Saturday, September 12, 2020

The Bone Doctor and the Widow


I love my orthopedic doctor even if he is small enough that I could bench press him if I was into that sort of thing. And even if he often sounds like a wind-up doll where you pull a string and out comes a canned speech. In his case his canned speeches are explaining in great detail, what he’s seeing on your x-rays, what he thinks is going on that’s causing your pain and additional steps needed to gather more information before a conclusive diagnosis can be made. When I pulled the string for the last time today at my long awaited appointment and I got the speech where he walked me through the various approaches he and I can take to getting rid of the worst of the problems going on in my arm---needles-and-pins several inches above and below my elbow when I type and the feeling of dead weight at other times.

He quickly ruled out the failed elbow surgery I had back in 1999 that was x-rayed again in 2019 where it was discovered that I’ve got a loose screw off in La-La-Land in my lower arm and another screw that had backed out but is still attached to one of the two bones it originally held together. In my mind I thought that loose screw had migrated and was pressing on a nerve and it was time to get the last resort elbow replacement we talked about back in 2019. After a few touchy-feely tests he didn't even feel the need to x-ray it to know my theory was wrong. Nope, I just have to keep doing what I've been doing for the past 15 months which is not lifting anything above my waist and always keep elbow tucked into my waist when I do pick anything up because the tactic has done a good job of keeping the shooting pains I get when I do forget at bay.

He did take lots of x-rays, though, of my back, neck and upper arm but before taking them Dr. Bones asked me to do a series of things that he said are going to sound silly but would give him some diagnostic information. He really does like to over explain himself which I like because you never have to ask questions or get home feeling like you should have asked such-and-such. He had me hold the backs of my wrists together at shoulder height for two minutes to see if it cause the needles-and-pins. It didn’t. Then he had me stand with my head and shoulders back and, sure enough, the needles-and-pins replicated within seconds but it wasn’t until after he looked at the x-rays that he explained that if the needles-and-pins was coming from a carpal tunnel issue I wouldn’t have been able to do the wrist-to-wrist test. Evidently, carpal tunnel pain can go well up past your elbow.

The head and shoulders test, he said, is backed up with an x-ray showing I have an issue with cervical vertebra C-6 in my neck. He also told me that having the needle-and-pins happening only on the inside of my arm is another indication of a C-6 involvement and it rules out some other causes that stem from more general health issues---heart, diabetes and something else I've forgotten. Still, he’s sending me to see a hand specialist to get tested for carpal tunnel just to make sure it’s not contributing to the maze of stuff going on in my arm. Given how much I type a mild case could be likely. Once that test is done, he’s having me back in the office to map out a course of treatment. In the meantime, he’s putting me on a six day round of prednisone. I love that drug! Every time he’s given it to me in the past all my joints magically feel great and I feel like a 30 years younger version of myself. The prednisone probably won’t do anything to address the needles-and-pins, he says, but either way it's giving him more information to work with. Prednisone is in the corticosteroid class of drugs and according to Google, "It prevents the release of substances in the body that cause inflammation." But doctors don't like you to be on it long term---trust me, I've asked---because it can also suppresses your immune system.

Also going on in my arm was pain and clicking in the shoulder joint. He had shot some gel-like stuff in that joint five years ago and he did a labrum tear surgery in the area six years ago. Thankfully, all the range of motion tests he had me do today indicated the labrum tear repair is still holding up. I was happy about that. My great-niece-in law had to have hers done over already and we had our surgeries done on the same day. As for the bone-on-bone in the shoulder joint that is causing the clicking and pain in my upper arm, the x-rays shows it’s not a large area and he thinks another round the gel stuff will work well again, which I got today. Instant relief and I'll be able to sleep on that side again!

Back to how the cervical vertebra C-6 problem is treated. There are surgical and non-surgical approaches and my bone doctor always starts off with the lowest possible treatment to get the job done and he works his way through them until we find out what works. The first car on that treatment train is medications ending with surgery as the caboose. The other treatment cars in between the engine and the caboose are things like neck braces, injections and physical therapy. And he didn’t say it but I can see a new computer chair in my future. My posture while using my current chair is terrible. Whatever I have to do to get rid of the needles-and-pins I'll do because I can't stand typing like this. It's frustrating!

