Wednesday, October 3, 2012

Little Lame Donkey

Three or four months ago micro tears in one of my left shoulder's rotator cuff muscles were aggravated by a routine movement in an osteopath's treatment room causing instant pain that flared and quickly died. I didn't think much of it until shadows and whispers of the same pain began to haunt me throughout the summer.

'Swimming will help!' I thought. And hit the beach daily though July and much of August, swimming sometimes up to 800 metres in the sea – except I could not do front crawl; it was too uncomfortable. I switched to breast stroke.

An imagined tarantula in my post-shower towel one evening (imagined that time, they have been known to be real) made me twist my body and shoulder, and a nano-second later I was curled, weeping, on the bathroom floor. Again the pain died quickly, but this time the shadows and whispers of its recurrence gained more form and substance. I knew that the time had come to seek help, but I had had bad experiences with several local physiotherapists and wanted to wait until J, an English lady who used to work with the British athletics team, returned from the Olympics.

Cue a third trauma: when my arm was accidentally pulled over my head, the pain gave a resounding shout. I knew that things were serious.

J returned and I drove fifty minutes up into the hills to her sports injury clinic. 'Tendon tear', she said succinctly, explaining that it was the result of long-term stresses (if I had known when lifting 15 kilos of BCD and scuba tanks over my head day in and day out for three years that I would suffer later, would I have continued it? Huh! But I can't say that I wasn't warned...) probably from overworking or trying to prove that I had upper-body strength equal to a man. She gave me a massage and exercises and sent me home with a follow-up appointment in two weeks.

Ice packs and exercises seemed to reduce the problem and I was regaining some of the mobility and losing some of the pain, when suddenly two weeks ago I turned the wrong way in my sleep and landed, not back at Square One, but at Square Minus Ten.

“Oh pooh!” said J. “Much more swollen, not good at all. And you can hardly move it!” She gave me another lovely massage, and encouraged me, but warned that many times the only sure route to fixing a tendon tear is via the operating table.

“Go and see my mother's orthopaedic surgeon, Manamou,” said Best Beloved. “We need you fixed.”

So I did, but the visit was not a success. I had the feeling that he was a fine doctor, but we did not do well on the personal level. “Frozen shoulder,” he told me, writing a scrip for an MRI and saying: “That needs to be treated first – probably with oral cortisone – and we'll deal with tears and impingement surgically later.” Except that he said it all in Greek, having told me at the beginning of our appointment that he did not speak English, and leaving me at a distinct disadvantage.

I had the MRI and the report returned replete with '-oses' and '-itises' as well as mentioning a 'partial thickness tear of the distal supraspinatus tendon', and that evening, Dr X phoned me back. “It's not good news,” he said in perfect English. “You will need to have a surgery, and although it's not an emergency, I would like to see you as soon as is convenient.”

The last week has been very bad – mostly because of the impossibility of sleep. I took Ibuprofen but it didn't seem to help. Last night I took a combination of Paracetamol and Codeine that had been prescribed for Sophia when her plantars wart was lasered, and at last I got some proper rest.

This morning, I took Best Beloved to my appointment with Dr X – not only as a translator, but as someone who is not cowed by either personalities or terminology, and is not afraid to ask questions.

They got on like a house afire, and the doctor reiterated J's opinion that the tendon damage had taken place long ago. ("You mean that you were flawed when I married you?" BB turned to me in surprise.  "Can I send you back?  Get a replacement?") Dr X said that that the frozen shoulder needs to be treated before any other issues can be addressed, and wants to do this with oral corticosteroids:  “This is the German protocol,” he said. “I know that the English prefer injection into the joint, but there is a risk of tendon necrosis. You must be careful not to eat too much sugar or salt and limit alcohol. I will see you in two weeks, and I think that you will have a great improvement both with pain and mobility.” I asked him about non-steroidal anti-inflammatories, and he said that they were not as effective, that I would have to take them for a long time, and that they were hard on the stomach. “Nothing is completely risk-free,” he said. “But with this schedule, I will be able to do the surgery in about a month.”

So, I start tomorrow. Five days of 40 miligrams of cortisone, followed by 5 days of 30, then 5 days each of twenty, ten, five, and 2.5 mg. Then a trip to the hospital, and an op followed by physiotherapy...

Watch this space...


  1. Ouch Asproulla, that's going to hurt. I know, I had a frozen shoulder three years ago, triggered by severe tendonitis in the suprasprinata.

    An orthopedic surgeon in Larnaca was all set to operate when I stumbled on something that was worth a little more research. Within two weeks the improvement was such that the surgeon saw no point in surgery. 50% improvement within two weeks.

    Take a look at the Neil Asher technique and then give William Lenihan in Tala a call.

    I *know* that random suggestions from the internet sound kooky, but there's a double-blind clinical trial from Addenbrookes that is much more scientific :-)

    Best of luck,

    1. Mands, thanks so much for reading and taking the time to comment! I actually ran across the Neil Asher web page when I was doing some research, and I have met William, so it's not such a kooky idea :)! If I were not already advancing down the road I'm on, and if I did not have a tear and also severe impingements (calcification on the bone which restricts tendons' passage through the shoulder), I would certainly be onto it. But from everything I have read, tears really need surgery for any sort of complete recovery of strength and mobility, and two members of the family have had wonderful success and great recovery with this particular surgeon. BUT my Right shoulder is feeling all the strain of new movements to compensate for the left's inactivity, and I have a feeling that tendonitis is beginning to appear there (hard to tell as the steroids are tamping down any other inflammation). If that's the case, I'll definitely contact William. As I said, I had seen the Neil Asher page, but had dismissed it with a 'Well, no-one in Cyprus would be a practitioner...". That may have been the case 10 years ago, but is probably not true today, so THANKS for the kooky random suggestion ! :)))