when it comes to helping myself through recovery. There is a time window to how much mobility one can regain, so if the patient blows off PT, that window will be closed, and he or she will never be able to make up the lost opportunity. I met a woman once who was so mad at her husband that I wondered if the marriage was in danger. The problem was that he didn’t do his exercises after shoulder replacement, and ended up unable to use his shoulder. When a person fails himself by not doing the required work, he’s also failing his family.

“Wishing you a quick and speedy recovery.”

Thank you, Stephen.

Snowbrush said...

“Yes, let us not leave off praying.
Not for God our soul to keep
but just to die, of old age, in our sleep.”

I’ll be memorizing this poem, Philip. Imagine if someone had told you when you were a lad that the best you could hope for as you neared the end of your life was that you would die in your sleep! I’m sure I wouldn’t have been able to take it in—or even take it seriously—because time seemed endless. I’m reading a book about the decade of the ‘60s, a decade that started when I was eleven and ended when I was 21. It seemed like such a very long decade to back then, yet my decades now seem to fly past, as if I’m a piece of steel that is being drawn ever closer to a magnet. I suppose that dying during surgery would be somewhat like dying while asleep, except that it probably wouldn’t be a timely death. I recall a patient of Peggy’s who had who just retired from her job, and was looking forward to a happy retirement traveling with her husband. Her breasts were of such a size that she had always felt discomfited by them, so in order to make her retirement more enjoyable, she opted for a reduction. Unfortunately, she threw a clot during the surgery, and died. How does a man go on when his life dies from a simple procedure that was supposed to be a life opener rather than a life closer. I have similar hopes for my knee surgery because even short walks have become a problem for me, so who knows but what I might regain some lost freedom.

“Surgery is a very good thing to avoid but sometimes we are short of other options.”

Yes. Sometimes, surgery is the only option, but it’s certainly good to try everything else first when possible.

“Fingers crossed for you.”

Thank you, Sue.

“The people I know who have had knee replacement are glad they did. Without exception. Kris”

That’s good to hear, Kris. I expect some nerve deadness; that lifting heavy weights won’t be a good idea; and that it will be hard to do jobs that make it necessary to kneel, but that’s not a lot to give up compared to what having a bad knee has already made me give up.

Emma Springfield said...

I am sad to learn you need the surgery but I have high hopes it will be completely successful and allow you to move with more ease. I have problems with my knees also. I want to tough it out until I absolutely have to take care of it. The time is coming. I know you will let us know about how well you can dance when you recover.

joared said...

Well, that's quite a list of surgeries and medical terms. Can appreciate your reluctance to undergo surgery one more time. Expect you're pretty adept by now at weighing all the pros and cons for the various procedures and that's all any of us can do. Meanwhile, hope you experience a minimum of pain and discomfort as you wait to get "repaired".

Winifred said...

Good grief that's a horrendous list of operations. Have to say I've managed to avoid all but a tonsillectomy when I was 5! I had no say in that but would have objected if I could have. That article was a bit of a shocker. A friend of ours died after pretty ordinary surgery a few years ago & we were surprised. We had thought surgery in the US was supposed to be really good. However maybe it's not. My husband had cancer of the oesophagus a few years ago & was treated successfully at the RVI in Newcastle here in the North East of England on the NHS. The surgeon told him that a chap he had seen a few months ago had been sent to the US by a Harley Street consultant (private doctor supposedly top of the tree in London - but obviously NOT). He went there and was treated but the cancer returned quickly. He was then referred to the RVI in Newcastle where the surgeon diagnosed he had been given incorrect treatment. They managed to give him an extra 18 months but could have saved him if he had trusted the NHS instead of private & expensive treatment.

Knee surgery can be very successful a friend of mine had her knee done last year & is absolutely great. She followed the post surgery physiotherapy to the letter & is adamant this really helped.

Love Peggy's expression "Full of himself" it's one my Mam used so I use it too. Thankfully I haven't come across a doctor like that for a very long time. I think the training in patient communication has improved a lot here in recent years!

Take care Snow hope the surgery is a great success & you can get back to hiking.

Snowbrush said...

“I have high hopes it will be completely successful…”

I’m more optimistic now after the supportive comments, and after talking to two nurses who offered that Brian (Jewett is his last name) is a really good surgeon.

“I have problems with my knees also. I want to tough it out until I absolutely have to take care of it.”