There are several different surgeries, including an implant fusion, that could be done on my neck but other than touch on the topic Dr. Bones is saving that canned speech for down the road, if needed. My next appointment is early in October which means this whole thing is going to take some time to work through. But let me tell you, I feel like dark cobwebs have been cleaned out of my head. I was so sure I would end up with the elbow replacement with its painful turn-buckle cast and long therapies afterward in the middle of my moving project. Knowing that’s not on the table will go a long way in getting my mojo back. I was/still am seriously getting concerned about the level of depression I’ve been nursing lately. It's not like me to be stuck on the dark side for such a long stretch. ©

48 comments:

  1. Okay, so one of your last sentences where you said you'd been nursing lately, I instantly thought of nursing Babies, I don't know why and it made me LMAO. I found myself doing your exercises he needed to diagnose shit too, I must really be bored out of my mind. Anyway, nothing happened when I did them so the FUBAR shoulder from my Senior fall early into Pandemic Lockdown apparently isn't anything those movements would diagnose. I don't know at this point if I'll ever get it seen to... just contemplating going into a Waiting Room at a Doc's Office or ER gives me an Anxiety Attack! I'm certain there are COVID Viruses floating around everywhere in those places? Tho', to be Fair, they're probably floating around everywhere else I go but it doesn't Panic me nearly as much as places Sick people would surely be without a doubt.

    ReplyDelete
    Replies
    1. Sick people don't usually go to bone doctor's offices plus medical offices, at least here, won't let you in their waiting rooms if you have a temperature so you're probably safer there than in a restaurant. And public service announcement tell us not to go into a doctor's office if you feel sick or have been exposed to the virus. We're supposed to call a number and follow directions for getting tested and are given resource material...whatever that means. You being anxious when out and about is probably a good thing because you'll keep your guard up and not get careless with social distancing, masks and hand washing. That said, I would have a panic attack if I had to go to ER. I've never liked being there before the pandemic.

      Delete
    2. I want to second the low risk of dr visits right now. Quite a few during the pandemic due to foot surgery. An unexpected bonus is that wait times once you are there are extremely short.

      Delete
    3. And I'll second your second about doctor visits. I saw my dermatologist on Thursday (I had a melanoma years ago and have to go for routine skin checks). He shares a waiting room with a radiation oncologist and those patients definitely don't want to get sick because of immunosuppression from their treatments so they had the waiting room closed to everyone. When I got to my appointment I had to phone them and answer questions about my health and any possible exposure to Covid-19. When they were ready for me they phoned me and I had to wear a mask, as did the doctor and nurses. I was in and out in less than a half hour, so that was a plus.

      Delete
    4. That's what a lot of offices are doing around here as well. Makes you feel protected as much as humanly possible.

      I have to do yearly dermatology appointments for the same reason, Had 4-5 removed. I have a friend with one the size of a quarter on her face and I can't believe her family (who she lives with) isn't nagging her to get it removed.

      Delete
  2. well, you and me both...I got a loose screw too. but, a whole different scenario. I guess in other words ... one card short of a full deck. I'm waiting for more to disappear before I see a specialist.

    Hope by October's appointment, you two can set up a plan that will work.

    ReplyDelete
    Replies
    1. We will. Already feel better just knowing I won't have to go through elbow surgery again. Knowing the cause of the needles-and-pins takes the worry and unknown out of it.

      Delete
  3. Being able to cross elbow surgery off the to-do list has to be a huge relief. Maybe even a cosmic relief. It sounds like you have a doc who's both knowledgeable and willing to give real attention to a patient. That's a combination worth celebrating.

    ReplyDelete
    Replies
    1. It is a huge relief. Neither he nor I want to go through it if I can avoid it.

      He's a great doctor which is why I was willing to wait a few weeks to get into him instead of seeking out someone else who didn't know the history of everything that's gone on in that arm in the past. I wasn't worried about the needles-and-pins being caused by a general health issue because I knew it was situational, happening only when I do certain things. I was shocked, though, that it's coming from my neck.

      Delete
  4. So glad you are on the road to finding a solution.

    ReplyDelete
  5. He sounds like a terrific doctor. Hang on to that one, no matter what.

