Saturday, January 5, 2013

Chip on my shoulder: no more!

The blistering pace I had set with consecutive daily posts as 2013 got underway has been temporarily abandoned, as I had a chip on my shoulder to deal with. Well, not exactly a chip, more like a bulge.

When I was in my 20's I was somewhat over-zealous when it came to physical activities, most of which involved mountain biking, rock climbing, tennis, and so forth. Oh, and practicing martial arts 3~4 times per week. in the winter I would snowboard and hit the gym. One time, while repping out deadlifting 315 lbs, I felt a weird thing happen to my right shoulder. It hasn't been the same since. Not bragging about the weight I was lifting, for there are far stronger people out there than me. More to the point was I just tended to overdo things. Over train, turn the volume to 11. I reflect back on that now and wish I had known a mentor of some sort at the time, who could have told me that my behavioral pattern was going to lead to some difficulties down the road. Would have have listened to such advice? Hah, perhaps not.

So, that right shoulder has been bugging me on and off for the past 20 years. It was a visit to the doctor, after a spell of work in California on the Ellison residence, to see about my shoulder that landed me the reception desk job which launched my furniture making career. My shoulder injury, the initial damage was to the supraspinitus, one of the three muscles making up the rotator cuff:





The injury never fully healed as it was to the tendon, more than the muscle, which was damaged. Eventually I found I couldn't hang from a bar, which ruled out the rock climbing, and I couldn't dead lift or do pull downs, so going to the gym eventually was curtailed as well. I've been able to work around the injury, though I have always had to be careful lifting heavy beams and the like.

2012 was a year with a lot of work on the slate, not much of which actually materialized. My shoulder was bugging me back in April after completing a prototype for one client, and I thought that the lack of shop work which ensued over much of the rest of the year would allow me to get a bunch of rest and the shoulder would have a good chance to heal up. Well, that didn't happen either! My shoulder just got gradually worse and worse. I could still pull a hand plane, but lifting things overhead, or lifting heavy things, were not on my top ten list, that's for sure. The pain was spreading, with my right bicep getting progressively weaker, and twinges started to take place down in my forearm as well. Not the direction I was looking to go.

Coming from Canada to the US to live permanently, I will allow that one of the biggest trepidations I had about the move concerned the health care system here. Canadians are indoctrinated to believe in the superiority of their health care system over that in the US - indeed, I think Canadians as a whole feel a certain degree of superiority, maybe even smugness in certain cases, about having a single payer universal health care system.  That's right, the dreaded socialized commie medical system many in the US are terrified of - a lot of Canadian's really like it. No one who needs health care is going to go bankrupt from receiving that care in Canada, and pharmaceuticals are a whole lot cheaper too.

The Canadian health care system is really there because of the push by one man. An idealist. A democrat. A socialist. A eugenicist. A former amateur boxer, and a journeyman Linotype operator. The premier of the Province of Saskatchewan from 1944-1961. He is revered - and reviled - in Canada in much the same way as FDR is in the US. His name was Tommy Douglas:


Hand up, how many of my American friends have heard of him? Well, to be honest, most younger Canadians probably don't know much about him either. Not to be mentioned in polite circles, that sort of thing (I'm kidding).

Douglas created the first program in Canada to offer free hospital care to all citizens. After his service to the people of Saskatchewan, Douglas entered federal politics. In 1966, the Liberal Party (despite the name, a right of center party) minority government of Lester B. Pearson created such a program, with the federal government paying 50% of the costs and the provinces the other half. So, the adoption of health care across Canada ended up being the work of three men with diverse political ideals - Tommy Douglas, John Diefenbaker and Lester B. Pearson. with all the blather about 'bipartisanship' one hears emanating out of politicians in Washington these days,  perhaps they should be considering 'tripartisanship', who knows? Oh yeah, I do know we're only allowed to have red and blue here, so what was I thinking? It did work that one time in Canada at least.

