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Rotator Cuff Injury
Part Two

by Gary F. Zeolla

  

This article is continued from Rotator Cuff Injury: Part One.

 

Finishing PT and Surgeon Appointment

 

      I had my eighth and final physical therapy (PT) session on Thursday afternoon, July 22, 2021. The next morning, I had an appointment with an orthopedic surgeon. Both the therapist and surgeon agreed that the eight weeks of PT had done little to improve the loss of range of motion (ROM) and pain caused by my rotator cuff tear. The cortisone injection and prescription anti inflammatory (Meloxicam) had not been effective either. As such, the surgeon said it was time to get an MRI done.

      I knew eight weeks ago that the PT would not be effective and that I would need an MRI. But I had to jump through all of these hoops (as the surgeon put it) in order for my insurance to pay for the MRI. Consequently, I suffered through those eight PT appointments, with my Multiple Chemical Sensitivity (MCS) reaction getting worse and worse with each appointment, and I wasted two months, all due to some stupid insurance rules.

      The secretary at surgeon’s office said it might take as long as two weeks for the MRI to be approved. But I got a call by the time I got home telling me it had been approved. I immediately called the MRI place to schedule an appointment. It is just a mile from my home, so it would have been very convenient. But the earliest they could schedule an appointment was August 9.

      But she then checked at my local hospital, a few miles away, and they could do it on August 2, so I took that appointment. I then called the surgeon’s office to make a follow-up appointment there, and the earliest I could get one there was August 9.

      What that means it, it will be another 2-1/2 weeks until I get the results of the MRI and consult with the surgeon. It won’t be until then that I will know how I will proceed. But the surgeon already said that it will come down to if I want to the surgery, followed by months of rehab, or to just live with it as it is.

      I have several questions for the surgeon before I make that decision. But he won’t be able to answer any of them until I get the MRI results. Consequently, I am in a holding pattern until August 9. I’ll just keep doing what I’ve been doing and see how I feel and what the MRI shows, then I’ll figure out how to proceed then.
7/23/21

 

Shingles Vaccine and Rotator Cuff Surgery

 

      After my surgeon appointment, I went to my local CVS to get the second dose of the shingles shot. I got my first does back on October 9, 2020, but I was not aware two doses were needed. CVS informed me by way of text a month ago, but this was my first chance to get it done.

      I got the shot about 11:00 am. When I got home, I realized I did not have my cell phone! I looked all through my car, couldn’t find it, so I drove back to CVS to see if it was there. It wasn’t, but then I checked again in my car, and apparently, it had fallen out of my front pants pocket and onto the floor in the back.

      In any case, after all of that, I went home and showered, as I always do due to my MCS, ate lunch, and rested a bit. Then I had stuff to do in the kitchen for a couple of hours, as I describe in my newly updated autobiography. Then I rested again for an hour.

      When I tried to get up, my legs were very stiff, and I had a hard time getting up and walking across the room to my PC, and then an even harder time walking up the stairs to eat dinner. This was a manifestation of my Stiff Person Syndrome, triggered by my MCS. I was also sore all over and feeling quite fatigued, a manifestation of my fibromyalgia. And I barely slept at all that night, as always happens when I am exposed to something I am sensitive to.

      I had a similar reaction to the cortisone shot I had gotten at the surgeon’s office two months before and to the second dose of the Pfizer Covid vaccine a month before that (see Why I Decided to Get Vaccinated), and even after my first shingles shot over nine months before.

      I mention all this here, as it is a one reason I am very leery about getting rotator cuff surgery. I would need to be put under, and I am fearful of what kind of reaction I could have to the anesthesia given this reaction to vaccines. I could very well wake up paralyzed and then not be able to sleep for some time afterwards.

      The stiffness from the each vaccine only lasted a few hours, and the sleeplessness only one night, so I doubt I would be paralyzed or unable to sleep for that long. But still, it is a fear. But, as the surgeon pointed out, it would be up to me if I could endure a short-term side effect, even if that severe, for a long-term possible benefit of the surgery.

