Thawing The Shoulder

Having a frozen shoulder doesn't only hurt a ton, and isn't only HUGELY inconvenient, it SUCKS BIG TIME.

So, last week, I went into the hospital for a procedure they call 'capsular distention'. It's a fancy way of saying they fill your shoulder joint with lots and lots of fluid under pressure with very large needles while you writhe in absolute pain and continue trying to smile and not kick the doctor in the gonads (which, of course, means he was a he, and not a she, in which case the kick would probably result in contact with the lower vaginal area).

I had a frozen shoulder in my right shoulder over 4 years ago. They don't know why these shoulders 'freeze', but it happens with relative frequency, and apparently can be a real problem with diabetics. Of course, I'm not a diabetic.

Cortisone shots and physiotherapy helped with it that first time. Then, at the beginning of this year, I noticed similar pain in my left shoulder, but ignored it as I always do because there's too much to do and too little time. I ignored it until I started passing out from the pain whenever I would move my arm a little the wrong way (which was almost any way at all). I then thought it was time I get checked out. See here for more on my frozen shoulder http://marymoores.blogspot.com/2008_10_01_archive.html.

So, after a few months of physio and not a lot of progress, my doc suggested I go the next step, which is capsular distention. This is done in a hospital under local anaesthetic, and what they're basically doing is forcing the shoulder capsule open again very much against its will by filling it with lots of saline solution, cortisone, dye, and other goodies. Like I said, they do give you anaesthetic for the procedure, but man, it still really really hurts. And I mean a gut-wrenching hurt not unlike being punched really hard in the solar plexus.

I am the kind of weird person who likes to know EXACTLY what is going to happen and when, how it's going to feel, and what it will look like. I want all the details. I've even asked to stay awake during a surgical procedure because I wanted to experience it all. Yeah. I know. Weird. Anyway, so, always in tune with this all-knowing aspect of myself, before the procedure began, I asked the nurse if it would hurt. And she said it's "uncomfortable", which we all know is just another way to say it sucks big time and boy is she glad she's not me right now.

She told me they do give you anaesthetic, but that it often is still somewhat "uncomfortable". I asked for a definition of "uncomfortable" because, like I said, I need to know all. She winced visibly. Then, before she could answer, I continued, "Like, what I mean is, do people cry when this is done?" Mr. Handsome stood there, mouth open, not really believing what he was hearing escape his beautiful wife's gaping, drooling mouth.

So, then the nurse said, after swallowing hard and wiping her brow, "Well, yes. Sometimes people do cry. But not that often. We had one cry today already, so that should be it for today." And then she smiled.

I smiled back and said, "Does anyone do more than that? Like, pass out or something?" I asked this, more for the humorous aspect of it all, knowing full well that of course no one passes out from this procedure. It can't be that bad...

"Umm, well, yesss, we do have some people faint, but they're usually the men," the nurse said reassuringly.

I really thought she was joking, but she wasn't. And then I thought, this pain can't be worse than labour pain. And we women ALL know what that's like. Having some fluid infused into your shoulder joint WITH anaesthetic cannot be worse than labour without meds or an epidural.

Well, I'm here to tell you that it wasn't. It really really hurt. A lot. But it wasn't all that bad. I cried out, I kicked my legs a lot, I writhed on the surgical bed, I had sweat running down my brow, and my pits were damp, but I did not cry and I did not pass out, and I was able to get up off the table right afterward and MOVE MY ARM in a circle, which I have not been able to do for the past year! Hallelujah! The doctor, this cute little man who couldn't have weighed more than 98 lbs. wet, gently moved my arm around and around, watching my face intently for signs of impending death. They never came.

This procedure is relatively new here in Canada. It was only done in Australia for many years, and recently it was introduced to North America. Before that, they would put you under a general anaesthetic and manually (and violently, I might add) rip your shoulder joint apart, which apparently sometimes did the trick, but oftentimes really damaged the joint in the process. This capsular distention with fluid is much gentler, albeit very painful, and it still produces the same effect with a better rate of success. The fluid is under pressure, and when the doctor is injecting it into your shoulder joint, you can actually feel it expanding (that is, while you lie on the table and writhe in pain), not unlike an old balloon that has collapsed onto itself and is now being filled up and expanded with air or water. The fluid rips the adhesions apart that have occurred in the shoulder joint, which is why movement ceases in the first place. Thoughtfully, the doctor places a heavy sandbag on your hand so that you cannot move your arm while he injects it and causes extreme anguish, all the while saying, "You okay? You okay?"

I have noticed I have more mobility, for sure. Still painful, but I can now move. I start physio again this week with lovely Allen, and hopefully this will do the trick. If not, I'll have to have the distention done again. That's the bad news. The good news is, they haven't had anyone have to come in for a THIRD distention procedure yet!

Of course, there's always a first time...

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