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Topic: Shoulder Injury - Updated (Read 405 times) |
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Lizzie2
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Shoulder Injury - Updated
« on: Oct 10th, 2006, 8:03pm » |
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Last night, my dad took me to the ER at Jefferson because of having excruciating left shoulder/arm pain and the muscles kept spasming in that arm. It kinda started on Friday morning, but I did work an 8 hour shift on Friday, and then a 16 hour shift (4 hours OT) on Saturday and a 12 hour shift on Sunday...got through by taking 3 aleve twice a day. But then yesterday morning, the pain woke me up from sleep. It was excruciating.
I got up and took 4 motrin and then put a lidoderm patch on my shoulder, but it didn't really help. During the day, I tried ice and heat. At around 4pm, I took 2 ultracet for pain. Still didn't help. In the evening, I ended up calling my dad with tears streaming down my face. At first, he was insistent that he was going to take me to the ER, but I said no....I decided I wanted to try a hot shower first to see if that would help. I got the shower, but it didn't help at all - I couldn't lift my arm...and every movement led to spasms.
So he took me to the ER, and even though I did remind them that I work in neonatology and used to work in the ER, it didn't get me in any faster - I waited an hour and a half! My heart rate was in the 120's and my blood pressure was like 145/96, however. I know my heart rate is usually fast and I do have high blood pressure (but not on meds currently), but I think the pain was making it worse.
After that I got to my "bed" which was actually a big comfy chair in the staging area, where they put patients that don't need to lie down or have intense monitoring (though I was actually the worst off one in this area - one homeless guy was there with a spider bite and the others there just needed antibiotics and an xray) - but it actually was a quiet enough area and the docs were kind enough to take me to a private exam room when they needed to talk or do exams. The nurse taking care of me said, "Oh...you work here and you still had to wait that long? They must not have known you are an employee!" Not that I was vying for special treatment...but they did know, and I still had to wait. Luck of the draw I guess! There was one time I went and when the charge nurse saw me in the waiting room, he rushed to get me back.
But anyways - the whole car ride in, every bump my dad would hit in the road, my arm would go into these spasms that lasted roughly 5 seconds but were soooooo painful. And these spasms continued while in the ER. My left shoulder and arm are swollen. I did let them know that I had a past history of DVTs (blood clots) in that arm and also the avascular necrosis of the knees. After she wrote that stuff down and the rest of my medical history, she said that I was going to scare off the interns... Heh heh heh....
The resident was pretty nice. He ended up asking me what I usually take for pain....and aside from my daily regimen, I only ever use the ultracet once in awhile and that hadn't helped. He told me he was going to give me valium for muscle relaxation and dilaudid. The nurse gave me the choice of IV or IM dilaudid while the doc was still around - she told me the IV would work faster but the IM would last longer. Since I've had 3 picc lines and all kinds of IV issues, we went with the IM. After those meds, the spasms stopped but the pain was still really bad. And I still couldn't move my arm.
I then saw the attending ER doc and he was good too. However, after asking me questions and doing the exam, he said my xray was negative and this may just be a "new ache and pain related to my autoimmune disease." Hrmmm... I am being treated for either lupus or RA, but neither has been definitively declared. And the attacks I've had before were nothing like this. I almost got the vibe that he was saying if they couldn't figure out what this was, then I'd just have to live with it. That set off the panic alarm in my brain because I can't really lift my arm right now and it hurts like hell. Let's not forget that besides being a neonatal nurse, I'm also a professional pianist!
To be continued...
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| « Last Edit: Oct 11th, 2006, 12:32pm by Lizzie2 » |
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Lizzie2
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Re: Worried - and spent a lot of last night in the
« Reply #1 on: Oct 10th, 2006, 8:04pm » |
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...Continued
Then the doc ordered for me to get a toradol injection. The nurse gave that in the bad arm because it burns and we decided I should just have all the pain in one place! At first it didn't seem like it was working, but after awhile I could tolerate it. The doc came back and asked if I wanted him to page ortho. I said no - I'd rather get through the night and call my ortho in the morning. I asked if he thought I should have a CT or something to look for non-bone causes of the pain, and he said I definitely needed an MRI, but couldn't get one last night. So he had the nurse put my arm in a sling and gave me scripts for skelaxin (muscle relaxer) and 8 percocet tabs to have until I could get to the ortho.