Which is what I have done, largely because, as I understood it, the whole darn replacement would itself have to be replaced in ten or fifteen years. Now, if Brian is right, only the plastic component will someday require a replacement because the metal parts will outlast me. Another thought that’s leading me to get the job done sooner rather than later is that other physical problems could come along that would rule out the surgery, and I need the surgery that I don’t want to take any risk of not being able to have it because I delayed a day longer than necessary. Finally, I’m sick of having to try to limit the time I’m on my feet each day because of the pain I’ll be in by evening. I know that patients sometimes ask their doctors when they should get the job done, and that some doctors tell them, “You’ll know when you’re ready.” Indeed, I’m ready, and not just for me, but also for Peggy because she’s gone from having a husband who enjoyed hiking with her to having a husband who won’t even walk around the block.

Another thing to think about in regard to when to have the job done is that pain can sometimes take on a life of its own, which means that it can (I don’t have any numbers for you) continue even after the problem has been removed. One way to know if a knee replacement is going to relieve the pain is to see if a steroid shot helps because since the pain comes from inflammation, then temporarily solving the inflammation problem with a steroid shot should help. Oddly, I’ve had two steroid shots to the knee this year, and the first, which was given by the other orthopedist, helped very little, whereas this one has helped so much that my other knee hurts more than the knee I’m having surgery on. What’s more, this shot hurt less going in, but why? Could it be that Brian is simply that much better? (The other doctor did hit the bone and had to back out a little before he could proceed.) Of course, I know that I might be in pain again in another few days, but for now, the knee feels so good that, if I didn’t KNOW that the pain will come roaring back, I would be balking at having the surgery.

I just wish I had asked about getting the other knee replaced at the same time, but since I haven’t even had it x-rayed, much less had it treated through other means, I’m sure I did just as well to get the really bad one done first. It might be easier on my body that way too, although a lot of people say they were very glad to have the whole thing over sooner by getting both knees done at the same time.

My worst fears are two: death and complex regional pain syndrome (CRPS). Both are rare, but the one ends your life and the other make you wish it were ended, and that’s no joke. Of the various disease-related hells-on-earth, it’s the worst of the worst, and no narcotic will even touch the pain.

Snowbrush said...

“Expect you're pretty adept by now at weighing all the pros and cons for the various procedures and that's all any of us can do.”

Did you know that surgeons didn’t used to be considered doctors but were seen as technicians who did the grunge work prescribed by doctors? My, but the times have changed, with specialists like surgeons being at the top of the food chain, and family doctors being looked down upon (by the specialists) as less stellar individuals who are relegated to doing the grunt work. I think that a part of this is due to the fact that specialists won’t do anything that doesn’t bring them bookoos of money.

“Have to say I've managed to avoid all but a tonsillectomy when I was 5!”

I don’t know how I made it to 19 before I had mine out since I grew up in an era when tonsillectomies were very common. I drove down to a hospital some twenty miles distant and was alone the whole time. The surgery is a WHOLE LOT more painful in adults, and since I didn’t know that I could ask for pain relief, I didn’t get any, and literally spent the night with my throat hurting too much to swallow spit. A child who had his out at the same time I did was eating ice cream soon after awakening.

“We had thought surgery in the US was supposed to be really good. However maybe it's not.”

The most important determinant in a successful surgical outcome is having the job done by a surgeon who does the same surgery many many times per year, which means that the narrower the focus of the surgeon, the more likely it is that he or she will be to do a good job. The U.S. is good in that it offers a lot of choices, and that one can usually see a doctor sooner—and have a procedure done sooner—than in the UK. Because I’m on the government insurance for seniors (Medicare), and also have private insurance that will pay what Medicare doesn’t pay no matter where I go, I can see any doctor (who accepts Medicare) anywhere in the U.S. Unfortunately, the wealthy are now paying upwards of $100,000 a year for insurance that will allow them to go the front of the line even when their need is not as great as someone who was there before them. It’s just one symptom of the rapidly increasing divide here between the wealthy and everyone else. Why anyone thinks that Donald Trump—or his political party is the answer—to this, I have no idea other than possible stupidity. I do know that when people who support him and his party become sick and unable to work, they’re like rats off a sinking ship because, deep down, they know that they could die in the street for all the Republicans Party cares.

