entering the consultation room, i saw my anaesthetist pouring over the notes in the system written by my rheumy, the EMD doctors and his colleague who saw me. my shoulder has really got them all puzzled, and now he was my last hope of alleviating my pain. he is after all, a pain specialist. and what my rheumatologist cannot do, he surely can. he looked at my dismally low ESR of only 17, and could not correlate it to the RC tendinitis. so he asked about my neck (second person to ask this), palpated trigger points on my shoulder, and then said something no one guess. his guess? MUSCLE SPASMS. i
it was hard for me to digest that muscle spasms can cause such excruciating pain in my shoulder. but he is a very intelligent doctor and i respect his opinion. since i’m exhausting all options, why not listen to his opinion? he suggested a few trigger point injections along the shoulder to relax the muscle spasms and hopefully ease the pain in the shoulder. i went along with it, and ended up getting 3 of it with bupivacaine. then i unabashedly asked for him to give me a suprascapular nerve block because i wanted to go SUPing for my birthday. he acceded and i had the 4th jab. for all my shots now, he’s not using any steroids. both of us learnt the lesson together last year with my steroid load haha. he spent 30 minutes with me, and i was grateful for that. the rest of the day my shoulder was aching. i was seriously doubting that he was right. but by the next day all was good. he might be right after all.
it’s been 3 good shoulder days now and i’m still glad it’s doing ok. my left shoulder is bugging me now, but aye one at a time.
it’s taken at least 3 doctors to try to figure out what is up with my shoulder- orthopaedic surgeon, rheumy, anaesthetist- and all of them have very different ideas of what is happening. i don’t know who i should be listening to. i don’t know if muscle spasms causing the pain means my RC tendinitis is not valid? although the ultrasound shows it to be? i don’t know if RA is involved in the process as well. i guess i may never know, nor will they. we just have to bounce back and forth, here and there, until we are sure.
that’s the complexity, but also the beauty of rheumatology. it’s not fun for me, but is definitely challenging for rheumatologists (i know some are in it because they love the challenge). i guess right now the medical doctor i can rely best on is still my anaesthetist. my rheumy can only do so much and offer that some ol’ drugs which i’ve tried almost all that’s in my paying capacity. so…
ah. and yes. people do cringe when i say i get poked in my back, into my spine, into my joints, at my nerves etc. and rather often at that too. nurses when assisting my doctors for my injections, get cautious in case i scream or faint (patients do fall over, believe me). i secretly think they’re more afraid than i am, that i have to reassure them that i’m ok. my rheumy and anaesthetist who have poked me enough also have to tell the nurses to back off a bit because they know i’m gonna be ok. dealing with painful chronic illnesses inevitably ends up with these injections as a treatment option. compared to the pain i go through everyday, all these momentary pain is nothing in comparison. really. i’m so good with needles that nothing gets to me anymore. one just has to be. if not, how else? it’s just one way to cope. that’s life.