For more than a year now I have been in pain when I use my left arm. Everyday things like giving an injection, doing surgery or picking up an animal made my left shoulder hurt. Finally, the pain started waking me up during the night. That is when I had to see a human orthopedic doctor to determine what I injured and what was needed to fix this annoying problem. It was also an interesting opportunity to see how those other doctors work up an orthopedic case.
The first visit was filled with a long list of questions, some range-of motion exercises, and some digital X-rays. The X-rays showed a bone spur and some arthritic changes in the shoulder. The doctor began with a simple treatment consisting of a prescription-strength nonsteroidal, anti-inflammatory medication and a follow-up check in three weeks. That did not work.
The second office visit started with more range-of-motion exercises and a steroid injection into the shoulder muscles. I was expecting this to be a painful injection, similar to the make-my-eyes-water sensation of a cortisone injection I had in my wrist several years ago. I was pleasantly surprised, because the injection did not hurt. This doctor mixed the cortisone with a local anesthetic that blocks the nerves. The cortisone injection helped some, so a second steroid injection was given after three weeks.
Unfortunately the injections did not do the trick, so an MRI was performed. In addition to the bone spur and arthritis, it showed a tear in the muscles of the rotator cuff. Surgery was needed to repair the damage. I delayed the surgery until the slower time of the year at the clinic (the beginning of November). By then I was more than ready to have my shoulder finally fixed.
The anesthesiologist used propofol followed by sevoflurane with a nerve block of the shoulder. This is very similar to what we use in veterinary medicine. The next thing I knew I was waking up from a successful surgery. It was rather weird to be unable to move my fingers, hand or arm for several hours due to the nerve block. However, the nerve block did prevent any pain sensation for roughly 19 hours.
It has been nine days from the day of surgery, and most of the bruising has resolved, but the painful physical therapy has just begun. In two weeks, I hope to have some new small animal cases to cover.