“Love Peggy's expression "Full of himself" it's one my Mam used so I use it too.”

One problem with dealing with such people is that it can be hard to tell if their unbounded confidence in their own ability is justified. An excess of testosterone (which I fully believe that Brian suffers from) can cause everything from over confidence to recklessness to violence, so when it comes to having him perform the surgery, I was negatively impressed by what I considered his extreme macho animus. However, I do find enough good in what I’ve learned about him and what others have said about him to allow him to do the job

rhymeswithplague said...

Remember that movie Crouching Tiger, Hidden Dragon? I'm hoping someone will be inspired by your post to make .

The missus had both knees replaced, two months apart, over ten years ago. She has been glad ever since that she had the work done and wishes she had had it done sooner. She did do all the physical therapy suggested. Her brother would not do any of his therapy and had a terrible time after his knees surgeries.

Hoping you have a good outcome.

The doctor's arrogance, or testosterone, or anything else besides his surgical skills, should not matter.

rhymeswithplague said...

Oops, I left out the name of the movie I hope someone will make! It's Anal Polyps, Oral Cysts.

Talk about anti-climactic.

PhilipH said...

In the UK, surgeons are not called Doctor or Dr. but Mr. Some may be called Professor and not Dr. It seems that the term "Dr." is used for medical consultants and some other professions outside of medicine. Is this the case in the States?

G. B. Miller said...

Good luck with the surgery. I'm not a fan of surgeries, since my current medical condition would prevent me from doing rehab properly, which in turn would probably prevent the doctor from clearing me for full regular duty, which would prevent me from returning to work.

So with some of my medical maladies needing surgery, I'll probably wait until I retire.

I Are Writer!

Snowbrush said...

“Remember that movie Crouching Tiger, Hidden Dragon?”

No, I don’t. Could you enlighten me, please?

“The doctor's arrogance, or testosterone, or anything else besides his surgical skills, should not matter.”

You left out ethics, professionalism, and a commitment to those aspects of patient care that don’t bring in the most money. For instance, if a doctor blows-off my questions, it impedes my ability to make good decisions and to take proper care of myself, and if a doctor doesn’t demonstrate professional concern for my welfare, then I think it reasonable to doubt his commitment to do everything possible to help me. There’s a surgeon named Butters at the clinic I’m going to. Butters is supposed to be one of those doctors who are excellent surgeons but have no bedside manner. Some patients say that they don’t need good bedside manner because they’re not children. Well, I think that’s just so much silliness, because it’s not about maturity, it’s about wanting to get the job done right. In the case of Butters, he did a shoulder replacement on a friend, and the friend was left in a LOT more pain after the surgery than she was in before the surgery. Butters’ response was to say that that was just the way things go sometimes, and that she should go home and deal with it. She finally went to another doctor who told her that the new joint hadn’t been attached correctly, and was therefore floating around freely in there. He send Butters a letter saying that Butters needed to stand behind his work. Butters would have known that the job hadn’t been done right based upon all of those post-surgical X-rays, but to admit it would have been a blow to his ego, so he left the patient hanging. Maybe he really is a good technician most of the time when it comes to what he does in the O.R., but he’s a sucky man, and it very much matters. I try to think of surgeons as being like car mechanics. If a car mechanic is haughty and non-communicative, why would anyone excuse him by saying that they’re too mature to expect a mechanic to hold their hand when their transmission fails? I know that doctors aren’t going to feel my pain on a personal level, and it would probably interfere with they ability to help me if they did, but I very much expect them to demonstrate a competence that extends beyond deftly handling a scalpel. I think that the kind of surgeon who people excuse by saying that “he’s a great surgeon but not a great person” is the kind of surgeon who hates his job and/or is just in it for the money. They’re also the kind of surgeon who is the most likely to get sued when the patient reflects upon the fact that he or she put out buckets of money and all they got in return was the shaft.

“Anal Polyps, Oral Cysts.”

Oh, I answer as I read, and this was a separate comment.

Snowbrush said...

“It seems that the term "Dr." is used for medical consultants and some other professions outside of medicine. Is this the case in the States?”

