Shoulder Doc Part 1

I finally had my long awaited appointment with the shoulder doc yesterday. You can imagine my anxiety as we drove to the clinic - my previous hospital experiences have not been great. You worry that the doctor wont take you seriously, or wont want to do anything, or will just put you on some massive waiting list.
My appointment was at the Melbourne Orthopaedic Group in Windsor, a suburb south of the Yarra River in Melbourne. Windsor is a very affluent suburb with great tree lined avenues, huge houses and unbelievably expensive delis. Melbourne Orthopaedic Group is one of the main and best regarded centers of Orthopaedics in Melbourne and was recommended by numerous people.

http://www.melbourneorthopaedics.com.au/index.html

We passed from the quiet, well kept garden and entrance into a heaving waiting room. My heart sank. You could hardly find a seat. The place was packed with the sick and injured. Half of the people were on crutches or in a wheel chair. Everyone was waiting apprehensively for their turn to see a doctor. I had flash backs to my time in ERI where the place was always so jam packed and crowded you waited ages to see your consultant and were then chucked out the surgery after 5 minutes.
For whatever reason Orthopaedic Clinics always seem to to be incredibly  busy. I can't complain of course as I am just another of the pilgrims desperate to find a cure.

After we had filled out the forms and found seats I calmed down a bit. The place was busy but the patients were getting seen very quickly. And looking round you could see faces tight with exactly the same anxiety as I felt. Everyone was in the same boat. Our future health and mobility were all on the line. There's even a bizarre sense of camaraderie; people were making jokes about the walking wounded and the place looking like the aftermath of a war zone.
They soon called my name and and it was my turn to be seen.

The appointment went very well I am glad to say. My consultant is called Ashley Carr. I think he's younger than I am but he really knows his stuff.

http://www.ashleycarr.com.au/

He took a full history of my shoulder problems, did a careful examination and then explained that the long head of my biceps tendon is buggered (not his exact choice of words). He said this is unfortunately a common complication of my previous operation - a SLAP repair. Basically, after my initial injury the tendon had torn loose and had to be reattached. However in an effort to get good healing the tendon may be then too tight. This explain my feelings of having a 'tight arm' for the last 18 months. The tightness leads to degeneration of the tendon - biceps tendonopathy. The tendon gets stuck in its sheath and much pain is the result.

The SLAP repair cannot be redone, but there is another procedure which can fix me: a biceps tenodesis, which involves cutting out completely the damaged tendon and reattaching the head of the biceps to the top of my humerus (upper arm) with a screw. It sounds drastic but apparently it has a great success rate for this situation and the French have been doing it for years (is this meant to make me feel better?)

http://www.shoulderdoc.co.uk/article.asp?article=724&section=559

I have an appointment next tuesday for an xray and MRI scan to confirm the diagnosis and then I will see Mr Carr the day after that to make a plan. If surgery is the only option it could happen as soon as mid december, and then I would have my arm in a sling (hilarious I know), and a few months of physio/rehabilitation before I could return to work and normal activities.

The doctor was also worried about my elbow. Because I've immobilised my arm for so long to control the shoulder pain, there is a danger my elbow could tighten up and become a whole new problem. He advised that I ditch the sling and see a physio to get my elbow moving, even if it meant some pain.

I was worried that I might be in extreme pain following the examination given that my shoulder has not responded well to previous attempts to get it moving, but so far so good. It was sore last night and I was on the ice and painkillers but it has eased off a bit today and so far is not as bad as I'd expected. I'm going to contact a physio today to see about the elbow thing.

I am very happy that things have taken a leap forward regarding my shoulder but am still concerned about this next operation, its success and effect on my work and hobbies. Also I may have the op just a few weeks before the baby is due so it looks increasingly likely that I'll have my arm in a sling during the labour and wont be much use for driving or cooking. I can always provide one handed massages.

And if things don't work out with this operation I can always have the giant robotic arm fitted that I've been dreaming about.