I was overdue for my second RDO, so I took it to coincide with Foundation day. Four days to do my own thing. Cool.
I visited Dr Theron on Friday. It was time to renew my BP medication, and since my shoulder is still painful – it has been giving me hell since we moved those two sofas into Suma’s and Mata’s flat. And that was months ago.
I have not consulted Dr Theron before. Last time I went to the surgery, I saw Dr Du Preez for a medical to get my drivers licence. I did not need pills then, and did not mention the shoulder for some reason that I regretted every night afterwards.
Theron. I could not get the notion out of my head that I was going to see Charlize – so I showered shaved and scented nicely. As it turned out, though she is an attractive South African, she is not quite Charlize, but turned out to be in some ways much better. She listens to her patient, and takes time to explain things. I have not had that since Dr Ah Chan long ago in Auckland. She sorted me out effortlessly. Last night was my first pain-free full night of sleep since I helped carry the sofas up to the ladies’ flat. Today my arm is completely mobile again. I can’t believe that it was so much better so quickly.
I had (have) something called a rotator cuff injury. Here is what the medical pages say about it:
The rotator cuff is made up of four muscles that help move and stabilize the shoulder joint. Damage to any one of the four muscles or their ligaments that attach the muscle to bone can occur because of acute injury, chronic overuse, or gradual aging. This can cause significant pain and disability with range of motion or use of the shoulder joint.
The shoulder is a ball-socket joint that allows the arm to move in many directions. It is made up of the humeral head (the upper end of the bone of the upper arm) fitting into the glenoid fossa of the scapula (shoulder blade). The humeral head is kept in place by the joint capsule and labrum, thick bands of cartilage that form an elongated cone where the humeral head fits. The rotator cuff muscles are the dynamic stabilizers and movers of the shoulder joint and adjust the position of the humeral head and scapula during shoulder movement.
When the rotator cuff is damaged, a variety of issues arise:
- Pain and spasm limit the range of motion of the shoulder. (yes!)
- The muscles do not make the small adjustments within the joint to allow the humeral head to move smoothly.
- Inflammation causes fluid accumulation within the joint and limits movement.
- Arthritis and calcium deposits that form over time limit range of motion.
The severity of injury may range from a mild strain and inflammation of the muscle or tendon, that will lead to no permanent damage, to a partial or complete tear of the muscle that might require surgery for repair.
I can tell you it was not pleasant. I have a pretty high tolerance for pain, but it was getting the best of me, despite the Panadol, Panadiene and Voltaren I was taking. They helped, but only a little. Apart from the difficulty reaching out or up to pick something from a cupboard or shelf, the pain badly affected my sleep. I could not lie on the sore shoulder, nor on the other side unless I supported my bad arm with a pillow. So as soon as I moved in my sleep I woke myself up.
Why didn’t I go to the doctor sooner? Because I have to take sick leave or an RDO. I waited for the next RDO, as it would coincide with the need to renew my prescriptions. It is no cheaper to visit the doctor here than in NZ, and, as it turns out, much more expensive to get prescriptions.
It seems I was on the right track with the medications I prescribed myself, I was just not taking strong enough doses. Dr Theron has put me on 150mg diclofenac a day and a whopping 3990 mg – 3.99 grammes!!! of Osteo Panadol. But it works.