rotator cuff tendinitis

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in the ultrasound image captured on film above, it compares the supraspinatus of my chronically painful right shoulder to the less affected left shoulder. following the indictors that mark distance, and looking at the bottom left where the numbers are shown, it says that my right supraspinatus is thicker than the left by about 0.11cm.

yesterday as i left the hospital, i looked through one of the private hospital’s directory (the one that i only ever go to actually) to look for an orthopaedic surgeon. i didn’t have an idea who i could see, so i looked at the directory, looked at who’s good at the shoulder, and oddly also whether the doctor’s face is endearing (this is very important!). and so i settled on one and tried to ask if i could see him. yesterday wasn’t possible, so it has to be today. i am that desperate with my shoulder.

i saw him today, with merely an ultrasound report of my shoulders from 2011. i told him of the problems i was having, my history and what i’ve been getting and given. he did a PROPER physical examination of my shoulder, and it’s true that a physical examination can give the doctor a lot of clues, oft times accurate ones too. as we discussed what can be done to see what it really is, i just had to ask him what he thinks it is, although it’s really too early to tell. he said honestly that it seems like a Rotator Cuff Tendinitis or Tear. WELL NOBODY TOLD ME THAT FOR 10 YEARS SUFFERING FROM SHOULDER FLARES. i’ve only always been told it’s tenosynovitis/ bursitis.

i managed to, not that i was imposing, convince the doctor that perhaps an ultrasound of my shoulder today will do some good. he did agree in the end, because he gave me a solution of injecting my shoulder with steroids, and he thought that if the ultrasound excluded anything in the subacromial space, then of course it would make more sense to go into the glenohumeral joint. it couldn’t have been vice versa though. he, like my other private doctors, always advocate for getting things done in the restructured hospitals if i am a subsidised patient,  didn’t recommend didn’t a MRI. i pushed for an ultrasound (although the doctors at the hospital yesterday ordered for one) because i just wanted to have an ease of mind knowing that it is something benign, or rather something that i feel i can tackle head on. and so i did, and it was a day of waiting. it wasn’t too bad though.

when i returned to see him with the report and film of the ultrasound (i already had a look at the film and i was guessing thickening, but could not correlate), he said it was definitely Rotator Cuff Tendinitis. so from there i would get my jab of triamcinolone+lignocaine in the subacromial space. i did ask him what am i to do if it persists, seeing that i’ve already failed oral medications and 3 intra-articular steroid injections. his recommendation is that the next step is physiotherapy. and if that fails, then i should look at surgery. SURGERY??? 😦

i cringed at the thought of physiotherapy. if i couldn’t get rid of the pain, i don’t know how i could start on physiotherapy. i gave the go-ahead for the injection anyway. how weird is it that i miss the feeling of the needle piercing through the shoulder anatomy, and the feeling of the drugs being pushed in? maybe it’s been too long.

anyhow, it must have been God’s grace that i met this doctor. the whole time i was talking to him, he needed to know who my rheumy and anaesthetist was. and when i spoke of them, he seemed to know them. nearing the end of the consult, i asked if he was from that hospital (you know, the one which i used to work in, and the same one i’m a patient in), and he said yes! i actually told him that honestly, i’m scared that i’m gonna get scolded by my rheumy for not heeding her advice by getting a joint injection outside. but he told me to mention that i saw him to both my doctors, because the both of them would know him and it would not be a problem. REALLY???

and so when i was getting ready to leave and had to make payment, the doctor told his staff to waive ALL charges except for the drugs used in the injection. i couldn’t believe my ears! because i know the consultation fees were at least $200, more perhaps because i spent quite a bit of time in his office, i was trying to get a discount by “pulling strings”, citing that i used to work upstairs (it works like that, when you are the ex/staff of doctors, the other doctors tend to give you discount). but in the end i think he waived off everything because i was a long-time patient of 2 doctors he knew from his old work place.

grateful.

i know i will have my share of critics for doctor-seeking, especially since me coming out of the emergency room only yesterday. i’m not finding excuses for what i’m doing. but i do this because i need and want the help that only doctors can give. my problem was NOT remedied yesterday. remember the IM diclofenac injection that was given to me at 2.15pm? by 7pm, i was flaring all over again and i was in deep regret for what i put myself through. i already knew it wasn’t going to work well nor for long, but i didn’t know it was going to be that bad. as a chronic patient i choose to be proactive in seeking help for a joint that’s “crying” for help. and while i know my joints are always crying for help whenever i flare, i also have to give them time and myself the patience to endure the pain, to tell if they truly are in trouble. this shoulder is the first, and it has been taken very lightly. mind you, me raising the issue of this shoulder pain wasn’t even this year. it started way back since last year.

being in the system as a patient for long and having worked in the system, i know how it works and goes. me resorting to the private system is me waving the white flag and recognising that the doctors in the private sector have higher priorities for their patients (although i cannot deny they have priorities for costs too; but now 4 of them have waived all costs, except for drugs!). i know that at least when i’m in their care, i am taken care of, and if i need to be treated, then i’m treated! but the reality is, i cannot afford to be treated by them long-term, and that’s why i am still cared for in the hospital.

now the only thing i hope is for the steroids to quell the inflammation in my shoulder. i have to await my rheumy’s appointment next Wednesday, and till then, i have to see how it goes. i hope this steroid injection lasts me for loooooooooooooooong, and not the mere 1-2 months like it has always been.

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