Part of my shoulder therapy mercifully included some interesting pain killers. Or at least that was the theory behind prescribing them. Ibuprofin wasn't cutting it, at least while I was unwilling to bring it up to the maximum dosage. When the knees were busy grinding bone-on-bone for years, because I had to continue walking, I was regularly up to 4 pills at a time, 4 times a day. I've been limiting them to 3 for 3.
Note that I can't recommend that dose to anybody else despite using it myself. All my doctors agreed on that point back before they were replaced due to geographical distance, and several now-local ones even afterwards, in the wisdom of their hindsight for me. I had been able to stop altogether for a while once the knee grinding ended. I started again when the shoulders demanded attention. One helpful doc in Arizona had just finished making that anti-recommendation while he was reviewing my lab work. When he got to the kidney function he noted it was down a bit... before adding my levels were "right on for my age". So much for that warning, eh? The docs all warn against digestion issues as well, but I call mine a "cast iron stomach" and have for decades. Once that final pregnancy was over, it took spoiled food to get it to pay attention.
However, when I took my current primary doc up on her recommendation to see somebody about my shoulders - after delaying long months because I'd heard enough about how painful it was - I was told that PT (physical therapy for those lucky enough to never have needed it) was the mandated first step after X-rays, which had shown severe arthritis in both shoulders. My immediate response was "No PT without pain control." They already hurt enough, to the point where use prompted the shoulder pain to run down the arm to the elbow, and continued use sent it into the thumb, finally tingling the fingertips. PT on top of that? NO WAY IN HELL!
Without batting an eye the orthopedic doc sent a prescription in to my pharmacy... for steroids.
Steroids? Seriously? OK, then. I made my first PT appointment for the time I was taking those, a collection of pills that started off at 6 the first day, 5 the next, and so on, one less per day until they were gone. One card held them all, so if you took them start to finish you knew exactly where you were and what time to take the next. No "did I take that one yet?" The biggest issue was reading the teensey tiny print under the pills to see when to take them. Then just poke the foil and push one out.
The first side effect was terrible! Taste! OMG the bitterest thing I've ever had in my mouth! It was best if I had something to coat my tongue with immediately, but not all the timing of them allowed for that. I eventually semi-mastered the technique of keeping them off my tongue as much as possible on their speedy route down the hatch. Note "possible" does not equate with "perfect." Blecchhhhh! Water does not "cleanse the palate". Be warned.
Day one was 6 pills, from before breakfast till before bed. You'd think I'd get some pain relief after those, right? Hey, want to buy a bridge too? I know where one is for sale.......
Day two was my afternoon start to PT. The only effect so far was morning diarrhea! Wowsa! Six pounds gone in a flash! Yee-hahhh! Maybe I could learn to like this stuff, eh? Who knew it was a weight loss drug? OK, maybe everybody else in the world, but I'd never had any interest in using them for any reason before in my life. And I still wasn't noting any pain relief. With nothing more to lose I gritted my teeth, walked into the PT facility, and met a sweet young thing named Kim. OK, maybe she was 35 or so, but from my perspective, "sweet young thing" was accurate enough.
A quick discussion gave her my history, and some gentle manipulation of my arms verified what I couldn't do. I was correct about them self-dislocating when my arms were raised, even the small amount I could do myself. Trust me, no bragging there about being right, not when it's a sharp increase in pain level. Yep, even on the steroids.
We switched to the rest of the hour being her guiding my arms into different positions and me saying "OW!" when it was time for her to stop. Bless her, she stopped! She brought out plastic angle-measuring things and wrote down what my starting range of motion was. Then followed some stretches, held for 90 seconds each if I could. I confess to pulling back a bit on those as 90 got closer. It seemed a better idea than whining.
We chatted through much of it. She'd been surprised by how flexible and pain free my back was, but was even more surprised by the reason: 6 years of belly dancing way back when. I demonstrated a few things that didn't need anything except back flexibility. No pain. Still lots of motion there though I don't do it any more.
She's pondering looking for a teacher....
Once the stretches were done, she checked my range of motion again. It had improved, as being defined by my ability to move the arms a little farther before the "Ouch". I couldn't actually tell since the ouch was still just as much of an ouch. But she was happy with the possibility of progress. I tried to be too. since she'd explained to me that if they need to do surgery, and providing I wished to have it, they wouldn't even consider it unless I could demonstrate increased range of motion before they even started.
Apparently surgery for pain control is not to be considered. Do you suppose Big Pharma helped put that rule in place? What? Paranoia?
There were 4 more days of steroids, one less pill each day. Pain levels increased to familiar levels, pointing out to me that they had actually been doing some good while I was taking the larger doses. I bet you're trying to be polite and not wonder about the diarrhea being ongoing, eh? Well, my eating habits had no change, but nothing was coming through until 2 days after the pills ran out. And in the next several days I watched the numbers on the scale return to their previous normal. No higher, thank goodness. But as a diet pill those things are a total failure.
Sigh.....
And I seem to be losing the increased range of motion I'd gained with that first visit. I can no longer touch my hands behind my hips, for example. During my PT visit I'd done it for 2 seconds! (Fingers splayed, of course.) I haven't been back to PT but only because they were booked three weeks out, at which (re)starting point I booked three in a row, a week apart. Same weekday, same hour, easy to remember. The stretches are reaching shorter points, except the one against a door frame needed to put deodorant on in the morning. It hurts less as well. Oddly, putting things up into the microwave over the oven is more painful than before.
I think however that I'll be raising my ibuprofin dosage to it's highest for the next month or so. I'm hoping to make progress, but I'm not hoping for more pain. And I'm back to one arm aching just because it's hanging from my shoulder. So I guess those nasty pills had some effect.
Time for that other appointment, the one with the pain doc.