      However, this is by no means my only concern about surgery. I will discuss the many others later, after I get the MRI and have the follow-up appointment with the surgeon and can have my many questions answered.
7/24/21

More on the Shingles Shot

 

      Otherwise on the side effects of the shingles shot, I got it in my right arm, and it was really hurting the next day, almost as much as my left. The pain was not just at the injection site but through the entire upper arm. Combined with not sleeping, I was quite miserable all day long. But that is why I planned on getting it on a Friday, with Saturday being my off day, so I could just rest all day, as discussed in my autobiography.

      Two days later, the arm pain had mostly cleared up, but there was still soreness at the injection site, making it hard to lay on that side. That soreness continued through the next day, meaning it lasted over 72 hours.

      This was probably the worst experience I have had with an injection. That was probably because it was the second shot. That has me really concerned if it turns out a third (booster) shot is required for the Pfizer Covid vaccine. I had enough problems with the second; a third could be quite difficult.

      Relating this all back to my rotator cuff issues, there will only be one surgery thus only one exposure to anesthesia. But afterwards, there would once again be weeks of going to PT. Again, it got increasingly difficult with each visit. Another round of visits could really adversely affect me, as I get more and more sensitive to the smells at the at the rehab center.
7/26/21

 

A Major Setback

 

      I had a major setback on my rotator cuff injury the morning of Monday, July 26, 2021. I had just put in a squat workout. I was very careful throughout the workout so as not to aggravate my injury. I had to wear an elbow sleeve pulled up to cover my upper arm to keep the pain down. But with doing that, I was able to put in a good workout. But I needed to pull the sleeve up and down between sets, as it is too tight to just leave in place.

      When I was done with my last set, I took the sleeve off and began to clean up. I am not exactly sure what happened, as I really was not paying attention. I’ve cleaned up from a squat workout in my home gym a thousand times before, so I was on automatic.

      But at some point, I mishandled a 45-pound plate, and pain flared up in my arm. I dropped the plate, it knocked over another 45 leaning against my power rack, knocking both down causing a loud crash, while I screamed in pain. It would have been quite a scene if I had been at a public gym.

      The pain is in a different place. Previously, it had either been on the front of the shoulder, the anterior deltoid, or in the triceps. But this pain is in the front of armpit. I’m not sure if I caused a new injury or worsened the previously one. But it hurts, it really hurts. And I could barely use my arm all that evening.

      I barley slept that night. The next day (Tuesday) was my wash day, and I had a very difficult time getting my laundry done, with still not being able to use my left arm. Then once again, I had a couple of hours of kitchen stuff to do in the afternoon, which again was very difficult to do with just one arm. And trying to type now is very difficult. And it is especially difficult using my left arm to work the mouse.

      I called both the MRI place and my doctor’s office Tuesday morning to see if I could move the appointments up, but I was not able to do so. That means, I will be suffering like this for at least the next two weeks. I don’t know if I will be able to get much of any work done, and I doubt I will be able to work out at all.

      That ends any thoughts of competing in another contest this year. In fact, I was already scheduled for a contest on November 6. It is already sold out, but there are people on a waiting list. I had been myself, but when a spot came up, they held it for me, giving me until the end of this month (July) to tell them if I would be able to compete or not. But I contacted them and canceled my position, so that the next person on the wait list could take my place.

      There are now other contests about that time, but I doubt seriously I will be entering any of them either, and possibly never again. With as bad as my arm now is, surgery seems an almost certainty.

      And here I am now, very early Wednesday morning (about 1am), and once again, I cannot sleep. No matter how I lay or position my arm, I just cannot get comfortable due to the arm pain. And frankly, I am pissed knowing I am going to have to put up with this for at least the next two weeks.

      Note also, today, Wednesday, July 28, 2021, marks 22 years since my bicycle accident. As mentioned in Part One, the messed up right shoulder from that accident is why I use my left hand to work the mouse and cannot sleep on my right side. But now, my left shoulder could end up even worse than my right. Very frustrating.
7/28/21

 

Surgery Scheduled

 

      I had my MRI as planned on August 2, 2021. It was very painful laying in the MRI machine for over half an hour, with my shoulder pressed against a plastic support to keep me from moving it. But I had the technician play KLOVE, so I tried to listen to that as best as I could, though it was hard to hear with the loud clicking and others sounds of the MRI.