Unfortunately, we don't have any 24 hour pharmacies around here, and I got home at 1:30am. My arm did end up hurting really badly again during the night last night. I just kept getting up every few hours and putting more ice on it. Today it has times that are worse or better than others. I still cannot lift my arm any higher than my waist.
I got in to see the ortho tomorrow morning at 9am. I had a neuro appt today, so I picked up my xray from last night and my chart from the ER. I guess what worries me most is that I don't know if this may be a rotator cuff tear. That would be bad... With my job, even if it's temporary, I don't know if I can work on Thursday as scheduled. Since I can't lift my arm, I can't do the care as I should - can't lift a baby, etc... So that has me stressed. Since I can't think of a specific insighting incident, I don't know if I would qualify for worker's comp due to repetitive motion or if I'd have to take some form of short or long term disability or just take an unpaid leave of absense. Any of these options results in a pay cut for me... And if it is torn, the possibility of surgery... It may not be torn, but the way it is right now, I still can't do what I need to do.
So tomorrow I will get the next bit of news. I will probably still have to have an MRI, but I imagine he'll give me his initial impression. The info from the Rothman Institute says both a rotator cuff tear and impingement syndrome (less severe) are mainly diagnosed based on physician exam, but an MRI can be done to rule out a full thickness tear. I guess after that appt, I'll have to go over to the unit and see what my boss wants me to do as far as work...
So obviously I'm a little nervous and stressed... I still don't have a savings built up, especially not after just getting home from England!! Please think a good thought or two!! If anyone has gone through a bad shoulder injury, I'd love to know more about what happened...especially if you can help ease my worries!!!
Why do these things always happen to me? I'm convinced my muscles must be made out of more breakable materials than the norm!
Wish me luck!
Carrie 
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Opus
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Re: Worried - and spent a lot of last night in the
« Reply #2 on: Oct 10th, 2006, 8:47pm » |
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Carrie,
Sorry to hear you are still undiagnosed. My mother had Lupus for years but went untreated because she tested negative for Lupus and positive for RA.
I am not saying you have this but it does seem to fit you symptoms.
Chronic myofascial pain
Paul
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Re: Worried - and spent a lot of last night in the
« Reply #3 on: Oct 10th, 2006, 9:02pm » |
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I can't believe that I have to bang my
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Gonna take a breath and try again.
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marlinsfan
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Re: Worried - and spent a lot of last night in the
« Reply #4 on: Oct 10th, 2006, 9:12pm » |
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Good luck, Carrie! I had something similar, though not as bad. My left shoulder, tricep area and elbow were killing me for a few days. Finally had chiropractor look at me and thought it might be a herniated disk in my neck. Had an MRI and sure enough, there it was. C5/C6 I think it was. 2 epidural steriod injections later and I'm mostly PF.
Keep us posted.
PF wishes.
Jose
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alchemy
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Re: Worried - and spent a lot of last night in the
« Reply #5 on: Oct 10th, 2006, 9:36pm » |
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Carrie sorry for your pain, hopefully an answer will come soon.
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Tara Ann
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Re: Worried - and spent a lot of last night in the
« Reply #6 on: Oct 10th, 2006, 10:02pm » |
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What a horrible ordeal! Big hugs and vibes whatever it is isn't serious and heals quickly.