Here, everyone with a M.D. degree is called “Doctor,” but I’m unwilling to go along with it because I see no justification for elevating doctors above the rest of the world’s inhabitants. Many of the physical therapists (physiatrists, I think you call them) I’ve been to have a Ph.D., and people with Ph.D.s are commonly called “Doctor” here in America. However, this does not apply to physical therapists because the M.D.s say it would be too confusing for non-MDs to also be called “Doctor.” Hardly anyone is called “Mr,” “Mrs,” “Miss,” or “Ms,” in America anymore. When I go into a bank, for instance, I’m invariably called by my first name by a nineteen year old clerk who thinks she’s (it’s rarely a he) being welcoming by acting as if we’re buddies. The only time any doctor calls me by any name is usually when we first meet. After that, I’m nameless to them, and this includes my internist who I’ve been going to for decades. I therefore don’t usually call a doctor by any name, but when I do, I use his or her (it’s rarely a she because I prefer males because I typically feel better treated by them) first name. For Brian to have introduced himself by his first name was unusual.

“So with some of my medical maladies needing surgery, I'll probably wait until I retire.”

If you’re not already on it, I’ll just say that I think you’ll like Medicare. I would suggest a supplement (rather than an “Advantage Plan”) to go with your regular Medicare policy (Plan N is good). When Republicans talk about improving medical insurance by turning it all over to the private sector, I remember all of those decades that I had to fight with one insurance company or another to honor their promises. With government handling it, the profit motive is absent, whereas the profit motive is everything with private insurers.

lotta joy said...

I'm glad you found Brian. Maybe you should have requested he wear a brace for his giant ego so it doesn't affect his precision. I went to the best we've got down here and five months later I still cannot lift my arm to the side, or to the back. The therapist said shoulder surgery is THE most painful surgery there is. After all my operations, I agree. I am still sleeping upright and always will. Laying down is impossible because the shoulder joint cannot fit in any position other than straight down. I met you when you were wondering how to keep your icepacks from sliding down in the recliner. I just hope my recliner holds up because it's an ancient Broyhill and knows where my ass fits.

Kranhu said...

I met with a few HS classmates today and one had a knee replacement in Sept and went for a long hike this last weekend, she also can ski again. Another gal had one knee replaced and is having her next one in a month. Both were happy with the knee replacement outcomes.
Thank you for the thank you card! My grand dog is a Dalmatian:)

Snowbrush said...

" I am still sleeping upright and always will."

I found that my best pain relief came with Therapy Gel Ice Packs that are large enough to drape over my shoulders. I keep four of them on hand (in a chest freezer rather than a refrigerator freezer because they stay colder that way), so I can rotate them out through the night. Just remember that they can cause frostbite, and that this will be more likely if you use them while taking painkillers. Peggy says she would never use them, but she just doesn't know. She imagines that she would get by with heating pad, but when I found that heating pads greatly accelerated the pain. The most painful experience of my life was when I had a shoulder MRI, not because of the MRI but because I couldn't bear lying down for even a minute. I was in so much pain that I couldn't stop trembling, and so the tech had to keep starting over, which greatly irritated him. I realized during that MRI that I would break under torture, yet I don't think I handle pain worse than the average person.

"five months later I still cannot lift my arm to the side, or to the back."

Unlike a lot of people, I had better flexibility before the surgeries than I do now, which means that I had them done for the pain alone. All you can do to regain flexibility is to preform your physical therapy exercises to the letter. I don't remember how flexibility progresses, but five months is still early enough that you will hopefully make more gains. If you're doing your exercises and not making any progress, then you need to go back to the surgeon and see what's going on in there.

"The therapist said shoulder surgery is THE most painful surgery there is."

I just knew that mine were very painful for a long time (the partial replacement was the worst--I was told that partial replacements are worse than full replacements), but I never thought about shoulder surgeries in general being the most painful of surgeries. I should think that that designation would go to FAILED back surgeries, but I guess it's not fair to count surgeries that fail. My sister had a knee replacement a few years ago, and was told by a fellow knee patient who had previously had a shoulder replacement, that post-surgical knee pain was minor compared to post-surgical shoulder pain.

"I met you when you were wondering how to keep your icepacks from sliding down in the recliner."

I had two shoulder surgeries in 2009 and another in 2011, but would have imagined that you and I went back further than that. By the way, it's very good to hear from you again.

"Both were happy with the knee replacement outcomes."

It does encourage me to hear of such results as you've reported.

"Thank you for the thank you card!"

I've been regularly using one of your husband's pipes (a bent-stem GBD 508). Since I mostly smoke while doing yardwork, I have no idea what I'll do when winter comes.