      Of course, the technician could not tell me anything about what the MRI showed. I had to wait another week for that. I finally had the consultation with the orthopedic surgeon on August 9.

      He told me my shoulder was quite a mess. There are “significant” tears in two different rotator cuff tendons, the one at the top of the shoulder and the one in the front of the shoulder. In addition, the biceps muscle is in subluxation with one of the tendons. Basically, the biceps muscle somehow got twisted around with one of the torn tendons. That sounded worse than the tears themselves. It is also something that clearly could not be fixed by any method other than a surgeon physically going inside and untwisting it. The tears themselves also of course need fix.

      What this means is, all that I did over the past five our months was a complete waste of time. The anti-inflammatory medication, the cortisone shot, the physical therapy, all a complete was of time. Meanwhile, over the last five months, my arm has gotten worse and worse, more painful and less usable.

      It really gets me mad. When I went to the ER back on April 12, I knew what I needed was an MRI, not an X-ray. But the cute medical technician told me she could not order an MRI, only a surgeon could. Then the surgeon told me my insurance would not pay for an MRI without trying everything else first.

      It got me thinking, if I were a professional athlete, you know, one of those woke millionaire athletes who kneel for the national anthem, complaining about how terrible the USA is, I probably would have gotten the MRI way back in mid-March, right after I first felt pain in my arm and shoulder. If I had, I probably would have had done just what I did, gone through with the powerlifting contest at the end of March, with just cutting back a bit on Benches. But then, I would have had surgery right afterwards, in early April. In that case, I would already be over four months post-op and on my way to recovery. In addition, all of the pain, suffering, and sleepless nights I have experienced over the past months would have been avoided.

      To look at it another way, if I were rich, I could have just paid for the MRI myself back in March or April, without having to jump through a bunch of hoops and wait for insurance to approve it. Think about it. Do you really think if Jeff Bezos needed an MRI, he would wait months for it? Hardly.

      In any case, I scheduled the surgery for Friday, August 20, over five months after the initial injury back on March 14. I won’t know the exact time for the surgery until the hospital calls me the day before. But I was told I need to be there an hour before, the surgery will last about 1-1/2 hours, then at least an hour in recovery. Altogether, I will probably at the hospital about four hours.
8/13/21

        

Will I Ever Powerlift Again?

 

      After my setback back on July 26, I continued to do Squats and Deadlifts, but it got increasingly difficult, especially for the former. The next time I squatted, I could not lift a 45-pound plate high enough to put it on the power bar in the power rack. I tried and tried, but I just could not lift it up far enough. I almost gave up.

      But then I thought of a simple solution—move the bar down lower in my power rack. I did so, by three holes or six inches. I also put the boards I use for Deficit Deadlifts on the floor where I stand when doing so to raise me up a couple of inches. With that, I could get the 45s on the bar, but just barely.

      However, that meant I had to do a half-squat to get the bar out of and back into the rack. As a result, I had to drop my planned weight some for my top sets, with doing an extra rep on each set. Of course, that extra rep makes more of a difference as the reps get lower (e.g., an extra rep on a ten-rep set is 5% more effort. An extra rep on a single is 50% more effort).

      I also had to wear an elbow sleeve on my upper arm for both Squats and Deadlifts, but with doing so, both lifts continued to go very well.

      Meanwhile, I could not do anything in regard to upper body work. Previously, I could at least do Rows with full effort. But now, I could not even do them. And I could not do Benches at all. I literally cannot bench my fist! Seriously, I cannot lay down with arms extended and lower my arm down to chest level without great effort. I might be able to do so after several reps. But that is it. Using any kind of weight is out of the question. Overhead Presses are a bit better. I can use a few pounds, but that is it. The same goes for Curls of any sort. It got to the point that I just gave up trying to do any upper body work.

      But then my last of Squat and Deadlift workouts before the consultation with the surgeon went very well. It got me thinking I might want to try to enter a contest and do just Squats and Deadlifts before I got the surgery. But the only contest in August I could find was an RPS contest in Lancaster, PA on August 21. The entry deadline had passed, and the lifter limit had been met. But the online entry form was still available, so I contacted the meet director, and she said I could still enter it.