    What a relief to get a diagnosis and a plan. That's all we need, usually; then we can proceed with information and expectation. It's the Unknown that creates the most problems.

    If you find yourself still mired in the darkness, however, I hope you'll find some help from a therapist/counselor and not ignore that part of your health.

    ReplyDelete
    Replies
    1. My bone doctor is much younger than I am so I'm hoping he won't retire before I die. Knock on wood.

      I hear you on the 'mired in darkness' but I don't see talking to a therapist as doing me any good because I Know the source/s of my depression. I'm hoping the election will help with 50% of it and the other 50% is universal to all of us living threw the pandemic. My brand of self-help therapy is writing my blog---letting it all out---and getting feedback and it's free. LOL

      Delete
  6. I really like your small wind up doc. Wow what a breath of fresh air. He took the time, manipulated your bones and offered non surgical fixes. BTW, I am a huge proponent of the keeping your elbow close. I had shoulder pain for 3 years and that was the one thing that worked perfectly and was so simple.
    Keep us informed on this super doc and your progression.

    ReplyDelete
    Replies
    1. Isn't it amazing how simple, free and easy it is to avoid pain when you keep your elbow close to your body. I don't forget much anymore but when I do I get shooting pains that last for 15-20 minutes afterward.

      It's funny, but just paying attention to my posture while sitting and typing has cut down on the needles-and-pins and I know it's not the Prednisone because I just started it this morning. (Had to put it off because of the flu shot.)

      Delete
  7. I'm so happy to hear the doc visit had a positive outcome! I hope you continue on an upwards mental trajectory too. The blues aren't fun.

    Hugs,

    Deb

    ReplyDelete
    Replies
    1. Thanks! Virtual hugs back at you. You are my role model for a successful relocation.

      Delete
  8. Glad you have a doctor who takes the time to explain everything to you and explore every solution. You don't often find that these days - doctors are sometimes in a rush with so many patients to see. Hope you will find your cure. I have been so down and can't wait for the election to be over so we can either celebrate (hopefully) or prepare ourselves for 4 more years of tweets and lying (ugh!) I have a hard time motivating myself each day. We will hang in there somehow - your posts help! Thanks!

    ReplyDelete
    Replies
    1. He's a keeper.

      Like I commented to Nance above, 50% of my downer mood will be lifted if we get a new president. But I'm not counting my chickens before they're hatched because I did that with Hillary. I'm pretty sure if Trump wins I'm going to check out entirely and hope his fans suffer the consequences right along with me of living in a country where our very democracy is coming undone.

      Delete
  9. It sounds like you have a great doc, as others have said. And I completely understand the relief of not needing that surgery. Yikes. It's always amazing to me how they can do a few things and rule out many of my biggest worries. If my shoulder continues to tweak me off and on (nothing like yours, but annoying nonetheless), I may PM you for his name. Like you, I love the idea of my docs being young enough to outlive me. I said that to my GP once and it seemed to make him uncomfortable. LOL.

    I'm with you on the mental health aspect of this election. Driving around this area and seeing Trump signs makes me crazy. I need to wander into another area of town and find more Biden signs. Even if Biden wins, I worry about the insanity of Trump's reaction and the turmoil he will cause. ARGH. I think I'll eat something. ha!

    ReplyDelete
    Replies
    1. The Trump supporters are very visible around here, aren't they. Like you, I don't think the election---if Biden wins---is going to be the end of all the nastiness and him trying to drum up drama and discourse among his followers. But it will be a good start towards civility again.

      Delete
  10. I had a ruptured disc (herniated it is also called) and it caused the same thing. They made me do exactly like you with all these funny things and all the while thinking, my legs like this make a difference? But I did them and it appeared to explain to them why I was getting this. I had a ruptured disc and an MRI showed it. Sadly that meant surgery but immediatley no pain or tingling. I was so scared yet it was the best thing I did for myself. I hope you get some good answers. Trump has done a number on us all. We will go down if he returns and it scares me shitless. SAdly I recall learning about Nostrodamus telling us about him. it's hard not to be depressed knowing all we know.

    ReplyDelete
    Replies
    1. Back and neck surgery does sound scary but without as long of a recovery as with the elbow replacement so I went home happy which might be short lived when I get the canned speech about the surgery choices. LOL Glad to know yours went so well.