All Consuming said...

You've had so much surgery dear. Blimey. I want to be asleep for all of mine, however when I have had to be awake the pain is just unbearable, because they never give enough painkiller or anaesthetic to counter the Fibromyalgia issue.

It sounds good news all in all and I like the latter sound of your doc, he's doing what you want and sounds efficient too, so fingers crossed there, and best to get it done now, because time will fly and afterwards you'll still be young enough to do something exciting with your legs. *nods* X

Snowbrush said...

“when I have had to be awake the pain is just unbearable, because they never give enough painkiller or anaesthetic to counter the Fibromyalgia issue.”

If you were having lower body surgery, a spinal might be an option. With a spinal, you wouldn’t even know you had a lower body, and if you chanced to touch it, it would feel like a piece of hot meat that was not a part of you. It is for this reason that Peggy, as a labor and delivery nurse, saw patients freak-out because they didn't realize how unrelated to them their own bodies would feel.

lotta joy said...

When I went through one of the many CT scans I've been given since landing here, not only was the opening covered in JESUS LOVES YOU stickers (defacing expensive equipment is what I call it) the tech got vicious in ordering me to lift my arm above my head and lay it flat. By the time he finished, my arm was shaking and quivering like I had palsy and I had to take a pain pill in the parking lot. Heat is SO comforting that people think it helps. The minute you remove the heat, the "help" stops. But there's a prolonged period of relief after icing. I just hate the chill. I love you, buddy. I just don't have anyone (and I mean anyone) who writes me anymore, so I lost the yearn to write.

Snowbrush said...

"When I went through one of the many CT scans I've been given since landing here, not only was the opening covered in JESUS LOVES YOU sticker"

That's the South for you. If the same thing happened here, enough people would complain to get it stopped, and depending upon where you had the scan, you might be able to get it stopped there by contacting the Freedom from Religion Foundation. The good thing about CT scans is that they're over in a fraction of the time that it takes to complete an MRIs, but the downside is that each one is the equivalent of hundreds of x-rays. The most pain I ever felt in my entire life came from trying to hold still for a 45-minutes MRI. The tech had to keep starting over because I would move without meaning to or even knowing that I had done so. Pain will do that to a person.

"there's a prolonged period of relief after icing. I just hate the chill."

I found that how much I hated the chill depended upon how bad the pain was, it sometimes being so bad that the chill was nothing compared to the hurting. I'm surprised you can even use a heating pad because they caused me so much pain that I felt like an ant under a magnifying glass with the sun shining through it.

"I love you, buddy. I just don't have anyone (and I mean anyone) who writes me anymore, so I lost the yearn to write."

I'm so glad to hear from you again. I went a month or two without blogging, and I'm still not visiting blogs as much as I used to because it came to seem more like work than fun. When someone visits my blog, I feel obligated to visit theirs, and it's not that I don't want to but that it can get overwhelming. Face-to-face, I no longer have friends to speak of, and if not for Peggy, would probably become a recluse. On the Internet, it's another story, partly because I write better than I talk, and partly because people don't tend to rub me--or me them--the wrong way as much on blogs. Of course, I have had blog friends who went away mad, and sometimes I have been the one who went away mad, but for the most part, I get along well enough with my blog friends that we and I are at least feel pleased by the other's visits.

lotta joy said...

I don't use heat on my shoulder, but while guarding my shoulder I sneezed and threw my back out. Four weeks later and it's hard to tell which hurts worse. I use the heating pad on my back. I'm a walking wrecking ball. My new TENS unit had me hopeful, but I've found out that things only work on your problem if you don't have anything wrong to begin with.

Snowbrush said...

“My new TENS unit had me hopeful…”

Is it powerful enough to make your muscles visibly contract without your consent? Are the pads the right size for the body area, and are you positioning them correctly? Are you using the unit for an adequate time per session. I have an Empi brand unit that I’ve used on my back, shoulders, and knees, off and on for years. When I started using it, I was told that I could make myself horribly sore if I used it too much, and this kept me from using it enough. I eventually started using it more and more for longer periods of times until I could use on a high setting for as much an hour. The worst I ever got in terms of soreness was a slightly bruised feeling.

fiftyodd said...

You must have really good Medical Insurance but I am really sorry that you suffer from depression, but I can see why. Good luck with it all. Soldier on.

possum said...

