Last visit

I’ve been seeing Mark (my orthopedist—that’s him in the photo) every six weeks since my surgery in March, and I always take a written update in order to better describe any changes. This is yesterday’s update.

“Until ten days ago, the pain in my right shoulder was worse than when I last saw you, and the pain in my left shoulder had increased to the point that both shoulders interfered greatly with my sleep. They hurt similarly, as if someone were jabbing them with broomsticks. Percocet only quieted the pain enough for me to sleep an hour or two at a time, and it made me itch considerably even with the Benadryl. My middle back below the shoulder blades continues to hurt day and night, and I can’t sleep comfortably in any position.

“I had long feared that the shoulder pain would become bad enough that I would have to sleep in a chair again. I dreaded doing so, but was glad to know that I at least had a way to escape the worst of the pain if all else failed. All else did fail so, two weeks ago, I returned to a chair only to find that the pain in both shoulders was as bad there as in bed.

“I saw no change after my thirty days on a raw food diet, so I stopped both it and the acupuncture three weeks ago, and started taking SAM-e, MSM, glucosamine, and raw ginger. I am also drinking an extra gallon of water each day and have doubled my intake of fish and fish oil.

“Ten days ago, the nighttime pain in both shoulders began to decrease, and I have since been able to sleep three or four nights without medication, although I still use ice packs all night every night. During the day, my right shoulder, at its worse, still hurts as if a bee were stinging me deep inside the joint with the pain radiating down the outside of my upper arm. At its best, the joint itches so badly that I feel compelled to scratch it, although scratching does no good. The left shoulder feels slightly stiff during the day but is seldom painful.

“The following is a comprehensive list of factors other than arthritis that can cause continued pain after tendon repair. I’m enclosing it on the off chance that you might have overlooked some rare problem.”

“Brachial plexopathy, Cervical radiculopathy, Long-thoracic neuropathy, Neoplasm, Reflex sympathetic dystrophy, Spinal-accessory neuropathy, Suprascapular neuropathy, Thoracic outlet syndrome, Adhesive capsulitis, Articular cartilage defect, Bicipital tendonitis, Instability, Lateral tears, Acromioclavicular arthropathy, Deltoid insufficiency, Rotator cuff defect, Subacromial impingement”


The fact that the right shoulder seems to be improving precludes a joint replacement on that side—the side he operated on in March—and only in my worst moments do I contemplate one anyway because, once the bone is gone, it’s gone forever, and the replacements just aren’t that good. The 70% tendon tear in the left shoulder doesn’t justify the risks of sewing it up in the absence of significant pain or disability. I have had both, but since they seem to be lessening, Mark suggested that we hold off, and I happily agreed. We didn’t schedule another visit.

I left his office with mixed feelings. Although he hasn’t been able to do anything to help me—other than narcotics and sleeping pills—since my surgery on March 27, I took comfort in having at long last found a doctor I could trust and talk to, and I feel a little lonely now that I can no longer say, “I’m under the care of a physician.” Or a physical therapist for that matter. I’m entirely on my own, and I fear that I still have a long way to go. Fortunately, what I have already gone through has made me stronger on the inside even while debilitating me on the outside.