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cootie
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Re: Worried
« Reply #7 on: Oct 11th, 2006, 12:38am » |
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OUCH......I've had smilar bouts with my one shoulder......it's sustained alot of damage thru the years of 'raceing horses' and stupid people tricks. I have muscle anthropy (???.....loss of muscle on that shoulder and very visible)......when it flares up it even looks crooked ! Doc said I probly have rotor cup damage also from a few nasty accidents where I was drug hanging onto the rope of my horse and then slammed into the rear bumper of a big truck denting it which of course 'made me let go' of the rope. I always feel like I am holding sumthin heavy in that arm lifting it and not sure what causes it to flare up or 'go out' but I will wake up with it hurting like hell sumtimes and it goes from there. Takes a while to settle down and alot of pain for sure !! It 'catches' too sumwhere in my shoulder blade too real bad and I can't help it but I scream when it does it cuz it's like sumthing RIPPED off or got cut in half inside. I was tested for RA and Lopus but tests were negative but I hear sumtimes it doesn't show up for a while ? Weather changes are my worst enemy.....hits me like a rock all over. Scream team Pam
Hope ya feel better real soon !!!!!
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| « Last Edit: Oct 11th, 2006, 12:40am by cootie » |
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roy21302
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Re: Worried - and spent a lot of last night in the
« Reply #8 on: Oct 11th, 2006, 9:53am » |
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Sorry to hear you are going through a bad time at the moment, I'll be thinking of you and sending you good vibes
PS you didn't do any arm wrestling with Helen did you??
Roy
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DonnaHar
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Re: Worried - and spent a lot of last night in the
« Reply #9 on: Oct 11th, 2006, 11:47am » |
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Carrie......I did a complete rotator cuff tear about 4 years ago...playing with a little tame rabbit, I lost my balance and fell on my right shoulder and hip.. hit the ground just like a falling tree with nothing to hang onto or any way to catch my balance. Little did I know that it was my LEFT rotator cuff that tore. I didn't even feel it tear..no real pain, no spasms, nothing at all until the next day.
To make a long story short, I didn't opt for the surgery as suggested and was told that if I didn't have it done within 6 months it would be too late as the torn muscle would receed up closer to my neck and they wouldn't be able to stretch it back to the normal position. It didn't hurt enought for the surgery at the time, so I just didn't have it. In month 8 after the fall, it started giving me a bit of a problem, but by then it was too late for surgery.
Today, I have very little problem with pain in that shoulder, but there are times when I can't sleep on that side because of pain and times when it hurts to lift a gallon of milk out of the refrig., etc.
Did you fall on the opposite side or do anything tarumatic to the opposide side?
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sandie99
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Re: Worried - and spent a lot of last night in the
« Reply #10 on: Oct 11th, 2006, 12:08pm » |
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Carrie,
I'm so sorry that you had to go through that one, too. I hope it gets easier... You're in my prayers, my friend.
Hugs,
Sanna
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Lizzie2
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Re: Worried - and spent a lot of last night in the
« Reply #11 on: Oct 11th, 2006, 12:19pm » |
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Thanks for all the messages and everything! I have just a few responses to some things, but also I just got home from my ortho appt and stopping by work, so I'll give the update now, too!
Paul - I remember you telling me about your mom and the lupus stuff. I don't have CMP, but thanks for the link. I was diagnosed with FMS when I was younger, but now we know that it was probably more incorrect as this looks more like lupus or RA. You can actually have RA without a positive rheumatoid factor by meeting certain criteria. And also I have 5 of 11 lupus criteria, but you need 7 to actually diagnose it. I guess time will tell, but I am on the methotrexate to treat questionable RA.
Ex2 - 's back.
Jose - Really glad they found out the source of your pain and that the injections helped! Both of my grandmothers have spinal stenosis and both of them have had epidural injections, but unfortunately they haven't helped that much, but with spinal stenosis, sometimes the only true "fix" is surgery... I also had an injection of the Sacroiliac joint earlier this year for Sacroileitis (sp?) and this really allowed me to increase what I was doing at physical therapy and eventually, 5 months after starting PT, get rid of my bad limp from the AVN and really help heal the SI joint. I never thought it would improve because it was a long haul, but the injection really helped!
Alchemy and Tara - Thanks!!