I do believe personally that health care is a basic human right, along with clean drinking water, safe schools and streets, etc., and it is not something that should not be doled out on the basis of who can pay and who cannot. How a society treats its weakest and most vulnerable members tells you a lot about its values. I see no reason why a society cannot be arranged to provide the benefit of health care for all of its members. 

While most Canadians are fairly happy with the socialized medical system, there are definitely powers at work who would very much like to see it dismantled and privatized, for the usual self-serving greedy reasons. Canada's Medicare is certainly not a perfect health care system by any stretch. For non-critical health problems, including slow moving cancers and the like, sometimes you must wait for months and months to see a specialist. And it is a very costly program to run. Factoring in a rapidly-aging population and vast swaths of baby-boomers hitting retirement and having increased need for medical care in general, the sustainability of the system remains a question mark to be sure.

Coming to the US, as I mentioned earlier, brought up a lot of fear for me that if my health went sideways, I could end up either receiving no care or going bankrupt. Stories about that sort of thing abound in the Canadian press, so I was well conditioned. I have long had a back up plan of flying back to Canada if I ever needed a significant amount of medical care.

Massachusetts, as those of you who paid attention to the US election process will apprehend, was an albatross of sorts for a certain Mitt Romney, as he was the 70th Governor of Massachusetts from 2003~2007, during which time the dreaded 'Romneycare' (The Massachusetts Health Reform Law) came into existence. This Law, which would probably strike many Canadians as a bit absurd, requires nearly all Massachusetts residents to buy health insurance coverage or face escalating tax penalties, including the loss of their personal income tax exemption. While it seems like little more than a transfer of money to Big Insurance, this is the system in place today, and it is the system in which I am paying into. Actually, my wife is paying into it as she has a job at a university and a plan through that. I am on her insurance as a dependent. This is very lucky for me, as otherwise, as a self-employed woodworker I would likely have to pay around $400~500 per month to have a no frills basic health care insurance, the kind one could go bankrupt on if a major hospital stay occurred. And since my profession is one in which slicing off fingers and having shards of wood shot into one's body is by no means a rare occurrence, I would have good cause to reassess whether woodworking might be the right career choice, just based on the health care roulette.

Fortunately I do not have to make that choice. My wife's plan allows me to visit the doctor, and each time I go I write a check for $25~35 in what is called a 'co-pay'. Obviously if I went to the doctor frequently this could get a bit expensive, however so far so good. It's reasonable.

Back to the shoulder of mine. With it getting worse despite abundance of rest I was enjoying, I decided to see the doctor. So, first there was the x-ray, which showed nothing abnormal. Then I went for half a dozen physiotherapy appointments, which made for no improvement whatsoever. I even tried a bit of chiropractic care for my shoulder, which temporarily helped with range of motion, but wasn't tending in the direction of improvement either. Then I went and had a MRI for the first time in my life. A loud and claustrophobia-inducing machine, within which one must keep perfectly still for 45 minutes. The MRI revealed no muscle tears, which was good news. Then I went and saw a surgeon, who looked over the MRI carefully and told me, in summary, that I was getting old and had developed bone spurs on the end of my clavicle which were impinging the rotator cuff muscles. I'm an old fart now I guess. That consultation was back in early December, and I made the decision to have a 45-minute arthroscopic surgical procedure where the bone spurs would be ground back. That operation took place yesterday, early in the morning. I only had to wait a month - in Canada, I imagine the wait would have been far longer.

I must say I was very impressed with the whole process at the hospital yesterday. It was a brand new building, completely dedicated to orthopedic surgery. I came in on time, and after filling out a bit of paperwork, I had barely time to sit down in the waiting are before my name was called. In Canadian hospital emergency rooms, I have waited hours in the past to be looked it. The nurse had me strip down and put on a gown and a funny-looking silver cap, took my temperature with a fancy instant digital thermometer, took my blood pressure and pulse using other fancy equipment, and carefully ran me through the upcoming process. Basically they would be tunneling into my shoulder in 4 spots, taking pictures and grinding bone, cleaning up the scene, etc. Life can be a real grind sometimes, you know? Everything about the facility and staff was so professional, sleek, serious, that I had none of those mental images such as come to mind in, say, a rural Thai hospital - and I've been in one before - where you wonder if the surgeon might use a rusty steak knife to cut you open....

