Physical Therapy Day 1

Yesterday morning I had my first physical therapy session. To start things off in the right direction, I bought my physio a pack of Double Stuffed Oreo cookies and said, "These are for you. You'll need them by the time you are done with me this morning". That seemed to be a good ice breaker. Fifteen minutes into my appointment I knew coming out here was already worth it. Twenty minutes into my appointment my right shoulder and neck were examined more than what any doctor in the past year has done (minus the doctor in Pennsylvania). I was taken very serious and really listened to. I was able to explain my viewpoint on what I think is going on and I finally felt like I was talking to a medical professional instead of a wall.

After recapping on everything that has occurred this past year I stood up to show my motion, and my "superhuman crazy trick" of flexing my neck way down towards the ground which drastically increases the motion in my right shoulder in every single direction. I think astonishment is a good word to describe the look on my physical therapist's face. It is pretty amazing how much I can move. It's irritating that many of the doctors I have seen this year seem to just write off the increase in motion with neck positioning and haven't really investigated why this phenomenon happens.

New discoveries were made too. After some manual testing/poking/prodding at my neck and shoulder my physical therapist noticed I had these bright red splotches appearing over the side of my neck, over the right side of my jaw, right side of my cheek, and on my chest. This is an autonomic response that the body does when nerves are very, very irritated. We left things alone to see if the splotches would fade away; they did but as soon as he started poking at me they came back. Pretty weird! We also learned I can strengthen my shoulder with light cords/bands and a 1 pound weight...don't be too jealous of my muscle strength :) There's a catch though...my neck better be flexed down towards the ground otherwise there is a ton of pain and I can't move. Towards the end of my appointment my physio wanted one of the physical therapy aid assistants to do a laser treatment. This was the first time I've ever had it done. It doesn't hurt when it's done but you are supposed to feel warmth like that you get from the sun. I felt nothing. In my afternoon appointment we realized I don't feel anything because I have diminished sensation over part of my shoulder, clavicle, and neck. Who'd a thought? You learn something new every day.

As far as the left scapula goes it is not in good shape. I am having a lot of trouble with my serratus anterior muscle which is in part due to damage to my long thoracic nerve and part of my serratus tendon was transferred to the bottom of my scapula to stabilize it. My upper trapezius muscle is hypertrophied which means it is bigger than it should be because it's taking over the job of my other scapular stabilizing muscles. There were a few exercises I tolerated relatively okay in therapy but once I got home the pain started to increase quite a bit and I am killing today. Short and simple basically nothing is functioning properly on that side at all. We are going to try a lot of muscle reactivating/training to do which is ridiculously hard. Mentally I get exactly what I'm supposed to do but I physically can't make it happen; when it does happen, a normal motion pattern feels so wrong! It's one of those things you completely take for granted unless you've injured yourself. You don't realize all the intricate things that each muscle is doing to allow you to move that body part. The swelling on the side of my rib cage is because my scapula is grating over my ribs which is causing inflammation in the soft tissue.

We tried taping my scapula. It seemed to help
during my exercises a little bit. It only stays on
during my appointment though because my body
reacts negatively when it's in a 'forced' position.
You can kind of see the swelling on my left side.

It's going to be a lot of hard work to retrain these muscles to work as one.

Posterior Shoulder Muscle Anatomy

Next plan of attack: there is absolutely no doubt that my inability to use my right shoulder is nerve related. There is so much tension on my nerves from all the scar tissue basically clamping it down. Flexing my neck increases my motion because it decreases the tension on my  nerves. Very, very light pressure causes symptoms up my neck, into face (my trigeminal nerve is getting compressed causing the facial symptoms). There is this crazy twitching/spasming that occurs over the front of my shoulder that I have zero control over. It's the weirdest thing when it happens. At the beginning of my appointment there was a subtle hint that I might have to go to Denver to meet with a doctor and by the end of the appointment I was told I have to go back to our condo and call Dr. A's office in Denver to schedule. It's kind of ironic that I am being sent to this doctor because I had an appointment set up in May 2014 but had to cancel to go see the doctor in Boston. Unfortunately, Dr. A is on vacation for 3 weeks and I can't get in until October 28th so I am on a cancellation list. We all are REALLY hoping I can get in sooner to be evaluated.

Today I am off from therapy. I've been alternating between ice and heat all day. I see a new pain management doctor this afternoon and hopefully he will have suggestions. My pain doctor in Illinois mentioned possibly doing injections to help make the pain more tolerable. We shall see what the doctor has to say. It's raining here in Colorado today so my mom has some chicken tortilla soup cooking in the crock-pot. Since it's pretty nasty out it's a good day to work on a puzzle and watch a movie. I did get to meet another person that found me through my blog though today. It's a good feeling to know that I've helped another person find a doctor that can help them. Tomorrow it's back to therapy and we shall see what the day brings.