Would you go back to doc who sent you away or look for a new one?

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Alcie
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Date Joined Oct 2009
Total Posts : 5029
   Posted 12/17/2010 9:22 AM (GMT -6)   
Here's the dilemma:
     I went to a shoulder doc (surgeon) for severe shoulder pain not controlled with tramadol or even Vicodin.  He had me lift my arms a few times, took some x-rays, said it wasn't arthritis, gave me a steroid shot in the big bursa.  The shot seemed effective for a couple of days, then nothing.  So when I came back he said it wasn't arthritis or bursitis or tendonitis so I should see a neurosurgeon or a rheumatologist because it was either in my neck or it was just the fibromyalgia.
 
     Then I went to my pain doc who had me lift my arms a few times, gave me 3 trigger point shots (boy did those hurt!) and sent me for an MRI.  The trigger point shots did help on the back side of my shoulder.  The MRI showed tendonopathy (doc called it tendonitis - just called, left message, no visit) and bursitis because there were signs on the tendons and fluid in one of the bursae.  He said I needed to go to a shoulder specialist.
 
I tried Mobic after I found out I had tendonitis and bursitis because they cause swelling.  That just upset my stomach.  So I took 3 Advil, which helped quite a bit!  I'd really like to get another shot, maybe in a different place, different bursa or in the tendon area.

So do I ask to be seen back at the shoulder surgeon? Or should I go find someone else, maybe the rheumatologist the shoulder doc said is not too far away but I have never seen???  I do trust that the shoulder doc is competent.  I think he just didn't spend enough time with me.  But maybe that's reason not to see him again. 

keep the faith
Regular Member


Date Joined Nov 2009
Total Posts : 91
   Posted 12/17/2010 10:09 AM (GMT -6)   
I had severe shoulder pain like that and my RA doctor sent me to physical therapy. It took about 6 weeks of weekly therapy and it is gone. It had gotten so that I could not even lift my arm over my head without even more pain.  Is that a possibility that you could try or are you in PT?
Good luck

JNO2
Regular Member


Date Joined Jun 2010
Total Posts : 62
   Posted 12/17/2010 11:42 AM (GMT -6)   
I had constant knee pain for over a year and went through all of the hoops before I saw a Ortho-Surgeon. (Bursitis, Tendonitis, Therapy, Cortisone, etc)
 The Surgeon looked at my MRI and said "I don't see anything surgical" and dismissed me. I decided I wanted a second opinion, and scheduled one. I knew I had severe chronic pain, and I was sick of being treated like I was imagining the pain.
 The second surgeon said the MRI didn't show much but he was willing to do exploratory (arthroscopic) surgery since I was in pain for so long. When I came out of surgery the surgeon showed me a bunch of pics he had taken of all of the arthritis and cartilage tears he had cleaned up. He told me since the cartilage was torn like "flaps" it did not show up on the MRI, but were quite evident when he went in.  I have an appt to consult on the other knee next week and I am sure they will find the same.
 
So from my experience I would definitely pursue your case further with another surgeon. If I had listened to the first surgeon I saw, (who by the way is mysteriously not there anymore??) I would still be in pain with no answers as to what was causing it. You really have to be your own advocate. Good Luck

Chartreux
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Date Joined Aug 2006
Total Posts : 9664
   Posted 12/17/2010 4:07 PM (GMT -6)   
I agree with the others, go and see a different shoulder doctor...MRI's don't always show everything...
good luck well wishes and keep us posted...
(((((((((((((((((((((((((((((((((((((((((Alcie))))))))))))))))))))))))))))))))))))))))))))))
healing hugz
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sjkly
Veteran Member


Date Joined Dec 2007
Total Posts : 2113
   Posted 12/17/2010 6:31 PM (GMT -6)   
My rhuemy wouldn't give me injections for tendonitis. She said I had a few choices, steroids-oral, physical therapy, or rest and see.

Alcie
Veteran Member


Date Joined Oct 2009
Total Posts : 5029
   Posted 12/17/2010 8:38 PM (GMT -6)   
Thanks for the advice/opinions.  I think I will pursue the new rheumy option.  The shoulder doc did give me an Rx for PT, but I can't go until everyone leaves after the holidays.  Does PT help with inflammation???  I'm afraid it will only make it worse. 
 
I don't tolerate oral steroids, there's no time to rest for a couple of weeks.  My house is Grand Central Station for holidays - 4 sons, 3 wives and 3 grandchildren.  I love seeing everyone but it takes a couple of weeks to recover afterward.  Rest?  Not an option right now.
 
