Tuesday, September 27, 2011

BAAACK! WITH A VENGENCE..

Well, Hellooo!

Yes, it HAS been over a year since I posted anything here...thank you for noticing.  Ehem.  I've been busy living life, working, and paying my mortgage.  Yes, apparently I DO still have MS somewhere in my pea-brain, but for the most part, it continues to keep itself on simmer on the back burner...WooHoo.  I am still off all the DMD's, have not needed any ROIDS for well over 2 years, and continue to be employed full-time.  Now don't be a "hater" bout this, Mkay?  It is what it is...for ME, but prolly not for YOU.

But just because I am not frequenting my neurologist's office every five minutes anymore with an MS complaint DOESN'T mean I am exempt from the dysfunction of the Medical Establishment (ME) these days.  O' quite contrare', dear-ies.  I still have *issues* with living and I still have delightful encounters with the Medical Establishment...which is why I am coming back to this blog today...

I probably should have titled this blog post, "The System IS Broken"...but it's hard to sheepishly return to something I haven't paid any attention to for over a year, then blast out an opinion, still narcissistically thinking anyone out there still CARES what my opinion may be (if they ever did)!  Perhaps it is only the painkillers talking now anyway...

Saturday evening I was assisting with the hanging and OCD straightening of some pictures while standing on a not-so-secure-chair and, as would be typical for a blundering idiot, I managed to fall off said not-so-secure-chair to the floor.  After the laughter ceased from my graceful performance piece (because I MEANT to do that...hehe) and much later in the evening, I began to get twinges of pain in my left shoulder and neck, which became pounding aches while trying to sleep at 3:00AM.  By Sunday evening (24 hours later, but seemed like a week), the pain in my shoulder was so great, I began contemplating my Last Will and Testament (because I realized if I died from this mystery pain issue, there were a couple of people I wanted to add and delete from my Will!).  I had out the ice bags, the Ibuprofen, the narcotics, and dusted off the Bible (just in case).

Now, for those of you who used to read this blather, you may recall I have *issues* with the Medical Establishment anyway and will generally avoid the Beast at all costs...and, because the last time I was in an ER it was because I had removed a Scopolamine patch, then promptly stuck my finger in my eye, causing my pupil to "blow", and a subsequent  emergent $7,000 work up for a stroke that I didn't have...well, I am a little embarrassed to go through those doors again unless I am squirting blood from my aorta and really can't apply pressure myself to stop the hemorrhage!

So, I gritted my teeth, chewed the leather strap, and waited it out until Monday morning.

Because I have been assigned to so many specialists in the past for so many reasons (some necessary, some unnecessary), I already have my name on the roster of an Orthopedic Doctor.  At the stroke of 9:00:01 Monday morning, I hit the speed dial for young Sports Medicine Ortho Doc and pushed the magical buttons several times to reach a live person...with my good arm/hand.  I was told by the young Sports Medicine Ortho Doc's gate keeper that the soonest I could get an appointment was Wednesday and to try calling my Primary Care Physician...*click*.

The pain was too great...I dialed my PCN (Primary Care Nurse...because I believe in ARNP's far more than MD's) and pushed the magical buttons several times again to reach a live person...only to be told my ARNP was on vacation (how DARE she be during my time of need?!?).  I was advised by the 12 year old receptionist at my PCN's office to try calling the Urgent Care Clinic instead.

Sigh...the pain continued.  So I looked up the number for the Consulting Nurse for the Urgent Care Clinic I have gone to in the past and dialed AGAIN.  This time I got a live person who took my information and told me someone would call me back.  I waited...in pain...less patiently than I had waited at 9:00:01AM.

Eventually a Consulting Nurse called my number and I answered it before the *ing* could sound on the *burring* noise the phone makes.  The Consulting Nurse asked me a bunch of questions, wrote down some information (like what meds I take daily), then advised me to GO TO AN ER because she felt my symptoms warranted an ER visit per her checklist sheet she was using to tentatively diagnose my condition because free thinking is NOT a part of the consulting component of healthcare.

**THUD**

I girded my loins, took an hour to dress myself with the use of only one arm and the other in bad pain, and headed to my local ER...only to wait another 2 1/2 hours before getting into a room (which frankly is a pretty short wait these days at an ER, given EVERYONE now uses the ER for primary care issues due to lack of insurance...but I digress).  I had my blood pressure taken and 3 x-rays of my shoulder before a Physician's Assistant knocked on my curtain and introduced herself...she told me she had to wait until the radiologist (at some remote site in Liberia) could read my x-rays before she could talk to me and left.

GOOGLE is a wonderful search engine...and, in my obvious spare time, I began GOOGLING (verb) my condition.  I AM a healthcare professional myself, after all...I know how to GOOGLE as well as THEY do!

Rotator Cuff Injury...Ta Da!  Classic symptoms, moderate to severe pain, inability to lift the arm laterally, deep/aching pain in the shoulder joint, clicking noise with attempted movement, pain much worse at night.  GOOGLE even told me the treatment:  rest, ice, passive range of motion exercises, cortisone shot in the tendon.

By the time my x-rays were transmitted electronically to Liberia, read by the radiologist, called back to the PA in the ER, and her return to throw back my curtain and announce her diagnosis given to her by the radiologist, I already HAD the diagnosis in hand...the look on her face was one of let down when I told her first I was pretty certain there was nothing broken and I had sustained a Rotator Cuff Injury.  She "concurred" (I love using that term).  I also had Calcific Tendonitis in the shoulder (she got to add that one to trump me) as seen on x-ray.  She told me I would probably need an MRI as well as there was a high probability I had torn the cuff, but that wasn't a test they would typically do in an ER because there was no "urgency" (like the urgency of someone having a freaking stroke or THOUGHT to be having a freaking stroke because they stuck their finger in their eye with medicine on it!!). 

I explained I had already been doing the rest, ice, ROM to the extent I could, and taking way too many narcotics/anti-inflammatories to try to cut the pain (causing me stomach upset and probable ulcer) and inquired about the cortisone shot to give me some relief.  And THIS is where I became painfully aware of how broken the system is:

The PA told me, "Oh, we don't give cortisone shots in the ER because it's a specialized shot and you'll have to see an Orthopedic Doctor to do that because we don't want to rupture your tendon in the ER."  She gave me a sling, told me to do what I had been doing, and go home and see my young Sports Medicine Ortho Doc.

                                  ********************

Day two off work and I wait...in pain...for my Wednesday appointment that I made on Monday because apparently only a SPECIALIST can do "special" treatments.  I called this morning at 9:00:01AM to the young Sports Medicine Ortho Doc's office to inquire if I could be on a wait list for anyone who may cancel today because I am only 10 minutes away from his clinic and remain in moderate to severe pain.  I was told by the young Sports Medicine Ortho Doc's handler that the doctor was in surgery all day and not in the clinic...apparently there are also SURGICAL repairs for my condition.  I GOOGLED it...

2 comments:

Roger M said...

LD. Love your writing voice. Welcome back, despite the trauma. RM

Aussie Michelle said...

Sorry to hear this. I injured my RC last year. I wasn't in as much pain as you, but it got worse and worse until I bit the bullet and went to the doctor. A couple of months of PT and it was a lot better. Now (apart from a disturbing clunk during certain movements), I barely remember there was a problem. Good luck.