Wondering how you are making out... Hope all went well - hope all goes well for you.
I was told years ago I would soon need a knee replacement - but I am allergic to most metals and even some plastics. That leave replacement surgeries out. At least you don't have that problem.
Wishing the best for you!

Snowbrush said...

"Hope all went well - hope all goes well for you."

Hey, Poss, the surgery isn't until mid-August because that's when I wanted it, and, as it turned out, that was when the surgeon could work me in.

"I was told years ago I would soon need a knee replacement - but I am allergic to most metals and even some plastics."

If I were you, I would look into the possibility of surgery again (especially if you didn't undergo allergy tests the first time around) because it could be that there are more options now. I googled the problem, and here was the first link that came up: https://www.hss.edu/newsroom_knee-replacement-metal-allergy-patient-travels-hss.asp.

possum said...

Thanks, Snowy... I will definitely consider contacting them...
I do know that I am allergic to titanium... discovered that when my eye Dr suggested titanium glass frames because of the rash and burning from last couple pair of glasses. Boy! Am I ever allergic to titanium! Burned my skin real bad within a half an hour! Gold causes my skin to peel. My wedding ring set is platinum... I can wear them!
So... my fear of more problems than the ones I know about - like the lady in the link you gave me - both causes me to hesitate and have hope at the same time. Now, next question - will my insurance cover it? Or will that get screwed by the republicans... I don't have the insurance our senators have!

Snowbrush said...

"Now, next question - will my insurance cover it?"

I guess you could check in advance and maybe investigate other companies if it doesn't. If you have Medicare, I've no doubt but what you would be covered, and if you have a good Medicare supplement, they're contractually bound to cover anything that Medicare approves. I plan to call tomorrow and be sure that the anesthesiologist for my coming surgery accept Medicare assignment (by which I mean won't charge more than the Medicare approved amount) because people get bit in the butt everyday by assuming that if they have surgery, go to the ER, etc., that everyone in the feeding chain will surely accept Medicare assignment, but there is no law requiring that providers do so, and sometimes different doctors in the SAME PRACTICE have different policies about Medicare. This is probably no where more true than with anesthesiologists. I think that any doctor who practices in a hospital that accepts Medicare assignment should also have to accept Medicare assignments, especially in an ER situation.

Joe Todd said...

Real life is better than any fiction.. Good luck with the surgery.

DDD said...

Wish you speedy recovery!

"that he give me whole lot more post-surgical narcotics than I’m already taking (he said he would double the amount for the first six weeks)"
Please share how you handle so much narcotics!
I was on codeine/acetaminophen for three days, and became constipated. The nurse told me to cut out bananas. I overdid on castor oil, that put me on the other side of the fence for a week.
Have you a plan on how to deal with the side effects when the narcotics doubled.

Snowbrush said...

"Please share how you handle so much narcotics!"

You start building up a tolerance from day one.

"The nurse told me to cut out bananas."

Maybe the nurse was inexperienced, but I've heard worse. NO one warned a friend of friend who went in for a short stay procedure about narcotic-induced constipation, and he ended up in the ER with a bowel blockage in the middle of a weekend night. I would suggest that a day or two before going on narcotics you take two sodium docusate capsules, and that you repeat everyday thereafter, or until you discover that you can get by on less. Flax is also good, but it's just so darn easy to take the docusate with other pills. Another thing you might do is when you're sitting on the pot, and you can tell that the feces is right there at your anus, but you just can't quite squeeze it through, take your fingers and push against the skin just above your anus. You can literally feel the feces through your skin, and if you keep kneading it, it will eventually come through the opening. Enemas are also useful assuming you're able to jump up from the floor and get to the pot in time, and of course, there's always laxatives. I would also suggest that you drink a lot of water because otherwise you'll awaken in the wee hours feeling as dry as a dead horse in the desert.

"Have you a plan on how to deal with the side effects when the narcotics doubled."

Aside from the constipation, I don't have side effects, and I've gotten so accustomed to dealing with the constipation that it doesn't freak me out the way it used to. I would just suggest that you try to find a balance between doing nothing and doing too much. It always amazes me how hard the body tries to find stasis, and it seems to me that, after years on narcotics, they're just not the problem for me that they used to be. I don't even itch anymore, which was something that used to be a considerable annoyance.