Saturday 4 May 2019

Adhesive Capsulitis a.k.a. Frozen Shoulder

If you have it, you'll know it. No...you'll REALLY know it.

It was one year ago, around March or April 2018, as I pulled my seat belt on, ready to take Tara to school. I picked up a book from the seat next to me, and put my arm back to gently toss it on the back seat next to Tara. As I brought my arm back, I felt a twinge on my left shoulder joint. I grimaced, but carried on. This went on for a few days. At that time I was also starting a Tai chi lesson, once a week. I remember thinking, that the gentle exercise will soothe my mind, make me breathe better and work out these annoying twinges and aches.

As days went by I noticed that my left shoulder felt tighter and seemed to catch during the Tai chi class. No grace and beauty would happen in my Tai chi lesson anytime soon. One evening I was playing on the bed with Tara. We rolled around laughing and giggling when suddenly I crumpled up with a huge gasp. That night I couldn't undo my bra, the left hand just wouldn't go up behind my back anymore. I noticed I had to ease my coat sleeve up my left arm  and wriggle about to get my right arm in. I couldn't raise my arm to thank motorists for giving way as I merged, and got honks and dirty glares as they revved past me. A friend taught me to flash lights as a thank you instead. After a while, the arm couldn't lift to open a cupboard door, to turn on the tap or reach for an object.

Within a few weeks the pain went from an annoying twinge to the most excruciating, debilitating and mind blowing kind of pain I have experienced. That pain was accompanied by an alarming reduction in arm movement. I've experienced many terrible pains, but this one ranked up there with the best of them. Everyday life became unbearable, school runs had to be done, gears, hand-brakes, steering wheel and all. I wasn't going to let the home front slip, so continued doing everything-cooking, laundry, cleaning and above all Tara's education and lessons, clubs etc.

Those that know me well, know that I don't cut myself any slack. I genuinely believe that I should be able to do everything I'm supposed to do. One evening I found myself most uncharacteristically sobbing aloud, tears streamed down from my face. I couldn't sleep. My left shoulder had to be raised on two pillows and if I were to turn to my right, I needed another pillow wedged under my arm to maintain a gap between the shoulder and my body. (Pillows and their positioning during a frozen shoulder could be a whole new topic). Tara was worried so called her father to check me out. I screamed at the lightest touch. There was nothing anyone could do. After everyone was asleep, I got out of bed and started researching what was happening to me.

It turned out to be something called Adhesive Capsulitis, commonly called Frozen Shoulder. Just my luck that at present, in the medical field :

There is no known cause

There is no known cure and

It may sort itself out in around three years, irrespective of whether you seek treatment or leave it alone. (Did they say 'may' sort itself out?)

I felt as if the rug had been pulled out from under my feet. This couldn't be happening. I researched further.

Women get it far more than men

It may run in families

The pain would subside after a year

The shoulder remains frozen in the second year

It starts de-frosting in year three.

I cried all night-partly because of the unbelievable pain, and partly because I couldn't get my head around being so unwell for at least three years. In a way, that night's crying was a good thing. I tend to move through the whole cycle of denial, anger, bargaining, depression and acceptance in a hurry - if there is action to be taken at the other end. Not doing anything is never an option for me, regardless of any expert anywhere in the world. I ended up doing a lot of research and reading. I put myself on the waiting list for physiotherapy knowing it will take a few months of waiting before I even saw someone.

Then something alarming started happening to my arm. It became emaciated. What on earth was happening? At the start of the year, I had the beginnings of "bingo wings" that used to annoy me, now one arm was rapidly turning into a twig. Fashion, or the cosmetic horror of my arm was furthest from my mind.  I remembered feeling the same way when I had Alopecia a few years ago and I had crumpled down, sobbing in the shower as bunches of hair just let go of my head leaving large, smooth bald patches. It isn't vanity, this unfamiliar cauldron on emotion is much bigger than that. It is a traumatic feeling that can be best understood when experienced.