Coots - Yeah you are my sister in orthopedic injuries!! Since you threw a couple of question marks in there, I would venture to guess that the word is muscle atrophy (shrinking or wasting of the muscle due to injury or lack of use) and the rotator cuff muscle is the one made up of 4 different parts that control the ability to rotate the shoulder. Sucks, don't it? I understand the scream when your shoulder locks up there - I was crying hysterically on Monday night because my shoulder kept going into spasm...it was horrible. And on the way to the hospital, every bump my dad hit in the car, it sent spasms through my arm - it was so unbelievably painful....ugh! Wish they could find out the cause of all your joint pains/problems, too...!
Roy - thank you! No, Helen and I did not arm wrestle!! Her son Barney broke his arm while I was over in England, so maybe that rubbed off on me or something! haha
Donna - Thanks for sharing that story - isn't that always the way that you think you're fine and then when it's too late, you have problems? I was in a car accident where we didn't go through insurance or get a police report, and maybe a week afterwards, my right shoulder began to hurt probably from jarring that arm in the accident, but by then it was too late to attribute it to the accident! (That was a few years ago now...) I have not injured or fallen or done anything to either arm that I recall. I did work 16 hours on Saturday and then 12 hours on Sunday, so I probably made it worse just by the everyday wear and tear that we have to do....all the baby care (babies are still a strain to carry around and also they require you to completely support their head and every part of them, basically!) plus also moving warmers, etc - we did have a few codes happen over the weekend and there was a lot going on...but I can't remember a single moment where I shouted "OW!" and then my shoulder hurt ever since... I wish I could! This is always the way with me....I wake up with something hurting and all messed up, but I can't remember a specific incident that brought it on! Frustrating... As far as sleep - I can't sleep on the good side because that seems to leave the left shoulder unsupported and that is excruciating. I can't sleep on the bad side because that smooshes up the shoulder. So I have found a way to sleep, more or less sitting up (I'm in the least amount of pain when fully upright) and sort of tilted a bit towards the right, but I still wake up very frequently during the night. I think that just makes all the pain worse - today I woke up with a CH, and I was feeling really overwhelmed between my head killing me and my shoulder also really hurting...it was too much!
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Lizzie2
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Re: Worried - and spent a lot of last night in the
« Reply #12 on: Oct 11th, 2006, 12:31pm » |
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So I went to the ortho this morning. I went to this same doctor at the Rothman Institute back shortly after New Years because I'd ended up in the ER then unable to walk due to extreme back pain. So he does know me and instantly recognized me when walking in today. He's a sports med doc, and although he doesn't specialize in shoulder alone, I thought it was better to try to get in quickly with a doc that knows me.
He agreed that the xray was okay. His first remark was that he knew the sling I had on well because his family recently took a trip to Disney World, and 9 days before they went, his daughter broke her arm and ended up in the same sling! That had to suck... So anyways....
He couldn't even examine my arm really because as he tried to move it around, the pain was too great for me to allow much movement. He said I'm a little too young for a frozen shoulder or even a rotator cuff tear without direct trauma, but you never know... I have a history of having weird injuries that most young people don't get, without any known cause.
So he decided to inject my shoulder with an anesthetic (lidocaine I think) and a steroid and said that would be diagnostic and hopefully would at least allow him to examine the shoulder more easily. He brought a resident in since I tend to be one of those types of patients who has things happen that don't happen that often, apparently! First he sprayed my shoulder and arm with this cold numbing stuff.... So I never felt the needle going in, but the injection itself was soooo painful. I had my right hand gripped on my leg and was just trying not to yell or cry! He asked if I was okay, and I just said yes and tried to breathe through it.
Then they let me sit for a few minutes to let the injection kick in. When he came back in, he asked how it was, and I said that I didn't have as much pain just sitting at rest. He had me stand up, and we tested the movement. I could move it a couple inches farther than before, but I still can't lift my arm more than maybe 5 or 6 inches away from my side. He said he doesn't want to get an MRI just yet. He wants to see me in 1 week and that should be enough time to allow the injection to settle in. If in 1 week, things are better, he'll just have me go to physical therapy. If it's worse, then we may need an MRI or further investigation.