      I seriously thought about doing so. I could have entered the Squat Only and Deadlift Only divisions. But that would be two separate divisions, costing extra money. If I could just do a token Bench, I could have entered Full Power, and it would only be one division, and I would have gotten a total in as well. But again, I cannot bench my first let alone a 50-pound empty Bench bar.

      Also, Squats would have been difficult in that I would need to find someone to load the bar for me in the warmup room and to wrap my knees, if I wanted to use wraps. I had to stop using them weeks ago, as there is no way I can wrap with one hand, so I have only been using sleeves in training. I could use sleeves at a contest, but that would cost me 20-30 pounds on the Squat, making it less worthwhile.

      But most of all, it is a four-hour drive from the Pittsburgh area where I live to Lancaster. Plus, there would be all of the packing and unpacking and then wash to do afterwards. All of that would be just too much with my arm as bad as it now is. If it were not for the setback on July 26, maybe, but not now. And if there had a been a contest close enough that a hotel stay would not be required with in the next month, then again maybe. But sadly, none existed.

      But thinking I might give it a try, I initially scheduled the surgery for September 3, so that I could enter the Lancaster contest. But then, at this late of date, I could not find an inexpensive hotel with rooms still available close to the contest site. The cost of a more expensive hotel and the extra entry costs, and with only being able to do Squats and Deadlifts, led me to conclude it would not be worth it.

      Consequently, I rescheduled the surgery for August 20. The surgeon said I will be in a sling for about a month afterwards. Then it will be months of rehab. I hope I can do it mostly at home, but he said I will probably need to go to physical therapy at least some.

      But most of all, he said it would probably be about six months before I could even do Squats and Deadlifts again, longer for Benches. With being in my 60s, I am not sure if I would be able to make a third comeback after all of that. And if I do come back, I doubt seriously I could ever get my Squat and Deadlift back to where they are right now.

      I say that, as each time I have come back, in my early forties after not competing since college, then again in my mid-50s after stopping in my late-40s, I never got my lifts back up to where they were previously. I suspect it would be the same now. That is why I wanted to try to enter a contest before surgery, to get credit for all of the effort I put into still squatting and deadlifting over the past four months. But again, there were just too many obstacles.

      But as it is, six months will mean it will be well onto 2022 until I am able to lift again. After that long of a layoff, I am sure it will take at least a year to get my lifts back up to a respectable level. That means, it will be 2023 at the earliest before I would even think about competing again. That is, if I even bother to try to make a third comeback. I’m not sure at this point if it would be worth the effort or not.
8/13/21

 

Working and Other Post-Op Concerns

 

      My other main concern is not being able to type for at least the first month-post-op when my left arm is in a sling. I will need to go back to using my right hand for using the mouse, as discussed previously. In fact, I was having problems working the mouse with my left hand as I type this, so I switched to right-hand mousing . It feels very awkward after 22 years of using my left hand. Just moving the keyboard to the left to make room for the mouse on the right feels weird.

      I had a female friend tell me she managed to type one-handed rather well, once she got used to it after a similar procedure. But I don’t know if I will be able to master it or not. I really don’t remember what I did after my bicycle accident, if I did much one-handed typing or not. I just remember switching to my left hand for mousing.

      But I will try to get as much done as I can before the surgery that would require two hands, and I will try to leave things I can do one-handed more easily for after the surgery. But the surgery itself and feeling I am sure awful afterwards will detract significantly from work time, as has everything I have had to do so far due to this injury. It really has gotten me behind in projects I had hoped to have finished by now.

      And again, I am very concerned about what effect the surgery will have on my health. I will be receiving both a general and a local anesthesia. The general for the operation itself. The local to keep pain done for about 24 hours post-op. After that, there will probably be significant pain for at least a short while, though the surgeon wasn’t too forthcoming in terms of the length or severity of possible post-op pain.

      I am very concerned the two types of anesthesia could cause a significant allergenic reaction, leading to stiffness, pain, and fatigue, as I always experience when I am exposed to something I am sensitive to. Then I am concerned that all of those symptoms and others could worsen simply due to the inactivity post-op.

