Tuesday, February 26, 2013
I saw my orthopedist yesterday for a follow-up on the MRI that I had 2 weeks ago. I actually received the report and the CD of the actual MRI last Saturday but I wasn't clear as to what the actual diagnosis would be. There was a lot of medical terminology in the report and I was able to do some research on my own so I could ask appropriate questions yesterday. Keep in mind that researching on the internet can only take you so far without knowing what certain combinations of conditions create.
I had two doctors working with me yesterday. One doctor was a sports injury specialist and trouble shooter for difficult cases (like mine) and the other doctor was a shoulder specialist. I started out with the shoulder specialist and ended up with both doctors in the room with me. It was really interesting to see the way they looked at my MRI and to hear their subsequent discussion. Much of the discussion was way over my head and the shoulder specialist apologized for excluding me and talking in a way that I couldn't understand. The result was that they gave me 2 choices for possible treatment.
The first choice was another steroid shot under the AC joint. The second choice was surgery. Thank goodness I had done some research!!! I asked if the AC joint had grown a hook on the end. The answer was yes and there was also a bone spur. My research told me that once the AC joint grows a hook on the end, the space under it is compromised and narrowed. This causes the bone to rub and tear the rotator cuff which is located under the AC joint. (This is the simplified version of a long explanation) My question to the doctors was, that if we inject under the AC joint, will the space get bigger and prevent further tears to the rotator cuff. The answer was no. I then commented that if it won't make the space bigger, and the compromised, narrowed space was damaging the rotator, what would be the purpose of having the shot. The doctors said that it might reduce the pain. I asked if the shot would dissolve the bone spur and they both said no. Then I said that the problem could only be fixed with surgery. The problem shooter doctor replied, "You are correct, but sometimes people want a non invasive solution." The shoulder specialist said, "In this case, I think a shot wouldn't work and she would be right back in this office within 2 weeks with the same issue."
I made the decision then and there, to have the surgery. Then the two of them dropped the bomb. Since I have a small tear in the rotator and they saw a shadow in another area that could be an additional issue, I may require a more complex surgery. The doctors did some strength testing and some additional poking and prodding. They were surprised at how strong my arm is despite the injury. They determined that the shoulder hadn't frozen at all yet. This is thanks to my wonderful physical therapist who refused to give up on me despite the pain that keeping the joint from freezing brought me.
The final plan is to start with arthroscopic surgery. They will shave the hook off the AC joint, remove the bone spur and arthritis, enlarge the space under the AC joint and examine the damage to the rotator cuff. If the examination shows any issues that need to be fixed, they will do regular rotator cuff surgery.
The arthroscopic surgery will keep me on the sidelines for 6-8 weeks - allowing time for the bone in the AC joint to heal. If they have to do regular rotator cuff surgery in addition to the AC joint repair, the recuperation time is about 6 months. Of that six months, approximately 6 weeks will be with my arm tied to my side to prevent any movement in the shoulder while it is healing.
I was thankful that my doctors were very frank with me. I know that it may be a painful recovery but at least they will fix the problem and stop the pain. (It has taken over 4 years to get a complete diagnosis to multiple part problems.) I am thankful that my neurosurgeon is working with my orthopedists to finally get me fixed. My surgery is scheduled for March 12. To all of my Spark friends, please understand that I will not be very active on SP for a while after my surgery. I will miss everyone and will be back as soon as I can.