The diagnosis from the doctor is that I have a sprain, not a separation. I guess technically that’s a Type 1 separation (nondisplaced sprain of the AC ligament). This is good news, because it means that ordinary activity, while painful, is not going to tear anything loose.

Probably.

This is where I get angry.

It’s PROBABLY a sprain, not a separation. How does the doctor tell the difference? There are two methods:
1) speed of recovery
2) MRI

If I had this to do over, I would have demanded an MRI. This is my livelihood we’re talking about. Had I been a Major League Baseball player, the initial exam would have included X-rays and an MRI. I just got X-rays. Apparently my doctor doesn’t believe me when I tell him that my right arm feeds my family.

So yeah, I’m a little upset right now. I agree, it’s probably just a sprain, and I’m going to act that way. But the four days I spent convalescing so that the initial diagnosis could be refined could have been much, MUCH more productive (better convalescence, more peace of mind) if I’d had more information up front. The next time (knock on wood) something happens to my right arm, the doctor is going to get a left-handed death-grip on his short and curlies, to be released only when I’ve had every test he can imagine necessary for full diagnosis.

Anyway, here’s the deal: I start physical therapy on Friday, and I start drawing again as soon as I’m done writing this. I’ll have to back off on the Lortab and the Soma anytime I plan to draw, and I’m not good to drive stick for a few days. I have a prescription for 800mg dosages of ibuprofen and for 50mg of something called Ultram, of which the doctor gave me a glowing recommendation, but was unable to supply sufficient detail. I’ll go get a second opinion from Doctor Google before I eat any of that crap.

I appreciate all of your “you’ll be fine, take it easy, don’t try to draw” votes. I’m exercising the executive veto here. I hope you don’t take it personally.

–Howard

I’ve taken no painkillers this morning. No Lortab, no Soma, no caffeine, no Ibuprofen — nothing, not since I popped my last Lortab around midnight.

It hurts a lot.

“It” in this case is more of a hive-minded “them” — my shoulder, my neck, my head, my arm, and my back. It hurt enough that I got drowsy and went back to sleep, where I remained for almost two hours. Now that I’m awake, I can feel “tracks” radiating out from the tip of my shoulder, indicating exactly where the injury originated, and where the outward rippling displaced, tweaked, sprained, strained, jarred, bruised, and/or otherwise “adjusted” the state of nearby bits.

I know this is largely illusion. There are no tracks. This is not the thumbprint of a giant, and the CSI team is not going to be able to use this information to reconstruct the grille of the truck that hit me. This is just pain receptors announcing that signals are coming in five by five.

The doctor is going to get an accurate answer to the “how do you feel?” question, which is what I want to provide, and that’s why I’ve been off meds for almost 12 hours now.

The instructions he provides following diagnosis will almost certainly include “start taking your painkillers again, you idiot,” and I will enthusiastically comply.

–Howard

For some reason the “create a poll” interface keeps disappearing on me. It’s in the little grey box of links I get when I update my journal from the Livejournal website, but that grey box vanishes as the page loads.

The poll was going to be “what will the doctor say today?”

This article has some useful information about separated shoulders, and made for good reading just before I went to bed last night. It seems there are six types of separated shoulders, numbered 1 through 6, and that numbers 4 through 6 almost always require surgery. Type 3 used to get operated on, but is now treated more conservatively. Type 1 and type 2 are treated with a sling, painkillers, and lots of rest.

I suspect I’ll be found possessed of a Type 1 Separation. The X-ray indicated separation, but the tenderness in my shoulder seemed to be in the wrong place for that (on the back instead of the front), which would be consistent with Type 1 if the doctor I saw doesn’t consider Type 1 a separation at all, but a sprain (and that’s kind of supported by the wording on the page I linked). Type 1 means that I’ll be healing up quickly, and with that particular verdict I’ll almost certainly begin drawing again today.

Type 2 means I’ll start drawing again today, but I’ll feel guilty about it.

–Howard

In my experience, doctors never prescribe anything to stimulate or accelerate actual healing. They only prescribe stuff for pain, and to kill the boojums that cause it, but all they’re really doing is removing the obstacles that stand between your natural healing mechanisms and your injury.

Is that accurate? Are there exceptions? Help me out here…

Here’s the experience I would have LIKED to have with the doctor:

“Well, Howard, it looks like you’ve separated your shoulder. I’m going to give you enough painkillers that you’ll sit down and do nothing for four days, but you HAVE TO TAKE THEM. That will prevent you from injuring yourself further, and you’ll be too stoned to be bored. I’m also going to give you a nutritional supplement that will ensure that your body has the necessary materials to quickly rebuild that shoulder of yours.”

Then the doctor would hand me some pieces of paper, I’d go to the pharmacy, and I’d come away with a rejuvenative, regenerative cocktail, and I’d understand why I needed each of the pieces.

I know, I know, there are lots of supplements out there. Off the shelf I could probably acquire steroids, ligament strengtheners, and protein isolates which would dramatically accelerate the process by which my useless shoulder is made useful. I’m also very nearly smart enough to figure out what to buy without the help of a doctor. Sure, some of it is snake-oil, and even the stuff that appears to work for everybody has very limited “scientific” support in the form of clinical trials, but hey… I could figure out what’s what on my own.

My question is why won’t doctors do that for me? Isn’t there money to be made there? Wouldn’t it make sense for an association of (for instance) doctors who specialize in physical therapy to get together with (for instance) a company that makes protein powders, and underwrite a formal study on using supplements to treat (for instance) separated shoulders?

No, the pharmaceutical companies don’t stand to make quetzlcoatillions of dollars selling non-patentable protein powders, but certainly your local pharmacy could make a buck or two. SOMEBODY out there (besides us miserable convalescents) stands to benefit from the formalization of prescription-strength “healing aids.”

I’m sure some of you will tell us how the modern medical establishment is little more than a conspiracy to keep natural healers on the lunatic fringe and make the megapharms and their stockholders fithily richer. I want answers that are a little more firmly grounded.

–Howard
ps: I mixed up some glutamine and creatine this evening, and my shoulder started to burn about an hour later. It felt like the burn I get after a workout, not like an injury. It was “new” pain, and it fascinates me. And this evidence of the existence of a niche for prescribed supplements is not especially firmly grounded.