      I have trying to explain to people for years that one reason I am so intent on powerlifting is I truly believe my health in general will deteriorate rapidly without working out, and powerlifting gives me one more incentive to continue to do so. But with that incentive removed, it is going to be hard for me simply care about taking care of myself.

      Immediately post-op, the best I will be able to do is to go for walks. I haven’t done walking for exercise for many years, due to the risk of being exposed to something I am sensitive to while I am outside. The last time went for an exercise walk, I had four, yes, four constructions trucks pass me by. The diesel and tar smells left in a serious allergenic state that did not calm down for days. That is when I gave up going for walks. There is just too much of a risk of something passing by me that expels smells that could cause me problems. But I guess I will have no choice but to try now, if I want to do something.

      After that, I will be back in rehab, which again, caused me increasing problems each time I went. I am already struggling with all of the doctor visits I needed to do to prepare for this surgery. Along with getting the MRI and the consultation with the surgeon, I had to go get a blood test and EKG done at my local hospital and then see my PCP. My PCP’s office insisted the blood test and EKG be done first in time for them to have the results when I went there, rather than doing one then the other on the same day as I usually do for blood tests and doctor visits.

      Then I have already scheduled two follow-up visits with the surgeon, one a week post-op and the other a month after that. The rehab will probably start after that second visit. It really has been and will continue to be a struggle for someone who rarely left my home before all of this began to have to go out so often, all to places that cause me problems and none of which are in any sense “fun,” other than meeting several cute female medical personnel. Too bad I’m not good at spur of the moment flirting.

      In any case, all of these visits are already causing a setback in my health situation, with my sleeplessness, body soreness, stiffness, and fatigue worsening. It is all very frustrating and will only get worse before it can get better. May the LORD be with as I continue to struggle through this ordeal. Prayers are appreciated.
8/13/21

 

MRI Report

 

      Allegheny Health Network (AHN) is one of the two major health providers in southwest PA, where I live, and it is the provider my insurance is with. With AHN, I have access to MyChart, a record of all of my health provider activities. Included on MyChart is the actual MRI report. I have reproduced it below, as copied from MyChart. I don’t understand all of it, but what I do understand doesn’t sound good. My surgery is scheduled for Friday, August 8, 2021 at 8:30 am. Here’s praying the surgeon can fix this mess.

 

Study Result
IMPRESSION:
Complete supraspinatus tendon tear. There is also evidence of a complete subscapularis tendon tear with medial subluxation of the biceps tendon into the glenohumeral joint.

 

Narrative:
MRI SHOULDER LEFT WO CONTRAST August 02, 2021 6:46 PM

 

INDICATIONS:
RCT LEFT

COMPARISON:
None.

 

TECHNIQUE:
Sequences were employed to display the shoulder in the axial, sagittal, and coronal projections without the administration dye.

 

FINDINGS:
Evaluation of the supraspinatus muscle and tendon demonstrates a complete tear involving the distal supraspinatus tendon. There is a section of tendon which is retracted as well to the level of the apex of the humeral head. There is also evidence of a probable tear involving the attachment of the subscapularis tendon anteriorly. The long head of the biceps tendon has subluxed into the glenohumeral joint. Correlation with any anterior symptoms is recommended.

Evaluation of the cartilaginous and bony labrum demonstrates no acute tear.

Bone marrow sequences demonstrate advanced degenerative changes involving the acromioclavicular joint and glenohumeral joint.

 

Component Results:
There is no component information for this result.
8/19/21

 

Imaginary Contest 2

 

       I wasn’t able to squeeze in a powerlifting contest before my rotator cuff surgery. But I went ahead and ended my training plan as if I were entering a contest. That would then let me know what I would have attempted if I had entered a contest at this time. For details, see Imaginary Contest 2.
8/19/21

 

See Rotator Cuff Injury: Part Three for the continuation of this story.

 

Rotator Cuff Injury: Part Two. Copyright 2021 by Gary F. Zeolla.

The above page was first posted on this website July 24, 2021.
The individual updates were added as dated.

Dealing with Health Difficulties
Rotator Cuff Injury: Dealing with Health Difficulties

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