Chapter 7: The Mental Game and Starting Physical Therapy

I’m 10 days into my recovery, and I never thought that mental anguish would be the hardest part of this journey. I am happy to say I no longer need pain medications, just muscle relaxers. Besides that, I am bored out of my freaking mind. As the saying goes, a stagnant mind is the devil’s playground…the boredom is really starting to bum me out, leaning toward depression.

I’m still walking daily, more than once a day if I can manage it. I’m embracing my turtle pace, taking time to observe the wildlife, identifying trees and plants, and mushroom hunting. Kentucky is rich in chanterelles, jack-o-lanterns, turkey tail, morels, and a host of other varieties.

Typing one-handed is made easier with the assistance of talk-to-text, during the brief periods when I’m alone in peace and quiet. I also think about all the things I’m looking forward to getting back to doing after my shoulder is healed. Keeping a lighthearted, positive mindset is getting harder as the days drag on. I’m running low on things to do with one arm in a sling for 6 weeks.

I talk to family and friends when they have time. However, the feeling that you are standing still while the rest of the world marches on, is tough. Generally speaking, I’m the kind of person who likes to stay busy and/or productive, so being still (and slow) for this long is a challenge for me.

Whenever I try to help my dear husband with things around the house, I mostly just seem to get in the way. He’s got all these projects that he needs or wants to get done and not being able to help him with most of it sucks. It’s infuriating because I would love to, especially with the outside projects. I enjoy working outside.

With spring now coming into full swing, I’m watching the world around me come back to life, other people going places and doing things, while I feel stagnant. I know that’s not true. I know my body is doing some very important work right now and I must be patient to allow it to happen.

I know this “crawling” is a very important and necessary step. I have to say, though, Tom Petty worded it best: “You take it on faith, you take it to the heart, the waiting is the hardest part.” Rest in peace, you legendary musician.

Now we’re on day 12, the day of my 2-week post-op follow-up appointments, first with Dr. Grantham. During our visit, he noted that my incision looked really good, and is healing beautifully. During light palpation of the area, he said “the fact that I wasn’t hyper-sensitive was a very good sign, as well as the fact that I noticed a significant difference in my shoulder and arm now feeling attached, and no longer an alien extremity.”

Doctor G then showed me a surgery picture, pointing out what the detached muscles looked like. Next, a short video clip showing that he could tug on the detached muscles and the scapular bone would not move at all. Which is definitely not normal, and probably one of the craziest real-life things I have ever seen. Sadly, I was not able to a copy of these images or video.

He pointed out the yellow parts that indicated scar tissue where my body had tried to heal the injury on its own. Seeing that I was absolutely enthralled instead of passing out, Dr. G continued by explaining the repair in vivid detail, pointing to where he had drilled holes in the bone, and passed sutures through the muscle and then through the bone.

I was the sewing project.

It reminded me of sewing together layers of fabric in an intermediate sewing project. It’s fascinating but wild at the same time because these are my insides, not a sewing project. I was the sewing project. That’s something I never thought I would say in my lifetime.

I got cleared to start testing out if I can sleep in my bed on my opposite side. At this point, this is really my only difficulty…sleeping well. My body knows I am not a back sleeper, and has alerted me to this discrepancy by waking me up at 3-3:30 a.m. every morning with restless legs or back/hip cramps, etc. When I am finally able to fall asleep, that is my consolation prize.

Anyway, Dr. G said the hand swelling should disperse and go away in the next couple of weeks as I begin moving the arm with gentle PT exercises. This is wonderful news for me, as I have not been able to get my wedding ring back on. I grow weary of my tingly sausage fingers.

I discussed with him my wishes to share the knowledge of this condition with others. This is including the original treating physician, whom was unable to solve the puzzle due to a lack of knowledge of the condition. He graciously printed off my post-op notes for me, as well as an article from the original scapular dyskinesis case with his predecessor. I’ll have to upload that at some point, for anyone who is interested.

“We let the shoulder come to us, we don’t push the shoulder.”

-Will

Next, I met with my physical therapist Will, who inquired about my pain level, which to his surprise, was a zero. Though a little dismayed to hear I had another 4-6 wks in the sling, I’m glad the worst part is over. I was also relieved to hear that the foundation of the physical therapy program is as follows, “we let the shoulder come to us, we don’t push the shoulder.”

The progression of exercises includes markers for range of motion, first without resistance, then with it. Ability to (without pain) slide my arm forward on the table, then raise my arm to shoulder level, then slide it up the wall to a full extension. The process will take at least 6.5 months. Apparently weirdos like me who come out of the operation with no pain at the 2 week assessment do really well with rehabilitation.

Paraphrasing here as to what Will told me: “There will be about 3-4 times where you’re going to feel like you’ve re-torn it, in line with each progression. I can assure you that is not the case, aside from something traumatic happening like falling on the arm. At the 9-12 month mark, you may get that feeling again because we tend to fall out of practice and old (incorrect) muscle habits die hard. You will probably need a PT refresher at that point.”

“It’s about the journey, not just the destination.”

-Unknown, probably someone wiser and more patient than I.

He cautioned me not to push myself, as he has noted that the people that do that have more episodes of pain where they feel as though they have re-torn it. My PT also said there might be days where I’m too sore to do anything and that’s totally fine, and I should listen to my body. We discussed the exercises, and he explained the issues/surgery from his perspective, even whipping out an anatomy and physiology textbook.

I have a feeling he loves it when he gets to whip out that book lol. Though I can’t say I blame him one bit. I’m a bit of a science and medicine nerd myself. I find it fascinating and have been known to watch surgery videos and study grotesque surgery pictures.

Final Thoughts for the Day:

I am still in awe that my shoulder pain is at a ZERO. This is seriously the best my shoulder has felt in YEARS. Not just during the 3-year intense pain period, nor am I referencing only the part of my shoulder that was repaired. Rather, my whole shoulder has not felt this good since 2011, when I first began having pain in my shoulder.

I am so relieved and overjoyed I could cry, dance, and shout at the same time. I know I have a long way to go to get back to 100% (or as close approximation as I can get to 100%), but I am so happy that this part is over. I am repaired, properly, and ready for the next step.

I will gladly do whatever it takes to get there, whilst daydreaming about lifting again. About being strong and capable again. About not constantly being in pain every time I use my arm again. About once more doing all the shoulder-dependent hobbies I enjoyed and haven’t been able to do for a long time.

Furthermore, I plan to get the word out about this condition. This is knowledge that more medical professionals in the orthopedic surgery and physical therapy realms need to know. Not to mention, similarly afflicted people need to know, and know how to get it fixed the right way the first time. Besides keeping me sane, this is why I am chronicling my journey.

I sincerely hope it helps other people, present and future, in navigating their own journeys to proper healing. I hope it helps physicians trying to figure out this puzzle for their patients, as well as physical therapists helping them bounce back after repair. Stay tuned for the next chapter!