The downside is that he wrote a note for me to be out of work until I go back next week. I don't have the type of job where I can just do light duty or do anything really with a bad arm. The good side of that is that in the entire next week, I only was scheduled to work 8 hours tomorrow, 8 hours Friday, and 12 hours Saturday (weekend makeup day...), so at least I wasn't scheduled to work a ton of days. At first, they weren't able to find an appt with me for a couple of Mondays, but I am scheduled to go back to work next Thursday, so I really stressed to the receptionist that I need to see him to get cleared to go back to work. So she spoke with his nurse, and they squeezed me in next Wednesdasy afternoon.
I went over to the neonatal unit where everybody that saw me asked what happened. The worst part is that my first response is just that I don't know!! I don't know what I did to my arm!! So, I must've run through the story about 10 different times, and my boss was in a meeting, but we paged her and she called back after about 10 minutes. I told her what happened, and she sounded none too happy.....but what else can I do really? I don't know if I have 28 hours of sick time (I have to check) or if I'll fall short by a few hours and just lose that pay... If I end up needing to miss further time after the appt next week, then I think I'm going to have to rely on short term disability or something. I don't know if I can really chalk it up to worker's comp since I can't recall a direct incident that caused this. Yes, the wear and tear and repetitive motion at work are probably what did this, but I don't know if that will fly for worker's comp or not... Not even sure where to turn to find out which I should do, but I have a week to just rest and hopefully I'll be fine and be able to go back to work!
Thanks for the good vibes. I guess it's nice to have an unexpected "vacation" but not great to lose out financially.... Also, I have no clean clothes and no food here, but I can't carry the laundry to the basement to do it or go food shopping! So I may go out to my parents' house or something...at least then the washer and dryer are on the 1st floor, and if I could take my clothes in parts out to my car, then I could get them home and do the wash. We'll see... I have a lot that needs to be done, and I just have to see what my arm will tolerate.
I'll post any other updates if I have any more news about it! Let's now just hope that this injection will help enough that I can go back to work next week!!
Hugz,
Carrie
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pattik
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Re: Shoulder Injury - Updated
« Reply #13 on: Oct 11th, 2006, 2:07pm » |
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Carrie, keep us up to date. I hope over the next week you see tons of improvement, and that you'll only need the PT.
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Re: Shoulder Injury - Updated
« Reply #14 on: Oct 11th, 2006, 3:47pm » |
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Ditto to what Patti said and going to your parents sounds like the best idea for now too. At least you can have some degree of control there in getting stuff done etc. Hope you see a lot of improvement!
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Re: Worried - and spent a lot of last night in the
« Reply #15 on: Oct 11th, 2006, 3:51pm » |
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on Oct 11th, 2006, 9:53am, roy21302 wrote:PS you didn't do any arm wrestling with Helen did you??
Roy |
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But she did try and wrestle with me on Helens sofa 
Sorry Carrie but i just couldnt resist 
I hope that the injection kicks in soon and that it does the job and you get the use of your arm back very quickly.
Lots of love
Dape, Julie, Joshua & Bump 
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Charlie
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Re: Shoulder Injury - Updated
« Reply #16 on: Oct 11th, 2006, 10:08pm » |
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Hang on and by all means let us know wtf is going on with you.
Rats.
Charlie
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Jonny
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Re: Shoulder Injury - Updated
« Reply #17 on: Oct 11th, 2006, 10:12pm » |
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on Oct 11th, 2006, 10:08pm, Charlie wrote:| Hang on and by all means let us know wtf is going on with you. |
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Nooooo, Charlie!!!!!!
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It is up to YOU to educate yourself and then help your doctor plan your treatment. If you just sit down in front of your doctor and say "make me better" you are setting yourself up for a great deal of pain.
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