Then two anesthesiologists came by to say 'hello' - they were also most pleasant and efficient - and they hooked me up to an intravenous drip and injected a chemical into my neck which completely numbed my right arm. I was put under general anesthetic and next thing I knew I was coming to with my arm in a sling, all done. The surgeon came back to see me and explained how things had gone -very well - and I am scheduled for a post-op visit in another week. The total cost of this is looking to be about $500. That's very reasonable, and again, I'm glad to have insurance. I have a positive impression of the health care system here now, and there was a time not so many years ago when I would have found it hard to imagine coming to that perspective.

Now I'm resting at home and popping opiates to control the pain. My arm's numbness took about 10 hours to fully subside. I wasn't able to sleep well last night but I should be more or less back to normal - as 'normal' as I get at least - in about a week. I can already operate the mouse on my computer, and that's how I can type this today. I'll be popping out a few more posts on the Japanese gate thread in the next day or so, and I'll have plenty of time to catch up on my reading. Currently I'm reading the 1922 non-fiction work Public Opinion by Walter Lippmann - highly recommended.  A foundation text for the public relations and propaganda industries, so most enlightening. Not enlightening in an inspiring or heart-warming way mind you, and just the sort of thing I like to read.

Thanks for coming by the Carpentry Way.

6 comments:

  1. I'm glad you are doing well and that you will (hopefully) be in better shape in the long run. I've had arthroscopic surgery done to both of my knees and had identical experiences to yours with each. Except I had large amounts of cartilage removed not any repairs, so my joints will get worse as I age. :-(

    Hopefully this will be a good start to a better year for you.

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  2. Adam,

    your kind words are appreciated, and sorry to hear about your knees. As the Mick Jagger sang, what a drag it is gettin' old...(and he's still ticking along!)

    ~Chris

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  3. You gotta love good surgery. I had a diskectomy, which gave me a whole new lease on life, and a repaired tendon on my right arm, which restored the leverage of my right hand. This was all the result of being a competitive tennis player, guitarist, woodworker, and tree farmer. Chronic over-use... if anybody had suggested I not do all those things or maybe do them less frequently or less intensely, would I have heeded the advice? My son's an athlete. It took him three trips to the hospital before he quit playing Rugby. Nothing I might say about "think long-term" had a chance of sinking in.
    Glad to hear about the success of your procedure. Here's to a productive new year.

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    Replies
    1. Tico,

      yeah, I also doubt I would have listened when I was young, except, perhaps, I would have taken in stuff from an acknowledged mentor, someone who really knew the sport or activity I was doing. Maybe I would have listened. I never crossed paths with people like that through when I was young.

      I think better still would have been to have learned good training habits at the outset in terms of how to train. Instead, I was pretty much unsupervised, and read fitness magazine and manuals. In high school, I was the entirety of the track and field team. The school provided me with a singlet and that was it- maybe I'd get a ride to the meet if I was lucky

      Anyway, I'm feeling significantly better today, physically and psychologically. I discovered that morphine doesn't work so well for me - it gave me insomnia, so I have stopped taking it. I'll be taking the shoulder bandage off later today, and am interested to see how things look. So far, I'm feeling very positive about the outcome and my range of motion already seems quite a bit better.

      Tico, I also wish you all the best this year - take care of yourself, and keep the shavings flying!

      ~C

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  4. Chris,
    Glad you're recovering well.
    But, don't overdo it.
    Take it easy.
    May you get even older.

    Charlie Simonds

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    Replies
    1. Charlie,

      thanks! You're right - I need to be careful not to overdo things in recovery.

      You might want to check out the forum - I just added a buy/sell/trade section, as you requested.

      ~C

      Delete

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