      It's scary that he could again win the electoral college by just a handful of votes in key areas (around here and other swing states) but lose the populate vote again like he did with Hillary. We can't let our guard down now, we need to keep speaking out.

      Delete
  11. Boy do we wish there were more of his kind! Most docs are pretty good about not rushing anyone into surgery, but not all are good at 'splaining what's going on. The pins and needles business is the kind of thing that really messes with quality of life. We're all dealing with varying degrees of changes that do that, but some are more tolerable than others!

    ReplyDelete
    Replies
    1. Me too on the 'splaining' part...well, on the needles-and-pins messing with the quality of your life as well. I'm usually pretty good at dealing with stress but for everyone it's gone on so long with the pandemic and politics. I've just reached the edge of my envelope.

      Delete
  12. Surgery can be scary even run of the mill surgery, the older we get more likely we going to need some sort of surgery.

    ReplyDelete
    Replies
    1. I don't remember my dad ever having surgery of any kind. He rarely ever had to see a doctor but he did get really sick from a flu shot once when they used live viruses.

      Delete
  13. I’m glad you have a good doctor, one that thinks, explains things, and tries to help the problem with the least amount of drugs and surgery. Fingers crossed!

    ReplyDelete
    Replies
    1. My comments are moderated and that's way you didn't see the other post you left. I forget that on a few blogs I comment on too and left a second. Bloggers needs to put that in a larger font.

      I wish my internet was as good as my bone doctor but he's got a good practicing nurse that I can see for many things and she's great.

      Delete
    2. Thanks! I commented using my iPad and got confused. :)

      Delete
  14. I had a spinal fusion in 2003 in the same area as your problem. Sounds funny to say, but it was great (pain relief). I agree that you need a new ergonomic chair, and I advise that you should go all in and get a really good one despite the cost. I am about to replace my old one and am comparing one made by Smith (in Michigan) and a stressless one. Also, if you find yourself holding your head in a certain way to see your computer screen, ask your optician about computer glasses; it changed my life when I was still working. I have some pointers for living with neck pain - Number One, a u-shaped Bucky neck pillow that can be microwaved makes your life immeasurably better for fast relief. Bucky also makes smaller, softer u-shaped pillows that are great for cushioning your neck while watching tv or reading (I even use mine to supplement my bed pillow). Also things like CBD lotion or Bio-Freeze to rub on help a lot (just don't use heat after applying Bio-Freeze!) I also use a compounding pharmacy where they convert Tylenol into a rub-on ointment - once people in my office learned about it, I was buying it in bulk to pass around. A recliner is essential for neck surgery recovery, but it also comes in handy on days when things are acting up. My surgeon told me that I will need another fusion at some point, but I've managed to keep it at bay with some of these aids - and without having to resort to taking too much medication along the way. Sorry for going on so long with unsolicited advice!

    ReplyDelete
    Replies
    1. Don't be sorry! I REALLY appreciate all your suggestions. I'm guessing a lot of what you're saying is what I'd learn in physical therapy---the computer glasses, the pillows, chair, etc. MY posture needs a lot of improvement as my pillow choices. Can you believe I've been using a kitchen chair with my computer? My old computer chair broke and I originally thought I'd wait until after I move to get a new one, but I'm no longer sure that's a good idea. THANK YOU!

      Delete
    2. Just wanted to say you live "near" a great company store. It's a major furniture manufacturer, and they generally have ergonomic chairs that are gently used and much less expensive than buying a new one. PM me if you need more info. My DH is forever lecturing me on my posture, but I do have a good chair bought with my (former) employee discount.

      Delete
    3. Thank you! I will do that. I tried to look up something local but all I would was places to order on line and I really want to sit in a chair if I'm going to pay those prices.

      Delete
  15. It sounds like a good appointment (yay, prednison -- I know just what you mean!) and best of all you have answers and a plan of sorts, which is a very big deal. It's also so good to know what it's NOT and have some of those concerns alleviated. It sounds like you have a terrific Dr. Bones. I appreciate over explanation, so long as it is in lay language and it's great to khave that and not get home thinking "I should have asked...." Well done.

