I had a recent consult with my primary doc last week. One shoulder was getting much worse, which I'm told can happen as range of motion is restored. The amount it can move around partially depends on wearing down those places in the joint which are irregular. Yes, it's way more complicated than that, and I hope you never have to know all the details. I wish I didn't. They hurt - literally. Just note that as those places get worn away, it becomes easier for the joint to become out-of-joint. Dislocated. The resulting pain contributes greatly to reluctance to continue physical therapy. The required starting treatment, on which future medical decisions about procedures rely, actually becomes counter-productive.
Have I mentioned that my primary has seen my x-rays now and was very... uh...impressed... with the deterioration. (So much for working 29 years in a "man's job". Or better known as getting a living wage.)
Much of my discussion with this doc was to ask for a specific prescription for pain. I don't want a narcotic, or not yet. They can be great - for a while - post surgery while healing takes place. After that, they interfere with life. In my case, they rob this household of a legal driver. I've been the sober designated driver - whether circumstances need one or not - since I got my license. And I mean totally sober. I could tell a tale of a major drunk-to-the-point-of-sick from college days, but nevermind. I wasn't driving yet anyway. For some years after that I might have a couple sips here or there, but it was no hardship to give it up. In fact it was a blessing not to have to even smell it. Narcotics are a great help when I need them. But if I don't, my body has this quirk of reacting to them as if I were allergic. Once I need them again, not a problem. It drives docs and pharmacists nuts.
I've been living on ibuprofin in high doses during various long periods in my life. Recently my shoulders have driven me back to them, and as long as I take them with food, my body is fine. (Lab work agrees.) Mostly the pain is lessened. Lately however this wasn't been working as well as hoped. Steroids don't do a thing. And as stated, I'm not ready for narcotics. Steve's doc solved that problem.
I go into the exam room with him, partly to be his memory of past history, partly to become memory of future instructions, and partly just for support. This doc offered a pain treatment that is doing wonders for Steve, described by this doc as super-ibuprofin. It's called Meloxicam. One pill (instead of up to 16 in my case) lasts a full day, is stronger during that time, and builds up in your system over a week of taking it daily. I tried just one of Steve's and decided to ask for my own prescription.
Yes I returned one of mine to him, which tells you that my doc approved them for me. So much for spoilers. But it had been a terrible week when I saw her, so bad one arm was essentially useless for normal stuff including just keeping still, not to mention it's totally preventing PT. I had PT Tuesday where, after finding out how much backsliding has occurred, my therapist found some new range-of-motion exercises I can actually do despite the pain because the joints don't self-dislocate while doing them. Not a total preventative, but still doable exercises.
Wednesday I called my pharmacy to ask why the delay on my pills.They said according to their records I'm allergic to NSAIDS.
SAY WHAT? I explained how many I currently take with no problems except for my needing something stronger to avoid narcotics. I'd just had this discussion with my primary because her computer flashed when she tried to put the order through during my visit. It seems there is one med I took way back in 1985 that had side effects, and I note I never want to take it again to all my doctors. It's called clinoril, and in a month it caused depression. Stopping it had me emotionally bouncing off the ceiling for a day until it wore off. My doc way back then claimed it didn't have that side effect, but switched me over to Motrin. No problem ever again... until now, when somehow it's categorized as an NSAID and stupid computers think I am allergic to ALL NSAIDS. Nope, just one... if you call that an allergy. I just know I'll never take that particular medication again. The pharmacist changed my status in their computer system while we spoke, and within an hour I was picking up my pills.
Every day gets a little better. Driving for a long day of errands, as Steve and I discovered, is not pain free. Not remotely close. But the PT exercises are getting easier, aka less painful. The muscle loss is going to take more time and work, but now I'm actually back to working on them.
There are two offshoots from needing better pain control. First, I called my son to stop on his way home from work so I could drive him to the local store to help me pick up, transfer in/out of cart and car, a new microwave. Yes, we already have a microwave... up over the stove. It's been excruciating to lift a simple mug of water up into it to heat for my morning instant coffee. Now that one is "resting" though still technically functional. The new one is on the counter by the toaster, and some things are rearranged to accommodate loss of counter space, or converting the top of the microwave to substitute counter for, say, the instant coffee or paper towels much used with the machine. Still in basically the same location, easier to cook with. Steve did have to locate a single multi-plug now that one outlet needed to support three appliances, already at capacity with a toaster and light. Don't worry, we don't use all three at once.
Second, I got a referral back to my orthopedic guy. The appointment is early next month. Both my primary and PT people think it's time to start discussing next steps. According to the "system", that would be steroid shots into the joint, before considering surgery. I fully plan to refuse the shots. Steroids do nothing for me. I had them as injections for my knees, and as pills before starting PT. Useless! As if that weren't reason enough, once one starts those, surgeons refuse to do anything until after 4 months have gone by without them. Hell no!
I will need to check on whether those pointless steroid pills count in the 4 months requirement. Even so, if they do, by the time surgery can be scheduled it's likely that the required time will have passed already. By the time I see the orthopedic guy for the referral, 6 weeks will have passed anyway. That was the end of July.
Meanwhile I have a few exercises to do. Even when the shoulder dislocates now, the pain eases off in 20 minutes or so. That was yesterday, of course. We'll see if the medication has built up enough more to cut that back a bit.