That's why I was hoping for a shot.  I've had them for hip bursitis and they worked great.  But the shoulder doc did try one in a bursa and it didn't work.  I don't know enough physiology to know if it wasn't in the right place or if it just wouldn't work for shoulders.  The pain doc's trigger point injections did help, but only on the back side of the shoulder where he injected.
 
Back to the ice pack, tramadol and 3 Advil.  Not fun on cold winter nights!

White Beard
Forum Moderator


Date Joined Feb 2009
Total Posts : 3702
   Posted 12/18/2010 1:36 AM (GMT -6)   
Alcie
 
Was the MRI of just of your shoulder?  You said that your shoulder doctor said it might be your neck, did they check your neck, cervical spine for nerve impingement  that could also cause shoulder and arm pain? Or have they ruled that out? I ask this only because just because the pain is in your shoulder and or arm it doesn't mean that the cause is there, spinal nerve impingement is notorious for causing pain in the limbs away from where the actual damage is.  Anyway I was just curious if they had check that out. 
 
 You know I have problems with my right hip and I was sent to this one surgeon who told me there was absolutely nothing wrong with it, he even told me the MRI was normal and nothing showed up on it. (I guess he did not know I had already seen the Radiology report of the arthrogram and MRI of my hip).  Which said there was some major problems with it! Anyway I left his office knowing he was a quack!!  My pain doctor was amazed at his response, and he  ended up sending me to another surgeon, who agreed that there was a problem but he wants to wait before doing surgery. The thing I am trying to tell you, is if you had seen this one surgeon, I would go and see a different one and get a second opinion, and if need be maybe even a third oppinion!  I do hope you have a little bit of time that you can give your shoulder a rest!
I wish you all the best and hope that you have a very nice Christmas!
 
White Beard
Moderator Chronic Pain
After spending nearly 22 1/2 years in the USAF, I retired in Sept, 1991. I then went back to school and became a licensed RN in 1994, and I worked on Oncology and then a Med Surg Unit, I became disabled in late 1999 and was approved SSD in early 2002!-- DDD, With herniated Disk at T-12 and L4-5. C5-C6 ACDF in Sep 2009, C6-C7 ACDF in Mar 1985, Osteoarthritis, Ulcerative colitis, Chronic Pain, Fibromyalgia, Complex Sleep Apnea, and host of other things to spice up my life!(NOT!) Medications:Oxycontin, Percocet, Baclofen, Sulfasalazine, Metoprolol, Folic Acid, Supplemental O2 at 3lpm with VPAP Adapt SV I am White Beard with a White Beard!

Alcie
Veteran Member


Date Joined Oct 2009
Total Posts : 5029
   Posted 12/18/2010 6:38 AM (GMT -6)   
Excellent question, WB!
Yes, the latest MRI was shoulder only, but I'd had a previous one of neck which showed some facet arthritis, moderate foramenal narrowing. So there is possible nerve impingement.

I also previously had a full body scan after a syrinx was found on a thoracic MRI. Sryinx was determined to be nothing important, but shoulder tips showed up bright, as did other places where I have bone pain (slipping ribs). This would tend to go along with inflammation, tendonitis. Of course my whole spine looks like a big white curvy streak.

Since the shoulder MRI showed bursitis and tendinopathy, and since 3 Advil plus tramadol (which wasn't helping by itself) relieves the pain temporarily, I believe that the major problem is what the MRI showed. I'm probably overusing the shoulder. I drove the old Ford tractor (not a baby riding mower) mowing a couple of hours twice a week all summer, have to plow the snow, which also takes a couple of hours, and I've been cleaning and painting a bedroom after we had to replace walls from last winter's snow and ice damage. I can get a guy up the hill to do more of the plowing. He just doesn't do a good job - plows the snow in front of the tenants' garage doors.

I'm wondering if Phys Therapy is good or bad for bursitis and tendonitis??? If I'm already overusing wouldn't that make it worse?
Alcie
 
 

JNO2
Regular Member


Date Joined Jun 2010
Total Posts : 62
   Posted 12/18/2010 12:09 PM (GMT -6)   
I believe the philosophy is the therapy will loosen up the shoulder and help with strengthening, and range of motion, thus reducing pain. But my own experience tells me that if there is something wrong, then pushing it more will only cause more pain. (just my opinion)
I think therapy has it's place after surgery, or tramatic injury, but it seems like that is just one of the steps Dr's have to put you through before they will actually do something about your complaints. (could be an insurance thing too?) (again, just my opinion)
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