Three or Four months had passed. I would like to mention at this point that The Husband offered virtually zero emotional or physical support during this time. A couple of nights when I was in a frenzy of pain, I did ask him to put some pain ointment in my arm, and he obliged. I hated myself for asking for physical help, when there was no voluntary, human support. So I stopped asking. The quality of the pain in the first stage of frozen shoulder is very strange. In addition to the overall pain, there were spontaneous patches of nerve shocks that pulsated - like searing painful shocks -non stop. These were interspersed with the kind of pain you get when a muscular injection goes wrong, only a hundred times worse. Non-stop. None of the usual pain killers made a dent, so I stopped taking them.

Then there was a new hygiene issue. I like to believe that I am fundamentally a clean person. No one told me that Frozen shoulder can make you smelly. That's right. Smelly. Due to the nature of the condition, the arm is almost always pressed against the body, and since the arm doesn't lift, the armpit is, shall we say-not aired enough. No matter how I scrubbed in the shower my armpit wasn't fresh and I felt smelly. That didn't help my mental state.

After a few months I started physiotherapy. At that point the young physio didn't declare my condition to be frozen shoulder. She chose instead to begin by strengthening my rotator cuff muscle, which had just stopped working. I did as she said. All of last year I worked though the pain, surprising even the physio who said that I was among the very few patients she had met who never complained about the pain no matter how much she poked, pulled or prodded. Occasionally tears ran down my face-a combination of the obvious pain and mostly the mental sadness, but I never let out as much as a whimper. I was on a mission. I had to defeat this thing-whatever it was.

I can honestly say that I was a lot more short tempered than usual. I wasn't patient when every week I begged Tara to sit still while I shampooed her hair in terrible pain, then untangled and brushed it for her every day before school and every night before bed, my arm a mangle of pain with every stroke. She didn't co-operate. I barely slept, so when Tara and The Husband didn't appear on the table at meal times I was snappy. Why was no one sitting down together address how they could help in the situation? Why were there no plans of action to adjust a little bit? I had set the routine, made planners for the new school, prepared study charts etc. yet Tara was not doing any of it till I raised my voice. At my lowest why was there so much of obscene taking for granted? Finally, when I swallowed what was left of my pride and asked The Husband to step in and back me up in correcting Tara, why did he step back?

The final straw was a combination of incessant acute pain, and a deep hurt at the lack of compassion or demonstration of any ongoing, proactive concern from the two people I most craved it from. Then, I broke, and the rest if history. November 2018 my estrangement with my Tara began along with gut wrenching crying every night. All that crying caused my sinuses to get inflamed, so I decided to stop crying every night.  It was hard as my sadness was like a bereavement. It was also my replacement of anger. So what does one do? January 2019 I resolved to use my grief and pain to defeat my arch enemy - rage and anger. As of today I can confirm that it's been four months and no visible flare of anger. The crying still happens, but not every night.

I completed one year of my frozen shoulder last month. I can now confirm that the excruciating pain has dissipated. The nerve twinges have disappeared. My arm is no longer a twig and looks like my old arm again. I am now officially in Stage two, so still have lack of movement but the pain is behind me. There are still dull aches and the odd soreness, but nothing unbearable. I have a new physio now, who is working on releasing the tightness and freezing. Apparently my brain needs to believe that my shoulder can move and function. This message has to be sent through my subconscious, and my shoulder has to "believe" it. I thought that Me, my brain and my shoulder were all the same person. Apparently not...what do ya know!

During my research and speaking to other people who've had Frozen Shoulder I think there is a case to be made for a Cortisone injection at the very start of this condition. While there is no conclusive study to back this up, Ive spoken to people who within one or two months of the condition setting in, got guided, precise cortisone injections in their shoulder cavity. Some of them recovered completely in six months. Others had no where the level of pain I experienced. Experts opine that those cases may not have been Frozen Shoulders to begin with. In hindsight, if I knew about the injection at the start, I would definitely have it.

If this is the year of the Freeze, I accept it. It's a vast improvement from the past year of Pain, in so many ways. Next year will be the year of Hope.

My final comment on the Frozen Shoulder condition is that it should be renamed. It is misleading to think that it involves only a freeze on movement. There is no indication in it's name, of the level of pain involved. So whoever does the naming, please make note. To those that will unfortunately get Frozen Shoulder, I send out a great big hug and a message of courage. This too shall pass.

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