    ReplyDelete
    Replies
    1. My youngest niece sees the same bone doctor and we often kid about his canned speeches but we both like them and his lay language, not to mention the results of his surgery. He even told me once in the past that if insurance wouldn't pay for a test he wanted done, then he's cover the cost.

      Delete
  16. I'm sorry to hear that you're having a bout with depression. I know what that is like. I hope it lifts soon. I'm very glad you won't need the elbow replacement, and glad there are treatments for the pins and needles. I always say that anything short of surgery is a good thing. I like a doctor who sees surgery as a last resort, especially for us more mature folks.

    ReplyDelete
    Replies
    1. Thanks. I feel better already and have actually spent a couple of productive days since seeing Dr. Bones. Worrying about what you don't know is far worse that accepting what you do know, if that makes any sense.

      Delete
  17. I find my self-diagnoses often miss the mark. LOL Good on you for finding a thorough, surgery last, doctor. When you say bone doctor, do you mean orthopedics? Or "joint doctor" as in rheumatologist? I fine orthos like to rush to surgery, so if yours didn't...good!

    ReplyDelete
    Replies
    1. Nope, he's a orthopedist who does "complete and comprehensive musculoskeletal care" according to his website. He specializes in sports medicine and reconstructive surgery. He spearheaded him and a couple of other surgeons to build their surgical center when the hospital tried to get them to use one-size-fits all joints to save money instead of letting them order replacements parts to fit each patient individually from whatever company they wanted.

      Delete
  18. Your Ortho Dr. sounds quite thorough. I recently saw one here but only once and then she retired. The really good group that would practice quite independently as you describe that I would want have ceased practice. They, too, built their reputation with sports figures and association with a prominent Rehab. Hospital where I trained some with children and years later worked outpatient with adults one summer. Tragically the lead Dr. has developed Alzheimer's -- his wife, wrote a book describing her escape from Poland from Nazi's, was in our writing group. So far I haven't learned of any other Ortho Dr here I would want to see, but time will tell. Do hope all continues to go well for you as sounds like you're in good hands.

    ReplyDelete
    Replies
    1. Wow, what an interesting person to have your writing group. It's tragic that her husband ended up the way he did...so hard on spouses and other family.

      I'm very much relieved and doing better. But of course, I always feel that way on Prednisone.

      Delete
  19. did you think that destroying your own children's future would have no consequence? We millennials are now full blown communists, and you boomers are going to watch your country become communist before you finally drop dead

    ReplyDelete
  20. Jean, I have some carpal tunnel, and I've been managing it for the past 17 years by simply wearing splints when I sleep that keep me from putting my hands/wrists in the wrong position. Occasionally, I'll have some trouble in the morning when I sit down to the computer; if so, I just put my splint back on for a couple of hours.
    I'm also very familiar with cervical disc problems (including that C5-C6 disc space); just about every disc in my spine has some kind of problem. (I've reached the point where I can tell from where the pain is which disc it is.) I've had great luck with physical therapy. I like the fact that the physical therapy usually relieves the pain within a couple of sessions, and that they can show me what's going on in my spine and teach me how to move differently to both relieve the pain and to avoid it in the first place. I've also had very good luck with the posture approach in a book called *Eight Steps to a Pain-Free Back* by Esther Gokhale (which my physical therapist recommended).

    ReplyDelete
    Replies
    1. Oh my gosh, I sleep with my wrist curled under my head. I can see how it could make a difference getting a spine. I see the hand doctor next week. I'm going to ask him about that.

      Thanks for the book recommendation. I'd really like to avoid surgery/ies if at all possible. I can already tell a difference when I remember to sit up straighter when I type.

      Delete
  21. You sure have learned a lot about options and treatments and that is good how your doctor starts with the least invasive treatments. It sounds like you got some immediate relief as a start, thank goodness.

    ReplyDelete
    Replies
    1. He's been my bone doctor for 15 (?) years now. I wouldn't think of seeing anyone else, even when I have to wait to get in.

      Delete

Thanks for taking the time to comment. If you are using ANONYMOUS please identify yourself by your first name as you might not be the only one. Comments containing links from spammers will not be published. All comments are moderated which means I might not see yours right away to publish through for public viewing as I don't sit at my computer 24/7.